HomeMy WebLinkAboutChyma's Machine and Welding Shop, Inc.egs
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CITY OF WATERLOO
CITY CLERK'S OFFICE
JUN 23 2016 Pm- 2:05..E 6
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FORM OF BID OR PROPOSAL
FY 2016 LOWER PLAZA FENCING
CITY CONTRACT NO. 915
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1. The undersigned, being a Corporation exi t' g under the laws of the St.t of , .L a Partnership
consisting of the following partners: I if /, 1; / ; . " i [ 1'���� ��• g familiarized
(himself) (themselves) (itself) with the existin_ conditions on the project area a " ectin: 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 this FY 2016 LOWER
PLAZA FENCING, CITY CONTRACT NO. 915, all in accordance with the above -listed documents and
for the unit prices for work in place for the items and quantities shown on the following pages:
FY
2016
CITY
CITY
LOWER
OF
CONTRACT
WATERLOO,
PLAZA
NO.
FENCING
IOW
915
, 3F1r
Item
No.
Description
Unit
Unit
Price
Quantity
Total
Price
Bid
1
Cable
Steel
Guardrails,
Posts
With
Galvanized
LF
$
1
-
119.58
$'
i:511.1,
s9D
TOTAL
BID
AMOUNT
Si?
,'�X
Li,��=
2. It is understood that the quantities set forth are approximate only and subject to variation and that the unit bid
price for the work done shall govern in the actual payment to Contractor.
3. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa, to reject
any or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or delivered to the
undersigned within thirty (30) days after the opening thereof, or at any time thereafter before this bid is
withdrawn, the undersigned agrees to execute and deliver an agreement in the prescribed form and furnish the
required bond and certificate of the insurance within ten (10) days after the agreement is presented to him for
signature, and start work within ten (10) days after "Notice to Proceed" is issued. j)C 6
4. Security in the sum of I W Li/Lk eii t lt{- 4 L C` Q4 k & t.�..i� .� hu t[tj'ed Pl ',U/t/ R 1 Dollars
($ 23 1]; p . in the form of 1 4 djo d , is submtfted herewith in accordance
with the A* INSTRUCTIONS TO BIDDERS.
5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Resident Bidder Certification ( V' ), or Non -Resident Bidder Certification
( ). (Mark one.)
7. The bidder is prepared to submit a financial and experience statement upon request.
FORM OF BID
AECOM 60494736
CITY CONTRACT NO. 912 BF-1 of 2
�.. -• •.. .•{• ..•. •.v. •.•••.
8. The Prune 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. h Wee, Date n oh y/
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10. 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.
//IDS i{/��/���� ���,111h1 W71/y1/My /j/ chi, f; 023 �f�
(N. of Bidder) Date)
Title ) ner
Official Address: (Including Zip Code):
2.0(p 2- k 1 five , Tv ted°, (5-0134
I.R.S. No. LJ(, ' `'l e6 q /0 oQ
FORM OF BID
AECOM 60494736
CITY CONTRACT NO.9I2 BF-2 of 2
E'
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NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State ofaj et - )
)ss
County of
, being first duly swom, deposes and says that:
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1. He is (Owner . artner, Officer, Representative. or Agent) , ofebOwil /Zi%'ktLi
/ bid /ij, /4y2 the Bidder that has submitted attached Bid;Q« � � �i�G. the,
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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 interest, including this affiant.
(Signed)
re -\
Subscribed and sworn to before me this 23
My commission expires 6 /2-7 /2 o (1
NON -COLLUSION
AECOM 60494736
Title
, 2016.
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day of
JERIMI KOPSA
Commission Number 753451
MY COMM- 7NUiXp,IRES
CITY CONTRACT NO. 915 NCA-I of 2
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CONTRACT NO:
PROJECT NAME:
DATE OF LETTING:
RESIDENT BIDDER CERTIFICATION
9/5-
261(o L-6wcr t'Icua.
Jukte, r2S1ot alb
To be a qualified resident bidder, the bidder shall be a person or entity authorized to transact
business in this state and having a business for at least three years prior to the date of the first
advertisement for the public improvement. If another state or foreign country has a more stringent
definition of a resident bidder, the more stringent definition is applicable as to bidders from that
state or foreign country.
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This qualification as resident bidder shall be maintained by the contractor and his subcontractors at the work site
until this project is completed.
I hereby certify that I am a resident bidder as defined above.
RESIDENT BIDDER
AECOM 60494736
COMPANY NAMEOil/
! l`jSAehlh,0 akt V e I � in Sh t(
t`�
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vf/
CORPORATE OFFICER (hod etimit,
TITLE OW1/1
DATE (p-Q'3,2o/4'
CITY CONTRACT NO. 915 RB-2 of 3
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i‘jEQUAL OPPORTUNITY CLAUSE
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(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, pattems, 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.
EQUAL OPPORTUNITY
AECOM 60494736
CITY CONTRACT NO. 915 EOC-1 of 2
1
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, 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.
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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.
EQUAL OPPORTUNITY
AECOM 60494736
(Signed
(f opropriate Official)
OLOn el/
(Title)
(Date)
CITY CONTRACT NO. 915 EOC-2 of 2
\l..V17• C•tc1V/l•/°Mr..;Vie. •-••••.. .. ...• .. • .. .• .... ..•• •• ..•.
Bond No. SUR31000164
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Chyma's Machine and Welding Shop, Inc.*
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as Principal, and Ironshore Indemnity Inc., PO Box 3407, New York, NY 10008
as Surety are held and firmly bound unto the CITY OF WATERLOO. 715 Mulberry Street** , IOwa,
hereinafter called "OWNER," in the penal sum Five Percent (5%) of amount bid
Dollars ($ 5% of amount bid ) lawful money of the United States, for the payment of which
*206 2nd Ave, Toledo, IA 52342 **Waterloo, IA 50703
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 23rd day of June , 2016, for
FY 2016 Lower Plaza Fencing, Contract No. 915
Waterloo. IA
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 small 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 shalt 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
arc corporations, have caused their corporate seals to be hereto axed and these presents to be signed by their
proper officers this 21st day of June , A.D. 2016.
Chyma's Machine and Welding Shop, Inc. (Seal)
Principal
Itness
By
4 a) 4
7rn4 (U Ole/1tr
(Title)
Ironshore Indemnity Inc.
Surety
By
Witness Cal Anderson Ronald L. Kaihoi
BID BOND
AECOM 60494736
CITY CONTRACT NO. 915
Attorney-in-fac
(Seal)
ACKNOWLEDGMENT OF PRINCIPAL (Individual)
State of
County of
On this day of , in the year , before me
personally comes
to me known and known to me to be the perso ho is described in and executed the foregoing instrument, and
acknowledges to me that he/she executed the same.
State of
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Partnership)
County of
}
On this day of , in the year , before me
personally come(s)
a member of the co -partnership of
to me known and known to me to . e the person who is described in and executed the foregoing instrument, and
acknowledges to me that he/she executed the same as the act and deed of the said co -partnership.
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Corporation/LLC)
State of 101Am
County of 1 AMA
On this 2,3 day of 3ukk , in the year //Up , before me personally come(s)
ChM (fr,ymA , to me known, who being duly sworn, deposes and says that
he/she resides in the City of 'u_no that he/she is the CO - Q,,,,Nice_ of the
Ch yMA 5 MAC of 1\1 iWn We-LflM [, ShoP ; IPJ&
, the corporation described in and
which executed the foregoing instrument, and that he/she signed his/her name thereto by like order.
JERIMI KOPSA
Commission Number 753451
MY,COfy(vllSSIO,�Je)) IRE3
Public
No ary
POWER OF ATTORNEY
Ironshore Indemnity Inc.
III- 31000164
KNOW ALL MEN BY THESE PRESENTS, that IRONSHORE INDEMNITY INC., a Minnesota Corporation, with its principal office in New York, NY does
hereby constitute and appoint: Jack L. Anderson and Ronald L. Kaihoi its true and lawful Attorney(s)-In-Fact to make, execute, seal and deliver for, and
on its behalf as surety, any and all bonds, undertakings or other writings obligatory in nature of a bond.
This authority is made under and by the authority of a resolution which was passed by the Board of Directors of IRONSHORE INDEMNITY INC. on the
22nd day of April, 2013 as follows:
Resolved, that the Director of the Company is hereby authorized to appoint and empower any representative of the company or other person or
persons as Attorney -In -Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or other writings obligatory
in nature of a bond not to exceed $7,500,000 dollars, which the Company might execute through its duly elected officers, and affix the seal of the
Company thereto. Any said execution of such documents by an Attorney -In -Fact shall be as binding upon the Company as if they had been duly
executed and acknowledged by the regularly elected officers of the Company. Any Attorney -In -Fact, so appointed, may be removed for good cause and
the authority so granted may be revoked as specified in the Power of Attorney.
Resolved, that the signature of the Director and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the
signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or
certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certificate
so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and binding on the Company.
IN WITNESS THEREOF, IRONSHORE INDEMNITY INC. has caused this instrument to be signed by its Director, and its Corporate Seal to be affixed this
7th day of August, 2013
IRONSHORE INDEMNITY INC.
By
Dan ei 1. Suss
Director
ACKNOWLEDGEMENT
On this 7th Day of August, 2013, before me, personally came Daniel L. Sussman to me known, who being duly sworn, did depose and say that he is the
Director of Ironshore Indemnity, Inc. , the corporation described in and which executed the above instrument; that he executed said instrument on
behalf of the corporation by authority of his office under the By-laws of said corporation.
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AMJY TAYLO R
Ilolsry Punic- State of Tennessee
Davidson County
L1yCommission Expires 07.0E-19
BY
CERTIFICATE
I, the undersigned, Secretary of IRONSHORE INDEMNITY INC., a Minnesota Company, DO HEREBY CERTIFY that the original Power of Attorney of
which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in force.
Signed and Sealed at this 21st Day of June , 20 16
;fig 1�dy
'4 cP OR,,A•y`.
!', SEAL
1919 I
\. ' Souse': /
Paul S. GI dano
Secretary
"WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance or statement of claim
containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent
insurance act, which is a crime and subjects such person to criminal and civil penalties."
ACKNOWLEDGEMENT OF SURETY
STATE OF MINNESOTA
COUNTY OF CHIPPEWA
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On this 21 st day of June , 2016 , before me, a Notary Public within and for said
County, personally appeared Ronald L. Kaihoi to me personally known, who being by me duly
sworn he/she did say that he/she is the attorney -in -fact of Ironshore Indemnity Inc. , the
corporation named in the foregoing instrument, and the seal affixed to said instrument is the
corporation seal of said corporation, and sealed on behalf of said corporation by authority of its
Board of Directors and said Ronald L. Kaihoi acknowledged said instrument to be the free act
and deed of said corporation.
OTARYPUBLIC
My Commission Expires 14)-00
.t-:''\ REBECCA J. RIBA
i �.I'-t
�� Notary Public -Minnesota
,-;; My Commission Expires Jan 31, 2020
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