6-2. IFB ANTHC 25-B-391043 Bid Package Only.pdf

INVITATION FOR BID #: ANTHC 25-B-391043

Residential Well & Septic System Installations, Nome, AK

BID FORM FOR CONSTRUCTION CONTRACT

The terms used in this Bid with initial capital letters have the meanings stated in the Instructions to Bidders, the General Conditions, and the Supplementary Conditions.

ARTICLE 1—OWNER AND BIDDER

1.01 This Bid is issued by: Kristina Vnuk : kavnuk@anthc.org

Division of Environmental Health and Engineering (DEHE) Contracting Department

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

ARTICLE 2—ATTACHMENTS TO THIS BID

2.01 The following documents are submitted with and made a condition of this Bid:

A. Required Bid security;

B. Contractor’s license number as evidence of Bidder’s State Contractor’s License or a covenant by Bidder to obtain said license within the time for acceptance of Bids;

C. ANTHC Representations and Certifications

ARTICLE 3—BASIS OF BID—LUMP SUM BID AND UNIT PRICES

3.01 Lump Sum and Unit Price Bids

A. A. Bidder will complete the Work in accordance with the Contract Documents for the following lump sum (stipulated) price(s), together with any Unit Prices indicated in each Table.

1. Indicated unit prices will be used for any work that exceeds the quantities below, or for issuing credits if the quantities used are less than anticipated.

B. Bidder acknowledges that:

1. Each Bid Unit Price includes an amount considered by Bidder to be adequate to cover Contractor’s overhead and profit for each separately identified item, and

2. Estimated quantities are not guaranteed, and are solely for the purpose of comparison of Bids, and final payment for all Unit Price Work will be based on actual quantities, determined as provided in the Contract Documents.

3. Bidder must include a price for all items. Failure to include a price for each item, even if the price is $0.00, will result in the bid being considered non-responsive, and rejected.

4. All COVID-19 related costs shall be represented in the bid under Miscellaneous M1- Mobilization / M2- Demobilization.

Residential Well & Septic System Installations – Nome, AK

Bid Form

00 41 00 - 2 of 6 This document is a MODIFIED version of EJCDC® C-410, Copyright© 2018 by the National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers, or is based in part on excerpts from copyrighted EJCDC documents. All rights reserved. Those portions of the text that originated in copyrighted EJCDC documents remain subject to the copyright.”

Site #1 – Well & Septic System – S. Esparza

Well System Installation

Line# No. Description Qty. Unit Unit Cost Total Cost

1 W1 Well Drilling 200 LF $ $

2 W2 Well Screen 5 LF $ $

3 W3 Test Pumping 4 HR $ $ 4 W4 Sanitary Grout 10 LF $ $ 5 W5 Disinfection & Water Analysis 1 LS - $ 6 W6 Well Appurtenances 1 LS - $ 7 W7 Water Service Line 10 LF $ $ 8 W8 Water Service Line Heat Trace 270 LF $ $ 9 W9 Insulated Well Head Cover 1 EA $ $

10 W11 Arctic Box 1 EA $ $

11 W12 Well Abandonment/Decommissioning 1 LS - $

12 W13 Bollards 2 EA $ $

Total Well Tasks = $ Septic System Installation 13 S1a Conventional Septic System 1 LS - $ 14 S2 Sewer Service Line 97 LF $ $ 15 S5 Insulated Utilidor 1 EA $ 16 S6 Arctic Box 1 EA $ $

Total Septic Tasks = $ Well & Septic Tasks Total Site 1 = $

Site #2 – Septic System Installation – B. Gologergen-Tran Line# No. Description Qty. Unit Unit Cost Total Cost 17 S1b REPS Septic System 1 LS - $ 18 S2 Sewer Service Line 53 LF $ $ 19 S4 Septic Tank Abandonment 1 LS - $ 20 S5 Insulated Utilidor 1 EA $ $ 21 S6 Arctic Box 1 EA $ $

Total Tasks Site 2 = $ Site #3 – Well & Septic System Installation – J. Blandford

Well System Installation

Line# No. Description Qty. Unit Unit Cost Total Cost

22 W1 Well Drilling 200 LF $ $

23 W2 Well Screen 5 LF $ $

24 W3 Test Pumping 4 HR $ $ 25 W4 Sanitary Grout 10 LF $ $ 26 W5 Disinfection & Water Analysis 1 LS - $ 27 W6 Well Appurtenances 1 LS - $ 28 W7 Water Service Line 113 LF $ $ 29 W8 Water Service Line Heat Trace 330 LF $ $ 30 W9 Insulated Well Head Cover 1 EA $ $

31 W10 Insulated Utility Box/ Utilidor 1 EA $ $

32 W11 Arctic Box 1 EA $ $

Total Well Tasks = $

Bid Form

00 41 00 - 3 of 6 This document is a MODIFIED version of EJCDC® C-410, Copyright© 2018 by the National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers, or is based in part on excerpts from copyrighted EJCDC documents. All rights reserved. Those portions of the text that originated in copyrighted EJCDC documents remain subject to the copyright.”

Septic System Installation 33 S1b REPS Septic System 1 LS - $ 34 S2 Sewer Service Line 38 LF $ $ 35 S3 Sewer Service Line Heat Trace 30 LF $ $ 36 S4 Septic Tank Abandonment 1 LS - $ 37 S5 Insulated Utility Box/ Utilidor 1 EA $ $ 38 S6 Arctic Box 1 EA $ $ 39 S7 Bollards 2 EA $ $

Total Septic Tasks = $ Well & Septic Tasks Total Site 3 = $

Miscellaneous

Line# No. Description Total Cost

40 M1 Mobilization $

41 M2 Demobilization $

42 M3 Site Clearing & Grubbing $

43 M4 Grading and Site Clean-up $ Total Miscellaneous = $

Additive Alternates

Line# No. Description Qty Unit Unit Cost Total

44 A1 Circulating Water System 1 LS - $

3.02 Total Bid Price (Lump Sum and Unit Price totals from tables in 3.01)

Total Bid Price (Sites 1, 2 & 3), plus Miscellaneous & Add. Alternates $__________________

ARTICLE 4—TIME OF COMPLETION

4.01 Bidder must complete this section before submitting the Bid Form.

4.02 Bidder agrees that all tasks will be substantially complete on or before July 31, 2026, and ready for final payment in accordance with Paragraph 15.06 of the General Conditions on or before August 31, 2026.

4.03 Bidder accepts the provisions of the Agreement as to liquidated damages.

ARTICLE 5—BIDDER’S ACKNOWLEDGEMENTS: ACCEPTANCE PERIOD, INSTRUCTIONS, AND

RECEIPT OF ADDENDA

5.01 Bid Acceptance Period

A. This Bid will remain subject to acceptance for 60 days after the Bid opening, or for such longer period of time that Bidder may agree to in writing upon request of Owner.

5.02 Instructions to Bidders

A. Bidder accepts all of the terms and conditions of the Instructions to Bidders, including without limitation those dealing with the disposition of Bid security.

Bid Form

00 41 00 - 4 of 6 This document is a MODIFIED version of EJCDC® C-410, Copyright© 2018 by the National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers, or is based in part on excerpts from copyrighted EJCDC documents. All rights reserved. Those portions of the text that originated in copyrighted EJCDC documents remain subject to the copyright.”

5.03 Receipt of Addenda

A. Bidder hereby acknowledges receipt of the following Addenda:

Addendum Number Addendum Date

ARTICLE 6—BIDDER’S REPRESENTATIONS AND CERTIFICATIONS (DIFFERENT FROM 00 93 00

ANTHC REPRESENTATION & CERTIFICATIONS, WHICH MUST BE COMPLETED AS WELL TO

QUALIFY FOR THE AN/AI PREFERENCE.)

6.01 Bidder’s Representations

A. In submitting this Bid, Bidder represents the following:

1. Bidder has examined and carefully studied the Bidding Documents, including Addenda.

2. Bidder is familiar with all Laws and Regulations that may affect cost, progress, and performance of the Work and including all American Iron and Steel requirements.

3. Bidder has considered the information known to Bidder itself; information commonly known to contractors doing business in the locality of the Site; information and observations obtained from visits to the Site; the Bidding Documents; and the Technical Data identified in the Supplementary Conditions or by definition, with respect to the effect of such information, observations, and Technical Data on (a) the cost, progress, and performance of the Work; (b) the means, methods, techniques, sequences, and procedures of construction to be employed by Bidder, if selected as Contractor; and

(c) Bidder’s (Contractor’s) safety precautions and programs.

4. Based on the information and observations referred to in the preceding paragraph, Bidder agrees that no further examinations, investigations, explorations, tests, studies, or data are necessary for the performance of the Work at the Contract Price, within the Contract Times, and in accordance with the other terms and conditions of the Contract.

5. Bidder is aware of the general nature of work to be performed by Owner and others at the Site that relates to the Work as indicated in the Bidding Documents.

6. Bidder has given Owner written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder has discovered in the Bidding Documents, and of discrepancies between Site conditions and the Contract Documents, and the written resolution thereof by Owner is acceptable to Contractor.

7. The Bidding Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work.

8. The submission of this Bid constitutes an incontrovertible representation by Bidder that without exception the Bid and all prices in the Bid are premised upon performing and furnishing the Work required by the Bidding Documents.

Bid Form

00 41 00 - 5 of 6 This document is a MODIFIED version of EJCDC® C-410, Copyright© 2018 by the National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers, or is based in part on excerpts from copyrighted EJCDC documents. All rights reserved. Those portions of the text that originated in copyrighted EJCDC documents remain subject to the copyright.”

6.02 Bidder’s Certifications

A. The Bidder certifies the following:

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

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

4. Bidder has not engaged in corrupt, fraudulent, collusive, or coercive practices in competing for the Contract. For the purposes of this Paragraph 6.02.A:

a. Corrupt practice means the offering, giving, receiving, or soliciting of anything 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 Owner, (b) to establish bid prices at artificial non-competitive levels, or (c) to deprive Owner 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 Owner, 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.

Bid Form

00 41 00 - 6 of 6 This document is a MODIFIED version of EJCDC® C-410, Copyright© 2018 by the National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers, or is based in part on excerpts from copyrighted EJCDC documents. All rights reserved. Those portions of the text that originated in copyrighted EJCDC documents remain subject to the copyright.”

Bidder/Offeror Certification and Representation Signature (Different from 00 93 00 ANTHC Representation & Certifications, which must be completed as well to qualify for the AN/AI preference.)

By signing below, the Bidder/Offeror represents that all of its statements, certifications, and representations, and other information supplied herein are true and correct as of the date of submittal of this bid/offer. BIDDER hereby submits this Bid as set forth above:

Bidder: ___________________________________________________________________ (typed or printed name of organization)

By:

(individual’s signature)

Name:

(typed or printed)

Title:

(typed or printed)

Date:

(typed or printed)

If Bidder is a corporation, a partnership, or a joint venture, attach evidence of authority to sign.

Attest:

(individual’s signature)

Name:

(typed or printed)

Title:

(typed or printed)

Date:

(typed or printed)

Address for giving notices:

Bidder’s Contact:

Name:

(typed or printed)

Title:

(typed or printed)

Phone:

Email:

Address:

Remittance Address (if different):

Bidder’s AK Contractor License No.:

State of AK Business License #:

DUNS number:

Bidder further represents that: (1) this proposal is genuine and not made in the interest of or on behalf of any undisclosed individual or entity; (2) Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham proposal; (3) Bidder has not solicited or induced any individual, firm, or entity to refrain from proposing; and (4) Bidder has not sought by collusion to obtain for itself any advantage over any other Bidder or over ANTHC.

00 43 13 - 1 This document is a MODIFIED version of EJCDC® C-430, Copyright© 2018 by the National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers, or is based in part on excerpts from copyrighted EJCDC documents. All rights reserved. Those portions of the text that originated in copyrighted EJCDC documents remain subject to the copyright.”

BID BOND (PENAL SUM FORM)

Bidder Surety

Name: Name:

Address (principal place of business): Address (principal place of business):

Owner Bid: ANTHC 25-B-391043

Name:

Alaska Native Tribal Health Consortium Division of Environmental Health & Engineering

Project:

Address: Residential Well & Septic System Installations, Nome, AK 4500 Diplomacy Drive

Anchorage, AK 99508

Bid Due Date: 08/22/2025

Bond

Penal Sum:

Date of Bond:

Surety and Bidder, intending to be legally bound hereby, subject to the terms set forth in this Bid Bond, do each cause this Bid Bond to be duly executed by an authorized officer, agent, or representative.

Bidder Surety

(Full formal name of Bidder) (Full formal name of Surety) (corporate seal)

By: By:

(Signature) (Signature) (Attach Power of Attorney)

Name: Name:

(Printed or typed) (Printed or typed)

Title: Title:

Attest: Attest:

(Signature) (Signature)

Name: Name:

(Printed or typed) (Printed or typed)

Title: Title:

Phone # Phone # _____________________________

Email:

Email:

_______________________________Notes: (1) Note: Addresses are to be used for giving any required notice. (2) Provide execution by any additional parties, such as joint venturers, if necessary.

00 43 13 - 2 This document is a MODIFIED version of EJCDC® C-430, Copyright© 2018 by the National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers, or is based in part on excerpts from copyrighted EJCDC documents. All rights reserved. Those portions of the text that originated in copyrighted EJCDC documents remain subject to the copyright.”

1. Bidder and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assigns to pay to Owner upon default of Bidder the penal sum set forth on the face of this Bond. Payment of the penal sum is the extent of Bidder’s and Surety’s liability.

Recovery of such penal sum under the terms of this Bond will be Owner’s sole and exclusive remedy upon default of Bidder.

2. Default of Bidder occurs upon the failure of Bidder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents.

3. This obligation will be null and void if:

3.1. Owner accepts Bidder’s Bid and Bidder delivers within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents, or

3.2. All Bids are rejected by Owner, or

3.3. Owner fails to issue a Notice of Award to Bidder within the time specified in the Bidding Documents (or any extension thereof agreed to in writing by Bidder and, if applicable, consented to by Surety when required by Paragraph 5 hereof).

4. Payment under this Bond will be due and payable upon default of Bidder and within 30 calendar days after receipt by Bidder and Surety of written notice of default from Owner, which notice will be given with reasonable promptness, identifying this Bond and the Project and including a statement of the amount due.

5. Surety waives notice of any and all defenses based on or arising out of any time extension to issue Notice of Award agreed to in writing by Owner and Bidder, provided that the total time for issuing Notice of Award including extensions does not in the aggregate exceed 120 days from the Bid due date without Surety’s written consent.

6. No suit or action will be commenced under this Bond prior to 30 calendar days after the notice of default required in Paragraph 4 above is received by Bidder and Surety, and in no case later than one year after the Bid due date.

7. Any suit or action under this Bond will be commenced only in a court of competent jurisdiction located in the state in which the Project is located.

8. Notices required hereunder must be in writing and sent to Bidder and Surety at their respective addresses shown on the face of this Bond. Such notices may be sent by personal delivery, commercial courier, or by United States Postal Service registered or certified mail, return receipt requested, postage pre-paid, and will be deemed to be effective upon receipt by the party concerned.

9. Surety shall cause to be attached to this Bond a current and effective Power of Attorney evidencing the authority of the officer, agent, or representative who executed this Bond on behalf of Surety to execute, seal, and deliver such Bond and bind the Surety thereby.

10. This Bond is intended to conform to all applicable statutory requirements. Any applicable requirement of any applicable statute that has been omitted from this Bond will be deemed to be included herein as if set forth at length. If any provision of this Bond conflicts with any applicable statute, then the provision of said statute governs and the remainder of this Bond that is not in conflict therewith continues in full force and effect.

11. The term “Bid” as used herein includes a Bid, offer, or proposal as applicable.

D IV IS ION OF ENVIRONMENT HEALT H & ENGI NEERING

REPRESENTATIONS AND CERTIFICATIONS OF BIDDER/OFFEROR

Form 00 93 00

ANTHC Form 00 93 00 ANTHC 25-B-391043 Residential Well & Septic System Installations – Nome, AK 1

1. Type of Business Organization The Bidder/Offeror, by checking the applicable box, represents that --

(a) It operates as

[__] a corporation incorporated under the laws of the State of , [__] an individual, [__] a partnership, [__] a nonprofit organization, or [__] a joint venture; or

(b) If the Bidder/Offeror is a foreign entity, it operates as

[__] an individual, [__] a partnership, [__] a nonprofit organization, [__] a joint venture, or [__] a corporation registered for business in the Country of

(c) The Bidder/Offeror is not

[__] on the List of Parties Excluded from Federal Procurement and Non-Procurement Programs, compiled, maintained, and distributed by the General Services Administration; and [__] barred from bidding or contracting with the State of Alaska.

2. Parent Company Information The Bidder/Offeror by checking the applicable box represents that --

[__] It is independently owned and operated and it is not owned or controlled by a parent company or parent organization.

[__] It is not independently owned and operated; it is owned or controlled by a parent company or parent organization; and the full name and address of the Bidder/Offeror's parent company or parent organization is:

[__] If not independently owned and operated, the parent company or parent organization's Taxpayer Identification Number (TIN) or Employer Identification Number (E.I. No.) is

3. Taxpayer Identification

(a) Definitions.

"Common parent," as used in this solicitation provision, means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a member.

"Corporate status," as used in this solicitation provision, means a designation as to whether the offeror is a corporate entity, an unincorporated entity (e.g., sole proprietorship or partnership), or a corporation providing medical and health care services.

"Taxpayer Identification Number (TIN)," as used in this solicitation provision, means the number required by the IRS to be used by the offeror in reporting income tax and other returns.

(b) All offerors are required to submit the information required in paragraphs (c) through (e) of this solicitation provision in order to comply with reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M and implementing regulations issued by the Internal Revenue Service (IRS). If the resulting contract is subject to the reporting requirements described in FAR 4.903, the failure or refusal by the offeror to furnish the information may result in a 31 percent reduction of payments otherwise due under the contract.

ANTHC 25-B-391043 Residential Well & Septic System Installations – Nome, AK Page 2 of 7

(c) Taxpayer Identification Number (TIN). TIN:

[__] TIN has been applied for.

[__] TIN is not required because:

[__] Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the U.S.

and does not have an office or place of business or a fiscal paying agent in the U.S.;

[__] Offeror is an agency or instrumentality of a foreign government;

[__] Offeror is an agency or instrumentality of a Federal, state, or local government;

[__] Other. State basis for no TIN

(d) Corporate Status.

[__] Corporation providing medical and health care services, or engaged in the billing and collecting of payments for such services;

[__] Other corporate entity;

[__] Not a corporate entity:

[__] Sole proprietorship [__] Partnership [__] Hospital or extended care facility described in 26 CFR 501(c)(3) that is exempt from taxation under 26 CFR 501(a).

(e) Common Parent.

[__] Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision.

Name and TIN of common parent:

Name TIN

4. Contingent Fee Representation and Agreement (Note: The offeror must check the appropriate boxes. For interpretation of the representation, including the term "bona fide employee," see the General Provision of this contract entitled, COVENANT AGAINST

CONTINGENT FEES.)

(a) Representation. The offeror represents that, except for full-time bona-fide employees working solely for the offeror, the offeror:

(1) [__] has, [__] has not employed or retained any person or company to solicit or obtain this contract; and

(2) [__] has, [__] has not paid or agreed to pay to any person or company employed or retained to solicit or obtain this contract any commission, percentage, brokerage, or other fee contingent upon or resulting from the award of this contract.

(b) Agreement. The offeror agrees to provide information relating to the above Representation as requested by the ANTHC and, when subparagraph (a) (1) or (a) (2) is answered affirmatively, to promptly submit to the Contracting Officer:

(1) A complete Standard Form 119, Statement of Contingent or Other Fees, (SF 119); or

(2) A signed statement indicating that the SF 119 was previously submitted to the same procurement officer, including the date and applicable solicitation or contract number, and representing that the prior SF 119 applies to this bid or offer.

ANTHC 25-B-391043 Residential Well & Septic System Installations – Nome, AK Page 3 of 7

5. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions (This provision is applicable only if the amount of the bid exceeds $100,000.)

(a) The definitions and prohibitions contained in the clause, at General Provisions 8 (Limitation on Payments to Influence Certain Federal Transactions), included in this solicitation, are hereby incorporated by reference in paragraph (b) of this certification.

(b) The offeror, by signing its offer, hereby certifies to the best of his or her knowledge and belief that on or after December 23, 1989--

(1) No Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf 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;

(2) If any funds other than Federal appropriated funds (including profit or fee received under a covered Federal transaction) have been paid, or will be paid, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with this solicitation, the offeror shall complete and submit, with its offer, OMB standard form LLL, Disclosure of Lobbying Activities, to the Contracting Officer; and

(3) He or she will include the language of this certification in all subcontract awards at any tier and require that all recipients of subcontract awards in excess of $100,000 shall certify and disclose accordingly.

(c) Submission of this certification and disclosure is a prerequisite for making or entering into this contract imposed by section 1352, title 31, United States Code. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure form to be filed or amended by this provision shall be subject to a civil penalty of not less than $10,000, and not more than $100,000, for each such failure.

6. Certification of Non-segregated Facilities

(a) "Segregated facilities", as used in this provision, means any waiting rooms, work areas, rest rooms and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees, that are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, or national origin because of habit, local custom, or otherwise.

(b) By submission of this offer, the Bidder/Offeror certifies that it does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at any location under its control where segregated facilities are maintained. The Bidder/Offeror agrees that a breach of this certification is a violation of the Equal Opportunity clause in the contract.

(c) The Bidder/Offeror further agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will --

(1) Obtain identical certifications from proposed subcontractors before the award of subcontracts under which the subcontractor will be subject to the Equal Opportunity clause;

(2) Retain the certifications in the files; and

(3) Forward the following notice to the proposed subcontractors (except if the proposed subcontractors have submitted identical certifications for specific time periods):

ANTHC 25-B-391043 Residential Well & Septic System Installations – Nome, AK Page 4 of 7

NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF

NONSEGREGATED FACILITIES.

(a) Certification of Nonsegregated Facilities must be submitted before the award of a subcontract under which the subcontractor will be subject to the Equal Opportunity clause. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e., quarterly, semi-annually, or annually).

(b) The Offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(c) Failure of the Offeror to furnish a certification or provide such additional information as requested by the Contracting Officer may render the Offeror nonresponsible.

(d) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a) of this provision. The knowledge and information of an Offeror is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly rendered an erroneous certification, in addition to other remedies available to the ANTHC, the Contracting Officer may terminate the contract resulting from this solicitation for default.

7. Certificate of Independent Price Determination

(a) The offeror certifies that--

(1) The prices in this offer have been arrived at independently, without, for the purpose of restricting competition, any consultation, communication, or agreement with any other offeror or competitor relating to--

(i) Those prices;

(ii) The intention to submit an offer; or

(iii) The methods or factors used to calculate the prices offered.

(2) The prices in this offer have not been and will not be knowingly disclosed by the offeror, directly or indirectly, to any other offeror or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a negotiated solicitation) unless otherwise required by law; and

(3) No attempt has been made or will be made by the offeror to induce any other concern to submit or not to submit an offer for the purpose of restricting competition.

(b) Each signature on the offer is considered to be a certification by the signatory that the signatory--

(1) Is the person in the offeror's organization responsible for determining the prices being offered in this bid or proposal, and that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision; or

(2) (i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision

[insert full name of person(s) in the offeror's organization responsible for determining the prices offered in this bid or proposal, and the title of his or her position in the offeror's organization];

(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2)(i) of this provision have not participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision; and

(iii) As an agent, has not personally participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision.

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(c) If the offeror deletes or modifies subparagraph (a)(2) of this provision, the offeror must furnish with its offer a signed statement setting forth in detail the circumstances of the disclosure.

8. Drug Free Workplace To the extent that any facilities, equipment, vessel, or vehicle to be provided under this bid/offer is to be used as a place of work by Owner employees, the Bidder/Offeror certifies that it does and will maintain such place of work as a drug free workplace in compliance with the Drug Free Workplace Act of 1988 (P.L.

100-690) subject to all the sanctions and penalties in that Act. To this end the Bidder/Offeror represents that it is in compliance with the requirements of the clause prescribed by the Federal Acquisition Regulations (FAR) 52.223-5. (A copy of the FAR 52.223-5 clause is available from the office issuing this solicitation upon request.)

9. Cooperation for Required Determination of Responsible Prospective Contractor Prior to Award of Contract

(a) (This subparagraph applicable to Construction only) Signing of the bid shall be deemed to be a certification by the bidder that:

(1) Bidder is a construction contractor who owns, operates, or maintains a place of business, regularly engaged in construction, alteration or repair of buildings, structures, communication facilities, or other engineering projects, including furnishing and installing of necessary equipment; or

(2) If newly entering into a construction activity, bidder has made all necessary arrangements for personnel, construction equipment, and required licenses to perform construction work; and

(3) Upon request, prior to award, bidder will promptly furnish to ANTHC a statement of facts in detail as to bidder's previous experience (including recent and current contracts), organization (including company officers), technical qualifications, financial resources and facilities available to perform the contemplated work.

(b) The Bidder shall, upon request, promptly furnish ANTHC with a current certified statement of the Bidder's financial condition and such data as ANTHC may request with respect to the Bidder's operations. ANTHC will use this information to determine the Bidder's financial responsibility and ability to perform under the contract.

(c) Failure of a Bidder to comply with a request for information may be cause for rejection of the bid on responsibility grounds.

(d) ANTHC may make such investigations as they deem necessary to determine the ability of the bidder to perform the work, and the bidder shall furnish to ANTHC all such information and data for this purpose as ANTHC may request. ANTHC reserves the right to reject any bid if the evidence submitted by, or investigation of such bidder fails to satisfy ANTHC that such bidder is properly qualified and responsible to carry out the obligations of the contract and to complete the work contemplated therein.

10. Native Preference Representation

a) Representation: The offeror represents that

[__] it is, [__] is not an Alaska Native/American Indian or an Alaska Native / American Indian Entity as defined in Section 11 below. An Offeror that represents he or she qualifies as an Alaska Native / American Indian must submit satisfactory evidence of his or her Native status. An Offeror that represents it is an Alaska Native/American Indian Entity must submit satisfactory evidence to demonstrate the specific degree of Alaska Native/American Indian ownership, control and management.

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(b) (This is applicable only if this is an Alaska Native/American Indian Entities preference or set-aside).

The specified degree of Alaska Native/American Indian ownership, control and management must be maintained during the period covered by this contract.

(c) Any Offeror that misrepresents itself as an Alaska Native/American Indian or as an Alaska Native/American Indian Entity in order to secure the award of a contract or purchase order shall be disqualified from being awarded the contract or, if the contract has already been awarded, shall be considered in material breach of the contract or purchase order and subject to the penalties specified in, the contract, purchase order or ANTHC policy, including immediate termination of the contract or purchase order.

11. DEFINITIONS

(a) Alaska Native/American Indian:

Any of the following natural persons:

(1) Any citizen of the United States who is a person of one-fourth degree or more Alaska Native or American Indian heritage or who is regarded as an Alaska Native by the Native village or Native group of which he or she claims to be a member and whose father or mother is (or, if deceased, was) regarded as Native by any village or group; or

(2) Any person of Indian or Alaska Native descent who is a member of, or eligible for membership in, any Federally recognized Indian Tribe, or an original ANCSA shareholder; or

(3) Any descendant of a person of American Indian or Alaska Native descent who is or was (if deceased) a member of, or eligible for membership in, any Federally recognized Indian Tribe or an original ANCSA shareholder.

(b) Alaska Native / American Indian Entity.

An Alaska Native / American Indian (AN/AI) Entity includes an entity described in (1), (2) or (3) below:

(1) an Indian tribe, a tribal organization and intertribal consortium.

(2) any Alaska Native Claims Settlement Act Regional Corporation, Village Corporation, Urban

Corporation or Group Corporation whose Settlement and Common Stock and other stock held by holders of Settlement Common Stock and by Natives and descendants of Natives represent greater than 50% of both

(a) the total equity of the corporation, and

(b) the total voting power of the corporation for the purpose of electing directors

(3) a cooperative, enterprise, corporation, subsidiary, joint venture (JV), partnership, Limited Liability Partnership (LLP), Limited Liability Company (LLC), or other business association that meets the conditions of subsections (a) and (b) below.

(a) The entity is owned or controlled by AN/AI interests as demonstrated by at least one of the following:

(i) Greater than 50% of the total voting power of the governing board or its equivalent is

AN/AI-controlled; or

(ii) Greater than 50% of the total equity of the enterprise is AN/AI- contributed, with

“equity” for purposes of this subsection to include the market value of the enterprise’s stock and all other capital, and the market value of the enterprise’s real and personal property.

(b) The entity is primarily administered for the benefit of AN/AIs as demonstrated by one of the following:

(i) At least 51% of the enterprise’s service costs under the contract is expended on

AN/AIs or AN/AI Entities, to include the cost of employee salaries and benefits, and the cost of service subcontractors during the term of a contract; or

(ii) Greater than 50% of the profits (if any) or revenue expenditures inure to AN/AI benefit.

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(c) Inter-Tribal Consortium: A coalition of two or more separate Indian Tribes or tribal organizations that join together for the purpose of participating in self-governance under the Indian Self-Determination Act

(d) Tribal Organization:

An entity that meets the definition of “tribal organization” under the Indian Self-Determination Act or the recognized governing body of any Indian tribe; any legally established organization of Indians which is controlled, sanctioned, or chartered by such governing body or which is democratically elected by the adult members of the Indian community to be served by such organization and which includes the maximum participation of Indians in all phases of its activities.

(e) Indian Tribe. Any Indian Tribe, band, nation or other organized group or community, including any Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act, which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.

12. Bidder/Offeror Certification and Representation Signature By signing below, the Bidder/Offeror represents that all of its statements, certifications, and representations, and other information supplied herein are true and correct as of the date of submittal of this bid/offer.

BIDDER/OFFEROR:

(Type or Print Company Name)

(Address of Bidder/Offeror)

AUTHORIZED SIGNATURE:

(Signature) (Date)

(Printed Name)