PALP INC. DBA EXCEL PAVING COMPANY (3)

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Local Assistance Procedures Manual V~ EXHIBIT 12-E PS&E Checklist Instructions Attachment A ATTACHMENT A SECTION 14. FEDERAL REQUIREMENTS FOR FEDERAL -AH) CONSTRUCTION PROJECTS GENERAL.—The work herein proposed will be financed in whole or in part with Federal funds, and therefore all of the statutes, roles and regulations promulgated by the Federal Gov- emment and applicable to work financed in whole or in part with Federal fiords will apply to such work. The 'Required Contract Provisions, Federal -Aid Construction Contracts, "Form FHWA 1273, are included in this Section 14. Whenever in said required contract provisions references are made to "SHA contracting officer," "SHA resident engineer," or "authorized representative of the SHA," such references shall be construed to mean "Engineer" as defined in Section 1-1.18 of the Standard Specifications. PERFORMANCE OF PREVIOUS CONTRACT.—In ad- dition to the provisions in Section II, "Nondiscrimination," and Section VII, "Subletting or Assigning the Contract," of the re- quired contract provisions, the Contractor shall comply with the following: The bidder shall execute the CERTIFICATION WITH RE- GARD TO THE PERFORMANCE OF PREVIOUS CON- TRACTS OR SUBCONTRACTS SUBJECT TO THE EQUAL OPPORTUNITY CLAUSE AND THE FILING OF REQUIRED REPORTS located in the proposal. No request for subletting or assigning any portion of the contract in excess of $10,000 will be considered under the provisions of Section VII of the required contract provisions unless such request is accompanied by the CERTIFICATION referred to above, executed by the proposed subcontractor. NON -COLLUSION PROVISION.—The provisions in this section are applicable to all contracts except contracts for Federal Aid Secondary projects. Title 23, United States Code, Section 112, requires as a condi- tion precedent to approval by the Federal Highway Administrator of the contract for this work that each bidder file a sworn statement executed by, or on behalf of, the person, fine, association, or corporation to whom such contract is to be awarded, certifying that such person, firm, association, or corporation has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive biddingin connection with the submitted bid. A form to make the non -collusion affidavit statement required by Section 112 as a certification under penalty of perjury rather than as a sworn statement as permitted by 28, USC, Sec. 1746, is included in the proposal. PARTICIPATION BY DISADVANTAGED BUSINESS EN- TERPRISES IN SUBCONTRACTING.—Part 26, Title 49, Code of Federal Regulations applies to this Federal -aid project. Pertinent sections of said Code are incorporated in part or in its entirety within other sections of these special provisions. Schedule B—Information for Determining Joint Venture Eli- gibility FR -1 (This form need not be filled in if all joint venture firms are DBE owned.) 1. Name ofjoint venture 2. Address ofjoint venture 3. Phone number ofjoint venture 4. Identify the frets which comprise the joint venture. (The DBE partner must complete Schedule A.) a. Describe the role of the DBE firm in the joint venture. b. Describe very briefly the experience and business qualifications of each non -DBE joint venturer: 5. Nature of the joint venture's business 6. Provide a copy of the joint venture agreement. 7. What is the claimed percentage of DBE ownership? 8. Ownership ofjoint venture: (This need not be filled in if described in the joint venture agreement, provided by question 6.). Revised 3-95 0&M-95 Page 12-9 OR 12-04 June 29, 2012