ATTACHMENT A - Required Bid Submittal Checklist~1.pdf

ATTACHMENT A: REQUIRED BID SUBMITTAL CHECKLIST

Project: 2024 Type III Slurry Seal Project

EXHIBIT DOCUMENT PAGES √

C Bid Schedule 1 D Bid Security Bond 2 E Independent Contractor Certification 1 F Bidder’s Residency Statement 1 G Tax Compliance & Non-Discrimination Statements 1 H First Tier Subcontractor Disclosure Form 1 I Proposal 3 J Non-Collusion Affidavit 2 K Prevailing Wage 1 L Contractor’s Experience Questionnaire 2 M Contractor’s Equipment Listing 1 N Drug Testing Policy 1

Addenda

TOTAL BID PROPOSAL WILL CONTAIN A MINIMUM OF: 17 PAGES

Exhibit C: Bid Schedule Use the provided form to fill in all blanks. The bid shall include all labor, materials, equipment, and services called for and necessary to complete the project. Exhibit A shall not include any recapitulation of work to be done. Bid shall be typed or prepared in blue ink and be submitted without erasures. By signing and returning the bid, the bidder acknowledges they understand the terms and conditions within the solicitation documents and accept all terms in their entirety.

Exhibit D: Bid Security Bond Enclose a bidder's bond, certified check (or cashier's) check made payable to the Owner in an amount equal to 5% of the total bid. The City shall return bid security to all bidders upon execution of the contract.

The City shall retain bid security if successful proposer fails to promptly and properly execute the contract.

(ORS 279B.0550)

Exhibit E: Independent Contractor Certification To establish status as an “Independent Contractor” as defined in ORS 670.600, certain standards must be met by the individual or business entity performing that work.

Exhibit F: Bidder’s Residency Statement Contractor must certify that it is or is not an Oregon business as per ORS 279A.120. ORS 279A.120 requires public contracting agencies, in determining the lowest responsible bidder, to add a percent increase to each out-of-state bidder's bid price which is equal to the percent of preference given to local bidders in the bidder's home state. The bidder shall certify that it is or is not an Oregon contractor as defined under ORS 279A.120, Preferences; Foreign Contractor, i.e., a foreign contractor is one who is not domiciled in or registered to do business in the State of Oregon.

Exhibit G: Tax Compliance & Non-Discrimination Statements Contractor shall certify that they are not in violation of any Oregon tax as described in ORS 305.380(4).

Contractor shall certify, pursuant to ORS 279A.110, a non-discrimination statement in compliance with Oregon state laws.

Exhibit H: First Tier Subcontractor Disclosure Form Subcontractors shall submit Contractor's Board license number, Federal Identification Number, State Unemployment Number, and Certification of ORS 279A.120. All subcontractors are required to be listed on the Bid, and, if applicable, on the First-Tier Subcontractor Disclosure Form. The City of Redmond retains the right to reject bid if the Subcontractor’s list in the Bid is incomplete. All subcontractors are to be approved in writing by the Owner and carry the same insurance requirements as the prime contractor.

Exhibit I: Proposal The Proposal Form shall be completed and returned.

Exhibit J: Non-Collusion Affidavit The Non-Collusion Affidavit shall be completed and returned.

Exhibit K: Prevailing Wage Rate Statement The Prevailing Wage Rate Statement shall be completed and returned with the Bid Schedule. Certified Payroll and Wage Rates (BOLI) shall be in compliance with ORS 279C.800 – 279C.870.

Exhibit L: Contractor’s Experience Questionnaire The Contractor’s Experience Questionnaire shall be completed and returned with the Bid Schedule. ODOT Prequalification package may be substituted for the Experience Questionnaire Form.

Exhibit M: Contractor’s Equipment Listing The Contractor's Equipment Listing shall be completed and returned with the Bid Schedule. ODOT Prequalification package may be substituted for the Equipment Listing Form.

Exhibit N: Drug Testing Policy The Drug Testing Policy Statement shall be completed and returned with the Bid Schedule per ORS 279C.505 (2003 Chapter 794.138).

CITY OF REDMOND BID SCHEDULE

All Bid prices are for items installed complete and accepted by the City of Redmond 4/9/2024 Anything not listed specifically on bid sheet but shown in plans is incidental to the project.

ITEM DESCRIPTION QUANTITY UNIT UNIT PRICE TOTAL PRICE

1 Mobilization ALL LS

2 Temporary Traffic Control, Complete ALL LS

3 Public Notification/Outreach ALL LS

4 Modified Slurry Seal Type III 117,702 SQ YD

5 Other

Total Bid: $

Total Bid (As written): $

BIDDER License #

Authorized Signature of Bidder Date Tax ID

Business Address

EXHIBIT C - BID SCHEDULE

2024 TYPE III SLURRY SEAL PROJECT

I acknowedge that I have read and understand the terms and conditions contained in the solicitation documents. I accept and agree the terms and conditions.

EXHIBIT D: Bid Bond

KNOW ALL MEN BY THESE PRESENTS, That ________________________________ hereinafter called the PRINCIPAL, and a corporation duly organized under the laws of the State of ___________________ , having its principal place of business at ____________________________________ , in the State of ___________________, and authorized to do business in the State of Oregon, as SURETY, are held and firmly bound unto the

City of Redmond, Oregon, as obligee, hereinafter called the CITY, in the penal sum of

___________________________________________________________dollars ($ ) for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

THE CONDITIONS OF THIS BOND ARE SUCH That, whereas the PRINCIPAL herein is herewith submitting their bid proposal for the 2024 Type III Slurry Seal Project said bid proposal, by reference thereto, being hereby made a part hereof.

NOW, THEREFORE, if the said bid proposal submitted by the said PRINCIPAL be accepted, and the contract be awarded to said PRINCIPAL, and if the said PRINCIPAL shall execute the proposed Agreement and shall furnish such performance and payment bonds as required by the bidding and Contract Documents within the time fixed by said documents, then this obligation shall be void; if the PRINCIPAL shall fail to execute the proposed Agreement and furnish said bond, the SURETY hereby agrees to pay to the CITY the penal sum as liquidated damages.

Signed and sealed this day of , 2023.

By

Principal

Surety

By Attorney-in-fact

(A certified copy of the agent's power-of-attorney must be attached hereto.)

EXHIBIT E: Independent Contractor Certification

To establish status as an “Independent Contractor” as defined in ORS 670.600, certain standards must be met by the individual or business entity performing that work.

The undersigned certifies that he/she/the business entity meets the following standards:

1. The individual or business entity providing labor or services is registered under ORS Chapter 701 “Construction Contractors”, if the individual or business entity provides labor or service for which such registration is required; and

2. Federal and State income tax returns in the name of the business or business Schedule C or farm Schedule F as part of the personal income tax return were filed for the previous year if the individual or business entity performed labor or services as an independent contractor in the previous year; and

3. The individual or business entity represents to the public that the labor or services are to be provided by an independently established business. Except when the individual or business entity files a Schedule F as part of the personal income tax returns and the individual or business entity performs farm labor or services that are reportable on Schedule C, and individual or business entity is considered to be engaged in an independently established business when four or more of the following circumstances exist.

Contractor is to check four or more of the following:

□ The labor or services are primarily carried out at a location that is separate from the residence of an individual who performs the labor or services, or are primarily carried out in a specific portion of the residence, which portion is set aside as the location of the business;

□ Commercial advertising or business cards are customary in operating similar businesses, are purchased for the business, or the individual or business entity has a trade association membership;

□ Telephone listing and service are used for the business that is separate from the personal residence listing and services used by an individual who performs the labor or services;

□ Labor or services are performed only pursuant to written contracts;

□ Labor or services are performed by two or more different persons within a period of one year; or

□ The individual or business entity assumes financial responsibility for defective workmanship or for services not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance, or liability insurance relating to the labor or services to be performed.

Contractors Signature Date

Printed Name Federal Tax I.D. #

EXHIBIT F: Bidder’s Residency Statement

BIDDER’S RESIDENCY STATEMENT

Pursuant to ORS 279A.120, Oregon’s Reciprocal Preference Law, public contracting agencies shall, for the purpose of determining the lowest responsible bidder and the awarding of a contract, add a percent increase on the bid of a non-resident bidder equal to the percent, if any, of the preference given to that bidder in the state in which the bidder resides.

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 business address in this state, and has stated in the bid whether the bidder is a “Resident Bidder’. A “Non-resident Bidder” is a bidder who does not meet the definition of a Resident Bidder as stated above.

1. Bidder □ IS or □ IS NOT (check one) a Resident Bidder as set forth above.

2. If a Resident Bidder, enter your Oregon Business Address: _____________________________

3. If a Non-resident Bidder, enter state of residency: ______________________________

Bidder hereby certifies that the information provided is true and accurate.

Contractors Signature Date

Printed Name Name of Company

EXHIBIT G: Tax Compliance & Non-Discrimination Statements

TAX COMPLIANCE STATEMENT

In compliance with ORS 305.380 B 305.385, the undersigned, as provider of goods, services, or real estate space to the City of Redmond, hereby certifies under penalty of perjury that to the best of my knowledge, the undersigned is not in violation of any Oregon tax described in ORS 305.380(4).

Bidder hereby certifies that the information provided is true and accurate.

Contractors Signature Date

Printed Name Name of Company

NON-DISCRIMINATION STATEMENT

Pursuant to ORS 279A.110, discrimination in subcontracting is prohibited. Any contractor who contracts with a public contracting agency shall not discriminate against minority, women, or emerging small business enterprises in the awarding of contracts.

By signature of the authorized representative of the bidder, the bidder hereby certifies to the City of Redmond that this bidder has not discriminated against minority, women, or emerging small business enterprises in obtaining any subcontracts; and, further, that if awarded the contract for which this bid is submitted, shall not so discriminate.

Bidder hereby certifies that the information provided is true and accurate.

Contractors Signature Date

Printed Name Name of Company

EXHIBIT H: First Tier Subcontractor Disclosure Form

BID SUBMITTAL: Date: _____________________ Time: ____________________

DISCLOSURE DEADLINE: Date: April 9, 2024 Time: 4:00 p.m.

List below the Name, Address, Contact Name and Telephone Number of each subcontractor that will be furnishing labor or labor and materials that are required to be disclosed. Enter “NONE” if there are no subcontractors that need to be disclosed. (Attach additional sheets if needed).

Name/Address Nature of Work Performed

Contact Phone # Contract Amount

1.

2.

3.

4.

5.

The above listed First-Tier Subcontractor(s) are providing labor or labor and materials with a dollar value equal to or greater than:

a. 5% of the total Contract Price, but at least $15,000 (including all alternates). If the dollar value is less than $15,000 do not list the subcontractor above; or,

b. $350,000 regardless of the percentage of the total Contract Price.

FAILURE TO SUBMIT THIS FORM BY THE BID OPENING DEADLINE WILL RESULT IN A

BID SUBMITTED BECOMING NON-RESPONSIVE, AND SUCH BIDS SHALL NOT BE

CONSIDERED FOR AWARD.

FORM SUBMITTED BY (BIDDER NAME): __________________________________________

CONTACT NAME: ____________________________________ PHONE #: ________________

DELIVER FORM TO AGENCY: City of Redmond PERSON DESIGNATED TO RECEIVE FORM: City Recorder PHONE #: 541.923.7752 AGENCY ADDRESS: 411 SW 9th St. Redmond, OR 97756

UNLESS OTHERWISE STATED IN THE ORIGINAL SOLICITATION, THIS DOCUMENT SHALL NOT BE

FAXED. IT IS THE RESPONSIBILITY OF THE BIDDERS TO SUBMIT THIS DISCLOSURE FORM AND

ANY ADDITIONAL SHEETS, WITH THE PROJECT NAME CLEARLY MARKED, AT THE LOCATION

INDICATED BY THE SPECIFIED DISCLOSURE DEADLINE. SEE INSTRUCTIONS TO BIDDERS.

Rev: 03-09-2000 Agency will insert “N/A” above if the Contract amount value is anticipated to be less than $100,000. Otherwise this form must be submitted within two working hours of the advertised bid closing date and time; no later than the DISCLOSURE DEADLINE stated above. Bids which are submitted by Bid Closing, but for which the separate disclosure submittal has not been made by the specified deadline, are Not Responsive and shall not be considered for Contract award.

EXHIBIT I: Proposal

BIDDER'S DECLARATION:

The undersigned, hereinafter called the Bidder, declares that the only persons or parties interested in this proposal are those named herein, that this proposal is, in all respects, fair and without fraud, that it is made without collusion with any official of the City, and that the proposal is made without any connection or collusion with any person making another proposal on this Agreement.

The Bidder further declares that he has carefully examined the Contract Documents for the construction of the project, that he has personally inspected the site, that he has satisfied himself as to the quantities involved, and that this proposal is made according to the provisions and under the terms of the Contract Documents, which documents are hereby made a part of this proposal.

The Bidder further declares that the provisions required by ORS 279C.800 to 279C.870 relating to prevailing wage rates shall be complied with.

The Bidder further agrees that he has exercised their own judgment regarding subsurface condition and has utilized all data which he believes pertinent from the City and other sources in arriving at their conclusions.

CONTRACT EXECUTION:

The Bidder agrees that if this proposal is accepted, he will, within ten (10) days, not including Sundays and legal holidays, after notice of award, sign the Agreement in the form annexed hereto, and will at that time, deliver to the City of Redmond the PERFORMANCE BOND and the PAYMENT BOND required herein, and will to the extent of their proposal, furnish all machinery, 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 specified in the Contract Documents and required by the City thereunder.

In the event that the Bidder shall fail to enter into a contract within such time, the bid security in the amount stated in the INVITATION TO BID and deposited herewith, shall be retained by the City and it is agreed that said sum is a fair measure of the amount of damage that the City will sustain because of such failure to enter into a contract.

CERTIFICATES OF INSURANCE:

The bidder further agrees to furnish the City, before commencing the work under the Contract, the certificates of insurance as specified in these documents.

CONSTRUCTION TIME LIMITS:

The Bidder agrees to begin work within ten (10) calendar days after the date of the City's written notice to proceed, and to complete all work to be done under the contract in the time frames noted in the INVITATION TO BID after the date of the City’s written notice to proceed.

LIQUIDATED DAMAGES:

In the event the Bidder is awarded the Agreement and shall fail to complete the work within the time limit or extended time limit agreed upon, as more particularly set forth in the Contract Documents, liquidated damages shall be paid to the City per Redmond Public Works Standards and Specifications, General Conditions.

SUBCONTRACTORS:

The Bidder will list all proposed subcontractors by their proper corporate name and the portion of the work the subcontractor intends to perform in the spaces provided below. Contractor is also required to comply with the regulations regarding First Tier Subcontractors and applicable submittals.

Subcontractor Work item to be performed

1. __________________________________________________________________________

2. __________________________________________________________________________

3. __________________________________________________________________________

4. __________________________________________________________________________

5. __________________________________________________________________________

The City reserves the right to reject any subcontractor that the City deems unfit for the scope of the work proposed.

LUMP SUM OR UNIT PRICES:

The Bidder further proposes to accept as full payment for the work proposed herein the amounts computed under the provisions of the Contract Documents and based on the following lump sum or unit price amounts. The Bidder agrees that the lump sum prices, and the unit prices represent a true measure of the labor and materials required to perform the work, including all allowances for overhead and profit for each type and unit of work called for in these Contract Documents.

The City reserves the right to reject any and all bids, to waive any informalities and to accept the bid of the lowest responsible Bidder.

ADDENDA:

The Bidder acknowledges that addenda numbers (Bidder insert number of each addendum received) have been received and examined as part of these Contract Documents.

SURETY:

If the bidder is awarded the construction contract on this proposal, the surety who provides the "Performance Bond" and "Payment Bond" will be:

Name: Address:

BIDDER:

The name of the bidder submitting this proposal:

Name: Address:

The above stated address is the address to which all communications concerned with this proposal and with the contract are to be sent. The names of the principal officers of the corporation, or partnership, or of all persons interested in this proposal as principals are as follows:

If sole proprietor or partnership:

In witness hereto the undersigned has set their hand this

_____ day of _________________, 2024.

Signature of Bidder

Title

If corporation:

In witness whereof the undersigned corporation has caused this instrument to be executed by its duly authorized officers this

____ day of _________________, 2024__________________________________ Name of Corporation

By __________________________________ President

EXHIBIT J: Non-Collusion Affidavit

STATE OF OREGON )

) SS.

COUNTY OF _________ )

I state that I am the ______________________ of _____________________________ and that I am authorized to make this affidavit on behalf of my firm, and its owners, directors and officers. I am the person responsible in my firm for the price(s) and the amount of this bid.

I further state that:

(1) The price(s) and amount of this bid have been arrived at independently and without consultation, communication or agreement with any other contractor, bidder or potential bidder, except as disclosed on the attached appendix.

(2) That neither the price(s) nor the amount of this bid, and neither the approximate price(s) nor approximate amount of this bid have been discussed with any other firm or person which is a bidder or potential bidder, and they will not be disclosed before bid opening.

(3) No attempt has been made or will be made to induce any firm or person to refrain from bidding on this contract, or to submit a bid higher than this bid, or submit a bid intentionally high or non-competitive or any other form of complementary bid.

(4) The bid of my firm is made in good faith and pursuant to any agreement or discussion with, or inducement from, any firm or person to submit a complementary or other non-competitive bid.

(5) , its affiliates, and subsidiaries, officers, (NAME OF FIRM) directors and employees are not currently under investigation by any government agency and have not in the last four years been convicted of or found liable for any act prohibited by State and Federal law in the jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract, except as described on the attached appendix.

I further state that understands and acknowledges that the

(NAME OF FIRM)

above representations are material and important and will be relied on for the City of Redmond, Oregon in awarding the contract from which this bid is submitted. I understand and my firm understands that any misstatement in this affidavit is and shall be treated as fraudulent concealment from the City of Redmond, Oregon of the true facts relating to the submission of bids for the contract.

Name of Contractor: ____________________________________________

Signature: ____________________________________________

Printed Name: ____________________________________________

Title: ____________________________________________

Sworn to and subscribed before me this __________ day of ____________, 2024.

(SEAL)

NOTARY PUBLIC OF OREGON

My commission expires: __________________________

EXHIBIT K: Prevailing Wage

Contracts may be subject to both the State of Oregon Prevailing Wage Rate and Federal Davis-Bacon Act.

ORS 279C.830; OAR 839-025-0020, Federal Davis-Bacon Act. The Contractor is responsible for adhering to State and Federal wage payment requirements and paying the higher of the State prevailing wage or Federal prevailing wage on projects subject to both state and federal prevailing wage law.

The bidder states that provisions of ORS 279C.800 – 279C.870 (Oregon Prevailing Wage Rates) will be complied with on the 2024 Type III Slurry Seal Project.

COMPANY NAME ___________________________________

SIGNATURE ___________________________________

TITLE ___________________________________

DATE ___________________________________

• Applicable prevailing wage rates are those in effect at the time the initial specifications are first advertised for bid solicitation. The workers must be paid not less than the applicable state or federal prevailing wage rate, whichever is higher. ORS 279.830

• The contractor and every subcontractor must have a public works bond filed with the Construction Contractors Board before starting work on the project. Every subcontractor is required to have a public works bond filed with the Construction Contractors Board before starting work on the project. ORS 279C.836.

• If the contractor fails to pay for labor and services, the City can pay for them and withhold these amounts from payments to the contractor. ORS 279C.515; OAR 839.025.0020.

• The contractor must pay daily, weekly, weekend and holiday overtime as required. ORS 279C.520; OAR 839-025- 020.

• The contractor must make prompt payment for all medical services and workers ‘compensation for which the contractor has agreed to pay, and for all amounts for which the contractor collects or deducts from the worker’s wages. ORS 279C.530; OAR 839-025-0020.

• The employer must give written notice to the workers of the number of hours per day and days per week they may be required to work. OAR 839-025-0020.

BOLI Contact:

Bureau of Labor and Industries Wage and Hour Division Prevailing Wage Unit 800 N.E. Oregon Street, #32 Portland, OR 97232 www.oregon.gov/BOLI http://www.oregon.gov/BOLI

EXHIBIT L: Contractor’s Experience Questionnaire

Please list at least five similar projects to the 2024 Type III Slurry Seal Project that have been completed in the last five years.

#1

PROJECT OWNER:

DESCRIPTION OF PROJECT:

PROJECT ENGINEER:

TOTAL COST OF PROJECT:

CONTACT NAME:

CONTACT NAME TELEPHONE #:

#2

PROJECT OWNER:

DESCRIPTION OF PROJECT:

PROJECT ENGINEER:

TOTAL COST OF PROJECT:

CONTACT NAME:

CONTACT NAME TELEPHONE #:

#3

PROJECT OWNER:

DESCRIPTION OF PROJECT:

PROJECT ENGINEER:

TOTAL COST OF PROJECT:

CONTACT NAME:

CONTACT NAME TELEPHONE #:

#4

PROJECT OWNER:

DESCRIPTION OF PROJECT:

PROJECT ENGINEER:

TOTAL COST OF PROJECT:

CONTACT NAME:

CONTACT NAME TELEPHONE #:

#5

PROJECT OWNER:

DESCRIPTION OF PROJECT:

PROJECT ENGINEER:

TOTAL COST OF PROJECT:

CONTACT NAME:

CONTACT NAME TELEPHONE #:

EXHIBIT M: Equipment Listing Project: 2024 Type III Slurry Seal Project

As part of the bid, the bidder shall list the applicable equipment proposed for use on the 2024 Type III Slurry Seal Project listing the equipment below satisfies this requirement. Bidder understands and agrees that submittal of a suitable equipment list is a requisite for bid consideration, and that an inadequate list may cause rejection of the bidders’ proposal. Adequacy of the equipment set forth shall be determined solely by the Engineer or their authorized representative.

EQUIPMENT:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

SAFETY EQUIPMENT:

1.

2.

3.

4.

5.

Contractor’s Signature Date

EXHIBIT N: Drug Testing Policy

The bidder states that provisions of ORS 279C.505 [Chapter 794.138] requiring a written employee drug-testing program is in place for the Contractor’s employees that include, at a minimum, the following:

□ Drug testing for all new Employees working on the project site every 6 months on a random selection basis, and;

□ Testing of an Employee working on the project site when Contractor has a reasonable cause to believe the Subject Employee is under the influence of drugs, and;

□ Testing of an Employee working on the project site is involved in an incident causing injury requiring treatment by a physician, or damage to property or equipment.

Company Name

Signature

Title

Date