HomeMy WebLinkAboutRes.2797.02-17-2014BILL NO. 14-24
RESOLUTION NO. c >?A1 /
A RESOLUTION AUTHORIZING THE CITY MANAGER TO
EXECUTE AN AGREEMENT WITH JACOBS ENGINEERING
GROUP INC., FOR SANITARY SEWER COLLECTION
SYSTEM REHABILITATION PROJECTS
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF CAPE
GIRARDEAU, MISSOURI, AS FOLLOWS:
ARTICLE 1. The City Manager, for and on behalf of the
City of Cape Girardeau, Missouri, is hereby authorized to
execute an Agreement with Jacobs Engineering Group Inc., for
Sanitary Sewer Collection System Rehabilitation, in the City of
Cape Girardeau. The Agreement shall be in substantially the
form attached hereto as Exhibit A, which document is hereby
approved by the City Council, with such changes therein as shall
be approved by the officers of the City executing the same.
PASSED AND ADOPTED THIS � DAY OF( 2014.,
ATTEST:
Gaylq)L. Conrad, City Clerk
Harry E. Rediger, Mayor
CONTRACT
For
SANITARY SEWER COLLECTION SYSTEM REHABILITATION PROJECTS
CONSULTANT NAME: Jacobs En2ineerinQ Group Inc.
IRIS CONTRACT is between City of Cape Girardeau, Missouri, hereinafter referred to as the "City",
and Jacobs Engineering Group Inc., 501 North Broadway; St. Louis, Missouri 63102, hereinafter
referred to as the "Consultant"`.
INASMUCH as funds are available to the City through Wastewater Treatment User Fees and this
project has been approved for participation in the Clean Water State Revolving Fund (CWSRF)
program, the City intends to complete Sanitary Sewer Collection System_ Rehabilitation projects and
requires professional engineering services. The Consultant, upon the City's request through written
Task Orders, will provide the City with any and all professional services hereinafter detailed for the
planning, design and/or construction inspection of the desired improvements and the City will pay the
Consultant as provided in this contract and subsequent Task Orders. It is mutually agreed as follows:
ARTICLEI - SCOPE OF SERVICES
A. DESIGN PHASE - The Consultant will if requested by the City:
1. determine the needs of the project for the City;
2. conduct topographic, property and utility surveys "sufficient to develop plans for the
project;
3. arrange for subsurface investigations if needed;
4. conduct hydrologic/hydraulic studies, prepare alternative designs and cost estimates,
develop preliminary plans, and recommend to the City the best overall general design
based on these studies;
5. submit appropriate copies of preliminary plans, estimates and/or studies for review by
the City;
6. prepare detailed construction plaits, cost estimates, specifications and related documents
as necessary for the purpose of soliciting bids for constructing the project. Provision
will be made in the contract documents for that portion of the work that will be
performed by City's forces;
7, secure adequate property title information, determine right-of-way requirements, prepare
right-of-way plans, and assist the City in acquiring the right-of-way deeds and necessary
easements needed for the project;
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8. comply with water quality requirements by coordinating with the Missouri Department
of Natural Resources and the U.S. Army Corps of Engineers and also ensure compliance'
with the requirements of the Federal Emergency Management Agency (FEMA);
9. comply with historic preservation requirements through coordination with the Missouri
Department of Natural Resources; and if deemed necessary; arrange to have the site
examined by a qualified archaeologist on asubcontract basis;
10. comply with all regulations in regards to noise abatement and air quality, if necessary;
and
11. after making final corrections resulting from reviews by agencies involved, provide the
City with the appropriate. sets of completed plans, specifications, studies and/or cost
estimates for the purpose of obtaining construction authorization from the City.
B. BIDDING PHASE - The Consultant will if requested by the City:
assist the City in advertising for bids and evaluating bids.
2. Bid's Exceeding Cost Estimate: If all bids exceed Consultant's Estimate, due to gross
errors in plan quantities or gross misjudgment of costs, the; Consultant shall, at the
request of City and for no additional, cost, preparea report for City identifying why all
the bids exceed the estimate. The City has four (4) options if all bids exceed
Consultant's Estimate. The City may: (1) -give written approval of an increase in the
Project cost; (2) authorize rebidding of the Project, (3) terminate the Project and this
Agreement, or (4), cooperate in revising the Project scope; plans, or specifications, or all
as necessary to reduce the construction cost. In the case of (4), Consultant, without
additional charge to City, shall consult with City and shall revise and modify, the scope,
plans, or specifications as necessary to achieve compliance with the "Consultant's
Estimate".
C. CONSTRUCTION PHASE — if requested by the City, the Consultant will serve as the City's
representative for administering the terms of the construction contract between City and their
Contractor. Consultant will endeavor to protect the City against defects and deficiencies in
workmanship and materials in work by the Contractor. However, the furnishing of such
project representation will not make Consultant responsible for the construction methods and
procedures used by the Contractor or for the Contractor's failure to perform work in
accordance with the contract documents. Consultant's services will include more specifically
as follows if needed:
assist the City with a preconstruction conference to discuss project details with the
Contractor;
2. make periodic site visits to observe the Contractor's progress and quality of work, and
to determine if the work conforms to the contract documents. The Consultant will
accompany City representatives on visits of the project site as requested;
check shop drawings and review schedules and drawings submitted by the Contractor;
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4. reiect work not conforming to the project documents;
5. prepare change orders for issuance by the City as necessary and assure that proper
approvals are made prior to work being performed;
6. review wage rates, postings, equal employment opportunity and other related items
called for in the, contract documents;
7. inspect materials, review material certifications furnished by Contractor, sample
concrete and other materials as required, and arrange for laboratory testing of samples
by others on a subcontract basis. Independent assurance samples and tests will be
performed by City personnel and such sampling and testing is excluded from the work
to be performed by the Consultant under this contract;
S. maintain progress diary and other project records, measure and document quantities,
and review monthly estimates for payments due the Contractor;
9. be present during critical construction, operations, including; but not limited, to the
following:
a. structure layout;
b. excavation and backfilling;
C. driving of piles;
d. checking of reinforcing steel prior to concrete placement;
C. concrete batching and: pouring;
f. placement of girders; and
g. placement of surfacing materials; and
10. participate in ficial inspection, provide the City with project documentation (diaries,
test results, certifications, etc.), and provide as -built plans for the City's records.
ARTICLE II - ADDITIONAL SERVICES
The City reserves the right to request additional work; changed or unforeseen conditions may require
changes and work beyond the scope of this contract. in this event; a supplement to this agreement
shall be executed and submitted for the approval of City prior to performing the additional or
changed work or incurring any additional cost thereof. Any change in compensation will be covered
in the supplement.
ARTICLE IR - RESPONSIBILITIES, OF CITY
The City will cooperate fully with the Consultant in the development of the project, including the
following:
A. make available all information pertaining to the project which may be in the possession of the
City;
B. provide the Consultant with the City's requirements for the project;
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C. make provisions for the Consultant to enter upon property at the project site for the
performance of his duties;
D. examine all studies and layouts developed by the Consultant and render decisions thereon in a
prompt manner so as not to delay the Consultant;
E. designate a City's employee to act as City's representative under this contract, such person
shall have authority to transmit instructions, interpret the City's policies and render decisions
with respect to matters covered by this agreement;
F. perform appraisals and appraisal review, negotiate with property owners and otherwise
provide all services in connection with acquiring all right-of-way and easements needed to
construct this project.
ARTICLE IV'- PERIOD OF SERVICE
The Consultant will commence work within two weeks after receiving signed Task Order and notice
to proceed from the City. The phases of work shall be completed in accordance with the associated
Task Order.
The times are exclusive of review time by other agencies and exclusive of time needed to ;acquire
right-of-way. The City will grant time extensions for unavoidable delays beyond the control of the
Consultant. Requests for extensions of time should be requested in writing by the Consultant, stating
fully the reasons for the request.
ARTICLE V - STANDARDS
The Consultant shall be responsible for working with the Cityin determining the appropriate design
parameters and construction specifications for the project using good Engineering judgment based on
the specific site conditions, City needs, and guidance provided in the:most current version of City of
Cape Girardeau Standard Specifications and Drawings. tf the project is on.MoDOT Right -of -Way,
then the latest version of Engineering Policy Guide (EPG) and Missouri Standard Specifications for
Highway Construction shall be followed.
ARTICLE VI - COMPENSATION
For services provided under this contract, the City will compensate the Consultant as determined in
the Task Order based on Consultant's Charge Out Rates as determined below:
Charge Out rates shall include all direct payroll, general and administrative overhead,
specialized equipment costs, payroll taxes, holiday and vacation pay, sick leave pay,
insurance benefits, retirement and incentive pay.
2. Additional work incurred by others on a subcontract basis, said costs are to be passed through
the Consultant on the basis of reasonable and actual cost as invoiced by the subcontractors,
only if required and approved by the City.
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METHOD OF PAYMENT — Unless otherwise stated in the Task Order, partial payments; will be
made to the Consultant for work satisfactorily completed upon receipt of itemized invoices by the
City.
1, Invoices will be submitted monthly. Invoices submitted on or before the 20th
day of any month shall become dueand payable on the 10th day of the
following month. Invoices for each Task Order shall be submitted` separately.
2. City's Right to Withhold Payment. In the ;event City becomes informed that
any representations of Consultant provided in its monthly billing, are wholly or
partially inaccurate, City may withhold payment of sums then or in the future
otherwise due to Consultant until the inaccuracy and the cause thereof, is
corrected to City's reasonable satisfaction. Consultant shall correct or revise
any errors or deficiencies in its designs, drawings or specifications without
additional compensation when due solely to Consultant's negligent acts, errors,
or omissions.
PROPERTY ACCOUNTABILITY - If it becomcs.necessary to acquire any specialized equipment
for the performance of this contract, appropriate credit will be given for any residual value of said
equipment after completion of usage of the equipment.
ARTICLE VII - COVENANT AGAINST CONTINGENT FEES
The Consultant warrants that lie has not employed or retained any company or person, other than a
bona fide employee working for the Consultant, to solicit or secure this agreement, and that he has
not paid or agreed to pay any company or person, other than a bona fide employee, any fee,
commission, percentage, brokerage fee, gifts, or any other consideration, contingent upon or'resulting
from the award or making of this contract. For breach or violation of this warranty, the City shall
have the right to annul, this agreement without liability, or in its discretion to deduct from the contract
price or consideration, or otherwise recover, the full amount of such fee„ commission, percentage,
brokerage fee, gift, or contingent fee, plus reasonable attorney's fees.
ARTICLE' VIII - SUBLETTING, ASSIGNMENT OR TRANSFER
No portion of the work covered by this contract, the contract itself, or any Task Order, except as
provided herein, shall be assigned, sublet or transferred without the written consent of the City. The
subletting of the work shall not relieve the Consultant of his primary responsibility for the quality and
performance of the work. The Consultant may engage subcontractors for the purposes of. foundation
borings and tests, abstracts of title, archaeological studies and environmental studies, if required and
approved by the City.
ARTICLE IX - PROFESSIONAL ENDORSEMENT
All plans, specifications and other documents shall be endorsed by the Consultant and shall reflect
the name and seal of the Professional Engineer endorsing the work. By.signing and sealing the
PS&E submittals the Engineer of Record will be representing to, the City that the design is meeting
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the intent of the program. Any review or approval by City of any documents prepared by the
Consultant and/or its consultants including but not limited to, the plans and specifications, shall be
solely for the purpose of detennining whether such documents are consistent with City's construction
program and intent and shall not be construed as approval of same by City. No review of such
documents shall relieve Consultant of its responsibility for the.accuracy, adequacy, fitness, suitability
and coordination of its work product.
Consultant shall assign only qualified personnel to perform any service concerning the Project. At
the time of execution of the Task Order, the parties will agree on the Project Manager for the Task.
This person shall be the primary contact with the City's Project Manager and shall have authority to
bind Consultant.
ARTICLE X -RETENTION OF RECORDS
The Consultant shall maintain all records, survey notes, design documents, cost and accounting
records, construction records and other records pertaining to this contract and to the project covered
by this contract, for a period of not less than three years following final payment by City. Said
records shall be made available for inspection by authorized representatives of the City during regular
working hours at the Consultant's place of business.
ARTICLE XI - OWNERSHIP OF DOCUMENTS
Plans, tracings, maps and specifications prepared under this contract shall be delivered to and become
the property of the City upon termination or completion of work. Basic survey notes, design
computations and other data prepared under this contract shall be made available to the City upon
request. All such information produced under this contract shall be available for use by the City
without restriction or limitation on its use. 'If the City incorporates any portion of the work into a
project other than that for which it was performed, the City shall save the Consultant harmless from
any claims and liabilities resulting from such use.
ARTICLE XII - TERMINATION
The City may terminate the contract at any time by giving written notice. if the contract is terminated
because the project is abandoned or postponed, by the City, the Consultant will be paid for actual time
and covered expenses incurred up to the date of termination, plus a pro -rated portion of any fixed fee.
If the contract is terminated due to the Consultant's services being unsatisfactory in the judgment of
the City, or if the Consultant fails to prosecute the work with due diligence, the City may procure
completion of the work in such.manneras it deems to be.m. the best interest of the City. A Notice of
Termination will be sent to the Consultant and the Consultant shall have a period of ten (10) days to
remedy the cause for termination. The Consultant will be responsible for any excess cost in addition
to that provided forin this contract or any damages the City may sustain by reason of the termination
of this contract due to unsatisfactory performances or prosecution. When Consultant services have
been so tenninated, such termination shall, not affect any rights or remedies of the City against
Consultant then existing or which may later accrue. Similarly, any retention or payment of monies
due the Consultant shall not release the Consultant from liability.
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ARTICLE X1II - DECISIONS UNDER THIS CONTRACT
The City will determine the acceptability of work performed under, this contract, and will decide all
questions which may arise concerning the project. The City's decision shall be, final and conclusive.
ARTICLE XIV - SUCCESSORS AND ASSIGNS
Subject to the restrictions on assignments in Article VIII above, the City and the Consultant agree
that this contract and all contracts entered into under the provisions of this contract shall be binding
upon the parties hereto and their successors and assigns.
ARTICLE XV - COMPLIANCE WITH LAWS
The Consultant shall comply with all federal, state, and local laws, ordinances, and regulations
applicable to the work,. including Title VI of the Civil Rights Act of 1964 and non-discrimination
clauses incorporated herein; and shall procure all licenses and permits necessary for the fulfillment of
obligations under this contract. Consultant, shall further comply with the following state law
requirements:
147ork Authorization Prograin. If the Contract is for services expected to cost more than $5,000.00,
the Consultant shall comply with of Section 285.530 RSMo., pertaining to enrollment and
participation in a federal 'work authorization program (as defined therein) and shall provide
verification through an affidavit (attached as Attachment C) that the Consultant (1) floes not
knowingly employ any person who is an unauthorized alien in connection with the Contract and (2) is
enrolled in a federal work authorization program and provide documentary proof thereof The
affidavit shall contain the notarized signature of the registered agent, legal representative or corporate
officer of the Consultant including but not limited to the human resources director or their equivalent.
Proof of Lawful Presence. Section 208.009 RSMo., requires that all applicants at the time of
application for any contract provided by a local government provide "affirmative. proof that the
applicant is a citizen or a permanent resident of the United States or is lawfully present in the United
States." Consultant's affirmative proof must be established through (i) a.Missouri driver's license,
(ii) any "documentary evidence recognized by the department of revenue when processing an
application for a driver's license," or (iii) "any document issued by the federal government that
confirms an alien's lawful presence in the United States." §208.009.3
ARTICLE XVI - RESPONSIBILITY FOR CLAIMS AND LIABILITY
To the extent of Consultant's negligence, Consultant shall indemnify and hold harmless the City and
its consultants, officers, agents and employees from and against third party claims of personal injury
or property damage, including, but not limited to, reasonable attorneys' fees, arising out of or
resulting from the negligent performance of Consultant's services hereunder. Comparative fault
principles shall apply to this indemnity obligation.
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ARTICLE XVII — INSURANCE
The Consultant shall maintain commercial general liability, automobile liability, and worker's
compensation and employer's liability insurance in full force and effect to protect the Consultant
from claims under Worker's Compensation Acts, claims for damages for personal injury or death,
and for damages to property arising from the negligent acts, errors, or omissions of the Consultant
and its employees, agents and Sub consultants in the performance of the services covered by this
Agreement, including, without limitation, risks insured against incommercial general liability
policies.
The Consultant shall also maintain professional liability insurance to protect the City against the
negligent acts,, errors, or omissions, of the Consultant and those for whom it is legally responsible,
arising out of the performance of professional services under this Agreement.
Unless another amount is agreed to by the City Engineer based, on the circumstances, the Consultant
and his Sub consultants shall procure and maintain during the life of this Agreement insurance of the
types and minimum amounts as follows:
Insurance Type Amount
Worker's Compensation: In full compliance with statutory requirements of
Federal and State of Missouri
Comprehensive General and Professional Liability: $3,000,000 per occurrence and $3,000,000 in the
aggregate
Comprehensive Automobile Liability:
Employer Liability:
$3,000,000 per occurrence and $3,000,000 -in the
aggregate
$3,000,000 per occurrence and $3,000,000 in the
aggregate
The City's Protective policy shall name the City as the Insured. Certificates evidencing such
insurance shall be famished the City prior to Consultant commencing the work on this project. The
certificates must state, "The CITY OF CAPE GIRARDEAU is an additional insured". The City
Engineer reserves the right to adjust the limit coveragerequirements in accordance with changes in
the statutory sovereign immunity limits over the life of this contract to reflect any changes in the
limits as published by the_ N issouri Department of Insurance in the state register pursuant.to RSMo.
§537.610.
The Consultant shall, upon request at any time, provide the City with certificates of insurance
evidencing the Consultant's commercial general or professional liability policies and evidencing that
they and all other required insurance is in effect, as to the services under this Contract.
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Any insurance policy required as specified in this Article shall be written by a company that is
incorporated in the United States of America or is based in the United States of America, Each
insurance policy must by issued by a company authorized to issue such insurance in the State of
Missouri.
ARTICLE XVIII — FINDINGS CONFIDENTIAL
To the fullest extent permitted by law, all reports, information, data, etc. prepared or assembled by
the Consultant under this contract are confidential, and the Consultant agrees they shall not be made
available to any individual or organization without the prior written approval of the City.
ARTICLE XIX - NONDISCRIAHNATION
The Consultant, 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 or national origin in the selection
and retentionof subcontractors. The Consultant will comply with Title VI of the Civil Rights Act of
1964, as amended. More specifically, the Consultant will comply with the regulations of the
Department of Transportation relative to ,nondiscrimination in federally assisted programs of the
Department of'l'ransportation, as contained in 49 CFR 21 through. Appendix H and 23 CFR 710.405
which are herein incorporated by reference and made a part of this contract. In all solicitations either
by competitive bidding or negotiation made by the Consultant for work to be performed under a
subcontract, including procurements of materials or equipment; each potential subcontractor or
supplier shall be notified by the Consultant's obligations under this contract and the regulations
relative to non-discrimination: on the ground of color, race or national origin.
ARTICLE XX — PERIOD OF SERVICE
This contract shall remain in effect for five years
ARTICLE XXI - ATTACHMENTS
The following exhibits are attached hereto and are hereby made part of thiscontract:
Attachment A — Charge out rates for 2014, 2015, 2016, 2017, 2018, and 2019
Attachment B — Certification Regarding Debarment; Suspension, and Other
Responsibility Matters - Primary Covered Transactions.
Attachment C — Affidavit of Participation in Federal Work Authorization Program
Executed by the Consultant this 5 re day of 20 1V
Executed by the City this day of 20.
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FOR: CITY OF CAPE GIRARDEAU
BY:
ATTEST:
Scott Meyer, City Manager
City Clerk
FOR: JACOBS ENGINEERING GROUP INC.
BY: :]b 1�2, (2 . ._) �r '
David Diestelkamp, St. Louis Operations Manager
ATTEST:
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ATTACHMENT A
Break Out Rates
For Years 2014 thru 2019
Classificatioh's
Hoi rly Rate
2014 and
2015
Hourly Rate
2016 and
201:7
Hourly Rate
2018 and `
2019
Project Principal/ Executive
$ 165
$ 170
$ 174
Senior Technical Advisor
$ 180
$ 184
$ 187
Senior Project Manager
$ 145
$ 149
$ 152
Project Manager
$ 130
$ 134
$ 137
Engineer VIII
$ 150
$ 154
$ 157
Engineer VII
$ 140
$ 144
$ 147
Engineer VI
$ 123
$ 126
Engineer V
$ 103
$ 106
Engineer IV
$ 93
$ 96
Engineer 111
N12
$ 82
$ 84
Engineer 11
$ 72
$ 74
Engineer 1
$ 64
$ 66
Junior CADD Designer / Technician
$ 77
$ 79
Mid -Level CADD Designer/ Technician
$ 88
$ 90
Senior CADD Designer / Technician
$ 115
$ 118
$ 120
Junior Resident Project Representative
$75
$ 77
$ 79
Mid -Level Resident Project
Representative
$ 95
$ 97
$ 100
Senior Resident Project Representative
$ 120
$ 123
$ 126
Project Controls
$ 90
$ 93
$ 96
Senior Project Controls
$ 120
$ 123
$ 126
Clerical / Administrative Assistant
$ 62
$ 64
$ 66
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ATTACHMENT B
CERTIFICATION REGARDING DEBARMENT,
SUSPENSION, AND OTHER' RESPONSIBILITY MATTERS -
PRIMARY COVERED TRANSACTIONS
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective primary participant is providing the
certification set out below.
2. The inability of a person to provide the certification required below will not necessarily result
in denial of participation in this covered transaction. The prospective participant shall submit
an explanation of why it cannot provide the certification set out below. 'Hie certification or
explanation will be considered in connection with the department or agency's determination
whether to enter into this transaction. However, failure of the prospective primary participant
to furnish a certification or an explanation shall disqualify such person from participation in
this transaction.
The certification in this clause is a material representation of fact upon which reliance was
placed when the department or agency determined to enter into this transaction. If it is later
determined that the prospective primary participant knowingly rendered an erroneous
certification in addition to other remedies available to the Federal Government, the
department or agency may terminate this transaction for cause of default.
4. The prospective primary participant shall provide immediate written notice to the department
or agency to whom this proposal is submitted if at any time the prospective primary
participant learns that its certification was erroneous when.submitted or has become erroneous
by reason of changed circumstances.
5. The terns "covered transaction," "debarred," "suspended," "ineligible," 'lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal,"
and "voluntarily excluded," "proposal" and "voluntarily excluded," as used in this clause;
have the meanings set out in the Definitions and Coverage sections of the rules implementing.
Executive Order 12549. You may contact the department or agency to which this proposal is
being submitted for assistance in obtaining a copy -of those regulations.
6. The prospective primary participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into; it shall not knowingly enter into any lower tier
.covered transaction with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded fiom participation in this covered transaction, unless authorized by the,
department or agency entering into this transaction.
The prospective primary participant further agrees by submitting this proposal that it will
include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion --Lower Tier Covered Transaction" provided by the departinent or
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agency entering into this covered transaction, without modification; in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred suspended, ineligible; or
voluntarily excluded, from the covered transaction, unless it knows that the certification is
erroneous. A participant may decide the method and frequency by which it determines the
eligibility of its principals. Each participant may, but is not required to check the
Nonprocurement List, at the Excluded Parties List System.
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9, Nothing, contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The
knowledge and information of a participant is not required,to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
10. Except for transactions authorized under paragraph 6 oftheseinstructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a'person who
is suspended, debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies; available to the Federal Government, the department
or agency may terminate this transaction for cause or default.
Certification Regarding Debarment, Suspension, and Other Responsibility Matters -Primary
Covered Transactions
The prospective primary participant certifies to the best of its knowledge and belief, that it
and its principals:
a. Are not presently debarred, suspended, proposed:for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal department or agency;
b. Have not within a three-year period preceding this proposal been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain or performing a public (Federal, State
or local) transaction or contract under a public transaction; violation of Federal or
State antitrust statutes or commission of embezzlement, theft, forgery', bribery,
falsification or destruction of records, making false statements, or receiving stolen
property;
C. Are not presently indicted for or otherwise criminally or civilly charged by a
governmental entity (Federal, State or local) with commission of any of the offenses
enumerated in paragraph (1)(b) of this certification; and
d. Have not within a three-year period preceding this application/proposal had one or
more public transactions (Federal, State or local) terminated for cause or default.
2. Where the prospective primary participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
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ATTACHMENT C
AFFIDAVIT OF PARTICIPATION IN
FEDERAL WORK AUTHORIZATION PROGRAM
Comes now Pu., 0 b ESTett+^j%s 4) i hm"rnua first being duly sworn, on my oath,
'(name] (ofEre held)
affirm T4 -0r Cwco.nye..c Zx - ("Consultant') is enrolled and will continue to participate in a
(company name)
federal work authorization program in respect to employees that will work in connection with the
contracted services related to 5.«,....r Seaa 4,4A Y w 470 e^A'�vnd any incidental items
(describe project)
associated with this work for the duration of the contract, if awarded, in accordance with Section
285.530.2, Revised Statutes of Missouri. I also affirm that the Consultant does not and will not
knowingly employ a person who is an unauthorized alien in connection with the contracted services for
the duration of the contract, if awarded. Attached to this affidavit is documentation of the Consultant's
participation in a federal work authorization program.
(ATTACH DOCUMENTATION SHOWING THAT COMPANY PARTICIAPTES IN FEDERAL WORK
AUTHORIZATION PROGRAM. ALSO ATTACH PROOF OF LAWFUL PRESENCE, AS PROVIDED IN THE
GENERAL CONDITIONS)
In. Affirmation thereof the facts stated above are true and correct (The undersigned
understands that false statements made in this filing are subject to the penalties provided under
Section 575.040, RSMo).
Signature (person with autho ity)
-5 T. Le ,5 L PrtT�OT7`.rd !"A^�bsexr
Title
State of Missouri
) ss.
County of
Printed Name
Date
STS
Subscribed and sworn to before me this _ day of I'cr3rw+*ry 201x.
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My commission expires; `7' a a/( S
pueuc
NOTARY SEAL
Commission 0
, 11131764 .
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