KENTON COUNTY AIRPORT BOARD CINCINNATI/NORTHERN KY INTERNATIONAL AIRPORT

CONCOURSE A APRON RECONSTRUCTION – BID PACKAGE 1

EXHIBIT A

PROPOSAL DOCUMENTS

Table of Contents

PROPOSAL

PROPOSAL FORM

EEO CERTIFICATION

NONSEGREGATED FACILITIES CERTIFICATION

BIDDER’S QUALIFICATIONS

BID TAB

PROPOSAL BOND

FORM 1: DISADVANTAGED BUSINESS ENTERPRISE (DBE) UTILIZATION

FORM 2: LETTER OF INTENT

AFFIRMATIVE ACTION CERTIFICATION

NON-DEBARMENT OR SUSPENSION CERTIFICATION

BUY AMERICAN CERTIFICATION – CONSTRUCTION PROJECTS

DISCLOSURE OF LOBBYING ACTIVITIES CERTIFICATION

AFFIDAVIT REGARDING WORKER'S COMPENSATION

SAFETY EVALUATION AND PLANS

SAFETY EVALUATION FORM

CERTIFICATION OF OFFEROR/BIDDER REGARDING TAX DELINQUENCY AND FELONY CONVICTIONS 24

CERTIFICATION REGARDING DOMESTIC PREFERENCES FOR PROCUREMENTS

PROPOSAL

PROPOSAL FORM

TO: Owner Kenton County Airport Board Cincinnati/Northern Kentucky International Airport

Boone County, Kentucky P.O. Box 752000 Cincinnati, Ohio 45275-2000

FROM: Bidder

Address

City/State/Zip

DATE:

1. The undersigned bidder (“Bidder”) declares that having familiarized itself with the local conditions affecting the cost of the work, Contract Documents including the Notice to Bidders, Instructions to Bidders, Proposal and Bid Schedule, General Provisions, Special Provisions and the Specifications and Drawings and other related Documents prepared by the Kenton County Airport Board titled:

CINCINNATI/NORTHERN KENTUCKY INTERNATIONAL AIRPORT

dated March 2025 together with any addenda to such Documents, proposes to furnish all materials and perform all work required in strict accordance with the provisions of the documents noted above for the consideration of prices quoted in Bid #25-020-ITB, titled the same as written above, which is incorporated by reference.

The Project Bid Package 1 is located southeast of Concourse A and includes Gates A19 and A21.

In addition, portions of Taxilanes 2N, 2C, 2S, R and Taxiway S will be reconstructed. Bituminous shoulders along Taxilane R will be reconstructed as well as the existing underdrain and airfield lighting. This area was selected to allow the taxilanes to accommodate ADG V and VI aircraft and improve taxing efficiency by removing the paved island between Taxilane 2N and 2S. There are drainage issues in this area and surrounding islands so the new pavement grading will allow for better drainage. The existing pavement has reached its design life and needs to be reconstructed to limit FOD concerns and maintain safety around the apron.

A. Included in the above improvements are all appurtenances required for complete and functional systems. It should be noted that other contractors may require access in the vicinity of the project site. Accordingly, cooperation between contractors and close coordination between all parties concerned will be required and is of utmost importance.

B. Bidder understands that the quantities shown in the "Bid Schedule" are approximate only, are intended principally to serve as a guide in evaluating proposals and are subject to either increase or decrease.

C. Bidder affirms that in making such bid, neither Bidder nor any company that Bidder may represent, nor anyone on behalf of Bidder, directly or indirectly, has entered into any combination, collusion, undertaking or agreement with any other bidder or bidders to maintain the prices of said work, or any compact to prevent any other bidder or bidders from bidding on said Contract or work and further affirms that such bid is made without regard or reference to any other bidder or proposer and without any agreement or understanding or combination either directly or indirectly with any other person or persons with reference to such bidding in any way or manner whatsoever.

D. Bidder shall enter into a Contract with the Owner within 10 days from the date on the

Notice of Award for the execution of the work described within the period of time allocated, and shall give Performance Bond and Payment Bond, with good and sufficient surety.

E. Contractor shall commence the work within 10 calendar days after the date of the Notice to Proceed. Contractor shall complete the work in accordance with the completion schedule set forth in the Special Provisions of these Specifications including amendments, if any. If Contractor fails to complete the work as provided in the completion schedule, Contractor expressly agrees that the Owner may deduct the stipulated sum of liquidated damages from the Contract price as provided in the Special Provisions for each day that any phase of work under this Contract remains uncompleted thereafter, and retain that sum for failure of the Contractor to complete this Contract on or before the expiration of the period shown in the completion schedule.

F. Contractor agrees that the Owner's damages caused by delay are capable of being established but would be difficult to measure accurately. Accordingly, the sums specified as liquidated damages in the Contract Documents are not a penalty, but represent the parties' estimate of the actual damages which the Owner would suffer per day if the work is not completed as scheduled.

G. The Owner reserves the right to waive any informality or irregularity in any bid or bid guaranty, to reject any and all bids, to award or refrain from awarding a contract for the work and to negotiate with an apparent qualified responsible low bidder to such extent as may be beneficial to the Owner. It is agreed THAT THIS BID MAY NOT BE WITHDRAWN

FOR A PERIOD OF 120 DAYS AFTER THE OPENING THEREOF.

H. Bidder has attached its Proposal Bond in an amount equal to but not less than 5% of the aggregate amount of the bid, payable to the Kenton County Airport Board, as required in the Instructions to Bidders. Bidder agrees that in case Bidder fails to enter into the

Contract and furnish the required Payment and Performance Bonds, with surety or sureties to be approved by Owner, and Insurance Certificates within 10 days after Notice of Award of the Contract to Bidder, the Owner may determine that Bidder has abandoned its rights and interest in such bid and that the Proposal Bond accompanying its bid has been forfeited. Otherwise, upon request by the Bidder the Proposal Bond will be returned to Bidder upon the execution of the Contract and acceptance of the Bonds and Insurance Certificates, or upon rejection of its bid.

I. Bidder affirms it has completed, signed and included in its submittal all required forms and pricing. A bid may be considered nonresponsive and rejected if it fails to include these fully executed statements or if Bidder fails to furnish required data. When a determination has been made to award the Contract to Contractor, Contractor shall furnish such other pertinent information regarding its own employment policies and practices as well as those of its proposed subcontractors as the FAA, the Owner, Secretary of Labor, the Labor Cabinet of the Commonwealth of Kentucky or the Office of Federal Contract Compliance (OFCC) may require.

J. Contractor shall furnish similar statements executed by each of its first-tier and second-tier subcontractors whose contracts equal Ten Thousand Dollars ($10,000.00) or more, and shall obtain similar compliance by such subcontractors before awarding subcontracts.

No subcontract may be awarded to any noncompliant subcontractor.

K. All work items are guaranteed for 1 year from the date of Final Acceptance. This is in addition to any third-party warranties.

L. Bidder affirms it has completed all of the unit prices on the Line Items tab on the online bidding system under Concourse A Apron Reconstruction – Bid Package 1 (#25-020-ITB) and agrees that where a discrepancy occurs the unit price governs when determining final costs or award of Contract.

M. Bidder agrees that the Contract amount will be decreased or increased where planned quantities shown on the drawings are decreased or increased, and that such increase or decrease shall be determined by use of the applicable unit price submitted in response to this ITB, except as provided for in Section 40-02 of the General Provisions.

N. Bidder affirms that wages not less than the minimum rates or wages, as predetermined for this project by the Department of Labor as provided in Section 7 of the Special Provisions of these Specifications, were used in the preparation of this proposal.

O. Bidder acknowledges the requirement to provide evidence of qualifications to conduct business as the project's contractor under the laws of the Commonwealth of Kentucky within five days following the Owner's issuance of a Notice of Award.

P. Bidder acknowledges that Contract Time will be based on the number of consecutive calendar days as stipulated in these Contract Documents beginning on the date the Notice-to-Proceed is issued by the Owner, with intermediate time(s) for selected phase(s) of work.

Q. The legal status of Bidder is:

1. A corporation duly incorporated under the laws of the state of ______________________________, and authorized to do business in the Commonwealth of Kentucky, for whom __________________________, bearing official title of ______________________, whose signature is affixed to this bid, is duly authorized to execute contracts.

The names, titles and business addresses of the President, Secretary and Treasurer are as follows:

President:

Secretary:

Treasurer:

If non-Kentucky corporation:

Date of qualification in Kentucky: _____________________________

Name and address of process agent in Kentucky:

2. A partnership, all of the members of which, with addresses are: (Designate general partners as such.)

If all partners are non-resident of Kentucky: (Designate name and address of agent for service of process located in Kentucky.)

3. An individual, whose signature is affixed to this Bid: (If non-resident of Kentucky, resident agent for the service of process must be designated below.)

The Bidder shall fill out the appropriate form (1., 2., or 3. above) and strike out the other two.

R. Bidder declares that the Bidder is the only person interested in this bid. This bid is made without any connection with any person making another bid for the same contract. Bidder did not, in any way, collude, conspire, or agree, directly or indirectly with any person, firm, corporation or other person in regard to the amount, terms, or conditions of this bid. No member of the Kenton County Airport Board (Board) or any person in the employ of the Board, is directly or indirectly interested in this bid, or in the supplies or work to which it relates or in any portion of the profits.

Dated and signed at _______________________________________________________, _______________ this _______ day of__________________, 20____.

NAME OF BIDDER:

BY:

TITLE:

BUSINESS ADDRESS: __________________________________________________________

WITNESS:

END OF SECTION

EEO CERTIFICATION

The Bidder certifies and agrees that all persons employed by such firm, its affiliates, subsidiaries, or holding companies are and will be treated equally by the firm without regard to or because of race, religion, ancestry, national origin, age, handicap, or sex, and in compliance with all anti-discrimination laws of the United States of America and the Commonwealth of Kentucky.

BIDDER'S CERTIFICATION

1. The Bidder has a written policy statement prohibiting discrimination in all phases of employment.

Answer "YES" or "NO" __________________

2. The Bidder periodically conducts a self-analysis or utilization analysis of its work force.

3. The Bidder has a system for determination if its employment practices are discriminatory against protected groups.

4. Where problem areas are identified in employment practices, the Bidder has a system for taking reasonable corrective action to include establishment of goals and timetables.

Answer "YES" or "NO” __________________

Name: Bidding Contractor ________________________________________________________

By __________________________________________ Date: _________

(SIGNATURE)

Name and Title _______________________________________________________

(PRINT OR TYPE)

Business Address _______________________________________________________

IRS Employer ID# _______________________________________________________

NONSEGREGATED FACILITIES CERTIFICATION

The Bidder certifies that it does not maintain or provide for its employees any segregated facilities at any of its establishments and that it does not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The Bidder certifies further that it will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it will not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The Bidder agrees that a breach of this certification is a violation of the Equal Opportunity Clause in any resultant Contract. As used in this Certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, sex, or national origin, because of habit, local custom, or any other reason. The Bidder agrees that (except where it has obtained identical Certifications from proposed subcontractors for specific time periods) it 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 it will retain such Certifications in its files.

Per 41 CFR 60-1.8, Contractors receiving federally-assisted construction contract awards, and Contractors receiving subcontract awards, exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause will be required to provide for the forwarding of the below notice to prospective contractors for supplies and construction contracts where the subcontracts exceed $10,000 and are not exempt from the provisions of the Equal Opportunity Clause.

CERTIFICATION TO BE SUBMITTED BY FEDERALLY ASSISTED CONSTRUCTION CONTRACTORS AND THEIR SUBCONTRACTORS (APPLICABLE TO FEDERALLY ASSISTED CONSTRUCTION CONTRACTS AND RELATED

SUBCONTRACTS EXCEEDING $10,000 WHICH ARE NOT EXEMPT FROM THE EQUAL OPPORTUNITY

CLAUSE).

CERTIFICATION

The information above is true and complete to the best of my knowledge and belief. (Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001).

Name: Bidding contractor __________________________________________________________

By _________________________________________Date: _____________

(SIGNATURE)

Name and Title __________________________________________________________

(PRINT OR TYPE)

Business Address __________________________________________________________

IRS Employer ID# __________________________________________________________

BIDDER’S QUALIFICATIONS

Each bidder shall furnish the following completed and signed statements on "evidence of competency" and "evidence of financial responsibility" with its bid in accordance with General Provision 20-02. In addition, the Owner reserves the right to conduct such additional investigation into the competency and responsibility of the bidders (or any particular bidder) as the Owner may deem necessary.

1. Name of Bidder: _____________________________________________________

2. Business address: ____________________________________________________

3. Telephone number: ___________________________________________________

4. When organized: _____________________________________________________

5. Where incorporated: __________________________________________________

6. How many years have you been engaged in the contracting business under the present firm name?

7. What is the type of construction work in which you are principally engaged?

8. On separate sheet, list major contracts in past 10 years.

9. On separate sheet, list equipment and plant available for this project.

10. Enclose evidence of financial responsibility per General Provisions Section 20-02.

11. Credit available for this Contract $________________________

12. On a separate sheet, list all projects presently under Contract by name, gross amount, and percent complete.

13. Have you ever refused to sign a Contract at your original bid? _________________

14. Have you ever been declared in default on a Contract? ______________________

15. Total amount of bonding capacity $ _______________________________________

16. Total bonding capacity available for the project $ ____________________________

17. Remarks: ___________________________________________________________________

(The above statements must be subscribed and sworn to before a Notary Public.)

Date: _______________________________________

Firm Name: __________________________________

By: _________________________________________ (Signature)

Title: ________________________________________

STATE OF ___________________________________

COUNTY OF _________________________________

Subscribed and sworn to before me, a Notary Public, in and for the County and State aforesaid by

______________________________ duly authorized so to sign this _____ day of __________________, 20____.

Notary Public

My Commission Expires: _____________________________

BID TAB

** For reference only – pricing must be submitted through the online bidding system **

Line Item Description Quantity UOM

1 Contractor Quality Control Program 1 LS

2 Temporary Seeding and Mulching [*] 3950 SY

3 Temporary Inlet Protection [*] 8 EA

4 Temporary Inlet Filter Bag [*] 11 EA

5 Temporary Rock Construction Entrance [*] 2 EA

6 Silt Fence [*] 1600 LF

7 Concrete Washout Pit [*] 2 EA

8 Mobilization 1 LS

9 PCC Pavement Removal 40900 SY

10 AC Pavement Removal 3100 SY

11 Joint and Crack Repair 850 LF

12 Cold Milling 85 SY

13 Removal of Pipe and Other Buried Structures 1 LS

14 Remove Bollards 10 EA

15 Unclassified Excavation 13545 CY

16 Crushed Aggregate Base Course (6 to 7 inches) [*] 44300 SY

17 Crushed Aggregate Base Course (variable depth - up to 12 inches) [*] 1070 SY

18 Cement-Treated Base Course (6-inch) [*] 40900 SY

19 Asphalt Mixture Course [*] 1900 TON

20 Concrete Pavement [*] 40900 SY

21 Emulsified Asphalt Tack Coat [*] 950 GAL

26 Surface Preparation 6500 SY

27 Marking Removal 10100 SF

28 Marking [*] 21000 SF

29 Preformed Markings [*] 650 SF

30 Reflective Media [*] 1 LS

31 Temporary Marking [*] 21000 SF

32 6-inch Pipe Underdrain, Complete [*] 930 LF

33 Inspection Holes [*] 8 EA

34 Seeding [*] 22900 SY

35 Topsoil (Furnished from Off the Site) [*] 2750 CY

36 Mulching [*] 2600 SY

37 Remove #8 AWG L-824 Cable 5150 LF

38 Remove 1W-2” PVC Duct Bank in Pavement to be Demolished 1910 LF

39 Remove 3W-Multi PVC Duct Bank in Pavement to be Demolished 420 LF

40 Remove Fixture and L-867B Base Can 23 EA

41 Remove Fixture and L-868B Base Can 7 EA

42 Remove L-868B Base Can with Blank Cover 3 EA

43 Remove Sign and Foundation 2 EA

44 Remove Aircraft-Rated Manhole 1 EA

45 Remove Non-Aircraft-Rated Manhole 1 EA

46 No. 8 AWG, 5 kV , L-824, Type C Cable, Installed in Trench, Duct Bank, or Conduit [*] 5150 LF

No. 6 AWG, Solid, Bare Counterpoise Wire Installed above the Duct Bank or Conduit, including Connections/Terminations [*] 2040 LF

48 Concrete-Encased, Electrical Duct Bank, 1-Way 2-inch C, 24-inch Minimum Cover [*] 1630 LF

49 Concrete-Encased, Electrical Duct Bank, 4-Way, 2-inch C, 24-inch Minimum Cover [*] 410 LF

50 4-Can Pullcan Plaza [*] 1 EA

51 New 861T(L) Elevated Taxiway Edge Light Fixture and Base [*] 15 EA

52 New L-852(L) Taxiway Centerline Fixture and Base [*] 7 EA

53 L-868B Base Can in Pavement with Blank Cover [*] 3 EA

54 Replace Sign Panel [*] 1 SIDE

55 New Sign and Foundation [*] 1 EA

56 Temporary Lighting 1 LS

57 Low-Profile Barricades [*] 5200 LF

58 Maintenance of Haul Road during Construction 1 LS

59 Contractor Security Officer 1 LS

60 Vehicle and Construction Equipment Control Plan and SPCD 1 LS

61 Contractor Badging 1 LS

62 Unlit Construction Signs 4 EA

63 Airport Safety and Security - Gate Guards 2700 HOUR

64 Airport Safety and Security - Escorts 5400 HOUR

65 Structure Modification 2 EA

66 Pipe Abandonment 3010 LF

67 Bollard [*] 8 EA

PROPOSAL BOND

KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned bidder _____________________________, as Principal, and ____________________________, as a Corporation Surety authorized under the laws of the Commonwealth of Kentucky, and authorized to write this type of bond through a resident agent of the corporation located in the State of ___________________, as surety, are held and firmly bound unto the Kenton County Airport Board in the sum of _______________________________________ Dollars ($_____________) for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves and our heirs, executors, administrators, successors, and assigns.

The condition of the above obligation is such that if the attached proposal of ___________________________________________ for the improvement of airport facilities stipulated in said proposal in accordance with the Plans and Specifications provided therefore, is accepted and the Contract awarded to the above named Bidder, and the said Bidder shall within 10 days after notice of said award enter into a Contract in writing and furnish the required Payment and Performance Bonds with surety, or sureties, to be approved by the Kenton County Airport Board this obligation shall be void. Otherwise, the same shall be in full force and virtue of law, and the full amount of this Proposal Bond will be paid to the Kenton County Airport Board as stipulated for liquidated damages.

Signed this ________ day of ______________________, 20____.

(PRINCIPAL MUST INDICATE WHETHER

CORPORATION, PARTNERSHIP, COMPANY,

OR INDIVIDUAL)

Principal (Seal)

THIS PERSON SIGNING SHALL IN HIS/HER

OWN HANDWRITING SIGN THE PRINCIPAL'S BY:

NAME AND TITLE. BY WHERE THE

PERSON SIGNING FOR A CORPORATION IS

OTHER THAN THE PRESIDENT OR VICE (Name and Title)

PRESIDENT, HE/SHE MUST, BY AFFIDAVIT AS

CONTAINED HEREIN, SHOW AUTHORITY ____

TO BIND THE CORPORATION. Surety (Seal)

(Name and Title)

FORM 1: DISADVANTAGED BUSINESS ENTERPRISE (DBE) UTILIZATION

The undersigned bidder has satisfied the requirements of the bid specification in the following manner (please check the appropriate space):

_____ The bidder is committed to a minimum of ____ % DBE utilization on this contract.

_____ The bidder (if unable to meet the DBE goal of ____%) is committed to a minimum of ____% DBE utilization on this contract and submits documentation demonstrating good faith efforts.

Name of bidder’s firm: ______________________________________

State Registration No. ____________________

By ___________________________________ ______________________ (Signature) Title

FORM 2: LETTER OF INTENT

Name of bidder’s firm: ________________________________________________________

Bidder’s address: ___________________________________________________________

City: ___________________________________ State: _____________ Zip: ____________

Name of DBE firm: __________________________________________________________

Address: __________________________________________________________________

City: ____________________________________State: ____________ Zip: ____________

Telephone: _______________________________________________________________

Description of work to be performed by DBE firm (Include associated NAICS, and if Manufacturer, Regular Dealer, Distributor, or Broker):

The bidder intends to utilize the above-named DBE firm for the work described above. The estimated amount of work is valued at $ ___________________.

Affirmation The above-named DBE firm affirms that it will perform the portion of the contract for the estimated dollar value as stated above.

By (Signature) (Title) (Company)

If the above-named bidder is not determined to be the successful bidder, this Letter of Intent and Affirmation is null and void. The undersigned bidder/offeror is committed to utilizing the above-named DBE firm for the work described above.

The above-named Bidder affirms that it will utilize the listed DBE firm for the portion of the contract for the estimated dollar value as stated above.

By (Signature) (Title) (Company)

The bidder/offeror understands that if it is awarded the contract/agreement resulting from this procurement, it must enter into a subcontract with the DBE firm identified above that is representative of the type and amount of work listed. Bidder/offeror understands that upon submitting this form with its bid/offer, it may not substitute or terminate the DBE listed above without following the procedures of 49 CFR Part 26, §26.53.

(Submit this page for each DBE subcontractor.)

AFFIRMATIVE ACTION CERTIFICATION

The Bidder HAS / HAS NOT (strike out inappropriate term) participated in a previous contract subject to the Equal Opportunity Clause prescribed by Executive Order 10925, or Executive Order 11246, or Executive Order 11114.

The Bidder HAS / HAS NOT (strike out the inappropriate term) submitted all compliance reports in connection with any such contract due under the applicable filing requirements; and that representations indicating submission of required compliance reports signed by proposed subcontractors will be obtained prior to award of subcontracts.

If the Bidder has participated in a previous contract subject to the Equal Opportunity Clause and has not submitted compliance reports due under applicable filing requirements, the Bidder shall submit a compliance report on Standard Form 100, "Employee Information Report" prior to the award of the Contract.

Name: Bidding Contractor _______________________________________________________

By _____________________________________Date:_______________

Name and Title ________________________________________________________

NON-DEBARMENT OR SUSPENSION CERTIFICATION

In accordance with the CODE OF FEDERAL REGULATIONS, Part 49, CFR Section 29.510, the Bidder, being duly sworn (or under penalty of perjury under the laws of the United States), certifies to best of his/her knowledge and belief, that its principals:

1. are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency;

2. have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of record, making false statements, or receiving stolen property;

3. are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in the above paragraph of this certification; and

4. have not within a three-year period preceding this proposal had one or more public transactions (federal, state, or local) terminated for cause or default.

Where the Bidder is unable to certify to any of the statements in this certification, such Bidder shall list exceptions below. Exceptions will not necessarily result in denial of award, but will be considered in determining contractor responsibility. For any exception noted, indicate below to whom it applies, the initiating agency, and the dates of the action. Providing false information may result in criminal prosecution or administrative sanction. If an exception is noted, the Bidder must contact the Sponsor to discuss the exception prior to award of the Contract.

The Bidder certifies under penalty of perjury under the laws of the Commonwealth of Kentucky that the foregoing is correct and true.

Name: Bidding contractor ___________________________________________________

By _________________________________Date:_______________

Name and Title ____________________________________________________

Subscribed and sworn before me this date: Month _________ Day ______ Year __________

Notary Public's signature: ____________________________________________________

Commission expires: _________________________________________________________

BUY AMERICAN CERTIFICATION –

CONSTRUCTION PROJECTS

The contractor shall comply with 49 USC § 50101, which provides that Federal funds may not be obligated unless all steel and manufactured goods used in AIP-funded projects are produced in the United States, unless the FAA has issued a waiver for the product; the product is listed as an Excepted Article, Material Or Supply in Federal Acquisition Regulation subpart 25.108; or is included in the FAA Nationwide Buy American Waivers Issued list.

As a matter of bid responsiveness, the bidder or offeror must complete, sign, date, and submit this certification statement with their proposal. The bidder or offeror must indicate how they intend to comply with 49 USC § 50101 by selecting one on the following certification statements. These statements are mutually exclusive. Bidder must select one or the other (not both) by inserting a checkmark () or the letter “X”.

Bidder or offeror hereby certifies that it will comply with 49 USC § 50101 by:

a) Only installing steel and manufactured products produced in the United States, or;

b) Installing manufactured products for which the FAA has issued a waiver as indicated by inclusion on the current FAA Nationwide Buy American Waivers Issued listing, or;

c) Installing products listed as an Excepted Article, Material or Supply in Federal

Acquisition Regulation Subpart 25.108.

By selecting this certification statement, the bidder or offeror agrees:

1. To provide to the Owner evidence that documents the source and origin of the steel and manufactured product.

2. To faithfully comply with providing US domestic product

3. To furnish US domestic product for any waiver request that the FAA rejects

4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified.

The bidder or offeror hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC § 50101(a) but may qualify for either a Type 3 or Type 4 waiver under 49 USC § 50101(b). By selecting this certification statement, the apparent bidder or offeror with the apparent low bid agrees:

1. To the submit to the Owner within 15 calendar days of the bid opening, a formal waiver request and required documentation that support the type of waiver being requested.

2. That failure to submit the required documentation within the specified timeframe is cause for a non-responsive determination may result in rejection of the proposal.

3. To faithfully comply with providing US domestic products at or above the approved US domestic content percentage as approved by the FAA.

4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified.

Required Documentation

Type 3 Waiver - The cost of the item components and subcomponents produced in the United States is more that 60% of the cost of all components and subcomponents of the “item”. The required documentation for a type 3 waiver is:

a) Listing of all product components and subcomponents that are not comprised of 100% US domestic content (Excludes products listed on the FAA Nationwide Buy American Waivers Issued listing and products excluded by Federal Acquisition Regulation Subpart 25.108; products of unknown origin must be considered as non-domestic products in their entirety).

b) Cost of non-domestic components and subcomponents, excluding labor costs associated with final assembly at place of manufacture.

c) Percentage of non-domestic component and subcomponent cost as compared to total “item” component and subcomponent costs, excluding labor costs associated with final assembly at place of manufacture.

Type 4 Waiver – Total cost of project using US domestic source product exceeds the total project cost using non-domestic product by 25%. The required documentation for a type 4 of waiver is:

a) Detailed cost information for total project using US domestic product

b) Detailed cost information for total project using non-domestic product

False Statements: Per 49 USC § 47126, this certification concerns a matter within the jurisdiction of the Federal Aviation Administration and the making of a false, fictitious or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code.

Date Signature

Company Name Title

DISCLOSURE OF LOBBYING ACTIVITIES CERTIFICATION

Certification for Federal-Aid Construction Services. In accordance with Public Law 101-1210, Section 319, by signing and submitting this bid, the Bidder certifies to the best of Bidder’s knowledge and belief:

1. that no federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement; and

2. that if any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence and officer or employee of any federal agency, a Member of Congress, and officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.

This certification is a material representation of fact upon which reliance will be placed when a transaction is made or entered into. Submission of this Certification is a prerequisite for making or entering into a transaction imposed by Section 1352, Title 31, United States Code. Any person who fails to file the required Certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

The Bidder also agrees by submitting its bid that Bidder shall require the language of this Certification be included in all lower tier subcontracts, which exceed $100,000 and all subrecipients shall certify and disclose accordingly.

The Bidder certifies under penalty of perjury under the laws of the Commonwealth of Kentucky that the foregoing is correct and true.

Name: Bidding contractor ________________________________________________________

By __________________________________________Date:__________

(SIGNATURE)

Name and Title ________________________________________________________

(PRINT OR TYPE)

Subscribed and sworn before me this date: Month _____________________ Day ______ Year _____

Notary Public's signature: ______________________________________________

Commission expires: ______________________________________________

AFFIDAVIT REGARDING WORKER'S COMPENSATION

The undersigned Contractor, being awarded a Contract by the Kenton County Airport Board, operator of the Cincinnati/Northern Kentucky International Airport, identified as:

________________________________ hereby assures that all Contractors and subcontractors employed, or that will be employed, under the provisions of the foregoing identified contract shall be in compliance with Kentucky requirements for Worker's Compensation Insurance according to KRS Chapter 342 and unemployment insurance according to KRS Chapter 341.

DATED this day of , 20____.

Signature: ___________________________________________________

Name and Title (Printed):

STATE OF

COUNTY OF

Subscribed and sworn to before me, a Notary Public, by ________ , on behalf of the foregoing identified Contractor this day of ____ 20 .

Notary Public

My Jurisdiction is:

My Commission Expires:

SAFETY EVALUATION AND PLANS

1.1 It is the goal of the Board to maintain a safe working environment for contractors, subcontractors and Airport personnel. All bidders must provide the following safety information for the bidder and all subcontractors for the three previous calendar years on the attached Safety Evaluation Form:

1. Documented DART Rate;

a. Desired DART Rate equal to or less than the BLS industry average

2. NCCI Workers’ Compensation Experience Modification Rate (EMR):

a. Desired EMR of 1.0 or less

3. Documented Recordable Incidence Rate;

a. Desired Incident Rate equal to or less than the BLS industry average

b. The rates for the “Construction” Industry Sector on the Bureau of Labor

Statistics most recent Table 7 - Incidence rates of nonfatal occupational injuries and illnesses by major private industry sector and selected case types will be used for comparison with industry standard. Table 7 may be found at http://www.bls.gov/news.release/osh.t07.htm

c. Information on calculating Incident Rates can be found at http://data.bls.gov/iirc/

4. Completed and signed OSHA 300 logs & OSHA 300A forms; and,

5. Any serious or willful KYOSHA, Federal OSHA or any other state OSHA plan violations.

1.2 At or before the preconstruction meeting and prior to commencement of physical work on this project, the successful bidder shall provide:

1 A site-specific safety program for this project which includes the name of contractor’s safety manager for this project who will serve as the primary liaison to the Board for safety related issues, including all safety issues relating to subcontractors;

2 Certification that all contractor and subcontractor personnel on the project have been trained on the site-specific safety program;

3 Completed and signed Contractor Safety Survey (form provided by Owner); and, 4 A description of Contractor’s and all subcontractors’ alcohol and drug free workplace plans, which at least includes pre-employment and post-accident drug and alcohol testing, and certification that all personnel working on the project are in compliance with these plans.

http://www.bls.gov/news.release/osh.t07.htm http://data.bls.gov/iirc/

*Bidder to make photocopies of this sheet if additional room is required. END OF SECTION

SAFETY EVALUATION FORM

Bidders must provide the following information for its company and all subcontractors which will be doing work on this project for evaluation by the Owner.

See Specifications for further details.

COMPANY NAME Discipline Documented recordable Incident Rate

NCCI WORKER’S

COMPENSATION

EXPERIENCE

MODIFICATION

FACTOR(EMR)

Serious or Willful KOSHA or Other State Plan

VIOLATIONS

If greater than “0" provide written details.

DOCUMENTED DART

RATE

(Last three calendar years)

2022 2023 2024 2022 2023 2024 2022 2023 2024 2022 2023 2024

CERTIFICATION OF OFFEROR/BIDDER REGARDING TAX DELINQUENCY AND FELONY

CONVICTIONS

The applicant must complete the following two certification statements. The applicant must indicate its current status as it relates to tax delinquency and felony conviction by inserting a checkmark () in the space following the applicable response. The applicant agrees that, if awarded a contract resulting from this solicitation, it will incorporate this provision for certification in all lower tier subcontracts.

Certifications

1) The applicant represents that it is (____) is not (____) a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.

2) The applicant represents that it is (____) is not (____) a corporation that was convicted of a criminal violation under any Federal law within the preceding 24 months.

Note

If an applicant responds in the affirmative to either of the above representations, the applicant is ineligible to receive an award unless the sponsor has received notification from the agency suspension and debarment official (SDO) that the SDO has considered suspension or debarment and determined that further action is not required to protect the Government’s interests. The applicant therefore must provide information to the Owner about its tax liability or conviction, who will then notify the FAA Airports District Office, which will then notify the agency’s SDO to facilitate completion of the required considerations before award decisions are made.

Term Definitions

Felony conviction: Felony conviction means a conviction within the preceding twenty-four (24) months of a felony criminal violation under any Federal law and includes conviction of an offense defined in a section of the U.S. code that specifically classifies the offense as a felony and conviction of an offense that is classified as a felony under 18 U.S.C. § 3559.

Tax Delinquency: A tax delinquency is any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted, or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.

CERTIFICATION REGARDING DOMESTIC PREFERENCES FOR PROCUREMENTS

The Bidder or Offeror certifies by signing and submitting this bid or proposal that, to the greatest extent practicable, the Bidder or Offeror has provided a preference for the purchase, acquisition, or use of goods, products, or materials produced in the United States (including, but not limited to, iron, aluminum, steel, cement, and other manufactured products) in compliance with 2 CFR § 200.322.