Attachment_Task_Order_001.pdf

TASK ORDER- GRAVEL MATOC

ATTACHMENT 001

PRICE PROPOSAL- SEED PROJECT

Solicitation Number: DTFH6816R00002

Standard Specifications for Construction of Roads and Bridges on Federal Highway Projects, FP-03, U.S. Customary Units

U.S. Department of Transportation Federal Highway Administration

Central Federal Lands Highway Division 12300 West Dakota Avenue, Suite 360

Lakewood, CO 80228 Website: http://www.cflhd.gov/

Email: CFLContracts@fhwa.dot.gov

CO OM-AD 300(61a) Minuteman Missile Access

Roads

State:

Nebraska

County:

Cheyenne

Length: Schedule A = 30.1 miles

Type of Improvement:

Aggregate surface course, aggregate surface reconditioning

TABLE OF CONTENTS

Notice to Offerors ............................................................................................................ A-i

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

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

Buy American Act and Hazardous Materials ................................................................ A-6

Solicitation Provisions .....................................................................................................B-1

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

Davis Bacon Wage Determinations ................................................................................ D-1

Division 100 ..................................................................................................................... E-1 Division 150 ................................................................................................................... E-12 Division 200 ................................................................................................................... E-20 Division 300 ................................................................................................................... E-21 Division 400 .......................................................................................................... See FP-03 Division 500 .......................................................................................................... See FP-03 Division 600 ................................................................................................................... E-26 Division 700 ................................................................................................................... E-27

Appendices

Appendix A ................................................................................................................... Plans

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

A-i

NOTICE TO OFFERORS

Before submitting your offer, please check the following:

• You have completed the SF-1442, Solicitation, Offer & Award.

• You have completed the bid schedule and checked your bid figures, including calculations on your work sheets.

• 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 4212, Page A-ii; Bidders’ Information, Pages B-3 through B-6; Reps and Certs, Page B-7 and Certification Regarding Responsibility Matters (FAR 52.209-5), Pages B-8 and B-9.

BASE MATOC IDIQ Contract - The Provisions and Clauses provided in the Multiple Award Task Order Contract solicitation are in effect for this Task Order solicitation.

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 to contract award may require award to the next successful registered offeror. See FAR Subpart 4.1103(c). 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. The System for Award Management (SAM) is the Official U.S. Government system that consolidated the capabilities of CCR/FedReg, ORCA, and EPLS.

Please include NAICS 237310 in 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.

A-ii

NOTICE TO OFFERORS (cont.)

Vets 4212 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

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.

Insurance requirements - See Subsection 107.05 of the FP-03.

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

TECHNICAL QUESTIONS REGARDING THIS SOLICITATION WILL NOT BE

ACCEPTED AFTER 4 P.M. ON JUNE 17, 2016

Questions 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) 963-3360

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

A-1

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

Prescribed by GSA FAR (48 CFR) 53-236-1(d)

SOLICITATION, OFFER

AND AWARD

(Construction, Alteration or Repair)

1. SOLICITATION NO.

DTFH6816R00002

2. TYPE OF SOLICITATION

SEALED BID (IFB)

NEGOTIATED (RFP)

3. DATE ISSUED

5/25/2016

PAGE OF

PAGES

IMPORTANT - THE "OFFER SECTION ON THE REVERSE MUST BE FULLY COMPLETED BY OFFEROR.

4. CONTRACT NO.

5. REQUISITION/PURCHASE REQUEST NO. 6. PROJECT NO.

CO OMAD 300 (61a)

CODE: 69050001 7. ISSUED BY:

FEDERAL HIGHWAY ADMINISTRATION

CENTRAL FEDERAL LANDS DIVISION

12300 WEST DAKOTA AVENUE

LAKEWOOD, COLORADO 80228

8. ADDRESS OFFER TO:

FEDERAL HIGHWAY ADMINISTRATION

CENTRAL FEDERAL LANDS HIGHWAY DIVISION

ATTN: JEREMIAH ROGERS

12300 WEST DAKOTA AVENUE, SUITE 360

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 (TITLE, IDENTIFYING NO.):

CONSTRUCTION OF 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, FP-03,

7. SUBCONTRACTING PLAN (IF APPLICABLE)

See Subsection 104.04 of the FP for governing order of precedence

* See subsection 108.01 of the SCRs for completion date

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.

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 pm Denver local time on 6/24/16. 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.

X

X X

X

A-2

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)

CODE FACILITY CODE

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 BLOCK 27

(4 copies unless otherwise specified)

25. OTHER THAN FULL AND OPEN COMPETITION PURSUANT TO

15 U.S.C. 637( a ) 41 U.S.C. 253(c)( 5 )

26. ADMINISTERED BY CODE:

27. PAYMENT WILL BE MADE BY

CENTRAL FEDERAL LANDS HIGHWAY DIVISION

12300 W. DAKOTA AVENUE, SUITE 167

LAKEWOO, COLORADO 80228

CONTRACTING OFFICER WILL COMPLETE ITEM 28 OR 29 AS APPLICABLE

28. NEGOTIATED AGREEMENT (Contractor is required to sign this document and return one (1) 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

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

A-3

Block 11: COMPLETION DATE: Work shall be completed on or before the date specified in

Subsection 108.01 of the SCRs.

Block 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- 03.

Block 24: SUBMITTING INVOICES: See Subsection 109.08 Progress Payments of the FP-03.

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

TECHNICAL QUESTIONS REGARDING THIS SOLICITATION WILL NOT BE

ACCEPTED AFTER 4 P.M. ON JUNE 17, 2016.

Questions 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 facsimile or telegraphic notice, 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 telegraphic 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) 963-3360

ESTIMATED PRICE: The price range of Schedule A and all options is between $2,000,000.00 and $4,000,000.00.

A-4

Bid Schedule Instructions

This Proposal is comprised of one schedule as follows:

Schedule A – Aggregate surface course on 30.1 miles of roadway.

Insert a numeric unit price for each pay item for which a quantity appears in each bid schedule/option.

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

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

Total all amounts bid for each pay item and show the Total on the last line of each bid schedule/option and on the Summary Page.

Evaluation Factors for Award

To be eligible for award of contract, the offeror shall submit prices for each item in Bid Schedule A.

Accordingly, this task order award will be made to the lowest responsible bidder who was also awarded an IDIQ contract as a result from DTFH6816R00002 and conforming to the solicitation, provided funds are available.

B I D S C H E D U L E Schedule A

Project No: NE OMAD 300(61a)

Project Name: Minuteman Missile Access Roads CQ = "Contract Quantity"

Item No. Quantity Unit Unit Price Amount

15101-0000 Line A0010 ALL LPSM $

15301-0000 Line A0020 ALL LPSM $

15401-0000 Line A0030 ALL LPSM $

15705-1400 Line A0040 100 LNFT $ $

15802-0000 Line A0050 ALL LPSM $

20402-0000 Line A0060 100 CUYD $ $

30110-0000 Line A0070 75,288 TON $ $

30301-5000 Line A0080 30.400 MILE $ $

62201-0450 Line A0090 50 HOUR $ $

62201-2850 Line A0100 80 HOUR $ $

62301-0000 Line A0110 80 HOUR $ $

63502-0700 Line A0120 100 EACH $ $

63504-1000 Line A0130 320 SQFT $ $

63506-0500 Line A0140 400 HOUR $ $

MOBILIZATION

CONTRACTOR QUALITY CONTROL

CONTRACTOR TESTING

SOIL EROSION CONTROL, FIBER ROLL

WATERING FOR DUST CONTROL

SUBEXCAVATION

TEMPORARY TRAFFIC CONTROL, CONSTRUCTION SIGN

TEMPORARY TRAFFIC CONTROL, FLAGGER

AGGREGATE SURFACE COURSE

AGGREGATE SURFACE RECONDITIONING

BACKHOE LOADER, 4 CUBIC FOOT MINIMUM RATED CAPACITY BUCKET, 18-INCH WIDTH

MOTOR GRADER, 12 FOOT MINIMUM BLADE

GENERAL LABOR

TEMPORARY TRAFFIC CONTROL, CONE

Schedule Total: ________________________

Submitted by: _________________________

Jeremiah.Rogers Typewritten Text A-5

Jeremiah.Rogers Typewritten Text

Jeremiah.Rogers Typewritten Text

Jeremiah.Rogers Typewritten Text

A-6

BUY AMERICAN ACT - CONSTRUTION MATERIAL

UNDER TRADE AGREEMENTS

It is understood and agreed that the materials and components listed in Subpart 25.108 of the Federal Acquisition Regulations 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) and (d) and FAR Provision 52.225-10 Paragraph (b).

Material and/or Component

Nondomestic Material Unit of

Measure Quantity *Cost Delivered to Job Site

Comparable Domestic Material

Material and/or Component

Nondomestic Material Unit of

Measure Quantity *Cost Delivered to Job Site

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-7

HAZARDOUS MATERIALS

The following information and any applicable supporting data is required under FAR Clause 52.223-3, Hazardous Materials Identification and Safety Data - Alternate I, for all hazardous materials that the offeror 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)

PERCENT OF

BID PRICE

AMOUNT NOT TO EXCEED

BID DATE INVITATION NO.

DTFH6816R00002

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.

3.

Corporate

Seal

NAMES(S) &

TITLE(S)

(Typed)

2. 3.

INDIVIDUAL SURETY(IES)

NAME(S)

CORPORATE SURETY(IES)

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT

SURETY A

B-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

CORPORATE SURETY(IES) (Continued)

SURETY B

SURETY C

SURETY D

SURETY E

SURETY F

SURETY G

B-3

CENTRAL FEDERAL LANDS HIGHWAY DIVISION

BIDDER'S QUALIFICATIONS

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 Email Address

* Necessary for Government reporting purposes only County To obtain a Dun & Street number, call 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:

Name

Percent of Business Owned

Years of Business Experience

(Include Individuals who have signatory / obligating authority on behalf of the agency)

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

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-6

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-7

Solicitation Provisions

52.203-98 -- Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements-Representation (DEVIATION 2015-02)

(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 in this provision, means a concern that is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.6

(b) Representation. [Complete only if the offeror is a women-owned business concern and has not represented itself as a small business concern in paragraph (b)(1) of FAR 52.219-1, Small Business Program Representations, of this solicitation.] The offeror represents that it [ ] is women-owned business concern.

B-8

52.204-8 -- Annual Representations and Certifications. (DEC 2014)

(a)

(1) The North American Industry Classification System (NAICS) code for this acquisition is 237310.

(2) The small business size standard is $36.5 million or less.

(3) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees.

(b)

(1) If the provision at 52.204-7, System for Award Management, is included in this solicitation, paragraph (d) of this provision applies.

(2) If the provision at 52.204-7 is not included in this solicitation, and the offeror is currently registered in the System for Award Management (SAM), and has completed the Representations and Certifications section of SAM electronically, the offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certifications in the solicitation. The offeror shall indicate which option applies by checking one of the following boxes:

[ ] (i) Paragraph (d) applies.

[ ] (ii) Paragraph (d) does not apply and the offeror has completed the individual representations and certifications in the solicitation.

(c)

(1) The following representations or certifications in SAM are applicable to this solicitation as indicated:

(i) 52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless--

B-9

(A) The acquisition is to be made under the simplified acquisition procedures in Part 13;

(B) The solicitation is a request for technical proposals under two-step sealed bidding procedures; or

(C) The solicitation is for utility services for which rates are set by law or regulation.

(ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000.

(iii) 52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the provision at 52.204-7, System for Award Management.

(iv) 52.204-5, Women-Owned Business (Other Than Small Business). This provision applies to solicitations that—

(A) Are not set aside for small business concerns;

(B) Exceed the simplified acquisition threshold; and

(C) Are for contracts that will be performed in the United States or its outlying areas.

(v) 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations— Representation. This provision applies to solicitations using funds appropriated in fiscal years 2008, 2009, 2010, or 2012.

(vi) 52.209-5, Certification Regarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.

(vii) 52.214-14, Place of Performance—Sealed Bidding. This provision applies to invitations for bids except those in which the place of performance is specified by the Government.

(viii) 52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the Government.

B-10

(ix) 52.219-1, Small Business Program Representations (Basic & Alternate I).

This provision applies to solicitations when the contract will be performed in the United States or its outlying areas.

(A) The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard.

(B) The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard.

(x) 52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract will be performed in the United States or its outlying areas.

(xi) 52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-26, Equal Opportunity.

(xii) 52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity.

(xiii) 52.222-38, Compliance with Veterans’ Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition threshold and the contract is not for acquisition of commercial items.

(xiv) 52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of USDA–designated items; or include the clause at 52.223-2, Affirmative Procurement of Biobased Products Under Service and Construction Contracts.

(xv) 52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPA–designated items.

(xvi) 52.225-2, Buy American Certificate. This provision applies to solicitations containing the clause at 52.225-1.

(xvii) 52.225-4, Buy American—Free Trade Agreements—Israeli Trade Act

B-11

Certificate. (Basic, Alternates I, II, and III.) This provision applies to solicitations containing the clause at 52.225-3.

(A) If the acquisition value is less than $25,000, the basic provision applies.

(B) If the acquisition value is $25,000 or more but is less than $50,000, the provision with its Alternate I applies.

(C) If the acquisition value is $50,000 or more but is less than $79,507, the provision with its Alternate II applies.

(D) If the acquisition value is $79,507 or more but is less than $100,000, the provision with its Alternate III applies.

(xviii) 52.225-6, Trade Agreements Certificate. This provision applies to solicitations containing the clause at 52.225-5.

(xix) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan—Certification. This provision applies to all solicitations.

(xx) 52.225-25, Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-Representation and Certifications. This provision applies to all solicitations.

(xxi) 52.226-2, Historically Black College or University and Minority Institution Representation. This provision applies to solicitations for research, studies, supplies, or services of the type normally acquired from higher educational institutions.

(2) The following certifications are applicable as indicated by the Contracting Officer:

[ ](i) 52.204-17, Ownership or Control of Offeror

[ ](ii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

[ ](iii) 52.222-48, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain

B-12

Equipment- Certification.

[ ](iv) 52.222-52, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services-Certification.

[ ](v) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA–Designated Products (Alternate I only).

[ ](vi) 52.227-6, Royalty Information.

[ ](A) Basic.

[ ](B) Alternate I.

[ ](vii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

(d) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through https://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in paragraph (c) of this provision have been entered or updated within the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201); except for the changes identified below [offeror to insert changes, identifying change by clause number, title, date].

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

FAR Clause Title Date Change

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted on SAM.

B-13

52.209-5 -- Certification Regarding Responsibility Matters. (APR 2010)

(a)

(1) The Offeror certifies, to the best of its knowledge and belief, that --

(i) The Offeror and/or any of its Principals --

(A) Are [ ] are not [ ] presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(B) Have [ ] have not [ ], within a three-year period preceding this offer, 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) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property (if offeror checks "have", the offeror shall also see 52.209-7, if included in this solicitation);

(C) Are [ ] are not [ ] presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this provision; and

(D) Have [ ], have not [ ], within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

(1) Federal taxes are considered delinquent if both of the following criteria apply:

(i) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(ii) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced

B-14 collection action is precluded.

(2) Examples.

(i) The taxpayer has received a statutory notice of deficiency, under I.R.C. Sec.6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(ii) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. Sec. 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(iii) The taxpayer has entered into an installment agreement pursuant to I.R.C. Sec. 6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(iv) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code).

(ii) The Offeror has [ ] has not [ ], within a three-year period receding this offer, had one or more contracts terminated for default by any Federal agency.

(2) "Principal," for the purposes of this certification, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

B-15

This Certification Concerns a Matter Within the Jurisdiction of an Agency of the United States and the Making of a False, Fictitious, or Fraudulent Certification May Render the Maker Subject to Prosecution Under Section 1001, Title 18, United States Code.

(b) The Offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(c) A certification that any of the items in paragraph (a) of this provision exists will not necessarily result in withholding of an award under this solicitation. However, the certification will be considered in connection with a determination of the Offeror's responsibility. Failure of the Offeror to furnish a certification or provide such additional information as requested by the Contracting Officer may render the Offeror nonresponsible.

(d) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a) of this provision. The knowledge and information of an Offeror is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly rendered an erroneous certification, in addition to other remedies available to the Government, the Contracting Officer may terminate the contract resulting from this solicitation for default.

52.211-6 -- Brand Name or Equal. (AUG 1999)

52.214-3 -- Amendments to Invitations for Bids. (DEC 1989)

52.214-4 -- False Statements in Bids. (APR 1984)

52.214-5 -- Submission of Bids. (MAR 1997)

52.214-6 -- Explanation to Prospective Bidders. (APR 1984)

52.214-7 -- Late Submissions, Modifications, and Withdrawals of Bids. (NOV 1999)

52.214-18 -- Preparation of Bids - Construction. (APR 1984)

52.214-19 -- Contract Award -- Sealed Bidding - Construction. (AUG 1996)

52.214-34 -- Submission of Offers in the English Language. (APR 1991)

B-16

52.214-35 -- Submission of Offers in U.S. Currency. (APR 1991)

52.216-1 -- Type of Contract. (APR 1984)

The Government contemplates award of a FIRM FIXED PRICE contract resulting from this solicitation.

52.222-23 -- Notice of Requirement for Affirmative Action to Ensure Equal Employment Opportunity for Construction. (FEB 1999)

(a) The offeror's attention is called to the Equal Opportunity clause and the Affirmative Action Compliance Requirements for Construction clause of this solicitation.

(b) The goals for minority and female participation, expressed in percentage terms for the Contractor's aggregate workforce in each trade on all construction work in the covered area, are as follows:

Goals for Minority Participation for Each Trade

Goals for Female Participation for Each Trade

5.3% 6.9%

These goals are applicable to all the Contractor's construction work performed in the covered area. If the Contractor performs construction work in a geographical area located outside of the covered area, the Contractor shall apply the goals established for the geographical area where the work is actually performed. Goals are published periodically in the Federal Register in notice form, and these notices may be obtained from any Office of Federal Contract Compliance Programs office.

(c) The Contractor's compliance with Executive Order 11246, as amended, and the regulations in 41 CFR 60-4 shall be based on (1) its implementation of the Equal Opportunity clause, (2) specific affirmative action obligations required by the clause entitled Affirmative Action Compliance Requirements for Construction, and (3) its efforts to meet the goals. The hours of minority and female employment and training must be substantially uniform throughout the length of the contract, and in each trade. The Contractor shall make a good faith effort to employ minorities and women evenly on each of its projects. The transfer of minority or female employees or trainees from Contractor to Contractor, or from project to project, for the sole purpose of meeting the Contractor's goals shall be a violation of the contract, Executive Order 11246, as amended, and the regulations in 41 CFR 60-4. Compliance with the goals will be measured against the total work hours performed.

(d) The Contractor shall provide written notification to the Deputy Assistant Secretary for Federal Contract Compliance, U.S. Department of Labor, within 10 working days following

B-17 award of any construction subcontract in excess of $10,000 at any tier for construction work under the contract resulting from this solicitation. The notification shall list the -

(1) Name, address, and telephone number of the subcontractor; (2)

Employer's identification number of the subcontractor;

(3) Estimated dollar amount of the subcontract;

(4) Estimated starting and completion dates of the subcontract; and

(5) Geographical area in which the subcontract is to be performed.

(e) As used in this Notice, and in any contract resulting from this solicitation, the covered area is Cheyenne, NE.

52.222-38 -- Compliance with Veterans' Employment Reporting Requirements. (SEP 2010)

52.225-10 -- Notice of Buy American Act Requirement—Construction Materials (FEB 2009)

(a) Definitions. “Commercially available off-the-shelf (COTS) item,” “construction material,” “domestic construction material,” and “foreign construction material,” as used in this provision, are defined in the clause of this solicitation entitled “Buy American Act—Construction Materials” (Federal Acquisition Regulation (FAR) clause 52.225-9).

(b) Requests for determinations of inapplicability. An offeror requesting a determination regarding the inapplicability of the Buy American Act should submit the request to the Contracting Officer in time to allow a determination before submission of offers. The offeror shall include the information and applicable supporting data required by paragraphs (c) and (d) of the clause at FAR 52.225-9 in the request.