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HomeMy WebLinkAboutRESPONSE - BID - 5929 CSU TRANSIT CENTERSECTION 00300 BID FORM SECTION 00400 SUPPLEMENTS TO BID FORMS 00410 Bid Bond 00420 Statement of Bidder's Qualifications 00430 Schedule of Subcontractors KNOW ALL MEN - as Principal, and hereby held and OWNER, in the sum truly to be made, and assigns_ SECTION 00410 BID BOND BY THESE PRESENTS: that we, * the undersigned .TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA as Surety, are firfrly bound unto the City of Fort Collins, Colorado, as of $--5%--** for the payment of which, well and we hereby jointly and severally bind ourselves, successors, 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 constructior_ of Fort Collins Project, Bid 5929, City of Fort Collins and Colorado State University Transit Center NOW THEREFORE, (a) If said Bid shall be rejected, or (b) If said Bid shall be accepted and the 2rincipal shall execute and deliver a Contract in the form of•Contract attached he-eto (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 taerewith, 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 valve received, Thereby stipulates and agrees Jhat 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 no -ice 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. * MARK YOUNG CONSTRUCTION, INC. ** FIVE PERCENT OF TOTAL AMOUNT BID --- ----------- 7/96. Section 00410 Page 1 r IN WITNESS WHEREOF, the Principal. and the Surety have hereunto and seals this 18th day of Auguset their hands , August set corporations have caused their caxe orporate seals to be hereto affixed andr and such of thematheze Presents to be signed by their proper officers, she day and year first set forth above. PRINCIPAL SURETY TRAVELS Name: MARK YOUNG CONSTRUCTION, INC. COMPANY" OFCKOUALTY AMERICA AND SURETY Address:155 North College Ave., Ste 220 P.O. BOX 469025 rt Q61##/ CO 80524 By Title: (SEAL) 7/96 Denver, C 8 By: Title: A orn y-In-Fact T R Richards Section 00410 Page 2 STPAUL TRAVELERS IMPORTANT DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE On Nov 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 percent of the amount of covered losses caused by certain acts of terrorism, which is in excess of an insurers 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 billion, 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. u.T--rocs (9104) `• ` 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)-M-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") bath made, constituted and appointed, and do by these presents make, constitute and appoint: Courtney T. Peterson, James S. Rosulek, J. R- Richards, Douglas J. Rothey, Susan J. Lattarulo, Cynthia M. Burnett, Frank C. Penn, DiLynn Guern, Pamela J. Hansen, Kevin W. McMahon, Donald E. Appleby, Gloria C. Blackburn, Kristen L. McCormick, Florietta Acosta, of Denver, Colorado, their true and lawful Attoe s -m-Fact with full power and authority hereby conferred to sign,PP y� following instrument(s): by his/her sole signature anct,xany and all bonds, rreco at any place within the United States, the writings obligatory in the nature of a bond, recognizance,gnany an , contracts consents incident thereto and to indemnity, and other bind the Companies, thereby as fully and to tsame extent as if thonal undertaking same ere 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 Secre 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 to sign with the Company's �' �Y appoint Attorneys -in -Fact name and seal with the Company's seal bonds, recognizances, contracts of indemni Y y prescribe the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors ,at and other writings obligatory in appointee and revoke the power given him or her. y time may remove any such VOTED; That the Chairman, the president, any Vice Chairman, may delegate all or any part of the foregoing authority to one or oree officers or mplony Executive Vice esof this Company, m writing and a copy thereof is filed in the office of the Secretary, President any Senior Vice President or any Vice President provided that each such delegation is VOTED: That any bond, recognizance, contract of indemnity, or writingobligatory undertaking shall be valid and binding upon the Company the President, m the nature of a bond, recognizance, or conditional Senior Vice President or any Vice President, any Second Vice (P esideni th Treasurein��Assistant Trea n, an E Executive Vice SePresident, any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant SecrettheCorporate or any required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or(theirucertificateso(under seal, if 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, power of attorney or to any certificate relating thereto appointing and the seal si the Company may be affixed by facsimile to any Purposes onlyof executing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for ting 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 by such facsimile signature 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. 01-00 Standard) IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrument to be signed by their Senior Vice President and their corporate seals to be hereto affixed this 19th day of May 2003. STATE OF CONNECTICUT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY }SS. Hartford FARMINGTON CASUALTY COMPANY COUNTY OF HARTFORD Ya �tY Ap SUnw Jr O GASU,4 "y[y �°j mG,D Oa��OI��Ay Z�iLC a HARTFORD, i 0 '1932 � O By CONN. cONN. c • i w ;`b yam �d,a George W. Thompson Senior Vice President On this 19th day of May, 2003 before me personally came GEORGE W. THOMPSON to me known, who, being by me duly sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, the corporations described in and which executed the above instrument; that he/she knows the seals of said corporations; that the seals affixed to the said instrument are such corporate seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing Resolutions thereof. r(�o.nv. e '�.a�nzcuil,k My commission expires June 30, 2006 Notary Public Marie C. Tetreault CERTIFICATE I, the undersigned, Assistant Secretary of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, stock corporations of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and furthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the Certificate of Authority, are now in force. Signed and Sealed at the Home Office of the Company, in the City of Hartford, State of Connecticut. Dated this 18 th day of August , 20 OS. a a" ttARr�oRo, � gJ,LtY ANON o� L9m Ao?ty � ryr y a HARTFORD, < l5 19 8 2�' o CCNN. By YGt Kori M. Johanson Assistant Secretary, Bond 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: ►,�)L lO19pci COPSTjaucl'lM), ►NC. 2. Permanent main office address: 41GO SASoi f ST. I [DE.NWWj CD 50ZII 3. When organized: C,41141IC1841 4. If a corporation, where incorporated: COLOIZADO 5. How many years have you been engaged in the contracting business under your present firm or trade name? 15 `{�S 6. Contracts on hand: (Schedule these, showing the amount of each contract and the appropriate anticipated dates of completion.) SE'1: A'rA��1►-tar NT 7. General character of Work performed by your company: Ca60EPAL CoNTR,AGT1Wg lcoNSTRueTIDN MA0AAQ_kLEQ_r 5EIr1F-PEtiz ft' .k C"CIZel:F: , VoLXIR 1t FItOlstA CARP61-4-11L{ CttF1elEir 8. Have you ever failed to complete any Work awarded to you? Q0 If so, where and why? A 10 Have your ever defaulted on a contract? 00 If so, where and why? Are you debarred by any government agency? 00 If yes list agency name. _ 7/96 Tl oo Section 00420 Page 1 0 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 off rnnstruction. V-16DF-0 FAPL"!5 ; 51M foRI-6,C)U-105, Co IZ rAIL_ 12. List your major equipment available for this contract. 5WRUDADr--�l B,4oY S Surtd�y�1JC��Ql7lP1.dE1Jr CANSTjZUG'RotJ "[AAILE.tz. ldtSG. SUpPL1ES 13. Experience in construction Work similar in importance to this project: CSV- tNC110*,FP1Wq {��SEhEac}{ GEt�1T�� GSV - ENVI�ZoNnJ 61V-tiSS LAS , CSV- UJbVSTPtAL Sr- IiNGES ; GSV- CREW .l • 14. Background and experience including officers: OAVIDCUIDA, PRESIDUNT - of the principal members of your organization, -"1{Z5 EXFr--gIENC.E. Iti cc"Me 15. Credit available: $ Si000.000 16. Bank reference: Uf LLS fA`ZGtO BANS N.h. CoNTAGT , DAN CASMp- 4O Ltd r.T Coll. WSJ CO 8052 17. Will you, upon request, fill out a detailed financial statement and furnish any other information that may be required by the OWNER? `iES 18. Are you licensed as a General CONTRACTOR? lEs If yes, in what city, countv and state? Ibp--r [.ol.Llr4%, co What class, license and numbers? $-*6 19. Do you anticipate subcontracting Work under this Contract? 41;5 If yes, what percent of total contract? TO e9-- OC17er-Mt► 4 t> and to whom? ARioUS sutae-ov.YmAGiDP.S 'T'o t3E DE'TaQLkWEb 20. Are any lawsuits pending against you or your firm at this time?_o IF yes, DETAIL 7/96 Section 00420 Page 2 f� f 21. What are the limits of your public liability? DETAIL 4 111 0001600 What company? P-AVSL*S 22. What are your company's bonding limitations? N SING'!✓ t-jmiT — Zo1Jl I kr4QvaEghiE l..l► it — No C.utl FF pr I. l,j"ITATl 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. II Dated at ' �+ U 0 LAVA this 23�b day of AUGiUST 20oG. 11 I„U S GTl oIQ C.- Name of By. Q�" Title: U� State of C6 County of AV1d I4V,dN being duly sworn depgs�_ r ,,says that he is of (name of organization) the answers to the foregoing questions and all statements therein contained are true and correct. ubs ribed and sworn to before me this Myd day of 2005. Y M��,� N ; ' NOTAR }.4 My commission expires D 0 L1`V 7/96 Section 00420 Page 3 last update 7/8 Mark Young Construction, Inc. Date: August 23, 2005 Work Currently Under Contract 1. Maintenance King Soopers, Inc., City Market Varies 70n70n Contracts 7+1-$600,000 2. Retail Grocery King Soopers, Inc./CityMarket Varies ShelvingrFixtures 3. Retail Grocery King Soopers, Inc./City Market Varies Varies On Going On Going Refrigeration 4. King Soopers #97 King Soopers, Inc. Michael Bray Architects $3,479,275 99% 08/05 New Grocery Store O.C. Larson Michael Bray 2602 Timberline Road (303) 778-3069 Ft. Collins CO 303-840-4770 S. Rigden Farms Komfield, Koslosky, Properties Wyatt and Associates $2,046,007 95% O11105 Site Construction Joe Koslosky Dennis Wyatt 2602 Timberline Road Ft. Collins GO 303-777-0386 303-698-1717 6. Rigden Farms Komfield, Koslosky, Properties Wyatt and Associates $1,659,633 98% 8105 Retail Buildings Joe Koslosky Dennis Wyatt 2608 & 2614 Timberline Rd. Ft. Collins CO 303-777-0386 303-698-1717 7. Maintenance Miller Weingarten Realty Varies Varies On Going On Going Management Company Denver CO 8. Refrigeration Service & Whole Foods, Inc. N/A Varies On going On Going Maintenance Multiple Stores Colorado 9. 965 S. Hover Street Macy Development Sanderson Architects, LLC 772,137.00 89% 08/05 Addition & Remodel Don Macy George Sanderson Longmont, CO 303-321-8888 303443-BO60 10. King Soopers #87 King Soopers, Inc. Michael Bray Architects 3,825,861.00 54% 10/05 New Store Construction Terry Scott Michael Bray David Avenue & Confer Road Conifer, CO 303-778-3045 303-8404770 11. The Village at Conifer Aspen Park Investors Wyatt & Associates, P.C. 6,458,090.00 15% 12105 Retail Buildings 4,5.6A. 613, 7A, 7B Ben Hummel Dennis Wyatt 25557, 25577, 25587, 25597 Conifer Road Conifer, CO 214-360-9600 303698-1717 12. The Shops @ Walnut Creek Westminster Development Company H.C. Klover Architect $5,046,410.00 60% 11/05 Building A-E Dennis Richardson Kevin Campbell 10442 Reed Street Westminster, CO 816-777-3500 916649-8181 13. 1079 S. Hover Street M3 Properties, LLC. Sanderson Architects, LLC 1,421,645.00 17% 12105 2 Story Office Building Don Macy George Sanderson Longmont, CO 303321-8888 303443-8060 14. King Soopers #5 King Soopers, Inc. Mitchell Plus Associates 363,970.00 71 % OB/05 Store Remodel Bill Bates Jeff Pelaez 1355 Krameria Street Denver, CO 303-7783050 303477-2770 15. The Shops Q Walnut Creek Westminster Development Company H.C. Mover Architect 3,529,286.00 1% 12/05 Building F-I Dennis Richardson Kevin Campbell 10442 Reed Street Westminster, CO 816-777-3500 916649-8181 16. King Soopers #97 - Fuel Facility King Soopers, Inc. Galloway, Romero, & Associates $322,799.00 49% 08/05 2602 Timberline Road O.C. Larson 5350 DTC Parkway, Greenwood Village Ft. Collins, CO (303) 778-3069 (303) 770-8884 SECTI0N 00300 BID FORM PROJECT:5929 City of Fort Collins and Colorado State University Transit Center Place Pu eNASkPQ Dt\)Mlow 0MCS Da- 3:O0q PM 1. In compliance with your Invitation to Bid dated dUL.y L'�and subject to all conditions thereof, the undersigned a (Corporation, Limited Liability Company, Partnership, Joint venture, or Sole Proprietor)** authori2ed 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 fer 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, a].] 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 TOTAU IND ($ 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:-MA)eUtgS INSV 2A1�1Gt✓ 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. o'. 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 5 SECTION 00500 AGREEMENT FORMS 00510 Notice of Award 00520 Agreement 00530 Notice to Proceed OAP-k IDUNG COPSTFZVCTIOtJl it-4c. vA\Jir)_ A v V.)%jeCo aOZll - so%. 4-71. 9013 4 A'-TERr 1PI-EL; 1DD Ln Fia s, Skyl -',hzs a:: 2 r, v t - - i ucco arld !)�,I�:o c ADD L.-, bas:(- t,�jn. 2►,10"15 Use St c r) L i u�:c:o, i n c i r-, pending accrp:_at:�le much: ALIL', to base bid "ri'd piov_.Jc Atli upf,-:,r it!v,!l rerlov,11-i"'11 1s ADD t,<) )ici 7,15(o4 7. 1-1*1,--,.jlC It . hanciicappcd '-Cvc-L ADD to 6,jd E. -'-iann upgrade pmding flow Lest rc-p-,rt, as jtr,ted: j.,DL:, to base bic; i s 1,26o F:C. ; ras;li!+'. } Itacaptacl-: A__.l)I::I Y,1C'I' r,DD or DEDUCT, _n,_ LLauh/a_n ze•cep acle per i,:,-;t ion ins La1L comc,Let_d. ... DEDUCT ).: DEDUCT, on: ot 4" Y1,_rstone vener per s_,cciticsroans, installed complete. 1 _Jl. Thin .L iC Qnc Cc ne or l i I r ^`ir_'d m :1 i DGLJ__ ADD__ DEDUCT, . nc syuc,_ I_ +L Ot thin v _ .tw_ F! y: z.ne vane,,. faVprovcd match), tins r-i11e.d ..omnI tto _ 2.60 2bo Ur-:PUC.T ADL' or DEDUCT, on _ min trica_ ovt_et oer s�,=c (. _ complete. mp1cL•�. :.. o .-➢cutlets: y IN'.DUC'I' F:D9_ ..r :,EDUCT, one data outlet per spec. _:)aip.la te. oi DrD'}-T, r,e ❑pp.:n ,,nel MUM mi 11 w•�_�rl: st,ec, co. 111 I .- .Q h., ADD ..r DEDUCT por s:E M interior ::a1i ciumoli Liar. j 3.00 ra)r-- I r „EL' T ,e 1- .,E rleW :asp r,;t. _3,oO DEDLIi=T ?DD ADD w DEDUCT per s1 of _..._a.ior ne,intincl L. s—IM,__FiLin ADD Qi DEDUCT each I-,;pi.-.aL u" .. G" rortr. sir.n -1. 5!00 ;),) ,il ADD ur DEMITY E;,_•u of _:arp�t, 1, ', ,W 4. .00—D7, D.( IcT n' t 5.00 .u)U ilr 5.00 -)ERUCT li' 25 ADD I s 29 DEDUC-7 u. .�0 DEt»cT' 4-1 --. s ADD ADD or DOXXT pw W n •.r..m is tie 2" ..._ i nr:t-a i l e= . -' 15ABDEU`J`'7 :..: Af: Li :•r i^I'I)4 .I' <,:h aft K 25i ,- a=u t ', - • 1 ADD 01 DKIRK•I' n=�� r,ii i.a,r:. ecrd concrcLc pa';iny 2 L L: :SCECUC� .75 bA2 DED:JC - ,_,- �:..'�.J:.:1 p-: .. qi:a �:. ;•zlr:l <.clorc(3 :'-.�icr _. c. ,:_i^any }iD nr C)�Ci'?i':i 1%car ,;j stuc reVeals IADI: r,.L. DEDUCT ll:ar.;;al," i:<.I cny-ICI-.a LLD .._ � ..L.-:- ^�FI�.. t•!-.: 'ur.:al lyill irs:-:tl,,c� nI�. J. �a T:. i. G-_t.C:'!' ner sC ! co _ z:1Cd ccr.___zc r t or ')EDUC"I City I]%L Cc?J"7 �,rrnr anri iiNl fr.=_nlr- C.^.fn p:� Le ..i Ljl IF, c:r C,,T17CT r,nr- iF ol` caonrtacec7 i:nee wall or rubb�e ,_c.SC Bi:D e*oflE LF of: Tile. Cd^..3Dr.ovc^' IEOc_S n:£ qr anit_ _asc�:' ?a-tist David (11- qA ;3U_',jDenver, CO LC"O1 1. E_j)ed glans raiaiRc7:le tail 111:;' - SheeL n-7.1 -- OC11VC__',r �f glass from railing mfg --o Great Canes Glass tac>r ks LnC. ._ g41.0 vlµ;Ill I(Irsnl AvL1 . - Clr'f1Vt]rr L',i 8C2 L6 - '303-294-0927 - drf�13L '✓,:nia ::C wi 1 1 :>r:r:cv_n^ I: hz: ..>h,l_o Gmi.ils inn etch i;• �l=Liver t<, si.? r uj_;eu ..ornl l .t on for inFtal Iat-icnn by i Contrac t cr. $:1D'-L':�.:dG 31U ip}1,:,I:o e;mulsi_�n priCr b;: rrTi�ier) Lavc rod wa:Ll bozrro -- Dcst:ai1 11*13 ;"!.J - C+aa Relief --�.:t_yer-r-,d _f. l.,.al�•h L,..:I nI_�ch_� :tt �-t.1-l.• CyFi �.-,11` .. 4r as pan- -is b••,: art-.ist.: r i.'_tl c.�lar rmz�nL _r.�•lr:;,_ on:- jfr� )t?I �3e nS::d1.InTl. lnt_ a. :r..r itt^Lxl_aLiun. f j 1 t : 1-1 ,, n i n c, 3 1 f.A 11, [).tail li3 Sri, �t A-, . 2- ul - . 1- "Im� - - -, - r, i � I (,- 7 �T� ot a r u�l rit r��i !-,c ve r I-u, f4-i o h,v c T a 1! 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Ela L Ah*� -f F- FbZ'T- CA.)t-w0s, CO qb-ri,24 AB -1645 1-9JOI 4 d - RUG 24 2005 3:51PM MARK YOUNG CONSTRUCTION I 7202144727 p.2 Vn� COLORADO DEPARTMENT OF TRANSPORTATION PROJECTNO. ANTI -COLLUSION AFFIDAVIT Csv LOCATION G01 (�OLLg1.NS , CO 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: f. 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. 213. 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 firth 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 riot 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 fora 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. I 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 NY OTHER APPLICABLE STATE OR FEDERAL LAWS, THAT THE STATEMENTS MADE ON THIS DOCUMF�IT j1 RUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. , / Contactors firm o, compsrry name 10V pci Colicz7m c"noo, INC—. m or a Vwry name. M vim Y*4we.) Sworn to before me this A+rvA W ocomrsyon expires p e7 Title 5 By Date cfilgfr- Tits L day of, rn v (i��{ 1 p��Y.M C q� O oGJ NOTE: This document must be signed In ink 40-6. w PUBLIC CDOT Form #M 1= 0 COLORADO DEPARTMENT OF TRANSPORTATION project No.: CSU TRANSIT GENT E42- CERTIFICATE OF PROPOSED UNDERUTILIZED DBE (UDBE) Project Code (SA#): PARTICIPATION Location: �OpI'" 6bl.L105t GD Form #: of Prime Contractor — Send completedlsigned 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 Speclar Provisions, for further Information concerning counting DBE participation of subcontractors, suppliers and service providers toward the project's UDBE goal.) PART 1 n _ SIIRCdNTRACT NAME OF UDBE FIRM TIER CERTIFICATION # EXPIRATION DATE ELIGIBLE UDBESUBCONTRACT AMOUNT (ACTUAL CONTRACT AMOUNT 4 IZD9:SAt.Vi OSMkL 5��`I {D 151101 Lk), MO �j M�C'I�111J IGAI. f T GU WIlaIN� E� �V ACr ITEMS OF WORK SUBCONTRACTED: PART I _ SUPPLY CONTRACT If the supplier is a UDBE "Manufacturer" of the item(s): f• 4+, r. Ip • ACTUAL UDBE AMOUNT =Entire expenditure for materials and supplies including cost bf any delvarys rvces provided by the firm u • ELIGIBLE UDBE SUPPLY AMOUNT = � (ACTUAL UDBE AMOUNT X 100 /• If the supplier is a UDBE "Regular Dealer of the item(s): • ACTUAL UDBE AMOUNT = Entire expenditure for materials and supplies liicludrng cc) stof any delivery services provided by the firm • ELIGIBLE UDBE SUPPLY AMOUNT = C (ACTUAL UDBE AMOUN) S If the supplier is neither a "Manufacturer" nor a "Regular Deale r{Iher�sj set PART I — SERVICE I BROKER CONTRACT. NAME OF UDBE FIRM CERTIFJCION°# 'EXPRATJON � ' i ACTUAL UDBE ELIGIBLE UDBE SUPPLY „DATE= AMOUNT AMOUNT WJA fK �1 .K rl s MATERIALS SUPPLIED V. rFl 1 1' I'J 'v PART le- SE'OWIDE' 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) ] (NOTE: The amounts that count toward UDBE goals are limited to the compensation retained by the UDBE broker/agent 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 1J A 1 1 SERVICES RENDERED: Original — Business Programs Office Previous editions may not be used CDOT Form 715 05103 11111111111101 10 .00 1111110 ow 11111110 me No 'W so no so me PART 2 - UDBE PARTICIPATION SUMMARY A) What is the total dollar value of this proposed subcontract, supply contract, OR servicelbroker contract that is eligible for counting toward contract goals? (NOTE: Provide In actual subcontractor dollars and not prime contract prices) A> —74, MQ A = j TOTAL FROM "ELIGIBLE" COLUMNS IN PART 1 ] B) What is the total dollar value of proposed subcontracts that are eligible for counting towards B> ` , 0 515 I� I� contract goals from prior sheets/forms? C) What is the accumulative value of proposed subcontracts that are eligible for counting towards contract goals? C> l� i C)t coo C=[A + B] What is the original contract bid total? D> � �D) I 318 1 scv- E) What is the accumulative percent of contract bid total subcontracted to all underutilized DBEs? Ni „k E _ [ (C - D) X 100 1: n i PART 3 - PRIME CONTRACTOR CERTIFICATION I certify that: r 1 st'," 1 i • my company has met the contracted UDBE goals or has -AttaiMedta-cotnplet 'd DOT Form #718, DBE Good Faith Effort Documentation.=,1� ' .- • my company has accepted a proposal from Pub UDksubt:ontraetb; named above. • my company has notified the proposed UDBE subcontract©t�f �e°bontracted UDBE commitment. • my company's use of the propose, ,,,,, - subco. J— t. R "'Mhe items of work listed above is a condition of the contract award. • my company will invite the proposed UDBI=sdbcbntra`" to attend the preconstruction conference. • my company will not use, a sbWItu`(e UD�BE:,subcontractor for the proposed UDBE subcontractor's failure to perform under a fully executed subcontract, uitless'rny cpr pany compiles with the definitions and requirements section of the DBE Special Provisions • 1 understaudfhat llufe toscomp� with the informatlon shown on this form will be considered grounds for contract termination. I declare under penalty of pe1. rt-urj in the second degree, and any other applicable state or federal laws, that the statements made on this document ere true and complete to the best of my knowledge. Prime Contractor Name: yC)L) cl (,C>0S-T*R0C-no0J INC Date: 09 1231 ZUOS Officer Signature and Title: INS I KUL; I IUNb Prime Contractor: 1. An officer of the contractor(s) must complete this form. 2. Include only DBE firms which meet the underutilized criteria in the contract goal specification for this project (i.e., UDBE firms). 3. Complete ONLY ONE section for Part 1 (1 a, 1b, OR 1c) 4. Complete ALL sections of Part 2 and Part 3 5. Submit a separate CDOT Form #715 for EACH proposed UDBE. — Business Proorams may 61AIEf 4ES 1vU 6. Retain a photocopy for your records. 7. Send original to: Colorado Department of Transportation Business Programs Office 4201 E. Arkansas Ave. Denver, Colorado 80222 FAX: (303) 757-9019 PAGE 2