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Home My WebLink About20131557.tiff °v1861Y � h MEMORANDUM JTO: Board of County Commissioners U COUNTY DATE: September 24, 2015 FROM: Elizabeth Relford, Transportation Manager SUBJECT: Amendment#2 Clean Energy Contract for LNG Mobile Fueler— Design Build This project has experienced many delays. The LNG station was originally awarded in July of 2013. The project location fell through and we had to extend our contract with Clean Energy on August 26, 2013. Then, CDOT funding wasn't available under our current CDOT IGA, so we had to get a new one, which caused us to have to amend the existing contract date with Clean Energy again in September of 2014. Then, the site location fell through again and the new site location had to go through the City of Greeley land use process. Now we are requesting to extend the existing Clean Energy contract, which expires on September 29th to December 31, 2015. As a reminder, Weld County and CDOT are responsible for 0% of the project costs. This project is wholly funded by federal Congestion, Mitigation, Air Quality program funds from the North Front Range Metropolitan Planning Organization (NFR MPO)for fiscal year(FY) 2014. Costs beyond the $550,000 are part of Clean Energy's local match to the project. Clean Energy has entered into a lease agreement with Wells Ranch to place the LNG fueler on a 1.89 acre site in the City of Greeley adjacent to the Greeley-Weld Airport on WCR 62. Clean Energy's Use by Special Review (USR) application was approved by the City of Greeley on September 22, 2015. Therefore, Clean Energy will obtain the necessary electrical and fire permits in order to begin constructing the facility. This project is anticipated to be completed in November and will be open to the public 24 hours a day, 7 days a week with a credit card reader. By providing a public fueling source, it is the hope more heavy duty fleets consider converting their trucks to LNG, which promotes the effort to reduce dependency on foreign oil and utilize a natural resource found with the county. The only difference between the new agreement and the existing agreement is the date and the addition of#9, which nullifies the existing agreement to be replaced with this new agreement. I'm available to answer any questions you may have. BOARD OF COUNTY COMMISSIONERS REVIEW/WORK SESSION REQUEST RE: Liquefied Natural Gas(LNG)Contract Extension—Clean Energy DEPARTMENT: PUBLIC WORKS DATE: 9/18/15 PERSON(S)REQUESTING: Elizabeth Relford Brief description of the problem/issue: The county currently has an existing contract with Clean Energy to construct a mobile LNG station on Steve Wells property to assist PW with fueling our LNG trucks. This project has been delayed many times due to locations falling through. However,the delay now is not the location,but going through the City of Greeley land use process. Clean Energy submitted an application in February and was just schedule for Planning Commission on September 22"d. Unfortunately,our existing contract expires September 29t. Therefore,in order to keep the project moving forward,I would like to get a contract extension for December 31'of this year. We anticipate Greeley PC approval on the 22"d and release of building permits shortly thereafter. Construction will begin immediately with an anticipated completion date of November 2"d. By extending the contract to December 31',it gives us additional time should unexpected weather occur. The only difference between the new agreement and the existing agreement is the date and the addition of#9, which nullifies the existing agreement to be replaced with the new agreement. Recommendation to the Board: Staff is recommending the contract extension be placed on the next available BOCC agenda. Approve Schedule Recommendation Work Session Comments Barbara Kirkmeyer,Chair Mike Freeman Mf. Sean P. Conway Julie Cozad el`/4„,5t -- Steve Moreno AGREEMENT DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE THIS AGREEMENT,made this 28th day of September ,2015,by and between Weld County,Colorado,hereinafter called"County" and Clean Energy doing business as(an individual,)or(a partnership,)or(a corporation)hereinafter called "Contractor". WITNESSETH: That for and in consideration of the payments and agreements hereinafter mentioned: 1. The Contractor will commence and complete the following:DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B1300115. 2. The Contractor will furnish all of the material,supplies,tools,equipment,labor and other services necessary for the construction and completion of the Project described herein. 3. The Contractor will commence the work required by the Contract Documents within ten(10)calendar days after the Notice to Proceed and will complete the DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE by December 31,2015 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$ 550,000 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" 6. The County 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- a ?/ - 1c52 7. This Agreement shall be binding upon all parties hereto and their respective heirs,executors,administrators, successors,and assigns. 8. Contract Appropriations: The County 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 County unless the County 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. 9. The County and the Contractor agree that upon the execution of this Agreement(Design/Build Turnkey Operation to Install Equipment for the NFR LNG Fueling Site)by the County and Contractor,that certain Agreement(Design/Build Turnkey Operation to Install Equipment for the NFR LNG Fueling Site), entered into by and between the County and Contractor,dated as of September 29,2014("Previous Agreement")shall terminate,be of no force or effect and neither Contractor,nor the County shall have any liability under such Previous Agreement. 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 CONTRACT B TaAQ .4Jc.- BY NAME Barbara Kirkmeyer NAME Pete Grace (Please Type) TITLE Chair TITLE Sr.VP Sales&Finance SEP jetwa Date �r ADDRESS 4675 MacArthur Court,Suite 800 4j•\‘. ie Lj . Newport Beach.CA 92660 I .ro► �11 V 1861 �. `�.. I p� � (SEAL)) 11 1 (SEAL) ATTEST: r—4110 / v• Jel "' ATTEST: Weld County lerk to the Board BY BY ‘4 • eputy Clerk to the Board (Please Type) TITLE f4{-C S ec� -5- RE: CLEAN ENERGY ATTEST: BOARD OF COUNTY COMMISSIONERS untyCllerk to the :oard W. LD COUNTY, CO RADO BY. t OnnLD l ICJ • . �- D:•t y Clerk to the Boar ��'• EL 4 arbara Kirkmeyer, Chair S P 2 g 2015 APPROVED AS TO FUNDI 361 `� �" 'PROVED A 0 BSTANCE: /5 Re:t 1 . •� Head Controller � �� ,...-� Ele e .. aal or Department APPROVED AS TO FORM: Director_of General Servic- eS County torney�''� � MEMORANDUM TO: Board of County Commissioners o U N T Y DATE: September 23,2014 FROM:Elizabeth Relford,Transportation Planner SUBJECT: Amended Clean Energy Contract for LNG Mobile Fueler—Design Build The Commissioners may recall awarding one Bid on July 8,2013 for the purchase of one Liquefied Natural Gas(LNG)mobile fueler to Clean Energy. While CDOT had given us their concurrence to award the LNG construction contract,it was discovered the funding for the project wasn't available under the current IGA. Therefore,the county needed to enter into a new IGA with CDOT in order to have the funding to complete the project.Weld County now has a new executed contract with CDOT,and therefore, needs to amend our existing construction contract with Clean Energy. The current contract expired August 26,2013. The new contract will be good for one year from the Board's approval date. The Clean Energy contract remains consistent in the amount of$550,000. Construction of the project will begin upon Notice to Proceed (NTP) and is anticipated to take from 9 to 11 months with Completion around the summer of 2015. Weld County and CDOT are responsible for 0%of the project costs. This project is wholly funded by federal Congestion, Mitigation,Air Quality program funds from the North Front Range Metropolitan Planning Organization(NFR MPO)for fiscal year(FY) 2014. Costs beyond the$550,000 are part of Clean Energy's local match to the project. Clean Energy is still negotiating a site for the fueler,which will be open to the public 24 hours a day,7 days a week and will be accessed with a credit card reader. By providing a fueling source,it is the hope that more heavy duty fleets consider converting their trucks to LNG,which promotes the effort to reduce dependency on foreign oil and utilize a natural resource found with the county. I'm available to answer any questions you may have. I origii 12W C' Q L Ea.> ao/3-/557 F�oo68 BID REQUEST NO. B1300115 WELD COUNTY DEPARTMENT OF PUBLIC WORKS CONTRACT BID DOCUMENTS FOR INSTALLATION OF EQUIPMENT FOR A LIQUEFIED NATURAL GAS FUELING FACILITY IN THE NFR 8-HOUR OZONE NONATTAINMENT BOUNDARY FEDERAL AID PROJECT NO. CMS 13-HTD-50079, 19232 Iy \ 1861 / ja, � J COUNTY August 2013 Weld County Public Works P.O. Box 758 1111 H Street Greeley, Colorado 80632 970-304-6496 &dual°gut& A/3- 1557 9-a9-aoiy EGoo( g TABLE OF CONTENTS The following provisions take precedence over Specifications or Plans and supplement the 2013 edition of the Colorado Department of Transportation"Standard Specifications for Road and Bridge Construction"(Standard Specifications)which is to be used to control construction of this project. WELD COUNTY CONTRACT FORMS: *Low Bidder must submit these forms prior to Contract Award. *Notice of Award 3 *Agreement 4-5 *Performance Bond 6-7 *Labor and Materials Payment Bond 8-9 Notice to Proceed 10 Change Order 11 Certificate of Substantial Completion 12 Lien Waiver 13 Final Lien Waiver 14 Notice of Acceptance 15 FHWA Form 1273 16 \ 1861IS7tE livsmipis„..etenHlimstussopieooLoe• ooi UT G O` ,r -2 - NOTICE OF AWARD DESIGN/BULLD TURNKEY OPERATION TO INSTALL EOUIPMENT FOR THE NFR LNG FUELING SITE 4421 To:Clean Energy Date: Aupust3 4955 Peoria Street.Unit A Denver,CO 80239 Project Description: The project in general consists of a public-private partnership for the purchase and installation of Liquefied Natural Gas(LNG) equipment for a design/build "turnkey" operation for one mobile LNG site to locate Weld County's NFR MPO 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$55 0000 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(I 0)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 day of August 2013 Weld County,Colorado,Owner By ell / P /(tiC/¢]Jfj' Elizabeth elr rd,Transportation snner ACCEPTANCE OF NOTICE : / c�ACry Receipt/ of the above Notice of Award is hereby acknowledged bye/Jf, �1' o &(W j e/Id' lAm ecte*Contractor) 3 Dated this / *.!_ of / ///��/',J,,2010 (�}-(/�j'_� By: 1 Title: l X.l.t�l " r1f'.�'f l� I -3" AGREEMENT DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE THIS AGREEMENT,made this(/19 day of&ptembee. ,2014,by and between Weld County,Colorado,hereinafter called"County"and Clean Energy doing business as(an individual,)or(a partnership.)or(a corporation)hereinafter called "Contractor". W ITNESSETH:That for and in consideration of the payments and agreements hereinafter mentioned: 1. The Contractor will commence and complete the following:DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B1300115. 2. The Contractor will furnish all of the material,supplies,tools,equipment,labor and other services necessary for the construction and completion of the Project described herein. 3. The Contractor will commence the work required by the Contract Documents within ten(10)calendar days after the Notice to Proceed and will complete the DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE 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 S 550,000,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" 6. The County 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. -1- ao13-1557 7. This Agreement shall be binding upon all parties hereto and their respective heirs,executors.administrators, successors.and assigns. 8. Contract Appropriations:The County 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 stork 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 County unless the County 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 BYJkp�Jah�t�S�� BY �� NAME Douglas Rademacher NAME �C�,Y1-)es //1. /tr- (Pleasee Type) r TITLE Chair TITLE OLAp c /'��(�,('L(� /1 `Cr Date SEP 2 9 20t4 ADDRESS yc.GlS /-ICVGr. /,tr C74 S—u . O (SEAL) - F- 'V! (SEAL) 144s.tr'NV ATTEST: �"" (�je:L;ok ATTEST: /r ��(/� Weld Counts-Clerk to the Board '164. kl "Z'wiriY BY *Id BY ILA1/b1 L. Z-c,4- D uty Clerk to the Board (Please Type) TITLE C L 4 CG( P t , J 2 I /3003/55-7 Executed in Five(5)Counterparts Bond No.1(08842917 PERFORMANCE BOND DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE KNOW ALL MEN BY THE PRESENTS;that Clean Energy dba Clean Energy Fuels Corp. (Name of Contractor) 4675 MacArthur Court,Suite 800,Newport Beach,CA 92660 (Address of Contractor) ,hereinafter called Contractor,and a(Corporation,Partnership,or Individual) Westchester Fire Insurance Company (Name of Surety) 436 Walnut Street,Philadelphia,PA 19106-3703 (Address of Surety) hereinafter called surety,are held and firmly bound unto Weld County,Colorado (Name of County) P.O.Box 758, 1111 H Street,Greeley,Colorado 80632 (Address of County) hereinafter called County,in the penal sum of Five Hundred Fifty Thousand 00/100 Dollars,($550,000.00), in lawful money of the United States of America,for the payment of which sum well and truly to be made,we bind ourselves,successors and assigns,jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas,the Contractor entered into a certain Contract with the County,dated the 24'"day of June, 2013,a copy of which is hereto attached and made a part hereof for the construction of: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B1300115. 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 County,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 County from all costs and damages which it may sufferhy reason of failure to do so,and shall reimburse and repay the County all outlay and expense which the County 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 County and the Contractor shall abridge the right of any beneficiary hereunder,whose claim may be unsatisfied. - 1 - PERFORMANCE BOND DESIGN/BUILD TURNKEY OPERATION TO INSTALL EOUIPMENT FOR THE NFR LNG FUELING SITE IN WITNESS WHEREOF,this instrument is executed in five(5)counterparts,each one of which shall be deemed an original,this 14th day of August,2013. Clean Ener dba Clean Ener a Fu Is Co .. C. tractor (Contractor)Secretary By (SEAL) 410irzir; 4675 MacArthur Court,Suite 800 (Witness/assn to Contractor)r (Address) / c, 711 tar /er Jr-CcyA(f'Newport Beach,CA 92660 (Address) iusq,-„bn„,, CG Qz&w „rt l_. urety) (SEAL) Westchester Fire Insurance Company By alat Diane Moraski,Witness as Surety a Kathleen M. nagan, [A lorney-in-Fact 195 Farmington Avenue,Suite 300 436 Walnut Street (Address) (Address) Farmington CT 06032 Philadelphia,PA 19106-3703 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. 2 • Executed in Five(5)Counterparts • Bond No. K08842917 LABOR&MATERIALS PAYMENT BOND DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE KNOW ALL MEN BY THE PRESENTS;that Clean Energy dba Clean Energy Fuels Corp. (Name of Contractor) 4675 MacArthur Court,Suite 800,Newport Beach,CA 92660 (Address of Contractor) ,hereinafter called Contractor,and a(Corporation,Partnership,or Individual) Westchester Fire Insurance Company (Name of Surety) 436 Walnut Street,Philadelphia,PA 19106-3703 (Address of Surety) hereinafter called surety,are held and firmly bound unto Weld County,Colorado (Name of County) P.O.Box 758. 1111 H Street.Greeley,Colorado 80632 (Address of County) hereinafter called County,in the penal sum of Five I undred Fifty Thousand 00/100 Dollars,($550,000.00),in lawful money of the United States of America,for the payment of which sum well and truly to be made,we bind ourselves,successors and assigns,jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas,the Contractor entered into a certain Contract with the County, dated the 24th day of June,2013,a copy of which is hereto attached and made a part hereof for the construction of: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.BI300115. 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 contractor 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 County and the Contractor shall abridge the right of any beneficiary hereunder,whose claim may be unsatisfied. 3 LABOR&MATERIALS PAYMENT BOND DESIGN/BUILD TURNKEY OPERATION TO INSTALL EOUIPMENT FOR THE NFR LNG FUELING SITE IN WITNESS WHEREOF,this instrument is executed in five(5)counterparts,each one of which shall be deemed art original, this 14th day of August,2013. Clean En y: dba Clean Enere Fu-1 Co By I (Contractor)Secretary 6 • (SEAL) • 4675 MacArthur Court,Suite 800 (Witness as to Contractor) (Address) 441114100 Crif(4,4/Newport Beach,CA 92660 (Address) a /cssrfker6J (1-76 6, ATTEST: 1 � A/ eroni(Surety)Attorney-in-Fact (SEAL) Westchester Fire Insurance Company By /\IAYf�5C.tt Diane Moraski,Witness as to urety Kathleen M.Flanaga ttorney-in-Fact 195 Farmington Avenue,Suite 300 436 Walnut Street (Address) (Address) Farmington CT 06032 Philadelphia,PA 19106-3703 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. 4 Power of WESTCYkESTER FIRE-INSURANCE COMPAN Attorney, ,t %nown:mob bplhese presdfb'thsel }t 'litiRE INSIISIANGE G7MYANY*Cdtporaudif fUICtCommgnWYaTUtOtlthuyl'ahtaPursuantm thr tudowNg R,4 brQti`adaytedb}'.4804,4o{Dili*OP et thesaid Company oh Dec b r I l'..2030;•;';!,b' ' - sDLvFA:a,..uefgnon7Re fihona+le"tfrinc+Pme'mmtwmralaadneewrormee«aymr ermdr w�a4lnt:,nooP.m+6€solF. ..daabeaao�onna.,3-.' :c� nr IneB tiX5'!''-t fm ;114. 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Errs a " wnnen n< iN Tf.SFi+�iONY@{1.REOF I+pca'h,Eeunm�p6rny.hatWandaffiz:„:.1 ua d.tttheO a ...';aftihmtlu d4 T 2iir y i,..s EI .� n b E ; Itz s e 4?2s�F I I r _i v, t$53� t eq h r .tea s :. •� d I i",$4"g iarilt.f¢„d'``� t :rk :' al., r. JhM " .IaovrirPa.O. 'n o Ithe uvdeYpjgne�{y1sslfhnt5.y�uyl' $,e 74'."•.. 4iai¢P URANCE€OMPANYdo*eG�crnm&thatdledngmd POW T'A19'ORNSYbf,ter , „) I ff i„i4dhe obng,s m tcid,ywaend�p v,i Ifometd#ect r ''.•;..„:....-'.1.,„..1".4.•' �' `. / it-.7-,„ ' -I wiiic ' A ecr? rpv ya d+' /� in wh'tile wnHeof..l ,91tItmltosutis$IyW'hfyriSfii.''a4 s-a1M5 andataxed'thew rate {-qC4.iivt this df e ?L M1: 2 , 1 .,. $ 1 7:77 I* 3 { L $ 3i4l4r �.4777 \ l'QW61(Qf r,eiii b`}'hf%Y NO t USED TAERECUTE AN'Y HOHt W°iaN A$IN `PPlOJj MTE AFT Julyl1y�20(4 s p. f y�'' 4111 i rElr 1f _ +f, 1' _ l—..rf 1. F Ci .eI i — 46 _ 1 � _. u ....t E ., i . 1 aoSI ., � , la,.r33- •-! r'- r • THE SACK OF THIS DOCUMENT LISTS VARIOUS SECURITY FEATURES • THAT WILL PROTECT AGAINST COPY COUNTERFEIT AND ALTERATION. • f NOTICE TO PROCEED DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE To: Clean Energy Date: 4955 Peoria Street, Unit D Denver,CO 80239 Name of Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids, Bid No. B1300115. You are hereby notified to commence Work in accordance with the Agreement dated . The Contract Time allowed in the Agreement is 365 calendar days. The substantial completion date for all Work is therefore Weld County, Colorado,(County) By: Elizabeth Relford, Transportation Planner ACCEPTANCE OF NOTICE Receipt of the above Notice to Proceed is hereby acknowledged by: (Contractor) Dated this day of ,2013. By Title - 10 - CHANGE ORDER NO. (EXAMPLE) DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE Date: Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids, Bid No. B 13001 15. County: 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: County Representative: Date: William F. Garcia(Chair) Engineer: Date: APPROVALS: Contractor: Date: County: Date: CDOT Representative: Date: _ 11 _ CERTIFICATE OF SUBSTANTIAL COMPLETION DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE County's Project No: Engineer's Project No: Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids, Bid No. B1300115. 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 County,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 maybe 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 County,the Engineer, and the Contractor. County: Date: Engineer: Date: Contractor: Date: - 12 - LIEN WAIVER (GENERAL CONTRACTOR) DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE TO: Weld County Public Works Attn: Elizabeth Relford, Transportation Planner P.O. Box 758 Greeley,Colorado 80632 To Whom It May Concern: For a valuable consideration paid by the Board of County Commissioners of Weld County, the receipt and sufficiency of which is hereby acknowledged,the undersigned hereby,releases unto Weld County and to its heirs,executors,administrators or assigns,all rights of the undersigned to claim a mechanic's lien for material heretofore furnished for use in and for labor heretofore performed upon the construction,alteration, addition to or repair of the structures or improvements described in the Contract Documents as: Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids, Bid No. B1300115. Contractor: (If no legal description is shown following the description of Project,we acknowledge that the foregoing is an adequate description of the real properties and improvements inasmuch as the foregoing is the description given in the Contract Documents which govern the performance of the Work for which consideration has been received.) In executing this release,we certify that all claims for labor,or materials,or both,furnished or performed on our behalf by our material suppliers or subcontractors have been paid or that satisfactory arrangement for payment has been made. We agree to defend Weld County from any and all claims on the part of our material suppliers,laborers,employees,servants and agents or subcontractors arising from our Work on the Project,and we further agree to reimburse the Board ofCounty 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 ,2013, by My commission expires: Notary Public - 13 - FINAL LIEN WAIVER(SUBCONTRACTORS) DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE 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 County. NOW, THEREFORE,this day of ,2013, 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 County, on account of labor, services, material, fixtures, apparatus or machinery heretofore or which may hereafter be furnished by the undersigned to or for the above described premises by virtue of said contract. (F) (SEAL) (Name of sole Countyship,corporation or partnership) (Affix Corporate seal here) (SEAL) (Signature of Authorized Representative) Title: INSTRUCTIONS FOR FINAL WAIVER (A) Person or firm with whom you agreed to furnish either labor,or services,or materials,or both. (B) Fill in nature and extent of work; strike the word labor or the word materials if not in your contract. (C) If you have more than one contract on the same premises,describe the contract by number if available,date and extent of work. (D) Furnish an accurate enough description of the improvement and location of the premises so that it can be distinguished from any other property. (E) Amount shown should be the amount actually received and equal to total amount of contract as adjusted. (F) If waiver is for a corporation,corporate name should be used,corporate seal affixed and title of officer signing waiver should be set forth;if waiver is for a partnership,the partnership name should be used,partner should sign and designate himself as partner. - 14- NOTICE OF ACCEPTANCE DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE To: Clean Energy Date: 4955 Peoria Street, Unit D Denver, CO 80239 RE: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids, Bid No. B 1300115. This is to inform you that the above referenced job,has been satisfactorily completed in accordance with the Contract documents and is hereby accepted. Final payment will be made on or about Final acceptance does not relieve the Contractor of the minimum one(I)year guarantee on all work and materials incorporated into this Project. Such guarantee shall begin on the date of this acceptance. Weld County,Colorado,(County) By: Elizabeth Relford,Transportation Planner - 15 - 36. EXHIBIT 1-FEDERAL-AID CONTRACT PROVISIONS I l w'Ja-11!.l l o-rr.-.:..1a rr-Pin,-,I.-141,1 FL"9A-'crm 1273 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONSTRUCTION CONTRACTS Carers' - fPycicaae tc d1 Fede ai 1d e,lebtettr ronl•ac:.all la al •gabs I loalocl-.•Lvlaa.... _ .. TubJai-1mMcl 6-SOLOcr mete.) ll Nerevey,elebd Friuilee....._ J M pwlenri al=tecaler-,pled Miasmas.V'ape..._........•....._ 'd -.Egunl Employment OppertAmiry:Fitw e-iiini r evii Iyfaunri.; Y.3banerte es c Paresis _ _._......_C (LW. ea.rerrerl:17b dIsatmhoee ao b Imka eh twelve amenit Iel.Rismo,alYaWise.tipcpl ea.a'd Leer".._....__ C =sae raxil aim:tally as :e1 loll- under lewrs ei.saWwr cruets. +11 $..:dellrr ci Aaegnrgthe:.om7a_..._ _.. _...... r rtes.m9uadal:ea CFFi:•b.29 CM:8llt1 1•'rA 41 irsTri Eciard cr.rr+ VIII. Sltety:Ass Jeri'H*w ildon 7 a ire Se--sissy d Labx a.molned try the pra.lebn.reeeatec X.Falle3tots--arts Co-riernnM showy Prole=...._....................._-_ I Parer.ardrtxex?Dues.tot:1Jl3.C.-•1C vial xr•elr etoEEC X.Imale-erlman X Clean A rAal and Fetes :ne specific ahrmJt.c aclon :brdaICa for t-e erre: let prof R'3aerP.IllnCeraoAct..__ ii .eclPA'es seer els \rxe-er1.The Ezell Ocpei1JYty a1:lhlr,.cr I XI.L:edrlcallor Hea-rdt.c Oet.,r .crr,Sinerrsi^.n, Cfrrracl SW:Iaalnla Mr brit ander 41 l:F1: Er.l3 ani the ln.ivally.mad Vet..111rry Ezeinro•r 0 p.Q."M'a d On Amite'Dime Woe.AAi of 10)0(4;11.5.::.171:11 ci XII Canrra;rr R.3a:einv We of Caltaet f..rr&fa• tn.:,tea p7,,wale --re CcR 3 tiro N C.FR lkth Ara i'.:rrrrlAili 9j :I:11,749 .. g nela•etrs n'in Memu,- ni In IN,w.ar.Jied.f Iha pr)f.rYi-aeI.dye camnm43. a,7leea le atrrply VALI the frlk...vino ...rims- ice:sric ATTACH►IFN:S ,r.u.m-.s•l.yHilea o'rFCI- A.E•netanl'cnt Pr"krsnce Mr APpak Hewn Ci:ul.ena a Thu:arrrnnkr rdl.ln,k vilh INC511112 N31.,iy a3ar,q•;SHA'• ;1-ctata l ii Apps act Or rm rq;,,a any} end ti-e feceial bliwa 1-err ri rd1)rY cu FR:MtEArt.IAG aril i 11-Air ..rr,ir..ci-.wt*r rod Wi1i,lariat•1/1r:1A111'l. L OE1dERAL t. Ile xrlleclo•en I aro7 as 1a uptimir•n paid':1:.fskevi'r 1 Those.rupee-,wiseacre slat apply so al notE pe'feihnedol tie slamniert attar:e/the crlraclres oen o-linsatll'.rd with Itie asy.Lume a ,;mere .r3e Ire caolme sis immeielm imbed-Aerdelce and la SI P I.Its axlei or but coInrsey to *cadre Po!*easels ens *nit re•areJ re Ps* airlrrct 7y aie•evtdlt. stnon n^t a ty emptied ord 11x:empcyees me twits,ei4raj empkryme•r. s.taortra:t otbzteo:rd b*el-race ',Agra,sex.osier,national olrle.ape 31 dl:ablry.S c,zel ea Mal rends: e1e13r,ere. Lear.unc 1 Eluoet:l a.dPennuc xrIJe1 tar In ext.se xc Ma cclP :Kr iama:cr,cr Iren:tar re:rl'boie or recrMtmell alp:I-Math.4-44•X' al la;cn in can 4Jautrlr4cl all a1 Itd alb-SL.:.au..onoii rl in 1 tot- :u leo•.,n.i:i,..Alnw 1a pay nr dt.cr fan's al curFcr6Y-cr,and RivsAred Cenitu t PZYkare,ird Pinta(espLia fee a::IiNxi'r euj rflw:lci far 1•Aiiia:).r eLdirc AA:n*11 lb pre-.opraMcCrea Lv.*r Ili.r.r-C.'t-W In pu •as-rte=thel ally r Zen be'n ce Tie 'nib'.In-1he1 4.snr,.' R.as,wa Ciao aJ P_share aha I-as-,is rra-t:aislei ty,..prism n CT.case. x prime cow-acme shat be__:pintlae 10-colptca:e be 'L.Cttt',Meer:Ire xrtraesor ntldealnmlr arc r-eka'vio..i.7 t. ale :u xu-tracts• as- Inv* ler sbboorbacto-wit th=e -less roe FhiA co-trading sixes en EEO CHoer wile wit true*e remenxbii2j Ca-erael',eslden:. Mr.:r.I mint be cepabe al ell'eslIvely adrehirertir sric CffY1t1C or artva colrxler pal.o et l,.W and vino rust be a.tiplec aaecscle J.A tr&ci 7 any ce lie Stlasalbru Cuna1nai n Tate GegJroc nulhasta and ic.aerstt tires 12 72. Ca-tract l'-a.1!bns shy ae enbClem..grounds to--a•ranaten el tie ¢m.al, 7. Olseemflalloa at Poem Al Irembe-s hi:1e.)Years*seer ore aro aLeran ca la hrr sup=hose, praralc. and dxNorCC A P. artier ci .111 %,N,Mng rAau.C. as- die Reeii.i'a_ Cam a_► errbU.ea:,co-aro rocam-erd 5JCh:Alice-,cc woo 3V sub.rzrttally I e'Jncr:mae 21x be j-nund:Ice cebarreld:a onsibed Ir i 1l-R. Imtkdd 11 sxs =clan, wvl at n•ade vN ccsrimi a, and all g 71, lmoamcid.bc caltacmN E7D pane*and colra:0cl reessom aille: n: :,n.v,dn FFO in sou,Bn,.1A..c.rifdrca:er a enacyr•o'c Tr Fe llr I.paraor+pl,i on,..a-1:1 Pi4 t:La Al1.arrr'I.11 be 1.s-..Ire lataetnn rtl ors vAl Eisner P1,aararapht 1.29,1,mod 7. hi 10+t MN in iuirant ee:b! '..:rrnylplelt*I ire ie U',cugh 2p. a. Pe1wc reels.. o' survivau•y end pere:mo on.> j i ep ie...a ny p ..i-f he Isbc•*lands ds rrayl:arm T Sectal M empla nee.It be wld.cleo asz a Ilia*mil c.vier.rd rhea not two, ;.a.atd 1s...t.eJ. .1) w•:) Sc_Sir, h al Pop" React led t3.i'ir,t piton Ps..,tens.(.wry Ni nr:n.Ia,r rote.._umw 1t.a,r,NJu.EEC rile.A i:11=a'Al 1.Y Vi it le bit IS Ile!aesisiel eripute clone cf U-i! pafcr d n la i ii:l.tiOl.4dirl 411 ha miaow: a,..1 aimeinal T-c .L31eenoon ...di *two*Aril aro reaot.ed s-1 axare,hlce with lie meelreie nil kc e,tri.eaee by*,rr tt rink. Vucvpt..no.1 la 1,3 7.pv1W at ci Lebx(UUI)..see rc,U1 In kll CFR 5.(t.4,14 .' lhaptite-eU-in the-menu;al lies Lame rr.IJe b.M 'env surysiecor n' pm'e+..ci otrce oirpLiveiie .il '> Strom*sleeve t+e ccnt-eeb-;a ale xf te cut crlreefosci and be goer!a Iharourl riednnason es-the rro r(F-s..ar,e•i,7'II m1 :elbacat-p alii-r. 7M XL, a'ate cartracure erciNze=or TsPl• aeectr as-the:crbacUr3 LL-1 3altasJues whin Hirai:tells ITWnr1; 1rpn=c-rmvr_. User•seen eo ror Ire MP the cae:M:40r. I.Selection of Leber.Ltalna tre mummer al Ws.•`.9'e-'lie; z..Ai perxrel,ho am enbsael Pl dent-es..t•wat.4a'LP1e re ccntra:br*al rot *eget wi 3e rstrudei by tee CEO Uffcel n lie xrllasira't rcceirc.tr loo.='J1p0rd litter tiredly grew e 'pia:eec. a dRaimrete ageing Isbo-Tali a-re Mee-Slab pcs:ees en,s- xnlare cf le Urmc Slain.Mimes'ci e-tlaymere prctrien c is- J.Nabs-:and xcies*tins bib the crnlractcr.EEC sole). Ascdla:len carmacb.vxr oable:.alc,x❑pealtce in d-g.:Mr:ire S.:, oil oc lea=In e-ee madly aaeercl:le 13 alelayex,appleacu tar x amnirrronvi arr.rnlam al ctnpCjvso. ,,ndw cantle'i:l....fa•dory}1.,p.a.e rJ-i-.11ow i+...ci.1•n .-..s.rrgwkr EEO pain.era r.:preoalu-e.to irptrerc xepa tbs.: I I.!aber perm-nod ay semen ,fe am or pose• asc1 paler snit be broom x die e,erdol of errilaiees a1•means or :.ipe vilh:ct le^w'..1.prtalkn metal res. a"f1a.ee harrbents ar t11er aap'osub roes. A. NUN UI3LHIMMAIIUN S Hecruttrncnt that a:rietiano fo-e•lauyeee.he canna:Mr cal scan I1 al al.ahlf:Cm='r;.lac l'Ot3eee5 the retina: 1.l, 6a,e PROP 1 of R REQUIRED 3'23 CFR B313."02 - - 16 - Opportunity Employer.' M anew advertisements will be pieced In either directly or through a coetrscrofs assoclalion acting as agent will . publications havinga large cPmteilon among minority groups in the area include the procedures set forth below: front which he project work fame wouldnomully be derived. a.The contractor will use best drone to develop,in cooperation a.The contractor wilt unless precluded bye valid bargaining with the unions.joint veining programs aimed toward guanine more agreement.conduct syStematic and direct recruitment through public minority group members and women for membership in the unions and and private employee tetanal sources likely to yield qualified minority increasing the skits of minority group employees and women so Pat group applicants.To meet this requirement the coalmen MD Merely they MSY qualify for higher paying rnpiolment sources of potencal minority group employees,and establish w th such Identified sources procedures whereby minority group applicants maybe b.The contractor will tee best efforts to incorporate an EEO referred to the contractor for employment consideration. clause Into each union agreement to the end That such union wet be co ntrctuaiy bound to refer applicants without regard to heir race.collar. b.hi the avant the contractor has a valid bargaining agreement religion sex.national origin,age or disability. providing tor tenon hiring hall mini;he is expected toobserve the provisions el hag agreement to the extent that the system peeMs the c. The contractor Is to abtaih information as to the referral contractor's eamptance nth EEO contract provisions.(The DOL has practces and policies of the labor union easept that to the extent such held that where Implemenufmne 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 ID fumnish such Information to the contedor. do he same,such Inpementation violates Executive Order 11246,as the contractor shall so certify to the SHA and shall sat forth what efforts amended.) have been made to obtain such information c.The wnuactor vet encourage hla present employees to rely d.In he even the union is unable to provide the contractor with a minority group applicants ter employment.Information and procedures reasonable flow of minority and women mlenals within the time lanil eel wan regard to referring minority group applicants will be dicr,dced seth forth In the cadective bargaining agreement the eemraotor will,through employees. independent recruitment affirm,RI the pnploym®n vacancies without regard to racet cola.religion.sea.national ongiu age or 6abWy; S. Personnel Actions:Wages,working conditions,and employee making tut efforts to obtain quelled anther qualieble ninemy grad benefits shall be established and administered.and personnel amour of persons and women.(The DOL has held that a shag be no excuse that every hype. Including King,upgrading,promotion•transfer,demotion, the union with which the cenbadtor has a collative barganing layoff, and termination shall be taken without regard to race, color, agreement providing for exdusne referral failed to refer minority religion,sex,national origin age or disability.The following procedures employees.) In the event the union relent France prevents the shall be lotwred: contractor from meeting the negation pursuant to Executive Omer 112a6,as amended.and these spend provisions.suh tentacles shall a.The convector MI conduct periodic inspections or prc(ect ties immediately notify the Silk to insure that rotting cmdiWns and employee facades do not indicate discriminatory treatment of project site personnel. B.Selection of Subcontractors.Procurement of Materials and Leasing of Equipment The contractor aDe l not dImm i ste on the b.The contractor will periodically evaluate the spread of wages grounds of race.calor,region.set national origin.age or disabaly in • paid within each chasigcalion to determine any evidence d the selection and retention of subcontractor,lnchdhg proWm • ral of discriminatory wage pradraa. materials and leave of equipment c. The contractor will periodically review selected Pannier a. The contractor shall notify all potential subcontractors and actions In death to detemdne whether there is evidence of daunt. suppliers of halher EEO obligations under hisAntevnanr. nation. Where evidence Is found. the Contractor will promptly take comment action.if the review indicates that the OacrnJraton may b.Disadvantaged Paster enterprises IOHE),as defined In 49 extend beyond the anions reviewed,such thermos*action Shall ndade CFR 23, shag have equal oppanwty In carom@ for and Perform all affected persons subcontracts which the convector enters WO pursuant to this Agreement.The contractor will use Ns best efforts to solicit bide from d. The contractor will promptly awesigate all cpnplahts of staged and to utexa OSE slewmianprs or subcontractor with mernnglut discrimination made to to contractor in connection rah his obligations minify group end female reprexmatIon among their employees. udder this Agreement,veil attempt to resolve such complaints,end will Contractors shag obtain psis of OBE consauhon liens Worn SIIA take appropriate correceve action WIMn a. reasonable time. II the personnel. investigation indicates that the discrimination may affect persons other than the complainant.such connive action shall Include such other e.The connector win use his best efforts to ensure subcontractor Arsons. Upon cemplmon of each investigation. the contractor writ compliance with their EEO obligations. inform every complainant of all of his avenues d appeal. 9.Records and Reports:The contractor shell keep sum records as 6.Training and Promotion: necessary to document oemMmce with the EEO repbemenb.Such meads shag be retained branded of three yeas following comfletlon a.The contractor we assist in locating,qualifying.and increasing of the contract work and shall be available at seasonable antes and he skills of renonty group and women employees and applicants for paws for Inspection by edhorked representatives of the SHA and he employment. FHWA b.Consistent with the co tfeeWS work force requirements and a. The records kept by the centredpr dell document the as permissible littler Federal and State regulation,the contractor shell roaceitr : make furl use of liaising programs,I.e.,apprenticeship,end oMhe{ob Inning programs for the geographical area of contract pedormenco. (I)The number cal mtnony and naaamnony group members Where feadble.25 proem ofappreMIces or trainees in each entrench and womenemployed in each wok cleserfeadon on the project: shall be in that Iksl year d apprerleeshlp or toning.In the event a special proviebn for draining is provided under INS Agreement this (2)The Progress and efforts being made In coopeabon web subparagraph will be superseded as inhaled In the special prevision. units. when applicable, to increase employment opportunities for minorities and women; c. The contactor will advise employees and apricana for employment of available turning programs and entrance requirements (S)The progress and efforts being made in locating,hring. for each training,ponying.and upgrading mkwriy and female employees:and d. The ceaacaor Ms penedieally review the training and (4)The progress and efforts being made in securing the . promotion potential of minority group end women employees and will services of OBE subcontractors or subcanracltrs with meaningful encourage Sign employees to apply he such training and promotion. minority and female representation among their employees. T.Unions:II he contractor miles in whole or in part upon untomes a b.The contractors will submit an annual report to the SHA earn source al employees.the contractor we une Nether bat efforts to obtain .lily car the duration el line project irdkaing the number of minority. • the cooperation of such unions to Increase oppomrn hies for minority women,and non-minority group employees cogently engaged in each groups and women within the union,and to effect referrals by such wok classification required by the contact work.This Information is to unions of manly and female employees Actions by the contractor Pago 2 of 8 REOIJIRED 8Y 23 CFR 633.102 •• be reported on Form FHWA-1391.If orate job Raining is being regdred c. All Mings and Interpretations of the Davis-Bacon Act and by special provision.the contractor will be required to matt and report relaxed acts contained in 29 CFR I.3,and 5 are herein incorporated by • baring data. mimosa in Ms Agreement. M.NONSEGREGATED Face-IVES 2.Classificnaon (heritable to ad Federal-aid construction comrade and in all related a. The SRA contradi g officer shall require Thal any class of sot-teat d 010b00 or more.) laborers a mechanics employed order tie corded.with is not fisted in the wage determinate.shall be classified he conformance with the a.By submisslon of Ws bd.the execution of Nis Agreement a wage determinate. steamiest or the ceaunrnafion of Ws material supply agreement or purchase order, as approprale, the bidder. Federal-add construction b. 11:4 contracting officer shalt approve an additional conneclor,subcontractor,material supplier.of vendor,as appropriate. clasalfoeton. wage ale and fringe bandits only when the laaowing certifies that the firm does net maintain or provide for Ice unpryeee any criteria have bean met: segregated teddies at any of its establishment,and that the Srm does not permit its employees In perform their services el any location.under Mt week to be petted by the Stational dassdmaton Its control.where segregated fatties we maintained.The fine agrees requested Ls not performed by a daasi0nagn In the wage deferaimallorn: Mat a breach of lads certification Is a viation of the EEO provision of this Agmemcm.The firm further writes Net no employee will be denied (2)the additional dassifcal to is utilized In the area by the access to ademrle(notes on the bade of sex or disability. conslnctan industry: b.As used In Ws certification,the term^segregated facilities' (3)the proposed wage ate.hitting any bier Me hinge means any walling moms. work areas. restroora and washrooms, beneMs.bears a reasonable relationship to the wage rates cotter r In restaurama and other eating areas,emeclocas,raker moms.and other the wage delermiaion:and • storage or dressing ants,parking Iola,drinking fountains,recreation or • endearment areas,taaponeuon and housing Modifies prodded for (4) with respect to helpers. when such a dassigagon emrolees which are segregated by esprit(Ilredve,or are,In fad, prevails in the area In nett the work Is petted. segregated on the basis of race.color,nation.national might age or daabtity, because of habit, local custom. or otherwise. The only c.If the toreador or subcontractors.as appropriate,ire laborers exception will be for the dlsabrea when Me demands for accessibility and mechanize(if known)to be employed In the additional classification override(e.g.disabled parking). Or their repesengaves. and the contacting officer agree on Me dassifmmion and liege ate(including the amour designated far hinge c The contractor agrees that II has attired or will obtain dmacd benefits wfele appropriate),a tepee(d the action oaken shwa be sent by centcilon from proposed subcontractors or material stroking prier to the co tacung after to the D01.Administrator of the Wage and Hop award of su bcomrads or mnsummabon of materiel soppy agreements Division. Employment Standards Administalion, Washington. D-C- d 510.000 or more and that it'AI eiatn such certifications In its tiles. 20210.The Wage and Hour Admbdataror,or an eutodxed representa- tive.will approve,modty,or disapprove every additional casaatcaben W.PAYMENT OF PREDETERMINED MINIMUM WARE action within 30 days of receipt and so advise the conbardag @Meer or will notify the ardaofing oiler within the 30day period that additional • (Applicable to air Federal-ad statelier =erects exceeding ante le necessity. 52,000 and to all related subconaca.except for protean located on roadways classified as total roads or rural mirror collectors,with are 0.In It event the contain,or submitdors,as appropriate. exempt.) has laborers or nrechamts lobe employed in the additional dassddalion or their representatives,and the contracting officer de not agree on to 1.General: proposed caasetation and wage rate(lnduding the amount designated j For fringe beadle,where appropriate),fie contang officer shall toter a.Al mottles and laborers employed or working upon the aae Me questions. including the views d at interested pales and fire of the work will be paid unconditionally and not less often than once a rewmnendeeon el the anbacli g officer, to the Wage and lime week and without eubseque d deductor or rebate on any account Administrator for dt nation. Said Administrator,Of an authorized (except such payroll deductions aura permitted by regulations(20 CFR representative,will Issue a deletmlreta when 30 days of receipt end 3)Issued by the Secrete of Labor under Me Copeland Act(40 MSC. so advise the conbacng officer or wig nerdy the an rapag officer 2T6c)f the full anode of wages and beer fide Mega benefits(or ash width the 30day period that additional dine IS neaxany equivalents thereof)due at gore of payment.The payment stall be computed at wage rat not mss than those contained In Me wage e.The wage rap(including kings arras where appopbe) deleirdradon of the Secretary of Labor(hereinafter'tie wage tenni- daiemaed pursuant to paragraph 2c or 2d of tits tenon he shall be nation')which Is attached hereto and made a pan hereof,regardless of paid to all workers performing wile In the addiMlwf desdfeation from any contractual relana nstep which may be alleged to oaks between the the rest day on which work is performed In the classification aneraGar or as subcontractors and Sorb laborers and medamts.The wage deernmaaon(indmarp any attend dasaiec ens and wage a.Paymentof Fringe Benefits: rates matt under peareph 2 of this Section IV eat the DOI. poster(WH-1321)or Form FHWA-1495)shall be posted at at times by a.Whenever the minimum wage rate prescribed In the comet the contractor and ID subcontracted el the silo of Me wads In a For a class of Wborea or mechanics includes a forge benefit which Is not prominent and eccei4ble place where It can be essay seen by the expressed as an handy rate. the contractor at subcntractors. as workers,Poe Me purpose of life Section.gnu@Was made or cods appaprlale. shin ether pay the berets as dated In the wage reasonably arddwad far boa fide fringe benells under Section l(b)(2) deemdnation or shag pay another boa We fringe bere0t or en hourly of the Dams-Bacon MI(90 U.S.C. 2TSe)cm bate of laborers or case equivalent thereof. mechanics are considered wages paid to such laborers or mechanics, subject to the pronalons of Section 1V,paragraph 30.hereof.Mao.for b. If the contract or subscriber-oar,as appropriate,Oct not me purpose d eta Section,regular contributions made or casts Incurred make payments t e trustee or ether WS person,hiehe may Mader for more than a weekly period(WA rat less tan than quartet)under as a pan of the wages of any aboer or mechanic the amount of any dare.funds.or programs,which cover the pardoner weekly period.are ass reasonably anticipated In providing boa Ode binge benefits under deemed to be censNaavdy made or Incurred during such weekly a flan Of program,provided.eat Me Secretary d Labor has found,upon Period.Such laborers and mechanics shag be paid the'adroit'?wage the titian request of the contractor.that the applicable standards GUM rate and fringe benefits on the wage determination for the classification Davis-Bacon Act have been met The Secretary of tabor may require of work actually performed.without regard to eke,except as provided in the contractor to set aside el a separate account assels for the meeting paragraphs a and 5 of Ws Section re. ofobigatwrs under to plan or Program_ b. Laborers or mechanics performing wont in more Man ate 4.APprenifas and Trainees(Programs of the U.S. DOL)and • clasafradon may be compensated al the rate specified for each Helpers: classification for the time actually worked therein,provided, Mai the • employers payroll records accurately set fain the Was spent In each a.Apprenbes: • classification in which work is performed. (1)Apprentices will be permitted to work at less than the predetermbdd ale for Me work they performed when they are employed Page 3 of 8 REQUIRED BY 23 CFR 633.102 -- ,wnuate to am kxfvieually registered in a bone We twerenscestp • program registered oath the DOL Engbynent and Training c.Helpers: Adnarseetion,Bureau of ApprergushM and Training,or satin a Slate agpran4asNP agency recognized by the Buena or if a person Is Helpers wit be permitted In wok Ono protect it the helper employed In Maher first 90 days o1 probationary employment as an classification es specified ana 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 IoM in registered In the piogram.bur who has been sanded by the Bartle of Section W.2,My worker fisted on a payroll al a battier wage role,who Is Apprenticeship and Training or a Sete epprengceMp agency(where not a helper under a approved definition,abed be paid not hiss than the appropriate) to be dicers for probationary empbynwnt as an applicable wage rate on the wage determination for the classification of apprentice. work renthallY performed. (2)The allowable redo of apprentices to journeyman-level 5.Apprentices and Trainees(Programs of the U.S.DOT): employees an the job site in any craft daasllnalbn shag not be greater than Use ratio emitted to the contractor as to Iha entire work farce Apprentices and trainees woadmg ceder appemkealkp and skill under the registered program.Any employee hated on a payroll at en batting pagans which have been certified by ma Secretary of apprentice wage rate,who is not registered or mMrtee employed as Teansponabon as promoting EEO in connection with FedeiWdd stated above,shall be paid not less than the applicable wage rate listed highway construction programs are non rapt to the repkemmus or in the wage determination for the classification of work actually paragraph 4 of this Section W.The straight erne hourly wage rates for performed to addition,any apprentice performing work on the job site in apprentices and trainees under such programs will he esubgshed by the excess of the nag permitted under the mastered program shall be paid particular programs.The ratio of apprentices and trainees to iolmeymen not less than the applicable wage rate on the wage deteminalon fur the shall not be greater an permitted by the lemur or the particular work actually pMonmed. Where a contractor or subcontractor is ptaaam. pedarmblg construction on a prefect in a locality other than that in which tie program is registered. the ratios and wage rates(expressed in 6.WUhholdtne percentages of the joumeymanlevel harul)! rain) speeded in me contractors or subcontractors registered program shall be Marred. The SHA Snail span Is own action or upon written Requestol en authorized rapreaentadve el the DOL withhold of cause to be withheld. (3)Every apprentice must be pad at not bas than the rate from the contractor or subcontractor under ads Apewnem a any other specified in the regismred program for the apprentices level of progress. Federal contract well the same prime contractor.or any other Federally expressed as a percentage of ihejourneyman-tevel hourly rare spMTied assisted contract subjeel to Davrs-Bacon prevailing wage requirements in the applicable wage determination.Apprentices shag be Paid bags which is held by the same prime contractor.as much of the accrued benefits In accordance with the provisions d the apprenticeship payments or advances as may beconsidered necessary no pay laborers program if the apprenticesip program does Nat Spedly fringe benefits. and mechanics.imckiding pprek,cea.trainees,and helpers.employed apprentices must be paid the lull amount of fringe benefits listed on gm by the contractor or anysrbcontraddr the lug amount of wages required wage determination for the applicable dassdiaabon.U 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 Irckding any apprentice,trainee,or helper,employed or working on the prevails h the applicable apprentice clessigcaaan,fringes shall be paid the of the work,agar pan of he wages rewired by the contract.the hi accordance Mm that determination. SHA contracting officer may,alter Mien notice to the contractor.lake such action as may be mammy to cause Ow suspension of any hither • (4)to the event the Bureau of Apprenticeship pr hp and Training. pent,advance or guarantee of funds until wala0ona have ar a Slate appreeleeship agency recognized by the Bureau,withdraws ceased. approval of en apprenticeship program,the contractor or subcontractor will nor longer be permitted to Mize apprentices at less than the 7.Overtime Requirements: appll®ke pmdetanmined ram for the comparable work performed by regular<mplolen unlit anaaapable program Is approved. No contractor or subcontractor contracting to any pail of the contract work which may require or invoke the employmee el laborers. b.Trainees: mechanics,watchmen or guards 6nckdlag apprentices,trainees.and helpers described In paragraphs 4 and 5 Memel shah regdre or permit (1)Except as provided In 29 CFR 5.16,trameea will not be any laborer,mechanic,watchman Of guard in any workweek in which pennited to work at less than the predetermined rale for the work tdsle is employed an such work,to work in excess of 40 hours in such performed ness they are employed pursuant to and Indndudly WOW/reek unless such laborer.mechanic watchman.er guard receives regislned In a program Mitch has received prior approval evidenced by compensation at a rate not lass than dre-endPnellet ernes tapper formal centri llon by the DOL, Employment — Training basic rate of pay for all hours worked b excess of 40 bows In such Adminheatiws woaweek (2)The radio of trainees to pro eymaMevel employees an 8.Violation: the job site shall not be greater than penited undo the plan approved by the Etpklymelt and Training Administration Any employee Paled on LbbNMY h Unpaid Wawa Lipddaled Damages:in the event of any the payroll mainlines tale whiz IS net registered arm pefla0ng In a riaNtdn of the dame set hill in paragraph 7 above,the con ractor and mining plan approved by the Employment and Training Administration any subcenvecar respmnwbr meteor shall be lame to the effected shall be paid net less than the applicable wage late on the wage employee for homer unpaid wages.In addition such contractor end determination for the classification d walk actually performed. in aebcankada aloe be liable to the Mired States(in the case of work Addeu&any trainee performing not on the Job sae In excess of to done under contract for S dsnd of Columbia ore territory.to such mgt peewted ceder the tegeered program shall be paid not lens den Center es to such.erdtnry)for egedebd damages.Such tgialdaled the applicable wage rate on the wage doemena6nn for the week aetully demons shall be computed with reseed to each rdivide&labeler, perfumed recbantc.wacenm,or guard employed In vitiation or the dace ad forth in paragraph 7,in the aura of 510 for each calendar day on which 13)Every trainee must be paid at net eas tan em Se such employee was requited or permitted to work in excess of the speed n the approved program for htaPer level d progress. standard work weak en 40 halm without payment of the evaMna wages expended as a petcernage of the lnaneymenlevel hourly late specified regdred by the clause sot him in paragraph 7. lin the meltable wage determination.Trainees she be paid hinge benefits in accordance with the provisions of the bathe program.ll the a Withholding for Unpaid Wages and Liquidated Damages: trainee program does nes mention fringe benefits,ulnes sbee be paid the full mecumot fringe benefits listed on the wage de ermlnaeon unless The SHA slag upon iv own action or upon mitten request of any the herbagremr of the Wage and Hour Division Mermen=Mai tiara a authorized representative of fire DOL wiltimd.or muse to be withheld, an apprenticeship program associated with the snmaspondkg from any monies Male on account el work performed by the prrneynan4evel wage late on the wage determination which provides contractor or subcontractor under any such contact or any other • for less Nan full fringe benelUs for apprentices.in which case such Federal contract with the same Prime contrnetor.of any other Feaaaliy tablets shall receive the same(Mtge benefits as apprentices. assisted contract subject to the Contract Work Hours and Safety Standards Act,which Is held by the same pine oonuacur.seen sums I 14)In tie event the Employment and Trailing Administration as may be determined to be necessary to satisfy any aabgdas of such '.. withdraws approval of a training program, to contractor or contractor Of subcontractor for unpaid wages and lquidated damages as I subcontrabr will no longer be permitted to Mize trainees at less than Provided in file clause set form in Paragraph 6 abova I the applicable predetermined rate for the woad performed until an accepabe program®approved. Page 4 of 8 REQUIRED BY 23 CFR 633.102 — f V.STATEMENTS AND PAYROLLS 1.The fatsmralion of any of the above cenitratans may subject • the contractor to civil or cdmnal prosecution under 19 U.S.C.1001 and • (Applicable to all Federalaid cprarrelloa contracts exceeds 52.000 31 U.S.C.231. and to aD related subcontracts.except sir projects located on roadways classified as local roads antral collectors,which Bree:te pt) B The contractor or subcontractor shall mane the records remised under paragraph 20 al this Section V sealable for interaction. 1.Compliance with Copeland Regulations(23 CFR 3): copying.or transcription by authorized representatives of to SNA.the FHWA.or Ina DCL and shall pent such reaesenaMs to tntemiew The contractor alias comply with the Copeland Ragulatons of the employees durirs woddng haws on the job. If Vie contractor a Secretary of Labor width are herein brorporatod by reference. subcontractor falls to submit the required records or to make them available.the SHA,the F1AVA,the DOL.or an may.after man nice 2.Payrolls and Payroll Records: to the spo nsor.onsor.appl ant.or owner.lake such actions as may be re<n•+ry to cars the suspension of any runner payment,advance. a Payrolls and basic records Waling Renato shall be or guarantee of funds. Furl emmae. failure to submit the mound maintained by the contractor and each nbcorrpador dung the course recordsuponrequest or to make suit records available matte grounds of the work and preserved for a period of 3 years from the date of for debarment actionpurswm to 20 CFR 5.12. completion of the contract for all laborers. mechanics. apprentices. trainees.watchmen.helpers.and guards working al ore site of the work. VI.RECORD OF MATERIALS,SUPPLIES.AND LABOR b. The payroll records shag contain the name,social security 1. On at Federated contracts on the Mayoral Highway System. ' number, and address of each mach employers his or for correct except arse which provide solely for the installation al etplecb've classification:hourly rates of wages paid(including rates of corNrlbilons device➢al railroad grade crossings.those which are entrusted on a or costs antidpaNd for bona fide range benumb or cash equivalent niceaccount or direst labor basis.highway beaatleation contracts.and I thereof the types deathbed in Section 1(bX2)08)of the Davis Bacon contracts for Warn the total find cemsircotlon cost lot roadway and • Act daily arid weekly number of born wonted:deductions made:and bridge Is less then 11.000.000(23 CFR 635)the comrador shag. actual wages peld. In&Ration.for Appalachian contracts,the payroll records shall contain a notation Indian°whether the employee does, a. Become familiar with the list of specific mefdals and or does not,normally reside in the labor area as defined In Attachment supplies contained in Farm FHWAd7, 'Statement of Materials and A.paragraph 1.Wherever the Secretary or Labor,pursuant to Section Labor Used by Contractor of Highway Constructor involving Federal IV.paragraph 3b.has found that the sages of any abater a mechanic Funds'prior to the commencement of work underline Agreement riches the amount of any costs reasons*anticipated In providing benefits under a plan or program described In Section 1(bg2X8)of the b. Maintain a record of the total oast of all materials and Davis Bacon At.the rnrme:t and each suteonlacmr shad maintain supplies purchased for end incorporated In the work and also of the records which chew that the commhmem to provide such benefits is gaaNes of those sapadfc miedets and supplies tiled on Farm FHWA- enforceable.that the plan or program is financially responsible,dial the 47.and In the units shown on Form FNWA'41. plan or program has been communicated in waling to the taborets or mechanics affected.and show the cost antcipa ed or the actual cost 0. 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 web the data requited in apprentices or sinees new approved programs shy maintain wetn paragraph lb relative to materiels and supplies.a Gnat labor summary of ill evidence of the registration of apprentices and trainees,and ratios and at contract ark indicating pre total hours waded and the total amount wage rates prescribed mthe applicable programs earned. c.Each contractor and subcanbacter shall furnish.each week In 2.At the prime contractors option.ether a angle mean covering all which any contract work Is performed.to are SHA resident engineer a contract work or separate reports for the contractor and for each pays of wages paid each of is employees(Including apprentices, subcontract shall be submitted. trainees.and helpers,deathbed In Seceen IV,paragraphs 4 and 5.and watchmen and guards engaged on wok Wring the preceding vaceklY VII.SUBLETTING OR ASSIGNING THE CONTRACT payroll period). The payzb ermined slab set on accurately and completely all of the ttomnallon rewired to be maintained under 1.The convector shall perlann well is own ogar®Ym contract ' paragraph 2b of We Section V.This Woenaaon may be submitted in work amounting to not lass san 30 percent(or a greater pescenlage If any form desired.Optimal Form WH347 Ic available for this purpose specified elsewhere in the contract)of the Mal o iglnal contract price. and may be purWsed front the Superintendent of Documents(Folioed exdutng any specialty Items desgated by the State.Specialty items stock number 029-0050014-1). U.S. Governnnt Printing Office. may be performed bysubcontract and the amount of any such specially Washinglan. D.C.20402 The prime contractor Is resporsble for the here performed may be deducted from the meat original contract price NrMniesgn of copies of payrolls by all sbcon ractors. before computing the amount of cork required to be performed by tie contractor's own organization(23 CFR 535). d.Each payroll atntbed shall be aocaMsded by a'Statement al Comeliance signed by the contractor or subcontractor or Manor a. 'Ili own argaNzatbn"snag be construed to include any agent who pays or supervises the payment of the palWa employed %wakens employed and paid drs0y by the pre contractor and under the contract and shell teary the following: egrlprrcnt owned or rented by the prime contractor.with or without operators.Such team does not include employees or equipment of a (1) that the Payroll for the payon with contains the subcontractor.assignee.or agent of the are corrector. InMmamn required to be maintained under paragraph 2b of this Section V and that such etnalon IS area and compete In. Speedily Veins"shall be construed to be tinged to work that requires Ngidy spalatiaed knwAedge,aba as.or-tenement at (2)that such laborer or mechanic(Including each helper. ordinary evadable Innihe type or contracting organizations quified and apprenae, and frames)employed an the contract during she payroll expected to bid on the contract as a whole and In general are to be period has been paid the fug weekly wages earned.without rebate. limited to minor components of the overall contract. either directly or indirectly.and kw no deductions have been made either rlredgy or Indirectly hat the full wages and, other than 2.The contract amount upon which the requirements set moth in pensSlbk deductions as cod forth in Ow Repdatlda.29 CFR 3: mettdaccturagraph ed produudsWwlhiicha are to be purchass ed cost or material yand thee (3)that each taborer or methane hat been pia eel loss and mnNOCmr under the tunnel provisions. the applicable wage rate and hinge banns or ash equivalent Ira the classification of worked perfemed,as specified in the applicable wage 3.The commctor shall furnish(a)a competent superintendent or detennirallon incorporated Into the Contract supettsor who is employed by the Rnn, has rut authority to direct performance of the work In accordance wall the cant requirements. and is in charge of all construction operations (regardless of who e The weekly etdmissien of a properly executed certification set performs the week) and (b) such other of hs oval ogaNzattonal • forth on die averse side Of Optional Farm WH347 shag satisfy the resources(supervision.management.and cosh-reefing services)as the requirement for submission of the'Statement of Compliance'required SHA contracting officer determines is necessary to assure the by paragraph 2d al this Sedan V. performance el he contract. 4 No portion of the contract shall be sublet,assigned or Otherwise Page 5 of 8 REQUIRED BY 23 CFR 633.102 — r disposed of except with the written consent of the SHA contracting officer.or authorised representative,and such consent valan given shall By submission of tiro bid or the evocation of pile Agreement. or • not be=aimed to relieve the contractor of any responselty for the subcontract as appropriate. the bidder. Federal-ale construction 1ultllmern of the contract Written consent will be given only after the contractor.or subeonuaeor.es appropriate. will be deemed to have SHA has assured that each subcontract is evidenced to writing and that stipulated as follows: it contains ea pertinent pmdelone and requirements of tie prime contract 1.That any eddy taI Is or cal be ntesed In tie performance of this Agreement.unless such contract Is exempt under the Clean Air Act as VIR SAFETY:ACCtOENT PREVENTION -amended(42 USA 155713 egg..as amended by PW.L 91404).and under the Federal Weser Pollution Connor Act as amended(93 U.S.C. t In tie performance of this Agreement the tentacle'avail campy 1251 et mt..as amended by Pohl_92-500),Executive Order 11738. with an app trade Federal, State, and kcal laws governing safety. and reayultons In implementation thereof(40 CFR 15)Is not freed,on . health,and sanitation(23 CFR 635).The contractor shall provide at the dale of contact award. on is U.S. Erwironmenel Protection safeguards,safety devices and protective equipment and lake any other Agency(EPA)List d Violating Facldes pursuant to 40 CFR 1520. needed actions as t determines.or as the SHA contracting ol4rer may determine.to to reasonably necessary to protest the life end health of 2 That the Min ogees to candy and remain in compgece ram all the employees on the job and the safely of the public and to protect properly requirements of Section 114 of the Clean Alr Act and Section 308 of the in connectIon with the performance of the won covered by the comma Federal Water Pdkadn Control Act and at regulators and guidelines listed thereunder. 2-n is a condition of the Agreement and shall be made a wrdtion of each subcorract which the contractor enters Into pursuant 10 this 3.Thal the Om that promptly notify the SIIA of the receipt of any Agreement,that to contractor and any subcontractor sled not permit communication from the Director. OM=of Feder*Activities. EPA, any employee.In performance of thecantare.to work in aungaidaigs or indicating Fate Iadtly that is or will be Wised for the contract Is under under ce dllions which are unsanitary, hazardous or dangerous le caddealmn to be listed on the EPA List of gloleing Fadltes. Nellie health or safety,as detenni ed under construction safety and health standards(29 CFR 1926)promulgated by the Secretary or Lebo,. 4. That the mm agrees le include or cause to be Included the in accordance with Section 107 of the Contract Work Hours and Safety requirements of paragraph 1 eadugh 4 of the Section X In every Standards Act(40 U-S.C.333). nonexempt subcontract and further egnees to take such action as the government may direct ass means of enforcing such requirements. 3.Assuan(to 29 CFR 19262 it is a condition of this Agreement that 0e Secretary of Labor or euthorleed representative thereof.shall have XI.CERTIFICATION REGARDING DEBARMENT,SUSPENSION, right of entry to any s5a of canna performance to Inspect or investigate INELtGIBWTY AND VOLUNTARY EXCLUSION the matter el compliance with the construction safety end health standards and to catty mettle duties of the Secretary under Section 107 1.Instr ctionsfor Cedl0otan-Primary Covered Transactions: of the Contract Work Hours and Safdy StandardsAd 140 U.S.C.333). (Applicable to all Federal-aid contacts-49 CFR 29) M.FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS a. By signing and submldlng tits proposal. the prospective In order to assure high dually and durable canalisation In wnknniy primary participant is providing the cMleaton set out below. all oAtu approved plans and specifications and a high degree Of reliability on statement.and representations made by engineers,cankadpm,sup A- b.The Inabfly d a person lP provide the cerebration set out ars.and workers on Federal-aid highway projects.it is essential that all below we riot necessarily result in denial of panidpaton to des covered persons concerned with the project perform their functions as carefully, transaction.'the prospective participant shalt submit an explanation of thoroughly.and honesty as possible.Wilful falsification,*amnion,or why Il cannot provide the cotlAkauon sel out below.The cedtiation or misrepresentatfon with respect to any fads related to the prgeu is a eapfanatun alt be considered in connection with the department or violation of Federal law.To prevent any m®undeaandl g ragaeeng tie agency's determination whetter to eider hen Nis transaction.However. serkeisneas of these and Sm tar acts.the following mete shall be teen of the prospective pommy penetrant to furnish a ceNteeton or posted on each f'derei*d highway pmlec1(28 CFR 535)In one or an explanation shall disqualify such a poison from paraeladon In this more places where It Is readily available to at Koons concerned with transaction. Ne project c The oeitfatlon in the dawn IS a materiel representation of NOTICE TO ALL PERSONNEL ENGAGED ON FEDERAL-AID fact upon which reliance was plead when the department or agency HIGHWAY PROJECTS determined to enter Into this transaction.If ills refer determined that the Prospective Primary pa4dpent knowingly rendered an erroneous 18 U.S.C.1020 reeds es Meows: ceNacabon, In addition lo other remedies available to the Federal Goverment,the department or agency may terminate this transaction 'Whoever-being an offload agent.or employe°odds united dialed for cause of default or of any Sfax or TernRay,or whoever.wi eder a person,assaiatlax tam or comaetbn, knowingly melee any lobe atela cent Iebe d.The Pro marflve primary participant shall provide Immediate remaaarreria.or Mho report as to the dwracer,weaed:greM4y.or written notice to the department or agency to wheat the proposal le cost a7 the material used or to be used.or the[mangy Or'Nobly of ilia submitted if any tea the prospective primary participant leans that is work pedwnicd or to be pertnied,or the toes thereof In connection certification was erroneous when submitted or has become erroneous wen are edmfaaorn alplaa maps,spedkayesa contracts.or casts of by reason*changed riiwrnsances. construction on any highway or tended payed wtnalfed for approval to ''..'��a�,a the Secnefayd Tmraporleltgry 0' a The anti"cowered transaction''debarred,"•suspended• Saligaae.' lower gm coyotes Vansasfon.' "participant? 'person' Wnavor Anoatgty manes any lake slalemard,raise rePeaenaiirt "primary coveted banucion."'fsincipet'"proposal and'Valonteey farce topwf et Ste*aim with,espeof In Ma UMraak/,guady.guaranty, excluded.'as used in NU clause,have to meanings set out in the or cast of anywort perfcnmed or ice be perfarmwd,or metMatt Aaniehhad Oefnitons and Coverage sections of rules Implementing Executive or to be tarnished,in coreocoa arab Pre construction of any Mghwayor Order 12549.You may contact the deamnant or agency to which tots periled*Mtn nlPruvedby to Seaelary d Traapwt*km:or proposal is submitted for assistance in chinking a copy of those regulations. Wfdwwer knowigly nukes any Seise statement or /*se representation as to mariai tae in any statement earrMeM,or rapers I.Tha Plasoechrve Panary participant agrees by sWnd6rg Its submtad par WON fo prostates of lire feda*aa Roads Act apploved proposal that should the proposed covered uaneaelon tam entered ink). Wily 1.1916.(39 Stat.355),as amentkd and sacrament* It shall not knoviryly ode into any lower tiro covered transaction wNi a parses who is debated,suspended dedarad ineligible,or vohmtadry Shat be fined nor code Mat 510,000 or imprisoned not more Man 5 excluded hom articiann In this covered bar salon. unless ID yearsa0ath." authorised by the departmentor agency teaming Into tdstiameactioa L MIPL.EMENTA11ON OF CLEAN AIR ACT AND FEDERAL g. The preNrective primary participant hater agrees by WATER POLLUTION CONTROL ACT sulNetg the Proposal that ft will include In dame titled'Certification Regarding Debarment.Suspension.Irrelgibdny end Voluntary Exdusion- (Applcable to all Federa laid construction contracts and to el elated Lower Tier Covered Transaction,'provided by the department or agency subcontraels of1100.000 or more.) • Page 8 of 8 REQUIRED BY 23 CFR 633.102 — III Antenna into this covered transaction.without modiSwllon,In all loner c.The prospective lower tier participant else provide immediate tier covered lrartsactiens and in all sdidladons for lower ter revered written noire to the person b which as proposal la Preferred if at any • transactions. time the prospective lower tier participant leans that Its cemWllon was cnoneous by reason of clanged clrcurestncef. h. A pMkaaa Ina covered trruuacuon may rely upon a cenfcalon of a prospective participant in a tower per covered d.Tie terms -covered maedton'idebarred"suspended." transaction that Is not debarred. Suspended. Ineligible. or voluntarily UedlpbeP -primary covered transecton' berscgeiC 'person: excluded from the covered transaction, Mess it knows that the 'peindpaL'bMpmal,'and'rolwlanly excluded.'as used n this Clause. codification is erroneous.A participant may decide the method and have the meanings set out In the Definitions and Coverage sections of frequency by width 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 Ire assistants In obtmmng a copy of portion of the lists of Parties Fsdwed From Federal woopamem or those regulations. Nm-pracuremem Programs'(No procurement Usti which n compiled by the General Services Administration. e.The prospective bon tier participant agrees by submitting this proposal that should the proposed covered aanxtion be entered into. L Nothing comemed in the foregoing shall be construed to remise It shall not knowingly enter Into any rawer lee covered transactor,with a eembliahinem of a system of records in order to render in goon faith the person who is debarred,suspended,declared helgible.or voluntarily certification required by this clause.The knowledge and information of excluded front participation in this covered transaction. Mess participant is not requred In exceed that which is normally possessed by atahorimd by the department or agency with which this rensecton a prudent person in the ordinarycourse of business dealings. originated. j.Except for transactions authorised under paragraph l of these f. The prospective lower liar pankipanl further agrees by Instructions,if a participant In a covered tranaadion knowingly enters submitting this proposal that It troll include thls clause tied'Certification Into a rower her revered ranaemiw with a person who is suspended, Regarding Debarment Suspension.Inellgiblly and Vdunbry Exclusion- debated,ineligible, or vdunadly excluded from pankJpaion in this tower Tier Covered Transaction,'mahout modttadon,In all lower ter transaction. in addition to other remedies available to the Federal revered transactions and in all soldalbns For lower der covered Government,the department or agency may terminate this transaction transactions, for cause or default g. A participant in a covered kanackm may rely upon a wneication of a prospective participant in a lower fen covered transience that Is not downed,suspended,ineligible.or vclmadly excluded from the covered transaction. unless it knows that the . Certification Regarding Debarment,Suspension,Ineligibility and certification is enenmus. A participant may deride the method and Voluntary Exclusion—Primary Covered Transactions frequency by watch It determine the eligibility of its principals.Each 1. The prospective primary participant certifies to the best of is participant may,ism l9 not required to.check the NWFphgWemeM List knowledge end betel.that it and Its IMlrtpaa: h. Nothing contained in the loregorg stag be construed to regare establishment of a system of retort In order to render in good a. Are not presently debarred. suspended, proposed for lath to certeicatton ceased by this clause. The knowledge and debarment declared ineligible. or vokmlarly excluded Irani covered information or paticipant Is nee required to exceed that which to normally transactions by any Federal departmern°regency, possessed by a prudent person in the ordinary course of business dealings. b.Have not within a 3-year parted preceding Its proposal been convicted of or had a dog Judgment rendered against them for I.Except for rsnsactions authorized under paragraph e of these commission of fraud or a criminal offense In connection with obtaining. rd:Mons,if a paNdpani in a covered transaction knowingly enters attempting to Main.or performing a public(Federal. Sate or loal) Into a lower tier covered transaction with a person who is Suspended. transaction or contract under a public immegikm vioalion of Federal or debarred, ineligible, or voluntarily excluded from participation in this Salo antitrust statutes or commission of embezzlement,Weft forgery, transaction, In •ddaion to other remedies available lo the Federal Mary,falsification or desurwdon of records.makkg false stelements. Government the department or agency with wend,this uensactph or receiving elan properly. c.*naled may pursue available remedies.including suspension amour debarment e Are not presently Indicted for or ogsnvae crnmaly or civilly rlavgad by a governmental entity (Federal. State or local) with core rmission of any of the offenses enumerated in paragraph lb of Ws our acorn and Certification Regarding Debarmentt Suspension,Ineligibility and d. Have nor within a 3-yea period preceding Ws Voluntary Exdtsanluwef Tler Covered Transactions: apailcatiompgposal had one or more public transactions(Federal,Slate or local)terminated for cause or defaulh. 1.The prospective lower tier pertcipam reMfies,by suemission of leas probes.that mom it nor its pampers is presently debarred, 2.Where the prospmive primary participant is unable to certify to pepeldM,proposed for debamert,declared ineligible.or voluntarily any of the smsmeres in rile wet ria,sure prospective Foreman' secludedIrern panitlpafnn In Ibis transaction by any Federal atoll attach an esplafallonto WP proposal secluded Or agency. 2.Where the prospective ewe ler padppae is unable lo certify to any of flit statements In this camfraton.such prospective penkapat shell attach art explanation to lids proposal 2. lnstrsp6ons for Cedlfication-Lower ller Covered Teeneac' lions: (Applicable to all subcontracts,pamhase odem and Wier tower tar XII.CERTIFICATION REGARDING USE OF CONTRACT FUNDS OR bansactpns of 525.000m more-45 CFR 291 LOBBYING a.By signing and submitting this proposal.the prospective tower (Applicable to an Federal-aid conduction contracts and to at related tier is providing the ceretoadon sal out below. Subcoraees which exceed 5100,000-49 CFR 20) b.The certification in this clause Is a material representation of 1.The prospectve participant cantles,by signing and submitting Ws fact upon which reliance was paced when this transaction was entered hid or proposal.to the nest of Its or her krawledge and belief,that • Imo.It It is later downwind tat the pmepedire lower tier pankipari Morrie* rendered an enmeom malalien. in addition to other a.No Federal appropriated fends have been paid or wit be paid. remedies available to the Federal Government the department. or by or on behalf of the undersigned,to any person for influencing of agency with which this transaction originated may pursue available atempina to Influence en offerer 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 connedron with the awarding of Page 7 of 8 REQUIRED BY 23 CFR 633.102 — • any Federal connect the making of any Federal.grant.Pb mffr or 2 11*catillealson S e manat representation or lad upon which any Federal ten,the entwine 14 of any ceapetslle egreedlent and regent*was plated peenIle aaaacion was made Or steered no. tee extenml a.nylwa$0A remrel aemymed.Or medlar-00M et any 2.Sndmssionof this p11ge9NM is a pereaeNe for making or sobbing Federal apntreat grant ban,or cooperative agreement Isibis trenesogerriewtedT 31-0.43,Z.18$1-Any Pan^1 o bit'.2 Reim ra bed ee%cayeneheOM ]a a cnfpegNy(beefless b.taw yews swathe Feral appnjp41. ma d la ham dean Inn 810. t00and not mom asS1 :do 00 IfdtMit rIM&am. pay or yell he pia t0 a11y serest sa M$fml rag or Swift t m also agrees by adblrtlyrgTN or her dd or Nuance an dicer a erpPlatee m any Pdtlernn+6May.a Monter M 3.The pmapeclle wabeWnl l000reaa ea off s m erp yap ofComm,.oral gOPbyw el a propos dint he or she shell results that the ilegla9e of On alaelaer 0T..Congress in paM4cfmn SienaFeda51 cettatl._aron1 astMcadan be Included m eli lower Oar subcontraW,met exceed bbl,or ooOParaSe Agreement,be enderersend slag ernSaby pod itapd00 and that en such implants eMit eel* and Schaal submit Ste ad form-1.11.. sure Pam so R ppo n Leaayks"In accordingly accordance Wall l4 ebeuelons. • I al _. . _ Page-8 of 8 - -REQUIRED SY 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 1836(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)(Conslruclion 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,end sub-Agreements of amounts in excess of$100,000). • C.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 orA-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 see,42 USC 2000d,29 USC 794,and implementing regulation,45 C.F.R.Part 80 et. sea.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 USC611. 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.248-258).(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 sea.). N.Age Discrimination Act of 1975 The Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.sea.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.Pad 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 Provision%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"Regulation?), 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. Ili.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,andfor 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 Slate and in addition,the Contractor may request the FHWA to enter into such litigation to pr otect the interests of the United States. g • 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 riot 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, 1.7.5. Loan Guarantees, 1.1.6. Subsidies, 1.7.7. Insurance, 1.11 Food commodities, 411 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 properly provided in lieu of money,even if the award is called a grant; 1.1.13. My 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 Tube, 14.2. 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 subreciplent 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 Subreciplent 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. CCR-Contractor shall maintain the currency of its information in the CCR until the Contractor submits the final financial report required under this award or receives final payment whichever is later. Contractor shall review and update the CCR information at least annually after the initial registration,and more frequently if required by changes in its information 3.2. DUNS-Contractor shall provide its DUNS number to its Prime Recipient,and shall update its information in Dun&Bradstreet at least annually after the initial registration,and more frequently if required by changes in its information. 4. Total Compensation—Contractor shall include total compensation in CCR for each of its five most highly compensated executives for the preceding completed fiscal year if: Page 2 of 3 4.1.the total Federal funding authorized to date under this award is$25„000 or more,and 4.2.In the preceding fiscal year,Contractor received: 4.2.1. 80 percent or more of Its annual gross revenues from Federal procurement contracts and subcontracts and Federal financial assistance subject to the Transparency Act, and 4.2.2. $25,000,000 or more in annual gross revenues from Federal procurement contracts and subcontracts and Federal financial assistance subject to the Transparency Act, and 4.3.the public does not have access to information about the compensation of the executives through periodic reports filed under section 13(a)or 16(d)of the Securities Exchange Act of 1934(15 U.S.C.78m(a),78o(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 s 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(16 U.S.C.3710a).No direct payment shall be made to Contractor for providing any reports required under these Supplemental Provisions,as the cast 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 Slate 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 hftp://www.colorado.govidpaidfp/sco/FFATAhtm 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,E 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 dale 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: 39.72.1 Primary Place of Performance Information,including:Street Address,City,State, Country,Zip code+4,and Congressional District. 8. Vendor—There are no Transparency Act reporting requirements for vendors. 9. Event of Default.Failure to comply with these Supplemental Provisions shall constitute an event of default under the Contract and the State of Colorado may terminate the Contract upon 30 days prior written notice if • the default remains uncured five calendar days following the notice period.This remedy will be in addition to any other remedy available to the State of Colorado under the Contract,at law or in equity. Page 3 of 3 BID REQUEST NO. B1300115 WELD COUNTY DEPARTMENT OF PUBLIC WORKS CONTRACT BID DOCUMENTS FOR INSTALLATION OF EQUIPMENT FOR A LIQUEFIED NATURAL GAS FUELING FACILITY IN THE NFR 8-HOUR OZONE NONATTAINMENT BOUNDARY FEDERAL AID PROJECT NO. CMS 13-HTD-50079, 19232 \ 1861/ Tl V BNTy GO August 7, 2013 Weld County Public Works P.O. Box 758 1111 H Street Greeley, Colorado 80632 970-304-6496 gfaol2013 / ��7/i,�aizied ,ere ao'3-/597 6Coca,er TABLE OF CONTENTS The following provisions take precedence over Specifications or Plans and supplement the 2013 edition of the Colorado Department of Transportation"Standard Specifications for Road and Bridge Construction"(Standard Specifications)which is to be used to control construction of this project. WELD COUNTY CONTRACT FORMS: *Low Bidder must submit these forms prior to Contract Award. *Notice of Award 3 *Agreement 4-5 *Performance Bond 6-7 *Labor and Materials Payment Bond 8-9 Notice to Proceed 10 Change Order 11 Certificate of Substantial Completion 12 Lien Waiver 13 Final Lien Waiver 14 Notice of Acceptance 15 FHWA Form 1273 16 -1861 / -1� v COUNTY J -2- NOTICE OF AWARD DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE To: Clean Energy Date: August',2013 4955 Peoria Street,Unit D r Denver,CO 80239 Project Description: The project in general consists of a public-private partnership for the purchase and installation of Liquefied Natural Gas (LNG) equipment for a design/build "turnkey" operation for one mobile LNG site to locate Weld County's NFR MPO 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$550,000 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. Al Dated this day of August 2013 Weld County, Colorado,Ownbar By Bel& i 2 k. Elizabeth el ord,Transportation Ilinner ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged by ��,,T- �y�/Ete�� ',l (lin l (��.1 -a7 61-�-�ic,(Contra/c'tor) 0 Dated this �� id of O- f_J , 2013 By: Title: € 0 3 . AGREEMENT DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE THIS AGREEMENT,made thisadt d ay of Adtj ( ,2013,by and between Weld County,Colorado,hereinafter called"Owner" and .Jl Clean Enemy doing business as(an individual,)or(a partnership,)or(a corporation)hereinafter called "Contractor". WITNESSETH: That for and in consideration of the payments and agreements hereinafter mentioned: 1. The Contractor will commence and complete the following:DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B1300115. 2. The Contractor will furnish all of the material,supplies,tools,equipment,labor and other services necessary for the construction and completion of the Project described herein. 3. The Contractor will commence the work required by the Contract Documents within ten(10)calendar days after the Notice to Proceed and will complete the DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE 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$ 550,000 . 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" 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 l� E�COUNTY COMMISSIONERS ::N ORBY • NAME William F. Garcia N Jar es N. Harger (Please Type) TITLE Chair TITLE Chief Marketing Officer Date AUG 2 6 2013 ADDRESS 4675 MacArthur Court, Suite 800 Newport Beach, CA 92660 vnt ✓ J 1961 f i0/5 crJNI (SEAL) p �� q (SEAL) ATTEST: ATTEST: L J Weld County Clerk to the Board itezeifi jczer- BY BY itchell W. Pratt Deputy CI to the Board (Please Type) TITLE Chief Operating Officer&Corporate Secretary ieJ ca0/3.- /55 Executed in Five (5) Counterparts Bond No. 1(08842917 PERFORMANCE BOND DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE KNOW ALL MEN BY THE PRESENTS;that Clean Energy dba Clean Energy Fuels Corp. (Name of Contractor) 4675 MacArthur Court, Suite 800,Newport Beach,CA 92660 (Address of Contractor) ,hereinafter called Contractor,and a(Corporation,Partnership,or Individual) Westchester Fire Insurance Company (Name of Surety) 436 Walnut Street,Philadelphia,PA 19106-3703 (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County,Colorado (Name of County) P.O. Box 758, 1111 H Street,Greeley, Colorado 80632 (Address of County) hereinafter called County, in the penal sum of Five Hundred Fifty Thousand 00/100 Dollars, ($550,000.00), in lawful money of the United States of America,for the payment of which sum well and truly to be made,we bind ourselves,successors and assigns,jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas,the Contractor entered into a certain Contract with the County,dated the 24th day of June , 2013, a copy of which is hereto attached and made a part hereof for the construction of: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B1300115. 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 County, 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 County from all costs and damages which it may suffer by reason of failure to do so,and shall reimburse and repay the County all outlay and expense which the County 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 County and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. - 1 - PERFORMANCE BOND DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE IN WITNESS WHEREOF, this instrument is executed in five(5)counterparts,each one of which shall be deemed an original, this 14th day of August,2013. Clean Ener dba Clean Ener Fu Is Cor . C tractor (Contractor)Secretary (SEAL) '`�l.Cis�,Q,Q�hK' 11 4675 MacArthur Court, Suite 800 // (Witness as to Contractor) t (Address) `j`7k° '7.T✓10(04tir S Newport Beach,CA 92660 (Address) 1Irl- c, eg Qe ATTEST: ch everoni(Surety) (SEAL) Westchester Fire Insurance Company a Sat By ' �`''��`l�"y��/jam—' lane Moraski,Witness as o Surety L Kathleen I nagan, ttorney-in-Fact 195 Farmington Avenue, Suite 300 436 Walnut Street (Address) (Address) Farmington CT 06032 Philadelphia,PA 19106-3703 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. 2 Executed in Five (5) Counterparts Bond No. 1(08842917 LABOR & MATERIALS PAYMENT BOND DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE KNOW ALL MEN BY THE PRESENTS;that Clean Energy dba Clean Energy Fuels Corp. (Name of Contractor) 4675 MacArthur Court,Suite 800,Newport Beach,CA 92660 (Address of Contractor) ,hereinafter called Contractor,and a(Corporation,Partnership,or Individual) Westchester Fire Insurance Company (Name of Surety) 436 Walnut Street,Philadelphia,PA 19106-3703 (Address of Surety) hereinafter called surety,are held and firmly bound unto Weld County, Colorado (Name of County) P.O. Box 758, 1111 H Street, Greeley,Colorado 80632 (Address of County) hereinafter called County,in the penal sum of Five Hundred Fifty Thousand 00/100 Dollars, ($550,000.00), in lawful money of the United States of America, for the payment of which sum well and truly to be made,we bind ourselves, successors and assigns,jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas,the Contractor entered into a certain Contract with the County, dated the 24th day of June,2013, a copy of which is hereto attached and made a part hereof for the construction of: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No. B1300115. 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 County and the Contractor shall abridge the right of any beneficiary hereunder,whose claim may be unsatisfied. 3 LABOR & MATERIALS PAYMENT BOND DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE IN WITNESS WHEREOF, this instrument is executed in five(5)counterparts,each one of which shall be deemed an original, this 14th day of August, 2013. Clean En dba Clean Enera Fue Cor . C r r By (Contractor) Secretary (SEAL) ,A � u '�� y��}' 4675 MacArthur Court.Suite 800 (Witness as to Contractor) / (Address) t '7'�Q �'�'� (Q�'��i,P�U—� ti!�'/ JNewportBeach, CA92660 (Address) ke eCIL< '67266 o ATTEST: C/ R/ hard A L eroni (Surety)Attorney-in-Fact (SEAL) Westchester Fire Insurance Company f5Z�L, �_) By t .e-_krb —�- Diane Moraski,Witness as to urety Kathleen M.Flanaga ttorney-in-Fact 195 Farmington Avenue, Suite 300 436 Walnut Street (Address) (Address) Farmington CT 06032 Philadelphia, PA 19106-3703 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. -4- eta Power of WESTCHESTER"FIRE INSURANCE COMPANY Attorney know all men by these presents That WESTCHESTER.FIRE INSURANCE COMPANY, corporation of the Commonwealth of Pennsylvania pursuant to the following Resolution adoptedby the Board of Directors of the said Company on December 11,2006 to Wit •,•RES©LVE0,that iha(dlloy`ugaudortoalons fslatp to the executi for and on tietialfofaie Company;of bands undena):inga, ecogniznpces;.comrads and othefwnnen conumlmentsaf the Compan 'onleted t *1-ofdineycoot ofbusmesc(each a`Wntten CodmWEcnt"): • (q . Each of the Cha tali,iheP dept and alto Vic WeEdenm ofilie Company is hereby authorizeW to oredute any Written Cmmt entformid'oat behallfof the Campaaa,under rite Seal ofte Company or (2) = 6nch duEcappoirita9 attorney n fact oldie.Company a hereby authnmd to sate anyW men Conimitment for and on behplfofthe Coniiiaay,lider mescal ofthp Company or otherwise,to m cxteettai ' ' " sucbtank is aut2i6xlzed9)yllt9.9rani949,avilproin.deal f 'i 'suchp"rsmm Wniteir:dppetdiment as such attorney-in-fear • (3) Each ofd1 Ch tan me Prestdont and the Vic Pro desk ofibo,Coeppany is herebWatitherized,for and oil behalf ofth Company to appoint in svntang any pangs the att mey-tir fact otll Cd pany.with full pas rand auih my to execute,for and'onbeh If of the Company under aleseal¢fiche Company or ettletz,vise7stihWWWiteei Commtments or the Company as may be pee fied In such Written ,„ ,appointmnrlhtch enecif Hon m50'be by:eeeed type of class rofW ttenCmtmtntentsar by pacification of one or more patdplerWntten Commitments, (9) - '=aaoh of Eio Chaumaq,the PS d i dVgrr Prwdeor oflhe Company in herebyauth nzed for and onibelalfofihe Company,ladeleg to nwaling any Ether officer pith;C pan}thee tbenlyto . ' execute,for and on behalf()laic Cain any;'ttndar iheCompeny'a seal m rwtse sorb Wntten Commitments ofthe Companyas spaoified in such written delegation which specifitahon may be b) , . ' ' •general type.or teec'pfWntten Commitments onbispecificadoil Drone or met a parpe Iar WOE(Commitments . (5) . The vyt t df any otiS or orstherliatsop executing any Walton mmWtenlof appmnttnoat or delegatcn p rsuant to this R solpit s mad the 099 91 94 Company,may ba affixed by G 1such .. WnttenCamttmoat r'rane pptorment oldfsion .. '.t .: -n , + ' '.. ' FURTHER RESOLVED,that tfi foregotng,Resoi t n shallafet be deemed rob sn'exclttnrt atetementofth powers and authority of ffsers,employees and otharpenos io ace for and:n behalfafthe ` Company land such Resoleaon}hall nottiimfprothennstegaa.9 Di,iv se 9f any'sudh pourerot anNJnty oche altdly'gantd&9 vei≤ed:-r. . Does hereby nominate,constitute and appoint Donaald HIvlc,Carter Jean M�Feeney,John I Gambino KathleemM Flanagan Michael J Cusack,Natalie Coneys,Nicole , Roy,Richard A Leveront,SandraC Lopes,all of the City of BOSTON,Massachuseus;each individually if there he more than one named,its true•and lawful attorney in fact,to make)execute,areal'andddehver art its behalf;and as=its act and deed any and all born s;pndertakings,•recognizance,contracts and other in the nature thereof in penalties not eltceeding Ten million dolfars&zero e nts($1100,000,000 0O).and the execution of such wr?tinge'in pursuance.of these presents.shall be as , = • _binding upon"said`Company,=as fully and amply as iftheyhad been'duly executed add acknowledged bythe•regularly elected officers of the Company,at its principal,,, IN WITNESS'WI-I REOF,the Said Stephen;M Haney,Vice-President;has hereunto subscribed his nameand affixed the Corporate seal of the said WESTCHESTER ,'IRE INSURAvrNTCE COMPANY this It day of July 2012: ,. ";.'.. ..... '_ ' > :.. , • yi ' t 'WESTCHESTER FIRE INSURANCE•COMPANY p y h * rt 'Sciphsia M,Iitmz5,Vitt PtrAidrnt COMMONWEALTH OFPENNSYLVANIA ' " ' • ` _ ' ' COUNTY OP PHILADELPHIA >,SR& '` "•On this 11 day,ofJuly,AD 2012"before ne a Notary Publie•ofthe Commonwealth of Pennsylvania in and rot the County of Philadelphia came Stephen M: Haney Vice President of the WESTCHESTER FIRE INSURANCE'COMPANY io me,personally known to be the,individual and officer who.executed the preceding instrument and he'acknowledged that he executed the same,-and-that the seal affixed to the preceding instrument is the•corporate seal of said Company;that the said.corporate seal ariAtiik signature were duly affixed by the authority and direction of the said;corporation,and that Resolution,adopted by the:Board ofDiscctoss„ of said Company,referred toxin the preceding*instrument,is now m force "' " "' " "' "' IN TESTIMONY W}IERBOE,I haveheieuntosotmy hand and affixed myofftcial sad.at the City ofPhiladelphia/theday'and year firstabove•written. , `,..e3.ye3 �ay CY z{, `r.OFIFi0ffs41sALTItG?1t[iiFlllit.VliTAA . 'ice 'tif1r.4� f2 r £:5RtiNDT. ` .? Nip .,41k , 3 . , , • o I the undersignedA'ssistantecretary ofthe WESTCHESTER FIRE INSURANCE COMPANY,do hereby certify that the original POWER OF ATTORNEY of which the foregoipg is a substantially true and correct copy,is in full force and affect. > '- rift In witness whereof I have hereunto subscribed my name at Assistant Secretary and affixed the corporate•aeal of the Corporation,this/.• day of Iv Asti1*V Y Ifs, Fr a I • »nirm l..Icely AsYiwnt . ut ' TI RS POWER OF ATTORNEY MAY ilNi0T,HE,USED TO-EXECUTE ANY BOND WITH AN INCEPTION DATE AFTER July 11;2014 " cr • THE BACK OF THIS DOCUMENT LISTS VARIOUS SECURITY FEATURES ® THAT WILL PROTECT AGAINST COPY COUNTERFEIT AND ALTERATION. NOTICE TO PROCEED DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE To: Clean Energy Date: 4955 Peoria Street,Unit D Denver, CO 80239 Name of Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B 1300115. You are hereby notified to commence Work in accordance with the Agreement dated . The Contract Time allowed in the Agreement is 365 calendar days. The substantial completion date for all Work is therefore Weld County, Colorado,Owner By: Elizabeth Relford,Transportation Planner ACCEPTANCE OF NOTICE Receipt of the above Notice to Proceed is hereby acknowledged by: (Contractor) Dated this day of ,2013. By Title - 10- CHANGE ORDER NO. (EXAMPLE) DESIGN/HUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE Date: Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B1300115. 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: William F.Garcia(Chair) Engineer: Date: APPROVALS: Contractor: Date: Owner: Date: CDOT Representative: Date: -11 - CERTIFICATE OF SUBSTANTIAL COMPLETION DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NPR LNG FUELING SITE Owner's Project No: Engineer's Project No: Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B1300115. Contractor Contract For Contract Date This Certificate of Substantial Completion applies to all Work under the Contract Documents except for the following specified parts thereof: The Work to which this Certificate applies has been inspected by authorized representatives of the Owner,Contractor and Engineer,and that Work is hereby declared to be substantially complete in accordance with the Contract Documents on Date of Substantial Completion A list of items to be completed or corrected may be attached hereto. This list may not be all-inclusive,and the failure to include an item in it does not alter the responsibility of the Contractor to complete all the Work in accordance with the Contract Documents. The items in the list shall be completed or corrected by the Contractor within 5 days of the above date of Substantial Completion. During completion of the punchlist work items,the Contractor will be responsible for the traffic control costs. To be effective,this form must be signed by the Owner,the Engineer,and the Contractor. Owner: Date: Engineer: Date: Contractor: Date: - 12- LIEN WAIVER(GENERAL CONTRACTOR) DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE TO: Weld County Public Works Attn:Elizabeth Re(ford,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 amechanic's lien for material heretofore furnished for use in and for labor heretofore performed upon the construction, alteration, addition to or repair of the structures or improvements described in the Contract Documents as: Project: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No.B1300115. Contractor: (If no legal description is shown following the description of Project,we acknowledge that the foregoing is an adequate description of the real properties and improvements inasmuch as the foregoing is the description given in the Contract Documents which govern the performance of the Work for which consideration has been received.) In executing this release,we certify that all claims for labor,or materials,or both,furnished or performed on our behalf by our material suppliers or subcontractors have been paid or that satisfactory arrangement for payment has been made. We agree to defend Weld County from any and all claims on the part of our material suppliers,laborers,employees,servants and agents or subcontractors arising from our Work on the Project,and we further agree to reimburse the Board of County Commissioners of Weld County for any and all costs,including reasonable attorney fees,which they may incur as a result of such claims. Contractor By: Title: Date: STATE OF )ss. COUNTY OF The foregoing instrument was acknowledged before me this day of 2013,by My commission expires: Notary Public - 13 - FINAL LIEN WAIVER(SUBCONTRACTORS) DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE 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 ,2013, for and in consideration of the sum of(E) Dollars paid simultaneously herewith,the receipt whereof is hereby acknowledged by the undersigned,the undersigned does hereby waive and release any lien rights to,or claim of lien with respect to and on said above described premises, and the improvements thereon, and on the monies or other considerations due or to become due from the Owner,on account of labor, services,material, fixtures,apparatus or machinery heretofore or which may hereafter be furnished by the undersigned to or for the above described premises by virtue of said contract. (F) (SEAL) (Name of sole ownership,corporation or partnership) (Affix Corporate seal here) (SEAL) (Signature of Authorized Representative) Title: INSTRUCTIONS FOR FINAL WAIVER (A) Person or firm with whom you agreed to furnish either labor,or services,or materials,or both. (B) Fill in nature and extent of work;strike the word labor or the word materials if not in your contract. (C) If you have more than one contract on the same premises,describe the contract by number if available,date and extent of work. (D) Furnish an accurate enough description of the improvement and location of the premises so that it can be distinguished from any other property. (E) Amount shown should be the amount actually received and equal to total amount of contract as adjusted. (F) If waiver is for a corporation,corporate name should be used,corporate seal affixed and title of officer signing waiver should be set forth;if waiver is for a partnership,the partnership name should be used,partner should sign and designate himself as partner. - 14- NOTICE OF ACCEPTANCE DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR THE NFR LNG FUELING SITE To:Clean Energy Date: 4955 Peoria Street,Unit D Denver,CO 80239 RE: DESIGN/BUILD TURNKEY OPERATION TO INSTALL EQUIPMENT FOR ONE MOBILE LNG FUELING SITE described in the Invitation for Bids,Bid No. B1300115. This is to inform you that the above referenced job,has been satisfactorily completed in accordance with the Contract documents and is hereby accepted. Final payment will be made on or about Final acceptance does not relieve the Contractor of the minimum one(I)year guarantee on all work and materials incorporated into this Project. Such guarantee shall begin on the date of this acceptance. Weld County,Colorado, Owner By: Elizabeth Relford,Transportation Planner - 15 - 36. EXHIBIT I - FEDERAL-AID CONTRACT PROVISIONS FHWA-1273 Electronic version._March to,1994 FHWA Form 1273 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONSTRUCTION CONTRACTS I.General 1 (Applicable to ail Federal-ad construction contracts and to ail related i II.Nonaiscrinlination 1 subcontracts of 510,000 or more.) Ill.Non-segregated Facilities 3 iV.Payment of Predetermined Minimum Wage 3 1. Equal Employment Opportunity:Equal empoyment opportunity V Statements and Payrolls 8 (EEO)requirements not to discriminate and to take affirmative action to VI.Record of Materials,Supplies,and Labor G assure equal opportunity as set torah 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.Implementatidn 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 Xl.Certification 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 eLf XII. Certification Regarding Use of Contract Funds for egg.)set forth under 28 CFR 35 and 29 CFR 1630 are Incorporated by Lobbying 9 reference In Oils Agreement. In the execution of this Agreement. the contractor agrees to comply with the following minimum specific ATTACHMENTS requirement activities of EEO; A,Emptoyment Preference for Appalachian Contracts a.The contractor will work with the State highway agency(SHA) (included in Appalachian contracts only) and the Federat Government in carrying out EEO obligations and in their review of hislher 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 vrth the assistance of workers under the contractor's immediate superintendence and to ail .11 Is the policy of this Company to assure that applicants are work performed on the contract by piecework, station work, or by employed, and that employees are treated during employment subcontract. without regard to their race,religion,sex.coter,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 snail insert In each subcontract all of the stipulations contained in these or termination, rates of pay or other forms of compensation:and i Required Contract Provisions,and further require their inclusion rn any selection for training.Including apprenticeship,pre-apprenlrcesbip, tower tier subecntract or purchase order that may in turn be made.The andfor on-lhe•jot training." Required Contract Provisions shall not be incorporated by reference in any case.The prime contractor shall ho responsible for compliance by 2.EEO Officer:The contractor will designate and make known to the any subcontractor or tower 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 arlministering and promoting an active contractor program of EEO and who must be assigned adequate 3.A breach of any of 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, arid 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 contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To Section I.paragraph 2; ensure that the above agreement will be met.the following actions will Section IV,paragraphs 1,2,3.4.and 7; be taken as a minimum: Section V,paragraphs 1 and 2a through 2g. a. Periodic meetings of supervisory and personnel office 5.Disputes arising out of the labor standards provisons at Section IV employees will be conducted before the start of work and then not less (except paragraph 5) and Section V of These Required Ccniracl often than once every six months,at wh'ch 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, 6,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 direct recruitment for the tie contractor shall not: project will be instructed by the EEC Officer in the contractor's procedures for locating and hiring minority group employees. ill a.discriminate against labor from any other State,possession,or territory of the United Slates (except for employment preference far 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 employees,applicants for or employment and potential employees. b employ convict labor far any purpose within the limits of the e.The contractor's EEO policy and the procedures to implement project unless It Is !elem. 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 a0 advertisements for employees the nctauon: "An Equal Page 1 of 8 REQUIRED BY 23 CFR 633.102 - I 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 quallfyfor 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 appl'cents without regard to their race.Color, b. in the event the contractor has a valid bargaining agreement religion,sex.oatmeal origin,age or disability. providing for exclusive hiring hall referrals,he is expected le observe the provisions of that agreement to the extent that the system permits the c. The contractor fs to obtain information as to the referral contractors compliance wlh 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 11248,as the contractor shall so certify to the SHA and shall set forth what efforts amended.) have been made to obtain such information. c.The contractor will encourage his present employees to refer d.In the event the union is unable to provide the contractor with a minority group applicants for employment. Information and procedures reasonable new of minority and women referrals within the time limit eel weh regard to referring minority group applicants will be discussed wish forth in the collective bargaining agreement,the contractor will,through employees. independent recruitment efforts, fill tire 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 snail 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 concitions and employee facilities do not indicate discriminatory treatment of protect site personnel. B. 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 selection and retention of subcontractors,including procurement of discnminalory wage practices. materials and leases of equipment c. The contractor will penodicelly review selected personnel 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 h. Disadvantaged business enterprises(DBE).as defined in 49 extend beyond the actions reviewed,such corrective action shalt 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 ce 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 discnminalion may affect persons other than the complainant. such corrective action shall include such other c.The contractor veil 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 alt of his avenues of appeal. 9.Records and Reports:The contractor shag keep such records as G.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 m.nonty group end women employees, and applicants for places for inspection by authorized representatives of the SHA and the employment. EN NA. A. b.Consistent with the contractors 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 mlnonty 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 apprenticeship or training. In the event a special provision for training is provided under this Agreement, this (2)The progress and efforts being made In cooperation with subparagraph will be superseded as indicated In the special provision. unions, when applicable, to increase employment opportunities for minorities and women; c. The contractor will advise employees and applicants for employment of available training programs and entrance requirements (3)The progress arid efforts being made in locating,hiring. for each. training,qualifying,and upgrading minority and female employees:and d. The contractor will periodically review the training and (4) The progress and efforts being made in suturing the promotion potential of minority group and women employees arid will services of DBE subcontractors or subcontractors with meaningful encourage eligible employees to apply for such training and promotion. minority and female representation among their employees. 7.Unions:If the contractor relies in whole or in part upon unions as a b.The contractors wifi submit an annual report to the SHA each source of employees,the contractor wet 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 -- } be reported on Form FHWA-1307_if on-the lob training is being required c. All rulings and interpretations of the Davis-Ratan Act and by special provision,the contractor wilt be required to collect and report related acts contained in 29 CFR 1,3,and 5 are herein incorporated by training data. reference in this Agreement. Ifl,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 S10,000 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 crder, as appropriate, the bidder, Federal-aid construction b. The contracting officer shall approve an additional contractor, subcontractor,material supplier,or vendor,as appropriate, 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(0 perform their services at any location,under (1)the week to be performed by the additional classification Its control,where segregated facilities are maintained.The fine 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 walling rooms, work areas, restrooms and washrooms, benefits.bears a reasonabte relationship to the wage rates contained In restaurants and other eating areas.timectocks,tacker rooms,and other the wage determ nation: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, nr 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 appropriate,the laborers exception will be for the disabled when the demands for accessibility and mechan.cs(if known)to be employed in the additional classification overcde(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- ot$10.0011 or more and that it will retain such certifications in its Wes. 20210.The Wage and Hour Administrator.or an authorized representa- tive.will approve,modify,or disapprove every addifonal classification 1V.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. $2,000 and to all related subcontracts,except for projects located on roadways classified as local roads or rural miner 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 riot agree on the 1.General: proposed classification and wage rate(including the amcamt designated (or 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 unconditionally and not less viten than once a recommendation of the contracting officer, to the Wage and Hour week and without subsequent deduction or rebate on any arr-ruml Administrator for determination. Said Administrator, or an authorized ;except such payroll deductions as are permitted by regulations(29 CFR representative,wiii 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))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 fess than those contained in the wage e. The wage rate(including fringe benefits where appropriate) determination of the Secretary of Labor(hereinafter'the wage determr- 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 Irons 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 is 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 far 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. 270a) 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 Of subcontractor. as appropriate, does not Ine purpose of this Section,regular contributions made or costs incurred make payments to a trustee or other third person,hefshe may consider for more than a weekly period(out not less often than quarterly)under as a part of the wages of any laborer or mechanic the amount of any plans,funds,or programs,which cover the particular weekly period.are costs reasonably anticipated In providing bona fide fringe benefits under deemed to be constructively made or Incurred during such weekly a plan or program,provided,that the Secretary of Labor has found,upon period.Such laborers and mechanics shall be paid the appropriate wage the written request of the contractor,that the applicable standards of the rale 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 clossifcatlon may be compensated at the rate specified for each Helpers: classification for the lime 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 9 REQUIRED BY 23 CFR 633.102 -- pursuant to and individually registered in a bona fide apprenticeship • program registered with the DOL. Employment and Training c.Helpers. Administration.Bureau of Apprenticeship and Training,or with a Slate 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 htsfher first SO days of prebatonary employment as an classification is specified aria 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 iV.2.Any worker listed on a payroll at a helper wage rale,who is Apprenticeship end 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 a towable ratio of apprentices to journeyman-level 5.Apprentices and Trainees(Programs of the U.S.DOT): employees on the job site in any craft cassifcation 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 EEO in connection with Federal.ald stated above,shall he 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 permitted 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 he greater than permitted by the terms of Pre particular i 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 contractors or subcontractors 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 rare specified assisted contract subject to Davis-Bacon prevailing wage requirements in the applicable wage determination. Apprentices shag 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.ti the apprenticeship program does not specify fringe benefits, and mechanics,including apprentices,trainees,and helpers,employed apprentices must be paid the full amount of fringe benefits listed on the by the contractor or any subcontractor the full amount of wages requited wage determination for 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 centrect, 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 40 (4)In the event the Bureau of Apprenticeship and Training, payment, advance, or guarantee of funds until such violations have or a Stale apprenticeship agency recognized by the Bureau,withdraws ceased, approval of an apprenticeship program,the contractor or subcontractor wilt no longer be permitted to utilize apprentices at less than the 7.Overtime Requirements: applicable predetermined rate for the comparable work performed by regular employees until an acceptable program Is approved. No contractor or subcontractor contracting for any part of the contract work which may require 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 arc employed pursuant to and individually workweek artless 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-ball times his/her formal certification by the DCL, Employment anti Training basic rate of pay for all hours worked In excess of 40 hours In such Administration. workweek. (2)The ratio of trainees to journeyman-level employees on 8.ViolatIon: the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration.Arty employee listed on Liability for Unpaid Wages:LIquldaled 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 by 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 tire 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 permmtteo under the registered program shall be paid not less than District or to such territory) for liquidated damages. Such liquidated the applicable wage rate en 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 cf S10 fox 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 journeyman-level hourly rate specified required by the clause set forth in paragraph 7. in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program.If the 9.Withholding far Unpaid Wages and Liquidated Damages: trainee program does net 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 lir for less than full fringe benefits for apprentices. in 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 Contrast Work Hours and Safety Standards Act,which is held by the same prime contractor,such sums 14)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 8 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 - - i V.STATEMENTS AND PAYROLLSill f.The falsification of any of the above certifications troy subject the contractor to civil or criminal prosecution under 18 U.S-C.1001 and (Applicable to all Federal-aid construction contracts exceeding S2.000 31 U.S.C.231. and to all related subcontracts,except for prefects 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 24 of this Section V available for Inspection. 1,Compliance with Copeland Regulations(29 CFR 3): copying.or transcription by authorized reprosentelives of the SHA,the FHWA,or the DOL,and shall permit such representatives to interview The contractor shall comply with the Copeland Regulations of the employees during working hours on the job. If the contractor or Secretary of Labor which are herein incorporated by reference. subcontractor fails to submit the required records or to make them available,the SHA,the FHWA,the DOL,or 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.arid 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-art 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 i thereof the types described in Section 1(leX2XB)of the Davis Bacon contracts rcr 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 ccntracts, the payroll records shall contain a notation indicating whether the employee does, a. Become familiar with the list of specrfrc materials and or does not,normally reside in the labor area as defined in Attachment supp ies contained in Form FHWA-47, 'Statement of Materials and A,paragraph 1.Whenever the Secretary of Labor, pursuant to Section Labor Used by Contractor of Highway Conseuct.on Involving Federal IV.paragraph 30.has found that the wages of any laborer or mechanic Funds,"prior to the commencement ref work under this Agreement. include the amount of any costs reasonably anticipated In providing benefits under a plan or program described In Section 1(bX2)(B)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-4!. 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 en Form FHWA-47 together with the data required in apprentices or trainees under approved programs shall maintain wntten paragraph lb relative to materials are!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 wage rates prescribed in the applicable programs. earned. c.Each contractor and subcontractor shall furnish,each week in 2.At the prime contractor's option,either a single 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 DR ASSIGNING THE CONTRACT payroll period). The payroll submitted shall set out accurately and completely all of the infennatiun required to be maintained under t The contractor shall perform with ll own organization contract paragraph 2b of this Section V.This information may be submitted In work amounting to not less than 30 percent(or a greater percentage If any form desired.Optional Form 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 028.005-0014-1). U.S. Government Printing Olflce. 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 he 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 nr 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 ten 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; h. "Specialty Items"shall be construed to be limited to work that requires highly specialized knowledge, abilities.ar equipment not (2) that such laborer or mechanic(Including each helper. ordinarily available In the type of contracting organlzatrons aualifi❑d and apprentice, and trainee)employed oil 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 urges 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 material and manufactured products which are to be purchased or produced by the (3)that each laborer or mechanic has been paid not loss that contractor under the contract provisions, the applicable',sage rate awe hinge benefits or cash equivalent for the classification 01 worked performed,as specified in the applicable wage 3. The contractor shall furnish (a) a competent superintendent or determination incorporated Into the contract. supervisor who Is employed by the firm, has ftel authority to direct performance of the work in accordance with the contract requirements, and is in charge of all construction operations (regardless of who tr.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 WH347 shall satisfy the resources(supervision,management,and engineering services)as the requirement for submission of the"Statement of Compliance"required SHA contracting officer determines is necessary to assure the by paragraph 2d of this Section V. performance of the contract. 4 No portion❑f the contract shah be sublet, assigned or otherwise Page 5 of 8 REQUIRED BY 23 CFR 633.102 — I disposed 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 VIII.SAFETY:ACCIDENT PREVENTION amended(42 U.S.C.1657 eJ sgagg.,as amended by Pub.L.91-604).and I 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 sag.,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 all the date of contract award, on the U.S. Environmental Protection safeguards.safety devices and protective equipment and take any other Agency(EPA)List of Violating Facilities pursuant to 40 CFR 15.20. needed actions as tl determines,or as the SHA contracting officer may determine,to be reasonably necessary to protect the life and health of 2.That the firm agrees to comply and remain in compliance with all the employees on the job and the safety of the public and to protect property requirements of Section 114 of the Clean Alr Act and Section 308 of the in connection with the performance of the work covered by the contract. Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. 2.It is a condition of this Agreement,and shall be made a condition of each subcontract. which the contractor enters into pursuant to this 3, That the firm shall promptly notify the SHA of the receipt of any Agreement,that the contractor and any subcontractor shall not permit communication from the Director, Office of Federal Activities, EPA, any employee.In performance of the contract,to work in surroundings or indicating that a facility that Is or will be utilized for the contract Is under under conditions which are unsanitary, hazardous or dangerous to consideration to be listed on the EPA List of Violating Facilities. his/her health or safety,as determined under construction safely 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 I 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 statements and representations made by engineers,contractors,suppli- b. The inability of a person to provide the certification set out ers,and workers on Federal-aid highway projects.it is essential that all below will not necessarily result in denial of participation in this covered persons concerned with the project perform their functions as carefully, transaction.The prospective participant 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 law.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 pnmary participant to furnish a certification or posted on each Federal-aid highway project(23 CFR 635)in one or an explanation shall disqualify such a person from participation In this more places where it Is readily available to all persons concerned with transaction. the 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.G.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 Stales, for cause of default. or of any Stare or Territory,or whoever,whether a person,association, firm, or corporation. knowingly makes any false statement, false d.The prospective primary participant shall provide immediate representation, or false report as to the character, qualify,quantity, or written notice to the department or agency to whom this proposal is cast of Ike material used or to be used,or the quantify or quality of the submitted if any time the prospective primary participant learns that its work performed or to be performed, or the cost thereof in connection certification was erroneous when submitted or has become erroneous with the submission of 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 any false statement,false representation. "pnmary covered transaction." "principal.' "proposal" and Voluntarily (also report or false claim with respect bathe character,quality,quantify, excluded,'as used in this clause, have the meanings set out in the or cost of any work performed or to be peAormed,or materials furnished Definitions and Coverage sections of rules implementing Executive or to be furnished,in connection with tire construction of any highway or Order 12549,You may contact the department or agency to which this related pmjgrl 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 prrsuanf to provisions of the Federal-aid Roads Act approved proposal that.should the proposed covered transaction be entered into. July 1.1916.(39 Staf.355),as amended and supplemented: it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,suspended, declared ineligible, or voluntarily Shall be fined not more that 570,000 or imprisoned not more than 5 excluded from participation in this covered transaction, unless years orbolfs" authorized by the department or agency entering Into Ibis 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- (Applicable to all Federal aid construction contracts and to all related Lower Tier Covered Transaction,"provided by the department or agency subcontracts of$100.000 or more.) Page 6 of 8 REQUIRED BY 23 CFR 633.1O2 -- / Entering into this covered transaction.without modification,in all lower c.The prospective tower tier participant shall provide immediate tier covered transactions and in all solicitations for lower tier covered written notice to the person to which this proposal.s submitted if at arty 0 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"voluntanty excluded."as used'n this Clause, certification is erroneous. A participant may decide the method and have the meanings set out in the Definitions and Ccverage 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 certilication required by this clause. The knowledge and information at 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 tower tier participant further agrees by instructions. If a participant in a covered transaction knowingly enters submitting this proposal that II 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 aodition 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 voluntarily i 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 or its principals. Each participant may,but Is not required to.check the Non-procurement List. 1. The prospective primary participant certifies to lire 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 by this clause. The knowledge and debarment. declared ineligible, or voluntarily excluded from covered information of participant is not required w exceed that which is normally 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 e of these commission of fraud or a criminal offense in connection with obtaining. instructions,if a participant in a covered transaction knowingly enters attempting to obtain,or performing a public (Federal, Slate or local) into a lower tier covered transacfon with a person wile 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 criminally or civilly charged by a governmental entity (Federal, Slate or local) with commission of any of the offenses enumerated in paragraph lb of this certification;and Certification Regarding Debarment,Suspension.Ineligibility and d. Have not within a 3-year period preceding this Vo tu nt a ry 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 uresently debuircd, 2. Where the prospective primary participant is unable to certify to suspended, proposed for debarment,declared ineligible°or voluntarily any or 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 Iler XII.CERTIFICATION REGARDING USE OF CONTRACT FUNDS OR transactions of$25,000 or more-49 CFR 29) LOBBYING a.By signing and submitting this proposal,the prospective lower (App'icable to all Federal aid construction contracts and to all related tier Is providing the certification set out below. subcontracts which exceed$100,000-49 CFR 20) b.The certification in this clause is a matenel representation of 1.The prospective participant certifies,by signing and submitting this fact upon which reliance was placed when this transaction was entered bid or proposal,to the best of his Of her knowledge and belief,that: IIinto. If It is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other a.No Federal appropriated funds have been paid or will be paid. remedies available to the Federal Government. the department, or by or on behalf of the undersigned, to any person for influencing or agency with which this transaction originated may pursue available attempting to influence an officer or employee of any Federal agency,a remedies,including suspension and/or debarment. Member of Congress, an officer or employee of Congress. or an employee of a Member of Ccngress in connection with the awarding of Page 7 of 8 REQUIRED BY 23 CFR 633.102 - ° l • any Federal contract,the mailing Of any F$tlelal grant,the making ofill 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 ceniflcalion is a prerequisite for making or entering Federal contract grant loan,or cooperative agreement. into this transaction imposed by 31 O.C 1358 Artypereon who fails to MO the required certification shall be ill a civil penalty of not less b.If any funds other than Fcstezi app"topnated iundrtthdge 4 t if n.$10,000 and not more than S100.OOO lot-eeh such failure. paid or will be paid to any person for fnlIdenoing:Ot'�atteI 1pfnp•fu influence an officer or employee pt:afi Federal a90l y a Mem6ef of 3.The prospective participant also agrees by submitting his or tier bid or Congress.an otflcar or employee•of Congre;e,or an employee'of a proposal that he or she shalt require that the language of this Member of Congress in connection with tills Federal contract. gram certification be included in all tower der subcontracts, which exceed loan,or cooperative agreement, the undersignetEshell complete and $100,000 and that ail such recipients shall certify and disclose submit Standard Form-ILL."Duotosure Form to..1.10cd Lcbllyfngr":In accordingly accordance with its instructions. 1 Ili • • • J .1- . • . • ... • . , . . . .. r • . :......_ . . . • • • - Page 8.0$t. ...REt 111RED BY 23 CFR 633.7102-- i 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 0 Executive Order 11246 of September 24, 1965 entitled "Equal Employment Opportunity," as amended by Executive Order 11375 of October 13, 1967 and as supplemented in Department of Labor regulations (41 CFR Chapter 60)(All construction contracts awarded in excess of $10,000 by the Local Agencys and their contractors or sub-the Local Agencys). C. Copeland "Anti-Kickback" Act The Copeland "Anti-Kickback" Act(18 U.S.C. 874)as supplemented in Department of Labor regulations(29 CFR Part 3)(All contracts and sub-Agreements for construction or repair). D. Davis-Bacon Act The Davis-Bacon Act(40 U.S.C. 276a to a-7)as supplemented by Department of Labor regulations(29 CFR Part 5)(Construction contracts in excess of$2,000 awarded by the Local Agencys and sub-the Local Agencys when required by Federal Agreement program legislation. This act requires that all laborers and mechanics employed by contractors or sub-contractors to work on construction projects financed by federal assistance must be paid wages not less than those established for the locality of the project by the Secretary of Labor). E.Contract Work Hours and Safety Standards Act Sections 103 and 107 of the Contract Work Hours and Safety Standards Act(40 U.S.C. 327- 330)as supplemented by Department of Labor regulations(29 CFR Part 5). (Construction contracts awarded by the Local Agencys and sub-the Local Agencys in excess of$2,000, and in excess of$2,500 for other contracts which involve the employment of mechanics or laborers). F. Clear Air Act Standards, orders, or requirements issued under section 306 of the Clear Air Act(42 U.S.C. 1857(h), section 508 of the Clean Water Act(33 U.S.C. 1368). Executive Order 11738, and Environmental Protection Agency regulations(40 CFR Part 15)(contracts, subcontracts, and sub-Agreements of amounts in excess of$100,000). G. Energy Policy and Conservation Act 7 Page 1 of 3 Mandatory standards and policies relating to energy efficiency which are crontained in the:state: energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94-163). H.OMB Circulars Office of Management and Budget Circulars A-87,A-21 or A-122, and A-102 or A-110, whichever is applicable. 1.Hatch Act. The Hatch Act(5.USC.1501-1508)and Public Law 95-454 Section.4728.These statutes state that federal funds cannot be;used for partisan political purposes of any kind by,any.person or organization involved in the administration of federally-assisted programs. .f.Nondiscrimination 42 USC 6101 et sea.:42 USC 2000d, 29 USC 794,end implementing regulation, 45 C.F.R.Part 80 e: sea.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, 1214.1_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.). It Age:Discrimination Act of 1975 The Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et sea. 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 irplementing regulation 45 C.F.R.Part 84. 0.23 C.FR..Pad 172 23 C.F.R. Part 172, concerning"Administration of Engineering and Design Related Contracts". I<.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.F R. Part 635, concerning"Construction and Maintenance Provisions". R Title VI of the Civil Rights Act of 1964 and 162(aj 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 pad 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. n al ro 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 properly provided in lieu of money, even if the award is called a grant; 1.1.13. Any classified award;or 1.1.14. Any award funded in whole or in part with Recovery funds, as defined in section 1512 of the American Recovery and Reinvestment Act(ARRA)of 2009(Pub. L. 111-5) 1.2. "Central Contractor Registration(CCR)"means the Federal repository into which an Entity must provide information required for the conduct of business as a recipient. 1.3. "Data Universal Numbering System(DUNS)Number'means the nine-digit number established and assigned by Dun and Bradstreet, Inc.to uniquely identify business entities. 1.4. "Entity"means all of the following as defined at 2 CFR part 25,subpart C: 1.4.1. A governmental organization, which is a State,local government,or Indian Tribe, 1.4.2. A foreign public entity, 1.4.3. A domestic or foreign non-profit organization, 1.4.4. A domestic or foreign for-profit organization,and 1.4.5. A Federal Agency, but only a subrecipient under an award or subaward to a non-Federal entity. 1.5. "Subaward"means a legal instrument to provide support for the performance of any portion of the substantive project or program funded by federal funds to a Prime Recipient that a Prime Recipient awards to a Subrecipient. ® 1.6. "Contract"means the contract to which these Supplemental Provisions are attached and includes all award types in§1.1. Page 1 of 3 1.7. "Contractor" means the party or parties to the Contract other than the Prime Recipient and includes a grantee, subgrantee,Subrecipient, or a borrower. For purposes of FFATA reporting, Contractor is • either a Subrecipient or a Vendor under this Contract. 1.8. "FFATA" means the Federal Funding Accountability and Transparency Act of 2006(Public Law 109- 282). Also referred to as the"Transparency Act.' 1.9. "Prime Recipient"means a Colorado State Agency or Institution of Higher Education that receives federal funds directly from a Federal Agency in the form of an award in §1.1. 1.10. "Subrecipient" means a non-Federal Entity receiving Federal funds through a Prime Recipient to support the performance of the Federal project or program for which the federal funds were awarded. A Subrecipient is subject to the terms and conditions of the Federal award to the Prime Recipient, including program compliance requirements.The term"Subrecipient"includes and may be referred to as Subgrantee. 1.11. "Supplemental Provisions"means these Supplemental Provisions for Contracts, Grants,and Purchase Orders using Federal funds except those funds provided under the American Recovery and Reinvestment Act of 2009, as may be revised pursuant to ongoing guidance from the relevant Federal or State of Colorado Agency or Institution of Higher Education. 1.12. "Total Compensation" means the cash and noncash dollar value earned by the executive during the Prime Recipient's or Subrecipient's preceding fiscal year and includes the following 1.12.1. Salary and bonus, 1.12.2. Awards of stock, stock options,and stock appreciation rights. This amount shall equal the dollar amount recognized for financial statement reporting purposes with respect to the fiscal year in accordance with the Statement of Financial Accounting Standards No. 123(Revised 2005)(FAS 123R),Shared Based Payments, 1.12.3. Earnings for services under non-equity incentive plans. This does not include group life, health, hospitalization or medical reimbursement plans that do not discriminate in favor of • • executives and are available generally to all salaried employees, 1.12.4. Change in pension value, this amount shall equal the change in present value of defined benefit and actuarial pension plans, 1.12.5. Above-market earnings on deferred compensation which is not tax-qualified, and 1.12.6. Other compensation, if the aggregate value of all such other compensation(e.g. severance,termination payments,value of life insurance paid on behalf of the employee, perquisites or property)for the executive exceeds$10,000. "Vendor" means a dealer, distributor, merchant or other seller providing goods or services required for a project or program funded by Federal funds.A Vendor is not subject to all the terms and conditions of the Federal award,and all program compliance requirements do not pass through to a Vendor. 2. Compliance.Contractor shall comply with all applicable provisions of the Transparence Act and the regulations issued pursuant thereto,including but not limited to these Supplemental Provisions.Any revisions to such provisions or regulations shall automatically become a part of these Supplemental Provisions, without the necessity of either party executing any further instrument.The State of Colorado may provide written notification to Contractor of such revisions, but such notice shall not be a condition precedent to the effectiveness of such revisions. 3. Central Contractor Registration(CCR)and Data Universal Numbering System (DUNS)Requirements. 3.1. CCR-Contractor shall maintain the currency of its information in the CCR until the Contractor submits the final financial report required under this award or receives final payment, whichever is later. Contractor shall review and update the CCR information at least annually after the initial registration, and more frequently if required by changes in its information 3.2. DUNS-Contractor shall provide its DUNS number to its Prime Recipient, and shall update its information in Dun&Bradstreet at least annually after the initial registration, and more frequently if required by changes in its information. • 4. Total Compensation-Contractor shall include total compensation in CCR for each of its five most highly compensated executives for the preceding completed fiscal year if: Page 2 of 3 li 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), 78o(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 Contractors 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/dpaldfp/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 0 award is$25,000 or mora if the Initial award is below$25,000 but subsequent award modifications result in a total award of$25,000 or more,the award is subject to the reporting requirements as of the date the award exceeds$25,000. If the initial award is$25,000 or more, but funding is subsequently de-obligated such that the total award amount falls below$25,000,the award continues to be subject to the reporting requirements. 7. Subrecipient Reporting Requirements. If Contractor is a Subrecipient, Contractor shall report as set forth below. 7.1 To CCR. A Subrecipient shall register in CCR and report the following data elements in CCR: 7.1.1 Subrecipient DUNS Number 7.1.2 Subrecipient DUNS Number+4 if more than one electronic funds transfer(EFT) account 7.1.3 Subrecipient Parent DUNS Number 7.1.4 Subrecipient's address, including:Street Address, City, State, Country,Zip+4, and Congressional District 7.1.5 Subrecipient Officers'Names of top 5 highly compensated officials if the criteria in§4 are met. 7.1.6 Subrecipient Officers'Total Compensation of top 5 highly compensated officials if criteria in§4 met 7.2 To Prime Contractor. A Subrecipient shall report to its Prime Recipient,upon the effective date of the contract, the following data elements: 39.7.2.1 Primary Place of Performance Information, including: Street Address, City, State, Country,Zip code+4, and Congressional District. 8. Vendor—There are no Transparency Act reporting requirements for vendors. 9. Event of Default. Failure to comply with these Supplemental Provisions shall constitute an event of default under the Contract and the State of Colorado may terminate the Contract upon 30 days prior written notice if • the default remains uncured five calendar days following the notice period.This remedy will be in addition to any other remedy available to the State of Colorado under the Contract, at law or in equity. Page 3 of 3 1861 _ �\ MEMORANDUM TO: Board of County Commissioners G O U N--� DATE: July 3, 2013 FROM: Elizabeth Relford, Transportation Planner SUBJECT: Award Bid # B1300115 - LNG Mobile Fueler— Design Build We received one bid from Clean Energy. My recommendation is to accept the sole bid in the amount of $550,000.00. Clean Energy will pay the matching funds for this CMAQ project which is approximately $111,629 for a total project cost of$661,629. Weld County received $537,000 in Congestion, Mitigation, and Air Quality (CMAQ) funds from the North Front Range Metropolitan Planning Organization (NFR MPO) for fiscal year (FY) 2013. This project is to support liquefied natural gas fleet fueling efforts. Bids were received and opened on June 20, 2013 and presented to the BOCC on June 24th with approval on July 8, 2013 for the purchase of one Liquefied Natural Gas (LNG) mobile fueler. The CDOT contract for this project is approximately $550,000. Weld County is partnering with Dairy Farmers of America on this LNG effort. As part of the bid, DFA is offering to lease their land to Clean Energy for placement of the LNG fueling equipment at their new Greeley Transportation Depot facility (WCR 47 & WCR 62). Please see DFA's letter of support. This fueler will be open to the public 24 hours a day, 7 days a week and will be accessed with a credit card reader. By providing a fueling source, it is the hope that more heavy duty fleets consider converting their trucks to LNG, which promotes the effort to reduce dependency on foreign oil and utilize a natural resource found with the county. I'm available to answer any questions you may have. 0/8 aoi3 aoi3 /Ss 7 aeG I WELD COUNTY PURCHASING 1150 O Street Room 107, Greeley CO 80631 LL6 E-Mail: mwaltersco.weld.co.us TA r — 1, E-mail: reverett@co.weld.co.us Phone: (970) 356-4000, Ext 4222 or 4223 Fax: (970) 336-7226 ._C0UNTY DATE OF BID: JUNE 20TH, 2013 REQUEST FOR: LNG MOBILE FUELER— DESIGN BUILD DEPARTMENT: PUBLIC WORKS DEPT BID NO: #B1300115 PRESENT DATE: JUNE 24TH, 2013 APPROVAL DATE: JULY 8TH, 2013 LNG MOBILE VENDOR STATION COST CLEAN ENERGY $550,000.00 4955 PEORIA ST UNIT D DENVER CO 80239 **BIDS ARE BEING REVIEWED BY PUBLIC WORKS/ELIZABETH RELFORD AT THIS TIME. 2013-1557 04024/3S6 00 8 Hello