Quote Sir Lines A LotQUOTEFORM
2018 PAVEMENT MARKING PROJECT
CITY OF SHOREWOOD, MN
WSB PROJECT NO. R-011854-000
Qiuote Due By. 12:00 PM Noon (Fax, Mail, Ernail to WS B)
Quote Due Date: Monday, July 23, 2018
email to: kkoscie1ak(,4),wsbeng.coni
Honorable City Council
City of Shorewood
5755 Country Club Road
Shorewood, MN 55331
Dear Council Members:
'rhe following quote is made for the furnishing and installing all labor and materials necessary for the 2018 Pavement Marking
Project, for the City of Shorewood, Minnesota,
The undersigned certifies that the Contract Documents listed in the Instructions to Bidders have been carefully examined, and
that the site of the work has been personally inspected. The undersigned declares that the amount and nature of the work to
be (lone is understood, and that at no time will misunderstanding of the Contract Documents be pleaded. On the basis of the
Contract Documents, the undersigned proposes to furnish all necessary apparatus and other means of construction, to do all
the work and furnish all the materials in the manner specified, and to accept as Full compensation therefore the sum of the
various products obtained by multiplying each unit price herein bid for the work or materials, by quantities thereof actually
incorporated in the completed project, as determined by the Engineer. The undersigned understands that the quantities
mentioned herein are approximate only, and are subject to increase or decrease, and hereby proposes to perform all work as
either increased or decreased, in accordance with the provisions of the specification, at the unit prices bid in the following
proposal schedule, unless such schedule designates lump sum bids.
2. RESPONSIBLE CONTRACTOR: The provisions of Minn. Stat, 16C.285 are imposed as a requirement of this contract. All
bidders and persons or companies providing a response/submission to the Advertisement For Bids/REP of the Owner shall
comply with the provisions of the statute,
a. Any prime contractor or subcontractor that does not meet the rninimuni criteria established for a "responsible
contractor" as defined in Minn. Stat. § 16C.285, subd. 3, or fails to verify that it meets those criteria is not a
responsible contractor and is not eligible to be awarded a construction contract for the Project or to perform work on
the Project.
b. A responding contractor shall Submit to the Owner a signed statement under oath by an owner or officer verifying
compliance with each of the rninimurn criteria in clauses (1)-(6) of Minn. Stat. § 16C.285, subd. 3, at the time that it
responds to this solicitation document. A responding contractor must also submit a list of first-tier subcontractors it
intends to retain on the project, at the time that it responds to this solicitation document.
c. Prior to being awarded a contract, the apparent successful prime contractor must submit a supplemental verification
under oath confirming that all subcontractors and motor carriers meet the minimum criteria of Minn. Stat.
16C.285, subd. 3. The apparent successful prime contractor has an ongoing duty to submit supplemental
verification forms for each additional subcontractor retained for the project.
ol. A, false statement under oath verifying compliance with any of the minimum criteria shall make the prime contractor
or subcontractor that makes the false statement ineligible to be awarded a construction project and may result in
termination of'a contract awarded to a prime contractor or subcontractor that submits a false statement,
3. PROPOSED SCI 1EDULE: The Bidder agrees to) perform all work described in the specifications and Shown on the plans, for
the following unit prices:
9—ITC
2018 PAVEMENT WRKING PROJECT
CITY OF SHORUMOOD, MN
WSB PROJI.ICTNUMBER. R- 011854 -4 01 O
No. Mat. No. Item Units Quantity Unit Price Total Price
SCHEDULE A - CITY OF SHORE'~ OOD ROADWAY PAVENIENTMARKINGS
1 2021,501
MOBILIZATION
1,S
1
$
3nv ta o
$
300c),T30
2 2581518
PAVT MSSG PAINT
S1,
800
$
PARKING LOT
$
7-0 3 0 - 0 vi
3 2582.503
4" SOLID LINEPAINT
L F
93500
S
1
$
l on
4 2581503
12" SOLID LINE PAINT
L F
700
$
2
$
5 2582.503
24" SOLID LINE PAINT
1,F
700
$
3 ko%
$
!S- 2-n
6 2582.503
4" BROKEN LINE PAIN'r
L F
130
$
7 2581503
4" DBLE SOLID LINE PAINT
1.11"
22000
$
1
6u.ov
8 2582.518
CROSSWALK PAINT
S F
1500
$
2 -7 0
$
kA fj Sb e1 b
Total SCHEDULE A - CITY OF SHOREWOOD
ROADWAV PAVEMENT
$
MARKINGS
SCHEDULE B. - CITY OF SHOREWOOD PARIONG LOT IMPROVEMENTS
9 2021.501 MOBILIZATION LS
I
10 2582,519 PAVTMSSGPAINT SF
40
3 So
11 2581503 4" SOLID LINE PAINT LF
1500 $
900,60
Total SCHEDULE B. - CITY OF SHOREWOOD
PARKING LOT
s
7-0 3 0 - 0 vi
IMPROVEMENTS
...........
GRAND,'rO"I'AL BID $ ZVS74%0 .-I r)
PAGE 2
2018 11AVEMENTMARKING PROJECT
UTY 01; S1 1(,aREW001), MN
W S 13 PROJ ECT N0. R-0 1 1 8 54 -000
4. The basis of award of the Contract will be on the Total Base Bid. The City reserves the right to reject any or all bids. The
award of Contract will be made within sixty (60) calendar (lays after opening of proposals to the lowest responsible bidder of
the Base Bid plus accepted Alternate defined appropriate by the Owner, The Owner reserves the right to delete any item
prior to final contract
5, The undersigned further proposes to execute the Contract Agreement and to furnish satisfactory bond within tell (10) days
after notice of the award of contract has been received. The undersigned further proposes to begin work as specified, to
complete the work oil or before date specified, and to maintain at all times performance and payment bonds, approved by the
Owner, in an amount equal to the total bid.
6. Accompanying this proposal is the Bid Security, in the arnount of five percent (5%), required to be furnished by the Contract
Documents, the same being subject to forfeiture in the event of default by the undersigned.
7. In submitting this proposal, it is understood that the right reserved by the Owner to reject any or all proposals and to waive
infort-nalities.
8. In submitting this proposal, the Undersigned acknowledges reeciptof and has considered the following Addenda issued to the
Contract Documents:
Addendum No. Dated Addendum No, Dated:
Addendum No. Dated:
Addendurn No, Dated:
If any Addenda are required as determined by the Engineer, it is the responsibility of the Contractor to verify the
issuance and receipt of any Addenda, and to properly acknowledge such Addenda in the appropriate location on the
Proposal Form.
9. If a corporation, what is the state of incorporation?
M If a partnership, state full name of all co-partners,
Official Address
--I Cl S- Coll, a V-0"
Date: -7 � Z 3 1 VR
ZAffi
I
By,
;
(An Authorized Signature)
�kLv'k-" el �We
J
Affidavit of Non-Collusion:
I hereby swear (or affirm) under the penalty for perjury:
(1) That I am the bidder (if the bidder is an individual), a partner in the bidder (if the bidder is a
partnership), or an officer or employee of the bidding corporation having authority to sign on its
behalf (if the bidder is a corporation).
(2) That the attached bid or bids have been arrived at by the bidder independently, and have been
submitted without Collusion with, and without any agreement, understanding, or planned common
course of action with, any other vendor of materials, supplies, equipment or services described in
the invitation to bide, designed to limit independent bidding or competition;
That the contents of the bid or bids have not been communicated by the bidder or its surety on
any bond furnished with the bid or bids, and will not be communicated to any such person prior to
the official opening of the bid or bids; and
(4) That I have fully informed myself regarding the accuracy of the statements made in this affidavit.
Subscribed and sworn to before me this
Wc�dayof
# - I -
Iwo'
Signed
Firm Name
(Number used on employer's quarterly federal tax return, U.S. Treasury Department Form 941)�
Fair Trade Items:
List below each item upon which a bid is made, the price of which is affected by a resale price
maintenance or "fair trade" contract between to bidder and the person or firm supplying the item to the
bidder. (Use reverse side if necessar
2018 PAVEMENT MARKING PROJECT AFFIDAVIT
CITY OF SHOREWOOD, MN
WSB PROJECT NO. R-01185"00
INITIAL CONTRACTOR VERIFICATION OF COMPLIANCE
By signing this document I certify that I am an owner or officer of the company, and I swear
under oath that:
My company meets each of the minimum criteria in subclauses (1) — (6) of Minn. Stat.
16C.285, surd, 3, the Responsible Contractor statute,
The undersigned understands that a failure to meet or verify compliance with the
minimum criteria established for a "responsible contractor" as defined in Minn. Stat. § 1 6C,285,
subd. 3, renders a bidder ineligible to be awarded a construction contract for the Project or to
perform work on the Project.
The undersigned understands that a false statement under oath verifying compliance with
any of the minimum criteria shall make the undersigned, ineligible to be awarded a construction
project and may result in termination of a contract awarded to the undersigned. A contracting
authority shall not be liable for declining to award a contract or terminating a contract based on a
reasonable determination that the contractor failed to verify compliance with the minimum criteria
or falsely stated that it meets the minimum criteria.
The undersigned understands that, if the undersigned is the apparent low bidder, the
undersigned will be required to submit a supplemental verification under oath as a condition
precedent to the execution of the contract, If the undersigned fails to provide the required
supplemental verification,, it could forfeit its bid bond,
I have attached a list of all of my company's first-tieir subcontractors that it intends to
retain for work on the project.
Date: 'I I -L S I I Y
Contractor:
2018 PAVEMENT MARKING PROJECT INITIAL VERIFICATION
CITY OF SHOREWOOD, MN
w PROJECT NO. R- 011854 -000
I-lil
PROJECT 'TITLE: 2—b k
Attach Additional Sheets if Necessary
t L
Contractor:
S)V UvNlci - LO
Pits GjL"4"-t
2018 PAVEMENT MARKING PROJECT SUBCONTRACTOR LIST
CITY OF SHOREWOOD, MN
WS8 PROJECT NO. R-011,11854-000
L k I R-10YU91 AN
By signing: this document I certify that I am an owner or officer of the company, and I swear under
oath that:
My company meets each of the minimum criteria of Minn. Stat. § 160.285, subd. 3, the
Responsible Contractor statute,
Pursuant to Stat. § 160.285, subd. 3(7), my company has obtained from all
subcontractors and motor carriers with which it wil'l have a direct contractual relationship a signed
statement under oath by an owner or officer verifying that they meet all of the minimum criteria in,
subdivision 3 prior to execution of a construction contract with each subcontractor or motor
carrier.
The undersigned agrees that, if it retains additional subcontractors on the project after
submitting its verification of compliance, it shall obtain verifications of compliance from each
additional subcontractor with which it has a direct contractual relationship and shall submit a
supplemental verification confirming;; compliance with Minn. Stat. § 16C.285, subd. 3(7), within 14
days of retaining the additional subcontractors.
Upon request, the undersigned shall submit to the contracting; authority copies of the
signed verifications of compliance from all subcontractors of any tier and all motor carriers
providing for-hire transportation of materials, equipment, or supplies for a project.
The undersigned understands that a failure to meet or verify compliance with the
minimum, criteria established for a "responsible contractor" as defined in Minn. Stat. § 16C.285,
subd. 3, renders a bidder ineligible to be awarded a construction contract for the Project or to
perform work on the Project.
The undersigned understands that a false statement under oath verifying compliance with
any of the minimum criteria shall make the undersigned, ineligible to be awarded a construction
project and may result in termination of a contract awarded to the undersigned, A contracting
authority shall not be liable for declining to award a contract or terminating a contract based on a
reasonable determination that the contractor failed to verify compliance with the minimum criteria
or falsely stated that it meet's the minimum criteria,
L01 �W �f
By
(please print name)
Signature
(please sign name)
Its
2018 PAVEMENT MARKING PROJECT SUPPLEMENTAL VERIFIICA'nON
CITY OF SHOREWOOD, MNI
WSW PROJECT NO. R-011864.000