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Home My WebLink AboutAward Bid - Janitorial-Cleaning Supplies 2017 Spec S - VariousBidder Line Items Awarded Sanco Distributing Sec 1— Chemicals - Line Item 29 & 30 SB Chemical Sec 1— Chemicals - Line Item 27 Sec 2 - Supplies — Line Item 36, 69, & 71 Sec 3 - Paper Products — Line Item 74 KSS Enterprises Sec I— Chemicals - Line Item 15 & 25 Sec 2 - Supplies — Line Item 38, 44, 45, & 68 Acuity Special ty Sec 2 - Supplies - Line Item 33 d/b/a Zep Sales Central Poly Corp Sec 4 —Poly Trash Bags — Line Item 84 Interboro Packaging Sec 2 - Supplies - Line Item 50, 51, 52, & 53 Sec 4 —Poly Trash Bags — Line Item 86 Unipak Corp Sec 4 — Poly Trash Bags — Line Item 81 All American Poly Sec 4 —Poly Trash Bags — Line Item 79, 80, 82 & 85 Reit Price Company No sections awarded If you have any questions or concerns regarding this matter please don't hesitate to call. Sincerely, Toni Laisure, Superintendent V Central Services Division 0 av �o n ni w a b a 'C q W U rYi 00 O 'h O 00 N N M N O h• N nl i0 M G� O O CI 00 00 N `O O 00 7� 'O '/i F W � �O CL M '/! O T 7 a ,� N b m w � �O CI b 0 �� t: O N N aC r• N� � l4 O� a� ^+ N r- [� •O � O T N O h 00 M i` O V1 � O O ill e o .. o E M '�l -t c. W J' ooh --rl `Y �o — oc p Nr T `T oo rl�m noN�m b T rt F ao oa � -z -• G1 s�ry �rl J h ew'n —rn O G1 �a c. a � v W 'c v uv�f yay R v rC e0 yy R vv�i td t0 .� R NN FN td a' V U U V U U U V 0. V U U V U U U 0. U U U U U a w ri r M = � U � N tD .tea P C W •N U O 'a vl •9v _ a It V [7 b G a m � •� � '� d u�� r RCA mo WC7 C7 ',xa¢',z v�, N �'�•fi c'c ti E 2� U 2 w 0 0 0 O ZO. m VUUUUUU UUUU W C O ii O O O .0 m U VD rir 000 O inn O m nU O vzi CO n�. U �C C7 V V vrggV O R: 6U. U :L rn z m�N'nbnooa HM NNNNNn rn C U O S+1 ,y F •-r c o-rr=m O D N -r h n r� rio h V' v, c, �n--� �I O — nKri�ao +D n� I, ' N c F V5 .o n oa--�ri •� �i h � '/1 o x c' o a. E 5 � v L J H� U N <C rC N iO iV �y N itl N �q �q 211 W LU (13 Lf! ✓ai N R w V N U V tC Ll1 V m m W U U U U U U U U U U U U U V U U V V . a M . a a . td U a . . u U a a . . . . a U W N ai a . v a a J z ti vvss N u `a w' 44?? V 'LS a y u [S 'UW � u� L ['Oi tS u tsi U u s L LL�qq U U Y El V N G v V L N v a�i L a N GO �f U M � U n L L n F y ry x. E � � ❑ 0 � 3 � e G � � 3 � � � a — $ A Q o 0 G F z x z U h �� N O 1c I V] r •dc• u Mvi mr ^ c� Maaa�•a�v��,�b:�b�� o N m �o 0o c� •rr h �o rn o r] b h Ly fi W E Lrr] E w" Jq E ci w W S E s� 0 W W �� M1 O_ fl to ii O Ti W Q 7 u m E w '� �. 3 Q 0 r�. U �C� F Q KS .� O .� �--, a a ML CITY OF SOUTH BEND, INDIANA SELLER'S BID FOR SALE OR LEASE OF MATERIALS AND NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND NON-DISCRIMINATION COMMITMENT FOR SELLERS BID NAME Spec S — Janitorial -.Cleaning Supplies 2017 FOR BIDS DUE June 27, 2017, 9:30 a.m., local time Bidder Date: June 13, 2017 (Firm): HP Products Corporation Address: 4220 Saguaro Trail City/State/Zip: Indianapolis, IN 46268 Telephone Number: (800 ) 457-0916 ext 1369 Agent of Bidder (if Applicable): Michelle Bates, Bids Coordinator When the prospective Contractor is unable to certify to any of the statements belo)v, 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: Indianapolis Marion 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 farm, 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. 4 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 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. 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 MBEIWBE; however, it may not unlawfully discriminate against said WBEIMBE. A finding of a discriminatory practice by the City's MBEIWBE 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). I 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. R 1, , V. 9 I tt tas BID/PROPOSAL CITY OF SOUTH BEND BID NAME Spec S — Janitorial -Cleaning Supplies 2017 FOR BIDS DUE June 27, 2017, 9:30 a.m., local time 10 -ism -Apm.. NEW-5-:- . ... -.- .. .. 0 MIA 11530,11 0 r� Jim ■ . ��`� e '" ,:q ..,f i.LL 1'�4- mt 0 17 w- .>ii', ia6"; �'1 ■ "$��-s._ h.,? lf�.-i.��,.A.'..e re.�-.`: 'f.:.aA �aa { »'. 5€, .�:,. __ �.`,, — 7■T�■''—� __— -— L _ — _ #'-£ .7a�_�3 �_F {��. §'s—: � s . �. �i ]`? i^:.��" ,. '! �>.a.�x:°.,E I �V,p� x.. ��d•.:s,� __ ■ — -- — � � ^�. _.� _ 1 i��{ ��gEu��r��ff � � ,� ■ } f f.Ei ��'k�..�_�i.8 •�{a,��i __-_ .. �-.as-�:v4� gz ., ''ja� i� .'fin � .r •• w..� g { r,. M x 1 } I'� rr� F,i. � if:l �F 4— 7 ■ — � L � u �� —y — �1r r m i'il ,. i%S n ¢9 � M, _R !^` �)< "0. 1�' 1 r ila� S.. u,`S�i��? � (x �k�`: € ��>� ��r i��`;d ,�'�l ,* i I� .. 1,.�... ��` � ,a �' 1 �� p��:4! � ,��`� �-•- I,�' � EL mol— — — r— ■ — ■ n y @' ., ' P Y a�� . �� e•�:r�sL �R��$ee, �;sik�� a�iy�s -7�,s ra�Yt �� x 3 a9 �i," ��;. N � �_�# 5 N3 Pil� �.1rx [F' 1 1&Ar %54^S,l f�1 ■ 7 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 ($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 (h) 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 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 5 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. 5-16-5-1). I 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. 31 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 day of u , 20LT �C&X' n (' 'n mgzy c L� U11� Con actor/Bidden birm) S Signa re of Contr for/Bidder• or Its Agent Printed Name and Title Subscribed and sworn to before me this day ofJ"-) , i}= My Commission Expires 11 wo 2 County of Residence DIANE M GONZALES `��`AtrEr►4p ♦ 5�.... OF �i �.�Notary Public. State of Indiana La Porte County SFA�,� Commission M 669310 �� My Commission Expires June 17, 2023 No l�u-4blic ]k� CUM . � � \ j | � . � Bidder {Firm}: Address: City/State/Zip: Telephone Number: �0 M 0 �,A f �c. I k) LAo350 BOARD OF PUBLIC,WORKS ."*2n k6jtk' Gary A. Gilot, President Suzanna M. Fritzberg, Member Ja4 A. Mueller, Member lal, k. Elizabeth A. Maradik, Member T er se J. Do u, 416mber 1 + est: Linda M. Mah in, Cleo 14 �� .. �■00�■ '� �-..'Y�'- __l � '".�.' tom; .... __... CITY OF SOUTH BEND INDIANA SELLER'S BID FOR SALE OR LEASE OF MATERIALS AND NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND NON-DISCRIMINATION COMMITMENT FOR SELLERS BID NAME Spec S - Janitorial -Cleaning Supplies 2017 FOR BIDS DUE June 27. 2017. 9:30 a.m.. local time Date: Address: City/State/Zip 06-26-17 Bidder (Firm): 919 N. OLIVE ST. SANCO DISTRIBUTING INC. south �Rgg IN 46�Agphone Number: ( 574) 282-981 0 Agent of Bidder (if Applicable): When the prospective Contractor is unable to cerfrft to any of the statements heloiv, 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 (Must be completed for all quotes and bids. Please type or print) STATE OF ST • INDIANA ) ST. JOSEPH ) SS: COUNTY } The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: l . 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 Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. 4 I hereby affirm under the penalties of pei jury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 0 6— 2 6 day of 26 2017 RACHEL LOVE Notary Public State of Indiana My Commission Expires May 16, 2025 SANCO DISTRIBUTING INC. Co ctor/Bi er (Fire Sifatu e of Contr ctor i er or Its Agent JOHN SANDERS Printed Name and Title 26TH Subscribed and sworn to before me this JUNE da UNE 1 7 My Commission Expires Mow 1 0 1 20Z /1050-21im0- County of Residence Yost Ph I , I � � ItIll "fill V� i zi N �'� u, A A A A 41 .p A A A -P 0 Ln n A iJ IJ .fa IJ N IJ .A rb ' �•. v, v, >u b v b �v p v a � � o° � S � x C� o n G� o s:� t7 a � t�, a �, t� r,� ar to � m rp 0 m 0 ao 3 � r� �'' o a ¢ P a o o y H m m m n n o 0 0 c: 0 W v P- P. G-i Cv" G"i' ' ,roi 'd = m c�°i o co O O O O O O R R R w w W tJ W A A o O R A A Nq° UN .AN77 x' G. R 0. no a ❑ C7 so n rn no _ cxa m Q m R n td - A s a .� m' pr 10 CLO ro yflp�. m �-: W o" S CL ^mil: [p} � [J ro Vi V, In Vi Ut Vi fo � ro ro R Pi.' Pn' Pn' �' �,' Pn' � � �n'T .n^. .n^T �.. � :r Ys .- ,�' C o' :s' Cr n' � � — n• � � � � [9 m N n h k n N N n n n n n n �, '�' � x x ]z X � .^ R � R ;s 5 � G• a' � .n^s' j' �' �' v' 'ns P. w W O 6� IJ N N N A W N •--• V� In w '-- w .-. O y,. O N O ^-. O '-. T Crynry w O�y� ^. N O7 N A N N J+ W 0 IO7 �xW7 �Qyl �N�y �Qy� IOy �Qs7� IOy IVy7� ?� ?� ��7 W [O'� W [Q�ry\ W C�' �Wn W �T} Idy7+ I-yO� n n n n n n n C n 0 p. o. n 0 n P G p� 4 O P. v tis a U C Q3 C U � U _U _U '.. • • p CD U U { U a a C}] a • !• Pf m Lo tj w 06 OD LO d' d� t e} o U a U • • o U • T I• rF r (N i t) °" V U G U �" V U Q 0 cj Q U. ul I I y m o — C V N ca N ca w o o n a a o a o a o W W W Y K ai ai v�i W v vUi U� U Ar _ O .❑ O�V '', W Q N 4 O N fl O. C,J U C} U �d C,J N CJ cV U rd C 1 v � � p u y `� a U U w 0 `� zi U fR a E•: 44 "`, c CL10 O M r C7 N V L7 O. O F -0 N 49 Q oR Q v) voU�a F F21 91 9F°9 � ;� ;�avSaa v y Zia u V J 13 Bidder (Firm): Address: City/State/Zip: SANCO DISTRIBUTING INC. 919 N. OLIVE ST. SOUTH BEND IN 46628 Telephone Number: 574-282-281 0 Fax Number: NIA By JO N SANDER SSig afure) BOARD OF PUBLIC WORKS 6/Mbk Gary A. Gilot, President Suzanna M. Pritzberg, Member yI Jamg A. Mueller, Member (Printed Name) PRESIDENT (Title) -PE7jj , j. uAc Elizabet A. Maradik, Member Ther e J. Dor u, ember 4t' �- Att st: Linda M. Mart'n, Clerl 14 CITY OF SOUTH BEND INDIANA SELLER'S BID FOR SALE OR LEASE OF MATERIALS AND NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND NON-DISCRIMINATION COMMITMENT FOR SELLERS BID NAME Spec S -- Janitorial -Cleaning Supplies 2017 FOR BIDS DUE June 27, 2017.9:30 a.m., local time Date: Address: Bidder / r 7 (Firm): Sc�k� j� {-�� City/State/Zip: Telephone Number: Agent of Bidder (if Applicable): , cr t t . 4 When the prospective Contractor is unable to certify to any of'the statements below, it shall attach an explanation to this Affrdayit. 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 (Most be completed for all quotes and bids. Please type or print) STATE OF''� ) _ ) SS: 51, gi COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of petjury 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, firths, 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. 4 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 tune -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 ii. Contractor, its successor or its affiliate, is a financial institution thatextends 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 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 tern 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 persons 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 E 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 frotxr 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 ernployrnent 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). I 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 unreasonablc. I understand that violations hereunder- may result in forfeiture of contractual payments. 6 m BID/PROPOSAL CITY OF SOUTH BEND BID NAME Spec 5—Janitorial-Cleaning Supplies 2017 FOR BIDS DUE _,tune 27, 2017, g;30 a.m., iocal time 10 K S �Wz�� 4.4r��3Y Ifli j j J1 s c� 4 � F f T; nMAW it d P t 9 1� 16. Bidder (Firm):.........c-h__ Address: 7 J - City/State/Zip: 9 /Ze Telephone Number: C BO RD OF PUBLIC WO KS s� Gary A. Gilot, President Fax Number: - -St-`a (Sigpnre) �!.. ...._..._Yr� A � (Printed dame) (Title Elizabeth A. Maradik, Member Suzanna M. Fritzberg, Member Ter se J. Dora , Metrtber Ja s A. Mueller, Member t st: Linda M. MartiNClk 14 s CITY OF SOUTH BENQ INDIANA SELLER'S BID FOR SALE OR LEASE OF MATERIALS AND NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND NON-DISCRIMINATION COMMITMENT FOR SELLERS BID NAME Spec S —Janitorial-Cleaning Supplies 2017 FOR BIDS DUE June 27, 2017, 9,30 a.m., local time Bidder Date: - ( (Firm): SS L AJ f w r I S ! 5 Address: OS m City/State/Zip: BeAA.— `"'AJ Telephone Number: Agent of Bidder (i€ Applicable): lotco 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, NONDISCRIMINATION 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 Ola . } } SS: Us 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, firrns, 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. 4 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-I6.5-8, 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 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 lie/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 T.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 unlawfiilly 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. T 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). I 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. 6 iu b`5 � 3 W — — _ c ! 4 3m mmaguir -jr wj MIM 4!. Bidder (Firm): Address: 'gQ g C A m S'4 City/State/Zip: Telephone Number: 69'1-933 7S3S BOARD OF PUBLIC WORKS Gary A. dffot, President Suzanna M. Fritzberg, Member Jam A. Mueller, Member 14 Fax Number:- �3 3 - -7& qS Lit I f� (Signature) 1/6" C" IV IAJAI (Printed Name) (Title) 04beth 41v.adik, Member Ther se J. Dora , e be a. tttst: Linda M. Martin, Olerk 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 aciivities 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 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 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 i 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. 5-16-5-1). 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. G i - � 3 f� ... v�.� 3;��''. -- 3Er°.:E x'..; "�..'`Ey� •. N �'d,�' I I I 'r�'6.. �,:5 ,.- i _. _ "'.,i0.,�`�.:. �"� - _ _ -WWI rf ter.: � �a � '� � •,= — — � € m_, YH.1ps isle" W I ism I _ " I I Wu Lana Y s n� h Y: '3 ei i6 1M Qw In OEM I " v =.E r E ::b I aar, 'ate m Z,%A-. � — I: �� N ,T .t 7 CMI I .. MZAMMMJim =a =s. — — �`wv � rP;,, army � ,^,";tic+ �-• u� " ,:sue ,r fi air AliillriYtll�:'- -- � � - _ - .ice lii9➢I�i�1�� fir.- �_... ___.._ � _ — - —. — [ Nmnw- - : a. � �x�� , � �. :.� � s �.-� �,�, . � -- �,:,: mow•= mftmm" im� z ll!'='YM Bidder (Firm): Acuity Specialty Products, Inc dlbla Zep Sales and Services Address: 3300 Cumberland Parkway, Suite 700 City/State/Zip: Atlanta, GA. 30339 Telephone Number: 877-428-9937 BOARD OF PUBLIC WORKS Gary A. Gilot, President Suza a M. Fritzberg, Member IN --- Jame A. Mueller, Member Fax Num e : 866 393-7329 By (�Z (Signature) Maureena Fabien-Watson (Printed Name) Government and Bid (Title) Elizabeth A. Maradik, Member zvn'— /1' J5��-�2 71$9fese J. Do*,MedAer 14 Attest: Linda M. Martin, Clerk AMMENNEW - ONE"=. Aw- 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 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. 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 5 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. 5-16-5-1). 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 nay 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. N� i� BID NAME FOR BIDS DUE BIDIPROPOSAL CITY OF SOUTH BEND Spec S T Janitorial -Cleaning Supplies 2017 June 27. 2017. 9:30 a.m.. local time 10 c� U «s ro ed Rf E1 N i3 R1 U VUUUUUUUUa.UUUUUUU UUam.UUUUUUUUUUU cC '.. to b C-- V� 4'9 O o0 N N M O r N Ul � V N w M In I' 07 O O . � W� � V U y V y H J N N 'y y ti N N N N UVi tUI1 � �' H V U Y N G] V N U vUi V Uy V b v U U N U Ei dy R uuy N N o. m y y U ��., U ui o �' A U o N �� ^.� .N-� .N- N N CV M hl r tgh C.1 -8 N GfJ fry N o� M� t-1 Y PdYEll a . f�1 -417 U 3 v U Z o o al a v~o MR, N N 'i`p` S•i b L: 14 .W. 0 L z d 'G 'G L C u1 H "�Q3 nw�d�ad` 3wcoa a`� a��i u A I A ' w4aCOi msza��U�U�uUUU�Usawwwwa.�v,rnr.,�U,�>3 a,_1Oi s o 0 0 o n n o 0 0 n c* M O a, VMi G o 'P. U 7 V � v)FQP. Ux uW m3r,U aex� �^' '� O •-+ N M 7 N if [� oa G� G N M �n op C A M 11 u v U tUy tU� [Uy [Uy eU� ttVj .r �V1 A'- .� tU�1 .� �Vy I .4 A, �Vj .ri �+ U X.' (U� � X (U� aK A QK A k k eU� trU� �Vp � I) V �Vy C�'-} �Cry� LH � 4L1 �(Up 4fT GZ] ¢'a (9 W �V W [.i � �.1 u [? u u W U 00 b b p� n O 1P O 2©N 0m 0 M LiS ` 'O bA .0 �Up .0 U .ti U .0 �Up .0 �Up .. Ury n �Up .. 41 .. �4y .. U ., WV � � ,r � A N .0 V F.. N X X x x r' .� .� u U X ti ti ✓vi � y V .�' �] : � [., NUy N Q ul IS 9Q' 2 m, y- N a s A cn °o C 3' 3 •,sE .y yr x �u y 0. cr ,Q .y V E o ka 4 A CY4q En� a' � � •u '' � � a. 33r � •� p "� 'N 'N� � V) °] Op. a�i ,� y: p � � v° o � v '4 a 'G a�i � F°- cYi ,.q � y5e¢ 3 a 2V3 ti YR-RE��, ° ° 7 q' p A 3 N N � •v F L1�i b A N A [tl c6 t� 3 U p T w `� aCgi acgi ncgi ai 3 ni eq 3 b .1 b 'm •v O o O O 4 O P y T cg 0 ca �°n ° ° ° ° A N 3 G N Q ❑ C1.n yam' N �] .� 10 10G c�3 t�3 U Li.. �R iL ,g LL LL tx Vj O p G `a Yd O b ,� .� O O O O a 'O 'C 'G '9 9 O O U] GO O Iz, t- O o y, b r} b M b It b '�l b �° t b d 12 I L POWN11 4 M. "LOLMAUCI�JUM, � � in � b� AA ZC ",kk, � A 11P I I IIE CITY OF SOUTH BEND, INDIANA SELLER'S BID FOR SALE OR LEASE OF MATERIALS AND NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND NON-DISCRIMINATION COMMITMENT FOR SELLERS BID NAME Spec S — Janitorial -Cleaning Supplies 2017 FOR BIDS DUE June 27, 2017. 9:30 a.m., local time Bidder Date: � a (Firm): 1 er�� ✓ �� i` �� , n Address: i�a `! ;/ d City/State/Zip: 41 �A / Jos-/sTelephone Number: (F`is) �)��3 - 6 J-n c,, Agent of Bidder (if Applicable):�a 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 Ae va 'rr� } } 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 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. 0 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 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. 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 conirniss ions may consider the 5 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). I 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. 0 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 day of f-yhQ , 20 Contractor/Bidder (Firm) , Signature of Contractor/Bidder or Its Agent 7,rq Printed Nance and Title Subscribed and sworn to before me this day of ru, e , 20 1 My Commission Expires,'1 Notary Public County of Residence C}c¢�1/ f MAYER JEREMIAS Notary Public - State Of New York No. OIJE6343141 Quatlffsd In Orange County My Commission Expires June 08, 2020 7 BID/PROPOSAL CITY OF SOUTH BEND BID NAME Spec S — Janitorial -Cleaning Supplies 2017 FOR BIDS DUE June 27, 2017, 9.30 a.m., local time 10 i U i { j 3 I 3 i N ro 3 i r0 V E f t :5✓ U G] 4? W N N 0 Ql 0 u N U i a ,::'. p-I UUUUUUUUU P Ua] UW Uy UU UN Uyy UN UN P. UN Uy UU u u u6i UQJ uN E E i w y o0 00 10 0 m W N N M O V N Vl e} N W M V] V oa er 10 � y do b O O O O O pO O U yOyC O O V X p 5 N i'S pN � 4r E E E L E E — E .N-. d' h '. 00 .N.. h E R �O W 10 o0 19 i I ..f 'i1il b zz Is A fA F a U vi � O N Ot ;G 3 U G U h .L L' � V � _G .� •� `� ¢ �q �n ..,. 0.1 fA w C7 t,7 x E-1 �¢ � Ova rn � r• � o y Ln C/} G .a e93 - 0 0 0 0 0 0 o n o �3 000�r�C�UUUUV UU V UUUUG]wwwa,w�nv�vav�rnrnn� V U U vZi p3 p. U `� 4 U eY C9 Gd U U �4 �A W n I E b la w Bidder (Firm): In Address: 1 I-/ A j City/State/Zip: (h c '--7 Telephone Number: 9-11- W -:)-6�001 BOARD OF PUBL7WORKS Atp—,-�3 10-1- Gary A. Gilot, President Suzanna M. Fritzberg, Member I,--, Jame A. Mueller, Member Fax Number: :GJ�' (Signature) (Printed Name) S ec re 41, (Title) Elizabeth A. Maradik, Member Therpse J. Dor u, Mt5hiber hest; Linda M. Martin, Clbrk 14 a � , CITY OF SOUTH BEN© INDIANA SELLER'S BID FOR SALE OR LEASE OF MATERIALS AND NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND NON-DISCRIMINATION COMMITMENT FOR SELLERS BID NAME Spec S — Janitorial -Cleaning Supplies 2017 FOR BIDS DUE June 27, 2017, 9:30 a.m., local time Bidder Date: Wel (Firm): � L�_v Address: ea "906 �" City/State/Zip k) 0 Telephone Number: Agent of Bidder (if Applicable): When the prospective Contractor is unable to certify to any ofthe 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: 1l3 a� 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. 4 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 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 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. 5-16-5-1). I 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. R 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 9' day of ` (J -' , 20_L� UiA-� Ce� Contrac rBidder (Firm) Signature ook Contracto- r/BiddVr or Its Agent Printed Name and Title Subscribed and sworn to before me this day of Z5�-J`0 20f Z My Commission Expires 2o26 gfz w��'— N ry Public County of Residence k-i I., G,\ (� At.EKSANDA YUNUSOV Notary Public State of New York N0. 01YU6257739 Qualified in Queens County My Comi-fission Expires Mar 19, 2020 a . ........... r - V ?T c U i L ..0 ,i L L' L2 N N N N N N Lly' 61 P. W.G W.Fry' W.G` W.C� W.i WryC ML 0'L WL AL' ML, olL W.� UN VV Wt u U U v U U W U 6 �O N �O R O PO �O In �O O Vl N O �➢ 0 0 ^ C, N C, M 0 ^ '8 rn N ^ o rn ^ Vl ^ tnl -zt N N N N O �D O m 1� w Gt�t U U U U U U V V Utp K X K K y V h U y ti N ti U A � @JR N lJtpp N N �G�qq u tU 4i .Uy Ei N W W V N W N N tUt�� N tUtpp V N P A P p �Vy V �U�tt V U U V U U U V N N '.: y •'] �l O O � BOO BOO y y U N N N N N Ra O 7i �i U U � V U Q U ,� u U V N ', ' .0 .0 .0 J7 .� •C CO D D� � L J7 u � v� 'O @ 'O R 'O 4V 'O @ -6 R 'O @ "� V @ v U N V N V N V W V N V S S S pCpL p V V U � .� V U •c E 'g V n 91 rn 3 `-i ai a�yi 6y ai u rLk O O o 5 O, A R R N N C O c� t r N *n _ o o cs o r� v v ' @��j y C 0 3 o 3 'IV 3 b o V 0 N y^ '6-• O G¢ J b F"" .g' 4 iS 4 X 'v X sa 'v X o 3 Q 5 �G � Ny v N 0 O O D O s D p VJ: p N. n @ ty y�. '4 O 6 `1 N v csi N �o Q Ci W vOi N vOi N v O `� O �o Q +n ss N u- - - - GIr - Y � U rn GN ..o NN W N L rL m O O cCv�W mmm[-�mW aUaOaaAAAC.�AgC7C7C7C7 aa,c..a.9L.a.rnrn t�C t�C tad - o z z S z S z S S In 24 N rI, N h Fli © ' /r n z ,El to n'1 rn f'l t�l t�l to rY tf d' � 7 7 � 7 � � V� V� Vi Vi Vi vl h h U'S � �O •O �O �O �O �O �O �V d A 1�, Bidder (Firm): Address: City/State/Zip: Telephone Number:"))8 — 6 7 ) — ✓d&:- BOARD OF PUBLIC WORKS Gary A. Gilot, President Suzanna M. Fritzberg, Member e*-� Jame A. Mueller, Member a JU 11 �67�'o Fax Number: (Signature) f (Printed Name) (Title) 14 Elizabeth A. Maradik, Member Ther9se J. Dorau, Memer st: Linda M. Martin, Olerk !r 1 ��- nYh%trr iI '4:' 4 plw&z w K 9 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 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. 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 5 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. 5-16-5-1). 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. no i 'IComm A as I Fri - �4A 1' 1 _ 11 _ BID/PROPOSAL CITY OF SOUTH BEND BID NAME Spec S — Janitorial -Cleaning Supplies 2017 FOR BIDS DUE June 27, 2017, 9:30 a.m., local time 10 U — a U Z C 6) O U v H h y rVi, vays� N rwr�� 7yyy w N `�' a `�' N m 0 0 Q 0 N N a) dJ N N N li N N lu 00 (C U a U 0 U 0 U lC C.) t6 U [6 Cl)V c4 id U cp U w U U U � U m U m U m U m U m U � a m u m U m U m U m U m U m U m U m U m U m U O CL OD a, lb d 00 d• d' 'D l� 00 oa v1 V �A O O n, o0 Ch] N M O N b1 N oo M V oo O O Z Z � U V ID ID V V C-4 w�� a Cy r� U t^ N oVo .n m '� V V N a V ^d v Ob 10 N+ O "LS 1=... 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