BID PACKAGE

For

Route 30 Signal Equipment Modernization Project

Green Light-Go Program

City of York York County, PA

July 1, 2026

TABLE OF CONTENTS

1. Instruction to Bidders

2. Bid Package

3. Traffic Signal Construction Plans (7 sheets)

INSTRUCTIONS TO BIDDERS

AND TECHNICAL SPECIFICATIONS

1. The work proposed as part of this Bid Package is as follows:

Loucks Road (SR 0030) / Roosevelt Avenue (SR 4001) The existing vehicular signal heads and pedestrian signal heads will be replaced along with new wiring for the new signal heads. The City of York will be purchasing the signal heads, but the contractor will be responsible for the installation and new wiring of the new signal heads. The controller assembly will be replaced including the MMU. Any recently installed equipment in the controller cabinet as part of the recent PennDOT project will be reused (i.e.

controller). The controller cabinet is not being replaced, just the equipment within the cabinet.

Loucks Road (SR 0030) / Fairlane Road & Shopping Center Driveway The existing vehicular signal heads and pedestrian signal heads will be replaced along with new wiring for the new signal heads. The City of York will be purchasing the signal heads, but the contractor will be responsible for the installation and new wiring of the new signal heads. The controller assembly will be replaced including the MMU. Any recently installed equipment in the controller cabinet as part of the recent PennDOT project will be reused (i.e.

controller). The controller cabinet is not being replaced, just the equipment within the cabinet.

Loucks Road (SR 0030)/Pennsylvania Avenue The existing vehicular signal heads and pedestrian signal heads will be replaced along with new wiring for the new signal heads. The City of York will be purchasing the signal heads, but the contractor will be responsible for the installation and new wiring of the new signal heads. The controller assembly will be replaced including the MMU. Any recently installed equipment in the controller cabinet as part of the recent PennDOT project will be reused (i.e.

controller). The controller cabinet is not being replaced, just the equipment within the cabinet.

2. The approximate quantities shown in the proposal (schedule of prices) are the best available estimate of the quantities of materials that the City of York will require during the contract period.

3. MS-944 The length of the Contract will be one hundred and eighty (180) days from Notice to Proceed.

4. Bidders shall submit the following with the respective bids:

a. Proposal and Contract MS-944 (pages 1 through 5);

b. Bid Bond (ten percent (10%)):

c. Special provisions to Contract MS-944 (Attachment #1-A), signed and dated by the Contractor;

d. Anti-Collusion Affidavit (D-7126 (7-09));

e. Public Works Employment Verification Form.

5. Contractor warrants they are in compliance with the Americans with Disabilities Act (Public Law 101-336) and that they will, in carrying out requirements of this Contract; comply in all respects with the provisions of the Act and its implementing regulations.

6. Contractor warrants they are in compliance with the United States Omnibus Transportation Employee Testing Act of 1991, and related Federal Highway Administration Regulations regarding commercial driver’s license (CDL) requirements for its employees; and that they will, in carrying out the requirements of the Contract, comply in all respects with the provisions of this Act.

7. All Successful Bidders will be required to furnish the following:

a. Certificate of Insurance, in accordance with attached requirements;

b. Performance Bond;

c. Payment Bond;

d. Workmen’s Compensation Affidavit.

8. All materials and workmanship must be in accordance with the Technical Provisions and PennDOT Publication 408 latest edition.

9. If applicable, all materials supplied under this Contract must be approved prior to delivery by submitting the job mix formula five (5) days prior to the start of construction. Form CS-4171 Certificate of Compliance, shall be supplied daily to the Engineer or City Representative.

10. Schedule of Prices for each project is listed within the MS-944 Attachment 1 within this bid package.

11. For the MS-944 Contract, the Contractor will furnish an itemized invoice and completed MS- NCP Notice of Completion form to the City or its Engineer.

12. All Work shall comply with any additional requirements stipulated in the Signal Permit plans, issued by the Pennsylvania Department of Transportation, a copy of which is incorporated herewith. Note that the Signal Permit plans will remain as is since this project is just upgrades to the existing signal equipment.

13. The City of York reserves the right to reject any or all proposals and to make an award which is in the best interest of the City. The Owner fully intends to construct the work for which bids are solicited. However, the Owner specifically reserves the right, which all bidders acknowledge by submission of a bid, to reduce quantities and/or eliminate projects to meet available finances. Reduction of quantities or elimination of projects will not constitute grounds of additional or compensatory charges to the successful bidder.

14. CONTRACTOR is required to comply with the rules and conditions of the Pennsylvania Department of Labor and Industry Prevailing Minimum Wage Determination, Serial No. 26- 06227 dated 6/29/26, a copy of which is attached hereto.

MS 944

The Contract will be awarded to the lowest responsible bidder, based upon the low total of Bid Items enclosed.

NOTE: The City of York reserves the right to reject any or all proposals and to make an award in the best interest of the City.

MS-944 (7-09)

TIME

, on the above Letting Date.

TIME

PROPOSALS MUST BE SUBMITTED

ELECTRONICALLY VIA PENNBID, THE ELECTRONIC

BID MANAGEMENT SYSTEM.

and specifications on file at as well as the supplements

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 special requirements contained herein and/ or attached hereto and current PennDOT Specifications (Publication 408), except (a) bidders need not be prequalified by PennDOT

INSTRUCTIONS ON PAGE 4

Bids will be electronically opened and read at

DATE

THIS PROPOSAL INCLUDES

INSTRUCTIONS TO BIDDERS

ADDRESS

A. DEPOSIT OF PROPOSALS.

Electronic Proposals will be received on or before

All bids shall be submitted electronically via the PennBid Program for letting on

PROPOSAL AND CONTRACT

( WHEN EXECUTED )

calendar days.complete all work within

3 Accompanying this proposal is a certified check or bid bond in the amount of 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 requirements of the proposal.

B. PROPOSAL OF:

The only person interested in the proposal as principal (s) is (are):1

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.

p ( ), p ( ) p q y (Sec.102.01), and (b) Volumetric testing of bituminous paving materials is not required (Sec. 409).

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 see attachment 1-A

-1-

It is hereby certified as follows:

NAME / ADDRESS OF CONTRACTOR

CONTRACTORS CERTIFICATION

All plans and specifications referred to above and the site of the work have been examined by the contractor. The contractor understands that the quantities indicated herein are approximate and are subject to change as may be required; and that all work is payable on the basis of the unit price listed on the Schedule of Prices. (Attachment 1).

Director of Public Works

MUNICIPALITY (NAME & TYPE)

City of York

James Gross

101 South George Street York, PA 17401

10:00 AM

10:00 AM

ten (10%)

August 11, 2026

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 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.

The contractor will provide the municipality with a performance bond, conditioned th f ithf l f f th t t i d ith th lupon the faithful performance of the contract 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 Works Contractors’ Bond Law of 1967; and an affidavit accepting the provisions of the Workmen’s Compensation Act of 1915, as amended.

BY: DATE:

TITLE:

CONTRACTOR

DATE:

TITLE:

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

WITNESSED OR ATTESTED BY:

MUNICIPALITY

BY:

ACCEPTED ON :

DATE

TITLE:

BY:

TITLE:

BY:

TITLE:SEAL

TITLE:

ATTESTED BY:

-2-

SEAL

County:

LS

0901-0001 LS Maintenance and Protection of Traffic

0954-0202 LF Signal Cable, 14 AWG, 5 Conductor

0954-0203 LF Signal Cable, 14 AWG, 7 Conductor

4955-3208 10 Ea Vehicular Signal Head, Three 12" Sections

4955-3209 2 Ea Vehicular Signal Head, Four 12" Sections

4955-3210 Ea Vehicular Signal Head, Five 12" Sections

Ea LED Countdown Pedestrian Signal Head, Type A

4952-1040 Ea Controller Assembly Replacement

SUBTOTAL

SHEET 4

Project Number: 113.083.24

ATTACHMENT 1

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

York Municipality: City of York

LOCATION OF WORK:

Loucks Road (SR 0030) / Roosevelt Avenue (SR 4001)

DESCRIPTION OF WORK:

The project includes replacing all vehicular and pedestrian signal heads with new signal heads and providing new wiring for the new signal heads. Also, the controller assembly will be replaced including the MMU. Any recently installed equipment in the controller cabinet as part of the PennDOT project will be reused.

ESCALATOR CLAUSE:( if adopted by Municipality.)

N/A

0608-0001 1 Mobilization

3,565

SCHEDULE OF PRICES

Item 1 No.

Approxim ate

Unit

*Description

Unit 5 Price

Total

4955-3722

- 3 -

* DESCRIPTION:

LS

0901-0001 LS

LF

4955-3208 Ea

4955-3722 Ea

4952-1040 Ea

SUBTOTAL SHEET

Maintenance and Protection of Traffic

Signal Cable, 14 AWG, 5 Conductor

Vehicular Signal Head, Three 12" Sections

Controller Assembly Replacement

ATTACHMENT 1

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

York Municipality: City of York

ESCALATOR CLAUSE:( if adopted by Municipality.)

N/A

Unit 5 Price

Total

Project Number: 113.083.24

LOCATION OF WORK:

SCHEDULE OF PRICES

Item 1 No.

Approximate 2 Quantities

Unit

*Description

Loucks Road (SR 0030) / Fairlane Road & Shopping Center Driveway

DESCRIPTION OF WORK:

The project includes replacing all vehicular and pedestrian signal heads with new signal heads and providing new wiring for the new signal heads. Also, the controller assembly will be replaced including the MMU. Any recently installed equipment in the controller cabinet as part of the PennDOT project will be reused.

- 4 -

0608-0001 Mobilization

0954-0202

LED Countdown Pedestrian Signal Head, Type A

* DESCRIPTION:

3,100

0608-0001 LS Mobilization

0901-0001 1 LS Maintenance and Protection of Traffic

0954-0202 3,695 LF Signal Cable, 14 AWG, 5 Conductor

LF

4955-3208 10 Ea Vehicular Signal Head, Three 12" Sections

4955-3210 2 Ea Vehicular Signal Head, Five 12" Sections

4955-3722 8 Ea LED Countdown Pedestrian Signal Head, Type A

4952-1040 1 Ea

SUBTOTAL SHEET 5

- 5 -

SUBTOTAL FROM SHEET 4

* DESCRIPTION:

SUBTOTAL FROM SHEET 3

BID TOTAL

SCHEDULE OF PRICES

Item 1 No.

Approximate 2 Quantities

Unit

*Description

Unit 5 Price

Total

0954-0203 400 Signal Cable, 14 AWG, 7 Conductor

Controller Assembly Replacement

LOCATION OF WORK:

Loucks Road (SR 0030) / Pennsylvania Avenue

DESCRIPTION OF WORK:

The project includes replacing all vehicular and pedestrian signal heads with new signal heads and providing new wiring for the new signal heads. Also, the controller assembly will be replaced including the MMU. Any recently installed equipment in the controller cabinet as part of the PennDOT project will be reused.

ESCALATOR CLAUSE:( if adopted by Municipality.)

N/A

Project Number: 113.083.24

ATTACHMENT 1

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

York Municipality: City of York

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

ATTACHMENT 1 – CONTINUED

DESCRIPTION OF WORK:

Contractor shall be responsible for temporary traffic control in accordance with PennDOT Publication 213. The City of York will not assist the Contractor with temporary traffic control. Traffic flow in all directions must be maintained during construction.

0608-0001: Mobilization: Shall consist of the assembling of labor, equipment, and materials and setting up for the project. The cost of required insurance and bonds and/or any other initial expense required for the start of the work will be included in this item. A written schedule should be provided to the City, which identifies completion dates of project milestones. Payment for this item will be at the lump sum price bid.

0901-0001: Maintenance and Protection of Traffic: Contractor shall be responsible for temporary traffic control in accordance with PennDOT Publication 213. Contractor will be responsible for notifying the City and all adjacent residents, businesses, and schools of pending work to be performed at least 48 hours in advance.

Contractor shall supply any “no parking” signs needed and post said signs 48 hours in advance. Payment for this item will be at the lump sum price bid.

0954-0202: Signal Conductor, 14 AWG, 5 Conductor: Furnish and install of this item per PennDOT Publication 408 in the previously installed conduit, poles, mast arms, junction boxes, controller cabinet, etc.

Payment for this item will be made at the linear foot price bid for this item supplied and completed in place.

0954-0203: Signal Conductor, 14 AWG, 7 Conductor: Furnish and install of this item per PennDOT Publication 408 in the previously installed conduit, poles, strain wires, junction boxes, controller cabinet, etc.

Payment for this item will be made at the linear foot price bid for this item supplied and completed in place.

4955-3208: Vehicular Signal Head, Three 12” Sections: Install this item per PennDOT Publication 408 and the approved traffic signal permit plan. Signals shall be LED (Dialight). The City of York will purchase the signal heads, but the contractor will be responsible for pick-up and installation. Payment for this item will be made at the each price bid for this item supplied and completed in place.

4955-3209: Vehicular Signal Head, Four 12” Sections: Install this item per PennDOT Publication 408 and the approved traffic signal permit plan. Signals shall be LED (Dialight). The City of York will purchase the signal heads, but the contractor will be responsible for pick-up and installation. Payment for this item will be made at the each price bid for this item supplied and completed in place.

4955-3210: Vehicular Signal Head, Five 12” Sections: Install this item per PennDOT Publication 408 and the approved traffic signal permit plan. Signals shall be LED (Dialight). The City of York will purchase the signal heads, but the contractor will be responsible for pick-up and installation. Payment for this item will be made at the each price bid for this item supplied and completed in place.

4955-3722: LED Countdown Pedestrian Signal Head, Type A: Install this item per PennDOT Publication 408 and the approved traffic signal permit plan. Signals shall be LED (Dialight). The City of York will purchase the signal heads but the contractor will be responsible for pick-up and installation. Payment for this item will be made at the each price bid for this item supplied and completed in place.

4952-1040: Controller Assembly Replacement: Furnish and install of this item per PennDOT Publication 408 and the approved traffic signal permit plan. The existing controller assembly will be replaced including the MMU.

Any recently installed equipment in the controller cabinet as part of the recent PennDOT project is to be reused in the new cabinet. Payment for this item will be made at the each price bid for this item supplied and completed in place.

York City York County York City 2025 GLG Projects

SPECIAL PROVISION

General Type: Project Specific

Detail Provision Name: Item 4955-3208 Vehicular Signal Head, Three 12” Sections Provision Name: Item 4955-3209 Vehicular Signal Head, Four 12” Sections Provision Name: Item 4955-3210 Vehicular Signal Head, Five 12” Sections Provision Name: Item 4955-3722 LED Countdown Pedestrian Signal Heads, Type A

Associated Items Item Number 4955-3208 Item Description Vehicular Signal Head, Three 12” Sections

Item Number 4955-3209 Item Description Vehicular Signal Head, Four 12” Sections

Item Number 4955-3210 Item Description Vehicular Signal Head, Five 12” Sections

Item Number 4955-3722 Item Description LED Countdown Pedestrian Signal Heads, Type A

Header Item 4955-3208 Vehicular Signal Head, Three 12” Sections Item 4955-3209 Vehicular Signal Head, Four 12” Sections Item 4955-3210 Vehicular Signal Head, Five 12” Sections Item 4955-3722 LED Countdown Pedestrian Signal Heads, Type A

Provision Body The signal heads should be installed in accordance with Section 955 and the approved traffic signal permit plans. The City of York will purchase the required signal heads. The contractor will be responsible for coordinating with the City of York to pick-up the signal heads and installation of the signal heads. New signal wiring for the signal heads to be furnished and installed by the contractor as part of the proposed signal head installation.

Measurement and Payment

Each

York City York County York City 2025 GLG Projects

SPECIAL PROVISION

General Type: Project Specific

Detail Provision Name: Item 4952-1040 Controller Assembly Replacement

Associated Items Item Number 4952-1040 Item Description Controller Assembly Replacement

Header Item 4952-1040 Controller Assembly Replacement

Provision Body The contractor to furnish and install new controller assemblies (inside equipment) for the three (3) signalized intersections in accordance with Section 0952 and the approved traffic signal permit plans. The old controller assemblies and equipment will be removed, however any recently installed equipment (i.e. TS-1 controller, etc.) as part of the recent PennDOT project is to be reused in the new controller assembly if feasible. This controller cabinet is proposed to remain; just the equipment inside the cabinet is to be replaced. All old controller equipment is to be returned to the City of York.

Measurement and Payment

Each

Traffic Control and Safety Devices to be provided by the Contractor.

Delivery tickets for all materials.

CS-4171 Certificate of Compliance and/ or TR-465 Daily Bituminous Mixture Certification required for all materials.

five working days prior to start of project.

. After per calendar day.the rate of $ )prior to start of project.municipalityRoadway to be power broomed by (contractor .)municipalityExcess material to be removed by (contractor

Municipality to inspect project.

Need Bill of Lading for each shipment of bituminous material per Section 702.1(c) of Specifications 408.

Tack Coat required per Section 460, or 409 for superpave, of Specifications 408 and is incidental to paving item unless noted otherwise.

Prime Coat required per Section 461 of Specifications 408.

Bituminous Seal on all abutting pavement and curbs required.

Saw cut or Milled Paving Notch required and incidental to paving item unless noted otherwise.

Scratch/ Leveling Courses to be placed at the discretion of appointed inspector(s).

Municipality reserves the right to limit work completed.

Taper pavement the last 3 feet to curb.

For FOB Source bids, hauling distance will determine selection of bid award.

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

Incidental Preparation and clean up required. ( Project Construction Materials ) The municipality reserves the right to make an award on the basis of the aggregate total for all like items on which quotations are received.

Provide design, which meets Specifications Form 408 to the municipality 5 days prior to start of work.

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

Contractor required to review proposed project with Municipality’s Representative prior to bidding.

Oil Samples required from each distributor truck by contractor (1) one quart : A.M. & P.M. and witnessed by municipality and retained by municipality. (Oil samples must be placed in an approved type container that is compatible with oil sample.)

At least three random stone samples to be taken by contractor on project site witnessed by municipality and retained by municipality.

Complete all testing in accordance with Specification Form 408 Section 409 except for superpave volumetric testing.

Notice to Proceed will be the date of Contract acceptance.

Final Completion Certificate & Notice of Completion required.

Future award of Contract will be based on quality of work as determined by the municipality.

Contractor, notify all residents of pending work to be performed.

My signature signifies that I have read and understand the above 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.

Date

Notify the Municipality

(5-06) SPECIAL PROVISIONS TO CONTRACT MS-944 ( Attachment 1-A )

CONTAINS IMPORTANT INFORMATION FOR THE CONTRACTOR

The Prime Contractor and subcontractors must comply with all of the following provisions that are marked with an "X".

( Maintenance and Protection of Traffic to comply with current MUTCD, Publication 212 and Publication 213.)

Company Municipality

Contractor's Representative Municipality's Representative Date

Work to be completed on or before Liquidated damages apply at

Full width pavement with one pass required.

x x x x x x x x x x x x x x x x x x

Attachment 2

($ ) dollars

WHEREAS, the above bounden Principal has entered into a contract with the above Municipality, bearing even date herewith, for

It is further provided that any alteration which may be made in the terms of the contractor or its specifications with the express

PERFORMANCE BONDMS-944-S (7-09)

(NAME OF MUNICIPALITY)

in the full and just sum of

(NAME OF STATE)

are held and firmly bound unto

KNOW ALL MEN BY THESE PRESENTS, That we, as Surety as Principal and a corporation incorporated under the laws of the State of

(SURETY COMPANY)

(NAME AND ADDRESS OF CONTRACTOR)

(With Corporate Surety)

NOW, THEREFORE, the condition of this obligation is such that if the above bounden Principal, as Contractor, shall in all lawful money to the United States of America, to be paid to the above Municipality or its assigns, to which payment well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

forebearance being hereby waived.

shall be and remain in full force, virtue and effect.

approval of the Municipality or the Principal to the other, shall not in any way release the Principal and the Surety or either or any of them, 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 the undertaking of certain obligations as therein set forth.

respects comply with and faithfully perform the terms and conditions of said Contract, including the Specifications and conditions referred their heirs, executors, administrators, successors or assigns from their liability hereunder, notice to the surety of any such alteration or authorizing the same to be done on .

BY

TITLE:

TITLE:

TITLE:

Attest / Witness:

IN WITNESS WHEREOF, the said Principal and Surety have duly executed this Bond under Seal, pursuant to due and legal action forebearance being hereby waived.

(DATE OF BOND)

- 1 -

CONTRACTOR

SURETY COMPANY

Attest / Witness:

PLACE

SEAL

HERE

PLACE

SEAL

HERE

MS-944S

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

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

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

for approximately the sum of: ($ ) dollars.

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

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

PAYMENT BOND Attachment 3 as PRINCIPAL and and may prosecute the same to final for such sum or sums as may be justly due him, them or it, and have execution thereon. Provided, however, that the Obligee shall not be liable for the payment of any costs of expenses of such suit.

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

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

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

WITNESS:

CONTRACTOR

BY:

SURETY COMPANY

TITLE: TITLE:

#REF!

- 2 -

WITNESS:

day of

PLACE

SEAL

HERE

PLACE

SEAL

HERE

Attachment 4

State of ) ) ss:

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

Act with .

( TYPE OR PRINT)

(SURETY COMPANY)

AFFIDAVIT RE

ACCEPTING PROVISIONS OF THE WORKMEN’S COMPENSATION ACT

CONTRACTOR

BY

day of A.D. 20 .

My Commission Expires

- 3 -

SIGNATURE

Sworn to and subscribed before me this

( DATE )

SIGNATURE

D-7126 ( 7-09 )

County

Municipality

Project Number

State of Fed. Project No.

( If Applicable )

The undersigned deponent deposes and says that he is the of the

County of

ANTI-COLLUSION AFFIDAVIT

competitive bidding in connection with such contract.

into any agreement, participated in any collusion, or otherwise taken any action in restraint of free

Company; that he is authorized to make this

Publication 408, as amended and that the said company has not, either directly or indirectly, entered affidavit on behalf of said company in compliance with section 102.06 (e) of Department Specifications, BY

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

Notary Public

My Commission expires

(Contractor)

York

113.083.24

MS-NCP

MUNICIPALITY

Name of Contractor

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

DATE OF AWARD

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

NOTICE OF COMPLETION

IN REFERENCE TO PROJECT #

Signature of Contractor

Signature of Municipality pavement restoration.

*DATE

period of one year from this date.

* The contractor is responsible for maintenance of permanent pavement repairs for a

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

FINAL COMPLETION CERTIFICATE

THIS PORTION TO BE COMPLETED BY MUNICIPALITY

Authorized Agent for the Municipality by the municipality as completed.

113.083.24

Type of Insurance Required Limits

Commercial General Liability (Per Occurrence Basis)

General Aggregate $ 1,000,000 Products & Completed Operations Aggregate 1,000,000 Person & Advertising Injury 1,000,000 Each Occurrence 1,000,000 Explosion, Collapse and Underground (XCU) 1,000,000 Fire Damage (Any one fire) 50,000 Medical Expense (Any one person) 5,000

Automobile Liability (Owned, Hired, & Non-Owned Autos

Combined Single Limit 1,000,000

Worker's Compensation and Employer's Liability (Statutory)

Each Accident 100,000 Disease - Aggregate Policy Limit 500,000 Disease - Each Employee 100,000

Deductible Limits

BELOW IN THE FOLLOWING MINIMUM AMOUNTS:

CERTIFICATES OF INSURANCE SHALL BE FURNISHED FOR ALL COVERAGE LISTED

SUPPLIERS, CONTRACTORS AND SUBCONTRACTORS

INSURANCE REQUIREMENTS FOR ALL

York, PA 17401 101 South George Street City of York

Certificate Holder holder.

changed or renewal refused until at least 30 days prior written notice has been given to the certificate

All policies shall contain a provision that coverage affected will not be cancelled, materially

Notice of Cancellation

Deductible limits shall not exceed 5% of aggregate or combined single limits stated above.

Engineer’s Project No. 113.083.24

COMMONWEALTH�OF�PENNSYLVANIA�

PUBLIC�WORKS�EMPLOYMENT�VERIFICATION�FORM��

Date�_______________________�

Business�or�Organization�Name�(Employer)_________________________________________________ �

Address� _____________________________________________________________________________ �

City�_____________________________________ �State_____________����Zip�Code���________________�

Contractor ��

Contracting�Public�Body�� _______________________________________________________________ �

Contract/Project�No� ___________________________________________________________________ �

Project�Description� ____________________________________________________________________ �

Project�Location� ______________________________________________________________________ �

As�a�contractor/subcontractor�for�the�above�referenced�public�works�contract,��I�hereby�affirm�that�as� of�the�above�date,�our�company�is�in�compliance�with�the�Public�Works�Employment�Verification�Act�

(‘the�Act’)� through�utilization�of� the� federal� E‐Verify�Program� (EVP)�operated�by� the�United� States�

Department� of� Homeland� Security.� � To� the� best� of�my/our� knowledge,� all� employees� hired� post�

January�1,�2013�are�authorized�to�work�in�the�United�States.���

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

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

Authorized�Representative�Signature�

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BID BOND

KNOW ALL MEN BY THESE PRESENTS that we, (hereinafter called the “Principal”) as Principal, and a corporation authorized to transact business in Pennsylvania, and having its principal office at

(hereinafter called the “Surety”) as surety, are held and firmly bound unto

(hereinafter called the “Obligee”) as Obligee, in the sum of

DOLLARS ($ ),

lawful money of the United States of America; for the payment of which we bind ourselves, and each of our respective heirs, legal representatives, successors, and assigns, jointly and severally, by these presents, on this day of , 20 .

WITNESSETH THAT:

WHEREAS, said principal is herewith submitting to the Obligee a proposal to perform the contract work for the Obligee’s, proposed pursuant to plans, specifications and other Contract Documents incorporated into said proposal by reference; and it is a condition of the Obligee’s receipt and consideration of said proposal that the proposal be accompanied by bid security to be held by the Obligee on terms embodied herein.

THEREFORE, the condition of this obligation is that if said principal shall furnish a performance bond, payment bond, and insurance certificates to the Obligee upon the Obligee’s delivery to the principal of fifteen days notice of intention to accept his proposal and to make a formal award of contract to him, and shall enter into such contract in all respects as required by said Contract Documents, then this obligation shall be void; but otherwise it shall remain in full force, and the principal and surety will pay to the Obligee the difference between the amount of the Principal’s accepted bid(s) and any higher amount for which the

Obligee may contract for the required work, plus any advertising, architect’s, legal and other expenses

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incurred by the Obligee by reason of the default; provided, however, that the obligations of the Surety hereunder shall not exceed the amount of this bond together with the interest.

IN WITNESS WHEREOF, the Principal and Surety, intending to be legally bound, have executed this bond the day and year aforementioned.

(Individual Principal)

(SEAL)

Witness: (Signature of Individual)

Trading and doing business as

(Partnership Principal)

(SEAL)

(Name of Partnership) Witness:

By:

(SEAL) (Partner)

(Corporation Principal)

(Name of Corporation)

ATTEST:

Title or (if appropriate)

*By:

(Authorized Representative) Witness or Attest:

*Attach appropriate proof, dated as of the same date as the Bond, evidencing authority to execute in behalf of the Corporation.

(Corporation Surety)

Witness or Attest:

**By:

Title

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the Bond, evidencing the authority of the Attorney-In-Fact to act in behalf of the Corporation.

**Attach an appropriate power of attorney, dated as of the same date as

(CORPORATE SEAL)

INSTRUCTIONS TO COMPLETE THE FORM

1. COUNTY, LR/SR, SEC/SEG. ECMS#

To be completed by the party that will ship the material to the construction project, otherwise leave blank.

2. NAME OF MANUFACTURER, FABRICATOR, COATER, PRECASTER OR PRODUCER

Check appropriate box; either manufactured, fabricated, coated, precasted or produced as appropriate.

Also, provide the name and the supplier code of the manufacturer, fabricator, coater or precaster of the material listed in Bulletin #15 or the name and the supplier code of the Producer of material listed in Bulletin # 14, 41 or 42.; to be completed by the party that is shipping approved material to the next destination.

3. MEETS SPECIFICATION REQUIREMENTS

To be completed by the party that is shipping approved material to the next destination.

4. SHIPPED TO

List name of company that material is being shipped to.

5. LOT NUMBER, QUANTITY, DESCRIPTION OF MATERIAL

To be completed by the party that is shipping approved material to the next destination.

6. CHECK THIS BLOCK IF YOUR PRODUCT CONTAINS IRON OR STEEL

To be completed by the party that is shipping approved material to the next destination.

7. VENDOR CLASSIFICATION (CHECK ONE BLOCK ONLY)

If you are a Manufacturer, Fabricator, Coater or Precaster listed in Bulletin #15, or a Producer listed in Bulletin # 14, 41 or 42, check block # 1.

If you are a *Distributor, *Supplier or *Private Label Company of Bulletin #15 items, check block # 2.

(* - These categories are not eligible for listing in Bulletin #15, however, you may provide material for PennDOT projects on condition that the material being shipped is listed in Bulletin #15.)

8. CERTIFICATION REQUIREMENTS, Name, Title, Date, Company Name, and Signature Enter the required information and sign the Certificate of Compliance form.

9. COMPLETE LINE # 9 ONLY IF YOU CHECKED BLOCK # 2 ON LINE # 7, OTHERWISE LEAVE BLANK List company that sold the material to you. (Company Name)

IN ADDITION:

2. & 5. Private Label Companies who complete the Certificate of Compliance form CS-4171 must identify the true manufacturer (Line 2) and the approved material (Line 5) as it is listed in Bulletin # 15 under that manufacturers listing.

After completing the Certificate of Compliance form CS-4171, maintain the original at your companyʼs location. A copy of the Certificate of Compliance form must accompany your material shipment to its next destination. Also, if you receive material shipments from other companies related to PennDOT projects, the accompanying Certificate of Compliance forms must be kept on file at your location. These files must be available for inspection and verification by a Department Representative for a period of not less than THREE years from the date of the last shipment.

CS-4171 (11-09)

CERTIFICATE OF COMPLIANCE

CS-4171 (11-09)

CERTIFICATE OF COMPLIANCE

1. ��COUNTY:_________________________ ��LR/SR:____________ ��SEC/SEG:____________ ��ECMS#:____________ (� - To be completed by the party that will ship the material to the project, otherwise leave blank.)

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

� 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:______________________________________________________________

5. LOT NO. QUANTITY APPROVED MATERIAL AS LISTED IN BULLETIN # 14 or 15 BULLETIN # 41 or 42 PRODUCERS, LIST HMA / PCC JMF.

6. � CHECK HERE IF YOUR PRODUCT CONTAINS IRON OR STEEL I / WE certify that we received a copy of the Mill Certification Form(s) from the manufacturer(s) of any steel or iron materials contained in our product and all manufacturing processes including coatings application (e.g.. epoxy, galvanizing, or painting) have occurred in the United States and we are maintaining copy(s), in our files in accordance with Section 106.03(b)3. Note: While coating materials themselves are not covered by Buy America, the application of these materials on steel or iron must occur in the United States.

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 # 14, 41 or 42 Also, complete line 9

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

8. NAME (print) : ____________________________________________ TITLE:__________________________________ COMPANY NAME : ________________________________________________________________________________ SIGNATURE : ______________________________________________________ DATE: ________________________

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

After completing the Certificate of Compliance form CS-4171, maintain the original at your companyʼs location. A copy of the Certificate of Compliance form must accompany your material shipment to its next destination. Also, if you receive material shipments from other companies related to PennDOT projects, the accompanying Certificate of Compliance forms must be kept on file at your location. These files must be available for inspection and verification by a Department Representative for a period of not less than THREE years from the date of the last shipment.

*Private Label Companies must identify the true manufacturer (Line 2) and the approved material (Line 5) as listed in Bulletin # 15.

(Name of Manufacturer, Fabricator, Coater, Precaster or Producer) (Supplier Code)

(Company Name)

By Responsible Company Official (QC Staff only if you checked block #1 on line 7)

(Company Name)

PENNSYLVANIA PREVAILING WAGE ACT SUPPLEMENT

TO SECTION VI

OBLIGATIONS OF THE CONTRACTOR AND THE OWNER (AWARDING AGENCY)

The general prevailing minimum wage rates, including contributions for employee benefits, as determined by the Secretary which shall be paid to the workmen employed in the performance of the contract. The contract shall specifically provide that the contractor shall pay at least the wage rates as determined in the decision of the Secretary and shall comply with the conditions of the act approved August 15, 1961 (Act No. 442), and the Regulations issued thereto, to assure the full and proper payment of the rates.

The contract shall contain the stipulation that workmen shall be paid at least the general prevailing minimum wage rates, and other provisions to assure payment thereof as set forth in this section.

The contract provisions shall apply to all work performed on the contract by the contractor and to work performed on the contract by subcontractors.

The contractor shall insert in each of his subcontracts the stipulations contained in these required provisions and such other stipulations as may be required.

The contract shall provide that no workman may be employed on the public work except in accordance with the classification in the decision of the Secretary. If additional or different classifications are necessary, the procedure in §9.107 (relating to petition for review of the rates and hearings) shall he followed.

The contract shall provide that workmen employed or working on the public work shall be paid unconditionally, regardless of whether a contractual relationship exists or the nature of a contractual relationship which may be alleged to exist between a contractor, subcontractor and workmen, at least once a week, without deduction or rebate, on any account, either directly or indirectly except authorized deductions, the full amounts due at the time of payment, computed at the rates applicable to the time worked in the appropriate classification. Nothing in the contract, the act or this title prohibits the payment of more than the general prevailing minimum wage rates as determined by the Secretary to a workman on public work.

The contract shall provide that the contractor and each subcontractor shall post for the entire period of construction the wage determination decisions of the Secretary, including the effective date of changes thereof, in a prominent and easily accessible place or places at the site of the work and at the places used by them to pay workmen their wages. The posted notice of wage rates must contain the following information:

▪ The name of project.

▪ The name of the Awarding Agency for which it is being constructed.

▪ The crafts and classifications of workmen listed in the Secretary's general prevailing minimum wage rate determination for the particular project.

▪ The general prevailing minimum wage rates determined for each craft and classification and the effective date of any changes.

▪ A statement advising workmen that if they have been paid less than the general prevailing minimum wage rate for their job classification or that the contractor or subcontractor is not complying with the act or this title, they may file a protest in writing with the Secretary within three (3) months of the date of the occurrence, objecting to the payment to a contractor to the extent of the amount due or to become due to them as wages for work performed on the public work project. A workman paid less than the rate specified in the contract shall have a civil right of action for the difference between the wage paid and the wages stipulated in the contract, which right of action must be exercised within six (6) months from the occurrence of the event creating such right.

The contract shall provide that the contractor and all subcontractors shall keep an accurate record showing the name, craft or classification, number of hours worked per day and the actual hourly rate of wage paid, including employee benefits, to each workman employed by him in connection with the public work.

The record shall include deductions from each workman. The record shall be preserved for two (2) years from the date of payment and shall be open at reasonable hours to the inspection of the Awarding Agency awarding the contract and to the Secretary or his authorized representatives.

The contract shall provide that apprentices shall be limited to numbers in accordance with a bona fide apprenticeship program registered with and approved by The Pennsylvania Apprenticeship and Training Council and only apprentices whose training and employment are in full compliance with The Apprenticeship and Training Act (43 P.S. §90.1-90.10), approved July 14, 1961, and the regulations issued thereto shall be employed on the public work project. A workman using the tools of a craft who does not qualify as an apprentice within the provisions of this subsection shall be paid the rate predetermined for journeymen in that particular craft or classification.

Wages shall be paid without any deductions except authorized deductions. Employers not parties to a contract requiring contributions for employee benefits which the Secretary has determined to be included in the general prevailing minimum wage rate shall pay the monetary equivalent thereof directly to the workman.

Payment of compensation to workmen for work performed on public work on a lump sum basis, or a piece work system, or a price certain for the compensation of a certain amount of work, or the production of a certain result, shall be deemed a violation of the act and this subchapter, regardless of the average hourly earnings resulting therefrom.

The contract shall also provide that each contractor and each subcontractor shall file a statement each week and a final statement at the conclusion of the work on the contract with the Awarding Agency, and in form satisfactory to the Secretary, certifying that all workmen have been paid wages in strict conformity with the provisions of the contract as prescribed by this section, or if any wages remain unpaid, to set forth the amount of wages due and owing to each workman respectively.

Only the first and final wage certifications require notarization by an officer of the contractor or subcontractor.

Awarding Agency will enforce the posting of wage rate determinations at the job site.

Awarding Agency hereby requires the contractor and all subcontractors to file weekly wage certifications prior to mailing periodic payments. A copy of approved form is made a part of this supplement.

Before final payment is made, Awarding Agency will require final wage certifications from all contractors and subcontractors.

When notified by Secretary of Labor and Industry of the filing of wage claims by workmen, the

Awarding Agency will withhold from the monies due to the contractor or subcontractor sufficient funds to pay all claims determined to be valid and when so directed by the Secretary of Labor and Industry and will pay wages directly to the workmen.

Where the Awarding Agency has knowledge that any person or firm has failed to pay the rates predetermined, it must notify the Secretary of Labor and Industry in writing.

The fiscal officer of the public body, the treasurer or other officer of the Awarding Agency charged with the custody and disbursement of the funds of the public body shall ascertain that the wage rates as determined by the Secretary are paid and that the job classifications are maintained, otherwise it is his duty to hold up final payment and to inform the Secretary of the failure by the contractor or a subcontractor to comply with the act.

LLC-26 REV 05-19

Auxiliary aids and services are available upon request to individuals with disabilities.

Equal Opportunity Employer/Program

Under…