EJCDC C-451, Qualifications Statement.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

QUALIFICATIONS STATEMENT

ARTICLE 1—GENERAL INFORMATION

1.01 Provide contact information for the Business:

Legal Name of Business:

Corporate Office

Name: Phone number:

Title: Email address:

Business address of corporate office:

Local Office

Name: Phone number:

Title: Email address:

Business address of local office:

1.02 Provide information on the Business’s organizational structure:

Form of Business: ☐ Sole Proprietorship ☐ Partnership ☐ Corporation

☐ Limited Liability Company ☐ Joint Venture comprised of the following companies:

1.

2.

3.

Provide a separate Qualification Statement for each Joint Venturer.

Date Business was formed: State in which Business was formed:

Is this Business authorized to operate in the Project location? ☐ Yes ☐ No ☐ Pending

1.03 Identify all businesses that own Business in whole or in part (25% or greater), or that are wholly or partly (25% or greater) owned by Business:

Name of business: Affiliation:

Address:

Name of business: Affiliation:

Address:

Name of business: Affiliation:

Address:

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

1.04 Provide information regarding the Business’s officers, partners, and limits of authority.

Name: Title:

Authorized to sign contracts: ☐ Yes ☐ No Limit of Authority: $

Name: Title:

Authorized to sign contracts: ☐ Yes ☐ No Limit of Authority: $

Name: Title:

Authorized to sign contracts: ☐ Yes ☐ No Limit of Authority: $

Name: Title:

ARTICLE 2—LICENSING

2.01 Provide information regarding licensure for Business:

Name of License:

Licensing Agency:

License No: Expiration Date:

Name of License:

Licensing Agency:

License No: Expiration Date:

ARTICLE 3—DIVERSE BUSINESS CERTIFICATIONS

3.01 Provide information regarding Business’s Diverse Business Certification, if any. Provide evidence of current certification.

Certification Certifying Agency Certification Date

☐ Disadvantaged Business Enterprise

☐ Minority Business Enterprise

☐ Woman-Owned Business Enterprise

☐ Small Business Enterprise

☐ Disabled Business Enterprise

☐ Veteran-Owned Business Enterprise

☐ Service-Disabled Veteran-Owned Business ☐ HUBZone Business (Historically Underutilized) Business

☐ Other

☐ None

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

ARTICLE 4—SAFETY

4.01 Provide information regarding Business’s safety organization and safety performance.

Name of Business’s Safety Officer:

Safety Certifications

Certification Name Issuing Agency Expiration

4.02 Provide Worker’s Compensation Insurance Experience Modification Rate (EMR), Total Recordable Frequency Rate (TRFR) for incidents, and Total Number of Recorded Manhours (MH) for the last 3 years and the EMR, TRFR, and MH history for the last 3 years of any proposed Subcontractor(s) that will provide Work valued at 10% or more of the Contract Price. Provide documentation of the EMR history for Business and Subcontractor(s).

Year

Company EMR TRFR MH EMR TRFR MH EMR TRFR MH

ARTICLE 5—FINANCIAL

5.01 Provide information regarding the Business’s financial stability. Provide the most recent audited financial statement, and if such audited financial statement is not current, also provide the most current financial statement.

Financial Institution:

Business address:

Date of Business’s most recent financial statement: ☐ Attached Date of Business’s most recent audited financial statement: ☐ Attached Financial indicators from the most recent financial statement

Contractor’s Current Ratio (Current Assets ÷ Current Liabilities)

Contractor’s Quick Ratio ((Cash and Cash Equivalents + Accounts Receivable + Short Term Investments) ÷ Current Liabilities)

ARTICLE 6—SURETY INFORMATION

6.01 Provide information regarding the surety company that will issue required bonds on behalf of the Business, including but not limited to performance and payment bonds.

Surety Name:

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Surety is a corporation organized and existing under the laws of the state of:

Is surety authorized to provide surety bonds in the Project location? ☐ Yes ☐ No Is surety listed in “Companies Holding Certificates of Authority as Acceptable Sureties on Federal Bonds and as Acceptable Reinsuring Companies” published in Department Circular 570 (as amended) by the Bureau of the Fiscal Service, U.S. Department of the Treasury?

☐ Yes ☐ No Mailing Address (principal place of business):

Physical Address

Phone (main): Phone (claims):

ARTICLE 7—INSURANCE

7.01 Provide information regarding Business’s insurance company(s), including but not limited to its Commercial General Liability carrier. Provide information for each provider.

Name of insurance provider, and type of policy (CLE, auto, etc.):

Insurance Provider Type of Policy (Coverage Provided)

Are providers licensed or authorized to issue policies in the Project location? ☐ Yes ☐ No Does provider have an A.M. Best Rating of A-VII or better? ☐ Yes ☐ No Mailing Address

Physical Address

Phone (main):

Phone (claims):

ARTICLE 8—CONSTRUCTION EXPERIENCE

8.01 Provide information that will identify the overall size and capacity of the Business.

Average number of current full-time employees:

Estimate of revenue for the current year:

Estimate of revenue for the previous year:

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

8.02 Provide information regarding the Business’s previous contracting experience.

Years of experience with projects like the proposed project:

As a general contractor: As a joint venturer:

Has Business, or a predecessor in interest, or an affiliate identified in Paragraph 1.03:

Been disqualified as a bidder by any local, state, or federal agency within the last 5 years?

☐ Yes ☐ No Been barred from contracting by any local, state, or federal agency within the last 5 years?

☐ Yes ☐ No Been released from a bid in the past 5 years? ☐ Yes ☐ No

Defaulted on a project or failed to complete any contract awarded to it? ☐ Yes ☐ No Refused to construct or refused to provide materials defined in the contract documents or in a change order? ☐ Yes ☐ No Been a party to any currently pending litigation or arbitration? ☐ Yes ☐ No

Provide full details in a separate attachment if the response to any of these questions is Yes.

8.03 List all projects currently under contract in Schedule A and provide indicated information.

8.04 List a minimum of three and a maximum of six projects completed in the last 5 years in Schedule B and provide indicated information to demonstrate the Business’s experience with projects similar in type and cost of construction.

8.05 In Schedule C, provide information on key individuals whom Business intends to assign to the Project. Provide resumes for those individuals included in Schedule C. Key individuals include the Project Manager, Project Superintendent, Quality Manager, and Safety Manager. Resumes may be provided for Business’s key leaders as well.

ARTICLE 9—REQUIRED ATTACHMENTS

9.01 Provide the following information with the Statement of Qualifications:

A. If Business is a Joint Venture, separate Qualifications Statements for each Joint Venturer, as required in Paragraph 1.02.

B. Diverse Business Certifications if required by Paragraph 3.01.

C. Certification of Business’s safety performance if required by Paragraph 4.02.

D. Financial statements as required by Paragraph 5.01.

E. Attachments providing additional information as required by Paragraph 8.02.

F. Schedule A (Current Projects) as required by Paragraph 8.03.

G. Schedule B (Previous Experience with Similar Projects) as required by Paragraph 8.04.

H. Schedule C (Key Individuals) and resumes for the key individuals listed, as required by Paragraph 8.05.

I. Additional items as pertinent.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

This Statement of Qualifications is offered by:

Business:

(typed or printed name of organization)

By:

(individual’s signature)

Name:

(typed or printed)

Title:

(typed or printed)

Date:

(date signed)

(If Business is a corporation, a partnership, or a joint venture, attach evidence of authority to sign.)

Attest:

(individual’s signature)

Name:

(typed or printed)

Title:

(typed or printed) Address for giving notices:

Designated Representative:

Name:

(typed or printed)

Title:

Phone:

Email:

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EJCDC® C-451, Qualifications Statement—Schedule C—Key Individuals.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Schedule C—Key Individuals

Project Manager Name of individual Years of experience as project manager Years of experience with this organization Number of similar projects as project manager Number of similar projects in other positions Current Project Assignments Name of assignment Percent of time used for this project Estimated project completion date

Reference Contact Information (listing names indicates approval to contact named individuals as a reference) Name Name Title/Position Title/Position Organization Organization Telephone Telephone Email Email Project Project Candidate’s role on project

Candidate’s role on project

Project Superintendent Name of individual Years of experience as project superintendent Years of experience with this organization Number of similar projects as project superintendent Number of similar projects in other positions Current Project Assignments Name of assignment Percent of time used for this project

Reference Contact Information (listing names indicates approval to contact named individuals as a reference)

Title/Position Title/Position Organization Organization Telephone Telephone Email Email Project Project Candidate’s role on project

Candidate’s role on project

EJCDC® C-451, Qualifications Statement—Schedule C—Key Individuals.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Safety Manager Name of individual Years of experience as project manager Years of experience with this organization Number of similar projects as project manager Number of similar projects in other positions Current Project Assignments Name of assignment Percent of time used for this project

Reference Contact Information (listing names indicates approval to contact named individuals as a reference)

Title/Position Title/Position Organization Organization Telephone Telephone Email Email Project Project Candidate’s role on project

Candidate’s role on project

Quality Control Manager Name of individual Years of experience as project superintendent Years of experience with this organization Number of similar projects as project superintendent Number of similar projects in other positions Current Project Assignments Name of assignment Percent of time used for this project

Reference Contact Information (listing names indicates approval to contact named individuals as a reference)

Title/Position Title/Position Organization Organization Telephone Telephone Email Email Project Project Candidate’s role on project

Candidate’s role on project

EJCDC® C-410, Bid Form for Construction Contract.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

This document has important legal consequences; consultation with an attorney is encouraged with respect to its use or modification. This document should be adapted to the particular circumstances of the contemplated Project and the controlling Laws and Regulations.

BID FORM FOR CONSTRUCTION CONTRACT

Prepared By

Endorsed By

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Copyright© 2018

National Society of Professional Engineers

1420 King Street, Alexandria, VA 22314-2794

(703) 684-2882 www.nspe.org

American Council of Engineering Companies

1015 15th Street N.W., Washington, DC 20005

(202) 347-7474 www.acec.org

American Society of Civil Engineers

1801 Alexander Bell Drive, Reston, VA 20191-4400

(800) 548-2723 www.asce.org

The copyright for this EJCDC document is owned jointly by the three sponsoring organizations listed above. The National Society of Professional Engineers is the Copyright Administrator for the EJCDC documents; please direct all inquiries regarding EJCDC copyrights to NSPE.

NOTE: EJCDC publications may be purchased at www.ejcdc.org, or from any of the sponsoring organizations above.

http://www.nspe.org/ http://www.acec.org/ http://www.asce.org/ http://www.ejcdc.org/

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

BID FORM FOR CONSTRUCTION CONTRACT

The terms used in this Bid with initial capital letters have the meanings stated in the Instructions to Bidders, the General Conditions, and the Supplementary Conditions.

OWNER AND BIDDER

This Bid is submitted electronically through PennBid to:

Rye Township (Owner)

1775 New Valley Road

Marysville, PA 17053

The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Owner in the form included in the Bidding Documents to perform all Work as specified or indicated in the Bidding Documents for the prices and within the times indicated in this Bid and in accordance with the other terms and conditions of the Bidding Documents.

ATTACHMENTS TO THIS BID

The following documents are submitted with and made a condition of this Bid:

A. 00250: Required Bidder Qualifications Statement with supporting data

00300: Bid Form

00311: Non-Collusion Affidavit of Prime Bidder

00330: Certificate of Equal Employment Opportunities

00340: Nondiscrimination/Sexual Harassment Clause

00350: Certification of Non-Segregated Facilities

00600: Required Bid Security in the form of Bid Bond Form 00600

00631: Public Works Employment Verification

List of Proposed Subcontractors

List of Proposed Suppliers

Evidence of authority to do business in the state of the Project; or a written covenant to obtain such authority within the time for acceptance of Bids;

Contractor’s license number as evidence of Bidder’s State Contractor’s License or a covenant by Bidder to obtain said license within the time for acceptance of Bids;

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

BASIS OF BID—LUMP SUM

Bidder will complete the Work in accordance with the Contract Documents for the following lump sum (stipulated) price(s), together with any Unit Prices indicated in Paragraph 3.02:

Lump Sum Price (Single Lump Sum)

Lump Sum Bid Price (General Construction) $

TIME OF COMPLETION

Bidder agrees that the Work will be substantially complete and will be completed and ready for final payment in accordance with Paragraph 15.06 of the General Conditions on or before the dates or within the number of calendar days indicated in the Agreement.

Bidder agrees that the Work will be substantially complete within 210 calendar days after the date when the Contract Times commence to run as provided in Paragraph 4.01 of the General Conditions, and will be completed and ready for final payment in accordance with Paragraph 15.06 of the General Conditions within 240 calendar days after the date when the Contract Times commence to run.

Bidder accepts the provisions of the Agreement as to liquidated damages.

BIDDER’S ACKNOWLEDGEMENTS: ACCEPTANCE PERIOD, INSTRUCTIONS, AND RECEIPT OF ADDENDA

Bid Acceptance Period

This Bid will remain subject to acceptance for 60 days after the Bid opening, or for such longer period of time that Bidder may agree to in writing upon request of Owner.

Instructions to Bidders

Bidder accepts all of the terms and conditions of the Instructions to Bidders, including without limitation those dealing with the disposition of Bid security.

Receipt of Addenda

Bidder hereby acknowledges receipt of the following Addenda: [Add rows as needed. Bidder is to complete table.]

Addendum Number Addendum Date

BIDDER’S REPRESENTATIONS AND CERTIFICATIONS

Bidder’s Representations

In submitting this Bid, Bidder represents the following:

Bidder has examined and carefully studied the Bidding Documents, including Addenda.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Bidder has visited the Site, conducted a thorough visual examination of the Site and adjacent areas, and become familiar with the general, local, and Site conditions that may affect cost, progress, and performance of the Work.

Bidder is familiar with all Laws and Regulations that may affect cost, progress, and performance of the Work.

Bidder has carefully studied the reports of explorations and tests of subsurface conditions at or adjacent to the Site and the drawings of physical conditions relating to existing surface or subsurface structures at the Site that have been identified in the Supplementary Conditions, with respect to the Technical Data in such reports and drawings.

Bidder has carefully studied the reports and drawings relating to Hazardous Environmental Conditions, if any, at or adjacent to the Site that have been identified in the Supplementary Conditions, with respect to Technical Data in such reports and drawings.

Bidder has considered the information known to Bidder itself; information commonly known to contractors doing business in the locality of the Site; information and observations obtained from visits to the Site; the Bidding Documents; and the Technical Data identified in the Supplementary Conditions or by definition, with respect to the effect of such information, observations, and Technical Data on (a) the cost, progress, and performance of the Work; (b) the means, methods, techniques, sequences, and procedures of construction to be employed by Bidder, if selected as Contractor; and (c) Bidder’s (Contractor’s) safety precautions and programs.

Based on the information and observations referred to in the preceding paragraph, Bidder agrees that no further examinations, investigations, explorations, tests, studies, or data are necessary for the performance of the Work at the Contract Price, within the Contract Times, and in accordance with the other terms and conditions of the Contract.

Bidder is aware of the general nature of work to be performed by Owner and others at the Site that relates to the Work as indicated in the Bidding Documents.

Bidder has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder has discovered in the Bidding Documents, and of discrepancies between Site conditions and the Contract Documents, and the written resolution thereof by Engineer is acceptable to Contractor.

The Bidding Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work.

The submission of this Bid constitutes an incontrovertible representation by Bidder that without exception the Bid and all prices in the Bid are premised upon performing and furnishing the Work required by the Bidding Documents.

Bidder’s Certifications

A. The Bidder certifies the following:

This Bid is genuine and not made in the interest of or on behalf of any undisclosed individual or entity and is not submitted in conformity with any collusive agreement or rules of any group, association, organization, or corporation.

Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid.

Bidder has not solicited or induced any individual or entity to refrain from bidding.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Bidder has not engaged in corrupt, fraudulent, collusive, or coercive practices in competing for the Contract. For the purposes of this Paragraph 8.02.A:

Corrupt practice means the offering, giving, receiving, or soliciting of anything of value likely to influence the action of a public official in the bidding process.

Fraudulent practice means an intentional misrepresentation of facts made (a) to influence the bidding process to the detriment of Owner, (b) to establish bid prices at artificial non-competitive levels, or (c) to deprive Owner of the benefits of free and open competition.

Collusive practice means a scheme or arrangement between two or more Bidders, with or without the knowledge of Owner, a purpose of which is to establish bid prices at artificial, non-competitive levels.

Coercive practice means harming or threatening to harm, directly or indirectly, persons or their property to influence their participation in the bidding process or affect the execution of the Contract.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

BIDDER hereby submits this Bid as set forth above:

Bidder:

(typed or printed name of organization)

By:

(individual’s signature) Name:

(typed or printed) Title:

(typed or printed)

Date:

If Bidder is a corporation, a partnership, or a joint venture, attach evidence of authority to sign.

Attest:

(individual’s signature)

Name:

(typed or printed)

Title:

(typed or printed)

Date:

Address for giving notices:

Bidder’s Contact:

Name:

(typed or printed)

Title:

(typed or printed)

Phone:

Email:

Bidder’s Contractor License No.: (if applicable)

HEISLEY ROAD CULVERT REPLACEMENT NONCOLLUSION AFFADAVIT OF PRIME BIDDER

RYE TOWNSHIP 00311-1

SECTION 00311

NONCOLLUSION AFFIDAVIT OF PRIME BIDDER

The undersigned, being first duly sworn, deposes and says that:

1. He/She is _______ of ______________________ , (owner, partner, officer, representative or agent) (company name) the BIDDER that has submitted the attached Bid.

2. He/She is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid.

3. Such Bid is genuine and is not a collusive or sham Bid;

4. Neither the said BIDDER not any of its officers, partners, owner, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm or person to fix price or prices in the attached Bid or of any overhead, profit or cost element for the Bid prices or the Bid price of any BIDDER, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the OWNER or any person interested in the proposed Contract; and

5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the BIDDER or any of its agents, representatives, owners, employees, or parties in interest including this affiant.

(Signed)

(Title)

Notarized:

Subscribed and sworn to before me this ______ day of ________________, 2026

My commission expires: _________________________

HEISLEY ROAD CULVERT REPLACEMENT NONCOLLUSION AFFADAVIT OF PRIME BIDDER

RYE TOWNSHIP 00311-2

NONCOLLUSION AFFIDAVIT OF SUBCONTRACTOR

The undersigned, being first duly sworn, deposes and says that:

1. He/She is ___ of , (owner, partner, officer, representative or agent) (company name) the BIDDER that has submitted the attached Bid, hereinafter referred to as the “Subcontractor”.

2. He/She is fully informed respecting the preparation and contents of the Subcontractor’s

Proposal submitted to the Contractor for certain work in connection with;

(project name)

3. Such Subcontractor’s Proposal is genuine and is not a collusive or sham Proposal.

4. Neither the said Subcontractor not any of its officers, partners, owner, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other Bidder, firm or person to submit a collusive or sham Proposal in connection with the Contract for which the attached Bid has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm or person to fix price or prices in the attached Bid or of any other BIDDER, or to fix the price or prices in Subcontractor’s Proposal, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the OWNER or any person interested in the proposed Contract; and

5. The price or prices quoted in the Subcontractor’s Proposal are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the BIDDER or any of its agents, representatives, owners, employees, or parties in interest including this affiant.

(Signed)

(Title)

Notarized:

Subscribed and sworn to before me this ______ day of ________________, 2026

My commission expires: _________________________

HEISLEY ROAD CULVERT REPLACEMENT EQUAL OPPORTUNITY CERTIFICATIONS

RYE TOWNSHIP 00330-1

SECTION 00330

CERTIFICATIONS OF EQUAL EMPLOYMENT OPPORTUNITIES

CERTIFICATION OF BIDDER REGARDING EQUAL EMPLOYMENT OPPORTUNITY

INSTRUCTIONS

This certification is required pursuant to Commonwealth of Pennsylvania Procurement Code, Title 62 C.S. § 3701. The implementing rules and regulations provide that any bidder or prospective contractor, or any of their proposed subcontractors, shall state as an initial part of the bid or negotiations of the contract whether it has participated in any previous contract or subcontract subject to the equal opportunity clause; and, if so, whether it has filed all compliance reports due under applicable instructions.

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

CERTIFICATION BY BIDDER

NAME AND ADDRESS OF BIDDER (Include ZIP Code)

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

∼ Yes ∼ No

2. Compliance reports were required to be filed in connection with such contract or subcontract.

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

4. Have you ever been or are you being considered for sanction due to violation of Commonwealth of Pennsylvania Procurement Code, Title 62, as amended?

NAME AND TITLE OF SIGNER (Please Type)

SIGNATURE

DATE

HEISLEY ROAD CULVERT REPLACEMENT EQUAL OPPORTUNITY CERTIFICATIONS

RYE TOWNSHIP 00330-2

SECTION 00330

CERTIFICATION BY PROPOSED SUBCONTRACTOR REGARDING

EQUAL EMPLOYMENT OPPORTUNITY

NAME OF PRIME CONTRACTOR PROJECT NO

INSTRUCTIONS

This certification is required pursuant to Commonwealth of Pennsylvania Procurement Code, Title 62. The implementing rules and regulations provide that any bidder or prospective contractor, or any of their proposed subcontract, shall state as an initial part of the bid or negotiations of the contract whether it has participated in any previous contract or subcontract subject of the equal opportunity clause; and, if so, whether it has filed all compliance reports due under applicable instructions.

Where the certification indicates that the subcontractor has not filed a compliance report due under applicable instructions, such subcontractor shall be required to submit a compliance report before the owner approves the subcontract or permits work to begin under the

SUBCONTRACTOR’S CERTIFICATION

Subcontractor’s Name:

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

2. Compliance reports were required to be filed in connection with such contract or

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

4. If the answer to item 3 is "No," please explain in detail on reverse side of this certification.

Certification - The information above is true and complete to the best of my knowledge and belief.

NAME AND TITLE OF SIGNER (Please Type)

SIGNATURE DATE

HEISLEY ROAD CULVERT REPLACEMENT NONDISCRIMINATION/SEXUAL HARASSMENT

RYE TOWNSHIP 00340-1

SECTION 00340

NONDISCRIMINATION/SEXUAL HARASSMENT CLAUSE

During the term of the Grant, the Grant Applicant and contractor or subcontractor agrees as follows:

1. In the hiring of any employee(s) for the manufacture of supplies, performance of work, or any other activity required under a contract or any subcontract, the Grant Applicant, subcontractor, or any person acting on behalf of the Grant Applicant or subcontractor shall not, by reason of gender, race, creed, or color, discriminate against any citizen of this Commonwealth who is qualified and available to perform the work to which the employment relates.

2. Neither the Grant Applicant nor any contractor or subcontractor nor any person on their behalf shall in any manner discriminate against or intimidate any employee involved in the manufacture of supplies, the performance of work, or any other activity required under the contract on account of gender, race, creed, or color.

3. The Grant Applicant, or any contractor and subcontractor shall establish and maintain a written sexual harassment policy and shall inform their employees of the policy. The policy must contain a notice that sexual harassment will not be tolerated and employees who practice it will be disciplined.

4. The Grant Applicant or any contractor or subcontractor shall not discriminate by reason of gender, race, creed, or color against any contractor or subcontractor or supplier who is qualified to perform the work to which the contracts relates.

5. The Grant Applicant and each contractor and subcontractor shall furnish all necessary employment documents and records to and permit access to their books, records, and accounts by the contracting agency and the Bureau of Contract Administration and Business Development, for purposes of investigation, to ascertain compliance with provisions of this Nondiscrimination/Sexual Harassment Clause. If the Grant Applicant or any contractor or subcontractor does not possess documents or records reflecting the necessary information requested, the Grant Applicant, contractor or subcontractor shall furnish such information on reporting forms supplied by the contracting agency or the Bureau of Contract Administration and Business Development.

6. The Grant Applicant shall include the provisions of this Nondiscrimination/Sexual Harassment

Clause in every contract so that such provisions will be binding upon each contractor.

7. The Commonwealth Financing Authority may cancel or terminate the Grant, and all money payable pursuant to the Grant may be forfeited for a violation of the terms and conditions of this Nondiscrimination/Sexual Harassment Clause. In addition, the Commonwealth Financing Authority may proceed with debarment or suspension and may place the Grant Applicant in the Grantee Responsibility File.

HEISLEY ROAD CULVERT REPLACEMENT NONDISCRIMINATION/SEXUAL HARASSMENT

RYE TOWNSHIP 00340-2

ACCEPTED BY:

Title

Company Name and address:

I _________________________of _________________________ certify that (company name)

_________________________ met the provisions of Nondiscrimination/Sexual (company name)

Harassment Clause when providing services to Rye Township for the Heisley Road Culvert Replacement project.

Signature Date

Name/Title

HEISLEY ROAD CULVERT REPLACEMENT NONSEGREGATED FACILITIES CERT

RYE TOWNSHIP 00350-1

SECTION 00350

CERTIFICATION OF NON SEGREGATED FACILITIES

The Bidder certifies that they do not maintain or provide for their employees any segregated facilities at any of their establishments, and that they do not permit their employees to perform their services at any location, under the Bidder’s control, where segregated facilities are maintained. The Bidder certifies further that they will not maintain or provide for their employees any segregated facilities at any of their establishments, and that they will not permit their employees to perform their services at any location under the Bidder’s control where segregated facilities are maintained. The Bidder agrees that a breach of this certification will be a violation of the Equal Opportunity clause in any contract resulting from acceptance of this bid. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, transportation, and housing facilities provided for employees which are segregated by explicitly directive or are in fact segregated on the basis of race, color, religion, or national origin, because of habit, local custom, or otherwise. The Bidder agrees that (except where they have obtained identical certification from proposed subcontractors for specific time periods) they will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal

Opportunity clause, and that they will retain such certifications in their field.

Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.

Date , 2026

Name of Bidder

Official Address By (including ZIP CODE): Signature

Title

EJCDC® C-430, Bid Bond (Penal Sum Form).

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

This document has important legal consequences; consultation with an attorney is encouraged with respect to its use or modification. This document should be adapted to the particular circumstances of the contemplated Project and the controlling Laws and Regulations.

BID BOND (PENAL SUM FORM)

Prepared By

Endorsed By

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

Copyright© 2018

National Society of Professional Engineers

1420 King Street, Alexandria, VA 22314-2794

(703) 684-2882 www.nspe.org

American Council of Engineering Companies

1015 15th Street N.W., Washington, DC 20005

(202) 347-7474 www.acec.org

American Society of Civil Engineers

1801 Alexander Bell Drive, Reston, VA 20191-4400

(800) 548-2723 www.asce.org

The copyright for this EJCDC document is owned jointly by the three sponsoring organizations listed above. The National Society of Professional Engineers is the Copyright Administrator for the EJCDC documents; please direct all inquiries regarding EJCDC copyrights to NSPE.

NOTE: EJCDC publications may be purchased at www.ejcdc.org, or from any of the sponsoring organizations above.

http://www.nspe.org/ http://www.acec.org/ http://www.asce.org/ http://www.ejcdc.org/

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

BID BOND (PENAL SUM FORM)

Bidder Surety

Name: Name:

Address (principal place of business): Address (principal place of business):

Owner Bid

Name: Rye Township Project (name and location):

Address (principal place of business): 2024-0770-02 – Heisley Road Culvert Replacement 1775 New Valley Road

Marysville, PA 17053

Bid Due Date:

Bond

Penal Sum:

Date of Bond:

Surety and Bidder, intending to be legally bound hereby, subject to the terms set forth in this Bid Bond, do each cause this Bid Bond to be duly executed by an authorized officer, agent, or representative.

Bidder Surety

(Full formal name of Bidder) (Full formal name of Surety) (corporate seal)

By: By:

(Signature) (Signature) (Attach Power of Attorney)

Name: Name:

(Printed or typed) (Printed or typed)

Title: Title:

Attest: Attest:

(Signature) (Signature) Name: Name:

(Printed or typed) (Printed or typed)

Title: Title:

Notes: (1) Note: Addresses are to be used for giving any required notice. (2) Provide execution by any additional parties, such as joint venturers, if necessary.

Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved.

1. Bidder and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assigns to pay to Owner upon default of Bidder the penal sum set forth on the face of this Bond.

Payment of the penal sum is the extent of Bidder’s and Surety’s liability. Recovery of such penal sum under the terms of this Bond will be Owner’s sole and exclusive remedy upon default of Bidder.

2. Default of Bidder occurs upon the failure of Bidder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents.

3. This obligation will be null and void if:

3.1. Owner accepts Bidder’s Bid and Bidder delivers within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents, or

3.2. All Bids are rejected by Owner, or

3.3. Owner fails to issue a Notice of Award to Bidder within the time specified in the Bidding Documents (or any extension thereof agreed to in writing by Bidder and, if applicable, consented to by Surety when required by Paragraph 5 hereof).

4. Payment under this Bond will be due and payable upon default of Bidder and within 30 calendar days after receipt by Bidder and Surety of written notice of default from Owner, which notice will be given with reasonable promptness, identifying this Bond and the Project and including a statement of the amount due.

5. Surety waives notice of any and all defenses based on or arising out of any time extension to issue Notice of Award agreed to in writing by Owner and Bidder, provided that the total time for issuing Notice of Award including extensions does not in the aggregate exceed 120 days from the Bid due date without Surety’s written consent.

6. No suit or action will be commenced under this Bond prior to 30 calendar days after the notice of default required in Paragraph 4 above is received by Bidder and Surety, and in no case later than one year after the Bid due date.

7. Any suit or action under this Bond will be commenced only in a court of competent jurisdiction located in the state in which the Project is located.

8. Notices required hereunder must be in writing and sent to Bidder and Surety at their respective addresses shown on the face of this Bond. Such notices may be sent by personal delivery, commercial courier, or by United States Postal Service registered or certified mail, return receipt requested, postage pre-paid, and will be deemed to be effective upon receipt by the party concerned.

9. Surety shall cause to be attached to this Bond a current and effective Power of Attorney evidencing the authority of the officer, agent, or representative who executed this Bond on behalf of Surety to execute, seal, and deliver such Bond and bind the Surety thereby.

10. This Bond is intended to conform to all applicable statutory requirements. Any applicable requirement of any applicable statute that has been omitted from this Bond will be deemed to be included herein as if set forth at length. If any provision of this Bond conflicts with any applicable statute, then the provision of said statute governs and the remainder of this Bond that is not in conflict therewith continues in full force and effect.

11. The term “Bid” as used herein includes a Bid, offer, or proposal as applicable.

HEISLEY ROAD CULVERT REPLACEMENT PWE VERIFICATION FORM

RYE TOWNSHIP 00631-1

COMMONWEALTH OF PENNSYLVANIA

PUBLIC WORKS EMPLOYMENT VERIFICATION FORM

Date , 2026

Business or Organization Name (Employer)

Address

City State Zip Code

Contractor Subcontractor (check one)

Contracting Public Body Rye Township

Contract/Project No Heisley Road Culvert Replacement

Project Description Heisley Road Culvert Replacement

Project Location Rye Township, Perry 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

B. Unless otherwise stated in the Bidding Documents, the Bidder may use and rely upon complete sets of Electronic Documents of the Bidding Documents, described in Paragraph 2.05.A above. However, Bidder assumes all risks associated with differences ar...