2-83000-112-II-24-Meter21-P2 REQUIRED Documents.pdf

BIDDER’S QUALIFICATIONS 001153-1

CONTRACTOR’S QUALIFICATION STATEMENT

All questions must be answered and the date given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit additional information if he so desires.

The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading.

Submitted to:

Address:

Submitted by:

Corporation:

Name:

Partnership:

Address:

Individual:

Principal Office:

Other:

Name of Project (if applicable)

Type of Work (file separate form for each Classification of Work):

General Construction

HVAC

Plumbing

Electrical

Other (please specify)

1. ORGANIZATION

1.1

How many years has your organization been in business as a Contractor?

1.2

How many years has your organization been in business under its present business name?

1.2.1 Under what other or former names has your organization operated?

1.3

If your organization is a corporation, answer the following:

1.3.1 Date of incorporation:

1.3.2 State of incorporation:

1.3.3 President's name:

1.3.4 Vice-president’s name:

1.3.5 Secretary’s name:

1.3.6 Treasurer’s name:

1.4

If your organization is a partnership, answer the following:

1.4.1 Date of organization:

1.4.2 Type of partnership (if applicable):

1.4.3 Name(s) of general partner(s):

1.5

If your organization is individually owned, answer the following:

1.5.1 Date of organization:

1.5.2 Name of owner:

1.6

If the form of your organization is other than those listed above, describe it and name the principals:

BIDDER’S QUALIFICATIONS 001153-2

2. LICENSING

2.1

List jurisdictions and trade categories in which your organization is legally qualified to do business, and indicate registration or license numbers, if applicable.

2.2

List jurisdictions in which your organization’s partnership or trade name is filed.

3.

EXPERIENCE:

3.1

List the categories of work that your organization normally performs with its own forces.

3.2

Claims and Suits: (If the answer to any of the questions below is yes, please attach details).

3.2.1 Has you organization ever failed to complete any work awarded to it?

3.2.2 Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your organization or its officers?

3.2.3 Has your organization filed any law suits or requested arbitration with regard to construction contracts within the last five years?

3.3

Within the last five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract?

3.4

On a separate sheet, list major construction projects your organization has in progress, giving the name of project, owner, architect, contract amount, percent complete and scheduled completion date.

3.4.1 State total worth of work in progress and under contract:

3.5

On a separate sheet, list the major projects your organization has completed in the past five years, giving the name of project, owner, architect, contract amount, date of completion and percentage of the cost of the work performed with your own forces.

3.5.1 State average annual amount of construction work performed during the past five years:

3.6

On a separate sheet, list the construction experience and present commitments of the key individuals of your organization

4.

REFERENCES

4.1

Trade References:

4.2

Bank References:

4.3

Surety:

4.3.1 Name of bonding company:

4.3.2 Name and address of agent:

5.

FINANCING:

5.1

Financial Statement:

5.1.1 Attach a financial statement, preferably audited, including your organization’s latest balance sheet and income statement showing the following items:

Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials inventory and prepaid expenses);

Net Fixed Assets;

Other Assets:

Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, provision for income taxes, advances, accrued salaries and accrued payroll taxes);

Other liabilities (e.g. capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings).

5.1.2 Name and address of firm preparing attached financial statement, and date thereof:

5.1.3 Is the attached financial statement for the identical organization named on page one?

BIDDER’S QUALIFICATIONS 001153-3

5.1.4 If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent-subsidiary).

5.2

Will the organization whose financial statements attached act as guarantor of the contract for construction?

6.

AFFIRMATIVE ACTION PROGRAM

6.1

Each bidder must provide with his/her proposal a written statement describing the exact nature scope and history of their Affirmative Action Program in the interest of extending work opportunities to qualified minority workers.

6.2

Failure of a bidder to provide information as required under this paragraph may be cause for disqualification of the bidder’s proposal.

7.

APPRENTICESHIP TRAINING

7.1

A bidder shall be a participant in a state or federally approved Apprenticeship Training Program. Each bidder shall submit with his/her proposal a complete description of the Apprenticeship Training Program in which the bidder participates, including a list of the number of graduated apprentices every year for the past five years.

7.2

If requested by the Owner, the bidder shall submit within three days of the date of the request, the name, address, and telephone number of the state and federal agency which certifies the bidder’s Apprenticeship Training Program and the bidders identification number (if any) that would enable the Owner’s representative to verify the information provided by the bidder.

7.3

Failure of a bidder to provide information as required under this paragraph may be cause for disqualification of the bidders proposal.

8.

INSURANCE

Proof and submission of a description of any health care plans, worker’s compensation insurance and unemployment insurance maintained for the benefit of the contractor’s employees.

9.

Proof that the Contractor is not presently debarred by Federal, State or Local Authorities, and a history containing a full and complete description of events underlying any debarment with in the prior 10 year period.

10.

Proof that the Contractor has not defaulted on a project, trade or contracting license or been suspended or revoked and has not violated any prevailing wage laws.

11.

SIGNATURE

Dated at this ________ day of ____________________________________

Name of Organization: _____________________________________________

By: _____________________________________________________________

Title: ___________________________________________________________

____________________ being duly sworn deposes and says that the information provided herein is true and sufficiently complete so as not to be misleading

Subscribed and sworn before me this day of _____________________________________

My Commission Expires: _________________________________________

FORM OF PROPOSAL 004116-1

SECTION 004116

FORM OF PROPOSAL

CONTRACT A – SANITARY SEWER RELINING

TO: Township of Ridley FROM:

100 E. MacDade Blvd.

Folsom, PA 19033 Phone:

Fax:

Central Contractor Reg. #:

DUNS #:

Dear Commissioners:

The undersigned, having familiarized himself with the existing conditions in the Project Area affecting the cost of the Work, and with the Contract Documents which includes the Notice to Bidders, Instructions to Bidders, Non-Collusion Affidavit, Form of Proposal, Bid Bond, Articles of Agreement, Performance Bond, Labor and Materials Bond, General Conditions, Special Conditions and Technical Specifications and Drawings, as prepared by Catania Engineering Associates, Inc., Consulting Engineers, 520 W. Mac Dade Boulevard, Milmont Park, PA 19033 (610-532-2884), hereby proposes to furnish and install all supervision, technical personnel, labor, materials, machinery, tools, appurtenances and equipment required for the Sanitary Sewer Relining along Fairview Road, Ridley Township in accordance with the above listed documents for the total sum of:

AMOUNT IN WRITING (TOTAL PROJECT COST)

AMOUNT IN FIGURES (TOTAL PROJECT COST)

Based on the following:

BASE BID Fairview Road: Chester Pike to Worrall Street Item Description Quantity Unit Price Total

1. 10” Ø CIPP Liner 875 LF $ /LF $

2. Re-Establish Services Laterals 25 EA $ /EA $

3. Testing Allowance 1 LS $ /LS $

BASE BID TOTAL $

ALTERNATE BID 1 Fairview Road: Worrall Street to Walter Street Item Description Quantity Unit Price Total

1. 10” Ø CIPP Liner 215 LF $ /LF $

2. Re-Establish Services Laterals 7 EA $ /EA $

3. Testing Allowance 1 LS $ /LS $

ALTERNATE BID 1 TOTAL $

ALTERNATE BID 2 Fairview Road: Walter Street to Emlen Street

1. 10” Ø CIPP Liner 260 LF $ /LF $

2. Re-Establish Services Laterals 1 EA $ /EA $

3. Testing Allowance 1 LS $ /LS $

ALTERNATE BID 2 TOTAL $

PROJECT TOTAL $

FORM OF PROPOSAL 004116-2

In submitting this Bid, the Bidder understands that the right is reserved by the Owner to reject any and all Bids. If written notice of the acceptance of this Bid is mailed, telegraphed or delivered to the undersigned within 30 days after the opening thereof, or at any time thereafter before this Bid is withdrawn, the undersigned agrees to execute and deliver an Agreement in the prescribed form and furnish the required bond within 10 days after the Agreement is presented to him for signature.

Security in the sum of Dollars ($ ) in the form of is submitted herewith in accordance with the INSTRUCTIONS TO

BIDDERS.

Attached hereto is an affidavit in proof that the undersigned has not colluded with any person in respect to this bid or any other bid or the submitting of bids for the Contract for which this Bid is submitted.

The Bidder is prepared to submit a Financial and Experience Statement and Bidder's Qualifications Statement upon request.

WE HEREBY ACKNOWLEDGE RECEIPT OF ADDENDUM #_____ DATED .

WE HEREBY ACKNOWLEDGE RECEIPT OF ADDENDUM #_____ DATED .

Respectfully submitted:

By:

Name Title

Email address

Business Address and Zip Code (SEAL – if bid is by a corporation)

FORM OF PROPOSAL 004116-3

WORKER'S CLASSIFICATION

A list of the classes of all workers to be used on this project must be included with your Form of Proposal.

This must include classes for any and all sub-contractors to be utilized.

FORM OF PROPOSAL 004116-4

SUBCONTRACTOR DECLARATION FORM

Each prime contractor is required to submit a list of subcontractors it intends to use on the project.

Subcontractor Business Address Type of Work

Project Name

Prime Contractor

Signature

NON-COLLUSION AFFIDAVIT 004117-1

SECTION 004117

NON-COLLUSION AFFIDAVIT

State of: _ __________________________

County of: ___________________________

I, the undersigned, state that I am authorized to make this Affidavit on behalf of my firm, and its Owners, Directors and Officers. I am the person responsible in my firm for the price(s) and the amount of this Bid.

I state that:

The price(s) and amount(s) of this Bid have been arrived at independently and without consultation, communication or agreement with any other Contractor, Bidder or potential Bidder.

Neither the price(s) nor the amount(s) of this Bid, and neither the approximate price(s) nor approximate amount(s) of this Bid have been disclosed to any other firm or person who is a Bidder or potential Bidder, and they will not be disclosed before Bid opening.

No attempt has been made or will be made to induce any firm or person to refrain from bidding on this Contract, or to submit any intentionally high or competitive Bid or other form of Complementary Bid.

The Bid of my firm is made in good faith and not pursuant to any Agreement or discussion with, or inducement from, any firm or person to submit a complementary or other noncompetitive Bid.

This firm, its affiliates, subsidiaries, officers, directors and employees are not currently under investigation by any governmental agency and have not in the last 4 years been convicted or found liable for any act prohibited by state or federal law in any jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract, except as follows:

I state that this firm understands and acknowledges that the above representations are material and important, and will be relied on by the Owner in awarding the Contract(s) for which this Bid is submitted. I understand, and my firm understands, that any misstatement in this Affidavit is and shall be treated as fraudulent concealment from the Owner of the true facts relating to the submission of Bids for this Contract.

FIRM

NAME

TITLE

SWORN TO AND SUBSCRIBED BEFORE ME

THIS DAY 20 .

NOTARY PUBLIC

MY COMMISSION EXPIRES .

INSTRUCTIONS FOR NON-COLLUSION AFFIDAVIT

1. This Non-Collusion Affidavit is material to any contract awarded pursuant to this Bid. According to the Pennsylvania Anti-Rigging Act, 73 P.S. §§ 1611 eq seq., governmental agencies may require Non-Collusion Affidavits to be submitted together with Bids.

2. This Non-Collusion Affidavit must be executed by the member, officer or employee of the Bidder who makes the final decision on prices and the amount quoted in the Bid.

3. Bid rigging and other efforts to restrain competition, and the making of false sworn statements in connection with the submission of bids are unlawfully and may be subject to criminal prosecution. The person who signs the Affidavit should examine it carefully before signing and assure himself or herself that each statement is true and accurate, making diligent inquiry, as necessary, of all other persons employed by or associated with the Bidder with responsibilities for the preparation, approval or submission of the Bid.

4. In the case of a Bid submitted by a joint venture, each party to the venture must be identified in the Bid Documents, and an Affidavit must be submitted separately on behalf of each party.

5. The term "Complementary Bid" as used in the Affidavit has the meaning commonly associated with that term in the bidding process, and includes the knowing submission of Bids higher than the Bid of another firm, any intentionally high or noncompetitive Bid, and any other form of Bid submitted for the purpose of giving a false appearance of competition.

6. Failure to file an affidavit in compliance with these instructions may result in disqualification of the Bid.

WORKERS’ COMPENSATION ACT 004317-1

AFFIDAVIT RE:

ACCEPTING PROVISIONS OF THE WORKER'S COMPENSATION ACT

STATE OF: ___________________________________

COUNTY OF: _________________________________

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

Type or Print Name of Contractor

BY:

(Title)

Sworn to and subscribed before me this day of , 20____.

(Notary Public)

My commission expires:

(Date)

PUBLIC WORKS EMPLOYMENT VERIFICATION 006003-2

COMMONWEALTH OF PENNSYLVANIA

PUBLIC WORKS EMPLOYMENT VERIFICATION FORM

Date:___________________

Business or Organization Name (Employer):__________________________

Address: ____________________________________

City: __________________ State: ________________________ Zip Code: _______________________

Contractor Subcontractor

Contracting Public Body Ridley Township______________________________________________________________

Contract/Project No 83000-112-I&I-24-Meter-21-Phase 2________________________________________

Project Description: Sanitary Sewer Rehabilitation (Meter 21) Sanitary Sewer Relining – Phase 2 .

Project Location: Ridley Township, Delaware County, PA__________________________________________

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

(Check one)

RIDLEY TOWNSHIP CONTRACTOR QUALIFICATION FORMS RT-2

RIDLEY TOWNSHIP

CONTRACTOR RESPONSIBILITY CERTIFICATION

Firm Name:

Firm Address:

Contact Name:

Telephone No.:

Fax No.:

Email Address:

Project Name:

The submitting firm is required to certify compliance with the contractor responsibility standards set forth below by checking appropriate boxes and providing the supplemental information at the time of submitting the bid.

(1) Does the firm have or will it obtain all valid, effective licenses, registrations or certificates required by federal, state, county, or local law, including, but not limited to, licenses, registrations or certificates required to: (a) do business in the designated locale; and (b) perform the contract work it seeks to perform. These shall include, but not be limited to, licenses, registrations or certificates for any type of trade work or specialty work which the firm proposes to self-perform?

Yes No

(2) Does the firm meet the bonding requirements for the contract as required by applicable law or contract specifications and any insurance requirements as required by applicable law or specifications, including general liability insurance, workers compensation insurance and unemployment insurance requirements?

(3) Has the firm been debarred by any federal, state or local government agency or authority in the past three (3) years?

(4) Has the firm defaulted on any project in the past three (3) years?

(5) Has the firm had any type of business, contracting or trade license, registration, or other certification suspended or revoked in the past three (3) years?

(6) Has the firm been cited for a willful violation of federal or state safety laws determined by a final decision of a court or government agency in the past three (3) years?

RIDLEY TOWNSHIP CONTRACTOR QUALIFICATION FORMS RT-3

(7) Has the firm or its owners been convicted of any crime relating to the contracting business as determined by a final decision of a court or government agency in the past ten (10) years?

(8) Has the firm, in the past three (3) years, been found by a final decision of a court or government agency in violation of any law applicable to its contracting business, including, but not limited to, licensing laws, tax laws, prompt payment laws, wage and hour laws, prevailing wage laws, environmental laws or other, where the result of such violation was the payment of a fine, back pay damages or any other type of penalty in the amount of $10,000 or more?

(9) Does the firm agree to pay all craft employees that it employs on the project the current wage rates and benefits as required under applicable federal or state wage laws for the duration of the referenced project?

(10) Does the firm participate in an Approved Registered Apprenticeship Program as defined in the

Ordinance for each separate trade or classification in which it employs craft employees and agree to continue to participate in such program or programs for the duration of the referenced project?

(A) attach list of all trades or classifications of craft workers to be used on the project

(B) attach copy of apprenticeship program registration certificate

(C) attach list of employees to be used on the project who have graduated from an Approved

Registered Apprenticeship Program

(D) attach copies of Employee Certification of Completion of Apprenticeship Program

(11) Does the firm have all other technical qualifications and resources, including equipment, personnel and financial resources, to perform the referenced contract, or agree that it will obtain some through the use of qualified, responsible subcontractors?

(12) Does the firm have at least the OSHA ten (10) hour training course for safety established by the

U.S. Department of Labor, Occupational Safety and Health Administration

(13) Does the firm agree to notify the Township Administration Office of any material changes to any matters attested to in this certification within seven (7) days?

(13) Does the firm understand and agree that it shall provide a Subcontractor List that identifies any subcontractors it will use in connection with the project and furnish Contractor Responsibility Certifications for all identified subcontractors with all required supporting documentation at the time of submitting the bid.

RIDLEY TOWNSHIP CONTRACTOR QUALIFICATION FORMS RT-4

(14) Does the firm understand and agree that this certification must be completed by an authorized representative of the firm that has sufficient knowledge and information to address all matters addressed here?

In executing this Responsibility Certification, the submitting firm understands and agrees that if the

Township determines that this certification contains false or misleading material information that was provided knowingly or with reckless disregard for the truth or omits material information knowingly or with reckless disregard of the truth, the firm may be prohibited from performing work for the Township for a period of three (3) years. Such circumstances shall also subject the firm to any other penalties and sanctions, including contract termination, available to the Township under law. A contract terminated under these circumstances shall further entitle the Township to withhold payment of any monies due to the firm as damages.

I certify that the foregoing representations regarding the past performance and present qualifications of the undersigned firm are true and correct.

Sign Name

Print Name

Title

Name of Firm

Date

Subscribed and sworn to before me this _____ day of , 20___.

Notary Public

My Commission Expires:

RIDLEY TOWNSHIP CONTRACTOR QUALIFICATION FORMS RT-5

SUBCONTRACTOR LIST

1.

Subcontractor

Responsibility Certification Attached

Phone:

Scope of Subcontract:

2.

3.

4.

RIDLEY TOWNSHIP CONTRACTOR FORMS RT-6

5.

6.

7.

RIDLEY TOWNSHIP CONTRACTOR FORMS RT-7

RIDLEY TOWNSHIP

SUBCONTRACTOR RESPONSIBILITY CERTIFICATION

Prime Contractor:

Subcontractor: _____________________________________________________________

Telephone No.:

Fax No.:

Email Address:

Project Name:

The submitting firm is required to certify compliance with the contractor responsibility standards set forth below by checking appropriate boxes and providing the supplemental information at the time of submitting the bid.

(1) Does the firm have or will it obtain all valid, effective licenses, registrations or certificates required by federal, state, county, or local law, including, but not limited to, licenses, registrations or certificates required to: (a) do business in the designated locale; and (b) perform the contract work it seeks to perform. These shall include, but not be limited to, licenses, registrations or certificates for any type of trade work or specialty work which the firm proposes to self-perform?

(2) Does the firm meet the bonding requirements for the contract as required by applicable law or contract specifications and any insurance requirements as required by applicable law or specifications, including general liability insurance, workers compensation insurance and unemployment insurance requirements?

(3) Has the firm been debarred by any federal, state or local government agency or authority in the past three (3) years?

(4) Has the firm defaulted on any project in the past three (3) years?

(5) Has the firm had any type of business, contracting or trade license, registration, or other certification suspended or revoked in the past three (3) years?

RIDLEY TOWNSHIP CONTRACTOR FORMS RT-8

(6) Has the firm been cited for a willful violation of federal or state safety laws determined by a final decision of a court or government agency in the past three (3) years?

(7) Has the firm or its owners been convicted of any crime relating to the contracting business as determined by a final decision of a court or government agency in the past ten (10) years?

(8) Has the firm, in the past three (3) years, been found by a final decision of a court or government agency in violation of any law applicable to its contracting business, including, but not limited to, licensing laws, tax laws, prompt payment laws, wage and hour laws, prevailing wage laws, environmental laws or other, where the result of such violation was the payment of a fine, back pay damages or any other type of penalty in the amount of $10,000 or more?

(9) Does the firm agree to pay all craft employees that it employs on the project the current wage rates and benefits as required under applicable federal or state wage laws for the duration of the referenced project?

(10) Does the firm participate in an Approved Registered Apprenticeship Program as defined in the Ordinance for each separate trade or classification in which it employs craft employees and agree to continue to participate in such program or programs for the duration of the referenced project?

(A) attach list of all trades or classifications of craft workers to be used on the project

(B) attach copy of apprenticeship program registration certificate

(C) attach list of employees to be used on the project who have graduated from an

Approved Registered Apprenticeship Program

(D) attach copies of Employee Certification of Completion of Apprenticeship Program

(11) Does the firm have all other technical qualifications and resources, including equipment, personnel and financial resources, to perform the referenced contract, or agree that it will obtain some through the use of qualified, responsible subcontractors?

(12) Does the firm have at least the OSHA ten (10) hour training course for safety established by the U.S. Department of Labor, Occupational Safety and Health Administration

(13) Does the firm agree to notify the Township Administration Office of any material changes to any matters attested to in this certification within seven (7) days?

RIDLEY TOWNSHIP CONTRACTOR FORMS RT-9

(14) Does the firm understand and agree that it shall provide a Subcontractor List that identifies any subcontractors it will use in connection with the project and furnish Contractor Responsibility Certifications for all identified subcontractors with all required supporting documentation at the time of submitting the bid.

(15) Does the firm understand and agree that this certification must be completed by an authorized representative of the firm that has sufficient knowledge and information to address all matters addressed here?

In executing this Responsibility Certification, the submitting firm understands and agrees that if the

Township determines that this certification contains false or misleading material information that was provided knowingly or with reckless disregard for the truth or omits material information knowingly or with reckless disregard of the truth, the firm may be prohibited from performing work for the Township for a period of three (3) years. Such circumstances shall also subject the firm to any other penalties and sanctions, including contract termination, available to the Township under law. A contract terminated under these circumstances shall further entitle the Township to withhold payment of any monies due to the firm as damages.

I certify that the foregoing representations regarding the past performance and present qualifications of the undersigned firm are true and correct.

Sign Name

Print Name

Title

Name of Firm

Date

Subscribed and sworn to before me this _____ day of , 20___.

Notary Public

My Commission Expires: