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FORM OF BID OR PROPOSAL
PARK AVENUE BRIDGE HISTORIC MARKER
CONTRACT NO. 1121
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
IOWA
a Partnership consisting of the following partners:
, having familiarized (himself) (themselves)
(itself) with the existing conditions on the project area affecting the cost of the work, and with all the contract
documents listed in the Table of Contents and Addenda (if any), as prepared by the City Engineer of the City
of Waterloo now on file in the office of the City Clerk, City Hall, Waterloo, Iowa, hereby proposes to furnish all
supervision, technical personnel, labor, materials, machinery tools, appurtenances, equipment, and
services, including utility and transportation services required to construct and complete this PARK AVENUE
BRIDGE HISTORIC MARKER, Contract No. 1121, all in accordance with the above -listed documents and for
the unit prices for work in place for the following items and quantities:
PARK AVENUE BRIDGE HISTORIC MARKER
CONTRACT NO. 1121
BID ITEM
ITEM
DESCRIPTION
UNIT
EST.
QTY.
UNIT
PRICE
BID
TOTAL
BID
PRICE
1
RESTORE
EXISTING
BRIDGE
BEAM
SECTION
EA
1.0
$
225,000.00
$ 225,000.00
2
CONSTRUCT
BRIDGE
BEAM
SUPPORTS
LS
1.0
$ 19,250.00
$ 19,250.00
3
INSTALL
RESTORED
BRIDGE
BEAM
SECTION
EA
1.0
$
17,920.00
$ 17,920.00
4
EARTHWORK
AND
SITE
GRADING
LS
1.0
$
20,000.00
$ 20,000.00
5
PLAZA
CONCRETE
CONSTRUCTION
LS
1.0
$ 21,120.00
$ 21,120.00
6
PLAZA
ELECTRICAL
LS
1.0
$ 4,000.00
$ 4,000.00
7
PLAZA
STORM
SEWER
LS
1.0
$ 15,435.00
$ 15,435.00
8
IRRIGATION
LS
1.0
$ 5,660.00
$ 5,660.00
9
LANDSCAPING
AND
RESTORATION
LS
1.0
$ 12,220.00
$ 12,220.00
10
EXHIBIT
SIGNS
AND
SUPPORTS
EA
3.0
$ 13,030.00
$ 13,030.00
TOTAL BID $
353,725.00
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before this bid is withdrawn the undersigned agrees to execute and deliver an agreement in the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
FORM OF BID
CONTRACT NO. 1121 Page 1 of 3
after the agreement is presented to him for signature, and start work within ten (10) days after "Notice
to Proceed" is issued.
4. Security in the sum of 5% Dollars ($
) in the form of Bid Bond , 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.
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. N/A
N/A
N/A
Date
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.
FORM OF BID
CONTRACT NO. 1121 Page 2 of 3
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.
PETERSON CONTRACTORS INC.
(Name of Bidder)
4/24/2025
(Date)
v
BY: Title A44000frgor hafts
Official Address: (Including Zip Code):
104 BLACK HAWK ST
REINBECK, IA 50669
I.R.S. No. 42-0921654
FORM OF BID
CONTRACT NO. 1121 Page 3 of 3
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of ToWi
County of GtZuNDy )
)ss
vt•t-stL , being first duly sworn, deposes and says that:
1. He is (Owner, PartneaiFENRepresentative, or Agent) , of-PETE-RSCI CopfllZf\CTOZS
NG, the Bidder that has submitted the attached Bid;
2. He is fully -informed respecting the preparation and contents of the attached Bid and of all pertinent
circumstances respecting such Bid;
3. Such Bid is genuine and is not a collusive or sham Bid:
4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees, or
parties in interest, including this affiant, has in any way colluded conspired, connived or agreed, directly or
indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the
Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such
Contract, or has in any manner, directly or indirectly sought by agreement or collusion or communication or
conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other
Bidder, or, to fix any overhead, profit or cost element of the bid price or the bid price of any other Bidder, or
to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against the
City of Waterloo, Iowa, or any person interested in the Proposed Contract; and
5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion,
conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents, representatives,
owners, employees, or parties in interest, including this affiant.
(Signed) /
Ass.-nvvr
Title
Subscribed and sworn to before me this day of ZL
Tite
My commission expires 8 30 _)-C
On I. AMY L. CLARK
T. Commission Number 798999
• My Commission Expir$
OWt' August 30, 2025 ',; ,
hri-tacte ,Oa l3 t- I C
•
20a5
Bidder Status Form
To be completed by all bidders Part A
Please answer "Yes" or "No" for each of the following:
Yes (J No My company is authorized to transact business in Iowa.
(To help you determine if your company is authorized, please review the worksheet on the next page).
Yes ❑ No My company has an office to transact business in Iowa.
Yes ❑ No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
Yes ❑ No My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
Yes ❑ No 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 B and D of this form.
If you answered "No" to one or more questions above, your company is a nonresident bidder. Please
complete Parts 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: 12 / 22 / 1965 to cu / rr / ent Address: 104 Blackhawk St
City, State, Zip: Reinbeck, IA 50669
Dates: / / to / / Address:
City, State, Zip:
Dates: / / to / I Address:
You may attach additional sheets) if needed. City, State, Zip:
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?
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.
Yes l I No
You may attach additional shoots) if needed.
To be completed by all bidders Part D
I 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: Peterson Contractors, Inc.
Signature:
Date:
You must submit the completed form to the governmental body requesting bids per 875 Iowa Administrative Code
Chapter 156. This form has been approved by the Iowa Labor Commissioner.
309-6001 (09-15)
Worksheet: 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.
Yes LJ No My business is currently registered as a contractor with the Iowa Division of Labor.
Yes V No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes.
Yes ✓ 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 Lj 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 ✓ 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)
MBE/WBE BUSINESS ENTERPRISE
PRE -BID CONTACT INFORMATION FORM
Prime Contractor Name: 'ETERSoyc CowTMC7-Uz5 /NG.
Project: rtro,E HISTo2IC matgyaz
Letting Date: 'f/Z 1/201.S
NO MBE/WBE SUBCONTRACTORS: If you are NOT using any MBE/WBE 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 bottom portion of this form.
Contractor Signature:,
Title: foss �, 5
Date: 4 Z4�
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 MBE/WBE 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 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 Rudy Jones, 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
Subcontractors
MBE/WBE
Contacted
Dates
Yes/No
Contacted
Dates
Yes/No
Dollar
Amount
be
Subcontracted
Proposed
to
SE-'2V
1tC
SIN
►,N(,
3 /Z3/25
45
11/23/Z C
165
vo
I
MO -
(Form CCO-4) Rev. 06-20-02
No MBE/DBE's were able to provide a full scope of work for work not being self -performed work.
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 the Total 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 24th day of
April , 20 25 , for Park Avenue Bridge Historic Marker, Contract No. 1121, Waterloo, IA
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the alternate,
(b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the form specified and
shall furnish a bond for his faithful performance of said contract, and for the payment of all persons performing
labor or furnishing materials in connection therewith, and shall in all other respects perform the agreement
created by the acceptance of said Bid,
Then this obligation shall be void, otherwise the same 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 11th day Of April , A.D. 20 25
Witness
00.41„a,
Witness Jamie Gifford
BID BOND
Travelers Casualty and Surety Company op re s t d e n
America
/ \ eal)
urety
BY l
Sara L Huston, Attorney-
-fact
Peterson_Contractors, Inc.
(Seal)
Prtforpal
ker,
(Title)
Unm1uui1Hq
.N`�`NQ SURETY 1„
•:*As.!• 0%
Lit
:: CONN. :o
Page 1 of 1
TRAVELERS . I
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Sara L Huston of
WAUKEE , Iowa , their true and lawful Attorney(s)-in-Fact 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 21st day of April,
2021.
State of Connecticut
By:
City of Hartford ss.
f
Robert L. Raneenior Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
My Commission expires the 30th day of June, 2026
I; UMW
.i1 fib
<gine
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, 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 seas, 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.
Anna P. Nowik, Notary Public
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this 11th day cf
April 2025
Kevin E. Hughes, Assistant Secretary
To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880.
P/ease refer to the above -named Attorneys) -in -Fact and the details of the bond to which this Power of Attorney is attached.