2018-04-26_PERMIT FILE - M2018020

• Permit No: M2018020
• IBM Index Class Name: PERMIT FILE
• Doc Date: 4/26/2018
• Doc Name Note: Application
• Doc Name: Application
• From: Castle Rock Construction Company of Colorado, LLC
• To: DRMS
• Email Name: JLE
• Email Name: WHE
• Media Type: D
• Archive: No

2A. ,Neither the price(s) nor the amount of this bid have been disclosed to any other firm or person who
is a bidder or potential prime bidder on this project, and will not be so disclosed prior to bid
opening.
2B. Neither the prices nor the amount of the bid of any other firm or person who is a bidder or
potential prime bidder on this project have been disclosed to me or my firm.
3A. No attempt has been made to solicit, cause or induce any firm or person who is a bidder or potential
prime bidder to refrain from bidding on this project, or to submit a bid higher than the bid of this
firm, or any intentionally high or non-competitive bid or other form of complementary bid.
3B. No agreement has been promised or solicited for any other firm or person who is a bidder or
potential prime bidder on this project to submit an intentionally high, noncompetitive or other form of
complementary bid on this project.
4. The bid of my firm is made in good faith and not pursuant to any consultation, communication,
agreement or discussion with, or inducement cr solicitation by or from any firm or person to submit any
intentionally high, noncompetitive or other form of complementary bid.
5. My firm has not offered or entered into a subcontract or agreement regarding the purchase or sale of
materials or services from any firm or person, or offered, promised or paid cash or anything of value to
any firm or person whether in connection with this or any other project, in consideration for an
agreement or promise by any firm or person to refrain from bidding or to submit any intentionally high,
noncompetitive or other form of complementary bid or agreeing or promising to do so on this project.
6. My firm has not accepted or been promised any subcontract or agreement regarding the sale of
materials or services to any firm or person. and has not been promised or paid cash or anything of value
by any firm or person, whether in connection with this or any other project, in consideration for my
firms submitting any intentionally high, noncompetitive or other form of complementary bid, or agreeing
or promising to do so, on this project.
7. I have made a diligent inquiry of all members, officers, employees, and agents of my firm with
responsibilities relating to the preparation, approval or submission of my firm's bid on this project
and have been advised by each of them that he or she has not participated in any communication,
consultation, discussion, agreement, collusion, or other conduct inconsistent with any of the statements
and representations made in this affidavit.
8. I understand and my firm understands that any misstatement in this affidavit is and shall be treated
as a fraudulent concealment from the Colorado Department of Transportation, of the true facts relating
to submission of bids for this contract.
UNDER PENALTY OF PERJURY IN THE SECOND DEGREE, AND ANY OTHER APPLICABLE STATE OR FEDERAL LAWS, THAT THE
STATEMENTS MADE ON THIS DOCUMENT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
Contractor's firm or company name: Castle Rock Construction Company of Colorado, LLC
Title CEO By Ralph Bell Date 03/08/18
2nd Contractor's firm or company name:
(if joint venture)
Title By Date
Sworn to me this ( I day of, 114-Pri 114-PrI 20 16
Notary Public
Commission Expiration Date '2 !J t J i DAVID BROOI S
NOTARY PUBLIC
STATE OF COLORADO
NOTE: This document must be signed in Ink. NOTARY ID It 20154047623
MY COMMISSION EXPIRES DECEMBER 11,2019
CDOT Form # 606 01/02
[PAGE BREAK]
Vendor 1275A's Bid Information for Call 001, Letting 20180308, 03/08/2018
COLORADO DEPARTMENT OF TRANSPORTATION ANTICIPATED DBE PARTICIPATION PLAN
Individual's Name: Castle Rock Construction Company of Colorado, LLC
PROJECT NO. ER144A-002 //�c