Morris Field Bridge Replacement.pdf

GENERAL SERVICES

PROJECT MANUAL

FOR

Morris Field Bridge Replacement

PROJECT NUMBER: PM51215035

TIP NUMBER: B-5931

NCDOT WBS NUMBER: 50152.1.1, 50152.2.1, and 50152.3.1

FEDERAL AID NUMBER: BRSTP-1003(146)

BID NUMBER:

269-2027-007

CITY OF CHARLOTTE, NORTH CAROLINA

ADVERTISEMENT DATE: July 8, 2026

2024 NCDOT STANDARD SPECIFICATIONS

v.9-12-2024 (Bonfire Version)

Project #: PM51215035 Division 00 - Procurement & Contracting Requirements Project Name: Morris Field Bridge Replacement

INTRODUCTION 00 01 00 - 1

PROFESSIONAL ENGINEER SEAL

(Project Special Provisions Prepared for the City of Charlotte, General Services, 600 East Fourth Street, Charlotte, North Carolina 28202):

Docusign Envelope ID: A74BE87E-088B-8922-8026-998484356AED

7/7/2026

INTRODUCTION 00 01 00 - 2

TABLE OF CONTENTS

DIVISION 00 - PROCUREMENT AND CONTRACTING REQUIREMENTS

00 10 00 – INVITATION TO BID

00 20 00 – INSTRUCTIONS TO BIDDERS

ARTICLE 1: DEFINITIONS

ARTICLE 2: BIDDER’S REPRESENTATIONS

ARTICLE 3: BIDDING PROCEDURES

ARTICLE 4: BID AWARDS AND REJECTIONS

ARTICLE 5: POST-AWARD

00 40 00 – BID FORMS AND SUPPLEMENTS

ITEMIZED BID

ACKNOWLEDGMENT OF ADDENDA

CERTIFICATION OF BUY AMERICA (DOMESTIC STEEL & IRON)

CERTIFICATION FOR FEDERAL-AID CONTRACTS (NCDOT, SP1 G85)

COMMERCIAL NON-DISCRIMINATION CERTIFICATION

CONFLICT OF INTEREST

NON-COLLUSION, DEBARMENT AND GIFT BAN CERTIFICATION

CERTIFICATION OF DEBARMENT

BID BOND

00 45 00 – EXECUTION OF CONTRACT (POST BID REQUIREMENT)

00 50 00 – ACCEPTANCE BY THE CITY

00 60 00 – PROJECT FORMS

00 70 00 – STANDARD SPECIAL PROVISIONS

ARTICLE 1: NCDOT STANDARD SPECIFICATIONS

1.1 NCDOT Standard Specifications

1.2 NCDOT Standard Notes (Federal Aid)

1.3 SP1 G04 Haul Roads

1.4 SP1 G05 Build America, Buy America (BABA)

1.5 SP1 G63 Disadvantaged Business Enterprise (Local Government Agencies)

1.6 SP1 G90 Restrictions On ITS Equipment And Services

1.7 SP1 G92 Use Of Unmanned Aircraft System (UAS)

1.8 SP1 G96 Equipment Idling Guidelines

1.9 SP1 G100 U.S. Department Of Transportation Hotline

1.10 SP1 G112B Subsurface Information

1.11 SP1 G133 Cooperation Between Contractors

1.12 SP1 G146 Twelve Month Guarantee – LGA Projects

1.13 SP1 G179 Erosion and Sediment Control/Stormwater Certification (LGA)

1.14 SP1 G181 Procedure for Monitoring Borrow Pit Discharge

1.15 SP2 R02A Clearing and Grubbing - Method II

INTRODUCTION 00 01 00 - 3

1.16 SP2 R05 Burning Restrictions

1.17 SP2 R45A Shoulder and Fill Slope Material

1.18 SP6 R45 Final Surface Testing Not Required

1.19 SP8 R52A Detectable Warning Surface at Curb Ramps

1.20 SP8 R97R Adjustment Of Manholes, Meter Boxes, And Valve Boxes

1.21 SP11 R04 Work Zone Installer

1.22 SP12 R04 Pavement Markings:

1.23 SP10 R91 ELECTRICAL JUNCTION BOXES:

1.24 SP16 R01 Wattle Devices

1.25 Z-2 Availability of Funds – Termination of Contracts

1.26 Z-3 NCDOT General Seed Specification for Seed Quality

1.27 Z-4 Errata

1.28 Z-4a Plant and Pest Quarantines

1.29 Z-6 Title VI And Nondiscrimination

1.30 Z-7 Minority and Female Employment Requirements

1.31 Z-8 FHWA 1273 Required Contract Provisions Federal - Aid Construction Contracts

1.32 Z-10 On The Job Training

1.33 Z-88 Minimum Wages

1.34 Z-200 Greenways and Multi-Use Paths

ARTICLE 2: CITY STANDARD PROVISIONS

2.1 Curb and Gutter Tapers and Transitions

2.2 Pipe Culverts

2.3 Existing Utilities

2.4 CDOT Street Maintenance Division Street Cut Regulations

2.5 Concrete

2.6 Reclamation of Waste or Borrow Sources

2.7 Hazardous Materials

2.8 Sedimentation Pollution Control Act

2.9 Construction Stakes, Lines, and Grades

2.10 Maintenance of the Project

2.11 Storage of Materials and Equipment

2.12 Quantity Tickets

2.13 Periodic Payments

2.14 Final Payment

2.15 Payment Reporting

2.16 Sales and Use Tax

2.17 Commercial Non-Discrimination Policy

2.18 E-Verify

2.19 Indemnification

2.20 Guarantee

2.21 Insurance Requirements

2.22 Holiday Work Restrictions

2.23 Drainage Structures

2.24 Termination

2.25 Dispute Resolution

2.26 Surface Water Quality Protection

2.27 Prohibition of Use of High PAH Pavement Products

2.28 Billing Records

2.29 Energy Efficiency

2.30 No Government Obligation to Third Parties

2.31 Record Retention

INTRODUCTION 00 01 00 - 4

2.32 Procurement of Recovered Materials

2.33 DHS Seal, Logo and Flags

00 75 00 – PROJECT SPECIAL PROVISIONS

ARTICLE 1: GENERAL REQUIREMENTS

1.1 Contract Time and Liquidated Damages

1.2 Intermediate Contract Time (ICT) # 1 and Liquidated Damages

1.3 Intermediate Contract Time (ICT) # 2 and Liquidated Damages

1.4 Permanent Vegetation Establishment

1.5 Price Adjustments – Asphalt Cement for Plant Mix

1.6 Bituminous Plant Mix Pavements - Recycled

1.7 Minimize Removal of Vegetation

1.8 Stabilization Requirements

1.9 Temporary Seeding

1.10 Fertilizer Topdressing

1.11 Supplemental Seeding

1.12 Mowing

1.13 Construction Materials Management

1.14 Waste and Borrow Sources

1.15 Maintenance and Protection of Traffic Beneath Proposed Structure at Station 16+28.39 -L-

1.16 Thermal Sprayed Coatings (Metallization)

1.17 Falsework and Formwork

1.18 Submittal of Working Drawings

1.19 Crane Safety

1.20 Grout for Structures

1.21 FAA Notice of Proposed Construction:

1.22 Note To Contractor:

1.23 FAA Requirements:

1.24 Special Provisions for Protection of Railway Interest (SPECIAL)

1.25 Railroad Site Data (SPECIAL)

ARTICLE 2: SPECIAL PROVISIONS (SP)

SP-01R 6” CONCRETE WHEELCHAIR RAMPS

SP-02A, VINYL COATED CHAIN LINK FENCE, 72" FABRIC

SP-02B, CHAIN LINK FENCING WITH BARBED WIRE ON EXTENSION ARMS

SP-03 SAFETY RAIL, METAL CLDS 50.04

SP-04, GREEN THERMOPLASTIC

SP-05, ELECTRICAL CONDUIT SYSTEMS

SP-06, SAFETY FENCE AND JURISDICTIONAL FLAGGING

SP-07, CONCRETE WASHOUT STRUCTURE

SP-08, RAIL ROAD FLAGGING

SP-09, WEIR PLATE WITH ORIFICE AND TRASH RACK

SP-10, ASBESTOS ASSESSMENT

SP-11, MODIFIED 74" PRESTRESSED CONCRETE GIRDERS

SP-12, CLASSIC CONCRETE BARRIER RAIL

SP-13, ORNAMENTAL FENCE

SP-14, MECHANICALLY STABILIZED EARTH RETAINING WALLS

SP-15, SOIL NAIL RETAINING WALLS

SP-16, BRIDGE APPROACH FILLS

ARTICLE 3: CHARLOTTE WATER SPECIAL PROVISIONS

WATER AND SEWER UTILITIES CONSTRUCTION

ARTICLE 4: REAL ESTATE SPECIAL PROVISIONS

INTRODUCTION 00 01 00 - 5

ARTICLE 5: APPENDIX E – NORFOLK SOUTHERN – SPECIAL PROVISIONS FOR PROTECTION OF RAILWAY INTERESTS

ARTICLE 6: NORFOLK SOUTHERN LICENSING AGREEMENT

00 90 00 – ADDENDA

INTRODUCTION 00 01 00 - 6

LIST OF PLANS

INVITATION TO BID 00 10 00 - 1

00 10 00 – INVITATION TO BID

The City of Charlotte (hereinafter the “City”) will receive sealed bids for the following Project:

PROJECT NAME: Morris Field Bridge Replacement

PROJECT NUMBER: PM51215035

PRE-BID DATE: July 16, 2026

PRE-BID TIME: 11:00 AM

PRE-BID LOCATION: In-Person Meeting Only

Meeting Location:

Charlotte Mecklenburg Government Center

600 East 4th Street, Room: 270/271 Charlotte, NC 28202

The Pre-Bid meeting is not mandatory, but attendance is strongly encouraged.

BID DUE DATE: August 5, 2026 BID DUE TIME: Before 1:00 PM

BID SUBMISSION LOCATION: Bids must be submitted electronically through the Procurement

Portal (https://charlottenc.bonfirehub.com)

BID OPENING DATE: August 5, 2026

BID OPENING TIME: 1:00 PM

BID OPENING LOCATION: Microsoft Team Meeting Only

Join the meeting now Meeting ID: 218 825 492 055 642

Passcode: yb2zG36a Dial in by phone

+1 872-256-4172,,641627296# United States, Chicago Find a local number Phone conference ID: 641 627 296#

NOTICE TO BIDDERS

(As a precautionary measure due to COVID-19), the City will hold all Bid Opening Meetings via conference call or video conference only until further notice.

DESCRIPTION OF WORK:

This project will replace the bridge on Morris Field Drive, between Wilkinson Blvd and Golf Acres Drive, over the Norfolk Southern Railroad, with a single span prestressed concrete girder bridge. This bridge includes concrete rails, decorative fencing, lighting, and associated roadway tie in work.

Bidding documents, which includes a downloadable copy of one (1) Project Manual and one (1) full-size Drawing set, are available for free from the Procurement Portal.

https://teams.microsoft.com/l/meetup-join/19%3ameeting_NDZhNzA5MzUtOGZjMC00ZGZiLWFiNTMtYmNjOTQ0MDdjYmNl%40thread.v2/0?context=%7b%22Tid%22%3a%223392a0ee-6ccb-49c5-94b5-f5e6d8a665d6%22%2c%22Oid%22%3a%2232c03a29-7099-4cfd-8869-d999a4c32a18%22%7d

INVITATION TO BID 00 10 00 - 2

Bidders must be properly licensed within 60 calendar days of the bid opening under North Carolina state law to perform the work.

ALL BIDDERS SHALL COMPLY WITH ALL APPLICABLE LAWS REGULATING THE PRACTICE OF GENERAL CONTRACTING AS CONTAINED IN CHAPTER 87 OF THE GENERAL STATUTES OF NORTH CAROLINA WHICH REQUIRES THE BIDDER TO BE LICENSED BY THE N.C. LICENSING BOARD FOR CONTRACTORS WHEN BIDDING ON ANY NON-FEDERAL AID PROJECT WHERE THE BID IS $40,000 OR MORE, EXCEPT FOR CERTAIN SPECIALTY WORK AS DETERMINED BY THE LICENSING BOARD. BIDDERS SHALL ALSO COMPLY WITH ALL OTHER APPLICABLE LAWS REGULATING THE PRACTICES OF ELECTRICAL, PLUMBING, HEATING AND AIR CONDITIONING AND REFRIGERATION CONTRACTING AS CONTAINED IN CHAPTER 87 OF THE GENERAL STATUTES OF NORTH CAROLINA. NOTWITHSTANDING THESE LIMITATIONS ON BIDDING, THE BIDDER WHO IS AWARDED ANY FEDERAL

- AID FUNDED PROJECT SHALL COMPLY WITH CHAPTER 87 OF THE GENERAL STATUTES OF NORTH CAROLINA

FOR LICENSING REQUIREMENTS WITHIN 60 CALENDAR DAYS OF BID OPENING.

A 5% bid security is required with each bid that equals or exceeds $100,000.

The estimated cost of this Project is between $5,000,000 and $10,000,000.

For information regarding this Invitation to Bid, contact as follow:

Haley Lay, Contracts Administrator 600 East Fourth Street, Charlotte, NC 28202 Direct Phone: (980) 395-2613 Email: Haley.Lay@charlottenc.gov

Please submit questions or inquiries at least seven (7) calendar days before the Bid Due Date. Questions or inquiries past this deadline may not be addressed by the City prior to the Bid Due Date. Questions or inquiries should be submitted in writing through the Vendor Discussions section of the Procurement Portal (https://charlottenc.bonfirehub.com).

SUBSTITUTION DURING BID PHASE

The intent of these bid documents is to comport with North Carolina General Statute 133-3 in all instances. Refer to the Substitution Request Form found on the Procurement Portal.

Substitution requests will be accepted via e-mail requests per the following instructions:

The subject line must identify:

o The fact that it is a substitution request, o The name of the project, and o The specification section number for the product;

All materials shall be in PDF format;

Manufacturer’s model number, and other pertinent identification (including the manufacturer’s name address and phone number);

Attest that the alternate material is in compliance with all specification requirements;

A line by line comparison of the substituted product compared with the specified products shall be included with the product information; and Data to support the justification for the substitution.

Equivalent submittals shall specify manufacturer’s model number, and other pertinent identification, and attest that the alternate material is in compliance with all specification requirements.

INVITATION TO BID 00 10 00 - 3

All requests must be submitted no later than fifteen (15) full calendar days, as stated herein or as amended by addendum, prior to the day that bids are due. Requests received after this deadline will not be addressed by the engineer. Submit requests to the following:

Jim Beck DRMP, Inc.

4235 South Stream Boulevard, Suite 150 Charlotte, North Carolina 28217 Main Phone: 704.332.2289 Email: jbeck@drmp.com

The City of Charlotte reserves the right to reject any and all bids and to waive any informalities or technicalities as it may deem to be in its best interest.

The contract entered into by and between the successful Bidder and the City will be subject to the requirements of a financial assistance contract between the City and the U.S. Department of Transportation. The Contractor, and his Subcontractors performing Work will be required to comply with federal statutes and regulations including but not limited to: 49 CFR Part 29; the Occupational Safety and Health Standards and the Safety and Health Regulations for Construction, 29 CFR Parts 1910 and 1926; the Davis-Bacon Act; the Anti-Kickback Act; the Contract Work Hours Standards; and the President’s Executive Orders No. 11246 and No. 11375.

There is NO goal for participation by Disadvantaged Business Enterprises for this contract.

INSTRUCTIONS TO BIDDERS 00 20 00 - 1

00 20 00 – INSTRUCTIONS TO BIDDERS

ARTICLE 1: DEFINITIONS

Whenever the following terms are used in the NCDOT Standard Specifications, in any of the Contract Documents, or in the plans, the intended meaning of such terms shall be as follows:

1) “Chief Engineer”, or “State Highway Administrator” shall mean the “City Engineer”

2) “Alternate” or “Alternate Bid” shall mean the amount stated in the Bid which may be added to or subtracted from the Base Bid amount if such Alternate(s) are accepted by the City.

3) “Total Amount Bid” or “Total Base Bid” shall mean the correct sum total obtained by adding together the amounts bid for every item in the proposal including contingencies or allowances, but excluding Alternates.

4) “Board of Transportation” shall mean “City Council”

5) “City” shall mean the “City of Charlotte, North Carolina”; the City is the Project Owner

6) “City Engineer” shall mean the “Head of the City of Charlotte Engineering and Project Management

Division”.

7) “City Standard” shall mean the latest edition of the applicable “Charlotte Land Development Standards

Manual (CLDSM)”, “Charlotte-Mecklenburg Storm Drainage Design Manual”, “Charlotte Mecklenburg BMP Design Manual” and “Charlotte-Mecklenburg Utility Department Policies, Procedures, Standards and Specifications”

8) “Construction Manager”, “Engineer”, “Division Engineer” or “Resident Engineer” shall mean the City Engineer’s duly authorized Construction Manager to oversee the construction of the project

9) “Contract” shall mean the reciprocal undertakings, obligations, and rights of the City and the Contractor evidenced by the executed agreement and other Contract Documents between the City and the Contractor, covering the performance of and compensation of the Work.

10) “Contract Amount”, “Total Contract Amount” or “Contract Sum” shall mean the Total Base Bid plus Alternates accepted by the City.

11) “Contract Documents” shall consist of the Project Manual, all forms from Section 00 40 00, Bonds and Certificate of Insurance, Acceptance by the City, and any change orders issued after execution of the contract.

12) “Date of Availability” shall mean “Notice to Proceed Date”

13) “Department”, “Department of Transportation”, “Division of Highways”, and “Raleigh Central Office” shall all mean “City of Charlotte General Services”.

14) “Procurement Portal” shall mean the electronic portal where Bids will be digitally submitted. The portal can be accessed at https://charlottenc.bonfirehub.com.

15) “Project Manual” shall mean the complete set of bidding documents issued by the City of Charlotte

General Services to include the Invitation to Bid, Instructions to Bidders, Bid Forms, sample project forms, conditions and special provisions of the contract, addenda issued prior to the execution of the contract, and drawings.

16) “State” shall mean “City of Charlotte”

17) “State Contract Officer” shall mean “Contract Officer”

18) “Supplemental Agreements” shall mean “Change Orders”

INSTRUCTIONS TO BIDDERS 00 20 00 - 2

ARTICLE 2: BIDDER’S REPRESENTATIONS

2.1 Contractor’s Licenses

Bidders shall be properly licensed under North Carolina state law to perform the Work specified in the Bidding Documents and per SECTION 102-14 of the NCDOT Standard Specifications. Bidder has 60 days after the bid opening to obtain licensure per SECTION 102-14(B). Bids received from bidders not meeting the applicable Contractors’ licensure requirements as required by law and as determined by the Engineer’s estimate may be considered non-responsive and may not be considered for award.

2.2 Bidder Qualifications

Any firm that wishes to bid as a prime contractor shall be prequalified with NCDOT as a Bidder prior to submitting a bid. Information regarding prequalification can be found at:

https://connect.ncdot.gov/business/Prequal/Pages/default.aspx

Failure to obtain NCDOT pre-qualification before the Bid opening date will be ground for Bid rejection. All proposed subcontractors must be pre-qualified before being allowed to begin work.

2.3 Site Investigation and Conditions Affecting the Work

By submitting a bid, Bidders certify to have carefully examined the Project site and familiarized themselves with the existing conditions on the Project, affecting the cost and execution of the work as described in Section 102-6 of NCDOT Standard Specifications.

ARTICLE 3: BIDDING PROCEDURES

3.1 Electronic Bids

All bids shall be prepared and submitted in accordance with the following requirements. Failure to comply with any of the requirement may cause the bid to be considered irregular and may be grounds for bid rejection.

1) Obtain an account on the Procurement Portal ‘Bonfire’ to bid electronically at https://charlottenc.bonfirehub.com.

2) Download and read carefully the Project Manual, Plans, and other supplemental documents related to this project from the Procurement Portal.

3) Download electronic bid submittal forms from the Procurement Portal. Bid submittal forms includes 1) Itemized Bid Form, 2) Acknowledgement of Addenda Form, 3) Listing of DBE Subcontractor Form, 4) Certification of Buy America (domestic Steel & Iron) Form, 5) Certification for Federal-Aid Contracts Form,

6) Certification of Debarment Form, 7) Commercial Non-Discrimination Certification Form, 8) Conflict of Interest Form, 9) Non-Collusion, Debarment and Gift Ban Certification (Execution of Bid Form), and 10) Bid Bond Form. Each form must be completed in its entirety. Upon completion, bidders shall upload them back on the Procurement Portal as part of the bid submittal. Failure to complete and submit the required forms may be grounds for bid rejection.

4) Itemized bid form in Microsoft Excel format must be completed in its entirety. Bidders shall enter a unit price for each line item requiring a bid amount. The electronic version of the Itemized Bid Form will contain formulas to calculate the extensions, percentages and totals which shall not be altered by the bidders.

5) The bid shall be accompanied by a bid bond or bid deposit when applicable. The bid bond shall be prepared in accordance with Article 3.3 Bid Security of this section. Bidder shall use the Bid Bond form provided with the Project Manual.

6) Addenda will be published on the Procurement Portal. Bidders shall be responsible for inquiring if any addendum has been issued and shall acknowledge receipt of all addenda on the Acknowledgement of Addenda” Form. All addenda shall become part of the Contract Documents whether or not received or acknowledged by the Bidder.

INSTRUCTIONS TO BIDDERS 00 20 00 - 3

7) All bids shall be submitted with an electronically affixed digital signature. Affixing a digital ID to the bid shall be equivalent of signing before a notary public. If the bidder does not have such digital ID, a wet signature will be acceptable when it is notarized on the bid form.

8) On the day of the bid opening, bids will be opened and read publicly at the time mentioned on the Invitation to Bid.

3.2 The Project Manual

The Project Manual is the bidding document and shall not be altered.

3.3 Bid Security

A five-percent (5%) bid security is required with each bid that equals or exceeds $100,000. Bid Bond or Bid Deposit, made payable to the City of Charlotte, must be provided in accordance with Section 102-10 of NCDOT Standard Specifications.

3.3.1 Electronic Execution of Statutorily-Required Bid Bond

Traditionally, the City has required bonds to be submitted as hard copies with wet signatures. Until further notice, the City will also accept electronically executed bid bonds to satisfy the requirements of N.C.G.S. 143-129(b). In order for electronically executed bid bonds to be valid, a principal and N.C. licensed surety must agree to transact by electronic means. Additionally, the City requires the bidder and surety to use digital signatures that have the following characteristics: (a) each signature is unique to the person using it; (b) the signatures are capable of certification; and (c) each signature is under sole control of the person using it. The notary requirement is waived for bid bonds that are signed electronically.

The bid bond must meet all other statutory criteria for bid bonds and must be submitted in compliance with the Instruction to Bidders. The City reserves the right to reject bid bonds that do not meet the above criteria.

3.4 Sales and Use Tax

Refer to Section 00 70 00 of this Project Manual for additional information on sales and use tax. The City reserves the right to request from the bidder after bid opening the estimated amount of total Eligible Taxes that were used to calculate the Bid and any supporting documentation of such. The Bidder, in submitting the Bid for consideration, agrees to provide any such sales or use tax estimates or documentation that may be requested by the City.

ARTICLE 4: BID AWARDS AND REJECTIONS

4.1 Bid Opening

Bid Opening will be conducted in accordance with Section 102-13 of NCDOT Standard Specifications.

4.2 Rejection of Bids and Disqualification of Bidders

Rejection of Bids and Disqualification of Bidders will be provided in accordance with Sections 102-14 and 102-15 respectively of NCDOT Standard Specifications.

4.3 Award and Execution of Contract

Award and execution of Contract will be in accordance with Section 103 of NCDOT Standard Specifications.

The City will award the contract or contracts conditioned upon funds being available for construction and other governmental approvals as may be required.

The City reserves the right to accept Alternates in any order or combination. The City further reserves the right to determine the low bidder on the basis of the Total Base Bid.

ARTICLE 5: POST-AWARD

5.1 Bonds and Insurance

INSTRUCTIONS TO BIDDERS 00 20 00 - 4

For bids equal to or greater than $100,000, the successful bidder shall provide the City with performance and payment bonds each in the amount equal to one hundred percent (100%) of the contract amount. Bonds shall be submitted to the City upon ten (10) calendar days of award of the Contract and shall be in conformance with NC GS 44A-33. Failure to provide acceptable bonds within ten (10) calendar days of award of the Contract shall be just cause for forfeiture of the bid bond or bid deposit and rescinding the award of the Contract. Award may then be made to the next lowest responsive, responsible bidder or the Project may be re-advertised at the City’s sole discretion.

The Contractor shall submit to the City within ten (10) calendar days of recommendation of award of the Contract a certificate of insurance in the minimum amounts required in the Contract Documents.

5.1.1 Electronic Execution of Statutorily-Required Performance and Payment Bonds Traditionally, the City has required bonds to be submitted as hard copies with wet signatures. Until further notice, the City will also accept electronically executed performance and payment bonds to meet the requirements of N.C.G.S. 143-129(c) and Article 3 of Chapter 44A of the General Statutes. In order for electronically executed bonds to be valid, a principal and N.C. licensed surety must agree to transact by electronic means. Additionally, the City requires the bidder and surety to use digital signatures that have the following characteristics: (a) each signature is unique to the person using it; (b) the signatures are capable of certification; (c) each signature is under sole control of the person using it; and (d) each signature is linked to document in such a manner that if the text of the document is changed, the electronic signature is invalidated. The notary requirement is waived for payment and performance bonds that are signed electronically and electronically submitted.

Per N.C.G.S. 44A-33, bonds are still required to be submitted to the City upon ten (10) calendar days of award of the Contract.

The bonds must meet all other statutory criteria for payment and performance bonds and must be submitted in compliance with the Instruction to Bidders. The City reserves the right to reject payment and performance bonds that do not meet the above criteria.

5.2 Pre-Construction Conference

A pre-construction conference will be scheduled as soon as practical after award of the Contract. The Contractor shall attend the pre-construction conference with the prospective project superintendent, any anticipated major subcontractors and major suppliers. A proposed progress schedule in a form satisfactory to the Construction Manager and a statement of the anticipated monthly progress payments showing the percent of progress each month shall be submitted by the Contractor to the City. The Contractor shall also provide at least two (2) local telephone numbers that may be used to contact the Contractor or the Contractor’s authorized representative in the event of an emergency after normal business hours. The Contractor shall also provide the name of the Contractor’s on-site representative who is OSHA certified for trenching, shoring, and confined space entry.

5.3 Notice to Proceed

The City will issue a Notice to Proceed (NTP) to the Contractor upon award and execution of the contract. The Contractor shall not perform any Work prior to the date on which the NTP commences. The City reserves the right to issue an Administrative Notice to Proceed authorizing the Contractor to place orders for products requiring long lead times, or to obtain certain permits prior to beginning any Work. If an Administrative Notice to Proceed is issued, the Contractor shall not perform any Work prior to the date on which the Notice to Proceed commences.

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 1

00 40 00 – BID FORMS AND SUPPLEMENTS

Bidder shall download individual BID FORMS posted on the Procurement Portal at https://charlottenc.bonfirehub.com

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 2

ITEMIZED BID

Bidder Name:

Project #: PM51215035

SECTION 1: BID

Item # Section # Description Qty Unit Unit Price ($) Amount Bid ($)

(Qty x Unit Price)

1 800 Mobilization 1 LS

2 SP-10 Asbestos Assessment 1 LS

3 200 Supplementary Clearing and Grubbing 1 AC

4 225 Undercut Excavation 400 CY

5 226 Grading 1 LS

6 265 Select Granular Material 200 CY

7 270 Geotextile for Soil Stabilization 200 SY

8 300 Foundation Conditioning Material, Minor Structures

105 TN

9 300 Foundation Conditioning Geotextile 398 SY

10 310 15" R.C. Pipe Culverts, Class III 88 LF

11 310 36" R.C. Pipe Culverts, Class III 40 LF

12 310 42" R.C. Pipe Culverts, Class III 40 LF

13 310 36" R.C. Pipe Culverts, Class IV 128 LF

14 310 42" R.C. Pipe Culverts, Class IV 184 LF

15 402 Removal of Existing Structure Sta.

16+28.39 -L-

1 LS

16 412 Unclassified Structure Excavation Sta.

17 420 Class A Concrete 67.2 CY

18 420 Grooving Bridge Floors 7228 SF

19 420 Reinforced Concrete Deck Slab 7895 SF

20 422 Bridge Approach Slabs Sta. 16+28.39 -L- 1 LS

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 3

(Qty x Unit Price)

21 425 Reinforcing Steel 10796 LB

22 430 Elastomeric Bearings 1 LS

23 450 PDA Testing 1 EA

24 450 Steel Pile Points 22 EA

25 505 Shallow Undercut 100 CY

26 505 Class IV Subgrade Stabilization 100 TN

27 SP-14 MSE Retaining Walls No. 1 and 2 3220 SF

28 SP-15 Soil Nail Retaining Walls 4810 SF

29 SP-15 Soil Nail Verification Tests 4 EA

30 SP-15 Soil Nail Proof Tests 14 EA

31 607 Incidental Milling 100 SY

32 607 Milling Asphalt Pavement, 0.0" to 1.5" 1110 SY

33 610 Asphalt Concrete Base Course, Type B 25.0C

450 TN

34 610 Asphalt Concrete Intermediate Course, Type I 19.0C

350 TN

35 610 Asphalt Concrete Surface Course, Type S 9.5B

1000 TN

36 620 Asphalt Binder for Plant Mix 100 TN

37 801 Construction Surveying 1 LS

38 815 6" Perforated Subdrain Pipe 200 LF

39 840 Masonry Drainage Structures 6 EA

40 840 Masonry Drainage Structures 22 LF

41 840 Frame with Grate & Hood, Std 840.03, Type F

2 EA

42 840 Frame with Grate & Hood, Std 840.03, Type G

4 EA

43 846 2' 6" Concrete Curb and Gutter 1200 LF

44 848 4 " Concrete Sidewalk or pad 750 SY

45 SP-01 6" Concrete Wheelchair Ramps 20 SY

46 862 Steel Beam Guardrail 325 LF

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 4

47 862 Guardrail End Units, Type 350, TL-2 4 EA

48 862 Guardrail Anchor Units, Type III 4 EA

49 863 Remove Existing Guardrail 512 LF

50 SP-02A Vinyl Coated Chain Link Fence, 72" Fabric 300 LF

51 SP-02A

Temporary Vinyl Coated Chain Link Fence, 72" Fabric 255 LF

52 SP-03 Safety Rail, Metal CLDS 50.04 230 LF

53 876 Geotextile for Drainage 220 SY

54 901 Contractor Furnished, Type E Sign 36 SF

55 903 Supports, 3-lb (4.5 kg) Steel U-Channel 105 LF

56 904 Sign Erection, Type E 10 EA

57 907 Disposal of Sign System, U-Channel 5 EA

58 907 Disposal of Sign, D, E or F 1 EA

59 1110 Work Zones Signs (Barricade Mounted) 120 SF

60 1110 Work Zones Signs (Stationary) 400 SF

61 1120 Portable Changeable Message Sign 2 EA

62 1130 Drums 10 EA

63 1145 Barricades (Type III) 125 LF

64 1205 Cold-Applied Plastic Pavement Marking Lines, 4" Solid Lines, Type 3

358 LF

65 1205 Cold Applied Plastic Pavement Marking Lines, 6" Lines, Type 3

742 LF

66 1205 Thermoplastic Pavement Marking Lines, 4", 90 mils

3055 LF

67 1205

6", 90 mils

1427 LF

68 1205

8", 90 mils

1082 LF

69 1205

24", 90 mils

83 LF

70 1205 Thermoplastic Pavement Marking Symbols, 90 mils

7 EA

71 1205 Heated-In-Place Thermoplastic Pavement Marking Symbols, 90 mils

15 EA

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 5

72 SP-04 Green Thermoplastic (90 mils) 1100 SF

73 1605 Temporary Silt Fence 2145 LF

74 1610 Erosion Control Stone, Class A 70 TN

75 1610 Erosion Control Stone, Class B 135 TN

76 1610 Sediment Control Stone 120 TN

77 1615 Temporary Mulching 3 AC

78 1620 Fertilizer For Temporary Seeding 1 TN

79 1620 Seed For Temporary Seeding 200 LB

80 1622 Temporary Slope Drains 200 LF

81 1630 Silt Excavation 180 CY

82 1631 Matting for Erosion Control 9810 SY

83 1632 1/4" Hardware Cloth 425 LF

84 1642 Flocculant 15 LB

85 1640 Coir Fiber Baffles 25 LF

86 1660 Seeding and Mulching 3 AC

87 1660 Mowing 3 AC

88 1661 Fertilizer for Repair Seeding 1 TN

89 1661 Seed for Repair Seeding 50 LB

90 1662 Seed for Supplemental Seeding 75 LB

91 1665 Fertilizer Topdressing 2 TN

92 1667 Specialized Hand Mowing 10 MH

93 1642 Coir Fiber Wattles 70 LF

94 SP-06 Safety Fence 200 LF

95 SP-07 Concrete Washout Structure 1 EA

96 1675 Response for Erosion Control 19 EA

97 SP-09

Weir Plate with Orifice and Trash Rack

(ATTACHED TO STANDARD STRUCTURE

840.02)

2 EA

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 6

(Qty x Unit Price)

98 SP-05

Electrical Conduit System at Station 16+28.39

99 SP-05

Electrical Conduit System for Signals at Station 16+28.39

100 1510 4" Water Line 130 LF

101 1510 8" Water Line 135 LF

102 1510 12" Water Line 750 LF

103 1510 Ductile Iron Water Pipe Fittings 2140 LB

104 1515 8" Valve 1 EA

105 1515 12" Valve 2 EA

106 1515 Water Service Line 130 LF

107 1515 1" Air Release Valve 1 EA

108 1515 Relocate Water Meter 1 EA

109 1515 Relocate Fire Hydrant 1 EA

110 1515 Fire Hydrant Leg 17 LF

111 1530 Abandon 4" Utility Pipe 71 LF

112 1530 Abandon 8" Utility Pipe 610 LF

113 1530 Abandon 12" Utility Pipe 152 LF

114 1540 20" Encasement Pipe 220 LF

115 1550 Bore and Jack of 20" 220 LF

116 1515 Relocate 4” Water Meter 1 EA

117 1515 Relocate 8” Water Meter 1 EA

118 SP-11

Modified 74” Prestressed Concrete Girders

950 LF

119 450 HP 14x73 Steel Piles 963 LF

120 SP-12 Classic Concrete Barrier Rail 271 LF

121 SP-13 Ornamental Fence 271 LF

122 SP-08 Rail Road Flagging 150 DY

123 450 Pile Driving Equipment Set Up for HP 14x73 Steel Piles

22 EA

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 7

124 462 4" Slope Protection 40 SY

125 SP-16

Type 2 Bridge Approach Fill, Sta.

126 876 Rip Rap, Class B 2 TN

127 340 Pipe Removal 218 LF

128 SP-07 Prefabricated Concrete Washout 3 EA

Total Bid

Do not include any North Carolina Sales and Use Tax that qualifies as Eligible Taxes per Section 00 70 00, Subsection 2.17 “Sales and Use Tax”.

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 8

ACKNOWLEDGMENT OF ADDENDA

Project #: PM51215035

Project: Morris Field Bridge Replacement

Name of Company (Bidder):

The undersigned acknowledges receipt of the following addenda (initial next to each addendum):

# 1: ______ # 2: _____ # 3: _____ # 4:_____ # 5: _____ #6: _____ # 7: _____ # 8: _____ # 9: _____

By:

Signature of Company’s Authorized Representative

Printed Name:

Title:

Date:

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 9

CERTIFICATION OF BUY AMERICA (DOMESTIC STEEL & IRON)

FOR

COMPLIANCE WITH NCDOT STANDARD SPECIFICATIONS SECTION 106-1(B)

DOMESTIC STEEL AND IRON PRODUCTS (Buy America):

PROJECT NAME: Morris Field Bridge Replacement

The Contractor hereby certifies that it will comply with the requirements of NCDOT Standard Specifications Section 106-1(B).

Signature of Contractor’s Authorized Official

Name:

Printed Name of Contractor’s Authorized Official

Title of Contractor’s Authorized Official

Subscribed and sworn to before me this day of 202___

Signature of Notary Public of County

State of

My Commission Expires:

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 10

CERTIFICATION FOR FEDERAL-AID CONTRACTS (NCDOT, SP1 G85)

(3-21-90) SP1 G85

PROJECT NAME: Morris Field Bridge Replacement

The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that:

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying, in accordance with its instructions.

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

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

Signature of Authorized Official

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 11

COMMERCIAL NON-DISCRIMINATION CERTIFICATION

Project: Morris Field Bridge Replacement

The undersigned Bidder hereby certifies and agrees that the following information is correct:

1. In preparing its Bid, the Bidder has considered all bids submitted from qualified, potential subcontractors and suppliers, and has not engaged in or condoned discrimination, as defined in Section 2 below.

2. For purposes of this form, discrimination means discrimination in the solicitation, selection, or treatment of any subcontractor, vendor, supplier or commercial customer on the basis of a person's race, color, gender, religion, national origin, ethnicity, age, familial status, sex (including sexual orientation, gender identity and gender expression), veteran status, pregnancy, natural hairstyle or disability, or any otherwise unlawful form of discrimination. Without limiting the foregoing, discrimination also includes retaliating against any person or other entity for reporting any incident of discrimination.”

3. Without limiting any other remedies that the City may have for a false certification, it is understood and agreed that, if this certification is false, such false certification will constitute grounds for the City to reject the bid submitted with this certification and terminate any contract awarded based on such bid. It shall also constitute a violation of the City’s Commercial Non-Discrimination Ordinance and shall subject the Bidder to any remedies allowed thereunder, including possible disqualification from participating in City contracts or bid process for up to two years.

4. As a condition of contracting with the City, the Bidder agrees to promptly provide to the City all information and documentation that may be requested by the City from time to time regarding the solicitation and selection of subcontractors in connection with this solicitation process. Failure to maintain or failure to provide such information shall constitute grounds for the City to reject the bid submitted by the Bidder and terminate any contract awarded on such bid. It shall also constitute a violation of the City’s Commercial Non-Discrimination Ordinance and shall subject the Bidder to any remedies allowed thereunder.

5. As part of its bid, the Bidder shall provide to the City a list of all instances within the past ten years where a complaint was filed or pending against the Bidder in a legal or administrative proceeding alleging that the Bidder discriminated against its subcontractors, vendors or suppliers, and a description of the status or resolution of that complaint, including any remedial action taken.

6. As a condition of submitting a bid to the City, the Bidder agrees to comply with the City’s Commercial Non-

Discrimination Policy as described in Section 2, Article V of the Charlotte City Code, and consents to be bound by the award of any arbitration conducted thereunder.

Signature of Company’s Authorized Representative

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 12

CONFLICT OF INTEREST

Except as may be identified and explained below, the undersigned hereby certifies that, no member of the Charlotte City Council, officer, employee, or former employee of the City, AND no relative of persons described above, has an interest whatsoever (regardless of how indirect and how remote that interest may be) in the Bidder’s organization and/or in the proceeds of any contract and/or agreement which might be made between the Bidder and the City as result of the successful bid/proposal accompanied by this certification; no person who is or who during the past twelve (12) months has been a member of the Charlotte City Council, an officer or employee of the City is employed by or on behalf of the Bidder’s organization; and that until acceptance of all work or services to be performed under any resulting contract or agreement, the Bidder shall not enter into any contract involving services or property, whether or not related to the performance of any resulting contract or agreement, with any of the aforementioned persons or with any business in which any such person has an interest, direct or indirect.

Except as identified and explained below and with City’s prior approval the Bidder shall not engage in any activity, or accept any employment, interest or contribution that would create an appearance of a conflict of interest (personal or organizational) or reasonably appear to compromise the Bidder’s judgment with respect to all work or services to be performed under any resulting contract or agreement.

The undersigned certifies that he is legally authorized by the Bidder to make the above representation, and that the representation is true to the best of his knowledge and belief and without deliberate omission of any inquiry which would to the best of his belief tend to change the above representation. The undersigned understands that any representation made knowing it to be false may be cause to disqualify the Bidder from competing for award for the contract at hand, may be cause to terminate the resulting contract and disqualify the Bidder from being awarded future contracts by the City.

The Bidder certifies that neither he nor any agent, representative, or other party acting on his behalf has offered or given any gratuity or gratuities, in the form of gifts, entertainment, or otherwise, to any director, officer, or employee of the City or of any person, firm, consultant or contractor retained by the City, with a view to securing the contract or of securing favorable treatment with respect to the award hereof, and the Bidder further certifies that neither he nor any agent, representative, or other party acting on his behalf will offer or give any such gratuity to any director, officer, or employee of the City or of any such consultant or contractor with a view to securing favorable treatment with respect to any change or amendment to the contract, or to any other action with respect to the performance hereof.

The Bidder further understands that in addition to submitting this certification at the time of bid/proposal submission to the City, the Bidder shall also be required to submit a similar certification at the time of execution of any resulting contract.

NOTE: THIS CERTIFICATION MUST BE SIGNED AND SUBMITTED WITH THE BID/PROPOSAL

Signature:

Title: Date of Signing: _______ Firm or Corporate Name: _______ Address:

Telephone Number:

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 13

Contract No. Rev. 10-31-24 County

NON-COLLUSION, DEBARMENT AND GIFT BAN CERTIFICATION

CORPORATION

The prequalified bidder, declares (or certifies, verifies, or states) under penalty of perjury under the laws of the United States that neither he, nor any official, agent or employee has entered into any agreement, participated in any collusion, or otherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract, that the prequalified bidder has not been convicted of violating N.C.G.S. §133-24 within the last three years, and that the prequalified bidder intends to do the work with his own bona fide employees or subcontractors and will not bid for the benefit of another contractor.

By submitting this non-collusion, debarment and gift ban certification, the prequalified bidder is attesting his status under penalty of perjury under the laws of the United States in accordance with the Debarment Certification attached, provided that the Debarment Certification also includes any required statements concerning exceptions that are applicable.

N.C.G.S. §133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any gift from anyone with a contract with the State, or from any person seeking to do business with the State. By execution of any response in this procurement, you attest, for your entire organization and its employees or agents, that you are not aware that any such gift has been offered, accepted, or promised by any employees of your organization.

SIGNATURE OF PREQUALIFIED BIDDER

Full name of Corporation

Address as Prequalified

Attest By Secretary/Assistant Secretary President/Vice President/Assistant Vice President (Select appropriate title) (Select appropriate title)

Print or Type Signer’s name Print or Type Signer’s name

CORPORATE SEAL

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 14

PARTNERSHIP

The prequalified bidder, declares (or certifies, verifies, or states) under penalty of perjury under the laws of the United States that neither he, nor any official, agent or employee has entered into any agreement, participated in any collusion, or otherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract, that the prequalified bidder has not been convicted of violating N.C.G.S. § 133-24 within the last three years, and that the prequalified bidder intends to do the work with its own bona fide employees or subcontractors and will not bid for the benefit of another contractor.

By submitting this non-collusion, debarment and gift ban certification, the prequalified bidder is attesting his status under penalty of perjury under the laws of the United States in accordance with the Debarment Certification attached, provided that the Debarment Certification also includes any required statements concerning exceptions that are applicable.

N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any gift from anyone with a contract with the State, or from any person seeking to do business with the State. By execution of any response in this procurement, you attest, for your entire organization and its employees or agents, that you are not aware that any such gift has been offered, accepted, or promised by any employees of your organization.

Full Name of Partnership

Signature of Witness Signature of Partner

Print or Type Signer’s Name Print or Type Signer’s Name

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 15

LIMITED LIABILITY COMPANY

The prequalified bidder, declares (or certifies, verifies, or states) under penalty of perjury under the laws of the United States that neither he, nor any official, agent or employee has entered into any agreement, participated in any collusion, or otherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract, that the prequalified bidder has not been convicted of violating N.C.G.S. § 133-24 within the last three years, and that the prequalified bidder intends to do the work with its own bona fide employees or subcontractors and will not bid for the benefit of another contractor.

By submitting this non-collusion, debarment and gift ban certification, the prequalified bidder is attesting his status under penalty of perjury under the laws of the United States in accordance with the Debarment Certification attached, provided that the Debarment Certification also includes any required statements concerning exceptions that are applicable.

N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any gift from anyone with a contract with the State, or from any person seeking to do business with the State. By execution of any response in this procurement, you attest, for your entire organization and its employees or agents, that you are not aware that any such gift has been offered, accepted, or promised by any employees of your organization.

Full Name of Firm

Signature of Witness Signature of Member/Manager/Authorized Agent (Select appropriate Title)

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 16

JOINT VENTURE (2) or (3) The prequalified bidder, declares (or certifies, verifies, or states) under penalty of perjury under the laws of the United States that neither he, nor any official, agent or employee has entered into any agreement, participated in any collusion, or otherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract, that the prequalified bidder has not been convicted of violating N.C.G.S. § 133-24 within the last three years, and that the prequalified bidder intends to do the work with its own bona fide employees or subcontractors and will not bid for the benefit of another contractor.

By submitting this non-collusion, debarment and gift ban certification, the prequalified bidder is attesting his status under penalty of perjury under the laws of the United States in accordance with the Debarment Certification attached, provided that the Debarment Certification also includes any required statements concerning exceptions that are applicable.

N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any gift from anyone with a contract with the State, or from any person seeking to do business with the State. By execution of any response in this procurement, you attest, for your entire organization and its employees or agents, that you are not aware that any such gift has been offered, accepted, or promised by any employees of your organization.

SIGNATURE OF PREQUALIFIED BIDDER

Instructions: 2 Joint Venturers Fill in lines (1), (2) and (3) and execute. 3 Joint Venturers Fill in lines (1), (2), (3) and (4) and execute. On Line (1), fill in the name of the Joint Venture Company. On Line (2), fill in the name of one of the joint venturers and execute below in the appropriate manner. On Line (3), print or type the name of the other joint venturer and execute below in the appropriate manner. On Line (4), fill in the name of the third joint venturer, if applicable and execute below in the appropriate manner.

(1) Name of Joint Venture

(2) Name of Contractor

Address as Prequalified

Signature of Witness or Attest BY Signature of Contractor

Print or Type Signer's Name Print or Type Signer's Name If Corporation, affix Corporate Seal AND

(3) Name of Contractor

Address as Prequalified

Signature of Witness or Attest BY Signature of Contractor

If Corporation, affix Corporate Seal AND

(4)

Address as Prequalified

Signature of Witness or Attest BY Signature of Contractor

If Corporation, affix Corporate Seal

CORPORATE SEAL(S)

BID FORM AND SUPPLEMENTS Initials: _______ 00 40 00 - 17

INDIVIDUAL DOING BUSINESS UNDER A FIRM NAME

The prequalified bidder, declares (or certifies, verifies, or states) under penalty of perjury under the laws of the United States that neither he, nor any official, agent or employee has entered into any agreement, participated in any collusion, or otherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract, that the prequalified bidder has not been convicted of violating N.C.G.S.