HomeMy WebLinkAboutBid Received i
RECEIVED
Document A310 TM - 2010 JUN 4 2020 :
Conforms with The American Institute of Architects AIA Document 310
Bid Bond Southold Town Clerk
CONTRACTOR: SURETY:
(Name,legal status and address) (Name,legal stalus and pM»cipal place(jbinhiess)
Aspen American Insurance Company
B&W Paving &Landscaping, LLC 175 Capital Boulevard, Suite 300 This document has important
70 Foster Road Rocky Hill, CT 06067 legal consequences.Consultation
Waterford, CT 06385 Mailing Address for Notices with an attorney is encouraged
with respect to Its completion or
OWNER: modification.
(Nanny,legal stales and address) Any singular reference to
Town of Southold Contractor,Surety,Owner or
other party shall be considered
53095 Route 25 plural where applicable.
Southold, NY 11971
BOND AMOUNT: 5% Five Percent of Amount Bid
PROJECT:
Wame,location or address andl'roject ru mber,(fan})
Airport Entrance Road Rehabilitation Project @ Elizabeth Airport
The Contractor and Surety are bound to the Olvncr in the amount set forth above,for the payment of which the Contractor and Surety bind
themselves,their ileus,executors,administrators,successors and assigns,jointly and severally,as provided herein.The conditions of this
Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents,or'vithin such time period
as may be agreed to by the Owmer and Contractor,and the Contractor either(1)eaters into a contract with the Owmer in accordance vvith
the terms of such bid,and gives such bond or bonds as may be specified in the bidding or Contract Documents,with a surety admitted in
the jurisdiction of the Project and otherwise acceptable to the Omer,for the faithful performance of such Contract and for the prompt
payment of labor and material furnished in the prosecution thereof;or(2)pays to the Omer the difference,not to exceed the amount of
this Bond,between the amount specified in said bid and such larger amount for which the Omer Wray in good faith contract with another
party la perlbrm the work covered by slid bid,then this obligation shall be null and void,otherwise to remain in lull force and ellecl.The
Surety hereby-waives any notice ol'un agreement between the Owner and Contractor to extend the time in which the Owner may accept the
bid.Waiverofnolice by lite Surely%ball not apply to any extension exceeding sixty(60)days in the aggregate beyond the time for
acceplunce or bidsspecified in the bid documents,and the Owner and Contractor shall obtain the Surety'%consent lir an extension beyond
sixty(60)days.
If this Bond is issued in connection with a subcontractor's bid to a Contractor,the term Contractor in this Bond shall be deemed to be
Subcontractor and the tart Owner shall be deemed to be Contractor.
When this Bond has been lurnished to comply moth a statutory or other legal requirement in the location of the Project,any provision in
this Bond conllicling With said statutory or legal requirement shall be deemed deleted herelirom and provisions conforming to such
statutory or other legal requirement shall be deemed incorporated herein.When so furnished;the intent is that this Hord shall be construed
ac a statutory bond and not as a common la%v bond.
Signed and scaled this 29th day of May, 2020.
B &W Paving &Landscaping, LLC
&inclpal) (seal)
tl f"n
B :
(trite)
a���rGtt�r�RStrrd4y�
Aspen American Insurance Company ��fri, •.�o
(Surely)
(1T ilnes�) =a'n ac=sem
By yb�•.........r �5,�'
(iolle),le ica Picciri to Attorney-in-Fact �,,, ga a.•��
S-00541AS 8110
Elizabeth Field Airport Airport Entrance Road Rehabilitation
STATEMENT OF SURETY'S INTENT
TO: Town of Southold
We have reviewed the bid of B &W Pavinq & Landscaping, LLC
(Contractor)
of 70 Foster Road, Waterford, CT 06385
(Address)
for the Airnort Entrance Road Rehabilitation
project for which bids will be received on: 6/4/2020
(Bid Opening Date)
and wish to advise that should this Bid of the Contractor be accepted and the Contract awarded to him, it is
our present intention to become surety on the performance bond and labor and material bond required by
the Contract.
Any arrangement for the bonds required by the Contract is a matter between the Contractor and ourselves
and we assure no liability to you or third parties if for any reason we do not execute the requisite bonds.
We are duly authorized to do business in the State of New York.
ATTEST: J7 Aspen American Insurance Company
Surety's horized Signatures)
Jessica L. Piccirillo, Attorney-in-Fact
(Corporate seal, if any.If no seal,write "No Seal"across this place and sign.)
ATTACH PROPOSAL GUARANTEE
ATTACH POWER OF ATTORNEY
(This form must be complete and submitted with the Proposal.
Copies of this form may be filled out and attached to this page.)
2018 PROPOSAL-18
CORPORATE ACKNOWLEDGMENT
State of
County of Ss.:
On this day of in the year 2020 before me personally come(s)
to me known, who, being by me duly sworn, deposes and says that same resides in
that same is the
of the the corporation described
in and which executed the foregoing instrument; that same knows the seal of the said corporation; that the seal
affixed to the said instrument is such corporate seal;that it was so affixed by the order of the Board of Directors
of said corporation,and that same singed the name thereto by like order.
(Signature of Notary taking acknowledgment)
LIMITED LIABILITY COMPANY ACKNOWLEDGMENT
State of
County of Ss.:
On this day of in the year 2020, before me personally come(s)
to me known, who, being by me duly sworn, deposes and says that
same resides in that same is the of the
the Limited Liability Company
described in and which executed the foregoing instrument;that same knows the seal of the said corporation;that
the seal affixed to the said instrument; and that same authorized under the Articles of Organization and the
Operating Agreement as amended and in effect this date to execute the forgoing instrument and so bind the
Limited Liability Company.
(Signature of Notary taking acknowledgment)
SURETY ACKNOWLEDGMENT
State of Connecticut
County of Hartford Ss.:
On this 29" day of May in the year 2020,before me personally come(s) Jessica L.Piccirillo to me know,who,
being by me duly sworn, deposes and says that same resides in Farmington,CT that same is the Attorney-in-
Fact of the Aspen American Insurance Company the corporation described in and which executed the
foregoing instrument; that same knows the seal of the said corporation; that the seal affixed to the said
instrument is such corporate seal;that it was so affixed by the order of the Board of Directors of said corporation
and that same signed the name thereto by like order.
(Signaturt of Notary takmg ac owledgment)
Victoria P.Parkerson,Notary Public
My Commission Expires: 2/28/2023
J r.
i
ASPEN
Aspen American insurance Company
175 Capital Boulevard,Rocky Hill,Cr 06067
Surety Bond No. Bid Bond
Principal: B&W Paving&Landscaping,LLC
Obligee: Town of Southold
POWER OF ATTORNEY
KNOW ALL PERSONS BY THESE PRESENTS,THATAspett American Insurance Company,a corporation duly organized under the laws of the
State of Texas,and having its principal offices in Rocky Hill,Connecticut,(hereinaller the"Company")does hereby make,constitute and appoint:
Jessica Piccirillo of Alliant Insurance Services,Inc. its true and lawful Attorney-in-Fact,with full power and authority
hereby conferred to sign,execute and acknowledge on behalf of the Company,at any place within the United States,the following instrument(s)
by his/her sole signature and act:any and all bonds,mcognizanccs,and other writings obligatory in the nature of a bond,recognizance,or conditional
undertaking and any and all consents incident thereto,and to bind the Company thereby as fully and to the same extent as if the same were signed
by the duly authorized officers of the Company.All acts of said Attomey-in-Fact done pursuant to the authority herein given are hereby ratified and
confirmed.
This appointment is made under and by authority of the following Resolutions of the Board of Directors of said Company effective on April 7,2011,which
!resolutions are now in full force and effect,
VOTED:All Executive Ol&ees oftheCompaay(ineludingthePmsident;anyIbwwtiv%SeniororAssistant Vice President,any VicePtesident,any Treasurer,Assistant
Treasurer,orSecretaryorAss Scaretary)mayappointAttomeys-in-FacttoactfarandonliftfoftbeCompanytnsigawiththeOurippy'snameandsea[withthe
Company's seal,bonds,recogibmices,and other writings obligatory in the nature ofa band,recogni artce,or conditional undertaking,and any ofsaid Executive Officers at
any time may remove any such appnir¢ee and revoke the power given him or her.
VOTED:The foregoutgauthority forcertainelmnes ofofficers ofthe CompanytuappointAtkmzT-in-FactbyvidueofaPmverofAttomeyti)sign andseal bonds,
recrngoirauces,
and other writings obligatory in the nature ofa bond,recognir�"or conditional undertaking,as well as to revoke any such Power ofAttamey,ishemby
granted gmilically to the following individual otGcersofAspen Specialty Insurance ManagemeaK hrc.:
Michael Toppi,Executiv*Vioe President,Scott Sadowsky,Senior Vice President, Mathew Raino,Vice President,Revin Gillen,Senior Vice President
and Ryan Field,Vice President,
This Power of Attorney may be signed and sealed by facsimtle(mechanical or printed)under and by authority of the following Resolution voted by
the Boards of Directors of Aspen American Insurance Company,which Resolution is now in full force and effect:
VOTED:That the signature of any of the Officers identified by title or specifically named above may be affixed by facsimile to any Power of Attorney for purposes
only of executirgand attesting bonds and undertakings and other writings obligatory in the nature thereog and any and all consents incident thereto,and any such Pamr
ofAtiomey or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company.Any such power so execaned and certified by
such facsimile signature and/or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking so executed.
IN WITNESS WHEREOF,Aspen American Insurance Company has caused this instrument to,be signed and its corporate seal to be hereto affixed this 24th
day of June,2016.
Aspen Am an insygnce Company
STATE OF CONNECTICUT
SS. ROCKY HILL
COUNTY OF HARTFORD, K in Gillen,Senior Vice President
On this 24a1 day of June,2016 before me personally came Kevin Gillen to me knova who being by me duly sworn,did depose and say;that he/she is Senior Vice
President,ofAspen American Insurance Company,the Company described in End which executed the above instrument;that he/she knows the seal ofsaid corporation:that
the seal affixed to the said insmunentissuch corporate seal,,and that be(sheexecuted thesaideoh[mreotoniehiilfoftheCompany by authority of his/her office tinder the above
Resolutions thereof.
oA
otary Public
My commission expires:May 31,2021
CERTIFICATE
I,the undersigned,Kevin Men of Aspen American Insurance Company,a stock corporation ofthc State ofTcxas;do haft certifythatthe foregoing Poaerbf
Attorney remains in full farce and has not been revoked:and furthermore,thatthe Resolutions ofthe Boards of Directors,as set forth above,are now and remain in
full force and effect
Given under-my hand and seal of said Company,in Rocky Bill,Connecticut,this 29th day of May , 2020
nw"
r
} C00
��
f�rs�
By: Nam `°
Name:Kevin Gillen,Senior Vice President "
*For verification of the authenticity of the Power of Attorney you may call(860)760-7728 or email:Patricia.Taber@aspen-insurnnce-com
Aspen Afnerican Insurance Cotnpanq
STATUTORY STATEMENT OF FINANCIAL CONDITION
December 31,2019
Assets
Bonds $ 457,121,334
Common stocks 183,092,685
Cash and short term investments 138,712,770
Other Invested'assets 41,677,152
Premiums_In course of collection 132,$34,153
Amounts recoverable from reinsurers 58,987,053
Other assets 5,705,764
Total Assets $ 1,017,830,851
I Lfab Ilties
Reseryefor lossesand adjustment expenses $ ,244,423,610
Commissions payable,-contingent commissions and other similar charges 2,946,564
Unearned premiunis� 168,488,803
Ceded reinsurance premiums payable 59,266,471-
Amounts withheld or retained by coinpanyfor account of othePs 41,197,182
Payable to parent,subsidiaries and affiliates 9,851,008
Retroactive Reinsurance (60,581,404)
Reserve for taxes,expenses and other liabilities 49;860;832
Total Ltabilltl'es 57.5,453,066
Surplus as regards policyholders 502,377 785
Total Surplus and Uabilitles $, 1,017,830,851
Me, -
Tre surer&CFO
State of Connecticut
County of Hartford
Kenneth Gerald Cadematorl,Treasurer and CFO being duly sworn,of Aspen American Insurance Company,Texas;and that
the foregoing is a true and correct statement of financlal condition of said company,as of December 31,2019-This,
unaudited financial statement is in agreement with-Aspen American Insurance Company's December 31,2019 filings to the
NAIL and to the State of Texas. ,,� �
Subscribed and sworn to before me,this Lqd y of February 2020.
Notary Public '
KIM D.SLIVA
N6TARYPU9,LTC ,
MY,OOMMISSIONEXPIRES JUNE 00,2021
PROPOSAL
FOR CONSTRUCTION OF THE
AIRPORT ENTRANCE ROAD REIIABILI`fl'ATION
AT
ELIZABETH I+IELD AIRPORT
FISHERS ISLAND
TOWN OF SOUTH[OLD,NEW YORK
TO: Southold Town Clerk's Office
53095 Route 25
Southold,New York 11971
The undersigned, as bidder, hereby declares that he/she has examined the site of the work and informed
himself/herself fully in regard to all conditions pertaining to the place where the work is to be done•, that
he/she has examined and read the Contract Documents and Contract Drawings for the work and all addenda
relative thereto furnished prior to the opening of bids;that he/she has satisfied himself/herself relative to
the work to be performed.
The bidder understands that the advertisement, located in the front of these Contract Documents, contains
the location and a description of the proposed construction,as well as indicates the place, date, and time of
the proposal opening; information about a Pre-Bid conference, if scheduled, is contained in the
advertisement;a listing of estimated quantities is located in the front of these Contract Documents;the time
in which the work must be completed shall be in accordance with the subsection titled FAILURE TO
COMPLETE ON TIME of Section 80. If the bidder considers that the time to complete the work is
inadequate,they should not submit a bid.
The bidder understands the quantities for bid items listed on the proposal sheets are estimated quantities
only for the purpose of comparing bids; any difference between these estimated quantities and actual
quantities required for construction shall not be taken as a basis for claims by the Contractor for extra
compensation; compensation will be based upon the unit prices and actual construction quantities.
The bidder understands that the description under each item, being briefly stated, implies,although it does
not mention, all incidentals and that the prices stated are intended to cover all such work, materials and
incidentals as constitute bidder's obligations as described in the specifications and any details not
specifically mentioned, but evidently included in the Contract shall be compensated for in the item which
most logically includes it.
The bidder understands that proposal guaranty shall be in the form of a bid bond in the amount of
five percent(5%) of this bid in accordance with,the subsection titled BED GUARANTEE of Section
20; the proposal guaranty shall become the property of the Owner in the event the Contract and
bond(s) are not executed within the time above set forth, as liquidated damages for the delay and
additional expense to the Owner caused thereby.
The bidder agrees that upon receipt of written notice of the acceptance of this proposal,bidder will execute
the Contract attached within 15 days and deliver a Surety Bond or Bonds as required by the subsection
titled REQUIREMENTS OF CONTRACT BONDS OF Section 30.The bidder further agrees to commence
construction with an adequate work force, plant and equipment on the date stated in the written notice to
proceed and will progress therewith to its completion within the time stated, and in accordance with this
Contract and Specification.
2018 PROPOSAL-1
ELIZABETH FIELD AIRPORT-FISHERS ISLAND
AIRPORT ENTRANCE ROAD IMPROVEMENTS
ITEM UNIT
NO SPEC DESCRIPTION QUANTITY UNITS- PRICE TOTAL
8 P-605, JOINT SEALING 900 LF 7,200.00
9 D-751 DRAINAGE STRUCTURES TO BE.CLFANED 5 EACH 6,000.00
90 D-751 CONCRETE GUTTERS TO BE CLEANED gip Li✓:s:,� -
9,720.00
11 F-162 24-FOOT DOUBLE SWING GATE 1 EACH 7,400.00
i
TOTAL CONTRACT
259,626.00
PROPOSAL-3
Elizabeth Field Airport Airport Entrance Road Rehabilitation
The bidder states that this proposal is based upon prevailing wages in Suffolk County,NY and in no case
are wages considered less than those predetermined by the State and Federal Departments of Labor,
schedules of which are contained in the;Contract Documents.
The bidder proposes and agrees, if this Proposal is accepted, to contract in the form of contract specified
with-the Town of Southold/Fishers Island Ferry District (Owner), 'to furnish all necessary materials,
equipment, machinery,, tools, apparatus, means df transportation and labor necessary to complete the
construction of the Airport Entrance Road Rehabilitation project in full and complete accordance with the
shown, noted, described and reasonably intended requirements of the Contract Documents and Contract
Drawings,to the full and entire satisfaction of the above said Owner,with a definite understanding that no
inoney will be allowed for extra work except as set forth in the attached Contract Documents, for the unit
prices listed for each item.
BIDDER,IF AN INDIVIDUAL:
BY:
(Printed Name)
(Signature)
COMPANY NAME:
ADDRESS:
PHONE NO:
DATE:
°zoic PROPOSAL-4
Elizabeth Field Airport. Airport Entrance Road Rehabiliwion
LLC
BIDDER,IF A PARTNERSHIP(GIVE NAMES AND ADDRESSES OF EACH PARTNER):
BY: James Wray,Member
(Printed Name)
(Signature)
COMPANY NAME:_B&W Paving&Landscaping LLC
ADDRESS: 70 Foster Road,Waterford CT 06385
PHONE NO: 860-572-9942
DATE: 6/3/2020
PARTNER'S PARTNER'S
Nom; James Wray - �_ NAME-
BUSINESS BUSINESS
ADDIMSS. 70 Foster Road ADDRESS,
Waterford CT 06385
PARTNER'S PARTNER'S
NAME: NAME:
BUSINESS BUSINESS
ADDRESS: ADDRESS:
2018 PROPOSAL-5
Elizabeth Field Airport Airport Entrance Road Rehabilitafion
BIDDER,YF A CORPORATION:
BY:
(Printed Name&Title)
(Signature)
CORPORATION
NAME:
ADDRESS: (SEAL)
STA'T'E OF CORPORATION
CHARTER:
PHONE NO:
DATE:
PRESIDENT'S
NAME:
BUSINESS
ADDRESS:
SECRETARY'S TREASURER'S
NAMEE• NAME
BUSINESS BUSINESS
ADDRESS: ADDRESS:
201,E PROPOSAL-6
Elizabeth Field Airport Airport Entrance Road Rehabilitation
ATTACHMENTS TO PROPOSAL
BIDDER and his/her surety, where appropriate, have completed and executed the attached documents,
which are identified below.
'Non-Collusive Bidding Certificate
/Resolution for Corporate Bidders
,Auy American Certification
Certificons:
acertification ofNon-Segregated Facilities
/bebarmeni&Suspension Certification
/Lobbying and Inluencing Federal Employees
,certification of Offeror/Bidder Regarding Tax Delinquency and Felony Convictions
- 4rade Restriction
Bidder's Statement of Previous Contracts Subject to EEO Clause m Described in Section 70-21
/Certification for Receipt of Addenda
/Statement of Surety's Intent
-franian Energy Sector Divestment Statement
•/ertification of Compliance with the Iran Divestment Act
-'Disadvantaged Business Enterprise(DBE)and Small Business Element(SBE)Statement
"Bidder's List Collection Form.(Bidder's Information)
Bidder's List Collection Form(Subcontractervs Information)
/Safety Plan Compliance Document(SPCD)Certification
2018 PROPOSAL-7
Elizabeth Field Airport Airport Entrance Road Rehabilitation
NO-N COLLUSIVIE BIDDING CERTMCATE
The Signer of this Bid declares:
A. That he/she has carefully exapiined the annexed form of the Agreement and Contract.
B. Pursuant to Section 103-d of1he General,Municipal Law, by submission-of this Bid, each Bidder and
each person signing on behalf of any Bidder certifies,,and in the case of a joint Bid each party thereto
certifies as to its own organization,under penalty ofperjury,that to the best of knowledge-and belief:
I. The prices in this Bid have been arrived'at independently without collusion, consultation,
communication or agreement,for the purpose of restricting competition,as to any matter relating
to such prices with-any other Bidder or with any competitor;
2. Unless otherwise required-by-law,the prices which have been quoted in this Bid have not been
knowingly disclosed by the Bidder, and will not knowingly be disclosed by the Bidder prior to
opening,directly or indirectly,to any other Bidder or to any competitor, and.
3. No attempt has been made or will be made by the Bidder to induce any other person,partnership
or corporation to submit or not to submit a Bid for the purpose of restricting competition.
I hereby affirm under the penalties of perjury that the foregoing statement is true.
Affix Seal BIDDER: B&W Paving&Landscaping LLC
if Principal
is Corporation BY: James Wra
TITLE: Member
CT
STATE OF NEW YORK)
SS: Waterford
COUNTY OF N.L. �
On the 3 day of Tune .2020. .,before me personally came_ James Wray _
to me known,who,being by me duly sworn,did swear and affirm that he/she resides at
83 Burdick Lane, Griswold CT • that he/she is the Member
of the Bidder herein and signs the foregoing Non-Collusive Certification on behalf of such Bidder, that
lie/she executed the foregoing Non-Collusive Certification;and that,to the best of his knowledge and belief,
the statement made iii the foregoing Non-Collusive Certifica ' is true. D
1
NOT PUBLIC
MY COMMISSION EXPIRES: r• -: ELIZABETH P MUCHA
Notary
Public,State of Connecticut
. ,., Expires May 31,2022
(This-form must be completed and submitted with t e Pyr
2018 PROPOSAL-8
Elizabeth Field Airport Airport Entrance Road Rehabilitation
RESOLUTION FOR CORPORATE BIDDERS N/A
RESOLVED,that be authorized
(Name of Officer)
to sign and submit the bid or proposal of this corporation for the following-project:
Airport Entrance Road Rehabilitation
and to include in such bid or proposal the certificate as to non-collusion required by section one hundred
three-d of the General Municipal Law as the act and deed of such corporation,and for any inaccuracies or
misstatements in such certificate this corporate bidder shall be liable under penalties of perjury.
The foregoing is a true and correct copy of the resolution adopted by
Corporation at a meeting of its Board of
Directors held on the day of,24
(Secretary)
(Seal)
(This form must be completed and submitted with the Proposal.)
2018 PROPOSAL-9
Elizabeth Field Airport Airport Entrance Road Rehabilitation
BUY AMERICAN CERTIFICATION
The Contractor agrees to comply with 49 USC § 50101, which provides that Federal funds may not be
obligated unless all steel and manufactured goods used in AIP funded projects are produced in the United
States, unless the Federal Aviation Administration has issued a waiver for the product;the product is listed
as an Excepted Article,Material Or Supply in Federal Acquisition Regulation subpart 25.108;or is included_.
in the FAA Nationwide Buy American Waivers Issued list.
A bidder or offeror must complete and submit the Buy America certification included herein with their bid
or offer. The Owner will reject as nonresponsive any bid or offer that does not include a completed
Certificate of Buy American Compliance.
CERTIFICATE OF BUY AMERICAN COMPLIANCE FOR TOTAL FACIELITY
As a matter of bid responsiveness, the bidder or offeror must complete, sign, date, and submit this
certification statement with its proposal. The bidder or offeror must indicate how it intends to comply
with 49 USC §50101 by selecting one of the following certification statements. These statements"are
mutually exclusive. Bidder must select one or-the other(i:e. not both)by inserting a check-mark(V')or
the letter"X'.
Bidder or offeror hereby certifies that it will comply with 49 USC. 50101 by:
a) Only installing steel and manufactured products produced in the United States; or
b) Installing manufactured products for which the FAA has issued a waiver as indicated by
inclusion on the current FAA Nationwide Buy American Waivers Issued listing;or
c) Installing products listed as an Excepted Article, Material or Supply in Federal
Acquisition Regulation Subpart 25.108.
By selecting-this certification statement,the bidder or offeror agrees:
1. To provide to the Owner evidence that documents the source and origin of the steel and
manufactured product.
2. To faithfully comply with providing US domestic products.
3. To refrain from seeking a waiver request after establishment of the contract, unless
extenuating circumstances emerge thatthe FAA determines justified.
❑ The bidder or offeror hereby certifies it cannot comply with the 100%Buy American Preferences
of 49 USC § 50101(a) but"may qualify for either a Type 3 or Type 4 waiver under 49 USC §
50101(b). By selecting this certification statement,the.apparent bidder or offeror with the apparent
low bid agrees:
1. To submit to the Owner within 15 calendar days of the bid opening, a formal"waiver
request and required documentation that support the type of waiver being requested.
2. That failure to submit the required documentation within the specified timeframe is
cause for a non-responsive determination that may result in rejection of the proposal.
3. To faithfully comply with providing US domestic products at or above"the approved
US domestic content percentage as approved by the FAA.
4. To fiurnish US domestic product for any waiver request that the FAA rejects.
5. To refrain from seeking a waiver request rifler establishment"of the contract, unless
extenuating circumstances emerge that the FAA determines justiiied,
2019 PROPOSAI,-10'
Elizabeth Field Airport Airport Entrance Road Rehabilitation
Required Documentation
Tyre 3 Waiver-The cost of components and subcomponents produced in.the United States is more than
600/a of the cost of all components and subcomponents of the"facility".The required documentation for
a Type 3 'Waiver is:
a) Listing of all manufactured products that are not comprised of 100% US domestic content
(Excludes products-listed on the FAA Nationwide Buy American Waivers Issued Iisting-and-
products excluded by Federal Acquisition Regulation Subpart 25.108;products of ufflmbwn origin
must be considered as non-domestic products in their entirety)
b) Cost of non-domestic components and subcomponents,excluding labor costs,associated with final
assembly and installation at project location,
c) Percentage of non-domestic component and subcomponent cost as compared to total "facility"
component and subcomponent costs, excluding labor costs associated with final assembly and
installation at project location.
Type 4 Waiver---Total cost of project using US domestic source-product exceeds the total project cost
using non-domestic product by 25%.The required documentation for a Type 4 Waiver is:
a) Detailed costinformation for total project using US domestic product
b) Detailed cost information for total project using non-domestic product
False Statements: Per 49 USC §47126,this certification concerns a matter within the jurisdiction ofthe,
Federal Aviation Administration and the making of a false,fictitious or fraudulent certification may render
the maker subject to prosecution under Title.18,United States Code.
6/3/2020
Date Signature
B&W Paving&Landscaping LLC Member
Company Name Title
(Buy American form(s)must be completed and submitted with the FroposaL)
2019 PROPOSAL-11
Elizabeth Field Airport Airport Entrance-Road Rehabilitation
CERTIFICATIONS `
BIDDER'S NAME: B&W Paving&Landscaping LLC
ADDRESS: 70 Foster Road,Waterford CT 06385
TELEPHONE NO.: 860-572-9942 FAX NO, 860-536-5833
IRS EMPLOYER IDENTIFICATION NUMBER: 06-1466584
NOTICE OF NONSEGREGATED FACILITIES REQUIREMENT
Notice to Prospective Federally Assisted Construction Contractors
1. A Certification of Non-segregated Facilities shall be submitted prior to the award of a federally assisted
construction contract exceeding $10,000, which is not exempt from the provisions of the Equal
Opportunity Clause,.
2. Contractors receiving federally-assisted construction contract awards exceeding$10,000 which are not
exempt from the provisions of the Equal Opportunity Clause will be required to provide for the
forwarding ofthe following notice to prospective subcontractors for supplies and construction contracts
where the subcontracts exceed $10,000 and are not exempt from the provisions of the Equal
Opportunity Clause,
3. The penalty for making false statements.in offers is prescribed in 18,U.S.C. § 1001_
Notice to Prospective Subcontractors of Requirements for Certification of Non-Segregated
Facilities
1. A Certification of Non-segregated Facilities shall be submitted prior to the award of a subcontract
exceeding$10,000,which is not exempt from the provisions of the Equal Opportunity Clause.
2. Contractors receiving subcontract awards exceeding$10,000 which are not exempt from the provisions
of the Equal Opportunity Clause will be required to provide for the forwarding of this notice to
prospective subcontractors for supplies and construction contracts where the subcontracts exceed
$10,000 and are not exempt from the provisions of the Equal Opportunity Clause.
3. The penalty for making false statements in offers is prescribed in 18 U.S.C.§-1001,-
CERTIFICATION OF NON-SEGREGATED)FACILITIES
The federally-assisted construction contractor certifies that she or he does not maintain or provide,for his
employees, any segregated facilities at any of his establishments and that:she or he does not permit his
employees to perform their services at any location, under his control, where segregated facilities are
maintained. The federally-assisted construction contractor certifies that she or he will not maintain or
provide, for his employees, segregated facilities at any of his establishments and that she or he will not
permit his employees to perform their services at any location under his control where segregated facilities
are maintained. The federally-assisted construction contractor agrees-that a breach of this certification is a
violation,of the Equal Opportunity Clause in this contract.
As used in this certification, the term "segregated facilities" means any waiting rooms, work area's,
restrooms,and washrooms,restaurants and other eating areas,time clocks,locker rooms and other storage
or dressing areas, parking.lots, drinking fountains, recreation or entertainment areas, transportation, and
2018 PROPOSAL-12
Elizabeth Field Aitport Airport Entrance Road rehabilitation
housing facilities provided for employees which are- segregated by explicit directives. or are, in fact,
segregated on the basis of race, color, religion, or national origin because of habit, local custom, or any
other reason. The federally-assisted construction contractor agrees that (except where she or he has
obtained identical certifications from proposed subcontractors for specific time periods) she at he will
obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding
$10,000 which are not exempt from the provisions of the Equal Opportunity Clause and that she or he will
retain such certifications in his files.
CERTIFICATION OF OFFEROR/BIDDER REGARDING DEBARMENT
By submitting a bid/proposal under this solicitation, the bidder or offeror certifies that neither it nor its
principals are presently debarred or suspended by any Federal department or agency from participation in
this transaction.
CERTIFICATION OF DOWER TIER CONTRACTORS REGARDING DEBARMENT
The successful bidder, by administering each lower tier subcontract that exceeds $25,000 as a "covered
transaction'; must verify each lower tier participant of a"covered transaction" under the project is not
presently debarred or otherwise disqualified from participation in this federally assisted project, The
successful bidder will accomplish this by:
L Checking the System for Award Management at website: http://www.sam.gov
2. Collecting a certification statement,similar to the-Certificate Regarding Debarmentand Suspension
(Bidder or Offero"r),above.
3. Inserting a clause or condition in the covered transaction with the lower tier contract
If the FAA later determines that a lower tier participant£ailed to disclose to a higher tier participant that it
was excluded or disqualified at the time it entered the covered transaction, the FAA may pursue any
available remedies,including suspension and debarment of the non-compliant participant.
CERTIFICATION REGARDING LOBBYING
The bidder or offeror certifies by signing and submitting this bid or'proposal, to the best of his or her
knoWledge and belief,that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the Bidder or
Offeror, to any person for influencing or attempting to influence an officer or employee of an
agency, a Member of'Congress,an officer or employee of Congress, or an employee of a Member
of Congress in connection with the awarding of any Federal contract, the making ofany Federal
grant, the making of any Federal loan,the entering into of any cooperative agreement, and the
extension,continuation,-renewal,amendment,or modification of any Federal contract,grant,loan,
or cooperative agreement.
(2) rf any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in
2019 PROPOSAL-13
Elizabeth Field Airport Airport Entrance Road RehabilM.on
connection with this Federal contract,grant,loan,or cooperative agreement,the undersigned shall
complete and submit Standard Form-LLL,"Disclosure Form to Report Lobbying,"in accordance
with its instructions.
(3) The undersigned shall require that the language of this certification;be included in the award
documents for all sub-awards at all tiers(including subcontracts, sub-grants, and contracts under
grants, loans, and cooperative agreements) and that all sub-recipients shall certify and disclose
accordingly.
This certification is a.material representation of fact upon which reliance was placed whenthis transaction
was made or entered into. Submission ofthis certification is a prerequisite for making or.entering into this-
transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less•than$10,000 and not more than$1.00,000 for-each-
such
oreachsuch failure.
CERTIFICATION OF OFFERER/BIDDER REGARDING TAX DELINQUENCY
AND FELONY CONVICTION'S
The Contractor must complete the following two certification statements.The Contractor must indicate its
current status as it relates to tax delinquency and felogy conviction by inserting a cheekrnark or"X"in the
space following the applicable res bn nse. The Contractor agrees that, if awarded a contract resulting from
this solicitation,it will incorporate this provision for certification in all lower tier subcontracts.
Certifications:
1) The Contractor represents that it is(`)is not C.LXJ a corporation that has any unpaid Federal tax
liability that has been assessed, for which all judicial and administrative remedies have been
exhausted or have lapsed,and that is not being paid in a timely manner pursuant to an agreement
with the authority responsible for collecting the tax liability.
2) The Contractor represents that,it is(__)is not(X )a corporation that was convicted of a criminal
violation under any Federal law within the preceding 24 months.
Note:
If a Contractor responds in the affirmative to either of the above representations,the-Contractor is ineligible
to receive an award unless the sponsor has received notification from the agency suspension and debarment
official(SDO)that the SDO has considered suspension or debarment and determined that further action is
not required to protect the Government's interests. The Contractor therefore must provide information to
the owner about its tax liability or conviction to the Owner,who will then notify the FAA Airports District
Office, which will then notify the agency's $DO to facilitate completion of the required considerations
before award decisions are made,
Term Definitions
Felony conviction:Felony conviction means n conviction within the preceding twenty four(24)months of
a felony criminal violation under any Federal law and includes conviction of an offense defined in.a section
of the 1U.8, code that specifically•classffies the offense as a felony and conviction of an offense that is-
-classified.-as a felony-under IS U.S.C. §3559.
2018 PROPOSAL-14
Elizabeth Field Airport Airport Entrance Road Rehabilitation
Tax Delinquency:A tax delinquency is any unpaid Federal tax liability that has been assessed,for which
all judicial'and administrative remedies have been exhausted, or have Lapsed, and that isnot being paid in
a timely manner pursuant to an agreement with the authority responsible far collecting the tax liability.
TRADE RESTRICTION CERTIFICATION
By submission of an offer, the Offeror certifies that with respect to this solicitation and any resultant
contract,the.Offeror
a, is not owned or controlled by one or more citizens of a foreign country included in the list of
countries that discriminate against U.S.firms as published by the Office of the United States Trade
Representative(U.S.T.R.);
b. has not knowingly entered into any contract or subcontract for this project with a person that is a
citizen'or national of a foreign country included on the list of countries that discriminate against
U.S.firms as published by the U.S.TA; and
c. has not entered into any subcontract for any product to be used on the Federal on the project that is
produced in a foreign country included on the list of countries that discriminate against U.S.firms
published by the U.S.T.R.
This certification concerns a matter within,the jurisdiction of an agency of the United States of America
and the making of a false,fictitious,or fraudulent certification may render the maker subject to prosecution
under Title 18,`United States Code, Section 1001.
The Offeror/Contractor must provide immediate written notice to the Owner if the Offeror/Contractor learns
that its certification or that of a subcontractor was erroneous when submitted or has become erroneous by
reason of changed circumstances. The Contractor must require subcontractors provide immediate written
notice to the Contractor if at any time it learns that its certification was erroneous by.-reason of changed
circumstances.
Unless the restrictions of this clause are waived by the Secretary of Transportation-in accordance with 49
'GFR 30.17, no contract shall be awarded to an Offeror or subcontractor:
(1) who is owned or controlled by one or more citizens or nationals of a foreign country included on
the list of countries that discriminate against U.S.firms published by-the U.S.T.R or
(2) whose subcontractors are owned or controlled by one or more citizens or nationals of a foreign
country on such U.S.T.R,list or
r
(3) who incorporates in the public works project any product of a foreign country on such U.S.T.R.
list;
Nothing contained in the foregoing shall be construed to require establishment of a system of records in
order to render,in good faith,,the certification required by this provision. The knowledge and information
of contractor is notrequired to exceed that which is normally possessed by a prudent person in the ordidary
course of business dealings.
2018 PROPOSAL-15
Elizabeth Field Airport Airport Entrance Road Rehabilitation.
The Offeror agrees that, if awarded a contract resulting from this solicitation, it will incorporate"this
provision for certification without modification in in all lower tier-subcontracts. The contractor may rely
on the.certification of a prospective subcontractor that itis not a firm.from a Foreign country included on
the list of countrie$that discriminate against U.S. firms as published by U.S.T.R, unless the Offeror has
knowledge that the certification is erroneous.
This certification is a material representation of fact upon which reliance was placed when mating an
award. If it is later determined that the Contractor or subcontractor knowingly rendered an erroneous
certification,the Federal Aviation Administration may direct through.the Owner cancellation of the contract
or subcontract for default at no cost to thea Owner or the FAA.
Printed Name&Title: lames Wray,Member
Signature: -�
Date, 6/3/2020
(These certifications must be completed and submitted With thePropasal)
2018 PROPOSAL-16
Elizabeth Field Airport Airport Entrance Road Rehabilitation
BIDDER'S STATE,MENT OF'PREVIOUS CONTRACTS SUBJECT TO EEO CLAUSE AS
DESCRIBED IN SECTION'7a 21
The Bidder shall complete the following statement by checking the appropriate boxes.
The Bidder has X has not participated in a previous contract subject to the Equal
Opportunity Clause prescribed by Executive Order 11246,as amended,of September 24, 1965.
The Bidder has X has not submitted all compliance reports in connection with any such
contract due under the applicable filing requirements; and that representations indicating submission of
required compliance reports -signed by proposed subcontractors will be obtained prior to award'of
subcontracts.
If the'Bidder has participated in a previous contract subject to the Equal Opportunity Clause and
has not submitted compliance reports due under applicable filing requirements,the Bidder shall submit a
compliance report on Standard Form 100, "Employee Information Report EEO-1", attached to this
proposal.
CERTIFICATION FOR RECEIPT OF ADDENDA
Receipt of the following Addenda is acknowledged:
ADDENDUM NO.: DATED:
ADDENDUM NO.: DATED:
ADDENDUM NO.: DATED:
B&W Paving&Landscaping LLC
(Firm or Corporation Making Bid)
James Wray,Member
(Sign re o Authorized Person)
P.O. Address: 70 Foster Road,Waterford CT 06385
Dated: 6/3/2020
(This form must be completed and submitted with the Proposal.)
2018 PROPOSAL-17
Elizabeth Field Airport Airport Entrance Road Rehabilitation
STATEMENT OF SURETY'S"INTENT
TO: Town of Southold
We have reviewed-the bid of
(Contractor)
Of
(Address)
for the Airport Entrance Road Rehabilitation
project for which bids will be received on: _
(Bid Opening Date)
and wish to advise that should this Bid of the Contractor be accepted and the Contract awarded Whim, it is
our present intention to become surety on the performance bond and labor and material bond required by
the Contract.
Any arrangement for the bonds required by the Contract is a matter between the Contractor and ourselves
and we assure no liability to you or third parties if for any reason we do not-execute the requisite bonds.
We are duly authorized to do business in the State of New York.
ATTEST:
Surety's Authorized Signatures)
(Corporate seal,if any.If no seal,write"No Seal"across this place and sign.)
ATTACH PROPOSAL GUARANTEE
ATTACHPOWER OF ATTORNEY
(This.form must be complete and submitted with the Proposal.
Copies of this form may be filled out and attached to-this.page.)
2018 PROPOSAL-18
1 '
i
Elizabeth Field Airport Airport Entrance Road Rehabilitation
IRANIAN ENERGY SECTOR DIVESTMENT STATEMENT
1. Contractor/Proposer hereby represents that said Contractor/Proposer is,in compliance with New
York State General Municipal Law Section 103-g entitled"Iranian Energy Sector Divestment",in
that said Contractor/Proposer has not:
(a) Provided goods or services of $20 Million or more in the energy sector of Iran
including but not limited to the provision of oil or liquefied natural gas tankers or
products used to construct or-maintain.pipelines used to'transport oil or liquefied
natural gas for the energy sector oflran; or
(b) Acted as a financial institution and extended $20 Million or more in credit to another
person for forty-five days or more, if that person's intent was to use the credit to
provide goods or services in the energy sector in Iran.
2. Any Contractor/Proposer who has undertaken any of the above and is identified on a list created
pursuant to Section 165-a (3)(b) of the New York State Finance Law as- a person engaging in
investment activities in Iran, shall not be deemed a responsible bidder pursuant to Section 103 of
the New York State General'Municipal Law.
3. Except as otherwise specifically provided herein, every Contractor/Proposer submitting a
bid/proposal in response to this Request forBids/Request for Proposals must certify and affirm the
following under penalties of perjury:
(a) `By submission of this bid, each bidder and each person signing on behalf of any_
bidder certifies,and in the case of a joint bid,each party thereto certifies as to its own
organization,under penalty of perjury,that to the best of its knowledge and belief,that
each bidder-is not on the list created pursuant to NYS Finance Law Section 165-a
(3)(b)."
4. Except as otherwise specifically provided herein,any Bid/Proposal that is submitted without having
complied with subdivision (a) above, shall not be considered for award. In any case where the
Bidder/Proposer cannot make the certification as set forth in subdivision (a) above, the
Bidder/Proposer shall so state and shall furnish with the bid x signed;statement setting forth in detail
the reasons therefore. The Owner reserves its rights, in accordance with General Municipal Law
Section 103-g to award the Bid./Proposal to any Bidder/Proposer who cannot make the certification,
on a case-by-case basis under the following circumstances:
(1) The investment activities in Iran were made before April 12, 2012, the investment
activities in Iran have not been expanded or renewed after April 12, 2012, and the
Bidder/Proposer has adopted,publicized and is implementing a formal plan to cease
the investment activities in Iran and to refrain from engaging.in any new investments
in Iran;or
(2) The Owner has made a determination that the goods or services are necessary for the
Owner to perform its functions and that, absent such an exemption,the Owner would
be unable to obtain the goods or services for which the Bid/Proposal is offered. Such
determination shall be made by the Owner in writing and shall be a public document.
-5." Bidder or Proposer shall sign and notarize the attached "Certification of Compliance with
the Iran Divestment Act"form with your proposal.
2019 PROPOSAL-19
Elizabeth Field Airport. Airport:Entrance Road Rehabilitation
CERTIFICATION OF COAWLIANCE WITH THE IRAN DIVESTMENT ACT
As a result-of the Iran Divestment Act of 201.2(the"Act"), Chapter I of the 2012 Laws of New York, a
new provision has been added to State Finance Law(SFL) § 165-a and New York General Municipal Law
§ 103-g, both effective April 12;2012. Under the Act the Commissioner of the Office of General Services
(OGS)will be developing a list of"persons"who are engaged in"investment activities in Iran" (both are
defined terms in the law)(the "Prohibited Entities List"). Pursuant to*SFL,§ 165-a(3)(b),"the initial Iist-is
expected to be issued no later than 120 days after the Act's effective date at which time it will be posted on
the OGS website.
By submitting a bid in response-to-this solicitation or by assuming the responsibility of Contract awarded-
heret►nder,each Bidder/Contractor,any person signing on behalf of any Bidder/Contractor and any assignee
or subcontractor and, in the case of a joint bid, each party thereto, certifies,under penalty of perjury,that
once the Prohibited Entities List is posted on the OGS website,that to the best of its knowledge and belief,
that each Bidder/Contractor and-any-subcontractor or-assignee is not identified on the Prohibited Entitieg
List created pursuant to SFL§ 165-a(3)(b-).
Additionally, Bidder/Contractor is advised that once the Prohibited Entities List is posted on the OGS
Website, any Bidder/Contractor seeking to renew or extend a Contract or assume the responsibility of a
Contract awarded in response to this solicitation must certify at the time the Contract is renewed,extended
or assigned that it is not includes on the Prohibited Entities List.
During the term of the Contract, should the Owner receive information that a Bidder/Contractor is in
violation of the above-referenced certification,the Owner will offer the person or entity an opportunity to
respond, If the person or entity fails to demonstrate that he/she/it has ceased engagement in the-investment
which is in violation of the Act wnhiii 90 days after the determination of such violation,then the Owner
shall take such action-as may be appropriate including, but not limited to, imposing sanctions, seeking
compliance,-recovering damages or declaring the Bidder/Contractor in default.
The Owner reserves the right to refect any bid or request for assignmentfor a Bidder/Contractor-that appears,
on the Prohibited Entities List prior to the award df a contract and to pursue a responsibility review with
respect to any Bidder/Contractor that is awarded a contract and subsequently appears on the Prohibited
Entities List.
1,_ James Wray _ , being duly sworn,deposes and says
that he/she is the ----M-eraber of the B&W Paving&Landscaping LLC
Corporation and that neither the Bidder/Contractor nor any proposed subcontractor is identified on the
Prohibited Entities List.
SIGNED
SWORN to before me this
3 day of June 20 20
Notary Public: /
s form mast>te cottn leted and submitted with the Proposal.)
ELIZABETH P MUCHA
Notary Public,State of Connecticut
MY CommWion ExEirou May 31,2822
2018 PROPOSAL-20
Elizabeth Field Airport Airport Entrance Road Rehabilitation
DISADVANTAGED BUSINESS ENTERPRISE(DISE) STATEMENT
The requirements of 49 CFR Part 26, Regulations of the U.S. Department of Transportation, apply to this
contract. It is the policy of the Sponsor to practice nondiscrimination based on race,color,sex,or national
origin in the award or performance of this contract.
DISADVANTAGED BUSINESS ENTERPRISE:
The requirements of 49 CFR Part 26, Regulations of the U.S. Department of Transportation, apply to this
contract. It is the policy of the Sponsor to practice nondiscrimination based on race,color,sex,or national
origin in the award or performance of this contract. All funis qualifying under this solicitation are
encouraged to submit proposals. Award of this contract will be conditioned upon satisfying the DBE
requirements of this contract. These requirements apply to all bidders, including those who qualify as a
DBE. An overall DI3E goal of 2.63 percent will be utilized for this contract.The bidder shall make good
faith efforts, as defined in Appendix A,49 CFR Part 26,to meet the contract goal for DBE participation in
the performance of this contract. Excerpts from 49 CFR Part 26 are included in Section 70-21.13.
As a matter of responsibility,within 5 days after the opening of bids,all Bidders or Offerors shall submit
the"Contractor's DBE Plan",and"DBE Letter of Intent Forms"from each of the DBE funis the Bidder or
Offeror intends to use.If the DBE goal is not met, Bidder or Offeror shall include documentation of good
faith efforts with its DBE Plan.
The Contractor's DBE Plan Form and DBE Letter Of Intent Form are located in Section 200.The website
for the Unified Certification Program directory in the state of New York is: http://www.nysitep.net/.
CERTIFICATION OF BIDDER/OFFEROR: The undersigned Bidder or Offeror will satisfy the DBE
requirements of these specifications in the following manner(please check the appropriate space):
X The Bidder or Offeror is committed to meeting or exceeding the DBE utilization goal stated
above on this contract.
The Bidder or Offeror, is unable to meet the DBE utilization goal stated above.However,
we are committed to a minimum of % DBE utilization on this contract, and include
documentation demonstrating good faith efforts.
SMALL BUSINESS PARTICIPATION:
This Contract does not have a Small Business Element(SBE)set-aside. r
IRS Number: 06-1466584
James Wray,Member
Si ature and Title
2018 PROPOSAL-21
Elizabeth Field Airport Airport Entrance Road Rehabilitation
BIDDER'S LIST COLLECTION FORM
(Bidder's Information)
The sponsor is required by CFR Title 49, Subtitle A, Part 26, Subpart A, Section 26.11 to collect the
following information from the bidder. As such, it is the responsibility of the bidder to complete the
following information as a condition of submitting a proposal for this project. The sponsor will consider
incomplete information to be an irregular proposal.
Airport Name: Elizabeth Field Airport AIP No. 3-36-0029-023-2018
Project Name: Airport Entrance Road Rehabilitation
Bidder's Information
Firm Street Address, DBE/Non
Firm Name City,State,Zip Code, DBE Age of Firm Annual Gross
Phone No. Status Receipts
B&W Paving& 70'Foster Road ElLess than 1 year 0 Less than$500K
Landscaping Waterford CT 06385 ❑ 1-3 years ❑ $500K-$1M
LLC 860-572-9942 ❑ DBE ❑ 4-7 years ❑ $1-$2M
Non-DBE
❑ 8-10 years ❑ $2-$5M
CX More than 10 yrs. } More than$5M
(This form must be completed and submitted with the ProposaI.)
2018 PROPOSAL-22
Elizabeth Field Airport Airport Entrance Road Rehabilitation
BIDDER'S LIST COLLECTION FORM
(Subcontractor's Information)
The sponsor is required by CFR Title 49,.Subtitle AA, Part 26, Subpart A, Section 26.11 to collect the
following information from each subcontractor submitting a quote,bid or proposal to the bidder.As such,
it is the responsibility of the bidder to complete the following information as a condition of submitting_ a
proposal for this project.The sponsor will consider incomplete information to be an irregular proposal.
Please note that the information requested below must be filled out for each quote received by the bidder,
regardless"of DBE status. For example, if the bidder requests quotes from three contractors for electrical
work, the information requested_below must filled out for the three subcontractors.It is important to note
that providing the information does.not commit the bidder to using any one of the three subcontractors Mt
the work.
Airport Name: Elizabeth Field Airport AIP No. 3-36-0029-023-2018
Project Name: Airport Entrance Road Rehabilitation
Subcontractor's Information
Firm Street Address, DBE/Non
Firm Name City,State,Zip Code, DBE Age of Firm Annual Gross
Phone No. Status Receipts
790 Grundy Ave ❑ Less than 1 year ❑ Less than$500K
Holbrook Plastic
Pipe Supply Holbrook NY 11741 X DBE ❑ 1-3 years ❑ $500K-$1M
❑ Non-DBE ❑ 4-7 years ❑ $1-$2M
❑ 8-10 years ❑ $2-$5M
K More than 10 yrs. fK More than$5M
❑ Less than 1 year ❑ Less than$500K
11 DBE ❑ 1-3 years ❑ $500K-$1M
❑ Non-DBE El 4-7 years ❑ $1-$2M
❑ 8-10 years ❑ $2-$5M
❑ More than 10 yrs. ❑ More than,$5M
❑ Less than 1 year ❑ Less than$500K
❑ DBE ❑ 1-3 years ❑ $500K-$1M
❑ Non-DBE ❑ .4-7 years ❑ $142NI
❑ 8-10 years ❑ $2-$5M
❑ More than 10 yrs. ❑ More than$5M
2018 PROPOSAL-23
Elizabeth Field Airport Airport Entrance Road Rehabilitation
Firm Street Address, DBE/Non Annual Gross
Finn Name City,State,Zip'Code, DBE Age of Firm Receipts
Phone No: Status
❑ Less than 1 year Q Less than$500K
n DBE D 1-3 years 0 $500K-$1M
Nan-DBE C] 4-7 years I1 $1$2M
❑ 8-10 years B $2-$5M
0 More than 10,yrs. "D More than$5M
LS Less than 1 year 0 Less than$500K
DBE
❑ 1-3 years ❑ SSOOK-$1M
"i Non-DBE 4-7 years Of $I-$2M
D 840 years 0 $245M
DD
More than 10 yrs. '! More than$SM
Less than 1 year ❑ Less than$500K
ICI ME
❑ 1-3 years ?1 $500K-$1 M
EI Non-DBE
G 4-7 years i=; $1-$2M
❑ 8-10 years 11 $2-$5M
D More than 10 yrs. 0 More than$5M
7 Less than 1 year' 0 Less than$500K
DEE D 1-3 years G $50OK-$1M
L Nan-DBE U 4-7 years ::? $I-$2M
0 8-10 years $245M
3 More than 10 yrs. i 1 More than$5M
(Copy this form and submit with your original proposal if more space is needed.)
(This form mast be completed and submitted with the Proposal.)
2018 PROPOSAL-24
Elizabeth Field Airport Airport Entrance Road Rehabilitation
SAFETY PLAN COMPLIANCE DOCUMENT (SPCD) CERTIFICATION
Project Location: Southold NY
r
Project dame: Elizabeth Airport
r
Contractor's Official Name: B&W Paving&Landscaping LLC
Contact Person: James Wray Telephone: 860-572-9942
Street Address: 70 Foster Road
City: Waterford State: -CT Zip: 06385
Certification Statement-
I certify thatl have reviewed the General and Construction safety and Phasing Plan(CSPP)included in the
Contract Drawings section of the Contract Documents-and if awarded this Contract, I will abide by its
requirements as presented in the Contract Drawings.
I certify.that I have read the Safety Plan Compliance Document(SPCD)included in the Contract Documents
and if awarded this Contract,I will abide by its"requirements.as written;
I certify that I will provide the information required in the SPCD prior to the start of construction worl,if
awarded this Contract, and that Twill provide any additional information requested by the Owner.
James Wray
Printed Name of Signer Signature
Member 6/3/2020
Title Date
END OF PROPOSAL
2018 PROPOSAL 25
B&W Paving i�-a"'d :aping, LLC
70 Foster Road
Waterford, CT 06385
RECEIVED ,
JUN 4 2020
Southold Town Clerk
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