PROJECT MANUAL

Culvert No. 1 Channel Grading Pine Grove Township Schuylkill County, Pennsylvania

Prepared For

Pine Grove Township 175 Oak Grove Road Pine Grove, PA 17963

September 2026 Project No. 0326-609038.02

Copyright 2026, of Alfred Benesch & Company. All rights reserved. This plan and design content is the property of Alfred Benesch & Company. Use, reuse, reproduction or modification of this plan or design information, or any part thereof, is strictly prohibited, except by written permission of this firm.

Pine Grove Township |Culvert No. 1 Channel Grading| Project Manual|i

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PENNDOT SHORT FORM DOCUMENTS

Proposal and Contract *

Attachment 1 for Proposal and Contract *

Special Provisions to Contract (Attachment 1A) *

Proposal and Contract Instructions

Attachment 2 Performance Bond

Attachment 3 Payment Bond

Attachment 4 Affidavit Accepting Provisions of the Workmen’s Comp. Act *

Attachment 5 Anti-Collusion Affidavit *

Attachment 6 Notice of Completion

Attachment 7 Insurance Requirements

Attachment 8 Certification of Bidder Regarding Equal Employment Opportunity *

OTHER EXHIBITS

Bid Bond *

Agreement of Surety *

Certificate of Compliance (CS-4171)

Nondiscrimination/Sexual Harassment Clause *

Contractor’s Statement of Compliance with CDL Testing Program *

Compliance with the Prohibition of the Illegal Alien Labor Act *

Compliance with the State Contractors Responsibility Program *

Contract Provisions Right to Know Law *

Certification of Non-Segregated Facilities *

Contractor Integrity Provisions *

Provisions Concerning the Americans with Disability Act *

Public Works Employment Verification Form *

Statement of Bidders Qualifications Form *

PA1 Call

Location Map

Construction Plans

* Submit with Bid

TABLE OF CONTENTS

Pine Grove Township |Culvert No. 1 Channel Grading | Project Manual

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Pine Grove Township – Culvert No. 1 Channel Grading – Project# 0326-609038.02 ADVERTISEMENT FOR BIDS Section 001000

AD-1

ADVERTISEMENT FOR BID

SEALED BIDS for the Pine Grove Township (Schuylkill County) CULVERT NO.1 CHANNEL GRADING will be received online via the PennBid Program by Pine Grove Township until Monday, October 12, 2026, at 12:00 P.M. (prevailing time) and will be publicly announced during the Township Supervisors Regular Meeting scheduled on Wednesday, October 14, 2026, at 6:00 P.M. Bid results will be available online at http://PennBid.bonfirehub.com following the meeting.

The project will consist of channel grading at a 4 ft bottom width and 2:1 side slope to expose and match the existing channel for a total of 135 ft downstream to provide positive drainage from a previously installed elliptical pipe. Tree removal will be required for construction access and grading. The items of work are identified more specifically in the Project Specifications. The entire project will be awarded to one (1) Contractor.

All documents and project details are available at no cost at http://PennBid.bonfirehub.com

A certified check or bank draft, payable to the order of PINE GROVE TOWNSHIP, negotiable US Government Bonds (at par value), or satisfactory Bid Bond executed by the Bidder and acceptable surety in the amount of 10% of the Total Bid of construction shall be submitted with each bid.

The SUCCESSFUL BIDDER will be required to furnish and pay for satisfactory Performance and Payment Bond, each in the amount of 100% of the Contract Price with a corporate surety approved by the Owner.

This bid is for a public works contract and bidder is therefore subject to the provisions, duties, obligations, and penalties of the Public Works Employment Verification Act, 43 P.S. 167.1-167.11. All submitted bids shall be accompanied with the Public Works Employment Verification Form.

The Owner reserves the right to waive any informality or to reject any or all items or portions thereof or to waive any technicalities and informalities in the bid for the best interest of the Owner.

No bidder shall withdraw a bid within sixty (60) days after the actual date of the Bid opening.

PINE GROVE TOWNSHIP

MR. SHELBY SATTIZAHN, CHAIRMAN

TO: POTTSVILLE REPUBLICAN, POTTSVILLE, PA

PLEASE PUBLISH ON:

1. TUESDAY, September 29, 2026

2. FRIDAY, October 2, 2026

PLEASE SEND INVOICE TO: PINE GROVE TOWNSHIP

175 OAK GROVE ROAD

PINE GROVE, PA 17963

ATTENTION: MR. SHELBY SATTIZAHN, CHAIRMAN

PLEASE SEND CONFIRMATION OF PUBLICATION TO:

MARIANN GRABISH

mgrabish@benesch.com http://pennbid.bonfirehub.com/

PENNDOT SHORT FORM DOCUMENTS

PROPOSAL AND CONTRACT

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MS-944 03-07

DISTRICT 5-0

PROPOSAL & CONTRACT (THIS PROPOSAL INCLUDES

(WHEN EXECUTED) INSTRUCTIONS TO BIDDERS)

A. DEPOSIT OF PROPOSALS.

All Bid proposals shall be clearly marked Pine Grove Township

“Pine Grove Township Culvert No. 1 Municipality Name and Type

Channel Grading Proposal Bid Proposal Due By

Monday, October 12, 2026” 570-345-4202 Date Telephone No.

Mayanna Kroh

Secretary

Sealed Proposals will be received on or before

12:00 p.m., on Monday, October 12, 2026. 175 Oak Grove Road

Time and Date Address

Bids will be announced at approximately Pine Grove, PA 17963

6:00 p.m., on Wednesday, October 14, 2026. Proposals must be submitted online at:

Time and Date http://PennBid.bonfirehub.com

1. The contractor proposes to furnish and deliver all materials (including Form CS-4171, Certificate of Compliance and/or TR-465 Daily Bituminous Mixture Certification) and to do and perform all work on the following project as more specifically set forth in the Schedule of Prices (Attachment), in accordance with drawings and specifications on file at http://PennBid.bonfirehub.com. This form (MS-944) will serve as the proposal and contract form for the awarded contractor.

2. Requirements for bidders include the supplements and special requirements contained herein and/or attached hereto and current PennDOT specifications (Publication 408). Bidders do not have to be prequalified by PennDOT.

3. If designated as the successful bidder, the contractor will 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 December 11, 2026. If all work is not completed on time, liquidated damages will be assessed at the rate of $975.00 per additional calendar day.

4. Accompanying this proposal is a certified check or bid Bond in the amount of 10% 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

-2-required; and that all work is payable on the basis of the unit prices listed on the Schedule of Prices (Attachment 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 performance bond, conditioned upon the faithful performance of the contractor in accordance with the plans, specifications and conditions thereof, and a 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; and an affidavit accepting the provisions of the Workmen’s Compensation Act of 1915, as amended.

7. “The parties agree that the relationship between the Contractor and the Municipality 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 the Municipality. Contractor hereby certifies, represents and warrants to the Municipality 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

ATTACHMENT 1 FOR PROPOSAL AND CONTRACT

ATTACHMENT 1- Base Bid

TO MS - 944 ( PROPOSAL AND CONTRACT MS - 944 )

County: Schuylkill Municipality: Pine Grove Township

Project Number: 0326-609038.02

LOCATION OF WORK:

DESCRIPTION OF WORK:

Approximate *Description

2 Quantiities 4

4201-0001 1 LS Clearing and Grubbing

0203-0001 250 CY Class 1 Excavation

0608-0001 1 LS Mobilization

0804-0032 5 LBS Formula T Temporary Grass Mix, Including Mulch

0804-0033 4 LBS Formula W Wetland Conservation Mix, Including Mulch

0806-0102 270 SY

Temporary Ultra Short-Term, Rolled Erosion Control

Product, Type 1C

4849-0010 1 EA Construction Access

0855-0003 1 EA Pump Water Filter Bag

0867-0012 54 LF Compost Filter Sock, 12" Diameter

9000-0001 1 EA Temporary Pump Bypass System

SUBTOTAL

TOTAL AMOUNT OF BID

* 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.

SUBTOTAL FROM OTHER ATTACHMENTS

- 3A -

Item

1 No.

Unit

Unit

5 Price

Total

ESCALATOR CLAUSE: (if adopted by Municipality.)

For Informational Purposes Only - Please complete on PennBid None

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LOCATION 1:

Oak Grove Rd (T-866) Culvert No.1 between Beuchler Ln (T-876) and Circle Dr (T-882)

(135' in length, average 4' width)

The contractor shall clear site as required and install all necessary temporary Erosion Control Features and construct the Temporary Pump Bypass system and divert flow around the construction area. The contractor shall then excavate and remove existing sediment buildup in the stream channel and regrade the channel to provide positive flow from the previously installed elliptical pipe. Stabilize all disturbed areas as indicated on the plans with proper seeding and soil supplements. Clearing and grubbing shall include tree removal (2 large trees over 2 ft diameter and approx. 6 smaller trees under 2 ft diameter). Work shall include the following incidental items: sweeping of roadway and roadway paving restoration (if damages occur during construction). Contractor to properly dispose of excavated material.

SPECIAL PROVISIONS TO CONTRACT

(ATTACHMENT 1A)

County: Schuylkill Municipality: Pine Grove Township Benesch No.: 0326-609038.02

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Attachment 1-A

SPECIFICATIONS AND SPECIAL PROVISIONS TO CONTRACT MS-944

CONTAINS IMPORTANT INFORMATION FOR THE CONTRACTOR

The Prime Contractor and Subcontractors must comply with all of the following provisions:

TRAFFIC CONTROL

- Traffic Control and Safety Devices to be provided by the Contractor. (Maintenance and Protection of Traffic to comply with current MUTCD, PennDOT Publication 212 and PennDOT Publication 213.)

GENERAL

-- For further information regarding the project, please submit questions through PennBid by 12:00 PM

Wednesday October 7, 2026.

- Delivery tickets for all materials is required.

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

- The Bidder must supply certified truck weight slips for bituminous material and aggregate used on the job.

- No payments will be made until the bidder has supplied all required designs, delivery slips and certifications.

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

- Work schedule must be coordinated with the Municipality and must be completed by December 11, 2026.

- Work to be completed between October 14, 2026, and December 11, 2026. After December 11, 2026, liquidated damages apply at the rate of $975.00 per calendar day.

- Roadway to be power broomed by the Contractor at end of project.

- Excess construction materials are to be removed by the Contractor.

- Municipality and its Representative will inspect the project.

- Need Bill of Lading for each shipment of bituminous material per Section 702.1(c) of PENNDOT Specifications Form

408.

- Completion of NON-COLLUSION AFFIDAVIT required.

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

- Contractor is responsible for defects that occur within one year of applications.

- Final Completion Certificate, “MS-NCP Notice of Completion” is required at the completion of the project.

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

- Bidders do not have to be PENNDOT prequalified.

- Contractor required to review project with road foreman prior to submitting bid. Call 570-624-6817 for a meeting date.

- Contractor to supply proof of CDL Drug and Alcohol Compliance upon award of the bid.

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

- The Municipality intends to award the contract to one bidder; bidders need to bid on all items.

- The Municipality reserves the right to accept or reject any and or all proposals or portions thereof, and to delete projects and/or portions of the project depending on budgetary constraints.

- A Fuel surcharge will not apply to this contract.

PENNSYLVANIA PREVAILING WAGES

PA Prevailing Wages apply to road work contracts in excess of one hundred thousand dollars ($100,000).

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Attachment 1-A

SPECIFICATIONS AND SPECIAL PROVISIONS TO CONTRACT MS-944

CONTAINS IMPORTANT INFORMATION FOR THE CONTRACTOR

INSURANCE REQUIREMENTS

The awarded contractor shall purchase and maintain, at its expense, during the term of this contract and any renewals or extensions thereof, insurance issued by companies acceptable to the Municipality. See the INSURANCE REQUIREMENTS attachment.

PUBLIC WORK EMPLOYMENT VERIFICATION ACT

General. In accordance with Act 127 of 2012, known as the Public Works Employment Verification Act (“the Act”), effective January 1, 2013, 43 P.S. §§167.1-167.11, the Contractor shall use the Federal Government’s E-Verify system to ensure that all employees performing work on the project, including subcontractor’s employees, are authorized to work in the United States.

Verification Form. The Contractor shall verify the employment eligibility of each new employee hired after January 1, 2013 and submit the Commonwealth Public Works Employment Verification Form (“Form”) included in the bid package attachments to the Municipality.

Contractor. Mail the Form, signed by an authorized representative of the Contractor to the Municipality along with the Performance and Payment Bonds as specified by the contract documents. Failure or refusal to provide the Form will be considered a refusal to comply with bidding requirements, will result in rejection of the bid, and may subject the Contractor to the enforcement activities, sanctions and civil penalties specified in the Act.

Subcontractor. The Prime Contractor will obtain a Form signed by an authorized representative of any subcontractor performing work on the project, possessing sufficient knowledge to make the representations and certifications on the Form. The Prime Contractor shall submit the Form to the Municipality prior to requesting subcontractor approval and before the subcontractor performs any work. Failure or refusal to provide the Form will be considered a refusal to comply with subcontractor approval requirements, will result in rejection of the subcontractor request, and may subject the subcontractor to the enforcement activities, sanctions and civil penalties specified in the Act.

The Prime Contractor shall include information about the requirements of the Act in all subcontracts.

Department of General Services. The Department of General Services is the Commonwealth agency responsible for enforcement and administration of the Act. Please direct questions about the Act to:

Department of General Services Public Works Employment Verification Compliance Office Room 105 Tent Building 18th and Herr Streets Harrisburg, PA 17125 Fax: 717-214-3669

-6-

ITEM NO. 4201-0001 CLEARING AND GRUBBING

In accordance with Sections 0203 and 0810 of PennDOT Publication 408 in its latest revision and as follows:

Description: Removal of organic matter within the limits of excavation including selective tree removal (2 large trees over

2 ft diameter and approximately 6 small trees under 2 ft diameter).

Construction: All items of work necessary to remove organic matter within the excavation limits

Unit of Measurement: LUMP SUM (LS)

ITEM NO. 4849-0010 CONSTRUCTION ACCESS

In accordance with Section 0849 of PennDOT Publication 408 in its latest revision and as follows:

Description: Construction, maintenance, and removal of a temporary rock construction entrance and/or timber matting entrance. First 50 ft at a minimum must be rock. The remaining 100 ft can either be rock or timber matting for access.

Construction: All items of work necessary to provide construction access.

Unit of Measurement: EACH (EA)

ITEM NO. 9000-0001 TEMPORARY BYPASS SYSTEM

In accordance with PennDOT Publication 408 and Standards of Roadway Construction in their latest revisions and as follows:

Description: Temporarily block stream channel and pump water around construction site.

Material:

• Upstream and Downstream Cofferdams

• Temporary bypass pump

Construction: All items of work necessary to temporarily block upstream and downstream channels during construction and pump water from upstream across Oak Grove Road to the downstream channel below all construction work.

Unit of Measurement: EACH (EA)

-7-

Attachment 1-A

SPECIFICATIONS AND SPECIAL PROVISIONS TO CONTRACT MS-944

CONTAINS IMPORTANT INFORMATION FOR THE CONTRACTOR

GENERAL DESCRIPTION OF WORK

1. LOCATION 1 (BASE BID): Oak Grove Rd (T-866) Culvert No.1 between Beuchler Ln (T-876) and

Circle Dr (T-882).

(135’ in length, average 4' width)

The contractor shall clear site as required and install all necessary temporary Erosion Control Features and construct the Temporary Pump Bypass system and divert flow around the construction area. The contractor shall then excavate and remove existing sediment buildup in the stream channel and regrade the channel to provide positive flow from the previously installed elliptical pipe. Stabilize all disturbed areas as indicated on the plans with proper seeding and soil supplements. Clearing and grubbing shall include tree removal (2 large trees over 2 ft diameter and approx. 6 smaller trees under 2 ft diameter). Work shall include the following incidental items: sweeping of roadway and roadway paving restoration (if damages occur during construction). Contractor to properly dispose of excavated material.

* NOTE: The length of the work and quantity of material needed on these roadways may be reduced or increased depending on cost and budgetary constraints.

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.

Contractor’s Representative Date Municipality’s Representative Date

Company Municipality

PERFORMANCE BOND

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MS-944 (02-01) PERFORMANCE BOND Attachment 2 (REPRODUCE LOCALLY) (With Corporate Surety)

KNOW ALL MEN BY THESE PRESENTS, that we, _______________________________________________

(NAME AND ADDRESS OF CONTRACTOR)

as Principal and ____________________________________________________________________________________

(SURETY COMPANY)

a corporation incorporated under the laws of the State of _____________________________________________as Surety

(NAME OF STATE)

are held and firmly bound unto ____________________________________________________ . In the full and just sum of _________________________________________________________ ($ _____________________________) dollars lawful money of 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 bouden 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 obligations such that if the 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 contract 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 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)

SEAL Attest / Witness CONTRACTOR

_____________________________________ BY:___________________________________________________

TITLE TITLE

SEAL Attest / Witness ___________________________________________________

SURETY COMPANY

____________________________________ BY:____________________________________________________

TITLE TITLE

PAYMENT BOND

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MS-944 PAYMENT BOND Attachment 3

KNOW ALL MEN BY THESE PRESENTS, that we, _______________________________________________ of _____________________________________, as PRINCIPAL and ________________________________________ 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 true 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 to 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 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 therefore, may sue in assumpsit’s on this Payment bond in his, 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 or 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:_______________________________________________

TITLE TITLE

WITNESS:

SURETY COMPANY

______________________________________ BY: ______________________________________________

TITLE TITLE

AFFIDAVIT ACCEPTING PROVISIONS OF THE

WORKMEN’S COMP. ACT

-11-

MS-944 Attachment 4

AFFIDAVIT RE

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 accepted the provisions of the Workmen’s Compensation Act of 1915 of the Commonwealth of Pennsylvania, with its supplements and amendments, and have insured their liability hereunder in it accordance with the terms of said

Act with _________________________________________________________________________________________

(SURETY COMPANY)

(TYPE OR PRINT) CONTRACTOR

BY: ______________________________________

SIGNATURE

Sworn to and subscribed before me this ________________________________________________________ day of

_______________________________________A.D. 20 ____________

My Commission Expires ___________________________

(DATE)

ANTI-COLLUSION AFFIDAVIT

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D-7126 ( 6-99 )

ANTI-COLLUSION AFFIDAVIT

County Schuylkill

Municipality Pine Grove Township

Project Number 0326-609038.02

State of Pennsylvania 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)

BY

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

Notary Public

My Commission expires

NOTICE OF COMPLETION

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MS-NCP

MUNICIPALITY Pine Grove Township, Schuylkill County

NOTICE OF COMPLETION

IN REFERENCE TO PROJECT NO.: 0326-609038.02

Name of Contractor:

Performance of work as specified on the above numbered contract is completed and final pavement inspection has been made by the contractor and municipality in accordance with the terms of the contract awarded.

DATE OF AWARD:

Signature of Municipality

Signature of Contractor

Both copies of this form to be filled by the Contractor-Municipality on completion of final pavement restoration.

THIS PORTION TO BE COMPLETED BY MUNICIPALITY

FINAL COMPLETION CERTIFICATE

By the affixing of my signature I hereby certify that final inspection has been made and all work has been performed in accordance with the above contract # and is hereby accepted by the municipality as completed.

Authorized Agent for the Municipality

*DATE: _______________

* The Bidder is responsible for maintenance of permanent pavement repairs for a period of one year from this date.

INSURANCE REQUIREMENTS

Pine Grove Township – Culvert No. 1 Channel Grading Schuylkill County, Pennsylvania

Benesch No. 0326-609038.02

INSURANCE REQUIREMENTS

The awarded Contractor shall purchase and maintain, at its expense, during the term of this contract and any renewals or extensions thereof, the following types of insurance issued by companies acceptable to the Municipality.

1. Workmen’s compensation insurance sufficient to cover all of the employees of the contractor working to perform this contract as required by the laws of the Commonwealth.

2. Comprehensive general liability insurance, property damage insurance, and where appropriate automobile liability insurance. The minimum amount of coverage shall be $250,000.00 per person and $1,000,000.00 per occurrence for bodily injury, including death and $250,000.00 per person and $1,000,000.00 per occurrence for property damage.

These coverages shall be occurrence-based. The policy shall name the Municipality and Alfred Benesch & Company as an additional insured and shall contain a provision that the coverages afforded thereunder shall not be cancelled or changed unless at least thirty (30) days prior written notice has been given to the Municipality.

Prior to the commencement of work, the Contractor shall provide the Municipality with a current certificate(s) of insurance showing the required coverages and provisions.

3. Your attention is directed to the hold harmless and indemnification provision:

“The Contractor shall hold the Municipality harmless and indemnify the Municipality against any and all claims, demands, and actions based upon or arising out of any activities performed by the Contractor and its employees and agents under this Contract and shall, at the request of the Municipality, defend any and all actions brought against the Municipality based upon any such claims or demands.”

Signature

CERTIFICATION OF BIDDER REGARDING

EQUAL EMPLOYMENT OPPORTUNITY

CERTIFICATION OF CONTRACTOR REGARDING EQUAL EMPLOYMENT

OPPORTUNITY

COMMONWEALTH OF PENNSYLVANIA

DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT

BUREAU OF HOUSING AND DEVELOPMENT

SMALL COMMUNITIES PROGRAM DIVISION

CERTIFICATION OF BIDDER REGARDING EQUAL EMPLOYMENT OPPORTUNITY

INSTRUCTIONS

This certification is required pursuant to Executive Order 11246 (30 F.R 12319-25). The implementing rules and regulations provide that any bidder or prospective contractor, or any of their proposed subcontractors, shall state as an initial part of the bid or negotiations of the contract whether it has participated in any previous contract or subcontract subject to the equal opportunity clause; and, if so, whether it has filed all compliance reports due under applicable instructions.

Where the certification indicates that the bidder has not filed a compliance report due under applicable instructions, such bidder shall be required to submit a compliance report within seven calendar days after bid opening. No contract shall be awarded unless such report is submitted.

CERTIFICATION BY BIDDER

NAME AND ADDRESS OF BIDDER (Include ZIP Code)

1. Bidder has participated in a previous contract or subcontract subject to the Equal

Opportunity Clause.

Yes No

3. Bidder has filed all compliance reports due under applicable instructions, including SF- 100.

Yes No None Required

4. Have you ever been or are you being considered for sanction due to violation of Executive

Order 11246, as amended?

Yes No

NAME AND TITLE OF SIGNER (Please Type)

SIGNATURE DATE

OTHER EXHIBITS

BID BOND

EJCDC C-435 Bid Bond (Damages Form) Prepared by the Engineers Joint Contract Documents Committee.

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

Attest: Attest:

Signature Signature

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.

AGREEMENT OF SURETY

AS-1

(Note: This Agreement must be properly executed and must accompany the certified check or bid bond, whichever is furnished as proposal security).

KNOW ALL MEN BY THESE PRESENTS, that we , as Surety, a corporation existing under the laws of the State of _________________________________________________ and authorized to transact business in the Commonwealth of Pennsylvania, hereby agree to execute within the time limit specified in the Contract, the Bonds, in the forms and in the amounts required for to faithful performance and proper fulfillment of the Contract for the ________________________________________________________ on behalf of hereinafter called the Bidder, provided that the above Contract be awarded to the Bidder within sixty

(60) days after the date of receipt of Bids; and the Surety further agrees that should the Surety, after notification of such award, omit or refuse to execute the required bonds, then the Surety shall pay to ______________________________________________________, any difference between the total amount specified in said Bidder's proposal for the required work and the amount for which said Owner may procure the same work, if the latter amount be in excess of the former, and after deduction therefrom of payment made by reason of the forfeiture of the Proposal Security.

DATE CORPORATE SURETY

CORPORATE SEAL

BY

TITLE

BUSINESS ADDRESS

CERTIFICATE OF COMPLIANCE (CS-4171)

1. uCOUNTY:_________________________ uLR/SR:____________ uSEC/SEG:____________ uECMS#:____________ (u - To be completed by the party that will ship the material to the project, otherwise enter N/A.)

2. I / WE hereby certify that the material listed on line 5 was:

If a single company performs more than one operation (e.g., a company manufactures and coats guiderail), more than one box may be checked.

¨Manufactured ¨Fabricated ¨Coated ¨Precasted ¨Produced By_____________________________________________________________ ____________________________________________

3. and the party listed above certifies that the material(s) on line 5 meets the requirements of Publication 408, Section(s) ______________________________________________________________________________________ AASHTO, ASTM, Federal or other designation ______________________________________________________________________

4. The material listed below is being shipped to (Company Name): __________________________________________________________ 5.

6. ¨CHECK HERE IF YOUR PRODUCT CONTAINS IRON OR STEEL. I certify the material identified above conforms to Sections 106.01 and 106.10(a) of Publication 408.

CHECK ONE OF THE TWO BOXES:

¨Product is 100% US steel. ¨Product contains minimal foreign steel in accordance with Act 3 and Buy America.

Attach Form CS-4171S with receipts or invoices.

CHECK THE BOX THAT APPLIES TO YOUR PRODUCT:

¨ ‘Identifiable Steel’ - Steel products that contain permanent markings that identify that the material was melted and manufactured in the

United States. Only Form CS-4171 is required.

¨ Steel Products and Products Containing Steel with In-Plant Inspection by the Department or a Department Representative -

For 100% US steel products where in-plant inspection has verified that the steel was melted and manufactured in the United States, only Form CS-4171 is required. For products where in-plant inspection has verified minimal foreign steel in accordance with Act 3 and Buy America, attach bills of lading or shipping documents for foreign steel, and attach Form CS-4171S with supporting documentation.

¨ ‘Unidentified Steel’ – Steel products that do not meet the definition of ‘‘Identifiable Steel’ and do not receive in-plant inspection as defined above. For 100% US steel products, attach supporting documentation including invoices, bills of lading and mill test reports that positively identify that the steel was melted and manufactured in the United States. For products containing minimal foreign steel in accordance with Act 3 and Buy America, attach bills of lading or shipping documents for foreign steel, and attach Form CS-4171S with supporting documentation.

7. VENDOR CLASSIFICATION (CHECK ONE BLOCK ONLY) -

¨#1 Manufacturer, Fabricator, Coater, Precaster ¨#2 Distributor, Supplier or *Private Label Company

Listed in Bulletin #15, or Producer Listed in Not Listed in Bulletin #15. Bulletin #15 or Agent listed in Bulletin #14, 41 or 42 Bulletin #14. Also, complete line 10

I certify that the above statements are true and to the best of my I certify that the material being supplied is one and the same as provided to us knowledge, fairly and accurately describe the product(s) listed. by the manufacturer listed on this document and quantities listed above are accurate.

8. By signing this document, you are certifying that this product meets the Build America, Buy America Act requirements and conforms to Section 106.11 of Publication 408.

9. NAME (print) : ____________________________________________ TITLE: ____________________________________________

COMPANY NAME : ______________________________________________ SHIPMENT/CERTIFICATION DATE: ______________

SIGNATURE : ______________________________________________________ DATE: __________________________________

10. List company that sold you the material(s) documented above: __________________________________________________________ (Complete if you checked Block # 2 on line # 7, otherwise leave blank.)

(Name of Manufacturer, Fabricator, Coater, Precaster or Producer) (Supplier Code) Must match exactly as in eCAMMS

(Company Name)

CS-4171 (2-25)

CERTIFICATE OF COMPLIANCE

www.pa.gov/penndot

By Responsible Company Offical

LOT NO. HEAT NO. QUANTITY UNIT OF

MEASURE APPROVED MATERIAL AS LISTED IN PENNDOT BULLETIN

LOT NO. HEAT NO. QUANTITY UNIT OF MEASURE APPROVED MATERIAL AS LISTED IN PennDOT BULLETIN

CS-4171 (2-25)

CERTIFICATE OF COMPLIANCE

www.pa.gov/penndot

NONDISCRIMINATION SEXUAL HARASSMENT CLAUSE

Pine Grove Township – Culvert No. 1 Channel Grading – Project# 0326-6090438.02

NONDISCRIMINATION/SEXUAL HARASSMENT CLAUSE

The Contractor agrees:

1. In the hiring of any employee(s) for the manufacture of supplies, performance of work, or any other activity required under the contract or any subcontract, the Contractor, each subcontractor, or any person acting on behalf of the Contractor or subcontractor shall not discriminate by reason of race, gender, creed, color, sexual orientation, gender identity or expression, or in violation of the Pennsylvania Human Relations Act (PHRA) and applicable federal laws, against any citizen of this commonwealth who is qualified and available to perform the work to which the employment relates.

2. Neither the Contractor nor any subcontractor nor any person on their behalf shall in any manner discriminate by reason of race, gender, creed, color, sexual orientation, gender identity or expression, or in violation of the PHRA and applicable federal laws, against or intimidate any employee involved in the manufacture of supplies, the performance of work, or any other activity required under the contract.

3. Neither the Contractor nor any subcontractor nor any person on their behalf shall in any manner discriminate by reason of race, gender, creed, color, sexual orientation, gender identity or expression, or in violation of the PHRA and applicable federal laws, in the provision of services under the contract.

4. Neither the Contractor nor any subcontractor nor any person on their behalf shall in any manner discriminate against employees by reason of participation in or decision to refrain from participating in labor activities protected under the Public Employee Relations Act, Pennsylvania Labor Relations Act or National Labor Relations Act, as applicable and to the extent determined by entities charged with such Acts' enforcement, and shall comply with any provision of law establishing organizations as employees' exclusive representatives.

5. The Contractor and each subcontractor shall establish and maintain a written nondiscrimination and sexual harassment policy and shall inform their employees in writing of the policy. The policy must contain a provision that sexual harassment will not be tolerated and employees who practice it will be disciplined. Posting this Nondiscrimination/Sexual Harassment Clause conspicuously in easily-accessible and well-lighted places customarily frequented by employees and at or near where the contracted services are performed shall satisfy this requirement for employees with an established work site.

6. The Contractor and each subcontractor shall not discriminate by reason of race, gender, creed, color, sexual orientation, gender identity or expression, or in violation of PHRA and applicable federal laws, against any subcontractor or supplier who is qualified to perform the work to which the contract relates.

7. The Contractor and each subcontractor represents that it is presently in compliance with and will maintain compliance with all applicable federal, state, and local laws, regulations and policies relating to nondiscrimination and sexual harassment. The Contractor and each subcontractor further represents that it has filed a Standard Form 100 Employer Information Report ("EE0-1") with the U.S. Equal Employment Opportunity Commission ("EEOC") and shall file an annual EE0-1 report with the EEOC as required for employers' subject to Title VII of the Civil Rights Act of 1964, as amended, that have 100 or more employees and employers that have federal government contracts or first-tier subcontracts and have 50 or more employees. The Contractor and each subcontractor shall, upon request and within the time periods requested by the commonwealth, furnish all necessary employment documents and records, including EE0-1 reports, and permit access to their books, records, and accounts by the contracting agency and the Bureau of Diversity, Inclusion and Small Business Opportunities for purpose of ascertaining compliance with provisions of this Nondiscrimination/Sexual Harassment Clause.

8. The Contractor shall include the provisions of this Nondiscrimination/Sexual Harassment Clause in every subcontract so that those provisions applicable to subcontractors will be binding upon each subcontractor.

9. The Contractor's and each subcontractor's obligations pursuant to these provisions are ongoing from and after the effective date of the contract through the termination date thereof. Accordingly, the Contractor and each subcontractor shall have an obligation to inform the commonwealth if, at any time during the term of the contract, it becomes aware of any actions or occurrences that would result in violation of these provisions.

10. The commonwealth may cancel or terminate the contract and all money due or to become due under the contract may be forfeited for a violation of the terms and conditions of this Nondiscrimination/Sexual Harassment Clause. In addition, the agency may proceed with debarment or suspension and may place the Contractor in the Contractor Responsibility File.

Management Directive 215.16 Amended (August 2, 2018)

This directive replaces, in its entirety, Management Directive 215.16, dated May 11, 2017.

Name:

Title:

Signed:

Date:

CONTRACTOR’S STATEMENT OF COMPLIANCE WITH CDL TESTING PROGRAM

Rev. 02/15 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…