1-Documents to be submitted with bid.pdf

Schuylkill County - Reilly Township CDBG Waterline Project – Project No. 0325-609043.20 BID FORM Section 004100

BID FORM Section 004100 – Page 1

SECTION 004100 - BID FORM

ARTICLE 1 – BID RECIPIENT

1.01 This Bid is submitted to:

Owner: Schuylkill County

Project No.: 0325-609043.20

1.01 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.

ARTICLE 2 – BIDDER’S ACKNOWLEDGEMENTS

2.01 Bidder accepts all of the terms and conditions set forth in the Instructions to Bidders, which are incorporated herein by reference, including without limitation those terms and conditions regarding the disposition of Bid security. After the commencement of opening of Bids, no Bid may be withdrawn during the period specified for the holding of Bids as hereinafter set forth, except as provided in Pennsylvania Act 4 of 1974, P.L. 9, relating to withdrawal of a Bid in the event of a mistake. The Owner shall award the Contract to the lowest responsive and responsible Bidder, or shall reject all Bids within sixty (60) days of the date of Bid opening, and no Bidder may withdraw his Bid before the expiration of such sixty (60) day period; provided however, if the award of the Contract is delayed by required approval of another government agency, the sale of bonds, closing on project loans or the award of a grant or grants, the Owner shall reject all Bids or award the Contract to the lowest responsible Bidder within one hundred twenty (120) days of the date of Bid opening, and in such event no Bidder may withdraw his Bid before the expiration of such one hundred twenty

(120) day period. Extensions of the date for the award of the Contract may be made by the mutual written consent of the Owner and lowest responsible Bidder.

ARTICLE 3 – BIDDER’S REPRESENTATIONS

3.01 In submitting this Bid, Bidder represents that:

A. Bidder has examined and carefully studied the Bidding Documents, other related data identified in the Bidding Documents, and the following Addenda, receipt of which is hereby acknowledged:

Addendum No. Addendum Date

B. Bidder has visited the Site and become familiar with and is satisfied as to the general, local, and

Site conditions that may affect cost, progress, and performance of the Work.

C. Bidder is familiar with and is satisfied 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 contiguous to the Site and all drawings of physical conditions relating to existing surface or

BID FORM Section 004100 – Page 2 subsurface structures at the Site (except Underground Facilities) that have been identified in SC-

4.02 as containing reliable "technical data," and (2) reports and drawings of Hazardous Environmental Conditions, if any, at the Site that have been identified in SC-4.06 as containing reliable "technical data."

E. Bidder has considered the information known to Bidder; 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 the 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, including applying the specific means, methods, techniques, sequences, and procedures of construction expressly required by the Bidding Documents; and (3) Bidder’s safety precautions and programs.

F. Based on the information and observations referred to in Paragraph 3.01.E above, Bidder does not consider that further examinations, investigations, explorations, tests, studies, or data are necessary for the determination of this Bid for performance of the Work at the price(s) 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 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 of the Work for which this Bid is submitted.

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

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;

BID FORM Section 004100 – Page 3

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.

ARTICLE 5 – BASIS OF BID

5.01 Bidder will complete the Work in accordance with the Contract Documents for the following price(s) as included in Exhibit A.

5.02 Unit Prices have been computed in accordance with Paragraph 11.03.B of the General Conditions.

5.03 Bidder acknowledges that estimated quantities are not guaranteed, and are solely for the purpose of comparison of Bids, and final payment for all unit price Bid items will be based on actual quantities, determined as provided in the Contract Documents

5.04 All specifications sections are considered incidental to ALL the unit price items unless otherwise noted.

ARTICLE 6 – TIME OF COMPLETION

6.01 Bidder agrees that the Work will be substantially complete and will be completed and ready for final payment on or before the dates or within the number of calendar days indicated in the Agreement.

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

6.03 The terms used in this Bid which are defined in the General Conditions of the construction contract included as part of the Contract Documents have the meaning assigned to them in the General Conditions

6.04 Bidder understands that the OWNER reserves the right to reject any or all bids, reject any or all items, and further reserves the right to delete any item or parts of items

6.05 Bidder understands that the OWNER shall award the contract on the basis of the lowest total sum bid submitted, which total sum bid shall include the total of the base bid plus any alternates selected by the OWNER.

BID FORM Section 004100 – Page 4

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. Bid Form (Section 004100);

C. Electronic PennBid Bid Table Form;

D. Agreement of Surety Form;

E. PSATS CDL Program Contractor’s Statement of Compliance Form;

F. Non-Collusion Affidavit Form;

G. Nondiscrimination/Sexual Harassment Clause;

H. Certification of Bidder Regarding Equal Employment Opportunity;

I. Federal Contract Provisions Certification Form;

J. Buy American Certification;

K. Bidder Certification of Prequalification Classification and Work Capacity Form

L. Certification of Non-Segregated Facilities

M. Compliance Illegal Alien Labor Act;

N. Compliance with The State Contractor Responsibility Program;

O. Contract Provision Right to Know Law;

P. Contractor Integrity Provision;

Q. Provisions Concerning the Americans With Disabilities Act;

R. Public Works Employment Verification Form;

S. Stop-Call Before You Dig;

T. 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;

U. Required Bidder Qualification Statement with Supporting Data; and

V. The bidders must submit documentary evidence of Minority and Women Business Enterprises that have been contacted and to whom commitments have been made. Documentation of such solicitations and commitments shall be submitted concurrently with the bid (Form DCED-CCD-

286) MBE/WBE Section 3 Contract/Solicitation and Commitment Statement, Table and Plan are required to be submitted for all bids greater than $200,000. Failure to submit this form will render

BID FORM Section 004100 – Page 5 the bid non-responsive and therefore result in rejection of the bid. Section 3 documents shall be requested from engineer for proposed bids over $200,000.

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 SUBMITTAL

9.01 This Bid is submitted by:

If Bidder is:

An Individual

Name (typed or printed):

By:

(Individual’s signature)

Doing business as:

A Partnership

Partnership Name:

By:

(Signature of general partner -- attach evidence of authority to sign)

Name (typed or printed):

A Corporation

Corporation Name:

(SEAL)

State of Incorporation:

Type (General Business, Professional, Service, Limited Liability):_______

By:

(Signature -- attach evidence of authority to sign)

Name (typed or printed):

Title:

(CORPORATE SEAL)

Attest

Date of Qualification to do business in PA is ____/____/____.

BID FORM Section 004100 – Page 6

A Joint Venture

Name of Joint Venture:

First Joint Venturer Name:

(SEAL)

By:

(Signature of first joint venture partner -- attach evidence of authority to sign)

Name (typed or printed):

Title:

Second Joint Venturer Name: (SEAL)

By:

(Signature of second joint venture partner -- attach evidence of authority to sign)

Name (typed or printed):

(Each joint venturer must sign. The manner of signing for each individual, partnership, and corporation that is a party to the joint venture should be in the manner indicated above.)

Bidder's Business Address

Phone No. _____________________________________ Fax No.

E-mail ______________________________ _______

SUBMITTED on , 20____.

State Contractor License No. . [If applicable]

Contractor Federal ID No.

Contractor UEI No.

EJCDC C-435 Bid Bond (Damages Form)

Prepared by the Engineers Joint Contract Documents Committee.

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 and Include Location):

BOND

Bond Number:

Date (Not earlier than Bid due 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: Above addresses are to be used for giving any required notice. Provide execution by any additional parties, such as joint venturers, if necessary.

EJCDC C-435 Bid Bond (Damages Form)

Prepared by the Engineers Joint Contract Documents Committee.

1. Bidder and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assigns to pay to Owner upon default of Bidder any difference between the total amount of Bidder’s Bid and the total amount of the Bid of the next lowest, responsible Bidder who submitted a responsive Bid as determined by Owner for the work required by the Contract Documents, provided that:

1.1 If there is no such next Bidder, and Owner does not abandon the Project, then Bidder and Surety shall pay to Owner the penal sum set forth on the face of this Bond, and

1.2 In no event shall Bidder’s and Surety’s obligation hereunder exceed the penal sum set forth on the face of this Bond.

1.3 Recovery 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 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 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.

FEDERAL CONTRACT PROVISIONS CERTIFICATION FORM

OWNER NON-FEDERAL ENTITY FEDERAL CONTRACT PROVISIONS CERTIFICATION FORM 1

FEDERAL CONTRACT PROVISIONS CERTIFICATION FORM

REQUIRED CONTRACT PROVISIONS FOR NON-FEDERAL ENTITY CONTRACTS UNDER FEDERAL AWARDS-

APPENDIX II TO 2 CFR PART 200

To procure goods and services using funds under a federal grant or contract, specific federal laws, regulations, and requirements may apply in addition to those under state law. This includes, but is not limited to, the procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards, 2 CFR 200 (sometimes referred to as the “Uniform Guidance”), and the State of

Pennsylvania. All Vendors submitting proposals must complete this Certification Form regarding Vendor’s willingness and ability to comply with certain requirements which may be applicable to specific purchases using federal grant funds.

For each of the items below, Vendor should certify Vendor’s agreement and ability to comply, where applicable, by having Vendor’s authorized representative complete and initial the applicable boxes and sign the acknowledgment at the end of this form. If you fail to complete any item in this form, the Owner will consider and may list the Vendor’s response as “NO,” the Vendor is unable or unwilling to comply. A “NO” response to any of the items may, if applicable, impact the ability of Owner to purchase from the Vendor using federal funds.

The following provisions are required and apply when federal funds are expanded by the Owner for any contract resulting from this procurement process.

(A) Contracts for more than the simplified acquisition threshold currently set at $150,000, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition

Regulations Council (Councils) as authorized by 41 U.S.C. 1908, must address administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate.

Pursuant to Federal Rule (A) above, when federal funds are expended by the Owner, Owner reserves all rights and privileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract by either party.

Does vendor agree? YES ______ Initials of Authorized Representative of vendor

(B) Termination for cause and convenience by the grantee or subgrantee including the manner by which it will be effected and the basis for settlement. (All contracts in excess of $10,000)

Pursuant to Federal Rule (B) above, when federal funds are expended by the Owner, Owner reserves the right to immediately terminate any agreement in excess of $10,000 resulting from this procurement process in the event of a breach or default of the agreement by Vendor, in the event vendor fails to: (1) meet schedules, deadlines, and/or delivery dates within the time specified in the procurement solicitation, contract, and/or purchase order; (2) make any payments owed; or (3) otherwise perform in accordance with the contract and/or the procurement solicitation.

OWNER NON-FEDERAL ENTITY FEDERAL CONTRACT PROVISIONS CERTIFICATION FORM 2

The Owner also reserves the right to terminate the contract immediately, with written notice to vendor, for convenience, if Owner believes, in its sole discretion that it is in the best interest of the Owner to do so. The vendor will be compensated for work performed and accepted and goods accepted by the Owner as of the termination date if the contract is terminated for convenience of the Owner. Any award under this procurement process is not exclusive and the Owner reserves the right to purchase goods and services from other vendors when it is in the best interest of the Owner.

(C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, “Equal

Employment Opportunity” (30 FR 12319,12935,3 CFR Part, 1964-1965 Comp., p.339), as amended by Executive

Order 11375, ”Amending Executive Order 11246 Relating to Equal Employment Opportunity,” and implementing regulations at 41 CFR Part 60, “Office of Federal Contract Compliance Programs, Equal

Employment Opportunity, Department of Labor.”

Pursuant to Federal funds are expended by the Owner on any federally assisted construction contract, the equal opportunity clause is incorporated by reference herein.

Does vendor agree to abide by the above? YES ______ Initials of Authorized Representative of vendor

(D) Davis-Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime construction contracts in excess of $2,000 awarded by non-Federal entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, “Labor Standards Provisions Applicable to Contracts Covering Federally

Financed and Assisted Construction”). In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be required to pay wages not less than once a week. The non-Federal entity must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non-Federal entity must report all suspected or reported violations to the Federal awarding agency. The contracts must also include a provision for compliance with the Copeland “Anti-Kickback” Act (40 U.S.C. 3145, as supplemented by Department of

Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States”). The Act provides that each contractor or subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non- Federal entity must report all suspected or reported violations to the Federal awarding agency.

Pursuant to Federal Rule(D) above, when federal funds are expanded by the Owner, during the term of an award for all contracts and subgrants for construction or repair, the vendor will be in compliance with all applicable

Davis-Bacon Act provisions.

Does vendor agree? YES ______ Initial of Authorized Representative of vendor

OWNER NON-FEDERAL ENTITY FEDERAL CONTRACT PROVISIONS CERTIFICATION FORM 3

(E) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all contracts awarded by the non-Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by

Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence.

Pursuant to Federal Rule (E) above, when federal funds are expanded by the Owner, the vendor certifies that during the term of an award for all contracts by the Owner resulting from this procurement process, the vendor will be in compliance with all applicable provisions of the Contract Work Hours and Safety Standards Act.

(F) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of

“funding agreement” under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that “funding agreement.” The recipient or subrecipient must comply with the requirements of 37 CFR Part 401, “Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative

Agreements,” and any implementing regulations issued by the awarding agency.

Pursuant to Federal Rule (F) above, when federal funds are expended by the Owner, the vendor certifies that during the term of an award for all contracts by Owner resulting from this procurement process, the vendor agrees to comply with all applicable requirements as referenced in Federal Rule (F) above.

(G) Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended-Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non- Federal award to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal water Pollution Control Act as amended

(33 U.S.C. 1251-1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA).

Pursuant to Federal Rule (G) above, when federal funds are expended by the Owner the vendor certifies that during the term of an award for all contracts by the Owner resulting from this procurement process, the vendor agrees to comply with all applicable requirements as referenced in Federal Rule (G) above.

OWNER NON-FEDERAL ENTITY FEDERAL CONTRACT PROVISIONS CERTIFICATION FORM 4

(H) Debarment and Suspension (Executive Orders 12549 and 12689) – A contract award (see 2 CFR 180.220) must not be made to parties listed on the government wide exclusions in the System for Award Management

(SAM), in accordance with the OMB guidelines at 2 CFR 180 that Implement Executive Orders 12549 (3 CFR

Part 1986 Comp., p.189) and 12689 (3 CFR Part 1989 Comp., p. 235), “Debarment and Suspension.” SAM

Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549.

Pursuant to Federal Rule (H) above, when federal funds are expended by the Owner, the vendor certifies that during the term of an award for all contracts by the Owner resulting from this procurement process, the vendor certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any federal department or agency.

(I) Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)-Contractors that apply or bid for an award exceeding

$100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the non-

Federal award.

Pursuant to Federal Rule (I) above, when federal funds are expended by the Owner, the vendor certifies that during the term and after the awarded term of an award for all contracts by the Owner resulting from this procurement process, the vendor certifies that it is in compliance with all applicable provisions of the Byrd Anti-

Lobbying Amendment

(31 U.S.C. 1352). The undersigned further certifies that:

1. No Federal appropriated funds have been paid or will be paid for on behalf of the undersigned, 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 the awarding of a Federal contract, the making of a Federal grant, the making of a Federal loan, the entering into a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a 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 grant 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 covered sub-awards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose accordingly.

OWNER NON-FEDERAL ENTITY FEDERAL CONTRACT PROVISIONS CERTIFICATION FORM 5

(J) A Non-Federal entity that is a state agency or agency of a political subdivision of a state and its contractors must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines.

Pursuant to Federal Rule (J) above, when federal funds are expended by the Owner the certifies that during the term of an award for all contracts by the Owner resulting from this procurement process, the vendor agrees to comply with all applicable requirements as referenced in Federal Rule (J) above.

RECORD RETENTION REQUIREMENTS FOR CONTRACTS PAID FOR WITH FEDERAL FUNDS 2 CFR §200.333

When federal funds are expended by the Owner for any contract resulting from this procurement process, the vendor certifies that it will comply with the record retention requirements detailed in 2 CFR §200.333. The vendor further certifies that vendor will retain all records as required by 2 CFR §200.333 for a period of three years after grantees or subgrantees submit final expenditure reports or quarterly or annual financial reports, as applicable, and all other pending matters are closed.

CERTIFICATION OF COMPLIANCE WITH EPA

REGULATIONS APPLICABLE TO GRANTS, SUBGRANTS, COOPERATIVE AGREEMENTS, AND CONTRACTS IN

EXCESS OF $100,000 OF FEDERAL FUNDS

When federal funds are expended by the Owner for any contract resulting from this procurement process in excess of $100,000, the vendor certifies that the vendor is in compliance with all applicable standards, orders, regulations, and/or requirements issued pursuant to the Clean Air Act of 1970, as amended (42 U.S.C. 1857(h)), Section 508 of the Clean Water Act, as amended (33 U.S.C. 1368), Executive Order 117389 and Environmental

Protection Agency Regulation, 40 CFR Part 15.

CERTIFICATION OF COMPLIANCE WITH THE ENERGY POLICY AND CONSERVATION ACT

When federal funds are expended by the Owner for any contract resulting from this procurement process, the vendor certifies that the vendor will be in compliance with mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94 163, 89 Stat. 871).

OWNER NON-FEDERAL ENTITY FEDERAL CONTRACT PROVISIONS CERTIFICATION FORM 6

CIVIL RIGHTS / DISCRIMINATION:

When federal funds are expended by the Owner for any contract resulting from this procurement process, the vendor certifies that the vendor will comply with the provisions of Title VI of the Civil Rights Act of 1964. No person shall, on the grounds of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.

SMALL AND MINORITY FIRMS, WOMEN’S BUSINESS ENTERPRISE, AND LABOR SURPLUS AREA FIRMS

Necessary affirmative steps to procure from minority firms, women’s business enterprises, and labor surplus area firms whenever possible.

Vendor agrees to comply with all federal, state and local laws, rules, regulations and ordinances, as applicable. It is further acknowledged that the vendor certifies compliance with all provisions, laws, acts, regulations, etc. as specifically noted above.

Vendor’s Name/Company Name: __________________________________________________________

Address, City, State and Zip Code: __________________________________________________________

Phone Number: _____________________________Fax Number: ________________________________

Printed Name and Title of Authorized Representative: _________________________________________

Email Address: _________________________________________________________________________

Signature of Authorized Representative: ____________________________________________________

Date: _________________________________________________________________________________

American Recovery and Reinvestment Act of 2009 – Buy American Certification

Please check one of the following and sign where indicated.

All of the iron, steel, and manufactured goods used in the project are produced in the United States.

An appropriate waiver has been approved by the U.S. Environmental Protection Agency. (Attach a list of the items covered by the approved waiver.)

A waiver is being requested from the Buy American provision due to the following exception:

Applying the Buy American Requirement would be inconsistent with the public interest;

Iron, steel, or relevant manufactured goods are not produced in the United States in sufficient and reasonably available quantities and of a satisfactory quality; or

Inclusion of iron, steel, or manufactured goods produced in the United States will increase the cost of the overall project by more than 25 percent.

Documentation of at least one of the cases above must be provided. List below the materials that cannot comply with the Buy American provisions of the American Recovery and Reinvestment Act of 2009.

Additional sheets (attach if necessary)

Name of Contracting Firm

Signature Date

Name and Title of Signer (Please type)

This certification must be signed and the waiver approved prior to materials purchase.

Updated May 5, 2020

BIDDER CERTIFICATION OF PREQUALIFICATION CLASSIFICATION AND

WORK CAPACITY FORM

In accordance with the requirements of PennDOT Publication 408 – Specifications, Section 102

- Bidding Requirements and Conditions, the bidder hereby certifies that they meet the following to qualify their proposal as an acceptable bid:

1. The Contractor has the necessary eligible prequalification rating, as required by Sections

102.01 and 102.06(c), Publication 408. A prequalification rating is considered eligible when the bidder’s assigned current maximum capacity exceeds the sum of both (a) the total of all uncompleted work the Contractor has under contract at the time of bid submission and (b) the total bid price of this proposal (less any credit for sublettings as allowed by Section 457.15 of the Regulations on Prequalification of Prospective Bidders).

2. The classified types of work, on which the Contractor is eligible to bid, constitutes over 50 percent of the total bid price (the cost of specialty items may be deducted from the total bid price before computing the amount of work required to be performed by the

Contractor) as indicated in Section 108.01, Publication 408.

3. To the best of their knowledge, each proposed subcontractor is prequalified in conformance with said Regulations, mentioned above, for the contract items designated, and each has adequate eligible prequalification (defined above) to cover amount of subcontract.

The making of a false certification of any of the above bidding requirements shall constitute cause for rejection of the bidder’s proposal and shall subject the bidder to making of payment to the

Owner of an amount of five (5%) percentum of the total amount of the bid as liquated damages, or disqualification of the bidder from bidding on future work for a period of ninety (90) calendar days, or both, as deemed appropriate.

Should the bidder fail to make said payment within thirty (30) calendar days of notification the bidder shall be disqualified for a period of one (1) year. An application for renewal of prequalification will not be considered by the Owner until the bidder makes payment.

Name:

Signed:

Date:

CERTIFICATION OF NON SEGREGATED FACILITIES

The Bidder 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. The Bidder 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 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 has obtained identical certification 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, and that he will retain such certifications in his files.

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):

(Title)

Compliance with the Prohibition of Illegal Alien Labor on Assisted Projects Act.

Compliance with the Prohibition of Illegal Alien Labor on Assisted Projects Act. Pursuant to the Act of May 11, 2006 (P.L. 173, No. 43), known as the Prohibition of Illegal Alien Labor on Assisted Projects Act, the Grantee shall not knowingly employ, or knowingly permit any of its subcontractors to knowingly employ, the labor services of an illegal alien on activities funded in whole or in part by a grant or loan issued by an executive agency of the Commonwealth of Pennsylvania.

Violation of the Prohibition of Illegal Alien Labor on Assisted Projects Act.

A. In the event that the Contractor

i. knowingly employs, or knowingly permits any of its subcontractors to knowingly employ, the labor services of an illegal alien on activities funded in whole or in part by grants or loans issued by an executive agency of the Commonwealth of Pennsylvania; and

ii. the Contractor or any of its subcontractors are sentenced under Federal law for an offense involving knowing use of labor by an illegal alien on activities funded in whole or in part by grants or loans issued by an executive agency of the Commonwealth of Pennsylvania, the Contractor shall repay to the Granter all grant funds received by the Grantee from the Grantor pursuant to this Grant. A check shall be written, payable to the Commonwealth of Pennsylvania, and forwarded to the Granter.

Name: _____________________________________

Title: ______________________________________

Signed: _____________________________________

Date: ________________________________________

Compliance with the State Contractor Responsibility Program

The Contractor and all subcontractors agree as follows:

For the purpose of these provisions, the term Contractor is defined as any person, including, but not limited to, a bidder, offeror, loan recipient, grantee, or subgrantee, who has furnished or seeks to furnish goods, supplies, services, or leased space, or who has performed or seeks to perform construction activity under contract, subcontract, grant, or subgrant with the Commonwealth, or with a person under contract, subcontract, grant, or subgrant with the Commonwealth or its state-affiliated entities, and state-related institutions. The term Contractor may include a permittee, licensee, or any agency, political subdivision, instrumentality, public authority, or other entity of the Commonwealth.

1. The Contractor must certify, in writing, for itself and all its subcontractors, that as of the date of its execution of any Commonwealth contract, that neither the Contractor, nor any subcontractors, nor any suppliers are under suspension or debarment by the Commonwealth or any governmental entity, instrumentality, or authority and, if the Contractor cannot so certify, then it agrees to submit, along with the bid/proposal, a written explanation of why such certification cannot be made.

2. The Contractor must also certify, in writing, that as of the date of its execution, of any Commonwealth contract it has no tax liabilities or other Commonwealth obligations.

3. The Contractor's obligations pursuant to these provisions are ongoing from and after the effective date of the Grant through the termination date thereof. Accordingly, the Contractor shall have an obligation to inform the Grantor if, at any time during the term of the Grant, it becomes delinquent in the payment of taxes, or other Commonwealth obligations, or if it or any of its subcontractors are suspended or debarred by the Commonwealth, the federal government, or any other state or governmental entity. Such notification shall be made within 15 days of the date of suspension· or debarment.

4. The failure of the Contractor to notify the Granter of its suspension or debarment by the Commonwealth, any other state, or the federal government shall constitute an event of default of the Grant with the

Commonwealth.

5. The Contractor agrees to reimburse the Commonwealth for the reasonable costs of investigation incurred by the Office of State Inspector General for investigations of the Contractor's compliance with the terms of this or any other agreement between the Contractor and the Commonwealth, which results in the suspension or debarment of the Contractor. Such costs shall include, but shall not be limited to, salaries of investigators, including overtime; travel and lodging expenses; and expert witness and documentary fees. The Contractor shall not be responsible for investigative costs for investigations that do not result in the Contractor's suspension or debarment.

6. The Contractor may obtain a current list of suspended and debarred Commonwealth contractors by either searching the internet at https://www.dgs.internet.state.pa.us/debarment_list/ or contacting the: Department of

General Services | Office of Chief Counsel | 603 North Office |Building |Harrisburg, PA 17125 | Telephone

No: (717) 783-64 72 | FAX No: (717) 787-9138

Name: _____________________________________

Title: ______________________________________

Signed: _____________________________________

Date: ________________________________________

CONTRACT PROVISIONS – RIGHT TO KNOW LAW 8-K-1532 EXHIBIT G - PAGE 1

REVISED FEBRUARY 1, 2010

Contract Provisions – Right to Know Law 8-K-1532

a. The Pennsylvania Right-to-Know Law. 65 P.S. §§ 67.101-3104, (“RTKL”) applies to this Contract. For the purpose of these provisions, the term “the Commonwealth” shall refer to the contracting

Commonwealth agency.

b. If the Commonwealth needs the Contractor’s assistance in any matter arising out of the RTKL related to this Contract, it shall notify the Contractor using the legal contact information provided in this Contract.

The Contractor, at any time, may designate a different contact for such purpose upon reasonable prior written notice to the Commonwealth.

c. Upon written notification from the Commonwealth that it requires the Contractor’s assistance in responding to a request under the RTKL for information related to this Contract that may be in the

Contractor’s possession, constituting, or alleged to constitute, a public record in accordance with the

RTKL (“Requested Information”), the Contractor shall:

1. Provide the Commonwealth, within ten (10) calendar days after receipt of written notification, access to, and copies of, any document or information in the Contractor’s possession arising out of this Contract that the Commonwealth reasonably believes is Requested Information and may be a public record under the RTKL; and

2. Provide such other assistance as the Commonwealth may reasonably request, in order to comply with the RTKL with respect to this Contract.

d. If the Contractor considers the Requested Information to include a request for a Trade Secret or

Confidential Proprietary Information, as those terms are defined by the RTKL, or other information that the Contractor considers exempt from production under the RTKL, the Contractor must notify the

Commonwealth and provide, within seven (7) calendar days of receiving the written notification, a written statement signed by a representative of the Contractor explaining why the requested material is exempt from public disclosure under the RTKL.

e. The Commonwealth will rely upon the written statement from the Contractor in denying a RTKL request for the Requested Information unless the Commonwealth determines that the Requested Information is clearly not protected from disclosure under the RTKL. Should the Commonwealth determine that the

Requested Information is clearly not exempt from disclosure, the Contractor shall provide the Requested

Information within five (5) business days of receipt of written notification of the Commonwealth’s determination.

f. If the Contractor fails to provide the Requested Information within the time period required by these provisions, the Contractor shall indemnify and hold the Commonwealth harmless for any damages, penalties, costs, detriment or harm that the Commonwealth may incur as a result of the Contractor’s failure, including any statutory damages assessed against the Commonwealth.

g. The Commonwealth will reimburse the Contractor for any costs associated with complying with these provisions only to the extent allowed under the fee schedule established by the Office of Open Records or as otherwise provided by the RTKL if the fee schedule is inapplicable.

h. The Contractor may file a legal challenge to any Commonwealth decision to release a record to the public with the Office of Open Records, or in the Pennsylvania Courts, however, the Contractor shall indemnify

CONTRACT PROVISIONS – RIGHT TO KNOW LAW 8-K-1532 EXHIBIT G - PAGE 2

REVISED FEBRUARY 1, 2010

the Commonwealth for any legal expenses incurred by the Commonwealth as a result of such a challenge and shall hold the Commonwealth harmless for any damages, penalties, costs, detriment or harm that the

Commonwealth may incur as a result of the Contractor’s failure, including any statutory damages assessed against the Commonwealth, regardless of the outcome of such legal challenge. As between the parties, the Contractor agrees to waive all rights or remedies that may be available to it as a result of the

Commonwealth’s disclosure of Requested Information pursuant to the RTKL.

i. The Contractor’s duties relating to the RTKL are continuing duties that survive the expiration of this

Contract and shall continue as long as the Contractor has Requested Information in its possession.

Enclosure 1 to Management Directive 215.8 Amended Page 1 of 3

CONTRACTOR INTEGRITY PROVISIONS

It is essential that those who seek to contract with the Commonwealth of Pennsylvania

(“Commonwealth”) observe high standards of honesty and integrity.