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Contract - Cutler Repaving, Inc. - 4/27/2023 (3) BID COPY/ORIGINAL CITY OF ROUND ROCK TRANSPORTATION DEPARTMENT ROUND ROCK TEXAS Project Manual For: 2022 ARTERIAL STREET MAINTENANCE PROGRAM February 2023 Prepared By: Matthew Bushak, PE ......................... MATTHEW BUSH...AK �...:*.F APPROVED BY � ..•.111.......................%...,% 91480 CITY ATTORNEY tQ. !fCENS*—S- NAL NOTICE TO BIDDERS Pursuant to the provisions of Texas Government Code, Section 2269.101,it is the intention of the City of Round Rock to select a prime contractor by using the Competitive Bidding Method for the construction of the 2022 Arterial Street Maintenance Program as generally described herein. Sealed bids addressed to Matthew Bushak, City of Round Rock, Transportation Department, 3400 Sunrise Road, Round Rock, TX 78665, for furnishing all labor, material, and equipment and performing all work required for the project titled, 2022 Arterial Street Maintenance Program(project includes asphalt and concrete repair and paving),will be received until March 21,2023, at 2:00 p.m.,then publicly opened and read aloud at the same address. Bid envelopes shall state the date and time of bid and"2022 Arterial Street Maintenance Program." Bids must also be accompanied by a"Statement of Bidder's Safety Experience" included in Section 410 of the Project Manual. No bids may be withdrawn after the scheduled opening time. Any bids received after the scheduled bid opening time will be returned unopened. Bids must be submitted on City of Round Rock bid forms and must be accompanied by an acceptable bid security as outlined in the Instructions to Bidders, payable to the City of Round Rock, Texas, equal to five percent(5%) of the total bid amount. Plans,Bid Forms, Specifications, and Instructions to Bidders may be obtained at roundrocktexas.gov/solicitations and https://www.civcastusa.com. Bidders shall be responsible for printing or obtaining prints of the aforementioned documents as necessary. For questions, please contact the City's Project Manager, Matthew Bushak, 512-341-3318. In case of ambiguity,duplication,or obscurity in the bids,the City of Round Rock reserves the right to construe the meaning thereof. The City of Round Rock further reserves the right to reject any or all bids and to waive any informalities and irregularities in the bids received. The successful bidder will be expected to execute the City of Round Rock's standard contract and to furnish performance and payment bonds, all as described in the bid documents. Contractors and subcontractors shall pay to laborers,workmen,and mechanics the prevailing wage rates as determined by the City of Round Rock. Publish Dates: Round Rock Leader: 3/3/23 3/10/23 00020 03-2021 Notice to Bidders 00193093 Page 1 City of Round Rock,Texas Contract Forms Standard Form of Agreement: Section 00500 City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor n 2 AGREEMENT made as of the 2S tL( )day of in the year 20 2 3 BETWEEN the Owner: City of Round Rock,Texas(hereafter"Owner"or"City") 221 East Main Street Round Rock,Texas 78664 and the Contractor Cutler Repaving,Inc. ("Contractor") 921 East 27th Lawrence,KS 66046 The Project is described as: 2022 ARTERIAL STREET MAINTENANCE PROGRAM The Engineer is: Matthew Bushak,PE Proiect Manager Citv of Round Rock 512-341-3318 For and in consideration of the mutual terms, conditions and covenants of this Agreement and all accompanying documents between Owner and Contractor, the receipt and sufficiency of which are hereby acknowledged,Owner and Contractor agree as follows: ARTICLE I THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement,Conditions of the Contract(General,Supplementary and other Conditions),Drawings, Specifications,Addenda issued prior to execution of this Agreement,other documents listed in this Agreement and Modifications issued after execution of this Agreement;these form the Contract,and are as fully a part of the Contract as if attached to this Agreement or repeated herein. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations,representations or agreements, either written or oral.An enumeration of the Contract Documents,other than Modifications,appears in Article 7. ARTICLE 2 THE WORK OF THIS CONTRACT Contractor shall fully execute the Work described in the Contract Documents,except to the extent specifically indicated in the Contract Documents to be the responsibility of others. 00500 4-2020 Page 1 Of 5 Standard Foran of Agreement 00443647 ARTICLE 3 DATE OF COMMENCEMENT; DATE OF SUBSTANTIAL COMPLETION; DATE OF FINAL COMPLETION 3.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a Notice to Proceed issued by Owner. 3.2 The Contract Time shall be measured from the date delineated in the Notice to Proceed. 3.3 Contractor shall commence Work within ten ( 10 ) calendar days from the date delineated in the Notice to Proceed. 3.4 Contractor shall achieve Substantial Completion of the items of Work listed on Attachment A to this Agreement no later than N/A ( N/A )calendar days from issuance by Owner of Notice to Proceed, and Contractor shall achieve Substantial Completion of the entire Work no later than one hundred and fifty 150 )calendar days from issuance by Owner of Notice to Proceed,subject to adjustments of this Contract Time as provided in the Contract Documents. 3.5 If Contractor fails to achieve Substantial Completion of the Work(or any portion thereof)on or before the date(s)specified for Substantial Completion in the Agreement,Contractor shall pay to Owner,as liquidated damages, the sum of one thousand and No/100 Dollars($ 1,000.00 ) for each calendar day that Substantial Completion is delayed after the date(s) specified for Substantial Completion. It is hereby agreed that the liquidated damages to which Owner is entitled hereunder are a reasonable forecast of just compensation for the harm that would be caused by Contractor's failure to achieve Substantial Completion of the Work(or any portion thereof)on or before the date(s)specified for Substantial Completion in the Agreement and is not a penalty. It is agreed that the harm that would be caused by such failure, which includes loss of expected use of the Project areas,provision of alternative storage facilities and rescheduling of moving and occupancy dates,is one that is incapable or very difficult of accurate estimation.It is hereby agreed that if Substantial Completion of the Work(or any portion thereof)is not achieved on or before thirty(30)days after the date(s) specified for Substantial Completion in the Agreement, the Owner shall have the option to either collect liquidated damages as set forth herein or to thereafter rely on its remedies under the Contract Documents and at law and in equity, including without limitation, the recovery of actual damages. The date(s) specified for Substantial Completion of the Work(or any portion thereof)in the Agreement shall be subject to adjustment as provided in the Contract Documents. 3.6 Contractor shall achieve Final Completion of the entire Work no later than one hundred and eighty (_L80 )calendar days from issuance by Owner of Notice to Proceed. ARTICLE 4 CONTRACT SUM 4.1 Owner shall pay Contractor the Contract Sum in current funds for Contractor's full and complete performance of the Work and all of Contractor's obligations under this Agreement. The Contract Sum shall be Six million,five hundred forty-three thousand,three hundred forty-two dollars and ninety-nine cents ($6,543,342.99 ),subject to additions and deductions as provided in the Contract Documents. 4.2 Does the Contract Sum include alternates which are described in the Bid Form? No X Yes .Ijyes,please provide details below: 00500 4-2020 Page 2 of 5 Standard Form of Agreement 00443647 ARTICLE 5 PAYMENTS 5.1 PROGRESS PAYMENTS 5.1.1 Based upon Applications for Payment submitted to Engineer and Owner by Contractor,and Certificates for Payment issued by Engineer and not disputed by Owner and/or Owner's lender,Owner shall make progress payments on account of the Contract Sum to Contractor as provided below, in Article 14 of the General Conditions, and elsewhere in the Contract Documents. 5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month. 5.1.3 Provided that an Application for Payment is received by Engineer and Owner, and Engineer issues a Certificate of Payment not later than the tenth (10th) day of a month, Owner shall make payment to Contractor of amounts approved by the Owner not later than the tenth(10th)day of the next month.If an Application for Payment is received by Engineer and Owner after the application date fixed above,payment shall be made by Owner not later than one month after the Engineer issues a Certificate for Payment. The Owner shall not have any obligation to pay any amount covered by the Engineer's Certificate for Payment that is disputed by the Owner. 5.1.4 Each Application for Payment shall be based on the most recent schedule of values submitted by Contractor in accordance with the Contract Documents.The schedule of values shall allocate the entire Contract Sum among the various portions of the Work. The schedule of values shall be prepared in such form and supported by such data to substantiate its accuracy as Engineer and Owner may require.This schedule,unless objected to by Engineer or Owner, shall be used as a basis for reviewing Contractor's Applications for Payment. 5.1.5 Applications for Payment shall warrant the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.1.6 Subject to other provisions of the Contract Documents, the amount of each progress payment shall be computed as provided in Article 14 of the General Conditions. 5.1.7 Except with Owner's prior written approval, Contractor shall not make advance payments to suppliers for materials or equipment which have not been delivered and stored at the site. 5.2 FINAL PAYMENT 5.2.1 Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by Owner to Contractor when: .1 Contractor has fully performed the Contract except for Contractor's responsibility to correct Work, and to satisfy other requirements,if any,which extend beyond final payment;and .2 a final Certificate for Payment has been issued by Engineer and approved by the Owner. 5.2.2 Owner's final payment to Contractor shall be made no later than thirty (30) days after the issuance of Engineer's final Certificate for Payment. In no event shall final payment be required to be made prior to thirty(30) days after all Work on the Contract has been fully performed.Defects in the Work discovered prior to final payment shall be treated as non-conforming Work and shall be corrected by Contractor prior to final payment,and shall not be treated as warranty items. ARTICLE 6 TERMINATION OR SUSPENSION 6.1 The Contract may be terminated by Owner or Contractor as provided in Article 15 of the General Conditions. 00500 4-2020 Page 3 of 5 Standard Form of Agreement 00443647 6.2 The Work may be suspended by Owner as provided in Article 15 of the General Conditions. ARTICLE 7 ENUMERATION OF CONTRACT DOCUMENTS 7.1 The Contract Documents,except for Modifications issued after execution of this Agreement,are enumerated as follows: 7.1.1 The Agreement is this executed version of the City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor,as modified. 7.1.2 The General Conditions are the "City of Round Rock Contract Forms 00700," General Conditions, as modified. 7.1.3 The Supplementary,Special,and other Conditions of the Contract are those contained in the Project Manual dated February 2023 7.1.4 The Specifications are those contained in the Project Manual dated February 2023 7.1.5 The Drawings,if any,are those contained in the Project Manual dated February 2023 7.1.6 The Insurance&Construction Bond Forms of the Contract are those contained in the Project Manual dated February 2023 7.1.7 The Notice to Bidders,Instructions to Bidders,Bid Form,and Addenda,if any,are those contained in the Project Manual dated February 2023 7.1.8 If this Agreement covers construction involving federal funds, thereby requiring inclusion of mandated contract clauses, such federally required clauses are those contained in the "City of Round Rock Contract Forms 03000,"Federally Required Contract Clauses,as modified. 7.1.9 Other documents,if any,forming part of the Contract Documents are as follows: a 1A ARTICLE 8 MISCELLANEOUS PROVISIONS 8.1 Where reference is made in this Agreement to a provision of any document, the reference refers to that provision as amended or supplemented by other provisions of the Contract Documents. 8.2 Owner's representative is: Matthew Bushakl,P.E. Transportation Engineer 3400 Sunrise Rd Round Rock,TX 78665 8.3 Contractor's representative is: John D.Miles Vice President-Operations 921 East 27th St. Lawrence,KS 66046 8.4 Neither Owner's nor Contractor's representative shall be changed without ten(10)days'written notice to the other party. 00500 4-2020 Page 4 of 5 Standard Form of Agreement 00443647 8.5 Waiver of any breach of this Agreement shall not constitute waiver of any subsequent breach. 8.6 Owner agrees to pay Contractor from available funds for satisfactory performance of this Agreement in accordance with the bid or proposal submitted therefor,subject to proper additions and deductions,all as provided in the General Conditions, Supplemental Conditions, and Special Conditions of this Agreement, and Owner agrees to make payments on account thereof as provided therein. Lack of funds shall render this Agreement null and void to the extent funds are not available. This Agreement is a commitment of City of Round Rock's current revenues only. 8.7 Although this Agreement is drawn by Owner,both parties hereto expressly agree and assert that,in the event of any dispute over its meaning or application,this Agreement shall be interpreted reasonably and fairly,and neither more strongly for nor against either party. 8.8 This Agreement shall be enforceable in Round Rock,Texas,and if legal action is necessary by either party with respect to the enforcement of any or all of the terms or conditions herein, exclusive venue for same shall lie in Williamson County, Texas. This Agreement shall be governed by and construed in accordance with the laws and court decisions of the State of Texas. 8.9 Both parties hereby expressly agree that no claims or disputes between the parties arising out of or relating to this Agreement or a breach thereof shall be decided by an arbitration proceeding,including without limitation,any proceeding under the Federal Arbitration Act(9 USC Section 1-14)or any applicable state arbitration statute. 8.10 The parties, by execution of this Agreement, bind themselves, their heirs, successors, assigns, and legal representatives for the full and faithful performance of the terms and provisions hereof. This Agreement is entered into as of the day and year first written above and is executed in at least two(2) original copies,of which one is to be delivered to Owner. OWNER CONTRACTOR CITY ROUN OCK,/T EXAS Cutler Repaving,Inc. z v Printed N me: Printed Name:111/ A Charles R.Veskema Title Title: President Date Signed: 5(25I 2?J Date Signed: May 5,2023 ATTEST: City Clerk FOR CITY,APPROVED AS TO FORM: —City—Attorney 00500 4-2020 Page 5 of 5 Standard Form of Agreement 00443647 Bond No. 674220548 PERFORMANCE BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Cutler Repaving, Inc. , of the City of Lawrence , County of Douglas , and State of Kansas , as Principal, and Liberty Mutual Insurance Company authorized under the law of the State of Texas to act as surety on bonds for principals, are held and firmly bound unto the CITY OF ROUND ROCK,TEXAS (Owner), in the penal sum of Six Million Five Hundred Forty Three Thousand Three Hundred Forty Two and 99/100 Dollars ($6,543,342.99 ) for the payment whereof, well and truly to be made the said Principal and Surety bind themselves, and their heirs, administrators, executors, successors and assigns,jointly and severally, by these presents: WHEREAS, the Principal has entered into a certain written Agreement with the Owner dated the Zr!5'�= day of tDDAk, , 2023 to which the Agreement is hereby referred to and made a part hereof as fully and to thelkame extent as if copied at length herein consisting of: 2022 ARTERIAL STREET MAINTENANCE PROGRAM NOW, THEREFORE, THE CONDITIONS OF THIS OBLIGATION IS SUCH, that if the said Principal shall faithfully perform said Agreement and shall, in all respects, duly and faithfully observe and perform all and singular the covenants, conditions and agreements in and by said Agreement, agreed and covenanted by the Principal to be observed and performed, including but not limited to, the repair of any and all defects in said work occasioned by and resulting from defects in materials furnished by or workmanship of,the Principal in performing the Work covered by said Agreement and occurring within a period of twelve (12) months from the date of Final Completion and all other covenants and conditions, according to the true intent and meaning of said Agreement and the Plans and Specifications hereto annexed,then this obligation shall be void; otherwise to remain in full force and effect; PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253, Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter 2253 to the same extent as if it were copied at length herein. Pagel 00610 4-2020 Performance Bond 00443639 PERFORMANCE BOND (continued) Surety, for value received, stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Agreement, or to the Work performed thereunder, or the Plans, Specifications, or drawings accompanying the same, shall in anywise affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Agreement, or to the work to be performed thereunder. If Principal fails to faithfully perform said Agreement, Surety, after receipt of written notice of Principal's default,shall perform all of Principal's duties and obligations under the Agreement. If, within ten (10) days after receipt of such notice from Owner, Surety does not commence to complete the obligations of Principal with a contractor acceptable to Owner and diligently complete the performance of the Principal's duties and obligations, Owner shall have the right but not the obligation to have the duties and obligations of Principal performed. In such event, Surety shall pay to Owner, upon demand, all costs, expenses and damages sustained by Owner as a result of Principal's failure to perform its duties and obligations under the Agreement up to the $6,543,342.99 sum of this Performance Bond, plus all costs and expenses, including attorney's fees and expert and consultant fees incurred by Owner to enforce its rights under this Performance Bond. IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this instrument this day of , 2023. Cutler Repaving, Inc. Liberty Mutual Insurance Company Principal Surety Charles R.Veskema Todd Alan Rambo Printed Name Printed Name By: _4�iafL Title: President Title: Attorney-in-Fact Address: 921 E. 27th St Address: 175 Berkeley Street Lawrence, KS 66046 Boston, MA 02116 Resident Agent of Surety: Signature Non-Resident Agent: Todd Alan Rambo Printed Name 430 E. Douglas Ave., Ste 400 Street Address Wichita, KS 67202 City, State & Zip Code License No. 2262809 Page 2 00610 4-2020 Performance Bond 00443639 Bond No. 674220548 PAYMENT BOND THE STATE OF TEXAS § § KNOW ALL MEN BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Cutler Repaving, Inc. , of the City of Lawrence County of Douglas , and State of Kansas , as Principal, and Liberty Mutual Insurance Company authorized under the laws of the State of Texas to act as Surety on Bonds for Principals, are held and firmly bound unto the CITY OF ROUND ROCK, TEXAS (OWNER), and all subcontractors, workers, laborers, mechanics and suppliers as their interest may appear, all of whom shall have the right to sue upon this bond, in the penal sum of Six Million Five Hundred Forty Three Thousand Three Hundred Forty Two and 99/100 Dollars($ 6,543,342.99 ) for the payment whereof,well and truly be made the said Principal and Surety bind themselves and their heirs, administrators, executors, successors, and assigns,jointly and severally, by these presents: WHEREAS,the Principal has entered into a certain written Agreement with the Owner, dated the QS'Oe day of bNOA.V, 2023 to which Agreement is hereby referred to and made a part hereof as fully and to the -,&e extent as if copied at length herein consisting of: 2022 ARTERIAL STREET MAINTENANCE PROGRAM NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal shall well and truly pay all subcontractors, workers, laborers, mechanics, and suppliers, all monies to them owing by said Principals for subcontracts,work, labor, equipment, supplies and materials done and furnished for the construction of the improvements of said Agreement, then this obligation shall be and become null and void; otherwise to remain in full force and effect. PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253, Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter 2253 to the same extent as if it were copied at length herein. Page 1 00620 04-2020 Payment Bond 00437699 PAYMENT BOND (continued) Surety, for value received, stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Agreement, or to the Work performed thereunder, or the plans, specifications or drawings accompanying the same shall in anywise affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract, or to the work to be performed thereunder. IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this Instrument this ')A day of , 201Z. Cutler Repaving, Inc. Liberty Mutual Insurance Company Principal Surety Charles R.Veskema Todd Alan Rambo Printed Name n� Printed Name By: Title: President Title: f Attorney-i - act Address: 921 E. 27th St Address: 175 Berkeley Street _ Lawrence. KS 66046 Boston, MA 02116 Resident Agent of Surety: Signature Non- Resident Agent: Todd Alan Rambo Printed Name 430 E. Douglas Ave., Ste 400 Street Address Wichita, KS 67202 City, State & Zip Code License No. 2262809 Page 2 006201-2020 Payment Bond 00090656 This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company Mutual. The Ohio Casualty Insurance Company Certificate No:8209420-674007 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Desiree E. Westmoreland;Myriah A.Valdivia;Timothy C.Smith;Todd Alan Rambo;Clara R.Navarro Abela all of the city of Wichita state of KS each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 9th day of February , 2023 Liberty Mutual Insurance Company P�1NS1J,0 P�ZV INS& a INS t/Rq The Ohio Casualty Insurance Company j2`oavoRgToy �`)=`i- ..,-- \G=`OaPog4Toy� West American Insurance Company ; 1912ya o 1919 2 1991 C-) z v p a) a O �/ rdJ��;�*U'��da ZD�y~/AMPS P �aa3 fs��4'DIANN,aD3 y' B (� 1 * M * 1 C: - M David M.Carey,Assistant Secretary t`a State of PENNSYLVANIA a) County of MONTGOMERY ss On this 9th day of February 2023 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance cv Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument far the purposes > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. � caIm IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. •— O 9P wF PAST > �oNF<' Commonwealth ofPennsylvania-Notary Seal i p o9� y Teresa Pastella,Notary Public Montgomery County _ OF My commission expires March 28,2025 v Commission number 1126044 By: ?�NSyLON CG Member.Pennsylvania Association of Notaries Teresa Pastella,Notary Public 0 4qy PU c This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company,Liberty Mutual Insurance ECompany,and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV-OFFICERS:Section 12.Power of Attorney. ) Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the President oo¢ . may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety any and all > a: undertakings, bonds, recognizances and other surety obligations.Such attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such instruments shall Z be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of P�1NS(/Rq PVSV INgUR d \NSUgq J 3G0 aF0 �T01•cn 3°0 PO&,Tp-9yc' V, ogg Q Tpym 1912yo 0 1919 f 1991 : o Q o rdjl9sS4c.u50 dD Z0��YAM? a '� �NOIANP a3 By. 9/7 * *e� 41, * *ad s�,M # d Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co 02121 7/11/22,2:39 PM Sircon for Agencies TM P � � TPXA� General Lines Agent Property and Casualty TODD ALAN RAMBO 430 E DOUGLAS AVE STE 400 WICHITA, KS 67202-3408 is authorized to transact business as described above License No: 2262809 Issue Date: 01-23-2018 Expiration Date: 07-31-2024 Generated by Sircon 273418202 TEXA _,.`tir,tt S IS HEREBY AUTHORIZED TO TRANSACT BUSINESS z x IN ACCORDANCE TO THE LICENSE DESCRIPTION 1)LPARfM1\1 Or IN$URANC't , SHOWN BELOW: THIS IS TO CERTIFY THAT 'sem General Lines Agent TODD ALAN RAMBO Property and Casualty 430 E DOUGLAS AVE STE 400,WICHITA,KS 67202-3408 Issue Date:01-23-2018 Expiration Date:07-31-2024 LICENSE NUMBER:2262809 Generated by Sircon 273418202 https://www.sircon.com/ComplianceExpress/ServiceRequest/licPrnt.do?method=submit 1/1 WIFF- IMA , L! V� CONSIDER IT DONE PLEASE NOTE: None of the attached bonds or powers-of-attorney have been dated as the contract copy provided did not contain a contract date. Once the contract has been dated, it is important that the same date be inserted onto each bond and each power of attorney wherever a date is requested. Please notify IMA of the contract date once known. Thank you. Todd Alan Rambo Surety Account Executive IMA Bond Department 316-266-6507 P: 316.267.9221 IMA of Kansas, Inc. Box 2992 B P.O. RISK MANAGEMENT, INSURANCE & F: 316.266.6254 P.O. BWichita KS 67201-2992 EMPLOYEE BENEFITS SOLUTIONS www.imacorp.com AFFILIATIONS:ASSU REX I INTE RSUftE dba IMA of Kansas Insurance Services California Lic#OD28748 Liberty Mutual. SURETY TEXAS TEXAS IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener information o para someter una queja: You may call toll-free for information or to Usted puede llamar al numero de telefono gratis make a complaint at para information o para someter una queja al 1-877-751-2640 1-877-751-2640 You may also write to: Usted tambien puede escribir a: 2200 Renaissance Blvd., Ste. 400 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 19406-2755 King of Prussia, PA 19406-2755 You may contact the Texas Department of Puede comunicarse con el Departamento de Insurance to obtain information on companies, Seguros de Texas para obtener information coverages, rights or complaints at acerca de companias, coberturas, derechos o 1-800-252-3439 quejas al 1-800-252-3439 You may write the Texas Department of Insurance Puede escribir al Departamento de Seguros Consumer Protection(111-1 A) de Texas Consumer Protection (111-1 A) P. O. Box 149091 P. O. Box 149091 Austin, TX 78714-9091 Austin, TX 78714-9091 FAX: (512)490-1007 FAX#(512)490-1007 Web: http://www.tdi.texas.gov Web: http://www.tdi.texas.gov E-mail: ConsumerProtectionna,tdi.texas.gov E-mail: ConsumerProtection(a-),tdi.texas.gov PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: Should you have a dispute concerning your Si tiena una disputa concerniente a su prima o a premium or about a claim you should first contact un reclamo, debe comunicarse con el agente o the agent or call 1-800-843-6446. primero. Si no se resuelve la disputa, puede If the dispute is not resolved, you may contact the entonces comunicarse con el departamento (TDI) Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA: POLICY: This notice is for information only and does not Este aviso es solo para proposito de information y become a part or condition of the attached no se convierte en parte o condition del document. documento adjunto. NP 70 68 09 01 LMS-15292 10/15 CUTLREP-02 LHERVEY ACORO CERTIFICATE OF LIABILITY INSURANCE DATE( YYYY) 5/55/202/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lynn Hervey NAME: Johnston Fiss Insurance PHONE FAX 5225 W.75th Street,Suite 200 (AIC,No,Ext): (A/C,No): Shawnee Mission,KS 66208 AppRE :lhervey@johnstonfiss.com INSURERS AFFORDING COVERAGE NAIC 0 INSURER A:Cincinnati Casualty Company 28665 INSURED INSURER B:MIDWEST BUILDER'S CASUALTY MUTUAL COMPANY 13126 Cutler Repaving,Inc. Attn: Bob Veskerna INSURERC: 921 E.27th Street INSURER D; Lawrence,KS 66046-4917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSIR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE rX OCCUR X EPP 0584980 8/1/2022 8/1/2023 DAMAGE TO RENTED $ 500,000 price)MED EXP(Any oneperson) $ 10'000 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 POLICY Fxl jpR& F]LOC PRODUCTS-COM P/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 _(Ea accident) X ANY AUTO X EPP 0584980 81112022 8/112023 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTO.pSWN BODILY INJURY Per accident $ AUTOS ONLY AUUTOS ONLY PPerr acEcidentDAMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS-MADE EPP 0584980 8/1/2022 8/1/2023 AGGREGATE $ 5'000'000 DED I I RETENTION$ $ B WORKERS COMPENSATION X PER I OTH- AND EMPLOYERS'LIABILITY TA UTE 71 ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE WC100-0003848-2022A 8/1/2022 8/1/2023 1,000,000 OFFICER/MEMBER EXCLUDED? ❑N NIA E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1'000'000 It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:2022 Arterial Street Maintenance Program City of Round Rock as additional insured. The carrier will provide the City of Round Rock notice of any changes,cancellation,etc at least thirty(30)days prior to date of change. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI Of Round Rock THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City ACCORDANCE WITH THE POLICY PROVISIONS. Transportation Department 3400 Sunrise Road Round Rock,TX 78665 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BID BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Cutler Repaving Inc. of the City of Lawrence County of Douglas State of Kansas as Principal, and Liberty Mutual Insurance Company authorized under the laws of the State of Texas to act as surety on bonds for principals,are held and firmly bound unto the CITY OF ROUND ROCK,TEXAS("Owner"), in the penal sum of Five Percent(5%)of the total amount of the Bid of the Principal submitted to the Owner, for the Work described below; for the payment whereof, well and truly to be made,and the said Principal and Surety do herby bind themselves and their heirs, administrators, executors, successors and assigns, jointly and severally,as follows: In no case shall the liability of the Surety hereunder exceed the sum of( Five Percent of Amount Bid Dollars($ 5% THE CONDITIONS OF THIS OBLIGATION ARE SUCH that,whereas,the Principal has submitted the above-referenced Bid to the Owner, for construction of the Work under the "Specifications for Construction of 2022 ARTERIAL STREET MAINTENANCE PROGRAM 91 for which Bids are to be opened at the office of Owner on the 21st day of March ,20 23 . NOW,THEREFORE,if the Principal is awarded the Contract,and within the time and manner required under the"Instructions to Bidders,"after the prescribed forms are presented to herlhim for signature,enters into a written Agreement substantially in the form contained in the Bid Documents,in accordance with the Bid, and files the two(2) bonds with the Owner, one to guarantee faithful performance and the other to guarantee payment for labor and materials,then this obligation shall be null and void;otherwise, it shall be and remain in full force and effect. If, however, Principal fails to enter into a written Agreement with the Owner in accordance with the Bid or Principal and Surety fail to timely deliver to Owner the performance and payment bonds required by the Bid Documents, Surety within five(5)business days after receipt of a written demand from Owner shall pay to Owner the full penal sum of this Bid Bond,subject to the limitation described herein. In the event that suit is brought upon this Bond by the Owner and judgment is recovered, said Surety shall pay all costs incurred by the Owner in such suit, including a reasonable attorney's fee to be fixed by the Court. IN WITNESS WHEREOF, the said Principal and Surety have signed this instrument on this the 21 st day of the month of March 2023 . Cutler Repaving, Inc. Liberty Mutual Insurance Company Principal Surety Charles R'Veskema Todd Alan Rambo \\\.•,,r""P cued Name /J Printed Name Y 0,v e o Bye. Title: Attorney In-FaL ct i} t Address: •921 E. 27th St ' Address: 430 E. Douglas live-Ste 4Q0 Lawrence, KS 66046Wichita, KS 672 J - j" IN \' 00200 4-2020 Page I Bid Bond 00443638 Resident Agent of Surety: Signature Todd Alan Rambo- License No. 2262809 Printed Name 430 E. Douglas Ave. Ste 400 Street Address Wichita, KS 67202 City, State,Zip Page 2 00200 4-2020 Bid id Band This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company Mutual® The Ohio Casualty Insurance Company Certificate No:8209420-674007 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Desiree E. Westmoreland;Myriah A.Valdivia;Timothy C.Smith;Todd Alan Rambo;Clara R.Navarro Abela all of the city of Wichita state of KS each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 9th day of February 2023 Liberty Mutual Insurance Company P�tNst,Rq P�v( INS& a %NSIJ The Ohio Casualty Insurance Company o°aPOa,�atim �J2°°aPO�r�vy �P°oaPORar�y� West American Insurance Company W 3 o m „ 1912yo oZ1919� o s 1991 0 �f Yd'�9SS4, '51MPS�,aa �s /NDIANP aa$• t! 10/7 * eta �'yl * td dyt t ti� By: ctt — / M State of PENNSYLVANIA David M.Carey,Assistant Secretary a County of MONTGOMERY ss 0 a On this 9th day of February 2023 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance EF-9 N Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. N N :3 IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. •— c� 0 O gyp, PAST tpoN Wf F( Commonwealth of Pennsylvania-Notary Seal Qj O oa A v Teresa Pastella,Notary Public O OF Montgomery County My commission expires March 28,2025 C By; Commission number 1126044 V)+-• ti hSyLN1` `G Member,Pennsylvania Association of Notanes Teresa Pastella,Notary Public N N ARV P 0 This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company,Liberty Mutual Insurance ECompany,and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV-OFFICERS:Section 12.Power of Attorney. Q( Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the President od6 may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety any and all CID C undertakings,bonds,recognizances and other surety obligations.Such attomeys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall have full o power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such instruments shall Z be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attomey-in-fact under the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is lr%ufol�en�effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 21 st day of March 2023 P�1NSU? PSS•( INS& %NSlio Ov J aao 4 N ' J °o Baro m QJ3°oavoRyr'pyy `P°oavor�l•9/yC, - =1912 " �O " w 2 �O cA —C�'�'�7� .: Z Y ; yo 0 1919 2 1991 0 v :� : 4Q.u o a o Yd:II 4C. s;aa3 yO F�NAM?$ a� /A'D1A a� Biy. J • 1./ '•• 47 ej� y1 * *�a s�,M # *aa Renee C.Llewellyn,Assistant Secr 617 • t'A LMS-12873 LMIC OCIC WAIC Multi Co 02/21 .J 7/11/22,2:39 PM Sircon for Agencies TM a Z P � � TAX A General Lines Agent Property and Casualty TODD ALAN RAMBO 430 E DOUGLAS AVE STE 400 WICHITA, KS 67202-3408 is authorized to transact business as described above License No: 2262809 Issue Date: 01-23-2018 Expiration Date: 07-31-2024 Generated by Sircon 273418202 TE XAS _ _lIS HEREBY TO-_E ` ��i�~�' IN ACCORDANCEOTO THE LICENSE DESCRIPTION BUSINESS DEPARIMM Of IXSURAM-1- /\ % SHOWN BELOW: THIS IS TO CERTIFY THAT ` General Lines Agent TODD ALAN RAMBO Property and Casualty 430 E DOUGLAS AVE STE 400,WICHITA,KS 67202-3408 Issue Date:01-23-2018 Expiration Date:07-31-2024 LICENSE NUMBER:2262809 Generated by Sircon 273418202 https://www.sircon.com/ComplianceExpress/ServiceRequest/licPrnt.do?method=submit 1/1 Solicitation Requirements, Contract Forms & Conditions of Contract Statement of Bidder's Safety Experience Section 00410 Bidder must submit a signed Statement of Bidder's Safety Experience form with his Bid; failure to do so will constitute an incomplete Bid that may be rejected. In order to make a responsive Bid, Bidder must provide evidence that it meets minimum OSHA construction safety program requirements, has not been fined by OSHA for any willful safety violations in the past three years, and has a lost time injury rate that doesn't exceed the limits established below. All questions must be answered and data given must be clear and comprehensive. If necessary, questions may be answered on separate attached sheets. Company Name: Cutler Repaving, Inc. Address: 921 East 27th St. Lawrence,KS 66046 Phone: 785-843-1524 Completed by: Charles R. Veskerna Date: March 3, 2023 1. Does the company have a written construction Safety program? [2]Yes ❑No 2. Does the company conduct construction safety inspections? [aYes ❑No 3. Does the company have an active construction safety-training program? ❑✓Yes ❑No 4. Has the company been fined by OSHA for any willful safety violations in the past ❑Yes ❑✓ No three years? 5. Does the company have a lost time injury rate of 7.8 for SIC 15,or 7.6 for SIC 16, ❑Yes ❑✓ No or less over the past three years? Attach the company's OSHA 200/300 logs for the past three years. 6. Does the company or affected subcontractors have competent persons in the following Areas? A. Scaffolding ❑Yes ❑No [D N/A B. Excavation ❑Yes []No [DN/A C. Cranes ❑Yes []No ❑✓ N/A D. Electrical ❑Yes []No [21 N/A E. Fall Protection ❑Yes ❑No ❑✓ N/A F. Confined Spaces ❑Yes [:]No ❑✓ N/A I hereby certify that the above information is true and correct. Signature (",444. u ` � ms ,µ Title President Page 1 00410 8-2014 Statement of Bidder's Safety Experience 00090654 MM Note:You can type input Into this form and save it. Because the forms in this recordkeeping package are"fillable/writable" PDF documents,you can type into the input form fields and Calculating Injury and Illness Incidence Rates then save your inputs using the free Adobe PDF Reader. addition, the forms are programmed to auto-calculate as appropriate. What is an incidence rate? (c)The number of hours all employees actually various classifications(e.g.,by industry,by An incidence rate is the number of recordable worked during the year.Refer to OSHA Form employer size,etc.).You can obtain these injuries and illnesses occurring among a given 300A and optional worksheet to calculate this published data at www.bls. og v/iif or by calling number of full-time workers(usually 100 full- number. a BLS Regional Office. time workers)over a given period of time You can compute the incidence rate for all (usually one year).To evaluate your firm's injury recordable cases of injuries and illnesses using the and illness experience over time or to compare following formula: your firm's experience with that of your industry Total number of injuries and illnesses X 200,000 as a whole,you need to compute your incidence Number of hours worked by all employees=Total Worksheet rate.Because a specific number of workers and a recordable case rate specific period of time are involved,these rates can help you identify problems in your workplace (The 200,000 figure in the formula represents the Number of and/or progress you may have made in preventing number of hours 100 employees working 40 hours Total number of hours worked Total recordable work-related injuries and illnesses. per week,50 weeks per year would work,and injuries and illnesses provides the standard base for calculating by all employees case rate How do you calculate an incidence incidence rates.) rate? You can compute the incidence rate for 8 X 200,000 376,940.00 4,24 You can compute an occupational injury and recordable cases involving days away from work, illness incidence rate for all recordable cases or days of restricted work activity or job transfer for cases that involved days away from work for (DART)using the following formula: your firm quickly and easily.The formula (Number of entries in column H+Number of requires that you follow instructions in paragraph entries in column I)X 200,000–Number of hours (a)below for the total recordable cases or those in worked by all employees=DART incidence rate Number of paragraph(b)for cases that involved days away You can use the same formula to calculate hours worked DART incidence from work,and for both rates the instructions in incidence rates for other variables such as cases Number of entries in c by all employees rate paragraph O• involving restricted work activity(column(I)on Column H+Column I (a)To find out the total number of recordable Form 300A),cases involving skin disorders 6X 200,000 376 — 3" 8 1 injuries and illnesses that occurred during the (column(M-2)on Form 300A),etc.Just substitute — ,940.00 — v year,count the number of line entries on your the appropriate total for these cases,from Form OSHA Form 300,or refer to the OSHA Form 300A,into the formula in place of the total number 300A and sum the entries for columns(H),(I), of injuries and illnesses. and(J). (b)To find out the number of injuries and What can I compare my incidence rate Reset illnesses that involved days away from work, to? count the number of line entries on your OSHA Form 300 that received a check mark in column The Bureau Labor Statistics(BLS)conducts a (H),or refer to the entry for column(H)on the survey of occupational injuries and illnesses each �•._ year and publishes incidence rate data by �=m� OSHA Form 300A. i• OSHA's Form 300 (Rev. 04/2004) Note:You can type input into this form and save it. Attention:This form contains information relating to Loo f Wo rk-Related Because the forms in this recordkeeping package are"fillable/writable" employee health and must be used in a manner that gPDF documents,you can type into the input form fields and protects the confidentiality of employees to the extent Year 20 22 then save your inputs using the free Adobe PDF Reader.In addition, possible while the information is being used for U.S. Department of Labor Injuries and Illnesses the forms are programmed to auto-calculate as appropriate. occupational safety and health purposes. occupational safety and Health Administration Please Record: Reminders: Form approved OMB no.1218-0176 •Information about every work-related death and about every work-related injury or illness that involves loss of •Complete an Injury and Illness Incident Report(OSHAForm 301)or equivalent consciousness,restricted work activity orjob transfer,daysawayfrom work,or medical treatment beyond first aid. form foreach injury or illness recorded on this form.Ifyou're not sure whether a Establishment name Cutler Repaving Inc. -Significant work-related injuries and illnesses that are diagnosed by a physician or licensed healthcare professional. case is recordable,callyour local OSHA office for help. •Work-related injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR Part 1904.8 •Feel free to use two lines fora single case ifyou need to. through 7904.12. •Complete the 5 steps for each case. city Lawrence State KS Step 1.Identify the person Step 2.Describe the case Step 3.Classify the case SELECT ONLY ONE circle based on the (A) (B) (C) (D) (E) (F) Enter the number of days the injured or ill Select one column, Case Employee's name Job title Date of Injury Where the event occurred Describe injury or illness,parts of body worker was, no. (e.g.,Welder) or onset of (e.g.,Loading dock north end) affected,and object/substance that illness directly injured or made person W(e.g., Remained at Work Illness (e.g.,2110) Second degree burns on right forearm from acetylene torch) Days away Job transtar Other record- Away Onion (M) Death from work or restriction able cases from transfer or work restriction (G) (H) (1) (3) (K) (L) sem` a o a x <= (1) (2) (3) (4) (5) (6) Reset 1 Eberardo Diaz Operator 1 ,18 Plantation, FL Chest & ribs 0 0 � 0 13 monthlaity nays ____days00000 Reset 2 Fernando Cortez Operator 2 /11 McAllen,TX Bump on the head 0 0 0 month/day days _days 000 0 Reset 3 Brook Castleberry Traffic Control 6 /3 Taos, NM Bruised back & legs 0 • days _ears00000 month/day Reset 4 Jordan Nicklow Crew Hand 7 1 5 Orlando, FL Heat Stress 0 (�i) 0 0 2 00000 nanth/day _days _days Reset 5 Guillermo Lopez Operator 7 ,12 Ruidoso, NM Strained lower back& leg 0 0 0 19 Th /day _days _days tom• 0 O 00 0 Reset 6 Nicholas Nicklow Crew Hand 7 ,19 Orlando, FL Heat Stress 0 0 0 0 4000000 month/day _days _days Reset 7 Rodrigo Garza Operator 8 3 Orlando, FL Heat Stress 0 0 0 4 month/ 00000 -------- - ---- day _days _days Reset 8 Joshua Crawford Crew Hand 10/ 26 Ruidoso, NM Leg injury 0 0 0 3 month/day _days _days O 0 00 0 month day _days _days 0 000 00 -- / Reset /_ 0 0 0 0 _days _days O O QO O O month/day public reporting burden for this collection of information is estimated to average 14 minutes per response,including time to review the inPage totals ► 0 5 1 2 32 13 5 0 0 0 0 3 instructions,search and gather the data needed,and complete and review the collection of information.persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.If you have any comments about these Add a Form Page Be sure to transfer these totals to the Summary page(Form 300A)before you post it. estimates or any other aspect,of this data collation,conmcc U5 Department of Labor,OSTIA Office of Statistical Analysis,Room a ° .5 0 N-7644,200 Constitution Avenue,NW,Washington,DC 20210.Iw not send the completed fors to this office. y a o z (1) (Z) (3) (4) (5) (6) OSHA's Form 300A (Rev.04/2004) Note:You can type input into this form and save It. Because the forms in this recordkeeping package are"fillable/writable" Year 20 22 PDF documents,you can type into the input form fields and Summary of Work-Related Injuries and Illnesses then save your inputs using the free Adobe PDF Reader. U.S.Department of Labor Occupational Safety and Health Administration Foran nppr,,—1 OMIT nn.1218-0176 All establishments covered by Part 1904 must complete this Summary page,even if no work-related injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this summary. Using the Log,count the individual entries you made for each category.Then write the totals below,making sure you've added the entries from every page of the Log.If you had no cases,write"0." Establishment information Employees,former employees,and their representatives have the right to review the OSHA Form 300 in its entirety.They also have limited access to the OSHA Form 301 or its equivalent.See 29 CFR Part 1904.35,in OSHA's recordkeeping rule,for further details on the access provisions for Yourearablisnmentnama Cutler Repaving Inc. these forms. Street 921 E 27th St Number of Cases City Lawrence state KS zip 66046 Total number of Total number of Total number of cases Total number of deaths cases with days with job transfer or other recordable Industry description(e.g.,Manufacture ofmotor truck trailers) away from work restriction cases 0 5 1 2 Asphalt Paving Contractor (G) (H) (1) (J) North American Industrial Classification(NAICS),if known(e.g.,336212) 237310 Number of Days Employment information(lfyou don't have these figures,see the Total number of days Total number of days of Worksheet on the next page to estimate.) away from work job transfer or restriction Annual average number of employees 152 32 13 (K) (L) Total hours worked by all employees last year 376,940.00 Sign here Injury and Illness Types Knowingly falsifying this document may result in a fine. Total number of... 1 certify that I have examined this document and that to the best of (M) (1)Injuries 5 (4) Poisonings 0 my k�;pwledge the a�es are true,accurate,and co Tette J y;Lla / /�1/V �G tom/ ✓PCI(1 (2)Skin disorders 0 (5) Hearing loss 0 Company executive Title (3)Respiratory conditions 0 (6) All other illnesses 3 Phone 785-843-1524 Date 1/25/2022 Post this Summary page from February 1 to April 30 of the year following the year covered by the form. Reset Public reporting burden for this collection of information is estimated to average 58 minutes per response,including time to review the instructions,search and gather the data needed,and complete and review the collection of information.Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.If you have any comments about these estimates or any other aspects of this data collation,contact:US Department of Labor,OSHA Office of Statistical Analysis,Room N-3644,200 Constitution Avenue,Nw, Washington,DC 20210.Do not send the completed forms to this office. T OSHA's Form 300A (Rev.01/2004) rear 20 A i Summary of Work-Related Injuries and Illnesses U.S.Department of Labor 0-4—ti—I Sa/slr irrd INaMh Ad itildsbation our m apin i.vid(IM H.n r.111x+,1:1, All establishments covered b Pail 1904 must complete this Summary _------- Y W lorry page.ever:it no work related injures a illnesses occurred doing the year Remember to review the Log to very that the entries are complete and accurate before completing this summary Using the Log,count the individual entries you made for each category Then write the totals below,making sure you're added He enures from every page of the Log.If you Establishment information had no cases,write'0.' Employees,former employees.and their representatives have the right to review the OSHA Form 300 in its entirety they also have limited-access to the OSHA Form 301 or r-t stu/r—t— [^•- ufleye its equivalent.See 29 CFR Part 7904.35,in OSHA's recordkeeping m/e.for further derails on the access provisions for Mese forms. Srrrl (:vy sua 1tS ZII'Number of Cases Total number of Total nutnber of Total number of Total number of Ind-try dot ipnnns�7a/rip ou�r}y mmnr in k rrailaa7 deaths cases with days cases with joh other recordable away from work transfer or restriction cases Standar)Indu,rul(aassrtirariow(SIC).If known(qp.,171,) (G) (H) (q (J) Ott • North Amerian Induurial(1—ifi-rum(NAICS).if known(e.g...i..36?12) Number of Days xx 3.2 Al 1 SZ Totalnumix-ifdats.nvay InLllnumber ofdays ofjob Ernpioymetitinformatfottll7l.rrdnn'rlwrrAir,r7(iurc;.wda from work transfer or astriction Itnddmrnnrk larknirhopap•mmirxnrr.l 2 Aun 1 i-r,W numb,,,ofemploy,,,. 135 . �tL 3 — (K) (L) T nal hours wurkd Ivy ill aoployees last yea, J3 A7 DOS Injury and Illness Types Sign here Total number of... Knowingly falsifying this docurnent may result in a fine. (M) (T)Injuries (4)Poisonings O O 1 certify that I lu%c csan7inird this document and that w the best of my (5)1 Icaring loss knowledge the cutrios arc true,accurate,and complete. (2)Skin disorders 0 (6)All otter illnesses (3)Respiratory conditions 7Ss 9/7-/9;L;- /7.9,?03! Post this Summary page tram February t to April 30 of the year following the year covered by the form. hd,b,nTnx a Inudrn lar Ju,nrlkrr r.l mIm r o r.lrmaud rn a.eugt.x n .ire a.prrn rthwxr�q oro .the-......urn.....Ji and xe,hrr the dao rrac.hvl,and rrn.pk .idrrr row Jon roti«mrn,xnrhnrnahun�Yn.rrrn,air non mporr.d to re,prud o.,he rulkrdrm ufondum..unrn unle„x d.4A. enll.vAd OXIHr. nhn.n her.If—ha. ..., urht .rya. t dr1.J.a.r rulhrnun,runtarr IIN Iky nw .11.&.OSIIA Offirt ul Valuliral:\nalv.r.,H..nn V-.or I IN'dxr(�,.naiwuuo A,tour.W \v a�•Inn4li.n,n('llrr 111'Ik„rn+..nil thrumldio.il arm.n.11n.irllr.••. OSHA's Form 300 (Rev. 0412004) Note:You can type input into this form and save it. Attention:This form contains information relating to Log of Work-Related Because the forms in this recordkeeping package are"tillable/writable" employee health and must be used in a manner that PDF documents,you can type into the input form fields and protects the confidentiality of employees to the extent Year 20 then save your inputs using the free Adobe PDF Reader.In addition, possible while the information is being used for Injuries and Illnesses the forms are programmed to auto-calculate as appropriate. occupational safety and health purposes. U.S.Department of Labor Occupational Safety and Health Administration Please Record: Reminders: Fem,,pp,e..d uMH m,12118-1176 •Information about every work-related death and about every work-relatedmlury or illness thatmvolves loss of •Complete an Injury and Illness Incident Report(OSHA Form 301)or equivalent consciousness,restricted work activity orjob transfer days away from work•or medical treatment beyond first aid. form for each injury or illness recorded on this form,lfyou're,not sure whether a Estabnshmenr name •Significant work-related injuries and illnesses that are diagnosed by a physician or licensed health care professional, case is recordable,callyour local OSHA office for help. •Work-related injuries and illnesses that meet any of the specific recording criteria listed on 29 CFR Port 1904.8 •Feel free to use two lines for a single case d you need to. through 1904.12. •Complete the 5 steps for each case. Gty C,L c t Stara Step 1.Identify the person Step 2.Describe the case I Step 3.Classify the case (A) SELECT ONLY ONE circle based on the C (B) (c) (D) (E) (F) most serious outcome: Enter the number o/ mpoyee's name Job title Date of injury Where the event occurred days me injured or ill Select one column: no. J Describe injury or jllncss,parts of hod* worker was, (e.g..IY<ddrr) or onset of 6,g_Landing dock nnrrlr rnrf) affeeled,and nhjecUsuhsUnre than illness directly injurer!or made person ill(rg. Remained at Work 221101 Sec,erj degree hunts,...rr�hr/urennn Drum Illtk:ss erWylrnr Inrelr) Days away .lob transter Other record. Away On job (M) Death from work or r,,tr,ct,,, able casesro of m J+ lunslcr ai? (G) (H) (i) (J) work restriction `' ;o 1 a (K) (L) S _Y (3) (a) (5 �6 RVf7(yt •�jyl(�VZ i',..^. li'� ye.rr +' 00000 rrunm,a,.Y �jyf uv ..dun tun<v0 0 O t,• Reset tsN MY 1 eS t, `.,,1, 1 �I m,day C�1el,�.i<, ,�� r *00000 p f LCnar _revs Reset J IIpU��'� 's�ray��5f Cf��n✓ aaY l� tYrPGf/!� AM OVt✓ toe lt, O � O O Reset r �L— Qday. 00000® K,,t try gr>'kt.r /clu �v erSa-- md,m r der 1 r ✓CC "! <I L VJ j.�r�Yf-t C ° 0 O Q- 00000 Reset flsel:, �der. `�My: In Z7 It t" 1(_ bfJ/ !JC[Cfi �s)'UtJ' Qsay. ays (@00000 Reset ; 21 p✓1 )K;>,1{ {i✓,,"Y."' 0 0 0 0 `d.r _Mr (20000 0 mw,m rds� (6U>,`:./V/•' .i/? 1 Y'~' y.71 ' Reset -� ��:?A V,��(•✓moi sr/'{ =l ) } - — ^ O den ,r t=—'°ave OOOOO ,i i Reset _/_ In r My 0 0 0 0 _days __y, 000000 mn„ Reset 0 0 0 0 _days _day. 000000 r,wrdn r day Reset / _ 0 0 0 0 _dor . 000000 mama coy Rdd,c r.-pwnny hw.km Iw lws cullenxm of ml,xnul_n osnnu.d w me,ag.I:mwa,.>Iw,,.,pw,x.,oclulmp mnx w nvkw dw 00' O 0 O O O O P.=,...,r,h,ed cm.,Ih,Jut,ik-..kd.—1'—wi io 1211 r..�r.it.—11..,,,x,.,t,memennn.r.,w,n a,,nw"ynned w � Page totals 0 0 0 0 0 0 .zwnd w�ne.xue.n,.�„r�m.,,n,n,m xnk.,x m<pl,y:,.mrsmly y,ne unsw.emnJ nwnn,.li y.w na,.,ny.,,mnk„�„Ik,m m.:. Add a Form Page — Nimatd m my mhc,..ry-,la u IN,Jm,.nlle.h,m.am,ai tIS Lk-1 mal Uh,n„SHA 011ie,nl S„uA,r,I A-ky—,Xv Be sure to frensfer these totals to the Summdrypage(Form 300A)before you post it n-sr,a.±Inc,e,.v„x..,.,..n,,,-.n,,.w...wneum.lx•±n±mu,nm,.rw ln...x,�nl,l.-J lm,n.l„mr.,ul,. _ � s — _� (1) (2) (3) (4) (5) (s) Attention:This form contains information relating to — OSHA's Form 300 (R.,01/2004) employee health and must be used in a manner that protects the confidentiality of employees to the extent Year 20 � Log of Work-Related Injuries and Illnesses Possible while the information is being used for U.S.Department of Labor J occupational safety and health purposes. occupational safety and Health Administration ..I You must record uiformation about every work-rektied death and about ovary work-teluled injury of illness that involves loss of consciousness,(c5tricfed work aetiv!(y OfjOb transfer, - days away from work,or medical treatment beyond first aid.You must also record significant work-related injuries and illnesses that are diagnosed by a physician or licensed health s- care professional.You must also record work-related injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR Part 1904.8 through 1904.12.Feel tree to Establishment name_�tt TLEA CEPA V I fJ 4l 1 W-1. use two lines for a single case if you need to.You must complete an Injury and Illness Incident Report(OSHA Form 301)or equivalent form for each injury or illness recorded on this II -- A form.If you're not sure whether a case is recordable,call your local OSHA office for help. city_L. w&s#jC6 State Ks Identify the person Dscribe the case Classify the case e (A) (B) (C) (D) (E) (F) CHECK ONLY ONE Enter the number of based on the most serious outcome fordays the injured or Check the"Injury"column or Case Employee's name job title Date of injury Where the event occurred Describe injury or illness,parts of body affected, ill worker was: choose one type of illness: no. (e.g.,Welder) or onset (e.g.,Looding(lack north end) and object/substance that directly injured of illness or made person ill(e.g.,Second degree hunks on Remained at Work (M) right fDreanrt from acetylene torch) Away On job K, _ _ _ N Days away Job transfer Other record• fro transfer or Death from work or restriction able cases work restriction :F i .. 1 A6eiLFL (G) N) CO (J) (K) W (1) (2) (3) (4) (5) (6) 001 ;10 -3AIMMA S4M�GtL WK 3 /14 CeurxAtarllt�s�C-- UACAL IT SAGO- GtAN`�a 7j- E ❑ ❑ ❑ � 7 month/daY - 4 days _days ) t r"; �� eea-,U BROOK�Strab6tlty -1'ei .Cid. 5/3o Ntr" oa Sigd&&AP Fir�Lea days _days X ❑ � ❑ �- month/day 69S.240 LeVaML 101 LU hrAS _M 6840M - G /81 Pittgao It11.wspusl UVWwl -Ayc& oZ da s day, montNtlay • ❑ ❑ ❑ YIli. ooy•atl Awavo Y VASqmi2 L A6o"A L /11 HEAT MMM LST104 ❑ ❑ ❑ days _days montNday DOS-ae TSA1101 IjQQ/S >t 4 /."A _ASOMALT Su" Oat LEE ❑ ❑ ❑ � -A-days _day, � L1 F1 Fl F] 1 monthfdev �.�/► {� Na•a0 ESILs L4r�fl _ N !14r l.oeSEeltef�,BOLT- c�rErr PA,a ❑ ❑ _L montNday days day, RAMSFA _ �(�k ❑ }�+1 /+n��1'�.rA��+ II t/1;16 -.,L—I7EAT EXNA'wS71e� days _days I l month/day ❑ X fo>r-oro ,SHkrkn6K W%U-lAV15 tt 4 /0y rt 4( p .R. ❑ FA ❑ days _days `\<I-1 monlvday 1 h los-,70 �ZA1,ft* SUTL u (O L" -__.. COLCAL. AAAI WMIL Pool `I�iI ---_ ❑ IN ❑ ❑ i-0 days _days month/day, (-I Its-30 PEOb 19e01L4A %1Z. i1 m /14 Ptts/entA,z wnwNo© ;:@G-r ❑ ❑ ❑ month/day - days days _. — LldamontNday -- -__ - ❑ ys ❑ ❑ days _ / ❑ ❑ ❑ ❑ des des . ( montNday - / ❑ ❑ ❑ ❑ —days _day, month/day Page totals> 0 g —a ( LL s 1'uhh(reporting burden for this enllattion of udiumation is estimated to average 14 mimnes per response,including time to review Be sure to transfer these totals to the Summary page(Form 300A)before you post it. y° o [he instructions,se:urh and gather the deka marded,and mtnpletr and review the collrctinn oi'in(urmation.Persons are not required to i-its ud to the collection of information unless it displays a currently valid OMR control numlxr.11you have any coutmenL �'E alenu i6ese estimah•s ur any other aspects of dtix data coilydion,anntact:LIS Deparuneut of Lahor,OtiHA Office of tilakisticai ]r r S Analysis,Rtwm N-31144,200 Constitutiun Avenue,NW,Washington,DC 202111.Do nut savul the complend limrms to this ollice, Ppe_ et_! (1) (2) (3) (4) (5) (6) OSHA's Form 300A (Ray.01(2004) Year 20__ Summary of Work-Related Injuries and Illnesses U.S.Department of Labor Occupational Safety and Health Administration Penn approval OJlli no.1218-0176 All establishments covered b Part 1904 must complete this Summa e,even it no work-related injuries or illnesses occurred during the y Summary page, / g year.Remember to review the Log to verily that the entries are complete and accurate before completing this summary. Using the Log,count the individual entries you made for each category.Then write the totals below,making sure you've added the entries from everypage of the Log.11 you Establishment information had no cases,write'0.' Employees,former employees,and their representatives have the right to review the OSHA Form 300 in its entirely.They also have limited access to the OSHA Form 301 or you.oatamranmont name �.u'rLEREPAV 1 Ia4 rIJC its equivalent.See 29 CFR Part 1004.35,in OSHA's recordkeeping ride,for further details on the access provisions for these forms. Street 9A I E .X7 rl ST• City AWAff0"___stale Ki_/..111 (IG�Nb Number of Cases Total number of Total number of Total number of Total number of Industry description(cg.,Man jature o(nulortmrk tr+ilen) deaths cases with days cases with job other recordable AM"Aur PAV144 Cal►f7YlAerS& /r►.tQ, away from work transfer or restriction cases Standard Industrial Classification(SIC:),if known(e.g.,3715) (G) (R) (l) (d) OR North American Industrial Classification(NAICS),if known(c.g.,1.16212) Number of Days Total number of days away Total number of days of job Employment informatlon(/J)on don't haw three igares,.see die from work transfer or restriction Worksbert nn lite bark tf this putty•to estimate.) _.q1 Q S, Annual average number ofemployees -.-_•—j-- (K)J (E) 'Final hours worked by all auployces last year 7�i Injury and Illness Types Sign here Total number of... Knowingly falsifying this document may result in a fine. (t)Injuries 4 (4)Poisoninp _-_ I certify that I have examined this document and that to the best of my (5)Hearing loss kill the entries are tr , calrate,and complete. (2)Skin disorders (6)All other illnesses L4(3)Respiratory conditions __ f"' _._ �a' mo-4— nc Post this Summary page from February 1 to April 30 of the year following the year covered by the form- Pnb ic-purling burden lir''his<ullertiun of inlia-aion i.rstim:ord ro:rvr...g,611 minutes pr e I trlullmg u.,n,to rrrirx for ion �„iious,sr:uah and Barber rho•dal.r i'led.and r r ova•,u r ruurpk-w and—iea 11 ro11.aion of inch atiou.1"-- ria required m r,,,fon I to the collection of inlo'naliun oolcss it display.a,ni nvth•valid OhIlW o.a."l uuwhet.If you Garr:up. ,uuonvnir:,luroi Ihesr"o atasur any of heraspertr nl'Ihis dela collrcI ion,run,a:Illi mep;mrn.•m of Lal OSI IA 0llin•,&S.arisl6A A.,.,1),i,.k,.rn,W)6 ld,kin r'on.Inon Ar.uo NW. 11':ahiugion,DC 2112111.mo not sen I the completed Gram to this ollin•. it BID FORM PROJECT NAME: 2022 Arterial Street Maintenance Program PROJECT LOCATION: Round Rock, Texas OWNER: City of Round Rock, Texas DATE: February 8, 2023 Gentlemen: Pursuant to the foregoing Notice to Bidders and Instructions to Bidders, the undersigned bidder hereby proposes to do all the Work, to furnish all necessary superintendence, labor, machinery, equipment, tools, materials, insurance and miscellaneous items, to complete all the Work on which he bids as provided by the attached Bid Documents, and as shown on the plans for the construction of 2022 Arterial Street Maintenance Program and binds himself on acceptance of this bid to execute the Agreement and bond for completing said Work within the time stated, for the following prices, to wit: Any addenda issued will be posted with the Project Manual and/or Contract Documents on the City's website at httr)s://www.roundrocktexas.aov/city-businesses/solicitations/ by the close of business on March 17, 2023 . Prior to submitting a bid, the bidder is responsible for determining if any addenda have been issued and for following any instructions in any addenda issued. Bidder acknowledges receipt of the following Addenda by listing Addendum "number" and "date". Note: An eligible bid includes a complete Base Bid, or a complete Alternate Bid, or both BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 1 228,916 SY In-Place Pavement Recycling complete in place per SY for Four dollars and no cents. $ 4.00 $ 915,664.00 2 12,877 TON Type D HMAC Surface Course complete in place per TON for One hundred seventeen dollars and Twenty-five cents. $ 117.25 $ 1,509,828.25 00300-9-2015 Page 1 of 13 Bid Form 3 BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 3 22,892 GAL Rejuvenator Agent complete in place per GAL for Four dollars and Ten cents. $ 4.10 $ 93,857.20 4 228,916 SY Surface Milling(1" Depth) complete in place per SY for Two dollars and Sixty cents. $ 2.60 $ 595,181.60 5 984 TON Machine-Laid Type D HMAC Overlay(2-inch) complete in place per TON for One hundred twenty-seven dollars and no cents. $ 127.00 $ 124,968.00 6 80 EA Valve Can Adjustment complete in place per EA for Fifty dollars and no cents. $ 50.00 $ 4,000.00 7 60 EA Manhole Adjustment complete in place per EA for Fifty dollars and no cents. $ 50.00 $ 3,000.00 8 13,116 TON Pavement Repair(12" Depth) complete in place per TON for One hundred fifty dollars and Ninety-five cents. $ 150.95 $ 1,979,860.20 00300-9-2015 Page 2 of 13 Bid Form BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 9 13,255 SF Remove and Replace Reinforced Concrete Sidewalk complete in place per SF for Twenty-eight dollars and Eighty-nine cents. $ 28.89 $ 382,936.95 10 5,535 LF Remove and Replace Concrete Curb and Gutter complete in place per LF for Eighty-seven dollars and Seventy-four cents. $ 87.74 $ 485,640.90 11 1,960 SF Remove and Replace Reinforced Concrete Driveway complete in place per SF for Twenty-nine dollars and Ninety-six cents. $ 29.96 $ 58,721.60 12 17 EA Reinforced Concrete Sidewalk Ramp complete in place per EA for eight dollars and Fifty cents. $ 3.798.50 $ 64,574.50 13 460 SF Remove and Replace Reinforced Concrete Valley Gutter complete in place per SF for Forty-seven dollars and no cents. $ 47.00 $ 21,620.00 14 1,899 LF REFL PAV MRK TY I (V)6"(SLD)(100 MIL) complete in place per LF for One dollars and Seventy-six cents. $ 1.76 $ 3,342.24 00300-9-2015 Page 3 of 13 Bid Form BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 15 15,256 LF REFL PAV MRK TY I (V)6"(BRK)(100 MIL) complete in place per LF for No dollars and Sixty-six cents. $ 0.66 $ 10,068.96 16 1,004 EA REFL PAV MRKR TY I-C complete in place per EA for Five dollars and Sixty-seven cents. $ 5.67 $ 5,692.68 17 62,847 LF REFL PAV MRK TY I (Y)6"(SLD)(100 MIL) complete in place per LF for No dollars and Sixty-six cents. $ 0.66 $ 41,479.02 18 2,420 LF REFL PAV MRK TY I (Y)6"(BRK)(100 MIL) complete in place per LF for No dollars and Sixty-six cents. $ 0.66 $ 1,597.20 19 1,257 EA REFL PAV MRKR TY II-A-A complete in place per EA for Four dollars and Forty cents. $ 4.40 $ 5,530.80 20 7,800 LF REFL PAV MRK TY I (V)8"(SLD)(100 MIL) complete in place per LF for One dollars and Thirty-two cents. $ 1.32 $ 10,296.00 00300-9-2015 Page 4 of 13 Bid Form BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 21 221 LF REFL PAV MRK TY I (V)8"(BRK)(100 MIL) complete in place per LF for Two dollars and Nine cents. $ 2.09 $ 461.89 22 2,808 LF REFL PAV MRK TY I (W)12"(SLD)(100 MIL) complete in place per LF for Six dollars and Sixty cents. $ 6.60 $ 18,532.80 23 685 LF REFL PAV MRK TY I (Y)12"(SLD)(100 MIL) complete in place per LF for Six dollars and Sixty cents. $ 6.60 $ 4,521.00 24 1,320 LF REFL PAV MRK TY I (V)24"(SLD)(100 MIL) complete in place per LF for Ten dollars and Fixty-six cents. $ 10.56 $ 13,939.20 25 82 EA REFL PAV MRK TY I (V)(ARROW)(100 MIL) complete in place per EA for One hundred eighty-one dollars and Fifty cents. $ 181.50 $ 14,883.00 00300-9-2015 Page 5 of 13 Bid Form BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 26 48 EA REFL PAV MRK TY I (W)(WORD "ONLY")(100 MIL) complete in place per EA for One hundred ninety-eight dollars and no cents. $ 198.00 $ 9,504.00 27 48 EA REFL PAV MRK TY I (W)18"(YLD TRI)(100 MIL) complete in place per EA for Sixty-six dollars and no cents. $ 66.00 $ 3,168.00 28 5 EA REFL PAV MRK TY I (W)(WORD "YIELD")(100 MIL) complete in place per EA for Three hundred sixty-three dollars and no cents. $ 363.00 $ 1,815.00 29 1 EA REFL PAV MRK TY I (W)(WORD "MERGE")(100 MIL) complete in place per EA for Four hundred twenty-nine dollars and no cents. $ 429.00 $ 429.00 30 1 EA REFL PAV MRK TY I (W)(WORD "RIGHT")(100 MIL) complete in place per EA for Three hundred sixty-three dollars and no cents. $ 363.00 $ 363.00 00300-9-2015 Page 6 of 13 Bid Form BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 31 6 EA REFL PAV MRK TY I (W)(CROSSBUCK)(100 MIL) complete in place per EA for Three hundred thirty dollars and no cents. $ 330.00 $ 1,980.00 32 6 EA REFL PAV MRK TY I (W)(WORD "RR")(100 MIL) complete in place per EA for Two hundred thirty-one dollars and no cents. $ 231.00 $ 1,386.00 33 5 MO Traffic Control complete in place per MO for Thirty thousand nine hundred dollars and no cents. $ 30,900.00 $ 154,500.00 TOTAL BASE BID (Items 1 thru 33 ) $ 6,543,342.99 Materials: $ 2,630,416.15 All Other Charges: $ 3,912,926.84 * Total: $ 6,543,342.99 * Note: This total must be the same amount as shown above for "Total Base Bid" 00300-9-2015 Page 7 of 13 Bid Form ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount AA=1 26,737 TON Machine-Laid Type D HMAC Overlay (2-inch) complete in place per TON for No Bid dollars and cents. A2 228,916 SY Surface Milling(2" Depth) complete in place per SY for dollars and cents. AA3 80 EA Manhole Adjustment complete in place per EA for dollars and cents. AA=4 60 EA Valve Can Adjustment complete in place per EA for dollars and cents. AA5 13,116 TON Pavement Repair(12" Depth) complete in place per TON for dollars and cents. AA=6 13,255 SF Remove and Replace Reinforced Concrete Sidewalk complete in place per SF for dollars and cents. AA=7 5,535 LF Remove and Replace Concrete Curb and Gutter complete in place per LF for dollars and cents. 00300-9-2015 Page 1 of 13 Bid Form ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount A_8 1.960 SF Remove and Replace Reinforced Concrete Driveway complete in place per SF for dollars and cents. A_9 17 EA Reinforced Concrete Sidewalk Ramp complete in place per EA for dollars and cents. A-10 460 SF Remove and Replace Reinforced Concrete Valley Gutter complete in place per SF for dollars and cents. A-1 1 1,899 LF REFL PAV MRK TY I (V)6"(SLD)(100 MIL) complete in place per LF for dollars and cents. A-12 15,256 LF REFL PAV MRK TY I (V)6"(BRK)(100 MIL) complete in place per LF for dollars and cents. A-13 1,004 EA REFL PAV MRKR TY I-C complete in place per EA for dollars and cents. 00300-9-2015 Page 2 of 13 Bid Form ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount A-14 62.847 LF REFL PAV MRK TY I (Y)6"(SLD)(100 MIL) complete in place per LF for dollars and cents. A-15 2,420 LF REFL PAV MRK TY I (Y)6"(BRK)(100 MIL) complete in place per LF for dollars and cents. A-16 1,257 EA REFL PAV MRKR TY II-A-A complete in place per EA for dollars and cents. A-17 7,800 LF REFL PAV MRK TY I (V)8"(SLD)(100 MIL) complete in place per LF for dollars and cents. A-18 221 LF REFL PAV MRK TY I (V)8"(BRK)(100 MIL) complete in place per LF for dollars and cents. A-19 2,808 LF REFL PAV MRK TY I (V)12"(SLD)(100,MIL) complete in place per LF for dollars and cents. 00300-9-2015 Page 3 of 13 Bid Form ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount A-20 685 LF REFL PAV MRK TY I (Y)12"(SLD)(100 MIL) complete in place per LF for dollars and cents. A-21 1,320 LF REFL PAV MRK TY I (W)24"(SLD)(100 MIL) complete in place per LF for dollars and cents. A-22 82 EA REFL PAV MRK TY I (W)(ARROW)(100 MIL) complete in place per EA for dollars and cents. A-23 48 EA REFL PAV MRK TY I (W)(WORD "ONLY")(100 MIL) complete in place per EA for dollars and cents. A-24 48 EA REFL PAV MRK TY I (W)18"(YLD TRI)(100 MIL) complete in place per EA for dollars and cents. A-25 5 EA REFL PAV MRK TY I (W)(WORD "YIELD")(100 MIL) complete in place per EA for dollars and cents. 00300-9-2015 Page 4 of 13 Bid Form J ` � ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount A-26 I EA REFL PAV MRK TY I (W)(WORD "MERGE")(100 MIL) complete in place per EA for dollars and cents. A-27 1 EA REFL PAV MRK TY I (W)(WORD "RIGHT-')(100 MIL) complete in place per EA for dollars and cents. A-28 6 EA REFL PAV MRK TY I (W)(CROSSBUCK)(100 MIL) complete in place per EA for dollars and cents. A-29 6 EA REFL PAV MRK TY I (W)(WORD "RR")(100 MIL) complete in place per EA for dollars and cents. A-30 5 MO Traffic Control complete in place per MO for dollars and cents. TOTAL ALTERNATE BID (Items 1 thru A-30 ) No Bid Materials: All Other Charges: * Total: * Note: This total must be the same amount as shown above for "Total Alternate Bid" 00300-9-2015 Page 5 of 13 Bid Form w If this bid is accepted, the undersigned agrees to execute the Agreement and provide necessary bonds and insurance certification as per the Instructions to Bidders. The undersigned certifies that the bid prices contained in the bid have been carefully checked and are submitted as correct and final. The Owner reserves the right to reject any or all bids and may waive any informalities or technicalities. Respectfully Submitted, Cutler Repaving, Inc. Signature Charles R. Veskerna 921 East 27th Lawrence, KS 66046 Print Name Address President 785-843-1524 Title Telephone Cutler Repaving, Inc. Name of Firm March 21, 2023 Date Secre , if Bidder is a Corporation �r t a w3 J 00200-9-2015 Page 1 of 13 Bid Form