HomeMy WebLinkAbout211-11 RESOLUTIONRESOLUTION NO. 211-11
A RESOLUTION TO APPROVE A CONTRACT BETWEEN THE CITY OF
FAYETTEVILLE AND PICK -IT CONSTRUCTION, INC. IN THE AMOUNT
OF NOT -TO -EXCEED $112,353.00 FOR CONSTRUCTION OF DUGOUTS
AND BLEACHER COVERS AT WALKER PARK AND TO APPROVE A
BUDGET ADJUSTMENT OF $16,419.00
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves
the attached contract between the City of Fayetteville and Pick -It Construction, Inc in the amount
of not -to -exceed $112,353.00 for construction of dugouts and bleacher covers at Walker Park,
authorizes Mayor Jordan to sign this contract and approves a budget adjustment of$16,419.00.
PASSED and APPROVED this 6th day of December, 2011.
APPROVED:
By:
IO ELD ► AN, Mayor
ATTEST:
zh
By:
LISA BRANSON, Deputy City Clerk
,`�,,�sstrttrrrryr��
U ••A;
FAYETTEVILLE;
mss•
�R A 'J:
Byron Humphry
Submitted By
City of Fayetteville Staff Review Form
City Council Agenda Items
and
Contracts, Leases or Agreements
12/6/2011
City Council Meeting Date
Agenda Items Only
Park Maintenance
Division
Action Required:
Parks and Recreation
Department
resolution awarding Bid #11-67 and approval of a contract with Pick -jt Construction, Inc. in the amount of $102,139
with a 10% project contingency of $10,214 for a total project cost of $112,353 for the Construction of Dugouts and
Bleacher Covers at Walker Park and approval of a budget adjustment in the amount of $16,419 from Parks
Development Funds.
112,353.00
Cost of this request
2250.925.5315.00
Account Number
11024.1101
Project Number
Budgeted Item
116,419.00
Category / Project Budget
Contract Servs/Walker Park Baseball
Program Category / Project Name
4,066.00 Parks Development / Contract Srvs
Funds Used to Date Program / Project Category Name
112,353.00
Remaining Balance
Budget Adjustment Attached
Parks Development Capital
Fund Name
Department Dire
City Attorney
Date
Date
ri DJ'
Finane and Internal Services Director
Previous Ordinance or Resolution #
Original Contract Date:
Original Contract Number:
Received in C yt 1 B -1 1 P 0 3: 5 2 1 N
Clerk's Office ► i
Comments:
Revised January 15, 2009
v' a�efl�ville
THE CITY OF FAYETTEVILLE, ARKANSAS
DEPARTMENT CORRESPONDENCE
ARKANSAS
www.accessfayetteville.org
CITY COUNCIL AGENDA MEMO
To: Mayor Lioneld Jordan and City Council
Thru: Don Marr, Chief of Staff ,
Connie Edmonston, Parks and Recreation Director
From: Byron Humphry, Maintenance Superintendent
Date: November 18, 2011
Subject: Bid #11-67, Construction of Walker Park Dugouts and Bleacher Covers
Agenda Request for December 6, 2011 Meeting
PROPOSAL.:
The Fayetteville Youth Baseball Board of Directors has requested improvements to the Baseball Complex at
Walker Park for many years. The Baseball Complex was built by volunteers starting in 1960. It is an old facility
that needs improvements to serve the baseball community until the Regional Park's Baseball Complex is built.
On August 2, 2011, the City Council passed Resolution Number 132-11 to approve a budget adjustment in the
amount of $100,000 to be used to fund Walker Park Baseball Improvements. Parks and Recreation staff have
worked with Fayetteville Youth Baseball (FYBB) to develop a list of priority projects including construction of
new dugout areas with benches and the addition of bleacher safety/shade structures. These improvements will
help Fayetteville to attract more tournaments, but more importantly will serve youth ages 5 to 12 who love to
play the game of baseball. Currently there are 855 youth playing baseball at Walker Park. In addition, there are
11 competitive teams who utilize the fields. Improvements are planned to be completed by March 2012, in time
for the spring baseball season.
The project was advertised for bid on October 19 and 26, and bids were opened on November 4, 2011. Two
vendors including Pick -It Construction, Inc. and Heckathorn Construction Company, Inc. submitted bids. Pick -
It Construction, Inc. was the low bid in the amount of $ 111,054, after taking all deductive alternatives. (See
attached bid tabulation sheet.)
Because the low bid was $111,054 and only $95,000 was certified, Parks staff negotiated with Pick -It
Construction to change the scope of work in order to reduce the contract price. A change order in the amount
of $8,915 was agreed upon and is submitted in conjunction with this agreement. The contract price with
Change Order No. 1 will be $102,139.
If approved, the project is anticipated to begin in December 2011 and be completed by March 2012.
THE CITY OF FAYETTEVILLE, ARKANSAS
RECOMMENDATION:
A resolution awarding Bid #11-67 and approval of a contract with Pick -It Construction, Inc. in the amount of
$102,139 with a 10% project contingency of $10,214 for a total project cost of $112,353 for the Construction of
Dugouts and Bleacher Covers at Walker Park and approval of a budget adjustment in the amount of $16,419
from Parks Development Funds.
BUDGET.iMPACT:
This project is funded with Park Development Funds. Total project cost including a 10% project contingency is
$112,353.
Attachments:
Staff Review Form
Bid Tabulation Sheet
Pick -It Construction, Inc. Bid Submittal
Agreement Signed by Contractor
Purchase Requisition
Budget Adjustment
Pick -It Construction Change Order No. 1 Cost Estimate
Change Order No. 1
Qeo
r
ta-a1- #!
RESOLUTION NO.
A RESOLUTION TO APPROVE A CONTRACT BETWEEN THE CITY OF
FAYETTEVILLE AND PICK -IT CONSTRUCTION, INC. IN THE AMOUNT
OF NOT -TO -EXCEED $112,353.00 FOR CONSTRUCTION OF DUGOUTS
AND BLEACHER COVERS AT WALKER PARK AND TO APPROVE A
BUDGET ADJUSTMENT OF $16,419.00
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby
approves the attached contract between the City of Fayetteville and Pick -It Construction, Inc in
the amount of not -to -exceed $112,353.00 for construction of dugouts and bleacher covers at
Walker Park, authorizes Mayor Jordan to sign this contract and approves a budget adjustment of
$16,419.00.
PASSED and APPROVED this 6th day of December, 2011.
APPROVED: ATTEST:
By: By:
LIONELD JORDAN, Mayor SONDRA E. SMITH, City Clerk/Treasurer
City of Fayetteville
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Agreement — Between City of Fayetteville and Contractor
This agreement is dated as of the 4 day of Deektair in the year of 2011 by and between the City of
Fayetteville, Arkansas (hereinafter called CITY OF FAYETTEVILLE) and Pick -It Construction, Inc. (herein after called
CONTRACTOR). CITY OF FAYETTEVILLE and CONTRACTOR, in consideration of the mutual covenants
hereinafter set forth, agree as follows:
1. CONTRACTOR at its own cost and expense shall furnish all labor, materials, supplies, machinery, equipment,
tools, supervision, bonds, insurance, tax permits, and all other accessories and services necessary to complete
items bid per Bid 11-67 as stated in Pick -It Construction, Inc. bid proposal, and in accordance with specifications
attached hereto and made a part hereof under Bid 11-67, all included herein as if spelled out word for word.
2. The CITY OF FAYETTEVILLE shall pay CONTRACTOR based on their bid proposal in an amount not to
exceed $111,054.00 (bid price includes taking all three deductive alternates totaling $32,850.00). Payments will
be made after approval and acceptance of work and submission of invoice. Payments will be made approximately
30 days after receipt of invoice.
3. The Contract documents which comprise the contract between the CITY OF FAYETTEVILLE and
CONTRACTOR consist of this Contract and the following documents attached hereto, and made a part hereof:
A. Bid form identified as Invitation to Bid 11-67 with the specifications and conditions typed thereon.
B. CONTRACTOR's bid proposal.
C. The Notice to Prospective Bidders and the Bid Tabulation.
4. These Contract documents constitute the entire agreement between the CITY OF FAYETTEVILLE and
CONTRACTOR and may be modified only by a duly executed written instrument signed by the CITY OF
FAYETTEVILLE and CONTRACTOR.
5. CONTRACTOR shall not assign its duties under the terms of this agreement.
6. CONTRACTOR agrees to hold the CITY OF FAYETTEVILLE harmless and indemnify the CITY OF
FAYETTEVILLE, against any and all claims for property damage, personal injury or death, arising from
CONTRACTOR' s performance of this contract. This clause shall not in any form or manner be construed to
waive that tort immunity set forth under Arkansas Law.
7. Contract Time: The Work shall be substantially completed within 45 consecutive calendar days after the date
when the Contract Time commences to run and shall be completed and ready for final payment within 60
consecutive calendar days after the date when the Contract Time commences to run.
8. Liquidated Damages: CITY OF FAYETTEVILLE and CONTRACTOR recognize that time is of the essence of
the Agreement and that CITY OF FAYETTEVILLE will suffer financial loss if the Work is not completed within
the times specified in paragraph 7 above, plus and extensions thereof allowed in accordance with the General
Terms and Conditions. They also recognize the delays, expense and difficulties involved in proving the actual loss
suffered by CITY OF FAYETTEVILLE if the Work is not completed on time. Accordingly, instead of requiring
any such proof, CITY OF FAYETTEVILLE and CONTRACTOR agree that as liquidated damages for delay (but
not as a penalty) CONTRACTOR shall pay CITY OF FAYETTEVILLE Two hundred and fifty dollars ($250.00)
for each day that expires after the time specified in paragraph 7 above for Substantial Completion until the Work
City of Fayetteville, AR
Agreement - Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 1 of 3
is substantially complete. After Substantial Completion, if CONTRACTOR shall neglect, refuse or fail to
complete the remaining Work within the time specified in paragraph 7 above for completion and readiness for
final payment or any proper extension thereof granted by CITY OF FAYETTEVILLE, CONTRACTOR shall pay
CITY OF FAYETTEVILLE Two hundred and fifty dollars ($250.00) for each day that expires after the time
specified above for completion and readiness for final payment.
9. The CONTRACTOR shall be entitled to payment of ninety-five percent (95%) of the earned progress payments
when due, with the CITY OF FAYETTEVILLE retaining five percent (5%) to assure faithful performance of the
contract.
10. CONTRACTOR shall furnish a certificate of insurance addressed to the CITY OF FAYETTEVILLE, showing
that he carries the following insurance which shall be maintained throughout the term of the Contract. Any work
sublet, the CONTRACTOR shall require the subcontractor similarly to provide worker's compensation insurance.
In case any employee engaged in work on the project under this contract is not protected under Worker's
Compensation Insurance, CONTRACTOR shall provide and shall cause each Subcontractor to provide adequate
employer's liability insurance for the protection of such of his employees as are not otherwise protected.
Workmen's Compensation Statutory Amount
Comprehensive General &
Automobile Insurance
Bodily Injury Liability
Property Damage Liability
$500,000 for each person injured.
$1,000,000 for each accident.
$1,000,000 aggregate.
The premiums for all insurance and the bond required herein shall be paid by CONTRACTOR.
11. CONTRACTOR to furnish proof of licensure as required by all local and state agencies.
12. This contract may be terminated by the CITY OF FAYETTEVILLE or CONTRACTOR within 10 days written
notice.
13. Freedom of Information Act: City of Fayetteville contracts and documents prepared while performing city
contractual work are subject to the Arkansas Freedom of Information Act. If a Freedom of Information Act
request is presented to the City of Fayetteville, the contractor will do everything possible to provide the
documents in a prompt and timely manner as prescribed in the Arkansas Freedom of Information Act (A.C.A. 25-
19-101 et. Seq.). Only legally authorized photo coping costs pursuant to the FOIA may be assessed for this
compliance.
14. Changes in Scope or Price: Changes, modifications, or amendments in scope, price or fees to this contract shall
not be allowed without a prior formal contract amendment approved by the Mayor and the City Council in
advance of the change in scope, cost or fees.
15. No liens against this construction project are allowed. Arkansas law (A.C.A. §§ 18-44-501 through 508)
prohibits the filing of any mechanics' or materialmen's liens in relation to this public construction project.
Arkansas law requires and the Contractor promises to provide and file with the Circuit Clerk of Washington
County a bond in a sum equal to the amount of this contract. Any subcontractor or materials supplier may bring
an action for non-payment of labor or materials on the bond. The Contractor promises to notify every
subcontractor and materials supplier for this project of this paragraph and obtain their written acknowledgement
of such notice prior to commencement of the work of the subcontractor or materials supplier.
City of Fayetteville, AR
Agreement - Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 2 of 3
WITNESS OUR HANDS THIS DAY OF 1/ Q �' , 2011.
CONTRACTOR
By:
WAruivi azxzx/! /'
Printed Contractor Nime & Title
ATTEST:
v
Company Se e ary
01410
10024 N. Campbell Road
Business Address
Fayetteville, AR. 72701
City, State & Zip Code
Date Signed: November 17, 2011
CITY OF FAYETTEVILLE, ARKANSAS
ATTEST:
Date Signed:
City of Fayetteville, AR
Agreement - Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 3 of 3
aVe ev1I1e
hiiKAN 5A5
BID: 11-67
DATE: 11/04/11
TIME: 2:00 PM
CITY OF FAYETTEVILLE
Bid 11-67, Construction - Walker Park Dugouts and Bleacher Covers
BODER'..: .
1 Hsckathorn Construction Company, Inc.
Deductive Alternative 1 $
Deductive Alternative 2 $
Deductive Alternative 3 $
20,190.00
10,095.00
20,190.00
Total Less Deductives
TOTAL
$225,023.00
$174,548.00
2 Pick -it Construction, Inc.
Deductive Alternative 1 $ 13,140.00
Deductive Alternative 2 $ 6,570.00
Deductive Alternative 3 $ 13,140.00
Total Less Deductives
$143,904.00
$111,054.00
'NOTICE; BId award 1s contingent upon vendor meeting minimum specifications and Formal authorization by City officials.
CERTIFIED:
-P 44 111 ��a//
P. VICE, MACH MGR WITNESS r DIYiE
City of Fayetteville
Bid 11-67, Construction -- Walker Park Dugouts and Bleacher Covers
Document 00400: Bid Form
Contract Name: Drake Field Security Improvements
Bid Number 11-67
BID TO:
Owner: The City of Fayetteville, Arkansas
113 West Mountain Street
Fayetteville, Arkansas 72701
BID FROM:
Bidder: l 1T enti/S% T OA4 4':
14 //L -L- 7?70f
Article 1— Intent:
A. The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an agreement with the
City in the form included in the Bid Documents to perform and furnish all Work as specified or indicated in
the Bid Documents for the Bid price and within the Bid time indicated in this Bid and in accordance with
the other terms and conditions of the Bid Documents.
Article 2 — Terms & Conditions:
A. Bidder accepts ail of the terms and conditions of the Invitation to Bid and Instructions to Bidders,
including without limitation those dealing with the disposition of Bid security. This Bid will remain subject
to acceptance for 180 days after the day of Bid opening. Bidder will sign and deliver the required number
of counterparts of the Agreement with the Bonds and other documents required by the Bidding
Requirements within 15 calendar days after the date of City's Notice of Award.
Article 3 — Bidder's Representation:
In submitting this Bid, Bidder represents, as more fully set forth in the Agreement, that:
A. Bidder has examined and carefully studied the Bid Documents, and the following Addenda, receipt of
all which is hereby acknowledged:
Number Date
t A/ /1
/WW WI(
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 21 of 34
B. Bidder has visited the Site and become familiar with and is satisfied as to the general, local, and Site
conditions that may affect cost, progress, performance, and furnishing of the Work.
C. Bidder is familiar with and is satisfied as to all federal, state, and local Laws and Regulations that may
affect cost, progress, performance, and furnishing of the Work.
D. Bidder has carefully studied all: (1) reports of explorations and tests of subsurface conditions at or
contiguous to the Site and all drawings of physical conditions in or relating to existing surface or
subsurface structures at or contiguous to the Site; and (2) reports and drawings of a Hazardous
Environmental Condition, if any, at the Site. Bidder acknowledges that such reports and drawings are
not Contract Documents and may not be complete for Bidder's purposes. Bidder acknowledges that
the City and Engineer do not assume responsibility for the accuracy or completeness of information and
data shown or indicated in the Bid Documents with respect to Underground Facilities at or contiguous
to the Site.
E. Bidder has obtained and carefully studied (or assumes responsibility for having done so) all such
additional or supplementary examinations, investigations, explorations, tests, studies, and data
concerning conditions (surface, subsurface, and Underground Facilities) at or contiguous to the Site or
otherwise which may affect cost, progress, performance, or furnishing of the Work or which relate to
any. aspect of the means, methods, techniques, sequences, and procedures of construction to be
employed by Bidder and safety precautions and programs incident thereto.
F. Bidder does not consider that any additional examinations, investigations, explorations, tests, studies,
or data are necessary for the determination of this Bid for performing and furnishing of the Work in
accordance with the times, price, and other terms and conditions of the Bid Documents.
G. Bidder is aware of the general nature of work to be performed by Owner and others at the Site that
relates to Work for which this Bid is submitted as indicated in the Bid Documents.
H. Bidder has correlated the information known to Bidder, information and observations obtained from
visits to the Site, reports, and drawings identified in the Bid Documents, and all additional examinations,
investigations, explorations, tests, studies, and data with the Bid Documents.
I. Bidder has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that
Bidder has discovered in the Contract Documents, and the written resolution thereof by Engineer is
acceptable to Bidder.
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 22 of 34
J. The Contract Documents are generally sufficient to indicate and convey understanding of all terms and
conditions for performing and furnishing the Work for which this Bid is submitted.
K. This Bid is genuine and not made in the interest of or on behalf of any undisclosed person, firm, or
corporation and is not submitted in conformity with any agreement or rules of any group, association,
organization, or corporation; Bidder has not directly or indirectly induced or solicited any other Bidder to
submit a false or sham bid; Bidder has not solicited or induced any person, firm, or a corporation to
refrain from bidding; and Bidder has not sought by collusion to obtain for himself any advantage over
any other Bidder or over the City of Fayetteville.
This form continues on the next page.
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 23 of 34
Article 4 - Bid Price:
Bidder will complete the Work in accordance with the Contract Documents for the following prices listed below:
Bid Form: Bid 11.87, Construction -Walker Park Dugouts and Bleacher Covers
FIELD
#
Line
item
Description
Price Per Each
Quantity
1
A
Dugout
$ 6); Zia" "
X
2
/TOTTAL
$ /GI 6917 —
B
Bleacher Cover
N/A
X
N/A
=
N/A
2
A
Dugout
$ /01345-"--
X
2
$ 4,52/D JCD ,•-.
B
Bleacher Cover
NIA
X
NIA
-
N/A
3
A
Dugout
$ A/ -2)11S
x
2
$ / t '�
B
Bleacher Cover
$ b r
X
2
. .
$ / NO
4
A
Dugout
$ 6r3
X
2
=
$ /2 49.0 "
8
Bleacher Cover
$ Atc770 -
x
2
-
$ 13i / L!O
5
A
,
Dugout
$ /a qs-"'"
x
2
=
$! 7(090 r
B
Bleacher Cover
l
$ (, 5-7C1 --
X
2
=
$ 13/114v
6
A
Dugout
N/A
x
NIA
.
N/A
B
Bleacher Cover
$ 4570
x
1
'
$ 4$1 '"�
7
A
Dugout
$ roc? 1S -
X
2
=
t,
$ 12, ,90
B
Bleacher Cover
N/A
x
NIA
=
N/A
8
A
Dugout
NIA
"
NIA
N/A
B
Bleacher Cover
$ 41570 '
x
2
=
$13,1 itD '-
NIA:
Other
9
Mobilization (ship not exceed 5% of total bid)
x
1
-
$
$ J
10
Insurance and Bonds
$ 62- 8 17/3
x
1
-
$ '..--
TOTAL
I'331?D q ''
This form continues on the next page.
City of Fayetteville, AR
Bid 11-67, Construction - Walker Park Dugouts and Bleacher Covers
Page 24 of 34
.
���'
:�
-P -- 11'r a ,,, ,, t1 - C� n" t
a a.- SI9 4-,,,,:4-, c � �`� o a •
ai r a , o, _�
^2 . _. .. <,,
_ / ...e=,° , �!
' 7 i yr r ''a Y
r° ° �s ` -ws
..... ia , _ :
'FIELD
#
Line'
Item
Description
Price Per Each
Quantity
TOTAL TO DEDUCT
8
B
DEDUCTIVE ALTERNATE #t' Price to
��.�
$61c
x
2
=
$ ��l I V
Ashould
SUBTRACT from the total base bid to remove
bleacher covers this contract - Field 8. This
match Line item 8B
6
B
DEDUCTIVE ALTERNATE #2; Price to
�j
$ (, / ®
x
1
$ ! 4 / 0
SUBTRACT from the total base bid to remove
bleacher covers this contract - Field B. This
should match Line item BB
3
B
DEDUCTIVE ALTERNATE #3; Price to
$ 5`70
x
2
=
$
.
7,� IJ h .......•
6 V
SUBTRACT from the total base bid to remove
bleacher covers this contract - Field 3, This
match Line item 3B
**NOTICE: BIDDERS ARE REQUIRED TO PROVIDE PRICING FOR ALL LINE ITEMS. FAILURE TO PROVIDE
DEDUCTIVE ALTERNATE PRICING CAN RESULT IN YOUR BID BEING REJECTED.
**THE CITY WILL AWARD THIS CONTRACT TO THE LOWEST QUALIFIED RESPONSIVE RESPONSIBLE
BIDDER BASED ON THE LUMP SUM BID AS LONG AS SUCH BID FALLS WITHIN THE AMOUNT OF FUNDS
CERTIFIED FOR THE PROJECT (PLUS 25%).
IN THE EVENT NO BID FALLS WITHIN THE AMOUNT OF FUNDS CERTIFIED FOR THE PROJCET, PLUS 25%,
THE CITY WILL UTILIZE THE DEDUCTIVE ALTERNATES IN ORDER UNTIL BIDS CAN BE COMPARED WITHIN
THE AMOUNT CERTIFIED, PLUS 25%.
IN THE EVENT ALL DEDUCTIVE ALTERNATES ARE SUBTRACTED AND NO BID FALLS WITHIN THE AMOUNT
CERTIFIED, PLUS 25%, ALL BIDS WILL BE REJECTED.
This form continues on the next page.
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 25 of 34
Article 5 — Contract Times:
A. Bidder agrees that the Work will be substantially completed and completed and ready for final payment
within the number of calendar days indicated in the Agreement.
B. Bidder accepts the provisions of the Agreement as to liquidated damages in the event of failure to
complete the Work within the times specified in the Agreement.
Article 6 — Bid Content:
The following documents are attached to and made a condition of this Bid:
A. Required Bid se,,rity in the form of a certified or bank cashier's check or a Bid Bond and in the amount
of 5 4 r p 7�
Dollars ($
)•
B. A tabulation of Subcontractors and other persons and organizations required to be identified in this Bid.
Sub -contractor name:. i°t 12d Percent of work: 4`
Sub -contractor name:___1_/ /Art Percent of work: _ Oe %
Sub -contractor name: 1106 Percent of work:
Sub -contractor name: Percent of work: %
Sub -contractor name: Percent of work: %
Article 7 — Bid Communications:
Communications concerning this Bid shall be addressed to the Bidder as follows:
on
/"� e-Conx /u4-x/M,;
lop -?-111, (%, ie lb,
Fornmet.ia- °7? -7O/
Phone Noble70 73 -7,f
E -Mail: _do
FAX No. et*
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 26 of 34
Article 8 — Bid Signature:
If Bidder is:
An Individual
Name (type or printed):
By: (SEAL)
(Individual's Signature)
Doing business as:
Business address:
Phone No.: FAX No.:
A Partnership
Partnership Name: (SEAL)
By:
(Signature of general partner — attach evidence of authority to sign)
Name (type or printed):
Business address:
Phone No.: FAX No.:
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park dugouts and Bleacher Covers
Page 27 of 34
A Corporation ,
Corporation Name: / /4* t T incfre /M� (SEAL)
State of Incorporation: A,e 14irSif
Type (General Business, Professional,-�-�Service, Limited Liability):
‘::r.07742924 -e— C t fit" ev2
By:
(Signature — attach evidence of authority to sign)
Name (type or printed):
Title:
(CORPORATE SEAL)
Attest:
(Signature of Corporate Secretary)
Business address:
Phone No.: FAX No.:
END OF DOCUMENT 00400
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 28 of 34
City of Fayetteville
Bid 11-67, Construction - Walker Park Dugouts and Bleacher Covers
Vendor References
The following information is required from ail Bidders so all bids may be reviewed and properly evaluated. All bidders are
required to have performed at least four (4) contracts of similar scope within the past five (5) years.
COMPANY NAME: [ {GK'" St`guerr®A Arc,
BUSINESS ADDRESS: loop if A > ,dba&k1 ZC jb, Xfierrrt4GLE- 7? yb(
NUMBER OF YEARS IN BUSINESS: 9, HOW LONG IN PRESENT LOCATION: 751.0
TOTAL NUMBER OF CURRENT EMPLOYEES:
FULL TIME IX PART TIME
NUMBER OF EMPLOYEES YOU PLAN TO USE TO SERVICE THIS CONTRACT: y' FULL TIME a . PARTTIME
PLEASE LIST LOCAL COMMERCIAL AND/OR GOVERNMENTAL REFERENCES THAT YOU HAVE PREVIOUSLY
PERFORMED SIMILAR CONTRACT SERVICES FOR WITHIN THE PAST THREE (3) YEARS (All fields must be
completed):
1. Alittifki,1/4.1 LST A) at/C .44/022t$ 2.
COMPAN NAME
COMPANY NAME
Fbr & O" 1D1343
CITY, STATE, �/
A7.fbi1E )/t6f..S
CONTACT PERSON
(20,1-.7
TELEPHONE
FAX NUMBER
E-MAIL ADDRESS
3. Otit-Wienalf
COMPANY NAME
CITY, ' TATE, ZIP
RAM> F�
CONTACT PERSON
4't�-/fT
779)
PHONE
FAX NUMBER
E-MAIL ADDRESS
rihal I, A -1:YU.sb
CITY, STATE, 21P
,ivbs 144,/vi it
CONTACT PERSON
L PHO E
FAX NUMBER
E-MAIL ADDRESS
4. r. (Z _W lags
COMPANY NAME
CITY, STATE, ZIP
Osa �Or/
071)387—'7573
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TELEPHONE
FAX NUMBER
E-MAIL ADDRESS
City of Fayetteville, AR
Bid 11-67, Construction - Walker Park Dugouts and Bleacher Covers
Page 29 of 34
City of Fayetteville
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Debarment Certification Form — THIS FORM SHOULD BE SUBITTED WITH ALL BIDS
As A BIDDER on this project, you are required to provide debarment/suspension certification
indicating that you are in compliance with the below Federal Executive Order. Certification can be
done by completing and signing this form.
Debarment:
Federal Executive Order (E.O.) 12549 "Debarment and Suspension" requires that all
contractors receiving individual awards, using federal funds, and all sub -recipients certify that
the organization and its principals are not debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded by any Federal department or agency from doing
business with the Federal Government.
Your signature certifies that neither you nor your principal is presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in this
transaction by any federal department or agency.
Questions regarding this form should be directed to the City of Fayetteville Purchasing Division.
NAME: �..r5l lT
COMPANY: 73C44— L=-6sa
PHYSICAL ADDRESS: _../Trail
MAILING ADDRESS: 71�rYiE ,rte
PHONE: 670 9x73.5 o9
EMAIL: Yiic
SIGNATURE:
DATE:
�'ror
FAX:
NOTICE:
CAUSE: Debarment by an agency pursuant to FAR 9.406-2, GPO Instructions 110.11A, or PS Publication 41, for one or more of the following
causes (a) conviction of or civil judgment for fraud violation of antitrust laws, embezzlement, theft, forgery, bribery, false statements, or other
offenses indicating a lack of business integrity; (b) violation of the terms of a Government contract, such as a willful failure to perform in
accordance with its terms or a history of failure to perform; or (c) any other cause of a serious and compelling nature affecting responsibility.
(See Code N- Debarment pursuant to FAR 9.406 2(b)(21 Drug Free Workplace Act of 1988.)
TREATMENT: Contractors are excluded from receiving contracts, and agencies shall not solicit offers from, award contracts to renew or
otherwise extend the duration of current contracts, or consent to subcontracts with these contractors, unless the City determines that there
is a compelling reason for such action. Government prime contractors, when required by the terms of their contract, shall not enter into any
subcontract equal to or in excess of $25,000 with a contractor that is debarred, suspended, or proposed for debarment, unless there is a
compelling reason to do so. Debarments are for a specified term as determined by the debarring agency and as indicated in the listing.
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 30 of 34
City of Fayetteville
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Statement of Disclosure — To Be Submitted With ALL Bids
This page does not count towards page limitations set forth in this request for proposal or bid.
Proposer must disclose any possible conflict of interest with the City of Fayetteville, including, but not
limited to, any relationship with any City of Fayetteville employee. Your response must disclose if a
known relationship exists between any principal or employee of your firm and any City of Fayetteville
employee or elected City of Fayetteville official.
If, to your knowledge, no relationship exists, this should also be stated in your response. Failure to
disclose such a relationship may result in cancellation of a purchase and/or contract as a result of
your response. This form must be completed and returned in order for your bid/proposal to be eligible
for consideration.
PLEASE CHECK ONE OF THE FOLLOWING TWO OPTIONS, AS IT APPROPRIATELY APPLIES
TO V
YODUR FIRM:
1.) NO KNOWN RELATIONSHIP EXISTS
2.) RELATIONSHIP EXISTS (Please explain)
PLEASE FILL OUT THE SECTION BELOW AND SUBMIT THIS FORM WITH YOUR BID OR
PROPOSAL:
1.) I, as an officer of this organization, or per the attached letter of authorization, am duly authorized
to certify the information provided herein are accurate and true; and
2.) My organization shall comply with all State and Federal Equal Opportunity and Non -Discrimination
requirements and conditions of employment.
--47-Arked Q�
Printed Nam
VAre
Signature
//2/(
Date
City of Fayetteville, AR
Bid 11-67, Construction — Walker Park Dugouts and Bleacher Covers
Page 31 of 34