10 New Premium Sites and 6 Premium Cabins & Site Repairs and Renovations

STATE OF MISSOURI
Bid Time: 1:30 PM
Bid Date: _____________
All bid documents shall be emailed to FMDCBids@oa.mo.gov
SECTION 004113 - BID FORM
1.0 BID
A. From: ________________________________________________________________________
(Bidder's Company Name)
Sole Proprietorship/General Partnership LLC Limited Partnership Corporation Joint Venture
Address:___________________________________________________________________________________
City, State, Zip ______________________________________________________________________________
Phone: ________________________ Email: :______________________________________________________
Federal ID Number: _________________________ Missouri Business Charter Number:____________________
Contact Name: _______________________________Contact email: ____________________________________
herein after called the "Bidder".
B. To: Director, Division of Facilities Management, Design and Construction
Room 730, Harry S Truman State Office Building
301 West High Street
Jefferson City, Missouri 65101
herein after called the "Owner."
C. For: 10 New Premium Sites and 6 Premium Cabins & Site Repairs and Renovations
Wakonda State Park
Lagrange, Missouri
D. Project Number: X2410-01
hereinafter called the "Work."
E. Documents: The undersigned, having examined and being familiar with the local conditions
affecting the work and with the complete set of contract documents, including the
Drawings, the Invitation For Bid, Instructions To Bidders, Statement of Bidders
Qualifications, General Conditions, Supplement to General Conditions, and the
technical specifications, including: addenda number _______ through _______
hereby proposes to perform the Work for the following:
F. Bid Amount: ___________________________________________________________________
______________________________ Dollars ($____________________________)
G. Alternates: Alternate No. 1: The work to be performed under Alternate #1 to furnish all labor,
tools, materials, machinery and equipment necessary to complete the Work in
accordance with the Contract Documents for the following: Sanitary sewer lift
stations, controls, force mains, connection to the public utility, lagoon
decommissioning and associated removals as identified on the plans. See Drawings,
noted as Alternates and Project Manual for additional information.
___________________________________________________________________
______________________________ Dollars ($____________________________)
SECTION 004113 - BID FORM Page 1 of 5
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Alternate No. 2: The work to be performed under Alternate #2 to furnish all labor,
tools, materials, machinery and equipment necessary to complete the Work in
accordance with the Contract Documents for the following: The furnishing and
installation of concrete parking lots at the Cabins site and concrete roadway
pavements at the Campsites area in lieu of asphalt pavements in the base bid.
___________________________________________________________________
______________________________ Dollars ($____________________________)
2.0 MBE/WBE/SDVE PERCENTAGE OF PARTICIPATION PROJECT GOALS
A. This project's specific goals are: MBE 10%, WBE 10%, and SDVE 3%. NOTE: Only MBE/WBE firms
certified by the State of Missouri Office of Equal Opportunity, and SDVE(s) meeting the requirements of
Section 34.074, RSMo, and 1 CSR 30-5.010, as of the date of bid opening can be used to satisfy the
MBE/WBE/SDVE participation goals for this project.
3.0 BID BOND
A. Accompanying the bid is: ___ 5% Bid Bond or ___ Cashier's Check/Bank Draft for 5% of base bid that is
payable without condition to the Division of Facilities Management, Design and Construction, State of
Missouri, as per Article 5 of "Instructions To Bidders".
4.0 CONTRACT COMPLETION TIME AND LIQUIDATED DAMAGES
A. The Bidder agrees to complete the work within 250 working days from the date the Notice of Intent to
Award is issued as modified by additional days added by the Owner's acceptance of alternates, if applicable.
This includes ten (10) working days for document mailing and processing. The Bidder further agrees to pay
to, or allow the State as liquidated damages the sum of $1,000 for each working day thereafter that the entire
work is not substantially complete.
5.0 ATTACHMENTS TO BID
004337 MBE/WBE/SDVE Compliance Form
004338 MBE/WBE/SDVE Joint Venture Form
004339 MBE/WBE/SDVE Waiver Form
004340 SDVE Business Form
004541 Affidavit of Work Authorization
004545 Anti-Discrimination Against Israel Act Certification form
6.0 BIDDER'S CERTIFICATIONS
By signing and submitting this bid form, the Bidder certifies as follows:
A. No Undisclosed Interests or Associations, Collusion, or Solicitation of Other Bidders
1. This bid is genuine and is not made in the interest of or on behalf of any undisclosed person, firm, or
corporation, and is not submitted in conformity with any agreement or rules of any group, association or
corporation.
2. The Bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham
proposal.
3. The Bidder has not solicited or induced any person, firm or corporation to refrain from submitting a bid.
4. The Bidder has not sought by collusion or otherwise to obtain any advantage over any other bidder or over
the Owner.
SECTION 004113 - BID FORM Page 2 of 5
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B. Accuracy of Contract Documents
The Bidder has based this bid upon an official/complete set of contract documents, either obtained from the
Owner or from a secondary source known to the Bidder to have provided a complete and accurate set of
contract documents. If the Bidder received the contract documents from such a secondary source, any errors or
omissions in the contract documents shall be interpreted and construed in favor of the Owner and against the
Bidder. This bid is based upon the conditions within Article 1.2 of the General Conditions.
C. Non-Discrimination
The Bidder will not discriminate against any employee or applicant for employment because of race, creed,
color or national origin in the performance of the Work.
D. Prevailing Wage
MISSOURI PREVAILING WAGE LAW (Sections 290.210 to 290.340, RSMo): The Contractor shall pay
not less than the specified hourly rate of wages, as set out in the wage order attached to and made part of the
specifications for work under this contract, to all workers performing work under the contract, in accordance
with sections 290.210 to 290.340, RSMo. The Contractor shall forfeit a penalty to the Owner of one hundred
dollars per day (or portion of a day) for each worker that is paid less than the specified rates for any work done
under the contract by the Contractor or by any subcontractor, in accordance with section 290.250, RSMo.
DAVIS-BACON ACT: The requirements of the Davis-Bacon Act are not applicable to this project, which is
funded solely by Coronavirus State and Local Fiscal Recover Funds (SLFRF) under the American Rescue Plan
Act (ARPA).
E. Transient Employers
The Bidder will comply with the provisions of Sections 285.230-234, RSMo, regarding transient employers.
F. Federal Work Authorization Program
The Bidder has enrolled and is participating in, and will continue to participate in, a federal work authorization
program in accordance with Sections 285.525 and 285.530, RSMo for the duration of any contract awarded
because of this bid.
G. Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA)
1. If awarded contract for this project, the Bidder/Contractor shall only utilize personnel authorized to work
in the United States in accordance with applicable federal, state and local laws. This includes, but is not
limited to, the Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) and INA Section
274A.
2. If found to be in violation of this requirement or any applicable laws, and if the State of Missouri has
reasonable cause to believe that the Contractor has knowingly employed individuals who are not eligible
to work in the United States, the state shall have the right to cancel the contract immediately without
penalty or recourse and suspend or debar the contractor from doing business with the state.
3. The Contractor agrees to cooperate fully with any audit or investigation from federal, state or local law
enforcement agencies.
H. Anti-Discrimination Against Israel Act
1. If the awarded Contractor meets the definition of a company as defined in section 34.600, RSMo, and has
ten or more employees, the Contractor shall not engage in a boycott of goods or services from the State of
Israel; from companies doing business in or with Israel or authorized by, licensed by, or organized under
the laws of the State of Israel; or from persons or entities doing business in the State of Israel as defined in
section 34.600, RSMo.
2. If, at any time during the life of the contract, Contractor meets the definition of a company as defined in
section 34.600, RSMo, and the company's employees increases to ten or more OR the contractor's
business status changes to become a company as defined in section 34.600, RSMo, and the company has
ten or more employees, then the Contractor shall submit to the Division of Facilities Management, Design
SECTION 004113 - BID FORM Page 3 of 5
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and Construction a completed Box C of the exhibit titled "Anti-Discrimination Against Israel Act
Certification, and shall comply with the requirements of Box C.
7.0 SIGNATURES
FOR SOLE PROPRIETORSHIPS/GENERAL PARTNERSHIPS ONLY
________________________________ Name each general partner: ___________________________________
Sole Proprietor's Name (printed)
___________________________________
___________________________________
Today's Date: _______________
___________________________________
I, ______________________, being the sole proprietor/general partner of (name of business)
____________________________ (and if the name of said business is other than my legal name, having filed a
Registration of Fictitious Name with the Missouri Secretary of State in order to allow me to use such name in
connection with my business, as provided by Section 417.200, RSMo, et seq.), do hereby submit this bid and agree to be
bound unto the State of Missouri as herein provided (if a general partnership, all partners must sign below).
Signature: ___________________________________ Signature: _____________________________________
Signature: ___________________________________ Signature: _____________________________________
FOR LIMITED LIABILITY COMPANIES ONLY
_______________________________________________ today's date _______State(s) of organization: ______________
Manager's (or Managing Member's) Name (printed)
I, _____________________________, being the Manager (or Managing Member) of (full legal name of limited
liability company from Articles of Organization) ___________________________________, and being duly
authorized to act as herein provided on behalf of said limited liability company, do hereby submit this bid on behalf of
said limited liability company and agree that said limited liability company shall be bound unto the State of Missouri as
herein provided.
Signature: _________________________________
FOR LIMITED PARTNERSHIPS/LIMITED LIABILITY PARTNERSHIPS/LIMITED LIABILITY LIMITED
PARTNERSHIPS ONLY
________________________________________ today's date: __________State(s) of organization:_____________________
General/Managing Partner's Name (printed)
I, _____________________________, being the General Partner/Managing Partner of (full legal name of limited
partnership/limited liability partnership/limited liability limited partnership from partnership agreement or Certificate of
Limited Partnership) ______________________________, and being duly authorized to act as herein provided on
behalf of said limited partnership/limited liability partnership/limited liability limited partnership, do hereby submit this
bid on behalf of said limited partnership/limited liability partnership/limited liability limited partnership and agree that
said limited partnership/limited liability partnership/limited liability limited partnership shall be bound unto the State of
Missouri as herein provided.
SECTION 004113 - BID FORM Page 4 of 5
01/2025

Signature:_________________________________
FOR CORPORATIONS ONLY
____________________________ ____________________________ _________________________
President's Name (printed) Secretary's Name (printed) Today's date
State(s) of incorporation: ____________________________________________
I, _____________________________, being the (officer or title) ________________________ of (full legal name of
corporation, from Articles of Incorporation) ________________________________________, and being duly
authorized by the Board of Directors of said corporation to act as herein provided on behalf of said corporation, do
hereby submit this bid on behalf of said corporation and agree that said corporation shall be bound unto the State of
Missouri as herein provided.
Signature: __________________________________ Attested by:____________________________________
President Corporate Secretary
The President should sign as the bidder. If the signator is other than the corporate president, the bidder must provide satisfactory evidence
that the signator has the legal authority to bind the corporation.
FOR ASSOCIATIONS/JOINT VENTURES
If multiple business entities/individuals are bidding collectively as an association or joint venture, each business
entity/individual bidding as part of the association or joint venture shall sign this bid in the above sections relevant to
the form that such business entity or individual does business, and the bidder shall duplicate the necessary number of
signature pages so that all members of the association or joint venture shall sign this bid. If a name is adopted for use
by the association or joint venture, the association or joint venture shall file a Registration of Fictitious Name with the
Missouri Secretary of State in order to use such name in connection with the association or joint venture, as provided by
Section 417.200, RSMo, et seq.
SECTION 004113 - BID FORM Page 5 of 5
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SECTION 004337 - MBE/WBE/SDVE COMPLIANCE EVALUATION FORM
Project Name: _________________________________________________________________ Project No.: X2410-01
This form is to be completed by bidders and submitted to the State of Missouri, Division of Facilities Management, Design and
Construction with the bid submittal. Submit one form per MBE/WBE/SDVE firm involved with the project. This includes any
MBE/WBE/SDVE general contractor, joint venture, subcontractor or supplier, regardless of how many tier levels of sub-contracts.
A condition for remaining in competition for award is the satisfactory completion of this form for each minority/woman/service disabled
veteran-owned firm that will perform a commercially useful function on the contract. The undersigned submits the following data with
respect to the following firm's assurance to meet the Office of Administration's goal for MBE/WBE/SDVE participation.
1. Name of General Contractor: ______________________________________________________________________
2. MBE/WBE/SDVE Firm:___________________________________________________________________________
(Name)
___________________________________________________________________________
(Address) (City, State, Zip Code)
___________________________________________________________________________
(Phone Number) (email address)
Type of Business: ______________________________ Type of Firm: MBE WBE SDVE
Officer Name & Title: ___________________________________________________________________________
3. Describe the subcontract actual work to be performed (List BASE BID work and any ALTERNATE work separately):
BASE BID SCOPE OF WORK: ____________________________________________________________
ALTERNATE (S) SCOPE OF WORK: (identify separately)
____________________________________________________________
____________________________________________________________
____________________________________________________________
4. Indicate the dollar ($) amount of contract to be subcontracted to the MBE/WBE/SDVE Firm:
BASE BID: $ _________________________________________________________
ALTERNATE (S): (identify separately)
$ __________________________________________________________
$ __________________________________________________________
$ __________________________________________________________
5. Is the proposed subcontractor listed in the Minority/Women Business Enterprise Directory maintained by the Office of Equal
Opportunity (OEO) or the Division of Purchasing's SDVE directory? YES NO
Name of General Contractor Signee (Print): _____________________________________________________
Signature: _____________________________________________________
Title: _____________________________________________________
Date: _____________________________________________________
SECTION 004337 - MBE/WBE/SDVE COMPLIANCE EVALUATION FORM
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SECTION 004338 - MBE/WBE/SDVE ELIGIBILITY DETERMINATION FORM FOR JOINT
VENTURES
Project Name: __________________________________________________________ Project No.: X2410-01
If bidder is a joint venture, this form shall be completed and submitted with the bid submittal to the Missouri State Division
of Facilities Management, Design and Construction.
1. Joint Venture Firm: ____________________________________________________________________________
(Name)
____________________________________________________________________________
(Address) (City, State, Zip Code)
____________________________________________________________________________
(Phone Number) (email address)
2. In order to be counted toward project MBE/WBE/SDVE goals, the MBE/WBE/SDVE partner(s) must be currently certified by a
State of Missouri public entity or have proof of SDVE eligibility. Identify the firms which comprise the joint venture and include
a copy of the certification of each MBE/WBE/SDVE firm included in the joint venture.
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
(a) Describe the role of each MBE, WBE, or SDVE firm in the joint venture:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
(b) Briefly describe the experience and business qualifications of each non-MBE/WBE/SDVE co-venturer:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
3. What is the claimed percentage of MBE/WBE/SDVE ownership in the joint venture?
__________________________________________________
4. Ownership of joint venture. Attach a copy of the joint venture agreement. (The following need not be filled in if
described in the joint venture agreement)
(a) Description of profit and loss sharing:
_____________________________________________________________________________________________
____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
SECTION 004338 - MBE/WBE/SDVE ELIGIBILITY DETERMINATION FORM FOR JOINT VENTURES
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(b) Description of capital contributions, including equipment:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
(c) Description of other applicable ownership interests:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
6. Control of, and participation in, this contract. Identify by name, race, sex, and "firm" those individuals (and their
titles) who are responsible for day-to-day management and policy decision making including, but not limited to,
those with prime responsibility for:
Financial Decisions Management Decisions Estimating Marketing Sales
Hiring (of management) Firing (of management) Purchase of major items or supplies
Name Race Sex Firm & Title Responsibility Management Decisions
NOTE: If after filing this information and before the completion of the joint venture's work on the contract covered by this
regulation, there is any significant change in the information submitted, the joint venture must inform the Commissioner,
either directly or if the joint venture is a subcontractor through the prime contractor.
AFFIDAVIT
"The undersigned swear that the foregoing statements are correct and include all material and information necessary to
identify and explain the terms and operation of our joint venture and the intended participation by each joint
venturer in the undertaking. Further, the undersigned covenant and agree to provide the Commissioner, Office of
Administration, current, complete and accurate information regarding actual joint venture work and the payment
therefore and any proposed changes in any of the joint venture arrangements and to permit the audit and
examination of the books, records, and files of the joint venture, or those of each joint venturer relevant to the joint
venture, by authorized representatives of the Commissioner of the Office of Administration. Any material
misrepresentation will be grounds for terminating any contract which may be awarded and for initiating action under
Federal or State laws concerning false statements."
Name of Firm: ___________________________________ Name of Firm: ______________________________________
Signature: ___________________________________ Signature: ______________________________________
Name: ___________________________________ Name: ______________________________________
Title: ___________________________________ Title: ______________________________________
Date: ___________________________________ Date: ______________________________________
SECTION 004338 - MBE/WBE/SDVE ELIGIBILITY DETERMINATION FORM FOR JOINT VENTURES
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Date: ___________________________________________
State of: ___________________________________________
County of: ___________________________________________
On this ______________________________ day of ______________________________, 20____, before me appeared
(name) ________________________________________ to me personally known, who, being duly sworn, did execute the foregoing
affidavit, and did state that he or she was properly authorized by (name of firm) ___________________________________________
to execute the affidavit and did so as his or her own free act and deed.
Notary Public: ______________________________________________ (seal)
My commission expires: ______________________________________
Date: ___________________________________________
State of: ___________________________________________
County of: ___________________________________________
On this ______________________________ day of ______________________________, 20____, before me appeared
(name) ________________________________________ to me personally known, who, being duly sworn, did execute the foregoing
affidavit, and did state that he or she was properly authorized by (name of firm) ___________________________________________
to execute the affidavit and did so as his or her own free act and deed.
Notary Public: ______________________________________________ (seal)
My commission expires: ____________________________________
SECTION 004338 - MBE/WBE ELIGIBILITY DETERMINATION FORM FOR JOINT VENTURES
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THIS PAGE IS FOR MBE
SECTION 004339 GOOD FAITH EFFORT (GFE) DETERMINATION MBE GFE ONLY
Failure to submit for each diversity
Bidder may reach goals for each category as outlined in Section 001116 - Invitation to Bid
category on a separate page may
by participation, GFE or a combination of both.
result in rejection of the bid.
INSTRUCTIONS: To meet full MBE GFE goals, refer to Section 002113-Instructions to Bidders providing at least 3 certified companies with all
columns completed for each company.
If the bidder has identified companies with actual participation in Section 004337 - MBE/WBE/SDVE Compliance Form do not list those companies below as they will only be
scored for participation, not GFE. Any questions or clarifications should be directed to the Contract Specialist of record.
In order to be counted toward the goals, an MBE or WBE must be certified by the State of Missouri, Office of Equal Opportunity and an SDVE must be certified by the State of
Missouri, Office of Equal Opportunity or by the Veteran Small Business Administration.
MBE and WBE: https://apps1.mo.gov/MWBCertifiedFirms/ SDVE: https://oeo.mo.gov/sdve-certification-program/ or https://veterans.certify.sba.gov/#search
Bidder's Company Name: _________________________________ Project Number: X2410-01
Name of Firm and Person Contacted: Response from
Category of Work (e.g.: Electrician) or
Verify that firm is currently certified with Date of Contact Subcontractor or Supplier
Type of Supplier (e.g.: Plumbing Supplier)
Office of Equal Opportunity (OEO)
SECTION 00 43 39 - GOOD FAITH EFFOR T D ETE RMINATION FORM
01/2025