ITB 2024_016 Peters Park Restroom Constructio.pdf

City of Tucker

Invitation to Bid

ITB # 2024-016

PETERS PARK RESTROOM CONSTRUCTION

BID MANUAL

City of Tucker 1975 Lakeside Parkway, Suite 350

Tucker, Georgia 30234

City of Tucker Invitation to Bid

ITB #2024-016

Peters Park Restroom Construction

INVITATION: The City of Tucker, Georgia requests that interested parties submit bids for the Peters Park Restroom Construction Project. Bids will be accepted until the date and time listed below and will be awarded to the responsive and responsible bidder whose bid, conforming with all the material terms and conditions of the ITB, is the lowest in price. Addenda and updates to this bid manual will be posted on the City of Tucker website http://tuckerga.gov/bids or may be requested by email procurement@tuckerga.gov.

BID ACTIVITY SCHEDULE

Invitation to Bid Issued August 27, 2024 Deadline for Questions September 10 at 1:00 p.m. EST Responses to Questions Posted (Addenda) September 13, 2024 Bid Deadline September 26, 2024, at 4:00 p.m. EST Award at Council Meeting October 15, 2024 (Tentative) Completion from Notice to Proceed 120 calendar days

SCOPE OF WORK: Refer to Exhibit A.

PRE-BID CONFERENCE: A pre-bid conference will not be scheduled for this project.

QUESTIONS: Submit all questions in writing to procurement@tuckerga.gov. Reference ITB #2024-016 in the subject line of the email no later than September 10, 2024 at 1:00pm EST.

ADDENDA: Responses to the questions received will be by addenda and will be posted on the City website www.tuckerga.gov/bids. The signed acknowledgement issued with each addendum must be submitted with the proposal. It is the vendors responsibility to verify if any addenda were created.

SUBMITTAL REQUIREMENTS: Vendor shall submit ITB Response no later than September 26, 2024 at 4:00 p.m. EST electronically to procurement@tuckerga.gov with the subject line “Submittal: ITB #2024-016”. The email must contain the vendor’s contact information. Bid Submittal should be one PDF file and named <Company Name>.ITB 2024-016.Bid Submittal.pdf The submittal email will be opened to confirm receipt of the submittal; however, the attached PDF file will remain unopened until the public opening.

BID OPENING: All bids received prior to the deadline will be opened publicly on Thursday, September 26, 2024 at 4:05pm EST at Tucker City Hall located at 1975 Lakeside Parkway, Suite 350, Tucker, Georgia.

BID TABULATON: Preliminary Bid results will be posted on the City’s website, www.tuckerga.gov/bids, following the bid opening.

http://tuckerga.gov/bids mailto:procurement@tuckerga.gov mailto:procurement@tuckerga.gov.

http://www.tuckerga.gov/bids http://www.tuckerga.gov/bids

BID DOCUMENT SUBMITTAL REQUIREMENTS:

1. Unit Price Cost Proposal Form – Exhibit B

2. W-9 Form (provided)

3. Certificate of Current Insurance

4. Proposed List of Subcontractors Form (provided)

5. E-Verify Affidavit Form (provided)

6. E-Verify Subcontractor Affidavit Form (provided)

7. Bid Bond Form (provided)

8. Contact Information Form (provided)

9. Related Experience and References Form (provided)

10. Oath of Non-Collusion Form (Provided)

11. Acknowledgement of Addendum issued with each Addendum.

All responses must be received electronically by the Bid Deadline. (Addenda will show any schedule updates). No bids will be received orally or by phone. Late bids will not be considered.

Bids received after the deadline will be filed unopened. The City of Tucker reserves the right to reject any and all bids or any part, to waive any formalities to make an award and to re-advertise in the best interest of the City.

The city reserves the right to negotiate pricing and may, in its discretion, award a contract to the lowest responsible and responsive bidder submitting the proposal.

Exhibit A:

Project Specifications/Scope of Work

ITB #2024-016 Peters Park Restroom Construction

PURPOSE, INTENT AND PROJECT DESCRIPTION

The City of Tucker (City), requests that interested parties submit formal electronic bids for the construction of a new two-stall restroom building, including water and sanitary sewer connections to existing water and sanitary sewer infrastructure. This document in its entirety for ITB 2024- 016 Peters Park Restroom Construction is available for download on the City of Tucker website:

www.tuckerga.gov/bids or request via email to procurement@tuckerga.gov .

GENERAL CONDITIONS

The contractor shall execute the work according to and meet the requirements of the following:

• DeKalb County Design & Construction Standards Manual

• The Contract Documents including but not limited to the scope of work, plans, and specifications.

• City of Tucker ordinances and regulations.

• OSHA standards and guidelines

• Any other applicable codes, laws and regulations including but not limited to Section 45- 10-

20 through 45-10-28 of the Official Code of Georgia Annotated, Title VI of the Civil Rights Act, Drug-Free Workplace Act, and all applicable requirements of the Americans with Disabilities Act of 1990.

The contractor will be responsible for providing all labor, materials, and equipment necessary to perform the work. This is a unit price bid. Payment will be made based on actual work completed.

The contractor is responsible for inspecting the jobsite prior to submitting a bid. No change orders will be issued for differing site conditions.

The successful bidder must have verifiable experience at construction of similar projects in accordance with these specifications. The bidder shall provide at least three examples and reference information (including company name, project name, contact name, phone number and email address) demonstrating experience successfully completing projects of similar scope.

5% retainage will be withheld from the total amount due the contractor until Final Acceptance of work is issued by the City. The City will inspect the work as it progresses.

PROSECUTION AND PROGRESS

The Contractor will mobilize with sufficient forces such that all construction identified as part of this contract shall be substantially completed by 120 calendar days of Notice to Proceed. The contractor will be considered substantially complete when all work required by this contract has been completed (excluding punch list work).

Upon Notice of Award, the Contractor will be required to submit a Progress Schedule.

The normal workday for this project shall be 8:00AM to 7:00PM and the normal workweek shall http://tuckerga.gov/ http://www.tuckerga.gov/bids

Exhibit A be Monday through Friday. The City will consider extended workdays or workweeks upon written request by the Contractor on a case-by-case basis. No work will be allowed on national holidays (i.e. Memorial Day, July 4th, Labor Day, etc.).

The work will require the bidder to provide all labor, administrative forces, equipment, materials and other incidental items to complete all required work. The City shall perform a Final Inspection upon substantial completion of the work. The contractor will be allowed to participate in the Final Inspection. All repairs shall be completed by the contractor at the contractor’s expense prior to issuance of Final Acceptance.

The contractor shall be assessed liquidated damages in the amount of $500.00 per calendar day for any contract work (excluding punch list) that is not completed by 120 calendar days. Liquidated damages shall be deducted from the 5% retainage held by the City. The contractor will also be assessed liquidated damages in the amount of $500.00 per calendar day for not completing any required Punch List work within 45 calendar days.

The contractor shall provide all material, labor, and equipment necessary to perform the work without delay until final completion.

The contractor shall submit a two-week advance schedule every Friday by 2:00p.m, detailing the scheduled activities for the following week.

PERMITS AND LICENSES

The contractor shall procure all permits and licenses, pay all charges, taxes and fees, and give all notices necessary and incidental to the due and lawful prosecution of the work.

BONDING AND INSURANCE REQUIREMENTS

No bid may be withdrawn for a period of ninety (90) days after the bid deadline.

All bids must be accompanied by a Bid Bond of a reputable bonding company authorized to do business in the State of Georgia, in an amount equal to at least five percent (5%) of the total amount of the bid.

Upon Notice of Award, the successful contractor shall submit a Performance Bond payable to the City of Tucker in the amount of 100% of the total contract price. The successful contractor shall also submit a Payment Bond in the amount of 100% pursuant to O.C.G.A. § 36- 91-70 and 90.

The contractor shall procure and maintain the following insurance policies:

1. Commercial General Liability coverage at their sole cos and expense with limits of not less than $3,000,000 in combined single limits for bodily injury and/or property damage per occurrence, and such policies shall name the City of Tucker as an additional named insured.

2. Statutory Workers Compensation and Employers Liability Insurance with limits of not less than $1,000,000, which insurance must contain a waiver of subrogation against the City of Tucker and its affiliates.

3. Commercial automobile liability insurance with limits of not less than $1,000,000 combined single limit for bodily injury and/or property damage per occurrence, and such policies shall name the City of Tucker as an additional named insured.

EXISTING CONDITIONS / DEVIATION OF QUANTITIES

All information given in this ITB concerning quantities, scope of work, existing conditions, etc. is for information purposes only. It is the Contractor’s responsibility to inspect the project site to verify existing conditions and quantities prior to submitting their bid. This is a Unit Price bid and no payment will be made for additional work without prior written approval from the City. At no time will Contractor proceed with work outside the prescribed scope of services for which additional payment will be requested without the written authorization of the City.

The City reserves the right to add, modify, or delete quantities. The City may also elect to add or eliminate certain work locations at its discretion. The Contractor will not be entitled to any adjustment of unit prices or any other form of additional compensation because of adjustments made to quantities and/or work locations. The contractor will be paid for actual in-place quantities completed and accepted for pay items listed in the Bid Schedule. All other work required by this ITB, plans, specs, standards, etc. but not specifically listed in the Bid Schedule shall be considered “incidental work” and included in the bid prices for items on the Bid Schedule.

PROTECTION AND RESTORATION OF PROPERTY AND LANDSCAPE

The contractor shall be responsible for the preservation of all public and private property, crops, fish ponds, trees, monuments, highway signs and markers, fences, grassed and sodded areas, etc. along and adjacent to the highway, road or street, and shall use every precaution necessary to prevent damage or injury thereto, unless the removal, alteration, or destruction of such property is provided for under the contract.

When or where any direct or indirect damage or injury is done to public or private property by or on account of any act, omission, neglect or misconduct in the execution of the work, or in consequence of the non-execution thereof by the contractor, he shall restore, at his/her own expense, such property to a condition similar or equal to that existing before such damage or injury was done, by repairing, rebuilding or otherwise restoring as may be directed, or she/he shall make good such damage or injury in an acceptable manner. The contractor shall correct all disturbed areas before retainage will be released.

ADJUSTING UTILITY STRUCTURES TO GRADE

All sewer manholes and water valves are to be adjusted by the DeKalb County Department of Watershed Management. The contractor shall coordinate required utility adjustments with the CEI inspector.

CLEANUP

All restoration and clean-up work shall be performed daily. Operations shall be suspended if the contractor fails to accomplish restoration and clean-up within an acceptable period of time. Asphalt and other debris shall be removed from gutters, sidewalks, yards, driveways, etc. Failure to perform clean-up activities may result in suspension of the work. Milling operation shall be followed immediately by clean-up at which the contractor is to provide power brooms, vacuum sweepers, power blowers, or other means to remove loose debris or dust. Do not allow dust control to restrict visibility of passing traffic or to disrupt adjacent property owners. All pavement areas shall be clean and dry prior to placing tack coat, asphaltic concrete or other materials.

SAFETY

Beginning with mobilization and ending with acceptance of work, the contractor shall be responsible for providing a clean and safe work environment at the project site. The contractor shall comply with all OSHA regulations as they pertain to this project.

SPECIAL CONDITIONS

1. Contractor to call 811 for utility locations. Minor field adjustments may be necessary or directed by the City.

RESTROOM AND CONCESSION BUILDING

The scope of the project is to be the Design and providing a set of Issued for Construction documents for a new +/- 250 sf Single Story Free Standing Building under the existing pavilion, utilizing existing pavilion roof as bathroom roof, that will contain the following Spaces:

• 2(ea) Family Restrooms

• Storage, Janitor, Mechanical and Electrical Room

• Maintenance Chase (with access) Separating Men’s & Women’s Restrooms

Design Criteria

Code Compliances:

• Applicable Design Codes by local municipality building authorities requirements

• U.S. Department of Justice A.D.A. Standards for Accessible Design (ADA) – 2010 edition

• State Registered Architect/Engineer/Design Professional Signed, Sealed & Dated w/registration number on all sheets

• Construction Type: VB

• Occupancy Classification: Assembly

• Fire Rating Construction: Non-Rated Building

• Sprinkler Requirement: Non-Sprinkled

• Allowable Building Height & Area Single Story & (area to be determined)

• Occupancy Load Calculations (per LSC) (to be determined)

• Plumbing Fixture Requirements / (to be determined)

Proposed Fixture Count (including calc’s)

Design Loads:

• Live Loads:

o 100 PSF FLOORS

• Wind Design Data:

o Risk Category: Category II o Exposure Category: Category C o Basic Design Wind Speed: V=106mph o Allowable Stress Design Wind Speed: V=89mph o Enclosure Classification: Enclosed o Internal Pressure Coefficient: +/- 0.18

Seismic Design Data:

o Risk Category Category II o Seismic Importance Factor 1.0 o Mapped Spectral Response Accelerations: (to be determined) o Site Class: (to be determined) o Design Base Shear: (to be determined)

• Snow Loads: Ground Snow Load: 5 PSF

Scope of Material

ARCHITECTURAL

Foundation - (see Structural below for further information)

• 4” reinforced concrete monolithic slab, 3000 PSI

Exterior Walls - (see Structural below for further information)

• Concrete reinforced masonry units (CMU)

• Mortar joint: Gray

• Unit Size: Typical Nominal 8”x16”x8”

• Surface Finishes: Split Face

• Block Color: Standard Gray

• Exterior block to have anti-graffiti coating

Exterior Doors and Frames

• Exterior insulated composite metal doors (Level III, 16 gauge, extra heavy duty, model two seamless w/polyurethane core)

• Welded steel frame (16 gauge w/backbend turns)

• Both doors and frames to be powder coated (color selected by owner)

Interior Walls - (see Structural below for further information)

• Concrete reinforced masonry units (CMU)

• Mortar joint: Gray

• Unit Size: Typical nominal 8”x16”x6”

• Surface Finishes: Standard (smooth)

• Block Color: Standard Gray

Interior Ceilings

• Hard surface - smooth, washable and mildew resistant surface finish - all rooms including service chase

Interior Doors and Frames

• Insulated composite metal doors (Level III, 16 gauge, extra heavy duty, model two seamless w/polyurethane core)

• Welded steel frame (16 gauge w/backbend turns)

• Both doors and frames to be powder coated (color selected by owner)

Hardware

• Stainless steel ball bearing heavy duty hinges

• Heavy duty door closers

• Doors to have stainless steel kick plates (both sides) w/ aluminum thresholds for exterior doors

• Doors to have grade 2, lever locks with latch plate guards

• Restroom doors to have magnetic locking system w/ locked indicator light

• Hardware to meet ADA compliance

ADA Restrooms

• Wall mounted, top supply, stainless steel toilets w/ exposed sensor flush valves

• Wall mounted stainless steel sinks w/ motion sensor faucets, hardwired with transformer

• Surface mounted mirrors with stainless steel frames

• Wall mounted light fixture above mirror at sinks

• Wall mounted stainless steel 2-roll toilet paper dispensers

• Wall mounted stainless steel soap dispensers

• Wall mounted stainless steel electric hand dryers

• Surface mounted diaper deck

• ADA grab bars to meet code and fixture count

Finishes - (colors selected by owners)

• Concrete floor to be stained and sealed

• Walls to receive 4” rubber cove base

• Painted surfaces to receive prime coat and one finish coat

• All rooms to receive epoxy paint

STRUCTURAL

(see Architectural for other structural associated information)

Foundation

• Continuous reinforced concrete spread footings.

• Allowable soil bearing pressure presumed to be 2,000 psf, to be confirmed with geotechnical exploration

• Reinforced slab on grade on 4” compacted GAB

• Concrete:

o F’c= 3,000 psi for footings o F’c= 4,000 psi for slabs. Provide air entrainment for exposed slabs on grade

Wall Framing

• Exterior walls: 8” reinforced split face cmu, F’m = 2,000psi

• Interior walls: 8” reinforced standard cmu, F’m = 2,000psi

MECHANICAL, ELECTRICAL & PLUMBING

(see Architectural for other MEP associated information)

Electrical

• New electrical panel sized for the new restroom building

• Motion sensor interior lights. Comcheck report for lighting to confirm code compliance

• Exterior Security wall pack lights (photocell)

• Wall outlets and required GFI outlets per code

• Circuiting for lighting and electric outlets

• Circuiting for the water heater

• Provide (2ea) 1” PVC conduits from electrical panel to outside of building for future needs

Plumbing

• Frost free hose bibs w/ recessed security box located on each exterior wall

• Frost free hose bibs w/ recessed security box located in each space (except service chase)

• Water service to include isolation valves and backflow preventer

• Waste system to include cleanouts

• Floor Drains in each space with trap primers

• Tank type water heater serving the lavatories in the restrooms, water heater to be located in the Mechanical Storage room

• Thermostatic mixing valve for the hot water serving the toilet room lavatories to prevent scald

Exhibit B: Unit Price Cost Proposal

Item # Item Description UNIT Qty UNIT COST TOTAL COST

1 Grading Complete 1

2 1” PVC Water Service Line, Incl. Connection to Existing Service Line LF 150

4” PVC Sanitary Sewer Lateral, Incl. Cleanouts and Connection to Ex. Manhole w/Outside Drop Connection

LF 170

4 Remove and Replace 4” Concrete Sidewalk SF 100

5 Bathroom Building 1

*In case of discrepancy between the unit price and the total price on the completed Bid Schedule, the unit price will prevail, and the total price will be corrected.

Proposal Price Certification

In compliance with the attached specification, the undersigned understands the City’s minimum scope requirements.

The undersigned offers and agrees that if this proposal is accepted by the Mayor and City Council within one hundred twenty (120) days of the date of proposal opening, that the undersigned will furnish any or all of the deliverables and additional services offered, at the quoted price, to the designated point(s) within the time specified.

COMPANY__________________________________________________________________

ADDRESS___________________________________________________________________

AUTHORIZED SIGNATURE____________________________________________________

PRINT / TYPE NAME __________________________________________________________

CONTACT’S PHONE NUMBER __________________________________________________

CONTACT’S EMAIL ADDRESS __________________________________________________

PROPOSED SUBCONTRACTOR FORM: ITB 2024-016

BIDDERS MUST RETURN THIS FORM WHICH WILL BE ADDED TO SUBMITTED PROPOSAL

Please complete this form and return as part of your bid package when it is submitted.

Name of Bidder

1. Subcontractor Name: _____________________________________________________

% of Bid Amount: __________________________________________________________

Description of Work provided: _______________________________________________

2. Subcontractor Name: _____________________________________________________

% of Bid Amount: __________________________________________________________

Description of Work provided: _______________________________________________

3. Subcontractor Name: _____________________________________________________

% of Bid Amount: __________________________________________________________

Description of Work provided: _______________________________________________

4. Subcontractor Name: _____________________________________________________

% of Bid Amount: __________________________________________________________

Description of Work provided: _______________________________________________

Please complete and submit in bid package. Duplicate if needed.

REVISED 10.25.2022

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT AFFIDAVIT

GEORGIA E-Verify and Public Contracts: The Georgia E-Verify law requires contractors and all sub-contractors on Georgia public contract (contracts with a government agency) for the physical performance of services over $2,499 in value to enroll in E-Verify, regardless of the number of employees.

Contractor Name:

Solicitation/Bid number or Project Description:

By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, entity or corporation which is engaged in the physical performance of services under a contract on behalf of the City of Tucker, Georgia has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91.

Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period as required by O.C.G.A. § 13-10-91(b) and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present and affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b). Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization User Identification Number Date of Authorization (EEV/E-Verify Company Identification Number)

Name of Contractor

I hereby declare under penalty of perjury that the foregoing is true and correct

Printed Name (of Authorized Officer or Agent of Contractor) Title (of Authorized Officer or Agent of Contractor)

Signature (of Authorized Officer or Agent) Date Signed

SUBSCRIBED AND SWORN BEFORE ME ON THIS THE

DAY OF , 20

[NOTARY SEAL]

Notary Public

My Commission Expires:

REVISED 10.25.2022

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT AFFIDAVIT

GEORGIA E-Verify and Public Contracts: The Georgia E-Verify law requires contractors and all sub-contractors on Georgia public contract (contracts with a government agency) for the physical performance of services over $2,499 in value to enroll in E-Verify, regardless of the number of employees.

Contractor Name:

Subcontractor’s (Your) Name

Solicitation/Bid number or Project Description:

By executing this affidavit, the undersigned subcontractor verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, entity or corporation which is engaged in the physical performance of services under a contract on behalf of the City of Tucker, Georgia has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91.

Furthermore, the undersigned subcontractor will continue to use the federal work authorization program throughout the contract period as required by O.C.G.A. § 13-10-91(b) and the undersigned subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors who present and affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b). Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization User Identification Number Date of Authorization (EEV/E-Verify Company Identification Number)

Name of Subcontractor

I hereby declare under penalty of perjury that the foregoing is true and correct

Printed Name (of Authorized Officer or Agent of Contractor) Title (of Authorized Officer or Agent of Contractor)

Signature (of Authorized Officer or Agent) Date Signed

SUBSCRIBED AND SWORN BEFORE ME ON THIS THE

DAY OF , 20

[NOTARY SEAL]

Notary Public

BID BOND

KNOW ALL MEN BY THESE PRESENTS, THAT

(Name of Contractor) at

(Address of Contractor)

(Corporation, Partnership and / or Individual) hereinafter called Principal, and

(Name of Surety)

(Address of Surety)

A corporation of the State of __________________ , and a surety authorized by law to do business in the State of Georgia, hereinafter called Surety, are held, and firmly bound unto

(Name of Obligee) City of Tucker Georgia

(Address of Obligee) 1975 Lakeside Parkway, Suite 350, Tucker, Georgia 30084

Hereinafter referred to as Obligee, in the penal sum of Dollars ($_______________) in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents.

WHEREAS, the Principal is about to submit, or has submitted, to the City of Tucker, Georgia, a proposal for furnishing materials, labor, and equipment for:

ITB # 2024-016

PETERS PARK RESTROOM CONSTRUCTION

WHEREAS, the Principal desires to file this Bond in accordance with law in lieu of a certified Bidder’s check otherwise required to accompany this Proposal.

NOW, THEREFORE, the conditions of this obligation are such that if the bid is accepted, the Principal shall within ten days after receipt of notification of the acceptance execute a Contract in accordance with the Bid and upon the terms, conditions, and prices set forth in the form and manner required by the City of Tucker, Georgia, and execute a sufficient and satisfactory Performance Bond and Payment Bond payable to the City of Tucker, Georgia, each in an amount of 100% of the total Contract Price, in form and with security satisfactory to said the City of Tucker, Georgia, and otherwise, to be and remain in full force and virtue in law; and the Surety shall, upon failure of the Principal to comply with any or all of the foregoing requirements within the time specified above, immediately pay to the City of Tucker, Georgia, upon demand, the amount hereof in good and lawful money of the United States of America, not as a penalty, but as liquidated damages.

PROVIDED, FURTHER, that Principal and Surety agree and represent that this bond is executed pursuant, to and in accordance with the applicable provisions of the Official Code of Georgia Annotated, as Amended, including, but not limited to, O.C.G.A. § 13-10-20, et. Seg. And § 36- 91-50, et.

Seg. and is intended to be and shall be constructed as a bond in compliance with the requirements thereof.

Signed, sealed, and dated this _________day of _______________________A.D., 20____.

ATTEST:

(Principal Secretary) (Principal)

(SEAL) BY:

(Witness to Principal) (Address)

(Address) (Surety)

ATTEST:

BY:

(Attorney-in-Fact) and Resident Agent

(Attorney-in-Fact)

(SEAL)

(Address)

(Witness as to Surety)

Contact Information Form

Please fill out this form with the appropriate contact information for your company.

Full Legal Name of Company:

Date:

Contractor Information:

Primary Contact Person:

Title: Telephone Number:

E-mail Address:

Secondary Contact Person:

Title: Telephone Number:

E-mail Address:

Preferred Contact for Administration: (i.e. Document Processing) (Choose one)

☐ Primary Contact ☐ Secondary Contact

Address:

City / State / Zip:

Mailing Address (If different than above):

City / State / Zip:

Federal Employee ID Number (FEIN):

REFERENCES FORM: ITB 2024-016

BIDDERS MUST RETURN THIS FORM WHICH WILL BE ADDED TO SUBMITTED

PROPOSAL

Please complete this form and return as part of your bid package when it is submitted.

Name of Bidder

REFERENCE #1

Contact Name: ___________________________________________________________

Contact Number: __________________________________________________________

Brief Description of work provided:___________________________________________

REFERENCE #2

Contact Name: ___________________________________________________________

Contact Number: __________________________________________________________

Brief Description of work provided:___________________________________________

REFERENCE #3

Contact Name: ___________________________________________________________

Contact Number: __________________________________________________________

Brief Description of work provided:___________________________________________

Please complete and submit in bid package

OATH OF NON-COLLUSION

COMES NOW, ______________________________________________ (“Contractor”), [name of Contractor] appearing by and through _______________________________________________________, [name of individual with authority to bind Contractor] its _____________________________________ (“Individual And Representative Affiant”), and [title]

[insert the names of all those required to give the oath]

(collectively, “Individual Affiants”), and each of the Individual And Representative Affiant and

Individual Affiants, after first being duly sworn, deposes and says that:

1. Contractor has not directly or indirectly violated subsection (d) of the Official Code of

Georgia Annotated Section 36-91-21, which provides as follows:

Whenever a public works construction contract for any governmental entity subject to the requirements of this chapter is to be let out by competitive sealed bid or proposal, no person, by himself or herself or otherwise, shall prevent or attempt to prevent competition in such bidding or proposals by any means whatever. No person who desires to procure such work for himself or herself or for another shall prevent or endeavor to prevent anyone from making a bid or proposal therefor by any means whatever, nor shall such person so desiring the work cause or induce another to withdraw a bid or proposal for the work.

Code Section 36-91-21(d) also applies to municipal street system contracts pursuant to

Official Code of Georgia Annotated Section 32-4-122.

2. Individual And Representative Affiant is the officer of Contractor whose duty it is to make the payment.

3. If Contractor is a partnership, then Individual and Representative Affiant and Individual

Affiants together constitute all of the partners and any officer, agent or other person who may have represented or acted for Contractor in bidding for or procuring the contract.

4. If Contractor is a corporation, then Individual and Representative Affiant and Individual

Affiants together constitute all officers, agents, or other persons who may have acted for or represented Contractor in bidding for or procuring the contract.

Further affiants sayeth not.

This ____ day of ________________, 20___.

By: _________________________________________, individually and on behalf of Contractor [signature of Individual And Representative Affiant]

Name: _____________________________ Title: ______________________________

Individual Affiants’ signatures and names:

Name: Name:

Name: Name:

Name: Name:

Subscribed and Sworn before me on this ______ day of ________________, 20_____.

NOTARY PUBLIC