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HomeMy WebLinkAboutBid Opening - MLK JR Center HVAC Revisions - Herrman&GoetzCITY 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 Date: Address: City/State/Zip: (Must be completed for all bids. Please type or print) August 23, 2016 Bidder (Firm): Herrman & Goetz, Inc. 225 S. Lafayette Blvd. south?Bedd. IN 46601Telephone Number: _ ( 574 ) 282-2596 Agent of Bidder (if Applicable): N/A 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: M/E Design and dated for the sum of (enter the Total Base Bid as shown on the Proposal) Three hundred seventy nine thousand seven hundred eight & no/400 379,708.00 ) (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. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown o _RD--p separate attachment. 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 SpazNgBfU BID/PROPOSAL CITY OF SOUTH BEND Project Name Martin Luther King, Jr. Center HVAC Revisions Project No. 116-064 For Bids Due August 23, 2016 BASE BID Item No. Description Quantity Unit Unit Price Total Amount Provide new Gymnasium heating and air conditioning equipment, removal of existing Lump 1 Gymnasium heating and ventilating units 1 Sum and replacement of boilers and various Boiler Room accessories. BASE BID TOTAL $379, 708.00 ALTERNATE #1 Item No. Description Quantity Unit Unit Price Total Amount In lieu of the Base Bid Trane HVAC Units, provide Daikin "Rebel" Model DP3020A Units (2 required). All Specified requirements for the Trane Units shall apply, except that the Unit EER may be 11.1 and 1 the summer ERV sensible effectiveness 1 Lump may be 0.76. The feeder size indicated for Sum 12, 715.00 the Trane units is still acceptable, however, the overcurrent protection device shall be a 150A/3P HACR circuit breaker. i to whether amount is an affdor a deduct. ALTERNATE #1 TOTAL 12,715.00 Bidder (Firm) Address: 225 S. Lafayette Blvd. City/State/Zip; Telephone Number: ( ) So. Bend, IN 46601 574 282-2596 By nature) Thomas J. Herrman, President (Printed Name of Person Signing) Version 7/31/2015 Contractor's Bid for Public Works - 7 CNA SURETY Bid Bond CONTRACTOR: (Name, legal status and address) Herrman & Goetz, Inc. 225 S. Lafayette Blvd. South Bend, IN 46601 OWNER: (Name, legal status and address) City of South Bend 227 W Jefferson South Bend, IN 46601 BOND AMOUNT: 5% Bond No. Bid Bond SURETY: Continental Casualty Company : IL Corporation (Name, legal status and principal place of business) 333 S. Wabash Avenue 41st Floor Chicago, IL 60604 Five Percent of Amount Bid PROJECT: (Name, location or address, and Project number, if any) Martin Luther King Jr Center HVAC Revisions This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owneror other party shall be considered plural where applicable. 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 furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 23rd day of August 2016 Printed in cooperation with the American institute of Architects (AIA). The language In this document conforms to the language used in AIA Document A310 -Bid Bond - 2010 Edition. POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT :£nor,. All Men By These Presents, That Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company (herein called "the CNA Companies"), are duly organized and existing insurance companies having their principal offices in the City of Chicago, and State of Illinois, and that they do by virtue of the signatures and seals herein affixed hereby make, constitute and appoint Tracie House , Individually of South Bend, IN their true and lawful Attomey-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on their behalf bonds, undertakings and other obligatory instruments of similar nature S=tyBondNo: Bid Bond -InUnlimitedAmounts- Principat: Herrman & Goetz, Inc. Obligee: City of South Bend and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Boards of Directors of the insurance companies. In Witness Whereof, the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto affixed on this 1st day of December, 2015. r� Continental Casualty Company fiv National Fire Insurance Company of Hartford �'r ,aca9reaAr�e American Ca ty Company of Reading, Pennsylvania lair ]i, y Is]z a Paul T. Bruflat ice President State of South Dakota, County of Minnehaha, ss: On this 1st day of December, 2015, before me personally came Paul T. Bruflat to me known, who, being by me duly swom, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company described in and which executed the above instrument; that he knows the seals of said insurance companies; that the seals affixed to the said instrument are such corporate seals; that they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance companies. J. MOHR � ,( w wuraanKmx My Commission Expires June 23, 2021 J. Mohr Notary Public CERTIFICATE I, D. Bull, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance companies printed on the reverse hereof is still in force. In testimony whereof have hereunto subscribed my name and affixed the seal of the said insurance companies this 23rd day of August, 2016. 01 °"sw<r poavoaAtp C °o SEAL 1997 Form F6853-4/2012 dwaNr oA Continental Casualty Company fi National Fire Insurance Company of Hartford S0t09r9a41FE;% American Casualty Company of Reading, Pennsylvania IDLY ]I, 1392 � 1 D. Bult Assistant Secretary Authorizing By -Laws and Resolutions ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY: This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company at a meeting held on May 12, 1995: "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instmments on behalf of the Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective." This Power of Attorney is signed by Paul T. Brufiat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of Continental Casualty Company. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 25e day of April, 2012: "Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute various policies, bonds, undertakings and other obligatory instruments of like nature; and Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of my Authorized Officer shall be valid and binding on the Company. " ADOPTED BY THE BOARD OF DIRECTORS OF NATIONAL FIRE INSURANCE COMPANY OF HARTFORD: This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company by unanimous written consent dated May 10, 1995: "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective." This Power of Attorney is signed by Paul T. Bmtlat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of National Fire Insurance Company of Hartford. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 25' day of April, 2012: "Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute various policies, bonds, undertakings and other obligatory instruments of like nature; and Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or otherwise in an electronic format (collectively, `Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of my Authorized Officer shall be valid and binding on the Company. " ADOPTED BY THE BOARD OF DIRECTORS OF AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA: This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company by unanimous written consent dated May 10, 1995: "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective." This Power of Anomey is signed by Paul T. Bmfiat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of American Casualty Company of Reading, Pennsylvania. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 25' day of April, 2012: "Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute various policies, bonds, undertakings and other obligatory instruments of like nature; and Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or otherwise in an electronic format (collectively, `Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of my Authorized Officer shall be valid and binding on the Company. " ACCEPTANCE The above bid is accepted this day of subject to the following conditions: Contracting Authority Members: PART II (For projects of $100,000 or more — IC 36-1-12-4) Governmental Unit: Bidder (Firm) Herrman & Goetz nc,- Date: 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 1. What public works projects has your organization completed for the period of one (1) year prior to the date of the current bid? 2. Completion Contract Amount Class of Work Date Name and Address of Owner 92,O23 45fL. Electri-ca 6120-L4— R- Tn ,A )h Pulp o t u iBi 7.P 1i `e DSr-ds,--_ 346,719-.- Electr' 6/2014 442,000-^- E;.ec, �x Mech. 6/2015 Our_ —mac', of the Lake-Edw-zr Rochester %o'^nurltY School 334,000. 2/2OT5 What public works projects are now in process of construction by your organization? Contract Amount I Class of Work I Completion I Name and Address of Owner 2,750,000. EIP.c. 1/ O1- 1,/g�15 S t �_G 1�yp= 6R4 -1� Elkhartrcn ti r 3ucha�a ,1 - ..orfolk Souther- R 0- 7 1 21- :°ech - r 324,400. Mech. 4/201.7 B-15 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. Culver Academies Memorial Hospital of South Bend Carpenter Co Honeywell St. Joseph Regional Med Ctr. South Bend Medical Foundation SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE t. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, completed the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.) In conjunction with construction manager & other trades 2. 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 expect to require a bond. However, if you are unable to currently provide a listing, please understand, a listing must be provided prior to contract approval. Unknown at this time 3. 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. As required 4. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? Otherwise, please explain the rationale used which would corroborate the prices listed. Yes PART II (For projects of $100,000 or more— IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his bid. Attach additional pages 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.) 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, NON- 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 Indiana ) ) SS: St. Joseph 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 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 Contractor's Bid for Public Works - 4 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 23rd day of Aug , 20_16 Thomas J. Herrman, President Printed Name and Title Subscribed and sworn to before me this 23rd day of August 20 16 My Commission Expires 7/13/2022 Notary Public Watherine J. Gruber County of Residence St. Joseph Version 7/31/2015 Contractor's Bid for Public Works - 6 0 0 w' n 0 0 W a 0 c c g 0 0 m m N CD C a 3 CD OQ L w rn o p C o r p Z m:Ej G+ .4 3 r • 0 w m wO m Ft D H y od w 3 N p m 0 n w W r m n � Z 3 x 3z 00 N o h] m d 0 v m m N 'b D ro �c 0 0 N o o mg rt O m o ro a [ N o W 0o rt c o' A � 0 fD o m n� 0 -� �a N d r mo N 03 d N mD 0 0 O 3� O 0 00 m� W 0 o m 0 0 0 � o o m m m a O O CD (D CD Z 3 u (D 9 co m o co (D m G) O w M C- 3m s o U) � � d O °oa 7 (D O (O N Boa CD m N 3' O N N 7 m O CDC aaa a c: c c. a (p (D (D (3D N C NNa N O Na 5. a N O 7 N W v CL a N .Z1 O o T O CD m O , ; T •G O, 'S CO T 0 A - co ID < M 3 o D •`�Am N 0 (p S D O 0 _3 Co >_ > > O O O Z a C) O a D O C 3 0 w x 7 N as N 0 0 7 A 0 N N N (D (� N O (p C N 5. 'S Z O X z Z O m0 m m � rZ{ 0m0 g C T CO Co ZO -.4 mC 1 W 2 Omm >MO 22 W m 0 m X { a 00 w o n O m m N r O 3 m -u W rb m m h VjUt+h - ^O`T"a¢.q, CITY OF SOUTH BEND of MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM FORM MWBE-2.0 dx 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 (` IDOA"). Project Number: 116-064 Date: August 23, 2016 Project Name: Martin Luther King, Jr. Center HVAC Revisions Bidder: Herrman & Goetz, Inc. Contact Person: Tom Adams Telephone: (574) 282-2596 Address: 225 S. Lafayette Blvd. City: Smith Rand State: TN zip: 46601 Email: tndnmg@hgservices.com 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 (hftp://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 MBE/WBEs of contracting and subcontracting opportunities. 2. Advertise in general circulation and/or trade association publications concerning subcontracting opportunities, and allow MBENUBEs 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 MBE/WBE 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, Q including providing such MBE/WBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject MBE/WBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. SMALL CONTRACT(S): The bidder selected specific portions of the work to be performed by �P MBENVBEs in order to increase the likelihood of meeting the MBENVBE goals (including breaking down contracts into smaller units to facilitate MBENVBE participation) CONTRACT RECORDS: The bidder has maintained the following records for each MBENUBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 1 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 MBENUBE 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 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM FORMMWBE-2.1 `, v MBE/WBE CONTACTED " 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: 116-064 MBE/WBE Participation Goal Project Name: Martin Luther King, Jr. Center HVAC Revisions Bidder: He & Goetz Inc. By: I President August 23, 2016 (Signature (Title) (Date) MBE/WBE Firm Innovative Mechanical Solutions Owner or Contact at MBENVBE Firm Mr. Kim Finn Telephone: 117-706-1500 Fax: 866-485-9313 Email: kfinn@imcanical.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Furnish (2) RTU units RESULTS OF CONTACT WITH THE MBE/WBE FIRM: Agreed to terms. We will purchase (2) RTU units should we be awarded t,'-=z's 1r3eet MBENVBEFirm Supprinr F.nivironmental Owner or Contact at MBE/WBE Firm Telephone: 574-256-1490 Fax: 574-256-1491 Email: emma@ser90.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Asbestos abatement RESULTS OF CONTACT WITH THE MBE/WBE FIRM: This firm does Pat perform achestnc abatement Version 7/31/2015 Contractor's Bid for Public Works - 10 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601.1830 PHONE 574/235-9251 FAX 574/235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND PETE 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: H RAA I t &OCrZ Authorized Signature: Date: g— 7-7-- 1 S- 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-I830 Date: To: From Subject PHONE 574/235-9251 FAX 574/ 235-9171 TDD 574/235-5567 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS August 16, 2016 All Bidders ... - rmtTe T 11 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: IW— 2.2— I L I - Soil Tit GF 1316 COUNTY -CITY BUILDING 18N '.� PHoNE 574/235-9251 227 W. JEPPERSON BOULEVARD t, c FAX 574/ 235-9171 y rnrn SOUrH BEND, INDIANA 4660I-1830 TDD 574/235-5567 t i Y S ISfiS CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS Date: To: From Subject August 18, 2016 All Bidders Linda M. Martin, Clerk, Board of Public Works Addendum Number: 3 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: 9,— Z2— I (o POWER OF ATTORNEY I, Thomas J. Herrman, President and Resident Agent of an Indiana Corporation in good standing known as Herrman & Goetz, Inc., do hereby nominate and appoint Larry Cripe, an employee of said Corporation, who resides at 67950 Yankee Lane, Edwardsburg, Michigan to act as attorney -in -fact to do the following acts for me in my name, as President and Resident Agent. 1. To possess the full powers to execute and enter into all business related contracts on behalf of the Corporation, as any other authorized agent of said Corporation would have the ability to sign/execute, including myself. r 2. The powers granted by this document shall begin on July 1, 2016 and conclude/expire on June 30, 2017 or to such other extended time as shall be made by written faxed extension executed by me to this authorization. 3. The powers extended by this document may be filed for record in any public office as just circumstances might dictate and the original and all executed duplicates shall have equal force, validity and effect. declare, as President and Resident Agent of Herrman & Goetz, Inc. that any lawful act or thing done under the powers granted by this Power of Attorney, shall be binding on the Corporation. IN WITNESS WHEREOF, I, Thomas J. Herrman, President and Resident Agent of Herrman & Goetz, Inc. have signed this instrument on this the 23rd day of June, 2016. L Thomas J. Herrman President and Resident Agent Herrman & Goetz, Inc. Subscribed and sworn to before me, a Notary Public, residing in St. Joseph County, State of Indiana, this the 23rd day of June, 2016 Catherine J. Grdber Notary Public Residing in St. Joseph County, State of IN My Commission Expires 7/13/2022 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Martin Luther King, Jr. Center HVAC Revisions Project No. For Bids Due 116-064 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. x 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 x Certification of use of United States Steel Products or Foundry Products. Proof of MBENVBE 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 MBEMBE Contacted Form [MWBE-2.1]. Proper bid security included. The bidder has the option of providing either a Certified Check x or Bid Bond. Acknowledge Receipt ofl' �, 3Addendum(s) included with the bid. x All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either x printed or typed underneath signature. x 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: By Authorized Signature: Print Name & Herrman & Goetz, Inc. Date: August 23,2016 Version 7/31/2015 Contractor's Bid for Public Works - 1