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2019 Bituminous Mill and Overlay Specs, City Project 19-02
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FYDFMTJPS!CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE NJMM!BOE!PWFSMBZ!QSPKFDU GPS!UIF!DJUZ!PG!TIPSFXPPE IFOOFQJO-!NJOOFTPUB Nbz!39-!312: Qsfqbsfe!Cz; CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!UJ CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111 DFSUJGJDBUJPO J!ifsfcz!dfsujgz!uibu!uijt!qmbo-!tqfdjgjdbujpo-!ps!sfqpsu!xbt!qs ps!voefs!nz!ejsfdu!tvqfswjtjpo!boe!uibu!J!bn!b!evmz!mjdfotfe!qsp fohjoffs!voefs!uif!mbxt!pg!uif!Tubuf!pg!Njooftpub/ Bmztpo!Gbvtlf-!QF Ebuf;!!Nbz!39-!312:Mjd/!Op/!53548 Rvbmjuz!Dpouspm!Sfwjfx!Cz; Lbujf!Lptdjfmbl-!FJU Ebuf;!!Nbz!39-!312: CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!DF CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111 TABLE OF CONTENTS TITLE SHEET CERTIFICATION TABLE OF CONTENTS BIDDING REQUIREMENTS ADVERTISEMENT FOR BIDS * INSTRUCTIONS TO BIDDERS * BID BOND FORM (EJCDC C-430) NOTICE TO BIDDERS PROMPT PAYMENT TO SUBCONTRACTORS – NOTICE TO BIDDERS BIDDERS ACKNOWLEDGEMENT – ’ BID FORM * CONTRACT FORMS NON-COLLUSION AFFIDAVIT RESPONSIBLE CONTRACTOR VERIFICATION AND CERTIFICATION OF COMPLIA AGREEMENT * PERFORMANCE BOND FORM (EJCDC C-610) PAYMENT BOND FORM (EJCDC C-615) CONTRACTOR AFFIDAVIT (IC134 FORM) EXEMPTION FROM SURETY DEPOSITS FOR NON-MN CONTRACTORS (SDE FORM) SPECIFICATIONS DIVISION 1 GENERAL REQUIREMENTS – DIVISION 2 SPECIFICATIONS – * This document is a MODIFIED version of the corresponding EJCDC ® document (C-111, C-200, C-410, C-520 and C-800), Copyright © 201 the National Society of Professional Engineers, American Society Engineers, and American Council of Engineering Companies, or is in part on excerpts from EJCDC documents. Those portions of the originated in published EJCDC documents remain subject to the co BIRCH BLUFF ROAD, COUNTRY CLUB ROAD, EDGEWOOD ROAD, EXCELSIOR TA BOULEVARD, AND LAKE LINDEN ROAD MILL AND OVERLAY PROJECT CITY OF SHOREWOOD, MN WSB PROJECT NO. R-013234-000 BEWFSUJTFNFOU!GPS!CJET CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!CP BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU GPS!UIF!DJUZ!PG!TIPSFXPPE IFOOFQJO!DPVOUZ-!NJOOFTPUB uibu!tfbmfe!cjet!gps!uif!dpotusvdujpo!pg! OPUJDF!JT!IFSFCZ!HJWFO!Cjsdi!Cmvgg!Spbe-!Dpvousz!Dmvc! xjmm!cf! Spbe-!Fehfxppe!Spbe-!Fydfmtjps!Cpvmfwbse-!boe!Mblf!Mjoefo!Spbe!N sfdfjwfe!cz!bu!Tipsfxppe!Djuz!Ibmm!mpdbufe!bu!6866!Dpvousz!Dmvc!Spbe-! Djuz!pg!Tipsfxppe-!NO! 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Bmm!qsjdft!uibu!Cjeefs!tfut!gpsui!jo!jut!Cje!tibmm!cf!cbtfe!po!u xjmm!gvsojti!uif!nbufsjbmt!boe!frvjqnfou!tqfdjgjfe!ps!eftdsjcfe! tvqqmfnfoufe!cz!Beefoeb/!Boz!bttvnqujpot!sfhbsejoh!uif!qpttjcjmj ps.frvbm!ps!tvctujuvujpo!sfrvftut!bsf!nbef!bu!Cjeefst!tpmf!sj CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!JO CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111QBHF!8 PENALSUMFORM .L5.hb5 AnysingularreferencetoBidder,Surety,Ownerorotherpartyshallbeconsideredpluralwhereapplicable. BIDDER(NameandAddress): SURETY(Name,andAddressofPrincipalPlaceofBusiness): OWNER(NameandAddress): BID BidDueDate: Description(Projectb;IncludeLocation): BOND BondNumber: Date: Penalsum (Words)(Figures) SuretyandBidder,intendingtobelegallyboundhereby,subjecttothetermssetforthbelow,doeachcause thisBidBondtobedulyexecutedbyanauthorizedofficer,agent,orrepresentative. .L559w{ w9 (Seal)(Seal) .z77;©xNameandCorporateSeal{Ò©;·äxNameandCorporateSeal By:By: SignatureSignature(AttachPowerofAttorney) PrintNamePrintName TitleTitle Attest:Attest: SignatureSignature TitleTitle Note:Addressesaretobeusedforgivinganyrequirednotice. Provideexecutionbyanyadditionalparties,suchasjointventurers,ifnecessary . 9W/5/½/ r.z7.7t;{ÒC©utÒ,zw;7 u t©;¦©;7,ä·w;9mz;;©Wz·/·©-·5-Ò;·/z··;;u tm; E PENALSUMFORM 1. BidderandSurety,jointlyandseverally,bindthemselves,theirheirs,executors,administrators,successors,and assignstopaytoOwnerupondefaultofBidderthepenalsumsetforthonthefaceofthisBond.Paymentofthepenal sumistheextentof.z77;©xand{Ò©;·äxliability.RecoveryofsuchpenalsumunderthetermsofthisBondshallbe hÞ;©xsoleandexclusiveremedyupondefaultofBidder. 2. DefaultofBiddershalloccuruponthefailureofBiddertodeliverwithinthetimerequiredbytheBidding Documents(oranyextensionthereofagreedtoinwritingbyOwner)theexecutedAgreementrequiredbytheBidding DocumentsandanyperformanceandpaymentbondsrequiredbytheBiddingDocuments. 3. Thisobligationshallbenullandvoidif: 3.1 Owneraccepts.z77;©xBidandBidderdeliverswithinthetimerequiredbytheBiddingDocuments(orany extensionthereofagreedtoinwritingbyOwner)theexecutedAgreementrequiredbytheBidding DocumentsandanyperformanceandpaymentbondsrequiredbytheBiddingDocuments,or 3.2 AllBidsarerejectedbyOwner,or 3.3 OwnerfailstoissueaNoticeofAwardtoBidderwithinthetimespecifiedintheBiddingDocuments(orany extensionthereofagreedtoinwritingbyBidderand,ifapplicable,consentedtobySuretywhenrequiredby Paragraph5hereof). 4. PaymentunderthisBondwillbedueandpayableupondefaultofBidderandwithin30calendardaysafterreceipt byBidderandSuretyofwrittennoticeofdefaultfromOwner,whichnoticewillbegivenwithreasonablepromptness, identifyingthisBondandtheProjectandincludingastatementoftheamountdue. 5. SuretywaivesnoticeofanyandalldefensesbasedonorarisingoutofanytimeextensiontoissueNoticeofAward agreedtoinwritingbyOwnerandBidder,providedthatthetotaltimeforissuingNoticeofAwardincludingextensions shallnotintheaggregateexceed120daysfromtheBidduedatewithout{Ò©;·äxwrittenconsent. 6. NosuitoractionshallbecommencedunderthisBondpriorto30calendardaysafterthenoticeofdefaultrequired inParagraph4aboveisreceivedbyBidderandSuretyandinnocaselaterthanoneyearaftertheBidduedate. 7. AnysuitoractionunderthisBondshallbecommencedonlyinacourtofcompetentjurisdictionlocatedinthestate inwhichtheProjectislocated. 8. NoticesrequiredhereundershallbeinwritingandsenttoBidderandSuretyattheirrespectiveaddressesshown onthefaceofthisBond.Suchnoticesmaybesentbypersonaldelivery,commercialcourier,orbyUnitedStates deemedtobeeffectiveupon RegisteredorCertifiedMail,returnreceiptrequested,postageprepaid,andshallbe receiptbythepartyconcerned. 9. SuretyshallcausetobeattachedtothisBondacurrentandeffectivePowerofAttorneyevidencingtheauthority oftheofficer,agent,orrepresentativewhoexecutedthisBondonbehalfofSuretytoexecute,seal,anddeliversuch BondandbindtheSuretythereby. 10. ThisBondisintendedtoconformtoallapplicablestatutoryrequirements.Anyapplicablerequirementofany applicablestatutethathasbeenomittedfromthisBondshallbedeemedtobeincludedhereinasifsetforthatlength. IfanyprovisionofthisBondconflictswithanyapplicablestatute,thentheprovisionofsaidstatuteshallgovernand theremainderofthisBondthatisnotinconflicttherewithshallcontinueinfullforceandeffect. 11. Theterm{.z7|asusedhereinincludesaBid,offer,orproposalasapplicable. 9W/5/½/ r.z7.7t;{ÒC©utÒ,zw;7 u t©;¦©;7,ä·w;9mz;;©Wz·/·©-·5-Ò;·/z··;;u tm;E NOTICE TO BIDDERS Minnesota Statutes that require prompt payment to subcontractors: 471.425 Prompt payment of local government bills . Subd. 1. Definitions. For the purposes of this section, the following terms have the meanings here given them. (d) "Municipality" means any home rule charter or statutory city, county, town, school district, political subdivision or agency of local government. "Municipality" means the metropolitan council or any board or agency created under chapter 473. Subd. 4a.Prompt payment to subcontractors. Each contract of a municipality must require the prime contractor to pay any subcontractor within ten days of the prime contractor's receipt of payment from the municipality for undisputed services provided by the subcontractor. The contract must require the prime contractor to pay interest of 1-1/2 percent per month or any part of a month to the subcontractor on any undisputed amount not paid on time to the subcontractor. The minimum monthly interest penalty payment for an unpaid balance of $100 or more is $10. For an unpaid balance of less than $100, the prime contractor shall pay the actual penalty due to the subcontractor. A subcontractor who prevails in a civil action to collect interest penalties from a prime contractor must be awarded its costs and disbursements, including attorney's fees, incurred in bringing the action. HIST: 1985 c 136 s 5; 1995 c 31 s 1 Cjeefs; Beesftt; Djuz-!Tubuf-![jq; F.nbjm!Beesftt;Ufmfqipof!Op/; CJE!GPSN CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS! 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Beefoevn!Op/!!Ebufe;!Beefoevn!Op/!!Ebufe;! 8/Cjeefs!bhsfft!uibu!uif!Xpsl!xjmm!cf!tvctuboujbmmz!dpnqmfuf!boe Qbsbhsbqi!26/17!pg!uif!Hfofsbm!Dpoejujpot!po!ps!cfgpsf!uif!ebuft Bhsffnfou/ 9/Uif!gpmmpxjoh!epdvnfout!bsf!tvcnjuufe!xjui!boe!nbef!b!dpoejujp b/Sfrvjsfe!Cje!tfdvsjuz< c/Opo.Dpmmvtjpo!Bggjebwju< d/Sftqpotjcmf!Dpousbdups!Wfsjgjdbujpo!boe!Dfsujgjdbujpo!pg!Dpnqm e/Cjeefst!Bdlopxmfehfnfou!pg!Opujdf!up!Cjeefst/ CJEEFS;!\Joejdbuf!dpssfdu!obnf!pg!cjeejoh!foujuz^ Cz; \Tjhobuvsf^ \Qsjoufe!obnf^ Ujumf; Tvcnjuubm!Ebuf; Beesftt!gps!hjwjoh!opujdft; Jg!Cjeefs!jt!b!dpsqpsbujpo-!xibu!jt!uif!tubuf!pg!jodpsqpsbujpo@ Jg!Cjeefs!jt!b!qbsuofstijq-!tubuf!gvmm!obnf!pg!bmm!dp.qbsuofst; Gfefsbm!Fnqmpzfs!JE!Ovncfs!)FJO*; CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!CJE!GPSN CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111QBHF!7 OPO.DPMMVTJPO!BGGJEBWJU Uif!gpmmpxjoh!Opo.Dpmmvtjpo!Bggjebwju!tibmm!cf!fyfdvufe!cz!uif!c Tubuf!Qspkfdu!Op/!!!!!!!!!!!!O0B Gfefsbm!Qspkfdu!Op/!!!!!!!!!!!!O0B Tubuf!pg!Njooftpub!!* *!tt Dpvouz!pg!!* J-!!-!ep!tubuf!voefs!qfobmuz!pg )obnf!pg!qfstpo!tjhojoh!uijt!bggjebwju* qfskvsz!voefs!39!V/T/D/!2857!pg!uif!mbxt!pg!uif!Vojufe!Tubuft; )2*uibu!J!bn!uif!bvuipsj{fe!sfqsftfoubujwf!pg!! )obnf!pg!qfstpo-!qbsuofstijq!ps!dpsqpsbujpo!tvcnjuujoh!uijt!qspq boe!uibu!J!ibwf!uif!bvuipsjuz!up!nblf!uijt!bggjebwju!gps!boe!po! )3*uibu-!jo!dpoofdujpo!xjui!uijt!qspqptbm-!uif!tbje!cjeefs!ibt!opu! joejsfdumz!foufsfe!joup!boz!bhsffnfou-!qbsujdjqbufe!jo!boz!dpmmv sftusbjou!pg!gsff!dpnqfujujwf!cjeejoh< )4*uibu-!up!uif!cftu!pg!nz!lopxmfehf!boe!cfmjfg-!uif!dpoufout!pg!ui cffo!dpnnvojdbufe!cz!uif!cjeefs!ps!cz!boz!pg!ijt0ifs!fnqmpzfft!p bo!fnqmpzff!ps!bhfou!pg!uif!cjeefs!ps!pg!uif!tvsfuz!po!boz!cpoe! opu!cf!dpnnvojdbufe!up!boz!qfstpo!xip!jt!opu!bo!fnqmpzff!ps!bhfo qsjps!up!uif!pggjdjbm!pqfojoh!pg!uif!qspqptbm-!boe )5*uibu!J!ibwf!gvmmz!jogpsnfe!nztfmg!sfhbsejoh!uif!bddvsbdz!pg!uif! jo!uijt!bggjebwju/ Tjhofe;!! )cjeefs!ps!ijt0ifs!bvuipsj{fe!sfqsftfoubujwf* CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!OP CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111 ATTACHMENT A PRIME CONTRACTOR RESPONSE RESPONSIBLE CONTRACTOR VERIFICATION AND CERTIFICATION OF COMPLIA STATE PROJECT NUMBER: ____________________________________________________ This form includes changes by statutory references from the Laws sections 1-9. This form must be submitted with the response to this solicitati received without this form, will be rejected. IMPLEMENTATION. Minn. Stat. §16C.285, Subd. 7. …anyprime contractor or subcontractor or motor carrier that does not meet the minimum criteria in subdivision 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… RESPONSIBLE CONTRACTOR, MINIMUM CRITERIA Minn. Stat. §16C.285, Subd. 3. . "Responsible contractor" means a contractor that conforms to the responsibility requirements in the solicitation document for its portion of the work on the project and verifies that it meets the following minimum criteria: (1)The Contractor: (i) is in compliance with workers' compensation and unemployment insurance requirements; (ii) is in compliance with Department of Revenue and Department of Employment and Economic Development registration requirements if it has employees; (iii) has a valid federal tax identification number or a valid Social Security number if an individual; and (iv) has filed a certificate of authority to transact business in Minnesota with the Secretary of State if a foreign corporation or cooperative. (2)The contractor or related entity is in compliance with and, during the three-year period before submitting the verification, has not violated section 177.24,177.25, 177.41 to 177.44, 181.13, 181.14, or 181.722, and has not violated United States Code, title 29, sections 201 to 219, or United States Code, title 40, sections 3141 to 3148. For purposes of this clause, a violation occurs when a contractor or related entity: (i) repeatedly fails to pay statutorily required wages or penalties on one or more separate projects for a total underpayment of $25,000 or more within the three-year period, provided that a failure to pay is “repeated” only if it involves twoor more separate and distinct occurrences of underpayment during the three-year period; (ii) has been issued an order to comply by the commissioner of Labor and Industry that has become final; (iii) has been issued at least two determination letters within the three-year period by the Department of Transportation finding an underpayment by the contractor or related entity to its own employees; (iv) has been found by the commissioner of Labor and Industry to have repeatedly or willfully violated any of the sections referenced in this clause pursuant to section 177.27; (v) has been issued a ruling or findings of underpayment by the administrator of the Wage and Hour Division of the United States Department of Labor that have become final or have been upheld by an administrative law judge or the Administrative Review Board; or (vi) has been found liable for underpayment of wages or penalties or misrepresenting a construction worker as an independent contractor in an action brought in a court having jurisdiction. Provided that, if the contractor or related entity contests a determination of underpayment by the Department of Transportation in a contested case proceeding, a violation does not occur until the contested case proceeding has concluded with a determination that the contractor or related entity underpaid wages or penalties;* 15 Revised 9/29/2015 Page of The contractor or related entity is in compliance with and, during the three-year period before submitting the (3) verification, has not violated section 181.723 or chapter 326B. For purposes of this clause, a violation occurs when a contractor or related entity has been issued a final administrative or licensing order;* The contractor or related entity has not, more than twice during the three-year period before submitting the (4) verification, had a certificate of compliance under section 363A.36 revoked or suspended based on the provisions of section 363A.36, with the revocation or suspension becoming final because it was upheld by the Office of Administrative Hearings or was not appealed to the office;* The contractor or related entity has not received a final determination assessing a monetary sanction from the (5) Department of Administration or Transportation for failure to meet targeted group business, disadvantaged business enterprise, or veteran-owned business goals, due to a lack of good faith effort, more than once during the three-year period before submitting the verification;* * Anyviolations, suspensions, revocations, or sanctions, as defined in clauses (2) to (5), occurring prior to July 1, 2014, shall not be considered in determining whether a contractor or related entity meets the minimum criteria. The contractor or relatedentity is not currently suspended or debarred by the federal government or the state of (6) Minnesota or any of its departments, commissions, agencies, or political subdivisions that have authority to debar a contractor; and All subcontractors and motor carriers that the contractor intends to use to perform project work have verified to (7) the contractor through a signed statement under oath by an owner or officer that they meet the minimum criteria listed in clauses (1) to (6). SUBCONTRACTOR VERIFICATION Minn. Stat. §16C.285, Subd. 5. . A prime contractor or subcontractor shall include in its verification of compliance under subdivision 4 a list of all of its first-tier subcontractors that it intends to retain for work on the project. Prior to execution of a construction contract, and as a condition precedent to the execution of a construction contract, the apparent successful prime contractor shall submit to the contracting authority a supplemental verification under oath confirming compliance with subdivision 3, clause (7). Each contractor or subcontractor shall obtain from all subcontractors with which it will have a direct contractual relationship a signed statement under oath by an owner or officer verifying that they meet all of the minimumcriteria in subdivision 3 prior to execution of a construction contract with each subcontractor. If a prime contractor or any subcontractor retains additional subcontractors on the project after submitting its verification of compliance, the prime contractor or subcontractor 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 subdivision 3, clause (7), within 14 days of retaining the additional subcontractors. A prime contractor shall submit to the contracting authority upon request copies of the signed verifications of compliance from all subcontractors of any tier pursuant to subdivision 3, clause (7). A primecontractor and subcontractors shall not be responsible for the false statements of any subcontractor with which they do not have a direct contractual relationship. A prime contractor and subcontractors shall be responsible for false statements by their first-tier subcontractors with which they have a direct contractual relationship only if they accept the verification of compliance with actual knowledge that it contains a false statement. Motor carrier verification. Subd. 5a. A prime contractor or subcontractor shall obtain annually from all motor carriers with which it will 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 aconstruction contract with each motor carrier. A prime contractor or subcontractor shall require each such motor carrier to provide it with immediate written notification in the event that the motor carrier no longer meets one or more of the minimum criteria in subdivision 3 after submitting its annual verification. A motor carrier shall be ineligible to perform work on a project covered by this section if it does not meet all the minimum criteria in subdivision 3. Upon request, a prime contractor or subcontractor shall submit to the contracting authority the signed verifications of compliance from all motor carriers providing for-hire transportation of materials, equipment, or supplies for a project. 25 Revised 9/29/2015 Page of VERIFICATION OF COMPLIANCE. Minn. Stat. §16C.285, Subd. 4. A contractor responding to a solicitation document of a contracting authority shall submit to the contracting authority a signed statement under oath by an owner or officer verifying compliance with each of the minimum criteria in subdivision 3, with the exception of clause (7), at the time that it responds to the solicitation document. A contracting authority may accept a signed statement under oath as sufficient to demonstrate that a contractor is a responsible contractor and shall not be held liable for awarding a contract in reasonable reliance on that statement. A prime contractor, subcontractor, or motor carrier that fails to verify compliance with any one of the required minimum criteria or makes a false statement under oath in a verification of compliance shall be ineligible to be awarded a construction contract on the project for which the verification was submitted. A false statement under oath verifying compliance with any of the minimum criteria may result in termination of a construction contract that has already been awarded to a prime contractor or subcontractor or motor carrier that submits a false statement. 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. A verification of compliance need not be notarized. An electronic verification of compliance made and submitted as part of an electronic bid shall be an acceptable verification of compliance under this section provided that it contains an electronic signature as defined in section 325L.02, paragraph (h). CERTIFICATION By signing this document I certify that I am anowner or officer of the company, and I swear under oath that: 1) My company meets each of the Minimum Criteria to be a respons compliance with Minn. Stat. £16C.285, and 2) if my company is awarded a contract, I will submit Attachment A-1 prior to contract execution, and 3) if my company is awarded a contract, I will also submit Attac-2 as required. Authorized Signature of Owner or Officer:Printed Name: Title:Date: Company Name: NOTE: Minn. Stat. §16C.285, Subd. 2, (c) If only one prime contractor responds to a solicitation document, a contracting authority may award a construction contract to the responding prime contractor even if the minimum criteria in subdivision 3 are not met. 35 Revised 9/29/2015 Page of ATTACHMENT A-1 FIRST-TIER SUBCONTRACTORS LIST SUBMIT PRIOR TO EXECUTION OF A CONSTRUCTION CONTRACT STATE PROJECT NUMBER: ____________________________________________________ Minn. Stat. §16C.285, Subd.5. A prime contractor or subcontractor shall include in its verification of compliance under subdivision 4 a list of all of its first-tier subcontractors that it intends to retain for work on the project. Prior to execution of a construction contract, and as a condition precedent to the execution of a construction contract, the apparent successful prime contractor shall submit to the contracting authority a supplemental verification under oath confirming compliance with subdivision 3, clause (7). Each contractor or subcontractor shall obtain from all subcontractors with which it will 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. FIRST TIER SUBCONTRACTOR NAMES* Name of city where company (Legal name of company as registered with the Secretary of home office is located State) *Attach additional sheetsas needed for submission of all first-tier subcontractors. SUPPLEMENTAL CERTIFICATION FOR ATTACHMENT A-1 By signing this document I certify that I am an owner or officer that: All first-tier subcontractors listed on attachment A-1 have verified through a signed statement under oath by an owner or officer that they meet the minimum criteria inMinn. Stat. £ 16C.285. Authorized Signature of Owner or Officer:Printed Name: Title:Date: Company Name: 45 Revised 9/29/2015 Page of ATTACHMENT A-2 ADDITIONAL SUBCONTRACTORS LIST PRIME CONTRACTOR TO SUBMIT AS SUBCONTRACTORS ARE ADDED TO THE PR STATE PROJECT NUMBER: ____________________________________________________ This form must be submitted to the Project Manager or individual as identified in the solicitation document. Minn. Stat. §16C.285, Subd.5. … If a prime contractor or any subcontractor retains additional subcontractors on the project after submitting its verification of compliance, the prime contractor or subcontractor 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 subdivision 3, clause (7), within 14 days of retaining the additional subcontractors. … ADDITIONAL SUBCONTRACTOR NAMES* Name of city where company (Legalname of company as registered with the Secretary of home office is located State) *Attach additional sheets as needed for submission of all additional subcontractors. SUPPLEMENTAL CERTIFICATION FOR ATTACHMENT A-2 By signing this document I certify that I am an owner or officer that: All additional subcontractors listed on Attachment A-2 have verified through a signed statement under oath by an owner or officer that they meet the minimum criteria to be a responsible contract in Minn. Stat. £ 16C.285. Authorized Signature of Owner or Officer:Printed Name: Title:Date: Company Name: 55 Revised 9/29/2015 Page of BHSFFNFOU!CFUXFFO!PXOFS!BOE!DPOUSBDUPS GPS!DPOTUSVDUJPO!DPOUSBDU UIJT!BHSFFNFOU!jt!cz!boe!cfuxffoUif!Djuz!pg!Tipsfxppe)Pxofs*!boe )Dpousbdups*/ Pxofs!boe!Dpousbdups!ifsfcz!bhsff!bt!gpmmpxt; BSUJDMF!2!!XPSL 2/12Dpousbdups!tibmm!dpnqmfuf!bmm!Xpsl!bt!tqfdjgjfe!ps!joejdbufe jt!hfofsbmmz!eftdsjcfe!bt!gpmmpxt; Uif!gvsojtijoh!pg!bmm!mbcps-!nbufsjbmt-!uppmt-!boe!frvjqnfou!ofd njmm!boe!pwfsmbz!jnqspwfnfout!boe!bqqvsufobou!xpsl/ BSUJDMF!3!!UIF!QSPKFDU 3/12Uif!Qspkfdu-!pg!xijdi!uif!Xpsl!voefs!uif!Dpousbdu!Epdvnfout! gpmmpxt;! 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DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111QBHF!7 PERFORMANCE BOND CONTRACTOR SURETY (name and address): (name and address of principal place of business): OWNER (name and address): CONSTRUCTION CONTRACT Effective Date of the Agreement: Amount: Description (name and location): BOND Bond Number: Date (not earlier than the Effective Date of the Agreement of the Con: Amount: Modifications to this Bond Form: None S Surety and Contractor, intending to be legally bound hereby, sub this Performance Bond to be duly executed by an authorized offic CONTRACTOR AS PRINCIPALSURETY (seal) (seal) Contractors Name and Corporate SealSuretys Name and Corporate Seal By: By: SignatureSignature (attach power of attorney) Print NamePrint Name TitleTitle Attest:Attest: SignatureSignature TitleTitle Notes: (1) Provide supplemental execution by any additional part (2) Any singular reference to Contractor, Surety, Owner, or other party shall be considered pl EJCDC® C-610, Performance Bond Copyright © 2013 National Society of Professional Engineers, Ame and American Society of Civil Engineers. All rights reserved. 1. The Contractor and Surety, jointly and severally, bind to be secured with performance and payment bonds executed themselves, their heirs, executors, administrators, successors, by a qualified surety equivalent to the bonds issued on the assigns to the Owner for the performance of the Construction Construction Contract, and pay to the Owner the amount of Contract, which is incorporated herein by reference.damages as described in Paragraph 7 in excess of the Balance of the Contract Price incurred by the Owner as a result of the Contractor Default; or 2. If the Contractor performs the Construction Contract, the Sur and the Contractor shall have no obligation under this Bond, exc when applicable to participate in a conference as provided in 5.4 Waive its right to perform and complete, arrange for Paragraph 3.completion, or obtain a new contractor, and with reasonable promptness under the circumstances: 3. If there is no Owner Default under the Construction Contract, the Suretys obligation under this Bond shall arise after:5.4.1 After investigation, determine the amount for which it may be liable to the Owner and, as soon as practicable after the amount is determined, make payment 3.1 The Owner first provides notice to the Contractor and to the Owner; or the Surety that the Owner is considering declaring a Contractor Default. Such notice shall indicate whether the Owner is requesting a conference among the Owner, Contractor, and 5.4.2 Deny liability in whole or in part and notify the Surety to discuss the Contractors performance. If the Owner Owner, citing the reasons for denial. does not request a conference, the Surety may, within five (5) business days after receipt of the Owners notice, request such a 6.If the Surety does not proceed as provided in Paragraph 5 with conference. If the Surety timely requests a conference, the reasonable promptness, the Surety shall be deemed to be in defau Owner shall attend. Unless the Owner agrees otherwise, any on this Bond seven days after receipt of an additional written n conference requested under this Paragraph 3.1 shall be held from the Owner to the Surety demanding that the Surety perform i within ten (10) business days of the Suretys receipt of the obligations under this Bond, and the Owner shall be entitled to Owners notice. If the Owner, the Contractor, and the Surety enforce any remedy available to the Owner. If the Surety procee agree, the Contractor shall be allowed a reasonable time to provided in Paragraph 5.4, and the Owner refuses the payment or perform the Construction Contract, but such an agreement shall Surety has denied liability, in whole or in part, without furthe not waive the Owners right, if any, subsequently to declare a the Owner shall be entitled to enforce any remedy available to t Contractor Default; Owner. 3.2 The Owner declares a Contractor Default, terminates 7.If the Surety elects to act under Paragraph 5.1, 5.2, or 5.3, the Construction Contract and notifies the Surety; and the responsibilities of the Surety to the Owner shall not be gre than those of the Contractor under the Construction Contract, an 3.3 The Owner has agreed to pay the Balance of the the responsibilities of the Owner to the Surety shall not be gre Contract Price in accordance with the terms of the Construction than those of the Owner under the Construction Contract. Subjec Contract to the Surety or to a contractor selected to perform ththe commitment by the Owner to pay the Balance of the Contract Construction Contract.Price, the Surety is obligated, without duplication for: 4. Failure on the part of the Owner to comply with the notice 7.1 the responsibilities of the Contractor for correction of requirement in Paragraph 3.1 shall not constitute a failure to cdefective work and completion of the Construction Contract; with a condition precedent to the Suretys obligations, or release the Surety from its obligations, except to the extent the Surety 7.2 additional legal, design professional, and delay costs demonstrates actual prejudice. resulting from the Contractors Default, and resulting from the actions or failure to act of the Surety under Paragraph 5; and 5. When the Owner has satisfied the conditions of Paragraph 3, t Surety shall promptly and at the Suretys expense take one of the 7.3liquidated damages, or if no liquidated damages are following actions: specified in the Construction Contract, actual damages caused by delayed performance or non-performance of the Contractor. 5.1 Arrange for the Contractor, with the consent of the Owner, to perform and complete the Construction Contract; 8.If the Surety elects to act under Paragraph 5.1, 5.3, or 5.4, Suretys liability is limited to the amount of this Bond. 5.2 Undertake to perform and complete the Construction Contract itself, through its agents or independent contractors; 9.The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the Construc 5.3 Obtain bids or negotiated proposals from qualified Contract, and the Balance of the Contract Price shall not be red contractors acceptable to the Owner for a contract for or set off on account of any such unrelated obligations. No rig performance and completion of the Construction Contract, action shall accrue on this Bond to any person or entity other t arrange for a contract to be prepared for execution by the the Owner or its heirs, executors, administrators, successors, a Owner and a contractor selected with the Owners concurrence, assigns. EJCDC® C-610, Performance Bond Copyright © 2013 National Society of Professional Engineers, Ame and American Society of Civil Engineers. All rights reserved. 10.The Surety hereby waives notice of any change, including for damages to which the Contractor is entitled, reduced by all changes of time, to the Construction Contract or to related valid and proper payments made to or on behalf of the subcontracts, purchase orders, and other obligations. Contractor under the Construction Contract. 11.Any proceeding, legal or equitable, under this Bond may be 14.2 Construction Contract: The agreement between the instituted in any court of competent jurisdiction in the locatioOwner and Contractor identified on the cover page, including all which the work or part of the work is located and shall be instiContract Documents and changes made to the agreement and within two years after a declaration of Contractor Default or withe Contract Documents. two years after the Contractor ceased working or within two year after the Surety refuses or fails to perform its obligations und 14.3 Contractor Default: Failure of the Contractor, which Bond, whichever occurs first. If the provisions of this paragra has not been remedied or waived, to perform or otherwise to void or prohibited by law, the minimum periods of limitations comply with a material term of the Construction Contract. available to sureties as a defense in the jurisdiction of the su applicable. 14.4 Owner Default: Failure of the Owner, which has not been remedied or waived, to pay the Contractor as required 12.Notice to the Surety, the Owner, or the Contractor shall be under the Construction Contract or to perform and complete or mailed or delivered to the address shown on the page on which th comply with the other material terms of the Construction signature appears. Contract. 13.When this Bond has been furnished to comply with a statutory 14.5 Contract Documents: All the documents that comprise or other legal requirement in the location where the constructio the agreement between the Owner and Contractor. to be performed, any provision in this Bond conflicting with sai statutory or legal requirement shall be deemed deleted herefrom 15.If this Bond is issued for an agreement between a contractor provisions conforming to such statutory or other legal requireme subcontractor, the term Contractor in this Bond shall be deemed shall be deemed incorporated herein. When so furnished, the int be Subcontractor and the term Owner shall be deemed to be is that this Bond shall be construed as a statutory bond and not Contractor. common law bond. 16.Modifications to this Bond are as follows: 14.Definitions 14.1 Balance of the Contract Price: The total amount payable by the Owner to the Contractor under the Construction Contract after all proper adjustments have been made including allowance for the Contractor for any amounts received or to be received by the Owner in settlement of insurance or other claims EJCDC® C-610, Performance Bond Copyright © 2013 National Society of Professional Engineers, Ame and American Society of Civil Engineers. All rights reserved. PAYMENT BOND CONTRACTOR SURETY :: (name and address)(name and address of principal place of business) OWNER : (name and address) CONSTRUCTION CONTRACT Effective Date of the Agreement: Amount: Description : (name and location) BOND Bond Number: Date ): (not earlier than the Effective Date of the Agreement of the Con Amount: Modifications to this Bond Form: None Se Surety and Contractor, intending to be legally bound hereby, sub this Payment Bond to be duly executed by an authorized officer, CONTRACTOR AS PRINCIPALSURETY (seal) (seal) Contractors Name and Corporate SealSuretys Name and Corporate Seal By: By: SignatureSignature (attach power of attorney) Print NamePrint Name TitleTitle Attest: Attest: SignatureSignature TitleTitle Notes: (1) Provide supplemental execution by any additional par (2) Any singular reference to Contractor, Surety, Owner, or other party shall be considered EJCDC® C-615, Payment Bond Copyright © 2013 National Society of Professional Engineers, Ame and American Society of Civil Engineers. All rights reserved. 6.If a notice of non-payment required by Paragraph 5.1.1 is given by the Owner to the Contractor, that is sufficient to 1.The Contractor and Surety, jointly and severally, bind satisfy a Claimants obligation to furnish a written notice of themselves, their heirs, executors, administrators, non-payment under Paragraph 5.1.1. successors, and assigns to the Owner to pay for labor, materials, and equipment furnished for use in the 7.When a Claimant has satisfied the conditions of Paragraph performance of the Construction Contract, which is 5.1 or 5.2, whichever is applicable, the Surety shall incorporated herein by reference, subject to the following promptly and at the Suretys expense take the following terms. actions: 2.If the Contractor promptly makes payment of all sums due 7.1Send an answer to the Claimant, with a copy to the to Claimants, and defends, indemnifies, and holds Owner, within sixty (60) days after receipt of the harmless the Owner from claims, demands, liens, or suits Claim, stating the amounts that are undisputed and by any person or entity seeking payment for labor, the basis for challenging any amounts that are materials, or equipment furnished for use in the disputed; and performance of the Construction Contract, then the Surety and the Contractor shall have no obligation under this Bond. 7.2Pay or arrange for payment of any undisputed amounts. 3. If there is no Owner Default under the Construction Contract, the Suretys obligation to the Owner under this 7.3The Suretys failure to discharge its obligations Bond shall arise after the Owner has promptly notified the under Paragraph 7.1 or 7.2 shall not be deemed to Contractor and the Surety (at the address described in constitute a waiver of defenses the Surety or Paragraph 13) of claims, demands, liens, or suits against Contractor may have or acquire as to a Claim, the Owner or the Owners property by any person or except as to undisputed amounts for which the entity seeking payment for labor, materials, or equipment Surety and Claimant have reached agreement. If, furnished for use in the performance of the Construction however, the Surety fails to discharge its Contract, and tendered defense of such claims, demands, obligations under Paragraph 7.1 or 7.2, the Surety liens, or suits to the Contractor and the Surety. shall indemnify the Claimant for the reasonable attorneys fees the Claimant incurs thereafter to recover any sums found to be due and owing to 4.When the Owner has satisfied the conditions in Paragraph the Claimant. 3, the Surety shall promptly and at the Suretys expense defend, indemnify, and hold harmless the Owner against a duly tendered claim, demand, lien, or suit. 8.The Suretys total obligation shall not exceed the amount of this Bond, plus the amount of reasonable attorneys fees provided under Paragraph 7.3, and the amount of this 5.The Suretys obligations to a Claimant under this Bond Bond shall be credited for any payments made in good shall arise after the following: faith by the Surety. 5.1 Claimants who do not have a direct contract with 9. Amounts owed by the Owner to the Contractor under the the Contractor, Construction Contract shall be used for the performance of the Construction Contract and to satisfy claims, if any, 5.1.1have furnished a written notice of non- under any construction performance bond. By the payment to the Contractor, stating with Contractor furnishing and the Owner accepting this Bond, substantial accuracy the amount claimed they agree that all funds earned by the Contractor in the and the name of the party to whom the performance of the Construction Contract are dedicated materials were, or equipment was, to satisfy obligations of the Contractor and Surety under furnished or supplied or for whom the this Bond, subject to the Owners priority to use the funds labor was done or performed, within for the completion of the work. ninety (90) days after having last performed labor or last furnished materials or equipment included in the 10.The Surety shall not be liable to the Owner, Claimants, or Claim; and others for obligations of the Contractor that are unrelated to the Construction Contract. The Owner shall not be 5.1.2have sent a Claim to the Surety (at the liable for the payment of any costs or expenses of any address described in Paragraph 13). Claimant under this Bond, and shall have under this Bond no obligation to make payments to or give notice on behalf of Claimants, or otherwise have any obligations to 5.2 Claimants who are employed by or have a direct Claimants under this Bond. contract with the Contractor have sent a Claim to the Surety (at the address described in Paragraph 13). 11.The Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related subcontracts, purchase orders, and other obligations. EJCDC® C-615, Payment Bond Copyright © 2013 National Society of Professional Engineers, Ame and American Society of Civil Engineers. All rights reserved. 12.No suit or action shall be commenced by a Claimant under 8.The total amount due and unpaid to the this Bond other than in a court of competent jurisdiction in Claimant for labor, materials, or equipment the state in which the project that is the subject of the furnished as of the date of the Claim. Construction Contract is located or after the expiration of one year from the date (1) on which the Claimant sent a 16.2 Claimant: An individual or entity having a direct Claim to the Surety pursuant to Paragraph 5.1.2 or 5.2, or contract with the Contractor or with a (2) on which the last labor or service was performed by subcontractor of the Contractor to furnish labor, anyone or the last materials or equipment were furnished materials, or equipment for use in the performance by anyone under the Construction Contract, whichever of of the Construction Contract. The term Claimant (1) or (2) first occurs. If the provisions of this paragraph also includes any individual or entity that has are void or prohibited by law, the minimum period of rightfully asserted a claim under an applicable limitation available to sureties as a defense in the mechanics lien or similar statute against the real jurisdiction of the suit shall be applicable. property upon which the Project is located. The intent of this Bond shall be to include without 13.Notice and Claims to the Surety, the Owner, or the limitation in the terms of labor, materials, or Contractor shall be mailed or delivered to the address equipment that part of the water, gas, power, shown on the page on which their signature appears. light, heat, oil, gasoline, telephone service, or Actual receipt of notice or Claims, however accomplished, rental equipment used in the Construction shall be sufficient compliance as of the date received.Contract, architectural and engineering services required for performance of the work of the Contractor and the Contractors subcontractors, 14.When this Bond has been furnished to comply with a and all other items for which a mechanics lien may statutory or other legal requirement in the location where be asserted in the jurisdiction where the labor, the construction was to be performed, any provision in materials, or equipment were furnished. this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal 16.3 Construction Contract: The agreement between requirement shall be deemed incorporated herein. When the Owner and Contractor identified on the cover so furnished, the intent is that this Bond shall be construed page, including all Contract Documents and all as a statutory bond and not as a common law bond.changes made to the agreement and the Contract Documents. 15.Upon requests by any person or entity appearing to be a potential beneficiary of this Bond, the Contractor and 16.4 Owner Default: Failure of the Owner, which has Owner shall promptly furnish a copy of this Bond or shall not been remedied or waived, to pay the permit a copy to be made.Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction 16.Definitions Contract. 16.1 Claim: A written statement by the Claimant 16.5 Contract Documents: All the documents that including at a minimum: comprise the agreement between the Owner and Contractor. 1. The name of the Claimant; 2. The name of the person for whom the labor 17. If this Bond is issued for an agreement between a was done, or materials or equipment contractor and subcontractor, the term Contractor in this furnished; Bond shall be deemed to be Subcontractor and the term 3.A copy of the agreement or purchase order Owner shall be deemed to be Contractor. pursuant to which labor, materials, or equipment was furnished for use in the performance of the Construction Contract;18. Modifications to this Bond are as follows: 4. A brief description of the labor, materials, or equipment furnished; 5. The date on which the Claimant last performed labor or last furnished materials or equipment for use in the performance of the Construction Contract; 6.The total amount earned by the Claimant for labor, materials, or equipment furnished as of the date of the Claim; 7.The total amount of previous payments received by the Claimant; and EJCDC® C-615, Payment Bond Copyright © 2013 National Society of Professional Engineers, Ame and American Society of Civil Engineers. All rights reserved. IC134 - $ $ Yes Department of Revenue approval Date Complete and - No state agency or local unit of government You must have a Minnesota tax ID number cally. Go to www.revenue.state.mn.us and if you have employees who work in Min- choose Withholding Tax. Under the File nesota. You must enter your Minnesota tax that the contractor and any subcontractor ID number on Form IC134. Information for Government Projects. - If you dont have a Minnesota tax ID sota withholding tax laws. number, apply online at www.revenue.state.mn.us or by calling our If you are a prime contractor, a contractor or a subcontractor who did work on a proj- ect for the state of Minnesota or any of its withholding tax laws, the department will local government subdivisions such as a If you have no employees and did all the sign your Form IC134 and return it to you. county, city or school district you must work yourself, you do not need a Minnesota - tax ID number. Instead, enter your Social - Security number in the space for Minnesota ment unit for which the work was done. If compliance. tax ID number and explain who did the work. - The Department of Revenue needs all the Form IC134 cannot be processed by the requested information to determine if you have met the state income tax withholding Additional forms and information, includ- work. If you submit the form before the requirements. If all required information is ing fact sheets and frequently asked ques- project is completed, it will be returned to not provided, Form IC134 will be returned tions, are available on our website. you unprocessed. to you for completion. Website: www.revenue.state.mn.us If any withholding payments are due to the - is private by state law. It cannot be given to Email: withholding.tax@state.mn.us ments before we approve your Form IC134. others without your permission, except to the Internal Revenue Service, other states If you are a subcontractor or sole contrac- that guarantee the same privacy and certain tor, submit the form when you have com- This information is available in alternate government agencies as provided by law. pleted your part of the project. formats. If you are a prime contractor, submit the form when the entire project is completed If you were hired as a subcontractor to do work on a project, and you subcontracted all or a part of your portion of the project to another contractor, you are a prime contrac- tor as well. Complete both the subcontrac- tor and prime contractor areas on a single Form IC134. either electronically or by mail. This af- the state or any of its subdivisions can make SDE Contractor Total contract amount Minnesota tax ID number $ Business type (check one): Partnership Sole proprietor Contract owners address City State ZIP Code Project number (M.S. 290.9705)check one box only and : City State ZIP Code Period of Bond (Month/Day/Year) From / / To / / Mail to: Department of Revenue Approval The above-named non-Minnesota contractor is exempt from the sure Department of Revenue approval Date (Rev. 12/17) Unless the non-Minnesota construction " The contractor gives the department a contractor is approved for exemption, any cash surety. A cash surety is evidence of To apply for an exemption from Minnesota person or business that hires or contracts with the contractor must withhold 8 percent of deposit in, or issued by, a state bank, start the project. of their compensation as a Minnesota national bank, or savings and loan as- Mail this form and any required attach- surety deposit.sociation doing business in Minnesota. ments to the address on the front. Interest and dividends earned on the The withholding amount is deposited with principal amount may be retained by the the department and is used as a surety to contractor. If we approve the exemption, we will sign the bottom of the form and return it to you. " The contractor is performing work for a the requirements for withholding, sales and Make a copy for your records and give the government agency and has a payment use, franchise, and income taxes. original to the business for whom you are and performance bond. For additional information regarding the doing the work. " The contractor has done construction 8 percent withholding, see Fact Sheet 12, work in Minnesota during the past three Surety Deposits for Non-Minnesota Con- calendar years and has fully complied If we determine youre not eligible for struction Contractors. with Minnesota laws regarding with- exemption, 8 percent of each payment made holding, sales and use, franchise, and to you must be withheld by the business for If you are a non-Minnesota construction income taxes. whom you are doing the work and depos- contractor and you want to apply for an ex- If a non-Minnesota contractor is hired or ited with the Department of Revenue. emption from the surety deposit (see Ex- contracted to perform construction work in emption Requirements below), complete Minnesota, the person or business who is Refund of Surety Deposits for Non- paying the contractor must withhold 8 per- Minnesota Contractors. When the project is before you start the project. cent of the payment as a Minnesota surety complete, and we determine that you have deposit. complied with Minnesota income, with- Unless the contractor has received exemp- holding, corporate franchise and sales and you are doing the work to show you are tion from surety deposits, payments made use tax laws, youll receive a refund plus exempt from the 8 percent surety deposit. to the contractor are subject to 8 percent interest. withholding, if: " the construction work was performed in If you hire or contract with a non-Minneso- Additional forms and information, includ- Minnesota; and ta contractor to perform construction work ing fact sheets and frequently asked ques- " the total amount paid to the non-Minne- in Minnesota, you must withhold 8 percent tions, are available on our website. sota construction contractor during the (.08) of their compensation as a Minne- Website: www.revenue.state.mn.us year exceeds $50,000. sota surety deposit. Payments are subject Email: withholding.tax@state.mn.us to 8 percent withholding only if the work was performed in Minnesota and the total A non-Minnesota contractor can apply for payments during the year exceed $50,000. This information is available in alternate an exemption if your contract exceeds or If the total payments exceed $50,000 in a formats. is expected to exceed $50,000 or multiple calendar year, all of the payments, even the contracts have exceeded $50,000 cumula- tive per calendar year for work done in All information on this form is required Minnesota. except for your phone number. A non-Minnesota construction contrac- All information, except your Minnesota tax tor may qualify for an exemption from You must have a Minnesota tax ID number ID number, is private by state law. It cannot the surety deposit if one of the following from the Department of Revenue to request be given to others without your permission, requirements are met: an exemption from surety deposit. " The contractor gives the department a other states that guarantee the same privacy, If you dont have a Minnesota ID number, bond that is secured by an insurance the contract owner or bonding company and you may apply online at www.revenue. company licensed in Minnesota and is certain government agencies as provided state.mn.us or by calling our Business equal to 8 percent of the contract. The by law. bond remains in effect until the con- Non-Minnesota Contractors Bond, to submit to the department. EJWJTJPO!2 HFOFSBM!SFRVJSFNFOUT HS.2!!TVNNBSZ!PG!XPSL////////////////////////////////////////// HS.3!!XPSL!TFRVFODF//////////////////////////////////////////// HS.4!!)2512*!JOUFOU!PG!DPOUSBDU//////////////////////////////// HS.5!!)2513*!DPOUSBDU!SFWJTJPOT//////////////////////////////// HS.6!!)2514*!OPUJGJDBUJPO!GPS!DPOUSBDU!SFWJTJPOT/////////////// HS.7!!)2515*!NBJOUFOBODF!PG!USBGGJD!BOE!)3674*!USBGGJD!DPOUSPM/ HS.8!!)2516*!VTF!PG!NBUFSJBMT!GPVOE!PO!UIF!QSPKFDU///////////// HS.9!!)2517*!QSFTFSWBUJPO!PG!IJTUPSJDBM!PCKFDUT//////////////// HS.:!!)2613*!QMBOT!BOE!XPSLJOH!ESBXJOHT//////////////////////// HS.21!!)2615*!DPPSEJOBUJPO!PG!DPOUSBDU!EPDVNFOUT/////////////// HS.22!!)2617*!TVQFSWJTJPO!CZ!DPOUSBDUPS//////////////////////// HS.23!!)2618*!VUJMJUZ!QSPQFSUZ!BOE!TFSWJDF///////////////////// HS.24!!)2624*!SFTUSJDUJPOT!PO!NPWFNFOU!BOE!TUPSBHF!PG!IFBWZ!MPB FRVJQNFOU/////////////////////////////////////////////////////// HS.25!!)2625*!NBJOUFOBODF!EVSJOH!DPOTUSVDUJPO////////////////// HS.26!!)2626*!DPOUSPM!PG!IBVM!SPBET//////////////////////////// HS.27!!)2712*!TPVSDF!PG!TVQQMZ!BOE!RVBMJUZ///////////////////// HS.28!!)2717*!TUPSBHF!PG!NBUFSJBMT///////////////////////////// HS.29!!)2718*!IBOEMJOH!NBUFSJBMT/////////////////////////////// HS.2:!!)2719*!VOBDDFQUBCMF!NBUFSJBMT/////////////////////////// HS.31!!)271:*!EFQBSUNFOU!QSPWJEFE!NBUFSJBM///////////////////// HS.32!!)2812*!MBXT!UP!CF!PCTFSWFE////////////////////////////// HS.33!!)2817*!FNQMPZFF!IFBMUI!BOE!XFMGBSF////////////////////// HS.34!!)2818*!QVCMJD!DPOWFOJFODF!BOE!TBGFUZ//////////////////// HS!35!!)2821*!QSPKFDU!BDDFTT!BOE!BDDFTT!UP!QSPQFSUJFT////////// HS.36!!)2823*!QSPUFDUJPO!BOE!SFTUPSBUJPO!PG!QSPQFSUZ/////////// HS.37!!)2827*!DPOUSBDUPST!SFTQPOTJCJMJUZ!GPS!XPSL///////////// HS.38!!)2828*!BJS-!MBOE-!BOE!XBUFS!QPMMVUJPO/////////////////// HS.39!!)2913*!RVBMJGJDBUJPOT!PG!XPSLFST//////////////////////// HS.3:!!)2916*!NFUIPET!BOE!FRVJQNFOU//////////////////////////// HS.41!!)2917*!EFUFSNJOBUJPO!BOE!FYUFOTJPO!PG!DPOUSBDU!UJNF///// HS.42!!)2:12*!NFBTVSFNFOU!PG!RVBOUJUJFT//////////////////////// HS.43!!)2:19*!GJOBM!FTUJNBUF!BOE!QBZNFOU!!DPOEJUJPOT!BOE!QSPDF HS.44!!)2:21*!DPTU!FTDBMBUJPO////////////////////////////////// CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!EJ CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU!HFOFSBM DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111 EJWJTJPO!2 HFOFSBM!SFRVJSFNFOUT HS.2!!TVNNBSZ!PG!XPSL Uif!Cjsdi!Cmvgg!Spbe-!Dpvousz!Dmvc!Spbe-!Fehfxppe!Spbe-!Fydfmtjps!Cp Njmm!boe!Pwfsmbz!Qspkfdu!tibmm!jodmvef!uif!gvsojtijoh!pg!bmm!mbcps-!nbufsjbmt-!uppmt-!boe ofdfttbsz!up!dpnqmfuf!uif!cjuvnjopvt!fehf!njmm-!gvmm!xjeui!qbwfn tipxo!po!uif!Qmbot!boe!tqfdjgjfe!ifsfjo/ Uif!PXOFS!jt!uif!Djuz!pg!Tipsfxppe/!!Bmm!xpsl!xjmm!cf!epof!xjuij PXOFS-!qvcmjd!sjhiu.pg.xbz-!fbtfnfout!pcubjofe!cz!uif!PXOFS-!ps! 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Uif!Dpousbdups!tibmm!dppsejobuf!bdujwjujft!xjui!uif!bdujwjujft!p mjnjut/!Uijt!jodmveft!efmbzt!bttpdjbufe!xjui!tdifevmjoh!dpogmjdu dpotusvdujpo!tfswjdft-!boe!bmm!ujnf!ofdfttbsz!up!dpnnvojdbuf!boe qspkfdu!mjnjut/ Uif!mpdbujpo-!qspufdujpo-!nbjoufobodf!boe0ps!sfqbjs-!jg!ebnbhfe- sftqpotjcjmjuz!pg!uif!Dpousbdups/ Xifsf!dpotusvdujpo!pqfsbujpot!sfrvjsf!uif!joufssvqujpo!pg!tfswjd vujmjuz!bu!mfbtu!59!ipvst!cfgpsf!uif!joufssvqujpo!boe!tibmm!bewj tfswjdf!xjmm!cf!sftupsfe/ HS.24!!)2624*!SFTUSJDUJPOT!PO!NPWFNFOU!BOE!TUPSBHF!PG!IFBWZ!MPB FRVJQNFOU Uif!qspwjtjpot!pg!NoEPU!2624!bsf!npejgjfe!boe0ps!tvqqmfnfoufe!xj Uif!Dpousbdups!tibmm!mjnju!uif!spbexbzt!vujmj{fe!gps!efmjwfsz!pg Uif!Dpousbdups!tibmm!qspwjef!boe!vtf!pomz!svccfs!ujsf!ep{fst-!gs frvjqnfou!po!bmm!xpsl!xifsf!tusffu!qbwfnfout!ps!qpsujpot!pg!qbwf qspufdujpo!pg!uif!qbwfnfout!ps!jo!tvdi!mpdbujpot!bt!uif!Fohjoffs Op!dpnqfotbujpo!xjmm!cf!bmmpxfe!up!uif!Dpousbdups!gps!sfqmbdfnfo sfqmbdjoh!ebnbhfe!qbwfnfout/ HS.25!!)2625*!NBJOUFOBODF!EVSJOH!DPOTUSVDUJPO Uif!qspwjtjpot!pg!NoEPU!2625!tibmm!bqqmz/ CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!EJ CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU!HFOFSBM DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111QBHF!4 HS.26!!)2626*!DPOUSPM!PG!IBVM!SPBET Uif!qspwjtjpot!pg!NoEPU!2626!tibmm!bqqmz/ HS.27!!)2712*!TPVSDF!PG!TVQQMZ!BOE!RVBMJUZ Uif!qspwjtjpot!pg!NoEPU!2712!tibmm!bqqmz/ HS.28!!)2717*!TUPSBHF!PG!NBUFSJBMT Uif!qspwjtjpot!pg!2717!.!TUPSBHF!PG!NBUFSJBMT!jo!uif!Djuz!pg!Tip ebufe!Kbovbsz!3129!bsf!npejgjfe!boe0ps!tvqqmfnfoufe!xjui!uif!gpm Boz!ejtuvscfe!bsfb!tibmm!cf!dmfbofe!vq!boe!gvmmz!sftupsfe!up!uif uijt!qspkfdu/!Uif!Dpousbdups!tibmm!cf!sfrvjsfe!up!jotubmm!qspufd bsfb/!Uif!qspufdujpo-!dmfbovq-!boe!sftupsbujpo!pg!uif!qspkfdu!tu sftqpotjcjmjuz<!op!dpnqfotbujpo!xjmm!cf!nbef!gps!uijt!xpsl/!Ju!j tupdlqjmjoh!pg!nbufsjbmt-!xjmm!cf!dpnqmfufe!xjuijo!uif!spbexbz!s HS.29!!)2718*!IBOEMJOH!NBUFSJBMT Uif!qspwjtjpot!pg!NoEPU!2718!tibmm!bqqmz/ HS.2:!!)2719*!VOBDDFQUBCMF!NBUFSJBMT Uif!qspwjtjpot!pg!NoEPU!2719!tibmm!bqqmz/ HS.31!!)271:*!EFQBSUNFOU!QSPWJEFE!NBUFSJBM Uif!qspwjtjpot!pg!NoEPU!271:!tibmm!bqqmz/ HS.32!!)2812*!MBXT!UP!CF!PCTFSWFE Uif!qspwjtjpot!pg!NoEPU!2812!bsf!npejgjfe!boe0ps!tvqqmfnfoufe!xj Efmfuf!NoEPU!2812/3!boe!sfqmbdf!xjui!uif!gpmmpxjoh; Uif!Pxofs!joufoet!up!qspwjef!b!xpslqmbdf!gsff!pg!wjpmfodf-!uisfb ejtdsjnjobujpo/!Uif!Pxofs!ibt!{fsp!upmfsbodf!gps!wjpmfodf!jo!uif xpslqmbdf!gsff!pg!wjpmfodf-!ibsbttnfou-!boe!ejtdsjnjobujpo/!Uif! gspn!uif!Qspkfdu!boz!fnqmpzff!pg!uif!Dpousbdups!ps!b!Tvcdpousbdu Uif!Dpousbdups!tibmm!opu!ejtdsjnjobuf!bhbjotu!qsptqfdujwf!fnqmpz dsffe-!sfmjhjpo-!obujpobmjuz-!ps!ejtbcjmjuz/ Efmfuf!NoEPU!2812/4!jo!jut!foujsfuz/ HS.33!!)2817*!FNQMPZFF!IFBMUI!BOE!XFMGBSF Uif!qspwjtjpot!pg!NoEPU!2817!bsf!npejgjfe!boe0ps!tvqqmfnfoufe!xj Uif!Dpousbdups-!bu!uifjs!pxo!fyqfotf-!tibmm!qspwjef!boe!nbjoubjo evsjoh!uif!dpotusvdujpo!qfsjpe!tvggjdjfou!gps!uif!tdifevmfe!xpsl bhsff!up!uif!mpdbujpo!pg!uif!ufnqpsbsz!upjmfe!gbdjmjujft/ Bsfbt!pg!tqfdjbm!dpodfso!jodmvef-!cvu!bsf!opu!mjnjufe!up-!fydbwb qspufdujpo!gspn!pwfsifbe!ib{bset-!wfijdmf!cbdlvq!qspufdujpo-!dpo boe!qfstpobm!tbgfuz!efwjdft/ CJSDI!CMVGG!SPBE-!DPVOUSZ!DMVC!SPBE-!FEHFXPPE!SPBE-!FYDFMTJPS!EJ CPVMFWBSE-!BOE!MBLF!MJOEFO!SPBE!NJMM!BOE!PWFSMBZ!QSPKFDU!HFOFSBM DJUZ!PG!TIPSFXPPE-!NO XTC!QSPKFDU!OP/!S.124345.111QBHF!5 Uif!Dpousbdups!nvtu!opu!vtf!npups!wfijdmf!frvjqnfou!uibu!ibt!bo! ibt!b!sfwfstf!bmbsn!uibu!jt!bvejcmf!bcpwf!uif!tvsspvoejoh!opjtf! pqfsbups!uibu!ju!jt!tbgf!up!sfwfst/ HS.34!!)2818*!QVCMJD!DPOWFOJFODF!BOE!TBGFUZ Uif!qspwjtjpot!pg!NoEPU!2818!bsf!npejgjfe!boe0ps!tvqqmfnfoufe!xj Xpsljoh!ipvst!xjmm!cf!gspn!8;11!b/n/!up!8;11!q/n/-!Npoebz!uispvh Tbuvsebzt/!Uif!Dpousbdups!tibmm!opu!cf!qfsnjuufe!up!xpsl!po!Tvoe fnfshfodjft/!Sfrvftut!gps!npejgjdbujpo!pg!xpsljoh!ipvst!nvtu!cf! 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