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{ FORM OF BID OR PROPOSAL
i FY 2016 FLOOD CONTROL GATEWELL REPAIRS
l CITY CONTRACT NO.895
CITY OF WATERLOO,IOWA
Honorable Mayor and City Council
Waterloo,Iowa
Gentlemen:
1. The undersigned, being a Corporation existing under the laws of the State of It'1.dPr ,a Partnership
1 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
[-f 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 FLOOD
CONTROL GATEWELL REPAIRS,CITY CONTRACT NO.895,all in accordance with the above-Iisted
documents and for the unit prices for work in place for the following items and quantities:
FY 2016 FLOOD CONTROL GATEWELL REPAIRS
CITY CONTRACT NO.895
BID UNIT BID
ITEM DESCRIPTION UNIT EST.QTY. PRICE TOTAL BID PRICE
1 Gatewell M LS 1.0 $ ,• 6 $ 7 ` woo
2 Gatewell P LS 1.0 $ j.`01/' oC $ Ica, /g(' .cC)
f 3 Traffic Control LS 1.0 $ LI,SZc c: $ Z 5,00
4 Granular Surfacing on Road TONS 250.0 $ - $ e 616. CO ./
TOTAL BASE BID AND ALTERNATE BID S 4/Pi, 5 5=0 '
—�,/ r
L 1
2. It is understood that the quantities set forth are approximate only and subject to variation and that the unit bid
i .
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withdrawn,the undersigned agrees to execute and deliver an agreement in the prescribed form and furnish the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
t: signature,and start work within ten(10)days after"Notice to Proceed" is issued.
4. Security in the sum of t1 Dollars
($ )in the form of in lam' ' , is submitted herewith in
11.
accordance with the INSTRUCTIONS TO BIDDERS.
5. Attached hereto is a Non-Collusion Affidavit of Prime Contractor.
I
FORM OF BID CITY CONTRACT NO.895 BF-I oft
AECOM 60441314
r
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.
8. The Prime Contractor and Subcontractor(s),which have performed an aggregate of$10,000.00 in work for the
City in the current calendar year,are prepared to submit an AAP or Update and an EOC,within ten(10)days
of notification that the bid submitted is lowest and acceptable.
9. The bidder has received the following Addendum or Addenda: !:-
Addendum No. 1.. Date Z--g"/�a
10. The bidder shall list the MBE/WBE subcontractor(s), amount of subcontracts and bid items on the City of
Waterloo Minority and/or Women Business Pre-bid Contact Information Form submitted with this Form of
Bid or Proposal. The apparent low Bidder shall submit a list of all other Subcontractor(s)to be used on this
Project to the City of Waterloo by 5:00 p.m.the business day following the day Bids on this Project are due
along with the Non-Collusion Affidavits of All Subcontractor(s).
The Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND
I
APPROVAL"Form to be provided by City prior to approval of contract.
The subcontractors Iisted on this proposal and/or submitted to the Contract Compliance Officer cannot be
changed except for the following reasons:
I) 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.
s ems"(. Eg � V..,07 0! 1 0r--S t /A-)1..- 3 (.87Z,4.)/6 ..
(Aiff
ame of Bidder) (Date)
BY: L7OI/ Title 6.- .7/- 1�/04
Official Address: (Including Zip Code):
®. ' 3x ;fir
I.R.S.No. 442-0(? 16.5-171
FORM OF BID CITY CONTRACT NO.895 BF-2 of 2
AECOM 60441314
1
NON-COLLUSION AFFIDAVIT OF PRIME BIDDER
1 State of 10 Lk A )
County of G i U NJ I) )Ss
ICaleb ,1 L.9 0 I ,being first duly sworn,deposes and says that:
1. He is (Owner,Partner,Officer,gpresentatives r Agent) ,of P r5o 11
(;O'ftraC1-vr5 .1.. )C. ,the Bidder that has submitted the attached Bid;
i
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
i'• 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 idder or any of its agents,representatives,
owners,employees,or parties in interest,including,thi ant.
(Signed)
'rD?Ct Marla jerI f5-tirvl(v6/2
Title
� �
Subscribed and sworn to before me this 1 7 day of
T;t1.21((JIGU{'1lf ,2016
/ K SO a lu -fy f i Sf sl eaW&-er
Title
/...
My commission expires 1 I-1 Jjc -
:° Commissio
< < F JENNIFERn RNumber 76.LOCKHART129 2 A
My Commission Expire
oW January 4,201 c ,....
I.
I
{ .
NON-COLLUSION CITY CONTRACT NO.895 NCA-I of2
i
AECOM 60441314
RESIDENT BIDDER CERTIFICATION
CONTRACT NO: -5-
PROJECT NAME: f 1907 d .r1 C9-TQ Gz— i
riCS
DATE OF LETTING: `Z.6l7Zp/,6
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.
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
CORPORATE OFFICE'
ar
\UMW --"""ffillikk
TITLE
DATE 2/1/(o
RESIDENT BIDDER CITY CONTRACT NO.895 RB-2 of 3
AECOM 60441314
?3
`p MBE/WBE BUSINESS ENTERPRISE
►1.,,t?%/ PRE-BID CONTACT INFORMATIION FORM
Prime Contractor Nam ,Ej -� F Project i4//,'.- OY Letting Date: OV;e/(-
,..
NO MBE/WBE SUBC NTRACTORS:if you are NOT using any MBE/WBE subcontractors to complete this project,sign below.Attach a brief explanation
as to why subcontracting was n w. this project.If any MBE/WBE su ntractors will be used, lease use the bottom portion of this form.
Contractor Signature: Title: . -‘..-- ate: Z/ r�3
SUBCONTRAC RS APPLICA E:You are required,in order for your id to be considered responsive,to provide the information n6 this form showing
ALL of your MBE/WBE subcont ctor contacts made for your bid submission.This information is subject to verification.Any questions should be directed to
• Contract Compliance Office 319-291-4429.
r You are required,in order for your bid to be considered responsive,to provide the information on this Form showing your MBE/WBE Business Enterprise
contacts made prior to your bid submission.This information is subject to verifications and confirmation.
If you are unable to identify MBE/WBE firms to perform portions of the work,please contact Louis Starks,Contract Compliance Officer,for assistance at(319)
291-4429.
• In the event it is determined that the MBE/WBE Business Enterprise goals are not met,then before awarding the contract the City of Waterloo will make a
determination as to whether or not the apparent successful low bidder made good faith efforts to meet the goals.
TABLE OF INFORMATION SHOWING BIDDER'S PRE-BID
MBE/WBE BUSINESS ENTERPRISE CONTACTS
Quotes Received Quotation used in bid
MBE/WBE Dates Yes/No Dates Yes/No Dollar Amount Proposed to
Subcontractors Contacted Contacted be Subcontracted
1
(Form CCO-4)Rev.06-20-02
MBE/WBE PARTICIPATION CITY CONTRACT NO.895
AECOM 60441314 M-6 of 6
cll.?" 0 ii-. SEGO ?ef-Fe--'ffiL A-t-t•-- toli'P r-
BID BOND
KNOW ALL MEN BY THESE PRESENTS,that we, Peterson Contractors, Inc.
as Principal,and Travelers Casualty and Surety Company of America
as Surety are held and firmly bound unto the CITY OF WATERLOO ,Iowa,
hereinafter called"OWNER,"in the penal sum Five Percent of Amount Bid----
Dollars($ °
° ,)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 18th day of February ,2016,for
FY 2016 Flood Control Gatewell Repairs In the City of Waterloo, Iowa, City Contract No. 895
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 10th day of February ,A.D.2016.
Peterson actors, Inc. (Seal)
Prinraar
„........)
By 6.4.c.(r)( ', .,6
president (Title)
_ L`_,'( �a_ / Travelers ualty d Surety Company of America(Seal)
Witness Surety
Witness Lacey Cramblit nne Crowner Attorney-in-fact
BID BOND CITY CONTRACT NO.895 BB-1 of l
AECOM 60441314
•
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
AftTRAVELERS POWER OF ATTORNEY
Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
Attorney-In Fact No. 226103 Certificate No. 006376400
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the
laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint
Craig E.Hansen,Jay D.Freiermuth,Brian M.Deimerly,Cindy Bennett,Anne Crowner,Tim McCulloh,Stacy Venn,Lacey Cramblit, Shirley S.
Bartenhagen,and Dione R.Young
of the City of West Des Moines ,State of Iowa ,their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 12th
December 2014
day of ,
Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
GR5U•/ �� ;. '\IY�. pE 6 N IN •�4 NS".. tv 4 N�Wy;,
p2 ovalfr'L V i° c <� G r'. .y' \�......SG9 P�......�Fy,w, P� No sG ,�N�^.p�J•C \O�TY'�'��p°04 Oi P J
y Q• � o: .,ti% F
a 9 • S C1 n7DDR �'1�00.POR�)'•i Q: C,; 'P •'
FORATED., s� m al e a ooaeoRar',. m
u 19 8 2 O 1,9]] _ m i -• m t f p ._ -e' ; W HARTFORD, < J'HA„.RD, a � rED
. � 19514 !x n �S o
�s, et41/ ~ ry i ' ;ti ; ,,.o^ -AS Io SEAL.a ;, cONN. o r�l,..--- r m 1896
�y. tiN ! �i '� 4,;'m F„recF,c' 4af sa AN�D2` 1... ..:aa° 'sb dai $t,,,...^ °V �ll9'I
Attie
State of Connecticut _ By.
City of Hartford ss. Robert L.Raney, enior Vice President
12th December 2014
On this the day of , ,before me personally appeared Robert L.Raney,who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul
Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers
Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
In Witness Whereof,I hereunto set my hand and official seal. TTAA .h CMy Commission expires the 30th day of June,2016. * PIMA * Marie C.Tetreault,Notary Public
58440-8-12 Printed in U.S.A.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER •
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company,-Fidelity
and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance,-
Company,
St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company,which resolutions are now in full force and effect,reading as follows:
RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice
President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf
of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the
Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any
of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is
FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy
thereof is filed in the office of the Secretary;and it is
FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature of a bond,recognizance,or conditional undertaking
shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice
President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the
Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power
prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President,
any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any
certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds
and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal
shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on
the Company in the future with respect to any bond or understanding to which it is attached.
I,Kevin E.Hughes,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance
Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and
Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing
is a true and correct copy of the Power of Attorney executed by said Companies,which is in full force and effect and has not been revoked.
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 1 0 t h day of February 20 16
lee40"*. 1
Kevin E.Hughes,Assistant Sec tary
GAS U,�tr gyn.•t�(�,_ +a.. fat tiFEb'W.'0 t0 DNS ...� 1MSU ttY Ah w�•"`Mare
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tiµ i 1• •/ , ` Fnuct l �D., o.�.. . as $ ►r ``."'p' G�,1 fiti d
To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www.travelersbond.com.Please refer to the Attorney-In-Fact number,the
above-named individuals and the details of the bond to which the power is attached.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER