2023 RFP 23-01 Pavement Maintenance Program

CONTRACT DOCUMENTS AND SPECIFICATIONS 2023 PAVEMENT MAINTENANCE PROGRAM ASPHALTIC CONCRETE OVERLAY Bid 23-01 City of Grain Valley Community Development Department 711 S. Main Street Grain Valley, MO 64029 Bidder’s Name and Address: ___________________________ Phone & Fax No. ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ January 2023 TABLE OF CONTENTS CONTRACT DOCUMENTS AND SPECIFICATION 2023 PAVEMENT MAINTENANCE PROGRAM ASPHALTIC CONCRETE OVERLAY CITY OF GRAIN VALLEY, MO PAGE TO PAGE SUBJECT (INCLUSIVE) Advertisement to Bid A-1 : A-2 Instructions to Bidders IB-1 : IB-8 Missouri E-Verify Affidavit EV-1 : EV-2 Bidders Affidavit BA-1 : BA-2 Bid Form BF-1 : BF-6 Bid Requirements BR-1 : BR-2 Bid Bond Form BB-1 : BB-2 Bid Guaranty BG-1 Notice of Award NA-1 Missouri Domestic Products Procurement Law MO-PR-1 Agreement (Unit Price) AUP-1 : AUP-5 Performance Bond PEB-1 : PEB-2 Payment Bond PAB-1 :

PAB-2 Maintenance Bond MB-1 : MB-2 Surety Authorization Letter SA-1 Missouri Project Exemption Certificate MOPEC-1 Missouri Division of Labor Standards/Annual Wage Order No. 27 AWO-1 : AWO-4 Missouri Statement of Compliance MO-SC-1 Missouri Affidavit of Compliance AFC-1 Notice to Proceed NTP-1 Contractor’s Affidavit and Release for Partial Payment APP-1 Receipt and Release Final RR-1 Final Consent of Surety CS-1 Certificate of Substantial Completion CSP-1 General Conditions Table of Contents GC-i : GC-iii General Conditions GC-1 : GC-44 Project Special Conditions SC-1 : SC-3 Technical Specifications Cold Milling CM-1 Asphaltic Concrete AC-1 : AC-4 Appendix Map of Improvements MAP-1 List of Improvements L-1 Details D-1 : D-3 A-1 FORM 2-20-03 CITY OF GRAIN VALLEY, MISSOURI (“Owner”) COMMUNITY DEVELOPMENT DEPARTMENT 2023 PAVEMENT MAINTENANCE PROGRAM ASPHALTIC CONCRETE OVERLAY ADVERTISEMENT FOR BIDS Sealed Bids will be received by the City of Grain Valley at City Hall, 711 Main Street, Grain Valley, Missouri until 2:00 p.m. on February 2, 2023. At said place and time, all Bids that have been duly received will be publicly opened and read aloud in the Lower Level Conference Room. The Work is generally described as follows: 2023 Pavement Maintenance Program All Bids must be in accordance with the Bidding Documents, including, Drawings, Specifications, and Contract Documents on file at the Community Development Department, located in City Hall, 711 Main Street, Grain Valley, Missouri. Copies of plans, specifications, bid documents, and other Contract Documents can be seen and downloaded on-line at www.cityofgrainvalley.org. Information regarding this project can be found under the “Bid Notices” link on the website. Prospective bidders desiring hard copies of the Contract Documents for use in preparing bids may obtain a set of such documents from the City of Grain Valley Community Development Department, 711 S. Main Street, Grain Valley, MO 64029. Any questions regarding the project, plans, specification, or bid documents should be directed to Richard Tuttle, City Engineer at (816) 847-6222 or dtuttle@cityofgrainvalley.org. Bids will be received on a unit price basis. Each Bid shall be accompanied by a certified check, made payable to the City of Grain Valley, Missouri in an amount not less than five percent (5%) of the total Bid or by a Bid Bond with a Surety licensed to do business in the State of Missouri in the amount of five percent (5%) of the total Bid. This Security may be retained by the Owner until the Contract for the Project has been fully executed. The Contractor and all subcontractors will be required to comply with all applicable Federal and State labor regulations including Equal Employment Opportunity, Non-segregated Facilities, Minimum Wage Rates and Affirmative Action requirements. The City of Grain Valley hereby notifies all Bidders that it will affirmatively ensure that in any Contract entered into pursuant to this Advertisement, minority business enterprises will be afforded full opportunity to submit Bids without discrimination, regardless of race, color, or national origin in consideration for any award. Wage rates paid for Work for this Project shall be at least equal to the prevailing wage rates as determined by the Division of Labor Standards of the State of Missouri. The project contractor and each subcontractor shall require each on-site employee to complete the ten- hour safety program required under Section 292.675, RSMo, within 30 days of beginning any of the work on the project if he or she has not previously completed the program or does not have documentation of having done so. All bids are subject to the Buy Local/American policy and any other applicable purchasing statutes of the State of Missouri. http://www.cityofgrainvalley.org/ A-2 FORM 2-20-03 No bidder may withdraw its Bid within 90 days after the actual date of the opening of Bids. The City of Grain Valley, Missouri reserves the right to award the Contract by sections, to reject any or all Bids, and to waive any informalities or irregularities therein. Owner: City of Grain Valley, Missouri Date: January 10, 2023 PRE-BID CONFERENCE A pre-Bid conference will be held at City of Grain Valley, City Hall Lower Level Conference Room, 711 Main Street, Grain Valley, Missouri, 2:00 p.m. on January 24, 2023. Representatives of Owner will be present to discuss the Project. Bidders are encouraged to attend and participate in the conference. Owner will transmit to all prospective Bidders of record such Addenda as Owner considers necessary in response to questions arising at the conference. Oral statements may not be relied upon and will not be binding or legally effective. City of Grain Valley, Missouri 711 Main ◊ Grain Valley, MO 64029 Phone: (816) 847-6200 ◊ Fax: (816) 847-6209 2023 Pavement Maintenance Program Asphaltic Concrete Overlay INSTRUCTIONS TO BIDDERS ARTICLE 1 - DEFINED TERMS 1.01 Terms used in these Instructions to Bidders will have the meanings indicated in the General Conditions of the Contract for Construction and any Supplementary Conditions as contained in the Bidding Documents. Additional terms used in these Instructions to Bidders have the meanings indicated below which are applicable to both singular and plural thereof: A. Bid - The offer of a Bidder submitted on the prescribed form contained in the Bidding Documents setting forth the price(s) for the Work to be performed. B. Bidder- The entity who submits a Bid for the Work described in the Contract Documents. C. Bidding Documents - The Bidding Requirements and the Contract Documents (including without limitation all Drawings, Specifications and Addenda issued prior to receipt of Bids). D. Bidding Requirements - The Advertisement for Bids or Invitation to Bid, these Instructions to Bidders, the Bid Form and required attachments as set forth in the Bidding Documents and Bid Security. E. Bid Security - The deposit of an approved Bid Bond, Cashier's Check or Certified Check furnished by the Bidder and made payable to the Owner for the amount stipulated in the Advertisement for Bids or Invitation to Bid. F. Owner- City of Grain Valley, Missouri, 711 Main, Grain Valley, Missouri 64029. ARTICLE 2 - COPIES OF BIDDING DOCUMENTS 2.01 Complete sets of the Bidding Documents may be obtained from Owner as set forth in the Advertisement for Bids. A copy of the Bidding Documents are on file with the Owner at the City of Grain Valley, Missouri, 711 Main, Grain Valley, Missouri 64029. 2.02 Complete sets of Bidding Documents must be used in preparing Bids; Owner assumes no responsibility for errors or misinterpretations resulting from the use of incomplete sets of Bidding Documents. 2.03 Owner in making copies of the Bidding Documents available on the above terms do so only for the purpose of obtaining Bids for the Work and do not confer a license or grant for any other use. IB-1 ARTICLE 3 - QUALIFICATIONS OF BIDDERS 3.01 The Bidder must be qualified by experience, adequate financing, and equipment to perform the Work required by the Contract within the Contract Times. 3.02 To document Bidder's qualifications to perform the Work, within five (5) days of Owner's request, Bidder shall submit written evidence such as financial data, previous experience, qualifications of personnel, present commitments, and other data regarding Bidder's qualifications. ARTICLE 4 - EXAMINATION OF BIDDING DOCUMENTS AND SITE 4.01 It is the responsibility of each Bidder, before submitting a Bid, to (a) thoroughly examine the Bidding Documents, (b) visit the site to become familiar with local conditions that may affect cost, progress, performance, or furnishing of the Work, (c) consider federal, state, and local laws and regulations that may affect cost, progress, performance, or furnishing of the Work, (d) study and carefully correlate Bidder's observations with the Bidding Documents, and (e) notify the City of all conflicts, errors, or discrepancies discovered by Bidder in the Bidding Documents. 4.02 Bidder must carefully study all 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 which have been made available to Bidder, but Bidder shall not be entitled to rely upon the accuracy or completeness of such reports or tests. Such reports and drawings are not Contract Documents and may not be complete for Bidder's purposes, including without limitation, any reports or test described on Exhibit A hereto. Owner does not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Bidding Documents with respect to subsurface conditions, physical conditions or underground facilities at or contiguous to the site. Bidder must obtain and carefully study, and assume responsibility for all such additional or supplementary examinations, investigations, explorations, tests, studies, and data concerning conditions, including, but not limited to, 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 as Bidder deems necessary. Any discrepancies between the reports and drawings made available to the Bidder and the information revealed in the Bidder's own examinations, tests, studies, explorations or investigations of any type shall be immediately reported in writing by the Bidder to Professional. 4.03 Provisions concerning responsibilities for the adequacy of data furnished to prospective Bidders on subsurface conditions, underground facilities, and other physical conditions appear in the General Conditions. 4.04 Before submitting a Bid, each Bidder will be responsible to make or obtain such explorations, tests, and data concerning physical 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 and which Bidder deems necessary to determine its Bid for performing and furnishing the Work in accordance with the time, price, and other terms and conditions of the Contract Documents. On reasonable notice, Owner will provide each Bidder access to the site to conduct such explorations and tests as each Bidder deems necessary for submission of a Bid. Bidder shall fill all holes, clean up, and restore the site to its former condition upon completion of such explorations. Each Bidder wishing to inspect the site and any existing facilities shall contact: Richard J. Tuttle, P.E. City Engineer I 816.847.6222 I dtuttle@cityofgrainvalley.org Michael Myers I 816.847.6272 I mmyers@cityofgrainvalley.org IB-2 mailto:dtuttle@cityofgrainvalley.org mailto:mmyers@cityofgrainvalley.org IB-3 4.05 The submission of a Bid will constitute an incontrovertible representation by Bidder that Bidder has complied with the provisions of Section 4 of the Instructions to Bidders, that without exception the Bid is premised upon performing and furnishing the Work required by the Contract Documents, that Bidder has given Professional written notice of all conflicts, errors, ambiguities, and discrepancies that Bidder has discovered in the Bidding Documents and the written resolutions thereof by Professional are acceptable to Bidder, and that the Bidding Documents are sufficient in scope and detail to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work. ARTICLE 5- SITE AND OTHER AREAS 5.01 The lands upon which the Work is to be performed and access thereto, and other lands designated for use by Contractor in performing the Work are identified in the Bidding Documents. All additional lands and access thereto required for temporary construction facilities, construction equipment, or storage of materials and equipment to be incorporated in the Work are to be obtained and paid for by Contractor. ARTICLE 6 - INTERPRETATIONS AND ADDENDA 6.01 All questions about the meaning or intent of the Bidding Documents are to be directed to Professional. Questions concerning the Bidding Documents may be directed to: Richard J. Tuttle, City Engineer I816.847.6222 I dtuttle@cityofgrainvalley.org 6.02 Interpretations or clarifications considered necessary by Owner in response to such questions will be issued by Addenda. Questions received less than four (4) days prior to the date for the receipt of Bids may not be answered. Only answers issued by formal written Addenda will be binding. Oral and other interpretations or clarifications will be without legal effect. Addenda may also be issued to modify the Bidding Documents as deemed advisable by Professional. Such Addenda must also be in writing in order to be binding. ARTICLE 7 - BID SECURITY 7.01 A Bid must be accompanied by Bid security made payable to Owner in an amount of five percent (5%) of Bidder's maximum Bid Price and in the form of a certified or bank check or a Bid Bond on the form attached issued by a surety meeting the requirements of the General Conditions. 7.02 The Bid Security of the Successful Bidder will be retained until such Bidder has executed the Contract Documents, furnished the required Contract Security and met the other conditions of the Notice of Award, whereupon the Bid Security will be returned. If the Successful Bidder fails to execute and deliver the Contract Documents and furnish the required contract security within fifteen (15) days after the Notice of Award, Owner may annul the Notice of Award and the Bid Security of that Bidder will be forfeited. The Bid Security of other Bidders whom Owner believes to have a reasonable chance of receiving the award may be retained by Owner until the earlier of seven (7) days after the Effective Date of the Agreement or ninety one (91) days after the Bid opening, whereupon Bid Security furnished by such Bidders will be returned. 7.03 Bid Security of other Bidders whom Owner believes do not have a reasonable chance of receiving the award will be returned within seven (7) days after the Bid opening. mailto:dtuttle@cityofgrainvalley.org IB-4 ARTICLE 8 - CONTRACT TIMES 8.01 The Contract Times shall be the dates by which: (a) Contractor shall achieve Substantial Completion of the entire Work; and (b) Contractor shall achieve Final Completion of the entire Work. The Contract Times for the Project are set forth in Article 3 of the Agreement Between Owner and Contractor. ARTICLE 9 - LIQUIDATED DAMAGES 9.01 Provisions for liquidated damages are set forth in Article 3 of the Agreement. ARTICLE 10 - SUBSTITUTE AND "OR-EQUAL" ITEMS 10.01 The Contract, if awarded, will be on the basis of materials and equipment specified or described in the Bidding Documents without consideration of possible substitute or "or-equal" items. Whenever it is specified or described in the Bidding Documents that a substitute or "or-equal" item of material or equipment may be furnished or used by Contractor if acceptable to Owner, application for such acceptance will not be considered by Owner until after the Effective Date of the Agreement. The procedure for submission of any such application by Contractor and consideration by Owner is set forth in the General Conditions and may be supplemented in the General Requirements or the Supplementary Conditions. ARTICLE 11 - SUBCONTRACTORS, SUPPLIERS AND OTHERS 11.01 If the Supplementary Conditions require the identity of certain Subcontractors, Suppliers, individuals, or entities to be submitted to Owner in advance of a specified date prior to the Effective Date of the Agreement, the apparent Successful Bidder, and any other Bidder so requested, shall within five (5) days after Bid opening, submit to Owner a list of all such Subcontractors, Suppliers, individuals, or entities proposed for those portions of the Work for which such identification is required. Such list shall be accompanied by an experience statement with pertinent information regarding similar projects and other evidence of qualification for each such Subcontractor, Supplier, individual or entity if requested by Owner. If Owner or Professional after due investigation has reasonable objection to any proposed Subcontractor or Supplier, Owner may, before the Notice of Award is given, require the apparent Successful Bidder to submit a substitute, in which case, apparent Successful Bidder shall submit an acceptable substitute, and Bidder's Bid price will be adjusted in accordance with Paragraph 6.09 of the General Conditions. 11.02 Contractor shall not be required to employ any Subcontractor, Supplier, individual, or entity against whom Contractor has reasonable objection. ARTICLE 12-PREPARATION OF BID 12.01 The Bid Form is provided in the Bidding Documents. Bid Forms must be fully completed in ink or typewritten and include all required attachments. 12.02 Bids by corporations must be executed in the corporate name by the president or vice-president (or other corporate officer accompanied by evidence of authority to sign), and the corporate seal shall be affixed and attested by the secretary or an assistant secretary. The state of incorporation shall be shown below the corporate name. Bids by partnerships must be executed in the partnership name and signed by a partner (accompanied by evidence of authority to sign) and the official address of the partnership must be shown below the signature. Bids by joint ventures shall be signed by each participant in the joint venture or by an authorized agent of each participant. Bids by limited liability companies shall be executed in the name of the firm by a member and accompanied by evidence of authority to sign. The state of formation of the firm IB-5 and the official address of the firm must be shown below the signature. All names shall be typed or printed in ink below the signatures. The address and telephone number for communications regarding the Bid shall be shown. 12.03 A Bid by a person who affixes to his signature the word "president", "secretary", "agent", or other designation without disclosing his principal may be held to be the bid of the individual signing. 12.04 All blank spaces in the Bid Form shall be filled. 12.05 The Bid shall contain an acknowledgment of receipt of all Bidding Documents. 12.06 Each Bid shall be accompanied by an executed Affidavit in the form attached hereto. ARTICLE 13 - BASIS OF BID 13.01 The Bidder shall complete the schedule of unit prices included in the Bid Form and shall accept all fixed unit prices listed therein. The total Bid will be calculated as the sum of the products of the estimated quantity of each item and the unit price bid. Discrepancies in the multiplication of units of Work and unit prices will be resolved in favor of the unit prices. Discrepancies between the indicated sum of any column of figures and the correct sum thereof will be resolved in favor of the correct sum. The unit prices set forth in the Bid Form shall be considered complete and include: (1) all materials, equipment, labor, delivery, installation, overhead and profit; and (2) any other costs or expenses in connection with, or incidental to, the performance of that portion of the Work to which such unit prices apply. Any estimated quantities of Work contained in any Bidding Document or Contract Document are not guaranteed and are solely for the purpose of comparison of Bids. Estimated quantities may change because of changes ordered by Owner or because of actual site conditions or other reasons. The unit prices for the Work shall remain unchanged even if the actual quantity of Work performed by Contractor differs materially and significantly from any estimated quantity of such items. Contractor agrees that it shall make no claim for an adjustment in any unit price for any variance between the actual quantity of Work performed by Contractor and any estimated quantity of such item. ARTICLE 14 - SUBMISSION OF BIDS 14.01 Bids shall be submitted no later than the date and time prescribed in the Advertisement or Invitation for Bids, or the modified time and place indicated by Addendum. The unbound copy of the Bid Form is to be completed and accompanied by all other required documents, including the Bid Security. 14.02 Bids shall be enclosed in an opaque sealed envelope plainly marked as a "Bid" with the Project title and marked with the name and address of the Bidder. If the Bid is sent through the mail or other delivery system, the sealed envelope shall be enclosed in a separate envelope with the notation "BID ENCLOSED" on the face of it. 14.03 Bids received after the time and date for receipt of Bids will be returned unopened. Bidder shall assume full responsibility for timely delivery at the location designated for receipt of Bids. Oral, telephone, telegraph, or facsimile Bids are invalid and will not receive consideration. IB-6 ARTICLE 15- MODIFICATION AND WITHDRAWAL OF BIDS 15.01 Bids may be modified or withdrawn by an appropriate document duly executed in the manner that a Bid must be executed and delivered to the place where Bids are to be submitted at any time prior to the opening of Bids. ARTICLE 16-OPENING OF BIDS 16.01 Bids will be opened and read aloud publicly. An abstract of the amounts of the base Bids will be made available to Bidders after the opening of Bids. ARTICLE 17- BIDS TO REMAIN SUBJECT TO ACCEPTANCE 17.01 All Bids will remain subject to acceptance for 90 days after the day of the Bid opening, but Owner may, in its sole discretion, release any Bid and return the Bid security prior to that date. Any extension of the commencement date for Work as specified in the Contract Documents shall be governed by the applicable provisions of the Contract Documents and shall not be grounds for withdrawal of a Bid. ARTICLE 18-APPROVAL BY BOAD OF ALDERMAN 18.01 The Contract will not be binding and effective on the City until approved by Resolution of the Board of Alderman of Grain Valley, Missouri. ARTICLE 19-AWARD OF CONTRACT 19.01 Owner reserves the right to reject any and all Bids, including, without limitation, the right to reject any or all bids which in the Owner's discretion are nonconforming, nonresponsive, unbalanced, or conditional Bids and to reject the Bid of any Bidder if Owner believes that it would not be in the best interest of the Project to make an award to that Bidder, whether because the Bid is not responsive or the Bidder is unqualified or of doubtful financial ability or fails to meet any other pertinent standard or criteria established by Owner. Owner also reserves the right to waive all informalities not involving price, time, or changes in the Work. 19.02 In evaluating Bids, Owner will consider the qualifications of the Bidders, whether or not the Bids comply with the prescribed requirements, and such alternatives, unit prices, and other data, as may be requested in the Bid Form or prior to the Notice of Award. 19.03 Owner may conduct such investigations as Owner deems necessary to assist in the evaluation of any Bid and to establish the responsibility, qualifications, and financial ability of Bidders, proposed Subcontractors, Suppliers, and other persons and organizations to perform and furnish the Work in accordance with the Contract Documents to Owner's satisfaction within the prescribed time. 19.04 If the Contract is to be awarded, it will be awarded to the lowest, responsive and responsible Bidder whose evaluation by Owner indicates to Owner that Bidder is responsible and qualified to perform the Work. 19.05 More than one Bid for the same Work from an individual or entity under the same or different names will not be considered. Reasonable grounds for believing that any Bidder has an interest in more than one Bid for the Work may be cause for disqualification of that Bidder and the rejection of all Bids in which that Bidder has an interest. IB-7 ARTICLE 20- CONTRACT SECURITY AND INSURANCE 20.01 The General Conditions as may be modified by the Supplementary Conditions, set forth the requirements as to Performance and Payment Bonds and insurance. When the Successful Bidder delivers the executed Agreement to Owner, it must be accompanied by the required Performance and Payment Bonds. ARTICLE 21- EXECUTION OF AGREEMENT AND BONDS 21.01 When Owner gives a Notice of Award to the Successful Bidder, it will be accompanied by unsigned counterparts of the Agreement with other written Contract Documents attached; the required number of copies will be determined by Owner. Within fifteen (15) days thereafter Contractor shall sign, leaving the dates blank, and deliver the required number of counterparts of the Agreement and attached documents to Owner with the required Bonds and power of attorney. After confirmation of the Contract by action of the City, if required, or within fifteen (15) days if not required, Owner shall execute all copies of the Agreement and other Contract Documents submitted by Contractor/Successful Bidder, insert the date of Contract on the Agreement, Bonds, and power of attorney, and return all copies to Contractor for distribution. Distribution of signed copies shall be as directed by Owner. ARTICLE 22- TAXES AND PERMITS 22.01 Responsibility for payment of taxes and permits is set forth in the General Conditions. As set forth in the General Conditions, certain equipment and materials are exempt from State and Local Sales and Use taxes. Said taxes shall not be included in the Bid. ARTICLE 23- LAWS AND REGULATIONS 23.01 Provisions concerning Laws and Regulations are set forth in the Contract Documents. 23.02 Bids shall be based on payment by Contractor and each Subcontractor of wage rates not less than the prevailing hourly wage for each craft or classification of workmen engaged on the Work as determined by the Industrial Commission of Missouri on behalf of the Department of Labor and Industrial Relations. Higher prevailing wage rates may apply if a federal governmental agency is providing funding for this Project. Requirements regarding payment of prevailing wage rates are set forth in the General Conditions. 23.03 Information on the Missouri Domestic Product Procurement (Buy American) Act is contained in the General Conditions. 23.04 A pre-Bid conference will be held at City of Grain Valley, City Hall Lower Level Conference Room, 711 Main Street, Grain Valley, Missouri, 2:00 p.m. on January 24, 2023. Representatives of Owner will be present to discuss the Project. Bidders are encouraged to attend and participate in the conference. Owner will transmit to all prospective Bidders of record such Addenda as Owner considers necessary in response to questions arising at the conference. Oral statements may not be relied upon and will not be binding or legally effective. 23.05 Successful bidder must obtain a City of Grain Valley Business License prior to the start of work. IB-8 EXHIBIT A REPORTS AND DRAWINGS REFERRED TO IN PARAGRAPH 4.02 NONE AFFIDAVIT of COMPLIANCE (Section 285.530.2, Revised Statutes of Missouri) State of Missouri ) ss: County of ) Now this and says: day of _, 2021 the undersigned being first duly sworn, deposes 1. I am more than 18 years of age. 2. I make this affidavit from my personal knowledge of the facts stated herein or upon information and facts available to me as a duly authorized owner, partner, corporate, or LLC officer or Human Relations Director of ("Contractor"). 3. I am authorized to make this affidavit on behalf of Contractor. 4. I state and affirm that Contractor is enrolled and is currently participating in E-Verify, a federal work authorization program or another equivalent electronic verification of work authorization program operated by the United States Department of Homeland Security under the Immigration Reform and Control Act of 1986. 5. Further, Contractor does not knowingly employ any person who is an unauthorized alien. 6. Further, Contractor has performed an electronic verification check as described above on all workers hired since January 1, 2009 or obtained documents required for completion of a Federal 1-9 form before it began participating in E-Verify. 7. Attached to this affidavit is a true and accurate copy of Contractor's Memorandum of Understanding with the United States concerning the use of E-Verify. I certify under penalty of perjury that the statements above are complete, true and accurate to the best of my knowledge and belief. Authorized Agent, Partner, Owner or Officer Printed Name Title If Contractor has a Human Relations Director or equivalent that person must sign as an affiant as well. EV-1 EV-2 I certify under penalty of perjury that the statements above are complete, true and accurate to the best of my knowledge and belief. Human Relations Director Printed Name Title Subscribed and sworn to before me this_ day of _,20_. Notary Public My commission expires: This form is promulgated pursuant to 15CSR 60-15.020. Use of this form is not required but the Attorney General has deemed this affidavit sufficient in form to satisfy the requirements of section 285.540 RSMo., Supp. 2008. BA-1 City of Grain Valley, Missouri 711 Main ◊ Grain Valley, MO 64029 Phone: (816) 847-6222 ◊ Fax: (816) 847-6209 2023 PAVEMENT MAINTENANCE PROGRAM ASPHALTIC CONCRETE OVERLAY BIDDER'S AFFIDAVIT STATE OF -1 )ss: COUNTY OF _, I (Name}, representing (Name of Bidder), (hereinafter "the Bidder") upon oath depose and state that neither the Bidder nor anyone in Bidder's employment has employed any person to solicit or procure this Contract nor will any agent, representative, employee, servant, officer, director, manager or member of Bidder make any payment or agreement for payment of any compensation in connection with the procurement of this Contract. I further depose and state that no part of the Contract Price was paid or will be paid to any person, corporation, firm, association, or other organization for soliciting the Contract, other than the payment of their normal compensation to persons regularly employed by the Bidder whose services in connection with the construction of the public building or project were in the regular course of their duties for the Bidder. I further depose and state that the Bid is genuine and not collusive or sham; that said Bidder has not colluded, conspired, connived, or agreed, directly or indirectly, with any Bidder or person, to put in a sham bid or to refrain from bidding, and has not in any manner, directly or indirectly, sought by agreement, or collusion, or communication, or conference with any person to fix the bid price of Bidder or of any other Bidder, and that all statements in said Bid are true. I further depose and state that Bidder has and will continue to comply with any Affirmative Action Plan and Disadvantaged Business Enterprise Plan of the City of Grain Valley, Missouri, as well as all Ordinances and directives of the City referring to the participation of Small, Disadvantaged, Women owned and Minority Businesses applicable to this Bid and the Contract to be awarded through this Bidding Process. I further depose and state that the undersigned, the Bidder, and all, officers, directors, employees and agents of Bidder and all Subcontractors and Suppliers Bidder intends to use if awarded the Contract, are not currently debarred or suspended from bidding on contracts with any governmental entity or agency, nor are any such persons or companies proposed to be debarred or suspended from bidding on such contracts, nor have any such persons or companies been excluded from participating in the Contract to be awarded through this bid process by any federal, state or local governmental entity or agency. I further depose and state that neither the Bidder, nor any person who is an agent, representative, employee, servant, officer, director, manager or member of the Bidder has offered, gave, or agreed to give any employee or former employee of the City, any gratuity, payment or gift in connection with any decision, approval, disapproval, or recommendation, influencing the content of any specification or procurement standard, rendering of advice, investigation, auditing, or in any other advisory capacity in any proceeding or application, request for filing, determination, claim or controversy, or other particular matter, pertaining to any program requirement or a contract or subcontract, or to any solicitation or proposal therefore. BA-2 I further depose and state that Bidder has not received any payment or gratuity from a Subcontractor or Supplier, as an inducement for the award of a subcontract or a purchase order. The undersigned further warrants that he or she has the authority to execute this affidavit on behalf of the Bidder. Signature , before me, a Notary Public, personally appeared to me known to be the person who executed the within Bidder's Affidavit, and acknowledged to me that he/she executed the same for the purposes therein stated. Notary Public My commission expires: BID FORM 2022 TABLE OF CONTENTS Page ARTICLE 1- Bid Recipient ................................................................................................................................... 1 ARTICLE 2 - Bidder's Acknowledgements .................................................................................................... 1 ARTICLE 3 - Bidder's Representations ............................................................................................................... 1 ARTICLE 4- Bidder's Certification ....................................................................................................................... 2 ARTICLE 5 - Basis of Bid ...................................................................................................................................... 3 ARTICLE 6 -Time of Completion .............................................................................................................. 4 ARTICLE 7 -Attachments to this Bid ............................................................................................................. 4 ARTICLE 8 - Bid Submittal ................................................................................................................................... 5 BF-1 ARTICLE 1- BID RECIPIENT 1.01 This Bid is submitted to: City of Grain Valley, Missouri C/O Richard Tuttle, City Engineer 711 Main Grain Valley, Missouri 64029 1.02 The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Owner in the form included in the Bidding Documents to perform all Work as specified or indicated in the Bidding Documents for the prices and within the times indicated in this Bid and in accordance with the other terms and conditions of the Bidding Documents. ARTICLE 2 - BIDDER'S ACKNOWLEDGEMENTS 2.01 Bidder accepts all of the terms and conditions of the Instructions to Bidders, including without limitation those dealing with the disposition of Bid security. This Bid will remain subject to acceptance for 90 days after the Bid opening, or for such longer period of time that Bidder may agree to in writing upon request of Owner. ARTICLE 3 - BIDDER'S REPRESENTATIONS 3.01 In submitting this Bid, Bidder represents that: A. Bidder has examined and carefully studied the Bidding Documents, and any data and reference items identified in the Bidding Documents, and hereby acknowledges receipt of the following Addenda: Addendum No. Addendum, Date B. Bidder has visited the Site, conducted a thorough, alert visual examination of the Site and adjacent areas, and become familiar with and satisfied itself as to the general, local, and Site conditions that may affect cost, progress, and performance of the Work. C. Bidder is familiar with and has satisfied itself as to all Laws and Regulations that may affect cost, progress, and performance of the Work. D. Bidder has carefully studied all: (1) reports of explorations and tests of subsurface conditions at or adjacent to the Site and all drawings of physical conditions relating to existing surface or subsurface structures at the Site that have been identified in the Supplementary Conditions, especially with respect to Technical Data in such reports and drawings, and (2) reports and drawings relating to Hazardous Environmental Conditions, if any, at or adjacent to the Site that have been identified in the Supplementary Conditions, especially with respect to Technical Data in such reports and drawings. BF-2 Bidder has considered the information known to Bidder itself; information commonly known to contractors doing business in the locality of the Site; information and observations obtained from visits to the Site; the Bidding Documents; and any Site-related reports and drawings identified in the Bidding Documents, with respect to the effect of such information, observations, and documents on (1) the cost, progress, and performance of the Work; (2) the means, methods, techniques, sequences, and procedures of construction to be employed by Bidder; and (3) Bidder's safety precautions and programs. E. Bidder agrees, based on the information and observations referred to in the preceding paragraph, that no further examinations, investigations, explorations, tests, studies, or data are necessary for the determination of this Bid for performance of the Work at the price bid and within the times required, and in accordance with the other terms and conditions of the Bidding Documents. F. Bidder is aware of the general nature of work to be performed by Owner and others at the Site that relates to the Work as indicated in the Bidding Documents. G. Bidder has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder has discovered in the Bidding Documents and confirms that the written resolution thereof by Engineer is acceptable to Bidder. H. The Bidding Documents are generally sufficient to indicate and convey understanding of all terms and conditions for the performance and furnishing of the Work. I. The submission of this Bid constitutes an incontrovertible representation by Bidder that Bidder has complied with every requirement of this Article, and that without exception the Bid and all prices in the Bid are premised upon performing and furnishing the Work required by the Bidding Documents. ARTICLE 4 - BIDDER'S CERTIFICATION 4.01 Bidder certifies that: A. This Bid is genuine and not made in the interest of or on behalf of any undisclosed individual or entity and is not submitted in conformity with any collusive agreement or rules of any group, association, organization, or corporation; B. Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid; C. Bidder has not solicited or induced any individual or entity to refrain from bidding; and D. Bidder has not engaged in corrupt, fraudulent, collusive, or coercive practices in competing for the Contract. For the purposes of this Paragraph 4.01.D: 1. "corrupt practice" means the offering, giving, receiving, or soliciting of anything of value likely to influence the action of a public official in the bidding process; 2. "fraudulent practice" means an intentional misrepresentation of facts made (a) to influence the bidding process to the detriment of Owner, (b) to establish bid prices at artificial non-competitive levels, or (c) to deprive Owner of the benefits of free and open competition; BF-3 3. "collusive practice" means a scheme or arrangement between two or more Bidders, with or without the knowledge of Owner, a purpose of which is to establish bid prices at artificial, non-competitive levels; and 4. "coercive practice" means harming or threatening to harm, directly or indirectly, persons or their property to influence their participation in the bidding process or affect the e execution of the Contract. ARTICLE 5 - BASIS OF BID 5.01 Bidder will complete the Work in accordance with the Contract Documents for the following price(s): Project 1-Asphaltic Concrete Overlay Item No. Description Units Quantity Unit Price Extension 1 2-Inch Edge Mill SY 30,400 2 2-Inch Cold Milling SY 11,180 3 4-Inch Cold Milling SY 4,600 4 2-Inch Asphaltic Concrete Overlay Tons 7,100 5 4-Inch Asphaltic Concrete Overlay Tons 510 6 Restore Section Corner Monument Boxes EA 2 7 Traffic Control LS 1 8 Force Account (Set) 1 FA $15,000.00 $15,000.00 Total Amount of Base Bid Total Amount of Bid for Project (Typed or Written) The City reserves the right to adjust quantities for budget purposes Bidder acknowledges that (1) each Bid Unit Price includes an amount considered by Bidder to be adequate to cover Contractor's overhead and profit for each separately identified item, and (2) estimated quantities are not guaranteed, and are solely for the purpose of comparison of Bids, and final payment for all unit price Bid items will be based on actual quantities, determined as provided in the Contract Documents. ARTICLE 6 -TIME OF COMPLETION 6.01 Bidder agrees that the Work will be substantially complete within 45 days of Notice to Proceed and will be completed and ready for final payment in accordance with Paragraph 14.10 of the General Conditions within 15 days of final punch list. 6.02 Bidder accepts the provisions of the Agreement as to liquidated damages. ARTICLE 7 -ATTACHMENTS TO THIS BID 7.01 The following documents are submitted with and made a condition of this Bid: A. Required Bid security; B. Bidders Affidavit; C. E-Verify Affidavit; D. List of Proposed Subcontractors; E. List of Proposed Suppliers; F. List of Equipment; G. List of Contracts on Hand; H. Evidence of authority to do business in the state of Missouri; or a written covenant to obtain such license within the time for acceptance of Bids; I. Contractor's License No.: [or] Evidence of Bidder's ability to obtain a State Contractor's License and a covenant by Bidder to obtain said license within the time for acceptance of Bids; J. All manufactured goods or commodities used or supplied under this contract must meet the requirements of the Domestic Products Procurement law RSMo 34.350 - RSMo 34.359. Compliance certification must be submitted with the bid. 7.02 The terms used in this Bid with initial capital letters have the meanings stated in the Instructions to Bidders, the General Conditions, and the Supplementary Conditions. BF-5 ARTICLE 8 - BID SUBMITTAL BIDDER: [Indicate correct name of bidding entity] By: [Signature] [Printed name] {If Bidder is a corporation, a limited liability company, a partnership, or a joint venture, attach evidence of authority to sign.) Attest: [Signature] [Printed name] Title: Submittal Date: Address for giving notices: Telephone Number: Fax Number: Contact Name and e-mail address: Bidder's License No.: (where applicable) BF-6 2023 PAVEMENT MAINTENANCE PROGRAM ASPHALTIC CONCRETE OVERLAY BID SPECIFICATIONS EQUIPMENT QUESTIONNAIRE The undersigned hereby represents that he proposes to perform the work in the following manner and with the following equipment: a. The work, if awarded, will have the personal supervision of whom? b. List below the equipment that will be used or is available for use on this contract. QUANTITY ITEM DESCRIPTION, SIZE, CAPACITY, ETC. CONDITION YEARS OF SERVICE PRESENT LOCATION Attach additional sheets if required. BR-1 2023 PAVEMENT MAINTENANCE PROGRAM BID SPECIFICATIONS ASPHALTIC CONCRETE OVERLAY LIST OF CONTRACTS ON HAND LOCATION TYPE OF WORK/CONTRACTING AGENCY CONTRACT PRICE DATE % COMPLETE Attach additional sheets if required. BR-2 293113v1 FORM 2-20-03 BID BOND Any singular reference to Bidder, Surety, Owner or other party shall be considered plural where applicable. BIDDER (Name and Address): SURETY (Name and Address of Principal Place of Business): OWNER (Name and Address): City of Grain Valley, Missouri 711 Main Street Grain Valley, MO 64029 PROJECT Date: Amount: Description (Name and Location): 2021 Pavement Maintenance Program Asphaltic Concrete Overlay BOND Date: Amount: Surety and Bidder, intending to be legally bound hereby, subject to the terms printed on the reverse side hereof, do each cause this Payment Bond to be duly executed on its behalf by its authorized officer, agent or representative. BIDDER AS PRINCIPAL Company: (Corp. Seal) Signature: Name and Title: SURETY Company: (Corp. Seal) Signature: Name and Title: (Attach certified Power of Attorney) 293113v1 FORM 2-20-03 NOW THEREFORE, Bidder and Surety jointly and severally agree to bind themselves, their heirs, executors, administrators, successors and assigns to pay to Owner upon default of Bidder the penal sum set forth on the face of the Bond and subject to the following terms and conditions: 1. Default of Bidder shall occur upon the failure of Bidder to deliver within the time required by the Bidding Documents the executed Agreement required by the Bidding Documents and the performance and payment bonds required by the Bidding Documents and Contract Documents. 2. This obligation shall be null and void if: a. Owner accepts Bidder's bid and Bidder delivers within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and the performance and payment bonds required by the Bidding Documents and Contract Documents, or b. All bids are rejected by Owner, or c. Owner fails to issue a notice of award to Bidder within the time specified in the Bidding Documents (or any extension thereof agreed to in writing by Bidder. 3. Payment under this Bond will be due and payable upon default of Bidder and within ten (10) calendar days after receipt by Bidder and Surety of written notice of default from Owner. 4. Notice required hereunder shall be in writing and sent via U.S. Mail or hand delivered to both Bidder and Surety at their respective addresses shown on the face of this Bond and shall be deemed to be effective upon receipt by the party concerned. 5. Surety waives notice of and any and all defenses based on or arising out of any time extension to issue notice of award agreed to in writing by Owner and Bidder. 6. Surety shall cause to be attached to this Bond a current and effective Power of Attorney evidencing the authority of the officer, agent or representative who executed this Bond on behalf of Surety to execute, seal and deliver such Bond and bind the Surety thereby. 7. This Bond is intended to conform to all applicable laws. Any applicable requirement of any applicable law that has been omitted from this Bond shall be deemed to be included herein as if set forth at length. If any provision of the Bond conflicts with any applicable provision of any applicable law, then the provisions of said laws shall govern and the remainder of this Bond that is not in conflict therewith shall continue in full force and effect. Address of Owner: City of Grain Valley, Missouri 711 Main Street Grain Valley, MO 64029 Address of Bidder: [Insert Name and Address] Address of Surety: [Insert Name and Address] BID GUARANTY Attached hereto is a ____________________Certified Check from _________________________________________________ (the “ Bidder”) in the amount of ___________________________Dollars ($_______________), which represents no less than five percent (5%) of the total Bid and payable to the City of Grain Valley, Missouri. The Undersigned Bidder agrees that the accompanying Bid Security shall be forfeited to and become the property of the Owner should Bidder fail or refuse within the time required by the Bidding Documents to fully execute the Agreement as required by the Bidding Documents and timely delivery of a fully executed Performance Bond and Payment Bond required by the Bidding Documents and Contract Documents. Dated this ______ day of ________________, 20___ Name of Bidder (typed) By: (Authorized Signature) Printed Name: Title: Address: ATTEST: _________________________ Secretary (If Corporation) Affix Corporate Seal BG-1 295890v1 FORM 2-20-03 NOTICE OF AWARD 20__ TO: FROM: CITY OF GRAIN VALLEY, MISSOURI AT: 711 Main Street Grain Valley, MO 64029 “Contractor” “Owner” RE: 2023 Pavement Maintenance Program Asphaltic Concrete Overlay “Project” You are notified that your Bid dated __________________for the referenced Contract has been evaluated. Your organization has been determined to be the lowest responsible and best Bidder, and has been awarded the Contract for the Work. The Contract Price of your Contract is Dollars ($ ). Five (5) copies of the Agreement Between Owner and Contractor accompany this Notice of Award. Your organization shall comply with the following conditions precedent within the number of days after receipt of the Notice of Award specified in the Instruction to Bidders or otherwise stipulated, that is by ______________, 20__ you shall: Sign and return to the Professional the executed Notice of Award and all of the following required documents: 1. Five (5) fully executed counterparts of the Agreement Between Owner and Contractor 2. Fully executed Performance and Maintenance Bond and Payment Bond as specified in the General Conditions which may be modified by Supplementary Conditions. 3. Certificate of Insurance as specified the General Conditions which may be modified by Supplementary Conditions. Failure to comply with these conditions within the time specified may entitle the Owner to consider your Bid abandoned, annul this Notice of Award and declare your Bid Security forfeited. Issued On Behalf Of The Owner: Contractor By: By: Printed Name: Richard J. Tuttle Printed Name: Title: City Engineer Title: Received on , 20 Return to the Professional: Domestic Products Procurement Law - 8-SMo 34.350 - 34.359 Certification Each contract for the purchase or lease of manufactured goods or commodities by any public agency, and each contract made by a public agency for construction, alteration, repair, or maintenance of any public works shall contain a provision that any manufactured goods or commodities used or supplied in the performance of that contract or any subcontract thereto shall be manufactured or produced in the United States. (34.353.1 RSMo) Project Name: Project Number: Contract Name: Please check one of the following and sign where indicated. All of the iron, steel, and manufactured goods used in the project are produced in the United States. A waiver is being requested from the domestic products provision due to the following exception: The specified products are not manufactured or produced in the United States in sufficient quantities or manufactured or produced in the United States within the necessary time frames in sufficient quantities. The cost for the specified products would increase the cost by more than 10 percent; or Only one line of a product is manufactured or produced in the United States. Documentation of at least one of the cases above must be provided. List below the materials that cannot comply with the Domestic Product Procurement Law provisions. Additional sheets (attach if necessary) Name of Contracting Firm Signature Date Name and Title of Signer (Please type) This certification must be signed and the waiver approved prior to materials purchased. Missouri DNR CWSRF/DWSRF) (11/10) MO-PR-1 AUP-1 2023 Pavement Maintenance Program Asphaltic Concrete Overlay AGREEMENT BETWEEN OWNER AND CONTRACTOR (UNIT PRICE) THIS AGREEMENT BETWEEN OWNER AND CONTRACTOR (this "Agreement") is made and Entered into and is effective on this day of , 2023, by and between the City of Grain Valley, Missouri, a municipality, (“Owner”), and Superior Bowen Asphalt Company, LLC a Limited Liability Company, having its principal place of business located at 520 W. Pennway St., Suite 300, Kansas City, MO 64108 (“Contractor“) WHEREAS, Owner has caused to be prepared specifications, plans and other Contract Documents for the Work herein described, and has approved and adopted the Contract Documents defined herein and has invited proposals for furnishing materials, labor, and equipment for, and in connection with, the construction of improvements in accordance with the terms of the Contract Documents; and WHEREAS, the Contractor, in response to the invitation, has submitted to Owner in the manner and at the time specified, a proposal in accordance with the terms of the Contract Documents; and WHEREAS, Owner has opened, and examined the bids submitted and as a result of such examination, has determined and declared the Contractor to be the lowest and best bidder for constructing said improvements, and has duly awarded to this Contract to Contractor. Owner and Contractor, in consideration of the mutual covenants herein set forth, agree as follows: ARTICLE 1 WORK Contractor, at his own cost and expense, will provide all labor, tools, equipment and materials required to complete all Work specified or indicated in the Contract Documents or reasonably inferable by the Contractor therefrom as necessary to produce the results intended by the Contract Documents. ARTICLE2 PROFESSIONAL The Project has been designed by the City of Grain Valley, who is referred to in the Contract Documents as the Professional. Professional, and its duly authorized agents, are to act as Owner's representative, assume all duties and responsibilities, and have the rights and authorities assigned to Professional in the Contract Documents in accordance with the Contract Documents. ARTICLE 3 CONTRACT TIME AND COMPLETION 3.1 The date of commencement is the date from which the Contract Time(s) of Paragraph 3.3 is measured and shall be fixed in a written notice to proceed issued by Owner. 3.2 The Contractor shall achieve Substantial and Final Completion of the entire Work, and if set forth below, the various designated stages of the Work, not later than the dates shown in Section 3.3. 3.3 Bidder agrees that the Work will be substantially complete within forty-five (45) calendar days of Notice to Proceed and will be fully completed and ready for final payment in accordance with Paragraph 14.10 of the General Conditions within fifteen (15) calendar days following receipt of notice of substantial completion. AUP-2 3.4 Time is of the essence to the Contract Documents and all obligations thereunder. The Contractor acknowledges and recognizes that (1) Owner is entitled to full and beneficial occupancy and use of the completed Work following expiration of the Contract Times and (2) Owner will sustain damages if the Contract Time(s) are not met by Contractor. The Contractor further acknowledges and agrees that if the Contractor fails to achieve Substantial Completion of the entire Work or any phase of the Work within the Contract Time(s), Owner will sustain extensive damages and serious loss as a result of such failure. The exact amount of such damages will be extremely difficult to ascertain. Therefore, Owner and the Contractor agree as follows in this Paragraph 3.4: .1 If the Contractor fails to achieve Substantial Completion of the Work or designated portions within the Contract Time(s) as set forth in Paragraph 3.3, Owner shall be entitled to retain or recover from the Contractor, as liquidated damages and not as a penalty, the following per diem amounts for each day that expires after the time specified in Paragraph 3.3 for Substantial Completion of the Work or designated phases of the Work and continuing until the actual Date(s) of Substantial Completion: $900 per Calendar Day .2 After Substantial Completion, if Contractor shall neglect, refuse or fail to complete remaining Work or designated portions within the Contract Time(s), as set forth in Paragraph 3.3, Owner shall be entitled to retain or recover from Contractor as liquidated damages and not as a penalty, the following per diem amounts for each day that expires after the time specified in Paragraph 3.3 for final completion of the Work or phases of the Work and until the actual date(s) of final completion: $900 per Calendar Day .3 All such liquidated damages referred to in this Paragraph 3.4 are hereby agreed to be a reasonable pre-estimate of damages Owner will incur as a result of delayed completion of the Work or phases of the Work. Owner may deduct liquidated damages described in Paragraph 3.4 from any unpaid amounts then or thereafter due the Contractor under this Agreement. Any liquidated damages not so deducted from any unpaid amounts due the Contractor shall be payable to Owner at the demand of Owner, together with interest from the date of the demand at a rate of one and one-half percent (1.5%) per month. ARTICLE 4 CONTRACT SUM 4.1 Owner shall pay Contractor for completion of the Work in accordance with the Contract Documents and Contractor’s bid an amount equal to the sum of the established unit price of each separately identified item of Work as set forth in the bid, times the actual quantities of that item completed by Contractor ("Contract Price"): SEE ATTACHED BID 4.2 The unit prices set forth in the bid are considered complete and include: (1) all materials, equipment, labor, delivery, installation, overhead and profit; and (2) any other costs or expenses in connection with, or incidental to, the performance of that portion of the Work to which such unit prices apply. 4.3 Owner will determine the actual quantities and classifications of Unit Price Work performed by Contractor. Owner will review with Contractor's representative preliminary determinations on such matters before rendering a written decision thereon (by recommendation of an Application for Payment or otherwise). Owner's written decisions thereon will be final and binding upon Contractor, unless, within ten (10) days after the date of any such decision, Contractor delivers to Owner a written objection to such determination. 4.4 Any estimated quantities of Work contained in any Contract Document are not guaranteed and are solely for the purpose of comparison of Bids. Contractor acknowledges and agrees that the estimated quantities may change because of changes ordered by Owner or because of actual site conditions or other reasons. Contractor agrees that the unit prices for the Work shall remain unchanged even if the AUP-3 actual quantity of Work performed by Contractor differs materially and significantly from any estimated quantity of such items. Contractor agrees that it shall make no claim for an adjustment in any unit price for any variance between the actual quantity of Work performed by Contractor and any estimated quantity of such item. ARTICLE 5 PAYMENTS 5.1 Contractor shall submit Applications for Payment in accordance with the General Conditions of the Contract for Construction and in the form provided by Owner. Owner shall make progress payments to Contractor in accordance with the Contract Documents. The period covered by each Application for Payment shall be one (1) calendar month ending on the last day of the previous month. 5.2 The Application for Payment submitted by Contractor shall include the quantities of each item of Work completed by Contractor. Subject to the provisions of the Contract Documents, the amount of each progress payment shall be computed as follows: .1 The value of all completed Work by Contractor as determined by the sum of the unit price of each separately identified item of Work set forth in Paragraph 4.1 times the actual quantities of that item completed as determined by Owner as set forth in Paragraph 4.3; .2 Less retainage of five percent (5%) of the amount of Subparagraph .1; .3 Less the aggregate of previous payments made by Owner; and .4 Less amounts, if any, for which the Owner has withheld or nullified an approval of payment as set forth in the Contract Documents. 5.3 Owner shall make progress payments and final payment in accordance with the General Conditions of the Contract for Construction. ARTICLE 6 CONTRACTOR'S REPRESENTATIONS In order to induce Owner to enter into this Agreement, Contractor makes the following representations: 6.1 Contractor has examined and carefully studied the Contract Documents (including the Addenda listed in Article 7) and the other related data identified in the Bidding Documents including "technical data." 6.2 Contractor has visited the site and become familiar with and satisfied itself as to the general, local, and site conditions that may affect cost, progress, performance, or furnishing of the Work. 6.3 Contractor is familiar with and has satisfied itself as to all federal, state and local Laws and Regulations that may affect cost, progress, performance and furnishing of the Work. 6.4 Contractor has been provided any and all 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. Contractor acknowledges that such reports and drawings are not Contract Documents. A list of such reports and drawings are attached hereto as Exhibit A. Contractor acknowledges that Owner and Professional do not assume responsibility for the accuracy or completeness of such information. Contractor also acknowledges that Owner and Professional do not assume responsibility for the accuracy or completeness of data shown or indicated in the Contract Documents with respect to underground facilities or utilities at or contiguous to the site, and Contractor shall not be entitled to rely on the accuracy or completeness of such data. Contractor has obtained and carefully studied (or assumes responsibility for having done so) all such additional supplementary examinations, investigations, explorations, tests, studies, and data concerning conditions (surface, subsurface, and underground facilities and utilities) 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 Contractor and safety precautions and programs incident thereto. Contractor does not consider that any additional examinations, investigations, explorations, tests, studies, or data are necessary for the performance and furnishing of the Work at the AUP-4 Contract Sum, within the Contract Times, and in accordance with the other terms and conditions of the Contract Documents. 6.5 Contractor is aware of the general nature of work to be performed by Owner and others at the site that relates to the Work as indicated in the Contract Documents. 6.6 Contractor has correlated the information known to Contractor, information and observations obtained from visits to the site, reports and drawings identified in the Contract Documents, and all additional examinations, investigations, explorations, tests, studies, and data with the Contract Documents. 6.7 Contractor has given Owner written notice of all conflicts, errors, ambiguities, or discrepancies that Contractor has discovered in the Contract Documents and the written resolution thereof by Owner is acceptable to Contractor, and the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work. 6.8 Contractor has the full power and authority to make, execute, deliver and perform the Work hereunder and has authorized the undersigned to bind it to this Contract and the Contract Documents. 6.9 The representations of Contractor shall be continuing and shall survive the execution and termination of this Contract. ARTICLE 7 CONTRACT DOCUMENTS The Contract Documents, except for Modifications executed after the date of this Contract, which comprise the entire agreement between Owner and Contractor concerning the Work, consist of the following: 7.1 This Agreement. 7.2 Exhibits to this Agreement, if any. 7.3 Notice to Proceed. 7.4 General Conditions of the Contract for Construction. 7.5 Supplementary Conditions of the Contract. 7.6 Performance Bond. 7.7 Payment Bond. 7.8 Maintenance Bond 7.9 Specifications of the Contract 7.10 The Drawings, as follows: “Map of Proposed Roads” and standard details. 7.11 Addenda, if any, as follows: Number Date Pages 7.12 Other documents, if any, as follows: There are no Contract Documents other than those listed above in this Article 7 or the General Conditions of the Contract for Construction. ARTICLE 8 MISCELLANEOUS 8.1 Terms used in this Contract which are defined in Article 1 of the General Conditions of the Contract for Construction will have the meanings indicated in the General Conditions of the Contract for AUP-5 Construction. 8.2 Owner and Contractor each binds itself, its partners, successors, assigns, and legal representatives to the other party hereto, its partners, successors, assigns, and legal representatives in respect to all covenants, agreements, and obligations contained in the Contract Documents. 8.3 The business address of Contractor given herein is the place to which all notices, letters, and other communication to Contractor will be mailed or delivered. The address of Owner appearing herein is hereby designated as the place to which all notices, letters, and other communication to Owner shall be mailed or delivered. Either party may change his address at any time by an instrument in writing delivered to Professional and to the other party. IN WITNESS WHEREOF, Owner and Contractor have signed this Contract by and through their duly authorized representatives. All portions of the Contract Documents have been signed or identified by Owner and Contractor or by Professional on their behalf. THE CONTRACT DOCUMENTS CONTAIN AN ARBITRATION PROVISION WHICH MAY BE ENFORCED BY THE PARTIES ATTEST: CITY OF GRAIN VALLEY, MISSOURI "Owner" By: City Clerk Printed Name: Title: "Contractor" By: Printed Name: _ Title: 293135v1 FORM 2-20-03 PERFORMANCE BOND Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. CONTRACTOR (Name and Address): SURETY (Name and Address of Principal Place of Business): OWNER: City of Grain Valley, Missouri 711 Main Street Grain Valley, MO 64029 CONTRACT Date: Price: Description (Name and Location): BOND Date: Amount: Surety and Contractor, intending to be legally bound hereby, subject to the terms printed on the reverse side hereof, do each cause this Performance Bond to be duly executed on its behalf by its authorized officer, agent or representative. CONTRACTOR AS PRINCIPAL Company: (Corp. Seal) Signature: Name and Title: SURETY Company: (Corp. Seal) Signature: Name and Title: (Attach certified Power of Attorney) 293135v1 FORM 2-20-03 1. Contractor and the Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to Owner and any successor, grantee or assignee of Owner for the full performance of all of Contractor’s obligations under the Contract. The Contract is incorporated herein by this reference. 2. If the Contractor fully performs all of its duties and obligations under the Contract, the Surety and the Contractor shall have no obligation under this Bond. 3. The Surety’s obligations under this Bond shall arise after: a. The Contractor fails to fully perform of all its duties and obligations under the Contract; b. The Owner has given Surety notice of Contractor’s failure to fully perform of all its duties and obligations under the Contract; and c. The Owner has agreed to pay the Balance of the Contract Price, if any, to the Surety in accordance with the terms of the Contract. 4. When Owner has satisfied the conditions of Paragraph 3, the Surety shall promptly and at Surety’s expense take one of the following actions: a. Arrange for Contractor, with the written consent of the Owner, to perform, complete or cure the default or breach of the Contract; or b. Undertake to perform and complete the Contract itself through qualified contractors approved by Owner; c. Waive its right to perform, complete or cure the default of breach of the Contract and pay to the Owner the total amount of this Bond. 5. If the Surety does not proceed as provided by Paragraph 4 within fifteen (15) days of the Owner’s compliance with Paragraph 3 and complete its obligations with diligence and promptness, Surety shall be deemed to be in default under this Bond. 6. If Surety elects to act under Paragraph 4(a) or 4(b) above, then the responsibilities of Surety to Owner shall not be greater than those of the Contractor under the Contract, and the responsibilities of Owner to Surety shall not be greater than those of the Owner under the Contract. Surety recognizes and acknowledges that subject to the amount of the Bond, Surety’s obligations under this Bond, include but are not limited to: a. The responsibilities of Contractor for correction of defective work and completion of the Contract; b. Attorneys’ fees and design professional fees and delay costs resulting from Contractor’s breach of or default under the Contract, or resulting from the acts or omissions of the Surety; c. Liquidated damages, or if no liquidated damages are specified in the Contract, actual damages caused by the delayed performance or non- performance of the Contractor under the Contract or the Surety under this Bond. 7. The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the Contract, and the Balance of the Contract Price shall not be reduced or set off on account of any such unrelated obligations. No right of action shall accrue on this Bond to any person or entity other than the Owner. 8. The Surety hereby waives notice of any change, including changes of times, to the Contract or to related subcontracts, purchase orders and other obligations. 9. It is agreed by Contractor and Surety that notwithstanding any contrary provisions contained in this Bond or the Contract, that there shall be no limits on the Owner’s right to sue under this Bond for defects, defaults, or breaches not discovered or known by Owner at the time such Work was paid for and accepted by Owner except those limits provided by the statute of limitations applicable to suits on contracts. 10. Surety further agrees that in event of any default by the Owner in the performance of the Owner’s obligations to the Contractor under the Contract, the Contractor or Surety shall cause written notice of such default specifying said default in detail to be given to the Owner, and the Owner shall have thirty (30) days from time after receipt of such notice within which to cure such default, or such additional reasonable period of time as may be required if the nature of such default is such that it cannot be cured within thirty (30) days. Such Notice of Default shall be sent by certified or registered U.S. Mail, return receipt requested, first class postage pre-paid, to the Owner. 11. Surety further agrees this Bond shall remain in effect following the date of Final Payment during the Guarantee Period or the time required to resolve any items of incomplete Work and the payment of any disputed amounts for the period provided in the statute of limitations applicable to suits on contracts. This Bond shall be in an amount equal to the Contract Price and any adjustments thereto. 12. Surety agrees that it is obligated under the bonds to any successor, grantee or assignee of Owner. 13. Definitions a. Balance of the Contract Price: The total amount payable by the Owner to the Contractor under the Contract after all proper adjustments have been made, including allowance to the Contractor of any amounts received or to be received by the Owner in settlement of insurance or other claims for damages to which the Contractor is entitled, reduced by all valid and proper payments made to or on behalf of the Contractor under the Contract. b. Contract: The agreement between the Owner and the Contractor identified on the signature page, including all Contract Documents and changes thereto and including, but not limited to, all duties to correct or repair non-conforming Work. Address of Owner: City of Grain Valley, Missouri 711 Main Street Grain Valley, MO 64029 Address of Contractor/Principal: [Insert Name and Address] Address of Surety: [Insert Name and Address] 293137v1 FORM 2-20-03 PAYMENT BOND Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. CONTRACTOR (Name and Address): SURETY (Name and Address of Principal Place of Business): OWNER (Name and Address): City of Grain Valley, Missouri 711 Main Grain Valley, MO 64029 CONTRACT Date: Amount: Description (Name and Location): BOND Date: Amount: Surety and Contractor, intending to be legally bound hereby, subject to the terms printed on the reverse side hereof, do each cause this Payment Bond to be duly executed on its behalf by its authorized officer, agent or representative. CONTRACTOR AS PRINCIPAL Company: (Corp. Seal) Signature: Name and Title: SURETY Company: (Corp. Seal) Signature: Name and Title: (Attach certified Power of Attorney) 293137v1 FORM 2-20-03 1. The Contractor and the Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to the Owner and any successor, grantee or assignee of Owner to pay for labor, materials and equipment furnished by Claimants for use in the performance of the Contract, which is incorporated herein by reference. 2. With respect to the Owner this obligation shall be null and void if the Contractor promptly makes payment, directly or indirectly, for all sums due Claimants. 3. With respect to Claimants, this obligation shall be null and void if the Contractor promptly makes payment for all sums due Claimants. 4. The Surety's total obligation shall not exceed the amount of this Bond. 5. Amounts due and payable by the Owner to the Contractor under the Contract shall be used for the performance of the Contract and to satisfy claims, if any, under the Performance Bond provided in connection with the Contract. By the Contractor furnishing this Bond, Contractor agrees that all remaining funds due and payable by the Owner to the Contractor in the performance of the Contract are dedicated to satisfy obligations of the Contractor and the Surety under this Bond subject to the Owner's priority to use the funds for the completion of the Work. 6. The Surety shall not be liable to the Owner, Claimants or others for obligations of the Contractor that are unrelated to the Contract. The Owner shall not be liable for payment of any costs or expenses of any Claimants under this Bond, and shall have under this Bond no obligation to make payments to, give notices on behalf of, or otherwise have obligations to Claimants under this Bond. 7. The Surety hereby waives notice of and consents to any changes, including changes of time, to the Contract or to related subcontracts, purchase orders and other obligations. 8. No suit or action shall be commenced by a Claimant under this Bond other than in a court of competent jurisdiction in the location of the Project or after the expiration of one year from the date which the last labor or service was performed by anyone or the last materials or equipment were furnished by anyone under the Contract. If the provisions of this Paragraph are void or prohibited by law, the minimum period of limitation available to sureties as a defense in the jurisdiction of the suit shall be applicable. 9. Notice to the Surety or the Contractor shall be mailed or delivered to the address shown on the signature page. Actual receipt of notice by Surety or the Contractor, however accomplished, shall be sufficient compliance as of the date received at the address shown on the signature page. 10. Any provision in the Bond conflicting with any applicable law shall be deemed deleted herefrom and provisions conforming to such applicable law shall be deemed incorporated herein. 11. Upon request by any person or entity appearing to be a potential beneficiary of this Bond, the Contractor or Surety shall promptly furnish a copy of this Bond or shall permit a copy to be made. 12. The Contract is hereby made a part of this bond. 13. Surety agrees that it is obligated under this Bond to any successor, grantee or assignee of the Owner. 14. DEFINITIONS a. Claimants: Individuals or entities that furnish labor, materials or equipment for use in the performance of the Contract. The intent of this Bond shall be to include without limitation in the terms "labor, materials or equipment" that part of water, gas, power, light, heat, oil, gasoline, telephone service or rental equipment used in the Contract, design services required for performance of the Work of the Contractor and the Contractor's subcontractors. b. Contract: The agreement between the Owner and the Contractor identified in the first page of this Bond, including all Contract Documents and changes thereto. Address of Owner: City of Grain Valley, Missouri 711 Main Street Grain Valley, MO 64029 Address of Contractor/Principal: [Insert Name and Address] Address of Surety: [Insert Name and Address] MAINTENANCE 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 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 on the day of , 20 , the Principal entered into a written agreement with the OWNER, for the construction and reconstruction, or repair of certain public improvements as designated and described in the said agreement; and Whereas, it was a condition of the contract award by the Owner that these presents be executed by the Principal and Surety aforesaid, and Whereas, the Principal agrees to guarantee the work hereinabove described, including all materials and workmanship, for the period of one ( 1 ) year(s) beginning on the date the Owner so accepts said Work, said date being the formal acceptance date. NOW, THEREFORE, if the Principal shall and will, in all particulars, well, duly, and faithfully observe, perform and abide by each and every covenant, condition and part of said written agreement and other Contract Documents and shall protect the Owner against all damages, losses and expenses which may occur to Owner, by reason of defective materials used, or by reason of defective workmanship done, and for the construction, reconstruction or repair of said public improvements, and settlement of backfill excavated areas. MB-1 IN WITNESS WHEREOF, this instrument is executed in counterparts, each one of which shall be Number deemed an original, this the day of , 20 . ATTEST: Principal (Principal) Secretary (SEAL) By (s) (Witness as to Principal) (Address) (Address) Surety ATTEST: By (s) (Witness to Surety) Attorney-in-Fact (Address) (Address) NOTE: 1. Date of BOND must not be prior to date of contract. 2. If CONTRACTOR is partnership, all partners should execute BOND. 3. 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. 4. Accompany this bond with Attorney-in-Fact's Authority from the Surety Company certified to include the date of the bond. MB-2 Form 5060 Project Exemption Certificate Taxation Division Phone: (573) 751-2836 P.O Box 358 Fax: (573) 522-1666 Jefferson City, MO 65105-0358 E-mail: salestaxexemptions@dor.mo.gov Visit http://dor.mo.gov/business/sales/sales-use-exemptions.php for additional information. Form 5060 (Revised 11-2019) Name of Exempt Entity Issuing the Certificate Missouri Tax Exemption Number Address City State ZIP Code E-mail Address Project Number Project Begin Date (MM/DD/YYYY) Estimated Project End Date (MM/DD/YYYY) Description of Project Project Location Certificate Expiration Date (MM/DD/YYYY) Signature of Authorized Exempt Entity Printed Name of Authorized Exempt Entity Date (MM/DD/YYYY) Provide a signed copy of this certificate, along with a copy of the exempt entity’s Missouri Sales and Use Tax Exemption Letter to each contractor or subcontractor who will be purchasing tangible personal property for use in this project. It is the responsibility of the exempt entity to ensure the validity of the information on the certificate. The exempt entity must issue a new certificate if any of the information changes. | | | | | | | E xe m pt E nt ity a nd P ro je ct In fo rm at io n ___ ___ / ___ ___ / ___ ___ ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ This form is to be completed and given to your contractor. The Missouri exempt entity named above hereby authorizes the purchase, without sales tax, of tangible personal property to be incorporated or consumed in the construction project identified herein and no other, pursuant to Section 144.062, RSMo. Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct. C on tr ac to r Name of Purchasing Contractor Signature of Contractor Date (MM/DD/YYYY) Address City State ZIP Code ___ ___ / ___ ___ / ___ ___ ___ ___ Name of Purchasing Subcontractor Address City State ZIP Code Signature of Contractor Contractor’s Printed Name Date (MM/DD/YYYY) S ub co nt ra ct or Contractors - Present this to your supplier in order to purchase the necessary materials tax exempt. Complete the Subcontractor portion if extending the certificate to your subcontractor. The contractor must sign the form in the space provided below. ___ ___ / ___ ___ / ___ ___ ___ ___ http://revisor.mo.gov/main/OneSection.aspx?section=144.062 CW/DW SRF P&S E Statement of Compliance (To be submitted with weeldy payroll if not using form WH-347) I hereby certify the following: I) The payroll for the payroll period contains the information required to be provided under § 5.5 (a)(3)(ii) of Regulations, 29 CFRpart 5, the appropriate information is being maintained under§ 5.5 (a)(3)(i) of Regulations, 29 CFR part 5, and that such infonnation is correct and complete; 2) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weeldy wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than pennissible deductions as set forth in Regulations, 29 CFR part 3; 3) That each laborer or mechanic has been paid not Jess than the applicable wage rates and fringe benefits or cash equivalents for the classification of work perfom1ed, as specified in the applicable wage determination incorporated into the contract. Signature of Contractor or Subcontractor Date MO-SC-1 MISSOURI DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS DIVISION OF LABOR STANDARDS AFFIDAVIT $ DIVISION OF LABOR STANDARDS COMPLIANCE WITH THE PREVAILING WAGE LAW 1, ________________ , upon being duly sworn upon my oath state that:(!) I am the (Name) _____________ of __________________ ; (2) all requirements of (fitle) (Name a/Company) §§ 290.210 to 290.340, RSMo, pertaining to the payment of wages to workers employed on public works projects have been fully satisfied with regard to this company's work on _________________ _, (Name of Project) (3) I have reviewed and am familiar with the prevailing wage rules in 8 CSR 30-3.010 to 8 CSR 30-3.060; (4) based upon my knowledge of these rules, including the occupational titles set out in 8 CSR 30-3.060, I have completed full and accurate records clearly indicating (a) the names, occupations, and crafts of every worker employed by this company in connection with this project together with an accurate record of the number of hours worked by each worker and the actual wages paid for each class or type of work perfomled, (b) the payroll deductions that have been made for each worker, and ( c) the amounts paid to provide fringe benefits, if any, for each worker; (5) the amounts paid to provide fringe benefits, if any, were irrevocably paid to a trustee or to a third party pursuant to a fund, plan, or program on behalf of the workers; (6) these payroll records are kept and have been provided for inspection to the authorized representative of the contracting public body and will be available, as often as may be necessary, to such body and the Missouri Department of Labor and Industrial Relations; (7) such records shall not be destroyed or removed from the state for one year following the completion of this company's work on this project; (8) when in effect, the requirements of§§ 290.550 through 290.580, RSMo, pertaining to excessive unemployment were fully satisfied; and (9) there has been no exception to the full and complete compliance with the provisions and requirements of Annual Wage Order No. __ Section ___ issued by the Missouri Division of Labor Standards and applicable to this project located in County, Missouri, and completed on the __ day of The matters stated herein are true to the best of my information, knowledge, and belief. I acknowledge that the falsification of any information set out above may subject me to criminal prosecution pursuant to §§290.340, 570.090, 575.040, 575.050, or 575.060, RSMo. Signature Subscribed and sworn to me this __ day of __________ _ My commission expires _________________ . Notary Public Receipt by Authorized Public Representative PW-4 (08-11) Al EJCDC® C-550, Notice to Proceed. Prepared and published 2013 by the Engineers Joint Contract Documents Committee. Page 1 of 1 NOTICE TO PROCEED Owner: City of Grain Valley, MO Owner's Contract No.: R23- Contractor: Contractor’s Project No.: Project: 2023 Pavement Maintenance Program Asphaltic Concrete Overlay Contract Name: Effective Date of Contract: TO CONTRACTOR: Owner hereby notifies Contractor that the Contract Times under the above Contract will commence to run on [_____________________, 2023]. On that date, Contractor shall start performing its obligations under the Contract Documents. No Work shall be done at the Site prior to such date. In accordance with the Agreement, the date of Substantial Completion is ________________________, and the date of readiness for final payment is_____________________. Before starting any Work at the Site, Contractor must comply with the following: [Note any access limitations, security procedures, or other restrictions] Owner: City of Grain Valley, Missouri Authorized Signature By: Richard J. Tuttle Title: City Engineer Date Issued: Copy: Engineer CONTRACTOR’S AFFIDAVIT AND RELEASE FOR PARTIAL PAYMENT Application for Payment No.: ___________ Application for Payment Application Date: ____________ ____________________________________ (“Contractor”) has entered into a Contract with the City of Grain Valley, Missouri (“Owner”) to furnish labor, materials, equipment and services for the construction of improvements located at - _________________________________________________ (“Project”) For and in consideration of the above-said progress payment under the said Contract, the sufficiency of which is hereby acknowledged, Contractor upon its oath states: 1. Contractor, in making this request for payment, hereby certifies that all work, materials, and services required to date under said Contract have been furnished and that the work has been completed in a satisfactory and workmanlike manner and in compliance with drawings, specifications, instructions and Contract Documents furnished to the Contractor. 2. Contractor also certifies that all work, labor, materials, machinery, and equipment furnished by the Contractor through the date of the last previous Application for payment have been paid for by the Contractor and that there are no amounts unpaid in favor of any subcontractor or materialman or any other person furnishing labor and materials to said Contractor for such period and utilized in the performance of the obligations of the Contractor under the Contract. 3. Contractor warrants and represents that through the date of this Application for Payment it has complied with all applicable laws and requirements of the Contract Documents, including prevailing wage Laws. 4. It is further certified that all amounts, including taxes, required by law or by agreement, to be withheld from employees’ wages have been withheld and distributed in the manner provided by law or by the Contract. 5. Except for the amount of retainage, Contractor hereby releases, relinquishes, discharges and waives any and all rights, and claims arising out of labor, services, equipment, and/or materials and supplies ordered, furnished or provided to or in connection with the construction of the Project through the Application for Payment Date stated above, whether such rights or claims arise by by virtue of contract, statute, ordinance, regulation, constitution, common law, or otherwise. CONTRACTOR BY: _____________________________ (authorized signature) TITLE: ___________________________ DATE: ___________________________ STATE OF )SS COUNTY OF ________________ The undersigned personally appeared before me, is personally known to me to be the _____________________ of the above-named Contractor, and after being duly sworn, stated that: he/she was and is duly authorized by the above-named Contractor to make the statements, undertakings, warranties, releases, waivers, and discharges contained in the above and forgoing Contractor’s Affidavit and Release for Partial Payment; the statements made therein are true and correct; and, he/she executed the same for the purposes and consideration therein expressed. Subscribed and sworn before me this day of , 20___. ______________________________________ Notary Public My Commission Expires: ___________________________ APP-1 293150v1 FORM 2-20-03 RECEIPT AND RELEASE FINAL _____________________________________________ ("Contractor") has entered into a Contract with Owner of Grain Valley, Missouri (“Owner") to furnish labor, material, equipment and other services for the construction of improvements located at ___________________________________________________________ ("Project"). For and in consideration of the sum of $___________________ (hereinafter referred to as "Final Payment"), the receipt and sufficiency of which is hereby acknowledged, Contractor hereby releases and forever discharges Owner from any and all claims, demands, and liability of any nature whatsoever arising out of Contractor’s participation in the Project, regardless of whether such liability is alleged to arise in tort, strict liability, contract, statute, ordinance, regulation, constitution, common law, or otherwise. To induce Owner to release the Final Payment to Contractor, Contractor and the person who executes this document on behalf of Contractor warrants, represents, and affirms to Owner that Contractor has paid or caused to be paid all bills, invoices, charges, expenses, or other amounts arising out of labor, services, equipment, and/or materials ordered, provided, or furnished in connection with Contractor’s participation in the Project, including but not limited to all payroll and fringe benefit obligations and all applicable federal, state or local taxes or assessments. To induce the Owner to release the Final Payment to Contractor, Contractor and the person who executes this document on behalf of Contractor warrants, represents and affirms to Owner that Contractor has completed the Work in accordance with the Contract Documents, that it has provided all documents, certifications and information to Owner required to receive Final Payment, that it is entitled to Final Payment, and that it has complied with all applicable Laws in performing the Work, including prevailing wage Laws. Contractor BY:__________________________________________ (authorized signature) TITLE:_______________________________________ STATE OF ) ) SS COUNTY OF ) The undersigned personally appeared before me, is personally known to me to be the __________________ of the above-named Contractor, and after being duly sworn, stated that: he/she was and is duly authorized by the above-named Contractor to make the statements, undertakings, warranties, releases, waivers, and discharges contained in the above and foregoing Receipt and Release; the statements made therein are true and correct; and, he/she executed the same for the purposes and consideration therein expressed. Subscribed and sworn before me this _____ day of ____________, 20___. ___________________________________ Notary Public My Commission Expires: _________________________