INDIANA

DEPARTMENT OF TRANSPORTATION

CONTRACT INFORMATION

BOOK (CIB)

PART I

CONTRACT NO.

LETTING DATE:

Certified By:

Date:

Covering Items in Table of Contents, PART I For Release for Bidding Purposes

R -43687-A

MAY 7, 2026

4-1-2026

CONTRACT INFORMATION

TABLE OF CONTENTS

CONTRACT NO.

This book shall be examined to determine that each page set out in the Contract Information Table of Contents, and the Special Provisions Table of Contents is attached, legible, and current.

PART I PAGES

PROPOSAL PAGE 1

SCHEDULE OF PAY ITEMS 1 –

RECURRING PLAN DETAILS 1 -

TRAFFIC CONTROL DEVICE REPORT 1

SPECIAL PROVISIONS 1 –

PART II

CONTACTS FOR DISTRICT PERSONNEL ONLY

Contractors shall submit contract specific questions by completing the Question Form accessed from http://entapps.indot.in.gov/cqa/ The Department will attempt to have an answer on-line within two business days. Contract specific questions asked by any other method will not be answered by the Department.

Retrieve the Question and Answer Form for a specific contract by going on–line in the same manner you retrieve Contract Information Books and Plans. http://erms.indot.in.gov/viewdocs/ will display the interface used for selection of contract letting documents. For the document category, Select "Q and A Form".

CONTRACT SPECIFIC QUESTIONS

R -43687-A

(intentionally left blank) --

CONSULTING FIRM: EGIS GROUP PHONE: 317-806-2414

CONSULTING FIRM CONTACT: BRETT WALLS 317-806-2414

EMAIL: brett.walls@egis-group.com

PROJECT MANAGER: JESSICA MASSING PHONE: 765-361-5243

AREA ENGINEER: BRIAN NEWMAN PHONE: 765-918-6727

EMAIL: bnewman@indot.IN.gov

DBE GOAL: A contract provision goal of percent of the contract bid price has been established as the minimum amount for contracting to disadvantaged business enterprises.

The initial payment for clearing right-of-way will be limited to % of the original total bid.

Indiana Department of Transportation

10:00 AM

Date of Letting:

Location of Letting: INDIANA GOVERNMENT CENTER NORTH

100 N. SENATE AVENUE, N758-CONTRACTS

INDIANAPOLIS, IN 46204

May 07, 2026 Time of Letting:

Proposal

0.00

R -43687-A

Counties:

Districts:

FOUNTAIN, PARKE, VERMILLION

Not Applicable

COLD-IN-PLACE RECYCLING

Pre-Bid Meeting Date:

Contract Number: Crawfordsville

Description:

The following documents are included in the Contract:

2026 INDOT Standard Specifications effective 9-1-2025 INDOT Standard Drawings listed on Standard Drawings Index effective 9-1-2025 INDOT Qualified Materials Lists and Certified Sources Lists Pre-bid Questions and Answers published on the INDOT website

Additional reference material may be available on the INDOT website, which may include, but is not limited to permits, asbestos reports, geotechnical reports and utilities information. The contractor shall consider the available additional reference material when preparing their proposal bid.

Location: ON SR 234 FROM SR 63 TO 2.5 MILES WEST OF US 41

1.0

Project Control No. LocationFederal/State No.

2100194 COLD-IN-PLACE RECYCLING2100194

FOUNTAIN COUNTY - ON SR 234 FROM SR 63 TO 2.5 MILES WEST

OF US 41

Time ID Completion Date or Number of Units Time Type Liquidated Damages RateDescription

00 5/31/2028 DT $3,000.00 per DayCOMPLETION DATE

01 10/31/2026 DT $2,500.00 per DayINTERMEDIATE

COMPLETION DATE 246+75

TO 48+20

02 11/30/2026 DT $1,000.00 per DayINTERMEDIATE

COMPLETION DATE TREE

CLEARING

03 10/31/2027 DT $2,500.00 per DayINTERMEDIATE

COMPLETION DATE 51+84

TO 270+65

(*) - Indicates Cost Plus Time Site. See Schedule of Items for Cost Per Unit

3/24/2026 11:13 AM

Letting Date: May 07, 2026Indiana Department of Transportation

Proposal ID: R -43687-A Project(s): 2100194

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

LUMP SUMLUMP SUM _________._____

0001 105-06845

CONSTRUCTION ENGINEERING

1.00 1.00 0002 109-08359

LIQUIDATED DAMAGES DOL

1.000

1.00 1.00 0003 109-08360

CONTRACT LIENS DOL

1.000

1.00 1.00 0004 109-08440

QUALITY ADJUSTMENTS, HMA DOL

1.000

1.00 1.00 0005 109-08443

QUALITY ADJUSTMENTS,

TEMPORARY TRAFFIC CONTROL

DEVICES

DOL

1.000

1.00 1.00 0006 109-08444

QUALITY ADJUSTMENTS, FAILED

MATERIALS

DOL

1.000

1.00 1.00 0007 109-09377

QUALITY ADJUSTMENTS, PAVEMENT

TRAFFIC MARKINGS

DOL

1.000

1.00 1.00 0008 109-11362

QUALITY ADJUSTMENTS, FAILURE TO

MAINTAIN TEMPORARY EROSION

AND SEDIMENT CONTROL

MEASURES

DOL

1.000

LUMP SUMLUMP SUM _________._____

0009 110-01001

MOBILIZATION AND DEMOBILIZATION

LUMP SUMLUMP SUM _________._____

0010 201-52370

CLEARING RIGHT-OF-WAY

0011 202-02271

HEADWALL, REMOVE EACH

7.000

0012 202-91385

INLET, REMOVE EACH

2.000

Schedule of Pay Items Page 1 of 9

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

0013 202-93741

GUARDRAIL END TREATMENT,

REMOVE

EACH

13.000

0014 202-96133

PIPE, REMOVE LFT

719.000

0015 202-99187

FENCE, FARM FIELD, REMOVE LFT

70.000

0016 203-02000

EXCAVATION, COMMON CYS

4,040.000

0017 203-08607

LINEAR GRADING LFT

2,450.000

0018 205-11626

PUMP AROUND EACH

11.000

1.00 93,682.00 0019 205-12108

STORMWATER MANAGEMENT

BUDGET

DOL

93,682.000

LUMP SUMLUMP SUM _________._____

0020 205-12616

STORMWATER MANAGEMENT

IMPLEMENTATION

0021 207-09935

SUBGRADE TREATMENT, TYPE IC SYS

2,073.000

0022 211-09265

STRUCTURE BACKFILL, TYPE 2 CYS

599.000

0023 211-09268

STRUCTURE BACKFILL, TYPE 5 CYS

29.000

0024 214-11796

GEOGRID, TYPE IB SYS

574.000

0025 301-12233

COMPACTED AGGREGATE, NO. 8 CYS

203.000

Schedule of Pay Items Page 2 of 9

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

0026 303-01180

COMPACTED AGGREGATE, NO. 53 TON

8,008.000

0027 304-07493

WIDENING WITH HMA, TYPE B TON

272.000

0028 304-12623

HMA PATCHING, FULL DEPTH, TYPE B TON

1,075.000

0029 306-08036

MILLING, ASPHALT, 2 IN. SYS

131,892.000

0030 306-08042

MILLING, SCARIFICATION SYS

114,427.000

0031 306-08432

MILLING, APPROACH SYS

3,642.000

0032 306-11872

MILLING, PROFILE SYS

114,427.000

0033 401-000002

QC/QA-HMA, 3, 58S, SURFACE, 9.5

mm

TON

14,508.000

0034 401-11526

JOINT ADHESIVE LFT

719.000

LUMP SUMLUMP SUM _________._____

0035 401-12169

INERTIAL PROFILER, HMA

0036 401-12439

VOID REDUCING ASPHALT

MEMBRANE FOR HMA

LFT

75,787.000

0037 402-07451

HMA WEDGE AND LEVEL, TYPE B TON

156.000

0038 406-05520

ASPHALT FOR TACK COAT TON

47.000

0039 408-12028

CRACKS IN ASPHALT PAVEMENT, FILL TON

1.000

Schedule of Pay Items Page 3 of 9

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

0040 416-12129

COLD IN-PLACE RECYCLING SYS

114,427.000

0041 416-12262

CORRECTIVE AGGREGATE, CIR TON

1,589.000

0042 416-12263

STABILIZING MATERIAL, ASPHALT

EMULSION

TON

644.000

0043 416-12468

STABILIZING MATERIAL, PORTLAND

CEMENT

TON

99.000

0044 601-02241

GUARDRAIL, REMOVE LFT

1,982.000

0045 601-12281

GUARDRAIL, MGS W-BEAM, 6 FT 3 IN.

SPACING

LFT

1,475.000

0046 601-12292

GUARDRAIL TRANSITION, MGS

WITHOUT CURB

EACH

13.000

0047 601-94689

GUARDRAIL END TREATMENT, TYPE

OS

EACH

13.000

0048 603-06040

FENCE, FARM FIELD, 47 IN. LFT

101.000

0049 606-12399

MILLED HMA CORRUGATIONS,

CONVENTIONAL

LFT

27,726.000

0050 606-12400

MILLED HMA CORRUGATIONS,

SINUSOIDAL

LFT

43,441.000

0051 610-07487

HMA FOR APPROACHES, TYPE B TON

300.000

Schedule of Pay Items Page 4 of 9

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

0052 615-06490

RIGHT-OF-WAY MARKER EACH

42.000

0053 615-06505

MONUMENT, TYPE B EACH

64.000

0054 615-06510

MONUMENT, TYPE C EACH

4.000

0055 615-06527

MONUMENT, SECTION CORNER EACH

2.000

0056 616-05688

RIPRAP, CLASS 1 TON

77.000

0057 616-05689

RIPRAP, CLASS 2 TON

19.000

0058 616-06405

RIPRAP, REVETMENT TON

510.000

0059 616-12246

GEOTEXTILE FOR RIPRAP, TYPE 1A SYS

1,069.000

0060 616-12248

GEOTEXTILE FOR RIPRAP, TYPE 2A SYS

983.000

0061 621-01004

MOBILIZATION AND DEMOBILIZATION

FOR SEEDING

EACH

4.000

0062 621-06559

MULCHED SEEDING, TYPE R SYS

2,216.000

0063 621-06560

MULCHED SEEDING, TYPE U SYS

372.000

0064 628-09403

FIELD OFFICE, TYPE C MOS

24.000

0065 628-11976

COMPUTER SYSTEM EQUIPMENT EACH

1.000

Schedule of Pay Items Page 5 of 9

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

0066 629-000149

TOPSOIL PROCESSING AND

DISTRIBUTION

SYS

2,588.000

1.00 5,176.00 0067 629-000150

TOPSOIL AMENDMENT BUDGET DOL

5,176.000

0068 714-11192

STRUCTURE, REINFORCED

CONCRETE, BOX SECTIONS, 4 FT X 3

FT

LFT

68.000

0069 714-11197

STRUCTURE, REINFORCED

CONCRETE, BOX SECTIONS, 3 FT X 2

FT

LFT

94.000

0070 715-05119

PIPE, TYPE 1, CIRCULAR, DIAMETER

15 IN.

LFT

34.000

0071 715-05121

PIPE, TYPE 1, CIRCULAR, DIAMETER

18 IN.

LFT

195.000

0072 715-05123

PIPE, TYPE 1, CIRCULAR, DIAMETER

24 IN.

LFT

44.000

0073 715-05124

PIPE, TYPE 1, CIRCULAR, DIAMETER

27 IN.

LFT

105.000

0074 715-05127

PIPE, TYPE 1, CIRCULAR, DIAMETER

42 IN.

LFT

64.000

0075 715-05233

PIPE, TYPE 1, DEFORMED, MIN. AREA

3.3 SFT

LFT

91.000

0076 715-05325

PIPE, TYPE 2, DEFORMED, MIN. AREA

1.0 SFT

LFT

46.000

Schedule of Pay Items Page 6 of 9

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

0077 715-05595

PIPE EXTENSION, CIRCULAR,

DIAMETER 15 IN. , CORRUGATED

METAL

LFT

4.000

0078 715-08305

HMA FOR STRUCTURE

INSTALLATION, TYPE B

TON

252.000

0079 715-09064

VIDEO INSPECTION FOR PIPE LFT

745.000

0080 715-46005

PIPE END SECTION, DIAMETER 15 IN. EACH

3.000

0081 715-46010

PIPE END SECTION, DIAMETER 18 IN. EACH

6.000

0082 715-46020

PIPE END SECTION, DIAMETER 24 IN. EACH

2.000

0083 715-46025

PIPE END SECTION, DIAMETER 27 IN. EACH

3.000

0084 715-46045

PIPE END SECTION, MIN. AREA 1.1

SFT

EACH

1.000

0085 718-12307

GEOTEXTILE FOR UNDERDRAINS,

TYPE 2A

SYS

300.000

0086 720-02442

PIPE, PLUG EXISTING EACH

1.000

0087 720-45030

INLET, TYPE E7 EACH

1.000

0088 801-04308

ROAD CLOSURE SIGN ASSEMBLY EACH

17.000

0089 801-06209

TEMPORARY PAVEMENT MARKING,

REMOVABLE, 6 IN.

LFT

57,759.000

Schedule of Pay Items Page 7 of 9

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

0090 801-06211

TEMPORARY PAVEMENT MESSAGE

MARKING, REMOVABLE, LANE

INDICATION ARROW

EACH

2.000

0091 801-06218

TEMPORARY TRANSVERSE

PAVEMENT MARKING, REMOVABLE,

24 IN.

LFT

26.000

0092 801-06625

DETOUR ROUTE MARKER ASSEMBLY EACH

38.000

0093 801-06640

CONSTRUCTION SIGN, TYPE A EACH

66.000

0094 801-06645

CONSTRUCTION SIGN, TYPE B EACH

6.000

LUMP SUMLUMP SUM _________._____

0095 801-06775

MAINTAINING TRAFFIC

0096 801-07118

BARRICADE, TYPE III-A LFT

288.000

0097 801-07119

BARRICADE, TYPE III-B LFT

168.000

0098 802-05704

SIGN POST, SQUARE, TYPE 1,

UNREINFORCED ANCHOR BASE

LFT

43.000

0099 802-07059

SIGN, SHEET, AND SUPPORTS,

REMOVE

EACH

5.000

0100 802-09838

SIGN, SHEET, WITH LEGEND, 0.080

IN. THICKNESS

SFT

16.000

0101 802-09840

SIGN, SHEET, WITH LEGEND, 0.100

IN. THICKNESS

SFT

16.000

Schedule of Pay Items Page 8 of 9

1 COLD-IN-PLACE RECYCLINGSECTION:

Alt Set ID: Alt Mbr ID:

Unit Price Bid Amount Approximate Quantity and

UnitsDescription Item ID

Proposal Line

Number

0102 802-76055

SIGN POST, TYPE A LFT

16.000

0103 804-93726

DELINEATOR EACH

6.000

LUMP SUMLUMP SUM _________._____

0104 808-09381

RETRO-REFLECTIVITY TESTING

0105 808-12764

LINE, PAINT, BROKEN, YELLOW, 6 IN. LFT

8,483.000

0106 808-75007

LINE, PAINT, SOLID, WHITE, 6 IN. LFT

96,137.000

0107 808-75047

LINE, PAINT, SOLID, YELLOW, 6 IN. LFT

49,276.000

0108 808-75297

TRANSVERSE MARKING,

THERMOPLASTIC, STOP LINE,

WHITE, 24 IN.

LFT

26.000

0109 808-75320

PAVEMENT MESSAGE MARKING,

THERMOPLASTIC, LANE INDICATION

ARROW

EACH

2.000

0110 808-75996

SNOWPLOWABLE RAISED PAVEMENT

MARKER, REMOVE

EACH

876.000

0111 808-75998

SNOWPLOWABLE RAISED PAVEMENT

MARKER

EACH

118.000

Section: 1 _________._____Total:

Schedule of Pay Items Page 9 of 9

02-01-15

103-C-584d

103-C-584d DBE JOINT CHECK REQUEST FORM

(Revised 12-11-14)

INDIANA DEPARTMENT OF TRANSPORTATION

DBE JOINT CHECK REQUEST FORM

Name of DBE Contract Number

Name of Prime Contractor Item Number(s)

Name of Material Supplier

INDOT will closely monitor the use of joint checks. To receive DBE credit for performing a commercially useful function with respect to obtaining materials and supplies, a DBE must “be responsible for negotiating price, determining quality and quantity, ordering the material and installing (where applicable) and paying for the material itself.” Only when a DBE meets all of these requirements should credit be counted for the procurement of the items by the DBE. Please refer to the attached Procedures for Using Joint Checks under the Disadvantaged Business Program for qualifying conditions. If proper procedures are not followed or INDOT determines that the arrangement results in lack of independence for the DBE involved, no credit for the DBE’s participation as it relates to the material cost will be counted toward the contract goal requirement.

I have read and understand the above information and have attached a copy of the Joint Check Agreement relating to this request. I hereby acknowledge that the information provided on this form is true and accurate.

Authorized DBE Representative

Signature Title Date

Authorized Prime Contractor Representative

Signature Title Date

Authorized Material Supplier Representative

Signature Title Date

INDOT USE ONLY

Date Received: INDOT Representative:

Approved Denied Note: Do not process this request without a signed copy (all parties) of the Joint Check Agreement, statement of history, and any related policies.

Comments:

Please send the DBE Joint Check Request Form and supporting documentation to promptpayment@indot.in.gov 1

1 Updated March 22, 2021

CRAWFORDSVILLE DISTRICT CONTRACT NO. R -43687

02-01-15

103-C-584d

INDIANA DEPARTMENT OF TRANSPORTATION

PROCEDURES FOR USING JOINT CHECKS UNDER THE DISADVANTAGED BUSINESS

ENTERPRISE (DBE) PROGRAM

A joint check is a “two party” check payable to two parties. Typically, a joint check is issued by a prime contractor to a subcontractor and to a material supplier or another third party for items or services to be incorporated into a project.

INDOT understands that prime contractors, subcontractors and suppliers may wish to use joint check arrangements for a variety of legitimate reasons, such as assuring that timely payment will be for the supplier’s items or dealing with situations in which it is difficult for a subcontractor to obtain bonding at a competitive rate. However, INDOT also understands that that the use of joint checks can raise questions about whether it is proper to count DBE credit for the items purchased using the joint check.

When joint checks are utilized, DBE credit toward the contract goal will only be allowed when the DBE is performing a “commercially useful function” in accordance with 49 CFR 26.55(c)(1):

“A DBE performs a commercially useful function when it is responsible for execution of the work of the contract and is carrying out its responsibilities by actually performing, managing, and supervising the work involved. To perform a commercially useful function, the DBE must also be responsible, with respect to the materials and supplies used on the contract, for negotiating price, determining quality and quantity, ordering the material, and installing (where applicable), and paying for the material itself.”

The following conditions will apply to payments to DBE subcontractors and material vendors using joint checks. INDOT will closely monitor the use of joint checks to ensure that such a practice does not erode the independence of the DBE nor inhibit the DBE’s ability to perform a commercially useful function. Joint checks will not be allowed simply for the convenience of the prime contractor. Failure to follow these conditions may disqualify DBE participation or adversely impact a contractor’s bidding status.

1. Any implementation of a Joint Check Agreement must first be approved by INDOT and requested by the DBE involved using the DBE Joint Check Request Form provided by INDOT;

2. A formalized Joint Check Agreement between the parties involved (including the conditions of the arrangement and expected use of the joint checks) must accompany the DBE Joint Check Request Form;

3. Each party to the Joint Check Agreement must also submit a statement of its history in using joint checks and any related policies with the DBE Joint Check Request Form;

4. Joint checks should be focused on accomplishing the procurement of materials needed for a particular purpose at a particular time (i.e., contract specific).

5. Even with joint checks, the DBE will remain responsible for the other elements of 49 CFR 26.55(c)(1);

6. No requirement by the prime contractor that the DBE is to use a specific supplier nor the prime contractors “negotiated” price;

7. DBE must release the joint check to the material supplier (upon determining that the material supplier or other third party has fulfilled its responsibilities under the contract);

8. DBEs must be more than an extra participant in releasing the check to the material supplier;

9. Prime contractors must make joint checks available to all contract participants, and may not be restrictive to any one participant; and

10. All parties involved in a formalized joint check agreement must provide INDOT (upon request) with any documentation deemed necessary to substantiate compliance.

Storm Water, Erosion, and Sediment Control Inspection Report INDOT (4-2012)

Project Information

INDOT Lead Des Number: Inspection Type Inspection Date:

Contract Number: 024 hr (After a > 0.5" Event) Date of Last Precipitation:

Road/County: []weekly DQAlQC Amount of Last Precipitation:

Areas Inspected

Area Type Inspected Area Type Inspected Area Inspected ,;INA ';INA Type -/INA

Disturbed Areas Areas where Water Leaves the Erosion Project Site Controls

Material Storage Areas Other: Sediment Controls

How was inspection conducted? (check D Windshield D Walking D Other all that apply)

Stationing Inspected Sta. to Sta. to Sta. to [JEntire Project DSelect Stations: Sta. Sta. Sta.

Part A: Erosion and Sediment Control Best Management Practices (BMPs Ins}!ected Except for the instances listed below, all sediment and erosion controls have been inspected and were found to be in working order and do not require maintenance or conective actions.

BMPType Approximate Station

(see table on From To page 3)

Survey Line: Left, BMP Maintenance or Corrective Action Needed Right or centerline Describe required corrective actions, maintenance, additions, or directions. Along with description provide image filename here for any reference pictnres provided.

Page 1 of5

108-C-192d

Storm Water, Erosion, and Sediment Control Inspection Report

Part B: Additional Quantities or Additional BMPs Needed

INDOT

(4-2012)

Any additional control quantities or new BMPs not shown on the SWPPP must be approved by the PEIPS. If multiple locations are involved, identify the exact location of each addition. Justification for the measure must be provided.

BMPType Approximate Station Survey Line: Left, Description/Justification for the additional BMPs (see table on From To

Right or centerline Along with description provide image filename here for any pa2e 3) reference pictures provided.

Part C: Temporarily or Permanently Suspended Construction Activities Where construction activities (grading, excavating, embankment filling, or other land disturbing activities have been suspended either temporarily or permanently, describe why stabilization measures were not initiated within 7 days.

BMPType Approximate Station Survey Line: Left, Description (see table on From To Right or centerline Along with description provide image ftlename here for any pa2e 3) reference pictures provided.

Part D: Compliance Evaluation (check only one) yWith the maintenance and improvement actions noted, the areas inspected will meet the intent of the Erosion and Sediment ontrol Plan and INDOT contract documents and specifications related to temporary erosion and sediment control.

q The areas inspected are not meeting the intent and are in potential noncompliance with the Erosion and Sediment Control Plan and/or INDOT contract documents and specifications related to temporary erosion and sediment control. There is off site sedimentation and/or a high potential for off-site sedimentation on this project. (If this box is checked, complete the following "Part E: Potential Noncompliance Issues" section of this form)

BMPType (see table on page 3)

Part E: Potential Noncompliance Issues Approximate Station

From To

Survey Line: Left, Describe the potential noncompliance issue(s) e.g. failure to

Right or centerline adequately inspect the project, repeated failure of a BMP, failure to install a required BMP, a visible off-site discharge of material (silt, sand, oily water, etc.), or potential off-site discharges or potential failures.

Page 2 of5

108-C-192d

Storm Water, Erosion, and Sediment Control Inspection Report

Part F: Inspection Certification

INDOT

(4-2012)

I certifY that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assme that qualified personnel properly gather and evaluate the infOlmation submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is to the best of my knowledge and belief, true, accmate, and complete.

Inspector Name Printed: I Company: I Title: I Date:

Inspector Signature:

If evaluating an inspection performed by another inspector, please check one of the following boxes:

o I concur with the inspector 0 I do not concur with the inspector (please circle any findings that you do not agree with)

Owner Representative Name: Signature:

Date:

A pennanent copy must be filed with the project records and be provided to lNDOT or IDEM personnel according to requirements or upon request.

Table of Types of Erosion and Sediment Control Best Management Practices (BMPs) 1 Diversion Interceptor 8 Check Dam, 15 Filter Berm 22 Concrete Washout

Traversable

2 Temporary Seeding 9 Slope Drain 16 Filter Sock 23 Secondary Spill Containment

3 Permanent Sod or Seed 10 Splash Pad 17 Turbidity Curtain 24

4 Mulch (hydraulic 01' 11 Sediment Trap 18 Smface Roughening 25 bonded fiber mulch)

5 Straw Mulch 12 Sediment Basin 19 Vegetative Filter Strip 26 (blown/laid)

6 Manufactured Surface l3 Retention Pond 20 Inlet Protection 27 Protection Products

7 Check Dam 14 Silt Fence 21 Construction 28 entrance/exit cc: Prime Contractor Superintendent (add Prime Contractor OwnerlPresident when appropriate) INDOT Project Engineer (add INDOT Area Engineer when appropriate) INDOT District E&SC Specialist (add INDOT Central Office E&SC Specialist when appropriate)

Page 3 of5

108-C-192d

Storm Water, Erosion, and Sediment Control Inspection Report INDOT (4-2012)

Instructions for the Contractor's representative: Fill out this document completely including filling out the Project Information, Areas Inspected and Parts A, B, C, D, E and F the day of your field investigation and put it on file for the project. Submit the signed document to the INDOT project representative the same day. Always provide pictures to document site conditions observed in your report.

Instructions for INDOT's representative:

� When you receive a completed and signed inspection report as completed by the contractor, visit the site within 24 hours of receipt of the contractor's inspection to verify the contractor's fmdings. If you concur with the contractor's inspection, fill out part F and sign as the INDOT representative. If you don't concur with the contractor's inspection, fill out parts E, F and circle any areas where you believe the inspection misrepresented the site's state of compliance with the intent ofINDOT standards. If possible, provide pictures to document site conditions observed. Upon completion, sign under Part F, put it on file with the project and copy the prime contractor's representative.

� If you are completing this as an evaluation of an INDOT project without regard to the contractor's inspection, fill out all parts of the form including part D, E and sign as the inspector in part F. Always provide pictures to document site conditions observed in your report. Provide a copy to the INDOT PE/PS for the project and the Area Engineer. It is recommended that the inspection report be provided to the contractor immediately for their information (not their concurrence). It is also recommended another INDOT rep. visit the site within 24 hours to verify the inspection for their records and sign concurrence or non-concunence in Part F.

Additional Explanation:

• Part A - Only put BMPs in Part A that were deemed to be in need of maintenance or alteration. Do not provide a list of every BMP inspected on the project. The intent is to document only those which were deemed in need of maintenance or alteration in order to continue to meet the intent of the measure at the location.

• Part B - Only put additional BMPs not yet installed on the project site in Part B. These can be BMPs intended for a different construction phase of the project or BMPs planned for other areas of the project that make sense to be deployed at additional locations. This is also where recommendations of measures would occur that identify new BMPs not in the contract documents.

• Part C - This is a list of known bare/exposed areas of the project and the justification why they are remaining bare or exposed during the review period despite a lack of construction activities. This especially includes any areas that are or are planned to be exposed for greater than 7 days without immediate plans to stabilize.

• Part D - Checking that the project is not in compliance with the intent ofINDOT standards indicates that despite the additional maintenance measures and BMPs, the project's oversight is failing to ensure that sediment is prevented from leaving the project site or has the potential to leave the project site.

• Part E - List principles of storm water or erosion and sediment control that appear to be lacking on the proj ect which demonstrate the lack of oversight of the proj ect by qualified personnel.

• Part F - The "I certify" signature of the inspector is important in order to document whose opinion is being provided by the filling out of this form.

Page 4 of5

108-C-192d

BMPType (see table on pa2e 3)

Storm Water, Erosion, and Sediment Control Inspection Report

Approximate Station

From To

Additional Information for Part Left, Right or centerline

Page 5 of5

108-C-192d

Description

INDOT

(4-2012)

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Contract Number: R -43687-A

CRAWFORDSVILLE DISTRICT Contract No. R -43687

III i

SPECIAL PROVISIONS

TABLE OF CONTENTS

100-C-147 PAYMENT OF PREDETERMINED MINIMUM WAGE DETERMINATION (DAVIS-

BACON ACT) General Decision Number IN20250006

100-C-151A FHWA-1273

100-C-151D EXECUTIVE ORDER 11246

100-C-151E TITLE VI ASSURANCES

100-C-188 STANDARD SPECIFICATIONS

100-C-214 CONSTRUCTION LETTING EMAIL BOX

100-C-246 CARGO PREFERENCE ACT

100-C-281 PG BINDER GRADES

103-C-268 INDIANA-KENTUCKY DBE RECIPROCITY

103-C-269 SUBMITTAL OF DBE QUOTES AND DBE SUPPLIER FORM

106-C-277 BUILD AMERICA, BUY AMERICA ACT REQUIREMENTS

106-C-280 E-TICKETING INCENTIVE

107-B-040 ENVIRONMENTAL RESTRICTIONS

107-C-266 MAINTAINING PEDESTRIAN ACCESSIBILITY DURING CONSTRUCTION

201-C-052 INITIAL PAYMENT FOR CLEARING RIGHT-OF-WAY

203-R-806 EXCAVATION AND EMBANKMENT

205-R-740 PUMP AROUND

416-R-807 COLD IN-PLACE RECYCLING, CIR

505-R-795 EXCEPTIONS TO AASHTO T 152

621-R-800 SEEDING AND SODDING

714-R-801 REINFORCED CONCRETE BOX STRUCTURES

720-R-646 CURB INLET CASTING

801-C-157 CERTIFICATION OF TEMPORARY TRAFFIC CONTROL DEVICES

801-R-542 WORKSITE ADDED PENALTY SIGNS

801-T-198 TRAFFIC CONTROL FOR TRAFFIC BREAKS

801-T-246 ROAD WORK AHEAD SIGNS

CRAWFORDSVILLE DISTRICT Contract No. R -43687

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901-M-069 PORTLAND CEMENTS AND BLENDED CEMENTS

904-M-073 AGGREGATES

913-M-071 WATER

914-M-070 ROADSIDE DEVELOPMENT MATERIALS

918-M-072 GEOGRID

105-C-247 BRIDGE INSPECTION COORDINATION

107-R-169 STATEMENTS ABOUT EXISTING CONDITIONS OF UTILITIES, ADDITIONAL

RIGHT-OF-WAY, AND ENCROACHMENTS

108-C-094 FAILURE TO COMPLETE ON TIME FOR INTERMEDIATE COMPLETION DATE

VERMILLION COUNTY SURVEYOR COORDINATION

ROAD CLOSURE RESTRICTIONS

MAINTENANCE OF TRAFFIC COORDINATION AND ACCESS

NOTIFICATIONS OF TRAFFIC RESTRICTIONS

UNDISTRIBUTED QUANTITIES

BAT AVOIDANCE AND MITIGATION MEASURES

ENVIRONMENTAL COORDINATION

FAILURE TO COMPLETE ON TIME FOR INTERMEDIATE COMPLETION DATE, TREE

CLEARING

BALD EAGLE RESTRICTIONS

LANDSCAPE BOULDER RELOCATION

HEADWALLS AND WINGWALLS FOR CIRCULAR PIPES

PLUG EXISTING DRAINAGE PIPES

100-C-147 PAYMENT OF PREDETERMINED MINIMUM WAGE DETERMINATION (DAVIS-BACON

ACT) General Decision Number IN20250006

(Revised 06-16-22)

General Decision Number IN20250006 shall apply to this contract.

The above referenced wage determination is available from the USDOL at the

SAM internet website https://sam.gov/content/wage-determinations. Any modification published there by the USDOL not later than 10 days prior to letting is applicable to this contract.

The Department will confirm the modification number and publication date for the General Decision effective for the bid opening. Notice of confirmation will be published on the Contract Administration website https://www.in.gov/dot/div/contracts/letting/index.html at least one week prior to the bid opening. The bidder shall acknowledge in applicable wage determination, modification, and publication date in the proposal form.

100-C-151A FHWA-1273

(Revised 10-23-23)

REQUIRED CONTRACT PROVISIONS

FEDERAL - AID CONSTRUCTION CONTRACTS

I. General II. Nondiscrimination III. Non-segregated Facilities IV. Davis-Bacon and Related Act Provisions V. Contract Work Hours and Safety Standards Act Provisions VI. Subletting or Assigning the Contract VII. Safety: Accident Prevention VIII. False Statements Concerning Highway Projects IX. Implementation of Clean Air Act and Federal Water Pollution Control Act X. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion XI. Certification Regarding Use of Contract Funds for Lobbying XII. Use of United States-Flag Vessels:

ATTACHMENTS

A. Employment and Materials Preference for Appalachian Development Highway System or Appalachian Local Access Road Contracts (included in Appalachian contracts only)

I. GENERAL

1. Form FHWA-1273 must be physically incorporated in each construction contract funded under title 23, United States Code, as required in 23 CFR 633.102(b) (excluding emergency contracts solely intended for debris removal). The contractor (or subcontractor) must insert this form in each subcontract and further require its inclusion in all lower tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services). 23 CFR 633.102(e).

The applicable requirements of Form FHWA-1273 are incorporated by reference for work done under any purchase order, rental agreement or agreement for other services. The prime contractor shall be responsible for compliance by any subcontractor, lower-tier subcontractor or service provider. 23 CFR 633.102(e).

Form FHWA-1273 must be included in all Federal-aid design-build contracts, in all subcontracts and in lower tier subcontracts (excluding subcontracts for design services, purchase orders, rental agreements and other agreements for supplies or services) in accordance with 23 CFR 633.102. The design-builder shall be responsible for compliance by any subcontractor, lower-tier subcontractor or service provider.

Contracting agencies may reference Form FHWA-1273 in solicitation-for-bids or request-for-proposals documents, however, the Form FHWA-1273 must be physically incorporated (not referenced) in all contracts, subcontracts and lower-tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services related to a construction contract). 23 CFR 633.102(b).

2. Subject to the applicability criteria noted in the following sections, these contract provisions shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractor's immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract. 23 CFR 633.102(d).

3. A breach of any of the stipulations contained in these Required Contract Provisions may be sufficient grounds for withholding of progress payments, withholding of final payment, termination of the contract, suspension / debarment or any other action determined to be appropriate by the contracting agency and

FHWA.

4. Selection of Labor: During the performance of this contract, the contractor shall not use convict labor for any purpose within the limits of a construction project on a Federal-aid highway unless it is labor performed by convicts who are on parole, supervised release, or probation. 23 U.S.C. 114(b) The term Federal-aid highway does not include roadways functionally classified as local roads or rural minor collectors. 23 U.S.C.

101(a).

II. NONDISCRIMINATION (23 CFR 230.107(a); 23 CFR Part 230, Subpart A, Appendix A; EO 11246)

The provisions of this section related to 23 CFR Part 230, Subpart A, Appendix A are applicable to all Federal-aid construction contracts and to all related construction subcontracts of $10,000 or more. The provisions of 23 CFR Part 230 are not applicable to material supply, engineering, or architectural service contracts.

In addition, the contractor and all subcontractors must comply with the following policies: Executive Order 11246, 41 CFR Part 60, 29 CFR Parts 1625-1627, 23 U.S.C. 140, Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), Title VI of the Civil Rights Act of 1964, as amended (42 U.S.C. 2000d et seq.), and related regulations including 49 CFR Parts 21, 26, and 27; and 23 CFR Parts 200, 230, and 633.

The contractor and all subcontractors must comply with the requirements of the Equal Opportunity Clause in 41 CFR 60-1.4(b) and, for all construction contracts exceeding $10,000, the Standard Federal Equal Employment Opportunity Construction Contract Specifications in 41 CFR 60-4.3.

Note: The U.S. Department of Labor has exclusive authority to determine compliance with Executive Order 11246 and the policies of the Secretary of Labor including 41 CFR Part 60, and 29 CFR Parts 1625-1627.

The contracting agency and the FHWA have the authority and the responsibility to ensure compliance with 23 U.S.C. 140, Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), and Title VI of the Civil Rights Act of 1964, as amended (42 U.S.C. 2000d et seq.), and related regulations including 49 CFR Parts 21, 26, and 27; and 23 CFR Parts 200, 230, and 633.

The following provision is adopted from 23 CFR Part 230, Subpart A, Appendix A, with appropriate revisions to conform to the U.S. Department of Labor (US DOL) and FHWA requirements.

1. Equal Employment Opportunity: Equal Employment Opportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws, executive orders, rules, regulations (see 28 CFR Part 35, 29 CFR Part 1630, 29 CFR Parts 1625-1627, 41 CFR Part 60 and 49 CFR Part 27) and orders of the Secretary of Labor as modified by the provisions prescribed herein, and imposed pursuant to 23 U.S.C. 140, shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract. The provisions of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) set forth under 28 CFR Part 35 and 29 CFR Part 1630 are incorporated by reference in this contract. In the execution of this contract, the contractor agrees to comply with the following minimum specific requirement activities of EEO:

a. The contractor will work with the contracting agency and the Federal Government to ensure that it has made every good faith effort to provide equal opportunity with respect to all of its terms and conditions of employment and in their review of activities under the contract. 23 CFR 230.409(g)(4) & (5).

b. The contractor will accept as its operating policy the following statement:

"It is the policy of this Company to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, sexual orientation, gender identity, color, national origin, age or disability. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre-apprenticeship, and/or on-the-job training."

2. EEO Officer: The contractor will designate and make known to the contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active EEO program and who must be assigned adequate authority and responsibility to do so.

3. Dissemination of Policy: All members of the contractor's staff who are authorized to hire, supervise, promote, and discharge employees, or who recommend such action or are substantially involved in such action, will be made fully cognizant of and will implement the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met, the following actions will be taken as a minimum:

a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not less often than once every six months, at which time the contractor's EEO policy and its implementation will be reviewed and explained. The meetings will be conducted by the EEO Officer or other knowledgeable company official.

b. All new supervisory or personnel office employees will be given a thorough indoctrination by the EEO Officer, covering all major aspects of the contractor's EEO obligations within thirty days following their reporting for duty with the contractor.

c. All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractor's procedures for locating and hiring minorities and women.

d. Notices and posters setting forth the contractor's EEO policy will be placed in areas readily accessible to employees, applicants for employment and potential employees.

e. The contractor's EEO policy and the procedures to implement such policy will be brought to the attention of employees by means of meetings, employee handbooks, or other appropriate means.

4. Recruitment: When advertising for employees, the contractor will include in all advertisements for employees the notation: "An Equal Opportunity Employer." All such advertisements will be placed in publications having a large circulation among minorities and women in the area from which the project work force would normally be derived.

a. The contractor will, unless precluded by a valid bargaining agreement, conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minorities and women. To meet this requirement, the contractor will identify sources of potential minority group employees and establish with such identified sources procedures whereby minority and women applicants may be referred to the contractor for employment consideration.

b. In the event the contractor has a valid bargaining agreement providing for exclusive hiring hall referrals, the contractor is expected to observe the provisions of that agreement to the extent that the system meets the contractor's compliance with EEO contract provisions. Where implementation of such an agreement has the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Federal nondiscrimination provisions.

c. The contractor will encourage its present employees to refer minorities and women as applicants for employment. Information and procedures with regard to referring such applicants will be discussed with employees.

5. Personnel Actions: Wages, working conditions, and employee benefits shall be established and administered, and personnel actions of every type, including hiring, upgrading, promotion, transfer, demotion, layoff, and termination, shall be taken without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or disability. The following procedures shall be followed:

a. The contractor will conduct periodic inspections of project sites to ensure that working conditions and employee facilities do not indicate discriminatory treatment of project site personnel.

b. The contractor will periodically evaluate the spread of…