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FORMI
17:
OF BID OR PROPOSAL
F.
F.Y. 2016 FITZWAY DRIVE AND GALACTIC DRIVE EXTENSIONS
CONTRACT NO. 896
CITY OF WATERLOO, IOWA
IRISE PROJECT NO. RM-8155(747)--9D-07
:
Honorable Mayor and City Council
Waterloo, Iowa
LGentlemen:
1. The undersigned, being a Corporation existing under the laws of the State of
, a Partnership consisting of the following partners:
/c' L-e Cc-1 s-94vc--v c,-. t (., )
1 , 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 VJ Engineering, Cedar Falls, Iowa, now on file in the office of the City Clerk,
City Hall, Waterloo, Iowa, hereby proposes to furnish ail supervision, technical
personnel, labor, materials, machinery, tools, appurtenances, equipment, and
services, including utility and transportation services required to construct and
complete this F.Y. 2016 Fitzway Drive and Galactic Drive Extension,
Contract 896, City of Waterloo, Iowa, all in accordance with the above-listed
documents and for the unit prices for work in place for the following items and
: quantities:
DIVISION I - IDOT ELIGIBLE ITEMS
BID ' IDOT ITEM DESCRIPTION UNIT EST. UNIT BID . TOTAL BID
ITEM, CODE QTY. PRICE PRICE
•
01 2115-0100000 MODIFIED SUBBASE, 6 IN. C.Y. 620 $ y6. $ x `>^9e
L EARTHEN BASE ,_.
S.Y. ca
02 2599-9999019 PREPARATION 3600 $ / $ 3.&°
03 2599-9999003 SUBGRADE REPAIR C.Y. 200 3 / 7 $ , yOo
PAVEMENT, STANDARD OR
SLIP FORM, P.C.C. CLASS C, S 93 $ /35i 76/4`"
04 2301-1032070 7 IN. W/SLOPED CURBING S.Y. 3227 _
TOPSOIL, STRIP, SALVAGE
05 2105-8425015 AND SPREAD C.Y. 1250 s `/ $ 5;Ue,k)
EXCAVATION, CLASS 10, `
[: 06 2102-2710070 ROADWAY&BORROW C.Y. 2000 S $ f OUA /
FORM OF BID PAGE 1 OF 5 PAGES
E.
BID I IDOT ITEM DESCRIPTION UNIT EST. UNIT BID ' TOTAL BID
ITEM CODE QTY. PRICE PRICE rj
COMPACTION W/MOISTURE �t , �j
07 2107-0875000 + DENSITY CONTROL C.Y. 1239 .$ $ 1,fs
RECREATIONAL TRAIL, 00 �;,
08 2511-0302500 P.G.C.,5 IN. S.Y._ 1033 $ 9 $ 9, 9-7 1
PEDESTRIAN RAMP, P.C.C, = '°
$ $
09 2511-7526006 6 IN. S.Y. 35 7 ,)I (.0 S j_.
10 2511-7526004 SIDEWALK, P.C.C.,4 IN. S.Y. 277 $ A -o $ 3) D 33 4I
11 2503-0114215 SEWER,STORM, 15 IN. RCP L.F. _ 674 $ ?) $ :7gj,3/�
APRON, RCP 15 IN. DIA., o��
12 2422-0360015 W/TIES EACH 1 $ - j .'i J $ g .V
13 2435-0250700 INTAKE, SW-507 EACH 4 $ 9 Ct.( $ a, 00 a
14 2435-0251000 INTAKE, SW-510 EACH 2 $ S-, C'(Y) . $ /0) Doe)
MANHOLE, STORM SEWER 'c;, 1
15 2435-0140200 SW-402,48 IN. EACH 2 $ :1_))0 (a$ )C�SU
SUBDRAIN, PERFORATED
PLASTIC,4 IN. W/POROUS (:-'` i
' 16 2502-8212204 BACKFILL L.F. 1641 Si/0 $ 17,9,
SUBDRAIN OUTLET, DS-303, j
17 2502-8220193 4 IN., W/RODENT GUARD EACH 9 $ /�/0 ' $ ger&
0,-, ,,,, -,:=-"<--
18 1 2599-9999005 DRAIN LINE TAP&COLLAR EACH 1 i5� $ 7
4 to
19 2602-0000020 SILT FENCE L.F. ! 2150 $ d . ' $ 9, 3 00 —
20 2599-9999009 WATTLES _ L.F. _ 1600 $ $ 3 , bOO '"
21 2601-3000000 STOP LOG STRUCTURE EACH 6 $ 9 /• 'I'e $ 5f/'
EROSION STONE,
�
22 2507-8029000 W/ENGINEERING FABRIC TONS 30 $ $ // 7yd '
SEEDING AND FERTILIZING c F`. I
23 2601-2636044 (URBAN) ACRE 1.5 $.2, 006 $ 3, 00 c.
24 2601-2634100 MULCHIING ACRE 1.5 $ .2 600`— $ :;/, 4� '
re, 5' '25 , 2599-9999001 TEMPORARY SEEDING ACRE 1 $ - , OSt' $ /J Os'G
26 2528-8445110 TRAFFIC CONTROL L.S. 1 $ : , 7te' $ 2, l"
TYPE A SIGNS, SHEET E,, c
27 2524-9325001 ALUMINUM S.F. 93 $ 7 $ ) � �
POSTS,TYPE A SIGNS, c:: ['I'
_ 28 2599-9999009 STEEL 2"TELSPAR L.F. 224 $ / $ , '��
PAVEMENT MARKINGS, $ 3� $.2,' .
29 2599-9999010 WHITE AND YELLOW L.S. 1
DETECTABLE WARNING/ r=._ i
30 2511-7528101 TRUNCATED DOME INSERT S.F. 160 $ 3 $ 4)
FORM OF BID PAGE 2 OF 5 PAGES
I
BID !DOT ITEM DESCRIPTION UNIT EST. UNIT BID TOTAL BID
ITEM CODE _ QTY. PRICE PRICE
31 2533-4980005 MOBILIZATION L.S. 1 s i/ UW .) $ Ij 006
1.. SWPPP IMPLEMENTATION 8 t,�
32 2599-9999010 MAINTENANCE L.S. 1 $ 9 00() — $ .) 060
>
F. 33 2599-9999005 LIGHT POLE FOUNDATION EACH 3 $ 9CJD ' $ : ',A'
34 2599-9999005 LIGHT POLE EACH 3 $ �� S $ 7 S oO
35 2599-9999010 LUMINAIRES -L.S. 1 $,� .- 06 $ - lb'
UNDERGROUND ELECTRIC '
r, 36 2625-0000200 LIGHT SERVICE L.S. $ 7 Tao s 7 7 'c
SUBTOTAL DIVISION I %w„,,Q_ a S $ 3 /
i00°06 ov
co e' `io- .�S 1)1-, .
gp
DIVISION II - IDOT INELIGIBLE ITEMS
I. SANITARY MANHOLE / f ��
37 2435-0600010 ADJUSTMENT, MINOR w EACH 2 $ % $
SANITARY MANHOLE
I. 38 2435-0600020 ADJUSTMENT, MAJOR EACH 1 �, _ $ >>
REMOVE EX. 6 IN. SANITARY 39 2504-0240036 SERVICE L.F. 20 $ /D $
SANITARY SEWER GRAVITY, 0,c, c
ti 40 2599-9999009 TRENCHED 8 IN.,TRUSS L.F. 110 $ S $ 6J0c�/
2-YEAR MAINTENANCE
41 2599-9999010 BOND L.S. 1 $ /0 Oct $ /4 Uec: c.c.)
SUBTOTAL DIVISION II $',.( "'C
L TOTAL BID (Division I + Division II) $ o r 06;104
63\ 114
L.
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.
L 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
I FORM OF BID PAGE 3 OF 5 PAGES
L
for signature, and start work within ten (10) days after "Notice to Proceed" is
issued.
4. Security in the sum of 5 `'t1
Dollars ($ ) in the form of L, <<;(
, is submitted herewith in accordance with the INSTRUCTIONS TO BIDDERS.
5. Attached hereto is a Non-Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Resident Bidder Certification.
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. Date
10. The apparent low Bidder shall submit a list of all Subcontractor(s) to be used
on this Project to the City of Waterloo by 4:00 p.m. within two business days
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
the subcontractors on "SUBCONTRACTOR REQUEST AND APPROVAL"
form to be provided 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 shall follow the contract provisions titled "TSB Affirmative Action
Responsibilities on Non-Federal Aid Project (Third-Party State-Assisted
Projects)".
'1 2. The bidder has filled in all blanks on this proposal. Those blanks not
applicable are marked "none" or"NA".
'l3. The bidder has attached all applicable forms.
FORM OF BID PAGE 4 OF 5 PAGES
14. 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.
l ..
I
ei,5t Ct i.,is 4((A-4 cc, Carp•
(Name of Bidder)) (Date)
BY: Title
Official Address: (Including Zip Code):
Ks;a, l 1 e T'd9
I.R.S. No. q 7 - 4/4 8-s'o?
t._
L
. FORM OF BID PAGE 5 OF 5 PAGES
F
[:-!i, NON-COLLUSION AFFIDAVIT OF PRIME BIDDER
State of -- )
)ss
t . County of,%7%c lc /-7k .i )
Y , being first duly sworn, deposes and says that
1. He is �t�Ovwidr, Partner,Officer, Representative, or Agent) , of 2,,4 e_
c• /.+roc-L,,, c-,-p , the Bidder that has submitted the attached Bid;
C..
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 arrant, 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
I: 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
I
affiant.
(Signed) ' -) e.;c�` ----
I . Title
� _'
Sub cribed and sworn to before me this ://'I 4"
Or 1 i ,201 • day of
Y\ -bct,
Ir.Q TitleC
r�
My commission expires ItCf fc. VA 1 5'� 01 1
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t,
r ems, MELODY KIEWIET
a % COMMISSION NUMBER 795197 ,
MY COMMISSION EXPIRES
/�1E March 15, 2019
•1
EQUAL OPPORTUNITY CLAUSE
(As provided in Executive Order No. 11246)
1 ‘
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.
EQUAL OPPORTUNITY CLAUSE PAGE 1 OF 2 PAGES
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, 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) '//G .
(Appropriate Official)
(Title)
(Date)
EQUAL OPPORTUNITY CLAUSE PAGE 2 OF 2 PAGES
RESIDENT BIDDER CERTIFICATION
CONTRACT NO: c,&
PROJECT NAME: /k -T. D Di
DATE OF LETTING: t/ - I - %t
To be a qualified resident bidder, the bidder shall be a person or
entity authorized to transact business in this state and having a t:..
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, I.:;
the more stringent definition is applicable as to bidders from that
state or foreign country.
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.
COMPANY NAME Goci t, ec-i4s
CORPORATE OFFICER
TITLE Q G-
DATE --(72 6 /6
•
Revised February 2003
CONTRACTOR'S OR SUBCONTRACTOR'S
4R S AFFIRMATIVE ACTION PROGRAM
Check box that applies to party completing program:
( % ) General Contractor
( ) Subcontractor
I. Section A to be completed by GENERAL CONTRACTORS only:
A.
[. Name of Company /vc),C cL, p
Address of Company?o /30,c ys f clue ../( }.w9Zip 6/6 (
Telephone Number ( -� I � ) 22 3 9-- C2 q(3
Federal ID Number(if no Federal ID Number, Owner/President's Social
Security Number)
( _ Name of Equal Employment Officer S-Iee)e. Goc
Name of Project 30/f D N
Project Contract Number cf'
Estimated Construction Work Dates / ' / 9-3o
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
- 1 -
C. Remainder of program to be completed by party completing program,
either Prime or Subcontractor.
1. The Owners and/or Principals of your company:
Ethnic
Name Address Position Sex Origin
,fie e_ p.Q, go/ c
•
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
11. 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
-2 -
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.
t.
E. C�:�t cf will give training
(Name of Company)
and employment opportunities to local residents of Waterloo, Iowa, to
the greatest extent feasible.
HI. AFFIRMATIVE ACTION
A. �U�� ����s�r�c�� ' recognizes that the
(Name of Company)
effective application of a policy of merit employment involves more than
just a policy statement, and Z,.LCy Cc.?
- (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. Zvege. cc,&,C11"rcA cc,s P. 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.
l: 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 advertisingmedia
m dta (newspapers, radio, TV);
2. Community organizations (churches, clubs, schools);
3. Public and private institutions in the area (UM, Hawkeye
Community College);
4. Job Service of Iowa; and
5. Other.
z - 3 -
L
D- • `c C0 s-itve.4-iz frt c e,y 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.
O. - L -'-c J c C c-Ut Cc-gyp - 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. " �'� t C i ��p 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")
1. C e,-1( t/(, c Dui J ct ,i`es
2. e"-t°t-d eci C c- pc4 S
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. ce'c c c rp. 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 focal persons in their total work
force.
-4 -
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
1 realize these goals will be reviewed on an annual basis.
i
L. c, c, C c �,j? will keep records of
(Name of Company)
[l• 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.
M. Parity figures for companies located in Waterloo are as follows:
o
Minority Parity = .08 (8/o)
N. C, L (Lci5 f yt C C'G
`�; ' p 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 201L, 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: / .t
*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 201L. 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).
F
( - 5 -
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CONTRACTOR'S TOTAL WORK FORCE
(WATERLOO)
HOURLY
NAME AND ADDRESS JOB CATEGORY RACE SEX WAGE
y
2 5#, liA tc../�o
flc ;*e ) /,�� /r oe r1/4/0--. tor 4,lh. f /'Ifs/C /7 G 6
c7Q /1) j ree tv,9tr�e
Ae,\4v p,c �Qr,�'t�v:� � c��. t rid/� ' 11. d
)a S 1 J J r/l'e. (dc,
LAiu 'P t-'k Hz_ /)3E/L ' '7 Ob
v20 N<-004S►, ( rc:fc
/'c,s,v r/SecrPlcr tL,h,`fe. ic4f,c'/r. S4�cv
She-� Lrcti- L
7330 1 v y✓e lye , 7�,Fs �C,� Gl��/t_ /tea`. .s/c r y
INDICATE: DISABLED VETERAN: DV
VIETNAM ERA VETERAN: VV
HANDICAPPED: H
-6 -
F
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: .4
Company Exe utive
Date
By:
Equal Employment
Opportunity Officer
Ei /7/ 0
Date
fCity of Waterloo Affirmative Action Officer
Approved
Disapproved Reason:
L<
By:
Date:
L.
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BID BOND
KNOW ALL MEN BY THESE PRESENTS,that we, Lodge Construction, Inc.
as Principal,and North American Specialty Insurance Company
as Surety are held and firmly bound unto the CITY OF WATERLOO _, Iowa,hereinafter called
"OWNER." in the penal sum Five Percent of 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 21st day of April
2016 ,for F.Y.2016 Fitzway Drive and Galactic Drive Extensions in the
City of Waterloo, Iowa-Contract No. 896
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 presents to be
signed by their proper officers this 14th day of April ,A.D.201 6
Lodge Construction, Inc. (Seat)
Principal r7�_
By Qom-.��
(Title)
re3j —- North, ican Special. r ce Company(Seal)
Wit17C?SS $Ural]/
dut.4.1..,e_k_t_
Witness Cindy l nnett Attofey-i ` a Dione R.Young
.t
•
NAS SURETY GROUP
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under
laws of the State of New Hampshire,and having its principal office in the City of Manchester,New Hampshire,and Washington International
Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of
Schaumburg,Illinois,each does hereby make,constitute and appoint:
JAY D.FREIERMUTH,CRAIG E.HANSEN,BRIAN M.DEIMERLY,SHIRLEY S.BARTENHAGEN,
CINDY BENNETT,ANNE CROWNER,TIM McCULLOH,STACY VENN,LACEY CRAMBLIT and DIONE R.YOUNG
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by
law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: FIFTY MILLION($50,000,000.00)DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on the 9th of May,2012:
"RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President,
the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached."
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\Q�ce0 !(Qy u+\atintntlutatn,/urr h••i.
.�1 �ypSlONgj
SEAL�`:$' ByaC2 g
2 _rn= Steven P.Anderson,Senior Vice President of Washington International Insurance Company SEAL F' tt-'=
gZ 1973 =c
: Qrui ` &Senior Vice President of North American Specialty Insurance Company __p: :m F.
dtr
Michael A.IItto Senior Vice President o_ ton International Insurance Company Agpn»utitiut0
&Senior Vice President of North American Specialty Insurance Company
IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their
official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 8th day of September ,2015
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois
County of Cook ss:
On this 8th day of September ,2015 before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito,
Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance
Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and
acknowledged said instrument to be the voluntary act and deed of their respective companies.
OFFICIAL SEAL
M KENNY �i l, t ,.
NOTARY PUBLIC,STATE OF IWNOIS M.Kenny,Notary Public
MY COMMISSION EXPIRES 12/04/2017
I, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington
International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North
American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect.
IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 14th day of April ,20 16 .
Jeffrey Goldberg,Vice President&Assistant Secretary of
Washington International Insurance Company&North American Specialty Insurance Company