appendix d forms - san francisco bay...

WETA Richmond Ferry Terminal Forms Addendum #1: February 23, 2017 Table of Contents – of 1

APPENDIX D FORMS

Form A-1 Technical Proposal Letter

Form A-2 Price Proposal Letter

Form A-3 Acknowledgement of Insurance Requirements

Form B-1 Identification of Major Participants, and Financially Responsible Parties*

Form B-2 Identification of Listed Subcontractors*

Form B-3 Information about Major Participants and Financially Responsible Parties*

Form C Certification of Responsible Major Participant, and Financially Response Party*

Form D Non-Collusion Affidavit

Form E Buy America Certification

Form F Fly America Certification

Form G Use of Contract Funds in Lobbying Certification

Form H Debarment and Suspension Certification

Form I-1 Major Participant, Subcontractor / Subconsultant / Supplier Report*

Form I-2 Small Business Enterprise Affidavit*

Form I-3 Description of Subcontractor / Subconsultant / Supplier Selection Process*

Form J Equal Employment Opportunity Certification

Form K Conflict of Interest Disclosure

Form L Levine Act Disclosure

Form M Iran Contracting Certification

Form O Industrial Safety Record for Major Participants

Form P Price Proposal Form

Form Q-1 Proposal Bond

Form Q-2 Payment Bond

Form Q-3 Performance Bond

Form R References*

* Due no later than 5 days after the Technical and Price proposal submission date.

WETA Richmond Ferry Terminal Technical Proposal Letter Addendum #1: February 23, 2017 Form A-1 – Page 1 of 4

FORM A-1

TECHNICAL PROPOSAL LETTER

FORM OF TECHNICAL PROPOSAL LETTER

SAN FRANCISCO BAY AREA WATER EMERGENCY TRANSPORTATION AUTHORITY

RICHMOND FERRY TERMINAL INSTRUCTIONS TO OFFERORS

TECHNICAL PROPOSAL LETTER

Offeror: _____________________________________________________________________

Proposal Date:

San Francisco Bay Area Water Emergency Transportation Authority Pier 9, Suite 111, The Embarcadero San Francisco, CA 94111

The undersigned (“Offeror”) submits this detailed technical proposal (“Technical Proposal”) in response to that certain Request for Proposals (the “RFP”) issued by the San Francisco Bay Area Water Emergency Transportation Authority (“WETA”), dated [INSERT DATE], as may be modified by Addenda from time to time, to design and construct the Richmond Ferry Terminal (the “Project”), as more specifically described herein and in the documents provided with the RFP (the “RFP Documents”). Initially capitalized terms not otherwise defined herein shall have the meanings set forth in the RFP and the RFP Documents. The Price Proposal for the above referenced RFP accompanies this Technical Proposal in a separate sealed envelope. The Certifications and conditions in this cover letter apply equally to the Price Proposal.

In consideration for WETA supplying us, at our request, with the RFP Documents and agreeing to examine and consider this Technical Proposal, the undersigned undertakes [jointly and severally] [If Offeror is a joint venture or association other than a corporation, limited liability company or a partnership, leave in words “jointly and severally” and leave in the brackets; otherwise delete the entire phrase.]:

A. to keep this Technical Proposal open for acceptance for 180 days after the date when Proposals are due as determined by WETA without unilaterally varying or amending its terms and without any member or partner withdrawing or any other change being made in the composition of the Offeror team on whose behalf this Technical Proposal is submitted, without first obtaining the prior written consent of WETA, in WETA’s sole discretion;


B. if its Technical Proposal is accepted and Offeror is determined to be the best value Offeror, to execute the Contract or, if WETA elects to negotiate with one or more Offerors, to negotiate in good faith; and

C. if this Technical Proposal is accepted, to provide security (including bonds and insurance) for the due performance of the Contract, as stipulated in the Contract Documents and the RFP.

D. to keep the accompanying Price Proposal open for acceptance for 180 days after the date when Proposals are due as determined by WETA without unilaterally varying or amending its terms and without any member or partner withdrawing or any other change being made in the composition of the Offeror team on whose behalf this Price Proposal is submitted, without first obtaining the prior written consent of WETA, in WETA’s sole discretion;

E. if the accompanying Price Proposal is accepted, to execute the Contract or, if WETA elects to negotiate with one or more Offerors, to negotiate in good faith; and

F. if the accompanying Price Proposal is accepted, to provide security (including bonds and insurance) for the due performance of the Contract, as stipulated in the Contract Documents and the RFP.

Offeror acknowledges receipt of the following Addenda and sets of questions and responses:

Offeror certifies that its Technical Proposal and Price Proposal are submitted without reservation, qualification, assumptions or conditions. Offeror certifies that it has carefully examined and is fully familiar with all of the provisions of all of the RFP Documents, has reviewed all materials in the RFP and the Addenda, and is satisfied that the RFP Documents provide sufficient detail regarding the obligations to be performed by the Design-Builder and do not contain internal inconsistencies; that it has carefully checked all the words, figures and statements in this Technical Proposal and Price Proposal; that it has conducted such other field investigations and additional design development which are prudent and reasonable in preparing this Technical Proposal; and that it has notified WETA of any deficiencies in or omissions from any RFP Documents or other documents provided by WETA and of any unusual site conditions observed prior to the date hereof.

Offeror represents that all statements made in the Technical Proposal and Price Proposal are true, correct and accurate as of the date hereof.

Offeror understands that WETA is not bound to award the Contract to the best value Offeror.

Offeror further understands that all costs and expenses incurred by it in preparing this Technical Proposal and Price Proposal and participating in the RFP process will be borne solely by the


Offeror.

Offeror agrees that WETA will not be responsible for any errors, omissions, inaccuracies or incomplete statements in this Technical Proposal or Price Proposal

This Technical Proposal shall be governed by and construed in all respects according to the laws of the State of California.

Offeror's business address:

____________________________________________________________________________ (No.) (Street) (Floor or Suite)

____________________________________________________________________________ (City) (State or Province) (ZIP or Postal Code) (Country)

State or Country of Incorporation/Formation/Organization: ______________________________

[Insert appropriate signature block from following pages]


1. Sample signature block for corporation or limited liability company:

[Insert the Offeror’s name] __________________ __________

________________________________________

Print Name: ______________________________

Title: ___________________________________

2. Sample signature block for partnership or joint venture:

[Insert the Offeror’s name] _____________ ________________

[Insert general partner’s or member’s name]

________________________________________

Print Name: ______________________________

Title: ___________________________________

[Add signatures of additional general partners or members as appropriate.]

3. Sample signature block for attorney in fact:

[Insert the Offeror’s name] ___________________________

________________________________________

Print Name: ______________________________ Attorney in Fact

[End of Form]

WETA Richmond Ferry Terminal Price Proposal Letter Addendum #1: February 23, 2017 Form A-2 – Page 1 of 2

Form A-2

FORM OF PRICE PROPOSAL LETTER


RICHMOND FERRY TERMINAL INSTRUCTIONS TO OFFERORS

FORM OF PRICE PROPOSAL LETTER

Offeror: _____________________________________________________________________

Proposal Date:

San Francisco Bay Area Water Emergency Transportation Authority Pier 9, Suite 111, The Embarcadero San Francisco, CA 94111

The undersigned (“Offeror”) submits this detailed price proposal (“Price Proposal”) to accompany our Technical Proposal in response to that certain Request for Proposals (the “RFP”) issued by the San Francisco Bay Area Water Emergency Transportation Authority (“WETA”), dated ______________.

Offeror agrees that WETA will not be responsible for any errors, omissions, inaccuracies or incomplete statements in this Price Proposal. Undersigned acknowledges that its Total Price shall remain firm and binding for a period of 120 calendar days from the date the Proposals are due. Undersigned has read the foregoing proposal and has full authority to enter into contracts on behalf of the Offeror, and hereby agrees to the conditions stated therein by affixing its signature below: This Price Proposal shall be governed by and construed in all respects according to the laws of the State of California.

Offeror's business address:

____________________________________________________________________________ (No.) (Street) (Floor or Suite)

____________________________________________________________________________ (City) (State or Province) (ZIP or Postal Code) (Country)

State or Country of Incorporation/Formation/Organization: ______________________________

WETA Richmond Ferry Terminal Price Proposal Letter Addendum #1: February 23, 2017 Form A-2 – Page 2 of 2

[Insert appropriate signature block from following]

1. Sample signature block for corporation or limited liability company: [Insert the Offeror’s name] ______________________________

________________________________________

Print Name: ______________________________

Title: ___________________________________

2. Sample signature block for partnership or joint venture:

[Insert the Offeror’s name] ______________________________

[Insert general partner’s or member’s name] ______________________________

________________________________________

Print Name: ______________________________

Title: ___________________________________

[Add signatures of additional general partners or members as appropriate.]

3. Sample signature block for attorney in fact:

[Insert the Offeror’s name] ______________________________

________________________________________

Print Name: ______________________________ Attorney in Fact

WETA Richmond Ferry Terminal Acknowledgment of Insurance Requirements Addendum #1: February 23, 2017 Form A-3 – Page 1 of 2

FORM A-3

ACKNOWLEDGEMENT OF INSURANCE REQUIREMENTS Included in the Contract Price is full compensation for the requirements set forth in Section 00 08 10 contained in the Contract Documents, including: a) WORKERS’ COMPENSATION (per statutory requirement).

Policy shall include a Waiver of Subrogation.

b) EMPLOYER’S LIABILITY coverage.

Five Million Dollars ($5,000,000) minimum limits.


c) U.S. Longshoreman and Harbor Workers Insurance coverage, if the Contract involves work on or adjacent to navigable water, as defined by the U.S. Department of Labor (per statutory requirement).


d) COMMERCIAL GENERAL LIABILITY coverage (including but not limited to premises and operations; personal and advertising injury; explosion, collapse, and underground coverage; and products and completed operations, of not less than:

Five Million Dollars ($5,000,000) combined single limit per occurrence or claim; and

Five Million Dollars ($5,000,000) general aggregate.

Policy shall include a Waiver of Subrogation and Additional Insured endorsement. Policy will also contain a Separation of Insureds Clause. Policy will further contain Primary and Non-Contributory wording.

e) BUSINESS AUTOMOBILE LIABILITY INSURANCE coverage of not less than:

Five Million Dollars ($5,000,000) combined single limit occurrence.

Policy shall include a Waiver of Subrogation and Additional Insured endorsement. Policy will also contain Primary and Non-Contributory wording.

f) PROPERTY INSURANCE coverage with limits at least equal to the replacement cost of the property described in Section 1.05 of the Insurance Requirements in Attachment C to the Agreement, and Builder’s Risk for property in the course of construction on an “all risk” basis for the full replacement cost of materials, supplies, all property to be incorporated into the finished Work and completed Work in an amount not less than the full completed value of the covered structure or the replacement value of alterations or additions. WETA shall be named as a loss payee and losses will be payable to both Design-Builder and WETA as their interests may appear.

Such insurance shall include a waiver of subrogation.

WETA Richmond Ferry Terminal Acknowledgment of Insurance Requirements Addendum #1: February 23, 2017 Form A-3 – Page 2 of 2

g) PROFESSIONAL LIABILITY INSURANCE coverage for all professional architectural, engineering and design services of not less than: Two Million Dollars ($2,000,000) per occurrence and in the annual aggregate.

h) CONTRACTOR’S POLLUTION LIABILITY INSURANCE and/or ENVIRONMENTAL LIABILITY INSURANCE coverage with limits not less than: Five Million Dollars ($5,000,000) per occurrence and in the annual aggregate.

Policy shall include a Waiver of Subrogation and Additional Insured endorsement. Policy will also contain a Separation of Insureds Clause. Policy will further contain Primary and Non-Contributory wording.

i) HULL & MACHINERY INSURANCE, if the Contract involves marine activities or work from a boat, vessel, skiff, floating platform, or any other equipment that floats, at market value of vessel on American Institute Hull Clauses, 6/2/77 form.

j) PROTECTION AND INDEMNITY (INCLUDING JONES ACT), if Contract involves marine activities, or work from a boat, vessel, skiff, floating platform, or any other equipment that floats, coverage including injury to a crew (Jones Act) and passengers; Protection & Indemnity, SP 38 or SP 23 for $5 million combined single limit per occurrence.

Policy shall include a Waiver of Subrogation and Additional Insured endorsement. Policy will further contain Primary and Non-Contributory wording.

Signature of Offeror/Title Date

END OF ACKNOWLEDGEMENT OF INSURANCE REQUIREMENTS

WETA Richmond Ferry Terminal Identification of Offeror Addendum #1: February 23, 2017 Form B-1 – Page 1 of 1

FORM B-1

IDENTIFICATION OF OFFEROR, PRINCIPAL PARTICIPANTS, AND FINANCIALLY RESPONSIBLE PARTIES*

*Include information requested in this form for Principal Participants and Financially Responsible Parties, if applicable.

NAME OF ENTITY AND

CONTACT INFORMATION

(address, representative, phone,

fax, e-mail)

ROLE OF ENTITY IN OFFEROR

ORGANIZATION (i.e., Offeror,

Principal Participant, or

Financially Responsible

Party)

California Contractor Licenses

(if applicable)

Description of Work

to be Performed By Entity (if applicable)

The above information is true, correct and accurate.

[INSERT THE OFFEROR’S NAME.] ______________________________

Print Name:

Title:

[End of Form]

WETA Richmond Ferry Terminal Identification of Subcontractors Addendum #1: February 23, 2017 Form B-2 – Page 1 of 2

FORM B-2

IDENTIFICATION OF LISTED SUBCONTRACTORS

This form will be used to provide information about any Subcontractors that have been identified by Offeror as of the Proposal Due Date. Refer to ITO (Section 00 02 00 paragraph 8.C.) regarding Subcontractor listing and procurement requirements.

OFFEROR: [INSERT OFFEROR NAME] ______________________________

Subcontractor Name / Address of Head Office Telephone / Email California Scope of Work Is the Firm a Contact Contractor (Refer to Project Certified

License No. and Element(s), if DBE? License Limit applicable) (if applicable)

Add additional rows as necessary.

WETA Richmond Ferry Terminal Identification of Subcontractors Addendum #1: February 23, 2017 Form B-2 – Page 2 of 2

If any Subcontractor identified above is a single purpose entity formed for the Project, complete the following matrix for each such single purpose entity:

Name of Subcontractor

Form of Entity (partnership, joint

venture, LLC, corporation, etc.

Entities with Ownership Interest

Percentage of Ownership Interest

Ex: Subcontractor AB, JV

Joint Venture Contractor A 60%

Contractor B 40%

The undersigned Offeror hereby certifies that it has not entered into any substantive negotiations with Subcontractors resulting in an agreement to enter into any subcontracts with respect to the Project, except for those listed above. The Offeror agrees that it will follow applicable Contract requirements with respect to Subcontractors.

I declare under penalty of perjury under the laws of the State of California that the foregoing declaration is true and correct.

Executed: , 2017

[INSERT THE OFFEROR’S NAME.] ______________________________

Print Name:

Title:

[End of Form]

WETA Richmond Ferry Terminal Information about Offeror Addendum #1: February 23, 2017 Form B-3 – Page 1 of 2

FORM B-3

INFORMATION ABOUT MAJOR PARTICIPANTS AND FINANCIALLY RESPONSIBLE PARTIES

Complete this Form for each Major Participant (as defined in Section 00 02 00 paragraph 1.A.)and each Financially Responsible Party, as applicable. Make additional copies of this form as necessary.

1.

Name of Offeror:

2.

Name of firm completing this Form B-3:

3.

Firm’s role on Offeror team (check one):

□ Offeror; ☐ Other Major Participant; ☐ Financially Responsible Party

4.

Number of years (measured from the date of issuance of the RFP) firm has been in its current line of business:

5.

Number of years (measured from the date of issuance of the RFP) firm has been in business under its present name:

6.

Other names under which firm has operated:

7.

State/country of organization:

8.

Name of firms CEO/chairperson:

9.

Name and title firm’s authorized representative signing this Form B-3:

10.

Firm’s federal tax ID no.:

11.

Firm’s business organization (check one):

□ Corporation; ☐ Partnership; ☐ Joint Venture / Consortium; ☐ Limited Liability Company;

□ Other (describe):

12.

Firm headquarters’ address:

13.

Location of office performing work:

WETA Richmond Ferry Terminal Information about Offeror Addendum #1: February 23, 2017 Form B-3 – Page 2 of 2

14.

Firm’s role/anticipated scope of work on the Project:

15.

If firm completing this Form B-3 is a partnership, joint venture, or limited liability company, provide the name and role of each partner, joint venture, or member firm, as applicable:

16.

List and attach to this Form B-3 all California licenses held by firm completing this Form B-3:

I declare under penalty of perjury under the laws of the State of California that the foregoing declaration is true, correct and accurate.

Executed , 2017

[INSERT NAME OF FIRM COMPLETING FORM B-3.] ______________________________

Print Name:

Title:

[End of Form]

WETA Richmond Ferry Terminal Financially Responsible Party Addendum #1: February 23, 2017 Form C – Page 1 of 5

FORM C

CERTIFICATION OF RESPONSIBLE MAJOR PARTICIPANT, AND FINANCIALLY RESPONSIBLE PARTY

Complete this Form for Offeror, each Other Major Participant, and each Financially Responsible

Party, as applicable. Make additional copies of this form as necessary.

OFFEROR: [INSERT OFFEROR NAME] ______________________________

Name of entity on whose behalf Form C is provided: [INSERT ENTITY NAME] (“Entity”) ______________________________

Role of entity on Offeror team (check one):

□ Offeror; ☐ Other Major Participant; ☐ Financially Responsible Party

1. Has Entity or any Affiliate* ever been disqualified, removed, debarred, or suspended from performing work for the federal government, any state or local government, or any foreign governmental entity within the past eight years (measured from the date of issuance of the RFP)?

Yes ☐ No ☐

If yes, please explain the circumstances on a separate sheet.

2. Has Entity or any Affiliate ever sought protection through receivership or under any provision of any bankruptcy act within the past eight years (measured from the date of issuance of the RFP)?

Yes ☐ No ☐


3. Has Entity or any Affiliate or any current officer, director, or employee of the entity been indicted or convicted of bid (e.g., fraud, bribery, collusion, conspiracy, antitrust, etc.) or other contract-related crimes or violations or any other felony or serious misdemeanor within the past eight years (measured from the date of issuance of the RFP)?

Yes ☐ No ☐


4. Has Entity or any Affiliate been found, adjudicated or determined by any federal or state court or agency (including, but not limited to, the Equal Employment Opportunity Commission, the Office of Federal Contract Compliance Programs and any applicable California governmental agency) to have violated any laws or Executive Orders relating to employment discrimination or affirmative action within the past ten years (measured


from the date of issuance of this RFP), including but not limited to Title VII of the Civil Rights Act of 1964, as amended (42 U.S.C. Sections 2000e et seq.); the Equal Pay Act (29 U.S.C. Section 206(d)); and any applicable or similar California law?

Yes ☐ No ☐


5. Has Entity or any Affiliate been found, adjudicated, or determined by any state court, state administrative agency, including, but not limited to, the State of California Labor & Workforce Development Agency, federal court or federal agency, to have violated or failed to comply with any law or regulation of the United States or any state within the past ten years (measured from the date of issuance of this RFP) governing prevailing wages (including but not limited to payment for health and welfare, pension, vacation, travel time, subsistence, apprenticeship or other training, or other fringe benefits) or overtime compensation?

Yes ☐ No ☐


6. Has Entity or any Affiliate ever been found liable in a civil suit or found guilty in a criminal action for making any false claim or other material misrepresentation to a public entity within the past eight years (measured from the date of issuance of this RFP)?

Yes ☐ No ☐

If yes, as to each such inquiry, state on a separate sheet the name of the public agency, the date of the inquiry, the grounds on which the public agency based the inquiry, and the result of the inquiry.

7. Has any construction project performed or managed by Entity or any Affiliate involved

repeated or multiple failures to comply with safety rules, regulations, or requirements, or has Entity or any Affiliate defaulted on a construction contract within the past eight years (measured from the date of issuance of this RFP)?

Yes ☐ No ☐

If yes, please identify on a separate sheet the team members and the projects, provide an explanation of the circumstances, and provide owner contact information including telephone numbers.

8. With respect to each of Questions 1-7 above, if not previously answered or included in a

prior response on this form, is any proceeding, claim, matter, suit, indictment, etc. currently pending against Entity that could result in being found liable, guilty or in violation of the matters referenced in Question 1-7 above and/or subject to debarment, suspension, removal or disqualification by the federal government, any state or local government, or any foreign governmental entity?


Yes ☐ No ☐

If yes, please explain and provide on a separate sheet the information requested as to such similar items set forth in the questions above.

9. In the past five years, has Entity or any Affiliate been convicted of violating a state or

federal law respecting the employment of undocumented aliens?

Yes ☐ No ☐


10. In the past five years, has Entity or any Affiliate been found ineligible to bid or work on, or be awarded, a public works project pursuant to Labor Code §§ 1777.1 or 1777.7?

Yes ☐ No ☐


11. Has there been any instance where Entity or any Affiliate, or its owners, officers or managing employees submitted a bid on a public works project and were found to be nonresponsive or were found by an awarding body not to be a responsible bidder?

Yes ☐ No ☐


12. Has a surety for Entity or any Affiliate completed a contract on the entity’s behalf or paid for completion because the entity was in default or terminated by the project owner within the last five years?

Yes ☐ No ☐

If yes, please explain the circumstances on as separate sheet.

13. Has there been any violation of the Contractors' State License Law, as described in Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, including alleged violations of federal or state law regarding the payment of wages, benefits, apprenticeship requirements, or personal income tax withholding, or Federal Insurance Contribution Act (FICA) withholding requirements settled against Entity or any Affiliate?

Yes ☐ No ☐


14. Has there been any settled adverse claim, dispute, or lawsuit between the owner of a public works project and Entity or any Affiliate during the last five years in which the claim, settlement, or judgment exceeded fifty thousand dollars ($50,000).


Yes ☐ No ☐

If yes, please explain the circumstances.

15. In the past five years have there been any citations, assessed penalties or settlements against Entity or any Affiliate for any serious, willful, or repeat violations of Part 1 (commencing with Section 6300) of Division 5 of the Labor Code or the federal Occupational Safety and Health Act of 1970 (Public Law 91-596)?

Yes ☐ No ☐

If yes, please explain the circumstances.

16. Has Entity or any Affiliate ever been an “expatriate corporation” as that term is defined in California Public Contract Code (PCC) §10286.1(b)?

Yes ☐ No ☐

If yes, provide the date such “expatriate corporation” was established: .

If yes, does the entity meet the requirements of PCC §10286.1(b)(2)(A) or (B)?

No ☐

Yes, the entity meets the requirements of PCC §10286.1(b)(2)(A) ☐

Yes, the entity meets the requirements of PCC §10286.1(b)(2)(B) ☐

17. In the past five (5) years, has Entity or any Affiliate had any license, credential, or registration revoked or suspended?

Yes ☐ No ☐

If yes, please provide on a separate sheet specific details including date(s), reason(s), for revocation or suspension, whether same was reinstated, and any conditions thereto.

Explain the circumstances underlying any “yes” answers for the aforementioned questions on separate sheets attached hereto.

As used in this Form C, the term “Affiliate” means and includes parent companies at any tier, subsidiary companies at any tier, entities under common ownership, joint ventures and partnerships involving only the Major Participants as a joint venturer or partner, and any Financially Responsible Party, that, within the past five years (measured from the date of issuance of the RFP) have engaged in business or investment in North America. The information sought by this Form C for Affiliates is limited to the projects and matters that have occurred within the past five years (measured from the date of issuance of the RFP) in North America. Under penalty of perjury, I certify that the foregoing is true and correct, and that I am the


applicable entity’s official representative:

Print Name:

Title:

Date: ____________________________________

[End of Form]

WETA Richmond Ferry Terminal Non Collusion Affidavit Addendum #1: February 23, 2017 Form D – Page 1 of 1

FORM D

NON-COLLUSION AFFIDAVIT

(In accordance with Cal. Pub. Con. Code § 7106)

The undersigned declares:

I am the of , the party making the foregoing Proposal. The Proposal is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The Proposal is genuine and not collusive or sham. Offeror has not directly or indirectly induced or solicited any other Offeror to put in a false or sham Proposal. Offeror has not directly or indirectly colluded, conspired, connived, or agreed with any Offeror or anyone else to put in a sham Proposal, or to refrain from Proposing. Offeror has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the Proposal price of Offeror or any other Offeror, or to fix any overhead, profit, or cost element of the Proposal Price, or of that of any other Offeror. All statements contained in the Proposal are true. Offeror has not, directly or indirectly, submitted his or her Proposal Price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham Proposal, and has not paid, and will not pay, any person or entity for such purpose. Any person executing this declaration on behalf of a Offeror that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the Offeror.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on:

, at , Date City State

[INSERT NAME OF OFFEROR] ______________________________

Print Name:

Title:

[End of Form]

WETA Richmond Ferry Terminal Buy America Certification Addendum #1: February 23, 2017 Form E – Page 1 of 1

FORM E

BUY AMERICA CERTIFICATION

(To be signed by authorized signatory(ies) of Offeror.)

Certificate of Compliance with 49 U.S.C. 5323(j)(2)(C).

Offeror hereby certifies that it will comply with the requirements of 49 U.S.C. 5323(j)(2)(C) and the regulations at 49 CFR Part 661.

Signature Date

Company Name

Title

Certificate of Non-Compliance with 49 U.S.C. 5323(j)(2)(C)

The Offeror hereby certifies that it cannot comply with the requirements of 49 U.S.C. 5323(j)(2)(C), but may qualify for an exception pursuant to 49 U.S.C. 5323(j)(2)(B) or (j)(2)(D) and the regulations in 49 CFR 661.7.

Signature Date

Company Name

Title

[End of Form]

WETA Richmond Ferry Terminal Fly America Certification Addendum #1: February 23, 2017 Form F – Page 1 of 1

FORM F

FLY AMERICA CERTIFICATION

(To be signed by authorized signatory(ies) of Offeror.)

1. The undersigned agrees to comply with 49 U.S.C. 40118 (the “Fly America” Act) in accordance with the General Services Administration’s regulations at 41 CFR Part 301- 10, which provide that recipients and subrecipients of Federal funds and their contractors are required to use U.S. Flag air carriers for U.S Government-financed international air travel and transportation of their personal effects or property, to the extent such service is available, unless travel by foreign air carrier is a matter of necessity, as defined by the Fly America Act.

2. The undersigned shall submit, if a foreign air carrier was used, an appropriate certification

or memorandum adequately explaining why service by a U.S. flag air carrier was not available or why it was necessary to use a foreign air carrier and shall, in any event, provide a certificate of compliance with the Fly America requirements.

3. The undersigned agrees to include the requirements of this section in all subcontracts that

may involve international air transportation.

Offeror, [INSERT NAME OF OFFEROR] ______________________________, certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, Offeror understands and agrees that the provisions of 31 U.S.C. A 3801, et seq., apply to this certification and disclosure, if any.

Signature Date

Company Name

Title

[End of Form]

WETA Richmond Ferry Terminal Use of Contracting Funds in Lobbying Addendum #1: February 23, 2017 Form G – Page 1 of 1

FORM G

USE OF CONTRACT FUNDS IN LOBBYING CERTIFICATION

(Pursuant to 49 CFR Part 20, Appendix A)

The undersigned certifies, to the best of his or her knowledge and belief, that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the under-signed, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal appropriated funds have been paid or will be paid to any

person for making lobbying contacts to an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form of Lobbying Activities,” in accordance with its instructions and as amended by “Government wide Guidance for New Restrictions on Lobbying,” 61 Fed. Reg. 1413 (1/19/96).

3. The undersigned shall require that the language of this certification be included in the

award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Offeror, [INSERT NAME OF OFFEROR] ______________________________, certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, Offeror understands and agrees that the provisions of 31 U.S.C. A 3801, et. seq. apply to this certification and disclosure, if any.

Name and title of Offeror’s authorized official

Signature/title Date

WETA Richmond Ferry Terminal Disclosure of Lobbying Activities Addendum #1: February 23, 2017 Standard Form LLL – Page 1 of 3

STANDARD FORM LLL DISCLOSURE OF LOBBYING ACTIVITIES

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352

1. Type of Federal Action:

a. contract b. grant

c. cooperative agreement d. loan e. loan guarantee f. loan insurance

2. Status of Federal Action: a. bid/offer/application

b. initial award c. post-award

3. Report Type: a. initial filing

b. material change

For material change only: Year quarter Date of last report

4. Name and Address of Reporting Entity: Prime Subawardee

Tier , if Known:

Congressional District, if known:

5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime:

Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description:

CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known:

$

10. a. Name and Address of Lobbying Registrant (if individual, last name, first name, MI):

b. Individuals Performing Services (including address if different from No. 10a)

(last name, first name, MI):

11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Signature:

Print Name:

Title:

Telephone No.: Date:

Federal Use Only

Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97)


INSTRUCTIONS FOR COMPLETION OF STANDARD FORM-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of a covered federal action, or a material change to a previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered federal action. Use the Standard Form-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

1. Identify the type of covered federal action for which lobbying activity is and/or has been

secured to influence the outcome of a covered federal action.

2. Identify the status of the covered federal action.

3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered federal action.

4. Enter the full name, address, city, state and zip code of the reporting entity. Include

Congressional authority, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

5. If the organization filing the report in item 4 checks "Subawardee", then enter the full name,

address, city, state and zip code of the prime federal recipient. Include Congressional authority, if known.

6. Enter the name of the Federal agency making the award or loan commitment. Include at

least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the federal program name or description for the covered federal action (item 1). If

known, enter the full Catalog of Federal Domestic Assistance (“CFDA”) number for grants, cooperative agreements, loans, and loan commitments.

8. Enter the most appropriate federal identifying number available for the federal action

identified in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number; grant announcement number, the contract, grant, or loan award number, the application/bid control number assigned by the Federal agency). Include prefixes (e.g., "IFB-DE-90-001")


9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.

10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged

by the reporting entity identified in item 4 to influence the covered Federal action.

(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).

11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting

entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made.

12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an

in-kind contribution, specify the nature and value of the in-kind payment.

13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.

14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted.

15. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached.

16. The certifying official shall sign and date the form, print his/her name, title, and telephone

number.

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503.

[End of Form]

WETA Richmond Ferry Terminal Debarment and Suspension Certification Addendum #1: February 23, 2017 Form H – Page 1 of 1

FORM H

DEBARMENT AND SUSPENSION CERTIFICATION

The undersigned Offeror certifies to the best of its knowledge and belief, that it and its Other Major Participants, and listed Subcontractors:

1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or

voluntarily excluded from covered transactions by any federal department or agency;

2. Have not within a three-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;

3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental

entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (2) of this certification; and

4. Have not within a three-year period preceding this Proposal had one or more public

transactions (federal, state or local) terminated for cause or default.

If Offeror is unable to certify to any of the statements in this certification, Offeror shall attach an explanation to this certification.

I hereby certify that I am authorized to execute this certification on behalf of Offeror and certify the truthfulness and accuracy of the contents herein or attached hereto to the best of my belief.

Signature Date

Name

Offeror Name

Title

[End of Form]

WETA Richmond Ferry Terminal Offeror Team Report Addendum #1: February 23, 2017 Form I-1 – Page 1 of 6

FORM I-1

MAJOR PARTICIPANT, SUBCONTRACTOR / SUBCONSULTANT / SUPPLIER REPORT

Section A: Contractor* Information: * If Offeror is a consortium, partnership or any other form of joint-venture, complete this Section A for the lead or majority owner Principal Participant only. For all other Principal Participants provide applicable information in Section B below.

1. Contract # and Name: 2. Offeror’s Name: 3. Address: 4. Phone: Email: 5. Owner or Contact Person:

6. Title: 7. Contractor NAICS Codes: 8. Is your firm a Small Business Enterprise (SBE)?: Yes No 9. If your firm is a DBE or SBE please list certification type or No. and

Certifying Agency: 10. If your firm is an SBE, please read and fill out, if applicable, the SBE

Affidavit of Size form and attach a copy of your firm’s certification. 11. Age of your firm: 12. Annual Gross Receipts (please check one): Below $500K:

$500K-$1M: $1M-$4M: $6M-$13M: Above $13M:

Section B: Major Participant Information: Offeror MUST provide the following information on ALL Subcontractors that provided Offeror a bid, quote, or proposal for work, services or supplies associated with the Work pursuant to WETA’s sub- proposal reporting requirements. Include all sub-proposal acceptance(s) AND rejection(s). You must include the DBE/SBE certification number in column 7 for each DBE/SBE joint-venture member not identified in Section A, if any, and each subcontractor/subconsultant/supplier (i.e., Subcontractor) listed, if applicable fill out SBE Affidavit of Size form (Form I-2). Attach “Intent to Perform” letter signed by each Subcontractor who will perform Work if Offeror is awarded the Agreement. Please carefully read all instructions on page 3 of this Form I-1.

DBE/SBE PARTICIPATION

1. 2. 3. 4. 5. 6. 7. DBE 8. 9. 10. Major Participant Annual Gross Contractor's Certified Certified DBE/SBE Certification Describe Work or Type of Proposal Percentage of

Receipts License No. DBE SBE Certifying No. &/or Materials/Supplies and list Accepted Contract (check one) (if applicable) (Yes/No) (Yes/No) Agency SBE Type NAICS Codes (Yes/No) Participation Name: Below $500K Address: $500K-$1M $1M-$4M Contact Person: $4M-$6M NAICS Codes: Phone: $6M-$13M Email: Above $13M Age of Firm:


DBE/SBE PARTICIPATION

1. Major Participant

2. Annual Gross

Receipts (check one)

3. Contractor's

License No. (if applicable)

4. Certified

DBE (Yes/No)

5. Certified

SBE (Yes/No)

6. DBE/SBE Certifying Agency

7. DBE Certification

No. &/or SBE Type

8. Describe Work or Type of

Materials/Supplies and list NAICS Codes

9. Proposal Accepted (Yes/No)

10. Percentage of

Contract Participation

Name: Below $500K Address: $500K-$1M $1M-$4M Contact Person: $4M-$6M NAICS Codes: Phone: $6M-$13M Email: Above $13M Age of Firm: Name: Below $500K Address: $500K-$1M $1M-$4M Contact Person: $4M-$6M NAICS Codes: Phone: $6M-$13M Email: Above $13M Age of Firm: Name: Below $500K Address: $500K-$1M $1M-$4M Contact Person: $4M-$6M NAICS Codes: Phone: $6M-$13M Email: Above $13M Age of Firm: Name: Below $500K Address: $500K-$1M $1M-$4M Contact Person: $4M-$6M NAICS Codes: Phone: $6M-$13M Email: Above $13M Age of Firm:

Attach additional sheets as necessary.

• DBE Participation: %

• SBE Participation: %


The undersigned will enter into a formal agreement with the Subcontractor(s) whose sub-proposal was accepted conditioned upon execution of a contract with the San Francisco Bay Area Water Emergency Transportation Authority. I certify under penalty of perjury that the information included on this form is accurate and true.

Signature: Name (Print):

Title: Date:


How to Fill out Major Participant DBE/SBE Report (Form I-1)

Section A: Proposer Information

1. Contract # and Name: Insert name of the WETA agreement or contract.

2. Proposer’s Name: Insert company name. If Proposer is a consortium, partnership or any other form of joint-venture, complete Section A for the lead or majority owner Major Participant only. For all other Major Participants provide applicable information in Section B.

3. Address: Insert address of company.

4. Phone & Email: Insert phone number and email address of person responsible for filling out

information contained in this form.

5. Owner or Contact Person: Insert contact name for Proposer.

6. Title: Insert title of person listed in #5.

7. Contractor NAICS Codes: List the North American Industry Classification System Code(s) for work performed by Proposer. Codes can be found at www.census.gov/naics.

8. Is your firm a Small Business Enterprise (SBE)? Indicate, by checkmark, if your firm is a Small

Business Enterprise as defined in the attached description of WETA’s SBE Program Eligibility. Please see instructions for Section B #7, below, for SBE Certifications accepted by WETA.

9. If your firm is a DBE or SBE list certification type or No. and Certifying Agency: For DBE firms

list the certification number provided by the California Unified Certification Program and the certifying agency. For SBE firms please list the type of certification (e.g., SMBE, SWBE, SB, MB, SBA, SBE/MBE/WBE) and the certifying agency. Please see the description of WETA’s Small Business Enterprise Program in WETA’s Diversity Program For Contracts for eligible SBE Certifications accepted by WETA.

10. If your firm is an SBE, read and fill out, if applicable, the SBE Affidavit of Size form (Form I-

2) included in this RFQ/RFP and attach a copy of your firm’s certification.

11. Age of your firm: Provide the number of years your firm has been in business.

12. Annual Gross Receipts: Indicate, by checkmark, the range of annual gross receipt your firm receives.

Section B: Major Participant Information

PLEASE NOTE THE IMPORTANT REQUIREMENTS BELOW:

http://www.census.gov/naics


Offeror MUST provide the following information on ALL Major Participants (except for the lead or majority owner Major Participant whose information is included in Section A), if applicable, and each subcontractor/subconsultant/supplier (i.e., Subcontractor) that provided Proposer with a bid, quote, or proposal for work, services or supplies associated with the Work pursuant to WETA’s sub-proposal reporting requirements. This information shall be provided for all sub-proposers regardless of tier for DBEs, SBEs, non-DBEs and non-SBEs. Include all sub-proposal acceptance(s) AND rejection(s).

Attach “Intent to Perform” letter signed by each Subcontractor who will perform Work should the Agreement be executed. (An Intent to Perform letter is not required from joint- venture members listed in Section B.)

1. Insert the name, address, contact person, phone number, email address and age of firm for each Subcontractor. 2. Annual Gross Receipts: Indicate, by checkmark, the range of the firm’s annual gross receipts. 3. Contractor’s License No.: If applicable, insert the contractor’s license number. 4. Certified DBE (Yes/No): Indicate if the firm is a certified DBE firm accepted by WETA. WETA accepts DBE participation only from firms currently certified in the California Unified Certification Program (CUCP), go to www.californiaucp.org for further information. Do not indicate more than one “Yes” for alternative Subcontractor for the same work. 5. Certified SBE (Yes/No): Indicate if the firm is a certified SBE accepted by WETA. Please see the description of WETA’s Small Business Enterprise Program in WETA’s Diversity Program For Contracts for eligible SBE Certifications accepted by WETA. Proof of SBE certification and, if applicable, SBE Affidavit of Size must be attached to your submittal. 6. DBE/SBE Certifying Agency: If you marked yes as a Certified DBE or SBE, note which agency your certification letter is from—BART, SFMTA, SamTrans, etc. 7. DBE Certification No. & Type / SBE Type: If you marked yes as a Certified DBE, you must provide the CUCP Certification Number and the number corresponding to the type of DBE as follows: 1. African-American, 2. Hispanic, 3. Native American, 4. Asian-Pacific, 5. Asian- Indian, 6. Female-Woman, 7. Other. If you marked yes as a Certified SBE please list the type of certification (eg. SMBE, SWBE, SB, MB, SBA, SBE/MBE/WBE). Please see the description of WETA’s Small Business Enterprise Program Eligibility on the following pages for SBE Certifications accepted by WETA. 8. Describe Work or Type of Materials/Supplies and list NAICS Codes: DBE/SBE participation includes that portion of the Work actually performed by a certified DBE/SBE with its own forces. For example, for DBE supplier, count 60% of the costs of materials and supplies. List the North American Industry Classification System Code(s) for the work to be performed by the Subcontractor. Codes can be found at www.census.gov/naics.

http://www.californiaucp.org/

http://www.census.gov/naics


9. Proposal Accepted (Yes/No): Indicate if the Subcontractor’s proposal has been accepted. If yes, please attach “Intent to Perform” letter signed by each Subcontractor who will perform work should this contract be awarded to the Prime listed above. 10. Percentage of Contract Participation: Insert the percentage participation of the sum of the Preconstruction Services (based on Offeror’s Maximum Preconstruction Services Amount) and Early Construction Work (based on Offeror’s Early Construction Work Compensation), as applicable, for each Subcontract. For each Subcontractor indicate whether it will perform work for the Preconstruction Services or Early Construction Work. Contactor understands that the percentage participation from DBE or SBE firms listed on this form is a firm commitment and will become a condition of the Agreement. 11. DBE Participation: Insert the sum of column 10 for each DBE listed. 12. SBE Participation: Insert the sum of column 10 for each SBE listed.

Use additional sheets if necessary. If there are no Subcontractors proposed, Section B will remain blank.

[End of Form]

WETA Richmond Ferry Terminal Small Business Enterprise affidavit Addendum #1: February 23, 2017 Form I-2 – Page 1 of 1

FORM I-2

SMALL BUSINESS ENTERPRISE AFFIDAVIT If your business was certified by any of the following, please complete and submit this form with a copy of your certification. This form may be used for Contractor, joint-venture members, if any, and Subcontractors (i.e., subcontractors, subconsultants, and suppliers). See WETA Diversity Program for Contracts Exhibit C, section A1, A1 and Section B for further information.

• SMBE/SWBE Certification by state other than California, provided that your firm’s average

annual gross receipts fall below the SBA industry-specific size cap and in no case exceed $23.98 million.

• SB Certification by the California DGS, provided that your firm’s average annual gross

receipts fall below the SBA industry-specific size cap and in no case exceed $23.98 million. • SBA 8(a) Certification by the Small Business Administration provided that your firm’s

average annual gross receipts fall below the SBA industry-specific size cap and in no case exceed $23.98 million.

• SBE/MBE/WBE Certification by any California county or local government-certifying agency

or out-of-state government-certifying agency, provided that your firm’s average annual gross receipts fall below the SBA industry-specific size cap and in no case exceed $23.98 million.

I HEREBY DECLARE AND AFFIRM that I am the (Title) and duly authorized representative of (Name of Firm) whose address is .

and whose phone number is

I HEREBY DECLARE AND AFFIRM that the firm is a Small Business Enterprise (SBE) in accordance with San Francisco Bay Area Water Emergency Transportation Authority (WETA) standards as defined in its Diversity Program for Contracts. The firm is certified as of the date that WETA receives the bid/proposal for:

(RFP/RFQ Name) and I will provide the certification to document this fact with this enclosure.

I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE CONTENTS OF THE FOREGOING STATEMENTS ARE TRUE AND CORRECT, AND THAT I AM AUTHORIZED, ON BEHALF OF THE ABOVE FIRM, TO MAKE THIS AFFIDAVIT.

(Date) (Affiant) (Title)

[End of Form]

WETA Richmond Ferry Terminal Description of Subcontractor Process Addendum #1: February 23, 2017 Form I-3 – Page 1 of 2

FORM I-3

DESCRIPTION OF SUBCONTRACTOR/ SUBCONSULTANT/SUPPLIER SELECTION PROCESS

Contract # and Name:

Offeror’s Name:

Address:

Phone: Fax:

Owner or Contact Person: Title:

Provide a narrative description of how Offeror selected its subcontractors/subconsultants/suppliers (i.e., Subcontractors), including the following elements (please attach additional sheets as necessary):

1. Soliciting small businesses, including DBEs, to participate through all reasonable and available means.

Example: Include attendance at pre-bid meeting, advertisements, written notices and agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using small business concerns.

2. Selecting portions of the Work that are economically feasible for small businesses, including DBEs.

Example: List items of work which Offeror made available to small business concerns, including, where appropriate, any breaking down of the scope of services (including those items normally performed by Offeror with its own forces) into economically feasible units to facilitate DBE/SBE participation.

3. Providing adequate information about the scope of the Work in a timely manner to DBEs/SBEs.

Example: List dates of written notices soliciting bids from DBEs/SBEs and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs/SBEs were interested.

4. Negotiating in good faith with DBEs/SBEs.

WETA Richmond Ferry Terminal Description of Subcontractor Process Addendum #1: February 23, 2017 Form I-3 – Page 2 of 2

5. Not rejecting DBEs/SBEs as unqualified without sound business reasons.

Example: Explain reasons for rejecting bids from DBEs/SBEs and accepting proposals from selected firms.

6. Making efforts to assist DBEs/SBEs in obtaining required insurance.

7. Making efforts to assist DBEs/SBEs in obtaining necessary equipment, supplies or materials.

8. Describe any other steps that Offeror used to select its Subcontractors for the Work.

The undersigned certifies that the above narrative description is true and accurate.

Signature Date

Name

Offeror Name

Title

[End of Form]

WETA Richmond Ferry Terminal Equal Employment Opportunity Certification Addendum #1: February 23, 2017 Form J – Page 1 of 2

FORM J

EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION To be executed by Major Participants and Proposed/Listed Subcontractors (From

Form B-2)

The undersigned certifies on behalf of , that:

(Name of entity making certification)

[Check one of the following boxes.]

□ It has developed and has on file at each establishment affirmative action programs pursuant to 41 CFR Part 60-2 (Affirmative Action Programs).

□ It is not subject to the requirements to develop an affirmative action program under 41 CFR Part 60-2 (Affirmative Action Programs).

[Check one of the following boxes.]

□ It has not participated in a previous contract or subcontract subject to the equal opportunity clause described in Executive Orders 10925, 11114 or 11246.

□ It has participated in a previous contract or subcontract subject to the equal opportunity clause described in Executive Orders 10925, 11114 or 11246 and, where required, it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President’s Committee on Equal Employment Opportunity, all reports due under the applicable filing requirements.

Signature Date

Name

Offeror Name

Title

If not Offeror, relationship to Offeror: ☐ Other Major Participant ☐ Proposed/Listed Subcontractor Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b)(1)), and must be submitted by Offerors only in

WETA Richmond Ferry Terminal Equal Employment Opportunity Certification Addendum #1: February 23, 2017 Form J – Page 2 of 2

connection with contracts which are subject to the equal opportunity clause. Contracts that are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally, only contracts of $10,000 or under are exempt.)

Currently, Standard Form 100 (EEO-1) is the only report required by Executive Orders or their implementing regulations.

Major Participants or proposed/Listed Subcontractors who have participated in a previous contract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor.

[End of Form]

WETA Richmond Ferry Terminal Conflict of Interest Disclosures Addendum #1: February 23, 2017 Form K – Page 1 of 2

FORM K

CONFLICT OF INTEREST DISCLOSURE

Offeror: [INSERT NAME OF OFFEROR] ______________________________

1. Policy

The procurement process for this project must comply with the provisions of FTA Circular 4220.1F. The circular language specifically prohibits solicitation requirements that unduly restrict competition, and organizational conflicts of interest are considered restrictive of competition. Chapter VI, paragraph 2.a.(4)(h) prohibits practices that result in organizational conflicts of interest and defines that an organizational conflict of interest occurs when any of the following circumstances arise:

a) Lack of Impartiality or Impaired Objectivity — When the contractor is unable, or

potentially unable, to provide impartial and objective assistance or advice to the recipient (Owner) due to other activities, relationships, contracts, or circumstances.

b) Unequal Access to Information — The contractor has an unfair competitive

advantage through obtaining access to nonpublic information during the performance of an earlier contract.

c) Biased Ground Rules — During the conduct of an earlier procurement, the

contractor has established the ground rules for a future procurement by developing specifications, evaluation factors, or similar documents.

2. Disclosure

In the space provided below, and on supplemental sheets as necessary, identify all relevant facts relating to past, present or planned interest(s) of the Offeror and the Offeror team (including Other Major Participants, identified at the time of the submittal of the Proposal, and their respective personnel) which may result, or could be viewed as, an organizational conflict of interest in connection with the RFP.

3. Explanation

In the space provided below, and on supplemental sheets as necessary, identify steps that have been or will be taken to avoid, neutralize or mitigate any organizational conflicts of interest described herein.

WETA Richmond Ferry Terminal Conflict of Interest Disclosures Addendum #1: February 23, 2017 Form K – Page 2 of 2

4. Certification

The undersigned hereby certifies that, to the best of his or her knowledge and belief, no interest exists that is required to be disclosed in this Conflict of Interest Disclosure Statement, other than as disclosed above.


Print Name:

Title:

Date:

[End of Form]

WETA Richmond Ferry Terminal Levine Act Disclosure Addendum #1: February 23, 2017 Form L – Page 1 of 1

FORM L

LEVINE ACT DISCLOSURE

To be completed with the submission of any Proposal.

Offeror Name:

Party’s Name:

Street Address:

City / State / Zip:

Phone:

Request for Proposal No. 16-020

WETA Board Member(s) or Alternate(s) to whom you and/or your agent made campaign contributions and dates of contribution(s) in the 12 months preceding October 7, 2016:

Name of Member:

Name of Contributor (if other than Party):

Date(s):

Amounts(s):

Name of Member:

Name of Contributor (if other than Party):

Date(s):

Amounts(s):

[Insert additional members as necessary.]

If no contributions are noted above, I hereby certify that no contributions have been made by the Party identified above to any of WETA Board Member or their Alternates.

Date:

Signature of Party and/or Agent:

[End of Form]

WETA Richmond Ferry Terminal Iran Contracting Certification Addendum #1: February 23, 2017 Form M – Page 1 of 1

FORM M

IRAN CONTRACTING CERTIFICATION

Section 2200 et seq. of the California Public Contract Code prohibits a person from submitting a proposal for a contract with a public entity for goods and services of $1,000,000 or more if that person is identified on a list created by the Department of General Services (DGS) pursuant to Section 2203(b) of the California Public Contract Code. The list will include persons providing goods or services of $20,000,000 or more in the energy sector of Iran and financial institutions that extend $20,000,000 or more in credit to a person that will use the credit to provide goods or services in the energy sector in Iran. DGS is required to provide notification to each person that it intends to include on the list at least 90 days before adding the person to the list.

In accordance with Section 2204 of the California Public Contract Code, the undersigned hereby certifies that:

□ It is not identified on a list created pursuant to Section 2203(b) of the California Public Contract Code as a person engaging in investment activities in Iran described in Section 2202.5(a), or as a person described in Section 2202.5(b), as applicable; or

□ It is on such a list but has received permission pursuant to Section 2203(c) or (d) to submit a proposal in response to RFP.

Note: Providing a false certification may result in civil penalties and sanctions.


Print Name:

Title:

Date:

[End of Form]

WETA Richmond Ferry Terminal Industrial Safety Record Addendum #1: February 23, 2017 Form O – Page 1 of 3

FORM O

INDUSTRIAL SAFETY RECORD FOR MAJOR PARTICIPANTS

OFFEROR’S NAME: [INSERT OFFEROR NAME] ______________________________

NAME OF TEAM MEMBER: [INSERT TEAM MEMBER NAME] ______________________________

ROLE OF ENTITY ON OFFEROR TEAM (check one): ☐ Offeror; ☐ Other Major Participant; This form shall be filled out separately and provided for each Major Participant of Offeror’s team that has undertaken work in the United States and will perform or supervise Work, and including information for any entity affiliated with such team member that has undertaken work in the United States. Information must be provided with regard to all construction work undertaken in the United States (including the State of California) by the entity, with separate statistics relative to the State of California. For Offeror team members that are members of joint ventures, information as to the joint venture shall be provided as though 100% of the results were for the listed participant. Offeror may be requested to submit additional information or explanation of data which WETA may require for evaluating the safety record.

For purposes of this form, the term “affiliated” means parent companies at any tier, subsidiary companies at any tier, entities under common ownership, joint ventures and partnerships involving such entities (but only as to activities of joint ventures and partnerships involving any Major Participant as a joint venturer or partner and not to activities of other joint venturers or partners not involving the any Major Participant), and other financially liable or responsible parties for the entity, that within the past five years (measured from the date of issuance of the RFP) have engaged in business or investment in the United States. The information sought for affiliates is limited to the projects and matters that have occurred within the past five years in the United States.


2013 2014 2015 AVERAGE 1) Total Hours Worked (in thousands)

Nationwide: California:

2) Number of fatalities:* Nationwide: California:

3) Number of lost workdays:* Nationwide: California:

4) Number of lost workdays* cases: Nationwide: California:

5) Number of injury/illness* cases: Nationwide: California:

6) Number of days of* restricted work activity due to injury/illness:


7) Incidence Rate** Lost Workday Cases


Days Lost Nationwide: California:

8) Worker's Compensation Experience Modifier Nationwide: California:

* The information required for these items is the same as required for columns 3 to 6, Code 10, Log and Summary of Occupational Injuries and Illnesses, OSHA Form 200.

** Incidence Rate = No. Injuries (Cases) x 200,000 / Total Hours Worked


Is the team member a party to an alternative dispute resolution system as provided for in Labor Code § 3201.5?

Yes No

For the Offeror only: Please attach a summary of the Offeror’s worker safety program, which shall include a description of how the Offeror will provide protection to prevent damage, injury, or loss to employees of the Offeror and its subcontractors and other persons who are on the Project site and will minimize lost or restricted workdays due to injuries. The above information was compiled from the records that are available to me at this time and I declare under penalty of perjury under the laws of the State of California that the information is true and accurate within the limitation of those records.

Name of Company (Print) (Signature)

(Address) (Title)

City State Zip

(Telephone Number)

(or international address, if applicable)

[End of Form]

WETA Richmond Ferry Terminal Price Proposal Form Addendum #1: February 23, 2017 Form P – Page 1 of 2

FORM P

PRICE PROPOSAL FORM

Instructions for completing price proposal form: 1. Design (line item 1), shall be the lump sum total of Offeror’s bid for Design

activities. Except as included elsewhere on Form P, this amount shall cover all contractors allowable costs from Design Phase notice to Proceed to Construction Phase Notice to Proceed including but not limited to the labor, materials, equipment, supplies, overhead and profit that are required to perform research, site investigations, drafting, design review meetings, design submissions and any other activities required to provide complete plans and specifications acceptable to WETA and necessary for successful construction.

2. Construction (line item 2.1) shall be the lump sum total of Offeror’s bid for all remaining activities required to complete the contract work except for costs covered in line items 2.2, 2.3, 2.4 and Option A. Costs shall include but not be limited to labor, materials, equipment, permits, supplies overhead, profit, mobilization an other expenses required to complete the project construction per the contract documents including any anticipated warranty, maintenance or other costs which may be contractually incurred following project acceptance by Owner.

3. Disposal of contaminated soils, Disposal of Hazardous Soils and Off-site Groundwater disposal (line items 2.2, 2.3 and 2.4) shall be the unit cost difference between the cost Offeror will charge for disposing of the indicated material and the cost Offeror would have charged within line item 2.1 had the same material been uncontaminated/non-hazardous. The Price entered for these items will be included in the Total Contract Price for purposes of Price Proposal evaluation however, payment for these line items will only be made should off-site disposal of contaminated/ hazardous soil or water be required. Such payments, if any, will be made at unit price bid, regardless of quantity. Offerors shall familiarize themselves with specification Section 01 57 20 and other specification sections concerned with soils, excavations and groundwater. Handling, treatment, storage, disposal or import of soil or water that is not addressed by these lines items 2.2, 2.3 and 2.4 will be considered as covered in line item 2.1 – Construction, as discussed in Paragraph 2 above.

4. Daily Extended Overhead Rate, Line item 2.5, is defined in Section 00 72 00. The Price entered for this item will be included in the Total Contract Price for purposes of Price Proposal evaluation however, payment under this line item will only be made if applicable conditions described in Article 8 of the General Conditions (Section 00 72 00) are met. Should that occur, the amount entered may be audited per per Article 6 paragraph 6.8.4.5 of the General Conditions (Section 00 72 00) and if warranted, the amount may, at WETA’s sole discretion, be renegotiated with the Design-Builder.

WETA Richmond Ferry Terminal Price Proposal Form Addendum #1: February 23, 2017 Form P – Page 2 of 2

5. Line Item Option A: This is an option for dredging. The Price entered for this item will be included in the Total Contract Price for purposes of Price Proposal evaluation however, payment for this line item will only be made if the option to dredge is executed. Price entered shall include the full lump sum cost of dredging including mobilization, demobilization and disposal at the Montezuma wetlands restoration disposal area. Volume of material to be removed is approximately 1,700 Cubic Yards (CY). Lump sum bid for this line item shall be valid for volumes up to 150% of the given estimated volume (2,550 CY).

6. Line Item Option B1: This is an option for providing infrastructure necessary to support installation of future EV charging stations by others.

7. Line Item Option B2: This is an option for providing 7 Electric Vehicle (EV) charging stations at the locations indicated on the plans and all infrastructure, electrical work and testing necessary for proper functioning of the charging stations.

8. In the event of any error or discrepancy between the Unit Price and the calculated Total Price, the Unit Price shall govern.

9. The amounts in the Price Amount column must be added together in arriving at the Total Contract Price.

10. Prices provided shall be inclusive of all direct and indirect costs of the covered work including direct costs of subcontractors, suppliers, vendors and materialmen, plus a proportionate share of the costs for general requirements, overhead, insurance, applicable taxes and any other indirect costs and profit.

11. Unbalanced Proposals: Offerors are strongly discouraged from submitting unbalanced Price Proposals. As used herein, “Unbalanced Price Proposal” means any Price proposal that does not include a reasonably proportionate allocation of indirect costs and profit to each item indicated in the form.

Offeror:

Address:

Addenda Addenda Date

Unit Price Unit Quantity Price

1 Design LS 1Total for Design

2 Construction Unit Price Unit Quantity Price

2.1 Construction LS 1

2.2 Dispose of Contaminated Soil Ton 100

2.3 Dispose of Hazardous Soil Ton 100

2.4 Off-site Groundwater Disposal Gal. 500

2.5 Daily Extended Overhead Rate Day 30

Option A Dredging (1,700 CY Approx) LS 1

Total for Construction

Total Contract Price (to be used for evaluation) = Design + Construction

Option B1 Stub Up for EV Charging Station EA 7

Option B2 Electric Vehicle Charging Station EA 6

Notes: 2.2 Is "Contaminated Soil" as defined by 14 CCR 173612.3 Is soil containing "Hazardous Waste" as defined in 22 CCR 66261.12.4 Is water generated during construction which requires off-site disposal per permit or Federal, State or local regulation.

Signature Title

Printed Name

Options B1 and B2 will NOT be considered in evaluating price proposals


PRICE PROPOSAL FORM New Construction Ferry Terminal, Richmond, CA

of

Date

To the SAN FRANCISCO BAY AREA WATER EMERGENCY TRANSPORTATION AUTHORITY

Offerors Please Note: Before preparing the Price Proposal, carefully read the Contract Documents.

The Offeror shall insert a unit price in figures opposite each pay item for which an estimated quantity appears in the Price Proposal. The Offeror shall add the items together and enter the Total Price in the space provided. If there is a discrepancy between a unit price and extended line item price, the unit price shall control. WETA reserves the right to correct any math errors apparent on the face of the Price Proposal.

The basis for the Award will be determined by the criteria and methodology set forth in the Instructions to Offerors.

The undersigned hereby agrees that WETA may rely on the information provided in this Price Proposal as being factual and correct. The undersigned acknowledges this Price Proposal will be incorporated into the final Contract Documents. The undersigned acknowledges receipt of the following Addenda to the drawings and/or specifications (give number and date of each).

Offeror affirms that the Total Project Price above represents the entire cost to WETA to complete the Work in accordance with the Contract Documents, and that no claim shall be made on account of any increase in costs for labor, materials, tools, equipment, services, Subcontractors, Suppliers, taxes, insurance, shipment, delivery, overhead, profit or any other rates necessary to perform the Work in accordance with the Contract Documents.

Undersigned acknowledges that its Total Price shall remain firm and binding for a period of 180 calendar days from the date the Proposals are due.

Undersigned has read the foregoing proposal and has full authority to enter into contracts on behalf of the Offeror, and hereby agrees to the conditions stated therein by affixing its signature below:

WETA Richmond Ferry Terminal Proposal Bond Addendum #1: February 23, 2017 Form Q-1 Page 1 of 4

FORM Q - 1

PROPOSAL BOND

BOND NO.:

KNOW ALL PERSONS BY THESE PRESENTS, that the [INSERT NAME OF OFFEROR AS THE PRINCIPAL AND DELETE THIS BRACKETED TEXT], as Principal and [INSERT NAME(S) OF SURETY(IES) AND DELETE THIS BRACKETED TEXT], as Surety or as Co-Sureties, each a corporation duly organized under the laws of the state indicated on the attached page, having its principal place of business at the address listed on the attached page, in the state indicated on the attached page, and authorized as a surety in the State of California, are hereby jointly and severally held and firmly bound unto the San Francisco Bay Area Water Emergency Transportation Authority (“WETA”), in the sum of US$1,600,000.00 (one million and six hundred thousand US dollars) (the “Bonded Sum”).

WHEREAS, concurrently with delivery of this bond to WETA, Principal is by these means submitting its Proposal to WETA in response to WETA’s Request for Proposals dated as of ______(as amended or supplemented, the “RFP”) to enter into a Construction Management At-Risk Agreement (“Agreement”) for the New Construction Ferry Terminal, Richmond, CA Project, which Proposal is incorporated into this bond by this reference. Initially capitalized terms not otherwise defined in this bond shall have the meaning set forth in the Instructions to Offerors (“ITP”) included in the RFP;

NOW, THEREFORE:

1. The obligation to pay the Bonded Sum hereunder is absolute and unconditional, and

unless said obligation is sooner discharged as provided below, the Bonded Sum shall be forfeited to WETA as liquidated damages and not as a penalty, upon receipt by Principal and Surety or by Principal and Sureties listed on the attached page (the "Co-Sureties") of notice of such forfeiture from WETA.

2. Upon occurrence of any of the following events, then this obligation shall be null and void;

otherwise it shall remain in full force and effect:

(a) Principal’s receipt of written notice from WETA that either (i) no Agreement for the Project will be awarded by WETA pursuant to the ITO, or (ii) WETA has awarded the Agreement for the Project, has received the executed Agreement and other required documents, and does not intend to award the Agreement to Principal;

(b) Except as expressly provided otherwise in the ITO or agreed to by WETA in writing,

Principal’s satisfaction of the conditions to award and execution of the Agreement under paragraph 8.D of the ITO (Section 00 02 00) and execution of the Agreement by the applicable deadlines, as such deadline may be extended in accordance with the ITO; or


(c) If WETA has not previously delivered notice of forfeiture as provided for under the terms of this bond, failure of WETA to conditionally award the Agreement to Offeror within 120 days after the Proposal Due Date.

3. The Principal and the Surety or Co-Sureties agree to pay to WETA the full Bonded Sum

as liquidated damages and not as a penalty, within ten days after occurrence of any of the following events:

(a) Offeror withdraws, repudiates, or otherwise indicates in writing that it will not meet any commitments made in its Proposal; or

(b) Offeror is selected as the best-value Offeror and fails to (i) negotiate in good faith with the WETA, as described in ITP Section 3.4, or (ii) satisfy the conditions to award and execution of the Agreement, including, without limitation, failure to provide the documents required under ITP Section 3.4

Principal agrees and acknowledges that such liquidated damages are reasonable in order to compensate WETA for damages it will incur as a result of Principal’s failure to satisfy the obligations under the RFP to which Principal agreed when submitting its Proposal. Such damages include potential harm to the credibility and reputation of WETA transportation program and Project, including with policy makers and with the general public, delays to the Project and additional costs of administering this or a new procurement (including engineering, legal, accounting, overhead and other administrative costs). Principal further acknowledges that these damages would be difficult and impracticable to measure and prove, are incapable of accurate measurement because of, among other things, the unique natures of the Project, the efforts required to receive and evaluate proposals for the Project, and the unavailability of a substitute for those efforts. The amounts of the liquidated damages stated in this bond represents good faith estimates and evaluations as to the actual potential damages that WETA would incur as a result of Principal’s failure to satisfy the obligations under the RFP to which Principal agreed when submitting its Proposal, and do not constitute a penalty. Principal agrees to such liquidated damages in order to fix and limit Principal’s costs and to avoid later disputes over what amounts of damages are properly chargeable to Principal.

4. The following terms and conditions shall apply with respect to this bond:

(a) This bond shall not be subject to forfeiture in the event that WETA disqualifies the

Proposal based on a determination that it is non-responsive or non- compliant.

(b) If suit is brought on this bond by WETA and judgment is recovered, Principal and Surety or Co-Sureties shall pay all costs incurred by WETA in bringing the suit, including, without limitation, reasonable attorneys’ fees and costs as determined by the court.

(c) Any extension(s) of the time for award of the Agreement that Principal may grant

in accordance with the RFP or otherwise, shall be subject to the reasonable approval of Surety [or Co-Sureties].


(d) Correspondence or claims relating to this bond should be sent to Surety or Co- Sureties at the following address(es):

SIGNED and SEALED this day of , 2017.

Principal

[Co-Surety]

Attorney in Fact

__________

[Co-Surety]

Attorney in Fact

[Co-Surety]

Attorney in Fact

[ADD APPROPRIATE SURETY ACKNOWLEDGMENTS]


CO-SURETIES

SURETY NAME

SURETY ADDRESS

INCORPORATED IN

WETA Richmond Ferry Terminal Payment Bond

Addendum #1: February 23, 2017 Form Q-2 – Page 1 of 2

FORM Q-2

PAYMENT BOND KNOW ALL PERSONS BY THESE PRESENTS, that, WHEREAS THE SAN FRANCISCO BAY AREA WATER EMERGENCY TRANSPORTATION AUTHORITY (herein after referred to as “WETA”) and ________________________________________ ____________________________________________________________________________________ (herein after referred to as “Principal”) have entered into a contract for the design build and delivery of the New Construction Ferry Terminal, Richmond, CA Project and; WHEREAS, under the terms of said contract, Principal is required to furnish a bond securing payment of the claims: NOW, THEREFORE, we, the Principal, and _______________________________________________, as Surety, are held and firmly bound unto WETA in the penal sum of __________________________________Dollars ($___________.00) lawful money of the United States, for the payment of which sum well and truly to be made we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. The condition of this obligation is such that if said Principal or any of its Subcontractors fails to pay all just claims for labor performed and materials, equipment, and supplies furnished upon or for the work under said Contract, whether said labor be performed and said materials, equipment, and supplies be furnished under the original Contract, any subcontract, or any duly authorized modifications thereto, or amounts due an express trust fund to which a portion of a laborer's total compensation is to be paid pursuant to an applicable employment agreement or a collective bargaining agreement for the provision of benefits, including, but not limited to, employer payments described in Section 1773.1 of the Labor Code and regulations thereunder, or amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract, or for any amounts required to be deducted, withheld, and paid over to the California Employment Development Department from the wages of employees of the Principal or its Subcontractors pursuant to Section 13020 of the California Unemployment Insurance Code, with respect to such work and labor, the Surety will pay for the same and also will pay, in case amount not exceeding the amount hereinabove set forth and also will pay, in case suit is brought upon this bond, a reasonable attorney’s fee, to be fixed by the Court. This bond will inure to the benefit of any of the persons providing labor, materials, equipment and supplies, and any express trust fund meeting the requirements above, so as to give a right of action to such persons or their assigns if any suit is brought upon this bond. The liability of the Principal and Surety hereunder is governed by the laws of the State of California. The Surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract or to the work to be performed thereunder or the Specifications accompanying the same shall in any wise affect its obligations on this bond and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the work or to the Specifications. IN WITNESS WHEREOF, the above bound parties have executed this instrument under their seals this _______ day of __________________, 20_____, the name and corporate seal of each corporate body being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body.

WETA Richmond Ferry Terminal Payment Bond Addendum #1: February 23, 2017 Form Q-2 Page 2 of 2

NOTE: To be considered complete, both the Principal and Surety must sign this Payment Bond. In addition, the Surety’s signature must be notarized and a copy of the Surety’s Power of Attorney must be attached.

Principal:

Surety: Address:

The offered bond has been checked for adequacy under the applicable statutes and regulations: ______________________________________________________ _________________________ San Francisco Bay Area Water Emergency Transportation Authority Date Authorized Representative

WETA Richmond Ferry Terminal Performance Bond

Addendum #1: February 23, 2017 Form Q-3 – Page 1 of 3

FORM Q-3

PERFORMANCE BOND

KNOW ALL PERSONS BY THESE PRESENTS, that, WHEREAS SAN FRANCISCO BAY AREA WATER EMERGENCY TRANSPORTATION AUTHORITY (hereinafter referred to as “WETA”) has entered into a contract with __________________ ____________________________________________________________________________________ (herein after referred to as “Principal”) for performance of the NEW CONSTRUCTION FERRY TERMINAL, RICHMOND, CA (the “Contract”); and WHEREAS said Principal is required under the terms of said Contract to furnish a bond of faithful performance of said Contract, NOW, THEREFORE, we, the undersigned Principal, and ___________________________, as Surety, are held and firmly bound unto WETA, in the sum of __________________ Dollars ($________________) lawful money of the United States, to be paid to WETA or its successors and assigns; for which payment, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the above-bound Principal, or its heirs, executors, administrators, successors, or assigns approved by WETA, shall promptly and faithfully perform the covenants, conditions and agreements in the Contract during the original term and any extensions thereof as may be granted by WETA, with or without notice to Surety, and during the period of any guarantees or warranties required under the Contract, and shall also promptly and faithfully perform all the covenants, conditions, and agreements of any alteration of the Contract made as therein provided, notice of which alterations to Surety being hereby waived, on Principal’s part to be kept and performed at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify, defend, protect, and hold harmless WETA as stipulated in the Contract, then this obligation shall become and be null and void; otherwise it shall be and remain in full force and effect. No extension of time, change, alteration, modification, or addition to the Contract, or of the Work required thereunder, shall release or exonerate Surety on this bond or in any way affect the obligation of this bond; and Surety does hereby waive notice of any such extension of time, change, alteration, modification, or addition. Whenever Principal shall be and declared by WETA to be in default under the Contract, Surety shall promptly remedy the default, or shall promptly do one of the following at WETA’s election: 1. Undertake through its agents or independent Contractors, reasonably acceptable to WETA, to complete the Contract in accordance with its terms and conditions and to pay and perform all obligations of Principal under the Contract, including without limitation, all obligations with respect to warranties, guarantees, and the payment of Liquidated Damages. 2. Reimburse WETA for all costs WETA incurs in completing the Contract, and in correcting, repairing or replacing any defects in materials or workmanship and/or materials and workmanship which do not conform to the specifications in the Contract. Surety’s obligations hereunder are independent of the obligations of any other surety for the performance of the Contract, and suit may be brought against Surety and such other sureties, jointly and severally, or against any one or more of them, or against less than all of them without impairing WETA’s rights against the others. No right of action shall accrue on this bond to or for the use of any person or corporation other than WETA or its successors or assigns.

WETA Richmond Ferry Terminal Performance Bond Addendum #1: February 23, 2017 Form Q-3 Page 2 of 2

In the event suit is brought upon this bond by WETA, Surety shall pay reasonable attorney’s fees and costs incurred by WETA in such suit. IN WITNESS WHEREOF, the above-bound parties have executed this instrument under their seals this _______ day of __________________, 20______, the name and corporate seal of each corporate party being hereto affixed and these presents duly executed by its undersigned representative, pursuant to authority of its governing body. Note: To be executed by Principal and Surety with acknowledgment and notarial seal attached.

(Principal) By By (Surety) (Address) By By

WETA Richmond Ferry Terminal Reference Form Addendum #1: February 23, 2017 Form R – Page 1 of 3

FORM R REFERENCE FORM

After completing this cover sheet, send this sheet with the attached form to your references. Your reference should then complete the attached form and mail the completed form and this cover sheet to WETA using the address provided below. Pursuant to Appendix C of the Instructions to Offerors, reference sheets should be sent to five organizations for each Major Participant, Offerors shall submit, with their Technical Proposals, a copy of the first page of all reference forms sent on behalf of Offeror and its Other Major Participants.

Prospective Design Build Contractor (Offeror) or Other Major Participant completes this section:

Offeror or Other Major Participant:

Project Information Project Name: Project Location: _____________________________ Dates: _____________ to Project Scope & Value: Owner/Reference Information Organization: Point of Contact Name: _________________________________ Position: (Street Address) (City, State, Zip) Phone: (____) _______ - __________ Fax: (____) ________ - __________ e-mail: I hereby authorize the above named person and organization to answer the following questions and to release any pertinent information relative to our performance on the referenced project. Furthermore, I hereby release them from any and all liability of any type for providing this information. (Authorized representative’s Signature) (Date)

PRINT Name (First & Last)

Reference The above named contractor has listed your company as one of their past clients. We would appreciate it if you would answer the questions on the attached sheet with reference to their work for you. Please note that this applicant has signed a waiver authorizing you and your company to provide this information to us, and releasing you and your company from "any and all liability of any type as a result of providing this information." Please mail the completed form and this cover sheet to: Chad Mason

San Francisco Bay Area Water Emergency Transit Authority Pier 9, Suite 111, The Embarcadero San Francisco, CA 94111

WETA Richmond Ferry Terminal Reference Form Addendum #1: February 23, 2017 Form R – Page 2 of 3

Reference for Prospective Design Build Contractor (Offeror) or Other Major Participant: ________________________________________________________

(Printed name of Prospective Design-Build Contractor(Offeror) for which reference is provided) Are the project Name, Scope and Dates provided on the cover sheet accurate. Yes No If not, please provide the correct information Project Name: Project Scope & Value: Approximate dates of the contractor’s performance: From ____________________ To ____________________ Would you want to use this contractor again if given the opportunity? Yes No Please circle the appropriate completion to the following

On the provided 1 to 10 scale, this contractor’s ______

Was Completely Unsatisfactory

Met Expectations

Far Exceeded Expectations

1 Overall performance 1 2 3 4 5 6 7 8 9 10 2 Ability to meet schedule requirements 1 2 3 4 5 6 7 8 9 10 3 Ability to meet cost requirements 1 2 3 4 5 6 7 8 9 10

4 Attitude toward safety 1 2 3 4 5 6 7 8 9 10 5 Communication of progress 1 2 3 4 5 6 7 8 9 10 6 Communication of problems and issues 1 2 3 4 5 6 7 8 9 10 7 Collaboration to resolve change orders, claims, issues

and other problems 1 2 3 4 5 6 7 8 9 10

8 Attitude toward public and regulatory agency concerns and questions

1 2 3 4 5 6 7 8 9 10

9 Performance during project close out 1 2 3 4 5 6 7 8 9 10 10 Management of Subcontractors 1 2 3 4 5 6 7 8 9 10 11 Ability to prevent impacts on adjacent areas 1 2 3 4 5 6 7 8 9 10 12 Technical competence 1 2 3 4 5 6 7 8 9 10

Additional comments:

Reference Form Completed By: (Print Name) Contact phone number Date

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