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HomeMy WebLinkAboutBOOMERANG CORPBoomerang Corp 13225 Circle Dr. Suite A P.O. Box 227 Anamosa, Iowa 52205 JUL 16' 6p412:68 2S Proposal For: FY 2023 Cattle Congress Sanitary Sewer Lift Station Reconstruction To: City Clerk City of Waterloo 715 Mulberry Street Waterloo, Iowa 50703 Letting: July 16th, 2026 @ 1:00 PM • Bid Security: FY 2023 Cattle Congress Sanitary boomerang Sewer Lift Station Reconstruction PO Box 227 Anamosa, IA 52205 To: City Clerk City of Waterloo 715 Mulberry Street Waterloo, Iowa 50703 Letting: July 16th, 2026 @ 1:00 PM 0 FORM OF BID OR PROPOSAL FY 2023 CATTLE CONGRESS SANITARY SEWER LIFT STATION RECONSTRUCTION CONTRACT NO. 1075 CITY OF WATERLOO, IOWA Honorable Mayor and City Council Waterloo, Iowa Gentlemen: 1. The undersigned, being a Corporation existing under tl erlaws of the State of---CJA a Partnership consisting of the following partners: IV j 1'1 having familiarized (himself) (themselves) (itself) with the existing conditions on the project area affecting the cost of the work, and with all the contract documents listed in the Table of Contents and Addenda (if any), as prepared by AECOM now on file in the office of the City Clerk, City Hall, Waterloo, Iowa, hereby proposes to furnish all supervision, technical personnel, labor, materials, machinery, tools, appurtenances, equipment, and services, including utility and transportation services required to construct and complete the CATTLE CONGRESS LIFT STATION SANITARY SEWER RECONSTRUCTION, CONTRACT NO. 1075, all in accordance with the above-listed documents and for the unit prices for work in place for the following items and quantities: FY 2023 CATTLE CONGRESS SANITARY SEWER LIFT STATION RECONSTRUCTION CONTRACT NO. 1075 Item SODAS- Estimated Unit Bid Total Bid No. Measurement& Description Unit Quantities Price Price Payment BASE BID 1 11020-A MOBILIZATION LS 1.0 $ CCQOCO$5t-T.( . -Co 2 2010-D-1 TOPSOIL, ON-SITE,6 INCHES CY 248.6 $L) $ 3 2010-E EXCAVATION,CLASS 10-EMBANKMENT-IN- CY 400.0 $ $ PLACE ^� JCS 4�C�i� OO 4 2010-I SUBGRADE TREATMENT,GEOFABRIC SY 175.0 $(t, C 6 $ 1,150,dO 5 2010-J SUBBASE, MODIFIED, 11' SY 224.8 $.2m c $1./c./ �'( 6, cc 6 2010-M COMPACTION TESTING LS 1.0 $ ;C; (Yc.) 7 3010-D REPLACEMENT OF UNSUITABLE BACKFILL CY 2872.4 $ $ MATERIAL �D. q -jc OC3 8 3010-H TRENCH COMPACTION TESTING LS 1.0 $ � �� DDs©o 9 4010 C 1 SANITARY SEWER FORCE MAIN,TRENCHED, LF $ �. $ PVC, 10-INCHES 512.85L _Cc : Sig,44Ob.0O 10 4010-C-1 SANITARY SEWER FORCE MAIN,TRENCHED, LF 5.5 Si, DUCTILE IRON, 10-INCHES /ca.(L $?, C6. 00 11 4010 C 2 SANITARY SEWER FROCE MAIN, LF 300.0 $• - $ TRENCHLESS, PVC, 10-INCHES vt�cY QL�, L�� .Ld 12 4010-L SANITARY SEWER ABANDONMENT, FILL AND LF 815.3 $ PLUG, 10-INCHES �5 CC $��, 3 a.11 5O 13 4050-G-3 BYPASS PUMPING LS 1.0 FifiCsCL Ch qU0, csOo• b© 14 4060 FORCE MAIN TESTING LS 1.0 $.?.CeL-Cd CNN,00 15 5010-C-2 FORCE MAIN FITTING LB 720.0 $ytt`C? $.y $6l+..0 C) 16 6010-G-1 CONNECTION TO EXISTING MANHOLE EA 1.0 $i,au\ $ !` ` 06 17 7030-H-3 DRIVEWAY,GRANULAR,6-INCHES TON 172.9 $Ljb Co $1j, ict• oO 18 8030-A TEMPORARY TRAFFIC CONTROL LS 1.0 $q See C<$ y, 5LC1,00 19 9010-B HYDRAULIC SEEDING,SEEDING, AC 0.4 $ FERTILIZING,AND MULCHING,TYPE 1 CCC C') Oct` FORM OF BID CONTRACT NO. 1075 FB-1 of 3 AECOM#60696351 FY 2023 CATTLE CONGRESS SAN SEWER LIFT STATION RECONSTRUCTION 20 9010-B HYDRAULIC SEEDING,SEEDING, AC 0.2 $s $ FERTILIZING,AND MULCHING,TYPE 4 la,cc0.00 a`I,'-100.00 21 9040-A-1 SWPPP PREPARATION LS 1.0 $c1,001.00$L1,DOD.OO 22 9040-A-2 SWPPP MANEGEMENT LS 1.0 At boo.0(1$ 12,000.00 23 9060-D REMOVAL AND REINSTALLATION OF LF 40.0 $ $ EXISTING FENCE,CHAINLINK,GALVANIZE _ )16.00 4,y00.co 24 9080-A CONCRETE STEPS,TYPE A SF 115.5 $a00.0p $, 3,100 s 00 25 9080-B HANDRAIL,32-INCHES LF 22.0 $.24,bser $g,-Laos 00 26 9080-C SAFETY RAIL LF 44.8 %1eA,OD 11,(ogg,00 27 10010-A DEMOLITION WORK-WET WELL LS 1.0J$o,000 L}$300,C'60•GO 28 10010-A DEMOLITION WORK-LIFT STATION LS 1.0 $ BUILDING AND EQUIPMENT 1 ,000.0 p 154 0 DO,00 29 11050-A CONCRETE WASHOUT LS 1.0 $.506O0 $506.t 0 30 AS PER PLANS SANITARY SEWER MANHOLE EA 5.0 g$ $ ABANDONMENT a,000-DO /0,WO.00 31 AS PER PLANS LIFT STATION WET WELL LS 1.c6400.00 $S50,000.00 32 AS PER PLANS PREFABRICATED OPERATOR'S BUILDING LS 1.014E01000.0),C(0)MO.a) 33 AS PER PLANS BYPASS MANHOLE LS 1.0 $1,0,D00.06 /a0,QQD•00 34 AS PER PLANS SITE ELECTRICAL LS 1.1341010 ob . •Q$aO01000.DO 35 AS PER PLANS STAND-BY GENERATOR LS 1.010$,OAt1.cos )n4/OO.OD 36 AS PER PLANS BOLLARDS EA 6.0 $/,abb.00$1,.20G.00 37 AS PER PLANS STRUCTURAL CONCRETE RETAINING WALL CY-GENERATOR PAD AND STAIRS 30.2 $I,`a00`CO$34,,a y 0,00 38 AS PER PLANS STRUCTUAL CONCRETE PAD-GENERATOR CY 8.1 $(a00.e0$4,810),00 39 AS PER PLANS COMPACTING BACKFILL-GRADING CY 400.0 $JOO.00 $y0,000.66 PROJECT TOTAL $5.06114$512.5.) 2. It is understood that the quantities set forth are approximate only and subject to variation and that the unit bid price for the work done shall govern in the actual payment to Contractor. 3. In submitting this bid,the bidder understands that the right is reserved by the City of Waterloo,Iowa, to reject any or all bids. If written notice of the acceptance of this bid is mailed,telegraphed,or delivered to the undersigned within thirty(30)days after the opening thereof,or at any time thereafter before this bid is withdrawn,the undersigned agrees to execute and deliver an agreement in the prescribed form and furnish the required bond and certificate of the insurance within ten(10)days after the agreement is presented to him for signature, and start work within ten (10)days after "Notice to Proceed"is issued. I^ 4. Security in the sum of ��0 Dr a_rnOLn'f Nlid `_ , Dollars ($ )in the form of h in bone ,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 indicating Resident Bidder Certification( ✓ ),or Non-Resident Bidder Certification( ). (Mark one.) 7. The bidder is prepared to submit a financial and experience statement upon request. FORM OF BID CONTRACT NO.1075 FB-2 of 3 AECOM#60696351 FY 2023 CATTLE CONGRESS SAN SEWER LIFT STATION RECONSTRUCTION 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 -1- -06a2 . -16'�a (D 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. 00rilefofl ik COY-13 —7--I CD -2)Dfc (Name of Bic dr) (Date) BY: (Vj\-.44.1-)-6)." Title `_ L 1_ ! — - Official Address: (lncludin Zip Code): I ? 3C, c.I . ; i ie_Gc4 14 A PO 13c)x ,Oar) I.R.S. No. `I,g-^ )`Jai 1 i 9 FORM OF BID CONTRACT NO. 1075 FB-3 of 3 AECOM#60696351 FY 2023 CATTLE CONGRESS SAN SEWER LIFT STATION RECONSTRUCTION NON-COLLUSION AFFIDAVIT OF PRIME BIDDER State of :_ I-CA)I\ ) )ss County of�-. ( 1�Q,`� ) -03,0,10. t-{ o., IA , being first duly sworn, deposes and says that: 1 . e is Partnerc-----;-,--- (Owner, ffie Representative, or Agent) , of (2 ctimp-�-a c --`T , 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, o ies in interest, including this affiant. (Signed) o,� tkl--51- ---- y I 'i d.P,f) f Title * �Subscribed and sworn to before me this , 1LA_ day of L a 20jC!% i N. ill ---.... N.)04tayr ._I C J Title LAnn DAWN M KING My commission expires I /C ' c� ` Commission Number855430 My C mission Expires NO 1(I a-7 I NON-COLLUSION AFFIDAVIT CONTRACT NO. 1075 NCA-1 of 2 AECOM #60696351 FY 2023 CATTLE CONGRESS SAN SEWER LIFT STATION RECONSTRUCTION Bidder Status Form To be completed by all bidders Part A Pie e answer"Yes" or"No" for each of the following: Yes ❑ 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). es ❑ No My company has an office to transact business in Iowa. es ❑ No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. ❑ No YMy company has been conducting business in Iowa for at least 3 years prior to the first request for bids on this project. Yes El 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 wa during the past 3 years at the following addresses: Dates: / L. / 0 to [ A.-Gren. Address:13 _ C rrJ;br i Lk' S.e.; TP. I City, State, Zip: — . _ Dates: / / to / / Address: City, State, Zip: Dates: / /_ to / / Address: You may attach additional sheet(s) 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 ❑ Yes ❑ 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: , a.oci' C0--rnJSignature: L �- ' Date:-1 —_Jb " , rJ,g(P 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 El 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. El 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 ❑ 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. El Yes El 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) BSF-2 SRF Required Front-End Specifications Attachment 1: -RESERVED- Attachment 2: Statement in Advertisement for Bids on Debarment and Suspension/Certification Regarding Debarment and Suspension Form (to be completed and signed by Prime Contractor and submitted with the bid) Attachment 3: Disadvantaged Business Enterprise Certification Form (to be completed and signed by Prime Contractor and submitted with the bid) Attachment 4: DBE Program Subcontractor Performance Form (to be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid) *If no DBE was chosen by the Prime Contractor to be utilized for this project,then this form is not required to be submitted. Attachment 5: DBE Program Subcontractor Utilization Form (to be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid) *If no DBE was chosen by the Prime Contractor to be utilized for this project,then this form is not required to be submitted. Attachment 6: -RESERVED- Attachment 7: Other Federal Requirements Language A. -RESERVED- B. Federal Labor Standards Provisions (including Davis-Bacon prevailing wage rates**) C. -RESERVED D. Historical and Archeological Finds E. Prohibitions on Procurement from Violating Facilities Attachment 8: Right of Entry and Records Retention Attachment 9: American Iron &Steel Requirement Attachment 10: Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment (to be completed and signed by Prime Contractor and submitted with the bid) July 2025 -Attachment 1: RESERVED- July 2025 Attachment 2: SRF Required Front-End Specifications Debarments and Suspensions *This form to be completed by the Prime Contractor and submitted with the bid. Any bidder or equipment supplier whose firm or affiliate is listed in on the U.S. General Services Administration Excluded Parties List will be prohibited from the bidding process. The excluded parties records search engine is located at the System for Award Management (SAM)website: https://sam.gov. Pursuant to 2 CFR Part 180, as supplemented by 2 CFR 1532, any entity submitting a bid while the SAM website lists that entity as having an active exclusion will be determined by the DNR to be a non-responsive bidder and will not be able to receive SRF funding. United States Environmental Protection Agency Washington, DC 20460 Certification Regarding Debarment, Suspension, and Other Responsibility Matters The prospective participant certifies to the best of its knowledge and belief that it and the principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local)transaction or contract under a public transaction:violation of Federal or State antitrust statutes or commission of embezzlement, theft,forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local)terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. In addition, under 18 U SC Sec. 10 01, a false statement may result in a fine or imprisonment, or both. _Signature of Authorized Representative Printed Name Title I am unable to certify to the above statements. My explanation is attached. July 2025 Attachment 3: SRF Required Front-End Specifications Disadvantaged Business Enterprise (DBE) Solicitation *This form to be completed by Prime Contractor and submitted with the bid. In Iowa, DBEs must be certified through the Iowa Department of Transportation (IDOT). Information on certification requirements and a list of certified DBEs is on the IDOT website at https://secure.iowadot.gov/DBE/Home/Index/. Prime contractors' DBE requirements for SRF projects include: • Taking affirmative steps for DBE participation • Documenting the efforts and the proposed utilization of certified DBEs PROJECT INFORMATION SRF Applicant: _ Bidder: PXfrflfcbJ)q(y ,. .. Address: 1��. J . �'C le ,v.'� (_)(ter 4-e ! 1 c)t LY. fl City: Nr,\Cti4)QC\_ State: 1 ,- t__) , Zip: , agO� Contact Person: lecvaa. [1,61,1 Phone Number: _ maii: COr+cO (J' e_ kx o ! e. 0 nq Cn rp. C6 i 1 1. At this oint in time, has the prime contractor begun to solicit work opportunities to subcontractors for this project? es rlo EIN/A 2. Do you agree to use the good faith efforts checklist to ensure the DBEs have the opportunity to compete for procur ments funded by EPA financial assistance funds? Yes ONo 3. If yes,was a DB chosen by the prime contractor to be utilized for this project? Des No Signature: ct..----?)-)L.J._v_9___ 6 July 2025 GOOD FAITH EFFORTS CHECKLIST Please complete the checklist to determine if you have complied with the requirement to make good faith efforts to ensure that certified DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds. Bidders/offerers must make good faith efforts prior to submission of bids/proposals. 1. Did you ensure that DBEs are made aware of contracting opportunities to the fullest extent practicable through outre ch and recruitment activities? Yes flNo 2. Did you make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs i the competitive process?This includes, whenever possible, posting solicitation for bids or proposals for a minim of 30 calendar days before the bid or proposal closing date. es No 3. Did you consider in the contracting process whether firms competing for large contracts could subcontract with DBEs?This will include dividing total requirements, when economically feasible, into smaller tasks or quantities to permit aximum participation by DBEs in the competitive process. es No 4. Did you encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle ndividually? es No 5. Did you to the services of the Small Business Administration and the Minority Business Development Agency of the Depar ent of Commerce to identify potential subcontractors? Yes nNo 6. List the potential DBE subcontractors that were contacted. Only list those that are certified through the Iowa Department of Transportation. Name How Contacted (e.g. letter, Response (e.g. did not respond, not I T phone call,fax,e-mail) interested, not competitive) Prk. J I i C rr' C_ J e-TYY1..) I C r'd (l o f (Q s p iTyNcY l i (2c - ) CtiCISCC2p P-mQi I d. ( 1-v) f re5p01cJ CONTRACT ADMINISTRATION PROVISIONS Several contract provisions are required to prevent unfair practices that adversely affect DBEs. These include: 1. Prime Contractor must pay its Subcontractor for satisfactory performance no more than 30 days from the Prime Contractor's receipt of payment from the SRF loan recipient. 2. Prime Contractor must notify the SRF loan recipient in writing prior to termination of a DBE subcontractor for convenience. 3. Prime Contractor must employ the six Good Faith Efforts to solicit a replacement subcontractor if a DBE subcontractor fails to complete work under a subcontract for any reason. July 2025 Attachment 4: SRF Required Front-End Specifications Disadvantaged Business Enterprise (DBE) Subcontractor Performance Form *This form to be completed by Prime and DBE Subcontractor for each subcontract and submitted with the bid. *If a DBE has NOT yet been selected by the Prime Contractor or if no DBEs are needed, then this form is not required to be submitted at this time. This form is intended to capture the DBE'subcontractor's' description of work to be performed and the price of the work submitted to the prime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to have its DBE subcontractors complete this form and include all completed forms in the prime contractor's bid or proposal package. Subcontractor Name: Project Name: Bid/Proposal No.: Assistance Agreement ID No. (if known): Point of Contact: Address: Telephone No.: Email: Prime Contractor Name: CY) ;Y Issuing/Funding Entity: Contract Item Description of Work Submitted to the Prime Contractor Involving Price of Work Submitted Number Construction,Services, Equipment or Supplies to the Prime Contractor I:)G Q Cntran or I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. Prime Contractor Signature Print Name - I Title Date July 2025 Subcontractor Signature Print Name Title Date lA DBE is a Disadvantaged, Minority,or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 2Subcontractor is defined as a company,firm,joint venture,or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. July 2025 Attachment 5: SRF Required Front-End Specifications Disadvantaged Business Enterprise (DBE) Subcontractor Utilization Form *This form to be completed by Prime and DBE Subcontractor for each subcontract and submitted with the bid. *If a DBE has NOT yet been selected by the Prime Contractor or if no DBEs are needed, then this form is not required to be submitted at this time. This form is intended to capture the prime contractor's actual and/or intended use of identified certified DBE' subcontractors' and the estimated dollar amount of each subcontract.An EPA Financial Assistance Agreement Recipient must require its prime contractors to complete this form and include it in the bid or proposal package. Prime contractors should also maintain a copy of this form on file. Prime Contractor Name: )�) (1C5y- Project Name: r I�Z (�1 i"l-�r�'� Jf 71C'�Y`-�J C , t Git 1.4_2,2( �) 0E �1G�- ,//fl r Bid/Proposal No.: Assistance Agreement ID No. (if known): Point of Contact: u�ik \A,04-0Ic i Address: j,3 5 iQ 'i uP k '''SC / 59 c �JJCii / ' 1C'�ff J ' c —CLLA , tr J Telephone No.: 3I ci `-t�f��. `-JLJ 5 Email: COT\ rac rye s, .ra' (Cry, (join Issuing/Funding Entity: i I have identified potential DBE certified subcontractors Yes 4o If yes, complete the table below. If no, explain: 2)() (^ [-h c C`Y`n l ) `.`(A Cf) mCc Subcontractor Name/ Estimated Currently DBE Company Name Company Address/Phone/Email Dollar Amount Certified? EYes No Yes No Yes No Yes nNo EYes nNo I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. (21,....„4„ )--,Q____., ThCLda. HrC)1(I Prime Contractor Signature Print Name 4 Q (4, ,f)ri -7-/(0-, ./ Title Date July 2025 'A DBE is a Disadvantaged, Minority,or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 2Subcontractor is defined as a company,firm,joint venture,or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. July 2025 -Attachment 6: RESERVED- July 2025 IOWA STATE REVOLVING FUND I in wiv iowasrf.com State Revolving Fund Attachment 10: SRF Required Front-End Specifications *This form to be completed by Prime Contractor and submitted with the bid. PROHIBITION ON CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT This term and condition implements 2 CFR 200.216 and is effective for obligations and expenditures of EPA financial assistance funding on or after 8/13/2020. EPA recipients and subrecipients, including borrowers under EPA funded revolving loan fund programs, are prohibited from obligating or expending loan or grant funds to: (a) Procure or obtain, extend or renew a contract to procure or obtain; (b) Enter into a contract (or extend or renew a contract) to procure; or (c) Obtain the equipment, services, or systems that use "covered telecommunications equipment or services" identified in the regulation as a substantial or essential component of any system, or as critical technology as part of any system. Certain equipment, systems, or services, including equipment, systems, or services produced or provided by entities subject to the prohibition are recorded in the System for Award Management exclusion list, website: https://sam.gov. (1) As described in Public Law 115-232, section 889, covered telecommunications equipment or services includes: (i) Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities). (ii) For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities). (iii) Telecommunications or video surveillance services provided by such entities or using such equipment. (iv) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country. (2) Consistent with 2 CFR 200.471, costs incurred for telecommunications and video surveillance services or equipment such as phones, internet, video surveillance, and cloud servers are allowable except for the following circumstances: (i) Obligating or expending EPA funds for covered telecommunications and video surveillance services or equipment or services to procure (enter into, renew or extend contracts) or obtain the equipment, services, or systems as described in 2 CFR 200.216. I understand the above prohibitions and certify that the project will be in compliance with all the requirements. 2 - 1 L, - ��(li2//��` ()),A049-'--- i nature ate ai_.\\ (f_X k,f2,f-z_-__)J 1 c I \-- "3-31fc('-e.n 71 Printed Name Title July 2025 Bond No.LC000149 BID BOND KNOW ALL MEN BY THESE PRESENTS,that we, Boomerang Corp. as Principal,and Ascot Surety&Casualty Company as Surety are held and firmly bound unto the CITY OF WATERLOO ,Iowa,hereinafter called "OWNER." In the penal sum Five Percent of Bid Amount(5%of Bid Amount) Dollars($ XXX )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 16th day of July ,20 26 ,for FY 2023 Cattle Congress Sanitary Sewer Lift Station Reconstruction 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 pres- ents to be signed by their proper officers this 6th day of July ,A.D.2026. Boomerang Corp. (Seal) Principal (� Ascot Surety&Casualty Company Witness Surety By � tness Attorney-in-fact Troy Staples-. - BID BOND CONTRACT NO.1075 BB-1 of l— -- AECOM#60696351 FY 2023 CATTLE CONGRESS SAN SEWER LIFT STATION RECONSTRUCTION ACKNOWLEDGMENT OF PRINCIPAL (Individual) State of ) County of ) On this day of , in the year , before me personally come(s) , to me known and known to me to be the person(s) who (is) (are) described in and executed the foregoing instrument and acknowledge(s) to me that he/she executed the same. Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Partnership) State of ) County of ) On this day of , in the year , before me personally come(s) , a member of the co-partnership of to me known and known to me to be the person who is described in and executed the foregoing instrument and acknowledges to me that he/she executed the same as for the act and deed of the said co-partnership. Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporation) State of J0 ) c ) County of n this day of l� , in the year JcD2O, before me personally come(s) c_VO1 tJI4f C , to me known, who ing duly sworn, deposes and says that he/she is the (e- } d of the the corporation described in and which ex ted the foregoing instrument; that he/she knows the seal of the said corporation; the seal affixed to the said instrument is such corporate seal; that it was so affixed by the order of the Board of Directors of said corporation, and that he/she signed his/her name thereto by like order. DAWN M KING Commission Number 855430 Notary Public My Commission E i0w1► f(y ;171 ACKNOWLEDGMENT OF SURETY State of Minnesota ) County of Dakota ) On this 6th day of July, in the year 2026, before me personally come(s) Troy Staples, Attorney(s)-in-Fact of Ascot Surety & Casualty Company with whom I am personally acquainted, and who, being by me duly sworn, says that he/she is (are) the Attorney(s)-in-Fact of Ascot Surety & Casualty Company company described in and which executed the within instrument; that he/she know(s) the corporate seal of such company; and that seal affixed to the within instrument is such corporate seal and that it was affixed by order of the Board of Directors of said c+mpany, and that he/she signed said instrument as Attorney(s)-in-Fact of the said company by like order. 4 UHF sr Lindsay Ann Hilderbrand I `,.t+ =`: Notary Public • ry Public °s .= Minnesota `:�;k1.0-°- My Commission Expires 01/31/2030 oonsamminii Ascot Surety & Casualty Company Avramo Ascot Insurance Company 1020 Highland Colony Parkway, Suite 700 Ridgeland, MS 39157 got; Power of Attorney KNOW ALL MEN BY THE PRESENTS: That Ascot Surety & Casualty Company and Ascot Insurance Company, each a corporation organized and existing under the laws of the State of Colorado (the "Companies"), do hereby constitute and appoint: Troy Staples, Zachary Pate, Maxwell Bohlig, Nicholas Hochban and Jennifer Boyles of West St. Paul, MN (city, state) and each its true and lawful Attorney(s)-in-Fact, with full authority to sign, execute, seal, acknowledge and deliver for, and on its behalf, and as its act and deed any place within the United States, or, if the following line is filled in, only within the area and up to the amount therein designated, any and all bonds, undertakings, recognizances, and other contracts of indemnity or writings obligatory in the nature thereof, issued in the course of its surety business, and to bond the Companies as follows: Any such obligations in the United States not to exceed $100,000,000.00. The Companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority Resolutions adopted by the Board of Directors of the Companies, which resolutions are still in effect: RESOLVED, that any of the Chief Executive Office, the Chief Operating Officer or the Chief Underwriting Officer, acting in conjunction with the head of the surety business line for the Corporation (each an Authorized Individual" and, collectively, the Authorized Individuals"), are authorized to jointly appoint one or more attorneys-in-fact to represent and act for and on behalf of the Corporation in the transaction of the Corporation's surety business to execute (under the common seal of the Corporation if appropriate) bonds, undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature thereof. RESOLVED, that in conjunction with the Corporation's transaction of surety business the signatures and attestations of the Authorized Individuals and the seal of the Corporation be affixed to any such Power of Attorney or to any certificate relating thereto (electronic or otherwise) by facsimile and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seals (electronic or otherwise) shall be valid and bonding upon the Corporation when so affixed with respect to any bond, undertaking, recognizance or tother contract of indemnity or writing obligatory in the nature thereof; RESOLVED, that in connection with the Corporation's transaction of surety business, the facsimile electronic or mechanically reproduced signature of any Authorized Individual, whether made heretofore or hereafter, whenever appearing upon a copy of any Power of Attorney of the Corporation, with signatures affixed as next above noted, shall be valid and binding upon the Corporation with the same force and effect as though manually affixed. IN WITNESS WHEREOF, the Companies have caused these presents with the respective corporate seals and to be executed by the individuals named below who are duly authorized and empowered to execute the Power of Attorney on the Companies' behalf, this 13th day of March 2025. "" {""""'"'•• ASCOT SURETY & CASUALTY COMPANY :. R'�°�' ���� �? ';; c�''• ASCOT INSURANCE COMPANY SEAL1°, I SEA.1;1 �'• 2021 jt t 5$8 z .�y� . . �'�t,�r<�.�:• •ram'.= �:. •.�z�sta'�''. ‘< /1/1 „,,./010 140-tko' Matthew Conrad Kramer (Chief Executive Officer) ra North (Exe tive Vice President, Surety) STATE OF CONNECTICUT ) COUNTY OF FAIRFIELD ) ss. On this 13th day of March 2025, before me came the above named Chief Executive Officer of each Ascot Surety & Casualty Company and Ascot Insurance Company and the head of the surety business line for each of Ascot Surety & Casualty Company and Ascot Insurance Company, to me personally known to be the individuals described herein, and acknowledged that the seals affixed to the preceding instrument and the corporate seals of each Ascot Surety & Casualty Company and Ascot Insurance Company, and that the said corporate seals and signatures were duly affixed and subscribed to said instrument by the authority and direction of said Companies. KSENIA E. GUSEVAA . NOTARY PUBLIC `' 0.4,44 STATE OF CONNECTICUT Notary Public Ksenia E Guseva My Commission Expires June 30, 2029 My commission expires on June 30, 2029 I, the undersigned Secretary of the Company, do hereby certify that the foregoing excerpts of the Resolution adopted by the Board of Directors of the Companies, and the Power of Attorney issued pursuant thereto, are true and correct, and further certify that both the Resolution and the Power of Attorney are still in full force and effect. This Certificate may be signed by facsimile under and by the authority of the following resolution of the Board of Directors of the Companies. RESOLVED, that in connection with the Corporation's transaction of surety business the signatures and attestations of the Authorized Individuals and the seal of the Corporation be affixed to any such Power of Attorney or to any certificate relating thereto (electronic or otherwise) by facsimile and any such Power of Attorney of certificate bearing such facsimile signatures or facsimile seal (electronic or otherwise) shall be valid and binding upon the Corporation when so affixed with respect to any bond, undertaking, recognizances or other contract of indemnity or writing obligatory in the nature thereof; IN WITNESS WHEREOF; I have hereunto set my hand and affixed the seal of the Companies, this 6th day of July 2026 ASCOT SURETY & CASUALTY COMPANY ASCOT INSURANCE COMPANY a //710 ied _ = — _ — John Gill, Secretary 1 -- J All-Ciaims Notices should ha sent to Ascot Group, 1020 Highland Colony Parkway, Suite 700, Ridgeland, MS 39157: Attention Surety Claims suretvciaims ascotttroirra.com