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Home My WebLink About20111500.tiff 1861 - 2011MEMORANDUM • TO: Board of County Commissioners _ �1 WELD COUNTY DATE July 27, 2011 FROM: Elizabeth Relford, Transportation Planner SUBJECT: Contract Approval for Bid Request No. B1100069 Bids were received and opened on June 15, 2011 for a design/build turnkey facility for the construction of a compressed natural gas fueling station within Weld County's DRCOG boundary. Four bids were received for the project and the amounts ranged from $735,000 to $870,000 with the lowest bid submitted by Mansfield Gas Equipment Systems from Gainesville, Georgia. The project estimate was $760,000, which is represented in the approved contract between Weld County and CDOT dated 2/24/2011. Weld County and CDOT are responsible for 0% of the project costs. This project is wholly funded by the Congestion, Mitigation, Air Quality program funds for the DRCOG region, which are federal funds. CDOT has given us their concurrence to award the construction contract. The intent of this item is to request authorization of your signature to execute a contract with Mansfield Gas Equipment Systems. Construction of the project is anticipated to begin in August/September with completion in Spring of 2012. I onci 4o. L Pc/ ford /ii ennaUJ- agenda_ - //)EL 1)L/ S-I 2O/► s' i1'// 7 a cio y Esther Gesick From: Elizabeth Relford Sent: Friday, July 22, 2011 7:37 AM To: Bruce Barker Cc: Esther Gesick; Pat Persichino Subject: Schedule contract for BOCC Agenda Attachments: Mansfield Contract- DRCOG CNG Station.pdf Importance: High FJi,Bruce, We need to schedule the attached Mansfield contract on the BOCC agenda for signatures. I will deliver the original to Esther. Mansfield is the company constructing the Natural Gas Fuel Station in the DRCOG Boundary. Please let me know which BOCC agenda you think we can get it on so I can estimate a notice to proceed date. FYI — CDOT is now requiring us to attach FHWA Form 1273 (Federal Provisions) to all of our contracts. I have attached CDOT's letter stating so, which is the last page of the scanned pdf. Please do not hesitate to contact me if you have any questions. Thanks, Elizabeth Elizabeth RelJirrd Trunsportution Plonner Weld County Public Works 1111 II Street PO Box 758 Greeley, CO 80632-0758 Errfuil:erelford@co.weld.co.u4 Office:(970)304-6496 Ext. 3748 Mobile:(970) 673-5836 Web:http://www.co.weld.co.us WE t`D-•'CO V.N T Y u Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. 1 fl. Mansfield Gas Equipment Systems July 18,2011 Attention: Elizabeth Relford Weld County Public Works 1111 H Street Greeley, Colorado 80632 RE: No. B1100069-DRCOG Weld County Boundary Turnkey Design/Build of CNG Fueling Station-Contracts Dear Elizabeth, Per your request on July 11th, 2011, enclosed, please find the signed Contract agreement, Notice of Award, Certificate of Insurance, and the Performance and Payment bonds (in (5) counterparts as requested on the bonds signature pages) from Mansfield Gas Equipment Systems Corporation (MGES). I also have included and additional original copy of the Contract Agreement and Notice of Award for your signatures and return to MGES for our records. Please feel free to contact me with any questions or need for additional information. Again,we are very excited about receiving this award and the opportunity to work with Weld County on this project. Sincerely, ��AA Ginger cDaniel Analyst Enclosures CNG Fuel Station • Design • Engineering • Manufacturing • Construction • Maintenance • Methane Detection Systems North America Packager for Gardner Denver CNG • Distributors for: Ingersoll-Rand CNG • BRC FuelMaker Corp. 1025 Airport Parkway,SW Gainesville,GA 30501 • Phone1.800.695.6626 • Fax 678.207.3106 • moesbids(a)mansfieldoil.com BID REQUEST NO. B1100069 WELD COUNTY DEPARTMENT OF PUBLIC WORKS CONTRACT BID DOCUMENTS FOR INSTALLATION OF EQUIPMENT FOR A COMPRESSED NATURAL GAS FUELING STATION IN THE DRCOG 8-HOUR OZONE NONATTAINMENT BOUNDARY FEDERAL AID PROJECT NO. AOC CO30-042, 18074 1861 - 2011 WELD._._.000NTY I I July 11, 2011 Weld County Public Works P.O. Box 758 1111 H Street Greeley, Colorado 80632 970-304-6496 TABLE OF CONTENTS The following provisions take precedence over Specifications or Plans and supplement the 2011 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 4 *Agreement 5-6 *Performance Bond 7-8 *Labor and Materials Payment Bond 9-10 Notice to Proceed 11 Change Order 12 Certificate of Substantial Completion 13 Lien Waiver 14 Final Lien Waiver 15 Notice of Acceptance 16 FHWA Form 1273 17 COLORADO -2- NOTICE OF AWARD INSTALLATION OF EOUIPMENT FOR DRCOG CNG FUELING STATION To:Mansfield Gas Equipment Systems Corporation 1025 Airport Parkway,SW Gainesville,GA 30501 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 Weld County's DRCOG 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$735,000 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 21st day of July ,2011. Weld County,Colorado,Owner By E i beth Belford,Tr portation Planner ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged by Mansfield Gag Fquipment Systems Cnrpnratinn(Contractor) Dated this 18th day of July ,2011 By: Title: Vice President/Treasurer G exander -3 - AGREEMENT INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION THIS AGREEMENT,made this 11th day of July 2011,by and between Weld County, Colorado,hereinafter called "Owner"and Mansfield Gas Equipment Systems 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: INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION described in the Invitation for Bids,Bid No.BI 100069. 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 INSTALLATION OF EQUIPMENT FOR DRCOG 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$ 735,000 ,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 April 27,2011. No.2, dated May 19,2011. No.3, dated May 19,2011. No.4 dated May 23,2011. No.1, dated May 31,2011. 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 COUNTY COMMISSIONERS CONTRACTOR BY 4&L}JL 41 'AiytNAME BarbaraKirkmeyer NAME J. Alexander (Please Type) TITLE Chair TITLE Vice President/Treasurer Date AUG 0 12011 ADDRESS 1O25 Airport Parkway, SW Gainesville, GA 3O5O1 I�IEs Lam` (SEAL) Fie A, (SEAL) ATTEST: � ATTEST: ///j/� Weld County Clerk to the Board �{ "'—!F^� BY4211/094/1/4 BY John Byrd Deputy CI (Please Type) TITLE Secretary/CFO -5 - a0//— /5A PERFORMANCE BOND Bond #1922677 INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION KNOW ALL MEN BY THE PRESENTS;that Mansfield Gas Equipment Systems Corporation (Name of Contractor) 1025 Airport Parkway. SW, Gainesville, GA 30501 (Address of Contractor) enrpnra ti nn hereinafter called Contractor,and a (Corporation,Partnership,or Individual) The Hanover Insurance Company (Name of Surety) 7130 Glen Forest Drive, Suite 400, P. 0. Box 85610, Richmond, VA 23285-5612 (Address of Surety) hereinafter called surety,are held and firmly bound unto Weld County,Colorado (Name of Owner) P.O.Box 758, 1111 H Street,Greeley, Colorado 80632 (Address of Owner) hereinafter called Owner,in the penal sum of (*) Dollars,($ 735.000. ), 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. (*) Seven Hundred Thirty-five Thousand & no/100--------- THE CONDITION OF THIS OBLIGATION is such that whereas,the Contractor entered into a certain Contract with the Owner, dated the 11th day of July , 2011,a copy of which is hereto attached and made a part hereof for the construction of: INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION described in the Invitation for Bids, Bid No. BI100069. 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. -6- PERFORMANCE BOND INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION IN WITNESS WHEREOF,this instrument is executed in five(5)counterparts,each one of which shall be deemed an original,this 12th day of July ,2011. MANSFIELD GAS EOUTPMENT SYSTEMS CORPORATION Contractor By John Byrd Secreatary/CFO (Contractor) retary (SEAL) 1025 Airport Parkway, SW (Witness as to Contractor) Ginger McDaniel (Address) 1025 Airport Parkway, SW Gainesville, GA 30501 (Address) Gainesville, GA 30501 THE HANOVER INSURANCE COMPANY ATTEST: K ^ Surety (Surety)Secretary Barbara A. Duvall Attorney—in—Fact (SEAL) • tecilt, By _ / I Witness as to Surety Brenda Attom -m-Fact V. tan R. Crutchfield c/o Little and Smith, Inc. c/o Little and Smith, c. (Address) 202 Church Streetd,ess) 202 Church Street, NE NE Marietta, GA 30060 Marietta, GA 30060 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. -7- LABOR& MATERIALS PAYMENT BOND Bond 11922677 INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION KNOW ALL MEN BY THE PRESENTS;that Mansfield Gas Equipment Systems Corporation (Name of Contractor) 1025 Airport Parkway, SW, Gainesville, GA 30501 (Address of Contractor) Corporation ,hereinafter called Contractor,and a (Corporation,Partnership,or Individual) The Hanover Insurance Company (Name of Surety) 7130 Glen Forest Drive, Suite 400, P. 0. Box 85610, Richmond, VA 23285-5612 (Address of Surety) hereinafter called surety,are held and firmly bound unto Weld County,Colorado (Name of Owner) P.O.Box 758. 111 I H Street,Greeley, Colorado 80632 (Address of Owner) hereinafter called Owner,in the penal sum of Seven Hundred Thirty—five Thousand & no/100-- Dollars,($ 735,000. ) 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 11th day of July , 2011, a copy of which is hereto attached and made a part hereof for the construction of: INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION described in the Invitation for Bids, Bid No. B1100069. 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. -8- LABOR& MATERIALS PAYMENT BOND INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION IN WITNESS WHEREOF,this instrument is executed in five(5)counterparts,each one of which shall be deemed an original, this 12th day of July ,2011. MANSFIELD GAS EQUIPMENT SYSTEMS CORPORATION Contractor By John Byrd Secretary / CFO ontractor) cretary (SEAL) 1025 Airport Parkway, SW (Witness as to Contractotinger McDaniel (Address) 1025 Airport Parkway. SW Gainesville, GA 30501 (Address) Gainesville, GA 30501 THE HANOVER INSURANCE COMPANY ATTEST: Surety Qr\ (Surety)Secretary Bar ara all Attorney—in—Fact (SEAL) jeCIA. By yWitness as to Surety Brenda R Atto ey-in-Fac ivian R. Crutchfield c/o Little and Smith, Inc. c/o Little and Smith, In . (Address) (Address) 202 Church Street, NE 202 Church Street, NE I4arietta, GA 30060 Marietta. GA 30060 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. -9- • THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY • CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint A.D.Little,William D.Smith,Eugene Y.Northcutt,James R.Elrod,William D.Smith JR,David B.Burruss,Barbara A. Duvall, h Vivian R.Crutchfield and/or Brenda Ray of IMarletta,GA and each is a true and lawful Attorney(s)-in-fact to sign,execute,seal,acknowledge and deliver for, and on its behalf, and as its act and deed any place within the United States,or,if the following line be filled in,only within the area therein designated any and all bonds,recognizances,undertakings,contracts of Indemnity or other writings obligatory in the nature thereof,as follows: Any such obligations In the United States,not to exceed Ten Million and No/100($10,000,000)In any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: . "RESOLVED; That Die President or any Vice President, in conjunction with any Assistant Vice President; be ant theyare-hereby authorized-and- empowered to appoint Attorneys-in-fact of the Company,in its name and as its acts,to execute add acknowledge for and on its behalf as Surety any and all bonds,retognizances,centracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company.My such writings so executed by such Attitmeys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company In their own proper persons."(Adopted October 7,1981-The Hanover Insurance Company;Adopted April 14,1982—Massachusetts Bay Insurance Company;Adopted September 7,2Q01-Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY 'INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by a Vice President and an Assistant Vice President,this 31st day of October 2008. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY ,x -,r. V CITIZEN SURANCE COMPANY OF AMERICA Lneocei Robes K.Grennan,Assistan I e President • THE COMMONWEALTH OF MASSACHUSETTS ) . - ' COUNTY OF WORCESTER )ss. On this 31st day of October 2008, before me came the above named Vice President and Assistant Vice President of The Hanover Insurance Company:Massachusetts Bay Insurance:Company and-Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. r• y ' & .- r7?/G0.% i " 19+. Notary Public . My commission expires on November 3, 2011 I, the undersigned Assistant Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify that the above and foregoing is a full, true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by.authority of the following resolution of the Board of Directors of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED, That any and all Powers of Attorney.and Certified Copies of such Powers of Attorney and certification In respect thereto, granted and executed by the President or any Vice President in conjunction with any Assistant Vice President of the Company,shall be binding on the Company to the same extent as if all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile."(Adopted October 7, 1981 -The Hanover Insurance Company;Adopted April 14, 1982 Massachusetts Bay Insurance Company;Adopted September 7, 2001- Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies,at Worcester, Massachusetts,this 12th day of July ,2011. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COM PANT CITI S INSU CE CO ANY OF ERICA T Step .Brau, ssistan Ice Pres nt Client#: 78626 14MANSFIELD ACORDYM CERTIFICATE OF LIABILITY INSURANCE DATE(MM(DD/YYYY) 7/12/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: J.Smith Lanier&Co.-Atlanta (PHONENo,Ext): I(NC 770 476-1770 (NC,No): 7704763651 NC, 11330 Lakefield Drive E-MAIL ADDRESS: Bldg 1,Suite 100 INSURERS)AFFORDING COVERAGE NAICN Duluth,GA 30097 INSURER A:Evanston Insurance Company 35378 INSURED INSURER B:Ironshore Specialty Insurance C 25445 Mansfield Gas Equipment INSURER C:Twin City Fire Insurance Co. 29459 Systems Corporation Interstate Fire&Casualt 22829 1025 Airport Parkway,SW INSURER o: Y p INSURER E:Farmland Mutual Ins.Co. 13838 Gainesville,GA 30501 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP UMITS (MOLICIYEFF (MOLIC/YEXP) A GENERAL LIABILITY 11EGLM00057 03/15/2011 04/01/2013 EACH OCCURRENCE 51,000,000 Ep X COMMERCIAL GENERAL LIABILITY PREMISES(TppEaEaao°nre) $100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $5,000 PERSONAL S ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY n JECT LOC $ PRO- -1 E AUTOMOBILE LIABILITY CA119529A 04/01/2011 04/01/2012 EaaccidentSINGLELIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) $ B x UMBRELLA LIAB X OCCUR 000194802 04/01/2011 04/01/2012 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED I XI RETENTIONS25000 $ C WORKERS COMPENSATION 20WEOG6025 04/01/2011 04/01/2012 X TRYIIIIMITS I I FFRH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under EL DISEASE-POLICY LIMIT E1,000,000 DESCRIPTION OF OPERATIONS below A Pollution 10CPLM00175 05/14/2010 04/01/2013 $5M Each Claim/$5M Agg D Excess Umbrella HFX00024068611 04/01/2011 04/01/2012 $IoM XS$IoM DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Weld County is named as additional insured as per written contract, but only with respects to the general liability,auto and umbrella Insurance and subject to the provisions and limitations of the policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Weld County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN c/o Purchasing ACCORDANCE WITH THE POLICY PROVISIONS. 915 10th Street,3rd floor Greeley, CO 80631 AUTHORIZED REPRESENTATIVE � '� IZ ©19 8- 1O ACORD CORPORATION.All rights reservec ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1257725/M1216852 AZL NOTICE TO PROCEED INSTALLATION OF EOUIPMENT FOR DRCOG CNG FUELING STATION To:Mansfield Gas Equipment Systems Corporation Date: 2011 1025 Airport Parkway,SW Gainesville,GA 30501 Name of Project: INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION described in the Invitation for Bids,Bid No.B1100069. You are hereby notified to commence Work in accordance with the Agreement dated 2011. The Contract Time allowed in the Agreement is 25 calendar days. The substantial completion date for all Work is therefore 2011. Weld County,Colorado,Owner By: Q El eth Relford,Tra s ortation Planner ACCEPTANCE OF NOTICE Receipt of the above Notice to Proceed is hereby acknowledged by: (Contractor) Dated this day of ,2011. By Title - 10- CHANGE ORDER NO. (EXAMPLE) INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION Date: Project: INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION described in the Invitation for Bids Bid No.B1100069 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: Barbara Kirkmeyer(Chair) Engineer: Date: APPROVALS: Contractor: Date: Owner: Date: CDOT Representative: Date:_ _ 11 _ CERTIFICATE OF SUBSTANTIAL COMPLETION INSTALLATION OF EOUIPMENT FOR DRCOG CNG FUELING STATION Owner's Project No: Engineer's Project No: Project: INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION described in the Invitation for Bids,Bid No.B1100069 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) INSTALLATION OF EQUIPMENT FOR DRCOG 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: INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION described in the Invitation for Bids Bid No.B1100069. 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 govem 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 ,2011,by My commission expires: Notary Public - 13 - FINAL LIEN WAIVER(SUBCONTRACTORS) INSTALLATION OF EQUIPMENT FOR DRCOG 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 ,2011, 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 fumished 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) Fumish 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 INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION To: Mansfield Gas Equipment Systems Corporation Date: July 2011 1025 Airport Parkway, SW Gainesville,GA 30501 RE: INSTALLATION OF EQUIPMENT FOR DRCOG CNG FUELING STATION described in the Invitation for Bids,Bid No.B1100069. 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(1)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 III FHWA•1273 Electronic version--Marcn 10,1994 FHWA Form 1273 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONSTRUCTION CONTRACTS I. General 1 (Applicable to all Federal-aid construction contracts and to all related II. Nondiscrimination 1 subcontracts of$10,000 or more.) III.Non•segregaled Facilities 3 IV.Payment of Predetermined Minimum Wage 3 1. Equal Employment Opportunity: Equal employment opportunity V.Statemerlts and Payrolls 6 (EEO)requirements not to discriminate and to take affirmative action to VI.Record of Materials,Supplies,and Labor 6 assure equal opportunity as set forth under laws, executive orders. VII. Subletting or Assigning the Contract 7 rules,regulations(28 CFR 35.29 CFR 1630 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 Protects 7 herein,and imposed pursuant to 23 U.S.C.140 shall constitute the EEO X.Implementation of Clean Air Act and Federal and specific affirmative action standards for the contractor's project Water Pollution Control Act 8 activities under this Agreement The Equal Opportunity Construction XI.Certiification 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 et XII. Certification Regarding Use of Contract Funds for sew.)set forth under 28 CFR 35 and 29 CFR 1630 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.Employment 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 hisfner activities under the contract I.GENERAL b.The contractor will 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 -It 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 shall include: employment, upgrading, 2. Except as otherwise provided for in each section, the contractor demotion,or transfer;recruitment or recruitment advertising;layoff shall insert in eacn 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 inclusion in any selection for training,including apprenticeship,pre-apprenticeship, over tier subcontract or purchase order that may in turn be made.The and/or on-the-job 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 will designate and make known to the any subcontractor or lower tier subcontractor with these Required SHA contracting officers an EEO Officer who will 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 c!the stipulations contained in these Required authority and responsibility to do so. Contract Provisions shall be sufficient grounds for termination of the contract. 3. Dissemination of Policy: All 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, will be made fully cognizant of, and will 5.12: implement, the contractors 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 will be met,the following actions will Section IV,paragraphs 1,2.3.4.and 7: be taken as a minimum: Section V,paragraphs I 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 will 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 months, at which time the contractor's EEO Provisions shall not be subject to the general disputes clause of this policy and its implementation will 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(DOL)as set forth in 29 CFR 5. E. and 7. Disputes within the meaning of this clause include b. All new supervisory or personnel office employees will be disputes 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, their reporting for duty with the contractor. 6. Selection of Labor: During the performance of this Agreement, c. All personnel who are engaged in d'reet recruitment for the :he contractor snail not: 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 Stale,possession,or territory of the United States (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 placed in areas readily accessible to emploerecs. applicants for eF or employment and potential employees. i L I isb employ convict labor for any purpose within the limits of the e.The contractor's EEO policy and the procedures to implement project 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. II. NONDISCRIMINATION 4. Recruitment:When advertising for employees,the contractor will include in all advertisements for emp,oyees the notation: "An Equal Page 1 of 8 REQUIRED BY 23 CFR 633.102 -- Opportunity Employer.' All such advertisements will be placed in either directly or through a contractor's association acting as agent will • publications having a large circulation among minority groups in the area include the procedures set forth below. from which the project work force would normally be derived. a. The contractor will use best efforts to develop,in cooperation a. The contractor will, unless precluded 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 qualify for higher paying employment. sources of potential minority group employees,and establish with such identified sources procedures 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 information 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 MI 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 shall 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.) In 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 conditions and employee facilities do not Indicate discriminatory treatment of project site personnel. 8. Selection of Subcontractors, Procurement of Materials and Leasing of Equipment: The contractor shall not discriminate on the b.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 se'ection and retention of subcontractors, including procurement of 0 discriminatory wage practices• materials and leases of equipment. c. The contractor will periodically review selected personae' a The contractor shall notify all potential subcontractors and actions in depth to determine whether there is evidence of discnmi- suppliers of his/her EEO obligations under this Agreement. nation. Where evidence Is found, the contractor will promptly take corrective action. 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 equal opportunity to compete for and perform all 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 minority group and female representation among their employees. under this Agreement,will 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 complainant 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 shall be retained for a period of three years following completion a.The contractor will assist in locating,qualifying,and Increasing of the contract work and shall be available at reasonable times 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 work classification on the project: shall be in their first year of apprenticesh.p 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 wilt be superseded as indicated in the special provision. unions, when applicable. to increase empioyment opportunities for minorities and women: C. The contractor will advise employees and applicants for employment of available training programs and entrance requirements (3)The progress and efforts being made in locating, hiring, for each. training,qualifying,and iiograding minority and female employees;and d. The contractor will periodically review the training and (4) The n-ogress and efforts being made :n securing the II promotion potential of mnonty group and women employees and will services of DBE subcontractors or subcontractors with meaningful encourage eligible employees to apply for such training and promotion minorty and female representation among their employees. 7.Unions:If the contractor relies in whole or in part upon un ons as a b.The contractors will submit an annual report to the SHA each source of employees,the contractor will use his/her best efforts to obtain July for the duration of the project, 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 female employees. Actions by the contractor Page 2 of 8 REQUIRED BY 23 CFR 633.102 -- i oe reported on Form FHWA-1391.If on-the job training is being required c. Al rulings and interpretations of the Davis-Bacon Act and by special provision,the contractor will be required to collect and report related acts contained in 29 CFR 1,3,and 5 are herein incorporated by ill training data. reference in this Agreement. Ill.NONSEGREGATED FACILITIES 2.Classification: (Applicable to all Federal-aid construction contracts and to all 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 additional contractor, subcontractor. material supplier, or vendor, as appropnate. classification, wage rate and fringe benefits only when the following 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 firm 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 disability. 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, work areas. restrooms and washrooms. benefits,bears a reasonable relationship to the wage rates contained in restaurants and other eating areas,timectocks,locker rooms,and other the wage determination;and storage or dressing areas,parking lots,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 explicit directive, or are, in fact, prevails in the area in which the work is performed. segregated on the basis of race.color,religion, national origin,age or disability, because of habit local custom, or otherwise. The only c.If the contractor or subcontractors,as appropnate,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 it 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. Washington, D.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 representa- tive, 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 S2,000 and IC all related subcontracts, except for projects located on roadways classified as local roads or rural minor collectors, which are d. In the event the contractor or subcontractors,as appropriate, exempt.) the laborers or 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.All mechanics and laborers employed or working upon the site the questions. including the views of all interested parties and the of the work will be paid uncondltionaily 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 determination. Said Administrator, or an authorized [except such payroll deductions as are permitted by regulations(29 CFR representative,will issue a determination 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 276c)J the full amounts of wages and bona fide fringe benefits(or cash within the 30-day 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 fringe benefits where appropnate) determination of the Secretary of Labor(hereinafter"the wage determi- determined pursuant to paragraph 2c or 2d of this Section IV shall be nation")which is attached hereto and made a part hereof,regardless of paid 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 subcontractors and such laborers and mechanics. The wage determination (including any additional classifications and wage 3.Payment of Fringe Benefits: rates conformed under paragraph 2 of this Section IV and the DOL. poster(WH-1321)or Form FHWA-1495)shall 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. shall 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. 276a) 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 contributions 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,cr 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 period.Such laborers and mechanics shall be paid the appropriate wage the written request of the contractor,that the applicable standards of the rase 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 skill,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 at the rate specified for each Helpers: classification for the time actually worked therein, provided, that the employer's payroll records accurately set forth the lime spent in each a.Apprentices: classification in which work is performed. (1) Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed Page 3 of 8 REQUIRED BY 23 CFR 633.102 - pursuant to and individually registered in a bona tide apprenticeship • 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 employment as an classification is specified and defined on the applicable wage determine- apprentice in such an apprenticeship program, who is not individually lion or is approved pursuant to the conformance procedure set forth in registered in the program, but who has been certified by the Bureau of Section P1.2.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,shall 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 journeyman-level 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 not registered or otherwise employed as Transportation as promoting BED in connection with Federal-aid staled 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 IV.The straight time hourly wage rates for performed.In addition.any apprentice performing work on the job site in apprentices and trainees under such programs will be established by the excess of the ratio permeted under the registered program shall 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 work 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 6.Withholding: percentages of the journeyman-level hourly rate) specified in the contractor's or subcontractor's registered program shall 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-level hourly rate specified assisted contract subject to Davis-Bacon prevailing wage requirements in the applicable wage determination. Apprentices shall be paid fringe which is held by the same prime 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 apprenticeship program does not specify fringe benefits, and mechanics,including apprentice;, 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 far the applicable classification. If the Administrator by the contract. 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, all or part of the wages required by the contract, the in accordance with that determination. SHA contracting officer may,after written notice to the contractor.take such action as may be necessary to cause the suspension of any further III (4)In the event the Bureau of Apprenticeship and Training, payment, advance, or guarantee of funds until such violations have or a State apprenticeship agency recognized by the Bureau,withdraws ceased. approval of an apprenticeship program,the contractor or subcontractor will no Monger 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 or involve the employment of laborers, b.Trainees: mechanics. watchmen, or guards (Including apprentices, trainees, and 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 any 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 performed unless they are employed pursuant to and individually workweek unless such laborer,mechanic,watchman,or guard receives registered in a program which has received prior 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 sae shall not be greater than permitted under the plan approved by the Employment and Training Administration.Any employee fisted on Liability for Unpaid Wages:Liquidated Damages:in the event of any the payroll at a trainee rate who is not registered and participating in a violation of the clause set forth in paragraph 7 above,the contractor and training plan approved try the Employment and Training Administration any subcontractor responsible thereof shall be liable to the affected shall be paid not less than the applicable wage rate on the wage employee for his/her unpaid wages. In addition, such contractor and determination for 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 temtory) 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, performed. 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 hours without payment of the overtime wages expressed as a percentage of the joumeyman-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 shall be paid the full amount of fringe benefits listed on the wage determination unless The SHA shall upon its own action or upon written request of any the Administrator of the Wage and Hour Division determines that there is authorized representative of the DOL withhold,or cause to be withheld. an apprenticeship program associated 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 IIIII for less than full fringe benefits for apprentices, :,r which case such Federal contract with the same prime contractor,or any other Federally- trainees shall 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 Administration 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 will no longer be permitted to utilize trainees at less than provided in the clause set forth in paragraph B above. the applicable predetermined rate for the work performed until an acceptable program is approved. Page 4 of 8 REQUIRED BY 23 CFR 633.102 - V.STATEMENTS AND PAYROLLS I.The falsification of any of the above certifications may subject the contractor to civil or criminal prosecution under 18 U.S.C. 1001 and III (Applicable to all Federal-aid construction contracts exceeding 52,000 31 U.S.C.231. and to all related subcontracts.except for projects located on roadways classified as local roads or rural 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 transcription by authorized representatives 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 OOL,or all 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 during the course records upon request or to make such records available may be grounds of the work and preserved for a 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. VI.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 direct 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 cost for roadway and Act):daily and weekly number of hours worked:deductions made:and bridge is less than$1,000,000(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 Matenals 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 the work, and also of the records which show that the commitment to provide such benefits is quantities of those specific materials and supplies listed on Form FHWA- enforceable,that the plan or program Is financially responsible,that the 47,and in 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 1b relative to materials and supplies,a final labor summary of evidence of the registration of apprentices and trainees,and ratios and all contract work indicating the total hours worked and the total amount illwage 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 report 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,described 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 infonmaton 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 arty form desired. Optional Form WH-347 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-O05-O014-1), U.S. Government Printing Office, may be performed by subcontract and the amount of any such specialty Washington. D.C. 20402. The prime contractor is responsible for the items performed may be deducted from the total original 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 submitted shall be accompanied by a"Statement of Compliance," signed by the contractor or subcontractor or his/her a. -Its own organization' shall be construed to include only agent who pays or supervises the payment of the persons employed workers employed and paid directly by the prime contractor and under the contract and shall 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 required 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 each helper, ordinarily 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 deductions as set forth in the Regulations.29 CFR 3: paragraph 1 of Section VII is computed includes the cost of matenal and manufactured products which are to be purchased or produced by the (3)that each laborer or mechanic has been paid not less that contractor under the contract provisions. the applicable wage rate and fringe benefits or cash equivalent for the classification of worked performed,as specified in the applicable wage 3. The contractor shall furnish (a) a competent superintendent or determination incorpoiate"l 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, • e. and is in charge of all construction operations (regardless of who 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 contractingof the contract officer determines is necessary to assure the by paragraph 2d of this Section V. performance 4. No portion of the contract shall be sublet, assigned or otherwise Page 5 of 8 REQUIRED BY 23 CFR 633.102 -- r cisposed of except with the written consent of the SHA contracting officer,or authorized representative,and such consent when given shall By submission of this bid or the execution of this Agreement, or not be construed to relieve the contractor of any responsibility for the subcontract, as appropriate, the bidder, Federal-aid construction fulfillment of the contract. Written consent will 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 and that stipulated as follows: it 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 Vllt.SAFETY:ACCIDENT PREVENTION amended(42 U.S.C.1857 g(s, +g.,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 seq..as amended by Pub.L.92.500), Executive Order 11738, with all applicable Federal, State, and local laws governing safety, and regulations in Implementation thereof(40 CFR 15)is not listed,on health, and sanitation (23 CFR 635). The contractor shall provide al 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 ii 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 safely of the public and to protect property requirements of Section 114 of the Clean Air Act and Section 308 of the in connection with the performance of the work covered by the contract Federal Water Po:lution 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 shat 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 Facilities. 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 in 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,it Is a condition of this Agreement that the Secretary of Labor or authorized representative thereof,shall have XI.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 all Federal-aid contracts-49 CFR 29) IX.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 plans 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 carefutty, transaction. The prospective participant shall submit an explanation of thoroughly. and honestly as possible. Willful falsification, distortion, or why it cannot provide the certification set out below.The certification or misrepresentation with respect to any facts related to the project Is a explanation will be considered in connection with the department or violation of Federal taw.To prevent any misunderstanding regarding the agency's determination whether to enter into this transaction. However. seriousness of these and similar acts, the following notice shall be failure of the prospective 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 ft is readily available to all persons concerned with transaction. the project: 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 default or of any State or Tenitay,or whoever,whether a person,association, firm, or corporation, knowingly makes any false statement. false d. The prospective pnmary participant shall provide immediate representation, or false report as to the character. quality, quantify, 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 submitted if any time the prospective pnmary participant learns that its work performed or to be performed, or the cast thereof in connection certification was erroneous when submitted or has become erroneous with the submission of plans,maps,specifications,contracts,or costs of by reason of changed circumstances. construction on any highway or related project submitted for approval to the Secretary of Transportation;or e. The terms 'covered transaction' "debarred,' 'suspended,' 'ineligible,' 'lower tier covered transaction," "participant.' 'person.' Whoever knowingly makes arty false statement,false representation, "pnmary covered transaction' 'principal,' 'proposal' and 'voluntarily false report or false claim with respect to the character,quality,quantity, excluded,'as used in this clause, have the meanings 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 he 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 is 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 knowingly enter into any lower tier covered transaciaoa with a person who is debarred, suspended. declared ineligible, or voluntarily Shall be fined not more that 510,000 or imprisoned not more than 5 excluded from participation in this covered Iransactiv unless years or both.' authorized 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 it will include the clause titled'Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion- Lower 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 - JD Lntering into this covered transaction, without modification, in all lower c.The prospective lower tier participant shall provide immediate tier covered transactions and in all solicitations for lower tier covered written notice to the person to which this proposai is submitted if at any 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 voluntarily "ineligible.' 'primary covered transaction' 'participant.' 'person,' excluded from the covered transaction, unless it knows that the 'principal.""proposal,"and'voluntarily excluded,"as used in this clause, certification Is erroneous. A participant may decide the method and have the meanings set out In the Definitions 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 participant may, but is not required to, check the non-procurement to which this proposal is submitted for assistance In obtaining a copy of portion of the "Lists of Parties Excluded From Federal Procurement or those regulations. Non-procurement Programs'(Non-procurement List)which is 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 foregoing shall be construed to require it shall not knowingly enter into any lower 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 Voluntary Exclusion- debarred. ineligible, or voluntarily excluded from participation in this Lower Tier Covered Transaction,'without modification,in all lower 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 lower tier covered transaction that is not debarred, suspended. Ineligible, or voluntaniy 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. 1. 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 certification required try this clause. The knowledge and debarment, declared ineligible. or voluntarily excluded from covered information of participant is not required to exceed that which is normally ii, 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 authorized under paragraph a of these commission of fraud or a criminal offense in connection with obtaining, instructions, it a participant in a covered transaction knowingly enters attempting to obtain, or performing ing a public (Federal, State or local) into a lower tier covered transaction with a person who is suspended, transaction or contract under a public transaction:violation of Federal or debarred, ineligible, or voluntarily excluded from participation in this State antitrust statutes or commission of embezzlement, theft,forgery, transaction, in addition to other remedies available to the Federal bribery,falsification or destruction of records,making false statements. Government- the department or agency with which this transaction or receiving stolen property, originated may pursue available remedies,including suspension and/or debarment. c.Are not presently indicted for or otherwise cnminally or civilly charged by a governmental entity (Federal, State or loca'.) with commission of any of the offenses enumerated in paragraph 1b of this certification;and Certification Regarding Debarment,Suspension,Ineligibility and d. Have not within a 3-year period preceding this 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 any 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 Tier Covered Transac- tions: (Applicable to all subcontracts, purchase orders and other lower tier XII.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 lower (Applicable to all Federal-aid construction contracts and to all related tier is providing the certification set out below. subcontracts which exceed$100,000-49 CFR 20) b.The certification:r this clause is a material representation of 1.The prospective participant cerlifias,by signing and submitting this fact upon which reliance was placed when this transaction was entered bid or proposal,to the best of his or her knowledge and belief,that: 4„ 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 will 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 reliance was placed when this transaction was made or entered into. the extension,continuation,renewal,amendment,or modification of any 2.Submission of this certification is a prerequisite for making or entering Federal contract,grant.loan,or cooperative agreement. into this transaction imposed by 31 U.S.C.1352.Any person who fails to file the required certification shall be subject to a civil penalty of not less b.If any funds other than Federal appropriated funds have been than$10,000 and not more than$100,000 for each such failure. paid or will be paid to any person for influencing or attempting to influence an officer or employee of any 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 $100.000 and that all such recipients shall certify and disclose submit Standard Form-LLL, "Disclosure Form to Report Lobbying," In accordingly accordance with its instructions.ill 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). 1 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. I. 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. • 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 trio initial registration, and more frequently if required by changes in its information. 0 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 Contractor's 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 S'ipplemental 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 3of3 1861 - 201MEMORANDUM • TO: Board of County Commissioners WELD € O U N T Y DATE July 6, 2011 FROM: Elizabeth Relford, Transportation Planner SUBJECT: Bid Request No. B1100069 Bids were received and opened on June 15, 2011 for a design/build turnkey facility for the construction of a compressed natural gas fueling station within Weld County's DRCOG boundary. Four bids were received for the project and the amounts ranged from $735,000 to $870,000 with the lowest bid submitted by Mansfield Gas Equipment Systems from Gainesville, Georgia. The project estimate was $760,000, which is represented in the approved contract between Weld County and CDOT dated 2/24/2011. Weld County and CDOT are responsible for 0% of the project costs. This project is wholly funded by the Congestion, Mitigation, Air Quality program funds for the DRCOG region, which are federal funds. Upon approval from CDOT for concurrence to award the construction contract, it is my recommendation to award the project to Mansfield Gas Equipment Systems. Construction of the project is anticipated to begin in August/September with Completion in March of 2012. /4/Zii 006 Y poi// oo WELD COUNTY PURCHASING 915 10TH St Room #334, Greeley CO 80631 1 8 6 I - 2 0 I I E-Mail: mwaltersaco.weld.co.us E-mail: reverettco.weld.co.us Phone: (970) 356-4000, Ext 4222 or 4223 Fax: (970) 336-7226 WEL_ ► ' OUNTY DATE OF BID: June 15th, 2011 REQUEST FOR: CNG FUELING STATION -SOUTH/ DRCOG AREA DEPARTMENT: Public Works Dept BID NO: #B1100069 PRESENT DATE: JUNE 20TH, 2011 APPROVAL DATE: JULY 6TH, 2011 VENDORS PROJECT TOTAL MANSFIELD GAS EQUIPMENT $735,000.00 SYSTEMS CORPORATION 1025 AIRPORT PARKWAY SW GAINESVILLE GA 30501 ZEIT ENERGY $747,860.00 TWO LINCOLN CENTER 5420 LBJ FREEWAY SUITE #750 DALLAS TX 75240 FUELTEK SOLUTIONS INC $800,000.00 5660 E 58TH AVENUE UNIT B COMMERCE CITY CO 80022 ENCANA NATURAL GAS INC $870,000.00 370 17TH STREET SUITE #1700 DENVER CO 80202 The bids are being reviewed by the Public Works Dept. ACk) -, �A-)(0/ 2011-1500 Hello