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Home My WebLink AboutOpening of Quotes - Ziker Sample Street Building Restroom Remodel Proj No 117-123 - Premier I Construction IncPROJECT NAME Ziker Sample Street Building: Restroom Remodel PROJECT NO. 117-123 QUOTESD!UE July24,2018 Division A — Area 2 Item No. Description Unit Unit Price Total Amount Remodel of two (2) existing bathrooms, relocation of Mechanical room, and storefront window replacement LS $ 114 3153 Total Amount of Division A $ /37, 383 Division B — Area 3 Item No. Description Unit Unit Price Total Amount Remodel and installation of two (2) new 1 bathrooms. LS $ (q I Total Amount of Division B $ 1-1 1 q1 Division C — Area 4 Item No. Description Unit Unit Price 'Total Amount Remodel and installation of one (1) new 1! bathroom. 1 LS $ Total Amount of Division C $ e'7 L-- Firm: _Rkr VWt Address: City/State/Zip: Telephone Number: Fax Number-, /7\ 1 14 (S gnalure), AMA-� /U L,4- (Printed Name of Person SIgning) Version 10/31/2017 Page - 11 Public Works Quote M11 M M M, ... .... . . ... CITY OF SOUTH BEND, INDIANA ,e CQUIRACIMS QUOTE FORRUBLIQ WQR "A PROJECT NAME: ZIker Sample Street Building: Restroom Remodel PROJECT NO. 117-123 QUOTES DUE Jul y24,2018 Date: Address. City/State/Zip: (Must be completed for all quotes. Please type or print) C)O&Pvl r) M Telephone Number: (S-7LO)-) 3?- 71)& 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., the City of South Bend, Indiana, in accordance with plans and specifications prepared by: The City of South Bepd, Department of Public, Works and dated '] for the sum of (enter the Total Quote as shown on the Pro�posal) 4-1a,icA�wi) f'iv�-j 70oflAA (s 2- / 9, 0 6 rn of ra6h Division shown on P (N,uffierical) If alternative quotes 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 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 attachment. By Do," n (Printed Name of Person Signing) The above quote is accepted this Subject to the following conditions: Gary A, Gilot, President Elizabeth A, Maradik:, Member James A. Mueller, Member Version 10/31/2017 ACCEPTANCE day of — 20 Suzanna M. Fritzberg, Member Therese J. Dorau, Member Attest: Linda M. Martin, Clerk Page - 7 Public Works Quote When the prospective Contractor is unable to certify to any of Ilse 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 JD2tl, �t� -_ 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 -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 - 8 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 ("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 Version 10/31/2017 Page - 9 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 Z3''tA day of �, 20:0 Cor^ctar/Bidden) Y PU Tataneshla M. White, Notary Public Comm. Expires Aug, 31, 2023 Resides in S. Joseph Co., IN �* Comm. Number 672377 ame and Title or Its Agent r� Subscribed and sworn to before me this �3 day of , 20 ``..ryrye My Commission Expires WOLetaL'&�&A. Notary Public County of Residence Cat Version 10/31/2017 Page -10 Public Works Quote Client#: 41974 PREMICO ACORD. CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDIYYYY) 07/17/2018 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 policy(les) 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CRAJACTConnie J. Messer ONI Risk Partners _ PHo R — — Eat : 674-314-9190 FAX mcA o A/C No , 866-8934638 — 100 East Wayne Street, Ste 315 ADDREss: Cannie.messera�onirisk.com South Bend, IN 46601 INSURER(*) AFFORDING COVERAGE NAIC IV INSURER A: Cincinnati Insurance Co. 10677 INSURED Premier 1 Construction, Inc INSURER B : 105 E. Jefferson Blvd, Suite 216 INSURER C ; ------------------- --- South Bend, IN 46601 INSURERo_ INSURER E ; INSURER F : Lorm I IF'r[:A I it rVL11VIKITH' 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 BYpPAID I LTR TYPE OF INSURANCE INSR SU p POLICY NUMBER MWPDNYYY �CLLAIMS. MAIIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR PD Ded:500 X X EPP0448837 8/01/2018 08/0112019 EACHOCCURRENCE $1 000 000 RAM01EaoNrrencel 1500,000 X MED EXP (Any one person) $ O OOO PERSONAL & ADV INJURY- $1,000r000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I ^I ECT L.X_J LOC OTHER: GENRA EL AGGREGATE - $ 2,000,000 PRODUCTS -COMPIOPAGG $2,000,000 $ A _ AUTOMOBILE LIABILITY ANY NNAUTO AUTOSDONLY AVTpSULED AUTOS ONLY X NON -OWNED AUTOS ONLY EPPO448837 8/01/2018 08/01/201 Ea & en01SiNGLE LIMIT 1,000 OOO BODILY INJURY (Per parson) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Par aoGdent $ _X A UMBRELLA LIAB X EXCESS LIAB OCCUR CLAIMS -MADE X X EPPO448837 — 010112018 0810112019 EACH OCCURRENCE_ _ $1 000 000 AGGREGATE $1 00O OOO DIED I X RETENTION $0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERlMEMSER EXCLUDED? (Mandatory In NH) DESCRIPTION OF OPERATIONS below N / A X EWC0448834 8/01/2018 08/01/201 X PER oTH- E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $500000 E.L. DISEASE - POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Additional Remark* Schedute, may be attached If more space Is required) All as contained herein when required by written contract PROOF OF INSURANCE ONLY SOUTH BEND, IN 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 C ACORD 26 (2016/03) 1 of 1 #S16042091M1604207 O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CMESS