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HomeMy WebLinkAboutRes.3099.08-07-2017 BILL NO. 17-126 RESOLUTION NO. 30q? A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE AN AGREEMENT WITH APEX PAVING CO. , TO PERFORM RUNWAY 02-20 PARTIAL OVERLAY AND REHABILITATION AT THE CAPE GIRARDEAU REGIONAL AIRPORT 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 Apex Paving Co. , to perform Runway 02-20 Partial Overlay and Rehabilitation at the Cape Girardeau Regional Airport (Project No. 16-077A-1) , in the City of Cape Girardeau, Missouri. The Agreement shall be in substantially the form attached hereto as Exhibit A, which document is hereby approved by the City Council, and incorporated herein by reference, with such changes therein as shall be approved by the officers of the City executing the same. /�„ PASSED AND ADOPTED THIS /DAY OF A.I/ /` , 2017. tha Harry E. Rediger, Mayor ATTEST: ehaf_ Lfel Bruce Taylor, Deputy City Clerk /4� i �. G'',4 ymi IVB' U1Y- '�• ` BID OPENING REPORT BIDS WERE OPENED ON May 12 2017 AT 2:00 P.M FOR Runway 2-20 OverlaV and Rehabilitation PRE-BID ESTIMATE $851,621.34 CONTRACTOR ADD1 BOND AMOUNT ✓ ✓ Ancv Povinn (:n 0?) 131 �- 2. ASA Asphalt —6D 4 L 7 1 SIGNED DATE v �� THE ABOVE BID AMOUNTS HAVE NOT BEEN CHECKED. THE BID TOTALS ARE SUBJECT TO CORRECTION AFTER THE BIDS HAVE BEEN COMPLETELY REVIEWED. CMT May 18, 2017 Mr. Bruce Loy Airport Manager Cape Girardeau Regional Airport 860 Rush Limbaugh Drive Scott City, MO 63780 Re: Cape Girardeau Regional Airport Runway 2-20 Overlay and Rehabilitation State Project No. 16-077A-1 CMT Project Number., 17405-01-06 Recommendation to Award Dear Mr. Loy, We have reviewed the information on the bids received on May 12, 2017 for the above referenced project. Based upon our review of the bid proposals, the lowest responsible bidder is: Apex Paving Co. 1208 S. Kingshighway Cape Girardeau, MO 63703 As of this date, Apex Paving Co. is not debarred, suspended, or otherwise ineligible to participate in a project funded with federal money. Therefore, based upon the Tabulation of Bids and the available budget, CMT recommends that the contract for the above referenced project be awarded to Apex Paving Co. in the corrected amount of $698,131.20. We are submitting with this letter the Tabulation of Bids, a review of the bidding process, and Bid Proposal from Apex Paving Co., along with a copy of their Bid Bond. Upon the City concurrence, please send these documents along with the enclosed cover letter to MoDOT for their formal review at the following address: Via U.S. Mail Via UPS/FedEx Mr. Darrell Goth Mr. Darrell Goth Missouri Department of Transportation Missouri Department of Transportation MoDOT Aviation Section MoDOT Aviation Section P.O. Box 270 105 West Capitol Ave. Jefferson City, MO 65102 Jefferson City, MO 65101 Crawford, Murphy & Tilly Centered in Value Gateway towor One Memonal onva suite Soo St. LOInS. Mesnun 63101 vnoN6 3 ia.J3rs50o PAX 3ta.436.0133 cv.tanq..co,n [utt;nee.z aan cu,,.:ultanrc Mr. Bruce Loy May 18, 2017 Page 2 of 2 Once MoDOT gives their authorization to award, I will send you a copy of the Notice of Award that will need to be sent to the contractor. If you have any questions, do not hesitate to contact me at 314571-9077 or by e-mail at bhutseIKZDcmtengr.com. I am also e -mailing you an electronic copy of the letter for you to send to MoDOT in the event that you would like to make changes. Sincerely, CRAWFORD, MURPHY & TILLY, INC. ;< /i// H, Tom Morris, P.E. Project Engineer Enclosures: Cover Letter, Tabulation of Bids, Bid Proposal from Apex Paving Co., Bid Bond CC: Mr. Darrell Goth. — MoDOT Aviation (PDF copy) Brian Hutsell, PE—CMT, Inc. Crawford, Murphy & Tilly Centered in Value Gateway Tower one Memonal ur,ve Aute Ow SL LOWS. M, 10, ,, 63204 PHONE 31a.- 30.SSOO FA% 3]d [36.0743 eminnpgcnm Fnginaerz. qn(1 cO,i Jtants MAY. 12, 2017 Bid Tabulation Gape Girardeau Regional A MOA RUNWAY b20 OVERLAY AND REI4ABUTATION Gape G'valeeae. Mise.. Peapvee ay: Cie.M m.MWavpOryn.e.ga.I6neV 4MF OD%k CMT NlA WA Gant 1u 60rsbun 63103 131i)[3¢d500 Prpq(f ane [m.w:ariu Yee 4ae0M Yee Yee AekhtlWea Acmce.eM In.rW wryewanmuo�br�rnmmpay.arymaawermarvws«.++n. tn.n¢wl.uvmw smmmrnouelxamndgprowavrnce. Yaf Yea W Prtasa4finMw4vamaaWlp.aaanaunwnu llrmmoxpeNullen. 6Vmry: &,W M/AaaCR Ne �� spvurrw Mnl. Yu Y. BY TnM45 W. Mmk. P E-hw/IIXC. MWp"y8T,1y. lY OaaprvBNEn9=ni WPE1. M60E631 Sfi5'alim Sa50553" cele. Engnmm311MA}TI' .1o..04 .1o.W .10 WOM eua BiET,nal PFWect GartlEn,mtleE1: 39466MA6 .1.1.111 AT.., UPaatm: Wa017 CITY Of CAPE GIRARDEAU OFFICE OF THE AIRPORT MANAGER NOTICE OF AWARD Cape Girardeau Regional Airport Cape Girardeau, Missouri State Block Grant No. 16-077A-1 RUNWAY 2-20 OVERLAY AND REHABILITATION TO: Apex Paving Company 1208 South Kingshighway P.O. Box 637 Cape Girardeau, Missouri 63702 The City of Cape Girardeau, Missouri having considered the bids submitted for improvements to the Cape Girardeau Regional Airport for the Runway 2-20 Overlay and Rehabilitation in accordance with the Contract Documents and your Proposal, and it appearing that your bid of Six Hundred Ninety Eight Thousand, One Hundred Thirty One Dollars and Twenty Cents ($698,131.20) for the Base Bid, is fair and equitable, and in the best interests of the City of Cape Girardeau, and having authorized the work to be performed, the said bid is hereby accepted at the bid prices contained herein. In accordance with the terms of the contract documents, you are required to execute the formal Contract Agreement and furnish the required Performance and Payment Bonds within ten (10) consecutive calendar days from and including the date of this notice. The Bid Bond submitted with your proposal will be returned upon execution of the Contract Agreement and the furnishing of the Performance, and Payment Bonds. In the event you fail to execute the Contract Agreement and furnish the Performance and Payment Bonds, within the time specified, said Bid Bond will be forfeited to the Owner. City of Cape Girardeau By: Date: PROPOSAL FORM CAPE GIRARDEAU REGIONAL AIRPORT RUNWAY 2-20 PARTIAL OVERLAY AND REHABILITATION STATE PROJECT NO. 16-077A-1 PROPOSAL FORM CITY OF CAPE GIRARDEAU State Block Grant Project No. 16-077A-1 TO: Assistant City Administrator The undersigned, in compliance with the request for bids for construction of the following project RUNWAY 2-20 OVERLAY AND REHABILITATION: hereby proposes to furnish all labor, permits, material, machinery, tools, supplies and equipment to faithfully perform all work required for construction of the Project in accordance with the project manual, project drawings and issued Addenda within the specified time of performance for the following prices: BASE BID BID FAA or APPROX. ITEM DESCRIPTION QUANTITY UNIT PRICE EXTENSION ITEM MODOT AND 1 P-105- 1 1.0 LVI.t.ANI CT 2 3.1 MOBILIZATION L Sum �(}}— " 0 d� 00 gO oO OV P-101- PAVEMENT REMOVAL 14,547 5.1 P-101- -2.6, HMA PAVEMENT REMOVAL S.Y. U10 110 2A > 5.1 P 401- — 2.5' HMA ON PCC 628 S.Y. I O 1 � O(D -a' MINERAL AGGREGATE 2,341 A' 8.1 SURFACE COURSE Tons 25 Ob 2Q 2 U P-401- ASPHALT CEMENT 112 Y 8.2 P-603- SURFACE COURSE Tons 12.5 00 I 000 Ob It 5.1 BITUMINOUS TACK 2,276 � WATERBORNE PAINT, Gals. 0 Z � � 1.t� 51lh-((� 00 P 0 -WHITE, WITH 81631 S.F. Ir 5.1-1 REFLECTIVE MEDIA WATERBORNE 5 4 x112 :J -1 S P-620- PAINT, 185 ` EJ 5.1-2 YELLOW, WITHS.F. REFLECTIVE MEDIA 5 25 n (—1 1 IS P-620- WATERBORNE PAINT, 2,.F.539 l 01 9' 5.1-3 BLACK, WITHOUT REFLECTIVE MEDIA L 5 Ob I2,U 00 SP -16.1 TRANSVERSE CRACK 6,000 'D REPAIR L.F. 2c) O° I W, coo OU TOTAL BID (Base Bid) 6 b©lR12, t Zv 17405-01' ACKNOWLEDGEMENTS BY BIDDER 115 Rev. 2/18/16 a. By submittal of a proposal, the BIDDER acknowledges and accepts that the quantities established by the OWNER are an approximate estimate of the quantities required to fully complete the Project and that the estimated quantities are principally intended to serve as a basis for evaluation of bids. The BIDDER further acknowledges and accepts that payment under this contract will be made only for actual quantities and that quantities will vary in accordance with the General Provisions subsection entitled "Alteration of Work and Quantities". b. The BIDDER acknowledges and accepts that the Bid Documents are comprised of the documents identified within the General Provisions. The BIDDER further acknowledges that each the individual documents that comprise the Bid Documents are complementary to one another and together establishes the complete terms, conditions and obligations of the successful BIDDER c. As evidence of good faith in submitting this proposal, the undersigned encloses a bid guaranty in the form of a certified check, cashier's check or bid bond in the amount of 5% of the bid price. The BIDDER acknowledges and accepts that refusal or failure to accept award and execute a contract within the terms and conditions established herein will result in forfeiture of the bid guaranty to the owner as a liquidated damage. d. The BIDDER acknowledges and accepts the OWNER'S right to reject any or all bids. e. The BIDDER acknowledges and accepts the OWNER'S right to hold all Proposals for purposes of review and evaluation and not issue a notice of award for a period not to exceed One Hundred and Twenty (120) calendar days from the stated date for receipt of bids. L The undersigned agrees that upon written notice of award of contract, he or she will execute the contract within thirty (30) days of the notice of award, and furthermore, and provide executed payment and performance,bonds within fifteen (15) days from the date of contract execution. The undersigned accepts that failure to execute the contract and provide the required bonds within the stated timeframe shall result in forfeiture of the bid guaranty to the owner as a liquidated damage. g. Time of Performance: By submittal of this proposal, the undersigned acknowledges and agrees to commence work within ten (10) calendar days of the date specified in the written "Notice to Proceed" as issued by the OWNER The undersigned further agrees to complete the Project within Thirty -Five (35) Calendar days from the commencement date specified in the Notice to Proceed. day h. The undersigned acknowledges and accepts that for each and every Calendar the project remains incomplete beyond the contract time of performance, the Contractor shall pay the non -penal amount of seven hundred fifty dollars ($750.00) per Calendar day as a liquidated damage to the OWNER i. The undersigned prime contractor, if not a MoDOT certified DBE, hereby assures that they will subcontract 0% (zero) percent of the dollar value of the prime contract to DBE firms or make good faith efforts to meet the DBE contract goal. In addition, the prime contractor will include the DBE clauses (see Supplementary Provision No. 6 of the Federal and State Provisions) required by the DBE Program adopted by MoDOT and the Sponsor in all contracts and subcontracts relating to this project. The undersigned will complete the DBE Participation information included herein when a DBE goal has been established, including a demonstration of good faith efforts if the DBE goal is not met. If the undersigned prime contractor is a MoDOT certified DBE firm, then the prime contractor must perform at least thirty percent (30%) of the total contract value work with its own forces, and will receive DBE credit for all work which the prime contractor and any other MoDOT certified DBE firm performs directly. j. The BIDDER, by submission of a proposal, acknowledges that award of this contract is subject to the provisions of the Davis -Bacon Act and the Missouri Prevailing Wage Law. The BIDDER accepts the requirement to pay prevailing wages for each classification and type of worker as established in the attached wage rate determinations as issued by the United States Department of Labor and the Missouri Division of Labor Standards. The BIDDER further acknowledges and accepts their requirement to incorporate the provision to pay the established prevailing wages in every subcontract agreement entered into by the Bidder 17405-01 116 Rev. 2118/16 j PROPOSAL FORM CAPE GIRARDEAU REGIONAL AIRPORT RUNWAY 2.20 PARTIAL. OVERLAY AND REHABILITATION STATE PROJECT NO, 16-mA-1 under this project. The highest rate between the two (Federal and State) for each job classification shall be considered the prevailing wage. k. Compliance Reports (41 CFR Part 60-1.7): Within 30 days after award of this contract, the Contractor/Subcontractor shall file a compliance report (Standard Form 100) if s/he has not submitted a complete compliance report within 12 months preceding the date of award. This report is required if the Contractor/Subcontractor meets all of the following conditions: 1. Contactors/Subcontractors are not exempt based on 41 CFR 60-1,5. ' 2. Has 50 or more employees. 3. Is a prime contractor or first tier subcontractor. 4. There is a contract, subcontract, or purchase order amounting to $50,000 or more L The undersigned acknowledges receipt of the following addenda: Addendum No. dated-5JEA ) -1 Date Received Addendum No. dated Date Received Addendum No. _ dated Date Received Addendum No. _ dated Date Received Addendum No. dated Date Received REPRESENTATIONS BY BIDDER ' By submittal of a proposal (bid), the BIDDER represents the following: a. The BIDDER has read and thoroughly examined the bid documents, including all authorized addenda. b. The BIDDER has a complete understanding of the terms and conditions required for the satisfactory performance of project work. a The BIDDER has fully informed themselves ofthe project site, the project site conditions and the surrounding area d. The BIDDER has familiarized themselves with the requirements of working on an operating airport and understands the conditions that may in any manner affect cosi, progress or performance of the work. e. The BIDDER has correlated their observations with that of the project documents. L The BIDDER has found no errors, conflicts, ambiguities or omissions in the project documents, except as previously submitted in writing to the owner that would affect cost, progress or performance of the work g. The BIDDER is familiar with all applicable Federal, State and local laws, rules and regulations pertaining to execution of the contract and the project work. h. The BIDDER has complied with all requirements of these instructions and the associated project documents. CERTIFICATIONS BY BIDDER a. The undersigned hereby declares and certifies that the only parties interested -in this proposal are named herein and that this proposal is made without collusion with any other person, firm or corporation. The undersigned further certifies that no member, officer or agent of OWNER'S has direct or indirect financial interest in this proposal. b. Certification of Non -Segregated Facilities (41 CFR 'P art 60-1.8) The BIDDER as a potential fedeml]y_assisted construction contractor, certifies that it does not maintain or provide, for its employees, any segegated facilities at any of its establishments and that it does not permit its employees to perform their services at any location under its control, where segregated facilities are maintained• The BIDDER certifies that it will not maintain or provide, for its employees, segregated facilities at any of its establishments and that it will not permit its employees to perform their services at any location 17405.01 117 Rev. 2/18/16 PROPOSAL FORM CAPE GIRARDEAU REGIONAL AIRPORT RUNWAY 2-20 PARTIAL OVERLAY AND REHABILITATION STATE PROJECT NO. 16-077A-1 under its control where segregated facilities are maintained. The Bidder agrees that a breach of this certification is a violation of the Equal Opportunity Clause, which is to be incorporated in the contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms, and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated on the basis of race, color, religion, or national origin because of habit, local custom, or any other reason. The Bidder agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause and that it will retain such certifications in its files. c. Trade Restriction Certification (49 U.S.C. § 50104, 49 CFR Part 30) The submission of an offer, the Offeror certifies that with respect to this solicitation and any resultant contract, the Offeror: 1. is not owned or controlled by one or more citizens of a foreign country included in the list of countries that discriminate against U.S. forms published by the Office of the United States Trade Representative (U.S.T.R.); 2. has not knowingly entered into any contract or subcontract for this project with a person that is a citizen or national of a foreign country included on the list of countries that discriminate against U.S. firms as published by the U.S.T.R.; and 3. has not entered into any subcontract for any product to be used on the project that is produced in a foreign country included on the list of countries that discriminate against U.S. firms published by the U.S.T.R. This certification concerns a matter within the jurisdiction of an agency of the United States of America and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code, Section 1001. The Offeror/Contractor must provide immediate written notice to the Owner if the Offeror/Contractor learns that its certification or that of a subcontractor was erroneous when submitted or has become erroneous by reason of changed circumstances. The Contractor must require subcontractors provide immediate written notice to the Contractor if at any time it learns that its certification was erroneous by reason of changed circumstances. Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance with 49 CFR 30.17, no contract shall be awarded to an Offeror or subcontractor: I. who is owned or controlled by one or more citizens or nationals of a foreign country included on the list of countries that discriminate against U.S. funis published by the U.S.T.R- or 2. whose subcontractors are owned or controlled by one or more citizens or nationals of a foreign country on such U.S.T.R. list or 3. who incorporates in the public works project any product of a foreign country on such U.S.T.R. list. MOM 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 provision. The knowledge and information of a contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 17405.01 118Rev1 . 2/18/16 I !J PROPOSAL FORM CAPE GIRARDEAU REGIONAL AIRPORT RUNWAY 2-20 PARTIAL OVERLAY AND REHABILITATION STATE PROJECT NO. 16-077A-1 The Offeror agrees that, if awarded a contract resulting from this solicitation, it will incorporate this Provision for certification without modification in all lower tier subcontracts. The contractor may rely on the certification of a prospective subcontractor that it is not a firm from a foreign country included on the list of countries that discriminate against U.S. firms as published by U.S.T.R., unless the Offeror has knowledge that the certification is erroneous. This certification is a material representation of fact upon which reliance was placed when malting an award. If it is later determined that the Contractor or subcontractor knowingly rendered an erroneous certification, the Federal Aviation Administration (FAA) may direct through the Owner cancellation of the contract or subcontract for default at no cost to the Owner or the FAA. A. Certification of Offeror/Bidder Regarding Debarment (2 CFR Part 180 (Subpart C), 2 CFR Part 1200, DOT Order 4200.5) By submitting a bid/proposal under this solicitation, the Bidder or Offeror certifies that neither it nor its principals are presently debarred or suspended by any Federal department or agency from participation in this transaction. e. Certification of Lower Tier Contractors Regarding Debarment (2 CFR Part 180 (Subpart C), 2 CFR Part 1200, DOT Order 4200.5) The successful Bidder, by adminiaYPring each lower tier subcontract that exceeds $25,000 as a "covered transaction", must verify each lower tier participant of a "covered transaction" under the project is not presently debarred or otherwise disqualified from participation in this federally assisted project The successful bidder Will accomplish this by: 1. Checking the System for Award Management at website: htm://sam.sov: 2. Collecting a certification statement similar to the Certificate Regarding Debarment and Suspension (Bidder or Offeror), above; and 3. Inserting a clause or condition in the covered transaction with the lower der contract. If the FAA and/or MoDOT later determines that a lower tier participant failed to disclose to a higher tier Participant that it was excluded or disqualified at the time it entered the covered transaction, the FAA and/or MoDOT may pursue any available remedies, including suspension and debarment of the non-compliant participant. L Certification Regarding Lobbying (31 U.S.C. § 1352,2 CFR § 200 Appendix 11(.1), 49 CFR Part 20, Appendix A) The Bidder or Offer certifies by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 17405-01 I. No Federal appropriated funds have been paid or will be paid, by or on behalf of the Bidder or Offeror, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employer of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the award documents for all sub -awards at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients shall certify and disclose accordingly. 119 Rev. 2/18/16 PROPOSAL FORM CAPE GIRARDEAU REGIONAL AIRPORT RUNWAY 2.20 PARTIAL. OVERLAY AND REHABILITATION STATE PROIECr NO. 16-077A4 This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, United States Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for such failure. g. Buy American Certification: (Title 49 U.S.C. § 50 101) The bidder agrees to comply with 49 U.S.C. § 50101, which provides that Federal funds may not be obligated unless all steel and manufactured goods used in ALP -funded projects are produced in the United States, unless the FAA has issued a waiver for the product; the product is listed as an Excepted Article, Material Or Supply in Federal Acquisition Regulation subpart 25.108; or is included in the FAA Nationwide Buy American Waivers Issued List. A bidder or offeror must submit the appropriate Buy America certification included herein with their bid or offer. The Owner will reject as nonresponsive any bid or offer that does not include a completed Certificate of Buy American Compliance. Certificate of Buy American Compliance for Manufactured Products (Non -building construction projects, equipment acquisition projects) As a matter of bid responsiveness, the bidder or offeror must complete, sign, date, and submit this certification statement with their proposal. The bidder or offeror must indicate how they intend to comply. with 49 USC § 50101 by selecting one of the following certification statements. These statements are mutually exclusive. Bidder must select one or the other (i.e. not both) by inserting a checkmark (�) or the letter "W'. Bidder or offeror hereby certifies that it will comply with 49 USC 50101 by: a) Only installing steel and manufactured products produced in the United States; or b) htstallmg manufactured products for which the FAA has issued &waiver as indicated by inclusion on the current FAA Nationwide Buy American Waivers Issued listing; or C) Installing products listed as an Excepted Article, Material or Supply in Federal Acquisition Regulation Subpart 25.108. By selecting this certification statement, the bidder or offeror agrees: 1. To provide to the Owner evidence that documents the source and origin of the steel and manufactured product. 2. To faithfully comply with providing US domestic product. 3. To fiunish US domestic product for any waiver request that the FAA rejects. 4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. - - Bidder or offeror hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC-§ 50101(a) but may qualify for either a Type 3 or Type 4 waiver under 49 USC § 50101(b). By selecting this certification statement, the apparent bidder or offeror with the apparent low bid agrees: 1. To submit to the Owner within 15 calendar days of the bid opening, a formal waiver request and required documentation that support the type of waiver being requested 2. That failure to submit the required documentation within the specified timeframe is cause for a non-responsive determination which may result in rejection of the proposal. 17405-01 120 Rev. 2/18/16 PROPOSAL FORM CAPE GIRARDEAU REGIONAL AIRPORT RUNWAY 2-20 PARTIAL OVERLAY AND RERABILrrAT ION STATE PROJECT NO. 1&077A-1 3. To faithfiilly comply with providing US domestic products at or above the approved US domestic content percentage as approved by the FAA. 4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justifie(. Required Documentation Type 3 Waiver — The cost of the item components and subcomponents produced in the United States is more than 60% of the cost of all components and subcomponents of the "item". The required documentation for a Type 3 waiver is: a) Listing of all product components and subcomponents that are not comprised of 100% US domestic content (excludes products listed on the FAA Nationwide Buy American Waivers Issued listing and products excluded by Federal Acquisition Regulation Subpart 25.108; products of unknown origin must be considered as non-domestic products in their entirety). b) Cost of non-domestic components and subcomponents, excluding labor costs associated with final assembly at place of manufacture. C) Percentage of non-domestic component and subcomponent cost as compared to total "item" component and subcomponent costs, excluding labor costs associated with final assembly and at place of manufacture. Type 4 Waiver — Total cost of project using US domestic source product exceeds the total project cost using non-domestic product by 25%. The required documentation for a Type 4 waiver is: d) Detailed cost information for total project using US domestic product. e) Detailed cost information for total project using non-domestic product. False Statements; Per 49 USC § 47126, this certification concerns a matter within the jurisdiction of the Federal Aviation Administration and the making of a false, fictitious or fraudulent certification may render the maker subject to prosecution under Title 18; United States Code. NM Dai �7 Date 6, Cam any Name Signature ' 1141 fc nts�(d �Aa s1Q'FA`�" True h. Compliance with the Work Authorization Law (as required by Section 285.530, Revised Statues of Missouri) For all contracts where the total bid amount is in excess of $50,000 (local match in excess of $5,000), the Bidder, by submission of an offer and by signing the Worker Eligibility Verification Affidavit for All Contract Agreements in Excess of $50,000, certifies that it: 1. doe's not knowingly employ any person who is an unauthorized alien in connection with the contracted services; 2. has enrolled and actively participates in a federal work authorization program; A general contractor or subcontractor of any tier shall not be liable under sections 285.525 to 285.550 when such general contractor orsubcontractor contracts with its direct subcontractor who violates subsection I of this section if the contract binding the contractor and subcontractor affirmatively states thatthe direct subcontractor's not knowingly in violation of subsection 1 of this section and shall not henceforth be in such 17405.01 121 Rev. visile PROPOSALFORU CAPE GIRARDEAU REGIONAL AIRPORT - RUNWAY 2-20 PARTIAL OVERLAY AND REHABMZA71ON STATE PRO1ECr NO. 1"77A-1 violation and the contractor or subcontractor receives a sworn affidavit under the penalty of perjury attesting to the fact that the direct subcontractor's employees are lawfully present in the United States. -aezt 17405-01 122 1 i i Rev. 21104 FORM CAPE GIRARDEAU REGIONAL AIRPORT RUNWAY 2-20 PARTIAL OVERLAY AND REHABILITATION STATE PROJECT NO. 16-077A-1 WORKER ELIGIBILITY VERIFICATION AFFIDAVIT FOR ALL CONTRACT AGREEMENTS IN EXCESS OF $50,000 (Local match in excess of $5,000) (for joint ventures, a separate affidavit is required for each business entity) STATE OF - 198 ) ) ss COUNTY OF E\ I Y r On this _� day of PAU 2017_, before me appeared 1LIl �`'°� I'r personally known to me or proved to me on the basis of satisfactory evidence to be a person whose name iIsubscribed to this affidavit, who being by me duly sworn, deposed as follows: ✓ My same is It � i i DAA I and I am of sound mind, capable of making this affidavit, and personally certify the facts herein stated as required by Section 285.530, RSMo, to enter into any contract agreement with the state or any of its political subdivisions to perform any job, task, employment, labor, personal services, or any other activity for which compensation is provided, expected, or due, including but not limited to all activities conducted by business entities: L� A I am the I F [ i tof DLX I A / 1 and I am duly authorized, directed, and/or Ae (bTs n e empowered to act officially and properly on behalf of this business entity. I hereby affirm and warrant that the aforementioned business entity is enrolled in a federal work authorization program operated by the United States Department of Homeland Security, and the aforementioned business entity shall participate in said program to verify information (employment eligibility) of newly hired employees working in connection to work under the within contract agreement. I have attached documentation to this affidavit to evidence enrollment/participation by the aforementioned business entity in a federal work authorization program, as required by Section 285.530, RSMo. In addition, I hereby affirm and wan -ant that the aforementioned business entity does not and shall not knowingly employ, in connection to work under the within contract agreement, any alien who does not have the legal right or authorization under federal law to work in the United States, as defined in 8 U.S.C. § 1324a(h)(3). I am aware and recognize that, unless certain contract and affidavit conditions are satisfied pursuant to Section 285.530, RSMo, the aforementioned business entity may be held liable.under Sections 285.525 though 285.550, RSMo, for subcontractorsthat knowingly employ or continue to employ any unauthorized alien to work within the state of Missouri. I acknowledge that I am signing this affidavit as a free act and deed of the aforementioned business entity and not under duress. t� (Afliant Signature Subscribed and sworn to before me this day of♦m A� 20-0— VIRGINIA G. SMITH - No Public -Notes, g� Ufita�ri� ph1 bTTE IS R1 `7✓ , d My (Notary Public) iq [Documernadon of enrollmenr/part[c[patlon in a federal work authorization program is attached Acceptable enropment and participation documentation consists of dtejoHowing two pages of the E- Verify Memorandum of Understand[ag; (I) A valid, completed copy of the first page identifying the business entity; and (2) A valid copy of die signature page completed and signed by the business entity, die Socia[SecurityAdmin[stration, andthe Deparbnent ofMomeland Security - Verification Division./ 17405-01 123 - Rev. ffi8/16 PROPOSAL FORM CAPE GIRARDEAU REGIONAL AIRPORT RUNWAY 2-20 PARTIAL OVERLAY AND REHABILITATION STATE PROJECT NO. 16.077A.1 DISADVANTAGED BUSINESS ENTERPRISE (DBE) PARTICIPATION The information shown in this section must be completed when a DBE contract goal has been established. The percentage must equal or exceed the DBE contract goal. If the percentage is below the contract goal, then the bidder must submit complete written documentation of good faith efforts taken to meet the DBE contract goal. a. The undersigned submits the following list of DBEs to be used in accomplishing the work of this contract. The work, supplies or services, applicable value and percent of total federal contract each DBE is to perform or furnish is as follows: b. Joint venture with a DBE. The undersigned submits the following list of bid items the DBE prime is responsible for and any items that will be subcontracted out are noted with an asterisk or a similar notation. The work, applicable value and percentage of total federal contract the DBE prime is responsible for are as follows: (A) DBE Name and Address (B) Bid Item Number(s) Or Work Performed (C) Dollar Value of DBE Work �* (D) Percent Applicable to DBE Goal (100%, 60%) (E) Dollar Amount Applicable to DBE Goal (C x D) (F) Percent of Total Contract (C /Total Contract Amount) TOTAL DBE PARTICIPATION $ "Cannot exceed contract amount for given item of work. Trucking services credited at 100% if the DBE owns the trucks or is leasing from a DBE firm Merchant wholesalers (supply) are credited at 60%. Brokered services will only receive credit for fees. (Please reproduce the above sheet if additional space is needed.) 1. 17405-01 124 Rev. 1118/16 p PROPOSAL FORM CAPE GIRARDEAU REGIONAL AIRPORT I _ RUNWAY 2-20 PARTIAL. OVERLAY AND REHABILITATION STATE PROSECT NO. 16-077A-1 THIS EXECUTED PROPOSAL FORM MUST BE SUBMITTED IN THE ORIGINAL BOUND PROJECT MANUAL. SIGNATURE OF BIDDER The undersigned states that the correct LEGAL NAME AND ADDRESS of (1) the individual bidder, (2) each partner or joint venturer (whether individuals or corporations, and whether doing business under a fictitious name), or (3) the corporation (with the state in which it is incorporated) are shown below; that (if not signing with the intention to bind themselves to become responsible and sole bidder) they are the agent of, and they are signing and executing this (as indicated in the proper spaces below) as the bid of a ( ) sole individual ( ) partnership ( ) joint venture corporation, incorporated under the laws of state of [ (166,6 kc ) Executed by bidder this day of Name of individual, all partners or joint venturers: Address of each: doing business under the name of: (If us ng a fictitious name, show this name above in addition to legal names) apjf AVinc 4, pf a corporation, show ih name above) A ST: (SEAL) (Sipature3 Secretary A IMr2,f1 LSm li) Please Orint name Address of principal place of business in Missouri: 6n�C �7 mA,ti�ha� CLPE &AdAdf L , YA6 by6;, (Signature) (Title) 49AL 0b6al, Please print name NOTE: If bidder is doing business under a fictitious name, the bid shall be executed in the legal name of the individual partners, joint ventures, or corporation, with the legal address shown, and registration of fictitious name filed with the secretary of state, as required by sections 417.200 to 417.230 RSMo. If the bidder is a corporation not organized under the laws of Missouri, it shall procure a certificate of authority to do business in Missouri, as required by section 351.572 et seq RSMo. 17405-01 125 Rm. 2/18/16 ANNUAL WORKER ELIGIBILITY VERIFICATION AFFIDAVIT (for joint ventures, a separate affidavit is required for each business entity) STATEOF Miasmrriss ) COUNTY OF Cape Girardeau On the 3rd day of January , 20 17, before me appeared Rick Moody , Affientmeme personally known to me or proved to me on the basis of satisfactory evidence to be a person whose name is subscribed to this affidavit, who being by me duly sworn, stated as follows: • I, the Affiant, am of sound mind, capable of making this affidavit, and personally certify the facts herein stated, as required by Section 285.530, RSMo, to enter into any contract agreement with the state to perform any job, task, employment, labor, personal services, or any other activity for which compensation is provided, expected, or due, including but not limited to all activities conducted by business entities. • I, the Affiant, am the President of Apex Paving Co. and I am duly cif et usmeas name authorized, directed, and/or empowered to act officially and properly on behalf of this business entity. • I, the Affiant, hereby affirm and warrant that the aforementioned business entity is enrolled in a federal work authorization program operated by the United States Department of Homeland Security, and the aforementioned business entity shall participate in said program to verify the employment eligibility of newly hired employees working in connection with any services contracted by the Missouri Highways and Transportation Commission (MHTC). I have attached documentation to this affidavit to evidence enrollment/participation by the aforementioned business entity in a federal work authorization program, as required by Section 285.530, RSMo. • I, the Affiant, also hereby affirm and warrant that the aforementioned business entity does not and shall not knowingly employ, in connection with any services contracted by MHTC, any alien who does not have the legal right or authorization under federal law to work in the United States, as defined in 8 U.S.C. § 1324a(h)(3). • I, the Affiant, am aware and recognize that, unless certain contract and affidavit conditions are satisfied pursuant to Section 285.530, RSMo, the aforementioned business entity may be held liable under Sections 285.525 though 285.550, RSMo, for subcontractors that knowingly employ or continue to employ any unauthorized alien to work within the state of Missouri. • I, the Affiant, acknowledge that I am signing this affidavit as a free act and deed of the aforementioned business entity and not under duress. Affiant Signatur Subscribed and swom to before me in Cape Girardeau—, MO the day and year fust above -written. city(orw;NoPublic state Aa My commission expires: February 28, 2019 (documentation Of enrolhnenUparticfpation in a federal work authorizadon program attached/ VIRGINIA G. SMITH Notary Public - No Seal STATE OF MISSOURI Cape Girardeau County Commission # 150175 My Commlaslon Expiroo; 2/29/2019 M(lyc:= Verify. ... 2-%E�IF1 h aOCVIC O! OM Company ID Number. 188332 THE E -VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANDUM OF UNDERSTANDING ARTICLE i PURPOSE AND AUTHORITY This Memorandum of Understanding (MOU) sets forth the points of agreement between the Department. of Homeland Security (DHS) and Apex (Employer) regarding the Employer's participation in the Employment Eligibility Verification Program (E -Verify). This MOU explains certain features of the E -Verify program and enumerates specific responsibilities of DHS, the Social Security Administration (SSA), and the Employer. E -Verify is a program that electronically confines an employee's eligibility to work in the United States after completion of the Employment Eligibility Verification Form (Form 1-9). For covered government contractors, E - Verify is used to verify the employment eligibility of all newly hired employees and all existing employees assigned to Federal contracts. Authority for the E -Verify program is found in Title IV, Subtitle A, of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L. 104208, 110 Stat. 3009; as amended (8 U.S.C. § 1324a note), Authority for use of the E -Verify program by Federal contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility Verification", of the Federal Acquisition Regulation (FAR) (hereinafter referred to in this MOU as a "Federal contractors) to verify the employment eligibility of certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive Order 12989, as amended. ARTICLE If FUNCTIONS TO BE PERFORMED A. RESPONSIBILITIES OF SSA 1. SSA agrees to provide the Employer with available information that allows the Employer to confirm the accuracy of Social Security Numbers provided by all employees verified under this MOU and the employment authorization of U.S. citizens. 2. SSA agrees to provide to the Employer appropriate assistance with operational . problems that may arise during the Employer's participation in the E -Verify program. SSA agrees to provide the Employer with names, titles, addresses, and telephone numbers of SSA representatives to be contacted during the E -Verify process. 3. SSA agrees to safeguard the information provided by the Employer through the E Verify program procedures, and to limit access to such information, as is appropriate by law, to individuals responsible for the verification of Social Security Numbers and for evaluation of the E -Verify program or such other persons or entities who may be authorized by SSA as governed by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA regulations (20 CFR Part 401). Page 1 of 131E•Veify MDU for EmployerlRevision Date iorMa OF Company F� CY IEA ]LPYfC O MY Company ID Number. 188332 4. SSA agrees to provide a means of automated verification that is designed (in conjunction with DHS's automated system if necessary) to provide confirmation or tentative nonconfinnation of U.S. citizens' employment eligibility within 3 Federal Government work days of the initial inquiry. 5. SSA agrees to provide a means of secondary verification (including updating SSA records as may be necessary) for employees who contest SSA tentative nonconfirmations that is designed to provide final confirmation or nonconfirmation of U.S. citizens' employment eligibility and accuracy of .SSA records for both citizens and aliens within 10 Federal Government work days of the date of referral to SSA, unless SSA determines that more than 10 days may be necessary. In such cases, SSA will provide additional verification instructions. B. RESPONSIBILITIES OF DHS 1. After SSA verges the accuracy of SSA records for aliens through E -Verify, DHS agrees to provide the Employer access to selected data from DHS's database to enable the Employer to conduct, to the extent authorized by this MOU: • Automated verification checks on alien employees by electronic means, and e Photo verification checks (when available) on employees, 2. DHS agrees to provide to the Employer appropriate assistance with operational problems that may arise during the Employer's participation in the E -Verify program. DHS agrees to provide the Employer names, titles, addresses, and telephone numbers of DHS representatives to be contacted during the E -Verify process. 3. DHS agrees to provide to the Employer a manual (the E -Verify User Manual) containing instructions on E -Verify policies, procedures and requirements for both SSA and DHS, including restrictions on the use of E -Verify. DHS agrees to provide training materials on E -Verify. 4. DHS agrees to provide to the Employer a notice, which indicates the Employer's participation in the E Verify program. DHS also agrees to provide to the Employer anti- discrimination notices issued by the Office of Special Counsel for Immigration -Related Unfair Employment Practices (OSC), Civil Rights Division, U.S. Department of Justice. 5. DHS agrees to issue the Employer a user identification number and password that permits the Employer to verify information provided by alien employees with DHS's database. 6. DHS agrees to safeguard the information provided to DHS by the Employer, and to limit access to such information to individuals responsible for the verification of alien employment eligibility and for evaluation of the E -Verify program, or to such other persons or entities as may be authorized by applicable law. Information will be used only to verify the accuracy of Social Security Numbers and employment eligibility, to enforce the Immigration and Nationality Act (INA) and Federal criminal laws, and to administer Federal contracting requirements. 7. DHS agrees to provide a means of automated verification that is designed (in conjunction with SSA verification procedures) to provide confirmation or tentative Page 2 of i91E-VMfy MOU for EnvloyerlRevision Date 10119MB v.ns %d{14,'�-VSA s a �K`Verify Q-YMifY ZS A StAYICY Of ptl5 Company ID Number: 188332 nonconfirmation of employees' employment eligibility within 3 Federal Government work days of the initial inquiry. 8. DHS. agrees to provide a means of secondary verification (including updating DHS records as may be necessary) for employees who contest DHS tentative nonconfirmations and photo non -match tentative nonconfirmations that is designed to provide final confirmation or nonconfirmation of the employees' employment eligibility within 10 Federal Government work days of the date of referral to DHS, unless DHS determines that more than 10 days may be necessary. In such cases, DHS will provide additional verification instructions. C. RESPONSIBILITIES OF THE EMPLOYER 1. The Employer agrees to display the notices supplied by DHS in a prominent place that is clearly visible to prospective employees and all employees who are to be verified through the system. 2. The Employer agrees to provide to the SSA and PHS the names, titles, addresses, and telephone numbers of the Employer representatives to be contacted regarding E -Verify. 3. The Employer agrees to become familiar with and comply with the most recent version of the E -Verify User Manual. 4. The Employer agrees that any Employer Representative who will perform employment verification queries will complete the E -Verify Tutorial before that individual initiates any queries. A. The Employer agrees that all Employer representatives will take the refresher tutorials initiated by the. E -Verify program as a condition of continued use of E - Verify, including any tutorials for Federal contractors if the Employer is a Federal contractor. B. Failure to complete a refresher tutorial will prevent the Employer from continued use of the program. 5. The Employer agrees to comply with current Form 1-9 procedures, with two exceptions: If an employee presents a "List B" identity document, the Employer agrees to only accept "List B" documents that contain a photo. (List B documents identified in 8 C.F.R. § 274a.2(b)(1)(B)) can be presented during the Form 1-9 process to establish identity.) If an employee objects to the photo requirement for religious reasons, the Employer should contact E -Verify at 888-464-4218. If an employee presents a DHS Form 1-551 (Permanent Resident Card) or Form 1-766 (Employment Authorization Document) to complete the Form 1-9, the Employer agrees to make a photocopy of the document and to retain the photocopy with the employee's Form 1-9. The employer will. use the photocopy to verify the photo and to assist DHS with its review of photo non -matches that are contested by employees. Note that employees retain the right to present any List A, or List B and List C, documentation to complete the Form 1-9. DHS may in the future designate other documents that activate the photo screening tool. Page 3 of 131E -Verify MOU for EmployerlRevlsion Date 10728f08 .. - teG�� :�. _ 2-VLTIfY I! .q 58RVf[�O] 7N6 Company ID Number. 188332 6. The Employer understands that participation in E -Verify does not exempt the Employer from the responsibility to complete, retain, and make available for inspection Forms 1-9 that relate to its employees, or from other requirements of applicable regulations or laws, including the obligation to comply with the antidiscrimination requirements of section 2746 of the INA with respect to Form 1-9 procedures, except for the following modified requirements applicable by reason of the. Employer's participation in E -Verify: (1) identity documents must have photos, as described in paragraph 5 above; (2) a rebuttable presumption is established that the Employer has not violated section 274A(a)(1)(A) of the Immigration and Nationality Act (iNA) with respect to the hiring of any individual if it obtains confirmation of the'identity and employment eligibility of the individual in compliance with the terms and conditions of E -Verify; (3) the Employer must notify DHS if it continues to employ any employee after receiving a final nonconfirmation, and is subject to a civil money penalty between $550 and $1,100 for each.failure.to notify DHS of continued employment following a final nonconfirmation; (4) the Employer is subject to a rebuttable presumption that it has knowingly employed an unauthorized alien in violation of section 274A(a)(1)(A) if the Employer continues to employ an employee after receiving a final nonconfirmation; and (5) no person or entity participating in E -Verify is civilly or criminally liable under any law for any action taken in good faith based on information provided through the confirmation system. DHS reserves the right to conduct Form 1-9 compliance inspections during the course of E -Verify, as well as to conduct any other enforcement activity authorized by law. 7. The Employer agrees to initiate E -Verify verification procedures for new employees within 3 Employer business days after each employee has been hired (but after both sections 1 and 2 of the Form 1-9 have been completed), and to complete as many (but only as many) steps of the E -Verify process as are necessary according to the E -Verify User Manual, The Employer is prohibited from initiating verification procedures before the employee has been hired and the Form 1-9 completed. If the automated system to be queried is temporarily unavailable, the 3 -day time period is extended until it is again operational -in order to accommodate the Employer's attempting, in good faith, to make inquiries during the period of unavailability. In all cases, the Employer must use the SSA verification procedures first, and use DHS verification procedures and photo screening tool only after the SSA verification response has been given. Employers may initiate verification by notating the Form 1-9 in circumstances where the employee has applied for a Social Security Number (SSN) from the SSA and is waiting to receive the SSN, provided that the Employer performs an E -Verify employment verification query using the employee's SSN as soon as the SSN becomes available. 8. The Employer agrees not to use E -Verify procedures for pre-employment screening of job applicants, in support of any unlawful employment practice, or for any other use not authorized by this MOU. Employers must use E -Verify for all new employees, unless an Employer is a Federal contractor that qualifies for the exceptions described in Article II.D.1.c. Except as provided in Article ILD, the Employer will not verify selectively and will not verify employees hired before the effective date of this MOU. The. Employer understands that if the Employer uses E -Verify procedures for any purpose other than as authorized by this MOU, the Employer may be subject to appropriate legal action and termination of its access to SSA and DHS information pursuant to this MOU. 9. The Employer agrees to follow appropriate procedures (see Article 111. below) regarding tentative nonconfirmations, including notifying employees of the finding, providing written referral instructions to employees, allowing employees to contest the finding, and not taking Me 'Or iale-veiny M u ror CrtployeJReYWon Date 1029/08 . a,� rDAMYs, .., c;t 1t r,•; N "YY 3F'CVg ri:'•'. : Mefiry, g Company ID Number. 188332 adverse action against employees if they choose to contest the finding. Further, when employees contest a tentative nonconfirmation based upon a photo non -match, the Employer is required to take affirmative steps (see Article III.B. below) to contact DHS with information necessary to resolve the challenge. 10. The Employer agrees not to take any adverse action against an employee based upon the employee's perceived employment eligibility status while SSA or DHS is processing the verification request unless the Employer obtains knowledge (as defined in 8 C.F.R. § 274a.1(p) that the employee is not work authorized. The Employer understands that an initial inability of the SSA or DHS automated verification system to verify work authorization, a tentative nonconfirmation, a case in continuance (indicating the need for additional time for the government to resolve a case), or the finding of a photo non -match, does not establish, and should not be interpreted as evidence, that the employee is not work authorized. In any of the cases listed above, the employee must be provided a full and fair opportunity to contest the finding, and if he or she does so, the employee may not be terminated or suffer any adverse employment consequences based upon the employee's perceived employment eligibility status (including denying, reducing, or extending work hours, delaying or preventing training, requiring an employee to work in poorer'oonditions, refusing to assign the employee to a Federal contract or other assignment, or otherwise subjecting an employee to any assumption that he or she is unauthorized to work) until and unless secondary verification by SSA or DHS has been completed and a final nonconfirmation has been issued. If the employee does not choose to contest a tentative nonconfirmation or a photo non -match or if a secondary verification is completed and a final nonconfirmation is issued, then the Employer can find the employee is not work authorized and terminate the employee's employment. Employers or employees with questions about a final nonconfinnation may call E -Verify at 1-888-464-4218 or OSC at 1-800- 255-8155 or 1-800-237-2515 (TDD). 11. The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section 274B of the INA by not discriminating unlawfully against any individual in hiring, firing, or recruitment or referral practices because of his or her national origin or, in the case of a protected individual as defined in section 274B(a)(3) of the INA, because of his or her citizenship status. The Employer understands that such illegal practices can include selective verification or use of E -Verify except as provided in part D below, or discharging or refusing to hire employees because they appear or sound "foreign" or have received tentative nonconfirmations. The Employer further understands that any violation of the unfair immigration -related employment practices provisions In section 274B of the INA could subject the Employer to civil penalties, back pay awards, and other sanctions, and violations of Title VII could subject the Employer to back pay awards, compensatory and punitive damages. Violations of either section 274B of the INA or Title VII may also lead to the termination of its participation in E -Verify. If the Employer has any questions relating to the anti -discrimination provision, it should contact OSC at 1-800-255-8155 or 1-800-237-2515 (TDD). 12. The Employer agrees to record the case verification number on the employee's Form 1-9 or to print the screen containing the case verification number and attach it to the employee's Form 1-9. 13: The Employer agrees that it will use the information it receives from SSA or DHS pursuant to E -Verify and this MOU only to confirm the employment eligibility of employees as Pepe 6 of 13IE-Verify MOV for Employer!RaYUoll Date 1023/06 .ipy se¢, map M-Venry s- enrrr n n senna ar oxs Company ID Number. 188332 authorized by this MOU. The Employer agrees that it will safeguard this information, and means of access to it (such as PINS and passwords) to ensure that it is not used fog any other purpose and as necessary to protect its confidentiality, including ensuring that it is not disseminated to any person other than employees of the Employer who are authorized to perform the Employer`s responsibilities under this MOU, except for such dissemination as may be authorized in advance by SSA or DHS for legitimate purposes. 14. The Employer acknowledges that the information which it receives from SSA'is governed by the Privacy Act (5 U.S.C. § 552a()(1) and (3)) and the Social Security Act (42 U.S.C. 1306(a)), and that any person who obtains this information under false pretenses or uses it for any purpose other than as provided for in this MOU may be subject to criminal penalties. 15. The Employer agrees to cooperate with DHS and SSA in their compliance monitoring and evaluation of E -Verify, including by permitting DHS and SSA, upon reasonable notice, to review Forms 1-9 and other employment records and to interview it and its employees regarding the Employer's use of E -Verify, and to respond in a timely and accurate manner to DHS requests for information relating to their participation in E -Verify. D. RESPONSIBILITIES OF FEDERAL CONTRACTORS 1. The Employer understands that if it is a Federal contractor subject to the employment verification terms in Subpart 22.18 of the FAR it must verify, the employment eligibility of any "employee assigned to the contract" (as defined in FAR 22.1801) in addition to verifying the employment eligibility of all other employees required to be verged under the FAR. Once an employee has been verified through E -Verify by the Employer, the Employer may not reverify the employee through E -Verify. . a.Federal contractors not enrolled at the time of contract award: An Employer that is not enrolled in E -Verify as a Federal contractor at the time of a contract award must enroll as a Federal contractor in the E -Verify program within 30 calendar days of contract award and, within 90 days of enrollment, begin to use E -Verify to initiate verification of employment eligibility of new hires of the Employer who are working in the United States, whether or not assigned to the contract Once the Employer begins verifying new hires, such verification of new hires must be initiated within 3 business days after the date of hire. Once enrolled in E -Verify as a Federal contractor, the Employer must initiate verification of employees assigned to the contract within 90 calendar days after the date of enrollment or within 30 days of an employee's assignment to the contract, whichever date is later. b. Federal contractors already enrolled at the time of a contract award: Employers enrolled in E -Verify as a Federal contractor for 90 days or more at the time of a contract award must use E -Verify to initiate verification of employment eligibility for new hires of the Employer who are working in the United States, whether or not assigned to the contract, within 3 business days after the date of hire. If the Employer is enrolled in E -Verify as a Federal contractor for 90 calendar days or less at the time of contract award, the Employer must, within 90 days of enrollment, begin to use E -Verify to initiate verification of new hires of the contractor who are working in the United States, whether or not assigned to the contract. Such verification of new hires must be initiated within 3 business days after the date of hire. An Employer enrolled as a Federal contractor in E -Verify must initiate verification of each employee assigned to the Page$of 731E -Verify MOU for EmployerfRevlelon Date IWO= WV;,-+.tf(},g.t��(eV: O!"riv u, p.u-ec _ s Hair - n senv,¢ ae axs Company ID Number. 188332 contract within 90 calendar days after date of contract award or within 30 days after assignment to the contract, whichever is later. C. institutions of higher education, State, local and tribal governments and sureties: Federal contractors that are institutions of higher education (as defined at 20 U.S.C. 1001(a)), State or local governments, governments of Federally recognized Indian tribes, or sureties performing under a takeover agreement entered into with a Federal agency pursuant to a performance bond may choose to only verify new and existing employees assigned to the Federal contract. Such Federal contractors may, however, elect to verify all new hires, and/or all existing employees hired after November 6, 1986. The provisions of Article ILD, paragraphs 1.a and 1.b of this MOU providing timeframes for initiating employment verification of employees assigned to a contract apply to such institutions of higher education, State, local and tribal governments, and sureties. d. Verification of all employees: Upon enrollment, Employers who are Federal contractors may elect to verify employment eligibility of all existing employees working in the United States who were hired after November 6, 1986, instead of verifying only those employees assigned to a covered Federal contract. After enrollment, Employers must elect to do so only in the manner designated by DHS and initiate E -Verify verification of all existing employees within 180 days after the election. e. Form 1-9 procedures for Federal contractors: The Employer may use a previously completed Form 1-9 as the basis for initiating E -Verify verification of an employee assigned to a contract as long as that Form 1-9 is complete (including the SSN), complies with Article II.C.5, the employee's work authorization'has not expired, and the Employer has reviewed the information reflected in the Form 1-9 either in person or in communications with the employee to ensure that the employee's stated basis in section 1 of the Form 1-9 for work authorization has not changed (including, but not limited to, a lawful permanent resident alien having become a naturalized U.S. citizen). if the Employer is unable to determine that the Form 1-9 complies with Article II.C.5, if the employee's basis for work authorization as attested in section 1 has expired or changed, or if the Form 1-9 contains no SSN or is otherwise incomplete, the Employer shall complete a new 1-9 consistent with Article II.C.5, or update the previous 1-9 to provide the necessary information. If section 1 of the Form 1-9 is otherwise valid and up-to- date and the form otherwise complies with Article II.C.6, but reflects documentation (such as a U.S. passport or Form 1-551) that expired subsequent to completion of'the Form 1-9, the Employer shall not require the production of additional documentation, or use the photo screening tool described in Article II.C.5, subject to any additional or superseding instructions that may be provided on this subject in the E -Verify User Manual. Nothing in this section shall be construed to require a second verification using E -Verify of any assigned employee who has previously been verified as a newly hired employee under this MOU, or to authorize verification of any existing employee by any Employer that is not a Federal contractor. 2. The Employer understands that if it is a Federal contractor, its compliance with this MOU is a performance requirement under the terms of the Federal contract or subcontract, and the Employer consents to the release of information relating to compliance with its verification responsibilities under this MOU to contracting officers or other officials authorized to review the Employers compliance with Federal contracting requirements. Page 7 or 131E -Verify MOU for EmployerlRevision Date 1029MB worw.d".4v / ,P -d SVCS -verify. ", Company ID Number: 188332 ARTICLE III REFERRAL OF INDIVIDUALS TO SSA AND DHS A. REFERRAL TO SSA 1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must print the tentative nonconfirmatiori notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the tentative nonconfirmation. 2. The Employer will refer employees to SSA field offices only as directed by the automated system based on a tentative nonconfirmation, and only after the Employer records the case verification number, reviews the input to detect any transaction errors, and determines that the employee contests the tentative nonconfirmation. The Employer will transmit the Social Security Number to SSA for verification again if this review indicates a need to do so. The Employer will determine whether the employee contests the tentative nonconfirmation as soon as possible after the Employer receives it. 3. If the employee contests an SSA tentative nonconfirmation, the Employer will provide the employee with a system -generated referral letter and instruct the employee to visit an SSA office within 8 Federal Government work days. SSA will electronically transmit the result of the referral to the Employer within 10 Federal Government work days of the referral unless it determines that more than 10 days is necessary. The Employer agrees to check the E -Verify system regularly for case updates. 4. The Employer agrees not to ask the employee to obtain a printout from the Social Security Number database (the Numident) or other written verification of the Social Security Number from the SSA. B. REFERRAL TO DHS 1. If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must print the tentative nonconfirmation notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the tentative nonconfirmation. 2. If the Employer finds a photo non -match for an employee who provides a document for which the automated system has transmitted a photo, the employer must print the photo non - match tentative nonconfirmation notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the finding. 3. The Employer agrees to refer individuals to DHS only when the employee chooses to contest a tentative nonconfirmation received from DHS automated verification process or when the Employer issues a tentative nonconfirmation based upon a photo non -match. The Employer will determine whether the employee contests the tentative nonconfirmation as soon as possible P.O. a of 13i E-Vorify MOU for EmPloyOdRaYision OaW 1029/08 NJ�y1v_ :11-a� Cfilvri'i. ,1. �''lrti/ YCI Ag1"i� \�45iC4 R � r w• uif^ iLPSFI' S A ,i� l�'C Verfy SE�VJC3 CT pY5 Company ID Number: 188332 after the Employer receives it. 4. If the employee contests a tentative nanconfirmation issued by DHS, the Employer will provide the employee with a referral letter and instruct the employee to contact DHS through its toll-free hotline (as found on the referral letter) within 8 Federal Government work days. 5. If the employee contests a tentative nonconfirmation based upon a photo non -match, the Employer will provide the employee with a referral letter to DHS. DHS will electronically transmit the result of the referral to the Employer within 10 Federal Government work days of the referral unless if determines that more than 10 days is necessary. The Employer agrees to check the E - Verify system regularly for case updates. 6. The Employer agrees that if an employee contests a tentative nonconfirmation based upon a photo non -match, the Employer will send a copy of the employee's Form 1-551 or Form 1-766 to QHS for review by: Scanning and upioading the document, or Sending a photocopy of the document by an express mail account (furnished and paid for by DHS). 7. The Employer understands that if it cannot determine whether there is a photo match/non-match, the Employer is required to forward the employee's documentation to DHS by scanning and uploading, or by sending the document as described in the preceding paragraph, and resolving the case as specked by the immigration Services Verifier at DNS who will determine the photo match or non -match. ARTICLE IV SERVICE PROVISIONS SSA and DHS will not charge the Employer for verification services performed under this MOU. The Employer is responsible for providing equipment needed to make inquiries. To access the E -Verify System, an Employer will need a personal computer with Internet access. ARTICLE V PARTIES A. This MOU is effective upon the signature of all parties, and shall continue in effect for as long as the SSA and DHS conduct the E -Verify program unless modified in writing by the mutual consent of all parties, or terminated by any party upon 30 days prior written notice to the others. Any and all system enhancements to the E -Verify program by DHS or SSA, including but not limited to the E -Verify checking against additional data sources and instituting new verification procedures, will be covered under this MOU and will not cause the need for a supplemental MOU that outlines these changes. DHS agrees to train employers on all changes made to E - Verify through the use of mandatory refresher tutorials and updates to the E -Verify User Manual. Even without changes to €-Verify, DHS reserves the right to require employers to take Page 9of 13JE-Verify Mou for employerlRevMW Dale lorzsrots ?--•:�-�^•' ••4'- "*• *?A, v��secr? ..,. ¢e �y* Company ID Number. 188332 mandatory refresher tutorials. An Employer that is a Federal contractor may terminate this MOU when the Federal contract that requires its participation in E -Verify is terminated or completed. In such a circumstance, the Federal contractor must provide written notice to DHS. If an Employer that is a Federal contractor fails to provide such notice, that Employer will remain a participant In the E -Verify program, will remain bound by the terms of this MOU that apply to non -Federal contractor participants, and will be required to use the E -Verify procedures to verify the employment eligibility of all newly hired employees. B. Notwithstanding Article V, part A of this MOU, DHS may terminate this MOU if deemed necessary because of the requirements of law or policy, or upon a determination by SSA or DHS that there has been a breach of system integrity or security by the Employer, or a failure on the part of the Employer to comply with established procedures or legal requirements. The Employer understands that if it is a Federal contractor, termination of this MOU by any party for any reason may negatively affect its performance of its contractual responsibilities. C. Some or all SSA and DHS responsibilities under this MOU may be performed by contractor(s), and SSA and DNS may adjust verification responsibilities between each other as they may determine necessary. By separate agreement with DHS, SSA has agreed to perform its responsibilities as described in this MOU. D. Nothing in this MOU is intended, or should be construed, to create any right or benefit, substantive or procedural, enforceable at law by any third party against the United Stater;, its agencies, officers, or employees, or against the Employer, its agents, officers, or employees. E. Each party shall be solely responsible for defending any claim or action against it arising out of or related to E -Verify or this MOU, whether civil or criminal, and for any liability wherefrom, including (but not limited to) any dispute between the Employer and any other person or entity regarding the applicability of Section 403(d) of IIRlRA to any action taken or allegedly taken by the Employer. F. The Employer understands that the fact of its participation in E -Verify is not confidential information and may be disclosed as authorized or required by law and DHS or SSA policy, including but not limited to, Congressional oversight, E -Verify publicity and media inquiries, determinations of compliance with Federal contractual requirements, and responses to inquiries under the Freedom of Information Act (FOIA). G. The foregoing constitutes the full agreement on this subject between DHS and the Employer. H. The individuals whose signatures appear below represent that they are authorized to enter into this MOU on behalf of the Employer and DHS respectively. Page 10 of 131E -Verify MOU for EmployerlRevlsion Date 1012MB W WWe'1°Vffi-vee• ' �p �d�nf J, septi E-Ver ®'1.<s-ti 3=/tRiPV IS P SBmICs a pY.S Company ID Number. 188332 To be accepted as a participant in E -Verify, you should only sign the Employer's Section of the signature page. If you have any questions, contact E -Verify at 888-464-4218. Yplh3!�T Apex r.ti%tiioA: Naftla(VJ asa- T ' ar Print) 1nca�ryslyner, 02106/2009 rgrldKife Date I�E3rfi rit,bfH9imeI64de0tty—rifieafian Qivissiq 1;WI,>>i11.4�{9=v.{siOi1 P$ � e.(P(erse.TyrlB HAM"affy ftBafi 02/06/2009 [gttattlre - - . Date Page 11 of 13JE-Verify MOU for EmployertRevlslon Data 1ol2U10e 9•�*'e•.'.1?.r , % -rbc v? ,�r THE AMERICAN INSTITUTE OF ARCHITECTS AM Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, THAT WE Apex Paving Company P.O. Box 637 Cape Girardeau MO 63702 as Principal, hereinafter called the Principal, and Liberty Mutual Insurance Company 175 Berkeley Street Boston MA 02116 a corporation duly organized under the laws of the State of Massachusetts as Surety, hereinafter called the Surety, are held and firmly bound unto City of Cape Girardeau, 401 Independence Street Cape Girardeau MO 63703 as Obligee, hereinafter called the Obligee, in the sum of Five Percent of Total Bid Dollars ($ 57 of Total Bid for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Cape Girardeau Regional Airport, Runway 2-20 Overlay and Rehabilitation NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and materials furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 11th day of Virginia Smith, Asst. Secretary I n: i i s �. Rick Moodv, Pre ent 2017 AIA DOCUMENT A310 • BID BOND • AIA • FEBRUARY 1970 ED. • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON, D.C. 20006 THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the ads of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. 7590321 Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a Corporation duly organized under the laws of the State of Indiana (herein collectively called the'Companies'), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, all of the city of Hartford state of OT each individually g there be more than one named, Its true and lawful attomey-in-W to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surely obligations, in pursuance of these presents and shall be as binding upon the Companies as it they have bean duly signed by the president and attested by the secretary of the Companies In their own proper persons. IN WITNESS WHEREOF, this Parer of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 10th day of January 2017 0(0(0 apgtNSUea'kA°� 1991eyi °9u S i STATE OF PENNSYLVANIA COUNTY OF MONTGOMERY The Ohio Casualty Insurance Company Liberty Mutual Insurance Company West American Insurance Company By:Ji. , David M. Care , Assistant Secretary EC'b On this 10th day of January , 202, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance O d Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes 2 therein contained by signing on behalf of the corporabons by himself as a duly authorized officer. A y > IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first soon • wwyrriitteenn. , i'+ R p poet COMMONWEALTH OF PENNSYLVANIA f'.O/ a Wp�o e�FC� Notarial Seal C'— ti u s v Teresa Faslane. Notary Public By; toy or upper Marion Twp., Mo+e9cmery county Teresa Postage, Notary Public C .y� My Commission Expires March 28, 2017 M O -{!). YP mB r.PMnsywar+OATswasan MNManet 9 pu" C M This Power of Attorney is made and executed pursuant to and by authority of ate following By-laws and Authorizations of The Ohio Casually Insurance Company, Liberty Mutual y" �`, Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: m �Q ARTICLE IV -OFFICERS -Section 12. Power ofAnomey. Any officer mother official of the Corporagon authorized for that purpose in writing by the Chairman or the President, and subject ; l to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, sea, o c acknowledge and deliver as surety any and all undertakings,bonds, recognizances and other surety obligations. Such attorneys+n-fact, subject to the limitations set forth in their respective E si powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as g signed by the President and attested to by the Secretary. Any power of authority granted to any representative or allomey-in-fact under M T the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. .1 C ARTICLE XIII - Execution of Contracts - SECTION 5. Surety Bonds and undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, > 2 and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, p 3 seal, acknowledge and deliver as surety any and ail undertakings, bonds, recognizances and other surely obligationhs. Such attorneys -in -fact subject to the limitations set forth in Heir Z Ls respective pavers of attorney, shall have full power to bind the Company by their signature and execution of any such Instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, sea, acknowledge and deliver as surely any and all undertakings, bonds, reoognizances and other surety obligations. Authorization - By unanimous consent of the Company s Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Lleweltyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and Vest American Insurance Company do hereby comfy that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and affect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals d said Companies this I ( day of , 20 -Ll— J�IY INSL�ON'U44��By:Renee C. Lk Iplt!AssiNard Secretary nL-L76i:e LMS -12613_082316 Liberty LIBERTY MUTUAL INSURANCE COMPANY MLttllal. FINANCIAL STATE\IF-NT — DECEDIBER 31, 2015 SURETY Assets Liabilities Cash and Bank Deposits ......................................... $753,038.641 Unearned Premiums................................................ $6,580,520.311 'Bonds— U.S Government ..................................... 1,547,613,446 Reserve for Claims and Claims Expense................. 16,917,138,677 `Other Bonds............................................................ 11,088.162,545 Funds Held Under Reinsurance Treaties ................. 210,794,503 Reserve for Dividends to Policyholders .................. 358,033 'Stocks ...................... .._........................................... 9.919,835,033 Additional Statutory Reserve.................................. 29.659,093 Real Estate.............................................................. 295,926,247 Rescme for Commissions, Taxes and Agents' Balances or Uncollected Premiums........... 4,487,501,643 Other Liabilities ................................................ 2JK478276 Accrued Interest mrd Rents ..................................... 120.872.424 Total ................. ........................ .................... S26,527.948,893 Special Surplus Funds ................. $67,890,944 Other Admitted Assets .............................................. 14.130.266.527 Capital Stock ............................... 10,000,000 Paid in Surplus ............................ 8,829,183,823 Unassigned Surplus.....................6,908,192,846 Total Admitted Assets.....................................c.l .u2 s Lfi.Sml. Surplus to Polleyholden ............................... 15.815.267.613 Total Liabilities and Surplus .......... _.................... S42,341.2 16,506 M1 ^ ,NSURR4 e ^„ • Bonds are stated at amortized or investment value; Stocks at Association Market Values. isiz °s The foregoing financial information is taken from Liberty Mutual Insurance Company's financial e�4rK �'i statement tiled with the state of Massachusetts Department of Insurance. 1, TIM MIKOLAJEWSKI, Assistant Secretary of Liberty Mutual Insurance Company, do hereby certify that the foregoing is a we, and correct statement of the Assets and Liabilities of said Corporation, as of December 31, 2015, to the best army knowledge and belief. IN WITNESS WHEREOF, I hale hereunto set my hand and affixed the seal of said Corporation at Seattle, Washington, this 15th day of Much, 2016. Assistant Secretary 618 mjcla3,516