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Opening of Quotes - City Cemetery Monument Repairs - Stone Revival Historial Preservation
CITY OF SOUTH BEND, INDIANA CONTRACTOR'S QUOTE FOR PUBLIC WORK PROJECT NAME: City Cemetery Monument Repairs PROJECT NO. 1068-2018 QUOTES DUE ...JUly 101', 2018 9:00am -` (Must be completed for all quotes. Please type or print) Date: (A �`1'.6-1 di918 Firm: d < e V i Va P/'5fc-D `r' Cie Address: Y r --')as G"i ;ck& t�� City/State/Zip: 0 C� / � �q&[�fl ephane Number: Aail%) Agent of Bidder (if Applicable): C'C VQtl Pursuant to notices given, the undersigned offers to furnish lab r 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: The City of South Bend, Department of Public Works and dated Dn�)l El for the sum of (enter the Total Quote as shown on the Proposal) (Enter Sum of Total Quote plus Alternates shown on Proposal) (Numerical) If alternative quotes apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the quote is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachMnt. By ACCEPTANCE The above quote is accepted this day of Subject to the following conditions: BOARD OF PUBLIC WORKS Gary A. Gilot, President Suzanna M. Fritzberg, Member Elizabeth A. Maradik, Member James A. Mueller, Member Therese J. Dorau, Member Attest: Linda M. Martin, Clerk 20 Version 10/31/2017 Page - 9 Public Works Quote QUOTE/PROPOSAL CITY OF SOUTH BEND PROJECT NAME City Cemetery Monument Repairs PROJECT NO. 1068-2018 QUOTES DUE July 101" 2018 9:00am Item No. Description Quantity Total Amount Repair and/or reset of monuments listed in specifications. 67 Monuments/ lump sum $ J��� Total Amount of Quote $l0 Cost per additional Monuments Average Price per Repair $ C' Average Price per Reset $ r� �O 7,� Firm: f ry �� I �—[ / 5� r C Cc Address:r City/State/Zip: ('a' P i,Cx-_�,l M Telephone Number: 010 r- `6r�� Fax Number: ( t By J i nature) (Printed Name of Person Signing) Version 10/31/2017 Page - 13 Public Works Quote ACORa CERTIFICATE OF LIABILITY INSURANCE L� DATE(MMIDDIYYYY) 1 06/01/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policyjies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s). PRODUCER CONNAME CT Annette M Lacy ISU American Business Insurance 320 West Main Street PHONE (317) 888-7283 pIC No : (317) 888-3450 -MAtL service m ABl.com ADDRESS: G� y INSURER S AFFORDING COVERAGE NAIC @ INSURERA: Indiana Farmers Mutual Greenwood W 46142 INSURED INSURERS: INSURERC: Slone Revival Historical Preservation 129 Brunswick Dr. INSURER D ; INSURER E : INSURERF: Greenwood IN 46143 COVERAGES CERTIFICATE NUMRFR: RFVlclnM MI IMpr=R• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILIRR TYPE OF INSURANCE ADDLISUBRI POLICYNUMBER P LICY EFF IMMIDU= POLICY EXP iMWDX)IYYYY)LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE rx-1 OCCUR EACH OCCURRENCE $ 1,000,000 t A E _Td RENTED PREMISES fEa occurrence $ 2,000 MED EXP {An one parson) $ X Business Owners PERSONAL & ADV INJURY $ A BOP1OO5793 03/21/2018 03/21/2019 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- ❑ JECT LOG GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY (Per i ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE {Per accident $ UMBRELLA LIAO OCCUR HCLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORMARTNERIEXECUTlVE OFFICERIMEMBER EXCLUDED? ❑ NIA PER I I OTH- STATUTE ER E.L. EACH ACCIDENT _. $ _.._. E.L. DISEASE - EA EMPLOYE $ (Mandatary in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (ACORD 101, Additfonal Remarks Schedule, may be attached If more space Is required) Coverage for operations within the State of Indiana. Coverage only applies for work as classified on policy. City of South Bend Department of Venues, Parks and Arts 227 W Jefferson Blvd. South Bend SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE; WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE IN 46601��— ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD When the prospective Contractor is unable to certify to any of the statensents below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF ) SS: 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 firin, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency, and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran., or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Version 10/31/2017 Page - 10 Public Works Quote Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WEE") 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). 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 Version 10/31/2017 Page - 11 Public Works Quote have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations, hereunder may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 5— day of,,,J(,) Co id r F Si-7 i of ContrZ(or/Biader or Tts Agent Printed Name and Title I I Subscribed and sworn to before me this 5 day of J* lk I"-, 20-1-�- - My Commission Expires IVA -9� 01 ;2q County of Residence Mims Notary Public I NOTARY \Dos PUBLIC -6F """00111mll Version 10131/2017 Page - 12 Public Works Quote