6-25-14_Flo971523B_Appendix_I_Construction&Admin_Forms_.pdf

APPENDIX I

CONSTRUCTION & ADMINISTRATION FORMS

Flo971523B Nutrient Reduction Wetland Project DOCUMENT LL

Bid No. 25-14 NOTICE-OF-AWARD

LL-1

October 1, 2025

Contractor name and address

Delivery via email: Contractor Email

RE: NOTICE-OF-AWARD – Flo971523B Nutrient Reduction Wetland Project, Contract 25-14

Dear _______________________________, This is to notify you that the Division of Soil Conservation and Water Quality has determined __________________ is the successful bidder for the Flo971523B Nutrient Reduction Wetland Project.

Award is being made for the base bid of $____________.

In accordance with Item #9 of the Instructions to Bidders, Document BB, you have fourteen (14) calendar days from the date of receipt of this notice to obtain the Performance Bond (Document NN), submit your Construction Progress Schedule (Document JJ) for review, and execute the Contract (Document DD). In addition, the Division must be provided with a Certificate of Insurance pursuant to the General Conditions, Insurance and Related Provisions (Document FF, Part 6-01).

Please note that Iowa Code Section 91C.7, requires that all construction contractors awarded a contract to perform work for the state or an agency of the state must be registered with the Iowa Department of Inspections, Appeals & Licensing. The Division of Soil Conservation and Water Quality cannot execute a contract with your firm unless you provide proof of this registration. Be sure to fill in the Department of Inspections, Appeals & Licensing registration number blank on the Contract (Document DD).

Enclosed are the Contract (Document DD), Construction Progress Schedule form (Document JJ), and the Performance Bond (Document NN). Please complete, sign and return scanned electronic copies along with completed Performance Bond. In addition, we must have the Certificate of Insurance pursuant to the General Conditions and/or Special Conditions.

Congratulations on being the successful bidder. We look forward to working with your company on this project. If you have any questions, please contact Tracy Bruun, (515) 344-6279.

Sincerely, Jake Hansen, Chief Water Resources Bureau Division of Soil Conservation and Water Quality

JH/tab Enclosures

CC:

Flo971523B Nutrient Reduction Wetland Project DOCUMENT JJ

Bid No. 25-14 CONSTRUCTION PROGRESS SCHEDULE

JJ-1

STATE OF IOWA

DIVISION OF SOIL CONSERVATION AND WATER QUALITY

CONSTRUCTION PROGRESS SCHEDULE

Project ID: Flo971523B Date: _______________________________

Contractor: ___________________________________________________________________________________

Contract End Dates:

All Construction Work Except Seeding: November 15, 2026

Seeding: December 15, 2026

Scheduled Dates:

Anticipated Construction Start Date:

Preconstruction Conference Date Range*:

*Preconstruction Conference must be held prior to Construction Start Date, by no more than seven (7) days

Estimated Completion Date of All Work Except Seeding:

Final Walkthrough should be held prior to Contract End Date for all construction work except seeding

Major Construction Work Item(s) Order of Work Estimated Duration of

Work

(Items to be established/grouped by Division on an individual project basis)

Dates established in this schedule may be adjusted as described in Document FF, Paragraph 3-21.

Flo971523B Nutrient Reduction Wetland Project DOCUMENT JJ

Bid No. 25-14 CONSTRUCTION PROGRESS SCHEDULE

JJ-2

FOR THE CONTRACTOR

(Company Representative)

(Date)

(Name of Company)

(Address of Company)

(City, State, Zip code

FOR THE DIVISION

Mike Bourland, Water Resources Bureau

Accepted

Adjustment Requested

If adjustment is requested, describe below:

END OF DOCUMENT JJ

Flo971523B Nutrient Reduction Wetland Project DOCUMENT SS

Bid No. 25-14 APPLICATION AND CERTIFICATE FOR PAYMENT

SS-1

Flo971523B Nutrient Reduction Wetland Project DOCUMENT SS

Bid No. 25-14 APPLICATION AND CERTIFICATE FOR PAYMENT

SS-2

Flo971523B Nutrient Reduction Wetland Project DOCUMENT HH

Bid No. 25-14 CHANGE ORDER REQUEST

HH-1

STATE OF IOWA

CHANGE ORDER REQUEST

Change Order Request No.

Project ID: Flo971523B Date:

Name of Project: Flo971523B

Location of Project: Floyd County

Name of Contractor:

Architect/Engineer: Bolton & Menk, Brandon Short P.E.

Contract Plan and

Detail Reference:

Change Order Request

Drawing No. and Date:

Contract Specification

Reference:

Description of Change:

BREAKDOWN OF CONTRACT COST:

Original Project Contract Amount: $

Approved Change Orders No. thru : $

Pending Recommended Change Order Requests Nos. : $

This Change Order Request: $

Resulting Total Recommended Amount: $

Flo971523B Nutrient Reduction Wetland Project DOCUMENT HH

Bid No. 25-14 CHANGE ORDER REQUEST

HH-2

Reason for Contract Change:

Change Requested by:

(Signature) (Date)

CONTRACTOR APPROVAL

By:

(Company) (Signature)

(Address) (Date)

IDALS PROJECT REPRESENTATIVE RECOMMENDATIONS

Concur Recommend Rejection (Attach Explanation)

IDALS Project Representative:

(Signature) (Date)

DIVISION OF SOIL CONSERVATION AND WATER QUALITY AUTHORIZATION

Change Order required due to:

Immediate authorization to proceed granted: Yes No

APPROVED: DENIED:

Susan Kozak, Director Susan Kozak, Director

Division of Soil Conservation and Water Quality Division of Soil Conservation and Water Quality

Iowa Department of Agriculture Iowa Department of Agriculture and Land Stewardship and Land Stewardship

(Date) (Date)

END OF DOCUMENT HH

Flo971523B Nutrient Reduction Wetland Project DOCUMENT II

Bid No. 25-14 CONSTRUCTION CONTRACT AMENDMENT

II-1

State of Iowa

Iowa Department of Agriculture and Land Stewardship

Flo971523B Nutrient Reduction Wetland Project Construction Contract Amendment

THIS AMENDMENT, made this ______ day of ___________________________, 20____, by and between the State of Iowa, acting through:

hereinafter called the DIVISION, and

(Name of Company)

(Address)

(City, State, Zip) hereinafter called the CONTRACTOR.

WITNESSETH: That the DIVISION and the CONTRACTOR mutually agree to amend the agreement made the

_____day of __________, 20_____, for the Floyd County Nutrient Reduction Wetland Project (Flo971523B – Bid

No. 25-14) in this Amendment Number _________ as described below:

Description of Amendment:

Contract Plan Sheet(s) and Detail Reference(s):

Amendment No. _____

Drawing No. and Date:

Contract Specification

Reference(s):

Reason for Revision of

Contract Completion Date(s):

Original Contract Completion Date for All Work Except Seeding: November 15, 2026

Original Contract Completion Date for Seeding: December 15, 2026

Current Completion Date for All Work Except Seeding:

Current Completion Date for Seeding:

Revised Completion Date for All Work Except Seeding, This Amendment:

Revised Completion Date for Seeding, This Amendment:

Flo971523B Nutrient Reduction Wetland Project DOCUMENT II

Bid No. 25-14 CONSTRUCTION CONTRACT AMENDMENT

II-2

BREAKDOWN OF AMENDMENT CONTRACT COST BY BID ITEM:

Item # Description

Adjustment

Quantity Unit Cost

Total Cost

Adjustment

TOTAL $

Original Project Contract Amount: $ 0.00

Approved Contract Amendments No. ____ through ____: $ 0.00

Pending Recommended Change Order Requests No. ____ through ____: $ 0.00

Approved Change Order Requests No. ____ through ____: $ 0.00

This Amendment Request: $ 0.00

Resulting Total Recommended Amount: $ 0.00

IN WITNESS WHEREOF, the parties hereto have executed this Amendment, in the day and year first above mentioned.

FOR THE DIVISION FOR THE CONTRACTOR

Grant D. Menke, Deputy Secretary

(Company Representative)

(Date) (Date)

(Name of Company)

(Address of Company)

(City, State, Zip Code)

CONSENT FROM SURETY

Seal if by a corporation

(Surety Representative)

(Name of Surety)

END OF DOCUMENT II

Flo971523B Nutrient Reduction Wetland Project DOCUMENT QQ

Bid No. 25-14 SALES TAX EXEMPTION CERTIFICATE

IOWA

Department of Revenue www.state.ia.us/tax

Designated Exempt Entity Iowa Construction Sales Tax Exemption Certificate

This document may be completed by a designated exempt entity and given to their contractor and/or subcontractor along with an authorization letter. Seller: Keep this certificate in your files. Contractor/Exempt Entity: Keep a copy of this certificate for your records. Do not send this to the Department of Revenue

Designated Exempt Entity Division of Soil Conservation and Water Quality Iowa Department of Agriculture and Land Stewardship

Address 1 1305 East Walnut Street

Address 2

City Des Moines

State

IA

Zip Code 50319

Construction Project Name Flo971523B Nutrient Reduction Wetland Project

Construction Project Number (if used) Job No. 25-14

General Contractor or Subcontractor Name Sample

Address 1 123 Construction Ave

Address 2

City Dig City

State

IA

Zip Code 55555

Description of contract/subcontract (please print/type clearly)

Construction of Nutrient Reduction Wetland.

The named contractor may purchase building materials used in the contract, exempt from sales tax. This exemption does NOT apply to materials, equipment and supplies consumed by the contractor or subcontractor.

Designated Exempt Entity Authorized Agent ._____________________________________ Date: _____________

Authorization Letter From Division of Soil Conservation and Water Quality - Agriculture and Land Stewardship

Pursuant to Iowa Code Sections: 422.42 (16) & (17), and 422.47 (5), you are authorized to purchase construction materials tax free for the contract specified above.

The exemption certificate (or a copy of the certificate) may be provided to the suppliers of your construction materials and will authorize them to sell you the materials exempt from Iowa sales tax and any applicable local option sales tax and school infrastructure local option sales tax. Complete information on qualifying materials can be found at www.state.ia.us/tax, the Department of Revenue (IDR) website.

It is your responsibility to have records identifying the materials purchased and verifying they were used on this contract. Any materials purchased tax-free and not used on the construction project are subject to sales and applicable local option taxes. Should this occur, the tax must be paid directly by you to IDR in the same calendar quarter the project is completed. E-mail the department at: idrf@idrf.state.ia.us if you have questions on this requirement.

Contractors should be aware that use of the certificate to claim exemption from tax for items not used on this project or that do not qualify for exemption could result in civil or criminal penalties.

31-013 (12/10/02)

END OF DOCUMENT QQ