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VUI.uoiy I CI IVCIUSIC iw.L.lLLt cut r-DUUC-N0L4-0L0D-'fUF1/OJ 1/.7LJu <br /> Print Name: Ralph Bell <br /> Title: CEO <br /> Date: 4/8/2021 <br /> 2nd company name (if joint venture) : <br /> 2nd Address: <br /> County: <br /> By (signature) <br /> Print Name: <br /> Title: <br /> Date: <br /> Attest: <br /> [seal] <br /> NOTE: This document must be signed in ink by an individual with the legal authority to bind the <br /> contractor. It must also be attested by the corporate secretary and bear the seal of the corporation. <br /> CONTRACTORS PROPOSAL CHECKLIST (For information only) <br /> The documents checked below are included in and made a part of this proposal. I have completed and <br /> signed all forms where indicated. <br /> Proposal Guarantee/Bid Bond (All Projects) <br /> Proposal (CDOT Form #85) (All Projects) <br /> Invitation for bids, plus any revision notices (All Projects) <br /> Anti-Collusion Affidavit (CDOT Form #606) (All Projects) <br /> _ Disadvantaged Business Enterprise Bid Conditions Assurance <br /> (CDOT Form #1414) (All Projects with DBE Goals) <br /> _ Statement of Residence for Bidder Preference (CDOT Form #604) <br /> (Non Federal Aid Projects Only) <br /> Bid Schedule (All Projects) <br /> CDOT Form # 85 05/06 <br /> [PAGE BREAK] <br /> Vendor 1275A's Bid Information for Call 001, Letting 20210210, 02/10/2021 <br /> COLORADO DEPARTMENT OF TRANSPORTATION ANTI-COLLUSION AFFIDAVIT <br /> PROJECT NO. NHPPR400-370 <br /> LOCATION <br /> I hereby attest that I am the person responsible within my firm for the final decision as to the price <br /> (s) and amount of this bid or, if not, that I have written authorization, enclosed herewith, from that <br /> person to make the statements set out below on his or her behalf and on behalf of my firm. <br /> I further attest that: <br /> 1. The price(s) and amount of this bid have been arrived at independently, without consultation, <br /> Exhibit A-Page 3 of 12 <br />