HomeMy WebLinkAboutRES.2710.08-20-2012 j
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BILL N0. 12-114 RESOLUTION N0. ��l�
A RESOLUTION AUTHORIZING THE CITY MANAGER TO
EXECUTE AN AGREEMENT WITH D & S SIGN
COMPANY, INC. , DBA CANEDY SIGN & GRAPHICS
FOR THE INSTALLATION OF CITY-WIDE WAYFINDING
SIGNAGE, IN THE CITY OF CAPE GIRARDEAU,
MISSOURI
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 D & S Sign Company, Inc. , DBA Canedy Sign &
Graphics for the installation of City-Wide Wayfinding Signage,
in the City of Cape Girardeau, Missouri . A copy of said
Agreement is attached to this Resolution and ma a part hereof.
;
PASSED AND ADOPTED THIS �;����1 DAY OF ' , 2012 .
Ha ry E. Re ' er, Mayor
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Gayl L. Conrad, City Clerk � `�;`_ �,;'rl�o��
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CITY OF CAPE GIRARDEAU
INSTALLATION OF CITY-W1DE
WAYFINDING SIGNAGE
STANDARD FORM OF AGREEMENT
BETWEEN OWNER AND CONTRACTOR
ON THE BASIS OF A STIPULATED PRICE
THIS AGREEMENT is dated as of the �� day of 5ep�vr�qiEr in the year
2012 by and between the City of Cape Girardeau, Missouri (hereinafter called OWNER) and
D & S Sign Company Inc. DBA Canedy Siqn & Graphics (hereinafter called
CONTRACTOR).
OWNER and CONTRACTOR, in consideration of the mutual covenants hereinafter set
forth, agree as follows:
Article 1. WORK.
CONTRACTOR shall complete all Work as specified or indicated in the Contract
Documents. The Work is generally described as follows:
The work to be performed underthese Contract Documents consists of
furnishing and installing city-wide wayfinding signage, submitting shop
drawings, layouts, samples, and mock-ups for owner approval, structural
design and wind-load calculations for all signs and foundations, and any other
related work as stated in the specifications or shown on the project plans.
Sign Type F—Gateway, Sign Type G—Alternative Gateway, and Sign Type H
—Neighborhood Gateway will not be furnished or installed with this project. A
traffic control plan shall be submitted and approved by the City Engineer
before installation can begin. Any landscape disturbed by installation shall be
repaired to pre-installation conditions. Contractor is responsible for locating
utilities. All other appurtenances are as specified in the bid documents for the
City of Cape Girardeau, Missouri.
Article 2. ENGINEER.
The City Engineer or his designee is to act as OWNER'S representative, assume all duties
and responsibilities and have the rights and authority assigned to ENGINEER in the
Contract Documents in connection with completion of the Work in accordance with the
Contract Documents.
Article 3. CONTRACT TIMES.
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�
General Conditions, and completed and ready for final payment in accordance with
paragraph 14.13 of the General Conditions within one hundred twenty (120) days after the
date when the Contract Times commence to run.
3.2 Liquidated Damages. OWNER and CONTRACTOR 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 3.1 above, plus any extensions thereof
allowed in accordance with Article 12 of the Generai Conditions. They also recognize the
delays, expense and difficuities involved in proving the actual loss suffered by OWNER if
the Work is not competed on time. Accordingly, instead of requiring any such proof,
OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as a
penalty) CONTRACTOR shall pay OWNER seven hundred fifty dollars $ 750.00 for
each day that expires after the time specified in paragraph 3.1 for Substantial Completion
until the Work is substantially complete. After Substantial Completion, if CONTRACTOR
shall neglect, refuse or fail to complete the remaining Work within the time specified in
paragraph 3.1 for completion and readiness for final payment or any proper extension
thereof granted by OWNER, CONTRACTOR shall pay OWNER one thousand dollars
$1,000.00 for each day that expires after the time specified in paragraph 3.1 for
completion and readiness for final payment.
Article 4. CONTRACT PRICE.
OWNER shall pay CONTRACTOR for completion of the Work in accordance with the
Contract Documents an amount in current funds equal to the sum of the amounts
determined pursuant to paragraphs 4.1 and 4.2 below:
4.2 for all Unit Price Work, an amount equal to the sum of the established unit price for
each separately identified item of Unit Price Work times the estimated quantity of that item
as indicated in the bidding documents.
TOTAL OF ALL UNIT PRICES: Two hundred nineteen thousand, eiqht hundred six
dollars and eiqhty-four cents ($ 219,806.84 )
As provided in paragraph 11.9 of the General Conditions estimated quantities are not
guaranteed, and determinations of actual quantities and classification are to be made by
ENGINEER as provided in paragraph 9.10 of the General Conditions. Unit prices have
been computed as provided in paragraph 11.9.2 of the General Conditions.
Article 5. PAYMENT PROCEDURES.
CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the
General Conditions. Applications for Payment wi�l be processed by ENGINEER as
provided in the General Conditions.
5.1 Progress payments; Retainage. OWNER shall make progress payments on account
of the Contract Price on the basis of CONTRACTOR'S Application for Payment as
A-2
recommended by ENGINEER, on or about the 10th day of each month during construction
as provided in paragraphs 5.1.1 and 5.1.2 below. All such payments will be measured by
the schedule of values established in paragraph 2.9 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.
5.1.1 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
previousiy made and less such amounts as ENGINEER shall determine, or OWNER may
withhoid, in accordance with paragraph 14.7 of the General Conditions.
90% of Work compieted (with the balance being retainage). If Work has
been 50% completed as determined by ENGINEER, and ifthe 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,
the remaining progress payments prior to Substantial Completion will be an
amount equal to 100% of the Work completed.
90% (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 14.2 of the
General Conditions).
5.1.2 Upon Substantial Completion, in an amount sufficient to increase total payments to
CONTRACTOR to 95% of the Contract Price (with the balance being retainage), less such
amounts as ENGINEER shall determine, or OWNER may withhold, in accordance with
paragraph 14.7 of the General Conditions.
5.2 Final Payment. Upon final completion and acceptance of the Work in accordance with
paragraph 14.13 of the General Conditions, OWNER shall pay the remainder of the
Contract Price as recommended by ENGINEER as provided in said paragraph 14.13.
Article 6. INTEREST.
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.
In order to induce OWNER to enter into the Agreement, CONTRACTOR makes the
following representations:
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�.- ' CONTRACTOR has examined and carefully studied the Contract Documents
������uding the Addenda listed in paragraph 8) and the other related data identified in the
Bidding Documents, including "technical data".
7.2 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, performance and
furnishing of the Work.
7.3 CONTRACTOR is familiar with and is satisfied as to all federal, state and local Laws
and Regulations that may affect cost, progress, performance and furnishing of the Work.
7.4 CONTRACTOR has carefully studied all 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
Underground Facilities) which have been identified. CONTRACTOR acknowledges that
such reports and drawings are not Contract Documents and may not be complete for
CONTRACTOR'S purposes. CONTRACTOR acknowledges that OWNER and ENGINEER
do not assume responsibility for the accuracy or completeness of information and data
shown or indicated in the Contract Documents with respect to Underground Facilities at or
contiguous to the site. CONTRACTOR has obtained and carefully studied (or assumes
responsibility for having done so) all such additional supplementary examinations,
investigations, explorations, tests, studies and data concerning conditions (surface,
subsurface and Underground Facilities) at or contiguous to the site or otherwise which may
affect cost, progress, performance or furnishing of the Work or which relate to any aspect
of the means, methods, techniques, sequences and procedures of construction to be
employed by CONTRACTOR and safety precautions and programs incident thereto.
CONTRACTOR does not consider that any additional examinations, investigations,
explorations, tests, studies or data are necessary for the performance and furnishing of the
Work at the Contract Price, within the Contract Times and in accordance with the other
terms and conditions of the Contract Documents.
7.5 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.
7.6 CONTRACTOR has correlated the information known to CONTRACTOR, information
and observation obtained from visits to the site, reports and drawings identified in the
Contract documents and all additional examinations, investigations, explorations, tests,
studies and data with the Contract Documents.
7.7 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, and the Contract
Documents are generally sufficient to indicate and convey understanding of all terms and
conditions for performance and furnishing of the Work.
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Article 8. CONTRACT DOCUMENTS.
The Contract Documents which comprise the entire agreement between OWNER and
CONTRACTOR concerning the Work consist of the following:
8.1 This Agreement (pages to inclusive).
8.2 Exhibits to this Agreement (pages BF- to BF- , inctusive).
8.3 Performance, Payment, and other Bonds, identified as exhibits and consisting of
pages.
8.4 Notice to Proceed.
8.5 General Conditions (pages 1 to 55 , inclusive). (EJCDC No. 1910-8 1990 Edition)
8.6 Suppiementary Conditions (pages SC-1 to SC- 5 , inclusive).
8.7 Specifications bearing the title INSTALLATION OF CITY-WIDE WAYFINDING
SIGNAGE .
8.8 Drawings.
8.9 Addenda numbers _ to _, inclusive.
8.10 CONTRACTOR'S Bid (pages BF- 1 to BF- 8 , inclusive) marked exhibit A .
8.11 Pursuant to 285.530 R.S. Mo, the contractor must affirm its enrollment and
participation in a federal work authorization program with respect to the employees
proposed to work in connection with the services requested herein by 1) submitting a
completed, notarized copy of AFFIDAVIT OF WORK AUTHORIZATION and 2) providing
documentation affirming the bidder's enrollment and participation in a federal work
authorization program with respect to the employees proposed to work in connection with
the services requested herein.
8.12 Documentation submitted by CONTRACTOR prior to Notice of Award (pages _to
, inclusive).
8.13 The following which may be delivered or issued after the Effective Date of the
Agreement and are not attached hereto: All Written Amendments and other documents
amending, modifying or supplementing the Contract Documents pursuant to paragraphs
3.5 and 3.6 of the General Conditions.
The documents listed in paragraphs 8.2 et seq. above are attached to this Agreement
(except as expressly noted otherwise above).
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—' �� no Contract Documents other than those listed above in the Article 8. The
.,,..�,�ac� Uocuments may only be amended, modified or supplemented as provided in
paragraphs 3.5 and 3.6 of the General Conditions.
Article 9. MISCELLANEOUS.
9.1 Terms used in this Agreement which are defined in Article 1 of the General Conditions
will have the meanings indicated in the General Conditions.
9.2 No assignment by a party hereto of any rights under or interests in the Contract
Documents 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 will release or discharge
the assignor from any duty or responsibility under the Contract Documents.
9.3 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.
9.4 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.
9.5 Pursuant to 292.675, R.S. Mo, the contractor is informed that all contractors or
subcontractors doing work on this project to provide, and require its on-site employees to
complete, a ten (10) hour course in construction safety and health approved by the
Occupational Safety and Health Administration ("OSHA") or similar program approved by
the Missouri Department of Labor and Industrial Relations which is at least as stringent as
an approved OSHA program. The training must be completed within sixty(60) days of the
date work on the project commences. On-site employees found on the worksite without
documentation of the required training shall have twenty (20) days to produce such
documentation.
9.6 The General Contractor shall provide to the City of Cape Girardeau City Engineer's
Office weekly certified payrolls from the General Contractor and all Subcontractors during
the course of the project. These must be provided on a weekly basis; if no work was done,
then a payroll stating "No Work Done" must be submitted.
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IN WITNESS WHEREOF, OWNER and CONTRACTOR have signed the Agreement in
multiple copies, One counterpart each has been delivered to CONTRACTOR and
ENGINEER and two counterparts to the OWNER. All portions of the Contract Documents
have been signed, initialed or identified by OWNER and CONTRACTOR or identified by
ENGINEER on their behalf.
This Agreement will be effective on �p}PYYI.b� a0 , 201� (which is the
Effective Date of the Agreement).
OWNER City of Cape Girardeau CONTRACTOR D & S Siqn Company, Inc. DBA
Canedy Sign & Graphics
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Scott Me r C� ana er �v.,, 8�--
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B By. Ellis Bradshaw ;.'` .�-1 ' r��
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[CORPO ATE EAL] CORPORATE SE .]�J ", '� �Y�� �7', :
Attest ,,�i',c. ✓���1��� Attest ,� cf� ,�� ,.�'n
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Address for giving notices Address for giving notices
401 Independence Street '-��`� N�µ��
Cape Girardeau, MO 63703 Cl�� G�R'4{���-c� i(K.0 Ce3��l
(If OWNER is a public body, attach License No. �l�lo
evidence of authority to sign and
resolution or other documents Agent for service of process:
authorizing execution of Agreement.
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��la�r'' �'� (If CONTRACTOR is corporation,
�"�' _� �� ��> attach evidence of authorit to si n.
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EXHIBIT A
CITY OF CAPE GIRARDEAU
INSTALLATION OF CITY-W1DE
WAYFINDING SIGNAGE
BI� rOf�P�
(EJCDC 1910-18) (1990)
PROJECT IDENTIFICATION:
The work to be performed under these Contract Documents consists
of furnishing and installing city-wide wayfinding signage, submitting shop
drawings, layouts, samples, and mock-ups for owner approvai, structural
design and wind-load calculations for all signs and foundations, and any
other related work as stated in the specifications or shown on the project
plans. Sign Type F — Gateway, Sign Type G — Alternative Gateway, and
Sign Type H — Neighborhood Gateway will not be furnished or installed with
this project. A traffic control plan shall be submitted and approved by the
City Engineer before installation can begin. Any landscape disturbed by
installation shall be repaired to pre-installation conditions. Contractor is
responsible for locating utilities. All other appurtenances are as specified in
the bid documents for the City of Cape Girardeau, Missouri.
THIS BID IS SUBMITTED TO CITY OF CAPE GIRARDEAU, MO
401 INDEPENDENCE STREET
CAPE GIRARDEAU, MO 63703
1. The undersigned BIDDER proposes and agrees, if the Bid is accepted, to enter into an
agreement with OWNER in the form included in the Contract Documents to perform and
furnish all Work as specified or indicated in the Contract Documents for the Bid Price and
within the Bid Times indicated in this Bid and in accordance with the other terms and
conditions of the Contract Documents.
2. BIDDER accepts all of the terms and conditions of the Advertisement or Invitation to Bid
and Instructions to Bidders, including without limitation those dealing with the disposition of
Bid security. This Bid will remain subject to acceptance for sixty days after the day of Bid
opening. BIDDER will sign and deliver the required number of counterparts of the
Agreement with the Bonds and other documents required by the Bidding Requirements
within fifteen days after the date of OWNER'S notice of Award.
3. In submitting this Bid, BIDDER represents, as more fully set forth in the Agreement,
that:
BF-1
�''��DER has examined and carefully studied the Bidding Documents and the
IUi�U�v'v111C�. .
Addenda, feCelpt Of aII WI11CIl IS Ilerel�y aCI(fIOWIeCIg2CJ: �List Addenda by Addendum Number and Date)
(b) BIDDER has visited the site and become familiar with and is satisfied as to the
general, local and site conditions that may affect cost, progress, performance and
furnishing of the Work;
(c) BIDDER is familiar with and is satisfied as to all federal, state and local Laws and
Regulations that may affect cost, progress, performance and furnishing of the Work.
(d) BIDDER has carefully studied all 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
Underground Facilities) which have been identified. BIDDER acknowledges that such
reports and drawings are not Contract Documents and may not be complete for BIDDER'S
purposes. BIDDER acknowledges that OWNER and Engineer do not assume
responsibility for accuracy or completeness of information and data shown or indicated in
the Bidding Documents with respect to Underground Facilities at or contiguous to the site.
BIDDER has obtained and carefully studied (or assumes responsibility for having done so)
all such additional or supplementary examinations, investigations, explorations, tests, j �
studies and data concerning conditions (surface, subsurface and Underground Facilities) at � �
or contiguous to the site or otherwise which may affect cost progress, performance or
furnishing of the Work or which relate to any aspect of the means, methods, techniques, ;: ;
sequences and procedures of construction to be employed by BIDDER and safety � �
precautions and programs incident thereto. BIDDER does not consider that any additional
examinations, investigations, explorations, tests, studies or data are necessary for the j �
determination of this Bid for performance and furnishing of the Work in accordance with the
times, price and other terms and conditions of the Contract Documents.
;
(e) BIDDER is aware of the general nature of Work to be performed by Owner and '
others at the site that relates to Work for which this Bid is submitted as indicated in the ;- ,
Contract Documents. i �
l
(fl BIDDER has correlated the information known to BIDDER, information and
observations obtained from visits to the site, reports and drawings identified in the Contract ( �
Documents and all additional examinations, investigations, explorations,tests, studies and L
data with the Contract Documents.
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i-.�
BF-2 , i
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(g) RIDDF_R has given Engineer written notice of ail conflicts, errors, ambiguities or
discrepancies that BIDDER has discovered in the Contract Documents and the written
resolution thereof by ENGINEER is acceptable to BIDDER, and the Contract Documents
are generally sufficient to indicate and convey understanding of all terms and conditions for
performing and furnishing the Work for which this Bid is submitted.
(h) This Bid is genuine and not made in the interest of or on behalf of any undisclosed
person, firm or corporation and is not submitted in conformity with any agreement or rules
of any group association, organization or corporation; BIDDER has not directly or indirectly
induced or solicited any other Bidder to submit a false or sham Bid; BIDDER has not
solicited or induced any person, firm or corporation to refrain from bidding; and BIDDER
has not sought by collusion to obtain for itself any advantage over any other Bidder or over
OWNER.
(i) Pursuant to 285.530 RSMo, the bidder must affirm its enrollment and participation in
a federal work authorization program with respect to the employees proposed to work in
connection with the services requested herein by
• submitting a completed, notarized copy of AFFIDAVIT OF WORK
AUTHORIZATION and
• providing documentation affirming the bidder's enrollment and participation in a
federal work authorization program with respect to the employees proposed to work
in connection with the services requested herein.
• http://www.uscis.gov/portal/site/uscis
(j) Bidders are informed that the Project is subject to the requirements of Section
292.675, R.S. Mo, which requires all contractors or subcontractors doing work on the
Project to provide, and require its on-site employees to complete, a ten (10) hour course in
construction safety and health approved by the Occupational Safety and Health
Administration ("OSHA") or similar program approved by the Missouri Department of Labor
and Industrial Relations which is at least as stringent as an approved OSHA program. The
training must be completed within sixty (60) days of the date work on the Project
commences. On-site employees found on the worksite without documentation of the
required training shall have twenty (20) days to produce such documentation.
B F-3
� � "_'� will complete the Work in accordance with the Contract Documents for the
foii�������y �rice(s):
UNIT PRICE BID
NO {TE�J� JN{I LJT. UIvIT TOTAL .
QTY. PRICE EST. PRICE
1 . Traffic Control LS 1 $ $
2. Seed and Mulch LS 1 $ J /� . '-�`J $ `�� `�, �'�
, �a
3. Sign Type A — Large EA 14 $ ��r��� �'`�� $ ��<�W� �
Vehicular ,�
4. Sign Type B — Small EA 20 $ a�`� E � �� $ .�� a'�,� • �
Vehicular
5. Sign Type C — Kiosk EA 9 $ � `� � `�� � y � $ a5 ��`� • ��
6. SignTypeD — EA 10 � 1g �`� ' �� $ I � d2�• ��
Pedestrian Directional
7. Sign Type E — Parking ID EA 15 $ �y��`=���y $ � � ��Q• `� d
�$L{.
TOTAL BID FOR ALL UNIT PRICES $
c�� '� , g��ft . � '
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�wa Nv�dr�� � iN�.�r.�r•.� �`t��L��`�,���'� � J�i�►-i-r I� vNDr��� �
� �
5,�C E�o L.�r�R S �,n��. IU I N�'�`( - ��J� ��.N'C� ,
(Written figure)
; ,
,
,,�
(Total bid amount is to be shown in both words and figures. In case of discrepancy, the
amount shown in words will govern. In case of error in extension, the unit and lump sum
prices under each Pay Item will be considered correct, and these sums when properly
extended, shall constitute the Bid.)
. ;
Unit Prices have been computed in accordance with paragraph 11.9.2 of the General ' �
Conditions.
BIDDER acknowledges that quantities are not guaranteed and final payment will be based ' ,
on actual quantities determined as provided in the Contract Documents. `--
5. BIDDER agrees that the Work will be substantially complete within ninety days (90) ���J
calendar days after the date when the Contract Times commences to run as provided in
�_ �
BF-4 ' :
,- paragraph 2.3 of the General Conditions, and completed and ready for final payment in
accordance with paragraph 14.13 of the General Conditions within one hundred twenty
- days (120) calendar days after the date when the Contract Times commences to run.
� BIDDER accepts the provisions of the Agreement as to liquidated damages in the event of
� failure to complete the Wo�k withir the times speciiied in the Agreemeni.
i
6. The following documents are attached to and made a condition of this Bid:
(a) Required Bid Security in the form of bid bond or cashiers check.
(b) Exhibit Affidavit of Work Authorization
(c) The E-Verify Program for Unemployment Verification Memorandum of
' Understanding http://www.uscis.gov/files/nativedocuments/MOU.pdf
;
(d) Exhibit Affidavit of OSHA Training
' . (e) Certification Regarding Debarment, Suspension and Other Responsibility Matters
7. Bidder agrees to submit the following documents within three (3) business days after
the opening of Bids if requested:
(a) BIDDER'S Qualification Statement with supporting data.
8. Communications concerning this Bid shall be addressed to:
�� Name ��c�t.(�- L�4a.S�S
Address ��`�`� Nt�Si� RD — C�Q=z ��(Z
(a) Performance and Payment Bonding Company
" Name
, i�ddress
Agent\f�ower of Attorney Name (if used)
Address
BF-5
�. Tarms used in the Bid which are defined in the General conditions or Instructions will
have the meanings indicated in the General Conditions or Instructions.
SUBMITTED on , 20_.
State Co�tractor Licerse Na.
IF BIDDER is:
An Individual
By (SEAL)
(Individual's Name)
doing business as
Business address:
Phone No.:
A Partnership
By (SEAL)
(Firm Name)
(General Partner)
Business address:
Phone No.: -
i t tr
,�s��i� I J11lf!
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rt � � �� �
�t`�� f�+�•`CA$fbJcf� ///����
A Cor oration =��, `�,��r f��`°� �
By c�nd S S�� � �=( W C- '�^-� �SE����F a's .
: �
(Corporation Name) `t� �� �.+_s°j �'����
E ss.;, �,t��''a
�\SS�U�Cz� ,� �,r�; � .,���
, i�/ �—'g— �~pF , `
(State of Incorporation) �=,, ;' ro%�_.� s��`�: �R
��
Y ,, � ,,u � ''�a�
,; �
B �C�� S ���� S�.� — - > ��1�1.��,
t;:,;,
� /}/\ (Name of Person Authorized to Sign) �
`f \9
(Title)
(Corporate Seal)
Attest�,_ � __
(Secretary)
BF-6
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�USIi�ESS �3d�i�SS: iJ� L�� ��ti�`�i-� ��, _ t � �)-, f:_rr� n(� , ,fi� , ) ?' ,7i._ i
Phone No.: '�`�-'� =�-3�' `-��-�`�/
Date of Qualification to do business is �r.i ��s��}�s SiN�� �<< 37
A Joint Venture
gy (SEAL)
(Name)
(Address)
gy (SEAL)
(Name)
(Address)
Phone Number and Address for receipt of official communications:
(Each joint venturer must sign. The manner of signing for each individual, partnership and
corporation that is a party to the joint venture should be in the manner indicated above.)
BF-7
�-?�?EAKDOWN OF WORK FORCE (Required)�
The Contractor shali be registered with the Missouri Secretary of State in order to work on
this project.
BIDDER hereby states that he will perform the following items of work directly without
employment of subcontractors:
It is anticipated that the following subcontractors will be employed for work on this project:
*SUBCONTRACTORS: .
(Name of Company) (Type of Work)
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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 LAtiz'..d�`( SiE-�� (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 confirms an empioyee'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.
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 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 Empioyer appropriate assistance with operational
problems that may arise during the Empioyer'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 dur ing 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).
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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
nonconrirmafion oT U.S. citizens' empioymeni eiigibifity within :5 Federai C�overnment work ciays
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' empioyment
eligibility and accuracy of SSA records for both citizens and aliens within 10 Federai
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 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 `
• 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 dur ing 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.
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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.
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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 f }
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conjunction with SSA verification procedures) to provide confirmation or tentative
nonconfirmation of employees' employment eligibility within 3 Federal Government work days of j
the initial inquiry. ( �
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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
phoio non-ma2cn ientative nonconrirmations that is ciesigned to provide tinai contirmation 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 empioyees and all employees who are to be verified through the
system.
2. The Employer agrees to 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 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 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 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 the photocopy with the employee's
Form t-9. The employer wili 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.
6. The Empioyer understands that 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
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the obligation to comply with the antidiscrimination requirements of section 274B 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 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 empioyment eligibility of
the individual in compiiance 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 civiliy 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.
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 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 must use the SSA verification procedures first, and use DHS verification procedures �
and photo screening tooi only after the SSA verification response has been given. Employers
may initiate verification 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, '
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provided that the Employer performs an E-Verify employment verification query using the
employee's SSN as soon as the SS N becomes available. ; -k
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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 i
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.
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9. The Employer agrees to 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 ��l
adverse action against employees if they choose to contest the finding. Further, when ; _I
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. i�l
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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(I))
that the employee is not work authorized. The Employer understands that an initiai inability of
the SSA or DHS automated verification system to verify work authorization, a tentative
nonconfirmation, a case in continuance (indicating the need for additiona� 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 empioyee 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) 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 nonconfirmation may calf 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 couid 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 I-9
or to print the screen containing the case verification number and attach it to the employee's
Form I-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
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, inciuding ensuring that it is not disseminated to
any person other than empioyees of the Employer who are authorized to perform the
Empioyer's responsibilities under this MOU, except for such dissemination as may be
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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(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.
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 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. 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 contracY' (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 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. � �
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b. Federat 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 etigibility for new hires of the Employer I �
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 !. i
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 hi her education, State, local and tribal overnments and sureties: �.-�
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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 ( I
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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. I he provisions o�Articie II.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 may use a
previously completed Form I-9 as the basis for initiating E-Verify verification of an empioyee
assigned to a contract as long as that Form I-9 is complete (including the SSN), complies with
Article II.C.S, 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 I�.C.S, 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.S, 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.5, 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.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 Fede ral 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
Employer's compliance with Federal contracting requirements.
ARTICLE III
REFERRAL OF INDIVIDUALS TO SSA AND DHS
A. REFERRAL TO SSA
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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 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 empioyee 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 Govern ment 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 empioyee so that the employee may determine whether he or she will contest the tentative '
nonconfirmation.
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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 empioyee 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 will
provide the employee with a referrai 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. �`
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5. If the employee contests a tentative nonconfirmation based upon a photo non-match, the
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Employer will provide the employee with a referral letter to DHS. DHS will electronically transmit
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the result of the referral to the Employer within 10 Federal Govemment work days of the referral
unless it determines that more than 10 days is necessary. The Employer agrees to check the L-
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 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. 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 DN S 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
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 E-Verify, DHS reserves the right to require employers to take
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, wilt 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 ail 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
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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 negativefy 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 DHS may adjust verification responsibilities between each other as
thPy 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 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 IIRIRA 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,
inciuding 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 DH S respectively. „ ,
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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.
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Information relating to your Company:
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AI�F�II�AVI"l' O�� OSTIA TRAII�Ti'�rG
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C;O11�'.ti �C)���' (�A;ime) r 1��5 �:'C��S4�Lit.� xS (C)f�ice I I�I�{� `�-���.1{�°�l ���'..�Y\Gf„ '��
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of(Company 1�!.�me/Contracror) Ls�✓l�e.�i� ���C��1 � c•_��-� `> �iC�r� aiicl ftr�t being clulti' s���vr�i, <��l
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__ (1'rojecr Name) for the duration of the contcact, as follo�vs:
1. Contractor sl�all piovidc a ten (10) h�,tu� Occuj��in��rlu1 Saren� and Health
�1cln�iiiistrat.ion (O�I��A) c��nstrue[iun safcty probr�lm (c>r all ��npl�>���•e� ���h� �rill 1>c <>>i-sit� at [h�
Project. The construction safet�� program shall include a course ii1 coilstrtiction s�fery and health
dlat is appiovcd b}� OSHA or a similar program approved by the 1�lissouri llepara��ent of Labor and
Industrial Relations which is at least as st�ingent as an approved OSH11 ptogl-am as required by
Scction 292.675, RSIv1o.
2. Contractor shall require its on-site employees to complete a construction safety
program within siYty (60) days after the date �vork on the Project commences, as required by Secdon
292.675, RSMo.
3. Contractor acknowledges and agrees that any of Contractor's employees found on
the Project site without documentation of the successful completion of a construction safery
program shall be required to produce such documentation �vithin twenty (20) days, or will be subject
to removal Erom the Project.
4. Contractor shall require all of its Subcontractors to comply with the requirements of
Section 292.675, RSMo.
S. Contractor acknowledges that pursuant to Secuon 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 portion thereof, such on-site employee is employed �vithout the construction safety training
required in Section 292.675, RSNIo.
6. Contractor acknowledges that violations of Section 292.675, RSMo, and unposition
of the penalties described therein shall be im�estigated and determined by the Missouri Department
of Labor and Industrial Relations.
7. Contractor acknowledges that in the event that the Nlissouri Department of Labor
and Industrial Relations has determined that a violation of Secuon 292.675, RSi��1o., has occurred
� � � ����rnalr�° shall be .�ssessecl, the Cin' shall �vitl�llol�l ancl ret:iin a11 ;uins a�i�i ain��unt� �ue an�l
<,���in�;r ��l�cn ni:�l:in�� j�.i�»>c�it: i��� C��,ntr;ict<�r un�lcr thi� C�,���nrracr.
}��L'�1Z"f'f IT?R ,�1FFIi1N"1' �:�1I"I�H NC�T.
IN AFFIRMATION THEREOF, the facts stated above are true and correct (the
unciersigned understaiids that false statements made in this filinb are subject to the
penalties provided in Section 575.040, RSMo.) . '
� c`.��� S �i ' � C� ��n � �L-
(name of corporation
By: �Fj��-,� �� - �J' � ,
(name of officer of corporation and tide) -
�,�1,r�;S�I�:
�_ /�'
Secretary(or other officer)
(SEAL OF CORPORATION)
STATE OF MISSOURI ) i �
) ss.
COUNTY OF CAPE GIRARDEAU ) � �
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On this IS�day of v.S-� , 201a-, before me appeared �ll�s ��d.Sh�„� ,
to me personally known, �vho, being by me duly s�vorn, did say that he/she is the��r-a C�—�.�,� ` '
of �a��SY�/�SSd�Go.l��• , a Missouri Corporation, and that the seal affixed to the i �
foregoing instrument is the seal of said Corporation, and that the said instrument was signed and
sealed in behalf of said Corporation by authority of its Board of Disectors, and acknowledged said
instrument to be the free act and deed of said Corporation. ,
IN TESTINIONY WH�REOr, I have hereunto set my hand and affixed my ofFicial seal, at '
my office in Cape Girardeau, Missouri, the day and year first above written. � i
Notary Public LJ
My Commission E�pues: TERESAA.CRUMP
��y Public-Notary Seal ��
State of Missouri
��__��t_�_._. Commissioned tor ScoQ Cp�ty
_.____ My Commission Exp(res:AP►�I 03,20i 5
Commisslon Number:111 B7489 �
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AFFID�IVI'T Ol� ��'ORK _�t'T}IORI"/.A7'10N
,
C:()�'IL,� N()��� (\':�mc) ��Z,L{`= (5�'r}l�S�f�?v�.ts (()Eti<< f 1.1�11 � '':.�'�(��tt�_ �ti1f�.'�-ftt_�t(`-
of(Compan��Name/Contracror) Ci4N�zfli� �K�� ����� � �iC=�� __ �nd tirst bein� dulv s�v��rn, c�rt
mti� oatl�, affirm as follo���s:
1. (Company Name/Contractor)l���`� S��� � � Gv� J �i C�i(1 �C 7v�f�rv�i (tv C
l�__—
is enrolleel aad �vill eontinue ro j�articipate in a federal work authoi�izarion prc>>ram in res��ct t��
en�ployees that �vill�vork vi coilnecuoil �vith tlle contractee� services relat�el �v (P�u�ec� N�m��
�1�.i�Uf='�'�l���vC� S lC�v,4C� for d�e duration of tl�e contract in accordance �c�ith RSMo
Chapter 285.530(2).
2. I also affirm that (Company Name/Concraccor) Ci'�`�%_.(�� Si�s.� � �c.v.i S docs
not and �vill not knowingly employ a person �vho is an unauthor.ized alien u7 connection with the
contract services related to (Projecc Name) 1�11(i��''�t'�Q i�=G S)C�1}��- for
the duration of the contract.
3. Attached hereto is documentation affirmuig Cont�actor's enrollment and
participation in a federal ��ork authorization program �vith respect to the employees working in
connection with the contracted services.
FURTHER AFFIANT SAITH NOT.
IN AFFIRMATION THEREOF, the facts stated above are true and correct (the
undersigned understands that false statements made in this �ling are subject to the
penalties provided in Section 575.040, RSMo.)
� C�t�l S �i �(l ; rv.��rn�1 ��l�
(name of corporacion)
By: � ���,, ---� �,��
(name of officer of corporation and tide)
t1TTEST:
�,_ �
Secretary (or other officer)
(SE.�1L OF CORPORz�TION)
S"I'1:"I��.� Ol� ��IISSOUIZI j
) ss.
CC`� 'V"17' Ol� C�1PI.�, GIIZr�1ZDE�1U )
On this (S�`day of .s�- , 20l� bcfore me appeared G�lt�s �-�,5.�,,�,� , �
to me �ersonall�� kno�vn, �vho, bc g bt� me duh� s«'�rn, clid s.iv that he�she is t1�eE�d.Q- �a�t't-✓' �
�
o{(�A,.el._ S��/��..Co, (,�,G , a ��Iissouri Curporation, and that the scal aftixed to the
foregoing�-trument is the seal of said Corporation, and that the said instrument was signed and -
sealed in behalf of said Corporatioii by authority of its Board of Duectors, and ackno��ledged said
uistrument to be the frce act and deed of said Corporation. .
IN TESTIMONY WHEREOF, I have hereunto set my hand and affi�ed my official seal, at
my office in Cape Girardeau, Missouri, the day and year first aUove �vritten.
Q. \ ,7
Notary Public
My Coizunission Expires:
TERESA A.CRUMP
����'s Notary Pubiic-Notary Seal
State of Missouri ; i
Commissioned for Scott Courdy � ;
My Commission Expires:April 03,2015
Commission Number:11167489
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4 r�rtifi���inn R�aarrlin�
llebarr��ent, Suspensio�� and Other Responsibility Matters
�l,hc contractor hereby certities to the best of its knowledce �in�j belief and that it and its principals
and its subci�ntractors a»d their principals:
(a) Are not presently debarred, suspended, proposecl foi- debai�l��ent, declai-ed i��eli�ible oi-
voluntarily excluded from covered transactions by any Federal or State departrnent or agency;
(b) Have not within a three (3) year period preceding this proposal been convicted of or had a
civil judgment rendered againsi them for commission of fratid oi- a criminal offense ii1
connection with obtaining, attempting to obtain or perforining a public (Federal, State or
Local) transaction or contract under a public transaction; violation of Federal or State antitrust
statutes or commission of embezzlement, theft, forgery, bi-ibery, falsification or destruction of
records, making false statements or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly charged by a government
entity (Federal, State or Local) with commission of any of the offenses enumerated in
paragraph (1)(b) of this certification; and
(d) Have not within a three-year period preceding this subcontract had one or more public
transactions (Federal, State or Local) terminated for cause or default.
I understand that a false statement on this certification may be grounds for rejection of this
contractor or termination of the contract. In addition, under 18 USC Sec. 1001, a false
statement may result in a �ne of up to $ 10,000 or imprisonment for up to five (5) years or
both.
�U.-)S �iZA l�.S 1��1 ���u�l�l� i�'1�Al.�fl��-�-r�
Typed Name & Title of Authorized Representative
� � f�"1S' I�-
Signature of Authorized Representative �-- Date
❑ I am �inable to certify to the above statement. N1y explanation is attached.