DPP-NCA-52-75 REVISED: 3-18-08 GOVERNMENT OF THE VIRGIN ISLANDS DEPARTMENT OF PROPERTY AND PROCUREMENT NON-COLLUSION AFFIDAVIT 0 resssssseeseer DING duly sworn, deposes and says that — (1) He is [owner, partner, officer, representative, or agent] Of 2... elec cece ccc eee cece ccscsvssseavesvasens the bidder that has submitted that attached bid; (2) He is duly informed respecting the preparation and contents of the attached bid and of all pertinent circumstances respecting such bid; (3) Such bid is genuine and is not a collusive or sham bid; (4) Neither the said bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other bidder, firm or person to submit a collusive or sham bid in connection with the contract for which the attached bid has been submitted or to refrain from bidding in connection with such contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other bidder, firm or person to fix the price or prices in the attached bid or of any other bidder, or to fix any overhead, profit or cost element of the price or the bid price of any other bidder, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against The Government of the Virgin Islands or any person interested in the proposed contract; and (5) The price or prices quoted in the attached bid are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the bidder or any of its agents, representatives, owners, employees, or parties in interest, including this affiant. Signature of Affidavit SUBSCRIBED AND SWORN to before me this............... GORY OF siieei5i 2 emnnnmennnnpannnnsnanerneereonicasersvis Notary Public DATE BOND EXECUTED ‘Must not be later than bid BID BOND epening dare) OMB NO.: 9000-0045 (See instruction on reverse! Public reporting burden for this collection of information is estimated to average 25 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the FAR Secretariat (MVR), Federal Acquisition Policy Division, GSA, Washington, DC O5. PRINCIPAL (Legal name and business adcress} TYPE OF ORGANIZATION ("x one) CI INDIVIDUAL CJ PARTNERSHIP CO JOINT VENTURE C] CORPORATION STATE OF INCORPORATION SURETY(IES) (Name and business address} PENAL SUM OF BOND | BID IDENTIFICATION en AMOUNT NOT TO EXCEED eID DATE INVITATION NO. PRICE MILLION(S) THOUSANDIS) HUNDRED(S) CENTS EOR (Construction, Supplies,or Services) OBLIGATION: We, the Principal and Surety(ies) are firmly bound to the United States of America (hereinafter called the Government) in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally" as well as “severally” only for the purpose of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly and severally with the Principal, for the payment of the sum shown opposite the name of the Surety. If no limit of liability is indicated, the limit of liability is the full amount of the penal sum. CONDITIONS: The Principal has submitted the bid identified above. THEREFORE: The above obligation is void if the Principal - (a) upon acceptance by the Government of the bid identified above, within the period specified therein for acceptance (sixty (60) days if no period is specified), executes the further contractual documents and gives the bond(s) required by the terms of the bid as accepted within the time specified (ten (10) days if no period is specified) after receipt of the forms by the principal; or (b) in the event of failure to execute such further contractual documents and give such bonds, pays the Government for any cost of procuring the work which exceeds the amount of the bid. Each Surety executing this instrument agrees that its obligation is not impaired by any extension(s) of the time for acceptance of the bid that the Principal may grant to the Government. Notice to the surety(ies) of extension(s) are waived. However, waiver of the notice applies only to extensions aggregating not more than sixty (60) calendar days in addition to the period originally allowed for acceptance of the bid. WITNESS: The Principal and Surety{ies) executed this bid bond and affixed their seals on the above date. PRINCIPAL 1 2. 3 SIGNATURE(S} (Seal) {Seal} (Seal) Corporate NAME(S) & | 2 3. Seal TITLE(S) (Typed) INDIVIDUAL SURETYI(IES) 1. SIGNATURE(S) & (Seal) (Seal NAME(S) 1. 2. (Typed) CORPORATE SURETY(IES) CARNE a STATE OF INC. LIABILITY LIMIT (3) «| ADDRESS > T. 2. 55 | SIGNATURES) Corporate Es Seal NAME(S) & [7, ) “TITLE(S) ‘a (Typed) AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 24 (REV. 10-98) Previous edition is usable Prescribed by GSA - FAR (48 CFR) 53.228(a) HAME & STATE OF INC, LIABILITY LIMIT (5) mo| ADDRESS = T. uy SIGNATURE(S) ii Corporate | NAME(S) & 1. 2 oe TITLE(S) : (Typed) eo STATE OF INC, LIABILITY LIMIT (3) «| ADDRESS > 7. {5 [SIGNATURE(S) i Corporate = Seal | NAMES) & [1 2 .° TITLE(S) . (Typed! NAME & STATE OF INC, LIABILITY LIMIT (3) o| ADDRESS al in 5 |signatureis) - Corporate s Seal a NAME(S) & {7 2 res) , yped) NAMES: STATE OF INC. LIABILITY LIMIT (8) uw | ADDRESS > 7 by |SIGNATURE(S) a Corporate s Seal | NAME(S) & 7. 3; TITLE(S) (Typed) NAME & STATE OF INC. LIABILITY Lint (3) u| ADDRESS > 7 3. 1 |SIGNATURE(S) Corporate ES Seal am| NAME(S) & 1/7, 2 TITLE(S) (Typed) NAME & STATE OF INC. LIABILITY LIMIT (3) «| ADDRESS > i: 2. Fy |SIGNATURE(S} Corporate o Seal Z| NAMES) & 7. 2. TITLE(S) (Typed) INSTRUCTIONS 1. This form is authorized for use when a bid guaranty is required. Any deviation from this form will require the written approval of the Administrator of General Services. 2. Insert the full legal name and business address of the Principal in the space designated “Principal” on the face of the form. An authorized person shall sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of the firm, partnership, or joint venture, or an officer of the corporation involved. 3. The bond may express penal sum as a percentage of the bid price. In these cases, the bond may state a maximum dollar limitation (e.g., (e.g., 20% of the bid price but the amount not to exceed dollars). 4. (a) Corporations executing the bond as sureties must appear on the Department of the Treasury's list of approved sureties and must act within the limitation listed therein. where more than one corporate surety is involved, their names and addresses shall appear in the spaces (Surety A, Surety B, etc.) headed "CORPORATE SURETY(IES)." In the space designed “SURETY(IES)" on the face of the form, insert only the letter identification of the sureties. (b) Where individual sureties are involved, a completed Affidavit of Individual surety (Standard Form 28), for each individual surety, shall paca coal the bond. The Government may require the surety to furnish additional substantiating information concerning its financial capability. 5. Corporations executing the bond shall affix their corporate seals. Individuals shall execute the bond opposite the word "Corporate Seal", and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requiring adhesive seals. 6. Type the name and title of each person signing this bond in the space provided. 7. Inits application to negotiated contracts, the terms "bid" and "bidder" shall include “proposal” and "offeror." STANDARD FORM 24 (REV. 10-98) BACK FORM. P&P-P8.20-73 GOVERNMENT OF THE VIRGIN ISLANDS REVISED 31808 PAYMENT BOND COMM. OF PROP.& PROC, (See Instructions on Reverse) DATE BOND EXECUTED PRINCIPAL SURETY PENAL SUM OF BOND (Express in words and figures) CONTRACT NO. DATE OF CONTRACT KNOW ALL MEN BY THESE PRESENTS, That we, the PRINCIPAL and SURETY above named, are held and firmly bound unto the Government of the Virgin Islands, hereinafter called the government, in the penal sum of the amount stated above, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the principal entered into a certain contract with the Government, numbered and dated as shown above and hereto attached: NOW THEREFORE, if the principal shall promptly make payment to all persons supplying labor and material in the prosecution of the work provided for in said contract, and any and all duly authorized modifications of said contract that may hereafter be made, notice of which modifications to the surety being hereby waived, then this obligation to be void; otherwise to remain in full force and virtue. IN WITNESS WHEREOF, the above-bounden parties have executed this instrument under their several seals on the date indicated above, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. In Presence of: WITNESS INDIVIDUAL PRINCIPAL 5 Co [SEAL] eee oe a [SEAL] Svea ee bee eee eee CS [SEAL] eee ASCO ee [SEAL] WITNESS INDIVIDUAL PRINCIPAL Veeco ee ce te cee ceece cece eee eee cece eee e eee cence ee oe [SEAL] 2 one eevee cnn ce tte e eee bbe eeeeeeteee re [SEAL] CORPORATE PRINCIPAL Attest BUSINESS ADDRESS BY AFFIX CORPORATE TITLE SEAL CORPORATE SURETY Attest BUSINESS ADDRESS BY AFFIX CORPORATE TITLE SEAL The rate of premium on this bond is per thousand. Total amount of premium charged, $ (The above must be filled in by corporate surety) CERTIFICATE AS TO CORPORATE PRINCIPAL , certify that | am the secretary of the corporation named as principal in the within bond, that who signed the said bond on behalf of the principal, wasthen of said corporation; that | know his/her signature, and his/her signature thereto is genuine; and that said bond was duly signed, sealed, and attested for and in behalf of said corporation by authority of its governing body. [CORPORATE] [ SEAL ] INSTRUCTIONS 1 This form, for the protection of persons supplying labor and material, shall be used whenever a payment bond is required. It may also be used in any other case in which a payment bond is to be required. There shall be no deviation from this form except as authorization by the Government of the Virgin Islands. 2 The surety on the bond may be any corporation authorized under the laws of the Government of the Virgin Islands any State or possession of the United States, or by the Secretary of the Treasury to act as surety, or two responsible individual sureties. Where individual sureties are used, this bond must be accompanied by a complete Affidavit of Individual Surety for each individual surety (Standard Form.) 3 The name; including full Christian name, and business or residence address of each individual party to the bond shall be inserted in the space provided therefor, and each such party shall sign the bond with his usual signature on the line opposite the scroll seal, and if signed in Maine or New Hampshire, an adhesive seal shall be affixed opposite the signature. 4 If the principals are partners, their individual names shall appear in the space provided therefor, with the recital that they are partners composing a firm, naming it, and all the members of the firm shall execute the bond as individuals. 5 If the principal or surety is a corporation, the name of the State in which incorporated shall be inserted in the space provided therefore, and said instrument shall be executed and attested under the corporate seal as indicated in the form. If the corporation has no corporate seal the fact shall be stated, in which case a scroll or adhesive seal shall appear following the corporate name. 6 The official character and authority of the person or persons executing the bond for the principal, if a corporation shall be certified by the secretary or assistant secretary, according to the form herein provided. In lieu of such certificate there may be attached to the bond copies of so much of the records of the corporation as will show the official character and authority of the officer signing, duly certified by the secretary or assistant secretary, under the corporate seal, to be true copies. 7 The date of this bond must not be prior to the date of the instrument in connection with which it is given. FORM - P&P-PB-20-73 GOVERNMENT OF THE VIRGIN ISLANDS DATE BOND EXECUTED he eo PERFORMANCE BOND COMM. OF PROP.& PROC. (See Instructions on Reverse) PRINCIPAL SURETY PENAL SUM OF BOND {Express in words and figures) CONTRACT NO. DATE OF CONTRACT KNOW ALL MEN BY THESE PRESENTS, That we, the PRINCIPAL and SURETY above named, are held and firmly bound unto the Government of the Virgin Islands, hereinafter called the government, in the penal sum of the amount stated above, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the principal entered into a certain contract with the Government, numbered and dated as shown above and hereto attached: NOW THEREFORE, if the principal shall well and truly perform and fulfill all the undertakings, covenants, terms, conditions, and agreements of said contract duringthe original term of said contract and any extensions thereof that may be granted by the Government, with or without notice to the surety, and during the life of any guaranty required under the contract, and shall also well and truly perform and fulfill all the undertakings, covenants, terms, conditions, and agreements of any and all duly authorized modifications of said contract that may hereafter be made, notice of which modifications to the surety being hereby waived, then, this obligation to be void; otherwise to remain in full force and virtue. IN WITNESS WHEREOF, the above-bounden parties have executed this instrument under their several seals on the date indicated above, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. In Presence of: WITNESS INDIVIDUAL PRINCIPAL Ve. ASCO [SEAL] Ds celine ae ai ei als eatansgehaccegese area esac aston. [SEAL] 3. AStO [SEAL] 4 eee BS tO oe [SEAL] WITNESS INDIVIDUAL PRINCIPAL TL coma ee de aur umes ages ceparaeacenecateeo esata To [SEAL] re BSPO [SEAL] CORPORATE PRINCIPAL Attest BUSINESS ADDRESS BY AFFIX CORPORATE TITLE SEAL CORPORATE SURETY Attest BUSINESS ADDRESS BY AFFIX CORPORATE TITLE SEAL The rate of premium on this bond is per thousand. Total amount of premium charged, $ (The above must be filled in by corporate surety) CERTIFICATE AS TO CORPORATE PRINCIPAL who signed the said bond on behalf of the principal, was then of said corporation; that | know his/her signature, and his/her signature thereto is genuine; and that said bond was duly signed, sealed, and attested for and in behalf of said corporation by authority of its governing body. [CORPORATE] [ SEAL ] INSTRUCTIONS 1 This form shall be used for construction work or the furnishing of supplies or services, whenever a performance bond is required. There shall be no deviation from this form except as authorized by the Department of Property and Procurement. 2 The surety on the bond may be any corporation authorized under the laws of the Government of the Virgin Islands any State or possession of the United States, or by the Secretary of the Treasury to act as surety, or two responsible individual sureties. Where individual sureties are used, this bond must be accompanied by a complete Affidavit of Individual Surety for each individual surety (Standard Form.) 3 The name; including full Christian name, and business or residence address of each individual party to the bond shall be inserted in the space provided therefor, and each such party shall sign the bond with his usual signature on the line opposite the scroll seal, and if signed in Maine or New Hampshire, an adhesive seal shall be affixed opposite the signature. 4 lf the principals are partners, their individual names shall appear in the space provided therefor, with the recital that they are partners composing a firm, naming it, and all the members of the firm shall execute the bond as individuals. 5 If the principal or surety is a corporation, the name of the State in which incorporated shall be inserted in the space provided therefore, and said instrument shall be executed and attested under the corporate seal as indicated in the form. If the corporation has no corporate seal the fact shall be stated, in which case a scroll or adhesive seal shall appear following the corporate name. 6 The official character and authority of the person or persons executing the bond for the principal, if a corporation shall be certified by the secretary or assistant secretary, according to the form herein provided. In lieu of such certificate there may be attached to the bond copies of so much of the records of the corporation as will show the official character and authority of the officer signing, duly certified by the secretary or assistant secretary, under the corporate seal, to be true copies. 7 The date of this bond must not be prior to the date of the instrument in connection with which it is given. Form P & P - A15-1-73 Approved 3-26-73 AFFIDAVIT OF Revised 3-18-08 Comm. of Prop. & Proc. INDIVIDUAL SURETY (See Instructions on Page 2) STATE OF ss: COUNTY OF ) I, the person whose signature appears below as surety, being duly sworn, depose and say that | am one of the sureties to the attached bond; that | am a citizen of the United States (a Resident Alien who has declared his intention to become a Citizen of the United States,) and of full age and legally competent; that | am not a partner in the business of the principal on the bond or bonds on which | appear or may appear as surety; that the information herein below furnished is true and correct. This affidavit is made to induce the Government of the Virgin Islands to accept me as surety on the attached bond. MY NAME (first, middle, last) MY ADDRESS (street and number, city and State) TYPE AND DURATION OF MY OCCUPATION NAME OF MY EMPLOYER MY BUSINESS ADDRESS (Street and number, city and State) Amount | am worth in Real Estate and Personal Property over and above (1) All my debts and liabilities owing and incurred. (2) Any property exempt from execution (3) Any pecuniary interests | have in the business of the principal on said bond. And (4) Any interest | have in any so-called community property. LOCATION AND DESCRIPTION OF REAL ESTATE OF WHIC sale under any homestead law, community or marriage law, or H1AM SOLE OWNER IN FEE SIMPLE (not exempt from seizure and upon attachment, execution, or judicial process) FAIR VALUE OF SUCH REAL ESTATE ASSESSED VALUE OF SUCH REAL ESTATE FOR TAXATION PURPOSES ALL MORTGAGES OR OTHER ENCUMBRANCES AGAINST ABOVE REAL ESTATE. THERE BEING NO OTHERS (if none, so state) MY LIABILITIES OWING AND INCURRED DO NOT EXCEED THE AMOUNT OF Amount | am worth in Real Estate and Personal Property over Personal property subject to execution and sale. This amount being additional to the real estate above described THE ABOVE PERSONAL PROPERTY CONSISTS OF THE FOLLOWING ALL OTHER BONDS ON WHICH |! AM SURETY (state character and amount of each bond; if none; so state) MY SIGNATURE AS SURETY Subscribed and sworn to before me this date at (Signature) OFFICIAL SEAL (Title of official administering oath) (Date) CERTIFICATE OF SUFFICIENCY | HEREBY CERTIFY, that the surety named herein is personally known to me; that, in my judgment, said surety is responsible, and qualified to act as such; and that, to the best of my knowledge and belief, the facts stated by said surety in the foregoing affidavit are true. NAME (typewritten) SIGNATURE OFFICIAL TITLE ADDRESS INSTRUCTIONS 1. This form shall be used whenever sureties on bonds to be executed in connection with Government contracts are individual sureties. There shall be no deviation from this form except as authorized by the Department of Property and Procurement. 2. Afirm, as such, will not be accepted as a surety, nor a partner for copartners or for a firm of which he is a member. Stockholders of a corporate principal may be accepted as sureties provided their qualifications as such are independent of their stockholdings therein. Sureties, if individuals, shall be citizens of the United States or Resident Aliens who have declared their intention to become United States Citizen. 3. The individual surety shall justify, under oath, in a sum not less than the penalty of the bond, according to the form appearing on the face hereof, before a notary public, or some other officer having authority to administer oaths generally. If the officer has an official seal, it shall be affixed, otherwise the proper certificate as to his official character shall be furnished. Where citizenship is not required, as provided in paragraph 2 of these instructions, the affidavit may be amended accordingly. 4. The certificate of sufficiency shall be signed by an officer of a bank or trust company, under Oath by two persons not related to the surety. 5. By signing this affidavit, the individual surety agrees to assign to the Government of the Virgin Islands as security for performance by the Principal such real and/or personal property as the Government of the Virgin Islands shall designate having a fair market value of three times the bonded amount. DPP-FS—64_75 Approved 5/7/75 Revised 3/18/08 Give Condensed Current Financial Statement Condition at Close of Business — Date ASSETS Dollars Cents 1. Cash (a) on hand $ .................. 20. (b) In Bank — $............ccee eee (cV-EseWhete Svanccomcmsanesoreay (d) Total Cash $...... 0.00. cceceseeesesees 2. Notes receivable (a) Due within 90 days .........0.0.0.0 000. ccceesecesceseeeceneeees (b) Due after ......... AUS censsenanawsehimernummanmamuccneyy (e) Pastdue severe eanommersceepancamaueepen cee emereess 3. Accounts receivable from completed contracts, exclusive of claims not approved for payment 2.0.0.0... 0.0.0.0. ccc eee cee eee e su ceteseseestesecsesessenss 4, Sums earned on uncompleted contracts as shown by Engineer’s or Architect’s estimate (a) Amount receivable after deducting retainage ......................0c0eecuees (b) Retainage to date due to upon commencement of Contracts ............... 5. Accounts receivable from source other then commencement of Contracts... 0.2... c eee ce eee ccncen eee ee eects eee eeeeaeneneseeeecaenens 6. Deposits for bids or other guarantees: (a) Recoverable within .......... OAS sccrsecureea en eae aa (b) Recoverable after ......... eee ET aa eee CET aT Oy ee . 7. Interest accrued on loan, Securities, CtC. 0.0... .....0ccc ccc cee ces een eeeeeeceeneeeeess 8. Real estate (a) Used for business purposes ...............0.0cccceeuceseeeeeeseues (b) Not used for business purposes ..............ccccsseessseneesseenseennees 9. Stocks and Bonds (a) Listed — present market value ......................0.00055 (b) Unlisted — present Valle! ccc ccscecccwewnwmmnwereervens 10. Materials in stock not included in Item 4 (a) For uncompleted controls (present value) .........-.. 0.2 ecceee eee ceeeeeeeenees (b) Other materials (present value) ..........2... 02.2202 ccc ce cece eecee eee eeeeeeeees LJ. BQu pment, BOOK Na MES i camcnmneausaacxammmnemaonnnnamennnieaununcnnecaaauena eens 12, Furniture and fixtures, book value ...........0 0.0... ccccccceeeeeeeeeesetsuteeuaeess TS OUIGR BSS CIS tac crenapupaciera aaa Bese edlSteeremnnmennneea emer menaaomnece nema meennoeemnmects TOTAL ASSETS LIABILITIES 1. Notes payable (a) To banks regular ......... 0.0... c ccc cece cece cee eee ene eens eneened (bh) To: bank for certified GheGhs ov sccnssnscsenrnraseinecenuceraciw een eaewewnareradon (c) To others for equipment obligations .......... 0... ccc ccc cece cence eee see tees (d) To others exclusive of equipment obligations .................. cee eee ese ee ees 2. Accounts payable (a) Not past due ............. 006.0000 cece cee ccececeseuenenseueeey (D) Past di Gis cesmnwrnmemnenm poems rE eRRGEIER 3.:Real Estate encumbrances cascssseeceseige veins icc iis erennseeparenesenenanerceaneese 4. Other Liabilities 2.00.00... 0.0 e cee cece cece cence ec eeeeeee senses eeueeunneueueresesess DCEO gsc tica as vei msbee asst ata acetates cea senna nC 6. Capital stock paid up (@) CommOn. 1.20.00 ccensecomvvwies ve desasudsacceveterse (B) COMMON wesaszay ese ess, cinema mnnnnnenaneennimenmnnn (c) Preferred 2.0... ...... ccc ccc ccccececees tee seeeeeusueneaeere CY Pele cos cwcaawrnaeazeneneannreeaeniarenanenasmewcuen 7: OHIPHIS (HEEWONE) Bartied Brscscweancmenesyemanenmmsmerernseiel Unearned $......... 02. cece cece nceenceceaeeececeeeceseeeusaen eaves TOTAL LIABILITIES GIVE CONDENSED CURRENT FINANCIAL STATEMENT Cont CONTINGENT LIABILITIES Liability on notes receivable, discounted or sold es Liability on accounts receivable, pledged, assigned or sold ee ay Liability s bondman ee i ie ee re ee er er Liability as guarantor on contracts or on accounts of others ee ee ea Other contingent liabilities i a ee i ee i a aes TOTAL CONTINGENT LIABILITIES include all amounts owing subcontractors for all work in placed and accepted on completed and uncompleted contracts, including retainage. This is to certify that the information herein reported is to the best of our knowledge true and accurate. Name of Company ee) Print Name ee er ee ee ee ee a ee eee ee eee ee ee Signature ere eee ee eee eee eee ee ee ee i Telephone Number / Cell Phone Number 2. COMM. OF PROP. & PROC. P & P-COS-13-73 APPROVED: 3-26-73 REVISED 3-18-08 GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES CONTRACTOR'S QUALIFICATION STATEMENT CONTRACTOR PSPS C SSPE SST EHH H HHT THT OTHERS THEE SETH THT H THEE Too eee eee ADDRESS DATE TEL. NUMBER PToPTCR UCU CEO CeCe e eee CEC CET eee eee ere eee eer ee SSCS STORE TTS EHTS RKTT THT OT HSS TEST TTS T STH KHER ESOS TE eee e ee ee eOEe CEL. NUMBER P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 1. How many years experience in construction work has your organization had (a) As a General Construction ....... 0... cece cence cece cece ence esse sees ee eeesesesesseuenseeesssesusneesneneusueavanenens IL OAAERSIORE cxcensenesmpnene asec cs msnewmsezesmencesc aay merce SH de ee eat ceeneNCmcesaL 2. List the construction contracts your organization has under way on this date: Percent Completed Location Name of Owner Contract Amount Class of Work 3. List contracts your organization has completed in the past three years: Contract Amount Class of Work Completed Location Name of Owner P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 4.. Have yowever failed to complete any work awarded t0°YOU? cccscccccescawescearsess eveveneaees voweeweneeseedantives TESO WHS MIG WHY? encssscananaxawsarmanemencnwnmmmenveetinoamEN py ~MapRNEeERepeN eee Ne er eaREINcameRa rates sioRcE ee ee ee re es 5. Has any officer or partner of your construction ever been an officer or parent of some other organization that failed to complete a construction contract? ............. If so, state name of individual, other organization and POASUAANEPETORE se canewsseeascewmaecenenseneniensrmaeumeseweenemendtomnamemeann meta ent meee aomSINemeyannpeseies Ce eee eee eee 6. Has any officer or partner of your organization ever failed to complete a construction contract handled in his OWN NAME? 0... cece cece cc cee ce eucceeececucceuuens If so, state name of individual, name of Owner and reason therefore ............00.ccccccccee ce cescueseeeeeeueeeeeas ee ee ees ee ee ee ee a ees P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 8. What is the construction experience of the principal individual of your organization? Years of Present Position Magnitude and Type Individual’s Name or Office Construction of Work In what Capacity Experience 9 In what manner have you inspected this proposed work? Explain in detail. ee ee 10. Explain your plan or lay out for performing the proposed work. ee ee ee ee ee ee ee ee a ee ee ee ee ee ee ee ee ee ee eee ee eee ee ee ee ee ee ee ee ee ee ee ee ee ee -4- P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 17. If so, state amount of sub-contract, and if known, the name and address of the sub-contractor, amount and type of his equipment and financial responsibility. ee ee eR ee 18. From which sub-contractors do you expect to require a bond? ........... 6.20. cece cece ec eee cee cence eee eeeee eens ne ens ee i ee ee 19. What equipment do you own that is available for proposed work? Years of Item Description, Condition Present Location Quantity Size, Capacity, Etc. Service -6- P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 11. The work, if awarded to you, will have the personal supervision of Whom? .................0cccccce cee eeeueeseeesees i ee i ee CC i Ck re ee ee 13. If you intend to sublet the transportation or perform it through an agent, state estimated amount of sub-contract or agent’s contract, and , if known, the name and address of sub-contract or agent, amount and type of his equipment and financial responsibility. ee ee ee ee ee ee ee ee 14. Do you intend to do grading and foundation work with your own forces? ........ 0.0.0. ccceee eee ee ee ee een en eneneaee If so, give type of equipment to be used. 2.20.0... eee cece cece cece cence renee eae e renee enna nen ee ea eed ewe teE ee Sete ee eee ee ee ee ee 15. If you intend to sublet the grading and foundation work or perform it through sub-contract, give the name and address of sub-contractor, if known of his equipment and financial responsibility. eee eee ee ee ee ee ee ee ee ee ee ee ee ee ee ee a eet eee eee ee ee ee ee 16. Do you intend to sublet any other portion of the Work? .......... ccc ccc cecce ese e eee eeeeneeseeeeeeneaeeeeeenetesenaaaes FORM NO. P&P-ITB-CC-16-73 APPROVED: 3-26-72 COMM. OF PROP. & PROC. REVISD; 3-18-08 INSTRUCTIONS TO BIDDERS (CONSTRUCTION CONTRACT) 1. Explanation to Bidders. Any explanation desired by a bidder regarding the meaning or interpretation of the invitation for bids, drawings, specifications, etc., must be requested in writing and with sufficient time allowed for a reply to reach bidders before the submission of their bids. Any interpretation made will be in the form of an amendment of the Invitation for bids, drawings, specifications, etc., and will be furnished to all prospective bidders. Its receipt by the bidder must be acknowledged by letter or telegram received before the time set for opening of bids. Oral explanations or instructions given before the award of the contract will not be binding. 2. Conditions Affecting the Work. Bidders should visit the site and take such other steps as may be reasonably necessary to ascertain the nature and location of the work, and the general and local conditions which can affect the work or the cost thereof. Failure to do so will not relieve bidders from the responsibility for estimating properly the difficulty or cost of successfully performing the work. The Government will assume no responsibility for any understanding or representations concerning conditions made by any of its officers or agents prior to the execution of the contract, unless included in the invitation for bids, the specifications, or related documents. 3. Bidder's Qualifications. Before a bid is considered for award, the bidder may be requested by the Government to submit a statement regarding his previous experience in performing comparable work, his business and technical organization, financial resources, and plant available to be used in performing the work. 4. Bid Guarantee. Where a bid guarantee is required by the invitation for bids, failure to furnish a bid guarantee in the proper form and amount, by the time set for opening of bids, may be cause for rejection of the bid. A bid guarantee shall be in the form of a firm commitment, such as a bid bond, postal money order, certified check, cashier's check, irrevocable letter of credit or certain bonds or notes of the United States. Bid guarantees, other than bid bonds, will be returned (a) to unsuccessful bidders as soon as practicable after the opening of bids, and (b) to the successful bidder upon execution of such further contractual documents and bonds as may be required by the bid as accepted. If the successful bidder, upon acceptance of his bid by the Government within the period specified therein for acceptance (sixty days if no period is specified) fails to execute such further contractual documents, if any, and give such bond(s) as may be required by the terms of the bid as accepted within the time specified (ten days if no period is specified) after receipt of the forms by him, his contract may be terminated for default. In such event he shall be liable for any cost of procuring the work which exceeds the amount of his bid, and the bid guarantee shall be available toward offsetting such difference. 5. Preparation of Bids. (a) Bids shall be submitted on the forms furnished, or copies thereof, and must be manually signed. If erasures or other changes appear on the form, each erasure or change must be initialed by the person signing the bid. Unless specifically authorized in the invitation for bids, telegraphic bids will not be considered. (b) The bid form may provide for submission of a price or prices for one or more items, which may be lump sum bids, alternate prices, scheduled items resulting in a bid on a unit of construction or a combination thereof, etc. Where the bid form explicitly requires that the bidder bid on all items, failure to do so will disqualify the bid. When submission of a price on all items is not required, bidders should insert the words “no bid” in the space provided for any items on which no price is submitted. (c) Unless called for, alternate bids will not be considered. (d) Modifications of bids already submitted will be considered if received at the office designated in the invitation for bids by the time set for opening of bids. Telegraphic modifications will be considered, but should not reveal the amount of the original or revised bid. 6. Submission of Bids. Bids must be sealed, marked, and addressed as directed in the invitation for bids. Failure to do so may result in a premature opening of, or a failure to open, such bid. P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 11. The work, if awarded to you, will have the personal supervision of WhOM? .................0eeces cence eee e eee eeeeeees ee ee ee 13. If you intend to sublet the transportation or perform it through an agent, state estimated amount of sub-contract or agent’s contract, and , if known, the name and address of sub-contract or agent, amount and type of his equipment and financial responsibility. errr ee ee ee ee ee ee ee em aera re ae a ee ee ee ee 14. Do you intend to do grading and foundation work with your own forces? ............:6::eceeeee eee eee eee ee seen eee ees If so, give type of equipment to be Used) wisciscccssiaeweesiascaemasies wivevensarsniisesneeeswenenesaeneweeewass eee ee ee ee ee ee ee ee ee ee ee a ee ee oe ee] 15. If you intend to sublet the grading and foundation work or perform it through sub-contract, give the name and address of sub-contractor, if known of his equipment and financial responsibility. Tete eee eee eee eee ee ee ee ee ee ee a a ee ee ee eC ee 16. Do you intend to sublet any other portion Of he Wotk?