3-Bid 2026-48 Forms for Submission.pdf

Signature Page City of Allentown BID No. 2026-48 Purchasing Office 435 Hamilton Street Page A Allentown, PA 18101

Proposals must be accompanied by the Signature Page. Failure to sign and submit the Signature Page with the bid will result in the bid being rejected as non-responsive.

To: The City of Allentown, Pennsylvania

FIFTEENTH STREET IMPROVEMENT PROJECT

The Undersigned, having examined the Specifications, Standard Requirements and all other documents and being familiar with the various conditions under which these services and/or supplies are to be used, agrees to all terms and conditions set forth in the bid and to furnish all labor, material, tools, equipment and services to furnish the requirements called for in the bid, for the prices stated.

The Undersigned hereby certifies that this response is genuine and not fraudulent or made in the interest of or on behalf of any person, firm, or corporation, not herein named, and that the undersigned has not, directly or indirectly, induced or solicited any Bidder to submit a false or fraudulent bid or prohibited any other person, firm or corporation from bidding and that the undersigned has not, in any manner, sought by collusion to secure for himself any advantage over any Bidder.

A signed Bid/quote submitted to the City obligates the bidder to all terms and conditions stated within the bid/quote document.

Company Name

Address

Signature Printed Name

Title

Email

Phone P.O. Email ______

TRADING AND DOING BUSINESS AS (Check One)

{ } Individual

{ } Partnership

{ } Corporation

Federal I.D.# or Social Security #

Addendum #1 (date)

Addendum #2 (date)

Addendum #3 (date)

(SEAL)

Qualification Statement City of Allentown BID No. 2026-48

435 Hamilton Street Page C

CONTRACTORS QUALIFICATION STATEMENT

NAME

ADDRESS

TELEPHONE DATED

EXPLANATORY

Before any bids are deemed to be properly submitted to the City of Allentown, Pennsylvania, it will be required that each and every question herein contained be answered, giving specific, definite and detailed information.

An answer must not be evasive, indefinite or general.

Qualifications of Bidders: After the bid opening, the City of Allentown may make such investigation as it deems necessary to determine the ability of the bidders to perform the work, and the bidders shall furnish to the City of Allentown all such information and data for this purpose as the City may request. The City of Allentown reserves the right to reject any bid if the evidence submitted by, or investigation of, such bidder fails to satisfy the City that such bidder is properly qualified and responsible to carry out the obligations of the contract and to complete the work contemplated therein.

If the space provided in this form to answer any question is not large enough, the contractor shall add additional sheets or space.

1. How many years has your organization been in business as a contractor under your present name?

2. Have you ever failed to complete any work awarded to you? If so, when, where, and why?

3. Has any officer or partner of your organization ever failed to complete a municipal contract handled in his own name? If so, when, where, and why?

435 Hamilton Street Page C2

4. Has any officer or partner of your organization been in business under any other corporate organization or partnership which failed to complete a municipal contract? If so, when, where, and why?

5. Have liens or lawsuits of any kind been filed against any of your contracts? Give full details.

6. If a corporation, give the date and the state in which you are incorporated.

7. List Surety Companies and Bonding Companies which have heretofore bonded you within the last

5 years. Give name and address of company and name and amount of contract and amount of bond for the same.

8. List all contracts which you are now performing, or for which you have signed contracts but not started work. (Give names and amounts of contracts and owners).

435 Hamilton Street Page C3

9. State all your banking connections and give banking references:

10. The work, if awarded to you, will have the personal supervision of whom?

Work Experience City of Allentown BID No. 2026-48

435 Hamilton Street Page D

Work Experience

BEGIN WITH THE MOST RECENTLY COMPLETED PROJECT

TYPE OF WORK: ______________________________________________________________

Job Title Date Owner Completed Contract Administrator Description

Equipment City of Allentown BID No. 2026-48

435 Hamilton Street Page E

EQUIPMENT

List below the number and type of all major pieces of equipment - backhoes, trucks, etc. - that you propose to use under this contract.

Resident Preference Form City of Allentown BID No. 2026-48

435 Hamilton Street Page F Allentown, PA 18101

Article 815 of the Home Rule Charter of the City of Allentown requires that a five (5%) percent bidding preference, not to exceed $2,500, be granted to resident businesses which maintain either a principal place of business or maintain an office employing at least five (5) employees, or manufacture a product in Allentown, or manufactured by an entity headquartered within the city limits of the City of Allentown.

BIDDERS SHALL COMPLETE THE FOLLOWING:

________ We qualify for the City of Allentown Preference because:

________ We do not qualify for the City of Allentown Resident Preference.

FAILURE TO RESPOND AFFIRMATIVELY TO THE ABOVE WILL IN NO WAY HAVE A NEGATIVE IMPACT ON YOUR

BID.

FIRM NAME:

BY:

PRINTED:

TITLE:

IBE Preference Form City of Allentown BID No. 2026-48

435 Hamilton Street Page G

Article 815B of the Home Rule Charter of the City of Allentown requires that bids received from an Identified Business Enterprise, i.e. Small Business, Small diverse Business, and Veteran Business, the contract shall be awarded to the IBE whose responsible bid is nearest to the bid price of the otherwise low IBE, if the bid price of the IBE is made lower than the bid price of such non-IBE when multiplied by a factor .95. In order to qualify for the preference, the IBE must be properly licensed to do business in the City of Allentown and in compliance with all City Ordinances and regulations. This section shall not apply to bids for the construction of public improvements more than $50,000 or where the difference between the lowest non-resident bid and the lowest resident bid is more than $2,500, or where otherwise prohibited by law or state of federal regulation. In the case of competing IBE’s the award shall be made to the lowest bidder.

BIDDERS SHALL COMPLETE THE FOLLOWING:

________ We qualify for the IBE Preference because:

________ We do not qualify for the IBE Preference.

FAILURE TO RESPOND AFFIRMATIVELY TO THE ABOVE WILL IN NO WAY HAVE A NEGATIVE IMPACT ON YOUR

BID.

FIRM NAME:

BY:

PRINTED:

TITLE:

MBE/WBE SUBCONTRACTORS AND

SUPPLIER

SOLICITATION AND COMMITMENT FORM

CITY OF ALLENTOWN

PURCHASING OFFICE

435 HAMILTON STREET

ALLENTOWN, PA 18101

BID NO. 2026-48

PAGE M1

No subcontractor needed _______ Prime Contractor is a MBE or WBE _______

INSTRUCTION FOR COMPLETION OF THE MBE/WBE SUBCONTRACTOR AND SUPPLIER SOLICITATION AND COMMITMENT FORM

The purpose of this form is to determine whether the bidder has discriminated in the selection of subcontractors and suppliers. Bidders must solicit MBE and WBE vendor participation for any work the bidders intend to subcontract or for any supplies/materials required to perform the contract.

1. Provide the company names, address, telephone number, fax number, email address and contact person.

2. Provide subcontractors name, address, zip code, telephone number and contact person.

3. Indicate whether the firm is a certified MBE or WBE. Place an (X) in the appropriate column. If the firm is certified MBE and WBE, the bidder will receive credit for the firm as either MBE or WBE.

4. Briefly describe the specific work to be performed and/or materials to be supplied by the certified MBE or WBE. In order to count towards reaching the MPLs, bidders must solicit certified MBE’s/WBE’s in the areas which they are certified. For example, if an MBE/WBE is certified for electrical supplies and the bidder lists plumbing supplies, the bidder will not receive credit.

5. Enter the total dollar ($) amount of the quote received. If the quote was received in the form of unit prices or hourly rates, a total dollar amount must still be provided. If the subcontractor did not respond to the bidder, the bidder must indicate “No Response”. Copies of all MBE/WBE quotes must be submitted with the bid.

6. Enter acceptance or rejection of the quote.

7. If quote is rejected complete the reason for rejection of the quote.

8. The bidder must complete both pages and submit form Page M1 with its bid.

9. The bidder must include on Page M1 all solicited and unsolicited quotes received by the bidder from MBE’s and WBE’s as long as the quotes are within the scope of work.

10. The bidder’s contact with MBE/WBE subcontractors and suppliers should be a minimum of (10) days prior to the bid opening date. This will ensure that MBE/WBE’s have sufficient time to prepare a quote. Ten days is a guide. However, adequate time must be provided to all subcontractors and suppliers to respond.

If additional forms are needed, you are permitted to photocopy form.

IMPORTANT NOTICE: FAILURE TO COMPLETE THIS FORM AND SUBMIT IT WITH BIDS OVER $40,000.00 WILL BE SUFFICIENT CAUSE FOR

REJECTION OF THE BID AS NOT RESPONSIVE.

COMPANY NAME:______________________________________________ FAX NUMBER:_________________________________________________

ADDRESS:_____________________________________________________ E-MAIL ADDRESS:______________________________________________

_____________________________________________________ CONTACT PERSON: _____________________________________________

TELEPHONE:___________________________________________________

PAGE M1

Company name, Address, Zip Code, Tel No. w/ Area Code, Contact Person’s Name.

M B E

W B E

Type of Work to be Performed and/or Material to

Be Supplied.

Total Dollar Amount Of

Quote

Quote Accepted

Quote Rejected

Reason for rejection

PAGE M2

CITY OF ALLENTOWN

DEPARTMENT OF COMMUNITY & ECONOMIC DEV.

MWBE-9-08 - (9-08) (PLEASE PRINT)

MINORITY & WOMEN’S BUSINESS ENTERPRISE

PRIME CONTRACTOR’S QUARTERLY UTILIZATION REPORT

(This form should be returned within 10 working days at the end of each quarter.)

PRIME CONTRACTOR’S FIRM NAME REPORTING PERIOD

ADDRESS CONTRACT NUMBER

TELEPHONE

CONTACT PERSON DATE RECEIVED (Office use Only)

List State certified minority and/or women-owned businesses whose services and/or supplies you have purchased in reference to this contract.

COMPANY NAME ADDRESS

TELEPHONE

NUMBER

MBE

(X)

WBE

(X)

TRANSACTION

DATE

PAID

MBE/WBE

ACTUAL

DOLLARS*

SUB

CONTRACT

(X)

SUPPLIES (X)

Prepared By: Title: Phone No: E-Mail Address:

Political Contribution Disclosure Form PAGE H City of Allentown Purchasing Office For Non-Competitive Bid Contracts or

Financial Assistance in Excess of $2,500

Pursuant to the City’s Administrative Code Section 130.16 (H), for all non-competitive bid contracts or financial assistance in excess of

$2,500, an individual or business (including: family members with a financial interest in the business, business associates, subcontractors, contribution to a PAC which makes a candidate contribution, consultants) shall not make a contribution in excess of

$250.00 inclusive of in-kind services in the aggregate, to a candidate for any elective City office or to an elected City office incumbent during the incumbent’s term of office.

VENDOR INFORMATION

Name________________________________________________________________________________________

Address_______________________________________________________________________________________

City_____________________________________________State__________Zip____________________________

CONTRIBUTION DISCLOSURE

Contributor Name Recipient Name Date Dollar Amount

Check here if the information is continued on subsequent page (s).

SUB-CONTRACTOR/CONSULTANT IDENTIFICATION

Name Employer Address

Check here if the information is continued on subsequent page(s).

I certify that NO contributions in the aggregate total over Two Hundred Fifty ($250.00) Dollars were made to an applicable public official by me, a family member or representative. I understand that this certification applies for the length of this contract, and that breach of such contribution rules shall be cause for the void of this contract. I further understand that I will be liable for liquidated damages of 10% of the maximum payment made to me should this contract be voided due to my breach of such contribution rules.

Read and accepted by: ________________________________________________________________________

Signature

Printed Name

Date: ___________________________________ _______________________________________________

Title (Position)

PAGE I

COMMONWEALTH OF PENNSYLVANIA

PUBLIC WORKS EMPLOYMENT VERIFICATION FORM

Date

Business or Organization Name (Employer) ________________________________

Address ____________________________________________________________

City _____________________________________ State _____________ Zip Code

Contractor Subcontractor (circle one)

Contracting Public Body __________________

Contract/Project No _____________________

Project Description ______________________

Project Location _________________________

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

SUBMITTALS CHECKLIST

To help ensure that you include all the submittals necessary to complete a thorough evaluation of your bid proposal, we suggest that you use this checklist as a reminder to yourself, by placing a check in each box in the Verified column indicating that the items are completed and/or enclosed with your bid proposal packet.

VERIFIED DESCRIPTION OF SUBMITTAL REF PAGE NO.

10 % Bid Bond – Must be the first Item in your proposal packet. (Note: Bid Bonds are not needed for RFP’s, unless stated otherwise in the proposal)

Signature Page Page A

Proposal Page Page B

Qualification Statement Page C, C2, C3

Work Experience Page D

Equipment Page E

Resident Preference Form Page F

IBE Preference Form Page G

MBE/WBE Commitment Form M1

MBE/WBE Prime Contractor Form M2

Political Contribution Disclosure Form Page H

Public Works Employment Form Page I

Remember to attach a copy of your most recent W-9 Form.

Remember to direct any/ all bid questions using the PennBid Website. Utilizing this site will guarantee questions are documented and answered quickly and promptly electronically or responded to in form of an addendum.

Remember to check PennBid for any Addenda that may have been issued regarding this bid.