Loading...
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 rD W N H 0 W W V M Ln A W N I' CD W V m Url A W N H O W W V M Vs A W N H O W V N '� W N l-a 9 p D Q n n n n n n n M M M M n n D K K E K K� K v 4? 00 00 C w w N H N N N H H H H t-' w O T N v v n �p T O O O O �. v Oi v N 9 n ro O O T 00 A N N 00 V [n CS C7 @ 0 n rr v .6' � � O 7 N � � � DJ C '° 0) W X X X X X ri• a O 4 i i i i � e � i A O O O !D n n 7c' O 3 v �p - }s N O O O U7 O N O iD W N W O N [n 3 O? O ro 2 r1• N Q m a .Nr �3 W N -ryZ,' O X X X f1 W j W W (n (D O 00 (HD Ln Q W M H m Z G 3 W pNj V) m ,y. ^ 'G ro m O �p 3 0 O p 3 y Os N W 4 W A v n 7 b N W rt X H i� A V V7 V O Cl 00 V W •D coDD O W =, O N O 7C o� o O O Ol VE V7 O V3 \ O y 0 n cn H v n X o @ 3 W p 0 6 \ \\ \ o \ v z\ m ^ n ro r = m m c o N � oe d� m p o 0 Q D@ D o o Z c rt o v 4 O'4 en `C •G M, •O n O ry �' \ In S N p O O K �CCC [➢ ro •C ro N Oq rt q� �+ 5 3 0 ro 0 0 0 v v Q rt v O n rtn[_ O O C W Q A v v O v O 7 X n = =r 7 � y O N W o 6 0 n 6 N 6. (Hjt `J W\ W H N@ m OD X @ O@ o o w m\ (n w Q� Q O o Z' Ao o LA v O fi w cr n z 0 of Z , - + m '+ -0 -o 0 -v •n D n N z Oq F-a Oq \ ,G •C l/� O Ln �. v W eZi• (�0 'I-, a 3 oQ 0 m 7 -0 7 7 O N m 7 O > "O 3 'O ro oe A o mO O N n Oq N •� n @ O H O• � �'I l� N S O \ m o� n @ +� fi S V7 @ �n O n o 1, (n C C 3 Cl a [x 3 ❑ cu (D = n z rt n, ° V Q inc 0 ' a H 00 0 0 0 @ 0 3 n 3Y o c 3 z 00. �- 3 0 N w n C: a R T c z 0 0_ 0 N 3 N N N N N N N N N N N N N" N N -0 I� [n W M (n Ul Ol .O M (n Oq M Oq Oq •p W (n (n (n (n [n (n (n (n 'W (n (n F p = 9 Uq M p C v bq N v v v C Oq y Oq M M Oq Oq M Oq Oq Oct m Oq V7 VT [n In in In In (n Ul VF [1'i (I'i Ul Ln to Oq O o- m o o d v o °' o 0 0 0 94 Al - su ru sv as nu v w a w w v v_? N n O O '0 0 3 �� O` o = 0 0 0 o o o o o o o o m t/r 11 to "1 to V> yr Vr Vr t/} ri. Vw ih to iR v+ L' t/ jf� tR 4r% in t'* � t6 t^ th eh to to th to t/s to in to vi to to V-� {R S W C, H W H H H H H Y W Y W N N W W H W W W V w F' H (P F' W W N N W A to W W W V W W W V N 00 N A N CA H V O1 Od V A M F+ 7 w W V O W V O cn (n F' 'p O W H (n A (D Vn V N m W V W W V W O �"� W-- In V W N W H W w O 0 0 0 V (O in In W C) A 4 c 4 (n W V[ W V Cl H O W W A Vy V A H 00 A W dl N (n N O CO W T N ro 0 0 0 0 0(D LA 0 0 0 0 0 0(D O O W 0 Q O Q O O O W O W W W (n O Ul O Vt In Ul (n (n 0 0 U, O N i/F VT VF V? t/w iR µ Vw to tR lf> t/� t/t VT CA H Vt F+ H w F+ H H H W N N (D M Y tR to t' iD t' to Z Z {h i!F VT Fl H {!? tl J " VT t/r ( - Z t/T i!h VT 4 Vf W W WLm (/n O W 1-� W W W A A H 7 A V F, p W N H W H N 00 A A W H H N N N N A A O N N W 14 :+ 0o N A V V A Y V F'' W W Ol In V H Vy N V DO N CO W CO O H W A GO (D (D (F1 U'1 V Ol UJ (n V@ Ln w6 N U'I Qt Oo W A O W w W O N V 00 O A A Ul (n V O Ln Un W H 0 O O p N co W (D V w O D O w 0 (n p W W 01 W V 61 1--+ W E5 W O N H O C. O O O O O W Ut d> O rD Z Z Z z Z z z Z z Z z z Z Z Z Z Z Z z Z z z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z,, 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 •0 n T 2 2 T (/? (/? L/� v? 2! T T S (^ T z T v? (n S v? v? v? S LA 2 S S (/? rl- rk ei rF .! fll pl d rY N 91 Ov i•Y rT N M rt M Al M w v w M w w q) ru m ro ro O O O O O m ro ro O ro m@ O O @ 0 0 0 m Oro @@ O@ — 3 > > 0 .7.7EW 3 == --- -- --Q � cn w ro cn � N N H �+ H � fn w �n v, v< <n . v, 0 n rD @ @ @ N N N 3 C ro cu ri aNi w w aNi W a co a7 N al N N a) N N N N � N N a) al N al N N N N � N al a1 al N al al N N N al aY a/ a1 al N N ��� o L o o v o o v o o 0 0 0 0 o v 0 0 0 0 0 0 0 rb ra m ro ra r`a m •+�� Qj � m m ro ra , ro ate-+ ,ate+ a�� m +a+ a,-+ m ro + +�+ �, +'V a'U ra rrs a a a (5 S Vn of S N S S S S en S S N Ul T in S S S 2 in 2 in v1 Ln 2 in in S 2 2 in in Ul V) Ul 2 2 N m N p p d d d 0 O O O t7 a 0 g Q t7 O g q a O 0 a 0 q 4 0 0 0 q O p q q q D O q W 4 0 0 r,n m m m CO m m m m m m m m m CQ m O] m m m a0 m m m 00 03 m m 00 G] 00 OQ m m m m O] CD 00 CQ L"^? O O O O O O O O O O O O O O O O O O O O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 m or� z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z� 1\ Op O r-i �-1 r- 0 0 rn O p p to ^ M O m M O m p M in N o n p o p p N o m in CO to p O p p p p V n 1• CO O O N O N r-1 O 0 r0 N d' r- O d• Ln O O rD N M Cp ct O to 1` � O O tr n ro 1` 6 O 6 [fl [O [L M Ln m M M C) h o rD o v Vq rri m 1; o Q; N rl.M kD w „� rn rn o rn W o Cri ao m m io op o (' (D M N v-1 m m o M o M io u N N 1 m an d �Li ^� r` N� to rn N 1O N m �o 0 o 0 0 0 t1} �-i N N N m �' m 1n .--1 N in• c-I ;n c-[ r-1 cO .-I L71 �-I r-I Ch t? n t/? �!) iR t/} y} N N � t!1 ul V-F U). t/) t/) ih U). t/) in t? in• iA in• t!T 7n• t/} in t/} t/) t/) iR t/) t? Z z Z O p Ln S7 0 0 O O M O O p M M O O O O O O p rn 0 0 0 0 0 0 0 0 0 0 0 0 p_ O O p p p f` 0 f, N W O O O N O O 6 N p r-t O O m "1 p m N a't 0 0� In O 4 O O O lD p f, rD N M M M 1D m rn n r` 4'1 o W m H "' `Dv n� m� 00 m rn N z Ln 0� 4N1 -i ON Vim, •^ m N 61 i� ai 0 i o 0 000 Ll N lO m m N V rl n — t�T H N N r-1 M M M Ln r ri V N N Hr ih " tfi �-i i-I l0 N rn N r-I 6) t` y/} ih [/} Z [/) N N Z Z Z 1/} </? [/} t/} t/) t/) t/} in t1T tr�th in t/} ih [/} tr) � t/) t/) t/F vi t/ lr} V)- in ih in VII C CC '�OC C C C CCCC O O Q O O 4C OC O OOM_N f6 C O E CO DrJ -C 0 d 6 a C(O (lfCf5C4� Stl vi p bA bA ba b0 b0 fCf 3� x bo fC5 rtl ICV N W ba by N Lo 0 O bA ro by b.0 UA p O 3 p •Q b.0 N , O — a m 0 N b4 Ln Ln rn to bA H O Ln 4a bA 4a r1 Ln rh rn to W Ln Ln N Ln bD rn rn to bA N cr V u) N u) N Ln N i-i N N N N rV nj nl N nj rV CV rV CV rj rV 3 U Ca LU N m In N ca N N L l7 -- bn b l7 a b ria a1 u O u vNi X D I- ii bNN° Q. *—' vCU x u C7 i v1 Ln Ln 7 i1 N X CL X N v rp T V p V 00 U i N O C Q al C N 7 y, U cc a-� CL a1 ,r C C C u +.+ �7 C7 V7 [t L O -O O U "� +, m 1a m n .0 2 C it j O Q al O In rn N to 'p N m m ,n x `� ++ C 'm @ N rp 'O sJ O C7 0 rb T n7 d-) w a� h b O L dl C u O 4 [a N G1 O• a-, 00 o w a o u a '� ro n x a o m a� a o m D a cx N N y >- N al a/ dt O .0 O O p N bD C 0 S]. W ar N O N L Q7 - 7 3 a w u. u. V' S S=�� �� Z a m a a m of rn vn in {n vi Ln v) N F N F F F f- F rn F 7 X a a T d rn Lo r, Co m O H N m�T lf) w r, w m O -1 N m �t In w 1-1 w m O cq N m RE to SD r, w m O c-1 N m c} m *�r v v a v 0 rn rn M Ln M rn 1n m in w w w w w w w co w w n 1` n rn 1` r r rn n r w w co w w w 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 x x x x x z z 5, 0 m T z Z z '0 m 0 jz z 0 p 0 fn - O M 0 Im 0 0 0 e ry 'U 0 9 a y G 9 4 Ul V 0 m z Ch 40 w M4 En 0 ch 0 0 0 db - 00 -A C, io is �70 (-h Lq m Lh qh ro na CL =h 0 :1 o ut ti (L (D 0) 0 25Q 0 0 co q CNI 0 61) 0) C14 6 LO T 691 0) LO 0 0 r-- 691 Lq C14 Lf) tti N ol C=1co (D Lc) LO 64 m 0 OD 69, ui to 0 sky6c). in a) IL Al a IM 0) 0 N 0 M LO rl- II 0 — m CY) Lr) (13 0) Ll? cq 0 0V It x n IC ci CCI C xa .2 V V ca 0 LO w E Z3 0 Z, 0 E (D w E a) co -j 0 U- a) w > m C) L) w r) U) U) E (D M m as E ui aM L) 'E 0 r- 0) 0) 0 0 CA 0 0 N 0 LO o 0 0 0 6 C7 U,�) t, 0) o (o (D q, Lf) P'.: 0 0 �O 0 C) C? 0 Lo LiD 0 Lo� 0) 0 0 0 LO (Y) C) 0) of ID cr (1) r 0 .2 r 0 0 0 0) 0 cn 0 t m :3 cr a w 0 RM '79 .2 in 0 'a cm Yi (D (D CL ol cr w m -6 ILL .9 i: ca wo 0 0 0 L) ow r u (b K CL 0 LL 0 CL X u u .2 u a u 19 f3i I 0 z -E C4 w x .2 & w E uj LL IL LL -1 - 4� V� , M 0 04 Us 0 cy 0) tr C) 0 m Qj c;:, 4 co 09, 0 0 ra 643, m CN t 0 LO CN 0 CN 0) CN ol CD Lq LO v. cr ,0 CL c z 0 C) 0 x of of a) E + .2 0 x Z, 2 '0 0 C: 2 IL (D (D C) 0 �O 0 LO 0 6, Cl W� 0 V� 69, LO (D 0 N 0 0 0 0 LO C> 64 0 z LO 6% CD N en V) Cq tm U� 0 ui C11 0 w tm q 2m t. 0 0 Cn W! 2 "ii (M .2 7i 0) 2 w m .2 0) Lq .2 0 Iq 2 m kq .2 Im W� -M IQ U) 0 Lo (q .2 is 0 Lq 'Ni r 2 cn u v 0 m ct r .2 c 0 0 E c > 2 IL (L m U) ( D co CL ig CL w (D 0� 0 r- � 00 Ci (D r--_ LO w 0 cm 0 co ;2 a) CL E N U) o 0 0 0 0 0 C14 rl- 0) (D N Lf) A 1 05 0 C14 0 0 0 6% 6, 6f� 6% 60 (a 61� 61> 61) 6131, W 2 t 0 W "ru is A 7i cn Im m ol CD N cr IACq LIi Ni O v U CL 'm a LU 0 0 0 0 U. r- 0 U) 0 r: 0 r- w 0 .2 2 m 'a Cl. 0 E .0 CL -a -�2 r r= E N t a 3 U) (D 1— g 11 1" U) > CQ m V7 r. rZ r.. oa� . —W 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 � •-16� 2 04-2468%Nulur+lenq SOP WMJnor+ 504 16 • 3 10R0.2059% Melhex SOA +e7`�+ +7 _�'-. 0 b 16.2.16 Tau filled Gag 0 17Jh940%Nolfalene,37%AS, PC. SOP WA 40 G 40 7 JIB.9-te 66%Nahalen+w165nor9 SOP SON 45-St w NuAll, V iv- b 22-0.1075%P n41, 26%AS,40p son a�.,-' %] ✓' 1041.g♦7 B 22.2-1015%Pw on 0180%Po1on, SOP 609 ---4.0 D 0- £0 24-04560%pw on 4V40%Pot an 41. 60%Po on SOP 600 ..y�'. Q la. -M IQ Oyu ig rl t8L-0 60W Aklluz wlmfnef+, SOP 609 y 6b t.-'.-_00.�: �{� �i�tM 22 2444$10%Paton 43, 60%Pnlon SOP 600 !-tv •0nn�__l 43 30-0.776%Pot n4E.6, MOP 2%Fe 60A -.1a�1 6% (- "V-76/ +� �+^� 14 30-0897%Paton 42. MP 60P '.W.�:US,W s -o- IV Joe 0 1C 16 Verde.cal K Plux 04 60A ADO', -O- 6.+ 4-16 is Blo-Max 4-0-0 [slaNhzed Nllrogen.R%Fe, 3%Mn, 62%Auaphylium Nodo+unl 2A lion '� 1 -OrO t 1T aio-Max nowt enhancer [6%Fe. £0%Fwvlc Acre, Ps h Iluex Nodos9mi 2.6 lion 18 6io�Max 1244 Slabillzed Nllzo n,6% Pot assiom CArale 1%Fe. MM. Asco h lum Nedosum 2.5 Ihal is EadhMAX 3%Co +wc matter from Humas,4.3%11-1nW Ilan Homas 2.5 lit. ►4a WR 20 Max £ronMnMg ($%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� - S- ZO tit 22 Mas 1244 12%slaboiud Nl[r en.6%Fe, 3%Mo aeo 2,6 n I 's i. ` Y ' ,A�1 Nf 23 Max N303e-0-0e 30%slabiOttd Nita en. Pseo h rum Nadosum 2,6 anon "�." fr -0-a RE Ma+Pho+ horn]p2us3J0J 3%N,30%Phns Orkadd,3%K ilo 2.b +n :,G?%a+A 0 b6 [.1y. . 26 MStress Ndele 0-036 2d% Potassium+casaEe aADG 1.6 +Iron y-' ft ho 28 Mas YAle Phyre 0-0J010%Pala+alum has I[e 2R ahon .... - 3Tl t Lfa'j� i-v P 1'1 �v� ` 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+ d�~ ,, 1 � 1 (AAAVY1 y 1 Vq 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 `�� Wif (�� 0lv\\ i {S t4k 40 Criterion 2F gallon 7�� [„�� /U 57 41 .l Daconll Actlon u w� 2.6gallon A 42 Daconil Uitrex[KIWfO 5lbs. J �� —" J,� t Q 4 rr lb • pG f 43 Dtsm€ss NXT u;oc 10 oz. 44 IDylax 6.2 O 301b. Q�'7 r 45 Emerald 10x.491b. l9 � oo � v' 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 Y 51 Instrata 2.6 gallon f�j {—` {/ • OD 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 I ,,to v .ryV �7r �+ 56 Mirage Slressgard 2,8 gallon umj 4 57 Nonionic Spreader Slicker gallon [/�� •�� Ll+f!{= 58 par SG gallon p�/; /���.(IQC[- yA C �+o 7(Ld C.i 11G s i I 59 C Primo Maws l.. gallon {� "' 1� • �Ij� 1 �r • •� 60 Provaunt 1201, • 61 Proxy 2.5 gallon /y'� 1 2-- togg�/ tS L 62 Reward Ckw 2,5 gallon 117 "� C L ` JLL Z 7�' I �•� �`Q LA • W 63 Roundup No 2,5 gallon k�qG �t.- ' F{. Z•S O • �� 64 GG Secure L 2.5 gallon ], —j I D• 65 Scythe gallon y/y V' v �•' i1 /1 J U 11 1 • fib Signature X7RA5tressgard V0 .61b. t� C 67 Snapshot 2,6713 601b. 68 Sonar One 201b. t •� 69 S aedzone Red 2.5 gallon • 1 / P �` {„�� W { �� ■ `• �� 7 ` v J 1�/1 •��f 1 { 70 Subdue Maxs gallon O• V v - % t Y ZAQ 44 • �� 71 Symphony 2.6 gallon �Pt {� t/•/3 �• �... �^^_ O 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 Tardan RTU quart 78 ire€€an BG 40lb. 78 Suspend SC plotV •�` a0 Triptat SF 2.8 gallon G �I� { V +/7Yr �/J �`'1/� �+•-O' "v 81 Valista t0%22 oz. PO eQ 92 them €ar & 11.4 oz. 0J •.��-.. i Q,�+ q v/1 z— 7 �� ��+ •�� 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 13 ru ml tJ GI O. 9 . . . . CL to a. a. A t o o LL ao Om IL z z m a. m m W222 222 CL D a au ao co (D aj fL D cr al 0 0 m 2 0 .2 0 0 a is tn 0 m m m 0 mm m mrn m tr m mm CA mm tr m U) 0 m Ui w 414 C4 N Fn CL ua cr r U. 2 1111 0) U_ 22 i'l 4t N z Ci 0 =c =c -0: (D 0 a) 0 x -1 r CL cl Iq 0 0 E 0 u cr 0, 0 o 0 - m m E m L) (j, L) L) Fj U in al 31 0 Lul LL LL AN 0 M T7 M 0 0 r Cl r 0 C 0 0 c .2 c c r 0 0 0 a to 'I a m m rl N IN N N cq ID rn 0 ta w tm di tA o W1 m QL to 2 a. EL 0 4) o u U) m r 0 W 6. to kp w Lo w w w 0i OM 41 Iq W Vcn 64f1 N C14 C4 clt 4N LU 03 rcs 0 luj W d) "m i Q (n 0 w c c r LL w Im 04 00) CL c E 0 0 0 4) 3 0 z p 3-: LO 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