D265689.pdf

PROPOSAL

Contractor Information:

D265689

F.A. PROJECT

Book 1 of 2

Submitted in accordance with the Highway Law and with the Standard Specifications and Standard Sheets officially finalized and adopted on May 1, 2026 as posted on the Department's website.

US CUSTOMARY UNITS

Federal Identification Number

Name

Address

CONTRACTOR'S BID PACKAGE

Proposal Description:

CULVERT REPLACEMENTS - Various Rts in Town of Conesus, Java, Middlebury, Mount Morris & Sparta

Letting of 8/13/2026 @ 10:30 A.M.

50 Wolf Road, Albany, NY 12232

0020 Per Contracts L05/01/20

TABLE OF CONTENTS

PROPOSAL SECTION PAGE NO.

PROJECT TITLE SHEET 1

CONTRACTOR’S BID PACKAGE CONTENTS 2

Jurat (Proposal Form) / Bid Bond / DBE Commitment / Bid Survey /State Businesses / Itemized Proposal (Proposal Form)

REQUIRED CONTRACT PROVISIONS 29

EEO Goals / DBE/MBE/WBE/SDVOB - Goals / CONR 9, Supplemental Information / Electronic Bid / Federal Aid Provisions / Percentage Bid Items / Railroad Insurance / New York State Uniform Contracting Questionnaire

SPECIAL NOTES 55

Location Maps / Landscape Development Notes / ROW / Thruway / Canals / Funding / Asphalt & Fuel Price Adjustments / Specialty Items / etc...

PROJECT DETAILS N/A

STANDARD SPECIFICATIONS REVISIONS 109

SPECIAL SPECIFICATIONS 111

PREVAILING WAGE RATES 150

NOTE: This form, Table of Contents, and subsequent listed section title pages were developed for repetitive use throughout all contract proposals and may identify items not applicable to this specific project. The Contractor is responsible for review of this proposal containing the contract requirements.

D265689

CONTRACT NO: D265689

COUNTY(IES): LIVINGSTON, WYOMING

ITEMIZED PROPOSAL FOR CULVERT REPLACEMENTS - VARIOUS RTS IN TOWN OF CONESUS, JAVA, MIDDLEBURY, MOUNT MORRIS & SPARTA

CAPITAL PROJECT IDENTIFICATION NO

DEPOSIT REQUIRED.......................................... Bid bond, certified check, or cashier’s check in the minimum amount of 5% of the total bid

COMPLETION DATE

4LC1.01

THIS JOB CONTAINS SPECIAL PROVISIONS FOR INCENTIVE WORK.

SEE PAGES 89 - 92 FOR DETAILS.

F.A. PROJECT

STATE OF NEW YORK

DEPARTMENT OF TRANSPORTATION

ENGINEERING DIVISION

December 31, 2028

PROJECT TITLE SHEET

Bids Should Be Submitted through Bid Express or in a Sealed Envelope prominently labeled “BID ENCLOSED”;

addressed to NYSDOT, Contract Management Bureau, 50 Wolf Road, First Floor, Suite 1CM, Albany NY 12232;

and delivered prior to the proposal due date and time, during normal business hours (Monday through Friday, 7:00am to 4:00pm). Clearly identify the Contractor Name, Address, Federal Identification Number, Project Number and Project Description on the envelope. The same Federal Identification number should be used on both the envelope and the Planholders List. Low bidders must have a current NYS Vendor Responsibility Questionnaire For- Profit Construction (CCA-2) on file or submit one within 10 days of receipt of the contract. Questionnaires are available at: www.dot.ny.gov/bids-and-lettings/construction-contractors/general-info. Please call (518) 457-2421 if a reasonable accommodation is needed to participate in the Letting.

Project-related technical questions or comments must be submitted through the Construction Contracting section of the Business Center on the NYSDOT website at:

Questions www.dot.ny.gov/doing-business/opportunities/const-notices Contract administration or procurement questions may either be submitted through the website, or directed to the Contract Management Bureau contacts listed on the Important Bidder Information page on the back of the cover of Proposal Book 2.

D265689 1

CONTRACTOR’S BID PACKAGE CONTENTS

0040 Page 1 of 1 L01/01/20

Jurat (Proposal Form)

Bid Bond

Federal DBE Commitment and GFE Bid Requirements (Federal Aid Contracts Only)

Bid Survey (Optional)

Encouraging Use of NYS Businesses (100% State Funded Contracts Only)

Itemized Proposal (Proposal Form)

NOTE: This form was developed for repetitive use throughout all contract proposals and may identify items not applicable to this specific project.

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JURAT

1. Itemized Proposal

In submitting this bid, the undersigned declares that it is made without any connection with any person making another bid for the same contract; that the bid is in all respects fair and without collusion, fraud or mental reservation; and that no official of the State, or any person in the employ of the State is directly or indirectly interested in said bid or in the supplies or work to which it relates, or in any portion of the profits thereof.

The undersigned also hereby declares to have carefully examined the plans, specifications and form of contract, and to have personally inspected the actual location of the work together with the local sources of supply, to be satisfied as to all the quantities and conditions, and understands that in signing this proposal waives all right to plead any misunderstanding regarding the same.

The undersigned further understands and agrees to furnish and provide for the respective item price bid all the necessary material, machinery, implements, tools, labor services and other items of whatever nature, and to do and perform all the work necessary under the aforesaid conditions, to complete the improvement of the aforementioned project in accordance with the plans and specifications for said improvement, which plans and specifications it is agreed are a part of this proposal, and to accept in full compensation therefore the amount of the summation of the products of the approximate quantities multiplied by the unit prices bid. This summation will hereinafter be referred to as the gross sum bid.

For Design Bid Build projects, the undersigned further agrees to accept the aforesaid unit bid prices as compensation for any additions or deductions caused by variation in quantities due to more accurate measurement, and for use in the computation of the value of the work performed for monthly estimates, unless otherwise specifically provided for in the Standard Specifications.

The undersigned further agrees that should the bidder challenge any administrative action of the

Department regarding the award of the Contract, such special proceeding shall be brought in Supreme

Court, Albany County, and in no other location.

The undersigned further agrees that at any time during the progress of work the State adds, alters or omits portions of the work it shall so perform such work and accept compensation in accordance with the

Standard Specifications.

The undersigned further understands and agrees not to start any work until the contract agreement is signed by the Commissioner or the Commissioner's duly authorized representative. In no event shall the undersigned start any contract work which involves a disturbance within the State right of way prior to award of the contract by the Comptroller.

2. Bid Deposit

Accompanying this proposal is a bid bond, certified check or bank cashier's check for the specified amount of deposit required. In the event this proposal is accepted by the Department of Transportation and the undersigned shall fail to execute the contract and in all respects comply with the provisions of

Section 38 of the Highway Law, as amended, the moneys represented by such bid bond, certified check or bank cashier's check shall be regarded as liquidated damages and shall be forfeited and become the property of the State of New York; otherwise to be returned to the depositor in accordance with the provisions of said Section 38 of the Highway Law, as amended.

On acceptance of this proposal for said work the undersigned does or do hereby bind herself/himself or itself/themselves to enter into written contract, within ten days of date of notice of award, with the said

Department of Transportation, and to comply in all respects with §38(6) of the Highway Law, as amended, in relation to security for the faithful performance of the terms of said contract.

3. Certifications

A. Non-Collusive Bidding Certifications (NYS Finance Law §139-D)

1. Every bid hereafter made to the state or any public department, agency or official thereof, where competitive bidding is required by statute, rule or regulation, for work or services performed or to be

0700 11/05/2025

D265689 3 performed or goods sold or to be sold, shall contain the following statement subscribed by the bidder and affirmed by such bidder as true under the penalties of perjury:

a. By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of his knowledge and belief:

(1) The prices in this bid have been arrived at independently without collusion, consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor;

(2) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, directly or indirectly, to any other bidder or to any competitor; and

(3) No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit or not to submit a bid for the purpose of restricting competition.

b. A bid shall not be considered for award nor shall any award be made where a. (1)(2) and (3) above have not been complied with; provided however, that if in any case the bidder cannot make the foregoing certification, the bidder shall so state and shall furnish with the bid a signed statement which sets forth in detail the reasons therefore. Where a. (1)(2) and (3) above have not been complied with, the bid shall not be considered for award nor shall any award be made unless the head of the purchasing unit of the state, public department or agency to which the bid is made, or his designee, determines that such disclosure was not made for the purpose of restricting competition.

The fact that a bidder: (a) has published price lists, rates, or tariffs covering items being procured,

(b) has informed prospective customers of proposed or pending publication of new or revised price lists for such items or (c) has sold the same items to other customers at the same prices being bid, does not constitute, without more, a disclosure within the meaning of subparagraph 1. a.

2. Any bid hereafter made to the state or any public department, agency or official thereof by a corporate bidder for work or services performed or to be performed or goods sold or to be sold, where competitive bidding is required by statute, rule or regulation, and where such bid contains the certification referred to in subdivision one of this section, shall be deemed to have been authorized by the board of directors of the bidder and such authorization shall be deemed to include the signing and submission of the bid and the inclusion therein of the certificate as to non-collusion as the act and deed of the corporation.

B. Non-Collusive Bidding Certification (49 CFR 20)

The Contractor to whom the above identified contract is to be awarded does hereby tender to the New

York State Department of Transportation this sworn statement pursuant to Section 112(c) of Title 23 U.S.

Code Highways and does hereby certify, in conformance with said 23 USC 112(c) that the said Contractor has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the above identified contract.

The signatory to this proposal, being duly sworn, certifies that, EXCEPT AS NOTED BELOW, its company and any person associated therewith in the capacity of owner, partner, director, officer, or major stockholder (five percent or more ownership):

1. is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency;

2. has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past three years;

3. does not have a proposed debarment pending; and

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4. has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent Jurisdiction in any matter involving fraud or official misconduct within the past three years.

EXCEPTIONS - List any relevant information, attaching additional sheets if necessary. (Exceptions will not necessarily result in disapproval, but will be considered in determining responsibility. For any exception noted, indicate below to whom it applies, the initiating agency, and dates of action. Providing false information may result in criminal prosecution or administrative sanctions.)

4. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion. (FHWA

Section 1273 X.) [For Federal-Aid Contracts Only]

A. The Bidder certifies to the best of its knowledge and belief, that it and its Principals:

1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency;

2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity

(Federal, State or local) with commission of any of the offenses enumerated in paragraph (a)(2) of this certification; and

4. Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default.

B. Where the Bidder is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

5. Certification Regarding Use of Contract Funds for Lobbying (FHWA 1273 Section XI.) [For

Federal-Aid Contracts Only]

A. The Bidder certifies, by signing and submitting this bid or proposal, to the best of his/her/their knowledge and belief, that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress 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 have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of

Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.

B. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S. Code §1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

D265689 5

C. The Bidder also agrees by submitting its bid or proposal that the Bidder shall require that the language of this certification be included in all lower tier subcontracts which exceed $100,000, and that all such subrecipients shall certify and disclose accordingly.

6. Bidder Assurance of No Conflict of Interest or Detrimental Effect.

The firm offering to provide services pursuant to this Contract, as a Contractor or joint venture

Contractor, attests that its performance of the services outlined in this proposal does not and will not create a conflict of interest with nor position the firm to breach any other contract currently in force with the State of New York.

Furthermore, the firm attests that it will not act in any manner that is detrimental to any State project on which the firm is rendering services. Specifically, the firm attests that:

a. The fulfillment of obligations by the firm, as proposed in the response, does not violate any existing contracts or agreements between the firm and the State;

b. The fulfillment of obligations by the firm, as proposed in the response, does not and will not create any conflict of interest, or perception thereof, with any current role or responsibility that the firm has with regard to any existing contracts or agreements between the firm and the State;

c. The fulfillment of obligations by the firm, as proposed in the response, does not and will not compromise the firm’s ability to carry out its obligations under any existing contracts between the firm and the State;

d. The fulfillment of any other contractual obligations that the firm has with the State will not affect or influence its ability to perform under any contract with the State resulting from this proposal;

e. During the negotiation and execution of any contract resulting from this proposal, the firm will not knowingly take any action or make any decision which creates a potential for conflict of interest or might cause a detrimental impact to the State as a whole including, but not limited to, any action or decision to divert resources from one State project to another;

f. In fulfilling obligations under each of its State contracts, including any contract which results from this proposal, the firm will act in accordance with the terms of each of its State contracts and will not knowingly take any action or make any decision which might cause a detrimental impact to the State as a whole including, but not limited to, any action or decision to divert resources from one State project to another;

g. No former officer or employee of the State who is now employed by the firm, nor any former officer or employee of the firm who is now employed by the State, has played a role with regard to the administration of this contract procurement in a manner that may violate section 73(8)(a) of the

State Ethics Law; and

h. The firm has not and shall not offer to any employee, member or director of the State any gift, whether in the form of money, service, loan, travel, entertainment, hospitality, thing or promise, or in any other form, under circumstances in which it could reasonably be inferred that the gift was intended to influence said employee, member or director, or could reasonably be expected to influence said employee, member or director, in the performance of the official duty of said employee, member or director or was intended as a reward for any official action on the part of said employee, member or director.

Firms responding to this proposal should note that the State recognizes that conflicts may occur in the future because a firm may have existing or new relationships. The State will review the nature of any such new relationship and reserves the right to terminate the contract for cause if, in its judgment, a real or potential conflict of interest cannot be cured.

7. False Claims Certification (31 USC §3729, NYS Finance Law Article 13)

Under the Federal False Claims Act, 31 U.S. Code §3729, any person or entity who knowingly presents, or causes to be presented to the Federal Government, a false or fraudulent claim for payment or approval is liable to the United State Government for a civil penalty of not less than $5,000 and not more than $10,000, plus three times the amount of damages the Government sustains.

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Under the New York State False Claims Act, NYS Finance Law Article 13, any person or entity who knowingly presents or causes to be presented to the State of New York or Local Governments within the

State of New York, a false or fraudulent claim for payment or approval is liable to the Government for a civil penalty of not less than $6,000 and not more than $12,000, plus three times the amount of damages the Government sustains.

“Knowingly” is defined as: (1) actual knowledge; (2) acting in deliberate ignorance of the truth or falsity of information; or (3) acting in reckless disregard of the truth or falsity of information; no proof of specific intent to defraud is required.

The Contractor to whom the above-identified contract is to be awarded does hereby certify to New

York State Department of Transportation that it understands the prohibitions under the Federal and New

York State False Claims Acts, and that it has not and will not submit or cause to be submitted any fraudulent claims in the submission of this bid or in connection with the above identified contract. The

Contractor further certifies that it understands retaliatory actions, against employees and officers who initiate a Qui Tam (public) action on behalf of the government or cooperate in the investigation of a false claim, are prohibited and are subject to an assessment of damages and penalties, under the provisions of the Federal and New York State False Claims Acts.

8. Executive Order 177 Certification

The New York State Human Rights Law, Article 15 of the Executive Law, prohibits discrimination and harassment based on age, race, creed, color, national origin, sex, pregnancy or pregnancy-related conditions, sexual orientation, gender identity, disability, marital status, familial status, domestic violence victim status, prior arrest or conviction record, military status or predisposing genetic characteristics.

The Human Rights Law may also require reasonable accommodation for persons with disabilities and pregnancy-related conditions. A reasonable accommodation is an adjustment to a job or work environment that enables a person with a disability to perform the essential functions of a job in a reasonable manner. The Human Rights Law may also require reasonable accommodation in employment on the basis of Sabbath observance or religious practices.

Generally, The Human Rights Law applies to:

a. All employers of four or more people, employment agencies, labor organizations and apprenticeship training programs in all instances of discrimination or harassment;

b. Employers with fewer than four employees in all cases involving sexual harassment; and

c. Any employer of domestic workers in cases involving sexual harassment or harassment based on gender, race, religion or national origin.

In accordance with Executive Order No. 177, the Proposer / Bidder hereby certifies that it does not have institutional policies or practices that fail to address the harassment and discrimination of individuals on the basis of their age, race, creed, color, national origin, sex, sexual orientation, gender identity, disability, marital status, military status, or other protected status under the Human Rights Law.

Executive Order No. 177 and this certification do not affect institutional policies or practices that are protected by existing law, including but not limited to the First Amendment of the United States

Constitution, Article 1, Section 3 of the New York State Constitution, and Section 296(11) of the New

York State Human Rights Law.

9. US Department of Transportation Office of Inspector General – Fraud, Waste, & Abuse Hotline

The U.S. Department of Transportation (USDOT) Office of Inspector General (OIG) maintains a

Hotline for receiving allegations of fraud, waste, abuse, or mismanagement in USDOT programs or operations. Persons with knowledge of bid collusion (i.e., contractors, suppliers, work persons, etc.), or other questionable contract related practices (inadequate materials, poor workmanship, theft of materials, etc.), are encouraged to report such activities by calling the Hotline at 1-800-424-9071, emailing hotline@oig.dot.gov, or writing to the USDOT Inspector General, 1200 New Jersey Ave SE, West Bldg.

7th Floor, Washington, DC 20590. Allegations may be reported 24 hours a day, seven days a week by DOT employees, contractors, or the general public.

D265689 7

10. New York State Office of the Inspector General Hotline

The New York State Office of the Inspector General maintains a Hotline for receiving allegations of governmental misconduct. Reports of New York State governmental misconduct may be made in strict confidence to the Toll Free 24-hour Statewide HOTLINE at 1-800-DO RIGHT (1-800-367-4448), the on-line complaint form at www.ig.ny.gov or in writing to the New York State Office of the Inspector General, Empire State Plaza, Agency Building 2 - 16th Floor, Albany, New York 12223.

11. Offerer Disclosure of Prior Non-Responsibility Determinations – Contractor must complete the form below:

1. Has any Governmental Entity made a finding of non-responsibility regarding the individual or entity seeking to enter into the Procurement Contract in the previous four years? (Please circle):

No Yes

If yes, please answer questions 2-4. If no, skip to question 5.

2. Was the basis for the finding of non-responsibility due to a violation of State Finance Law §139-j?

(Please circle):

No Yes

3. Was the basis for the finding of non-responsibility due to the intentional provision of false or incomplete information to a Governmental Entity? (Please circle):

No Yes

4. If you answered yes to any of the above questions, please provide details regarding the finding of non-responsibility below.

Governmental Entity: _________________________________________________________________

Date of Finding of Non-responsibility: ___________________________________________________

Basis of Finding of Non-Responsibility: __________________________________________________

(Add additional pages as necessary)

5. Has any Governmental Entity or other governmental agency terminated or withheld a Procurement

Contract with the individual or entity seeking to enter into the Procurement Contract due to the intentional provision of false or incomplete information? (Please circle):

No Yes

6. If yes, please provide details below.

Governmental Entity: _________________________________________________________________

Date of Termination or Withholding of Contract: ___________________________________________

Basis of Termination or Withholding: ____________________________________________________

(Add additional pages as necessary)

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BY EXECUTING THIS PROPOSAL, THE CONTRACTOR AGREES TO:

1. Perform all work listed in accordance with the Contract Documents including all amendments, (found at https://www.dot.ny.gov/doing-business/opportunities/const-notices or https://www.dot.ny.gov/main/business-center/designbuild) at the prices bid; subject to the Changed Conditions provisions if applicable;

2. Accompany this proposal with a bid bond, certified check or bank cashier's check for the specified amount of deposit required;

3. All the terms and conditions of the non-collusive bidding certifications required by §139-d of the State Finance Law and 49 CFR Part 20;

4. For Federal-Aid contracts only, certify, under penalty of perjury, as to the current history regarding suspensions, debarments, voluntary exclusions, determinations of ineligibility, indictments, convictions or civil judgments required by FHWA Form 1273 Required Contract Provisions Federal-Aid Construction Contracts- Section X “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion”;

5. For Federal-Aid contracts only, certify that no Federal appropriated funds have been paid or will be paid, to any person for lobbying a Federal official or employee, or disclosure was made in accordance with 31

USC 1352 required by FHWA Form 1273 Required Contract Provisions Federal-Aid Construction Contracts- Section XI “Certification Regarding Use of Contract Funds for Lobbying”;

6. Attest that its performance of the services outlined in this proposal does not and will not create a conflict of interest with nor position the firm to breach any other contract currently in force with the State of New

York;

7. Certify that it understands the prohibitions under the Federal False Claims Act (31 USC §3729) and the New York State False Claims Act (NYS Finance Law Article 13);

8. Certify that all information provided to the Department with respect to the requirements contained in the Procurement Lobbying Law (State Finance Laws §139j and §139k) is complete, true and accurate;

9. Affirm, under penalty of perjury, that all the responses provided to the Department with respect to its submitted Form CCA-2 New York State Vendor Responsibility Questionnaire For-Profit Construction, are complete, true, and accurate, and further affirms and acknowledges that it must remain a responsible Contractor throughout the duration of the contract, in accordance with §105-05 Vendor Responsibility;

10. Provide commitments to meet the established DBE/MBE/WBE/SDVOB participation goal(s) or to demonstrate sufficient good faith efforts to do so;

11. By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that the bidder has and has implemented a written policy addressing sexual harassment prevention in the workplace and provides annual sexual harassment prevention training to all of its employees. Such policy shall, at a minimum, meet the requirements of Section 201-G of the New York State Labor Law.

12. By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that the bidder has and has implemented a written policy addressing gender-based violence and the workplace and has provided such policy to all of its employees, directors and board members. Such policy shall, at a minimum, meet the requirements of subdivision 11 of section five hundred seventy-five of the executive law.

13. Certify to all other clauses required by this proposal and contained herein.

Dated___________________________, 20______

Legal Name of person, firm or corporation

By ______________________________________

Signature (Title)

D265689 9

(Acknowledgment of individual Contractor)

STATE OF NEW YORK

County of_______________________ ss.:

On this______ day of _______________ 20____, before me personally came _____________________ to me known and known to me to be the person described in and who executed the foregoing instrument, and acknowledged that he/she/they executed the same.

Notary Public

(Acknowledgment of co-partnership Contractor)

STATE OF NEW YORK

County of ____________________________ ss.:

On this _____ day of _______________ 20____, before me personally came ______________________ to me known and known to me to be the person who executed the foregoing instrument, who being by me duly sworn, did for himself/herself/themself depose and say that he/she/they is a member of the partnership of _______________________________ , consisting of himself/herself/themself and

________________________ , and that he/she/they executed the foregoing instrument in the firm name of ___________________________, and that he/she/they had authority to sign same, and did duly acknowledge to me that he/she/they executed the same as the act and deed of said firm for the uses and purposes mentioned therein.

Notary Public

(Acknowledgment of Contractor, if a corporation)

STATE OF NEW YORK

County of _____________________________ ss.:

On this _____ day of _______________ 20____, before me personally came _____________________ to me known and known to me to be the person, who being duly sworn, did depose and say that he/she/they resides in ___________________________ , that he/she/they is the ______________________ , of the

______________________ , the corporation described in and which executed the foregoing instrument;

and that he/she/they signed her/his/their name thereto by order of the Board of Directors of said

Corporation.

Notary Public

(Acknowledgment of Contractor, if a Joint Venture)

A bidder that is a Joint Venture shall include a separate, signed and notarized copy of the acknowledgment page for each party in the joint venture.

Please Complete Information Requested Below:

The address of the bidder is:

Federal Identification No ________________

Contact Person ________________________

Phone No. ( ) _______________________

__________________________ (Street)

City, State and Zip Code E-mail _______________________________

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If a Partnership

Name Address

If a Corporation

Name Address

__________________________, President _________________________________

__________________________, Secretary _________________________________

__________________________, Treasurer _________________________________

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BID BOND

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KNOW ALL PERSONS BY THESE PRESENTS, that ________________________________ (Name of Contractor / Proposer) (Address) (hereinafter called the "Principal") and the __________________________________________ a corporation created and existing under the laws of the State of ________________, having its principal office in the City of ____________ and authorized as a surety in the State of New York (such surety or Co-sureties are hereinafter called the "Surety"), are held and firmly bound unto The People of the State of New York (hereinafter called the "State"), in the full just sum of [ Five Percent ( 5%) of Attached Price Proposal], good and lawful money of the United States of America, for the payment of which said sum of money, well and truly to be made and done, the said Principal binds themselves (himself/herself, itself), their (his/her, its) heirs, executors and administrators, successors and assigns, and the said Surety binds itself, its successors and assigns jointly and severally, firmly by these presents:

WHEREAS, the said Principal has submitted to the Commissioner of Transportation of the State of New York, a proposal for _____________________________________________ (Project Description), and

WHEREAS, under the terms of the Laws of the State of New York as above indicated, the said Principal has filed or intends to file this bond to guarantee that the Principal will execute all required contract proposal documents and furnish such faithful performance or other bonds as may be required by law in accordance with the terms of the Principal's said proposal.

NOW, THEREFORE, the condition of the foregoing obligation is such, that if the said Principal shall promptly execute and submit, and the Commissioner of Transportation shall accept, all required contract proposal documents including such faithful performance bond or other bonds as may be required by law in accordance with the terms of the Principal's said proposal, then this obligation shall be null and void, otherwise to remain in full force and virtue.

In case of multiple or co-sureties, the Co-Sureties agree to empower a single representative with authority to act on behalf of all of the Co-Sureties with respect to this Bond, so that the Department will have no obligation to deal with multiple sureties hereunder. All correspondence from the Department to the Co-Sureties and all claims under this Bond shall be sent to such designated representative, and all correspondence so sent shall be deemed to have been sent to all Co-Sureties. The Co-Sureties also agree to designate a single agent for service of process with respect to any actions on this Bond, which agent shall either be a natural person or a corporation qualified to act as an agent for service of process under the laws of the State of New York. The designated representative and agent for service of process may be changed only by delivery of written notice (by personal delivery or by certified mail, return receipt requested) to the Department designating a single new representative and/or agent, signed by all of the Co-Sureties. The initial representative shall be:

(Name of Representative) (Address) (City, State, Zip) and the initial agent for service of process shall be:

(Name of Initial Agent)

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0710 Page 2 of 3 EI 19-009

(Address)

(City, State, Zip)

IN TESTIMONY WHEREOF, the said Principal has hereunto set his/her (their, its) hand and the said Surety has caused this instrument to be signed by its authorized officer.

Signed and delivered this ____ day of ________________ 20____ in the presence of:

(Company) By ___________________________________________) Principal

(Signature)

(Title of Authorized Officer)

(Company) By __________________________________________) Surety (or Co-Surety)

(Signature)

(Title of Authorized Officer)

(Company) By __________________________________________) Co-Surety

(Signature)

(Title of Authorized Officer)

(Company) By __________________________________________) Co-Surety

(Signature)

(Title of Authorized Officer)

(The Surety Company shall append a single copy of a statement of its financial condition and a copy of the resolution authorizing the execution of Bonds by officers of the Company to the bond(s).)

(Acknowledgment of principal, unless it be a corporation) STATE OF NEW YORK ss.:

14 D265689

0710 Page 3 of 3 EI 19-009

COUNTY OF______________

On this _____ day of _____________ 20 ___, before me personally came ________________________ to me known and known to me to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same.

Notary Public

(Acknowledgment of principal, if a corporation) STATE OF NEW YORK ss.:

COUNTY ______________

On this _____ day of _____________ 20 ___, before me personally came _________________________ to me known and known to me to be the person, who being by me duly sworn, did depose and say that he/she resides in _________________________ that he/she is the ______________________ of ___________________________ the corporation described in and which executed the foregoing instrument; and that he/she signed his/her name thereto by order of the Board of Directors of said Corporation.

Notary Public

(Acknowledgment of contractor, if a limited liability company) STATE OF NEW YORK ss.:

COUNTY OF ______________

On this ____ day of _____________ 20 ____, before me personally came _________________________ to me known, and known to me to be the person who being duly sworn, did depose and say that he/she resides in _________________________; that he/she is the duly authorized member of the limited liability company described in and which executed the foregoing instrument; and that he/she executed the foregoing instrument on behalf of the limited liability company for the purposes set forth therein as the act and deed of said limited liability company.

Notary Public

(Acknowledgment of Surety Company) STATE OF NEW YORK ss.:

COUNTY OF ______________

On this _____ day of _____________ 20 ___, before me personally came ________________________ to me known and known to me to be the person, who being by me duly sworn, did depose and say that he/she resides in _____________________. that he/she is the ___________________ of _________________________________ the corporation described in the foregoing instrument; and that he/she signed his/her name thereto by order of the Board of Directors of said Corporation.

Notary Public

D265689 15

0750 1 of 2 rev. 1/30/15 L05/07/15

OPTIONAL – RETURN WITH BID DOCUMENTS

NYSDOT CONTRACT DOCUMENT BID-ABILITY SURVEY

NYSDOT requests your feedback on the bid-ability of contract documents to assist in prioritizing improvement opportunities. On a scale of 1 to 5 with 5 being the best score, please rate the following based on your review of the contract documents at the bid preparation stage. Please provide written comments in the space provided.

A. CONTRACT INFORMATION

1. Contract Number ______________________________________

2. Letting Date __________________________________________

B. BID-ABILITY

1. The plans were complete, well organized, and easy to understand. 1 2 3 4 5

2. Sufficient detail was provided for bid preparation. 1 2 3 4 5

3. The print quality was adequate for all plan sheets. 1 2 3 4 5

4. The specifications were clear, complete, and consistent with other contract requirements. 1 2 3 4 5

5. All specification items required for the work were included in the contract documents. 1 2 3 4 5

6. Special notes were clear, complete and consistent with other contract requirements. 1 2 3 4 5

7. The estimate of quantities agreed with your independent estimate. 1 2 3 4 5

8. The supplemental information available to bidders was complete and readily available for inspection. 1 2 3 4 5

9. The letting date was appropriate for the type of contract work to be performed. 1 2 3 4 5

10. The contract completion date was reasonable and achievable. 1 2 3 4 5

11. If amendments were issued, they were clearly written and easy to understand. 1 2 3 4 5

C. OVERALL RATING

1. Compared to other NYSDOT contract documents, how would you rate the overall bid-ability of this contract?

□ Above Average □ Average □ Below Average

2. Compared to contract documents from other Agencies/Owners, how would you rate the overall bid-ability of this contract?

□ Above Average □ Average □ Below Average

16 D265689

0750 2 of 2 rev. 1/30/15 L05/07/15

D. GENERAL COMMENTS

Please provide any additional comments regarding the contract documents. Include positive/negative comments and recommendations for improvement.

Comments/Suggestions: ___________________________________________________

E. CONTACT INFORMATION (OPTIONAL)

Name: __________________________________________________________________ Company: _______________________________________________________________ Prime Contractor ___ Subcontractor ___ Supplier ___ Address: ________________________________________________________________ Phone: ________________________ e-mail: ________________________

The completed survey should be returned with your bid. If faced with time constraints, you may also mail the completed survey at a later date to:

New York State Department of Transportation PS&E Section, Design Quality Assurance Bureau 50 Wolf Road, POD 23 Albany, NY 12232

D265689 17

Proposal ID: D265689Project(s): 4LC101

Bid AmountUnit Price Approximate Quantity and

UnitsDescription

Item ID Proposal

Line Number Dollars Cents Dollars Cents

Bid Req.

Code

SY _________._____

0002 201.07000004

CLEARING AND GRUBBING

2,339.000

CY _________._____

0004 203.02

UNCLASSIFIED EXCAVATION

AND DISPOSAL

2,384.000

CY _________._____

0006 203.03

EMBANKMENT IN PLACE

10,957.000

CY _________._____

0008 203.07

SELECT GRANULAR FILL

3,211.000

TON _________._____

0010 203.24010017

SHOULDER BACKUP MATERIAL

82.000

CY _________._____

0012 206.01

STRUCTURE EXCAVATION

18,403.000

CY _________._____

0014 206.0201

TRENCH AND CULVERT

EXCAVATION

467.000

EACH _________._____

0016 206.05

TEST PIT EXCAVATION

4.000

SY _________._____

0018 207.20

GEOTEXTILE BEDDING

672.000

SY _________._____

0020 207.26

PREFABRICATED COMPOSITE

STRUCTURAL DRAIN

1,128.000

SY _________._____

0022 209.1003

SEED AND MULCH -

TEMPORARY

3,133.000

EACH _________._____

0024 209.110101

CHECK DAM (DITCH BOTTOM

WIDTH 0.0 TO 3'), STONE -

TEMPORARY

5.000

LF _________._____

0026 209.1341

Fiber Roll - Temporary, 12"

1,118.000

SY _________._____

0028 209.190301

ROLLED EROSION CONTROL

PRODUCT, CLASS II TYPE

C,INTERMEDIATE

203.000

LF _________._____

0030 209.20120010

BIO-FIBER ROLLS 12 INCH

32.000

SY _________._____

0032 209.2101

SOIL STABILIZERS, CLASS IV

TYPE A

3,133.000

18 D265689

Approximate Quantity and

UnitsDescription

Item ID Proposal

Line Number Dollars Cents Dollars Cents

Bid Req.

Code

CY _________._____

0034 304.12

SUBBASE COURSE, TYPE 2

1,723.000

TON _________._____

0036 404.0189

Truing & Leveling F9, Asphalt, 80 Series Compaction

171.000

TON _________._____

0038 404.0983

9.5 F3 Top Course Asphalt, 80

Series Compaction

690.000

TON _________._____

0040 404.1989

19 F9 Binder Course Asphalt, 80 Series Compaction

578.000

TON _________._____

0042 404.3789

37.5 F9 Base Course Asphalt, 80

Series Compaction

953.000

GAL _________._____

0044 407.0102

DILUTED TACK COAT

981.000

LF _________._____

0046 418.7603

ASPHALT PAVEMENT JOINT

ADHESIVE

3,076.000

SY _________._____

0048 490.30

MISCELLANEOUS COLD

MILLING OF BITUMINOUS

CONCRETE

4,135.000

EACH _________._____

0050 553.030001

TEMPORARY WATERWAY

DIVERSION STRUCTURE

1.000

EACH _________._____

0052 553.030002

TEMPORARY WATERWAY

DIVERSION STRUCTURE

1.000

EACH _________._____

0054 553.030003

TEMPORARY WATERWAY

DIVERSION STRUCTURE

1.000

EACH _________._____

0056 553.030004

TEMPORARY WATERWAY

DIVERSION STRUCTURE

1.000

EACH _________._____

0058 553.030005

TEMPORARY WATERWAY

DIVERSION STRUCTURE

1.000

EACH _________._____

0060 553.030006

TEMPORARY WATERWAY

DIVERSION STRUCTURE

1.000

CY _________._____

0062 555.0011

Footing Concrete, Performance

650.000

D265689 19

Approximate Quantity and

UnitsDescription

Item ID Proposal

Line Number Dollars Cents Dollars Cents

Bid Req.

Code

CY _________._____

0064 555.0021

Concrete for Structures, Performance

276.000

CY _________._____

0066 555.05010001

PERFORMANCE ENGINEERED

MIXTURE (PEM) CONCRETE

FOR SPECIAL APPLICATIONS

23.000

QU 6.000

0068 555.9901

Performance Concrete Quality Adjustment - Footing Concrete

1.000

6.00Fixed

QU 17.500

0070 555.9902

Performance Concrete Quality Adjustment - Concrete for Structures

1.000

17.50Fixed

LB _________._____

0072 556.0201

UNCOATED BAR

REINFORCEMENT FOR

CONCRETE STRUCTURES

56,348.000

LB _________._____

0074 556.0202

EPOXY-COATED BAR

REINFORCEMENT FOR

STRUCTURES

11,048.000

SY _________._____

0076 562.0101

REINFORCED CONCRETE SPAN

UNITS

179.000

QU 27.500

0078 562.99

Performance Concrete Quality Adjustment

1.000

27.50Fixed

LF _________._____

0080 568.51

STEEL BRIDGE RAILING (FOUR

RAIL)

105.000

LF _________._____

0082 568.70

TRANSITION BRIDGE RAILING

320.000

SF _________._____

0084 595.50000018

SHEET-APPLIED

WATERPROOFING MEMBRANE

12,092.000

EACH _________._____

0086 603.171216

GALVANIZED STEEL END

SECTIONS-PIPE (2-2/3" X

1/2"CORRUGATIONS) 18 INCH

DIAMETER, 16 GAUGE

2.000

EACH _________._____

0088 603.171614

GALVANIZED STEEL END

SECTIONS-PIPE (2-2/3" X

1/2"CORRUGATIONS) 30 INCH

DIAMETER, 14 GAUGE

2.000

20 D265689

Approximate Quantity and

UnitsDescription

Item ID Proposal

Line Number Dollars Cents Dollars Cents

Bid Req.

Code

LF _________._____

0090 603.63080415

PRECAST CONCRETE BOX

CULVERT, 8 FOOT SPAN, 4 FOOT

RISE

82.000

LF _________._____

0092 603.64090515

PRECAST CONCRETE BOX

CULVERT (FILL HEIGHT 24 IN OR

GREATER) 9 FOOT SPAN, 5

FOOT RISE

93.000

LF _________._____

0094 603.64160815

PRECAST CONCRETE BOX

CULVERT (FILL HEIGHT 24 IN OR

GREATER) 16 FOOT SPAN, 8

FOOT RISE

100.000

SY _________._____

0096 603.67000001

PRECAST CONCRETE

WINGWALL UNITS FOR BOX

CULVERTS

55.000

LF _________._____

0098 603.9815

SMOOTH INTERIOR

CORRUGATED POLYETHYLENE

CULVERT AND STORMDRAIN 15

INCH DIAMETER

104.000

LF _________._____

0100 603.9824

SMOOTH INTERIOR

CORRUGATED POLYETHYLENE

CULVERT AND STORMDRAIN 24

INCH DIAMETER

81.000

LF _________._____

0102 604.300691

RECTANGULAR DRAINAGE

STRUCTURE TYPE F FOR

PARALLEL BAR #11PCB FRAME

4.000

LF _________._____

0104 606.10

BOX BEAM GUIDE RAILING

1,464.000

LF _________._____

0106 606.100002

BOX BEAM GUIDE RAILING

(SHOP BENT OR SHOP

MITERED)

264.000

EACH _________._____

0108 606.120101

BOX BEAM END PIECE

3.000

EACH _________._____

0110 606.120102

BOX BEAM GUIDE RAILING END

ASSEMBLY, TYPE I

4.000

EACH _________._____

0112 606.120201

BOX BEAM GUIDE RAILING END

ASSEMBLY, TYPE IIA

10.000

D265689 21

Approximate Quantity and

UnitsDescription

Item ID Proposal

Line Number Dollars Cents Dollars Cents

Bid Req.

Code

EACH _________._____

0114 606.1203

BOX BEAM END ASSEMBLY,

TYPE III

1.000

LF _________._____

0116 606.71

REMOVING AND DISPOSING

CORRUGATED BEAM GUIDE

RAILING

651.000

LF _________._____

0118 606.73

REMOVING AND DISPOSING

BOX BEAM GUIDE RAILING

1,038.000

EACH _________._____

0120 606.7910

REMOVING AND DISPOSING

ANCHORAGE UNITS FOR

CORRUGATED BEAMGUIDE

RAILING AND MEDIAN BARRIER

12.000

EACH _________._____

0122 606.7920

REMOVING AND DISPOSING

BOX BEAM GUIDE RAILING

TURNED DOWN TERMINAL

7.000

LF _________._____

0124 607.41010010

TEMPORARY PLASTIC BARRIER

FENCE

73.000

LF _________._____

0126 607.96000008

REMOVE AND DISPOSE OF

EXISTING FENCE

90.000

TON _________._____

0128 608.020102

ASPHALT SIDEWALKS,

DRIVEWAYS AND BICYCLE

PATHS,AND VEGETATION

CONTROL STRIPS

124.000

SY _________._____

0130 610.1605

Turf Establishment Performance

3,509.000

MGAL _________._____

0132 610.19

WATERING VEGETATION

2.000

EACH _________._____

0134 611.0151

PLANTING - MAJOR DECIDUOUS

TREES - 2 INCH CALIPER BALL&

BURLAP, FIELD POTTED OR

FIELD BOXED

3.000

EACH _________._____

0136 611.0211

PLANTING - MINOR DECIDUOUS

TREES - SIZE AS SPECIFIED

BALL& BURLAP, FIELD POTTED

OR FIELD BOXED

4.000

22 D265689

Approximate Quantity and

UnitsDescription

Item ID Proposal

Line Number Dollars Cents Dollars Cents

Bid Req.

Code

EACH _________._____

0138 611.0391

PLANTING - CONIFEROUS

TREES - 9 FOOT HEIGHT BALL &

BURLAP, FIELD POTTED OR

FIELD BOXED

2.000

EACH _________._____

0140 611.19010024

POST PLANTING CARE WITH

REPLACEMENT - MAJOR

DECIDUOUS TREES

3.000

EACH _________._____

0142 611.19020024

POST PLANTING CARE WITH

REPLACEMENT - MINOR

DECIDUOUS TREES

4.000

EACH _________._____

0144 611.19030024

POST PLANTING CARE WITH

REPLACEMENT - CONIFEROUS

TREES

2.000

CY _________._____

0146 613.04000001

STOCKPILING AND PLACING

EXISTING STREAM BED

MATERIALS

647.000

EACH _________._____

0148 614.060104

TREE REMOVAL OVER 4 INCHES

TO 6 INCHES DIAMETER

BREAST HEIGHT - STUMPS

GRUBBED

8.000

EACH _________._____

0150 614.060204

TREE REMOVAL OVER 6 INCHES

TO 12 INCHES DIAMETER

BREAST HEIGHT - STUMPS

GRUBBED

23.000

EACH _________._____

0152 614.060304

TREE REMOVAL OVER 12

INCHES TO 18 INCHES

DIAMETER BREASTHEIGHT -

STUMPS GRUBBED

11.000

EACH _________._____

0154 614.060404

TREE REMOVAL…