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Improvement Contracts with Performance, Payment, and Maintenance Bonds
City of Dubuque City Council ITEM TITLE: SUMMARY: SUGGUESTED DISPOSITION: ATTACHMENTS: Copyrighted November 3, 2025 CONSENT ITEMS # 11. Improvement Contracts with Performance, Payment, and Maintenance Bonds Iseler Demolition Inc. for the 500,000 Gallon Double Ellipse Demolition; Top Grade Excavating, Inc. for the Water Systems Improvements 2024 North English Road Water Main Extension. Receive and File; Approve 1. Eagle Point Park Water Tower Decon Project 2025 Request 2. N English Rd WM Extension Page 365 of 525 PUBLIC IMPROVEMENT CONTRACT SECTION 00500 500,000 Gallon Double Ellipse Demolition THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for reference purposes the 41t day of C)C.•__; , 2025 between the City of Dubuque, Iowa, by its City Manager, through authority conferred upon the City Manager by its City Council (City), and Iseler Demolition Inc. (Contractor). For and in consideration of the mutual covenants herein contained, the parties hereto agree as follows: CONTRACTOR AGREES: 1. To furnish all material and equipment and to perform all labor necessary for the 500,000 Gallon Double Ellipse Demolition. 2. CONTRACT DOCUMENTS A. The Contract Documents consist of the following: 1. Project Title Page (Section 00100). 2. Project Directory Page (Section 00101). 3. This Contract (Section 00500). 4. Performance, Payment, and Maintenance Bond (Section 00600). 5. Out -of -State Contractor Bond (Section 00610). 6. Other Bonds: , , 7. The Iowa Statewide Urban Design And Specifications (SUDAS) 2017 Edition. 8. CITY OF DUBUQUE Supplemental Specifications 2017 Edition. 9. Other Standard and Supplementary Specifications as listed on the Title Page of the Contract Document Manual. 10. Special Provisions included in the project Contract Document Manual. 11. Drawing or drawings consisting of sheets bearing the following general title: A. Section 02005 Demolition Work — Elevated Tank containing existing tower plans and along with Photographs from the latest tower inspection. 12. Addenda (numbers N/A to , inclusive). 13. Insurance Provisions and Requirements (Section 00700). Page 366 of 525 14. Sales Tax Exemption Certificate (Section 00750). 15. Site Condition Information (Section 00775). 16. Construction Schedule and Agreed Cost of Delay (Section 00800). 17. Erosion Control Certificate (Section 00900). 18. Consent Decree (Section 01000). 19.Other Project Information and Permits (Sections 01100 - 00000). 20. Exhibits to this Contract a. Contractor's Big (pages 1 to 6 inclusive). b. Bidder Status Form (Section 00460). C. The following documentation that must be submitted by Contractor prior to Notice of Award: i. Contractor Background Information ii. Form (Section 00471) 21. The following which may be delivered or issued on or after the Effective Date of the Agreement: a. Notice to Proceed (Section 00850). b. Project Certification Page (Section 00102). C. Change Orders (Not attached to this Contract). 22. Authorizing Resolution, either: a. Resolution 286 — 17, City Manager's Authority to Execute Contracts/Leases b. Project Specific Resolution, Resolution No. B. There are no other Contract Documents. The Contract Documents may only be amended, modified, or supplemented as provided in this Contract. 3. All materials used by the Contractor in the Project must be of the quality required by the Contract Documents and must be installed in accordance with the Contract Documents. 4. The Contractor must remove any materials rejected by the City as defective or improper, or any of said work condemned as unsuitable or defective, and the same must be replaced or redone to the satisfaction of the City at the sole cost and expense of the Contractor. 5. Five percent (5%) of the Contract price will be retained by the City for a period of thirty (30) days after final completion and acceptance of the Project by the City Council to pay any claim by any party that may be filed for labor and materials done and furnished in connection with the performance of this Contract and for a longer period if such claims are Page 367 of 525 not adjusted within that thirty (30) day period, as provided in Iowa Code Chapter 573 or Iowa Code Chapter 26. 6. The Contractor has read and understands the Contract Documents herein referred to and agrees not to plead misunderstanding or deception related to estimates of quantity, character, location, or other conditions for the Project. 7. In addition to any warranty provided for in the Contract Documents, the Contractor must also fix any other defect in any part of the Project, even if the Project has been accepted and fully paid for by the City. The Contractor's maintenance bond shall remain in place for a period of two years after the issuance of the Certificate of Substantial Completion. 8. The Contractor must fully complete the Project under this Contract on or before the date indicated in the Construction Schedule and Agreed Cost of Delay Section of the Contract Documents. 9. INDEMNIFICATION FROM THIRD PARTY CLAIMS; LIABILITY FOR CITY DAMAGE. To the fullest extent permitted by law, Contractor shall defend, indemnify and hold harmless City, its officers and employees, from and against all claims, damages, losses and expenses claimed by third parties, but not including any claims, damages, losses or expenses of the parties to this Contract, including but not limited to attorneys' fees, arising out of or resulting from performance of this Contract, provided that such claim, damages, loss or expense is attributable to bodily injury, sickness, disease or death, or injury to or destruction of property, including loss of use resulting therefrom, but only to the extent caused in whole or in part by negligent acts or omissions of Contractor, or anyone directly or indirectly employed by Contractor or anyone for whose acts Contractor may be liable, regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. The Contractor shall also be liable to the City for any damage to City property arising out of or related to the Contractor's negligent performance of the Contract. 10. The Contractor hereby represents and guarantees that it has not, nor has any other person for or in its behalf, directly or indirectly, entered into any arrangement or contract with any other bidder, or with any public officer, whereby it has paid or is to pay any other bidder or public officer any sum of money or anything of value whatever in order to obtain this Contract; and it has not, nor has another person for or in its behalf directly or indirectly, entered into any contractor arrangement with any other person, firm, corporation, or association which tends to or does lessen or destroy free competition in the award ofthis Contract and agrees that in case it hereafter be established that such representations or guarantees, or any of them are false, it will forfeit and pay not less than ten percent (10%) of the Contract price but in no event less than $2,000.00 (Two Thousand Dollars) to the City as agreed upon damages. 11. The surety on the Bond furnished for this Contract must, in addition to all other provisions, be obligated to the extent provided for by Iowa Code 573.6 relating to this Contract. 12. The Contractor agrees, and its Bond is surety therefore, that after the Page 368 of 525 Certificate of Substantial Completion has been issued by the City, it will keep and maintain the Project in good repair for a period of two (2) years. 13. The Project must be constructed in strict accordance with the requirements of all applicable federal, state, and local laws, rules, and regulations and in accordance with the Contract Documents. A. All applicable standards, orders, or regulations issued pursuant to the Clean Air Act of 1970 (42 U. S. C. 1958 (H) et. seq.) and the Federal Water Pollution Act (33 U. S. C. 1368 et. seq.) as amended, Executive Order 11738, and Environmental Protection Agency regulations (40 CFR, Part 15). Contractor must comply with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) and Department of Labor Regulations (29 CFR, Part 5). B. The City of Dubuque in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d-2000d-4 and Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally assisted programs of the Department of Transportation issued pursuant to such Act, hereby notifies all bidders that it will affirmatively insure that in any contract entered into pursuant to this advertisement, minority business enterprises will be afforded full opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, national origin, sex, age, or disability in consideration for an award. 14. CONSENT DECREE APPLICATION CONSENT DECREE RELATING TO THE PROJECT Check appropriate box and initial in appropriate location ❑ THIS CONTRACTOR IS PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY SEWER COLLECTION SYSTEM. THEREFORE, THE CONSENT DECREE AND THIS SECTION ARE APPLICABLE. CITY CONTRACTOR IV THIS CONTRACTOR IS NOT PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY SEWER COLLECTION SYSTEM. THEREFORE THE CONSENT DECREE AND THIS SECTION ARE NOT APPLICABLE. CITY CONTRACTOR If Contract involves work related to the Water & Resource Recovery Center or the Sanitary Sewer Collection System, Contractor must also complete Exhibit II. Page 369 of 525 15. The City agrees to pay the Contractor for the work actually performed under this Contract, up to the amount stated below, less any agreed damages provided for in the Contract Documents. CITY OF DUBUQUE, IOWA BY: AJk�� Date ichael C. Van Milligen, City Manager CONTR TOR: Isel De olition, Inc. BY: ` Date: �-Se Printed Name: �--� �' o� �, . .�. 10/20/2025 ___= END OF SECTION 00500 Page 370 of 525 Page 1 of 6 PUBLIC IMPROVEMENT CONTRACT SECTION 00500 WATER SYSTEMS IMPROVEMENTS 2024 NORTH ENGLISH ROAD WATER MAIN EXTENSION THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for references purposes the 6t" day of October, 2025,_between the City of Dubuque, Iowa, by its City Manager, through authority conferred upon the City Manager by its City Council (City), and Top Grade Excavating, Inc. (Contractor). For and in consideration of the mutual covenants herein contained, the parties hereto agree as follows: CONTRACTOR AGREES: 1. To furnish all material and equipment and to perform all labor necessary for the Water Systems Improvements 2024 North English Road Water Main Extension (Project). 2. CONTRACT DOCUMENTS A. The Contract Documents consist of the following: 1. Project Title Page (Section 00100). 2. Project Directory Page (Section 00101). 3. This Public Improvement Contract (Section 00500). 4. Performance, Payment, and Maintenance Bond (Section 00600). 5. Out -of -State Contractor Bond (Section 00610). 6. Other Bonds: NOT APPLICABLE. 7. The Iowa Statewide Urban Design And Specifications (SUDAS) 2023 Edition. 8. CITY OF DUBUQUE Supplemental Specifications 2023 Edition. 9. Other Standard and Supplementary Specifications as listed on the Title Page of the Contract Document Manual. 10. Special Provisions included in the project Contract Document Manual. 11. Drawings consisting of sheets bearing the following general title: Water Systems Improvements 2024 North English Road Water Main Extension 12. Addenda (numbers 1 to 3, inclusive). 13. Insurance Provisions and Requirements (Section 00700). 14. Sales Tax Exemption Certificate (Section 00750). 15. Site Condition Information (Section 00775). 16. Construction Schedule and Agreed Cost of Delay (Section 00800). 17. Erosion Control Certificate (Section 00900). 18. SRF Requirements (Sections 02000). Page 371 of 525 SECTION 00500 Page 2 of 6 19. Exhibits to this Contract (enumerated as follows): a. Contractor's Bid (pages 1 to 6 inclusive). b. Bidder Status Form (Section 00460). c. SRF Required Forms c. The following documentation that must be submitted by Contractor prior to Notice of Award. i. Contractor Background Information Form (Section 00471) 20.The following which may be delivered or issued on or after the Effective Date of the Agreement: a. Notice to Proceed (Section 00850). b. Project Certification Page (Section 00102). c. Change Orders (Not attached to this agreement). There are no other Contract Documents. The Contract Documents may only be amended, modified, or supplemented as provided in General Conditions. 3. All materials used by the Contractor in the Project must be of the quality required by the Contract Documents and must be installed in accordance with the Contract Documents. 4. The Contractor must remove any materials rejected by the City as defective or improper, or any of said work condemned as unsuitable or defective, and the same must be replaced or redone to the satisfaction of the City at the sole cost and expense of the Contractor. 5. Three percent (3%) of the Contract price will be retained by the City for a period of thirty (30) days after final completion and acceptance of the Project by the City Council to pay any claim by any party that may be filed for labor and materials done and furnished in connection with the performance of this Contract and for a longer period if such claims are not adjusted within that thirty (30) day period, as provided in Iowa Code Chapter 573 or Iowa Code Chapter 26. The City will also retain additional sums to protect itself against any claim that has been filed against it for damages to persons or property arising through the prosecution of the work and such sums will be held by the City until such claims have been settled, adjudicated or otherwise disposed of. 6. The Contractor has read and understands the Contract Documents herein referred to and agrees not to plead misunderstanding or deception related to estimates of quantity, character, location or other conditions for the Project. 7. In addition to any warranty provided for in the specifications, the Contractor must also fix any other defect in any part of the Project, even if the Project has been accepted and fully paid for by the City. The Contractor's maintenance bond will be security for a period of two years after the issuance of the Certificate of Substantial Completion. 8. The Contractor must fully complete the Project under this Contract on or before the date indicated in the Construction Schedule and Agreed Cost of Delay Section of the Contract Documents. 9. INDEMNIFICATION FROM THIRD PARTY CLAIMS. To the fullest extent permitted by law, Contractor shall defend, indemnify and hold harmless City, its officers and employees, from and against all claims, damages, losses and expenses claimed by third parties, but not including any claims, damages, losses or expenses of the parties to this Contract, including Page 372 of 525 Page 3 of 6 but not limited to attorneys' fees, arising out of or resulting from performance of this Contract, provided that such claim, damages, loss or expense is attributable to bodily injury, sickness, disease or death, or injury to or destruction of property, including loss of use resulting there from, but only to the extent caused in whole or in part by negligent acts or omissions of Contractor, or anyone directly or indirectly employed by Contractor or anyone for whose acts Contractor may be liable, regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. 10. The Contractor hereby represents and guarantees that it has not, nor has any other person for or in its behalf, directly or indirectly, entered into any arrangement or Contract with any other Bidder, or with any public officer, whereby it has paid or is to pay any other Bidder or public officer any sum of money or anything of value whatever in order to obtain this Contract; and it has not, nor has another person for or in its behalf directly or indirectly, entered into any Contractor arrangement with any other person, firm, corporation or association which tends to or does lessen or destroy free competition in the award of this Contract and agrees that in case it hereafter be established that such representations or guarantees, or any of them are false, it will forfeit and pay not less than ten percent (10%) of the Contract price but in no event less than $2,000.00 (Two Thousand Dollars) to the City. 11. The surety on the Bond furnished for this Contract must, in addition to all other provisions, be obligated to the extent provided for by Iowa Code 573.6 relating to this Contract, which provisions apply to said Bond. 12. The Contractor agrees, and its Bond is surety therefore, that after the Certificate of Substantial Completion has been issued by the City, it will keep and maintain the Project in good repair for a period of two (2) years. 13. The Project must be constructed in strict accordance with the requirements of the laws of the State of Iowa, and the United States, and ordinances of the City of Dubuque, and in accordance with the Contract Documents. A. All applicable standards, orders, or regulations issued pursuant to the Clean Air Act of 1970 (42 U. S. C. 1958 (H) et. seq.) and the Federal Water Pollution Act (33 U. S. C. 1368 et. seq.) as amended, Executive Order 11738, and Environmental Protection Agency regulations (40 CFR, Part 15). Contractor must comply with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) and Department of Labor Regulations (29 CFR, Part 5). B. The City and the Contractor agree to comply with all provisions of the Davis -Bacon Federal Prevailing Wage Act, and related labor requirements and regulations and the Federal Wage Determination for this Project. C. Equipment or products authorized to be purchased with funding awarded for this Contract must comply with American Iron and Steel (AIS) requirements, in accordance with the Consolidated Appropriations Act, 2014. D. The City of Dubuque in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d-2000d-4 and Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally assisted programs of the Department of Transportation issued pursuant to such Act, hereby notifies all bidders that it will affirmatively insure that in any contract entered into pursuant to this advertisement, minority business enterprises will be afforded full opportunity to submit bids in response to this invitation and will not be Page 373 of 525 SECTION 00500 Page 4 of 6 discriminated against on the grounds of race, color, national origin, sex, age, or disability in consideration for an award. CONSENT DECREE RELATING TO THE PROJECT 14. THIS CONTRACTOR IS PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY SEWER COLLECTION SYSTEM. THEREFORE, THE CONSENT DECREE AND THIS SECTION ARE APPLICABLE. CITY CONTRACTOR THIS CONTRACTOR IS NOT PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY SEWER COLLECTION SYSTEM. THEREFORE THE CONSENT DECREE AND THIS SECTION ARE NOT APPLICABLE. The City has entered into a Consent Decree in the case of The United States of America, and the State of Iowa v. The City of Dubuque, Iowa, Civil Action Number Case 2:11-cv-01011-EMJ, Civil Action Number 2008V00041, DOJ Case Number 90-5-1-1-09339, United States District Court for the Northern District of Iowa. The provisions of the Consent Decree apply to and are binding upon the City and its officers, directors, employees, agents, servants, successors, assigns, and all persons, firms and corporations under contract with the City to perform the obligations of the Consent Decree. The City is required to provide a copy of the Consent Decree to any contractor or consultant retained to perform work required by the Consent Decree. A copy of the Consent Decree is included in the Contract Documents and can be viewed at http://www.citVofdubugue.org/DocumentCenter/Home/View/3173. A hard copy is available upon request at the City's Engineering Department Office. The City must condition any contract to perform work required under the Consent Decree upon performance of the work in conformity with the provisions of the Consent Decree. The Consent Decree also provides that until five (5) years after the termination of the Consent Decree, the City must retain, and must instruct its contractors and agents to preserve, all non -identical copies of all documents, reports, data, records, or other information (including documents, records, or other information in electronic form) in its or its contractors' or agents' possession or control, or that come into its or its contractors' or agents' possession or control, and that relate in any manner to the City's performance of its obligations under this Consent Decree, including any underlying research and analytical data. This information -retention period, upon request by the United States or the State, the City must provide copies of any documents, reports, analytical data, or other information required to be maintained under the Consent Decree. At the conclusion of the information -retention period, the City must notify the United States and the State at least ninety (90) Days prior to the destruction of any documents, records, or other information subject to such requirements and, upon request by the United States or the State, the City must deliver any such documents, records, or other information to the EPA or IDNR. Page 374 of 525 Page 5 of 6 CERTIFICATION BY CONTRACTOR NOT APPLICABLE The undersigned, on behalf of the Contractor, with full authority to act on behalf of the Contractor, certifies to the City of Dubuque as follows: I have received a copy of the Consent Decree in the case of The United States of America, and the State of Iowa v. The City of Dubuque, Iowa, Civil Action Number Case 2:1 1-cv-0101 1-EMJ, Civil Action Number 2008V00041, DOJ Case Number 90- 5-1-1-09339, United States District Court for the Northern District of Iowa. 2. All work performed will be in conformity with the provisions of the Consent Decree. 3. All documents reports, data, records, or other information (including documents, records, or other information in electronic form) that relate in any manner to the performance of obligations under the Consent Decree, including any underlying research and analytical data, will be retained as required by the Consent Decree. 4. The Contractor agrees to defend, indemnify, and hold harmless the City, its officers, agents, or employees from and against any claims, including penalties, costs and fees as provided in the Consent Decree, relating to or arising out of the Contractor's failure to comply with the Consent Decree. CONTRACTOR: NOT APPLICABLE Ta 6RAPC &*V*FTAo,JA1;C. Contractor By: <=;�r-- Ua Signatu Printed Name V. P. Title It)- IS-ZS Date Page 375 of 525 SECTION 00500 Page 6of6 THE CITY AGREES: 15. Upon the completion of the Contract, and the acceptance of the Project by the City Council, and subject to the requirements of law, the City agrees to pay the Contractor as full compensation for the complete performance of this Contract, the amount determined for the total work completed at the price(s) stated in the Contractor's Bid Proposal and less any Agreed Cost of Delay provided for in the Contract Documents. CONTRACT AMOUNT $1,487,135.00 CITY OF DUBUQUE, IOWA: Water Department By: .( v Mi hael C. Van Milligen City Manager 10/28/25 Date CONTRACTOR: Top Grade ExcavatjRgJ Inc. By: � &i JaxXi aid Pr Date Page 376 of 525 SECTION 00400 Page 1 of 6 UNIT PRICE BID PROPOSAL FORM SECTION 00400 PROJECT: Water Systems Improvements 2024 North English Road Water Main Extension BID TO: City Clerk's Office City of Dubuque 50 W. 13th Street Dubuque, Iowa 52001 BID FROM: 102 G UPE 61:12-ALIAT1-4) 1 A) C. (Company) 71 '9TH ACE A (Street Address) PA 2 L e -TA 52OY (City, State, Zip) rl 400.1 General -4 ((o Telephone) (Email Address) The undersigned Bidder agrees, if the Bid is accepted, to enter into an Contract with the City, in the form included in the Contract Documents, to perform and furnish the Work as specified or indicated in the Contract Documents for the Total Bid Amount and within the Bid time indicated in the Contract Documents and in accordance with other terms and conditions of the Contract Documents. 400.2 Recitals In submitting this Bid, Bidder represents, as more fully set forth in the Public Improvement Contract, that: a. This Bid will remain subject to acceptance for forty-five (45) calendar days after the day of Bid opening; b. The City has the right to reject this Bid and to waive any informalities in the Bidding; c. Bidder accepts the provisions to the Instructions to Bidders regarding dispositions of Bid Security; d. Bidder will sign and submit the Public Improvement Contract with the Bond and other documents required by the Contract Documents within ten (10) calendar days after the date of City's Notice of Award; Page 377 of 525 SECTION 00400 Page 2 of 6 The Bidder hereby certifies that the Bidder is the only person or persons interested in this proposal as principals; that an examination has been made of the plans, specifications, contract form, including the special provision contained herein, and the work site, and the Bidder understands that the quantities of work shown herein are approximate only and are subject to increase or decrease. The measured unit quantity of any item stated in the plans, specification, or on the bid proposal form are approximate only and the final payment must be made by the work covered in the contract (Public Improvement Contract - Section 500). The Contractor further understands that all quantities of work, whether increased or decreased, are to be performed at the Unit Prices as stipulated herein; the Bidder proposes to furnish all necessary machinery, equipment, tools, labor and other means of construction, and to furnish all materials specified in the manner and time prescribed and to do the work at the prices herein set out. 400.3 Bidder's Acknowledgment In submitting this Bid this Bidder acknowledges and represents that: 1) Bidder has examined copies of all the Contract Documents; 2) Bidder has visited the Project Area and become familiar with the general, local, and site conditions; 3) Bidder is familiar with Federal, State, and local laws, ordinances and regulations that govern the work specified by the Contract Documents; 4) Bidder has correlated the information known to the Bidder, observations obtained from the examination of the site, reports and drawings identified in the Contract Documents and additional investigations, explorations, tests, studies and data within the Contract Documents; 5) This Bid is genuine and not made in the interest of or on behalf of an undisclosed person, firm or corporation; Bidder has not directly or indirectly induced or solicited another Bidder to submit a false or sham Bid; Bidder has not solicited or induced a person, firm or corporation to refrain from Bidding; and Bidder has not sought by collusion to obtain for itself an advantage over another Bidder or over City; 6) Local and State sales and use taxes are not included in the Bid Amount. 7) Bidder has examined and understands that the following reports listed in Section 00775 are part of the Contract Documents have been considered and are included in the Bid Amount. NOT APPLICABLE 400.4 Unit Prices and Bid Amount Page 378 of 525 THE C7 OF DUB E Masterpiece on the Mississippi CITY OF DUBUQUE, IOWA WATER SYSTEM IMPROVEMENTS 2024 NORTH ENGLISH ROAD WATER MAIN EXTENSION BID SCHEDULE REVISED PER ADDENDUM NO. 3 NOTE: Bids shall EXCLUDE sales tax and all other applicable taxes and fees NO. DESCRIPTION UNIT QUANTITY PRICE Division 2010 - Earthwork, Subgrade, and Subbase 1 Clearing and Grubbing C 1 LS $ 8,000.00 2 Topsoil, On -site 2420 CY $ 6.00 3 Subbase, Granular Subbase Gr 12a (Granular Subbase Pile) 80 TON $ 17.00 Division 3010 - Trench Excavation and Backfill 4 Rock Excavation 100 CY $ 65.00 5 Replacement of Unsuitable Backfill Material, Gr 12a (Granular Subbase Pile) 2700 TON $ 17.00 6 Class I, Bedding Material, Gradation 3 (ASTM 57) 200 TON $ 20.00 7 Class II, Bedding Material Gradation 30 (Granular Base Pile) 5750 TON $ 17.00 Division 5010 - Pipe and Fittings 8 Water Main, Trenched, DIP, 6" 110 LF $ 82.00 9 Water Main, Trenched, DIP, 8" 55 LF $ 86.00 1D Water Main, Trenched, DIP, 12" 3550 LF $ 97.00 11 Water Main, Trenched, DIP, 16" 3300 LF $ 123.00 12 Water Main, Trenchless, DIP, 8" 140 LF $ 121.00 13 Water Main, with Casing Pipe, Trenchless, DIP, 16" 112 LF $ 929.00 14 Fittings by Weight, DI 8100 LBS $ 6.30 15 Joint Restraint, Bell Harness, 8" 10 EA $ 562.00 16 Joint Restraint, Bell Harness, 12" 5 EA $ 911.00 17 Joint Restraint, Bell Harness, 16" 18 EA $ 1,425.00 18 Joint Restraint, Megalug, 6" 50 EA $ 55.00 19 Joint Restraint, Megalug, 8" 8 EA $ 78.00 20 Joint Restraint, Megalug, 12" 45 EA $ 150.00 21 Joint Restraint, Megalug, 16" 70 EA $ 260.00 22 Water Main Connection Removal, 12" 1 EA $ 1,100.00 Division 5020 - Valves, Fire Hydrants, and Appurtenances 23 Valve, Gate, 6" 13 EA $ 1,742.00 24 Valve, Gate, 8" 2 EA $ 2,349.00 25 Valve, Gate, 12" 10 EA $ 3,993.00 26 Valve, Butterfly, 16" 11 EA $ 6,300.00 27 Fire Hydrant 13 EA $ 5,259.00 Division 7030 - Sidewalks, Shared Use Paths, and Driveways 28 Removal of Driveway 140 SY $ 9.00 29 Driveway, Paved, PCC, 6" (Thickness) 60 SY $ 135.00 30 Driveway, Paved, HMA, 6" (Thickness) 80 SY $ 45.00 31 Driveway, Granular by Ton 250 TON $ 17.00 Division 7040 - Pavement Rehabilitation 32 Full Depth Patches HMA 110 SY $ 45.00 This bid schedule accompanies the bid proposal of SECTION 00400 Page 3 of 6 TOTAL PRICE $ 8,000.00 $ 14,520.00 $ 1,360.00 $ 6,500.00 $ 45,900.00 $ 4,000.00 $ 97,750.00 $ 9,020.00 $ 4,730.00 $ 344,350.00 $ 405,900.00 $ 16,940.00 $ 104,048.00 $ 51,030.00 $ 5,620.00 $ 4,555.00 $ 25,650.00 $ 2,750.00 $ 624.00 $ 6,750.00 $ 18,200.00 $ 1,100.00 $ 22,646.00 $ 4,698.00 $ 39,930.00 $ 69,300.00 $ 68,367.00 $ 1,260.00 $ 8,100.00 $ 3,600.00 $ 4,250.00 $ 4,950.00 TOP GRADE EXCAVATING. INC. J. Page 379 of 525 ba-�*-TE Masterpiece on the Mississippi CITY OF DUBUQUE, IOWA WATER SYSTEM IMPROVEMENTS 2024 NORTH ENGLISH ROAD WATER MAIN EXTENSION BID SCHEDULE (continued) REVISED PER ADDENDUM NO. 3 NO. DESCRIPTION Division 8030 - Temporary Traffic Control 33 Temporary Traffic Control Division 8040 - Signing Materials 34 Remove and Reinstall Traffic Signs Division 9010 - Seeding 35 Conventional - Seeding, Type 1, by AC 36 Conventional - Seeding, Type 2, by AC 37 Conventional- Seeding, Type 4, by AC 38 Conventional - Seeding, Type 5, by AC Division 9040 - Erosion and Sediment Control 39 Stormwater Pollution Prevention Plan (SWPPP) Management 40 Filter Socks, 12" 41 Filter Socks, Removal 42 Temporary Rolled Erosion Control Products (RECP) by SY 43 Silt Fence or Silt Fence Ditch Check, Installation 44 Silt Fence or Silt Fence Ditch Check, Removal of Sediment 45 Silt Fence or Silt Fence Ditch Check, Removal of Device 46 Stabilized Construction Entrance by SY 47 Inlet Production Device, Installation 48 Inlet Protection Device, Maintenance Division 11,020 - Mobilization 49 Mobilization Division 11,050 - Concrete Washout 50 Concrete Washout TOTAL OF BID This bid schedule accompanies the bid proposal of QUANTITY PRICE SECTION 00400 Page 4 of 6 PRICE 1 LS $ 3,500.00 $ 3,500.00 2 EA $ 125.00 0.4 AC $ 3,000.00 2.6 AC $ 1,800.00 0.4 AC $ 1,500.00 2.6 AC $ 800.00 1 LS $ 3,500.00 1600 LF $ 2.50 1600 LF $ 0.20 1850 SY $ 1.70 2100 LF $ 1.70 2100 LF $ 0.10 2100 LF $ 0.10 420 SY $ 7.80 3 EA $ 150.00 3 EA $ 10.00 1 LS $ 49,566.00 1 LS $ 150.00 250.00 $ 1,200.00 $ 4,680.00 $ 600.00 $ 2,080.00 $ 3,500.00 $ 4,000.00 $ 320.00 $ 3,145.00 $ 3,570.00 $ 210.00 $ 210.00 $ 3,276.00 $ 450.00 $ 30.00 $ 49,566.00 $ 150.00 $ 1,487,135.00 TOP GRADE EXCAVATING, INC. V. Page 380 of 525 SECTION 00400 Page 5of6 400.7 Timeliness Bidder agrees that the work shall be Substantially Complete and made ready for final payment in accordance with Contract Documents no later than the date(s) indicated in Section 00800 — Construction Schedule and Agreed Cost of Delay. 400.8 Additional Documents To Be Submitted With Bid The following additional documents are included and made a condition of this Bid: A. Bid Bond (Section 00450y--or other approved Bid Security. Accompanying this Bid in a separate sealed envelope is a Bid Bond, cashier's check, or certified check in the penal sum of ten percent (10%) of the submitted Bid. It is understood that the Bid security will be retained in the event a contract is not executed by the Contractor if award is made to the undersigned. If a Bid Bond is submitted it must be executed by the Bidder and acceptable corporate surety. If a Cashier's check or certified check is submitted it must be made payable to the City Treasurer, City of Dubuque, drawn on a bank in Iowa or a bank chartered under the laws of the United States. B. Bidder Status Form (Section 00460) C. Signed SRF Forms: - Attachment 1 Certification of Non -Segregated Facilities - Attachment 2 Certification Regarding Debarment, Suspension, Other Responsibility Matters - Attachment 3 Disadvantaged business Enterprise (DBE) Solicitation - Attachment 4 DBE Subcontractor Performance Form (not required if no DBE is utilized) - Attachment 5 DBE Subcontractor Utilization Form (not required if no DBE is utilized) - Attachment 10 Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment 400.9 Document Submittal Requirements by Apparent Low Bidder The apparent low bidder must submit the Contractor Background Information Form (Section 00471) to the Jurisdiction Representative within 72 hours after the bid opening. Failure to submit the Contractor Background Information Form by the required deadline may be considered justification for the City to determine the Bidder as not responsible. 400.10 Contract Execution The Bidder further agrees to execute a formal contract and Bond, within ten (10) calendar days after the date of the City's Notice of Award. The Bidder also agrees it will commence work on or before ten (10) calendar days after the date of City's Notice to Proceed, and it will complete the work within the specified contract period or pay the Agreed Cost of Delay stipulated in the Contract Documents. 400.11 Questions and Interpretations Failure by the Bidder to request clarification of the Contract Documents during the bidding process does not waive the responsibility for comprehension of the documents and Page 381 of 525 SECTION 00400 Page 6of6 performance of the work in accordance with the Contract Documents. Signing of the Bid Proposal Form constitutes the Contractor's certification as implicitly denoting thorough comprehension of intent of the Contract Documents. 400.12 Addenda The Bidder acknowledges receipt of the following addenda: ADpe,A)O AA # ( Dated: -21-_2$ A DD 4A) W &A *' Z Dated: 7- 23 - 2-f AD pEnl D j M # 3 Dated: - lq- ZS 400.13 Signatures Contractor: oP 6RAO 4 &.4vA-na& , 1 4) C Contractor Name L77 ! q , u Ai & !) k) Street (Business Location) FAa.LLI/ City Title Dated: Dated: Q -21- 2 S Dated: 8'ZI -Z-S The Bidder's State of does ( ) / doeq not ( ) utilize a percentage preference for in -state Bidders. The amount of preference is percent. ==== END OF SECTION 00400 === Page 382 of 525 Attachment 1 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid.) U.S. Environmental Protection Agency Certification of Non -Segregated Facilities (Applicable to contracts, subcontracts, and agreements with applicants who are themselves performing federally assisted construction contracts, exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause.) By the submission of this bid, the bidder, offeror, applicant, or subcontractor certifies that he does not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. He certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The bidder, offeror, applicant, or subcontractor agrees that a breach of this certification is a violation of the Equal Opportunity clause in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national original, because of habit, local custom, or otherwise. He further agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause; that he will retain such certifications in his files; and that he will forward the following notice to such proposed subcontractors (except where the proposed subcontractors have submitted identical certifications for specific time periods): NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF NON -SEGREGATED FACILITIES A Certification of Non -segregated Facilities, as required by the May 9, 1967, order (33 F.R. 7808, May 28, 1968) on Elimination of Segregated Facilities, by the Secretary of Labor, must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Opportunity clause. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e., quarterly, semiannually, or annually). 7-Zy-Zs Sign re AuthorizedRepresentative Date J4A' �ayo(L&,) Ac.D Printed Name Title NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. EPA-7 5720-4.2 September 2023 INVESTING IN IOWXS WATER www.iowasrf.com DNR Form 542-0621 Page 383 of 525 Attachment 2 SRF Required Front -End Specifications (This form must be completed and signed by the Prime Contractor and submitted with the bid.) Debarments and Suspensions 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 of up to $10,000 or imprisonment for up to 5 years, or both. Signa re Authorized Representative 14-) Printed Name 77 2q -- ZS Date o(Ce- Title ❑ I am unable to certify to the above statements. My explanation is attached. September 2023 INVESTING IN IOWXS WATER www.iowasrf.com DNR Form 542-0621 Page 384 of 525 Attachment 3 SRF Required Front End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid.) Disadvantaged Business Enterprise (DBE) Solicitation It is EPA's policy that recipients of EPA financial assistance through the State Revolving Fund programs award a "fair share" of subagreements to small, minority and women -owned businesses, collectively known as Disadvantaged Business Enterprises (DBEs). Iowa's Fair Share goals are: Minority -Owned Business Enterprise (MBE) Goal Women -Owned Business Enterprise (WBE) Goal Construction 1.7% 2.2% Supplies 0.6% 5.6% Services 2.5% 11.3% Goods/Equipment 2.5% 10.4% Average 1.8 % 7.4 Only work performed by certified DBEs can be counted toward the goals. 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 IDOTwebsite 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: Ci�T'/ OI% �JuBu12,1 E Bidder: —TOP 4 a&AQC �J91_hJA'17A6, ,-C Address: 471 9TH L+jc Alj r City: State: ZA Zip: SZo -1 c. Contact Person: JA.Sb.) V02..J Phone Number: 5(o3— '7 q,4 _3y((p Email: Tops►ra�P�'�9�C�cCask�tnq,Co•+�1 Check if Prime Contractor is: ❑ Minority -Owned ❑ Women -Owned 1. Do you agree to use the good faith efforts checklist to ensure the DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds? ®Yes El No 2. At this point in time, has the prime contractor begun to solicit work opportunities to subcontractors for this project? [K Yes ❑ No ❑ N/A 3. If yes, was a DBE chosen by the prme contractor to be utilized fore this El Yes 9No �_ 1A J Signature: September 2023 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Page 385 of 525 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 outreach and recruitment activities? ®Yes El No 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 in the competitive process? This includes, whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date. Yes El 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 maximum participation by DBEs in the competitive process. N Yes ❑ No 4. Did you encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually? Ftl Yes El No 5. Did you use the services of the Small Business Administration and the Minority Business Development Agency of the Department orIf�Commerce to identify potential subcontractors? El Yes uNo 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, phone call, fax, e-mail) Response (e.g. did not respond, not interested, not competitive) SEE ATrK�+EO G jAk' A t!_. Dio Af i i?oN o S d a M A t t— oT (/t�/iTE Q E srE �nGK G �M 1,L or Cvrsten-f7✓� TiEoi AA aSeQ Y CAA ► L ----* A)o r Co."PEn -n 0 C September 2023 INVESTING IN IOWXS WATER www.iowasrf.com DNR Form 542-0621 Page 386 of 525 From: Jason Vorwald Sent: Wednesday, July 16, 2025 11:24 AM -X To: Topgrade <topgrade@tgexcavating.com> Subject: Bid Solicitation - Water Main Systems Improvements 2024 North English Road Water Main Extension -Dubuque, Iowa - TOP GRADE EXCAVATING, INC Sent to: sar@aviationallianceinc.com; bcoleman@brprojectmgmt.com; btucker@btconstructiongroup.com; barb@barbarajsales.com; rupa@barupon.com; baselinesupply@gmail.com; jennifer.p@besterectors.com; tamara@bistatebarricade.com; barricades@netzero.com; amy@boylebuilt.com; kathy@boyswaterproducts.com; carlo@carloelectrical.com; guss@centrexelectric.com; darrell@chandlercampbelle.com; bhickman@chenhallstaffing.com; jonathan@coicompany.com; viarose@civildesigninc.com; christina@clausenstructures.com; josie@collinsconcrete.net; rskinner@wbesales.com; ying@communitycpa.com; aonyewuc@compasscentral.com; sri@comtech-global.com; laura@constructionanchors.com; carlos@cscassd.com; kelly@cooperresourcesllc.com; juliaespey@courtiandllc.net; bcrowley@wi.rr.com; norbeck@cwise.com; dallasschwarz22@gmail.com; danielle@dameltransport.com; deb@danashtrucking.com; karna@davidsontrkg.com; wendy@shipdavisfreight.com; ddpatterson@delonginc.com; Icbensen@departure-media.com; depot.electric@gmail.com; aschmitt@dibuild.com; mmeyer@dsinc.pro; jmesa@dbuilds.com; dirty30iowa@gmail.com; jose@dtwrail.com; dnd@dndelectric.com; nell@doneriteconst.com; colleen@donovaninc.com; james@dormark.com; elliottrthreatt@gmail.com; mckena.r25@gmail.com Hello, Please find attached information related to a project we will be submitting a bid on in Dubuque, Iowa. By this email, we are requesting that you provide a subquote that matches your construction specialty. If interested, please return that subquote prior to the day of the bid. Also, please return the required completed SRF forms for compliance with the terms of the instructions to bidders. Signatures are required specifically on Attachment 4 and other company information is necessary on Attachment 5. Please call me with questions. Thank you. Jason Vorwald Top Grade Excavating, Inc. 9719th Avenue NW Farley, IA 52046 PH: 563-744-3416 FAX: 855-884-2769 Page 387 of 525 Jason Vorwald From: Michelle Meyer <mmeyer@dsinc.pro> Sent: Monday, July 21, 2025 2:27 PM To: Jason Vorwald Subject: Re: Bid Solicitation - Water Main Systems Improvements 2024 North English Road Water Main Extension -Dubuque, Iowa - TOP GRADE EXCAVATING, INC I will not be submitting a quote for this project. Thankyou, Michelle Meyer, president Diamond Solutions, Inc www.dsinc.pro DBE certified in multiple states On Jul 16, 2025, at 11:24 AM, Jason Vorwald <jvorwald@tgexcavating.com> wrote: Hello, Please find attached information related to a project we will be submitting a bid on in Dubuque, Iowa. By this email, we are requesting that you provide a subquote that matches your construction specialty. If interested, please return that subquote prior to the day of the bid. Also, please return the required completed SRF forms for compliance with the terms of the instructions to bidders. Signatures are required specifically on Attachment 4 and other company information is necessary on Attachment 5. Please call me with questions. Thank you. Jason Vorwald Top Grade Excavating, Inc. 9719t" Avenue NW Farley, IA 52046 PH: 563-744-3416 FAX: 855-884-2769 <21197 - Bid Specifications.pdf> Page 388 of 525 Attachment 4 SRF Required Front -End Specifications (This form must 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. Disadvantaged Business Enterprise Program DBE Subcontractor Performance Form This form is intended to capture the DBEs 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.: Point of Contact: Address: Telephone No.: Prime Contractor Name: Issuing/Funding Entity: _ Assistance Agreement ID No. (if known): Email: Contract Item Number Description of Work Submitted to the Prime Contractor Involving Construction, Services, Equipment or Supplies Price of Work Submitted to the Prime Contractor DBE Certified by ❑ DOT ❑SBA ❑ Other: Meets/exceeds EPA certification standards? ❑ Yes ❑ No ❑ Unknown '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. 'Subcontractor 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. IA SRF6100-3 September 2023 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Page 389 of 525 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. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). Prime Contractor Signature Title Subcontractor Signature Title September 2023 Print Name Date Print Name Date IA SRF6100-3 INVESTING IN IOWA S WATER www.iowasrf.com DNR Form 542-0621 Page 390 of 525 Attachment 5 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid if utilizing DBE subcontractors.) * If no DBE was chosen by the Prime Contractor to be utilized for this project, then this form is not required to be submitted. Disadvantaged Business Enterprise Program DBE Subcontractor Utilization Form This form is intended to capture the prime contractor's actual and/or intended use of identified certified DBE' subcontractorS2 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: Project Name: _ Bid/Proposal No.: Point of Contact: Address: Telephone No.: Issuing/Funding Entity: Assistance Agreement ID No. (if known): Email: I have identified potential DBE certified subcontractors ❑ Yes ❑ No If yes, complete the table below. If no, explain: Subcontractor Name/ Company Name Company Address/Phone/Email Estimated Dollar Amount Currently DBE Certified? ❑Yes ❑No D� &41 Q-k'D ❑Yes ❑No El Yes ❑No ❑Yes ❑No El Yes ❑No '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. ZSubcontractor 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. September 2023 IA SRF61OO-4 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Page 391 of 525 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. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). Prime Contractor Signature Title September 2023 Print Name Date IA SRF61OO-4 INVESTING IN IOWXS WATER www.iowasrf.com DNR Form 542-0621 Page 392 of 525 Attachment 10 SRF Required Front -End Specifications (This form must be completed and signed 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 prohibitionspnd certify that the project will be in compliance with all the requirements. SignatV ` f A] V 02ti,1 �L p Printed Name Date Title September 2023 INVESTING IN IOWXS WATER www.iowasrf.com DNR Form 542-0621 Page 393 of 525 SECTION 00460 Page 1 of 2 Bidder Status Form SECTION 00460 To be completed by all Bidders PartA Please answer "Yes" or "No" for each of the following: 14 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). KlYes ❑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. WYes ❑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 non-resident Bidder. Please complete Parts C and D of this form. To be completed by all resident Bidders PartB My company ht6l ma.ntained offices in Iowa during the past 3 years at the following addresses: Dates: o I to PIZ &S .6 a T Address: / -71 Iro Ai /J (mm/dd/yyyy) City, State, Zip: F^AC 6 V., 1A 520 `%G Dates: to Address: (mm/dd/yyyy) City, State, Zip: Dates: to Address: (mm/dd/yyyy) City, State, Zip: You may attach additional sheet(s) if needed. To be completed by all non- resident Bidders Part C Name of your home state or foreign country reported to the Iowa Secretary of State. Al 4 Does your company's home state or foreign country offer preferences to Bidders who are residents? ❑ Yes ❑ No 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 Q 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: 1 VP 6 R AaZ 6 Afn A1�6- A t ^J L Signature: V Date: S - Z1- Z S You must submit t co lete form to the government body requesting Bids per 875 Iowa Administrative Code Chapter 156 This Form has been approved by the Labor Commissioner 309-6001 02-14 Page 394 of 525 SECTION 00460 Page 2of2 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. 1,S Yes ❑ No My business is currently registered as a contractor with the Iowa Division of Labor. ❑ Yes © No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. ❑ Yes © 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. C1 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. 19 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. ad 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. C1 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. ___= END OF SECTION 00460 =___ Page 395 of 525