BID PACKAGE

GHOST TOWN TRAIL 2024 STORM REPAIRS

(TWIN ROCKS TRAIL REPAIRS) PROJECT

FOR

CAMBRIA COUNTY CONSERVATION & RECREATION AUTHORITY

Cambria County, Pennsylvania

Bids Submitted via PennBID,www.pennbid.net

BID OPENING DATE: June 12, 2026

BID OPENING TIME: 11:00 A.M. (Prevailing Time)

Submitted By:

Address:

Phone No.:

Fax No.:

E-Mail:

EIN:

http://www.pennbid.net/

BID DOCUMENTS:

• Bid Form

• Bid Bond

• Qualifications Statement

• Non-Collusion Affidavit of Prime Bidder

• Certification Of Non-Segregated Facilities & Illegal Alien Labor

• Public Works Employment Verification Form

• Small-MBE-WBE-Labor Surplus Area Firms Bidder Certification

Affirmative Steps

• Certification for Contracts, Grants, Loans & Co-Op Agreements

• Certification Regarding Disbarment, Suspension, Ineligibility, and

Voluntary Exclusion -Lower Tier Covered Transactions

• Build America, Buy America Contractor’s Self-Certification (FEMA)

Bid Form 004143 - i This document is a MODIFIED version of EJCDC® C-410, Bid Form for Construction Contracts.

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

BID FORM (Form of Proposal)

GHOST TOWN TRAIL 2024 STORM REPAIRS

(TWIN ROCKS TRAIL REPAIRS) PROJECT

FOR

CAMBRIA COUNTY CONSERVATION &

RECREATION AUTHORITY

TABLE OF CONTENTS

Page

Article 1 – Bid Recipient

Article 2 – Bidder’s Acknowledgements

Article 3 – Bidder’s Representations

Article 4 – Bidder’s Certification

Article 5 – Basis of Bid

Article 6 – Time of Completion

Article 7 – Attachments to this Bid

Article 8 – Defined Terms

Article 9 – Bid Submittal

[THIS PAGE LEFT INTENTIONALLY BLANK.]

Bid Form 004143 - 1

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Bid Form (Form of Proposal)

Ghost Town Trail 2024 Storm Repairs (Twin Rocks Trail Repairs) Project

Cambria County Conservation & Recreation Authority

ARTICLE 1 – BID RECIPIENT

1.01 This Bid is submitted electronically via PennBid (https://pennbid.bonfirehub.com) to: CAMBRIA

COUNTY CONSERVATION & RECREATION AUTHORITY (Owner).

1.02 The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with

Owner in the form included in the Bidding Documents to perform all Work as specified or indicated in the Bidding Documents for the prices and within the times indicated in this Bid and in accordance with the other terms and conditions of the Bidding Documents.

1.03 All bids must be submitted electronically via PennBid (https://pennbid.bonfirehub.com) and shall include the required bid forms. All blank spaces for bid prices must be filled in and the bid form must be fully completed and executed when submitted.

ARTICLE 2 – BIDDER’S ACKNOWLEDGEMENTS

2.01 Bidder accepts all of the terms and conditions of the Instructions to Bidders, including without limitation those dealing with the disposition of Bid security. This Bid will remain subject to acceptance for 60 days after the Bid opening. If the award is delayed by the required approval of another government agency, the sale of bonds or the award of a grant, this Bid will remain subject to acceptance for 120 days after the Bid opening. Extensions of the date for the award may be made by mutual written consent of the Owner and

Bidder.

2.02 Bidder consents that alternates, if any, as presented in the Bid Form may be applied in any order and the award may be made to the Successful Bidder on its base Bid and any combination of its alternate Bids for which the Owner determines funds will be available at the time of award.

ARTICLE 3 – BIDDER’S REPRESENTATIONS

3.01 In submitting this Bid, Bidder represents that:

A. Bidder has examined and carefully studied the Bidding Documents, and any data and reference items identified in the Bidding Documents, and hereby acknowledges receipt of the following Addenda:

Addendum No. Addendum, Date

B. Bidder has visited the Site, conducted a thorough, alert visual examination of the Site and adjacent areas, and become familiar with and satisfied itself as to the general, local, and Site conditions that may affect cost, progress, and performance of the Work.

https://pennbid.procureware.com/ https://pennbid.procureware.com/

Bid Form 004143 - 2

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

C. Bidder is familiar with and has satisfied itself as to all Laws and Regulations that may affect cost, progress, and performance of the Work.

D. Bidder has carefully studied all: (1) reports of explorations and tests of subsurface conditions at or adjacent to the Site and all drawings of physical conditions relating to existing surface or subsurface structures at the Site that have been identified in the Supplementary Conditions, especially with respect to Technical Data in such reports and drawings, and (2) reports and drawings relating to

Hazardous Environmental Conditions, if any, at or adjacent to the Site that have been identified in the Supplementary Conditions, especially with respect to Technical Data in such reports and drawings.

E. Bidder has considered the information known to Bidder itself; information commonly known to contractors doing business in the locality of the Site; information and observations obtained from visits to the Site; the Bidding Documents; and any Site-related reports and drawings identified in the

Bidding Documents, with respect to the effect of such information, observations, and documents on

(1) the cost, progress, and performance of the Work; (2) the means, methods, techniques, sequences, and procedures of construction to be employed by Bidder; and (3) Bidder’s safety precautions and programs.

F. Bidder agrees, based on the information and observations referred to in the preceding paragraph, that no further examinations, investigations, explorations, tests, studies, or data are necessary for the determination of this Bid for performance of the Work at the price bid and within the times required, and in accordance with the other terms and conditions of the Bidding Documents.

G. Bidder is aware of the general nature of work to be performed by Owner and others at the Site that relates to the Work as indicated in the Bidding Documents.

H. Bidder has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that

Bidder has discovered in the Bidding Documents, and confirms that the written resolution thereof by

Engineer is acceptable to Bidder.

I. The Bidding Documents are generally sufficient to indicate and convey understanding of all terms and conditions for the performance and furnishing of the Work.

J. The submission of this Bid constitutes an incontrovertible representation by Bidder that Bidder has complied with every requirement of this Article, and that without exception the Bid and all prices in the Bid are premised upon performing and furnishing the Work required by the Bidding Documents.

ARTICLE 4 – BIDDER’S CERTIFICATION

4.01 Bidder certifies that:

A. 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;

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

Bid;

C. Bidder has not solicited or induced any individual or entity to refrain from bidding; and

Bid Form 004143 - 3

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

D. Bidder has not engaged in corrupt, fraudulent, collusive, or coercive practices in competing for the

Contract. For the purposes of this Paragraph 4.01.D:

1. “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;

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

3. “collusive practice” means a scheme or arrangement between two or more Bidders, with or without the knowledge of Owner, a purpose of which is to establish bid prices at artificial, non-competitive levels; and

4. “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.

E. The _________________________________________is a corporation organized and existing under the laws of ____________________________________and has (has not) been granted certificate of authority to do business in Pennsylvania as required by the business corporation law, approved May

5, 1933, PL 364, as amended.

F. The_________________________________________ is an individual or partnership trading under a fictitious or assumed name and has (has not) registered under the Fictitious Name Act of

Pennsylvania; namely, the Act of May 24, 1945, PL 967.

ARTICLE 5 – BASIS OF BID

5.01 Bidder will complete the Work in accordance with the Contract Documents for the following price(s):

Ghost Town Trail 2024 Storm Repairs (Twin Rocks Trail Repairs)

Cambria County Conservation and Recreation Authority

BID SCHEDULE

No. Description Quantity Unit Unit Price Total Price

1. Mobilization / Demobilization / General Contract Provisions. 1 LS

2. Project 01 (Coordinates: 40.52235, -78.85029 - 40.48175, -78.84515)

a. AASHTO No. 10 Stone (2" depth) and Subgrade Preparation. 8,975 SY

b. Envirogrid Filled with Infill, Nonwoven Geotextile, AASHTO #2A, and Subgrade Preparation 1,490 SY

c. Subbase, Unclassified Fill 500 CY

d. Ditch Cleaning, 3' Wide x 2' Deep 1,190 LF

3. Project 02 (Coordinates: 40.484468, -78.88910)

a. Furnish and Install Wooden Split Rail Fence 40 LF

b. Subbase, Unclassified Fill 50 CY

4. Project 03 Embankment (Coordinates: 40.48499, -78.88311)

a. Native Soil Embankment Restoration Above the River 534 CY

5. Project 04 Embankment (Coordinates: 40.48793, -78.87208)

a. Native Soil Embankment Restoration Above the River 54 CY

6. Project 08 (Coordinates: 40.488253, -78.870416)

a. Furnish and Install 24" HDPE Storm Pipe 30 LF

b. Subbase, Unclassified Fill 7 CY

7. Project 09 (Coordinates: 40.48726, -78.875636)

a. Furnish and Install 15" HDPE Storm Pipe 30 LF

8. 1 LS

BASE BID

Furnish and Install Erosion and Sedimentation Controls

Ghost Town Trail 2024 Storm Repairs (Twin Rocks Trail Repairs) Base Bid Subtotal =

Bid Form MODIFIED version of EJCDC® C-410, Bid Form.Copyright © 2013 NSPE, ACEC, and ASCE. All rights reserved. 004143 - 4

Bid Form 004143 - 5

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Bidder to include in other Bid item(s) the other costs (if any) associated with accepting such assignment and administering the assigned contract.

Bidder acknowledges that (1) each Bid Unit Price or Lump Sum includes an amount considered by Bidder to be adequate to cover Contractor’s overhead and profit for each separately identified item, and (2) estimated quantities are not guaranteed, and are solely for the purpose of comparison of Bids, and final payment for all unit price or Lump Sum Bid items will be based on actual quantities, determined as provided in the Contract Documents.

ARTICLE 6 – TIME OF COMPLETION

6.01 Bidder agrees that the Work will be completed and ready for final payment in accordance with Paragraph

15.06 of the General Conditions within 90 days of the issued Notice to Proceed.

Bidder accepts the provisions of the Agreement as to liquidated damages.

ARTICLE 7 – ATTACHMENTS TO THIS BID

7.01 The following documents are submitted with and made a condition of this Bid:

A. Required Bid security;

B. List of Project References;

C. Evidence of authority to do business in the state of the Project; or a written covenant to obtain such license within the time for acceptance of Bids;

D. Contractor’s License No.: __________ or Evidence of Bidder’s ability to obtain a State Contractor’s

License and a covenant by Bidder to obtain said license within the time for acceptance of Bids

E. Required Bidder Qualifications Statement with supporting data

F. Non-Collusion Affidavit of Prime Bidder

G. Certification of Non-Segregated Facilities and Non-Employment of Illegal Alien Labor

H. Public Works Employment Verification Form

I. Certification for Contracts, Grants, Loans & Co-Op Agreements

J. Certification Regarding Disbarment, Suspension, Ineligibility, and Voluntary Exclusion -Lower Tier

Covered Transactions

K. Build America, Buy America Contractor’s Self-Certification

L. Small-MBE-WBE-Labor Surplus Area Firms Bidder Certification Affirmative Steps and

Supporting Documentation ( (if applicable)

ARTICLE 8 – DEFINED TERMS

8.01 The terms used in this Bid with initial capital letters have the meanings stated in the Instructions to

Bidders, the General Conditions, and the Supplementary Conditions.

Bid Form 004143 - 6

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

ARTICLE 9 – BID SUBMITTAL

BIDDER: [Indicate correct name of bidding entity]

By:

[Signature]

[Printed name]

(If Bidder is a corporation, a limited liability company, a partnership, or a joint venture, attach evidence of authority to sign.)

Attest:

[Signature]

[Printed name]

Title:

Submittal Date:

Address for giving notices:

Telephone Number:

Fax Number:

Contact Name and e-mail address:

Bidder’s License No.:

PENAL SUM FORM

EJCDC® C-430, Bid Bond (Penal Sum Form). Published 2013.

Prepared by the Engineers Joint Contract Documents Committee.

Bid Bond 004313-1

BID BOND

Any singular reference to Bidder, Surety, Owner or other party shall be considered plural where applicable.

BIDDER (Name and Address):

SURETY (Name, and Address of Principal Place of Business):

OWNER (Name and Address):

BID

Bid Due Date:

Description (Project Name— Include Location):

BOND

Bond Number:

Date:

Penal sum $

(Words) (Figures) Surety and Bidder, intending to be legally bound hereby, subject to the terms set forth below, do each cause this Bid Bond to be duly executed by an authorized officer, agent, or representative.

BIDDER SURETY

(Seal) (Seal)

Bidder’s Name and Corporate Seal Surety’s Name and Corporate Seal

By: By:

Signature Signature (Attach Power of Attorney)

Print Name Print Name

Title Title

Attest: Attest:

Signature Signature

Title Title

Note: Addresses are to be used for giving any required notice.

Provide execution by any additional parties, such as joint venturers, if necessary.

PENAL SUM FORM

EJCDC® C-430, Bid Bond (Penal Sum Form). Published 2013.

Prepared by the Engineers Joint Contract Documents Committee.

Bid Bond 004313-2

1. Bidder and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assigns to pay to Owner upon default of Bidder the penal sum set forth on the face of this Bond. Payment of the penal sum is the extent of Bidder’s and Surety’s liability. Recovery of such penal sum under the terms of this Bond shall be Owner’s sole and exclusive remedy upon default of Bidder.

2. Default of Bidder shall occur upon the failure of Bidder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents.

3. This obligation shall be null and void if:

3.1 Owner accepts Bidder’s Bid and Bidder delivers within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents, or

3.2 All Bids are rejected by Owner, or

3.3 Owner fails to issue a Notice of Award to Bidder within the time specified in the Bidding Documents (or any extension thereof agreed to in writing by Bidder and, if applicable, consented to by Surety when required by Paragraph 5 hereof).

4. Payment under this Bond will be due and payable upon default of Bidder and within 30 calendar days after receipt by Bidder and Surety of written notice of default from Owner, which notice will be given with reasonable promptness, identifying this Bond and the Project and including a statement of the amount due.

5. Surety waives notice of any and all defenses based on or arising out of any time extension to issue Notice of Award agreed to in writing by Owner and Bidder, provided that the total time for issuing Notice of Award including extensions shall not in the aggregate exceed 120 days from the Bid due date without Surety’s written consent.

6. No suit or action shall be commenced under this Bond prior to 30 calendar days after the notice of default required in Paragraph 4 above is received by Bidder and Surety and in no case later than one year after the Bid due date.

7. Any suit or action under this Bond shall be commenced only in a court of competent jurisdiction located in the state in which the Project is located.

8. Notices required hereunder shall be in writing and sent to Bidder and Surety at their respective addresses shown on the face of this Bond. Such notices may be sent by personal delivery, commercial courier, or by United States Registered or Certified Mail, return receipt requested, postage pre-paid, and shall be deemed to be effective upon receipt by the party concerned.

9. Surety shall cause to be attached to this Bond a current and effective Power of Attorney evidencing the authority of the officer, agent, or representative who executed this Bond on behalf of Surety to execute, seal, and deliver such Bond and bind the Surety thereby.

10. This Bond is intended to conform to all applicable statutory requirements. Any applicable requirement of any applicable statute that has been omitted from this Bond shall be deemed to be included herein as if set forth at length. If any provision of this Bond conflicts with any applicable statute, then the provision of said statute shall govern and the remainder of this Bond that is not in conflict therewith shall continue in full force and effect.

11. The term “Bid” as used herein includes a Bid, offer, or proposal as applicable.

Qualifications Statement 004513 - 1 This document is a MODIFIED version of EJCDC® C-451, Qualifications Statement.

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, QUALIFICATIONS STATEMENT

THE INFORMATION SUPPLIED IN THIS DOCUMENT IS CONFIDENTIAL TO THE EXTENT

PERMITTED BY LAWS AND REGULATIONS

1. SUBMITTED BY:

Official Name of Firm:

2. SUBMITTED TO:

3. SUBMITTED FOR:

Owner:

Project Name:

TYPE OF WORK:

4. CONTRACTOR'S CONTACT INFORMATION

Contact Person:

Title:

Phone:

Email:

5. AFFILIATED COMPANIES:

Name:

Qualifications Statement 004513 - 2

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies,

6. TYPE OF ORGANIZATION:

SOLE PROPRIETORSHIP

Name of Owner:

Doing Business As:

Date of Organization:

PARTNERSHIP

Date of Organization:

Type of Partnership:

Name of General Partner(s):

CORPORATION

State of Organization:

Date of Organization:

Executive Officers:

- President:

- Vice President(s):

- Treasurer:

- Secretary:

LIMITED LIABILITY COMPANY

State of Organization:

Date of Organization:

Members:

Qualifications Statement 004513 - 3

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, JOINT VENTURE

Sate of Organization:

Date of Organization:

Form of Organization:

Joint Venture Managing Partner

- Name:

- Address:

Joint Venture Managing Partner

Joint Venture Managing Partner

7. LICENSING

Jurisdiction:

Type of License:

License Number:

Jurisdiction:

Type of License:

License Number:

8. CERTIFICATIONS CERTIFIED BY:

Qualifications Statement 004513 - 4

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, Disadvantage Business Enterprise:

Minority Business Enterprise:

Woman Owned Enterprise:

Small Business Enterprise:

Other ( ):

9. BONDING INFORMATION

Bonding Company:

Bonding Agent:

Contact Name:

Phone:

Aggregate Bonding Capacity:

Available Bonding Capacity as of date of this submittal:

10. FINANCIAL INFORMATION NOT USED INTENTIONALLY

Financial Institution:

Account Manager:

Phone:

INCLUDE AS AN ATTACHMENT AN AUDITED BALANCE SHEET FOR EACH

OF THE LAST 3 YEARS

11. CONSTRUCTION EXPERIENCE:

Qualifications Statement 004513 - 5

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, Current Experience:

List on Schedule A all uncompleted projects currently under contract (If Joint Venture list each participant's projects separately).

Previous Experience:

List on Schedule B all projects completed within the last 5 Years (If Joint Venture list each participant's projects separately).

Has firm listed in Section 1 ever failed to complete a construction contract awarded to it?

YES NO

If YES, attach as an Attachment details including Project Owner's contact information.

Has any Corporate Officer, Partner, Joint Venture participant or Proprietor ever failed to complete a construction contract awarded to them in their name or when acting as a principal of another entity?

YES NO

If YES, attach as an Attachment details including Project Owner's contact information.

Are there any judgments, claims, disputes or litigation pending or outstanding involving the firm listed in

Section 1 or any of its officers (or any of its partners if a partnership or any of the individual entities if a joint venture)?

YES NO

If YES, attach as an Attachment details including Project Owner's contact information.

12. SAFETY PROGRAM:

Name of Contractor's Safety Officer:

Include the following as attachments:

Provide as an Attachment Contractor's (and Contractor's proposed Subcontractors and Suppliers furnishing or performing Work having a value in excess of 10 percent of the total amount of the Bid)

OSHA No. 300 - Log & Summary of Occupational Injuries & Illnesses for the past 5 years.

Provide as an Attachment Contractor's (and Contractor's proposed Subcontractors and Suppliers furnishing or performing Work having a value in excess of 10 percent of the total amount of the Bid) list of all OSHA Citations & Notifications of Penalty (monetary or other) received within the last 5 years (indicate disposition as applicable) - IF NONE SO STATE.

Provide as an Attachment Contractor's (and Contractor's proposed Subcontractors and Suppliers furnishing or performing Work having a value in excess of 10 percent of the total amount of the Bid) list of all safety citations or violations under any state all received within the last 5 years (indicate disposition as applicable) - IF NONE SO STATE.

Qualifications Statement 004513 - 6

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, Provide the following for the firm listed in Section V (and for each proposed Subcontractor furnishing or performing Work having a value in excess of 10 percent of the total amount of the Bid) the following (attach additional sheets as necessary):

Workers' compensation Experience Modification Rate (EMR) for the last 5 years:

YEAR EMR

YEAR EMR

YEAR EMR

YEAR EMR

YEAR EMR

Total Recordable Frequency Rate (TRFR) for the last 5 years:

YEAR TRFR

YEAR TRFR

YEAR TRFR

YEAR TRFR

YEAR TRFR

Total number of man-hours worked for the last 5 Years:

YEAR TOTAL NUMBER OF MAN-HOURS

YEAR TOTAL NUMBER OF MAN-HOURS

YEAR TOTAL NUMBER OF MAN-HOURS

YEAR TOTAL NUMBER OF MAN-HOURS

YEAR TOTAL NUMBER OF MAN-HOURS

Provide Contractor's (and Contractor's proposed Subcontractors and Suppliers furnishing or performing Work having a value in excess of 10 percent of the total amount of the Bid) Days Away

From Work, Days of Restricted Work Activity or Job Transfer (DART) incidence rate for the particular industry or type of Work to be performed by Contractor and each of Contractor's proposed

Subcontractors and Suppliers) for the last 5 years:

YEAR DART

YEAR DART

YEAR DART

YEAR DART

YEAR DART

13. EQUIPMENT:

MAJOR EQUIPMENT:

List on Schedule C all pieces of major equipment available for use on Owner's Project.

Qualifications Statement 004513 - 7

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, I HEREBY CERTIFY THAT THE INFORMATION SUBMITTED HEREWITH, INCLUDING ANY

ATTACHMENTS, IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF.

NAME OF ORGANIZATION:

BY:

TITLE:

DATED:

NOTARY ATTEST:

SUBSCRIBED AND SWORN TO BEFORE ME

THIS DAY OF , 20___

NOTARY PUBLIC - STATE OF

MY COMMISSION EXPIRES:

REQUIRED ATTACHMENTS

1. Schedule A (Current Experience).

2. Schedule B (Previous Experience).

3. Schedule C (Major Equipment).

4. Audited balance sheet for each of the last 3 years for firm named in Section 1. NOT USED

INTENTIONALLY

5. Evidence of authority for individuals listed in Section 6 to bind organization to an agreement.

6. Resumes of officers and key individuals (including Safety Officer) of firm named in Section 1.

7. Required safety program submittals listed in Section 12.

8. Additional items as pertinent.

Qualifications Statement 004513 - 8

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, SCHEDULE A

CURRENT EXPERIENCE

Project Name Owner's Contact Person Design Engineer Contract Date Type of Work Status Cost of Work

Telephone:

Name:

Company:

Telephone:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Qualifications Statement 004513 - 9

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, SCHEDULE B

PREVIOUS EXPERIENCE (Include ALL Projects Completed within last 5 years)

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

SCHEDULE B

Qualifications Statement 004513 - 10

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, PREVIOUS EXPERIENCE (Include ALL Projects Completed within last 5 years)

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Telephone:

Name:

Qualifications Statement 004513 - 11

Copyright © 2013 National Society of Professional Engineers, American Council of Engineering Companies, SCHEDULE C - LIST OF MAJOR EQUIPMENT AVAILABLE

ITEM PURCHASE DATE CONDITION ACQUIRED VALUE

NON-COLLUSION AFFIDAVIT

OF PRIME BIDDER

004519-1

State of

County of

, being first duly sworn, disposes and says that:

(1) Is (Owner, partner, officer, representative, or agent) of , the Bidder that has submitted the attached Bid:

(2) Is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid;

(3) Such Bid is genuine and is not a collusive or sham Bid;

(4) Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affidavit, has in any way colluded, conspired, connived, or agreed, directly or indirectly with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix any overhead, profit or cost element for the Bid prices or the Bid price of any Bidder, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the or any person interest in the proposed Contract; and

(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties in interest, including this affidavit.

(Signed)

(Title)

Subscribed and sworn to before me this day of , 20 .

Notary Public Signature My commission expires .

004533-1

CERTIFICATION OF NON-SEGREGATED FACILITIES

& NON-EMPLOYMENT OF ILLEGAL ALIEN LABOR

The Bidder certifies that he/she does not maintain or provide for his/her employees any segregated facilities at any of his/her establishments, and that he/she does not permit his/her employees to perform their services at any location, under his/her control, where segregated facilities are maintained. The Bidder certifies further that he/she will not maintain or provide for his/her employees any segregated facilities at any of his/her establishments, and that he/she will not permit his/her employees to perform their services at any location under his/her control where segregated facilities are maintained. The Bidder agrees that a breach of this certification will be a violation of the Equal Opportunity Clause in any contract resulting from acceptance of this Bid. 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 explicitly directive or in fact segregated on the basis of race, color, religion, or national origin, because of habit, local custom, or otherwise. The Bidder agrees that (except where he/she has obtained identical certifications from proposed subcontractors) prior to award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause, that he/she will retain such certifications in his/her files.

The Bidder further certified in accordance with Act 43 (PL May 11, 2006) that he/she shall not knowingly employ, or knowingly permit any of its subcontractors to knowingly employ, the labor services of an illegal alien.

In the event that the Bidder

a) Knowingly employs or knowingly permits any of its subcontractors to knowingly employ, the labor services of an illegal alien; and

b) The Bidder or any of its subcontractors are sentenced under Federal Law for an offense involving knowing use of labor by an illegal alien, the Bidder shall be subject to penalty as prescribed in Pennsylvania Act 43 (PL May 11, 2006).

Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. § 1001.

Date___________________, 20____ __________________________________

(Name of Bidder)

Official Address By_________________________________

(Including ZIP CODE): (Signature)

(Title)

Employer Identification Number

Street Address 2

City State Zip Code

Doing Business As:

(if different from Legal Name)

Commonwealth of Pennsylvania Public Works Employment Verification Form

Complete and return the form to the contracting Public Body prior to the award of the contract.

Company Legal Name: ___________________________________________________________

Mailing Address: ______________________________________________________

Check one: Contractor Subcontractor

Contracting Public Body: _________________________________________________________

Contract/Project Number: ________________________________________________________

Project Description: _____________________________________________________________

Project Location: _______________________________________________________________

Date Enrolled in E-Verify (MM/DD/YYYY): ___________________________________________ As a contractor/subcontractor for the above referenced public works contract, I hereby affirm that as of today’s date, __________________________, our company is in compliance with the Public Works Employment Verification Act (‘the Act’) through utilization of the federal E-Verify Program (EVP) operated by the United States Department of Homeland Security. To the best of my/our knowledge, all employees hired are authorized to work in the United States.

It is also agreed to that all public works contractors/subcontractors will utilize the federal EVP to verify the employment eligibility of each new hire within five (5) business days of the employee start date throughout the duration of the public works contract. Documentation confirming the use of the federal EVP upon each new hire shall be maintained in the event of an investigation or audit.

I,____________________________________________, authorized representative of the company above, attest that the information contained in this verification form is true and correct and understand that the submission of false or misleading information in connection with the above verification shall be subject to sanctions provided by law.

Authorized Representative Signature Date of Signature

Printed Name: _________________________________________________________________

Phone Number: ______________________ Email: ____________________________________

Street Address 1

Small/Minority Businesses, Women’s Business Enterprises, and Labor Surplus Area Firms

BIDDER CERTIFICATION of AFFIRMATIVE STEPS

Bidders and the awarded Prime Contractors for this project must comply with the six affirmative steps to promote participation by small/minority businesses, women’s business enterprises, and labor surplus area firms. These requirements are mandated by 2 C.F.R. § 200.321 and are part of the revised FEMA procurement standards.

A. Will your firm need to purchase supplies, rent equipment, or hire any subcontractors for this project?_____________ Yes or No

If your answer is YES, proceed to paragraph B. below, if your answer is NO, proceed to paragraph C. below:

B. YES – Perform the Six Affirmative Steps (2 C.F.R. § 200.321)

Bidders and Prime Contractors must take all necessary affirmative steps to ensure Disadvantaged Business

Enterprises (DBEs), small businesses, and minority- and women-owned business enterprises (MBE/WBE) are utilized when possible. Required Actions:

1. Maintain Solicitation Lists: Include qualified small, minority, and women-owned businesses on procurement source lists.

2. Actively Solicit: Ensure these firms are formally solicited whenever they are potential sources.

3. Divide Requirements: When economically feasible, divide total project requirements into smaller tasks or quantities to maximize participation opportunities.

4. Optimize Schedules: Establish delivery and construction schedules that encourage participation, where project requirements permit.

5. Utilize Federal Agencies: Use the services and assistance resources of the Small Business

Administration (SBA) and the Minority Business Development Agency (MBDA) of the

Department of Commerce.

6. Enforce Downstream Compliance: Require all subcontractors and lower-tier prime contractors to take these same five affirmative steps.

Documentation & Certification Requirement

Bidders and the awarded Prime Contractor must document these efforts and maintain all supporting evidence within their procurement files. A copy of the Bidder’s supporting documentation must be attached to this form.

By signing below, I certify that the affirmative steps detailed above have been completed to the best of our ability, and the required supporting documentation is attached.

Company Name

Signature Date

C. NO - Self-Performance & In-Stock Supply Certification

If the bidder intends to self-perform all project work using existing inventory without any new procurement, the following certification must be signed:

By signing below, I certify that our firm will self-perform all work for this project. Furthermore, I certify that all required equipment and supplies are currently in stock, and no items, services, or subcontracts will be procured for this project.

Company Name

Signature Date

004546.14-1

004546.21-1

CERTIFICATION FOR CONTRACTS, GRANTS, & LOANS & COOPERATIVE AGREEMENTS

The undersigned certifies, to the best of his or her knowledge and belief, that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

The Contractor, , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. Chap.

38, Administrative Remedies for False Claims and Statements, apply to this certification and disclosure, if any.

Name of Contractor’s Organization or Firm

Signature of Contractor’s Authorized Official

Name and Title of Contractor’s Authorized Official

Date

004546.22-1

Instructions for Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion –Lower Tier Covered Transactions

1. By signing and submitting this form, the prospective lower tier participant is providing the certification set out on the reverse side in accordance with these instructions.

2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

4. The terms “covered transaction,” “debarred,” “suspended,” “ineligible”, “lower tier covered transaction,” “participant,” “person,” “primary covered transaction,” “principal,” “proposal,” and “voluntarily excluded,” as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations.

5. The prospective lower tier participant agrees by submitting this form that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated.

6. The prospective lower tier participant further agrees by submitting this form that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion – Lower Tier Covered Transaction,” without modification, in all lower tier covered transaction and in all solicitations for lower tier covered transactions.

7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntary excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Non-procurement List.

8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in

004546.22-2 addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY

EXCLUSION – LOWER TIER COVERED TRANSACTIONS

This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR part 3017, Section 3017.510, Participants’ responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733). Copies of the regulations may be obtained by contacting the Department of Agriculture agency with which this transaction originated.

(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS)

1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.

2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

Organization Name PR/Award Number or Project Name

Name(s) and Title(s) of Authorized Representative(s)

Signature(s) Date

05/14/2026

004546.24-1

BUILD AMERICA, BUY AMERICA

Self-Certification for FEMA Funded Contracts

The undersigned certifies, to the best of their knowledge and belief, that:

The Build America, Buy America Act (BABAA) requires that no federal financial assistance for “infrastructure” projects is provided “unless all of the iron, steel, manufactured products, and construction materials used in the project are produced in the United States.” Section 70914 of Public Law No. 117-58, §§ 70901-52.

The undersigned certifies that for the (Project Name) located at (Location) that the iron, steel, manufactured products, and construction materials used in this contract are in full compliance with the BABAA requirements including:

1. All iron and steel used in the project are produced in the United States. This means all manufacturing processes, from the initial melting stage through the application of coatings, occurred in the United States.

2. All manufactured products purchased with FEMA financial assistance must be produced in the United

States. For a manufactured product to be considered produced in the United States, the cost of the components of the manufactured product that are mined, produced, or manufactured in the United States is greater than 55% of the total cost of all components of the manufactured product, unless another standard for determining the minimum amount of domestic content of the manufactured product has been established under applicable law or regulation.

3. All construction materials are manufactured in the United States. This means that all manufacturing processes for the construction material occurred in the United States.

“The Contractor, , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the understands and agrees that the provisions of 31 U.S.C. Chap. 38, Administrative Remedies for False Claims and Statements, apply to this certification and disclosure, if any.”

The Contractor hereby further represents that they are aware that this requirement applies to all portions of the project, including subcontracts.

Name of Contractor

Signature of Authorized Official Corporate Seal

(where appropriate)

Name and Title of Authorized Official

Date