HomeMy WebLinkAboutRESPONSE - BID - 5868 ATMS COMMUNICATIONS SYSTEM PHASE 3 (5)SECTION 00300
BID FORM
PROJECT: ATMS COMMUNICATIONS SYSTEM PHASE 3; Bid No. 5868
Place
Date
1. In compliance with your Invitation to Bid dated
and subject to all conditions thereof, the undersigned
US c 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
ro 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 T�90 r�p-rrxraN� 0s,cz-, ($
) 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 Z�V2�Y5 SAS axa�t y �- S�C2� �`! Car.PA►*� c�� 1�r�� ��
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.
1% through ' X— .
7/96 Section 00300 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. 1P 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. ` 0 Yes ❑ No I have participated in a previous contract/subcontract subject to the equal opportunity
clause.
3. Yes ❑ No I have filed with the Joint Reporting Committee, the Director, or the Equal Employment
Opportunity Commission all reports due under the applicable filing requirements.
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:
Date:
j
1�4
�
CDOT Form N347 11194
COLORADO DEPARTMENT OF TRANSPORTATION Project #
UNDERUTILIZED DBE BID
CONDITIONS ASSURANCE Location
�••��••- �UIIJNIVL� allU �UUHIJL rlilb ruins wun your Dia. rteport 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? t4yes ❑ no
2) Total intended Underutilized DBE (UDBE) participation: Meets contract goals
_-fin _% ❑ yes ❑ no
3) List the UDBE firms you intend to use for your UDBE participation
Name of UDBE firm(s) Certification Intended item(s)
expiration date of work
o
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.
Company name
V 5 �.w.aa.� A't� o►l�
Date
Compa y icer signature
Title
0 anti may no[ oe usea CDOT Form #714 6/02
SECTION 00430
SCHEDULE OF SUBCONTRACTORS
List all subcontractors for the work items listed below and all subcontractors
performing over 100 of the contract.
ITEM SUBCONTRACTOR
7 " L \ v T Q-,C pal__ ( /�1 • .T
7/96
Section 00430 Page 1
SECTION 00410
.BID BOND
KNOW ALL MEN BY THESt PRESENTS: that we, the undersigned
us COMMMICATIOKS U-C as Principal, and TRAYIE[ERS::CASUALTY a SURETY COMPAMY OF AMERICA as
Surety, are hereby held and
as OWNER, in the sum of
truly to be made, we hereby jointly
assigns.
gnto the City of Fort Collins, Colorado,
for the payment of which, well and
severally bind ourselves, successors, and
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, ATMS COMMUNICATIONS SYSTEM PHASE 3; BID NO. 5868.
NOW THEREFORE,
(a) If said Bid shall be rejected, or
(b) 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
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 s•tipulates.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 such Bid; 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.
7/96 Section 00410 Page 2
11
IN WITNESS WHEREOF, the Principal and the surety have hereunto set their hands
and seals this 19TH day of JULY , 2004, 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, US CONMRiICATIONS,LLC
Addre : 'I (:'
By:
Title:
ATTE97 ,
i s
SURETY .
TRAVELERS CASUALTY A SURETY CWANY OF ANERICA
g d
Title: NANCY A• kftE ATTORNEY IN FACT
MY Commission Expires 08/01/07
5130 W.120th Ave.
Westminster, CO 80020
7/96 Section 00410 Page 3
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
TRAVELERS CASUALTY AND SURETY COMPANY
FARMINGTON CASUALTY COMPANY
Hartford, Connecticut 06183-9062
POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT
KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,
corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford,
County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these
presents make, constitute and appoint: H. Riley Holliday, H. A. Wright, Jr., E. J. Pennisi, Jr., John C. Middleton, Nancy A.
Locke, Michael D. Regan, Deborah S. Hudgins, William R. Phillips, of Nashville, Tennessee, their true and lawful Attorney(s)-in-
Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the
following instrument(s): by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the
Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all
the acts of said Attorney(s)-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed.
This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now
in full force and effect:
VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any
Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and
Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign
with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature
of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee
and revoke the power given him or her.
VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in
writing and a copy thereof is filed in the office of the Secretary.
VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking
shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice
President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant
Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary, or (b) duly executed (under seal, if required) by
one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more
Company officers pursuant to a written delegation of authority.
This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by
authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY
COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY
COMPANY, which Resolution is now in full force and effect:
VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice
President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any
power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for
purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney
or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and
certified b y s uch f acsimile s ignature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or
undertaking to which it is attached.
(11-00 Standard)
rj
1tavel�ers
L�
IMPORTANT DISCLOSURE NOTICE OF TERRORISM
INSURANCE COVERAGE
On November 26, 2002, President Bush signed into law the
Terrorism Risk Insurance Act of 2002 (the "Act"). The Act
establishes a short-term program under which the Federal
Government will share in the payment of covered losses caused
by certain acts of international terrorism. We are providing you
with this notice to inform you of the key features of the Act, and to
let you know what effect, if any, the Act will have on your premium.
Under the Act, insurers are required to provide coverage for
certain losses caused by international acts of terrorism as defined
in the Act. The Act further provides that the Federal Government
will pay a share of such losses. Specifically, the Federal
Government will pay 90% of the amount of covered losses caused
by certain acts of terrorism which is in excess of Travelers'
statutorily established deductible for that year. The Act also caps
the amount of terrorism -related losses for which the Federal
Government or an insurer can be responsible at
$100,000,000,000.00, provided that the insurer has met its
deductible.
Please note that passage of the Act does not result in any change
in coverage under the attached policy or bond (or the policy or
bond being quoted). Please also note that no separate additional
premium charge has been made for the terrorism coverage
required by the Act. The premium charge that is allocable to such
coverage is inseparable from and imbedded in your overall
premium, and is no more than one percent of your premium.
SECTION 00300
BID FORM
m
Mate of Colorado
County of Adams
Subscribed and swom L before me CONTRACTOR
6 s 9 ay of L , ap0� �.
�wd(a BY:
No ary Pu I' ADDRESS
MY Commission Expires 08/01/07
5130 W.1201h Ave.
Walminster, CO 80020
8. BID SCHEDULE (BASE BID
ITEM
#
PAY
ITEM
DESCRIPTION
UNIT
CITY.
UNIT PRICE
ITEM COST
1
203
Potholing
HOUR
600
$137.50
$82,500.00
2
613
2" Electrical Conduit (Plastic)
Lin. Foot
38,545
$7.50
$289,087.5
3
613
Pull Box 12"x18"
Each
15
$200.00
$3,000.00
4
613
jPull Box 24"x36"
Each
1 35
$250.00
$8,750.00
5
Pull Box 30"x48"
Each
35
$460.00
$16,100.00
6
613
Pull Box 48"40"
Each
4
$510.00
$2,040.00
7
614
Fiber Optic Cable (Install Only)
48s.m.
Lin.Foot
65,576
$0.47
$30,820.72
8
626
Mobilization
Lump Sum
1
$5,000.001
$5,000.00
9
630
Construction Traffic Control f
Lump Sum 1
1
$25,000.00
$26,000.00
TOTAL COST 1
$462,298.22
ff l v a Llwlg wawa rage c
The following Alternate Work locations are to be bid as separate
work items.
ALTERNATE BID
ITEM
#
PAY
ITEM
DESCRIPTION
UNIT
CITY.
UNIT PRICE
ITEM COST
Laurel St.
1
203
Potholing
HOUR
25
$137,50
$3,437.50
2
613
2" Electrical Conduit Plastic
Lin.Foot
3,030
$7.50
$22,725.00
3
613
Pull Box 12"x18"
Each
1 1
$200.00
$200.00
4
613
Pull Box 24"x36
Each
4
$250.00
$1,000.00
5
Pull Box 30'k48"
Each
0
$460.00
$0.00
6
613
Pull Box 48'k60")
Each
0
$510.00
$0.00
7
614
Fiber Optic Cable (Install Only)
48s.m.)
Lin.Foot
3,528
$0.47
$1,658.16
8
626
Construction Traffic Control
1-um Sum
1
$2,000.001
$2,000.00
TOTAL COST
$31,020.66
S. College
1
203
Potholinq
HOUR
50
$137.50
$6,875.00
2
613
2" Electrical Conduit Plastic
Lin.Foot
15,834
$7.50
$118,755.00
3
613
Pull Box 12'N18"
Each
1
$200.00
$200.00
4
613
Pull Box 24"x36"
Each
17
$250.00
$4,250.00
5
Pull Box 30'W8"
Each
0
$460.00
$0.00
6
613
Pull Box (48"x60")
Each
0
$510.00
$0.00
7 1
614
Fiber Optic Cable (Install Only)
48s.m.
Lin.Foot
17,514
$0.47
$8,231.58
8
630
Construction Traffic Control I
Lump Sum
1
$1,100,00
$1,100.00
7196 Section 003000 Page 3
TOTAL COST
$139,411.58
W. Harmony
I
1
203
Potholing
HOUR
0
$137.50
$0.00
2
613
2" Electrical Conduit (Plastic)
Lin.Foot
20
$7.50
$150.00
3
613
Pull Box 12'k18"
Each
0
$200.00
$0.00
4
613
Pull Box 24"x36"
Each
7
$260.00
$1,750.00
5
Pull Box (30N48")
Each
3
$460.00
$1,380.00
6
613
Pull Box 48"x60"
Each
1 0
$510.00
$0.00
7
614
Fiber Optic Cable (Install Only)
48s.m.)
Lin.Foot
5,780
$0.47
$2,716.60
8
630
Construction Traffic Control
Lump Sum
1
$750.00
$750.00
TOTAL COST
$6,746.60
W. Elizabeth
1
203
Potholing
HOUR
25
$137.50
$3,437.50
2
613
2" Electrical Conduit Plastic
Lin.Foot
1,628
$7.50
$12,210.00
3
613
Pull Box 12"x18"
Each
1
$200.00
$200.00
4
613
Pull Box 24"x36"
Each
1
$250.00
$250.00
5
Pull Box 30"AW'
Each
0
$460.00
$0.00
6
613
Pull Box (48'WO")
Each
1 0
$510.00
$0.00
7
614
Fiber Optic Cable (Install Only)
48s.m.
Lin.Foot
1,785
$0.47
$838.95
8
630
Construction Traffic Control
Lump Sum
1
$1.400.00
$1,400.00
TOTAL COST
$18,336.45
IM Section 003000 Page 4
Horsetooth Rd.
1
203
Potholing
HOUR
25
$137.50
$3,437.50
2
613
2" Electrical Conduit (Plastic)
Lin.Foot
1,853
$7.50
$13,897.50
3
613
Pull Box (12"x18")
Each
0
$200.00
$0.00
4
613
Pull Box (24"x36")
Each
4
$250.00
$1,000.00
5
Pull Box (30"x48")
Each
0
$460.00
$0.00
6
613
Pull Box (48"x60")
Each
1 0
$510.00
$0.00
7
614
Fiber Optic Cable (Install Only)
(48s.m.)
Lin.Foot
2,168
$0.47
$1,018.96
8
630
Construction Traffic Control
Lump Sum
1
$1,800.00
$1,800.00
TOTAL COST
$21,153.96
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 Aqreement Price.
Date
Di
l - �,sR-�\ NFL �- State of Colorado
Titre y County of Adams
sod and sworn to before me
:Nortary
y U
z
License Number (If Applicable) (Seal - if Bid is by corporation) - is
Attest: My Commission Expires 08101107
f 5130 W.120th Ave.
Address .6 25 Westminster, CO 80020
6ree /P, cc �r3 I1
Telephone (9%G) 34,'5
7/96 Section 00300 Page 5
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: US Communicktions
2. Permanent main office address: 7905 W. 120th Ave. Broomfield, CO 80020
4. If a corporation, where incorporated: Delaware
5. How many years have you been engaged in the contracting business under your
present firm or trade name? 9 ysoxrc „ndimr nr nm R years as US Communicat.
6. Contracts on hand: (Schedule these, showing the amount of each contract and
the appropriate anticipated dates of completion.)
OWact Communirationa $2,000,000 00
rnMCaSt $$41000,000 00
prem sis Camraluinications $500,000 00
7. General character of Work performed by your company:
8. Haves ructionf al e Bu r tc
y cXofnplete any Work awarded to you. Nn
If so, where and why?
9. Have your ever defaulted on a contract? No
If so, where and why?
10. Are you debarred by any government agency? No
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.
Anwcer Rnginears 6 miles fiher ap irr underground construction build
^pl ^ted january 2004 $2, 500, 000 00, [?S Army Ft Carson, Premi si s
Completed -March-2004-$200, 000 00
12. List your major equipment available for this contract.
¢ Large Directional Drill, 2 small-520 Bir-eetlenal Brills
-2-Baekhees, 2 beg Davis fiber pullers, etc
13. Experience in construction Work similar in importance to this
project:
Yes ,west Co,....,,,..iGatiens, US Army, Two —present —Foreman worked
c+� n l l rMS nl. .. 1 F R
- r c ce i'"a z: v as�ltEti1=rE}wPSt—Communications
14. Background and experience of the principal members of your organization,
including officers:
M-i kp- n-a'-ea President 20-TeaIce
Paul General bigr-20 years e�c�erienee
-Keith Braeleen Manager, 16 years experience
15. Credit available: $ $10,000,000 00
16. Bank reference: Bank of America
17. Will you, upon request, fill out a detailed financial statement and furnish
any other information that may be required by the OWNER?
18. Are you licensed as a General CONTRACTOR? 3�es
If yes, in what city, county and state? If Collins, r.arimer, (• hat
class, license and numbers?
19. Do you anticipate subcontracting Work under this Contract? yes
If yes, what percent of total contract? 20%
and to whom?UTI Communications
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
Wha company? Wi11ic North Amari ca
22. What are your company's bonding limitations? $,10foon.,Onn_nn P0,r nrnjp t
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 this L6&- day of \ ��� , 20�
Title:,"
State of C(1Li>jr�C7
County of AQ 6A:5
jic-1,4 W . eeAt'K being duly sworn deposes and says that he is
—fA'Y (LQ & of S• NS A1LLA( 6-R-r7011 `, 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 lg -Y1 day of
3ut 206L .
tar Pub i
My commission expires
My Commission Expires 001101
5130 W.120M Ave,
der, CO 80020
7/96 Section 00420 Page 3
COLORADO DEPARTMENT OF TRANSPORTATION
PROJECT NO.
ANTI -COLLUSION AFFIDAVIT
LOCATION
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.
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.
Contractors firm or company name
By _
Dale
Title
a -
2nd contractors firth or company name. (it joint venture.)
By
Date
Title
S orn,.to'bet6reirne this jci day of, JU l 20
Notary is�'
issionExpifee
IMn�
1'V'
y commis5ion expires / _
U 5130 W.120th Ave.
IA
604n6w
NOTE., This' docup,ent must be signed in ink.
CDOT Form #606 1102