- Call No
- 238
- County
- SHERMAN
- Pdf Text
- Dwight D. Eisenhower State Office Building
700 S.W. Harrison Street
Topeka, KS 66603-3745
Phone: 785-296-3576
Hearing Impaired - 711
publicinfo@ksdot.org
http://www.ksdot.org
Bureau of Construction and Materials
FEDERAL PROJECT NUMBER: HSIP-A809(501)
STATE PROJECT NUMBER: 091 KA 8095-01
CALL ORDER NUMBER: 238
PROPOSAL NUMBER: 526102383
LETTING DATE 10/21/2026
COUNTY: SHERMAN
FUND TYPE: FEDERAL
ATWOODKDOT CONSTRUCTION OFFICE:
PROJECT DESCRIPTION
PAVEMENT MARKING.K27; FR RM 169.95 TO 170.79; US-24B; FR .65 MI
W OF K27 JCT THEN E .203 MI TO .138 MI E OF K27 JCT.SH CO. LGTH
1.043 MI
RESTRICTED DAYS
(15)
TOTAL CONTRACT DAYS
(25)
Earliest Start Date:
Latest Start Date:
1:11:00PM9/16/2026 @
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
091 KA 8095-01 HSIP-A809(501)
CONTRACT PROPOSAL
DOT Form No. 202 Rev. 02/19
Contract ID: 526102383
1. The Secretary of Transportation of the State of Kansas [Secretary] will accept only electronic internet
proposals from prequalified contractors for construction, improvement, reconstruction, or maintenance work in
the State of Kansas, said work known as Project No.:
091 KA 8095-01 / HSIP-A809(501)
The general scope, location and net length are:
PAVEMENT MARKING.K27; FR RM 169.95 TO 170.79; US-24B; FR
.65 MI W OF K27 JCT THEN E .203 MI TO .138 MI E OF K27
JCT.SH CO. LGTH 1.043 MI
2. This is the Proposal of [Contractor] to complete the Project for the amount set out in the accompanying
Unit Prices List.
3. The Contractor makes the following ties and riders as part of its Proposal in addition to state ties, if
any:
4. Contractors and other interested entities may examine the Bidding Proposal Form/Contract Documents (see
paragraph 11 below) at the County Clerk's Office in the County in which the Project is located and at the
Kansas Department of Transportation [KODT] Bureau of Construction and Materials, Eisenhower State Office
Building, 700 SW Harrison, Topeka, Kansas 66603. Contractors may examine and print the Bidding Proposal
Form/Contract Documents by using KDOT's website at http://www.ksdot.gov and choosing the following
selections: "Doing Business", "Highway Contractors" and "Highway Letting Information",and using the links
provided in the Project information for this project. KDOT will not print and mail paper copies of Proposal
Forms. Contractors shall notify KDOT of their intent to bid as a prime contractor by identifying themselves
as a Bid Holder on the website above. Contractors shall furnish this notice no later than 5:00 P.M. on the
Monday preceding the scheduled Letting Date. For a fee, Contractors and other interested entities may order
paper copies of the KDOT Standard Specifications for State Road and Bridge Construction, 2015 Edition,
[Standard Specifications] by using KDOT's website of http://www.ksdot.gov and choosing the following
selections: "Doing Business", "Highway Contractors", "Contractor Resources and "Specifications".
5.Contractors shall use the Bidx.com website to complete and submit the bid form. Project bid forms are
available on Bid Express' website at http://www.bidx.com.
6. Contractors shall only use the Project Bids software to create a proposal and submit an electronic
internet proposal to KDOT using the Bid Express website.
7. The KDOT Bureau of Construction and Materials will only accept electronic internet proposals on-line using
Bid Express until 1:00 P.M. Local Time on the Letting Date. KDOT will open and read these proposals at the
Eisenhower State Office Building, 700 SW Harrison, Topeka, Kansas 66603 at 3:00 P.M. Local Time on the
Letting Date. Bids are read on a conference call at 785-414-8630. The conference ID is 856 616 050#.
8. The Contractor shall execute a contract for the proposed work within ten (10) business days after notice
of the award of the contract.
9. The contractor shall complete work to open the project to unrestricted traffic within _15_ Restricted Days
and shall complete the work within the total Contract Working Days of _25_.
Contractor: Check:Page 1
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
10. The Contractor shall complete the Project according to the plans, Standard Specifications, provisions
identified in the Special Provision List and all other Contract Documents identified in Standard
Specifications subsection 101.3
11. The undersigned declares that the Contractor has carefully examined the Bidding Proposal Form for the
Project. The Contractor understands the following:
A. The Bidding Proposal Form consists of the following documents: the Bidx bid form on the Bid Express
website (which includes DOT Form 202, required contract provisions, and the Unit Prices List), special
provision list, project special provisions, special provisions, Standard Specifications, plans, exploratory
work documents, any additional contract information, any addenda, all questions and answers posted on the Bid
Express website, and any amendments the Secretary provides for the Project. The Contractor can obtain these
documents at KDOT's website (see paragraph 4).
B. The special provision list identifies all required contract provisions, project special provisions and
special provisions that apply to the Project.
C. The Bidding Proposal form becomes the Contractor's Proposal after the Contractor completes the Bidx bid
form, electronically signs the Proposal where required on DOT Form 202, and submits the completed Bidx bid
form documents and bid bond to KDOT using Bid Express. The special provision list, project special
provisions, special provisions, Standard Specifications, plans, exploratory work documents, any additional
contract information, all questions and answers posted on the Bid Express website, and any addenda are
incorporated by reference into the Proposal. These documents are part of the Contractor's Proposal.
D. In electronically signing this Proposal, the Contractor waives the right to claim that the Contractor
misunderstood the contents of the Proposal or the procurement process.
12. The Contractor has inspected the actual location of the work. The Contractor has determined the
availability of materials. The Contractor has evaluated all quantities and conditions. In electronically
signing this Proposal, the Contractor waives the right to claim that the Contractor misunderstood the scope
of the work.
13. SPECIAL PROVISIONS REQUIRING INFORMATION. The following Required Contract Provisions (I-XVII) require the
Contractor to furnish information. The current versions of these provisions are contained in the Bidx bid
form. Some or all of these apply to the Project as indicated in the Special Provision List. The Contractor
shall complete these provisions within the Bidx bid form file. When these documents are required, the
Secretary will reject proposals that fail to contain completed Provisions I, II, III, or IV in the EBSX file,
and may reject proposals that fail to contain completed Provisions V, VI, VII, VIII, IX, X, XI, XII, XIII,
XIV, XV, XVI, or XVII in the Bidx bid form.
I. 08-10-66 Certification-Noncollusion & History of Debarment
II. 04-30-82 Certification-Financial Prequalification Amount
III. 04-26-90 Declaration-Limitations on Use of Federal Funds for Lobbying
IV. 08-04-92 Certification-Contractual Services with a Current Legislator or a Current Legislator's Firm
V. 10-10-00 Price Adjustment for Fuel
VI. 06-01-06 Price Adjustment for Asphalt
VII. 08-31-09 Price Adjustment for Emulsified Asphalt
VIII. 08-08-01 Furnishing and Planting Plant Materials Unit Cost
IX. 05-18-07 Repair (Structures) Unit Cost
X. 11-15-17 Electric Lighting System Unit Cost
XI. 04-06-09 ITS Unit Cost
XII. 08-17-16 Water System Unit Cost
XIII. 06-19-19 Sanitary Sewer System Unit Cost
XIV. 01-01-18 Smart Work Zone System Unit Cost
XV. 08-12-24 CORS Unit Cost
XVI. 04-06-26 Federal Restrictions on Foreign Drones
XVII. 01-01-11 Kansas Department of Revenue Tax Clearance Certificate
Contractor: Check:Page 2
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
14. The funding source for this Project is FEDERAL. On Projects involving City or County funds, the Secretary
acts as the Agent of the City or County and as the administrator of federal or state funds. Each governmental
entity's responsibilities are described in a contract between the entities which is available on request.
15. FEDERAL AID DOCUMENTS INCLUDED IN PROPOSAL. If the Project is supported in whole or in part by Federal
funds, the latest revisions of the following provisions (I - IV) also apply to the Project. These documents
are not included in the Project EBSX file but are accessible on KDOT's website and incorporated by reference
into the proposal like other provisions and the exploratory work documents.
I. 11-03-80 Affirmative Action For EEO
II. 11-15-96 Affirmative Action & EEO Policies
III. 09-06-94 U.S. DOT Fraud Hotline
IV. FHWA-1273 Federal-Aid Required Contract Provisions
16. The Secretary reserves the right to reject any and all proposals and to waive any or all technicalities.
17. SIGNATURE SECTION:
A. Electronic Internet Proposal
The person submitting the electronic internet Proposal, on the Contractor's behalf, shall be the person whose
digital identification is used to submit this Proposal. That person shall complete paragraphs B and C. The
person whose digital identification is used to electronically sign this Proposal binds the Contractor to this
Proposal and binds the named individual to the certification in paragraph B.
B. Certification
I CERTIFY THAT I AM AUTHORIZED TO REPRESENT THE CONTRACTOR IN PREPARING AND PRESENTING THIS PROPOSAL. I
CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING (INCLUDING BUT NOT LIMITED TO THE INFORMATION CONTAINED
IN THE SPECICIAL PROVISIONS REFERENCED IN PARAGRAPH 13) IS TRUE AND CORRECT.
EXECUTED ON
C. Signature
Number of company or joint venture:
Name of company or joint venture:
Name of person signing:
Title of the person signing:
Signature: Electronic Internet Proposal
RELEASED FOR CONSTRUCTION:
Date:____________________________________
_________________________________________
Chief of Construction and Materials
Contractor: Check:Page 3
KANSAS DEPARTMENT OF TRANSPORTATION
SPECIAL PROVISION LIST
PAGE:
DATE:
1
09/09/26
STATE PROJECT NO: 091 KA 8095-01 STATE CONTRACT NO: 526102383
FEDERAL PROJ NO.
PRIMARY DISTRICT:
DESCRIPTION:
PRIMARY COUNTY: SHERMAN3
PAVEMENT MARKING.K27; FR RM 169.95 TO 170.79; US-24B; FR .65 MI W OF K27
JCT THEN E .203 MI TO .138 MI E OF K27 JCT.SH CO. LGTH 1.043 MI
HSIP-A809(501)
PROVISION NO. DESCRIPTION
NOTE: THE FOLLOWING LIST OF SPECIAL PROVISIONS ARE FOR THIS PROJECT.
OMISSION OF ALL OR PART OF A SPECIAL PROVISION IN THE ATTACHED
PROPOSAL (CONTRACT) DOES NOT RELIEVE THE CONTRACTOR OF THE
RESPONSIBILITY FOR OBTAINING THE COMPLETE PROVISION AS LISTED.
REQUIRED CONTRACT PROVISION-NONCOLLUSION / HISTORY-DEBARMENT08-10-66-R05
REQUIRED CONTRACT PROVISION-FINANCIAL PREQUALIFICATION04-30-82-R07
REQUIRED CONTRACT PROVISION-CONTRACTUAL SERVICES-LEGISLATOR08-04-92-R03
REQUIRED CONTRACT PROVISION-LIMITS OF FED FUNDS FOR LOBBYING04-26-90-R05
REQUIRED CONTRACT PROVISION-FEDERAL RESTRICTIONS ON FOREIGN DRONES04-06-26
REQUIRED CONTRACT PROVISION-NOTICE FOR AFFIRMATIVE ACTION11-03-80-R09
REQUIRED CONTRACT PROVISION-EEO REQUIREMENT11-15-96-R06
REQUIRED CONTRACT PROVISION - BOYCOTT OF ISRAEL PROHIBITED07-01-17-R1
MINIMUM WAGE RATE (SHERMAN COUNTY)KS20260121
REQUIRED CONTRACT PROVISION-NDAA 889 TELECOMM PROHIBITION12-17-20
REQUIRED CONTRACT PROVISION-TAX CLEARANCE CERTIFICATE01-01-11-R01
NOTICE TO CONTRACTORS (USDOT HOTLINE)09-06-94-R01
REQUIRED CONTRACT PROVISION-FEDERAL-AID CONSTRUCTION CONTRACTSFHWA-1273
ERRATA SHEET FOR STD SPEC BOOK FOR RD & BR CONST, 2015 ED15-ER-1-R23
POLICY AGAINST SEXUAL HARASSMENT03-01-18
INFORMATION TO CONTRACTORS (STATUS OF UTILITIES)15-01002
ENVIRONMENTAL CONCERNS - MIGRATORY BIRD TREATY ACT15-01011-R06
PROSECUTION AND PROGRESS15-01016-R04
CONTROL OF MATERIALS15-01018-R01
CONTROL OF WORK15-01019-R02
BIDDING REQUIREMENTS AND CONDITIONS15-01021-R03
SCOPE OF WORK15-01022-R04
BIDDING REQUIREMENTS AND CONDITIONS15-01023
AWARD AND EXECUTION OF CONTRACT15-01024
WORK ZONE TRAFFIC CONTROL AND SAFETY (FOR 1R'S)15-08001-R04
WORK ZONE TRAFFIC CONTROL & SAFETY15-08019-R04
DURABLE PAVEMENT MARKING15-08020-R02
WORK ZONE TRAFFIC CONTROL AND SAFETY (WORKERS PRESENT SIGNS)15-08029
STORMWATER POLLUTION MANAGEMENT15-09002-R05
STEEL SIGN POSTS15-16002-R03
THERMOPLASTIC15-22001-R01
PAVEMENT MARKING PAINT15-22004-R02
IMAGE SYSTEMS15-22005-R03
RETROREFLECTIVE SHEETING15-22006-R01
PREFORMED THERMOPLASTIC PAVEMENT MARKING MATERIAL15-22008-R01
KANSAS DEPARTMENT OF TRANSPORTATION
SPECIAL PROVISION LIST
PAGE:
DATE:
2
09/09/26
STATE PROJECT NO: 091 KA 8095-01 STATE CONTRACT NO: 526102383
FEDERAL PROJ NO.
PRIMARY DISTRICT:
DESCRIPTION:
PRIMARY COUNTY: SHERMAN3
PAVEMENT MARKING.K27; FR RM 169.95 TO 170.79; US-24B; FR .65 MI W OF K27
JCT THEN E .203 MI TO .138 MI E OF K27 JCT.SH CO. LGTH 1.043 MI
HSIP-A809(501)
PROVISION NO. DESCRIPTION
NOTE: THE FOLLOWING LIST OF SPECIAL PROVISIONS ARE FOR THIS PROJECT.
OMISSION OF ALL OR PART OF A SPECIAL PROVISION IN THE ATTACHED
PROPOSAL (CONTRACT) DOES NOT RELIEVE THE CONTRACTOR OF THE
RESPONSIBILITY FOR OBTAINING THE COMPLETE PROVISION AS LISTED.
ROLL-UP SIGNS15-22011
PATTERNED COLD PLASTIC15-22013
HIGH DURABILITY PAVEMENT MARKING MATERIAL15-22014
TEMPORARY PAVEMENT MARKING TAPE15-22016
WOOD POSTS15-23001-R03
FIELD HANDLING AND PRESERVATIVE TREATMENT OF WOOD PRODUCTS15-23003-R02
PART V15-25001-R07
MATERIALS CERTIFICATIONS15-26001-R13
END OF SPECIAL PROVISION LIST
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
REQUIRED CONTRACT PROVISION - 08-10-66-R05 (Rev. 07/05)
CERTIFICATION - NONCOLLUSION AND HISTORY OF DEBARMENT
K.A.R. 36-30-4, 49 C.F.R. 29.335, 23 U.S.C. 112(c), 49 U.S.C. 322
Complete the exceptions below if applicable. The Contractor's signature on the last page of the Contractor's
Proposal (DOT Form 202) supplies the necessary signature for this Certificate.
NONCOLLUSION
I certify that the Contractor submitting this bid has not, either directly or indirectly, entered into any
agreement, participated in any collusion, or otherwise taken any action, in restraint of free competitive
bidding in connection with the submitted bid.
HISTORY OF DEBARMENT
I certify that, except as noted below, the Contractor submitting this bid and any person associated with this
Contractor in the capacitiy of owner, partner, director, officer, principal, investigator, project director,
manager, auditor, or any position involving the administration of federal funds:
1. Are not currently suspended, debarred, voluntarily excluded or disqualified from bidding by any federal or
state agency;
2. Have not been suspended, debarred, voluntarily excluded or disqualified from bidding by any federal or
state agency within the past three years;
3. Do not have a proposed debarment pending;
4. Within the past three years, have not been convicted or had a civil judgment rendered against them by a
court of competent jurisdiction in any matter involving fraud, antitrust violations, theft, official
misconduct, or other offenses indicating a lack of business integrity or business honesty; and
5. Are not currently indicted or otherwise criminally or civilly charged by a federal, state, or local
government with fraud, anti-trust violations, theft, official misconduct, or other offenses indicating a lack
of business integrity or business honesty; and
6. Have not had one or more federal, state, or local government contracts terminated for cause or default
within the past three years.
Answer 'Yes' if there are exceptions to the above described circumstances. Answer 'No' if
there are no exceptions.
◯ Yes ◯ No
The exceptions, if any, are:
Contractor: Check:Page 4
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
REQUIRED CONTRACT PROVISION - 04-30-82-R07 (Rev. 01/11)
CERTIFICATION - FINANCIAL PREQUALIFICATION AMOUNT
Select the appropriate response below to indicate whether this Proposal exceeds the Contractor's financial
prequalification amount. The Contractor's signature on the last page of the Contractor's Proposal (DOT Form
202) supplies the necessary signature for this Certificate.
I understand that I may be required to identify the outstanding contract and subcontract work of my firm,
association or corporation on DOT Form 284 prior to an award of contract. Unless I obtain approval, I
understand that the Secretary may reject this Proposal if the dollar value of work on this Contract combined
with unearned amounts on our unfinished contract and subcontract work exceeds our prequalification amount.
I certify that the amount of this Proposal plus the total unearned amount of other contracts with the Kansas
Department of Transportation plus the unearned amount of all other contracts in this state or other states
◯ exceeds ◯ does not exceed the financial prequalification amount of our firm, association or corporation. I
also certify that our firm, association or corporation has the financial ability to do the work.
If this Proposal exceeds the financial prequalification amount, I certify that I obtained approval to submit
this bid from the KDOT representative I have listed below. (Prior approval to exceed the prequalification
limit may be made by telephone or personal contact).
KDOT Approval Granted by:
KDOT Approval Date:
Contractor: Check:Page 5
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
REQUIRED CONTRACT PROVISION- 04-26-90-R05 (Rev. 07/13)
DECLARATION
LIMITATIONS ON USE OF FEDERAL FUNDS FOR LOBBYING
PURSUANT TO 31 U.S.C. 1352
The Contractor's signature on the last page of the Contractor's Proposal (DOT Form 202) supplies the
necessary signature for this Certificate.
DEFINITIONS:
1. Designated Entity: an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress.
2. Federal Grant: an award of financial assistance by the Federal government. (Federal Aid Highway Program is
considered a grant program.)
3. Influencing (or attempt): making, with the intent to influence, any communication to or appearance before
any designated entity in connection with the making of a Federal contract or Federal grant.
4. Person: an individual, corporation, company, association, authority, firm, partnership, society, State or
local government.
5. Recipient: all contractors, subcontractors, subgrantees, at any tier, and other persons receiving funds in
connection with a Federal grant.
EXPLANATION:
As of December 23, 1989, 31 U.S.C. section 1352 limits the use of appropriated Federal funds to influence
Federal contracting. Under this law, recipients of Federal grants shall not use appropriated funds to pay any
person for influencing or attempting to influence a designated entity in connection with the making of a
Federal grant or the extension, continuation, renewal, amendment or modification of a Federal grant. These
restrictions apply to contracts and grants exceeding $100,000.00. Federal law requires submission of this
declaration. If a recipient fails to file the declaration or amend a declaration, the recipient shall be
subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each failure. If the
recipient uses appropriated Federal funds to influence or to attempt to influence a designated entity
contrary to this provision, the recipient shall be subject to a civil penalty of not less than $10,000.00 and
not more than $100,000.00 for each such payment.
CERTIFICATIONS:
I certify that the Contractor recipient (including its owners, partners, directors, officers, or principals)
has not paid and will not pay federally appropriated funds to any person for influencing or attempting to
influence a designated entity in connection with the making of a Federal grant, or the extension,
continuation, renewal, amendment or modification of a Federal grant.
Answer 'Yes' if a person registered under the Lobbying Disclosure Act of 1995 (Registrant) has made lobbying
contacts on the Contractor recipient's behalf with respect to this contract. Answer 'No' if no Registrant has
lobbied on the Contractor recipient's behalf with respect to this contract.
◯ Yes ◯ No
The Registrants, if any, are:
I certify that the Contractor recipient will report payments made to a person for influencing or attempting
Contractor: Check:Page 6
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
to influence a designated entity, that come from funds other than appropriated Federal funds. The Contractor
recipient shall report such payments on Form LLL "DISCLOSURE FORM TO REPORT LOBBYING" according to the
instructions and may obtain Form LLL from the KDOT Bureau of Construction and Materials.
I certify that, if information contained in this DECLARATION changes, the Contractor recipient will amend the
DECLARATION within 30 days of the change(s).
I certify that the Contractor recipient will provide to and require subcontractors to sign a like
DECLARATION, if the subcontract work exceeds $100,000.00.
The Contractor recipient understands that this declaration is a material representation of fact and the
Secretary will have relied upon this declaration in entering into a contract with the Contractor recipient.
____________________________________________________________
NOTE: This Reporting requirement does not apply to payments made to the recipient's regular employees and
contracts, subcontracts, and grants less than $100,000.00.
Contractor: Check:Page 7
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
REQUIRED CONTRACT PROVISION - 08-04-92-R03 (Rev. 07/05)
CERTIFICATION - CONTRACTUAL SERVICES WITH A CURRENT
LEGISLATOR OR A CURRENT LEGISLATOR'S FIRM
Select the appropriate response below to indicate whether this contract is with a legislator or a firm in
which a legislator is a member. The Contractor's signature on the last page of the Contractor's Proposal (DOT
Form 202) supplies the necessary signature for this Certificate.
Kansas Law, K.S.A. 46-239(c), requires this agency to report all contracts entered into with any legislator
or any member of a firm of which a legislator is a member, under which the legislator or member of the firm
is to perform services for this agency for compensation. The Contractor certifies that:
This Contract ◯ is ◯ is not with a legislator or a firm in which a legislator is a member. That Legislator
is:
Name:
Address:
City State Zip:
Business Telephone:
Contractor: Check:Page 8
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
REQUIRED CONTRACT PROVISION - 04-06-26
CERTIFICATION OF COMPANY NOT CURRENTLY ENGAGED IN THE PROCUREMENT OR
USE OF PROHIBITED FOREIGN UNMANNED AERIAL SYSTEMS
Effective December 22, 2025, the American Security Drone Act of 2023 (ASDA) and OMB Memorandum M-26-02
strictly prohibits the use of federal funds for unmanned aerial systems (UAS) manufactured by covered foreign
entities including any aircraft, flight controller, camera, or ground control station supplied by a
manufacturer that is based in, or subject to the control of, a foreign adversary country, specifically the
People’s Republic of China. This prohibition restricts the use of drones from these countries on any
federal-aid project even if the drone related costs are billed separately or not at all. Any use of these
covered drones including operation, maintenance or data processing on federal aid projects is prohibited.
The Contractor agrees that the procurement and/or use of any drone (UAS) to complete any primary or
supporting tasks within the scope of this Contract, as well as any subcontracts, will comply with the
following directives:
• National Defense Authorization Act (NDAA) - American Security Drone Act of 2023 (ASDA, Pub. L. No. 118-31).
• Office of Management and Budget Memorandum M-26-02 - Restrictions on using federal funds to purchase or
operate prohibited foreign UAS.
• Federal Acquisition Regulation Clause 52.240-1 - Prohibition on Unmanned Aircraft Systems Manufactured or
Assembled by American Security Drone Act-Covered Foreign Entities.
If Contractor has violated, misrepresented, or otherwise fails to comply with this certification document as
determined by KDOT, KDOT may terminate this Contract according to Section 108.11 of the State Specifications
for State Road and Bridge Construction (2015 Edition).
By signing the below, Contractor acknowledges and agrees to comply with the provisions of this policy.
CONTRACTOR
____________________________________
Signature, Title
____________________________________
Date
*4/6/26 C&M (JVN)
April-2026 Letting
Contractor: Check:Page 9
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
REQUIRED CONTRACT PROVISION - 01-01-11-R01 (01-01-11-R01)
TAX CLEARANCE CERTIFICATE
Answer 'Yes' if the Contractor has a current Tax Clearance Certificate. Answer 'No' if the Contractor does
not have a current Tax Clearance Certificate.
◯ Yes ◯ No
Insert the Tax Clearance Confirmation Number if available at the time of bidding:
Contractors shall have a current Tax Clearance Certificate from the Kansas Department of Revenue [KDOR] at
the time of contract award. The Tax Clearance process is a tax account review by KDOR to determine that the
Contractor's account is compliant with Kansas tax laws administered by the Director of Taxation. The
Secretary will reject the Contractor's Proposal as non-responsive if the Contractor does not have a current
Tax Clearance Certificate at the time of the contract award.
To obtain a Tax Clearance Certificate, the Contractor shall complete and submit to KDOR an Application for
Tax Clearance obtained from KDOR's website at http://www.ksrevenue.org/taxclearance.htm. The Application Form
can be completed and submitted on-line, by mail, or by fax. After the Contractor submits the Application,
KDOR will provide the Contractor a Transaction ID number. The Contractor shall use the Transaction ID number
to retrieve the Tax Clearance Certificate. Decisions on on-line applications are generally available the
following business day.
After the Contractor obtains the Tax Clearance Certificate, the Contractor shall insert on this Required
Contract Provision the Confirmation Number contained in the Certificate or the Contractor shall submit a copy
of the Tax Clearance Certificate to the KDOT Bureau of Construction and Materials by hand delivery, mail,
e-mail or fax. Before awarding a contract, the Bureau of Construction and Materials will authenticate the
Certificate through the Confirmation Number inserted on this Required Contract Provision or contained on the
Certificate submitted.
If the Contractor is unable to retrieve the Tax Clearance Certificate or if KDOR denies the Contractor's
Application for Tax Clearance, the Contractor shall call KDOR's Special Projects Team at 785-296-3199 to
determine why KDOR failed to issue the certificate.
Tax Clearance Certificates are valid for 90 days after issue. To renew a clearance, submit a new Tax
Clearance Application. Information pertaining to a Tax Clearance is subject to change for various reasons,
including a state tax audit, federal tax audit, agent actions, hearings, and other legal actions. The Tax
Clearance Certificate is not "clearance" for all types of taxes the State of Kansas may assess.
Subcontractors also shall have a current Tax Clearance Certificate from KDOR before the Secrtary approves
them for subcontract work. The Contractor shall submit to the KDOT Field Office the Subcontractor's Tax
Clearance Certificate with KDOT Form 259, Request for Approval of Subcontractor.
Contractor: Check:Page 10
Letting 10/21/2026 Kansas Department of Transportation Project No. 091 KA 8095-01
Contract No. 526102383
Line Number Item Number Quantity Unit Unit Price Extension Price
Section 01
COMMON ITEMS
1 025323 1.000 LS
MOBILIZATION /
2 025324 1.000 LS
TRAFFIC CONTROL /
3 070580 1.000 HOUR $30.000 $30.00
FLAGGER (SET PRICE) /
Section 01 Total 30.00
Section 02
PAVEMENT MARKING ITEMS
4 013019 25569.000 LNFT
PAVEMENT MARKING REMOVAL /
5 070741 13759.000 LNFT
PAVEMENT MARKING (PATTERNED COLD PLASTIC) (WHITE) ( 6") /
6 070750 11272.000 LNFT
PAVEMENT MARKING (PATTERNED COLD PLASTIC) (YELLOW) ( 4") /
7 070753 377.000 LNFT
PAVEMENT MARKING (PATTERNED COLD PLASTIC) (YELLOW) (12") /
8 013348 26.000 EACH
PAVEMENT MRK SYM (INTERSECTION GRADE) (WHITE) (LEFT ARROW) /
9 013812 161.000 LNFT
PAVEMENT MARKING (INTERSECTION GRADE) (WHITE) (24") /
Section 02 Total
Item Total $30.00
Contractor: Check:Page 11
! "#$ %#& ' % ( )*+, - "(./),)01*(&).(),2., ,*33,*2*.4444444456464++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++*,.+78, - "*,./.,),9,11,2344444444444444444444444444444456:4684++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++1:+::, - ",1 ,*;),.--,.2 ,14444444444444444444444445464,1 ,*;),-32<) 2 3./<.=444444444444444444445:44,1 ,*;), 1&(2 2 )&44444444444444444444444547:4,1 ,*;),/2),,14444444444444444444444444457474,1 ,*;),(*1(,1444444444444444444444444454:4,2--*.,.3),;*) ,*;),44444444444444444445844),;*)&2)01*(&)44444444444444444444444444444445466478.(),2.,,*(*&2!*)444444444444444444444444445:4:6848:.(),2.,,..&*33,.1 &2444444444444444444444445464.(),2.,,..&*334444444444444444444444444444444445744.(),2.,,2.,44444444444444444444444444444444445484.(),2.,,)) 44444444444444444444444444444444444544.(),2.,,2(),4444444444444444444444444444444444544.(),2.,,.33),4444444444444444444444444444444444458474.(),2.,(2;),>2(!2392,)2)92 .,))?44444444444444444444444444444444444444444445464.(),2.,&)!2*444444444444444444444444444444444544.(),2.,&2),*23,2-),;)!*3)4444444444444444564:4.(),2.,3.2 ),444444444444444444444444444444444445474.(),2.,,2 ),<32 )44444444444444444444444444444574:47.(),2., *,*<1.,44444444444444444444444444444454:4.(),2.,,2)4444444444444444444444444444444444445474.(),2.,.,))2/444444444444444444444444444445474.(),2.,.,))-**!*&2!*)444444444444444544.(),2.,<133 .@),444444444444444444444444444444445747467.(),2.,<,..&/))(),444444444444444444444444444456484.(),2.,<.<2* )),* 3.2 ),44444444444454:4.(),2.,<2!.))A2;2.,,2!.)44444444444444454774:.(),2.,2(!23(3244444444444444444444444444445844
BCDCEBFGHIDJK LJKMNOP
QRRSTHCCTUVMNOPCWUNXYZXRX[V\]UR\O]C^LE_EB_`E`C` `CI
! " # $ % # ! &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&'(')*'+,-'.+'/(+)0'123+(+,2-.'+23+4)563.'+,-)35-378)(87'91)56)/)5()1'5-,9::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::3-';'(<-)*'+1'+=> $#/-,09)/8)56,)1)(?',*'23+ '1'+,935-+,(-3+/,..9)'/-3,99(35-+,(-//<0@'(--3-8',*)/&,(35(-23+78)(8-8'(35-+,(-)/,7,+1'1=,51,5A/39)()-,-)357,/)//<'1>353+,2-'+B,5<,+A $ 2-8)/(35-+,(-)/(3*'+'10A-8'-8'(35-+,(-3+4</-.+3*)1''4.93A''/7)-8 83<+32.,)1/)(?9',*'23+'*'+A83<+/-8'A73+?<.-3"#83<+/32.,)1/)(?9',*'',(8A',+4.93A''/4</-0'.'+4)--'1-3</'.,)1/)(?9',*'23+-8')+375)995'//)5@<+A3+3-8'+8',9-8&+'9,-'15''1/)5(9<1)56.+'*'5-)*'(,+'C-3,//)/-,2,4)9A4'40'+=3+.'+/35783)/9)?'2,4)9A-3-8''4.93A''>783)/)99)5@<+'13+8,/3-8'+8',9-8&+'9,-'15''1/)5(9<1)56.+'*'5-)*'(,+'C3+23++',/35/+'/<9-)562+343+-3,//)/-,2,4)9A4'40'+=3+.'+/35783)/9)?'2,4)9A-3-8''4.93A''>783)/,*)(-)432134'/-)(*)39'5('/';<,9,//,<9-3+/-,9?)56 11)-)35,9)523+4,-)3535(35-+,(-3++'D<)+'4'5-/,5173+?'+.+3-'(-)35/<51'+-8')/,*,)9,09',-8--./%%777 139 63*%,6'5()'/%781%63*'+54'5-&(35-+,(-/3-';'(<-)*'+1'+ #"6'5'+,99A,..9)'/-3(35-+,(-//<0@'(--3-8',*)/&,(35(--8,-7'+',7,+1'1353+0'-7''5B,5<,+A ",51B,5<,+A!,51-8,-8,*'53-0''5+'5'7'13+';-'51'1353+,2-'+B,5<,+A ;'(<-)*'+1'+ #"13'/53-,..9A-3(35-+,(-//<0@'(-359A-3-8',*)/&,(35'9,-'1(-/+'6,+19'//3278'5-8'A7'+',7,+1'1 2,(35-+,(-)//<0@'(--3;'(<-)*'+1'+ #"-8'(35-+,(-3+4</-.,A,99(3*'+'173+?'+/,-9',/- #".'+83<+=3+-8',..9)(,09'7,6'+,-'9)/-'135-8)/7,6'1'-'+4)5,-)35)2)-)/8)68'+>23+,9983<+//.'5-.'+23+4)5635-8'(35-+,(-2+34,A #-8+3<68'('40'+ # 8',..9)(,09';'(<-)*'+1'+4)5)4<47,6'+,-'7)990',1@</-'1,55<,99A11)-)35,9)523+4,-)3535(35-+,(-3++'D<)+'4'5-/,5173+?'+.+3-'(-)35/<51'+;'(<-)*'+1'+ #")/,*,)9,09',-777 139 63*%781%63*(35-+,(-/59)/-'1(9,//)2)(,-)35/5''1'123+73+?53-)5(9<1'17)-8)5-8'/(3.'32-8'(9,//)2)(,-)35/9)/-'14,A0',11'1,2-'+,7,+1359A,/.+3*)1'1)5-8'9,03+/-,51,+1/(35-+,(-(9,</'/=! " "=,>= >=)))>>&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&8'031A32',(87,6'1'-'+4)5,-)359)/-/-8'(9,//)2)(,-)35/,517,6'+,-'/-8,-8,*'0''523<51-30'.+'*,)9)5623+-8'-A.'=/>32(35/-+<(-)35,516'36+,.8)(,+',(3*'+'10A-8'7,6'1'-'+4)5,-)35 8'(9,//)2)(,-)35/,+'9)/-'1)5,9.8,0'-)(,93+1'+<51'++,-')1'5-)2)'+/)51)(,-)5678'-8'+-8'.,+-)(<9,++,-')/,<5)35+,-'=(<++'5-<5)355'63-),-'1+,-'>,/<+*'A+,-',7')68-'1<5)35,*'+,6'+,-',/-,-',13.-'1+,-'3+,/<..9'4'5-,9(9,//)2)(,-)35+,-'5)35,-'1'5-)2)'+/
EFGFHEIJKLGMN OMNPQRS
TUUVWKFFWXYPQRSFZXQ[\][U[^Y_`XU_R`FaOHbHEbcHcFc HFL
!" #$%&'()*''+',-'(-.'./$%& !" $" '()* " " $" %'()*0 !" ''+ !" " " 0 ',-'(-.'./ !" " " 123 " 456 7 8 0 (''9 :&$% #;2''(''(-'(-.'./ ;2 ; 0 ! " ''(' !" " " 0 '(-'(-.'./ !" " " < " 7 8 0 4 .)=7(.6 " " !" #=%.'..'',>-.,-.'./ =% = .'.. 0 ! " '', !" " " 0 >-.,-.'./ !" " " 2 1 23 41236 .)=7(>464(6 7 8 0 46 " .)=7(?4646 !" #& .'.?'','(-'?-.'./ & & .'.? " 0 ! " '', !"
@ABAC@DEFGBHI JHIKLMN
OPPQRFAARSTKLMNAUSLVWXVPVYTZ[SPZM[A\JC]C@]^C^A^ _AG
! " #####################################################################################################$!%&'&&()*+!*,+!--&!. -(,/&01 2 30 45 5 0 0$1' 0 6 0 , 45 7 45 $1'8$ 45 (7 4 4 9 4 5 38$ 45$ 1 '4 : ' . / !4 +$$ '/( 5 7 $1'8/ $' (7 4 8/$'#,9 45 38/ $' $ 1 '4 : ' . / !4 +$$ '/0* 5 56 50 7 4 $ 1 ! 6 ;/<(-= ;/<(->0(7 4 4 9 4 5 3$ 1 ! : ' . / !4 +$$ '/7 5 5? 5 65 @ 07 4 0* ! 4 5 5 5! 4(48 6 5$! 8 0$3! 4(48: ' . / !4 +$$ '/AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA&+',<%&+&(!.'&/* *,+B
CDEDFCGHIJEKL MKLNOPQ
RSSTUIDDUVWNOPQDXVOYZ[YSY\W]^VS]P^D_MF`FC`aFaDa JDJ
12-17-20
Sheet 1 of 2
REQUIRED CONTRACT PROVISION
FEDERAL-AID CONTRACTS
PROHIBITION ON COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES
PURSUANT TO SECTION 889 OF THE NATIONAL DEFENSE AUTHORIZATION ACT (2019)
As of August 13, 2020, recipients and subrecipients of federal aid funds are prohibited from obligating or expending
loan or grant funds to procure or obtain; extend or renew a contract to procure or obtain; or enter into a contract (or
extend or renew a contract) to procure or obtain equipment, services, or systems that use Covered Telecommunications
Equipment or Services as a substantial or essential component of any system, or as critical technology as part of any
system. See Section 889 of Public Law 115-232 (National Defense Authorization Act 2019)(NDAA). In addition to
preventing direct purchases of such Covered Telecommunications Equipment or Services, federal law prevents
KDOT, LPA’s, and their Contractors from using federal aid funds to pay for Covered Telecommunications Equipment
or Services that the Contractor may use on a Project. Costs for such Covered Telecommunications Equipment or
Services are unallowable under 2 CFR 200.216 and 2 CFR 200.471.
The term ‘‘Covered Telecommunications Equipment or Services’’ means any of the following:
Telecommunications equipment produced by and/or telecommunications services provided by Huawei
Technologies Company, ZTE Corporation, Hytera Communications Corporation, Hangzhou Hikvision Digital
Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities).
Video surveillance equipment produced by and/or video surveillance services provided by Huawei Technologies
Company, ZTE Corporation, Hytera Communications Corporation, Hangzhou Hikvision Digital Technology
Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities).
Telecommunications and/or video surveillance services provided by third parties that are using equipment
produced by Huawei Technologies Company, ZTE Corporation, Hytera Communications Corporation, Hangzhou
Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such
entities) in performing such services.
Telecommunications or video surveillance equipment or services produced or provided by an entity that the
Secretary of Defense, in consultation with the Director of the National Intelligence or the Director of the Federal
Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise connected to,
the government of a covered foreign country [defined under 889(f)(2) as “the People’s Republic of China”].
As a Contractor on a federal-aid construction contract with the Secretary of Transportation, as the principal contracting
party for the State of Kansas or as the agent for a disclosed Local Public Authority (LPA), the Contractor shall not be
required to provide to KDOT or the LPA Covered Telecommunications Equipment or Services in the performance of
any contract, subcontract, supply contract, or other contractual instrument resulting from or associated with this
Project. The Contractor will notify KDOT if the Contractor believes the Project scope requires the acquisition of any
Covered Telecommunications Equipment or Services.
Current federal law does not prohibit the Contractor from using Covered Telecommunications Equipment or Services
on the Project; however, the costs of Covered Telecommunications Equipment or Services are federal-aid non-
participating. Thus, the Contractor shall notify KDOT or the LPA if the Contractor and/or any of its subcontractors
or suppliers at any tier are using Covered Telecommunications Equipment or Services on the Project. This notice is
necessary so KDOT can reimburse the Contractor with state funds, local funds, or a combination thereof rather than
with federal-aid funds.
12-17-20
Sheet 2 of 2
The Contractor will ensure that this Required Contract Provision is included in all subcontracts, supply agreements,
and other contractual instruments resulting from or associated with this Project, so the prohibition is made binding on
all subcontractors and suppliers at any tier. For purposes of this Required Contract Provision, the term subcontractors
and suppliers shall have the broadest application to include manufacturers, producers, and all other entities that have
a contractual instrument resulting from or associated with this Project.
12-17-20 C&M (CDB)
Jan 2021 – Letting; retroactive on earlier Federal Aid Projects with payments
1
FHWA-1273 – Revised June 25, 2026
CONTRACT PROVISIONS FOR
FEDERAL-AID CONSTRUCTION CONTRACTS
I. General
II. Nondiscrimination
III. Davis-Bacon and Related Act Provisions
IV. Contract Work Hours and Safety Standards Act
Provisions
V. Subletting or Assigning the Contract
VI. Safety: Accident Prevention
VII. False Statements Concerning Highway Projects
VIII. Implementation of Clean Air Act and Federal Water
Pollution Control Act
IX. Certification Regarding Debarment, Suspension,
Ineligibility and Voluntary Exclusion
X. Certification Regarding Use of Contract Funds for
Lobbying
XI. Use of United States-Flag Vessels
ATTACHMENTS
A. Employment and Materials Preference for Appalachian
Development Highway System or Appalachian Local Access
Road Contracts (included in Appalachian contracts only).
I. GENERAL
1. Historically, contracting agencies using Federal-aid highway
funds were required to ensure Form FHWA-1273 was
physically incorporated into all contracts and subcontracts.
Effective June 10, 2026, this requirement was eliminated [91
FR 25492]. Future use of Form
- Contract
- 526102383
- Pdf Pages
- 43
- Letting Date
- Oct 21, 2026
- List Url Hint
- kdotapp.ksdot.gov/Proposal/Proposal.aspx
- Pdf Enriched
- Yes
- Working Days
- 15
- Categorized By
- llm
- Project Number
- 091 KA 8095-01
- Work Description
- PAVEMENT MARKING
- Construction Office
- ATWOOD
- Federal Project Number
- HSIP-A809(501)
Kansas Department of TransportationIssuing agency·Kansas·via a public procurement portal