HomeMy WebLinkAboutOpening of Bids - Berlin Place #2 Plumbing - Hermann & Goetz, Inc.:3
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PART 11
(Complete sections 1, 11, and III for all state and local public works projects)
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?
Contract
Amount
Class of
Work
When
Completed
Name and Address of
Owner
$2,781,321.
Mechanical.
2/2016
Buchanan Schools --Middle School
$ 689,037.
Electrical
4/2016
Elkhart CSO 6 & 7
384,000
Mechanical
2 2015
Rochester Community Schools
2. What public works projects has your organization now in process of construction:
Contract
Amount
Class of
Work
When
Completed
Name and Address of
Owner
0.418.454.
Electrical
4 2017
E. Pulaski School Corp-H.S.
$ 834,301.60
Electrical
9/2017
Niles Community Schools -Ring Lard
4 627 066.
M&chanical
12/2017
Rochester Community Schools-H.S.
a
4.
Have you ever failed to complete any work awarded to you?
why?
no If so, where and
List references frorn private firms for which you have performed work.
Memo.r.ia.l.. Hospital of South Bend . Honeywell
St. Joseph Regional Med Ctr. Mish & Plymouth Bethel College
Utilimaster Uniifax
er
TSC 215161 Bid Form Section 00 3100-7
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
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 4/17/2015 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:
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.
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 ($20,000,000) or more in value in the energy sector of Iran;
or
ii. Contractor, its successor or its affiliate, is a financial institution that extends
twenty million dollars ($20,000,000) or more in credit to another person for
forty-five (45) days or more, if that person will (i) use the credit to provides
goods and services in the energy sector in Iran; and (ii) at the time the
financial institution extends credit, is a person identified on Iist 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 4/17/2015 Contractor's Bid for Public Works - 4
Contractor agrees that he/she/it shall enroll in and verify the 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/her/its subcontractors performing work under this public contract to
certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien,
and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees
to maintain this certification throughout the term of the contract with the City of South Bend, and understands
that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision
no later than thirty (30) days after being notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City
of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or
applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions,
or privileges of employment, or any matter directly or indirectly related to employment because of race, sex,
religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or
disability that does not affect that person's ability to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any
combination of the foregoing including, but not limited to, public works contracts awarded under public
bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards,
or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors
certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise
("WBE") as a factor in determining the lowest, responsible, responsive bidder.
In no event shall persons or entities seeking the award of a City contract be required to award a subcontract
to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a
discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from
being awarded a City contract for a period of one (1) year from the date of such determination, and such
determination may also be grounds for terminating the contact for which the discriminatory practice or
noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made
a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its
agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the
performance of this contract with privileges of employment, or any matter directly or indirectly related to
employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation,
handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of
contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1).1 hereby
certify that I and all subcontractors employed by me for this project will use steel products or foundry
products made in the 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.
Version 4/17/2015 Contractor's Bid for Public Works - 5
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid
for public works are true and correct.
Dated this 4th day of May , 20 17
Subscribed and sworn to before me this 4th
My Commission Expires 7 / 13 /2022
County of Residence
Herrman & Goetz,Inc.
Contractor/Bidder (Firm)
b
Signature Contra r/Bidder or Its Agent
Thomas J. Herrman, President
Printed Name and Title
day of May , 20 17
Notary Public
St. Joseph
Version 4/17/2015 Contractor's Bid for Public Works - 6
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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 (wane, 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.
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.
I 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.
AL -----
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. Gr ber
Notary Public
Residing in St. Joseph County, State of IN
My Commission'Expires 7/13/2022
C� kV1 &VOIN "'
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, Indiana; Board of Public Wrks
County -City Building, Room 1316, 227 W Jefferson Blvd.
South Bend, IN 46601
Bond No. Bid Bond
SURETY: Continental Casualty Company : IL Corporation
(Name, legal status and principal place
of business)
333 S. Wabash Avenue
41 st Floor
Chicago, IL 60604
BOND AMOUNT: 5% Five Percent of Amount Bid
PROJECT:
(Name, location or address, and Project number, if any)
Berlin Place BP##2 Plumbing
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, Owner or
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 4th day of May 2017
J Herrman & oetz, Inc.
a C`� 6
(Witness)
C:
(Witness)
ct3�iti�'41�AY� ('Lade
o Conti
House
Com
, Attorney -in -Fact
(Seal)
(Seal)
Printed in cooperation with the Amedcan Institute of Architects (AIA).
The language in this document conforms to the language used In AIA Document A310 - Bld Bond - 2010 Edition,
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
Know 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 Attorney -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
- In Unlimited Amounts -
SuretyBondNo.: Bid Bond
Principal: Herrman & Goetz, Inc.
Obligee: City of South Bend, Indiana; Board of Public W orks
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 Vica President and their corporate seals to be hereto
affixed on this Sth day of April, 20I7.
A5U.�r� Q� �tt5it C pANroe
eogpwa�r� �i ; �a'� .NcoaeoRprfi
SEAL { JUue I 02 E'
i897 HART"" r
Continental Casualty Company
National Fire Insurance Company of Hartford
American Ca alty Company of Re ding, Pennsylvania
Paul T. Bruflat Wee President
State of South Dakota, County of Minnehaha, ss:
On this Sth day of April, 2017, before me personally came Paul T. Bruflat to me known, who, being by me duly sworn, 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.
Lp
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IIOTARYM8110
SO MOAwTA 4
My Commission Expires June 23, 2021 J. Mohr Notary Public
CERTIFICATE
I, D. Johnson, 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 I have hereunto subscribed my name and affixed the seal of the said
insurance companies this 4th day of May , 2017.
GASt�tKSURpNro,*
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001WORAtt, 0 *09r0R4P*,
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SEAL 'r °� ~7t 10z rs
?897 NARY"' •
Form F6853-412012
Continental Casualty Company
National Fire Insurance Company of Hartford
American Casualty Company of Reading, Pennsylvania
.(-0. apvv��
D. Johnson► Assistant Secretary
Authorizing By -Laws and Resolutions
ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY:
This ower 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 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. Bruflat, 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 251s 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 any 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. Bruflat, 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 251 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 any 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 Attorney is signed by Paul T. Bruflat, 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 any Authorized Officer
shall be valid and binding on the Company. "