4-City Project No. 106168.xlsx

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The referenced forms may be downloaded from the links provided below.

Form CIQ (Conflict of Interest Questionnaire) (state.tx.us) https://www.ethics.state.tx.us/data/forms/conflict/CIS.pdf

CIQ Form does not apply

CIQ Form is on file with City Secretary

CIQ Form is being provided to the City Secretary

CIS Form does not apply

CIS Form is on File with City Secretary

CIS Form is being provided to the City Secretary

BIDDER:

By:

Signature:

Title:

END OF SECTION

&"Arial,Regular"&8&A

CONFLICT OF INTEREST STATEMENT

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&"Arial,Regular"&8CITY OF FORT WORTH

STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS

Revised February 24, 2020 &"Arial,Regular"&8 2026 Asphalt Resurfacing Contract 1 &F https://www.ethics.state.tx.us/data/forms/conflict/CIQ.pdf 00 41 00

FOR: 2026 Asphalt Resurfacing Contract 1

City Project No.: 106168

Units/Sections: -

1. Enter Into Agreement

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

2. BIDDER Acknowledgements and Certification

2.1. In submitting this Bid, Bidder accepts all of the terms and conditions of the INVITATION TO BIDDERS and INSTRUCTIONS TO BIDDERS, including without limitation those dealing with the disposition of Bid Bond.

2.2. Bidder is aware of all costs to provide the required insurance, will do so pending contract award, and will provide a valid insurance certificate meeting all requirements within 14 days of notification of award.

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

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

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

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

a. "corrupt practice" means the offering, giving, receiving, or soliciting of any thing of value likely to influence the action of a public official in the bidding process.

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

c. "collusive practice" means a scheme or arrangement between two or more Bidders, with or without the knowledge of City, a purpose of which is to establish Bid prices at artificial, non-competitive levels.

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

3. Prequalification

The Bidder acknowledges that the following work types must be performed only by prequalified contractors and subcontractors:

a. Asphalt Paving Heavy Maintenance ($1,000,000 and OVER)

b. -

c. -

d. -

e. -

f. -

g. -

h. -

4. Time of Completion

4.2. Bidder accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work {and/or achievement of Milestones} within the times specified in the Agreement.

5. Attached to this Bid

The following documents are attached to and made a part of this Bid:

a. This Bid Form, Section 00 41 00

b. Required Bid Bond, Section 00 43 13 issued by a surety meeting the requirements of Paragraph 5.01 of the General Conditions.

c. Proposal Form, Section 00 42 43

d. Vendor Compliance to State Law Non Resident Bidder, Section 00 43 37

e. MWBE Forms (optional at time of bid)

f. Prequalification Statement, Section 00 45 12

h. Any additional documents that may be required by Section 12 of the Instructions to Bidders

6. Total Bid Amount

6.1. Bidder will complete the Work in accordance with the Contract Documents for the following bid amount. In the space provided below, please enter the total bid amount for this project. Only this figure will be read publicly by the City at the bid opening.

6.2. It is understood and agreed by the Bidder in signing this proposal that the total bid amount entered below is subject to verification and/or modification by multiplying the unit bid prices for each pay item by the respective estimated quantities shown in this proposal and then totaling all of the extended amounts.

6.3. Total Bid

Total Bid $185,000.00

7. Bid Submittal

This Bid is submitted on by the entity named below.

Respectfully submitted, Receipt is acknowledged of the following Addenda: Initial

Title:

Company: Corporate Seal:

Address:

State of Incorporation:

Email:

Phone:

END OF SECTION

BID FORM

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&"Arial,Regular"&8CITY OF FORT WORTH

STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS

Revised 9/30/2021 &"Arial,Regular"&8 2026 Asphalt Resurfacing Contract 1 &F

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UNIT PRICE BID Bidder's Application UNIT PRICE BID Owner's Application

Project Item Information Bidder's Proposal Project Item Information Bid Item Funding and Percentage Breakdown

Bidlist Item No. Description Specification Section No. Unit of Measure Bid Quantity Unit Price Bid Value Bid Item No. Description % This Item Portion of Bid Value Amount % This Item Portion of Bid Value Amount % This Item Portion of Bid Value Amount % This Item Portion of Bid Value Amount % This Item Portion of Bid Value Amount % This Item Portion of Bid Value Amount