HomeMy WebLinkAboutQuote Opening - WWTP Bank Stabilization Phase 1 - Indiana Earth IncCITY OF SOUTH BEND, INDIANA
CONTRACTOR'S QUOTE FOR PUBLIC WORK
PROJECT NAME: Wastewater Treatment Plant Bank Stabilization Phase 1
PROJECT NO. n/a
QUOTES DUE April 11, 2017"
Date
Address:
City/State/Zip:
(Must be completed for all quotes. Please type or print)
V—/O- 12 Firm: J4'a4 � ECa e 7 �, "r ',IC
Agent of Bidder (if Applicable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
j� e1 public fworksproject of:
%
( /� 'tP a "l er 1I'e4
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
The City of South Bend, Department of Public Works & Cardno
and dated lai /d L ] for the sum of (enter the Total Quote as shown on the Proposal)
Ker5um"o Tota Total Quote �c„ .� $
n plus Alternates shown on Proposal) (Numerical)
If alternative quotes 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 quote is to be awarded on a unit basis, the
itemization of the units shall be shown on a separa+e ++..,.+,.,..,,,,+
By
ACCEPTANCE
The above quote is accepted this day of
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Elizabeth A. Maradik, Member
James A. Mueller, Member
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Suzanna M. Fritzberg, Member
Therese J. Dorau, Member
Attest: Linda M. Martin, Clerk
Page - 7 Public Works Quote
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 }
} SS:
S� 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
tine -to -time.
b. As provided by Ind. Code § 5-22-16.5-5, 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 han; 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 eligibility status of all of
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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 employce 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.
1, 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 (t.C. 5-16-
8-1). 1 hereby certify that I and al subcontractors employed by me for this project will use steel
products or foundry products made in the United States on this project if awarded. I understand I
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M,A-r
IM
1
PROJECT NAME
PROJECT NO.
QUOTES DUE
QUOTE/PROPOSAL
CITY OF SOUTH BEND
Wastewater Treatment Plant Bank Stabilization Phase 1
n/a
Arpil 11, 2017
Item No.
Description
Quantity
Unit
Unit Price
Total Amount
1
INWTP Bank Stabilization
1
LS
$ c?� —,Z?U
$ c % 70v
Total Amount of Quote
$
Firm:
Address: /v 3 Y
City/State/Zip: Cf�n-.....__,4`�� Telephone Number: 2 �.
Fax Number. G""y C. Cy
BY �KI44�ee �
(Signature)
Zq g- 6-S &C / GiIT�—
{Printed Name of Pers nSigning)
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