HomeMy WebLinkAboutOpening of Bids - Ameritech Drive Pavement Improvements Proj NO 117-057A - Walsh and Kelly IncLON k, ki I am Lei LiM M1,1111 :421]:] 11 0
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Project Name Ameritech Drive Pavement Improvements
Project No. 117-057A
For Bids Due June 12, 2018
PART I
(Must be completed for all bids. Please type or print)
Date: 6112/18 Bidder (Firm): Walsh& Kelly, Inc.
Address: 24358 SR 23
City/State/Zip: SC)Uth (Bend, IN 46614 Telephone Number: ( 574 ) 288,-4811
Agent of Bidder (if Applicable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of:
Ameritech Drive Pavement Improvements
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
Abonimarche Consultants
and dated 4/30/18 for the sum of (enter the Total Bid as shown on the Proposal)
Five hundred twenty thousand five hundred & seventy dollarsand zero cents ($ 520,570.00
(Enter sum of Total Base Bid plus Alternates shown on Proposal) (Numerical)
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in
the notice of the letting. If alternative bids 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 imate ,fiqlJncluded In the contract are needed, the cost of units must be the same as that
shown in the origloi6 EN
-Cifaccepted by the City of South Bend. If the bid is to be awarded on a unit
basis, the itemiz , a11 be shown on�.pa to attachment.
Co.
(8igriature)
6aKn M. Peisker, VP of Asphaft Operations
(Printed Name of Person, Signiingi)
%
The above bid is 26E
4
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Elizabeth A. Maradik, Member
ACCEPTANCE
day of
Suzanna M. Fritzbeirg, Member
Therese J. Dorau, Member
James A. Mueller, Member Attest: Linda M. Martin, Clerk
Version 10/17/20,16 Contractor's Bid for Public Works - 2
Rol
Conctractor"s Bid for Public Work - City of South Bend
Project No. 117-057A
PROJECT NAME Ameritech Drive Pavement Improvements
PROJECT NUMBER 117-057A.
FOR BIDS DUE June 112 2018
Base Bid
May 2018
Item No.
Description
Quantity
Unit.
Unit (Price
Total Amount
1.
Construction Engineering
1
LS
$ 3,700.00
$ 3,700.00
2.
Mobilization/Demobilization
1
LS
$ 18,500.00
$ 18,500.00
3.
Clearing Right of Way
1
LS
$ 8,4%00
$ 8,450.00
4.
Sheet Sign, Remove and Relocate
3
EACH
$ 400.00
$ 1,200.00
5.
Fire Hydrant Assembly, Remove and Relocate
1
EACH
$ 5,200.00
$ 5,200.00
6.
Concrete Curb and Gutter, Remove
820
LFT
$ 5.30
$ 4,346.00
7.
Concrete Approaches, Remove
240
SYD
$ 11.00
$ 2,640.00
8.
Common Excavation
2,370
CYD
$ 24.00
$ 56,880.00
9.
"B" Borrow
1,490
CYD
$ 30.80
$ 45,892.00
10.
Milling, Asphalt, Variable Depth
4,0160
SYD
$ 3.00
$ 12,180.00
111.
HMA for Patching (Undistributed)
340 .
TON
$ 58.00
$ 19,720.00
12.
Compacted Aggregate for Base, No. 53
630
TON
$ 40.00
$ 25,200.00
13.
HMA Surface, 9.5 mm, Type B
480
TON
$ 82,00
$ 39,360.00
14.
HMA Intermediate, 19.0 mm, Type B
170
TON
$ 78.00
$ 13,260.00
15.
HMA Base, 25.0 mm, Type B
670
TON
$ 58.00
$ 38,860.00
16.
Concrete Curb and Gutter, 6"
820
LFT
$ 29,00
$ 23,780.00
17.
PCCP for Approaches„ 6"
60
SYD
$ 72.00
$ 4,320.00
18.
PCCP for Approaches, 9"
320
SYD
$ 79,50
$ 25,440.00
19.
Mulched Seeding, Type U
860
SYD
$ 6,67
$ 5,736.20
20.
Maintaining Traffic
1
LS
$ 15,474.80
$ 15,474.80
21.
Line, Thermoplastic, Yellow, 4"
518
LFT
$ 2,00
$ 1,036.00
22.
Line, Thermoplastic, White, 4",
230
LFT
$ 2.00
$ 460.00
23.
Transverse Line, Thermoplastic, White, 24", Stop Bar
40
LFT
$ 10,00
$ 400.00
24.
Pavement Message Marking, Thermoplastic, Lane Indication
2
EACH
$ 250.00
$ 500.010
Arrow
25.
HMA for Temporary Pavement
445
SYD
$ 37.00
$ 16,465.00
Total Amount of (Base Bid! (items 1 through 25) 1 $389,000,001
Alternate A: Mill and Resurface North of Cleveland Road
Item No.
Description
Quantity
Unit
Unit Price
Total Amount
Al.
Milling, Asphalt, Variable Depth
8,650
SYD
$ 3.60
$ 31,140.00
A2.
HMA Surface, 9.5 mm, Type B
750
TON
$ 79.00
$ 59,250.00
A3.
IHMA for Patching (Undistributed)
1 710
1 TON j
$ 58.00
$ 41,180.00
Total Amount of Add Alternate A (Items Al through A3)
$ 131,570A0
Total Amount of Base Bid $389,000.00
Total Amount of Add Alternate A $131,570.00
Total Amount of Base Bid + Add Alternate A $520,570.00
Bidder (Firm): _Walsh & Kelly, Inc.
Address: 24358 SR 23
City/State/Zip: South Bend IN 46614 Telephone Number: (574) 288-4811
John M. P"er, VP of Asphalt Operations
(Printed Name of Person Submitting)
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When the prospective Contractor is unable to certify to any of the statements belon; it shall attach an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION
REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON-
DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL
PRODUCTS OR FOUNDRY PRODUCTS
(Must be completed for all quotes and bids. Please type or print)
STATE OF Indiana )
) SS:
St. Joseph COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury
that:
1. Contractor has not, nor has any other member, representative, or agent of the firm, company,
corporation or partnership represented by him, entered into any combination, collusion or agreement with
any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding
nor to induce anyone to refrain fi•om 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.
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.
Version 10/17/2016 Contractor's Bid for Public Works - 4
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/slue/it shall enroll in and verify the work eligibility status of all of Contractor's
newly hired employees through the E-Verify Program as defined by T.C. 22-5-1.7-3. Contractor's
documentation of enrollment and participation in the E-Verify Program is included and attached as part of
this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public contract to
certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien,
and that the subcontractor has enrolled in and is participating in the &Verify Program. The Contractor agrees
to maintain this certification throughout the term of the contract with the City of South Bend, and understands
that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision
no later than thirty (30) days after being notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City
of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or
applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions,
or privileges of employment, or any matter directly or indirectly related to employment because of race, sex,
religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or
disability that does not affect that person's ability to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any
combination of the foregoing including, but not limited to, public works contracts awarded under public
bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards,
or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors
certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise
("WBE") as a factor in determining the lowest, responsible, responsive bidder.
In no event shall persons or entities seeking the award of a City contract be required to award a subcontract
to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a
discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity fi•om
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 cormnissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the
performance of this contract with privileges of employment, or any matter directly or indirectly related to
employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation,
handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of
contract.
1, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or Foundry products made in the United States (I.C. 5-16-8-1). I hereby
certify that I and all subcontractors employed by me for this project will use steel products or foundry
products made in the United States on this project if awarded. I understand I have an affirmative duty to
notify the City in my bid that my proposal does not include the use of steel products or foundry products
made in the United States. I understand it is my sole obligation and responsibility to provide a justification
to the City, subject to review and approval, why the cost of United States made steel or foundry products is
unreasonable, Prior to award and upon submission of bid which does not use steel products or foundry
products made in the United States, the City, through its director of public works, shall make a determination
if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder
Version 10/17/2016 Contractor's Bid for Public Works - 5
may result in forfeiture of contractual payments.
I hereby affirm under the penalties of perjury that the facts and infon-nation contained in the foregoing bid
for public works are true and correct,
Dated this 12th day of June , 2018
��1,ti41E�Pi9d`�
a ORA TF a {� �• �
ate: o e _
Walsh & Kelly, Inc.
Contractor/Bidder (FFiinn
Ury ,
&aVe of Contractor/Bidder or Its Agent
John M. Peisker. VP of Asphalt Operations
Printed Narne and Title
Subscribed and sworn to before me this 12th day of Junp. , 201
My Commission Expires 615122
Notary Pub rc Alisha K eger
County of Residence St. Joseph
KRUEGER
�...... trrr ALISH
PUa{2 Notary Public. Stet' of Indla"
St.JasephCDUnIV
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MY Commly9101) Expiry®
0612022
June
Version 10117/2016 Contractor's Bid for Public Works - 6
13,16 C OUNTY-Crry BUILDINO PjioNF 574/ 235 -9251
27 W. JEF TFRSON BOULEVARD FAX 574/ 235-9171
2
SOUTI I BEND, INDIANA 46601-1830 I'DD 574/ 235-5567
CITY OF Sou'rii BENT) PETE, BUTTI(:uIE-G, MAYOR
BOARD OF PUBLIC WORKS
Date:
To:
From
Subject
June 6, 2018
All Bidders
Linda M. Martin, Clerk, Board of Public Works
Addendum Number: 1
Project Name: Ameritech Drive Pavement Improvements
Project
Number: 117-057A
Exa
I i CpMeLIMAT"DI 011`111 CM11011 Irs)
Date Received: 6/6/18
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum by
faxing this sheet to the Board of Public Works at (574) 235-9171. A copy
MUST also be included with your bid package upon submittal.
Note:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein,
Company: Walsh & Kefly, Mc.
Authorized Signature:
Peisker, VP of Asphalt Operations
Date:
ELt
C)
()\�?ORAIe%
SEs
OF
D 1 NO
'118111160,
Surety 0 +908.903.3485
202B Halls Mill Road, PO Box 1650 l: + 908,903.3656
Whitehouse Station, M 08889-1650
Federal Insurance Company
AIA Document A310TI41 Bid Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable.
CONTRACTOR
(Name le al status and address):
Walsh Kelly, Inc.
24358 State Road 23
South Bend, IN 46614
OWNER
(Name, legal scants and address):
City of South Bend, Indiana
227 W. Jefferson Blvd,
South Bend, IN 46601
BOND AMOUNT
SURETY
(Name, legal status and principal placeofbitsiness):
Federal Insurance Company
202B Halls MW Rd., PO Box 1650
Whitehouse Station, lq 08889-I650
In an amount not less than five percent (5%) of the base bid plus any alternates.
PROJECT
(Name, location or address, and Project number, if any)
Ameritech Drive Pavement Improvements
Project No. 117-057A
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the
Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and
severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor
within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and
Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such
bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted
in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract
and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the
difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount
for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this
obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of
an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid, Waiver
of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for
acceptance of bids specified in the bid documents, and the Owner and Contractor shad obtain the Surety's consent for
an extension beyond sixty (60) days.
If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall
be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.
Printed in cooperation with the American Institute of Architects (AL4) by Chubb. The language in this document conforms to the language used in
AM Document A310 "w• 2010,
Form 15-02-057.1;.rM (Rev, 3/17)
When this Bond has been furnished to comply with a statutory or other legal requirement in the location ofthe Project,
any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted here
from and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein.
When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law
bond.
Signed and sealed this 12th
(Witness) Allslig Rrueger
day of June, 2018.
VPof South Bend Area �esktfttjra
(Title)
e• QoRATF .IC
�.
s o'P
vec
C By:
(witness) David M. 0li �p
Insurance Company
Eric M. Wahlstrom
Printed in cooperation with theAmerican Institute of Architects (ALA) by Chubb. The language in this document conforms to the language used in
AM Document A310 T" 1- 2010.
Form IS-o2-0575TED (Rev.3/17)
CHUBS"
Power of Attorney
Federal Insurance Company f Vigilant Insurance Company I Pacific Indemnity Company
Know All by These Presents, That FEDERAL. INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC
INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Tla A. Boise, Terry R. Hurst, Brian T, Morton, David M. oliger,
Robert M. Rutigliano, Christina Marie Schmitter, Tina N. Senefeld and Eric M. Wahistrom of Indianapolis, Indiana — — —-----•-- -_...� __.`_—__
each as their true and lawful Attorney -in -Fact to execute under such designation In their names and to affix (heir corporate seals to and deliver far and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory In the nature thereof (other than bail bonds) given or executed In the course of business, and any
Instruments amending or alteringthe same, and consents to the modification or altemi(on ofany instrument referred to in safd bonds orobligations,
In Witness Whereof. said FEDERAL INSURANCL COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these
presents and affixed their corporateseals on this 19ib day ofianuary, 2017. / 1l,.� i
Dawn M. Chloros, Assistant Secretary Catherine A. D00%W,, Vice President
LA
STATE OF NEW JERSEY
County arHunterdon
On Ihfs 1911 day of January, 2017 before rite, a 3Nolary Public of New Jersey, personally came Dawn M. Chlores, to me known to be Assistant Secretary of FEDERAL INSURANCE
COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M.
Chloros, being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL, iNSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC
iNDEMN17Y COMPANY and knows the corporate seal, thereof, that the seats affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by
authority of said Companies; and that she signed said Power of Attorney as Assistant Secretary of Bald Companies by like authority; and that she Is acquainted with Catherine A.
Donahue, and knows him to be Vice President of said Companies; and that the stgnalure of Catherine A. Donahue, subscribed to said Power of Attorney is In the genuine
handwriting ofCatherin a and was thereto subscribed by authority ofsAdGompanlesand Irk deponent'spresencc.
NotarialSeal tt,Q`� E' KATHERINE J. ADELAAR
IaOAR NOTARY PUBLIC OF NEW JERSEY
ON-0-0 too. 231 BeaS Notary Public
PUBLIC Commission Expires .Euly qqg
CERTIFIIIRY Sl�f
Resolutions adopled by Dtr&lom ofFEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on Augus(30,2016:
-RESOLVED, that the following authorintloncrelate to the execution, for and on behalf of the Company,orbands, undettxldhgs, reevgnizatt= cvntrags and other written commitments of the Company
entered Into In the ordinarycoume of bwiness (each a -Written Commitmene),
(1) Each of the Chairman, the President and the Vice Pres(dents of the Company Is hereby authorized to execute any Written Commitment for andon behaRbf thcoompany. under the
seat of the Company or otherwise.
(2) Each duty appointed Attorneyan-fact of the Company is hereby authorised to execute any Written Commitment for and on behalf of the Company, trader the seal of the Company or
otherwise. to the extent that such action is authorized by the grant of powers provided for in such person's written appointment as such auorneyln-fan.
(3) Fadh of the Chairman, the Prealdent and the Vice Presidents of the: Company is hereby authorized, for and on behalfoftheCompany, toappoint Inwrlting any person the attorney-
Waet of the Company with tali power andau[thoritytoerteatie rot and on behatfofthucompany. under the sea) of the Commnyorotherv&e,sudtWritten commirmentxorihe
Company as may be specined in such written appolmment, which specification maybe by general type or days of Written Commfunents or by specification of one ormore particular
Written Commitments.
(4) Each of the Chairman. the President and the Vice Presdenw of the Companyishereby authorized, forandonbehatroftheCompany. todelegateInwritngtosnyotheranleerofthe
Company the authority to execute, forand on behalf of the Company, under the Company's sea) or otherwise, sudr Written Commitments ofthe Company as are specified in such
%iittendelegation,whfch"cifimnon maybe by general type or dam of Written Commitment%orhyspedficationorone ormore panlcularWrittencommliments,
(5) The signature of anyolRcer orother person ex"Ongany Written Commitment or fppointmem or delegation pursuant to this Resolution. and the seal of the Company, maybe atnxedby
facthnlloonsuchWritten Commitment orwritten appolntmenrordelegatl n.
FURTiiER RFSOLVRD, that the foregoing Resolution shall not he deemed lobe an exdwive statement ofthe powers andawhorityororrim a,employce.%and other persons toad for and on behalf of
the Company, andsudh Resolution shall not llm€t or otherwise affect the exercise ofany such power or authority otherwise validly granted or vested."
1, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies) do hereby
ret ury that
(i) the foregoing Resolutions adopted by the Board of Directors ofthe Companies are true, correct and In full force and effect,
(0) the Companies are duly licensed and authorized to transact surety business in all So of the United States of America and the DtsWct of Columbia and are
authorized by the US.Treasury Department, further, Federal and Vigilant are licensed In the U.S. Virgin Islands, and Federal is licensed in Guam. Puerto Rico,
and each ofthe Provinces of Canada except Prince Edward Island and
(III) the foregoing Power of Auomey is true, correct and In full force and effect.
Given under my hand. and Seals ofsald Companies at Whitehouse Station, NJ, this 12th say of Jme, 2018.
x<
02ga,
Dawn M. Chloros,start Assistant Secretary
InTNIt1VBATYC1(tWI5nTONOTIFYUSOFACLAIM.VERIFY7HRAliltiF.Nt'ICITYOFTHISDONDOtt NOTIFY USOFANY OTIMRMA7TREi,PI ASE00r%TACPUsAT-
- Tdt phone(908)903-303 FAx(908)903.3956 e-mal:.gmytkhuhbc=
Form 15-10 n?256;f �i' 0 -N CONSENT (rev. 12-16)
ZI LI K A
�
Moi N 113 1111 lo] " .4 :11rr
Project Name Ameritech Drive Pavement Improvements
Project No.
For Bids Due
117.057A
June 12, 2018
From time to time the South Bend Board of Public Works finds it necessary to reject a bid because
it does not comply with statutory requirements. In preparing your bid, please use the following
checklist in order to make sure that your bid is done in the proper manner.
Proper bid security included. The bidder has the option of providing either a Certified Check
or Bid Bond,
Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely
X executed.
Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments
with Iran, Employment Eligibility Verification,, Non -Discrimination Commitment, and
_X Certification of use of United States Steel Products or Foundry Products.
Proof of MBEIWBE Participation Goal Form [MiWBE-1,0]. If minimum participation goal is not
met, also provide Evidence of Good Faith Efforts Form [MWBE-2.,0] and MBEPVVBE Contacted
X Form [MWBE-2.1].
X Acknowledge Receipt of 1 Addendum(s) included with the bid.
X All required additional information is included with the bid.
Proposal statements and other affidavits all signed by the proper party with name either
X printed or typed underneath signature.
X This checklist submitted' with the Bid.
This checklist is provided for bidder's use in assuring compliance with, required
documentation; however, it does not include all specifications requirements and does not
relieve the bidder of the need to read and comply with the specifications.
Bidder: Walsh & Kelly, Inc.
By Authorized Represe
Signature:
Print Name & Title: in U.
a
Version, 10/17/2016 Contractor's Bid for Public Works - 1
Date: 6/12/18
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10�11111000
PART II
(For projects of $100,000 or more — IC 36-1-12-4)
These statements to be submitted under oath by each bidder with and as part of his bid.
Attach additional pages for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
1. Attach information regarding projects your organization has completed for the period of one
(1) year prior to the date of the current bid.
2. Attach a listing of public works projects currently in process of construction by your
organization.
3. Attach information regarding any failure to complete any work awarded to you and the
location thereof.
4. Attach references from private firms for which you have performed work.
SECTION 11 PLAN AND EQUIPMENT QUESTIONNAIRE
1. Attach an explanation of your plan or layout for performing proposed work. (Examples could
include a narrative of when you could begin work, complete the project, number of workers,
etc. and any other information which you believe would enable the City of South Bend to
consider your bid.)
2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside
your own firm who have performed part of the work) that you have used on public works
projects during the past five (5) years along with a brief description of the work done by each
subcontractor.
3. If you intend to sublet any portion of the work, attach the name and address of each
subcontractor, equipment to be used by the subcontractor, and whether you will require a
bond. However, if you are unable to currently provide a listing, please understand a listing
must be provided prior to contract approval. Until the completion of the proposed project, you
are under a continuing obligation to immediately notify the City of South Bend in the event that
you subsequently determine that you will use a subcontractor on the proposed project.
4. Attach a listing of equipment you have available to use for the proposed project.
5. Have you entered into contracts or received offers for all materials which substantiate the
prices used in preparing your proposal? If not, attach an explanation for the rationale used
which would corroborate the prices listed.
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said
financial statement as required by statute shall thereby be rendered invalid. The financial
statement provided hereunder to the City of South Bend awarding the contract must be specific
enough in detail so that said City of South Bend can make a proper determination of the bidder's
capability for completing the project if awarded.
Version 10/17/2016 Contractor's Bid for Public Works - 3
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CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS
This completed form should be Included as part of the Bids documents related to City of South Bend Public
Works Projects requiring Good Faith Efforts to obtain MBEfWBE participation. It is the bidder's sole
responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority
or Women's owned business as defined by the Indiana Department of Administration, ("IDOA"').
Project Number:
Project Name:
Bidder:
Contact Person:
Address:
117-057A
- Ameritech Drive Pavement Improvements
Walsh & Kelly. Inc.
Date: 6/12/18
,Edward Pilipow Telephone: 574-288-4811
24358 SIR 23
City: South3end state: Indiana zip: 46614
Email: eoiliDowa.walshkeb.com
To determine whether a bidder has demonstrated good faith efforts to reach the MBEIWBE utilization goals set
forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or
commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table lbelow*:
EVIDENCE OF GOOD FAITH EFFORTS
MBE[WBE LIST(S):: The bidder reviewed the City of South Bend's Minority and Women Business
Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women
Owned Business as found on their website (h,ttp://www.in.go,v/ldoa).
ACTION (ADVE,RTISEIC�ONTACT): In, order for your bid to be deemed responsive, the City of South
B;pr quires that all perspective bidders complete no less than 2 of the following:
Attend all pre -bid meetings scheduled by the City to inform MBE/WBEs of contracting and
subcontracting opportunities.
Z Advertise in general circulation and/or trade association publications concerning subcontracting
opportunities, and allow MBEIWBEs reasonable time to respond.
Perform any and all necessary steps to provide written notice in a manner reasonably calculated
to inform MBEArVBEs of subcontracting opportunities and allowed sufficient time for them to
participate effectively.
4. Utilize pre-existing services of available community organizations, small and/or disadvantaged
business assistance offices and other organizations that provided assistance in the recruitment
and placement of MBEMBE firms,
"Bidder must circle or otherwise notate which of the two (2) required actions were performed.
GOOD FAITH NEGOTIATIONS: The bidder negotiated in good' faith with interested MBE/WBEs,
including providing such MiBEIWBE's with adequate Information about the plans, specifications and other
requirements of the subcontract and did not reject MBE/WBEs as unqualified without sound business
reasons based on a thorough investigation of their capabilities,
SMALL CONTRACT(S): The bidder selected specific portions of the work to be performed by
MBE/WBEs In order to increase the likelihood of meeting the MBENVBE goals (including breaking down
contracts into smaller units to facilitate MBEIWBE participation)
CONTRACT RECORDS: The bidder has maintained the following records for each MBE/WBE that has
bid on the subcontracting opportunity:
1. Name, address, and telephone number;
2. A description of information provided by the bidder or subcontractor; and
3. A statement of whether an agreement was reached, and if not, why not, Including any reasons for
concluding that the MBEANBE was unqualified to perform the job.
*Proper demonstration of Good Faith Effort requires your Initials inext to all of the above boxes. Any
omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of
South Send reserves the right to request additional information.
Version 10/1712016 Contractor's Bid for Public Works - 10
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.1
MBEMBE CONTACTED
This completed form should be supplliedl with Bids that pertain to City of South Bend Public Works Projects
requiring contacted MBEIWBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify
whether any listed minority or woman business meats the qualifications of a Minority or Women's owned
business. PAGE 1 OF
Project Number: 117-057A M,BE/WBE Participation Goal 7-10%�,
L IL
Project Name: Ameritech Drive Pavement Improvements
0;
Bidder: Walsh & K Inc,
By: of Asphalt Operations 6/12—
John M. Peisker (Title) (Date )�:
Md�BE Firm State Barricading, Inc.
Owner or Contact at MBE/WBE Firm James Michalski
Telephone: 574-,287-2078 Fax: 574-287-1744 Email: statebarricadel@aol,com
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Maintaining of traffic and traffic control devices
RESULTS OF CONTACT WITH THE MBEIWBE FIRM:
Subcontractor will perform, the work
MBEAIVBE Firm C, Lee Construction Services, Inc.
Owner or Contact at IMBEIWBE Firm Chip Lee
Telephone: 219-922-7733 Fax: 219-888-9564 Email: chii�p@cleecsi.com
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Trucking - Hauling
RESULTS OF CONTACT WITH THE MBE/WBE FIRM:
Subcontractor wfli perform the work_
Version 10/17/2016 Contractor's Bid for Public Works - 11
Part of State Form52414 (R212-13) Form 96 (Revised 2013)
ii •
Walsh & Kelly, Inc.
(Contractor)
94358 SR 23
(Address)
South Bend IN 46614
FOR
PUBLIC WORKS PROJECTS
OF
City of South Bend, Indiana
Ameritech Drive Pavement Improvements
Project No. 117-057A
Filed June 12th, 2018
Action taken
State Form 52414 (R 19-10)
Prescribed by State Board of Accounts Form No. 96 Revised 2013
CONTRACTOR'S BID FOR PUBLIC WORK — FORM 96
PART
(To be completed for all bids. Please type or print)
Date (month, day, year): June 121", 2018
1. Governmental Unit (Owner): City of South Bend, Indiana
2. County: St- Joseph
3. Bidder (Firm):
Address:
City/State:
4. Telephone Number:
5. Agent of Bidder (If applicable):
Walsh & Kelly, Inc.
24358 SR 23
South Bend IN 46614
(574) 288-4811
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of City of South Bend, Indiana (Governmental Unit) in accordance with plans and
specifications prepared by Abonmarche Consultants and dated April 30, 2018 for the sum of See
Attached $ See Attached
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of
the letting. If alternative bids 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 Governmental Unit. If the bid is to be awarded on a unit basis, the
itemization of the units shall be shown on a separate attachment.
The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or
applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or
indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant
may be regarded as a material breach of the contract.
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS
(If applicable)
1, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation
to use steel products made in the United States. I.C. 5-16-8-2. 1 hereby certify I and all subcontractors employed by me
for this project will use U.S. steel products on this project if awarded. I understand that violations hereunder may result in
forfeiture of contractual payments.
ACCEPTANCE
The above bid is accepted this day of subject to the following conditions:
Contracting Authority Members:
PART II
(For projects of $150,000 or more — IC 36-1-12-4)
Governmental Unit: City of South Bend, Indiana
Bidder (Firm): Walsh & Kelly, Inc.
Date(month, day, year) L June 12, 2018
These statements to be submitted under oath by each bidder with and as part of his bid. Attach additional pages
for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
What public works projects has your organization completed for the period of one (1) year prior to the date of
the current bid?
Contract Amount
Class of Work
When Completed
Name and Address of Owner
$12,926,200
Reconstruction
October 2017
INDOT
$ 5,970,162
Reconstruction
May 2017
Town of Merrillville
$ 5,521,779
Resurface
December 2017
City of Mishawaka
$ 2,646,574
Reconstruction
September 2017
St. Joseph Cty Hwy Dept
2. What public works projects are now in process of construction by your organization?
Contract Amount
Class of Work
When to be Completed
Name and Address of Owner
$10,695,118
Reconstruction
November 2018
Walsh Construction
$ 8,146,239
Resurface
May 2018
INDOT
$ 4,073,719
Reconstruction
July 2018
City of East Chicago, IN
$ 2,662,813
Reconstruction
October 2018
INDOT
3. Have you ever failed to complete any work awarded to you? No If so, where and why?
4. List references from private firms for which you have performed work.
Gatlin Plumbing & Heating,Inc. 11 I I E. Main St. Griffith IN Ms. Clara Mulphy
Gough, Inc. 2200 E. 881h Dr., Merrillville, IN 46410 Mr. Raymond Gough
Dyer Construction Co. 1716 Sheffield Avenue Dyer, IN Janet Furman
Grimmer Construction Co. Inc. 2619 Main Street Highland, IN Mr. Greg Grimmer
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could
begin work, completed the project, number of workers, etc. and any other information which you believe would
enable the governmental unit consider your bid.)
As required by owner
2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have
performed part of the work) that you have used on public works projects during the past five (5) years along with a
brief description of the work done by each subcontractor.
See Attached List
3. If you intend to sublet any portion of the work, state the name and address of each subcontractor, equipment to be
used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a
listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed
project, you are under a continuing obligation to immediately notify the governmental unit in the event that you
subsequently determine that you will use a subcontractor on the proposed project.
Will supply upon award of contract
4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors
may also be required to be listed by the governmental unit.
QUANTITY
ITEM
DESCRIPTION,
SIZE, CAPACITY,
ETC.
CONDITION
YEARS
OF
SERVICE
PRESENT LOCATION
5
Asphalt Plants
Various
Good
Griffith, South Bend,
Valparaiso, Lowell, LaPorte
19
Asphalt Pavers
Various
Good
Griffith, South Bend
4
Slipform Cone. Paver
Various
Good
Griffith, South Bend
3
Road Widener
Various
Good
Griffith, South Bend
5
Motor Graders
CAT/J.D.
Good
Griffith, South Bend
54
Rollers
Various
Good
Griffith, South Bend
30
Rubber Tire Loaders
Various
Good
Griffith, South Bend
15
Excavators
Various
Good
Griffith, South Bend
9
Bulldozers
Various
Good
Griffith, South Bend
6
LowBoy Tractors
Various
Good
Griffith, South Bend
8
Flatbed Dumps
Various
Good
Griffith, South Bend
48
'/2 and 3/ ton Pickups
Various
Good
Griffith, South Bend
65
1 Ton Crew Trucks
Various
Good
Griffith, South Bend
3
Cold Planers
Wirtgen 1900
DC
Good
Griffith, South Bend
3
Tri-Axle Dump
Mack
Good
South Bend
5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing
your proposal? Otherwise, please explain the rationale used which would corroborate the prices listed.
Yes, we received quotes from potential subcontractors and suppliers
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
4
Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required
by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding
the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's
capability for completing the project if awarded.
SECTION IV CONTRACTOR'S NON -COLLUSION AFFIDAVIT
The undersigned bidder or agent, being duly sworn on oath, says that he 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.
He 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
SECTION V OATH AND AFFIRMATION
I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION
CONTAINED IN THE FOREGOING BID FOR PRBLIC WORKS ARE TRUE AND CORRECT.
Dated at South Send this 12th day of June, 2018
�o%%W111111 f,`o® Walsh & Kelly, Inc.
®a L.LY �i®� (Name rganization)
d F gAor
L,04n M. Peisker, VP of Asphalt Operations
`•,° (Title of Person Signing)
° A 'IhEDGEMENT
®o®$pld ,,I1
STATE OF Indiana 1
ss
COUNTY OF St. Joseph
Before me, a Notary Public, personally appeared the above -named John M. Peisker and
swore that the statements contained in the foregoing document are true and correct.
Subscribed and sworn to before me this 12"' day of June, 2018
Alis ueger, Notary Public
My Commission Expires: June 5, 2022
ALISHA KRUEGER
County of Residence: St. Joseph I% Notary Public. state of Indiana
"SEAL.
st, Joseph county
*'•
my commission expires
i
Form 96 Section II, #2
Subcontractors Used on Public Works Contracts Duriin
SUBCONTRACTORS
COMPANY ADDRESS CITY/STATE/ZIP
SEINER
B&DSewer
Deboer Egolf
Delta III
Dyer Construction
Gatlin Plumbing & Heating
Gough, Inc.
Grimmer Construction
Hasse Construction
HRP Construction
Rex Construction
Wirtz & Yates, Inc.
Woodruff & Sons
MILLING
C.E. Hughes Milling, Inc.
Javelina Construction, Inc,
Mid America Milling Co,
McCrite Milling
Specialties Company
ELECTRICAL INSTALLATION
Hawk Enterprises
Midwestern Electric
S/T Bancroft Electric
Sweney Electric Company
Trans Tech Electric
SIGN INSTALLATION
Hawk Enterprises
Midwestern Electric
RoadSafe Traffic Systems
State Barricading, Inc.
Traffic Control Specialists, Inc.
PA1/EMIENT MARKINGS
The Airmarking Company
Blackout Sealcoating
RoadSafe Traffic Systems
State Barricadingi, Inc.
Traffic Control Specialists, I'nc.
Traffic Management Company
TRAFFIC CONTROL
RoadSafe Traffic Systems
Traffic Control Specialists, Inc.
Traffic Management Company
LANDSCAPE
Great American Landscape
Hubinger Landscape
Slusser's Green Thumb, Inc.
T & J Landscape Service
531 Winston Ct
5772 Melton Road
2063 W 1250 S
1716 Sheffield Avenue
1111 E. Main Street
2200 E. 88th Drive
2619 Main Street
10 Lincoln Avenue
5777 Cleveland Rd.
700 Schuller Avenue
P.O. Box 411
P.O. Box 450
the Past 5 Years
Schererville, IN 46375
Portage, IN 46368
Hanna, IN 46340
Dyer, IN 46311
Griffith, IN 46319
Merrillville, IN 46410
Highland, IN 46322
Calumet City, IL 60409
South Bend, IN 46624
Schererville, IN 46375
Kentland, IN 47951
Michigan City, IN 46361
. +� I•'y�F:l
(219) 322-2300
(219) 763-9700
(219) 797-4004
(219) 865-2961
(219) 924-6972
(219) 756-2200
(2119) 924-1623
(21' 9 )932-1611
(574)271-7800
(219) 322-8090
(219) 474-6542
(219) 872-8605
(219) 865-0065
(219) 763-9703
(219)797-3008
(219) 865-2.963
(219) 924-11401
(219) 756-2202
(219) 924-0328
(219) 932-6829
(674)271-0624
(219) 322-0031
9) 8795339
3113 Holmans Lane
Jeffersonville, IN 47130
(812) 725-8665
(812) '725-8672
13476 Britton Park Rd.
Fishers, IN 46038
(317) 841-8364
(317) 841-0075
6200 W. Hwy 62, Ste 400
Jeffersonville, IN 47130
(812) 282-2761
(812) 283-9846
209 Quality Ave. Ste 9
New Albany, IN 47150
(812) 941-0252
(812) 941-0852
9350 E. 30th St.
Indianaoolis, IN 46229
(317) 594-0291
(317) 594-0271
1850 E. North St
1620 E. Chicago Ave
25020 State Road 2
9111 Louisiana St,
4601 Cleveland Road
1850 E. North St
1620 E. Chicago Ave
3122 Olympia Dr
24963 U.S. Highway 20
1810 W Pacific Avenue
P.O. Box 526
7440 W. 87th Place
3122 Olympia Dr
24963 U.S. Highway 20
1810 W Pacific Avenue
3542 Highway Avenue
3122 Olympia Dr
1' 810 W Pacific Avenue
3542 Hiqhwav Avenue
P.O. Box 235
210 E. 113th Avenue
125 Montgomery Street
8253 Wicker Avenue
Crown Point, IN 46307
East Chicago, IN 46312
South Bend, IN 46619
Merrillville, IN 464110
South Bend, IN 46619
Crown Poirot, IN 46307
East Chicago, IN 46312
Lafayette, IN 47909
South Bend, IN 46628
Knox, IN 46534
Rochester, IN 46975
Bridgview, IL 60455
Lafayette, IN 47909
South Bend, IN 46628
Knox, IN 46534
Highland, IN 46322
Lafayette, IN 47909
Knox, IN 46534
Highland„ IN 46322
Dyer, IN 46311
Crown Point, IN 46307
Logansport, IN 46947
St. John, IN 46373
(219) 662-8090
(219) 397-4444
(574) 287-6490
(219) 769-6007
(574) 272-9673
(219) 662-8090
(219) 397-4444
(317) 780-1825
(574) 287-2078
(574)772-7001
(219) 662-8093
(219)397-8888
(219) 769-0565
(574) 271-0144
(219) 662-8093
(219) 397-8888
574) 772-7002
(574) 223-5817 (574) 223-7959
(219) 864-2300 (708) 430-6910
(317) 780-1825
(574) 287-2078
(574)772-7001 (574)772-7002
(291)746-2433
(317) 780-1825
(574)772-7001 (574)772-7002
(219) 746-2433
(219) 322-7033 (219) 322-4419
(219) 662-9911 (219) 662-6206
(574) 722-3102 (574) 722-1628
(219) 374-9900 (219) 374-9950
6
GUARDRAIL/FENCING,
Acorn Fence
2041 164th Street
Hammond, IN 46320
(219) 844-8400
(219) 844-8441'
C Tech Corporation
5300 W. 100 North
Boggstown, IN 46110
(317) 85-2745
(317) 835-2781
H. drew Company
8701 Zionsville Rd.
Indianapolis, IIN 46268
(317) 876-3739
(317) 876-3829
,James
Security Industries
1000 Georglana St.
Hobart„ IN 46342
(219) 942-9447
(219) 942-9448
Specialties Company
9350 E. 30th St,
Indianapolis, IN 46229
(317) 594-0291
(317) 594-0271
TRUCKING/HAULING
C. Lee Construction Services
1011 S. Lake St
Gary, IN 46403
(219) 888-9554
(2119) 888-9564
Condon Trucking, LLC
18245 Amberley Ln
South Bend, IN' 46637
(574) 360-4326
(574) 271-8984
Fanlo Services
28015 SR 23
North, Liberty, IN 46554
(574) 233-3236
Gilmer Trucking
20390 New Road
South Bend, IN 46614
(574) 229-3233
Material Transfer Inc.
7811 West 101 st Ave.
Crown Point, IN 46307
(219) 865-9575
Morris Motor Service, Inc.
10525 WW US Hwy 30 Bld
WWanatah, IN 463910
(219) 733-9430
7
P & C Trucking
4410, Ross Road
Gary, IN 46408
(219) 972-0193
Superior Construction Co., Inc.
1456 Louis Sullivan Dr
Portage, IN 46368
(219) 787-0850
V & R Trucking, Inc.
1846 Elmer St,
South Bend, IN 46628
(574) 329-2102
SRPM'S
K & S Markers, Inc.
2189 N 600 WW
Thorntown, IN 46071
(765) 482-6184
(765) 482-684
UNDERSEAL
Rieth-Riley Construction Co.,
2454 West CR 450 North
LaPorte, IN 46350
(219) 362-6178
Inc.
TREE REMOVAL
Dave''s Tree Service
1555 Park West Circle
Munster, IN 46321
(219) 922-9829
(219) 922-9843
Homer Tree Service
14000 S. Archer Ave
Lockport, IL 60441
(815) 838-0320
Timber Masters LLC
P.O. Box 245
Dyer, IN 46311
(219) 864-8733
(219) 322-9391
LIME STABILIZATION
Mt. Carmel Sand & Gravel
1611 College Dr.
Mt. Carmel, IL 62863
(618) 262-5118
(618) 263-4084
Rack Solid Stabilization,
5104 Mann Drive
Ringwood, IL 60072
(815) 653-2585
(815) 653-2583
Specialties Company
9350 E. 30th St.
Indianapolis, IN 46229
(317) 594-0291
(317) 594-0271
PIPE LINING
Indiana Reline, Inc.
312 E. Main Street
Sulphur Springs, IN
(765) 766-5040
(765) 533-5831
47388
SAW CUTTING
Diamond Coring Co., Inc.
11800 S Ewing Ave
Chicago, IL 60617
(773) 978-5000
Quality Saw & Seal, Inc.
7600 W. 79th Street
Bridgeview, IL 60455
(773) 767-9300
SEAL COATI NG/STRPIPING
Site Services, Inc.
10117 Kennedy Ave
Highland,, IN 46322
(219) 924-9944
Blackout Seallcoating
7440 W. 87th Place
Brlidgview, IL 60455
(219) 864-2300
(708) 430-6910
UNDERDRAIN
3D Company, Inc.
3200 East CR 350 North
Muncie, IN 47303
(765) 288-3326
(765) 288-3344
General Form No. 96-a
Prescribed by the SNIP Board of
Accounts of Indiana. Revised 1949.
Standard Questionnaires and
Financial Statement for Bidders
Prescribed by
THE STATE BOARD OF ACCOUNTS OF INDIANA
For use in investigating and determining the qualifications of bidders on public
construction when the aggregate cost of any such work or improvement will be Five Thousand
Dollars or more.
These statements to be submitted under oath by each bidder with and as a part of his bid, as provided
by Chapter 306, page 1248, Acts of 1947
Submitted to City of South Bend, Indiana
By Walsh & Kelly,Inc.
Address 24358 SR 23 South Bend IN 46614
Date submitted June 12, 2018
Filed
A.E. BOYCE CO., MUNCIE, IND.
fA Corporation
I
Sec. 2 of an Act entitled "AN ACT concerning the awarding of contracts for the performance of public work and
authorizing the board of accounts to prescribe certain forms to be used in ascertaining the responsibility of contractors who
submit bids for the performance of such work, providing for plans and specifications, providing for bids repealing certain laws
and declaring an emergency." (Approved March 13, 1947.)
Sec. 2. Whenever the aggregate costs of any work or improvement will be five thousand dollars ($5,000.00) or more, for
the purpose of enabling such board, commission, trustee, officer or agent to ascertain and determine which of the bidders
submitting bids for the performance of any such public work is, in the judgment of such board, commission, trustee, officer or
agent, the lowest and/or best bidder and to exercise intelligently the discretion hereby conferred on such board, commission,
trustee, officer or agent each bidder shall be required to submit under oath with and as a pail of his bid a statement of his
experience, his proposed plan for performing such work and the equipment which he has available for the performance of such
work and a financial statement. The statements hereby required shall be submitted on forms which shall be prescribed by the state
board of accounts. The forms so prescribed shall be designated, respectively, as the experience questionnaire, the plan and
equipment questionnaire and the contractor's financial statement, and shall be based, so far as applicable, on the standard
questionnaires and financial statement for bidders as approved and recommended by the joint conference on construction
practices, for use in investigating the qualifications of bidders on public construction work, and the forms so prescribed are
hereby prescribed as the forms which shall hereafter be used by all such boards, commissions, trustees, officers and agents in
obtaining the information which is required in the administration of this act. If the information submitted by any bidder on the
forms herein prescribed is found, on examination, to be unsatisfactory, the bid submitted by such bidder shall not be considered.
(Burns Statutes 1933, Sec. 53-109) Sec. 2, Chapter 306, Acts of 1947.
TO THE BIDDER —
The following forms of questionnaires and financial statement are prescribed by the State Board of
Accounts in conformity with the statute set out on the preceding page.
These forms, properly filled out and attested, must accompany each bid of five thousand dollars or
more on any public work.
The forms are designed to cover all contracts for all kinds of work and the bidder is required to
answer such questions as are pertinent to the work upon which he is bidding. The purpose of the
questionnaire and financial statement, as set forth in the law, is to enable the awarding body to determine
the qualifications of the bidder to carry out successfully the contract if the same is awarded to him.
The bidder will find it to his advantage to answer fully all questions coming within the range of the
work upon which he is bidding. Particular attention should be given the "Financial Statement' and the
details relative to the assets and liabilities set out. This form is made in extensive detail so that the bidder
may explain his assets and liabilities in proper sequence and in a uniform manner.
T. M. HINDMAN,
State Examiner
Submitted by Walsh & Kell Inc. { x A Corporation
Principal Office at 1700 East Main Street Griffith IN 46319
To City of South Bend Indiana
EXPERIENCE QUESTIONNAIRE
The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers
to interrogatories hereinafter made.
1. How many years has your organization been in business as a general contractor under your present
business name? 52 Years
2. How many years' experience in asphalt paving construction work has your organization had: (a)
As a general contractor 71 years (b) As a sub -contractor 71 Years
3. What projects has your organization completed?
Contract Amount
Class of Work
When Completed
Name and Address of Owner
$ 12,926,200
Reconstruction
October 2017
INDOT
$ 5,970,162
Reconstruction
May 2017
Town of Merrillville, IN
$ 5,521,799
Resurface
December 2017
City of Mishawaka, IN
$ 2,646,574
Reconstruction
September 2017
St. Joseph County Hwy
Department
3-A. What projects has your organization now in process of construction?
CONTRACT AMT. CLASS OF WORK
WHEN TO BE COMPLETED
NAME AND ADDRESS OF OWNER
$ 10,695,118
Reconstruction
November 2018
Walsh Construction
$ 8,146,239
Resurface
May 2018
INDOT
$ 4,073,719
Reconstruction
July 2018
City of East Chicago, IN
$ 2,662,813
Reconstruction
October 2018
INDOT
4. Have you ever failed to complete any work awarded to you? No If so, where and why?
5. Has any officer or partner of your organization ever been an officer or partner of some other
organization that failed to complete a construction contract? No If so, state name of individual,
other organization and reason therefore
6. Has any officer or partner of your organization ever failed to complete a construction contract
handled in his own name? No If so, state name of individual, name of owner and reason therefor
7. In what other lines of business are you financially interested? None
4
For what corporation or individuals have you performed work, and to whom do you refer?�
BP Amoco Whitin Indiana
Torn & Blank Construction 1623 Greenwood Ave. Michigan Cit IN 46360
Grimmer Construction Co. Inc. 2619 Main Street Hi hland IN 46322
University of Notre Dame South Bend Indiana
Gough Inc., 1151 E. Summit, Crown Point, IN46307
9. For what cities have you performed work and to whom do you refer?
Town of Griffith
Director of Public Works
Griffith IN
Town of Schererville
Town Manager
Schererville, IN
City of Hammond
City Engineer
Hammond, IN....
City of South Bend
City Engineer
South Bend IN
Town of St. John
Town Manager
St. John IN
10. For what counties have you performed work and to whom do you refer?
Lake Count Highway Su erintendent Crown Point IN
Porter Cougly Highway Su erintendent Valparaiso, -IN
St. Joseph Cougly Highway Su erintendent South Bend IN
Elkhart County Highway Su erintendent Elkhart IN
Laporte County Highway Superintendent_ Laporte, IN
11. For what State bureaus or departments have you performed work and to whom do you refer?
Indiana Department of Transportation INDOT LaPorte District Laporte IN
Department of Natural Resources Indiana olis IN
12. Have you ever performed any work for the U.S. Government Yes
If so, when and to whom do you refer?
U.S. Army Corps of Engineers Chicago, IL
Indiana National Guard,..Dot.- of Administration Indianapolis, IN
Federal Highway Administration Sterlin VA
13. What is the construction experience of the principal individual of vour orizanization?
INDIVIDUAL'S NAME
PRESENT POSITION OR
OFFICE
YEARS OF
CONSTUCTION
EXPEREINCE
MAGNITUDE AND
TYPE OF WORK
IN WHAT CAPACITY
Kevin J. Kelly.........._President
33
All Types
General Manager
Jeffrey L. Swan
Executive Vice President
34
All Types
Supt. Engineering
David J. Misirly
Vice President
33
Bituminous
Pavia
Engineer
Greg A. Hoffman
Vice President
31
Bituminous
Paving
Engineer
John C. Wall
Vice President
41
All types
Engineer
John M. Peisker
Vice President
33
All types
General Manager
J. Michael
Schaum
Secretary/Treasurer
46
Administration
General Manager
Jamie L. Tancos
Controller
14
Administration
General Manager
Lynn J. Bauer
South Bend Ops Mgr
23
All types
Engineer
Dustin P. Hilary
South Bend Area Mgr
18
All types
Engineer
Mark E.
Krachenfels
Engineer
28
All types
Engineer
Keith A. Gardina
Engineer
23
All types
Engineer
Nikolas G. Relias
Engineer
1 16
Bituminous
Engineer
Paving
PLAN AND EQUIPMENT QUESTIONNAIRE
The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers
to interrogatories hereinafter made.
1. In what manner have you inspected this proposed work? Explain in detail.
Plans Specifications, and Site Ins ections
2. Explain your plan or layout for performing the proposed work
As directed by owner/engineer
3. The work, if awarded to you, will have the personal supervision of whom?
Kevin J. Kelly, Jeffrey L. Swan, David J. Misirly, Gregory A. Hoffman,, Dustin P. Hilary, and Lynn J.
4. *Do you intend to do the hauling on the proposed work with your own forces? Yes
If so, give amount and type of equipment to be used As needed
5
*If you intend to sublet the hauling or perform it through an agent, state amount of sub -contract or
agent's contract, and if known, the name and address of sub -contractor or agent, amount and type of
his equipment and financial responsibility
Items 4,5,6 and 7 may not be applicable in all building contracts; if not, omit.
6. *Do you intend to do the grading on the proposed work with your own forces?
If so, give type of equipment to be used
7. *If you intend to sublet the grading or perform it through an agent, state amount of sub -contract or
agent's contract, and, if known, the name and address of sub -contractor or agent, amount and type of
his equipment and financial responsibility
8. Do you intend to sublet any other portions of the work? If so, state
amount of sub -contract, and, if known, the name and address of the sub -contractor, amount, and type
of this equipment and financial responsibility
9. From which sub -contractors or agents do you expect to require a bond? None
10. What equipment do you own that is available for the proposed work?
QUANTITY
ITEM
DESCRIPTION,
SIZE, CAPACITY,
ETC.
CONDITION
YEARS
OF
SERVICE
PRESENT LOCATION
5
Asphalt Plants
Various
Good
Griffith, South Bend,
Valparaiso, Lowell, LaPorte
19
Asphalt Pavers
Various
Good
Griffith, South Bend
4
Slipform Conc. Paver
Various
Good
Griffith, South Bend
3
Road Widener
Various
Good
Griffith, South Bend
5
Motor Graders
CAT/J.D.
Good
Griffith, South Bend
54
Rollers
Various
Good
Griffith, South Bend
30
Rubber Tire Loaders
Various
Good
Griffith, South Bend
15
Excavators
Various
Good
Griffith, South Bend
9
Bulldozers
Various
Good
Griffith, South Bend
6
LowBoy Tractors
Various
Good
Griffith, South Bend
8
Flatbed Dumps
Various
Good
Griffith, South Bend
48
%z and 3/ ton Pickups
Various
Good
Griffith, South Bend
65
1 Ton Crew Trucks
Various
Good
Griffith, South Bend
3
Cold Planers
Wirtgen 1900
DC
Good
Griffith, South Bend
3
Tri-Axle Dump
Mack
Good
South Bend
7
11. What equipment do you intend to purchase for use on the proposed work, should the contract be
awarded to you?
QUANTITY
ITEM
DESCRIPTION, SIZE, CAPACITY, ETC.
APPROXIMATE
COST
None
12, How and when will you pay for the equipment to be purchased? NIA
13. Do you propose to rent any equipment for this work?No If so, state type, quantity and reasons for
renting
14, Have you made contracts or received firm offers for all materials within prices used in preparing your
proposal?
Do not give names of dealers or manufacturers
Dated at South Bend this 12t" day of June 2018
®a%%tillitorl,a
®®®ALLY, °r®�
0 AT F o
0
�< �°�®tea
o STATE OF Indiana®�®''®®, s•..°���
aabe
{ 55.
COUNTY OF St. Joseph
Walsh & Kelly, Inc.
(Name Organization)
B ,
Y
M. Peisker. VP of Asphalt Operations
(Title of Person Signing)
John M. Peisker being duly sworn deposes and says that he is VP of Asphalt Opera
of the above Walsh & Kell Inc.
(Name of Organization)
and that the answers to the questions in the foregoing questionnaires and all statements therein contained
are true and correct.
Subscribed and sworn to before me this 1211' day of June 2018
My Commission expires June S, 2022
.ju
Alisha Krueger, otary Public
h����1ylYElpl���G
.'Ge��:
ALISHA KRUEGER
'o '' Notary
Pobiia, state of Indiana
?SEAL'"
St. Joseph C-unty
*.
r'���DIAC`�`,
My Commission Expiraa
�,
June 05, 2022
State of Indiana
Office of the Secretary of State
CERTIFICATE OF EXISTENCE
To Whom These Presents Come, Greeting:
I, CONNIE LAWSON, Secretary of State of Indiana, do hereby certify that I am, by virtue of the laws of
the State of Indiana, the custodian of the corporate records and the proper official to execute this
certificate.
I further certify that records of this office disclose that
WALSH .&.KELLY INC
duly filed the requisite documents to commence. business activities under.. the laws of the State of
Indiana on March 29, 1966,and was in existence or authorized to transact business in the State of
Indiana on March 05, 2018.
I further certifi.y. this Domestic For -Profit Corporation has filed its most recent report required by
Indiana law with the Secretary of State, or is not yet required to file such report, and that no notice of
withdrawal, dissolution, or expiration has been .filed or taken place. All fees, taxes, interest, and
penalties owed to Indiana by the domestic or foreign entity and collected by the Secretary of State
have been paid.
In Witness Whereof, I have caused to be affixed my
signature and the seal of the State of Indiana, at the City
of Indianapolis, March 05, 2018
drx� C% ""M
CONNIE LAWSON
SECRETARY OF STATE
194484-057 / 2018548044
Verify this certificate:https://bsd.sos.in.gov/VaI!dateCertificate
CERTIFICATE OF QUALIFICATION
to provide
CONSTRUCTION SERVICES
for
PUBLIC WORKS PROJECTS
to t1ld
STATE OF INDIANA
This Certification Board, having duly considered application for qualification in terms of apparent experience and financial
resources; and under the applicable Indiana Code 4-116-4 and adopted rules of this Board, hereby issues a
Certificate of Qualification to provide construction services to the State of Indiana for Public Works Projects to:
WALSH & KELL,Y INC
1700 E MAIN ST
GRIFFITH IN 46319
Phone 219-924-5900
Fax 219-924-8768
Company Official
KEVIN KELLY
for the twenty-seven month period stated fiercin, unless revoked by this Board for cause,
and in the classifications of services stated below. This certificate supercedes any previous certificate.
1611.0,1 Concrete Construction of Roads & Curbing
1611.,02 Asphalt Construction of Roads and Parking Lots
CERTIFICATION DATE 311412018
EXPIRATION DATE 611412020
THIS CERTIFICATE ISSUED BY THE STATE OF INDIANA, PUBLIC WORKS DIVISION CERTIFICATION BOARD,
402 WEST WASHINGTON STREET, ROOM W467, INDIANAPOLIS, INDIANA 46204,
ALSO ACTS AS THE OFFICIAL, NOTICF, Or EXPIRATION.
Tracy L. Cross, Executive S6,retary
Certification Board
DAPW P02 State Form 3983R Rev. 07M
WRITTEN CONSENT TO RESOLUTIONS
of the
BOARD OF DIRECTORS
of
WALSH & KELLY, INC.
The undersigned, being all of the Directors of WALSH & KELLY, INC., an Indiana Corporation,
hereby consent to the following actions to be taken by the Corporation without a meeting of the hoard of
Directors under the applicable provisions of the Indiana Business Corporation Law, as amended:
RESOLVED that the following be, and hereby are, elected officers of the Corporation, to
hold the office until the next regular meeting of the Board of Directors and until their
successors are duly elected and have qualified:
Kevin J. Kelly, President and Chief Executive Officer
Jeffrey L. Swan, Executive Vice President
Jamie L. Tancos, Controller
John M. Peisker, Vice President of Asphalt Operations
David J. Misirly, Vice President
Gregory A. Hoffman, Vice President
John C. Wall, Vice President and EEO Officer
J. Michael Schaum, Secretary and Treasurer, CFO
RESOLVED FURTHER that the actions of the Officers of the Corporation taken since the
last meeting of the Board of Directors be, and the same hereby are, fully ratified and
approved.
RESOLVED FURTHER that the following be, and they hereby are, authorized to execute
all contracts or similar documents on behalf of the Corporation:
Kevin J. Kelly, President and Chief Executive Officer
Jeffrey L, Swan, Executive Vice President
Jamie L. Tancos, Controller
John M. Peisker, Vice President of Asphalt Operations
David J. Misirly, Vice President
Gregory A. Hoffman, Vice President
Dustin P. Hilary, South Bend Area Manager
Lynn J. Bauer, South Bend Operations Manager
John C. Wall, Vice President and EEO Officer
J. Michael Schaum, Secretary and Treasurer, CFO
RESOLVED FURTHER that this consent shall be in lieu of an annual meeting of the Board
of Directors of the Corporation and shall be filed in the minute book of the Corporation in
place of any such annual minutes.
<<SIGNATURES ON THE NEXT PAGE>>
EXECUTED this 7"' day of March, 2017,
Fred Fehsenfeld, Jr.
Thomas P. Bertsch
James C. Fehsenfeld
John P. Vercruysse
-� a��^�• •QRATF°°� f��
m � • ore °:
Kevin J. Kelly d o
a
EXECUTED this 7" day of March, 2017,
11 IVA4 ?IfA"%60" p a
Fred Fehs,enfeld, Jr.
Thomas R Bertsch
Kevin J. Kelly
I---
JameYC, Fehsenfeld
4, 4-f V";' c ", �S;' �j z ... ± �
GRIFF11"H SOUTH BEND
Walsh & 1700 East Main Sfi-eet 24358 State Road 23
Griffith, Indiana 46319 South Bond, Indiana 46614
lKelly1fle. Phone (219) 924-5900 Phone (574) 288-4811
0),0) Fax (219) 924-8768 Fax (574) 289-7174
www.watshkelly.coni
EQUAL EMPLOYMENT OPPORTUNITY POLICY
1. It is the policy of this Company to assure that the applicants are employed, and that employees are treated
during employment, without regard to their race, religion, sex, gender identity, sexual orientation, color,
national origin, age, association with the Vietnam era or any other war, disability, genetic information,
citizensbip status, military status, veteran status, ancestry, or any other status protected under applicable
law. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment
advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training,
including apprenticeship, pre -apprenticeship, and/or on the job training.
A. The Contractor will work with the State Highway Agency (HA) and the Federal Government in carrying
out EEO obligations and in their review of his/her activities under the contract.
H. Vice President of Business Development; John C. Wall, shall be designated as Walsh & Kelly, Inc.'s
Equal Employment Officer. He will be responsible for all activities associated with the implementation of
all policies affecting equal employment opportunity.
III. Walsh & Kelly, Inc. assures nondiscriminatory recruitment by taking appropriate steps such as:
A. Placing employment advertisements in newspapers which serve the largest number of minority group
people in the recruiting area.
B. Recruiting through schools and vocational colleges having substantial proportions of minority
students.
C. Maintaining systematic contacts with minority and human relations organizations leaders referral of
qualified minority applicants.
D. Encourage present employees to refer minority applicants.
E. Make it known to all recruitment sources that qualified minority members are being sought whenever
there is hiring.
IV. This policy is intended to comply with the Civil Rights Act of 1964, as amended, the Federal Highway Act
of 1968, the Executive Order 11246 and 11.375, the Rehabilitation Act of 1973, as amended, the Disabled
Veterans and Vietnam Era Veterans Readjustment Act of 1974, as amended, the Indiana Civil Right Act,
and other Federal and State Laws and Regulations pertaining to Equality of Opportunity and Affirmative
Action Policies.
V. Forms for riling any complaints are available in the office located at 1700 E. Main Street, Griffith, IN
46319. In addition, employees can call (219) 924-5900 to report any workplace concerns under this
policy.
WALSH & KELLY, INC.
..........
r
00 %
John C. Wall,
Vice President of Business Deve(doment*
Revised: August 17, 2017
EQUAL OPPORTUNITY EMPLOYER
|NDVVNxPOL8.ov April 19,2018
we]
GRIFFITH, IN
who has filed with the Department a Contractor's Statement of Experience and Financial Condition
required under Indiana Code 8-23-10, is hereby qualified to bid at any Department of Transportation
letting in Classes of Work and within the amount and other limitation of each classification as listed
below, for such period as the uncompleted work on hand from all sources does not exceed the Aggregate
amount. Classification references by name or s, mbol are In accordance with the definitions in the
Contractor's Statement of Experience and Financiarcondition. This certificate supersedes any certificate
previously Issued, but is subject to revision or revocation according to the law, if and when changes
in the financial condition of the contracting firm or other facts justify such revision or revocation.
AGGREGATE-... -................ ........ _---......................................
......... .............. ............. ... WmvmMTEn
A(B)
CONCRETE PAVEMENT: LIMITED ................ -......
-........... ..... -...................... ......... ---- $25,000,00
B(A)
ASPHALT oAroMFmcwuwoozCFanmsnpmoA
............ ......... ............ ............. ...... ......... 'mmmLIMoau
C(B)
moxrmRADnva............. .......................... .............. ---
............ ... ... ...... ......... ............ ...... .$mmmMouu
n(E-)
SMALL mTnm(-r8msoAND DRAINAGE ITEMS ..........
......... ...... ............ --- ... -..... -............ ... w25,000,00
E(F)
SURFACE MASONRY AND MImcCONCRETE .........
_-............ ..... _-............ ......... ............ ..... $50,000,00
8(m)
TRAFFIC CONTROL: PAVEMENT MARKINGS .........
-......................... ................ ........ .... ---- ... watvouov
a@n
DEEP SEWER AND/OR uxcavxzuON-.... --......
......... ...... ........ .................... --- .......... .... $25,*00,00
E(Q)
cOwcvanEPAVEMENT REPAIRS ..... ...... ---.........
-................ .................................. ..... $25,000/00
PREQUACINCATION ENGINEER