00 35 13

The referenced forms may be downloaded from the links provided below.

Form CIQ (Conflict of Interest Questionnaire) (state.tx.us) https://www.ethics.state.tx.us/data/forms/conflict/CIS.pdf

CIQ Form does not apply

CIQ Form is on file with City Secretary

CIQ Form is being provided to the City Secretary

CIS Form does not apply

CIS Form is on File with City Secretary

CIS Form is being provided to the City Secretary

BIDDER:

By:

Signature:

Title:

END OF SECTION

&"Arial,Regular"&8&A

CONFLICT OF INTEREST STATEMENT

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&"Arial,Regular"&8CITY OF FORT WORTH

STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS

Revised February 24, 2020 &"Arial,Regular"&8&F https://www.ethics.state.tx.us/data/forms/conflict/CIQ.pdf 00 41 00

FOR: Water & SS Replacement Contract 2021, WSM-A Part 1

City Project No.: 103498

1. Enter Into Agreement

The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with City in the form included in the Bidding Documents to perform and furnish all Work as specified or indicated in the Contract Documents for the Bid Price and within the Contract Time indicated in this Bid and in accordance with the other terms and conditions of the Contract Documents.

2. BIDDER Acknowledgements and Certification

2.1. In submitting this Bid, Bidder accepts all of the terms and conditions of the INVITATION TO BIDDERS and INSTRUCTIONS TO BIDDERS, including without limitation those dealing with the disposition of Bid Bond.

2.2. Bidder is aware of all costs to provide the required insurance, will do so pending contract award, and will provide a valid insurance certificate meeting all requirements within 14 days of notification of award.

2.3. Bidder certifies that this Bid is genuine and not made in the interest of or on behalf of any undisclosed individual or entity and is not submitted in conformity with any collusive agreement or rules of any group, association, organization, or corporation.

2.4. Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid.

2.5. Bidder has not solicited or induced any individual or entity to refrain from bidding.

2.6. Bidder has not engaged in corrupt, fraudulent, collusive, or coercive practices in competing for the Contract. For the purposes of this Paragraph:

a. "corrupt practice" means the offering, giving, receiving, or soliciting of any thing of value likely to influence the action of a public official in the bidding process.

b. "fraudulent practice" means an intentional misrepresentation of facts made (a) to influence the bidding process to the detriment of City (b) to establish Bid prices at artificial non-competitive levels, or (c) to deprive City of the benefits of free and open competition.

c. "collusive practice" means a scheme or arrangement between two or more Bidders, with or without the knowledge of City, a purpose of which is to establish Bid prices at artificial, non-competitive levels.

d. "coercive practice" means harming or threatening to harm, directly or indirectly, persons or their property to influence their participation in the bidding process or affect the execution of the Contract.

3. Prequalification

The Bidder acknowledges that the following work types must be performed only by prequalified contractors and subcontractors:

a. Water Distribution, 12-inch diameter and smaller

b. Water Transmission, 24-inch diameter and smaller

c. Sewer Collection System, 12-inches and smaller

d. Asphalt Paving Construction/Reconstruction (Less Than 15,000 Square Yards)

e. Concrete Paving Construction/Reconstruction (Less Than 15,000 Square Yards)

f. CCTV, 12-inches and smaller

g. Augur Boring - Greater than 24-inch diameter casing and greater

h. -

4. Time of Completion

4.2. Bidder accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work {and/or achievement of Milestones} within the times specified in the Agreement.

5. Attached to this Bid

The following documents are attached to and made a part of this Bid:

a. This Bid Form, Section 00 41 00

b. Required Bid Bond, Section 00 43 13 issued by a surety meeting the requirements of Paragraph 5.01 of the General Conditions.

c. Proposal Form, Section 00 42 43

d. Vendor Compliance to State Law Non Resident Bidder, Section 00 43 37

e. Small Business Forms (required at time of bid)

f. Prequalification Statement, Section 00 45 12

h. Any additional documents that may be required by Section 12 of the Instructions to Bidders

6. Total Bid Amount

6.1. Bidder will complete the Work in accordance with the Contract Documents for the following bid amount. In the space provided below, please enter the total bid amount for this project. Only this figure will be read publicly by the City at the bid opening.

6.2. It is understood and agreed by the Bidder in signing this proposal that the total bid amount entered below is subject to verification and/or modification by multiplying the unit bid prices for each pay item by the respective estimated quantities shown in this proposal and then totaling all of the extended amounts.

6.3. Evaluation of Alternate Bid Items

Total Bid $200,000.00

7. Bid Submittal

This Bid is submitted on by the entity named below.

Respectfully submitted, Receipt is acknowledged of the following Addenda: Initial

Title:

Company: Corporate Seal:

Address:

State of Incorporation:

Email:

Phone:

END OF SECTION

BID FORM

Page &P of &N

&"Arial,Regular"&8CITY OF FORT WORTH

STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS

Revised 9/30/2021 &"Arial,Regular"&8&F

00 42 43

UNIT PRICE BID Bidder's Application UNIT PRICE BID Owner's Application

Project Item Information Bidder's Proposal Project Item Information Bid Item Funding and Percentage Breakdown

Total Base Bid $0.00

Alternate Bid

Total Alternate Bid $0.00

Deductive Alternate Bid

Total Deductive Alternate Bid $0.00

Additive Alternate Bid

Total Additive Alternate Bid $0.00

Total Bid $200,000.00

END OF SECTION

&8&A

BID PROPOSAL

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&8CITY OF FORT WORTH

Revised 9/30/2021 &8&F

00 43 13

KNOW ALL BY THESE PRESENTS:

PRINCIPAL:

Witness as to Principal Name and Title

Address:

SURETY:

Name and Title

Address:

Witness as to Surety Telephone Number:

Attach Power of Attorney (Surety) for Attorney-in-Fact

*Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by laws showing that this person has authority to sign such obligation. If Surety’s physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded.

END OF SECTION

BID BOND

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&"Arial,Regular"&8CITY OF FORT WORTH

Revised 9/30/2021 &"Arial,Regular"&8&F

00 43 37

Texas Government Code Chapter 2252 was adopted for the award of contracts to nonresident bidders. This law provides that, in order to be awarded a contract as low bidder, nonresident bidders (out-of-state contractors whose corporate offices or principal place of business are outside the State of Texas) bid projects for construction, improvements, supplies or services in Texas at an amount lower than the lowest Texas resident bidder by the same amount that a Texas resident bidder would be required to underbid a nonresident bidder in order to obtain a comparable contract in the State which the nonresident’s principal place of business is located.

The appropriate blanks in Section A must be filled out by all nonresident bidders in order for your bid to meet specifications. The failure of nonresident bidders to do so will automatically disqualify that bidder. Resident bidders must check the box in Section B.

BIDDER:

By:

(Signature)

Title:

Date:

END OF SECTION

VENDOR COMPLIANCE TO STATE LAW

Page &P of &N

&"Arial,Regular"&8CITY OF FORT WORTH

Revised 9/30/2021 &"Arial,Regular"&8&F

00 45 12

Each Bidder for a City procurement is required to complete the information below by identifying the prequalified contractors and/or subcontractors whom they intend to utilize for the major work type(s) listed.

Major Work Type Contractor/Subcontractor Company Name Prequalification Expiration Date

Water Distribution, 12-inch diameter and smaller

Water Transmission, 24-inch diameter and smaller

Sewer Collection System, 12-inches and smaller

Asphalt Paving Construction/Reconstruction (Less Than 15,000 Square Yards)

Concrete Paving Construction/Reconstruction (Less Than 15,000 Square Yards)

Augur Boring - Greater than 24-inch diameter casing and greater

Augur Boring - Greater than 24-inch diameter casing and greater

The undersigned hereby certifies that the contractors and/or subcontractors described in the table above are currently prequalified for the work types listed.

BIDDER:

0 By: 0

Date:

END OF SECTION

PREQUALIFICATION STATEMENT

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&"Arial,Regular"&8CITY OF FORT WORTH

Revised 09/30/2021 &"Arial,Regular"&8&F