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Contract - Austin Traffic Signal Construction Company, Inc. - 4/27/2023 CITY OF ROUND ROCK TRANSPORTATION DEPARTMENT ROUND ROCK TEXAS Project Manual For: AW GRIMES BLVD AT TERAVISTA CLUB DR INTERSECTION IMPROVEMENTS FEBRURARY 2023 Prepared By: ..........................a ...VIVEK. .......DESH ,AN,u � ...... ...... ...� o 105960 d BENS. Kimley-Horn and Associates, Inc. /� eaelOtA`w APPROVED BY 10814 Jollyville Road Campus IV, Ste CITY ATTORNEY Austin, TX 787599 512.418.1771 TBPE Firm Registration No 928 00500 AGREEMENT 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 AGREEMENT made as of the 25 ( )day of in the year 2023 BETWEEN the Owner: City of Round Rock,Texas(hereafter"Owner"or"City") 221 East Main Street Round Rock,Texas 78664 and the Contractor Austin Traffic Signal Construction Co.,Inc. ("Contractor") P.O.Box 130 Round Rock,TX 78680 The Project is described as: AW GRIMES BLVD AT TERAVISTA CLUB DR The Engineer is: Kimley-Horn and Associates,Inc. Vivek Deshpande,P.E. 10814 Jollyville Road,Campus IV,Suite 200 Austin,TX 78759 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 Form 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 ten1( 0 ) 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 five-hundred and No/100 Dollars($ 500.00 ) 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 180 )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 Three hundred seventy-five thousand fifty-five dollars and zero cents ($375,055.00 ),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 .If yes,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 FEBRURARY 2023. 7.1.4 The Specifications are those contained in the Project Manual dated FEBRURARY 2023 . 7.1.5 The Drawings,if any,are those contained in the Project Manual dated FEBRURARY 2022. 7.1.6 The Insurance&Construction Bond Forms of the Contract are those contained in the Project Manual dated FEBRURARY 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 FEBRURARY 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: NONE 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 Bushak,P.E.,City of Round Rock,Texas 3400 Sunrise Rd,Round Rock,TX 78665 512-341-3318 mbu`�sh ak-�nrounndrocktex(as.gov 8.3 Contractor's representative is: GNU r� S ch( v 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 tWR K,TEXASMrp- Date onstruction Co; nc. CITY K,TEXASPrinted ame: Printed Title Y r�lt'C LO K— 2 Title:Signed: S(2 s 12 7 Date Signed: — `U ATTEST: City Clerk FOR CITY,APPROVED AS TO FORM: " �t, i y Attney 00500 4-2020 Page 5 of 5 Standard Form of Agreement 00443647 00600 INSURANCE AND CONSTRUCTION BOND FORMS BONDS AND INSURANCE INSTRUCTIONS Instruction Sheet 1. Insurance Company must be licensed by State of Texas. 2. Agent signing bonds must be licensed in Texas. 3. Agent signing bonds must have Power of Attorney on behalf of insurance company. 4. If Agent signing bonds has Power of Attorney, but not licensed in Texas, then the bond must be counter-signed by Texas local recording agent. ALL THE ABOVE INFORMATION CAN BE FOUND AT Texas Department of Insurance website www.tdi.state.tx.us 5. Make sure the dollar amount on both Performance and Payment Bonds match the amount of the Agreement&Bid Form Sheet. 6. Both Performance and Payment Bonds should be signed by Authorized Person. If the contractor is a corporation, then it should be signed by the President or the Vice-President. If the contractor is not incorporated, then it may be signed by the Owner. Please state the title of the authorized person. .i Bond No. 9425912 PERFORMANCE BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Austin Traffic Signal Construction Co.,Inc , of the City of Pflugerville , County of Travis , and State of Texas , as Principal, and Colonial American Casualty and Surety 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 Three hundred seventy-five thousand fifty-five dollars and zero cents Dollars ($375,055.00 ) 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 25*-4* day ofL , 20Z3 to which the Agreement is hereby referred to and made a part hereof as fully and two thJJsame extent as if copied at length herein consisting of: AW GRIMES BLVD AT TERAVISTA CLUB DR INTERSEC11ON IMPROVEMENTS 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. Page 1 006104-2020 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 $375,055.00 sum of this Performance Bond, plus all costs and expenses, including attorney's fees and expert and consultant fees incurred by Owner to enforce its rights under this Performance Bond. IN WITNESS W Oe said Principal and Sur have signed and seale this instrument this day of ,20 Austin Traffic Signal Construction Co.,Inc. Colonial American Casualty and Surety Company n*-iTmISurety aly Robbi Morales Print e Printed Name By: Title: Title: Attorney-in-fact Address:4615 Priem Lane Address: 1299 Zurich Way, 5th Floor Pfulgerville,TX 78660 Schaumburg,IL 60196-1056 Resident Agent of Surety: Signature Robbi Morales Printed Name 5005 LBJ Freeway, Suite 1500 Street Address Dallas, TX 75244 City, State&Zip Code Page 2 00610 4-2020 Performance Bond 00443639 Bond No. 9425912 PAYMENT BOND THE STATE OF TEXAS § § KNOW ALL MEN BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Austin Traffic Signal Construction Co.,Inc. , of the City of Pflugerville , County of Travis , and State of Texas , as Principal, and Colonial American Casualty and Surety Company authorized under the laws of the State of Texas to act as Surety on Bonds for Principals,are held and firmly bound unto the CITY OF ROUND ROCK, TEXAS (OWNER), and all subcontractors, workers, laborers, mechanics and suppliers as their interest may appear, all of whom shall have the right to sue upon this bond, in the penal sum of three hundred seventy-five thousand,fifty-five dollars and zero cents Dollars($ 375,055.00 )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 2518k day of , 2023to which Agreement is hereby referred to and made a part hereof as fully and to the same extent as if copied at length herein consisting of: AW GRIMES BLVD AT TERAVISTA CLUB DR 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 HE-REOF, the said Princip d Surety have signed and sealed this Instrument this � 1 day of , 2Q:-J. Austin Traffic Signal Construction Co.,Inc. Colonial American Casualty and Surety Company P ' i 1 Surety Robbi Morales Printed Printed Name By: By: �.�` �� Title: Title: Attorney-in-fact Address:4615 Priem Lane Address: 1299 Zurich Way, 5th Floor Pflugerville,TX 78660 Schaumburg, IL 60196-1056 Resident Agent of Surety: Signature Robbi Morales Printed Name 5005 LBJ Freeway, Suite 1500 Street Address Dallas, TX 75244 City, State&Zip Code Page 2 006201-2020 Payment Bond 00090656 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D.Murray,Vice President,in pursuance of authority granted by Article V.Section 8,of the By-Laws of said Companies,which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate,constitute, and appoint Ricardo J.REVNA,Tina MCEWAN,Don E.CORNELL,Joshua SAUNDERS,Robbi MORALES,Sophinie HUNTER, Kelly A.WESTBROOK,Tonie PETRANEK, Milcaela PEPPERS of Dallas,Texas,EACH, its true and lawful agent and Attorney-in- Fact,to make,execute,seal and deliver,for,and on its behalf as surety,and as its act and deed: any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents,shall be as binding upon said Companies.as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills,Maryland.,and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF,the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 1 Ith day of May,A.D.2021. ti a om MAL 4y ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Robert D.Murray Vice President By: Dawn E.Brown Secretary State of Maryland County of Baltimore On this 11th day of May, A.D.2021, before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,Robert D. Murray,Vice President and Dawn E.Brown,Secretary of the Companies,to the personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly sworn,deposeth and saith.that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. Chi.. ? ! >•,,:''..:? Constance A.Dunn,Notary Public My Commission Expires:July 9,2023 Autbenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings,or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Pourer of Attorney is still in full force and effect on the date of this certificate:and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile wider and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the I Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President.Secretary,or Assistant Secretary of the Company,whether made heretofore or hereafter,wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this day of Fna otrQy. � &SAL a M By: Brian M.Hodges Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND,PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND,THE BOND NUMBER,AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg,IL 60196-1056 vwvw.reportsfclainis(_@zurich na.com 800-626-4577 Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 ZURICH Texas Important Notice IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para presentar una queja: You may call Zurich North America's toll-free telephone Usted puede Ilamar al numero de telefono gratuito de number for information or to make a complaint at: Zurich North America's para obtener informacion o para 1-800-382-2150 presentar una queja al: You may contact the Texas Department of Insurance to 1-800-382-2150 obtain information on companies, coverages, rights, or Usted puede comunicarse con el Departamento de Se- complaints at: guros de Texas para obtener informacion sobre com- 1-800-252-3439 panias, coberturas, derechos, o quejas al: 1-800-252-3439 You may write the Texas Department of Insurance: Usted puede escribir al Departamento P.O. Box 149104 de Seguros de Texas a: Austin, TX 78714-9104 P.O. Box 149104 Fax: (512) 490-1007 Austin, TX 78714-9104 Web: www.tdi.texas.gov Fax: (512) 490-1007 E-mail: ConsumerProtection@tdi.texas.gov Sitio web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or DISPUTAS POR PRIMAS DE SEGUROS O about a claim, you should contact the company first. If RECLAMACIONES: the dispute is not resolved, you may contact the Texas Si tiene una disputa relacionada con su prima de seguro Department of Insurance. o con una reclamacion, usted debe comunicarse con la compahia primero. Si la disputa no es resuelta, usted ATTACH THIS NOTICE TO YOUR POLICY: puede comunicarse con el Departamento de Seguros de This notice is for information only and does not become Texas. a part or condition of the attached document. ADJUNTE ESTE AVISO A SU POLIZA: Este aviso es solamente para propositos informativos y no se con- vierte en parte o en condicion del documento adjunto. U-GU-296-E(06/15) Page 1 of 1 Client#: 148784 AUSTITRA1 =5,08/m2/02'3 Y) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 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 ISSUAG 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 any rights to the certificate holder in lieu of such endorsement(s). NAMEACT Cindy Ellis PRODUCER PHONE 512 467-0113 USI Southwest Austin (AJC, A/c No,Ext):512 651-4164 Alc No 7600-C N. Capital of TX Hwy#200 E-MAI ADLDRESS: y'Cind Ellis usi.conl Austin,TX 78731 INSURER(S)AFFORDING COVERAGE NAIC# 512 451-7555INSURERA Zurich American Insurance Company 16535 INSURED • INSURER B:American Guarantee&Liability Ins Co. 26247 Austin Traffic Signal Construction INSURER C:RSUI Indemnity Company 22314 CO., Inc. Travelers Lloyds Insur,nce Company 41262 INSURER D: y P.O. Box 130 INSURER E: Round Rock,TX 78680 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 PER IOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LIMITS ADDLSUBR POLICY EFF POLICY EXP TRR TYPE OF INSURANCE INSR WVO POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY GL04839723 03/01/2023 03101/202 EACH OCCURRENCE $2 OOO OOO DAMAGE TO RENTED PREMISES to occurrence) ccurrence $100,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS-COMP/OP AGG $4,000,000 POLICY I ^I JECT CI LOC $ OTHER: COMBINED SINGLE LIMIT 2 000,000 A AUTOMOBILE LIABILITY BAP4839724 03/01/2023 03/01/2024, Ea accident BODILY INJURY(Per person) $ X ANY AUTO OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE $ HIRED NON-OWNED Per accident X AUTOS ONLY X AUTOS ONLY $ B X UMBRELLA LIAB X OCCUR AUC5490849 03/01/2023 03/01/2024,EACH OCCURRENCE s5,000,000 AGGREGATE s5,000,000 X EXCESS LIAR CLAIMS-MADE C DED RETENTION$ BNHAO97121 03/01/2023 03101!202 Excess Liab. $5M xs$5m A WORKERS COMPENSATION WC4839722 03/01/2023 03/01/202 X�EACH OTH- AND EMPLOYERS'LIABILITY E.LIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N OFFICER/MEMBER EXCLUDED? a NIA E.L.DISEASE-EA EMPLOYEE $1 000 000 (Mandatory In NH) Ifyes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below D Installation QT6605W18005ATLC23 03/0112023 03/011202 $500,000 Deductible varies Floater-Blanket Coverage DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is req�lred) Job#2625. The General Liability and Auto policies include a blanket automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder(and other entities as required by the Prime Contract), only when there is a written contract that requires such status and only with regard to work performed on behalf of the named insured. The General Liability, Auto and Workers Compensation policies (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Round Rock THE EXPIRATION DATE ThiEREOF, NOTICE WILL BE DELIVERED IN 221 E Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Round Rock, TX 78664 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) _ _.1--of 2 The ACORD name and logo are registered marks of ACORD DAMHB 00200 BID BOND BID BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Austin Traffic Signal Construction Company,Inc. of the City of Pflugerville County of Travis State of Texas as Principal, and Colonial American casualty and surety 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 the Greatest Amount Bid Dollars($5%GAB ). 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 AW Grimes Blvd at Teravista Club Dr Intersection Improvements t) for which Bids are to be opened at the office of Owner on the 1 St day of March ,2023 . 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 her/him 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 10th day of the month of February 2023 Austin Traffic Signal Construction Company,Inc. Colonial American Casualty and Surety Company Pr' cipal � � Surety Sophinie Hunter Pr' ed am Printed Name - By: Title: Title: Att ey-In-Fact Address: 4615 Priem Lane Address: 1299 Zurich Way, 5th Floor Pflugerville,TX 78660 Schaumburg. IL 60196 00200 4-2020 Page 1 Bid Bond 00443638 Resident Agent of Surety: lu4t�a Signafure Sophinie Hunter Printed Name 5005 LBJ Freeway, Suite 1500 Street Address Dallas,TX 75244 City,State,Zip Page 2 00200 4-2020 Bid Bond 00443638 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D.Murray,Vice President,in pursuance of authority granted by Article V,Section 8,of the By-Laws of said Companies,which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate,constitute, and appoint Ricardo J.REYNA,Tina MCEWAN,Don E.CORNELL,Joshua SAUNDERS,Robbi MORALES,Sophinie HUNTER, Kelly A.WESTBROOK,Tonie PETRANEK,Mikaela PEPPERS of Dallas,Texas, EACH, its true and lawful agent and Attorney-in- Fact,to make,execute,seal and deliver,for,and on its behalf as surety,and as its act and deed: any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents,shall be as binding upon said Companies,as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills,Maryland.,and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF,the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 11 th day of May,A.D.2021. �a OIro7,. --ta`� wrrr Ilia o itw I�ohm ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Robert D.Murray Vice President By: Dawn E.Brown Secretary State of Maryland County of Baltimore On this 11th day of May, A.D.2021, before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,Robert D. Murray,Vice President and Dawn E.Brown,Secretary of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly swom,deposeth and saith,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. Zi filet ptrdti,.'•�` Constance A.Dunn,Notary Public '�i�kih��{i�>��•` My Commission Expires.July 9,2023 f7/7f111111,� Authenticity of this bond can be confirmed at buntiv:tlitlator.zarichna.com or 410-559-8790 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attomevs-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President,Secretary,or Assistant Secretary of the Company,whether made heretofore or hereafter,wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, chis l 0th, day of February 2023 . BtAL By: Brian M.Hodges Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND,PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND,THE BOND NUMBER,AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg,IL 60196-1056 www.reportsfc l aim s(a,zurichna.com 800-6264577 Authenticity of this bond can be confirmed at bon dvaIidator.zurich na.com or 410-559-8790 ZURICH Texas Important Notice IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informaci6n o para presentar una queja: You may call Zurich North America's toll-free telephone Usted puede Ilamar al numero de telefono gratuito de number for information or to make a complaint at: Zurich North America's para obtener informaci6n o para 1-800-382-2150 presentar una queja al: 1-800-382-2150 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights, or Usted puede comunicarse con el Departamento de Se- complaints at: guros de Texas para obtener informaci6n sobre com- 1-800-252-3439 panias, coberturas, derechos, o quejas al: 1-800-252-3439 You may write the Texas Department of Insurance: Usted puede escribir al Departamento P.O. Box 149104 de Seguros de Texas a: Austin, TX 78714-9104 P.O. Box 149104 Fax: (512)490-1007 Austin,TX 78714-9104 Web: www.tdi.texas.gov Fax: (512)490-1007 E-mail: ConsumerProtection@tdi.texas.gov Sitio web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or DISPUTAS POR PRIMAS DE SEGUROS O about a claim, you should contact the company first. If RECLAMACIONES: the dispute is not resolved,you may contact the Texas Si tiene una disputa relacionada con su prima de seguro Department of Insurance. o con una reclamaci6n, usted debe comunicarse con la compania primero. Si la disputa no es resuelta, usted ATTACH THIS NOTICE TO YOUR POLICY: puede comunicarse con el Departamento de Seguros de This notice is for information only and does not become Texas. a part or condition of the attached document. ADJUNTE ESTE AVISO A SU POLIZA: Este aviso es solamente para prop6sitos informativos y no se con- vierte en parte o en condici6n del documento adjunto. U-GU-296-E(06/15) Page 1 of 1 00410 STATEMENT OF BIDDER'S SAFETY EXPERIENCE Page 1 00410 8-2014 Statement of Bidder's Safety Experience 00090654 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: Austin Traffic Signal Construction Co, Inc. Address: �J� Phone: Completed b -d_11" Date 1. Does the company have a written construction Safety program? ro 2. Does the company conduct construction safety inspections? 3. Does the company have an active construction safety-training program? 4. Has the company been fined by OSHA for any willful safety violations in the past 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 o 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 ❑7es ❑No /A B. Excavation No ❑N/A C. Cranes es ❑No ❑N/A D. Electrical LrKes No ❑N/A E. Fall Protection ��AesE]No No ❑N/A F. Confined Spaces ❑N/A I hereby cert' hat the above ' formation is true and correct. Signa Title Page 00410 8-2014 Statement of Bidder's Safety Experience 00090654 Attention: This form contains information relating `I``� to employee health and must be used in a manner Year 220 O S HA's Form 300 (Rev.0112004) that protects the confidentiality of employees to the extent possible while the information is being used U.S. Department of Labor for occupational safety and health purposes. Log of Work-Related Injuries and Illnesses Occupational Safety and Health Administration Form approved OMB no.1218-0176 You must record information about every work-related injury or illness that involves loss of consciousness,restricted work activity or job 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 care professional. You must also record work-related Establishment name Austin Traffic Signal Construction Company injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR 1904.8 through 1904.12. Feel free to 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 form. If you're not sure whether a case is recordable,call your local OSHA office for help. City Pflugerville State Texas Describe the case Classify the case Identify the person Enter the number of (A) (B) (C) (D) (E) (F) CHECK ONLY ONE box for each case based on days the injured or ill Check the"injury"column or choose one type of illness Case Employee's Name Job Title (e.g., Date of Where the event occurred(e.g. De ri eeUsubstanll e that darts oftly injured affected,made the most serious outcome for that case: worker was'. (M) No Welder) injury or Loading dock north end) person ill(e. Second degree bums on right N onset of P g� On job illness forearm from acetylene torch) Days away Away transferor Z Death Remained at work o (mo./day) from work From restriction D m g m t Job transfer Other record- Work (days) ? 'a v N � o or restriction able cases (days) 00 W�i a = Q (G) (H) ll) (J) (K) (L) (1) l2) (3) (4) (5) (6) IH 35 Southbound near Ronald Reagn Blvd,Jarrell,Texas Neck sprain when jumping over CTB to avoid on 26 x 1 Eliodoro Ruiz Utility Laborer 04/10/20 coming vehcile x Red River&4th Street,Austin, Thoraic chest strain from slip when entering 59 x 2 Brian Bice Laborer 5!6120 TX manhole/fractured slemum x Ezequiel Benavides- 4615 Priem Lane,Pflugerville, 24 x 3 Sandoval Crew Leader 5!4!20 TX COVID-19 x 4615 Priem Lane,Pflugerville, 27 x COVID-19 x 4 Everardo Prieto Laborer 515/20 TX SERGIO CONTRERAS- 4615 Priem Lane,Pflugerville, 20 x 5 TONCHE Laborer 5/5/20 TX COVID-19 x 4615 Priem Lane,Pflugerville, 14 x 6 JOAQUIN CISNEROS Crew Leader 5/11!20 TX COVID-19 x 4615 Priem Lane,Pflugerville, 15 x COVID-19 x 7 Andreas Leal Jr Crew Leader 516/20 TX 4615 Priem Lane,Pflugerville, 1 g7 x Ri ht index finger distal fx x B Ton Vasquez Laborer 7/23!20 TX X 10 x 9 Ste hen R Leal Laborer 10/20/20 Job site:Waco,TX Middle left finger laceration Page totais o s a o tot 164 a o 0 0 o s Be sure to transfer these totals to the Summary page(Form 300A)before you post it. o 0 o16a o d _ a �2 m o —_ � U a Public reporting burden for this collection of information �n is estimated to average 14 minutes per response,including time x = to review the instruction,search and gather the data needed,and complete and review the collection of information. o Persons are not required to respond to the collection of information unless it displays a currently valid OMB control 3 number. If you have any comments about these estimates or any aspects of this data collection,contact: US Department of Labor,OSHA Office of Statistics,Room N-3644,200 Constitution Ave,NW,Washington,DC 20210. Do Page 1 of 1 (1) (2) (3) (4) (5) (6) ,pot send the completed forms to this office. Attention: This form contains Information relating e`*� to employee health and must be used in a in Year 2�2 that protects the confidentiality of employees to the OSHA�s Form 300 (Rev. 0112004) extent possible while the information is being used U.S. Department of Labor for occupational safety and health purposes. Log of Work-Related Injuries and Illnesses Occupational Safety and Health Administration y Form approved OMB no.1218-0176 You must record information about every work-related injury or illness that involves loss of consciousness,restricted work activity or job 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 care professional. You must also record work-related Establishment name Austin Traffic Signal Construction Company injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR 1904.8 through 1904.12. Feel free to 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 form. If you're not sure whether a case is recordable,call your local OSHA office State Texas for help. City Pflugerville Describe the case Classify the case Identify the person __ Enter the number of (A) (B) (0) (D) (E) (F) CHECK ONLY ONE box for each case based on days the injured or ill Check the"injury"column or choose one type of illness: Case Employee's Name Job Title (e.g., Date of Where the event occurred(e.g. Describe d object/substance injuryor illness, lli that directly body affected,made the most serious outcome for that case: worker was: (M) N No. Welder) injury or Loading dock north end) onset of person ill(e.g.Second degree bums on right On job illness forearm from acetylene torch) Death Days away Away transfer or "R Z c from work Remained at work From 0 ` J (mo./day) restriction m o t 0 0 Job transfer Other record- Work (days) .a _ or restriction able cases (days) N �r j a = G (G) (H) (0 (J) (K) (L) (1) (2) (3) (4) (6) (6) Job 2077-Austin,TX Employee fell onto angle iron.Laceration of right x x leg below knee. 1 Ezequiel Benavides-Sandoval Crew Leader 211121 Laceration to left pointer and middle finger. Caught between ground box lid and concrete x x 2 Sergio Anaya Crew Leader 3/2/21 Job 2251-Waco,Texas base. Bucket truck Shop yard-4615 Priem Lane, x x 3 Daniel Herr hand 3115/21 Pflugerville,TX Laceration to right upper leg from razor blade Shop yard-4615 Priem Lane, 3 4 x Pflu erville,TX Back contusion and scalp laceration x 4 Jose Luis Gonzalez Laborer 4123!21 9 X 10 x 5 Nicholas Dowling - Laborer 5/6/21 SH 21 @ FM 535,Bastrop,TX Twisted left ankle Job 2345:130 @ Pecan, x 6 x 6 Adam Dominguez Crew Leader 7/16/21 Pflugerville,TX 78660 Pulling cable fell onto pull box L3-L5 hematoma Page totals 0 1 2 3 3 20 6 0 0 0 0 0 oc' N Be sure to transfer these totals to the Summary page(Form 300A)before you post it. a o 0 `o o m Y U a t Public reporting burden for this collection of information is estimated to average 14 minutes per response,including time _ a to review the instruction,search and gather the data needed,and complete and review the collection of information Cl) 0 Persons are not required to respond to the collection of information unless it displays a currently valid OMB control 3 number. If you have any comments about these estimates or any aspects of this data collection,contact: US Page 1 of 1 (1) (2) (3) (4) (5) (6) Department of Labor,OSHA Office of Statistics,Room N-3644,200 Constitution Ave,NW,Washington,DC 20210 Do not send the completed fortes to this office. Eeeafl his form contains information relating ealth and must be used in a mannerYear 2022the confidentiality of employees to theOSHA's Form 300 (Rev. 01/2004) le while the information is being used U.S. Department of Labor nal safety and health purposes. Log of Work-Related Injuries and Illnesses Occupational Safety and Health Administration Form approved OMB no.1216-0176 You must record information about every work-related injury or illness that involves loss of consciousness,restricted work activity or job transfer,days away from work,or medical treatment beyond first ad. You must also record significant work-related injuries and illnesses that are diagnosed by a physician or licensed health care professional. You must also record work-elated Austin Traffic Signal Construction Company injuries and illnesses that meet any of the specific recording cntena listed in 29 CFR 1904.8 through 1904.12. Feel free to use two lines far a single case rf you need to. You must complete an Establishment name g injury and illness incident report(OSHA Form 301)or equivalent form for each injury or illness recorded on this form. If you're not sure whether a case�s recordable.call your local OSHA office State Texas for help. City Pflugerville Describe the case Classify the case Identify the person Enter the number of (A) (B) (C) (D) (E) du(F) CHECK ONLY ONE box for each case based on days the injured or ill Check the"injury"column or choose one type of worker was: illness: Case Employee's Name Job Title (e.g., Date of Where the event occurred(e.9. and object/substance ect/subslanescribe injury or lce that direcparts tly njed or made the most serious outcome for t a case: ,(M) H No Welder) injury or Loading dock north end) 1 onset of person ill(e.g.Second degree bums on right On job forearm from acetylene torch) Days away Away transfer or 2' c illness Death Remained at work From `o o c (mo./day) from work restriction m o t Job transfer Other re Work (days) n� y 'c o cord- or resinction able cases (days) c 0 �U a = a (G) (H) (1) 1 (J) (K) (L) (1) (2) (3) (4) (5) (6) Cow Leader 6/14/22 IH 14 Belton,Texas Twisted(r)ankle stepping off of trailer x 5 x 1 Ruben Escobar Job 2516.Manor Road,Austin, x 16 x 2 Sergio Contreras Laborer 9/20/22 Tx Laceration of(L)5th digit,fx Page totals o 0 2 0 o z1 z o 0 0 0 0 Z d Z q � " N Be sure to transfer these totals to the Summary page(Form 300A)before you post it. a o. 0 `o �v o d n C a 0 C C �v L nse,including time Public reporting burden for this collection of information is estimated to average 14 minutes per respo _ 0 to review the instruction,search and gather the data needed,and complete and review the collection of information. a Persons are not required to respond to the collection of information unless itdisplays a currently valid OMB control number. If you have any comments about these estimates or any aspects of this data collection,contact. US page 1 of 1 (1) (2) (3) (4) (5) (6) Department of Labor,OSHA Office of Statistics,Roam N-3644,200 Constitution Ave,NW,Washington,DC 20210. Do not send the completed forms to this office. 00300 BID FORM Austin Traffic Signal Construction Co, Inc. BID FORM PROJECT NAME: AW Grimes Blvd at Teravista Club Dr Intersection Improvements PROJECT LOCATION: Round Rock,Texas OWNER: City of Round Rock, Texas DATE: February 1,2023 Gentlemen: Pursuant to the foregoing Notice to Bidders and Instructions to Bidders, the undersigned bidder hereby AW Grimes Blvd at Teravista Club Dr Intersection Improvements and binds himself on acceptance of this bid to execute the Agreement and bond for completing said Work Any addenda issued will be posted with the Project Manual and/or Contract Documents on the City's website at https://www.roundrocktexas.gov/businesses/solicitations/ by the close of business on February 23,2023 . 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". BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 1 50 SY REMOVING CONC (SIDEWALKS) or}�plete in place per SY p for 0 e a f /1 dollars ' and cents. ,---a- :5--7 2 30 LF REMOVE CONC (GUTTER) com&te in place per LF for dollarsOJ v and �' cents. 4d ' 00300-9-2015 Page 1 of 19 Bid Fonn Austin Traffic Signal Consruction Co, Inc, BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 3 10 SY FURNISHING AND PLACING TOPSOIL (4") com fete in place per SY forcC� 11-AJe- dollars rn v and zly4u cents. 4 10 SY BLOCK SODDING cor. ete in place per SY td for —�Af- dollars and cents. 5 11.2 LF DRILL SHAFT(TRF SIG POLE) (36 IN) corn Tete 'n place per LF p to for /� neT dollars �C and7 cents. 6 65.7 LF DRILL SHAFT(TRF SIG POLE) (48 IN) co lete in place per LF l �t for ✓ ¢ dollars and cents. 1 7 1 LS MOBILIZATION compl to in placper LS d for dollars and cents. ' 00300-9-2015 Page 2 of 19 Bid Fonn Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 8 3 MO BARRICADES, SIGNS AND TRAFFIC HANDLING c plete in ce per MO for 84eI.d dollars /�r]� 6 and cents. Z 9 400 LF BIODEG EROSN CONT LOGS (INSTL) (12") Ao;m�plete in place per LF 00 for dollars and cents. 10 400 LF BIODEG EROSN CONT LOGS (REMOVE) complete in place per LF Ua for dollars and cents. 11 30 LF CONC CURB (RIBBON) complete in lac per LF for t�✓� "7 dollars Qo L/j and '��' cents. Za c� 12 52 SY INTERSECTIONS (CONC) omp�gte jn pla a per SY for f dollars 4 �/ and cents. 00300-9-2015 Page 3 of 19 Bid Fonn Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 13 46 SY CONC SIDEWALKS (6") com lete in vlacper Sy for W• u dollars and cents. 14 6JA� CURB RAMPS (TY 7) c Tete in plac per EA for dollars (�r and cents. 71 15 445 LF CONDT(PVC)(SCH 80) (2") v, compl to in lace per LF G� for c N '�/ dollars and cents. 16 250 LF CONDT(PVC) (SCH 80) (3") omple place per LF for `(�.�t.^J dollars �r and cents. 17 30 LF CONDT(PVC) (SCH 80) (4") -� com ete in place per LF / dollars for (k,,,� and cents. 1 Q 00300-9-2015 Page 4 of 19 Bid Fonn Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 18 3320 LF ELEC CONDR(NO.8) BARE Com, complete in place per LF — D Q� for � c,✓U� � dollars � 0 / LjA and r v cents. 19 1690 LF ELEC CONDR(NO.8) INSULATED complete in place per LF �C for U-Z dollars and cents. 33 20 85 LF ELEC CONDR(NO.6) BARE complete in place per LF O r [J U for �' dollars . and C>1 cents. 21 170 LF ELEC CONDR(NO.6) INSULATED --eo plete in place per LF L for t dollars C and cents. ' 22 1 EA GROUND BOX TY D (162922)W/APRON 'r-� co pl a in p ce er EA �¢) for dollars and � cents. 2J � 00300-9-2015 Page 5 of 19 Bid Form BASE BID Austin T a +t Signal Construction Co, Inc Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 23 1 EA ELC SRV TY D 120/240 100(NS)AL(E)PS(U) co plet in p ace p r A for �,�/ ollars and cents. `< V 24 33 SF ALUMINUM SIGNS (TY A) omplete in place per SF 0 for Jfy dollars and �EJ�-cents. 25 2 EA IN SM RD SN SUP&AM TY l OB W G(1)SA(P) Corn let i ,plagepe A for lade ollars and cents. 26 1 EA RELOCATE SM RD SN SUP&AM TY IOBWG s 4 c mp ete in lad per EA for � dollars and cents. (� 27 4 EA REMOVE SM RD SN SUP&AM c &plete in place per EA for `� dollars C and c'111W cents. \ " 00300-9-2015 Page 6 of 19 Bid Form Austin Traffic Signal Construction Co, Inc, BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 28 185 LF REFL PAV MRK TY I (W)4"(SLD)(1 OOMIL) complete in place per LF a L for dollars and cents. 29 555 LF REFL PAV MRK TY I (W)12"(SLD)(100MIL) complete in place per LF �C G for ��� dollars C and cents. U� 30 160 LF REFL PAV MRK TY I (W)24"(SLD)(1 OOMIL) fa complete in place per LF a6 for -Ok dollars O (� and cents. � 1 31 4 EA REFL PAV MRK TY I (W)(ARROW)(100MIL) co ple e in p ac er Ej foro �.0 dollars and cents.' 32 2 EA REFL PAV MRK TY 1(W)(DBL ARROW)(1 OOMIL) com lete in pl ce er EA �J for Mars and cents. 00300-9-2015 Page 7 of 19 Bid Fonn Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 33 2 EA REFL PAV MRK TY I (W)(WORD)(IOOMIL) o plete in p ace er EA for hUr.,t dollars and cents. 34 225 LF REFL PAV MRK TY I (Y)4"(SLD)(100MIL) complete in place per LF for !'CP— dollars and cents. 35 410 LF PAVEMENT SEALER 4" complete in place per LF L c� for dollars I l and cents. \ 36 555 LF PAVEMENT SEALER 12" r�1 complete in place per LF SCJ for , dollars and cents. 37 160 LF PAVEMENT SEALER 24" for �4complete in place per LF %+ L dollars 3 and cents. 00300-9-2015 Page 8 of 19 Bid Form Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 38 4 EA PAVEMENT SEALER — - — (ARROW) - / co pie t n place per EA for `-� dollars and cents. 3 CJS 39 2 EA PAVEMENT SEALER(WORD) ,l c plete ip place per EA V for �Q- �— dollars ( � and cents. _7S ' l 40 2 EA PAVEMENT SEALER(DBL ARROW) co fete jn,,place per EA for ��%, V'' {- dollars7-S , and ZGWIku cents. 41 985 LF ELIM EXT PAV MRK& MRKS (4") 04— mplete in place per LF for dollars and 42 66 LF ELIM EXT PAV MRK& MRKS (24") complete in place per LF a J for lI dollars and Z cents. 00300-9-2015 Page 9 of 19 Bid Form Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 43 3 EA ELIM EXT PAV MRK &MRKS (ARROW) c o m pl to in place per EA for a -i,� .. dollars and z cents. � � 44 32 EA ELIM EXT PAV MRK& MRKS (SYMBOL) c plete in place per EA for � dollars and cents. V ` 45 120 LF PAV SURF PREP FOR MRK (4") for �om lete in place per LF ^ dollars and cents. l 46 577 LF PAV SURF PREP FOR MRK (12") complete in place per LF for dollars and cents. c 47 137 LF PAV SURF PREP FOR MRK (24") complete in place per LF for dollars / and Z cents. r 00300-9-2015 Page 10 of 19 Bid Fonn Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 48 1 EA PAV SURF PREP FOR MRK (ARROW) ,—complete in place per EA for /C? dollars 00 and cents. f 49 2 EA PAV SURF PREP FOR MRK (DBL ARROW) omplete in place per EA for > dollars and 7 cents. l r 50 1 EA INSTALL HWY TRF SIG (ISOLATED) a �f plete in ace per A for (alt re�C/� dollars ^^�� and cents. 51 10 EA VEH SIG SEC (12")LED(GRN) I corfplpte in lace per EA ham( �� for ��! dollars and cents. J 52 4 EA VEH SIG SEC (12")LED(GRN ARW) C:C ICo�pl�tin p ce er E d for r �� � i dollars and Z- (t/ 7 cents. / 00300-9-2015 Page 1 I of 19 Bid Form Austin Traffic Signal Construction Co In BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 53 10 EA VEH SIG SE (12")LED(YEL) c11=14, A/dolla pl re er EA -to for (� rs r � `� and cents. J 54 6 EA VEH SIG SEC (12")LED(YEL ARW) �co pl t1 ce per EA for dollars and cents. 55 10 EA VEH SIG SEC (12")LED(RED) for `comp,�ete1 in lace per EA ,� PC� a.� 6(11/' dollar & `Z 3& and cents. � �J 56 4 EA VEH SIG SEC (12")LED(RED ARW) jjla e per—PA for ftv_j � dollars and cents. ► C� 57 6 EA PED SIG SEC (LED)(COUNTDOWN) c plete(in pl ce per EA for �v�°�,,,��( dollars bzx and cents. 00300-9-2015 Page 12 of 19 Bid Form Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 58 2 EA BACKPLATE W/REFL BRDR(4 SEC) compl to ' place per EA 0 for dollars and � � cents. ��P\C' 59 12 EA BACKPLATE W/REFL BRDR(3 SEC) for nC Mete in p c per EA SP- dollars and -' cents. 60 1600 LF TRF SIG CBL (TY A)(12 AWG)(2 CONDR) f complete in place per LF for lc� _ dollars y LEN andl v o t Tv cents. 61 1015 LF TRF SIG CB (TY A)(12 AWG)(3 CONDR) complete in place per LF ba for L(AJ � dollars and 'Z cents. J 62 453 LF TRF SIG CBL (TY A)(14 AWG)(5 CONDR) � complete in place per LF for dollars C\ and /LO cents. 00300-9-2015 Page 13 of 19 Bid Form BASE BID Austin Traffic Signal Construction Co Inc. Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 63 2257 LF TRF SIG CBL (TY A)(14 AWG)(7 CONDR) complete in place per LF for —Q dollars and -,�- cents. I �f 64 915 LF TRF SIG CBL (TY A)(14 AWG)(20 CONDR) c mplete in place per LF for dollars 73 and cents. / 65 1 EA INS TRF SIG PL AM(S)1 ARM(44')ILSN (INSTALL ONLY) 4plete in pi#ce per EA for dollars and zr=& cents. '- 66 1 EA INS TRF SIG PL AM(S)I ARM(50')LUM&ILSN (INSTALL ONLY) Enplete i place per EA for l a dollars D a d Aband cents. 67 2 EA INS TRF SIG PL AM(S)1 ARM(65')LUM&ILSN (INSTALL ONLY) omplet n place per EA A' for .� � ��yi dollars / and cents. 00300-9-2015 Page 14 of 19 Bid Form Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 68 3 EA PED POLE ASSEMBLY mplete in pla Aper EA J for dollars �� and cents. 0 ' 69 6 EA PED DETECT PUSH BUTTON (APS) Agmpl to iSffa per EA for dollars (6 and cents. if 70 1 EA PED DETECTOR CONTROLLER UNIT ,�umple iplaqt per A for 7/w� ollars4�D and — cents. 71 3 EA PORTABLE CHANGEABLE MESSAGE SIGN co p�te n pla e for n u7aJ /I.� Mars to and ZP-51 Ize cents. 72 120 LF ITS COM CBL(ETHERNET) con¢plete in place per LF for �{�✓ dollars and Z— d cents. 00300-9-2015 Page 15 of 19 Bid Form Austin Traffic Signal Construction Co, Inc, BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 73 670 LF CONDUIT(PREPARE) complete in place per LF for `�•4C7 dollars and cents. . ' 13 74 6 EA GROUND BOX(PREPARE) co pl to in place per EA for �/Q_ dollars I and cents. �ro 1 75 1 EA BBU SYSTEM (EXTERNAL BATT CABINET) _C= to in ac pe A -a� for 0 +�„� = ollars and cents. 956D 76 1 EA ILSN(LED) (6 D) cort e in pi e per EA for f�� „�c dollars �ra�� and cents. UU 77 3 EA I L SN LED (I OD) COY 1 e m ace a EA �d (� r�, for �la =dollars �,fl. 9 (00u . and cents. 00300-9-2015 Page 16 of 19 Bid Fonrn Austin Traffic Signal Construction Co, Inc. BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 78 1 EA VIVDS PROSR SYS co iplete in place per EA ,ba for '�,+( dollars `f Ox and cents. / 79 4 EA VIVDS CAM ASSY FXD LNS `-telmp:eeAn place per EAfor /l�� dollars and cents. y�'• \ �� 80 1 EA VIVDS CNTRL SOFTWARE cmplet in la EA c� for ollars and r cents. 81 1 191 LF VIVDS CABLING complete in place per LF Q� for dollars and cents. 82 3 EA OPTICOM DETECTOR - GTT MODEL 722 code in pce r EA for dollars and n cents. C 00300-9-2015 Page 17 of 19 Bid Form Austin Traffic Signal Construction Co, Inc; BASE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount 83 1 EA OPTICOM PHASE SELECTOR- GTT MODEL 764 co piete 'n p ce per EA for I � lCS dollars n (� and cents. G 84 1 EA OPTICOM CARD RACK - GTT MODEL 760 co/npletj in lace per EA for �f -A4 dollars r� and cents. 85 808 LF OPTICOM CABLE - GTT MODEL 138 om lete in place per LF for dollars and cents. 86 1 EA WIRELESS ETHERNET RADIO co pl in �IaXcr EA for dollars and cents. C �, 87 1 EA HARDENED ETHERNET WITCH co let in plce p rl EA fo u✓ dollars and cents. V 88 1 EA AXIS PTZ CAMERA cor MItin p ce per EAfor / dollars l LJ and J"6 cents. 00300-9-2015 Page 18 of 19 Bid Form C, TOTAL BASE BID (Items 1 thru 88 )�� Materials: All Other Charges: * Total: * Note: This total must be the same amount as shown above for "Total Base Bid" If this bid is accepted, the undersigned agrees to execute the Agreement and provide necessary bonds and e itte , Austin Traffic Signal Construction Co, Inc, Signature ri t Name Address Title Telephone 1— Name of Firm 2-0 r Date Secretary, if Bidder is a Corporation 00200-9-2015 Page 19 of 19 Bid Form