HomeMy WebLinkAboutAward Bid - Venues Parks and Arts 2018 Chemical Supply - VariousCtlY OF'SOUVA PEND
'VENUES PARKS G ARTS
Patrick Sherman
Facilities & Grounds
102o High St.
South Bend, IN 466ol
574-235-56ol
psherman@southbeiidin.gov
1/16/2018
Dear Board of Public Works,
With the approval of the Board of Public Works, we requested bids through public
publication for a list of chemicals we use within VPA, primarily in golf but also among
other VPA divisions.
We received three (3) bids from the following qualified firms.
® Harrell's LLC
® Site One Landscape Supply
* Spear Corporation
Based on the quotations we received at the 12/21/2017 Board of Public Works meeting,
we recommend awarding the individual,bid items based on the matrix below,
Harrell's LLC
1-15, 17, 18, 19, 21, 25, 28, 30, 32, 33, 34, 40, 41, 42,
43, 45, 48, 50, 51, 52, 53, 55, 56, 59, 61, 62, 63, 64, 66,
70, 73, 74, 75, 81, 82
Site One Landscape Supply
16, 20, 22, 23, 24, 26, 27, 31, 35, 36, 37, 38, 39, 44, 46,
47, 49, 54, 57, 58, 60, 65, 67, 68, 69, 71, 72, 76, 77, 78,
79,80
Spear Corporation
83,84,85
Warm regards,
Patrick Sherman
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1316 COUN'ry-Crry Buil-DING
227 W. JEFFERSON BOULEVARD
SOUTI I BLIND. INDIANA 46601-1830
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
January 23, 20 18
Jack Harrell
Harrell's LLC
5105 New Tampa Hwy,
Lakeland, FL 33815
RE: Award Bid - Venues, Parks, and Ails 2018 Chemical Supply
Dear Mr. Harrell:
PIJONL 574/2359251
FAx 574/ 235-9171
The Board of Public Works, at its meeting held on January 23, 2018, awarded the above
referenced bid to the below listed vendors. Your award will be listed in bold print.
a) Hari-ell's LLC
(1) Item Nos. 1-15, 17, 18, 19, 21, 25, 28, 30, 32, 33, 34, 40, 41, 42, 43, 45, 48, 50,
51, 52, 53, 55, 56, 59, 61, 62, 63, 64, 66, 70, 73, 74, 75, 81 and 82
b) SiteOne Landscape Supply
(1) Item Nos. 16, 20, 22, 23, 24, 26, 27, 31, 35, 36, 37, 38, 39, 44, 46, 47, 49, 54,
57, 58, 60, 65, 67, 68, 69, 71, 72, 76, 77, 78, 79 and 80
c) Spear Corporation
(1) Item Nos. 83, 84, and 85
Due to a bid bond not being required for this bid, enclosed you will find your bid bond. A
representative from the Venues, Parks, and Arts Department will contact you regarding the bid
award.
Please call this office with any questions regarding this matter at (574) 235-925 1.
Sincerely,
da M. Martin, Clerk
Enclosure
C: Patrick Sherman, Venues, Parks, and Arts
GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMEs A. MUELLER THERESE J. DORAU
ZWUL��
CITY OF SOUTH BEND, INDIANA
SELLER'S BID FOR SALE OR LEASE OF MATERIALS
Venues Parks & Arts 2018 Chemical Su
December 211t, 20�17 @ 9�:30am
Bidder
Date: (Firm):
Address:
City/State/Zip: Lazf4gd4
Agent of Bidder (if Applicable):
I I
Wcre.I& _L_ C_
elephone Number:(Y6,3) C,0'7-�(
When theprospective Contractor is unable to certify to any of the statements beloiv, it shall attach anexplanation 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-Qc �J
)SS.,
alk COUNTY
The undersigned Contractor, being duly swam upon his/her/its oath, affirms under the penalties of perjury
that:
I . Contractor has not, nor has any other member, representative, or agent of the film,
company, corporation or partnership represented by him, entered into any combination,
collusion or agreement with any person relative to the price to be bid by anyone at such
letting nor to prevent any person from bidding nor to induce anyone to refrain from
bidding, and that this bid is made without reference to any other bid and without any
agreement, understanding or combination with any other person in reference to such
bidding. Contractor further says that no person or persons, firms, or corporation has, have
or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on
account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any
of its principals are presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this transaction by any Federal
department or agency; and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
For purposes of this Certification, "Iran" means the government of Iran and any agency
or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as
amended from time -to -time.
Ver. 13 — 6101115
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 MBE/WBE; however, it may not unlawfully discriminate against
said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE
Ver. 13 — 6101115
I hereby affirm under the penalties of perjury that the facts and infonuation contained in the foregoing bid
for public works are true and correct.
Dated this ON day of e:, , 20/
Contractor/B dd r (F
'N MY COMMISSION #FF099586 S gna ure of Contractor/Bidderor Its Agent
" � o EXPIRES March 9, 016
DE(407) 398-0153 FlariclaNcalaryService.c�raa U. r o a
Printed Name and Title 5�, Nrkchlt,
Subscribed and sworn to before me this day of C" , 20
My Commission Expires
Notary Public
County of Residence A /A
Ver. 13 — 6101115
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Bidder (Firm)
Address:
City/State/Zip
H-artf �1
Slos- Xe-ti 11
La�,elaad Fl- 33'SIS-
Telephone Number: =--=-W0"7
a
BOARD OF PUBLIC WOR
Gary A. Gilot,"President
uzanna M. Friitzbergi, Member
James A. Mueller, Member
Therese-J4 Dorafi, M6-m1ber
I kTj M WT, k 11
Linda M. Matt
Ve,i13 — 6101115
1316 COUNTY-Crry BUILDING
227 W. JEFFERSON BOULEVARD
Sou'm BEN. INDIANA 46601-1830
CITY OF SOUTi-i BEND PETE BUTTIGIEG, MAYOR
January 23, 2018
Keith McGinty
SitcOnc Landscape Supply
13 85 East 3611, Street
Cleveland, OH 44114
RE: Award Bid -- Venues, Parks, and Arts 2018 Chernical Supply
Dear Mr. McGinty:
PHONE 574/235-9251
1-"Aid 574/2359171
The Board of Public Works, at its meeting held on January 23, 2018, awarded the above
referenced bid to the below listed vendors. Your award will be listed in bold print,
a) Harrell's LLC
(1) Item Nos. 1-15, 17:, 18, 19, 21, 25, 28,30, 32,33, 34, 40, 41, 42, 43, 45, 48, 50,
51, 52, 53, 55, 56, 59, 61, 62, 63, 64, 66, 70, 73, 74, 75, 81 and 82
b) SiteOne Landscape Supply
(1) Item Nos. 16, 20, 22, 23, 24, 26, 27, 31, 35, 36, 37, 38, 39, 44, 46, 47, 49, 54,
57, 58,, 60, 65, 67, 68, 69, 71, 72, 76, 77, 78, 79 and 80
c) Spear Corporation
(1) Item Nos. 83, 84, and 85
A representative front the Venues, Parks, and Arts Department will contact you regarding the
bid award.
Please call this office with any questions regarding this matter at (574) 235-925 1,
Sincerely,
rin 'Ya Mal
Enclosure
c . Patrick Sherman, Venues, Parks, and Arts
GARY A. GILOT SUZANNA M. FRrrZ13FRo ELIZABETH A. MARADIK JAMEs A. MUELLER THERESE J. D'ORAIJ
CITY OF SOUTH BEND, INDIANA
SELLER'S BID FOR SALE OR LEASE OF MATERIALS
BID NAME Venues Parks & Arts 2018 Chemical Supply
FOR BIDS DUE December 2111t, 2017 @ 9:30am
Cd
iderSiteftne Landscape SuppyDate: Fm): 1385 E;ast 36th itreet
Address: Qm1and, uhlo 44,114
City/State/Zip: Telephone Number: 7o94 -!?060
Agent of Bidder (if Applicable):
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
A SS:
Q CCOUNTY
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury
that:
I . Contractor has not, nor has any other member, representative, or agent of the firm,
company, corporation or partnership represented by him, entered into any combination,
collusion or agreement with any person relative to the price to be bid by anyone at such
letting nor to, prevent any person from bidding nor to induce anyone to refrain from
bidding, and that this bid is made without reference to any other bid and without any
agreement, understanding or combination with any other person in reference to such
bidding. Contractor further says that no person or persons, firms, or corporation has, have
or will receive directly or, indirectly, any rebate, fee, gift, commission or thing of value on
account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any
of its principals are presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this transaction by any Federal
department or agency; and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
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,
Ver. 13 — 6101115
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:
L 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 include and attached as part of this bid/quote;
and ! ` S ? £ �b°�^-C.
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
Ver. 13 — 6101115
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.
Ver. 13 -- 6101115
Item
Ferillizer tsoospec shoals for items 146
Pka. Size
Unit Price
If Alternative -Include additional Information
Alternate Pk , Size
Alternate Unit Price
1
0 040 MIA Po on SOP
son
�
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2
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0
b
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WA
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7
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600
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30-0.776%Pot n4E.6, MOP 2%Fe
60A
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14
30-0897%Paton 42. MP
60P
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s -o- IV Joe 0 1C
16
Verde.cal K Plux 04
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is
Blo-Max 4-0-0 [slaNhzed Nllrogen.R%Fe, 3%Mn, 62%Auaphylium Nodo+unl
2A lion
'�
1
-OrO t
1T
aio-Max nowt enhancer [6%Fe. £0%Fwvlc Acre, Ps h Iluex Nodos9mi
2.6 lion
18
6io�Max 1244 Slabillzed Nllzo n,6% Pot assiom CArale 1%Fe. MM. Asco h lum Nedosum
2.5 Ihal
is
EadhMAX 3%Co +wc matter from Humas,4.3%11-1nW Ilan Homas
2.5 lit.
►4a
WR
20
Max £ronMnMg ($%Mg,6.76%s,3%fe.4%Mnchelaledwithdlnc+cl
2.6 ]lion
f. C
2£
Max MOM,PNae-0-0 6%Nesale.2%M ,3%Fe,6%Mn,.6%Znl
1.6 Ikn
'si� -
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22
Mas 1244 12%slaboiud Nl[r en.6%Fe, 3%Mo
aeo 2,6 n
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Max N303e-0-0e 30%slabiOttd Nita en. Pseo h rum Nadosum
2,6 anon
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Ma+Pho+ horn]p2us3J0J 3%N,30%Phns Orkadd,3%K
ilo 2.b +n
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2R ahon
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Item
Chemicals -Requested
Pkg. size - Requested
Unit Priiiccey/
If Alternative - Include additional Information
Alternate Pkg. Size
Alternate Unit Price
27
Acerepryn
.6gallon
A
26
Aquathol K
2.5 gallon
�/ /' �y
V K iA a
1
\
�%{j,
a i - -74-
29
Aulrol EC
quart
00
30
Banner Maxx 11 VI+
gallon1
31
Banal �N
garton
y 1 1"n�fUr✓
D j {ALTO`
•r(�
32
fp
Barricade4F1. C..l;•IJI
gallon
�J("'
33
Briskway
gallon
00
34
Concertg
2.6 gallon
35
Confront
gallon
2
J
n+
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,, 1 �
1 (AAAVY1
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36
Conserve SC
quart
I Ito
37
Capper Sulfate Crystals __SO
lb.
bat A e4
15
3zr�3q
36
Chipco 2S019F
2.5 gallon
'
39
Clearys 3336F
2.5 gation
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40
Criterion 2F
gallon
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41
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Daconll Actlon u w�
2.6gallon
A
42
Daconil Uitrex[KIWfO
5lbs.
J �� —"
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lb •
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43
Dtsm€ss NXT u;oc
10 oz.
44 IDylax
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301b.
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r
45
Emerald
10x.491b.
l9
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46
Fleet166
2.S gallon
47
Flight Control, Pius
gallon
Li! j
48
Garton 3A
2.5 gallon
1
49
Habitat
2.5 gallon
lot�]
•
a v 4 _ t 3
60
Heritage Nnoilb.
,1
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51
Instrata
2.6 gallon
f�j
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52
Infrerrace Slressgard
2.6 gallon
C
63
Medallion SC `�.
�. gallon
jjam�-?-
5-6 or
54
Mandan 25WG
17 oz.
•
65
Merit 76 WSP (Mini Gdm)
11100.6 oz.
-eft
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56
Mirage Slressgard
2,8 gallon
umj
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57
Nonionic Spreader Slicker
gallon
[/�� •��
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58
par SG
gallon
p�/; /���.(IQC[- yA
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gallon
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Provaunt
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61
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2.5 gallon
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62
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2,5 gallon
117 "�
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7�' I
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63
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2,5 gallon
k�qG �t.- ' F{.
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67
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601b.
68
Sonar One
201b.
t •�
69
S aedzone Red
2.5 gallon
•
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gallon
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71
Symphony
2.6 gallon
�Pt
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72
TZone SE
2.5 gallon
S so.,.
73
TartanSFressgard
2.6 gallon
A
1�+g1•7
74
ITearn 2G Dispersal
40 lb.
76
C
Tenacity i �
gallon
76
Tempo SC Ultra
240 mi.
- 3-..g3--O
F
T7
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quart
78
ire€€an BG
40lb.
78
Suspend SC
plotV
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G
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81
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PO eQ
92
them €ar &
11.4 oz.
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83
Pulsar Briquettes
Pulsar Shock
a0lb,
2Z 1b,
84
85
Hydrochloric Auld 20 BE
160 Fb.
Bidder (Firm): Site0ne lAndscape, Surppfy
1385 East 36th Street,
Address: C1,vietarid,, Chlo 4,4114
City/State/Zip:
Telephone Number: .9- Fax Number: 0 qk -591 - / q 3 5
BOARD OF PUBLIC W7kK
Gary A;.; — lot, President
Suzanna M. Fritzberg,(Member
James A. Mueller, Member
By 45��
Signature)
Keith McGinty
(Printed Namd)
(Title)
Theresp J. Dorauf MemVer
Martin,
Ver. 13 — 6101115
1316 COUNTY -CITY BuiLDING
227 W. JEFFERSON Bout,r',VARD
SOUTH BEND. INDIANA 46601-1830
CITY OF SOUTut BEND PE,rE BurriGIEG, MAYOR
BOARD OF PUBLIC WORKS
January 23, 2018
David Bollman
Spear Corporation
12966 N CR SO W
Roachdale, IN 46172
RE: Award Bid - Venues, Parks, and Arts 2018 Chemical Supply
Dear Mr. Bollman:
PHONt-, 574/235-9251
FAX 574/ 235-9171
The Board of Public Works, at its meeting held on January 23, 2018, awarded the above
referenced bid to the below listed vendors. Your award will be listed in bold print.
a) Harrell's LLC
(1) Item Nos. 1-15, 17, 18, 19, 21, 25, 28, 30, 32, 33, 34, 40, 41, 42, 43, 45, 48, 50,
51, 52, 53, 55, 56, 59, 61, 62, 63, 64, 66, 70, 73, 74, 75, 81 and 82
b) Site0ne Landscape Supply
(1) Item Nos. 16, 20, 22, 23, 24, 26, 27, 31, 35, 36, 37, 38, 39, 44, 46, 47, 49, 54,
57, 58, 60, 65, 67, 68, 69, 71, 72, 76, 77, 78, 79 and 80
c) Spear Corporation
(1) Item Nos. 83, 84, and 85
A representative from the Venues, Parks, and Arts Department will contact you regarding the
bid award.
Please call this office with any questions regarding this matter at (574) 235-925 1.
Sincer , ely,
Lin
a
M, Mai -tin, Cleric
er
Enclosure
G'. Patrick Sherman, Venues, Parks, and Arts
GARY A. GILOT SUZANNA M, FRrrzi3ERG D,IZABETH A. MARADIK JAMhs A. Mur�,LLEiz THE'.RFSE J. DORAU
Z,1.
CITY OF SOUTH -BEND, INDIANA
SELLER'S BID FOR SALE OR LEASE OF MATERIALS
PEM
BID NAME Venues Parks & Arts 2018 Chemical Supply . . . . . . . .........
FOR BIDS DUE December 21st, 2017 @ 9:30am
Bidder
Date: Z. - 7- ?:fZ,7 (Firm):
Address: /z9&b Al C.R. .50 of
City/State/Zip: 442e 4tlR Telephone Number: ( 7*65) - _IL - /1--ZG
Agent of Bidder (if Applicable):
When theprospective Contractor is unable to certify to any of the statentents below, it shall attach an explanation to this Af .fidavil.
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:
COUNTY
The undersigned Contractor', being duly sworn upon his/her/its oath, affirms under the penalties of perjury
that:
I , Contractor has not, nor has any other member, representative, or agent of the firm,
company, corporation or partnership represented by him, entered into any combination,
collusion or agreement with any person relative to the price to be bid by anyone at such
letting nor to prevent any person from bidding nor to induce anyone to refrain frorn
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 contract -or 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.
Vei-. 13 — 6101115
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 bran; 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 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 seeping 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
Ver. 13 — 6101115
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.
Ver. 13 — 6101115
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 7 TW day of ,rlEA 20 / 7
Contractor/Bidder (Firm)
Signature of Con •actor/Bidder or Its Agent
�� cncL,sr't,�r�l - In�s�d� Ste WW6A
Printed Name and Title
Subscribed and sworn to before me this 77ve day ofF��20-LZ
My Commission Expires I i2- Z3
Nol ary Public
County of Residence ��,��r,
FNotary
60LLMAN
Seat
- State of lniana
m County
Expires Nov 12, 2023
Ver. 13 - 6101115
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Bidder (Firm): .5kWA- �Rt'oR rio,�J
Address: /g%' At ex- s~o
CitylState/Zip:
Telephone Number: 76�-';-2-2-- 1/2-6 Fax Number:
By
e (Signature)
Afll� �Soc:Gsst�! _ _
(Printed Name)
(Title)
BOARD OF PUBLIC WORKS
/.L
Gary A. Girot, President
na M. Fritzberg, Member
A. Mueller, Member
Therese J.)Pora 7,em er
-tE4a
Elizabeth A. Maradik, Member
n�
--A st: Linda M. MaMn, Clerk
TVer. 13 -- 610111.5
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
1 11101241111
Name Patrick Sherman
Department VPA: Facilities and
Grounds
BPW Date 01/23/2018 Phone Extension 5601
Legal' ❑
Attorney Name Clara McDaniels
Controller
Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing
Michael Schmidt
Check the A
ro rime It rrt e' — Re lre0 forA11
❑ Agreement
El Contract ❑ Proposal ❑ Addendum,
❑ Professional Services
❑ Resolution
Bid Opening
M Bid Award ❑ Req. to Advertise ❑ Title Sheet
❑ Quote Opening
❑ Quote Award
❑ Change Order No.
❑ C/O & PCA No. ❑ PCA
❑ Ease/Encroach.
❑ Traffic Control
❑ Other:
Reaulrod Iriforrr ortJo
Company or Vendor Dame Various:
New Vendor
L J Yes N No LJ If Yes, Approved by Purchasing
MBIEANBE Contractor
❑ MBE ❑]'u''VBE
MBE/iNBE Contractor Requested ❑ No ❑ Yes Name of Company
Project Name
Venues Parrs & Arts 2018 Chemical Supply
Project Number
1032-2017
Funding Source
Various VPA Maintenance funds
Account No.
Various VPA Maintenance accounts
Amount
$ TBD based on departmental need.
Terms of Contract
Agreed upon cost as needed by VPA departments
Purpose/Description
Creating agreement for grounds and golf chemicals to be purchased
as needed throughout 2018
® Required Contractor's Certification Form,, Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.
Re Ured For khan Orders Cl "
Amount of ❑
Increase $
❑
Decrease $
Previous Amouint
$
Current Percent of Change:
New Amount
$
Total Percent of Change:
Copy
Original
❑
❑
❑
❑
0
0
Dispersal After Approval