HomeMy WebLinkAboutOpening of Bids - Berlin Place Site Concrete Landscape Plantings and Roof Pavers Project No 118-057 - Premium Concrete Services IncProject Name
Project No.
For Bids Due
DIVISION A
BID/PROPOSAL
CITY OF SOUTH BEND
"Berlin Place — Site Concrete, Landscape Plantings, and IBlldg. 4 Roof Pavers"
118-057
6/12/18
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
1
Provide and install full Site Concrete
1
LS
services'
2
Provide and install full Landscape Plantings
1
LS
services'
I
3
Install full Bldg. 4 Roof' Paver services'
I
L ai
M
DIVISION A BID TOTAL PIA
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
1
Provide and install fuill Site Concrete
I
LS
services'
DIVISION 8 BID TOTAL C I
�-
DIVISION C
Item
No.
1
� Description
Quantity
Unit
Unit Price
Total Amount
Provide and install full Landscape Plantings
1
LS
t"'11A
services'
DIVISION C BID TOTAL LA
DIVISION D
Item
NO.
Description
Quantity n t il t yyy
Unit
Unit Price
t
Total Amount
I
install full Bldg. 4 Roof Paver services'
1
Jq
LS
N�14
DIVISION D BID TOTAL,
according to the intent of the plans and specifications at "'The Ivy at Berlin Place" project located at the corner of Lafayette Blvd
and Western Ave in South Bend, IN.
Bidder (Firm): Oeml'um 646A,,-ie, 3:unlv. wlq6�
Address: W),
City/State/Zip: Mll,2,7"- Telephone N
M
(Printed Name of Person Sjq(iing)
Version 10/17/2017 Contractor's Bid for Public Works - 8
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Elizabeth A. Maradik, Member
James A. Mueller, Member
Suzanna M. Fritzberg, Member
Therese J. Dorau, Member
Attest: Linda M. Martin, Clerk
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/her/its 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.
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.
Version 10/17/2017 Contractor's Bid for Public Works - 3
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK 1865
Project Name "Berlin Place --Site Concrete, Landscape Plantings, and Bldg. 4 Roof Pavers"
Project No. 118.057
For Bids Due 6112/18
�PART 1
(MJSt be completed for all bids. Please type or print)
'Y Bidder (Firm): k _d Date: rf) I LA I'Tj
Address: Atc�w)
City/State/Zip: .) Telephone Number: (,S /(h, JFG cf-o
Agent of Bidder (if Appficable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of:
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
A
and dated for the sum of (enter the Total Bid as shown on the Proposal)
NZA is
(Enter sum of Total Division A Bid on Proposal) (Numerical)
qFoci". E 11111e4 e,J, r/ ($
(Enter sum of Total Division B BW on Proposal)
sum of Total Division C Bid on Proposal)
is
sum of Total Division D 131d on Proposal)
I ejol 1,5�
(Numerical)
(Numerical)
(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 addendurns 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 trt f outh Bend. If the bid ' to be awarded on a unit
r,vg,ity o2
basis, the itemization of the units shall be sho n a arate adachmefit.
The above bid is accepted this
Subject to the following conditions:
By I&Z4 (_.///
ign6fure)
t (Printed Name of arson Signing)
ACCEPTANCE
day of 20
Version 10/17/2017 Contractor's Bid for Public Works - 2
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 OFi�iti{� )
SS:
Et JA R2 { ' COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury
that:
1. Contractor has not, nor has any other member, representative, or agent of the firm, company,
corporation or partnership represented by him, entered into any combination, collusion or agreement with
any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding
nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and
without any agreement, understanding or combination with any other person in reference to such bidding.
Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or
indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals
are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency; and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
a. For purposes of this Certification, "Iran" means the government of Iran and any agency
or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as
amended from time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -titre, 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 10/1712017 Contractor's Bid for Public Works - 5
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 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).1 hereby
certify that I and all subcontractors employed by me for this project will use steel products or foundry
products made in the United States on this project if awarded. I understand I 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 ajustification
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 10/17/2017 Contractor's Bid for Public Works - 6
may result in forfeiture of contractual payments.
1 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 ! day otidj11 C- , 20_
JANEE M TOWNER
NOTARY PUBLIC
SEAL
ELKHART COUNTY, STATE OF INDIANA
MY COMMISSION EXPIRES FEBRUARY 12, 2026
COMMISSION NO.710399
E K1( U Iyl 6MCLt-!E 5E U
Vr7e
acdr (F'rm) 44
Jz, , ,,
ignature o Contr ctor idder or It gent
Printed Name and Title
Subscribed and sworn to before me this day of J U K)C , 20
My Commission Expires aI I.aaw-(, R N �Oazyu j-i,-
N tart' Public
County of Residence [,M)A Pi (i
Version 10/17/2017 Contractor's Bid for Public Works - 7
13 16 COUNI Y-('I Fy Miii,i)i'�ici
227 WAISFFERSON BOULEVARD
801JI I I BFND, I NDIANA46601-1830
PFIONL 574/ 235-9251
FAX 57V 235-9171
I'D D 574/ 235-5567
CITY OF Soum BENI), PE 'F,, B t vril G I EG � MA Y 0 R
BOARD OF PUBLIC WORKS
Date: June 5, 2018
To: All Bidders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number: I
Project Name: Berlin Place — Site Concrete, Landscape Plantings, and Roof Pavers
Project
Number: 118-057
IXOMT91
Date Received:
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) 235-917L
A copy MUST also be included with your bid package upon
submittal.
M05210 In 1111019111001105 L"Iya alai DION Iasi 0 kall I'M
Note:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
5e
Company:
Authorized Signature:
Date:
Version 4/07/2015 Special Provisions -I
1316, (,',0(JN,ry-Cn,y Btin.,UNG
227 WJE,'FFEASON 13001,FNARD
Sol flA I BIND, INDIANA 46601-1830
Pf IONI ; 574/ 235-925 1
FAX 5�74/ 235-9171
11M) 574/ 235-5567
0,rYOFS01,JTFjBE,ND PE"FIBUTTIGlEG, MAYOR
BOARD OF PUBLIC WORKS
Date: June 8, 2018
To: All Bidders
From Linda M. Martin, Clerk, Board of Public Works,
Subject Addendum Number: 2
Project Name: Berlin Place — Site Concrete, Landscape Plantings, and Roof Pavers
Project
Number: 118-057
Date Received:
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 If )
Authorized Signature:
6
Date: ,1,61,
',
U
Version 4/07/2015 Special Provisions -1
1316 (,'01JN'YY-(-'rrY MUDING
227 W. JEFFIRSON 1301J1,17VARD
SOH I 1 I! REND, I NDIANA46601-1830
Date:
To:
From
Subject
June 11, 2018
All Bidders
PHOW 574,1235-9251
FAX 574/ 235-9171
'I DD 574/ 235-5567
CITY OF SOUTH BEND PETS BUTTIGIEG, MAYOR
BOARD OF P'ULIC WORKS
Linda M. Mai -tin, Clerk, Board of Public Works
Addendum Number: 3
Project Name: Berlin Place — Site Conicrete, Landscape Plantings, and Roof (Pavers
Project
Number: 118-067
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received: // P163
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:
Authorized Signature.
Date:
Version 4/0�7/2015 Special Provisions -1
CONTRACTOR:
SURETY:
(Name, legal status and address)
(Name, legal status and principal place
Premium Concrete Services, Inc.
of business)
712 Richmond St
Old Republic Insurance Company
Elkhart, IN 46516
Brookfield, WI
OWNER:
(Name, legal status and address)
City of South Bend, Board of Public Works
1316 County -City Building, 227 West Jefferson Street
South Bend, IN 46601
BOND AMOUNT:!
Five Percent of the Total Bid
5% of Total Bid
PROJECT:
(Name, location or address, and Project number, if any)
This document has Important legal
consequences. Consultation with
an attorney is encouraged with
respect to its completion, or
modification.
Any singular reference to
Contractor, Surety, Owner or
other party shall be considered
plural where applicable.
The Ivy at Berlin Place; Berlin Place - Site Concrete, Landscape Plantings, and Bldg. 4 roof Pavers
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 shall 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 terns. Contractor in this Bond shall
be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.
When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project,
any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom 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 "a 8,th day of June 2018
Premiums Oct r1creW' ervipl6s, In.c,-.—.--.—
(Princ (Seal)
(Witness)
4 -7 A
(Title)
Old Republic Insurance Com/any
ON i'n�A (Surety), (Seal)
(Witness)
(Title)ic r L. Kdszn'ia- emey in Fact
CAUTIOWYOU shouid sign an odginall MA Contract Docurnent, on wolfd' this text appears In RED. An orighial assiures that
changes will not be obscured.
AIA Document A31OTm - 2010. Copyrig
Dht 0 1963,1970 and 2010 by The American Institute of Architects. All rights reserved.'WARNING,� This As
snit. ocurnent is protectmi by U.S. Copyriglit Lmm and iritmnavonai irreafles. Unaulhorized relproducidon or rftstflbufion ofthfis AIAO Document, w,
awry immidlon of it, may remilt in severe cNIN and crirnhiM penalltles, and wHI be prosecuted to the maximurn extent possMe under the raw.
Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail
The American Institute of Architects' legal counsel, copyright@ala.org. 061110
*4
OLD REPUBLIC INSURANCE COMPANY
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania stock insurance corporation, does
make, constitute and appoint:
NICOLE L BICKNELL, MEGAN E RIESENBERG, MARK EDWARD WOBBE, DEBRA K HULL, BARBARA E PEARSON, JENNIFER L KASZNIA, SANDRA L JUNK,
WILLIAM J CERNEY, Ili, WESLEY MANTOOTH, THERESA BURNS, JORDAN SCHEIBER, OF SOUTH BEND, IN
Its true and lawful Attorney(s)-in-Fact, with full power and authority, not exceeding $50,000,000, for and on behalf of the Company as surety, to execute
and deliver and affix the seal of the Company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature
thereof, of bonefits, asbestos abaternentcwiroittacba�nds, wade manage-
ment borvis, iwZa,,,ouv,, wwslo rernediafio,, lonids or black tong borlds), as follows:
ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED
FOUR MILLION DOLLARS($4,000,000) ......................... FOR ANY SINGLE OBLIGATION.
and to bind OLD REPUBLIC INSURANCE COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and
confirmed. This document is not valid unless printed on colored background and is multi -colored. This appointment is made under and by authority of
the board of directors at a meeting held on March 14, 2014, This Power of Attorney is signed and sealed by facsimile under and by the authority of the
following resolutions adopted by the board of directors of the OLD REPUBLIC INSURANCE COMPANY on March 14, 2014.
RESOLVED FURTHER, that the chairman, president or any vice president of the Company's surety division, in conjunction with the secretary or
any assistant secretary of the Company, be and hereby are authorized and directed to execute and deliver, to such persons as such officers of
the Company may deem appropriate, Powers of Attorney in the form presented to and attached, to the minutes of this meeting, authorizing such
persons to execute and deliver and affix the seal of the Company to lbonds, undertakings, recognizances, and suretyshlif obligations of all kinds,
other lhan baltl bonds, hank depository bonds, rnodgage define bonds, rnortDage guaranty � �innds, quaionle8so insalrnerA paper and note
gManty bond& The said officers may revoke any Power of Attorney previously granted to any such person. The authority of any Power of
Attorney granted by any such officer of the Company as aforesaid shall not exceed fifty million dollars ($50,000.000.00), except (a) bonds
required to be filed as open penalty bonds, and (b) bonds filed with any court or governmental authority requiring an unlimited penalty in bonds
filed in that court.
RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(i) when signed by the chairman, president or any vice president of the Company's surety division and attested and sealed (if a seal be
required) by any secretary or assistant secretary; or
(it) when signed by a duly authorized Attorney -in -Fact and sealed with the seal of the Company (if a seal be required).
RESOLVED FURTHER, that the signature of any officer designated above, and the seal of the Company, may be affixed by facsimile to any
Power of Attorney or certification thereof authorizing the execution, and delivery of any bond, undertaking, recognizance, or other suretyship
obligations of the Company, and such, signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC INSURANCE COMPANY has caused these presents to be signed by its proper officer, and its
corporate seal to be affixed this 2 9TH day of JULY, 2016.
OLD REPUBLIC INSURANCE COMPANY
SEAL j
1� 0
. ............. . .
✓ STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS Vice President
On this 29TH day of JULY, 2016 personally came before me, ALAN PAVLIC and
JANE E CHERNEYto me known to be the individuals and officers of the OLD REPUBLIC INSURANCE COMPANY who
executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say; that
they are said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seat of the corporation, and that said corporate
seat and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said
organization,
'00 op Notary Public
My commission expire,: 9/28/18
(Expiration of notary commission does not invalidate this instrument)
CERTIFICATE
1, the undersigned, assistant secretary of the OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania corporation. CERTIFY that the foregoing
and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in
the Power of Attorney, are now in force.
45 - 5i314 15rini r %"BURA Signed an sealed at the City of Brookfield, WWI this day of
--- 4 "1", rt SEAL
I , rfli�;;Iimlv�
22851 -B
1 10016-R (5-10)
A A
�riIlj 9 ip 111 I
A
M
Project Name Berlin Place — Site Concrete, Landscape Plantings, and Bldg. 4 Roof
Pavers"
Project No.
For Bids Due
118-057
6/12/18
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
executed,
Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments
with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and
Certification of use of United States Steel Products or Foundry Products.
Proof of MBENVBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not
met, also provide Evidence of Good Faith Efforts Form [MWBE-2,O] and MBEANBE Contacted
Form [MWBE-2.1].
Acknowledge Receipt of 3 Addendum(s) included with the bid.
I/ All required additional information is included with the bid.
Proposal statements and other affidavits all signed by the proper party with name either
printed or typed underneath signature.
J
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: &JEO) W ly) Date: (b
By Authorized
Signature:
NVIT17h, MI
Version 10/17/2017 Contractor's Bid for Public Works - 1
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CITY OF SOUTH BENDsn"T"�'<',
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY Ff' ;f-
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 MBEIWBE 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: 118-057
Project Name:
Bidder:
Contact Person:
Project
Number: 118-057
"Berlin Place - Site Concrete, Landscape Plantings, & Bldg. 4 Roof Pavers"
RLCMkU "> 00C-e r( 4r-v- Pm( -Cs, ��c _
Address: i ( a- -�N(C_Rmm.) 3V-et—r
Telephone: 5`f -acoW _.O t i 6
City: EI u_ .. State: J h) Zip: � ( Yp
Email: ,k (-'L wn 0 e I r1
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 below*:
EVIDENCE OF GOOD FAITH EFFORTS
MBEIWBE 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 (http://www.in.gov/idoa).
ACTION (ADVERTISE/CONTACT): In order for your bid to be deemed responsive, the City of South
Bend requires that all perspective bidders complete no less than 2 of the following:
1. Attend all pre -bid meetings scheduled by the City to inform MBE/WBEs of contracting and
subcontracting opportunities.
2. Advertise in general circulation and/or trade association publications concerning subcontracting
opportunities, and allow MBEIWBEs reasonable time to respond.
3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated
to inform MBE/WBEs 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 MBEIWBE 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 MBEIWBEs,
including providing such MBEIWBE'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
MBENWBEs in order to increase the likelihood of meeting the MBEIWBE goals (including breaking down
contracts into smaller units to facilitate MBE/WBE 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
& A statement of whether an agreement was reached, and if not, why not, including any reasons for
concluding that the MBEMBE was unqualified to perform the job.
*Proper demonstration of Good Faith Effort requires your initials next 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 Bend reserves the right to request additional information.
Version 10/17/2017 Contractor's Bid for Public Works - 11
CITY OF SOUTH BEND"'�Hl�r'}.
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM' "� 1�r
FORM MWBE-2.1
MBEIWBE CONTACTED
This completed form should be supplied 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 meets the qualifications of a Minority or Women's owned
business.
PA(;E__J_OF�__
Project Number: 118-057 Project Number: 118-057
Project Name: "Berlin Place - Site Concrete, Landscape Plantings, and Bldg. 4 Roof Pavers"
MBEIWBE Firm -P�m 1 ry) ( I)OQC T—c
Owner or Contact at MB
i EIWBE Firm �1 Y6n K,
Telephone: �j Z�'�1�� �� Fax:S 7q - ll(p 53C�� Email: buK Qc . \i I h rt con
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBEIWBE FIRM:
MBEIWBE Firm
Owner or Contact at MBEIWBE Firm
Telephone: Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBEIWBE FIRM:
Version 10/17/2017 Contractor's Bid for Public Works - 12
DEPARTMENT OF ADMINISTRATION
STATE OF INDIANA Division of Supplier Diversity
yr_
r Eric J. Holcomb, Governor Indiana Government Center South
402 West Washington Street, Room W478
Indianapolis, IN 46204
9/12/2017 (317) 232 - 3061
Becky L. Yeakey
Premium Concrete Services Inc.
712 Richmond Street
Elkhart, Indiana 46516
Subject: Application for WBE Certification
Dear Ms. Yeakey
Congratulations! The Indiana Department of Administration, Division of Supplier Diversity is
pleased to inform you that Premium Concrete Services Inc. is hereby certified as a Women's
Business Enterprise (WBE).
Your company provides a commercially useful function in the areas listed below. Only work
performed in these areas will be counted towards Women's Business Enterprise participation:
UNSPSC CODE(S)
Code
Des !ttion
95121500
_
Commercial and Entertainment Building
Structures
72152700
Concrete Installation and Repair Services
On September 13, 2010, the Governor's Commission on Minority and Women's Business
Enterprises approved the department's effort to streamline its recertification process. Instead of
conducting an onsite visit to each company seeking recertification, the department now has the
discretion to waive the visit after a thorough review of the company's file and recertification
documents. We have approved your recertification and it is valid tlu•ough 9/30/2020, Please
note that IDOA continues to reserve the right to conduct a site visit or phone interview at any
time to certified companies.
Although your certification is valid for a three-year period, you are required to submit an annual
Affidavit of Continued Eligibilifj� (ACE) form, located at
www.in. ov/idoa/iuwbe/files/ACE Form. df
Reference: Premium Concrete services Inc.
Please remember you must notify us immediately if any changes occur. Failure to notify us of
changes or to provide an ACE form annually will result in revocation of your certification.
Changes include, but are not limited to, changes in location; contact information, ownership and
control,
We encourage you to visit IDOA's procurement website, www.in.gov/idoa/2464.htln, and update
your Business Registration Profile. It is important that you review and update your profile
regularly, because state purchasing agents and prime contractors may use this information to
contact you for business opportunities. For questions regarding your registration profile, you
may contact our office at 317-232-3061.
While this letter serves as notification of certification, it does not serve to prove continued
eligibility. Please visit vA-A-�v.in.gov/idoa/mwbe/2743.htm to verify certification status: Please
contact our office at (317) 232-3061 if you have any other questions.
We ask that you please contact Amy L. Wolf, Director of Certification, at (317) 232-3061 or
awolf@idoa.in.gov idoa.in.gov if you have any questions or concerns about your letter.
Sincerely,
Amy L. Wolf, Director of Certification
Indiana Department of Administration
Division of Supplier Diversity
ALW/TAK
Premium Concrete Services, Inc..
712 Richmond Street
Elkhart, IN 46516
(574) 264-0196
SECTION I EXPERIENCE QUESTIONAIRE
1) PUBLIC WORKS PROJECTS COMPLETED IN PAST YEAR:
CONTRACT
AMOUNT
$105,219
CLASS OF
WORK
COMPLETION
DATE
10-01-2017
NAME & ADDRESS OF
OWNER
CITY OF SOUTH BEND
$1.12,154
7-21-2017
CITY OF KENDALLVIILLE
$ 56,150
$357,478
8-03-2017
11-21-2017
CITY OF ELKHART
INDOT
CONTRACT
AMOUNT
$71,431
CLASS OF
WORK
COMPLETION
DATE
11-30-2018
NAME & ADDRESS OF
OWNER
INDOT
$44,940
8w31-2018
City of Nappanee
3) HAVE NEVER FAILED TO COMPLETE ANY WORK THAT WAS AWARDED TO US.
4) REFERENCES:
a. NISOURCE — MAR. Luke Braidley —1039 PENNSYLVANIA AVE SOUTH BEND, IN 46601
b. LOZIER MANUFACTURING— MR. KEN MURR — 402 N IMAIN MIDDLEBURY, IN 46540
Premium Concrete Services, Inc.
712Richmond Street
Elkhart, KN4@5I6
/574\264-0196
SECTION UPLAN AND EQU|PMENTQUESTK}NA|RE
1) Project No, 1lR'057Berlin Place -Schedule:
After given the notice toproceed Premium Concrete Services, Inc. will contact Indiana 811to
locate all utility lines within construction limits. Layout and staking ofsite will benext (by TVVG
Construction). Then the excavation, grading @subgradewill begin for concrete work. After
excavation and grading phases are complete, concrete work will commence. Crews nf4'6
workers will install. Project with be completed on schedule.
2) a\ TCSInc. —�1810 W. Pacific Ave. Knox, |N46534—Traffic Maintenance, Signs and
Thermoplastic Lines.
b) Acorn Landscaping —3688VVSammp|e5tSouth Bend, |N 46G19—Top Soil and Sodding.
r) Kacbur Tree Service, LLC-316 Fw|kersmmRdNiles, KQ|4921Q-Tree Removal.
d\ Walsh 8'Kelly Inc. —Z43588N-23South Bend, IN' 4@614—Asphalt Paving.
m) R|tschardBrothers, Inc. —12O4 W.Sample St. South Bend, IN 46619—Removals
Premium Concrete Services, Inc. Does not require bonding for its subcontractors
3A Will supply list ofsubcontractors soon, after award ofproject.
4\ Equipment use for project: Bobcat, Mini Excavator, Excavator Compactor Ro|er,VVaUk-beh|nci
5avv Cut-off Saw, VibirmStrike, Dump Truck. Current plan |otnused owned equipment, however
depending omworkload some rental equipment may benecessary.
5) Yes, Premium Concrete Services, Inc. has quotes for all materials in proposal,
SECTION Ill 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 10/17/2017 Contractor's Bid for Public Works - 4