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HomeMy WebLinkAboutBid Opening - Chet Waggoner Court Proj No. 116-005 - Indiana Earth$OUT$ $ tti Y7 CITY OF SOUTH BEND, INDIANA Y : ,z= CONTRACTOR'S BID FOR PUBLIC WORK Project Name Chet Waggoner Court Project No. 116-005 For Bids Due August 18, 2016 PART (Must be completed for all bids. Please type or print) Date: /b Bidder(Firm): 7� �4.'r, r]o �t.r Address: /Q ,.3L/ 3 m c + n /t. 14t,, City/State/Zip: 04Gecr4 ITir, �4'.zr y Telephone Number: (S i4) G 74t- Cog Agent of Bidder (if Applicable): Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: the City of South Bend, Indiana, in accordance with plans and specifications prepared by: (hand dated for/the sum of (enter the Total Bid as shown on the Proposal) r ,r cG.e, aro'� ,.,+..'Vt. `",L,cO ($ 48—? ('95. 1� ) (Enter sum of Total ase Bid plus Alternates shown on Proposal) (Numerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are shown in the original contract if accepted by the City of basis, the itemization of the units shall be shown on a s£ ACCEPTANCE The above bid is accepted this day of Subject to the following conditions: BOARD OF PUBLIC WORKS Gary A. Gilot, President Elizabeth A. Maradik, James A. Mueller. Member cost of isr� t be the same as that If t bi / t)be awarded on a unit David P. Relos, Member Therese J. Dorau, Member Version 7/31/2015 Contractor's Bid for Public Works - 2 Linda M. Martin, Clerk 20 BID/PROPOSAL CITY OF SOUTH BEND Project Name Chet Waggoner Court Project No. 116-005 For Bids Due August 18, 2016 BASE BID Item Description Unit No. p Quantity Unit Price Total Amount 1 Construction Eneineerine. 1 LS I I,. o_ _ _ J - .. 2 CPM Schedule 1 LS 00 $ _ 3. 1 CPM Monthly Update 4 EA Si 4. Mobilization and Demobilization 1 LS 00 5 Video Record 1 LS 3 3oo 3 I 6. Utility Allowance 5,000 DOL $1.00 $5,000.00 Sprinkler Allowance 3,000 DOL $1.00 $3,000.00 8. Maintainin Traffic 1 LS 0000 I 9. Sidewalk, Concrete, Remove, Undistributed 140 SYS ) Lis. 10. Pavement Removal, Undistributed 210 SYS 11. HMA for Patching, Type A, Undistributed 40 TON 12 Detour Route Marker Assembly, Undistributed 5 EA SQQ_- 13. Road Closure Sign Assembly, Undistributed 5 EA /ovo, 14. Inspection Hole, Undistributed 5 EA ) 0d0, .S1 - 15. Structural Backfill, Type 2, Undistributed 100 CYS 47, -- 'doe r 16. Clearing of Right of Way 1 LS 3,8W _ 17. Curb, Concrete, Remove 160 LF /d.15- ) 560 - 18. Pedestrian Light, Remove and Relocate 1 EA ` 19. Pedestrian Light Foundation, Remove 1 EA do au, -- 20. Excavation, Common 3650 CYS f0. o '7ps. i -. 21. Temporary Erosion Control 1 LS % 00 -7 _ 22. Temporary Silt Fence 2110 LF it,_ r? d O - 23. Temporary Inlet Protection 14 EA 90 _ ) 24. No. 2Stone 100 TON 31y.- 3ztoo,- 25. Compacted Aggregate, No. 53, Base 1500 TON 31 AIL 6bo- 26. HMA for Patching, Type A 110 TON %! j _ )� a/o - 27. HMA Surface, 9.5 mm 485 TON ' '% ors- ,3,f- b) 7 • I, - Version 7/31/2015 Contractors Bid for Public Works - 7 28. HMA Intermediate, 19.5 mm 645 TON J-Y4 s- 35" 1 r 29. HMA Base, 25.0 mm 1930 TON S170 1101IJ l 30. HMA for Sidewalk 14 TON - 31. Curb Ramp, Concrete 19 Sys I qt aO 70/,aa 32. Curb and Gutter, Combined 3320 LF (Q, - 63 33. PCCP For Approaches, 8" 390 SYS $ %; 1 a0 3% 34. Mobilization and Demobilization for Seeding 1 EA 35. Seeding and Topsoil 5100 SYS tfdt? G3 LKiO.- 36. Storm Sewer Pipe 12" 810 LF, - (7 37. Storm Sewer Pipe 15" 350 LF %.000- 38. Storm Sewer Pipe 18" 250 LF 3y. - IT str,, - 39. Storm Sewer Pipe 24" 82 LF 9ao _ 40. Sanitary Sewer, PVC SDR 35, 8 IN 166 LF �13eg,- 41. Sanitary Sewer, PVC SDR 35, 10 IN 1606 LF Lj9, - % G 9,y.- 42. Sanitary Manhole 5 EA tt%V. as Orb.- 43. Catch Basin K10 7 EA 44. Manhole C15 3 EA 45. Riprap Stone 60 TON 46. Safety Metal End Section, Type 3, 24 IN 1 EA jory, - SOO . - 47. Geotextile Fabric 60 SYS 48. Irrigation Repair 260 SYS 49. Sign Post, Square, Type 2, Reinforced Anchor Base 19 LF G� 7q8.-� 50. Sign, Sheet With Legend 0.080 IN 6.3 SFT 1t7,7J 300,S 51. Sign, Sheet With Legend 0.100 IN 18 SFT -©80 52. Sign, Sheet With Legend 0.125 IN 7.5 SFT T0, 70 53. Handhole, Lighting 1 EA , %0 f LOV - 54. No. 4Wire 565 LF C,- 1 33cb- 55. Conduit, PVC, Schedule 80, 2 IN. 555 LF 14f 30, % 936 S0 56. Miscellaneous Equipment for Lighting 1 LS Roo aw_ 57. Light Pole Assembly 1 EA 58. Light Pole Foundation 2 FA 59. Line, Remove 640 LF 60. Traffic Transverse Marking, Liquid Thermoplastic Paint, Crosswalk, 6 IN 100 LF Version 7/31/2015 Contractor's Bid for Public Works - 8 61. Transverse Marking, Liquid Thermoplastic Traffic Paint, Stop Bar, 24 IN 16 LF 62. Salvage Decorative Bricks I 1 LS 1 Poo „ BASE BID TOTAL ADD ALTERNATE A: EXISTING DYLAN DRIVE INLETS. EXPANSION .IOINTS Item No. Description P Quantity Unit Unit Price Total Amount Al. Casting, Inlet, Adjust Expansion Joints 20 EA / 3Dd, a 6 A2. Maintaining Traffic 1 LS 00,. ALTERNATE A TOTAL a 6I g(no S' ADD ALTERNATE B: FLIR CAMERA DETECTION SYSTEM AT AMERITECH AND CLEVELAND Item Description No. P Quantity Unit AUnit477S al Amount B1. Vehicle Video Detection System 4 EA B2. Maintaining Traffic 1 LS a � GiJV ALTERNATE B TOTAL 73 yd0,� ADD ALTERNATF C RFMAININr: ATRFFT I IGUTc nN FUCT M,Ar_r_ K=i rn,.o� Item No. Description P Quantity ----- Unit Unit Price Total Amount Cl. Light Pole Assembly 3 EA _3_3 3 ,L/V C2. Light Pole Foundation 3 EA 937,y,,'do C3. No. 4 Wire 1220 LF ,Is- C4. Conduit, PVC, Schedule 80, 2 IN. 1200 LF /1 /, Ljs ' % 340 C5. Miscellaneous Equipment for Lighting 1 LS LWp )aw . rC6— Tesco Cabinet with Single Service, Wiring, Etc 1 EA O 7 3 a 7 r:3rb,- ALTERNATE C TOTAL Vr Bidder (Firm): 1-1 A141 n 0 CLt, Address: I009 3 y ? %1?ck " f /1 1�, v City/State/Zip: ACe&41—TkAkj0Telephone Number: bi C%� — Cf By (Signature) (Printed Name of Person Signing) Version 7/31/2015 Contractor's Bid for Public Works - 9 VAIA Document A310TM - 2010 Bid Bond CONTRACTOR: SURETY: (Name, legal status and address) (Xame, legal status and principal place Indiana Earth, Inc. of businessl North American Specialty Insurance Compa 10343 Mckiniey Highway 650 Elm Street his document has important legal t Osceola, IN 46561 Manchester03101 consequences. Consultation with , OWNER: an attorney is encouraged with (Name, legal status and address) respect to its completion or CillY of South Bend modification. 227 West Jefferson Boulevard Any singular reference to South Bend, IN 46601 Contractor, Surety, Owner or BOND AMOUNT: ***FIVE PERCENT OF AMOUNT BID` other party shall be considered plural where applicable. PROJECT: (Name, location or address, and Project numbe)-, if any) Road Work / Sewer / Storm - Chet Wagner Court The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction.of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material famished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Watver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so famished, # intent is that * Bond shall be construed as a statutory bond and not as a common law bond. Signed and/sealed this I18th day of August 2016 Oc 1-U, �1k E Ci (Wl ess) —, I f—(`1 fit, MA VCr •.` Insurance FiAv"-,_. P— (Title) O. Chambers. Attorney-Irtvsap. Gj� ALA Document A310TM —2010. Copyrighte, 1963, 1970 and 2010 by The American Institute of Architeds. All rights reserved. WAPMI �ty�yq (/tt1pp` � Init. Document is protected by U.S. Copyright Law and Internatfonal Treaties. Unauthorized reproduction or distribution of this AIA®.Doldr�rri� dr any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law:., / purchasers are permitted to reproduceten (10) coples of thls document when completed. To report copyright violations of AIA Contract Documents, e-mail The American Institute of Arehdeds' legal counsel, copyright@aia.org, 0...a NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: THOMAS O. CHAMBERS, TODD SCHAAP and KIMBERLY S. RASCH JOINTLY OR SEVERALLY Its true and lawful Attomey(*in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of.. FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9' of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." �oanflaull", 3DU IAtrrrl, /&, ry nrw By a 45..... p i?ZhapokrTP,� S ra...M1. sg; SEAL ms S[m'en P.Anderson, Senior Vke President afWesM1lnpJon lntmnaaonal insunnre Company ae E'• 1 g7sOp` &9eolor Vltt PrcnWent ofxmdh American Specialty iosunnce Company _Ot /Aluaaplliah By h/iehad A.Ito,Senror G'iee�n�fjnoanalTranise:ompauY •_. ..•''er: & Senior W. President of North American Specialty Insunnw Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 14th day of April , 2016 North American Specialty Insurance Company Washington International Insurance Company State of Illinois Comity of Cook ss: On this 141h day of April , 2016 , before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michacl A. Ito , Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company, personally known tome, who being by me duly swom, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the volmttary, act and deed of their respective companies. OFFICIAL SEAL _ M KENNY�..._�1i NOTARY PUBLIC, STATE OF IWNOIS MKenny, Notary Public MY COMMISSION EXPIRES 12l0412a1T I, Jeffrey Goldberg , be duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 18th day of August 2016 A Jeirrey Galdbery, Vim Pmziewt & Assismm Sanitary a( N'eNingtcm Intemabonal Insurance Compe�ryR NOM American Speciehylvsunnce Compmy PART II (For projects of $100,000 or more —I C 36-1-12-4) These statements t under oath by each bidder with and as part of his bid. Attach additional ages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 7/31/2015 Contractor's Bid for Public Works - 3 When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NOW DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF P►i ) SS: ,COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work Version 7/31/2015 Contractors Bid for Public Works - 4 eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote, and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products on this project if awarded. I understand that violations hereunder may result in forfeiture of contractual payments. Version 7/31/2015 Contractor's Bid for Public Works - 5 I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this (5 tk day of U U 20L1- MA-!- L e> LC /i r zzo 0 Printed Name and Title Subscribed and sworn to before me this day of ll UM 0� My Commission Expires t5 Zak `. Nota ublic County of Residence e Version 7/31/2015 Contractor's Bid for Public Works - 6 r H N w W w D K a� ❑wQ Z �- O mw0 �wa r 0 Z Z N h w LL 7 0 m 0 F w w O2> 0❑ z Q 0 z 2 0 m a. w 0 w O LL m LL 0 LL 0 0 w a rl+*- N E m Z m O O � -ff o �\ c m `oL En E 0 aw 0 m m O n N 76 C v° m� yl C a ] O 0 I `o m o d L ' a y 0 U Q C O 13 a o 0C �% M w m w m C � o V U J Z .vvlJlr ^- y 2 IN CITY OF SOUTH BEND "°fN? MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM --> FORM MWBE-2.0 - EVIDENCE OF GOOD FAITH EFFORTS a `. This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MBE/WBE participation. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business as defined by the Indiana Department of Administration (" IDOA" ). Project Number: 116-005 Date:' ly Project Name: Bidder: Contact Person: Address: City: ad -al /y State: , ✓L / zip: 4"SSG/ Email: tr/l A A I par /y Ot 'yu�100 C v rh To determine whether a bidder has demonstrated good faith efforts to reach the MBENVBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS MBE/WBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women Owned Business as found on their website (http://www.in.gov/idoa). ACTION (ADVERTISE/CONTACT): In order for your bid to be deemed responsive, the City of South Ben requires that all perspective bidders complete no less than 2 of the following: 1. Attend all pre -bid meetings scheduled by the City to inform MBENVBEs of contracting and subcontracting opportunities. 2. Advertise in general circulation and/or trade association publications concerning subcontracting opportunities, and allow MBE/WBEs reasonable time to respond. 3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated V to inform MBENVBEs of subcontracting opportunities and allowed sufficient time for them to participate effectively. 4 Utilize pre-existing services of available community organizations, small and/or disadvantaged business assistance offices and other organizations that provided assistance in the recruitment and placement of MBENVBE firms. **Bidder must circle or otherwise notate which of the two (2) required actions were performed. GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBE/WBEs, r / including providing such MBENJBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject Ni as unqualified without sound business reasons based on a thorough investigation of their capabilities. CONTRACT(S): The bidder selected specific portions of the work to be performed by Es in order to increase the likelihood of meeting the MBENVBE goals (including breaking down into smaller units to facilitate MBE/WBE participation) CT RECORDS: The bidder has maintained the following records for each MBE/WBE that has t�'3. e subcontracting opportunity: , address, and telephone number; cription of information provided by the bidder or subcontractor; and ement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBE/WBE was unqualified to perform the job. rroper demonstration of Good Faith Effort requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 7/31/2015 Contractor's Bid for Public Works - 11 -JAa CP CITY OF SOUTH BEND`s4`r"'!F"y,� MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY`-� 77 4 DEVELOPMENT PROGRAM FORM MWBE-2.1 �-c MBE/WBE CONTACTED S a`1°ate This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring contacted MBE/WBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business. PAGE__�.OF_)._ Project Number: 116.005 Project Name: Bidder: Z s 7 nr MBEMBE Firm V4 / 1^ Owner or Contact at MBE/WBE Firm MBE/WBE Participation Goal Telephone: s7+�-,23 �',�Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE/WBE FIRM: ( ^L Vlr�p C-a11 �rMQ. t �nJ'Q �(' Q �'"iY s� A�n'l MBE/WBE Firm Vennec1 Evi3ecsc Crne L, Owner or Contact at MBEIWBE Firm ' .cfvf—cAS Telephoner T7(1-17g, c'LI-7,4, Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBENVBE FIRM: Version 7/3112015 Contractor's Bid for Public Works - 12 1316 COUNTY-67v BUILDING 227 W. JrFFaRSON BomrVARD SOUTH BFND, INDIANA 46601-I830 Date: To: From Subject Project Narcic: Project Number: CITY OF SOUTH BEND PHONH 574/235-9251 FAX 574/235-9171 TDD 574/235-5567 PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS t,net waggoner Court 116-005 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by faxing this sheet to the Board of Public Works at (574) 235-9171. A copy MUST also be included with your bid package upon submittal. THIS ADDENDUM MAY AFFECT YOUR BID. Note: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: -4- rl > Authorized Signature: y, Date: — STATE OF WISCONSIN ) COUNTY OF Kenosha ) ON THIS 18th day of August , 2016 before me, a notary public, within and for said County and State, personally appeared Thomas O. Chambers to me personally known, who being duly sworn, upon oath did say that he is the Attorney -in -Fact of and for the North American Specfafty Insurance Company , a corporation of New Hampshire , created, organized and existing under and by virtue of the laws of the State of New Hampshire ; that the corporate seal affixed to the foregoing within instrument is the seal of the said Company; that the seal was affixed and the said instrument was executed by authority of its Board of Directors; and the said Thomas O. Chambers did acknowledge that he/she executed the said instrument as the free act and deed of said Company. Kimberl)(Vikasch NotaryPublic,Kenosha County, Wisconsin My Commission Expires 1/22/2018 INDIANA EARTH, INC. 10343 MCKINLEY HWY OSCEOLA,IN 46561 Section 1 Projects completed in the last year: 1) Excavation & Utilities —Central Park in Mishawaka 2) Demolition — Houses for the City of South Bend 3) Demolition — Warehouse for City of Columbus, IN 4) Exc & Utility — Appletree Learning Center, South Bend 5) Exc&Utility — Belle Tire, Mishawaka 6) Exc & Utility— Belle Tire, South Bend 7) Exc & Utility— Discount Tire, Warsaw, IN 8) Demolition —Summit Street Bridge, City of Nappanee 9) Exc & Utility—Pierceton Elementary, Pierceton, IN 10) Demolition — WWTP Towers for City of South Bend, IN 11) Caravan Drive, City of Elkhart, IN 12) Demolition of Houses for the City of Elkart Public Works in Process: 1) 2 Way Street Conversion —City of South Bend, IN 2) Demolition of School —Akron Elementary, Akron, IN 3) Demolition —Jonesville Community Schools Completed all work awarded to our firm. References of Private Firms 1) Rieth Riley Construction 574-288-8321 2) Gibson Lewis LLC 574-259-8581 3) Larson Danielson 219-362-2127 4) Holladay Group 574-234-2073 5) Robert Henry Const. 574-232-2091 Section 2 Plan of proposed work 1) Obtain permits, preconstruction meeting, file IDEM notifications, mobilize, erosion control measures if required by specs, strip site of vegetation, removals, storm and sewer pipes and structures, electrical lights, curb and gutter, asphalt paving, topsoil and seed. Subcontractors Utilized on Past Projects 1) Hydroseed —Osceola, IN 2) HydroTek—Nappanee, IN 3) Clean Air Environmental — North Liberty, IN Asbestos Abatement 4) Weaver Boos — Compaction Testing 5) Bob's Landscaping Subcontractors to Utilize on this Project — Possible subs listed, will determine prior to contract approval 1) Hydroseed —Osceola, IN 2) A-1 Striping Service Inc. — New Carlisle, IN 3) Rieth Riley —South Bend, IN 4) State Barricading, INC—South Bend, IN 5) Pemberton Davis —South Bend, IN 6) JPR—South Bend, IN List of our Equipment Owned: 1) 13 Excavators 2) 3 Dozers 3) 3 Dump Trucks 4) 2 Semi Trucks with dump trailers 5) 2 Rollers 6) 3 Loaders 7) 2 Skidsteers We have received pricing for services by potential subcontractors. Bidder: -lwn dl'Ctno By Authorized Representative: Signature: Print Name & Title: yqugr„e. b CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST s- CHECKLIST FOR BIDDERS Project Name Chet Waggoner Court Project No. 116-005 For Bids Due August 18, 2016 From time to time the South Bend Board of Public Works finds it necessaryto reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. Proper bid security included. The bidder has the option of providing either a Certified Check IL/ or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and Certification of use of United States Steel Products or Foundry Products. Proof of MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not / met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted Form [MWBE-2.1]. V Acknowledge Receipt of _L Addendum(s) included with the bid. I/ All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either printed or typed underneath signature. This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance documentation; however, it does not include all specifications requirements relieve the bidder of the need to read and comply with the specifications. y /eA. r Version 7/31/2015 Contractor's Bid for Public Works - 1 Date: with required and does not