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HomeMy WebLinkAboutFORM OF BID OR PROPOSAL FORM OF BID OR PROPOSAL F.Y. 2019 STREET RECONSTRUCTION PROGRAM CONTRACT NO. 965 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 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 F.Y. 2019 STREET RECONSTRUCTION PROGRAM, Contract No. 965, all in accordance with the above-listed documents and for the unit prices for work in place for the following items and quantities: FY 2019 STREET RECONSTRUCTION PROGRAM CONTRACT NO. 965 SUDAS SPECIFICATION *SEE BID SUPPLEMENTAL UNIT BID TOTAL BID ITEM SP=SPCL PROV DESCRIPTION UNIT EST QTY PRICE PRICE DIVISION 2-EARTHWORK 1 2010-108-D * TOPSOIL,4 INCHES, ON OR OFF SITE SY 6,599.00 $ $ 2 2010-108-H* SUBGRADE TREATMENT,WOVEN GEOTEXTILE SY 26,753.00 $ $ 3 2010-108-I * SUBBASE, MODIFIED TON 21,885.00 $ $ 4 2010-108-A CLEARING AND GRUBBING UNITS 54.00 $ $ 5 TOPSOIL REMOVAL FROM PARKING, SP#1 EARTHWORK SY 2,287.30 $ $ 6 SP#2 SPECIAL SUBGRADE MATERIAL CY 100.00 $ $ SUBTOTAL BASE BID EARTHWORK $ DIVISION 4-SEWERS AND DRAINS - SANITARY 7 4010 108 A 1 SANITARY SEWER GRAVITY MAIN,TRENCHED, PVC, 18 INCH LF 32.00 $ $ 8 4010 108 A-1 SANITARY SEWER GRAVITY MAIN, TRENCHED, TRUSS, 15 INCH LF 70.00 $ $ FORM OF BID CONTRACT NO. 965 Page 1 of 7 SUDAS SPECIFICATION *SEE BID SUPPLEMENTAL UNIT BID TOTAL BID ITEM SP=SPCL PROV DESCRIPTION UNIT EST QTY PRICE PRICE DIVISION 4-SEWERS AND DRAINS- SANITARY(CONTINUED) 9 4010-108-A-1 * SANITARY SEWER GRAVITY MAIN,TRENCHED, TRUSS, 12 INCH LF 106.50 $ $ SANITARY SEWER GRAVITY MAIN, TRENCHED, 10 4010 108 A-1 * TRUSS, 10 INCH LF 635.50 $ $ SANITARY SEWER GRAVITY MAIN,TRENCHED, 11 4010-108 A 1 * TRUSS, 8 INCH LF 1,307.50 $ $ SANITARY SEWER SERVICE STUB/RENEW, 12 4010-108 E 0 SDR 23.5,6 INCH LF 1,254.00 $ $ SANITARY SEWER ABANDONMENT, FILL AND 13 4010-108-K-2 PLUG, 8 INCH LF 386.00 $ $ SANITARY SEWER ABANDONMENT, FILL AND 14 4010-108-K-2 PLUG, 12 INCH LF 65.00 $ $ SANITARY SEWER ABANDONMENT, FILL AND 15 4010-108-K-2 PLUG, 15 INCH LF 327.00 $ $ 16 SP#6 SANITARY SEWER SERVICE,TRACE EACH 3.00 $ $ 17 SANITARY SEWER SERVICE, DYE TEST SP#5 INVESTIGATION EACH 8.00 $ $ 18 SANITARY SEWER SERVICE, UNDERGROUND SP#4 INVESTIGATION EACH 3.00 $ $ DIVISION 6-STRUCTURES FOR SANITARY SEWERS 19 6010-108-A-0 * MANHOLE,SW-301,48" EACH 11.00 $ $ 20 6010-108-C-0 DROP CONNECTION EACH 1.00 $ $ 21 6010-108-A-0 * MANHOLE, SW-301,60" EACH 1.00 $ $ 22 6010-108-H-0 * REMOVE MANHOLE, SANITARY EACH 10.00 $ $ 23 MANHOLE RING AND COVER, FURNISH AND SP#14 INSTALL EACH 2.00 $ $ SUBTOTAL BASE BID SANITARY SEWER $ DIVISION 4-SEWERS AND DRAINS-STORM STORM SEWER,TRENCHED, RCP 2000D, 18 24 4020-108 A 1 INCH _ LF 336.50 $ $ STORM SEWER,TRENCHED, RCP 2000D, 15 25 4020 108-A 1 INCH LF 126.70 $ $ STORM SEWER,TRENCHED, RCP 2000D, 12 26 4020 108 A 1 INCH LF 1,143.50 $ $ REMOVAL OF STORM SEWER, RCP, LESS 27 4020 108 C 0 THAN OR EQUAL TO 36 INCH LF 815:00 $ $ 28 4040-108-A-0 SUBDRAIN, PERFORATED PVC TYPE S,6 INCH LF 14,151.00 $ $ 29 4040-108-A-0 SUBDRAIN, PERFORATED PVC TYPE S,4 INCH LF 283.00 $ $ SUBDRAIN OUTLETS AND CONNECTIONS, 30 4040 108-D 0 CMP,6 INCH EACH 48.00 $ $ STORM SEWER SERVICE STUB, SOLID WALL 31 4040 108E 0 PVC TYPE S1,4 INCH LF 770.00 $ $ DIVISION 6-STRUCTURES FOR STORM SEWERS 32 6010-108-A-0 * MANHOLE, SW-401,48" EACH 15.00 $ $ 33 6010-108-A-0 * MANHOLE, SW-401,60" EACH 1.00 $ $ 34 6010-108-A-0 * MANHOLE, SW-402 EACH 3.00 $ $ 35 6010-108-A-0 MANHOLE, SW-406, SHALLOW RECTANGULAR EACH 6.00 $ $ 36 6010-108-B-0 INTAKE, SW-501, SINGLE GRATE EACH 16.00 $ $ FORM OF BID CONTRACT NO. 965 Page 2 of 7 SUDAS SPECIFICATION *SEE BID SUPPLEMENTAL UNIT BID TOTAL BID ITEM SP=SPCL PROV DESCRIPTION UNIT EST QTY PRICE PRICE DIVISION 6-STRUCTURES FOR STORM SEWERS(CONTINUED) 37 6010 108-B 0 INTAKE, SW-504, SINGLE GRATE W/FLUSH TOP MANHOLE EACH 1.00 $ $ 38 6010-108-B-0 INTAKE, SW-505, DOUBLE GRATE EACH 5.00 $ $ 39 6010-108-B-0 INTAKE, SW-506, DOUBLE GRATE W/MANHOLE EACH 1.00 $ $ 40 CONNECTION TO EXISTING INTAKE, DRAIN 6010-108-G-0 TILE EACH 29.00 $ $ _41 6010-108-H-0 * REMOVE MANHOLE OR INTAKE, STORM EACH 44.00 $ $ 42 INTAKE, SW-507, REMOVE AND REPLACE SP#15 SPECIAL SHAPING AND TOP EACH 2.00 $ $ 43 INTAKE, E-1-C, REMOVE AND REPLACE SP#15 BOXOUT EACH 14.00 $ $ 44 INTAKE, MODIFIED E-1-C, REMOVE AND SP#15 REPLACE BOXOUT AND TOP EACH 4.00 $ $ 45 INTAKE, E-2-C, REMOVE AND REPLACE SP#15 BOXOUT EACH 3.00 $ $ 46 INTAKE, E-3-C, REMOVE AND REPLACE SP#15 BOXOUT EACH 3.00 $ $ 47 FURNISH AND INSTALL SW-603 TYPE R SP#14 CASTING EACH 4.00 $ $ 48 FURNISH AND INSTALL MANHOLE RING AND SP#14 COVER EACH 2.00 $ $ SUBTOTAL BASE BID STORM SEWER $ DIVISION 5-WATER MAINS AND APPURTENANCES 49 5010-108-E-1 WATER SERVICE PIPE, COPPER, 3/4 INCH LF 210.00 $ $ 50 5010-108-E-2 WATER SERVICE CORPORATION,3/4 INCH EACH 10.00 $ $ 51 5010-108-E-3 * WATER SERVICE CURB STOP, 3/4 INCH EACH 10.00 $ $ 52 5010-108-E-3 * WATER SERVICE CURB BOX,3/4 INCH EACH 10.00 $ $ 53 5010-108-E-1 WATER SERVICE PIPE, COPPER, 1 INCH LF r 46.00 $ $ 54 5010-108-E-2 WATER SERVICE CORPORATION, 1 INCH EACH 1.00 $ $ 55 5010-108-E-3 * WATER SERVICE CURB STOP, 1 INCH EACH 1.00 $ $ 56 5010-108-E-3 * WATER SERVICE CURB BOX, 1 INCH EACH 1.00 $ $ 57 CONVERT WATER VALVE MANHOLE TO SP#12 ROADBOX EACH 5.00 $ $ 58 SP#8 WATER SERVICE TAP, 3/4 OR 1 INCH EACH 1.00 $ $ 59 SP#10 WATER SERVICE KILL EACH _ 3.00 $ $ 60 SP#11 LOWER WATER SERVICE,3/4" OR 1" EACH 2.00 $ $ 61 WATER SERVICE, UNDERGROUND SP#13 INVESTIGATION _ EACH 9.00_ $ $ 62 SP#9 INSULATE EXISTING COPPER WATER SERVICE EACH 2.00 $ $ SUBTOTAL BASE BID WATER APPURTENANCES $ DIVISION 7-STREETS AND RELATED WORK PCC PAVEMENT 63 7040-108-A-0 REMOVE AND REPLACE 3" HMA/6"PCC, C-4 SY 9.00 $ $ CURB AND GUTTER,24 IN WIDE, 6 IN THICK, 64 7010-108-E 0 C-4, MISCELLANEOUS LF 3.50 $ $ HMA PAVEMENT _ 65 7020-108-A-0 DRIVEWAY, PAVED, HMA,4 INCH SY _ 31.50 $ $ 66 7020-108-B-0 REMOVE/REPLACE HMA,3.5 INCH SY 20.00 $ $ 67 REMOVE SEAL COAT/REPLACE WITH 2 INCH SP#17 HMA SY 13.50 $ $ FORM OF BID CONTRACT NO. 965 Page 3 of 7 SUDAS SPECIFICATION *SEE BID SUPPLEMENTAL UNIT BID TOTAL BID ITEM SP=SPCL PROV DESCRIPTION UNIT EST QTY PRICE PRICE SIDEWALKS,SHARED USE PATHS AND DRIVEWAYS 68 7030-108-A-0 REMOVAL OF SIDEWALK AND DRIVEWAY SY 1,945.00 $ $ 69 7030-108-A-0 REMOVAL OF SIDEWALK, MISCELLANEOUS SY 172.70 $ $ _ 70 7030-108-E-0 SIDEWALK, PCC C-4,4 INCH, C-4 SY 248.00 $ $ SIDEWALK, PCC C-4,6 INCH PEDESTIAN 71 7030-108 E 0 RAMP, C-4 - SY 163.90 $ $ 72 7030-108-G-0 DETECTABLE WARNING SF 282.00 $ $ DRIVEWAY AND SIDEWALK, PAVED, PCC, 6 73 7030 108 H 1 INCH, C-4 SY 217.50 $ $ 74 7030-108 H 1 DRIVEWAY AND SIDEWALK, PAVED, PCC, 5 INCH, C-4 SY 1,446.80 $ $ 75 7030-108-H-2 DRIVEWAY, GRANULAR TON 33.20 $ $ PAVEMENT REHABILITATION 76 7040-108-H-0 * PAVEMENT REMOVAL, CONCRETE SY 21,260.90 $ $ _ 77 7040-108-H-0 * PAVEMENT REMOVAL,ASPHALT SY 7,481.60 $ $ SUBTOTAL STREETS AND RELATED WORK $ DIVISION 8-PAVEMENT MARKINGS AND TRAFFIC CONTROL PAVEMENT MARKINGS PAINTED PAVEMENT MARKINGS, 78 8020 108 B 0 SOLVENT/WATERBOURNE STA _ 2.48 $ $ TEMPORARY TRAFFIC CONTROL 79 8030-108-A-0 TEMPORARY TRAFFIC CONTROL LS 1.00 $ $ 80 8030-2.02 DIRECTIONAL SIGNS, PER DETAILS EACH 8.00 $ $ SUBTOTAL PAVEMENT MARKING AND TRAFFIC CONTROL $ DIVISION 9-SITE WORK AND LANDSCAPING _ _ SEEDING 81 9010-108 B-0 HYDRAULIC SEEDING, SEEDING, FERTILIZING AND MULCHING SY 8,927.00 $ $ 82 9010-108-E-0 * WARRANTY SY 1,000.00 $ $ EROSION AND SEDIMENT CONTROL 83 9040-108-E-0 TEMPORARY RECP,WOOD EXCELSIOR MAT SY 200.00 $ _ $ 84 9040-108-F-1 WATTLE, STRAW,6 INCH LF 1,000.00 $ $ _ 85 9040-108-F-2 WATTLE, REMOVAL LF 1,000.00 $ $ 86 9040-108 T 1 INLET PROTECTION DEVICE, INTERMEDIATE AND DROP IN EACH 49.00 $ $ 87 9040-108-T-2 * INLET PROTECTION DEVICE, MAINTENANCE EACH 49.00 $ $ _ CONCRETE STEPS, HANDRAILS AND SAFETY RAIL 88 9080-108-A-0 CONCRETE STEPS, CAST IN PLACE SF 38.90 $ $ SUBTOTAL SITE WORK AND LANDSCAPING $ DIVISION 11 -MISCELLANEOUS CONSTRUCTION SURVEY 89 11010-108-A CONSTRUCTION SURVEY LS 1.00 $ $ _ 90 7040-3.02-A SAW CUT LF 1,228.40 $ $ SUBTOTAL MISCELLANEOUS $ TOTAL BASE BID $ FORM OF BID CONTRACT NO. 965 Page 4 of 7 SUDAS SPECIFICATION *SEE UNIT BID TOTAL BID BID SUPPLEMENTAL SPCL PRO DESCRIPTION EST CITY PRICE PRICE ITEM SP=SPCL PROV AND RELATED WORK _-- _ DIVISION 7-STREETS A _ ALTERNATE A-HMA PAVEMENT, HMA 1.5", STANDARD TRAFFIC(ST) 1A 7020-108-B-0 * SURFACE, 1/2"MIX, PG 58-28S,75%CR., NO SY 24,163.00 $ $ FRICTION REQD. PAVEMENT, HMA, 1.5", STANDARD 2A 7020-108-B-0 * TRAFFIC(ST) INTERMEDIATE, 1/2"MIX, PG 58 SY 7,058.50 $ 28S,60%CR. PAVEMENT, HMA,3", STANDARD TRAFFIC(ST)3A 7020-108-B-0 * INTERMEDIATE, 112"MIX, PG 58-28S,60%CR. SY 17,104.50 $ PAVEMENT, HMA, 3", STANDARD TRAFFIC(ST) SY 24,163.00 4A 7020-108-B-0 * BASE,3/4"MIX, PG 58-28S,60/o CR. CURB AND GUTTER,24 IN WIDE,6 IN THICK, C LF 5,134.60 $ $ 5A 7010-108-E-0 SUD CURB AND GUTTER,24 IN WIDE,7.5 IN THICK, LF 8 893.00 6A 7010-108-E-0 C-SUD LS 1.00 nim, 7A 7020-108-H-0 HMA PAVEMENTCLASS SAMPLES AND TESTING LS CY g 001.00 $ 8A 2010-108-E-0 * EXCAVATION, LS 1.00 $ 9A 11,050-108-A-0 CONCRETE WASHOUTSY 478.00 $ $ MI 10A 7010-3.04 COLD WEATHER CONCRETE PROTECTION SY 2,472 00 $ $ 11A 7010,3.02, J * LINSEED OIL TREATMENT SUBTOTAL ALTERNATE A $ _ ALTERNATE B-PCC 8,203.50Y $ $ 1B 7010-108-A-0 PAVEMENT, PCC,6 INCH, C-SUD 19,053.90 $ $ 2B 7010-108-A-0 PAVEMENT, PCC, 8 INCH, C-SUD SY SY 3B 7020-108-H-0 PCC PAVEMENT SAMPLES AND TESTING LS g 25 1.00. 0 4B 2010-108-E-0 * EXCAVATION, CLASS 10 CYLS 1.00 $ $ 5B 11,050-108-A-0 CONCRETE WASHOUT 6B 7010-3.04 COLD WEATHER CONCRETE PROTECTION SY 15,159.00 $ $ 7B 7010,3.02, J * LINSEED OIL TREATMENT SY 14,358.00 $ SUBTOTAL ALTERNATE B $ TOTAL BASE BID + ALTERNATE A TOTAL BASE BID + ALTERNATE B 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. Waterloo 3. In submitting this bid, the bidder understands that the right d bid is the mailedCity f telegraphedWor to reject any or all bids. If written notice of the ace ptance of th s delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter FORM OF BID CONTRACT NO. 965 Page 5 of 7 before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement prescribed form and furnish the required bond and certificate of the insurance within ten (10 in the after the agreement is presented to him for signature, and start work within ten (10) ) daes "Notice to Proceed" is issued. days after 4. Security in the sum of ($ ) in the form of Dollars accordance with the INSTRUCTIONS TO BIDDERS. is submitted herewith in 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 $10,000.00 work for the City in the current calendar year, are prepared to submit an AAP or Update and an EOC within ten (10) days of notification that the bid submitted is lowest and acceptable. 9. The bidder has received the following Addendum or Addenda: Addendum No. Date 10. The bidder shall list the MBE/WBE subcontractor(s), amount of subcontracts and bid items on City of Waterloo Minority and/or Women Business Pre-bid Contact Information Form submitted with this Form of Bid or Proposal. The apparent low Bidder shall submit a list of all other Subcontractor(s to be used on this Project to the City of Waterloo by 5:00 p.m. the business day followingthe da) Bids on this Project are due along with the Non-Collusion Affidavits of All Subcontractor(s). y The Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND APPROVAL" Form to be provided by City prior to approval of contract. The subcontractors listed on this proposal and/or submitted to the Contract Compliance Officer cannot be changed except for the following reasons: 1) The City of Waterloo does not approve the subcontractors. 2) The subcontractors submit in writing that they cannot fulfill their subcontracts. 11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none" or "NA". 12. The bidder has attached all applicable forms. 13. The Owner reserves the right to select alternates, delete line items, and/or to reduce quantitiesprior to the award of a contract due to budgetary limitations. p FORM OF BID CONTRACT NO. 965 Page 6 of 7 (Name of Bidder) (Date) Title BY: Official Address: (Including Zip Code): I.R.S. No. FORM OF BID CONTRACT NO. 965 Page 7 of 7 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, as Principal, and as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called "OWNER." In the penal sum Dollars($ 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 20 , for day of 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 day of A.D. 201 Principal (Seal) By (Title) Witness (Seal) Surety Witness By Attorney-in fact NON-COLLUSION AFFIDAVIT OF PRIME BIDDER State of ) )ss County of ) , being first duly sworn, deposes and says that: 1. He is Owner Partner Officer Representative or A gentl ofthe 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; colluded, 4. Neither the said Bidder nor any of its officers, eluding pthis artneaffiantn hasagents,n any uves way representatives, employees, or parties in intere , t conspired, connived or agreed,Bid i directly in connection Lion with the Contractdirectly, with any rfordwhich the attached to submit a collusive or sham Bid has been submitted or to refrain from bidding in connection withsuch chr colntrionact or has in any manner, directly or indirectly, sought byagreement communication or conference with any other Bidder, firm or person to fix the priccosr prices in the attached Bid or of any other Bidder, or, to fix any element of the bid price or the bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance, unlawful in the agreement any d y advantaContract; ge against the City of Waterloo, Iowa, or any person interested r and are not 5, The price or prices quoted in the attar ched nlawfueagreement o Bid ar fair and pethe part of theta dder or by any collusion, conspiracy, connivance 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 201_. Title My commission expires Bidder Status Form To be completed by all bidders A Please answer"Yes"or"No"for each of the following: Part 0 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 nextpage). 0❑ 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, ❑ Yes ❑ No My company has been conducting business in Iowa for at least 3 years prior to th bids on this project. and e-mail. e first request for ❑ Yes ❑ No My company is not a subsidiary of another business entity or my company is a sub business entity that would qualify as a resident bidder in Iowa. sid.ary of another 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 My company has maintained offices in Iowa during the past 3 years at the following addresses: Part B Dates: / / to / / Address: 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 1. Name of home state or foreign country reported to the Iowa Secretary of State: Part C 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? your company 3. If you answered"Yes"to question 2, identify each preference offered byp y ❑ Yes ❑ No and the appropriate legal citation. s home state or foreign country You may attach additional sheet(s)if needed. To be completed by all bidders I certify that the statements made on this document are true and complete to the best of my knowledge and I know that my D failure to provide accurate and truthful information may be a reason to reject my bid. m Firm Name: 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 wor ksheet 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 ❑ No My business is currently registered as a contractor with the Iowa Division of Labor. 0 business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. 0 Yes ❑ No My Yes No My business is a general partnership or joint nt venture. o Iowa More for e than a in 50 e tax percent of pose general ❑ partners or joint venture parties are ❑ 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. oration e filed in a state other an owa, ❑ Yes ❑ No businessorora is a corporationeceiv whose a certificate)es of of authority from therIowa secretary of state,hhasifi filed the corporation hase neceiepd a its most recent biennial report with t it secreta of stat , and has s authority revoked.neither received a certificate of withdrawal from the secretary of statenor had Yes ❑ No My business is a limited liability partnership a which has filed a statement of qualification in this state and the statement has not been nt of ❑ Yes ❑ No business a a limited liability a statement partnership which has filed a of foreign qualification in Iowa and qualificationa statement me t of state other than Iowa, has cancellation has not been filed. ity ted partnershiP which has ❑ Yes ❑ No My business o l s a limitedd r partnership ipithis r limited state, andbhlas not'filed a statement of termination. d a certificate of limited part p ty ited partnership whose certificate Yes ❑ No My business is a limited 1partnershipastate other thandIowa,I'thellimited partnership or limited liability of limited partnership is filed in a for limited partnership has received been notification approved rom and the no Iowa notice of cancellationt has been filed by the for certificate of authority has limited partnership or the limited liability limited partnership. 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