2026-2027 Ditching 27-00000-06-GM

fiii.1'A
W Illinois Department Local Public Agency
of Transportation Formal Contract Proposal
;.
i .. . - ...... -- - . - --. . . COVER SHE ' - E ~ T - *. , ..... *-. -- - -*" - --
Proposal Submitted By:
Contractor's Name
I
Contractor's Address City Stale Zip Code
II II I
STATE OF ILLINOIS
rL~~~IP~u~b~llc~Ag~e~n~cy~--------------------------------~rC~o~un~N~----------,rS~ec~li~on~N~um~oo~r------,
l~ci_t~y_of_B_e_ll_e_vi_ll_e _____________________________~ l~!s_t._C_Ia_i_r_ _______~ l~~~2_7-_o_o_oo_o_-o_e_-_G_M_ _~
~~~~~~~~~--------------------------------------~~TuY~~o~f~Fu~n~d~s------------~
L----_.:_----------------------~~MFTffiF-
Ditching
181 0 0
Proposal Only Proposal and Plans Proposal only, plans are separate
Submil\ed/Approved
For Local Public Agency:
For a County and Road District Project For a Municipal Project
Submitted/Approved Submitted/Approved/Passed
I"'"""'' Sig"''"'*
Comml"''"" & Dolo ISI~K
I
I u~~\-ltcJ
Official TIUe
I
Submitted/Approved !Mayor
Countv Enoineer/Suoerlntendent of Hlahwavs Slonature & Date
Department of Transportation
Released for bid based on limited review
8 2026
Note: All proposal documents, including Proposal Guaranty Checks or Proposal Bid Bonds, should be stapled together to prevent loss
when bids are processed.
Completed 03/23/26 Page 1 of6 BLR 12200 (Rev. 01/19/23)

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NOTICE TO BIDDERS
Sealed proposals for the project described below will be received at the office of City Clerk
---'~---'----~--~~-----------
Name of Office
101 South Illinois Street, Belleville, Illinois 62220 unUI on
Address Time Date
--.:====-----------------
Sealed proposals will be opened and read publicly at the office of_C_it:._y_C_I_e_r_k _________
Name of Office
101 South Illinois Street, Belleville, Illinois 62220 at on
Address Time Date
DESCRIPTION OF WORK
Location
Various locations in the city
Prooosed lmorovement
Provide Labor and Equipment to clean drainage related infrastructure in Belleville at established prices subject to
terms and conditions contained in this proposal.
1. Plans and orooosal forms will be available in the office of
City Engineer
2300 W. Main St.; Bldg M-Suite M116, Belleville, Illinois 62226 and Belleville. net
2. 1:8! Prequalificatlon
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 lOOT District Office.
3. The Awarding Authority reserves the right to waive technlcaliUes 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. Affidav~ 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 deplh 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. 'Mlen an envelope
other than !he special one furnished by the Awarding Authority is used, it shall be marked to clear1y indicate its contents, 'Mlen sent
by mall, 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 lime for
opening proposals.
Completed 03/23126 Page 2 of6 BLR 12200 {Rev. 01/19/23)

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~~C~icy_o_f_Be_ll_av_ill_e ~l,ls_t_.c_la_ir ~--~11~27_-_oo_o_oo_-o_e_-G~M--~,L-----~--------~.
________ __
PROPOSAL
1. Proposalof __________________________________~ ~~~~~----------------------------------
Conlractor's Name
Contractor's Address
2. The plans for the proposed work are !hose prepared by"thc.:e::..:::C..::it"'y-'o:.:.f..:B:..:e:.:;ll..:e.:.vl"'*u..:e_ __________________________ _
and approved by the Deparlment of Transportation on-----------------------------------
3. The specifications referred to herein are those prepared by the Deparlmenl of Transportalion and designated as "Standard
Specifications for Road and Bridge ConstrucUon11 and the 11 Supplemental Specifications and Recurring Special Provisions" thereto,
adopted and in effect on the dale of invitation for bids.
4. The undersigned agrees to accepl, 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 wtthin _____ working days or by ..:0..::4/c.:3c.:O.c/2::.7'-----unless additional time
Is granted in accordance with the specifications.
6. The successful bidder at the time of execution of the contract will be required to deposit a contract bond for the full amount of
the award. When a contract bond Is not required, th.e proposal guaranty check will be held in lieu thereof. If this proposal is accepted
and the undersigned falls to execute a contract and contract bond as required, ills 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 quanllty, 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 perfonned 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 wilh 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 Bonds will be allowed as a proposal guaranty. Accompanying this proposal is either
a bid bond, if allowed, on Deparlment fonn BLR 12230 or a proposal guaranty check, complying with the specifications, made payable
to: City of Belleville Treasurer of B e II e Vi I( e
_____
Theamountofthecheckis _________________________________________________ __ ).
Attach Cashier's Check or Certified Check Hera
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, slate below where it may be found.
The proposal guaranty check will be found in the bid proposal for: Section Number -------------------
Completed 03123126 Page3of6 BLR 12200 (Rev. 01/19123)

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l._c..::.ity_o_f _Be_ll_ev_ill_e _____ JII._st_. C_l_ai_r ___ _.~II27-00000-06-GM
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 dellnquentin 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 Btd 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 5133E-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 a<!dition 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 unil 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 tt demonstrates to the governmental entity with which it seeks to contract and that entity finds that
the commission of the offense was nelther 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, tt 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 ofTitle 44 Subtitle A Chapter Ill Part 6 of the Illinois Administrative code. Furthermore, if
suspended prior to completion of this wort<, the contract or contracts executed for the completion of this wort< may be canceled.
Completed 03/23126 Page 4 of6 BLR 12200 (Rev. 01/19123)

r"Loca='-'1P ._,u,b"'li""c"'A'"ge.,n"'cLy ______ c,o"'u"n"'ty'--------, Section Number
11
l~c~ity_o_f_Be_ll_ev_ill_e ________~ l,ls_t_.c_la_ir_ _____~ ll~27_-_oo_o_oo_-o_s_-G__M _~ L-----~--------~
SIGNIA TURES
(If an Individual) Bidder Signature & Date
Business Address
rC,Ityr._ ___________ , State Zip Code
I
11~~~----~
Firm Name
(If a partnership)
\Signature & Date
Tille
Business Address
City Stale Zip Code
/r~--------~11'--~1----~
Insert the Names and Addresses of al! Partners
(If a corporation) Corporate Name
\Signature & Date
Tille
Business Address
rClit y Stale Zip Code
~--------~1'--1~ ~----~
Insert Names of Officers President
Completed 03/23/28 Page5of6 BLR 12200 (Rev. 01119123)

Secretary
Attest*
Treasurer
Secretary
Compleled03123126 Page6of6 BLR 12200 (Rev. 01/19/23)

~
IIUnols Department Local Public Agency
\,W
of Transportation Proposal Bid Bond
~L~o~~~I~P~u~bl~icuA~g~e~n~cyL-____________________________________, ~C~o~un~tLv ____________, ~S~e~ct~io~n~N~u~m~b~eLr ______~
Jlst.
/city of Belleville Clair 1127-000(}0-06-GM
WE, __________________________________ as PRINCIPAL, and
--.,--,--------,-,-----,--,----,-,,------------------'as SURETY, are held jointly,
severally and firmly bound unlo the above Lo~l Public Agency (hereafter referred to as "LPA") in the penal sum of 5% of the total bid
price, or for the amount specified In the proposal documents in effect on the date of invitation for bids, whichever is the lesser sum. We
bind ourselves, our heirs; executors, administrators, successors, and assigns, jointly pay to the LPA this sum under the conditions of this
Instrument.
'M-IEREAS THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH that, the said PRINCIPAL Is submilllng a writlen
proposal to the LPA acting through its awarding authority for lhe construction of lhe work designated as the above section.
THEREFORE if the proposal is accepted and a contract awarded to the PRINCIPAL by the LPA for lhe above designated section
and the PRINCIPAL shall within fifteen (15) days after award enter into a formal contract, furnish surety guaranteeing the faithful
performance of the work, and furnish evidence of the required insurance coverage, ail as provided In the "Standard Specifications for Road
and Bridge Construction" and appli~ble Supplemental Specifications, then lhis obligation shall become void; otherwise it shall remain In
full force and effect.
IN THE EVENT the LPA determines the PRINCIPAL has failed to enter into a formal contract In compliance with any
requirements set forth in the preceding paragraph, then the LPA ac ling through Its awarding authority shall immediately be entitled to
recover the full penal sum set out above, together wfih all court costs, all allorney fees, and any other expense of recovery.
IN TESTIMONY WHEREOF, the said PRINCIPAL and the said SURETY have caused this Instrument to be signed by their
respective officers this -----=:----of--===""'=-
Day Month and Year
Principal
Company Name Company Name
Si:nalure & Dale Si:nalure & Dale
I
~ ~
By:l By:
~rmn~ec===================================~ ~I@IEeC:::::::::::::::::::::::::::::::::::~
(If Principal is a joint venture of two or more contractors, the company names, and authorized signatures of each contractor must be
affixed.)
Surety
Name of Surety
Sianalure of Allornev-in-F act Sianature & Dale
By:
STATE OF IL
COUNTY OF
------------------------------------ , a Notary Public in and for said county do hereby certify that
{Insert names of Individuals s!Qnmg on behalf of PRINCIPAL &S ORE t Y)
who are each personally known Ia me to be the same persons whose names are subscribed to the foregoing Instrument on behalf of
PRINCIPAL and SURETY, appeared before me this day in person and acknowledged respectively, that they signed and delivered said
instruments as their free and voluntary act for the uses and purposes therein set forth.
Given under my hand and notarial seal this day or ___= ==~=---
Day Month and Year
!Notary Public Signature & Dale
(SEAL, if required by the LPA)
Date commission e'l<plres --------------
Completed 03123126 Page1of2 BLR 12230(Rev. 01119123)

Local Public Agency County Section Number
list.
icity of Belleville Clair 1127-00000-06-GM
ELECTRONIC BID BOND
D
Electronic bid bond Is allowed (box must be checked by LPA If electronic bid bond Is allowed)
The Principal may submit an electronic bid bond, in lieu of complellng the above section of the Proposal Bid Bond Form. By providing an
electronic bid bond ID code and signing below, the Principal is ensuring the Identified electronic bid bond has been executed and the
Principal and Surety are firmly bound unto the LPA under the conditions of the bid bond as shown above. (If PRINCIPAL is a joint venture
of two or more contractors, an electronic bid bond ID code, company/Bidder name tille and date must be affixed for each contractor in the
venture.)
Eleclronlc Bid Bond ID Code Company/Bidder Name
I I I I I I
I
Signature & Date
Tille
Completed03/23/26 Page 2 of2 BLR 12230 (Rev. 01119/23)

r:;;;;...IIHnols Department Apprenticeship and
~of li'ansportatlon Training Program Certification
rL,oca=l _,_P_,u,bl"ic:..:A_,.g,e"'n""cy._ ________, ,C,;o,u,_n,.,tv._ _____ , ,s,tr"'e"'et,_,N_,a"m'"e"'/R'-'o"'a"'d"N_,a.,m"'e"------, Section Number
_.ll27
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All contractors are required to complete the following certification
~ For this contract proposal or for all bidding groups In this deliver and install propos at.
0
For the following deliver and install bidding groups in this material proposal.
Illinois Department ofTransportation policy, adopted in accordance with the provisions of the IIHnois Highway Code, requires this contract
to be awarded to the lowest responsive and responsible bidder. The award decision is subject to approval by the Department. In addition
to all other responsibility factors, this contract or deliver and install proposal requires all bidders and all bidde~s subcontractors to disclose
participation in apprenticeship or training programs that are (1) approved by and registered with the United States Department of Labo~s
Bureau of Apprenticeship and Training, and (2) applicable to the work of the above indicated proposals or groups. Therefore, all bidders
are required to complete the following certification:
1. Except es provided In paragraph 4 below, the undersigned bidder certifies that it is a participant, either as an individual or as part of a
group program, In an approved apprenticeship or training program applicable to each type of work or craft thai the bidder will perform with
its own employees.
2. The undersigned bidder further certifies, for work to be performed by subcontract, that each of its subcontractors either (A) is, at the
time of such bid, participating in an approved, applicable apprenticeship or training program; or (B) will, prior to commencement of
performance of work pursuant to this contract, establish participation in an approved apprenticeship or training program applicable to the
work of the subcontract.
3. The undersigned bidder, by inclusion in the list in the space below, certifies the official name of each program sponsor holding the
Certificate of Registration for all of the types of work or crafts in which the bidder is a participant and that will be performed with the bidde~s
employees. Types of work or craft that will be subcontracted shall be included and listed as subcontract work. The list shall also indicate
any type of work or craft job category for which there is no applicable apprenticeship or training program available.
4. Except for any work identified above, if any bidder or subcontractor shall perform all or part of the work of the conlract or deliver and
install proposal solely by individual owners, partners or members and not by employees to whom the payment of prevailing rates of wages
0
would be required, check the following box, and Identify the owner/operator workforces and positions of ownership.
The requirements of this certification and disclosure are a material part of the contract, and the contractor shall require this certification
provision to be included in all approved subcontracts. The bidder Is responsible for making a complete report and shall make certain that
each type of work or craft job category that will be utilized on the project Is accounted for and listed. The Department at any time before or
afterward may require the production of a copy of each applicable Certificate of Registration Issued by the United States Department of
Labor evidencing such participation by the contractor and any or all of its subcontractors. In order to fulfill the participation requirement, It
shall not be necessary that any applicable program sponsor be currently taking or that It will take applications for apprenllceship, training or
employment during the performance of the work of this contract or deliver and Install proposal.
I
Bidder
Signature & Date
Tille
fA"'d"'d,_,re,.ss,__ __________________, rC'"it.__ _________- --, State Zip Code
~c=JIL- ---~
.___ __________________ _J.___ _________
Completed 03123/26 Page 1 of 1 BLR 12325 (Rev. 01119/23)

~
IIDnols Department
~of 11'ansportation Affidavit of Illinois Business Office
rL~o~~~I~P~u~bl~lc~A~g~e~n~cyL_ ________________~ ~C~o~umnlocv __________ 1 1S~t~re~e~t~N~am~effi~o~ad~N~amm~e----_,~S~e~ct~iown~N~uwm~b~eLr ______
0
1'--c--'ity'--o_f_B_el_le_vi_lle_ ______ __Jic.:.ls.:.:.t. -'-C-'-Ia.::..ir ___I ,Liv_a_rio_u_s- '--R"-ou:.:.:te"'s'--___ JII27-00000-06-GM
------=:=-::.,..,;::o;------
I, of-----:=:-::<;,-:-::------
Name of Affiant City of Affiant State of Affiant
being first duly sworn upon oath, state as follows:
1. Thall am the of
Officer or Position -------------.B"id"'de;;;r,.------------
2. That I have personal knowledge of the facts herein stated.
3. Thai, if selected under the proposal described above, , will maintain a business office in the
Bidder
Slate of Illinois, which will be located In -------;::,-.,.------County, Illinois.
county
4. That this business office will serve as the prtmary place of employment for any persons employed in the conslruction contemplated by
this proposal.
5. That this Affidavit is given as a requirement of slate law as provided in Section 30*22(8) of the Illinois Procurement Code.
rgnature & Date
Print Name of Affiant
Notary Public
State of IL
County
Signed (or subscribed or attested) before me on -----,=:;;------ by
(dale)
--------------,=====.----------------'authorized agent(s) of
(namets of personls)
Bidder
I
Notary Public Signature & Date
(SEAL) My commission expires-------------------
Completed03/23126 Page1of1 BLR 12326 (Rev. 01/20/23)