DTFH6815B00028.pdf

INVITATION FOR BID

SOLICITATION NUMBER: DTFH6815B00028

PROJECT NUMBER: UT FLAP 30053(1)

PROJECT NAME: NAVAJO LAKE ROAD

BID OPENING DATE:

See Page A-1, Item 13A

This solicitation cites Standard Specifications for Construction of Roads and Bridges on

Federal Highway Projects, FP-14 US Customary Units

ISSUING OFFICE:

U.S. DEPARTMENT OF TRANSPORTATION

FEDERAL HIGHWAY ADMINISTRATION

CENTRAL FEDERAL LANDS HIGHWAY DIVISION

12300 W. DAKOTA AVENUE, SUITE 360

LAKEWOOD, CO 80228

Web site: http://www.fbo.gov E-mail: CFLContracts@dot.gov mailto:CFLContracts@dot.gov

PROJECT UT FLAP 30053(1)

NAVAJO LAKE ROAD

LOCATION DIXIE NATIONAL FOREST

COUNTY KANE

STATE UTAH

LENGTH 5.70 Miles

TYPE OF CONSTRUCTION ROAD RECONSTRUCTION AND

REHABILITATION, GRADING,

DRAINAGE AND PULLOUT FACILITIES

TABLE OF CONTENTS

Notice to Bidders ............................................................................................................. A-i

Solicitation, Offer, and Award ........................................................................................ A-1

Bid Schedule Instructions and Basis for Award ............................................................. A-4

Bid Schedule ................................................................................................................... A-5

Buy American and Hazardous Materials ...................................................................... A-16

Solicitation Provisions .....................................................................................................B-7

Contract Clauses ..............................................................................................................C-1

Davis Bacon Wage Determination .................................................................................. D-1

Division 100 ..................................................................................................................... E-1 Division 150 ................................................................................................................... E-19 Division 200 ................................................................................................................... E-27 Division 300 ................................................................................................................... E-31 Division 400 ................................................................................................................... E-31 Division 500 ................................................................................................................... E-34 Division 600 ................................................................................................................... E-35 Division 700 ................................................................................................................... E-39

APPENDICES

Appendix A .................................................................. Small Business Subcontracting Plan

Appendix B ................................................................................................. 404/401 Permits

Appendix C .......................................................................................... Encroachment Letter

SPECIAL CONTRACT REQUIREMENTS (SCRs)

The following Special Contract Requirements amend and supplement the Standard Specification for Construction of Roads and Bridges on Federal Highway Projects

NOTICE TO BIDDERS

A-i

ELECTRONIC BIDS WILL NOT BE ACCEPTED. Submit a printed copy of your bid to the address listed on the SF-1442 (Page A-1, Item 8). Please submit the following with your bid:

Submit the following documents with your Bid Package–

• SF-1442, Solicitation, Offer & Award, Pages A-1 and A-2

• Bid Schedule including Buy American Act & Hazardous Materials, Pages A-5 through A-17

• Bid Guarantee (see FAR Clause 52.228-1), Pages B-1 and B-2. Bid bonds must be originals with original signatures and corporate seals. Photocopies and Faxed copies are NOT acceptable and will make your bid non-responsive.

• Completed VETS 100, Page A-ii; Bidders’ Information, Pages B-3 through B-6; Annual Representations and Certifications (52.204-8), Page B-7 thru B-12 and Certification Regarding Responsibility Matters (FAR 52.209-5), Pages B-12 thru B-15.

• HUBZone small business concerns electing to waive the evaluation preference, complete 52.219-4 Notice of Price Evaluation Preference for HUBZone Small Business Concerns, Section C.

Bidders should retain all other pages for their information. Bids should be submitted in a sealed enveloped and include the Contractor’s Name, Solicitation Number and the Project Number/Name.

I. PRE-BID INFORMATION

It is the responsibility of the bidder to verify that this solicitation document, including the plans, are complete as listed in the table of contents and the index to sheets. Plan sheets can be found at http://www.fbo.gov and viewed by individual sections, downloaded by individual sections, or the entire plan set downloaded in a zip file. Physical data relevant to this solicitation may also be viewed or downloaded at the above site.

This solicitation and subsequent contract are governed by the Federal Acquisition Regulations (FAR), agency supplemental regulations, and the Standard Specifications for Construction of Roads and Bridges on Federal Highway Projects, FP-14.

The FP-14 was utilized for the design of this project. Hard copies of the FP-14 will not be provided to bidders. The FP-14 is available electronically at http://flh.fhwa.dot.gov/resources/specs/ or may be purchased by contacting Bob Rosenblatt at ARC Western, telephone number 303-785-2520 or email bob.rosenblatt@e-arc.com. Limited numbers of hard copies of the FP-14 will be provided to the awarded Prime Contractor.

Applicable FAR provisions and clauses in this IFB are incorporated by reference or full text. FAR provisions and clauses incorporated by reference can be accessed on the Internet at https://www.acquisition.gov/far/.

Notice of SAM Registration – you must register in the System for Award Management (SAM – replaced CCR) prior to award of a contract resulting from this solicitation. Failure to register prior http://www.fbo.gov/ http://flh.fhwa.dot.gov/resources/specs/ mailto:bob.rosenblatt@e-arc.com https://www.acquisition.gov/far/

A-ii to contract award may require award to the next successful registered offeror. See FAR Subpart 4.1103©. Register online at www.sam.gov.

Representations and Certifications – This solicitation is issued under NAICS 237310 – Highway, Street & Bridge Construction with a small business size standard of $36.5 million. If your average annual gross receipts for the past 3 years are above $36.5 million, you are a large business for this solicitation. If they are below $36.5 million you are a small business. Please complete the certification listed in paragraph (b) of FAR Provision 52.204-8 Annual Representation and Certifications on Page B-7. Your small business information is pulled into the Online Representations and Certifications Application (ORCA) website from the System for Award Management (SAM). Please include NAICS 237310 in your SAM. Before submitting bids, please ensure you have completed your annual representations and certifications electronically at the SAM website at www.sam.gov.

Vets100 Reporting: - The Contractor must complete the report if required. See reporting requirements at: www.dol.gov/vets/programs/fcp/main.htm.

• My firm had a qualifying Federal Contract in 2015 and has complied with the reporting requirements.

• My firm did not have a qualifying Federal Contract in 2015 and is therefore exempt from the reporting requirements

This Solicitation Contains a Price Evaluation Factor - The Government will apply a factor of 10% to an apparent low bid submitted by a large business when we also receive a bid from a certified HUBZone small business concern. The 10% factor does not apply to apparent low bids submitted by small businesses. See FAR Clause 52.219-4 Notice of price evaluation preference for HUBZone small business concerns.

In the event this full and open competition results in a contract award to a qualified HUBZone SBC after a price evaluation preference, FAR Clause 52.236-1, Performance of Work by the Contractor does not apply.

§126.700 of the Code of Federal Regulations (Title 13, Part 126, Subpart G), stated below, will replace the performance of work requirements stated in the above mentioned FAR clause.

A qualified HUBZone SBC receiving a contract under this solicitation for general construction must spend at least 50% of the cost of the contract incurred for personnel on its own employees or employees of other qualified HUBZone SBCs. This requirement may be met by expending at least 50% of the cost of the contract incurred for personnel on its employees or it may subcontract at least 35% of the cost of the contract performance incurred for personnel to one or more qualified HUBZone SBCs. A qualified HUBZone SBC prime contractor may not, however, subcontract more than 50% of the cost of the contract incurred for personnel to non-qualified HUBZone SBCs.

http://www.sam.gov/ http://www.sam.gov/ http://www.dol.gov/vets/programs/fcp/main.htm

A-iii

Bid Guarantee – Follow the requirements of FAR Clause 52.228-1 Bid Guarantee and Subpart

102.03 of the FP-03. Bid bonds must be originals and have original signatures and corporate seals.

Photocopied and faxed copies of bonds will be rejected and cause your bid to be non-responsive.

ATTENTION: Minority, Women-owned, and Disadvantaged Business Enterprises (DBEs). The Department of Transportation (DOT), offers working capital financing and bonding assistance for transportation related contracts. DOT's Bonding Assistance Program (BAP) offers bid, performance and payment bonds on contracts up to $1,000,000. DOT's Short-Term Lending Program (STLP) offers lines of credit to finance accounts receivable. Maximum line of credit is $500,000 with interest at the prime rate. For further information, call (800) 532-1169. Internet address:

http://osdbuweb.dot.gov.

The Contractor is fully responsible to verify that all data is correct when an offer is submitted.

Failure to properly update your data may cause the offer to be rejected.

Request for Technical Information – Questions relative to the plans and SCRs for this solicitation will only be accepted in writing (see Item 9 on Page A-3).

TECHNICAL QUESTIONS REGARDING THIS SOLICITATION WILL NOT BE

ACCEPTED AFTER 4 P.M. ON MARCH 1, 2016

Questions for this solicitation can be submitted to CFLContracts@dot.gov. Questions and answers will be posted at http://www.fbo.gov

Modifications to Bids - Bids may be modified or withdrawn by regular mail, electronic commerce (email) or facsimile, if such notice is received prior to the time specified for receipt of bids. The Government will not be responsible for ANY failure attributable to the transmission or receipt of electronic commerce (email) or facsimile data.

For all modifications, we STRONGLY ENCOURAGE you to resubmit the entire bid schedule with a unit price and amount for every bid item, and a Schedule Total. See FAR Provision 52.214-5, Submission of Bids. Modifications which make the bid ambiguous, indefinite, or uncertain as to any essential requirement of the contract will cause the bid to be rejected as nonresponsive.

FAX Number to submit modifications to bids for this project is (720) 963-336

Email Address to submit modifications to bids for this project is cflcontracts@dot.gov

II. Post Award Information.

Subcontracting - FAR Clause 52.219-8, Utilization of Small Business Concerns states that Prime Contractors afford small business concerns, veteran-owned small business concerns, service-disabled veteran-owned small business concerns, HUBZone small business concerns, small disadvantaged business concerns, and women-owned small business concerns the maximum practicable opportunity to participate in performing contracts let by any Federal agency.

http://osdbuweb.dot.gov/ http://www.fbo.gov/

A-iv

FAR Clause 52.219-9, Small Business Subcontracting Plan, Alternate I, requires that the large business concern who is the successful low bidder on a Federal project with an anticipated award amount exceeding $1 million, is required to submit a subcontracting plan prior to contract award. The subcontracting plan expresses goals in terms of percentages of total planned subcontracting dollars for the use of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns as subcontractors. A sample plan for subcontracting requirements is available in Appendix A.

Prime Contractors, who are large businesses, are encouraged to post sources sought notices at the Small Business Administration’s Subcontracting Network (SUB-NET) http://web.sba.gov/subnet/ so that small businesses can identify opportunities in their areas of expertise. The use of SUB-Net fulfills the requirements set forth in Federal Acquisition Regulation (FAR) 5.206, Notice of Subcontracting Opportunities, for contractors and subcontractors to post notices and thereby increase competition for subcontracts. If the apparent successful low bidder fails to submit an acceptable subcontracting plan with their bid package, that bidder may be ineligible for award of the contract.

A list of currently known business concerns owned and controlled by socially and economically disadvantaged individuals and/or women-owned small business concerns that have indicated an interest in participating in highway construction is available at http://www.sam.gov

Insurance requirements - See Subsection 107.05 of the FP-14.

http://web.sba.gov/subnet/

A-1

SOLICITATION, OFFER

AND AWARD

(Construction, Alteration or Repair)

1. SOLICITATION NO.

DTFH6815B00028

2. TYPE OF SOLICITATION

SEALED BID (IFB)

NEGOTIATED (RFP)

3. DATE ISSUED

2/10/16 IMPORTANT - THE "OFFER SECTION ON THE REVERSE MUST BE FULLY COMPLETED BY OFFEROR.

4. CONTRACT NO. 5. REQUISITION/PURCHASE REQUEST NO.

CFL15HFPM364

6. PROJECT NO.

UT FLAP 30053(1)

NAVAJO LAKE ROAD

7. ISSUED BY:

FEDERAL HIGHWAY ADMINISTRATION

CENTRAL FEDERAL LANDS DIVISION

12300 WEST DAKOTA AVENUE

LAKEWOOD, COLORADO 80228

CODE: 69050001 8. ADDRESS OFFER TO:

JOE WILSON, CONTRACT SPECIALIST

FEDERAL HIGHWAY ADMINISTRATION

CENTRAL FEDERAL LANDS DIVISION

12300 WEST DAKOTA AVENUE

LAKEWOOD, COLORADO 80228

9. FOR INFORMATION CALL

SEE PAGE A-3

A. NAME:

SEE PAGE A-3

B. TELEPHONE NO. (Include area code)

SEE PAGE A-3

SOLICITATION

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder."

10. THE GOVERNMENT REQUIRES PERFORMANCE OF THE WORK DESCRIBED IN THESE DOCUMENTS:

ROADWAY CONSTRUCTION PROJECT IN STRICT ACCORDANCE WITH:

1. FEDERAL ACQUISITION AND TRANSPORATION ACQUISITION REGULATIONS (FAR & TAR)

2. DEPARTMENT OF LABOR, DAVIS BACON MINIMUM WAGE RATES

3. SPECIAL CONTRACT REQUIREMENTS

4. PLANS

5. BID SCHEDULE

6. STANDARD SPECIFICATIONS FOR CONSTRUCTION OF ROADS AND BRIDGES ON FEDERAL HIGHWAY

PROJECTS

7. SUBCONTRACTING PLAN (IF APPLICABLE)

See Subsection 104.04 of the FP-14 for governing order of precedence

11. The Contractor shall begin performance within 10 calendar days and complete it within * calendar days after receiving award notice to proceed. The performance period is mandatory negotiable. *Refer to Subsection 108.01 as amended in the Special Contract Requirements.

12A. THE CONTRACTOR MUST FURNISH ANY REQUIRED PERFORMANCE AND PAYMENT BONDS?

(If "YES," indicate within how many calendar days after award in Item 12B.) YES NO

12B. CALENDAR DAYS

13. ADDITIONAL SOLICITATION REQUIREMENTS:

A. Sealed offers in original and 0 copies to perform the work required are due at the place specified in Item 8. by 2:00 p.m. (hour) local time on 3/10/16 . If this is a sealed bid solicitation, offers will be publicly opened at that time. Sealed envelopes containing offers shall be marked to show the offeror's name and address, the solicitation number, and the date and time offers are due.

B. An offer guarantee is is not required.

C. All offers are subject to the (1) work requirements and (2) other provisions and clauses incorporated in the solicitation in full text or by reference.

D. Offers providing less than 60 calendar days for Government acceptance after the date offers are due will not be considered and will be rejected.

NSN 7540-01-155-3212 1442-102 STANDARD FORM 1442 (REV. 4-85)

Prescribed by GSA

FAR (48 CFR) 53-236-1(e)

X

A-2

GPO: 1985 0 - 469-796 STANDARD FORM 1442 PAGE 2 (REV. 4-85)

OFFEROR (Must be fully completed by offeror)

14. NAME AND ADDRESS OF OFFEROR (Include ZIP Code) 15. TELEPHONE NO. (Include area code)

16. REMITTANCE ADDRESS (Include only if different than Item 14)

DUNS NO.

17. The offeror agrees to perform the work required at the prices specified below in strict accordance with the terms of this solicitation, if this offer is accepted by the Government in writing with calendar days after the date offers are due. (Insert any number equal to or greater than the minimum requirement stated in Item 13D. Failure to insert any number means the offeror accepts the minimum in Item 13D.)

AMOUNTS SEE INDIVIDUAL BID SCHEDULE(S)

18. The offeror agrees to furnish any required performance and payment bonds.

19. ACKNOWLEDGMENT OF AMENDMENTS

(The offeror acknowledges receipt of amendments to the solicitation - give number and date of each)

AMENDMENT NO.

DATE

20A. NAME AND TITLE OF PERSON AUTHORIZED

TO SIGN OFFER (Type or print)

20B. SIGNATURE 20C. OFFER DATE

AWARD (To be completed by Government)

21. ITEMS ACCEPTED:

22. AMOUNT 23. ACCOUNTING AND APPROPRIATION DATA

24. SUBMIT INVOICES TO ADDRESS SHOWN IN ITEM 27

(4 copies unless otherwise specified)

25. OTHER THAN FULL AND OPEN COMPETITION PURSUANT TO

□ 15 U.S.C. 637( ) □ 41 U.S.C. 253(c)( )

26. ADMINISTERED BY CODE: 27. PAYMENT WILL BE MADE BY

FEDERAL HIGHWAY ADMINISTRATION

CENTRAL FEDERAL LANDS HIGHWAY DIVISION

12300 W. DAKOTA AVENUE, SUITE 167

LAKEWOOD, COLORADO 80228

CONTRACTING OFFICER WILL COMPLETE ITEM 28 OR 29 AS APPLICABLE

28. NEGOTIATED AGREEMENT (Contractor is required to sign this document and return copies to issuing office.)

Contractor agrees to furnish and deliver all items or perform all work requirements identified on this form and any continuation sheets for the consideration stated in this contract. The rights and obligations of the parties to this contract shall be governed by

(a) this contract award, (b) the solicitation, and (c) the clauses, representations, certifications, and specifications incorporated by reference in or attached to this contract.

29. AWARD (Contractor is not required to sign this document.) Your offer on this solicitation is hereby accepted as to the items listed. This award consummates the contract, which consists of (a) the Government solicitation and your offer, and (b) this contract award.

No further contractual document is necessary.

30A. NAME AND TITLE OF CONTRACTOR OR PERSON

AUTHORIZED TO SIGN (Type or print)

31A. NAME OF CONTRACTING OFFICER (Type or print)

30B. SIGNATURE 30C. DATE 31B. UNITED STATES OF AMERICA

BY

31C. AWARD

DATE

A-3

Item 8: LOCATION OF PUBLIC BID OPENING: Offers must be received by designated date and time as stated in Item 13A.

Item 9: FOR GENERAL INFORMATION: e-mail us at CFLContracts@dot.gov.

FOR TECHNICAL INFORMATION (plans and specifications): Questions must be submitted in writing by e-mail at CFLContracts@dot.gov or by fax to 720-963-3360.

FOR PHYSICAL DATA: The following data is available electronically with this solicitation at:

• Pavement Design Report (August 28, 2015)

• Geotechnical Design Report (August 27, 2015)

• Final Hydraulics Report (September 2015)

Item 11: COMPLETION DATE: Work shall be completed on or before the date specified in Subsection 108.01 of the SCRs.

Item 12A: PERFORMANCE AND PAYMENT BONDS: See FAR Clause 52.228-15 Performance and Payment Bonds-Construction (Clauses begin on Page C-1) and Subsection 102.06 of the FP-14.

Item 13B: BID BOND AMOUNT: See FAR Provision 52.228-1 Bid Guarantee (Provisions begin on Page B-1) and Subsection 102.03 Bid Guarantee of the FP-14. All bid guarantees must have original signatures with original corporate seals.

Item 19: ACKNOWLEDGMENT OF AMENDMENTS: FAILURE TO

ACKNOWLEDGE AMENDMENTS, IN ITEM 19 OF THE SF-1442, BY THE

DESIGNATED DATE AND HOUR SPECIFIED IN THE SOLICITATION

MAY RESULT IN REJECTION OF YOUR BID. If amendments are issued, they will be posted to www.fbo.gov.

Item 24: SUBMITTING INVOICES: See Subsection 109.08 Progress Payments of the

FP-14.

ESTIMATED

PRICE: The price range of the project work is between $5 and $7 million.

mailto:CFLContracts@dot.gov http://www.fbo.gov/

A-4

Bid Schedule Instructions

BIDDERS, PLEASE NOTE: This Bid Proposal is comprised of two schedules. Before preparing the bid, carefully read the Solicitation Provisions and the following:

• Insert a numeric unit bid price for each pay item for which a quantity appears in the bid schedule. Unit bid prices should be quoted no more precisely than the nearest cent (2 decimal places). Unit bid prices quoted more precisely will be rounded up to the nearest cent by the Government

• Multiply the unit price by the quantity for each pay item and show the amount bid.

When the words “Lump Sum” appear as a unit bid price, insert an amount for each lump sum pay item.

• Total all amounts bid for each pay item and show the Construction Cost Total on the space provided on the last page of each schedule or option.

• Also show the Construction Cost Total for each schedule/option as well as the combined Total of each Schedule and the Option in the spaces provided on the Bid Summary page.

NOTE: If the amount bid for a pay item is inconsistent with the product of the unit price provided by the bidder and the quantity provided by the Government, the unit price will govern and the Government will determine a corrected amount bid for the pay item by multiplying the unit price by the quantity.

Basis for Award

To be eligible for award of contract, the offeror shall submit prices for each item in Bid Schedule A, Option X, and Option Y. Accordingly, contract award will be made to the lowest responsible bidder conforming to the solicitation, provided funds are available.

Per FAR provision 52.217-5, Evaluation of Options (JULY 1990), the Government will evaluate offers for award purposes by adding the total price for all options to the total price for Schedule A.

Evaluation of options will not obligate the Government to exercise the option(s). If the determination is made to exercise any of the Options, the Contracting Officer will provide the contractor with written notice no later than 90 days after contract award, per FAR clause 52.217-7, Option for Increased Quantity- Separately Priced Line Item (MAR 1989).

A-5

B I D S C H E D U L E Schedule A Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

15101-0000 Line A0020 ALL LPSM

15201-0000 Line A0040 ALL LPSM

15215-1000 Line A0060 16 EACH $ $

15215-3000 Line A0080 39 EACH $ $

15225-0000 Line A0100 4.300 MILE $ $

15236-2000 Line A0120 4.300 MILE $ $

15301-0000 Line A0140 ALL LPSM

15401-0000 Line A0160 ALL LPSM

15501-0000 Line A0180 ALL LPSM

15705-1400 Line A0200 9,500 LNFT $ $

15706-0200 Line A0220 145 EACH $ $

15706-1600 Line A0240 1 EACH $ $

15802-0000 Line A0260 ALL LPSM

20101-0000 Line A0280 17.0 ACRE $ $

20220-1000 Line A0300 24 EACH $ $

20301-1900 Line A0320 29 EACH $ $

20301-2400 Line A0340 16 EACH $ $

20401-0000 Line A0360 37,000 CUYD $ $

20441-0000 Line A0380 22,000 CUYD $ $

Schedule Total: ________________________

Submitted by: _________________________

REMOVAL OF PIPE CULVERT

REMOVAL OF SIGN

ROADWAY EXCAVATION

MOBILIZATION

CONSTRUCTION SURVEY AND STAKING

SURVEY AND STAKING, APPROACH ROAD

SURVEY AND STAKING, DRAINAGE STRUCTURE

SLOPE, REFERENCE, AND CLEARING AND GRUBBING CONTROL

SURVEY CONTROL, GRADE FINISHING

WASTE

WATERING FOR DUST CONTROL

CLEARING AND GRUBBING

REMOVAL, INDIVIDUAL TREE

CONTRACTOR QUALITY CONTROL

CONTRACTOR TESTING

CONSTRUCTION SCHEDULE

SOIL EROSION CONTROL, FIBER ROLL

SOIL EROSION CONTROL, CHECK DAM

SOIL EROSION CONTROL, STABILIZED CONSTRUCTION EXIT

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Schedule A Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

Schedule Total: ________________________

Submitted by: _________________________

25101-0200 Line A0400 420 CUYD $ $

25101-0300 Line A0420 300 CUYD $ $

25210-0000 Line A0440 22,000 SQFT $ $

30101-0000 Line A0460 29,000 TON $ $

40101-1000 Line A0480 13,000 TON $ $

40601-0000 Line A0500 35 TON $ $

41101-1000 Line A0520 90 TON $ $

41201-0000 Line A0540 35 TON $ $

55706-2000 Line A0560 ALL LPSM

60103-0640 Line A0580 4 EACH $ $

60103-0660 Line A0600 2 EACH $ $

60103-1240 Line A0620 2 EACH $ $

60201-0600 Line A0640 75 LNFT $ $

60201-0800 Line A0660 1,520 LNFT $ $

60201-0900 Line A0680 360 LNFT $ $

60201-1000 Line A0700 190 LNFT $ $

60210-0600 Line A0720 2 EACH $ $

60210-0800 Line A0740 60 EACH $ $

60210-1000 Line A0760 2 EACH $ $

END SECTION FOR 24-INCH PIPE CULVERT

END SECTION FOR 36-INCH PIPE CULVERT

30-INCH PIPE CULVERT

36-INCH PIPE CULVERT

END SECTION FOR 18-INCH PIPE CULVERT

STRUCTURAL TIMBER AND LUMBER, TREATED

CONCRETE, HEADWALL FOR DOUBLE 30-INCH PIPE CULVERT

CONCRETE, HEADWALL FOR DOUBLE 36-INCH PIPE CULVERT

ROCKERY

AGGREGATE BASE

ASPHALT CONCRETE PAVEMENT, GYRATORY MIX, 3/4-INCH NOMINAL MAXIMUM SIZE AGGREGATE, 0.3 TO <3 MILLION ESAL

CONCRETE, HEADWALL FOR TRIPLE 30-INCH PIPE CULVERT

18-INCH PIPE CULVERT

24-INCH PIPE CULVERT

PLACED RIPRAP, METHOD A, CLASS 2

PLACED RIPRAP, METHOD A, CLASS 3

FOG SEAL

PRIME COAT, METHOD 1

TACK COAT

A-7

Schedule A Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

Schedule Total: ________________________

Submitted by: _________________________

60501-0000 Line A0780 1,400 LNFT $ $

61102-1700 Line A0800 1,000 LNFT $ $

62201-0200 Line A0820 32 HOUR $ $

62201-0950 Line A0840 32 HOUR $ $

62201-2850 Line A0860 32 HOUR $ $

62201-3350 Line A0880 32 HOUR $ $

62301-0000 Line A0900 96 HOUR $ $

62302-1000 Line A0920 96 HOUR $ $

62302-1100 Line A0940 96 HOUR $ $

62406-0300 Line A0960 18.0 ACRE $ $

62510-2000 Line A0980 18.0 ACRE $ $

62515-2000 Line A1000 18.0 ACRE $ $

63301-0000 Line A1020 28 EACH $ $

63313-0000 Line A1040 12,500 LNFT $ $

63316-1000 Line A1060 7 EACH $ $

63401-0300 Line A1080 90,200 LNFT $ $

63502-1250 Line A1100 180 EACH $ $

63504-1000 Line A1120 250 SQFT $ $

63506-0500 Line A1140 2,200 HOUR $ $

TEMPORARY TRAFFIC CONTROL, TUBULAR MARKER, TYPE 42-INCH

TEMPORARY TRAFFIC CONTROL, CONSTRUCTION SIGN

TEMPORARY TRAFFIC CONTROL, FLAGGER

SEEDING, HYDRAULIC METHOD

MULCHING, HYDRAULIC METHOD

SIGN SYSTEM

RUMBLE STRIP

REMOVE AND RESET SIGN

PAVEMENT MARKINGS, TYPE B, SOLID

MOTOR GRADER, 12 FOOT MINIMUM BLADE

HYDRAULIC EXCAVATOR, 1 CUBIC YARD MINIMUM CAPACITY

GENERAL LABOR

SPECIAL LABOR, HIRED TECHNICAL SERVICES

SPECIAL LABOR, HIRED SURVEY SERVICES

PLACING CONSERVED TOPSOIL, 4-INCH DEPTH

STANDARD UNDERDRAIN SYSTEM

2-INCH WATERLINE, POLYVINYL CHLORIDE (PVC)

DUMP TRUCK, 8 CUBIC YARD MINIMUM CAPACITY

WHEEL LOADER, 3 CUBIC YARD MINIMUM RATED CAPACITY

A-8

Schedule A Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

Schedule Total: ________________________

Submitted by: _________________________

63506-0600 Line A1160 480 HOUR $ $

TEMPORARY TRAFFIC CONTROL, PILOT CAR

A-9

Option X Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

15101-0000 Line X0020 ALL LPSM

15201-0000 Line X0040 ALL LPSM

15215-3000 Line X0060 4 EACH $ $

15225-0000 Line X0080 0.700 MILE $ $

15236-2000 Line X0100 0.700 MILE $ $

15301-0000 Line X0120 ALL LPSM

15401-0000 Line X0140 ALL LPSM

15501-0000 Line X0160 ALL LPSM

15705-1400 Line X0180 420 LNFT $ $

15706-0200 Line X0200 25 EACH $ $

15802-0000 Line X0220 ALL LPSM

20101-0000 Line X0240 2.9 ACRE $ $

20220-1000 Line X0260 3 EACH $ $

20301-1900 Line X0280 4 EACH $ $

20401-0000 Line X0300 8,000 CUYD $ $

20441-0000 Line X0320 6,500 CUYD $ $

25101-0200 Line X0340 190 CUYD $ $

30101-0000 Line X0360 4,600 TON $ $

40101-1000 Line X0380 2,050 TON $ $

Schedule Total: ________________________

Submitted by: _________________________

WASTE

PLACED RIPRAP, METHOD A, CLASS 2

AGGREGATE BASE

MOBILIZATION

CONSTRUCTION SURVEY AND STAKING

SURVEY AND STAKING, DRAINAGE STRUCTURE

SLOPE, REFERENCE, AND CLEARING AND GRUBBING CONTROL

SURVEY CONTROL, GRADE FINISHING

CONTRACTOR QUALITY CONTROL

ASPHALT CONCRETE PAVEMENT, GYRATORY MIX, 3/4-INCH NOMINAL MAXIMUM SIZE AGGREGATE, 0.3 TO <3 MILLION ESAL

REMOVAL, INDIVIDUAL TREE

REMOVAL OF PIPE CULVERT

ROADWAY EXCAVATION

CONTRACTOR TESTING

CONSTRUCTION SCHEDULE

SOIL EROSION CONTROL, FIBER ROLL

SOIL EROSION CONTROL, CHECK DAM

WATERING FOR DUST CONTROL

CLEARING AND GRUBBING

A-10

Option X Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

Schedule Total: ________________________

Submitted by: _________________________

40601-0000 Line X0400 6 TON $ $

41101-1000 Line X0420 15 TON $ $

41201-0000 Line X0440 6 TON $ $

60201-0800 Line X0460 210 LNFT $ $

60210-0800 Line X0480 8 EACH $ $

62201-0200 Line X0500 4 HOUR $ $

62201-0950 Line X0520 4 HOUR $ $

62201-2850 Line X0540 4 HOUR $ $

62201-3350 Line X0560 4 HOUR $ $

62301-0000 Line X0580 12 HOUR $ $

62302-1000 Line X0600 12 HOUR $ $

62302-1100 Line X0620 12 HOUR $ $

62406-0300 Line X0640 4.0 ACRE $ $

62510-2000 Line X0660 4.0 ACRE $ $

62515-2000 Line X0680 4.0 ACRE $ $

63313-0000 Line X0700 2,500 LNFT $ $

63316-1000 Line X0720 1 EACH $ $

63401-0300 Line X0740 9,600 LNFT $ $

63502-1250 Line X0760 40 EACH $ $

PAVEMENT MARKINGS, TYPE B, SOLID

TEMPORARY TRAFFIC CONTROL, TUBULAR MARKER, TYPE 42-INCH

MULCHING, HYDRAULIC METHOD

RUMBLE STRIP

REMOVE AND RESET SIGN

HYDRAULIC EXCAVATOR, 1 CUBIC YARD MINIMUM CAPACITY

GENERAL LABOR

SPECIAL LABOR, HIRED TECHNICAL SERVICES

TACK COAT

24-INCH PIPE CULVERT

END SECTION FOR 24-INCH PIPE CULVERT

SPECIAL LABOR, HIRED SURVEY SERVICES

PLACING CONSERVED TOPSOIL, 4-INCH DEPTH

SEEDING, HYDRAULIC METHOD

FOG SEAL

PRIME COAT, METHOD 1

DUMP TRUCK, 8 CUBIC YARD MINIMUM CAPACITY

WHEEL LOADER, 3 CUBIC YARD MINIMUM RATED CAPACITY

MOTOR GRADER, 12 FOOT MINIMUM BLADE

A-11

Option X Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

Schedule Total: ________________________

Submitted by: _________________________

63504-1000 Line X0780 125 SQFT $ $

63506-0500 Line X0800 400 HOUR $ $

63506-0600 Line X0820 60 HOUR $ $

TEMPORARY TRAFFIC CONTROL, CONSTRUCTION SIGN

TEMPORARY TRAFFIC CONTROL, FLAGGER

TEMPORARY TRAFFIC CONTROL, PILOT CAR

A-12

Option Y Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

15101-0000 Line Y0020 ALL LPSM

15201-0000 Line Y0040 ALL LPSM

15215-1000 Line Y0060 1 EACH $ $

15215-3000 Line Y0080 5 EACH $ $

15225-0000 Line Y0100 0.700 MILE $ $

15236-2000 Line Y0120 0.700 MILE $ $

15301-0000 Line Y0140 ALL LPSM

15401-0000 Line Y0160 ALL LPSM

15501-0000 Line Y0180 ALL LPSM

15705-1400 Line Y0200 1,050 LNFT $ $

15706-0200 Line Y0220 20 EACH $ $

15706-1600 Line Y0240 1 EACH $ $

15802-0000 Line Y0260 ALL LPSM

20101-0000 Line Y0280 2.2 ACRE $ $

20220-1000 Line Y0300 3 EACH $ $

20301-1900 Line Y0320 2 EACH $ $

20301-2400 Line Y0340 8 EACH $ $

20401-0000 Line Y0360 3,000 CUYD $ $

20441-0000 Line Y0380 2,000 CUYD $ $

Schedule Total: ________________________

Submitted by: _________________________

REMOVAL OF PIPE CULVERT

REMOVAL OF SIGN

ROADWAY EXCAVATION

MOBILIZATION

CONSTRUCTION SURVEY AND STAKING

SURVEY AND STAKING, APPROACH ROAD

SURVEY AND STAKING, DRAINAGE STRUCTURE

SLOPE, REFERENCE, AND CLEARING AND GRUBBING CONTROL

SURVEY CONTROL, GRADE FINISHING

WASTE

WATERING FOR DUST CONTROL

CLEARING AND GRUBBING

REMOVAL, INDIVIDUAL TREE

CONTRACTOR QUALITY CONTROL

CONTRACTOR TESTING

CONSTRUCTION SCHEDULE

SOIL EROSION CONTROL, FIBER ROLL

SOIL EROSION CONTROL, CHECK DAM

SOIL EROSION CONTROL, STABILIZED CONSTRUCTION EXIT

A-13

Option Y Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

Schedule Total: ________________________

Submitted by: _________________________

25101-0200 Line Y0400 10 CUYD $ $

30101-0000 Line Y0420 5,100 TON $ $

40101-1000 Line Y0440 2,350 TON $ $

40601-0000 Line Y0460 6 TON $ $

41101-1000 Line Y0480 15 TON $ $

41201-0000 Line Y0500 6 TON $ $

50101-0600 Line Y0520 180 SQYD $ $

60201-0800 Line Y0540 315 LNFT $ $

60210-0800 Line Y0560 12 EACH $ $

61902-2100 Line Y0580 1 EACH $ $

62201-0200 Line Y0600 4 HOUR $ $

62201-0950 Line Y0620 4 HOUR $ $

62201-2850 Line Y0640 4 HOUR $ $

62201-3350 Line Y0660 4 HOUR $ $

62301-0000 Line Y0680 12 HOUR $ $

62302-1000 Line Y0700 12 HOUR $ $

62302-1100 Line Y0720 12 HOUR $ $

62406-0300 Line Y0740 3.0 ACRE $ $

62510-2000 Line Y0760 3.0 ACRE $ $

PLACING CONSERVED TOPSOIL, 4-INCH DEPTH

SEEDING, HYDRAULIC METHOD

GENERAL LABOR

SPECIAL LABOR, HIRED TECHNICAL SERVICES

SPECIAL LABOR, HIRED SURVEY SERVICES

END SECTION FOR 24-INCH PIPE CULVERT

GATE, METAL, 30 FEET WIDTH

DUMP TRUCK, 8 CUBIC YARD MINIMUM CAPACITY

ASPHALT CONCRETE PAVEMENT, GYRATORY MIX, 3/4-INCH NOMINAL MAXIMUM SIZE AGGREGATE, 0.3 TO <3 MILLION ESAL

FOG SEAL

PRIME COAT, METHOD 1

WHEEL LOADER, 3 CUBIC YARD MINIMUM RATED CAPACITY

MOTOR GRADER, 12 FOOT MINIMUM BLADE

HYDRAULIC EXCAVATOR, 1 CUBIC YARD MINIMUM CAPACITY

PLACED RIPRAP, METHOD A, CLASS 2

AGGREGATE BASE

TACK COAT

MINOR CONCRETE PAVEMENT, REINFORCED, 6-INCH DEPTH

24-INCH PIPE CULVERT

A-14

Option Y Account: ALL

Project No: UT FLAP 30053(1)

Name: Navajo Lake Road CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

Schedule Total: ________________________

Submitted by: _________________________

62515-2000 Line Y0780 3.0 ACRE $ $

63301-0000 Line Y0800 11 EACH $ $

63313-0000 Line Y0820 3,600 LNFT $ $

63316-1000 Line Y0840 3 EACH $ $

63401-0300 Line Y0860 14,320 LNFT $ $

63502-1250 Line Y0880 60 EACH $ $

63504-1000 Line Y0900 125 SQFT $ $

63506-0500 Line Y0920 400 HOUR $ $

63506-0600 Line Y0940 60 HOUR $ $

PAVEMENT MARKINGS, TYPE B, SOLID

TEMPORARY TRAFFIC CONTROL, TUBULAR MARKER, TYPE 42-INCH

TEMPORARY TRAFFIC CONTROL, CONSTRUCTION SIGN

TEMPORARY TRAFFIC CONTROL, FLAGGER

TEMPORARY TRAFFIC CONTROL, PILOT CAR

MULCHING, HYDRAULIC METHOD

SIGN SYSTEM

RUMBLE STRIP

REMOVE AND RESET SIGN

A-15

Bid Schedule Summary

Schedule Bid Total

Schedule A - Base

Schedule X - Option

Schedule Y - Option

Total - Schedules

Submitted By: ________________________________

A-16

BUY AMERICAN ACT- CONSTRUCTION MATERIALS

UNDER TRADE AGREEMENTS

It is understood and agreed that the materials and components listed in Subparts 25.1 and 25.2 of the FAR are a part of this contract and are deemed to be Domestic Construction Material for the purposes of this contract.

NOTE TO CONTRACTOR:

The following information and any applicable supporting data is required for evaluation of requests under FAR Clause 52.225-9 Paragraph (c) & (d) and FAR Provision 52.225-10 Paragraph (b).

Material and/or Component

Construction Material Description Unit of Measure Quantity *Cost Delivered to Job Site

Foreign Construction Material

Comparable Domestic Material

Material and/or Component

Construction Material Description Unit of Measure Quantity *Cost Delivered to Job Site

Foreign Construction Material

Comparable Domestic Material

[* Include all delivery costs to the construction site and any applicable duty (whether or not a duty-free entry certificate is issued).] [Please include name, address, telephone number and contact for suppliers surveyed. Attach copy of response; if oral, attach summary. Include all applicable supporting information.]

A-17

HAZARDOUS MATERIALS

As required by FAR Clause 52.223-3, Hazardous Materials Identification and Safety Data - Alternate I, the apparent low bidder must submit prior to award a Material Safety Data Sheet (MSDS) for all hazardous materials that the bidder identifies in paragraph (b) of the FAR clause and defined under the latest version of Federal Standard No. 313.

Hazardous Material Identification Number

USE OF RECOVERED MATERIALS ON FEDERAL LANDS HIGHWAY PROJECTS

Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act (RCRA) of 1976, as amended (42 U.S.C. 6901 et seq.), requires Federal, State, and local procuring agencies using appropriated Federal funds to purchase items composed of the highest percentage of recovered materials practical. Use of recovered materials is strongly encouraged on Federal Lands Highway Projects. Highway construction items covered by the Environmental Protection Agency’s Comprehensive Guidelines for Procurement of Products Containing Recovered Materials include fly ash, ground granulated blast furnace slag, traffic barricades, traffic cones, hydraulic mulch and compost for mulch.

Use of fly ash and ground granulated blast furnace slag and construction materials containing fly ash and ground granulated blast furnace slag on Federal Lands Highway Projects:

• It is the policy of the United States Government that fly ash and ground granulated blast furnace slag and materials containing fly ash and ground granulated blast furnace slag shall have maximum practicable opportunity for incorporation into its construction projects.

• The Contractor agrees to investigate the use of fly ash and ground granulated blast furnace slag and materials containing fly ash and ground granulated blast furnace slag to the fullest extent consistent with the efficient performance of this contract. Both the contractor and the subcontractors are urged to seek out suppliers of fly ash and ground granulated blast furnace slag, cement and concrete containing fly ash and ground granulated blast furnace slag and to solicit bids for these materials.

• Names of firms that supply fly ash and ground granulated blast furnace slag and materials containing fly ash and ground granulated blast furnace slag are available from the American Coal Ash Association and the National Slag Association.

B-1

BID BOND

(See instructions on reverse) DATE BOND EXECUTED (Must not be later than bid opening date) OMB NO. 9000-0045

Public reporting burden for this collection of information is estimated to average 25 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the FAR Secretariat (MVR), Federal Acquisition Policy Division, GSA, Washington, D.C. 20405.

PRINCIPAL (Legal name and business address) TYPE OF ORGANIZATION (AX@ one)

INDIVIDUAL PARTNERSHIP

JOINT VENTURE CORPORATION

STATE OF INCORPORATION

SURETY(IES) (Name and business address)

PENAL SUM OF BOND BID IDENTIFICATION

PERCENT OF

BID PRICE

AMOUNT NOT TO EXCEED BID DATE INVITATION NO.

DTFH6815B00028

20 PERCENT MILLION(S) THOUSAND(S) HUNDRED(S) CENTS FOR (Construction, Supplies or Services) CONSTRUCTION

OBLIGATION:

We, the Principal and Surety(ies) are firmly bound to the United States of America (hereinafter called the Government) in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum “jointly and severally” as well as “severally” only for the purpose of allowing a joint action or actions against any or all of

us. For all other purposes, each Surety binds itself, jointly and severally with the Principal, for the payment of the sum shown opposite the name of the Surety. If no limit of liability is indicated, the limit of liability is the full amount of the penal sum.

CONDITIONS:

The Principal has submitted the bid identified above.

THEREFORE:

The above obligation is void if the Principal - (a) upon acceptance by the Government of the bid identified above, within the period specified therein for acceptance (sixty

(60) days if no period is specified), executes the further contractual documents and gives the bond(s) required by the terms of the bid as accepted within the time specified (ten (10) days if no period is specified) after receipt of the forms by the principal; or (b) in the event of failure to execute such further contractual documents and give such bonds, pays the Government for any cost of procuring the work which exceeds the amount of the bid.

Each Surety executing this instrument agrees that its obligation is not impaired by any extension(s) of time for acceptance of the bid that the Principal may grant to the Government. Notice to the surety(ies) of extension(s) are waived. However, waiver of the notice applies only to extensions aggregating not more than sixty (60) calendar days in addition to the period originally allowed for acceptance of the bid.

WITNESS:

The Principal and Surety(ies) executed this bid bond and affixed their seals on the above date.

PRINCIPAL

SIGNATURE(S)

1.

(Seal)

2.

(Seal)

3.

(Seal) Corporate

Seal NAMES(S) &

TITLE(S)

(Typed)

1. 2. 3.

INDIVIDUAL SURETY(IES)

SIGNATURE(S)

1.

(Seal)

2.

(Seal)

NAME(S)

(Typed)

1. 2.

CORPORATE SURETY(IES)

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT

SURETY A

SIGNATURE(S)

1. 2.

Corporate

Seal

NAMES(S) &

TITLE(S)

(Typed)

1. 2.

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 24 (Rev. 10-98) Previous edition is usable Prescribed by GSA - FAR (48 CFR) 53.228(a)

B-2 CORPORATE SURETY(IES) (Continued)

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT

SURETY B SIGNATURE(S)

1. 2. Corporate

Seal

NAMES(S) &

TITLE(S)

(Typed)

1. 2.

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT

SURETY C SIGNATURE(S)

1. 2. Corporate

Seal

NAMES(S) &

TITLE(S)

(Typed)

1. 2.

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT

SURETY D SIGNATURE(S)

1. 2. Corporate

Seal

NAMES(S) &

TITLE(S)

(Typed)

1. 2.

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT

SURETY E SIGNATURE(S)

1. 2. Corporate

Seal

NAMES(S) &

TITLE(S)

(Typed)

1. 2.

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT

SURETY F SIGNATURE(S)

1. 2. Corporate

Seal

NAMES(S) &

TITLE(S)

(Typed)

1. 2.

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT

SURETY G SIGNATURE(S)

1. 2. Corporate

Seal

NAMES(S) &

TITLE(S)

(Typed)

1. 2.

INSTRUCTIONS

1. This form is authorized for use when a bid guaranty is required. Any deviation from this form will require the written approval of the Administrator of General Services.

2. Insert the full legal name and business address of the Principal in the space designated “Principal” on the face of the form. An authorized person shall sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of the firm, partnership, or joint venture, or an officer of the corporation involved.

3. The bond may express penal sum as a percentage of the bid price. In these cases, the bond may state a maximum dollar limitation (e.g., 20% of the bid price but the amount not to exceed 3,000,000.00 dollars).

4. (a) Corporations executing the bond as sureties must appear on the Department of the Treasury=s list of approved sureties and must act within the limitation listed therein. Where more than one corporate surety is involved, their names and addresses shall appear in the spaces (Surety A, Surety B, etc.) headed “CORPORATE SURETY(IES).” In the space designated “SURETY(IES)” on the face of the form, insert only the letter identification of the sureties.

(b) Where individual sureties are involved, a completed Affidavit of Individual Surety (Standard Form 28), for each individual surety, shall accompany the bond. The Government may require the surety to furnish additional substantiating information concerning its financial capacity.

5. Corporations executing the bond shall affix their corporate seals. Individuals shall execute the bond opposite the word “Corporate Seal”;

and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requiring adhesive seals.

6. Type the name and title of each person signing this bond in the space provided.

7. In its application to negotiated contracts, the terms “bid” and “bidder” shall include “proposal” and “offeror.”

STANDARD FORM 24 (Rev. 10-98) BACK

B-3

FEDERAL HIGHWAY ADMINISTRATION

CENTRAL FEDERAL LANDS HIGHWAY DIVISION

BIDDER’S INFORMATION

INSTRUCTIONS: Answer all questions on this form inserting "none" or "not applicable" where appropriate. If more space is required attach additional sheets. Return the signed, dated and completed form with the bid to the address shown in the invitation for bids on or before the time set for bid opening. The prospective bidder shall provide any additional information requested by the Government during evaluation of the bids.

If the prospective bidder is a joint venture or general partnership, a separate Bidder's Qualifications form shall be provided individually for each joint venture participant or partner.

1. Name and address of business:

Name DUNS Number (See FAR Provision 52.204-6)*

Street Home Office Congressional District (Insert District #) *

City State Zip Code

* Necessary for Government reporting purposes only

To obtain a Dun & Street number, call County 800-333-0505.

Telephone Number (Include Area Code)

Fax Number (Include Area Code)

2. a. Type of organization (check appropriate box):

If a Foreign entity:

Individual Non-profit organization Corporation

Partnership Joint Venture Registered in:

b. Size and type of Business Concern (check appropriate boxes):

Large Business Concern Small Disadvantaged Business Concern Emerging Small Business

Small Business Concern Women-Owned Small Business SBA 8(a) Certified

HUB Zone Business Concern Veteran Owned Business Concern Service-Disabled Veteran-Owned Business Concern

Individual Non-profit organization Corporation

Partnership Joint Venture Incorporated in:

B-4

3. If a joint venture or general partnership:

a. Provide the name under which the project will be bid, the home office address, and name of the principal who will represent the company with regard to this project if different from "1." above.

Principal

Business Name

Street

City State Zip Code

b. Provide the name and home office addresses of each of the joint venture partners; indicate which partner is the sponsoring partner. Attach a separate sheet for additional partners.

Sponsoring Partner Other Partner

Street Street

City State Zip Code City State Zip Code

4. Date organization established: _______________________

5. Name of succeeded business, if any: _________________________________________________________

6. How many years have you been in business as:

a. General contractor years.

b. Subcontractor years.

7. a. Furnish the following information concerning the owner, partners, officers and directors:

Percent of Business Owned

Years of Business Experience

Name Title Contracting Other

b. Attach resumes of these key personnel as well as the on-site project manager(s) and superintendent(s), and specifically identify the following:

- Present position, responsibility, and length of employment.

- Amount and type of construction experience.

- Amount and type of highway construction experience, including position, responsibility, and a brief project description of each period of employment.

- Formal education and training, professional or technical registrations or licenses.

B-5

8. a. Contracts in force. (Attach additional sheets if necessary)

Project Name and Contract Numbers

Owner's Name, Address, and Contact Name and Telephone #

Scope of Work Performed Contract Amount Estimated Completion Date

Name of Surety

b. Are there any unresolved claims or lawsuits associated with these projects? If so, state the amount in dispute, parties involved, nature and circumstances of the dispute, and status of the matter on a separate sheet.

B-6

9. a. List at least five of the largest jobs you have completed in the last five years which are similar in project work scope to this project. (Attach additional sheets if necessary)

Project Name and Contract Numbers

Owner's Name, Address, Contact Name and Telephone #

Scope of Work Performed

Original and Final Contract Amounts

Original and Final Completion Dates

Names of On-site Project Manager and Superintendent

Name of Surety

b. Are there any unresolved claims or lawsuits associated with these projects? If so, state the amount in dispute, parties involved, nature and circumstances of the dispute, and status of the matter on a separate sheet.

B-7

Solicitation Provisions

52.203-98 -- Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements-Representation. (DEVIATION FEB 2015)

(a) In accordance with section 743 of Division E, Title VII, of the Consolidated and Further Continuing Resolution Appropriations Act, 2015 (Pub. L. 113-235), Government agencies are not permitted to use funds appropriated (or otherwise made available) under that or any other Act for contracts with an entity that requires employees or subcontractors of such entity seeking to report fraud, waste, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information.

(b) The prohibition in paragraph (a) of this provision does not contravene requirements applicable to Standard Form 312, Form 4414, or any other form issued by a Federal department or agency governing the nondisclosure of classified information.

(c) Representation. By submission of its offer, the Offeror represents that it does not require employees or subcontractors of such entity seeking to report fraud, waste, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information.

(End of provision)

52.204-5 -- Women-Owned Business (Other Than Small Business). (MAY 1999)

(a) Definition. "Women-owned business concern," as used…