Loading...
HomeMy WebLinkAboutOpening of Bids - Ductile Iron Pipe, Gate Valves, & Fire Hydrants - HD Suuply Waterworks LTDCITY OF SOUTH BEND, INDIANA SELLER'S BID FOR SALE OR LEASE OF MATERIALS BID NAME D FOR BIDS DUE A le Iron Pipe, Gate Va 11, 2017 at 9:30 a.m. & Fire Hydrants IAW I it jf�'. f Gi Y Bidder Date:' ! 7 I (Firm): D Address: ©Y3 c J-, City/StatelZip:,1/�1�3'%Telephone Numher:i Agent of Bidder (if Applicable): When the prospective Contractor is unable to certify to any of the statements helaiv, it shall attach an explanation to this Affrdavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH 1[RAN, 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 ,-:77-I) SS: .,_ 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 `IiHi, 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:._w.ithout .any. agreement, understanding or combination with any other person in reference to :such bidding. Contractor hirther says that no person or persons, firms, or corporations has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 1 Contractor certifies by submission of this proposal that neither contract& nbr any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Fed"thl 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 aril ,hy agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-I633-�;'izs amended from time -to -time. ` ; � Vu r .13 61,0185 b. As provided by Ind. Code § 5-22-16.5-8, as amended from tinie-to-tithe, 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 afTiliate, is wfinancial institution that extends twenty million dollars ($20,000,000) or more in credit to another person f6r: 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/shc/it shall enroll in and verify' hd,.1work 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 maiota n this certification throughout the term of the contract with the City of South lapnq,and. understands that the City may terminate the contract for default if the Contractor fi.4 is to cure a breach of this provision no later than thirty (30) days after being notified ,by the City. A 6. Persons, partnerships, corporations, associations, or joint venturers awarded`'a contract by the City of South Bend through its. agencies, boards, or commissions shall riot 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, sexuaLpfientatign 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, eggi mcnt, 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 liy.,the State of Indiana as a Minority Business ("MBE") or as a Women's Busiticss 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 discrimi. pBgte against said WBE/MBE. A finding of a discriminatory practice by the City's .M: , E/UVI3E R 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 nondisQrimin4on commitment shall be made a part of any contract which it may henceforth ento rAo`w th 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 aiplicant'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. 1, the undersigned bidder or agent as contractor on a public works project, u6do"rstand my statutory obligations to the use of steel products or foundry products made in, Abe United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employpo';l Y„rpe p� this project will use steel products or foundry products made in the United Sfato, .PO tlf is 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 tp .prciyje,. a justification to the City, subject to review and approval, why the cost of United States nude steel or foundry products is unreasonable. Prior to award and upon submission of�l id 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, '..+ r, I hereby affirm under the penalties of perjury that the facts and information contained in the,�nrcgajc' bid for public works are true and correct. Dated this 2 day of ! , 20 / 7 Contractor/Bidder (Firm) tg afore C tractor/Bidder or Its Agent Printed Name and Title Subscribed and sworn to before one this `7` Ada of ./__ 20_.L_�7 My Commission Expires N-�e County of Residence ` FI BIDIPROPOSALtj CITY OF SOUTH BEND V % rrinK BID NAME Ductile Iron Pipe, Gate Valves, & Fire Hydrants FOR BIDS DUE April 11, 2017 at 9:30 a.m. Item No. Estimated Quantity Item Unit Price Total 1A 100 ft 4" x 18' ductile iron pipe f 9. /J $ 7/s-011) 1 B 2000 ft 6" x 18' ductile iron pipe C $ 1 C 2000 ft 8" x 18' ductile iron pipe y $ � ; 3a6: 4 . 1 D 2000 ft 10" x 18' ductile iron pipe I $ 1 E 2000 ft 12" x 18' ductile iron pipe - $ s 1 F 2000 ft 16" x 18' ductile iron pipe $ -7iD 1 G 200 ft 20" x 18' ductile iron pipe $ �� 3 K. 1 H 200 ft 24" x 18' ductile iron pipe $ � _Tb,OD 11 100 ft 30" x 18' ductile iron pipe $ 0 ,7/ aj 2A 10 4" open right, MJ valve yps. 6B $ os _, 213 50 6" open right, MJ valve c $ 2C 50 8" open right, MJ valve 0 $ T� ��� eb0 2D 10 10" open right, MJ valve -Z I $ Jot 373, a71 2 E 40 12" open right, MJ valve �S� 7.S.f°� $ ( 3 oi)6, Y&, 2F 50 5.25" SB fire hydrant, 5 ftsg6 i $ 2G 50 5.25" SB fire hydrant, 6 ft dZ $.�`P 2H 20 5.25" SB fire hydrant, 7 ft $ J� TOTAL $ 1o6 %:: o_kj.q. Bidder {Firm} Address: City/State/Zip: i Telep hone Number: FaxNumber: MZ) 5a2V> IV C5-/- Jc)1 rr ;T7/�/ Wj -15 Ver. 13 6/01/1 S BOARD OF PUBLIC WORKS Gary A. Gilot, President Suzanna M. F'ritzberg, Member James A. Mueller, Member f (Si nature) (Printed Name) (Title) Therese J. Dorau, Member _.____..__ Elizabeth A, Maradik, Member Attest, Linda M. Martin, Cleric Vei•. 13 --• 6/01/]5 j A*l u s�v d Fa�. is I�Fr I,- ' I w I A mapm j I- -Ammum 1Aa,I wr, a� : .� acnct"Mhad"12 ._.vim .., . - .. `; r�° WESTCHESTER FIRE INSURANCE COMPANY FINANCIAL STATEMENT DECEMBER 31, 2016 ADMITTED ASSETS BONDS $1,492,813,619 SHORT-TERM INVESTMENTS 34,890,369 STOCKS 450,903 REAL ESTATE 0 CASH ON HANG] AND IN SANK 19,880,440 PREMIUM IN COURSE OF COLLECTION* 69,254,246 INTEREST ACCRUED 14,505,011 OTHER ASSETS 132,649,982 TOTAL ASSETS $1,764,444,470 LIABILITIES RESERVE FOR UNEARNED PREMIUMS $200,260,562 RESERVE FOR LOSSES 851,003,190 RESERVE FOR TAXES 16,081,016 FUNDS HELD UNDER REINSURANCE TREATIES 6,666,051 OTHER LIABILITIES (11,412,992) TOTAL LIABILITIES ' 1,061,697,827 CAPITAL: 70,005 SHARES, $71.43 PAR VALUE 51000,100 CAPITAL: PAID IN 304,543,059 AGGREGATE WRITE-INS FOR SPECIAL SURPLUS FUNDS 113,661,643 SURPLUS (UNASSIGNED) 279,641,841 SURPLUS TO POLICYHOLDERS 702,846,643 TOTAL $1,764,444,470 (-EXCLUDES PREMIUM MORE THAN 90 RAYS DUE.) STATE OF PENNSYLVANIA COUNTY OF PHILADELPHIA' John Taylor, being duly sworn, says that he is Senior Vice President of Westchester Fire Insurance Company and that to the best of his knowledge and belief the foregoing Is a true and correct statement of the said Company's financial condition as of the 31 st day of December, 2016, Sworn before m this March 22, 2017 (J" "; � �X�' Se for Vice President Notary Public My co mission expires COMM Oi (WEALTH OF PENNSYLVANIA ' NOTARIAL, SEAL blane Wright, Nowy public City of Phiiadciphfa, Phl€adelphla County My COMMIsslon I xpires Aug, e,'2A19 �R�{, p E Nt YLVANIh ASSfiCiAT14N OF NOFA31�5