stony road bridge (br 350-01) & culvert (cin … · nysdot pin 5759.95 erie county, new york....

ERIE COUNTY

BID SUBMITTAL

STONY ROAD BRIDGE (BR 350-01) & CULVERT (CIN 350-03) REPLACEMENT

TOWN OF LANCASTER

PROJECT NUMBER: FA-5759.95-17

NYSDOT PIN 5759.95

ERIE COUNTY, NEW YORK

SI 3

d) REVIEW THE SITE

The Contractor is advised to make a site visit prior to the bid to become familiar with the scope of work and component quantities required to complete the work. The Contractor acknowledges that he/she has satisfied himself/herself as to the nature and location of the work, the general and local conditions, particularly those bearing on transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties involving weather, groundwater table or similar physical conditions at the site, the formation and condition of the ground, the character, quality and quantity of surface and subsurface materials to be encountered, the character of equipment and facilities needed prior to and during the prosecution of the work and all other matters which can in any way affect the work or the cost thereof under this Contract. Any failure by the Contractor to acquaint himself/herself with all of the available information concerning these conditions will not relieve him/her of the responsibility for estimating properly the difficulty or cost of successfully performing the work.

The Contractor’s attention is drawn to the following items:

e) BID SUBMITTAL ITEMS: The Contractor is hereby notified that the following items SHALL be submitted with his/her bid otherwise the bid SHALL NOT be considered:

REQUIRED FOR ALL PROJECTS:

o Certified Check for the bid deposit required. Attach to inside of front cover.

o Completed Experience Questionnaire (Q 1 through Q 5).

o Project Construction Schedule, with description of tasks as detailed on SI 8, SI 9, SI 17 AND SI 18. Attach to inside of back cover.

o Identify the proposed Project Superintendent on the Project Schedule.

o Completed Form DA 1, Acknowledgement of Drug and Alcohol Testing

Program Compliance.

o Completed Itemized Proposal Including: Fill in IP Pages IP 1 through IP 11. Execute the proposal by signing on IP 14 and completing IP 15.

o Completed Apprenticeship Training Program Form ATP 1.

o Completed Pay Equity Certification Form PEC 1.

SI 4

DOES NOT APPLY TO LAFA PROJECTS:

o Supply Minority Business Enterprise forms as required on SI 2 and SI 20 through SI 24 and MBE 1-7, as applicable. The Contractor shall submit Part A of the Erie County Minority/Women Business Enterprise Utilization Report with the bid. CONTRACTOR’S BID SHALL NOT BE CONSIDERED WHERE A CONTRACTOR FAILS TO COMPLY WITH THIS REQUIREMENT.

REQUIRED FOR LAFA PROJECTS, ONLY:

o Completed LAFA Disclosure of Lobbying Activities, included in LAFA

Contract Forms section of this document.

o Completed LAFA Non-collusive Bidding Certification, included in LAFA Contract Forms section of this document.

f) SPECIAL NOTES:

APPLIES TO ALL PROJECTS-

1) The Contractor is advised to make a site visit prior to the bid to familiarize himself with the scope of work and component quantities required to complete the work.

2) The Contractor shall give particular attention and care to protect from

damage all existing vegetation, including turf, trees, ornamental plantings, etc. which is not within the actual construction limits. Every attempt shall be made to protect and save the vegetation that is near construction limits according to the instructions of the Engineer.

3) In addition to requirements and/or explanations contained in the NYSDOT

Standard Specifications, the Contractor is advised of the following: The Contractor shall satisfy himself/herself as to the exact location of

utility lines and shall protect and support in a suitable manner all utilities encountered during the proposed work. The Contractor shall make good any damage to those utilities caused by his/her operations. If the nature of the damage is such as to endanger the satisfactory operations of the utilities, and the necessary repairs are not immediately made by the Contractor, the work may be done by the respective owning companies and the cost thereof charged against the Contractor.

The Contractor shall notify Dig Safely New York at 1-800-962-7962, two days before any underground work is initiated.

4) The Contractor is to note that NO estimate will be processed without the

following, submitted with, or prior to, the estimate for payment:

ITEMIZED PROPOSAL

ITEM APPROXNUMBER QUANTITY DOLLARS CENTS DOLLARS CENTS

201.07 0.23

FOR:

Per ACRE

202.120001 1

FOR:

Per LS

202.19 43

FOR:

Per CY

203.02 390

FOR:

Per CY

203.03 250

FOR:

Per CY

203.07 20

FOR:

Per CY

203.21 690

FOR:

Per CY

203.24010017 21

FOR:

Per TON

IP 1

WRITTEN IN WORDS

Clearing and Grubbing

Removing Existing Superstructures

Removal of Substructures (Center Pier Only)

Unclassified Excavation and Disposal

Select Structural Fill

STONY ROAD BRIDGE AND CULVERT REPLACEMENT

UNIT BID PRICE AMOUNT BID

Embankment in Place


Shoulder Backup Material

ERIE COUNTY DEPARTMENT OF PUBLIC WORKS

P.I.N. 5759.95

BID SUMMARY FORM

ITEMS WITH UNIT BID PRICE

Select Granular Fill (36" Pipe)

ITEM APPROXNUMBER QUANTITY DOLLARS CENTS DOLLARS CENTSWRITTEN IN WORDS





P.I.N. 5759.95

BID SUMMARY FORM


204.01 53

FOR:

Per CY

206.01 2,060

FOR:

Per CY

206.0201 180

FOR:

Per CY

206.05 7

FOR:

Per EA

207.20 600

FOR:

Per SY

207.26 273

FOR:

Per SY

209.13 1000

FOR:

Per LF

304.12 551

FOR:

Per CY

IP 2

Geotextile Bedding

Test Pit Excavation

Prefabricated Composite Structural Drain

Controlled Low Strength Material (CLSM)

Structure Excavation

Trench and Culvert Excavation

Subbase Course, Type 2

Silt Fence, Temporary






P.I.N. 5759.95

BID SUMMARY FORM


402.098203 180

FOR:

Per TON

402.018903 55

FOR:

Per TON

402.198903 188

FOR:

Per TON

402.378903 265

FOR:

Per TON

407.0102 325

FOR:

Per GAL

490.30 350

FOR:

Per SY

551.014073 654

FOR:

Per LF

551.014117 567

FOR:

Per LF

IP 3

True & Leveling F9, Superpave HMA, 80 Series Compaction

19 F9 Binder Course HMA, 80 Series Compaction

37.5 F9 Base Course HMA, 80 Series Compaction

Miscellaneous Cold Milling of Bituminous Concrete

Steel H-Piles (HP 14x73)

Steel H-Piles (HP 14x117)

Diluted Tack Coat

9.5 F2 Top Course HMA, 80 Series Compaction






P.I.N. 5759.95

BID SUMMARY FORM


551.13 1

FOR:

Per LS

552.13 1296

FOR:

Per SF

553.020001 1

FOR:

Per EA

553.020002 1

FOR:

Per EA

553.030001 1

FOR:

Per EA

555.0105 2.6

FOR:

Per CY

555.09 250

FOR:

Per CY

556.0203 66,250

FOR:

Per LB

IP 4

Concrete for Structures, Class HP [Substitute Class A or Class H]

Galvanized Bar Reinforcement for Structures

Temporary Steel Sheeting

Cofferdam (Type 2) - South Abutment

Cofferdam (Type 2) - North Abutment

Concrete for Structures, Class A (Culvert Headwall)

Temporary Waterway Diversion Structure (Culvert)

Furnishing Equipment for Driving Piles






P.I.N. 5759.95

BID SUMMARY FORM


556.03 2,010

FOR:

Per EA

557.0109 492

FOR:

Per SY

557.2009 163.2

FOR:

Per SY

558.02 583

FOR:

Per SY

559.16960118 2,100

FOR:

Per SF

559.18960118 6,550

FOR:

Per SF

562.03 52.8

FOR:

Per SY

564.0501 1

FOR:

Per LS

IP 5

Wingwall with Footing

Structural Steel, Type 1 (Plate Girders)

Superstructure Slab w/Integral Wearing Surface (Bottom Formwork Required) - Type 9 Friction

Structural Approach Slab w/ Integral Wearing Surface - Type 9 Friction

Longitudinal Sawcut Grooving of Structural Slab Surface

Protective Sealing of Structural Concrete On New Bridge Decks and Bridge Deck Overlays

Stud Shear Connectors for Bridges

Protective Sealing of Structural Concrete






P.I.N. 5759.95

BID SUMMARY FORM


564.0502 1

FOR:

Per LS

568.51 251

FOR:

Per LF

568.54 44

FOR:

Per LF

568.70 256

FOR:

Per LF

572.010001 7300

FOR:

Per SF

580.01 26

FOR:

Per CY

595.50000018 1251

FOR:

Per SF

603.171912 2

FOR:

Per EACH

IP 6

Steel Bridge Railing (Four-Rail)

Steel Bridge Railing (Three-Rail)

Galvanized Steel End Section - Pipe 42" Diameter, 12 Gauge

Structural Steel Paint System: Shop Applied

Removal of Structural Concrete (Backwall, Pylon & Cheekwall Removal)

Structural Steel, Type 2 (Bridge Bearing Assemblies)

Transition Bridge Railing

Sheet Applied Waterproofing Membrane






P.I.N. 5759.95

BID SUMMARY FORM


603.9836 56

FOR:

Per LF

603.63180815 37.4

FOR:

Per LF

605.0901 70

FOR:

Per CY

605.1001 45

FOR:

Per CY

605.1701 630

FOR:

Per LF

606.10 57

FOR:

Per LF

606.100002 201

FOR:

Per LF

606.120101 5

FOR:

Per EA

IP 7

Underdrain Filter Type 2

Optional Underdrain Pipe, 4 inch diameter

Smooth Int. Corr. Polyethylene Culvert & Storm Drain Pipe, 36"

Precast Concrete Box Culvert (18' x 7.5') (Fill Height < 2'-0")

Underdrain Filter Type 1

Box Beam End Piece

Box Beam Guide Railing

Box Beam Guide Railing (Shop Bent or Shop Mitered)






P.I.N. 5759.95

BID SUMMARY FORM


606.120201 3

FOR:

Per EA

606.71 144

FOR:

Per LF

606.7910 4

FOR:

Per EA

608.020102 31

FOR:

Per TON

610.1402 140

FOR:

Per CY

610.1601 1,230

FOR:

Per SY

619.01 1

FOR:

Per LS

619.04 48

FOR:

Per EA

IP 8

Hot Mix Asphalt (HMA) Sidewalks, Driveways, Bicycle Paths & Vegetation Control Strips

Box Beam Guide Railing Assembly Type IIA

Removing & Disposing of Corrugated Beam Guide Railing

Removing & Disposing Anchorage Units for Corrugated Beam Guide Railing & Median Barrier

Topsoil - Roadside

Turf Establishment - Roadside

Type III Construction Barricades

Basic Work Zone Traffic Control






P.I.N. 5759.95

BID SUMMARY FORM


619.111211 4

FOR:

Per CW

619.1702 128

FOR:

Per LF

619.27 7

FOR:

Per EA

620.04 180

FOR:

Per CY

623.12 80

FOR:

Per CY

625.01 1

FOR:

Per LS

627.50140008 990

FOR:

Per LF

IP 9

Portable, Variable Message Sign (PVMS) Standard Size-Line or Char Matrix (LED)

Temporary Concrete Barrier (Unpinned) with Warning Lights

Mailboxes

Stone Filling (Medium)

Crushed Stone (In-Place Measure)

Survey Operations

Cutting Pavement






P.I.N. 5759.95

BID SUMMARY FORM


637.11 15

FOR:

Per MO

646.22 8

FOR:

Per EA

646.31 8

FOR:

Per EA

663.34 1

FOR:

Per EA

685.11 1,350

FOR:

Per LF

685.12 1,350

FOR:

Per LF

697.03 65,000

FOR: One Dollar and Zero Cents $1 00 $65,000 00

Per DC

698.06 100

FOR: One Dollar and Zero Cents $1 00 $100 00

Per DC

Field Change Payment (FCP)

IP 10

Adjust Existing Hydrant Elevation

White Epoxy Reflectorized Pavement Stripes - 20 Mils

Yellow Epoxy Reflectorized Pavement Stripes - 20 Mils

Steel/Iron Price Adjustment

Engineer's Field Office - Type 1

Delineator, Snowplowing Marker, Suppl. Snowplow Marker Panels

Steel Post, 1.1 lb/ft






P.I.N. 5759.95

BID SUMMARY FORM


SUBTOTAL BID IN NUMBERS

699.04 NEC

FOR:

Per LS

TOTAL OR GROSS SUM WRITTEN IN WORDS TOTAL BID IN NUMBERS

_________________________________________________________________________________________________

_________________________________________________________________________________________________ $_________________________

$_____________________________

IP 11

NOTES:1. Please ensure a bid is entered for each item.2. In the event that there is a discrepancy within the bid schedule, the written words will be the accepted value.

PLEASE BE SURE A BID IS ENTERED FOR EACH ITEM

MOBILIZATION (4% MAX) MUST NOT EXCEED 4% OF SUBTOTAL SHOWN ABOVE

IP 12

To the Commissioner of Public Works, Erie County, New York In submitting this bid the undersigned declares that he is or they are the only person or persons interested in the said bid; that it is made without any connection with any person making another bid for the same contract, that the bid is in all respects fair and without collusion, fraud or mental reservation; and that no official of the County, or any person in the employ of the County is directly or indirectly interested in said bid or in the supplies or work to which it relates, or in any portion of the profits thereof. The undersigned also, hereby declares that he has or they have carefully examined the plans, specifications and form of contract, and that he has or they have personally inspected the actual location of the work together with the local sources of supply, has or have satisfied himself or themselves as to all the quantities and conditions, and understand that in signing this proposal he or they waive all right to plead any misunderstanding regarding the same. The undersigned further understands and agrees that he is or they are to furnish and provide for the respective item price bid all the necessary material, machinery, implements, tools, labor, services, and other items of whatever nature, and to do and perform all the work necessary under the aforesaid conditions to complete the improvement of the aforementioned highway in accordance with the plans and specifications for said improvement, which plans and specifications it is agreed are a part of this proposal, and to accept in full compensation therefore the amount of the summation of the products of the approximate quantities multiplied by the unit prices bid. This summation will hereinafter be referred to as the gross sum bid. The undersigned further agrees to accept the aforesaid "unit bid" prices as compensation for any additions or deductions caused by variation in quantities due to more accurate measurement, or by any changes or alterations in the plans or specifications of the work, and for use in the computation of the value of the work performed for monthly estimates. The undersigned further agrees that at any time during the progress of work the County adds, alters or omits portions of the work he shall so perform such work and accept compensation in accordance with the Standard Specifications. Accompanying this proposal in cash, a draft or certified check for $ 100,000.00. In case this proposal shall be accepted by the County of Erie, New York, and the undersigned shall fail to execute the contract and in all respects comply with the provisions of Section 38 of the Highway Law, as amended, the monies represented by such cash, draft or certified check shall be regarded as liquidated damages and shall be forfeited and become the property of the County of Erie, otherwise to be returned to the depositor in accordance with the provisions of said Section 38 of the Highway Law, as amended. On acceptance of this proposal for said work the undersigned does or do hereby bind himself or themselves to enter into written contract within ten days of date of notice of award, with the said County of Erie and to comply in all respects with Subdivision 6 of Section 38 of the Highway Law, as amended, in relation to security for the faithful performance of the terms of said contract.

IP 13

NON-COLLUSIVE BIDDING CERTIFICATION (REQUIRED BY SECTION 103-d OF THE GENERAL MUNICIPAL LAW) Section 103-d "Statement of non-collusion of bids and proposals to political subdivision of the state. 1. Every bid or proposal hereafter made to a subdivision of the state or any public department, agency or

official thereof where competitive bidding is required by statute, rule or regulation or local law, for work or services performed or to be performed or goods sold or to be sold, shall contain the following statement subscribed by the bidder and affirmed by such bidder as true under the penalties of perjury: Non-collusive bidding certification.

a. By submission of this bid, each bidder and each person signing on behalf of any bidder certifies

and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of his knowledge and belief:

1) The prices in this bid have been arrived at independently without collusion, consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor; 2) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, directly or indirectly, to any other bidder or to any competitor; and

3) No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit or not to submit a bid for the purposes of restricting competition. b. A bid shall not be considered for award nor shall any award be made where "a" (1) (2) and (3)

above have not been complied with; provided however, that if in any case the bidder cannot make the foregoing certification, the bidder shall so state and shall furnish with the bid a signed statement which sets forth in detail the reasons therefore. Where "a" (1) (2) and (3) above have not been complied with, the bid shall not be considered for award nor shall any award be made unless the head of the purchasing unit of the political subdivision, public department, agency or official thereof to which the bid is made, or his designee determines that such disclosure was not made for the purpose of restricting competition.

The fact that a bidder (a) has published price lists, rates or tariffs covering items being

procured, (b) has informed prospective customers of proposed or pending publication of new or revised price lists for such items, or (c) has sold the same items to other customers at the same prices being bid, does not constitute, without more, a disclosure within the meaning of subparagraph one "a".

2. Any bid hereafter made to any political subdivision of the state or any public department, agency, or

official thereof by a corporate bidder for work or services performed or to be performed or goods sold or to be sold, where competitive bidding is required by statute, rule or regulation, and where such bid contains the certification referred to in subdivision one of this section, shall be deemed to have been authorized by the board of directors of the bidder and such authorization shall be deemed to include the signing and submission of the bid and the inclusion therein of the certificate as to non-collusion as the act and deed of the corporation."

IP 14

BY EXECUTING THIS PROPOSAL, THE CONTRACTOR AGREES TO: 1) perform all work listed in accordance with the Contract Documents at the unit prices bid; 2) all non-collusive bidding certifications required by Section 103-d of the General Municipal Law; 3) the affirmation of the Minority Business Enterprises Bidder's Certification; 4) certification of Specialty Items category selected, if contained in this proposal; 5) certification of any other clauses required by this proposal and contained herein. Date 20_____ ________________________________

Legal Name of Individual, Partnership, or Corporation By:_____________________________

Signature and Title

IP 15

Please Complete Information Requested Below The address of the bidder is: Street City and State Telephone/Fax E-mail Federal Employer Tax I.D. Number IF A CORPORATION Name Address President Secretary Treasurer IF A PARTNERSHIP Name Address

EXPERIENCE QUESTIONNAIRE

Q 1

EXPERIENCE QUESTIONNAIRE Attach Additional Sheets as Necessary

Submitted by, Name: _______________________________________________ a(n): Corporation Co-Partnership Individual Joint Venture Principal Office Address: ______________________________________________ Telephone # FAX # ______________E-MAIL_________________ The Signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatories hereinafter made. 1) How many years has your organization been in business as a general contractor under your present

business name? 2) How many years experience in ______________construction work has your organization had: a) As a General Contractor b) As a Sub-Contractor 3) What projects has your organization completed in the last 5 years Contract Class of Date Name and Address Amount Work Completed of Owner 4) List the Names and Addresses of Officers and/or Partners of the organization: 5) Have you ever failed to complete any work awarded to you? If so, provide the name of the project, the

date of the project, if the failure was as a subcontractor, the name of the prime contractor and the reasons for the failure to complete the work?

Q 2

6) Has any Officer or Partner of your organization ever been an Officer or Partner of some other

organization that failed to complete a construction contract? If so, state the name of individual, other organization and reason therefore.

7) Has this organization or any of its directors, officers, partners or owners:

a) Been convicted of any business related conduct constituting a crime under State or Federal law? If yes, provide dates and details.

b) Been debarred, suspended or in any way prohibited from bidding on government contracts? If yes, provide dates and details.

c) Had any of its bids rejected on the grounds that they were not a responsible bidder? If yes, provides dates and details.

d) Been determined to be in violation of any State or Federal Labor Law or regulation, including OSHA violations? If yes, provide dates and details.

e) Had its DBE, MBE, or WBE certification revoked? If yes, provide dates and details.

f) Had a bid rejected on any competitively bid contract for failure to meet statutory affirmative action, MBE or WBE requirements? If yes, provide dates and details.

g) Been determined to be in violation of Federal or State environmental laws in conjunction with any construction project? If yes, provide dates and details.

8) Has any officer or partner of your organization ever failed to complete a construction contract in his

own name? If so, state name of individual, name of owner and reason therefore.

Q 3

9) Does your firm have a financial interest in any other business? If yes, state the firm's name and address. 10) List those projects upon which your firm will be actively engaged at the time bids are received for this

project. Please provide the name and address of the Owner, the Architect/Engineer, the approximate contract amount and the approximate percentage of completion of your firm's work (as of the date of this project Bid Opening):

Name and Address Contract Percent of of Owner Amount Work Completed 11) List equipment and describe facilities which your firm has now or will have available to begin and

complete the work to be performed under the Contract. 12) What proportion of the work will be performed by your firm with your own force? 13) In the last five years have liquidated damages, penalties, liens, defaults or cancellations been imposed

or filed against your firm on any project? If so, please list those projects. 14) Within the last two years, has your firm been the lowest bidder in competitive bidding and not been

awarded the contract? If so, list project name and give reasons why contract was not awarded to you. 15) Within the past five years, have there been any contracts performed by your firm on which the final

payment was the subject of litigation? If so, please list names of projects involved.

Q 4

16) List Corporations or Individuals for whom your firm has performed work and the person who should be

contacted for references. 17) List Municipalities for whom your firm has performed work and the person who should be contacted

for references. 18) List Counties for whom your firm has performed work and the person who should be contacted for

references. 19) List State Bureaus or Departments for whom your firm has performed work and the person who should

be contacted for references. 20) Has your firm performed work for the Federal Government? If so, please list the projects and the person

who should be contacted for references. 21) What is the construction experience of all principal individuals of your firm? Please include: the

principal's name, current position in the firm, number of years of actual construction experience, type and magnitude of work.

22) Has your firm filed performance record reports with the Bureau of Contract Information, Inc.,

Washington, D.C.?

Q 5

23) Is any principal of the firm or any member of his immediate family employed by the County of Erie? If yes, what Department?__________________________________________ Name of County Employee ________________________________________ 24) The above information and such other information as the Owner may request or obtain will be used by

the Owner in determining the reliability and responsibility of the bidder. Dated at this day of 20 . ___________________________________________ Name of Organization

By: ______________________________________ Signature and Title of Person Signing

State of County of being duly sworn deposes and says that he/she is of _________________________________ Name of Organization and that answers to the foregoing questions and all statements therein contained are true and correct. Sworn to me before this day of 20_________ ___________________________________________ Notary Public My commission expires______________________________

DRUG AND ALCOHOL TESTING PROGRAM COMPLIANCE

DA 1

9/1/98[paymtcer]

ACKNOWLEDGMENT OF DRUG AND ALCOHOL TESTING PROGRAM COMPLIANCE

hereby acknowledges that a drug and alcohol (PRINT OR TYPE COMPANY NAME)

program which is required by Federal Department of Transportation rules (CFR, Title 49, Part 40 and 382), has been implemented by this Company. The program is administered by: Please select one ( ) The Company itself - The program administrator is: Company Administrator's Name and Telephone Number ( ) Third-Party Administrator - The program administrator is: Third-Party Administrator's Name Address Point of Contact/Telephone Number Company Official's Name Signature Date (NOTARY SEAL/STAMP) 1997(drug.frm)

LOCAL LAW 2-2006

APPRENTICESHIP TRAINING PROGRAM FORM

ATP 1

NEW YORK STATE CERTIFIED APPRENTICESHIP

TRAINING PROGRAM CERTIFICATION

Pursuant to Erie County Local Law 2-2006 the following MUST be submitted along with supporting documentation unless the Contracting Agency has otherwise determined under Section 2f of the Erie County Rules and Regulations that the New York State Certified Apprenticeship Training Program does not apply.

TO BE FILLED OUT BY BIDDER: please check that which applies and sign below

[ ] Enclosed is a copy of the certification of approval of the New York State Certified Apprenticeship Training Program (NYSCATP) by the New York State Department of Labor which, as Bidder, will use in connection with the construction contract. Also enclosed is a written plan demonstrating how apprentices will be utilized by the Bidder as Prime Contractor or by the Subcontractor(s) to the Bidder as Prime Contractor. Such plan shall include at a minimum:

i. An organized written plan in place that embodies the terms and conditions of employment, training and supervision of one or more apprentices;

ii. A schedule of wages to be paid to the apprentices consistent with the skills required and approved by the New York State Department of Labor;

iii. Equal employment and affirmative action plans; and iv. Demonstration that ten percent (10%) of the Workforce of the Prime

Contractor (inclusive of the workforce utilized by any Subcontractor(s) to the Bidder) shall consist of persons participating in NYSCATP.

[ ] Enclosed is a detailed explanatory written statement as to the inapplicability of apprenticeship participation due to: The lack of career opportunities in NYSCATP approved by New York State Department of Labor Commissioner; OR the magnitude of the construction contract which would make use of apprentices impracticable. ____________________ ____________________ ____________________ SIGNATURE COMPANY NAME DATE

ERIE COUNTY PAY EQUITY

PEC 1

Erie County Pay Equity Certification

In order to comply with Executive Order 13 dated November 6, 2014, we hereby certify that we are in compliance with federal law, including the Equal Pay Act of 1963, Title VII of the Civil Rights Act of 1964, Federal Executive Order 11246 of September 24, 1965 and New York State Labor Law Section 194 (together “Equal Pay Law”). The average compensation for female employees is not consistently below the average compensation for male employees, taking into account mitigating factors. We understand that this certification is a material component of this contract. Violation of the provisions of Executive Order 13, which is attached hereto and made a part hereof, can constitute grounds for the immediate termination of this contract and may constitute grounds for determining that a bidder is not qualified to participate in future county contracts. We have evaluated wages and benefits to ensure compliance with the Federal Equal Pay Law. ______________________________________

Signature

Verification STATE OF _______________ ) COUNTY OF _____________ ) SS: A) ___________________________________________, being duly sworn, states he or she is the owner of (or a partner in) ________________________________________, and is making the foregoing Certification and that the statements and representations made in the Certification are true to his or her own knowledge. B) _______________________________________, being duly sworn, states that he or she is the Name of Corporate Officer _______________________________________, of _________________________________, Title of Corporate Officer Name of Corporation the enterprise making the foregoing Certification, that he or she has read the Certification and knows its contents, that the statements and representations made in the Certification are true to his or her own knowledge, and that the Certification is made at the direction of the Board of Directors of the Corporation. Sworn to before me this ______ Day of ______________, 20__ __________________________

LOCALLY ADMINISTERED FEDERAL AID

CONTRACT FORMS

FA 1

DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See

reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial filing

b. grant c. cooperative agreement d. loan

b. initial award c. post-award

b. material change For Material Change Only:

year quarter

e. loan guarantee date of last report f. loan insurance

4. Name and Address of Reporting Entity: Prime Subawardee

Tier , if known:

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

Congressional District, if known: 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, Ml):

Information requested through this form is authorized by title 31 U.S.C. section 11. 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 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)

FA 2

REQUIREMENTS REGARDING LOBBYING ACTIVITIES ON FEDERAL AID CONTRACTS DISCLOSURE OF LOBBYING ACTIVITIES Approved by

OMB Continuation Sheet 0348-0046 Reporting Entity: Page Of Authorized for Local Reproduction - Standard Form LLL

FA 3

THE FOLLOWING PAGES ARE THE REQUIRED CERTIFICATION REGARDING NON-COLLUSIVE BIDDING PROCEDURES AND THE CONTRACTOR'S ELIGIBILITY TO SUBMIT A BID UNDER FEDERAL LAW. THE LAST PAGE IS A GENERAL BIDDER INFORMATION FORM. ALL SHOULD BE INCLUDED IN THE CONTRACT DOCUMENTS, IMMEDIATELY FOLLOWING THE PAGE(S) WHICH CONTAINS THE NON-COLLUSIVE BIDDING REQUIREMENTS. BY SIGNING ONE OF THESE CERTIFICATIONS, THE CONTRACTOR CERTIFIES THAT HE UNDERSTANDS AND AGREES TO BE BOUND BY THE PROVISIONS OF THE FOLLOWING LAWS: 1. NEW YORK STATE FINANCE LAW, ARTICLE 9, SECTION 139-d 2. TITLE 49, CFR, PART 29 3. TITLE 23, U. S. CODE-HIGHWAYS, SECTION 112 THE CONTRACTOR SHOULD CHOOSE THE APPROPRIATE NOTARIZATION WHICH CORRESPONDS TO THE TYPE OF COMPANY (SOLE PROPRIETORSHIP, PARTNERSHIP, OR CORPORATION) THAT HE/SHE REPRESENTS OR IS AFFILIATED WITH. ALL BIDDERS SHOULD FILL OUT THE APPROPRIATE SECTION OF THE BIDDER INFORMATION SHEET. BY EXECUTING THIS DOCUMENT, THE CONTRACTOR AGREES TO: 1. Perform all work listed in accordance with the Contract Documents at the unit prices bid; subject to the provisions of Section 104 -04, Standard Specifications, Construction and Materials, published by the New York State Department of Transportation, and dated May 4, 2006, if applicable; 2. All the terms and conditions of the non-collusive bidding certifications required by Section 139-d of the State Finance Law, and Section 112, Title 23, U.S. Code; 3. Certification of Specialty Items category selected, if contained in this proposal; 4. Certification of any other clauses required by this proposal and contained herein; 5. Certification, under penalty of perjury, as to the current history regarding suspensions, debarments, voluntary exclusions, determinations of ineligibility, indictments, convictions, or civil judgments required by 49 CFR Part 29.

FA 4

Date: (Legal Name of Person, Corporation, or Firm Which is Submitting Bid or Proposal) BY: ______________________________________ (Signature of Person Representing Above) AS: ______________________________________ (Official Title of Signator in Above Firm) (Acknowledgment by Individual Contractor, If a Corporation) STATE OF NEW YORK ) ) SS: COUNTY OF ) On this ________________day of ________________ , 20____, before me personally came

_______________________________ , to me known and known to me to be the person who

executed the above instrument, who being duly sworn by me, did depose and say that he/she

resides at _________________________________________________________

_______________________________________________________________________, and

that he/she is the __________________________________ of the corporation described herein

and which executed the above instrument, and that he/she signed his/her name thereto on

behalf of said Corporation by order of the Board of Directors of said Corporation.

Notary Public

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(Acknowledgment by Co-Partnership Contractor) STATE OF NEW YORK ) ) SS: COUNTY OF ) On this ___________________ day of _________________________, 20______, before

me personally came __________________________________________, to me known and

known to me to be the person described herein and who executed the above instrument, who,

being duly sworn by me, did for himself/herself depose and say that he/she is a member of the

firm of ________________________________, consisting of himself/ herself and

_______________________________, and that he/she executed the foregoing instrument in

the firm name of ________________________________________________, and that

he/she had authority to sign same, and did duly acknowledge to me that he/she executed same

as the act and deed of said firm of _________________________________________, for the

uses and purposes mentioned herein.

______________________________ Notary Public

FA 6

(Acknowledgment by Individual Contractor) STATE OF NEW YORK ) ) SS: COUNTY OF ) On this ______________________________ day of __________________, 20_______, before me personally came ___________________________________, to me known and known to me to be described in and who executed the foregoing instrument, and that he/she acknowledged that he/she executed the same. ______________________________ Notary Public

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NON-COLLUSIVE BIDDING CERTIFICATION BIDDER INFORMATION Bidder to provide information listed below: Bidder Address: _____________________________________ Street or P. O. Box No. _____________________________________ City _____________________________________ State ZIP Federal Identification No.: _____________________________ Name of Contact Person: ______________________________ Phone # of Contact Person: ____________________________ If Bidder is a Corporation: President's Name & Address: ______________________________________________________________________ Secretary's Name & Address: ______________________________________________________________________ Treasurer's Name & Address: ______________________________________________________________________ If Bidder is a Partnership: Partner's Name & Address: ________________________________________________________________________ Partner's Name & Address: ________________________________________________________________________ If Bidder is a Sole Proprietorship: Owner's Name & Address: ________________________________________________________________________