HomeMy WebLinkAboutOpening of Bids - Calvert St. Lift Station Replacement - Proj No. 116-053 - John Boettcher Sewer & ExcavatingSoU>'flg�,
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CITY OF SOUTH BEND, INDIANA u" e
CONTRACTOR'S BID FOR PUBLIC WORK
CHECKLIST FOR BIDDERS Iacs
Project Name Calvert Street Lift Station Replacement
Project No. 116-053
For Bids Due December 8, 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.
Proper bid security included. The bidder has the option of providing either a Certified Check
X or Bid Bond.
Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely
X 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 MBE/WBE Participation Goal Form [MWBE-1.0j. If minimum participation goal is not
met, also provide Evidence of Good Faith Efforts Form [MWBE-2.01 and MBE/WBE Contacted
X Form [MWBE-2.11.
X Acknowledge Receipt of Addendum(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: John Boettcher Sewer & Excavating Contractor Date: December 8, 2016
By Authorized
Signature:
Print Name &
Version 10/18/2016 Contractor's Bid for Public Works - 1
A Sill: T/1 g£,
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CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK Z
1865
Project Name Calvert Street Lift Station Replacement
Project No. 116-053
For Bids Due December 8, 2016
PART
(Must be completed for all bids. Please type or print)
Date: December 8, 2016 Bidder (Firm): John Boettcher Sewer & Excavating Contractor
Address: 3305 N Home Street
City/State/Zip: Mishawaka, IN 46545 Telephone Number: _( 574 ) 259-1418
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:
and dated December 8, 2016 for the sum of (enter the Total Bid as shown on the Proposal)
One Million Fifty Two Thousand Eight Hundred Twenty & 19/100 (g 1,052,820.19 )
(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 sho n on a sepa a hment.
By
(Signature)
okr W. Boettcher
(Printed Name of Person Signing)
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, Member
Suzanna M. Frltzberg, Member
Therese J. Dorau, Member
James A. Mueller, Member Attest: Linda M. Martin, Clerk
Version 10/18/2016 Contractor's Bid for Public Works - 2
20
PART II
(For projects of $Ioo,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.)
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 10/1812016 Contractor's Bid for Public Works - 3
ACCEPTANCE
The above bid is accepted this day of subject to the
following conditions:
Contracting Authority Members:
PART II
(For projects of $150,000 or more — IC 36-1-12-4)
Governmental Unit: City of South Bend
Bidder (Firm) John Boettcher Sewer & Excavating Contractor
Date (month, day, year): December 8, 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
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
1,324,531.14
SEWER SEPARATION
2016
CITY OF MISHAWAKA-GROVE, ELIZABETH
70,548.08
WATER EXTENSION
2016
CITY OF ELKHART-7TH ST WATER EXT
149,160.92
SANITARY SEWER EXT
2015
CITY OF MISHAWAKA-TRINITY PH II
610,647.00
STORM SEWER & ROAD
2016
CITY OF MISHAWAKA-TRINITY PH IV
2. 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
3. Have you ever failed to complete any work awarded to you? NO If so, where and why?
4.
2.
List references from private firms for which you have performed work.
CRESSY & EVERETT - 4100 EDISON LAKES PARKWAY, SUITE 350, MISHAWAKA, IN 46545
ROYAL EXCURSION, 12807 E. MCKINLEY, MISHAWAKA, IN 46545
CPM CONSTRUCTION, 2560 CLEVELAND AVE., ST. JOSEPH, MI 49085
CONTINENTAL BUILDING SYSTEMS, 150 E. BROAD ST., COLUMBUS, OH 43215
MAJORITY BUILDERS, 62900 U.S. 31, SOUTH BEND, IN 46614
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.)
To be submitted after notice to
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.
RIETH-RILEY CONSTRUCTION, PO BOX 1775, SOUTH BEND, IN 46634-ASPHALT / CONCRETE
STATE BARRICADING, PO BOX 3751, SOUTH BEND, IN 46619-TRAFFIC CONTROL
ELITE ELECTRICAL, 50654 TEALL RD. BRISTOL, IN 46507-ELECTRICAL
LANDMARK LANDSCAPING, 10882 MCKINLEY, OSCEOLA, IN 46561-LANDSCAPING
MARTELL ELECTRIC, 4601 CLEVELAND RD, SOUTH BEND, IN 46628-ELECTRICAL
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.
Slusser's, 125 montgomery, Logansport, IN 46947
Conco Spray Solutions, PO Box 36726, Indianapolis, IN 46236
State Barricading, PO Box 3751, South Bend, IN 46619 - Traffic Control
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.
All equipment necessary to diligently pursue this project.
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.
R'ben five prospective Contractor is unable to certify to any of the statements below, it shalt 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
(Nfust be completed for all quotes and bids. Please type or print)
STATE OF Indiana )
St. Joseph COUNTY SS:
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury
that:
I. 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:
Contractor, its successor or its affiliate, provides goods or services of twenty
million dollars (S20,000,000) 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.
Version 10/18/2016 Contractor's Bid for Public Works - 4
Contractor agrees that helshe.'it shall enroll in and verify die work 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/hearts subcontractors performing work under this public contract to
certify that the subcontractors do not knowingly employ or contract will) 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 ventures 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, terns,
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 die 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 arc 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") of 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 detennination, 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 illy statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I
hereby certify that I and all subcontractors employed by me for this project will use steel products or
foundry products made in tie United. States on this project if awarded. I understand I have an affirmative
duty to notify the City in my bid that my proposal does not include the use of steel products or foundry
products made in the United States. I understand it is my sole obligation and responsibility to provide a
justification to the City, subject to review and approval, why the cost of United States made steel or
foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel
products or foundry products made in the United States, the City, through its director of public works, shall
make a determination if the price of United States made steel or foundry is unreasonable. I understand that
violations hereunder may result in forfeiture of contractual payments.
kkY
Version 10/18/2016 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 8th day of Dec 20 16
Subscribed and sworn to before me this
My Commission Expires
May 9, 2024
John Boettcher Sewer & Excavating Contractor
Signal ce of Contractor,Bidder or Its Agent
Jo W. Boettcher, President
Printed Name and Title
8th day of December 20 16
Notary Public E�da A. Leo nard
County of Residence St. Joseph
ELICIA A. LEONARI)
�'• 'R ' Notar Public, State of Intllane
y
_* �—�tfz Commission k 684989
..... My Commission Expires
�roI„","�A May 09, 2024
Version 10/18/2016 Contractor's Bid for Public Works - 6
BID/PROPOSAL
CITY OF SOUTH BEND
Project Name Calvert Street Lift Station Replacement
Project No. 116-053
For Bids Due December 8, 2016
BASE BID
Item
No
Description
QUANTITY
UNIT
UNIT PRICE
TOTAL AMOUNT
1
Mobilization and Demobilization
1
LS
$19,245.00
$19,245.00
2
Maintaining Traffic
I
LS
$1,864.80
$1,864.80
3
Clearing Right of Way
1
LS
$13,205.00
$13,205.00
4
Construction Engineering
I
LS
$4,133.00
$4,133.00
5
ITemporary Erosion and Sediment Control
1
I LS
$4,750.001
$4,750.00
6
1 Maintain Flow
1
I LS
$20,927.001
$20,927.00
7
Dewatering
1
I LS
$98,920.001
$98,920.00
8
Curb and Gutter, Type'B'
20
1 LFT
$65.00
$1,300.00
9
Compacted Aggregate, No. 53, Base
120
TON
$25.00
$3,000.00
10
Concrete Pavement Patching
80
SYS
$94.36
$7,548.80
11
PCCP for Drive, 9"
280
SYS
$64.50
$18,060.00
12
1 Chain Link Fenc, PVC Coated, 6' Ht
296
LFT
$46.62
$13,799.52
13
Chain Link Swing Gate, 20' Opening, Double
Leaf
1
LS
$3,136.00
$3,136.00
14
Top Soil
320
CYS
$10.00
$3,200.00
15
Mulch Seeding
2800
SYS
$2.44
$6,832.00
16
Doghouse Manhole, 6' Dia.
2
EA
$7,700.00
$15,400.00
17
Manhole, Drop Type, 6' Dia.
1
EA
$12,941.87
$12,941.87
18
Manhole, 6' dia.
1
EA
$9,576.96
$9,576.96
19
Force Main, 8" Dia.
114
LFT
$191.461
$21,826.44
20
Sanitary Sewer, 24" Dia.
108
LFT
$179.451
$19,380.60
21
Sanitary Sewer, 30" Dia.
92
LFT
$199.77
$18,378.84
22
Lift Station
1
LS
$665,187.16
$665,187.16
23
Lift Station Electrical
1
LS
$41,440.00
$41,440.00
24
Lift Station Abandonment
1
LS
$28,095.20
$28,095.20
25
Sanitary Utility Signage
5
EA
$134.40
$672.00
BASE BID TOTAL $1,052,820.19
Contractor's Bid for Public Works - 7
Version 10/18/2106
Bidder (Firm): John Boettcher Sewer & Excavating Contractor
Address: 3305 N Home Street
City/State/Zip: Mishawaka, IN 46545 Telephone Number: (574) 259-1418
By 1 (Signature)
(Printed Name of Person Signing)
Version 10/18/2016 Contractor's Bid for Public Works - 8
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CITY OF SOUTH BEND oQ 4ovrlr q�ry
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY `
DEVELOPMENT PROGRAM 'z
FORM MWBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS ties
wn,pie.ea )orin snouio oe mcmoed 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: 116-053 Date: December 8, 2016
Project Name:
Bidder:
Contact Person:
Address:
City:
Calvert Street Lift Station Replacement
John Boettcher Sewer & Excavating Contractor
John Boettcher Telephone: 574-259-1418
N Home Street
Zip: 46545
Email: JohnW@JohnBoettcher.comcastbiz.net
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`:
Mishawaka State: IN
I I EVIDENCE OF GOOD FAITH EFFORTS
rern
WBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business
prise Diversity Development Program, which uses the IDOA approved list of Minority and Women
d Business as found on their website (hftp://www.in.gov/idoa).
N (ADVERTISE/CONTACT): In order for your bid to be deemed responsive, the City of South
requires that all perspective bidders complete no less than 2 of the following:
. Attend all pre -bid meetings scheduled by the City to inform MBE/WBEs of contracting and
subcontracting opportunities.
. Advertise in general circulation and/or trade association publications concerning
subcontracting opportunities, and allow MBENVBEs reasonable time to respond.
. Perform any and all necessary steps to provide written notice in a manner reasonably
calculated to inform MBE/WBEs of subcontracting opportunities and allowed sufficient time for
them to participate effectively.
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.
er must circle or otherwise notate which of the two (2) required actions were performed.
FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBENVBEs,
ng providing such MBE/WBE's with adequate information about the plans, specifications and
equirements of the subcontract and did not reject MBEfWBEs as unqualified without sound
ss reasons based on a thorough investigation of their caoabilitiaq.
r,1 d SMALL CONTRACT(S): The bidder selected specific Portions of the work to be performed by
J�V t MBE/WBEs in order to increase the likelihood of meeting the MSENVBE goals (including breaking down
contracts into smaller units to facilitate MBE/WBE participation)
CONTRACT RECORDS: The bidder has maintained the following records for each MBE/WBE 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 MSENVBE 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 10/18/2016 Contractor's Bid for Public Works - 10
CITY OF SOUTH BEND cttourxa�t
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM c
s
FORM MWBE-2.1 '2
MBE/WBE CONTACTED is's
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 1 OF 2
Project Number: 116-053 MBE/WBE Participation Goal 7.1 %
Project Name: Calvert Street Lift Station Replacement
Bidder: John Boettcher Sewer & Excavating Contractor
By: President
12/08/2016
(Signature)
(Title) (Dattee)
MBE/WBE Firm State Barricading, Inc.
Owner or Contact at MBEANBE Firm JameSMlchalski
Telephone: 574-287-2078 Fax 574-287-1744 Email: statebarricadel@aol.com
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Maintenance of traffic and utility signage
RESULTS OF CONTACT WITH THE MBE/WBE FIRM:
Received pricing and will use their services if we're the low bidder.
MBE/WBE Firm Premium Concrete
Owner or Contact at MBE/WBE Firm
Telephone:
Rob Becker
4-264-0196 Fax: 574-266-5392 Email: rbecker@premiumconcreteonline.com
TYPE OF WORK SOLICITED FOR THIS PROJECT: Concrete flat work.
RESULTS OF CONTACT WITH THE MBE/WBE FIRM: No bid received
Version 10/18/2016 Contractor's Bid for Public Works - 11
CITY OF SOUTH BEND O4 gOUTN q�i
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
s
FORM MWBE-2.1 '$
MBE/WBE CONTACTED IN65
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 2 OF 2
Project Number: 116-053 MBE/WBE Participation Goal 7.1 %
Project Name: Calvert Street Lift Station Replacement
Bidder: John Boettcher Sewer & Excavating Contractor
By: President
12/08/2016
(Signature)
(Title) (Date)
MBElWBE Firm SlusserS
Owner or Contact at MBE/WBE Firm John Williamson
Telephone: 574-722-3102 Fax: 574-722-2993 Email: jdw@slussers.com
TYPE OF WORK SOLICITED FOR THIS PROJECT:
mulched seeding
RESULTS OF CONTACT WITH THE MBE/WBE FIRM:
Received quote via fax. We will use their services if we're the low bidder.
MBE/WBE Firm Conco Spray Solutions
Owner or Contact at MBE/WBE Firm Jennifer Hoop
Telephone: 317-428-6543 Fax: 888-791-2220 Email: jhoop@concospray.com
TYPE OF WORK SOLICITED FOR THIS PROJECT: Coatings for exterior and interior of wetwelol and.
valve vault.
RESULTS OF CONTACT WITH THE MBE/WBE FIRM:
Received pricing and will use their services if we're the low bidder.
Version 10/18/2016 Contractor's Bid for Public Works - 11
Liberty
NjUiUdL The Ohio Casualty Insurance Company
SURETY BID OR PROPOSAL BOND
KNOW ALL MEN BY THESE PRESENTS, That we, John Boettcher Sewer & Excavating Contractor, LTD
of 3305 N. Home St, Mishawaka, IN 46545
(hereinafter called the Principal) as Principal, and The Ohio Casualty Insurance Company , with its principal
office in the City of Keene , New Hampshire (hereinafter called the Surety), as Surety, are held and
firmly bound unto City of South Bend, IN, Dept of Public Works
of 227 W. Jefferson St., South Bend, IN 46601
(hereinafter called the Obligee) in the penal sum of 5%
Dollars 5% lawful money of the United States, for the payment of which sum well and truly to be made,
we bind ourselves, our heirs, executors, administrators, successors, and assigns.
THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas, the Principal has submitted the accompanying
bid dated December 8, 2016 for Calvert Street Lift Station Replacement Project; Project No. 116-053
NOW, THEREFORE, if the Obligee shall make any award according to the terms of said bid and the Principal shall
enter into a contract with said Obligee in accordance with the terms of said bid and give bond for the faithful performance
thereof within the time specified; or if no time is specified within thirty days after the date of said award; or if the Principal
shall, in the case of failure so to do, indemnify the Obligee against any loss the Obligee may suffer directly arising by reason
of such failure, not exceeding the penalty of this bond, then this obligation shall be null and void: otherwise to remain in full
force and virtue.
Signed, sealed and dated: November 21, 2016
John Boettcher Sewer & Excavating Contractor, LTD,
(Principal) l//
:D—
By:
Jo oett her �
Th o Casualty Insurance Company
By:
Gregefry S. M ler I (Attorney -in -Fact)
S-137-Rev.
POWER OF ATTORNEY
The Ohio Casualty Insurance Company Bond Number:
Principal: John Boettcher Sewer & Excavating Contractor LTD
Agency Name: RICHARD S. MILLER & SONS, INC.
Obligee: City of South Bend, IN, Dept of Public Works Agent Code:133847
Know All Men by These Presents: That The Ohio Casualty Insurance Company, pursuant to the authority granted by Article IV, Section 12 of the Code of Regulations and
By -Laws of The Ohio Casualty Insurance Company, do hereby nominate, constitute and appoint: Gregory S. Miller, Christian L. Barnes of BREMEN, Indiana its true and lawful
agent(s) and attorney(ies)-m-fact, to make, execute, seal and deliver for and on its behalf as surety, and as its act and deed any and all BONDS, UNDERTAKINGS, and
RECOGNIZANCES, excluding, however, any bond(s) or undertaktng(s) guaranteeing the payment of notes and interest thereon.
And the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Company, as fully and amply, to all intents and purposes, as if
they had been duly executed and acknowledged by the regularly elected officers of said Company at their administrative offices in Keene, New Hampshire, in their own proper
persons. The authority granted hereunder supersedes any previous authority heretofore granted the above named attorney(res)-in-fact.
In WITNESS WHEREOF, the undersigned officer of the said The Ohio Casualty Insurance Company has hereunto subscribed his time and affixed the Corporate Seal of
said Company this 26th day of September, 2016.
s,SY [NSUp
a e°arogyrmWyc ��<y
� yr/4MP5°�S$
's'H1 FNd David M. Carey, Assistant Secretary
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY
On this 26th day of September, 2016 before the subscriber, a Notary Public of the State of Pennsylvania, in and for the County of Montgomery, duly commissioned and qualified,
came David M. Carey, Assistant Secretary of The Ohio Casualty Insurance Company, to me personally known to be the individual and officer described in, and who executed the
preceding instrument, and he acknowledged the execution of the same, and being by me duly sworn deposes and says that he is the officer of the Company aforesaid, and that the
seal affixed to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were duly affixed and subscribed to the said
instrument by the authority and direction of the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal at the City of King of Prussia, State of Pennsylvania, the day and year first above
written.
5y PA9T
oQ ,1 y
COMMONWEALTH OF PENNSYIVANIA
Notarial Seal
//iN�r�A�
OF
Teresa Pasteln'T",a. Notary Public
.�xx77
tipper Marian Twp., Mont9ameryCounty
My Commission Expires MarcM1 29, 2oi]
Mambec PenwylvaNeAaxotletlon M Notenea
Notary Public in and for County of Montgomery, State of Pennsylvania
My Commission expires March 28, 2017
This power of attorney is granted under and by authority of Article IV, Section 12 of the By -Laws of The Ohio Casualty Insurance Company, extracts from which read:
ARTICLE IV - Officers: Section 12. Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or President
may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all
undertakings, bond, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full
power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall
be as binding as if signed by the President and attested to by the Secretary.
Any power or authority granted to any representative or attorney -in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President
or by the officer or officers granting such power or authority.
This certificate and the above power of attorney may be signed by facsimile or mechanically reproduced signatures under and by authority of the following vote of the board of
directors of The Ohio Casualty Insurance Company effective on the 15th day of February, 2011:
VOTED that the facsimile or mechanically reproduced signature of any assistant secretary of the company, wherever appearing upon a certified copy of any power of attorney
issued by the company in connection with surety bonds, shall be valid and binding upon the company with the same force and effect as though manually affixed.
CERTIFICATE
I , the undersigned Assistant Secretary of The Ohio Casualty Insurance Company, do hereby certify that the foregoing power of attorney, the referenced By -Laws of the Company
and the above resolution of their Board of Directors are true and correct copies and are in full force and effect on this date.
IN WITNESS WHEREOF, I have hereunto set my hand and the seal of the Company this 21st
day of November 2016
o s1919m o
=0 �h'NAMP=aR
Dg
Renee C. Llewellyn, Assistant Secretary
1316 CouN Y-Cris BUILDCNO
227 W. JEFFERSaN BOULEVARD
SOIrrH BEND, INDIANA 46601-1830
Date.
To:
From
Subject
Project Name:.
Project No.;
P110m. 574I235-9251
FAX 574l235 -9171
"FDD 5741235-5567
CITY OF SOUTH BEND PE7'E BUITIGIEG, MAYOR.
BOARD Or PUBLIC WORKS
November 30, 2016
All Planholders
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received: %2- /-
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) 235-91.71
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
THIS ADDENDUM MAY AFFECT YOUR BID.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein,
Comp1
Authoi
Date:
ti 5OIL TH'&
1316 COUNTY -CITY BUILDING rlZ. PHONE 574'235-9251
227 W JEFFERSON BOULEVARD u �^ IV FAX 574 235-9171
SOUTH BEND, INCPNA 46601-1830 TDD 574/ 235-5567
1865
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
Date: November 16, 2016
To: All Planholders
From LindaM. Martin, Clerk, Board ofPublic Works
Subject Addendum Number: I
Project Name: Calvert Street Lift Station Replacement
Project No.: 116-053
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received: 1111611
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
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
THIS ADDENDUM MAY AFFECT YOUR BID.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become apart of herein.
Corrp1
Author
Date: