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RES 2012-0425 - Bid from Swain Construction Company • .� tAAHA,Ned Parks,Recreation& ;��,� �� j Public Property Department Omaha/Douglas Civic Center 12 fl R ,� 2 1819 Farnam Street,Suite 701 �r �t3 �" Omaha,Nebraska 68183-0701 PAO44 FEBgUt•I- CITY Cr F� R f i (402)444-5900 Q ' M ' E R, S K FAX(402)444-4921 City of Omaha Jim Suttle,Mayor March 27 2012 Honorable President and Members of the City Council, Transmitted herewith is a BID TABULATION and a RESOLUTION authorizing the Purchasing Agent to issue a Purchase Order to Swain Construction Company, to furnish all labor, materials, and equipment necessary to complete the construction of new concrete walks and related improvements at the ball fields at White Hawk Park, 20000 F Street, Omaha, Nebraska, in the total amount of$44,900.00, for the Parks, Recreation and Public Property Department. Swain Construction Company submitted the lowest and best bid. The following bids were received on February 29, 2012: CONTRACTOR BID SWAIN CONSTRUCTION COMPANY $ 44,900.00 (LOWEST BID) Mackie $ 53,495.00 Dostals $ 58,000.00 Navarro $ 63,303.02 Ryba $ 66,782.00 JMN $112,000.00 Swain Construction Company has on file a current Annual Contract Compliance Report Form (CC-1). As is City policy, the Human Relations Director will review the contractor to ensure compliance with the Contract Compliance Ordinance. Finance Department is authorized to pay the Funds in the total amount of$44,900.00 to Swain Construction Company from the 2010 Parks and Recreation Bond Fund No. 13355 and Organization No. 117316, 2011 Issue Parks and Cultures Bond. The Parks, Recreation and Public Property Department recommends the acceptance of the bid from Swain Construction Company being the lowest and best bid received, and requests your consideration and approval of this Resolution. { .3 -,� CITY ATTORNEY DATE p:1598tmb 4By /� ' ` cilmember Adopted M 2 7 2012 0 � . .-dop /Zg/rz City Cler Approved /i' ayor fications at the price(s)set forth In thin Exhibit conditioned upon execution of a contract by the undersigned with the City of Omaha. The undersigned/contractor agrees that irony rite representation made regarding utilization email and/or emerging smell business by the bidder knowing them to be false,or Utters is a failure by the successful bidder(I.e.the Contractor)to implement the staled agreements,intentions,objectives,goat,and comments ents set forth herein without approval of the Pubic Works Dtactor,such action shal constitute a material breach of the contract,entitling the City of Omaha to reject the contractors bid or to terminate the Centralia.default The right to so terminate shal be in addition to,end not In Neu of,any other rights or remedies the City of Omaha may have for other defauits under the Contact,under City of Omeha's Contract Compliance Ordinance e or otherwise.Addlionaiy.the u ned/contnxdorvra be subject to the terms of any future contract awards. Signature <JC �� _ Telephone Number PO)) (0i q3 C/ • Title ()UVA/JG- Date of Signing a- (o-La Firm.or Corporate Name e,j1l,Y1ars L_O(y)I.P k • Address 569 Mido,t0!(C &) • • • • • • y issuing said bond shall be licensed by the State of Nebraska,and listed on ' the current edition of Circular 570 of the United States Dept of the Treasury. // __ / • SIGN ALL COPIES Firm (k-A Sc)Ns L_ JJ,OMP �7 Cf)A'Ae1i • By iv ./1 i J4r nr'U Title (` r.r/k4,0 i • 1 to page 2 of 5 for Unit Prices and Bad Bond Information and page 3 of 5 for Completion Date,Performance Bond,Insurance Requirements and Pre-Bid _ Meeting Information. Refer any questions regarding the Bid or Contract Documental dhoctlyto the Park Planning,DlvIslon at 4024W.3198 et as noted in the Conjtct Documents. All bidders awarded a contract In the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on lie with the Human Relations Department the Contract Compliance Report(Form CC-1).This report shall be in elect for 24 months from the date received by the Human Relations Department Any questions regarding the Contract Compliance - Ordinance or PBEIDEB Listbrgs should be directed to the Human Relations Department at 402-4445055. (Please Print Legibly or Type) Firm JtiG1& ONs CO elyielc. t-Oyut/� Incorporated in AiC. (State) Name l,t°.iLi1 i - �J is r I��r)nl Signature • a • Title ( (,slitiv r _ Phone (/vim l,- 3(0/ Fax P(9) s/-2 -l9 • Address n ( a! it.e��e L'U�, /)iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 Page -2- Honorable President and Members of the City Council, Res ectfully sub itte , Brook Bench, Acting Director Date Parks, Recreation and Public Property Department Approved as to Funding: Approved: aril , -i.V l2-- f �j 9'i Pam Spaccarotella Date Human Rights and Relations Date Finance Director Referred to City Council for Consideration:7--7-<- --''''S Mayor's O1file/Title Date p:1595tmb 20/2_, /Z Mayor's Offi, e/Title Date p:1597tmb • • • r 'n1 • • `f A A{f �. ;s . m 0 0 .� H W d v Z V } CO O E2 O. Nr CO o a ca 2 I-- W o N z oi.. Cu CC n 2 > a co CO N 2 O (La b Ill co V M z a CO ' 0 a) o Y E- W tri N o Z U 1- 2 = a M a to m 0 0 Ci Z H W o a) E2 ni a CO O N0` 0 o Z o0 O to a. i N Q d v a) m a N 0 = J x O CI c a CU 03 i- MI'y• m m Z 0_ p al -L.. - S u O J • }O� ..hed a_ a) 0 a }- m c4 .c Z >+ E5 a acn v C z -c W Ili a • O a, Y V Ws 2 o U p N m Y a) a Ta in o 11 LA. 2 z Z Cf O 0 co O 0 = z �' co co O O N U Q _ NO CI F" c a m e m = U o al t d C m `� co fa- 0 Lt. 0n. a n Construction Company has on file a current Annual Contract Compliance Report Form (CC-1). As is City policy, the Human Relations Director will review the contractor to ensure compliance with the Contract Compliance Ordinance. Finance Department is authorized to pay the Funds in the total amount of$44,900.00 to Swain Construction Company from the 2010 Parks and Recreation Bond Fund No. 13355 and Organization No. 117316, 2011 Issue Parks and Cultures Bond. The Parks, Recreation and Public Property Department recommends the acceptance of the bid from Swain Construction Company being the lowest and best bid received, and requests your consideration and approval of this Resolution. { .3 -,� CITY ATTORNEY DATE p:1598tmb 4By /� ' ` cilmember Adopted M 2 7 2012 0 � . .-dop /Zg/rz City Cler Approved /i' ayor fications at the price(s)set forth In thin Exhibit conditioned upon execution of a contract by the undersigned with the City of Omaha. The undersigned/contractor agrees that irony rite representation made regarding utilization email and/or emerging smell business by the bidder knowing them to be false,or Utters is a failure by the successful bidder(I.e.the Contractor)to implement the staled agreements,intentions,objectives,goat,and comments ents set forth herein without approval of the Pubic Works Dtactor,such action shal constitute a material breach of the contract,entitling the City of Omaha to reject the contractors bid or to terminate the Centralia.default The right to so terminate shal be in addition to,end not In Neu of,any other rights or remedies the City of Omaha may have for other defauits under the Contact,under City of Omeha's Contract Compliance Ordinance e or otherwise.Addlionaiy.the u ned/contnxdorvra be subject to the terms of any future contract awards. Signature <JC �� _ Telephone Number PO)) (0i q3 C/ • Title ()UVA/JG- Date of Signing a- (o-La Firm.or Corporate Name e,j1l,Y1ars L_O(y)I.P k • Address 569 Mido,t0!(C &) • • • • • • y issuing said bond shall be licensed by the State of Nebraska,and listed on ' the current edition of Circular 570 of the United States Dept of the Treasury. // __ / • SIGN ALL COPIES Firm (k-A Sc)Ns L_ JJ,OMP �7 Cf)A'Ae1i • By iv ./1 i J4r nr'U Title (` r.r/k4,0 i • 1 to page 2 of 5 for Unit Prices and Bad Bond Information and page 3 of 5 for Completion Date,Performance Bond,Insurance Requirements and Pre-Bid _ Meeting Information. Refer any questions regarding the Bid or Contract Documental dhoctlyto the Park Planning,DlvIslon at 4024W.3198 et as noted in the Conjtct Documents. All bidders awarded a contract In the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on lie with the Human Relations Department the Contract Compliance Report(Form CC-1).This report shall be in elect for 24 months from the date received by the Human Relations Department Any questions regarding the Contract Compliance - Ordinance or PBEIDEB Listbrgs should be directed to the Human Relations Department at 402-4445055. (Please Print Legibly or Type) Firm JtiG1& ONs CO elyielc. t-Oyut/� Incorporated in AiC. (State) Name l,t°.iLi1 i - �J is r I��r)nl Signature • a • Title ( (,slitiv r _ Phone (/vim l,- 3(0/ Fax P(9) s/-2 -l9 • Address n ( a! it.e��e L'U�, /)iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 i Bid Fodn(Rev.01-2012) • DOUGLAS COUNTY REQUEST FOR BID AND BID SHEET ON: CITY OF OMAHA Concrete Walks at Whitehawk Park BaWiields RETURN BIDS TO: Published:8 February 2012 CITY CLERK,LC-1 OMAHA-DOUGLAS CIVIC CENTER NOT AN ORDER Page 1 of 5 Pages 1819 Farnam Street it Omaha,Nebraska 68183-0011 . BID BOND OR CERTIFIED CHECK REQUIRED IN THE AMOUNT OF 5%IF THE TOTAL AMOUNT FOR THE ITEMS OFFERED IS$20,000 OR MORE. BID BOND OR CERTIFIED CHECK SHALL BE MADE PAYABLE TO"CITY OF OMAHA". Bid Closing Date: gip;;;, - 11:00 A.M. 29 February 2012 . IMPORTANT 1.Bid must be in the office of the Acting CITY CLERK,LC-1,OMAHA-DOUGLAS CIVIC 5.810 MUST INCLUDE ANY DELIVERY OR SHIPPING CHARGES. CENTER, 1819 Famam Street, Omaha, NE 68183-0011 by closing date and time 6.When submitting bid on items listed,bidder may on a separate sheet,make suggestions indicated,in sealed envelope marked BID ON:Concrete Walks at Whitehawk Park covering reduction in costs wherever this is possible through redesign,change of material Ballfields. or utilization of standard items or quantity change. 2.As evidence of good faith a bid bond or certified check must be submitted with bid.Bid Bond or certified check shall be made payable to the'City of Omaha'. FAILURE TO DO PLEASE DO NOT CALL FOR THIS INFORMATION. SO IS CAUSE FOR REJECTION 3.Right Is reserved to accept or reject any or all bids in their enlrety and the bidders shall IIhave the right to appeal any decision to the City Council. Right is also reserved to accept or reject any part of your bid unless otherwise Indicated by you. 4.If Federal Excise Tax applies,show amount of same and deduct. Exemption certificates will be furnished.Do not include tax in bid. Quote your lowest price,best delivery and terms,F.O.B.delivery point on the terms(s)listed below: mi This is to certify that the undersigned has read and examined (a)the advertisements, (b)the requirements for bidding and instructions to bidders and (c) the specifications and drawings prepared by the Park Planning Division of the Omaha Parks, Recreation & Public Property Department for the Concrete Walks at Whitehawk Park Ballfields and that the bidder has made all the examinations and investigations required by said documents. IIBIDDER ACKNOWLEDGES RECEIPT OF ADDENDA NO 11/ ,THROUGH . It is understood (a) that as to the contract which may be awarded upon this proposal, the Contract period will be the term beginning with the notice to proceed and ending with the acceptance of the work,the number of consecutive calendar days hereinafter agreed on;and(b)that it is the intention of the Park Planning Division that a contract shall be awarded to the bidder regarded by the City of Omaha as having.submitted the lowest and best bid, having regard for his fitness and capacity to furnish in sufficient quantities the quality of material considered by said Park Planning Division best to meet the it requirements of the Park Planning Division;material purchased for this project will be State of Nebraska and City sales tax exempt. On the foregoing,understand that the bidder hereby offers and proposes to furnish all labor,all materials and all else whatsoever necessary to construct and properly finish all the work in connection with " Concrete Walks at Whitehawk Park Ballfields, 4506 S. 194th Street, Omaha, Nebraska 68135" in IIaccordance with the provisions of this proposal and contract documents to the satisfaction of the City of Omaha Parks, Recreation and Public Property Department for the lump sum of: BASE BID: r vp~ ($ '/ 9vo GO 1 Note: Refer to page 2 of 5 for Bid Bond,Completion Date&Performance Bond and page 3 of 5 for Insurance Requirements and Unit Prices. Refer any questions regarding the Bid or Contract Documerlti directly to the Parl PlanningDivision at 402-444.5900 or as noted in the Contract Documents. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Relations Department the Contract li Compliance Report(Form CC-1).This report shall be in effect for 24 months from the date received by the Human Relations Department.Any questions regarding the Contract Compliance Ordinance or P8E/DEB Listings should be directed to.the Human Relations Department at 402-444-5055. 111 (Please Print Legibly or Type) Firm •�wRiw CpwsT• .4 I. •4 •fed in II • • Name L.4,ae Xv4,,v cam..Signatur/ 4„ I. V- / IITitle RRd'S. Phone S7/-///0 Fa d)S7/-3147 • Address 4002 'V ge n Qi,Ci-cse , aw,vo /VE. 6y'/34i III Street/P.O.BBox City State I Zip • E-Mail Address I(Yl cdet t, SwCi n.-Qvn\C(J3(►vt-6-11 • 0.--b+3-7 I . )iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 Bid Form(Rev.01-2012) DOUGLAS COUNTY REQUEST FOR BID AND BID SHEET • ON: CITY OF OMAHA Concrete Walks at Whitehawk Park Bailfields NOT AN ORDER • Page 2 of 5 Pages The bidder hereby states that the above total cost to the City of Omaha includes all material,taxes,insurance royalties;transportation charges,use of all necessary tools and equipment, supervision, inspection and tests of materials, bond and overhead expense, all equipment furnished in accordance with the requirements of the contract documents considered severally and collectively. It is understood that the contract documents shall consist of the advertisement,the requirements forbidding and instruction to bidders,this proposal, the contract documents titled " Concrete Walks at Whitehawk Park Ballflelds",dated 8 February 2012 and the duly executed agreement or contract proper;that,said documents are complementary and that which is required,shown or specified by any one of these,shall be as binding as if required by all. The bidder hereby represents that the price contained in this proposal is neither directly nor indirectly the result of any agreement or any secret understanding with anyone with respect to any provisions contained in this proposal. BID BOND: In accordance with the requirements for bidding and instructions to bidders,there is deposited herewith a bid bond or a certified check payable to the City of Omaha,in the sum of: •r57P o.Boo _ ($ ),which is at feast five percent(5%)of the aggregate amount of the proposal. It is agreed that, in the event the bidder is awarded a contract based on this proposal,or a part thereof and fails or refuses to execute a written contract or fails to furnish a performance bond within ten days after the award of said contract,the sum deposited herewith shall be retained by the City of Omaha as liquidated damages and not as a penalty,as it is expressly agreed that said sum is a fair measure of the damages which will be sustained by the City of Omaha in case of any such failure or refusal on the part of the bidder. The said sum,however,will be returned to the bidder; if and when he shall faithfully keep and perform all of the conditions set fourth in the advertisement and the requirements for bidding and instructions to bidders,and furnish an acceptable surety bond. The surety company issuing said bond shall be licensed by the State of Nebraska,and listed on the current edition of Circular 570 of the United States Dept.of the Treasury. NOTICE: Unless the foregoing.proposal is free from alterations,additions and deductions and unless the name of the bidder as signed thereto is complete and correct,in accordance with the instructions to bidders,it may be rejected as informal. COMPLETION DATE: • The contract completion date for this project shall be 18 May 2012. All work associated with the project shall be completed on or before this date. PERFORMANCE BOND: Refer to Specification Section 00200, 'Instructions to Bidders", Part 2.10, "Bond Submission' and Section 00400, "Performance, Payment Maintenance Bond"requirements. . • SIGN ALL COPIES Firm iw• • 4 • By tic iGc/ 'f � . Title S • sh all labor,all materials and all else whatsoever necessary to construct and properly finish all the work in connection with " Concrete Walks at Whitehawk Park Ballfields, 4506 S. 194th Street, Omaha, Nebraska 68135" in IIaccordance with the provisions of this proposal and contract documents to the satisfaction of the City of Omaha Parks, Recreation and Public Property Department for the lump sum of: BASE BID: r vp~ ($ '/ 9vo GO 1 Note: Refer to page 2 of 5 for Bid Bond,Completion Date&Performance Bond and page 3 of 5 for Insurance Requirements and Unit Prices. Refer any questions regarding the Bid or Contract Documerlti directly to the Parl PlanningDivision at 402-444.5900 or as noted in the Contract Documents. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Relations Department the Contract li Compliance Report(Form CC-1).This report shall be in effect for 24 months from the date received by the Human Relations Department.Any questions regarding the Contract Compliance Ordinance or P8E/DEB Listings should be directed to.the Human Relations Department at 402-444-5055. 111 (Please Print Legibly or Type) Firm •�wRiw CpwsT• .4 I. •4 •fed in II • • Name L.4,ae Xv4,,v cam..Signatur/ 4„ I. V- / IITitle RRd'S. Phone S7/-///0 Fa d)S7/-3147 • Address 4002 'V ge n Qi,Ci-cse , aw,vo /VE. 6y'/34i III Street/P.O.BBox City State I Zip • E-Mail Address I(Yl cdet t, SwCi n.-Qvn\C(J3(►vt-6-11 • 0.--b+3-7 I . )iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 • if Bid Form(Rev.01-2012) DOUGLAS COUNTY REQUEST FOR BID AND BID SHEET ON: CITY OF OMAHA Concrete Walks at Whitehawk Park Bailfields NOT AN ORDER Page 3 of 5 Pages INSURANCE REQUIREMENTS: N Refer to Specification Section 00500, "General Conditions of the Contract for Construction", Part 2.15, "Contractor's Insurance" for insurance requirements. IUNIT PRICES: C.Y. = CubicYard S.F. = Square Foot S.Y. = Square Yard V.F. = Vertical Foot L.F. = Linear Foot EA. = Each The undersigned further proposes and agrees that if the amount of the work required be increased or decreased,by a request of the Owner,the following supplemental Unit Prices will be the basic price in place for computing extra cost or credit. Each Unit Price shall include all equipment, I tools,labor, permits,fee,etc.incidental to the completion of the work involved based on the construction detail(s)on the Contract Drawings and all materials listed in the noted Specification Section. Unit prices will be decreased ten percent(10%)if change requested is a reduction of work. • 111 UNIT PRICE DESCRIPTION 1. Fill Dirt(haul in,place&compact)-Section 02220 $ /: ,SG /CY 2. . Concrete Wheel Stops-Section 02519 $ SZ-'" /EA 3. 5-1/2"Fiber-Reinforced Concrete Walk Pavement-Section 02527 $ 3 ?/ /SF 4. Seeding(only)-Section 02936 $ /41 ISF 5. Hydromulching(only)-Section 02936 $ 'd 7 /SF SIGN ALL COPIES Firm .pia . . By *-zz-pn -PA.z.e. Title is proposal,or a part thereof and fails or refuses to execute a written contract or fails to furnish a performance bond within ten days after the award of said contract,the sum deposited herewith shall be retained by the City of Omaha as liquidated damages and not as a penalty,as it is expressly agreed that said sum is a fair measure of the damages which will be sustained by the City of Omaha in case of any such failure or refusal on the part of the bidder. The said sum,however,will be returned to the bidder; if and when he shall faithfully keep and perform all of the conditions set fourth in the advertisement and the requirements for bidding and instructions to bidders,and furnish an acceptable surety bond. The surety company issuing said bond shall be licensed by the State of Nebraska,and listed on the current edition of Circular 570 of the United States Dept.of the Treasury. NOTICE: Unless the foregoing.proposal is free from alterations,additions and deductions and unless the name of the bidder as signed thereto is complete and correct,in accordance with the instructions to bidders,it may be rejected as informal. COMPLETION DATE: • The contract completion date for this project shall be 18 May 2012. All work associated with the project shall be completed on or before this date. PERFORMANCE BOND: Refer to Specification Section 00200, 'Instructions to Bidders", Part 2.10, "Bond Submission' and Section 00400, "Performance, Payment Maintenance Bond"requirements. . • SIGN ALL COPIES Firm iw• • 4 • By tic iGc/ 'f � . Title S • sh all labor,all materials and all else whatsoever necessary to construct and properly finish all the work in connection with " Concrete Walks at Whitehawk Park Ballfields, 4506 S. 194th Street, Omaha, Nebraska 68135" in IIaccordance with the provisions of this proposal and contract documents to the satisfaction of the City of Omaha Parks, Recreation and Public Property Department for the lump sum of: BASE BID: r vp~ ($ '/ 9vo GO 1 Note: Refer to page 2 of 5 for Bid Bond,Completion Date&Performance Bond and page 3 of 5 for Insurance Requirements and Unit Prices. Refer any questions regarding the Bid or Contract Documerlti directly to the Parl PlanningDivision at 402-444.5900 or as noted in the Contract Documents. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Relations Department the Contract li Compliance Report(Form CC-1).This report shall be in effect for 24 months from the date received by the Human Relations Department.Any questions regarding the Contract Compliance Ordinance or P8E/DEB Listings should be directed to.the Human Relations Department at 402-444-5055. 111 (Please Print Legibly or Type) Firm •�wRiw CpwsT• .4 I. •4 •fed in II • • Name L.4,ae Xv4,,v cam..Signatur/ 4„ I. V- / IITitle RRd'S. Phone S7/-///0 Fa d)S7/-3147 • Address 4002 'V ge n Qi,Ci-cse , aw,vo /VE. 6y'/34i III Street/P.O.BBox City State I Zip • E-Mail Address I(Yl cdet t, SwCi n.-Qvn\C(J3(►vt-6-11 • 0.--b+3-7 I . )iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 Bid Form(Rev.01-2012) DOUGLAS COUNTY REQUEST FOR BID AND BID SHEET ON: CITY OF OMAHA Concrete Walks at Whitehawk Park Ballfields NOT AN ORDER Page 4 of 5 Pages UTILIZATION OF SMALL AND EMERGING SMALL BUSINESSES It is the policy of the City of Omaha that Small and Emerging Small Businesses shall have the maximum practicable opportunity to participate in City of Omaha projects. Consequently,the requirements of the Small and Emerging Small Business Program ordinance apply to this solicitation. For questions on certification, including a listing of what firms are certified under the Small and Emerging Small Business Program, please see the City of Omaha website at www.ci.omaha.ne.us or contact the Human Rights and Relations Department at 444-5055. CERTIFIED GROUP(SI With regard to this solicitation, the City has determined that a sufficient number of companies exist within the following CERTIFIED GROUP(S)**: [ XX ] Tier I Emerging Small Business [ XX j Tier II Emerging Small Business • [ XX ] Tier I Small Business [ XX j Tier II Small Business FIRM TO FULFILL [ ] this entire contract [ XX ] a portion of this contract as defined below—Furnish all labor,all materials and all else whatsoever necessary to construct and properly finish: Concrete Pavement installation and finishing(Specification 025271 • "Please note: in order to be considered for this solicitation, your firm must be CERTIFIED in the above-referenced category PRIOR TO the bid opening date of this solicitation. Pursuant to Omaha Municipal Code Section 10-203(d), the above-referenced category of bidders will be given preference in the selection of this bid. Submittals by non-certified bidders or.the failure of a prime contractor to utilize a certified subcontractor in the above-designated portion of this contract shall be deemed non-responsive and rejected. Bidders must complete Exhibit "A", titled "SMALL AND/OR EMERGING SMALL BUSINESS DISCLOSURE PARTICIPATION FORM"and submit it with their bid to be considered. • SIGN ALL COPIES Firm ;41+ . 4. y 2 Title Os• or bidding and instructions to bidders,and furnish an acceptable surety bond. The surety company issuing said bond shall be licensed by the State of Nebraska,and listed on the current edition of Circular 570 of the United States Dept.of the Treasury. NOTICE: Unless the foregoing.proposal is free from alterations,additions and deductions and unless the name of the bidder as signed thereto is complete and correct,in accordance with the instructions to bidders,it may be rejected as informal. COMPLETION DATE: • The contract completion date for this project shall be 18 May 2012. All work associated with the project shall be completed on or before this date. PERFORMANCE BOND: Refer to Specification Section 00200, 'Instructions to Bidders", Part 2.10, "Bond Submission' and Section 00400, "Performance, Payment Maintenance Bond"requirements. . • SIGN ALL COPIES Firm iw• • 4 • By tic iGc/ 'f � . Title S • sh all labor,all materials and all else whatsoever necessary to construct and properly finish all the work in connection with " Concrete Walks at Whitehawk Park Ballfields, 4506 S. 194th Street, Omaha, Nebraska 68135" in IIaccordance with the provisions of this proposal and contract documents to the satisfaction of the City of Omaha Parks, Recreation and Public Property Department for the lump sum of: BASE BID: r vp~ ($ '/ 9vo GO 1 Note: Refer to page 2 of 5 for Bid Bond,Completion Date&Performance Bond and page 3 of 5 for Insurance Requirements and Unit Prices. Refer any questions regarding the Bid or Contract Documerlti directly to the Parl PlanningDivision at 402-444.5900 or as noted in the Contract Documents. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Relations Department the Contract li Compliance Report(Form CC-1).This report shall be in effect for 24 months from the date received by the Human Relations Department.Any questions regarding the Contract Compliance Ordinance or P8E/DEB Listings should be directed to.the Human Relations Department at 402-444-5055. 111 (Please Print Legibly or Type) Firm •�wRiw CpwsT• .4 I. •4 •fed in II • • Name L.4,ae Xv4,,v cam..Signatur/ 4„ I. V- / IITitle RRd'S. Phone S7/-///0 Fa d)S7/-3147 • Address 4002 'V ge n Qi,Ci-cse , aw,vo /VE. 6y'/34i III Street/P.O.BBox City State I Zip • E-Mail Address I(Yl cdet t, SwCi n.-Qvn\C(J3(►vt-6-11 • 0.--b+3-7 I . )iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 41 . . . Bid form(Rev.01-2012) DOUGLAS COUNTY REQUEST FOR BID AND BID SHEET ON: CITY OF OMAHA Concrete Walks at Whitehawk Park Ballfields j ! NOT AN ORDER • `.i Page 5 of 5 Pages EXHIBIT"A" SMALL AND/OR EMERGING SMALL BUSINESS DISCLOSURE PARTICIPATION FORM (THIS FORM MUST BE SUBMITTED WITH THE BID) . In the performance of this contract.the tractor proposes and agrees to make Qoo�faith efforts to contract with etioibie City of Omaha certified small and/or emeraino small businesses,Should Lie below fisted small or ememine small business subcontractor be determined to be unable to orlon successfully or is not performing satisfactorily.the contractor , shall obtain prior approval from the Public Works Department Director or a designee.for substitution of the below fisted subcontractor with a City of Omahg certified small or ememinq small business. By submitting this form,the bidder is certifying that it has afforded suboontrac s particaaatino in the grogram(h2 oppodunt 19 submit bids on thi%proiect, Type of work and • Projected • • contract item or commence- • Name of small or Address parts thereof to rent and Agreed price Percentage(%) emerging small be performed completion with SB/ESB business date of work S medAv 4w%Teo 6 '4997�` �.,4lL urox Itt},, l -1411 Zo,Z /00 7d baaded> • • • Totals• /AO 476. • CERTIFICATION . The undersignedlcontractor certifies that he/she has read,understands,and agrees to be bound by small and/or emerging small business participation contract specifications,and the other terms and conditions of the Invitation for Bids. The undersigned(utter certifies that he/she Is legally authorized by the bidder to make the statements and representations in the small and/or emerging small business participation contract specifications and that said statements and representations are true and correct to the best of hislher knowledge and belief. . The undersigned will enter into format agreement(s)with small and/or emerging small businesses(which are otherwise deemed by the City of Omaha to be technically responsible to perform the work)listed in the contract specifications at the price(s)set forth In this Exhibit conditioned upon execution of a contract by the undersigned with the City of Omaha. The undersigned/contractor agrees that if any of the representation made regarding utilization of small and/or emerging small business by the bidder knowing them to be false,or if there is a failure by the successful bidder(i.e.the Contractor)to Implement the stated agreements,intentions,objectives,goals,and comments set forth herein without prior approval of the Public Works Director,such action shall constitute a material breach of the ntract,entitling the City of Omaha to reject the contractor's bid or to terminate the Contract for default.The right to so terminate shall in ddition to,an tin lieu of,any other to remedies the City of Omaha may have for other defaults under the Contract,under City of Omaha's Contract Compliance Ordi otherwise. di natty,the undersign con ctorwill be subject to the terms of any future contract awards. A.1a. Telephone Number Z} 7/-//ID Title nature . x�-v v'k I Date of Signing 1 ty !pa. Firm or Corporate Name S,rramr/:0� 6,vs7.4 • • Address 6mz At Arm //_'Yl ' l i 4 4gid 4 Nebraska 68135" in IIaccordance with the provisions of this proposal and contract documents to the satisfaction of the City of Omaha Parks, Recreation and Public Property Department for the lump sum of: BASE BID: r vp~ ($ '/ 9vo GO 1 Note: Refer to page 2 of 5 for Bid Bond,Completion Date&Performance Bond and page 3 of 5 for Insurance Requirements and Unit Prices. Refer any questions regarding the Bid or Contract Documerlti directly to the Parl PlanningDivision at 402-444.5900 or as noted in the Contract Documents. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Relations Department the Contract li Compliance Report(Form CC-1).This report shall be in effect for 24 months from the date received by the Human Relations Department.Any questions regarding the Contract Compliance Ordinance or P8E/DEB Listings should be directed to.the Human Relations Department at 402-444-5055. 111 (Please Print Legibly or Type) Firm •�wRiw CpwsT• .4 I. •4 •fed in II • • Name L.4,ae Xv4,,v cam..Signatur/ 4„ I. V- / IITitle RRd'S. Phone S7/-///0 Fa d)S7/-3147 • Address 4002 'V ge n Qi,Ci-cse , aw,vo /VE. 6y'/34i III Street/P.O.BBox City State I Zip • E-Mail Address I(Yl cdet t, SwCi n.-Qvn\C(J3(►vt-6-11 • 0.--b+3-7 I . )iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 DOUGLAS COUNTY PURCHASING DEPARTMENT 1819 FARNAM STREET 902 CIVIC CENTER OMAHA NEBR 68183 PHONE(402)444-7155 FAX(402)444-5423 13 February 2012 NOTICE TO BIDDERS: • REQUEST FOR BID ON CONCRETE WALKS AT WHITEHAWK PARK BALLFIELDS Whitehawk Park,4506 South 194th Street,Omaha, Nebraska Bid Opening Date: 29 February 2012 at 11:00 A.M CST. ADDENDUM NO. 1: Specifications: Item#1: Section 00200, "Instructions To Bidders", Part 2.07.B., "Site Inspection", delete "B" in its entirety and replace with the following: B. A non-mandatory pre-bid meeting will be held on Thursday. 16 February 2012 at 1:30 PM CST at the project site, Whitehawk Park, 4506 South 194th Street, Omaha, NE 68134. Meeting will be in the southern ballfield parking lot near Bailfields #1,#2 and#3. END OF ADDENDUM ACKNOWLEDGE RECEIPT OF THIS ADDENDUM BY SIGNING BELOW AND RETURNING THIS ' ADDENDUM COVER SHEET WITH YOUR BID. Patrick M. Burke, Douglas County Assistant Purchasing Agent • ,c1(/AJN L4a157. Lo Name of.'mAir 0 Si.47, : Title ent and Agreed price Percentage(%) emerging small be performed completion with SB/ESB business date of work S medAv 4w%Teo 6 '4997�` �.,4lL urox Itt},, l -1411 Zo,Z /00 7d baaded> • • • Totals• /AO 476. • CERTIFICATION . The undersignedlcontractor certifies that he/she has read,understands,and agrees to be bound by small and/or emerging small business participation contract specifications,and the other terms and conditions of the Invitation for Bids. The undersigned(utter certifies that he/she Is legally authorized by the bidder to make the statements and representations in the small and/or emerging small business participation contract specifications and that said statements and representations are true and correct to the best of hislher knowledge and belief. . The undersigned will enter into format agreement(s)with small and/or emerging small businesses(which are otherwise deemed by the City of Omaha to be technically responsible to perform the work)listed in the contract specifications at the price(s)set forth In this Exhibit conditioned upon execution of a contract by the undersigned with the City of Omaha. The undersigned/contractor agrees that if any of the representation made regarding utilization of small and/or emerging small business by the bidder knowing them to be false,or if there is a failure by the successful bidder(i.e.the Contractor)to Implement the stated agreements,intentions,objectives,goals,and comments set forth herein without prior approval of the Public Works Director,such action shall constitute a material breach of the ntract,entitling the City of Omaha to reject the contractor's bid or to terminate the Contract for default.The right to so terminate shall in ddition to,an tin lieu of,any other to remedies the City of Omaha may have for other defaults under the Contract,under City of Omaha's Contract Compliance Ordi otherwise. di natty,the undersign con ctorwill be subject to the terms of any future contract awards. A.1a. Telephone Number Z} 7/-//ID Title nature . x�-v v'k I Date of Signing 1 ty !pa. Firm or Corporate Name S,rramr/:0� 6,vs7.4 • • Address 6mz At Arm //_'Yl ' l i 4 4gid 4 Nebraska 68135" in IIaccordance with the provisions of this proposal and contract documents to the satisfaction of the City of Omaha Parks, Recreation and Public Property Department for the lump sum of: BASE BID: r vp~ ($ '/ 9vo GO 1 Note: Refer to page 2 of 5 for Bid Bond,Completion Date&Performance Bond and page 3 of 5 for Insurance Requirements and Unit Prices. Refer any questions regarding the Bid or Contract Documerlti directly to the Parl PlanningDivision at 402-444.5900 or as noted in the Contract Documents. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Relations Department the Contract li Compliance Report(Form CC-1).This report shall be in effect for 24 months from the date received by the Human Relations Department.Any questions regarding the Contract Compliance Ordinance or P8E/DEB Listings should be directed to.the Human Relations Department at 402-444-5055. 111 (Please Print Legibly or Type) Firm •�wRiw CpwsT• .4 I. •4 •fed in II • • Name L.4,ae Xv4,,v cam..Signatur/ 4„ I. V- / IITitle RRd'S. Phone S7/-///0 Fa d)S7/-3147 • Address 4002 'V ge n Qi,Ci-cse , aw,vo /VE. 6y'/34i III Street/P.O.BBox City State I Zip • E-Mail Address I(Yl cdet t, SwCi n.-Qvn\C(J3(►vt-6-11 • 0.--b+3-7 I . )iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 C-25A CITY OF OMAHA LEGISLATIVE CHAMBER Omaha,Nebraska RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA: WHEREAS, bids were received on February 29, 2012, to furnish all labor, materials, and equipment necessary to complete the construction of new concrete walks Wand related improvements at the ball fields at White Hawk Park, 20000 F Street, Omaha, Nebraska. The project shall include, but not be limited to the demolition and removal/disposal of existing concrete pavement and combination curb and gutter, providing/placement of fill, grading, storm drainage, installation of concrete for walks, seeding, and hydro mulching, for the Parks, Recreation and Public Property Department; and, WHEREAS, Swain Construction Company submitted the lowest and best bid, within bid specifications, attached hereto and made a part hereof, in the total amount of $44,900.00; and, WHEREAS, Swain Construction Company has complied with the City's Contract Compliance Ordinance No. 28885 in relation to Civil Rights -Human Relations; and, WHEREAS, the Mayor has recommended acceptance of this bid. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA: THAT, as recommended by the Mayor, the bid in the total amount of$44,900.00 from Swain Construction Company to furnish all labor, materials, and equipment necessary to complete the construction of new concrete walks and related improvements at the ball fields at White Hawk Park, 20000 F Street, Omaha, Nebraska. The project shall include, but not be limited to the demolition and removal/disposal of existing concrete pavement and combination curb and gutter, providing/placement of fill, grading, storm drainage, installation of concrete for walks, seeding, and hydro mulching, being the lowest and best bid received within bid specifications, attached hereto and made a part hereof, is hereby accepted. BE IT FURTHER RESOLVED, that the Purchasing Agent is authorized to issue a purchase order in conformance herewith. Funds in this amount shall be paid from the 2010 Parks and Recreation Bond Fund No. 13355 and Organization No. 117316, 2011 Issue Parks and Cultures Bond. APPROVED AS TO .• 38 596tmb j/ CITY TTORNEY DATE By cilmember Adopted `,� ' 5 2 7 20 i d � ity Cler /214Z Approved ayor if any of the representation made regarding utilization of small and/or emerging small business by the bidder knowing them to be false,or if there is a failure by the successful bidder(i.e.the Contractor)to Implement the stated agreements,intentions,objectives,goals,and comments set forth herein without prior approval of the Public Works Director,such action shall constitute a material breach of the ntract,entitling the City of Omaha to reject the contractor's bid or to terminate the Contract for default.The right to so terminate shall in ddition to,an tin lieu of,any other to remedies the City of Omaha may have for other defaults under the Contract,under City of Omaha's Contract Compliance Ordi otherwise. di natty,the undersign con ctorwill be subject to the terms of any future contract awards. A.1a. Telephone Number Z} 7/-//ID Title nature . x�-v v'k I Date of Signing 1 ty !pa. Firm or Corporate Name S,rramr/:0� 6,vs7.4 • • Address 6mz At Arm //_'Yl ' l i 4 4gid 4 Nebraska 68135" in IIaccordance with the provisions of this proposal and contract documents to the satisfaction of the City of Omaha Parks, Recreation and Public Property Department for the lump sum of: BASE BID: r vp~ ($ '/ 9vo GO 1 Note: Refer to page 2 of 5 for Bid Bond,Completion Date&Performance Bond and page 3 of 5 for Insurance Requirements and Unit Prices. Refer any questions regarding the Bid or Contract Documerlti directly to the Parl PlanningDivision at 402-444.5900 or as noted in the Contract Documents. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Relations Department the Contract li Compliance Report(Form CC-1).This report shall be in effect for 24 months from the date received by the Human Relations Department.Any questions regarding the Contract Compliance Ordinance or P8E/DEB Listings should be directed to.the Human Relations Department at 402-444-5055. 111 (Please Print Legibly or Type) Firm •�wRiw CpwsT• .4 I. •4 •fed in II • • Name L.4,ae Xv4,,v cam..Signatur/ 4„ I. V- / IITitle RRd'S. Phone S7/-///0 Fa d)S7/-3147 • Address 4002 'V ge n Qi,Ci-cse , aw,vo /VE. 6y'/34i III Street/P.O.BBox City State I Zip • E-Mail Address I(Yl cdet t, SwCi n.-Qvn\C(J3(►vt-6-11 • 0.--b+3-7 I . )iieht, A V Fov - . ( 0/OV • Street/P.O.Box City State Zip E-Mail Address ("l'�CJ n AL\ l Qm- 4.4 Aga Co 't — • — • '•- '1.-. • ..... ___,,, —... . •'p • '....',.4"E. • / 4 '.'•,:'"` • i; . t i • i',,'.1t Itl'It ' .... ., . . -. , . . 3 -..' .". Jil 1 ' ; 0A14‘0„t •; &b--:--• --';'' • , „.., i ...., __v. ,..,_.,....... ... . 11 , , . 1 ,....... ... ...J.... . i... 16, -• 4-. ,. . • , • i . .•• - . R.1 M- i . J W 4 IC ....',..1-._ -IMMIIIIIIMIal ,,,,,,.•••. ''''' ,...-.• t f .'".-- •'...": .--. ii 1 - ......— .-4=72taskft.- ..re....1_,. __... ..:, . .PA ) . .... ., ..,,, ...- ..41,:-.. I. ;.'-'1 . .....,„,>!,. 1..t . ..it.4.g.-io ....:,,,.- :;, •. --.-.1,.•,A,l',.:,;'{,--,- :2-' • .i.. • ---'. 3*•1".4"t..1'4.:'re.••••-f.,-.• ... . ' • 1 1 05 At 4'0 "b 0- a' C A v V] N. A Al *' O a O ." G . O 3 A 4 O co tJl .`3 E M A co . .n a C A N o O F, CA, m co o _ Cr R. N ci UOQ n 0 0 .j,6 a N 5 F"'' Da O �`,.; b G. O .x M N Al W O ? nZ 0 0A) CDr gQAC -CDaZ ^' y000 O �3 N cn �p O o O 0 co kC31/4-A \ �• o NJco p• y fa. 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