HomeMy WebLinkAboutRES.2625.06-20-2011 1 ...
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� �`��Morris 8
�ry� Munger AGREEMENT
�'�� Recrsed 9I10l1t9.ModiGed i/19/I 1
-' SECTION 00520 - AGREEMENT
, T-H-1��6}�E�-MEiV-T-is dat�d as of ehg ��—day of _--�3t�1�{ --— --Tn-t}�e year�d-#1 {�y-and betweert-ttr�Git��F
; Cape Girardeau, Missouri (hereinafter called OWNER)and Jokerst, I nc. (hereinafter called
CONTRACTOR).
x>; .
Owner and Contracror; in considerahon of the mutual covenants set forth herein,agree as follows:
ARTICLE 1 - ���ORK
1.01 Contractor shall complete all Work as specified or indicated in the Contract Documents. The Work is generally
described as follows:
The stabilization of Breckenridge Branch through the use of concrete block retaining walls, rip-rap,grade control
structures;and cleaning out the stream. This includes the relocation of storm sewer lines near the stream.
ARTICLE 2 - ENGINEER
2.01 The City Engineer or his designee is to act as OWNER'S representative,assume a11 duties and responsibilities and
have the rights and authority assigned to ENGINEER in ihe Contract Documents in connec[ion with completion of the
Work in accordance with the Contract Documents.
ARTICLE 3-CONTRACT T►MES
3.01 Days to Achieve Substantial Completion and Final Payment
A. The Work will be substantially completed within 90 calendar davs after the date when the Contract Times commence
. to run as provided in Paragraph 2.03 of the General Conditions, and completed and ready for final payment in
accordance with Paragraph 14.07 of the General Conditions within 15 davs after the date when the Contract Times
commence to run.
3.02 Liq�idated Damages
A. Contractor and Owner recognize that time is of the essence of this Agreement and that Owner will suffer financial
loss if the Work is not completed within the times specified in Paragraph 3Al above, plus any extensions thereof
allowed in accordance with Article 12 of the General Conditions. The parties also recognize the delays,expense, and
difficulties involved in proving in a legal or arbitration proceeding the actual loss suffered by Owner if the Work is
not completed on time. Accordingly, instead of reyuiring any such proof, Owner and Contractor agree that as
• liquidated damages for delay (but not as a penalty), Contractor shall pay Owner $700 per day per Missouri
- Department of Transportation charts.
ARTICLE 4- CONTRAC7� PR10E
4.01 Owner shall pay Contracror for completion of the Work in accordance with the Contract Documents an amount in
current funds equal to the sum of the amounts determined pursuant to Paragraphs 4.Ol.A and 4.OI.B below:
A. For all Work other than Unit Price Work,a Lump Sum as indicated in the bidding documents.
. B. For all Unit Price Work, an amount equal to the sum of the established unit price for each separately identified item of
Unit Price Work times the estimated quantity of that item as indicated in the bidding documents.
As provided in Paragraph 11.03 of the General Conditions, estima[ed quantities are not goaranteed, and
, determinations of actual quantities and classifications are to be made by Engineer as provided in Paragraph 9.07 of the
I General Conditions. Unit prices have been computed as provided in Paragraph ]1.03 of the General Conditions.
BRECKENRIDGE BRANCH STAB]LIZATION —Morris& Munger Engineers## 2009-25 00520- 1
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. �'';�Morris� • � ,
j��1lunger AGREEMENT
. ._.._ � Recised 9/lu/09.�todifed 1/l9/I I
. ARTICLE 5- PAYMEIVT PROCEDURES
5.01 Submittal and Processing of Payments
A. Contractor shall submit Applications for Payment in accordance with Article 14 of the General Conditions.
Applications for Payment will be processed by Engineer as provided in the General Conditions.
5.02 Progress Payments; Retainage
A. Owner shali make progress payments on account of the Contract Price on the basis of Comractor's Applications for
Payment as recommended by Engineer, on or about the 10'h day of each month during performance of the Work as
provided in Paragraphs 5.02.A.1 and 5.02.A.2 below. All such payments will be measured by the schedule of values
established as provided in Paragraph 2.07.A of the General Conditions (and in the case of Unit Price Work based on
the number of units completed) or, in the event there is no schedule of values, as provided in the General
Requirements.
l. Prior to Substantial Completion, progress payments will be made in an amount equal to the percentage indicated
below, but, in each case, less the aggregate of payments previously made and less such amounts as Engineer may
determine,or Owner may withhold in accordance with Paragraph 14.02 of the General Conditions:
a. 90 percent of Work completed (with the balance being retainage). If the Work has been 50 percent
completed as determirred by Engineer, and if the character and progress of the Work have been satisfactory to
Owner and Engineer, Owner, on recommendation of Engineer, may determine that as long as the character
and progress of the Work remain satisfactory to them, there will be no additional retainage on account of
Work completed, in which case,ihe remaining progress payments prior to Substantial Completion will be an
amount equal to ]00%of the Work completed.
b. 90 percent (with the balance being retainage) of materials and equipment not incorporated in the Work (but
delivered, suitably stored and accompanied by documentations satisfactory to OWNER as provided in
paragraph 142 of the General Conditions).
2. Upon Substantial Completion, in an amount sufficient to increase total payments to CONTRACTOR to 95
: percent of the Contract Price (with the balance being retainage), less such amounts as ENGINEER shall
� determine,or OWNER may withhold, in accordance with paragraph 14.04 of the General Conditions.
5.03 Final Payment
A. Upon final completion and acceptance of the Work in accordance with Paragraph 14.07 of the General Conditions,
Owner shall pay the remainder of the Contract Price as recommended by Engineer as provided in said Paragraph
14.07.
ARTICLE 6- INTEREST
6.01 All moneys not paid when due as provided in Article 14 of the General Conditions shall bear interest at the maximum
rate allowed by law at the place of the Project.
ARTICLE 7—CONTRACTOR'S REPRESENTATIONS
7.01 In order to induce Owner to enter into this Agreement Contractor makes the following representations:
A. Contractor has examined and carefully studied the Contract Documents and the other related data identified in the
Bidding Documents.
B. Contractor has visited the Site and become familiar with and is satisfied as to the general, local, and Site conditions
that may affect cost,progress,and performance of the Work.
00520-2 BRECKENRIDGE BRANCH STABILIZATION—Morris&Munger Engineers#2009-25
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�`��A'IOfC1S�
;j���tunyer AGREEMENT
- Rerised Y/10!(ry.ModiGed I/19/I I
' C. Contractor is familiar with and is satisfied as to all federal, state,and local Laws and Regulations that may affect cost,
progress; and performance of ihe Work.
; D. Contractor has carefuliy studied aIL- (1) reports of explorations and tests of subsurface conditions at or contiguous to
the Site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or
contiguous to the Site(except Undergro�nd Facilities)which have been identified in the Supp)ementary Conditions as
# provided in Paragraph 4.02 of the General Conditions and (2) reports and drawings of a Hazardous Environmental
- Condition, if any,at the Site which has been identified in the Supplementary Conditions as provided in Paragraph 4.06
of the General Conditions.
E. Contractor has obtained and carefully studied (or assumes responsibility for doing so) all additional or s�pplementary
examinations, investigations, explorations, tests, studies, and data concerning conditions (surface, subsurface, and
Underground Facilities) at or contiguous to the Site which may affect cost, progress, or performance of the Work or
which relate to any aspect of the means, methods, techniques, sequences, and procedures of construction to be
employed by Contractor, including any specific means, methods, techniques, sequences, and procedures of
construction expressly required by the Qidding Documents,and safety precautions and programs incident thereto.
F. Contracror does not consider that any further examinations, investigations, explorations, tests, studies, or data are
necessary for the performance of�he Work at the Contract Price, within the Contract Times, and in accordance with
the other terms and conditions of the Contract Documents.
G. Contractor is aware of the general nature of work to be performed by Owner and others at the Site that relates to the
Work as indicated in the Contract Documents.
H. Contractor has correlated the information known to Contractor, information and observations obtained from visits to
the Site, reporis and drawings identified in the Contract Documents, and all additional examinations, imestigations,
explorations,lests,studies, and data with the Contract Documents.
]. Contractor has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that Contractor has
discovered in the Contract Documents,and the written resolution thereof by Engineer is acceptable to Contractor.
J. The Contract Documents are generally sufficfent to indicate and convey understanding of all terms and conditions for
performance and furnishing of the Work.
ARTICLE S - CONTRACT DOCUMENTS
8.01 Contenis
A. The Contract Documents consist of the following:
l. This Agreement(pages 1 to 5, inclusive).
2. Performance,Vayment,and other Bonds.
3. General Conditions.
4. Supplementary Conditions.
5. Specifications as listed in the table of contents of the Project Manual.
b. Drawings consisting of sheets with each sheet bearing the following general title: BreckenridQe Branch
Stabilization.
7. Addenda(numbers 1 to 3 , inclusive).
8. Documentation submitted by Contractor prior to Notice of Award.
9. The following which may be delivered or issued on or afier the Effective Date of the Agreement and are not
attached hereto:
a. Notice to Proceed
b. Work Change Directives
c. Change Order(s)
d. All Written Amendments and other documents amending, modifying, or supplementing the Contract
Documents.
10. The Bid Proposal.
BRECKENRIDGE BRANCH STABILIZATION —Morris& Munger Engineers# 2009-25 00520- 3
� .
� � PAorris& `
.J��Munger AGREEMENT
Re��i<ed 9/IO.�fr9.ModiGed 1/19/I I
1 1. Contractor's Bid.
12. Notice to Proceed.
: _.__. ___ — _ _-13---�NaQe_Raies. __ _ _ _
14. Table of Contents.
15. Invitation to Bid.
16. Instructions and Information Available to Bidders.
17. Basis of Bids.
I8. Bid Bond.
19. Special Bidding Requirements.
20. Administrative Forms.
B. The documents listed in Paragraph 8.OI.A are attached to this �lgrcement (except as expressly noted otherwise
above).
C There are no Contract Documents other than those listed above in this Article 8.
D. The Contract Documents may only be amended, modified, or supplemented as provided in Paragraph 3.04 of the
General Conditions.
ARTICLE 9- MISCELLANEOUS
9.01 Terms
A. Terms used in this Agreement will have the meanings staled in the General Conditions and the Supplementary
Conditions.
9.02 Assignment of Contract
A. No assignment by a party hereto of any rights under or interests in the Contract will be binding on another party hereto
without the written consent of the party sought to be bound; and, specifically but without limitation, moneys that may
become due and moneys that are due may not be assigned without such consent(except to the extent that the effect of
this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an
assignment, no assignment ti�ill release or discharge the assignor from any duty or responsibility under the Contract
Documents.
9.03 Successors and Assigns
A. Owner and Contractor each binds itself, its partners, successors, assigns, and legal representatives to the other party
hereto, its partners, successors, assigns, and legal representatives in respect to all covenants, agreements, and
obligations contained in the Contract Documents.
9.04 Severability
� A Any provision or part of the Contract Documents held to be void or unenforceable under any Law or Regulation shall
, be deemed stricken, and all remaining provisions shall continue to be valid and binding upon Owner and Contractor,
who agree that the Contract Documents shall be reformed to replace such stricken provision or part thereof with a
valid and enforceable provision that comes as close as possible to expressing the intention of the stricken provision.
10. Contract Price
Owner shall pay Contractor for completion of all Unit Price 'rlork, an amount equal to the sum of
the established unit price for each separately identified item of Unit Price Work times the
estimated quantity of that item as indicated in the 5idding documents
TOTA� OF ALL UNIT PRICES: Two hundred s+xty six thousand five hundred ten do� ;ars and 00/100
00520-4 BRECKENRIDGE BRANCH STABILIZAT]ON—Morris&Munger Engineers#2009-25
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� � Morris 8
���htunger AGREEMENT
Rerised 9/10/09.Modifed I/19/I I
' 1N WITNESS WHEREOF, Owner and Contractor have siened this Agreement in multiple copies. One counterpart each has
been delivered to Owner and Contractor. Ail portions of the Contract Documents have been signed or identified by Owner
_._—_ ___ ---- _ _ ___ -_ _ _ _ _ ___ ___
- —and Cont�acfor or on iheir behalf.
. 7p41
This Agreement will be effective on� ►�J (which is the Effective Date of the Agreement).
_.;
OWNER: -,� CON"I'RACTOR:
�
Cit of Ca e G� ardeau Jokerst, I nc.
. �y: By:o��,m I�c�-,-.�1 LYIVN M. scxxEMP
�
Titie: � Title: VICE PRESIDENT
�' ��9�,
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� � �� f� ����� �`� ,.. c
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� ' cr�.�, ���•ao,�o -
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�t*,sl _ . . ..\ e � ,t wf .�i , . -y. � .
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7',:.A . ' p�. � . $ : �
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(,[CORPORA"TE r`� � ORPORATE `E;�1.� ':. � rry'� �'.
Attest: •��� f ti- /Attest: ��lyl �"//. �(�U- , :� `'d`.� ° �%Q
.�;�. '>' �-�.-3 . �`
ay= �-'�K'�' �-• WYtr2c� _` By: KIM M. WEILER ' . Ja``,y~y`
� ���
Title: � GQ� Title: CORPORATE SECRETARY '
Address for giving notices: Address for giving notices:
401 Indepe�dence 16444 HIGHWAY 32
Cape Girardeau,MO 63701 STE. GENEVIEVE, M0. 63670
License No-
QfOWner is a corporaUon,anach evidence of authoriry to sign (Where app�ICab�C�
If Owner is a public body, attach evidence of authonry to sign
and resoluuon or other documents authorizing execution of
O��ner-Contractor Agreement)
Agent for service or process:
(If Contractor is a corporation or a partnership,
attach evidence of authority to sign.)
END OF SECTION 00520
BRECKENRIDGE BRANCH STABILIZATION -Morris& Munger Engineers # 2009-25 00520- 5
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; j�PAOtfIS�
:�l�
N►un9er BID PROPOSAL
IRevised 3/23/Ofi.Modif ed I/19/1 I
SECTION 00300 — BID PROPOSAL
IProposal of JOKERST, INC.
(doing business as a corporation/a partnership/an individual--indicate which)
i - (hereinafter called "Bidder")
�
To CITY OF CAPE GIRARDEAU, MO
( (hereinafter called "Owner")
Gentlemen:
( The Bidder, in compliance with your invitation for bids for Breckenridge Branch Stabilization having
examined the plans and specifications with related documents and the site of the proposed work, and
I being familiar with all the conditions surrounding the construction of the proposed project including the
availability of materials and labor, hereby proposes to furnish all materials and suppiies; in accordance
with the Contract Documents, within the time set forth therein, and at the prices stated below. These
prices are to cover all expenses incurred in performing the work required under the Contract Documents,
of which this proposa) is a part.
Bidder agrees that the Work will be substantially complete and ready for finat payment in accordance
with the General Conditions on or before the dates or within the number of calendar days indicated in
the Agreement.
Bidder further agrees to the conditions and amounts of Liquidated Damages in accordance with the
Gener�l Conditions and as indicated in the Agreement.
I
I The Bidder acknowledges receipt of the following addenda:
ADDENDUM N0. 1 - MAY 16 2011
ADDENDUM N0. 2 - MAY 25, 2011
, ADDENDUM N0. 3 - MAY 31, 2011
� Bidder agrees to perform all the work described in the Contract Documents for the prices shown on the
attached Bid Schedule.
� The Bidder understands that the quantities given in the attached Bid Schedule are not guaranteed by the
Owner and are used solely for the purpose of comparing bids and awarding the contract, and may or
may not represent the actual quantities encountered on the job; and that the sum of the products of the
quantities listed in the attached Bid Schedule, multiplied by the unit price bid shall constitute the gross
sum bid. Partial payments after the award of the contract will be based on measured in place quantities
where measurable units are given in the Bid Schedule.
'I,he Bidder understands that the Owner reserves the right to reject any or all bids and to waive any
informalities in the bidding. The Bidder also understands that the Owner reserves the right to increase
c�r decrease the amount and type of work to be done.
IjRf:CKENRIDGE BRANCH STABILIZATION—Morris&Munger Engineers#2009-25 00300- 1
hlorris� BID SCHEDULE � �
Nlunger Revised 5-25-11
Base Bid Proposal Form (revised 5-25-11)
No Description Unit Est Qnty Unit Price Subtotal
1 Mobilization LS 1 $ 17,000.00 $ 17,000.00
2 Pre-Cast Concrete Blocks(p�o��deabyoWner) EA SSO $ 100.00 � 55,000.00
3 Pre-Cast Concrete Cap Blocks (Pro�sdea by owner) EA 180 $ 60.00 $ 10,800.00
4 1 1/2 Inch Clean Crushed Stone TON 650 $ 20.00 $ 13,000.00
5 42 Inch Chain Link Fence LF 460 $ 20.00 $ 9,200.00
6 48 Inch Corrugated Metal Pipe LF 75 $ 75.00 $ 5,625.0��
7 8 Inch SDR35 PVC Pipe LF 150 $ 110.00 $ 16,500.00
8 SCH40 PVC Pipe(Size Varies) LF 150 $ 20.00 $ 3,000.00
9 8 Tnch Ductile Iron Pipe LF 50 $ 50.00 $ 2,500.00
10 Standard Manhole EA 1 $ 2,000.00 $ 2,000.00
11 Doghouse Manhole EA 1 $ 5,000.00 $ 5,000.00
12 Type II Rip-Rap TON 1850 $ 25.00 $ 46,250.00
13 Type III Rip-Rap TON 160 $ 20.00 $ 3,200.00
14 Type N Rip-Rap TON 100 $ 20.00 $ 2,000.00
15 River Gravel (2-4" Dia.) TON 250 $ 25.00 $ 6,250.00
16 Grade Control Boulders TON 100 $ 70.00 $ 7,000.00
17 Geotextile(Wall Separation) SY 1700 $ 2.25 $ 3,825.00
18 Geotextile(Rip-Rap) SY 2000 $ 2.50 $ 5,000.00
19 Bulk Cut LS 1 $ 12,000.00 � 12,000.00
20 Asphalt Pavement Replacement SY 330 $ 42.00 $ 13,860.00
21 A_sphalt Curb LF 300 Q 20.00 � 6,000.00
22 Not Used *�* ****�* ************** ***�**�r*��*��x>
23 Seeding SY 5000 $ $
1 .0� 5,���.��
24 Ninebark Shrubs EA 50 $ 100.00 $ 5,000.00
25 "I'ree and Brush Removal LS 1 $ 11,000.00 $ 11,000.00
26 Ditch Check at Mt. Auburn Box Culvert LS 1 500.00 500.00
TOTAL CONTRAC,T PRICE: $ 266,510.00
TWO HUNDRED SIXT'Y SIX THOUSAND FIVE HUNDRED TEN DOLLARS AND NO/100
(;n Woras>
By � �� �� LYNN M. SCHREMP/VICE PRES
(signature)
(print)
BRECKENRIDGE BRANCH STABILIZATION—Morris& Munger Engineers #2009-25 00300a- 1
i . ` �
,`; ��lorris&
J1a�60ge� BID PROPOSAL
The Bidder a rees that this bid shall be ood and ma not be withdrawn for a eriod of sixd}z3�OModifed I/19/11
I g g Y P n' ( 1
calendar days after the scheduled closing time for receiving bids.
I 6/7/11 9:00 AM
Sealed proposals will be received at the Office of Finance until at for the Breckenridge
<.a�ch Stabilization. All bidders are required to purchase plans and specifications from the Owner to
submit a bid for this project. Proposals will be publicly opened and read aloud on 6/7/11 at 9:00 AI��
the Finance Office at City Hall.
Upon receipt of written notice of the acceptance of this bid, the Bidder will execute the attached formal
contract within fifteen (15)days and deliver a Surety Bond or Bonds as required by the General
Conditions.
The bid security attached in the sum of S% OF BID AMOUNT
($ ) is to be immediately
forfeited to the Owner, in the event the contract and bond are not executed within the time above set
forth, as liquidated damages for the delay and additiona] expense to the Owner caused thereby.
� Respectfully submitted:
I
Bidder: JOKERST, INC. '
�� Signature: � � �
Tit1e: VICE PRESIDENT
; .AddresS: 16444 HIGHWAY 32 STE. GENEVIEVE, M0. 63670
;r ���a;, ' :� �
4,.°'��� ,,n,�k�qne 'A.; {573)883-7401
4 � ��� -�f '-
`tc a \
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f�s ( �L `�yF�id is by a corporation)
,��� �. � � �� y
. ^ j� �, ^a b f�,�;v
;�. � �: .�,��.
,rA",��, ;�:
'�"°`�°'`-',`�° END OF SECTION 00300
_ q .
Attached are the following Bid Schedules:
Base Bid
00300- 2 BRECKENRIDGE BRANCH IMPROVEMENTS—Morris&Munger Engineers#2009-25
�� -
, � �
� � �� ,� City of Cape Girardeau
.
�,�<r.:. X �:-:� _,_ -- , ��{,., Public Works Department
2007 Southern Expressway, Cape Girardeau, Missouri 63703
� � Phone (573) 339-6351 Fax (573) 339-6363
� �
BRECKENRIDGE BRANCH STABILIZATION PROJECT
Addendum No. 1
To the Bid Documents
May 16, 2011
The following changes/modifications are made to the Bidding Documents. Bidders are
instructed to note the changes and use the replacement pages as described:
�'Changes to the Specification Book
Addendum Item# 1 —Basis of Bids Page 00290 -2
1.2.F 48 in CMP. Add the following sentence at the end of paragraph 1: At the completion
of the project the Contractor is to remove the 48 inch CMP and deliver the pipe to the storage
site specified by the Owner.
Addendum Item #Z - Basis of Bids Page 00290 -3
1.2.S Bulk Cut. Delete the text of Paragraph 2 and replace with : "2. Method of Payment:
Lump Sum"
Addendum Item # 3 - Basis of Bids Page 00290 -3
1.2.V Native Trees. Delete this item V in its entirety and replace with : "V. Not Used"
Addendum Item # 4 - Bid Proposal page 00300a-1
Remove this page and replace with new page 00300a-1 contained in this Addendum packet.
Addendum Item # 5 - Wage Rates page 00830-1
1.1 D 1. Delete the words "Wage Order No. 16 , Section 012 Cape Girardeau County, revised
3/2009" and replace with "Wage Order No. 17 Section 012 Cape Girardeau County, revised
4/2010".
Addendum Item # 6 - Wage Rates page 00830-2
In the list of attachments change the second reference from "Wage Order No. 16" to "Wage
Order No. 17"
Breckenridge Branch Stabilization Project Page 1 of 2
Addendum No. i
Addendum Item # 7 —Sec. 02300 Earthwork 02300-2
1.2 Unit Prices. Delete the words "Unit Prices" and replace with "Not Used". Delete
Paragraphs A, B, C, D entirely.
Addendum Item# 8 — Sec. 02300 Earthwork, page 02300-8
3.18 Disposal of Surplus and Waste Materials. Delete all of paragraph A and sub paragraph
1 and replace with " A. Proper and legal disposal of surplus and waste materials will the
responsibility of the Contractor."
Addendum Item # 9 — Sec. 02310 Excavating and Backfilling Trenches, page 02300-10
3.21 Disposal of Surplus and Waste Materials. Delete all of paragraph A and sub paragraph 1
and replace with " A. Proper and legal disposal of surplus and waste materials will the
responsibility of the Contractor."
Addendum Item # 10— Sec. 02830 Concrete Block Wall, page 02300-1
Part 2 Materials 2.1 Wall Units. In the Title after the words "Wall Units" add the words
"Supplied by Owner"
Addendum No. 1 Prepared and Approved by
f�� � .5- ��_/I
Stan Polivick Date
Stormwater Coordinator
Received and Acknow edged by the Bidder
: �
;� � �,,� S j C'� . r�
Signatu e Date
�W� '�'I . I� .� l(f �
Print Name
Breckenridge Branch Stabilization Project Page 2 of 2
Addendum No. I
, � , � �
� � �• City of Cape Girardeau
[f'Fi4�ietcraYrlru�ir,��,uk•gru�(a�e Public Works Department
�� 2007 Southern Expressway, Cape Girardeau, Missouri 63703
. � Phone (573) 339-6351 Fax (573) 339-6363
'
BRECKENRIDGE BRANCH STABILIZATION PROJECT
Addendum No. 2
To the Bid Documents
May 25,2011
The following changes/modifications are made to the Bidding Documents. Bidders are
instructed to note the changes and use the replacement pages as described:
.Chan�es to the Specification Book
Addendum Item# 1 —Page 00450 -1
Add to the list of attachments to be included in the Bid Package the"Certification Regarding
Debarment" Form. The form is included in the Specification book.
Addendum Item# 2 - Sec. 02300 Earthwork 02300-2
1.2 Unit Prices - Delete Paragraph E. Paragraphs "A" through"D" were deleted in
Addendum No. 1.
Addendum Item# 3 - In Addendum No. 1 Item 9 has a typographical error. The page
number reference is incorrect. The correct page number is 2310-10.
Addendum Item #4 - In Addendum No. 1 Item 10 has a typographical error. The page
nt:mb�r reference is incorrect. T�:e correct �age number is 283Q-?.
Addendum Item # 5 - Sec 02378 Rip Rap and Grade Control Rock page number 02378-1
Part 1, 1.3 B - add the following: "5. The Type II rip rap for the temporary road shall be
removed as the work for the lower wall section on the south bank progresses. The contractor
shall remove this rip rap and haul it to the Owners stockpile site at the east side of the Public
Works Facility at 2007 Southern Expressway. There will be no direct pay for the loading and
transport of the Type II rip rap to the owner's site."
Addendum Item# 6 - Sec 02378 Rip Rap and Grade Control Rock page number 02378-1
Part l, 1.3 C. Method of Measurements - Delete paragraph 1 entirely and replace with the
following: "1. Rip rap and grade control rock will be measured by the ton."
Breckenridge Branch Stabilization Project Page I of 3
Addendum No. 2
Addendum Item# 7—The Bid From Sheet to be used for bid submittal is attached to this
Addendum No. 2. It is a blue sheet. The Bidder is instructed to use the blue sheet for bid
submittal.
Addendum Item# 8 — Supplementary Conditions page 00800-5
Add a new paragraph as follows:
SC 17.07 Work Area Video Recording—The Contractor shall perform the work necessary to
video record the work area before the work commences and after the work is complete. This
shall be done in a DVD format. The owner is to receive a copy of the "before work video"
prior to any work commencing. The video shall be of sufficiently good quality to determine
the conditions of the site at the time of the recording.
Addendum Item # 9—Sec 00290 Basis of Bids page 00290-4
After Item Y add the following: "Z. Item No. 26 Ditch CheEk—Contractor shall provide,
install, and maintain a ditch check near the apron of the wing wall on the box culvert at Mt.
Auburn Road. This can be a commercially made product or shaped from Type II or Type III
rip rap. The purpose of the ditch check is to create a stilling pool where sediment will settle
before leaving the work site."
Addendum Item# 10—Sec �378 Rip Rap and Grade Control Rock page number 02378-1
Part 1, 1.2 products # 8—Delete the text for this item and replace with " Grade Control
Boulders should have dimensions of 3 to 4 feet in length, 18 to 30 inches in height, and 2 to 3
feet in width. Nominal weight should be a minimum of 1000 pounds. SEMO Stone calls this
"Shot Rock. Earthworks calls theirs"weathered limestone". Other supplies may be used;
these two are the ones we know about."
Addendum Item # 11 — Sec 00520 Agreement, page number 00520-1
Article 3 —Contract Times, 3.01 A—in the first line replace the words "90 calendar days"
with "60 calendar days".
General Notes
l. The contract quantity for Type II rip rap is for the temporary stream crossing and
temporary work road installation.
2. Bidders are instructed to prepare their bids in accordance with the construction
�equence that is presented on the drawings Sheet C5. Should complications be
� t: :iltered these will be addressed in the field.
3. The Owner will provide layout for the work. This will consist of two bench marks for
elevation reference, and staking the baseline and stationing.
Breckenridge Branch Stabilization Project Page 2 of 3
Addendum No.2
� r
Addendum No. 2 Prepared and Approved by
��_� -�-
_May 25, 2011
Stan Polivi�ck Date
Stormwater Coordinator
Received and Acknow edged by the Bidder
��,`� �� �'�-�/j/
Signat e Date
� a✓) � . �-r 1�1 `�
Print Name '
Breckenridge Branch Stabilization Project Page 3 of 3
Addendum No.2
Morris$� �
f�un9er BID SCHEDULE
Revised 5-25-11
Base Bid Proposal Form (revised 5-25-11)
No Description Unit Est Qnty Unit Price Subtotal
1 Mobilization LS 1 $ $
2 Pre-Cast Concrete Blocks(pro��dea by oW�er) EA 550 $ $
3 Pre-Cast Concrete Cap Blocks (Pro��dea by oWne�) EA 180 $ $
4 1 1/2 Inch Clean Crushed Stone TON 650 $ $
5 42 Inch Chain Link Fence LF 460 $ $
6 48 Inch Corrugated Metal Pipe LF 75 $ $
7 8 Inch SDR35 PVC Pipe LF 150 $ $
8 SCH40 PVC Pipe(Size Varies) LF 150 $ $
9 8 Inch Ductile Iron Pipe LF 50 $ $
10 Standard Manhole EA 1 $ $
11 Doghouse Manhole EA 1 $ $
12 Type II Rip-Rap TON 1850 $ $
13 Type III Rip-Rap TON 160 $ $
14 Type N Rip-Rap TON 100 $ $
15 River Gravel(2-4"Dia.) TON 250 $ $
16 Grade Control Boulders TON 100 $ $
17 Geotextile(Wall Separation) SY 1700 $ $
18 Geotextile(Rip-Rap) SY 2000 $ $
19 Bulk Cut LS 1 $ $
20 Asphalt Pavement Replacement SY 330 $ $
21 Asphalt Curb LF 300 $ $
22 Not Used *** ****** ************** *�*�*��****��*,�
23 Seeding SY 5000 $ $
2Q Ninebark Shrubs EA 50 $ $
25 '1'ree and Brush Removal LS 1 $ $
26 Ditch Check at Mt. Auburn Box Culvert LS 1
TOTAL CONTRAC,T PRICE: $
(in words)
By
(signature) (print)
BRECKENRIDGE BRANCH STABILIZATION—Monis&Munger Engineers#2009-25 00300a- 1
' � �
� � �• City of Cape Girardeau
►��:<< ��,;,ryr.�ro,�,�„_r«<<, Public Works Department
2007 Southern Expressway, Cape Girardeau, Missouri 63703
. • Phone (573) 339-6351 Fax (573) 339-6363
BRECKENRIDGE BRANCH STABILIZATION PROJECT
Addendum No. 3
To the Bid Documents
May 31, 2011
The following changes/modifications are made to the Bidding Documents. Bidders are
instructed to note the changes and use the replacement pages as described:
Chan�es to the Specification Book
Addendum Item# 1 —Section 02378, Page 02378-1
Part 1, 12 Products Item 6 River Gravel ... add the following text- "This product can be
river gravel or limestone."
Aiidendum No. 3 Prepared and Approved by
May 31, 2011
Stan Polivick Date
Stormwater Coordinator
Received and Ackno�ledged by the Bidder
�� �1. �.a.�, � I�-l� �
Signa re,� Date
� � �% l v�,�
Print Name
Breckenridge Branch Stabilization Project Page 1 of 1
Addendum No.3
' Mnrrlx E4 B�nd# 23850
��,. BID BOND
, :�1aMunn�r _.
Ro•�xe w�aoz Moa�rKa vm m�
�L;"
ti1�',CTION 00410— BID BOND
KN��W ALL ML N [iY 1141 t�1 I'f1f�SENT, that we, the undersigned, Jokerst Inc.
16444 Hwy 32 Ste Genevieve MO 63671 as Principal, and
American.,Southern Insurance_ Com�anv as Surety, are hereby heid and firmly
City of Cape Gira�eau Five Petr.a.�t of A�mt Bid
h�,ui�d unto ihe _ , as Owner in the penal sum of
not to exc'.�1
'll�irte� '7hotts�rl Sev� I��'Ecl Fiftv for the p�ay meni of which,well and truly to be made,we
_ —�rrl no/1UU Lbllars ($13,750.00)
hureby jointly and severally I�in�l ourselves, our heirs, executors, administrators, successors, and
:i�;siyns.
:�ic�ned, this �� day of J�a�e ,� 2411-
f h� Condiiion of the above obligation is such that whereas the Principal has submitted to �-tY of C�pe Gi�a�de�u
a certain Bid, attached hereto and hereby made a part hereof to entec into a
contract in writing,for Construction of Bn�k�trid�e B�ch StabiLi2ation •
NOW,7HEREFORE,
(a) If said Bid shall be rejected, or in the alternate,
(b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the
Form of Contract attached hereto (properly completed in accordance with said Bid)and
shall furnish a bond for his faithfui performance of said contract, and for the payment of
all persons performing labor or furnishing materials in connection therewith,and shall in
all other respects perform the agreement created by the acceptance of said Bsd, then
this obligation shall be void, otherwise the same shalf remain in f�rce and effect; it being
expressly understood and agreed that the liability of the Surety for any and all claims
hereunder shall, in no event, exceed the penal amount of this obligation as herein
stated_ The Surety, for value received, hereby stipulated and agrees that the obligations
of said Surety and its bond sha14 be in no way impaired or affected by and extension of
the time within which the Owner may accept such Bid; and said Surety does hereby
waive notice of any such extension.
BRECKENRIDGE BRANCH STABILIZATION—Morris&Munges Engineers#2009-25 00410- ]
� '�IMnrrlx& W`
�E���M�inncr BID BOND
Rerised NI9/OZ,Modified 9IION9
q�,�,���►11 p •:�.5.Wiif=Fll c it , Uic� ('rincipal and the Surety have hereunto set their hands and seais, and
�f-�9 M ° . /.,,. .,
e�-��h-�►¢ �raT����►c�-c:�,��-��-►+���:Ytaave-Ea�sed-t#��ir�oFpoEatgsgals-�o��b�rEfa��xe�an�thase— -----
�''�•' ��f.�:c.=�1��It��c�,�c�n�t�l I�y Ilira� ��ic�per officers,the day and year first set forth above.
A•�e �
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; �;�� ; �[ ,'�d R Brn�t Attomey-irrFact
.INl'�'��RTANT S�cety companies executing bonds must appear on the Treasury DepartmenYs most
�:ur�y�nt�rsty(Circula'r 570 as amended) and be authorized to transact business in the State where the
r�r��je�et is lo�ated�
END OF SECTION 00410
00410-2 BRECKENRIDGE BRANCH STABILIZATION—Morris&Munger Engineers#2009-25
. �
AMERICAN SOUTHERN INSURANCE COnIIPANY
Home Office: 3715 Northside Parkway, NW Mailing Address: P. O. Box 723030
Bldg. 400, Suite 800 Atlanta, GA 31139-0030
Atlanta, Georgia 30327
GENERAL POWER OF ATTORNEY
Know all men by these Presents, that the American Southern Insurance Company had made, constituted and
appointed, and by these presents does make, constitute and appoint Stefian E. Tauger of Parker, Colorado; Donald J. Kersey
af Sirmingham, Alabama; Arthur S. Johnson of Atlanta, Georgia; Donald H. Gibbs of Atlanta, Georgia; Andrew C. Heaner of
Atlanta, Georgia; Richard L. Shanahan of Atlanta, Georgia; Katherine S. Grimsley of Tampa, Florida; Jeffery L. Booth of
Parma, Ohio; James E. Feldner of West Lake, Ohio; Cheryl L. Torrao of Canton, Georgia; Garry W. Bfack of Murfreesboro,
Tennessee; Martha G. Ross of Charlotte, North Carolina; David R. Brett of Columbia, South Carolina; or Diane L. McLain of
Fitchburg, Wsconsin, EACH as its true and lawful attorney for it and its name, place and stead fo execute on behalf of the
said company, as surety, bonds, undertakings and contracts of suretyship to be given to alE obligees pravided that no bond or
unde�Eaking or contract of suretyship executed under this authority shall exceed in amount of the sum of$1,000,000 (one
miffion dollars}, including but not limited to consents of surety for the release of retained percentages and/or finaf estimates
on construction contracts or similar authority requested by the Department of Transportation, State of Florida; and the
execution af such undertakings, bonds, recognizances and other surety obligations, in pursuance of the presents, shall be as
binding upon the Company as if they had been duly signed by the President and attested by the Secretary of the Company in
their own proper persons.
This Power of Attorney is granfed and is signed and sealsd by facsimile under and by the authority of the following
Resofution adopted pursuant to due authorization by the Executive Committee of the Board of Directors of the American
Southem Insurance Company on the 26th day of May, 1998:
RESOLVED, that the Chairman, President or any Vice President of the Company be, and that each or any of them
hereby is, authorized to execute Powers of Attorney qualifying the attorney named in the given Power of Attorney fo execute
in behalf of the American Southern Insurance Company bonds, undertakings and all contracts of suretyship; and that any
Secretary or any Assistant Secretary be, and that each or any of them hereby is, authorized to attest the execution of any
such Pawer af Attorney, and to attach thereto the seal of the Company.
FURTFiER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such
Power of Attorney or io any cerfificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing
such facsimile signatures or facsimile seaf shall be valid and binding upon the Company when sa affixed and in the future,
with respect to any bond undertaking or contract of suretyship to which it is attached.
In �1(Ildt�Jess U1lhereof, the American Southern Insurance Company has caused ifs official seal to be hereto affixed, and
these�-�r�6e;Mts�o be signed by its President and atfested by its Secretary this 17th day of Qecember.2dOS.
At�s��Y� t> ��i_., �� s��� >y American South�rn Insurance Company
�� !� C���, By. :t
Gaif A � ; e� ry �' ; �C��.._....---'',
�y ' Scott-. Th mpso , President
srA��o��Eo��, R
��`&f� ,� " .-
COUt�CT9f d��`IJLTON,;.
On this t7f�-day-of Decamber,2009, before me personally came Scott G.Thompson to me known,who being by me duly swom,did depose and
say that he resides'fn Atlanta, in the County af Fult�n, State of Georgia, at 421 Hollydale Court; that he is the President of Ameri n�'o� Jnsurance
Company,the corporation described in and which executed the above instrument;that he knows the seal of the said corporation;� e se����to the
said instrument is such corporate seal;that it was so affixed and tha#he signed his name thereto pursuant to due authorizatian-�`�'��'"'r-„ �i�`�^
Candace T.Cheatham �',�AI�'�" �
STATE OF GEORGIA Notary Pubfic,State of Georgia -
SS: Quafified in DeKalb County . ����c '� rt.
COUNTY OF FULTON Commission Expires December7,2013 f�t��� i s�
: _'�"'• 6' l� r �•�gc ;
I, the undersigned, a�ce President of American Southerh,ItysaPanee Cba7p3ny�.�Kansas Corporation, d0 NEREBY��C,��tFY that t�j9't�e�Jcbing
and attached Pawer of Attorney remains in ful!force and has r�p��2rl���d`and,itqttherinore, tF►at the Resolution of the`E ec�R' �C"�� tte�e of the
Board of Directors set forth in the Power of Attome is now ir�fots-e.`-;; ��, �G� • ���
y r
s � A��nt�'`"����
� �. �:, .• �3'.'�: � �
Signed and seated at the City of Atlanta,Qated the ��-I day of '��` � `��
`.:€� ..
,,.•;,� ,k„� °j,:
- - . . • :A",..
� - .. -a.....
" , - � �� ;J:Qhn,R: Huot
Power No. 23850 ._ V�ce�President
.
American Southern Insurance Con�pany
NAIC Compa�iy Code 10235
NAIC Group Code 587
----��tutoy'F�uancial Statcmcnt------ ----- ------- —
As of DeccmUcr 31, 2010
LIA[311.[TIES
ASS�TS
������s $G2,832,979 Rescrve for Losses and Loss Expense $31,930,255
Stocks 22,638,2U Reserve Cor tJneamed Premiums 17,85G,I3G
Cash and Short-Term Investments 1,478,377 Reserve for Lxpenses,Taxes,Licenses and Fees 3,584,183
Agcnls 13alances 4,G01,538 Payable [o Parents,Subsidiaries and Affiliates 273,203
Other Assets 2,471,017 Other Liabilifies 5,395,787
Recciv�Ules Ior securities 4,084,764 Total Liabilitics 59,390,364
POLICYIIOLDF.RS' SURPLUS
Capital Stock 3,000,000
Swplus 35,716,523
Total Policyholdcrs' Smptus 38,716,528
'1'otal Assets $98,106,892 Total Liabilities and Yolicyhulders'Smplus $98,106,892
I3onds and stocks are valued in accordance with the basis adopted by the National Association of Insurance Commissioners(NAIC).
CERTIrICATC
llie ofGcers of U�is reporting entity being duly sworn,cach depose and say lhat they arc lhe described officers of said reporting entity,and thal
on the reporting period stated above,all of the herein described assets were the absolute property of the said reporting eneity,free and clear from
any liens or daims thereon,excepl as herein stateJ,and that this statement,together with related exhiUits,schedules and explanations thercin
coutaincd,anncxcd or referred to,is a full and truc statcmcnt of all the assets and liabilities and of the condition and affairs of the said reporting
cntity as of Lhe rcporting period stated above,anJ of its income and deductions lhercfrom Cor thc period ended,and have Ucen cmnpleted in
accordance with lhe NAIC Annual Stalement InsWctions and Accounting Praclices and Procedures manual except to the extent lhat:(1)stale
law may differ;or,(2)[hat state rules or rcgulations require differcnccs in reporting not rclated to accow�ting practiccs and procedures,accmding
to the bcst of thcir information,knowledge and bclicf,respectively. �%� —
� � --
Pr dcn Chiefrinancia licet
� ..,.�ul�Georgia
County of Fulton
On thc ZSth day of Fcliruary 2011,bcfore mc came thc ahovc named ofticcrs of thc American Southern Insurance Compaoy to mc personally
knorni lo he lhc individuals and of(icers dcscribed hcrcin,and acknowlcdgc that lhcy cxccuted thc forcgoino instrumcn[and al�xcd thc scal of
said company ihereto t>y authority of their office.
Mclrniic Coppola,Notary Public
My Commission Expires, May 17,2014
' ' � � SLC�
�.: � ���1��� " �.
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E,% �� _ � �����F: ',r,IIIIIII�;`'
�' "s �', i« e v arr s:'�^
_s r seavice oe�ns
Company ID Number: 200980
THE E-VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANDUM OF
UNDERSTANDING FOR DESIGNATED AGENTS
ARTICLE I
PURPOSE AND AUTHORITY
The parties to this Agreement are the Department of Homeland Security (DHS), and JOKERST,
INC. (Designated Agent). The purpose of this Agreement is to set forth terms by which SSA and
DHS will provide information to JOKERST, INC. (Designated Agent) on behalf of the
Designated Agent's client (the Employer). This MOU explains certain features of the E-Verify
program and enumerates specific responsibilities of DHS, SSA, the Employer, and the
Designated Agent. References to the Employer include the Designated Agent when acting on
behalf of the Employer. E-Verify is a program that electronically confirms an empfoyee's
eligibility to work in the United States after completion of the Employment Eligibility Verification
Form (Form I-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.
The Employer is not a party to this MOU. The E-Verify program requires an initial agreement
between DHS and the Designated Agent as part of the enrollment process. After agreeing to the
MOU as set forth herein, completing the tutorial, and obtaining access to E-Verify as a
Designated Agent, the Designated Agent will be given an opportunity to add a client once
logged into E-Verify. All parties, including the Employer, will then be required to sign and submit
a new MOU. The responsibilities of the parties remain the same in each MOU.
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. 104-208, 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 contractor") 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 II
FUNCTIONS TO BE PERFORMED
A. RESPONSIBILITIES OF SSA
1. SSA agrees to provide the Employer (through the Designated Agent) with
available information that will allow 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 the Employer and Designated Agent appropriate
assistance with operational problems that may arise during the Employer's
participation in the E-Verify program. SSA agrees to provide the Designated Agent
with names, titles, addresses, and telephone numbers of SSA representatives to
be contacted during the E-Verify process.
Page 1 of 15�E-:�e�i,"ry P�1GU icr Desig��e;ed Agent�Revisio�Da;e?r'f29lG& -y��;: ��.;.�gr; ��-:.Fc�siiy
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Company ID Number: 200980
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).
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 nonconfirmation 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 verifies the accuracy of SSA records for aliens through E-Verify, DHS
agrees to provide the Employer (through the Designated Agent) access to selected
data from DHS's databases to enable the Employer (through the Designated
Agent) to conduct, to the extent authorized by this MOU:
• Automated verification checks on alien employees by electronic means,
and
• Photo verification checks (when available) on employees.
2. DHS agrees to provide to the Employer and Designated Agent appropriate
assistance with operational problems that may arise during the Employer's
participation in the E-Verify program. DHS agrees to provide the Designated Agent
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 (through the Designated Agent), 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 (through the Designated Agent) a notice,
which indicates the Employer's participation in the E-Verify program. DHS also
agrees to provide to the Employer (through the Designated Agent) anti-
discrimination notices issued by the Office of S�7ecial Counsel for Immigration-
Related Unfair Employment Practices (OSC), Civil Rights Division, U.S.
Department of Justice.
Pa�a 2 of 15;E:/e�;;1,:1G1�`;,,D�s�cna:ed�.ye��[�Re�✓isio•��Ja�U?�!2�1G8 ;�rh , _,{,� ,; �. ,_,;sy
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Company ID Number: 200980
__ _ - ---- _ -- --___
__ —--- -- - - -- —_-- —
5. DHS agrees to issue the Designated Agent a user identification number and
password that will be used exclusively by the Designated Agent, on behalf of the
Employer, to verify information provided by alien employees with DHS's databases.
6. DHS agrees to safeguard the information provided to DHS by the Employer
(through the Designated Agent), 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
nonconfirmation of empfoyees' employment eligibility within 3 Federal Government
workdays 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 shall display the notices supplied by DHS (through the Designated
Agent) 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 shall provide to the SSA and DHS the names, titles, addresses, and
telephone numbers of the Employer representatives to be contacted regarding E-
Verify.
3. The Employer shall become familiar with and comply with the most recent version
of the E-Verify User Manual. The Employer will obtain the E-Verify User Manual
from the Designated Agent.
4. The Employer shall comply with current Form I-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
I-9 process to establish identity.) If an employee objects to the photo
requirement for religious reasons, the Employer should contact E-Verify at
1-888-464-4218.
• If an employee presents a DHS Form I-551 (Permanent Resident Card) or
Form I-766 (Employment Authorization Document) to complete the Form I-
9, the Employer agrees to make a photocopy of the document and to retain
Page 3 cf 151E-�I�;;fy iy10�J'�r Uesignete�Acur�Rc, isia:��,.E i0r`29i0S ;mr�&,�,, _, , . � ;�;,;`';
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Company ID Number: 200980
__ _---_ _.. -
the photocopy with the employee's Form I-9. The employer wiil 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 I-9. DHS may in the future designate other documents
that activate the photo screening tool.
5. Participation in E-Verify does not exempt the Employer from the responsibility to
complete, retain, and make available for inspection Forms I-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 I-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 4 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 I-9 compliance inspections during the course of E-Verify, as well as
to conduct any other enforcement activity authorized by law.
6. The Employer shall initiate E-Verify verification procedures (through the
Designated Agent), for new employees within 3 Employer business days after each
employee has been hired (but after both sections 1 and 2 of the Form I-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 I-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
(through the Designated Agent) must use the SSA verification procedures first, and
use DHS verificafion procedures and photo screening tool only after the SSA
verification response has been given. Employers may initiate verification, through
the Designated Agent, by notating the Form I-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 (through the Designated
Agent) performs an E-Verify employment verification query using the employee's
SSN as soon as the SSN becomes available.
7. The Employer may not use E-Verify procedures for pre-employment screening of
job applicants, in support of any unlawful employment practice, or for any other use
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not authorized by this MOU. Employers must use E-Verify (through its Designated
Agent) 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 II.D, 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.
8. The Employer (through the Designated Agent) shall follow appropriate procedures
(see Article III. 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 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.
9. The Employer shall not 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(I)) 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 conditions, 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, or otherwise mistreating an employee) 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 Emptoyer can find the
employee is not work authorized and terminate the employee's employment.
Employers or employees with questions about a final nonconfirmation may call E-
Verify at 1-888-464-4218 or OSC at 1-800-255-8155 or 1-800-237-2515 (TDD).
10. The Employer shall 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 th� INA,
because of his or her citizenship status. The Employer shall not engage in such
illegal practices as 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
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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).
11. The Employer shall record the case verification number on the employee's Form I-
9 or to print the screen containing the case verification number and attach it to the
employee's Form I-9.
12. The Employer will use the information it receives from SSA or DHS (through its
Designated Agent) pursuant to E-Verify and this MOU only to confirm the
employment eligibility of employees as 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 for 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.
13. The information that the Employer receieves through the Designated Agent from
SSA is governed by the Privacy Act (5 U.S.C. § 552a(i)(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.
14. The Employer agrees to cooperate with DHS and SSA in their compliance
monitoring and evatuation of E-Verify, including by permitting DHS and SSA, upon
reasonable notice, to review Forms I-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. EMPLOYERS THAT ARE FEDERAL CONTRACTORS
If the Employer 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 verified
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
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calendar days of contract award and, within 90 days of enroliment, 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 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 afl existing employees hired after November 6, 1986. The
provisions of Article 11, part D, 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 I-9 procedures for Federal contractors: The Employer (through its
Designated Agent), may use a previously completed Form I-9 as the basis
for initiating E-Verify verification of an employee assigned to a contract as
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long as that Form I-9 is complete (including the SSN), complies with Article
II.C.4, the employee's work authorization has not expired, and the Employer
has reviewed the information reflected in the Form I-9 either in person or in
communications with the employee to ensure that the employee's stated
basis in section 1 of the Form I-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 I-9 complies with Article II.C.4, if the employee's basis for work
authorization as attested in section 1 has expired or changed, or if the Form I-
9 contains no SSN or is otherwise incomplete, the Employer shall complete a
new I-9 consistent with Article II.C.4, or update the previous I-9 to provide the
necessary information. If section 1 of the Form I-9 is otherwise valid and up-
to-date and the form otherwise complies with Article II.C.4, but reflects
documentation (such as a U.S. passport or Form I-551) that expired
subsequent to completion of the Form I-9, the Employer shall not require the
production of additional documentation, or use the photo screening tool
described in Article II.C.4, 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 contraetor.
2. If the Employer 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 Employer's compliance with Federal contracting
requirements.
E. RESPONSIBILITIES OF DESIGNATED AGENT
1. The Designated Agent agrees to provide to the SSA and DHS the names, titles,
addresses, and telephone numbers of the Designated Agent representatives who
will be accessing information under E-Verify.
2. The Designated Agent agrees to become familiar with and comply with the E-Verify
User Manual and provide a copy of the manual to the Employer so that the
Employer can become familiar with and comply with E-Verify policy and
procedures
3. The Designated Agent agrees that any Designated Agent Representative who will
perform employment verification queries will complete the E-Verify Tutorial before
that individual initiates any queries.
A. The Designated Agent agrees that all Designated Agent 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.
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B. Failure to complete a refresher tutorial will prevent the Designated
Agent and Employer from continued use of the program.
4. The Designated Agent agrees to obtain the necessary equipment to utilize E-
Verify.
5. The Designated Agent agrees to provide the Employer with the notices described
in Article 11.B.4 above.
6. The Designated Agent agrees to initiate E-Verify procedures on behalf of the
Employer in accordance with the E-Verify Manual and E-Verify Web-Based
Tutorial. The Designated Agent will query the automated system using information
provided by the Employer and will immediately communicate the response back to
the Employer. 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 Designated AgenYs attempting, in good faith, to make inquiries
on behalf of the Employer during the period of unavailability. In all cases, the
Designated Agent will use the SSA verification procedures first, and will use DHS
verification procedures only as directed by the SSA verification response.
7. The Designated Agent 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 I-9 and other employment records and to
interview it and its employees regarding the 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.
ARTICLE 111
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 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. 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 (through the Designated Agent), will transmit the
Social Security Number to SSA for verification again if this review indicates a need
to do so. The Employer wifl 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
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employee to visit an SSA office within 8 Federal Government work days. SSA will
electronically transmit the result of the referral to the Employer (through the
Designated Agent) 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 shall not 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 shall 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 wil� determine whether the employee contests the
tentative nonconfirmation as soon as possible after the Employer receives it.
4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer
shall 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 referraf 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 it determines that more than
10 days is necessary. The Employer agrees to check the E-Verify system regularly
for case updates.
6. If an employee contests a tentative nonconfirmation based upon a photo non-
match, the Employer shall send a copy of the employee's Form I-551 or Form I-766
to DHS for review by.
•Scanning and uploading the document, or
•Sending a photocopy of the document by an express mail account (furnished and
paid for by DHS).
7. If the Employer cannot determine whether there is a photo match/non-match, the
Page 1Q af 15;E-Verify MO!�`or Uesigr:ata�+ky�r:t��?�v�sian f�ate i0?291�3
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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 specified by the Immigration Services Verifier
at DHS who will determine the photo match or non-match.
ARTICLE IV
SERVICE PROVISIONS
The SSA and DHS will not charge the Employer or the Designated Agent for verification
services performed under this MOU. DHS is not responsible for providing the equipment needed
to make inquiries. A personal computer with Internet access is needed to access the E-Verify
System.
ARTICLE V
PARTIES
A. This MOU is effective upon the signature of the 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 E-Verify,
DHS reserves the right to require Designated Agents to take mandatory refresher
tutorials. A Designated Agent for an Employer that is a Federal contractor may
terminate this MOU when the Federal contract that requires the Employer's participation
in E-Verify is terminated or completed. In such a circumstance, the Designated Agent
must provide written notice to DHS. If the Designated Agent fails to provide such notice,
it will remain a participant in the E-Verify program on behalf of the Employer, 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
the Employer's newly hired employees.
B. Notwithstanding Article V, part A of this MOU, DHS may terminate access to E-Verify if it
is 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 Designated Agent or the Employer, or a failure on the part of either to
comply with established procedures or legal requirements. The Designated Agent
understands that if the Employer is a Federal contractor, termination of this MOU by any
party for any reason may negatively affect the Employer's performance of its contractual
responsibilities.
C. Some or all SSA and DHS responsibilities under this MOU may be performed by
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contractor(s), and SSA and DHS 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
States, its agencies, officers, or employees, or against the Designated Agent, the
Employer, or their 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 befinreen the Designated Agent or
the Employer and any other person or entity regarding the applicability of Section 403(d)
of IIRIRA to any action taken or allegedly taken by the Designated Agent or the
Employer.
F. 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
Designated Agent.
The individuals whose signatures appear below represent that they are authorized to enter into
this MOU on behalf of the Designated Agent and DHS respectively.
If you have any questions, contact E-Verify at 1-888-464-4218.
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information Requ'ired for the'E-Verify Program
Information refating to your Company,;
Company Name: .IOKERST, ING.
Company Facility Address: 16444 HVVY 32
STE GEN'EVIEVE, MQ 6367D
' Company Alternate '
Address:
Gcsunty--or Farish: SAfNTE GENEV(E�IE
�rnployer ldentification
f+CtlthtbOC: 431�101'1'2
i�or�h American lndustry
Classifica#ian Sys#ems
Code: 237
Par�nt Company:
Number of Emptayees; 20 to 99
Number of Sites Verified
for: 1
Are you�erifying for more than 1 site? If yes, please provide the nurnber of sites verified-for in
each'State:
. MISSOURI 1 site(s)
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��''.�'x..'_.., � E-VERlFY IS A SBRYICE OF D95
Company ID Number: 200980
Information relating to the Pragram'Administrator(s}for your:Gompany on policy questions or
operational problems:
fVame: KIM M WEILER
Telephone Number. (573j 883-7401' Fax;Number: (573)883'-74Q3
E'-mail Address: jokerstinc@yahoo.com
Page 15 of 15;E-Veri`ry t��iC:�i.i`�r Desigratea Agert�R�v.s�cn Uat�'0?�yl�� ,�s,�-. c-
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I ANTI-COLLUSION STATEM
ENT
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ISTATE OF M]SSOURI
CITY/COUNTY OF STE. GENEVIEVE
I �
� SHE
LYNN M. SCHREMP being first duly sworn, deposes and says that�is
IVICE R TD NT
(Title of Person Signing)
Iof JOKERST, INC.
JOKERST, INC.
IName of Bidder
( that al1 statements made and facts set out in the proposal for the above project are true and
correct; and the bidder(The person, firm, association, or corporation making said bid) has not,
either directly or indirectly, entered into any agreement, participated in any collusion, or
I otherwise taken any action in restraint of free competitive bidding in connection with said bid or
any contract which may result from its acceptance.
Affiant further certifies that bidder is not financially interested in, or financially affiliated with,
any other bidder for the above project.
BY /�Y� �
BY
i
BY
Sworn to before me this � day of l,lY� 20 �+.
� �
Notary Pub �
_ My Commission Expires_ C( — a,3 — �.013
LORETTA A GRIFfARD
Notary Public-Notary Seal
State of Missouri,Ste Genevieve County
Commission #09872687
My Commisslon Expires Sep 23. 2013
EXHIBIT
AFFIDAVIT OF WORK AUTHORIZATION
Comes now LYNN M. SCHREMP as VICE PRESIDENT first being duly swom, on
Name Office hetd
my oath, affirm JOKERST, INC. is enrolled and will continue to
Company Name
� participate in a federal work authorization program in respect to employees that will work in connection
with the contracted services related to:
I�' Breckenridge Branch Stabilization
for the duration of the contract, if awarded in accordance with RSMo Chapter 285.530 (2).
f also affirm that JOKERST, INC. does not and will not knowingly
ICompany Name
employ a person who is an unauthorized alien in connection with the contracted services related to the
Project for the duration of the contract, if awarded.
In ajfirmation thereof, the jacts stated above are true and correct (The undersigned understands that
� false statements made in this filing are subject to 1he penalties provided under Section 575.090,
, RSMo.)
LYNN M. SCI-IREMP
Signature(perso with authority) Printed Name
VICE PRESIDENT 6-6-11
Title Date
Subscribed and sworn to before me this (l'� of `�l.t,i'72 20 / ( . ] am
I
I commissioned as a notary public within the County of p�'Q P�I�V��� ,
� State of r�(S�Ot,(�Zt and my commission expires on � -��- �.O 13
�
� --� - �.0 � ►
Signature ofNo' ( Date
LORETTA A GRIFFARD
Notary PubHc-Notary Seal
State of Missouri,Ste Genevieve County
Commission�09872687
My Commission Expires Sep 23,2013
� , .
EXHIBIT
_ ____AFFIDAVIT REGARDING EXCESSIVE UNEMPLOYMENT
COMES NOW (Name) LYNN M. SCHREMP as (Office Held� VICE PRESIDENT
of(Company I�ame/Conr�acrot) JOKERST, INC. and first being duly sworn, on
m5� oath, afFrm as follows:
l. �Y/henever there is a period of excessive unemployment in the State of Missoun, as
defined in Section 290.550, et seq., RSMo, the contractor will comply with all of the provisions of
this Statute in respect to employees that will work in connection with the contracted services related
to (Project Name) BKEcK�NRIDGE BF�A1V(�H SIABILIZATION for the duration of the contract.
2. I also affirm that (Compa�y Name/Contractor) JOKERST� INC.
does not and will not knowingly employ a laborer who is not a "Missouri Laborer" or a "Laborer
from a Nonrestrictive State", as those terms are defined in Section 290.550, et seq., RSMo, except
that other laborers may be used if such required laborers are not available, or are incapable of
performing that particular type of worked involved,if so certified by the contractor and approved by
the Ciry of Cape Girardeau or unless otherwise emutted b that Statute in connection with the
contracted services related to (Projecc Name) B������ ���EAU � for the duration of the
STABILIZATION
contract.
FURTHER AFFIANT SAITH NOT.
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 in Section 575.040, RSMo.)
JOKERST, INC.
(name of corporation)
B : LYNN M. SCHREMP/VICE PRESIDE ,�
Y
(name of of6cer of corporaaon and tide)
ATTEST: 1
' 0��� �6 �� �" l.�"l�
(� •Se.cretary`(�r ot�z_er officer)
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STATE OF MISSOURI )
s-����e,Y 1e.�1 Q� ) SS-
COUNTY OF }
/�_�
On [}us Ul day of U�-�� , 20�, before me appeared �--�.IYIYI M �'1 Y�.1'1��,
to me personally known,who, being by me duly sworn, did say that he/she is the VICZ�Y�2S\C�PY1�
of �o�ealS� �nC- , a Missouri Corporation, and that the seal affixed to the
foregoing instrument is the seal of said Corporation, and that the said instrument ��as signed and
sealed in behalf of said Corporation b}' authority of its Board of Directors, and acknowledged said
instrument to be the free act and deed of said Corporabon.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal, at
my office in Cape Girardeau, Missouri, the day and year first above writ
ta Public
My Commission Expires:
LORETTA A GRIFFARD
( Notary Public-Notary Seal
�— o�-�j—c�.(�\� State of Missouri,.Ste Genevieve County
Commission#09872687
My Commission Expires Sep 23,2013
I
I
(
!
( - - .
�
I
�
� ' �
!
� EXHIBIT
AFFIDAVIT OF OSHA TRAINING
_ ---- --- —_ _ _____ _ _-- -------------
COMES NOW (I�rame)LYNN M. SCHRII�IP as (OEfice Held) VICE PRF'STi)FNT
� of(Company Name/Concracror) JOKERST, INC. and first bein du]� swom on
ITY OF CA� G�RARDEAU
my oath, affirm in connection with the contracted services related to BRECKENRIDGE BRANCH STABILIZATION
� (Ptojecc Name) for the duration oE the contract, as follows:
l. Contractor shall provide a ten (10) hour Occupational Safety and I�ealth
Administration (OSHA) construction safery program for all employees who will be on-site at the
� Project. The construcaon safery program shall include a course in construction safety and health
that is approved by OSHA or a similar program approved by the Missouri Department of Labor and
� Industnal Relations which is at least as stringent as an approved OSHA program as re9uired by
Section 292.675, RSMo.
� 2. Contractor shall require its on-site employees to complete a construction safety
program within sixty (60) days after the date work on the Project commences, as required by Section
� 292.675, RSMo.
3. Contractor acknowledges and agrees that any of Contractor's employees found on
� the Project site without documentation of the successful compledon of a construction safety
program shall be required to produce such documentation within twenty (20) days, or will be subject
� to removal from the Project.
4. Contractor shall re9uire all of its Subcontractors to comply with the re9uirements of
� Section 292.675, RSMo.
S. Contractor acknowledges that pursuant to Section 292.675, RSMo., Contractor shall
� forfeit to City as a penalty two thousand five hundred dollars ($2,500.000), plus one hundred dollars
($100.00) for each on-site employee employed by Contractor or its Subcontractor, for each calendar
� day, or porcion thereof, such on-site employee is employed without the construction safety training
re9uired in Section 292.675, RSMo.
� 6_ Contractor acknowledges that violarions of Section 292.675, RSMo, and imposition
of the penalties descnbed therein shall be investigated and detemiined by the Missouri Department
IoELabor and Industrial Relations.
7. Contractor acknowledges that in the event that the Missoun Deparunent of Labor
and Industrial Relations has deternzined that a violation of Section 292.675, RSMo., has occurred
i
and that a penalry shall be assessed, the Citp shall�uithhold and retain all sums and amounts due and
__— - — -- - -- _ _ ---- - -— _ —
Iowing when making payments to Contractor under this Contract.
FURTHER r1FFIr1NT SAITH NOT.
( IN AFFIRMATION THEREOF, the facts stated above are true and correct (the
I i�ndersigned understands that false statements made in this filing are subject to the
penalties provided in Section 575.040, RSMo.)
IJOKERST, INC.
(name of corporation)
gy: LYNN M. SCHREMP/VICE PRESIDEN��
� (name of officer of corporation and title)
� \ .
ATTEST: j
�-,,, `7-�- �`Vz�
ISecretary(or other officer)
I (SEAL OF CORPORATIOI�
� STATE OF MISSOURI )
�r'e Ue,Y��,-V t�Vz: ) SS-
� COUNTY OF C AU )
u� ' , � (���
On this �day of��`l2. , 20�, before me appeared �Yl(1 M �Y.'_Yl1�eXY1l� ,
� to me personally known,who, being by me duly sworn, did say that he/she is the v���C S��Y��
of c�c���-Y� �r�C , a Missoun Corporation, and that the seal affixed to the
foregoing instrument is the seal of said Corporation, and that the said instrument was signed and
� sealed in behalf of said Corporation by authonty of its Board of Directors, and ackno�vledged said
instrument to be the free act and deed of said Corporation.
� IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed fficial seal, at
my office in Cape Girardeau,Missouri, the d an ear first a ove w te . r
' ota Public
' My Comrrussion Expires:
`'1 "a 3"� ����J LORETTA A GRIFfARD
Notary Public-Notary Seal
' State of Missourl, Ste Genevieve County
Commission #09872687
My Commission Expires Sep 23,2013
'
U6�U7iZU11 14:1�1 FAl 57� 883 7�OJ JOIZERST INC �U�i�
� l .
�
�
� Project Number
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1) ...1�.�. T:'1t�.T�lI.IhRr�lN7.i __.. .- .-___ -_-......-_'__
I
� �
, Certtfli.ation Regarding
Debarm���nt, Suspe�ision and Other �tesPonsi�ility IVlatters
7�he contractor hereby certi�ies to the be st of its knowledge and belief and that it and its principals
and its subcontractors and t:lieir princip�ls:
(a) Are not preser�tly debarred, suspend�d, proposed for debarment, declared ineligihle or
voluntarily e�ccluded frc�m covered transactions by any Federal or State departmezt or agenc�;
�
i (b) Have not within a three (3) year period preceding this proposal been eonvicted oi'or had a
civil judgment rendered against then� �or commission of fraud or a criminal offense in
connection vvith obtainir.�:g, attemptir�g to obtain or performing a public (Federal, ;�tate or
. Local) transaction or cor.��tract under i�public transaction; violation of Federal or State antitrust
statutes or commission uf embezzler��ent, theft, forgery, bribery, falsification or d�.struction of
� rccords, mal:ing false st�rtements or i�eceiving stolen property;
(c) Are not presently indictrd for or oth��rwise criminally or civilly charged by a gove:rnment
entity (Federal, State or:I:,ocal) with�:omr�ission of any of the offenses enumerated in
paragraph (l,)(b) of this r..ertification; and
(dj Nave not within a three-ti�ear period��i•eceding this subcontract had one or more p�iblic
transactions (Federal, St��..te or Local) terminated for cause or default.
l'
I understand that a false str:itement an Il�is certification may be grounds for rejection of this
contractor or termination af the contra ct. ln addition, under 18 CJSC Sec. 1.001, a. false
state�en� may result in a fi!�ie of up to :I� 10,400 or imprisonment for up to fve (5)years or
both.
KIM M. WEILER/CORPORATi^ SECRET�5'
Typed ame �c Title o�Auth���rized Repre:�entative
, I
�'''� ����. 6-6-11
Signature of Authorized Repr�::sentative Date �
❑ I am unable to certify r.�� the above ;tatement. My explanation is attached,