1-Hill Rd Bid Package.pdf

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Attached to
Earl Township Hill Road Storm Sewer Project
Solicitation number
Not on record
Issued by
Berks County, Pennsylvania

About this file

Summary of Earl Township Hill Road Storm Sewer Project Bid Package

This is a bid package and invitation to bidders issued by the Earl Township Board of Supervisors in Berks County, Pennsylvania, for the Hill Road Storm Sewer Project. The scope of work includes installation of 649 linear feet of 24-inch HDPE pipe, 26 linear feet of 15-inch HDPE pipe, 6 Type 1 M-Top inlet boxes, 2 endwalls, pavement restoration, swale grading, and related incidental work as detailed in the contract specifications. Bid proposals must be submitted through the PennBID online system no later than 11:00 AM on Thursday, July 16, 2026, with proposals to be opened and read aloud at 11:30 AM the same day. The Earl Township Board of Supervisors will award or reject the contract during their meeting on Monday, July 20, 2026, at 7:00 PM at the Earl Township Building, 19 Schoolhouse Road, Boyertown, PA 19512. All work must be completed by October 31, 2026. No pre-bid meeting or site visit is explicitly mandated, though bidders are expected to have examined the plans, specifications, and project site as part of their proposal preparation.

Bidders must submit a certified check or bid bond equal to 10 percent of their bid amount, along with a workman's compensation affidavit, proof of insurance, CDL compliance certificate, public works verification form, and anti-collusion affidavit. The successful bidder will be required to furnish a 100-percent performance bond and 100-percent payment bond within 20 days of contract award. Pennsylvania Prevailing Wage Rates apply to all work on the project. Liquidated damages are assessed at $500.00 per calendar day for work not completed by the deadline. No specific budget amount is disclosed in the invitation, and no set-asides for disadvantaged businesses are mentioned. The contract documents are available exclusively through the PennBID system, and all submissions must be made through that platform. Earl Township reserves the right to reject any or all bids and to waive defects, errors, or irregularities in bids received.

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INVITATION TO BIDDERS

Bid proposals will be received by the Earl Township Board of Supervisors until 11 AM, prevailing time, Thursday, July 16, 2026 via PennBID (www.pennbid.bonfirehub.com) only for the following scope of work:

Earl Township Hill Road Storm Sewer Project – Include installation of 649 LF of 24” HDPE, 26 LF of 15” HDPE, 6 Type 1 M-Top Inlet boxes, 2 endwalls, pavement restoration, swale grading and other incidental work as specified in the Bid Documents

Proposals will be opened via PennBID on Thursday, July 16, 2026, at 11:30 AM. The contract will be awarded or rejected during the Earl Township Board of Supervisors meeting held on Monday, July 20, 2026 at 7:00 p.m. at the Earl Township Building, 19 Schoolhouse Road, Boyertown, PA 19512.

Contract documents are available through the PennBID system and all required items shall be submitted through PennBID based upon contract documents.

All work must be completed by October 31, 2026. Liquidated damages apply at a rate of $500.00 per calendar day.

Pennsylvania Prevailing Wage Rates apply to this Contract.

A certified check or bank draft, payable to Earl Township or a satisfactory bid bond executed by the bidder and acceptable sureties in an amount equal to ten percent (10%) of the bid shall be submitted with the bid. In addition, the following documents must be included with the bid package: workman’s compensation affidavit, proof of insurance, CDL compliance certificate, public works verification form and anti-collusion affidavit.

A performance bond or certified check in the amount of 100% of the contract price as well as the payment bond and official insurance certificate shall be furnished by the successful bidder within 20 days after contract is awarded.

Earl Township reserves the right to reject any or all bids submitted or any part thereof or item therein that may not be in the public’s best interest. The Township also reserves the right to waive any defects, errors, omissions, irregularities or informalities in bids received.

Township of Earl Janice Haller Secretary-Treasurer http://www.pennbid.bonfirehub.com/

317MS-944 02-01 PROPOSAL & CONTRACT (THIS PROPOSAL INCLUDES

(WHEN EXECUTED) INSTRUCTIONS TO BIDDERS)

A. DEPOSIT OF PROPOSALS.

Bids shall be submitted via PennBID for EARL TOWNSHIP “Hill Road Storm Sewer Project” Municipality Name and Type for Letting of

July 16, 2026 JANICE HALLER Date Secretary

Sealed Proposals will be received on or before 11:00 A.M., on July 16, 2026 via PennBID 19 SCHOOLHOUSE RD Time Address

Bids will be opened and read at approximately BOYERTOWN, PA 19512 11:30 A.M. on the above Bid Date. Proposals must be submitted via PennBID.

1. The contractor proposes to furnish and deliver all materials (including Form TR-465. Daily Bituminous Mixture Certification) and to do and perform all work in the bid for the following project as more specifically set forth in the Bid Line Items (Attachment), in accordance with drawings and specifications and bid table on file on PennBID as well as the supplements and special requirements contained herein and/or attached hereto and current PennDOT specifications (Publication 408), bidders need to be prequalified by PennDOT (Sec. 102.01), except (a) Marshall testing of bituminous paving materials is not required (Sec. 401).

2. If designated as the successful bidder, the contractor may begin work on the date specified in the notice to proceed, or as otherwise provided in the special requirements, and will complete all work on or before October 31, 2026. If work is not completed per the above deadlines, liquidated damages will be assessed at the rate of $_500.00 per additional calendar day.

3. Accompanying this proposal is a certified check or bid Bond in the amount of 10% of the bid made payable to the municipality as a proposal guarantee which, it is understood, will be forfeited in case the contractor fails to comply with the requirement of the proposal.

B. PROPOSAL OF: _____________________________________________________________________________ Name of Contractor

Address

CONTRACTOR’S CERTIFICATION

It is hereby certified as follows:

1. The only person(s) interested in this proposal as principal(s) is (are): ________________________________

2. None of the above persons are employees of the municipality.

3. This proposal is made without collusion with any other person, firm, or corporation.

4. All plans and specifications referred to above and the site of the work have been examined by the contractor.

The contractor understands that the quantities indicated herein are approximate and are subject to change as may be required; and that all work is payable on the basis of the unit prices listed on the Schedule of Prices (Attachment 1).

- 1 -

5. The contractor will comply with all requirements of the laws and implementing regulations of the Commonwealth of Pennsylvania and the United States relating to human relations, equal opportunity and non-discrimination in employment, and will pay to workmen employed in the performance of the contract the wages to which they may be entitled.

6. The contractor will provide the municipality with a 100% performance bond, conditioned upon the faithful performance of the contractor in accordance with the plans, specifications and conditions thereof, and a 100% payment bond conditioned on the prompt payment of all material furnished and labor supplied or performed in the prosecution of the work, in accordance with the Public Work’s Contractors’ Bond Law of 1967; These items shall be submitted within 20 days of notice of award.

7. The contractor, with the bid submission, shall include a signed copy of the project specifications, an affidavit accepting the provisions of the Workmen’s Compensation Act of 1915, as amended, an insurance certificate, an anti-collusion affidavit, a public works employment verification form and CDL compliance certificate.

8. “The parties agree that the relationship between the Contractor and Earl Township is one of independent contractor and not the employer/employee and that the individual employees of the Contractor who will be performing the work pursuant to this contract are not employees of Earl Township. Contractor hereby certifies, represents and warrants to the Township that all persons performing any aspect of the work pursuant to this Contract who are required to have commercial driver’s license are subject to a program for drug and alcohol testing in accordance with the Omnibus Transportation Employee Testing Act of 1991 and the federal regulations adopted pursuant thereto.”

Contractor

WITNESSED OR ATTESTED BY:

BY:______________________________________

Title (Seal)

Title

SEAL

TO BE EXECUTED ONLY IN THE EVENT THE ABOVE PROPOSAL IS ACCEPTED

ACCEPTED ON:_______________________________________

Date

Municipality

ATTESTED BY:

________________________________________ BY:_______________________________________ Title Title

SEAL

- 2 -

ATTACHMENT #1

County: Berks Municipality: Earl Township Project No.: Hill Road Storm Sewer

Project T

H

IS

P O

R T

IO

N

T O

B E

C

O M

P L

E T

D

Y T

H E

M U

N

IC

IP

A

L

IT

LOCATION OF WORK

Hill Road between 36 Hill Road and Alder Ln, in Earl Township.

DESCRIPTION OF WORK:

As indicated below and in Attachments. Refer to all site drawings, details and notes. Refer to attached detailed scope of work for further explanation of line items below. Follow PADOT Pub. 408.

ESCALATOR CLAUSE:

Per Pub. 408 Section 110.04 Current Edition. Bituminous Price Adjustment applies to this contract.

Contractor required to supply Form CS-1-PA when applicable. Bid index is June 2026.

BID LINE ITEMS

1.Item

No.

2. Approx.

Quantities

3.

Units

4.*Description

LS

EA

LF

SY

SY

Mobilization

Type 1 Inlet Boxes

Standard Type M Inlet Tops w/ Bicycle Safe Grates

24” HDPE including stone backfill

Type DW Headwall for 24” HDPE Pipe

15” HDPE including stone backfill

Pavement Restoration

Removal of existing 15” CMP & HDPE Pipes

Swale grading along roadside between inlets

36 Hill Road Driveway Restoration

Seeding, Matting and Stabilization of all Disturbed Areas

Survey for Site Layout

Traffic Control

24” Compost Filter Sock

Filter Bag Inlet Protection

Stone & Concrete Block Inlet Protection

Stone Inlet Protection w/ Berm

R-4 Riprap Apron

ONLY

ENTER

PRICING

IN

PENNBID

ONLY

ENTER

PRICING

IN

PENNBID

*DESCRIPTION

Must include ADT on Wearing surfaces.

USE OF CUTBACK ASPHALT IS PROHIBITED BETWEEN MAY 1st AND OCTOBER 31st EXCEPT AS NOTED IN BULLETIN NO. 25.

3 – 1

Project

Attachment 1-A

SPECIFICATIONS AND SPECIAL PROVISIONS TO CONTRACT MS-944

CONTAINS IMPORTANT INFORMATION FOR THE CONTRACTOR(S)

The Prime Contractor(s) and subcontractors must comply with all of the following provisions:

TRAFFIC CONTROL

- Traffic Control and Safety Devices to be provided by the Contractor(s). (PA. DEPART. OF TRANS. Publication 213, WORKZONE TRAFFIC CONTROL, CURRENT EDITION.)

- The Contractor(s) may close one lane of the roadway provided sufficient traffic control / flagging is in place.

BIDDING

- All questions shall be submitted through PennBID and will be answered through PennBID.

- Bids must be submitted through PennBID only. All required bid documents shall be uploaded to PennBID as part of the bid submission

- Completion of Non-Collusion Affidavit, Public Work Verification, Insurance Certificate, and Workman’s Compensation affidavit required.

- Contractor(s) to supply proof of CDL Drug and Alcohol Compliance.

- The successful bidder(s) must provide a 100% Performance Bond and a 100% Payment Bond within 20 days of the award of the contract.

- Future award of Contracts will be based on quality of work as determined by the Municipality.

- Pennsylvania Prevailing Wage Rates apply to this project

GENERAL

- The Contractor(s) shall notify the Municipality and public five (5) calendar days prior to the start of the project.

- Work to start on or after issuance of Notice to Proceed and all work to be completed on or before October 31, 2026. After

10/31/26, liquidated damages apply at $500/day.

- A pre-construction meeting prior to start of construction with the Township and Township Engineer will be mandatory and the Contractor’s and any Sub-Contractor’s on-site foreman must attend. The Contractor(s) will schedule this meeting with the Municipality at least 3 calendar days prior to the start of the project.

- Municipality will inspect the project.

- Contractor(s) is (are) responsible for defects that occur within eighteen months of applications.

- Final Completion Certificate & Notice of Completion required.

- Contractor’s equipment may not leave project location until the contracted work has been completed.

- Delivery tickets shall be submitted for all materials.

- CS-4171 Certificate of Compliance required for all materials.

- Submit Bill of Lading for each shipment of bituminous material per Section 702.1(c) of PENNDOT Spec. Form 408.

- Submit Bill of Lading for each shipment of concrete material per Section 701.1(c) of PENNDOT Spec. Form 408.

- Municipality reserves the right to limit work completed.

- Municipality reserves the right to procure material which best suits their requirements after all bids and items are reviewed.

- 4 -

Project

Attachment 1-A

SPECIFICATIONS AND SPECIAL PROVISIONS TO CONTRACT MS-944

CONTAINS IMPORTANT INFORMATION FOR THE CONTRACTOR(S)

CONSTRUCTION

- Refer to all project drawings, details and additional project specifications contained in the bid documents

- Where Contract references current PennDOT specifications (Publication 408) or PennDOT Specifications Form 408, the latest edition in effect at time of letting of contract shall apply.

- Contractor to work within road right-of-way (33’ wide).

- Township Engineer or designee must witness / inspect / approve stone backfill compaction efforts for permanent restoration.

- Incidental preparation and clean up required by Contractor. (Project Construction Materials)

- Contractor to remove all excess material from the project site.

- Contractor is responsible for proper disposal of all materials being removed as part of this project.

BITUMINOUS PAVING

- Complete all testing in accordance with PENNDOT Specifications Form 408 Section 401 except Marshall Testing.

- Tack Coat is required per Section 460 / 409 of PennDOT Specifications Form 408 and is incidental to paving.

- Bituminous Seal on all abutting pavement, manholes, inlets and curbs required after wearing course.

- Saw cut or Milled Paving Notch per RC-28M is required and incidental to paving.

- Roadway is to be power broomed by the Contractor prior to start of paving.

My signature signifies that I have read and understand the above conditions and special provisions to this contract, and by being authorized by this company to act as their authorized representative, and on their behalf hereby agree to adhere to any and all of the provisions pertaining to this contract.

________6/17/26__________

Contractor’s Representative Date Municipality’s Representative Date

______________________________________________ _____ EARL TOWNSHIP_ _

Company Municipality

- 5 -

HW-1 TW 541.00

Inv In/out (24") 538.00 Station Type Length (LF) Slope (%)

I-1 T/G 536.50 HW-1 to I-1 24" HDPE 40 12.5 Type 1 Box, Type M Top Inv In (24") 533.00

Inv Out (24") 532.80

I-2 T/G 518.50 I-1 to I-2 24" HDPE 139 12.8 Type 1 Box, Type M Top Inv In (24") 515.00

Inv Out (24") 514.80

I-3 T/G 513.85 I-2 to I-3 24" HDPE 164 2.7 Type 1 Box, Type M Top Inv In (15" HDPE) 510.48 End-I-3 15" HDPE 26 5.3

Inv In (24") 510.30 Inv Out (24") 510.10

I-4 T/G 512.00 I-3 to I-4 24" HDPE 38 4.2 Type 1 Box, Type M Top Inv In (24") 508.50

Inv Out (24") 508.30

I-5 T/G 506.00 I-4 to I-5 24" HDPE 168 3.8 Type 1 Box, Type M Top Inv In (24") 502.00

Earl Township Hill Road

New Pipes

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363-2134-008 / March 31, 2012 / Page 99

STANDARD CONSTRUCTION DETAIL # 4-16

Filter Bag Inlet Protection - Type M Inlet

Adapted from PennDOT RC-70, 2008 Edition

Maximum drainage area =½ acre.

Inlet protection shall not be required for inlet tributary to sediment basin or trap. Berms shall be required for all installations.

Rolled earthen berm in roadway shall be maintained until roadway is stoned. Road subbase berm on roadway shall be maintained until roadway is paved. Earthen berm in channel shall be maintained until permanent stabilization is completed or remain permanently.

At a minimum, the fabric shall have a minimum grab tensile strength of 120 lbs., a minimum burst strength of 200 psi, and a minimum trapezoidal tear strength of 50 lbs. Filter bags shall be capable of trapping all particles not passing a No. 40 sieve.

Inlet filter bags shall be inspected on a weekly basis and after each runoff event. Bags shall be emptied and rinsed or replaced when half full or when flow capacity has been reduced so as to cause flooding or bypassing of the inlet. Damaged or clogged bags shall be replaced. A supply shall be maintained on site for replacement of bags. All needed repairs shall be initiated immediately after the inspection. Dispose accumulated sediment as well as all used bags according to the plan notes.

DO NOT USE ON MAJOR PAVED ROADWAYS WHERE PONDING MAY CAUSE TRAFFIC

HAZARDS.

363-2134-008 / March 31, 2012 / Page 274

STANDARD CONSTRUCTION DETAIL # 11-1

Erosion Control Blanket Installation

Source Unknown

Seed and soil amendments shall be applied according to the rates in the plan drawings prior to installing the blanket.

Provide anchor trench at toe of slope in similar fashion as at top of slope.

Slope surface shall be free of rocks, clods, sticks, and grass.

Blanket shall have good continuous contact with underlying soil throughout entire length. Lay blanket loosely and stake or staple to maintain direct contact with soil. Do not stretch blanket.

The blanket shall be stapled in accordance with the manufacturer’s recommendations.

Blanketed areas shall be inspected weekly and after each runoff event until perennial vegetation is established to a minimum uniform 70% coverage throughout the blanketed area. Damaged or displaced blankets shall be restored or replaced within 4 calendar days.

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D

J

A

M

A

T

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L

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Y

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N

A

D

S

U

S

E

T

O

O

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A

D

A

D

S

S

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A

D

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O

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E

I

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Y

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N

A

D

M

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Y

E

R

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E

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T

I

W

INLET I-1

INSTALL TYPE 1 M INLET

INV IN: 533.0

INV OUT: 532.8

T/G: 536.5

INLET I-2

INSTALL TYPE 1 M INLET

INV IN: 515.0

INV OUT: 514.8

T/G: 518.5

INLET I-3

INSTALL TYPE 1 M INLET

INV IN NEW 15" HDPE: 510.48

INV IN: 510.3

INV OUT: 510.1

T/G: 513.85

EX 15" CMP PIPE

TO BE REMOVED

INSTALL NEW

15" HDPE PIPE

26 LF @ 5.3%

INLET I-5

INSTALL TYPE 1 M INLET

INV IN: 502.0

INV OUT: 501.8

T/G: 506.0

INLET I-6

INSTALL TYPE 1 M INLET

INV IN: 501.0

INV OUT: 500.8

T/G: 505.50

HEADWALL HW-1

INSTALL DW HEADWALL

INV IN: 538.0

TW: 541.0

40 LF OF 24"

HDPE @ 12.5%

RESTORE DRIVEWAY

AFTER PIPE

INSTALL

139 LF OF 24"

HDPE @ 12.8%

164 LF OF 24"

HDPE @ 2.7%

38 LF OF 24"

HDPE @ 4.2%

168 LF OF 24"

HDPE @ 3.8%

48 LF OF 24"

HDPE @ 4.8%

U

R

C

I

N

U

INLET I-4

INSTALL TYPE 1 M INLET

INV IN: 508.5

INV OUT: 508.3

T/G: 512.0

52 LF OF 24"

HDPE @ 1.5%

REMOVE EXISTING

15" HDPE (54 LF)

UNDER ROADWAY

ENDWALL EW-1

INSTALL DW ENDWALL

INV OUT: 498.5

TW: 502.0

RIPRAP APRON RR-1

R-4 18" DEPTH

10' LONG X 10' WIDE AT END

I

P

I

P

I

P

I

P

I

P

I

P

22 LF OF 24" CFS

156 LF OF 24" CFS

172 LF OF 24" CFS

45 LF OF 24" CFS

171 LF OF 24" CFS

26 LF OF 24" CFS

REVISIONS

DRAWN CHECK SCALE

AS NOTED

PLAN NO.

SHEET

2026 HNT, LLC

C

06/18/2026

25-094

OF 03

Situate In:

Earl Township

Berks County, Pennsylvania

297 SUEDBERG ROAD, SUITE #7, PINE GROVE, PA 17963

(570) 345-8288 FAX: (570) 345-8299

EXISTING GROUND CONTOUR LINE

PLAN LEGEND

PROPOSED FEATURE

EXISTING FEATURE

SLANT LETTERING

VERTICAL LETTERING

PROPERTY LINE

RIGHT-OF-WAY LINE

STORM SEWER IMPROVEMENT

PLAN

FOR

HILL ROAD

NOTES:

1. BOUNDARY LOCATIONS ARE REPRESENTED BY TAX

PARCEL MAPPING.

2. ROAD RIGHT-OF-WAY DEPICT HILL ROAD AS 50'

RIGHT-OF-WAY

3. PA STATE PLANE SOUTH COORDINATE SYSTEM GPS

RTK

4. ELEVATION DATUM NAVD88

5. ALL INLETS SHALL BE TYPE 1

6. STORM SEWER PIPE LENGTHS ARE COMPUTED FROM

CENTER OF INLET BOX TO CENTER OF INLET BOX.

- STOP -

CALL BEFORE YOU DIG

PENNSYLVANIA ONE CALL SYSTEM, INC.

3 WORKING DAYS NOTICE IS THE LAW!

1-800-242-1776

S

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C

A

L

L

B

EF

O

R

E

Y

O

U

D

I

G

LOCATION MAP

1" = 2,000'

PROJECT

AREA

0 30 60 90

24" COMPOST FILTER SOCK

IP

-1

IP

-1

IP

-2

INLET PROTECTION (DETAIL 4-16)

INLET PROTECTION (DETAIL 4-18)

INLET PROTECTION (DETAIL 4-20)

Heath Machamer 6/18/2026

REVISIONS

DRAWN CHECK SCALE

AS NOTED

PLAN NO.

SHEET

2026 HNT, LLC

C

06/18/2026

25-094

OF 03

Situate In:

Earl Township

Berks County, Pennsylvania

297 SUEDBERG ROAD, SUITE #7, PINE GROVE, PA 17963

(570) 345-8288 FAX: (570) 345-8299

STORM SEWER IMPROVEMENT

PLAN

FOR

HILL ROAD

RIPRAP APRON AT PIPE OUTLET

WITH FLARED END SECTION OR ENDWALL

NOTES:

ALL APRONS SHALL BE CONSTRUCTED TO THE DIMENSIONS SHOWN. TERMINAL WIDTHS

SHALL BE ADJUSTED AS NECESSARY TO MATCH RECEIVING CHANNELS.

ALL APRONS SHALL BE INSPECTED AT LEAST WEEKLY AND AFTER EACH RUNOFF

EVENT. DISPLACED RIPRAP WITHIN THE APRON SHALL BE REPLACED IMMEDIATELY.

0% SLOPE

PLAN VIEW

SECTION Y-Y

SECTION Z-Z

AI

AI

Atw

Pd

Rt

Aiw

Pd

Y Y

Z

Z

OUTLET

NO.

PIPE

DIA

Pd

(IN)

RIPRAP APRON

SIZE

R-_

THICK.

Rt

(IN)

LENGTH

Al

(FT)

INITIAL

WIDTH

Aiw

(FT)

TERMINAL

WIDTH

Atw

(FT)

PADEP STANDARD CONSTRUCTION DETAIL #9-1

GEOTEXTILE

0% SLOPE

GEOTEXTILE

24 R-4 18 10 6 10

RR-1

-SIDE VIEW-

-PLAN VIEW-

-ISOMETRIC-

TOP RISER SECTION

33"

43"

8"

26"

26"

30°

52"

8"

26"

12"

6"

8"

PIPE ∅

6"

NOTES:

1. HEADWALLS, ENDWALL, AND END SECTIONS

SHALL BE SET ON A MINIMUM OF 12" AASHTO

NO. 57 (PENNDOT 2B) COARSE AGGREGATE.

NO SCALE

TYPE D-W ENDWALL DETAIL

1' MIN.

L

NO SCALE

W

ENDSECTION DETAIL

(AS MANUFACTURED BY ADS OR APPROVED EQUAL)

-SIDE-

B

-TOP-

A

H

P

I

-END-

A

L

H

PIPE DIA A Bmax H L W

12", 15" 6.5" 10" 6.5" 25" 29"

18" 7.5" 15" 6.5" 32" 35"

24" 7.5" 18" 6.5" 36" 45"

30" 10.5" NA 7.0" 53" 68"

36" 10.5" NA 7.0" 53" 68"

ENDSECTION DIMENSIONS

NOTE: USE ENDSECTION WITH

COLLAR ABOVE PIPE FOR SOIL

CONTAINMENT (WHERE AVAILABLE)

PRECAST INLET BOX BASE PREPARATION

NO SCALE

NO SCALE

(RC-34) PRECAST CONCRETE INLET BOXES

1. ALL CAST-IN-PLACE INLET TOPS SHALL CONFORM TO THE SHAPE

AND DIMENSIONS AS SHOWN ON THE STANDARD, AND AT THE OPTION

OF THE CONTRACTOR, MAY BE MONOLITHIC WITH THE INLET BOX.

2. CONCRETE TOP UNITS WHICH SEAT THE GRATE DIRECTLY WITHIN

THE

UNIT SHALL UTILIZE 1-1/4" X 1-1/4" ANGLES EMBEDDED IN THE

CONCRETE AS A BEARING AREA FOR THE GRATE.

3. THIS STANDARD DEPICTS THE SHAPE AND DIMENSIONS REQUIRED

FOR

UNIFORMITY AND COMPATIBILITY. IT IS NOT INTENDED TO SHOW THE

DETAILS REQUIRED FOR MANUFACTURING AND HANDLING. ONLY THOSE

ITEMS WHICH ARE SUPPLIED BY AN APPROVED MANUFACTURER AS

LISTED IN PA BULLETIN NO. 15 WILL BE PERMITTED.

4. THE SELECTION OF COMPONENTS TO ACHIEVE A SPECIFIED INLET

TYPE

IS THE CONTRACTOR'S RESPONSIBILITY.

5. PIPES SHALL BE LOCATED AS REQUIRED.

6. WEEP HOLES SHALL BE INSTALLED AS REQUIRED BY SECTION 605,

PA DOT FORM 408.

7. GRADE ADJUSTMENT RINGS MAY BE OF MASONRY OR PRECAST

CONCRETE CONSTRUCTION, AS APPROVED.

8. INLET BOX SHALL EITHER CAST-IN-PLACE CONCRETE, OR PRECAST

CONCRETE.

9. REFER TO PA DOT BUREAU OF DESIGN STANDARDS RC-34M.

10. ALL NEW CONSTRUCTION SHALL BE IN ACCORDANCE WITH PADOT

PUBLICATION 408, SECTION 605 & STANDARDS FOR ROADWAY

CONSTRUCTION, RC-34M. CONTRACTOR SHALL VERIFY INLET BOX

SIZING BASED ON PIPE SIZES AND ALIGNMENT PRIOR TO ORDERING

PRECAST STRUCTURES.

11. ALL DRAINAGE STRUCTURES SHALL HAVE POURED-IN-PLACE

CONCRETE

CHANNEL BOTTOMS.

12. SEAL AROUND UNIT TOP AND PAVING (ALL UNITS) WITH AC-20.

13. INLETS DEEPER THAN 6 FT. FROM TOP OF GRATE SHALL BE

EQUIPPED WITH METAL STEPS.

14. ALL INLET TOPS SHALL BE CONSTRUCTED WITH A 2" SUMP (10"

REVEAL AT ALL INLETS TO MATCH 8" CURB REVEAL ELSEWHERE).

15. FOR DOUBLE INLET BOX CONFIGURATION, REMOVE CENTER

KNOCKOUT PANELS AND GROUT JOINT CLOSED. JOINED STRUCTURE

SHALL HAVE POURED-IN-PLACE CONCRETE CHANNEL BOTTOM WITH

INVERT PER PLAN.

16. PLACE SUBBASE MATERIAL MEETING THE REQUIREMENTS OF

PENNDOT PUBLICATION 408, SECTION 350.2, IN LAYERS OF 4" THICK,

COMPACTED TO A DENSITY SATISFACTORY TO THE BOROUGH ENGINEER

(SEE DETAIL A).

(RC-34) PRECAST CONCRETE

TYPE M INLET TOP DETAIL

#4 BARS2-12"1-12"

6"

8"

24"

-SECTION-

-PLAN-

48-14"

57-14"

STRUCTURAL STEEL

GRATE (BICYCLE SAFE)

NO SCALE

PROVIDE ONE LAYER

OF REINF. BARS

(0.12 SQIN/FT.)

EACH WAY MIN

#4 BARS 12" C. TO C. (TYP)

EACH WAY TOP & BOTTOM

OR 0.20 SQIN/FT W.W.F.

(6" MAX SPACING)

PROVIDE ONE LAYER

OF REINF. BARS

(0.12 SQIN/FT.)

EACH WAY MIN

#4 BARS 12" C. TO C. (TYP)

EACH WAY TOP & BOTTOM

OR 0.20 SQIN/FT W.W.F.

(6" MAX SPACING)

38"

COVER ADJUSTMENT SLAB

TYPE 1

SECTION B-B

6" MIN

6"

M A X

H E I G H T

4" MIN

M I N

6"

A

T Y P

57-1/4"

STANDARD BOX

A

B

6" MIN

M A X

O D

M A X

H E I G H T

6" (TYP)

36" ∅ MAX

FOR RCP

STANDARD BOX EXPANDED IN

THE SHORT DIRECTION

TYPE 1

M A X

O D

SECTION A-A

B

57-1/4"

INLET NOTES

(RC-34) STRUCTURAL STEEL GRATE

BICYCLE SAFE

1/4" MIN

(TYP)

1/4" MIN

6 TRANSVERSE RODS

AT 3-5/8" C. TO C. (TYP)

3/8"∅ x 46-1/4" ROD

SECTION A-A

3' 11-3/4"

A

1-1/4"

3/4"

NO SCALE

26 BEARING BARS

AT 1-3/4" C. TO C. (TYP)

1/2" x 2-1/2" x 25" BAR

S E C T I O N

B B

A

B

3/4"

B

3/4"

2-1/2"

4"MIN.

MAX.

9'-0"

HEIGHT

A A

A

A

A A

7"

6"MIN.

COVER ADJUSTMENT SLAB

TYPE 2

SECTION C-C

PROVIDE

ONE LAYER OF

REINF. BARS

(0.12 in /FT.)

EACH WAY MIN.

AA

6"

A AAA

6"59.25"

DETAIL A

SUBBASE MATERIAL

12" MIN. SEE NOTE 16

COVER ADJUSTMENT SLAB

SECTION G-G

NO SCALE

TYPE 1

N

M I N

SECTION F-F

71 1/4''

57 1/4''

FF

57 1/4''

#5 BARS

6''

45 1/4''

SUPERPAVE ASPHALT MIXTURE DESIGN HMA

9.5MM WEARING COURSE, PG 64-22, 0.3 TO 3.0

MILLION ESALS, 1.5" DEPTH

SUPERPAVE ASPHALT MIXTURE

DESIGN HMA 25MM BASE COURSE,

PG 64-22, 0.3 TO 3.0 MILLION

ESALS, 5" DEPTH

PENNDOT 2A MODIFIED STONE

COMPACTED IN 6" LAYERS

EARL TOWNSHIP

TRENCH RESTORATION DETAIL

NOTES:

1. EXPOSED VERTICAL AND

HORIZONTAL SURFACES SHALL BE

PREPARED AS PER PUB 408,

SECTION 409.3.(g)

2. MINIMUM 1' PAVEMENT CUTBACK,

EXCAVATE OLD AND TEMPORARY

MATERIAL. RECOMPACT SUB-GRADE,

TACK COAT ALL VERTICAL EDGES.

INSTALL BASE COURSE AND

WEARING COURSE ON SEPARATE

DAYS.

3. TOWNSHIP ENGINEER MUST

OBSERVE STONE BACKFILL

COMPACTION.

4. MATCH EXISTING PAVING DEPTHS IF

GREATER.

5. HOT SEAL ALL EDGES W/ 12" WIDE

PG 64-22.

6. CLEAN FILL SHALL HAVE NO STONE

SIZE LARGER THAN 6".

1' MIN

6" MIN

1' MIN

6" MIN

CLEAN FILL COMPACTED IN 8"

LAYERS

PENNDOT 2A MODIFIED STONE

COMPACTED IN 6" LAYERS6" MIN

6" MIN

12" MIN

PAVED AREAS GRASS AREAS

ROADWAY SHOULDER TO BE

SWALED A MINIMUM 2' WIDE WITH

MINIMUM 4" SWALE DEPTH TO

CONVEY RUNOFF BETWEEN

INLETS

REVISIONS

DRAWN CHECK SCALE

AS NOTED

PLAN NO.

SHEET

2026 HNT, LLC

C

06/18/2026

25-094

OF 03

Situate In:

Earl Township

Berks County, Pennsylvania

297 SUEDBERG ROAD, SUITE #7, PINE GROVE, PA 17963

(570) 345-8288 FAX: (570) 345-8299

STORM SEWER IMPROVEMENT

PLAN

FOR

HILL ROAD

INSTALLATION DETAIL

PLAN VIEW

SECTION VIEW

ISOMETRIC VIEW

NOTES:

MAXIMUM DRAINAGE AREA = 1/2 ACRE.

INLET PROTECTION SHALL NOT BE REQUIRED FOR INLET TRIBUTARY TO SEDIMENT BASIN OR TRAP. BERMS

SHALL BE REQUIRED FOR ALL INSTALLATIONS.

ROLLED EARTHEN BERM IN ROADWAY SHALL BE MAINTAINED UNTIL ROADWAY IS STONED. ROAD SUBBASE

BERM ON ROADWAY SHALL BE MAINTAINED UNTIL ROADWAY IS PAVED. EARTHEN BERM IN CHANNEL

SHALL BE MAINTAINED UNTIL PERMANENT STABILIZATION IS COMPLETED OR REMAIN PERMANENTLY.

AT A MINIMUM, THE FABRIC SHALL HAVE A MINIMUM GRAB TENSILE STRENGTH OF 120 LBS., A MINIMUM

BURST STRENGTH OF 200 PSI, AND A MINIMUM TRAPEZOIDAL TEAR STRENGTH OF 50 LBS. FILTER BAGS

SHALL BE CAPABLE OF TRAPPING ALL PARTICLES NOT PASSING A NO. 40 SIEVE.

INLET FILTER BAGS SHALL BE INSPECTED ON A WEEKLY BASIS AND AFTER EACH RUNOFF EVENT. BAGS

SHALL BE EMPTIED AND RINSED OR REPLACED WHEN HALF FULL OR WHEN FLOW CAPACITY HAS BEEN

REDUCED SO AS TO CAUSE FLOODING OR BYPASSING OF THE INLET. DAMAGED OR CLOGGED BAGS SHALL

BE REPLACED. A SUPPLY SHALL BE MAINTAINED ON SITE FOR REPLACEMENT OF BAGS. ALL NEEDED

REPAIRS SHALL BE INITIATED IMMEDIATELY AFTER THE INSPECTION. DISPOSE ACCUMULATED SEDIMENT AS

WELL AS ALL USED BAGS ACCORDING TO THE PLAN NOTES.

DO NOT USE ON MAJOR PAVED ROADWAYS WHERE PONDING MAY CAUSE TRAFFIC HAZARDS.

FLOW

Filter Bag Inlet Protection - Type M Inlet

NOT TO SCALE

PADEP STANDARD CONSTRUCTION DETAIL #4-16

W

I

D

T

H

L

E

N

G

T

H

INLET GRATE

I" REBAR FOR BAG

REMOVAL FROM

INLET

EXPANSION RESTRAINT

(1/4" NYLON ROPE)

2" x 2" x 3/4"

RUBBER BLOCK

FLOW

STORM

INLET

2:1 MAX

(TYP.)

EARTHEN BERM TO BE

STABILIZED WITH TEMPORARY

OR PERMANENT VEGETATION

2:1 MAXIMUM

BERM

3:1

6" MINIMUM

HEIGHT

DROP OR

TYPE M

INLET

PLAN VIEW

SECTION A-A

A A

BERM

FLOW

3:13:1

NOTES:

MAXIMUM DRAINAGE AREA =1 ACRE.

INLET PROTECTION SHALL NOT BE REQUIRED FOR INLET TRIBUTARY TO SEDIMENT BASIN OR TRAP. BERMS

SHALL BE REQUIRED FOR ALL INSTALLATIONS NOT LOCATED AT A LOW POINT.

ROLLED EARTHEN BERM IN ROADWAY SHALL BE PROVIDED AND MAINTAINED IMMEDIATELY DOWN GRADIENT

OF THE PROTECTED INLET UNTIL ROADWAY IS STONED. ROAD SUBBASE BERM ON ROADWAY SHALL BE

MAINTAINED UNTIL ROADWAY IS PAVED. EARTHEN BERM IN CHANNEL SHALL BE MAINTAINED UNTIL

PERMANENT STABILIZATION IS COMPLETED OR TO REMAIN PERMANENTLY.

TOP OF BLOCK SHALL BE AT LEAST 6 INCHES BELOW ADJACENT ROADS IF PONDED WATER WOULD POSE

A SAFETY HAZARD TO TRAFFIC.

SEDIMENT SHALL BE REMOVED WHEN IT REACHES HALF THE HEIGHT OF THE STONE. DAMAGED OR

CLOGGED INSTALLATIONS SHALL BE REPAIRED OR REPLACED IMMEDIATELY.

FOR SYSTEMS DISCHARGING TO HQ OR EV SURFACE WATER, A 6 INCH THICK COMPOST LAYER SHALL BE

SECURELY ANCHORED ON OUTSIDE AND OVER TOP OF STONE. COMPOST SHALL MEET THE STANDARDS IN

TABLE 4.2 OF THE PA DEP EROSION CONTROL MANUAL.

Stone And Concrete Block Inlet Protection - Type M Inlet

NOT TO SCALE

PADEP STANDARD CONSTRUCTION DETAIL #4-18

FLOW

6" MINIMUM

M I N I M U M

M I N I M U M

1' MINIMUM

X

X

BERM

STORM

INLET

SECTION VIEW

NOTES:

INLET PROTECTION SHALL NOT BE REQUIRED FOR INLET TRIBUTARY TO SEDIMENT BASIN OR TRAP. BERMS

SHALL BE REQUIRED FOR ALL INSTALLATIONS NOT LOCATED AT A LOW POINT.

ROLLED EARTHEN BERM IN ROADWAY SHALL BE PROVIDED AND MAINTAINED IMMEDIATELY DOWN GRADIENT

OF THE PROTECTED INLET UNTIL ROADWAY IS STONED. ROAD SUBBASE BERM ON ROADWAY SHALL BE

MAINTAINED UNTIL ROADWAY IS PAVED. EARTHEN BERM IN CHANNEL SHALL BE MAINTAINED UNTIL

PERMANENT STABILIZATION IS COMPLETED OR TO REMAIN PERMANENTLY.

STONE INLET PROTECTION AND BERM FOR A TYPE M INLET CAN BE USED IN ONE ACRE MAXIMUM

DRAINAGE AREA WITH 15 IN. OVERFLOW PIPE AND 4 IN. HEAD. A PERFORATED PLATE WELDED TO A

METAL RISER MAY NOT BE SUBSTITUTED FOR THE WIRE MESH. A SLOTTED PLATE WELDED TO THE RISER

MAY BE USED IN CONJUNCTION WITH THE WIRE MESH IF CALCULATIONS ARE PROVIDED TO SHOW

SUFFICIENT CAPACITY OF THE INLET TO ACCEPT THE PEAK RUNOFF FOR A 2-YEAR STORM EVENT FROM

THE TRIBUTARY DRAINAGE AREA. TOP OF PIPE SHALL BE AT LEAST 6 INCHES BELOW ADJACENT

ROADWAY IF PONDED WATER WOULD POSE A SAFETY HAZARD TO TRAFFIC. EARTHEN BERM SHALL BE

ROLLED.

SEDIMENT SHALL BE REMOVED WHEN IT REACHES HALF THE HEIGHT OF THE STONE. DAMAGED OR

CLOGGED INSTALLATIONS SHALL BE REPAIRED OR REPLACED IMMEDIATELY.

FOR SYSTEMS DISCHARGING TO HQ OR EV SURFACE WATER, A 6 IN. THICK COMPOST LAYER SHALL BE

SECURELY ANCHORED ON OUTSIDE AND OVER TOP OF STONE. COMPOST SHALL MEET THE STANDARDS IN

TABLE 4.2 OF THE PA DEP EROSION CONTROL MANUAL.

DO NOT USE ON MAJOR PAVED ROADWAYS WHERE PONDING MAY CAUSE TRAFFIC HAZARDS.

BERM

FLOW

3:13:1

INLET PROTECTION

C ROAD

L

PLAN VIEW

M I N I M U M

Stone Inlet Protection And Berm - Type M Inlet

NOT TO SCALE

PADEP STANDARD CONSTRUCTION DETAIL #4-20

2:1 MAX

6" MINIMUM

HEIGHT

GRATE

15" MINIMUM DIAMETER PIPE

AASHTO #57 STONE

GALVANIZED WIRE MESH,

11 GAUGE OR PLASTIC MESH

(1/4" MAXIMUM OPENING)

EARTHEN BERM STABILIZED

WITH TEMPORARAY OR

PERMANENT VEGETATION

15" MINIMUM DIAMETER PIPE

AASHTO #57 STONE

F

L

O

W

F

L

O

W

DISTURBED AREA

SECTION

PLAN VIEW

DISTURBED AREA

UNDISTURBED AREA

NOTES:

SOCK FABRIC SHALL MEET STANDARDS OF TABLE 4.1 OF THE PA DEP EROSION CONTROL

MANUAL. COMPOST SHALL MEET THE STANDARDS OF TABLE 4.2 OF THE PA DEP EROSION

CONTROL MANUAL.

COMPOST FILTER SOCK SHALL BE PLACED AT EXISTING LEVEL GRADE. BOTH ENDS OF THE

BARRIER SHALL BE EXTENDED AT LEAST 8 FEET UP SLOPE AT 45 DEGREES TO THE MAIN

BARRIER ALIGNMENT. MAXIMUM SLOPE LENGTH ABOVE ANY BARRIER SHALL NOT EXCEED THAT

SPECIFIED FOR THE SIZE OF THE SOCK AND THE SLOPE OF ITS TRIBUTARY AREA.

TRAFFIC SHALL NOT BE PERMITTED TO CROSS COMPOST FILTER SOCKS.

ACCUMULATED SEDIMENT SHALL BE REMOVED WHEN IT REACHES 1/2 THE ABOVE GROUND

HEIGHT OF THE BARRIER AND DISPOSED IN THE MANNER DESCRIBED ELSEWHERE IN THE PLAN.

COMPOST FILTER SOCKS SHALL BE INSPECTED WEEKLY AND AFTER EACH RUNOFF EVENT.

DAMAGED SOCKS SHALL BE REPAIRED ACCORDING TO MANUFACTURER’S SPECIFICATIONS OR

REPLACED WITHIN 24 HOURS OF INSPECTION.

BIODEGRADABLE COMPOST FILTER SOCKS SHALL BE REPLACED AFTER 6 MONTHS;

PHOTODEGRADABLE SOCKS AFTER 1 YEAR. POLYPROPYLENE SOCKS SHALL BE REPLACED

ACCORDING TO MANUFACTURER’S RECOMMENDATIONS.

UPON STABILIZATION OF THE AREA TRIBUTARY TO THE SOCK, STAKES SHALL BE REMOVED. THE

SOCK MAY BE LEFT IN PLACE AND VEGETATED OR REMOVED. IN THE LATTER CASE, THE MESH

SHALL BE CUT OPEN AND THE MULCH SPREAD AS A SOIL SUPPLEMENT.

I N

M I N

PADEP STANDARD CONSTRUCTION DETAIL #4-1

EXISTING CONTOURS

2" x 2" WOODEN STAKES

PLACED 10' O.C.

COMPOST

FILTER

SOCK

2" x 2" WOODEN STAKES

PLACED 10' O.C.

COMPOST

FILTER

SOCK

BLOWN/PLACED

FILTER MEDIA

COMPOST FILTER SOCK

NOT TO SCALE

MS-944-S (7-09)

Attachment 2

PERFORMANCE BOND

(With Corporate Surety)

KNOW ALL MEN BY THESE PRESENTS, That we, as Principal and a corporation incorporated under the laws of the State of are held and firmly bound unto

(NAME AND ADDRESS OF CONTRACTOR)

(SURETY COMPANY)

as Surety

(NAME OF STATE)

in the full and just sum of

(NAME OF MUNICIPALITY)

($ ) dollars lawful money to the United States of America, to be paid to the above Municipality or its assigns, to which payment well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

WHEREAS, the above bounden Principal has entered into a contract with the above Municipality, bearing even date herewith, for the undertaking of certain obligations as therein set forth.

NOW, THEREFORE, the condition of this obligation is such that if the above bounden Principal, as Contractor, shall in all respects comply with and faithfully perform the terms and conditions of said Contract, including the Specifications and conditions referred to and made a part thereof, and such alterations as may be made in said Specifications as therein provided, and shall well and truly, and in a manner satisfactory to the municipality fulfill all obligations as therein set forth, then this Obligation shall be void, but otherwise the same shall be and remain in full force, virtue and effect.

It is further provided that any alteration which may be made in the terms of the contractor or its specifications with the express approval of the Municipality or the Principal to the other, shall not in any way release the Principal and the Surety or either or any of them, their heirs, executors, administrators, successors or assigns from their liability hereunder, notice to the surety of any such alteration or forbearance being hereby waived.

IN WITNESS WHEREOF, the said Principal and Surety have duly executed this Bond under Seal, pursuant to due and legal action authorizing the same to be done on .

(DATE OF BOND)

PLACE

HERE

Attest / Witness:

CONTRACTOR

BY

TITLE:

HERE

Attest / Witness:

SURETY COMPANY

TITLE: -7-

MS-944S PAYMENT BOND Attachment 3

KNOW ALL MEN BY THESE PRESENTS, that we as PRINCIPAL and a corporation incorporated under the laws of the State of as SURETY, are held and firmly bond unto the , in the full and just sum of

($ )dollars, lawful money of the United States of America, to be paid to the said or its assigns, to which payment well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

WHEREAS, the above bounden Principal has entered into a contract with the above municipality hereinafter called Obligee, bearing even date herewith, for the improvement of a certain section of highway or bridge in said Municipality consisting of:

for approximately the sum of: ($ ) dollars.

NOW, THEREFORE, the condition of this obligation is such that if the above bounden PRINCIPAL shall and will promptly pay or cause to be paid in full all sums of money which may be due by contract or otherwise, to any individual, firm, partnership, association or corporation, for all material furnished or labor supplied or performed in the prosecution of the work, whether or not the said for material or labor entered into and became component parts of the work and for rental of the equipment used and services rendered by public utilities in, or in connection with the prosecution of such work, then this obligation to be void, otherwise to remain in full force and effect.

The PRINCIPAL and SURETY, hereby, jointly and severally, agree with the Obligee herein that any individual firm, partnership, association or corporation, which has performed labor or furnished material in the prosecution of the work as provided, and any public utility which has not been paid in full therefor, may sue in assumpsit on this Payment Bond in his, their, or its own name and may prosecute the same to final for such sum or sums as maybe justly due him, them or it, and have execution thereon.

Provided, however, that the Obligee shall not be liable for the payment of any costs of expenses of such suit.

RECOVERY by any individual, firm, partnership, association or corporation hereunder shall be subject to the provisions of the “Public Works Contractors’ Bond Law of 1967", Act No. 385, approved December 20, 1967,P.L. 869, which Act shall be incorporated herein and made a part hereof, as fully and completely as though its provisions were fully and at length herein recited.

It is further provided that any alterations which may be made in the terms of the contract or in the work to be done or materials to be furnished or labor to be supplied or performed under it or the giving by the Obligee of any extension of time for the performance of the contract or any other forbearance on the part of either the Obligee or the Principal to the other, shall not in any way release the PRINCIPAL and the SURETY or SURETIES of any such alteration, extension of forbearance being hereby waived.

IN WITNESS WHEREOF, the said PRINCIPAL and SURETY have duly executed this Bond under seal this day of ,20 .

WITNESS:

CONTRACTOR

BY:

WITNESS:

SURETY COMPANY

TITLE: TITLE:

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AFFIDAVIT RE

Attachment 4

ACCEPTING PROVISIONS OF THE WORKMEN’S COMPENSATION ACT

State of )

) ss:

County of ) he has being duly sworn according to law deposes and says that they have it has accepted the provisions of the Workmen’s Compensation Act of 1915 of the Commonwealth of Pennsylvania, with has his its supplements and amendments, and have insured their liability thereunder in accordance with the terms of said its

Act with .

(SURETY COMPANY)

( TYPE OR PRINT) CONTRACTOR

SIGNATURE

Sworn to and subscribed before me this day of A.D. 20 .

SIGNATURE

My Commission Expires ( DATE )

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D-7126 ( 7-09 )

ANTI-COLLUSION AFFIDAVIT

County Berks

Municipality Earl Township

Project Number Hill Road

Storm Sewer Project

State of Fed. Project No.

( If Applicable )

County of

The undersigned deponent deposes and says that he is the ____________________ of the Company; that he is authorized to make this affidavit on behalf of said company in compliance with section 102.06 (e) of Department Specifications, Publication 408, as amended and that the said company has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with such contract.

(Contractor)

Sworn to and subscribed before me the undersigned notary public this day of , .

Notary Public

My Commission expires

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Commonwealth of Pennsylvania

Public Works Employment Verification Form

Public Works Employment Verification Office Department of General Services Bureau of Procurement 6th floor, Forum Place 555 Walnut Street

Harrisburg, PA 17101-1914

717-346-8115 ra-gsgseverify.pa.gov

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

Business or Organization Name (Employer)

Address

City State Zip Code

Check One:

Contractor

Subcontractor

Contracting Public Body

Contract/Project No.

Project Description

Project Location

Date enrolled in E-Verify

As a contractor/subcontractor for the above referenced public works contract, I hereby affirm that as of the above 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 post January

1, 2013 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

Rev 2/15 PSATS CDL Program Form Contractor

PSATS CDL Program Suggested Clause for Independent

Contractor Contracts

It is suggested that all participants in the PSATS CDL Program include the following language in any contract with any contractor hired to do work for the participating employer.

This language puts on record that the hiring party is not responsible for ensuring that the hired party’s CDL employees are covered by a qualified drug and alcohol testing program.

It is also suggested that the employer use a “Contractor’s Statement of Compliance with

CDL Testing Program Requirements” form to obtain the required information pertaining to any contractor’s compliance with these federal regulations.

Contract Language:

“The Parties agree that the relationship between the Contractor and the Employer is one of independent contractor and not employer/employee and that the individual employees of the

Contractor who will be performing the work pursuant to this Contract are not employees of the

Employer. Contractor hereby certifies, represents, and warrants to the Employer that all persons performing any aspect of the work pursuant to this Contract who are required to have a commercial driver’s license are in a program for drug and alcohol testing in accordance with the

Omnibus Transportation Employee Testing Act of 1991 and the federal regulations adopted pursuant thereto.”

Rev 2/15 PSATS CDL Program Form Contractor

Contractor’s Statement of Compliance with

CDL Testing Program Requirements

Due to the nature of the work that this contractor may perform for this employer, this contractor must use employees who perform safety-sensitive functions for which a Commercial

Driver’s License (CDL) is typically required. Section 49 CFR 382.301(c)(2) of the federal CDL regulations requires that, prior to the first time an employer uses a CDL employee employed by another entity (i.e., a contractor to whom the township is awarding a contract), and every six months of the contract, this employer must certify that any CDL employees used by each contractor remain covered by a qualified CDL drug and alcohol testing program.

An original signed copy of this form must be permanently retained by the employer with this contract and a new form received every 6 months of the contract’s duration.

If the contractor is not participating in a qualified CDL drug and alcohol testing program at the time of the awarding of the contract, or at any six-month re-certification point, then all the contractor’s CDL employees must obtain a negative result on a pre-employment drug test before beginning (or continuing) contracted work for this employer.

Contractor Name__________________________________________________________________________

By signing here, I, as the contractor’s authorized representative, verify that the contractor named above is a current participant in the below identified CDL testing program conforming to 49 CFR Part 40.

Contractor’s Authorized Representative ________________________________________________________

Today’s Date ____/____/____

Signature of Authorized Representative ________________________________________________________

CDL Testing Program Name ________________________________________________________________

Testing Program Contact Person ____________________________________________________________

Testing Program Address __________________________________________________________________

Phone #: ( ) City ______________________________ State _____ Zip __________

Contact person confirms program conforms to 49 CFR Part 40? (_____) Yes (______) No

Contact person confirms list of contractor’s CDL employees covered in this program and that all drivers are qualified to driver under 49 CFR Part 382.301? (_____) Yes (______) No

CERTIFICATE OF INSURANCE

NAME OF INSURED

ADDRESS

COVERAGE LIMITS OF LIABILITY EXPIRATION POLICY NO.

DATE

I. WORK.MEN'S State/Federal Statutory COMPENSATION Employer's Liability $I 00,000/$500,000/$100,000

Bodily Injury Property Damage

2. COMPREHENSfVE D Comprehensive Form Each Occurrence Each Occurrence COMMERCIAL D Premises- ($2,000,000 rcq 'd) ($ 1,000,000 req 'd)

GENERAL

LIABlLITY

Operations Explosion & Collapse Annual Aggregate Annual Aggregate

D Hazard ($2,000.000 re 'd ($1,000,000 re 'd D Underground Hazard D Products/ Completed

Operations Hazard D Contractural

Insurance D Broad Form Property

D Damage Independent Contractors

D Personal Injury Including Employees Each Occurrence Aggregate

($ 1,000,000 req 'd) ($1,000,000 rcq 'd)

3. AUTOMOTfVE D Comprehensive Form Each Person Each Occurrence LIABILITY D Owned ($500,000 req 'd) ($250,000 req 'd)

Hired OR D Non-Owned

Each Occurrence Combined Single ($1,000,000 req 'd) Limit of$1,000,000

4. EXCESS LIABILITY D Umbrella Form Each Occurrence ($5,000,000) D Other Than Umbrella

Form Annual Aggregate ($5,000,000)

5. OTHER-PROPERTY D Builders Risk Full Replacement Cost INSURANCE Installation Floater

Technicon Enterprises Inc. II Earl Township

Name (print):

Running Avg. of 5

%AC

Daily No. 1

Wearing Course

Specimen #1Test Results Pass #8

Plant:

Location:

Binder Course Base Course

Signature:

Title:

Publication 408, Section:

P.O. No.

Consigned to:

Material Class:

Plant Code:

Daily No. 2

County

PennDOT Maintenance

Municipality

Contractor S.R.

Group / P.O.C. No. ECMS No.

ESALS SRL PG Grade

Section

County

Date Shipped:

Daily No. 3

Daily AASHTO T209 Density:

Pass #200

Daily Avg.

Specimen #2 Specimen #1 Specimen #2 Air Voids VMA

CS-4171B (2-16) Formerly TR-465

CERTIFICATE OF COMPLIANCE

FOR DAILY BITUMINOUS MIXTURES

Please select the Payment factor percentage below, based on Pub 408 Sec.409.4(a) Table H:

Defective Pavement: The material as listed above shipped on this date does not conform to the certification tolerances for 100% pay as listed in Pub 408 Sec. 409.2(e) Table A. QC test results are being forwarded to the Inspector-In-Charge which indicate material must be removed and replaced or accepted at 50% CUP with District Executive approval in writing. Our records attesting to this statement are open for inspection by a Department Representative for not less than THREE years from the date of shipment.

Job Mix Formula: (Year-Number):

100% Payment Factor: The material as listed above shipped on this date conforms fully with the specification requirements of the Pennsylvania Department of Transportation. Our records, attesting to this statement, are open for inspection by a Department Representative for not less than THREE years from the date of shipment.

85% Payment Factor: The material as listed above shipped on this date does not conform to the certification tolerances for 100% pay as listed in Pub 408 Sec. 409.2(e) Table A. A reduced pay factor has been applied and QC test results are being forwarded to the Inspector-In-Charge. Our records attesting to this statement are open for inspection by a Department Representative for not less than THREE years from the date of shipment.

Tons Shipped:

MS-NCP

MUNICIPALITY

Name of Contractor

Performance of work as specified on the above numbered contract is completed and final pavement inspection has been made by the…

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