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HomeMy WebLinkAboutK&W Electric - FAA AIP Project No. 3-19-0094-048 - Misc Lighting - 3.4.2024CONTRACT FOR MISCELLANEOUS LIGHTING REPLACEMENT FAA AIP 3-19-0094-048 AT THE WATERLOO REGIONAL AIRPORT WATERLOO, IOWA THIS AGREEMENT, made and entered into this 4th day of March 2024, by and between the Waterloo Regional Airport for the City of Waterloo, Black Hawk County, Iowa, hereinafter referred to as the "Owner" and K&W Electric Inc. a corporation organized and existing under the laws of the State of Iowa, hereinafter referred to as the "Contractor." WITNESSETH: That the Contractor for and in consideration of Forty -Six Thousand Seventy Four and No/100 Dollars ($46,074.00), based on the unit bid prices payable as set forth in the Specifications constituting a part of this Contract, hereby agrees to construct in accordance with the Plans, Specifications and Special Provisions therefore, and in the location designated on the Plans, the various items of work awarded said Contractor on the day of , 2024, as follows, being numbered one (1) through three (3) as shown in schedule of prices bid in the attached Proposal which is a part of this Contract. Said Specifications and Plans are hereby made a part of and the basis of this Agreement and atrue copy of said Plans and Specifications is now with the Waterloo Regional Airport in the office of the Director of Aviation, Waterloo, Iowa, under date of February 15, 2024. 1. That in consideration of the foregoing, the Owner hereby agrees to pay the Contractor promptly and according to the requirements of the Specifications, the amounts set forth, subject to the conditions as set forth in the Specifications. 2. That it is understood that the parties named herein are the only persons interested in this Contract and principals. 3. That the Contractor has examined the site of the proposed work, Specifications, Special Provisions and Contract Documents in order that he might become familiar with the character, quality, and quantity of the work to be performed, the materials to be furnished and the requirements of the Specifications, Special Provisions and Contract Documents. 4. It is hereby further agreed that any reference herein to the "Contract" shall include all "Contract Documents" for the Waterloo Regional Airport, FAA Project No. 3-19-0094-048 Miscellaneous Lighting Replacement and said "Contract Documents" are hereby made a part of this agreement as fully as if set out at length herein, and that this contract is limited to the items in the proposal as signed by the "Contractor" and included in the "Contract Documents." 6. That the Contractor shall not commence any work to be performed under this Contract until he has obtained from responsible insurance companies, all insurance required, as set forth in the General Provisions and that the Contractor shall maintain this insurance in full force and effect until the work to be performed under this Contract has been accepted by the Owner. 7. That the Contractor shall not start working on any alterations requiring a supplemental agreement until the agreement setting forth the adjusted price shall be executed by the Owner and the Contractor. 8. That the Contractor, at all times, shall observe and comply with all federal, state, territory or possession and local laws, codes, ordinances and regulations in any manner affecting the conduct of the work, and the Contractor and his surety shall indemnify and save harmless the Owner and all his officers, Engineer, agents and servants against claims or liability arising from or based on the violation of any such law, ordinance, deregulation, order or decree, whether by himself or his employees. FAA AIP #3-19-0094-048 C-1 Miscellaneous Lighting Replacement Contract Waterloo Regional Airport - 60675091 That it is further understood and agreed by the parties to this Contract that the above work shall be commenced within 10 days after "Instructions to Offerors' and shall be completed accoi ding to the terms of the entire contract by April 12, 2024. Failure to complete within the allotted time will result in assessment of liquidated damages in the amount of $500 00 per calendar day for each day in excess of the authorized contract time. 10. The Contractor and Owner under stand and agree that time is of essence for completion of the Work and that the Owner will suffer additional expense and financial loss if said work is not completed within the authorized Contract Time Furthermore, the Contractor and Owner recognize and understand the difficulty, delay, and expense in establishing the exact amount of actual financial loss and additional expense. Accordingly, in place of requiring such proof, the Contractor expressly agi ees to pay the Owner as liquidated damages the non -penal sum of $500.00 per day for each calendar day iequii ed in excess of the authorized Conti act Time for the overall contract. Furthermore, the Contractor understands and agrees that: a. the Owner has the right to deduct from any moneys due the Contractor, the amount of said liquidated damages. b. the Owner has the right to recover the amount of said liquidated damages from the Contractor, Surety, or both. 11. The Contractor understands and agrees that all certifications made by the Contractor within the Proposal shall apply under this Agreement as if fully rewritten herein. The Contractor further certifies the following: a. Certification of Eligibility (29 CFR Part 5.5) (1) By entering into this contt act, the Contractor certifies that neither he or she nor any person or firm who has an interest in the Contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1); (2) No part of this contract shall be subcontracted to any person of 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); (3) The penalty for making false statements is prescribed in the U.S. Criminal Code 18 U.S.C. b. Certification of Non -Segregated Facilities (41 CFR Part 60-1.8) The federally assisted construction Contractor certifies that it does not maintain or provide, for its employees, any segregated facilities at any of its establishments and that it does not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The Bidder certifies that it will not maintain or provide, for its employees, segregated facilities at any of its establishments and that it will not permit its employees to perform their services at any location under its control where segregated facilities are maintained. The Bidder agrees that a breach of this certification is a violation of the Equal Opportunity Clause, which is to be incorporated in the contract. As used in this certification, the term "segregated facilities' means any waiting rooms, work areas, restrooms, and washrooms, restaurants and other eating areas, timeclocks, locker Looms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment at eas, transportation and housing facilities provided for employees which are segregated on the basis of race, color, religion, or national origin because of habit, local custom, or any other reason. The Bidder agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontt acts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause and that it will retain such certifications in its files. 12. It is further understood that any action in court against the Contractor or sureties on his bond because of damage to property or individuals by said Contractor or his workmen, or because of the violation of any provisions of the Specifications, or on account of the failure of said Contractor to fully comply with these provisions, shall be brought in the District Court of the State of Iowa in and for Black Hawk County. 13. Second Party shall maintain all work done hereunder in good order for a period of 12 months from and after the date it is accepted by the Waterloo Regional Airport, City of Waterloo, Iowa, which maintenance shall be without FAA AIP #3-19-0094-048 C-2 Miscellaneous Lighting Replacement Contract Waterloo Regional Airport - 60675091 expense to First Party or the abutting property. In the event of the failure or default of Second Party to remedy any or all defects appearing in said work within a period of 12 months from the date of its acceptance by said Board and after having been given ten (10) days' notice so to do by registered letter deposited in the United States Post Office in said City, addressed to said Contractor at the address herein given, then First Party may proceed to remedy such defects and the cost and expenses thereof may be recovered from said Second Party by action brought in any court of competent jurisdiction, but such suit may be brought in the District Court of Black Hawk County, Iowa. IN WITNESS WHEREOF, the pantie ereto have set their hands for the purpose herein expressed to this and three other iviacn instruments of like tenor, as of the day of , 2024. By CITY OF W T RL niftily Que(� SIGNED Mayor ATTEST: 7(elley FeCchle SIONFD SIGNFG vo(ext*x City Clerk CONTRACTOR K&W Electric Inc. By Firm Name grica► beNt eS Signature P•-esictejLt 1121 Li+n,co(r..54. Witness 471)thale4Wenta/ Witness Title C'eeeemr ll , (s, .1.69' S 6413 Business Address FAA AIP #3-19-0094-048 C-3 Miscellaneous Lighting Replacement Contract Waterloo Regional Airport - 60675091 PAGE INTENTIONALLY LEFT BLANK FAA AIP #3-19-0094-048 C-4 Miscellaneous Lighting Replacement Contract Waterloo Regional Airport - 60675091 Revised Per Addendum No. 1 — 2/16/2024 PROPOSAL FORM FOR MISCELLANEOUS LIGHTING REPLACEMENT FAA AIP 3-19-0094-048 AT THE WATERLOO REGIONAL AIRPORT WATERLOO, IOWA Waterloo Regional Airport 2790 Livingston Lane Waterloo, IA 50703 Gentlemen: • 1. The undersigned, being xisting under the laws ofthe State of idW c, 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 the City Engineer of the City of Waterloo now on file in the office of the City Clerk, City Hall, Waterloo, Iowa, hereby proposes to firrnish all supervision, technical personnel, labor, materials, machinery, tools, appurtenances, equipment, and services, including utility and transportation services required to construct and complete this Miscellaneous Lighting Replacement -- FAA AIP 3-19-0094-048, all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: 2. The extent of the work involved in FAA 3-19-0094-048 Miscellaneous Lighting Replacement is as follows: a. SRE Building: Replace twenty-two (22) HID high -bay fixtures with LED high -bay fixtures. Replace two (2) fluorescent strip fixtures with LED strips. b. ARFF Building: Demolish existing ceiling and fluorescent fixtures. Provide nine (9) LED high -bay fixtures and luminaire receptacles. Connect LED lighting to existing branch circuitry. Existing circuitry may be utilized to the maximum extent practical. Provide one (1) fan box for future ceiling fan. c. Hangar 1 & 2: Replace forty (40) high -bay fixtures with LED high -bay fixtures. Provide luminaire receptacles for each fixture and connect into the existing branch circuitry. Existing circuitry may be utilized to the maximum extent practical. d. Add Alte-+fie-No. 1: In the SRE buildingrrefrlace lighting circuitry and Iu ' i tastes--f efn- Iack to panel. Ex i s4i+g een -m y-bc reused -to the max irnutwe: tent-pr-aetica 1. Replaceg . • .4 breakers feeding -the -lighting circuits: 3. The undersigned, in compliance with your Invitation for Bicls dated 2. 1.5 2'-i , hereby proposes to do the work called for in said Contract and Specifications and Addendum Nos. 1 and to furnish all materials, tools, labor and all appliances and appurtenances necessary for the said work at the following rates and prices: IAA All' 3-19-0094-048 P-I Miscellaneous Lighting Replacement AECOM Project 1160675091 waterloo Regional Airport - 60675091 Revised Per Addendum No. 1— 2/16/2024 ITEMIZED PROPOSAL WATERLOO REGIONAL AIRPORT WATERLOO, IOWA PROJECT: • MISCELLANEOUS LIGHTING REPLACEMENT FAA AIP PROJECT NO. 3-19-0094-048 ITEM DESCRIPTION UNIT ESTIMATED QUANTITY UNIT PRICE QUOTE TOTAL QUOTE PRICE NO. 1 SRE REPLACEMENT LED HIGH BAY _ LS 1.0 $ 1 °21 31a `� do $ I '2, sq2 2 ARFF REVISIONS CEILING AND LIGHT LS 1.0 $ %0 1D $ ID vd 1 3 REPLACEMENT HANGAR 1 & 2 LED LIGHTING LS 1.0 $ �,Al $ �,2,91t oo $ $ ,'Z ,2.2 , TOTAL BASE BID `% $ auo 0 Li oc I ALTERNATE NO. 1 4i SRE Ci i r1I RC I• T LS -h- S N/A $ N/A S N/A .. . 1 , T , . 4. The undersigned understands that the above quantities of work to be done are approximate only and are intended principally to serve as a guide in evaluating the bids. All quantities are subject to increase or decrease and are to be performed at the unit prices stipulated herein. 5. It is understood that the schedule of minimum wage rates, as established by the Secretary of Labor and included in the Specifications, are to govern on this project, and the undersigned certifies that he has examined this schedule of wage rates and that the prices bid are based on such established wage rates. 6. The bidder shall make good faith efforts, as defined in Appendix A of 49 CFR Part 26, Regulations of the Office of the Secretary of Transportation, to subcontract zero (0%) percent of the dollar value of the prime contract to small business concerns owned and controlled by socially and economically disadvantaged individuals (DBE). Individuals who are rebuttably presumed to be socially and economically disadvantaged include women, Blacks, Hispanics, Native Americans, Asian -Pacific Americans, and Asian -Indian Americans. The apparent successful competitor Nvill be required to submit information concerning the DBE's that will participate in the contract. The information will include the name and address of each DBE, a description of the work to be performed by each named firm, and the dollar value of the contract. If the bidder fails to achieve the contract goal stated herein, it will be required to provide documentation demonstrating that it made good faith efforts in attempting to do so. In the event that the apparent successful competitor for this solicitation qualified as a DBE, the contract goal shall be deemed to have been met. A bid that fails to meet these requirements will be considered nonresponsive. 7. The undersigned certifies that he does not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The undersigned certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The undersigned agrees that a breach of this certification is a violation of the equal opportunity clause in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, or national origin, because of habit, local custom, or any other reason. The undersigned agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the equal opportunity clause, and that he will retain such certifications in his files. FAA AIP 3-19-0094-048 P-2 Miscellaneous Lighting Replacement A 'COM Project 1160675091 Waterloo Regional Airport - 60675091 The undersigned understands award of contract is contingent upon receipt of project funding from the Federal Aviation Administration. If funding is not received, the project will be postponed. 9. The undersigned finther agrees that if awarded the Contract, he will commence the work within ten (10) calendar days after the receipt of a "Notice to Proceed" and that he will substantially complete all work according to the terms of the entice contract by April 12, 2024. An extension of time may be allowed when extra or additional work is ordered by the Engineer, 10. The undersigned agrees that within 30 days after award of this contract, the Contractor/Subcontractor shall file a compliance report (Standard Form 100) if s/he has not submitted a complete compliance report within 12 months proceeding the date of award. This report is required if the Contractoi/Subcontractor meets all of the following conditions: a. Contractors/Subcontractors are not exempt based on 41 CFR 60-1,5. b. Has 50 or more employees. c. Is a prime contractor or first tier subcontractor. d. There is a contract, subcontract, or purchase order amounting to $50,000 or more. 11. To satisfy Clear Air and Water Pollution Control Requirements on all Construction Contracts and Subcont►acts exceeding $100,000.00 Contractors and Subcontractois agree: a. That any facility to be used in the performance of the Contract or to benefit from the Contract is not listed on the Environmental Protection Agency (EPA) List of Violating Facilities. b. To comply with all the requirements of Section 306 of the Clean Air Act (42 USC 1857(10), and Section 508 of the Clean Water Act (33 USC 1368), Executive Order 11738, and Environmental Piotection Regulations (40 CFR Part (15)). That as a condition for award of a Contract he shall notify the awarding official of the receipt of any communication from EPA indicating that a facility to be utilized for performance of of benefit from the Contract is under consideration to be listed on the EPA List of Violating Facilities. d. To include or cause to be included in any Contract or Subcontract which exceeds $100,000.00 the aforementioned criteria and requirements. 12. The contractor, by submission of this offer and/or execution of a contract, certifies that it: is not owned or controlled by one of more citizens or nationals of a foreign country included in Ole list of countries that discriminate against U.S. firms published by the Office of the United States trade Representative (USTR). b. has not knowingly entered into any contract or subcontract for this project with a contractor that is a citizen or national of a foreign country on saki list or is owned or controlled directly or indirectly by one or more citizens or nationals of a foreign country on said list has not procured any product nor subcontracted for the supply of any product for use on the project that is produced in a foreign country on said list. Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance with 49 CFR 30.17, no contract shall be awarded to a contractor or subcontractor who is unable to certify to the above. If the contractor knowingly procures or subcontracts for the supply of any product or sei vice of a foreign comity on the said list for use on the project the Federal Aviation Administration may direct, through the sponsor, cancellation of the contract at no cost to the Government. FAA AIP 3-19-0094-048 P-3 Miscellaneous Lighting Replacement AECOM Project #60675091 ‘Vatertoo Regional Airport - 60675091 Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will incorporate this provision for certification without modification in each contract and in all lower tier subcontracts. The contractor may rely upon the certification of a prospective subcontractor unless it has knowledge that the certification is erroneous, The contractor shall provide immediate Nwrittetr notice to the sponsor if the contractor learns that its certification or that of a subcontractor was erroneous when submitted or has become erroneous by reason of changed circumstances, The subcontractor agrees to provide iinmedielte written notice to the contractor, if at any time it learns that its certification was etroneous by reason of changed circumstances. This certification is a material representation of fact upon which reliance was placed when making the award. If it is latei determined that the contractor or subcontractor knowingly rendered an erroneous certification, the Federal Aviation Administintion may direct, through the sponsor, cancelleltion of the contract or subcontract for default at no cost to the Government. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by this provision. The knowledge and information of a contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. This certification concerns a matter within the jurisdiction of an agency of the United States of America and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code, Section 1001. 13. The bidder/offeror certifies, by submission of this proposal or acceptance of this contract, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. It further agrees by submitting this proposal that it will include this clause without modification in all lower tier transactions, solicitations, proposals, contracts, eltid subcontracts. Where the bidder/offer/contractor or any lower tier participant is unable to certify this statement, it shall attach an explanation to this solicitation/proposal. 14. 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), 15. 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). 16. The undersigned hereby declares that the only parties interested in this Proposal are named hetein, that this Proposal is made without collusion with any other person, firm, orcorpoiation, that no member of the Council, Waterloo Regional Airport or agent of the City of Waterloo, Iowa, is directly or indirectly financially interested in this bid. 17. Contractot certifies that all employees employed by Contractor or any subcontractor working on behalf of the Contractot are in compliance with the Immigration Reform Control Act of 1986 (IRCA) and indemnifies the Owner and holds harmless Owner for any violations of IRCA as a result of the Contractor's employees or his subcontractor's employees working an behalf of the Contractor on the Owner's project. 18. The undersigned certifies, to the best of his or her knowledge and belief, that: a. No Federal appropi iated funds shall be paid, by or on behalf of the Contractor, to any person for influencing of attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a member of Congress in Congress in connection with the making of any Federal grant and the amendment at modification of any Federal grant. b. If any funds other than Federal appropriated funds helve been paid or will be paid to any person for influencing or attempting to influence yin officer of employee of any agency, a member of Congress, an FAA AiP 3-19-0094-048 P-4 Mtseellaneous Lighting Replacement AECOM Project 1/60675091 Waterloo Regional Airport - 60675091 officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant the Contractor shall complete and submit Standard Form-LLL, "Disclosure of Lobby Activities", in accordance with its instructions. The Undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly, This certification is a mate' ial representation of fact upon which reliance was placed when this transaction was made of entered into. Submission of this certification is a prerequisite foi making or entering into this transaction imposed by Section 1352, Title 31 U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not mole than $200,000 foi each such failure. 19. BUY AMERICAN CERTIFICATE (Title 49 U.S.C. Chapter 501) As a condition of bid responsiveness, the bidder must how it intend to comply with the Buy American preferences established under Title 49 U.S.C. Section 50101. Bidder must complete the attached Buy American certification. If the bidder requests a permissible waiver to the Buy America iequitements, the Bidder identified as with the successful bid must submit a formal waiver request and component cost calculation within the prescribed time identified on the Buy America certification. 20. Drug Free Workplace, Act of 1988. a. By submission of this offer, the offeror, if other than an individual, who is making an offer that equals or exceeds $25,000 certifies and agrees tint with respect to all employees of the offeror to be employed under a contract resulting from this solicitation, it will --no later than 30 calendar days after contract award (unless a longer period is agreed to in writing, for contracts of 30 calendar days or more performance duration;) or as soon as possible for contracts of less than 30 calendar days performance duration, but in any case, by a date prior to when performance is expected to be completed-- (1) Publish a statement notifying such employees that the unlawful manufacturer, distribution, dispensing, possession, or use of a controlled substance is prohibited in the Contractor's woikplace and specifying the actions that will be taken against employees for violations of such prohibition. (2) Establish an on -going drug -free awareness program to inform such employees about -- (a) The dangers of ding abuse in the workplace. (b) The Contractors policy of maintaining a drug -free workplace. (c) Any available drug counseling, rehabilitation, and employee assistance programs; and (d) The penalties that may be imposed upon employees foi drug abuse violations occurring in the workplace, (3) Provide all employees engaged in performance of the contract with a copy of the statement required by subparagraph a. (1) of this provision. (4) Notify such employees in writing in the statement required by subparagraph a.(1) of this provision that, as a condition of continued employment on the contract resulting from this solicitation, the employee will -- (a) Abide by the terms of the statement; and (b) Notify the employer in writing of the employee's conviction under a criminal drug statute for a violation occurring in the workplace no later than 5 calendar days after suck conviction, (5) Notify the Contracting Officer in writing within 10 calendar days after receiving notice under subdivision a. (4) (b) of this provision, from an employee or otherwise receiving actual notice of such conviction The notice shall include the position title of the employee; and (6) Within 30 calendar days after receiving notice under subdivision a (4)(b) of this provision of a conviction, take one of the following actions with respect to any employee ‘N ho is convicted of a drug abuse violation occurring in the workplace FAA AiP 3-I9-0094.04E P-5 Ivliscellancous Lighting Replacement AECOM Proiect tl60675091 Waterloo Regional Airport - 60675091 (7) Take appropriate personnel action against such employee, up to and including termination; or Require such employee to satisfactorily participate in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State or local health, law enforcement, or other appropriate sigency. Make a good faith effort to maintain a drug -free workplace through implementation of subparagraphs a (I) through a. (6) of this provision b. By submission of its offer, the offeror, if an individual who is making an offer of any dollar value, certifies and agrees that other offeror will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in the performance of the contract resulting flout this solicitation. (a) (b) c. Failure of the offeror to provide the certification required by paragraphs a. or b, of this provision, renders the offeror unqualified and ineligible for award, [See FAR 9.I04-1(g) and 19.602-1a.(2)(a)]. d. In addition to other remedies available to the Government, the certification in paragraphs a. or b. of this provision concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the rnakei subject to prosecution uncle' title 18, United States Code, Section 1001. 21. Attachment to This Bid. The following documents are attached to and made a part of this Bid: a. Non -Collusion Affidavit of Prime Bidder. b. Statement of Intent Non -Discrimination and Equal Opportunity Statement. c. Buy American Certification Shitement, d. Synopsis of Experience Record, (IDOT Certification may be substituted.) e. Completed DBE forms "Utilization Statement' and "Letter of Intent." 22. The Bidder shall indicate whether the bid is submitted by a/an: ❑ Individual, Sole Proprietorship ❑ Pal tneiship Col potation ❑ Joint -venture: all parties must join -in and execute all documents ❑ Other Respectfully submitted, By Bidder �r 4AH• beVr- tS Signature residevs± Title I ‘ a i IJ it c o lfn. 54. Address C €DLr PAM S J .s * .570 & I 1 (Intl ide Zip Code) 314\-- 2-7 7 - oW /S Telephone No. FAA AIP 3-19-0094-048 P-6 Miscellaneous Lighting Replacement AECOM Project 860675091 waterloo Regional Airport - 60675091 NON -COLLUSION AFFIDAVIT OF PRIME BIDDER State of .i D W Dl. ) )ss County of 8(aC,\G. 44tAm)K ) B r i eA" De r i eS , being first duly sworn, deposes and says that: (1) He is (Owner, Partner(, Office Representative, or Agent) of Ic..c4- Eiee'%r j . Detc.. , the Bidder that has submitted the attached Bid: (2) He is fully informed respecting the preparation and contents of the attached bid and of all pertinent circumstances respecting such bid. (3) Such bid is genuine and is not a collusive or sham bid. (4) Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded conspired, connived or agi eed, directly or indirectly, with any other Bidder, fit m 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 indhectly, sought by agreement or collusion o1 communication or conference with any other Bidder, fit m or person to fix the price or prices in the attached bid or of any other Bidder, or, to fix any overhead, profit of 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 ate fair and proper and are not tainted by any collusion, conspiracy connivance, or unlawful agreement on the pat t of the Bidder or any of its agents representatives, owners, employees or parties in interest, including this affiant. Subscribed and sworn to before me this 5 t- day of FP✓innr r., , 20.XV Title My Commissionxpires / , 2V, JOANf' A M. onOWn ill i:'!ntocr 7(,C3.7 t ? taiy (Signed) Title Piss ! d ev-1- FAA ALP 3-19-0094-048 ACCOIvl Project 1160675091 P-7 Miscellaneous Lighting Replacement Waterloo Regional Airport - 60675091 NON -COLLUSION AFFIDAVIT OF SUBCONTRACTOR (To Be Submitted After Bid But Prior to Award) State of ) )ss County of ) being first duly sworn, deposes and says that: (1) He is (Owner, Partner, Officer, Representative, or Agent) of , the Bidder that has submitted the attached Bid: (2) He is fully informed respecting the preparation and contents of the attached bid and of' all pertinent circumstances respecting such bid. (3) Such bid is genuine and is not a collusive or sham bid. (4) Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant has in any way colluded conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham bid in connection with the Contract for which the attached bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or nxtir ectly, 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, piofit 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 rgreement any advantage against the City of Waterloo, Iowa, or any person interested in the proposed Contract; and (5) The price or prices quoted in the attached bid are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties in interest, including this affiant. Subscribed and sworn to before me (Signed) Title this day of , Title My Commission Expires , 20_. FAA All' 3-19-0094-048 P-8 Miscellaneous Lighting Replacement AI2COM Project 1160675091 Waterloo Regional Airport - 60675091 STATEMENT OF INTENT NONDISCRIMINATION AND EQUAL OPPORTUNITY STATEMENT The Contractor does hereby certify to the Waterloo Regional Airport, that no person shall, in any way, be favored or discriminated against because of his race, political or religious opinions and affiliations, national origins, sex, age, sexual orientation, gender identity, disability, color creed, maiital status, employee union or association membership or office herein, If selected as the successful bidder, this contractor hereby agrees to file either a nondiscrimination and equal opportunity statement and/or an Affirmative Action Program. lmprotements to the Waterloo Regional Airport consisting of Miscellaneous Lighting Replacement FAA AIP Project No. 3-19-0094-048 itid` It) cdrk.. re" C.. COMPANY EXECUTIVE OFFICER AFFIRMATIVE ACTION OFFICER ADDRESS OF THE AFFIRMATIVE ACTION OFFICER (la7 L?t..coI s±. Cee( 4. FaIis 1 � So&13 PHONE NUMBER 31 a1— .277 — /S' FAA AIP 3-19.0094•048 P-9 Miscellaneous Lighting Replacement AECOM Project 1160675091 Waterloo Regional Airport - 60675091 Name of Bidder SYNOPSIS OF EXPERIENCE RECORD (This synopsis must accompany Proposal Form.) lka-4J 61 ec4 ra'c tt&.c Business Address 1121 IS to 1,"•. 5+. Cecile v- Fd(s t TA- Soto 13 Individual ( ) Partnership ( ) Corporation] (Check One.) Construction successfully completed within past five years similar in size, scope, and difficulty of construction to the work bid upon. Name of Owner Name of Project I (kJ a`eti o-u 144 ‘opa,t' 1-6,,,c5 4,e- 03 LED 2 IVIC. 351 fitce(re7 l4v) L 61) Wo ret.oda e LED 4 4rn0 (.4 gliAre yv ly W Atoe (e ouf f LCD 5 kv4r Loa 4 Act S LunecsG LED 2 3 4 5 " Number of Contract Days Allowed for Above Projects 7 7 7 7 (Signed) (By) (TITLE) Date sc Location of Project W4,01-ram.-100 WoRkv10l L4 h•4ev-! b0 11.! 4. ib0 !gyp 4v/00 Actual Number of Days to Complete above Project O K. 44,-... @ .- Amount of Contract on '3/4):yar 477,370 31, +so 5/I250 Pam.- ; ••••••-•c_ 0 no- - I Nt t_ .l3ri�w D.eVr-yes' /res uetr Nance of Company FAA AIP 3-19-0094-048 AECOM Project N60675091 P-10 Miscellaneous Lighting Replacement Waterloo Regional Airport - 60675091 UTILIZATION STATEMENT Disadvantage Business Entef prise The undersigned bidder/offeror has satisfied the requirements of the bid specification in the following manner. (Please mai k the appropriate box) A The bidder/offeror is committed to a minimum of 0% DBE utilization on this cone act. © The bidder/offeror, while unable to meet the DBE goal of %, hereby commits to a minimum of % DBE utilization on this contract and also submits documentation, as an attachment demonstrating good faith efforts (GEE). The undersigned hereby further assures that the information included herein is true and correct, and that the DBE firm(s) listed herein have agreed to perform a commercially useful function in the work items noted for each firm. Tim undersigned further understands that no changes to this statement may be made without prior approval from the Civil Right Staff of the Federal Aviation Administration. k) ea rim .vtc, Bidder's/Offeres Finn Name Signature 7fnf2q Date DBE UTILIZATION SUMMARY Contract Amount DBE Amount Contract Percentage DBE Pi ime Contractor $ x 1.00 T $ D 0 % DBE Subcontractor x 1,00 = $ % DBE Supplier $ x 0.60 = $ % DBE Manufacturer $ x 1.00 = $ % Total Amount DBE DBE Goal $ 0 % Note: If the total proposed DBE participation is less than the established DBE goal, Bidder must provide written documentation of the good faith efforts as required by 49 CFR Part 26. FAA AlP 3-19-0094.048 AECOM Project tl60675091 P-11 Miscellaneous Lighting Replacement Waterloo Regional Airport - 60675091 LETTER OF INTENT Disadvantage Business Enterprise (Tins page shall be submitted for each DBE,frm) Bidder/Offer Name: Address: City: State: Zip: DBE Firm: DBE Contact Person: DBE Firm: Address: City: State: Zip: Name: Phone: ( ) DBE Certifying Agency: Expiration Date: Each DBE Finn shall submit evidence (such as a photocopy) of their certification status. Classification: Prime Contractor ❑Manufacturer ❑Subcontractor ❑Joint Venture ❑Supplier to Worts be performed DBE items) by Description of Wort em Quantity Total N // The bidder/offeror is committed to uhe ttGove-named DBE firm for the work described above. The estimated participation is as follows: DBE contract amount: $ Percent of total contract: % AFFIRMATION: The above -named DBE firm affirms that it will perform the portion of the contract for the estimated dollar value as stated above. By: (Signs[, re) egrC$ (Trite) Note: In the event the bidder/offeror does not receive award of the prime contract, any and all representations in this Letter of Intent and Affirmation shall be null and void. FAA AIP 3-19-0094-048 P-I2 Miscellaneous Lighting Replacement AECOM Project 1160675091 waterloo Regional Airport - 60675091 BUY AMERICAN CERTIFICATION FORM FOR TOTAL FACILITY (Building projects such as Terminal, SRE, ARFF, etc.) As a matter of bid responsiveness, the Bidder or Offeror must complete, sign, date, and submit this certification statement with their proposal. The Bidder or Offeror must indicate how they intend to comply with 49 USC § 50101 by selecting one of the following certification statements These statements are mutually exclusive. Bidder must select one or the other (i.e. not both) by inserting a checkmark (✓) or the letter "X". The Bidder or Offeror hereby certifies that it will comply with 49 USC. 50101 by: a) Only installing steel and manufactured products produced in the United States, or; b) Installing manufactured products for which the FAA has issued a waiver as indicated by inclusion on the current FAA Nationwide Buy American Waivers Issued listing, or; c) Installing products listed as an Excepted Article, Material or Supply in Federal Acquisition Regulation Subpart 25.108. By selecting this certification statement, the Bidder or Offeror agrees: 1. To provide to the Owner evidence that documents the source and origin of the steel and manufactured product. 2. To faithfully comply with providing US domestic products. 3. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. ❑ The Bidder or Offeror hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC § 50101(a) but may qualify for either a Type III or Type IV waiver under 49 USC § 50101(b). By selecting this certification statement, the apparent Bidder or Offeror with the apparent low bid agrees: 1. To the submit to the Owner within 15 calendar days of the bid opening, a formal waiver request and required documentation that support the type of waiver being requested. 2. That failure to submit the required documentation within the specified timeframe is cause for a non -responsive determination may results in rejection of the proposal. 3. To faithfully comply with providing US domestic products at or above the approved US domestic content percentage as approved by the FAA. 4. To furnish US domestic product for any waiver request that the FAA rejects. 5. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. Required Documentation Type III Waiver - The cost of components and subcomponents produced in the United States is more that 60% of the cost of all components and subcomponents of the "facility". The required documentation for a Type III waiver is: a► Listing of all manufactured products that are not comprised of 100% US domestic content (Excludes products listed on the FAA Nationwide Buy American Waivers Issued listing and products excluded by Federal Acquisition Regulation Subpart 25.108; products of unknown origin must be considered as non -domestic products in their entirety) b) Cost of non -domestic components and subcomponents, excluding labor costs associated with final assembly and installation at project location. FAA MP 3-19-0094-045 P-13 Miscellaneous Lighting Replacement AECOM Project P60675091 Waterloo Regional Airport - 60675091 c) Percentage of non -domestic component and subcomponent cost as compared to total "facility" component and subcomponent costs, excluding labor costs associated with final assembly and installation at project location. Type IV Waiver Total cost of project using US domestic source product exceeds the total project cost using non -domestic product by 25%. The required documentation for a Type IV of waiver is: a) Detailed cost information for total project using US domestic product b) Detailed cost information for total project using non -domestic product. False Statements: Per 49 USC § 47126, this certification concerns a matter within the jurisdiction of the Federal Aviation Administration and the making of a false, fictitious or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code, 0/22 Date Signature {CdL) `ivr fires 1d ewi Company Name Title FAA MP 3-19-0094-048 P-14 Miscellaneous Lighting Replacement AECOM Project #60675091 Waterloo Regional Airport - 60675091