Subrecipient Forms - PROCUREMENT STANDARDS, PROCEDURES, AND FORMS

CHAPTER II PROCUREMENT STANDARDS, PROCEDURES, AND FORMS

APPENDIX 2 Subrecipient Forms

Contents

Exhibit 2-1: Verification of Professional Services Eligibility Exhibit 2-2: Verification of Contractor Eligibility

Exhibit 2-3: Notice of Contract Award

Exhibit 2-4: Certification of Subrecipient and General Contractor Affirmative Action / EEO/

Section 3/ Prevailing Wage SWMVBEs Addendum to Construction Contracts and Bid Documents

Exhibit 2-5: Certification of Subrecipient NCR Federal Labor Standards Provisions – Davis Bacon Act and “Related Acts”

EXHIBIT 2-1

VERIFICATION OF PROFESSIONAL SERVICES ELIGIBILITY

*Please attach a copy of firm’s Business Registration Certificate (BRC) to this form.

1. Request for Clearance of Professional Services is hereby made by:

Name of Subrecipient CDBG-DR Number

2. Identification of the professional firm for which clearance is requested:

Legal Business Name DUNS number Street Address, City,

State, and Zip Code Phone Number(s)

3. Name of the principles of the firm and their title/position are as follows.

(Complete names preferred: Example—John Buford Brown is preferable to John Brown)

Name of Principals Title(s)

4. Description of professional services?

5. Signed: Date

City/Municipality CEO or Representative 6. (To be completed by the NJEDA)

Professional firm cleared: Yes No Date:

Signature, NJEDA’s staff Faxed or Mailed To Comments:

27 EXHIBIT 2-2

Verification of Contractor Eligibility (For use by Prime Contractor and all Subcontractors) Verification of Contractor Eligibility

Please Note: Verifications must be obtained prior to award of contract

1. Subrecipient/Owner Name

2. Disaster Recovery CDBG Contract Number/Loan Number

3. County

4. Bid Opening Date

 Identification of the contractor and principals of the firm.

5. Contractor Legal Business Name

6. DUNS number

7. Address

8. City

9. State

10. Zip Code

11. Contractor Phone Number

12. Enter the name of each principal below Enter the title of each principal 13.

14.

15.

 Signature and dates below indicate verification by NJEDA 16. Contractor’s eligibility

performed by

(Print) (Sign) (Date)

Instructions for Verification of Contractor Eligibility (Exhibit 2-2) Note: This form must be executed before the award of a contract.

1-3. Name, Contract #, County Name of grant Subrecipient/Owner, Disaster Recovery CDBG contract #/Loan #, County

4. Bid Opening Date The date construction bids were opened

5.-11. Contractor Identification The legal name of the contracting firm. Address, & Phone

12.-15. Identification and titles of Principals of the firm

Since the names are checked against a federal database of debarred names, list the complete name if possible.

In the case of corporations, “Principals” are owners or office holders as recorded legally. In sole proprietorships or partnerships, “Principals” are the owner(s).

Titles or Position: Examples—President, Vice Pres, Secretary.

16. Identification of NJEDA staff performing contractor eligibility verification

The name and signature of the NJEDA staff who verifies the contractor’s eligibility; date which the verification was performed

EXHIBIT 2-3

NOTICE OF CONTRACT AWARD

1. The CDBG- Disaster Recovery:

Subrecipient (Owner) Name CDBG-DR #

2. A prime construction contract has been awarded as follows:

Name of prime contractor Type of work to be done

Bid Opening Date Date of contract award Estimated date of start of construction

3. Components of the above listed contract identified by source, purpose and amount:

Source Purpose Amount

4. Total Amount of Contract Award (All funds—Local, CDBG, etc.)

5. A copy of the certified and itemized bid tabulation is attached: Yes No 6. Comments:

7. Signed

Subrecipient’s Labor Compliance Officer or CEO

8. Date

Instructions for Notice of Contract Award (Exhibit 2-3) 1. Subrecipient (Owner) Name

CDBG-DR Number

Name of Municipality or Town that is the Subrecipient of grant funds.

Six-digit project number between NJEDA and grant Subrecipient.

2. A prime construction contract

Name: of prime contractor.

Work Description: Examples: streetscape, facade, etc.

Bid Opening Date: self-explanatory.

Date of Award: official date by action of municipality.

Estimate: an educated guess on start date of construction.

3. Components of the above listed contract…source, purpose, & amount

Components of the construction contract must be identified by source, purpose and amount. Example:

Source Purpose Amount

CDBG Sewer lines, engineering 500,000.00

USDA Sewer treatment plant 300,000.00

Local Engineering 50,000.00

Some construction contracts involve only CDBG funds and have a single purpose. For such cases, use only a one-line entry.

4. Total amount of contract award

Components amounts added together should equal the total of the prime construction contract referred to under item “2”.

From the example in “3”, above, the total would be $850,000.00.

Enter the original amount of the award prior to any change orders.

5. Copy of the Certified and Itemized Bid Tabulation attached

A bid tabulation should be attached to this notice. Indicate whether the bid tab is attached by marking “yes” or “no”. If no, explain why in the

comment section of row 6 and, as necessary, establish a projected time table for the bid tabulation to be sent to NJEDA.

6. Comments Enter any applicable comments.

7. Signature or typed name Signature or typed name of the Subrecipient’s Labor Compliance Officer.

8. Date Date on which the form is prepared (not the contract award date). It must be sent to NJEDA within 30 days of the award of the contract.

EXHIBIT 2-4

Certification of Subrecipient and General Contractor Affirmative Action / EEO/Section 3/

Prevailing Wage SWMVBEs Addendum to Construction Contracts and Bid Documents

32 EXHIBIT 2-5

Certificate of Subrecipient – Federal Labor Standards

APPENDIX 3

Sample Bid Forms Contents

Exhibit 3-1: Bid Packet for Construction Contracts- Sample Forms and Certifications

EXHIBIT 3-1

BID PACKET FOR CONSTRUCTION CONTRACTS SAMPLE FORMS and CERTIFICATIONS

This does not represent all of the required content of the bid packet. It provides samples of forms (as designated) as well as required Certifications. Example: plans and specifications, maps, etc. are not included here, but must be a part of the total bid packet. Subrecipients typically include a sample form of contract to be used with the required Terms and Conditions, Compliance Provisions and General Conditions attached for Contractor

reference. Subrecipients must verify that all forms included in their bid documents are applicable to their specific project.

Advertisement for Bids Information for Bidders Bid Bond

Bidder Qualifications

NJEDA SWMVBE Bidders Form 1- General Contractor’s Schedule of Small, Women’s, Minority and Veteran owned Business Enterprise Utilization worksheet

Section 3 Plan Template

NJEDA Project Wage Rate Sheet Affirmative Action Form 1

ADVERTISEMENT FOR BIDS (Sample)

Project No. __________________________

_____________________________________________________________________________

(Owner)

Separate sealed bids for ______________________________ for will be received by ______________________ at the office of __________________________ until _______ o'clock (A.M.

_____ P.M._____ S.T. ______ DST) ___________, 20 ______, and then at said office publicly opened and read aloud.

The Information for Bidders, Form of Bid, Form of Contract, Plans, Specifications, and Forms of Bid Bond, Performance and Payment Bond, and other contract documents may be examined at the following:

_____________________________________________________________________________

Copies may be obtained at the office of _____________________________ located at ___________

upon payment of $______________ for each set. Any unsuccessful bidder, upon returning such set promptly and in good condition, will be refunded his payment, and any non-bidder upon so returning such a set will be refunded $ ____________.

The owner reserves the right to waive any informalities or to reject any or all bids.

Each bidder must deposit with his bid security in the amount, form and subject to the conditions provided in the Information for Bidders.

Attention of bidders is particularly called to the requirements as to conditions of employment to be observed and minimum wage rates to be paid under the contract, Section 3, Segregated Facility, Section 109, and E.O. 11246.

No bidder may withdraw his bid within 30 days after the actual date of the opening thereof.

___________________________________

(Date)

INFORMATION FOR BIDDERS (Sample)

1. Receipt and Opening of Bids

The _______________________ (herein called the "Owner"), invites bids on the form attached hereto, all blanks of which must be appropriately filled in. Bids will be received by the Owner at the office of _________________ until ______________ o'clock a.m./p.m., _____________ EST, ___________________ 20 _______, and then at said office publicly opened and read aloud. The envelopes containing the bids must be sealed, addressed to _______________ at ___________________

and designated as bid for ______________________________.

The Owner may consider informal any bid not prepared and submitted in accordance with the provisions hereof and may waive any informalities or reject any and all bids. Any bid may be withdrawn prior to the above scheduled time for the opening of bids or authorized postponement thereof. Any bid received after the time and date specified shall not be considered. No bidder may withdraw a bid within 30 days after the actual date of the opening thereof.

2.Preparation of Bid: Each bid must be submitted on the prescribed form and accompanied by Certification by Bidder Regarding Equal Employment Opportunity, Certification of Bidder Regarding Section 3 and Segregated Facilities. All blank spaces for bid prices must be filled in, in ink or typewritten, in both words and figures, and the foregoing Certifications must be fully completed and executed when submitted.

3. Subcontracts: The bidder is specifically advised that any person, or other party, to whom it is proposed to award a subcontract under this contract:

a. Must be acceptable to the owner after verification by the contractor of the current eligibility status; and

b. Must submit Certification by Proposed Subcontractor Regarding Equal Employment Opportunity, and Certification of Proposed Subcontractor Regarding Section 3 and Segregated Facilities. Approval of the proposed subcontract award cannot be given by the Owner unless and until the proposed subcontractor has submitted the Certifications and/or other evidence showing that it has fully complied with any reporting requirements to which it

is or was subject. Although the bidder is not required to attach such Certifications by proposed subcontractors to his bid, the bidder is here advised of this requirement so that appropriate action can be taken to prevent subsequent delay in subcontract awards.

4.Method of Bidding: The Owner invites the following bid(s): _____________________________

5. Qualifications of Bidder: The Owner may make such investigations as he deems necessary to determine the ability of the bidder to perform the work, and the bidder shall furnish to the Owner all such information and data for this purpose as the Owner may request. The Owner reserves the right to reject any bid if the evidence submitted by, or investigation of, such bidder fails to satisfy the owner that such bidder is properly qualified to carry out the obligations of the contract and to complete the work contemplated therein. Conditional bids will not be accepted.

6. Bid Security: Each bid must be accompanied by a bid bond payable to the Owner for ten percent of the total amount of the bid. As soon as the bid prices have been compared, the Owner will return all of the bonds except the three lowest responsible bidders. When the agreement is executed the bonds of the two remaining unsuccessful bidders will be returned. The bid bond of the successful bidder will be retained until the payment bond and performance bond have been executed and approved, after which it will be returned. A certified check may be used in lieu of a bid bond.

7. Liquidated Damages for Failure to Enter into Contract: The successful bidder, upon his failure or refusal to execute and deliver the contract and bonds required within 10 days after he received notice of the acceptance of his bid, shall forfeit to the Owner, as liquidated damages for such failure or refusal, the security deposited with his bid.

8. Time of Completion and Liquidated Damages: Bidder must agree to commence work on or before a date to be specified in a written "Notice to Proceed" of the Owner and to fully complete the project within ___________ consecutive calendar days thereafter. Bidder must agree also to pay as liquidated damages, the sum of $ ______________ for each consecutive calendar day thereafter as hereinafter provided in the General Conditions.

9. Conditions of Work: Each bidder must inform himself fully of the conditions relating to the construction of the project and the employment of labor thereon. Failure to do so will not relieve a successful bidder of his obligation to furnish all material and labor necessary to carry out the provisions of his contract. Insofar as possible the contractor, in carrying out the work, must employ such methods or means as will not cause any interruption of or interference with the work of any other contractor.

10. Addenda and Interpretations: No interpretation of the meaning to the plans, specifications, or other pre-bid documents will be made to any bidder orally.

Every request for such interpretation should be in writing addressed to ___________ at ______ and to be given consideration must be received at least five days prior to the date fixed for the opening of bids. Any and all such interpretations and any supplemental instructions will be in the form of written addenda to the specifications which, if issued, will be mailed by certified mail with return receipt requested to all prospective bidders (at the respective addresses furnished for such purposes), not later than three days prior to the data fixed for the opening of bids. Failure of any bidder to receive any such addendum or interpretation shall not relieve such bidder from any obligation under his bid as submitted. All addenda so insured shall become part of the contract documents.

11. Security for Faithful Performance: Simultaneously with his delivery of the executed contract, the Contractor shall furnish a surety bond or bonds as security for faithful performance of this contract and for the payment of all persons performing labor on the project under this contract and furnishing materials in connection with this contract, as specified in the General Conditions included herein. The surety on such bond or bonds shall be a duly authorized surety company satisfactory to the Owner.

12. Power of Attorney: Attorneys-in-fact who sign bid bonds or contract bonds must file with each bond a certified and effectively dated copy of their power of attorney.

13. Notice of Special Conditions: Attention is particularly called to those parts of the contract documents and specifications which deal with the following:

a. Inspection and testing of materials b. Insurance requirements

c. Wage rates d. Stated allowances

14. Laws and Regulations: The bidder's attention is directed to the fact that all applicable State laws, municipal ordinances, and the rules and regulations of all authorities having jurisdiction over construction of the project shall apply to the contract throughout, and they will be deemed to be included in the contract the same as though herein written out in full.

15. Method of Award - Lowest Qualified Bidder: If at the time this contract is to be awarded, the lowest base bid submitted by a responsible bidder does not exceed the amount of funds then estimated by the Owner as available to finance the contract; the contract will be awarded on the base bid only. If such bid

exceeds such amount, the Owner may reject all bids or may award the contract on the base bid combined with such deductible alternates applied in numerical order in which they are listed in the Form of Bid, as produces a net amount which is within the available funds.

16. Obligation of Bidder: At the time of the opening of bids, each bidder will be presumed to have inspected the site and to have read and to be thoroughly familiar with the plans and contract documents (including all addenda). The failure or omission of any bidder to examine any form, instrument, or document shall in no way relieve any bidder from any obligation in respect or his bid.

17. Safety Standards and Accident Prevention: With respect to all work performed under this contract, the contractor shall:

a. Comply with the safety standards provisions of applicable laws, building and construction codes, and the "Manual of Accident Prevention in Construction" published by the Associated General Contractors of America, the requirements of the Occupational Safety and Health Act of 1970 (Public Law 91-596), and the requirements of Title 29 of the Code of Federal Regulations, Section 1518 as published in the "Federal Register", Volume 36, No. 75, Saturday, April 17, 1971.

b. Exercise every precaution at all times for the prevention of accidents and the protection of persons (including employees) and property.

c. Maintain at his office or other well known place at the job site, all articles necessary for giving first aid to the injured, and shall make arrangements for the immediate removal to a hospital or a doctor's care of persons (including employees), who may be injured on the job site. In no case shall employees be permitted to work at a job site before the employer has made a standing arrangement for removal of injured persons to a hospital or a doctor's care.

BID BOND (Sample)

KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned, ________________________ as Principal, and ______________________ as Surety, are hereby held and firmly bound unto ____________________________ as owner in the penal sum of __________________________ for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, our heirs, executors, administrators, successors and assigns, this _____________ day of _____________, 20 _____.

The condition of the above obligation is such that whereas the Principal has submitted to ________________________ a certain Bid, attached hereto and hereby made a part hereof to enter into a contract in writing, for the __________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________ . NOW, THEREFORE,

1. If said Bid shall be rejected, or in the alternate,

2. 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 the payment of all persons performing labor or furnishing materials in connection therewith, 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 the extension of the time within which the Owner may accept such Bid; and said Surety does hereby waive notice of any such extension.

IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals, 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.

Name of State(s) in which incorporated: ________________________________________________

Date(s) of incorporation: ____________________________________________________________

If not incorporated in New Jersey:

1. Attach Certificate of Authority to do Business in New Jersey

2. Certificate Number: _______________________ Date: _________________________

____________________________________ _____________________________________

Names and Addresses of all partners: (use additional sheet if necessary)

1. ______________________________________________________________________________

Federal ID Number: ________________________ or SSN: ____________________________

Percent of work done by Contractor: ___________ Number of Permanent Employees: _______

Number of years in business: _________________

Geographical limits of operation: _____________________________________________________

If you have done business under a different name, please give name and location: _______________

_________________________________________________________________________________

Has firm ever failed to complete a project or defaulted on a contract? If so, state where and why:

_________________________________________________________________________________

Dated _____________ this day of _________________, 20_________.

Business Name: ___________________________________________________________________

Address: _________________________________________________________________________

Telephone: __________________________ Fax Number: ___________________

Federal ID Number: ___________________ SSN: __________________________

Incorporated under the laws of the State of: _____________________________________________

(If a corporation organized in a state other than New Jersey, attach certificate of Authority to do business in the State if New Jersey.)

_____________________________________ _____________________________________

(Bidder’s Signature) (Corporate Secretary’s Signature and Seal)

_____________________________________

(Typed or printed name(s)) (Seal)

General Information:

Date:

Signatures:

 Individual  Partnership  Joint Venture  Corporation

GENERAL CONTRACTOR'S SCHEDULE OF SMALL, WOMEN'S, MINORITY, AND VETERAN OWNED BUSINESS ENTERPRISE

UTILIZATION WORKSHEET

SANDY CDBG-DR ECONOMIC REVITALIZATION

This form to be submitted before contract execution :

GRANT OR LOAN APPLICANT: DATE:

In document NJEDA CDBG DR ADMINISTRATIVE MANUAL (Page 30-200)