12 - ST HELENS CWSRF DOCUMENTS.pdf

Form BC 1

Updated July 2020

State of Oregon Department of Environmental Quality

Bidders List Contact: Regional Project Officer

The Bidders List applies only to Clean Water State Revolving Fund loans over $250,000, and includes all firms that bid or quote on prime contracts and subcontracts, per CFR Section 33.501. This document should be included in project bid packages.

This list must be kept current as long as the loan recipient receives Clean Water State Revolving Fund dollars for this particular loan. Failure to comply with this requirement is subject to post award remedies, spelled out in Chapter 40 of the Code of Federal Regulations, Section 31.43. The loan recipient must provide a copy of the Bidders List at the request of the DEQ, EPA or an auditor.

Loan Recipient CWSRF Loan Number Project Name

Business name and point of contact

Business mailing address, phone number and email address

Procurement on which the entity bid or quoted and bid closing date

Status as

MBE WBE Non-MBE/WBE https://www.oregon.gov/deq/wq/cwsrf/Pages/CWSRF-Contacts.aspx

Form BC 1

Updated July 2020

Loan Recipient CWSRF Loan Number Project Name

Business name and point of contact

Business mailing address, phone number and email address

Procurement on which the entity bid or quoted and bid closing date

Status as

MBE WBE Non-MBE/WBE

Alternative formats DEQ can provide documents in an alternate format or in a language other than English upon request. Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

mailto:deqinfo@deq.state.or.us

Oregon Department of Environmental Quality

Pre-bid Checklist Form BC2 Contact: Regional Project Officer

Prior to publishing each Request for Bids for CWSRF funded project(s), the loan recipient must complete, sign, and submit this Pre-bid Checklist to the DEQ Project Officer for approval.

Section 1 CWSRF and Section 2 General Requirements are required to be included in the bid documents.

Explain and justify any No or N/A answer. Attach additional sheets to explain special circumstances.

Section 3 Other is included as informational only, and not explicitly required by CWSRF. They may be legal requirements or best practices.

The loan recipient is responsible to ensure their request for bids complies with their own rules and policies and all applicable Oregon state laws.

Loan recipient:

Project Name:

CWSRF Loan No.

1. CWSRF Forms and Contract Language

The loan recipient may choose to either: (1) Require all bidders to complete each form and accept the language as part of the Request for Bid(s), or (2) Only require the preferred contractor/ successful bidder to complete them prior to or as part of the contract award.

Location in bid document Sect & Page Yes No NA

A. Required Forms

Are the following CWSRF required forms included in the bid documents?

BC 1 Bidders List

BC 4 Sworn Statement of Compliance

BC 5 Prevailing Wage

BC 6 List of Contacted Disadvantaged Business Enterprises

BC 7 Certificate of Independent Price Determination

BC 8 Fair Share Objectives: Six Good-Faith Efforts, Contract Administration and Contract Language

Location in bid document Sect & Page Yes No NA

BC 9 Certification of Lobbying Activities

BC 10 Disclosure of Lobbying Activities

BC 11 Certification of Non-Segregated Facilities

BC 12 Non-Discrimination Notice

BC 14 Contractor's Compliance with EO 11246 Statement

Explanatory Comments (from loan recipient for any non-Yes answer):

Location in bid document Sect & Page Yes No NA

B. Contract Requirements

i. Prevailing Wages: Davis- Bacon and BOLI

Does the bid documents pass the Davis-Bacon contract language through to the contractor and subcontractors?

See Appendix E Parts One and Two of loan agreement.

Do the bid documents establish the date on which Oregon Bureau of Labor and Industries (BOLI) prevailing wage rates are in effect for this project?

Note: BOLI prevailing wage rates are those in effect on the date the project specifications are first advertised for bidding

Do the bid documents explain and reference the Federal Department of Labor’s (DOL) Davis-Bacon Wage Determination in effect for this project, including possible revisions during the solicitation period?

Note: While the solicitation remains open, the loan recipient shall monitor www.wdol.gov weekly to ensure that the wage determination contained in the solicitation remains current. If DOL issues a wage determination modification more than 10 days prior to the deadline for bid submissions, the bid package shall be updated to incorporate this new determination.

For more information, see EPA’s guide to Davis-Bacon Wage Rate Requirements.

Explanatory Comments (from loan recipient for any non-Yes answer):

Location in bid document Sect & Page Yes No NA

B. Contract Requirements cont’d

ii. Domestic Preference: American Iron and Steel (AIS) or Build America, Buy America (BABA)

Do the bid documents pass the American Iron and Steel or Build America, Buy America contract language through to the contractor and subcontractors?

AIS: See Appendix H of the loan agreement. BABA: See Appendix H of the loan agreement

Do the bid documents sufficiently describe the American Iron and Steel or Build America, Buy America requirements for CWSRF funded projects?

Note: Review the Domestic Preference Overview Dec 2023 presentation.

http://www.wdol.gov/ https://www.oregon.gov/deq/wq/Documents/EPADavis-BaconHandbook.pdf https://www.oregon.gov/deq/wq/Documents/cwsrf-bc15slides.pdf

Explanatory Comments (from loan recipient for any non-Yes answer):

2. General Requirements

Location in bid document Sect & Page Yes No NA

Has the loan recipient’s legal counsel reviewed the bid documents for consistency with OR state law and loan recipient’s statutes and policies, and approved?

Are ineligible project costs, those not funded by CWSRF like O&M costs, separated from eligible costs as part of a separate bid item?

Are all major work items included in the bid documents?

Is a form provided for listing major equipment manufacturers or suppliers? Applies when there is equipment that must be prequalified.

Is there a contract agreement form included as one of the bid documents?

Do the bid documents include reference(s) to adequate testing requirements, for example sewers according to state standard specifications, pump stations per DEQ guidelines?

Note: Loan recipient may request bidders to address the matter of additional compensation for mitigation activities.

Do the bid documents include a requirement for an application for a National Pollutant Discharge Elimination System stormwater 1200-C permit, if necessary?

Note: The loan recipient may elect to apply for the permit instead of having the contractor do it If an agency required and approved erosion and sediment plan is completed before the Request for Bids, it may be included in the contract documents.

Location in bid document Sect & Page Yes No NA

If a 1200-C permit is not required for the project, do contract documents describe erosion and sediment control measures that will need to be followed during construction?

When items are specified by brand name, are three alternative products listed, or do the specifications state "or equal"?

Note: In general, sole source procurement is not permitted under the Oregon Administrative Rules, though exceptions are made. It is the responsibility of the loan recipient to show that an exception is warranted.

Do the bid documents require a pre-construction conference with the date, time and place to be determined?

Do the bid documents require the contractor to submit a construction schedule and to update the schedule when it no longer reflects construction progress?

Do the bid documents require that the contractor provide a cost breakdown?

Note: This is necessary when the bidder is providing a lump-sum bid, and in unit-price contracts which contain lump-sum items, to establish the basis for progress payments.

Explanatory Comments (from loan recipient for any non-Yes answer):

3. Other

Included as informational only, and not explicitly required by CWSRF, which may be legal requirements or best practices. The recipient is responsible to ensure the Request for Bids complies with of their own rules and policies and all applicable OR state laws.

Location in bid document Sect & Page Yes No NA

Is there a minimum of 45 days firm pricing required after bids are opened prior to bid award?

Is there a requirement for a bid bond equal to at least 5 percent of the total contract amount?

Are both a performance bond and a payment bond, each for 100 percent of the contract price, required?

Are the terms "responsible" and "responsive" adequately defined for bidders?

Are appropriate liquidated damages established?

Do the bid documents detail how the successful bidder will be determined when contract documents provide for multiple schedules, additives, alternates and other options?

Are understandable owner procurement protest procedures provided?

Location in bid document Sect & Page Yes No NA

Are the following insurance requirements specified?

Public liability

Property damage

Workman’s compensation

Fire

Extended coverage or all risk

Flood insurance

Location in bid document Sect & Page Yes No NA

Is there a mechanism for adjusting unit prices, should quantities lead/lag estimates by more than 15 percent?

Is a form provided for listing major equipment manufacturers or suppliers?

Note: This applies when there is equipment that must be prequalified. It discourages bid shopping.

Location in bid document Sect & Page Yes No NA

Is the contractor required to submit operation and maintenance data for project equipment prior to 50 percent completion of the contract schedule?

Is responsibility for various tests assigned?

Note: It is preferable that responsibility be assigned to the engineer rather than the contractor

BORROWER SIGNATURE

I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. In addition, I agree to pay the annual compliance determination fee invoiced annually by DEQ and all other fees required by Oregon Administrative Rules, Chapter 340, Division 045.

Name of Borrower Authorized Representative Title

Signature of Borrower Authorized Representative Date

Non-discrimination statement DEQ does not discriminate on the basis of race, color, national origin, disability, age or sex in administration of its programs or activities. Visit DEQ’s Civil Rights and Environmental Justice page.

Translation or other formats Español | 한국어 | 繁體中文 | Pусский | Tiếng Việt | العربیة 800-452-4011 | TTY: 711 | deqinfo@deq.oregon.gov https://www.oregon.gov/deq/about-us/Pages/titleVIaccess.aspx https://www.oregon.gov/deq/about-us/Pages/titleVIaccess.aspx https://www.oregon.gov/deq/about-us/Pages/titleVIaccess.aspx https://www.oregon.gov/deq/about-us/Pages/titleVIaccess.aspx https://www.oregon.gov/deq/about-us/Pages/titleVIaccess.aspx https://www.oregon.gov/deq/about-us/Pages/titleVIaccess.aspx https://www.oregon.gov/deq/about-us/Pages/titleVIaccess.aspx

BC3

Updated January 2022 1

State of Oregon Department of Environmental Quality

Bid Review Checklist Contact: Project Officer

The loan recipient completes this form and submits it to the DEQ project officer along with:

1. a copy of the bid tabulation;

2. a copy of the apparent low bidder's bid package; and

3. proof of bid advertisement.

DEQ will review these documents before final approval of bid award.

Loan Recipient: CWSRF Project No.

Apparent Low Bidder: Date:

Bid Amount: Engineer’s Estimate

Reviewer’s Name and Title:

BIDDER FORMS: The following signed documents from the apparent low bidder must be included for DEQ to participate in this project’s funding. Documents that are not applicable should be marked "NA" and signed and dated.

Yes No N/A Form # Description

BC 1 Bidders List

BC 4 Sworn Statement of Compliance with Disadvantaged Business Enterprises Requirements

BC 5 Prevailing Wage Agreement

BC 6 List of Contacted Disadvantaged Business Enterprise

BC 7 Certificate of Independent Price Determination

BC 8 Six Good Faith Efforts, Contract Administration and Contract Language

Updated January 2022 2

BC 9 Certification Regarding Lobbying Activities

BC 10 Disclosure of Lobbying Activities (if any)

BC 11 Certification of Non-segregated Facilities

BC 12 Non-discrimination in Employment: Notice to Labor Unions or Other Organizations of Workers

BC 14 Contractor's Compliance Statement (with Executive Order #11246)

LOAN RECIPIENT/BORROWER FORMS: The following signed documents from the loan recipient must be included for DEQ to participate in this project’s funding.

Yes No N/A Form # Description

BC 1 Bidders list

BC 5

BOLI wage determination date:

BOLI wage amendment date:

BC 8 Six Good Faith Efforts, contract administration and contract language

Answers to the following questions must be “Yes” for DEQ to participate in this project’s funding.

Explain any “No” answers in the space provided under “Note.”

Yes No Description Note

Have pre-bid construction documents been approved by DEQ?

Date of approval? ____________________

Has a bid bond equal to at least 5 percent of the bid been included?

If applicable, does pre-qualified equipment meet requirements?

If applicable, are addenda acknowledged?

Is this project required to comply with Davis-Bacon?

If yes, the Department of Labor Wage Determination in effect at the time of contract award must be incorporated into the construction contract. The wage determination in effect at the time of contract award is:

Updated January 2022 3

1. Wage Determination #:

2. Modification #:

3. Publication Date:

If the low bid was contested by another bidder, has the protest been resolved?

Is award to lowest responsive, responsible bidder justified in lieu of re-advertising?

Recommendation for contract award

In my determination, the lowest responsive, responsible bidder is, and I recommend that this entity be awarded the contract.

Reviewer’s Signature: ____________________________________ Date: ____________________

Alternative formats

DEQ can provide documents in an alternate format or in a language other than English upon request.

Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

Sworn Statement of Compliance Contact: Regional Project Officer

Sworn Statement of Compliance with Small, Women and Minority Business Utilization Requirements

To be eligible for award of this contract, each bidder must execute, and submit, as part of their proposal, and together with their bid, the following certification relating to SBE/WBE/MBE participation. The certification below shall be deemed a part of the resulting contract.

The bidder has taken the following affirmative steps in awarding subcontracts:

(1) Include qualified small, minority and women’s businesses on solicitation lists

(2) Insure that small, minority and women’s businesses are solicited whenever they are potential sources

(3) Divide total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation of small, minority and women’s businesses

(4) Use the services and assistance of the Small Business Administration and the Minority Business Development Agency of the U.S. Department of Commerce as appropriate.

Contract # _____________________________________________________________

Contract Title: __________________________________________________________

Name of Company: ______________________________________________________

Signature of Authorized Official _______________ Date___________

Name and Title of Signer_______________________

Alternative formats DEQ can provide documents in an alternate format or in a language other than English upon request.

Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

Updated May 2019

Form BC 4

Form BC5

Updated May 2021 1

State of Oregon Department of Environmental Quality

Prevailing Wage Agreement Contact: Regional Project Office

The loan recipient, prime contractor and subcontractors all must initial and sign this form.

• The prime contractor copy must be submitted as part of the bid/proposal to the loan recipient.

• A copy of this form signed by the loan recipient and the prime contractor must be submitted with the contract copy to DEQ.

• The prime contractor must obtain a signed copy of this form from each subcontractor and retain them in the prime contractor’s contract file.

The undersigned understands that this public works project is funded in whole or in part by the Clean Water State Revolving Fund and is subject to the prevailing wage requirements of Oregon’s Bureau of Labor and Industry and the requirements of the Davis-Bacon Act.

_____ The undersigned agrees that, notwithstanding any other provision of law, all laborers and mechanics employed on the project must be paid wages at rates not less than those prevailing on projects of a similar character in the locality, as determined by the United States Secretary of Labor, or the Commissioner of the Oregon Bureau of Labor and Industries, whichever is higher, per ORS 279C.838; OAR 839-025-0035(2).

When a public works project is subject to both the state and federal prevailing wage rate laws, contractors and subcontractors must pay the higher of either the state or federal prevailing wage rates for the type of work being performed, per ORS 279C.838; OAR 839-025-0035(2).

Davis Bacon (federal law)

_____ Davis-Bacon applies to all treatment works construction projects for the entirety of the construction activities financed by a CWSRF loan through the completion of construction, no matter when construction commences.

_____ The Loan Agreement includes specific Davis-Bacon terms and conditions contract language that must be passed through to the prime contractor and all subcontractors in their contracts over $2,000.

_____ The Secretary of Labor's determination, regarding the prevailing wages applicable in the state of Oregon, are located at: http://www.wdol.gov/ While the solicitation remains open, the sub recipient shall monitor www.wdol.gov weekly to ensure that the wage determination contained in the solicitation remains current. The sub recipients shall amend the solicitation if DOL issues a modification more than 10 days prior to the closing date (i.e. bid opening) for the solicitation.

If DOL modifies or supersedes the applicable wage determination less than 10 days prior to the closing date, the sub recipients may request a finding from the State recipient that there is not a reasonable time to notify interested contractors of the modification of the wage determination. The State recipient will provide a report of its findings to the sub recipient.

http://www.wdol.gov/

Updated May 2021 2

If the sub recipient does not award the contract within 90 days of the closure of the solicitation, any modifications or supersedes DOL makes to the wage determination contained in the solicitation shall be effective unless the State recipient, at the request of the sub recipient, obtains an extension of the 90-day period from DOL pursuant to 29 CFR 1.6(c)(3)(iv). The sub recipient shall monitor www.wdol.gov on a weekly basis if it does not award the contract within 90 days of closure of the solicitation to ensure that wage determinations contained in the solicitation remain current.

_____The loan recipient or the prime contractor on behalf of the loan recipient maintains on-going wage information as a requirement of the CWSRF funding of a project subject to Davis-Bacon. The CWSRF program suggests using the wage matrix tool at this link http://www.deq.state.or.us/wq/loans/constructionForms.htm and instructions for the wage matrix at this link http://www.deq.state.or.us/wq/loans/docs/WageMatrixInst.pdf

_____The loan recipient conducts wage interviews with a representative group of workers during the project construction at 30 percent, 60 percent and 90 percent project completion. The loan recipient must conduct additional interviews if there is any reason to suspect a contractor or their subcontractor is at risk for violating wage requirements. As provided in 29 CFR 5.6(a)(6), all interviews must be conducted in confidence. The loan recipient must use Standard Form 1445 or equivalent documentation to memorialize the interviews.

Oregon Bureau of Labor and Industry (state law)

_____Bureau of Labor and Industry prevailing wage rates apply to projects over $50,000. Oregon prevailing wage rate regulations require every contractor or subcontractor employing workers on a public works project must pay to such workers no less than the applicable prevailing rate of wage for each trade or occupation, as determined by the commissioner, in which the workers are employed. OAR 839-025- 0035.

_____ The wage rates identified by the Commissioner of the Oregon Bureau of Labor and Industry are located at http://www.oregon.gov/boli/WHD/PWR/Pages/pwr_state.aspx

_____ The prevailing wage rates in effect at the time the bid specifications are first advertised are the Oregon wage rates that apply for the duration of the project. Prevailing wages obtained through the Bureau of Labor and Industry websites must be included in the bid solicitation and incorporated in all contracts resulting from the procurements.

_____All contractors and subcontractors shall file, with the Construction Contractors Board, a $30,000 public works bond with a corporate surety authorized to do business in this state. ORS 279C.836 The bond must provide that the contractor or subcontractor will pay claims ordered by Bureau of Labor and Industry to workers performing labor upon public works projects. It must be filed before starting work on a contract or subcontract for the project.

Payroll/Certified Statement (form WH-38)

Form WH-38 may be used by contractors for reporting their payroll as required by ORS 279C.845 on public works projects subject to the Prevailing Wage Rate Law. This form has not been officially approved by the United States Department of Labor, however it is designed to meet the requirements of the federal Davis-Bacon Act as well. Prevailing Wage Rate Forms.

http://www.deq.state.or.us/wq/loans/constructionForms.htm http://www.deq.state.or.us/wq/loans/docs/WageMatrixInst.pdf http://www.gsa.gov/portal/forms/download/115910 http://www.oregon.gov/boli/WHD/PWR/Pages/pwr_state.aspx http://egov.oregon.gov/BOLI/WHD/PWR/W_PWR_Forms.shtml

Updated May 2021 3

Signature Date

Title

Company

Alternative formats

Documents can be provided upon request in an alternate format for individuals with disabilities or in a language other than English for people with limited English skills. To request a document in another format or language, call DEQ in Portland at 503-229-5696, or toll-free in Oregon at 1-800-452-4011, ext. 5696; or email deqinfo@deq.state.or.us

Updated June 2025 Page 1

List of Contacted Disadvantaged Business Enterprises Contact: Regional Project Officer

Name of Business Certification # Contact Person

Phone Number

Date of Contact Reason for Non-participation

List of Disadvantaged Businesses Contacted Page 2

Name of Business Certification # Contact Person Phone Number Date of Contact Reason for Non-participation

DEQ does not discriminate on the basis of race, color, national origin, disability, age, sex, religion, sexual orientation, gender identity, or marital status in the administration of its programs and activities. Visit DEQ’s Civil Rights and Environmental Justice page.

List of Disadvantaged Businesses Contacted

Certificate of Independent Price Determination Contact: Regional Project Officer

The prime contractor must:

• Sign and submit this form as part of the bid/proposal to the loan recipient

• Include a signed copy in their contract

• Retain a signed copy of this form from each subcontractor

Bidder’s Name: _______________________________________________________________________

Address: ____________________________________________________________________________

a. The bid offeror certifies that:

1. The prices in this offer have been arrived at independently without, for the purpose of restricting competition, any consultation, communication or agreement with any other offeror or competitor relating to:

i. Those prices

ii. Intention to submit an offer

iii. Methods or factors used to calculate the prices offered

2. The prices in this offer have not been and will not be knowingly disclosed by the offeror, directly or indirectly, to any other offeror or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a negotiated solicitation) unless otherwise required by law

3. No attempt has been or will be made by the offeror to induce any other concern to submit or not to submit an offer for the purpose of restricting competition.

b. Each signature on the offer is considered to be a certification by the signatory that the signatory:

1. Is the person in the offeror's organization responsible for determining the prices being offered in this bid or proposal, and that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) above; or

2. Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) above;

3. As an authorized agent, certifies that the principals named below have not participated, and will not participate, in any action contrary to subparagraph (a)(1) through (a)(3) above; and

Form BC 7

4. As an agent, has not personally participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) above.

5. If the offeror deletes or modifies subparagraph (a)(2) above, the offeror must furnish with its offer a signed statement setting forth in detail the circumstances of the disclosure.

Insert full name of person(s) in the offeror's organization responsible for determining the prices offered in this bid or proposal, and the title of his or her position in the offeror's organization:

Full Name of Person(s) in the Offeror’s Organization

Title Date

Alternative formats DEQ can provide documents in an alternate format or in a language other than English upon request.

Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

Signature of Prime Contractor _______________________________________________

Signature of Subcontractor _______________________________________________

BC8

State of Oregon Department of Environmental Quality

Good Faith Efforts, Contract Administration and Contract Language Regional Project Officer

This form must be completed by the loan recipient, prime contractor and any subcontractor who will further subcontract on the Clean Water State Revolving Fund project within the scope of the loan.

All sections in this attachment must be initialed on the line provided and the form signed.

One completed attachment for the prime contractor must be submitted as part of the bid/proposal to the loan recipient.

One completed attachment for each subcontractor who will further subcontract must be submitted before the contract award.

A copy of those must be included in the contract copy to DEQ, along with one attachment initialed and signed by the loan recipient.

_____ DBE certification

All Minority Business Enterprises and Woman Business Enterprises must be certified by Oregon’s Office of Minority, Women and Emerging Small Businesses or by the state in which they are located. This office administers the Disadvantaged Business Enterprise, Minority Business Enterprise/Women Business

Enterprise, and Emerging Small Business programs.

_____ Good Faith Efforts

The good faith efforts are required methods to ensure that all DBEs have the opportunity to compete for procurements funded by the Clean Water State Revolving Fund. The loan recipient and their prime contractor are required to:

1. Ensure DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities. For Indian tribal, state and local government recipients, this will include placing DBEs on solicitation lists and soliciting them whenever they’re potential sources.

2. Make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process. This includes, whenever possible, posting solicitations for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date.

3. Consider in the contracting process whether firms competing for large contracts could subcontract with DBEs. For Indian tribal, state and local government recipients, this will include dividing total requirements when economically feasible into smaller tasks or quantities to permit maximum participation by DBEs in the competitive process.

4. Encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually.

https://www.oregon.gov/deq/wq/cwsrf/Pages/CWSRF-Contacts.aspx http://www.oregon4biz.com/How-We-Can-Help/COBID/ http://www.oregon4biz.com/How-We-Can-Help/COBID/

5. Use the services and assistance of the federal Small Business Administration, Minority Business

Development Agency of the U.S. Department of Commerce, and the state Office of Minority, Women and Emerging Small Business.

6. If the prime contractor awards subcontracts, require the prime contractor to take steps one through five above.

7. Native American provisions 40 CFR, Section 33.304

The recipient agrees to comply with the contract administration provisions of 40 CFR, Section

33.304. Any recipient, whether or not Native American, of an EPA financial assistance agreement for the benefit of Native Americans, is required to solicit and recruit Indian organizations and Indian-owned economic enterprises and give them preference in the award process prior to undertaking the six good faith efforts. If the efforts to solicit and recruit Indian organizations and Indian-owned economic enterprises is not successful, then the recipient must follow the six good faith efforts.

Contract administration _____ The Loan Recipient must require its prime contractor to employ the six good faith efforts even if the prime contractor has achieved its fair share objectives.

_____ If a DBE subcontractor fails to complete work under the subcontract for any reason, the Loan

Recipient must require the prime contractor to employ the six good faith efforts if soliciting a replacement subcontractor.

_____ The Loan Recipient must require its prime contractor to pay its subcontractor for satisfactory performance no more than 30 days from the prime contractor’s receipt of payment from the Loan

Recipient.

_____ The Loan Recipient must require written notification from its prime contractor prior to any termination of a DBE subcontractor for convenience by the prime contractor.

_____ Specific contract language

All contracts between the Loan Recipient and prime contractor, and prime contractor and subcontractors must include the following statement required by 40 CFR Part 33:

"The contractor shall not discriminate on the basis of race, color, national origin or sex in the performance of this contract. The contractor shall carry out applicable requirements of 40 CFR part 33 in the award and administration of contracts awarded under EPA financial assistance agreements. Failure by the contractor to carry out these requirements is a material breach of this contract which may result in the termination of this contract or other legally available remedies."

Updated May 2021 3

The undersigned has initialed the items above and understands the resulting responsibility for each item.

Accessibility Alternative formats DEQ can provide documents in an alternate format or in a language other than

English upon request. Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

Signature Date

Title

Company

Form BC 9

Certification Regarding Lobbying Activities Contact: Regional Project Officer

503-229-LOAN

This form must be signed by the prime contractor and submitted by the loan recipient by the time the contract is award. A copy must be included in the contract copy to DEQ. The prime contractor must obtain a signed copy of this form from each subcontractor, and retain them in the prime contractor’s contract file.

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

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

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

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

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

Signature Date

Alternative formats DEQ can provide documents in an alternate format or in a language other than English upon request.

Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

Updated May 2019

DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046

(See reverse for public burden disclosure.)

1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:

a. contract a. bid/offer/application a. initial filing

b. grant b. initial award b. material change

c. cooperative agreement c. post-award For Material Change Only:

d. loan year _________ quarter _________

e. loan guarantee date of last report ______________

f. loan insurance

4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime:

Tier ______, if known :

Congressional District, if known : Congressional District, if known :

6. Federal Department/Agency: 7. Federal Program Name/Description:

CFDA Number, if applicable: _____________

8. Federal Action Number, if known : 9. Award Amount, if known :

10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if (if individual, last name, first name, MI): different from No. 10a )

(last name, first name, MI ):

11. Signature:

Print Name:

Title:

Telephone No.: _______________________ Date:

Authorized for Local Reproduction

Standard Form LLL (Rev. 7-97)

Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less that $10,000 and not more than $100,000 for each such failure.

Prime Subawardee

Federal Use Only:

Form BC 10

INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.

2. Identify the status of the covered Federal action.

3.

4.

5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known.

6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizationallevel below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance

(CFDA) number for grants, cooperative agreements, loans, and loan commitments.

8.

9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.

10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action.

(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).

11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employeeof any agency, a Member of Congress, an officer or employeeof Congress, or an employeeof a Member of Congress in connectionwith a coveredFederalaction. Completeall items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

Identify the appropriateclassification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previouslysubmitted report by this reporting entity for this covered Federal action.

Enter the full name, address, city, State and zip code of the reporting entity. Include CongressionalDistrict, if known. Check the appropriateclassification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number;

Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001."

According to the PaperworkReduction Act, as amended,no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Managementand Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503.

Form BC 11

Updated January 2021

Certification of Non-Segregated Facilities Contact: Regional Project Officer

503-229-LOAN

This form must be signed by the prime contractor and submitted by the time of contract award from the

Loan Recipient. A copy must be included in the contract copy to DEQ. The prime contractor must obtain a signed copy of this form from each subcontractor, and retain them in the prime contractor’s contract file.

Applicable to federally-funded construction contracts and related subcontracts exceeding $10,000 which are not exempt from the Equal Opportunity clause.

The federally-assisted construction contractor certifies that they do not maintain or provide for their employees any segregated facilities at any of their establishments, and that they do not permit their employees to perform services at any location, under the contractor’s control, where segregated facilities are maintained. The federally-assisted construction contractor certifies further that they will not maintain or provide for their employees any segregated facilities at any of their establishments, and that they will not permit employees to perform services at any location, under the contractor’s control, where segregated facilities are maintained. The federally-assisted construction contractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause in this contract.

As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, rest rooms and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are, in fact, segregated on the basis of race, creed, color, or national origin, because of habit, local custom, or otherwise. The federally-assisted construction contractor agrees that (except where they have obtained identical certifications from proposed contractors for specific time periods) they will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause, and that they will retain a copy of such certification.

Signature Date

Name and Title of signer (please type)

DEQ can provide documents in an alternate format or in a language other than English upon request. Call

DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

Updated May 2019 1

Non-discrimination in Employment Notice to Labor Unions or Other Organizations of Workers

Contact: Regional Project Officer

503-229-LOAN

The CWSRF loan recipient must provide this notice to the contractor and subcontractor(s) advising the labor union or workers' representative of the contractor's commitments under Executive Order No. 11246.

The contractor will send a signed notice to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, and shall post copies of the notice in conspicuous places available to employees and applicants for employment.

TO: ___________________________________________________________________________________

NAME OF UNION OR ORGANIZATION OF WORKERS

The undersigned currently holds contract(s) with _____________________________________________

NAME OF LOAN RECIPIENT

Using funds or credit of the U.S. government, or one or more subcontractors with a prime contractor holding such contracts.

You are advised that under the provisions of the above contract(s) or subcontract(s) and in accordance with Section 202 of Executive Order 11246 dated Sept. 24, 1965, as amended, the undersigned is obliged not to discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin. This obligation not to discriminate in employment includes, but is not limited to, the following:

- EMPLOYMENT, UPGRADING, TRANSFER OR DEMOTION

- RECRUITMENT OR RECRUITMENT ADVERTISING

- RATES OF PAY OR OTHER FORMS OF COMPENSATION

- SELECTION FOR TRAINING INCLUDING APPRENTICESHIP, LAYOFF OR

TERMINATION

This notice is furnished to you pursuant to the provisions of the above contract(s) or subcontract(s) and Executive Order #11246.

CONTRACTOR OR SUBCONTRACTOR(S) DATE

Form BC 12

Updated May 2019 2

DEQ can provide documents in an alternate format or in a language other than English upon request. Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us

Updated March 2021

Form BC 13

Debarment and Suspension Requirements Contact: Regional Project Officer or call 503-229-LOAN

• List all companies proposed to perform work or provide goods/services, equal to or greater than $25,000, at the time the contract is awarded

• For each listed entity, provide a report from the System for Award Management database that shows an active registration with proof of no suspensions or debarments (“exclusions” )

• Submit completed form and reports to the DEQ project officer

The loan recipient must complete, sign and submit this form to the DEQ project officer before the loan project contract is awarded. Use additional pages if necessary.

Every contract, subcontract, professional services agreement and purchase order paid under this loan of an amount equal to or greater than $25,000 is subject to Subpart C of 2 Code of Federal Regulations Part 180 and 2 CFR Part 1532, entitled “Responsibilities of Participants Regarding Transactions (Doing Business with Other Persons).”

Registration and certification is available at the System for Award Management database (https://www.sam.gov/SAM/). User Guides for registration are available from SAM. Registration must be renewed annually.

This form is only submitted once, as part of the project loan contract approval. If additional companies receiving $25,000 or more become involved in the project, a System for Award Management report must be provided to DEQ as part of the Disbursement Request.

Loan recipient: Loan number:

Project:

Contractor name and mailing address

Phone number and email address

DUNS number or

CAGE code Known or expected amount to be paid https://www.sam.gov/SAM/

Updated March 2021

Contractor name and mailing address

Phone number and email address

DUNS number or CAGE code

Known or expected amount to be paid

Name and Title of Authorized Representative (type or print clearly) Date

DEQ can provide documents in an alternate format or in a language other than English upon request. Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

Form BC 14

Updated May 2019 1

State of Oregon Department of Environmental Quality

Contractor’s Compliance Statement Executive Order #11246 Contact: Regional Project Officer

503-229-LOAN

This form must be signed by the prime contractor and submitted by the time of contract award from the

Loan Recipient. A copy must be included in the contract copy to DEQ.

Date _____________________________

This statement relates to a proposed contract with ____________________________________________

(Name of CWSRF loan recipient) who expects to finance the contract with assistance from the Environmental Protection Agency. I am the undersigned bidder or prospective contractor. I represent that:

I have I have not participated in a previous contract or subcontract subject to Executive

Order 11246 of September 24, 1965 (regarding equal employment opportunity) or a preceding similar

Executive Order. I agree to comply with all the provisions of this Executive Order and the rules, regulations, and relevant orders of the Secretary of Labor. (41 CFR 60-1.4(b); 41 CFR 60 1.7 (b))

Signature Date

Name and Title of signer (please type)

Alternative formats

DEQ can provide documents in an alternate format or in a language other than English upon request.

Call DEQ at 800-452-4011 or email deqinfo@deq.state.or.us.

Translation or other formats Español | 한국어 | 繁體中文 | Pусский | Tiếng Việt | العربیة 800-452-4011 | TTY: 711 | deqinfo@deq.oregon.gov

Oregon Department of Environmental Quality

Project Sign Requirements Clean Water State Revolving Fund

The sign must be posted on the project site throughout the course of construction to permit public viewing. Sign requirements are described on the example below. DEQ allows the borrower to add their logo to the project sign, but not that of other funders.

Vinyl stickers of the DEQ logo and the EPA seal are supplied by your DEQ Project Officer.

Sign borders shall be equal on either side, with the longest line centered in the sign.

48”

DEQ logo placed to the left of center, and the EPA Seal placed to the right of center in the space between “Clean Water Investment” and Project Name.

Provide adequate supports for sign as site conditions may require. Keep sign a proper distance above prevailing grade to allow for public viewing.

DEQ does not discriminate on the basis of race, color, national origin, disability, age, sex, religion, sexual orientation, gender identity, or marital status in the administration of…