00120-1
SECTION 00120 BID FORM
To: City of Winchester
ATTN: Vicki Haney
113 E Washington Street, PO Box 408 Winchester, IN 47394
From:
Company Address:
City State Zip
Telephone ( )
(Hereinafter called BIDDER)
1. The undersigned BIDDER proposes and agrees, if this Bid is accepted, to enter into an Agreement with OWNER in the form included in the Contract Documents to furnish all labor, materials, tools, and services required for the construction of the Greenville Pike Widening project all in accordance with the Contract Documents prepared by HWC Engineering.
2. BIDDER accepts all of the terms and conditions of the Notice to Bidders and Instructions to Bidders, including without limitation those dealing with the disposition of Bid Security. This Bid will remain open for sixty (60) days after the date of Bid opening. Bidder will sign and submit the Agreement with the Bonds and other documents required by the Bidding Documents within five (5) days after the date of Owner's Notice Award.
3. In submitting this Bid, BIDDER represents, as more fully set forth in the Agreement, that; a. BIDDER has examined copies of all the Bidding Documents.
b. BIDDER has familiarized itself with the nature and extent of the Contract Documents, work, site, locality and all local conditions and legal requirements that in any manner may affect cost, progress, performance, or furnishings of the work, and has made such independent investigations as BIDDER deems necessary.
c. This Bid is genuine and not made in the interest or on behalf of any undisclosed person, firm or corporation, and is not submitted in conformity with any agreement or rules of any group, association, organization, or corporation. BIDDER has not directly or indirectly induced or solicited any other Bidder to submit false or sham bid; Bidder has not solicited or induced any person, firm, or corporation to refrain from bidding; and BIDDER has not sought by collusion to obtain for itself any advantage over any other Bidder or over OWNER.
d. By submission of the bid, each BIDDER certifies, and in the case of a joint bid each party thereto certifies as to his own organization, that in connection with the Bid:
1) The prices in the Bid have been arrived at independently, without consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other Bidder or with any competitor.
2) Unless otherwise required by law, the prices which have been quoted in the Bid have not knowingly been disclosed by the BIDDER, prior to opening, directly, or indirectly to any other Bidder or any competitor.
3) No attempt has been made or will be made by the BIDDER to induce any other person or firm to submit or not to submit a Bid for the purpose of restricting competition.
e. BIDDER agrees that no less than the prevailing rate of wages as found by OWNER or the Department of Labor or determined by the court on review, shall be paid to all laborers, workmen, and mechanics performing work under this contract.
4. BIDDER submits the following base bid and alternate bids for the Work to be performed in accordance with the Contract Documents and agrees that items of work not specifically mentioned in the Schedule which are necessary and required to complete the Work intended shall be done incidental to and as part of the items of work for which a unit price is given, and understands that no additional payment will be made for such incidental work. Work as specified in the project documents, including all material, labor, equipment and supervision required to construct the project in accordance with project documents.
5. BIDDER agrees that the Work will begin as set forth in the Notice to Proceed and will be Substantially Completed as follows:
PROJECT SCHEDULE
Completion Date Number of Calendar Days
Notice to Proceed May 19, 2014 0
Substantial Completion July 25, 2014 67
Final Completion August 22, 2014 28
Bidder accepts the provisions of the Agreement and the Instructions to Bidders as to liquidated damages in the event of failure to complete the Work on time.
00120-3 BID SCHEDULE City of Winchester Greenville Pike Widening
The BIDDER agrees to perform all work described in the CONTRACT DOCUMENTS for the following UNIT PRICE BID. All prices listed below include materials, installation and other costs. Unit price extensions must equate to the total bid price. Unit cost prices will be used to negotiate changes in more or less scope of work.
Item
Item Description
Unit
Quantity Unit Price
Extension
105-06845
CONSTRUCTION ENGINEERING
L.S.
1.00
110-01001
MOBILIZATION AND DEMOBILIZATION
L.S.
1.00
201-02250
TREE, 10 IN, REMOVE
EACH
1.00
201-02255
TREE, 18 IN, REMOVE
EACH
1.00
201-52370
CLEARING RIGHT-OF-WAY
L.S.
1.00
202-86946
HANDHOLE, REMOVE
EACH
1.00
203-02000
EXCAVATION, COMMON
C.Y.
456.00
205-06933
TEMPORARY INLET PROTECTION
EACH
7.00
205-06937
TEMPORARY SILT FENCE
L.F.
1,835.00
207-08267
SUBGRADE TREATMENT, TYPE IIIA
SYS
625.00
211-09264
STRUCTURAL BACKFILL, TYPE 1
C.Y.
82.00
301-07448
COMPACTED AGGREGATE, NO. 53, BASE
TON
230.00
303-99391
COMPACTED AGGREGATE FOR UNDERCUT
BACKFILL, SIZE NO. 53, MODIFIED
TON
267.00
306-08033
MILLING, ASPHALT, 1 IN
SYS
3,222.00
401-07320
HMA SURFACE, TYPE A
TON
85.00
401-07321
HMA SURFACE, TYPE B
TON
455.00
401-07355
HMA INTERMEDIATE, TYPE A
TON
200.00
401-07356
Item
Item Description
Unit
Quantity Unit Price
Extension
401-07423
HMA BASE, TYPE B
TON
286.00
402-07451
HMA WEDGE AND LEVEL, TYPE B
TON
228.00
406-05520
ASPHALT FOR TACK COAT
TON
3.10
601-01740
GUARDRAIL, TERMINAL SYSTEM, W-BEAM,
CURVED, 4
EACH
1.00
601-61390
GUARDRAIL TERMINAL END SECTION, CURVED,
SINGLE FACE, GALV
EACH
1.00
601-99105
GUARDRAIL, W-BEAM, 6 FT 3 IN SPACING
L.F.
12.50
604-06070
SIDEWALK, CONCRETE
SYS
675.00
604-07902
CURB RAMP, CONCRETE, H
SYS
81.00
605-06120
CURB, CONCRETE
L.F.
252.00
605-06140
CURB AND GUTTER, CONCRETE
L.F.
1,377.00
611-06497
MAILBOX ASSEMBLY, SINGLE
EACH
1.00
621-01004
MOBILIZATION AND DEMOBILIZATION FOR
SEEDING
EACH
1.00
621-04316
SPADE EDGE
L.F.
136.00
621-06560
MULCHED SEEDING, U
SYS
2,820.00
621-09908
PLANTING SOIL
C.Y.
36.00
621-98038
MULCH, HARDWOOD SHREDDED BARK
C.Y.
6.00
622-05630
PLANT, CONIFEROUS EVERGREEN, GLOBE,
DWARF, OVER 18 TO 24 IN
EACH
16.00
715-05149
PIPE, TYPE 2 CIRCULAR 12 IN
L.F.
303.00
715-08305
HMA FOR STRUCTURE INSTALLATION, TYPE B
TON
80.00
720-44000
CASTING, ADJUST TO GRADE {ADJUST
EACH
5.00
00120-5
Item
Item Description
Unit
Quantity Unit Price
Extension
720-98555
INLET, C15
EACH
4.00
801-06203 TEMPORARY PAVEMENT MARKING, 4 IN
LF
6,200.00
801-06640
CONSTRUCTION SIGN, A
EACH
12.00
801-06775
MAINTAINING TRAFFIC
L.S.
1.00
801-07612
TEMPORARY PAVEMENT MARKING, 24”
LF
44.00
802-05701
SIGN POST, SQUARE, TYPE 1, REINFORCED
ANCHOR BASE
L.F.
105.00
802-07060
SIGN, SHEET, RELOCATE
EACH
2.00
802-09838
SIGN, SHEET, WITH LEGEND 0.080"
S.F.
59.0
805-01842
HANDHOLE, SIGNAL, TYPE 1
EACH
2.00
805-06595
CONDUIT, PVC, 2 IN
L.F.
130.00
805-78470
SIGNAL CABLE, ROADWAY LOOP, COPPER
1C/14GA
L.F.
1,530.00
805-78510
SIGNAL CABLE, DETECTOR LEAD-IN COPPER
2C/16GA
L.F.
850.00
805-78785
SIGNAL DETECTOR HOUSING
EACH
3.00
805-78795
SAW CUT FOR ROADWAY LOOP AND SEALANT
L.F.
509.00
808-06703
LINE, THERMOPLASTIC, SOLID, WHITE, 4 IN.
L.F.
697.00
808-06716
LINE, REMOVE
LF
4,050.00
808-75240
LINE, THERMOPLASTIC, BROKEN, YELLOW, 4 IN
L.F.
223.00
808-75245
LINE, THERMOPLASTIC, SOLID, YELLOW, 4 IN
L.F.
2,098.00
808-75297
TRANSVERSE MARKING, THERMOPLASTIC, STOP
LINE, 24 IN
L.F.
155.00
808-75300
TRANSVERSE MARKING, THERMOPLASTIC,
CROSSWALK LINE, 6"
L.F.
524.00
808-75320
PAVEMENT MESSAGE MARKING,
THERMOPLASTIC, LANE INDICATION ARROW
EACH
14.00
808-75325
PAVEMENT MESSAGE MARKING,
THERMOPLASTIC, (ONLY)
EACH
4.00
TOTALS
The BIDDER agrees to perform all work described in the CONTRACT DOCUMENTS for the following UNIT PRICE BID. All prices listed below include materials, installation and other costs.
Total Base Bid: Written As: Dollars
Figures: $
Signature Title
00120-7
6. BIDDER submits the following documents with his Bid: a. Bid Form - signed and executed.
b. Required Bid Security in the form of _________________________________ (Certified Check or Bid Bond) in the amount of ____ (Dollars or Percent). c. Form 96 Contractor’s Bid for Public Works – Signed and Executed
d. Proof of Insurance
e. Letter from Surety indicating intent to provide the required Bonds to the successful bidder upon contract award.
7. Terms used in this Bid which are defined in the Standard General Conditions of the Construction Contract included as to them in the General Conditions.
8. BIDDER acknowledges receipt of the following Addenda:
Addendum Number Date Received
9. Each person signing the Bid shall certify that: (Check applicable.)
( ) He is the person in the Bidders organization responsible within that organization for the decision as to the prices being bid and that he was not participated, and will not participate, in any action contrary to that above; or
( ) He is not the person in the BIDDERS organization responsible within that organization for the decision as to the prices being bid but that he has been authorized to act as agent for the persons responsible for such decision in certifying that such persons have not participated, and will not participate, in any action contrary to the above, and as their agent shall so certify; and shall also certify that he has not participated, and will not participate, in any action contrary to that above.
Respectfully submitted, signed, and sealed this day of , 2014 BIDDER:
(SEAL) BY:
TYPED NAME: TITLE:
Form No. 96 (Revised 2000)
BID OF
(Contractor)
(Address)
FOR
PUBLIC WORKS PROJECTS
OF
Filed
, Action taken
Prescribed by the State Board of Accounts Form No. 96 (Revised 2000)
CONTRACTOR BID FOR PUBLIC WORK
PART I
(To be completed for all bids) (Please type or print)
Date
:
1. Governmental Unit (Owner): 2. County: 3. Bidder(Firm): Address: City/State: 4. Telephone Number:
5. Agent of Bidder (if applicable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of
(Governmental Unit) in accordance with plans and specifications prepared by
and dated for the sum of
$
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. An addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the Governmental Unit. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment.
The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant may be regarded as a material breach of the contract.
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS
(if applicable)
I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation to use steel products made in the United States. I.C. 5-16-8-2. I hereby certify that I and all subcontractors employed by me for this project will use U .S. steel products on this project if awarded. I understand that violations hereunder may result in forfeiture of contractual payments.
ACCEPTANCE
The above bid is accepted this day of , , subject to the
following conditions:
Contracting Authority Members:
PART II
(Complete sections I, II, III and IV for all state and local public works projects as required by statutes if project is one hundred thousand dollars ($100,000) or more. (IC 36-1-12-4)
Governmental Unit: Bidder (Firm):
Date:
These statements to be submitted under oath by each bidder with and as a part of his bid. Attach additional pages for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
1. What public works projects has your organization completed for the period of one (1) year prior to the Date of the current bid?
Contract Amount Class of Work
When
Completed Name and Address of Owner
2. What public works projects are now in process of construction by your organization?
Contract Amount Class of Work
When to be
3. Have you ever failed to complete any work awarded to you? If so, where and why?
4. List references from private firms for which you have performed work.
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, completed the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.)
2. If you intend to sublet any portion of the work, state the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you expect to require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval.
3. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit.
4. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? Otherwise, please explain the rationale used which would corroborate the prices listed.
SECTION III CONTRACTOR’S FINANCIAL STATEMENT
Attachment of bidder’s financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder’s capability for completing the project if awarded.
SECTION IV OATH AND AFFRIMATION
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct to the best of my knowledge and belief.
Dated at
this day of ,
(Name of Organization) By
(Title of Person Signing)
ACKNOWLEDGEMENT
STATE OF )
)
COUNTY OF )
being duly sworn, deposes and says that he is of the above
(Title) (Name of Organization)
and that the answers to the questions in the foregoing questionnaires and all statements therein contained are true and correct.
Subscribed and sworn to before me this day of , .
Notary Public My Commission Expires:
NON-COLLUSION AFFIDAVIT
The undersigned bidder or agent, being duly sworn on oath, says that he has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding not to include anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding.
He further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale.
OATH AND AFFIRMATION
I affirm under the penalties of perjury that the foregoing facts and information are true and correct to the best of my knowledge and belief.
Dated at this day of ,
(Name of Organization) By
(Title of Person Signing)
ACKNOWLEDGEMENT
STATE OF )
)
COUNTY OF )
being duly sworn, deposes and says that he is of the above
(Title) (Name of Organization)
and that the statements contained in the foregoing bid, certification and affidavit are true and correct.
Subscribed and sworn to before me this day of , .
Notary Public My Commission Expires:
Contractor’s Financial Statement
Submitted by______________________________________________________________
A Corporation A Co-partnership An Individual
with principal office at _________________________________________________________________________________
To_______________________________________________________________________________________________
ASSETS Dollars Cts.
1. Cash: (a) On Hand $ ________ (b) In bank $ _________ (c) Eslewhere $
2. Notes receivable (a) Due within 90 days
(b) Due after 90 days
(c) Past Due
3. Accounts payable from completed contracts, exclusive of calims not approved for
payment
4. Sums earned on uncompleted contracts as shown by engineer’ or architects estimate
(a) Amount receivable from deducting retainage
(b) Retainage to dade, due upon completion of contracts
5. Accounts receibable from sources other than construction contracts
6. Deposits for bids or other guarantees: (a) Recoverable within 90 days
(b) Recoverable after 90 days
7. Interest accured on loans, securities, etc.
8. Real estate: (a) Used for business purposes
(b) Not used for business purposes
9. Stocks and bonds: (a) Listed – present market value
(b) Unlisted – present value
10. Materials in stock not included in Item 4 (a) For uncompleted contracts (present value)
(b) Other materials (present value)
11. Equipment, book value
12. Furniture and fixtures, book value
13. Other assets
Total assets
LIABILITIES
1. Note payable: (a) To banks regular
(b) To banks for certified checks
(c) To others for equipment obligations
(d) To other exclusive of equipment obligations
2. Accounts Payable: (a) Not past due
(b) Past due
3. Real estate encumbrances
4. Other liabilities
5. Reserves
6. Capital stock paid up: (a) Common
(b) Common
(c) Perferred
(d) Perferred
7. Surplus (net worth)
DETAILS RELATIVE TO ASSETS
1
Cash(a) on hand__________________________________________________ $___________________
(b) deposited in banks named below________________________________ $___________________
(c) elsewhere – (state where)_____________________________________ $___________________
NAME OF BANK LOCATION DEPOSIT IN NAME OF AMOUNT
2
Notes receivable(a) due within 90 days__________________________________ $__________________
(b) due after 90 days___________________________________ $__________________
(c) past due_________________________________________ $__________________
RECEIVABLE FROM: NAME AND ADDRESS FOR WHAT DATE OF
MATURITY HOW SECURED AMOUNT
Have any of the above been discounted or sold? ____________ If so, state amount, to whom, and reason ______________________
_________________________________________________________________________________________________ _________________________________________________________________________________________________
3 *
Accounts receivable from completed contracts exclusive of claims not approved for payment $__________________NAME AND ADDRESS OF OWNER NATURE OF CONTRACT AMOUNT OF
CONTRACT
AMOUNT RECEIVABLE
Have any of the above been assigned, sold or pledged? ___________ If so, state amount, to whom, and reason _________________
_________________________________________________________________________________________________ _________________________________________________________________________________________________
4 *
Sums earned on uncompleted contracts, as shown by engineer’s or architect’s estimate:
(a) Amount receivable after deducting retainage ____________________________ $__________________
(b) Retainage to date due upon completion of contract________________________ $__________________
DESIGNATION OF CONTRACT AND NAME AND ADDRESS
OF OWNER AMOUNT OF CONTRACT AMOUNT EARNED AMOUNT RECEIVED
RETAINAGE AMOUNT
EX-CLUSIVE OF RETAINAGE
WHEN DUE AMOUNT
Have any of the above been sold, assigned, or pledged? ____________ If so, state amount, to whom, and reason_____________
_________________________________________________________________________________________________ _________________________________________________________________________________________________
DETAILS RELATIVE TO ASSETS (Continued)
5 *
Accounts receivable not from construction contracts______________________________ $___________________RECEIVABLE FROM: NAME AND ADDRESS FOR WHAT WHEN DUE AMOUNT
What amount, if any, is past due___________________________________________________ $___________________
6
Deposits with bids or otherwise guarantees____________________________________ $___________________DEPOSITED WITH: NAME AND ADDRESS FOR WHAT WHEN
RECEIVABLE AMOUNT
7
Interest accrued on loans, securities, etc._____________________________________ $___________________ON WHAT ACCRUED TO BE PAID WHEN AMOUNT
8
Real estate book value (a) Used for business purposes____________________________ $ __________________(b) Not used for business purposes_________________________ $ __________________
DESCRIPTION OF PROPERTY IMPROVEMENTS TOTAL BOOK
VALUE NATURE OF IMPROVEMENTS BOOK VALUE
1 2 3 4 5 6 7
LOCATION HELD IN WHOSE NAME ASSESSED
VALUE AMOUNT OF EMCUMBRANCES 1 2 3
9
Stocks and Bonds (a) Listed – present market value______________________ $_______________________(b) Unlisted – present market value___________________ $_______________________
DESCRIPTION ISSUING COMPANY
LAST INT. OR DIV. PAID PAR VALUE PRESENT MARKET VALUE QUAN- TITY AMOUNT DATE % 1 2 3 4 5 6 7
WHO HAS POSSESSION IF ANY ARE PLEDGED OR IN ESCROW, STATE FOR WHOM AND REASON
AMOUNT PLEDGED OR IN ESCROW 1 2 3 4 5 6 7
10
Materials in stock and not included in Item 4, Assets:
(a) For use on uncompleted contracts (present value)____________________ $_______________________
(b) Other materials (present value)___________________________________ $_______________________
DESCRIPTION OF MATERIAL QUANTITY
PRESENT VALUE FOR UNCOM- PLETED CONTRACTS OTHER MATERIALS
11*
Equipment at book value______________________________________________ $________________________QUAN-
TITY DESCRIPTION AND CAPACITY OF ITEMS
AGE OF ITEMS PRUCHASE PRICE DEPRECIATION CHARGED OFF BOOK VALUE
Are there any liens against the above? ____________________ If so, state total amount________________ $____________
12
Furniture and fixtures at book value_______________________________________ $________________________13
Other assets_______________________________________________________ $________________________DESCRIPTION AMOUNT
TOTAL ASSETS $
DETAILS RELATIVE TO LIABILITIES
1
Notes Payable(a) To banks, regular______________________________ $_____________________
(b) To banks for certified checks______________________ $_____________________
(c) To others for equipment obligations_________________ $_____________________
(d) To others exclusive of equipment obligations __________ $_____________________
TO WHOM: NAME AND ADDRESS WHAT SECURITY WHEN DUE AMOUNT
2
Accounts Payable (a) Not past due______________________________ $_____________________(b) Past due_________________________________ $_____________________
TO WHOM: NAME AND ADDRESS FOR WHAT DATE
PAYABLE AMOUNT
3
Real estate encumbrances (See Item 8, Assets)______________________________ $_____________________4
Other Liabilities_____________________________________________________ $_____________________DESCRIPTION AMOUNT
5
Reserves_________________________________________________________ $_____________________INTEREST INSURANCE BLDGS. & FIXT. PLANT DEPR. TAXES BAD DEBTS
$_______ $_________ $____________ $__________ $________ $__________ $________ $________
6
Capital stock paid (a) Common_________________________________ $_____________________If corporation answer this:
Amount for which incorporated_________________________________________________________________
Capital paid in cash_____________________________________________ $ ______________________
When incorporated _________________________________________________________________________
In what state ______________________________________________________________________________
Names and titles of all persons having authority to execute and receipt estimate vouchers and to conduct other business for the corporation, including its officers, the signatures of whom are legally binding.
Do you have necessary “certificate of authority” to transact corporate business in this state, under the terms of
Chapter 215, Acts of 1929, and acts amendatory thereto? ____________________________________________________
If a co-partnership answer this:
Date of organization_________________________________________________________________________
State whether co-partnership is general, limited or association___________________________________________
Give the manes, addresses and proportional interests of all parties:
Name Address Share
_________________________________________________________________________$____________________ _________________________________________________________________________$____________________ _________________________________________________________________________$____________________ _________________________________________________________________________$____________________ _________________________________________________________________________$____________________ _________________________________________________________________________$____________________ _________________________________________________________________________$____________________ _________________________________________________________________________$____________________ _________________________________________________________________________$____________________
The name of the partnership firm under which the above partners are operating is_______________________________________________________
________________________________________________________________________________________________________________________ Give names and titles of all persons having authority to execute and receipt estimate vouchers and to conduct other business for the partnership, the signatures of whom are legally binding.
________________________________________________________________________________________________________________________
The undersigned hereby declares that the foregoing is a true statement of the financial condition of the individual co-partnership or corporation herein first named, as of the date herein first given; that this statement is for the express purpose of inducing the party to whom it is submitted to award the submitter a contract; and that any depository, vendor or other agency herein named is hereby authorized to supply such party with any information necessary to verify this statement.
____________________________________________ Note: A co-partnership must firm name and address and ______________________________________ signatures of all partners. A corporation must give full corporate
name, signature of official and affix corporate seal. ______________________________________ ______________________________________ Affidavit for individual
STATE OF ______________
SS:
COUNTY OF_____________
_____________________________________________________________________ being duly sworn, disposes and says that the forgoing financial statement, taken from his books, is a true and accurate statement of the financial condition as of the date thereof and that the answers to the foregoing interrogatories are true.
Subscribed and sworn to before me this _______________________________________________
(Member of firm must sign)
____________day of_________________________20____
________________________________________________ Notary Public
Affidavit for Co-partnership
STATE OF ______________
SS:
COUNTY OF_____________
_________________________________________________________ being duly sworn, disposes and says that he is a member of the firm of ________________________________________________; that he is familiar with the books of the said firm showing its financial condition; that the forgoing financial statement, taken from his books of said firm, is a true and accurate statement of the financial condition of the said firm as of the date thereof and that the answers to the foregoing interrogatories are true.
Subscribed and sworn to before me this _______________________________________________ (Member of firm must sign here)
____________day of_________________________20____
_______________________________________________ Notary Public
Affidavit for Co-partnership
STATE OF ______________ SS:
COUNTY OF_____________
___________________________________________________________________being duly sworn, disposes and says that he is a member _______________________ of the ________________________________________; the corporation described in and which executed the foregoing statement, that he is familiar with the books of the said corporation showing its financial condition; that the forgoing financial statement, taken from his
PENAL SUM FORM
SECTION 00140
BID BOND
BIDDER (Name and Address):
SURETY (Name and Address of Principal Place of Business):
OWNER (Name and Address):
BID
BID DUE DATE:
PROJECT (Brief Description Including Location):
BOND
BOND NUMBER:
DATE (Not later than Bid due date):
PENAL SUM:
(Words) (Figures)
IN WITNESS WHEREOF, Surety and Bidder, intending to be legally bound hereby, subject to the terms printed on the reverse side hereof, do each cause this Bid Bond to be duly executed on its behalf by its authorized officer, agent, or representative.
BIDDER SURETY
(Seal) (Seal)
Bidder's Name and Corporate Seal Surety's Name and Corporate Seal
By: By:
Signature and Title Signature and Title
(Attach Power of Attorney)
Attest: Attest:
Signature and Title Signature and Title
Note: (1) Above addresses are to be used for giving required notice.
(2) Any singular reference to Bidder, Surety, OWNER or other party shall be considered plural where applicable.
PENAL SUM FORM
1. Bidder and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to pay to OWNER upon default of Bidder the penal sum set forth on the face of this Bond.
2. Default of Bidder shall occur upon the failure of Bidder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to in writing by OWNER) the executed Agreement required by the Bidding Documents and any performance and payment Bonds required by the Bidding Documents.
3. This obligation shall be null and void if:
3.1. OWNER accepts Bidder's Bid and Bidder delivers within the time required by the Bidding Documents (or any extension thereof agreed to in writing by OWNER) the executed Agreement required by the Bidding Documents and any performance and payment Bonds required by the Bidding Documents, or
3.2. All Bids are rejected by OWNER, or
3.3. OWNER fails to issue a Notice of Award to Bidder within the time specified in the Bidding Documents (or any extension thereof agreed to in writing by Bidder and, if applicable, consented to by Surety when required by paragraph 5 hereof). 4. Payment under this Bond will be due and payable upon default by Bidder and within 30 calendar days after receipt by Bidder and Surety of written notice of default from OWNER, which notice will be given with reasonable promptness, identifying this Bond and the Project and including a statement of the amount due.
5. Surety waives notice of and any and all defenses based on or arising out of any time extension to issue Notice of Award agreed to in writing by OWNER and Bidder, provided that the total time for issuing Notice of Award including extensions shall not in the aggregate exceed 120 days from Bid due date without Surety's written consent.
6. No suit or action shall be commenced under this Bond prior to 30 calendar days after the notice of
8. Notices required hereunder shall be in writing and sent to Bidder and Surety at their respective addresses shown on the face of this Bond. Such notices may be sent by personal delivery, commercial courier or by United States Registered or Certified Mail, return receipt requested, postage pre-paid, and shall be deemed to be effective upon receipt by the party concerned.
9. Surety shall cause to be attached to this Bond a current and effective Power or Attorney evidencing the authority of the officer, agent or representative who executed this Bond on behalf of Surety to execute, seal and deliver such Bond and bind the Surety thereby.
10. This Bond is intended to conform to all applicable statutory requirements. Any applicable requirement of any applicable statute that has been omitted from this Bond shall be deemed to be included herein as if set forth at length. If any provision of this Bond conflicts with any applicable statute, then the provision of said statute shall govern and the remainder of this Bond that is not in conflict therewith shall continue in full force and effect.
11. The term "Bid" as used herein includes a Bid, offer or proposal as applicable.
SECTION 00141 NON-COLLUSION AFFIDAVIT
The bidder, by its officers and
Agents, representatives present at the time of filing this Bid, being duly sworn, on their oaths say that neither they nor any of them have in any way, directly or indirectly, entered into an agreement or agreements with any other bidder, or with any public official. Whereby such affiant or affiants or either of them, has paid or is to pay to such bidder or public official, any sum of money, or has given or is to give such other bidder or public official anything of value whatever, or such affiant or affiants or either of them has not directly or indirectly entered into any agreement or agreements or arrangements with another bidder or bidders which tends to or does lessen or destroy free competition in the letting or the Contract sought for by the attached bids; that no inducement of any form or character other than that which appears upon the face of the bids will be suggested, offered, paid or delivered to any person whosoever to influence the acceptance of said bid or awarding of the Contract; nor has this bidder any agreement or understanding of any kind whatsoever, with any other person whomsoever to pay, deliver to, or share with any other person in any way or manner, any of the proceeds of the contract sought by this bid.
(Bidder) (SEAL)
By
(Title)
Subscribed and sworn to before me by
this day of , 20 .
(Notary Public) (SEAL)
My Commission Expires
In and For County.
SECTION 00150 SUBCONTRACTOR LIST Pursuant to bidding requirements for the Work titled:
City of Winchester Greenville Pike Widening Project
for portions of the work equaling or exceeding $10,000 Bidder proposes to use the following Subcontractors. Except as otherwise approved by Owner, Bidder proposes to perform all other portions of the Work with his own forces:
