Sewer Seperation Phase 3A

Maura T. Healey Rebecca L. Tepper
Governor Secretary
Kimberley Driscoll Bonnie Heiple
Lieutenant Governor Commissioner
Division of Municipal Services
State Revolving Fund Loan Program
Plans and Specifications Checklist
April 2025
This information is available in alternate format. Please contact MassDEP at 617-292-5500.
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DMS on the World Wide Web at https://www.mass.gov/lists/state-revolving-fund-applications-forms
1.Public Entity (LGU):
2.CWSRF or DWSRF Project ID and Project Name:
3.Contract Titled:
Contract Number
Title Sheet Dated:
Plans and Specifications Estimated Percentage Complete:
4.Engineering Consulting Firm:
Name of Consulting Engineer/Program Manager:
Mailing Address: Phone:
Consulting Engineer/Program Manager Email Address:
The grant or loan applicant, or their authorized assignee, shall complete all sections of this checklist and indicate
the corresponding page locations. The completed checklist must be uploaded to the eSRF Portal.
5. Signatures and Date
To the best of my knowledge and belief the information provided on this form, along with all the accompanying forms
and attachments, is true, correct, and complete and I am authorized to file this form on behalf of the above-named
LGU.
Consulting Engineer/Program Manager: Date:
DEP Reviewing Engineer:
Date:

Indicate
BID ADVERTISEMENT
Location/Page
# or Not For MassDEP
Applicable Use
(NA)
1) Check which Bid Law provisions apply to this contract.
A.M.G.L. c.30, s39M (Non-Building/Public Works Contracts)
B.M.G.L. c.149, ss44A-44J (Building Contract with Filed Sub-Bids)
C.Special Legislation
2) If bid under c.149, ss44A-44J, the bid advertisement must contain the prime category
of work. Every general bidder must furnish the certificate of eligibility showing that
the bidder has the classification and capacity rating to perform the required work from
the Division of Capital Asset Management (DCAM) and Maintenance and an updated
statement form in accordance with c.149, s44D.
3) The Bid Advertisement must contain the following information:
A. 5% bid deposit
B. Project description with time frame for the contract completion.
C. Where and how the bidding documents may be obtained or examined.
D. The location, date and time by which bids are required to be submitted.
E. A statement that the project is to be funded in part by the Massachusetts Clean Water
Trust (the "Trust").
F. A statement that the project requires compliance with the Department of
Environmental Protection's Diesel Retrofit Program.
4) The Bid Advertisement must contain the following paragraphs:
A."Procurement Considerations - Six Good Faith Efforts. 40 CFR, Part 33, Subpart C:
Pursuant to 40 CFR Section 33.301, the sub-recipient agrees to make good faith
efforts whenever procuring construction, equipment, services, and supplies under
an EPA financial assistance agreement, and to require that sub-recipients, loan
recipients, and prime contractors also comply. Records documenting compliance
with the six good faith efforts shall be retained. The specific six good faith efforts
can be found at: 40 CFR Section 33.301 (a)-(f)."
B. "Minimum Wage Rates as determined by the Executive Office of Labor and
Workforce Development under the provision of the Massachusetts General Laws,
Chapter 149, Sections 26 to 27D, as amended, apply to this project. It is the
responsibility of the contractor, before bid opening, to request, if necessary, any
additional information on Minimum Wage Rates for those trades people who may
be employed for the proposed work under this contract. Federal Minimum Wage
Rates as determined by the United States Department of Labor under the Davis-
Bacon Act also apply to this project."

Indicate
INSTRUCTIONS TO BIDDERS
Location/Page
For MassDEP
# or Not
Use
Applicable
(NA)
5) The provisions of the following paragraphs must be included in the
INSTRUCTIONS TO BIDDERS.
A. "Applicable provisions of Massachusetts General Laws and Regulations and/or the
United States Code and Code of Federal Regulations govern this Contract and any
provision in violation of the foregoing shall be deemed null, void and of no effect.
Where conflict between Code of Federal Regulations and State Laws and Regulations
exist, the more stringent requirement shall apply."
B. "Minimum Wage Rates as determined by the Executive Office of Labor and
Workforce Development under the provision of the Massachusetts General Laws,
Chapter 149, Sections 26 to 27D, as amended, apply to this project. It is the
responsibility of the contractor, before bid opening, to request, if necessary, any
additional information on Minimum Wage Rates for those trades people who may be
employed for the proposed work under this contract. Federal Minimum Wage Rates
as determined by the United States Department of Labor under the Davis-Bacon Act
also apply to this project." Davis Bacon Act Requirements
C. "The contractor guarantees that the Work and Services to be performed under the
Contract, and all workmanship, materials and equipment performed, furnished, used
or installed in the construction of the same shall be free from defects and flaws, and
shall be performed and furnished in strict accordance with the Drawings,
Specifications, and other contract documents, that the strength of all parts of all
manufactured equipment shall be adequate and as specified and that the
performance test requirements of the Contract shall be fulfilled. This guarantee shall
be for a period of one year from and after the date of completion and acceptance of
the Work as stated in the final estimate. If part of the Work is accepted in
accordance with that subsection of this AGREEMENT titled "Partial Acceptance",
the guarantee for that part of the Work shall be for a period of one year from the date
fixed for such acceptance."
"If at any time within the said period of guarantee any part of the Work requires
repairing, correction or replacement, the Owner may notify the contractor in writing
to make the required repairs, corrections or replacements. If the Contractor
neglects to commence making such repairs, corrections or replacements to the
satisfaction of the Owner within seven (7) days from the date of receipt of such
notice or having commenced fails to prosecute such Work with diligence, the
Owner may employ other persons to make said repairs, correction or
replacements, and charge the costs, including compensation for additional
professional services, to the Contractor."
D. "This project is subject to the Safety and Health Regulations of the U.S. Department
of Labor set forth in Title 29 CFR, Part 1926 and to all subsequent amendments, and
to any applicable Massachusetts regulations. Contractors shall be familiar with the
requirements of these regulations."
E. "Whenever it is written that an equipment manufacturer must have a specified period
of experience with his product, equipment which does not meet the specified
experience period can be considered if the equipment supplier or manufacturer is
willing to provide an "Efficiency Guarantee Bond" or cash deposit for the duration of
the specified time period which will guarantee replacement of that equipment in the
event of failure."
F. "This project is subject to the requirements of the Department of Environmental
Protection's Diesel Retrofit Program. Bidders must submit a signed and dated
Statement of Intent to Comply form as part of their bid proposal documents."
G.1 "This project is subject to the Build American, Buy America (BABA) requirements."
G.2 "This project is subject to the American Iron and Steel requirements of P.L. 113- 76,
the Consolidated Appropriations Act of 2014." BABA and AIS

Indicate
BID PROPOSAL
Location/Page
For MassDEP
# or Not
Use
Applicable
(NA)
6) The bid proposal must contain the following information:
A.Contract name, contract number and SRF project number designation
B.The method for determining the award of the contract when Bid Alternates are included
C. Acknowledgement of Addenda
D. A Labor and Material or Payment Bond in the amount of 100% of the total contract
price must be provided by the general contractor.
E. A Performance Bond in the amount of 100% of the total contract price must be
provided by the general contractor.
F."The time for completion of this contract is calendar days"
G."Liquidated damages specified in this contract are $ per day for each
calendar day beyond the contract completion date that work remains
uncompleted."
H. SRF eligible and ineligible items must be clearly separated in the bid proposal.
7) The following paragraph must be included in its entirety in the Bid Proposal. "The
time period for holding bids, where Federal approval is not required is 30 days,
Saturdays, Sundays and legal holidays excluded, after the opening of bids
and where Federal approval is required, the time period for holding bids is 30 days,
Saturdays, Sundays and holidays excluded after Federal approval."
8) Indicate which bidder's "Bid Law" certification statements apply to this contract.
A.M.G.L. c.30, s39M (a) and (c)
Certification Statement for Non-Building or Public Works contract
B.M.G.L. c.149, ss44D (1) (b) and s44E (2) (3)
Certification Statement for Building Contract with filed sub-bids
The following other certifications must be included in their entirety in the Bid Proposal.
C.State Taxes
"Pursuant to M.G.L.c.62C, s49A I certify under the penalties of perjury that I, to my
best knowledge and belief, have filed all state tax returns and paid all State Taxes
required under law."
See Certification Statement for Non-Building or Public Works contract
for the applicable contractor's certification statements required when bid under the
provisions of c.30 s39 (Non-Building/Public Works Contract) including certifications for
state taxes, work in harmony, Anti-Discrimination provisions, non-collusion, and non-
debarment.
See Certification Statement for Building Contract with filed sub-bids for the applicable
contractor's certification statements required when bid under the provisions of c.149
s44A-44J (Building Contract with filed sub-bids) including certifications for state taxes,
Anti-Discrimination provisions, eligibility update statement with non-collusion, work in
harmony, and non-debarment.

Indicate
BID PROPOSAL - CONTINUED
Location/Page
For MassDEP
# or Not
Use
Applicable
(NA)
D. Anti-Discrimination Provisions
"The undersigned bidder hereby certifies he/she will comply with the (a) the Civil
Rights Act of 1964, 42 USC s.2000(1) et seq., as amended, Section 13 of the Federal
Water Pollution Control Act (FWPCA) of 1972; Section 504 of the Rehabilitation Act of
1973, the Age Discrimination Act of 1975, and (b) shall make a good faith efforts to
comply with 40 CFR Part 33. The undersigned bidder shall also comply with
Executive Order 592 and Mass General Laws c 151B, 4.1."
E. Non-Debarment
"The undersigned further certifies under penalty of perjury that the said undersigned
is not presently debarred from doing public construction work in the Commonwealth
under the provisions of Section Twenty-Nine F of Chapter Twenty-Nine, or any other
applicable debarment provisions of any other Chapter of the General Laws or any
rule or regulation promulgated thereunder; and is not presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded
from covered transactions by any Federal department or agency."
F.Suspension and Debarment
The EPA prohibits the use of suspended or debarred contractors and suppliers in
SRF financed contracts. All SRF financed contracts and subcontracts must include
the following language requiring compliance with 2 CFR 180 and 2 CFR 1532.
Add the following statement in the bid proposal:
"Bidders must fully comply with Subpart C of 2 CFR Part 180 and 2 CFR Part 1532,
entitled responsibilities of Participants Regarding transactions (Doing Business with
Other Persons). Contractors, subcontractors, or suppliers that appear on the
Excluded Parties List System at www.usgovxml.com/dataservice.aspx?ds=EPLS are
not eligible for award of any contracts funded by the Massachusetts State Revolving
Fund." https://www.mass.gov/debarred-suspended-or-decertified-contractors
Add the following statement or a statement accomplishing the same purpose in the
contract:
The Contractor agrees that it will fully comply with Subpart C of 2 CFR Part 180 and 2
CFR Part 1532, entitled Responsibilities of Participants Regarding Transactions
(Doing Business with Other Persons). The Contractor shall not award any
subcontracts or purchase any materials from suppliers that appear on the Excluded
Parties List System.
The Contractor shall include this requirement in each subcontract and require it to be
included in all subcontracts regardless of tier. The Contractor shall maintain
reasonable records to demonstrate compliance with these requirements.
9)The following Diesel Retrofit Program form is included as part of the Bid Proposal:
Department of Environmental Protection's Diesel Retrofit Program Statement of Intent
to Comply.

Indicate
CONTRACT
Location/Page
For MassDEP
# or Not
Use
Applicable
(NA)
10)The following paragraphs must be included in their entirety in the Contract.
A. "Procurement Considerations - Six Good Faith Efforts. 40 CFR, Part 33, Subpart C:
Pursuant to 40 CFR Section 33.301, the sub-recipient agrees to make good faith
efforts whenever procuring construction, equipment, services, and supplies under an
EPA financial assistance agreement, and to require that sub-recipients, loan
recipients, and prime contractors also comply. Records documenting compliance
with the six good faith efforts shall be retained. The specific six good faith efforts can
be found at: 40 CFR Section 33.301 (a)-(f)."
B. Anti-Discrimination Requirements
"During the performance of this contract, the contractor agrees as follows:
1. The contractor will comply with the (a) the Civil Rights Act of 1964, 42 USC
s.2000(1) et seq., as amended, Section 13 of the Federal Water Pollution
Control Act (FWPCA) of 1972; Section 504 of the Rehabilitation Act of 1973,
the Age Discrimination Act of 1975, and (b) will also comply with
Executive Order 592 and the Mass General Laws c 151B, 4.1.
2. The contractor will, in all solicitations or advancements for employees placed
by or on behalf of the contractor, state that all qualified applicants will
receive consideration for employment consistent with Executive Order 592
and the Mass General Laws c 151B, 4.1.
3. The contractor will send to each labor union or representative of workers with
which he has a collective bargaining agreement or other contract or
understanding, a notice, to be provided by the agency contracting officer,
advising the labor union or workers' representative of the contractor's
commitments under Massachusetts Executive Order No. 592 and Mass General
Laws c 151B, 4.1, and shall post copies of the notice in conspicuous places
available to employees and applicants for employment.
4. The contractor will comply with all provisions of Massachusetts
Executive Order No. 592 and Mass General Laws c 151B, 4.1 and of
the rules, regulations, and relevant orders.
5. The contractor will furnish all information and reports required by
Massachusetts Executive Order No. 592 and Mass General Laws c 151B,
4.1, and by the rules, regulations, and orders, pursuant thereto, and will permit
access to his books, records, and accounts by the contracting agency for
purposes of investigation to ascertain compliance with such rules, regulations,
and orders.

Indicate
CONTRACT - CONTINUED
Location/Page
For MassDEP
# or Not
Use
Applicable
(NA)
6. In the event of the contractor's noncompliance with the nondiscrimination
clauses of this contract or with any of such rules, regulations, or orders,
this contract may be canceled, terminated, or suspended in whole or in part
and the contractor may be declared ineligible for further Government
contracts in accordance with procedures authorized in Executive Order No.
592 and Mass General Laws c 151B, 4.1 and such other sanctions may be
imposed and remedies invoked as by rule, regulation, or as otherwise
provided by law.
7. The contractor will include the provisions of paragraphs (1) through (7) in
every subcontract or purchase order unless exempted by rules or regulations,
so that such provisions will be binding upon each subcontractor or vendor.
The contractor will take such action with respect to any subcontract or
purchase order as a means of enforcing such provisions.
C. "The contractor shall not participate in or cooperate with an international boycott,
as defined in Section 999 (b)(3) and (4) of the Internal Revenue code 1986, as
amended, or engage in conduct declared to be unlawful by Section 2 of Chapter
151E of the Massachusetts General Laws."
11)The provisions of the following paragraphs must be included in the Contract. Other
language may be substituted provided the language changes do not substantively
alter the meaning of these provisions.
A. "The time for completion of this contract is calendar days."
B. "Liquidated damages specified in this contract are $ per day for each
calendar day beyond the contract completion date that work remains
uncompleted."
C. As per MassDEP's Policy Memorandum #10 - the agreed upon DIRECT LABOR
MARKUP (percentage) for Change Orders on this project shall be
percent.
12)The following LGU auditor/accountants certification must be included in contract
"Pursuant to M.G.L. c.44, s31C, I certify that an appropriation has been made in the total
amount of the contract."
13.a) All contracts must have a clause requiring compliance with American Iron and Steel
and the Build America, Buy America Act (BABA). The amendments to the Clean
Water Act, as part of WRRDA, apply the American Iron and Steel (AIS) requirements
to all treatment works projects. Furthermore, IIJA extends this procurement
requirement to all SRF construction projects going forward with the inclusion of the
Build America, Buy America Act (BABA). Starting on May 14, 2022, all steel, iron,
manufactured products, non-ferrous metals, plastic and polymer-based products
(including polyvinylchloride, composite building materials, and polymers used in
fiber optic cables), glass (including optic glass), lumber, and drywall used in
infrastructure projects for federal financial assistance programs must be produced in
the United States. MassDEP ensures that the required procurement language is
included in contracts and conducts field verifications of project compliance.

Indicate
CONTRACT - CONTINUED
Location/Page
For MassDEP
# or Not
Applicable Use
(NA)
13.b) All contracts must have a clause requiring compliance with the American Iron and Steel
(AIS) requirements. The following is suggested language developed by the EPA for use
in SRF construction contracts. Any deviation from this suggested language should be
reviewed and approved by local legal counsel.
The Contractor acknowledges to and for the benefit of the City/Town of ______
("Purchaser") and the Commonwealth of Massachusetts (the "State") that it
understands the goods and services under this Agreement are being funded with
monies made available by the Clean Water State Revolving Fund and/or Drinking Water
State Revolving Fund that have statutory requirements commonly known as "American
Iron and Steel;" that requires all of the iron and steel products used in the project to be
produced in the United States ("American Iron and Steel Requirement") including iron
and steel products provided by the Contactor pursuant to this Agreement. The
Contractor hereby represents and warrants to and for the benefit of the Purchaser and
the State that (a) the Contractor has reviewed and understands the American Iron and
Steel Requirement, (b) all of the iron and steel products used in the project will be and/
or have been produced in the United States in a manner that complies with the
American Iron and Steel Requirement, unless a waiver of the requirement is approved,
and (c) the Contractor will provide any further verified information, certification or
assurance of compliance with this paragraph, or information necessary to support a
waiver of the American Iron and Steel Requirement, as may be requested by the
Purchaser or the State. Notwithstanding any other provision of this Agreement, any
failure to comply with this paragraph by the Contractor shall permit the Purchaser or
State to recover as damages against the Contractor any loss, expense, or cost
(including without limitation attorney's fees) incurred by the Purchaser or State
resulting from any such failure (including without limitation any impairment or loss of
funding, whether in whole or in part, from the State or any damages owed to the State
by the Purchaser). While the Contractor has no direct contractual privity with the State,
as a lender to the Purchaser for the funding of its project, the Purchaser and the
Contractor agree that the State is a third-party beneficiary and neither this paragraph
(nor any other provision of this Agreement necessary to give this paragraph force or
effect) shall be amended or waived without the prior written consent of the State.
14)All contracts for clean and drinking water projects awarded as a result of a proposal or
invitation for bids under MGL Chapter 30 section 39M shall include a price adjustment
clause for fuel, both diesel and gasoline; liquid asphalt; and portland cement contained
in cast-in-place concrete. A base price for each material shall be set by the awarding
authority or agency and shall be included in the bid documents at the time the project
is advertised. The awarding authority or agency shall also identify in the bid documents
the price index to be used for each material. The price adjustment clause shall provide
for a contract adjustment to be made on a monthly basis when the monthly cost change
exceeds plus or minus 5 per cent.
15)All construction contracts are subject to the Davis Bacon wage rate requirements and
must include the provisions of the Davis Bacon Act Requirements in the contract.
The Davis Bacon Act Requirements are included.
16)The following suspension and debarment statement must be included in the contract:
"The Contractor agrees that it will fully comply with Subpart C of 2 CFR Part 180 and 2
CFR Part 1532, entitled Responsibilities of Participants Regarding Transactions (Doing
Business with Other Persons). The Contractor shall not award any subcontracts or
purchase any materials from suppliers that appear on the Excluded Parties List
System. The Contractor shall include this requirement in each subcontract and require
it to be included in all subcontracts regardless of tier. The Contractor shall maintain
reasonable records to demonstrate compliance with these requirements."

Indicate
GENERAL/SUPPLEMENTARY CONDITIONS
Location/Page
For MassDEP
# or Not
Use
Applicable
(NA)
17)The following federal statutes regulating construction projects must be included in the
specifications:
A.Prohibitions Relating to Violators of the Clean Air Act and the Clean Water Act with
Respect to Federal Contracts, Grants, or Loans Executive Order No. 11738 (1973)
Section 306 of the Clean Air Act, 42 U.S.C. 7606, and Section 508 of the Clean Water
Act, 33 U.S.C 1368
B.Demonstration Cities and Metropolitan Development Act Pub. L. No. 89-754
(1966), as amended 42 U.S.C. 3331 et. Seq.
C.Uniform Relocation Assistance and Real Property Acquisition Policies Act Pub.
L.No. 91-646 (1971), as amended 42 U.S.C. 4601-4655
D.Preservation of Open Competition and Government Neutrality Towards Government
Contractors' Labor Relations on Federal and Federally Funded Construction Projects
Executive Order No. 13202 (2001), as amended by
Executive Order No. 13208 (2001)
E.The Age Discrimination Act of 1975 42 U.S.C. 6102
F.Section 13 of the Federal Water Pollution Control Act Amendments of 1972 33
U.S.C. 1251
G.Section 504 of the Rehabilitation Act of 1973 29 U.S.C. 794
H.Title VI of the Civil Rights Act of 1964 42 U.S.C. 2000d
I.Prohibition on Certain Telecommunication and Video Surveillance Services or
Equipment in the SRF Programs
i.Effective August 13, 2020, recipients and subrecipients of EPA funded
assistance agreements, including borrowers under EPA funded revolving loan
funds, must comply with regulations at 2 CFR 200.216, Prohibition on certain
telecommunication and video surveillance services or equipment, implementing
section 889 of Public Law 115-232. The regulation prohibits the use of Federal
funds to procure (enter into, extend, or renew contracts) or obtain equipment,
systems, or services that use "covered telecommunications equipment or
services" identified in the regulation as a substantial or essential component of
any system, or as critical technology as part of any system. Prohibitions extend
to the use of Federal funds by recipients and subrecipients to enter into a
contract with an entity that "uses any equipment, system, or service that uses
covered telecommunications equipment or services" as a substantial or
essential component of any system, or as critical technology as part of any
system. Certain equipment, systems, or services, including equipment, systems,
or services produced or provided by entities subject to the prohibition are
recorded in the System for Award Management exclusion list.