20-00631-00-BT_BLR_12325.pdf

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S:\Gen\Document Services\Forms Support\AEM Forms\DOTLOGO2.bmp Apprenticeship and Training Program Certification Page of BLR 12325 (Rev. 01/19/23) Page of BLR 12325 (Rev. 01/19/23) BLR 12325 (Rev. 01/19/23) All contractors are required to complete the following certification Illinois Department of Transportation policy, adopted in accordance with the provisions of the Illinois Highway Code, requires this contract to be awarded to the lowest responsive and responsible bidder. The award decision is subject to approval by the Department. In addition to all other responsibility factors, this contract or deliver and install proposal requires all bidders and all bidder's subcontractors to disclose participation in apprenticeship or training programs that are (1) approved by and registered with the United States Department of Labor's Bureau of Apprenticeship and Training, and (2) applicable to the work of the above indicated proposals or groups. Therefore, all bidders are required to complete the following certification:

1. Except as provided in paragraph 4 below, the undersigned bidder certifies that it is a participant, either as an individual or as part of a group program, in an approved apprenticeship or training program applicable to each type of work or craft that the bidder will perform with its own employees.

2. The undersigned bidder further certifies, for work to be performed by subcontract, that each of its subcontractors either (A) is, at the time of such bid, participating in an approved, applicable apprenticeship or training program; or (B) will, prior to commencement of performance of work pursuant to this contract, establish participation in an approved apprenticeship or training program applicable to the work of the subcontract.

3. The undersigned bidder, by inclusion in the list in the space below, certifies the official name of each program sponsor holding the Certificate of Registration for all of the types of work or crafts in which the bidder is a participant and that will be performed with the bidder's employees. Types of work or craft that will be subcontracted shall be included and listed as subcontract work. The list shall also indicate any type of work or craft job category for which there is no applicable apprenticeship or training program available.

4. Except for any work identified above, if any bidder or subcontractor shall perform all or part of the work of the contract or deliver and install proposal solely by individual owners, partners or members and not by employees to whom the payment of prevailing rates of wages would be required, check the following box, and identify the owner/operator workforces and positions of ownership.

The requirements of this certification and disclosure are a material part of the contract, and the contractor shall require this certification provision to be included in all approved subcontracts. The bidder is responsible for making a complete report and shall make certain that each type of work or craft job category that will be utilized on the project is accounted for and listed. The Department at any time before or afterward may require the production of a copy of each applicable Certificate of Registration issued by the United States Department of Labor evidencing such participation by the contractor and any or all of its subcontractors. In order to fulfill the participation requirement, it shall not be necessary that any applicable program sponsor be currently taking or that it will take applications for apprenticeship, training or employment during the performance of the work of this contract or deliver and install proposal.

Instructions for BLR 12325 - Page 1 of 1 Instructions should not be included when the form is submitted.

This form shall be used by the Local Public Agency (LPA) for contract proposal or material proposal/deliver and install project. It must be completed by all bidders and submitted with their bids. This is not to be used for Federally Funded projects. See the Bureau of Local Roads and Streets Manual (BLRS) Chapter 12 for more information.

Local Public Agency Insert the name of the LPA soliciting bids for the project.

County Insert the name of the County in which the LPA is located.

Street Name/ Road Name Insert the name of the street/road on which the project is located. For projects that include several streets or roads insert various.

Section Number Insert the section number assigned to this project without dashes.

Box 1 Check this box if this is a contract proposal or if all groups are a deliver and install proposal.

Box 2 Check this box if there are only certain groups within the material proposal that require delivery and installation.

Groups Insert the individual groups from the material proposal schedule of prices (BLR 12241) that require the bidder to deliver and install.

Training Programs Insert the names of all the apprenticeship or training programs that the contractor or subcontractor participates in.

Ownership Check this box if the bidder or subcontractor will perform all or part of the work by individual owners, partners, or members and not by employees covered by prevailing wages.

Owner/operator Insert the name(s) and position(s) of the owner/operator, if the box from above has been checked.

Bidder Insert the name of the individual bidder or company name of the bidder.

Address Insert the address of the bidder.

Signature The bidder must sign and date here.

Title Insert the title of the bidder that signed above.

Distribution:

This form is to be included in the proposal packet, except for federally funded projects, completed by bidder and returned with bid. Upon execution of a formal contract this is to be submitted with the formal contract package to the Department. For a Material/Deliver and Install project this to be maintained by the LPA. Distribution will be as listed on BLR 12200, BLR 12320, BLR 12240.

11.0.0.20130303.1.892433.887364 Apprenticeship and Training Program Certification

BLR 12325