Loading...
1d. Kerber Blvd Mill & Overlay: Plans & Specs, Authorize Ad for Bids.690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317 (612) 937 -1900 • FAX (612) 937 -5739 CITY OF 1 1" CHANHASSEN 1 MEMORANDUM TO: FROM: DATE: SUBJ: The intent of this resurfacing project will be to restore the existing crown, enhance rideability and structural strength thereby increasing the service life of this roadway. The project will consist of milling the curbline followed by constructing a 2 bituminous overlay on the entire width of the roadway which will begin at West 78th Street and terminate at Powers Boulevard. Also included will be the restoration of pavement markings (stripping, crosswalks, etc.). Since Kerber Boulevard is a municipal finance the majority of the project with April 15, 1996, the project plans and sf MnDOT State Aid Office and at this pc add this item to the May 20, 19,96 City jrns g:�engNbi1IVicerber.cc Charles Folch, Director of Public Works Bill Bement, Engineering Technician II� May 14, 1996 Action by City Administrator Endorsed� Modific Rejected Datem_ Date Submit ed to Commission Datb Su l 'i;ad to Council Request for City Council Approval - Kerber Boulevard Resurfacing Project Project No. 96- 5 /S.A.P. No. 194- 101 -05 state aid roadway, State monies are proposed to be used to an estimated cost being approximately $149,000.00. On ecifications received preliminary approval from the ►int, City Council approval is requested. Therefore, please Council agenda for its review and approval. ' UlK1a:l UK UN YUt3Lll; WUKKS' I:UMMLiV l : I /1/ As Bill has indicated, Municipal State Aid construction dollars are proposed to fund the majority of this project. The current condition of Kerber. B6u' levard makes this repair necessary at this time before further deterioration and more costly repairs are required. Staff recommends plan and specification approval and authorization for advertising for bids. Engineer's Estimate Project: Kerber Boulevard Bituminous Overlay Project City Project No. 96 -5 S.A.P. No. 194-101-05 March 22, 1996 Item No. MnDOT Sec. No. Desciption Estimated Quantity Estimated Price Estimated Total 1 2341.508 Type 41A Wearcourse 4,450 Ton 30.00 133,500.00 2 2357.502 Bituminous Tack Coat 2,570 Gal. 1.00 2,570.00 3 2232.500 Miffing Curbline 10,300 s. y. 0.75 7,725.00 4 2506.3 Manhole Casting Adjust. 8 Each 200.00 1,600.00 5 0564.602 Painted Pavement Markings 6 0564.602 Left Arrow 2 Each 50.00 100.00 7 0564.602 Only 1 Each 70.00 70.00 8 0564.602 6" Solid White Crosswalk Line 8501.f. 0.35 297.50 9 0564.602 4" Solid White Lane Line 1501.f. 0.25 37.50 10 0564.602 4" Double Yellow Line 6,8001.f. 0.50 3,400.00 11 70564.602 1 18" Stop White Line 50 l.f. 1.00 50.00 TOTAL: $149,350.00 J CITY OF CHANHASSEN MUNICIPAL STATE AID PROJECT NO. 194- 101 -09 KERBER BOULEVARD (M.S.A.S. NO. 101) BITUNIINOUS OVERLAY PROJECT CITY PROJECT NO. 96-5 SPECIFICATIONS AND BID PROPOSAL I hereby certify that this plan, specification or report was prepared by me or under my direct supervision and that I am a duly registered Professional Engineer under the laws of the State of Minnesota. Charles D. Folch, Reg. No. 21474 Date: 3 "Z 7— 9'0 TABLE OF CONTENTS Advertisementfor Bids... ... -- ..... ............................... —...........,.............................. ..............................1 Proposal............. — ..... ... ......... .. ...... .. ....... ... ... ....................... ..,.,........................................ ..... 2 through 4 Special Provisions ................................. ...................................................................... SP -1 through SP -9 Street Construction Specifications... .................................................................................... 1 through 48 MnDotSpecifications ................................................................................................ ............................... Formof Contract .................................................................................... ............................... 1 through 3 Notice is hereby given that the Chanhassen City Council will receive sealed proposals for Kerber ' Boulevard M.S.A. Project No. 194- 101 -09 as detailed in the specifications dated March 1, 1996 at the office of the City Engineer until 2:00 PM, May 31, 1996, when they will be publicly opened at City Hall, 690 Coulter Drive, Chanhassen, Minnesota, 55317. ' The work includes approximately 4,450 tons of bituminous wear course overlay, 10,300 square yards of bituminous milling along curb lines, 8 manhole casting adjustments and restoration of pavement ' markings. All proposals shall be addressed to: ' Charles Folch City Engineer ineer ' City of Chanhassen 690 Coulter Drive Chanhassen, MN 55317 All proposals shall be securely sealed and shall be endorsed on the envelope with the statement "PROPOSAL FOR KERBER BOULEVARD M.S.A. PROJECT 194 - 101 -09" and shall be on the ' Proposal Form included in the plans and specifications. All bids shall be accompanied by a certified check, cashiers check or bid bond in the amount of five (5) percent of the total bid price made payable to the City of Chanhassen. ' Specifications for the above - mentioned work are on file in the office of the City Engineer, Chanhassen, Minnesota, where copies for bidders may also be obtained. The City reserves the right to reject any or all bids and to waive any irregularities in the bidding, and further reserves the right to award the contract in the best interest of the City. No bids may be withdrawn within thirty (30) days from the date bids are opened. Published in the Construction Bulletin on May 10, 1996 and May 17, 1996. Published in the Chanhassen Villager on May 9, 1996 and May 16, 1996. CITY OF CHANHASSEN ' ADVERTISEMENT FOR BIDS Municipal State Aid Project No. 194- 101 -09 Kerber Boulevard (M.S.A.S. No. 101) ' Bituminous Overlay Project City Project No. 96 -5 Notice is hereby given that the Chanhassen City Council will receive sealed proposals for Kerber ' Boulevard M.S.A. Project No. 194- 101 -09 as detailed in the specifications dated March 1, 1996 at the office of the City Engineer until 2:00 PM, May 31, 1996, when they will be publicly opened at City Hall, 690 Coulter Drive, Chanhassen, Minnesota, 55317. ' The work includes approximately 4,450 tons of bituminous wear course overlay, 10,300 square yards of bituminous milling along curb lines, 8 manhole casting adjustments and restoration of pavement ' markings. All proposals shall be addressed to: ' Charles Folch City Engineer ineer ' City of Chanhassen 690 Coulter Drive Chanhassen, MN 55317 All proposals shall be securely sealed and shall be endorsed on the envelope with the statement "PROPOSAL FOR KERBER BOULEVARD M.S.A. PROJECT 194 - 101 -09" and shall be on the ' Proposal Form included in the plans and specifications. All bids shall be accompanied by a certified check, cashiers check or bid bond in the amount of five (5) percent of the total bid price made payable to the City of Chanhassen. ' Specifications for the above - mentioned work are on file in the office of the City Engineer, Chanhassen, Minnesota, where copies for bidders may also be obtained. The City reserves the right to reject any or all bids and to waive any irregularities in the bidding, and further reserves the right to award the contract in the best interest of the City. No bids may be withdrawn within thirty (30) days from the date bids are opened. Published in the Construction Bulletin on May 10, 1996 and May 17, 1996. Published in the Chanhassen Villager on May 9, 1996 and May 16, 1996. MUNICIPAL STATE AID PROJECT NO. 194 - 101 -09 KERBER BOULEVARD (M.S.A.S. NO. 101) BITUMINOUS OVERLAY PROJECT CITY PROJECT NO. 96-5 CITY OF CHANHASSEN, MINNESOTA Honorable Mayor and City Council Members City of Chanhassen Chanhassen, Minnesota 55317 Gentlemen: The undersigned, being familiar with the local conditions affecting the cost of the work and with these contract documents dated March 1, 1996 on file in the office of the City Engineer of the City of Chanhassen, Minnesota, does hereby propose to furnish all labor, material, skills and equipment necessary to complete the bituminous overlay project according to the following schedule of approximate quantities and respective unit prices. 1. MnDOT 2341.508 Wearing Course Mixture Type 41A 4,450 Tons @ $ _ $ 2. MnDOT 2357.502 Bituminous Material for Tack Coat 2,570 Gallons @ $ _ $ 3. MnDOT 2232.500 Milling Curb Line 10,300 square yards @ $ _ $ 4. MnDOT 0506.602 Manhole Casting Adjustment 8 each @ $ _ $ 5. MnDOT 0564.603 Painted Pavement Markings (white) Left Arrow: 2 Each @ Only: 1 Each @ it 6. MnDOT 0564.603 Painted Pavement Markings 6" Solid White Line Crosswalk 850 L.F. @ 4" Solid White Lane Line 150 L.F.@ $ _$ 4" Double Yellow Line 6,800 L.F. @ $ _ 18" Stop White Line 50 L.F.@ $ _$ Total Bid $ The undersigned bidder also agrees to furnish the required bond and to enter into the contract with the City within ten (10) days after the City's acceptance of this Proposal or any section or sections thereof, and further agrees to complete the entire work covered in the contract award by October 15, 1996 except as noted in the specifications and subject to the provisions of the contract documents. Enclosed is the required Proposal guarantee in the amount of 5 %, which the undersigned bidder agrees to be forfeited to and become the property of the City of Chanhassen, as liquidated damages should this Proposal be accepted and a contract be awarded to him and he fails to enter into a contract within ten (10) days, but otherwise the aforesaid Proposal guarantee will be returned upon his signing the contract and delivering the approved bond. In submitting this bid, it is understood that the right is reserved by the City to reject any and all bids, ' waive the informalities in any bid, and award the work in the best interest of the city. it is further understood that this bid may not be withdrawn for a period of thirty (30) days after the scheduled time for the receipt of bids. Contract payments shall be based on actual quantities placed at unit prices bid. The City Engineer reserves the right to add or delete work items and/or bid quantities from this contract as may be necessary to accommodate budget limitations. Contractor shall be advised that MnDOT 1903 Compensation for Increased or Decreased quantities will not apply to this contract. No adjustments to the unit prices named in the proposal will be allowed for changes in actual quantities. All addenda shall become a part of the bid. We hereby acknowledge Addenda Nos. , and We have examined the site of the work and are familiar with all conditions affecting the work. 3 Where there is a discrepancy between the unit price and the total item cost, the unit price shall dictate. If this proposal is accepted, we will execute a contract in the form specified and will furnish a performance bond in the amount of the contract within ten days of City Council acceptance of project. Respectfully Submitted, Firm Name: Address: Telephone: By: Its: Signed: M I Project Description MUNICIPAL STATE AID PROJECT NO. 194 - 101 -09 KERBER BOULEVARD BITUMINOUS OVERLAY SPECIAL PROVISIONS ' The project shall be constructed in accordance with the current Minnesota Department of Transportation Standard Specifications for Construction, except as modified or altered below. The project will consist of constructing a bituminous overlay on Kerber Boulevard (M.S.A.S. No. 101) ' beginning at West 78th Street and ending at Powers Boulevard (C.S.A.H. No. 17). Also included will be the milling along all curb lines, the vertical adjustment of manhole castings and water valve boxes, and the installation of pavement markings upon completion of the overlay process. Bituminous Overlay ' All materials shall conform to and be applied in accordance with MnDOT Standard Specifications for Construction. 1. Intent It is intended to construct a bituminous overlay on Kerber Boulevard in such a manner as to restore the existing crown, enhance the structural strength and rideability of the roadway. ' The existing roadway exhibits transverse cracking, some spalling and some loss of crown. It is proposed to construct the overlay so on average of at least 2" of compacted material covers the roadway and will conform to the grade and surface contour required as per detail shown on ' the plans. The length of the overlay on Kerber Boulevard when complete will be approximately 7,535 feet with the bituminous paving width being 41.00 feet. All intersecting side street radiuses shall also be overlaid to a point past the radius return which will be marked in the field by the Engineer. ' The roadway may not be closed to traffic and must be kept open at all times. This will be accomplished by constructing one -half of the overlay to the roadway section at a time. Traffic ' control shall be the responsibility of the Contractor and shall include flaggers, barricades, warning signs and/or traffic cones as necessary in accordance with the MnDOT short-term work zone safety manual. Traffic control is considered incidental to the project. ' Street preparatory work consisting of patching, crack sealing, etc. will be completed by City forces prior to the mill and overlay project. ' 2. Bituminous MateriaL ' The contractor shall place and compact the bituminous wear of the type and depth specified. I SP -1 rl Plant mix bituminous wear shall be in accordance with Section 2331 (revised January 4, 1991) of the current Minnesota Department of Transportation Standard Specification (see Article 14.00), except as modified or altered below. (a) Bituminous material for mixture shall be asphalt cement of penetration 120 to 150, added at the rate determined by the design mix formula. The design mix formula shall be made by an approved testing agency and the results must be submitted to the city engineer for approval prior to construction. I F B I (b) The aggregate mixture shall be Type 41A as per Section 3139 of the current Minnesota Department of Transportation Standard Specification. I (c) Method of Rolling: The rolling of the new mat shall follow the accepted procedure of a steel wheel roller with the drive wheel forward directly behind the paver, rolling from the gutter edge of the mat toward the center seam. The same procedure shall be followed for additional passes. (d) Compaction shall be obtained by the specified density method to achieve a degree of compaction no less than 95% of the Marshall density as determined. for the "job mix" formula. (e) Weight tickets shall be required to check yield. Adjustment required if overall bituminous mixture yield is less than theoretical quantity based on Marshall test and design quantity. Bituminous testing will be performed for the owner by an independent testing laboratory. All failing tests shall be retested upon completion of corrective measures. The cost of all retests will be paid by the contractor. 1. One (1) sample for a Marshall density test per 1,000 tons of mix installed. 2. One (1) sample for extraction/gradation test per 1,000 tons of mix installed. 3. In place density tests performed by the following procedure: (a) A minimum of two (2) core samples for in place density tests per 1,000 tons of mix installed. 1 No cores are to be taken in the wheel tracks. Bituminous overlay material will be paid by the ton as bid in the proposal and measured by weight of actual material laid. SP -2 ' 3. Tack Coat Prior to the overlay procedure, a tack coat in accordance with MnDOT 2357 with optional grade shall be placed. Tack coat material will be paid by the gallon as bid in the ' proposal and measured by actual amounts applied. ' 4. Millin . Prior to the overlay procedure, all curb lines shall be milled with an approved milling machine with capabilities of removing a 6 -foot wide pass with a depth of cut at curb line to be 2 inches and 0 inches at 6 feet from edge of curb. All milling material shall become the ' property of the City and shall be transported and unloaded at the City Public Works yard located at 1591 Park Road in Chanhassen, Minnesota. ' When approaching an intersecting side street, the radius of the curb line shall be milled to past the end of the radius return as per typical detail shown on the plans. A butt joint shall also be milled at all overlay starting points. This joint will be marked in the field by the Engineer. The milling operation shall not take place more than 24 hours prior to the scheduled overlay work. Milling will be paid by the square yard and at the unit price bid in the proposal, to ' include square yards milled, removed, and hauled to the City's Public Works yard located at 1591 Park Road in Chanhassen, Minnesota and measured by the actual area milled. ' 5. Manhole Casting Adjustment Kerber Boulevard has approximately 8 manhole castings which will require a vertical adjustment due to the bituminous overlay. ' If bituminous thickness permits, a one -piece steel cover adjusting ring may be used during the overlay process as per Standard Detail Plate No. 2101A which is made part of these specifications. If the casting is situated where the steel cover adjusting ring will not permit its ' use, the traditional chop -out method must be performed. The use of 2 -piece steel cover adjusting rings will not be allowed. Manhole casting adjustments will be paid per each adjustment as bid in the proposal and measured by the actual number of castings adjusted. ' Any water gate valve adjustments shall be considered incidental to the project. 6. Pavement Markings Upon completion of the overlay process the pavement markings shall be re- established in accordance with MnDOT Specification No. 3567. ' Kerber Boulevard shall be centerline striped from West 78th Street to Powers Boulevard with a 4 -inch solid double yellow centerline stripe. At all intersection side streets a 50 -foot non - striped space is to be left open. ' The paint for pavement markings shall conform to current MnDOT specifications no. 3567 and shall be protected until properly cured by either cones or trailing vehicles. Paint shall be applied ' at a minimum rate of 320 linear feet of 4" line per gallon. The beads shall be of the drop -on floating type and shall be applied at the rate of 6 pounds per gallon of paint applied. I SP -3 The striping machine must be equipped with paint agitators, paint heaters., timing devices, footage counter, gallon meters to accurately measure the paint being used to the tenth of a gallon, rotating beacons, warning signs and all other devices needed to conduct operations in a safe and efficient manner. It shall be the Contractor's responsibility to perform all layout as per details shown on the plans. Incidental Work All work to be done by the Contractor as specified in this document, and all minor details of the work not specifically mentioned in the specifications but obviously necessary for the proper completion of work, shall be considered as incidental to and a part of the work for which prices ,are named in the proposal. The Contractor will not be entitled to any extra or additional compensation for such work except as specifically stated. Street sweeping between the milling and overlay operations and overlay and striping shall be considered incidental work. Work Hours The normal work hours under this contract shall be from 7:00 a.m. to 7:00 p.m. on weekdays, and from 9:00 a.n to 5:00 p.m on Saturdays with no such activity allowed on Sundays or any recognized legal holidays. Operation of all internal combustion engines used for construction or dewatering purposes beyond the normal work hours will require City Council approval. Under emergency conditions, this limitation may be waived by the consent of the City Engineer. Site Investi ag tion The Contractor acknowledges that he has satisfied himself as to the nature and location of the work and the general and local conditions of the various sites as well as the character of the equipment required during and after prosecution of the work. Any failure by the Contractor to acquaint himself with the available information will not relieve him from the responsibility for estinxiting properly the difficulty or cost of successfully performing the work. Conflict In the case of a conflict of meaning between any of the terms of the Contract Documents, the provisions of the document listed first below over those of a document listed later: 1. Contract Agreement Form 2. Special Provisions. 3. Plans, Bid, and Bid Form. 4. Specifications. 5. General Conditions. Special provisions and detail plans are intended to modify and prevail over standard plans and specifications. Time Schedule SP -4 I 11 1 ' Time Schedule ' The contractor shall indicate the completion date in the appropriate specs provided on the proposal form The completion date may be taken into account in making the award of this contract, but in no ' case shall the completion date by later than October 15, 1996. Failure to comply with the above - mentioned completion date shall result in the deduction of liquidated ' damages as set forth in Section 1807 of the MnDOT "Standard Specifications for Construction'. Insurance ' The contractor shall not commence work under this contract until all of the insurance and performance /payment bonds required under the Contract Documents has been submitted to the City ' and a preconstruction conference has been held. The Contractor shall not allow any subcontractor to commence any work until the requirements have been met. ' During the term of this contract, the contractor shall maintain such insurance as will protect him from claims as set forth below which may arise out of or from the contractor's operations under the contract, whether such operations be by himself or by a subcontractor or sub - subcontractor or anyone directly or ' indirectly employed by any of them, or by anyone for whose acts any of them may be held liable. (a) For claims arising under any Workmen's Compensation, Employer's Liability or any similar employee benefit. (b) For claims because of bodily injury, sickness, disease, or death of any person or persons other ' than his employees, and for claims because of damage to or destruction of property of others resulting therefrom, including loss of use thereof. ' Such insurance shall be written for amounts not less than the following as respects subparagraph (a) above: ' Workmen's Compensation .............................................................. ............................... Statutory Employer's Liability ............................................. ............................... $100,000 each occurrence ' and as respects subparagraph (b): ' Bodily Injury and Property Damage with a Combined Single Limit of Liability of $1,000,000 Each Occurrence ' of ' Bodily Injury General & Automobile General & Automobile ........................................... ............................... $500,000 each person ................................. ............................... $1,000,000 each occurrence SP -5 Property Damage General & Automobile ........... ............................... General ................................... ............................... .................... $500,000 each occurrence ' .............................. $500,000 aggregate The insurance referred to in subparagraph (b) above shall be written under the Comprehensive General and Comprehensive Automobile Liability policy forms, including coverage of all owned, hired, and non -owned automobiles. The contractor may at his option, provide the limits of liability as set out above by a combination of the above - described policy forms and an Umbrella Excess Liability policy. All responsibility for payment of any suns resulting from any deductible provision, corridors, or self - insured retention conditions or the policy or policies shall remain with the contractor. It is a condition of the contract that the policy or policies waive any and all governmental immunity as a defense in any action brought against the insured or any other party to the contract. Approval of the insurance by the owner shall not in any way relieve or decrease the liability of the contractor hereunder, and it is expressly understood that the owner /engineer do not in any way represent that the above specified insurance or limits of liability are sufficient or adequate to protect the contractor's interests or liabilities. Evidence of the above required insurance shall be furnished on a Certificate of Insurance form satisfactory to the owner. Copies of all certificates evidencing such insurance shall be filed with the owner. The certificates shall be executed by the insurer and shall expressly stipulate that the policies are non - cancelable prior to expiration of the contract period, unless ten days' notice in writing to the owner shaifl be filed with the owner. Certificates for liability policies must show that the City and engineer are the parties insured by the respective policies. Certificates of Insurance including a separate Worker's Compensation and Employers Liability form certifying that the above insurance is in force with companies acceptable to the City, along with a performance bond, shall be required as a part of the Contract Documents. Permits and Responsibility The Contractor shall, without additional expense to the City, obtain all licenses and permits required for the prosecution of work and shall be responsible for all damages to persons or property occurring as a result of his fault or negligence in connection with the prosecution of the work:. The contractor shall also be responsible for all materials delivered and work performed until completion and final acceptance except for any completed unit which previously may have been finally accepted. SP -6 C 0 r Contractor's Responsibilities The Contractor shall furnish all necessary machinery, tools, labor and material for every character required, and shall fully complete the work in accordance with the plan, specifications, and detail drawings, for the prices bid. All equipment to be used must be approved by the Engineer prior to starting the work. The entire work to be performed under the contract for this improvement is to be at the Contractor's risk, and he is to assume the responsibility for and risk of all damages to the work or to property adjacent to or on the line of said work. The Contractor shall have charge of and be responsible for the entire improvement until its completion and acceptance. It shall be his responsibility to maintain all stages of work in a safe and suitable condition at all times, including nights, weekends, and holidays. The Contractor shall make observations of his work during such periods as are necessary to insure proper care of the work. He shall be liable for any defects which may appear or be discovered on his work before the final payment herein specified. Whenever the Contractor is not present on the work, communications will be given to the superintendent or foreman who may have immediate charge thereof, and shall by him be received and strictly obeyed. The Contractor shall designate one person who shall have charge of the job and to whom the inspector may communicate. The Contractor shall submit, at such times as may reasonably be requested by the Engineer, schedules which shall show the order in which the Contractor proposes to carry on the work, with dates at which the Contractor will start the several parts of the work, and estimated dates of completion of the several parties. In accordance with the contract agreement, the Contractor and his sureties shall indemnify the City, the State of Minnesota, and any and all of its officers, Engineers, and employees from any claims and demands or losses, damages, costs, charges and expenses of every nature and description, whether direct or indirect, because of the performance of this contract, including all injuries to workmen or persons other than workmen and for all property damages. The Contractor shall indemnify the City and the State of Minnesota against any such loss or any liability of any nature, whether direct or indirect, and the City and the State of Minnesota reserves the right to deduct from any money due the Contractor the amount of any judgment or claims therefor. The obligations of the Contractor do not extend to the liability of the consultant or Engineer, his agents or employees arising out of the preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs or specifications which are certified by the Engineer. The approval of the above documents by the Engineer shall be subject to the conditions, limitations and exceptions stated on such documents and in contract documents. No approval of any document by the Engineer shall be implied. The Engineer shall not be deemed to have approved any document unless such document bears the Engineer's certificate or seal. Project Acceptance and Final Payment Contract payments shall be based on actual quantities placed at unit prices bid. SP -7 Upon completion of the work, the Engineer shall satisfy himself by examination and test that the work has been properly and fully completed in accordance with these specifications. Any and all manholes, ' gate valves, and/or storm castings covered by the overlay process will have to be exposed, cleaned, and operable as a part of final acceptance requirements. Once accepted and a two -year 100% warranty bond of the Contractor's work is provided along with ' lien waivers from all subcontractors, final payment, based upon actual quantities used, unit prices bid and approved change orders shall be made within thirty (30) days. Warranty Bond Prior to final payment and acceptance of work, the Contractor shall provide the City two-year 100% ' Y Ye warranty bond agreeing to maintain the stability of all work and materials done, furnished and installed under this contract for a period of two years after final acceptance. ' Drug and Alcohol Testing 1 All contractors and their subcontractors shall provide the City, prior to conducting any work, written verification of compliance with the Federal Highway Administration (FHWA) drug use and alcohol ' testing rules published February 15, 1994, which apply to persons required to have a commercial drivers license (CDL). Municipal State Aid Project ' This is a municipal state aid project and as such the project site shall be open to State; officials and their I inspectors at all times. L SP -8 1 C L VERIFICATION OF PARTICIPATION IN ALCOHOL AND CONTROLLED SUBSTANCES TESTING PROGRAM PURPOSE: The Federal Omnibus Transportation Employee Testing Act ("Testing Act') requires an employer who uses a driver more than once per year who participates in a drug and alcohol testing program administered by another entity to verify that the driver participates or participated in a program(s) that conforms to the requirements of the Testing Act and that the driver is qualified to drive under the Testing Act. The Testing Act also requires that the driver's employer provide certain information regarding testing of the driver within the previous six months. t:l5Vt�r� LOCATION: (Stred) (City) (State) (Zip) I, hereby authorize my employer to release pertinent information regarding drug and alcohol tests performed on myself by the employer under the requirements of the Testing Act. Drug Testing Program: (diver's signature) Name: Telephone No.: Location: (Street) (City) (State) (Zip) Contact: Name (Print) (Title) The above named driver: Participates Does not participate, in the above named drug testing program. Dates of participation: From To Specimen Collection Entity: Testing Laboratory: Medical Review Officer: Telephone No.: Telephone No.:, Telephone No.: Does this program conform to 49 C.F.R. Part 40? Yes No The date this driver was last tested for controlled substances: (Monilt/Day/Year) Results of tests taken in the last 6 months and any other violations of Subpart B of 49 C.F.R. Part 382: (Enter test result infomnation in the space provided Begin with the most recent test.) Date of Test: Result of Test: Negative Positive Date of Test: Result of Test: Negative Positive Date of Test: Result of Test SP -9