HomeMy WebLinkAboutOpening of Quotations - Sewer Cleaning Nozzles - Jack Doheny CompaniesIt
CITY OF SOUTH_ BEND, INDIANA
'S QUOTE FOR SALE OR LEASE OF
D NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND
QUOTE NAME Sewer Cleaning Nozzles
FOR QUOTES DUE August 22, 2017 at 9.00 a.m.
Date: AUGUST 4 2017 Firm:
Address: 4937A FIELDSTONE DRIVE
JACK DOHENY COMPANIES, INC.
City/State/Zip: WHITESTOWN= IN 46075 Telephone Number: ( 317 ) 768-2600
Agent of Firm (if Applicable): MIKE LETT, GENERAL MANAGER
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 III^ 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:
BOONE 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-I6.5-5, as
amended from time -to -time.
b. As provided by Ind. Code § 5-22-16.5-5, as amended from tithe -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 LC. 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
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NOT APPLICABLE
(To be completed only by Contractors/Bidders claiming to be a `local Indiana busloess" pursuant to I.C. 36-1-12-22)
INDIANA LOCAL BUSINESS PREFERENCE CLAIM
A "local Indiana business" refers to any of the following:
(1) A business whose principal place of business is located in an affected county.
(2) A business that pays a majority of its payroll (in dollar volume) to residents of affected counties.
(3) A business that employs residents of affected counties as a majority of its employees,
(4) A business that makes significant capital investments in the affected counties as defined in rules adopted by the
political subdivision.
(5) A business that has a substantial positive economic impact on the affected counties as defined by criteria in rules
adopted by the political subdivision.
An "affected county" refers to St. Joseph County, Indiana, or the following counties located adjacent to St. Joseph
County: Elkhart County, Marshal! County, Starke County and LaPorte, County
There are the following price preferences for supplies purchased from a local Indiana business:
• 5% for a purchase expected by the purchasing agency to be less than $50,000
• 3% for a purchase expected by the purchasing agency to beat least $50, 000 but less than $100, 000.
• i % for a purchase expected PZ the purchasing agentX to be at feast $100, 000.
Date:
Pursuant to I.C. 36-1-12-22,
preference for Project
South Bend, St. Joseph County, Indiana,
claims a local Indiana business
(Project # ) located within the City of
❑ The location of the principal place of business is
(Address)
r� St. Joseph County, Indiana
❑ The following county located adjacent to St, Joseph County, Indiana:
❑ The majority of the business's payroll for the 12 months prior to the date of this Bid is to residents of St.
Joseph County, Indiana or the adjacent county noted above.
❑ The majority of the business's employees for the 12 months prior to the date of this Bid are residents of St.
Joseph County, Indiana, or the adjacent county noted above.
If the business is deemed to be the apparent lowest, responsible, responsive bidder, then it shall provide
supporting documentation for the 12 month period prior to the date of the Bid of (i) the total payroll amount
paid to all employees of the business, and (ii) the total payroll amount paid to employees who are residents
of St. Joseph County and the adjacent county noted above,
WHEN SUPPLYING SUPPORTING PAYROLL RECORDS,
BIDDER SHALL REDACT ALL SOCIAL SECURITY NUMBERS.
Dated this day of, 24—.
Contractor/Bidder (Firm)
Signature of Contractor/Bidder or Its Agent
Printed Name and Title
mz
SPECIFICATIONS
CITY OF SOUTH BEND
QUOTE NAME Sewer Cleaning Nozzles
FOR QUOTES DUE August 22, 2017 at 9:00 a.m.
Pursuant to notices given, the undersigned offers Quote(s) to the City of South Bend in accordance with
the following attachment(s) which specify the class or item number or description, quantity, unit, unit price.
They City of South Bend is requesting quotes for Sewer Cleaning Nozzles listed below:
Two (2) 60 GPM 6 Jet floor cleaning nozzles with 1" inlet.
Four (4) 80 GPM 6 Jet floor cleaning nozzles with 1" inlet.
Two (2) 60 GPM 10 Jet floor cleaning nozzles with 1" inlet.
Four (4) 80 GPM 10 Jet floor cleaning nozzles with 1" inlet.
Two (2) 60 GPM 10 Jet 5 forward 5 rearward spinner type nozzles with 1" inlet.
Four (4) 80 GPM 10 Jet 5 forward 5 rearward spinner type nozzles with 1" inlet.
Please return all sealed quotes by August 22, 2017 at 9,00 a.m. to:
Board of Public Works, 13'h Floor
County City Building, Room 1316
227 West Jefferson Blvd,
South Bend, IN 46601
If you have any questions you can contact me at 574-235-9316.
Sincerel ,
L
Jeffrey D. I u ak, Manager
Central Services Division
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