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HomeMy WebLinkAboutPeterson Contractors, Inc.E�ERSOH 'a011RWIX0W3 UK- BOX A REINBECK, IOWA 50669-0155 -7[45 Lill 54:71Nen1 CoivtA975— Iy° VISA la:an -A\RS PAK- BOX A REINBECK, IOWA 50669-0155 7 (106 Lf{ 5777(1 i* 497C- ore a SRF Required Front -End Specifications Attachment 1: Certification of Non -Segregated Facilities Form (to be completed and signed by Prime Contractor and submitted with the bid) Attachment 2: Statement in Advertisement for Bids on Debarment and Suspension/Certification Regarding Debarment and Suspension Form (to be completed and signed by Prime Contractor and submitted with the bid) SRF STATE Attachment 3: Disadvantaged Business Enterprise Certification Form (to be completed and signed by REVOLVING FUND Prime Contractor and submitted with the bid) Attachment 4: DBE Program Subcontractor Performance Form (to be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid) *If no DBE was chosen by the Prime Contractor to be utilized for this project, then this form is not required to be submitted. Attachment 5: DBE Program Subcontractor Utilization Form (to be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid) * If no DBE was chosen by the Prime Contractor to be utilized for this project, then this form is not required to be submitted. Attachment 6: DBE Program Subcontractor Participation Form (for voluntary use of DBEs) Attachment 7: Other Federal Requirements Language A. Standard Equal Employment Opportunity Specifications B. Federal Labor Standards Provisions (including Davis -Bacon prevailing wage rates**) C. Preservation of Open Competition and Government Neutrality D. Historical and Archeological Finds E. Prohibitions on Procurement from Violating Facilities Attachment 8: Right of Entry and Records Retention Attachment 9: American Iron and Steel Requirements Attachment 10: Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment (to be completed and signed by Prime Contractor and submitted with the bid) January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 1 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid.) U.S. Environmental Protection Agency Certification of Non -Segregated Facilities (Applicable to contracts, subcontracts, and agreements with applicants who are themselves performing federally assisted construction contracts, exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause.) By the submission of this bid, the bidder, offeror, applicant, or subcontractor certifies that he does not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. He certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The bidder, offeror, applicant, or subcontractor agrees that a breach of this certification is a violation of the Equal Opportunity clause in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national original, because of habit, local custom, or otherwise. He further agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause; that he will retain such certifications in his files; and that he will forward the following notice to such proposed subcontractors (except where the proposed subcontractors have submitted identical certifications for specific time periods): NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF NON -SEGREGATED FACILITIES A Certification of Non -segregated Facilities, as required by the May 9, 1967, order (33 F.R. 7808, May 28, 1968) on Elimination of Segregated Facilities, by the Secretary of Labor, must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Opportunity clause. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e., quarterly, semiannually, or annually). 12-14-23 Signature Date Chris D. Fleshner Project Estimator / Manager Printed Name Title NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. EPA-7 5720-4.2 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 2 SRF Required Front -End Specifications (This form must be completed and signed by the Prime Contractor and submitted with the bid.) Debarments and Suspensions Any bidder or equipment supplier whose firm or affiliate is listed in on the U.S. General Services Administration Excluded Parties List will be prohibited from the bidding process. The excluded parties records search engine is located at the System for Award Management (SAM) website https://sam.gov. Pursuant to 2 CFR Part 180, as supplemented by 2 CFR 1532, any entity submitting a bid while the SAM website lists that entity as having an active exclusion will be determined by the DNR to be a non -responsive bidder and will not be able to receive SRF funding. United States Environmental Protection Agency Washington, DC 20460 Certification Regarding Debarment, Suspension, and Other Responsibility Matters The prospective participant certifies to the best of its knowledge and belief that it and the principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. In addition, under 18 U SC Sec. 10 01, a false statement may result in a fine of up to $10,000 or imprisonment for up to 5 years, or both. 12-14-23 Signature of Authorized Representative Date Chris D. Fleshner Project Estimator / Manager Printed Name Title I am unable to certify to the above statements. My explanation is attached. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 3 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid.) Disadvantaged Business Enterprise (DBE) Solicitation It is EPA's policy that recipients of EPA financial assistance through the State Revolving Fund programs award a "fair share" of subagreements to small, minority and women -owned businesses, collectively known as Disadvantaged Business Enterprises (DBEs). Iowa's Fair Share goals are: Minority -Owned Enterprise (MBE) Business Goal Women -Owned Enterprise (WBE) Business Goal Construction 1.7% 2.2% Supplies 0.6% 5.6% Services 2.5% 11.3% Goods/Equipment 2.5% 10.4% Average 1.8% 7.4% Only work performed by certified DBEs can be counted toward the goals. In Iowa, DBEs must be certified through the Iowa Department of Transportation (IDOT) Information on certification requirements and a list of certified DBEs is on the IDOT website at https://secure.iowadot.gov/DBE/Home/Index/. Prime contractors' DBE requirements for SRF projects include: • Taking affirmative steps for DBE participation • Documenting the efforts and the proposed utilization of certified DBEs SRF Applicant: Address: City: PROJECT INFORMATION Bidder: Contact Person: Phone Number: State: Zip: Email: Check if Prime Contractor is: Minority -Owned Women -Owned After the Good Faith Efforts Checklist was completed, was a DBE chosen by the primary contractor to be utilized for this Project? Signature: Yes No GOOD FAITH EFFORTS CHECKLIST Please complete the checklist to determine if you have complied with the requirement to make good faith efforts to ensure that certified DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds. Bidders/offerers must make good faith efforts prior to submission of bids/proposals. 1. Did you ensure that DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities? x Yes No January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 2. Did you make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process? This includes, whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date. x Yes No 3. Did you consider in the contracting process whether firms competing for large contracts could subcontract with DBEs? This will include dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by DBEs in the competitive process. n Yes No 4. Did you encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually? Yes x No 5. Did you use the services of the Small Business Administration and the Minority Business Development Agency of the Department of Commerce to identify potential subcontractors? Yes n No List the potential DBE subcontractors that were contacted. Only list those that are certified through the Iowa Department of Transportation. Name How phone Contacted call, fax, (e.g. e-mail) letter, Response interested, (e.g. did not not competitive) respond, not DC Corporation Phone 6" PCC Paving Tiedt Nursery email Erosion Control & Seeding PROPOSED UTILIZATION OF DBE SUBCONTRACTORS Please include Attachments 4 and 5 to document the proposed utilization of certified DBE subcontractors. CONTRACT ADMINISTRATION PROVISIONS Several contract provisions are required to prevent unfair practices that adversely affect DBEs. These include: 1. Prime Contractor must pay its Subcontractor for satisfactory performance no more than 30 days from the Prime Contractor's receipt of payment from the SRF loan recipient. 2. Prime Contractor must notify the SRF loan recipient in writing prior to termination of a DBE subcontractor for convenience. 3. Prime Contractor must employ the six Good Faith Efforts to solicit a replacement subcontractor if a DBE subcontractor fails to complete work under a subcontract for any reason. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 4 SRF Required Front -End Specifications (This form must be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid.) * If no DBE was chosen by the Prime Contractor to be utilized for this project, then this form is not required to be submitted. Disadvantaged Business Enterprise Program DBE Subcontractor Performance Form This form is intended to capture the DBE1 subcontractor's' description of work to be performed and the price of the work submitted to the prime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to have its DBE subcontractors complete this form and include all completed forms in the prime contractor's bid or proposal package. Subcontractor Name: DC Corporation Project Name: Titus Lift Station and Force Main Bid/Proposal No.: 975 Assistance Agreement ID No. (if known): Point of Contact: Terry Phillips Address: Telephone No.: (319) 493-2542 Email: N/A Prime Contractor Name: Peterson Contractors, Inc. Issuing/Funding Entity: City of waterloo, IA Contract Number Item Description of Work Construction, Submitted Services, to the Equipment Prime Contractor or Supplies Involving Price to the of Work Prime Submitted Contractor 975 6" PCC Paving $50,449.80 DBE Certified by DOT SBA x Other: City of Waterloo, IA Meets/exceeds EPA certification standards? Yes No x Unknown 'A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 'Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. IA SRF6100-3 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). Chris D. Fleshner Prime Contractor Signature Print Name Project Estimator / Manager 12-14-23 Title Date Terry Phillips Subcontractor Signature Print Name Owner / Operator Title Date IA SRF6100-3 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 4 SRF Required Front -End Specifications (This form must be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid.) * If no DBE was chosen by the Prime Contractor to be utilized for this project, then this form is not required to be submitted. Disadvantaged Business Enterprise Program DBE Subcontractor Performance Form This form is intended to capture the DBE' subcontractor's' description of work to be performed and the price of the work submitted to the prime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to have its DBE subcontractors complete this form and include all completed forms in the prime contractor's bid or proposal package. Subcontractor Name: Tiedt Nursery Project Name: Titus Lift Station and Force Main Bid/Proposal No.: 975 Assistance Agreement ID No. (if known): Point of Contact: Scott Tiedt Address: 2419 E. Bremer Ave. Telephone No.: (319) 352-0418 Email: Scott.Tiedt@gmail.com Prime Contractor Name: Peterson Contractors, Inc. Issuing/Funding Entity: City of Waterloo, IA Contract Number Item Description of Work Construction, Submitted Services, to the Equipment Prime Contractor or Supplies Involving Price to the of Work Prime Submitted Contractor 975 Erosion Control and Seeding $28,340.00 DBE Certified by x DOT SBA Meets/exceeds EPA certification standards? Other: Yes No x Unknown 'A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 'Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. IA SRF6100-3 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). 111 Chris D. Fleshner Prime Contractor Signature Print Name Project Estimator / Mananger 12-14-23 Title Date Scott Tiedt Subcontractor Signature Print Name Estimator Title Date IA SRF6100-3 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 5 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid if utilizing DBE subcontractors.) * If no DBE was chosen by the Prime Contractor to be utilized for this project, then this form is not required to be submitted. Disadvantaged Business Enterprise Program DBE Subcontractor Utilization Form This form is intended to capture the prime contractor's actual and/or intended use of identified certified DBE' subcontractors' and the estimated dollar amount of each subcontract. An EPA Financial Assistance Agreement Recipient must require its prime contractors to complete this form and include it in the bid or proposal package. Prime contractors should also maintain a copy of this form on file. Prime Contractor Name: Peterson Contractors, Inc. Project Name: Titus Lift Station and Force Main Bid/Proposal No.: 975 Assistance Agreement ID No. (if known): Point of Contact: Chris D. Fleshner Address: 104 Black Hawk St., P.O. Box A Reinbeck, IA 50669 Telephone No.: (319) 415-5212 Email: Issuing/Funding Entity: City of Waterloo, IA cfleshner@pcius.com I have identified potential DBE certified subcontractors If yes, complete the table below. If no, explain: x Yes No Subcontractor Company Name Name/ Company Address/Phone/Email Dollar Estimated Amount Currently Certified? DBE DC Corporation (319) 493-2542 $50,449.80 x Yes No Tiedt Nursery (319) 352-0418 $28, 340.00 x Yes No Yes No Yes No Yes No 1A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 'Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. IA SRF6100-4 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). Chris D. Fleshner Prime Contractor Signature Print Name Project Estimator / Manager 12-14-23 Title Date IA SRF6100-4 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 6 SRF Required Front -End Specifications (This form is for the voluntary use of DBE Subcontractors.) Disadvantaged Business Enterprise Program DBE Subcontractor Participation Form An EPA Financial Assistance Agreement Recipient must require its prime contractors to provide this form to its DBE subcontractors. The use of this form by DBE subcontractors is voluntary and is not required for bidding This form gives a DBE' subcontractor' the opportunity to describe work received and/or report any concerns regarding the EPA -funded project (e.g. in areas such as termination by prime contractor, late payments, etc.). The DBE subcontractor can, as an option, complete and submit this form to the EPA DBE Coordinator at any time during the project period of performance. Subcontractor Name: Project Name: Bid/Proposal No.: Point of Contact: Address: Telephone No.: Prime Contractor Name: Issuing/Funding Entity: Assistance Agreement ID No. (if known): Email: Contract Number Item Description of Work Construction, Submitted Services, to the Equipment Prime Contractor or Supplies Involving Price to the of Work Prime Submitted Contractor lA DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 'Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. IA SRF6100-2 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Please use the space below to report any concerns regarding the above EPA -funded project: Subcontractor Signature Print Name Title Date Return to: Regional Coordinator, Small Business Utilization, U.S. Environmental Protection Agency, Region 7, 11201 Renner Blvd, Lenexa KS 66219 IA SRF6100-2 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 7 SRF Required Front -End Specifications Other Federal Requirements Language A. Standard Federal Equal Employment Opportunity Construction Contract Specifications (Executive Order 11246) 1. As used in these specifications: a. "Covered area" means the geographical area described in the solicitation from which this contract resulted; b. "Director" means Director, Office of Federal Contract Compliance Programs, United States Department of Labor, or any person to whom the Director delegates authority; c. "Employer identification number" means the Federal Social Security number used on the Employer's Quarterly Federal Tax Return, U.S. Treasury Department Form 941. d. "Minority" includes: i. Black (all persons having origin in any of the Black African racial groups not of Hispanic origin); ii. Hispanic (all persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish Culture or origin, regardless of race); iii. Asian and Pacific Islander (all persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Sub -continent, or the Pacific Islands); and iv. American Indian or Alaskan Native (all persons having origins in any of the original peoples of North America and maintaining identifiable tribal affiliations through membership and participation or community identification). Whenever the Contractor, or any Subcontractor at any tier subcontracts a portion of the work involving any construction trade, it shall physically include in each subcontract in excess of $10,000 the provisions of these specifications and the Notice which contains the applicable goals for minority and female participation and which is set forth in the solicitations from which this contract resulted. 3. If the Contractor is participating (pursuant to 41 CFR 6-4.5) in a Hometown Plan approved by the U.S. Department of Labor in the covered area either individually or through an association, its affirmative action obligations on all work in the Plan area (including goals and timetables) shall be in accordance with that Plan for those trades which have unions participating in the Plan. Contractors must be able to demonstrate their participation in and compliance with the provisions of any such Hometown Plan. Each Contractor or Subcontractor participating in an approved Plan is individually required to comply with its obligations under the EEO clause, and to make a good faith effort to achieve each goal under the Plan in each trade in which it has employees. The overall good faith performance by other Contractors or Subcontractors toward a goal in an approved Plan does not excuse any covered Contractor's or Subcontractor's failure to take good faith efforts to achieve the Plan goals and timetables. 4. The Contractor shall implement the specific affirmative action standards provided in paragraphs 7a through p of these specifications. The goals set forth in the solicitation from which this contract resulted are expressed as percentages of the total hours of employment and training of minority and female utilization the Contractor should reasonably be able to achieve in each construction trade in which it has employee in the covered area. Covered construction contractors performing construction work in geographical areas where they do not have a Federal or federally assisted construction contract shall apply the minority and female goals established for the geographical area where the work in being performed. Goals are published periodically in the Federal Register in notice form, and such notices may be obtained from any Office of Federal Contract Compliance Programs office or from Federal procurement contracting officers. The Contractor is expected to make substantially uniform progress in meeting its goals in each craft during the period specified. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 S. Neither the provisions of any collective bargaining agreement, nor the failure by a union with whom the Contractor has a collective bargaining agreement, to refer either minorities or women shall excuse the Contractor's obligations under these specifications, Executive Order 11246, or the regulations promulgated pursuant thereto. 6. In order for the nonworking training hours of apprentices and trainees to be counted in meeting the goals, such apprentices and trainees must be employed by the Contractor during the training period, and the Contractor must have made a commitment to employ the apprentices and trainees at the completion of their training, subject to the availability of employment opportunities. Trainees must be trained pursuant to training programs approved by the U.S. Department of Labor. The Contractor shall take specific affirmative actions to ensure equal employment opportunity. The evaluation of the Contractor's compliance with these specifications shall be based upon its effort to achieve maximum results from its actions. The Contractor shall document these efforts fully, and shall implement affirmative action steps at least as extensive as the following: a. Ensure and maintain a working environment free of harassment, intimidation, and coercion at all sites, and in all facilities at which the Contractor employees are assigned to work The Contractor, where possible will assign two or more women to each construction project. The Contractor shall specifically ensure that all foremen, superintendents, and other on -site supervisory personnel are aware of and carry out the Contractor's obligation to maintain such a working environment, with specific attention to minority or female individuals working at such sites or in such facilities. b. Establish and maintain a current list of minority and female recruitment sources, provide written notification to minority and female recruitment sources and to community organizations when the Contractor or its unions have employment opportunities available and maintain a record of the organizations' responses. c. Maintain a current file of the names, addresses and telephone numbers of each minority and female off -the - street applicant and minority or female referral from a union, a recruitment source or community organization and of what action was taken with respect to each such individual. If such individual was sent to the union hiring hall for referral and was not referred back to the Contractor by the union or, if referred, not employed by the Contractor, this shall be documented in the file with the reason therefore, along with whatever additional actions the Contractor may have taken. d. Provide immediate written notification to the Director when the union or unions with which the Contractor has a collective bargaining agreement has not referred to the Contractor a minority person or woman sent by the Contractor, or when the Contractor has other information that the union referral process has impeded the Contractor's effort, to meet its obligations. e. Develop on-the-job training opportunities and/or participate in training programs for the area which expressly include minorities and women, including upgrading programs and apprenticeship and trainee programs relevant to the Contractor's employment needs, especially those programs funded or approved by the Department of Labor. The Contractor shall provide notice of these programs to the source complied under 7b above. f. Disseminate the Contractor's EEO policy by providing notice of the policy to unions and training programs and requesting their cooperation in assisting the Contractor in meeting its EEO obligations; by including it in any policy manual and collective bargaining agreement; by publicizing it in the company newspaper, annual report, etc.; by specific review of the policy with all management personnel and with all minority and female employees at least once a year; and by posting the company EEO policy on bulletin boards accessible to all employees at each location where construction work is performed. g. Review, at least annually, the company's EEO policy and affirmative action obligations under these specifications with all employees having any responsibility for hiring, assignment, layoff, termination or other employment decisions including specific review of these items with onsite supervisory personnel such as Superintendents, General Foremen, etc., prior to the initiation of construction work at any job site. A written record shall be made and maintained identifying the time and place of these meetings, persons attending, subject matter discussed, and disposition of the subject matter. h. Disseminate the Contractor's EEO policy externally by including it in any advertising in the news media, specifically including minority and female news media, and providing written notification to and discussing the January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Contractor's EEO policy with other Contractors and Subcontractors with whom the Contractor does or anticipates doing business. i. Direct its recruitment efforts, both oral and written, to minority, female and community organizations, to schools with minority and female students and to minority and female recruitment and training organizations serving the Contractor's recruitment area and employment needs. Not later than one month prior to the date for the acceptance of applications for apprenticeship or other training by any recruitment source, the Contractor shall send written notification to organizations such as the above, describing the openings, screening procedures, and test to be used in the selection process. j. Encourage present minority and female employees to recruit other minority persons and women and, where reasonable, provide after school, summer and vacation employment to minority and female youth both on the site and in other areas of a Contractor's workforce. k. Validate all tests and other selection requirements where there is an obligation to do so under 41 CFR Part 60-3. I. Conduct, at least annually, an inventory and evaluation at least of all minority and female personnel for promotional opportunities and encourage these employees to seek or to prepare for, through appropriate training, etc., such opportunities. m. Ensure that seniority practices, job classifications work assignments and other personnel practices, do not have a discriminatory effect by continually monitoring all personnel and employment related activities to ensure that the EEO policy and the Contractor's obligations under these specifications are being carried out. n. Ensure that all facilities and company activities are nonsegregated except that separate or single -user toilet and necessary changing facilities shall be provided to assure privacy between the sexes. o. Document and maintain a record of all solicitations of offers for subcontracts from minority and female construction contractors and suppliers, including circulation of solicitations to minority and female contractor associations and other business associations. p. Conduct a review, at least annually, of all supervisors' adherence to and performance under the Contractor's EEO policies and affirmative action obligations. 8. Contractors are encouraged to participate in voluntary associations which assist in fulfilling one or more of their affirmative action obligations (7a through p) The efforts of a contractor association, joint contractor -union, contractor -community, or other similar group of which the contractor is a member and participant, may be asserted as fulfilling any one or more of its obligations under 7a through p of these Specifications provided that the contractor actively participates in the group, makes every effort to assure that the group has a positive impact on the employment of minorities and women in the industry, ensures that the concrete benefits of the program are reflected in the Contractor's minority and female workforce participation, makes a good faith effort to meet its individual goals and timetables, and can provide access to documentation which demonstrates the effectiveness of actions taken on behalf of the Contractor. The obligation to comply, however, is the Contractor's and failure of such a group to fulfill an obligation shall not be a defense for the Contractor's noncompliance. 9. A single goal for minorities and a separate single goal for women have been established. The Contractor, however, is required to provide equal employment opportunity and to take affirmative action for all minority groups, both male and female, and all women, both minority and non -minority. Consequently, the Contractor may be in violation of the Executive Order if a particular group is employed in a substantially disparate manner (for example, even though the Contractor has achieved its goals for women generally, the Contractor may be in violation of the Executive Order if a specific minority group of women is underutilized). 10. The Contractor shall not use the goals and timetable or affirmative action standards to discriminate against any person because of race, color, religion, sex, or national origin. 11. The Contractor shall not enter into any Subcontract with any person or firm debarred from Government contracts pursuant to Executive Order 11246. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 12. The Contractor shall carry out such sanctions and penalties for violation of these specifications and of the Equal Opportunity Clause, including suspension, termination and cancellation of existing subcontracts as may be imposed or ordered pursuant to Executive Order 11246, as amended, and its implementing regulations, by the Office of Federal Contract Compliance Programs. Any Contractor who fails to carry out such sanctions and penalties shall be in violation of these specifications and Executive Order 11246, as amended. 13. The Contractor, in fulfilling its obligations under these specifications, shall implement specific affirmative action steps at least as extensive as those standards prescribed in paragraph 7 of these specifications so as to achieve maximum results from its efforts to ensure equal employment opportunity. If the Contractor fails to comply with the requirements of the Executive Order, the implementing regulations, or these specifications, the Director shall proceed in accordance with 41 CFR 60-4.8. 14. The Contractor shall designate a responsible official to monitor all employment related activity to ensure that the company EEO policy is being carried out, to submit reports relating to the provisions hereof as may be required by the Government and to keep records. Records shall at least include for each employee the name, address, telephone numbers, construction trade, union affiliation if any, employee identification number when assigned, social security number, race, sex, status (e.g., mechanic, apprentice, trainee, helper, or laborer), dates of changes in status, hours worked per week in the indicated trade, rate of pay, and locations at which the work was performed. Records shall be maintained in an easily understandable and retrievable form; however, to the degree that existing records satisfy this requirement, contractors shall not be required to maintain separate records. 15. Nothing herein provided shall be construed as a limitation upon the application of other laws which establish different standards of compliance or upon the application of requirements for the hiring of local or other area residents (e.g., those under the Public Works Employment Act of 1977 and the Community Development Block Grant Program). Federal Register, Vol. 43, No. 68 - Friday, April 7, 1978 (Corrected May 5, 1978). Effective Date: May 8, 1978 Federal Register, Vol. 45, No. 194. Paragraph 4, revised October 3, 1980 Effective Date: September 30, 1980 APPENDICES A and B-80 Notice of Requirement for Affirmative Action to Ensure Equal Employment Opportunity (Executive Order 11246) The Offeror's or Bidder's attention is called to the "Equal Opportunity Clause" and the "Standard Federal Equal Employment Specifications" set forth herein. 2. The goals and timetables for minority and female participation, expressed in percentage terms for the Contractor's aggregate workforce in each trade on all construction work in the covered area, are as follows: (See Appendix B-80 and Appendix A Below) These goals are applicable to all the Contractor's construction work (whether or not it is Federal or federally assisted) performed in the covered area. If the contractor performs construction work in a geographical area located outside of the covered area, it shall apply the goals established for such geographical area where the work is actually performed. With regard to this second area, the contractor also is subject to the goals for both its federally involved and non - federally involved construction. The Contractor's compliance with the Executive Order and in the regulations in 41 CFR Part 60 - 4 shall be based on its implementation of the Equal Opportunity Clause, specific affirmative action obligations required by the specifications set January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 forth in 41 CFR 60 - 4.3(a), and its efforts to meet the goals. The hours of minority and female employment and training must be substantially uniform throughout the length of the contract, and in each trade, and the contractor shall make a good faith effort to employ minorities and women evenly on each of its projects. The transfer of minority or female employees or trainees from Contractor to Contractor or from project to project for the sole purpose of meeting the Contractor's goals shall be a violation of the contract, the Executive Order and the regulations in 41 CFR Part 60 - 4. Compliance with the goals will be measured against the total work hours performed. 3. The Contractor shall provide written notification to the Director of the Office of Federal Contract Compliance Programs within 10 working days of award of any construction subcontract in excess of $10,000 at any tier for construction work under the contract resulting from this solicitation. The notification shall list the name, address and telephone number of the subcontractor, employer Identification number of the subcontractor, estimated dollar amount of the subcontract, and the geographical area in which the subcontract is to be performed. As used in this Notice, and in the contract resulting from this solicitation, the "covered area" is (State of Iowa). APPENDIX A The following goals and timetables for female utilization shall be included in all Federal and federally assisted construction contracts and subcontracts in excess of $10,000. The goals are applicable to the contractor's aggregate on - site construction workforce whether or not part of that workforce is performing work on a Federal or federally assisted construction contract or subcontract. Area covered: Goals for Women apply nationwide. Timetable Goals (percent) From Apr. 1, 1978 until March 31, 1979 3.1 From Apr. 1, 1979 until March 31, 1980 5.0 From Apr. 1, 1980 until March 31, 1981 6.9 Published, Federal Register May 5, 1978 APPENDIX B-80 Until further notice, the following goals for minority utilization in each construction craft and trade shall be included in all Federal or federally assisted construction contracts and subcontracts in excess of $10,000 to be performed in the respective geographical areas. The goals are applicable to each nonexempt contractor's total onsite construction workforce, regardless of whether or not part of that workforce is performing work in a Federal, federally assisted or nonfederally related project, contract or subcontract. Construction contractors which are participating in an approved Hometown Plan (see 41 CFR 60 - 4.5) are required to comply with the goals of the Hometown Plan with regard to construction work they perform in the area covered by the Hometown Plan. With regard to all their other covered construction work, such contractors are required to comply with the applicable SMSA of EA goal contained in this appendix B-80. Economic Areas State: Iowa Goal 096 Dubuque IA: SMSA Counties: 2200 Dubuque, IA 0.6 IA Dubuque Non-SMSA Counties 0.5 January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 IA Allamakee, IA Clayton, IA Delaware, IA Jackson IA Winneshiek 099 Davenport Rock Island Moline, IA -IL: SMSA Counties: 1960 Davenport Rock Island Moline, IA -IL 4.6 IL Henry, IL Rock Island Moline, IA Scott Non-SMA Counties 3.4 IL Carroll, IL Hancock, IL Henderson, IL Mercer, IL Whiteside, IA Clinton, IA Des Moines, IA Henry, IA Lee, IA Louisa, IA Muscatine, MO Clark 100 Cedar Rapids, IA: SMSA Counties: 1360 Cedar Rapids, IA 1.7 IA Linn Non-SMSA Counties 1.5 IA Benton, IA Cedar, IA Iowa, IA Johnson, IA Jones, IA Washington 101 Waterloo, IA: SMSA Counties: 8920 Waterloo -Cedar Falls, IA 4.7 IA Black Hawk Non-SMSA Counties 2.0 IA Bremer, IA Buchanan, IA Butler, IA Cerro Gordo, IA Chickasaw, IA Fayette, IA Floyd, IA Franklin, IA Grundy, IA Hancock, IA Hardin, IA Howard, IA Mitchell, IA Winnebago, IA Worth 102 Fort Dodge, IA: Non-SMSA Counties 0.4 IA Buena Vista, IA Calhoun, IA Carroll, IA Clay, IA Dickinson, IA Emmet, IA Greene, IA Hamilton, IA Humboldt, IA Kossuth, IA Palo Alto, IA Pocahontas, IA Sac, IA Webster, IA Wright 103 Sioux City, IA: SMSA Counties: 7720 Sioux City, IA -NE 1.9 IA Woodbury, NE Dakota Non-SMSA Counties 1.2 IA Cherokee, IA Crawford, IA Ida, IA Monona, IA O'Brien, IA Plymouth, IA Sioux, NE Antelope, NE Cedar, NE Cuming, NE Dixon, NE Knox, NE Madison, NE Pierce, NE Stanton, NE Thurston, NE Wayne, SD Bon Homme, SD Clay, SD Union, SD Yankton 104 Des Moines, IA: SMSA Counties: 2120 Des Moines, IA 4.5 IA Polk, IA Warren Non SMSA Counties: 2.4 IA Adair, IA Appanoose, IA Boone, IA Clarke, IA Dallas, IA Davis, IA Decatur, IA Guthrie, IA Jasper, IA Jefferson, IA Keokuk, IA Lucas, IA Madison, IA Mahaska, IA Marion, IA Marshall, IA Monroe, IA Poweshiek, IA Ringgold, IA Story, IA Tama, IA Union, IA Van Buren, IA Wapello, IA Wayne January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 143 Omaha, NE: SMSA Counties: 5920 Omaha, NE -IA 7.6 IA Pottawattamie, NE Douglas, NE Sarpy Non-SMSA Counties 5.3 IA Adams, IA Audubon, IA Cass, IA Fremont, IA Harrison, IA Mills, IA Montgomery, IA Page, IA Shelby, IA Taylor, NE Burt, NE Cass, NE Colfax, NE Dodge, NE Platte, NE Saunders, NE Washington Published, Federal Register October 3, 1980 B. Federal Labor Standards Provisions (including Davis -Bacon prevailing wage rates) Applicability The Project or Program to which the construction work covered by this contract pertains is being assisted by the United States of America and the following Federal Labor Standards Provisions are included in this Contract pursuant to the provisions applicable to such Federal assistance. (1) Minimum wages. (i) All laborers and mechanics employed or working upon the site of the work will be paid unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account (except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR part 3)), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment computed at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of paragraph (a)(1)(iv) of this section; also, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in Sec. 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided that the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination (including any additional classification and wage rates conformed under paragraph (a)(1)(ii) of this section) and the Davis -Bacon poster (WH-1321) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. (ii) (A) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (1) The work to be performed by the classification requested is not performed by a classification in the wage determination; and (2) The classification is utilized in the area by the construction industry; and (3) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination. (B) If the contractor and the laborers and mechanics to be employed in the classification (if known), or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, Washington, DC 20210. The Administrator, or an authorized January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. (C) In the event the contractor, the laborers or mechanics to be employed in the classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer, to the Administrator for determination. The Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. (D) The wage rate (including fringe benefits where appropriate) determined pursuant to paragraphs (a)(1)(ii) (B) or (C) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. (iii) Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. (iv) If the contractor does not make payments to a trustee or other third person, the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided that the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. (2) Withholding. The EPA shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld from the contractor under this contract or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to Davis -Bacon prevailing wage requirements, which is held by the same prime contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work, all or part of the wages required by the contract, the EPA may, after written notice to the contractor, sponsor, applicant, or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. (3) Payrolls and basic records. (i) Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social security number of each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section 1(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv) that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in section 1(b)(2)(B) of the Davis -Bacon Act, the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. (ii) (A) The contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to the (write in name of appropriate federal agency) if the agency is a party to the contract, but if the agency is not such a party, the contractor will submit the payrolls to the applicant, sponsor, or owner, as January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 the case may be, for transmission to the (write in name of agency). The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be included on weekly transmittals. Instead the payrolls shall only need to include an individually identifying number for each employee (e.g., the last four digits of the employee's social security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH-347 is available for this purpose from the Wage and Hour Division Web site at http://www.dol.gov/whd/programs/dbra/forms.htm or its successor site. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. Contractors and subcontractors shall maintain the full social security number and current address of each covered worker, and shall provide them upon request to the (write in name of appropriate federal agency) if the agency is a party to the contract, but if the agency is not such a party, the contractor will submit them to the applicant, sponsor, or owner, as the case may be, for transmission to the (write in name of agency), the contractor, or the Wage and Hour Division of the Department of Labor for purposes of an investigation or audit of compliance with prevailing wage requirements. It is not a violation of this section for a prime contractor to require a subcontractor to provide addresses and social security numbers to the prime contractor for its own records, without weekly submission to the sponsoring government agency (or the applicant, sponsor, or owner). (B) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (1) That the payroll for the payroll period contains the information required to be provided under Sec. 5.5 (a)(3)(ii) of Regulations, 29 CFR part 5, the appropriate information is being maintained under Sec. 5.5 (a)(3)(i) of Regulations, 29 CFR part 5, and that such information is correct and complete; (2) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in Regulations, 29 CFR part 3; (3) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract. (C) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH-347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph (a)(3)(ii)(B) of this section. (D) The falsification of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of title 31 of the United States Code. (iii) The contractor or subcontractor shall make the records required under paragraph (a)(3)(i) of this section available for inspection, copying, or transcription by authorized representatives of the EPA or the Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, the Federal agency may, after written notice to the contractor, sponsor, applicant, or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. (4) Apprentices and trainees (i) Apprentices. Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Employment and Training Administration, Office of Apprenticeship Training, Employer and Labor Services, or with a State Apprenticeship Agency recognized by the Office, or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has been certified by the Office of Apprenticeship Training, Employer and Labor Services or a State Apprenticeship Agency (where January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 appropriate) to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any worker listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not Tess than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not Tess than the applicable wage rate on the wage determination for the work actually performed. Where a contractor is performing construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. If the Administrator determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the event the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (ii) Trainees. Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration. The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for Tess than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rateon the wage determination for the classification of work actually performed In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program, the contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (iii) Equal employment opportunity. The utilization of apprentices, trainees and journeymen under this part shall be in conformity with the equal employment opportunity requirements of Executive Order 11246, as amended, and 29 CFR part 30. (5) Compliance with Copeland Act requirements. The contractor shall comply with the requirements of 29 CFR part 3, which are incorporated by reference in this contract. (6) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses contained in 29 CFR 5.5(a)(1) through (10) and such other clauses as the (write in the name of the Federal agency) may by appropriate instructions require, and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. (7) Contract termination: debarment. A breach of the contract clauses in 29 CFR 5.5 may be grounds for termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 (8) Compliance with Davis -Bacon and Related Act requirements. All rulings and interpretations of the Davis -Bacon and Related Acts contained in 29 CFR parts 1, 3, and 5 are herein incorporated by reference in this contract. (9) Disputes concerning labor standards. Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR parts 5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (and any of its subcontractors) and the contracting agency, the U.S. Department of Labor, or the employees or their representatives. (10)Certification of eligibility. (i) 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). (ii) 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). (iii) The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001. (b) Contract Work Hours and Safety Standards Act. The Agency Head shall cause or require the contracting officer to insert the following clauses set forth in paragraphs (b)(1), (2), (3), and (4) of this section in full in any contract in an amount in excess of $100,000 and subject to the overtime provisions of the Contract Work Hours and Safety Standards Act. These clauses shall be inserted in addition to the clauses required by Sec. 5.5(a) or 4.6 of part 4 of this title. As used in this paragraph, the terms laborers and mechanics include watchmen and guards. (1) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not Tess than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. (2) Violation, liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph (b)(1) of this section the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph (b)(1) of this section, in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (b)(1) of this section (3) Withholding for unpaid wages and liquidated damages. The loan recipient shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph (b)(2) of this section. (4) Subcontracts The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph (b)(1) through (4) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (b)(1) through (4) of this section. (c) In addition to the clauses contained in paragraph (b), in any contract subject only to the Contract Work Hours and Safety Standards Act and not to any of the other statutes cited in Sec. 5.1, the Agency Head shall cause January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 or require the contracting officer to insert a clause requiring that the contractor or subcontractor shall maintain payrolls and basic payroll records during the course of the work and shall preserve them for a period of three years from the completion of the contract for all laborers and mechanics, including guards and watchmen, working on the contract. Such records shall contain the name and address of each such employee, social security number, correct classifications, hourly rates of wages paid, daily and weekly number of hours worked, deductions made, and actual wages paid. Further, the Agency Head shall cause or require the contracting officer to insert in any such contract a clause providing that the records to be maintained under this paragraph shall be made available by the contractor or subcontractor for inspection, copying, or transcription by authorized representatives of the EPA and the Department of Labor, and the contractor or subcontractor will permit such representatives to interview employees during working hours on the job. C. Preservation of Open Competition and Government Neutrality Towards Government Contractors' Labor Relations on Federal and Federally Funded Construction Projects (Executive Order 13202, as amended by Executive Order 13208) Executive Order 13202, signed February 17, 2001 and amended April 4, 2001, requires all executive agencies that issue grants to ensure Government neutrality toward contractors' labor relations. This applies to recipients of SRF assistance. The Executive Order prohibits discrimination against contractors and their employees in construction contracts based upon labor affiliation or lack thereof. SRF assistance recipients and any construction managers acting on their behalf must ensure that bidding specifications, project agreements, and other controlling documents do not require, prohibit, or otherwise discriminate, with respect to labor affiliation or lack thereof. D. Historical and Archeological Finds If, during the course of construction, evidence of deposits of historical or archeological interest is found, the contractor shall cease operations affecting the find. The owner shall then notify the State Revolving Fund Environmental Review Specialist, who shall in turn notify the State Historic Preservation Office. The SRF shall consult with the SHPO and other interested parties to determine the proper course of action regarding the discovery. No further disturbance of the deposits shall ensue until the SRF Environmental Review Specialist determines that the project activities in that area may proceed. Compensation to the contractor, if any, for lost time or changes in construction to avoid the find, shall be determined in accordance with changed conditions or change order provisions of the specifications. Authority for this derives from the National Historic Preservation Act (16 U.S.C. §§ 470 et seq.) and 36 CFR Part 800. If human remains are discovered then state law also applies IC 263B. E. Prohibitions on Procurement from Violating Facilities (Section 306, Clean Air Act; Section 508, Clean Water Act; Executive Order 11738) Both the Clean Water Act and the Clean Air Act prohibit federal agencies from extending assistance by way of loans or contracts to persons who have been convicted of violations of either law Executive Order 11738 was issued to coordinate enforcement by the U.S. Environmental Protection Agency, which shall designate facilities which have given rise to a conviction for an offense under the criminal provisions of the Clean Air Act and the Clean Water Act. The Executive Order also prohibits agencies from extending assistance to facilities that are not in compliance with either Act. SRF assistance recipients may not procure goods, services, or materials from suppliers listed by the EPA as violators. The Excluded Parties Listing search engine is located at the System for Award Management (SAM) website: https://sam.gov. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 8 SRF Required Front -End Specifications Right of Entry and Records Retention The recipient shall provide access at all times for the Department of Natural Resources, the Iowa Finance Authority, the state auditor, and the U.S. EPA Office of the Inspector General to all project records and documents for inspection and audit purposes for a period of three years after the date of last loan payment. The same access to the project site(s) shall be provided for inspection purposes. 567 Iowa Administrative Code paragraph 92.8 (2).e. State inspections. Personnel of the department shall have the right to examine all construction aspects of the project, including materials and equipment delivered and stored on site for use on the project. Attachment 9 SRF Required Front -End Specifications "American Iron and Steel" Requirements H.R. 3547, the "Consolidated Appropriations Act, 2014," enacted January 17, 2014 by the U.S. Congress, includes "American Iron and Steel" provisions that require Clean Water and Drinking Water State Revolving Fund assistance recipients of these funds to use iron and steel produced in the United States. H.R. 3547 includes the following language in Division G, Title IV, under the heading, "Use of American Iron and Steel": Sec. 436. (a)(1) None of the funds made available by a State water pollution control revolving fund as authorized by title VI of the Federal Water Pollution Control Act (33 U.S.C. 1381 et seq.) or made available by a drinking water treatment revolving loan fund as authorized by section 1452 of the Safe Drinking Water Act (42 U.S.C. 30002) shall be used for a project for the construction, alteration, maintenance, or repair of a public water system or treatment works unless all of the iron and steel products used in the project are produced in the United States. (2) In this section, the term "iron and steel products" means the following products made primarily of iron and steel: Tined or unlined pipes and fittings, manhole covers and other municipal castings, hydrants, tanks, flanges, pipe clamps and restraints, valves, structural steel, reinforced precast concrete, and construction materials. (b) Subsection (a) shall not apply in any case or category of cases in which the Administrator of the Environmental Protection Agency (in this section referred to as the "Administrator") find that- 1) Applying subsection (a) would be inconsistent with the public interest; 2) Iron and steel products are not produced in the United States in sufficient and reasonably available quantities and of a satisfactory quantity; or 3) Inclusion of iron and steel products produced in the United States will increase the cost of the overall project by more than 25 percent. (c) If the Administrator receives a request for a waiver under this section, the Administrator shall make available to the public on an informal basis a copy of the request and information available to the Administrator concerning the request, and shall allow for informal public input on the request for at least 15 days prior to making a finding based on the request. The Administrator shall make the request and accompanying information available by electronic means, including on the official public Internet Web site of the Environmental Protection Agency. The final guidance and any published waivers are found at: https://www.epa gov/cwsrf/state-revolving-fund-american- iron-and-steel-ais-requirement. In particular the contractor should pay attention to the guidance for documentation of January 2021 INVESTING IN IOWA'S WATER www.iowasrfcom DNR Form 542-0621 compliance. There is also a waiver for incidental items; in order to qualify for this waiver the total materials and costs for the project must be tracked and incidental items identified. Sample 'American Iron and Steel" Contract Language In order to fulfill the requirements, the assistance recipient must in good faith design the project and solicit bids for construction with U.S.-made iron and steel. The following information will be included in any contracts resulting from this request for bids: The Contractor acknowledges to and for the benefit of the City of waterloo, IA ("Purchaser") and the State of Iowa (the "State") that it understands the goods and services under this Agreement are being funded with monies made available by the Clean Water State Revolving Fund and/or Drinking Water State Revolving Fund and such law contains provisions commonly known as "American Iron and Steel;" that requires all of the iron and steel products used in the project to be produced in the United States ("American Iron and Steel Requirement") including iron and steel products provided by the Contactor pursuant to this Agreement. The Contractor hereby represents and warrants to and for the benefit of the Purchaser and the State that (a) the Contractor has reviewed and understands the American Iron and Steel Requirement, (b) all of the iron and steel products used in the project will be and/or have been produced in the United States in a manner that complies with the American Iron and Steel Requirement, unless a waiver of the requirement is approved, and (c) the Contractor will provide any further verified information, certification or assurance of compliance with this paragraph, or information necessary to support a waiver of the American Iron and Steel Requirement, as may be requested by the Purchaser or the State. Notwithstanding any other provision of this Agreement, any failure to comply with this paragraph by the Contractor shall permit the Purchaser or State to recover as damages against the Contractor any loss, expense, or cost (including without limitation attorney's fees) incurred by the Purchaser or State resulting from any such failure (including without limitation any impairment or loss of funding, whether in whole or in part, from the State or any damages owed to the State by the Purchaser). While the Contractor has no direct contractual privity with the State, as a lender to the Purchaser for the funding of its project, the Purchaser and the Contractor agree that the State is a third -party beneficiary and neither this paragraph (nor any other provision of this Agreement necessary to give this paragraph force or effect) shall be amended or waived without the prior written consent of the State. Sample Certifications As indicated in the contract language, it will be the responsibility of the Contractor to obtain certifications that the products and materials used in the project are U.S.-made. EPA recommends the use of a step certification process for documenting compliance with AIS requirements, similar to one used by the Federal Highway Administration Step certification creates a paper trail which documents the location of the manufacturing process involved with the production of steel and iron materials Each handler (supplier, fabricator, manufacturer, processor, coater, etc.) of the iron and steel products certifies that their step in the process was domestically performed. The following information is provided as a sample letter of step certification for AIS compliance. Documentation must be provided on company letterhead. In this example, there may be multiple letters from different manufacturers if one manufacturer did not perform all of the steps. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Date Company Name Company Address City, State Zip Subject: American Iron and Steel Step Certification for Project (XXXXXXXXXX) I, (company representative), certify that the (melting, bending, coating, galvanizing, cutting, etc.) process for (manufacturing or fabricating) the following products and/or materials shipped or provided for the subject project is in full compliance with the American Iron and Steel requirement as mandated in EPA's State Revolving Fund Programs. Item, Products and/or Materials: 1. Xxxx 2. Xxxx 3. Xxxx Such process took place at the following location: If any of the above compliance statements change while providing material to this project we will immediately notify the prime contractor and the engineer. Signed by company representative Alternatively, the final manufacturer that delivers the iron or steel product to the worksite, vendor, or contractor, may provide a certification asserting that all manufacturing processes occurred in the US and providing detailed information on the steps involved. The following is a template for this type of final certification. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 SRF Template American Iron and Steel Certification Letter STATE On Manufacturer's Letterhead IRON & STEEL, INC. 1959 Steel Drive Iroo<<ltle, OH 12345 MATERIAL CERTIFICATION April 30, 2015 RE: Job Name: Waterprojectville, Iowa — 2015 State Revolving Fund Water Infrastructure Project SRF Project Number. CS1920999 01 References the SRF Project I certify that the processes for manufacturing or fabricating the following products and/or materials provided for the subject project took place at the following U.S. locations: • Quantity Description Manufacturing Processes Location Processes Where Occurred 3 count AB123456 4" Gate Valve Melting, poured, machined Ironville, OH 60 count XV654321 Manhole Reinforced Concrete Melted, rolled, fabricated Steel City, IA 60 count XZ123456 Manhole Cover Melted, cast, finished Stainless, MS 1200 linear feet AB654321 Pipe 4" Iron Water Melted, rolled, finished Pipet r, CA Ductile I further certify that products and/or materials are in full compliance with the American Iron and teel requirements as mandated in the U.S. Environmental Protection Agen s State Revolving Fund programs. If any of the above compliance st ements change while providing material to this project we will immediately notify the supplier, prime contractor, consulting engineer, or project owner_ Specifies the Products and Quantities On behalf of IRON & STEEL, INC., jZuce S'au#e Jane Smith Product Quality Manager Signature of Manufacturer's Representative Specifies the Manufacturing Processes and the U.S. Locations Where They Were Performed January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Covered and Non -Covered Items The EPA issued a waiver for De Minimus incidental components of eligible water and wastewater infrastructure projects. Funds used for such De Minimus incidental components cumulatively may comprise no more than a total of 5% of the total cost of the materials used in and incorporated into a project. The cost of an individual incidental item may not exceed 1% of the total cost of the materials used in and incorporated into a project. De Minimus incidental items include miscellaneous, generally low-cost components that are essential for, but incidental to, the construction and are incorporated into the physical structure of the project. For many of these incidental components, the country of manufacture and the availability of alternatives are not readily or reasonably identifiable prior to procurement in the normal course of business. For others, the country of manufacture may be known but the miscellaneous character in conjunction with the low cost, individually and (in total) as typically procured in bulk, mark them as properly incidental. Examples of incidental components could include small washers, screws, fasteners (i.e., nuts and bolts), miscellaneous wire, corner bead, ancillary tube, etc. Examples of items that are clearly not incidental include significant process fittings (i.e., tees, elbows, flanges, and brackets), distribution system fittings and valves, force main valves, pipes, treatment and storage tanks, large structural supports, etc. In consultation with their contractors, assistance recipients should determine the items to be covered by this waiver, and must retain relevant documentation (i.e. invoices) as to those items. Assistance recipients must summarize in reports to the State of Iowa the types and/or categories of items to which this waiver is applied, the total cost of incidental components for each type or category, and the calculations by which they determined the total cost of materials used in and incorporated into the project. The successful bidder will fill out the materials spreadsheet (shown below) and submit it to the assistance recipient to indicate iron and steel items proposed to be procured for the project. American Iron and Steel Material: Spreadsheet - to be Submitted by Successful Bidder Iowa Department of Natural Ftesources - January 2021 Based on EPA Memorandum (4/15/2014): De Minimis Waiver of Section 436 of P.t. 113 76, Consolidated Appropriation Acts (CAA), 2014 Project: Bidder: Date: *Covered Product Categories include: lined or unlined pipes or fittings; manhole covers; municipal castings; pipe clamps and restraints; valves; structural steel; hydrants, tanks; flanges; reinforced precast concrete; construction materials. • •Incidental items are miscellaneous, generality low-cost items, often procured In butte, such as washes, screws, fasteners, small amounts of wire, etc. Covered Products Description of Covered Category' Products 1 2 3 4 c t hoot,, .• r urns. thoe'.••nnitom. • t hoot•• .in item. ihOct •,••.rn (.•m. Documentation Wi i be Obtained Q • 1-1 Item is Incidental and will be ctalrned under De Mirs:mis Waivers' 0 r • 1-1 Bid Amount Covrred Products Bid Amount Incidentals At the end of construction, the contractor will submit a final list showing covered items being claimed as incidental components under the De Minimis Waiver. Assistance recipients will complete a De Minimis Waiver Incidental Components List for the entire project to demonstrate compliance with the De Minimis Waiver cost requirements outlined above. January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 1 American Iron end Steel • De Minims Waiver Incidental Components list Iowa Deportment of Natural Resources January 2021 Bated on EPA Memorandum (4/15/2014): De Minimus Waiver of Section 436 of P.L. 113-16, Consolidated Appropriation Acts (CM), 2014 This form Is to be used by the State Revolving Fund (SRO applicant to Identify all non -domestic Iron and steel Incidental components permanently Incorporated Into an SRF project that meet the requirements of the public Interest De Minim!, Waiver. This form can also be used by Individual contractor to submit their final incidental components list to the SRF applicant. SRF Applicant: SRF Project 11: r—_ Submitted By: I Date: Individual Contractor De Minlmis list 11111 Final De Mrumis list for SRF Project Total Materials Cost: Total amount claimed as De M inimis Incidental Components: Percent: (must be S% or less o/ toes rnotetmots (ort) I A U r71 p l t: Contractor Name IV Construction Covered Products Construction materials Description of Covered Products (>lst each Rem type sg pototrly) Stet? Doors Date Purchased 1-21-2020 1 2 • Choose an item. Individual Item/Unit Cast $500 Quantity Claimed as Incidental 5 Dollar Amount Incidental Components $2500 These documents are available online at http://www.iowasrf.com/documents-and-guides/ January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Attachment 10 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid.) PROHIBITION ON CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT This term and condition implements 2 CFR 200.216 and is effective for obligations and expenditures of EPA financial assistance funding on or after 8/13/2020. EPA recipients and subrecipients, including borrowers under EPA funded revolving loan fund programs, are prohibited from obligating or expending loan or grant funds to: (a) Procure or obtain, extend or renew a contract to procure or obtain; (b) Enter into a contract (or extend or renew a contract) to procure; or (c) Obtain the equipment, services, or systems that use "covered telecommunications equipment or services" identified in the regulation as a substantial or essential component of any system, or as critical technology as part of any system. Certain equipment, systems, or services, including equipment, systems, or services produced or provided by entities subject to the prohibition are recorded in the System for Award Management exclusion list, website: https://sam.gov. (1) As described in Public Law 115-232, section 889, covered telecommunications equipment or services includes: (i) Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities). (ii) For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities). (iii) Telecommunications or video surveillance services provided by such entities or using such equipment. (iv) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country. (2) Consistent with 2 CFR 200.471, costs incurred for telecommunications and video surveillance services or equipment such as phones, internet, video surveillance, and cloud servers are allowable except for the following circumstances: (i) Obligating or expending EPA funds for covered telecommunications and video surveillance services or equipment or services to procure (enter into, renew or extend contracts) or obtain the equipment, services, or systems as described in 2 CFR 200.216. I understand the abov- prohibitions and certify that the project will be in compliance with all the requirements. 12-14-23 Signature Date Chris D. Fleshner Project Estimator / Manager Printed Name Title January 2021 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 FORM OF BID OR PROPOSAL FY 2024 TITUS LIFT STATION AND FORCE MAIN CONTRACT NO. 975 CITY OF WATERLOO, IOWA Honorable Mayor and City Council Waterloo, Iowa Gentlemen: 1. The undersigned, being a Corporation existing under the laws of the State of Iowa a Partnership consisting of the following partners' 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 AECOM 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 the TITUS LIFT STATION AND FORCE MAIN, CONTRACT NO 975, all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: FY 2024 TITUS LIFT STATION AND FORCE MAIN CONTRACT NO. 975 Item No. SUDAS — Measurement & Payment Description Unit Estimated Quantities Unit Bid Price Total Bid Price BASE BID 1 11020-A MOBILIZATION LS 1.0 $ $ 2 8030-A TRAFFIC CONTROL LS 1.0 $ $ 3 2010-C CLEARING AND GRUBBING LS 1.0 $ $ 4 3010 B EXISTING PUMP BUILDING, VALVE VAULT REMOVAL PUMP VAULT AND LS 1.0 5 3010-B IMPORT FILL FOR LIFT STATION SITE CY 250.0 $ $ 6 3010-B IMPORT FILL FOR TRENCH REMOVALS CY 1,500.0 $ $ 7 2010-D-3 IMPORT TOPSOIL CY 2,420.0 $ $ 8 AS PER PLANS LIFT STATION WET WELL AND VALVE VAULT LS 1.0 $ $ 9 AS PER PLANS ELECTRICAL EQUIPMENT BUILDING LS 1.0 $ $ 10 AS PER PLANS SITE ELECTRICAL LS 1.0 $ $ 11 AS PER PLANS METERING MANHOLE LS 1.0 $ $ 12 4010 G AIR RELEASE MANHOLE STATION AT TITUS LIFT EA 1.0 $ $ 13 4010-G AIR RELEASE MANHOLE EA 5.0 $ $ 14 6010-A 48" MANHOLE EA 2.0 $ $ 15 AS PER PLANS STAND-BY GENERATOR - TITUS LS 1.0 $ $ 16 AS PER PLANS STAND-BY GENERATOR - PARK ROAD LS 1.0 $ $ 17 3010-B UNCLASSIFIED MATERIAL RAPPABLE ROCK) (REMOVAL OF CY 500.0 $ $ 18 3010-B ROCK EXCAVATION CY 500.0 $ $ 19 3010-C FOUNDATION ROCK TON 150.0 $ $ FORM OF BID AECOM #60590223 CONTRACT NO. 975 FB-1 of 3 FY 2024 TITUS LIFT STATION AND FORCE MAIN 20 3010-F TRENCH COMPACTION TESTING LS 1.0 $ $ 21 4010-L ABANDON AND PLUG 12" SANITARY SEWER LF 290.0 $ $ 22 4060 SANITARY SEWER FORCE MAIN TESTING LS 1.0 $ $ 23 4060 CLEANING, INSPECTION AND TESTING OF SANITARY SEWER GRAVITY MAINS LS 1.0 $ $ 24 4010 A 1 18" CUT SANITARY SEWER GRAVITY MAIN - OPEN LF 232.8 $ $ 25 4010 A 2 12" SANITARY SEWER FORCE MAIN DIRECTIONAL DRILLING LF 7,340.8 $ $ 26 0 --- --- $ $ ITEM INTENTIONALLY OMITTED 27 4010 A 1 12" CUT SANITARY SEWER FORCE MAIN - OPEN LF 653.6 $ $ 28 4010 A-1 8" SANITARY SEWER GRAVITY MAIN, DUCTILE IRON - OPEN CUT LF 55.0 $ $ 29 5010 4-INCH STEEL CASING PIPE WITH 2-INCH PVC COMMUNICATION CONDUIT LF 322.7 $ $ 30 5010 B 2 24" STEEL CASING WITH 12" SANITARY SEWER FORCE MAIN LF 392.9 $ $ 31 5010-C-2 FORCE MAIN FITTINGS LBS 3,875.0 $ $ 32 6010 G 1 CONNECTION TO EXISTING SANITARY MANHOLE EA 2.0 $ $ 33 5010E 1 WATER SERVICE, TRENCHED, COPPER, 1- INCH, INTEGRAL RESTRAINED JOINTS LF 95.0 $ $ 34 7010-A 6" PCC PAVEMENT SY 715.6 $ $ 35 7030 GRAVEL SURFACING SY 125.1 $ $ 36 7030 CRUSHED STONE - CLASS "A" SY 715.6 $ $ 37 9010 B SEEDING, FERTILIZING AND MULCHING FOR AC 1.9 $ $ HYDRAULIC SEEDING - TYPE 1 SEED MIX 38 9010 B SEEDING, FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 2 SEED MIX AC 1.9 $ $ 39 9010 B SEEDING, FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 4 SEED MIX AC 1.1 $ $ 40 9010 B SEEDING, FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 5 SEED MIX AC 1.1 $ $ 41 9040-N-1 SILT FENCE LF 2,900.0 $ $ 42 9040 SWPPP REQUIREMENTS LS 1.0 $ $ 43 9060-A 6' CHAIN -LINK FENCE LF 360.3 $ $ 44 9060-B 16' CHAIN -LINK GATE EA 2.0 $ $ 45 AS PER PLANS FORCE MAIN WARNING SIGN EA 5.0 $ $ PROJECT TOTAL $ $ Please see the attached Itemized Cost Report for Unit Prices. 2. It is understood that the quantities set forth are approximate only and subject to variation and that the unit bid price for the work done shall govern in the actual payment to Contractor. 3. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa, to reject any or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the prescribed form and furnish the required bond and certificate of the insurance within ten (10) days after the agreement is presented to him for signature, and start work within ten (10) days after "Notice to Proceed" is issued. FORM OF BID CONTRACT NO. 975 AECOM 1160590223 FB-2 of 3 FY 2024 TITUS LIFT STATION AND FORCE MAIN PETERSON CONTRACTORS, INC. www.petersoncontractors.com 104 Blackhawk Street P.O. Box A Reinbeck, Iowa 50669 Phone: 319-345-2713 Fax: 319-345-2991 PROPOSAL FOR: FY 2024 Titus Lift Station & Force Main ITEM It 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 17 18 19 20 21 22 23 24 25 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 DESCRIPTION MOB Traffic Control Clearing & Grubbing Existing Pump Building Pump Vault and Valve Import Fill for Lift Station Site Import Fill for Trench Removals Import Topsoil Lift Station Wet Well and Valve Vault Electrical Equipment Building Site Electrical Metering Manhole Air Release Manhole at Titus Lift Station Air Release Manhole 48" Manhole Stand-by Generator - Titus Unclassified Material (Removal of Rappable Rc Rock Excavation Foundation Rock Trench Compaction Testing Abandon & Plug 12" Santiary Sewer Sanitary Sewer Force Main Testing Cleaning Inspection and Testing of the Sanitar\ 18" Sanitary Sewer Gravity Main - Open Cut 12" Sanitary Sewer Force Main - Directional Dr 12"Sanitary Sewer Force Main - Open Cut 8"Sanitary Sewer Gravity Main DIP - Open Cut 4"Steel Casing Pipe with 2" PVC Communicatio 24" Steel Casing with 12" Sanitary Sewer Force Force Main Fittings Connection to Existing Sanitary Manhole Water Service Trenched Copper 1" Integral 6" PCC Paving Gravel Surfacing Crushed Stone - Class A Type 1 Hydraulic Seed Fert & Mulch Type 2 Hydraulic Seed Fert & Mulch Type 4 Hydraulic Seed Fert & Mulch Type 5 Hydraulic Seed Fert & Mulch Silt Fence SWPPP Requirements 6' Chain Link Fence 16' Chain Link Gate Force Main Warning Sign UNIT TYPE LS LS LS LS CY CY CY LS LS LS LS EA EA EA LS CY CY TN LS LF LS LS LF LF LF LF LF LF LBS EA Re LF SY SY SY AC AC AC AC LF LS LF EA EA QUANTITY 1.000 1.000 1.000 1.000 250.000 1,500.000 2,420.000 1.000 1.000 1.000 1.000 1.000 5.000 2.000 1.000 500.000 500.000 150.000 1.000 290.000 1.000 1.000 232.800 7,340.800 653.600 55.000 322.700 392.900 3,875.000 2.000 95.000 715.600 125.100 715.600 1.900 1.900 1.100 1.100 2,900.000 1.000 360.300 2.000 5.000 UNIT PRICE TOTAL AMOUNT $550,000.00 $35,000.00 $200,000.00 $50,000.00 $25.00 $15.00 $25.00 $1,900,000.00 $400,000.00 $225,000.00 $100,000.00 $175,000.00 $50,000.00 $60,000.00 $200,000.00 $75.00 $150.00 $75.00 $20,000.00 $30.00 $60,000.00 $5,000.00 $750.00 $150.00 $170.00 $300.00 $500.00 $760.00 $10.00 $12,500.00 $175.00 $80.00 $15.00 $12.50 $5,000.00 $4,000.00 $3,000.00 $3,000.00 $3.00 $5,000.00 $50.00 $1,750.00 $500.00 $550,000.00 $35,000.00 $200,000.00 $50,000.00 $6,250.00 $22,500.00 $60,500.00 $1,900,000.00 $400,000.00 $225,000.00 $100,000.00 $175,000.00 $250,000.00 $120,000.00 $200,000.00 $37,500.00 $75,000.00 $11,250.00 $20,000.00 $8,700.00 $60,000.00 $5,000.00 $174,600.00 $1,101,120.00 $111,112.00 $16,500.00 $161,350.00 $298,604.00 $38,750.00 $25,000.00 $16,625.00 $57,248.00 $1,876.50 $8,945.00 $9,500.00 $7,600.00 $3,300.00 $3,300.00 $8,700.00 $5,000.00 $18,015.00 $3,500.00 $2,500.00 TOTAL QUOTED AMOUNT $6,584,845.50 4. Security in the sum of 5% Dollars ($ ) in the form of Bid Bond accordance with the INSTRUCTIONS TO BIDDERS. 5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor. , is submitted herewith in 6. Attached hereto is a Bidder Status Form indicating Resident Bidder Certification ( x ), or Non -Resident Bidder Certification ( ). (Mark one.) 7 The bidder is prepared to submit a financial and experience statement upon request. 8. The Prime Contractor and Subcontractor(s), which have performed an aggregate of $10,000.00 in work for the City in the current calendar year, are prepared to submit an AAP or Update and an EOC, within ten (10) days of notification that the bid submitted is lowest and acceptable 9. The bidder has received the following Addendum or Addenda: Addendum No. #1 Date 11-28-23 #2 12-7-23 10. The bidder shall list the MBE/WBE subcontractor(s), amount of subcontracts and bid items on the City of Waterloo Minority and/or Women Business Pre -bid Contact Information Form submitted with this Form of Bid or Proposal. The apparent low Bidder shall submit a list of all other Subcontractor(s) to be used on this Project to the City of Waterloo by 5:00 p m. the business day following the day Bids on this Project are due along with the Non -Collusion Affidavits of All Subcontractor(s). The Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND APPROVAL" Form to be provided by City prior to approval of contract. The subcontractors listed on this proposal and/or submitted to the Contract Compliance Officer cannot be changed except for the following reasons: 1) The City of Waterloo does not approve the subcontractors. 2) The subcontractors submit in writing that they cannot fulfill their subcontracts. 11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none" or "NA". 12. The bidder has attached all applicable forms. 13. The Owner reserves the right to select alternates, delete line items, and/or to reduce quantities prior to the award of a contract due to budgetary limitations. BY: Peterson Contractors, Inc 12-14-23 Chris D. Fleshner Official Address: (Including Zip Code): 104 Black Hawk St., P.O. Box A Title (Date) Project Estimator / Manager Reinbeck, IA 50669 I.R.S. No. 42-0921654 FORM OF BID CONTRACT NO. 975 AECOM 460590223 FB-3 of 3 FY 2024 TITUS LIFT STATION AND FORCE MAIN THIS PAGE LEFT BLANK INTENTIONALLY INFORMATION NEEDED FOR IOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE CONTRACTOR NAME: Peterson Contractors, Inc. ADDRESS: 104 Black Hawk St., P.O. Box A Reinbeck, IA 50669 (Check One) PRIME x FEDERAL ID#: 42-0921654 SUBCONTRACTOR PROJECT NAME: Titus Lift Station and Force Main PROJECT CONTRACT NO.: DESCRIPTION OF WORK: 975 Brickwork • Carpentry * Concrete 1 Drywall -Plaster -Insulation Electrical xi Excavation/Grading Flooring • Heavy Construction g Heating -Ventilating -Air Cond. SALES TAX EXEMPTION AECOM 1160590223 E Landscaping • Painting L Paving k Plumbing Ls Roofing -Siding -Sheet Metal L Windows P Wrecking -Demolition ❑ Other (Please specify) CONTRACT NO. 975 v , STE-1 of 1 FY 2024 TITUS LIFT STATION AND FORCE MAIN State of (tat 9n. NON -COLLUSION AFFIDAVIT OF PRIME BIDDER )ss County of al U,'L39 ettr( b. fie k,m2 kr , being first duly sworn, deposes and says that: 1 He is (Owner, Partner, Officer, epresentativ , or Agent) , of Peterson Contractors, Inc. , the Bidder that has submitted t e attached Bid; 2. He is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid; 3. Such Bid is genuine and is not a collusive or sham Bid; 4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees, or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder, or, to fix any overhead, profit or cost element of the bid price or the bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against the City of Waterloo, Iowa, or any person interested in the Proposed Contract; and 5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties in in erest, including this affiant. (Signed) Project Estimator / Manager Subscribed and sworn to before me this /4' k My commission expires 9 30 ) C AMY L. CLARg8999 Commission Numb My Commissto t Expires August 30, NON -COLLUSION AFFIDAVIT CONTRACT NO. 975 AECOM #60590223 Title day of Den ine\-1/. , 20 in • Title tJ'17' 7 NCA-1 of 2 FY 2024 TITUS LIFT STATION AND FORCE MAIN EQUAL OPPORTUNITY CLAUSE (As provided in Executive Order No. 11246) All contractors, subcontractors, vendors and suppliers of goods and services doing business with the City and value of said business equals or exceeds ten thousand dollars ($10,000.00) annually agree as follows: 1. The contractors, subcontractor, vendor and supplier of goods and services will not discriminate against any employee or applicant for employment because of race, color, creed, sex, national origin, economic status, age, mental or physical handicap, political opinions, or affiliations. The contractor, subcontractor, vendor, and supplier will develop an Affirmative Action program to ensure that applicants are employed and that employees are treated during employment without regard to their race, creed, color, sex, national origin, religion, economic status, age, mental or physical disability, political opinions or affiliations. Such actions shall include but not be limited to the following: a. Employment b. Upgrading c. Demotion or Transfer d. Recruitment and Advertising e. Layoff or Termination f. Rates of Pay or Other Forms of Compensation g. Selection for Training Including Apprenticeship 2. The contractor, subcontractor, vendor and supplier of goods and services will, in all solicitations or advertisements for employees, state that all qualified applicants will receive consideration for employment without regard to race, creed, color, sex, national origin, religion, economic status, age, mental or physical disabilities, political opinion or affiliations. 3. The contractor, subcontractor, vendor and supplier or his/her collective bargaining representative will send to each labor union or representative of workers which he/she has a collective bargaining agreement or other contract or understanding, a notice advising said labor union or workers' representative of the contractor's commitment under this section. 4. The contractor, subcontractor, vendor and supplier of goods and services will comply with all published rules, regulations, directives, and order of the City of Waterloo Affirmative Action Program Contract Compliance Provisions. 5. The contractor, subcontractor, vendor and supplier of goods and services will furnish and file compliance reports within such time and upon such forms as provided by the Affirmative Action Officer. Said forms will elicit information as to the policies, procedures, patterns, and practices of each subcontractor as well as the contractor himself/herself and said contractor, subcontractor, vendor and supplier will permit access to his/her employment books, records and accounts to the City's Affirmative Action Officer, for the purpose of investigation to ascertain compliance with this contract and with rules and regulations of the City's Affirmative Action Program Contract Compliance Provisions relative to Resolution No. 24664. 6. In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such rules, regulations and orders, this contract may be canceled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further contracts in accordance with procedures authorized by the City Council. 7 The contractor, subcontractor, vendor and supplier of goods and services will include, or incorporate by reference, the provisions of the non-discrimination clause in every contract, EQUAL OPPORTUNITY CLAUSE CONTRACT NO. 975 EOC-1 of 2 AECOM 1160590223 FY 2024 TITUS LIFT STATION AND FORCE MAIN subcontract or purchase order unless exempted by the rules, regulations, or orders of the City's Affirmative Action Program, and will provide in every subcontract, or purchase order that said provisions will be binding upon each contractor, subcontractor, or supplier. 8. We, the undersigned, recognize that we are morally and legally committed to non-discrimination in employment. Any person who applies for employment with our company will not be discriminated against because of race, creed, color, sex, national origin, economic status, age, mental or physical disabilities. (Signed) (Appropriate Official) Project Esimator / Manager (Title) 12-14-23 (Date) EQUAL OPPORTUNITY CLAUSE CONTRACT NO. 975 EOC-2 of 2 AECOM #60590223 FY 2024 TITUS LIFT STATION AND FORCE MAIN TITLE VI CIVIL RIGHTS During the performance of this contract, the contractor (for itself), its assignees, and successors in interest (hereinafter referred to as the "contractor") agrees as follows: 1. Compliance with Regulations: The contractor shall comply with the Regulations relative to non- discrimination in Federally assisted programs of the DOT Title 49, Code of Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and made a part of this contract. 2. Nondiscrimination: The contractor, about the work performed by it during the contract, shall not discriminate on the grounds of race, color, national origin, sex, age, or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B of the Regulations. 3. Solicitations for Subcontracts, Including Procurement of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurement of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the contractor's obligations under this contract and the Regulations relative to non-discrimination on the grounds of race, color, national origin, sex, age, or disability. 4. Information and Reports: The contractor shall provide all information and reports required by the Regulations or directives issued pursuant there to, and shall allow access to its books, records, accounts, other sources of information, and its facilities as may be determined by the Contracting Authority, the Iowa DOT, or FHWA to be pertinent to ascertain compliance with such Regulations, orders and instructions. Where any information required of a contractor is in the exclusive possession of another who fails or refuses to furnish this information the contractor shall so certify to the Contracting Authority, the Iowa DOT, or the FHWA as appropriate, and shall set forth what efforts it has made to obtain the information. 5. Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination provisions of this contract, the Contracting Authority, the Iowa DOT, or the FHWA shall impose such contract sanctions as they may determine to be appropriate, including, but not limited to: a. Withholding of payments to the contractor under the contract until the contractor complies, and/or b. Cancellation, termination, or suspension of the contract, in whole or in part. 6. Incorporation of Provisions: The contractor shall include the provisions of paragraphs (1) through (6) in every subcontract, including procurement of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. The contractor shall take such action with respect to any subcontract or procurement as the Contracting Authority, the Iowa DOT, or the FHWA may direct as a means of enforcing such provisions including sanctions for non-compliance: Provided, however, that, in the event of a contractor becomes involved in, or it threatened with, litigation with a subcontractor or supplier as a result of such direction, the contractor may request the Contracting Authority or the Iowa DOT to enter into such litigation to protect the interests of the Contracting Authority or the Iowa DOT; and, in addition, the contractor may request the United States to enter into such litigation to protect the interest of the United States. TITLE VI CIVIL RIGHTS CONTRACT NO. 975 AECOM #60590223 TVI-1 of 1 FY 2024 TITUS LIFT STATION AND FORCE MAIN THIS PAGE LEFT BLANK INTENTIONALLY Bidder Status Form To be completed by all bidders Part A Please answer "Yes" or "No" for each of the following: x x x x x Yes U No My company is authorized to transact business in Iowa. (To help you determine if your company is authorized, please review the worksheet on the next page). Yes ❑ No My company has an office to transact business in Iowa. Yes ❑ No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. Yes ❑ No My company has been conducting business in Iowa for at least 3 years prior to the first request for bids on this project. Yes ❑ No My company is not a subsidiary of another business entity or my company is a subsidiary of another business entity that would qualify as a resident bidder in Iowa. If you answered "Yes" for each question above, your company qualifies as a resident bidder. 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: 12 / 22 / 68 to 12 / 14 / 23 Address: 104 Black Hawk St., P.O. Box A City, State, Zip: Reinbeck, IA 50669 Dates: / / to / / Address: City, State, Zip: Dates: / / to / / Address: You may attach additional sheet(s) if needed. City, State, Zip: To be completed by non-resident bidders Part C 1. Name of home state or foreign country reported to the Iowa Secretary of State: 2. Does your company's home state or foreign country offer preferences to resident bidders, resident labor force preferences or any other type of preference to bidders or laborers? 3. If you answered "Yes" to question 2, identify each preference offered by your company's home state or foreign country and the appropriate legal citation. Yes l I No 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: Peterson Contractors, Inc. Signature: Date: 12-14-23 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. x x Yes U No My business is currently registered as a contractor with the Iowa Division of Labor. Yes x No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. Yes x No My business is a general partnership or joint venture. More than 50 percent of the general partners or joint venture parties are residents of Iowa for Iowa income tax purposes. Yes U No My business is an active corporation with the Iowa Secretary of State and has paid all fees required by the Secretary of State, has filed its most recent biennial report, and has not filed articles of dissolution. Yes x No My business is a corporation whose articles of incorporation are filed in a state other than Iowa, the corporation has received a certificate of authority from the Iowa secretary of state, has filed its most recent biennial report with the secretary of state, and has neither received a certificate of withdrawal from the secretary of state nor had its authority revoked. Yes x No My business is a limited liability partnership which has filed a statement of qualification in this state and the statement has not been canceled. Yes MI No My business is a limited liability partnership which has filed a statement of qualification in a state other than Iowa, has filed a statement of foreign qualification in Iowa and a statement of cancellation has not been filed. Yes x No My business is a limited partnership or limited liability limited partnership which has filed a certificate of limited partnership in this state, and has not filed a statement of termination. Yes x No My business is a limited partnership or a limited liability limited partnership whose certificate of limited partnership is filed in a state other than Iowa, the limited partnership or limited liability limited partnership has received notification from the Iowa secretary of state that the application for certificate of authority has been approved and no notice of cancellation has been filed by the limited partnership or the limited liability limited partnership. Yes x No My business is a limited liability company whose certificate of organization is filed in Iowa and has not filed a statement of termination. Yes x No My business is a limited liability company whose certificate of organization is filed in a state other than Iowa, has received a certificate of authority to transact business in Iowa and the certificate has not been revoked or canceled. 309-6001 (09-15) BSF-2 Revised February 2003 CONTRACTOR'S OR SUBCONTRACTOR'S AFFIRMATIVE ACTION PROGRAM Check box that applies to party completing program: ( ( x ) General Contractor Subcontractor I. Section A to be completed by GENERAL CONTRACTORS only: A. Name of Company Peterson Contractors, Inc. Address of Company 104 Black Hawk St. Reinbeck, IA Zip 50669 Telephone Number ( 319 ) 415-5212 Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number) 42-0921654 Name of Project Titus Lift Station and Force Main Project Contract Number 975 Estimated Construction Work Dates 365 / 3-30-23 3-29-24 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 C. Remainder of program to be completed by party completing program, either Prime or Subcontractor 1 The Owners and/or Principals of your company: 1 Ethnic Name Address Position Sex Origin 2. Other Areas of Interest: If your company has branches or subsidiaries, or if your company is a branch or subsidiary of a parent organization, give the following information: Type of Name Address Affiliation Degree II. EMPLOYER'S POLICY (Please read carefully.) A. We, the undersigned, recognize that we are morally and legally committed to nondiscrimination in employment. Any person who applies for employment with our company will not be discriminated against because of race, color, creed, sex, national origin, economic status, age, mental or physical handicap. B. The employment policies and practices of the undersigned are to recruit and hire employees without discrimination, and to treat them equally with respect to compensation and opportunities for advancement, including training, upgrading, promotion, and transfer. However, we realize the inequities associated with employment training, upgrading, contracting and subcontracting for minorities and women and we will direct our efforts to correcting any deficiencies to the maximum extent possible. The same will be required of our SUBCONTRACTORS and suppliers. C. We submit this program to assure compliance with Executive Order 11246, as amended, and other subsequent orders that may pertain to equal employment opportunity and merit employment policies, fully realizing that our qualification and/or merit system should be evaluated and revised, if necessary. D. We agree to put forth the maximum effort to achieve full employment and utilization of capabilities and productivity of all our citizens without regard to race, creed, color, sex, national origin, economic status, age, and mental or physical handicap. E. will give training (Name of Company) and employment opportunities to local residents of Waterloo, Iowa, to the greatest extent feasible. III. AFFIRMATIVE ACTION A. recognizes that the (Name of Company) 2 effective application of a policy of merit employment involves more than just a policy statement, and (Name of Company) will, therefore, re-evaluate our Affirmative Action Program to ensure that equal employment opportunities are available on the basis of individual merit, and to actively encourage minorities, women and local residents to seek employment with our company on this basis. B. will undertake the (Name of Company) following six (6) steps to improve our Affirmative Action Program: 1. Minority Recruitment and Employment; 2. Local Recruitment and Employment; 3. Disabled Veteran and Vietnam Era Veteran Recruitment and Employment; 4. Handicapped Recruitment and Employment; 5. Female Recruitment and Employment; and 6. Training, Upgrading and Promotional Opportunities. C. will take (Name of Company) whatever steps are necessary to ensure that our total work force has adequate minority, female, and local representation. We will utilize the following methods in our recruitment attempts: 1. Local advertising media (newspapers, radio, TV); 2. Community organizations (churches, clubs, schools); 3. Public and private institutions in the area (UNI, Hawkeye Community College); 4. Job Service of Iowa; and 5. Other. D. will seek qualified minority, (Name of Company) female, and local group applicants for all job categories and will make asserted efforts to increase minority, female and group representation in occupations at the higher levels or skill and responsibility. E. All sources of employment used shall be aware that we are an Equal Employment Opportunity Employer. Labor organizations representing our employees will be notified of our Equal Employment Opportunity Policy and Affirmative Action Program. F Training, upgrading, promotion and transfer activities at all levels will be monitored to ensure that full consideration has been given to qualified minority, female, and local group employees. G. will encourage other (Name of Company) companies with whom we are associated and/or do business, to do the same and we will assist them in their efforts. H. has taken the following (Name of Company) Affirmative Action to ensure that minority, female, local contractors and/or suppliers were provided opportunities to negotiate and/or bid on this project: (if none, write "NONE") I. As a result of the above efforts, we have involved minority, female, and local contractors and/or suppliers in the following areas of subcontracting: (if none, write "NONE") 1. 2. J. will require approved (Name of Company) Affirmative Action Programs from all nonexempt contractors who propose to work on this project and will take whatever steps are necessary to ensure that non -minority contractors have adequate representation of minority, female and local persons in their total work force. K. In further accordance with rules and guidelines issued pursuant to Executive Order 11246 as amended, we establish the goals for our company, based on parity percentages supplied by the City, and we realize these goals will be reviewed on an annual basis. L. will keep records of (Name of Company) specific actions relative to recruitment, employment, training, upgrading and promotion and will provide the City of Waterloo with any information relative to same, including activities of our SUBCONTRACTORS and suppliers as necessary or when requested. N. Parity figures for companies located in Waterloo are as follows: Minority Parity = .08 (8%) Affirmative Action (Name of Company) Employment Goals: The definition of Affirmative Action Goals is as follows: "Goals may not be rigid and inflexible quotas which must be met, but must be targets, reasonably attainable by means of applying every good faith effort to make all aspects of the entire Affirmative Action Program work." For the year 201_, please submit percentage targets for employing minorities and women If you already have reached your target for hiring minorities and women, please submit that percentage. *Goals for Minorities: Goals for Women: % % *Your affirmative action goals should be between 1 % and 10% or more for minorities and 1 % and 5% or more for women. Please be advised that the goals or targets are purely your estimation of how many women and minorities your company can reasonably expect to hire in 201 _. Note, that none of the goals are rigid or inflexible. They are targets that your company calculates as reasonably attainable. This will help the City in its monitoring procedures as required by City of Waterloo Resolution No. 1984-142(4). CONTRACTOR'S TOTAL WORK FORCE (WATERLOO) NAME AND ADDRESS JOB CATEGORY RACE SEX HOURLY WAGE INDICATE: DISABLED VETERAN: DV VIETNAM ERA VETERAN: VV HANDICAPPED: H 5 We hereby certify that we are in compliance with all City and Federal Affirmative Action Regulations and agree to accept all liability for failure to comply. Respectfully submitted, By: Company Executive 12-14-23 Date By: Equal Employment Opportunity Officer Date City of Waterloo Affirmative Action Officer Approved Disapproved Reason: By: Date: DESCRIPTION OF JOB CATEGORIES 1 Officials/Manager: Occupations in which employees set broad policies, exercise overall responsibility for execution of all policies, or direct individual departments or special phases of the agency's operations or provide specialized consultation on a regional, district or area basis. Includes: department heads, bureau chiefs, division chiefs, directors, deputy directors, controllers, examiners, wardens, superintendents, unit supervisors, sheriffs, police and fire chiefs and inspectors and kindred workers. 2. Professionals: Occupations which require specialized and theoretical knowledge which is usually required through college training or thorough work experience and other training which provides comparable knowledge. Includes: personnel and labor relations workers, social workers, doctors, psychologists, registered nurses, economists, dietitians, lawyers, system analysts, accountants, engineers, employment and vocational rehabilitation counselors, teachers or instructors, police and fire captains and lieutenants and kindred workers. 3. Technicians: Occupations which require a combination of basic scientific or technical knowledge and manual skill which can be obtained through specialized post -secondary school education and through equivalent on-the-job training. Includes: computer programmers and operations, draftsmen, surveyors, licensed practical nurses, photographs, radio operators, technical illustrators, police and fire sergeants and kindred workers. 4. Office/Clerical: Workers are responsible for internal and external communication, recording and retrieval of data and/or information and other paper work required in an office. Includes: bookkeepers, messengers, office machine operators, clerk -typists, stenographers court transcribers, hearing reporters, statistical clerks, dispatchers, license distributors, payroll clerks and kindred workers 5. Skilled Craft Workers: Workers perform jobs which require special manual skill and a thorough and comprehensive knowledge of the processes involved in the work which is acquired through on-the-job training programs. Includes: Mechanics and repairman, electricians, heavy equipment operators, stationary engineers, skilled machine occupations, carpenters, compositors and typesetters and kindred workers. 6. Sales Workers: Occupations engaging wholly and primarily in direct selling. Includes: advertising agents and salesman, insurance agents and brokers, real estate agents and brokers, stock and bond salesmen, demonstrators, salesmen and sales clerks, grocery clerks and cashier checkers, and kindred workers. 7 Operatives (semi -skilled) Workers who operate machine or processing equipment or perform other factory -type duties of intermediate skill level which can be mastered in a few weeks and require only limited training. Includes: apprentices (auto mechanics), plumbers, building trades, metal working trades, bricklayers, carpenters, electricians, machinists, mechanics, printing trades, etc., operatives, attendants (auto service and parking), plasterers, chauffeurs, deliverymen and furnacemen, heaters (metal), laundry and dry cleaning operatives, milliners, mine operatives and laborers, motormen, oilers and greasers, (except auto painters), (except construction and maintenance), photographic process workers, stationary fireman, truck and tractor drivers, weavers, (textile), welders and flame cutters and kindred workers. 8. Laborers (unskilled): Workers in manual occupations which generally require no special training. Perform elementary duties that may be learned in few days and require the application of little or no independent judgment. Includes: garage laborers, car washers and greasers, gardeners (except farm) and groundskeepers, longshoremen, and stevedores, lumbermen, craftsmen and woodchoppers, laborers performing lifting, digging, mixing, loading and pulling operations and kindred workers. 7 9. Apprentices: Persons employed in a program including work training and related instruction to learn a trade or craft which is traditionally an apprenticeship, regardless of whether the program is registered with a Federal or State agency. 10. Trainees (on-the-job): Production. Persons in formal training for craftsmen when not trained under apprentice programs --operative laborer, and service occupations. White Collar. Persons engaged in formal training for clerical, managerial, professional, technical, sales, office and clerical occupations. 8 ITEMS OF POTENTIAL MBE/WBE PARTICIPATION NOTICE TO PROSPECTIVE BIDDERS: The following are items from the FY 2024 TITUS LIFT STATION AND FORCE MAIN NO. 975, project that have a potential for MBE/WBE Participation. This listing, however, is not intended to be all encompassing; to preclude MBE/WBE Contractors from bidding on any items of the Proposal as a Subcontractor or the entire Proposal as a Prime Contractor. ITEM BID DESCRIPTION UNIT EST. QTY 1 Mobilization LS 2 Control LS —Traffic 3 —Clearing and Grubbing LS 4 —Existing Pump Vault and Valve Vault Removal LS 5 Import Fill for Lift Station Site CY 6 Fill for Trench Removals CY —Import 7 Station Wet Well Valve Vault LS —Lift and 8 Equipment Building LS —Electrical 9 Electrical LS —Site 10 Stand -By Generator LS 11 Metering Manhole LS 12 Air Release Manhole LS 13 Retaining Wall LS 14 Removal of Ripable Rock CY 15 Foundation Rock TON 16 Trench Compaction Testing LS 17 Abandon and Plug 8-Inch Sanitary Sewer LF 18 Sanitary Sewer Force Main Testing LS 19 Cleaning, Inspection and Testing of Sanitary Sewer Gravity Mains LS 20 24-Inch Sanitary Sewer Gravity Main — Open Cut LF 21 24-Inch Sanitary Sewer Gravity Main — Directional Drilling LF 22 20-Inch Sanitary Sewer Gravity Main Ductile Iron — Open Cut LF 23 18-Inch Sanitary Sewer Gravity Main — Open Cut LF 24 10-Inch Sanitary Sewer Force Main — Directional Drilling LF 25 10-Inch Sanitary Sewer Force Main — Open Cut LF 26 8-Inch Sanitary Sewer Gravity Main — Open Cut LF 27 6-Inch Sanitary Sewer Gravity Main Ductile Iron — Open Cut LF 28 30-Inch Steel Casing, With 18-Inch Sanitary Sewer Gravity Main LF 29 20-Inch Steel Casing, With 10-Inch Sanitary Sewer Force Main LF 30 Force Main Fittings LBS 31 48-Inch Manhole Replacement EA 32 72-Inch Manhole Replacement EA 33 48-Inch Manhole EA 34 24-Inch Circular Area Intake — SW-512, With SW-604, Type 3B EA 35 Connection to Existing Sanitary Manhole EA 36 8-Inch Drop Connection EA 37 24-Inch RCP Storm Sewer LF 38 24-Inch RCP Apron EA MBE/WBE PARTICIPATION AECOM 460590223 CONTRACT NO. 975 M-1 of 7 FY 2024 TITUS LIFT STATION AND FORCE MAIN ITEM BID DESCRIPTION UNIT EST. QTY 39 18-Inch RCP Storm Sewer LF 40 18-Inch RCP Apron EA 41 12-Inch RCP Storm Sewer LF 42 12-Inch RCP Apron EA 43 Drain Tile Replacement LF 44 6-Inch PCC Pavement SY 45 8-Inch PCC Pavement SY 46 SY 8-Inch HMA Pavement 47 Gravel Surfacing SY 48 Crushed Stone — Class "A" SY 49 Pavement Removal SY 50 Seeding, Mix Fertilizing and Mulching for Hydraulic Seeding — Type 1 Seed AC 51 Seeding, Mix Fertilizing and Mulching for Hydraulic Seeding — Type 2 Seed AC 52 Seeding, Mix Fertilizing and Mulching for Hydraulic Seeding — Type 4 Seed AC 53 Seeding, Mix Fertilizing and Mulching for Hydraulic Seeding — Type 5 Seed AC 54 Erosion Stone SY 55 Silt Fence LF 56 Temporary Rolled Erosion Control Products (RECP) SY 57 SWPPP Requirements LS 58 6-Foot Chain -Link Fence LF 59 24-Foot Chain -Link Gate EA MBE/WBE GOALS FOR THIS PROJECT IMPORTANT: Prime Contract Bidders should be aware that ten percent (10%) MBE goal and a two percent (2%) WBE goal is attached to this project "Certified Return Receipt" letters are no longer needed with the bid showing proof of contacting MBE or WBE Subcontractors, but the Pre -Bid Contact Information Form must be filled out completely. City of Waterloo Contract Compliance Officer: Contract Compliance Officer Community Development Board Carnegie Annex, Suite 202 620 Mulberry Street Waterloo, IA 50703 Phone: (319) 291-4429 MBE/WBE PARTICIPATION CONTRACT NO. 975 AECOM #60590223 M-2 of 7 FY 2024 TITUS LIFT STATION AND FORCE MAIN SUBCONTRACTOR'S BID REQUEST FORM PRIME BIDDER'S LETTERHEAD Contract No.: Letting Date: I, (subcontractor's name), hereby attest that I have been solicited for a bid on (project name) in the area of (description of work and bid item no.). (Prime contractor) has informed me that if I am interested in bidding, a subcontracting bid proposal must be submitted to the company office by (date) and (time). Subcontractor's Company Name Date Subcontractor's Signature Date Prime Bidder's Signature MBE/WBE PARTICIPATION CONTRACT NO. 975 AECOM 1160590223 M-3 of 7 FY 2024 TITUS LIFT STATION AND FORCE MAIN LETTER TO BE USED WHEN SOLICITING FOR SUBCONTRACTOR QUOTES Subcontractor Company Name Address RE: Contract No.: Dear : (Prime Contractor's Company Name) is presently soliciting for the following work in connection with the above referenced project. (Insert bid Item Nos. and Description of Work) (Prime Contractor's Company Name) is an Equal Opportunity Employer, and all qualified bidders will not be discriminated against due to race, religion, color, sex, or origin If interested in bidding your proposal must be turned in to this office by Date and (Time) Sincerely, (Prime Contractor's Representative) Form COO- 3 (11 /28/2001) MBE/WBE PARTICIPATION CONTRACT NO. 975 AECOM #60590223 M-4of7 FY 2024 TITUS LIFT STATION AND FORCE MAIN LETTER OF INTENT TO BID (MBE/WBE LETTER) According to the Current MBE/WBE Contract Compliance Program - 2002, all MBE/WBE Contractors interested in submitting subcontractor quotes on construction projects with goals, MUST submit a LETTER OF INTENT TO BID to the City of Waterloo Contract Compliance Officer at least seven (7) days prior to bid opening. The LETTER OF INTENT TO BID must list the specific items which the MBE/WBE Contractor is interested in bidding. Letter should include the following: Name of Project: fia15 1 St y 4 Cne.ti Nrnan Your Company Name: h4erscin Carcikectairs. rare Address: It 4 t (a,dt HcuAk 5* . Phone: Ltct 4l`5 52 (Z. Date: /2/ P1/23 List of Specific items to be bid: Item No. Description: Item No. Description: Item No. Description: Item No. Description: Item No. Description: (Subcontractor's Company Name and authorized signature) Return this LETTER OF INTENT TO BID to: Contract Compliance Officer Community Development Board 620 Mulberry St. Carnegie Annex, Suite 202 Waterloo, IA 50703 Phone: (319) 291-4429 Form CCO-5 (06-20-2002) MBE/WBE PARTICIPATION CONTRACT NO. 975 AECOM 460590223 M-5 of 7 FY 2024 TITUS LIFT STATION AND FORCE MAIN D� m� m m o13 D 73) (0 N) co n 0 z 9L6 ON ±OVH±NOO Form CCO-4A Rev. 07-08-02 o 0 3 m n) 0 m -0 --I -) (n O 0- 7C7 • (0 ® m =h iii o dO So - co al CI. 6' • n aDmo cuo O� m 03Cm 0(D3�o> 30o*nco cD o 5 co O- —I m tY)r*a mn:0 0 (D ala. • z o i]) o O a C) Tl (n CD 0 O B. 00 0 012•73vo) aQ cr0 D(n o (D (D O O (n ® '-''0Qo •_IC - I (D (D - -h p- Q0 ° U).a0 m ai Ocn o5c0*a 7j Cr O o (n 0- o . a x0 Q0 0 0 cn 0 v (D (O,D o 0- (D o n. m a `< o C) a) o ��'3�(n - U) 0 1CD CD (D 7n 0< (D CO co 0 0 0 0 F Q (D -h 0 — 0 0- o o n o (D % 0 c. 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(Qo oo�w (0 -di 3la 0 000' oo cp35• 5..- QQ 0-a) (D (n • 5' 0 7 O TO cD opeJwo3 awed o :sai;ffigisuo om 0 m oDcn (0 7) N i W_ -o 0 z SL6 'ON ±OVaLNO0 (Form CCO-4) Rev. 06-20-02 Tiedt Nursery Quotes DC Corporation 0 03 Ct Ca et0 m 11 0 0 F-1 N I N I H Dates Intacted H W I IV W W I N W K K (0 0 0 Received Quotation used in bid m I IV 1 1-1 0 a Dates Intacted H w 1 N w 1 IV W K K oN/saA $28,340.00 tri uoognS aq ;unowbr aeiioc a to co O Proposed to itracted v sseuisng 38M/E9W �n -< o .c o ra 0 (D 3 (D 0 a C 0(D o a. °o ° 0 1< cn,< 0 o a CT CT Cs - a •-* 0 -030 cn o a 0 •En. o a Q i) (D __,a moo CL3 w. L (D o a o a 0• t o a" Q - 0 v o o o O f 0 3 a O O' 0 � � (D 0 O(v a o a. 3 � o�' o --h a ✓ 3 3 ✓ o a5. a Ica cD1/4.‹ 0 0 a w O a) s fl 0 co ry m C�C m a0 m 0 co co O = ® 1/41 m c o mco (D mn cl' D c 0 I- W (0 O C) o,< 0 ri-O CO Z m-I a m(0 v' a- 11 r 0 o O n Ca hr o g rn 0 _< co rt. c v u .p0).a N 0- C (0 CD R. o a- `� o 0 0 a - a -1 C 0- o (7' IT (0 o • —I (1). 3 0 ch o o a ui c C 0 o o < ID c�= ,� cD o 0 3 • a) > O in O C (D •-t- 0 a 0 (0 o (0 3 o c o o- 5' 0 ca Contractor Signature: Estimator / Manager Date: £Z-VT-ZT Z 1 O 0 ovm N CO a rn c D o0 1/4< O a - --I o 0X 5-1 O 7J cacti v =fi ID c (1)(1)(D Z aO (D 3 5. ca Eta) o �m • m c 00 0 rri CO o m0 c -* CT o O O o o Zni 0- (D -a (D a' U) (D O C D O � oesi CT a) O- O �. 3CD Prime Contractor Name: Peterson Contractors, EZ-VT-ZT Co ca om zm -1 co Dc nu) 0m Ez �rn Oao 7J O� 7m CERTIFIED MBE CONTRACTORS CARTER ELECTRIC 725 Adams Street Waterloo, IA 50703 Phone: (319) 232-9808 Pager: (319) 235-4021 Contact: Derrick Carter Specializing in: ELECTRICAL CONTRACTOR DANIELS HOME IMPROVEMENT 339 Albany Street Waterloo, IA 50703 Phone: (319) 961-1659 Contact: Sammy Daniels Specializing in: ALL TYPES OF CONCRETE FLATWORK, POURED WALLS ALL TYPES, FOOTINGS, LIGHT DEMOLITION D.C. CORPORATION 426 Beech Street Waterloo, IA 50703 Phone: (319) 493-2542 FAX: (319) 236-0515 Contact: Terry Phillips Certified: City of Waterloo Certified MBE, TSB Certified Specializing in: COMMERCIAL AND RESIDENTIAL DEMOLITION, CONCRETE PAVING, DRIVEWAYS, TRUCKING (ALL TYPES), GENERAL CONSTRUCTION QUICK CONSTRUCTION 217 Bates Street Waterloo, IA 50703 Phone: (319) 215-4166 Contact: Leroy Harrington Specializing in: ALL TYPES OF CONCRETE FLATWORK AND GENERAL CONSTRUCTION Updated 4-11-2022 E. CASTRO ROOFING 702 Riehl Street Waterloo, IA 50701 Phone: (319) 215-5683 Contact: Emillio Castro Specializing in: ROOFING, SIDING, GENERAL CONSTRUCTION JASON'S INDOOR AND OUTDOOR 700 Bishop Avenue Waterloo, IA 50707 Phone: (908) 675-7725 Contact: Jason Burt Specializing in: GENERAL CONSTRUCTION CERTIFIED WBE CONTRACTORS * DENOTES WOMEN BUSINESS ENTERPRISE Rudy D. Jones, Community Development Director Contract Compliance Office Community Development Board Carnegie Annex, Suite 202 620 Mulberry Street Waterloo, Iowa 50703 319-291-4429 phone 319-291-4431 fax orici auii Updated 4-11-2022 STATEMENT OF BIDDER'S QUALIFICATIONS (To be submitted by the Bidder only upon the specific request of the City of Waterloo, Iowa.) All questions must be answered, and the date given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit any additional information he desires. 1. Name of bidder. 2. Permanent main office address. 3. When organized. 4. If a corporation, when incorporated. 5. How many years have you been engaged in the contracting business under your present firm or trade name? 6. Contracts on hand: (Schedule these, showing amount of each contract and the appropriate anticipated dates of completion.) 7. General character of work performed by your company. 8. Have you ever failed to complete any work awarded to you? If so, where and why? 9. Have you ever defaulted on a contract? If so, where and why? 10. List the more important projects recently completed by your company, stating the approximate cost for each, and the month and year completed. 11. List your major equipment available for this contract. 12. Experience in construction work similar in importance to this project. 13. Background and experience of the principal members of your organization, including the officers. 14. Credit available: $ 15. Give bank reference: 16. Will you, upon request, fill out a detailed financial statement and furnish any other information that may be required by the City of Waterloo, Iowa? STATEMENT OF BIDDER'S QUALIFICATIONS CONTRACT NO. 975 AECOM #60590223 SBQ-1 of 2 FY 2024 TITUS LIFT STATION AND FORCE MAIN 17. The undersigned hereby authorizes and requests any person, firm, or corporation to furnish any information requested by the City of Waterloo, Iowa, in verification of the recitals comprising this Statement of Bidder's Qualifications. State of Dated at , this day of , 2022. County of ) ) ss: ) (Name of Bidder) By: Title: , being duly sworn deposes and says that he is of . (Name of Organization) and that the answers to the foregoing questions and all statements therein contained are true and correct. Subscribed and sworn to before me this day of , 2022. Notary Public My commission expires , STATEMENT OF BIDDER'S QUALIFICATIONS CONTRACT NO. 975 AECOM #60590223 SBQ-2 of 2 FY 2024 TITUS LIFT STATION AND FORCE MAIN PETERSON CONTRACTORS, INC. www.petersoncontractors.com 104 Blackhawk Street P.O. Box A Reinbeck, Iowa 50669 Phone: 319-345-2713 Fax: 319-345-2991 PROPOSAL FOR: FY 2024 Titus Lift Station & Force Main ITEM # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 17 18 19 20 21 22 23 24 25 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 DESCRIPTION MOB Traffic Control Clearing & Grubbing Existing Pump Building Pump Vault and Valve Import Fill for Lift Station Site Import Fill for Trench Removals Import Topsoil Lift Station Wet Well and Valve Vault Electrical Equipment Building Site Electrical Metering Manhole Air Release Manhole at Titus Lift Station Air Release Manhole 48" Manhole Stand-by Generator - Titus Unclassified Material (Removal of Rappable Rc Rock Excavation Foundation Rock Trench Compaction Testing Abandon & Plug 12" Santiary Sewer Sanitary Sewer Force Main Testing Cleaning Inspection and Testing of the Sanitary 18" Sanitary Sewer Gravity Main - Open Cut 12" Sanitary Sewer Force Main - Directional Dr 12"Sanitary Sewer Force Main - Open Cut 8"Sanitary Sewer Gravity Main DIP - Open Cut 4"Steel Casing Pipe with 2" PVC Communicatio 24" Steel Casing with 12" Sanitary Sewer Force Force Main Fittings Connection to Existing Sanitary Manhole Water Service Trenched Copper 1" Integral Re 6" PCC Paving Gravel Surfacing Crushed Stone - Class A Type 1 Hydraulic Seed Fert & Mulch Type 2 Hydraulic Seed Fert & Mulch Type 4 Hydraulic Seed Fert & Mulch Type 5 Hydraulic Seed Fert & Mulch Silt Fence SWPPP Requirements 6' Chain Link Fence 16' Chain Link Gate Force Main Warning Sign UNIT TYPE LS LS LS LS CY CY CY LS LS LS LS EA EA EA LS CY CY TN LS LF LS LS LF LF LF LF LF LF LBS EA LF SY SY SY AC AC AC AC LF LS LF EA EA QUANTITY 1.000 1.000 1.000 1.000 250.000 1,500.000 2,420.000 1.000 1.000 1.000 1.000 1.000 5.000 2.000 1.000 500.000 500.000 150.000 1.000 290.000 1.000 1.000 232.800 7,340.800 653.600 55.000 322.700 392.900 3,875.000 2.000 95.000 715.600 125.100 715.600 1.900 1.900 1.100 1.100 2,900.000 1.000 360.300 2.000 5.000 UNIT PRICE $550,000.00 $35,000.00 $200,000.00 $50,000.00 $25.00 $15.00 $25.00 $1,900,000.00 $400,000.00 $225,000.00 $100,000.00 $175,000.00 $50,000.00 $60,000.00 $200,000.00 $75.00 $150.00 $75.00 $20,000.00 $30.00 $60,000.00 $5,000.00 $750.00 $150.00 $170.00 $300.00 $500.00 $760.00 $10.00 $12,500.00 $175.00 $80.00 $15.00 $12.50 $5,000.00 $4,000.00 $3,000.00 $3,000.00 $3.00 $5,000.00 $50.00 $1,750.00 $500.00 TOTAL AMOUNT $550,000.00 $35,000.00 $200,000.00 $50,000.00 $6,250.00 $22,500.00 $60,500.00 $1,900,000.00 $400,000.00 $225,000.00 $100,000.00 $175,000.00 $250,000.00 $120,000.00 $200,000.00 $37,500.00 $75,000.00 $11,250.00 $20,000.00 $8,700.00 $60,000.00 $5,000.00 $174,600.00 $1,101,120.00 $111,112.00 $16,500.00 $161,350.00 $298,604.00 $38,750.00 $25,000.00 $16,625.00 $57,248.00 $1,876.50 $8,945.00 $9,500.00 $7,600.00 $3,300.00 $3,300.00 $8,700.00 $5,000.00 $18,015.00 $3,500.00 $2,500.00 TOTAL QUOTED AMOUNT $6,584,845.50 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, Peterson Contractors, Inc. as Principal, and Travelers Casualty and Surety Company of America as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called "OWNER." In the penal sum Five Percent of the Total Amount Bid Dollars ($ 5% ) lawful money of the United States, for the payment of which sum will and truly be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. The condition of this obligation is such that whereas the Principal has submitted the accompanying bid dated the 7th day of December , 20 23 , for FY 2024 Titus Lift Station and Force Main, Contract No. 975, Waterloo, Iowa NOW, THEREFORE, (a) If said Bid shall be rejected, or in the alternate, (b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the form specified and shall furnish a bond for his faithful performance of said contract, and for the payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the agreement created by the acceptance of said Bid, Then this obligation shall be void, otherwise the same shall remain in force and effect; it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. By virtue of statutory authority, the full amount of this bid bond shall be forfeited to the Owner in liquidation of damages sustained in the event that the Principal fails to execute the contract and provide the bond as provided in the specifications or by law. The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall be in no way impaired or affected by any extension of the time within which the Owner may accept such Bid or execute such contract; and said Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety, have hereunto set their hands and seals, and such of them as are corporations, have caused their corporate seals to be hereto affixed and these pres- ents to be signed by their proper officers this 20th day of November , A.D. 2023. Peterson Contractors, Inc. Witness W ness Jamie Giffo d BID BOND AECOM 1160590223 president Travelers Casualty and Surety Company of America (Seal) (Seal) a et• /1 • r. nne Crowner, Attorney -in -fact CONTRACT NO. 975 BB-1 of 1 FY 2024 TITUS LIFT STATION AND FORCE MAIN TRAVELERS 1 Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Anne Crowner of WAUKEE , Iowa , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April, 2021. State of Connecticut By: City of Hartford ss. On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission expires the 30th day of June, 2026 Robert L. Rane*tenior Vice President inr ��/Il/tb Anna P. Nowik, Notary Public � rf 1 . n11N� f. OF; LiG This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in - Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect. Dated this 20th day of November 2023 Kevin E. Hughes, Assistant Secretary To verify the authenticity of this Power of Attorney, please cal/ us at 1-800-421-3880. Please refer to the above -named Attorneys) -in -Fact and the details of the bond to which this Power of Attorney is attached.