HomeMy WebLinkAbout20120036.tiff BID REQUEST NO. B1100162
WELD COUNTY
DEPARTMENT OF PUBLIC WORKS
CONTRACT BID DOCUMENTS
FOR
INSTALLATION OF EQUIPMENT FOR A COMPRESSED NATURAL GAS FUELING
STATION IN THE UFR 8-HOUR OZONE NONATTAINMENT BOUNDARY
FEDERAL AID PROJECT NO. AQC C030-046, 18378
1861 - 2011
WELD____-COUNTY
January 18, 2012
Weld County Public Works
P.O. Box 758
1111 H Street
Greeley, Colorado 80632
970-304-6496
Lc P u ? � cO ‘
1- ZJ is
TABLE OF CONTENTS
The following provisions take precedence over Specifications or Plans and supplement the 2012 edition of the Colorado Department of
Transportation"Standard Specifications for Road and Bridge Construction"(Standard Specifications)which is to be used to control
construction of this project.
WELD COUNTY CONTRACT FORMS:
*Low Bidder must submit these forms prior to Contract Award.
*Notice of Award 3
*Agreement 4-5
*Performance Bond 6-7
*Labor and Materials Payment Bond 8-9
Notice to Proceed 10
Change Order II
Certificate of Substantial Completion 12
Lien Waiver 13
Final Lien Waiver 14
Notice of Acceptance 15
FHWA Form 1273 16
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NOTICE OF AWARD
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.2)
CNG FUELING STATION
To: ELA Group,Inc. (Zeit Energy) Date: January 18,2012
950 Aero Drive
Shreveport, LA 71107
Project Description:
The project in general consists of a public-private partnership for the purchase and installation of CNG equipment for a design/build
"turnkey" operation for one compressed natural gas fueling station to locate at an existing fuel site in the Town of Kersey located in
Weld County's UFR TPR 8-hour ozone nonattainment boundary. This is a Federal-Aid Project administered through CDOT Region 4.
The Owner has considered the Bid submitted by you for the above described Work in response to its Invitation for Bids and Instructions
to Bidders.
You are hereby notified that your Bid has been accepted in the amount of$482,120 or as shown in the Bid Schedule.
You are required by the Instructions to Bidders to execute the Agreement and furnish the required Performance Bond,Payment Bond
and Certificates of Insurance within ten(10)calendar days from the date of this Notice to you.
If you fail to execute said Agreement and to furnish said Bonds within ten(10)days from the date of this Notice, said Owner will be
entitled to consider all your rights arising out of the Owner's acceptance of your bid as abandoned. The Owner will be entitled to such
other rights as may be granted by law.
You are required to return an acknowledged copy of this Notice of Award to the Owner.
Dated this 18th day of January,2012.
Weld County,Colorado,Owner
By
ica-
Elizabeth ford,Transportati lanner
ACCEPTANCE OF NOTICE
Receipt of the above Notice of Award is hereby acknowledged by
(Contractor)
Dated this day of ,2012
By: Title:
AGREEMENT
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.21
CNG FUELING STATION
THIS AGREEMENT,made this day of ,2012,by and between Weld County,Colorado,hereinafter
called"Owner" and
ELA Group, Inc (Zeit Energy) doing business as (an individual,) or (a partnership,) or (a corporation) hereinafter called
"Contractor".
WITNESSETH: That for and in consideration of the payments and agreements hereinafter mentioned:
1. The Contractor will commence and complete the following: DESIGN/BUILD TURNKEY OPERATION TO
INSTALL EQUIPMENT FOR THE KERSEY(UFR#IA.2)CNG FUELING STATION described in the
Invitation for Bids,Bid No. B1100162.
2. The Contractor will furnish all of the material,supplies,tools,equipment,labor and other services necessary for the
construction and completion of the Project described herein.
3. The Contractor will commence the work required by the Contract Documents within ten(10)calendar days after the
Notice to Proceed and will complete the DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT
FOR THE KERSEY (UFR #1A.2) CNG FUELING STATION within 365 calendar days unless the period for
completion is extended otherwise by the Contract Documents.
4. The Contractor agrees to perform all of the Work described in the Contract Documents and comply with the terms
therein for the sum of$ 482,120 ,or as shown in the Bid Schedule.
5. The term "Contract Documents" means and includes the following:
(A) Invitation for Bids
(B) Instructions to Bidders
(C) Bid Proposal
(D) Bid Bond
(E) Statement of Qualifications and Subcontractors
(F) Required Project Forms
(G) Agreement
(H) Labor and Materials Payment Bond
(I) Performance Bond
(J) Notice of Award
(K) Notice to Proceed
(L) Change Order
(M) Certificate of Substantial Completion
(N) Lien Waiver
(O) Notice of Acceptance
(P) Contract,Specifications,and Drawings issued by the Weld County Public Works Department.
(Q) Colorado Department of Transportation "Standard Specifications for Road and Bridge
Construction"
(R) Colorado Department of Transportation Standard Plans"M&S Standards"
(S) Addenda:
No.1 dated December 9.2011.
6. The Owner will pay to the Contractor in the manner and at such times as set forth by the Contract Documents,or
otherwise agreed upon in writing.
-4-
7. This Agreement shall be binding upon all parties hereto and their respective heirs,executors,administrators,
successors,and assigns.
8. Contract Appropriations: The Owner hereby states and affirms that the amount of money appropriated for this
Contract is equal to or in excess of the Contract amount. No change order to this Contract requiring additional
compensable work to be performed,which work causes the aggregate amount payable under the Contract to
exceed the amount appropriated for the original Contract shall be issued by the Owner unless the Owner
assures the Contractor,in writing,that lawful appropriations to cover the costs of the additional work has been
made or unless such work is covered under a remedy-granting provision contained in the Contract.
IN WITNESS WHEREOF,the parties hereto have executed,or caused to be executed by their duly authorized officials,
this Agreement in two(2)copies each of which shall be deemed an original on the date first above written.
ORDERED BY: ACCEPTED BY:
THE BOARD OF WELD COUNTYCOMMISSIONERS CONTRACTOR
BY !/ - BY /�� /�
NAME Sean P.Conway NAME 1/.r t ieNaer
(Pleas pe -/
TITLE Chair TITLE /61 F1
Date JAN 18 2012 Q ADDRESS /� *et)
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(SEAL) ikr (SEAL)
ATTEST: - �rtr-r'�� ��J ATTEST:
/:--,�,- n THE Rf :A. N ANGEL
A ,1. ,, msiana
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Weld County Clerk to the Board '�'�$ Nntary io 0010(1
BY AZ/idm , , %idea.> BY-----
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Deputy Cler o the hoard (Please Type)
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PERFORMANCE BOND
DESIGNBUILD TURNKEY OPERATION TO INSTALL EOUIPMENT FOR THE KERSEY(UFR#1A.2)
CNG FUELING STATION
KNOW ALL MEN BY THE PRESENTS;that
ELA Group, Inc
(Name of Contractor)
950 Aero Drive,Shreveport,LA 71107
(Address of Contractor)
Corporation •
Chereinafter called Contractor, and a
(Corporation,Partnership,or Individual)
United Fire&Casualty Company
(Name of Surety)
P. O.Box 73909,Cedar Rapids, IA 52407
(Address of Surety)
hereinafter called surety,are held and firmly bound unto
Weld County.Colorado
(Name of Owner)
P.O.Box 758. 1111H Street,Greeley,Colorado 80632
(Address of Owner)
Four Hundred Eighty Two Thousand One
hereinafter called Owner,in the penal sum of Hundred Twenty and No/100 Dollars,($482 120 00 ), in lawful
money of the United States of America,for the payment of which sum well and truly to be made,we bind ourselves,successors and
assigns,jointly and severally firmly by these presents.
THE CONDITION OF THIS OBLIGATION is such that whereas,the Contractor entered into a certain Contract with the Owner,dated
the day of 2012,a copy of which is hereto attached and made a part hereof for the construction of:
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY (UFR #1A.2) CNG FUELING
STATION described in the Invitation for Bids,Bid No.B1100162.•
NOW THEREFORE, if the Contractor shall well,truly and faithfully perform its duties, all of the undertakings, covenants,terms,
conditions,and agreements of said contract during the original term thereof,and any extensions thereof which may be granted by the
Owner,with or without notice to the Surety and during the one year guaranty period,and if he shall satisfy all claims and demands
incurred under such contract,and shall fully indemnify and save harmless the Owner from all costs and damages which it may suffer by
reason of failure to do so,and shall reimburse and repay the Owner all outlay and expense which the Owner may incur in making good
any default,then this obligation shall be void;otherwise to remain in force and effect.
PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time,
alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the
same shall in any way affect its obligation on this Bond,and it does hereby waive notice of any such change, extension of time,
alteration or addition to the terms of the contract or to the Work or to the Specifications.
PROVIDED, FURTHER,that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary
hereunder,whose claim may be unsatisfied.
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PERFORMANCE BOND
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.2)
CNG FUELING STATION
IN WITNESS WHEREOF,this instrument is executed in five(5)counterparts,each one of
which shall be deemed an original,this 6 O " day of c—\:ler 2012.
ELA Group, Inc
// _` C ntr clot
C f J By
----� etary
(SEAL)
ti ` 1.4 5.el9 950 Aero Drive
(Witness as to Contractor) (Address)
950 Aero Drive Shreveport, LA 71107
(Address)
Shreveport, LA 71107 47
ATTEST: J
F t.C�PA> United Fire & Casualty Company
t
(Surety)Secretary
(SEAL)
:-.)j.... /r= ,,
Witn s as to Sure J ffrey .Pis mey-in-Fact
P.O. Box 5 P. . Box 5
(Address) (Address)
Shreveport, LA 71161 Shreveport, LA 71161
NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership,all partners should execute Bond.
IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list(Circular 570 as
amended)and be authorized to transact business in the State where the Project is located.
7-
LABOR&MATERIALS PAYMENT BOND
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.2)
CNG FUELING STATION
KNOW ALL MEN BY THE PRESENTS;that
ELA Group, Inc
(Name of Contractor)
950 Aero Drive, Shreveport, LA 71107
(Address of Contractor)
Corporation
,hereinafter called Contractor, and a
(Corporation,Partnership,or Individual)
United Fire & Casualty Company
(Name of Surety)
P. O. Box 73909, Cedar Rapids, IA 52407
(Address of Surety)
hereinafter called surety,are held and firmly bound unto
Weld County,Colorado
(Name of Owner)
P.O.Box 75$, 1111 H Street.Greeley.Colorado 80632
(Address of Owner)
hereinafter called Owner,in the penal sum of
Four Hundred Eighty Two Thousand One Hundred Twenty and No/100 Dollars (S 482,120.00 ),
in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves,
successors and assigns,jointly and severally firmly by these presents.
THE CONDITION OF THIS OBLIGATION is such that whereas,the Contractor entered into a certain Contract with the Owner,
dated the day of 2012,
a copy of which is hereto attached and made a part hereof for the construction of;
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY (UFR #1A.2) CNG FUELING
STATION described in the Invitation for Bids,Bid No.B1100162.
NOW,THEREFORE,if the Contractor shall promptly make payment to all persons,firms,Subcontractors,and corporations furnishing
materials for or performing labor in the prosecution of the Work provided for in such contract, and any authorized extension or
modification thereof, including all amounts due for materials, lubricants,oil,gasoline, repairs on machinery,equipment and tools,
consumed or used in connection with the construction of such Work,and all insurance premiums on said Work, and for all labor,
performed in such Work whether by Subcontractor or otherwise,then this obligation shall be void;otherwise to remain in full force and
effect.
PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time,
alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the
same shall in any way affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time,
alteration or addition to the terms of the Contract or to the Work or to the Specifications.
PROVIDED, FURTHER,that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary
hereunder,whose claim may be unsatisfied.
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LABOR&MATERIALS PAYMENT BOND
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.2)
CNG FUELING STATION
IN WITNESS WHEREOF,this instrument is executed in five(5)�counterparts,each one of which shall be deemed an original,
i c
this �0 day of AA.y4O..r ( ,2012.
ELA Group, Inc.
� Con r
By 4c/
(Contra aid Secretary
(SEAL) •
ji-e/120a._ L.4 - 950 Aero Drive
(Witness as to Contractor) rrr (Address)
950 Aero Drive Shreveport, LA 71107
(Address)
Shreveport, LA 71107
ATTEST:
United Fire & Casualty Company
(Surety)Secretary
•
(SEAL)
By 0 ( %e
Wi ss as to Surety ffr y D. Pitts Attorney-in-Fact
P.O. Box 5 P.O. Box 5
(Address) (Address)
Shreveport, LA 71161 Shreveport, LA 71161
NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership,all partners should execute Bond.
IMPORTANT: Surety companies executing Bonds must appear on the Treasury Departments most current list (Circular 570 as
amended)and be authorized to transact business in the State where the Project is located.
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UNITED FIRE& CASUALTY COMPANY
HOME OFFICE -CEDAR RAPIDS, IOWA
CERTIFIED COPY OF POWER OF ATTORNEY
(Original on file at Home Office of Company- See Certification)
KNOW ALL MEN BY THESE PRESENTS, That the UNITED FIRE & CASUALTY COMPANY, a corporation duly organized and
existing under the laws of the State of Iowa, and having its principal office in Cedar Rapids, State of Iowa,does make, constitute and
appoint JEFFREY D. PITTS, OR IRIS R. RICKS, OR RONALD BENNETT, OR GEORGE D. NELSON, JR. , OR PAMELA
G. PATTON, ALL INDIVIDUALLY of SHREVEPORT LA
its true and lawful Attorney(s)-in-Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful
bonds,undertakings and other obligatory instruments of similar nature as follows: All bonds not to exceed $5,000,000.00
and to bind UNITED FIRE &CASUALTY COMPANY thereby as fully and to the same extent as if such instruments were signed by
the duly authorized officers of UNITED FIRE & CASUALTY COMPANY and all the acts of said Attorney, pursuant to the authority
hereby given are hereby ratified and confirmed.
The Authority hereby granted is continuous and shall remain in full force and effect until revoked by UNITED FIRE &
CASUALTY COMPANY.
This power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by Board of
Directors of the Company on April 18, 1973.
"Article V-Surety Bonds and Undertakings"
Section 2, Appointment of Attorney-in-Fact. "The President or any Vice President, or any other officer of the Company may,
from time to time, appoint by written certificates attorneys-in-fact to act in behalf of the Company in the execution of policies
of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized
hereby,and the Corporate seal, may be affixed by facsimile to any power of attorney or special power of attorney or
certification of either authorized hereby; such signature and seal, when so used, being adopted by the Company as the
original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the
same force and effect as though manually affixed. Such attorneys-in fact, subject to the limitations set forth in their
respective certificates of authority shall have full power to bind the Company by their signature and execution of any such
instruments and to attach the seal of the Company thereto. The President or any Vice President, the Board of Directors or
any other officer of the Company may at any time revoke all power and authority previously given to any attorney-in-fact.
IN WITNESS WHEREOF, the UNITED FIRE & CASUALTY COMPANY has caused these presents to be signed by
r"�titti, its vi
" ce president and its corporate seal to be hereto affixed this 5th day of Apr t 1 , 2010
C ,
if CORPORATE {�
sFo UNITED FIRE &CASUALTY COMPANY
' o ea tF:
rso B
Y
State of Iowa, County of Linn, ss:
Vice President
On 5th day of April , 2010, before me personally came Dennis J. Richmann
to me known, who being by me duly sworn, did depose and say; that he resides in Cedar Rapids, State of Iowa; that he is a Vice
President of the UNITED FIRE& CASUALTY COMPANY, the corporation described in and which executed the above instrument;that
he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed
pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like
authority, and acknowledges same to be the act and deed of said corporation.
Mary A Jansen
Iowa Notarial Seal 415141 ""''
!®� Commission number 713273
My Commission Expires 10/26113 Notary Public
I, the undersigned officer of the UNITED FIRE & CASUALTY COMPANY, do hereby certify that I have compared the foregoing copy
of the Power of Attorney and affidavit, and the copy of the Section of the by-laws of said Company as set forth in said Power of
Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY, and that the same are correct transcripts
thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and
effect.
otrigsttoti, In testimony whereof I have hereunto subscribed my name and affixed the corporate seal of the said Company
S J-7, this day of 20
Lmi CORPORATE °L
ss u 447
scr 4-114ijit
Secretary
BPOA00190706
NOTICE TO PROCEED
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.2)
CNG FUELING STATION
To:ELA Group, Inc. (Zeit Energy) Date:
950 Aero Drive
Shreveport,LA 71107
Name of Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#IA.2)CNG
FUELING STATION described in the Invitation for Bids,Bid No.B 1100162.
You are hereby notified to commence Work in accordance with the Agreement dated . The
Contract Time allowed in the Agreement is 365 calendar days. The substantial completion date for all Work is therefore
2012.
Weld County,Colorado,Owner
By:
Elizabeth Relford,Transportation Planner
ACCEPTANCE OF NOTICE
Receipt of the above Notice to Proceed
is hereby acknowledged by:
(Contractor)
Dated this day of ,2012.
By
Title
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CHANGE ORDER NO. (EXAMPLE)
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.21
CNG FUELING STATION
Date:
Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EOUIPMENT FOR THE KERSEY(UFR#IA.2)CNG FUELING
STATION described in the Invitation for Bids, Bid No.B 1100162.
Owner: Weld County,Colorado
Contractor:
The following change is hereby made to the Contract Documents:
CHANGE TO CONTRACT PRICE:
Original Contract Price:
Current Contract Price adjusted by previous Change Order:
The Contract Price due to this Change Order will be increased by:
The new Contract Price,including this Change Order,will be:
CHANGE TO CONTRACT TIME:
The Contract Time will be increased by calendar days.
The date for completion of all Work will be:
RECOMMENDED:
Owner Representative: Date:
Sean P. Conway(Chair)
Engineer: Date:
APPROVALS:
Contractor: Date:
Owner: Date:
CDOT Representative: Date:
_ 11 _
CERTIFICATE OF SUBSTANTIAL COMPLETION
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#IA.21
CNG FUELING STATION
Owner's Project No:
Engineer's Project No:
Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.2)CNG FUELING
STATION described in the Invitation for Bids, Bid No.B1100162.
Contractor
Contract For Contract Date
This Certificate of Substantial Completion applies to all Work under the Contract Documents except for the following specified parts
thereof:
The Work to which this Certificate applies has been inspected by authorized representatives of the Owner,Contractor and Engineer,and
that Work is hereby declared to be substantially complete in accordance with the Contract Documents on
Date of Substantial Completion
A list of items to be completed or corrected may be attached hereto. This list may not be all-inclusive,and the failure to include an item
in it does not alter the responsibility of the Contractor to complete all the Work in accordance with the Contract Documents. The items
in the list shall be completed or corrected by the Contractor within 5 days of the above date of Substantial Completion. During
completion of the punchlist work items,the Contractor will be responsible for the traffic control costs.
To be effective,this form must be signed by the Owner,the Engineer,and the Contractor.
Owner: Date:
Engineer: Date:
Contractor: Date:
_ 12_
LIEN WAIVER (GENERAL CONTRACTOR)
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#IA.2)
CNG FUELING STATION
TO: Weld County Public Works
Attn:Elizabeth Relford,Transportation Planner
P.O. Box 758
Greeley,Colorado 80632
To Whom It May Concern:
For a valuable consideration paid by the Board of County Commissioners of Weld County,the receipt and sufficiency of which is
hereby acknowledged,the undersigned hereby,releases unto Weld County and to its heirs,executors, administrators or assigns,all
rights of the undersigned to claim a mechanic's lien for material heretofore furnished for use in and for labor heretofore performed upon
the construction,alteration,addition to or repair of the structures or improvements described in the Contract Documents as:
Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY (UFR #IA.2) CNG
FUELING STATION described in the Invitation for Bids,Bid No. BI 100162.
Contractor:
(If no legal description is shown following the description of Project,we acknowledge that the foregoing is an adequate description of
the real properties and improvements inasmuch as the foregoing is the description given in the Contract Documents which govern the
performance of the Work for which consideration has been received.)
In executing this release,we certify that all claims for labor,or materials,or both,furnished or performed on our behalf by our material
suppliers or subcontractors have been paid or that satisfactory arrangement for payment has been made.
We agree to defend Weld County from any and all claims on the part of our material suppliers,laborers,employees,servants and agents
or subcontractors arising from our Work on the Project,and we further agree to reimburse the Board of County Commissioners of Weld
County for any and all costs,including reasonable attorney fees,which they may incur as a result of such claims.
Contractor
By:
Title:
Date:
STATE OF
)ss.
COUNTY OF )
The foregoing instrument was acknowledged before me this day
of ,2012,by
My commission expires:
Notary Public
- 13 -
FINAL LIEN WAIVER(SUBCONTRACTORS)
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#1A.21
CNG FUELING STATION
To All Whom It may Concern:
WHEREAS,the undersigned has been employed by(A)
to furnish labor and materials for(B)
work,
under a contract(C)
for the improvement of the premises described as(D)
County of State of
of which
is the Owner.
NOW,THEREFORE,this day of 2012,
for and in consideration of the sum of(E)
Dollars paid simultaneously herewith,the receipt whereof is hereby acknowledged by the undersigned,the undersigned does hereby
waive and release any lien rights to, or claim of lien with respect to and on said above described premises, and the improvements
thereon, and on the monies or other considerations due or to become due from the Owner,on account of labor, services, material,
fixtures, apparatus or machinery heretofore or which may hereafter be furnished by the undersigned to or for the above described
premises by virtue of said contract.
(F) (SEAL)
(Name of sole ownership,corporation or partnership)
(Affix Corporate seal here)
(SEAL)
(Signature of Authorized Representative)
Title:
INSTRUCTIONS FOR FINAL WAIVER
(A) Person or firm with whom you agreed to furnish either labor,or services,or materials,or both.
(B) Fill in nature and extent of work;strike the word labor or the word materials if not in your contract.
(C) If you have more than one contract on the same premises, describe the contract by number if available,date and extent of
work.
(D) Furnish an accurate enough description of the improvement and location of the premises so that it can be distinguished from
any other property.
(E) Amount shown should be the amount actually received and equal to total amount of contract as adjusted.
(F) If waiver is for a corporation,corporate name should be used,corporate seal affixed and title of officer signing waiver should
be set forth;if waiver is for a partnership,the partnership name should be used,partner should sign and designate himself as
partner.
- 14_
NOTICE OF ACCEPTANCE
DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#IA.22
CNG FUELING STATION
To:ELA Group,Inc. (Zeit Energy) Date:
950 Aero Drive
Shreveport,LA 71107
RE: DESIGN/BU1LD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE KERSEY(UFR#IA.2)CNG FUELING
STATION described in the Invitation for Bids,Bid No.B 1100162.
This is to inform you that the above referenced job,has been satisfactorily completed in accordance with the Contract documents and
is hereby accepted. Final payment will be made on or about
Final acceptance does not relieve the Contractor of the minimum one(I)year guarantee on all work and materials incorporated into this
Project. Such guarantee shall begin on the date of this acceptance.
Weld County,Colorado,Owner
By:
Elizabeth Relford,Transportation Planner
- 15-
36. EXHIBIT I -FEDERAL-AID CONTRACT PROVISIONS
• FHWA Form 1273 FNWA-1273t]eca ro oncwer:on-rNa 10.1904
REQUIRED CONTRACT PROVISIONS
FEDERAL-AID CONSTRUCTION CONTRACTS
I General 1 (Applicable to all Federal-aid construction contracts and to alt related
II. Nondiscrimination _. 1 subcontracts of 510,000 or more.)
Ill.Nonsegregated Facilities ... .._.. 3
IV.Payment of Predetermined Minimum Wage..._..«...._....._...,_,...,. 3 1.Equal Employment Opportunity: Equal employment opportunity
V.Stalaments and Payrolls 6 (EEO)requirements not to discriminate and to lake affirmative action to
VI.Record of Materials.Supplies,and Labor .« _. _... 6 assure equal opporturty as sat forth under laws. executive orders.
VII. Subletting or Assigning the Contract 7 rules,regulations(28 CFR 35.29 CFR 1830 and 41 CFR 60)and orders
VIII. Safety.Accident Prevention 7 of the Secretary of Labor as modified by the provisions prescribed
IX.False Statements Concerning Highway Projects 7 herein,and unposed pu Suant to 23 U.S.C.140 shall constitute the EEO
X.Implemenfaton of Clean Air Act and Federal and specific affirmative action standards for the contractor's project
Water Pollution Control Act 6 activities under this Agreement The Equal Opportunity Construction
X1.Certificatlon Regarding Debarment,Suspension. Contract Specifications set forth under 41 CFR 60-4.3 and the
Ineligibility,and Voluntary Exclusion 8 provisions of the American Disabilities Act of 1990(42 U.S.C. 12101 gj
XII. Certification Regarding Use of Contract Funds for Etg.)set forth under 28 CFR 35 and 29 CFR 1830 are Incorporated by
Lobbying 9 reference in this Agreement In the execution of this Agreement the
contractor agrees to comply with the following minimum specific
ATTACHMENTS requirement activities of EEO:
A.Eniployment Preference for Appalachian Contracts a.The contractor will work with the State highway agency(SHA)
(included in Appalachian contracts only) and the Federal Government in carrying out EEO obligations and in their
review of his/her activities under the contract.
I.GENERAL
b.The contractor wi8 accept as his operating policy the following
1.These contract provisions shall apply to all work performed on the statement
contract by the contractor's own organization and with the assistance of
workers under the contractor's immediate superintendence and to all '11 is the policy of this Company to assure that applicants are
work performed on the contract by piecework, station work, or by employed. and that employees are treated during employment.
subcontract without regard to their race.religion.sex,color,national origin,age
or disability. Such action shalt include: employment, upgrading,
2. Except as otherwise provided for in each section, the contractor demotion,or transfer,recruitment or recmxbttent advertising;layoff
4„ shall insert in each subcontract all of the stipulations contained in these or termination; rates of pay or other forms of compensation;and
Required Contract Provisions.and further require their ihdusion in any selection for training,including apprenticeship,pre-apprenticeship,
borer tier subcontract or purchase order that may in turn be made.The and/or oretheeob training.'
Required Contract Provisions shall not be incorporated by reference in
any case.The prime contractor shall be responsible for compliance by 2.EEO Officer:The contractor win designate and make known to the
any subcontractor or lower tier subcontractor with these Required SHA contracting officers an EEO Officer who we have the responsibility
Contract Provisions. for and must be capable of effectively administering and promoting an
active contractor program of EEO and who must be assigned adequate
3.A breach of any of the stipulations contained to these Required authority and responslb4lty to do so.
Contract Provisions shall be sufficient grounds for termination of the
cpntract 3. Dissemination of Policy: Ad members of the contractor's staff
who are authorized to hire, supervise, promote, and discharge
4. A breach of the following clauses of the Required Contract employees, or who recommend such action, or who are substantially
Provisions may also be grounds for debarment as provided in 29 CFR involved in such action, win be made fully cognizant of, and wilt
5.12: Implement.the contractor's EEO policy and contractual responsibilities
to provide EEO In each grade and classification of employment. To
Section I.paragraph 2; ensure that the above agreement win be met.the following actions will
Section N,paragraphs 1,2.3,4.and 7; be taken as a minimum:
Section V.paragraphs 1 and 2a through 2g.
a. Periodic meetings of supervisory and personnel office
5.Disputes arising out of the labor standards provisions of Section IV employees wilt be conducted before the start of work and then not less
(except paragraph 5) and Section V of these Required Contract often than once every six maths.at which time the contractor's EEO
Provisions shall not be subject to the general disputes clause of this policy and its implementation wit be reviewed and explained. The
Agreement. Such disputes shall be resolved in accordance with the meetings will be conducted by the EEO Officer.
procedures of the U.S. Department of Labor(DOC)as set forth in 29
CFR 5, 6,and 7. Disputes within the meaning of this clause include b. All new supervisory or personnel office employees will be
deputes between the contractor(or any of its subcontractors)and the given a thorough indoctrination by the EEO Officer, covering all major
contracting agency. the DOL. or the contractor's employees or their aspects of the contractor's EEO obligations within thirty days following
representatives. thew reporting for duty with the contractor.
6. Selection of Labor: During the performance of this Agreement. c. Alf personnel who are engaged in direct recruitment for the
the contractor shall rot: project will be instructed by the EEO Officer In the contractor's
procedures for locating and hiring minority group employees.
a.discriminate against labor from any other State,possessiorn,or
territory of the United Stales (except for employment preference for d. Notices and posters setting forth the contractor's EEO policy
Appalachian contracts,when applicable,as specified in Attachment A), will be pieced in areas readily accessible to employees, applicants for
or employment and potential employees.
b employ convict labor for any purpose within the limits of the e.The contractors EEO policy and the procedures to implement
protect unless it 'is labor performed by convicts who are on parole, such policy will be brought to the attention of employees by means of
supervised release.or probation. meetings,employee handbooks,or other appropriate means.
IL NONDISCRIMINATION 4.Recruitment:When advertising for employees. the contractor will
include in an advertisements for employees the notation: -An Equal
Page 1 of 8 REQUIRED BY 23 CFR 633 102 --
/
Opponunty Employer' All such advertisements will be placed in either directly or through a contractor's association acting as agent wit
• publications having a large circulation among minority groups in the area exude the procedures sat forth below
from which the protect work force would normally be derived.
a.The contractor will use best efforts to develop,in cooperation
a The contractor will, unless preluded by a valid bargaining with the unions.joint training programs aimed toward qualifying more
agreement. conduct systematic and direct recruitment through public minority group members and women for membership in the unions and
and private employee referral sources likely to yield qualified minority increasing the skills of minority group employees and women so that
group applicants.To meet this requirement.the contractor will identify they may qualrfy for higher paying employment.
sources of potential minority group employees,and establish with such
identified sources proceeures whereby minority group applicants may be b. The contractor will use best efforts to incorporate an EEO
referred to the contractor for employment consideration. clause into each union agreement to the end that such union will be
contractually bound to refer applicants without regard to their race.color.
b. In the event the contractor has a valid bargaining agreement religion,sex,national origin,age or disability.
providing for exclusive hiring hall referrals.he is expected to observe the
provisions of that agreement to the extent that the system permits the c. The contractor is to obtain irdormation as to the referral
contractor's compliance with EEO contract provisions. (The DOL has practices and policies of the labor union except that to the extent such
held that where implementations of such agreements have the effect of information is within the exclusive possession of the labor union and
discriminating against minorities or women,or obligates the contractor to such labor union refuses to furnish such information to the contractor,
do the same,such implementation violates Executive Order 11246.as the contractor shall so certify to the SHA and shall set forth what efforts
amended.) have been made to obtain such information.
c.The contractor will encourage his present employees to refer d.In the event the union is unable to provide the contractor with a
minority group applicants for employment Information and procedures reasonable flow of minority and women referrals within the time limit set
with regard to referring minority group applicants will be discussed with forth in the collective bargaining agreement,the contractor will,through
employees. independent recruitment efforts, fill the employment vacancies without
regard to race, color, religion. sex, national origin, age or disability.
5. Personnel Actions: Wages. working conditions, and employee making full efforts to obtain qualified and/or qualifiable minority group
benefits shall be established and administered,and personnel actions of persons and women.(The DOL has held that it shad be no excuse that
every type. including hiring, upgrading. promotion, transfer, demotion. the union with which the contractor has a collective bargaining
layoff, and termination, shall be taken without regard to race, color, agreement providing for exclusive referral failed to refer minority
religion,sex,national origin,age or disability.The following procedures employees.) to the event the union referral practice prevents the
shall be followed: contractor from meeting the obligations pursuant to Executive Order
11246,as amended,and these special provisions,such contractor shall
a.The contractor will conduct periodic inspections of project sites immediately notify the SHA
to insure that working=debris and employee facilities do riot indicate
discriminatory treatment of prgect site personnel. 8. Selection of Subcontractors, Procurement of Materials and
Leasing of Equipment: The contractor shad not discriminate on the
illb.The contractor will periodically evaluate the spread of wages grounds of race,color,religion,sex, national origin,age or disability in
paid within each classification to determine any evidence of the selection and retention of subcontractors, including procurement of
discriminatory wage practices. matenals and leases of equipment.
c. The contractor we periodically review selected personnel a. The contractor shad notify all potential subcontractors and
actions in depth to determine whether there is evidence of dlscrii- suppliers of his/her EEO obligations under this Agreement.
nation. Where evidence is found. the contractor will promptly take
corrective aCion. If the review indicates that the discrimination may b. Disadvantaged business enterprises(DBE), as defined in 49
extend beyond the actions reviewed,such corrective action shall include CFR 23, shall have ecuat opporliuity to compete for and perform
ad affected persons. subcontracts which the contractor enters into pursuant to this
Agreement.The contractor will use his best efforts to solicit bids from
d. The contractor will promptly investigate all complaints of alleged and to utilize DBE subcontractors or subcontractors with meaningful
discrimination made to the contractor In connection with his obligations mrnorty group end female representation among their employees.
under this Agreement.writ attempt to resolve such complaints.and will Contractors shall obtain lists of DBE construction firms from SHA
take appropriate corrective action within a. reasonable time. If the personnel.
investigation indicates that the discrimination may affect persons other
than the complainant, such corrective action shall include such other C.The contractor will use his best efforts to ensure subcontractor
persons. Upon completion of each investigation, the contractor will compliance with their EEO obligations.
Inform every complalnant of all of his avenues of appeal.
9.Records and Reports:The contractor shall keep such records as
6.Training and Promotion: necessary to document compliance with the EEO requirements.Such
records shad be retained for a period of three years following completion
a.The contractor volt assist in locating,qualifying.and increasing of the contract work and shad be available at reasonable rimes and
the skills of minority group and women employees, and applicants for places for inspection by authorized representatives of the SHA and the
employment FHWA.
b. Consistent with the contractor's work force requirements and a. The records kept by the contractor shall document the
as permissible under Federal and State regulations.the contractor shall following:
make full use of training programs.i.e..apprenticeship,and on-the-job
training programs for the geographical area of contract performance. (1)The number of minority and non-minority group members
Where feasible.25 percent of apprentices or trainees in each occupation and women employed in each watt classification on the project
shall be in thew first year of apprenticeship or training. In the event a
special provision for training Is provided under this Agreement, this (2)The progress and efforts being made in cooperation with
subparagraph will be superseded as indicated in the special provision. unions. when applicable. to increase employment opportunities for
minonties and women;
c. The contractor wilt advise employees and applicants for
employment of available training programs and entrance requirements (3)The progress and efforts being made in locating, tiring,
for each. training,qualifying,and upgrading minority and female employees;and
d. The contractor will periodically review the training and (4) The progress and efforts being made in secunng the
ill promotion potential of minority group and women employees and wet services of D6E subcontractor or subcontractors with meaningful
encourage eligible employees to apply for such training and promotion. minenty and female representation among their employees.
7.Unions:If the contractor reties in whole or in part upon unions as a b.The contractors will su br rat an annual report to the SHA eacn
source of employees.the contractor will use hisser best efforts to obtain July for the duration of the protect, indicating the number of minority,
the cooperation of such unions to increase opportunities for minority women, and non-minority group employees currently engaged in each
groups and women within the unions, and to effect referrals by such work classification required by the contract work.This information is to
unions of minority and 'erWe employees. Actions by the contractor
Page 2 of 8 REQUIRED BY 23 CFR 633.102 --
be reported on Form FHWA-1391.It on-the rob training is being required c. All rulings and interpretations of the Davis-Bacon Act and
by special provision.the contractor w41 be required to collect and report related acts contained in 29 CFR 1,3.and 5 are herein incorporated by
0 training data reference in this Agreement.
III.NONSEGREGATED FACILITIES 2.Classification:
(Applicable to ail Federal-aid construction contracts and to ad related a. The SHA contracting officer shall require that any class of
subcontracts of$10,000 or more.) laborers or mechanics employed under the contract,which is not listed
in the wage determination, shall be classified in conformance with the
a. By submission of this bid.the execution of this Agreement or wage determination.
subcontract,or the consummation of this material supply agreement or
purchase order, as appropriate. the bidder. Federal-aid construction b. The contracting officer shall approve an aifOttonal
contractor, subcontractor.malenal supplier,or vendor, as appropriate, classification, wage rate and fringe benefits only when the foilcwing
certifies that the firm does not maintain or provide for its employees any criteria have been met_
segregated facilities at any of Its establishments,and that the firm does
not permit Its employees to perform their services at any location,under (1)the work to be performed by the additional classification
its control.where segregated facilities are maintained.The firm agrees requested is not performed by a classification in the wage determination;
that a breach of this certification is a violation of the EEO provisions of
this Agreement.The akin further certifies that no employee will be denied (2)the additional classification is utilized in the area by the
access to adequate facilities on the basis of sex or rdiabilty. construction industry:
b. As used in this certification, the term 'segregated facilities' (3)the proposed wage rate, including any bona fide fringe
means any waiting rooms. worts areas. restrooms and washrooms. benefits,bears a reasonable relationship to the wage rates contained in
restaurants and other eating areas.tirneciocks,locker rooms,and other the wage determination:and
storage or dressing areas.parking kits.drinking fountains,recreation or
entertainment areas, transportation,and housing facilities provided for (4) with respect to helpers, when such a classification
employees which are segregated by expicit directive, or are, in fact, prevails in the area in which the work is performed.
segregated on the basis of race.coke, religion, national origin, age or
disability. because of habit. local custom, or otherwise. The only c.If the contractor or subcontractors,as appropriate,the laborers
exception will be for the disabled when the demands for accessibility and mechanics(if known)to be employed in the additional classification
override(e.g.disabled parking). or their representatives. and the contracting officer agree on the
classification and wage rate(including the amount designated for fringe
c.The contractor agrees that:t has obtained or will obtain identical benefits where appropriate),a report of the action taken shall be sent by
certification from proposed subcontractors or material suppliers prior to the contracting officer to the DOL.Administrator of the Wage and Hour
award of subcontracts or consummation of material supply agreements Division. Employment Standards Administration, WashMplon. O.C.
of$10.000 or more and that it will retain such certifications in its files. 20210.The Wage and Hour Administrator,or an authorized represerna-
live, will approve,modify, or disapprove every additional classification
IV.PAYMENT OF PREDETERMINED MINIMUM WAGE action within 30 days of receipt and so advise the contracting officer or
will notify the contracting officer within the 30-day period that additional
(Applicable to all Federal-aid construction contracts exceeding time is necessary.
0 $2,000 and to all related subcontracts.except for protects located on
roadways classified as local roads or rural minor collectors, which are d, in the event the contractor Of subcontractors,as appropriate.
exempt.) the laborers Of mechanics to be employed in the additional classification
or their representatives,and the contracting officer do not agree on the
1.General: proposed classification and wage rate(Including the amount designated
for fringe benefits.where appropriate),the contracting officer shall refer
a M mechanics and laborers employed or working upon the site the queslioris. including the views of all interested parties and the
of the work will be paid unconditionally and not less often than once a recommendation of the contracting officer, to the Wage and Hour
week and without subsequent deduction or rebate on any account Administrator for detemsraton. Sad Administrator, or an authorised
(except such payroll deductions as are permitted by regulations(29 CFR representative.will issue a deternanation within 30 days of receipt and
3)Issued by the Secretary of Labor under the Copeland Act(40 U.S.C. so advise the contracting officer or will notify the contracting officer
278c))the full amounts of wages and bona fide fringe benefits(or cash within the 30elay period that additional time is necessary
equivalents thereof) due at time of payment. The payment shall be
computed at wage rates not less than those contained in the wage e. The wage rate (including lnnge benefits where appropriate)
determination of the Secretary of Labor(hereinafter"the wage determi- determined pursuant to paragraph 2c a 2d of this Section IV shall be
nation")which is attached hereto and made a part hereof,regardless of pad to all workers performing work in the additional classification from
any contractual relationship which may be alleged to exist between the the first day on which work is performed in the classification.
contractor or its subcamractors and such Laborers and mechanics.The
wage determination (including any additional classifications and wage 3.Payment of Fringe Benefits:
rates contained under paragraph 2 of this Section IV and the DOL
poster(WH-1321)or Form FHWA-1495)shad be posted at all times by a.Whenever the minimum wage rate prescribed in the contract
the contractor and its subcontractors at the site of the work in a for a class of laborers or mechanics Includes a fringe benefit which is not
prominent and accessible place where it can be easily seen by the expressed as an hourly rate, the contractor or subcontractors, as
workers. For the purpose of this Section, contributions made or costs appropriate, snail either pay the benefit as stated in the wage
reasonably anticipated for bona fide fringe benefits under Section 1(bX2) determination or shall pay another bona fide fringe benefit or an hourly
of the Davis-Bacon Act (40 U.S.C. 278a) on behalf of laborers or case equivalent thereof.
mechanics are considered wages paid to such laborers or mechanics,
subject to the provisions of Section IV,paragraph 3b.hereof.Also,for b. If the contractor or subcontractor, as appropriate, does not
the purpose of this Section.regular contrbubonis made or costs incurred make payments to a trustee or other third person.he/she may consider
for more than a weekly period(but not less often than quarterly)under as a part of the wages of any laborer or mechanic the amount of any
plans.funds.or programs-which cover the particular weekly period,are costs reasonably anticipated In providing bona fide fringe benefits under
deemed to be constructively made or incurred during such weekly a plan or program.provided,that the Secretary of Labor has found,upon
penod.Such laborers and mechanics shall be paid the appropriate wage the written request of the contractor,that the applicable standards of the
rate and fringe benefits on the wage determination for the classification Davis-Bacon Act have been met. The Secretary of Labor may require
of work actually performed,without regard to skid,except as provided in the contractor to set aside in a separate account assets for the meeting
paragraphs 4 and 5 of this Section IV. of obligations under the plan or program.
b. Laborers or mechanics performing work in more than one 4. Apprentices and Trainees (Programs of the U.S. DOL) and
classification may be compensated al the rate specified for each Helpers:
classification for the time actually worked therein, provided, that the
employes payroll records accurately set forth the time spent In each a.Apprentices:
classification in which work Is performed.
(1) Apprentices we be permitted to work at less than the
predetermined rate for the work(hey performed when they are employed
Page 3 of 8 REQUIRED BY 23 CFR 633.102 --
pursuant to and Individually registered in a bona fide apprenticeship
ID program registered with the DOL. Employment and Training c.Helpers:
Administration, Bureau of Apprenticeship and Training,or with a State
apprenticeship agency recognized by the Bureau. or If a person is Helpers will be permitted to work on a project if the helper
employed In his/her first 90 days of probationary emp ioymery as an class fkation is specified and defined on the applicable wage determine-
apprentice in such an apprenticeship program. who Is riot individually flat or is approved pursuani to the conformance procedure set forth in
registered in the program,but who has been certified by the Bureau of Section N.2.Any worker listed on a payroll at a helper wage rate,who is
Apprenticeship and Training or a State apprenticeship agency(where not a helper under a approved definition.shell be paid not less than the
appropriate) to be eligible for probationary employment as an applicable wage rate on the wage determination for the classification of
apprentice. work actually performed.
(2)The allowable ratio of apprentices to jourrreymarNevel 5.Apprentices and Trainees(Programs of the U.S.DOT):
employees on the job site in any craft classification shall not be greater
than the ratio permitted to the contractor as to the entire work force Apprentices and trainees working under apprenticeship and skill
under the registered program.Any employee listed on a payroll at an training programs which have been certified by the Secretary of
apprentice wage rate,who is rot registered or otherwise employed as Transportation as promoting EEO in connection with Federal-aid
stated above.shall be paid not less than the applicable wage rate listed highway construction programs are not subject to the requirements of
in the wage determination for the classification of work actually paragraph 4 of this Section N.The straight time hourly wage rates for
performed.In edditlon,any apprentice performing work on the job site'n apprentices and trainees under such programs wit be established by the
excess of the ratio permitted under the registered program snail be paid particular programs.The ratio of apprentices and trainees to journeymen
not less than the applicable wage rate on the wage determination for the shall not be greater than permitted by the terms of the particular
watt actually performed. Where a contractor or subcontractor Is program.
performing construction on a project In a locality other than that in which
its program is registered, the ratios and wage rates (expressed in 8.Withholding:
percentages of the journeyman-level hourly rate) specified In the
contractor's or subcontractor's registered program shad be observed. The SHA shall upon its own action or upon written request of an
authorized representative of the DOL withhold,or cause to be withheld,
(3)Every apprentice must be paid at not less than the rate from the contractor or subcontractor under this Agreement or any other
specified in the registered program for the apprentice's level of progress. Federal contract with the same prime contractor,or any other Federally-
expressed as a percentage of the journeyman-revel hourly rate specified assisted contract subject to Davis-Bacon prevailing wage requirements
in the applicable wage determination. Apprentices shall be paid fringe which is need by the same prene contractor, as much of the accrued
benefits in accordance with the provisions of the apprenticeship payments or advances as may be considered necessary to pay laborers
program.if the app rerdiceship program does not specify fringe benefits, and mechanics,Including apprentices,trainees,and helpers,employed
apprentices must be paid the full amount of fringe benefits listed on the by the contractor or any subcontractor the full amount of wages required
wage determination for the applicable ctassificauen.if the Administrator by the contracL In the event of failure to pay any laborer or mechanic,
for the Wage and Hour Division determines that a different practice including any apprentice,trainee,or helper,employed or working on the
prevails for the applicable apprentice classification,fringes shall be paid site of the work, at or part of the wages required by the contract. the
in accordance with that delerminalian. SHA contracting officer may,after written notice to the contractor.lake
Stich action as may be necessary to arse the suspension of any further
0 (4)In the event the Bureau of Apprenticeship and Training, payment. advance. or guarantee of funds until such vloiCtions have
or a State apprenticeship agency recognized by the Bureau.withdraws ceased.
approval of an apprenticeship program,the contractor or subcontractor
will no longer be permitted to utilize apprentices at less than the 7.Overtime Requirements:
applicable predetermined rate for the comparable work performed by
regular employees until an acceptable program Is approved. No contractor or subcontractor contracting for any part of the
contract work which may require Of involve the employment of laborers,
b.Trainees: mechanics, watchmen. or guards(including apprentices.trainees,end
helpers described in paragraphs 4 and 5 above)shall require or permit
(1)Except as provided in 29 CFR 5.16,trainees will not be arty laborer.mechanic, watchman. or guard in any workweek in which
permitted to work at less than the predetermined rate for the work he/she is employed on such work,to work in excess of 40 hours In such
petfwineo unless they are employed pursuant to and individually workweek unless such laborer,mechanic.watchman,or guard receives
registered in a program which has received pea approval,evidenced by compensation at a rate not less than one-and-one-half times his/her
formal certification by the DOL, Employment and Training basic rate of pay for all hours worked in excess of 40 hours In such
Administration. workweek.
(2)The ratio of trainees to journeyman-level employees on 8.Violation:
the job site shall not be greater than permitted under the plan approved
by the Employment and Training Administration.Any employee listed on Liability for Unpaid Wages;Liquidated Damages:In the event of any
the payrol at a trainee rate who is not registered and participating in a violation of the clause set forth in paragraph 7 above.the contractor end
training plan approved by the Employment and Training Administration any subcontractor responsible thereof shall be liable to the affected
shall be paid rot less than the applicable wage rate on the wage employee for his/her unpaid wages. In addition, such contractor and
determination fix the classification of work actually performed. In subcontractor shall be liable to the United States(in the case of work
addition,any trainee performing work on the job site in excess of the done under contract for the District of Columbia or a territory.to such
ratio permitted under the registered program shall be paid not less than District or to such territory) for liquidated damages. Such liquidated
the applicable wage rate on the wage determination for the work actually damages shall be computed with respect to each individual laborer,
perior ea. mechanic, watchman,or guard employed in violation of the clause set
forth in paragraph 7,in the sum of$10 for each calendar day on which
(3) Every trainee must be paid at not less than the rate such employee was required or permitted to work in excess of the
specified in the approved program for his/her level of progress. standard work week of 40 tours without payment of the overtime wages
expressed as a percentage of the journeyman-level hourly rate specified required by the clause set forth in paragraph 7.
in the applicable wage determination. Trainees shall be paid fringe
benefits in accordance with the provisions of the trainee program. If the 9.Withholding for Unpaid Wages and Liquidated Damages:
trainee program does not mention fringe benefits.trainees shill be paid
the full a r otmt of fringe benefits listed on the wage determination unless The SHA seal upon its own action or upon written request of any
the Adrmrrstrator of the Wage and Hour Division determines that there is authorized representative of the DOL withhold,or cause to be withheld,
an apprenticeship program aurvaated with the corresponding from any monies payable on account of work performed by the
journeyman-level wage rate on the wage determination which provides contractor or subcontractor under any such contract or any other
for less Iran full fringe benefits for apprentices. in which case sucniii,
Federal contract with the same prime contractor.or any other Federally-
trainees snap receive the same fringe benefits as apprentices assisted contract subject to the Contract Work Hours and Safety
Standards Act,which is held by the same prime contractor,such sums
(4)In the event the Employment and Training Aanrrustration as may be determined to be necessary to satisfy any liabilities of such
withdraws approval of a training program, the contractor or contractor or subcontractor for unpaid wages and liquidated damages as
subcontractor wet no longer be permitted to utilize trainees at less than provided in the clause set forth in paragraph 8 above
the applicable predetermined rate for the work performed unto an
acceptable program is approved.
Page 4 of 8 REQUIRED BY 23 CFR 633.102 -
V.STATEMENTS AND PAYROLLS f.The Ialsrfiuuon of any of the above certifications may subject
• the contractor to civil or criminal prosecution under 18 U.S C.1001 and
(Applicable to at Federal-ad construction contracts exceeding 52,000 31 U.S.C.231.
and to at related subcontracts,except for projects located cn roadways
classified as local roads or neat collectors.which are exempt.) g. The contractor or subcontractor shall make the records
required under paragraph 2b of this Section V available for inspection.
1.Compliance with Copeland Regulations(29 CFR 3): copying.or transcrption by authorized representaeves of the SHA, the
FHWA.or the DOL,and shall permit such representatives to interview
The contractor shall comply with the Copeland Regulations of the employees during working hours on the job. If the contractor or
Secretary of labor which are herein incorporated by reference. subcontractor fails to submit the required records or to make them
available.the SHA,the FHWA.the DOL.or at may.after written notice
2.Payrolls and Payroll Records: to the contractor,sponsor,applicant.or owner,take such actions as may
be necessary to cause the suspension of any further payment,advance.
a Payrolls and basic records relating thereto shall be or guarantee of funds. Furthermore. failure to submit the required
maintained by the contractor and each subcontractor dunng the course records upon request or to make such records available may be grounds
of the work and preserved fore period of 3 years from the date of for debarment action pursuant to 29 CFR 5.12.
completion of the contract for all laborers, mechanics. apprentices.
trainees,watchmen,helpers,and guards working at the site of the work. Vt.RECORD OF MATERIALS,SUPPLIES.AND LABOR
b. The payroll records shall contain the name. social security 1. On all Federal-aid contracts on the National Highway System.
number, and address of each such employee: his or her correct except those which provide solely for the installation of protective
classification;hourly rates of wages paid(including rates of contributions devices at railroad grade crossings.those which are constructed on a
or costs anticipated for bona fide fringe benefits or cash equivalent force account or i5reet labor basis,highway beautification contracts,and
thereof the types described in Section 1(bX2XB) of the Davis Bacon contracts for which the total final construction cast for roadway and
Act daily and weekly number of hours worked;deductions made:and bridge is less than 51,000,003(23 CFR 635)the contractor shall:
actual wages paid. In addition. for Appalachian contracts, the payroll
records shall contain a notation indicating whether the employee does, a. Become familiar with the list of specific materials and
or does not.normally reside in the labor area as defined in Attachment supplies contained in Form FHWA-47. 'Statement of Materials and
A.paragraph 1.Whenever the Secretary of Labor,pursuant to Section Labor Used by Contractor of Highway Construction Involving Federal
IV,paragraph 3b.has found that the wages of any laborer or mechanic Funds."prior to the commencement of work under this Agreement.
include the amount of any costs reasonably anticipated in providing
benefits under a plan or program described in Section 1(b)(2XB)of the b. Maintain a record of the total cost of all materials and
Davis Bacon Act. the contractor and each subcontractor shall maintain supplies purchased for and incorporated in tom work,and also of the
records which show that the commitment to provide such benefits is quanotles of those specific materials and supplies listed on Form FHWA-
enforceable,that the plan or program is financially responsible,that the 47.and 1n the units shown on Form FHWA-47.
plan or program has been communicated in writing to the laborers or
mechanics affected. and show the cost anticipated or the actual cost c. Furnish, upon the completion of the contract, to the SHA
incurred in providing benefits. Contractors or subcontractors employing resident engineer on Form FHWA-47 together with the data required in
apprentices or trainees under approved programs shall maintain written paragraph lb relative to materials and supplies,a final labor summary of
0 evidence of the registration of apprentices and trainees,and ratios and all contract work indicating the total hours worked and the total amount
wage rates prescribed In the applicable programs. earned.
c.Each contractor and subcontractor shall furnish,each week in 2.At the prime contractor's option,either a single soon covering all
which any contract work is performed. to the SHA resident engineer a contract work or separate reports for the contractor and for each
payroll of wages paid each of its employees (Including apprentices. subcontract shall be submitted.
trainees,and helpers.descnbed In Section IV.paragraphs 4 and 5.and
watchmen and guards engaged on work during the preceding weekly VII.SUBLETTING OR ASSIGNING THE CONTRACT
payroll period). The payroll submitted shall set out accurately and
completely all of the information required to be maintained under 1. The contractor shall perform with its own organization contract
paragraph 2b of this Section V. This information may be submitted in work amounting to not less than 30 percent(or a greater percentage if
any form desired.Optional Form WH347 is available for this purpose specified elsewhere In the contract)of the total original contract price,
and may be purchased from the Superintendent of Documents(Federal excluding any specialty items designated by the State.Specialty items
stock number 029-005-0014-1), U.S. Government Printing Office, may be performed by subcontract and the amount of any such specialty
Washington. D.C. 20402, The prrne contractor is responsible for the items performed may be deducted from the total ongnal contract price
submission of copies of payrolls by all subcontractors. before computing the amount of work required to be performed by the
contractor's own organization(23 CFR 635).
d.Each payroll Worsted shall be accompanied by a"Statement of Complan ce." signed by the contractor or subcontractor or hislher a. Its own organization" shall construed d to prime include
and a only
agent who pays or supervises the payment of the persons employed workers employed and directly by the
under the contract and snap certify the following: equipment owned or rented by the prime contractor, with or without
operators. Such term does not Include employees or equipment of a
(1) that the payroll for the payroll period contains the subcontractor.assignee,or agent of the prime contractor.
information recuired to be maintained under paragraph 2b of this
Section V and that such information is correct and complete; b. "Specialty Items" shall be construed to be limited to work
that requires highly specialized knowledge. abilities. or equipment not
(2) that such laborer or mechanic (including earth helper, onhiriarity available in the type of contracting organizations qualified and
apprentice, and trainee)employed on the contract during the payroll expected to bid on the contract as a whole and in general are to be
period has been paid the full weekly wages earned, without rebate, limited to minor components of the overall contract
either directly or indirectly. and that no deductions have been made
either directly or indirectly from the full wages earned. other than 2. The contract amount upon which the requirements set forth in
permissible deduciOns as set forth in the Regulations.29 CFR 3: paragraph 1 o1 Section VII is computed includes the cost of material and
manufactured products which are to be purchased or produced by the
(3)that each laborer or mechanic has been paid rat less that contractor under the contract provisions.
the applicable wage rate and fringe benefits or cash equivalent for the
classification of waked performed,as specified in the applicable wage 3. The contractor shall furnish (a) a competent superintendent or
determination incorporated Into the contract. supervisor who is employed by the firm, has full authority to direct
performance of the work in accordance with the contract requirements.
0 and is in charge of all construction operations (regardless of who
e.The weekly submission of a properly executed certification set performs the work) and (b) such other of its own organizational
forth on the reverse side of Optional Form WH-347 shall satisfy the resources(supervision,management.and engineering services)as the
requirement for submission of the 'Statement of Compliance"required SHA coetractting officer determines is necessary to assure the
by paragraph 2d of this Section V. performance of the contract.
4. No portion of the contract shall be sublet assigned or otherwise
Page 5 of 8 REQUIRED BY 23 CFR 633.102 --
disposed of except with the written consent of the SHA contracting
officer.or authonzed representative,and such consent when given snail By submission of this bid or the execution of this Agreement or
subcontract as appropriate,thisbi
not be construed to relievethe contactor Cl any responstbyity for the the bidder, Federal-aid construction
fulfillment of the contract Written consent coil be given only after the contractor, or subcontractor, as appropriate, will be deemed to have
SHA has assured that each subcontract is evidenced In writing end that stipulated as follows:
e contains all pertinent provisions and requirements of the prime
contract. 1. That any facility that Is or will be utilized In the performance of this
Agreement,unless such contract is exempt under the Clean Air Act,as
VIII.SAFETY:ACCIDENT PREVENTION amended(42 U.S.C.1857 ill fig.,as amended by Pub.L.91.604),and
under the Federal Water Pollution Control Act,as amended(33 U.S.C.
1.In the performance of this Agreement the contractor shall comply 1251 et mg.,as amended by Pub.L..92-500). Executive Order 11738.
with a8 applicable Federal. State, and local laws governing safety, and regulations in implementation thereof(40 CFR 15)is not listed.on
hearth, and sanitation (23 CFR 635). The contractor shall provide all the date of contract award, on the U.S. Environmental Protection
safeguards.safety devices and protective equipment and take any other Agency(EPA)List of Violating Facilities pursuant to 40 CFR 15.20.
needed actions as it determines,or as the SHA contracting officer may
determine.to be reasonably necessary to protect the life and health of 2. That the firm agrees to comply and remain in compliance with all the
employees on the job and the safety of the public and to protect property requirements of Section 114 of the Crean Air Act end Section 308 of the
in connection with the performance of the work covered by the contract. Federal Water Pollution Control Act and all regulations and guidelines
listed thereunder.
2.It is a condition of this Agreement and shall be made a condition of
each subcontract, which the contractor enters into pursuant to this 3. That the firm shall promptly notify the SHA of the receipt of any
Agreement, that the contractor and any subcontractor shall not permit communication from the Director. Office of Federal Activities, EPA,
any employee.In performance of the contract.to work in surroundings or indicating that a facility that is or will be utilized for the contract is under
under conditions which are unsanitary, hazardous or dangerous to consideration to be listed on the EPA List of Violating Faclites.
his/her health or safety, as determined under construction safety and
health standards(29 CFR 1926)promulgated by the Secretary of Labor, 4. That the firm agrees to include or cause to be included the
n accordance with Section 107 of the Contract Work Hours and Safety requirements of paragraph 1 through 4 of this Section X in every
Standards Act(40 U.S.C.333). nonexempt subcontract and further agrees to take such action as the
government may direct as a means of enforcing such requirements.
3.Pursuant to 29 CFR 1926.3,II is a condition of this Agreement that
the Secretary of Labor or authorized representative thereof,shad have Xl.CERTIFICATION REGARDING DEBARMENT,SUSPENSION,
right of entry to any site of contract performance to inspect or investigate INELIGIBILITY AND VOLUNTARY EXCLUSION
the matter of compliance with the construction safety and health
standards and to carry out the duties of the Secretary under Section 107 1.Instructions for Certification-Primary Covered Transactions:
of the Contract Work Hours and Safety Standards Act(40 U.S.C.333).
(Applicable to al Federal aid contracts-49 CFR 29)
+X.FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS
a. By signing and submitting this proposal, the prospective
In order to assure high quality and durable construction in conformity Primary participant is providing the certification set out below.
with approved piens and specifications and a high degree of reliability on
0 statements and representations made by engineers,contractors,suppli-
ers, b. The Inability of a person to provide the certification set out
and workers on Federal aid highway projects,it is essential that all below will not necessarily result in denial of participation in this covered
persons concerned with the project perform their functions as carefully. transaction.The prospective participant shad submit an explanation of
thoroughly, and honestly as possible.Willful falsification, distortion, or why a cannot provide the certification set out below.The certification or
mrsrepresentatbn with respect to arty facts related to the project is a explanation eel be considered in connection with the department or
violation of Federal law.To prevent arty misunderstanding regarding the agency's determination whether to enter Into this transaction.However.
senousness of these and similar acts. the following notice shall be failure of the prospector primary participant to furnish a certification or
posted on each Federal-aid highway project (23 CFR 635)In one or an explanation shall disqualify such a person from participation in this
more places where it is readily available to all persons concerned with transaction.
the peaect:
c. The certification in this clause is a material representation of
NOTICE TO ALL PERSONNEL ENGAGED ON FEDERAL-AID fact upon which reliance was placed when the department or agency
HIGHWAY PROJECTS determined to enter Into this transaction. If it Is later determined that the
prospective primary participant knowingly rendered an erroneous
18 U.S C.1020 reads as follows: certification. in addition to other remedies available to the Federal
Government.the department or agency may terminate this transaction
Whoever.being an officer.agent,or employee of the United Slates. for cause of defauft
or of any State or Territory,or whoever,whether a person,association,
firm, or corporation, knowvrgy makes any false statement. false d. The prove primary participant shall provide immediate
representation. or false report as to the character.euellfy, quantity, or written notice to the department or agency to whom this proposal is
cost of the material used or to be used,or the quantity or quality of the submrned if any time the prospective primary participant learns that its
work performed or to be performed, or the cost thereof in connection certification was erroneous when submitted or has become erroneous
with the submission of pans,maps,specifications,contracts,or costs of by reason of changed circumstances.
construction on any highway or related preyed submitted for approval to
the Secretary of Transportation,'or e. The terms 'covered transaction." 'debarred,' 'suspended.'
ineligible.' 'lower tier covered transaction,' 'participant.' 'person,'
Whoeverkrvwinyfy makes any false statement,false representation, "primary covered transaction" 'principal' 'proposal.' and 'voluntarily
false report or false claim with respect to the character.quabty,quantity, excluded,' as used in this clause, have the mearings set out in the
or cost of any work performed or to be performed,or materials furnished Definitions and Coverage sections of rules Implementing Executive
or to be furnished,in connection with the construction of any highway or Order 12549.You may contact the department or agency to which this
related project approved by the Secretary of Transportation;or proposal la submitted for assistance in obtaining a copy of those
regulations.
Whoever knowingly makes any false statement or false
representation as to material fact in any statement,certificate,or report f.The prospective primary participant agrees by submitting this
submitted pursuant to provisions of the Federal-aid Roads Act approved proposal that.should the proposed covered transaction be entered into.
July 1,1916.(39 Stat.355),as amended and supplemented: it shall not kno nngfy enter into any lower tier covered transaction with a
person who is debarred, suspended, declared ineligible, or voluntarily
Shall be fined not more that$10.000 or lmprisaftd not more than 5 excluded from participation in this covered transaction. unless
years or both authonzed by the department or agency entering into this transaction.
X.IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL g. The prospective primary participant further agrees by
WATER POLLUTION CONTROL ACT submitting this proposal that A will include the clause tithed'Certification
Regarding Debarment.Suspension.Ineligibility and Voluntary Exclusion-
(Applicable to all Federal-aid construction contracts and to all related tower Tier Covered Transaction.'provided by the department or agency
subcontracts of 5100,000 or more.)
Page 6 of 8 REQUIRED BY 23 CFR 633.102 -
ontenng into this covered transaction,without modification,in all lower c.The prospective lover tier participant shall provide immediate
tier covered transactions and in all solicitations for lower tier covered written notice to the person to which this proposal is submitted if at any
41
transactions. time the prospective lower tier participant learns that its certification was
erroneous by reason of changed circumstances.
h. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered d. The terms "covered transaction," "debarred,' 'suspended"
transaction that is not debarred, suspended, ineligible. or vbluntanly ineligible,' "primary covered transaction' "partldpanL""person-"
excluded from the covered transaction, unless it knows that the "principal."proposal'and"voluntarily ezciuded,"as used in this clause.
certification is erroneous. A participant may decide the method and have the meanings set out in the Deliiretions and Coverage sections of
frequency by which it determines the eligibility of its principals. Each rules implementing Executive Order 12549.You may contact the person
partcipam may. but a not required to, check the non-procurement to which this proposal is submitted for assistance iri obtaining a copy of
portion of the"Lists of Parties Excluded From Federal Procurement or those regulations.
Non-procurement Programs'(Non-procurement List)which a compiled
by the General Services Administration. e.The prospective lower tier participant agrees by submitting this
proposal that,should the proposed covered transaction be entered into.
I.Nothing contained in the foieywig shall be construed to require it shalt riot knowingly enter into arty tower tier covered transaction with a
establishment of a system of records in order to render in good faith the person who is debarred, suspended, declared ineligible,or voluntarily
certification required by this clause.The knowledge and information of excluded from participation in this covered transaction. unless
participant is not required to exceed that which is normally possessed by authorized by the department or agency with which this transaction
a prudent person in the ordinary course of business dealings. originated.
j. Except for transactions authorized under paragraph f of these f. The prospective lower tier participant further agrees by
instructions. if a participant in a covered transaction knowingly enters submitting this proposal that it will include this clause titled"Certification
Into a lower tier covered transaction with a person who Is suspended, Regarding Debarment.Suspension.ineligibility and Vduritary Exclusion-
debarred. ineligible, or voluntarily excluded from participation in this Lower Tier Covered Transaction,'without modification, in all brow tier
transaction, in addition to other remedies available to the Federal covered transactions and in all solicitations for lower tier covered
Government, the department or agency may terminate this transaction transactions.
for cause or default
g. A participant in a covered transaction may rely upon a
certification of a prospective participant In a tower tler covered
transaction that is not debarred, suspended, Ineligible, or voluntarily
excluded from the covered transaction, unless it knows that the
Certification Regarding Debarment,Suspension,Ineligibility and certification is erroneous. A participant may decide the method and
Voluntary Exclusion—Primary Covered Transactions frequency by which it determines the eligibility of its principals. Each
participant may.but is not required to.check the Non-procurement List.
t. The prospective primary participant certifies to the best of its
knowledge and belief,that it and its principals: h. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in good
a. Are not presently debarred, suspended, proposed for faith the cenif catbon required by this clause. The knowledge and
• debarment, declared ineligible. or vokmtanily excluded from covered information of participant Is not required to exceed that which is normally
0 transactions by any Federal department or agency, possessed by a prudent person in the ordinary course of business
dealings.
b Have not within a 3-year period preceding this proposal been
convicted of or had a civil judgment rendered against them for I.Except for transactions authe zed under paragraph a of these
commission of fraud or a criminal offense in connection with obtaining. instructions. if a participant In a covered transaction knowingly enters
attempting to obtain, or performing a public (Federal. State or local) into a lower tier covered transaction with a person who is susperxled,
transaction or contract under a sub is transaction;violation of Federal or debarred, ineligible, or voluntarily excluded from participation In this
State antitrust statutes or commission of embealement ihheft, forgery, transaction. In addition to other remedies available to die Federal
bribery,falsification or destruction of records,making false statements. Government the department or agency with which this transaction
or receiving stolen properly, originated may pursue available remedies.including suspension andlor
debarment.
c.Are not presently indicted for or otherwise cnminalty or civilly
charged by a governmental entity (Federal. State Ce local) with
commission of any of the offenses enumerated In paragraph ib of this
Certification:aria
Certification Regarding Debarment.Suspension,Ineligibility and
d. Have not within a 3-year period preceding thus Voluntary Exclusion—Lower Tier Covered Transactions:
application/proposal had one or more public transactions(Federal.State
or local)terminated for cause or default. 1. The prospective lower tier participant certifies. by submission of
this proposal. that neither it nor its principals Is presently debarred.
2. Where the prospective primary participant is unable to certify to suspended. proposed for debarment, declared ineligible. or voluntarily
arty of the statements in this certification, such prospective participant excluded from participation in this transaction by any Federal
shall attach an explanation to this proposal. department or agency.
2.Where the prospective lower tier participant is unable to certify to
any of the statements in this certification.such prospective participant
shall attach an explanation to this proposal
2. Instructions for Certification-Lower Tler Covered Transac-
tions:
(Applicable to all subcontracts,purchase orders and other lower tier Xll.CERTIFICATION REGARDING USE OF CONTRACT FUNDS OR
transactions of 525,000 or more-49 CFR 29) LOBBYING
a.By signing and submitting this proposal,the prospective tower (Applicable to all Federal-ad construction contracts and to all related
tier is providing the certification set out below. subcontracts which exceed 5100,0O0-49 CFR 20)
b. The certification in this clause is a material representation of 1.The prospective participant certifies,by signing and submitting this
fact upon which reliance was pieced when this transaction was entered bid or proposal,to the best of his or her knowledge and belief,that:
• into. If it is later determined that the prospective lower tier participant
knowingly rendered an erroneous certification, In addition to other a.No Federal appropriated funds have been paid or wilt be paid,
remedies available to the Federal Government. the department. or by or on behalf of the undersigned, to any person for influencing Or
agency with which this transaction originated may pursue available attempting to influence an officer or employee of any Federal agency,a
remedies,including suspension and/or debarment Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the awarding of
Page 7 of 8 REQUIRED BY 23 CFR 633.102
any Federal contract the making of any Federal grant.the making of 2 This certification is a material representation of fact upon which
any Federal loan, the entering into of any cooperative agreement,and
• rt Nance was placed when this transaction was made or entered into.
the extension.continuation,renewal.amendment,or modification of any 2.Submission of tins certification is a prerequisite for making or enterng
Federal contract,grant,loan.or cooperator agreement. into this transaction Imposed by 31 U.S.C.1352.My person who fails to
file the required certification shall be subject to a crvil penalty of not less
b. if any funds other than Federal appropriated funds have been than S 10.000 and not more than 5100.000 for each such failure,
paid or will be paid to any person for influencing or attempting to
influence an officer or employee of arty Federal agency,a Member of 3. The prospective participant also agrees by submitting his or her bid or
Congress, an officer or employee of Congress.or an employee of a proposal that he or she shall require that the Language of this
Member of Congress in connection with this Federal contract grant. certification be included In all lower tier subcontracts. which exceed
loan, or cooperative agreement, the undersigned shall complete and 5100.000 and that all such recipients sham certify and disclose
submit Standard Form-LLL. 'Disclosure Form to Report Lobbying,'In accordingly
accordance with its instructions.
0
0
Page 8 of 8 REQUIRED BY 23 CFR 633.102 --
•
37. EXHIBIT J-FEDERAL REQUIREMENTS
Federal laws and regulations that may be applicable to the Work include:
A. Uniform Administrative Requirements for Agreements and Cooperative Agreements to
State and Local Governments (Common Rule)
The "Uniform Administrative Requirements for Agreements and Cooperative Agreements to
State and Local Governments (Common Rule), at 49 Code of Federal Regulations, Part 18,
except to the extent that other applicable federal requirements (including the provisions of 23
CFR Parts 172 or 633 or 635) are more specific than provisions of Part 18 and therefore
supersede such Part 18 provisions. The requirements of 49 CFR 18 include, without limitation:
i. the Local Agency/Contractor shall follow applicable procurement procedures, as required by
section 18.36(d);
ii. the Local Agency/Contractor shall request and obtain prior CDOT approval of changes to
any subcontracts in the manner, and to the extent required by, applicable provisions of
section 18.30;
iii. the Local Agency/Contractor shall comply with section 18.37 concerning any sub-
Agreements;
iv. to expedite any CDOT approval, the Local Agency/Contractor's attorney, or other
authorized representative, shall also submit a letter to CDOT certifying Local
Agency/Contractor compliance with section 18.30 change order procedures, and with
18.36(d) procurement procedures, and with 18.37 sub-Agreement procedures, as
applicable;
v. the Local Agency/Contractor shall incorporate the specific contract provisions described in
18.36(i)(which are also deemed incorporated herein) into any subcontract(s)for such
services as terms and conditions of those subcontracts.
B. Executive Order 11246
• Executive Order 11246 of September 24, 1965 entitled "Equal Employment Opportunity," as
amended by Executive Order 11375 of October 13, 1967 and as supplemented in Department
of Labor regulations (41 CFR Chapter 60)(All construction contracts awarded in excess of
$10,000 by the Local Agencys and their contractors or sub-the Local Agencys).
C. Copeland "Anti-Kickback" Act
The Copeland "Anti-Kickback" Act (18 U.S.C. 874)as supplemented in Department of Labor
regulations (29 CFR Part 3) (All contracts and sub-Agreements for construction or repair),
D. Davis-Bacon Act
The Davis-Bacon Act (40 U.S.C. 276a to a-7) as supplemented by Department of Labor
regulations(29 CFR Part 5) (Construction contracts in excess of$2,000 awarded by the Local
Agencys and sub-the Local Agencys when required by Federal Agreement program legislation.
This act requires that all laborers and mechanics employed by contractors or sub-contractors to
work on construction projects financed by federal assistance must be paid wages not less than
those established for the locality of the project by the Secretary of Labor).
E. Contract Work Hours and Safety Standards Act
Sections 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-
330)as supplemented by Department of Labor regulations (29 CFR Part 5). (Construction
contracts awarded by the Local Agencys and sub-the Local Agencys in excess of$2,000, and in
excess of$2,500 for other contracts which involve the employment of mechanics or laborers).
F. Clear Air Act
Standards, orders, or requirements issued under section 306 of the Clear Air Act(42 U.S.C.
1857(h), section 508 of the Clean Water Act(33 U.S.C. 1368). Executive Order 11738, and
Environmental Protection Agency regulations(40 CFR Part 15) (contracts, subcontracts, and
sub-Agreements of amounts in excess of$100,000).
G. Energy Policy and Conservation Act
Page 1 of 3
Mandatory standards and policies relating to energy efficiency which are contained in the state
energy conservation plan issued in compliance with the Energy Policy and Conservation Act
• (Pub. L. 94-163).
H. OMB Circulars
Office of Management and Budget Circulars A-87, A-21 or A-122, and A-102 or A-110,
whichever is applicable.
1. Hatch Act
The Hatch Act(5 USC 1501-1508) and Public Law 95-454 Section 4728. These statutes state
that federal funds cannot be used for partisan political purposes of any kind by any person or
organization involved in the administration of federally-assisted programs.
J. Nondiscrimination
42 USC 6101 et seq. 42 USC 2000d, 29 USC 794, and implementing regulation, 45 C.F.R. Part
80 et. seq. These acts require that no person shall, on the grounds of race, color, national
origin, age, or handicap, be excluded from participation in or be subjected to discrimination in
any program or activity funded, in whole or part, by federal funds.
K.ADA
The Americans with Disabilities Act (Public Law 101-336; 42 USC 12101, 12102, 12111-12117,
12131-12134, 12141-12150, 12161-12165, 12181-12189, 12201-12213 47 USC 225 and 47
USC 611.
L. Uniform Relocation Assistance and Real Property Acquisition Policies Act
The Uniform Relocation Assistance and Real Property Acquisition Policies Act, as amended
(Public Law 91-646, as amended and Public Law 100-17, 101 Stat. 246-256). (If the contractor
is acquiring real property and displacing households or businesses in the performance of the
Agreement).
M. Drug-Free Workplace Act
The Drug-Free Workplace Act(Public Law 100-690 Title V, subtitle D, 41 USC 701 et seq.).
N. Age Discrimination Act of 1975
The Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and its implementing
regulation, 45 C.F.R. Part 91; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794, as
amended, and implementing regulation 45 C.F.R. Part 84.
0. 23 C.F.R. Part 172
23 C.F.R. Part 172, concerning "Administration of Engineering and Design Related Contracts".
P. 23 C.F.R Part 633
23 C.F.R Part 633, concerning "Required Contract Provisions for Federal-Aid Construction
Contracts".
Q. 23 C.F.R. Part 635
23 C.F.R Part 635, concerning "Construction and Maintenance Provisions".
R. Title VI of the Civil Rights Act of 1964 and 162(a) of the Federal Aid Highway Act of
1973
Title VI of the Civil Rights Act of 1964 and 162(a) of the Federal Aid Highway Act of 1973. The
requirements for which are shown in the Nondiscrimination Provisions, which are attached
hereto and made a part hereof.
S. Nondiscrimination Provisions:
S. Nondiscrimination Provisions:
In compliance with Title VI of the Civil Rights Act of 1964 and with Section 162(a) of the Federal
Aid Highway Act of 1973, the Contractor, for itself, its assignees and successors in interest,
agree as follows:
i. Compliance with Regulations
• The Contractor will comply with the Regulations of the Department of Transportation relative
to nondiscrimination in Federally assisted programs of the Department of Transportation
Page 2 of 3
(Title 49, Code of Federal Regulations, Part 21, hereinafter referred to as the "Regulations"),
which are herein incorporated by reference and made a part of this Agreement
• ii. Nondiscrimination
The Contractor, with regard to the work performed by it after award and prior to completion of
the contract work, will not discriminate on the ground of race, color, sex, mental or physical
handicap or national origin in the selection and retention of Subcontractors, including
procurement of materials and leases of equipment. The Contractor will not participate either
directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations,
including employment practices when the contract covers a program set forth in Appendix C
of the Regulations.
iii. Solicitations for Subcontracts, Including Procurement of Materials and Equipment
In all solicitations either by competitive bidding or negotiation made by the Contractor for
work to be performed under a subcontract, including procurement of materials or equipment,
each potential Subcontractor or supplier shall be notified by the Contractor of the
Contractor's obligations under this Agreement and the Regulations relative to
nondiscrimination on the ground of race, color, sex, mental or physical handicap or national
origin.
iv. Information and Reports
The Contractor will provide all information and reports required by the Regulations, or orders
and instructions issued pursuant thereto and will permit access to its books, records,
accounts, other sources of information and its facilities as may be determined by the State or
the FHWA to be pertinent to ascertain compliance with such Regulations, orders and
instructions. Where any information required of the Contractor is in the exclusive possession
of another who fails or refuses to furnish this information, the Contractor shall so certify to the
State, or the FHWA as appropriate and shall set forth what efforts have been made to obtain
the information.
ID v. Sanctions for Noncompliance.
In the event of the Contractor's noncompliance with the nondiscrimination provisions of this
Agreement, the State shall impose such contract sanctions as it or the FHWA may determine
to be appropriate, including, but not limited to: a. Withholding of payments to the Contractor
under the contract until the Contractor complies, and/or b. Cancellation, termination or
suspension of the contract, in whole or in part.
T. Incorporation of Provisions§22
The Contractor will include the provisions of paragraphs A through F in every subcontract,
including procurement of materials and leases of equipment, unless exempt by the Regulations,
orders, or instructions issued pursuant thereto. The Contractor will take such action with respect
to any subcontract or procurement as the State or the FHWA may direct as a means of
enforcing such provisions including sanctions for noncompliance; provided, however, that, in the
event the Contractor becomes involved in, or is threatened with, litigation with a Subcontractor
or supplier as a result of such direction, the Contractor may request the State to enter into such
litigation to protect the interest of the State and in addition, the Contractor may request the
FHWA to enter into such litigation to protect the interests of the United States.
Page 3 of 3
38. EXHIBIT K-SUPPLEMENTAL FEDERAL PROVISIONS
• Supplemental Provisions for Contracts, Grants, and Purchase Orders for Federal Funds
received pursuant to the Federal Funding Accountability and Transparency Act (FFATA)of 2006
and 2008. Amendments As of October 1, 2010
The contract, grant, or purchase order to which these Supplemental Provisions are attached has
been funded, in whole or in part, with federal funds. In the event of a conflict between the
provisions of these Supplemental Provisions, the Special Provisions, the contract or any
attachments or exhibits incorporated into and made a part of the contract, the provisions of
these Supplemental Provisions shall control.
1. Definitions. For the purposes of these Supplemental Provisions, the following terms shall have the
meanings ascribed to them below
1.1. "Award"means an award of Federal Financial assistance that a non-Federal Entity receives or
administers in the form of:
1.1.1. Grants,
1.1.2. Contracts,
1.1.3. Cooperative agreements(which does not include cooperative research and development
agreements(CRDA) pursuant to the Federal Technology Transfer Act of 1986, as
amended(15 U.S.C. 3710a)),
1.1.4. Loans,
1.1.5. Loan Guarantees,
1.1.6. Subsidies,
1.1.7. Insurance,
1.1.8. Food commodities,
1.1.9. Direct appropriations, or
1.1.10. Other financial assistance transactions that authorize the non-Federal Entities'
expenditure of Federal Funds.
Award does not include:
1.1.11. Technical assistance, which provides services in lieu of money;
1.1.12. A transfer of title to Federally-owned property provided in lieu of money, even if the award
is called a grant;
1.1.13. Any classified award; or
1.1.14. Any award funded in whole or in part with Recovery funds, as defined in section 1512 of
the American Recovery and Reinvestment Act(ARRA)of 2009 (Pub. L. 111-5)
1.2. "Central Contractor Registration(CCR)"means the Federal repository into which an Entity must
provide information required for the conduct of business as a recipient.
1.3. "Data Universal Numbering System (DUNS) Number" means the nine-digit number established
and assigned by Dun and Bradstreet, Inc.to uniquely identify business entities.
1.4. "Entity"means all of the following as defined at 2 CFR part 25, subpart C;
1.4.1. A governmental organization, which is a State, local government, or Indian Tribe,
1.4.2. A foreign public entity,
1.4.3. A domestic or foreign non-profit organization,
1.4.4. A domestic or foreign for-profit organization, and
1.4.5. A Federal Agency, but only a subrecipient under an award or subaward to a non-Federal
entity.
1.5. "Subaward"means a legal instrument to provide support for the performance of any portion of the
substantive project or program funded by federal funds to a Prime Recipient that a Prime Recipient
awards to a Subrecipient.
• 1.6. "Contract" means the contract to which these Supplemental Provisions are attached and includes all
award types in§1.1.
Page 1 of 3
1.7. "Contractor" means the party or parties to the Contract other than the Prime Recipient and includes
a grantee, subgrantee, Subrecipient, or a borrower. For purposes of FFATA reporting, Contractor is
either a Subrecipient or a Vendor under this Contract.
1.8. "FFATA" means the Federal Funding Accountability and Transparency Act of 2006 (Public Law 109-
282). Also referred to as the"Transparency Act."
1.9. "Prime Recipient"means a Colorado State Agency or Institution of Higher Education that receives
federal funds directly from a Federal Agency in the form of an award in §1.1.
1.10. "Subrecipient" means a non-Federal Entity receiving Federal funds through a Prime Recipient to
support the performance of the Federal project or program for which the federal funds were awarded.
A Subrecipient is subject to the terms and conditions of the Federal award to the Prime Recipient,
including program compliance requirements.The term "Subrecipient includes and may be referred to
as Subgrantee.
1.11. "Supplemental Provisions" means these Supplemental Provisions for Contracts, Grants, and
Purchase Orders using Federal funds except those funds provided under the American Recovery and
Reinvestment Act of 2009, as may be revised pursuant to ongoing guidance from the relevant Federal
or State of Colorado Agency or Institution of Higher Education.
1.12. "Total Compensation" means the cash and noncash dollar value earned by the executive during the
Prime Recipient's or Subrecipient's preceding fiscal year and includes the following
1.12.1. Salary and bonus,
1.12.2. Awards of stock, stock options, and stock appreciation rights. This amount shall equal
the dollar amount recognized for financial statement reporting purposes with respect to
the fiscal year in accordance with the Statement of Financial Accounting Standards No.
123(Revised 2005)(FAS 123R), Shared Based Payments,
1.12.3. Earnings for services under non-equity incentive plans. This does not include group life,
health, hospitalization or medical reimbursement plans that do not discriminate in favor of
• executives and are available generally to all salaried employees,
1.12.4. Change in pension value, this amount shall equal the change in present value of defined
benefit and actuarial pension plans,
1.12.5. Above-market earnings on deferred compensation which is not tax-qualified, and
1.12.6. Other compensation, if the aggregate value of all such other compensation (e.g.
severance, termination payments, value of life insurance paid on behalf of the employee,
perquisites or property)for the executive exceeds $10,000.
"Vendor" means a dealer, distributor, merchant or other seller providing goods or services required
for a project or program funded by Federal funds. A Vendor is not subject to all the terms and
conditions of the Federal award, and all program compliance requirements do not pass through to a
Vendor.
2. Compliance. Contractor shall comply with all applicable provisions of the Transparence Act and the
regulations issued pursuant thereto, including but not limited to these Supplemental Provisions.Any
revisions to such provisions or regulations shall automatically become a part of these Supplemental
Provisions, without the necessity of either party executing any further instrument.The State of Colorado
may provide written notification to Contractor of such revisions, but such notice shall not be a condition
precedent to the effectiveness of such revisions.
3. Central Contractor Registration (CCR)and Data Universal Numbering System (DUNS) Requirements.
3.1. CCR -Contractor shall maintain the currency of its information in the CCR until the Contractor
submits the final financial report required under this award or receives final payment,
whichever is later. Contractor shall review and update the CCR information at least annually
after the initial registration, and more frequently if required by changes in its information
3.2. DUNS—Contractor shall provide its DUNS number to its Prime Recipient, and shall update its
information in Dun &Bradstreet at least annually after the initial registration, and more
frequently if required by changes in its information.
• 4. Total Compensation—Contractor shall include total compensation in CCR for each of its five most highly
compensated executives for the preceding completed fiscal year if:
Page 2 of 3
4.1. the total Federal funding authorized to date under this award is$25,000 or more, and
4.2. in the preceding fiscal year, Contractor received:
4.2.1. 80 percent or more of its annual gross revenues from Federal procurement contracts
and subcontracts and Federal financial assistance subject to the Transparency Act,
and
4.2.2. $25,000,000 or more in annual gross revenues from Federal procurement contracts
and subcontracts and Federal financial assistance subject to the Transparency Act,
and
4.3. the public does not have access to information about the compensation of the executives
through periodic reports filed under section 13(a)or 15(d)of the Securities Exchange Act of
1934 (15 U.S.C. 78m(a), 780(d)or section 6104 of the Internal Revenue Code of 1986.
5. Reporting.Contractor shall include data elements in its CCR and report to its Prime Recipient Entity the
data elements required in §7 if Contractor is a Subrecipient for the award types of grants,contracts, and
cooperative agreements(which does not include cooperative research and development agreements
(CRDA)pursuant to the Federal Technology Transfer Act of 1986, as amended(15 U.S.C. 3710a). No
direct payment shall be made to Contractor for providing any reports required under these Supplemental
Provisions, as the cost of producing such reports shall be deemed included in the Contract price. The
reporting requirements in§7 are based on guidance from the US Office of Management and Budget(OMB),
and as such are subject to change at any time by OMB. Any such changes shall be automatically
incorporated into this Contract and shall become part of Contractors obligations under this Contract. The
State may provide written notice to Contractor of any such change in accordance with §2 above, but such
notice shall not be a condition precedent to Contractor's duty to comply with revised OMB reporting
requirements.The Colorado Office of the State Controller shall provide summaries of revised OMB reporting
requirements at http://www.colorado.gov/dpa/dfp/sco/FFATA.htm
6. Effective Date and Dollar Threshold for Reporting—The reporting requirements in §7 apply for new
Federal grants,contracts, and cooperative agreements (except CRDA)as of October 1, 2010, if the initial
• award is $25,000 or more. If the initial award is below$25,000 but subsequent award modifications result in
a total award of$25,000 or more, the award is subject to the reporting requirements as of the date the
award exceeds$25,000. If the initial award is $25,000 or more, but funding is subsequently de-obligated
such that the total award amount falls below$25,000, the award continues to be subject to the reporting
requirements.
7. Subrecipient Reporting Requirements. If Contractor is a Subrecipient, Contractor shall report as set forth
below.
7.1 To CCR. A Subrecipient shall register in CCR and report the following data elements in CCR:
7.1.1 Subrecipient DUNS Number
7.1.2 Subrecipient DUNS Number+4 if more than one electronic funds transfer(EFT)
account
7.1.3 Subrecipient Parent DUNS Number
7.1.4 Subrecipient's address, including: Street Address, City, State, Country, Zip +4, and
Congressional District
7.1.5 Subrecipient Officers' Names of top 5 highly compensated officials if the criteria in §4
are met.
7.1.6 Subrecipient Officers'Total Compensation of top 5 highly compensated officials if
criteria in §4 met
7.2 To Prime Contractor. A Subrecipient shall report to its Prime Recipient, upon the effective date of
the contract, the following data elements:
39. 7.2.1 Primary Place of Performance Information, including: Street Address, City, State,
Country, Zip code +4, and Congressional District.
8. Vendor—There are no Transparency Act reporting requirements for vendors.
9. Event of Default. Failure to comply with these Supplemental Provisions shall constitute an event of default
under the Contract and the State of Colorado may terminate the Contract upon 30 days prior written notice if
the default remains uncured five calendar days following the notice period.This remedy will be in addition to
any other remedy available to the State of Colorado under the Contract, at law or in equity.
Page 3 of 3
861
MEMORANDUM
TO: Board of County Commissioners
I� COUNTY DATE: January 18, 2012
FROM: Elizabeth Relford, Transportation Planner
SUBJECT: Contract Approval for Bid Request No.
B1100162
On December 30, 2011, Weld County Public Works received one.bid for CDOT Project
AQC C030-046, (18378) for the design/build turnkey facility of a compressed natural gas•
fueling station in the UFR TPR. ELA Group, Inc. submitted the proposal in the amount
of$482,120.
The project estimate was $760,000, which is represented in the approved contract
between Weld County and CDOT dated 5/11/2011. Weld County received $400,000 in
federal congestion, mitigation, air quality (CMAQ) program funds. The oil and gas
industry provided the 17.21% local match which equates to approximately $83,150.
ELA Group, Inc. was the only proposal submitted and they met all the required bid
specifications; therefore, staff recommends awarding the project to ELA Group, Inc.
Weld County received concurrence to award the construction contract from CDOT on
January 4, 2012; therefore, staff recommends entering into a contract with ELA Group,
Inc. Construction of the project is anticipated to be completed in 2012.
I'm available to answer any questions you may have.
STATE OF COLORADO
DEPARTMENT OF TRANSPORTATION
r. t OT
Contracts and Market Analysis Branch AQC 0030-046
4201 East Arkansas Avenue CNG Fueling Station
Denver,Colorado 80222 Project Code 18378
Telephone:(303)757-9736
Facsimile: (303)757-9868
January 4, 2012
Ms. Elizabeth Relford
Weld County
Public Works
PO Box 758
Greeley, CO 80632-0758
Dear Ms Relford:
Based on my review cf the financial statement dated December 30, 2011 and
receipt of:
-COOT Form 605, Contractors Performance Capability Statement
-CDOT Form 606, Anti-Collusion Affidavit
-COOT Form 621, Assignment of Anti-Trust Claims and
-Documentation of conformance with CDOT UDBE Contract Goal Policy,
the County' s award of Project AQC C030-046 to ELA Group, Inc is approved.
Please include a copy of FHWA Form 1273 as part of your contract with ELA
Group, Inc Your cooperation in this matter is appreciated.
Sincerely,
Richard F. Ott
CDOT Award Officer
JSW/jsw
cc:
Tim Tuttle, R-4
Region EEO Officer, R-4
Ott, Agreements
Yehdego/Ngo, Projects & Grants
Loeper, Program & Project Analysis
Lfljenberg, R. Business Programs
Central Files
WELD COUNTY PURCHASING
1150 "O" Street, Greeley CO 80631
1 8 6 I - 2 0 I i E-Mail: mwalters@co.weld.co.us
. E-mail: reverett@co.weld.co.us
Phone: (970) 356-4000, Ext 4222 or 4223
Fax: (970) 336-7226
WELD-COU NTY
u
DATE OF BID: DECEMBER 30TH, 2011
REQUEST FOR: CNG FUELING STATION — UPPER FRONT RANGE #1A
DEPARTMENT: Public Works Dept
BID NO: #61100162
PRESENT DATE: JANUARY 4TH, 2012
APPROVAL DATE: JANUARY 18T", 2012
VENDORS PROJECT TOTAL
ELA GROUP INC $482,120.00
ZEIT ENERGY
950 AERO DR
SHREVEPORT LA 71107
The bid is being reviewed by the Public Works Department at this time.
2012-0036
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