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STATE OF NORTH CAROLINADEPARTMENT OF TRANSPORTATIONPAT MCCRORYANTHONY J. TATAGOVERNORSECRETARYJanuary 13, 2015CONTRACT:TIP:WBS ELEMENT:FEDERAL-AID -0070(173)CravenRest AreaPRE-BID MEETING NOTESAND FOLLOW UP INFORMATIONA Pre-Bid Conference was held for the above referenced project on Thursday, January 8, 2015.The following were in attendance:NameCompanySarah LentineNCDOT – Division 2Betty CaldwellNCDOT – Division 2John WellsNCDOT – Division 2 Roadside EnvironmentalJeffery GurganusNCDOT – Division 2 Roadside EnvironmentalVann SparrowNCDOT – Division 2 Roadside EnvironmentalHeather CauseyNCDOT – Division 2 ConstructionSaundra LivelyNCDOT – Division 2 ConstructionTadd DavisNCDOT – Roadside Environmental UnitTony MedlinNCDOT - Contractor Utilization & CertificationJohn K. FarkasJKF ArchitectureRoland CoteDaniels & Daniels Construction Co. IncGeorge LottL. A. Downey & Son, Inc.Tony MarshallPro Construction, Inc.Todd GreenwoodBlue Ridge Enterprises, Inc.Michelle BentonSunland Builders Inc.Jimmy DillahuntJE Dillahunt & Assoc. / Trader ConstructionDoug BroughtonCalvin Davenport, Inc.Michael McKoyM & V Consulting and ContractsTerry L CarterCadet ConstructionBilly TaylorBrydge and LeeCarl MartinDanco BuildersMAILING ADDRESS:DIVISION TWO - OPERATIONSP.O. BOX 1587GREENVILLE, NC 27835TELEPHONE: (252) 439-2800FAX: (252) 830-3325WEBSITE: WWW.NCDOT.GOVLOCATION:1704 N GREENE STGREENVILLE, NC
DB00211 Pre-Bid MeetingPage 2 of 4Ms. Lentine began the meeting with general information regarding the bidding of Division LetProjects. She reviewed attachment #1, “Information for Bidders.” Common mistakes found onbids that were highlighted were; Leaving corporate seal off of the Execution of Bid form Not having the Execution of Bid form Notarized Incorrect math on the Itemized Proposal Sheet Missing signatures of the Authorized Agent and Witness on Signature SheetMr. Medlin then reviewed the attachment #2, regarding the use of DBE subcontractors. Theitems he highlighted were; How to find and use the Vendor Directory to search for DBE subcontractors The difference between DBE, MBE, WBE, and HUB Meeting contract goal requirements Submission of a Good Faith Effort if contract goal is not met Providing Letters of Intent from committed DBE subcontractors, after project is awarded Other ways to meet criteria using Manufacturers (Producers), which count 100% of dollaramount towards goal, or using Suppliers, which count 60% of dollar amount towards goalMs. Lentine then drew attention to the following information in the Project Special Provisions; Codes, Permits and Inspections, page 10o “All work under this contract shall conform to the North Carolina State BuildingCode and other state, local and national codes as are applicable. The cost of allrequired inspection and permits shall be the responsibility of the Contractor.”o “Inspection and certification of compliance by the NC Department of Insurance isrequired on the electrical work on the project.” Roof Guarantee, page 10o “ the Contractor shall guarantee the materials and workmanship of the roofingagainst defect due to faulty material, workmanship and negligence by Contractorsfor a period of twenty-four (24) months following final acceptance of the work ” Guarantee, page 12o “The Contractor shall guarantee the materials and workmanship against defectdue to faulty materials or faulty workmanship or negligence for a period of twelve(12) months following the final acceptance of the work” Disadvantaged Business Enterprise (Divisions), page 25-33o “ The following DBE goal for participation by Disadvantaged BusinessEnterprises is established for this contract: Disadvantaged Business Enterprises3.0%”
DB00211 Pre-Bid MeetingPage 3 of 4Ms. Lentine then opened the meeting up for questions.Question:What work code is required to be a prime contractor on this project?Answer:In order to bid on the project as a prime contractor, either work code Rest Area Building orOther – General Contractor for Vertical Construction are required. Please look your company upon our Vendor Directory to check your prequalification status.Additional Information (not provided at meeting):The work code numbers are “00400 – Rest Area Building” or “00099 – Other – GeneralContractor for Vertical Construction”Question:Is there a bid bond required for this project?Answer:There is no bid bond required for this project.Question:Are Level II Erosion Control Certifications required for this project?Answer:This project involves land disturbing activity and Level II Erosion Control Certifications will berequired.Additional information (not provided at meeting):It was determined that since this project has less than 1 acre of disturbance there will notbe a need for Level II Erosion Control Certifications.Question:Does the generator shown on plan sheet U1.3 come with an Automatic Switch?Answer:The plans state on sheet U1.3 that the generator will be provided “with service entry ratedmanual transfer switch”, there is no automatic switch.There were no further questions.Mr. Farkas stated that the contractors should take note that product substitutions will only bereviewed when they are received from a General Contractor only. They will not be reviewedwhen submitted by a producer or supplier.Mr. Wells provided the attachment #3, plan sheet with the trees to be removed numbered and alist with the description and size of each tree.
DB00211 Pre-Bid MeetingPage 4 of 4There being no further business the meeting was adjourned.Sincerely,Sarah LentineDivision Contract Officercc:Mr. Ed Eatmon, PEMr. Bill Kincannon, PEMs. Betty Caldwell, PEMr. Tad DavisMr. John Wells
Attachment #1
Information for Bidders:Bid Documents for NCDOT Division Let ProjectsThis document includes a checklist and examples of bidding documents. It is to be used as aresource for Bidders and does not replace or amend the proposal or the 2012 NCDOT StandardSpecifications. It is the sole responsibility of the Bidder to ensure all bid documents are inaccordance with the 2012 NCDOT Standard Specifications prior to their submission.
1Bidder’s ChecklistPrint the bid form furnished by NCDOT with the proposal. This shall be used and shall not be altered inany manner. DO NOT SEPARATE THE BID FORM FROM THE PROPOSAL!All entries on the bid form, including signatures, shall be written in ink.Enter a unit price for every item on the bid form. The unit prices for the various contract items shall bewritten in figures. ***Unit Prices shall be rounded off by the bidder to contain no more thanFOUR decimal places***Enter the amount bid on the bid form for every item. The amount bid for each item shall be determinedby multiplying each unit bid by the quantity for that item, and shall be written in figures in the "AmountBid" column of the form. ***Check the math***Enter the total amount bid. This shall be written in figures in the proper place on the bid form. The totalamount shall be determined by adding the amounts bid for each item. ***Check the math***Changes in any entry shall be made by marking through the entry in ink and making the correct entryadjacent thereto in ink. A representative of the Bidder shall initial the change in ink.If the Bidder elects to prepare their bid by electronic means, and it is an option for the project, they mustrefer to the provision titled “COMPUTER BID PREPARATION” found in the proposal.Fill out the proper Bid Execution Form. Bid Execution Form must be notarized. Corporations must sealthe Bid Execution Form.The bid shall be properly executed. All bids shall show the following information:Name of individual, firm, corporation, partnership, or joint venture submitting bid.Name and signature of individual or representative submitting bid and position or title.Name, signature, and position or title of witness.Completed attestation by Notary PublicBids submitted by corporations shall bear the seal of the corporation.Fill out signature sheet completely and have representative and witness sign.Fill out the DBE or MBE-WBE Worksheet. Follow the provision titled “DISADVANTAGEDBUSINESS ENTERPRISE (DIVISIONS)” or “MINORITY BUSINESS ENTERPRISE AND WOMENBUSINESS ENTERPRISE (DIVISIONS)” in the proposal, to fill out the worksheet.Place the proposal with the bid sheet still attached in a sealed envelope. Refer to the Instruction toBidders page in the proposal for the statement to display on the front of the sealed envelope.If delivered by mail, the sealed envelope shall be placed in another sealed envelope and the outerenvelope shall be addressed as stated on the Instruction to Bidders page in the proposal.Review the Instruction to Bidders page in the proposal.
2MBE-WBE Subcontractors
3M-3LISTING OF MBE/WBE SUBCONTRACTORSFirm Name and AddressCircleOneItem No.Item DescriptionSheet of* Agreed uponUnit Price** Dollar Volume of EWBEEXAddressNameMBEAddressWBE* The Dollar Volume shown in this column shall be the Actual Price Agreed Upon by the Prime Contractor and the MBE/WBEsubcontractor, and these prices will be used to determine the percentage of the MBE/WBE participation in the contract.** Dollar Volume of MBE/WBE Subcontractor Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
4M-3LISTING OF MBE/WBE SUBCONTRACTORSFirm Name and AddressCircleOneItem No.Item DescriptionSheet of* Agreed uponUnit Price** Dollar Volume of EWBEEXAddress* The Dollar Volume shown in this column shall be theActual Price Agreed Upon by the Prime Contractor and theMBE/WBE subcontractor, and these prices will be used todetermine the percentage of the MBE/WBE participationin the contract.** Dollar Volume of MBE Subcontractor MBE Percentage of Total Contract Bid Price %** Dollar Volume of WBE Subcontractor ** Dollar Volume of MBE/WBE SubcontractorWBE Percentage of Total Contract Bid Price %Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
5M-3LISTING OF MBE/WBE SUBCONTRACTORSCircleOneNameTRUCKS N’ MOREMBEAddressWBE528 PARK LANE, SUNNY, NCNameNO EROSION INCMBEAddressWBE75 BUSINESS PARK, SUNNY, NCNameMBEAddressWBENameAddressNameItem Description* Agreed uponUnit Price** Dollar Volume of Item7ASPHALT B25.0B(HAULING ONLY) 5.00 1000.008ASPHALT S9.5B(HAULING ONLY) 5.00 3000.00TEMP SILT FENCE 2.00 2000.00SEEDING ANDMULCHING 4500.00 4500.002021AMMBEItem No.PLEFirm Name and AddressSheet 1 of WBE* The Dollar Volume shown in this column shall be the Actual Price Agreed Upon by the Prime Contractor and the MBE/WBEsubcontractor, and these prices will be used to determine the percentage of the MBE/WBE participation in the contract.** Dollar Volume of MBE/WBE Subcontractor Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
6M-3LISTING OF MBE/WBE SUBCONTRACTORSFirm Name and AddressCircleOneItem No.Item DescriptionSheet 2 of 2* Agreed uponUnit Price** Dollar Volume of EWBEEXAddress* The Dollar Volume shown in this column shall be theActual Price Agreed Upon by the Prime Contractor and theMBE/WBE subcontractor, and these prices will be used todetermine the percentage of the MBE/WBE participationin the contract.** Dollar Volume of MBE Subcontractor 4000.00MBE Percentage of Total Contract Bid Price 2.0 %** Dollar Volume of WBE Subcontractor 6500.00** Dollar Volume of MBE/WBE SubcontractorWBE Percentage of Total Contract Bid Price 3.25 %Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
7DBE Subcontractors
8M-2LISTING OF DBE SUBCONTRACTORSFirm Name and AddressItem No.Item DescriptionSheet of* Agreed upon ** Dollar VolumeUnit Priceof eAddressNameEXAddressAMNameNameAddress* The Dollar Volume shown in this column shall be the Actual Price Agreed Upon by the Prime Contractor and the DBEsubcontractor, and these prices will be used to determine the percentage of the DBE participation in the contract.** Dollar Volume of DBE Subcontractor Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
9M-2LISTING OF DBE SUBCONTRACTORSFirm Name and AddressItem No.Item DescriptionSheet of* Agreed upon ** Dollar VolumeUnit Priceof eAddressNameEXAddressAMName* The Dollar Volume shown in this column shall be theActual Price Agreed Upon by the Prime Contractor and theDBE subcontractor, and these prices will be used to determinethe percentage of the DBE participation in the contract.** Dollar Volume of DBE Subcontractor Percentage of Total Contract Bid Price%** Dollar Volume of DBE Subcontractor Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
10M-2LISTING OF DBE SUBCONTRACTORSNameTRUCKS N’ MOREAddress528 PARK LANE, SUNNY, NCNameNO EROSION INCAddress75-A BUSINESS PARK, SUNNY, NCNameAddressAddressNameAddressName* Agreed upon ** Dollar VolumeUnit Priceof Item6ASPHALT B25.0B(HAULING ONLY) 5.00 1000.007ASPHALT S9.5B(HAULING ONLY) 5.00 3000.0020TEMP SILT FENCE 2.00 2000.0021SEEDING ANDMULCHING 4500.00 4500.00EXAddressItem DescriptionAMNameItem No.PLEFirm Name and AddressSheet 1 of 2NameAddress* The Dollar Volume shown in this column shall be the Actual Price Agreed Upon by the Prime Contractor and the DBEsubcontractor, and these prices will be used to determine the percentage of the DBE participation in the contract.** Dollar Volume of DBE Subcontractor Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
11M-2LISTING OF DBE SUBCONTRACTORSFirm Name and AddressItem No.Item DescriptionSheet 2 of 2* Agreed upon ** Dollar VolumeUnit Priceof eAddressNameEXAddressAMName* The Dollar Volume shown in this column shall be theActual Price Agreed Upon by the Prime Contractor and theDBE subcontractor, and these prices will be used to determinethe percentage of the DBE participation in the contract.** Dollar Volume of DBE Subcontractor 10,500.00Percentage of Total Contract Bid Price5.2 %** Dollar Volume of DBE Subcontractor Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
12M-2LISTING OF DBE SUBCONTRACTORSFirm Name and AddressItem No.Item Description12Sheetof* Agreed upon ** Dollar VolumeUnit Priceof ssNameAddressNameAddressNameAddress* The Dollar Volume shown in this column shall be the Actual Price Agreed Upon by the Prime Contractor and the DBEsubcontractor, and these prices will be used to determine the percentage of the DBE participation in the contract.** Dollar Volume of DBE Subcontractor Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
13M-2LISTING OF DBE SUBCONTRACTORSFirm Name and AddressNameItem No.Item Description2Sheetof2* Agreed upon ** Dollar VolumeUnit Priceof meAddressNameAddress* The Dollar Volume shown in this column shall be theActual Price Agreed Upon by the Prime Contractor and theDBE subcontractor, and these prices will be used to determinethe percentage of the DBE participation in the contract.0** Dollar Volume of DBE Subcontractor Percentage of Total Contract Bid Price0%** Dollar Volume of DBE Subcontractor Percentage of Total Contract Bid Price:If firm is a Material Supplier Only, show Dollar Volume as 60% of Agreed Upon Amount from Letter of Intent.If firm is a Manufacturer, show Dollar Volume as 100% of Agreed Upon Amount from Letter of Intent.Rev 11-4-13
14Execution of Bid Forms
15Contract No.Rev. 4-19-11CountyEXECUTION OF BIDNON-COLLUSION AFFIDAVIT, DEBARMENT CERTIFICATION AND GIFT BAN CERTIFICATIONCORPORATIONPLEThe person executing the bid, on behalf of the Bidder, being duly sworn, solemnly swears (or affirms) that neither he, nor anyofficial, agent or employee of the bidder has entered into any agreement, participated in any collusion, or otherwise taken anyaction which is in restraint of free competitive bidding in connection with any bid or contract, that the bidder has not beenconvicted of violating N.C.G.S. § 133-24 within the last three years, and that the Bidder intends to do the work with its ownbonafide employees or subcontractors and is not bidding for the benefit of another contractor.In addition, execution of this bid in the proper manner also constitutes the Bidder's certification of status under penalty of perjuryunder the laws of the United States in accordance with the Debarment Certification attached, provided that the DebarmentCertification also includes any required statements concerning exceptions that are applicable.N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any gift from anyonewith a contract with the State, or from any person seeking to do business with the State. By execution of any response in thisprocurement, you attest, for your entire organization and its employees or agents, that you are not aware that any such gift hasbeen offered, accepted, or promised by any employees of your organization.SIGNATURE OF CONTRACTORFull name of CorporationAMAddress as PrequalifiedAttestByPresident/Vice President/Assistant Vice PresidentSelect appropriate titlePrint or type Signer's namePrint or type Signer's nameEXSecretary/Assistant SecretarySelect appropriate titleCORPORATE SEALAFFIDAVIT MUST BE NOTARIZEDSubscribed and sworn to before me this theday of 20 .Signature of Notary Publicof CountyState ofMy Commission Expires:NOTARY SEAL
16Contract No. DZ00010Rev. 4-19-11County PlaceEXECUTION OF BIDNON-COLLUSION AFFIDAVIT, DEBARMENT CERTIFICATION AND GIFT BAN CERTIFICATIONCORPORATIONPLEThe person executing the bid, on behalf of the Bidder, being duly sworn, solemnly swears (or affirms) that neither he, nor anyofficial, agent or employee of the bidder has entered into any agreement, participated in any collusion, or otherwise taken anyaction which is in restraint of free competitive bidding in connection with any bid or contract, that the bidder has not beenconvicted of violating N.C.G.S. § 133-24 within the last three years, and that the Bidder intends to do the work with its ownbonafide employees or subcontractors and is not bidding for the benefit of another contractor.In addition, execution of this bid in the proper manner also constitutes the Bidder's certification of status under penalty of perjuryunder the laws of the United States in accordance with the Debarment Certification attached, provided that the DebarmentCertification also includes any required statements concerning exceptions that are applicable.N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any gift from anyonewith a contract with the State, or from any person seeking to do business with the State. By execution of any response in thisprocurement, you attest, for your entire organization and its employees or agents, that you are not aware that any such gift hasbeen offered, accepted, or promised by any employees of your organization.SIGNATURE OF CONTRACTORBig Time Corp.Full name of Corporation800 Office Blvd, Place, NCAMAddress as PrequalifiedAttestByPresident/Vice President/Assistant Vice PresidentSelect appropriate titleSally SmithJohn WilliamsPrint or type Signer's namePrint or type Signer's nameEXSecretary/Assistant SecretarySelect appropriate titleCORPORATE SEALAFFIDAVIT MUST BE NOTARIZEDSubscribed and sworn to before me this the1 day of January 20 .15Signature of Notary Publicof Place CountyState of NCMy Commission Expires: 12/31/16NOTARY SEAL
17Contract No.Rev. 4-19-11CountyEXECUTION OF BIDNON-COLLUSION AFFIDAVIT, DEBARMENT CERTIFICATION AND GIFT BAN CERTIFICATIONPARTNERSHIPPLEThe person executing the bid, on behalf of the Bidder, being duly sworn, solemnly swears (or affirms) that neitherhe, nor any official, agent or employee of the bidder has entered into any agreement, participated in any collusion, orotherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract,that the bidder has not been convicted of violating N.C.G.S. § 133-24 within the last three years, and that the Bidderintends to do the work with its own bonafide employees or subcontractors and is not bidding for the benefit ofanother contractor.In addition, execution of this bid in the proper manner also constitutes the Bidder's certification of status underpenalty of perjury under the laws of the United States in accordance with the Debarment Certification attached,provided that the Debarment Certification also includes any required statements concerning exceptions that areapplicable.N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any giftfrom anyone with a contract with the State, or from any person seeking to do business with the State. By executionof any response in this procurement, you attest, for your entire organization and its employees or agents, that you arenot aware that any such gift has been offered, accepted, or promised by any employees of your organization.SIGNATURE OF CONTRACTORAMFull Name of PartnershipAddress as PrequalifiedBySignature of PartnerPrint or type Signer's namePrint or type Signer's nameEXSignature of WitnessAFFIDAVIT MUST BE NOTARIZEDSubscribed and sworn to before me this theday of 20 .Signature of Notary Publicof CountyState ofMy Commission Expires:NOTARY SEAL
18Contract No. DZ00010Rev. 4-19-11County PlaceEXECUTION OF BIDNON-COLLUSION AFFIDAVIT, DEBARMENT CERTIFICATION AND GIFT BAN CERTIFICATIONPARTNERSHIPPLEThe person executing the bid, on behalf of the Bidder, being duly sworn, solemnly swears (or affirms) that neitherhe, nor any official, agent or employee of the bidder has entered into any agreement, participated in any collusion, orotherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract,that the bidder has not been convicted of violating N.C.G.S. § 133-24 within the last three years, and that the Bidderintends to do the work with its own bonafide employees or subcontractors and is not bidding for the benefit ofanother contractor.In addition, execution of this bid in the proper manner also constitutes the Bidder's certification of status underpenalty of perjury under the laws of the United States in accordance with the Debarment Certification attached,provided that the Debarment Certification also includes any required statements concerning exceptions that areapplicable.N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any giftfrom anyone with a contract with the State, or from any person seeking to do business with the State. By executionof any response in this procurement, you attest, for your entire organization and its employees or agents, that you arenot aware that any such gift has been offered, accepted, or promised by any employees of your organization.SIGNATURE OF CONTRACTORWilliams-Taylor ContractingFull Name of PartnershipAM100 Oak Lane, Place, NCAddress as PrequalifiedBySignature of WitnessSignature of PartnerJohn WilliamsPrint or type Signer's nameEXSally SmithPrint or type Signer's nameAFFIDAVIT MUST BE NOTARIZEDSubscribed and sworn to before me this the1 day of January 2015.Signature of Notary Publicof Place CountyState of NCMy Commission Expires: 12/31/16NOTARY SEAL
19Contract No.Rev. 4-19-11CountyEXECUTION OF BIDNON-COLLUSION AFFIDAVIT, DEBARMENT CERTIFICATION AND GIFT BAN CERTIFICATIONLIMITED LIABILITY COMPANYPLEThe person executing the bid, on behalf of the Bidder, being duly sworn, solemnly swears (or affirms) that neitherhe, nor any official, agent or employee of the bidder has entered into any agreement, participated in any collusion, orotherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract,that the bidder has not been convicted of violating N.C.G.S. § 133-24 within the last three years, and that the Bidderintends to do the work with its own bonafide employees or subcontractors and is not bidding for the benefit ofanother contractor.In addition, execution of this bid in the proper manner also constitutes the Bidder's certification of status underpenalty of perjury under the laws of the United States in accordance with the Debarment Certification attached,provided that the Debarment Certification also includes any required statements concerning exceptions that areapplicable.N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any giftfrom anyone with a contract with the State, or from any person seeking to do business with the State. By executionof any response in this procurement, you attest, for your entire organization and its employees or agents, that you arenot aware that any such gift has been offered, accepted, or promised by any employees of your organization.SIGNATURE OF CONTRACTORAMFull Name of FirmAddress as PrequalifiedSignature of Member/Manager/Authorized AgentSelect appropriate titlePrint or type Signer's namePrint or type Signer's NameEXSignature of WitnessAFFIDAVIT MUST BE NOTARIZEDSubscribed and sworn to before me this theday of 20 .Signature of Notary Publicof CountyState ofMy Commission Expires:NOTARY SEAL
20Contract No. DZ00010Rev. 4-19-11County PlaceEXECUTION OF BIDNON-COLLUSION AFFIDAVIT, DEBARMENT CERTIFICATION AND GIFT BAN CERTIFICATIONLIMITED LIABILITY COMPANYPLEThe person executing the bid, on behalf of the Bidder, being duly sworn, solemnly swears (or affirms) that neitherhe, nor any official, agent or employee of the bidder has entered into any agreement, participated in any collusion, orotherwise taken any action which is in restraint of free competitive bidding in connection with any bid or contract,that the bidder has not been convicted of violating N.C.G.S. § 133-24 within the last three years, and that the Bidderintends to do the work with its own bonafide employees or subcontractors and is not bidding for the benefit ofanother contractor.In addition, execution of this bid in the proper manner also constitutes the Bidder's certification of status underpenalty of perjury under the laws of the United States in accordance with the Debarment Certification attached,provided that the Debarment Certification also includes any required statements concerning exceptions that areapplicable.N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any giftfrom anyone with a contract with the State, or from any person seeking to do business with the State. By executionof any response in this procurement, you attest, for your entire organization and its employees or agents, that you arenot aware that any such gift has been offered, accepted, or promised by any employees of your organization.SIGNATURE OF CONTRACTORDriver Trucking, LLCAMFull Name of Firm123 Park Lane, Place, NCAddress as PrequalifiedSignature of WitnessJane DriverSignature of Member/Manager/Authorized AgentSelect appropriate titleJohn DriverEXPrint or type Signer's namePrint or type Signer's NameAFFIDAVIT MUST BE NOTARIZEDSubscribed and sworn to before me this the1 day of January 2015.Signature of Notary Publicof Place CountyState of NCMy Commission Expires: 12/31/16NOTARY SEAL
21Contract No.Rev. 4-19-11CountyEXECUTION OF BIDNON-COLLUSION AFFIDAVIT, DEBARMENT CERTIFICATION AND GIFT BAN CERTIFICATIONJOINT VENTURE (2) or (3)The person executing the bid, on behalf of the Bidder, b
Jimmy Dillahunt JE Dillahunt & Assoc. / Trader Construction Doug Broughton Calvin Davenport, Inc. Michael McKoy M & V Consulting and Contracts Terry L Carter Cadet Construction Billy Taylor Brydge and Lee Carl Martin Danco Builders MAILING ADDRESS: DIVISION TWO - OPERATIONS P.O. BOX 1587 GREENVILLE, NC 27835 TELEPHONE: (252) 439-2800
