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Home My WebLink AboutBid Opening - MLK JR Center HVAC Revisions - Edward J WhiteCITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Martin Luther King, Jr. Center HVAC Revisions Project No. 116-064 For Bids Due August 23, 2016 PART (Must be completed for all bids. Please type or print) Date: S %Z 3 U Bidder (Firm): CG�warc( .j . LJ i^. irr Address: ioi'l S <r L4, c' St City/State/Zip: 5:y1;, { L1(. c?j Telephone Number: (Say) zsl-6351 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: (r/c D-S, ^ 52'Y-es and dated for the sum of (enter the Total Base Bid as shown on the Proposal) n+AEF 14"''Or&0 E 104TY Two 7Ne -,A110 OPE 14u. q-CO bck, ASS ($ 3 1 Z 100 00 ) (Enter sum of Total Base Bid 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. —11 If additional units of material included in the contract are needed, the cost of units must be that shown in the original contract if accepted by the City of South Bend. If the bid is to be unit basis, the itemization of the units shall be shown on a separate attKhment. m The above bid is accepted this Subject to the following conditions: BOARD OF PUBLIC WORKS Gary A. Gilot, President Elizabeth A. Maradik, Member ACCEPTANCE day of David P. Relos, Member Therese J. Dorau, Member James A. Mueller, Member Attest: Linda M. Martin, Clerk Version 7/31/2015 Contractor's Bid for Public Works -2 20 Project Name Project No. For Bids Due BASE BID 0 k:- y C BID/PROPOSAL CITY OF SOUTH BEND iaas Martin Luther King, Jr. Center HVAC Revisions 116-064 August 23, 2016 Item No. Description Quantity Unit Unit Price Total Amount Provide new Gymnasium heating and air conditioning equipment, removal of existing Gymnasium heating and ventilating units and replacement of boilers and various 1 Boiler Room accessories. Work also 1 Lump 3 �` 1 CXl CD includes removal/abatement of Sum a approximately 140 lineal feet of TSI pipe insulation and associated asbestos - containing hard pack fittings from, the Boiler Room. BASE BID TOTAL 3'S f tJC3Cj ALTERNATE 91 Item No. Description Quantity Unit Unit Price Total Amount In lieu of the Base Bid Trane HVAC Units, provide Daikin "Rebel' Model DPS020A Units (2 required). All Specified 1y f requirements forthe Trane Units shall apply, ccluf except that the Unit EER may be 11.1 and OU 1 the summer ERV sensible effectiveness 1 Lump y / may be 0.76. The feeder size indicated for Sum the Trane units is still acceptable; however, the overcurrent protection device shall be a 150A/3P HACR circuit breaker. (Indicate whether amount is an add or a deduct. Bidder(Firm); Ec w� J(^;�,r'Kr Address: In/l S• .'r�Ir'/, Zi,c:, Sf• City/State/Zip: Version 7/31/2015 ALTERNATE #1 TOTAL k{ SOO cxl Telephone Number: (S71 ) 2.Is1-[o 3Sj Z (Signature) •J�� i�,.G.e.; fir.y". ,� . (Printed Name of Person Signing) Works - 7 drW BID BOND Travelers Casualty and Surety Company of America Hartford, CT 06183 CONTRACTOR: (Name, legal status and address) Edward J. White, Inc. 1011 S. Michigan Street South Bend, IN 46601 OWNER: (Name, legal status and address) City of South Bend, Indiana BOND AMOUNT: Five Percent (5%) of Total Bid Amount PROJECT: (Name, location or address, and Project number, j'any) Martin Luther King Jr. Center HVAC Revisions, South Bend, IN SURETY: (Name, legal status and principal place of business) Travelers Casualty and Surety Company or America Hartford, Connecticut 06183 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 furnished 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. Waiver 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 fumished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310, 2010 edition I Signed and sealed this 12th day of August 2016 Edw d J. White, Inc. (Pr tcip zl) (Seal) (Wit} ess) (Title j., t yj „4,, Xesde F Travelers Casualty and Surety Company of America (Sure, (Seal) (Witness)L (Title o nna Hoyt, Attorney -in-Fact The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310, 2010 edition I IS INVALID WITHOUT THE RED .A POWER OF ATTORNEY TRAVELERSJ Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact No. 229268 Certificate No. 006724213 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Donna J. Greiner, James J. lovino, Tamara Alexander, Donna Hoyt, Jennifer Fisher, Kyle Hoffman, Sharla R Snyder, and Casey Enzor of the City of Kokomo , State of Indiana , their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 15th day of March 2016 Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company i?^ ��EOPPyfl.119 •QaP`Vy 4JP�lY 4ryqu9p�yWtrfl�NI 4Y,�j. 6 0arAWiN �' e'n33 (y yRvmgr ` t 1896 �r,aE 1977 z r n` uP xnarroRo, avrtRoio, 9 "ao it $ 1951 SEAL SBAs;; cae. *��c"e -.0 N{ 4 d .......-a_ >�..... State of Connecticut City of Hanford ss. By: Robert L. Raney, enier Vice President On this the 15th day of March , 2016 , before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. p,TlT In Witness Whereof, I hereunto set my hand and official seal. T*AA' My Commission expires the 30th day of June, 2016. Ct AU8L1p.� Marie C. Temault, Notary Public 58440-8-12 Printed in U.S.A. The above bid is accepted this following conditions: Contracting Authority Members: ACCEPTANCE day of PART II (For projects of $150,000 or more — IC 36-1-12-4) Governmental Unit: City of South Bend Board of Public Works Bidder (Firm) Edward J. White, Inc. Date (month, day, year). 08/23/2016 These statements to be submitted under oath by each bidder with and as a part of his bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE subject to the What public works projects has your organization completed for the period of one (1) year prior to the date of the current bid? Contract Amount Class of Work Completion Date Name and Address of Owner 185,866.00 Mechanical 09/2015 Rochester Comm. Schools, Rochester, IN 197,203.00 Mechanical 09/2015 City of Mishawaka Parks Dept., Mishawaka, IN 125,000.00 HVAC 05/2016 Federal Aviation Administration, South Bend, IN 2. What public works projects are now in process of construction by your organization? Contract Amount Class of Work Expected Completion Date Name and Address of Owner 1,010,006.00 Mechanical 09/2016 Warsaw Community Schools, Warsaw, IN 763,438.00 Mechanical 09/2016 LaPorte Community Schools, LaPorte, IN 1,201,711.00 Mechanical 09/2016 St. Joseph County Airport Authority, South Bend, IN 3. Have you ever failed to complete any work awarded to you? No If so, where and why? 4. List references from private firms for which you have performed work. St. Joseph Regional Medical Center Verizon Wireless Key Bank First Federal Bank SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE Explain 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 governmental unit to consider your bid.) We are planning on a total of four men on the project to perform mobilization, demo of the existing boilers and installation of the new boilers. We will pour pads for the new air handler and run gas piping before the weather pets cold. 2. Please list 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. Deluxe Sheet Metal - South Bend, IN Valley Insulating Co. - Mishawaka, IN Johnson Controls - South Bend, IN Electric - South Bend, IN Fluid Dynamics - Ft. Wayne, IN 3. If you intend to sublet any portion of the work, state 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 governmental unit in the event that you subsequently determine that you will use a subcontractor on the proposed project. Electrical - Pemberton -Davis, Mishawaka, IN / Insulation -Valley Insulating Co., Mishawaka, IN General Contractor -Gibson -Lewis, LLC / Asbestos Abatement -Clean Air Environ. Svcs. Test & Balance - Fluid Dynamics, Ft. Wayne, IN Controls - Johnson Controls, Inc., South Bend, IN Sheet Metal - Deluxe Sheet Metal, South Bend, IN 4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit. Welder, Groove Machine, Lift, Pickup Truck 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, please explain the rationale used which would corroborate the prices listed. Yes 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 governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded. SECTION IV CONTRACTOR'S NON — COLLUSION AFFIDAVIT The undersigned bidder or agent, being duly sworn on oath, says that he 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 include 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. He 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. SECTION V OATH AND AFFIRMATION I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT. Dated at South Bend, IN this 23rd Edward J. White, Inc. day of August , 2016 (Name of Organization) Vice -President v (Title of Person Signing) ACKNOWLEDGEMENT STATE OF Indiana ) St. Joseph ) ss COUNTY OF P ) Before me, a Notary Public, personally appeared the above -named Jeff Bucher, Jr. and swore that the statements contained in the foregoing document are true and correct. Subscribed and sworn to before me this 23rd day of August 2016 Nota u6lc My Commission Expires: August 10, 2022 County of Residence: St. Joseph 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 SS: Sf )c znY� COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. 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 Z 3rd day of A-J 201 & Cdw.i rcl J. LJL,-�, Z:, Contractor/Bidder (Firm) Sign.*rel of Contract r/Bidder or Its Agent Jeff` GG,- er, Jr. Printed Name and Title Subscribed and sworn to before me this 23' day of J �J— 20 l My Commission Expires ;U 2 2_ County of Residence Not6 Public S4, J.:,f-,O1, `W •- Version 7/31/2015 Contractor's Bid for Public Works - 6 § LU § ƒ■ in§S _U)ƒ 2§Z �2 )uj LL W§ �0 ■13 k § § 0 2 ;\ IL ,\ §w k§ L; § § k( )o \} r {\ k0 CLCL 000 E� f0 !r 0 B, }L \ j , ]�\ a \ \\ % ; N} \ � f R ; f 0 } ƒ � � . � ^ m , / 12 f : \VN \ 7 \E \ < � � � \ g � ® $ ) % / ' ( \ w \ & { \ � / ) SOli TkA CITY OF SOUTH BEND Jq;- FrG MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY s DEVELOPMENT PROGRAM 'O W. > FORM MWBE-2.0 , EVIDENCE OF GOOD FAITH EFFORTS 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 (`9DOA"). Project Number: 116-064 Date: �3 f I (, Project Name: Martin Luther King, Jr. Center HVAC Revisions Bidder: fdwcrel J. LiL,, e 7,cc Contact Person: J,!FF r ,.r�I.�1 i Jr • Telephone: Address: City: ;, &t+c( State: Zti� Zip: `i tJCvOI Email: a e' Je.1'AC_.•Ae f_ To determine whether a bi der 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 LISTS): 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 Bend 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 MBENVBEs reasonable time to respond. 3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated 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, including providing such MBENVBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject MBENVBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. SMALL CONTRACTS): The bidder selected specific portions of the work to be performed by MBENVBEs in order to increase the likelihood of meeting the MBEIWBE goals (including breaking down contracts into smaller units to facilitate MBENVBE participation) CONTRACT RECORDS: The bidder has maintained the following records for each MBENVBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBENVBE was unqualified to perform the job. *Proper 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 - 9 Spuiti CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY, DEVELOPMENT PROGRAM FORM MWBE-2.1 i y MBE/WBE CONTACTED 1a. This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring contacted MBEIWBE 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 f OF / Project Number: 116-064 MBE/WBE Participation Goal Project Name: Martin Luther King, Jr. Center HVAC Revisions 3 By: MBENVBE Firm Owner or Contact at MBENVBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBENVBE FIRM: MBENVBE Firm Owner or Contact at MBENVBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBENVBE FIRM: Version 7/31/2015 Contractor's Bid for Public Works - 10 Oi p 1316 COUNTY -CITY BUILDING PHONE 574/235-9251 227 W. JEFFERSON BOUI.F.VARD !,; u` ._ o Fax 574/ 235-9171 SOUTH BEND, INDIANA 4660I-1830 S "�'�\ _ TDD 574/235-5567 v • s 1865 CITY OF SOUTH BEND PETS BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS Date: August 12, 2016 To: All Bidders From Linda M. Martin, Clerk, Board of Public Works Subject Addendum Number: 1 South Bend Parks Department Project Name: Martin Luther King, Jr. Center HVAC Revisions Project Number: 116-064 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: Ed1.. '+ J o ti, Authorized Signature: Date: Jti,�pU Tri aF�, 1316 COUNTY -CITY BUILDING '. `,l` PHONE 574/235-9251 227 W. JEFFERSON BOULEVARD -.=-- FAX 574/ 235-9171 SOUTH BEND, INDIANA 46601-1830 TDD 574/235-5567 CITY OF SOUTH BEND PETE BUITIGIEG, MAYOR BOARD OF PUBLIC WORKS Date: To: From Subject August 16, 2016 All Bidders Addendum Works South Bend Parks Department Project Name: Martin Luther King, Jr. Center HVAC Revisions Project Number: 116-064 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: Authorized Signature: Date: �e.�warcf J. oi7 ' il��U PH%t�J J 1316C01yM-CITY B1.91 DING .� NoNE 574/235-9251 227 W. JEFFERSON BOULEVARD [�,� IV FAx 574/135-9171 SOUTH Brrcn, INDr ANA 46601-I830 'S wAck TDD 5742'235-;%7 y tg65 CrIY OF So urn BEND PFTh BUT FIGIEG, MAYOR BOARD OF PUBLIC WORKS Date: August 18, 2016 To: All Bidders From Linda M. Martin, Clerk, Board of Public Works Subject Addendum Number: 3 South Bend Parks Department Project Name: Martin Luther King, Jr. Center HVAC Revisions Project Number: 1 16-064 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: _ • (Ji {�� G Authorized Signature: Date: Ok �� J C CITY OF SOUTH BEND, INDIANAz " CONTRACTOR'S BID FOR PUBLIC WORK z CHECKLIST FOR BIDDERS 186; - Project Name Martin Luther King, Jr, Center HVAC Revisions Project No. 116-064 For Bids Due August 23, 2016 From time to time the South Bend Board of Public Works finds it necessary to 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. M 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 MBEANBE 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]. Proper bid security included. The bidder has the option of providing either a Certified Check or Bid Bond. Acknowledge Receipt of 3 Addendum(s) included with the bid. 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 with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: c c 6 zt . tj 4e -4c. Date: By Authorized Representative: Signature: Print Name & Title: Version 7/3112015 Contractor's Bid for Public Works - 1