Crack Sealing Program

Local Public Agency
Formal Contract Proposal
COVER SHEET
Proposal Submitted By:
Contractor's Name
Contractor's Address City State Zip Code
STATE OF ILLINOIS
Local Public Agency County Section Number
Village of Lake Zurich Lake 26-00000-00-GM
Route(s) (Street/Road Name) Type of Funds
Various Locations throughout Village Motor Fuel Tax
Proposal Only Proposal and Plans Proposal only, plans are separate
Submitted/Approved
For Local Public Agency:
For a County and Road District Project For a Municipal Project
Submitted/Approved Submitted/Approved/Passed
Highway Commissioner Signature & Date Signature & Date
Digitally signed by Michael J.
Michael J. Brown
Brown
Date: 2026.04.06 16:38:14 -05'00'
Official Title
Submitted/Approved Director of Public Works
County Engineer/Superintendent of Highways Signature & Date
Department of Transportation
Released for bid based on limited review
Regional Engineer Signature & Date
Note: All proposal documents, including Proposal Guaranty Checks or Proposal Bid Bonds, should be stapled together to prevent loss
when bids are processed.
Completed04/07/26 Page 1 of 6 BLR 12200 (Rev. 01/19/23)

Local Public Agency County Section Number Route(s) (Street/Road Name)
Village of Lake Zurich Lake 26-00000-00-GM Various Locations throughout V
NOTICE TO BIDDERS
Village of Lake Zurich Village Hall
Sealed proposals for the project described below will be received at the office of
Name of Office
70 E. Main Street Lake Zurich. Illinois 60047 10:00 AM 05/28/25
until on .
Address Time Date
Village of Lake Zurich Village Hall
Sealed proposals will be opened and read publicly at the office of
Name of Office
70 E. Main Street Lake Zurich. Illinois 60047 10:00 AM 05/28/25
at on .
Address Time Date
DESCRIPTION OF WORK
Location Project Length
Various N/A
Proposed Improvement
Crack Sealing for various locations throughout Village. Priority locations are shown on Exhibit A included with the
specifications.
1. Plans and proposal forms will be available in the office of
www.lakezurich.org/296/Requests-Bids 2026 Crack Sealing
Contact Mike Cernock at 847-540-1696 with questions.
2. Prequalification
If checked, the 2 apparent as read low bidders must file within 24 hours after the letting an "Affidavit of Availability" (Form BC 57) in
triplicate, showing all uncompleted contracts awarded to them and all low bids pending award for Federal, State, County, Municipal
and private work. One original shall be filed with the Awarding Authority and two originals with the IDOT District Office.
3. The Awarding Authority reserves the right to waive technicalities and to reject any or all proposals as provided in BLRS Special
Provision for Bidding Requirements and Conditions for Contract Proposals.
4. The following BLR Forms shall be returned by the bidder to the Awarding Authority:
a. Local Public Agency Formal Contract Proposal (BLR 12200)
b. Schedule of Prices (BLR 12201)
c. Proposal Bid Bond (BLR 12230) (if applicable)
d. Apprenticeship or Training Program Certification (BLR 12325) (do not use for project with Federal funds.)
e. Affidavit of Illinois Business Office (BLR 12326) (do not use for project with Federal funds)
5. The quantities appearing in the bid schedule are approximate and are prepared for the comparison of bids. Payment to the Contractor
will be made only for the actual quantities of work performed and accepted or materials furnished according to the contract. The
scheduled quantities of work to be done and materials to be furnished may be increased, decreased or omitted as hereinafter
provided.
6. Submission of a bid shall be conclusive assurance and warranty the bidder has examined the plans and understands all requirements
for the performance of work. The bidder will be responsible for all errors in the proposal resulting from failure or neglect to conduct an
in depth examination. The Awarding Authority will, in no case, be responsible for any costs, expenses, losses or changes in
anticipated profits resulting from such failure or neglect of the bidder.
7. The bidder shall take no advantage of any error or omission in the proposal and advertised contract.
8. If a special envelope is supplied by the Awarding Authority, each proposal should be submitted in that envelope furnished by the
Awarding Agency and the blank spaces on the envelope shall be filled in correctly to clearly indicate its contents. When an envelope
other than the special one furnished by the Awarding Authority is used, it shall be marked to clearly indicate its contents. When sent
by mail, the sealed proposal shall be addressed to the Awarding Authority at the address and in care of the official in whose office the
bids are to be received. All proposals shall be filed prior to the time and at the place specified in the Notice to Bidders. Proposals
received after the time specified will be returned to the bidder unopened.
9. Permission will be given to a bidder to withdraw a proposal if the bidder makes the request in writing or in person before the time for
opening proposals.
Completed04/07/26 Page 2 of 6 BLR 12200 (Rev. 01/19/23)

Local Public Agency County Section Number Route(s) (Street/Road Name)
Village of Lake Zurich Lake 26-00000-00-GM Various Locations throughout V
PROPOSAL
1. Proposal of
Contractor's Name
.
Contractor's Address
2. The plans for the proposed work are those prepared byVillage of Lake Zurich
and approved by the Department of Transportation on .
3. The specifications referred to herein are those prepared by the Department of Transportation and designated as "Standard
Specifications for Road and Bridge Construction" and the " Supplemental Specifications and Recurring Special Provisions" thereto,
adopted and in effect on the date of invitation for bids.
4. The undersigned agrees to accept, as part of the contract, the applicable Special Provisions indicated on the "Check Sheet for
Recurring Special Provisions" contained in this proposal.
5. The undersigned agrees to complete the work within working days or by 10/30/26 unless additional time
is granted in accordance with the specifications.
6. The successful bidder at the time of execution of the contractwill be required to deposit a contract bond for the full amount of
the award. When a contract bond is not required, the proposal guaranty check will be held in lieu thereof. If this proposal is accepted
and the undersigned fails to execute a contract and contract bond as required, it is hereby agreed that the Bid Bond of check shall be
forfeited to the Awarding Authority.
7. Each pay item should have a unit price and a total price. If no total price is shown or if there is a discrepancy between the products of
the unit price multiplied by the quantity, the unit price shall govern. If a unit price is omitted, the total price will be divided by the
quantity in order to establish a unit price. A bid may be declared unacceptable if neither a unit price nor a total price is shown.
8. The undersigned submits herewith the schedule of prices on BLR 12201 covering the work to be performed under this contract.
9. The undersigned further agrees that if awarded the contract for the sections contained in the combinations on BLR 12201, the work
shall be in accordance with the requirements of each individual proposal for the multiple bid specified in the Schedule for Multiple Bids
below.
10. A proposal guaranty in the proper amount, as specified in BLRS Special Provision for Bidding Requirements and Conditions for
Contract Proposals, will be required. Bid Bondswill be allowed as a proposal guaranty. Accompanying this proposal is either
a bid bond, if allowed, on Department form BLR 12230 or a proposal guaranty check, complying with the specifications, made payable
to: Lake Zurich Treasurer of the Village of Lake Zurich .
The amount of the check is ( ).
Attach Cashier's Check or Certified Check Here
In the event that one proposal guaranty check is intended to cover two or more bid proposals, the amount must be equal to the
sum of the proposal guaranties which would be required for each individual bid proposal. If the proposal guaranty check is
placed in another bid proposal, state below where it may be found.
The proposal guaranty check will be found in the bid proposal for: Section Number .
Completed04/07/26 Page 3 of 6 BLR 12200 (Rev. 01/19/23)

Local Public Agency County Section Number Route(s) (Street/Road Name)
Village of Lake Zurich Lake 26-00000-00-GM Various Locations throughout V
CONTRACTOR CERTIFICATIONS
The certifications hereinafter made by the bidder are each a material representation of fact upon which reliance is placed should the
Department enter into the contract with the bidder.
1. Debt Delinquency. The bidder or contractor or subcontractor, respectively, certifies that it is not delinquent in the payment of any tax
administered by the Department of Revenue unless the individual or other entity is contesting, in accordance with the procedure
established by the appropriate Revenue Act, its liability for the tax or the amount of the tax. Making a false statement voids the
contract and allows the Department to recover all amounts paid to the individual or entity under the contract in a civil action.
2. Bid-Rigging or Bid Rotating. The bidder or contractor or subcontractor, respectively, certifies that it is not barred from contracting
with the Department by reason of a violation of either 720 ILCS 5/33E-3 or 720 ILCS 5/33E-4.
A violation of section 33E-3 would be represented by a conviction of the crime of bid-rigging which, in addition to Class 3 felony
sentencing, provides that any person convicted of this offense, or any similar offense of any state or the United States which contains
the same elements as this offense shall be barred for 5 years from the date of conviction from contracting with any unit of State or
local government. No corporation shall be barred from contracting with any unit of State or local government as a result of a conviction
under this Section of any employee or agent of such corporation if the employee so convicted is no longer employed by the
corporation: (1) it has been finally adjudicated not guilty or (2) if it demonstrates to the governmental entity with which it seeks to
contract that entity finds that the commission of the offense was neither authorized, requested, commanded, nor performed by a
director, officer or a high managerial agent on behalf of the corporation.
A violation of Section 33E-4 would be represented by a conviction of the crime of bid-rotating which, in addition to Class 2 felony
sentencing, provides that any person convicted of this offense or any similar offense of any state or the United States which contains
the same elements as this offense shall be permanently barred from contracting with any unit of State of Local government. No
corporation shall be barred from contracting with any unit of State or Local government as a result of a conviction under this Section of
any employee or agent of such corporation if the employee so convicted is no longer employed by the corporation and: (1) it has been
finally adjudicated not guilty or (2) if it demonstrates to the governmental entity with which it seeks to contract and that entity finds that
the commission of the offense was neither authorized, requested, commanded, nor performed by a director, officer or a high
managerial agent on behalf of the corporation.
3. Bribery. The bidder or contractor or subcontractor, respectively, certifies that, it has not been convicted of bribery or attempting to
bribe an officer or employee of the State of Illinois or any unit of local government, nor has the firm made an admission of guilt of such
conduct which is a matter or record, nor has an official, agent, or employee of the firm committed bribery or attempted bribery on
behalf of the firm and pursuant to the direction or authorization of a responsible official of the firm.
4. Interim Suspension or Suspension. The bidder or contractor or subcontractor, respectively, certifies that it is not currently under a
suspension as defined in Subpart I of Title 44 Subtitle A Chapter III Part 6 of the Illinois Administrative code. Furthermore, if
suspended prior to completion of this work, the contract or contracts executed for the completion of this work may be canceled.
Completed04/07/26 Page 4 of 6 BLR 12200 (Rev. 01/19/23)

Local Public Agency County Section Number Route(s) (Street/Road Name)
Village of Lake Zurich Lake 26-00000-00-GM Various Locations throughout V
SIGNATURES
(If an individual) Bidder Signature & Date
Business Address
City State Zip Code
Firm Name
(If a partnership)
Signature & Date
Title
Business Address
City State Zip Code
Insert the Names and Addresses of all Partners
Corporate Name
(If a corporation)
Signature & Date
Title
Business Address
City State Zip Code
Insert Names of Officers President
Completed04/07/26 Page 5 of 6 BLR 12200 (Rev. 01/19/23)

Secretary
Attest:
Treasurer
Secretary
Completed04/07/26 Page 6 of 6 BLR 12200 (Rev. 01/19/23)

INDEX
FOR
SUPPLEMENTAL SPECIFICATIONS
AND RECURRING SPECIAL PROVISIONS
Adopted January 1, 2023
This index contains a listing of SUPPLEMENTAL SPECIFICATIONS and frequently used RECURRING SPECIAL
PROVISIONS.
ERRATA Standard Specifications for Road and Bridge Construction (Adopted 1-1-22) (Revised 1-1-23)
SUPPLEMENTAL SPECIFICATIONS
Std. Spec. Sec. Page No.
202 Earth and Rock Excavation ............................................................................................................. 1
204 Borrow and Furnished Excavation ................................................................................................... 2
207 Porous Granular Embankment ........................................................................................................ 3
211 Topsoil and Compost ...................................................................................................................... 4
407 Hot-Mix Asphalt Pavement (Full-Depth) .......................................................................................... 5
420 Portland Cement Concrete Pavement ............................................................................................. 6
502 Excavation for Structures ................................................................................................................ 7
509 Metal Railings .................................................................................................................................. 8
540 Box Culverts .................................................................................................................................... 9
542 Pipe Culverts ................................................................................................................................... 29
586 Granular Backfill for Structures ........................................................................................................ 34
644 High Tension Cable Median Barrier ................................................................................................ 35
782 Reflectors ........................................................................................................................................ 36
801 Electrical Requirements .................................................................................................................. 38
821 Roadway Luminaires ....................................................................................................................... 40
1003 Fine Aggregates .............................................................................................................................. 41
1004 Coarse Aggregates ......................................................................................................................... 42
1020 Portland Cement Concrete ......... ................................................................................................... 43
1030 Hot-Mix Asphalt ............................................................................................................................... 44
1067 Luminaire ......... .............................................................................................................................. 45
1097 Reflectors ........................................................................................................................................ 52

RECURRING SPECIAL PROVISIONS
The following RECURRING SPECIAL PROVISIONS indicated by an "X" are applicable to this contract and are included
by reference:
CHECK SHEET # PAGE NO.
1 Additional State Requirements for Federal-Aid Construction Contracts ......................................... 53
2 Subletting of Contracts (Federal-Aid Contracts) ............................................................................. 56
3 EEO ................................................................................................................................................ 57
4 Specific EEO Responsibilities Non Federal-Aid Contracts ............................................................. 67
5 Required Provisions - State Contracts ............................................................................................ 72
6 Asbestos Bearing Pad Removal ..................................................................................................... 78
7 Asbestos Waterproofing Membrane and Asbestos HMA Surface Removal ................................... 79
8 Temporary Stream Crossings and In-Stream Work Pads ............................................................... 80
9 Construction Layout Stakes ............................................................................................................ 81
10 Use of Geotextile Fabric for Railroad Crossing ............................................................................... 84
11 Subsealing of Concrete Pavements ................................................................................................ 86
12 Hot-Mix Asphalt Surface Correction ................................................................................................ 90
13 Pavement and Shoulder Resurfacing ............................................................................................. 92
14 Patching with Hot-Mix Asphalt Overlay Removal ............................................................................ 93
15 Polymer Concrete ........................................................................................................................... 95
16 Reserved ......................................................................................................................................... 97
17 Bicycle Racks ................................................................................................................................. 98
18 Temporary Portable Bridge Traffic Signals ..................................................................................... 100
19 Nighttime Inspection of Roadway Lighting ...................................................................................... 102
20 English Substitution of Metric Bolts ................................................................................................. 103
21 Calcium Chloride Accelerator for Portland Cement Concrete ......................................................... 104
22 Quality Control of Concrete Mixtures at the Plant ........................................................................... 105
23 Quality Control/Quality Assurance of Concrete Mixtures ................................................................ 113
24 Reserved ........................................................................................................................................ 129
25 Reserved ........................................................................................................................................ 130
26 Temporary Raised Pavement Markers ........................................................................................... 131
27 Restoring Bridge Approach Pavements Using High-Density Foam ................................................ 132
28 Portland Cement Concrete Inlay or Overlay ................................................................................... 135
29 Portland Cement Concrete Partial Depth Hot-Mix Asphalt Patching .............................................. 139
30 Longitudinal Joint and Crack Patching ............................................................................................ 142
31 Concrete Mix Design - Department Provided ................................................................................. 144
32 Station Numbers in Pavements or Overlays ................................................................................... 145

Check Sheet for Recurring Special Provisions
Local Public Agency County Section Number
The Village of Lake Zurich Lake 26-00000-00-GM
Check this box for lettings prior to 01/01/2025
The Following Recurring Special Provisions Indicated By An "X" Are Applicable To This Contract And Are Included By Reference:
Recurring Special Provisions
Check Sheet # Page No.
1 Additional State Requirements for Federal-Aid Construction Contracts 79
2 Subletting of Contracts (Federal-Aid Contracts) 82
3 EEO 83
4 Specific EEO Responsibilities Non Federal-Aid Contracts 93
5 Required Provisions - State Contracts 98
6 Asbestos Bearing Pad Removal 104
7 Asbestos Waterproofing Membrane and Asbestos HMA Surface Removal 105
8 Temporary Stream Crossings and In-Stream Work Pads 106
9 Construction Layout Stakes 107
10 Use of Geotextile Fabric for Railroad Crossing 110
11 Subsealing of Concrete Pavements 112
12 Hot-Mix Asphalt Surface Correction 116
13 Pavement and Shoulder Resurfacing 118
14 Patching with Hot-Mix Asphalt Overlay Removal 119
15 Polymer Concrete 121
16 Reserved 123
17 Bicycle Racks 124
18 Temporary Portable Bridge Traffic Signals 126
19 Nighttime Inspection of Roadway Lighting 128
20 English Substitution of Metric Bolts 129
21 Calcium Chloride Accelerator for Portland Cement Concrete 130
22 Quality Control of Concrete Mixtures at the Plant 131
23 Quality Control/Quality Assurance of Concrete Mixtures 139
24 Reserved 155
25 Reserved 156
26 Temporary Raised Pavement Markers 157
27 Restoring Bridge Approach Pavements Using High-Density Foam 158
28 Portland Cement Concrete Inlay or Overlay 161
29 Portland Cement Concrete Partial Depth Hot-Mix Asphalt Patching 165
30 Longitudinal Joint and Crack Patching 168
31 Concrete Mix Design - Department Provided 170
32 Station Numbers in Pavements or Overlays 171
Printed01/09/25 Page 1 of 2 BLR 11300 (Rev. 11/19/24)

Local Public Agency County Section Number
The Village of Lake Zurich Lake 26-00000-00-GM
The Following Local Roads And Streets Recurring Special Provisions Indicated By An "X" Are Applicable To This Contract And Are
Included By Reference:
Local Roads And Streets Recurring Special Provisions
Check Sheet # Page No.
LRS 1 Reserved 173
LRS 2 Furnished Excavation 174
LRS 3 Work Zone Traffic Control Surveillance 175
LRS 4 Flaggers in Work Zones 176
LRS 5 Contract Claims 177
LRS 6 Bidding Requirements and Conditions for Contract Proposals 178
LRS 7 Bidding Requirements and Conditions for Material Proposals 184
LRS 8 Reserved 190
LRS 9 Bituminous Surface Treatments 191
LRS 10 Reserved 195
LRS 11 Employment Practices 196
LRS 12 Wages of Employees on Public Works 198
LRS 13 Selection of Labor 200
LRS 14 Paving Brick and Concrete Paver Pavements and Sidewalks 201
LRS 15 Partial Payments 204
LRS 16 Protests on Local Lettings 205
LRS 17 Substance Abuse Prevention Program 206
LRS 18 Multigrade Cold Mix Asphalt 207
LRS 19 Reflective Crack Control Treatment 208
Printed01/09/25 Page 2 of 2 BLR 11300 (Rev. 11/19/24)