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BID BOOKLET FOR BUILDING CONSTRUCTION LINCOLN COUNTY ROAD DEPARTMENT 880 NE 7TH STREET NEWPORT, OREGON 97365 Grading, Structures and Paving Little Switzerland Road Retaining Wall Tidewater, Oregon Project Number: 8030 DATE: October 26, 2016 BIDDER:

Grading, Structures and Paving Little Switzerland Road

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Page 1: Grading, Structures and Paving Little Switzerland Road

BID BOOKLET

FOR BUILDING CONSTRUCTION

LINCOLN COUNTY ROAD DEPARTMENT

880 NE 7TH STREET

NEWPORT, OREGON

97365

Grading, Structures and Paving

Little Switzerland Road Retaining Wall

Tidewater, Oregon

Project Number: 8030

DATE: October 26, 2016

BIDDER:

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Bid Booklet – Little Switzerland Road Retaining Wall 2016

TABLE OF CONTENTS

Bidder’s Checklist Page Bid Divider Bid Statement ................................................................................................................................ 1 Certifications: A. Non-collusion ................................................................................................................ 2 B. Residency...................................................................................................................... 2 C. Compliance With Oregon Tax Laws ............................................................................. 3 D. Employee Drug Testing Program ....................................................................................... 3 E. Nondiscrimination ............................................................................................................... 3 F. Use of Registered Subcontractors...................................................................................... 3 Scope of Work .................................... . 4 Bid Schedule ................................................................................................................................. 5 Signature Page ............................................................................................................................ 7 Bidder/Surety/Limiting Statement Page ...................................................................................... 8 Proposal Guaranty (Bid Bond) .................................................................................................... 9 First-Tier Subcontractor Disclosure Form ................................................................................... . 10 Appendix Divider Instructions for First-Tier Subcontractor Disclosure Form Instructions for Modification to Bid for Public Improvement Sample Format for Bid Changes Sample Contract Sample General Conditions Sample Performance Bond Sample Payment Bond

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Bid Booklet – Little Switzerland Road Retaining Wall 2016

BIDDER’S CHECKLIST Before sealing this bid, have you: 1. Read and understood the certification of non-collusion?

2. Filled in all the required information on the certification of residency?

3. Read and understood the certification of compliance with Oregon tax laws?

4. Read and understood the certification regarding the employee drug testing program?

5. Read and understood the certification regarding nondiscrimination?

6. Read and understood the certification regarding use of registered subcontractors?

7. Completed the Bid Schedule according to subsection 00120.40(c)?

8. Filled in the required information on pages 8 and 9, affixed proper signatures on page 8 according to subsection 00120.40(d), and had the signatures notarized?

9. Filled in and had the Surety sign the Bid Bond, or included a cashier's check, or a certified check according

to subsection 00120.40(e)? Failure to complete and/or affix signatures as noted above will be cause for rejection of your Bid. Notes: 1) The "Performance Bond" and "Payment Bond" forms are included in the Appendix for information only. 2) Failure to submit the Subcontractor Disclosure form by the disclosure deadline will result in a non-

responsive bid. A non-responsive bid will not be considered for award.

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BID FOR PUBLIC IMPROVEMENT

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Bid Booklet – Little Switzerland Road Retaining Wall 2016 1

BID STATEMENT

To the Lincoln County Commissioners: The undersigned, as Bidder, declares that:

• This Bid is for the Work described on the "Description of Work" sheet bound in this Bid;

• The only persons or parties interested in this Bid as principals are those named in this Bid;

• The Bidder submits this Bid in accordance with and subject to the terms and conditions stated in Sections 00120 and 00130 of the specifications;

• The Bidder has obtained and become acquainted with the applicable standard specifications,

special provisions, plans, and other required provisions applicable to the particular Work for which the Bid is submitted;

• The Bidder has personally inspected the location and the site of the Work and has become

acquainted with all conditions, local and otherwise, affecting it;

• The Bidder has obtained and become acquainted with the forms of Contract and bond which are to be signed by the successful Bidder;

• The Bidder is satisfied as to the quantities and conditions and understands that in signing this bid

the bidder waives all right to claim any misunderstanding regarding these quantities and conditions; and

• The Bid guaranty submitted with this Bid, if a Bid bond, is by this reference made a part of this Bid.

The Bidder also proposes and agrees that:

• If the Board of Commissioners accepts this Bid, the Bidder will execute the Contract form furnished

by the Commission, will provide all necessary machinery, tools, apparatus, and other means of construction, and will do all Work and furnish all the Materials specified in or called for by the Contract in the manner and time prescribed in the Contract and according to the requirements of the Engineer as given in the Contract;

• The Bidder will accept, as full payment for the Work performed and the Materials and Equipment

furnished, the amount earned under the Contract as computed in the manner described in the Specifications from the quantities of the various classes of Work performed and the respective unit prices bid as these prices are given in the "Bid Schedule" bound in this Bid; and

• Any Contract awarded to the Bidder shall include the provisions required by ORS 279C.840 or 40

U.S.C. 276a; and the Contractor will be bound by and shall comply with said provisions.

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To the Board of Commissioners of Lincoln County: A. Non-collusion:

• The price(s) and amount of this Bid have been arrived at independently and without consultation, communication, or agreement with any other contractor, Bidder, or potential Bidder except as disclosed on a separately attached statement.

• Neither the price(s) nor the amount of this Bid, and neither the approximate price(s) nor

approximate amount of this Bid has been disclosed to any other firm or person who is a Bidder or potential Bidder, and they will not be disclosed before the opening of Bids.

• No attempt has been made or will be made to induce any firm or person to refrain from bidding on

this Contract, to submit a Bid higher than this Bid, or to submit any intentionally high or noncompetitive Bid or other form of complementary Bid.

• This Bid is made in good faith and not pursuant to any agreement or discussion with, or inducement

from, any firm or person to submit a complementary or other noncompetitive Bid.

• The Bidder, its affiliates, subsidiaries, officers, directors, and employees are not currently under investigation by any governmental agency and have not in the last four years been convicted of or found liable for any act, prohibited by State or Federal law in any jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract except as described on a separately attached statement.

• The Bidder understands and acknowledges that the above representations are material and

important and will be relied on by the Board of Commissioners, in awarding the Contract for which this Bid is submitted. The Bidder understands that any misstatement in this certification is and shall be treated as fraudulent concealment from the Board of Commissioners, of the true facts relating to the submission of Bids for this Contract.

B. Residency: Oregon has a reciprocal preference law concerning the residency of bidders. This law applies to contracts for projects financed without federal funds. Refer to subsection 00120.80 of the Standard Specifications for additional information, including definitions of a resident and nonresident bidder. Complete the following:

1. Check one: Bidder is a ___ resident bidder ___ nonresident bidder. 2. If a resident bidder, enter your Oregon business address: 3. If a nonresident bidder, enter state of residency:

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C. Compliance With Oregon Tax Laws:

• To the best of my knowledge, the Bidder is not in violation of any Oregon tax laws. For purposes of this certification, "Oregon tax laws" are ORS Chapters 118, 119, 314, 316, 317, 318, 320, 321, and 323; Sections 10 to 20, Chapter 533, Oregon Laws 1981 as amended by Chapter 16, Oregon Laws 1982 (First Special Session); the Home-owners and Renters Property Tax Relief Program under ORS 310.630 to 310.690; and any local tax laws administered by the Oregon Department of Revenue under ORS 305.620.

D. Employee Drug Testing Program:

• Pursuant to ORS 279C.505, that the Bidder has an employee drug testing program in place, and will maintain such program for the entire period of this Contract. Failure to maintain such program shall constitute a material breach of Contract.

E. Nondiscrimination:

• Pursuant to ORS 279A.110, that the Bidder has not discriminated against minority, women or emerging small business enterprises in obtaining any required subcontracts. The Bidder understands that it may be disqualified from bidding on this public improvement Project if the County finds that the Bidder has violated subsection (1) of ORS 279C.110

F. Use of Registered Subcontractors:

• That all subcontractors performing work on this public improvement Contract will be registered with the Construction Contractors Board or licensed by the State Landscape Contractors Board in accordance with ORS 701.035 to 701.055 before the subcontractors commence work under this Contract.

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Scope of Work

The work to be done under this contract consists of the following: 1. Implement temporary traffic control and erosion control measures.

2. Remove, protect, stockpile and reinstall existing floating docks.

3. Construct tieback retaining wall Structure No. 22311.

4. Install loose riprap backfill.

5. Install subsurface drain.

6. Install 12 inch storm sewer pipe.

7. Construct crushed aggregate base and asphalt wearing surface.

8. Install Guardrail.

9. Remove and reinstall existing signs.

10. Install permanent seeding.

11. Perform additional and incidental work as called for by the Specifications and Plans and as required to provide a complete Project. .

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BID SCHEDULE GIVE THE PRICES PROPOSED, IN FIGURES, IN THE RESPECTIVE SPACES BELOW

Spec No.

Item No.

Bid Item Bid Unit Quantity Unit Price

Total Cost

TEMPORARY FEATURES AND APPURTENANCES

00210 10 Mobilization LS All LS

00225 20 Temporary Work Zone Traffic Control, Complete

LS All LS

00280 30 Erosion Control LS All LS

00290 40 Pollution Control Plan LS All LS

00298 50 Abandon Monitoring Wells LS All LS

ROADWORK

00305 60 Construction Survey Work LS All LS

00310 70 Remove, Protect, Stockpile and Reinstall Dock

LS All LS

00320 80 Clearing and Grubbing LS All LS

00330 90 General Excavation Cu. Yd. 300.0

00330 100 Extra for Selected Native Soil Material

Cu. Yd. 350.0

00350 110 Drainage Geotextile Type 2

Sq. Yd. 500.0

00350 120 Rip Rap Geotextile, Type 2

Sq. Yd. 1,100

00350 130 Sub Grade Geotextile Sq. Yd. 650

00390 140 Loose Riprap, Class 200 Cu. Yd. 2,600

DRAINAGE AND SEWERS

00430 150 8 Inch Drain Pipe Foot 370.0

00430 160 Subsurface Drain Outlets Each 1.0

00430 170 12 Inch Culvert Pipe, 5 foot depth

Ft 30.0

RETAINING WALL BRIDGE NO. 2311

00510 180 Structure Excavation LS All LS

00570 190 Timber and Lumber MFBM 200.0

00598 200 Furnish Steel Piles Sq. Ft. 12,600.0

00598 210 Retaining Wall, Tieback LS All LS

BASES

00640 220 Aggregate Base Ton 415.0

WEARING SURFACES

00744 230 Level 3, ½ inch Dense, MHMAC Mixture

Ton 135.0

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PERMANENT TRAFFIC SAFETY AND GUIDANCE DEVICES

00810 240 Guardrail Type 2A FT. 388.0

00810 250 Guardrail Anchors, Type 1 Ea. 4.0

00810 260 Guardrail End Pieces, Type C

Ea. 4.0

00810 270 Guardrail Terminals, Non Flared.

Ea. 2.0

00840 280 Delineators, Type W-1 Ea. 1.0

PERMANENT TRAFFIC CONTROL AND ILLUMINATION SYSTEMS

00905 290 Remove and Reinstall Existing Signs

LS All LS

RIGHT OF WAY DEVELOPMENT AND CONTROL

01030 300 Seeding Mobilization Ea. 1.0

01030 310 Permanent Seeding, Upland Seed Mix

Acre 0.3

01040 320 Plant Cuttings, Less than 1 inch

Ea. 120.0

TOTAL OF BID:

WRITTEN BID AMOUNT

Signature of Authorized Bidder

Company Name

Oregon’s Contractors Board Registration Number

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The Bidder is advised that by signing this Bid the Bidder is deemed to have signed and agreed to the

provisions of all the documents, certifications, and statements contained in this Bid. _______________________________________________________________________________ (Bidder's Name and Federal Tax ID Number) ______________________________________________ _______________ (Oregon Contractor's Board Registration Number) (Expiration Date)

By __________________________________________

(Signature of Bidder's Authorized Representative) ______________________________________________ Dated _________________, 20___ (Typed or Printed Name and Title of Signer) Sworn to before me on this ___________________ day

of _____________________________________, 20___

_____________________________________________ (Notary Public's Signature)

My commission expires _________________________ COMPLETE THE FOLLOWING IF A JOINT VENTURE: _____________________________________________ _______________ (Oregon Contractor's Board Registration Number) (Expiration Date) By __________________________________________ (Signature of Bidder's Authorized Representative) _____________________________________________ Dated _________________, 20___ (Typed or Printed Name and Title of Signer) Sworn to before me on this ___________________ day of ____________________________________, 20___ _____________________________________________ (Notary Public's Signature) My commission expires _________________________ FAILURE TO HAVE THE SIGNATURE(S) ON THIS BID NOTARIZED WILL BE CAUSE TO REJECT THIS BID.

SIGN HERE

IF JOINT VENTURE

ALSO SIGN HERE

NOTARY SIGN HERE

NOTARY SIGN HERE

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The party who is submitting this Bid and who, if awarded the Contract, will enter into the Contract is (Enter "an individual", "a partnership", or "a corporation".) doing business under the name of at (Street) (City) (State) (Zip Code) which is the address to which all communications concerning this Bid and the Contract should be sent. The telephone numbers to which communications may be directed are ( ) (Telephone No.) and ( ) (Facsimile No.) The name of the surety who will furnish the performance bond and payment bond covering the Contract, if awarded, and the name, address, and telephone number of the surety's local agent are: Name of surety Name of agent Tel. No. Address (Street) (City) (State) (Zip Code) Accompanying this Bid as bid guaranty is a (Enter "Bid Bond", "cashier's check", "postal

money order", or "certified check".) in the amount of at least ten (10) percent of the total amount of the bid. If the Board of Commissioners accepts this Bid and awards a Contract to the undersigned and if the undersigned then fails to promptly and properly execute the Contract or bonds according to the terms and conditions stated in Section 00130 of the specifications, the undersigned shall forfeit the Bid guaranty as liquidated damages to Lincoln County, by and through its Board of Commissioners. The undersigned agrees to be held jointly and severally liable with the surety of the undersigned for payment of liquidated damages if the Bid guaranty is a Bid Bond.

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LINCOLN COUNTY BOARD OF COMMISSIONERS

PROPOSAL GUARANTY (BID BOND)

KNOW ALL MEN BY THESE PRESENTS, that ___________________________________

_____________________________________________________________________________

a surety company duly organized under the laws of the State of___________________________

having its principle place of business at______________________________________________

in the State of______________________, and authorized to do business in the State of Oregon, is held

and firmly bound unto the County of Lincoln, in the full sum of ten (10) percent of the total amount of the

bid for the work hereinafter described, for the payment of which, well and truly to be made, we bind

ourselves, our heirs, executors, administrators and assigns, and successors and assigns, firmly by these

presents.

The condition of this bond is such that, whereas_________________________________ (Bidder)

is herewith submitting its bid for the following work, to wit:

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________

________________________________________________ said bid by this reference being made a part hereof;

NOW THEREFORE, if the said bid submitted by the said bidder be accepted by the Lincoln County Board

of Commissioners, and the contract for said work being awarded to said bidder, and if the said bidder

enters into and executes the said contract and furnishes bond as required by the Board of

Commissioners within the time fixed by the Board of Commissioners, then this obligation shall be void;

otherwise to remain in full force and effect.

Signed this____________________ day of ________________________, 2011.

_______________________ Surety Company

_______________________ Surety Signature

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FIRST-TIER SUBCONTRACTOR DISCLOSURE FORM

(Instructions for use of this form are found in the Appendix.) PROJECT NAME: _________________________________________________________ BID #: ________ BID CLOSING: Date: ______________ Time: _____________ This form must be submitted at the location specified in the Invitation to Bid on the advertised bid closing date and within two working hours after the advertised bid closing time. List below the name of each subcontractor that will be furnishing labor or materials and that is required to be disclosed, the category of work that the subcontractor will be performing and the dollar value of the subcontract. Enter 'NONE' if there are no subcontractors that need to be disclosed. (ATTACH ADDITIONAL SHEETS IF NEEDED.) NAME DOLLAR CATEGORY VALUE OF WORK 1) _______________________ $__________ __________________________ 2) _______________________ $__________ __________________________ 3) _______________________ $__________ __________________________ 4) _______________________ $__________ __________________________ 5) _______________________ $__________ __________________________ 6) _______________________ $__________ __________________________ 7) _______________________ $__________ __________________________ 8) _______________________ $__________ __________________________ Failure to submit this form by the disclosure deadline will result in a nonresponsive bid. A nonresponsive bid will not be considered for award. Form submitted by (Bidder Name): ______________________________________ Contact Name: __________________________ Phone no.: _______________

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APPENDIX

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INSTRUCTIONS FOR FIRST-TIER SUBCONTRACTOR DISCLOSURE FORM Instructions for Submitting Form Submit the First-Tier Subcontractor Disclosure form in one of the following manners:

• With your bid, or

• Not later than two working hours after the time set for Bid Closing. (For example, by 12:00 noon after a 10:00 a.m. Bid Closing.) Submit as follows:

Remove the form from the Bid booklet and deliver it the Board of Commissioners office at Lincoln County Courthouse, 880 NE 7th Street. in Newport, Oregon.

Fax submittals of Subcontractor Disclosure forms will not be accepted.

Instructions for First-Tier Subcontractor Disclosure When the Contract value for a public improvement is greater than $100,000, bidders are required to disclose information about first-tier subcontractors who will furnish labor or labor and Materials (See ORS 270C.370). Specifically, when the Contract Amount of a first-tier subcontractor is greater than or equal to: (1) 5% of the total Project Bid, but at least $15,000, or (2) $350,000 regardless of the percentage of the total Project Bid, you must disclose the following information about that subcontractor not later than two working hours after the Bid Closing time:

• The name of the subcontractor • Dollar amount of the subcontract • The category of Work the subcontractor will be performing

If your Bid is greater than $100,000 and you will not be using any subcontractors, you are still required to submit the form, with the word “NONE” entered on the first line of the form. THE COUNTY MUST REJECT THE BID if the Bidder fails to submit the disclosure form with the requested information by the stated deadline. To determine disclosure requirements, the County recommends that you disclose subcontractor information for any subcontractor as follows: 1) Determine your lowest possible prime Contract price. That will be your base Bid amount less all alternative deductive amounts, if any (exclusive of any options that can only be exercised after Award). 2) Provide the required disclosure information for any first-tier subcontractor whose potential services are greater than or equal to: (1) 5% of the lowest Contract price, but at least $15,000, or (2) $350,000 regardless of the percentage. In making this determination, total all possible work for each subcontractor. For example, if a subcontractor will provide $15,000 worth of services on the base Bid and $40,000 on an additive alternate, then the potential amount of the subcontractor’s services is $55,000. Assuming that $55,000 exceeds 5% of your lowest Contract price, provide disclosure for both the $15,000 services and the $40,000 services.

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INSTRUCTIONS FOR MODIFICATIONS TO BID FOR PUBLIC IMPROVEMENT

• Changes in Bids must be received in writing prior to the time designated for Bid Closing, using the sample format shown on page 12 of this Bid.

• The Project title and Contractor's name must be specified when submitting Bid changes. • Changes must be made for each Bid item affected. Lumping the changes into one Bid item may

result in the Bid item being unbalanced, causing the Bid to be considered irregular and constituting grounds for rejection.

• Bids will be modified at the Bid Opening in accordance with changes received prior to the designated

time of Bid Closing. Bid modifications received after that time will not be considered.

• Changes to Bids will not be accepted by FAX.

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SAMPLE FORMAT FOR BID CHANGES

(PREPARE ON YOUR OWN LETTERHEAD STATIONERY)

[Bid Opening Date] Lincoln County Road Department 880 NE 7th Street Newport, OR 97365 RE: [Project Title] (For a decrease in a bid amount): Reduce Bid Item No. by $ per ton, foot, etc. (For an increase in a bid amount): Increase Bid Item No. by $ per ton, foot, etc. This will (increase/decrease) our total Bid by $ . _____________________________________ (Signed by an individual authorized to

sign Bids and execute documents on behalf of the firm.)

NOTE: Changes (increase/decrease statement) must be made for each Bid item affected. Lumping the changes into one Bid item may result in the Bid item being unbalanced, causing the Bid to be considered irregular and constituting grounds for Bid rejection. The total difference in the Bid should always appear last. Do not refer to your original Bid total or new Bid total when making Bid changes. To expedite making changes at the Bid Opening, list all decreased-in-Bid items in numerical order first, followed by all increased-in-Bid items. Changes to Bids will not be accepted by FAX.

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CONTRACT FOR PUBLIC IMPROVEMENT

THIS CONTRACT, made and entered into, in duplicate, this __________________ day of __________________, 20__, by and between the County of Lincoln, by and through its Board of Commissioners, hereinafter called “County”, and _______________________________________, a(n) __________________________ (corporation/LLC/LLP), by and through its corporate officials doing business at ______________________________________________________________________, ________________________________________, hereinafter called “Contractor”, (Federal tax ID No.)

WITNESSETH:

That the said Contractor, in consideration of the sums to be paid by the County in the manner and at the time herein provided, and in consideration of the other covenants and agreements herein contained, hereby agrees to perform and complete the work herein described and provided for and to furnish all necessary machinery, tools, apparatus, equipment, supplies, material and labor and do all things in accordance with the applicable plans, the applicable Standard Specifications, and special provisions bound herewith, and in accordance with such alterations and modifications of the same as may be made by the Engineer or the Board, and in according to such directions as may from time to time be made or given by the Engineer under the authority and within the meaning and purpose of this contract. This agreement shall be binding upon the heirs, executors, administrators, successors and assigns of the Contractor. That the applicable plans, the applicable Standard Specifications, the special provisions bound herewith and the schedule of contract prices bound herewith are hereby specifically referred to and by this reference made part hereof, and shall by such reference have the same force and effect as though all of the same were fully written or inserted herein. That the Contractor shall faithfully complete and perform all of the obligations of this contract, and in particular shall promptly, as due, make payment of all debts, dues, demands and obligations incurred in the performance of said contract; and shall not permit any lien or claim to be filed or prosecuted against the County. It is expressly understood that the laws of the State of Oregon shall govern this contract in all things. In consideration of the faithful performance of all the obligations, both general and special, herein set out, and in consideration of the faithful performance of the work as set forth in this contract, the applicable plans, the Standard Specifications, special provisions, the schedule of contract prices, and all general and detailed plans and specifications which are part hereof, and in accordance with the directives of the Engineer and to his satisfaction, the County agrees to pay to the said Contractor the amount earned, as determined from the actual quantities of work performed and the prices and other bases of payment specified, and taking into consideration any amounts that may be deductible under the terms of the contract, and to make such payments in the manner and at the times provided in the applicable Standard Specifications or special provisions.

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IN WITNESS WHEREOF, the parties hereto have subscribed their names and affixed their respective official seals as of the date first above written. By the County:

for the Board of Commissioners Date

for the Board of Commissioners Date

for the Board of Commissioners Date

By the Contractor:

(Signature) Date

(Title)

(Oregon Contractors Board Expiration Date Registration Number)

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PERFORMANCE BOND

KNOW ALL PERSONS BY THESE PRESENTS, That we

as principal, and

as surety, are jointly and severally held and bound unto the County of Lincoln in the sum of

for the payment of which we jointly and severally bind ourselves, our heirs, executors, administrators, and

assigns or successors and assigns, firmly by these presents.

THE CONDITION OF THIS BOND IS SUCH

That, whereas, the said principal herein has made and entered into a certain contract, a copy of which is attached hereto, with the County of Lincoln, which contract, together with the applicable plans, Standard Specifications, special provisions, and schedule of contract prices, is by this reference made part hereof, whereby the said principal agrees to do in accordance with the certain terms, conditions, requirements, plans and specifications set out in said contract and all authorized modifications of the contract which increase the amount of work and the amount of the contract. Notice to the surety of any of the immediately foregoing are waived.

NOW, THEREFORE, if the principal herein shall faithfully and truly observe and comply with the terms, conditions and provisions of the said contract, in all respects, and shall well and truly and fully do and perform all matters and things by him undertaken to be performed during said contract, upon the terms set forth therein, within the time prescribed therein, or as extended as provided in the contract, and shall indemnify and save harmless the County of Lincoln, the Lincoln County Board of Commissioners, and members thereof, its officers, employees, and agents, against any direct or indirect damages of every kind and description that shall be suffered or claimed to be suffered in connection with or arising out of the performance of the said contract by the said Contractor or its Nonpayment of the bond premium will not invalidate this bond nor shall the County of Lincoln, by and through its Board of Commissioners, be obligated for the payment thereof. Witness our hands this day of , 20__. Authorized Signature, Principal

Authorized Signature, Surety

By Authorized Signature, Attorney in Fact (A Power of Attorney for the Attorney in Fact must be attached to this bond.)

Surety’s Seal Must be Affixed

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PAYMENT BOND

KNOW ALL PERSONS BY THESE PRESENTS, That we

as principal, and

as surety, are jointly and severally held and bound unto the County of Lincoln in the sum of

for the payment of which we jointly and severally bind ourselves, our heirs, executors, administrators, and

assigns or successors and assigns, firmly by these presents.

THE CONDITION OF THIS BOND IS SUCH

That, whereas, the said principal herein has made and entered into a certain contract, a copy of which is attached hereto, with the County of Lincoln, which contract, together with the applicable plans, Standard Specifications, special provisions, and schedule of contract prices, is by this reference made part hereof, whereby the said principal agrees to do in accordance with the certain terms, conditions, requirements, plans and specifications set out in said contract and all authorized modifications of the contract which increase the amount of work and the amount of the contract. Notice to the surety of any of the immediately foregoing are waived.

NOW, THEREFORE, if the principal herein shall make payment promptly, as due to all subcontractors and to all persons supplying to the Contractor or its subcontractors, equipment, supplies, labor or materials for the prosecution of the work, or any part thereof, provided for in said contract, and shall pay all contributions of amounts due its workers compensation carrier and the State Unemployment Compensation Trust Fund from such Contractor or subcontractors incurred in the performance of said contract, and pay all sums of money withheld from the Contractor’s employees and payable to the Revenue Department, and shall pay all other just debts, dues and demands incurred in the performance of the said contract and shall pay to the County of Lincoln, by and through its Board of Commissioners, such damages as may accrue to the County under said contract, then this obligation is to be void, otherwise to remain in full force and effect. Nonpayment of the bond premium will not invalidate this bond nor shall the County of Lincoln, by and through its Board of Commissioners, be obligated for the payment thereof. Witness our hands this day of , 20__. Authorized Signature, Principal

Authorized Signature, Surety

By Authorized Signature, Attorney in Fact (A Power of Attorney for the Attorney in Fact must be attached to this bond.)

Surety’s Seal Must be Affixed