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TJR IncSECTION 00310 -BID FORM CONTRACT NO. 12-012 GENERAL CONSTRUCTION BID FORM TO: The Town Board of the Town of Wappinger. v,,, In compliance with your Advertisement for Bids, /published in the ~~~1~~ tr f~n~ I~r->f-.~r /~~r,n t7~nr~l dated ~ / r ~ i '~_ ,the .undersigned, `~'1 ~,rtL, -~ ha4ing carefully examined the Contract ~. Documents and any Addenda thereto, proposes and agrees as follows: 1. To furnish all the equipment, and incidentals, and to furnish labor and do all the work required, to construct, furnish, and complete the Contract No. 12- 012, Roberts Road Sewer Improvements -General Construction and associated work in accordance with the prices so named in this bid in a worker like manner, in accordance with the plans and specifications, all of which are a part of the contract hereto annexed. • 2. To complete all the work as shown and specified, on which this bid is based, within the timeframe(s) specified in these Contract Documents and any Addendum thereto. 3. To furnish the Town within five (5) calendar days from the date of the request, if identified as the apparent low bidder and if requested by the Town, a Statement of Qualifications. 4. To enter into a contract and to furnish, with suitable surety to be approved by the Town Board, performance and labor and material payment bonds, the amount of each of the bonds to be the full amount of the awarded bid price as it appears in this proposal, within thirty (30) calendar days from the date of acceptance of this bid 5. To comply with the Davis-Bacon Act and other federal labor standards or provisions and to pay New York State prevailing wage rates applicable to this contract. In compliance with the Instructions to Bidders, the undersigned declares that .e/she has examined the site of the work and informed himself/herself fully in regard to all conditions pertaining to the place where the work is to be done. He/she has xamined the plans and specifications for the work and the contract documents relating t31D FORM 00310-1 '"' E:ldocuments\T Wappinger\a W2012\W21205 Roberts Rd Pump Station\Spec~cations\00310_General.doc ~++ thereto, has read all addenda furnished prior to the opening of bids, and has satisfied himself/herself relative to the work to be performed. If the undersigned fails to perform any of the promises made herein, the certified check, which is herewith deposited with the Town Clerk, will be paid to the Town of Wappinger or payment of the bond herewith deposited will be enforced for the benefit of the Town of Wappinger as liquidated damages for such default; otherwise the check or bond will be returned to the undersigned. ADDENDA' Receipt of the following addenda (if any) is hereby acknowledged and the provision(s) thereof is (are) included in this bid: ADDENDUM NO. The bidder proposes to perform the work required in accordance with the Contract Documents for the sum of: BASE BID (GENERAL CONSTRUCTION) (in writing Dated: mGt,UJ , 20~ SIGN BID HERE ~%._.~~::~ ~ ~~..--z-...~_.~,.. _----~...... j 5~' , j oo. c~ (and figures) rized Signature Title DATE SIGNATURE ~25,~ Print Name Legal Company Name ),~~,~,~ ~ ~"J nQ I~~tirQ r,~rC II~1C, . r-- Address ~ ~, ©, ~k ~~p( p City, State, Zip 2.~'j ~ Telephone No. Federal I.D. # / 3~ g3~ ,~Q 2 BID FORM 00310-2 E:\documentslT Wappingerla W2012\W21205 Roberts Rd Pump Station\Specifications\00310_General.doc f; ~ l ,1 BASE BID SHEET GENERAL CONSTRUCTION CONSTRUCTION BID AND CONTRACT ROBERTS ROAD SEWER IMPR(~VFMFNT~ ITEM NO./DESCRIPTION EST. PAYMENT UNIT PRICE BID TOTAL QTY. UNIT WRITTEN AMOUNT IN FIGURES PRICE BID 1. Furnish and install all materials, su lies e ui ment and other one humor d pp , q p facilities as required for construction ~ L.s. . e ~~~~.1~;,": ~.., ..._f of Roberts Road Sewer Improvements- General ~ (' rr ~ ~ ~U JC~-1 C~ ~lt'~'Ca ~ `~ ~ ~J~' ~d ~ ~q , Construction, including all ..JJ ~ incidentals, as shown and as specified in the Contract Documents. 2. Rock Excavation 30 C.Y. Y~r~d 5, 5~. ©a 5 boo, ~a 3. Authorized Additional Excavation 30 C.Y. ~ ~ ~~ ' SJ~. ~ 4. Lift Station Abandonment 1 EA ~~ ALLOWANCE #1 $5,000.00 Testing Services ___ __ _ ALLOWANCE #2 $20,000.00 Contingency Allowance -------- ------------------- --------------------------- -------------------- TOTAL BASE BID J ~J~ ~ ~p,0 - civu ur 5C~ 1IuN- rt i l~ MAY ~ ~ 2t~13 SECTION 004?0-BID BOND B1D BOND FORM KNOW ALL PERSONS BY THESE PRESENTS that ' C5, r JB~ond c~%~~~rS~3CU127899 ~1 ~ -y ~, . '~' ~j~'~,,~, ~° ~~ ~,3 T.J.R. Excavating Contractors Inc~f7,~ ~`?'Ar;~, as Pnncipal; and `~ ~~Y°~'' ~`°~.,~~ ~,., ., ~,~~~~ Tower Insurance Company of New York as Surety,{ are hereby held and firmly bound unto the Town Board, Town of Wappinger, New York in the amount of: Five Percent (5%)of the Total Amount _NOt to Exceed $7, 905.00 ~O11arS ($ 7, 905 . ~~ ) for the payment whereof Principal and Surety bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Signed this 6th _ day of Mav 2013 WHEREAS, The condition of the above obligation is such that, whereas the Principal has submitted #o the Town Board a certain bid, attached hereto and hereby made a part hereof, to enter into a contract in writing far the Roberts Road Sewer Improvements in the Town of Wappinger, New York, as shown and specified in the contract, plans and specifications. NOW THEREFORE, (a) if said Bid sha[I be rejected, or in the alternate (b) if said Bid shall be accepted and the Principal steal( execute and deliver the Contract Agreement in the form attached hereto (properly completed in accordance with said Bid) and furnish such performance bond and labor and material payment bond as required, ifien this obligation shall be void. Otherwise, the same shall remain in force and effect, ~ being expressly understood and agreed that the liability of the Surety for arty and all daims hereunder shall, in no event, exceed the amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall in no way be impaired or affected by any extension of the time within which the Principal may acxept such bid; and said Surety does hereby waive notice of any such extension. *Insert Bidder's Name "Insert Surety's Name BlD BOND 00410-1 E-ldcictxnentsl7 W~pmgerla YV20121YV21205 Robett5 Rd Pump StafiOnlspECdicahons100410.doc IN WITNESS WHEREOF, the Principal and the Surety have hereunto sef their hands and seals, and such of them as are Corporations have caused their Corporate seals to be hereto affrxed and these presents to be signed by their proper officers, the day and year first set forth above. (sea! of Principal if a Corporation} T.J.R. Excavating Contractors Inc. PRINCIPAL By: .~%~G-~- (Corporate Seal of Surety Co_} Tower Insurance Company of New York (Officer's/Partner'sllndividual's) signature (Surety) 195 Lake Louise Marie Rd, Rock Hill, NY 12775 ___ (Officer slPartner's/Individual's) name printed (Surety Address) f~ ~ ~ ~/'~ ~ ~ eanne McKean {Corporatio artnership/lndividua() name printed ~ (Attorney-in-Fact) STATE of ~Q ~ ~~ VK } ~~~ COUNTY of ) ss: On this ~_ day of ~1__ - , 20 ~ ~J before me personally came 1~'`1G~C (;LY I Ylp to me known and known to me to be the person described in and who executed the foregoing instrument, and he/she duly acknowledged that he/she executed the same. ~'1 ~'~ 'N6fairy Puf3lic, ~ County No. Term Expires RACHAEL L RANCOURT Notary Public -State of New fork -END OF SECTION- No• o1RAS250r3a7 aualified in Dutchess u My Commission Expires 31D BOND 00410-2 'ldocument5\T Wappingetta W20121W21205 F2oberts Rd Pump SWtion~SpedficaUoml00410.doc SURETY ACKNOWLEDGEMENT STATE OF NEW YORK ) ss: COUNTY OF SULLIVAN ) On the 6th day of May, 2013, before me, the undersigned, a Notary Public in and for said state, personally appeared Jeanne McKean, personally known to me, who being by me duly sworn, did depose and say that she resides in Barr~ille, NY; that she is the Attorney-in-Fact of the Tower Insurance Company of New York; the corporation described in and which executed the within instrument; that she knows the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that it was so affixed by rder of the Board of Directors of said corporation; and that she signed her name thereto by like~q der. ,~, ~~~~ ~~~ .IG'~~~ ary Public e cep _ mar rrree - euw,~eia~ lark eb. e~wmse~pe auea~e r sw~w. G MY Conrahfbn E~MM _T ~~ ~~ TOWER GROUP COMPANIES Tower Insurance Company of New York 120 Broadway, 311h 0 Nett' York, NY 10271 STATEMENT OF FINANCIAL CONDITION AS OF December 31, 2012 Ass a Is: Bonds S 531,401,776 Crash And Short•'I'erm Investments 33,247,760 Uthcr Invested AssMS 16,636,972 Kecervable For Secunhes 1,875 Common Stocks 103,331,797 Electronic Uata Processing Fgmpment and Sollware 8,673,080 Investment Ittmme Uue And Accrued S,y21,494 Uncollected Premmms And Agents' Balances In'I'he Course UI'Collection 58,945,325 Deferred Premmms And Agents' Balanx And lnstallrrxnts Booked 63,939,868 Amounts Recoverable From Retnsurtts 34,039,331 Funds Held By Ur Ueposned Under Ransurance Contracts 50,438,333 Advances lo'I'PA's 13,888,961 Net UeRrred'I'axAsset 32,339,423 Current Federal And Foreign Income'I'ar Recoverable And Interesl'I'hereon 17,122,892 Ulher Assets 11,736,686 Total Admitted Assets 5 983,903,973 tiabilllies and Surplus: Reserve For toss And Loss Ad3ustmcnt Expenses S ]29,334,029 Uther l•:xpenses 13,813,363 't'axes, Licenses And Fees 1,913,877 Unearned Premiums 187,992,379 (.'acted Reinsurance Premmms Payable 109,734,166 funds Held By Company Under Rcrosurance'I'remies 36,239,271 Amounts Wrthhcld Ur Retained By Company For Account Uf Uthers 626,760 Provtvon For Reinsurance 4,648,272 Payable For Pazent, Subsxliarutt and Attihates 13,648,608 Premum Collateral and Loss Fund [)eposrt 3,569,632 Uther Liabihues 13,113,323 Total liabilities S 716,660,100 Capital & Surplus: Common Stock, Paid Up 3,703,214 Gross Patd In And Conlnbuted Surplus 204,082,477 Unassiypcd Surplus 39,146,964 Aggregate Wrne•Ins For Special Surplus Funds 311,218 Surplus as Regards to Pollcyholden 5 267,243,873 TotatllabilftlcsandSurplus 5 983,903,973 I, William f~litsclbcrgcr, Chief Financial Officer of Tovvcr Insurance Company of New York, do hereby certify that the foregoing statement is a correct exhibit of the assets and surplus of the said company, on the 31n day of December 2012, according to the best information, knowledge, and belief. State of New York Willis s Berger ~ Chief F nancial Officer SS: County of Nca York On ~\ ~~ 1-0 ~ before me, ling Jing Yu, Notary Public in and for said county, personally appeared William I litselberger, w o has satisfactorily identified himself as the signer to the above-referenced document. ~iNG JING YU ~ 1Votary Public -State of Nt~w York Jing Jin u art' u tc N~. Of YU6214444 My Commission Gxpires December 7, 2013 ((`~~1fT~t:Y~lualifiedCin Kingrls,,Cou~ntuy rye r~ IV r)'t?FVSti YvSrS~~f I, tU~t~r,Q$ ~OIR7Fi~rn VC1 ~7~ N~ J I r~•~ SECTION 00410-BID BOND BID BOND FORM KNOW ALL PERSONS BY THESE PRESENTS: that Principal; and ** hereby held ~~~ _ ,~4 ~ l~~'_~II ` I Ii ~l D ~ , ,~~ MAY ~. ~ ~, ~ ~ ; TO~A!r, as as Surety, are and firmly bound unto the Town Board, Town of Wappinger, New York in the amount of: Dollars . ($ ) for the payment whereof Principal and Surety bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Signed this ~~ day of 20i~. WHEREAS, The condition of the above obligation is such that, whereas the Principal has submitted to the Town Board a certain bid, attached hereto and hereby made a part hereof, to enter into a contract in writing for the Roberts Road Sewer Improvements in the Town of Wappinger, New York, as shown and specified in the contract, plans and specifications. NOW THEREFORE, (a) If said Bid shall be rejected, or in the alternate (b) If said Bid shall be accepted and the Principal shall execute and deliver the Contract Agreement in the form attached hereto (properly completed in accordance with said Bid) and furnish such performance bond and labor and material payment bond as required, this obligation shall be void. Otherwise, the same shall remain in force and effect, it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall in no way be impaired or affected by any extension of the time within which the Principal may accept such bid; and said Surety does hereby waive notice of any such extension. *Insert Bidder's Name **Insert Surety's Name BID BOND 00410-1 E:\documentslT Wappingerla W2012\W21205 Roberts Rd Pump Station\Specifications\00410.doc IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals, and such of them as are Corporations have caused their Corporate seals to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. (Seal of Principal if a Corporation) PRINCIPAL By: (Officer's/Partner's/Individual's) signature (Officer's/Partner's/Individual's) name printed (Corporation/Partnership/Individual) name printed STATE of COUNTY of (Corporate Seal of Surety Co.) ss: On this day of , 20 before me personally came to me known and known to me to be the person described in and who executed the foregoing instrument, and he/she duly acknowledged that he/she executed the same. Notary Public, County No. Term Expires - END OF SECTION- BID BOND 00410-2 E:\documentslT Wappinger\a W2012\W21205 Roberts Rd Pump Station\Spec~cations\00410.doc SECTION 00480-CERTIFICATION OF NON-COLLUSION CERTIFICATION OF NON-COLLUSION BY BIDDER The undersigned represents that pursuant to Sections 103-a and 103-b of the General Municipal Law of the State of New York, no person referred to in the attached proposal who is the bidder or who is or was a member, partner, director or officer of the bidding firm or entity under this proposal has refused to sign a waiver of immunity or to answer any relevant questions relating to any transaction or contract with the State of New York, any political subdivision thereof, or any public authority, during the period of five years prior to the date hereof. The undersigned agrees that any contract awarded as a result of this bid may be canceled without penalty upon the grounds set forth in Sections 103-a and 103-b of the said General Municipal Law of the State of New York. The names and addresses of all persons and parties interested in the foregoing bid are as follows: ._.-- 2 (~ By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of knowledge and belief: 1. The prices in this bid have been arrived at independently without collusion, consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor; 2. Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, directly or indirectly, to any other bidder or to any competitor; and 3. No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit or not to submit a bid for the purpose of restricting competition. A bid shall not be considered for award nor shall any award be made where 1, 2 and 3 above have not been complied with; provided however, that if in any case the bidder cannot make the foregoing certification, the bidder shall so state and shall furnish with CERTIFICATION OF NON-COLLUSION 00480-1 E:\documents\T Wappinger\a W2012\W21205 Roberts Rd Pump Station\Specifications\00480.doc the bid a signed statement which sets forth in detail the reasons therefore. Where I, 2 and 3 above have not been complied with, the bid shall not be considered for award nor shall any award be made unless the head of the purchasing unit of the political subdivision, public department, agency or official thereof to which the bid is made, or his designee, determines that such disclosure was not made for the purpose of restricting competition. The fact that a bidder (a) has published price lists, rates, or tariffs covering items being procured, (b) has informed prospective customers of proposed or pending publication of new or revised price lists for such items, or (cj has sold the same items to other customers at the same prices being bid, does not constitute, without more, a disclosure within the meaning of subparagraph one. Any bid hereafter made to any political subdivision of the State or any public department, agency or official thereof by a corporate bidder for work or services performed or to be performed or goods sold or to be sold, where competitive bidding is required by statute, rule, regulation, or local law, and where such bid contains the certification referred to in subdivision one of this section, shall be deemed to have been authorized by the board of directors of the bidder, and such authorization shalt be deemed to include the signing and submission of the bid and the inclusion therein of the certificate as to non-collusion as the act and deed of the corporation. !.1 ~ k.f~xan~~~ ~~r . s. ~~ ~~ P ~~-~~ - END OF SECTION - CERTIFICATION OF NON-COLLUSION 00480-2 E:\documents\T Wappingerla W2012\W21205 Roberts Rd Pump Station\Spec~cations\00480.doc