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Cahoy Group
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Sumner, Iowa 50674
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/:o o 1°f Feb. I3th
FORM OF BID OR PROPOSAL
F.Y. 2024 HAWTHORNE AVENUE STORM SEWER LIFT STATION RELIEF WELL
CONTRACT NO. 1066
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 roc,J q ,
a Partnership consisting of the following partners: N !� (Corr
�ci Ro RA, w.. 3e , having familiarized (himself) (themselves)
(itself) wit the exis ing 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 furnish all
supervision, technical personnel, labor, materials, machinery, tools, appurtenances, equipment, and
services, including utility and transportation services required to construct and complete this F.Y. 2024
HAWTHORNE AVENUE STORM SEWER LIFT STATION RELIEF WELL, Contract No. 1066, all in accordance
with the above -listed documents and for the unit prices for work in place for the following items and
quantities:
F.Y. 2024 HAWTHORNE AVENUE STORM SEWER LIFT STATION RELIEF WELL
CONTRACT NO. 1066
BID ITEM
ITEM DESCRIPTION
UNIT
EST.
QTY.
UNIT
PRICE
BID
TOTAL BID
PRICE
1
INSTALL NEW RELIEF WELL
LS
1.0
$
Ic
._
3 LS
=f
$ ,
Ji C Jai
J
2
DEMO & PLUG EXISTING RELIEF WELL
LS
1.0L/$
3� 83 `
$ �3�I1 ���
_`.='
TOTAL BID $ tJ 7, 731
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before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the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.
4. S curity in the sum of SCOen 'keel rk.)C 4" IZ.,r /LJ14 1, 1).� S"x Dollars ($
��% `YC ) in the form of S`h etct , 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 Bidder Status Form.
7. The bidder is prepared to submit a financial and experience statement upon request.
FORM OF BID CONTRACT NO. 1066
Page 1 of 2
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. i Date Fs0 '% Alai-
10. The bidder shall list the MBE/WBE subcontractor(s), amount of subcontracts and bid items on the City
of Waterloo Minority and/or Women Business Pre -bid Contact Information Form submitted with this
Form of Bid or Proposal. The apparent low Bidder shall submit a list of all other Subcontractor(s) to
be used on this Project to the City of Waterloo by 5:00 p.m. the business day following the day Bids on
this Project are due along with the Non -Collusion Affidavits of All Subcontractor(s).
The Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND
APPROVAL" Form to be provided by City prior to approval of contract.
The subcontractors listed on this proposal and/or submitted to the Contract Compliance Officer cannot
be changed except for the following reasons:
1) The City of Waterloo does not approve the subcontractors.
2) The subcontractors submit in writing that they cannot fulfill their subcontracts.
11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none" or
"NA".
12. The bidder has attached all applicable forms.
13. The Owner reserves the right to select alternates, delete line items, and/or to reduce quantities prior
to the award of a contract due to budgetary limitations.
&wok/ PiAmp 3 rzv y'&, 341e. gii-&efl
(Name of Bid,der)(Date)
BY:
Official Address: (Including Zip Code):
1 4.7S C l so
ES
Title nets; Jo-,. -
5c.,Ther- ..roc„.) a SO c 7`)(
I.R.S. No. 4✓02trig 08`7
FORM OF BID
CONTRACT NO. 1066 Page 2 of 2
INFORMATION NEEDED
FOR
IOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE
CONTRACTOR NAME. oy Pti'p 5e na, armies
ADDRESS: ,gqsn /5'014' Sta-uv =Rl rat4 5-d eet+1
(Check One): PRIME
FEDERAL ID#:
41&/5/30 "l
SUBCONTRACTOR
PROJECT NAME: iF y 02424 HAW 4iD AUWu U Imam am Sewn
L2 try S-' AT fc'fv
PROJECT CONTRACT NO.: ! Obit
DESCRIPTION OF WORK:
Brickwork
H Carpentry
1 Concrete
1 1 Drywall -Plaster -Insulation
11 Electrical
H Excavation/Grading
H Flooring
1 Heavy Construction
H Heating -Ventilating -Air Cond
11 Landscaping
Painting
L] Paving
H Plumbing
H Roofing -Siding -Sheet Metal
1 Windows
H Wrecking -Demolition
Ether (Please specify)
w6tL Dant•TNIr
Mo s1413 I Con`TiAeroa iZEonAnisp foe pQo ce-
Stale of
NON -COLLUSION AFFIDAVIT OF SUBCONTRACTOR
) ss:
County of`N
•
being first duly sworn, deposes and says that:
1 He is
wner, Partner, Officer, Representative, or Agent) , of
hereinafter referred to as the "Subcontractor;"
2. He is fully informed resp ting the preparation and contents of the subcontractor's proposal submitted by
the subcontractor to , contract pertaining to the _
project in
(City or
0
State)
3. Such subcontractor's proposal is genuine a'd is not a collusive or sham proposal;
4. Neither the subcontractor nor any of its officers, •artners, owners, agents, representatives, employees, or
parties in interest, including this affiant, has in any ay colluded, conspired, connived, or agreed, directly or
indirectly, with any other bidder, firm or person to sue it a collusive or sham proposal in connection with
such contract or to refrain from submitting a proposal in c• nection with such contract, or has in any manner,
directly or indirectly, sought by unlawful agreement or con vance with any other bidder, firm or person to
fix the price or prices in said subcontractor's proposal, or to any overhead, profit or cost element of the
price of prices in said subcontractor's proposal, or to secure th •ugh collusion conspiracy, connivance or
unlawful agreement any advantage against the City of Waterlo., Iowa, or any person interested in the
proposed contract; and
5. The price or prices quoted in the subcontractor's proposal are fair and pr• •er and are not tainted by any
collusion, conspiracy, connivance or unlawful agreement on the part of th- bidder or any of its agents,
representatives, owners, employees, or parties in interest, including this affiant.
(Signed)
Title
Subscribed and sworn to before me this day of , 20
Title
My commission expires
EQUAL OPPORTUNITY CLAUSE
(As provided in Executive Order No. 11246)
All contractors, subcontractors, vendors and suppliers of goods and services doing business with the City and value of said
business equals or exceeds ten thousand dollars ($10,000 00) annually agree as follows:
1. The contractors, subcontractor vendor and supplier of goods and services will not
discriminate against any employee or applicant for employment because of race, color, creed, sex, national origin,
economic status, age, mental or physical handicap, political opinions or affiliations. The contractor, subcontractor, vendor
and supplier will develop an Affirmative Action program to ensure that applicants are employed and that employees are
treated during employment without regard to their race, creed, color, sex, national origin, religion, economic status, age,
mental or physical disability, political opinions or affiliations. Such actions shall include but not be limited to the following:
a. Employment
b. Upgrading
c. Demotion or Transfer
d. Recruitment and Advertising
e. Layoff or Termination
f. Rates of Pay or Other Forms of Compensation
g. Selection for Training Including Apprenticeship
2. The contractor, subcontractor, vendor and supplier of goods and services will, in all solicitations or advertisements for
employees, state that all qualified applicants will receive consideration for employment without regard to race, creed,
color, sex, national origin, religion, economic status, age, mental or physical disabilities, political opinion or affiliations.
3. The contractor, subcontractor, vendor and supplier or his/her collective bargaining representative will send to each
labor union or representative of workers which he/she has a collective bargaining agreement or other contract or
understanding, a notice advising said labor union or workers' representative of the contractor's commitment under this
section.
4. The contractor, subcontractor, vendor and supplier of goods and services will comply with all published rules,
regulations, directives, and order of the City of Waterloo Affirmative Action Program Contract Compliance Provisions.
5. The contractor, subcontractor, vendor and supplier of goods and services will furnish and file compliance reports within
such time and upon such forms as provided by the Affirmative Action Officer. Said forms will elicit information as to
the policies, procedures, patterns, and practices of each subcontractor as well as the contractor himself/herself and
said contractor, subcontractor, vendor and supplier will permit access to his/her employment books, records and
accounts to the City's Affirmative Action Officer, for the purpose of investigation to ascertain compliance with this
contract and with rules and regulations of the City's Affirmative Action Program —Contract Compliance Provisions
relative to Resolution No. 24664.
6. In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such
rules, regulations and orders, this contract may be canceled, terminated or suspended in whole or in part and the
contractor may be declared ineligible for further contracts in accordance with procedures authorized by the City Council.
7 The contractor, subcontractor, vendor and supplier of goods and services will include, or incorporate by
reference, the provisions of the non-discrimination clause in every contract, subcontract or purchase order
unless exempted by the rules, regulations or orders of the City's Affirmative Action Program, and will provide
in every subcontract, or purchase order that said provisions will be binding upon each contractor,
subcontractor, or supplier.
8. We, the undersigned, recognize that we are morally and legally committed to non-discrimination in employment. Any
person who applies for employment with our company will not be discriminated against because of race, creed, color,
sex, national origin, economic status, age, mental or physical disabilities.
(Signed)
(Appropriate Official)
Pre) ,' le , k-
(Title)
o.\ias
Da )
TITLE VI CIVIL RIGHTS
During the performance of this contract, the contractor (for itself), its assignees, and successors
in interest (hereinafter referred to as the "contractor") agrees as follows:
1. Compliance with Regulations: The contractor shall comply with the Regulations relative
to non-discrimination in Federally assisted programs of the DOT Title 49, Code of
Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter
referred to as the Regulations), which are herein incorporated by reference and made a
part of this contract.
2. Nondiscrimination: The contractor, with regard to the work performed by it during the
contract, shall not discriminate on the grounds of race, color, national origin, sex, age, or
disability in the selection and retention of subcontractors, including procurement of
materials and leases of equipment. The contractor shall not participate either directly or
indirectly in the discrimination prohibited by section 21.5 of the Regulations, including
employment practices when the contract covers a program set forth in Appendix B of the
Regulations.
3. Solicitations for Subcontracts, Including Procurement of Materials and Equipment: In all
solicitations either by competitive bidding or negotiation made by the contractor for work
to be performed under a subcontract, including procurement of materials or leases of
equipment, each potential subcontractor or supplier shall be notified by the contractor of
the contractor's obligations under this contract and the Regulations relative to non-
discrimination on the grounds of race, color, national origin, sex, age, or disability.
4. Information and Reports: The contractor shall provide all information and reports
required by the Regulations or directives issued pursuant there to, and shall allow
access to its books, records, accounts, other sources of information, and its facilities as
may be determined by the Contracting Authority, the Iowa DOT, or FHWA to be pertinent
to ascertain compliance with such Regulations, orders and instructions. Where any
information required of a contractor is in the exclusive possession of another who fails or
refuses to furnish this information the contractor shall so certify to the Contracting
Authority, the Iowa DOT, or the FHWA as appropriate, and shall set forth what efforts it
has made to obtain the information.
5. Sanctions for Noncompliance: In the event of the contractor's noncompliance with the
nondiscrimination provisions of this contract, the Contracting Authority, the Iowa DOT, or
the FHWA shall impose such contract sanctions as they may determine to be
appropriate, including, but not limited to:
a. Withholding of payments to the contractor under the contract until the contractor
complies, and/or
b. Cancellation, termination, or suspension of the contract, in whole or in part.
6. Incorporation of Provisions: The contractor shall include the provisions of paragraphs
(1) through (6) in every subcontract, including procurement of materials and leases of
equipment, unless exempt by the Regulations, or directives issued pursuant thereto.
The contractor shall take such action with respect to any subcontract or procurement as
the Contracting Authority, the Iowa DOT, or the FHWA may direct as a means of
enforcing such provisions including sanctions for non-compliance: Provided, however,
TITLE VI CIVIL RIGHTS Page 1 of 2
that, in the event of a contractor becomes involved in, or it threatened with, litigation with
a subcontractor or supplier as a result of such direction the contractor may request the
Contracting Authority or the Iowa DOT to enter into such litigation to protect the interests
of the Contracting Authority or the Iowa DOT; and, in addition, the contractor may
request the United States to enter into such litigation to protect the interest of the United
States.
TITLE VI CIVIL RIGHTS Page 2 of 2
Bidder Status Form
To be completed by all bidders
Please answer "Yes" or "No" for each of the following:
Yes ■No
Yes No
R. Yes El No
Yes ■ No
OYes C,No
PartA
My company is authorized to transact business in Iowa.
(To help you determine if your company is authorized, please roviow the worksheet on tho next page).
My company has an office to transact business in Iowa,
My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project,
My company is not a subsidiary of another business entity or my company is a subsidiary of another
business entity that would qualify as a resident bidder in Iowa.
If you answered "Yes" for each question above, your company qualifies as a resident bidder. Please
complete Parts H and D of this form.
If you answered "No" to one or more questions above, your company is a nonresident bidder, Please
complete Paris C and D of this form.
To be completed by resident bidders
Part B
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates:
Qs . l 01 cacato irg d o r-
Dates: D,3
Dates: U a
/ 01 fi res,tn±_.l Address:
Address: aOd (1-rc nt 6P,
City, State, Zip: /` 0 nne) XA k5 J5 Q
36 l 50 mil'
`.
City, State, Zip:.SIA 4 SOG7
19%19to 03 1 01 / Wm Address: III) E, S7`
You may attach additional shooks) if needed, City, State, Zip: F "e01 ep i ck S 6 5'O&30
To be completed by non-resident bidders Part C
1, Name of home state or foreign country reported to the Iowa Secretary of State:
2. Does your company's home state or foreign country offer preferences to resident bidders, resident labor
force preferences or any other type of preference to bidders or laborers? [J Yes (i No
3. If you answered "Yes' to question 2, identify each preference offered by your company's home state or foreign country
and the appropriate legal citation.
You may attach additional sheet(s) if needed.
To be completed by all bidders Part D
certify that the statements made on this document are true and complete to the best of my knowledge and I know that my
failure to provide accurate and truthful information may be a reason to reject my bid.
Firm Name:
Signature:
cr.C.,(7
train c. .
Date: 0:k / ob
You must submit the completed form to the governmental body requesting bids per 876 Iowa Administrative Code
Chapter 156. This form has been approved by the Iowa Labor Commissioner.
309-6001 (09 16)
Worksheets Authorization to Transact Business
This worksheet may be used to help complete Part A of the Resident Bidder Status form. If at least one of the following
describes your business, you are authorized to transact business in Iowa.
1<Yes ❑ No My business is currently registered as a contractor with the Iowa Division of Labor.
❑ Yes No My business is a sole proprietorship and I am an Iowa resident for Iowa Income tax purposes.
•
Yes 111 No My business is a general partnership or joint venture. More than 50 percent of the general
partners or joint venture parties are residents of Iowa for Iowa income tax purposes.
Yes ■ No My business is an active corporation with the Iowa Secretary of State and has paid all fees
required by the Secretary of State, has filed its most recent biennial report, and has not filed
articles of dissolution. •
[] Yes ■ No My business is a corporation whose articles of incorporation are filed in a state other than Iowa,
the corporation has received a certificate of authority from the Iowa secretary of state, has filed
its most recent biennial report with the secretary of state, and has neither received a certificate of
withdrawal from the secretary of state nor had its authority revoked.
•
•
Yes ❑ No My business is a limited liability partnership which has filed a statement of qualification in this
state and the statement has not been canceled.
Yes ❑ No
My business is a limited liability partnership which has filed a statement of qualification in a
state other than Iowa, has filed a statement of foreign qualification in Iowa and a statement of
cancellation has not been filed.
❑ Yes ❑ No My business is a limited partnership or limited liability limited partnership which has filed a
certificate of limited partnership in this state, and has not filed a statement of termination.
■
■
■
Yes [] No
My business is a limited partnership or a limited liability limited partnership whose certificate of
limited partnership is filed in a state other than Iowa, the limited partnership or limited liability
limited partnership has received notification from the Iowa secretary of state that the application
for certificate of authority has been approved and no notice of cancellation has been filed by the
limited partnership or the limited liability limited partnership.
Yes ❑ No My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
Yes 0 No
My business is a limited liability company whose certificate of organization is filed in a state other
than Iowa, has received a certificate of authority to transact business in Iowa and the certificate
has not been revoked or canceled.
•
309-6001 (09-15)
Revised February 2003
CONTRACTOR'S OR SUBCONTRACTOR'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.
N ame of Company tAiwv PtAM P SE(ZUTCi, river
Address of Company al45&t J5U 1-21 a Zip 6"Ob y41
51K fl'P' X v wA
Telephone Number ( 90 ) 67k / l iv
Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number)
4215730
N ame of Equal Employment Officer
LAR.e}/ VLAEtk'&Q
Name of Project F f day 4.1 AUnt10RNL? d ug/Nue s J o M ja'&'2
RWGCL
Project Contract Number /040a)
Estimated Construction Work Dates
Start Finish
LrPl 5--To a Al
Section B to be completed by SUBCONTRACTORS only:
B.
N ame of General or Prime Contractor , � pomp 5cizv7t& • 'At
N ame of Subcontractor VA
N ubcontractor's Address Zip
Subcontractor's Telephone Number ( )
Subcontractor's Federal ID Number (if no Federal ID Number Owner/President's Social Security Number)
N ame of Equal Employment Officer 1.¢12gY4b eK r'�t
AFFIRMATIVE ACTION PROGRAM Page 1 of 8
A. Remainder of program to be completed by party completing program, either Prime or Subcontractor.
1. The Owners and/or Principals of your company:
Name Address Position
//�� II tits. W ly a j -
at . �� 6u J S'erH ct. .Art CgqI
1/11,1,v j3lii n S frya
Ethnic
Sex Origin
M
/1
2. Other Areas of Interest:
If your company has branches or subsidiaries, or if your company is a branch or subsidiary of a
parent organization, give the following information:
Type of
Name Address Affiliation Degree
II. EMPLOYER'S POLICY (Please read carefully.)
A. We, the undersigned, recognize that we are morally and legally committed to nondiscrimination in
employment. Any person who applies for employment with our company will not be discriminated
against because of race, color, creed, sex, national origin, economic status, age, mental or physical
handicap.
B. The employment policies and practices of the undersigned are to recruit and hire employees without
discrimination, and to treat them equally with respect to compensation and opportunities for
advancement, including training, upgrading, promotion, and transfer. However, we realize the
inequities associated with employment training, upgrading, contracting and subcontracting for
minorities and women and we will direct our efforts to correcting any deficiencies to the maximum
extent possible. The same will be required of our SUBCONTRACTORS and suppliers.
C. We submit this program to assure compliance with Executive Order 11246, as amended, and other
subsequent orders that may pertain to equal employment opportunity and merit employment policies,
fully realizing that our qualification and/or merit system should be evaluated and revised, if
necessary.
D. We agree to put forth the maximum effort to achieve full employment and utilization of capabilities
and productivity of all our citizens without regard to race, creed, color, sex, national origin, economic
status, age, and mental or physical handicap.
E. 6 b o „icy (1: Lae.- � `. will give training
(Nellie of Company)
and employment opportunities to local residents of Waterloo, Iowa, to the greatest extent feasible.
AFFIRMATIVE ACTION PROGRAM Page 2 of 8
III. AFFIRMATIVE ACTION
A. PcArtioSete vicars .-R recognizes that the effective application of a policy of
(Na r e of Corfipany)
merit employment involves more than just a policy statement, and A /lc3� c/ --
(Narof Conipany)
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. �a 0 "c,�-�-�/I �&' v ,` (etc,
`(lame of Company)
our Affirmative Action Program:
rTh
will undertake the following six (6) steps to improve
1. Minority Recruitment and Employment;
2. Local Recruitment and Employment;
3. Disabled Veteran and Vietnam Era Veteran Recruitment and Employment;
4. Handicapped Recruitment and Employment;
5. Female Recruitment and Employment; and
6. Training, Upgrading and Promotional Opportunities.
C. 4 c L Sect. v .t-h ` will take whatever steps are necessary to
( me ofompany)
ensure that our total work force has adequate minority, female, and local representation. We will
utilize the following methods in our recruitment attempts:
1. Local advertising media (newspapers, radio, TV);
2. Community organizations (churches, clubs, schools);
3. Public and private institutions in the area (UNI, Hawkeye Community College);
4. Job Service of Iowa; and
5. Other.
D. ( AG.It ,✓ v. ss .��` will seek qualified minority, female, and local group applicants
(Name�f Company)
for all job categories and will make asserted efforts to increase minority, female and group
representation in occupations at the higher levels or skill and responsibility.
E. All sources of employment used shall be aware that we are an Equal Employment Opportunity
Employer. Labor organizations representing our employees will be notified of our Equal Employment
Opportunity Policy and Affirmative Action Program.
F. Training, upgrading, promotion and transfer activities at all levels will be monitored to ensure that full
consideration has been given to qualified minority, female, and local group employees.
G. [Ndvc.i..,.v V.`c,s�� will encourage other companies, with whom we are
(Name.jf CompAny) t
associated and/or do business, to do the same and we will assist them in their efforts.
AFFIRMATIVE ACTION PROGRAM
Page 3 of 8
H.
J.
Cyr gal f c. w. .
(Name Company)
minority, female, local contractors and/or suppliers were provided opportunities to negotiate and/or
bid on this project: (if none, write "NONE")
1.
2.
/Ione
has taken the following Affirmative Action to ensure that
Al
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.
(-64-Nis Rev, 5", vs -se
(Namejf Company)
all nonexempt contractors who propose to work on this project and will take whatever steps are
necessary to ensure that non -minority contractors have adequate representation of minority, female
and local persons in their total work force.
will require approved Affirmative Action Programs from
-TK
K. In further accordance with rules and guidelines issued pursuant to Executive Order 11246 as
amended, we establish the goals for our company, based on parity percentages supplied by the City,
and we realize these goals will be reviewed on an annual basis.
L. Le Lc � �v07ur will keep records of specific actions relative to
(Name o�omp hy) 1'
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:
Minority Parity = .08 (8%)
N. C c le ,c3� �cn,,.� v v' GG - 1/4._.
(Name of}Compar?y
Affirmative Action Employment Goals:
The definition of Affirmative Action Goals is as follows: "Goals may not be rigid and inflexible quotas
which must be met, but must be targets, reasonably attainable by means of applying every good
faith effort to make all aspects of the entire Affirmative Action Program work."
For the year 201 C 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:
C4a- r = /O
*Your affirmative action goals should be between 1% and 10% or more for minorities and 1% and
5% or more for women.
AFFIRMATIVE ACTION PROGRAM Page 4 of 8
INDICATE:
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 20(2 5 . Note, that none of the goals are
rigid or inflexible. They are targets that your company calculates as reasonably attainable. This will
help the City in its monitoring procedures as required by City of Waterloo Resolution No. 1984-
142(4).
CONTRACTOR'S TOTAL WORK FORCE
(WATERLOO)
DISABLED VETERAN: DV
VIETNAM ERA VETERAN: VV
HANDICAPPED: H
AFFIRMATIVE ACTION PROGRAM
Page 5 of 8
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:
By
Com •. ny Ex-cutive
v i 1 /, r
ate
qual Employment
Opportunity Officer
.2 i ( 3 / c=2 C
Date
City of Waterloo Affirmative Action Officer
Approved
Disapproved Reason:
By:
Date:
AFFIRMATIVE ACTION PROGRAM Page 6 of 8
DESCRIPTION OF JOB CATEGORIES
Officials/Manager: Occupations in which employees set broad policies, exercise overall responsibility for
execution of all policies, or direct individual departments or special phases of the agency's operations or
provide specialized consultation on a regional, district or area basis. Includes: department heads, bureau
chiefs, division chiefs, directors, deputy directors, controllers, examiners, wardens, superintendents, unit
supervisors, sheriffs, police and fire chiefs and inspectors and kindred workers.
2. Professionals: Occupations, which require specialized and theoretical knowledge, which is usually
required through college training or thorough work experience and other training which provides comparable
knowledge. Includes: personnel and labor relations workers, social workers, doctors, psychologists,
registered nurses, economists, dietitians, lawyers, system analysts, accountants, engineers, employment
and vocational rehabilitation counselors, teachers or instructors, police and fire captains and lieutenants and
kindred workers.
3. Technicians: Occupations, which require a combination of basic scientific or technical knowledge and
manual skill which can be obtained through specialized post -secondary school education and through
equivalent on-the-job training. Includes: computer programmers and operations, draftspersons, surveyors,
licensed practical nurses, photographs, radio operators, technical illustrators, police and fire sergeants and
kindred workers.
4. Office/Clerical: Workers are responsible for internal and external communication, recording and retrieval
of data and/or information and other paper work required in an office. Includes: bookkeepers, messengers,
office machine operators, clerk -typists, stenographers, court transcribers, hearing reporters, statistical
clerks, dispatchers, license distributors, payroll clerks and kindred workers.
5. Skilled Craft Workers: Workers perform jobs, which require special manual skill and a thorough and
comprehensive knowledge of the processes involved in the work, which is acquired through on-the-job
training programs. Includes: Mechanics and repairmen, electricians, heavy equipment operators, stationary
engineers, skilled machine occupations, carpenters, compositors and typesetters and kindred workers.
6. Sales Workers_ : Occupations engaging wholly and primarily in direct selling. Includes: advertising agents
and salesmen, insurance agents and brokers, real estate agents and brokers, stock and bond salesmen,
demonstrators, salesmen and sales clerks, grocery clerks and cashier checkers, and kindred workers.
7 Operatives (semi -skilled): Workers who operate machine or processing equipment or perform other
factory -type duties of intermediate skill level which can be mastered in a few weeks and require only limited
training. Includes: apprentices (auto mechanics), plumbers, building trades, metal working trades,
bricklayers, carpenters, electricians, machinists, mechanics, printing trades, etc., operatives, attendants
(auto service and parking), plasterers, chauffeurs, deliverymen and furnacemen, heaters (metal), laundry
and dry cleaning operatives, milliners, mine operatives and laborers, motormen, oilers and greasers, (except
auto painters), (except construction and maintenance), photographic process workers, stationary fireman,
truck and tractor drivers, weavers, (textile), welders and flame cutters and kindred workers.
8. Laborers (unskilled): Workers in manual occupations, which generally require no special training. Perform
elementary duties that may be learned in few days and require the application of little or no independent
judgment. Includes: garage laborers, car washers and greasers, gardeners (except farm) and
groundskeepers, longshoremen, and stevedores, lumbermen, raftsmen and woodchoppers, laborers
performing lifting, digging, mixing, loading and pulling operations and kindred workers.
AFFIRMATIVE ACTION PROGRAM Page 7 of 8
9. Apprentices: Persons employed in a program including work training and related instruction to learn a
trade or craft which is traditionally an apprenticeship, regardless of whether the program is registered with
a Federal or State agency.
10. Trainees (on-the-job): Production... persons in formal training for craftsmen when not trained under
apprentice programs --operative laborer, and service occupations.
White Collar... persons engaged in formal training for clerical, managerial, professional, technical, sales,
office and clerical occupations.
AFFIRMATIVE ACTION PROGRAM Page 8 of 8
ITEMS OF POTENTIAL MBE/WBE PARTICIPATION
NOTICE TO PROSPECTIVE BIDDERS:
The following are items from the FY 2024 HAWTHORNE AVENUE STORM SEWER LIFT STATION RELIEF
WELL, Contract No. 1066, that have a potential for MBE/WBE Participation. This listing, however, is not
intended to be all encompassing; to preclude MBE/WBE Contractors from bidding on any items of the
Proposal as a Subcontractor or the entire Proposal as a Prime Contractor.
ALL ITEMS FOR THIS PROJECT HAVE THE POTENTIAL FOR MBE/WBE PARTICIPATION.
MBE/WBE GOALS FOR THIS PROJECT
IMPORTANT: Prime Contract Bidders should be aware that ten percent (10%) MBE goal and a two percent
(2%) WBE goal is attached to this project. "Certified Return Receipt" letters are no longer needed with the
bid showing proof of contacting MBE or WBE Subcontractors, but the Pre -Bid Contact Information Form
must be filled out completely.
City of Waterloo Contract Compliance Officer:
Contract Compliance Officer
Community Development Board
Carnegie Annex, Suite 202
620 Mulberry Street
Waterloo, IA 50703
Phone: (319) 291-4429
ITEMS OF POTENTIAL MBE/WBE PARTICIPATIONS
CONTRACT 1066 Page 1 of 1
Contract No.:
Letting Date:
SUBCONTRACTOR'S BID REQUEST FORM
PRIME BIDDER'S LETTERHEAD
I, (subcontractor's name), hereby attest that I have been solicited for . id on (project name) in the area of
(description of work and bid item no.).
(Prime contractor) has informed me that if I am interested ' bidding, a subcontracting bid proposal must
be submitted to the company office by
Subcontractor's Company Name
Subcontractor's Signature
Prime Bidder's Signature
ate)
Date
Date
and
(Time).
LETTER TO BE USED WHEN SOLICITING FOR
SUBCONTRACTOR QUOTES
Subcontractor Company Name
Address
RE: Contract No.:
Dear
(Prime Contractor's Company Name) is presently soliciting for the followiwork in connection with the
above referenced project.
(Insert bid Item Nos. any d Description of Wpr`k)
(Prime Contractor's Company Name) i•S an Equal 0
pp
ftunity inployer, and all qualified bidders will not
be discriminated against due to race, religion, color ex, or o in.
If interested in bidding your proposal must be .rned in to his office by
and
(Date) (Time)
Sincerely,
(Prime Contractor'. Representative)
Form ' CO- 3 (11 /28/2001)
s C 6J0
MBEIWBE BUSINESS ENTERPRISE
PRE -BID CONTACT INFORMATION FORM
Prime Contractor Name: Cc e,,..cc k_,.� l
Project: Fi��/.� ���N- SJ1j,5,�S
)rfJ Letting Date:
NO MBEIWBE SUBCONTRACTORS: If you are NOT using any MBEIWBE subcontractors to complete this project,
sign below. Attach a brief explanation as to why subcontracting was not feasible with this project. If any MBE/WBE
subcontractors will be used, please use the botto portion of this form.
Contractor Signature:
Title: ties ie./ -A-
Date: u),/ / 31,E l]
SUBCONTRACTORS APPLICABLE: You are required, in order for your bid to be considered responsive, to provide
the information on this form showing ALL of your MBEIWBE subcontractor contacts made for your bid submission.
This information is subject to verification. Any questions may be directed to Contract Compliance Office 319-291-
4429.
You are required, in order for your bid to be considered responsive, to provide the information on this Form showing
your MBEIWBE Business Enterprise contacts made prior to your bid submission. This information is subject to
verifications and confirmation.
If you are unable to identify MBEIWBE firms to perform portions of the work, please contact Rudy Jones, Contract
Compliance Officer, for assistance at (319) 291-4429.
In the event it is determined that the MBEIWBE 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
Subcontractors
MBE/WBE
Contacted
Dates
YeslNo
Contacted
Dates
Yes/No
Dollar
Amount
bvbcontracted
Proposed
to
JL)
4
c�
(Form CCO-4) Rev. 06-20-02
MBE/WBE BUSINESS ENTERPRISE
PRE -BID CONTACT INFORMATION FORM INSTRUCTIONS
Prime Contractor Responsibilities:
Prime Contractors bidding on City of Waterloo contract work are required to ensure that MBE/WBE businesses are
provided the opportunity to participate in the performance of contracts and subcontracts. Prime contractors are required to
assist MBE/WBE businesses in overcoming barriers to participation, and must make good faith efforts to secure bids from,
and award subcontracts to, MBE/WBE businesses. For all contract bids of $50,000 or more, the following is required to
demonstrate good faith efforts in accordance with this policy:
1. "MBE/WBE BUSINESS ENTERPRISE PRE -BID CONTACT INFORMATION FORM" submitted with the prime contractor
bid, properly completed and signed on Form CCO-4 (Rev 06-20-02). Please note that this document must include all
subcontractor contacts, bids received, and awarded - not just those related to disadvantaged business enterprise vendors.
2. A minimum of three (3) MBE/WBE business contacts must be made and documented, if there are at least three (3)
MBENVBE businesses offering services in the areas to be subcontracted (see City of Waterloo MBE/WBE Certified List). If
less than three (3) are offering the services to be subcontracted, then a contact is required for any that are listed as
providing that service. If you have submitted a MBENVBE contact not on the City's MBE/WBE list, attach a copy of the
certification from another government agency.
3. Contacts to each MBE/WBE businesses are required to be a minimum of seven (7) working days prior to the date the
prime contractor submits the bid to the City of Waterloo.
4. The following documentation must accompany the "MBE/WBE BUSINESS ENTERPRISE PRE -BID CONTACT
INFORMATION FORM" for each MBE/VVBE business contacted:
a. A copy of the bid received from the MBENVBE, OR
b. If no bid was received, a copy of correspondence received from the MBE/WBE with a "no bid" response, OR
c. If no response was received, a copy of the solicitation sent to the MBE/WBE with proof of mailing attached.
5. If any MBE/WBE business submitting bids are not selected for subcontract award, documentation must accompany the
"MBE/WBE BUSINESS ENTERPRISE PRE -BID CONTACT INFORMATION FORM" on why the MBE/WBE was not
selected. These reasons could include:
a. Not low bid. Copies of the competing bids may be required for verification.
b. MBE/WBE did not bid, withdrew bid or was non -responsive.
c. Documentation of other business -related reason for not selecting the MBE/WBE business for a subcontract.
d. Prime contractor self performs work.
e. Any other reason relied on by the Prime Contractor.
The Contract Compliance Officer will determine the weight to be given to each item listed above (supported by appropriate
documentation) based on overall program goals.
Subcontractors Responsibilities:
1. Each MBE/WBE firm planning to submit quotes on construction projects with goals, shall submit a Letter of
Intent to Bid (Form CCO-5) to the City Contract Compliance Officer seven (7) working days prior to bid opening, listing
specific items which the MBE/WBE firm is interested in bidding. If the City Contract Compliance Officer does not
receive sufficient scope letters seven (7) working days prior to bid opening, goals on subject project will be reduced
accordingly. Agreements between the bidder/proposer and an MBE/WBE in which the MBE/WBE promises not to
provide subcontracting quotations to other bidders/proposers are prohibited.
Form CCO-4A Rev. 07-08-02
LETTER OF INTENT TO BID
(MBE/WBE LETTER)
According to the Current MBE/WBE Contract Compliance Program - 2002, all MBE/WBE Contractors
interested in submitting subcontractor quotes on construction projects with goals, MUST submit a LETTER
OF INTENT TO BID to the City of Waterloo Contract Compliance Officer at least seven (7) days prior to
bid opening.
The LETTER OF INTENT TO BID must list the specific items, which the MBE/WBE Contractor is
interested in bidding.
Letter should include the following:
Name of Project:
Your Company Name:
Address:
Phone: Date:
List of Specific items to be bid:
Item No. Description:
Item No. Description:
Item No. Description:
Item No. Description:
(Subcontractor's Company Name and au orized signature)
Return this LETTER OF INTENT 'O BID to:
Contract Compliance Officer
Community Development oard
620 Mulberry St.
Carnegie Annex, Sui 202
Waterloo, IA 5070
Phone: (319) 29 -4429
m CCO-5 (06-20-2002)
CERTIFIED
MBE/WBE CONTRACTORS
CITY OF WATERLOO, IOWA
Contract Compliance Office
Community Development Board
Carnegie Annex, Suite 202
620 Mulberry Street
Waterloo, IA 50703
City WEB Site: www.ci.waterloo.ia.us
Contract Compliance
WEB Site
for listing updates: http://www.cityofwaterlooiowa.com/contractcompliance
Contact: Rudy Jones, Community Development Director
Email: rudyjonesCa?waterloo-ia.org
Phone:
Fax:
(319) 291-4429
(319) 291-4431
CERTIFIED MBE CONTRACTORS
CARTER ELECTRIC
725 Adams Street
Waterloo, IA 50703
Phone: (319) 232-9808
Pager: (319) 235-4021
Contact: Derrick Carter
Specializing in:
ELECTRICAL CONTRACTOR
CULPEPPER ELECTRIC
1731 Cottage Grove Avenue
Waterloo, IA 50707
Phone: (319) 235-0885
Fax: (319) 236-8177
Contact: Martin Culpepper
Certified: City of Waterloo Certified MBE, Licensed Electrician
Specializing in:
ELECTRICAL CONTRACTOR
DANIELS HOME IMPROVEMENT
339 Albany Street
Waterloo, IA 50703
Phone: (319) 961-1659
Contact: Sammy Daniels
Specializing in:
ALL TYPES OF CONCRETE FLATWORK, POURED WALLS —ALL TYPES, FOOTINGS, LIGHT
DEMOLITION
D.C. CORPORATION
426 Beech Street
Waterloo, IA 50703
Phone: (319) 493-2542
FAX (319) 236-0515
Contact Terry Phillips
Certified: City of Waterloo Certified MBE, Iowa DOT, TSB Certified
Specializing in:
COMMERCIAL AND RESIDENTIAL DEMOLITION, CONCRETE PAVING, DRIVEWAYS, TRUCKING
(ALL TYPES), GENERAL CONSTRUCTION
GREER'S WORKS
2003 Plainview Street
Waterloo, IA 50703
Phone: (319) 233-4701
Contact: Willie Greer
Specializing in:
DRIVEWAYS, SIDEWALKS, CARPENTRY, ROOFING, GENERAL CONSTRUCTION
OLD GREER'S WORKS
2309 Springview Street
Waterloo, IA 50707
Phone: (319) 233-2150
Contact: David L. Greer, Sr.
Specializing in:
ROOFING & GENERAL CONSTRUCTION
QUICK CONSTRUCTION
217 Bates Street
Waterloo, IA 50703
Phone: (319) 215-4166
Contact: Leroy Harrington
Specializing in:
ALL TYPES OF CONCRETE FLATWORK AND GENERAL CONSTRUCTION
D & D CONSTRUCTION
1124 West Donald Street
Waterloo, IA 50703
Phone: (319) 961-4208
Contact: Darrell E. Caldwell, Sr.
Specializing in•
ROOFING AND GENERAL CONSTRUCTION
E. CASTRO ROOFING
702 Riehl Street
Waterloo, IA 50701
Phone: (319) 215-5683
Contact: Emillio Castro
Specializing in:
ROOFING, SIDING, GENERAL CONSTRUCTION
MARTINEZ CONCRETE, LLC
711 Reber Avenue
Waterloo, IA 50701
(319) 230 1983
Contact: Luis Martinez
Specializing in:
ALL TYPES OF CONCRETE FLATWORK
REYES CONSTRUCTION, LLC
908 W. 1st Street
Waterloo, IA 50701
(319) 883 7453 or (319) 576-8353
Contact: Bernardo Reyes
Specializing in: SIDEWALK, DRIVEWAY, PARKING LOTS, PATIOS
CERTIFIED WBE CONTRACTORS
ATLAS PAINTING, INC.*
911 Sycamore Street
P.O. BOX 65
Waterloo, IA 50704
Phone: (319) 232-9164
Specializing in:
COMMERCIAL AND INDUSTRIAL PAINTING
PETERMAN & HAES CARPET ONE*
4003 University
Waterloo, IA 50701
Phone: (319) 233-6131
Fax (319) 233-6133
Certified: City of Waterloo WBE
Email: JR11486@cfu.net
Contact: Carol Reese
Specializing in:
FLOOR COVERING
SERVICE SIGNING, LC*
3533 W. Airline Hwy
Waterloo, IA 50703
(319) 235-9356
Contact: Allison Baugher
Specializing in:
TRAFFIC CONTROL/SIGNAGE
* DENOTES WOMEN BUSINESS ENTERPRISE
STATEMENT OF BIDDER'S QUALIFICATIONS
(To be submitted by the Bidder only upon the specific request of the City of Waterloo, Iowa.)
All questions must be answered and the date given must be clear and comprehensive. This statement must be
notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit any
additional information he desires.
1. Name of bidder. Co_.I....o 10e S v ,-c G / ,,` �. .
2. Permanent main office address.
a(l41.5 L SOU S ,}� S c &-r, ✓1 C r' _r o c-3 c -s o c, 7(1
3. When organized.
4. If a corporation, when incorporated.
5. How many years have you been engaged in the contracting business under your present firm or trade
name? ) tI
s
6. Contracts on hand: (S hedule these, showing amount of eacicontr c,t and the appropriate anticipated
dates of completion.) • ;, Case, k--c.L. k-r a— ► n le 1, S -- M ref- T 1
7. General character of work performed by your company. tJ '// 4 fop Co n 5+ &-v-Uc
8. Have you ever failed to complete any work awarded to you? If so, where and why?
9. Have you ever defaulted on a contract? If so, where and why? /v
10. List the more important projects recently completed by your company, stating the approximate cost for
each, and the month and year completed. Sere A 1 ac;�
11. List your major equipment available for this contract.
Sc c A ACci
12. Experience in construction work similar in importance to this project.
A.
U
13. Background and experience of the principal members of your organization, including the officers.
14. Credit available: $ /. S/Ltl lac
15. Give bank reference:
PicottaA.,
16. Will you, upon request, fill out a detailed financial statement and furnish any other information that may be
required by the City of Waterloo, Iowa? Ve.s
17. The undersigned hereby authorizes and requests any person, firm, or corporation to furnish any
information requested by the City of Waterloo, Iowa, in verification of the recitals comprising this
Statement of Bidder's Qualifications.
STATEMENT OF BIDDERS QUALIFICATIONS Page 1 of 2
Dated at 0 tO0
State of focj Cj
County of ryE.- c
this 1.3 day of Y'cc u,/' , 20 ,.m) ` .
) ss:
a LA PAr-am
(Name odder)
By
Title:
•• ,
Cr e
aL- � 9
.: �Ji-n. , L , being duly sworn deposes and says that he is / vp�� d r t ..4
and that the answers to the
(Name of Organization)
to the foregoing questions and all statements therein contained are true, and
Subscribed and sworn to before me this
Signature
day of
NotarstPublic
My commission expires £ticr.stc&tro7l
STATEMENT OF BIDDERS QUALIFICATIONS
Fee.,10/1,4 c 4-7
0
IAL
0191 •
IOWA
TROY LAMPHIER
Commission Number 846324
My Commission expires
February 27, 2026
20
Page 2of2
•
Cahoy Pump Service
The Premier Provider of Municipal, Industrial, & Irrigation Water !fell Services
A Division of The Cahoy Group
CORPORATE RESOLUTION
Be it known that on this 27th Day of February, 2023 the Board of Directors of The Cahoy Group/Cahoy
Pump Service passed a Resolution authorizing the following individuals to sign any and all Bid
Documents, Bid Bonds, Performance Bonds, and all Binding Agreements.
Darin J. Cahoy
Mike Whittenbaugh
Anthony Sherman
Jonathan Lilja
Mike Stoddard
Dale Gilbert
Greg Johnson
Authorized by,
Darin J. Ca oy Mike Whittenbaugh
Chief Executive Offk er
President
24568 150" Street - Suite 200 Sumner, Iowa 50674
Serving 10 States with Locations in Iowa-2 : Illinios-2 : Nebraska : Wyoming
1-833-728-1288
WWW.CAHOYPUMP.COM
Cahoy Pump Service
The Premier Provider of Municipal, Industrial, & Irrigation {Baler Well Services
A Division of The Cahoy Group
KEY PERSONNEL:
DARIN CAHOY — Chief Executive Officer:
34 years experience in the water well industry. Licensed well contractor in Iowa, Nebraska, Illinois,
Kansas, Minnesota, Wyoming, South Dakota, and Missouri. Past member of National Groundwater
Association's Government Affairs Committee. Past Board member and past President of the Iowa
Water Well Association.
MIKE WHITTENBAUGH — President / Project Manager:
11 years experience in the municipal water well industry. Graduate of Purdue University with a degree
in Mechanical Engineering. Mike is experienced in all facets of water well drilling, well rehabilitation,
and well pump repairs.
DeGROOT, KAES — Vice President / Drilling Division Manager:
9 years drilling experience in air drilling, reverse circulation drilling, direct rotary and dual -wall reverse
circulation drilling methods. Licensed Driller in Iowa, Illinois, and Wisconsin. Kaes in OSHA 10 hour
trained, OSHA Hazwoper certified, and MSHA 8-hour certified. Kaes also possess an AS Degree in
Business Management from Kirkwood Community College.
JOHNSON, GREG — Chief Operating Officer:
Greg brings over 36 years of experience in the financial services industry along with 28 years of
management experience in the operation of two successful companies. Graduate of the University of
Iowa with a degree in Finance.
SHERMAN, ANTHONY — Regional Manager:
27+ years experience in the municipal water well industry. Well versed in geothermal drilling and
operating systems with many successful well rehabilitation and pump repair / replacement projects to
his credit. Possess an Engineering degree.
MARK CLAASSEN — CPA / Project Manager:
36 years experience in the water well industry. Licensed well contractor in Iowa, Missouri, and South
Dakota. 40 Hour OSHA HazMat certified. Holds the Master Groundwater Contractor designation as
recognized by the National Groundwater Association. Is our in-house Certified Public Accountant.
MIKE STODDARD — Regional Manager, Lincoln, Illinois:
25+ years experience in the municipal water well industry. Experienced in reverse circulation drilling,
lineshaft turbine repairs, submersible turbine repairs, and well rehabilitation.
SMILEY, JON — Regional Manager, Marne, Iowa:
3 years experience in the municipal water well industry. Experience in all facets of lineshaft turbine,
submersible turbine pumps, and water well rehabilitations. Is 40 Hour OSHA Hazwoper trained 10-
hour OSHA Safety trained and certified. Is a licensed Iowa Water Well Contractor.
24568 150"' Street - Suite 200 Sumner, Iowa 50674
Serving 10 States with Locations in Iowa-2 : Illinios-2 : Nebraska : Wyoming
1-833-728-1288
WWW.CAHOYPUMP,COM
LLOYD WURZER — Senior Project Manager:
14 years experience in the water well industry. Licensed well contractor in Iowa and Wisconsin 40
Hour OSHA HazWoper and 10-hr OSHA certified. Proficient in all facets of well pump installation /
repair and well rehabilitation techniques.
JON LILJA — Regional Manager:
16 S ears experience in the water well industry. 40 hour OSHA Hazwoper and 10-hr OSHA Safety
trained. Experienced in all facets of water well pump installations and well rehabilitations.
LARRY KEUCKER — Health & Safety:
Larry comes to us from the food production industry and has over 6 years experience with us as our
Health and Safety Director. Larry assures we are OSHA compliant and that all employees maintain
proper industry, safety, and DOT credentials.
ENINGEERING REFERENCES:
VEESTRA & KIMM, Dave Schechinger @ 319-499-5236
- Lisbon, Iowa. 18" x 12" open hole rock well to 380' deep. 600 gpm test pumping.
HDR ENGINEERING, Joseph Roberts @ 402-321-8726
- Council Bluffs Water Works, Three (3) 36" borehole x 24" screen & casing x 100' deep wells.
Test pumped at over 1500 gpm with efficiencies all in excess of 80%.
McCLURE ENGINEERING, Austyn Wolfe, Mike Trotter @ 515-576-7155.
- Ft. Dodge, IA. 516' deep, 28" borehole x 24" casing x 22" open hole. 2,000 gpm +
- Blairsburg, IA 450' deep, 14.75" borehole x 10" casing, 8" liner, 7" open hole
FARNSWORTH GROUP, Robert Kohlhase, Joe Milulecky @ 309-663-8435
- Atlanta, IL screened well project. 200' deep, 24" borehole x 12" screen & casing.
ISG, Kelly Evans @ 515-243-9143
Anthon, IA. 15" borehole x 10" SS screen & casing. 450 gpm+
IMEG, Megan Crook @ 309-833-4594.
LaHarpe, IL. Two (2), 1200' deep wells, 15" borehole, 8" casing
MSA Engineering, Nick Wagner, Scott Duckett, Abby Mouw @ 563-445-3501.
Albany, Illinois Well # 4 project
FOX ENGINEERING, Steven Troyer @ 515-233-0000.
- Grimes, Iowa Aquifer Storage Recovery well pump installation.
FEHR GRAHAM ENGINEERING, Andy Kieser @ 217-352-7688
- Long Creek Township Water District. 30" borehole x 16" screen / casing x 100' deep.
SEH ENGINEERING, Tom Madden @ 641-424-6344.
- Multiple well construction and pump installations.
GENERAL REFERENCES:
RAWLINS MUNICIPAL WATER DEPT., Rawlins, Wyoming. Cara -Lynn Brown. 307-321-7919.
MAHASKA RURAL WATER, Randy Pleima @ 641-660-0332
FORT MADISON WATER DEPARTMENT: Ft. Madison, Iowa: Norm Dodson @ 319-463-5200
UNIVERSITY OF NORTHERN IOWA: Cedar Falls, Iowa: Mike Hinney @ 319-273-2297 or 319-273-
4400
WAPELLO RURAL WATER ASSC: Ottumwa, Iowa: Dan Westegard @ 641-682-8351 or 641-799-
0896
USW UTILITY GROUP: Grimes, Iowa. Andrew Wood @ 515-986-3176
VILLAGE of CURTIS, WI. Todd Welch @ 715-613-2013.
CITY OF ROCKFORD, IL: Kyle Saunders @ 779-348-7371 (Jonathan Lilja has worked on multiple
deep well pumps, booster pumps, and reservoirs for Rockford)
CITY OF JOIET, IL: Nick Gornick @ 815-724-3675 (Darin, Derek, & Jon have worked on multiple
450 HP x 1200' set submersible pumps)
DRILLING EXPERIENCE:
LISBON, IOWA — 2023
Contract value of $ 225,000
18" casing to 25'.
12" casing to 162'
Total Depth of 380'
Test pumped at 600 gpm
CONTACT: Dave Schechinger @ 319-499-5236
Mt. PLEASANT MUNICIPAL UTILITIES, IOWA - 2023
Contract value approximately $ 1,100,000
30" casing to 80'
24" & 18" casing to 1350'
Total depth of 1,910'
Test pumped at 2,000 gpm
CONTACT: Mr. Jack Hedgecock @ 319-931-8785
COUNCIL BLUFFS WATER WORKS, IOWA — 2020
Drilled three (3) new production wells.
Contract value approximately $ 375,000.
Drill 36" diameter borehole to 100'.
Installed 24" diameter screen & casing.
Test pumped wells at 1500 gpm. All wells were in excess of 80% efficient.
CONTACT: Joe Roberts w/ HDR Engineering @ 402-321-8726.
BLAIRSBURG, IOWA — 2020
Drilled new production well.
Contract value approximately $ 215,000.
Drilled 14.75" hole to 165'. Set and grouted 10" steel casing.
Drilled 9.875" hole to 365'. Set 8" perforated liner.
Drilled 7" open hole to 450.
Test pumped well, install pitless unit and pump. 115 gpm+
CONTACT: Austyn Wolfe @ 515-890-1713
ANTHON, IOWA — 2020
Drilled new production well.
Contract value approximately $ 225,000.
Drilled 15" hole to 190'.
Installed 10" SS casing and 8" SS screen.
Test pumped at 600 gpm+, install pitless unit and well pump
CONTACT: Kelly Evans @ 515-243-9143
ALBANY, ILLINOIS — 2019
Drilled new production well.
Contract value approximate $ 400,000.
Drilled 14.75" hole to 456'.
Set and grouted 10" steel casing.
Drilled 9.875" hole to 850'.
Test pumped well at 225 gpm +.
CONTACT: Nick Wagner @ 563-445-3801
LAHARPE, ILLINOIS — 2019
Drilled two production wells
Contract value approximately $ 450,000
Drilled 12" hole to approximately 740' on each.
Set and grouted 8" steel casing.
Drilled 7.875" diameter hole to approximately 1200'
Test pumped at 250 gpm+
CONTACT: Megan Cook @ 309-833-4594
FT. DODGE, IOWA — 2019
Drilled one production well.
Contract value approximately $ 570,000.
Drilled 28.25" diameter hole to 280'.
Set and grouted 24" steel casing.
Drilled 22" diameter open hole to 516'
Test pumped well at 2,000 + gpm
CONTACT: Austyn Wolf cc 515-890-1713
WATERLOO CAREER CENTER, WATERLOO IOWA — 2018:
Drilled one production well and one injection well.
Contract value approximately $ 265,000.
Drilled 17.5" diameter hole to 220'.
Set and grouted 12" steel casing
Drilled 11.875" diameter open hole to 340'
Test pumped wells at 1,250 gpm.
CONTACT: Tyler Sell @ 319-290-3670
ORCHARD HILLS SCHOOL, CEDAR FALLS, IOWA — 2018:
- Drilled one production well and one injection well.
- Contract value approximately $ 235,000.
- Drilled 17.5" diameter hole to 200'.
- Set and grouted 12" steel casing.
- Drilled 11.875" diameter open hole to 300'.
- Test pumped wells in excess of 500 gpm.
CONTACT: Zach Berends @ 319-233-5616
ILLINOIS AMERICAN WATER — LINCOLN, ILLINOIS — 2018:
- Drilled 280' x 8" screened test well.
- Estimated value was $ 110,000.
- Test pumped at 400 gpm +.
CONTACT: Mike Stohl
LONG CREEK TOWNSHIP WATER DISTRICT, DECATUR, ILLINOIS — 2017
- Drilled 30" diameter borehole to 96' with 16" screen and casing.
- Install pitless unit and submersible pumping equipment.
- Contract value approximately $ 90,000.
CONTACTS: Andrew Kieser @ 217-352-7688 ( Engineer)
Wayne Dotson @ 217-519-0199 (Owner's Rep)
VILLAGE OF LEWISTOWN, ILLINOIS — 2016 & 2019
Contract value of $ 90,000 & $ 115,000
Drilled 24" diameter borehole to a depth of 45'.
Installed 12" screen and casing, pitless unit, and submersible pumping equipment in 2016 and
16" in 2019.
CONTACT: Dan Good w/ Mauer -Stutz, Engineer, r 309-693-7615
CITY OF CARTHAGE, ILLINOIS — 2016
Drilled to depth of 1,115'.
- 140' of 20" outer casing pipe grouted in place.
14" diameter pipe to 937' grouted in place.
Test pumped the well at 600 gpm.
CONTACT: Charlie Bach w/ PSBA 319-524-8730
MAJOR EQUIPMENT LIST:
2007 RD 120 (120,0001b Cap) rotary drilling rig w/ support equipment.
2019 GEFCO 90K rotary drilling rig w/ support equipment.
2021 GEFCO 40K rotary drilling rig w/ support equipment
- Portadrill RC drill rig
Simco mud rotary drilling rig
Six (7) various pump hoist rigs.
Two (2) Crane trucks
Hy -Rip chemical treatment trailer w/ support equipment.
Miscellaneous compressors, trailers, support trucks, and downhole tooling.
Three (4), color downhole video systems.
t.
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Cahoy Pump Service, Inc
as Principal, and Developers Surety and Indemnity Company , as Surety, are held and firmly
bound unto the CITY OF WATERLOO , Iowa, hereinafter called "OWNER." In the penal sum
Five percent (5%) of the bid amount 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 13th day of
February , 20 25 , for F.Y. 2024 Hawthorne Avenue Storm Sewer Lift Station Relief Well
•
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 13th day of February , A.D. 20 25
Witness
Cahoy Pump Service, Inc
Developers Surety and Indemnity Company (Seal)
Surety
By ert
ch Matter Attorney -in -fact
(Title)
(Sea))
BID BOND
Page 1 of 1
POWER OF ATTORNEY FOR
COREPOINTE INSURANCE COMPANY
DEVELOPERS SURETY AND INDENINITY COMPANY
59 Maiden Lane, 43rd Floor, New.York, NY 10038
(212)220-7120
KNOW ALL BY TEiESE PRESENTS that, except as expressly limited herein, COREPOINTE INSURANCE COMPANY and DEVELOPERS SURETY AND
INDEMNI re. COMPANY, do hereby make, constitute and appoint:
Zach Matter, Zach Mefferd, Tina Bockholt, Jimmy Brown and Havilah Watson
WITNESS my hand and official seal.
, of West Des Moines, IA
as its true aiid lawful Attorney -in -Fact; to make, execute, deliver and acknowledge, for and on behalf of said companies, as sureties, bonds, undertakings and contracts
of suretyship giving and granting uitto. said Attorney -in -Fact full power and authority to do and to perform every act necessary, requisite ern proper to be done in
connection therewith as each of said company could do, but reserving to each of said company frill power of substitution and revocation, and all of the acts of said
Attorney -in -Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is ctlective August 11, 2023
shall expire on December 31, 2025. and
This Power of Attorney is granted and is sigimed under and by authority of the following resolutions adopted by the Board of Directors of COREPOINTE INSURANCE
COMPANY and DEVELOPERS SURETY AND INDEMNITY COMPANY (collectively, "Company") on February 10, 2023,
RESOLVED, that Sam Zaza_ President. Surety Underwriting, James Bell. Vice President. SuretyUndenvritiit -� g, and Crane Dawfon. Executive Underwriter.
Surety, each an employee of AmTnisf North America, Inc., an affiliate of the Coinpany(the "Authorized Signors"), are hereby authorized to execute a Power
of' Attorney, qualifying attorneys) -in -fact raided in the Power of Attorney to execute, on behalf of the Company, bonds, undertakings and contracts or
suretyship, or other suretyship obligations; and that the Secretary or any Assistant Secretary ofthe Company be; and each of them hereby is, authorized to attest
the execution ofany such Power of Attorney.
RESOLVED, that time signature ofany one of the Authorized Signors and the Secretary or any Assistant Secretary of the Company, 'and the seal of the Company
must be affixed to any such Power of Attorney, and any such signature or seal may be affixed by facsimile, and such Power of Attorney shall be valid and
binding upon the Company when so affixed and in the.ftiture with respect to any bond, undertaking or contract of suretyship to which it is attached.
IN WITNESS WHEREOF, COREPOiNTE INSURANCE COMPANY and DEVELOPERS SURETY AND INDEMNITY COMPANY have caused these presents to be
sided by the Authorized Signor and attested by their Secretary or Assistant Secretary this . March 27, 2023
` os'im!!!s
By:
Printed NA Sam Zaza
Title: President, Surety Underwriting
ACKNOWLEDGEMENT:
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A notary pudic or other officer completing this certificate verifies only the
identity of the individual who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF California
COUNTY OF Orange
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los
On this 27 day of March , 20 23 , before me, 1-loang-Quyen Phu Pham , personally appeared Sam Zaza
who proved to me on the basis &satisfactory evidence to be the person whose name is subscribed to within the instrument and acknowledged to me that they 'executed
the same in their authorized capacity, and that by the signature on the instrument the entities upon behalf which the person acted, executed this instrument.
1 certily, under penalty of perjury, under the laws of the State of California that the foregoing paragraph is true and correct.
CORPORATE CERTIFICATION
The undersigned, the Secretary or Assistant Secretary of COREPOINTE INSURANCE COMPANY and DEVELOPERS SURETY AND INDEMNITY
COMPANY, does hereby certify that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in this Power of Attorney
are in force as of the date of this Certification.
'llmis Certification is executed in the City of Cleveland, Ohio, this March 19, 2023.
-3-
oe
Ui0!
HOANG-QUYEN P. PHAM
Notary Public - Cllifornia
Orange County
Commission # 2432970
My Comm. Expires Dec 31, 2026
B
DocuSigned by;
666415E7ADE546C...
Barry W. Moses, Assistant Secretary POA No. N/A
DocuSignEnvelopelD:3352BFD6-5E9D-4796-837E-C1 E455E6530F
Signed and sealed this `r day of \ejple.l tk3e\4 Z02s
Ed. 0323