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Home My WebLink AboutRES.2684.04-02-2012 BILL NO. 12-32 RESOLUTION NO. ��'�/� A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE AN AGREEMENT WITH FRONABARGER CONCRETERS, INCORPORATED, FOR IMPROVING THE BROADWAY CORRIDOR FROM PACIFIC STREET TO WATER STREET, IN THE CITY OF CAPE GIRARDEAU, MISSOURI BE IT RESOLVED BY THE COUNCIL OF THE CITY OF CAPE GIRARDEAU, MISSOURI, AS FOLLOWS : ARTICLE l . The City Manager, for and on behalf of the City of Cape Girardeau, Missouri, is hereby authorized to execute an Agreement with Fronabarger Concreters, Incorporated, for improving the Broadway Corridor from Pacific Street to Water Street, in the City of Cape Girardeau, Missouri . A copy of said Agreement is attached to this Resolution and made a part hereof . PASSED AND ADOPTED THIS �� DAY OF , 2012 . ��F r�'i, � ` �.� � � r' l;A ,< � ��r. , Harry E. ed ger, Mayor ��.;,�;,,..''"� -, � r� :;� \�!'';� �� `� A'X'TES�': �,� ,CC.,,� � �, ''r`� '�� '� ,� `�:�; �' l � � ,,,i'�. ��,.�7t��, `•J f" ,I:li a. t ''v E ON�� ,; �� ¢ .�c\�.. � � � �� Gay�e--�� nrad, City Clerk C I TY � � CAPE G 1 R A R � E A U BROADWAY STREETSCAPE IMPROVEMENTS STANDARD FORM OF AGREEMENT BETWEEN OWNER AND CONTRACTOR ON THE BASIS OF A STIPULATED PRICE THIS AGREEMENT is dated as of the �� day of �{��j ) � in the year 2012 by and between the City of Cape Girardeau, Missouri (hereinafter called OWNER) and Fronabarqer Concreters, Incorporated (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 under these Contract Documents consists of... Improving the Broadway Corridor from Pacific Street to Water Street by milling and overlaying the existing roadway with asphalt, removing and replacing sidewalks, removing and replacing concrete curb and gutter, storm sewer work, installing decorative streetscape elements which include stamped colored concrete, pavers, street and pedestrian lighting, landscaping, trees,tree grates, benches, trash receptacles and bicycle racks. Add alternates to the project include an irrigation system and fiber communication infrastructure. All other work to be performed as specified in the bid documents for the Broadway Streetscape Improvements. 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. A-1 Article 3. CONTRACT TIMES. 3.1 The Work will be substantially complete by November 5, 2012 and final completion will be reached by April 1, 2013. 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 General Conditions. They also recognize the delays, expense and difficulties 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 six thousand dollars$6,000 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 five thousand dollars 5 000 for each day that expires after the time specified in paragraph 3.1 for completion and readiness for final payment. NOTE: Contractor shall begin construction at the east end of the project and proceed to the west. No more than two blocks may be closed at a time. One block may not be closed for longer than three weeks (21 calendar days). Substantial completion for the project is Monday, November 5, 2012. Substantial completion shall consist of pavement, sidewalks, curb and gutter, storm sewer and lighting. Liquidated damages for not meeting substantial completion are $6,000 per day. Final completion is Monday, April 1, 2013. Final completion shall consist of landscaping, trees, tree grates, benches, trash receptacles, bicycle racks, and any other remaining project items, including paperwork. Liquidated damages for not meeting final completion are $5,000 per day. If a block is not opened completely within three weeks (21 calendar days), a $10,000 per day penalty will be incurred in addition to liquidated damages. Time milestones for completion or non- completion will be decided by the City. Asphalt overlay towards the end of the project will be acceptable as long as tra�c is able to move through the project area. Article 4. CONTRACT PRICE. OWNER shall pay CONTRACTOR for completion of the Work in accordance with the Contract Documents an amount in current funds equal to the sum of the amounts determined pursuant to paragraphs 4.1 and 4.2 below: 4.2 for all Unit Price Work, an amount equal to the sum of the established unit price for each separately identified item of Unit Price Work times the estimated quantity of that item as indicated in the bidding documents. A-2 TOTAL OF BASE BID UNIT PRICES: four million four hundred thirteen thousand five hundred thirteen dollars and seventy cents ($ 4,413,513.70) WITH ADD ALTERNATE 1A —forty eiqht thousand dollars and no cents ($ 48,000.00) and WITH ADD ALTERNATE 2 —thirty-eiqht thousand five hundred fifteen dollars and no cents ($ 38,515.00) for the TOTAL OF ALL UNIT PRICES SELECTED FOR THIS CONTRACT: four million five hundred thousand twenty-eight dollars and seventy cents ($ 4,500,028.70) 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 will 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 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 previously made and less such amounts as ENGINEER shall determine, or OWNER may withhold, in accordance with paragraph 14.7 of the General Conditions. 90% of Work completed (with the balance being retainage). If Work has been 50% completed as determined 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, 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). A-3 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: 7.1 CONTRACTOR has examined and carefully studied the Contract Documents (including 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. A-4 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. 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 A-1 to A-8 inclusive). 8.2 Exhibits to this Agreement (pages to , inclusive). 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 Supplementary Conditions (pages SC-1 to SC- 5 , inclusive). 8.7 Specifications bearing the title Broadwav Streetscape Improvements . 8.8 Drawings. 8.9 Addenda numbers 1 to 2 , inclusive. 8.10 CONTRACTOR'S Bid (pages BF-1 to BF-15 , inclusive) marked exhibit "A" A-5 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). There are no Contract Documents other than those listed above in the Article 8. The Contract Documents 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 A-6 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. A-7 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 � ��I�-- �J} , 2012 (which is the Effective Date of the Agreement). OWNER City of Cape Girardeau CONTRACTOR Scott Me er ' Mana er Fronabarqer Concreters, Incorporated By�- By: � � �i�� - P �5�,t��l�lT (CORPORATE SEAL] [CORPORATE SEAL] Attest Attest V��'� Gayle Conrad, City Clerk Address for giving notices Address for giving notices 401 Independence Street 3Z�''� ��r�re �w�,✓_ L Cape Girardeau, MO 63703 Q�tc ��va�� Mc� 1a�7��t (If OWNER is a public body, attach License No. evidence of authority to sign and resolution or other documents Agent for service of process: authorizing execution of Agreement. ",4� GIRq��_ `� �� (If CONTRACTOR is corporation, � \G attach evidence of authority to sign.) r' � �- '3� � , �� 1 . �� ,1�'v.��E Ah�� f . V _✓(/__..y�ti f�`'� '1 I' � � �� ..*�,E UNIpN � p`�Y��"* ',�.�AL A-8 EXHIBIT "A" C 1 TY CAPE G 1 R A R � E A U BROADWAY STREETSCAPE IMPROVEMENTS BID FORM (EJCDC 1910-18) (1990) PROJECT IDENTIFICATION: The improvement consists of... Improvement of the Broadway Corridor from Pacific Street to Water Street by milling and overlaying the existing roadway with asphalt, removing and replacing sidewalks, removing and replacing concrete curb and gutter, storm sewer work, installing decorative streetscape elements which include stamped colored concrete, pavers, street and pedesfrian lighfing, landscaping, trees, tree grates, benches, trash receptacles and bicycle racks. Add alternates to the project include an irrigation system and fiber communication infrastructure. All other work to be performed as specified in the bid documents for the Broadway Streetscape Improvements. THIS BID IS SUBMITTED TO: CITY OF CAPE GIRARDEAU, MO 401 /NDEPENDENCE 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 VI/ork as specified or indicated in the Contract Documents for the Bid Price and within the Bid Times indicated in this Bid and in accordance wifh the other terms and conditions of the Contract Documents. 2. BIDDER accepts all of the terms and conditions of fhe Advertisement or Invitation to Bid and lnstructions to Bidders, including without limifation 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 affer the date of OWNER'S notice of Award. 3. In submitting this Bid, BIDDER represents, as more fully sef forth in the Agreement, that: (a) BIDDER has examined and carefully studied fhe Bidding Documents and the following: BF-1 Addenda, C'ECeIPf Of aII WI7ICI1 IS I761'2I�y aCIC170WI8CIQ8CI: �List Addenda byAddendum Numberand Date) �-��.-. �,�, � .�- �� :��,�e�� /�-��. ��,�• �' �? �'1�-c�.�a �� (b) BIDDER has visited the site and become familiar with and is satisfied as to the general, local and site conditions thaf 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 conditrons in or relating to exisfing 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 for81DDER'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 wifh respect to Underground Facilities at or contiguous to the sife. BIDDER has obtained and carefully sfudied(orassumes responsi6ility forhaving done so) all such additional or supplementary examinations, investigations, explorations, tests, studies and data conceming conditions(surface, subsurface and Underground Facilities) at or contiguous to the site or otherwise which may affect cosf progress, performance or furnishing of the Work or which relafe to any aspect of the means, me#hods, 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 examinafions, investigations, explorations, tests, studies or data are necessary for the 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. (� B/DDER has correlated the information known fo B/DDER, information and observations obfained from visits to the site, reports and drawings identified in the Contract Documents and all additional examinafions, investigations, explorations, tesfs, studies and data with the Contract Documents. (g) B/DDER has given Engineer written notice of all conflicts, errors, ambiguities or discrepancies that BIDDER has discovered in the Contract Documents and the written resolufion fhereof by ENG/NEER is acceptable fo BIDDER, and the Contract Documents BF-2 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 nof submitted in conformity with any agreement or rules of any group association, organization or corporation; BIDDER has not directly orindirectly induced or solicifed any other Bidder to submit a fa/se or sham Bid; BIDDER has not solicifed or induced any person, firm or corporation to refrain from bidding; and BIDDER has not sought by collusron to obtain for itself any advantage over any other Bidder orover 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, nofarized copy of AFFIDAVIT OF WORK AUTHORIZATION and • providing documentation affirming the bidder's enroliment and participation in a federal work authorization program with respecf to the employees proposed to work in connection with the services requested herein. • http://www.uscis.qov/portal/sife/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 fhe Projecf 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') orsimilarprogram approved by the Missouri Department ofLabor 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 documenfation of fhe required training shall have twenty (20) days to produce such documentation. 4. BIDDER will complete the Work in accordance with the Contract Documents for fhe following price(s): BF-3 UNIT PRICE BID Broadway Improvements (Pacific Street to Water Street) NO ITEM UNIT EST. UNIT TOTAL QTy. PRICE EST. PRICE 1. Contractor Fumished Surveying and LS 1 $�� (kJQ ><.}J $ �j (.�,�t� Staking ' 2. TrafficControl LS 1 $ J.�j�(3{�.k)J $ 3 j Q � 3. Removal of Improvements LS 1 $ ��J� $ �Q , ��p, Ura �- 4. Removal of Pavement SY 8073 $�QI , � $ ��a�r�--{��, QS� 5. Removal of Sidewalks and SY 7022 � a Q , �� $ �� Q, �U Driveways 6. Cold Milling SY 11231 $ �i ,`3� $ 1-��y �Q ,�� 7. Type 1 Aggregate Base,4 Inches SY 10717 � �� $ ��;��(�,�� 8. Asphait Pavement SY 1820 $ ��,a� $��q 9. Type BP-2 Mix(Asphaltic Concrete TON 1248 � `(b�� $ � '4 �ca Pavement),2 Inches 10. Tack Coat-Emulsified Asphalt GAL 562 $ j,(j $ ��17Q , j� (SS-1 H) . 11. Concrete Sidewalk,4 Inches SF 52518 $ 5,�� $ ��, �J��,�C� 12. Remove and Replace Existing SY 567 $ �'j�,�f� $y rj��,� Sidewalk 13. Concrete Curb(6 Inch Height and LF 4081 � �. Q� l}C9 $ � O GD Under)Type S 14. Concrete Curb and Gutter,4 Inches LF 2739 � ��,�0 $ �� 1 (�,� 15. Concrete Curb and Gutter,6 Inches LF 1133 � .,��(� t�a $ �a. �Q,(�� 16. P.C.C.Concrete Pavement, SF 11477 � �S: � $ ��_ �,(�� 8 Inches BF-4 NO ITEM UNIT EST. UNIT TOTAL QTy. PRICE EST. PRICE 17. Manholes,Type A,4'-Diameter, EACH 7 $�/� ��r,� $ ��{ L ��f'�� Type 1 Frame, Closed Lid 18. Manholes,Type A, 5'-Diameter, EACH 17 $ � ��,°�� $�'?jW� f �� Type 1 Frame,Closed Lid 19. Manholes,Type A,6'-Diameter, EACH 1 $ ' � �� $ j , ,i � Type 1 Frame, Closed Lid 20. Manholes,Type A, 7'-Diameter, EACH 2 $ � Qxr�C� $ �� "��4 �a Type 1 Frame,Closed Lid —��;�� 21. Manholes,Type A, 8'-Diameter, EACH 1 $�`"�� $ (}' , �r� Type 1 Frame,Closed Lid 22. Manholes,Type A,9'-Diameter, EACH 1 $ ��, ��,,�(� $�Q T��, �]� Type 1 Frame, Closed Lid 23. Manholes,Type A,4'-Diameter, EACH 1 � l �,,� $ ,�C)@, �� Type 1 Frame,Open Lid 24. Manholes,Type A,5'-Diameter, EACH 1 � ' Q�� $� ��,�o Type 1 Frame,Open Lid 25. Inlets,Type A,Type 3 Frame and EACH 3 $ ` �p � $ ��r 4� Grate 26. Manholes,Type A,4'-Diameter, EACH 19 $ , 00.Z7� $ �� 0.'7.��'9 Type 3V Frame and Grate 27. inlets,Type A,Type 20 Frame and EACH 7 � ;},C� $�5�� , (�� Grate 28. Manholes,Type A,4'-Diameter, EACH 3 $ � �,� $ ,C�� Type 20 Frame and Grate 29. Manholes to be Adjusted with New EACH 6 $ � �(�,� $ q (3p0 r n� Type 1 Frame,Closed Lid 30. 5'Curb Inlet EACH 3 $ J(�x(� $�(XX.�, Q� 31. 6'Curb Iniet EACH 22 $ OC)C),0� $ � �04� �� 32. 12 InCh RCP LF 272 $ �Q�,(�G1 $ � Qr,� 33. 12 Inch RCP,Ctass V LF 149 $ `�0, Ot? $ �� -{�� ,�� 34. 15 Inch RCP LF 656 $ �,�,Cb0 $ � ��,00 BF-5 NO I TEM UNI T EST. UNI T TOTAL QTY. PRlCE EST. PRICE 35. 15 Inch RCP, Class V LF 9 $ ' (�� $ �� ,C3� 36. 18 Inch RCP LF 187 $ ��(� $ 1�1 57�,d� 37. 24 Inch RCP LF 130 $ �L�l�,�� $ i �, ��'j,t�d 38. 30 Inch RCP LF 901 $ � `;� , �(� $ i(;(�,(j ;Q(? 39. 42 Inch RCP LF 69 $ }�z(�J $ {�;,'�=,(� M�U 40. 4 Inch White Acrylic Waterborne LF 747 $ ; ,Q(� $ � �9�,�C� Pavement Marking Paint 41. 4 Inch Yellow Acrylic Waterborne LF 5290 $ �1 , DU $ S r��a,�o Pavement Marking Paint 42. 24 Inch White Acrylic Waterborne LF 432 $ �p $�?�Q,,O� Pavement Marking Paint 43. White Acrylic Waterborne Pavement EACH 7 $ �p� o t�a $ ��{}O,. c�D Marking Paint,Left Arrow 44. Handicap Parking Symbol EACH 8 $ ';�j,a''� $ �,GOC), ��7 45. Relocate Fire Hydrant EACH 0 $ .�� $ 46. Adjust Utility to Grade EACH 219 $ ��t�A $ '�� .��Q_DA 47. Coal Chute Top EACH 10 $ ��jOp,t� $ ��'. oop � oQ 48. Battery Backup System EACH 2 $ .5LY1, c� $ �`7,�,��1 49. Video Detection System EACH 1 $ �,(X� $ � D�QU, c�� 50. Trench Drain 405.1 LS 1 $ ��a 1 O t�,� $��,pp, p� 51. Trench Drain 402.4 LS 1 $ ��,,;10a=va $ �� . 1 Oo, D� 52. Trench Drain 310.1 LS 1 $ jO �'a�C�,� $ �0�,��1Q, �J� 53. Trench Drain 306.1 LS 1 $ �� ` , .,(,y0 $ � � ��, � 54. Trench Drain 303.1.1 LS 1 $�,p� $ ��, �O 55. Trench Drain 203.1 &121.1 LS 1 $_�(��}, �ip $ �?_�, (}G� 56. Trench Drain 119.1 LS 1 $_�(��p $ 10.��1{O,oq BF-6 NO ITEM UNIT EST. UNIT TOTAL QTY. PRICE EST. PRICE 57. Trench Drain 114.2 LS 1 $ , q $ Q� 58. Trench Drain 104.4 LS 1 $ � �st)3 $ `�. �'�,�O 59. Temporary Storm Sewer Plug,30" EACH 5 $ ��s(� $��'�.�,(� 60. Temporary Storm Sewer Plug,42" EACH 2 $ `39�j,� $ �q(� � �� 61. Mobilization LS 1 $ �, �Q(�r.� $ �� ,�,�� 62. Plank Stamped Concrete,4 Inches SF 7727 $�,� $��,�) (Pedestrian Areas) 63. StampedlColored Concrete,8 SF 17792 $ ��{�(�� $ 0��,c3c:� Inches(Vehicular Areas) 64. Pavers(Curb Ramps) SF 4199 $ i�,�C} $ , SD 65. Paver Detectable Warning Panel SF 778 $�l�'�5 $ (y� , � 66. Permeable Pavers(Parallel Parking SF 10754 $ [(}r(Dv $��`3 q�.��/�� Areas) 67. Tree Grates EACH 86 $ ��,� $ �� _�,0� 68. Planting Soil CY 895 $ ��,j�� $ : � T— 69. Mulch CY 50 $ C�,�� $ �,S�.t�o 70. Structural Soil CY 889 $ ��'�tJ $�j�, 3'��. (�Q 71. Perforated Schetlule 40 PVC Drain LF 4488 $ �3Q,ff�J $ ��(� �-rji.�1�, Qq Pipe,6 Inches 72. Tree"A" EACH 45 $ j�,�D $ s � Sf.�3.�� 73. Tree"B" EACH 34 $ (p�,t�� $ �� t p,q.Cyq 74. Tree"C" EACH 15 $ lp�},pc7 $ q;�UQ rD� 75. Tree"D" EACH 12 $ SQ�,�4� $ �,Q�CX1�� 76. Tree"E" EACH 11 $ (��rj,Ov $ (�9S,oD 77. Tree"F" EACH 11 $ �1S', �t� $ ��,25t0� 78. Groundcover Plantings"AC" EACH 452 $ ��,,,�9 $ �Ta�"a� BF-7 NO ITEM UNIT EST. UNIT TOTAL QTy PRICE EST. PRICE 79. Groundcover Plantings"OE" EACH 598 $ � ,q,� $ �,'� �1��; , Q� 80. Groundcover Plantings"PE" EACH 744 $ � �,�� $ ��j_�j� 81. Groundcover Plantings"SC" EACH 798 $ �,�� $ „ �� 82. Groundcover Plantings"CL° EACH 456 $ ��,'j (� $ �j. . � �� 83. Groundcover Piantings"BO" EACH 412 $ �� ,�,� $ � ,�; �p 84. Groundcover Plantings"NE" EACH 1073 $ 11 .,�� $ j��`}��,i�� 85. Groundcover Plantings°LI" EACH 949 $ �(}.,�� $ ��,��;p,�z� 86. Shrubs"IT" EACH 105 $ (�, 5� $ ��.�() 87. Shrubs"MP" EACH 118 $ ID'��.� $ 0 6,Qp 88. Shrubs°CS" EACH 109 $ �y n QQ $ � q� ,p0 89. Shrubs"IL" EACH 88 � 0� $ '; (f� f '� �-' 90. Bench EACH 23 $ ��,� $ ��,�io 91. Trash Receptacle EACH 23 $ 3 (X? $ ��,�`�(�.� 92. 25 Foot Pole EACH 60 $ �?j�� $ ' � � ,p� 93. 25 Foot Pole Base EACH 60 $ �� $ �3(G,�,� 94. Type"A"Fixture EACH 15 $ —'(,�r� $ � , �4fl,C3� 95. Type"B"Fixture EACH 28 $ � \(��r Q� $ 3�i$C�,� 96. Type"C"Fixture EACH 15 $ ,�C3 $ '3 _(y�,p� 97. 12 Foot Pole EACH 28 $ � �3 $ '��(,,�,Q�3 98. 12 Foot Pole Base EACH 28 $ �,� $ 1�, 00�,a� 99. Pull Box EACH 99 $ ��-4G? $ � .Q� 100. Tree Grate Receptacles EACH 79 $ 509.�� $ Qfl r0� 101. Pole Receptacles EACH 60 $ ��pQ $�T r'jO.9.C�c� 102. Power Supply EACH 2 $ Q�O,t3� $� �Q ,�� BF-8 NO I TEM UNI T EST. UNI T TOTAL QTy PRICE EST. PRICE 103. Trench LF 6775 $ q,Ql�' $ �=�.q �'��C?�% 104. 1 Inch PVC LF 630 � � ,�� $ L,�'��,�C� 105. 2 Inch PVC LF 6875 $ � ,�C� $ �?��,SC� 106. #6 CU LF 19835 $ � a�j $�(�'3�5 107. #8 CU LF 22220 $ �,,�� $ � � � �,�'3 108. #10 CU LF 4360 $ s�j� $ _ ��i,� 109. Detectable Warming Panels SF 1059 $ �-j��? $ � y� f� 110. Remove and Replace Existing SF 365 $ i��,p,� $ �{ `� b,c�� Ramps � 111. Connection to Existing Storm Sewer EACH 11 � � �Q,. `� $ �� ,.�� 112. Building Drain Connection EACH 20 $ �Q, �� $ ��. (�C), p� -�— 113. Tra�c Signage SF 81 $ �� '�' $ �-r-� M TOTAL BID FOR ALL UNIT PRICES $ Lj r�,., r1� , -�� x� i� �� 7. 1"1\1�� t..r-'N4v�rzd ��1�'�1 1►1�V�� 1-��Y��vv�� 'R�?;r� 1��`� - �11�� (Written figure) Add Alternate1A NO ITEM UNIT EST. UNIT TOTAL QTy. PRICE EST. PRICE 1. Irrigation—Sleeves and Taps Only LS 1 $ $�,`��' $ �-}Q�i� d�� TOTAL BID FOR ADD ALTERNATE 1A $ �� a, � f�"�i'�! � C—�t1t�1 1K1L�lSA�y'� 4at1�. Xy �a�� . (Written figure) BF-9 Add Alternate1 B NO ITEM UNIT EST. UNIT TOTAL QTy. PRICE EST. PRICE 1. Entire Working Irrigation System LS 1 ��3i �' $ ��,�(�,� _�� TOTAL BID FOR ADD ALTERNATE 1 B $ 1 '�'� ��.�'-=, j� � 1 �` t ` + �� { i � � � l i�� ulll.ls`� \t�vS7�� G"��A iJ �,�r�l.�.,Zf 1�Cv C� �l. ?C1f— �.Y•r (Written figure) Add Alternate 2 NO ITEM UNIT EST. UNIT TOTAL Q7-y. PRICE EST. PRICE 1. 1 Inch PVC Fiber LF 80 $ � ,Q� $ "j�(') ,O Q 2. 2 Inch PVC Fiber LF 6625 � � ,p� $ � (�j 3. Pull Box Fiber EACH 8 $ G�p, '� $ � �QL"�-O� 4. Fiber LF 3520 $ -�.� $ Q ��C�J 5. Trench Fiber LF 240 $ 1 Li,�� $ �p ,� TOTAL BID FOR ADD ALTERNATE 2 $ ,. �� -�r^��j�'1� �a�l'�tv.lD �J t' f 4v�,r:� 11�j� f�� a 61CtT_ _� (Written figure) BF-10 Add Alternate 3 NO ITEM UNIT EST. UNIT TOTAL QTy. PRICE EST. PRICE 1. 25 Foot Pole EACH 8 $j „�i� $ ��.u��U�� 2. 25 Foot Pole Base EACH 8 � �� '� $__��,��F�.(�;�� 3. Type"A"Fixture EACH 1 ��-."�"`"` $ �, 4. Type"C"Fixture EACH 3 $ ` ;�, $ ��.(�� 5. Pole Receptacles EACH 8 $ ��j,j�' $ ( ,�Q(,a.��% 6. Trench LF 800 � �,(�,� $ ,� 7. 21nch PVC LF 840 �� $ � � yQ> 8. #6 CU LF 2240 $ i ,j Q $� .�� 9. #8 CU LF 11060 � ��_ $ (�C� TOTAL BID FOR ADD ALTERNATE 3 $ `�� ,�= , �✓�",r'-�►� �I�e�s+t� l�-n�r �.�.,��,� �,y�� -� �.� C`��«a��, (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 fhese 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 quanfifies are not guaranfeed and final payment will be based on acfual quantities determined as provided in the Confract Documents. 5. BIDDER agrees that the Work will be substantially complete by November 5. 2012 and final completion will be reached by April 1, 2013. BF-11 BIDDER accepts the provisions of the Agreement as to liquidated damages in the evenf of failure to complete the Work within the times specified in the Agreement. 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 Affidavif of Work Authorization ✓ (c) Exhibit Affidavit of Excessive Unemployment (if applicable) � (d) The E-Verify Program for Unemployment Verification Memorandum of Understanding http://www.uscrs.qov/files/nativedocuments/MOU.pdf ✓ (e) Exhibit Affidavit of OSHA Training a/ (� Certification Regarding Debarment, Suspension and Other Responsibility Matfers ✓ 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 wifh supporting data. 8. Communications concerning this Bid shall be addressed to: , Name �� %�� .1��;.�;� Address ��at� ��-� ��+�+�1 �. Q<�r` �r�7�� 1� �z`�@7�'�? (a) Performance and Payment Bonding Company Name ��A �iIZE"�" CI�S,.��-;y �yr��,,,.��y Address ��a. �� C� ��-�k� ��►�s _ 1 a.�rs+ '>�� AgentlPower of Attorney Name (if used) �j1 tr�� Address �l�� l� �,�-?c ��i�xr c��a.v �,�t- {��'��7 9. Terms used in the Bid which are defined in the General conditions or Instructions will have the meanings indicated in the General Condifions or Instructions. BF-12 SUBMITTED on �1�� ."� , 20�'�. State Contractor License No. (��:�� IF BIDDER is: An Individual B y (SEAL) (Individual's Name) doing business as Business address: Phone No.: A Partnership By (SEAL) (Firm Name) (General Partner) Business address: Phone No.: A Cor oration BY �A�.�,L ' �� T�2C _ �. (SEAL) (Corporation Name) ��ss�,��i �" , , � (State of Incorporation) q�,��,��},�Y, ey �� l��0� � .��„��,�f4��:� (Name of Person Authorized to Sign) � �r, -*� �,`r��; J '" ,� � /� e C��a°�.1„�`,;� �'� .� �r�►;�i�� . ,�'�_.°'a�_�'�„_�`�/�Y'.a E -� ' �r (Title) � '"� � y�� >�/ � � P z� r31$ l",� 'Y� �y� s ,,y J.n',.�i � � :/_^4 X v.. (Corporate Seal) �M.� � ;,� � � r=;� < ' �� , �;r ��,(5��,., �'"�:�� " Ca♦ +�' Attest �;��`�'��'� ,� fap r ecre a �,,�<;�..� .. Business address: �� w��,- � �� p��_ �� BF-13 Phone No.: ��L�',��0_�' Date of Qualification to do business is�'��,'�'� A Joint Venture g y (SEAL) (Name) (A ddress) gy (SEAL) (Name) (Address) Phone Number and Address for receipt of otficial 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-14 BREAKDOWN OF WORK FORCE (Requirea): The Contractor shall be registered with the Missouri Secretary of State rn order to work on this project. BIDDER hereby states that he will perform the following items of work directly without employment of subcontractors: ��O ��T CytS 1:11ta �i[�2a� �E�l�� . ��'�t•t�.I �°�l��:/Vlz.�3� l_�Ji/•�Zt�E' 1�r2�C 1 It is anticipated that the following subcontractors will be employed for work on this project: *SUBCONTRACTORS: (Name of Company) (Type of Work) ��4a� -� '(�'��. l.��FwA� fT.v O l.�h:�1L��Lr�-ai=- !��NV'TW�SP��i�fL—�1��,�t^r1�c��O,�t/ ��' K �I�T�� L�ah��.,� � Li-."1'h - �fEC.,i r �nn "�' "�TiA�i—j *All subcontractors shall be registered with the Missouri Secretary of State in order to work on this project. BF-15 CITY OF CAPE GIRARDEAU BROADWAY STREETSCAPE IMPROVEMENTS ADDENDUM #1 March 22, 2012 The following additions and modifications have been made to the above named Project Manual: JSP 11 — Street Lighting Poles JSP 15 —Decorative Concrete Paving JSP 16 —Benches JSP 17—Trash Receptacles JSP 18 —Tree Grates JSP 19—Perforated PVC Drain Pipe Sheet COV: Cover Sheet Sheet C2-A.1: Summary of Quantities Sheets C2-B.5 and C2-B.6: Summary of Quantities Sheets C3-1.14 and C3-1.15: Existing Conditions and Removal Plan Sheets C4-1.1 through C4-1.17: Materials Plan Sheets C4-2.1 and C4-2.2: Materials Details Sheets L3-1.1 through L3-1.4: Irrigation Plan Sheets E1-1.17 through E1-1.20: Street Lighting Plan Bid Form This addendum must be signed and attached to your Bid Documents. Name 1 � S' � Date 3/ Z�t. �f Z CITY OF CAPE GIRARDEAU BROADWAY STREETSCAPE IMPROVEMENTS ADDENDUM #2 March 23, 2012 The following additions, modifications, and/or clarifications have been made to the above named Project Manual: 1. Sheet E1-2.2 Tree Grate Detail: The minimum conduit depth shall be 30". Remove Sealtite note from lower right corner. Conduit entering pull box shall be PVC. Note for 8"X8"X4" concrete base refers to receptacle pedestal base. 2. Sheet E1-2.2 Typical Conduit Burial Detail: Crushed Aggregate depth shall be 22" to coordinate with Tree Grate Detail. See City of Cape Girardeau Standard Specifications for backfill compaction. 3. Bid items 40, 41, 42, and 43 shall be paint, not tape. See attached bid form. 4. Clarification to JSP-1, paragraph 4: Reasonable effort shall be made to open lanes to traffic whenever possible and safe for motorists and pedestrians, including nights and weekends. 5. Clarification to JSP-1, paragraph 6: Requested overtime hours for nights, weekends, and holidays will be approved by the City. 6. Clarification to JSP-1, paragraph 7: A loud noise is considered louder than average truck traffic passing by the building. 7. Clarification to JSP-1, paragraph 8: All attempts shall be made to accommodate pedestrian access to businesses and residences along the project corridor. 8. Utilities along the project corridor have been notified that if they plan to upgrade any infrastructure, they need to be starting now. 9. Changes in the field will be handled by the City Inspector, City Project Manager, or other City personnel. 10. There are two bid items for the lighting, poles and bases. Bases can be installed before the poles. 1 l. Clarification to Add Alternate 2: Bid items 1" PVC Fiber and 2"PVC Fiber are the PVC conduit that the fiber will be placed. The actual fiber is a separate bid item in Add Alternate 2. 12. Alliance Water Resources will be replacing any old meter pits and adjusting fire hydrants. Page 1 of 3 13. AT&T will handle all work associated with adjusting their infrastructure. 14. Milling the entire street at the beginning of the project start is acceptable. The road shall be safe and passable for vehicles. 15. Areas that are removed for utility work can be patched back with concrete as long as the final surface is placed over the concrete patch, i.e. asphalt, decorative concrete, etc. 16. All details for work between Spanish and Water are shown on the plans and addenda. This work shall be coordinated directly with the City during construction. Separate bit items have been added for ramps and detectable warning panels. 17. The under drain pipe is detailed in Addendum 1. 18. All storm drain piping details are shown on the plans and addenda. 19. Clarification to JSP-9, 1.7A: Landscaper shall be approved by the City and provide details of three successfully completed projects of similar nature. 20. Structural soil shall be bid as shown. The structural soil is a specific growing medium that provides structural capacity and load bearing for pavement. 21. The edge restraint between the porous unit paving and the asphalt paving will be the asphalt pavement. 22. The final color of the detectable warning pavers will be decided upon by the City after review of mock-ups. 23. Clarification to JSP-8: Aqua-Bric Type 1 and Type 4 permeable paver systems are both acceptable for porous unit paving application. 24. Clarification to Add Alternate 1 B: Add Alternate 1 B includes the sleeves and taps in Add Alternate 1 A. 25. A bid item for Building Drain Connection has been added to the bid form. See attached bid form and JSP-21. Building drain connections to the storm sewer system shall be decided by the City. 26. The C6 series of the plan sheets detail grading in areas of pavement that do not match existing grade. Otherwise match existing grade. 27. For under drain pipe location, see Sheet C1-1.1, General Note 19. 28. Converting an existing inlet to a manhole is being paid for as shown on Sheet C2-B.4 denoted by *** Page 2 of 3 29. See Sheet C2-B for items being paid for by bid item 7. Rock base is incidental for asphalt pavement, 12" aggregate under permeable pavers, 8" aggregate under pavers at ramps, and 8" aggregate under truncated domes. 30. City Parks and Recreation department will install bicycle racks. 31. Concrete band details are in Addendum #1, Sheet C4-2.1, Detail G. 32. 8" stamped concrete details are in Addendum #1, JSP-15. 33. Bid item 64 does not include detectable warning pavers. Detectable warning pavers are covered under item 65. 34. A bid item has been added for Traffic Signage. See attached bid form. 35. A bid item for Detectable Warning Panels has been added. See attached bid form. The detectable warning panels are for curb ramps between Spanish and Water Streets and for alley crossings between Pacific and Spanish Streets. 36. A bid item for Remove and Replace Existing Ramps has been added. See attached bid form. The ramps are between Spanish and Water Streets. 37. Bid item 12 for Remove and Replace Existing Sidewalks and Ramps has been revised for description and quantity. See attached bid form. 38. A bid item for Connection to Existing Storm Sewer has been added. See attached bid form and JSP-20. 39. Bid item 45 for Relocate Fire Hydrate has been removed. See attached bid form. 40. Bid item 65 for Detectable Warning Panel has been revised for description. See attached bid form. 41. Bid item 15 for Concrete Curb and Gutter, 6 Inches has been updated for quantity. See attached bid form. 42. Bid item 71 for Perforated PVC Drain Pipe, 6 Inches has been modified for description. See attached bid form. This addendum must be signed and attached to your Bid Documents. Name � Date 3 2� f Z Page 3 of 3 � UNITED FIRE & CASUALTY COMPANY 118 Second Avenue SE, PO Box 73909 Cedar Rapids, lowa 52407-3909 319-399-5700 (A Stock Company) BID BOND KNOW ALL BY THESE PRESENTS, that we FRONABARGER CONCRETERS INC 3290 STATE HWY E, OAK RIDGE,MO 63769 as Principal, hereinafter called the Principal, and the UNITED FIRE &CASUALTY COMPANY, a corporation duly organized under the laws of the State of IOWA, as Surety, hereinafter called the Surety, are held and firmly bound unto City of Cape Girardeau 401 Independence Cape Girardeau, MO 63701 as Obligee, hereinafter called the Obligee, Ifl th@ SUR1 Of Five and 00/100 Percent of the Bid Amount Dollars ($5% ), for the payment of which sum well and truly to be made, the said principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. WHEREAS,the Principal has submitted a bid for Broadway Street Scape Improvements NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 28th day of March ,20 12 FRONABARGER CONCRETERSINC �a: � �a'iaif,�� .. �'• �]J, l�'I �� a y'�L� /i .. ¢.�w, ,�'ri �� l<i • � ..-�y*�� ,� (PRIN AL) :� < N� � �,• �?, '- .. �. � '��G�j �.(�y_y � _ � �L`�•:. I- z� .�0� � _ .. ; ITNESS) (TITLE) - �=�,9Q�•'�: _ -, � J ,.,J < ;<. ��: UNITED FIRE &CASUALTY CONG��k�t.�l �&e�Ja_,�;, (SURETY) +,�;°f' '' '';�y� ♦ A�'w: t. i •+ t- `�a � �e V :� By �l G'i. Gv rr -'% � +` ": � (WITNESS) (ATTORNEY-IN FA�s �r4— '= � � :__.,. -.� � '��,P,, r'� �- � '- " � � CONT 0001 0899 %��,�r •••• ,�`�`�� -��` � �'�r;��n;t s � 3' :a.r. . • *` �.�.. . W0006890 UNITED FIRE &CASUALTY COMPANY Son<! �_ _._._,__ _ ..__....__ . ____. ___ _ ... _.. _ Hon��E� (JFfict� C�edar f�aE�icfs ira�v�� (rriific Cl t of�� OI Powe�r of Attc�rn�:�y UI71i�;NeCity of Cape Girardeau lC)ri�;inal c>n tile ��t Hc>n1e Oi�ficf�o(C,c�mE�<iny -St�e�C�ertiii<;aticm) 401)ndependence _ Cape Girardeau,MO 63701 KN01N Al_l_ fvil:�! t3Y THLSL PKt:SE�I�TS,That th� IJNI"TEI�:)F1RF GG C;ASUALTY C'0;��1PAN1; �r r:c�rporation �.lufy ��r�;aniz��cl��u7r.! existii��; uncl�r tN�� la��s ot"�Fie Stat��c�t I��wa, an�� having its E�rir�c:ipal i�fi�icc� in Ce:�dai R��pids, StatE.o�I�a�va, does rn<�ke, consti- CutF�and ��C�p[�int CHARLES W DECKER,OR SHARON GLASCO,OR ALAN H RAUSENBERGER,OR JASON RAUSENBERGER,CARBONDALE,IL,OR TODD A WARD,OR NANCY STRAUSER,OR PRISCILLA B HUNTER ALL tNDIVIDUALLY [>{,CAPE GIRARDEAU,MO 63701 its true ancl la�vful r�ttarney(si-in-F<lr_t wiih j�c��ver and authc>rity herek�y conferted tc�si n, seal anc�execute in its behali all I a�,�- iul honcls, uiirlertakin�;s ancl ather obli�;atory instrurlu�nts nf similar naturc�as tollo�vs;��o,000,000.00 anr! 1t,I3iricl UNITED ��l�E �; C�Sl.li�L7Y CC).�!{'A��!1' theref�y as iullv and to the s�une extent as it s«ch ir�ytrumenis�v�re si�;necl bv the�1i.ily aulhorizc.�d c�(fic:c>rs of l)NITF[.) f=1RE & (:ASIJAITY C�C?�ti1N�\Y ancl �II the ac.�ts of saici,qttc�mcy, OUf�117111 �Q IIl(:' authc�rit�y hErebv givEn arr I�r_�r�by r��tifieci �tncl c��ni�irn�i�c�. Thc�Authority hereby gr��ntecl shall expire,1uly 26th,2012 ��nless srx�ner revoked, This po�ti��r r�f Ai�torritay is rriiacl��ncl exec:utecl��ursuant to<�r1d by� <auti7c�rity c�i"tf7� i�llc�wing k3y-Lrt�v c.luly adc��p�eel by th�� Bo;�rd of Directors ot the C:nmpany on April 18, I�)7:i. 'Arlicle4 S��r<rty I3c>nds and Uncic.rt�;kin�;s" Set ium 2.A��f.xiint+ntrnt of:�tton.eti-n-Fact_'The Pir�sitknt cx im Vi�tr pn��[lent,ur any�.�tht i uiticer trt thi^l:ex7yionY, rnay,iru�n tinz� tr t�in,r,apj,>oint I�}� t��rltlt�t CR�rhttc:�tlS attarne)�5-in•tat:t t0 at:t irt!k`ttttlf s�i Ihe l�o�'t�E�.ltt)'li1 tr�e extY:utit)n ctl Fx�(il;it'S u!inwf:t[ite.lxNida,urxlcrrYakn��;s antf r.>iho�•utJE�ipyt�t<)n^irtftrt�- � nxnts qf lik�n.�turt.The signaiurc'r cii.'u�1 ufhc��r ztuthcrnze�f h��rc�by,ar�rJ tirr C:e�rEx,rater s�sjl,.�t,�y tSE�aii�xc:tl lay i,�G�mi.:c�di>,�n. �x>ta4r c�f aitornery u�spc�c-i��1 �x,tve�of attomey ar tcrtiiicatian oi e"sthzrr autixxixcd here�by,surh signature and;��a�,tivh+,n sc,a�ed,bein>adc,pie�rl bti the C um�sany as the t�ris;i��al sigiia. tun�cj�su�;h c�iiirrr�nd the cmginal sr.t3 oi thr,•t:cmtpony.tc;be valici tand birizlinr{uE�ari ilict Gx,�mpany tti;t�thx>amr rrNcc�.�nd t�iter.t r+s thr�trgh nianu�lly a9iixcxl.Siich s�ttc�rntv�in-fFn�l.subjt�c't to�1te(imil;�tit�ris sert ft>ttfi iri Ih�ir rr,,�xtcti�e c rartiiic.}t�'s r�l tiuriiariry shall ha�=� iuU prnvr�r i�>fi�ii;d Ih��c�mpar»�ty} tficir signati�r�^�nc!r�tier ution c'd any sur:h ir3ctrui�x�nt�;Znzl tc>attac:h thr sE;�I t>r the C:nirtF�ain�I'h�tret��.The WrEKirk�ni��r 3nv Vicc Prs�sicir,��-r1. Ch��f3ckird c�t C�irech7r�or;in�othttr oifcr�r r>f?he CrxrtEr.any�may:�i am��iir�e rt�eakz�ail pci��c�r«tnd atrthcir'rty pri:�v'u�uciy'given ra any att�srnt��in-i,:<.t. IN bVi'T'��55 V1�H�REC)F, the-UNlT'EC)F112�&CASUAI:TY CC�tviF'AfvY has ciuseel these `��H1�I�up�� ]f�f'SE,'f1�5"tO hE:$1�jIlCC�h�.It5 YICC�JT4'''StC�E?ilt'clf`IC� ItS C:C)i'�()I'cll�SL'a1) t0 E)C.^'�lEf('tO i1J{IXEL�t�l1S '1��,,v�"5`•��•,6, 27th tl�y of March ,2012 . - °Q% 11N1TE[�FIRf&CASIIAiJY CC)tvlYrt�iY �y CON}'nR�TE e c ` ._. �; �y � 3 �- �,� stAL cfi�`� �--._ .�/�'�/+-v�a.� ,/��+hiiuii�`��```` v 'E? ��I'e51�E'tlt St�te ot lorna,"Coimty af t�inn, ss: C7n this 2�tn clay c>f March ,2012 he�are me�i�rsonally c<tmtz I�ennis Richmann tt>rYie.knc��vn, who 1�Eing l�y rrze cluly s�a��m, dir.l cleEx>se ancl say: that he resi�les in C:edar Ra�icls, 5tr7t�of I��va; th�t he is a Vice C'resicJt�r7t of thc U\fTF�[? i=1KE cY� G��SIJALTY CQ1�1NA�lY, the ccxpqratir.>n clescrik�eti in anc)�vhic#i �:xecuCeti#he:al�cn�c in�trumer�r t}iat hc;knoVvs tN�E� se�l c�i saitJ cc�rporatic�n; that the sea) afifixE?c9 tr.�tfie said instrument is such t��.>r��3ratc s��]; thai it was sc>a:ftixEtd �iursurant tr>�trtfuarity given fay the 6oarci caf[.)ir�sctors pf s�tici cr.arnc�tation .and thak hc�signeci f�is nairte th�rc;tc� p��rsuar7t tc7 likfr authc�rit,v, ancl �}ckncawleclgc5 sarne to b�the 7ct ar7r1 cl�ed af said cr>rparatinn. ;¢ � Mary A.Jans�n � �•-�./ � �y Iarfa Notariai 6e�i � ��' Commission number 7Y3233 ��>% ' ��>��- ow. My Cammfssion Expires 10t26l2013 M�Carnmission t±cpires Octc�hc:r�6,2013 CEf271FIC:,t�71C��v 1, David A, lan�;c, Secretary of UNITED FIf2E�CASUALTY CO�`viPA�Y, dn hereby c:ertify th��t I have rorn�7ared tiie fr�rE�oin�; coEay c.�f che Pawer of rltthrney ancl �tffidGrvit, �tnc) the copy of thc�Sc�ctic.�n caf th�tay-I��ws crf s��icl C.:c>m�:�any as set forth in saicl f'oM�er of Att�rnery, 4vith the�RIGINriLS(�l� FILE In THE NOME OFFIC[ �F SAID C�MPANY, ind thai the s��me are ran�ert transcri�ts th�r�af, and�f th��vhc�l�c�f the said�ri�;in��ls, anrJ that th��7ici Pc�we.r nf�tt��-ney has not b��en revcaked ancl is nc.�w in full ftirce�n�)eFfect. 1n tes��umy wher�f I have liereunto suhscribec!my namt>. ar�r) 7ftixcd th�cor�or7te seal c�l the s�ic1 C�r.�rnp�ny tfli5 28th t�il�Of MarCh ,2012 . `��w�`�sn.'.�i'�'y,r�� . �.�� coaeoxn��"= �' /1 f/f "= zr'� �.C�f-r .Z --•- . . +h. 5EAt -r�yC . E. . �i�jQ?j� �F�t`� S�:r �� BPUAUi�h1 102At17 �"�,,h�+a'"`ii+��•�` ACKNOWLEDGMENT OF SURETY State of Missouri County of Cape Girardeau On this ��R-�` day of 1�� , 20�� Personally appeared before me Todd A. Ward who being duly sworn did depose and say that he/she is the attorney-in-fact of the United Fire & Casualty Company of Cedar Rapids, Iowa, that the seal affixed to the attached instrument is the Corporate�Seal of said Corporation, and that said instrument was signed�and sealed on behalf of said Corporation by authority of its Board of Directors and the said Todd A. Ward acknowledged that he/she executed said instrument as such attorney-in-fact and as the free act and deed of said Corporation. �,.�.rr�..+��. NI�NC�Y.STRAUS�R Notary u liC, NOtqfy Seal Siote af Mlssourl Gape Girardeou County Commission # 1 1421529 My Commis$lon Explres July 26, 2015 Notary ublic UND-2031b EXHIBIT AFFIDAVIT OF WORK AUTHORIZATION COMES NOW (Name)1�11�-v�l7 /�1�C�:�.a.l as (OEfice Held) VI�'r- CC2t:-��.�2 of(Company Name/Contxactor) f i��lt{�Ik2b�cZ l.�ucSL�z�('' �1c. and first being duly sworn, on my oath, affirm as follows: � 1. (Company Name/Contracror) ��(��J J��F!(�L12 ��s�'�;��"S' 'L'Q5., �N�_ is enrolled and will continue to participate in a federal work authorization program-in respect to employees that will work in connection with the contracted services related to (Project Name) ��}f�rrA� J��fS�'�4,� i��v�tE��'or the duration of the contract in accordance with RSMo Chapter 285.530(2). f 2. I also afflrm that (Company Name/Contractor) �-(.�3N1R�Ti�t� �3�25... ��t�. does not and will not knowingly employ a person who is an unauthorized alien in connection with the contract services related to (Project Name) �:��w�.i �E�Se,�- ','hPi QU�M L�+S for the duration of the contract. 3. Attached hereto is documentarion affirming Contractor's enrollment and participation in a federal work authoxization progxam with respect to the employees working in connection with the contracted serviees. 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.) � � ��Pi�'��h�r� C.��tr�e� . ��. (name of corporarion) By: 1 w�/` f � - _ - Yr2L`'5��.�..i (na e oE officer of corporation and tide) ATTEST: �2 .? �x:` •. . � ' (��J�� . '��t . ..;�!�. II '�y,�`�a � rs°� .�' ¢t' � �TW'� `' ��t�,a .y,�la� ;1ce�� 6 r ��.r �� a� j� �� rx "tl ... ! _..s.. {kf'� , f��r�'/ ' 1j � � .��,,or' OE�7�P0R�TION) . � .. '��`if ,E: � �i��/ , �1��I �.Y� �: ,,f ,.,�" �;rr�: �o�b, i ', : �_;. i` �: ;. � .. STATE OF MISSOURI ) ! ± �,;,.�. ) ss. � COUNT`Y OF CAPE GIRARDEAU ) ; "� f(�� `. On this �7 day of ��(� , 20/�, before me appeared �ni�'/� /�/c�l{�U,V , to me personally known,who,being by me duly sworn, did say that he/she is the�//c� l'�RE'J/��'�/T �� '� of �sf'ord�?B.�iP6�'s2 �ivC1�F�`E'.2,� , a Missouri Corporation, and that the seal aff'ixed 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 authoriry of its Boaxd of Directors, and acknowledged said �� instrument to be the free act and deed of said Corporation. �'� �, _ �` . ;. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal, at �` ` my office in Cape Girardeau, Missouri, the day and yeax first above written. ,�I '. 1, : , L :` /� • ^ �-1. .. Notary Public �'�� i_,: ; I ' ti u�� . RRNDALL H..REISENBICHLER �, My Corruiiission Expires: Notary P�b��, Notary Sea► Sta7e of Missouri I•� ��r;y a/ �p'l� Comm ssiof a#a� �Ounty �Y Commission Expires A�q 4 746 v 2�, 2o�s : � I �. �, ;�' ��;::: � L',:r �.-.d Y� y kx a ti :.i i � . . ...!�.'�' �'^'. EXHIBIT AFFIDAVIT REGARDING EXCESSIVE UNEMPLOYMENT COMES NOW (Name)�9b �'ls'}'`'1J'u..�r� as (Of6ce Held) V�L':G' C�t�iDt.ai s of(Company Name/Contractox) �'RED►,Y��1ZeE('� :.1'SZ�,L�,.L t. and flrst being duly sworn, on . my oath, affirm as follows: 1. Whenever there is a period of e�cessive unemployment in the State of Missouri, 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) ��u�� r��Tr.��i�hr ��AF►zci+�M�is for the duration of the contract. 2. I also affirm that (Company Name/Contractor) �"f�Or�lAgP1(ZE�1;� oil:;�i:'TGYC_ �►1r. 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 laboYers are not available, or are incapable of performing that particular type of worked involved, if so certified by the contractor and approved by the City of Cape Girardeau, or unless otherwise permitted by that Statute, in connection with the contracted services related to (Project Name) Q�.�/� J��-�.� �r'�c+r�r��"tor the duration of the contract. r FU.RTHER�I�FFIANT SAITI-I NOT. �� , � IN AFFIRl'C�1�'��bN� �THEREO`F; tlie� 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.) � I�iZ.fir��l�� o�;��ZE�QS. �N� (name of corporation) By: ' 1�—�i r(•iJa� , ��— �2L`$i 7Ji.��./1 (name of officer of corporation and tide) ATTEST: ;. , ;._ ��, ��sxae: yi', e„a `''Se�g6ary•f�x,�t� ,pf�cer) ,y � e�• /� � r �„Y e,�. tl�, G�� , : +Y � �$�� ry'� � C� � � ��AL�F C��C�T�1"I'ION) �,, .� °�,; + ,rG,�. ��`r :�� ., r� . ) . �i ..�. .•s�a `�3` y�:. ' �C'y.�' �'. ��/ft � � Si�'. .. 'f'��'rIoQ3�C' : I . ::: 1 f_: I l: . I I .y.' STATE OF MISSOURI ) f. ' ) ss. i. COUNTY OF CAPE GIRARDEAU ) ` � ' . f ' On this a7 day of eec-�/ , 20j�, before me appeared ��l��a df'tC�u� , � to me personally known,who, being by me duly swoYn, did say that he/she is the ��i�� 'f/Oc'��v�' of d�Ra.�lJ�,t�.4�PG�'R �iY�l1�'�'!�(', a Missouri Corporation, and that the seal aff�ed 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 authority of its Board of Directors, and acknowledged said ,'� i .. instrument to be the free act and deed of said Corporarion. ; IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal, at i .. my office in Cape Girardeau, Missouri, the day and year first above written. ;. � �=_ � � � _ %��.�� .�e�YJ�,�C''�°G� j.� _ Notary Public i r' �-�.�,�„� i ` ' RANDAII H. REISENBICHLER " M Corrunission Ex ires: � - Y P �j Notary Public, Notary Seat `- r� State of Missouri ��n � � �, r F: Cape Girardeou County y_� aD/� �s' Commission # 09404746 ' My Commisslon Exp(res May 21, 20"13 .'i �� " � Y"�:` t l''t '� }� � .� _ F-`� :� 1" . ' ., _ '- (, � ��s"� �} . Iflllll : r' . . .. Company ID Number: 193478 TFiE E-VERiFY RROGRAM FOR EMPLOYMENT VERiFICATION MEMORANDUM OF UNDERSTANDING ARTICLE I PURPOSE AND AUTHORITY This Memorandum of Understanding (MOU) sets forth the points of agreement between the ueparimen't of Homeiand Securiiy (ui-iSj and Fronabarqer Concreters, Inc. (Err�ployer) 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 Sociai Security Administration (SSA), and the Employer. E-Verify is a program that electronicaliy confirms an employee'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 Sub;�art 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 Empioyer to confirm the accuracy of Social Security Numbers provided by all employees verified under this MOU and the employment authorization of U.S. citizens. 2. SSA agrees to provide to the Employer appropriate assistance with operationai problems that may arise during the Employer's participation in the E-Verify program. SSA agrees to provide the Employer with names, titles, addresses, and telephone numbers of SSA representatives to be contacted during the E-Verify process. 3. SSA agrees to safeguard the information provided by the Employer through the E-Verify program procedures, and to limit access to such information, as is appropriate by law, to individuals responsible for the verification of Social Security Numbers and for evaluation of the E-Verify program or such other persons or entities who may be authorized by SSA as governed by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA regulations (20 CFR Part 401). z^;@ 1 li it"_lI r i�'i:. ._� 'tc` . .;�t,�-;? , �J.� *��¢` �, — _ /,,,1wdj.\ �/U�: ' .. � ....III'I�) ,_-. Company ID Number: 193478 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. S�A agrees to prcvide a �, ears of seccndary verificaticr (including upda;irg SSA records as may be necessary) for employees who contest SSA tentative nonconfirmations that is designed to provide Tinal conTirmaiion or nonconTirmaiion of U.S. ciiizens' empioyment 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 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 during the E-Verify process. 3. DHS agrees to provide to the Employer a manua� (the E-Verify User Manuai) containing instructions on E-Verify policies, procedures and requirements for both SSA and DHS, including restrictions on the use of E-Verify. DHS agrees to provide training materials on E-Verify. 4. DHS agrees to provide to the Employer a notice, which indicates the Employer's participation in the E-Verify program. DHS also agrees to provide to the Employer anti- discrimination notices issued by the Office of Special Counsel for Immigration-Related Unfair Employment Practices (OSC), Civil Rights Division, U.S. Department of Justice. 5. DHS agrees to issue the Employer a user identification number and password that permits the Employer to verify information provided by alien employees with DHS's database. 6. DHS agrees to safeguard the information provided to DHS by the Employer, and to limit access to such information to individuals responsibie 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 �- 1 , � .� ,� _ . nn .,�.-.- � .iF ,.- ..-.: . , pu . , �. :v .'t� .� ._, , :c"' . .._�, .,,... . . . _ - �,% l.IA�:; L ,,s IIIII� , Company ID Number: 193478 nonconfirmation of employees' employment eligibility within 3 Federal Government work days of the initial inquiry. 8. DHS agrees to provide a means of secondary verification (including updating DHS records as may be necessary) for employees who contest DHS tentative nonconfirmations and photo non-match tentative nonconfirmations that is designed to provide final confirmation or nonconfirmation of the employees' employment eligibility within 10 Federal Government work da,s ef +hA ��+o rJf rgfgrrBl t0 DNS, w�nless DHS �+etermines that more thar �0 days may be necessary. In such cases, DHS will provide additionai verification instructions. C. RESPONSIBILITIES OF THE EMPLOYER 1. The Employer agrees to dispiay the notices supplied by DHS in a prominent place that is clearly visible to prospective employees and all employees who are to be verified through the system. 2. The Employer agrees to provide to the SSA and 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 anci 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 fhe E-Verify Tutoriai before ihat 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 Empioyer 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 i-9. The employer will use the photocopy to verify the photo and to assist DHS with its review of photo non-matches that are contested by employees. Note that employees retain the right to present any List A, or List B and List C, documentation to complete the Form I-9. DHS may in the future designate other documents that activate the photo screening tool. �; �o� , -l� .t, ,, ._.-,r t �, .,, _�: . _, ,. � �; � r�t�11 //��Us� � ' ' � �IIIIIIr� .-... Company ID Number: 193478 6. The Employer understands that participation in E-Verify does not exempt the Employer from the responsibility to complete, retain, and make available for inspection Forms 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 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 "as rot violated sectic� 274A(a)(1)(R) cf the Immigraticn and ^dati�nality P,ct (INA; with respect to the hiring of any individual if it obtains confirmation of the identity and employment eligibility of ihe individuai in compiiance witn ihe terms and conditions of E-Verifiy; (3) ihe cmployer musi 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 finai 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 weli 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 Empioyer is prohibited from initiating verification procedures before the employee has been hired anc+ 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 Empioyer's attempting, in good faith, to make inquiries during the period of unavailability. In all cases, the Employer must use the SSA verification procedures first, and use DHS verification procedures and photo screening tool only after the SSA verification response has been given. Employers may initiate verification by notating the Form 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 performs an E-Verify employment verification query using the employee's SSN as soon as the SSN becomes available. 8. The Employer agrees not to use E-Verify procedures for pre-employment screening of job applicants, in support of any unlawful employment practice, or for any other use not authorized by this MOU. Employers must use E-Verify for all new employees, unless an Employer is a Federal contractor that qualifies for the exceptions described in Articie II.D.1.c. Except as provided in Article II.D, the Employer will not verify selectively and wili not verify employees hired before the effective date of this MOU. The Employer understands that if the Employer uses E-Verify procedures for any purpose other than as authorized by this MOU, the Employer may be subject to appropriate legal action and termination of its access to SSA and. DHS information pursuant to this MOU. 9. The Employer agrees to follow appropriate procedures (see Article 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 �e 4�,r��r�` :v;vi�.,r:,�F_� �!F': � ..,�::� �__;-�,8 - ��r �s�=, - =U iiiuu Company ID Number: 193478 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 chailenge. 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 ICC{UCJI unless the Employ2r abta��s k��ovdledge (as d�fined in 8 C.F.R. � 274a.1(!)} that the employee is not work authorized. The Employer understands that an initial inability of the SSA or DHS automated verification system to veriry work authorizaiion, a ientaiive 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 estabiish, 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) 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 empfoyee is not work authorized and terminate the employee's employment. Employers or employees with questions about a final nonconfirmation may cali E-Verify at 1-888-464-4218 or OSC at 1-800- 255-8155 or 1-800-237-2515 (TDD). 11. The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section 274B of the INA by not discriminating unlawfully against any individual in hiring, firing, or recruitment or referral practices because of his or her national origin or, in the case of a protected individual as defined in section 274B(a)(3) of the INA, because of his or her citizenship status. The Employer understands that such illegal practices can include selective verification or use of E-Verify except as provided in part D below, or discharging or refusing to hire employees because they appear or sound "foreign" or have received tentative nonconfirmations. The Employer further understands that any violation of the unfair immigration-related employment practices provisions in section 274B of the INA could subject the Employer to civil penalties, back pay awards, and other sanctions, and violations of Title VII could subject the Employer to back pay awards, compensatory and punitive damages. Violations of either section 274B of the INA or Title VII may aiso 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 Empioyer 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 ,� ;� ,. ._. ,;� . ,g�� r „� � r�,�<<. �: �_ ,��,:. i . ,�t _ . — �r �s�; _ s� �ii�ii�,,:.� Company ID Number: 193478 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. 14. The �mp�oy�r ackraVvledges tha; the i�f�rmation ��;h�ch it receives f�om SSA �s 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)j, and that any person who obtains this inTormaiion under fa(se preienses 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 definzd 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 tnrough E-Verify by the Employer, the Employer may not reverify the employee through E-Verify. a. Federal contractors not enrolled at the time of contract award: An Employer that is not enrolled in E-Verify as a Federal contractor at the time of a contract award must enroll as a Federal contractor in the E-Verify program within 30 calendar days of contract award and, within 90 days of enrollment, begin to use E-Verify to initiate verification of employment eligibility of new hires of the Employer who are working in the United States, whether or not assigned to the contract. Once the Employer begins verifying new hires, such verification of new hires must be initiated within 3 business days after the date of hire. Once enrolled in E-Verify as a Federal contractor, the Employer must initiate verification of employees assigned to the contract within 90 calendar days after the date of enrollment or within 30 days of an employee's assignment to the contract, whichever date is later. b. Federal contractors already enrolled at the time of a contract award: Employers enrolled in E-Verify as a Federal contractor for 90 days or more at the time of a contract award must use E-Verify to initiate verification of employment eligibility for new hires of the Employer who are working in the United States, whether or not assigned to the contract, within 3 business days after the date of hire. If the Employer is enrolled in E-Verify as a Federal contractor for 90 calendar days or less at the time of contract award, the Employer must, within 90 days of enrollment, begin to use E-Verify to initiate verification of new hires of the contractor who are working in the United States, whether or not assigned to the contract. Such verification of new hires must be initiated within 3 business days after the date of hire. An Employer enrolled as a Federal contractor in E-Verify must initiate verification of each employee assigned to the r;�?t J�i2� 1 ,(.,n �,. .. `i int,. r?c. .�. ,'�<«I-� -.,�_�ii�� . � . ;:(, _ yJ,��1�� .�IU�:. yk„r- ' � . �IIIIU�l_.-. Company ID Number: 193478 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 pe�-Eormance bond may chcose to enly v�rify ne..� ard exis±irg employ�es assigned to the Federal contract. Such Federal contractors may, however, elect to verify all new hires, and/or ali existing empioyees hired after �Jovember 6, i986. The provisions oi Arficie II.D, paragrapns 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 empioyees: Upon enrollment, Empioyers 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 employee assigned to a contract as long as that Form I-9 is compiete (including the SSN), compiies with Article II.C.5, the employee's work authorzation 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 lawfut 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 tI.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.5, 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 Artic�e II.C.S, 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.S, subject to any additional or superseding instructions that may be provided on this subject in the E-Verify User Manual. Nothing in this section shall be construed to require a second verification using E-Verify of any assigned employee who has previously been verified as a newly hired employee under this MOU, or to authorize verification of any existing employee by any Employer that is not a Federal contractor. 2. The Employer understands that if it is a Federal contractor, its compliance with this MOU is a performance requirement under the terms of the Federal contract or subcontract, and the Employer consents to the release of information relating to compliance with its verification responsibilities under this MOU to contracting officers or other officials authorized to review the Employer's compliance with Federal contracting requirements. _. � .. ..>�_- _ r: , �.. ,,, .. . . _ - � ` F. � �� ff s�� _ 1�� IIIIIII r� � , � _ Company ID Number: 193478 ARTICLE III REFERRAL OF INDIVIDUALS TO SSA AND DHS A. REFERRAL TO SSA 1. !f t"e Employer receives a tentative ron�enfirmation issu�e�+ by SSA, the Fmployer must print the tentative nonconfirmation notice as directed by the automated system and provide it to ihe empioyee so 'that ihe employee may determine wnetner he or she wili 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 empioyee contests the tentative nonconfirmation. The Employer will transmit the Social Security Number to SSA for verification again if this review indicates a need to do so. The Employer will determine whether the employee contests the tentative nonconfirmation as soon as possible after the Employer receives it. 3. If the employee contests an SSA tentative nonconfirmation, the Employer will provide the employee with a system-generated referral letter and instruct the empfoyee to visit an SSA office within 8 Federal Government work days. SSA will electronically transmit the result of the referral to the Empioyer within 10 Federal Government work days of the referrai unless it determines that more than 10 days is necessary. The Employer agrees to check the E-Verify system regularly for case updates. 4. The Employer agrees not to ask the employee to obtain a printout from the Social Security Number database (the Numident) or other written verification of the Social Security Number from the SSA. B. REFERRAL TO DHS 1. If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must print the tentative nonconfirmation notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the tentative nonconfirmation. 2. If the Employer finds a photo non-match for an employee who provides a document for which the automated system has transmitted a photo, the employer must print the photo non- match tentative nonconfirmation notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the finding. 3. The Empioyer agrees to refer individuals to DHS oniy when the employee chooses to contest a tentative nonconfirmation received from DHS automated verification process or when the Employer issues a tentative nonconfirmation based upon a photo non-match. The Employer will determine whether the employee contests the tentative nonconfirmation as soon as possible _ �, _ ., F`if�'P- Csi<3� rr, �;;9�7. �J'�. 1 -:�h, o�,. ��.�- �ii�i_"_'1,1�� . . . _ . . . � � �� sa�." - r� , s� ��,��. _. Company ID Number: 193478 after the Employer receives it. 4. If the empioyee contests a tentative nonconfirmation issued by DHS, the Employer will provide the employee with a referral letter and instruct the employee to contact DHS through its toll-free hotline (as found on the referral letter) within 8 Federal Government work days. 5. If the employee contests a tentative nonconfirmation based upon a photo non-match, the �mp!oyer ..'I!! rrOL'�u� th� emN!oye� �4�lth a referra! I�tter te DHS. DN� �R�jl� ?�ectrenic��y� tt"w;1S^l!t the result of the referral to the Employer within 10 Federal Government work days of the referral uniess if determines ihai more than i u days is necessary. The Empioyer agrees to check the E- Verify system regularly for case updates. 6. The Employer agrees that if an employee contests a tentative nonconfirmation based upon a photo non-match, the Employer will send a copy of the employee's Form 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 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 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 ail 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 Manuai. Even without changes to E-Verify, DHS reserves the right to require employers to take s>,�; ��. .s'- ��'_ � -, _ � . ,. . .., � � �� i`u�' _ i� 1111111,= ��' , "' , " ,,, ., re F.v �.-.. ..... Company ID Number: 193478 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, wiii remain bound by the terms of this MOU that apply to non-Federal contractor pa�ticipants, and will be required to use the E-Verify procedures to verify the employment eligibility of all newly hired employees. B. Notwithstanding Articte V, part A of this MOU, DHS may terminate this MOU if deemed necessary because of tne requirements of law or policy, or upon a determinaiion oy SSA or DHS that there has been a breach of system integrity or security by the Employer, or a failure on the part of the Employer to comply with established procedures or legal requirements. The Employer understands that if it is a Federal contractor, termination of this MOU by any party for any reason may negative►y 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 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 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, including but not limited to, Congressional oversight, E-Verify publicity and media inquiries, determinations of compliance with Federal contractual requirements, and responses to inquiries under the Freedom of Information Act (FOIA). G. The foregoing constitutes the full agreement on this subject between DHS and the Employer. H. The individuals whose signatures appear below represent that they are authorized to enter into this MOU on behalf of the Employer and DHS respectively. � — .., ;�_I,� .L.n^,f'. � �;^�.:nn ,. .. . _. . '_. � . . . -^'3Ct:?1U c:f i,� -�r?'��i '�.._,,�;! ..... ... .......�c P�'\� .�..\.��:�:.'. . S -r�; :��sA�:;. . �`�� III�fI�A`:. r� � , ;«_- . Company ID Number: 193478 To be accepted as a participant in E-Verify, you shouid only sign the Employer's Section of the signature page. If you have any questions, contact E-Verify at 888-464-4218. Employer Fronabarger Concreters, Inc. David McMullin ----—----------- __..-------—------------- ---— ---—-- ---------- ��lame:P!ca„e Tvue c;r P,ir.�; ---- 7i�;e - _r ^c ,nrr^,:*�nra ."-r,l�SC:�t�`�U.�rF:,-:urit -7e'^��'��i=1i: JZ _•-7.G.ut;a __._ _...... _.._. _.._ .. .... __.__ .._. ..._. .._ ... _ _....... _..... . .._. . __.. __._ ._... __.... �ts;3.i�'.x'�.. �htG Department of Homeland Security—Verification Division USC1S Verification Division _ __ _._ __ __ ___ _ __ _ _ _ . _ �r:�fY'tc:Ih'�5?S6 ,fri.� ;f.''Ld) �!t's� �tc'Cfra,.iecit`!`y`J�ILyi;��,��i :IGi��1.%f.��,Dw - ---- --.._ _ :._- ---. __ __--- ___ . .__._.._ -_ ---- __------ -- ----_-- - ---__ __.____ . :1t�F:i3CLl�B ��tE.' ?='n�,jC" , . ,." ` .i ,. ..... .- ....- . ,-. ' . . �\.`: O /��!\) �/U��• - r' . � ��,�� _ w�.�, . , , _ Company ID Number: 193478 � Information Required for the E-Verify Program � ��` Information relating to your Company: '.�1fil�'titE"i�' i1i'c3x�;�i?: P"i':Jrt^�:u!'�@�"i�rJalr'CFiC:;':� �:1C. r , . .. .. .. 4_ �. y„ E. . . .. ,- E�'9�t r rI:�i••€s, ti. ,9�=� - - r. ._ tFGPa ,,c�c�i r�C�:f��/ v`� ;��u.. ..+t.. :si�a.c an.l. �_ _._ �:a., Rivc�e ��`?C)C�4`,'''�ti ._. r � ' __ _ _ ___ _ __. _._ _ _ _. _ _ _ __ _ __. _ _ _ _._ _ ._ __ _ ��lfit.:QkSj' Ye1i�1�CiEG r�i��f s`;��x�'S: ___. .__._ . _._... .._.. _...._ .._... ._.. ._.._ _._. ._.._ ....__. _.._.. �`CzUil�E}� �S' �3i"�S�'i: 1:,�'_�� {61ntZE:1F�t� ��'":i�2G�� f��t":31�'��ffc��€C7E"i i�U�I"Gi�a• �3i3966�3 P�rs�:� r�,��t��€c�� i��s[�y U#�ss�fFv�;.iist� �},S��t?35 Gcrt�e: �"s7 �'uT�'C.t�'�?4'1,3�'3�"t�j: z�!:�:":f32C G;' �:':3�?��f��=' 2v`'`�� _ _----_ _-_ _..-- __ __ _ _ ---- - ---- ___ �'�:.,ril��3 �!v�t.l��i V�'i�tiV:�s 1��. i Are you verifying for more than 1 site? If yes, please provide the number of sites verified for in each State: . MISSOURI 1 site(s) � ..�., r �� - - _ .:. ,.-.. . .. . �.� .. . � . �c..;f. Cz . , �� . .._� ,... �i�..�� i.;;:K _. . .. . ......✓:'v^ _ r�f, f�,J�: - s� ui�iu _ Company ID Number: 193478 Information relatiny to the Program Administrator(s) for your Company on poticy questions or operational problems: Name: David fYcnfiuilin Telephone Number: (573) 266 -3212 Fax Number: (573) 266-3235 E-mail Address: david@fronabarger.com � - . � - . , ". ., EXHIBIT AFFIDAVIT OF OSHA TRAINING COM�S NOW (Name)�avt� MsMuu.��/ as (Office Held) Utr_.C— ' 1�*Z��T of(Company Name/Contractor) F�d�JA-F�$(^�CR LA�tGQ�tc-Z4_ .l►.tc. and itrst being duly sworn, on my oath, affirm in connecrion with the contracted services related to �f�A��P.�'Sf.4� ��Lvt� (Project Name) for the duration of the contract, as follows: 1. Contractor shall provide a ten (10) hour Occupational Safety and Health Administrat�on (OSHA� constructio}n safet�,program for all employees who will be on-site at the ._.:V1'i+ �'yr(;�i�:'�.`�>��s' lb�.:l...'i'�;��1��">,��y?j�... Project. The construction safety program shall include a course in construction safety and health ,th;t,�s a��roved by:OrSHA o�a sun�lar program appYoved by the Missouri Department of Labor and : �^..►•,:�.r, . ,..,. � ��' , , � r�• a � Industrial Relations whicli is at least as stringent�as an approved OSHA program as required by Section 292.675, RSMo. 2. Contractor shall require its on-site employees to complete a construcrion safety program within sixty (60) days after the date work on the Project commencts; as reqnired b�� 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 completion 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 requirements of Section 292.675, RSMo. 5. Contractor acknowledges that pursuant to Section 292.675, RSMo., Contxactor shall forfeit to City as a penalty two thousand five hundxed dollaxs ($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 without the construction safety training required in Section 292.675, RSMo. 6. Contractor acknowledges that violations of Section 292.675, RSMo, and imposition of the penalties described therein shall be investigated and determined by the Missouri Department of Labor and Industrial Relations. 7. Contractor acknowledges that in the event that the Missouri Department of Labor and Industrial Relations has determined that a violation of Section 292.675, RSMo., has occurred .,,.-,��..� _ . _ _.. .. ..___ ,�. _��,; ..,, :......,:�w,N:. ,�,.;.,- . . and that a penalry shall be assessed, the City shall withhold and retain all sums and amounts due and ; owing when making payments to Contractor under this Contract. :�.��j�.�H��AF,�'��T SAITH NOTa�.a�vi�"R��'�'F� �tV�..,,} � ;_. �, ..,��'� �•�..7":�.5?�stn,� .��, `�.f ��`�L1A�i t i ` . �. II��.]�T,��p,��EREOF, the facts stated above are true and correct (the % � undersigned understands that false statements made in this filing are ��j�c��,ty�r�the penalties provided in Section 575.040, RSMo.) i �?�Pn�s4B/+RI�C-�i Co�v� c-izs �-��. (name of corporation) . By: � ''C „�GC, L - �� . (n me of oEficer of corpoxation and tide) � .:.r:,`� ,,` �,, I . > � �.. , r�� 1�,��a�•;� �', ,� �_ ' �+ i�y� s� �� Y � -� . S �5� 1i ' ��`-A.�� r '�. �� +�.�.• . ��w�� s i� � �- �S�CTEt��6��E��C FF1CPif'�.: �. �,1 , 1 r' ;i « j . � ,�" �: � �. 1��.sd'�TJ 4 Ox�rfi-^'+:-. . . . . � : , � �_ �_ `�� " �� '�"'QRPORATION) � � � I-f ' ,��r �` t ..:?�3. � . . � l' . ti �YY°}-`�� '� $g; � f . . . . . , �.. � 4 y z,�,- . � . . � � - r � �y I - STATE OF MISSOURI ) ) ss. I COUNT'Y OF CAPE GIRARDEAU } �� . On this �_day of i��,�BCh� , 20�, before me appeared ��y!D �L`/%/�(Ltii.0 I to me personally known,who,being by me duly sworn, did say that he/she is the!/�'cE d�'✓��C'�0.t�'�i �. of /�0�'/�4'��E'G�'R �'D�vr�E'r-6',21� , a Missouri Corporation, and that the seal afFiYed to the �� foregoing instrument is the seal of said Corporarion, and that the said instrument was signed and � sealed in behalf of said Corporation by authority of its Board of Directors, and acknowledged said � instrument to be the free act and deed of said Corporarion. �-� . _� IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal, at m office in Ca e Girardeau, Missouri, the da and ear fitst above written. �-'�' y p Y Y + � � �� s� ��; Notary Public � #'° �� My Commission Expires '��"� sYsrv� � , -:�,� �/� � RANDAII H. REISENBICHIER � �"(��/ � � f ��-� Notary Public, No#ary Seal „ • State of Missouri �� Cape Girardeau Couniy Commission # 09404�46 - � Uly Commisslon Expires May 21, 2013 I .. _ l'- � �. � 6149 .a . Project Number IC? t '';!h� .«n.g,��r�,i. �i:� � . Certification Regarding Debarment, Suspension and Other Responsibility Matters The contractor hereby certifies to the best of its knowledge and belief and that it and its principals and its subcontractors and their principals: (a) Are not preseritly debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal or State department or agency; (b) Have not within a three (3) year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain or performing a public (Federal, State or Local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a 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 fine of up to $ 10,000 or imprisonment for up to five (5)years or both. �ItV`� f \C�V Lt_i+J � Y �L� — \ ZCSi 1�i�iJ i Typed Name & Title of Authorized Representative �w./ �� _;�_. Signature of Authorized Representative ate ; ❑ I am unable to certify to the above statement. My explanation is attached. i,:._ � ��,- . f�. kr;,�...:�. �' ';t 1'.•.". f'. ' • �.. . ��_ ' �' r �'. . � ; , �; ; , f : �.:, . l.:�.. � r :. �" . i ' � `:�; "� �-A ` x, ,� I. I r; •.., ��t� . . . � . . .:�-, �'.. ra'i: !..