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RESPONSE - BID - 5802 ATMS COMMUNICATIONS SYSTEM 2 COLORADO BORING (2)
SECTION 00300 BID FORM PROJECT: COMMUNICATIONS SYSTEM PHASE 2; Bid No. 5802 Place215 N. Mason Street Date st-p ember 29, 2003 1. In compliance with your Invitation to Bid dated Saptemhe�5� 2DD3 and subject to all conditions thereof, the undersigned Tnr rmnun ain F.le- r' Tnr�_ a **(Corporation, Limited Liability Company, Partnership, Joint Venture, or Sole Proprietor)** authorized to do business in the State of Colorado hereby proposes to furnish and do everything required by the Contract Documents to which this refers for the construction of all items listed on the following Bid Schedule or Bid Schedules. 2. The undersigned Bidder does hereby declare and stipulate that this proposal is made in good faith, without collusion or connection with any other person or persons Bidding for the same Work, and that it is made in pursuance of and subject to all the terms and conditions of the Invitation to Bid and Instructions to Bidders, the Agreement, the detailed Specifications, and the Drawings pertaining to the Work to be done, all of which have been examined by the undersigned. 3. Accompanying this Bid is a certified or cashier's check or standard Bid bond in the sum of 5% of the total bid ($ 675,354.00 ) in accordance with the Invitation To Bid and Instructions to Bidders. 4. The undersigned Bidder agrees to execute the Agreement and a Performance Bond and a Payment Bond for the amount of the total of this Bid within fifteen (15) calendar days from the date when the written notice of the award of the contract is delivered to him at the address given on this Bid. The name and address of the corporate surety with which the Bidder proposes to furnish the specified performance and payment bonds is as follows: HRH of Colorado, 720 S Colorado Blvd_ Penthouse T)ansrcr, rn R0246 5. All the various phases of Work enumerated in the Contract Documents with their individual jobs and overhead, whether specifically mentioned, included by implication or appurtenant thereto, are to be performed by the CONTRACTOR under one of the items listed in the Bid Schedule, irrespective of whether it is named in said list. 6. Payment for Work performed will be in accordance with the Bid Schedule or Bid Schedules subject to changes as provided in the Contract Documents. 7. The undersigned Bidder hereby acknowledges receipt of Addenda No. l through 1 7/96 Section 00300 Page 1 ATTACHMENT TO CERTIFICATE OF INSURANCE NO. CERTIFICATE HOLDER: CITY OF FORT COLLINS 071555-01970-2004A-000630 INSURED: INTERMOUNTAIN ELECTRIC, INC. GENERAL LIABILITY POLICY INCLUDES CERTIFICATE HOLDER AS AN ADDITIONAL INSURED WHEN REQUIRED BY WRITTEN CONTRACT BUT ONLY AS RESPECTS LIABILITY ARISING OUT OF NAMED INSURED'S WORK FOR ADDITIONAL INSURED. AUTOMOBILE LIABILITY POLICY INCLUDES CERTIFICATE HOLDER AS AN ADDITIONAL INSURED WHEN REQUIRED BY WRITTEN CONTRACT. SMM/ECB 1/1 Attachment "B" iE WILLIAM D. SALZBRENER PRESIDENT GENERAL EXPERIENCE Mr. Salzbrener joined Intermountain in January 1981 working as a Field Coordinator and Field Engineer on high-rise buildings. He progressed from Coordinator/Engineer to Estimator, Chief Estimator, Project Manager, and Division Manager. He has over 35 years experience in all facets of electrical work ranging from 15 kv. distribution to fiber optics and communication. He possesses a well -respected reputation in the Rocky Mountain area with Owners, Architects, Engineers, and Field personnel. He has successfully been the Project Manager for projects up to $30 Million. Mr. Salzbrener became President of Intermountain Electric in 2001. RELEVANT EXPERIENCE: MILTEN R. YOUNG POWERHOUSE CABALLO LOG HANDLING FACILITY DMA PLAZA RESIDENTIAL MAY D&F — AURORA, SOUTHGLENN, and NORTHGLENN SAKS 5T" AVENUE DENVER ADMINISTRATION & DETENTION FACILITY REGENCY HOTEL DENVER PLACE / STELLAR PLAZA CHERRY CREEK MALL STAPLETON INTERNATIONAL AIRPORT DENVER INTERNATIONAL AIRPORT FT. COLLINS HIGH SCHOOL US WEST — NETWORK RELIABILITY CENTER ICG CORPORATE HEADQUARTERS SWEDISH MEDICAL CENTER THE CHILDREN'S HOSPITAL CRAIG HOSPITAL FITZSIMONS ARMY MEDICAL CENTER — BUILDING 500 ANSCHUTZ CANCER CENTER & CLINICAL ZONE ANSCHUTZ INPATIENT PAVILION Intermountain Electric, Inc. Attachment 'B" iE EARNEST L. BROWN EXECUTIVE VICE-PRESIDENT GENERAL EXPERIENCE: Mr. Brown has been Executive Vice -President since 2001. He has years of experience in all phases of electrical construction including commercial, industrial and government projects. His experience includes strong background in project estimating, project management, project cost controls, scheduling, purchasing, project engineering and marketing; excellent administration skills from bid stage to final completion. EDUCATION: University of New Mexico National Apprenticeship Program JATC/IBEW Primavera -Scheduling Software Accubid-Estimating Software Mc Cormick-Estimating Software Datatrac-Estimating Software LICENSE: IBEW 68 Journeyman Wireman State of Colorado Journeyman Electrician RELEVANT EXPERIENCE: ARROWHEAD REGIONAL MEDICAL CENTER — COLTON, CA Project Manager - $34M Installation of all electrical, 15KV infrastructure, nurse call systems, security, fire alarm, and all audio/visual systems. Approx. 1 million sq. ft. facility including 9-story critical care tower, 3-story diagnostic and treatment center, 3-story clinics and office building, 4-story mental health center, and facility central plant. AURARIA PERFORMING ARTS CENTER Project Manager $4M Installation of electrical, telecommunications, fire alarm, security, and facilities management systems. KMM PARKING GARAGE Project Manager-$1.6M electrical subcontract. Installation of electrical and Fire Alarm Systems. Intermountain Electric, Inc. EARNEST L. BROWN Page 2 of 2 COLORADO SPRINGS AIRPORT NEI Project Manager $2M Prime Contract -Installation of "in -Pavement", Centerline, and Touchdown Zone Runway Lighting Fixtures. Colorado Springs Runway 171/35R. BUCKLEY AIR FORCE BASE Project Director/Senior Project Manager $3M Prime Contract, rebuilding of existing ESS infrastructure including fiber optics, power distribution, storm drainage control, fencing, curb/gutter, and misc. civil works. MIRAGE ROOM REMODEL -Las Vegas, NV Project Manager - $4.5M Installation of all electrical, fire alarm, and audio/visual systems for remodel of rooms and suites for the Mirage Resort and Casino. HENDERSON COLD STORAGE, Las Vegas, NV Project Manager/Estimator $1.2M Installation of electrical, telephone and data systems. ELECTRICAL ESTIMATOR -Las Vegas, NV Sole Estimator for regional office in Las Vegas, NV. Duties included estimating electrical projects in range of $.25M-$100M. Projects included industrial, public transportation, commercial, entertainment, and telecommunications. Regional office generated $30M in annual revenues. SOUTHERN PACIFIC RAILROAD Project Engineer/Estimator $3M GMP-5 story remodel of all electrical systems including fire alarm. DENVER INTERNATIONAL AIRPORT Project Engineer $68M Terminal Building/Parking Structures. Installation of all electrical systems, lighting, fire alarm, telephone and data infrastructure, UPS Systems, etc. GENERAL FIELD EXPERIENCE From 1987-1991 served at various electrical contractors in New Mexico and California as electrical apprentice, journeyman wireman, and general foreman. Duties included installation of all aspect of electrical and specialty systems, service work and environmental controls. SUMMERLINE MEDICAL CENTER OFFICE BUILDING -Las Vegas NV Project Manager $3M Installation of all electrical, security, fire alarm and audiovisual systems for 6-Story Medical Office Building. Intermountain Electric, Inc. Attachment "B" iE CHARLES L. PEART ASSISTANT SECRETARY/CONTROLLER GENERAL EXPERIENCE: Mr. Peart has been a CFO, Controller/Assistant Controller since 1968. His experience includes both general and cost accounting areas. He is currently responsible for all job cost reporting, receivables, payables, payroll and fiscal policies. EDUCATION: Metropolitan State College — Denver, CO REVELANT EXPERIENCE: • Adapted software to accommodate service operation. • Worked with project management to implement monthly job profit projections based on estimated cost at completion. • Standardizing the financial reporting function. • Prepared Financial Reports/tax returns. Intermountain Electric, Inc. COLORADO DEPARTMENT OF TRANSPORTATION PROJECT NO. ANTI -COLLUSION AFFIDAVIT LOCATION Various Locations in Fort Collins I hereby attest that I am the person responsible within my firm for the final decision as to the price(s) and amount of this bid or, if not, that I have written authorization, enclosed herewith, from that person to make the statements set out below on his or her behalf and on behalf of my firm. I further attest that: t. The price(s) and amount of this bid have been arrived at independently, without consultation, communication or agreement for the purpose or with the effect of restricting competition with any other firm or person who is a bidder or potential prime bidder. 2A. Neither the price(s) nor the amount of this bid have been disclosed to any other firm or person who is a bidder or potential prime bidder on this project, and will not be so disclosed prior to bid opening. 2B. Neither the prices nor the amount of the bid of any other firm or person who is a bidder or potential prime bidder on this project have been disclosed to me or my firm. 3A. No attempt has been made to solicit, cause or induce any firm or person who is a bidder or potential prime bidder to refrain from bidding on this project, or to submit a bid higher than the bid of this firm, or any intentionally high or non- competitive bid or other form of complementary bid. 3B. No agreement has been promised or solicited for any other firm or person who is a bidder or potential prime bidder on this project to submit an intentionally high, noncompetitive or other form of complementary bid on this project. 4. The bid of my firm is made in good faith and not pursuant to any consultation, communication, agreement or discussion with, or inducement or solicitation by or from any firm or person to submit any intentionally high, noncom- petitive or other form of complementary bid. 5. My firm has not offered or entered into a subcontract or agreement regarding the purchase or sale of materials or services from any firm or person, or offered, promised or paid cash or anything of value to any firm or person, whether in connection with this or any other project, in consideration for an agreement or promise by any firm or person to refrain from bidding or to submit any intentionally high, noncompetitive or other form of complementary bid or agreeing or promising to do so on this project. 6. My firm has not accepted or been promised any subcontract or agreement regarding the sale of materials or services to any firm or person, and has not been promised or paid cash or anything of value by any firm or person, whether in connection with this or any other project, in consideration for my firm's submitting any intentionally high, noncompetitive or other form of complementary bid, or agreeing or promising to do so, on this project. 7. 1 have made a diligent inquiry of all members, officers, employees, and agents of my firm with responsibilities relating to the preparation, approval or submission of my firm's bid on this project and have been advised by each of them that he or she has not participated in any communication, consultation, discussion, agreement, collusion, or other conduct inconsistent with any of the statements and representations made in this affidavit. 8. 1 understand and my firm understands that any misstatement in this affidavit is and shall be treated as a fraudulent concealment from the Colorado Department of Transportation, of the true facts relating to submission of bids for this contract. I DECLARE UNDER PENALTY OF PERJURY IN THE SECOND DEGREE, AND ANY OTHER APPLICABLE STATE OR FEDERAL LAWS, THAT THE STATEMENTS MADE ON THIS DOCUMENT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. Contractor's firm or company name Intermountain Electric, Inc. 2 d contractor's firm or company name. (if joint venture.) Sworn to before me this 'It day of, Notary Publi a _ My commission r✓ /a!i� (, �?_ov7 C� NOTE: This document must be signed in ink. Title William D. S President Title Date Date O C Q CDOT Form #686 8193 COLORADO DEPARTMENT OF TRANSPORTATION Project # UNDERUTILIZED DBE BID Bid No. 5802 CONDITIONS ASSURANCE Location various Locations Instructions: Contractor - Complete and submit this form with your bid. Report only Underutilized DBE (UDBE) participa- tion which qualifies under the contract goal specification for this project. POLICY It is the policy of the Colorado Department of Transportation that underutilized disadvantaged business enterprises have maximum opportunity to participate in the performance of contracts financed with federal, state or local entity funds. INTENDED UNDERUTILIZED DBE PARTICIPATION 1) Will your company's intended Underutilized DBE (UDBE) participation meet contract goals? XX yes ❑ no 2) Total intended Underutilized DBE UDBE Meets contract goals ( )participation: 6.5 ❑ yes ❑ no 3) List the UDBE firms you intend to use for your UDBE participation Name of UDBE firm(s) Independent Traffic Certification Intended item(s) expiration date I of work 01-31— I understand that, if my company is determined to be the low bidder for the contract on this product, I must submit a completed CDOT Form #715 CERTIFICATION OF UNDERUTILIZED DBE PARTICIPATION to the Transportation Department by 4:00 pm the day after the bids are opened. In addition, if my company does not meet the intended contract goals, I must submit a completed CDOT Form #718 DBE GOOD FAITH EFFORT DOCUMENTATION before the above stated deadline. I understand my obligation to abide by the policy stated above. I shall not discriminate on the basis of race, color, age, sex, national origin, or handicap in the bidding process or the performance of contracts. I DECLARE UNDER PENALITY OF PERJURY IN THE SECOND DEGREE, AND ANY OTHER APPLICABLE STATE OR FEDERAL LAWS, THAT THE STATEMENTS MADE IN THIS DOCUMENT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. ipany name Intermountain Electric, Inc. Company officer signature r�� Date 9/29/03 Previous editions are obsolete and may not be used President CDOT Form #714a 6/02 s SECTION 00410 BID BOND KNOW ALL MEN BY THESE PRESENTS: that we, the undersigned in PUNWtain Rle trio, ar as Principal, and Federal Insurance Company - as Surety, are hereby held and firmly bound unto the City of Fort Collins, Colorado, as OWNER, in the sum of $ Five Percent (5%--) * for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, successors, and assigns. THE CONDITION of this obligation is such that whereas the Principal has submitted to the City of Fort Collins, Colorado the accompanying Bid and.hereby made a part hereof to enter into a Construction Agreement for the construction of Fort Collins Project, COMMUNICATIONS SYSTEM PHASE 2; Bid No. 5802. NOW THEREFORE, (a) If said Bid shall be rejected, or-. (b) If said Bid shall be accepted and the Principal shalI-execute and deliver a Contract in the form of Contract attached hereto -(properly completed in accordance with said Bid) and shall furnish a BOND for his faithful performance of said Contract, and for payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the Agreement created by the acceptance of said Bid, then this obligation shall be void; otherwise the same shall remain in force and effect, it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The Surety, for value received, hereby -stipulates and agrees that the obligations of said Surety and its BOND shall be in no way impaired or affected by any extension of the time within which the -OWNER may accept iilailBid; and said Surety does hereby waive notice of any such extension - Surety Companies executing bonds must be authorized to -transact business in the State of Colorado and be accepted by the OWNER. *of the Total Amount Bid -------------- 7/96 Section 00410 Page 2 3 IN WITNESS WHEREOF, the Principa and the Surety have,hereuato set their hands and seals this 29th— day of swul1twx r 2003, and such of them as are corporations have caused their corporate seals to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. PRINCIPAL Name: Intermountain Electric, Inc. Address: 602 S. Lipan SURETY Federal Insurance CampanY 15 Zbuntain View Road, P.O. Boa 1615 Denver., W 80223 W.Zam J,.07061-1615 By,���pp Vlltl=laiwl11 .. By, William D. Salzb ner e men Title: President Title: Attorney -In -Fact ATTEST: By: Mar lla McCarthy (SEAL) (SEAL) ofC loradRogaand Hamilton Company of Colorado P.O. Box 469025 !!S!rT1ngte Way Denver, CO 80246-9025 Tel 303-722-7776 • Fax 303-722-8862 Surety bonds and insurance 7/96 Section 00410 Page 3 a This Notice pertains to the following Surety Bond issued by a member insurer of the Chubb Group of Insurance Companies,: including Federal Insurance Company, Vigilant insurance Company and Pacific Indemnity Company; Bond Number: AW BOlex POLICYHOLDER DISCLOSURE NOTICI3 TERRORISM RISK INSURANCE ACT OF 2002 You are hereby notified that pursuant to the Terrorism Risk Insurance Act of 2002 (the -Act") effective November 26, 2002, we are making available to YOU coverage for losses arising out of certain acts of international terrorism. Terrorism is defined as any act certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of an air carrier or vessel or the premises of a United States Mission; and to have been committed by an individual or individuals acting on behalf of any foreign person or foreign interest, as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Coverage for acts of terrorism is already included in the captioned Surety Bond. You should know that, effective November 26, 2002, any losses caused by acts of terrorism covered by your Surety Bond will be partially reimbursed by the United States under the formula set fortis in the Act. Under this formula, the United States of America pays 90% of covered terrorism losses that exceed the statutorily established deductible to bepaidby the. insurance company providing the coverage. The portion of your premium that is attributable to coverage for such acts of terrorism is zero, because we could not distinguish (and separately charge for) acts of terrorism from other causes of loss when we calculated your premium. If you have any questions about this notice, please contact your agent or broker. ®J Intermountain Electric, Inc. CONTRACTOR BY: Brandon Landis ADDRESS: 602 S. Lipan Denver, CO 80223 8. BID SCHEDULE (Base Bid) PHASE II BID SCHEDULE IITEM # PAY ITEM DESCRIPTION UNIT QTY. UNIT PRICE ITEM COST 1 203 Potholin _ Hour 600 200.00 120 000.00 2 613 Proof Existing Conduit L.S. 1 15,935.0 15,935.00 3 613 1-1/2" Electrical Conduit Plastic Lin. Foot 5,800 7.50 43 500.00 4 613 2" Electrical Conduit (Plastic) Lin. Foot 26,500 12.65 335,225.00 5 613 Pull Box 08"x30" Each 15 540.00 8r100.00 6 613 Pull Box 18"x30" Stacked Each 35 580.00 20, 300.00 7 613 Pull Box 30"x48" Each 4 1 035.00 4, 140.00 8 614 Communication Hub Each 3 5 625.00 16,875.00 9 614 Fiber Optic Cable (Install Onl 48 s.m.) Lin. Foot 38,590 1.10 42, 449. 00 10 626 Mobilization Lump Sum 1 15,000.00 15,000.00 11 630 Construction Traffic Control Lump Sum 1 53,830.0 53,830.00 _ Total 675 354.00 Six Hundred Seventy Five Thousand, Three Hundred Fifty Dollars Four and Zero Cents 7/96 Section 00300 Page 2 No Text Know All by These , That FEDERAL INSURANCE COMPANY, an tndiarla er n.; yieuvir INSURANCE COMPANY,. a Now York trorpofatforro,andPACOIC MNFFYCOMPANY, aWisconsin corporation , doeaehherebyconstitute and, appoint Gloria t'. Blackburn,,, Kristen MiEcrzmick, Florietta Sanebeax Courtney Doran* Frank C, Pennt D 1y0yi Guei r Don R. Broyles3 3 Pame1 : Hansern, Donald L. Appleby. and Kevin W: hialah©n a I)env >~, Ealorric�-„ ---------------------------- _ _ ___ _ each as their true and 4w4ulAtfomey-ir!-Fact to execute under such designation in their names and to aff x their corporate seals to and deliver for and on their behalf as surety thereon or, otherwise, bonds (other than bail bonds) and undertakings given or executed in the course of its business (but not to include any instruments.amending or altering the same, nor consents to the modmcatton or akeration of any instrument referred to in said bonds or obilgationel In Wines; Whereof, said FEDERAL INSURANCE COMPANY, VICaItANT INSURANCE COMPANY, aril PACIFIC INFIEM[NVITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 13 th day of November, 2000 neth C. VJendet, Assistant Secrete dA Gerardo G. Mauriz, Vice Presi snt STATE OF NE_W JERSEY l Slotrrih of Sotnertel . j `c Qnthis 1It- h dpyadvetnbe; 2U00 : $et me mNb(aryFicofNewJ p',,,1'" t�eni!hc.weerdait iu' m4 lhfpvan t!i t7tl�:A'eiaistanl mart! of=pEbfkAL INSUR�WE6'COMRyNY, �tWSU�If 6CANY, and PAOIFIC IWD�IITY CE3MPAtJSr; rha oompgntes whioi! eteaouled.the forogoinq Power of Aaomeg, "ant! the said Kenneth C. Warxiel ma du swpm dal Ss�ry M1-E_DEiti1L INSURANtE 6'OMPANY• VIGILANT INSURANCE Cd1NP)tNV_ end aenctnwnnsv �..:..•.. _ ®� �`:thel he is Assistant elo wALSFiI 'o�Hetv�etatgi %L-a l:V210sApa M 2009 Notary Pubaa CERTIFICATION INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY:, .Pfau nr e,e --A -un - " .. .. No Text 9. PRICES The foregoing prices shall include all labor, materials, transportation, shoring, removal, dewatering, overhead, profit, insurance, etc., to cover the complete Work in place of the several kinds called for. Bidder acknowledges that the OWNER has the right to delete items in the Bid or change quantities at his sole discretion without affecting the Agreement or prices of any item so long as the deletion or change does not exceed twenty-five percent (25%) of the total Agreement Price. RESPECTFULLY SUBMITTED: SP Signature William Dlzb� Date President Title #32 License Number (If Applicable) (Seal - ) 'd is rpo a i ) Attest: Charles P art Address 602 S. Lipan Telephone 303-733-7248 7/96 Section 00300 Page 3 03 SECTION 00400 SUPPLEMENTS TO BID FORMS 00410Bid Bond 00420Statement of Bidder's Qualifications 00430Schedule of Subcontractors 7/96 Section 00410 Page 1 SECTION 00420 STATEMENT OF BIDDER'S QUALIFICATIONS All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit any additional information he desires. 1. Name of Bidder: In rmo3n ain p.lartrir,. rnr 2. Permanent main office address: 602 S Lipan, Denver, CO 80223 3. When organized: 1946 4. If a corporation, where incorporated: Colorado 5. How many years have you been engaged in the contracting business under your present firm or trade name?1983 6. Contracts on hand: (Schedule these, showing the amount of each contract and the appropriate anticipated dates of completion.) 270 & I-76 $9640953 11/1/03 UHCS Roadway $385,600 10/24/03 CBD Event Signal System $7160000 10/31/03 Union Blvd. Reconstruction $315,000 11/14/03 7. General character of Work performed by your company: Building electrical, industrial, traffic signal, fihPr o to ins, and law voltage 8. Have you ever failed to complete any Work awarded to you? No If so, where and why? 9. Have your ever defaulted on a contract? If so, where and why? 10. Are you debarred by any government agency? If yes list agency name. 7/96 Section 00420 Page 1 11. List the more important projects recently completed by your company, stating the approximate cost of each, and the month and year completed, location and type of construction. Colfax phase IT $709,000 7/03 trafficsignal, _fiber optic in rconne _ Thorn on 2002 traffic signals $565,000 1/03 12. List your major equipment available for this contract. Diggerd rQ rick, din truck,huk-t truck, cube vans, air compressors, hank hoes, and line trunk 13. Experience in construction Work similar in importance to this project: urrently completing CBD Event Signal..System for Denver, 24,000 iF fiher on in cahle — rpplaced 40 cabinets & controllers 7r800 TY 2" conduit, in tower downtown 14. Background and experience of the principal members of your organization, including officers: See a to _hm -nt "B" 15. Credit available: $parent company manages cash and pays all debts 16. Bank reference:Bank of America 1401 Elm St 5th floor, Dallas TX 75202 Janice Hock (800) 711-0725 17. Will you, upon request, fill out a detailed financial statement and furnish any other information that may be required by the OWNER? _ yes 18. Are you licensed as a General CONTRACTOR?No, Electrical Contractor If yes, in what city, county and state? State of Colorado What class, license and numbers? i,icense #32 19. Do you anticipate subcontracting Work under this Contract? yes If yes, what percent of total contract? 42 3$ and to whom? Independent Traffic Control Services, Drill Tech 20. Are any lawsuits pending against you or your firm at this time? No If yes, DETAIL 7/96 Section 00420 Page 2 21. What are the limits of your public liability? DETAIL Please see Attachment "A" What company?Tohn L. Wortham & Son L L P 22. What are your company's bonding limitations?Our aggregate bonding `nnat-ity iG q;300.000.000. We have $200.,000,000 available 23. The undersigned hereby authorizes and requests any person, firm or corporation to furnish any information requested by the OWNER in verification of the recital comprising this Statement of Bidder's Qualifications. Dated at 11-ISam this 26th day of RantPmhg-r 20_03• Tntarmnlintain Flartrjo, Tnr Name o Bidder By: I cQSkA/Wn D William D. Salzbreneir Title: President State of Colorado County of nPnvPr William D. Salzbrener being duly sworn deposes and says that he is _president _ofrnte mountain Electric, Inc .and that (name of organization) the answers to the foregoing questions and all statements therein contained are true and correct. Subscribed and sworn to before me this 200 3. Notary Public 0 44-14- t1 My commission expires day of 7/96 Section 00420 Page 3 I SECTION 00430 SCHEDULE OF SUBCONTRACTORS List all subcontractors for the work items listed below and all subcontractors performing over 10a of the contract. ITEM Traffic Control Directional Drilling 7/96 SUBCONTRACTOR Drill Tech Section 00430 Page 1 H'1"1'Hl:ril�!l;LV"1" li DATE (MMIDD/YYI ...::......:.......................... PRODUCER JOHN L. WORTHAM & SON, L.L.P. P.O. BOX 1388 HOUSTON, TEXAS 77251-1388 -01970-2004A-000630 INSURED INTERMOUNTAIN ELECTRIC, INC. 602 S. LIPAN ST. DENVER, CO 80223 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANY A OLD REPUBLIC INSURANCE COM COMPANY B ASSOC. ELECTRIC & GAS INS. COMPANY C COMPANY D ..:. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MMIDD/YY) DATE (MMIODIYY) A GENERAL LIABILITY MWZY55734 03/01/2003 08/01/2005 GENERAL AGGREGATE $ 1,750,000* X COMMERCIAL GENERAL LIABILITY SELF -INSURED RETENTION PRODUCTS - COMP/OP AGO $ 1 750,000* CLAIMS MADE Fx] OCCUR $250,000 PERSONAL& ADV INJURY $ 750,000* OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 750, 00O* *EXCESS OF SELF -INSURED FIRE DAMAGE (Any one fire) $ 750,000" RETENTION MED EXP (Any one person) $ EXCLUDED A AUTOMOBILE LIABILITY MWT318597 08/01/2003 08/01/2005 COMBINED SINGLE LIMIT $ 3,000,000 ANY AUTO X ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS IIPer person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS I IPer accident) PROPERTY DAMAGE I $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ B EXCESS LIABILITY CLAIMS MADE UMBRELLA FORM X OTHER THAN UMBRELLA FORM RETRO DATE 08/01/2002 X2059AlAO3 08/01/2003 08/01/2004 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ X INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL MWC108554 00 03/01/2003 08/01/2005 X I STATUTORY LIMITS EACH ACCIDENT $ 1,000,000 DISEASE - POLICY LIMIT $ 1,000,000 DISEASE - EACH EMPLOYEE $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSAOCATIONS/VEHICLES/SPECIAL ITEMS SEE ATTACHED BY • C . dk� EDWARD C. BENEDIX CITY OF FORT COLLINS 281 N. COLLEGE AVE. FORT COLLINS, CO 80522-0850 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.