HomeMy WebLinkAboutOpening of Quotations - FLIR Traffic Cameras Proj No 117-122 - Hawk Enterprises Inc (2)A." �
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S QUOTE FOR PUBLIC MK
ISO,,
PROJECT NAME: FUR Traffic Cameras
PROJECT NO. 117-122
QUOTES DUE December 19, 6" at 9:Ov am
(Must be completed for alll quotes. Please type or print)
Date: 12/19/2017 Firm: Hawk Enterprises, Inc.
Address: 1850 E. North Street
City/State0p: Crown IPoin , IN 46307 Telephone Number: 662-8090
Agent of Bidder (if Applicable):
Pursuant to notices given, the undersigned offers to �umish labor and/or material necessary (�oWWaomnpiate the
p
public works project of:
FUR Traffic Cameras„ Project No. 117-122
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
The City of South Bend, Department of Public Works
enter the Total Quote as shown ... a
and dated 12l19J1.7for the sum of j ( on the Proposal)
One hundred seven thousandl, six hundred and 00/11010 $ 107,600.00
_...-._
(Enter Sum of Total Gluote, including all divisions, on —Proposal) m m—CW6merical)
If alternative quotes apply, the undersigned submits a proposal for each in accordance with the notice. Any
addendums attached will' be specifically referenced at the applicable page.
If additional units of material Included In the contract are needed, the cost of units must be the same as that shown
in the original contract If accepted by the City of South Bend. If the quote is to be awarded on a unit (basis, the
itemization of the units shall be shown on a separate attar n
(~;Psnature)__..
Johanna Plank, President
—,LtPrintetf Name of Person signing)
ACCEPTANCE
The above quote is accepted this 19th day of
Subject to the following conditions, N/A
_ - •
dii A. Gilot, President —--- . -------
.
i
EI� zabeth A. _.._ .._ Malradl k, Member ....a, .........._ -
.tames A, Mue4ler„ Member .... _.. -_
December
20 17
Suzanne M,rltzlberg, Member
Therese)
, Dorau, Member
Attest. Linda M. Martin,,r
.. Clerk
Version 110/31 12017 Page - 8 Public Works Quote
QUOTEIPROPOSAL
CITY OF SOUTH BEND
PROJECT NAME FUR Traffic Cameras
PROJECT NO. 117-1122
QUOTES DUE December 19, 20117 at 9:00 am
DIVISION - A: Ireland Rd. and Ironwood Dr.
Item
No. D!! �r I ttp n Quantity Unit Unit Price, Total Amount
1 Maintaining Traffic
LS $1,200.00 $ 1,200.00
2 Vehicle Video Detection System 4 EA $10,000.00 $40,000.00
Total Amount of Division A $ 41,200.00,
DIVISION 13: Western Ave. and Lombardy...
item�
No. Descrilt,tion I
1 Maintaining, Traffic
.. . . . .... ..
2 Vehicle Video Detection System
DIVISION C: Nimtz Pa and US 3111
--it—em - - -- --- - - - qr-
No. Description
1 Maintaining Traffic
2 Vehicle Video Detection System
Firm:
Address:
City/State/Zip:
Intity Unit Unlit Price
Total Amount
1 LS $1,200.00
$ 1,200,010
4 EA $10,000.00,
$40,000,00
Total Amount of Division B 1
$ 41,2010.00
Quantity Unit Unit Price Total Amount
1 LS $1,200.00 $ 1,200.001
2 EA $12,000.00 $ 24,000.00
........... ...
Total Amount of Division'C"$25,200.00I"
QUOTE TOTAL (Divisions A + B + C). $107,600,00
Hawk Enterprises, Inc.
18,50 E. North Street
Crown Point, Indiana 46307
Telephone Number, .1_219 � 662-8090
Fax (219,1—W�-8093
Johanna Plank, President
(Printed Name of Person Signing)
Version 10/31/2017 Page - 12 Public Works Quote
When the prospectipe Contractor is unable to certify to any of the stateneents below, it shall attach an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT,
CERTIFICATION REGARDING INVESTMENT WITH MAN, 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 )
Lake ) COUNTY SS:
)
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
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
Version 10/3112017 Page - 9 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 detennining 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
fi-om the date of such determination, and such determination may also be grounds for terminating
the contact for which the discriminatory practice or noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination commitment shall
be made a part of any contract which it may henceforth enter into with the City of South Bend,
Indiana or any of its agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for
employment in the performance of this contract with privileges of employment, or any matter
directly or indirectly related to employment, because of race, religion, color, sex, gender
expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of
this provision may be regarded as material breach of contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-
8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel
products or foundry products made in the United States on this project if awarded. I understand I
Version 10131 /201 i Page - 10 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.
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 19th— day of oecember, 2017
Subscribed and sworn to before me this
My Commission Expires 10/14/23
Hawk Enterprises, Inc.
Contractor/Bidder (Firm)
Signature of Contractor/Bidder or Its Agent
Johanna Plank, President
Printed Name and Title
19th day of De tuber 2017
Notary Public
County of Residence
LaPorte
GORVPAUI BIItA.:.:
0 a
•"'• � Woinry
, i��lic, SfpIF o1 In�li�rui
k3porte Counly
t�q1
Cc ii ri3 ion # 67,1263
rely 4ormmission Lxpnc
0c I o b e r 14 2023
Version 10131/2017 Page - 11 Public Works Quote
CERTIFICATE OF LIABILITY INSURANCE
11DATEjM 7 DfYYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on
this certificate does not confer rights to the certificate holder In lieu of such endorsements .
PRODUCER
Arthur J. Gallagher Risk Management Services, Inc.
650 E. Carmel Drive, Suite 400
Carmel IN 46032
CONTACT
NAME: Joni Linhart
PHONE 317-587-1330 FAX 317-810-4930
-MAtL Ion! linhari@ajg.COm
INSURERS AFFORDING COVERAGE
NAIL N
INSURER A: Phoenix Insurance Company
25623
INSURED
INSURER s: Charter Oak Fire Insurance Company
25615
Hawk Enterprises, Inc.
INSURERc:Travelers Indemnity Company
25658
1850 East North Street
Crown Point, IN 46307-8566
INSURER D :Travelers Property Casualty Co of A
25674
INSURER E :
INSURER P
COVERAGES CERTIFICATE NIIMRFR- 1497747967 RF'VIRIAN NIIMRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDLSUBR
INSD
WVo
POLICY NUMBER
POLICY EFF
MMIDO YY
POLICY EXP
MMfDD Y
LIMITS
A
X
COMMERCIAL GENERAL LIABIUTY
CLAIMS -MADE FX OCCUR
-
DT-CO-9H818638-PHX-17
211/2017
211/2018
EACH OCCURRENCE
$1,000,000
DAMAGE T RENTED
PREMISES Me occurcenee
$300.000
MED EXP (Any one person)
$5,000
PERSONAL & ADV INJURY
$1,000.000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ] JERa � LOC
OTHER:
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMPIOP AGG
$2,000,000
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
DT-81G-OJ382147-COF-17
2/1/2017
211l2018
INGEE LIMIT
Ea aCUMccident
$1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Peraccident)
$
C
UMBRELLA LIAB
EXCESS LIAR
X OCCUR
CLAIMS -MADE
CUP-OJ675073-17-26
2/1/2017
2/1/2018
EACH OCCURRENCE
$9,000,000
X
AGGREGATE
$9.000,000
DEO I X I RETENTION 10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y 1 N
OFFICERIMEM ER EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE N
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N f A
UB-0J675602-17-26-G
2/1/2017
2/1/2018
PER OTH-
ER
X ISTATUTEANY
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYCE
$1,000,000
E.L. DISEASE -_POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
.y_1► lh R � sr_\l la] i I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
St Joseph County/City of South Bend Building THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
& Permit Department ACCORDANCE WITH THE POLICY PROVISIONS.
125 S Lafayette Blvd, Ste 100
South Bend IN 46601
USA AUTHORIZED
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
11ti�
E-Veril V
Company ID Number: 799651
THE E-VERIFY
MEMORANDUM OF UNDERSTANDING
FOR EMPLOYERS
ARTICLE I
PURPOSE AND AUTHORITY
The parties to this agreement are the Department of Homeland Security (DHS) and the
Hawk Enterprises, Inc. (Employer). The purpose of this agreement is to set forth terms and
conditions which the Employer will follow while participating in E-Verify.
E-Verify is a program that electronically confirms an employee's eligibility to work in the United States
after completion of Form 1-9, Employment Eligibility Verification (Form 1-9). This Memorandum of
Understanding (MOU) explains certain features of the E-Verify program and describes specific
responsibilities of the Employer, the Social Security Administration (SSA), and DHS.
Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal Immigration Reform and
Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L. 104-208, 110 Stat. 3009, as amended (8 U.S.C.
§ 1324a note). The Federal Acquisition Regulation (FAR) Subpart 22.18, "Employment Eligibility
Verification" and Executive Order 12989, as amended, provide authority for Federal contractors and
subcontractors (Federal contractor) to use E-Verify to verify the employment eligibility of certain
employees working on Federal contracts.
ARTICLE II
RESPONSIBILITIES
A. RESPONSIBILITIES OF THE EMPLOYER
1. The Employer agrees to display the following notices supplied by DHS in a prominent place that is
clearly visible to prospective employees and all employees who are to be verified through the system:
a. Notice of E-Verify Participation
b. Notice of Right to Work
2. The Employer agrees to provide to the SSA and DHS the names, titles, addresses, and telephone
numbers of the Employer representatives to be contacted about E-Verify. The Employer also agrees to
keep such information current by providing updated information to SSA and DHS whenever the
representatives` contact information changes.
3. The Employer agrees to grant E-Verify access only to current employees who need E-Verify access.
Employers must promptly terminate an employee's E-Verify access if the employer is separated from
the company or no longer needs access to E-Verify.
Page 1 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
E-Venry-
Company 117 Number: 799651
4. The Employer agrees to become familiar with and comply with the most recent version of the
E-Verify User Manual.
5. The Employer agrees that any Employer Representative who will create E-Verify cases will
complete the E-Verify Tutorial before that individual creates any cases.
a. The Employer agrees that all Employer representatives will take the refresher tutorials when
prompted by E-Verify in order to continue using E-Verify. Failure to complete a refresher tutorial
will prevent the Employer Representative from continued use of E-Verify.
6. The Employer agrees to comply with current Form 1-9 procedures, with two exceptions:
a. If an employee presents a "List B" identity document, the Employer agrees to only accept "List
B" documents that contain a photo. (List B documents identified in 8 C.F.R. § 274a.2(b)(1)(B)) can
be presented during the Form I-9 process to establish identity.) If an employee objects to the photo
requirement for religious reasons, the Employer should contact E-Verify at
888-464-4218.
b. If an employee presents a DHS Form 1-551 (Permanent Resident Card), Form 1-766
(Employment Authorization Document), or U.S. Passport or Passport Card to complete Form 1-9,
the Employer agrees to make a photocopy of the document and to retain the photocopy with the
employee's Form 1-9. The Employer will use the photocopy to verify the photo and to assist DHS
with its review of photo mismatches that employees contest. DHS may in the future designate
other documents that activate the photo screening tool.
Note: Subject only to the exceptions noted previously in this paragraph, employees still retain the right
to present any List A, or List B and List C, document(s) to complete the Form 1-9.
7. The Employer agrees to record the case verification number on the employee's Form 1-9 or to print
the screen containing the case verification number and attach it to the employee's Form 1-9.
8. The Employer agrees that, although it participates in E-Verify, the Employer has a responsibility to
complete, retain, and make available for inspection Forms 1-9 that relate to its employees, or from other
requirements of applicable regulations or laws, including the obligation to comply with the
antidiscrimination requirements of section 274B of the INA with respect to Form 1-9 procedures.
a. The following modified requirements are the only exceptions to an Employer's obligation to not
employ unauthorized workers and comply with the anti -discrimination provision of the INA: (1) List B
identity documents must have photos, as described in paragraph 6 above; (2) When an Employer
confirms the identity and employment eligibility of newly hired employee using E-Verify procedures,
the Employer establishes a rebuttable presumption that it has not violated section 274A(a)(1)(A) of
the Immigration and Nationality Act (INA) with respect to the hiring of that employee; (3) If the
Employer receives a final nonconfirmation for an employee, but continues to employ that person,
the Employer must notify DHS and the Employer is subject to a civil money penalty between $550
and $1,100 for each failure to notify DHS of continued employment following a final
nonconfirmation; (4) If the Employer continues to employ an employee after receiving a final
nonconfirmation, then the Employer is subject to a rebuttable presumption that it has knowingly
Page 2 of 17 E-Verify M€OU for Employers I Revision Date 06/01/13
E-Verlrv.,
��" Illllll
Company ID Number: 799651
employed an unauthorized alien in violation of section 274A(a)(1)(A); and (5) no E-Verify participant
is civilly or criminally liable under any law for any action taken in good faith based on information
provided through the E-Verify.
b. DHS reserves the right to conduct Form 1-9 compliance inspections, as well as any other
enforcement or compliance activity authorized by law, including site visits, to ensure proper use of
E-Verify.
9. The Employer is strictly prohibited from creating an E-Verify case before the employee has been
hired, meaning that a firm offer of employment was extended and accepted and Form 1-9 was
completed. The Employer agrees to create an E-Verify case for new employees within three Employer
business days after each employee has been hired (after both Sections 1 and 2 of Form 1-9 have been
completed), and to complete as many steps of the E-Verify process as are necessary according to the
E-Verify User Manual. If E-Verify is temporarily unavailable, the three-day time period will be extended
until it is again operational in order to accommodate the Employer's attempting, in good faith, to make
inquiries during the period of unavailability.
1.0. The Employer agrees not to use E-Verify for pre -employment screening of job applicants, in
support of any unlawful employment practice, or for any other use that this MOU or the E-Verify User
Manual does not authorize.
11. The Employer must use E-Verify for all new employees. The Employer will not verify selectively
and will not verify employees hired before the effective date of this MOU. Employers who are Federal
contractors may qualify for exceptions to this requirement as described in Article II.B of this MOU.
12. The Employer agrees to follow appropriate procedures (see Article III below) regarding tentative
nonconfirmations. The Employer must promptly notify employees in private of the finding and provide
them with the notice and letter containing information specific to the employee's E-Verify case. The
Employer agrees to provide both the English and the translated notice and letter for employees with
limited English proficiency to employees. The Employer agrees to provide written referral instructions
to employees and instruct affected employees to bring the English copy of the letter to the SSA. The
Employer must allow employees to contest the finding, and not take adverse action against employees
if they choose to contest the finding, while their case is still pending. Further, when employees contest
a tentative nonconfirmation based upon a photo mismatch, the Employer must take additional steps
(see Article I II.B. below) to contact DHS with information necessary to resolve the challenge.
13. The Employer agrees not to take any adverse action against an employee based upon the
employee's perceived employment eligibility status while SSA or DHS is processing the verification
request unless the Employer obtains knowledge (as defined in 8 C.F.R. § 274a.1(1)) that the employee
is not work authorized. The Employer understands that an initial inability of the SSA or DHS automated
verification system to verify work authorization, a tentative nonconfirmation, a case in continuance
(indicating the need for additional time for the government to resolve a case), or the finding of a photo
mismatch, does not establish, and should not be interpreted as, evidence that the employee is not work
authorized. In any of such cases, the employee must be provided a full and fair opportunity to contest
the finding, and if he or she does so, the employee may not be terminated or suffer any adverse
employment consequences based upon the employee's perceived employment eligibility status
Page 3 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
E -Ve r im r"v_
Company ID Number: 799651
(including denying, reducing, or extending work hours, delaying or preventing training, requiring an
employee to work in poorer conditions, withholding pay, refusing to assign the employee to a Federal
contract or other assignment, or otherwise assuming that he or she is unauthorized to work) until and
unless secondary verification by SSA or DHS has been completed and a final nonconfirmation has
been issued. If the employee does not choose to contest a tentative nonconfirmation or a photo
mismatch or if a secondary verification is completed and a final nonconfirmation is issued, then the
Employer can find the employee is not work authorized and terminate the employee's employment.
Employers or employees with questions about a final nonconfirmation may call E-Verify at 1-888-464-
4218 (customer service) or 1-888-897-7781 (worker hotline).
14. The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section 274B of
the INA as applicable by not discriminating unlawfully against any individual in hiring, firing,
employment eligibility verification, or recruitment or referral practices because of his or her national
origin or citizenship status, or by committing discriminatory documentary practices. The Employer
understands that such illegal practices can include selective verification or use of E-Verify except as
provided in part D below, or discharging or refusing to hire employees because they appear or sound
"foreign" or have received tentative nonconfirmations. The Employer further understands that any
violation of the immigration -related unfair employment practices provisions in section 274B of the INA
could subject the Employer to civil penalties, back pay awards, and other sanctions, and violations of
Title VI I could subject the Employer to back pay awards, compensatory and punitive damages.
Violations of either section 274E of the INA or Title VII may also lead to the termination of its
participation in E-Verify. If the Employer has any questions relating to the anti -discrimination provision,
it should contact OSC at 1-800-255-8155 or 1-800-237-2515 (TDD).
15. The Employer agrees that it will use the information it receives from E-Verify only to confirm the
employment eligibility of employees as authorized by this MOU. The Employer agrees that it will
safeguard this information, and means of access to it (such as PINS and passwords), to ensure that it
is not used for any other purpose and as necessary to protect its confidentiality, including ensuring that
it is not disseminated to any person other than employees of the Employer who are authorized to
perform the Employer's responsibilities under this MOU, except for such dissemination as may be
authorized in advance by SSA or DHS for legitimate purposes.
16. The Employer agrees to notify DHS immediately in the event of a breach of personal information.
Breaches are defined as loss of control or unauthorized access to E-Verify personal data. All
suspected or confirmed breaches should be reported by calling 1-888-464-4218 or via email at
E-Verify.-.dhs.gov. Please use "Privacy Incident —Password" in the subject line of your email when
sending a breach report to E-Verify.
17. The Employer acknowledges that the information it receives from SSA is governed by the Privacy
Act (5 U.S.C. § 552a(i)(1) and (3)) and the Social Security Act (42 U.S.C. 1306(a)). Any person who
obtains this information under false pretenses or uses it for any purpose other than as provided for in
this MOU may be subject to criminal penalties.
18. The Employer agrees to cooperate with DHS and SSA in their compliance monitoring and
evaluation of E-Verify, which includes permitting DHS, SSA, their contractors and other agents, upon
Page 4 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
'�� lilllu
E - Ve r i F"V--
•.r.c: 4itioff
Company ID Number: 799651
reasonable notice, to review Forms 1-9 and other employment records and to interview it and its
employees regarding the Employer's use of E-Verify, and to respond in a prompt and accurate manner
to DHS requests for information relating to their participation in E-Verify.
19. The Employer shall not make any false or unauthorized claims or references about its participation
in E-Verify on its website, in advertising materials, or other media. The Employer shall not describe its
services as federally -approved, federally -certified, or federally -recognized, or use language with a
similar intent on its website or other materials provided to the public. Entering into this MOU does not
mean that E-Verify endorses or authorizes your E-Verify services and any claim to that effect is false.
20. The Employer shall not state in its website or other public documents that any language used
therein has been provided or approved by DHS, USCIS or the Verification Division, without first
obtaining the prior written consent of DHS.
21. The Employer agrees that E-Verify trademarks and logos may be used only under license by
DHS/USCIS (see M-795 Web) and, other than pursuant to the specific terms of such license, may not
be used in any manner that might imply that the Employer's services, products, websites, or
publications are sponsored by, endorsed by, licensed by, or affiliated with DHS, USCIS, or E-Verify.
22. The Employer understands that if it uses E-Verify procedures for any purpose other than as
authorized by this MOU, the Employer may be subject to appropriate legal action and termination of its
participation in E-Verify according to this MOU.
B. RESPONSIBILITIES OF FEDERAL CONTRACTORS
1. If the Employer is a Federal contractor with the FAR E-Verify clause subject to the employment
verification terms in Subpart 22.18 of the FAR, it will become familiar with and comply with the most
current version of the E-Verify User Manual for Federal Contractors as well as the E-Verify
Supplemental Guide for Federal Contractors.
2. In addition to the responsibilities of every employer outlined in this MOU, the Employer understands
that if it is a Federal contractor subject to the employment verification terms in Subpart 22.18 of the
FAR it must verify the employment eligibility of any "employee assigned to the contract" (as defined in
FAR 22.1801). Once an employee has been verified through E-Verify by the Employer, the Employer
may not create a second case for the employee through E-Verify.
a. An Employer that is not enrolled in E-Verify as a Federal contractor at the time of a contract
award must enroll as a Federal contractor in the E-Verify program within 30 calendar days of
contract award and, within 90 days of enrollment, begin to verify employment eligibility of new hires
using E-Verify. The Employer must verify those employees who are working in the United States,
whether or not they are assigned to the contract. Once the Employer begins verifying new hires,
such verification of new hires must be initiated within three business days after the hire date. Once
enrolled in E-Verify as a Federal contractor, the Employer must begin verification of employees
assigned to the contract within 90 calendar days after the date of enrollment or within 30 days of an
employee's assignment to the contract, whichever date is later.
Page 5 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
E-Ver1mFV__
•„ lilllll,;�- aff
Company ID Number: 799651
b. Employers enrolled in E-Verify as a Federal contractor for 90 days or more at the time of a
contract award must use E-Verify to begin verification of employment eligibility for new hires of the
Employer who are working in the, United States, whether or not assigned to the contract, within
three business days after the date of hire. If the Employer is enrolled in E-Verify as a Federal
contractor for 90 calendar days or less at the time of contract award, the Employer must, within 90
days of enrollment, begin to use E-Verify to initiate verification of new hires of the contractor who
are working in the United States, whether or not assigned to the contract. Such verification of new
hires must be initiated within three business days after the date of hire. An Employer enrolled as a
Federal contractor in E-Verify must begin verification of each employee assigned to the contract
within 90 calendar days after date of contract award or within 30 days after assignment to the
contract, whichever is later.
c. Federal contractors that are institutions of higher education (as defined at 20 U.S.C. 1001(a)),
state or local governments, governments of Federally recognized Indian tribes, or sureties
performing under a takeover agreement entered into with a Federal agency under a performance
bond may choose to only verify new and existing employees assigned to the Federal contract. Such
Federal contractors may, however, elect to verify all new hires, and/or all existing employees hired
after November 6, 1986. Employers in this category must begin verification of employees assigned
to the contract within 90 calendar days after the date of enrollment or within 30 days of an
employee's assignment to the contract, whichever date is later.
d. Upon enrollment, Employers who are Federal contractors may elect to verify employment
eligibility of all existing employees working in the United States who were hired after November 6,
1986, instead of verifying only those employees assigned to a covered Federal contract. After
enrollment, Employers must elect to verify existing staff following DHS procedures and begin
E-Verify verification of all existing employees within 180 days after the election.
e. The Employer may use a previously completed Form 1-9 as the basis for creating an E-Verify
case for an employee assigned to a contract as long as:
i. That Form 1-9 is complete (including the SSN) and complies with Article II.A.6,
ii. The employee's work authorization has not expired, and
iii. The Employer has reviewed the Form 1-9 information either in person or in
communications with the employee to ensure that the employee's Section 1, Form 1-9
attestation has not changed (including, but not limited to, a lawful permanent resident alien
having become a naturalized U.S. citizen).
f. The Employer shall complete a new Form 1-9 consistent with Article II.A.6 or update the
previous Form 1-9 to provide the necessary information if:
i. The Employer cannot determine that Form 1-9 complies with Article II.A.6,
ii. The employee's basis for work authorization as attested in Section 1 has expired or
changed, or
iii. The Form I-9 contains no SSN or is otherwise incomplete.
Note: If Section 1 of Form 1-9 is otherwise valid and up-to-date and the form otherwise complies with
Page 6 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
ttm�-Verifv
or
Company ID Number: 799651
Article II.C.5, but reflects documentation (such as a U.S. passport or Form 1-551) that expired after
completing Form 1-9, the Employer shall not require the production of additional documentation, or use
the photo screening tool described in Article Il.A.5, subject to any additional or superseding instructions
that may be provided on this subject in the E-Verify User Manual.
g. The Employer agrees not to require a second verification using E-Verify of any assigned
employee who has previously been verified as a newly hired employee under this MOU or to
authorize verification of any existing employee by any Employer that is not a Federal contractor
based on this Article.
3. The Employer understands that if it is a Federal contractor, its compliance with this MOU is a
performance requirement under the terms of the Federal contract or subcontract, and the Employer
consents to the release of information relating to compliance with its verification responsibilities under
this MOU to contracting officers or other officials authorized to review the Employer's compliance with
Federal contracting requirements.
C. RESPONSIBILITIES OF SSA
1. SSA agrees to allow DHS to compare data provided by the Employer against SSA's database. SSA
sends DHS confirmation that the data sent either matches or does not match the information in SSA's
database.
2. SSA agrees to safeguard the information the Employer provides through E-Verify procedures. SSA
also agrees to limit access to such information, as is appropriate by law, to individuals responsible for
the verification of Social Security numbers or responsible for evaluation of E-Verify or such other
persons or entities who may be authorized by SSA as governed by the Privacy Act (5 U.S.C. § 552a),
the Social Security Act (42 U.S.C. 1306(a)), and SSA regulations (20 CFR Part 401).
3. SSA agrees to provide case results from its database within three Federal Government work days of
the initial inquiry. E-Verify provides the information to the Employer.
4. SSA agrees to update SSA records as necessary if the employee who contests the SSA tentative
nonconfirmation visits an SSA field office and provides the required evidence. If the employee visits an
SSA field office within the eight Federal Government work days from the date of referral to SSA, SSA
agrees to update SSA records, if appropriate, within the eight -day period unless SSA determines that
more than eight days may be necessary. In such cases, SSA will provide additional instructions to the
employee. If the employee does not visit SSA in the time allowed, E-Verify may provide a final
nonconfirmation to the employer.
Note: If an Employer experiences technical problems, or has a policy question, the employer should
contact E-Verify at 1-888-464-4218.
D. RESPONSIBILITIES OF DHS
1. DHS agrees to provide the Employer with selected data from DHS databases to enable the
Employer to conduct, to the extent authorized by this MOU:
a. Automated verification checks on alien employees by electronic means, and
Page 7 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
1tiF
E-Verifav_
Company ID Number: 799651
b. Photo verification checks (when available) on employees.
2. DHS agrees to assist the Employer with operational problems associated with the Employer's
participation in E-Verify. DHS agrees to provide the Employer names, titles, addresses, and telephone
numbers of DHS representatives to be contacted during the E-Verify process.
3, DHS agrees to provide to the Employer with access to E-Verify training materials as well as an
E-Verify User Manual that contain instructions on E-Verify policies, procedures, and requirements for
both SSA and DHS, including restrictions on the use of E-Verify.
4. DHS agrees to train Employers on all important changes made to E-Verify through the use of
mandatory refresher tutorials and updates to the E-Verify User Manual. Even without changes to
E-Verify, DHS reserves the right to require employers to take mandatory refresher tutorials.
5. DHS agrees to provide to the Employer a notice, which indicates the Employer's participation in
E-Verify. DHS also agrees to provide to the Employer anti -discrimination notices issued by the Office of
Special Counsel for Immigration -Related Unfair Employment Practices (OSC), Civil Rights Division,
U.S. Department of Justice.
6. DHS agrees to issue each of the Employer's E-Verify users a unique user identification number and
password that permits them to log in to E-Verify.
7. DHS agrees to safeguard the information the Employer provides, and to limit access to such
information to individuals responsible for the verification process, for evaluation of E-Verify, or to such
other persons or entities as may be authorized by applicable law. Information will be used only to verify
the accuracy of Social Security numbers and employment eligibility, to enforce the INA and Federal
criminal laws, and to administer Federal contracting requirements.
8. DHS agrees to provide a means of automated verification that provides (in conjunction with SSA
verification procedures) confirmation or tentative nonconfirmation of employees' employment eligibility
within three Federal Government work days of the initial inquiry.
9. DHS agrees to provide a means of secondary verification (including updating DHS records) for
employees who contest DHS tentative nonconfirmations and photo mismatch tentative
nonconfirmations. This provides final confirmation or nonconfirmation of the employees' employment
eligibility within 10 Federal Government work days of the date of referral to DHS, unless DHS
determines that more than 10 days may be necessary. In such cases, DHS will provide additional
verification instructions.
ARTICLE III
REFERRAL OF INDIVIDUALS TO SSA AND DHS
A. REFERRAL TO SSA
1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must print the
notice as directed by E-Verify. The Employer must promptly notify employees in private of the finding
and provide them with the notice and letter containing information specific to the employee's E-Verify
Page 8 of 17 E-Verify Moll for Employers I Revision Date 06/01/13
E-Verify
igllu,up
Company ID Number: 799651
case. The Employer also agrees to provide both the English and the translated notice and letter for
employees with limited English proficiency to employees. The Employer agrees to provide written
referral instructions to employees and instruct affected employees to bring the English copy of the letter
to the SSA. The Employer must allow employees to contest the finding, and not take adverse action
against employees if they choose to contest the finding, while their case is still pending.
2. The Employer agrees to obtain the employee's response about whether he or she will contest the
tentative nonconfirmation as soon as possible after the Employer receives the tentative
nonconfirmation. Only the employee may determine whether he or she will contest the tentative
nonconfirmation.
3. After a tentative nonconfirmation, the Employer will refer employees to SSA field offices only as
directed by E-Verify. The Employer must record the case verification number, review the employee
information submitted to E-Verify to identify any errors, and find out whether the employee contests the
tentative nonconfirmation. The Employer will transmit the Social Security number, or any other
corrected employee information that SSA requests, to SSA for verification again if this review indicates
a need to do so.
4. The Employer will instruct the employee to visit an SSA office within eight Federal Government work
days. SSA will electronically transmit the result of the referral to the Employer within 10 Federal
Government work days of the referral unless it determines that more than 10 days is necessary.
5. While waiting for case results, the Employer agrees to check the E-Verify system regularly for case
updates.
6. The Employer agrees not to ask the employee to obtain a printout from the Social Security
Administration number database (the Numident) or other written verification of the SSN from the SSA.
B. REFERRAL TO DHS
1. If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must promptly
notify employees in private of the finding and provide them with the notice and letter containing
information specific to the employee's E-Verify case. The Employer also agrees to provide both the
English and the translated notice and letter for employees with limited English proficiency to
employees. The Employer must allow employees to contest the finding, and not take adverse action
against employees if they choose to contest the finding, while their case is still pending.
2. The Employer agrees to obtain the employee's response about whether he or she will contest the
tentative nonconfirmation as soon as possible after the Employer receives the tentative
nonconfirmation. Only the employee may determine whether he or she will contest the tentative
nonconfirmation.
3. The Employer agrees to refer individuals to DHS only when the employee chooses to contest a
tentative nonconfirmation.
4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer will instruct the
Page 9 of 17 E-Verify MOIL for Employers I Revision mate 06/01/13
E-Verlrv_
mv
Company ID Number, 799651
employee to contact DHS through its toll -free hotline (as found on the referral letter) within eight
Federal Government work days.
5. If the Employer finds a photo mismatch, the Employer must provide the photo mismatch tentative
nonconfirmation notice and follow the instructions outlined in paragraph 1 of this section for tentative
nonconfirmations, generally.
6. The Employer agrees that if an employee contests a tentative nonconfirmation based upon a photo
mismatch, the Employer will send a copy of the employee's Form 1-551, Form 1-766, U.S. Passport, or
passport card to DHS for review by:
a. Scanning and uploading the document, or
b. Sending a photocopy of the document by express mail (furnished and paid for by the employer).
7. The Employer understands that if it cannot determine whether there is a photo match/mismatch, the
Employer must forward the employee's documentation to DHS as described in the preceding
paragraph, The Employer agrees to resolve the case as specified by the DHS representative who will
determine the photo match or mismatch.
8. DHS will electronically transmit the result of the referral to the Employer within 10 Federal
Government work days of the referral unless it determines that more than 10 days is necessary.
9. While waiting for case results, the Employer agrees to check the E-Verify system regularly for case
updates.
ARTICLE IV
SERVICE PROVISIONS
A. NO SERVICE FEES
1, SSA and DHS will not charge the Employer for verification services performed under this MOU. The
Employer is responsible for providing equipment needed to make inquiries. To access E-Verify, an
Employer will need a personal computer with Internet access.
ARTICLE V
MODIFICATION AND TERMINATION
A. MODIFICATION
1. This MOU is effective upon the signature of all parties and shall continue in effect for as long as the
SSA and DHS operates the E-Verify program unless modified in writing by the mutual consent of all
parties.
2. Any and all E-Verify system enhancements by DHS or SSA, including but not limited to E-Verify
checking against additional data sources and instituting new verification policies or procedures, will be
covered under this MOU and will not cause the need for a supplemental MOU that outlines these
changes.
Page 10 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
1, l]1 \llIyy
E-VenrY
off
Company ID Number: 799651
B. TERMINATION
1. The Employer may terminate this MOU and its participation in E-Verify at any time upon 30 days
prior written notice to the other parties.
2. Notwithstanding Article V, part A of this MOU, OHS may terminate this MOU, and thereby the
Employer's participation in E-Verify, with or without notice at any time if deemed necessary because of
the requirements of law or policy, or upon a determination by SSA or OHS that there has been a breach
of system integrity or security by the Employer, or a failure on the part of the Employer to comply with
established E-Verify procedures and/or legal requirements. The Employer understands that if it is a
Federal contractor, termination of this MOU by any party for any reason may negatively affect the
performance of its contractual responsibilities. Similarly, the Employer understands that if it is in a state
where E-Verify is mandatory, termination of this by any party MOU may negatively affect the
Employer's business.
3. An Employer that is a Federal contractor may terminate this MOU when the Federal contract that
requires its participation in E-Verify is terminated or completed. In such cases, the Federal contractor
must provide written notice to OHS. If an Employer that is a Federal contractor fails to provide such
notice, then that Employer will remain an E-Verify participant, will remain bound by the terms of this
MOU that apply to non -Federal contractor participants, and will be required to use the E-Verify
procedures to verify the employment eligibility of all newly hired employees.
4. The Employer agrees that E-Verify is not liable for any losses, financial or otherwise, if the Employer
is terminated from E-Verify.
ARTICLE VI
PARTIES
A. Some or all SSA and OHS responsibilities under this MOU may be performed by contractor(s), and
SSA and OHS may adjust verification responsibilities between each other as necessary. By separate
agreement with DHS, SSA has agreed to perform its responsibilities as described in this MOU.
B. Nothing in this MOU is intended, or should be construed, to create any right or benefit, substantive
or procedural, enforceable at law by any third party against the United States, its agencies, officers, or
employees, or against the Employer, its agents, officers, or employees.
C. The Employer may not assign, directly or indirectly, whether by operation of law, change of control or
merger, all or any part of its rights or obligations under this MOU without the prior written consent of
DHS, which consent shall not be unreasonably withheld or delayed. Any attempt to sublicense, assign,
or transfer any of the rights, duties, or obligations herein is void.
D. Each party shall be solely responsible for defending any claim or action against it arising out of or
related to E-Verify or this MOU, whether civil or criminal, and for any liability wherefrom, including (but
not limited to) any dispute between the Employer and any other person or entity regarding the
applicability of Section 403(d) of IIRIRA to any action taken or allegedly taken by the Employer.
E. The Employer understands that its participation in E-Verify is not confidential information and may be
disclosed as authorized or required by law and DHS or SSA policy, including but not limited to,
Page 11 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
E-Ver1rV_
Company ID Number: 799651
Congressional oversight, E-Verify publicity and media inquiries, determinations of compliance with
Federal contractual requirements, and responses to inquiries under the Freedom of Information Act
(FOIA).
F. The individuals whose signatures appear below represent that they are authorized to enter into this
MOU on behalf of the Employer and DHS respectively. The Employer understands that any inaccurate
statement, representation, data or other information provided to DHS may subject the Employer, its
subcontractors, its employees, or its representatives to: (1) prosecution for false statements pursuant to
18 U.S.C. 1001 and/or; (2) immediate termination of its MOU and/or; (3) possible debarment or
suspension.
G. The foregoing constitutes the full agreement on this subject between DHS and the Employer.
To be accepted as an E-Verify participant, you should only sign the Employer's Section of the
signature page. If you have any questions, contact E-Verify at 1-888-464-4218.
Page 12 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
�i-vermlrv__
Company ID Number: 799651
Approved by:
Employer
Hawk Enterprises, Inc.
Name (Please Type or Print)
Title
Johanna Plank
Signature
Date
Electronically Signed
07/21/2014
Department of Homeland Security — Verification Division
Name (Please Type or Print)
Title
USCIS Verification Division
Signature
Date
Electronically Signed
07/21/2014
Page 13 of 17 E-Verify MOU for Employers i Revision Date 06/01/13
Company ID Number: 799651
Information Required for the E-Verify Program
Information relating to your Company:
Company Name
Hawk Enterprises, Inc.
Company Facility Address
1850 E. North Street
Crown Point, IN 46307
Company Alternate Address
County or Parish
LAKE
Employer Identification Number
621339540
North American Industry
Classification Systems Code
238
Parent Company
Number of Employees
20 to 99
Number of Sites Verified for
1
Page 14 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
E-Verify
Company ID Number: 799651
Are you verifying for more than 9 site? If yes, please provide the number of sites verified for in
each State:
INDIANA 1 site(s)
Page 15 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
E-Veriff"V M-P,- -
t
Company ID Number: 799651
Information relating to the Program Administrator(s) for your Company on policy questions or
operational problems:
Name
Mary Mastrantonio
Phone Number
(219) 662 - 8090
Fax Number
(219) 662 - 8093
Email Address
mary@hawk-inc.com
Name
Johanna Plank
Phone Number
(219) 662 - 8090
Fax Number
(219) 662 - 8093
Email Address
greglp@hawkanc.com
Page 16 of 17 E-Verify MOU for Employers I Revision Date 06/01/13
E-VerIrV_
Company ID Number: 799651
Page intentionally left blank
Page 17 of 17 E-Verify MOU for Employers I Revision Date 06/01/13