4-EXHIBIT B-5.pdf

Exhibit B-5 Statement of Assurances & Certifications

Residential Meter Box Upgrade – Phase 16 City Project No. WA27BA Solicitation No. 26-3559

Bidder certifies that it has have carefully examined the Bid and Contract Documents for the activity required by the specifications and shall, if a trade contract, furnish all machines, tools, apparatus, and other means of construction and do the work and furnish all the materials necessary to complete the work in the manner, in the time, and according to the methods as specified in the Contract Documents

Bidder certifies that if its Bid is accepted, it shall within 7 calendar days after the Contract Award, sign the Contract and shall, at that time, deliver to the City of Bend the Performance and Payment Bond (if required).

Bidder certifies that the Bid submitted is genuine and not a sham or collusive Bid, or made in the interest or on behalf of any person not therein named; and further certifies that it has not directly or indirectly induced or solicited any Bidder or suppliers to put in a sham Bid, or any other person or corporation to refrain from bidding; and that Bidder has not in any manner sought by collusion to secure an advantage over any other Bidder or Bidders.

Bidder certifies that it shall do the Work as specified and at the price as quoted in conformance to all applicable City, State and Federal Regulations and shall indemnify the City of Bend against all claims arising out of any actions caused by Bidder or Bidder’s Subcontractors.

Bidder certifies that it:

1. Shall comply with Title VI of the Civil Rights Act of 1964, with Section V of the Rehabilitation Act of 1973, and with all applicable requirements of Federal and State civil rights and rehabilitation statues, rules and regulations.

2. Shall comply with the Americans with Disabilities Act (ADA) of 1990, as amended by the ADA Amendments Act (ADAAA) of 2008 and any subsequent amendments (42 U.S.C. § 12101, et seq.) (Pub No. 101-336), ORS 659A, and all regulations and administrative rules established pursuant to those laws.

3. Has not and shall not discriminate against a subcontractor in awarding a subcontract because the subcontractor is a minority, women or emerging small business enterprise certified under ORS 200.055 or a business enterprise that is owned or controlled by or that employs a disabled veteran, as defined in ORS 408.225.

4. Is a subject employer under the Oregon Workers' Compensation Law and shall comply with ORS 656.017, which requires contractors to provide all workers with compensation coverage.

5. We Certify that we ARE ARE NOT (mark one) a “Resident Bidder” as defined by ORS 279A.120. As defined in ORS 279A.120, “Resident Bidder” means a bidder that has paid unemployment taxes or income taxes in this state in the twelve calendar months immediately preceding submission of the bid, has a business address in this state, and has stated in the bid whether the bidder is a “Resident Bidder”. Resident of State ___________________.

6. Shall, in the performance of any Contract awarded by the City of Bend, comply with the City of Bend’s policy of non-discrimination, which prohibits discrimination on the basis of race, color, religion, sex, disability, family status, national origin, gender preference or gender identity.

7. Shall include requirements in its subcontracts requiring its Subcontractors to comply with all statutes, laws, regulations and policies referred to this Section.

8. Has inspected all work sites and has carefully reviewed the plans and specifications and understands the nature and location of the work; the conformation of the grounds; the character, quality, and quantities needed preliminary to and during the prosecution of the work; the general and local conditions; and all other matters which can in any way affect the work. Bidder understands that no verbal agreement or conversation with any officer, agent, or employee of the City, either before or after the submission of Bid, shall affect or modify any of the terms or obligations of the Contract Documents.

9. Is not a City official/employee, and that to the best of its knowledge, Contractor, nor any of its employee(s), officer(s) or director(s) are not a City official/employee or a relative of any City official/employee who: i) has responsibility in making decisions or ability to influence decision-making on the Bid or project to which this Price Agreement pertains; ii) has or will participate in evaluation or management of the Bid; or iii) has or will have financial benefits in the Bid. Contractor understands that should it elect to employ any former City official/employee during the term of the Bid then that the former City official/Contractor employee must comply with applicable government ethics and conflicts of interest provisions in ORS Chapter 244, including but not limited to ORS 244.040(5) and ORS 244.047.

10. Accepts all the specifications, terms and conditions contained herein, and in the event of a forthcoming agreement containing these same specifications, terms and conditions, we would agree without exception. Any exception to these terms should be attached to this Exhibit.

11. Shall comply with the provisions of ORS 279C.800 to 279C.870 (BOLI Wage Requirements). Contractor has reviewed the prevailing wage provisions of the Contract Documents which references applicable wage rates publications.

12. Has reviewed the City’s Public Contracts Conflict of Interest Policy

(Administrative Policy No. FIN-0102) and that Bidder’s Firm and its subcontractors DO / DO NOT have any Organizational Conflict of Interest, prior work on this project, and/or Individual Conflict of Interest (applicable to any individual identified in the Invitation to Bid). (If Bidder checks “DO”, explain the conflict or prior work and why the conflict or prior work does not exclude Bidder from bidding on this project under the City’s policy).

Name of Bidder: __________________________________________________

By______________________________________ Date __________________ (Signature of Authorized Official)

By______________________________________ Phone _________________ (Type or Print Name and Title)

CCB# ___________________ No. Years Registered w/CCB _______________

Are there any outstanding claims against your firm: Yes No

Payment and Performance Bond (list additional information below if not same):

Surety Company ____________________________________________________

Contact at Surety ______________________________ Phone # ______________ https://www.bendoregon.gov/home/showpublisheddocument/64520/638997627607030000