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Home My WebLink AboutRESPONSE - BID - 7003 HARMONY STREETS INTERSECTION IMPROVEMENTSSECTION 00300 BID FORM 1 1 1 1 Project: Harmony / Shields Intersection Improvements Project Federal Aid Project No. AQC A1355-074 Addendum l Spec/Item Estimated Description Unit Unit Cost Item Cost Number Quantity 700-70380 F/A Erosion Control I F/A $ 1.500.00 S 1.500.00 TOTAL PROJECT COST (Harmony/Shields Intersection Improvements Project) = S 1 , 177,956.23 OnelMillion One Hundred Seventy Seven Thousand Nine Hundred Fifty Six Dollars Twenty Three Cents E ' 9. Acceptance of Fuel Cost Adjustments Bidders have the option to accept Fuel Cost Adjustments in accordance with the Revision of Section 109 - Fuel Cost Adjustment. To accept this ' standard special provision the bidder must fill in an "X" next to "YES" below. No Fuel Cost Adjustment will be made due to fuel cost changes for bidders who answer "NO". If neither line is marked, the Department will assume the bidder rejects Fuel Cost Adjustments for this project. After bids are submitted, bidders will not be given any other opportunity to accept or reject this adjustment. (Mark only one line with an "X"): X Yes; I choose to accept Fuel Cost Adjustments for this project. No,'I 'choose NOT to accept Fuel Cost Adjustments for this project ,,' , (if,,. neither line is marked, the default is "NO", I choose NOT to accept Fuel Cost Adjustments for this project. 10. 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. I Rev 10/20/07 Section 00300 Page 1 RESPECTFULLY SUBMITTED: Lafarge West, Inc. CONTRACTOR BY: Kenneth R. Ball /,--3c In 9 Date General Manager Title 00239 License Number (If Applicable) (Seal - i;,-Bid is by corporatigV) Attest: Address Fort Collins, Co. 80521 Telephone 970 407-3600 Email N/A Rev 10/20/07 - Section 00300 Page 2 SECTION 00400 SUPPLEMENTS TO BID FORMS 00410 Bid Bond 00420 Statement of Bidder's Qualifications 00430 Schedule of Subcontractors SECTION 00410 Rev 10/20/07 Section 00410 Page 1 BID BOND KNOK ALL MEN BY THESE PRESENTS: that we, the undersigned *SEE BELOW* _ as Principal, and as Surety, are hereby held and firmly bound unto the City of Fort Collins, Colorado, as OWNER, in the sum of $ **SEE BELOW** for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, successors, and assigns. THE CONDITION of this obligation is such that whereas the Principal has submitted to the City of Fort Collins, :Colorado the accompanying Bid and hereby made a part hereof to enter into a Construction Agreement for the ' construction of Fort Collins Project, 7003 Harmony -Shields Intersection Improvements. NOW TI9EREFORE, ' (a) If said Bid shall be rejected, or (b) If. said Bid shall be accepted and the Principal sha.11 execute and deliver a Contract in the form of Contract attached hereto (properly completed in accordance with said Bid) and shall furnish a BOND for .his faithful performance of said Contract, and for payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the Agreement created by the acceptance of said Bid, then this obligation shall be void; otherwise the same shall remain in force and effect, it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The! Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its BOND shall be in no way impaired or affected by any extension of the time within which the OWNER may accept 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. *Lafarge North American, Inc dba Lafarge West, Inc* **Five Percent (5%) of Amount Bid** Rev 10/20/07 Section 00410 Page 2 I 11 1 1-7 Ii IN WITNESS WHEREOF, the Principal and the Surety2phave here ntouch a ttheir e rasand, aInd seals this 20th day of January are corporations have caused their corporate seals to be hereto affixed and these fir presents to be signed by their proper officers, the day and y forth above. PRINCIPAL Lafarge North American, Inc dba Lafarge West, Inc Naine M :... AF � I Rev 10/20(07 (SEAL) SURETY Safeco Insurance Company of Amarir^ Safeco Plaza Seattle, 13y' Sandra E. Bronson Tit 1 e : ct I Section 00410 Page 3 S 5` M1 . r +, J Safeco Insurance Company of America POWER General Insurance Company of America R Safeco Plaza OF ATTORNEY Seattle, WA98185 1 KNOW ALL BY THESE PRESENTS: No. 5014 That SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA, each a 1 Washington corporation, does each hereby appoint SANDRA E. BRONSON; ROSEMARIE CAPONI; RICHARD A. JACOBUS; DENNIS C. LAUSIER; ELIZABETH MARRERO ; MAUREEN MCNEILL; WAYNE G. MCVAUGH; MARY C. O'LEARY; ADRIENNE SEAFORD; DOUGLAS R. WHEELER; DARELLA E. WHITE; Philadelphia, Pennsylvania*************************************************************** its true and lawful attomey(s)-in-fact, with full authority to execute on its behalf fidelity and surety bonds or undertakings and other documents of a similar character issued in the course of its business, and to bind the respective company thereby. ' IN WITNESS WHEREOF, SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA have each executed and attested these presents this 10th November 2008 day of Edmund C Kenealy. Secretary Timothy A Mikolajewski Vice President CERTIFICATE ' Extract from the By -Laws of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attomeys-in-fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; ' provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power-of-attomey appointment is in full force and effect, 1 the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." I, Edmund C. Kenealy . , Secretary of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of these corporations, and of a Power of Attomey issued pursuant thereto, are true and correct, and that both the By Laws the Resolution ' and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set y hand and affixed the facsimil seal of said corporation this day of `� poi d1�F Nr �q� s E C CO�ORATE a J�, , SEAL SEAL x 1 a� 1953 4` WAS M dj Y . ��'VdSa�� Edmund C. Keneal Secrets r -* Safeco® and the Safeco logo are registered trademarks of Safeco Corporation. S-0974/DS 10/08 WEB PDF 11 1 SAFECO INSURANCE COMPANY OF AMERICA FINANCLAL STATEMENT — DECEMBER 31, 2007 Assets Cash and Bank Deposits ........................................ S 53,483,126 *Bonds —U.S Governnrent.............................................16,728,067 *Other Bonds.............................:....................I......... 2,478,71I,287 *Stocks.................................................................... 499,235054 RealEstate..................................................................... 0 Agents' Balances or Uncollected Premiums .................625,553,621 Accrued Interest and Rents .................................... 33,936,490 Other Admitted Assets ............................................. 359,599,572 Total Admitted Assets ._:._»._»_«_»._»««_« MAIM49 LlablUdes Unearned Premiums .............................................. $ 728,534,002 Reserve for Claims and Claims Expense...................1,560,913,950 Fiords Field Under Reinsurance Treaties ............... 430,979 Reserve for Dividends to Policyholders ......................... 2,421,611 Additional Statutory Reserve ................................ Reserve for Commissions, Taxes and _ Other Liabilities .............................................. 936336 881 Total ._»»»».»»»_»_»..«_«_»...»_»_»».»_ $3,22S,b37,123 Special Surplus Funds—..... S 226,334 CapitalStock. ............................... 5,000,000 Paid in Surplus................................275,002,873 Unassigned Surplus ................... 35g.381,487 Surplus to Policyholders.»_»_»_»_«_»_« 838.610 b94 Total Liabflitiesand Surplus ...... »_...... S 2aa_tt� * Bonds are stated at amortized or investment value; Stocks at Association Market Values, Securities carried at $124,368,976 are deposited as roquired bylaw. I, TIM MEOLAJEWSa Senior Vice -President of SAFECO Insurance Company of America, do hereby certify that the foregoing is a true, and correct statement of the Assets and Liabilities of said Corporation, as of December 31, 2007, to the best of my knowledge and belief. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Corporaion at Seattle, Washington, this 1st day of March, 2008, y� Senior Vice -President 6A registerea trademark of S* EC0 Corporabon 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: Lafarge West, Inc. 2. Permanent main office address: 1800 N. Taft Hill Rd. Ft. Collins, Co. 80521 3. When organized: 1989 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? 10+ Years 6. Contracts on hand: (Schedule these, showing the amount of each contract and the appropriate anticipated dates of completion.) Wal-Mart Supercenter $1 5 Million Spring 2009 Vesta Blade Factory $1.5 Million Spring 2009 Saddler Ridge $500,000 00 Spring 2009 7. General character of Work performed by your company: Asphalt, Paving, Aggregates, and Read Mix Supply 8. Have you ever failed to complete any Work awarded to you? No If so, where and why? Have your ever defaulted on a contract? If so, where and why? 10. Are you debarred by any government agency? If yes list agency name. 01 Rev 10/20/07 Section 00420 Page 1 r� IJ 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. Drake/Ziegler Improvements Ph32 1 Million, Fall ?008, Widening City of FC 2008 Project ? 1 Million, Fall 2008, Repair vario,ic stree City of Greeley 2008 2 Million, Fall 9008 Repair various streets 12. List your major equipment available for this contract. ' Please see attached list ' 13. Experience in construction Work similar in importance to this project: t City of Fort Collins 2008 Project Larimer County.Overlay_ Lemay Ave. Widenting 1 14. Background and experience of the principal members of your. organization, including officers: Steve Peterson 20+ Years vice President Kenneth R. Ball 20+ Years GpnPra1 Manaaar Bob Tews 20+ Years Operations Manager ' 15. Credit available: $ Unlimited 16. Bank reference: Wells Fargo ' 17. Will you, upon request, fill out a detailed financial statement and furnish any other information that may be required by the OWNER? Yes ' 18. Are you licensed as a General CONTRACTOR? 00239 If yes, in what city, county and state? Ft Collins, Larimer, Co, What class, license and numbers? General Contractor's Tir# 00939 19. Do you anticipate subcontracting Work under this Contract? Yes ' If yes, what percent of total contract? 20% and to whom? See schedule of Rlhs 20. Are any lawsuits pending against you or your firm at this time? No IF yesi'DETAIL J I ' Rev 10/20/07 Section 00420 Page 2 IPROJECT: SECTION 00300 BID FORM Place Date City of Fort Collins - Purchasingg Div. 215 N. Mason Ft. Collins, Co. 80522 1. In compliance with your Invitation to Bid dated January 30 =, 20 09 and subject to all conditions thereof, the undersigned a (Corporation, Limited Liability Company, Partnership, Joint Venture, or Sole Proprietor) authorized to do business in the State of Colorado hereby proposes to furnish and do everything required by the Contract Documents to which this refers for the construction of all items listed on the following Bid Schedule or Bid Schedules. 2. The undersigned Bidder does hereby declare and stipulate that this proposal is made.in good faith, without collusion or connection with any other person or persons Bidding for the same Work, and that it is made in pursuance of and subject to all the terms and conditions of the Invitation to Bid and Instructions to Bidders, the Agreement, the detailed Specifications, and the Drawings pertaining to the Work to be edone, all of which have been examined by the undersigned. 3. Accompanying this Bid is a certified or cashier's check or standard Bid bond in the sum of 5% ($ ) in accordance with the Invitation To Bid and Instructions to Bidders. D4. 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: Safeco Insurance CO. Safeco Plaza Seattle, Wa. 98185 5. All the various phases of Work enumerated in the Contract Documents with their individual jobs and overhead, whether specifically mentioned, I 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. O1 through 01 . Rev10/20/07 Section 00300 Page 1 i i 21. What are the limits of your public liability? DETAIL $10,000,000.00 What company? Safeco Insurance Company of America 22. What are your company's bonding limitations? $80,532,000.00 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. IDated at Noon this 30th day of January 2009. 11 State of Colorado County of Larimer Kenneth R. Ball being duly sworn deposes and says that he is General Manager of Lafarge West, Inc. and that (name of organization) the answers to the foregoing questions and all statements therein contained are true and correct. Subscribed and sworn to before me this 30th day of January 2009. Patrese E. Yarbrough Notary Public 01' I My cc I Rev 10/20/07 Section 00420 Page 3 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 Concrete Dirt & Pipe Fly Ash Conduit & Pull Boxes Tree Maintance Erosion Control Fence Miling Landscaping CG&S Concret Gerrard Excavation Son -Haul Inc. C& J Constructinn Jordan's Tree Moving Enviornmental Logistics Town & Country Fence Don Kehn Construction A&M Landscape Section 00430 Page 1 1-1 F 1 LAFARGE WEST, INC. EQUIPMENT LIST ASPHALT PLANTS -4, 4 Oil Distributors 18 Field Conveyors 2 Draglines SPRAYERS 11 Light plants & Generators 14 Conveyors, portable 17 Silos 3 Baghouses TRUCKS & AUTOMOBILES 22 Passenger Cars 10 Single Axle Mechanic's 2 Single Axle FlatBeds 1 Tandem Flatbed 7 Single Axle Water 4 Single Axle Water 2 Tilt Trailers 40 Pickup Trucks 7 Tandem Patch Trucks 6 Tandem Water Trucks 22 Tandem Dump Trucks 30 Over -the -Road 2 Gravel Tailers 1 Gravel Tractors 10 Tool Trailers 7 Oil Trailers 1 4000 Gallon Water 1 Pipe Trailer 8 Lab & Office Trailers 5 Loboy & Hiboy Trailers 1 Rock Trailers 3 Single Axle Fuel Trucks 7 1-Ton w/Dist. -Tanks TRACTOR- CRAWLERS 2 Farm Tractors 1 834 CAT Dozer LOADERS 1 5 Michigan Loader 1 75A-Michigan Loader - TRAILERS W/RAMPS 1 AC Loader - TERRAIN HYDRA CRANE. 1 125 Michigan Loader 1 175B Michigan Loader 2 966 CAT Loader 1 275E Michigan Loaders TRUCKS - 3 920 CAT Loaders TRUCKS 7 910 CAT Loaders TRUCKS 2 936 CAT Loaders 1 950 CAT Loader TRACTORS 3 Scoopmobiles 1 224 CAT Loader . COMPACTORS 2 Vibro Plate Compactors CAT 815 WEIGHING EQUIPMENT 1 Scales 4 Ramsey Belt Scales SCRAPERS 5 613 CAT Scraper ROAD WIDENERS 1 Blaw Knox Road Widener RAILROAD CARS 35 Gondola Type Cars 1 J n COLORADO DEPARTMENT OF TRANSPORTATION Project No.: BIDDERS LIST DATA and UNDERUTILIZED AC M455-074 DBE (UDBE) BID CONDITIONS ASSURANCE Location: Harmony and Shields Intersection ort Collins Prime Contractor Instructions: This form has two sections, both must be completed and submitted with your bid. Complete Section I to list all subcontract quotes received (non -DBE and DBE). Complete Section II to report only Underutilized DBE (UDBE) participation percentages which qualify under the contract goal specification for this project. Please review CDOT Form #715 instructions before completing Section II. Attach additional sheets as necessary. POLICY It is the policy of the Colorado Department of Transportation that underutilized disadvantaged business enterprises have equal opportunity to participate on projects financed with federal, state or local entity funds. Consistent with 49 Code of Federal Regulations (CFR) Part 26.11, the Bidders List data provided by the Contractors will provide CDOT as accurate data as possible about the universe of DBE and non -DBE firms actively seeking work on its highway construction contracts, for use in setting overall DBE goals. SECTION I: CDOT BIDDERS LIST INFORMATION (Non -DBEs and DBEs) 1) Are all subcontract bids (quotes) received by your firm for this project listed below? [3 Yes ❑ No 2) If No, make certain any additional subcontract bidding information is submitted to the CDOT Business Programs Office before 4:00 pm on the day after bids are opened to ensure CDOT has the best data possible for setting future DBE goals (use the same table format as below): CDOT Business Programs Office 4201 E. Arkansas Ave., Room 200 Denver, Colorado 80222 FAX: 303-757-9019 EMAIL: eo@dot.state.co.us 3) The most recent CDOT Bidders List will be posted online at: www.dot.state.co.us/EEO/DBEProgramPage.htm NAME OF FIRM CERTIFIED WORK ITEM(S) DESCRIPTION FIRM BEING USED. SUBMITTING BID/QUOTE DBE FIRM? ® Yes ❑ No 1. Yes b] No ElMaybe C&J Construction Conduit & Pull Boxes Yes ❑ No 2. El Yes � No [I Maybe JOrdan's Tree MovingTree Maintenance [2 Yes El No 3. Environmental Lo ist [X Yes El No cs Erosion Control ❑ Maybe 4 Town & Country El Yes ® No [ El Yes Maybe ❑ No Fence Fence [2 Yes El No 5. El Yes �] No ❑ Maybe Son —Haul, Inc. Fly —Ash [3d Yes ❑ No g. ElYes E] No El Maybe Don Kehn Constr. Milling ❑ Yes] No 7. Garza Concrete ® Yes ❑ No Concrete Structures ❑ Maybe ® Yes ❑ No 8 A&M Landscape ❑ Yes KI No Landscaping ❑ Maybe ❑ Yes ® No g. Phoenix Enterprises_ El Yes (� No Erosion Control ❑ Maybe Y [:1 Yes No 10. ❑ Yes ]E] No El Maybe Alpha MillingMilling ® Yes ❑ No 11. ® Yes ❑ No ❑ Maybe CG&SGConcrete Concrete [� Yes ❑ No 12. Gerrard Excavation El Yes $] No Earthwork & Pipe El Maybe ❑ Yes )] No 13. Sturgeon Electric ❑ Yes JZ] No I Conduit & Pull Boxes ❑ Maybe Previous editions may not be used CDOT Form 714 Page 1 of 2 4/08 Co. F F� u NAME OF FIRM SUBMITTING BID/QUOTE CERTIFIED DBE FIRM? WORK ITEM(S) DESCRIPTION FIRM BEING USED? ❑ Yes 9:1 No 14. ❑ Yes ® No Concrete El Maybe TLM ❑ Yes 1� No 15. El Yes ®No El Maybe Narara"o Civil Concrete El Yes �] No 16. ❑Yes [� No ❑ Maybe Keifer Concrete Concrete ❑ Yes � No 17. El Yes [� No ❑ Maybe TMT Milling ❑ Yes] No 18. Northstar Concrete [1 Yes ® No Concrete ❑ Maybe ❑ Yes ] No 19 Northern Colorado ❑ Yes ® No Earthwork and Pipe ❑ Maybe Constructors ❑ Yes K] No 20. ❑ Yes ® No Milling ElMaybe ARS, Inc. SECTION II: UNDERUTILIZED DBE (UDBE) PARTICIPATION COMMITMENT 1) Total eligible Underutilized DBE (UDBE) percentage amount from Box A below: 19 •3 % 2) Will your company's Underutilized DBE (UDBE) participation commitment meet the contract goal? [5� Yes ❑ No 3) List the UDBE firms, committed work items, and eligible UDBE percentage of your bid committed to each. CERTIFICATION COMMITTED % COMMITMENT UDBE FIRM NAME NUMBER WORK ITEM(S) TOWARD DBE GOAL* 1 Environmental '01 % Logistics 6167 Erosion Control 2' CG&S 145 Concrete 19 '29 3. % 4. % 5. % BOX A: TOTAL ELIGIBLE UDBE PERCENTAGE AMOUNT (Round to nearest hundredth) 19 30% " Detailed instructions on how to calculate DBE commitment amounts are available on CDOT Form #715 and in the "Counting DBE Participation Toward Contract Goals and CDOT's annual DBE goal" section of the "DBE — Definitions and Requirements" in the Standard Special Provisions. I understand that, if my company is determined to be the low bidder for the contract on this project, I must submit a completed CDOT Form #715 CERTIFICATION OF UNDERUTILIZED DBE PARTICIPATION for each firm listed in Section II of this form to the Transportation Department by 4:00 pm on the third work day after the day bids are opened. The actual amounts submitted on each CDOT Form #715 must equal or exceed the DBE percentage commitments documented on this form. In addition, if my company does not meet the DBE/UDBE goal for this project, I must submit a completed CDOT Form #718 DBE GOOD FAITH EFFORT DOCUMENTATION before 4:00 pm on the day after bids are opened. CDOT Form #715s submitted for firms not included on this form, OR for amounts exceeding those listed on this form, will be accepted but NOT counted as Good Faith Efforts. Only the efforts the contractor made rp for to the bid opening will count as Good Faith Efforts. I understand my obligation to abide by the Policy stated above Section I. 1 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 PENALTY 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: 01 (30/ 09 iLa fa r W n Ken t R a 1 Company Officer Title: General Manager P s editions may not be used CDOT Form 714 Page 2 of 2 4I08 7 1 COLORADO DEPARTMENT OF TRAiJSPORTATION ' F-OJ=CT 110. 7003 ANTI -COLLUSION AFFIDAVIT LCC.LTIp•< Harmony and Shields Intersection I hereby attest that I am the person responsible within my firm for the final decision as to the pricefs) and amount of this bid or, it not. that I haVe vaitten authorization. enclosed herewith, from that person to make the statements set out bsto,.v on his or her behalf and on behalf of my firm. I further attest that: i. The price(s) and amount of this bid have been arrived at indap ndenfly,'vith.ut 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 pricefs) nor the amount of this raid have been disclosed io any other firm or parson who is a bidder or potential prime bidder on this project. and v:ill not be so discloser.) prior to bid opening. 2B. PIslther the prices nor -the amount of the bid of any other firm or person :vho is a bidder or potential prime bidder on this project have been disclosed to rris or my firm. 3A. blo attempt has been made to solicit, cause or induce any firm or person e;ho is a bidder or potential prime bidder to retrain from bidding on this projert, or to submit a bid higher than the bid of fhds firm, or any Intentionally high or non- competitive bid or otPler form of con'Iplementan+ bid. 38. hia aareement has been promised or solicited for any other firm or person veho is a bidder or potential primfe bidder on this project to submit an intentionally high, noncompetitive or other form of complementary bid on this project. A. The bid of my firm is made In goal faith and not pursuant to an,,, consuliatlon, communication, agreement or discussion with, or inducement or solicitation by or from any firm or person to submit any intentionally high, norrom- petllnle or other form of complementary bid. 5. MyLinn has not afer5d or entered Into a subcontract or agr anent regarding the purchase or sale Of Imat21'IdIS or senlicps from any firm or person, or offered, promised or plaid cash or an Ahino 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 parson 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 selvices to any firm or person, and has r*ik been promised or paid cash or an;: Nino of value by any firm or person. whether in connection with this or any other project, In consideration for my firms submifting any intentionally high, noncompetitive or other fonm of complementary bid, or agreeing or promising till do so, on this project. 7. I have made a diliclent inquiry of all members, officers, employees. and agents of my firm %vith responsibilities relating to the preparailon, approval or submission of my firm's bid on this project and have been adAsed IIy Each of them that he or she has no" participated in any communication, consultation, discussion, agreement, collusion. or other ronduct inconsistent :viih any r1f the statements and representations made in this affidavit. . a. I understand and my firm understands trial any misciatement in this affidavit is and shall be treated as a fraudulent concealment from iha Colorado Department of Transportation. of the true fads relating to submission of bids for this contract. I DECLARE UNDER PEfIALTY OF PERJURY IN THE SECOi•JD DEGREE, AND ANY OTHE APPLICABLE STATE OR FEDERAL LA'hIS, THAT THE STA.TEK-0,1TS MADE ON THIS DOCUrAEIJT ARE TRUE " COMPLETE TO THE BEST OF MY KDIOWLEDGE. nn ✓:rile•: 0l3 llllf 01 ;,nTD3"'j !.'c T? 3y ale 01 30 0 -r. Lafarge West Inc en al na er c d and eci.TF 1iG 0,:omp3'Y n _T3 Ilf firil YMI�N r ` 3.' 7i�; N / A Thln Sworn to before me this 30th d cy of. January 20 09 /09 `� �`i•....... ..�(S NOTE: This document must be signed In Ink. e�— • �O ARY •� G — = ctN : G ' p = '��`O O��. s�o M ® ® ® ® M ® ® Project: Harmon} / Shields Intersection Improvements Project Federal Aid Project No. AQC N1455-074 Addendum 1 SpectItem Estimated Number Description Unit Unit Cost Item Cost Quantity Harmon / Shields Intersection Improvements Project 201-00000 Clearing and Grubbing 1 LS 3118.35 3118.35 202-00010 Removal of Tree 96 EA 182.22 17,493.12 202-00011 Tree Trimming 10 EA 81. 90 819.00 202-00035 Removal of Concrete Pipe 112 LF 1 n 71 1,199.52 202-00037 Removal of End Section 3 EA 198.44 595.32 202-00200 Removal of Sidewalk 740 SY _1 . 94 1 , 43 5 - 60 202-00202 Removal of Concrete Gutter (10 Foot Wide) 60 LF 5.04 302.40 202-00203 Removal of Curb and Gutter 1329 LF 1.73 2,299.17 202-00206 Removal of Curb Ramp 36 SY 8.40 302.40 202-00210 Removal of Concrete Pavement 45 SY 8140 378.00 202-00220 Removal of Asphalt Mat 9551 SY 4.22 40,305.22 202-xxxx Removal of Concrete Traffic Signal Pole Base (Top 3 Feet) 4 EA 498.73 1,994.92 _ A M ® M ® ® M ® ® ® M ® ® ® M M Project: Harmony / Shields Intersection Improvements Project Federal Aid Project No. AQC N1455-4174 Addendum 1 Spec/Item Estimated Description Unit Unit Cost ' Item Cost _ Number Quantity 203-00010 Unclassified Excavation (Complete In Place) 3917 CY 5.04 19,741.68 203-00100 Muck Excavation 200 CY 28.03 5,606.00 203-01596 Potholing With Surveying and Stationing of U/G Utilities I LS 7,369.21 7,369.21 8.40 294.00 206-00000 Structure Excavation 35 CY 206-00050 Structure Backfill 18 CY 23 . 73 427.14 206-00530 Filter Material (ClassQ 10 CY 33.70 337.00 207-00205 Topsoil 593 CY 9.45 5 s 603 . 85 207-00210 Stockpile Topsoil 1907 CY 2.83 '5,396.81 207-00405 Topsoil (Special) - Amended Onsite for Median and Parkway Areas 913 CY 17.85 16,297.05 208-00005 Wattle (25'Sections) 5.2 EA 152.24 791.65 208-00020 Silt Fence 515 LF 1.00 515.00 208-xxxxx Construction Fence 900 LF 1.63 1,467400 M M M M M M M M w M®®®®®®® M M Project: Harmony / Shields Intersection Improvements Project Federal Aid Project No. AQC n1455-074 Addendum I Spec/Item Estimated Description Unit Unit Cost Item Cost Number Quantity 208-00045 Concrete Washout Structure I EA 813.71 813.71 208-00050 Storm Drain Inlet Protection (Type 1) 3 EA 183.74 551.22 208-00051 Storm Drain Inlet Protection (Type 2) 2 EA 1 8"3 - 74 _367 - 48 208-00052 Storm Drain Inlet Protection (Type 3) 3 EA 204.74 614.22 208-00070 Stabilized Construction Entrance 2 EA 1,522.43 3,044.86 208-00205 Erosion Control Supervisor 75 HR 41.75 3,131.25 209-00100 Water (Landscaping) I LS 1,093.83 1,093.83 210-00010 Reset Mailbox Structure I EA 157.49 157.49 210-00030 Reset Water Service 2 EA 802.16 1,604.32 210-01000 Reset Fence 721 LF 9.19 6,625.99 210-04010 Adjust Manhole 3 EA 362.55 1,087.65 210-W20 Modify Inlet I EA 3,197.09 3,197.09 210-04050 Adjust Valve Box 9 EA 258.96 2,071.68 �r rr rr rr r r■� r �r �r rr rr r �r it r� r r �r rr Project: Harmonv / Shields Intersection Improvements Project Federal Aid Project No. AQC 114-55-074 Addendum t Spec/Item Estimated Number Description knit Unit Cost Item Cost Quantity 212-00005 Native Seeding 0.59 ACRE 1,957.53 1,154.94 304-04000 Aggregate Base Course (Class 5 or 6) (4" Depth) - Driveways and 2' Wide Shoulder 10 TON 72 .: 00 720.00 304-06000 Aggregate Base Course (Class 5 or 6) (6" Depth) 2995 TON 13 R5 41,510.7 307-00075 Hy Ash 946 TON 56.43 47,739.78 307-00250 Processing Fly Ash Treated Subgrade (12" Depth) 14094 SY 2.71 38 ,194. 74 403-00720 Hot Mix Asphalt (Patching) (Asphalt) 55 TON 98.00 5,390.00 403-32821 Hot Mix Asphalt (Grading SG) (100) (PG 58-28) (7" Depth) 2981 TON 45.75 136,380.75 403-33851 Hot Mix Asphalt (Grading S) (100) (PG 64-28) (2" Depth) 852 TON 80.25 68,373.00 412-006W Concrete Pavement (6 Inch) 14 SY 56.61 792.54 412-01050 Concrete Pavement (10.5 Inch) 3304 SY 54.46 179,935.84 M r M M M M M s M M M M M M M M M M M Project: Harmony / Shields Intersection Improvements Project Federal Aid Project No. AQC N1455-074 Addendum I SpecAtem Estimated Description Unit Unit Cost Item Cost Number Quantity 412-xxxxx Concrete Pavement (10.5 Inch) - Colored and Stamped Concrete Crosswalks 455 SY 91.45 41,609.75 412-01060 Concrete Pavement (10.5 Inch) - Fast Track (48 Hour) 1508 SY 56.67 85,458.36 412-01061 Concrete Pavement (10.5 Inch) - Fast Track (24 Hour) 150 SY 75.33 11,299.50 412-01100 Concrete Pavement (I t inch) 45 SY 65.88 2964.60 506-00212 Riprap (12 Inch) 514-00100 Handrail 94 18.5 CY 46.72 LF 164.26 601-01050 Concrete Class B (Wall) 33 CY 603-01365 36 Inch Reinforced Concrete Pipe (Complete In Place) 44 LF 603-02365 29 x 45 Inch Reinforced Concrete Pipe (Complete In Place) 27 LF 603-05036 36 Inch Reinforced Concrete End Section I EA 515.89 151.61 1,342.88 3,038.81 17,024.37 3,899.28 4,093.47 1,342.88 Project: Harmony / Shields Intersection Improvements Project Federal Aid Project No. AQC N1455-074 Addendum I Spec/Item Estimated Number Description Unit Unit Cost Item Cost Quantity 604-19310 Inlet Type R L 15 (10 Fool) I EA 5,918.56 5,918.56 604-30006 Manhole Slab Base (6 Foot) 2 EA 2,072.60 4,145.20 605-00004 4 Inch Non -Perforated Pipe Underdrain 176 LF 19.06 3,354.56 605-00040 4 Inch Perforated Pipe Underdrain 775 LF 13.96 10, 819.00 608-00006 Concrete Sidewalk (6 Inch) 1275 SY 30. 82 39,295.50 608-00010 Concrete Curb Ramp 158 SY 89.73 14, 177.34 609-21010 Curb and Gutter Type 2(Section l-B) 2154 LF 10.57 22,767.78 609-21020 Curb and Gutter Type 2 (Section 11-B) 1910 LF 11.32 21,621.20 609-24010 Gutter Type 2 (10 Foot) 60 LF 60.89 3,653.40 610-00010 Median Cover Material (Decorative) 1231 SF 6.09 7,496.79 = M M M M M M M M M M M M M M M s M M Project: Harmom° / Shields Intersection Improvements Project Federal Aid Project No. AQC M455-074 Addendum t Spec/Item Estimated Description Unit Unit Cost Item Cost Number Quantity 613-00200 2 Inch Electrical Conduit 300 LF 6.93 2,079.00 613-00400 4 Inch Electrical Conduit 300 LF 8.71 2,613.00 613-07010 Pull Box (Surface Mounted) 2 EA 1,154.94 2,309.88 620-00020 Sanitary Facility 2 EA 556.47 1,112 - 94 626-00000 Mobilization I LS 62,815.29 62,815.29 700-70010 F/A Minor Contract Revisions I F/A $ 77,175.00 S 77.175.00 700-70012 F/A Asphalt Pavement Incentive I F/A $ 1,200.00 S 1,200.00 700-70013 F/A Concrete Pavement Incentive I F/A $ 2,500.00 S 2,500.00 700-70016 F/A Fuel Cost Adjustment I F/A $ 7.800.00 S 7.800.00 700-70019 F/A Asphalt Cement Cost Adjustment I F/A $ 28,710.00 S 28,710.00 700-70021 F/A On the Job Trainee 320 HR $ 1.88 S 601.60 700-70022 F/A OJT Colorado Training Program I F/A $ 525.00 S 525.00