HomeMy WebLinkAboutContract 3984341.
CITY SECRETARY,3(�
SPECIFICATIONS CONTRACT NO.
AND
FORMS OF CONTRACT AND BONDS
FOR
Repainting and Renovation of Alta Mesa 9.2 Million
Gallon Ground Storage Facility, Structural Repairs and
Renovation for Eastwood 1.5 MG Elevated Storage Facility, and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility
-
Project No. P265-606180130580
No
—
August 2009
Prepared
for
CITY OF FORT WORTH, TEXAS
FORTWORTH
Prepared by
DELTATEK ENGINEERING
Registration Number F-4419
14114 DALLAS PARKWAY, SUITE 480
DALLAS, TEXAS 75254
469-374-9800 OFFICIAL RECORD
www.deltatekeng.com CITY SECRETARY
FT. WORTH, TX
,910,214
CITY SECRETARY' C
SPECIFICATIONS CON'iRACT NO. , R c
AND
FORMS OF CONTRACT AND BONDS
FOR
Repainting and Renovation of Alta Mesa 9.2 Million
Gallon Ground Storage Facility, Structural Repairs and
Renovation for Eastwood 1.5 MG Elevated Storage Facility, and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility
Project No. P265-606180130580
August 2009
Prepared
for
CITY OF FORT WORTH, TEXAS
FORTWORTH
Prepared by
DELTATEK ENGINEERING
Registration Number F-4419
14114 DALLAS PARKWAY, SUITE 480
DALLAS, TEXAS 75254
469-374-9800
www.deltatekeng.com
\,
1111(A
11 I
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Page 1 of 2
City of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 1/26/2010
DATE: Tuesday, January 26, 2010 REFERENCE NO.: C-24057
LOG NAME: 60ALTA MESA AND EASTWOOD ELEVATED TANK
SUBJECT:
Authorize a Contract with N.G. Painting, L.P., in the Amount of $1,329,600.00 for Repair and Renovation of
Alta Mesa 9.2 MG Ground Storage Facility, Structural Repair and Renovation of Eastwood 1.5 MG
Elevated Storage Facility and Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility Located
at 4328 Alta Mesa Boulevard, 4256 Strong Avenue and 5870 Blackmore Avenue (COUNCIL DISTRICTS 5,
6 and 7)
RECOMMENDATION:
It is recommended that the City Council authorize the City Manager to execute a contract with N.G.
Painting, L.P., in the amount of $1,329,600.00 for Repair and renovation of Alta Mesa 9.2 MG Ground
Storage Facility, Structural Repair and Renovation of Eastwood 1.5 MG Elevated Storage Facility and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility located at 4328 Alta Mesa
Boulevard, 4256 Strong Avenue and 5870 Blackmore Avenue.
DISCUSSION:
On July 14, 2009, (M&C C-23661) the City Council authorized the City Manager to execute an
Engineering Agreement with Deltatek Engineering for design and preparation of the contract documents
for the repair and renovation of Alta Mesa 9.2 MG Ground Storage Facility, Structural Repair and
Renovation of Eastwood 1.5 MG Elevated Storage Facility and Exterior Touchup Painting for Como 6.0
MG Ground Storage Facility.
The plant staff recently inspected the Alta Mesa ground storage tank, Eastwood elevated tank and Como
ground storage tank and found the coating system had reached the end of its serviceable lifetime and the
start of structural damage due to corrosion, requiring repairs and repainting to extend the tank service life.
This construction project consists of structural repair, safety modifications and repainting of the interior
and exterior of this tank.
This project was advertised on August 27, 2009, and September 3, 2009, in the Fort Worth Star -Telegram.
On October 1, 2009, the following bids were received:
Bidder
N.G. Painting, L.P.
Superior Industrial
Classic Protective
J.R. Stelzer
State Painting Corp.
JPI Painting
Blastco Texas, Inc.
Atlas Painting and Sheeting
IW
Bid Amount Contract
$1,329,600.00 150 Days
$1,759,061.00
$1,867,000.00
$1,418,185.00
$1,630,600.00
$1,576,500.00
$1,344,000.00
$2,683,950.00
:f app�a� it Doc Type=Print 1/27/2010
Page 2 of 2
Utility Service
TMI Coating
$1,704,420.00
$2,054,600.00
In addition to the contract amount $26,000.00 is required for project management by Water Department
staff and $65,888.00 is required for project contingencies.
N.G. Painting, L.P., is in compliance with the City's M/WBE ordinance by committing to 27 percent M/WBE
participation. The City's goal on this project is 21 percent.
This project is in COUNCIL DISTRICTS 5, 6 and 7.
FISCAL INFORMATION / CERTIFICATION:
The Financial Management Services Director certifies that funds are available in the current capital
budget, as appropriated, of the Water Capital Projects Fund.
FUND CENTERS:
TO Fund/Account/Centers FROM Fund/Account/Centers
P265
541200
606180130580
$1,395.488.00
P265
511010
606180130580
$26,000.00
CERTIFICATIONS:
Submitted for Citv Manaaer's Office bv: Fernando Costa (6122)
Oriainatina Department Head: S. Frank Crumb (8207)
Additional Information Contact: Seiavash Mir (8404)
ATTACHMENTS
1. 60ALTA MESA AND EASTWOOD ELEVATED TANK - Como Ground Storage Tank.odf (Public)
2. 60ALTA..MESA AND EASTWOOD ELEVATED TANK Eastwood_ Elevated Tank .pdf (Public)
3. 60AIta Mesa and Eastwood_ Elevated Tank FAR.p_df (CFW Internal)
4. 60ALTA MESA AND EASTWOOD ELEVATED TANK MWBE.pdf (CFW Internal)
5. 60AL_TAMESA AND EASTWOOD ELEVATED TANK -_Alta Mesa Reservoir.p_d_f (Public)
6. FUNDING.pdf (CFW Internal)
http://apps.cfwnet.org/ecouncil/printmc.asp?id=12618&print=true&DocType=Print 1/27/2010
Addendum No. 1
Repainting and Renovation of Alta Mesa 9.2 Million Gallon
Ground Storage Facility, Structural Repairs and Renovation for
Eastwood 1.5 MG Elevated Storage Facility, and Exterior Touchup
Painting for Como 6.0 MG Ground Storage Facility
Project Number P265-606180130580
City of Fort Worth, Texas
Addendum Date: September 28, 2009
To all plan holders via email
BIDPROPOSAL:
Bid Item 15:
Add:
Payment for construction of the overflow structure and all piping modifications shall be paid from this bid
item.
Bid Item 21:
Add:
Payment for 7501f of seam sealing cornice to shell connection shall be added to this bid item.
Seam sealer shall be Sikaflex I or approved equal.
Bid Item 35:
Clarification:
Payment shall be for seam sealing not seal welding top cornice to lower cornice connection.
Seam sealer shall be Sikaflex I or approved equal.
ADD:
General Conditions Section C 8-8 Pages C8-1 through C84
Measurement and Payment:
This section was inadvertently omitted from some sets of specifications.
End of Addendum No. 1
DELTATEK ENGINEERING
PRO
Bahram Niknam, P.E.
Attachments
1. Section C8-8 Pages C8-1 through C8-4
14114 Dallas Parkway, Suite 480 Dallas, Texas 75254
- . Firm Registration No. F-4419
469-374-9800 Fax 469-374-9801
Email: bn<a?deltatekens.com
*®I
BAHRAM NIKNAM
.......... .......
53254 . s
fffI- Q�STE�aG����®
Addendum No. 1
Page 1 of 1
PART C — GENERAL CONDITIONS
C8-8 MEASURMENT AND PAYMENT
C8-8 MEASURMENT AND PAYMENT
C8-8.1 MEASURMENT OF OUANTITIES: The determination of quantities of work
performed by the Contractor and authorized by the Contract Documents acceptably
completed under the terms of the Contract Documents shall be made by the Engineer,
based on measurements made by the Engineer. These measurements will be made
according to the United States Standard Measurements used in common practice, and will
be the actual length, area, solid contents, numbers, and weights of the materials and items
installed
C8-8.2 UNIT PRICES: When in the Proposal a "Unit Price" is set forth, the said "Unit
Price" shall include the famishing by the Contractor of all labor, tools, materials,
machinery, equipment, appliances and appurtenances necessary for the construction of
and the completion in a manner acceptable to the Engineer of all work to be done under
these Contract Documents.
The "Unit Price" shall include all permanent and temporary protection of overhead,
surface, and underground structures, cleanup, finished, overhead expense, bond,
insurance, patent fees, royalties, risk due to the elements and other causes, delays, profits,
injuries, damage claims, taxes, and all other items not specifically mentioned that may be
required to fully construct each item of the work complete in place an in a satisfactory
condition of operation.
C8-8.3 LUMP SUM: When in the Proposal a "Lump Sum" is set forth, the said "Lump
Sum" shall represent the total cost for the Contractor to furnish all labor, tools, materials,
machinery, equipment, appurtenances, and all subsidiary work necessary for the
constriction and completion of all the work to provide a complete and functional item as
detailed in the Special Contract Documents and/or Plans.
C8-8.4 SCOPE OF PAYMENT: The Contractor shall receive and accept the
compensation, as herein provided, in full payment for furnishing all labor, tools,
materials, and incidentals for performing all work contemplated and embraced under
these Contract Documents, for all loss and damage arising out of the nature of the work
or form the action of the elements, for any unforeseen defects or obstructions which may
arise or be encountered during the prosecution of the work at any time before its final
acceptance by the Owner, (except as provided in Paragraph C5-5.14) for all risks of
whatever description connected with the prosecution of the work, for all expense incurred
by or in consequence of suspension or discontinuance of such prosecution of the working
operations as herein specified, or any and all infringements or patents, trademarks,
copyrights, or other legal reservations, and for completing the work in an acceptable
manner according to the terms of the Contract Documents.
C8-8-1
Addendum No. 1
The payment of any current or partial estimate prior to final acceptance of the work by
the Owner shall in no way constitute an acknowledgment of the acceptance of the work,
materials, or equipment, nor in any way prejudice or affect the obligations of the
Contractor to repair, correct, renew, or replace at his own and proper expense, any defects
or imperfections in the construction or in the strength or quality of the material used or
equipment and machinery furnished in or about the construction of the work under
contract and its appurtenances, or any damage due or attributed to such defects, which
defects, imperfection, or damage shall have been discovered on or before the final
inspection and acceptance of the work or during the one year guarantee period after final
acceptance. The Owner shall be the sole judge of such defects, imperfections, or damage,
and the Contractor shall be liable to the Owner for failure to correct the same as provided
herein.
C8-8.5 PARTIAL ESTIMATES AND RETAINAGE: Between the 1" and 5'h day or
each month the Contractor shall submit to the Engineer a statement showing an estimate
of the value of the work done during the previous month, or estimate period under the
Contract Documents. Not later than the 16* day of the month the Engineer shall verify
such estimate, and if it is found to be acceptable and the value of work performed since
the last partial payment was made exceeds one hundred dollars in amount, 90% of such
estimated sum will be paid to the Contractor if the total contract amount is less than
$400,000, or 95% of such estimated sum will be paid to the Contractor if the total
contract amount is $400,000 or greater within twenty-five (25) days after the regular
estimate period The City will have the option of preparing estimated on form furnished
by the City. The partial estimate may include acceptable nonperishable materials
delivered to the work, which are to be incorporated into the work as a permanent part
thereof; but which at the time of the estimate have not been installed.(such payment will
be allowed on a basis of 85% of the net invoice value thereof) The Contractor shall
furnish the Engineer such information as he may request to aid him as a guide in the
verification or the preparation of partial estimates.
It is understood that the partial estimate from month to month will be approximate only,
and all partial monthly estimates and payment will be subject to correction in the
estimates rendered following the discovery of an error in any previous estimate, and such
estimate shall not, in any respect, be taken as an admission of the Owner of the amount of
work done or of its quality of sufficiency, or as an acceptance of the work done or the
release of the Contractor of any of his responsibilities under the Contract Documents.
The City reserves the right to withhold the payment of any monthly estimate if the
Contractor fails to the work strictly in accordance with the specifications or
provisions of this contract.
C8-8.6 W MOLDING PAYMENT: Payment on any estimate or estimates may be
held in abeyance if the performance of the construction operations is not in accordance
with the requirements of the Contract Documents.
C8-8-2
Addendum No. 1
said Contract Documents, all approved modifications thereof, and additions and
alterations thereto approved in writing by the Owner. The burden of proof of such
compliance shall be upon the Contractor to show that he has complied with the said
requirements of the Contract Documents, approved modifications thereof, and all
approved additions and alterations thereto.
C8-8.10 GENERAL GUARANTEE: Neither the final certificate of payment nor any
provision in the Contract Documents nor partial or entire occupancy or use of the
premises by the Owner shall constitute an acceptance of work not done in accordance
with the Contract Documents or relieve the Contractor of liability in respect to any
express warranties or responsibility for faulty materials or workmanship. The Contractor
shall remedy any defects or damages in the work and pay for any damage to other work
resulting therefrom which shall appear within a period of one year from the date of final
acceptance of the work unless a longer period is specified and shall furnish a good and
sufficient maintenance bond in the amount of 100 percent of the amount of the contract
which shall assure the performance of the general guarantee as above outlined The
Owner will give notice of observed defects with reasonable promptness.
C8-8.11 SUBSIDIARY WORK: Any and all work specifically governed by
documentary requirements for the project, such as conditions imposed by the Plans, the
General Contract Documents, or the Special Contract Documents, in which no specific
item for bid has been provided for in the Proposal, shall be considered as a subsidiary
item of work, the cost of which shall be included in the price bid in the Proposal, for each
bid item. Surface restoration, rock excavation, and clean-up are general items of work
which fall in the category of subsidiary work.
C8-8.12 MISCELLANEOUS PLACEMENT OF MATERIAL: Material may be
allocated under various bid items in the Proposal to establish unit prices for
miscellaneous placement of material. These materials shall be used only when directed
by the Engineer, depending on field conditions. Payment for miscellaneous placement of
material will be made for only that amount of material used, measured to the nearest one -
tenth unit. Payment for miscellaneous placement of material shall be in accordance with
the General Contract Documents regardless of the actual amount used for the project.
C8-8.13 RECORD DOCUMENTS: Contractor shall keep on record a copy of all
specifications, plans, addenda, modifications, shop drawings, and samples at the site, in
good order and annotated to show all changes made during the construction process.
These shall be delivered to the Engineer upon completion of the work.
C8-8-4
Addendum No. I
CJ
dfi
M
M
mi
SPECIFICATIONS
AND
FORMS OF CONTRACT AND BONDS
FOR
Repainting and Renovation of Alta Mesa 9.2 Million
Gallon Ground Storage Facility, Structural Repairs and
Renovation for Eastwood 1.5 MG Elevated Storage Facility, and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility
Project No. P265-606180130580
August 2009
Prepared
for
CITY OF FORT WORTH, TEXAS
FORTWORTH
Prepared by
DELTATEK ENGINEERING
Registration Number F-4419
14114 DALLAS PARKWAY, SUITE 480
DALLAS, TEXAS 75254
469-374-9800
www.deltatekeng.com
Repainting and Renovation of Alta Mesa 9.2 Million Gallon Ground Storage Facility,
Structural Repairs and Renovation for Eastwood 1.5 MG Elevated Storage Facility, and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility TABLE OF CONTENTS
Notice to Bidders A
Special Instructions to Bidders A
Proposal B
Conflict of Interest Questionnaire COI
Minority and Women Business Enterprises Specifications B
General Conditions C
Supplementary Conditions CS
Special Conditions D
TECHNICAL SPECIFICATIONS E
DIVISION 1- GENERAL REQUIREMENTS
01010
Summary of Work.............................................................................................................................01010 - 1 - 2
01011
Prevailing Wage Rate........................................................................................................................01011
- 1 - 1
01070
Abbreviations....................................................................................................................................01070
- 1 - 5
01150
Measurement and Payment...............................................................................................................01150
- 1 - 1
01300
Submittals.........................................................................................................................................01300
- 1 - 6
Sample........................................................................................................................................
Sample - 1 - 1
01310
Construction Schedule......................................................................................................................01310
- 1 - 1
01360
Quality Assurance.............................................................................................................................01360
- 1 - 2
01370
Schedule of Values............................................................................................................................01370
- 1 - 2
Sample......................................................................................................................................
Sample - A - D
01420
Inspection Services...........................................................................................................................01420
- 1 - 1
01700
Contract Close-Out...........................................................................................................................01700
- 1 - 2
01710
Cleaning and Adjusting.....................................................................................................................01710
- 1 - 2
DIVISION 2 - SITE WORK
02100 Site Preparation & Cleaning..................................................................... .........................................02100 - 1 - 1
DIVISION 3 - CONCRETE................................................................................................................................. Not Used
DIVISION4 - MASONRY................................................................................................................................... Not Used
DIVISION5 - METALS...................................................................................................................................... Not Used
05500 Metal Fabrications............................................................................................................................05500 - 1 - 7
05515 Ladders..............................................................................................................................................05515 - 1 - 3
05520 Handrails & Railings.........................................................................................................................05520 - 1 - 2
DIVISION 6 - WOOD AND PLASTICS............................................................................................................. Not Used
DIVISION 7 - THERMAL AND MOISTURE PROTECTION....................................................................... Not Used
DIVISION 8 - DOORS AND WINDOWS........................................................................................................... Not Used
Repainting and Renovation of Alta Mesa 9.2 Million Gallon Ground Storage Facility,
Structural Repairs and Renovation for Eastwood 1.5 MG Elevated Storage Facility, and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility
City of Fort Worth, Texas
Project P265-606180130580
August 2009
TOC -1
Repainting and Renovation of Alta Mesa 9.2 Million Gallon Ground Storage Facility,
Structural Repairs and Renovation for Eastwood 1.5 MG Elevated Storage Facdity, and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility TABLE OF CONTENTS
DIVISION 9 - FINISHES
09900 Painting.............................................................................................................................................09900 - 1 - 9
DIVISION10 - SPECIALTIES............................................................................................................................ Not Used
DIVISION 11- EQUIPMENT
11550 Fall Prevention System.....................................................................................................................11550 - 1 - 2
DIVISION 12 - FURNISHINGS.......................................................................................................................... Not Used
DIVISION 13 - SPECIAL CONSTRUCTION................................................................................................... Not Used
DIVISION 14 - CONVEYING SYSTEMS.......................................................................................................... Not Used
DIVISION 15 - MECHANICAL
DIVISION16 - ELECTRICAL........................................................................................................................... Not Used
PerformanceBond................................................................................................................................................................ F
PaymentBond...................................................................................................................................................................... F
MaintenanceBond............................................................................................................................................................... F
Certificateof Insurance....................................................................................................................................................._. F
Contractor Compliance With Worker's Compensation Law.........................:...................................................................... F
PartG - Contract................................................................................................................................................................. G
Appendix
Armstrong Lab Report Number: A9-3796A-00 I A
Project Sign
PLANSHEETS................................................................................................................................................... Cover - 14
END OF CONTENTS
Repainting and Renovation of Alta Mesa 9.2 Million Gallon Ground Storage Facility,
Structural Repairs and Renovation for Eastwood 1.5 MG Elevated Storage Facility, and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility
City of Fort Worth, Texas
TOC -2
Project P265-606180130580
August 2009
NOTICE TO BIDDERS
Sealed proposals for the Repainting and Renovation of Alta Mesa 9.2 Million Gallon Ground
Storage Facility and Structural Repairs and Renovation for Eastwood 1.5 MG Elevated
Storage Facility and Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility,
will be received at the office of the Purchasing Manager, lower level of City Hall, 1000
Throckmorton Street, Fort Worth, Texas 76102, until 1:30 P.M., Thursday, October 1, 2009 and
then publicly opened and read aloud at 2:00 P.M.
Plans and specifications may be obtained at the office of Deltatek En6neerine, 14114 Dallas
Parkway, Suite 480, Dallas, Texas, 75254, phone 469-374-9800. for a non-refundable fee of
$95.00 per set.
General Contract Documents and General Specifications for Water Department projects, dated
January 1, 1978, with the latest revisions, also compromise a part of the Contract Documents for
this project and may be obtained by paying a non-refundable fee of $50.00 for each set, at the
office of Water Department, Municipal Office Building, 1000 Throckmorton Street, Fort Worth,
Texas.
All bidders submitting bids are required to be pre -qualified in accordance with the requirements
of the special instructions to bidders.
A pre -bid conference will be held at 10:00 AM on Wednesday, September 9th, 2009 at the
Conference Room, South Holly Water Treatment Plant, SCADA Building, 1511 11`h Avenue,
76102, Fort Worth, Texas (MAPSCO 76G). The Engineer will transmit to all prospective
bidders of record such Addenda as he considers necessary in response to questions arising at the
pre -bid conference.
Bidders are responsible for obtaining all addenda to the contract documents and acknowledging
receipt of the addenda by initialing the appropriate spaces on the PROPOSAL form. Bids that do
not acknowledge receipt of all addenda may be rejected as being non -responsive. Information
regarding the status of addenda may be obtained by contacting the Deltatek Engineering at 469-
374-9800 or the Water Department at 817-392-8404.
The City reserves the right to reject any and/or all bids and waive any and/or all formalities. No
bid may be withdrawn until the expiration of ninety (90) days from the date the bids are received.
For additional information regarding the project, contact Mr. John Fields, Deltatek Engineering,
469-374-9800.
Advertising Dates:
August 27. 2009
September 3, 2009
SPECIAL INSTRUCTIONS TO BIDDERS
1. SPECIAL PREOUALIFICATION REOUIREMENTS. All contractors, submitting bids are
required to meet the Fort Worth Water Department special pre -qualification requirements for this
project prior to submitting bids. Previous oreaualification by the Forth Worth Water
Department will not be considered as meeting this requirement.
This one-time special project -specific process will pre -qualify potential bidders whose bids will be
considered for award based upon technical evaluation, historical schedule compliance
evaluation, evaluation of proposed manager and project superintendent. It is the bidder's
responsibility to submit documentation for those items listed below, to the Director of the Water
Department or his designated representative, at least fourteen (14) calendar days prior to the date
of bid opening. The bidder is not required to submit additional "Experience Record", "Equipment
Schedule", and "Financial Statement" on Owner famished forms one week prior to the bid opening
as described in the first paragraph of C2-2.1 of the General Conditions. The Water Department
may request any other documents it may deem necessary. Any additional documents so requested
shall be submitted to the Director of the Water Department or his designated representative at least
seven (7) calendar days prior to the date of the opening bids.
a) COVER LETTER. The cover letter provided by the prospective bidder with the pre -
qualification information must include name of a contact individual that the City may
contact for additional information.
b) FINANCIAL STATEMENT. The financial statement required shall have been prepared
by an independent certified public accountant or independent public accountant holding a
valid permit issued by an appropriate State licensing agency and shall have been so
prepared as to reflect the financial status of the submitting company. This statement must
be current and not more than one (1) year old. In the case that a bidding date falls within
the time a new statement is being prepared, the previous statement shall be updated by
proper verification.
c) EXPERIENCE RECORD. For an experience record to be considered to be acceptable for
a given project, it must reflect the experience of the firm seeking qualification in the work
" of both the same nature and technical level as that of the project for which bids are to be
received. Experience must be on projects that were completed no more than 5 years prior
to the date on which bids will be received. A minimum of three references must be
included. References must include a contact person name, telephone number, project
name and total cost, and type of work done.
d) EOUIPMENT SCHEDULE. The prospective bidder shall list the equipment that the
Contractor has available for the project and list the equipment that Contractor will rent as
may be required to complete the project on which the Contractor submits a bid.
e) PERSONNEL AND SCHEDULE COMPLIANCE RECORD. The prospective bidder
shall submit the names and resumes for the proposed project manager and project
superintendent. This information shall include a list of all projects that the proposed
project manager and project superintendent completed within the last five (5) years to
demonstrate ability to coordinate complex plant rehabilitation work and to perform work
while maintaining critical shutdown schedules, regardless of by whom they were
employed. Provide list of contact persons for all projects (preferably field inspectors or
resident engineers) with names and phone numbers for the last five years' project.
A-1
In the event the Bidder on this contract is a Joint Venture, financial statements from each joint venturer
shall be submitted for prequalification, as well as the experience record and list of equipment of each joint
venturer. The financial statements required shall have been prepared by an independent certified public
accountant or independent public accountant holding a valid license issued by an appropriate State licensing
agency and shall have been so prepared as to reflect the financial status of each joint venturer. The
statements must be current and not more than one (1) year old. In the case that a bidding date falls within
the time a new statement is being prepared, the previous statement shall be updated by proper verification.
It is not required that each joint venturer shall have the necessary experience and equipment, rather than
combined, the joint venture has the required experience and equipment. Upon request, the joint venture
agreement shall be submitted for review.
The Water Department will review each pre -qualification submittal. The following conditions will apply:
a) The Director of the Water Department shall be the sole judge as to the acceptability for
financial, experience, and other qualifications to bid on any Fort Worth Water
Department project.
b) The City, in its sole discretion, may reject a bid for failure to demonstrate experience
and/or expertise.
c) Any proposals submitted by a non pre -qualified bidder shall be returned unopened, and if
inadvertently opened, shall not be considered.
d) The City will attempt to notify prospective bidders whose qualifications (financial or
experience) are not deemed to be appropriate to the nature and/or magnitude of the
project on which bids are to be received. Failure to notify shall not be a wavier of any
necessary pre -qualification.
For additional information contact Seiavash Mir, Fort Worth Water Department at (817) 392-6828 (FAX
817-392-8404). Pre -qualification submittal should be sent to:
Mr. Seiavash Mir
Fort Worth Water Department
1000 Throckmorton
Fort Worth, TX 76102-6212
EXAMINATION OF CONTRACT DOCUMENTS AND SITE:
2.1 Before submitting his Bid, each Bidder must (a) examine the Contract Documents
thoroughly, (b) visit the site to familiarize himself with local conditions that may in any
manner affect performance of the work, (c) familiarize himself with federal, state and
local laws, ordinances, rules and regulations affecting performance of the work, and (d)
carefully correlate his observations with the requirements of the Contract Documents.
2.2 Reference is made to the Supplementary Conditions for the identification of those surveys
and investigation reports of subsurface or latent physical conditions at the site or
otherwise affection performance of the work which have been relied upon by Engineer In
preparing the Drawings and Specifications. The data is furnished for information only and
neither the Owner nor Engineer guarantees the accuracy of the data. Before submitting his
Bid, each Bidder will, at his own expense, make such additional surveys and
investigations as he may deem necessary to determine his bid price for performance of the
�. work within the terms of the Contract Documents.
A-2
PART B - PROPOSAL
This proposal must not be removed from this book of Contract Documents.
TO: Dale A. Fisseler, P.E.
City Manager
Fort Worth, Texas
PROPOSAL FOR: The furnishing of all equipment, materials, and labor and all incidental work required to respond as
requested by the Fort Worth Water Department for water and wastewater emergencies.
PROJECT NAME City of Fort Worth Water Department
Repainting and Renovation of Alta Mesa 9.2 Million Gallon Ground Storage Facility,
Structural Repairs and Renovation for Eastwood 1.5 MG Elevated Storage Facility, and
Exterior Touchup Painting for Como 6.0 MG Ground Storage Facility
Project Number P265-606180130580
Pursuant to the foregoing Notice to Bidders', the undersigned Bidder, having thoroughly examined the Contract
Documents, including plans, special contract documents, and the General Contract Documents and General
Specifications for Water Department Projects, the site of the project and understanding the amount of work to be done,
and the prevailing conditions, hereby proposes to do all the work, Punish all labor, equipment and material except as
specified to be furnished by the City, which is necessary to fully complete the work as provided in the Plans and Special
Contract Documents and subject to the inspection and approval of the Director of the Water Department of the City of
Fort Worth, Texas; and binds himself upon acceptance of this Proposal to execute a contract and furnish an approved
Performance Bond, Payment Bond, Maintenance Bond, and such other bonds, if any, as may be required by the Contract
Documents for the performing and completing of the said work. Contractor proposes to do the work within the time
.. stated and for the following sums:
B-1
REPAINTING AND RENOVATION OF ALTA MESA 9.2 MILLION GALLON GROUND STORAGE FACILITY,
STRUCTURAL REPAIRS AND RENOVATION FOR EASTWOOD 1.5 MG ELEVATED STORAGE FACILITY,
AND EXTERIOR TOUCHUP PAINTING FOR COMO 6.0 MG GROUND STORAGE FACILITY
BID SCHEDULE
PAY APPROX. DESCRIPTION OF ITEMS WITH UNIT TOTAL
ITEM QUANT. BID PRICES WRITTEN IN WORDS PRICE AMOUNT BID
(Furnish and install, including all appurtenant work, complete in place, the following items):
I I LS Bonds & Insurance.
Ten thousand Dollars &
No Cents $ 10, 000.00 $ 10, 000.00
2 1 LS Mobilization.
Ten thousand Dollars &
No Cents $ 10, 000.00 $ 10, 000.00
ALTA MESA GST
3 1 LS Interior surface preparation.
Four hundred fifty thousand Dollars &
No Cents $ 450, 000.00 $ 450, 000.00
4 1 LS Paint all interior surfaces.
Two hundred thousand Dollars &
No Cents $ 200, 000.00 $ 200, 000.00
5 1 LS Provide dehumidification for interior surface
preparation and painting.
Fifty thousand Dollars &
No Cents $ 50, 000.00 $ 50, 000.00
6 1 LS Exterior surface preparation by mechanical methods to
capture spent blast media.
Two hundred thousand Dollars &
w
No Cents $ 200, 000.00 $ 200, 000.00
7 1 LS Paint all exterior surfaces.
Sixty thousand Dollars &
No Cents $ 60, 000.00 $ 60, 000.00
B-2
PAY
APPROX.
DESCRIPTION OF ITEMS WITH
UNIT
TOTAL
ITEM
QUANT.
BID PRICES WRITTEN IN WORDS
PRICE
AMOUNT BID
(Furnish and install, including all appurtenant work, complete in place, the following
items):
8
1 LS
Disconnection and removal of the existing cathodic
protection system. Includes electrical disconnect,
removal of controller, conduits, and wiring.
_
Four thousand Dollars &
No Cents
$
4,000.00
$
4,000.00
9
1 LS
Furnish & install cathodic porthole replacement
covers. Includes seal welding on exterior & seam
sealing interior.
Four thousand Dollars &
No Cents
$
4,000.00
$
4,000.00
10
2 EA
Furnish & install 30"X 30" aluminum hatches..
Eight thousand Dollars &
No Cents
$
4,000.00
$
8,000.00
11
1 LS
Furnish & install 16" stainless steel ladder in wet
area. Includes antifall device.
Five thousand Dollars &
No Cents
$
5,000.00
$
5,000.00
12
2 E.4
Furnish & install 42" handrail modification as shown
on plan sheet.
Eight thousand Dollars &
No Cents
$
4,000.00
$
8,000.00
13
2 EA
Furnish & install 36" access manways.
Fourteen thousand Dollars &
No Cents
$
7,000.00
$
14, 000.00
14
1 LS
Furnish & install new 36" vandal resistant vent w/ 16
gauge stainless steel mesh insect screen.
Six thousand Dollars &
No Cents
$
6,000.00
$
6,000.00
15
1 LS
Remove & replace the existing overflow pipe. Reinstall
existing weir at same elevation.
Thirty thousand Dollars &
No Cents
$
30, 000.00
$
30, 000.00
PAY
APPROX.
DESCRIPTION OF ITEMS WITH
UNIT
TOTAL
ITEM
QUANT.
BID PRICES WRITTEN IN WORDS
PRICE
AMOUNT BID
(Furnish and install, including all appurtenant work, complete in place, the following items):
16
1 LS
Furnish & install labor & materials to mods center
column rafter support as shown on drawings.
Fifteen thousand Dollars &
No Cents
$ 15,000.00
$ 15,000.00
17
1 LS
Furnish & install temporary roof support during center
column modification.
Two thousand Dollars &
No Cents
$ 2, 000.00
$ 2,000.00
18
40 EA
Replace roof rafters and beams as directed by
engineer.
Sixteen thousand Dollars &
No Cents
$ 400.00
$ 16, 000.00
19
SO EA
Floor, wall, and roof underside pit repairs and
directed by engineer.
Five hundred Dollars &
No Cents
$ 10.00
$ 500.00
20
1 LS
Clean & grout exterior floor plate to ringwall
connection joint.
Two thousand Dollars &
No Cents
$ 2,000.00
$ 2,000.00
21
1 LS
Seam seal roofplate overlap connections.
Ten thousand Dollars &
No Cents
$ 10, 000.00
$ 10, 000.00
22
1 LS
Jacking and wedging the roofplate at the rafters.
Thirty thousand Dollars &
No Cents
$ 30,000.00
$ 30,000.00
23
1 LS
Removal & proper disposal of blast media.
Four thousand Dollars &
No Cents
$ 4,000.00
$ 4,000.00
PAY
APPROX.
DESCRIPTION OF ITEMS WITH
UNIT
TOTAL
ITEM
QUANT.
BID PRICES WRITTEN IN WORDS
PRICE
AMOUNT BID
(Furnish and install, including all appurtenant work, complete in place, the following items):
24
1 LS
Allowance for having structural drawings sealed and
signed by a Registered Professional Engineer.
Five thousand Dollars &
No Cents
$ 5,000.00
$ 5,000.00
25
10 EA
Floor, roof or wall repairs requiring plating of areas
larger than 30" square of material. Item shall only be
used with the advance approval of the Engineer.
One thousand Dollars &
No Cents
$ 100.00
$ 1,000.00
26
1 LS
Site clean-up & demobilization.
Two thousand Dollars &
No Cents
$ 2,000.00
2,000.00
27
250 SY
Block Sod all disturbed areas
Two thousand five hundred Dollars &
No Cents
$ 10.00
2,500.00
28
1 EA
Remove a working door sheet & replace upon
completion of interior work Have welds radiograph
tested.
One thousand Dollars &
No Cents
$ 1,000.00
$ 1,000.00
29
1 LS
Paint City of Fort Worth Logo
Six thousand Dollars &
No Cents
$ 6,000.00
$ 6,000.00
EASTWOOD EST
30 18 EA Remove existing spider rods and install new spider
rods.
Eighteen thousand Dollars &
No Cents $ 1,000.00 $ 18, 000.00
31 2 EA Remove upper and lower thrust rings and install new
thrust rings.
Eighteen thousand Dollars &
No Cents $ 9,000.00 $ 18, 000.00
B-5
PAY
APPROX.
DESCRIPTION OF ITEMS WITH
UNIT
TOTAL
ITEM
QUANT.
BID PRICES WRITTEN IN WORDS
PRICE
AMOUNT BID
(Furnish and install, including all appurtenant work, complete in place, the following
items):
32
1 LS
Install new upper level landing. Includes removal of
existing structure and members.
Ten thousand Dollars &
No Cents
$
10, 000.00
$ 10, 000.00
33
1 LS
Paint all new components and interior surfaces
affected by construction activities.
Twenty thousand Dollars &
No Cents
$
20, 000.00
$ 20, 000.00
34
1 LS
Touchup paint all exterior surfaces affected by
construction activities.
—
Two thousand Dollars &
No Cents
$
2,000.00
$ 2,000.00
COMO EST
35
1 LS
Solid seam weld the cornicelshell connection.
Two thousand Dollars &
No Cents
$
2,000.00
$ 2,000.00
36
12 EA
Drill'/ " weepholes at locations behind each faux
_
pilaster. Weld threaded nipple and install copper
tubing as shown on the plans.
Nine thousand six hundred Dollars &
No Cents
$
800.00
$ 9,600.00
37
12 EA
Remove and install each faux pilaster for installation
4
of the weepholes and tubing.
Twenty./bur thousand Dollars &
No Cents
$
2,000.00
$ 24, 000.00
38
1 LS
Power wash the tank shell to remove all rust stains.
Five thousand Dollars &
—
No Cents
$
5,000.00
$ 5,000.00
39
1 LS
Touchup paint all exterior cornice and shell areas
affected by welding activities.
Ten thousand Dollars &
No Cents
$
10, 000.00
$ 10, 000.00
:M
PAY APPROX. DESCRIPTION OF ITEMS WITH UNIT TOTAL
ITEM QUANT. BID PRICES WRITTEN IN WORDS PRICE AMOUNT BID
(Furnish and install, including all appurtenant work, complete in place, the following items):
40 1 LS Touchup paint all interior shell, roof, and rafter areas
affected by welding activities.
Five thousand Dollars &
No Cents $ 5,000.00 $ 5,000.00
41 1 LS Construction contingency allowance to be used only if
_ needed and with written direction from the Owner.
Fifty thousand Dollars &
No Cents $ 50, 000.00 $ 50, 000.00
TOTAL BID AMOUNT
One million three hundred twenty Dollars &
nine thousand six hundred
No Cents $ 1,329,600.00 S 1,329,600.00
(Unit prices are to be shown in both words and figures. In case of a discrepancy, the unit price in words will prevail. Prices
no listed above are the only compensation to be made. All items of work required to complete the work as shown in the plans
and as specified which are not listed as a pay item in this proposal are considered subsidiary to the items listed and the cost
of the subsidiary work should be included therein.)
no TOTAL AMOUNT BID
B-7
i
Within ten (10) days after acceptance of this Proposal, the undersigned will execute the formal contract and will deliver
an approved Surety Bond and such other bonds as required by the Contract Documents, for the faithful performance of
the Contract. The attached bid security in the amount of 5% of the Total Amount Bid is to become the property of the
City of Fort Worth, Texas, in the event the contract and bond or bonds are not executed and delivered within the time
above set forth, as liquidated damages for the delay and additional work caused thereby.
The undersigned bidder certified that he has been furnished at least one set of the General Contract Documents and
General Specifications for Water Department Projects dated January 1, 1978, and that he has read and thoroughly
understands all the requirements and conditions of those General Documents and the specific Contract Documents and
appurtenant plans.
The undersigned assures that its employees and applicants for employment and those of any labor organization,
subcontractors, or employment agency in either furnishing or referring employee applicants to the undersigned are not
discriminated against as prohibited by the terms of City Ordinance No. 7278 as amended by City Ordinance No. 7400.
(Complete A or B below, as applicable)
A. The principal place of business of our company is in the State of
Nonresident bidders in the State of , our principal
place of business, are required to be percent lower than resident bidders
by state law. A copy of the statute is attached.
Non resident bidders in the State of , our principal
place of business, are not required to underbid resident bidders.
B. The principal place of business of our company or our parent company or
�i majority owner is in the State of Texas.
The Bidder agrees to begin construction within 10 calendar days after issue of the work order, and to substantially
.� complete the contract within 150 calendar days after beginning construction as set forth in the written
work order to be furnished by the Owner.
I (we) acknowledge receipt of the following addenda to the plans and specifications, all of the provisions and
requirements of which have been taken into consideration on preparation of the foregoing bid:
Addendum No. 1 (Initials) Addendum No. 3 (Initials)
Addendum No. 2 (Initials) Addendum No. 4 (Initials)
�. Sig4
President
Title or Position
N.G. Painting,L.E.
.. Contractor
313 Mill Run
Street
Kerrville, TX 78028
City, State Zip
Seal 830-257-5940
If Bidder is Corporation
Date: Telephone Number
B-8
FORT WORTH
City of Fort Worth
..
Minority and Women Business Enterprise Specifications
SPECIAL INSTRUCTIONS FOR BIDDERS
APPLICATION OF POLICY
If the total dollar value of the contract is $25,000 or more, the M/WBE goal is applicable.
If the total dollar value of the contract is less than $25,000, the M/WBE goal is not applicable.
POLICY STATEMENT
It is the policy of the City of Fort Worth to ensure the full and equitable participation by Minority and Women Business
Enterprises (MNVBE) in the procurement of all goods and services to the City on a contractual basis. All requirements
and regulations stated in the City's current Minority and Women Business Enterprise Ordinance apply to this bid.
M/WBE PROJECT GOALS
The City's M/WBE goal on this project is 21 % of the total bid (Base bid applies to Parks and Community Services).
COMPLIANCE TO BID SPECIFICATIONS
On City contracts of $25,000 or more, bidders are required to comply with the intent of the City's M/WBE Ordinance by
either of the following:
1. Meet or exceed the above stated MIWBE goal, or
2. Good Faith Effort documentation, or:
3. Waiver documentation, or;
4. Joint Venture.
SUBMITTAL OF REQUIRED DOCUMENTATION
The applicable documents must be received by the Managing Department, within the following times allocated, in order
for the entire bid to be considered responsive to the specifications. The1_0ffer sW= r tt*.MVitBE documentation
in l . at�t employee, of the mans , dgPartrtx t :� obtal �€4 :rapt:..: Such receipt shall
be tr t i t!thadocumehl6tionin to time=aii A "i -0 4r not bpi accepter$
1. Subcontractor Utilization Form, if goal is received by 5:00 p.m., five (5) City business days after the bid
,r met or exceeded: opening date, exclusive of the bid opening date.
2. Good Faith Effort and Subcontractor received by 5:00 p.m., five (5) City business days after the bid
Utilization Form, if participation is less than opening date, exclusive of the bid opening date.
stated goal:
3. Good Faith Effort and Subcontractor received by 5:00 p.m., five (5) City business days after the bid
Utilization Form, if no M/WBE participation: opening date, exclusive of the bid opening date.
4. Prime Contractor Waiver Form, if you will received by 5:00 p.m., five (5) City business days after the bid
perform all subcontracting/supplier work: opening date, exclusive of the bid opening date.
5. Joint Venture Form, if utilize a joint venture received by 5:00 p.m., five (5) City business days after the bid
to met or exceed goal. opening date, exclusive of the bid opening date.
FAILURE TO COMPLY WITH THE CITY'S M/WBE ORDINANCE, WILL RESULT IN THE BID BEING CONSIDERED
NON -RESPONSIVE TO SPECIFICATIONS
Any questions, please contact the M/WBE Office at (817) 392-6104.
Rev. 1111105
FORT WORTH City of Fort Worth
Subcontractors/Suonliers Utilization Form
PRIME COMPANY NAME: I Check applicable block to describe prime
PROJECT NAME:
M1W/DBE I I NON-M/W/DBE
BID DATE
Citys M/VVBE Project Goal: Primes M/WBE Project Utilization: PROJECT NUMBER
Identify all subcontractors/suppliers you will use on this project
Failure to complete this form, in its entirety with requested documentation, and received by the Managing Department on or before
5:00 p.m. five (5) City business days after bid opening, exclusive of bid opening date, will result in the bid being considered non-
responsive to bid specifications.
The undersigned Offeror agrees to enter into a formal agreement with the M/WBE firm(s) listed in this utilization schedule,
conditioned upon execution of a contract with the City of Fort Worth. The intentional and/or knowing misrepresentation of facts is
grounds for consideration of disqualification and will result in the bid being considered non -responsive to bid specifications
M/WBEs listed toward meeting the project goal must be located in the nine (9) county marketplace or currently doing
business in the marketplace at the time of bid. Marketplace is the geographic area of Tarrant, Parker, Johnson, Collin, Dallas,
Denton, Ellis, Kaufman and Rockwall counties.
Identify each Tier level Tier is the level of subcontracting below the prime contractor, i.e., a direct payment from the prime
contractor to a subcontractor is considered 1 '2 tier, a payment by a subcontractor to its supplier is considered 2nd tier
ALL M/WBEs MUST BE CERTIFIED BEFORE CONTRACT AWARD.
Certification means those firms, located or doing business at the time of bid opening within the Marketplace, that have been
determined to be bonafide minority or women businesses by the North Central Texas Regional Certification Agency (NCTRCA), or
the Texas Department of Transportation (TX DOT), highway division. Disadvantaged Business Enterprise (DBE) is synonymous
with Minority/Women Business Enterprise (M/WBE).
If hauling services are utilized, the prime will be given credit as long as the M/WBE listed owns and operates at least one fully
licensed and operational truck to be used on the contract. The M/WBE may lease trucks from another M/WBE firm, including
M/WBE owner -operators, and receive full M/WBE credit. The M/WBE may lease trucks from non-M/WBEs, including owner -
operators, but will only receive credit for the fees and commissions earned by the M/WBE as outlined in the lease agreement.
aw
Primes are required to identify ALL subcontractors/suppliers, regardless of status; i.e., Minority, Women and non-M/WBEs.
Please list M/WBE firms first, use additional sheets if necessary.
Certification N
(check one) o
SUBCONTRACTOR/SUPPLIER T n Detail
•� Company Name ; N T Detail Supplies
C X M Subcontracting Work Dollar Amount
Address e M W T D W Purchased
Telephone/Fax r B B R O B
E E C T E
A
Mw
no
No
FORT WORTH
Primes are required to identify ALL subcontractors/suppliers, regardless of status; i.e., Minority, Women and non-M/WBEs.
aw Please list M/WBE firms first, use additional sheets if necessary.
Certification N
(check one)
SUBCONTRACTOR/SUPPLIER T n
Company Name i N T Detail Detail
Address M W C X M Subcontracting Work Supplies Purchased Dollar Amount
Telephone/Fax r B B T W
R �B
E E C T E
A
r
no
No
FORT�WQ�RTH
T
Total Dollar Amount of M/WBE Subcontractors/Suppliers $
Total Dollar Amount of Non-M/WBE Subcontractors/Suppliers $
TOTAL DOLLAR AMOUNT OF ALL SUBCONTRACTORS/SUPPLIERS
The Contractor will not make additions, deletions, or substitutions to this certified list without the prior approval of the Minority and
Women Business Enterprise Office Manager or designee through the submittal of a Request for Approval of Change/Addition. Any
unjustified change or deletion shall be a material breach of contract and may result in debarment in accord with the procedures outlined
in the ordinance. The contractor shall submit a detailed explanation of how the requested change/addition or deletion will affect the
committed M/WBE goal. If the detail explanation is not submitted, it will affect the final compliance determination.
.. By affixing a signature to this form, the Offeror further agrees to provide, directly to the City upon request, complete and accurate
information regarding actual work performed by all subcontractors, including M/W/DBE(s) arrangements submitted with the bid.
The Offeror also agrees to allow an audit and/or examination of any books, records and files held by their company. The bidder
agrees to allow the transmission of interviews with owners, principals, officers, employees and applicable
dw subcontractors/suppliers/contractors participating on the contract that will substantiate the actual work performed by the M/W/DBE(s)
on this contract, by an authorized officer or employee of the City. Any intentional and/or knowing misrepresentation of facts will be
grounds for terminating the contract or debarment from City work for a period of not less than three (3) years and for initiating action
under Federal, State or Local laws concerning false statements. Any failure to comply with this ordinance and create a material
breach of contract may result in a determination of an irresponsible Offeror and barred from participating in City work for a period of
time not less than one (1) year.
�. Authorized Signature
Title
Company Name
Address
City/State/Zip
Printed Signature
Contact Name/Title (if different)
Telephone and/or Fax
E-mail Address
Date
am
FORT WORTH
PRIME COMPANY NAME:
PROJECT NAME:
City s NMBE Project Goal:
%
City of Fort Worth
Prime Contractor Waiver Form
PROJECT NUMBER
ATTACHMENT 1B
Page 1 of 1
Check applicable block to describe prime
M/W/DBE I I NON-M/W/DBE
d BID DATE
If both answers to this form are YES, do not complete ATTACHMENT 1C (Good Faith Effort Form). All questions on this
form must be completed and a detailed explanation provided, if applicable. If the answer to either question is NO, then you
must complete ATTACHMENT 1 C. This form is only applicable if bath answers are yes.
Failure to complete this form in its entirety and be received by the Manama Department on or before 5:00 p.m.. five
(5) City business days after bid opening, exclusive of the bid opening date, will result in the bid being considered non-
responsive to bid specifications.
Will you perform this entire contract without subcontractors? YES
If yes, please provide a detailed explanation that proves based on the size and scope of this project, this is
your normal business practice and provide an operational profile of your business. NO
Will you perform this entire contract without suppliers? YES
If yes, please provide a detailed explanation that proves based on the size and scope of this project, this is
your normal business practice and provide an inventory profile of your business. i NO
The bidder further agrees to provide, directly to the City upon request, complete and accurate information regarding actual
work performed by all subcontractors, including M/WBE(s) on this contract, the payment therefore and any proposed
changes to the original M/WBE(s) arrangements submitted with this bid. The bidder also agrees to allow an audit and/or
examination of any books, records and files held by their company that will substantiate the actual work performed by the
M/WBEs on this contract, by an authorized officer or employee of the City. Any intentional and/or knowing
misrepresentation of facts will be grounds for terminating the contract or debarment from City work for a period of not less
than three (3) years and for initiating action under Federal, State or Local laws concerning false statements. Any failure to
comply with this ordinance creates a material breach of contract may result in a determination of an irresponsible offeror and
barred from participating in City work for a period of time not less than one (1) year.
Authorized Signature Printed Signatme
Title Contact Name (if different)
Company Name Phone Number Fax Number
Address Email Address
City/ state Lip Date
Rev. 6130103
Joint Venture
FORT WORTH Page 1 of 3
CITY OF FORT WORTH
Joint Venture Eligibility Form
All questions must be answered; use "NA" ff applicable.
Name of City project:
A joint venture form must be completed on each project
RFPBid/Purchasing Number:
1. Joint venture information:
Joint Venture Name:
Joint Venture Address:
(If applicable)
Telephone:
I Facsimile:
E-mail address:
Cellular:
Identify the firms that comprise the joint venture
Please attach extra sheets if additional
space is required to provide detailed explanations ofwork to be performed by each firm comprising the joint venture
M/WBE firm
I
Non-NLI"E
name:
firm name:
Business Address:
Business Address:
City, State, Zip:
I City, State, Zip:
Telephone Facsimile
E-mail
Telephone Facsimile
Cellular
Cellular
Certification Status:
E-mail address
Name of Certifying Agency:
2. Scope of work performed by
the Joint Venture:
Describe the scope of work of the M/WBE: Describe the scope of work of the non-M/WBE:
Rev. 5/30/03