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FORM OF BID OR PROPOSAL
FY 2026 SIDEWALK INFILL, SIDEWALK RAMP & TRAIL
REPAIR PROGRAIV1 ._ ZONE 5A
CONTRACT NO. 1131
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
in 3, , a Partnership consisting of the following partners:
• c . _vex �'�,���� _�c \(1\ , 1_1 C , 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 FY 2026 SIDEWALK
INFILL, SIDEWALK RAMP & TRAIL REPAIR PROGRAM o ZONE 5A, Contract No.
1131, all in accordance with the above -listed documents and for the unit prices for
work in place for the following items and quantities:
FY 2026
SIDEWALK
REPAIR
CONTRACT
INFILL,
PROGRAM
SIDEWALK
NO.
— ZONE
1131
RAMP
5A
&
TRAIL
ITEM
BID
SPECIFICATION
SUPPLEMENTAL
SP
=
SUDAS
SPCL
*SEE
PROV
DESCRIPTION
UNIT
EST
QTY
UNIT
PRICE
BID
TOTAL
PRICE
BID
DIVISION
1- SIDEWALK
INFILL
1
7030,
1.08,
A
REMOVE
SIDEWALK/DRIVEWAY
SF
993.1
$ `)
_OCN
$ ycllo5I5"5
2
7030,
1.08,
E
SIDEWALK,
PCC,
4"
SF
3,884.3
$ 1
Q .Ct`
$ Ai 14
Pe
3
7030,
1.08,
E
SIDEWALK,
PCC, 5"
SF
271.1
$ \ \,CO
$(.-YQ0.10
$ \cno
LIO
4
7030,
1.08,
E
SIDEWALK,
PCC,
6"
SF
769.7
$ (),
(-:°
5
7030,
1.08,
H,
1
DRIVEWAY,
PCC,
5"
SF
123.7
$
1 L ,
N)
$ `)
(qb
. -lp
6
7030,
1.08,
H,
2
GRANULAR
SURFACING
TON
5.0
$ `50.e°
$cDj0.°
FORM OF BID
CONTRACT NO. 1131
Page 1 of 4
ITEM
BID
SPECIFICATION
SUPPLEMENTAL
SP
=
SUDAS
SPCL
SEE
PROV
DESCRIPTION
UNIT
EST
QTY
UNIT
PRICE
BID
TOTAL
PRICE
BID
DIVISION
1
- SIDEWALK
INF
LL
(CONTINUED)
7
7010,
1.08,
F
BEAM
CURB
SF
178.6
$ ';
,C��
$40
n
CP
8
7030,
1.08,
G
DETECTABLE
WARNING
SURFACE
SF
112.0
$ `\f
00
$
la,
,
("
9
7092,
1.08,
C
SAWCUT,
1/2"
CURB
OPENING
LF
41.7
$
'S3.C\°
$
ML-V:\
�_. '
10
7010,
1.08,
E
CURB
&
GUTTER
R&R,
30",
6"
LF
30.1
$
,
L�
$CA
-()..C-\(
11
7010,
1.08,
E
CURB
&
GUTTER
R&R,
30",
8.5"
LF
81.4
$ \
`
.e°
$
$
\a,a\0•()0
s5±k>
CZ
12
7010,
1.08,
E
CURB
&
GUTTER
R&R,
30",
9"
LF
22.1
$ 1
kee:0b'
13
2010,
1.08,E
EXCAVATION,
CLASS
10
SF
9,782.2
$
')
WU
$
l )1-Aa;b
14
9010,
1.08,
B
HYDROSEEDING
SF
5,472.2
$
\
.\D
$
(O
M
\
•Ly
15
SP
#1
WATER
VALVE
ADJUSTMENT
EA
2.0
$
-)
.C-(3
$
x^'C,.00
16
SP
#2
EROSION
&
SEDIMENT
CONTROL
LS
1.0
$\CCQ
,O�
$ \Ut
•ee
17
8030,
1.08,
A
TRAFFIC
CONTROL
LS
1.0
$3-.COICC)
$aDM-
TOTAL
BID
a
DIVISION
1
$
l4-
Y
: %
ITEM
BID
SPECIFICATION
SUPPLEMENTAL
SP
=
SUDAS
*SEE
SPCL
PROV
DESCRIPTION
UNIT
EST
QTY
UNIT
PRICE
BID
TOTAL
PRICE
BID
DIVISION
2
®
ADA
SIDEWALK
RAMP
REPAIRS
1
7030,
1.08,
A
REMOVE
SIDEWALK
SF
5,677.8
$
5.''
$ 1
,1LS•
2
7030,
1.08,
E
SIDEWALK,
PCC,
4"
SF
2,718.6
$
]
`.
13L
$311
(
)(Y)
3
7030,
1.08,
E
SIDEWALK,
PCC,
6"
SF
2,903.8
$,,a-
$':31
)UV.
4
7030,
1.08,
E
SIDEWALK,
PCC,
CLASS
A
SF
77.0
$
,
1
C.`C
$
i
b 1`S_0
5
7030,
1.08,
G
DETECTABLE
WARNING
SURFACE
SF
389.4
$
\
ID
,e°
$ L
\M-31A
(A)
6
7092,
1.08,
C
SAW
CUT,
1/2"
CURB
OPENING
LF
220.9
$ 6
C0
$
11 1 t
1a9�
7
7010,
1.08,
E
CURB
&
GUTTER
R&R,
30",
8"
LF
195.0
$ \
50
OCC)
$(1)c-\ , `)
)a..°
8
7010,
1.08,
E
CURB
&
GUTTER
R&R,
30", 9"
LF
73.0
$ 't
(cr).CC
$1 \ ,
`\ 5
9
2010,
1.08,
E
EXCAVATION,
CLASS
10
SF
5,450.2
$ 3 .1a3
$a)
,1\
16
10
9010,
1.08,
B
HYDROSEEDING
SF
4,935.6
$ \ ,\0
$ )441,1(cl
11
SP #2
EROSION
& SEDIMENT
CONTROL
LS
1.0
$ >
00.ee
$ 1 `_ CC).Ce
12
8030,
1.08,
A
TRAFFIC
CONTROL
LS
1.0
$ rtn\.r>.K)
$ ()
r
,CC)
TOTAL
BID
a
DIVISION
2 $ \)n)
y)`,
i-Ia
FORM OF BID
CONTRACT NO. 1131
Page 2 of 4
ITEM
BID
SPECIFICATION
SUPPLEMENTAL
SP
=
SUDAS
SPCL
*SEE
PROV
DESCRIPTION
UNIT
EST
QTY
UNIT
PRICE
BID
TOTAL
PRICE
BID
DIVISION
3 —
TRAIL
REPAIRS
1
7030,
1.08,
A
REMOVE
TRAIL,
PCC
SF
6,880.0
$ '),-1
$ nO,rtD
v°
2
7030,
1.08,
E
TRAIL,
PCC,
6"
SF
6,880.0
$ 1 . LC
$1N,M
$ (515aSe
3
9010,
1.08,
B
HYDROSEEDING
SF
2,752.0
$ , ,(-;O
4
7040,108,
A
TRAIL
ASPHALT
FULL
DEPTH
PATCH
,
SF
333.0
$ 15`3.C(.
$)\,k1�)C`)
5
8030,
1.08,
A
TRAFFIC
CONTROL
LS
1.0
$
xj
(j
,
$;
ICC).
CO
TOTAL
BID
-
DIVISION
3 $ 15%)
Iry i .-
0 0
,
OTAL
BID
DBVBSUW!S
1., 2, es 3 $ `>11-13Y
h'L\O
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. Security in the sum of < 5 (I& Dollars ($
6 \)`M 1( Jc '� ) in the form of , is submitted
herewith in accordance with the INSTRUCTIONS TO BIDDERS.
5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Resident Bidder Certification ( ), or Non -Resident
Bidder Certification ( ). (Mark one.)
7 The bidder is prepared to submit a financial and experience statement upon
request.
B. 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.
FORM OF BID
CONTRACT NO. 1131 Page 3 of 4
9. The bidder has received the following Addendum or Addenda:
Addendum No. 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.
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.
r\ek c (bv --\-\
(Name of Bidder) (Date)
BY: Ritc64 lien
Title a.,CAr\e l
Official Address: (Including Zip Code):
1 ')U\� cox
I.R.S. No. `kb - No-MoNC
FORM OF BID
CONTRACT NO. 1131 Page 4 of 4
Nc.} <<y ALL MEN BY THESE PRESENTS, that we.
nr!r:4'ipai. and Nationwide Mutual Insurance Company
rr)..'„?t-; f nto the CITY OF WATERLOO
Five Percent of Bid Amount
BID BONED
Brock Even Construction LLC
...............a,J.., as Surety, are held and firmly
Iowa, hereinafter called "OWNER."
Dollars ($ 5% of Bid Amount
in thy- penal sUFI
) lawful money of
United States, for the payment of which sum will and truly be made, we bind ourselves, our heirs, executors.
3(J(r:il'iis(uators., anci successors, jointly and severally, firmly by these presents. The condition of this obligation is
such that whereas the Principal has submitted theaccompanying bid dated the 2nd day o`
October , 20 25 for FY 2026 Sidewalk Infill, Sidewalk Ramp & Trail Repair Program - Zone 5A - Contract No. 'Heal
NOW, THEREFORE.
(a) if said Bid shall be rejected, or in the alternate,
(b) If saki Bic; shall be accepted and the Principal shall execute and deliver a contract in the form specrfieo 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.
her, this obligation shall be void, otherwise the same shall remain in force and effect; it being expressly
t;{ier•:;ico J and agreed that the liability of the Surety for any and all claims hereunder shall. in no event, exceed
he penal amount ot this obligation as herein stated.
etv virtue of statutory authority, the full amount of this bits bond shall be forfeited to the Owner in liquidation 0i
i.4arn ages >tustained in the event that the Principal fails to execute the contract and provide the bons 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 sh tli
t)f3 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
there as are corporations, have caused their corporate seals to be hereto affixed and these presents to be signed
by their proper officers this 26th day of September . A.D. 20, 25
't tf itnecs
s:v Itr ess
Brock Even Construction LLC
♦Y•.H. 4•••WJJV1...a .a .S.4Y Y..e J M....•Mnrr.\.MMWNW
Principal
By
Nationwide Mutual Insurance Company
Surety
By
Shelby Ross Attvj,ey-in-fact
•
(Seal)
BID BOND
Page 1 of 1
Bond Number: N/A
Power of Attorney
KNOW ALL MEN BY THESE PRESENTS THAT:
Nationwide Mutual Insurance Company, an Ohio corporation
hereinafter referred to severally as the "Company" and collectively as "the Companies" does hereby make, constitute and appoint:
SIIELRY ROSS
each in their individual capacity, its true and lawful attorney -in -fact, with full power and authority to sign, seal, and execute on its behalf any and all bonds and
undertakings, and other obligatory instruments of similar nature, in penalties not exceeding the sum of
Seven Hundred Fifty Thousand and no/100 -- Dollars ($750,000.00)
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and all acts
of said Attorney pursuant to the authority given are hereby ratified and confirmed.
This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company:
"RESOLVED, that the president, or any vice president be, and each hereby is, authorized and empowered to appoint attorneys -in -fact of the Company,
and to authorize them to execute and deliver on behalf of the Company any and all bonds, forms, applications, memorandums, undertakings,
recognizances, transfers, contracts of indemnity, policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature that the business of the Company may require; and to modify or revoke, with or without cause, any such appointment or
authority; provided, however, that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any
of said documents on behalf of the Company."
"RESOLVED FURTHER, that such attorneys -in -fact shall have full power and authority to execute and deliver any and all such documents and to bind the
Company subject to the terms and limitations of the power of attorney issued to them, and to affix the seal of the Company thereto; provided, however, that
said seal shall not be necessary for the validity of any such documents."
This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company.
Execution of Instruments. Any vice president, any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all
approved documents, instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of
the board, the chief executive officer, president, treasurer or secretary; provided, however, the signature of any of them may be printed, engraved, or
stamped on any approved document, contract, instrument, or other papers of the Company.
IN WITNESS WHEREOF, the Company has caused this instrument to be sealed and duly attested by the signature of its officer the 1st day of April, 2024.
Antonio C. Albanese, Vice President of Nationwide Mutual Insurance Company
ACKNOWLEDGMENT
STATE OF NEW YORK COUNTY OF KINGS: ss
On this 1st day of April, 2024, before me came the above -named officer for the Company
aforesaid, to me personally known to be the officer described in and who executed the
preceding instrument, and he acknowledged the execution of the same, and being by me duly
sworn, deposes and says, that he is the officer of the Company aforesaid, that the seal affixed
hereto is the corporate seal of said Company, and the said corporate seal and his signature
were duly affixed and subscribed to said instrument by the authority and direction of said
Company.
Sharon Laburda
Notary Public, State of New York
No. 01LA6427697
Qualified in Kings County
Commission Expires January 3, 2026
CERTIFICATE
I, Lezlie F. Chimienti, Assistant Secretary of the Company, do hereby certify that the foregoing is a full, true and correct copy of the original power of attorney
issued by the Company; that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the
same has not been revoked or amended in any manner; that said Antonio C. Albanese was on the date of the execution of the foregoing power of attorney the
duly elected officer of the Company, and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of
said board of directors; and the foregoing power of attorney is still in full force and effect.
IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate seal of said Company this 26th day of
September 2025 / .
•
.r.CJ
Notary Pub'.c
My Commission Expires
January 3, 2026
BDJ 1(04-24 )00
Assistant Secretary
State of lr,ta
County of v-3\trp\(,_
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
)ss
S>N-t)ck (\ L—ve , being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Officer, Representative, or Agent) , of rock Lev �n
C h(\--1-YL� -\\c-n ,1 1 ( , 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)
Title
Subscribed and sworn to before me this
My commission expires
ires Ia a'P'()SIC
1 'alias J ..TLn.]L
xr••.-••.•.•••... f,-1•1111-=.osee.
MARGIE KNIPP
COMMISSION NO. 814768
MY COMMISSION EXPIRES
January 22, 20
Bidder Status Form
To be completed by all bidders
Part A
Please answer "Yes" or "No" for each of the following:
Oves QNO
Yes 0 No
Yes QNo
Yes fl1No
oYes ONo
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).
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 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 13
My company has maintained offices in Iowa during the past 3 years at the following addresses:
kkiy‘ }
Dates: to / / ? `` Address: i. \� M>C
Dates: / / to / /
Dates:
You may attach additional sheet(s) if needed.
City, State, Zip. , \e5,1,1r tj (-i%
Address'
City, State, Zip-
/ / to / / Address -
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 labor0 Yes 0 No
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.
You may attach additional sheet(s) 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: %
Signature:
ic-o0k\iecN (NT>C1\r< k(*vC ) LLB
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)
MBEIWBE BUSINESS ENTERPRISE
PRE -BID CONTACT INFORMATION FORM
Prime Contractor Name: ?artNek Ever <-1
1-vn t\ to* Cmn-1 LL_C
Project: ; aU-�lo -"Ty , (\(ke( calk Pm))A -77c,-k\ Letting Date: 1r)/S%h
c)c-cx\- \-11 - 7U (`( c N\.
NO MBEIWBE 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.
c�l
Contractor Signature:
Title: "\ \\\ j t
Date: \ (-1 1 /c)T
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
MBEIWI3E BUSINESS ENTERPRISE CONTACTS
Quotes
Received
Quotation
used
in
bid
Subcontractors
MBE/WBE
Contacted
Dates
Yes/No
Contacted
Dates
YeslNo
Dollar
be
Amount
Subcontracted
Proposed
to
(Form CCO-4) Rev. 06-20-02