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Opening of Bids - 2018 Street Paving Project No 118-070 - Walsh & Kelly Inc
192 191:41 21M R Let I Project Name 2018 Street Paving Project No. 118-070 For Bid'sDue August 9, 2018 at 9.30 am Local Time PART I (Must be completed for all bids. Please type or print) Date: August 9, 2018 Bidder (Firm): Walsh & Kelly, Inc. Address: 24358 SR 12 City/State/Zip: South 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: 2018 Street Paving 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 August 9, 2018 for the sum of (enter the Total Bid as shown on the Proposal) One million two hundred sixty four thousand one hundred dollars and zero cents ($ 1,264,100.00 (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 addendurns attached will be specifically re!prepced at the applicable page. If additional units of material included in the contract are'Keede , �th, st of units must be the same as that , d/" shown in the original contract if accepted by the Ci of So Be�V I the, bid is to be awarded on a unit basis, the itemization of the units shall be shown n a s arat@4 t6c - ment. �,tO4; 0 Irlig, F �,*% & K E t By1 ........ (Signature) Dustin Hilary, VP of Souith Bend Arm (Printed Name of Person Signing) ACCEPTANCE The above bid is accepted this day of Subject to the following conditions: BOARD OF PUBLIC WORKS Gary A. Giiot, President Suzanna M. Fritzberg, Member Elizabeth A. Maradik, Member Therese J. Dorau, Member James A. Mueller, Member Attest: Linda M. Martin, Clerk Version 10/17/2017 Contractor's Bid for Public Works - 2 BID/PROPOSAL CITY OF SOUTH BEND Project Name 2018 Street Paving - ADDENDUM #1 For Bids Due August 9, 2018 @ 9:30 am Local Time CONTRACTOR NAME: Walsk Kelly Inc. Item No. Description Quantity Unit Unit Price Total Amount I MAINTENANCE OF TRAFFIC 1 LS 47,100.00 $ 47,100.00 2 NOBILIZATION AND DEMOBILIZATION 1 LS 47,196.38 $ 47,196,38 3 MILLING, VARIES 1.5 TO 2.5 IINCHES 34,448 SY 2.90 $ 99,899.20 4 HMA SURFACE, 9,5 MIS - TYPE B 2,842 TONS 86.40 $ 245,548,80 5 HMA WEDGE, AND COVER- TYPE B 231 TONS 77.00 $ 17,787.00 6 TACK COAT 14 TONS 1.00 $ 14.00 JOINT ADHESIVE, SURFACE 23,156 LF 0.40 $ 9,262.40 8 ADJUST MANHOLE TO GRADE 24 EA 510.00 $ 12,240.00 9 ADJUST WATER LINE STRUCTURE TO GRADE 7 EA 60.00 $ 420.00 10 ADJ UST INLET TO G RAD E 18 EA 425.00 $ 7,6%00 11 TRAFFIC LOOP REAPLCEMEN�T, 6-FOOT 16 EA 462.00 $ DIAMETER CIRCULAR 7,392,00 12 SIGNAL CABLE, 2C 16 GA. SHIELDED 100 LF 1,80 $ 180.00 13 2-INCH CONDUIT 40 LF 42.00 $ 1,680,00 14 TRAFFIC DETECTOR HOUSING 4 EA 930,00 $ 3,720.00 15 PAVEMENT MESSAGE MARKINGS, THERMOPLASTIC,, WHITE, TURN ARROW 30 EA 100.00 $ 3,000,00 16 PAVEMENT MESSAGE MARKING, THERMOPLASTIC, WHITE, "'ONLY" 2 EA 150.00 $ 300.00 PAVEMENT MESSAGE MARKING, 17 THERMOPLASTIC, WHITE, BICYCLE AND 6 EA 275.00 $ 1,650,00 1ARROW 18 LINE, THERMOPLASTIC, BROKEN, WHITE, 110 LF 0.52 $ 57,20 4 INCHES 19 LINE, THERMOPLASTIC, STOP LINE, 425 LF 5.50 $ 2,337.50 SOLID, WHITE, 24 INCHES TRANSVERSE LINE, THERMOPLASTIC, 20 PARALLEL PARKING SPACES, SOLID, 351 LF 0.52 $ 182,52 PHITE, 4 INCHES 11 Walsh Kelly, hic, Project Name 2018 Street Paving - ADDENDUM #1 For Bids Due August 9, 2018 @ 9:30 am Focal Time CONTRACTOR NAME: Walsk Kelly Inc. 21 LANE, THERMOPLASTIC, SOLID, WHITE, 4 4,0610 LF 0.52 $ 2,111.20 INCHES 22 LANE, THERMOPLASTIC, DIAGONAL, 260 LP 0,52 $ 135.20 SOLID, WHITE, 4 INCHES 23 LINE, THERMOPLASTIC, LADDER CROSS 670 LF 5.50 $ 3,685.00 WALK, SOLID, WHITE, 24 INCHES 24 LINE, THERMOPLASTIC, CROSS WALKS, 1,290 LF 2.10 $ 2,709.00 SOLID, WHITE, 6 INCHES 25 LINE, THERMOPLASTIC, SOLID, YELLOW, 4 7,755 LF 0.52 $ 4,032.60 INCHES 26 LIME, THERMOPLASTIC, BROKEN, 400 LE 0.52 $ 208.00 YELLOW, 4 INCHES 27 LINE, THERMOPLASTIC, PEDESTRIAN 155 LE 2.10 $ 325.50 OASIS BOUNDARY, WHITE, 6 INCHES 28 PAVEMENT GROOVING FOR 4-INCH 12,325 LF 0.42 $ 5,176.50 THERMOPLASTIC LINES T gyp conitiractoii, ivnust lbid on both the bass. tyki aindIII lter rwre, Walsh Kelly„ Ine. BID/PROPOSAL CITY OF SOUTH BEND Project Name 2018 Street Paving - ADDENDUM #1 For Bids Due August 9, 2018 @ 9.30 am Local Time CONTRACTOR NAME: Walsk Kelly Inc. ALTERNATE A (Jade Crossing Subdivision) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 7,890.60 $ 7,890.60 2 MOBILIZATION AND DEMOBILIZATION 1 LS 8,100.00 $ 8,100.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 8,628 SY 2.20 $ 18,981.60 4 HMA SURFACE, 9.5 MM - TYPE B 1,170 TONS 78.00 $ 91,260.00 5 TACK COAT 5 TONS 1.00 $ 5.00 6 JOINT ADHESIVE, SURFACE 7,407 LF 0.40 $ 2,962.80 7 ADJUST MANHOLE TO GRADE 5 EA 475.00 $ 2,375.00 8 ADJUST WATER LINE STRUCTURE TO GRADE 5 EA 60.00 $ 300.00 9 ADJUST INLET TO GRADE 5 EA 425.00 $ 2,125.00 ALTERNATE A BID TOTAL: $ 134,000.00 ALTERNATE B (The Oaks Subdivision) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 4,572.60 $ 4,572,60 2 MOBILIZATION AND DEMOBILIZATION 1 LS 4,700.00 $ 4,700.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 3,762 SY 3.90 $ 14,671.80 4 HMA SURFACE, 9.5 MM - TYPE B 514 TONS 86.50 $ 44,461.00 5 ITACK COAT 2 TONS 1.00 $ 2.00 6 JOINT ADHESIVE, SURFACE 3,269 LF 0.40 $ 1,307.60 7 ADJUST MANHOLE TO GRADE 3 EA 510.00 $ 1,530.00 8 ADJUST WATER LINE STRUCTURE TO GRADE 3 EA 60.00 $ 180.00 9 ADJUST INLET TO GRADE 3 EA 425.00 $ 1,275.00 ALTERNATE B BID TOTAL: $ 72,700.00 Walsh Kelly, Inc. BID/PROPOSAL CITY OF SOUTH BEND Project Name 2018 Street Paving -ADDENDUM #1 For Bids Due August 9, 2018 @ 9:30 am Local Time CONTRACTOR NAME: Walsk Kelly Inc. ALTERNATE C (Dinan's Subdivision) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 4,775.20 $ 4,775.20 2 MOBILIZATION AND DEMOBILIZATION 1 LS 4,600.00 $ 4,600.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 3,101 SY 4.60 $ 14,264.60 4 HMA SURFACE, 9.5 MM — TYPE B 418 TONS 84.50 $ 35,321.00 5 TACK COAT 3 TONS 1.00 $ 3.00 6 JOINT ADHESIVE, SURFACE 2,628 LF 0.40 $ 1,051.20 7 ADJUST MANHOLE TO GRADE 3 EA 510.00 $ 1,530.00 8 ADJUST WATER LINE STRUCTURE TO GRADE 3 EA 60.00 $ 180.00 9 ADJUST INLET TO GRADE 3 EA 425.00 $ 1,275.00 ALTERNATE C BID TOTAL: $ 63,000.00 ALTERNATE D (Deer Hollow Subdivision) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 6;456.40 $ 6,456.40 2 MOBILIZATION AND DEMOBILIZATION 1 LS 6,800.00 $ 6,800.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 4,962 SY 3.60 $ 17,863.20 4 HMA SURFACE, 9.5 MM — TYPE B 686 TONS 81.80 $ 56,114.80 5 TACK COAT 4 TONS 1.00 $ 4.00 6 JOINT ADHESIVE, SURFACE 4,404 LF 0.40 $ 1,761.60 7 ADJUST MANHOLE TO GRADE 5 EA 475.00 $ 2,375.00 8 ADJUST WATER LINE STRUCTURE TO GRADE 5 EA 60.00 $ 300.00 9 ADJUST INLET TO GRADE 5 EA 425.00 $ 2,125.00 ALTERNATE D BID TOTAL: $ 93,800.00 Walsh Kelly, lnc. BID/PROPOSAL CITY OF SOUTH BEND Project Name 2018 Street Paving - ADDENDUM #1 For Bids Due August 9, 2018 @ 9:30 am Local Time CONTRACTOR NAME: Walsk Kelly Inc. ALTERNATE E (Southfield Subdivision) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 3,909.40 $ 3,909.40 2 MOBILIZATION AND DEMOBILIZATION 1 LS 4,000.00 $ 4,000.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 2,916 SY 5.00 $ 14,580.00 4 HMA SURFACE, 9.5 MM -- TYPE B 436 TONS 82.90 $ 36,144.40 5 TACK COAT 2 TONS 1.00 $ 2.00 6 1JOINT ADHESIVE, SURFACE 2,948 LF 0.40 $ 1,179.20 7 ADJUST MANHOLE TO GRADE 3 EA 510.00 $ 1,530.00 8 ADJUST WATER LINE STRUCTURE TO GRADE 3 EA 60.00 $ 180.00 9 ADJUST INLET TO GRADE 3 EA 425.00 $ 1,275.00 ALTERNATE E BID TOTAL: $ 62,800.00 ALTERNATE F (Southfield Lake Subdivision) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 1,241.90 $ 1,241.90 2 MOBILIZATION AND DEMOBILIZATION 1 LS 1,350.00 $ 1,350.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 3,488 SY 3.60 $ 12,556.80 4 HMA SURFACE, 9.5 MM - TYPE B 485 TONS 102.50 $ 49,712.50 5 TACK COAT 3 TONS 1.00 $ 3.00 6 JOINT ADHESIVE, SURFACE 3,127 LF 0.40 $ 1,250.80 7 ADJUST MANHOLE TO GRADE 3 EA 510.00 $ 1,530.00 8 ADJUST WATER LINE STRUCTURE TO GRADE 3 EA 60.00 $ 180.00 9 ADJUST INLET TO GRADE 3 EA 425.00 $ 1,275.00 ALTERNATE F BID TOTAL: $ 69,100.00 Walsh Kelly, Inc. BID/PROPOSAL CITY OF SOUTH BEND Project Name 2018 Street Paving -ADDENDUM #1 For Bids Due August 9, 2018 @ 9:30 am Local Time CONTRACTOR NAME: Walsk Kelly Inc. ALTERNATE G (Villas at Ireland Subdivision) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 1,902.80 $ 1,902.80 2 MOBILIZATION AND DEMOBILIZATION 1 LS 1,950.00 $ 1,950.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 886 SY 7.70 $ 6,822.20 4 HMA SURFACE, 9.5 MM - TYPE B 111 TONS 125.00 $ 13,875.00 5 TACK COAT 1 TONS 1.00 $ 1.00 6 JOINT ADHESIVE, SURFACE 660 LF 0.40 $ 264.00 7 ADJUST MANHOLE TO GRADE 3 EA 510.00 $ 1,530.00 8 ADJUST WATER LINE STRUCTURE TO GRADE 3 EA 60.00 $ 180.00 9 ADJUST INLET TO GRADE 3 EA 425.00 $ 1,275.00 ALTERNATE G BID TOTAL: $ 27,800.00 ALTERNATE H (Indiana Avenue) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 12,670.40 $ 12,670.40 2 MOBILIZATION AND DEMOBILIZATION 1 LS 12,650.00 $ 12,650.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 7,008 SY 2.30 $ 16,118.40 4 HMA SURFACE, 9.5 MM - TYPE B 789 TONS 75.00 $ 59,175.00 5 HMA WEDGE AND COVER - TYPE B 99 TONS 75.00 $ 7,425.00 6 TACK COAT 3 TONS 1.00 $ 3.00 7 JOINT ADHESIVE, SURFACE 4,133 LF 0.40 $ 1,653.20 8 ADJUST MANHOLE TO GRADE 8 EA 545.00 $ 4,360,00 9 ADJUST WATER LINE STRUCTURE TO GRADE 2 EA 60.00 $ 120.00 10 ADJUST INLET TO GRADE 13 EA 425.00 $ 5,525.00 ALTERNATE H BID TOTAL: $ 119,700.00 Walsh Kelly, Inc. BID/PROPOSAL CITY OF SOUTH BEND Project Name 2018 Street Paving -ADDENDUM #1 For Bids Due August 9, 2018 @ 9:30 am Local Time CONTRACTOR NAME: Walsk Kelly Inc. ALTERNATE I (Chapin Street) BID Item No. Description Quantity Unit Unit Price Total Amount 1 MAINTENANCE OF TRAFFIC 1 LS 5,371.10 $ 5,371.10 2 MOBILIZATION AND DEMOBILIZATION 1 LS 5,300.00 $ 5,300.00 3 MILLING, VARIES 1.5 TO 2.5 INCHES 9,133 SY 1.70 $ 15,526.10 4 HMA SURFACE, 9.5 MM --TYPE B 754 TONS 76.20 $ 57,464.80 5 HMA WEDGE AND COVER — TYPE B 33 TONS 80.00 $ 2,640.00 6 TACK COAT 4 TONS 1.00 $ 4.00 7 JOINT ADHESIVE, SURFACE 6,850 LF 0.40 $ 2,740.00 15 PAVEMENT MESSAGE MARKINGS, 2 EA 150.00 $ 300.00 THERMOPLASTIC, WHITE, TURN ARROW 16 PAVEMENT MESSAGE MARKING, 1 EA 175.00 $ 175.00 THERMOPLASTIC, WHITE, "ONLY' 18 LINE, THERMOPLASTIC, BROKEN, WHITE, 450 LF 0.64 $ 288.00 4 INCHES 19 LINE, THERMOPLASTIC, STOP LINE, 60 LF 5.50 $ 330.00 SOLID, WHITE, 24 INCHES TRANSVERSE LINE, THERMOPLASTIC, 20 PARALLEL PARKING SPACES, SOLID, 48 LF 2.00 $ 96.00 WHITE, 4 INCHES 21 LINE, THERMOPLASTIC, SOLID, WHITE, 4 350 LF 0.64 $ 224.00 INCHES 22 LINE, THERMOPLASTIC, DIAGONAL, 65 LF 0.64 $ 41.60 SOLID, WHITE, 4 INCHES 23 LINE, THERMOPLASTIC, LADDER CROSS 65 LF 5.50 $ 357.50 WALK, SOLID, WHITE, 24 INCHES 25 LINE, THERMOPLASTIC, SOLID, YELLOW, 4 1,680 LF 0.64 $ 1,075.20 INCHES 27 LINE, THERMOPLASTIC, PEDESTRIAN 155 SY 2.10 $ 325.50 OASIS BOUNDARY, WHITE, 6 INCHES 28 PAVEMENT GROOVING FOR 4-INCH 2,480 LF 1.19 $ 2,951.20 THERMOPLASTIC LINES ALTERNATE I BID TOTAL: $ 95,200.00 Walsh Kelly, Inc. Project Name 2018 Street Paving - ADDENDUM #1 For Bids Due August 9, 2018 @ 930 am: Local Time CONTRACTOR NAME: Walsk Kelly Inc. ... .. . ......... . . . .......... ... ........ . . . ......... ... .. . .... rIASE BID TOTAL- $ 526,000.00 P1.1-TEARATE 4,"l- S A - I TOTAL: $ 738,100.00 i, ; �1111111 I'll I'll �11 11 i ��� 11 1 1111;!11 M of A 1 1111.11*11A.11 I'Mi" Zi v7v 5,1II I I'm coinftacloir must Wd on both the base bid and all alkernates. Bidder (Firm): Walsh & Kelly Inc, Address: 24358 SIR 23 Cfty/StalI South Bend, IN 46614 Telephone Nu 10 By KP4 k,-,o R P 0 81 AV4 74)-288-4811 Dustin, Hilary, VP of South Bend Area (Printed Name of Person Signing) Walsh Kelly, Inc, 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON Boy .hLEVARD SOUI H DENT), INDIANA 46601-1830 PHONE,, 574/235-9251 FAX 574/ 235-9171 TDD 574/ 235-5567 Crry oi�' Soui'Fi Bl"NI) IIF.,,.,rE MAYOR BOARI) OF PUBUC WORKS Date: August 6, 2018 To: All Planholders From Linda M. Martin, Clerk, Board of Public Works Subject Addendum Number: I Project Name: 2018 Street Paving Project Number: 118-070 Date Received: 8/8/18 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 within hin 48 hours of receipt. A copy MUST also be included with your it bid package upon submittal. Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: Walsh & Kel Authorized Signature: Hilary, VP of South (Bend Area Versioii 4/2/2015 -- I --I L.,J ; Surety O +908.903.3485 202E Halls Mill Road, PO Box 1650 F + 908.903.3656 Whitehouse Station, W 08889.1650 Federal Insurance Company ALA Document A31OTm - 2010 Bid Bond Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. CONTRACTOR am, le gal status and address): also & Kelly, Inc. 24358 State Road 23 South Bend, 1N 46614 OWNER (Name, legalstatus and address): City of South Bend, Indiana 227 W. Jefferson Blvd. South Bend, IN 46601 BOND AMOUNT SURETY (Name, regal status and principal placeof business): Federal Insurance Company 202E Halls Mill Rd., PO Box 1650 Whitehouse Station,lq 08889-1650 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) 2018 Street Paving Project No. 118-070 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 fividshed 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 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 ofArchltects (ALA) by Chubb, The language In this document confonns to the language used in AU Document A3107M- 2010. Form 1502-0575.Pm (Rev.31M 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 Iaw bond. Signed and sealed this 9th (Witness) Krueger (Witness) Lisa M. Becker day of August, 2018. Walsh & ly, i C. By: (Pr' ci 1) Dustin Hilary of South Bend Area (Title) Federal Insurance Company By: Terry R. Hurst (CorporateSedll Printed in cooperation with the American Institute of Architects (ALA) by Chubb. The language in this document conforms to the language used in ALA Document A310 "1- 2010. Form 15.02-0575•FED (Rev.3/M 2 CHUBS' Power of Attorney Federal Insurance Company I 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 TIa A. Bolce, Terry R. Hurst, Brian T. Morton, David M. Qllger, Robert M. Rutigliano, Christina Marie Schmitter, Tina N. Senefeld and Eric M. Wahlstrom of Indianapolis, Indiana -- —---•••-- -- -----_ each as their true and lawful Attorney -in -Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than ball bonds) given or executed In the course of business, and any Instruments amending or altering the saute• and consents to the modification or alteration of any Instrument referred to in said bonds or obligations, in Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affxed their curporatesealson this 191" day ofjanuary, 2017, Dawn R, Chloros, Assistant Secretary Catherine A. Do ice President STATE OF NVW JERSEY County of Hunterdon On this 191" day of January, 20)7 before me, a Notary Public of New Jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL, INSURANCE COMPANY. VIGILANT INSURANCE COMPANY, and PACIFIC iN➢EMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chlom& being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals 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 said Companies by like authority; and that she Is acquainted with Catherine A. Donahue, and knows him to be Vice Pra-ildent or said Companies; and that the signature of Catherine A. Donahue, subscribed to sold Power of Attorney Is in the genuine handwrttingofCatherin a and was thereto subscribed hyauthority ofsaidCompanies and indelmnent'spresence. tiN NotarlalSeall KATHERINEJ, ADEL AAI3 N�rAHy NOTARY PUBLIC OF NEWERSEY .i NO.2310885 Notary Public COMMISslon ExpCE 1'[IF1CA7 fON Resolutions adopted by E Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016: 'RESOLVED, that the followingnuthortzatlani rd;aetn the execution, for and on behatfof the Onmpany.orbonds. undertakings. recogniaanass. contracts and other written commitmentsof the Company entered mto In the ordir Ary oourse of busttress (eadi a -Wrnen Commitmen0: (1) Each of the Chairman, the President and the Vice Presidents or the Company is hereby authorized to execute any Written0otntnitmeni forandonbebalfoftftt:0ampany.under the seal of the Company or otherwise. (2) rich duly appolmed attorney indact of the Company is hereby authorized to execute any Written Commitment rot and on behalf of the Company. under the seal of the Company or orhertyuse,iothe extentthatsuchaction isaudtwfzedbytheo ntofpowersprovidedforinsuchpersonswrittenappointmentassuchattorney-in-fart. (3) Each of the Chairman, the Presrdem and the Vice Presidents of the Company Ls hereby authorized, forand on behaifofthe Company. toappoint inwriting any person the attorney- mt-(act of the Company with Full power and authority to execute, rot and on behauoftbeCompany. under the sealerthe Cumpanyorothersvlse,such Written Comtnhmentsofthe Company as may be specified in such written appointment• which spedactlton maybeby general type or class of Written Comnftmenrs or by specification or one ormare particular written Commitments. (4) Fach of the Chairman, the President and the vice Presidents of the company is hereby authorized. for and on behall'ofthe Company. to delegate in wrIlIngto any other officer dEhe Company the authority to execute, for and on behalf of the Company. under the Companys sea] or otherwise, suer, WNtien Conmtfrtnots of the Company as ate specified In such written delegation. which specification may be by general typeor darsof Wrluen Commitments or hyspedfirationofoneormare p otcuiarWrtuenCommitmetrts. (5) The signature of anyolflceror other person cxmOng any written Com nitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, maybe affixed by facshnlleon such Written Commitment or written appolntmentordeleagathm, FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be art exdusiveMatementofthepowasand authority ofoalerrs• employees and other persons toaciforandark behaltur the Company, andsuch Resotudon shall not Ihnit or otherwtse aired the exercise of any such power or atuborlty otherwise vtltdly granted or vested" 1, Dawn M, Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies") do hereby certify that (I) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and elfer t, (11) the Companies are duly licensed and authorized to transact surety business In all Sri of the United States of America and die District of Columbia and are authorized by the US. Treasury Department; further, Federal and Vigilant are licensed in the US. Virgin Islands, and Federal is licensed in Guam. Puerto Rico, and each of the Provinces of Canada except Prince Edward Island; and (lip) the foregoing. Power ofAttorney Is true correct and In full force and effect. ` Given undetyiand�alspsa�ci»ompanicatVhirelotueStat[on,�,this9th day of August, 2018. 9- r Dawn M. Chloros, Assistant Secretary '` .. iNTHE E4£itTYOII)!IISI4TONOTIFY LISOFACLAIM. VERIFY THE AUrH&YTICITYOPTICS BOND ORNOTIFY USOFANY OTIIHRMA7?1yR.PLEASE CONI'ACfUSAT-. Tcle hona(9Oa)903-34sJ3 Pax{g0g)9{f3.3G5G cma11: st>rct @+c}tuhb.onm 1f t Farm151t> 02259 U 400 P014SENT(ray.1246) Re Nm Project Name 2018 Street Paving Project No. 118.070 For Bids Due August 9,2018 at9.30, am Local Time 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. IIn 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 X 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 MBEANBE Participation Goal Form [MWBE-1.0]., If minimum participation goal is not met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE 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. Thiis checklist is provided for (bidder's use in assuring compliance with required documentation; however, It does not, include all specifications requirements and does not relleve the bidder of the need to read and comply with the specifications. Bidder: Waslh &Kelly, Inc. By Authorized Representative: Signature: Print Name & Title: VP of South Bend Area Version 10/17/2017 Contractor's Bid for Public Works - 1 Date: 8/9/18 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 it 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. 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 10/1712017 Contractor's Bid for Public Works - 3 When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF 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 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 affiliatc, 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 10/17/2017 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/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 alter 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 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 commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable, Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder Version 10/1712017 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 information contained in the foregoing bid for public works are true and correct. Dated this 9th day of August, 20.18 CO :< of Contractor/Bidder or Its Agent tin Hilary, VP of South Bend Area Printed Name and Title Subscribed and sworn to before me this 9th day of Au st .2018 My Commission Expires 615122 / Notary Pu c"L� Alisha ueger County of Residence St. Jose y> , ` gL1SliA K19UEGER l Q�Y•PVA`+; iyptary Public, State of Indiana ° ' n ;- :SEAi SI. Soseph county f ^+iilP� i MY Commission Expiras jur)8i7�7,2o2 Version 10/17/2017 Contractor's Bid for Public Works - 6 uj LLI 0) (2, IL Ix LU z �- uj z 0 m uj 0 0) w Lu �- 0 —Z Z' Q) w 0 U. 02 IL ZLUi LU 0 Cl z 0 z i 6 !A T- 0 c .2-0E 46 .2 0m 0 . z, o LU .a (9 0 LU Q) LU 0 0 c o 0— > r .r CD CD Jd L- 0 CD E C) 0 0 0 N 03. 'r- LO 0 r 0 c 0 E 0 0 iL 0 0 E Q) 0 4- to �' r- 0 co 0 0 40. E S tm ai E z (L M W 4) > OL 0 CL Ln O 4) 0, o 0 CL E s- 0 %10 0 0 0 L z E 0 0.0 U m OP, '0 0 10 i� CL 2 0--Cl ca 46 C: 0 cL 6 E 0 CD < UJ C) c� Cz C> m ca 47 c -9.2 tf as 0 a) lo te 2 o = 0,8 od QL U) E > 0 a. 0 t 04 (D C4 E 0 04 E2 0) E .1 rl, F- Lo 0 cq w m 0 a) m in I v = :3 Co c U) 16 ID c v 0 U) 0 2 < QtY Lo 14 CC? 0 0 E ( -) § z U5 Z 0 x v- 0 00 CD Dil M. u 0 rl_ 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 MBENVBE 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: 118-070 Date: 819118 Project Name: 2018 Street Paving Bidder: Walsh & Kelly, Inc. Contact Person: -Ed IPilipow Telephone: 5,74-288-4811 Address: 24358 SIR 23 City: South Bend' state: Indiana zip: 46614, Email: epilipow@waIshkelly,com To determine whether a bidder has demonstrated good faith efforts to reach the MBENVBE 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 MBENVBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business Enterprise Diversity Development Programs, which uses the IDOA approved list of Minority and Women Owned Business as found on their webs,ite (http://www.in,gov/idoa). ACTION (ADVERTISE/CONTACT)-, IIn order for your bid to be deemed responsive, the City of South Be..quires that all perspective bidders complete no less than 2 of the following: Attend all pre -bid meetings scheduled by the City to inform MBEANBEs of contracting and subcontracting opportunities. . Advertise in general circulation and/or trade association, publications concerning subcontracting opportunities, and allow MBEAIVBEs reasonable time to respond!. Perform any and alll necessary steps to provide written notice in a manner reasonably calculated U 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 MBE/WBE 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 MBE/WBE's with, adequate information about the plans, specifications and other requirements of the subcontract and did not reject MBEANBEs 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 MBE/WBE 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 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 jiob, *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 10/17/20,17 Contractor's Bid for Public Works - 9 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM 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. PAGE OF Project Number: 118-070 Project Nanme:018 Street Paving Wa Bidder: a Kelly, Inc. By: Firm, Traffic Control S MBENVBE Participation GoaI 7% Cb' �yORIU41- VP of South Bend Area 8/9/18 (Title) (Date) % ialists, Inc. Owner or Contact at IVIBEMBE Firm Tracey Triska F614010% Telephone: 574-772-7001 Fax: Email: tracewo-,ftsspecialists. net TYPE OF WORK SOLICITED FOR THIS PROJECT: Pavement Markings RESULTS OF CONTACT WITH THE IVIBE1WBE FIRM: Subcontractor was entered into our bid. MBE/WBE Firm C. Lee Construction Services, Inc. Owner or Contact at MBE/WBE Firm Chip Lee Telephone: 219-922-7733 Fax: 219-888-9564 Ernail': chip@cleecsi.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Hauling - HMA & Millings RESULTS OF CONTACT WITH THE IVIBEMBE FIRM: Subcontractor was entered into our bid. Version 10/17/2017 Contractor's Bid for Public Works - 10 CERTIFICATE OF QUALIFICATION to provide CONSTRUCTION SERVICES for PUBLIC WORKS PROJECTS to th4 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 4-1164 and adopted rules of this Board, liefcby issues a Certificate ol'Quallificaflon to provide construction services to the State of Indiana for Public Works Projects to: 14 R W NMI 1111141: IFOLL AMN 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 licrein, unless revoked by this Board for cause, and in the classifications of services stated below. This certificate supercedes any previous certificate, 1611.01 Concrete Construction of Roads & Curbing 1611.02 Asphalt Construction of Roads and Parking Lots CERTIFICATION DATE 3/1412018 EXPIRATION DATE 6114/2020 THIS CERTIFICATE ISSUED 13Y THE STATE OF INDIANA, PUBLIC WORKS DIVISION CERTIFICATION BOARD, 402 WEST WASHINGTON STREET, Room W467, INDIANAPOLIS, INDIANA 46204, ALSO ACTS AS THE OFFICIAL NOTICE OF PXPIRATION. Tracy L. Cross, ExecutIve fS"'6'retary Certification Board DAPW PQ2 State Form 3983R Rev. 07/06 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 Board 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. <<SIGNATUR,ES ON THE NEXT PAGE>> EXECUTED this 7111 day of March, 2017. Fred Fehsenfeld, Jr. Thomas P. Bertsch James C, Fehsenfeld John P. Vercruysse ®%""y� 1C7 hi P ��®m®o Kevin J. Kelly o `°• ®®� EXECUTED this 7d'day of March, 2017. Fred Fehsenfeld, Jr, ............ Thomas P. Bertsch Kevin J. Kelly JameYC. Fehsenfeld ApAn P. Vercruysse WalshGRIFF1TI-1 SOUTH BEND 1700 East Main Street 24358 State Road 23 0)v Griffith, Indiana 46319 South Bend, indWna 46614 Kellrnc. Phone (219) 924-5900 Phone (574) 288-4811 Fax (219)924-a768 Fax (574) 289-7174 www,waishkelly.ccarmi EQUAL EMPLOYMENT OPPORTUNITY POLICY L 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, citizenship 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 ,fob training. A. The Contractor will work with the State highway Agency (SHA) and the Federal Government in carrying out EEO obligations and in their review of his/her activities under the contract. II. "'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. Mahe 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 11375, 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 filing 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 & KEL LY INC. John C. Wall, ......° Vice President of Business Developiuoli��EI w6C , c r Revised: August 17, 2017 UAL OPPORTUNITY EMPLOYER TnAirtrate of Quatifirutijorn ISSUED BY INDIANAPOLIS, IN April 19, 2018 HE WALSH & KELLY INC GRIFFITH, IN who has filed with the Department a Contractor's Statement of Experience and Financial Condition as 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 symbol are in accordance with the definitions in the Contractor's Statement of Experience and Financla Condition. This certificate supersedes any certificate previously Issued, but is subject to revision or revocation according to the law, if and when changes n the financial condition of the contracting firm or other facts justify such revision or revocation. 'Valid May 1, 2018 Thru April 30,2019 AGGREGATE......................................................... ........ ...... - ... ....... ......... .......-- ....... -- "LlIVUED A(B) CONCRETE PAVEMENT: LIMITED .......... - ........................ ......... -- ............ . ......... . ................. ... $25,000,000 B(A) ASPHALT PAVEMENT: WANDOTCERTIFIED HMA ...- ........ ................... ................... ..... ..$UNLtMI1*ED C(B) LIGHT GRADING ...... ............................. ......... .................... ... . .. ........ -- .... ..... ..... ... $UNLIMITED E(I--.) SMALL STRUCTURES AND DRAINAGE ITEMS .. ........................ ............ ........ -- -- ... ..... $25,000,000 E(F) SURF -ACE MASONRY AND MISC CONCRETE...... ........... ............... ...... ---- ............... -- ..... $50,000,000 E(G) TRAFFIC CONTROL: PAVEMENT MARKINGS .......................... .. ........................................................ $25,000,000 E(H) DEEP SEWER AND/OR EXCAVATION -- ...... ..................... --- ..... - ..... ........ -- ... - ...... -. $25,000,00,0 E(Q) CONCRETE PAVEMENT REPAIRS ............. ...... ............... . ................. ...... -- $25,000,000 E(R) ASPHALT PAVEMENT MILLING...................................................... ......................... - ...... — ........ $50,000,000 "'-ON iN kPREQUAL FRI &46iiii State Forum 20508 (R3 15-05) COMMISSIONER CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name: 2018 Street Paving Project No.: 118-070 For Bids Due: August 9, 2018 Contractor Name: Walsh & Kelly, Inc. The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 63 of The Responsible Bidding Ordinance No. 10694.18 (hereinafter, `Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders") by December 3181 for the upcoming calendar year, or within twelve (12) months of obtaining pre - qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective January 1 of the following year, or immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 4/17/2015 General Conditions - 6 POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty thousand dollars ($150,000,00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s), Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder and all subcontractors on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 4/17/2015 General Conditions - 7 PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements (i) _ By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. — By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (b) Attachments 0) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) _ Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. (iii) _ Evidence that I am utilizing a surety company which is on the United States Department of Treasury's Listing of Approved Sureties as required in the bid specifications or contract. (iv) List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. Version 4/17/2015 General Conditions - 8 It. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements W X By checking this box, I hereby acknowledge that I am not a pre - qualified bidder with the City of South Bend. (ii) X By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. (iii) X By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) X By checking this box, I hereby acknowledge and ensure that I and all sub -contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore, I acknowledge my understanding that it is my responsibility to ensure that all sub- contractors have the necessary licenses to undertake the work called for in this bid. If a sub -contractor loses their license at any point, it is the responsibility of that sub -contractor to notify the City. (b) Attachments (v) X Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (i) NIA List identifying all former business names. (ii) NIA Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) years. (iii) X Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. (iv) X Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances. (v) X Evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. (vi) X Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. (vii) X Evidence that I am utilizing a surety company which is on the Bureau Version 4/17/2015 General Conditions - 9 of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. (viii) NIA Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years.**No tax delinquencies (ix) X List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. Dustin Hila (Print Name Here) Walsh & Kelly, Inc. (Name of Company) 24358 SR 23 (Address of Company) South Bend (City) Indiana (State) 574-288-4811 (Telephone Number) r�` y & Kit ®® �l b�0oo o9ee••`{ ®®��fYVD i�ps 1 P, Version 4/17/2015 General Conditions - 10 Responsible Bidding Practices and Submission Requirements for Pre -Approval (b) Attachments (v) Attached (i) Not Applicable (ii) Not Applicable (iii) Staffing Capabilities: Walsh & Kelly, Inc. is signatory with the following unions which supply our workforce — Laborers International Union, Teamsters, Operating Engineers and Cement Masons. (iv) All individuals who will perform worn on the public works project on behalf of Walsh & Kelly, Inc. will be properly classified under applicable state and federal laws and local ordinances. (v) Attached (vi) Attached (vii) Attached (viii) Not Applicable — no tax delinquencies (ix) See Forms 96 and 96a 51 Dated: August 9, 2018 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 August 03, 2018. I further certifiy 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 fiie.: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, August 03, 2018 eox" 0% ""4n% CONNIE LAWSON SECRETARY OF STATE 194484-057 / 2018687975 All certificates should be validated here: https'Hbsd.sos.in.gov/ValidateCertificate Expires on September 02, 2018. 0614st20 ra 'rue Ili sf ea% 12100MI38a Lot" ar ®o-2vatt AORBfs411111' HY AND BBTWEEN FOUR COUNTY 111011WAY CONTRACTORS GROUP And 1ABORPRS' INTERNATIONAL UNION OF NORTH AMM CA STATE OF iNMNA DISDUCT COUNCIL FOR AND ON BEHALF OF ITS AFFI13ATBD LOCAL UNIONS k41 & 081 APRIL I, 2017 thm MARCH 31, 2022 Seeder 7. An Apprentice should, whenever practical, be roreted by The Employer through different typeaofwolk sa as to become trained in a variety of operaliom and wank skills. Where the Employer is unable to provide an Apprea6ce with expvAeaoe in the ful! renke ofcmn aid,, the )ATC may request the Local Union to reassign the Apprentice to other employment hr order evIde that experience. For so long as the Employer is able to provide the necessary ranee of mplo request the Employer will Binfimtrth y]ATCsaand to �Local B Unonnof an Apprentice'. job reassijtoments on a project. Seetioa S. Ali Apprentice shell not bePenalized for taking offfrom wort; to attend offsile training (though time off for training is unpaid). Section 9. Notwithstanding the provislonso€Seedon $, the Employer Nay call the Union for an indfi4c uei by name, provided he orshe is not then employed by another Crop[oym. IFavnHn an the Union sball Mier dint individual. Seetiun 10, The Unionagreesto hold harmless and to iademolfy, any Fmplo)w in any claim arising out oflhe Union's tctiurat mits/pmaices or the Union'or JATC`s administmlion oftiers Apprentlecship Program, ARTICL87(XRV BCRC/DRUG TSSI[NC Section]. The Union Reognims the right of the Empioyerto establish a drug testing policy for Employees. Section 2. 1a 01 situations Where an Employeris required to sgee to a testing program in ordtr to qualify to be the successful commoc, on s project, testing may be required, in accordance }sith The standards of this program, or, if the owner's regaimments for successful sou6aclors arc mom stringtnl, in accordanee with the owner'srRuiremeuts, No adverse empdoyniont action shed, be taken against a worker solely became he/she refused ajob assignment that has a substance testing requirement. Section 3, BCRC (A) The Association, the Union, various other Employer A5oeialers, and various other unions we members of the Building and Construction Resource Center, Luc. (heminafer °BCRC"), a non-profit wrpnmtion that wasformed to provide services in the construction industry, including, but not Imited to, education and Deferral services wnaming alcohol, drug and other substance abuse, which purposes me mom holy defined in the Articles of incvrpomdon and Bylaws Druid BCRC. (f) Feet, Employer under this Agremmenl shell pay to BCRC the amount as specified in Article XXXI of this Agreement per hour worked by each of Its panplo).ecs covered by this Agreement. PBeb Employer is obllgaled to make such wabdbutions, rcgwdless of whether or not such Employer is u an moor of BCRC. ARTICLEXX)C[V APPRENTICPS gecfioa 1, c t Applicants far employment with a signatory consmcMr who bave Power than 4,000 hum of eWdenoe as a Comoveren Craft Laborer (or oltemalively, cannot de eon mte equivalent skills by echleving a sailef@dory'�o""a in a pletxns{n! axemiaalion admieisrered by the Joi al Ap-nticcsblp and TYalaing Comralgce (]OTC), shell, wheaevd pracdtal, color and be .1 fa eaterthe 4pPrenticcahlppmer ononon-0iacrintinatorybmiv la aeeardeoee with the terms of !h0 Appteo6owhip Program. Arry pct9on entering but fliBrrg tie mdotain and complete his or her altpteaticeship, shall not be _Flo" by the Hrnjiloyel ea a ]admeywnrkee udder this Agreement. The Tailuro of any Apprpntita fa maiatein hie ar her eppreotioeship stela+ shall obligate tba Employer to dievhergatuah perwn upon eudice from the Urinal Section 2. The Apprenticeship and Training Stardards approved by the Federal Bu sen of Apprenticeship and TraWiaq or State Appreaticcehip Committee at hereby incorporated herein by reference and made a part ofthis Ag anent, Section 3, The Apprentice wage rates: Hours of cted'st Wage [late 1sn kx1 0-1000 boors '15%nfjaurdeyworker ram 2 period 1041.2000hours ti5°/,ofjottrrxywodcerrate 3Nperiod 2001-3009 horns SOBS oficurneywmker rate 41period M014000he= 9S%ofjoumeywcrkerrate Scetlep 4, TLa requirements for entry into the Apprenticeship progrmv shall be controlled by the IATC, wbk:babail ertsp[py appropriate testittSand scrcmdag procedures. An Appmnt'sea,xinnoas from one hom-Of credit and vmgarnte category to soother only upon delerminedan of setiafaclory perfornma by the JATC, pursuant to requirements specified in the Apprentim4hip Program which shall have the.autiority to grant accelerated credit when warranted by the performance ofm IudividualApprentice. Seellou b. Except- provided in Section 9, the Employer shall participate in !hc Apprenticcabip Pregrml by comidering Appmntices for employment upou mf¢md by the Union. Tile Employer aball have the akle right to Wtct ar any time, emy Apprroutite referred to il, or working for it. The Nrnployce Is nnl obligated to swept Laurie than ant (1) Apprentice for every fiyp (5) Joumeyvrorkers commencing with the sixth Laborer needed by thc Hmployer. This ratio shall be measured on a campaay wide basis, And does not Rqu'sM an Employer tohavea sixth Laborer, 117041y Events needed, as defeam,ned by tbo Rmployer. Section 6, The Employer may not emplay an Appinm6ce anti[ at leas! one (1) Joumeyworker is employed and the&AAct may not employ mom than one (1) AppRntice for every additional three (3) Jmmneyworkera. 29 AGRER1v113NT BY AND BETWEEN INDLANA CONSTRUCTORS, INC.—J.,ABOR RELATIONS DIVISION QC[-LRD) and LOCALUNIONS #120, #204, 0213, 9274, #561. 9645, IfAl, #795, k1112 OF LABORERS' D T,RNATIONAL UNJON OFNORTH AMRR1CA STATE OF MOMA DISTRICT COUNCIL APRIL 1, 2017 Thru MARCH 31, 2W2 29 Sutton 4. Should an Employer fall or refuse to provide the required surety band, when such 6 demanded by the Union, or should an Employ¢ fail to keep a bond in efftd at all times said Employ$ is required to bavo one, the Union shall have the light to *Ike and/or plckei after notica, and use all other legal mdlor oconotn€e means to cause the Employarta comply with this Article. ARTICLE XXXIII NO STILIKE CLAUSE During the term of this Agecari thdo shall be no lockouts by the Employer and no strikes, pldwgn$ work stoppages, slow dolws or other disruptive activity for any reason by the Union or by any Employee. Failure of the Union or Employees to ernes any picket lime at the EmploWs project site is a violation of this Article. The Union shall not enaction, aid or abet, encourage or couthrue any work stoppage, sbgre, picketing or other diiruptivo activity whieh violates thin Article and shall undertake all reasonable means to pprraavveat or W tta'rnlnen, any such activity. No Employee ahati eagpge In activity which viaiates thsa Article, Any Employee who participates in or cocourage, any aedv€ty which violates this Article shah be subject to d€scipEnsryac60% subject to the geievaucapmcedum The Union said its prindpal offices will €mmcd€ately instruct, order and use Its beat efforts to cause its members to Mae any violxt€on of this Artica If the Union initiates, participates ice, err supports a work stoppage, strike, Pickedng or other disruptive activity in vloletion of this Article, the Epmployer may pursue all legal end ndministrative remedies and say damages available thereto related to the Unioes ;oblation ofthis Article. This Article does not apply with regarda.to callecthm of del€nquent fringe benefits. ARTICLE XXXIV APPREI'MCES Section 1. New Applicants for employment with a signatory eoatraetor who have fewer than 4,000 hears of experience as a Constmction Coati Laborer (or sltemafively, earmat demonstrate equivalent 06W by achiavhmg a satisfactory seem in a placecuenl examination administered by the joint Appreat€oesblP and Training Committee (IATC), shall, whenever practical, enter and be allowed 10 enter the Apprealioeeldp program an a non-discriminatory baste in accordance with the terms of the Apprentimabip Program. Any person enlsring, but failing to maintain and complete his or her sppmaliaship, shall rot be employed by the Employer as a Jourmeyworker under Ode Agreement. The MUM of any Apprendee to maintain his m her apprenticeship status shalt obligate the Employer to discharge such person upon notice fmm the Unlam. 32 Employer. If aveitshle, the Union aball refer that individual. Sudan 10, The Union agrees to bold harmless and to indemnify any Employer is any claim olsimg out of the Unlon`s referral rolotpractiecs or the Unioa'a or IATC's administration oftheApprenticeshipProgram. ARTICLE XXXV SUBSTANCE A13USE TESTING Seciou 1, Recognizing thatpmjxt owners, 80vemmmtregulation,e, and other external pressures often asoassitata substance abuse taring, the Paedea mutually agree to huplament the substance abuse progwm("SAT Progranr'l and perform substance abuse testing in accordance with ducSAT program attached horde as ExIaNt A, Secant, 2. Each Employs part' to this coAective bargaining agreement age to Pay the SAT Pmgam $.03ftur 0 cents per hour) for each hour worked by eacb Employee working under this Agreement. The eonhibotlom to the SAT Program will be deposited each month, or at such other regular intervals as rally be determined by the ICI.LRD sA �trtpotma ed our such farms as y be designated b Aso Anc1e contributionsicontributionstd n, aallbe Section 3. Ee& Employer Party to this enllect€vo bargaining agreement agrees that a representative designated by the Association abal€ be pemtitted, upon inquest, to audit the payroll records of the Employer to determine compliance with this Article in the evtat a lawsuit Is commenced to tallest any delimpancies, ad a delinquency is determined due the the Employe agar to be rerpoeustbla fat, Dad to pay, all expenses and costs of collecting such delinquency including aftomey's fees Incurred by the Aasaciadoa in purmlt and u9ccdon of ankh dvIh*e mcy. gulden 4. R Is expressly agreed and understood that to Employee, Employer, or union has any varied or proprietary €ntwed in or right to arty maiden constituting a part Of such Subnance Abuso Testing Program. liecdom 5, no costa of One tests associated with this program will be paid irDm the contributions identified in Sedan 21n nuoi4aacowith da terms of the SAT Program. HXHffif1.A SUBSTANCE ABUSE TESTING PROGRAM L POLICY STATEMB,NT. All signatory Employers to this Agreement and the Union have a commitment to protect people and property, and to provide a safe working rmircamem, no purpose of the following program is to establish and maintahm a drug five, alcohol tiu, safe, healthy work environment for all Of its Employees covered by this Agreement. 34 Section 2. T1w Apprenticeship and Training Sra 14* approved by the Federal Blown of Apptent€oadlip and Twining or State Appmaduship Committee arc hereby taoorporarod ha tin by rafetealoe and made pat of this Agreement. Sacaon3. TheApprenticewagerotes: Hamofcredii WagoRsto 1'rad 0-1000hum 75%ofjoumeyworkuTate nnaett'm 2: pei€ud 1001.2000haora 95%ofJoumeyworkerrate 3iepelod 2001-SWOhours 90%ofJomneyworkerrata 4mperind 30014000 hours 95%ofjoumcywadrerrato Section 4. The requirements for entry into the Apprenticeship progam shall be controlled by the JATC, which absU "Vloy appropriate taeling and eereeming proudmcs. An Apprentice advances form sae houraof credit and wage -rate category to adathtr only upon determination of satisfactory performance by the JATC, pursuant to rognirementa specified in the Apprenticeship Program which shall have the authority to grant sooelerated credit where waranted by the pttfomumceof an indiv€dualApprooRce. Sutton S. Except as provided in Section 9, the Employer sholl participate in the Apprenticeship Program by considering Apprentices for employment upon refmal by the Union, The Employer shall have the sale tight to redba, at Bay time, any Apprentice referred to it, or worldpg far it. 'Ike Employeris rat obhgiated to eccxpt more than om (I) Apprentice far every five (5) i6umeyworkas commencing with the sixth Laboer needed by the Employer. Tide an shall be m6wrsd an a company wide basis, and does we repdte an Employer to have a sixth Laborer, if only five am needed, as determined by the.Employer. Sudan 6. The Employer may not employ an Apprentice until at ]cast one (I) joumeywurkar is employed and thereafter may not employ rams than one (1) Apprentice for every additional three (3) Joumeywoikers. Section 7. An Apprentice should, whenever practical, be rotated by the Employer through dificTent types ofwork so as to became trained in a variety ofaperaflons and walk Wit. where the Employer Is unable to provide an Apptntice with experience in the full range of craft i kilb, the JATC may request the Local Union to reassign the Apprentice to other employment in order to provide that experience. Per so long as the Employer is able to pxpvide the necel ry range of employment experence, the Employer may choose to retain the Apprentice from Job to job. Upon request the Employer will €nfon , the )ATC and Local Union of an Apprentice'sjob reaselglnmanrs on is project. Section 8, An Apprentla shell not be panelized for taking off from work to attend offaile tra€ning (though lime off fartrainhmg iaunpaid). Sudan 9. Notwithstanding the provis€ans of Section 5, the Employs' easy call Of ' Union for an €adividuat by name, provided he or she is not then employed by another 33 COLLECTIVE BARGAINING AGREEMENT SYAND BfjiVM INTERNATIONAL UNION of opERAT1NG F.NGINEFI(S LOCAL 150, AFL-CIo AND TOCIIt COUNTY HIGHWAY CONTRACTORS GROUP EFFECrME MAY 1, 2017 Tmour" APRIL 30, 2022 9 11 Paymrnts asnmpauiedby tnpnthlyrepolison formsprovided fornmeafedue wthe Vewtlan Savingr Plan OBiceAt6L50I D.MRoad,Countryside,Illinois60525,nottoterthanthetentb(tOlh)dayofthefotfatZ month for thepnced#agmonth. "part fomssareavallableattheaboveaddrcas. However,lfpayreehWootte by thetwentletb(2ath) dayofthe month, ishalbe Considered violationofthLiAgremintandshalibelMit for contrlbutiO4s due, ilqufdMd damsgs4Interests and any othercost of collection. - Addidonalinformatlon and Employer code numbers can be obtained WObe Vasetion Savings olflcest 611501ollet Rosd, Umtrydde, IIDaolc60525. ARUCLE X1 SECTIONL APPRU MCESW AND SHILL IMPRpVEhjgNT FUND ATrusteed Apprenticeublp and SMI Improvement Pundhas been created and lsknawn as theopamttng B*gineers Local 150 Apprenticeship Pun& Effective May 7, 2B17,the Employerahall pay one dollar and thirty five cents ($1.35) par hour for each bobs wegeaat* renewed bythe employees covered by this Agreement Into the aferesaldApprenticeship Pesnd Effective May 1, 2018, the Employer shall pay one donor and thirty five cents($1.35) per hour rot each hour wager an received bythe employees covered by th Is Agreement into the aforesaid Apprenticeship Fund llffettiveMay 1,2019 thaEmployer shanpay (TBO) per hour for each how wages arerecewWbythe employees havered by" Agnementwto the aforesaldApprenticeahip Fund. , . Motive May 1,2020,the Employer shall pay (MD) per hour foreach hour wages are reeked bythe employeescovired by this Agreement into the aforesaid Appreutlorship Fund. Effective May 1, 2021, the EmployershAlpay{TBO) perbourforeacb bowwages are received bythe employees covered by this Agreement into the aforesaid Apprenticeship Fund. It Is understood end agreed that the Employer shall -be hound by the terms and prnNslena of the Agreement and BsdaradunOTrustof thoApprmtembip Fund and all amendments heretofore orhereatter made thown, asthougb the samewere fully incorporated harew. The Employerfurtheragrees to bebat nd bythe lertasoftheAppreadmidp Standards establiahed by the)atntApprentioemp TrtW ngCemmKtoo ortheNorthern Olinole end Nortbem ltidLinaAppreeUceshlpand =;mp'rovamantPrograat osapproved bytheUnited States Beparimentoftabar, Bureau ofApprenticeship The Apprenticeship FYmd baboon established and shall be administered taaaordance withthe labor Management Relations Act of 1947; as amended Ind aBether applicable Federal and State Laver. Psyments scoompanled by monthly reports on farms pmvidtd byname are due In the fund offlce at 61% Joliet Road, Countryside, IL, 5052510 later than the 10th day of the following month for the preceding month. depart forms are available at the above address. However, If payment is not in by the 2" day ofthe mohOl,dtshaltbee.,Wderedoviol tionoftheigreement Contributions to thenforesaid Apprenticeship Fund philtnotcoostllute orbedeemedwagtsduetothe employee. , 31 tmnfaanty Htahw+y rmtn(.eb Brsap FnrALt D Febrnuy2a, 2APA ",I nip= rot TOMB Aim Foliates YMR MpelttttCF5 wiltAW rtCaaba Welfare $114 G2 !t UIAO fsI SL7a 5 tli1,75 Mo 4.uflan 1100 01100 see JLeO t1Ao y,FpremiterLlp.16 F..d $t3s Itt-as RNp $325 $350 %RC =Ode fora CULM SDAO ISDAS CAF SDAt la12 wAampoenLAPPRVIINIF7 sn�te gJIf39 5(3/AP J3424 GNOMIC sea St.7! Ir 2.d Yrar SUM $37.70 1Gtterof3ra Ymr J1ae0 $19.2 raaft lterLdYe.r 0M urns 19K.vor4aYev Ism 33et0 2ne NdfdttOYe.r 136,45 sum MEN prior to May jeer the total patluge aball be allocated between wager and binge bane t s as determined by the BNom Coniri butfoustothe Welfare, Panslonand ApprenticesblpFringe UeneEtFundssWnotcmWtute oodles to the employee, - Atthe end of6,000 aa•tbe•Iob training boors, the Appmullce shall became a loumtymOA Hn IWI and shallbe paid pursuant to the wage sale and dasstbatione set forth in this Agreement in no event shall the rate of pay for apprentices exceeding that rate provided for the dessiBcation of ."atha apprentlm may be operating as contained in Article XH alibis Agreement Appron0oce shall be paid the wage raid set forth ran the Apprenticeebip Introduction Slip issued to the Employer and the Apprentice at the time the Apprentice It dispatched to the Employer. She IntroductlonSnp shaEhldlcote the ttatasaftheAppramlea-As the RPPi &`5"Prggres9eslaperiodor step number, he shall be paid Pursuant to the rates set forth in this Agreement: In addition totheaboveprovisions Socrates efpay,the EmployerdhaUpayhiugebeneEtmntrlhutions as provided for In ftAgmement. ARTICLEE11 VMG6 BENEFITS AND WAGg RAIU POR LANE, PORTER, LAPORTEANO ST. jOSEPH COUNTIES FILINN SNIFT113 KLftawauv its 30z fish* 311119 75 Mw a aAas 0 Pepibn HMO Moo ARP 11Aa SL40 Yahtioe5..bss 1Ito ILim Appr/fP d othlprLed fLst i135 al$us 1350 acvc Sane an ctas7p Soda ID-0 , CAF Saw t0.I2 s3 t'enaariors Group Favre.uerylEldowey FINAL 2 DFasra Ftbnwyl8,1017 BfkrtiveMay 1, 2017,tho pwtlesremgnðathldividualsamplayedbymrpmLlimlE nployenwho oreparty to this Agmennentmayperrorm both bergalftwitunit and non•bargahrfng unitwork Certoduafthese employeearecein cempeAs2don In such it mannerthat Itts difficult to deterrnineforpurposeso(frloge benetlt contributions the precise number ofhours which ate span[performing bargawragunit work lttytbarefore agreed thotwhen an employeewtio is employed bya corporation/Empioyer,perforstsboM batgainhrgunitand noahargalning unit work and who: A. 1sarbu baldtr,Officerand/ordirectorofthecorporation/Employer, or R. 3s a 151A argreatevowner of an LLC or the egWvelentthereto, or G Is a relative (father, mother, son, daughter, brother, stater, husband, wire, m•law) of a aharebolder, n!i]ter and/ordl[eeEpr of the carpontlon/gmployer,thebatga0fiagpartits have agreed that any shareholder/relative reporting under dda clause mutt report one hundred thrty-Bve(135)hourspermonthtwehr(12)moi3ftsytorkrtspeWvaaftheam mtorwork they perform or the amount of compensation they receive in any ledlyldual month: Con4lbutiow ere due by the 10th day of the preceding mouth for which the employer Is nparting The Employer my elect to "part on the basis area" hours worked per month provided hours reported are In excess of one hundred thirty -tin (230 hours each momh Hourereported in excessofone hundred tldtty-flve (135) hoursarereportedon the Employer's rcgatar nniittenco reportdue bythe SOth day of the following month. The Employer shall be required to make contribution on ]tehav or such employees for at least a minimum of one hundredthtnir-Live {735) hounpermantn or, atWeemployee'se€eetioR actual houraworlmd In a month Ef greeter than onehundred tWrV Jin (135). Corporate officers, o"holders and their children will be exempt from this provlslon when they operate equipment doing bargahftg unit work during an emergency mch as Lire, flood, or to save life or pnparty. Vie sole flab* of the Employer to the Apprenticeship Fund shall be the payment of hourly contributions asset forthw thrFArtide,provided, hoveaver thatnothing herewsbaUbe wterpreiedto release the Emplvyerfrom Its obilsatiow mderthaAppmmtimbipSRandaMsas set forthabaveaod shallbe liable for cnntvlbutton due, llqutdated damages, interest, and anyuther cost ofoonerUon. SEC110N 2 • WAGES AND FMGE BENEFITS FOR APPRENTICES IN ALL COUNM The following schedule tow forth the rate of pay and conMbutlans for frtngebent fits for apprentices in the period or ate number Ind]rated an the intro ductlansbp: 711140IR (MU FOR FmSFAND SECONUMRAPPRBSTIM 7 1p2Aa HeaheAwetan veadwr 11156 1e.70 I&SAC 46el1.7s a1� 75 40PIlee 1730 ass 31A0 IL40 V.w1,es.,wd1 loan $am =vnu-1dprved This 1335 a115P t345 $3.50 OCRC Im lone SlittlP W fOAG Sa12 Eats tell 32 raorcouary i1�8hvnYWotradrarY flNAL2AL2 DFMM Febed.ry 2A IOI7 WAGIRAiM 511111 UJAII 1/Py19. fiam 1iL= n.RFarem.. HMO P 90 a9J1.7d fu$1.75 reasuo CIARl�weler � %3375 NUl rl a/112 75 /S%R�1dW Gael •,trP�arik�iPon a -4 cos rv. der Avon hart -tr omb A rnry6ata Plmt lesee Aut—a.l Fanaete Parr n •AvbmehdMp •Aommaed FNmA�.r Fo ro nerd, Nmdbe q=bhmd rbmhhue eeo Proot a.aetvr wer,nllrllRahxdEmertb HNOW tp curd. NelWdk oW Plder aft rVolbaema W eaaoe t cord 9lrahe.ha�pnmover, erkla.ti+ao,mb Weil aea.etar[aRj reuttaadur, r,sbdomrr `Finch an,a.r Taus Nou rated Caairruareft., IFPrnpexedl rim rMne [road) INAdaper doer mearlvineer, 27 rods tier coo raa'e.te -ter w VMareaHowned 'c0neh aroMa7helRevntra Ca sows Drer� tSd{P+ngBMJ ForenraueJwale. -cmo ..a—..h.ndgnwt.n (wdmamenbl •adoenlremmedea.d tCnnrlk.ae trG..Err;t.vnaetG aorr,Re4dfeLe� ••aerrtrli eDelt.L wrrnryr r.*a Dr.* •rn°Curb and peaevKid*e 36lpdeslout iheud beet red enr romd sGobed nwteMaams under 3dloaei Fwbe. F.12 u4lear4rTrp ULditecWudbaAnAmammtc taraden.odNeadoee a. tax Future s end R.a a err o cox truce kw m.d LadDrnter uevmFesre HDkt3Drooe SSdcandaru el on e.N4m 3 a a prumllydrtaurPmnr NNts Groan.y Pik DdNv(.ard FaeaM�t 14^ao�eureav 2seN rropeRHl) NFtlmm W.bral4la(SrD-0ropened] Iep W.rydtgrJawdp.vlrgNber 14.d-the ed. NW&Oie.nretdm houboaMardlnr P.—H lknnvoePldo[[Ceotr.tl@type] Faver-Nenler4er lee M[ver,shteer orn paw Ddrer,5tl11 Www.ra5lmWr Type Neaioes 'Rode D,�tlt fwler ae Ndd alg •PnanrIDTmralr.¢nied '•dolt FarAer aa•adewx "11e1 ftd. aetel a Velre rl.oa,m 3e' Th.trk YdYe aATU— ra nrrrr Bmokgpe rnntan.aoe 71rviCe V.ha edPOmunCvmtnaannoa Hosao.Niorlllvierta.per 3c PdvCwntr H�Earr+7 CMtraden Weep FtNALz DPW. rebra.ry 2&, 2at7 9 9 i d June 1, 2016 — L1ay 31, Mo ARTICLES OF AGREEfAeT for GENERAL whim IcTTON OF HEAVY& HIGHWAY PROJECTS Lake and PortorCoun"046Indiana ClIkamet Cfly, IlNnols TYAYSTERS LOCAL jio.142 Ale Afftlabe of the 111+maHonal Brotherhood et raemhrhem (b) Mw the elapm d thfdy (30) days firm the due dent, the Union has given tan (10) days writer Ndlce by wrtftd mall wHh a ropy 10 The Orsnp and arty apprsprsle pore ombnow, of won datinqueay, In which notoe the Union slakes stet the emPvfnr M delinquent and lease b make payment wMi n ten (101 days d necelpt of such rem wH result M a at0re; and (a) There Y rho genuine dispute that there Is odetnquemcy. ARTICLEIII BOND FOR WAGES, FRINGE 8ZKUT11s, HMO AND INDUSTRYFV14o The Unties mayad h dsaede require thoad Eaployaa wtm heals not mahttrinad on adaNkhad 911109 In the )udsdictim d the Teamsters Weal No. 142 for flva (6) years or more, w an Employee who has a pod mood orda0nqu9hhcis9 of payment to procure, pay the premium for. and delher 10 the Union, a bond written by a msponalbb Surety Company. Swh bond 4hat, at the d4wWon or the Ualoq be h a penal sum up to Ono Hundred Thaueand Dollars (6100,000) to kaum proper payments. the Envlo m T9amstans 142'1 wages, trhge bents, SORC, and Mdusby fund In accordance wkh this Aeroament If the Employer falls to pfovlde a band In socadanre with this Article, the Unlam, after giving the Employer ben (10) biainess days written noboe, shell have the dent 1u strike such Employer. Al bolts whet be matte payable toToemsIsrs Local No, 142. ARTICLE 11 HOURLYWAGE RATEa AND J08 CLASSIFICATIONS A, HOURLYWAOE RATES AND JG8 CLA8811FICATION FOR ALL COYERF.D WORK awtbn 1. Ef ouha June J. 2018. end oontlnuMg In full force and effect thr uph flay 31, 20t7 the follow" Hourly Rates of Pay shalt }vavall for the Job Ciuralttatlan listed below, Shalght Time Tana and Double Time Frbhge tforaly Rate One -Flan Rate Senefta Group 1 -2 a 3 Aide TnOm $32" USA4 684.68 624.56 Group 2 - 4 Ado Tnxi s 6324g 60T4 $64.98 $24.68 Grow 3-5 Ada TAX0 $32,119 F19.04 $W.36 $24.66 %oup4-0 Ada Treda $32.89 649.34 6a5178 624.60 Grote 5 • The miss for lima group are Gmup 4 rates plus $0.35 per sade for each a* over six (0J An Sadth-Tragarnarean oddlIonal $0.86 ova We pay. Caoup 6*jIlouleted Dumps IlM.64 $51.01 W.00 624.68 10 (4 Employees Isevkhg the job a4 their accord, axmpt of kopy. shall be paid odiy ter the time. adueffy wvrked, ll.an umplayee voluntarily quts or rwlpns his Job for my reeada, he ones be paid on the r4Qltatpayday. (0) The Employer ahall Pay 6100 In 6quldaled dlnlagea 10 employees who have been Issued ■ bad Check by tla employar, (h) All Pe w wl PmtWW Equipment (PPE) shall be fumWhad by the EmploW, This ahoy bhow,. but not be WT" to, herdhem, safely glasses, era" hioneaaea, safety rootxear ("I* tcs and mel3t8mil), MPNaW, hoe shleids, FRO, "k suite, rubber boors, eft, so doomed neoesa9hy by OSHA, MIST, Emlhloyarorthe Owns. ARMLEt LOAO@K4 AND UNL.QIl01NG Tnx41 Ortmm shah! help Mod and unload their OWNS and preform char dudes. anlww ka them that VM not 44otaIs the recognlred Jursdldhrh o1 arry other Union, ptovidad; hip MW, no Drtren wm to loqulrsd to hands nhemfandae tlohse glees hS01 wdangor his Personal Heath or Safety. Doren M6 be a0crded the Opportunity to hapeol all loads for safety oonsido dtana The Employer may not fake reooume agakhat a ddverwho refuses a lout for talld asoly vW t ra. ARTICLE 9 TNAININOAND APPAENneEmp FUND twiWn 1. Motive Juno 4, 2016 is pwbw 10 this AtrsornaM oulhorttea the Tsanakm Lacs[ No. 142 Trsbdng Mat Fated to became the Tssm W7S Looel No, 142 Tmkhkt, and ApproWneWip Tmel Fuad. The parties spree In reopen this Agreement for the We ptapose of addma*q tm apprentionshtp p"hem as may ba regtked by action arthe Board orTnMaw of t,a Training and AWwrdoe RM6, SattOn 2 On work wvsned by this Agreement the Employer agrees to pay hrtt the Teamsters LZW No. 142 TrolNng and Appw&whip Fund the loWMrkg son mob per hour. payment LW be made on the dales, In the imanner, fort and in owordeoe wlh the nuke sad mgufoibr a as odophd by the Trustees of the hermn moatoned Tratehntj and Apprwfta dp Puns. PERIOD EMPLOYERCONTR[SUPIDN e101116-WY17 $0.40 8/01f11-V31110 $0,40 6N1f76- V31110 60.40 Ssetlan A The Emphay+ar agrees to be bound by the Agreement and Dealrolbn d Treat entsma Into asbbilshkp the Teamatsn Union Lvmt No. 142 Troyang pod Apprenticeship Fund and perwiloottv Empkyen and by any amendments to sold That Agraensm. Section 4. TM Toamatem UNea Last No. 142 Trdnhg and Apprenticeship Fund shall be administered In attendance wth at phuvWont of appicabk lax. Section 6. In the ever an employer Is delinquent in the payment of the amounts due pursuant lit lee Article, the UAW shall, have the right to abtw such employer ony it.. (a) The payment In more than thirty (30) days past dve- 9 COLLECTIVE BARGAINING AGREEMENT FOR ROAD, BRIDGES AND AURPORTS BETWEEN OPERATIVE PLASTERERS AND CEMENT MASONS LOCAL 469Z Areas #165, #406, & 4438 and ROAD, BRIDGES, AND AIRPORT CONTRACTORS Jnnc 1, 2018 tfhroligih May 31, 2023 Arco 165 - Tim Hudson 219-713-4905 thudron®plcmtocn1692.arg Arcs 406 - Mmtl Rhosdn 219-771.0766 opem1h42S6@yahue.som Ares 438 - Tom Graham 219-363-5039 oprmia0li@A040. 1 N 8.7 App c.iiii -sf 1p. (a) The Employers ugree to make the contribution rate for the Apprenticeship ]'ands shall be tho amount sal forth in Section 8,1 above, for each hour worked by an Employee, (b) It is 6grted that there shall Lre "al1ished a Jnim Apprenticeship Twining Ce—hee comprised area esiuei number of Employee and Employer representatives, This CommiOee shelf bo ran in compliance with All applicable laws, and the Apprenticeship Twining Program shall he administered in accordance with the provisions of Ilia National Labor Rdaliam, Act, as untended, and also in accordance with the provision of the vast agreement, which established the Apprcntic"Hp1mining Fund. (e) Apprentire Ratio. For every two (2) )ournayman, trere may be one eppmntica ud2lwd when available. The Joint Apprenticeship & Twining Comniuee shall roll.€t and indenture a sufficient number of apprentices to meet the demands upon the program. (it) Apprenticeship Wuges Is( Period: DID 800Hrs-60%ofJoumeyman Rat, 2nd period: 801 to )600 HIS- 7045.fJoumeynrnn stale 3rd period: 1601 to 2406 His - 75%- of Journeyinan Rate 41h Period: 2401 to 3200 Ifrs - EMK ofJounioyrnan Role 5111 Period: 3201 (a 4600 Firs - 85 % of Joilmoymun Rate 611, Period: 40DI l0 5600 or; - 95% of Joumeyman Role 9.8 Con ialbnffons to SCILC (A) Various Employers under this Agreement and the Union me members of Building and Coashoulfon Resource Center, too. CTCRC"), a not -profit corporation that µas formed to piovide services in the construction industry, including, but mat limited to, education and ref rnl services coneertimg alcohol, drug, and other substance nbusc, which purposes are mom Polly defined in the Articles of Incorpomlion and By -Laws of sald BCRC. (h) F$idi Employer Rider Lhis Agreement Shull pay to BCRC in ncoorlaase with Section 8.9(a) below for o&ch hoot worked by e.elt of its Employees. Said payments sbiAil be made monthly in the manner and At avch limes as are atablislicd by the BCRC. Each Employer is obligated to make sac], contributions, regardless of ahe4ici or not such Employer IS &member of BCRC. (r) Payments required to be made to BCILC shall be dremed to be governed by the provisions of this AgNemam perlOmug In the cuilectiall of other payntcuts required I. be made by Employer. 8.9 Employee B&nnfit Rates. The Employee benofil rates set Toth in Section 8.1(a) above for each hour worked for Health & Wclfane, Pension, Savhigs, Apprealicestip, Dues Chock -Off, BCRC, aed CAF shall be combined into one check mad. payable to tiro Indiana State Council of Plmlerem & Cement Mesons H&W and Pension Fund and mailed (o P.O. Be. $0110, Ali eT) )cite A Wages Local 692 - AI•eas 165, 406, & 438 ROAD, BRIDGES, AND AIRPORT Pages 22, 23, alai 24 OPCAUA LOCAL 602 . ARrA 166 ROAD, $1fIDGE, & AIRPORT Agreement Agpeeeut Expiration Date May 31, 2023 ..„� i i OPCMIA LOCAL 692 a Altk A 4t6 ROAD IIIiIDG$. &AIRPORT Agreement Fxpiration Date stay 31. 2023 f. a!„ RATES EVPECI'lVE ON DATE SHOWN & PAID MR HOUR VlORItF.D RATE5 spPECrIVJ3 ON bATB SHOWN P<PAID PER HOUR 1'fDlnfl?D r I , r L , UAY -1 2019 $1�s�F�4'�'LY)�sLUSiF 1 7._4]_S_7_If.HOUC;F3T� _y _ RAVE &PIPLCT]\r]J J(1NF 1 2016 THRClJGH MAY Sl, 2019 Journeyman Comonl Masons ROAD Rale WC9 Journeyman Cement Masons ROAD Rate $33.90 Foreman ($3 above Journeyman) $3&09 Foreman above Journeyman)$$2. 9 Health & Welfare Fund $8�93 Health 8 Welfare Fund $9.686fl Pension Fund $9,07 Pension Fund $9.51 Apprenliceshlp Fund $0,70 Appienticeshlp Fund 10.70 Industry Fund $0,15 industry Fund $0.16 B.C.R,C. $0.10 B.C.R.C. gc.io TOTAL Package Cement Mason (Rb) $54.04 TOTAL Package Cement Masan (RD) $54.04 Savings Fund (DEDUCT) $&75 Savings Fund (DEDUCT) $4.25 Market Recovery (DEDUCT) $0,25 Market Recovery (DEDUCT) $0.25 Walk Dues (DEDUCT) $2,97 Work Due. (DEDUCT) lntemallDPai Dues (DEDUCT) $2.07 $0.54 International Dues (DEDUCT) $0,64 Fftectiye agog 1 019 there will be a One Dollar and Fifty Cent ($1.50) Increase. Seventy Cents ($0.70} to Banafis, Ten Cents ($0.10) to Apprenticeship Fund, and Seventy Cents ($0.70) to be disbursed as voted by the membership. t1 a Lr 1„„2pz0 there will be a One Dollar and Filly CeM ($1.50) increase. Seventy Cents ($0.70) to Benefile, Ten Cents ($0.10) to Apprenticeship Fund, and Seventy Cents ($0.70) to be disbursed as voted by the membership. ELfOc iva J ne J. 202t there will be s One Dollar and Filly Cent ($1.50) increase. Ten Cents ($D.hO) to AppleMceshlp Fund, and One Dollar and Forty Cents ($1,40} to be disbursed as voted by the membership. Effective JurJg,1 2022 there will be a One Dollar and Fifty Cent ($1.50) Increase 10 be disbursed as voted by the membership. ¢dONTHLY REPORTING: Comblae Health & We'fore, Apprenticeship, Industry, DCRC, and Duns monks in ONE clfECk Payable to ISC P&CM H&W FUND and msfl w.m reporting forms to Vii.arSCOPE g PO Boy 50440. ln63eapor5, Indians 46260. Art PENSION Hours& Morey should be made payable to Cement t,Sasons iSS Poaslon Hemmoud&Vkinity for all hours vrorked In Area 105 for o9 Cement Masons and mailed to Stewart C MiIRr C. C4 2111 W L'ncoln Hh y, 1.1—ifyim. Indian. 40450. TERRITORIAL JURISDICTION: The territory of area covered by this Agreement shall Include "Lake County except by the Northeastern Section lying north of Crown Point and east of G611161, and all of Navdon County"and shall be referred to as "Hammond, Indiana and Vicinity', 75ar fludsort - IJrietnesa Agen t tkuda0n�pfcra iacaf 698.org J-1 fi92 • Arnn 1fi5 D2D0Larueieun Sweet Alerrilli'i1le, lndieuu 9G410 (219) 713-41105 Phone plcmloca1G92.org Flfedivn ,hrne i. 2019 there will boa one Dollar and Fifty Cent ($1.601 increase. Seventy Coals ($0.7D) to Benefits. Ten Cents ($0,1D) to Apprenticeship Fund, and Seventy Cent, ($0.76) to he disbursed es voted by the mandsi shiia {jgy}jyp, IsTpn.,�. 2Q29 them wid be a ()me Dollar and Fifty Cent ($1.50} increase. Sov.ruy Cenle (50.7D) to Benefits, Ten Cents ($0.10) to Apprentleeship Fund, and Seventy Cenla ($0.70) to be disbursed as voted by the mambemhlp. E11n_ctvn Irrnn 1theta will ha a Or. Dollar and Filly Cent (Stan} Increase, Ten Con€s ($0s0) to Apprenticesip . 9n21 Fund, and One Dollar and Forty Cents (SIAS) to be disbursed as voted by Via membership. EOedtr_ WArl 1_4 them will he a One Dollar and Fifty Cam ($1,$0} increase to be disbumed as voted by tho membership. RONiHLY ftEAORTING: Combne ALL RONIES (H&W(PENStAPRrHAUDrariRCIUUES) En ONE CBECL(PAyubb b ISC P&CIA H&WFUND and ma7ln r&IKa1 t&Ilns ib H6p4"COPE a"tillsQ POaax60446. Indianapolis, lodia,m 46260. TERRITORIAL JURISDICTION: Boundaries of Area 406 shall be hounded on the North by Loke MICH!gan. The boundary to the Vast she' be Route No. 49 induding the city limits of Chesterton and Valparaiso Indiana. Procending so=id on Roule No, 49 to the Jasper, Benton, and White County lines, Including the city unites or Wheeler Id, Rensseiset and Remington, Indiana. To the wrest ilea boundary shall be the Nerdon and Pader County tlne including the city limits of DeMolte end Hebron, but not the city omits of Kouls, Indiana. Northward an take County Line in and Including lira dry limes of Martinville, Profane, "bul not" the city limns of Cmvm Point, Indiana. Northward to Rurta 30 and [hen Weshewd! to C€ins Ave to Route 30 and then Westward to Cline Avenue "but ant'the oily Ilmtls of Griffith, Indiana. Northward on Cline Avenue (enslside) to Lake Michigan, Afaff Rhondca-Business Agent opr mfa4260a, iorioo.cam 1.an1 Gat- Ara 406 e 92001...nh aSricrt rlerri9sille. rndlae9 dG416 (Bra) 771.67aa Phone ptemloenlGGI—a OPCMM LOCAL 692 e AREA A98 ROAD, BRIDGD, &AISPDRT g ` ? Agreemont Expiration Date May 31., 2029 RATES £6'BECTIVE ON DATE SHOWN & PAIN PER HOUR P70aRGu RATES rFt:I cilsr) uNr _. y�t8._Tjj ou NA1A .1 9 Journeyman Cement Masons ROAD Rate $32.19 Foreman ($3 above Journeyman) $35.19 Health & Welfare Fund $9.60 Pension Fund $11.D0 Apprenticeship Fund $0.70 Industry Fund $0.16 B.C,R.C. $0.10 TOTAL Package Cemanf Mesa" (RD) $53.73 Savings Fund (DEDUCT) ti Market Recovery (DEDUCT) $0.26 Wolk Dues (DEDUCT) $2.96 €ntematlonal Dues (DEDUCT) $0.54 lLecfive June3 1�2018 there will be a One Dollar and Fifty Cent ($1.50) increase. Seventy Cents ($0.70) to Benefits, Ten Cents ($D,;o) In Apprenticeship Fund. and Seventy Canis ($0.7i1} to be disbursed as voted by the marnbarshlp, fktcfiva June. i. 2020 there will be a one Defier and Fifty Cent ($1.50) increase. Seventy Cents ($0.70) to Benefits, Ten Cents ($0.10) to Apprenticeship Fund, and Seventy Cents ($0.70) to be disbursed as voted by the membership. E'!lertiyw Jerre 1. 2027 there will be a One Dollar end Fifty Cent ($1.50) Increase. Ten Cents ($0.10) to Apprenticeship Fund, end One Dollar and Forty Cents ($1.40) to be disbursed as voted by the rnembarehip, Eftaclit Juno 1. 2022 there will be a One Dollar and Fifty Cent )$1.60) Increase to be disbursed as voted by the membership. MONTHLY REPORTING: Comt:ne ALL MONIES (HBW1PENSIAPRNT1sCRCf)uES) dt ONE CHECK Pa"a to ISC PSCIA H&W FUND and mall Win mPDrfrg roams to Hea11h5COPE ©matte @j FO Box 50440, Ind14nep0s, Ind7ana40250. TERRITORIAL JURISDICTION: The judadiclion of Local Union #602 -Area #430 in ire State of India" is LaPorte and Starke Coun$es, the Northern two-thirds of Pulaski County; the Eastern pertion of Porter County, Including €(outs in cite South; and €Ito Northeastern portion of Jasper County, West to, but not Including the city of Whealfeld. 7 om Graham - Business Agent apctrrfa43A@ao1 coal 1-11,11 • Are¢ M 15365VeFker Avenue iW'nslo, Indians 46350 (211) SOB 0100 Ph r. ru—j ca1692.org March 1, 2018 SUBSTANCE ABUSE PROGRAM I. POLICY STATEMENT Walsh & Kelly, Inc. recognizes Ute importance of assuring properadministrative and operational decisions and actions in the asplish paving industry. We recognize the need to even those individuals who might endanger themselves through Ilia abuse of alcohol or controlled substances (drugs). In order to mitigate the risks, which result front, being under the influence of alcohol or drugs, the management of Walsh & Kelly, Inc. will enforce tmiform testing for determination of ability to work and disciplinary action as described in the following policy documenla€ion. Furthermore, Walsh & Kelly, Inc. does not allow, condone Ute consumption, or use of illegal controlled substances (drugs) during working hours or on company property. Any possession, consumption, or sale of contra€led substances on company property or worksdcs of Walsh & Kelly, Inc. is forbidden and "ill result in immediate termination. The consumption of alcohol is likewise prohibited, with the exception of social events sanctioned by senior management of Walsh & Kelly, Inc. where and when manufacturing stork is not taking place. Any consumption of alcohol on company property is strictly forbidden and will result in ternination. Management of Walsh & Kelly, Inc. also reserves the right to search all company properly, including, but not limited to, employee desks and lockers, company cars, tool boxes, elc. to prevent violations of this policy or for any other legitimate reasons. Entry onto company properly orjob site$ constitutes consent Wand recognition of Use right of Walsh & Kelly, Inc. company management to search the person, vehi(le, and other personal property orindividuals whi€o on company's pmporly. Such searches may be initiated by Walsh & Kelly, Inc. management without prior announcement and will he conducted at such limes and locations as deemed appropriate- Persons who refuse to cooperate with a search will not be allowed to remain on company property and will be subject to tetnunation_ In order to consistently meet thestandmds of the Walsh and Kelly Substance Abuse Program and the requirements of the Indiana Department of Transportation (DOT) requirements, Walsh and Kelly, Inc. will use the Building & Construction Resource Center, Inc. (BCRC) and the Indiana Construction Association's (ICA) Substance Abuse Programs found in Appendixes 1, 2, and 3 of this document. The Walsh & Kelly, Inc. Substance Abuse Program applies to all Walsh & Kelly, Inc. employees, including employees under collective bargaining agreements. III, QT„HER TESTING REQUIREMENTS Post Accident Tc5lina— As pan of Walsh & Kelly, Inc. accident investigation program, employees who require medial allenllon as the result of any injury or illness occurring Pursuant to the federal Drug -Free Workplace Act of 1988, employees are required to notify the company of any conviction for criminal drug violations that may affect their abilky. w work legally. Abiding by these regulations and Walsh & Kelly, Inc. Substance Abuse Program is a condition of continued employment. Violation of this program will subject the employee to termination. while on duty, Hill receive a drug and alcohol screen as soon as medically reasonable and possible during the first visit to the clinic for medical treatment, Thefacililymannger, corporate management, or the corporate safely Manager may, as a result of an accident, a near -miss accident, or unsafe incident, require involved employee$ to be tested. Such tests shall be conducted in accordance with the Reasonable Cause procedures ss described in B above. - Pursuant to the U.S. DOT regulations, any CDL driver involved in an accident resulting in a fatality, bodily injury, one or more vehicles which most he towed, or a moving tragic violation resulting from the accident, most W alcohol and drug tested within two (2) hours. All deviations from the$e requirements must he reported to the Walsh & Kelly, Griffith office at 1-219-924-5900 within twenty four (24) hours. Pre•A(cess Testing — In some cases, cuilomer contracts require that the Company perform drug screens an company employees prior to gaining access to the customer's work site- The company will perform such pre -access drug screens on all employees who will be working at the customer's site as appropriate. IV. CHANGES OR MODIFICATIONS Walsh & Kelly, Inc. reserves the right to change the provisions of this policy, including the uniform testing procedure and disciplinary action at any future time. V, SUBSTANCE ABUSE PROGRAM COORDINATORS The coordinator for Walsh & Kelly, Inc.' Substance Abuse Program shall be Heritage Group Safely (HGS). HGS shall review the program periodically and serve as the recipient of the test results from the Medical Review Officer (MRO) for testing done in accordance with the DOT regulations or from The (lint¢ for non -DOT testing_ The Medical Review Officer is the medical director or designate of the company - designated program conducting the substance abuse testing. 'Ilia MRO receives results from the NIDA - certified testing laboratory and/or Breath Alcohol Technician on substance abuse test results, determines Una basis for "positives", and communicates the results to the company. VI. EMPLOYEE INFORMATION AND TRAINING Employee infornnation and training sessions shall be conducted periodically. This training Hill provide informa€ion on program benefits, testing procedures and requirements, as well as answer any questions or concerns employees may hare about the program Training for supervisory personnel in recognition of die signs of alcohol and/or substance abuse and reasonable suspicion shall be provided. Polen€ial new employees shall be informed of the program and procedures prior to the pre -employment testing. Any questions nest be directed to the coordinator prior la the initial testing of the potential employee. Vff. CONVICI'IONSFOR DRUG VIOLATIONS SUBSTANCE ABUSE PROGRAM APPENDIX I PARTICIPATING UNION CRAFTS Z/ T TIRICICLA)'ERS _�&94A) e CARPENTERS RMILDING & GONSYMMION a IBEW RESOURCE CENTER, IN�C. e IRONTNVORKE RS a LABORERS * MILLWRIGHTS DRUG & ALCOHOL a OPERATING ENGINEERS * PAINTERS POLICY a PIPEFITTERS NORTHWEST INDIANA e PLUMBERS * ROOFERS e SHEETMETAL WORKERS a TEAMSTERS Promoting the Safety * TECHNICAL ENGINEERS and a PLASTERERS AND CEMENT MASONS Well -Being of Employees in the workplace e GLAZIERS *11ILS policy has beers appm, W by v 010 Nortimest Indimin Business Roundiable 5 6 INDEX lntmcluetlon PACE I's The Policy 116 Definition$ 118 Drugl'Ming 113 drug Group 124 Building & Construction Resource Centel-, Inc. Alcohol Testing Payment fat, Testing 124 125 Initial Testing (Pj-e-Employnienl) 125 6050 Southport Road, Suite B Rnmdonm Testing 126 Probable Cnilse Testing IV Portage, Indiana 46368 Post-AccidenVincident Testing 127 "Emergency" Work Assignment 128 Telephone: (219) 764-9500 Card Syslem 130 Sinters ("onfirinalio" 130 Toll Free: (877) 988-5400 insuffivient Specimen 131 Whited Specimen 131 Fax: (219) 764-9505 andlor Ont-41t-Temperature Range Spechnell 131 Consequences far a 11wifive 7es7 132 Websitc: BCRCNct.com Return-lo-Didy Testing 133 2017ollow-up Testing 133 Robert Anadell 21 Dispinled Posilin`(, Results 134 E,rovi(five Dirreffir Alpeed, and Prot-tim., 135 Letters of Notice for lAmdoon Testing four Employee Assistance Program (HAP): Alwhinent A — Gerwrof nodes 136 PFRSPECTIVES (800) 456-6327 AnAdiflA010 R Non-Barignining 137 Policy Revision Jimmy 1, 2013 AblAdlinent C —Pipe Filters US R CRC Aulhoriuii.n to,, Coiis,.4 to Drng and Alcohol Anolysis and 139 AulbinWtio. For Iftrivasc of Results Drag less Informadom undhistrudiam8beet 140 7 8 I BUILDING AND CONSTRUCTION RESOURCE CENTER, INC. INTRODUCTION The labor and management representatives orne Building and Construction Industry for Northwest Indiana have farmed an allimcelo address the problems caused by drug and alcohol abuse. Management and labor have created the Building and Construction Resource Center (hereafter "BCRC") an independent not -for -profit corporation which offers anide rangeaf services to its employees in the unionized construction industry, which include employers, labor union organi Anions, construction industry and related workers. 11 is BCRC's goal to assist employers to establish and mainla€n workplaces that are free of the destructive effects caused when employees use drugs and/or abuse alcohol. BCRC's activities are not inlendedto interfere nilhnormal practices of the unions ormanagement. BCRC recognizes its responsibility to communicale pith and educate its employees relative to this policy, as well as the harmful effects of drugs and alcohol in our society and in the nnrkplace. BCRC also recognizes the need to provide a program of assistance to those persons for wino drugs or alcohol may be causing problems. Finally, rrillic nol wishing to violate the rights orimade Ore privacy of any employee, BCRC's drug testing program will seek to identify those employees nho are toable or tmnilling to conform to BCRCS program. 'Ibis program has been cstablishedin accordonce nim federal guidelines for specimen collection, laboratory analysis and rcrierv, and standards of integmy and conftdenOalily- theirsubsiatce abuse or idoehol-related problem and choosing as appropdate course o€ireatmorl. Current employees will be referred to an EAP representative as a result of a positive drug test or alcohol or upon an individual's own mqucsi. In dthcr case, t€le content of the dismWoo with the EAP will be protected and core ideatial, to the extent allowed by law. A participant's use of the EAP is confidential and information will not be released to BCRC ormy of its subscribing organizations orparticipanls nithout wrillen release front the participant in accordance %idt the law. Employees nho use the EAP as a consequence of a positive drug or alcohol test hill be subject to the conditions established in the drug -testing portion of this policy. The EAP slatfhas kmoniedge of the level and types of benefits available to BCRC employees. Employees can access the services of the EAP through a hotline that is staffed twenty-four (24) hours a day, seven(?) days a week, throughout the entire year. Employees calling the EAP hotline are put in touch wvith acounselor wiro will conduct a professional assessment and who may meet pith them to €unher assess the nature of Vie problem in order la provide a referral to the best and most appropriate level of care. The EAP is staffed by cerlifted and credenlioled human services professionals who are sensitive to Vie needs of the individual. individuals nine take the initialise to comactihe EAP for assistance do so pith the assurance that their calls will be treated respectfully and confsdeoWly, no direct services provided by the EAP arc sponsored by BCRC. In compliance %%ith Public Inry 100-690 (line Drug -Free Workplace Act), nhich applies only to employers whmhave federal grants or federal contracts of more dram S100,(00, an employee wino is convicted of a workplace drug or alcohol violation and nbo is employed by a BCRC of iliattd employer must report this information to hisdrer immediate supervisor no later than fire (5) days after such conviction. The supervisor must repot this information immediately to the employer's program Administrator. 11 THE POI,IC!' Persons nho use illegal drugs or abuse alcohol or other controlled substances, on or off theirjobs, are likely to be less productive, to be less reliable, to be nwrefrequently absent, and to have other work related problems Oral can causeincremed cost, delays, accidents, and injuries. Tbese employees can also damage the heallh, safety and null -being of other workers on Ihejob. The unionized construction industry can control and reduce this problem dnrough recognition of the problem, development of a comprehensive policy and program of education and information, promotion of an assistance program, and implementation of fair and respectful drug testing that conforms to federal guidelines for specimen collection and analysis All of thus is to bo done pith the ulmostconfndenniality and respect for thoindiridual. In order to enhance substance abuse awareness among all employees, educational seminars and [mining programs still N offered- The educational seminars nill be directed toward education about the seriousness of the nationwide problem of drug and alcohol abuse, and haw One use of drugs and alcohol negatively impacts safety, produdiwity, and the competitive abilityef the American workforce. St"nisors will be trained to identify employcesin potentially diRicull situations, and to recognize signs of inipaimnent, as well as the supervisors' responsibilitylo document, inimen , and follow up %ilh the troubled individual. These sessions will be offered as ongoing training programs. BCRC encourages all employees troubled by their own, a family member's drug, of alcohol abuse to seek professional care and treatment. Early recognition and treatment of alcohol and drag abuse provides die greatest opportunity Far successful recovey. BCRC provides an Employee Assistance Program (EAP) for all employees and their families who need professional guidance in assessing 14) DEFINITIONS • Adulterated s semen means a specimen that contains a substance that is not expected to he present in human urine, or contains a substance expected to be present but is at a concentration so high that it is not consistent nilh human urine. • Air blank means, in evidential bread[ jesting devices (EBTs) using gas chromatography technology, a reading of One device's internal standard, In all other EBTs, a reading of ambient air containing no alcohol. • t aha! means the intoxicating agent in beverage alcohol, ethyl alcohol, or other low molecular weigh alcohols including ntethy€ and isopropyl alcohol. Alcohol concentration (or content} means the alcohol in a volume of breath expressed in teats of grams of alcohol per 210liters of breath as indicated by on evidential breath lest under this policy (BrAQ • Alcohol confirmation test means a sobsequcn€ lest using an EBT, following a screening test pith a result of 0.04 or greater, which provides quantitative data about the alcohol concentration, • Alcohol Screen it Device ASD means a breath device, other than an EBT, that is approved by the Natiuntd Highnny Traffic Safety Administration (NHTSA) and placed on a conforming products list (CP4) Far such devices. • Alcohol screening test means an analytic procedure to determine whether an employee may have a prohibited concentration of alcohol in a breath specimen. • Alcohol Jesting site means a place selected by the employer where employees present themselves for the purpose of providing breath form alcohol lest. • Alcohol use means the drinking or swal€omving of any beverage, liquid minture or preparation (including any medication), containing alcohol. • Apnlleant means a person, independent contractor, or employer, or person marking for an independent contractor, or employer who applies to became an employeeof a BCRC contmctorl employer participant, and includes a person nho has received ajob offer mode contingent on the person passing a drug lest. Association means Building mid Construction Resource Center, which is the association formed by labor and management representatives of the building and construction industry for Northwest Indiana, for the purpose of addressing problems of drugs and alcohol in the workplace. • Blind specimen or blind performance test specimen means a specimen submitted to a laboratory for quality control testing purposes, %ith a fictitious €dentiftec, so that the laboratory cannot distinguish it from an employee specimen. • Hivath Alcohol Technlcian_(BATI is a person who instructs and assists employees in the alcohol testing process and operates an Evidential Breath Testing device (EBT). 12 Canceled test means a drug or alcohol test that has a problem identified that carmat be or has not been corrected. A canceled test is neither a positive nor a negative test, An employer is not permitted to take adverse job action based on a canceled test. • Card Matinee r is the individual designated by each employer who hats [lie authority to access data information that Will confirm the status of employees through the call -in syaleny through the HCRC scanner by sMping employees' idenlificalian cards, or by electronic a -mail. • Chain of custadv means due procedure used to document the handling of the specimen from the lime The employee gives the specimen to the collector until the specimen is destroyed. • Collection container means a container into which [he employee urinates to provide the specimen for n drug test. • Collec&an site aeons a place designated by BCRC where individuals present themselves far the purpose of providing a specimen to be analyzed for the presence of controlled substances, or for purposes of providing breath sample to be analyzed far alcohol concentration. • Collector means a person who instructs and assists employees at a collection site, ,situ receives and makes an initial inspecsion of We specimen provided by those employees, and who initiates and eompleles necessmr• forms. • Company means an employer who is a member of Building and Construction Resource Center. • Confirmation (or confintrntaryl datelest means a second (2) analytical procedure Performed on a urine specimen to identify and quantify the presence of a specific drug or drug metabolite, • Confirmation (or eunfirrmikuyl validity lest means a second tell performed on a mine specimen to further support a validity test result • Confinmed drug lest means a confirmation lest result received by an MRO from a laboratory. • Confirmatory lest a) For alcohol testing, a confirmatory lest is a second lest following a screening test with a result of (m.02 or greater, conducted 15-30 minutes later, dial provides quantitative data ofalcohol concentration. This test is conducted on an ERT. b) For controlled substances testing, a confirmatory test is a second anahyticid procedure to idenli€yy the presence of a specific drug or nielabolile. This confirmatory lest Is independent of the initial test and uses a different technique and chenticai principle from that of the screwing lest in order to ensure reliability and accuracy. • Contractor onrticipunt means m employer w]iD is a contributing member of Building and Construction Resource Center • Controlled Substance means marijuana (THC), cocaine, opiates, phencyclidine (PCP), amphetamines (including methamphelantines), barbiturates, lemodimepine, 13 • Invalid drug test means die result of a drug test for a urine specimen dial contains an unidentified adullerml or an unidcnlifed interfering substance, has abnormal physical chaacterislics, or has an endogenous substance at an abnormal concentration that prevents the laboratory front compicting or obltdning a valid drug lest result. • Labornlai means a U.S. laboratory certified by DHHS under the National Laboratory Certification Program as meeting true minimum slandads of Subpar) C of the DHHS Mandatory Guidelines for Federal Workplace Dog Testing Programs. • Licensed medical nractttoner means a person who is licensed, certified, and/or registered, in accordance with applicable Federal, Slate, local, or foreign laws and regulations, to prescribe controlled substances and other drugs. • Atedleal Review Officer means a licensed physician responsible for receiving laboratory resulls gcneraled by BC]tC's drug hating program who has knowledge of substance abuse disorders and who has appropriate medical tanning to interpret and evaluate an individual's confinued positive lest result together With his/her medical history and any other relevant biomedical information. • Positive Test (alcohols occurs When an employee's confimtalory test result rcads 0.04 % BrAC or higher. • Positive Test dnr occurs when an employee's confmpnatory test or retest result is at or above cutoff levels specified by DHHS and has been verified by the MRO to be a positive lest. • Program Administrator means the individual who has administrative responsibilities for overseeing the drug and alcohol-lesting program for an employer. The Program Administrator may servo as an employer's DER. Properly means all employer -owned and/or -leased property, including but not limited to owned mid/or leased buildings and other real estate, parking lots and vehicles located on parking lots, and employer -owned and/or -leased vehicles, lockers, tools, equipment and desks. • Random selection means a scientifically valid method for selection of employees 10 be tested that result in an equal probability ilia[ any employee from a group of employees subject to the selection mechanism will be selected, and does not give an employer the discretion to waive the selection of any employee under the mechanism, Thus, an employee may not be selected more than twice (2) during a year. • Refuse to submit (to nn alcohol m• controlled substances tests means dial an employee: i> Fails(ed) to appear for any, lest (except a pre -employment test) within a reasonable time, as determined by the policy, after being directed to do so by ilia policy; i Fails(ed) to remain at the testing site mail the testing process is complete: S rattled) to provide a urine specimen for rosy drug test required by this 15 propoxyphene, methadone and ecstasy. • OHi1S means the Departmem of Health and Human Services or any designiee of the Secrelan,, Departmenl of f-€eallh and Human Son -ices. • DHIIS-annroyed laboialory means a laboratory dial is cenilied by die U.S_ Department of Health and Human Services, Drug tests under this progmnt will be performed by a DHHS certified laboratory. • Desieuated Employer Representative IDER4 means the Human Rcsource Manager, Card Nimager, Program Administrator or sindlar designee efeach employer who site)] receivo necessary communications related to this progmat • Dilute specimen means a specimen Willi crealinine and specific grai it), values diet are loner than expected for human urine, + DOT means U.S. Department of Transporlation Many of DOTS standards and procedures related to drug and alcohol testing are mirrored in BCRC's drug and alcohol policy. • Draw mean The substances forwhich tests we required under this policy and include marijuma (THC), cocaine. Nnphelamines (including m¢Ihamphelamines}, phencyclidine (PCP), opiates, bwbilumica, benzodiazepine, pmpoxypheae, methadone and ecslaoy. • Drug test means a lest conducted for controlled substances, • Employee means m enmplo),ee of a company, or of a conlraclorlemployer participant who is a member of Building and Construction Resource Center. • Emolovec Assistance Program (EAP) Counselor means a masters -]ere) professional with an education in psychology, social work, counseling, etc with knowledge of and clinical experience in diagnosis and treatment of alcohol aid controlled substance related disorders. The EAP will assess and make recommendations concerning education, treatment, follow-up testing and aftercare, • Emaloveimeans a company, or a conlraclorlemploycr pwticiptust, who is a member of Building and Construction Resource Center. • Evidential Breath Testing Device (EBT) means a device approved by NHTSA for tie evidential testing of breath at lW alcohol concentrations, placed on NHTSA's Conforming Products List (CPL) for "Evidential Breath Measurement Devices" and identified on the CPL as confomvog nitro the model specifications available front NHTSA•s Traffic Safety Program. • Fiat Occurrence Clouse mevms Wen employee does not report fora random lest, and it is the fursl lime the employee has failed to report, die Third Party Administrator (TPA) may allow due employee 10 take the test without reporting to die EAP for further review. Employees may utilize this clause only one time • Initial lest (for drugs) means an immunoassay screen to eliminate negative urine specimens front further consideration. Initial validity lest means the firsl lest used to determine ifa. specimen is adulterated, diluted, orsubsliluted. policy; In the case of a directly observed ormonilored collection in a drug lest, fails to permit the obsenalion or monitoring of the employees provision of a specimen; r Fails(ed) to provide n sufficient notount of urine when directed, and it has been determined, through a required medical evaluation, Ihm there was no acceptable medical explanation for the failure; > Fails(ed) or declines to lake a second lest lho employer or collector has directed the employee to lake; > Fails(ed) to undergo a medical examination or evaluation, as directed by the NIRO as part of fhe verification process, or as directed by the policy. In the case o€a pre -employment drug test, the employee is deemed to have refused to lest on this basis only if the pre- employment lest is conducted following a contingent offer of emp€oymenl; v Fails(ed) to cooperate nth any part of the testing process (e.g., reRue to amply pockets when so directed by the collector, behaves in a COnfroalAlionpi was'that disrupts tie cod"Otri process, provides incorrect or mar"oue information to hue collection site or on necoSag• farms, or fails to complete all documents); > Provides a second (2) specimen that is dilute • Srn•ecnin rink' 1 es me ns• • In drug testing, a tell to eliminate "negative" urine specimens frons further analysis or to identify a specimen that regaires additional testing for lime presence ofdmgs. • In alcohol testing, an analytical procedure la determine whether an employee may have a prohibited concentration of alcohol in a breath specimen • Sereenine Test Technician ISTT) means a petson who instructs and assists employees in the alcohol testing process and operates an Alwhol Screening Device (ASD)_ • ShIpIllng Container means a container that is used for transporting and protecting urine specimen battles and associated documents from the collection site to the laboratory • Specimen means a sample ofurine, used far analysis m&or diagnosis, For the 15 purpose of this policy; specimen is defined m urine. • Specimen bottle means the bottle that, after being sealed and labeled according to the procedures in this policy, is used to hold the urine specimen during transportation to the laboratory. • Split specimen memsapan oftheurinespecimen that issent toafirst laboratory and retained unopened, and which is hampooed to a second laboratory in the event that the employee requests that it be tested following a verified positive lest critic, primary specimen or a verified adulterated or substituted lest resull. • Substituted sneclmcn_ means a specimen with crealinine and specific gravity ralucs that are so diminished Wan they are not consistent With human urine. • Tesfine levels means levels at or above wheat a specimen is determined to be positive, and below when a specimen is determined to be negative. • Third Party Administrator TPA means an entity that provides orcoordin des one or more dmg mWor alcohol testing services to employers. A TPA typically provides or coordinates the provision Ora number of such somices and performs administrative tasks concerning the operation of dmg and alcohol testing programs for employers. This tenor includes, but is not limited to, groups of employers who join togetherto administer, as asingle entity, the drug and alcohol testing programs of its members (e.g., having a combined random testing pool). • Verified test means a drug lest result or validity testing result from a DIIHS-certihed laboratory that has undergone review and final determination by the MRO. DRUG TESTING BCRC hill provide an identification card to each participant which will reflect the results of the Drug & Alcohol Screen Test from the laboratory and as confirmed by the Medical Review Officer (MRO). To implement sit appropriate and acceptable progrant, BCRC has adopted six (6) safeguards that reflect the standards established bythe U.S. Department of Health and Human Services (DHHS) Substance Abuse and Mental Health Services Administration (SAMHSA) for testing mandated by the U.S. Department of Transportation. '€hose sneguards are as follows: I. The integrity of collected urine specimens will be ensured by ulilizalionof one collection procedure at all sites. Samples will be collected in accordance with federal standards that provide foraconlinuous chain of custody and which recognize privacy concerns regarding the individuals being tested. 2_ Testing will be conducted only by accredited labs that hn a obtained and retained DHHS certification. 3. All specimens that are posilive in an initial screen must Wen beconfirmed by gas chromalogrophy/mass spectrometry (GCIMS). GCIM confirmation is theslale-oflhaarl dmg testing technology, providing a fingerprint oribe detected dmg 4. If the result of We screening test indicates an alcohol concentration of 0.02 or greater, a Breath Alcohol Technician (BAT) vvill perform a confirmatory lest, no less than fifteen (15) and no more than thirty' (30) minutes if er the completion of We screening last. S. If We confirmatory test is positive (0.04 and above, BrAC), We Breath Alcohol Technician (BAT) shall immediately rmul5, the BCRC/Emplayers DER. 6. Results of additional tests arranged by an employee, orrequeaed by a medical practitioner, will not be considered. This includes testing of blood samples, hair samples, DNA, or ore)' other testing methods or protoco€s, Costs related 10 drug and alcohol testing Hill be home bythe program except for re-lesting of disputed test msulls by an employee. The issue of payment forthe employee's lime vvill be categorized as follows: I. For new or current union members or employees seeking an initial test, the Lest is a condition of empioyanenl, and employees in the BCRC Program will not be Paid for their time in providing aspecimen for tie initial test. 2. All current employees who are to lest for any of the following= Lale Random, Probable Cause, Post -Accident, Diluted Re -Test, Roum-to-Duly, or Follmv'-up Testing or Relest due to a flarved or rejected test, will not he paid for lheirtime in providing a specimen for -the test 3. Employees will be paid a (forty -dollar) $40 stipend by the program for the time necessary to secure subsequent random testing required by the program. 11 is understood that such lusting will occur on the employee's time. Test to be taken with seven (7) days o€notice. 4. Non-Barga€ning and Pipe Fitter's; trade code 14 are exempt from the stipend reimbursement A Medical Review Officer(MRO) rill review all dmg test positives prior to verificalion o€positive test results. The MRO is a physician nips specially training and expertise in substance abuse and drug testing. The MRO will review confirmed positivetest results to ersumproper procedure, prolocol, and reporting. The MRO +till €mervieve the individual who has a confirmed positiveint result by telephone (o investigate whether a legal prescription has caused Ihespecimen to lest Positive If the individual has no legal prescription, the MRO will take appropriate steps to report a rerified positive totho BCRC Program Administrator, who vvi€t then invalidate the employee's certification card. All persons who have tested positive must have their return to work cleared by the GAP. All positive specimens will be retained Frozen in a locked Facility nt the testing laboratory for one (I)year, The retained specimens will be available should the results of that test be disputed or should arbitration or litigation arise out of the actioas taken because of the test results. On a periodic basis, BCRC will submit blind pre -tested urine samples with appropriate documentation to thedmg-testing laboratory as a means of assuring itself of laboratory proficiency. DRUG GROUP The dmg-testing program will lest forthe following drugs at theselexels: Anatyte Inital Screening. Qniirmatmy lest Amphetamines LOW ngrmL 500 np/mL Cocaine 300ng1mL 150nghnL Madjumn 50 ngrmL €5 nglmL Opiates 2000 nglnlL 20M ag1m4 Phencyclidine 25 nglmL 25 ngrmr. Barbiturates 300 nglmL 200 ng/mL Benzodiazelimes 300 npjmL 200 nglmL Methadone 300 ng1mL 200 ng1mL Propoxyphene 300 ng/mL 200 ng1mL MDA-ANALOGUES (Ecstasy) 250 rig/ail. 200ng/mL ALCOHIOL TESTING Alcohol tests (screening and confirmatory) will be performed on a device that appears on the National Highway Traffic Safcly Administration's (NHTSA) Conforming Products List (CPL) and that meets the DDT's testing requirements. When a specific time for an employee's lest has been scheduled, and the employee does no(appear at the collection site at the scheduled time, the Breath Alcohol Technician (BAT) will contact the Designated Employer Representative (DER), who may deterinme that the employee has refused to be tested. For alcohol testing (screening and confirmatory), a breath sample will be collected and analyzed by a Breath Alcohol Technician (BAT) using an Evidentird Breath Testing device (EBT), For the screening lest, a breath sample may be collected by the Screening Test Technician (ST1), using an Alcohol Screening Device (ASD). INITIAL TESTING (PRE -EMPLOYMENT) Prospective employees and current employees of BCRC affiliated employers will be subject to the BCRC program. All persons who are eligible and who intend to obtain a BCRC card will be instructed to report to on approved BCRC collection site and to provide a urine specimen for initial (pre,employment) testing and aclear status before starting work forany participating employer. The individual will be directed by BCRC or by their employer, to report lu a BCRC approved collection site location. These selected collection sites will have collection hits, chain -of -custody farms, and all othernecessary supplies. RANDOM TESTING AOer the individual's completion of the initial dmg test (with a negative result), helshe will be placed in the Random Pool aftervvidchh0she will be notified via U.S. in" to report to an approved collection site for a random drug lest. The individuals chosen fora random dmg test will be selected anon)miowly, from a mmpulerized selection program. Fifty percent (5tP/o) of We currently active BCRC individual cardholders will be selected annually for random testing, Then, on a monody basis, one-twe€flh (1f12) of the selected employees will be notified to submit to a random lest in order to update their BCRC identification cards and slmus. A copy of the form letters notifying individuals of their selection for this random lest appears w an attachment A, B & C at the back of this booklet. Employees will be required to report to an approved collection site within seven (7) days front the date of the Notice for Random Testing letter in order to maintain Weir BCRC identification card and status. No employee will bo required to submit to a random lest mom than twice (2) in a twelve (12) month period. All employees will be selected for a randont at least once (I) every two (2) years. If mu employee does not provide a simple at an approved collection site wilhin scion (7) days of having been notified of n random selection, hisAter status in the BCRC Sub5laoce Abuse Program will be deenmcd "Not Available" Employees who fail to report for a random rest in die required lime should contact die Third Party Administrator (TPA). If an employee does not report for a random test, and it is the first (I) lime die employee has failed to report, the TPA may allow, lute employee to take ilia lest without reporting Ia the EAP for further review. Employees may choose to take a "First Occunence Clause' at this time. Employees may wilize this clause only one (1l lima Hiiwcver, mice this "Firs[ Occurrence Clause' has been utilized, an employee a ho faits to report for a random lest at any lime in the future hill be required to contact to the EAP for evaluation and to receive iminictions on [he required pmcedwe(s) far mnov4ng the "Not Available" scams firm his/her card, PROBABLE CAUSE TESTING An employee may be subject to drug and alcohol testing for Probable Cause based on observed and documented unusual behavior Circumstances sufficient to lead a reasonable person to suspect that an employee is under the influence of, or is in possession of a controlled substance shall W determined by an immediate superisorand should be confirmed by one other supen•isor whenever possible. The immediate supervisor shall docwnenl, in untiny the incident and the probable cause basis for such lesting The documentation shall specifically detail the behavior and conduct of ilia employee, the location, date, lime, of observation, conversmions, witnesses, (if any), and should be signed by the supervisor Who Witnessed the incident. Such employees may request that a union representative be available or present prior to any action taken by an employer, t( any, at any stage of the policy and its admultstration. 21 "E15fERGENCY" WORT{ ASSIGNMENTS To accomnsodale o% uers wi0u emergency wort:, craft personnel Who lire not previously held a BCRC idealiftcation card or taken an initial drub test, the following proiisions will apply when starting for emergency work assignment; 1. Upon arrival at a job loc lim for sign-up, the employer representative (Cord Manager) shall request Uueemplopee to present hisArer BCRC identification card. An individual dial does not have a BCRC card al the lime of hire will be requested to secure a card and submit to an initial drug test within one (1) day, in order to comply With due BCRC Polio•. 2. An employee vdlhoul a BCRC identification card may Work one (1) day, On the second (2) day, a chain or Custody term has proof of having submitted to a drug 1e51) or a BCRC card must be presented_ 3, An employee who has provided a specimen for testing must bring to thejob site his+Frer copy of the Chain of Custody fors, given to limvher by the collection site, as proof that he/she has submitted tow initial test. 4. If tine werk assignments are consecutive, the employee hill be allowed to wool: for up to a maximum of four (4) days in order for the employee to receive his BCRC identification curd and have the employer Card Manager swipe the card for slows verification 5. If Una member'. work assigrunen[ is teuninakd by hisAmerempioyer before the meniher's status is verified nifhin the alimvable four (4) days for verification, and die individual is rehired, the member ivill have to provide the same employer a BCRC identification card at the second (2) rehiring sign up, and a clear status. Except in the en am that the rehire is less Omen Lou (4) days from die initial hire date, the Individunl, focal and Non -Local, 23 POST -ACCIDENT I INCIDENT TESTING An employer may, require an employee to submit to a post -accident drug and alcohol test alter die involvement lit, or cause arm accidentkncidenl, Ural causes injury to die employee or amrther party. The employer niay also require an employee losubmit to a post-accidem drug and aloohol lest when the employee is involved in, or causes an accident, which resudls in damage or destruction to property. Post-accidenl drug and alcohol lesling must be compleled widmin nvo (2) hours of die recorded accideni/incidenl if a BCRC testing facility' is located on Ole job site or isitldn four(4) hours of the recorded accideriumncidenl if m employee is required to go oR'the job site to a BCRC testing facility. Any employee suspected of unnecessarily delaying the lest process will be considered to have refused to submir to testing. In instances atop.[-acciden>rncidenl or probable cause testing for drugs and alcohol, Ilia employee will be transported to Uue toiling facility by Use employer_ Al the option ofthe employer, the employee maybe suspended pending the lest result. In the event a negative lest result is reported, the employee shall be compensated for all lost time at the appropriate Yale within the collective bargaining agreement, slmiglit or premium pay. When an employee is injured in aqualifying accident, priority must be given to ilia employee's medical treatment before any considemlion is given tocolleeling a specimen forlesling. Such employees may request that a union representative be available orpresent prior to any action taken by an employer, litany, al any singe of die policy and its administration_ If an employee is aggrieved by any action taken wider this Drug mid Alcohol Policy and hisliter complaint cannot be resoled, the complaint may, if the employee or Union requests, be referred as grievance underthe grievance and arbitration provisions of the employee's collective bargaining agreement. In the event the mailer is referred to arbitration, the arbitrator shall be bound substantively by Ilse provision of this Drug and Alcohol Policy. 22 SCRC card holder shall accept and understand that should hisAier drug lest results be repelled m positive, he/she will be subject to disciplinary action up to and including lamination Nlithoul obligation far further compensation by the BCRC affiliated employer. Such temuinalion shall also be subject to the individual's rights under hisiher collective bargaimagagreemenl- CARD SYSTEBI Employees Will be required to give their BCRC Card ID Number to a Card Manager in order for Lite Card Manager to access the e-mail status confirmation system, Categories we: 1. Nol On File(NOF) 2_ Nol Avidlable(NIA) 3_ Clear (CL) Time Cud Manager will also have access to safety training infomuation, which has been dmsnloaded through Ute Conslruction Advancement Foundation (CAF) and accessible through the BCRC scanner or enact system only With the permission of each participating Local Union Participating employers may verify the slates of al€ BCRC employees, n ho are warking, by Inning their card status yerified m Ihdrjob site in order to delomuine if lime employee is available or not available raider the BCRC program The employer may wt the Plmunc-in System, Scanner or Electronic e-mail for verification When an employee's status is Not Available (N/A), he/she hill be advised to contact die BCRC office to resolve the N/A status, The individual may be required to follow the consequences for a positive test nilldn Sire BCRC Policy. 24 Tie employer may verify the employee's card after row (4) days to reconftmr the status and if the employee's status is still NIA, Ole employer may terminate the employee. An employee who receives a slaltxs of NIA a second (2) time will be referred to the Employee Assistance Program far ossessmem, mid will be required to follow the recommendations of the HAP Counselor before being considered for further assignments. The status of Clear (CL) will be restored only with wvillerl approval of dhe EAP. This procedure will protect the employee's confidentiahty and allow lice employerio audit die stales orhhsAheremployees, which nmy be required by the owner to be sul ndlled montihly. A person who provides an insufficient specimen of urine or breath whhen required to do so shall be referred to an appropriate medical professional, as designated by the BCRC for evaluation at Ole participant's expense. If the medical evaluation fails to reveal an acceptable medical explanation for the inability to provide a specimen, the donor shall be considered to have refused to test mid discipline shall be imposed according to this policy. If p ]egilimale medical reason is revealed, no action shall be taken mid the employed shall be reimbursed by BCRC for the medical evaluation expense. TLU Ehp T. S.S,PE_, l�..AiEN An employee providing a diluted specimen will he given the opportunity to return to a collection site within fail -eight (4a) hours to provide a second (2) specimen, on his ter own time. Employees should refrain Rom excessive consumption of fluids prior to the retest. No adverse action or discipline shall be taken against any employee based on a first (I) diluted specimen. A second (2) diluted specimen, without a valid medical reason, will be treated as a refusal to subtml to testing 25 4. A continued positive or a "N1A" status will not he the sale basis for lennination of employment. Only employees µfro we in non-compliance with this program may be discharged. For the purposes of this provision, "noncompliance" shall mean one or more ofthe following: • Failure to report in the program's Employee Assistance Progmnh as directed, Failure to follow andlor complete a EAP-prescribed treatment progrmL • Failure to take a retum-lo-duly or follow-up test, Failure to report for a random test request within seven (7) days, • Failure to submit to a drug malcohal lest whhen requested to do so by the EAP 5. All individual testing positive for a third (3) time in a twelve (12) month period shall not W permitted to take a Return-lo-Duty lest for one (1) year and hiAer BCRC Substance Abuse Card shall be irnulidated for the some time period. The individual must also complete an EAP-prescribed treatment program before reluming to wok, For the purposes of this policy, a negative lest most occur before any future positive tests will be counted as additional strikes. 6. An employee whose test results ere verified positive will be referred to the EAP by die MRO. The employee is expecied to attend all appointments with the EAP counselor and to follow Ole EAP counselors instructions. RETURN -TO -DUTY TESTING The return -to -duty lest is required for an employee to be re -instated into the program following a positive test. The participant must have a negative drug lest before resunting performance of his/)her jab duties. FOLLOR'-UP TESTING ADULTERATED, SUBSTITUTED, ANUIOR OUT-OF-TERIPERATURE RANGE SPECIMEN When a urine specimen is reported as adulterated, or substituted, or uiten the temperature range is below 90 degrees or above too degrees F., the employee will be considered to have not cooperated with the lestme, process, and the lest will be considered a refusal to be tested. In addition, Ole employee who has refused to be lasted, or who uses or possesses a cota3terfeit drug card, shall be subject to employer discipline up to and including discharge, subject to tile representation language. 1. An employee who tests positive for drugs "or alcohol shall be contacted directly by the Medical Review Officer (MRO). If the MRO verifies die results of the positive test, the MRO will notify the individual that he or she is ineligible for work and he/she will be directed to contact lire pmgram's Employee Assistance Program (EAP) for consuliation and review. If the MRO contacts the individual and finds Thal there is a reason rot the positive test (an authorized prescriptive medication) the MRO will downgrade the result to a negative, end the individual's card will be marked "CV'. 2, In the case of a confimhed positive drug or alcohol lest, the Third Party Administrator (TPA) will be notified that the employee's status should he marked "NIA". The "NIA" status will be effective at die moment that a confirmed positive test is received 3. Before returning to work, an employee most (1) complete on evaluation vvidh the ptograWs Employee Assistance Program provided by the BCRC EAP Provider, (2) follow a treatment plan prescribed by We pmgsam's EAP, (3) obtain written documentation front tile program's EAP verifying fitness for duty, and (4) obtain a negative result on a return -to -duty lesl- 26 Follow' -up testing for drags and alcohol is a requirement in order for a returning employee to stay in compliance Witt the BCRC Program Testing shall be determined by the Employee Assistance Counselor, and will be implemented vdhen the employee returns to walk. DISPUTED POSITIVE RESULTS An employee who disputes positive results shall have the right to have luOier initial sample independently re -tested by a Department of Health and Idummi Services (DHHS) certified laboraloiy of his/her choice, at his/her own expense, within ten (lo) working days of when Wshe was notified of the test resells- A portion ofthe initial sample shall be f lrowded under a chain - of -custody directly by BCRC's testing laboratory to the laboratory selected by the individual, Review of die drug tell result mum be performed by a qualified MRO who has been approved by BCRC. If the second lab report shows the presence of a controlled substance, die test result will be considered positive. If the second lab report test indicates no presence of aconlrolled substance, then boot tests will be considered negative. Tie following section only applies when tlheemployee tests due to Post -Accident or Probable Cause: If the test is negative, the affiliated emp€oyerwill reimbursethe individual for conhpensalim lost at the appropriate rate within tlhecollective bargaining agreement, strnighl or premium pay, during the period of hisdner disciplinmy suspension or termination and will reimburse die individual for the cost of the re -test. An individual whose test results are verified positve will be referred to die EAP by the MRO. The individual is avpecied to attend all appointments with like EAP counselor mid to follow the cotrnselor's recommendations and requirements, A posdivealedhol testing conducted on a breadh sample cannot be re -tested. 27 28 All problem situations shall be resolved in accordance with current guidelines and standards established by the U.S, DIMS or Department ofTransportalion. Employees vdie are subject to this policy continue to have access to the usual protections provided as a part of their union membership andlor as members or hahgeaOng units covered by collective bargaining agreements, Such individuals may request thal a union representative he available or present prior to any action taken by an employer, if any, at army stage or the policy mid its administration If an individual is aggrieved by any action taken under this Drug and Alcohol Policy and his/her complaint cannot be resolved, the complaint may, if Lite individual or Union requests, be referred as agrievance under the grievance and arbitration provisions of the individual's collective bargaining agreement. In tie even[ the nutter is referred to arbitration, We arbitrator shall he bound substantively by the provisions of this Drug and Alcohol Policy. 29 Anachmem B BCRC LETTER HEAD Letter of Notice for Random Testine Dear Your name has been randomly selected by BCRC's computer generated selection program to take a random drug test its order to maintain your "Clear'slalus on your BCRC identification card. our computer progmant selects the names of one -twelfth (1/12) of 50 of all BCRC cardholders for random updating each month. No one will be tested in this system more Wan twice in a lvehe month period. You will be required to report to an approved colleclion site within seven (7) days from the date or this "Nader for Random Testing' Idler to slay €n complianCe with the BCRC pohiuy. Ire order to avoid any' polental intertupton in tie status ofyour card, you most be tested no Inter Ilan midnight the (day) or (Month), 201_. Ifyou do not lake your random test within seven (7) days o€this notice, your BCRC card status will be deemed "Not Available''. Failure to report for a random test in the required time will make it necessary for you to contact Lite BCRC office to receive instructions on the required procedure(s) for removing the "Not Available" slatue from your card. Remember it is your responsibility to keep the BCRC infonned of any charge in your address or telephone number. Tho BCRC has Contmeled with Perspeel€yes as a fully independent, professional Employee Assistance Program LEAP) for you aad your family, Perspectives' 24 heir, 7 day a week holhnc number is (80(t) 45(r632T Please contact the BCRC office (ri) 219-764-95(81 or toll free Ca) 877-988-5400 if you have any questions. 71hnnk you for your cooperation. Sincerely, Robert Anadell Executive Director Attachment A BCRC LETTER HEAD Letter of Notice for Random Testins Dear Your time Ims been randomly selected by BCRC's computer generated selection program to take a random drug lest in order to maintain yrour "Clear' BCRC identification card status. Our computer progtum selects the names of one -twelfth (1112) of 50 % of all BCRC cardholders for update each month. No one will be tested in this system more Wan twice in a h+'elve month period. You will be required to report to an approved collection site within seven (7) days front We dale of this "Notice for Random Tesling' teller to slay in compliance with the BCRC policy. In order to avoid any potential interroplion in the status of your card, you must be tested no later than midnight the (day) of (Month), 20I_; This random lest Is to be taken ore yrour O++n little at any of the approved ColhecUm sites identified on Ole enclosed colleclion site list. You will be mailed a $40,00 stipend for the time necessary to secure random testing m long as your test is Iaken within seven (7) days of this notice_ Ifyou do not take your random last within seven (7) days of this notice, your BCRC card status will be deemed "Not Available". Failure to report for a random lest in the required time it will be necessary- for you to contact the BCRC office to receive instructions on We required procedure(s) for removing We "Not Available" status from your card. Remember it is your responsibility to keep [he BCRC informed of any change in your address or lelephonenunhber. The BCRC has contracted wiW Perspectives as a fully independent, professional Employee Assistance Program (EAP) for you and your family. Perspectives' 24 hour, 7 day a w-Cek hotine numberis (Wt) 45G6327, Please roman l Ole BCRC office n 219-7(4-9500 or loll free rn 877-988-5400 If you have my questions. Thank you foryom cooperation_ Sincerely, Robert Anadell Executive Director tin Attachment C Letter of Notice for Random Testing Dear Your name has been randonty selected by BCRC's computer generated selection prolptun to lake a random drug test in order to maintain your "Clear' status on your BCRC identification card. Our computer program selects the names of one -twelfth (Il12) of 501 of all BCRC cardholders for random updating each month. No one will be tested in this system more Winn twice in a twelve month period. You will be required to report to an approved collection site witan seven (7) days from lite date of lh€s "Notice for Random Testing" letter to stay in compliance with the BCRC policy. In order to avoid any potential interruption in the status of your card, you must he tested no later than midnight the (dayl of(Month), 201_. Tests may be taken on your Employer 1Contmetor's time al the collection facility selected front the enclosed list. If you do not take) our random test within seven (7) days of tiis notice, your BCRC card status trill be deemed "Not Available". Failury to report for a random test in dre required time will make it necessary for you to contact the TICRC office la receive instructions on tie required procedure(s) for removing the "Nut Available" stines €torn your card. Remember it is your responsibility io keep the BCRC informed of any change in your address or telephone nwnber, The BCRC lives contracted with Perspectives as a fully independent, professional Employee Assistance Pmgrant LEAP) for you and your fimily. Perspectives' 24 hour, 7 day a week hull€nc number is LEW) 456-6327, Please contact the BCRC office m 219-7(r4-95181 or loll free ,tea 8M988-54(t€ if )ou have nay questions. Tliank you foryour cooperation. Sincerely, Robert Anadell Executive Director 31 32 Attachment D BUILDING AND CONSTRUCTION RESOURCE CENTER INC. AUTHORIZATION FOR CONSENT TO DRUG AND ALCOHOL ANALYSIS AND AUTHORIZATION FOR RELEASE OF RESULT'S I, the undersigned, - do hereby, authorize the testing army body fluids forenrployment reasons and understand and agree that the resells of any such testing will be turned over to the Building and Constructions Resource Center, Inc. and, further than the testing procedures will be limited to tests for prohibited and illegal drugs and conlrolled substances - I understand that rite resells of these tests may be used for employment and disciplinary reasons and hereby authorize the release of such information from Ihelaboralmy and MRO. I further certify that the urine specimen collected from me is nine end not adulterated or altered in any manner. I have been advised that matters affecting me relative to the inlerpretation or application of the Dmg Policy and subject esclwively to the grievance and arbitration procedure under my collective bargoining agreement (irapplicable). Attachment F Signature of Applicanl/Employee Employee's Social SecurityNumbcr Time Employee's l'clephone Numbcr Employee's Address Slate & Zip Code 33 Drug and Alcohol Policy in compliance I, till 49 CFR Prn9 dQ and 49 CFR Par! 382 (FA1CSA) far DOT -Covered Contractor Participauls BCRC Board Approved Augusa ]s, 7004 BUILDING and CONSTRUCTION RESOURCE CENTER (BCRC) Drug and Alcohol Policy in compliance with 49 CPR Part 40, and 49 CFR Par( 392 (FMCSA) for DOT -Covered Contactor Participants BCRC Board Approved August 18, 2004 1. PURPOSE Bu€ldiag and Cansimciion Resource Crater ("BCRC",'yhe Association") has established this alcohol and controlled substances testing program for contractor participants who have employees that we drivers of Commercial Motor Vehicles (CMVs) and uhO require Commercial Drivers Licenses (CDIs), to meet requirements of the U.S, Department of Tramportntion (DOT). The overall goals of this testing program are to ensure a safe and drug -free transporlation environment, In reduce the potential for accidents and casualties related to accidents involving Company -mewed 1-leased vehicles, and to cooperate with the U.S. Department of Transportation and the transportation industry in efforts to eliminate the misuse of alcohol and the illegal use of controlled substances by our drivers. With these objectives in mind, BCRC has established the following policy and procedures for DOT -Covered employees ofits comaclor participants. Full compliance with this policy is a condition ofemployment with each individual contractor. 11. SCOPE 13CRC's Drug and Alcohol Policy for DOT- Covered Employees, outlined below, applies to all full-time, part-1€me, and temporary employees who are "covered drivers' as defsncd in Section VI (A). This policy also corers independent drivers who may be spoail€cally named in a contract to provide service In addition, dus policy covers a€€ job applicants 35 Attachment E BCRC APPLICANT/CARDHOLDER. DRUG TEST ©CRC is exercising extreme care to ensure that strict quality control measures are followed in the collection, handling, and analysis of you specimen You play an important role in this process and should be certain dial you have provided an unadulterated specimen to the laboratory. Remember, you are certifying that the specimen Much you provide is yours and is unadulterated. Anyadullemtion or switching of specimen is o breach of UCRC's roles and, if you are employed, may subject you to discipline up to and including termination by your employer. Far your our protection and pence of mind, vve ask thatyou: • Provide a picture identification to the collection site/lechnieian at lime of arrival; • He escorted to a collection mom and asked to provide an unadulterated specimen in the collection bottle provided. The bottle should be filled to 60 ad; • Return the specimen bottle to the medical technician and witness, initial and date the integrity seals placed on your specimen; • Verify the proper spellingofyour name as recorded on the log sheet; • Verify that your social security number has been properly recorded; • Verify that the social security number placed on your specimen bottle is the same as that recorded on dicing sheet and the Chain ofCuslody' form. I HAVE READ THE ABOVE AND HAVE HAD AN OPPORTUNITY TO ASK QUESTIONS REGARDING THIS PROCEDURE. BCRC ApplicenUCmdholder5ignature Date h71 IV. 34 for positions that require Commercial Drivers Licenses (CDL) for the operating of Commercial Motor Vehicles as described in Section VI JAI. In those circumstances that are not addressed by DOT regulations or in this policy, DOT - covered employees remain subject to rules and testing as defined in DCRC's Drug and Alcohol Policy for all employees. in addition, a driver will be required to submit to a non -DOT test for reasonable suspicion in those circumstances when the driver is suspected of drug or alcohol use, orhas violated a work mle as staled elsewhere in this policy, oris involved in or may have contributed to the causing of an accident, or causes injury to him4terself or to another person, Wien thecircunnslances related to that incident do not meet the requirements Ora DOT lest. REFERENCES Title 49 CFR §382, et al., Federal Motor Carrier Safely Administration (FMCSA) Regulations on Controlled Substances and Alcohol Use and Testing Title 49 CFR §40, Procedures For Tyrairsporlation Work lace Dm and Alcohol Teslin Programs Title 41 U.S.C. §§ 403, 701 el. Seq., Drug -Free 3Varkpiace Act of 1998. Note: If there ere conflicts between federal regulations and Otis policy, attributed in part to revisions to the law or changes in inlerpretaiions, and when those changes have not been updated oraccuralely sellecled in this policy, the federal law shoal prevail. POLICY! RULES OF CONDUCP A driver who violates the FMCSA prohibitions of this policy (Section VIIBj), including a refusal to be tested, must be inmtedialely removed from all FMCSA safety' -sensitive functions, including driving, in accordance pith 49 CFR Part 382 501, FMCSA rules and regulations. Under each employer's independent authority, the driver will be subject to discipliner)' action up to and including termination of emptoy'menl- An employer also reserves the right to take action against an employee, where appropriate, for i iolat€on of other general employer policies, procedures and/or rules that may be defined in rues that are separate from this policy for DOT -covered employees. A. A corered driver may not engage in any of the conducl(s) prohibited in Section VI IBj. B_ Under independent authority, BCRC prohibits the possession of alcohol, or the sale, purchase, manufacture, possession or transfer of rat illegal drug, or being under the influence of alcohol or of am illegal drug, during all cork lime, including meals and breaks, Or at any lime white on Company property, at a Company's job site, shipperlreeeiver site, truck slap, rest area, on Company business, or in a Company -owned Mcased vehicle. An employee who possesses alcohol, or who uses alcohol witi€e on duty, will be ler"mrwrl from employment- C. Under independent authority, BCRC prohibits the use of any over-the-counter medication by an employee during working time or any time while On Company 36 property, at ajob site, on Company business, Orin a Company-o+tned !-leased vehicle if such use may deuimenlally affect or impair the safely of coworkers, customers or members of lbe public, or an employee's jab performance, or the safe or efficient operation orthe Company, or its praperly. D. A driver who uses prescribed medicalion(s) will not be permitted or required to operate a Commercial Mator Vehicle until and artess the employer is provided with appropriate authorization from the employee's prescribing licensed medical professional. ]See Section V, Authorized Use of Control€ed Substances.] E. Cases of suspected trafficking, possession or use of illegal substances or drug paraphemaiia on Company property, in or on Company vehicles, and/or at job sites, will W referred to law enforcement authimlio, under each employer's independent authority. F, BCRC encourages participants who wish In voluntarily sees: assistance for questions or problems related to drugs and alcohol to so do by contacting ate Association's Employee Assistance Fmgrm. DOT -covered drivers wiso seek assistance under the provisions of die Self -Identification Policy will have to be removed from safely -sensitive function during the time of assessment and rehabilitation, but their admission of use will not be considered a DDT violation. In accordance with the policy, drivers +rho return to work after rehabilitation will be required to take a DOT velum -to -duty lest, and will be subject to nos -DOT follow-up testing. G. Ifis driver is called to duty during the driver's typical "off -duty" lime, the driver may report to work only if he/she has not consumed alcohol at any lime during the previous four (J) hours, Wien a driver has used alcohol during four (4) hours prior In his/her providing safely -sensitive duly, he/she will be expected to acknowledge such use al the lime he/she is called. If it is not possible for ale supervisor !o delay the requested stun time so as Io accommodalc 6gT's pre -duly requirement, ate employee will nil repots 10 work_ If an on -call employee acknowledges ate use of alcohol, he/she will he permitted to delemnine a start lime that wilt comply with the 4-hour prohibition, Under each employee's independent authority, no discipline will be taken against an employee who acknowledges his/her use oralcohol during die four (4) hours prior to being called to duly, unless such conduct has the effect of making that employee repeatedly unavailable for du(y. H. BCRC considers a conviction for criminal drug activity to be very serious, An employee who has a workplace-relaled drug conviction must repartThat conviction to hisaver supervisor within five(5) days ofreceiving it. Anemployee who fails to report such a conviction will, upon discovery of the conviction, be subject to inarediate termination from employment. 1. Each employer reserves the right to tat a DOT -covered employee fovalcoliol or controlled substance use under the Company's independent authority when DOT' regulations do no! apply_ These circumstances would include suspected impairment, violation of an employer's drug and alcohol rules, or of other rules participants) who are required to hold a Commercial Drivers License (CDL) and who operate a commercial motor vehicle (CMV), when that vehicle: • bps a (toss reihicle it combinarion weight rating of 2C,0U1 or n€ore polmds; • is designed to transport ]0 or more persons including a driver, or • Is n rehlcle gfm€y= rize vial transports hmnrdous materials and requires placarding under the Hazardous Maleri& Transportation Act. B. FMCSA PROHIBITIONS: A driver shall nor: • Report for duly or remain on duly requiring die performance of safety- sensilh a functions while having an€ alcohol concentration of Q(W or greater + Use alcohol, including medications that contain alcohol, while performing safety-sensilire functions, • Perform safety-sensilire functions within four(4) hours viler using alcohol, including the use ormedicolions that contain cleohot • Use alcohol for eight (8) hours following an accident, or until the driver has undergone a post -accident alcohol test, whichever occurs first, • Refuse to submit to a pre -employment, post -accident, random, reasonable suspicion, or follow-up alcohol or drug lest. Report for duly or remain on duly requiring are perfomuuce of safety - sensitive functions when he/she was any controlled substances, except nlien the use is pursuant to the instructions of a licensed medical practitioner who has advised the driver Ilia( the substance dots not adversely affect the driver's ability to operate a commercial motor vehicle safely, • Report for duty, remain on duty, or perform safety -sensitive functions if Itefshe tests positive for controlled substances, €f a driver engages in any o€the conducl(s) prohibited in (B) above, the driver is not qualified, under FMCSA regulations, to driye a commercial motor vehicle (Including operating any interstate commercial motor vehicle with GV WR of IDJXJI pounds or more). Helshe most be immediately removed from all sa€cry-sensitive functions including driving, and is subject to $"lien Vlll, Consequences of Prohibited Conduct A driver who engages in prohibited conduct a second time will be immediately terminated from employment. Under FMCSA regulations, a driver who is found to have an alcohol concentration of 0.02 or greater, but less than 0.04, may not operate or continue to operate a cominercial motor vehicle or provide other safety -sensitise functions for a twenty-four (24) hour period. Under each employer's independent authority, that driver will be an unpaid leave for any hours not worked, In this regard, under independent authority, a driver who provides an alcohol lest result greater than 0.02 but below 0.04 on a second incident will: lie subject to disciplinary that are staled in this policy, and causing or being involved in an accident or injury of self or anolher employee. In those cases, testing levels would be identical to DOT levels, but the lest would be conducted as a non -DOT lest, If a DOT -covered employee tests positive for drugs under an employer's independent authority, that employee will be considered to be in violation of DOTS prohibited use of control€ed.substances, lielshe will be immediately withdmwn from safely -sensitive fmiclion, and wilt be subject to consequences as defined in this Drug and Alcohol Policy for DOT Employees. If a DOT covered employee tests positive furaleohol under an employer's independent authoril), that employee will be considered to be in violation or BCRC's policy regarding alcohol in the workplace. Helshe will be subject to consequences as def€wed in BCRC's policy far employees who are tested under non -DOT circumslances. V. AUTHORIZED USE OF CONTROLLED SUBSTANCES Ifadriver undergoes prescribed medical treatment with a dmg or controlled substance, the driver is requ€red In report this treatment to his/her employer, who will take steps to investigate whether the driver'sjob assignment should be temporarily changed during the period of treatment, or whether milaraccommodations may be appropriate, BCRC requires a driver to make such notification as soon as possible, and prior to perforating a safely -sensitive function, and to provide written documentation from the prescribing licensed medical practitioner that the medication(s) will not affect the driver's ability to perform safely-sensilive functions safely, including operating a commercial molar vehicle. Each employer reserves the right to obtain an independent medical opinion regarding the potential effects of a prescription or over-the-counter drop, on p drivers ability to perform safety -sensitive functions or other aspects of hisdserjob. Furdter, each employer reserves the right to place any driver taking medication(s) on a leave of absonce pending a decision as to whether the driver may continue to perform his/her regularjob duties while taking The medication(s). Each employer may, a it determines necevalty, and when possible, temporarily reassign an employee to non -safety -sensitive functions for The duration of his/her use of such drug(s). However, due to the safety -sensitive nature of manyjebs in the construction industry, no employee can be guaranteed that these accommodations can always be made. Vl. TESTING FOR CONTROLLED SUBSTANCES AND ALCOHOL Employers who are members of BCRC will conduct controlled substance and alcohol testing of Ihe€r driverlapplicanis and their driver/employees (including mechanies and management driyors) in compliance with regulations established by the U.S. Department of Transportation (DOT), 49 CFR §§ 40 and 382, A. Covrnrn DrdvcRs In accord with U.S. Deparmeat ofTransporlalion FMCSA Regulations, drivers subject to drab and alcohol testing are those employees (of contractor action up to and including wrininalion orentploymem for disrupting normal business hours, C. DGr1NIT€0€Js • Accident means an occurrence involving a coommercial motor vehicle operating on p public road in which, a. There is the loss of human life; or b. The driver receives a citation under Slate or local law for a moving traffic violation arising front the accident; and (1) Any involved vehicle sustains disabling damage as defined in this policy; andlor (2) Anyone receives bodily injury that requires immediate medical treatment away from the accident scene_ • Acrualknowledge means actual knowledge by an employer that a driver has used alcohol or controlled substances based on the employer's direct observation of the employee, information provided by the driver's previous en,pioyer(s), a traffic citation for driving a CA1V white under the influence of aicoho! or controlled substances, or an employee's admission oralcohol or controlled substance use, except as provided by our Self- rdamiftcalionPoiicy(S"0im X)_ B¢Cause our nor -DOT testing is conducted under tie scone strict collection and laboratory standards os our DOT tests, we rdso consider a positive drag lest result to be actual knowledge that rat employee is using a controlled substance without authorization. • Adulterated specimen means a specimen that contains a $"balance that is not expected to be present in human urine- or contains a substance expc tied to be present but is at a concentration so high that it is not consistent with hummm urine_ • Alcohol means the inloxicaling agent in beverage alcohol, ethyl alcohol, or other lov molecutur weiglll alcohols including methyl and isopropyl alcohol. Alcohol concentration ar cmltenl means the alcohol in a Volume of breath expressed in terms of gauss of alcoltol per 210liters of breath as indicated by an evidential breath lest (BrAC). • Alcohol semen€ne device(ASD) means a breath or saliva device,other than an EBT, that is approved by the National Highway Traffic Safely Administration (NHTSA) and placed on a conforming products list (CPL) for such devices. • Alcohol screen€ne test means an analytic procedure In determine nhedier an employee may have a prohibited concentration of alcohol in a breath or saliva specimen • Alcohol use meansthe drinking or mialloeingo(any beverage, liquid mixture or preparation (including any medication), containing alcohol. •Applicant means a person, independent contractor, or person working for an independent contractor, who applies to become a driverfemployee of a BCRC contractor participant, and includes a person who has received a job offer made contingent on the person passing a drug test, • Association means Building and Construction Resource Center, which is ties association formed by labor and management representatives of The Building and Construclion Indwhy for Northwest Indiana, for the purpose oraddressing problenn ofdmgs and alcohol in the workplace. • Breath Alcohol Techniclon @M is an individual ssho is certified as trained to operate an Evidential Breath Testing device (EBT) and nho is proficient in breath -testing procedures. • Caneeled lest means a drug or alcohol lost that has a problem identified that cannot be orbas not been corrected, or which is olliensise required, by Pan d0, to be canceled. A canceled testis neither a positive nor a negative test. An employer is not permitted to take adrene job action based on a canceled lest. • Company means an employer who is a member of Building and Construction Resource Center. • Collection slle means a place designated by BCRC where individuals present themselves for the purpose of providing a specimen of their urine to be Analyzed for the presence of controlled substances, or for purposes of providing a suliva or breath sample to be au dyzed for alcohol concentration. • CpmpanV mnoetiv means all employer-oimed and/or -leased properly, including but not limited to owned and/or leased buildings and other real estate, parking lots and vehicles located on parking lots, and employer - mined and/or -leased vehicles, lockers, and desks. • Confirmatory test a For alcohol testing, a confirmatory test is a second lest following a screening test with a result of t1.02 orgreater, conducted 15-30 minutes later, that provides quantitative data of alcohol concentration. This test is conducted on an EDT. b. For controlled substances testing, a confirmatory test is a second analytical procedureto identify the presence of a specific drug or metabolite. This confirmatory test is independent of the initial lest and uses adifferent technique and chemical principle from that of the screening lest in orderto ensure reliability and accuracy, controlled substances testing as required by'the DOT rules and regulations and that acts on behalf of the employer. For purposes ofihis policy, BCRC serves as the consortium for contractor participants uito are members of Building and Construction Resource Center. • Contractorplilichlan! means an employer who is a contributing member of -Building and Construction Resource Center, • Controlled substances means marijuana (THC), cocaine, opiates, plieney elidine (PCP) and amphetamines (including rnethamphetamines.) • DER(deslenated emolorer'renresenlafFre}nummancmployce authorized by each employer to lake immediate actions) to remove employees from safely -sensitive duties and to make required decisions in the testing and evaluation processes, Tlhe DER also receives lest results, SAP reports, and other communications on behalf of his/her employer. (An employer may designate more Ilion one DER) • DHHS•approred.laboralo_ry means a laboratory that is certified under the U.S. Department of Health and Human Services Mandatoy Guidelines for federal workplace drug testing programs. Drug tests for DOT -covered drivers will be performed by a DHHS-certified laboratory. + Dilute specimen means a specimen with crealinine and specific gravity values that are lower than expected for human urine. • Dlsabllne damage means damage that precludes departure ofa motor vehicle from the scene of the accident in its usual manner in daylight after simple repairs - ckrslons. Damage to motor vehicles that could have been driven, but would have been further damaged i€so driven. Excluslons. ,_ Damage that can he remedied temporarily at the scene of the accident without special tools or parrs. u Tire disablement ssilhoul otherdamage even if no spare lire is available. a. Headlight at taillight damage. u,. Damage to turn signals, ham, or windshield Wipers dint make them inoperative. • Driver means any person who operates a commercial motorvehicle. This includes, but is not limited to: Full time, regularly employed drivers; casual, intermittent or occasional drivers; leased drivers and independent, owner-operntor contractors who are either directly employed by orunder lease to an employer, or who operate a commercial motor vehicle at the direction of or with the consent of an employer. • Consarlinm means an entity, including a group or association of • Drug tell means atest conducted for controlled substances, including employers or contractors that provides services related to alcohol or marijuana, cocaine, amphetamines, opiates, and phencyclidine. Employee means an employee of a company, orofa contractor participant who is a member of Building and Construction Resource Center. • Employer means a company, or p contractor parlicipanl, who is a conttbuting member of Binding aid Consimetion Resource Center, and who owns or leases a commercial motor vehicle that is subject to Writ roles, and who assigns persons to operate such a vehicle In [his policy, employer includes a company's agents, officers and representatives. • FMCSA means Federal Motor Carrier Safety Administration, an Operating Administration orthe Departmedl of Fransporlalion_ ♦ initial lest (for drugs) means an immunoassay screen to eliminate .'negative' urine specimens front further consideration. + Inim-Y (for post -accident testing) excludes (i) an occurrence involving only boardiag or alighting front a stationary motor vehicle; or (ii) an occurrence involving only the loading or unloading of cargo; or (iii) an occurrence in die course of the operation of a passenger car or a multipurpose passenger vehicle by an employee, unless the motor vehicle is transporting passengers for hire or hazardous materials of atype and quantity that require the mclor vehicle to be placarded. • Medical Review Officer means a licensed physician responsible for receiving laboratory results generated by BCRCs dmg testing program who has knowledge ofsubslance obese disorders and who has appropriate medical training to interpret and evahmle an individual's confirmed positive Lest result together with hisllier medical history and any other relevant biomedical information. • Positive Test (alcohol) occurs when a driver's corifinnutory test result reads 0.04% BrAC or higher, • Positive Test fdrual occurs when a driver's confirmatory lest or retush result is of or above cutoff levels specified by DHHS in DOT mles and regulations, and has been verified by the MRO to be a positive lest. • Random seleciion means a scientifically valid method for selection of drivers to be tested that results in an equal probability that any driver from a group of drivers subject to the selection mechanism rill be selected, and does not give an employer discretion to waive the selection of m)- employee under the mechanism, Thus, a driver might be selected more than once during a year. • Reasonablo suspicion means a belief Thar adriver has violated alcohol or controlled substances prohibitions, based on specific, contemporaneous, documentable observations concerning the appearance, behavior, speech, or body odors of that driver. in the case of controlled substances, die observations may include indicators of chronic and withdrawal effects of controlled substances. • Refusal Io submit to a rxanhxd alcohol test includes fai€ure to appear for any lest, failure to provide a breath or saliva specimen for a required lest, failure to remain at the tailing silo until the testing process is complete, failure to provide asufFhcient breath specimen without a medical explanation, fa€lure to undergo a medical examination following inability to provide a sufficient breath specimen, refusal to sign Step 2 of the Alcohol Testing Form, and failure to cooperate Mth the testing process. • Refusal to $Hb!nIL.JQ8 r tired dmg lest includes failure to appear for any lest within a reasonable time, failure to remain at the collection site until the testing process is complete, refusal to provide a urine specimen for arequired drug lest, failure to permit a directly observed or monitored collection when required, failure to provide a sufficient amount of urine Without a medical explanation, failure to take second lest Wien required by a collector or by his/her employer, failure to undergo a medical exanvnalion following inability to provide a sufficient urine sample, and failure Io cooperate with the collection/testing process (including refusing to empty pockets at the collection site), Under each employer's independent authority, an employee/driver who refuses to submit to required alcohol and drug testing sill be terminated from employment. • Safety -sensitive function means all time from the time a driver begins to work or is required to be in readiness to work until the time he/she is relieved from work and all responsibility for performing nork. Safety - sensitive ftahclions shall include: a) All lime at an employerer shipper plant, lemsinal, facility, or other property, or on any public property, wailing to be dispatched, unless the driver has been relieved from duty by The employer; b) All lime inspecting equipment as required by §§ 392.7 and 392.5 or odiensise inspecting, servicing, or conditioning any commercial motor vehicle at any time; e) All time spent at The driving controls of a commercial amlor vehicle in operation, d)ABlimo,other than driving time, in or upon any commercial motor vehicle except lime spurt msling in a sleeper berth (a berth conforming to the requirements of §393.76); o) All lime loading orunloading a vehicle, supervising, or assisting in die loading or unloading, attending a vehicle being loaded or unloaded, remaining in readiness to operate die vehicle, or in giving or receiving receipts for shipments loaded or unloaded; and 1) All time repairing, obtaining assistance, or remaining in attendance upon a disabled vehicle. A driver is considered to be performing a safety-sensilive functions during any period in sshich helsho is aclually performing, ready in perform, or immediately available to perform safety' -sensitive functions. • Scrrenine test (for alcohol) means an analytical procedure to determine whether a driver may have a prohibited concentration ofalcohol in a saliva or breath specimen. • Semen InP Test Technician ISM means a person tirho instmcls and assists employees in the alcohol testing process and operates an ASD (Alcohol Screening Device). • Substance Abuse Proressional (SAPI means a licensed physician (Medical Doctor or Doctor of Osteopathy), or a licensed or certified psychologist, social worker, employee assistance professional, or addiction counselor(certifted by the National Association of Alcoholism and Drug Abuse Counselors Certification Commission [NAADAC) or by die International Certification Reciprocity ConsodiunJAle0h0l & Other Drag Abuse [ICRC]), or by the National Board of Certified Counselors, Inc., and Affiliates/ Master Addiclions Counselor (NBCC), with knowledge of and clinical experience in the diagnosis mid treatment of alcohol and controlled substances -related disorders. A SAP evaluales employees wltohm•e violated a DOT drug and alcohol regulation and makes recommendations concerning education, treatment, faitowv-up Wing, and aftercare. Substituted specimen means a specimen with creatinine and specific gravity values dint are so diminished that they are not consistent with human urine. • Testing levels means levels established by Ole U.S. DIIHS, at which a specimen or sample is determined to he either negative or positive, according to 49 CPR §40, Procedures for Tramillortalion Work lace Drum and Alcohol Testing Programs. D_ Trs-rs ReQinurn As provided in D.S. Department o€Transportation rules and regulations, a driver who must possess a CDL shall be subject to pre-emplaymentlpre-placement testing (drug only), and random, reasonable suspicion, post -accident, relum-lo- duly and follow,up testing for alcohol and controlled substances. ], Pre-em fo nientl PrnEllflcemenl.Ttsflltz Every applicant for a driving position w%ho receives a job offer from a BCRC contractor puTlicipanl must submit to a urine drug lest. Thejob o1Ter is contingent on the applicant's providing a negative lest result. Each applicant will be asked whelherheAhe has tested posili%e, or refused to lest, on any DOT pre -employment drug or alcohol lest for a DOT eniplayerdunnglhepre%viouslwn),ears, Anapplicanlwhohaspreviotuly tested positive, or refused to be tested, will not be considered for employment until or unless he/she successfully completes DOTS ream to duly process. (See Section Vlll, Consequences of erobibiled Conduct). DOT does not require a driverlapphcant to submit to a pre-employmenl drug lest if all the following provisions ova mel to an employer's smtsraction', received a SAP's report of complience, including a follow-up testing requirement. ff the applicant is a current employee who is being transferred to a position or assignment that requires the driver to possess a CDL, a negative pre-employmonl drug lesi result must be received before the emptoyee assumes "he new position ar assignment. If the test result is positive, the oiler ofprnmolion or transfer hill be immediately nitrdrm%n, and the employee will be subject to rules drat the employer may have established in a separate drag and alcohol policy for non -DOT employees. When an employer uses but does not employ a driver to operate a Commercial Motor Vehicle more than once a year, the driver will be required to provide aulhoriz lion for the employer to obtain verification tit least once every six (G) montis that the driver is participating in a qualified drug and alcohol testing program, that there have been no refusals to be tested for alcohot or controlled substances, the dates the driver was last lasted for alcohol arhdlor controlled substances, She results of any tests within Ole previous six (6) months and any other violation of prohibited conduct as defined in VI(B) above. If tut employeris tmablo to satisfactorily obtain this information, the driver will W required to submit to a pro-employmenl drug lest with a negative lest result prior to being permdled or requested to provide safely'-sensiln•e runctions for that employer 2, Posl-accident Testing As soon as possible following an accident involving a commercial motor vehicle on a public highway, (See Section VI[C], Definitions), Ole surviving DOT drii er(s) im'oil ad in ilia accident must be tested far alcohol and drugs, a A past -occident alcohol lest, when required, must be administered as soon as possible, but within eight (S) hours follor fog the accident. If testing is required but is not conducted within I%%a (2) hours, the reasons the test was not conducted must be documented_ If lesling is required but is not able to be conducted within The next six (6) hours, the reasons the lest was not conducted must again be documented. After eight (It) hours, there i ii] be no more attempts to conduct an alcohol lest. b. A post -accident dmg lest, when required, must be administered ns soon as possible, but within thirty-u%a (32) hours following Ole accident. If lesling is required but is not able to be conducted w%ilhin thirty -Iwo (32) hours, the reasons the test was not conducted must be documenled. After thirty-swo (32) hours, there will be no more attempts to conduct a drug test- a The employer can verify that the driver has participated in a valid drug testing program (that meets the requirements of IIOT rules and regtdalioiis) within the preceding thirty (30) days; Aril b. %%title participating in flint program, Ole drivedapplicam was either tested within the past six (6) months or was enrolled in a random selection program for the previous livelce (12) monllts; and C. no prior employer of %%horn the employerhas knowledge has record that the driver violated any pad of die DOT rules and regulations regarding controlled substances use within the last six (6) months. ]f the applicant is a new hira, the lesling must be completed, and a negative lest result must be received, before the driver will be permitted to provide safely -sensitive function. [f the pr¢-employment lest result is Positive, the job after will be fnmhediatelg w-ilhdronn, and Ilia applicant will be provided with names of qualified SAPS, The applicant cannot be reconsidered unless and until he/she completes a SAP assessment and recommended assistance (Section VIE], Consequences of Prohibited Conduc ). An applicant who has previously refused to be tested or nho provided a positive lest result on a DOT pre-emplo)rttent WE for controlled substances for any other employer will be expected to report those test results at the time of application. Linder each employer's independent authority, failure to do so will constitute falsification of application information, and %don discovered, will result in removal front consideration for cmploymem, or, if already hired, immediate termioation ofempioymenl. An employer who wishes to reconsider the individual for ample ymeal %%till make such consideration only after the individual has completed a SAP assessment, complied %with the SAP's recommendations, and provided a negative resuh on a Return -to -Doh' East - ]f an applicant has previously complied whit a SAP's recommendations as the m91111 of a violation under a previous employer, the applicant's pre- employment last nil€ be considered to also be a Return -to -Dui% test. When significant time has lapsed since the SAP's report of compliance, an employer may require an additional, second follow-up evaluation to be conducted by a SAP, designated by the employer, to %erifv that die applicant is curready free of drug use, prior to being considered for hire. Tile cost of this SAP evaluation will be paid by the omployer who requests it. An applicant is required to sign a fomr uulheriAlip the hiring employer to obtain from all previous employers (in the previous three 13] years) a report of all DOT violations, including positive lest results and refusals to be tested. The hiring employer will also request copies of Substance Abuse Professional (SAP) reports related to each of these violations. An applicant with a violation cannot be hired until Ilse hiring employer has A driver who is subject to post accident lesling shall remain readily available for such testing. If the driver is not available for any reason, except for tearing die accident scene for the period necessary to obtain assistance in responding to the accident or to obtain necessary emergency medical rare, an employer will consider the driver to have refused to submit to testing. Under independent authority, a driver who has subnalled to a post- accidenl lest oil) be pemdlled to rettml to safety -sensitive Functions only at the direction of a super isor Even ifhighwav enforcement or other officials conduct a drug or alcohol lest following an accident, drivers are still subject to DOT testing under these employer rules. In the event that federal, stale, or local officials conduct breath or blood tests for the we of alcohol and/or urine tests for the use of controlled substances following an accident, and a DOT lest is required but is not able to be conducted, the tests co dueled by lawn enforcement may meal the requirement of this section, provided "lose tests conform to applicable federal, state, or local requirements. Each employer hill mquesl lest resells and other pertinent documenlalion from such agencies or law enforcement suthontics, and a driver is required to sign a release allowing hisllter employer to obtain such information. Under each employer's independent anlhurity, refusal to sign such a release will be grounds for termination of employment. In ilia event [hat a driver is so seriously injured [hat die driver cannot provide a sample or urine or breath al the lime of die accident, each employer requires that Ole driver provide necessary autorintion for his@her employer to obtain hospital records or other documents that would indicate whetter controlled substances or alcohol were present (and The resuitiug levels) in the driver's body at the time of the accident. Under each employer's independent authority, retusal to sign such a release will W grounds for lornunation aremploymenl- 3. Random Testing A percentage of drivers will be subject to random alcohol and drug testing each year. The percentage of drivers to be tested will be as determined annually by PMCSA and published in the Federal Register in January. (At the etYechce date of Otis policy, the minimum annual percentages are ten [ I(h] percent of tie average number of driver positions for alcohol testing, mid fifty [50] percent of the average number of driver positions for ding testing.) Selections of drivers to be tested shall be done by a scientifically valid method that provides that each driver will have an equal chance of being selected each lime that selections are made While a driver is subject to telling, the driver's name is never removed from tic pool. Thus, a dnvo might be selected more than once during a year. a. Random tests will be unannounced; the dales for random tests will be spread throughout the year. b. A driver mho is selected for random testing will be required to report to the collection site immediately upon notification. If the driver engages in conduct That does not lead to a collection as soon as possible after notification, such conduct will be considered as n refusal to submit to a lest. lhedriver mill he in a duly stales (paid) from the limehelshe leaves to go to the collection site until the time he/she returns from the collection site. u A random test for alcohol shall be scheduled to occur only just priorto, during, orjust after performing asafety-sensilive function, or at any lime dial the driver is in readiness to provide safety - sensitive function- d. A random test for controlled substances can be scheduled at any lime the driver is on duty, and is not related to when the driver is Performing safely-sensilive funclion e, An employee who has been selected for random testing must be tested in that testing period. FMCSA regulations do nor permit a replacement to be named if the selected employee is unavailable for testing. f BCRC will administer its own random selection through a scientifically valid means, mid will maintain all necessary records as required in 49 CFR §382, Subpart D, Recordkeeping. 4, Reasonable SlIMision_Test€ste BCRC shall require an employee 10 submit to drug and/or alcohol testing for reasonable suspicion when a supervisor has reason to believe that an employee has engaged in Prohibited Conduct (See Seclion VI (B), Prohibited Conduct, based on observation of Lhc employee's appearance, behavior, speech, and/or body odor. Such employee conduct most be witnessed and documented by asupervisor who has been trained in compliance mitt FMCSA rules and regulations. Should asupervisor determine that an employee might have violated a prohibition of these regulations, the employee must submit to testing. Documentmion is required for both drug and alcohol reasonable suspicion. Documentation for a drug test must be signed and submitted 10 the DER within 24 hours, and for an alcohol lest, prior to the conducting of the alcohol test - An employee who is represented by a bargaining unit and who is requested by a supervisor to submit to reasonable suspicion testing may request to have a union representative present, provided the employee signs a consent for the supervisorio nalify the union representative of the request for testing. When the suspicion involves drugs only, the employer will allow a maximum of one-half hour for the union representative to arrive and accompany the employee through the collection process. When prohhibited conduct- A Substance Abuse Professional (SAP) may, however, order testing for both alcohol and controlled substances. Each employer reserves the right to withhold a final decision regarding reinstatement of a driver until after a negative result of a Reium-to-Duty test has been received. A positive Return-to•Daty lest result is not considered to be an employee's second positive test, and is therefore not cause for Lamination. An employee may schedule additional Relum-to-Duty tests, until such time as a negative result is obtained. Under independem authority, an employer nifty require that The cost of Reium-lo-Duly tests will be bome by The driver. fi. Follow-up Testing A driver, who relums to duty after complying with the recommendation of a Substance Abuse Professional and after providing a negative result on a Reium-ta-Duly test, is subject to unannounced follow-up alcohol and/or controlled substances testing as directed by the Substance Abuse Professional. Follow-up testing may be scheduled for a period of up to silty (60) months, and must include no fewer than six (6) tests to be conducted in tire first twelve (f2) months after fire employee's retum-lo- duty date. Follow-up alcohol testing shall be conducted only just prior to, during, erjust after the drivers performance ofsafely-sensitive functions, or ssiten the driver is in readiness to perfomu safely -sensitive function Under independent authority, each employer may require that the cost of all follow-up tests nil€ be bome by the driver. When on employer, under independent authority, has leminated a driver from employment, the responsibility for any remaining follow-up tests recommended by a SAP must be assumed by the driver's gaining employer, provided the driver is offered employment as a DOT -covered employee nith anew employer. If anewly-hired driver is subject to follow-up testing due to a previous violation while working for a previous employer, that driver mill, under independent authority, be responsible for the east of any remaining follow-up tests as required by the Substance Abuse Professional, and such costs, if not paid by cash or personal check, will be deducted from the driver's r ext paycheck. E. GENERAL TESTING INFOUTATION(STANDARDSAND INTEGRITY OF TiELT1:s7iNG PROCESS) I. All tests shall be conducted as specified in 49 CFR §40, 2. An applicant or driver Its We right la request and receive from histher employer a copy of the test result report on any drug or alcohol test for which he/she provided n urine or breath sample. For alcohol test results, the request, in writing, should be addressed to the employer's DER. For drug tests, the Wesopicion involves alcohol only, or alcohol and drugs, the union representative may he notified, but because DOT requires alcohol testing to occurin a timely manner, the half-hour time allowance mill not apply. If the union representative is not immediately available, he/she may have to arrange independent transportation to the collection site, as regulations do not allow for delay of flue collection process. Observation and testing for reasonable suspicion for controlled substances use can occur at any time the employee is on duty, and is not related to when helshe performs safety-sensilive functions. A trained supervisor's detennination will be based on observation ofan emplaycc's appearance, behavior, speech andlor body odor, and on chronic Pad withdrawal effects erring use. An employee stho is suspected ofcontrolled substances use muss be immediately withdrmsn from safety -sensitive functions and is required to tmdergo drug testing, Obsen'olion and testing for reasonable suspicion for alcohol use can occur onlyjust prior in, during, orjust after the employee's performance of safety-sensilive function, or at any time that the employee is in readiness to provide safely-sensilive function, A trained supervisor's determination of suspected alcohol use will be based on observation ofan employee's appearance, behavior, speech and/or body odor. An employee who is suspected of alcohol misuse must be immedialely nithdrassn from safety - sensitive functions and cannot return unless an alcohol test has been conducted with an alcohol concentration rival measures less than 0.02, or (if no test is conducted) twenty-four (24) hors have elapsed since the reasonable suspicion determination occurred. An alcohol test far reasonable suspicion should be administered within the first two (2) hours, or within the nest six (6) boars, but no more than eight (8) hours after the initial observation occurred If alcohol testing is not conducted within two (2) hours, the reasons the test was not conducted must be documented. If alcohol testing then is not conducted uithin the nest six (6) hours, the reasons the lest was not conductedmustagoinbedocumented. After eight(8) hours, there will he no more attempts 10 conduct an alcohol test. If no alcohol test is conducted at W, the driver cannot perform safety -sensitive functions until twenty-four (24) hours have elapsed following the original determination of reasonable suspicion of alcohol use. If this emp€oyez must return to safety -sensitive functions before 24 hours have passed, he/she may do so only after taking another alcohol test and receiving a test result below 0.02. 5. RpJ9 rn• ejBrr tyTolin Under DOT regulations, before a driver can be considered for reinstatement aterhaving engaged in prohibited conduct (Section Vl, iBj, Prohibitions), the driver must provide a r 4palive Relum-to-Duty drug and/or alcohol lest, depending on the substance(s) involved in the request can be either verbal or in writing, and addressed to flue MRO. 3. Collection and testing procedures will be such as to protect the driver and the integrity of the tesdag process, safeguard the validity of the test results, and ensure that test results are attributed to the correct driver, 4, When on employee is required to obtain a medical examination by a medical specialist (related to the employee's inability to provide a sufficient breath or urine specimen), under each employer's independent authority, the emp€oye , will be required to pay the costs associated with that eamination. F. A.cowi, TFsniLa AND ME REPOaTa:a oFTEST RFsuL75 1. Alcohol tests (screening and confirmatory) mill be performed on a device that appears on the National Highway Traffic Safety Administration's (NHTSA) Conforming Products List (CPL) and that meets the DOT's testing requirements. 2. When a specific lime for an employee's test has been scheduled, and the employee does not appear al the collection site at the scheduled time, the BAT will courtier the employers DER, who may determine that the employee has refused to be tested. 3. For alcohol testing (screening and confirmatory), a breath sample will be collected and analyzed by a Breath Alcohol Technician (BAT) using an Evidential Breath Testing device (EBT). For the screening test, a saliva sample may be collected by a Screening Test Technician, rising an Alcohol Screening Device 4. If the result of the screening lest indicates an alcohol concentration ofO.02 or greater, a Breath Alcohol Technician (BAT) nill perform a confirmatory test, no less Won fineen (15) and no more than thirty (30) laminas afterthe completion of We screening lest. 5. If the confirmatory test is positive (0.04 and above BrAC), the Breath Alcohol Technician (BAT) shall inunediate€y nnlify the cnhployer's DER, 6, Random, reasonable suspicion and follow-up alcohol testing must be conducted jusl before, during, orjust after a driver performs safety -sensitive function, or at any time the driver is in readiness to perform safety -sensitive functions. 7. Results of additional tests arranged by an employee, or requested by a medical pmclitioner, alit not be considered. This includes testing of blood samples, hair samples, DNA, or arty other testing methods or protocols. G. CONTROLLED SuBsTANCFS TESTING, TBE MRO PROCESS AND REPORTING OF TuST RESULTS 1. All controlled substances testing specimens shall be analyzed by a laboratory that is approved by the U. S. Department ofHeahth and Hour" Services (DHHS), and thm observes applicable cb tin -of -custody procedures. 2, When a specific lime for an employee's less has been scheduled, and the employee does not appear at the collection site at the scheduled time, the collection site personnel will contact an employer's DER, who may determine that the employee has refused to be tested, At the collection site, the employee will be required to empty his/her pockets and display the items in them. A refusal to empty all pockets as directed b7 the collector will be a refusal to be tested. 3. If a urine specimen temperature is outside the acceptable range (q11— INl degrees F,), the collector must immediately require a new collection, =der direct observation. An employee who refuses to provide a second specimen, (Ir who refuses to permit a direct obseryatun collection, will be determined to have refused to be tested. 4 The DFBiS-approved testing laboratory shall forward the results of every drug test to a BCRC-designated Medical Review Officer (MRO) for review. 5. If a test result is negative, the result will be reported by the MRO to the employer's DER. C. If a lest result is non -negative, the MRO shall contact Ole driver, mid will give the driver an opportunity to discuss die lest results prior to making a final decision to verify a tell result, The MRO shall inform the driver of hiaer right to request a retest of the same specimen at a different DHHS-approved laboratory. Such request must be made by the driver within seventy-two (72) hours of file driver having been informed of a verified positive lest result, unless The driver presents inrornialhon to the MRO documenting that serious illness, injury, inability to coolact The MRO, lack o€actual knowledge orthe verified positive lest, or other circumstances unavoidably prevented die employee from contacting the MRO within 72 hours_ If the MRO concludes that there is a legitimate explanation fur the employee's failure to contact the MRO within 72 hours, the MRO shall direct that the reanalysis of the specimen be performed, T An employer, =der independent authority, will require that the cost of a retest Shall be Loma by the driver, and will be deducted from the driver's subsequent paycheck. S, If, after making 3 attempts in a 24-hour period, [lie MRO is not able to contact a drivcr, the MRO shall repair to the umploy'rr's DER that all reasonable efforts have been made to contact the driver, % illhoul success- The DER shall then, as soon as practicable, ask the driver to contact the MRO within the net 72 hours, and shall apprise the MRO that the driver has been so notified_ )_ The MRO may verify a test as positive without communicating with the driver r€ a. The driver expressly declines the opportunity to discuss Ole lest result; or b. Thu employer's DER has successfully made and documented a an identified person as directed by the specific, written consent of Ole driver =0horizing the release of Ole information. Vill. CONSEQUENCES OF PROHIBITED CONDUCT When a DER receives notice of a driver's verified posilivc drug or alcohol Irst result, or of a verified refusal to W lesled, or of any other violation of FMCSA rules (See Section VIJBJ, Prohibited Conduct , the driver will be immediately removed from nil FMCSA safety -sensitive functions (see definition), including driving, and will not be permitted or required to return to performing safety- sensitive functions until or notes the employee successfully completes the relum-lo-duty process that is required by FMCSA under this regulation. This includes a supervisor or manager having actual know ledge (see definition) [hat a driverhas used alcohol on duly, or a controlled substance on duty, without authorization. The employer's DER will provide the driver with the phone number of RCRC's Employee Assistance Program, who will in turn direct the driver to qualified SAPS, Under independent authority, each employer will accept eyalu lions conducted only by EAP-recommended SAPs. Additionally, DOT regulations do not Permit an employee to obtain a second SAP's evaluation, trialemployeo does obtain a second SAP's opinion, DOT regulations do not permit an employer to acknowledge lint second opinion. if an npplicanl intends to reapply to an employer, or to another transportation industry employer, lidshe must first successfully complete a SAP osessmenl and recommendalion. A driver who refuses to submit to testing will, under each employer's independent authority, be lenninated from employment, and Hill W provided with names, addresses and phone number of qualified SAPS and of available Ireatmem resources. DOT rules and regulations do not permit an employer to consider a driver For return to safe( y-waiilive Functions until the 4Hm er has been evaluatedqua by a qualified SAP, and has corhrplicd with the SAP's wcomniendalion(s) for rehabilitation andlor education. If and when possible, an employer may reassign a driver to non -safely -sensitive functions while helsle is following me SAP's rocommcaded program of assistance and/or education. However, due to the safety -sensitive nature of most of Ihejolis in this industry, no employer con guarantee that these accommodations can or will be made. For employers with more than 50 employees, a driver who is following a SAP's reconmtendalim urtreatmenl play access beneflls under Family and Medical Leave Act (FLMA), provided holshe is eligible for such benefits. Under separate authority, employers may permit a driver who has been removed from safety -sensitive functions under these regulations to request to receive gamed lime olf and/or vacation time benefils during the assessment and/or treatment phase. Upon receiving a SAP's report ofcompliancc with recommendations, each employer will arrange for the driver to take a Retur-to-Duly test In order for the employee to relum to safety -sensitive ftmclions, this Retum-to-Duty test must have n negative lest result, Under independent authority, each employer SNIT require that any costs incurred In regard to services provided by a SAP, or of treatment and/or education recommended by the contact nillr the driver and instmcled the driver to contact the MRO and more their 72 hours have passed since the time the employee was successfully contacted by the DER; or C. Neither the MRO nor the DER, after making all reasonable efforls, has been able to contact the employee within Ili doys of lire dale on which the MRO receives the confirmed positive test result from Ole laboratory. Ili. If a test is verified positive under the cilcumnslwces specified in 4In above, the driver may, within fill days, present to the MRO information documealtag that serous illness, injury or artier envumslances unavoidably prevented the driver from being contacted by the MRO orhisntor employer's DER, or from contacting die hIRO, as applicable, within lie limes provided. Tile MRO, on the basis ofsuch information, inky reopen the verification, allowing the driver to present information concerning a legitimate explanation for the confirmed posilive lest. If the MRO concludes that there is a legitimate explanation, llte MRO will declare the tell to be negative. 11. When a required drug lest (pre-employmem, relum-lo-duly, or follow-up) is canceled, the employee will be required to immediately take mother test, with minimum advance notice, 12. Results of additional tests that are arranged by an employee, or requesled by a medical practitioner, will not be Considered. Timis includes tolingo€blood samples, ho€rsamples, DNA, or any other testing mclltods or protocols_ 13. When a ding lest is reported as positive dilute (or negative dilute), the test result will he considered to be positive (or negative), respectively, 14. If, in the MRO's opinion, the employee provides information that medically disqualifies the employee from providing safety -sensitive functions, or that causes the MRO to have concern about the employee's ability to sorely perform his/her safety-sensilive duties, die MRO is required to give that infornmlion to an employer's DER. After verifying the lest results, die hIRO shall report the test results in a confidential loaner to the employer's DER. 15. Verified test results will be rcpor€ed by an MRO as either positive, negative, invalid, refused, or canceled_ VII, TEST RECORDS Records pertaining to the alcohol and controlled substances testing program shall be maintained in secured aad locked confidential files in the office ofeach employer's DER. Access to these records shall be limited 10 each employer's management officials on a need -to -know basis, Records mid report data shall be maintained as specified In U.S. DOT's rules and regulations. Except as required by law or expressly authorized or required by FMCSA's lulus and regulations, driver testing information maintained under the alcohol and controlled substances lesling program will be released only Sp the driver (on written request), or to SAP, which are not covered by a driver's insurance plan or by BCRC's Employ" Assislmlce Program, will be Ole responsibility of the driver. When a SAP requires a driver to participate in a program of aherrare, the driver's compliance with that requirement will he monitored by the EAP or the SAP. Under independent nuthority, any costs related to this monitoring will be the responsibility of the driver. The aftercare requirement will be included in a Relum4o-Duly Agreement, which most be signed by the driver. Failure to sign such agreement, or failure to adhere to terms teu of a signed agreement, will result in termination of employment. IX, BDUCATEON ANDTRA[N1NG Any employee who has questions or concerns regarding this policy may seek chvificalion and further details from hiOher employer's DER. EN PLOVFE ASSISTANCE PROGRAM (EAP) BCRC provides a comprehensive Employee Assistance Program (EAP) for employees of all contractor participants in the association. our EAP is accessible by a toll -free phone number. Employees are encouraged to access lire EAP for consultation and assistance regarding non -work -related problems that are or could potentially affect their ability to perform theirjobs satisfactorily or safely, including problems nillt alcohol misuse or the use of controlled substances, Educational materials, including a copy of this policy, and infomlation concerning Ole eRecls ofalcahol and courrol€ed substances use on ran individual's Ihealtt, work and personal life, signs and symptoms of an alcohol or controlled substances problem (the employee cnworkcr's) mid availablo nhelbuds for Pntervcning whorl all alcohol or controlled substances problem is suspected, will be provided to well employee. Additional materials may be requested and answers to questions about the materials may be obtained by coal acting his/her employer's DER. Attendance at training programs will be mandator, for supervisors and other employees im oh ed in administering die drug/olcohpl testing pmgmnL Supervisors who are designated to determine whethor or not reasonable suspicion ecisls and who then order a DOT FMCSA-covered employee to undergo testing =der FMCSA rules and regulations, will receive al least bit adnules of training on recognizing alcohol misuse, and at least 60 minutes orloming on recpymi Jng controlled substances use The training shall cover the physical, behavioral, speech, and performance indicators of probable alcohol nvsuse and use ofcontrolied substances, All supervisors wino participate in training will be given a certificate of completion of such training, The original certificate will be kept in Company records, and a copy will be provided to each supervisor forhislher own records, when requested, DRUG -FREE WORKPLACE EDUCATION BCRC employers are committed to a Drug -Free Awareness program For all employees_ Each employer will use that program in an ongoing educational effort to prevent and eliminate drug and alcohol abuse [hat may affect the workplace. The Drug -Free Awareness program Hill inform employees and their families about the dangers of alcohol and drug abuse in the workplace, of file employer's alcohol and drug policy, the availability of treatment for employees who voluntarily seek such assistance (including the Employee Assistance Program), and the consequences imposed by the employer on employees who violate the alcohol and drug policy. SELF -IDENTIFICATION PROGRAM AND POLICY BCRC encourages drivers vsdlo recognize that they may have a problem Ailh drugs and/or alcohol to seek assistance for resolving that problem before they have a DOT violation due to a positive test result or because they engaged in other DOT prohibited conduct. A diner who admits to a drug and/or alcohol problem will not have a DOT violation. Helshe will be given an opportunity to obtain a chemical use assessment from BCRC's Employee Assis€ante program (PAP). Prior to Ole assessment, however, each employer will require the driver to sign a release of information that will enable [hat employer's DER to receive the insults of the assessment, and to receive subsequent reports related to the assessment, and the driver's successful completion of all recommendations for assistance. The following conditions must apply to the driver's self -admission-, The driver's admission cannot be made during his/her on -duty time. It must occur prior to the driver's reporting for duty on any particular day. • The driver's admission cannot be made in an attempt to avoid a required DOT drug test. • Under 49 CPR Punt 382.121, DOT requires the employer to remove the driverfrom safely-sensilive functions, including driving. When the employer is satisfied that the driver has complied Aith the EAP's recommendations for assistance, the employer Aill retam Ole driver to safely-sensilive functions, provided that: c Prior to returning to safety -sensitive functions, the driver will be required to provide a nopWve DOT drug and/or alcohol lest result' and o Afler being returned to safety-seas€tive function, the driver nil/ besubject to follon,-up non -DOT testing, as permissible by BCRC's policy for non - DOT dmg end alcohol testing. • A driver who self -identifies under this policy, and who then fails to comply with Ole EAP's recommendations pill be considered to have engaged in conduct prohibited by the DOT in 49 CPR Pan 382, Subpart B, and Ail] not be permilled to return to safet•- sensitive function until lidshe has successfully complied pith the SAP return -to -duty process. Each BCRC employer Aill adhere to the following terms, in accordance wits 49 CPR Pan 392.121; ACKNOWLEDGEMENT AND AGREEMENT FORM FOR CONTRACTOR PARTICIPANTS WHO ARE CONTRIBUTING MEMBERS OF BUILDING AND CONSTRUCTION RESOURCE CENTER (BCRC) Contractor Participant: This acknowledges the receipt o€BCRC's Drug and Alcohol Policy in compliance with: © 49 CFR Part 382 (FMCSA) ❑ 49 CPR Pan 199 (RSPA) In addition, I understand that as an employer who is subject to federal requirements, laws and regulations related to misuse of alcohol and use of controlled substances, I am responsible for all requirements of compliance Aith these rules, i understand that my company is subject to DOT - levied sanctions and lines for non -compliant services. As an employer, I agree to: • Provide a copy of this policy, to all current employees iv he are subject to these rules. Require each employee to sign an Acknowledgement of Receipl of this policy; an employee wiho refuses to sign Rill be removed from safety.sensilive functions. • Give each applicant an opportunity to review the policy at the time of app€ication for employment, and Rill sign a form acknowledging that he/she has seen the policy. • Arrange for each manager/supervisor to receive training as required by the regulations of the transportation mode that apply to the employees he/she supervises, and to maintain documentation of the training in the managedsupervisor's file. Maintain all files and records as specified in the regulations, including a file that identifies all managers and administrators who have responsibilities related to this program, and the nature of those responsibilities. • Maintain a current list ofall employees wlmo are subject to testing under these regulations, and immediately inform BCRC of newly -hired and terminated employees nithin two (2) days of the date of occurrence. • Promote the Employee Assistance Program (EAP) as a reliable and confidential resource for employees who recognize that they may have personal problems related to drug and/or alcohol use • Seek assistance, clarification and guidance front BCRC when questions and problems arise related to the administration of this program - Immediately notify BCRC of aco-compliance problems and issues (known or potential) when they are discovered_ fa Camra:ur YaN:ipaN • No adversejob action Hill be taken against a driver who admits to drug and/or alcohol use under the terms above. • A driver who self-idemtifhes under this program Hill be given reasonable time to obtain the required assessment and assistance, Under independent authority, BCRC requires the assessment process to be initiated within three (3) days of the driver's disclosure. • A driver who complies with all requirements, and 010 complies satisfactorily widen the EAP's reconuuendations forassis€ance, Rill be permitted 10 retam to safety -sensitive functions, + A driver vvho cooperates and successfully complies %i€h this program will not be considered to have had a DOT violation of prohibited conduct under49 CPR Pan 382, Subpart B. THIS DRUG AND AEC 01101.. FOrlcy iS h1OT AN ElI A013JENF CONTRACT, ORAYOFFER OFAh•FVPT.Q)'.VFYT cO,1TWT acne ��rr.+nLr. •se., wrlmawir swau�rr�n,yma iwfn'•rndw„,,om nrizr.ar•+,nwd..,eaorur,nc,<,i Mmr+swrla., oedxeq,nn+rrrrn lw rrn.,wrm o+9�luaxuLar rLawmri�rr. Anq.ro,rser�r�l+XrLolirrLk�rrin +hr �Jllrr Iru:br �hryn iACR. F'ry�[orvrr may,rgaurmuriM1rrofLyai ml'lewduaing rramelwihe,rh , aaW ACKNOWLEDGEMENT OF RECEIPT OF DOT DRUG AND ALCOHOL POLICY AND TESTING PROGRAM FOR NALSH & KELLY, INC. I acknowledge that I have received a copy of the DOT Drug mid Alcohol Policy for WALSH R KELLY, INC. I understand that it is my responsibility to read the policy in its entirety. I understand Lhat as an employee of WALSH & KELLY, INC., I ran required la abide by the rules and regulations established by [his policy, and dial I am subject to consequences if I violate the policy. I understand that The policy may change to comply with federal and slate Ions, and that I may oblain a cumin copy of the policy at any lime during business )sours 6mn my employer's designated employer representative (DER), I understand that if I have any questions about this policy, or if I need ussislance or resources related to alcohol andlor drug -related issues or problems, I only mite those questions and contents to my employer's DER. Name of Gmployee (Print name) Social Security No. Signature of Supervisor or DER Employee's signature vale Instructions: DOT requires all DOT -covered employees in sign this ackmowledgement form. The original of this form Will be retained in the employee's file in compliance with DOT regulations. An emplo) ee alto refuses to sign this acknowledgement foot is disqualified from providing safely -sensitive function for WALSH & KELLY, INC. INFORi1tATION FOR APPLICANTS FOR DOT -COVERED POSITIONS Walsh & Kelly, Inc. Federal ]an'squires aFP]icaiHs ro indicate a]ieJrer Wey bare previously refused colic tested or eicVd u positive test resuh on any pre-employmcm rest for any other DOT employer. Please provide This infnonavon bclorv- l; is a federal ofcnsc to falsify Ibis [n$rmntion- El I lure NOT tested positive on a precmploymenl dmg test for wry other DOT employer in the past are years, nor have I refired to be tested, (If so, please sign helms, and complete the mmainderof dais fomn.) Ll Yes, I tested positive (or I refused to be tested) on a prccmploynical drug test for o rountr DOT employer in the past hso years. (irso, please sign beimv, and do net comin ic.) Sig,ralme ofApplieam Dale Each upplieant for u DOTcovcrcd position at Employer, after heingnotified drat helshe hill be ofcred ajob, must be dmg Icaled, in accordance witii federal rcgulalioirs 49 CFR par13g2_ If Jic test result is positive, or if the applicant noses to submil to a preemployment test, [lie job offer Will be ivilli irawn. We must have a negative test result in our file before are can request or allow an employ" m provide safetvaensitila function for us, The cast of the initial screening lest and the conf sntory test null W paid by (Company Nome), Every applicant who provides a positive test resuh frill hose an opportunity to speak wilh a Medical Revdesv Officer about uny rcccai use or prescription and non-prescription drugs llmt migla csplain the positive test result An applicant whose test result is positive may, within 72 boon, mquesl a re -test, al htsmerowzt expense. The re -lest will be conducted on the same sample as was provided for the initial lest, and must be conducted by a different testing laboratory that meets die requirements of eertificasion DOT's letting requirements_ I have not tested positive (or refused to be tested) on a DOT preemployment drug test, at any lime in the previous two years_ My signilme bctow means thm I hoe road this itd'ormation, Jot I love had an opportunity to review a copy of (Company Name) drug and alcohol testing policy, and Ilia if 1 am oftescd n Position, 1 consent to being tested fordmgs as a condition of empioymem, Signature of Applicant Date 61 62 Agreement BY AND BETIVEEN INDIANA CONSTRUCTORS, INC LABOR RELATION DIVISION And LOCAL UNIONS OF LABORERS' INTERNATIONAL SUBSTANCE ABUSE POLICY UNION OF NORTH AMERICA APPENDIX 3 STATE OF INDIANA DISTRICT COUNCIL MARCH 1, 2012 Through MARCH 31, 2017 Ly 64 SUBSTANCE ABUSE TESTING PROGRAM L POLICY VEATEMENT All signatory Employers to this Agreement and the Union have a commitment to protect people and property, and to provide n safe working environment- The purpose of the following program is to establish and maintain a drug free, alcohol free, safe, healthy work onviroriment for all orits employees covered by this Agreement, IT. DEFINITIONS A. Accident —Any event resulting in injury la a person or property to which an employee contributed as a direct or indirect cause. It Accredited Laboratory — A laboratory certified by the Substance Abuse and Menial Health Sen•ices Administration (SAMHSA) for testing of Prohibitive Items & Substances. C, Adulteration —To degrade a test sample by substilulion or addition of other ingredients in an effort to mask die presence of unauthorized drugs. An adullemled test shall be considered a positive lest. D. Diluted Sample— Urine samples which the laboratory reports as unacceptable widh regards to measured levels of crealinine or specific gravity will be considered diluted samples. The employee shall be required to provide another urine sample for lesting. E. Employees — All individuals who are covered by this Agreement, provided that individuals referred far employment by the Union under the hiring provisions of the Agreement ore considered "Applicants" until They are hired and put to work by the Empluq•er. F. "5-panel US DOT' Approved Test —Describes a laboratory test conducted by a SAMHSA certified laboratory for the presence of one or more of the five drugs or c€asscs of drugs described under the definition of" pmhtb€led items and/or substances" and listed in Seerlon IV.Lb. of the ICI SAT Program. O. Incident— An event which has all the attributes of an accident, except that no hams was caused to person or property. H. 'Wer ical Review Officer (MRO)-' --The MRO is a licensed physician who has knowledge of substance abuse disorders and the appropriate medical training to interpret and evaluate positive substance abuse test results together with the individual's medical history end any otherrelevanl biomedical information. The MRO is the individual responsible for receiving laboratory results. 65 individual's breath specimen in accordance with federal standards; most often a specimen analyzed by a breathalyzer listed on the US DOT's Conforming Products List. 111. CONF€DENTIALITI' A. All parties to this program should encourage any employee with a substance abuse problem to accept assistance in dealing with the problem All parties will take the necessary actions to assure the problem is handled in a confidential manner. B. When a lest is required, die specimen will be identified by a codenumber associated Milli a Chain of Custody Farm to insure confrdemiality of the employee. The employee must witness this procedure. C. Results will be reported to the Employer and the Union by the MRO. IV. RULES -DISCIPLINARY ACTIONS —GRIEVANCE PROCEDURES A. RULES — All employees must report to work in a physical condition that will enable them to perform theirjobs in a safe and efficient manner. Employees shall not: 1. Use, possess, dispense or receive prohibited substances on oral thejab site, or during working hours. 2. Report to work with above the measurable amount ofthe following prohibited substances in their system DRUG OR METABOLITE INITIAL TEST CONFIRMATION TEST DETECTED (GC/MS) Amplwlarnine 1,00a nglml 500 flyml (includes Afelhamplicumane) Cmnabinoid 50 ng/ml 15 ng/m1 (Marijuana, Hashish) Cocaine 300 nglnd 150 nglml Opiate: Morphine, Codeine 2,0V€s nEVml 2,000 ngrnd Phencyclidine (PCP) 25 nwml 25 nglmi Ethanol (Alcohol) .Ud% wlvol .04 wlvol (enzyme assay) ((iC1FD) 1. Not Suitable for Testing -- A urine sample that the Medical Review Officer (MRO) dercrmines as not meeting the requirements For a valid test. After consultation with Ume employee, a retest may be required. F. Premises— All conslmctionjob sites for which the Employer has responsibility This includes all job areas, offices, facilities, land, buildings, structures, and all company vehicles used in the Performance of covered work. R. Probable Cause — Probable cause shall be defined as observable abnormal or erratic behavior such as noticeable imbalance, incoherence, and disorientation. L. Prohibited Items and/or Substances — Prohibited substances include illegal drugs (including controlled substances, look alike drags and designer drugs), prescription drugs used by one for whom they were not prescribed, drug paraphernalia in the personal possession of or being used by an employee on the promises, Also prohibited are alcoholic beverages being consumed by an employee on the premises. M. Random Test — An unannounced test pursuant 10 an objective method for selection. Cost of strah testing will be, paid for by the Indiana Constructors, Inc. Substance Abuse Testing Program (ICI SAT Program). N. Rehabilitation Program — An Employer approved confidential counseling service, designed to help employoes resolve problems that involve alcohol or drug abuse, staffed by certifted and eredenlided human services professionals. Q. Reinstatement — Refers ro the requirements that a person who tested positive for prohibited items end/orsubsiances under the ICI SAT Program must satisfy before he is eligible to return to work. P. Retest — A second separate test necessitated by an adulterated or intentionally diluted sample or a lest considered not suitable for testing. A retest alai is considered as an adulterated or a diluted sample (whether diluted imersiionally or unintentionally), or as a lest not suitable for testing shall be considered a positive test Costs of relenting necessitated by an unintentionally diluted and/or a test considered not suitable for testing will be paid for by the ICI SAT Program Casts of retesting an adulterated or intentionally diluted sample will be paid for by The individual. Q. Substance Abuse Professional(SAP) — A SAP is a licensed physician or a licensed or certified psychologist, social worker, employee assistance professional, or addiction counselor (certified by the National Association of Alcoholism and Drug Abuse Counselors Certification Commission) with knowledge of and clinical experience in the diagnosis and treatment o€disorders relating to alcohol and dmg ab€me- R. Test —Is dcfincd as she collection of an individual's urine specimen and the subsequent 5-panel US DOT analysis of tlml specimen, in accordance vvitm federal standards. For alcohol, a test is defined as the collection and analysis of an 66 New drugs may be added as they are determined to be illegal or considered to be prohibited items and/or substances by mutual agreement. B. DISCIPLINE— When the Employer has probable causeto believe an employee is under the influence of a prohibiled substance, Far reason 017900t3l, the employee may be suspended until test results are available. Woe, test resoles are received after three (3) working days, the employee, if available, $hail be relumed to work with back pay subject to the lest results. If the test results prove negative, the employee shall be returned to work vvith back pay. In ate other eases: 1. Applicants testing positive for drug use will not he hired 2_ Employees who refuse to cooperate willt testing procedures coil€ be subject to immediate lemumatica . Ran individual does not provide a suitable specimen within two. hours (2 boors), it will be considered a refusal and treated as a positive test result and the individual will be subject to immediate termination. 3. Employees found to be in the possession of prohibiled items and/or substances %sit[ be terminated. d. Employees found selling or distributing prohibited items and/or substances will be terminated. Employees who lest above the measured amount of prohibited items and/or substances as provided for in IV. Lb. while on duty, or while operating a company vehicle, will be subject to termination. 5, First Positive Test Result The provisions below apply to an employee who is tested pursuant to this policy and who receives a positive test result a Consequence far First Positive Test Result: The employee is subject to immediate termination, upon notice to the Employer by the MRO, of the positivetest result. b. Reinstatement: Employee is not eligible for work until he has taken, at his own expense, a" 5-panel US DOT' approved lest, at an approved clinic and the results of this lest have been analyzed by a SAMHSA certified laboratory and the lest results must have been reviewed by an MRO and cenified as being negative for the prohibited items and/or substances listed in IV.Lb. and the ICI SAT Program Union and Employer have received thecertified negative test results. c. Sporadic Teslingor Reinstated Employees: Areiris€aledenlployee,who has previously tested positive, is subject to unscheduled sporadic resting for one year from the dale orreinslatement. Cost ofsuch testing will be paid far by the ICI SAT Program, 6. Second Positive Tesl Result: The provisions below apply to an employee who has previously tested positive, and tests positive n second lime pursuant to such random testing, sporadic testing or any other testing underthis policy: a Consequence for Second Positive Test Result: The employee is subject to immediate termination, upon notice to the Employer by the MRO, of the positive test result. b. Reinstatement: Employee is not eligible forwork until Ire has, at his own 67 68 VI. expense, been evaluated by an accredited SAP, successfully completed an SAP recommended rehabilitation program rind the SAP has wrilten a letter releasing the person to return to work and the ICE SAT Program, Union and Employer have received the results of o "5-panel US DOT' approved test, a copy ofthe letter written by the SAP and a copy of the rehabilitation program successful completion letter, taken at an approved clinic, analyzed by a SAMHSA certified laboratory and die lest results must have been reviewed by an MRO and certified as being negative for the prohibited items amucr substances listed in IV.I.b. c Sporadic Testing of Reinstated Employees: A reinstated employee, rho has previously tested positive, is subject to unscheduled sporadic testing for one year from the date of reinslatement- Cost ofsuch testing will he paid for by the ICI SAT Program, 7. Third and Additional Positive Test Ilcsults, The provisions below apply to an employee, who tests positive three or more times pursuant to such random testing, sporadic testing or any other testing under this policy: a Consequence forThird and Additional Positive Test Results: The employee is subject to immediate termination upon notice to the Employer by the MRO, of The posilive lest result and he will not he eligible for reinstatement for a period of six (6) months from date of the positive lest. b. Reinstatement: Employee is not eligible for vvork until lie has, at his own expense, been evaluated by an accredited SAP, successfully completed a SAP recommended rehabilitation program and die SAP has written a Seller releasing the person to retum to work and the ICI SAT Program the Union and Employer have received the results ofn "5-pancl US DOT" approved test, taken at an approved clinic, analyzed by a SAMHSA cerified laboratory, and the lest results must have been reviewed by an MRO and ceniftcd as being negative for the prohibited items andlorsubstancts listed in IV.I.b. e Sporadic Testing; A reinstated employee, who has previously tested positive three (3) or more times, is subject to unscheduled sporadic testing for Iwo (2) years front the dale of reinslatement Cost o€such testing will be paid for by the ICI SAT Program C. PRESCRIPTION DRUGS —Employees using a prescribed medication which may impair the performance of job duties, either mental or motor Functions, must immediately interns their supmisor of such prescription drug use. For die safely of all employees, the Employer sill consult with lite employee to delemune if a reassignment of duties is necessary. Ire reassignment is not possible, the employee will be relieved of duties until released as fit for duty by the prescribing physician, at which little the employee shall be reinstated to his former employment status if work for +which he is qualified is available at that lime. Ef the employcc is tested and the lest is positive, and the employee has not previously informed the Employer of the use of prescription drabs, the employee may, be in IV.2. The test result of the split sample must be released to the Employer within a maximum of five (5) working days. If the split sample test result is negative, the employee may be returned to work on the sane job site providing work for which he is qualified is still uvailnblc. Any employee who successfully challenges the accuracy are positive lest result shall be reimbursed rorhis cost for die second testing and any lime loss from work um p to a maximuof five (3) workdays. If the split sample tests positive, then the employee shall be subject to immediate temunatior Drug and alcohol testing Will be conducted by an accredited laboratory, and may consist of either blood or urine tests, or both, as required. Blood tests (for drugs and alcohol) will be utilized for post -accident investigation only if a urine or breathalyzer lest cannot be administered. A. An ICI SAT identi ficalion card will be issued to each person who tests negative in a Valid Icst. The card will conlaln the Applicant's name, photo and a unique ECI SAT database Edeatification number, The ICI SAT- card will be valid unlil the employee tests positive - The employee shall cam' their valid ICI SAT card whenever lhev are oil a job. Failure to produce the ICI SAT cord on request by the Employer or their agent may cause the employee to be suspended fatal the card is presented or until it is verified by the testing agency that the employee's last test was negative. Replacement of a lost or danmaged ICI SAT card shall he at the employee's expense. B. New hires, with an ICI SAT ideatiLealion card. Iran Applicant has a valid employee ICI SAT card they will present the card for pholocopying to the prospective Employer when they present themselves for employment. The Employer shall lun e the right to further validate the ICE SAT card by contacting tie agency responsible for insuring the employee's ICE SAT card is presently valid. The Applicant Will be placed on the payroll and put to work pending receipt of the result of the inquiry, Employment shall be probationary and continued employment of'16 individual shad€ be eoalEngent upon the validity of the employee's ICI SAT card being verified, The Employer shot] have three days to validate the ICI SAT crud_ If the ICI SAT card is invalid die employee will have no right to continued employment and may he terminated_ C. New hires, without an ICE SAT card. If the Applicant does not have a valid ICE SAT card, employment site][ be probationary and continued employment shall be contingent upon successful passage of the drug and alcohol test. D. When tested for why reason, the employee Will surrender the ICI SAT card to lite testing agent. If the test is negative, the emptoyee's valid ICI SAT card hill be sent to the employee. If the test is positive, the ICE SAT card Will not be returned, VIE, REHABILITATION AND EMPLOYEE ASSISTANCE PROGRAM. suspended for two reeks and is subject to unscheduled sporadic testing for six months. D, GRIEVANCE —Ali aspects ofthis program shall be subject to the grievance procedure spelled out in die Collective Bargaining Agreement. V. I)MGIALCOROL TESTING The parties to this program agree dial under certain circumstances the Employer nil! find that it is necessary for testing to be conducted for prohibited items a»dlor substances pursoant to the fcIlo+ving procedures_ A, A pre -employment drug and alcohol test may be administered to all Applicants ividwut a valid ICI SAT identification card. The Applicant will be placed on the payroll Find put to work pending receipt of the drug and alcohol test. Such employment shall be probationary in die sense that continued employment of the individual shall be contingent upon successful passage of the drug and alcohol lest. B. All employees shrill be subject to random testing. C. A lest may be administered in the event there is probable cause to believe that the employee has reported to work under the influence of a prohibited item and/or substance, or is or has been under the influence of a prohibited item and/or substance While on the job; or the employee has violated this drug program, During the process of establishing probable cause for testing, the employee has the right to request big on -site steward to be present, if avotabie, D. Testing may be required if an employee is involved in a work place accident/incident or injury. E, Employees may also be tested on a voluntary basis. F. Sporadic testing as provided for in IV.2. may be required as part of a follow-up to counseling or rehabilitation for substance abuse, For up to a two (2)-year period. Each Applicant or employee to be tested will be required to sign a consent and chain of custody form, assuring proper documentation and accuracy. ]fan Applicant or employee refuses to sign a consent Form authorizing the test, ongoing employment by tilt Employer will be terminated, The employee shall be paid for the lime lost for the following tests to be conducted, only ifthe test results are negative, Random, Post Accident, Incident, and Probable Cause. The Employer Will permit the employee who is required to lake a drug lest to obtain a "split sample;' and the employee may request the laboratory to send the "split sample" to an accredited laboratory of his choosing, at his osm expense, as described Employees are encouraged to seek help for a drug or alcohol probEcnt before it deteriorates into a disciplinary matter. If an employee voluntarily notifies supervision that he may have a substance abuse problem, the Employer may assist in Ieealing a suitable SAP and rehabilitation program for treatment. The Employer nil€ inform the employee that medical benefits maybe available trader the Health and Welfare Program, For benefit information, within Indiana, call 1-S1AI-962-3158. If treatment necessitates lime away from work, the Employer may provide for the employee an unpaid leave of absence for purposes of participation in an agreed upon Ireatment prograrm An employee who successfully completes a rehabilitation program may be reinstated to ]us former employment status, if work for which he is qualified is available al that time. Employees returning to work aRcr successfully completing the rehabilitation progrant will be subject to drug tests without prior notice For a period of one year. A positive last will Then result in disciplinan• action as previously outlined in this program_ VIII. COST Except as previously noted the costs ruffle tests assecialed With the program will be paid for by the Employer. The cost of a retiabilitalion program and consultation with a SAP silt be tlme responsibility of the enmployee, IX, SUtiSTANC); ABUSE TESTING PROGRAM, A. Each employer agrees to pay to die Indiana Constructors, Inc. Substance Abuse Testing Program ("ICE SAT') thnc 1S0.03) cents for each hour worked by each employee working under this Agreement, Each Employer wfiie participates in the ICI SAT Program is strongly encouraged to contribute to The Indiana Constructors Indwinr Advancement Fund (ICIAF), B. The canribution to the ICI SAT Program shall be deposited each month, or at regular intervals as tiny be determined by the ICI SAT Progrant, to die depositor, designated by the ICI SAT Program and such contributions shall be reported on such Forms as may be designated by the ICI SAT Program. C. The activities shall be determined by the ICE SAT Program and shall be financed Front tie payments provided for herein. The Employer expressly ratifies and adopts the ICI SAT policy. By execution of this Agreement, lite Employer ratifies all actions taken by the ICE SAT Program Within the scope of its nutrorily. This Substance Abuse Testing Program has been ratified, signed and scaled as of bythe Negotiating Committee, Labor Relations Division of Indinna Constructors, Inc Dale Time This Substance Abuse Testing Progranthas been mlifled, signed and scaled as of . by the Local Unions of Laborers' Intcntaliunal Union of North America Slate of Indiana District Counci€, SUBSTANCE ABUSE TESTING PROGRAM AUTHORIZATION FOR CONSENT TO DRUG AND ALCOHOL ANALYSIS AND AUTHORIZATION FOR RELEASE OF RESULTS I, the undersigned do hereby authorize the testing of my body fluids andlor breath for employment reasons and understand and agree that the results of any such testing µill be turned over to the Employer and the Union, further that the testing procedures will be limited to tests for prohibited and illegal drugs and controlled substances nod alcohol. I understand that The results of these tests may be used for employment and disciplinary reasons and hereby authorize the release of such informalion from the laboratories to the designated Employer and Union representatives. I further certify that any urine specimen collected from me is mine and nal adulteraled or uttered in an)' manner. I have been advised that mailers affecting me relalive to the interpretation or application o€the Drug Policy are subject exclusively to Ilia grievance and arbitration procedure under my Collective Bargaining Agreement. Signature ofProslimivo employcOEmployee LETTER OF UNDERSTANDING LEIFIT-R OF UNDERSTANDING FOR THE AGREEMENT by and between Ind€nna Constructors, Ent. Labor Relations Division and the Local Unions off.al—crg' Intermilionid Union of North America Stale of Indiana District Council concerning the Substance Abuse Testing Program. In regard 10 the Substance Abuse Testing Program, it is understood between the parties that under this progmm, the following guidelines µill be followed when a person lesis positive: First Positive Test Results in immediate lamination. For Reinstatement: • Provide a negative "5-panel US DOT" test result as interpreted by an MRO. • Sporadic testing for one(]) year following reinstalemenl- Second Positive Test Results in immediate tennination. For Re€nslalement: • Be evaluated by asr SAP. • Complete an SAP -recommended rehabiiitalion progmm. • Secmu writlen release (runt the SAP to retum to work. • Provide a negative "5-panel US DOT" test resull as ilrtcrpmtcd by an MRO. • Sporadic testing for one year following reinstatement. Third and Additional Positive Test Results in immediate termination; not eligible for reinstatement for six (6) months, For Reinstatement: • Be evaluated by an SAP. • Complete an SAP -recommended rehabilitation program. • Secure written release from the SAP to return to We& • Provide a negative "5-pane€ US DOTT"lest result as interpreted by an MRO. • Sporadic testing toy tun (2) years follwsing reinstatement. FURTHER it is understood that any costs associated with lie SAP, MRO, Rehabiblaaion Program, and testing required to be reinstaled, are the employees responsibility. ir GPa. z c P 0 17 t 0. 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(Contractor) 24358 SR 23 (Address) South Bend IN 46614 FOR PUBLIC WORKS PROJECTS OF City of South Bend, Indiana 2018 Street Paving Project No. 118-070 Filed August 9th 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 I (To be completed for all bids. Please type or print) Date (month, day, year): August 9th, 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 City of South Bend — Dept, of Public Works -- Engineering Dept. and dated June 29, 2018 for the sum of See Attached 8 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) I, 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. I 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 n , 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) 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? 3 4. List references from private firms for which you have performed work. Gatlin Plumbing & Heating, Inc. I I l I E. Main St., Griffith, IN Ms. Clara Murphy _ Gou h Inc. 2200 E. 88"' Dr., Merrillville IN 46410 Mr. Raymond Gough T Dyer Construction Co., 1716 Sheffield Avenue, Dyer, IN Janet Furman Grimmer Construction Co. Inc. 2619 Main Street Hi hland 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 Dum s Various Good Griffith, South Bend 48 '/a and % 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 fi•om 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 swom 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 Bend this ►►►►►1iii41r/4. p'SHCO P• °U „ .L Iry ►►►►►�N��ACKNOWLEDGEMENT STATE OF Indiana ) ) ss COUNTY OF St. JosMh Before me, a Notary Public, personally appeared the above -named Dustin Hilary and swore that the statements contained in the foregoing document are true and correct. Subscribed and sworn to before me this 9111' day of August, 2018 Ali eger, Notary Pub My Commission Expires: June 5, 2022 County of Residence: St. Joseph KRU EGt R wnir,l� ALISHA of Indiana Qt'r•pUs� Notary public, State o •' St se n county SkALi * " MY commission Expires '';•. �vpI PAP �`� .funefl5, 2022 ��1/li li 00\_ Form 96 Section 11, #2 Subcontractors Used on. Public "orbs Contracts During SUBCONTRACTORS COMPANY ADDRESS CITY/STATE/ZIP SEWER B & D Sewer Deboer Egolf Delta III Dyer Construction Catlin Plumbing & Heating Cough, 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. PAVEMENT MARKINGS The Airmarking Company Blackout Sealcoating Road Safe Traffic Systems State Barricading, Inc. Traffic Control Specialists, Inc. Traffic Management Company TRAFFIC CONTROL RoadSafe Traffic Systems Traffic Control Specialists, Inc. Traffic Management Comoanv 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 Schiller Avenue P.Q. Box 41 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 (219) 322-2300 (219) 763-9700 (219) 797-4004 (219) 865-2961 (219)924-6972 (219)756-2200 (219) 924-1623 (219 )932-1611 (574) 271-7800 (219)322-8090 (219) 474-6542 (219) 872-8605 (219) 865-0065 (219) 763-9703 (219) 797-3008 (219) 865-2963 (219) 924-1401 (219) 756-2202 (219) 924-0328 (219) 932-6829 (574)271-0524 (219) 322-0031 19) 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) 282-2751 (812) 283-9846 209 Quality Ave. Ste 9 New Albany, IN 47150 (812) 941-0252 (812) 941-0852 9350 E. 30th St, Indianapolis, 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 2.0 1810 W Pacific Avenue 3542 Highwav Avenue 3122 Olympia Dr 1810 W Pacific Avenue 3542 Hlghwav 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 46410 South Bend', IN 46619 Crown Point, 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 (2119) 769-6007 (574) 272-9673 (219) 662-8090 (219) 397-4444 (317) 780-1825 (574) 287-2078 (574)772-7001 «««« (219) 769-0565 (574) 271-0144 (219) 662-8093 (219) 397-8888 74)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) 374-9960 6 GUARDRAIL/FENCING Acorn Fence 2041164th Street Hammond, IN 46320 (219) 844-8400 (219) 844-8441 C Tech Corporation, 5300 W. 100 North Boggstown, IN 46110 (317) 835-2745 (317) 835-2781 James H. Drew Company 8701 Zionsville Rd. Indianapolis, IN 46268 (317) 876-3739 (317) 876-3829 Security Industries 1000 Georgiana. 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 TRUCKINGfHAULING C. Lee Construction Services 1011 S. Lake St Gary, IN 46403 (219) 888-9554 (219) 888-9564 Condon Trucking, LLC 18245 Amberley Ln South Bend, IN 46637 (574) 360-4326 (574) 271-8984 Fanio ,Services 28015 SIR 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. 10526 W4` US Hwy 30 IBld WWanatah, ]'IN 46390 (219) 733-9430 7 P &. C Trucking 4410 Ross Road Gary, IN 46408 (219) 972-0193 Superior Construction Co., Inc. 1455 Louis Sullivan Dr Portage, IN 46368 (219) 787-0850 V & R Trucking, Inc. 1845 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) 482-6284 UNIDERSEAL R1eth-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 (816) 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 Rock 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. 1,1800 S Ewing Ave Chicago, IL 60617 (773) 978-5000 Quality Saw & Seal, Inc. 7600 W. 79th Street Bridgeview, IL 60455 (773) 767-9300 SEAL COATING/STRIPING Site Services, Inc. 10117 Kennedy Ave Highland, IN 46322 (219) 924-9944 Blackout Sealcoating 7440 W. 87th Place Bridgview, 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 state 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. fA Corporation Address 24358 SR 23 South Bend IN 46614 Date submitted Auggst 9t' 2018 A.E. BOYCE CO., MUNCIE, INN. 1 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.) See, 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, officcr or agent each bidder shall be required to submit under oath with and as a part 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. 2 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 & Kelly, 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. l . 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 8. For what corporation or individuals have you performed work, and to whom do you refer? BP Amoco Whitin Indiana Tonn & Blank Construction 1623 Greenwood Ave., Michigan City, IN 46360 Grimmer Construction Co. Inc. 2619 Main Street Highland, IN 46322 University of Notre Dame, South Bend Indiana Gough, Inc. 1151 E. Summit Crown Point IN 46307 9. For what cities have you perfonned 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 County Highway Superintendent Crown Point IN Porter County Highway Superintendent Valparaiso, IN St. Joseph County Highway Superintendent South Bend IN Elkhart Count Hi hwa Su erintendent ElkhartIN 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 Indianapolis, 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 Dept. of Administration Indiana olis IN Federal Highway Administration Sterling, VA 13, What is the construction experience of the principal individual of your organization? tNDIVIDUAL`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. En ineerin David J. Misirly Vice President 33 Bituminous Paving Engineer Greg A. Hoffman Vice President 31 Bituminous Paving Engineer John C. Wall Vice President 41 All types En ineer John M. Pcisker 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 M r 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 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 Inspections 2. Explain your plan or layout for performing the proposed work As directed by owner/engincer The work, if awarded to you, will have the personal supervision of whom? Kevin J. Kelly, Jeffrey L. Swan David J. Misirly, Greyojy A. Hoffman Dustin P. HilaKy, 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 Sli form Conc. Paver Various Good Griffith, South Bend. 3 Road Widener Various Good Griffith, South Bend S 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 4 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 9`l` day of August, 2018 .�®"0�jIlm `g�Walsh 1 Inc �.. , (Name of4Hilaa,VP r�TF 0 By ustin itle of Person Signing) STATE OF Indiana 1 NO\-piP+®®�®� l®rIi9918�®�l {(SS. COUNTY OF. St. Joseph Dustin Hilary being duly sworn deposes and says that he is VP of South Bend Area of the above Walsh & Kelly, 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 9t" day of. August, 2018 Alisha Krueger, Notary Public Q My Commission expires � June 5, 2022 _ ALISHA KRUEGER Notary Public. Stato o{ India g ~ h county St. SoseA SEAL', x ? MY cprr,mi 3sior, Ey,plres Suns p5, 2U22