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Home My WebLink AboutQuote Opening - Main St. at Washington St. Roadside Improvements Proj No 116-001A - Walsh & Kelly, Inc.n V AA i "N IL.R i Av 5011 Z , When the prospective Contractor is unable to certify to any of the statements below, it shall attack 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, Josef 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 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 il. 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 eligibility status of all of Version 10/18/2016 Page - 24 Public Works Quote 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. 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 (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 Version 10/18/2016 Page - 26 Public Works Quote 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. 1 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 6th day of July 20 17 a ' •° C a .'• •,,...�t E.� Walsh & Kelly. Inc, Con tr Signature ntractor/Bidder or Its Agent Lynn Ba er, Operations Manager Printed Name and Title Subscribed and sworn to before me this 6th day of Jul , 0 17 My Commission Expires 6/5/22 —j4ja-" Notary Publr Alisha Krueger County of Residence St. Joseph ALISHA KRUEGER pY P oP &��' Notary Public, State of Indiana °z;SEALi"= St, Joseph County * •. =,r,ti..• �Q,�� My Commission E7fplf6$ June 06, 2022 Version 10/18/2016 Page - 26 Public Works Quote Item No. Description Quantity Unit Unit Price Total Amount 23 CLEARING RIGHT OF WAY 1 LS 6,775.00 $ 6,775.00 24 CONSTRUCTION 1 LS $ ENGINEERING 5,200.00 5,200.00 25 MOBILIZATION AND 1 LS $ DEMOBILIZATION 7,500.00 7,500.00 26 MAINTAINING TRAFFIC 1 LS 315.00 $ 315.00 Total Amount of Base Bid Division A $ 150,195.00 DIVISION B: Item No. Description Quantity Unit Unit Price Total Amount 27 SIDEWALK, CONCRETE, REMOVE 65 SYS 69.00 $ 4,485.00 28 SIDEWALK, CONCRETE, 5" 65 SYS 110.00 $ 7,150.00 29 COMMON EXCAVATION 20 CYS 335.00 $ 6,700,00 30 REMOVABLE FLOWABLE FILL 1 20 1 CYS 265.00 $ 5 ,300.00 Total Amount of Base Bid Division B $ 23 635.00 ALTERNATE 1: Item No. Description Quantity Unit Unit Price Total Amount BOLLARD, YELLOW POWDER 31 COATED 10 EACH 315.00 $ 3,150.00 Total Amount of Alternate 1 $ 3,150.001 ALTERNATE 2: Item No. Description Quantity Unit Unit Price Total Amount 32 BOLLARD, STAINLESS STEEL 10 EACH 315.00 $ 3,150.00 Total Amount of Alternate 2 $ 3,150,00 Firm: Walsh & Kelly, Inc. Address: 24358 SR 23 City/State/Zip: South Bend, IN 46614 Telephone Number: ( 574 ) 288-4811 F d1 •• • v ®j mCOQo"Te By �. A o e�areP8laidti°°° Version 10/18/2016 Page - 28 Public Works Quote Part of State Form52414 (R2 / 2-13) Form 96 (Revised 2013) Walsh & Kelly, Inc. (Contractor) 24358 SR 23 {Address} South Bend IN 46614 FOR PUBLIC WORKS PROJECTS OF The City of South Bend Indiana Department of Public Works Main Street at Washington Street Roadside Improvements Proiect No. 116-001-A Filed July 6th. 2017 Action taken State Form 52414 (R 19-10) Prescribed by State Board of Accounts Form No. 96 Revised 2013 CONTRACTOR'S BID FOR PUBLIC WORK — FORM 96 PART 1 (To be completed for all bids. Please type or print) Date (month, day, year): July 6, 2017 1. Governmental Unit (Owner): The City of South Bend, Indiana — Dept. of Public Works 2. County: 3. Bidder (Firm): Address: City/State: 4. Telephone Number: 5. Agent of Bidder (If applicable): St. Josebh Walsh & Kelly, Inc. 24358 SR 23 South Bend IN 46614 574-288-4811 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.. —...Dept, of Public Works (Governmental Unit) in accordance with plans and specifications prepared by Haas & Associates. LLC. dated May 2, 2017 for the sum of See Attached $ See Attached 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 Governmental Unit. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant may be regarded as a material breach of the contract. CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS (If applicable) I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation to use steel products made in the United States. I.C. 5-16-8-2. 1 hereby certify I and all subcontractors employed by me for this project will use U.S, steel products on this project if awarded. I understand that violations hereunder may result in forfeiture of contractual payments. 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: The City of South Bend, Indiana — Dept. of Public Works Bidder (Firm): Walsh & Kelly, Inc. Date(month, day, year): July 6, 2017 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 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 When Completed Name and Address of Owner $6,030,341 Resurface December 2015 Lake County Hwy Dept. $5,758,069 Resurface November 2015 Town of St. John $4,461,632 Reconstruction December 2015 INDOT $3,571,923 Reconstruction Jul 2015 INDOT 2. What public works projects are now in process of construction by your organization? Contract Amount Class of Work When to be Completed Name and Address of Owner $5,080,808 Reconstruction November 2017 City of South Bend, IN $5,938,220 Resurface October 2017 INDOT $5,775,000 Reconstruction November 2016 Town of Merrillville, IN $3,102,502 Reconstruction October 2016 INDOT 3. Have you ever failed to complete any work awarded to you? No If so, where and why? 3 4. List references from private firms for which you have performed work. Gatlin Plumbing & Heating,Inc. 1111 E. Main St., Griffith,.IN Ms. Clara Murphy Gough, Inc. 2200 E. 88t" Dr. Merrillville IN 46410 Mr. Raymond Gough D er Construction Co. 1716 Sheffield Avenue D er IN Janet Furman Grimmer Construction Co. Inc. 2619 Main Street Highland, IN Mr. Greg Grimmer SECTION lI PLAN AND EQUIPMENT QUESTIONNAIRE 1. 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 consider your bid.) As required by owner 2. 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. See Attached List 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. Will supply upon award of contract 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. QUANTITY ITEM DESCRIPTION, SIZE, CAPACITY, ETC. CONDITION YEARS OF SERVICE PRESENT LOCATION 5 Asphalt Plants Various Good Griffith, South Bend, Valparaiso, Lowell, LaPorte, 18 Asphalt Pavers Various Good Griffith, South Bend 4 Siipform Conc. Paver Comm II Good Griffith, South Bend 3 Road Widener Various Good Griffith, South Bend 5 Motor Graders CAT/J.D. Good Griffith, South Bend 48 Rollers Various Good Griffith, South Bend 31 Rubber Tire Loaders Various Good Griffith, South Bend 15 Excavators Various Good Griffith, South Bend 8 Bulldozers Various Good Griffith, South Bend 6 LowBoy Tractors Various Good Griffith, South Bend 7 Flatbed Dumps Various Good Griffith, South Bend 39 %z and 3/ ton Pickups Various Good Griffith, South Bend 59 1 Ton Crew Trucks Various Good Griffith, South Bend 3 Cold Planers Wirtgen 1900 DC Good Griffith, South Bend 3 Tri-Axle Dump Mack Good South Bend 5. 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, we received quotes from potential subcontractors and suppliers 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. The undersigned bidder or agent, being duly sworn on oath, says that he 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. He 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 SECTION V OATH AND AFFIRMATION I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION CONTAINED IN THE FOREGOING BID FOR PRBLIC WORKS ARE TRUE AND CORRECT. Dated at South Bend this 6`s / gay of me of Organization) KEL(y ®�® r .• B • ° �4ORAi n = .�® Dustin Hilary, Area Manager (Title of Person Signing) i •°�ND4P°°ACKNOWLEDGEMENT �',110111 � ti �� STATE OF Indiana ss COUNTY OF St. Joseph ) Before me, a Notary Public, personally appeared the above -named Dustin Hilary and swore that the statements contained in the foregoing document are true and correct. Subscribed and sworn to before me this 6tt' day of July, 2017. J) -if LA Alisha �_ A eger, Notary Public My Commission Expires: June 5, 2022 AL.iSHA KFiU7GER County of Residence: St. Joseph .��gP�Y•AUs'-r Notary Dubuc, State of Indiana Z. r;So.. 'L'O° EA hCountY St,Josap ~'%'NniA�P�� My Commission Expires Juna06.2022 �� °� r �� Si�'4G, }3.�. d. Ik y��__'p � '�v� ^�. w �'�✓:��' i..�^�g�'��4'�. aft fii� 'ib'�..3' g.�Taw�effirN `nAl [fin ,:TA.I �L a R �' �€ e„„',;c�a •�-' xa r-*� -q�w rrx +kxv— �-•i-^t-e� t '�„ r6 a� � r may,_ — rr•:r- s 3 W, �� r�4 r GJ` e � �£-�i� t�a-�-a".f�e _ #.�6 � R1 �k� eh .$��.s.'&� i��4-�''�S�6J �.c^rc^w'� �i��i 5 y)�ESY4 4-. Y't�t ;3ag e �,�^�a c�a,"u -... fr':?�,�,•�S �,i`��'�f-..z4 n':iyi��r �� a� �h ��.�».#.-_ �c�' �s�re �'"��7,� � — _ lots ,t -- ' n � ., � 'fi t — " a » _ �' ''` � q _ `' .ram. s �.�;� � General Form No. 96-a Prescribed by the State Board of Accounts of Indiana. Revised 1949, Standard Questionnaires and Financial Statement for Bidders Prescribed by THE STATE BOARD OF ACCOUNTS OF INDIANA For use in investigating and determining the qualifications of bidders on public construction when the aggregate cost of any such work or improvement will be Five Thousand Dollars or more. These statements to be submitted under oath by each bidder with and as a part of his bid, as provided by Chapter 306, page 1248, Acts of 1947 Submitted to The City of South Bend, Indiana — Dept. of Public Works By Walsh & Kell Inc. Address 24358 SR 23 South Bend IN 46614 Date submitted July 6"', 2017 Filed A,E, BOYCE CO„ MUNCCE, IND, fA Corporation 1 Sec. 2 of an Act entitled "AN ACT concerning the awarding of contracts for the performance of public work and authorizing the board of accounts to prescribe certain forms to be used in ascertaining the responsibility of contractors who submit bids for the performance of such work, providing for plans and specifications, providing for bids repealing certain laws and declaring an emergency." (Approved March 13, 1947.) Sec. 2. Whenever the aggregate costs of any work or improvement will be five thousand dollars ($5,000.00) or more, for the purpose of enabling such board, commission, trustee, officer or agent to ascertain and determine which of the bidders submitting bids for the performance of any such public work is, in the judgment of such board, commission, trustee, officer or agent, the lowest and/or best bidder and to exercise intelligently the discretion hereby conferred on such board, commission, trustee, officer or agent each bidder shall be required to submit under oath with and as a part of his bid a statement of his experience, his proposed plan for performing such work and the equipment which he has available for the performance of such work and a financial statement. The statements hereby required shall be submitted on forms which shall be prescribed by the state board of accounts. The forms so prescribed shall be designated, respectively, as the experience questionnaire, the plan and equipment questionnaire and the contractor's financial statement, and shall be based, so far as applicable, on the standard questionnaires and financial statement for bidders as approved and recommended by the joint conference on construction practices, for use in investigating the qualifications of bidders on public construction work, and the fonns so prescribed are hereby prescribed as the forms which shall hereafter be used by all such boards, commissions, trustees, officers and agents in obtaining the information which is required in the administration of this act. If the information submitted by any bidder on the forms herein prescribed is found, on examination, to be unsatisfactory, the bid submitted by such bidder shall not be considered. (Burns Statutes 1933, Sec. 53-109) Sec, 2, Chapter 306, Acts of 1947. ICOIN Y.10131130DIt+r"""! The following forms of questionnaires and financial statement are prescribed by the State Board of Accounts in conformity with the statute set out on the preceding page. These forms, properly filled out and attested, must accompany each bid of five thousand dollars or more on any public work. The forms are designed to cover all contracts for all kinds of work and the bidder is required to answer such questions as are pertinent to the work upon which he is bidding. The purpose of the questionnaire and financial statement, as set forth in the law, is to enable the awarding body to determine the qualifications of the bidder to carry out successfully the contract if the same is awarded to him. The bidder will find it to his advantage to answer fully all questions coming within the range of the work upon which he is bidding. Particular attention should be given the "Financial Statement" and the details relative to the assets and liabilities set out. This form is made in extensive detail so that the bidder may explain his assets and liabilities in proper sequence and in a uniform manner. T. M. HINDMAN, State Examiner 3 Submitted by Walsh & Kelly, Inc. { x A Corporation Principal Office at 1700 East Main Street Griffith IN 46319 To The City of South Bend, Indiana . Dept_ of Public Works EXPERIENCE QUESTIONNAIRE The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatories hereinafter made. 1. How many years has your organization been in business as a general contractor under your present business name? 60 Years 2. How many years of experience in asphalt paving_ construction work has your organization had: (a) As a general contractor 70 years (b) As a sub -contractor 70 Years 3. What projects has your organization completed? Contract Amount Class of Work When Completed Name and Address of Owner $ 6,030,341 Resurface December 2015 Lake County Hwy Dept. $ 5,758,069 Resurface November 2015 Town of St. John, IN $ 4,461,632 Reconstruction December 2015 INDOT $ 3,571,923 Reconstruction July 2015 INDOT 3-A. What projects has your organization now in process of construction? CONTRACT AMT. CLASS OF WORK. WHEN TO BE COMPLETED NAME AND ADDRESS OF OWNER $ 5,080,808 Reconstruction November 2017 City of South Bend, IN $ 5,938,220 Resurface October 2017 INDOT $ 5,775,000 Reconstruction November 2016 Town of Merrillville, IN $ 3,102,502 Reconstruction October 2016 INDOT 4. Have you ever failed to complete any work awarded to you? No If so, where and why? 5. Has any officer or partner of your organization ever been an officer or partner of some other organization that failed to complete a construction contract? No If so, state name of individual, other organization and reason therefore 6. Has any officer or partner of your organization ever failed to complete a construction contract handled in his own name? No If so, state name of individual, name of owner and reason therefor 7. In what other lines of business are you financially interested? None 8. For what corporation or individuals have you performed work, and to whom do you refer?_ BP Amoco, Whiting, Indiana Tonn & Blank Construction 1623 Greenwood Ave. Michi an Qity, IN 46360 Grimmer Construction Co. Inc. 2619 Main Street Highland, IN 46322 University of Notre Dame, South Bend, Indiana Gough, Inc. 1151 E. Summit Crown Point IN 46307 9. For what cities have you performed work and to whom do you refer? Town of Griffith Director of Public Works Griffith IN Town of Schererville Town Manager Schererville IN City of Hammond City Engineer Hammond, IN City of South Bend City Engineer South Bend IN Town of St. John Town Manager St. John, IN 10. For what counties have you performed work and to whom do you refer? Lake County Highway Superintendent Crown Point, IN Porter County Highway Superintendent Valparaiso, IN St. Joseph County Highway Superintendent South Bend, IN Elkhart County Highway Superintendent ElkhartIN 11. For what State bureaus or departments have you performed work and to whom do you refer? Indiana Department of Transportation (INDOD LaPorte District Laporte IN Department of Natural Resources Indianapolis, IN 12. Have you ever performed any work for the U.S. Government Yes If so, when and to whom do you refer? U.S. Army Corps of Engineers Chicago, IL Indiana National Guard Dept. of Administration Indiana olis IN Federal Highway Administration Sterling, VA 13. What is the construction experience of the mincinal individual of vour oraanization? INDIVIDUAL'S NAME PRESENT POSITION OR OFFICE. YEARS OF CONSTUCT lON EXPEREIN CE MAGNITUDE AND TYPE OF WORK IN WHAT CAPACITY Kevin J. Kelly President 32 All Types General Manager Jeffrey L, Swan Executive Vice President 33 All Types Supt. Engineering David Misirly Vice President 30 Bituminous Paving Engineer Greg Hoffman Vice President 30 Bituminous Paving Engineer Lynn Bauer South Bend O s Mgr 22 All types Engineer Dustin Hilary South Bend Area Mgr 16 All types Engineer Mark Krachenfels Engineer 27 Bituminous Paving_Engineer Douglas Kesler Engineer 42 Bituminous Paving Engineer PLAN AND EQUIPMENT QUESTIONNAIRE The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatories hereinafter made. 1. In what manner have you inspected this proposed work? Explain in detail. Plans, Specifications, and Site Inspections_ _ 2. Explain your plan or layout for performing the proposed work As directed by owner/engineer 3. The work, if awarded to you, will have the personal supervision of whom? Kevin J. Kelly,Jeffrey L. Swan David Misirly, Greg Hoffman Dustin HilaKy, and Lynn Bauer 4. *Do you intend to do the hauling on the proposed work with your own forces? Yes If so, give amount and type of equipment to be used As needed 5. *If you intend to sublet the hauling or perform it through an agent, state amount of sub -contract or agent's contract, and if known, the name and address of sub -contractor or agent, amount and type of his equipment and financial responsibility Items 4,5,6 and 7 may not be applicable in all building contracts; if not, omit. 6. *Do you intend to do the grading on the proposed work with your own forces? If so, give type of equipment to be used 7. *If you intend to sublet the grading or perform it through an agent, state amount of sub -contract or agent's contract, and, if known, the name and address of sub -contractor or agent, amount and type of his equipment and financial responsibility 8. Do you intend to sublet any other portions of the work? If so, state amount of sub -contract, and, if known, the name and address of the sub -contractor, amount, and type of this equipment and financial responsibility 9. From which sub -contractors or agents do you expect to require a bond? None 10. What equipment do you own that is available for the proposed work? QUANTITY ITEM DESCRIPTION, SITE, CAPACITY, ETC. CONDITION YEARS OF SERVICE PRESENT LOCATION 5 Asphalt Plants Various Good Griffith, South Bend, Valparaiso, Lowell, LaPorte 18 Asphalt Pavers Various Good Griffith, South Bend 4 Sli form Cone, Paver Various Good Griffith, South Bend 3 Road Widener Various Good Griffith, South Bend 5 Motor Graders CAT/J.D. Good Griffith, South Bend 48 Rollers Various Good Griffith, South Bend 31 Rubber Tire Loaders Various Good Griffith, South Bend 15 Excavators Various Good Griffith, South Bend 8 Bulldozers Various Good Griffith, South Bend 6 LowBoy Tractors Various Good Griffith, South Bend 7 Flatbed Dumps Various Good Griffith, South Bend 39 Viand % ton Pickups Various Good Griffith, South Bend 59 1 Ton Crew Trucks Various Good Griffith, South Bend 3 Cold Planers Wirtgen 1900 DC Good Griffith, South Bend 3 Tri-Axle Dump Mack Good South Bend 7 11. What equipment do you intend to purchase for use on the proposed work, should the contract be awarded to you? QUANTITY ITEM DESCRIPTION, SIZE, CAPACITY, ETC, I APPROXIMATE COST None 12. How and when will you pay for the equipment to be purchased? NIA 13, Do you propose to rent any equipment for this work?No If so, state type, quantity and reasons for renting 14. Have you made contracts or received firm offers for all materials within prices used in preparing your proposal? Do not give names of dealers or manufacturers Dated at South Bend this 6"' day of LY,a��C®®®�� Walsh kK Inc. ® s (Name o r nizatio kl E +� B c Y' ustin Hilam Area r ..... ° e �®®� (Ti le of Person Signing) STATE OF Indiana ei� ta�eer SS. COUNTY OF St. Josh Dustin Hilary being duly sworn deposes and says that he is Area Manager_ of the above Walsh & Kelly, Inc... (Name of Organization.) and that the answers to the questions in the foregoing questionnaires and all statements therein contained are true and correct. Subscribed and sworn to before me this 6"' day of j4dy. 2017 1 4A4 �_&4x_e Aiisha Kruege , otary Public My Commission expires June S, 2022 Y'p� ALiSHA KRUEGER m f, Notary public. state of Indiana -ztSEAL � St.JosaphCounty My commission Expires June 05, 2022