ࡱ> DFABCID \bjbjO O &3-a-aTLX X -----T....R/.ca1 2(424242333```````$Qdgha-|<33|<|<a--4242aIII|<-42-42`I|<`IIn\]42 ?V?\`3a0ca]khEkh(]]kh-]3(75I6<7333aaG333ca|<|<|<|<kh333333333X x,:  Iowa Guide 5pb THIS IS FOR PUBLIC BODIES This is an alternative form of contract documents for public bodies which may be used for contracts typically less than $100,000. Includes the following items: Notice of Public Hearing (provided by legal counsel) Advertisement For Bids (provided by legal counsel) Intructions To Bidders Bidders Proposal Contractors Quailification Form Contract Notice of Award Notice to Proceed General Conditions Certificate of Owner's Attorney USDA-Rural Development Concurrence Performance Bond Payment Bond Compliance Statement (used when contract is over $10,000) Construction Schedule Certification Regarding Debarment (used when contract is over $25,000) Statement of Final Completion and Owners Acceptance of the Work Certification for Contracts Grants and Loan (used when contract is over $100,000) Project sign Certification of Insurance (contractor supplied) Plans and Specifications (engineer/architect supplied) THIS PAGE IS FOR INFORMATION ONLY AND SHOULD NOT BE INCLUDED IN THE FINAL Documents. This document may be modified to specific project requirements. Rural Development requires that all changes be highlighted when submitted for RD review, the highlights will be removed in the bidding documents. A document certification is required to be submitted with the contract document submittal to Rural Development. The follow page is the certification form. Do not include the certification form with the Bidding Documents provided to the bidders. Short Form Certification [ ] This Certification is for the Architect/Engineer Agreement. [ ] This certification is for the Short Form Contract Documents. Modifications to the short form Rural Development documents may be necessary. For purposes of RD review and all modifications to these documents are made by either BOLD fonts for add items and strikethrough font (Strikethrough) for items to be deleted. The Bold fonts and strikeouts will be removed in the advertised documents. I hereby certify that we have only made changes to the Short Form Rural Development documents by fill in the blank, deleted the items allowed in the documents as either/or, and by bold fonts or strikethrough fonts only. I have reviewed the Environmental Assessment and have reviewed the mitigation measures required for this project. The project as designed meets the mitigation requirements. FIRM:_________________________ BY:___________________________ PRINT NAME:__________________ DATE:_______________ INSTRUCTIONS TO BIDDERS 1. All Bids must be submitted on the blank Form of Proposal attached hereto and submitted in a separate sealed envelope from the Bid Security, if a bid security is required. 2. When Bid Security is required each Bid shall be accompanied by a Bid Bond, certified check, cashier's check, or certified credit union share draft in a separate sealed envelope in an amount equal to ten per cent (10%) of the total amount of the Bid. If Bid Bond is submitted, it must be on the form provided with the Contract Documents. The certified check, cashier's check, or certified credit union share draft shall be drawn on a bank in Iowa, a bank chartered under the laws of the United States of America, or said certified share draft shall be drawn on a credit union in Iowa or chartered under the laws of the United States and payable to the Treasurer of the Owner as security that if awarded a Contract, the Bidderwill enter into a contract at the prices bid and furnish the required Performance and Payment Bonds and Certificate of Insurance. The certified check, cashier's check, or certified share draft may be cashed, or the Bid Bond forfeited, and the proceeds retained as liquidated damages if the Bidder fails to execute a contract or file acceptable Performance and Payment Bonds or provide an acceptable Certificate of Insurance within ten (10) days after the acceptance of said Bid by resolution of the Governing Body. No Bidder may withdraw a Bid within sixty (60) days after the date set for opening Bids. (not all projects require Bid Bonds contact legal Coucil for advise. Remove this note) 3. Performance and Payment Bonds, on forms approved by the Owner, as provided in the Contract Documents in the amount of one hundred percent (100%) of the contract price with a corporate surety approved by the Owner, will be required for the faithful performance of the Contract, and the Bidder shall state in the proposal the name and address of the surety or sureties who will sign the bonds in case the Contract is awarded to them. The Performance Bond guarantees the repair of all damage due to improper materials or workmanship for a period of one year after the final acceptance of the Work by the Owner. (not all projects require Bonds contact legal Coucil for advise. Remove this note) 4. The party to whom the Contract is awarded will be required to execute the Contract and furnish Performance and Payment Bonds, when required, and Certificate of Insurance within ten (10) calendar days from the date when the written Notice of Award of the Contract is mailed to the Bidder at the address given, said Contract being conditioned upon the approval of the United States Department of Agriculture Rural Development delegate. In case of failure by the Bidder, the Owner may consider that the Bidder has abandoned the Contract, in which case the bid security accompanying the proposal shall become the property of the Owner. 5. All Bidders shall be required to furnish evidence, satisfactorily to the Owner, of the necessary facilities, financial resources, past record of performance, organization, experience, technical skills and necessary equipment for performing the Work and shall complete the " Contractor's Qualifications Form. 6. The Contractor shall submit Construction Schedule(s) with the signed Contract. 7. Bidders must satisfy themselves by personal examination of the location of the proposed Work, by examination of the drawings and specifications, by performing exploratory borings, by reviewing the requirements of the Work and the accuracy of the estimates of the quantities of the Work to be done, and shall not at any time after the submission of a Bid, dispute or complain of such estimates nor assert that there was any misunderstanding in regard to the nature or amount of work to be done. 8. A Bidder may withdraw any Bid submitted at any time prior to the hour set for the receipt of Bids, provided the request for withdrawal is signed in a manner identical with the proposal being withdrawn. No withdrawal or modification will be permitted after the hour designated for Bid opening. 9. For the purpose of clarification, it is understood that the Work to be done is being financed in whole or in part by means of a loan and/or grant made or insured by the United States of America, acting through the United States Department of Agriculture Rural Development. The USDA Rural Development will therefore, require approval or concurrence by its representatives of all Contracts, attachments, and similar documents, all partial and final payment estimates, and all Change Orders. Bids shall include sales tax and all other applicable taxes and fees. 10. Payment to each Contractor will be made in monthly estimates and one final payment. Monthly estimates will be ninety-five percent (95%) of the contract value of the Work completed during the preceding calendar month. Final payment will be made to the Contractor no earlier than thirty-one (31) days from and after the date of the final acceptance of Work by the Owner in accordance with the requirements of the Contract Documents. 11. If the Contract exceeds $10,000 a "Compliance Statement," Form RD 400-6, is required with the Contract. If the Contract exceeds $25,000 the Certification Regarding Debarment is required with the Contract. If the Contract exceeds $100,000 the Certification for Contracts Grants and Loan is required with the Contract. 12. The Contract Documents including the detailed drawings contain the provisions required for the construction of the Project. No information obtained from any officer, agent, or employee of the Owner on any such matter shall in any way effect the risk or obligation assumed by the Contractor or relieve him from fulfilling any of the conditions of the Contract. 13. Bids which are incomplete, unbalanced, conditional, or obscure or which contain additions not called for, erasures, alterations, or irregularities of any kind or which do not comply with these Instructions To Bidders may be rejected at the option of the Owner. 14. Contractors may bid on any or all Divisions. However, a separate Contract may be awarded for each Division. Divisions may be linked such that the Contractor will only do the Work if the Contractor is awarded all divisions. If one Contractor is awarded more than one Division they may be combined into a single Contract. 15. Bid forms, Drawings and Specifications may be obtained from _______________. A deposit of $__________ will be required. Any Bidder or non bidder, upon returning the Contract Documents within 14 days of bid letting and in good condition, will be refunded the payment. 16. Unacceptable bidders. The following will not be allowed to bid on, or negotiate for, a contract or subcontract related to the construction of the project: (1) An engineer, architect, or individual/entity as an individual or firm who has prepared plans and specifications or was involved in the development of the project, or anyone who will be responsible for monitoring the construction; (2) Any firm or corporation in which the owner's architect or engineer is an officer, employee, or holds or controls a substantial interest; (3) The governing body's officers, employees, or agents; (4) Any member of the immediate family or partners in the entities referred to in paragraphs (1), (2), or (3) of this section; or (5) An organization which employs, or is about to employ, any person in the entities referred to in paragraphs (1), (2),(3), or (4) of this section. 17. An inspection can be arranged by calling _______________________________. Owner _____________________________________ By _________________________________________ Title ________________________________________ BIDDERS PROPOSAL Place ____________________ Date ____________________ 1. In compliance with your invitation for bids dated_______________________ and subject to all the conditions thereof, the undersigned ____________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ (hereinafter called Bidder) doing business as ___________________________________________ ____________________________________________________________________*, of the City of __________________________, State of _________________________ hereby proposes to furnish and complete work required by the Contract Documents for the construction of all structures listed at the prices shown for each bid item on the Bid Schedule. Any total cost found inconsistent with the unit cost when the bids are examined will be deemed in error and corrected to agree with the unit cost which shall be considered correct. 2. The undersigned Bidder does hereby declare and stipulate that this proposal is made in good faith, without collusion or connection with any other person or persons bidding for the same work, and that it is made in pursuance of and subject to all the terms and conditions of the Notice and Instructions to Bidders, the Construction Contract, the Detailed Specifications, and the Plans pertaining to the work to be done, all of which have been examined by the undersigned. 3. All the various phases of work enumerated in the Detailed Specifications with their individual jobs and overhead, whether specifically mentioned, included by implication or appurtenant thereto, are to be performed by the Bidder under one of the items listed in the Bid Schedule, irrespective of whether it is named in said list. 4. Payment for work performed will be in accordance with the Bid Schedule, subject to changes as provided for in the Construction Contract. 5. The undersigned Bidder understands that this contract must be concurred in by USDA Rural Development. 6. The Bidder will execute the contract within 10 days after notification of contract award. BID SCHEDULE NOTE: Bids shall include sales tax and all other applicable taxes and fees. ___________________________________________________________________________________ ___________________________________________________________________________________ Item Estimated Total Unit No. Description Quantity Price Price Total ___________________________________________________________________________________ ___________________________________________________________________________________ TOTAL BID PRICE $_____________ ___________________________________ ______________________________________ Bidder'S License No. (if applicable) Bidder By______________________________________ Seal (if a corporation) ______________________________________ Title ______________________________________ (Business Address) *Insert: "a corporation incorporated in the State of ________________________," "a partnership" or an individual, as applicable. CONTRACTOR'S QUALIFlCATION FORM Name & Address ____________________________________________________________ Type Organization ____________________ Date Established ___________ Incorporated in _______ State ____________ A. Furnish the following information: Owner, PARTNERS, OFFICERS, DIRECTORS Name Title _________________________________ ________________________________ __________________________________ ________________________________ __________________________________ ________________________________ __________________________________ ________________________________ B. List 5 most recent projects completed, location, type, and size: 1. ___________________________________________________________________ 2. ___________________________________________________________________ 3. ___________________________________________________________________ 4. ___________________________________________________________________ 5. ___________________________________________________________________ C. List major types and size of equipment presently owned: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ D. List names, experience and technical skills of supervisory personnel to be used on project: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ E. List Bonding companies from whom you have obtained surety bonds on the last 5 years: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ F. List all subcontractors to be used on this project: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Contract This Contract, made this ________ day of _____________________, 200__, by and between ________________________________________, hereinafter called "Owner" and (name of Owner), (an Individual) and ________________________________________ doing business as (an individual,) or (a partnership,) or (a corporation) hereinafter called "Contractor". Witnesseth: That for and in consideration of the payments and agreements herein after mentioned: 1. The Contractor will commence and complete the construction of ______________________________________________________________________ 2. The Contractor will furnish all of the materials, supplies, tools, equipment, labor, and other services necessary for the construction and completion of the Work described in the Contract Documents. 3. The Contractor will commence the Work required by the Contract Documents within ________ calendar days after the date of the Notice To Proceed and will complete the same within ________ calendar days of the Notice To Proceed unless the period for completion is extended otherwise by the Contract Documents. 4. The Contractor agrees to pay as Liquidated Damages the sum of $____________ for each and every calendar day intervening between the date of completion as specified in the Notice To Proceed and the date of actual completion. 5. The Contractor agrees to perform all of the Work described in the Contract Documents and comply with the terms therein for the sum of $_________________ or as shown in the Bid schedule. 6. The Owner will pay to the Contractor in the manner and at such times as set forth in the General Conditions such amounts as required by the Contract Documents. 7. This Contract shall be binding upon all parties hereto and their respective heirs, executors, administrators, successors, and assigns. 8. The Contract Documents include the following: (a) Bidders Proposal (b) Contract (c) Compliance Statement (d) Notice of Award (e) Notice to Proceed (f) General Conditions (g) Performance Bond (when required) (h) Payment Bond (when required) (i) Certification of Insurance (j) Construction Schedule (k) Certification Regarding Debarment (l) Certification for Contracts Grants and Loans (when required) (m) Plans and Specifications (n) Certificate of Owner's Attorney (o) USDA-Rural Development Concurrence (p) Addenda IN WITNESS WHEREOF, the parties hereto have executed, or caused to be executed by their duly authorized officials, this Contract in duplicate, on the date first above written. (SEAL) Owner: ATTEST: ______________________________________ Type Name ___________________________ Type Name ____________________________ Title__________________________________ Title__________________________________ ContractOR: (SEAL) By ___________________________________ Type Name ___________________________ Type Name ____________________________ Title__________________________________ Title__________________________________ Employer Identification ___________________ Notice of Award Description of work: Construction of____________________________________________________ ____________________________ for the_________________________________________________ ___________________________________________________________________________________ To: _______________________________________________________________________________ ___________________________________________________________________________________ The Owner has considered the Proposal submitted by you for the above described work in response to its Notice and Instructions to Bidders dated _____________________, 20____. It is to the best interest of said Owner to accept your Proposal in the amount of __________________ ___________________________________________________________($_____________________); you are hereby notified that your Proposal has been accepted for items _________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ You are required by the Notice and Instruction to Bidders to execute the contract within ten days from the date of the delivery of this Notice to you. Dated this _________________ day of ______________________________________, 20__ __ _____________________________________ Owner By____________________________________ Title __________________________________ ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged this ________ day of _______________________, 20____. By________________________________ Title ______________________________ NOTICE TO PROCEED TO: ________________________________ Date: __________________________ ________________________________ Project: __________________________ ________________________________ _________________________________ ________________________________ _________________________________ You are hereby notified to commence Work in accordance with the Agreement dated _____________________, 20____, on or before ____________________, 20____, and you are to complete the Work within __________ consecutive calendar days thereafter. The date of completion of all Work is therefore ____________________, 20____. ______________________________________ Owner By ___________________________________ Title _________________________________ ACCEPTANCE OF NOTICE Receipt of the above Notice To Proceed is hereby acknowledged this the ___________________________, 20____ By__________________________________ Title_________________________________ Employer Identification Number______________________________ GENERAL CONDITIONS 1. The Contractor shall furnish and pay the cost, including sales tax and all other applicable taxes and fees, of all the necessary materials and shall furnish and pay for all the superintendence, labor, tools, equipment and transportation and perform all the work required for the construction of all items listed and itemized under the bid schedule of the Bidder's Proposal attached hereto as in strict accordance with the Plans, Specifications, and General Conditions which are attached hereto and made a part hereof, and any amendments thereto and such supplemental plans and specifications which may hereafter be approved. 2. The Owner shall provide the land upon which the work under this contract is to be done, and will, so far as is convenient, permit the Contractor to use as much of the land as is required for the erection of temporary construction facilities and storage of materials, together with the right of access to same, but beyond this, the Contractor shall provide at the Contractor's cost and expense any additional land required. 3. In the event the Owner is dissatisfied with the slow progress or incompetency in the performance of the work in accordance with the schedule for completion of the various aspects of construction, the Owner shall give the Contractor written notice in which the Owner shall specify in detail the cause of dissatisfaction. Should the Contractor fail or refuse to remedy the matters complained of within five days after the written notice is received by the Contractor the Owner shall have the right to take control of the work and either make good the deficiencies of the Contractor itself or direct the activities of the Contractor in doing so, employing such additional help as the Owner deems advisable. In such event the Owner shall be entitled to collect from the Contractor any expenses in completing the work. 4. The Owner will withhold $_________________ as liquidated damages from the amount payable to the Contractor for each calendar day that the Contractor is in default after the time of completion stipulated in these Contract Documents. The Contractor and Owner recognize that time is of the essence of this Agreement and that the Owner will suffer financial loss if the Work is not completed within the specified time. The parties recognize the delays, expense, and difficulties involved in proving in a legal or arbitration proceeding the actual loss suffered by the Owner if the Work is not completed on time. Accordingly, instead of requiring any such proof, Owner and Contractor agree that as liquidated damages for delay (but not as penalty), Contractor shall pay Owner the above shown amount for each day that expires after the time specified until the Work is completed. 5. The Contractor guarantees all material and equipment furnished and all work performed for a period of one (1) year from the date of substantial completion of the contract. The Contractor's guarantees that the facility is free from defects due to faulty materials or workmanship and the Contractor shall make the necessary corrections to correct these defects. 6. The Contractor should give all notices and comply with all laws, ordinances, rules, and regulations bearing on the conduct of the work as specified in the Contract Documents. If the Contractor observes that the Contract Documents are at variation with any laws, ordinances, rules or regulations, the Contractor should promptly notify the Owner in writing and any necessary changes shall be adjusted through the use of contract change orders. 7. The Contractor agrees to pay all claims for labor, materials, services and supplies and agrees to allow no such charge to be fixed on the property of the Owner. 8. The Contractor agrees to comply with all laws, rules and regulations that apply to related work. 9. The actual performance of work and superintendence shall be performed by the Contractor but the Owner shall, at all times, have access to the premises for the purpose of observing or inspecting the work performed by the Contractor. 10. It is fully understood and agreed that none of the requirements of this Contract shall be considered as waived unless changes are made in writing and then only by the persons executing this contract upon concurrence of USDA Rural Development (USDA RD). 11. The Contractor agrees not to sublet or assign this work without the written consent of the Owner. 12. The Contractor shall have full responsibility under these conditions, general provisions, Plans and Specifications and for any subcontracts which the Contractor may let. 13. The Contractor shall indemnify and save harmless the Owner and the Owner's agents and employees, from and against all losses and all claims, demands, payments, suits, actions, recoveries, and judgments of every nature, and description brought or recovered against them by reasons of any act or omission of the said Contractor, its agents, or employees, in the execution of the work or in guarding the same. 14. Payment. Final payment shall be made to the Contractor when the work is completed and accepted by the Owner, Engineer/Architect and USDA RDThe total amount of the payment shall be the amount of the contract plus the value of all changes as reflected in approved contract change orders. The entire balance found to be due the Contractor but excepting such sums as may be lawfully retained by the Owner, shall be paid to the Contractor. Such payment shall be conditioned, however, upon the submission by the Contractor of evidence satisfactory to the Owner that all claims for labor, material, and any other outstanding indebtedness in connection with this Contract have been paid. The Owner will make payments as follows: (Check proper payment clause and effectively cross out all of the clauses not applicable.) _____ A. ONE LUMP SUM will be made for the whole contract, upon acceptance by the Owner and Rural Development, of all work required hereunder and compliance by the Contractor with all the terms and conditions of this contract. _____ B. PARTIAL PAYMENTS NOT TO EXCEED _______ PERCENT of the value of the work in place (less the aggregate of previous payments) will be made at monthly intervals. The value of work in place shall be as estimated by the Contractor and approved by the Owner, Engineer/Architect, and Rural Development. Prior to receiving any partial payment, the Contractor must furnish the Owner with a statement showing the total amount owed to date for materials and labor procured under this contract and, if required by the Owner or Rural Development, must also submit evidence showing that previous partial payments were properly applied and that the current payment will be properly applied. Upon completion of the whole contract and acceptance of the work as required hereunder, by the Owner, Engineer/Architect and Rural Development, and compliance by the Contractor with all terms and conditions of this contract, the amount due the Contractor will be paid. For public bodies, final payment to the Contractor shall be made no earlier than thirty-one days from and after final acceptance of work by the Owner, subject to conditions and in accordance with the provisions of Chapter 573 of the Code of Iowa. 15. Clean-up. Upon completion or termination of the work, the Contractor shall remove from the vicinity of the work all equipment and all temporary structures, waste materials and rubbish resulting from its operations, leaving the premises in a neat and presentable condition. In the event of failure to do so, the same may be done by the Owner at the expense of the Contractor. 16. Contract Approval. The Owner and the Contractor will furnish the Owner's Attorney such evidence as required so that the Owner's Attorney can complete and execute "Certificate of Owner's Attorney" before the Owner submits the executed Contract Documents to the USDA RD for concurrence. Concurrence by USDA RD designee of the Contract is required before it is effective and the USDA RD Concurrence form shall be attached and made a part of the Agreement. This Contract is expected to be funded in part with funds from USDA RD. Neither the United States nor any of its departments, agencies, or employees is or will be a party to this Contract or any Subcontract. 17. Contract Change Orders. All changes affecting the project's construction cost or modifications of the terms or conditions of the contract must be authorized by means of a written contract change order which is mutually agreed to by the Owner and Contractor and is approved byUSDA RD. The contract change order will include extra work, work for which quantities have been altered from those shown in the bidding schedule, as well as decreases or increases in the quantities of installed units which are different than those shown in the bidding schedule because of final measurements. All changes must be recorded on a contract change order before they can be included in a partial payment estimate. Form RD 1924-7, Contract Change Order or similar form approved by USDA RD shall be used to record Contract changes. When the Contract sum is, in whole or in part, based on unit prices, the Owner reserves the right to increase or decrease a unit quantity as may be deemed reasonable or necessary in order to complete the work contemplated by this Contract. 18. Partial Payment Estimate. Form RD 1924-18, "Partial Payment Estimate," or similar form approved by the United States Department of Agriculture Rural Development shall be used when estimating periodic payments due the Contractor. The Owner may after consultation with the Architect/Engineer withhold or, on account of subsequently discovered evidence, nullify the whole or part of any approved partial payment estimate to such extent as may be necessary to protect the Owner from loss on account of: Defective work not remedied. Claims filed. Failure of Contractor to make payments properly to subcontractors or suppliers. A reasonable doubt that the work can be completed for the balance then unpaid. Damage to another Contractor. Performance of work in violation of the terms of the Contract Documents. Where work on unit price items is substantially complete but lacks testing, clean-up and/or corrections, amounts shall be deducted from unit prices in partial payment estimates to amply cover such testing, clean-up and/or corrections. Payments will not be made that would deplete the retainage nor place in escrow any funds that are required for retainage nor invest the retainage for the benefit of the Contractor. 19. Conflict of Interest. Unacceptable bidders. An Engineer/Architect (individual or firm including persons they employ) who has prepared plans and specifications will not be considered an acceptable bidder. Any firm or corporation in which such Engineer/Architect (including persons they employ) is an officer, employee, or holds or controls a substantial interest will not be considered an acceptable bidder. Contracts or purchases by the Contractor shall not be awarded or made to a supplier or manufacturer if the Engineer/Architect (firm or individual) who prepared the plans and specifications has a corporate or financial affiliation with the supplier or manufacturer. Bids will not be awarded to firms or corporations which are owned or controlled wholly or in part by a member of the governing body of the Owner or to an individual who is such a member. The Owner's officers, employees, or agents shall not engage in the award or administration of this Contract if a conflict of interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of their immediate family; (c) their partner or (d) an organization which employs, or is about to employ, any of the above has financial or interest in the Contractor. The Owner's officers, employees, or agents shall neither solicit nor accept gratuities, favors or anything of monetary value from the Contractor or subcontractor. 20. Protection of Lives and Property. In order to protect the lives and health of its employees under the Contract, the Contractor shall comply with all pertinent provisions of the Occupational Safety and Health Administration (OSHA) and any State Safety and Health agency requirements. The Contractor alone shall be responsible for the safety, efficiency, and adequacy of its plant, appliances, and methods, and for any damage which may result from their failure or their improper construction, maintenance or operation. 21. Remedies. Unless otherwise provided in this Contract, all claims, counterclaims, disputes, and other matters in question between the Owner and the Contractor arising out of or relating to this Contract or the breach thereof will be decided by arbitration if the parties mutually agree, or in a court of competent jurisdiction within the State of Iowa. The arbitration provisions of this section may be initiated by either party to this Contract by filing with the other party and the Engineer/Architect a Written Request for arbitration. Each party to this Contract will appoint one arbitrator; the two arbitrators will select a third arbitrator. The arbitrators will select a hearing location as close to the Owner's locale as possible. The procedure for conducting the hearings will follow the Construction Industry Arbitration Rules of the American Arbitration Association. 22. Gratuities. If the Owner finds after a notice and hearing that the Contractor, or any of the Contractor's agents or representatives, offered or gave gratuities (in the form of entertainment, gifts, or otherwise) to any official, employee, or agent of the Owner, USDA RD officials in an attempt to secure this Contract or favorable treatment in awarding, amending, or making any determinations related to the performance of this Contract, the Owner may, by written notice to the Contractor, terminate this Contract. The Owner may also pursue other rights and remedies that the law or this Contract provides. However, the existence of the facts on which the Owner bases such findings shall be an issue and may be reviewed in proceedings under the Remedies clause of this Contract. In the event this Contract is terminated as provided in the above paragraph the Owner may pursue the same remedies against the Contractor as it could pursue in the event of a breach of the Contract by the Contractor. As a penalty, in addition to any other damages to which it may be entitled by law, the Owner may pursue exemplary damages in an amount (as determined by the Owner) which shall be not less than three nor more than ten times the costs the Contractor incurs in providing any such gratuities to any such officer or employee. 23. Audit and Access to Records. For all negotiated contracts (except those of $10,000 or less), USDA RD, the Comptroller General, the Owner or any of their duly authorized representatives, shall have access to any books, documents, papers, and records of the Contractor, which are pertinent to the Contract, for the purpose of making audits, examinations, excerpts and transcriptions. The Contractor shall maintain all required records for three years after final payment is made and all other pending matters are closed. 24. Small, Minority and Women's Businesses. If the Contractor intends to let any subcontracts for a portion of the work, the Contractor shall take affirmative steps to assure that small, minority and women's businesses are used when possible as sources of supplies, equipment, construction, and services. Affirmative steps shall consist of (1) including qualified small minority, and women's businesses on solicitation lists; (2) assuring that small, minority and women's businesses are solicited whenever they are potential sources; (3) dividing total requirements when economically feasible, into small tasks or quantities to permit maximum participation of small, minority and women's businesses; (4) establishing delivery schedules, where the requirements of the work permit, which will encourage participation by small, minority and women's businesses; (5) using the services and assistance of the Small Business Administration, and the Minority Business Development Agency of the U.S. Department of Commerce; (6) requiring each party to a subcontract to take the affirmative steps of this section; and (7) Contractors are encouraged to procure goods and services from labor surplus area firms. 25. Anti-Kickback. The Contractor shall comply with the Copeland Anti-Kickback Act (18 USC 874) as supplemented in Department of Labor regulations (29 CFR, Part 3). This act provides that each Contractor shall be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public facilities, to give up any part of the compensation to which they are otherwise entitled. The Owner shall report all suspected or reported violations to the Area Office. 26. Violating Facilities. Where this Contract exceeds $100,000 the Contractor shall comply with all applicable standards, orders or requirements issued under section 306 of the Clean Air Act (42 U.S.C. 1857(h)), section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738, and Environmental Protection Agency regulations 40 CFR Part 15 which prohibit the awarding of non-exempt federal contracts, grants, or loans to facilities included on EPA's list of violating facilities. The Contractor will report violations to the EPA. 27. State Energy Policy. The Contractor shall comply with the Energy Policy and Conservation Act (P.L. 94-163). Mandatory standards and policies relating to energy efficiency, contained in the State Energy Conservation Plan, shall be utilized. 28. Equal Opportunity Requirements. For all contracts in excess of $10,000, the Contractor shall comply with Executive Order 11246, entitled "Equal Employment Opportunity," as amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR Part 60). If the Contract exceeds $10,000, the Contractor will execute Form RD 400-6, "Compliance Statement." The Contractor's compliance with Executive Order 11246 shall be based on its implementation of the Equal Opportunity Clause, specific affirmative action obligations required by the Standard Federal Equal Employment Opportunity Construction Contract Specifications, as set forth in 41 CFR Part 60-4 and its efforts to meet the goals established for the geographical area where the Contract is to be performed. The hours of minority and female employment and training must be substantially uniform throughout the length of the Contract, and in each trade, and the Contractor shall make a good faith effort to employ minorities and women evenly on each of its projects. The transfer of minority or female employees or trainees from Contractor to Contractor or from project to project for the sole purpose of meeting the Contractor's goals shall be a violation of the Contract, the Executive Order and the regulations in 41 CFR Part 60-4. Compliance with the goals will be measured against the total work hours performed. The Contractor shall provide written notification to the Director of the Office of Federal Contract Compliance Programs within 10 working days of award of any construction subcontract in excess of $10,000 at any tier for construction work under the Contract resulting from this solicitation. The notification shall list the name, address and telephone number of the subcontractor; employer identification number; estimated dollar amount of subcontract; estimated starting and completion dates of the subcontract; and the geographical area in which the Contract is to be performed. 29. Insurance. 29.1 The Contractor shall purchase and maintain such insurance as will protect it and additional insured from claims set forth below which may arise out of, or result from, the Contractors execution of the Work, whether such execution be by the Contractor, any subContractor, or by anyone directly or indirectly employed by any of them, or by anyone for whose acts any of them may be liable: 29.1.1 Claims under workmen's compensation, disability benefit, damages because of bodily injury, occupational sickness or disease, or death of employees; 29.1.2 Claims for damages because of bodily injury, sickness or disease, or death of any person other than employees; 29.1.3 Claims for damages resulting from bodily injury including care, loss of services or death; 29.1.4 Claims for property damages because of injury to or destruction of tangible property, including loss of use resulting therefrom; 29.2 Certificates of Insurance shall be a part of the contract documents using the Accord 25-S for liability, and Accord 27 for property or other similar forms acceptable to the Owner. 29.3 The policy(ies) shall be endorsed to provide 15 days prior written notice be provided by the insurance company(ies) and shall be given to the Owner and Engineer/Architect in the event of cancellation, non-renewal, reduction of limits or deletion of coverage. 29.4 In addition an Owners and Contractors protective policy shall be provided to the Owner. 29.5 The Contractor shall procure and maintain, at the Contractors own expense, during the Contract Time, Liability insurance as hereinafter specified: 29.5.1 Contractor's General Liability and Property Damage Insurance including vehicle coverage issued to the Contractor and protecting the Contractor and additional insured from all claims for personal injury, including death, and all claims for destruction of or damage to property, arising out of or in connection with any operations under the Contract DocumentS, whether such operations be by the Contractor or by any subcontractor employed by the Contractor or anyone directly or indirectly employed by the Contractor or by a subcontractor employed by the Contractor. Insurance shall be written with a limit of liability of not less than $____________ for all damages arising out of bodily injury, including death and for all property damage; at any time resulting therefrom, sustained by any one person in any one accident; and a limit of liability of not less than $_____________ aggregate for any such damages sustained by two or more persons in any one accident. 29.6 The Contractor shall procure and maintain, at the Contractor'S own expense, during the Contract TIME, in accordance with the provision of the laws of the state in which the Work is performed, Workmen's Compensation Insurance, including occupational disease provisions, for all of the Contractor'S employees at the site of the Project and in any case any Work is sublet, the Contractor shall require such subcontractor similarly to provide Workmen's Compensation Insurance, including occupational disease provisions for all of the latter's employees unless such employees are covered by the protection afforded by the Contractor. In case any class of employees engaged in hazardous work under this contract at the site of the Project is not protected under Workmen's Compensation statute, the Contractor shall provide, and shall cause each subcontractor to provide, adequate and suitable insurance for the protection of its employees not otherwise protected. 29.7 The Contractor shall secure "All Risk" type Builder's Risk Insurance for Work to be performed. Unless specifically authorized by the Owner, the amount of such insurance shall not be less than the Contract price totaled in the Bid. The policy shall remain in force during the Contract time, and until the Work is accepted by the Owner. The policy shall name as the insured the Contractor and Owner. 29.7.1 If installing underground utilities the Contractor may provide ALL RISK - Inland Marine or Installation Floater coverage on all materials in lieu of the above total Bid price. 29.8 United States of America acting through United States Department of Agriculture shall be a certificate holder. 29.9 General aggregate limit under the general liability policy shall apply separately to each of the Contractors projects. The Certificate of Insurance shall show special endorsement. 29.10 The policy(ies) shall include the Owner and Engineer/Architect as additional insured. 30. Bonds. The Contractor shall within ten (10) days after receipt of Notice of Award furnish the Owner with (check the appropriate items) _____ Payment Bond _____ Performance Bond The United States of America acting through United States Department of Agriculture Rural Development shall be named as co-obligee. In the penal sums equal to the amount of the Contract price, conditioned upon the performance by the Contractor of all undertakings, covenants, terms, conditions and agreements of the Contract Documents, and upon the prompt payment by the Contractor to all persons supplying labor and materials in the prosecution of the Work provided by the Contract Documents. Such Bonds shall be executed by the Contractor and a corporate bonding company licensed to transact such business in the State of Iowa and named on the current list of "Surety Companies Acceptable on Federal Bonds" as published in the Treasury Department Circular Number 570. The expense of these Bonds shall be borne by the Contractor. 31. Environmental Requirements. When constructing a project involving trenching and/or other related earth excavations, Contractor shall comply with the following environmental constraints: Wetlands When disposing of excess, spoil, or other construction materials on public or private property, Contractor shall not fill in or otherwise convert wetlands. Floodplains When disposing of excess, spoil, or other construction materials on public or private property, Contractor shall not fill in or otherwise convert 100 year floodplain areas delineated on the latest Federal Emergency Management Agency Floodplain Maps, or other appropriate maps, i.e., alluvial soils on NRCS Soil Survey Maps. Historic Preservation Any excavation by Contractor that uncovers an historical or archaeological artifact shall be immediately reported to Owner and a representative of Agency. Construction shall be temporarily halted pending the notification process and further directions issued by Agency after Agency consultation with the State Historic Preservation Officer (SHPO). Endangered Species Contractor shall comply with the Endangered Species Act, which provides for the protection of endangered and/or threatened species and critical habitat. Should any evidence of the presence of endangered and/or threatened species or their critical habitat be brought to the attention of Contractor, Contractor will immediately report this evidence to Owner and a representative of Agency. Construction shall be temporarily halted pending the notification process and further directions issued by Agency after consultation with the U.S. Fish and Wildlife Service. Mitigation Measures The project had an Environmental Report, Environmental Assessment, or Environmental Impact Statement to meet the requirements of the National Environmental Policy Act, compliance with the mitigation measures in that document are hereby included as a condition of this contract. The mitigation measures are as follows: (None or Insert mitigation measures if any) CERTIFICATE OF OWNER'S ATTORNEY I, the undersigned, ______________________________, the duly authorized and acting Attorney for _____________________________________, do hereby certify as follows: I have examined the following attached contract documents submitted by _________________________________________________ for the _________________________________________ which includes (check each that applies): _____ 1. ADVERTISEMENT FOR BIDS _____ 2. BID _____ 3. BID BOND _____ 4. AWARD _____ 5. AGREEMENT _____ 6. PAYMENT BOND and POWER OF ATTORNEY _____ 7. PERFORMANCE BOND and POWER OF ATTORNEY _____ 8. CERTIFICATE OF INSURANCE _____ 9. COMPLIANCE STATEMENT _____ 10. CONSTRUCTION SCHEDULE _____ 11. CERTIFICATION REGARDING DEBARMENT _____ 12. CERTIFICATION FOR CONTRACTS, GRANTS, and LOANS I am of the opinion that each of the aforesaid agreements have been duly executed by the proper parties thereof acting through their duly authorized representatives; that said representatives have full power and authority to execute said instruments on behalf of the respective parties named hereon; and that the foregoing instruments constitute valid and legally binding obligations upon the parties executing the same in accordance with the terms, conditions, and provisions thereof. _________________________ ______________ Signed Date USDA RURAL DEVELOPMENT CONCURRENCE _______________________________________ Project Name As lender or insurer of funds to defray the costs of this contract, and without liability for any payments thereunder, the United States of America acting through United States Department of Agriculture, Rural Development hereby concurs in the award of this Contract to: ______________________________________ Contractor By __________________________ Title _________________________ Date _________ Rural Development Instruction 1942-A (Guide 19- Attachment 5) PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: that ________________________________________________________________________________________________ (Name of Contractor) ________________________________________________________________________________________________ (Address of Contractor) a ____________________________________________________________________, hereinafter called Principal, and (Corporation, Partnership, or Individual) ________________________________________________________________________________________________ (Name of Surety) ________________________________________________________________________________________________ (Address of Surety) hereinafter called Surety, are held and firmly bound unto __________________________________________________ ________________________________________________________________________________________________ (Name of Owner) ________________________________________________________________________________________________ (Address of Owner) hereinafter called Owner, and the United States of America hereinafter referred to as the Government in the total aggregate penal sum of_______________________________________________________________________ Dollars ($___________________ ) in 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, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the Owner, dated the ________________ day of ___________________ 20____, a copy of which is hereto attached and made a part hereof for the construction of: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties, all the undertakings, covenants, terms, conditions, and agreements of said contract during the original term thereof, and any extensions thereof which may be granted by the Owner, or GOVERNMENT, with or without notice to the SURETY and during the one year guaranty period and if the PRINCIPAL shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the Owner and GOVERNMENT from all costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the Owner and GOVERNMENT all outlay and expense which the Owner and GOVERNMENT may incur in making good any default, then this obligation shall be void, otherwise to remain in full force and effect. (5-23-79) PN 675 (4-7-97) SPN 508 (Guide 19- Attachment 5) (Page 2) Rural Development Instruction 1942-A PROVIDED, FURTHER, that the liability of the PRINCIPAL AND SURETY hereunder to the GOVERNMENT shall be subject to the same limitations and defenses as may be available to them against a claim hereunder by the Owner, provided, however, that the GOVERNMENT may, at its option, perform any obligations of the Owner required by the contract. PROVIDED, FURTHER, that the said SURETY, for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to Work to be performed thereunder or the SPECIFICATIONS accompanying same shall in any way affect its obligation 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. PROVIDED, FURTHER, that it is expressly agreed that this Bond shall be deemed amended automatically and immediately, without formal and separate amendments hereto, upon amendment to the Contract not increasing the contract price more than 20 percent, so as to bind the PRINCIPAL and the SURETY to the full and faithful performance of the Contract as so amended. The term "Amendment", wherever used in this Bond, and whether referring to this Bond, the Contract or the Loan Documents shall include any alteration, addition, extension, or modification of any character whatsoever. PROVIDED, FURTHER, that no final settlement between the Owner or GOVERNMENT and the PRINCIPAL shall abridge the right of the other beneficiary hereunder, whose claim may be unsatisfied. The Owner and GOVERNMENT are the only beneficiaries hereunder. IN WITNESS WHEREOF, this instrument is executed in ________ counterparts, each one of which shall be deemed an original, this the _____ day of ___________________ 20____. ATTEST: ____________________________________________________________________________________________( Principal ) SecretaryPrincipalSEALBy __________________________________________________________________________________________( Address )____________________________________________________________________________________________Witness as to Principal______________________________________________( Address )____________________________________________________________________________________________SuretyATTEST:______________________________________________By ____________________________________________Witness as to SuretyAttorney - in - Fact____________________________________________________________________________________________( Address )( Address )____________________________________________________________________________________________ NOTE: Date of Bond must not be prior to date of Contract. If ContractOR is partnership, all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the Project is located. ( 5-23-79 ) PN 675 (4-7-97) SPN 508 Rural Development Instruction 1942-A ( Guide 19- Attachment 6 ) PAYMENT BOND KNOW ALL PERSONS BY THESE PRESENTS: that _________________________________________________________________________________________________ ( Name of Contractor) _________________________________________________________________________________________________ ( Address of Contractor ) a __________________________________________________________________ hereinafter called PRINCIPAL and (Corporation, Partnership, or Individual) _________________________________________________________________________________________________ ( Name of Surety ) hereinafter called SURETY, are held and firmly bound unto _________________________________________________________________________________________________ ( Name of Owner ) _________________________________________________________________________________________________ ( Address of Owner ) hereinafter called Owner, and the United States of America hereinafter referred to as GOVERNMENT, and unto all persons, firms, and corporations who or which may furnish labor, or who furnish materials to perform as described under the contract and to their successors and assigns in the total aggregate penal sum of ______________________ ____________________________________________ Dollars ( $ _______________________) in 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, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the PRINCIPAL entered into a certain contract with the Owner, dated the ________ day of ____________ 20____ a copy of which is hereto attached and made a part hereof for the construction of: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ NOW, THEREFORE, if the PRINCIPAL shall promptly make payment to all persons, firms, and corporations furnishing materials for or performing Labor in the prosecution of the Work provided for in such contract, and any authorized extensions or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, coal and coke, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such Work, and for all labor cost incurred in such Work including that by a SUBContractOR, and to any mechanic or materialman lien holder whether it acquires its lien by operation of State or Federal law; then this obligation shall be void, otherwise to remain in full force and effect. PROVIDED, that beneficiaries or claimants hereunder shall be limited to the SUBContractORS, and persons, firms, and corporations having a direct contract with the PRINCIPAL or its SUBContractORS. PROVIDED, FURTHER, that the said SURETY, for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to Work to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation 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. (1-15-79 ) SPECIAL PN (4-7-97) SPN 508 Guide 19- Attachment 6) (Page 2) Rural Development Instruction 1942-A PROVIDED, FURTHER, that no suit or action shall be commenced hereunder by any claimant: (a) Unless claimant, other than one having a direct contract with the PRINCIPAL (or with the GOVERNMENT in the event the GOVERNMENT is performing the obligations of the Owner), shall have given written notice to any two of the following: The PRINCIPAL, the Owner, or the SURETY above named within ninety (90) days after such claimant did or performed the last of the work or labor or furnished the last of the materials for which said claim is made, stating with substantial accuracy the amount claimed and the name of the party to whom the materials were furnished, or for whom the work or labor was done or performed. Such notice shall be served by mailing the same by registered mail or certified mail, postage prepaid, in an envelope addressed to the PRINCIPAL, Owner, or SURETY, at any place where an office is regularly maintained for the transaction of business, or served in any manner in which legal process may be served in the state in which the aforesaid project is located, save that such service need not be made by a public officer. (b) After the expiration of one (1) year following the date of which PRINCIPAL ceased work on said Contract, is being understood, however, that if any limitation embodied in the Bond is prohibited by any law controlling the construction hereof, such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by each law. PROVIDED, FURTHER, that it is expressly agreed that this Bond shall be deemed amended automatically and immediately, without formal and separate amendments hereto, upon amendment to the Contract not increasing the contract price more than 20 percent, so as to bind the PRINCIPAL and the SURETY to the full and faithful performance of the Contract as so amended. The term "Amendment", wherever used in this Bond, and whether referring to this Bond, the Contract or the Loan Documents shall include any alteration, addition, extension, or modification of any character whatsoever. PROVIDED, FURTHER, that no final settlement between the Owner or GOVERNMENT and the ContractOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS WHEREOF, this instrument is executed in _________ counterparts, each of which shall be deemed an original, this the ______ day _________________________. ATTEST: ____________________________________________________________________________________________( Principal ) SecretaryPrincipalSEALBy __________________________________________________________________________________________( Address )____________________________________________________________________________________________Witness as to Principal______________________________________________( Address )____________________________________________________________________________________________SuretyATTEST:______________________________________________By ____________________________________________Witness as to SuretyAttorney - in - Fact____________________________________________________________________________________________( Address )( Address )____________________________________________________________________________________________ NOTE: Date of Bond must not be prior to date of Contract. If ContractOR is partnership, all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the Project is located. ( 1-15-79 ) SPECIAL PN (4-7-97) SPN 508 USDA Form FmHA 400 - 6 (Rev. 4-96) COMPLIANCE STATEMENT This statement relates to a proposed contract with __________________________________ __________________________________________________________________________ (Name of borrower or grantee) who expects to finance the contract with assistance from the Rural Housing Service (RHS), Rural Business Cooperative Service (RBS), or the Rural Utilities Service (RUS) or their successor agencies, United States Department of Agriculture (whether by a loan, grant, loan insurance, guarantee, or other form of financial assistance). I am the undersigned bidder or prospective contractor. I represent that : 1. I _____ have, _____ have not, participated in a previous contract or subcontract subject to executive order 11246 (regarding equal employment opportunity) or a preceding similar Executive order. 2. If I have participated in such a contract or subcontract, I _____ have, _____ have not, filed all compliance reports that I have been required to file in connection with the contract or subcontract. If the proposed contract is for $50,000 or more and I have 50 or more employees, I also represent that : 3. I _____ have, _____ have not previously had contracts subject to the written affirmative action program requirements of the Secretary of Labor. 4. If I have participated in such a contract or subcontract, I _____ have, _____ have not, developed and placed on file at each establishment affirmative action programs as required by the rules and regulations of the Secretary of Labor. I understand that if I have failed to file any compliance reports that have been required of me, I am not eligible and will not be eligible to have my bid considered or to enter into the proposed contract unless and until I make an arrangement regarding such reports that is satisfactory to either RHS, RBS, or RUS, or to the office where the reports are required to be filed. I also certify that I do not maintain or provide for my employees any segregated facilities at any of my establishments, and that I do not permit my employees to perform their services at any location, under my control, where segregated facilities are maintained. I certify further that I will not maintain or provide for my employees any segregated facilities at any of my establishments, and that I will not permit my employees to perform their services at any location, under my control, where segregated facilities are maintained. I agree that a breach of this certification is a violation of the Equal Opportunity clause in my contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, rest rooms and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because of habit, local custom, or otherwise. I further agree that (except where I have obtained identical certifications for proposed subcontractors for specific time periods) I will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $ 10,000 which are not exempt from the provisions of the Equal Opportunity clause; that I will retain such certifications in my files; and that I will forward the following notice to such proposed subcontractors (except where the proposed subcontractors have submitted identical certifications for specific time periods): (See Reverse). (4-7-97) SPN 508 FmHA 400-6(Rev. 4-96) RD 400 - 6 (Rev.4-96) Notice TO PROSPECTIVE SUBContractORS OF REQUIREMENTS FOR CERTIFICATIONS OF NON-Segregated FACILITIES A certification of Nonsegregated Facilities, as required by the May 9, 1967, order (32F.R. 7439, May 19, 1967) on Elimination of Segregated Facilities, by the Secretary of Labor, must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Opportunity clause. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e., quarterly, semiannually, or annually). NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. Date ____________ __________________________________ Signature of Bidder or Prospective Contractor __________________________________________ __________________________________________ __________________________________________ Address (including Zip Code) U.S. GPO:1996-755-010/22537 (4-7-97) SPN 508 CONSTRUCTION SCHEDULE NAME OF PROJECT: ________________________________________________________________________ Contract NO: __________________ ContractOR: __________________________________________ CALENDAR DAYS ITEM 0 30 60 90 120 150 180 210 240 270 300 330 360 1. 2. 3. 4. 5. 6. 7. 8. 9.10.11.12.13.14.15.16.17.18.19.20.21.22.23.24.PERCENT COMPLETION ContractOR will perform all Work described in the Contract Documents according to this CONSTRUCTION SCHEDULE unless revisions have been approved. CONCURRENCE OF ENGINEER ContractOR _____________________________________ ___________________________________ By __________________________________ By ________________________________ Date_________________________________ Date_______________________________ APPROVAL OF Owner ______________________________________ By ___________________________________ Date__________________________________ U. S. DEPARTMENT OF AGRICULTURE _____________________________________________________________________ Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions _____________________________________________________________________ This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR Part 3017, Section 3017.510, Participants' responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733). Copies of the regulations may be obtained by contacting the Department of Agriculture agency with which this transaction originated. (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS) (1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. _____________________________________________________________________ Organization Name PR/Award Number or Project Name _____________________________________________________________________ Name and Title of Authorized Representative(s) _____________________________________________________________________ Signature(s) Date FORM AD-1048 ( 1/92 ) INSTRUCTIONS FOR CERTIFICATION 1. By signing and submitting this form, the prospective lower tier participant is providing the certification set out on the reverse side in accordance with these instructions. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction, " "participant," "person, " " primary covered transaction," "principal," "proposal," and "voluntarily exclude," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this form that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this form that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous . A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Form AD-1048 (1/92) Iowa Guide 34a Iowa Instruction 1942-A STATEMENT OF FINAL COMPLETION AND OWNER'S ACCEPTANCE OF THE WORK PROJECT: _________________________ ENGINEER / _________________________ ARCHITECT: _________________________ _________________________ _________________________ _________________________ OWNER: _________________________ CONTRACTOR: ________________________ _________________________ _________________________ _________________________ _________________________ I, the undersigned Engineer / Architect of the above designated project, do hereby state that: 1. The construction provided for pursuant to Contract Documents including all approved amendments, Change Orders, and Environmental Assessment mitigation measures, hereafter called the Work between the Owner and Contractor has been completed and to the best of my knowledge and belief, is in substantial compliance with the provisions of the Contract Documents. 2. The final payment authorized hereto and made a part hereof is a complete and accurate summary of the Work performed in accordance with the Contract Documents. 3. The total cost of the Work as completed is ___________________________. I recommend, under the provisions of the Contract documents, that the Work be accepted and that the final payment be made. Engineer / Architect By __________________________________ Date ____________________ Accepted By ContractorAccepted BY OwnerBy __________________________________ By __________________________________Title _________________________________ Title _________________________________Date ____________Date ________________ FmHA Instruction 194O-Q Exhibit A-I CERTIFICATION FOR ContractS, GRANTS AND LOANS 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 undersigned, to any person 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 the awarding of any Federal contract, the making of any Federal grant or Federal loan, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant or loan. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person 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 this Federal contract, grant or loan, the undersigned shall complete and submit Standard Form - LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including contracts, subcontracts, and subgrants under grants and loans) 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 section 1352, title 31, U.S. Code. 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. __________________________________ __________________________________ (name) (date) __________________________________ (title) oOo (08-21-91) PN 171 Rural Development Instruction 1940-Q Exhibit A, page 16 6744 Federal Register/Vol. 55. No. 38/Monday, February 26, 1990/Rules and Regulations INSTRUCTIONS FOR COMPLETION OF SF-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 SF-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 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 District, 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 organizations 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 District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below the 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 (PFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract, grant, or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-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 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. 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