KENTON COUNTY AIRPORT BOARD CINCINNATI/NORTHERN KY INTERNATIONAL AIRPORT

TAXIWAY M RECONSTRUCTION

EXHIBIT A

PROPOSAL DOCUMENTS

Table of Contents

PROPOSAL

PROPOSAL FORM

BIDDER’S QUALIFICATIONS

BID TAB

PROPOSAL BOND

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 20

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 June 2026 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 #26-037-ITB, titled the same as written above, which is incorporated by reference.

The Project includes full-depth reconstruction of Taxiway M from Taxiway M3 to Taxiway M1.

Additional items include new centerline lights, drainage improvements, taxiway edge lights, shoulder, and reconstruction of ARFF pavements (ineligible, locally funded).

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 2 (#25-075-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

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

Table Line Description UOM Quantity Spec. No.

BASE BID 1 CONTRACTOR QUALITY CONTROL PROGRAM (CQCP) LS 1 C-100

BASE BID 2 INSTALLATION AND REMOVAL OF SILT FENCE LF 2100 C-102-5.1A

BASE BID 3 STABILIZED CONSTRUCTION ENTRANCE EA 1 C-102-5.1B

BASE BID 4

COMPLIANCE WITH POLLUTION, EROSION & SILTATION

CONTROL LS 1 C-102-5.1C

BASE BID 5 STORM DRAIN INLET PROTECTION (IN PAVEMENT) EA 3 C-102-5.1D

BASE BID 6 STORM DRAIN INLET PROTECTION (IN TURF) EA 15 C-106-5.1E

BASE BID 7 MOBILIZATION (7% MAX) LS 1 C-105-5.1

BASE BID 8 ENGINEER'S FIELD OFFICE LS 1 C-105-5.2

BASE BID 9 FIELD OFFICE EQUIPMENT LS 1 C-105-5.3

BASE BID 10 CONSTRUCTION ADMINISTRATION VEHICLES DLR 40000 C-105-5.4

BASE BID 11 SAFETY, SECURITY AND MAINTENANCE OF TRAFFIC LS 1 CX-106-4.1

BASE BID 12 LOW PROFILE BARRICADE EA 325 CX-106-4.2

BASE BID 13

RUNWAY/TAXIWAY OBJECT FREE AND SAFETY AREA

BOUNDARY FENCE LF 1350 CX-106-4.3

BASE BID 14 TEMPORARY ELEVATED EDGE LIGHT COVERS EA 40 CX-106-4.4

BASE BID 15 AIRFIELD SIGN MODIFICATIONS EA 20 CX-106-4.5

BASE BID 16 TEMPORARY CONSTRUCTION SIGN EA 11 CX-106-4.6

BASE BID 17 CONTRACT ESCORTING SERVICES DLR 465000 CX-106-4.7

BASE BID 18 TEMPORARY ACCESS GATE BOOTHS EA 1 CX-106-4.9

BASE BID 19 RECONSTRUCT HAUL ROAD SY 2400 CX-106-4.10

BASE BID 20 REHABILITATE HAUL ROAD SY 1000 CX-106-4.11

BASE BID 21 PAVEMENT REMOVAL, PCC, VARIABLE DEPTH SY 18900 P-101-5.1

BASE BID 22 PAVEMENT REMOVAL, PCC, 10" PAVEMENT SY 1000 P-101-5.2

BASE BID 23

PAVEMENT REMOVAL, ASPHALT SHOULDER, VARIABLE

DEPTH SY 15400 P-101-5.4

BASE BID 24 CONCRETE SPALL REPAIR SF 500 P-101-5.5

BASE BID 25 REMOVE DRAINAGE PIPE, 36" OR LESS LF 490 P-101-5.8

BASE BID 26 UNCLASSIFIED EXCAVATION CY 15300 P-152-4.1

BASE BID 27 GRANULAR FILL COURSE AGGREGATE CY 950 P-152-4.2

BASE BID 28 SEPARATION GEOTEXTILE SY 7500 P-152-4.3

BASE BID 29 CONTROLLED LOW-STRENGTH MATERIAL (CLSM) CY 100 P-153-6.1

BASE BID 30 CRUSHED AGGREGATE BASE COURSE CY 15900 P-209-5.1

BASE BID 31 CEMENT-TREATED BASE COURSE SY 19200 P-304-8.1

BASE BID 32 ASPHALT MIXTURE SURFACE COURSE (GRADATION 1) TON 3800 P-403-8.1

BASE BID 33 ASPHALT MIXTURE BASE COURSE (GRADATION 2) TON 250 P-403-8.2

BASE BID 34 CEMENT CONCRETE PAVEMENT (19 INCH) SY 20400 P-501-8.1

BASE BID 35 EMULSIFIED ASPHALT TACK COAT GAL 775 P-603-5.1

BASE BID 36 MARKING SF 24325 P-620-5.1

BASE BID 37 REFLECTIVE MEDIA LB 975 P-620-5.2

BASE BID 38 TEMPORARY RUNWAY AND TAXIWAY MARKING SF 11200 P-620-5.3

BASE BID 39 PREFORMED MARKING SF 3070 P-620-5.4

BASE BID 40 MARKING REMOVAL SF 7500 P-620-5.5

BASE BID 41 SOFT DIGS DAY 5 DX-800-4.1

BASE BID 42

14 INCH X 23 INCH ELLIPTICAL - REINFORCED CONCRETE

PIPE CLASS V LF 32 D-701-5.1

BASE BID 43 8 INCH SOLID PVC PIPE UNDERDRAIN OUTFALL LF 665 D-705-5.1

BASE BID 44 8 INCH PVC PIPE UNDERDRAIN, COMPLETE (SLOTTED) LF 3350 D-705-5.2

BASE BID 45 UNDERDRAIN CLEANOUT EA 15 D-705-5.3

BASE BID 46 CONNECT UNDERDRAIN OUTFALL TO EXISTING RCP EA 1 D-705-5.4

BASE BID 47 CONNECT UNDERDRAIN OUTFALL TO EXISTING STRUCTURE EA 9 D-705-5.5

BASE BID 48

AIRCRAFT RATED MANHOLE OR CATCH BASIN, 4-FOOT

DIAMETER EA 1 D-751-5.1

BASE BID 49 ADJUST MANHOLE OR CATCH BASIN - MINOR EA 3 D-751-5.2

BASE BID 50 ADJUST MANHOLE OR CATCH BASIN - MAJOR EA 4 D-751-5.3

BASE BID 51

RECONSTRUCT MANHOLE OR CATCH BASIN FOR STORM

CONNECTION EA 1 D-751-5.4

BASE BID 52 ADJUST EXISTING WATER VALVE EA 1 D-751-5.5

BASE BID 53 SEEDING ACRE 5 T-901-5.1

BASE BID 54

TOPSOIL (OBTAINED ON SITE OR REMOVED FROM

STOCKPILE) CY 2550 T-905-5.1

BASE BID 55 MULCHING ACRE 5 T-908-5.1

BASE BID 56

NO. 8 AWG, 5KV, L-824, TYPE C CABLE, INSTALLED IN

TRENCH, DUCT BANK OR CONDUIT LF 23500 L-108-5.1

BASE BID 57

NO. 6 AWG, SOLID, BARE COPPER COUNTERPOISE WIRE,

INSTALLED IN TRENCH, OR ABOVE THE DUCT BANK OR

CONDUIT, INCLUDING CONNECTIONS/TERMINATIONS LF 8000 L-108-5.2

BASE BID 58

CONCRETE ENCASED ELECTRICAL DUCT BANK, 2 WAY - 2

INCH LF 90 L-110-5.1

BASE BID 59

2 INCH DIAMETER CONCRETE ENCASED, SCHEDULE 40 PVC

ELECTRICAL CONDUIT, IN PAVEMENT LF 7400 L-110-5.2

BASE BID 60

2 INCH DIAMETER NON-ENCASED, SCHEDULE 80 PVC

ELECTRICAL CONDUIT, IN TURF LF 400 L-110-5.3

BASE BID 61 REMOVE ELECTRICAL MANHOLE EA 1 L-115-5.1

BASE BID 62 ELECTRICAL PULL BOX EA 1 L-115-5.2

BASE BID 63

EXISTING ELECTRICAL MANHOLE STRUCTURE ELEVATION

ADJUSTMENT EA 1 L-115-5.3

BASE BID 64

REMOVAL OF EXISTING TAXIWAY EDGE LIGHT FIXTURE

AND BASE EA 90 L-125-5.1

BASE BID 65

REMOVAL OF EXISTING TAXIWAY EDGE LIGHT FIXTURE

ONLY EA 7 L-125-5.2

BASE BID 66

REMOVAL OF EXISTING IN-PAVEMENT TAXIWAY

CENTERLINE LIGHT FIXTURE AND BASE CAN IN PAVEMENT EA 8 L-125-5.3

BASE BID 67

REMOVAL AND SALVAGE EXISTING AIRFIELD GUIDANCE

SIGN EA 6 L-125-5.4

BASE BID 68 REMOVAL OF EXISTING AIRFIELD GUIDANCE SIGN EA 1 L-125-5.5

BASE BID 69 REMOVAL OF EXISTING SIGN FOUNDATION EA 7 L-125-5.6

BASE BID 70

L-867 TAXIWAY EDGE LIGHT BASE CAN (PROVIDED BY

AIRPORT) INSTALLED IN NEW ASPHALT PAVEMENT EA 82 L-125-5.7

BASE BID 71

L-867 TAXIWAY EDGE LIGHT BASE CAN (PROVIDED BY

AIRPORT) INSTALLED IN EXISTING ASPHALT PAVEMENT EA 7 L-125-5.8

BASE BID 72

L-868 TAXIWAY CENTERLINE LIGHT BASE CAN (PROVIDED

BY AIRPORT) INSTALLED IN NEW CONCRETE PAVEMENT EA 44 L-125-5.9

BASE BID 73

L-861T(L) LED ELEVATED TAXIWAY EDGE LIGHT (PROVIDED

BY AIRPORT) INSTALLED ON NEW BASE CAN EA 86 L-125-5.10

BASE BID 74

L-861T(L) LED SEMI-FLUSH TAXIWAY EDGE LIGHT

(PROVIDED BY AIRPORT) INSTALLED ON NEW BASE CAN EA 3 L-125-5.11

BASE BID 75

L-852 LED SEMI-FLUSH TAXIWAY CENTERLINE LIGHT

(PROVIDED BY AIRPORT) INSTALLED ON NEW BASE CAN EA 44 L-125-5.12

BASE BID 76

L-852 LED SEMI-FLUSH TAXIWAY CENTERLINE LIGHT

(PROVIDED BY AIRPORT) INSTALLED ON EXISTING BASE

CAN EA 31 L-125-5.13

BASE BID 77

REMOVAL OF EXISTING TAXIWAY EDGE LIGHT FIXTURE

AND BASE CAN IN EXISTING ASPHALT SHOULDER

PAVEMENT WITH PAVEMENT RESTORATION EA 7 L-125-5.14

BASE BID 78

L-858 SIZE 3, 2-MODULE, AIRFIELD GUIDANCE SIGN

(PROVIDED BY AIRPORT) ON NEW CONCRETE

FOUNDATION EA 1 L-125-5.15

BASE BID 79

RE-INSTALL SALVAGED AIRFIELD GUIDANCE SIGN ON NEW

CONCRETE FOUNDATION EA 6 L-125-5.16

BASE BID 80 COORDINATION FOR ALCMS UPDATE DLR 10000 L-125-5.17

ADD-ON 1 81 STORM DRAIN INLET PROTECTION (IN PAVEMENT) EA 3 C-102-5.1D

ADD-ON 1 82 SAFETY, SECURITY AND MAINTENANCE OF TRAFFIC LS 1 CX-106-4.1

ADD-ON 1 83 TEMPORARY 36" PLASTIC DRUMS EA 50 CX-106-4.8

ADD-ON 1 84 PAVEMENT REMOVAL, PCC, 10" PAVEMENT SY 4000 P-101-5.2

ADD-ON 1 85 CONCRETE SPALL REPAIR SF 50 P-101-5.5

ADD-ON 1 86 JOINT SEALANT REMOVAL LF 5800 P-101-5.6

ADD-ON 1 87 REMOVE, STORE AND REINSTALL ROADWAY SIGN EA 3 P-101-5.7

ADD-ON 1 88 REMOVE EXISTING WHEEL STOPS EA 7 P-101-5.10

ADD-ON 1 89 UNCLASSIFIED EXCAVATION CY 840 P-152-4.1

ADD-ON 1 90 GRANULAR FILL COURSE AGGREGATE CY 125 P-152-4.2

ADD-ON 1 91 SEPARATION GEOTEXTILE SY 360 P-152-4.3

ADD-ON 1 92 CONTROLLED LOW-STRENGTH MATERIAL (CLSM) CY 20 P-153-6.1

ADD-ON 1 93 CRUSHED AGGREGATE BASE COURSE CY 715 P-209-5.1

ADD-ON 1 94 ASPHALT MIXTURE SURFACE COURSE (GRADATION 1) TON 4 P-403-8.1

ADD-ON 1 95 CEMENT CONCRETE PAVEMENT (10 INCH) SY 4275 P-501-8.2

ADD-ON 1 96 EMULSIFIED ASPHALT TACK COAT GAL 1 P-603-5.1

ADD-ON 1 97 JOINT CLEANING AND SEALING FILLER LF 5800 P-605-5.1

ADD-ON 1 98 MARKING SF 210 P-620-5.1

ADD-ON 1 99 REFLECTIVE MEDIA LB 20 P-620-5.2

ADD-ON 1 100 SOFT DIGS DAY 1 DX-800-4.1

ADD-ON 1 101 6 INCH PVC PIPE UNDERDRAIN, COMPLETE (SLOTTED) LF 125 D-705-5.2

ADD-ON 1 102 SEEDING ACRE 1 T-901-5.1

ADD-ON 1 103

TOPSOIL (OBTAINED ON SITE OR REMOVED FROM

STOCKPILE) CY 267 T-905-5.1

ADD-ON 1 104 MULCHING ACRE 1 T-908-5.1

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)

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:_______________

(SIGNATURE)

Name and Title ____________________________________________________

(PRINT OR TYPE)

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 U.S.C. § 50101 by selecting one on the following certification statements. These statements are mutually exclusive. Bidder must select one or the other (i.e., not both) by inserting a checkmark () or the letter “X”.

Bidder or offeror hereby certifies that it will comply with 49 U.S.C. § 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 U.S.C. § 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 U.S.C. § 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)

2023 2024 2025 2023 2024 2025 2023 2024 2025 2023 2024 2025

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.