HomeMy WebLinkAboutRESPONSE - BID - 5850 WEST ELIZABETH BIKE LANE IMPROVEMENTS (4)SECTION 00300
BID FORM
PROJECT: WEST ELIZABETH BIKE LANE IMPROVEMENTS; BID NO. 5850
Place
Date AP424L a-?;
1. In compliance with your Invitation to Bid dated APA2qL S, 200L-4
and subject to all conditions thereof, the undersigned
S'-;t C-0QT1N*-CA--%0G Co. a ** Corporation
y. 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 F\y[ LC1+-T OF T0j-f(X_ Z iD ($
G`6 oy- ) 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:
DEVEL- j}EaQ.S SUCZZTl A#r- ktot +Ni 1 "1 Came ;.
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.
through hx3WE
7/96 Section 00300 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.
ti�N '6� w1 6 yo0}000 C-%Tl o� t .-�., cor •P i aj 63
-��.,�Pu-,a cuc�C� �u�,v►s,� � z, ��. �� Crsc�P 1 a o 3
12
13
14
15
List your major equipment available for this contract.
S 40" 0 cT�-)(L C�N!L.I 4 Zak 1- - t3Y> o i_oo r , 315 Lvct-
ct S d 1E Lc oc>yi G F? o O Z�
CPC 15AT C*5 R-cou 2
Experience in construction Work similar in importance to this
pro"�ect:
I�pn--, Ct EA 3, I o o1 000
3-1 C- -
o 0
Background and experience of the principal members of your organization,
including officers:
Credit available: $ 500, 00020-
16. Bank reference: CS*JTE-tJO%N-L -F kt O'�- i�'& IJTtS[ S On 339 -34510
17. Will you, upon request, fill out a detailed financial statement and furnish
any other information that may be required by the OWNER?
YES
Uruv `1ST -T i.ti/MLK- 1 N 9-0 W
18. Are you licensed as a General CONTRACTOR? i,� &a��y.,, -&T-r C U.4%IS3
If yes, in what city, county and state. What
class, license and numbers?
19. Do you anticipate subcontracting Work under this Contract? YES
If yes, what percent of total contract?
and to whom?
20. Are any lawsuits pending against you or your firm at this time? 00
If yes,
DETAIL
7/96 Section 00420 Page 2
21. What are the limits of your public liability? DETAIL
Z,00a,ooa Pk�¢� �, + 1 0o0 000 E cF.ss L� 1LtiZ`_r
What company? �I FYGT01V 1NS�.fiAt�CE QVh0 Cpr p1��
22. What are your company's bonding limitations? 3 mkuAoh1 S1NG-L= —\N�wr�
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 8.0(0Pm this 'a'1 day of P-PV1 L 2oaq.
-a C-
Name of Bid
By:
Title:
State of C)lzntv�po
County of WEN.,>
SOt C- LjEO*,S -VL, being duly sworn deposes and says that he is
SEt/M'LA�3 of S—� C`yJZ�+in1G Co 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 a1 day of
J r:Rlli L , 20a4.
Kcutaf to
Notary Publi
My commissicn expires gyres
7/96 Section 00420 Page 3
QUALIFICATIONS OF KEY PERSONNEL
JOHN C. LEONE JR.
Education: Colorado School of Mines Golden, CO Graduated: 1992
• BS in Chemical Engineering and Petroleum Refining
• Minor in Applied Chemistry
Current Employer. J-2 Contracting Company Jun. `96-Present
Title: Secretary/Treasurer 50% Owner)
Job Description: Estimator, Project Manager, Purchasing
Previous Experience: General Chemical, Green River, WY Nov. `95-Jun. `96
• Estimated and Supervised Capital Improvement Projects.
United States Navy, Groton, CT Jan. `92-Oct. '95
• Junior Engineering Officer overseeing construction and testing
of a New Construction Submarine in the Groton, CT shipyard.
JOHN C. LEONE SR.
Education: Colorado State University Fort Collins, CO Graduated: 1970
• BS in Construction Management
Current Employer: J-2 Contractin Com an 1993-Present
Title: President (500 o Owner)
Job Description: Superintendent, Supervises all Field Operations
Previous Experience: KIP Construction, Golden, CO 1990-1993
• Project Manager for Heavy Highway Construction.
Greeley Excavation Company, Greeley, CO 1980-1990
• Owner, Estimator, Project Manager
Flatiron, Greeley, CO 1976-1980
• General Manager of Concrete Division
D-Leone Construction Co., Colorado Springs, CO 1970-1976
• Field Superintendent for Heavy Highway Construction
BARRETT JESSEPH
Education: KansasUniversity Lawrence KS
• BS in Mec�hamcal Engineering
Current Employer. J-2 Contracting Company
Title. FieldSuperintendent
Job Description: Supervises Field Operations
Graduated: 1991
7/01-Present
Previous Experience: Phillips Petroleum, Pasadena, TX 1991-2001
• Maintenance/Capital Improvement Superintendent.
SECTION 00430
SCHEDULE OF SUBCONTRACTORS
List all subcontractors for the work items listed below and all subcontractors
performing over 150 of the contract.
ITEM
Le) N C
SUBCONTRACTOR
""DuMA.(L LC)Nn erCN S
7/96 Section 00430 Page 1
COLORADO DEPARTMENT OF TRANSPORTATION
CERTIFICATION OF EEO COMPLIANCE
Instructions: Bidders and subcontractors must complete and submit this form with bid proposals for federally funded contracts
greater than $10,000. This is required by the Equal Employment Opportunity Regulations [41 CFR 60-1.7(b) (1)]. The regulation
also requires that if you have participated in a previous contract or subcontract and have not filed a Standard Form 100 (EEO-
1), you cannot be awarded this contract. You may file a report covering the delinquent period for consideration by the Federal
Highway Administration or the Director of the Office of Federal Contract Compliance, U.S. Department of Labor.
The Standard Form 100 (EEO-1) may be requested from the:
Joint Reporting Committee
P.O. Box 779
Norfolk, VA 23501
(757) 461-1213
1. Z Yes ❑ No I have developed and have on file at each establishment an affirmative action program as
required by 41 CFR Chapter 60, Part 60-2.
2. )Q Yes ❑ No I have participated in a previous contract/subcontract subject to the equal opportunity
clause.
3. �a Yes ❑ No 1 have filed with the Joint Reporting Committee, the Director, or the Equal Employment
Opportunity Commission all reports due under the applicable filing requirements.
I declare under penalty of perjury in the second degree and any other applicable state or federal laws, that the state-
ments made in this document are true and complete to the best of my knowledge.
Company
bidder ❑ proposed subcontractor
By:
Title:
s1&C/_T�n
Date:
vx-k 4
c,
Cool Form #347 11194
COLORADO DEPARTMENT OF TRANSPORTATION Pr ject#
xaCmy55—ol0
CONTRACTORS PERFORMANCE CAPABILITY STATEMENT 1410-1 b
1. List names of partnerships or joint ventures X none
2. List decreases in the contractors fiscal or workmanship qualifications compared to the last prequalification statement
submitted to CDOT. (Attach additional sheets if necessary.)
a. Key personnel changes none
b. Key equipment changes none
c. Fiscal capability changes (legal actions, etc.) none
d. Other changes that may effect the contractors ability to perform work. jj] none
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 CORRECT TO THE
BEST OF MY KNOWLEDGE
Contractor's firm or company name
By
7DateTitle n M4
SEL�E�PrS
2nd Contractor's firm or company name (if joint venture)
By
Date
Title
CDOT Form fi505 1192
COLORADO DEPARTMENT OF TRANSPORTATION
PROJECT NO.
AQC 55 ~0U20
ANTI -COLLUSION AFFIDAVIT
LOCATION
W EST EU ST1 FQ'r- C;jL_ ,%t6
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:
1. 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.
S. 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. /q
/
Contractor's firm or company name
By
Date
-I /oy
Title
2nd contractor's firm or company name. (If joint venture.)
By
Date
Title
Sworn to before me this ;Ilk—) day of, "J-3,iL 20CY4
Notary Public
My commission e
September 6 2006
NOTE: This document must be signed in ink.
COOT Form #606 1102
COLORADO DEPARTMENT OF TRANSPORTATION
PROJECT NO.
ASSIGNMENT OF ANTITRUST CLAIMS
AQc Moss_o
Contractor and Colorado Department of Transportation (CDOT) recognize that in actual economic practice
antitrust violations ultimately impact on CDOT. Therefore, for good cause and as consideration for executing this
contract and for receiving payments hereunder:
1. Contractor hereby irrevocably assigns to CDOT any and all claims it may now have or which may hereafter
accrue to it under federal or state antitrust laws in connection with the particular project, goods or services
purchased or acquired by CDOT pursuant to this contract.
2. Contractor hereby expressly agrees:
a. That, upon becoming aware that a third party has commenced a civil action asserting on Contractor's
behalf an antitrust claim which has been assigned to CDOT hereunder, Contractor shall immediately
advise in writing:
(1) Such third party that the antitrust claim has been assigned to CDOT, and
(2) CDOT that such civil action is pending and of the date on which, in accordance with subparagraph
a. (1) above, Contractor notified such third party that the antitrust claim had been assigned to CDOT;
b. To take no action which will in any way diminish the value of the claims or rights assigned or dedicated
to CDOT hereunder; and
c. Promptly to pay over to CDOT its proper share of any payment under an antitrust claim brought on
Contractor's behalf by any third parry and which claim has been assigned to CDOT hereunder.
3. Further, Contractor agrees that in the event it hires one or more subcontractors to perform any of its duties
under the contract, Contractor shall require that each such subcontractor:
a. Irrevocably assign to CDOT (as a third party beneficiary) any and all claims that such subcontractor may
have or which may thereafter accrue to the subcontractor under federal or state antitrust laws in connec-
tion with any goods or services provided by the subcontractor in carrying out the subcontractor's obliga-
tions to Contractor;
b. Upon becoming aware that a third party has commenced a civil action on the subcontractor's behalf
asserting an antitrust claim which has been assigned to CDOT hereunder, shall immediately advise in
writing:
(1) Such third party that the antitrust claim has been assigned to CDOT, and
(2) Contractor and CDOT that such civil action is pending and of the date on which, in accordance with
subparagraph b. (1) above, the subcontractor notified such third party that the antitrust claim had
been assigned to CDOT;
c. Take no action which will in any way diminish the value of the claims or rights assigned or dedicated to
CDOT hereunder; and
d. Promptly pay over to CDOT its proper share of any payment under an antitrust claim brought on the
subcontractor's behalf by any third party and which claim has been assigned or dedicated to CDOT
pursuant hereto.
I, acting in my capacity as officer of a bidder (bidders if a joint venture) do agree to the above assignment of
antitrust claims.
Contractor's firm or company name
�� 01- Ct3WiVl.�1-C�1N:s GJ,
By
Date
la 7 O
nue
2nd contractor's firm or company name. (If joint venture.)
By
Data
Title
CDOT Form X821 12191
COLORADO DEPARTMENT OF TRANSPORTATION
UNDERUTILIZED DBE BID
CONDITIONS ASSURANCE
Project #
Location
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
10
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
Will
1) your company's intended Underutilized DBE (UDBE) participation meet contract goals? » yes ❑ no
Meets contract goals
2) Total Underutilized DBE (UDBE) participation: as '/° 53 yes ❑ no
3) List the UDBE firms you will use for your intended UDBE participation
Name of UDBE firm(s) Certification Intended item(s)
expiration date of work
�UM1'11Z v�Tc�C�COQ-S �N (Z�7v1�0� C.ANG(2���
I
I understand that, if my is
company 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.
Company name
Date
-a CaN3W-Ac'ttvG Co, y%-7/0Y
Company officer signature 108
Title
Previous editions are obsolete and may not be used CDOT Form #714a 6101
COLORADO DEPARTMENT OF TRANSPORTATION
CERTIFICATE OF PROPOSED
UNDERUTILIZED DBE (UDBE)
PARTICIPATION
Project No.:
Project Code (SA#):
Location:
Form #: of
Prime Contractor — Send completed/signed form to the Business Programs Office (instructions on second page).
(NOTE: See 49 CFR part 26.55, and the "DBE - Definitions and Requirements" in the Standard Special Provisions, for further information concerning
counting DBE participation of subcontractors, suppliers and service providers toward the project's UDBE goal.)
PART I - SUBCONTRACT
EXPIRATION ELIGIBLE UDBE SUBCONTRACT
NAME OF UDBE FIRM
TIER
CERTIFICATION #
DATE AMOUNT
ACTUAL CONTRACT AMOUNT
ITEMS OF WORK SUBCONTRACTED:
PART I - SUPPLY CONTRACT
If the supplier is a UDBE "Manufacturer" of the item(s):
• ACTUAL UDBE AMOUNT = Entire expenditure for materials and supplies including cost Of any delivery services provided by the firm
• ELIGIBLE UDBE SUPPLY AMOUNT = (ACTUAL UDBE AMOUNT) X 100% J
If the supplier is a UDBE "Regular Dealer" of the item(s):
• ACTUAL UDBE AMOUNT = Entire expenditure for materials and supplies including cost of any delivery services provided by the firm
• ELIGIBLE UDBE SUPPLY AMOUNT = (ACTUAL UDBE AMOUNT) Elie/dI ',
If the supplier is neither a "Manufacturer" nor a "Regular Dealer" of tl)e item(s) see PART 1 c - SERVICE / BROKER CONTRACT.
NAME OF UDBE FIRM
CERTIFLI/ITION #
1 N
AT. -
ACTUAL UDBE ELIGIBLE UDBE SUPPLY
AMOUNT AMOUNT
rl l
MATERIALS SUPPLIED:
PART I - SERVICE I BROKER CONTRACT
Transportation service'(hauling) fees/commissions are to be counted toward contract goals in this section (provided the trucker is NOT
classified as a "Manufacturer" or a "Regular Dealer" for the materials supplied). Examples of other services to include in this section
would be brokering, bonding, consulting, security guards, and insurance.
For a UDBE "Service/Broker Contract":
• ACTUAL UDBE AMOUNT = Entire expenditure for services rendered including cost of any materialsisupplies provided by the firm
ELIGIBLE UDBE SERVICE FEE AMOUNT = [ (ACTUAL UDBE AMOUNT) — (Cost of any materials and supplies) J
(NOTE: The amounts that count toward UDBE goals are limited to the compensation retained by the UDBE brokeriagent for services rendered, provided
the fee/commission is determined by CDOT to be reasonable and not excessive as compared with fees customarily charged for similar services.)
NAME OF UDBE FIRM
CERTIFICATION #
EXPIRATION
ACTUAL UDBE ELIGIBLE UDBE SERVICE FEE
DATE
AMOUNT AMOUNT
1 /
SERVICES RENDERED:
Original — Business Programs Office Previous editions may not be used CDOT Form 715 05/03
5-a
CONTRACTOR
BY:
cC
ADDRESS: 9a9 38`" Qrve &r% *106
%ate-i . Co data34
8. BID SCHEDULE (Base Bid)
Please use the attached Bid Schedule when submitting your bid.
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 (250) of the total Agreement Price,
RESPECTFULLY SUBMITTED:
Pry L a- i Zooy
Signature/"���Date
i�t-t-si Title
License License Number (If Applicable)
(Seal - if Bid is br co oration)
Attest:
Address gac\ 3iina pN,c LT *1OLD
Telephone 9-10 3q-) —a(a9,L4
7/96 Section '00300 Page 2
PART 2 — UDBE PARTICIPATION SUMMARY
A) What is the total dollar value of this proposed subcontract, supply contract, OR service/broker
contract that is eligible for counting toward contract goals?
(NOTE: Provide in actual subcontractor dollars and not prime contract prices)
A>
A = [ TOTAL FROM "ELIGIBLE" COLUMNS IN PART 1 ]
B) What is the total dollar value of proposed subcontracts that are eligible for counting towards
B>
contract goals from prior sheets/forms?
C) What is the accumulative value of proposed subcontracts that are eligible for counting towards
contract goals?
C>
C=[A + B]
D) What is the original contract bid total?
D>
E) What is the accumulative percent of contract bid total subcontracted to all underutilized DBEs?
E=[(C + D) X 100]
PART 3 — PRIME CONTRACTOR CERTIFICATION
certify that:
• my company has met the contracted UDBE goals or has attached a completed CDOT Form #718, DBE Good Faith Effort
Documentation.
• my company has accepted a proposal from the UDBE subcontractor named above.
• my company has notified the proposed,Ut)EIF `subcontractor bfthe contracted UDBE commitment.
• my company's use of the proposeft U68E3 subcontractor forjhe items of work listed above is a condition of the contract award.
• my company will invite the p."os§d k.l Ott subcontractor to attend the preconstruction conference.
• my company will not use a subst1k4te'IJDk subcontractor for the proposed UDBE subcontractor's failure to perform under a
fully executed subcontract `unlf rry company complies with the definitions and requirements section of the DBE Special
Provisions.
• 1 understand thaffailure to comolY.with the information shown on this form will be considered grounds for contract termination.
I declare under palit ty of perjury in the second degree, and any other applicable state or federal laws, that the statements
made on this doct)tt imt are true and complete to the best of my knowledge.
Prime Contractor Name: I Date:
Officer Signature and Title:
FORM INSTRUCTIONS
Prime Contractor: 6. Retain a photocopy for your records.
1. An officer of the contractor(s) must complete this form. 7. Send original to:
2. Include only DBE firms which meet the underutilized criteria in Colorado Department of Transportation
the contract goal specification for this project (i.e., UDBE firms). Business Programs Office
3. Complete ONLY ONE section for Part 1 (1a, 1b, OR 1c) 4201 E. Arkansas Ave.
4. Complete ALL sections of Part 2 and Part 3 Denver, Colorado 80222
5. Submit a separate CDOT Form #715 for EACH proposed UDBE. FAX: (303) 757-9019
Original - Business Programs Office Previous editions may not be used CDOT Form 715
PAGE 2
COLORADO DEPARTMENTOFTRANSPORTATION Project
UNDERUTILIZED DBE GOOD FAITH EFFORT [Location
DOCUMENTATION
Date
The Contractor who is the apparent low bidder on a CDOT construction project and has failed to meet the Underutilized DBE (I.
contract goals shall use this form to document good faith efforts made to date by said Contractor to attempt to meet these goals.
FAILURE TO FULLY COMPLETE THIS FORM MAY RESULT IN REJECTION OF THE BID.
Each portion of this form is to be addressed in the space provided, or on supplemental sheets. Attach supporting documentation as
required. This completed form and required attachments are to be submitted to the Business Programs Office in the Center for Equal
Opportunity prior to 4:00 p.m. on the day after the day bids are opened. This form may be submitted by FAX (303-757-9019) with an
original copy to follow. An extension may be granted by the DBE Liaison. Solely at its discretion, CDOT may request additional
information and accept additional UDBE participation at any time and prior to the final decision concerning Good Faith Efforts.
I. List sufficient bid items (including portions of bid items) identified as subcontract work to be performed by UDBEs to achieve the
established UDBE participation goal. Indicate the total percentage of work identified for UDBE participation. The total percentage of
subcontract items identified for UDBE participation must equal or exceed the percentage goal established by CDOT.
II. For each subcontract item identified, contact by mail, FAX and/or telephone a minimum of two currently CDOT-certified UDBEs whose
work and function codes match the type of work being solicited. For projects in areas of the state where there are more than two UDBEs
capable of performing identified subcontract items, contact at least two thirds of those UDBEs. If soliciting by telephone, provide a
telephone log of calls, including topic of discussion, date, time, name of person contacted, and the response received. If soliciting by
mail, provide copies of letters to UDBEs and their responses. Letters and FAXes must specifically identify the project, the items to be
subcontracted, and the bid date. Letters and FAXes must provide an address and phone number where specific quantities or details will
be available to bidders. The Contractor shall provide sufficient time to allow the UDBEs to participate effectively in the bidding process.
Submit a detailed explanation addressing failure to provide any of the above.
Original -Business Programs Office, Copy -Contractor UVtR Previous editions are obsolete and may not be used CDOT Form #718 3/99
III. List all UDBE and non-UDBE bidders, bid dollar amounts for each bid item, and the name of the successful bidder. Describe how bid
items were broken down to increase opportunities for specific UDBE bidders. if the UDBE bids were rejected, give reasons for each
case. Cost alone may not be adequate justification for failure to use a UDBE bid. If the work is to be counted as a potential UDBE
subcontract item, the Contractor cannot elect to perform that work itself when a UDBE bid is competitive or only UDBE bids are received.
When a non-UDBE bid is significantly lower than a UDBE bid, the Contractor may choose to perform the item itself. Whether a bid is
"competitive" or "significantly lower' will be determined by CDOT. Provide a detailed explanation for failure to provide any of the above.
IV. The efforts required herein are not exhaustive or exclusive. Other factors or types of efforts may be relevant in appropriate cases. In
determining whether Good Faith Efforts have been made, the quantity and intensity of the efforts made as well as kinds of efforts made
may be considered. List any additional efforts to increase UDBE contract participation, such as requesting subcontractors to assist with
providing UDBE participation. Note the results of such efforts.
THE CONTRACTOR UNDERSTANDS THAT DEMONSTRATION OF GOOD FAITH EFFORTS IN ACHIEVING THE UDBE
GOALS ESTABLISHED BY CDOT IS REQUIRED THROUGHOUT THE PERFORMANCE OF THE CONTRACT.
Company Signature
Title Phone
FAX
003M
BIDSCHEDULS-REVISED
8I0 #5850 WEST ELIZABETH BIKE LANE IMPROVEMENTS
Items Na.
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OJT COLORADO INING PROGRAM
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Total Base Construction Cost
f
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ht&v &W Doug Business in Covpany Name
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A ♦ B X cat - Comt a off bW for mkwMm W the Inwat fuccas0d
bdder
What
A - Coamsaors atd bid Ix tM work iemu
B - Number ofColander Days required to subs nnsiallycmVide the Want
0* Cost for b6 Project - 33,82S.W
A- TalalCmnskutbonCog : 50(O 3lf/O 83
Page 1 of
-.l _2,
SECTION 00400
SUPPLEMENTS TO BID FORMS
00410 Bid Bond
00420Statement of Bidder's Qualifications
00430Schedule of Subcontractors
7/96 Section 00410 Page 1
SECTION 00410
BID BOND
K0. W ALL MEN BY THESE PRESENTS: that we, the undersigned
J-2* as Principal, and DEVELOPERS SURETY AND INDEMNITY COMPANY as
S q, ety, are hereby held and firmly bound unto the City of Fort Collins, Colorado,
a� OWNER, in the sum of $--5%--** for the payment of which, well and
till ly to be made, we hereby jointly and severally bind ourselves, successors, and
ash igns.
Tf CONDITION of this obligation is such that whereas the Principal has
sgmitted to the City of Fort Collins, Colorado the accompanying Bid and hereby
m ie. a part hereof to enter into a Construction Agreement for the construction of
F $t Collins Project, WEST ELIZABETH BIKE LANE IMPROVEMENTS; BID NO. 5850.
Nq� THEREFORE,
(� If said Bid shall be rejected, or
(1� If said Bid shall be accepted and the Principal shall 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
f6rce 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.
Tti0 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
e ension of the time within which the OWNER may accept such Bid; and said Surety
d s hereby waive notice of any such extension.
Mety Companies executing bonds must be authorized to transact business in the
te of Colorado -and be accepted by the OWNER.
* CONTRACTING COMPANY
�** FIVE PERCENT OF TOTAL AMOUNT BID
17�196 Section 00410 Page 2
J
IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands
and seals this 27th day of _April , 20 04, 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:J-2 CONTRACTING COMPANY
Address:_929 38th AVENUE COURT #106
(SEAL)
SURETY
DEVELOPERS SURETY AND INDEMNITY COMPANY
P.O. BOX 469025
DENVER, %CO 80246
By: —{�l7ls!lllL
// Title:ATTORNEY-IN-FACT, CYNTHIA M. BURNETT
HRH of Colorado
HRH® Denver, CO 80246-9025
m 303-722-7776
h I l b r o g a l & h o b b s- ® 303-722-8862
(SEAL)
7/96 Section•00410 Page 3
�I
POWER OF ATTORNEY FOR
DEVELOPERS SURETY AND INDEMNITY COMPANY
PO BOX 19725, IRVINE, CA 92623 • (949) 263-3300
www.inscoDico.com
KNOW ALL MEN BY THESE PRESENTS, that except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY does hereby make,
***6os t uneand W,
r� y 1pppeterson, James S. Rosulek, J.R. Richards, Douglas J. Rothey, Susan J. Lattarulo, Cynthia M.
Burnett, Florietta Acosta, Donald E. Appleby, Gloria C. Blackburn, Dilynn Guern, Pamela J. Hansen, Kristen L.
McCormick, Kevin W. McMahon, Frank C. Penn, jointly or severally***
as its true and lawful Attorney(s)-in-Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporation as surely, bonds, undertakings and
contracts of suretyship giving and granting unto said Attorney(s)-in-Fact full power and authority to do and to perform every act necessary, requisite or proper
to be done in connection therewith as the corporation could do, but reserving to the corporation full power of substitution and revocation, and all of the acts of
said Attorney(s)-in-Fact, pursuant to these presents, are hereby ratified and confirmed.
This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolution adopted by the Board of Directors of
DEVELOPERS SURETY AND INDEMNITY COMPANY effective as of November 1, 2000:
RESOLVED, that the Chairman of the Board, the President and any Vice President of the corporation be, and that each of them hereby is,
authorized to execute Powers of Attorney, qualifying the Attorneys) -in -Fact named in the Powers of Attorney to execute, on behalf of the corporation, bonds,
undertakings and contracts of suretyship; and that the Secretary or any Assistant Secretary of the corporation be, and each of them hereby is, authorized to
mlest the execution of any such Power of Attorney;
RESOLVED. FURTHER, that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by
facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporation when so affixed and
in the future with respect to any bond, undertaking or contract of suretyship to which it is attached.
IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY has caused these presents to be signed by its respective Executive
Vice President and allested by its Secretary this 71h day of November, 2001.
,.......,u,.,,,,
AND /N
David H. Rhodes. Executive Vice President
OCT. :'te
:� 10
:o
„
Walter A. Crowell, Secretary
STATE OF CALIFORNIA )
)SS.
COUNTY OF ORANGE )
On November 7, 2001, before me, Antonio Alvarado, personally appeared David H. Rhodes and Walter A. Crowell, personally known to me (or
proved to me on the basis of satisfactory evidence) to be the persons whose names are subscribed to the within instrument and acknowledged to me that they
executed the same in their authorized capacities, and that by their signatures on the instrument the entity upon behalf of which the persons acted, executed the
instrument.
WITNESS my hand and official seal
Signature
CERTIFICATE
ANTONIO ALVARADO
p r- COMM. N 1300303
e Notary Public - California 0
i ORANGE COUNTY -.
My Comm. Expires APRIL 10. 2005
The undersigned, as Chief Operating Officer of DEVELOPERS SURETY AND INDEMNITY COMPANY, does hereby certify that the foregoing
Power of Attorney remains in full force and has not been revoked, and furthermore, that the provisions of the resolution of the respective Boards of Directors
of said corporation set forth in the Power of Attorney, is in force as of the date of this Certificate.
This Certificate is executed in the City of Irvine, California, the 27th day of April 2004
By (a 4.
David G. Lane, Chief Operating Officer
ID-1439 (DSI) (11 /01)
-CAME
f ��� .,4
DISCLOSURE RIDER
Terrorism Risk Insurance Act of 2002
The Terrorism Risk Insurance Act of 2002 created a three-year program
under which the Federal Government will share in the payment of covered losses
caused by certain events of international terrorism. The Act requires that we
notify you of certain components of the Act, and the effect, if any, the Act will
have on the premium charged for this bond.
Under this program, the Federal Government will cover 90 rb of the
amount of covered losses caused by certified acts of terrorists, as defined by the
Act. The coverage is available only when agvregate losses resulting from a
certified act of terrorism exceed $5,000,000.00. Insurance carriers must also meet
a variable deductible established by the Act. The Act also establishes a cap of
$1.000.000,000.00 for which the Federal Government or an insurer can be
responsible.
Participation in the program is mandatory for specified lines of property
and casualty insurance, including surety insurance. The Act does not, however,
create coverage in excess of the amount of the bond, nor does it provide coverage
for any losses that are otherwise excluded by the terms of bond, or by
operation of law.
No additional premium has been charged for the terrorism coverage
required by the Act.
Developers Surety and Indemnity Company
Indemnity Company of California
17790 Fitch
Irvine, CA 92614
(949) 263 3300
xxR%mv.i nscodico.com
SECTION 00420
STATEMENT OF BIDDER'S QUALIFICATIONS
All questions must be answered and the data given must be clear and
comprehensive. This statement must be notarized. If necessary, questions may be
answered on separate attached sheets. The Bidder may submit any additional
information he desires.
1. Name of Bidder:-2 CoTSTfN�f�lnlCr CO•
2. Permanent main office address: rlaOQ ?j$ U-*M, C-aEBIb-11 CA3 '80U31i
3. When organized: II/ 95
4. If a corporation, where incorporated: C1uoy-of o
5. How many years have you been engaged in the contracting business under your
present firm or trade name? $'/JL YR5
6. Contracts on hand: (Schedule these, showing the amount of each contract and
the appropriate anticipated dates of completion.)
i�+-+py-%N Pry S�D�v�Syoci '6 fj -Zoo/000 `t3/2,00q
37TM`�/3`jT" A.c la+P f+-•s �, too ,000 y / Lo04
NuAC- 24-0 CE*m # 550 oad 5/2005
7. General character of Work performed by your company:
EpC�lwoct-�`,_1�%MOI.�"C1on•!� UT1L.1 TICS CONy{1-E�'E � '(�tSS�yAvT
8. Have you ever failed to complete any Work awarded to you? pc
If so, where and why?
9. Have your ever defaulted on a contract? tij o
If so, where and why?
10. Are you debarred by any government agency? ►J o
If yes list agency name.
7/96 Section 00420 Page 1