2-Bid Forms and Supplements.pdf

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 1

00 40 00 – BID FORMS AND SUPPLEMENTS

Bidder shall download individual BID FORMS posted on the Procurement Portal at https://charlottenc.bonfirehub.com https://charlottenc.bonfirehub.com/

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 2

ITEMIZED BID

Bidder Name:

Project #: 269-2026-151

Project Name: Unspecified Roadway and Signal Construction Services FY26B

SECTION 1: BID

Item # Section Item Description Quantity Unit Unit Price Amount

1 SP-01 Project Mobilization ($2,500) 20 EA 2500.00

2 SP-03 Select Material 500 TN

3 SP-04 Clearing and Grubbing 20 EA 500.00

4 SP-04 Selective Tree Removal 50 EA

5 SP-04 Mowing 25 EA

6 SP-05 Removal of Existing Pavement, Drives & Sidewalks 1000 SY

7 SP-05 Removal of Existing Curb & Gutter 1000 LF

8 225 Unclassified Excavation 10000 CY

9 226 Undercut Excavation 50 CY

10 230 Borrow Excavation 1000 CY

11 270 Geotextile for Soil Stabilization 250 SY

12 300 Foundation Conditioning Material, Minor Structures 500 TN

13 300 Foundation Conditioning Geotextile 150 SY

14 310 15" R.C. Pipe Culverts, Class III 500 LF

15 310 15” R.C. Pipe Culverts, Class IV 500 LF

16 310 18" R.C. Pipe Culverts, Class III 500 LF

17 310 18" R.C. Pipe Culverts, Class IV 500 LF

18 310 24" R.C. Pipe Culverts, Class III 100 LF

19 310 24" R.C. Pipe Culverts, Class IV 100 LF

20 310 15” Precast Parallel End Section 15 EA

21 310 18” Precast Parellel End Section 15 EA

22 310 24” Precast Parellel End Section 5 EA

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 3

Project #: 269-2025-151

23 310 15” Precast Flared End Section 15 EA

24 310 18” Precast Flared End Section 15 EA

25 310 24” Precast Flared End Section 5 EA

26 340 Pipe Removal 50 LF

27 350 Pipe Cleanout 160 EA

28 520 Aggregate Base Course 500 TN

29 545 Incidental Stone Base 500 TN

30 607 Milling Asphalt Pavement, 0.0" to 3.0" 2000 SY

31 610 Asphalt Concrete Base Course, Type B 25.0C 250 TN

32 610 Asphalt Concrete Intermediate Course, Type I 19.0C 250 TN

33 610 Asphalt Concrete Surface Course, Type S 9.5C 300 TN

34 610 Asphalt Concrete Surface Course, Type S 9.5B 250 TN

35 620 Asphalt Binder for Plant Mix 20 TN

36 654 Asphalt Plant Mix, Pavement Repair 20 TN

37 840 Frame with Grate (All Types) 10 EA

38 840 Masonry Drainage Structures 10 EA

39 840 Masonry Drainage Structures 20 LF

40 840 Pipe Collars 5 CY

41 840 Pipe Plugs 5 CY

42 846 1' 6" Concrete Curb and Gutter 500 LF

43 846 2' 0" Concrete Valley Gutter, CLDS 10.17B 500 LF

44 846 2' 6" Concrete Curb and Gutter 500 LF

45 846 6" X 18" Concrete Curb 500 LF

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 4

46 SP-06 6” Shared-Use-Path 500 SY

47 SP-07

6" Reinforced Concrete Sidewalks (Bridging Tree Roots, CLDS 40.11)

250 SY

48 SP-08 6" Concrete Wheelchair Ramps 1000 SY

49 SP-09 Pedestrian Refuge Island (Pass-Thru) 250 SY

50 SP-10 Concrete Bicycle Ramps 250 SY

51 848 6" Concrete Driveway 250 SY

52 848 6" Concrete Sidewalk 25 SY

53 848 4" Concrete Sidewalk 500 SY

54 852 4" Concrete Island Cover 75 SY

55 852 5" Monolithic Concrete Islands, (Keyed In) 75 SY

56 853 5" Monolithic Concrete Islands, (Surface Mounted) 75 SY

57 853 5" Monolithic Concrete Medians, (Keyed In) 75 SY

58 854 5" Monolithic Concrete Medians, (Surface Mounted) 75 SY

59 858 Adjustment of Catch Basins 5 EA

60 858 Adjustment of Drop Inlets 5 EA

61 858 Adjustment of Manholes 5 EA

62 859 Convert Existing Catch Basin to Drop Inlet 5 EA

63 859 Convert Existing Catch Basin to Junction Box with Manhole

5 EA

64 859 Convert Existing Drop Inlet to Catch Basin 5 EA

65 859 Convert Existing Drop Inlet to Junction Box with Manhole

5 EA

66 859 Convert Existing Junction Box to Drop Inlet 5 EA

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 5

67 859 Convert Existing Junction Box to Catch Basin 5 EA

68 SP-11 Wall, Precast Modular Block Retaining 1500 SF

69 SP-12 Safety Rail, Metal CLDS 50.04 750 LF

70 867 4' Chain Link Fence Reset 50 LF

71 867 8' Chain Link Fence Reset 50 LF

72 867 10' Chain Link Fence Reset 50 LF

73 867 12' Chain Link Fence Reset 50 LF

74 867 8' Wooden Privacy Fence Reset 50 LF

75 867 10' Wooden Privacy Fence Reset 50 LF

76 876 Geotextile for Drainage 200 SY

77 876 Rip Rap Class I 50 TN

78 876 Rip Rap Class II 50 TN

79 901 Contractor Furnished, Type D Sign 150 SF

80 901 Contractor Furnished, Type E Sign 150 SF

81 903 Supports, 3-lb Steel U-Channel 150 LF

82 904 Sign Erection, Type D 25 EA

83 904 Sign Erection, Type E 25 EA

84 904 Sign Erection, Relocate Type D (Ground Mounted) 10 EA

85 904 Sign Erection, Relocate Type E (Ground Mounted) 10 EA

86 907 Disposal of Sign System, U-Channel 10 EA

87 1115 Flashing Arrow Board 15 EA

88 1205 Paint Pavement Marking Lines, 4", 90 mils 500 LF

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 6

89 1205 Paint Pavement Marking Lines,24", 90 mils 500 LF

90 1205 Thermoplastic Pavement Marking Lines, 4", 90 mils 500 LF

91 1205 Thermoplastic Pavement Marking Lines, 6", 90 mils 500 LF

92 1205 Thermoplastic Pavement Marking Lines, 8", 90 mils 500 LF

93 1205 Thermoplastic Pavement Marking Lines, 24", 90 mils 500 LF

94 1205 Thermoplastic Pavement Marking Symbols, 90 mils 25 EA

95 1205 Thermoplastic Pavement Marking Characters, 90 mils 25 EA

96 1205 Removal of Pavement Marking Lines, 4" 500 LF

97 1205 Removal of Pavement Marking Lines, 8" 500 LF

98 1205 Removal of Pavement Marking Lines, 24" 500 LF

99 1205 Removal of Pavement Marking Symbols & Characters 25 EA

100 SP-13 Green Thermoplastic (90 mils) 5000 SF

101 SP-14 Reflective Paddles 10 EA

102 SP-15 6" Yellow Tactile Guide Strip 150 LF

103 1605 Temporary Silt Fence 1000 LF

104 1610 Sediment Control Stone 100 TN

105 1610 Erosion Control Stone Class A 75 TN

106 SP-16 Tree Protection Fence 500 LF

SPSRW-

Matting for Erosion Control 250 SY

108 1630 Silt Excavation 30 CY

109 1632 ¼” Hardware Cloth 100 LF

110 1642 Coir Fiber Wattle Barrier 250 LF

111 SP-17 Permanent Seeding and Mulching 1500 SY

112 SP-17 Temporary Seeding and Mulching 1500 SY

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 7

113 SP-17 Repair Seeding and Mulching 500 SY

114 SP-18 Catch Basin or Drop Inlet Protection - Filter Bag 25 EA

115 SP-19 Traffic Control (Major or Minor Thoroughfare) 5 EA

116 SP-19 Traffic Control (Major or Minor Thoroughfare) 5 EA

117 SP-19 Traffic Control (Collector) 5 EA

118 SP-19 Traffic Control (Local) 5 EA

119 SP-20

Concrete Foundation for 15-foot Metal Base/ Pole/Pedestrian Signal

5 EA

120 SP-20

Concrete Foundation for 10-foot Metal Base/ Pole/Pedestrian Signal

15 EA

121 SP-20 15 ft. Metal Base/Pole/Cap for Pedestrian Signal 12 EA

122 SP-20 10 ft. Metal Base/Pole/Cap for Pedestrian Signal 13 EA

123 SP-21 Concrete Base for Controller Cabinet 15 EA

124 SP-22 Supply/Install/Activate Controller Cabinet 4 EA

125 SP-23 2070LX Controller w/1C CPU, Modules, and Accessories 15 EA

126 SP-24

Supply/Install APS Pedestrian Pushbutton Detector, Sign, & 3‐Wire Control Board

25 EA

127 SP-25 Core drill concrete cabinet foundation 8 EA

128 SP-26 Green Uninterruptible Power Supply (UPS) 5 EA

129 SP-27 16" Pedestrian Signal Head 25 EA

130 SP-28 Vehicle Signal Head (Polycarbonate, 12", 3‐section) 25 EA

131 SP-28 Vehicle Signal Head (Polycarbonate, 12", 3‐section HAWK) 25 EA

132 SP-28 Vehicle Signal Head (Polycarbonate, 12", 3‐section Bi‐Modal

FYA)

25 EA

133 SP-28 Vehicle Signal Head (Polycarbonate, 12", 4‐section) 25 EA

134 SP-28 Vehicle Signal Head (Polycarbonate, 12", 4‐section FYA) 25 EA

135 SP-28 Vehicle Signal Head (Polycarbonate, 12", 5‐section) 25 EA

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 8

136 SP-29 Lead in Cable (1726 Modified) 2000 LF

137 SP-30 Standoff Bracket Assembly 8 EA

138 SP-31 LED Blankout Sign 10 EA

139 SP-32 3 Section 12" Signal Head Cover 50 EA

140 SP-32 4 Section 12" Signal Head Cover 50 EA

141 SP-32 5 Section 12" Signal Head Cover 50 EA

142 SP-32 Pedestrian Signal Cover 25 EA

143 1705 Signal Cable (16 AWG ‐ 4 Conductor) 20000 LF

144 1705 Signal Cable (16 AWG ‐ 7 Conductor) 20000 LF

145 1706 Backplates 100 EA

146 1710 Messenger Cable (3/8" Galvanized) 10000 LF

147 1715 Tracer Wire 2000 LF

148 1715 Unpaved Trenching (1-2" SCH80) 400 LF

149 1715 Unpaved Trenching (2-2" SCH80) 1000 LF

150 1715 Unpaved Trenching (3-2" SCH80) 750 LF

151 1715 Unpaved Trenching (4‐2" SCH80) 750 LF

152 1715 Unpaved Trenching (5‐2" SCH80) 750 LF

153 1715 Unpaved Trenching (6‐2" SCH80) 500 LF

154 1715 Paved Trenching (2‐2" SCH80) 250 LF

155 1715 Paved Trenching (6‐2" SCH80) 250 LF

156 1715 Directional Drill (2-2") 50 LF

157 1715 Directional Drill (3-2") 50 LF

158 1715 Directional Drill (4‐2") 250 LF

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 9

159 1715 Directional Drill (6‐2") 250 LF

160 1715 Directional Drill (8‐2") 250 LF

161 1716 Junction Box (24"x36"x30" PC, CDOT FIBER OPTIC logo) 15 EA

162 1716 Junction Box (13"x24"x12" PC, TRAFFIC SIGNAL logo) 50 EA

163 1716 Junction Box (24"x36"x24" PC, TRAFFIC SIGNAL logo) 10 EA

164 1716 Junction Box (17"x30"x24" PC, CDOT FIBER OPTIC logo) 3 EA

165 1716 Junction Box (24"x36"x24" PC, CDOT FIBER OPTIC logo) 10 EA

166 1716 Junction Box (30"x48"x36" PC, TRAFFIC SIGNAL logo) 3 EA

167 SP-33 Adjust Existing 13”x 24"x 12” CDOT PULL BOX 3 EA

168 SP-33 Adjust Existing 17”x 30"x 24” CDOT PULL BOX 2 EA

169 SP-33 Adjust Existing 24”x 36"x 24” CDOT PULL BOX 2 EA

170 SP-33 Adjust Existing 36”x 36"x 12” CDOT VAULT 2 EA

171 SP-33 Relocate Existing CDOT PULL BOX 5 EA

172 SP-34 Relocate/Adjust Conduit to Existing Pull Box 10 EA

173 SP-35 Supply/Install Video Detection Camera 10 EA

174 SP-35 Supply/Install Video Detection Comm Manager 10 EA

175 1720 Supply/Install Wood Poles (40/5) 6 EA

176 1721 Supply/Install Down Guy 7 EA

177 1721 Supply/Install Anchor 7 EA

178 1725 Inductive Loop Sawcut 4000 LF

179 1734 Remove Existing cable 1250 LF

180 1745 Sign for signals 20 EA

181 SP-36 Solar Powered Rectangular Rapid Flashing Beacons (RRFB) 10 PR

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 10

182 SP-37 Screw‐In Helical Foundation Assembly (Type I) 4 EA

183 SP-37 Screw‐In Helical Foundation Assembly (Type II) 8 EA

184 SP-38 24 Fiber Aerial Fiber Optic Cable (With Hardware) 3000 LF

185 SP-38 36 Fiber Aerial Fiber Optic Cable (With Hardware) 750 LF

186 SP-38 48 Fiber Aerial Fiber Optic Cable (With Hardware) 750 LF

187 SP-38 72 Fiber Aerial Fiber Optic Cable (With Hardware) 350 LF

188 SP-39 24 Fiber Underground Fiber Optic Cable 3000 LF

189 SP-39 36 Fiber Underground Fiber Optic Cable 750 LF

190 SP-39 48 Fiber Underground Fiber Optic Cable 750 LF

191 SP-39 72 Fiber Underground Fiber Optic Cable 350 LF

192 SP-40 6‐Fiber Cable Stub 1250 LF

193 SP-41 Fiber Optic Patch Panel 5 EA

194 SP-42 Supply/Install Aerial Fiber Optic Splice Enclosure 5 EA

195 SP-43 Supply/Install Underground Fiber Optic Splice Enclosure 5 EA

196 SP-44 Fiber Optic Cable Splicing Assembly Unit 100 EA

197 SP-45 Fiber Optic Power Level Test Assembly Unit 100 EA

198 SP-46 Fiber Optic Splice Test Assembly Unit 100 EA

199 SP-47 Supply/Install Fiber Curb Marker 25 EA

200 SP-48 Supply/Install Electronic Ball Marker 25 EA

201 SP-49 Supply/Install Cable Riser Guard Unit 4 EA

202 SP-50 Supply/Install 24 Fiber Optic Cable‐Slack Stow 250 LF

203 SP-50 Supply/Install 36 Fiber Optic Cable‐Slack Stow 50 LF

204 SP-50 Supply/Install 48 Fiber Optic Cable‐Slack Stow 50 LF

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 11

205 SP-50 Supply/Install 72 Fiber Optic Cable‐Slack Stow 50 LF

206 SP-50 Supply/Install 24 Fiber Optic Cable Splice‐Slack Stow Unit 250 LF

207 SP-50 Supply/Install 36 Fiber Optic Cable Splice‐Slack Stow Unit 50 LF

208 SP-50 Supply/Install 48 Fiber Optic Cable Splice‐Slack Stow Unit 50 LF

209 SP-50 Supply/Install 72 Fiber Optic Cable Splice‐Slack Stow Unit 50 LF

210 SP-1 Supply/Install Fiber Optic Jumper Assembly 50 EA

211 SP-52 Supply/Install SFP 42 EA

212 SP-53 Supply/Install Ethernet Switch 25 EA

213 SP-54 Remove Existing Fiber Cable from Conduit 250 LF

214 SP-55 Communication Cable De‐lashing 300 LF

215 SP-56 Communication Cable Lashing 400 LF

216 SP-57 Install Copper Interconnect Cable 150 LF

217 SP-58 Copper Interconnect Splicing 5 EA

218 SP-59 Supply/Install Copper Interconnect Splice Enclosure 3 EA

219 SP-60 Supply/Install Observation Camera 5 EA

220 SP-61 Aerial CAT 6 Ethernet Cable for Observation Camera 600 LF

221 SP-61 Aerial CAT 6 IP66 Ethernet Cable for Observation Camera 500 LF

222 SP-62 Underground CAT6 Ethernet Cable for Observation Camera 500 LF

223 SP-62

Underground CAT6 IP66 Ethernet Cable for Observation Camera

500 LF

224 SP-63 Pole Ground Assembly Unit 6 EA

225 SP-64 Remove Existing Junction Box 5 EA

226 SP-64 Remove Existing Wood Pole 10 EA

227 SP-64 Remove Existing Down Guy 5 EA

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 12

228 SP-64 Remove Existing Anchor 5 EA

229 SP-64 Remove Pedestrian Signal 10 EA

230 SP-64 Remove Push Button 10 EA

231 SP-64 Remove Pedestrian Signal Pole Foundation 10 EA

232 SP-65 Combination Meter Pedestal and Grounding Grid 5 EA 233 SP-66 Concrete Washout Structure 25 EA

234 SP-67 Riser Assembly (2" Sch. 80 PVC) 60 EA

235 SPU-01 Adjust Existing Water Valve 15 EA

236 SPU-01 Adjust Existing Meter Box 15 EA

237 SPU-01 Adjust Existing Fire Hydrant 5 EA

238 SPU-01 Adjust Existing Water Manhole 5 EA

239 SPU-01 Adjust Existing Water Vault 5 EA

240 SPU-01 Adjust Existing Sewer Manhole 5 EA

241 SPU-01 Adjust Existing Sanitary Sewer Cleanout 5 EA

242 SPU-01 Convert to Solid Lid & Sealed Frame & Cover (Watertight) 5 EA

243 SPU-02 Relocate Existing Water Meter & Meter Box 5 EA

244 SPU-03 Relocate Existing Fire Hydrant 3 EA

245 SPU-04 4” DI Restrained Joint Water Pipe, PC 350 50 LF

246 SPU-04 6” DI Restrained Joint Water Pipe, PC 350 50 LF

247 SPU-05 DI Restrained Joint Water Pipe Fittings 100 LB

248 SPU-06 4" Line Stop 2 EA

249 SPU-06 6" Line Stop 2 EA

250 SPU-06 8" Line Stop 2 EA

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 13

251 SPU-06 12" Line Stop 2 EA

252 SPU-07 Concrete Thrust Blocking 25 CY

TOTAL BID

Do not include any North Carolina Sales and Use Tax that qualifies as Eligible Taxes per Section 00 70 00, Subsection 2.17

“Sales and Use Tax”.

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 14

CBI FORM 3 - Subcontractor / Supplier Utilization Commitment (page 1 of 2)

This form MUST be submitted at the time of Bid Opening. Copy this CBI Form 3 as needed.

Failure to properly complete and submit Form 3 with the Bid constitutes grounds for rejection of the Bid.

Per Section 3.5 of the CBI Administrative Procedures Manual, the Subcontractor/Supplier Utilization Commitment (CBI Form 3), captures information regarding the MWSBEs and other subcontractors and suppliers that the Bidder intends to use on the Contract FOR ALL TIERS.

For Construction Contracts under $500,000, M/W/SBEs must satisfy the requirements of Section 2 of the CBI Administrative Procedures Manual in order to count the work they intend to perform on the contract with its own current workforces towards the established Subcontracting Goal, and must list themselves below along with their projected utilization amount.

Bidder Name:

Project Name: Unspecified Roadway and Signal Construction Services FY26B

Established MWBE Goal: Established MBE Goal:

Established MSBE Goal: Established WBE Goal:

Established SBE Goal:

List below all M/W/SBEs (Non-Hauling Services) that you intend to use on this Contract. NOTE: You will only receive credit for M/W/SBEs that are currently certified with the City as of the Bid Opening Date.

M/W/SBE Vendor Name (Non-Hauling Services) Description of work / materials NIGP Code Total Projected Utilization ($)

For all hauling services on this Contract, list below all SBEs and MBEs that you intend to provide such work and the Total Projected Utilization ($).

M/W/SBE Vendor Name

(Hauling Services) Description of work / materials NIGP Code Total Projected Utilization ($)

Total Subcontractor / Supplier Utilization (including SBEs, MBEs, WBEs, and Non-MWSBEs) $

Total MBE Utilization $

Total WBE Utilization $

Total SBE Utilization $

Total MWBE/MSBE Utilization (if goal listed above is combined) $

Total Bid Amount (including Contingency) $

Percent MBE Utilization* (Total MBE Utilization divided by Total Bid Amount) %

Percent WBE Utilization* (Total WBE Utilization divided by Total Bid Amount) %

Percent SBE Utilization* (Total SBE Utilization divided by Total Bid Amount) %

Percent MWBE/MSBE Utilization* (Total MWBE or MSBE Utilization divided by Total Bid Amount) %

* The M/W/SBE Utilization percentage stated MUST be rounded to (2) decimal places.

Version 06-2023

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 15

CBI FORM 3: Subcontractor / Supplier Utilization Commitment (page 2 of 2)

List below all non-M/W/SBEs (subcontractors and suppliers) that you intend to use on this Contract

Vendor Name Description of work / materials NIGP Commodity

Code Projected Utilization (if known) ($)

Letters of Intent submitted upon notice from the City Per Section 3.5 of the CBI Administrative Procedures Manual, within three (3) Business Days after receiving a request from the City (or within such longer time as may be communicated by the City in writing), Bidders must submit a separate Letter of Intent (CBI Form 4) for each M/W/SBE listed on CBI Form 3. Each Letter of Intent must be executed by both the M/W/SBE and the Bidder. The City shall not count proposed M/W/SBE utilization for which it has not received a Letter of Intent by this deadline. In addition, a Hauler’s fees or commissions charged by an MWSBE hauler for providing a Commercially Useful Function shall count towards meeting the applicable Contract Goals. The costs of a hauler’s materials or supplies shall not count as part of the fees or commissions. The Bidder is still obligated to pay the M/W/SBE the full amount listed on the Contract with the M/W/SBE regardless of what percentage is actually counted towards the M/W/SBE Goal.

Adding subcontractors or suppliers after submitting this form Nothing in this certification shall be deemed to preclude you from entering into subcontracting arrangements after submission of this form. However, per the CBI Administrative Procedures Manual, you must comply with the following:

• You must maintain the level of M/W/SBE participation proposed on this CBI Form 3 (and CBI Form 3A, if applicable) throughout the duration of the Contract, except as specifically allowed in Section 5

• If you need to terminate or replace a M/W/SBE, you must comply with Section 5.3

• If the scope of work on the Contract increases, or if you elect to subcontract any portion of work not identified on this form as being subcontracted, then you must comply with Section 5.4

• A Letter of Intent (CBI Form 4) must also be submitted for each M/W/SBE you add subsequent to contract award.

All Subcontractors and Suppliers must be registered with the City of Charlotte.

Pursuant to the City’s Vendor Registration Policy, each subcontractor or supplier (non-MBE/SBE, WBEs, SBEs and MBEs) that you use on this contract must be registered in the City’s vendor database.

Signature

Your signature below indicates that the undersigned firm certifies and agrees that:

(a) It has complied with all provisions of the CBI Policy and Administrative Procedures Manual; and,

(b) Failure to properly document such compliance in the manner and within the time periods established by the CBI Policy and Administrative Procedures Manual shall constitute grounds for rejection of your bid.

Signature of Authorized Official Printed Name Title Submittal Date

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 16

CBI FORM 3B: UTILIZATION COMMITMENT – TASK ORDER

(page 1 of 2)

This form MUST be submitted at the time of Task Order Submittal. Copy this CBI Form 3B as needed.

Failure to properly complete and submit Form 3B at the time of Task Order Submittal constitutes grounds for denial of the Task Order.

All MBEs, WBEs, SBEs, and other subcontractors/suppliers that are intended to be used on the Task Order FOR ALL TIERS must be documented.

For Construction Contracts under $500,000, any MWSBE must satisfy the requirements of the CBI Manual in order to count its performance with its own current workforces towards the Contract Goal and must list itself below along with their projected utilization amount.

Contractor Name:

Contract Name: Unspecified Roadway and Signal Construction Services FY26B

Contract Number:

Task Order Number:

Established MBE Goal: Established WBE Goal: Established SBE Goal:

List below all MBEs, WBEs, and/or SBEs (Non-Hauling Services) that you intend to use on this Task Order. NOTE: You will only receive credit, as of the Task Order Submittal Date, for SBEs that are currently certified with the City or MBEs and WBEs that are registered with the City.

MBE/WBE/SBE

Vendor Name

(Non-Hauling Services) Description of work / materials NIGP Code Vendor # Total Projected

Utilization ($)

For all hauling services only, list below all MBEs, WBEs, and SBEs that you intend to provide such work and the Total Projected

Utilization ($).

MBE/WBE/SBE

Vendor Name

(Hauling Services) Description of work / materials NIGP Code Vendor # Total Projected

Utilization ($)

Total Subcontractor / Supplier Utilization (including MBEs, WBEs, SBEs, and Non-MWSBEs)

Total MBE Utilization $

Total WBE Utilization $

Total SBE Utilization $

Total Task Order Amount (including Contingency) $

Percent MBE Utilization* (Total MBE Utilization divided by Total Task Order Amount) %

Percent WBE Utilization* (Total WBE Utilization divided by Total Task Order Amount) % Percent SBE Utilization* (Total SBE Utilization divided by Total Task Order Amount) %

* The Utilization percentage stated MUST be rounded to (2) decimal places.

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 17

CBI FORM 3: UTILIZATION COMMITMENT – TASK ORDER (page 2 of 2)

List below all non-MWSBE (subcontractors and suppliers) that you intend to use on this Task Order

Vendor Name Description of work / materials NIGP Commodity Code Vendor # Projected Utilization (if known) ($)

Letters of Intent submitted upon notice from the City Pursuant to the CBI Manual, within three (3) Business Days after receiving a request from the City (or within such longer time as may be communicated by the City in writing), Contractors must submit a separate Letter of Intent (CBI Form 4) for each MBE, WBE, and/or SBE listed on this CBI Form 3B. Each Letter of Intent must be executed by each MBE, WBE, and/or SBE and the Contractor. The City shall not count proposed MBE, WBE, and/or SBE utilization for which it has not received a Letter of Intent by this deadline. The Contractor is still obligated to pay the MBE, WBE, and/or SBE the full amount listed with the MBE, WBE, and/or SBE regardless of what percentage is actually counted towards the Contract Goal.

Adding subcontractors or suppliers after submitting this form Nothing in this certification shall be deemed to preclude you from entering into subcontracting arrangements after submission of this form. However, per the CBI Manual, you must comply with the following:

• You must maintain the level of MBE, WBE, and/or SBE participation proposed on this CBI Form 3B throughout the duration of the Task Order.

• If you need to terminate or replace a MBE, WBE, and/or SBE, you must comply with the CBI Manual requirements.

• If the scope of work on the Task Order increases, or if you elect to subcontract any portion of work not identified on this form as being subcontracted, then you must comply with the CBI Manual requirements.

• A Letter of Intent (CBI Form 4) must also be submitted for each MBE, WBE, and/or SBE you add subsequent to Task

Order assignment.

All Subcontractors and Suppliers must be registered with the City of Charlotte.

Pursuant to the City’s Vendor Registration Policy, each subcontractor or supplier that you use on this contract must be registered in the City’s vendor database. You will need to provide the vendor number for each subcontractor or supplier used on this contract as a condition for receiving payment on this Contract.

Signature Your signature below indicates that the undersigned firm certifies and agrees that:

(a) It has complied with all provisions of the CBI Manual; and,

(b) Failure to properly document such compliance in the manner and within the time periods established by the CBI Manual shall constitute grounds for liquidated damages under the CBI Manual.

Signature of Authorized

Printed Name Title Submittal Date

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 18

COMMERCIAL NON-DISCRIMINATION CERTIFICATION

Project: Unspecified Roadway and Signal Construction Services FY26B

Name of Company (Bidder):

The undersigned Bidder hereby certifies and agrees that the following information is correct:

1. In preparing its Bid, the Bidder has considered all bids submitted from qualified, potential subcontractors and suppliers, and has not engaged in or condoned discrimination, as defined in Section 2 below.

2. For purposes of this form, discrimination means discrimination in the solicitation, selection, or treatment of any subcontractor, vendor, supplier or commercial customer on the basis of a person's race, color, gender, religion, national origin, ethnicity, age, familial status, sex (including sexual orientation, gender identity and gender expression), veteran status, pregnancy, natural hairstyle or disability, or any otherwise unlawful form of discrimination. Without limiting the foregoing, discrimination also includes retaliating against any person or other entity for reporting any incident of discrimination.”

3. Without limiting any other remedies that the City may have for a false certification, it is understood and agreed that, if this certification is false, such false certification will constitute grounds for the City to reject the bid submitted with this certification and terminate any contract awarded based on such bid. It shall also constitute a violation of the City’s Commercial Non-Discrimination Ordinance and shall subject the Bidder to any remedies allowed thereunder, including possible disqualification from participating in City contracts or bid process for up to two years.

4. As a condition of contracting with the City, the Bidder agrees to promptly provide to the City all information and documentation that may be requested by the City from time to time regarding the solicitation and selection of subcontractors in connection with this solicitation process. Failure to maintain or failure to provide such information shall constitute grounds for the City to reject the bid submitted by the Bidder and terminate any contract awarded on such bid. It shall also constitute a violation of the City’s Commercial Non-Discrimination Ordinance and shall subject the Bidder to any remedies allowed thereunder.

5. As part of its bid, the Bidder shall provide to the City a list of all instances within the past ten years where a complaint was filed or pending against the Bidder in a legal or administrative proceeding alleging that the Bidder discriminated against its subcontractors, vendors or suppliers, and a description of the status or resolution of that complaint, including any remedial action taken.

6. As a condition of submitting a bid to the City, the Bidder agrees to comply with the City’s Commercial Non-

Discrimination Policy as described in Section 2, Article V of the Charlotte City Code, and consents to be bound by the award of any arbitration conducted thereunder.

By:

Signature of Company’s Authorized Representative

Title:

Date:

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 19

EXECUTION OF BID

NON-COLLUSION AFFIDAVIT, DEBARMENT CERTIFICATION AND GIFT BAN CERTIFICATION

The person executing the bid, on behalf of the Bidder, being duly sworn, solemnly swears (or affirms) that neither he, nor any official, agent or employee of the Bidder has entered into any agreement, participated in any collusion, or otherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract, that the Bidder has not been convicted of violating North Carolina General Statute 133-24 within the last three years, and that the Bidder intends to do the work with its own bona fide employees or subcontractors and is not bidding for the benefit of another contractor.

In addition, execution of this bid in the proper manner also constitutes the Bidder’s certification of status under penalty of perjury under the laws of the United States in accordance with the Debarment Certification attached, provided that the Debarment Certification also includes any required statements concerning exceptions that are applicable.

NC General Statute 133-32 prohibits the offer to, or acceptance by, any City employee of any gift from anyone with a contract with the City or State, or from any person seeking to do business with the City of Charlotte. By execution of any response in this procurement, you attest, for your entire organization and its employees or agents, that you are not aware that any such gift has been offered, accepted, or promised by any employees of your organization.

In the event the Bidder is awarded the Contract, execution of the Bid by the Bidder is considered the same as execution of the Contract. Affixing the corporate seal to this document is only intended to verify the officer signing on behalf of the corporation has the authority to do so.

The undersigned, having carefully examined the site and familiarized himself with the existing conditions on the Project area affecting the cost of work and hereby proposes to furnish all supervision, labor, equipment, materials and services required to construct and complete the Project in accordance with the Project Manual at and for the Total Amount Bid, excluding any Allowances, such as contingency, which may be used by the Contractor only upon written instructions from the Engineer in accordance with the terms of this Contract.

The undersigned agrees to comply with the self-performance requirement identified within Section 108-6 of the 2024 NCDOT Standard Specifications for Roads and Structures. 2024 Standard Specifications for Roads and Structures.pdf.

The undersigned acknowledges receipt of the following addenda (initial next to each addendum):

# 1: ______ # 2: _____ # 3: _____ # 4:_____ # 5: _____ #6: _____ # 7: _____ # 8: _____ # 9: _____

Type of Bidder: Sole Proprietor Partnership Corporation Limited Liability Company Joint Venture

(check 1 box) (if joint venture, complete this “Execution of Bid” sheet for each joint venture company and identify the “Name of Joint Venture” on each sheet)

NAME OF JOINT VENTURE: _________________________________________________________

Company Name:

Mailing Address:

City/State/Zip:

Phone: Email:

Printed Name: Title:

Signature: NC Gen. Contractor License #:

Subscribed and sworn to before me this day of 202___

Signature of Notary Public of County

State of

My Commission Expires:

https://connect.ncdot.gov/resources/Specifications/2024StandardSpecifications/2024%20Standard%20Specifications%20for%20Roads%20and%20Structures.pdf