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Opening of Bids - Spec S - One or More 2018 or Newer Emergency Medical Vehicle - Horton Emergency Vehicle - Part 1
CITY OF SOUTH BEND, INDIANA SELLER'S BIID FOR SALE OR LEASE OF MATERIALS BID NAME SPOC S—O'. (1 or M.,. 2018 �), Newer Eimerg—cy Meth —I Vehicle FOR BIDS DUE 28.2018 9:30 .— Bidder Date: t4,�,e 46W exerce"q Address: tA O_L�aortl kaa-a City/State/Zip: GftwLL,4,, ak4)j)6,j Telephone Number: (6/7) W (e - g AT,9 Agent of Bidder (if Applicable): A_ Wile" thoprospectjve Coorractor is tionwo to certify to ayattht.tts b.lcw, rtshaff.tth ., expl-1.0— tcthiAftid. vit. CONTRACTOR'SNON-COLLUSlON AND NOWDEBARMENTAFFI DAVIT, CER-11FICATION REGARDING INVESTIVIENTWITH IRAN, EMPLOYMENT ELIGI(ILITYVERIFICATION, NON-DISCRIMI NATION 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 XMJ.0,4 ) SS: COUNTY The undersigned Contractor, being duty 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. Conti -actor 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 1 Conti -actor 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 fi-om participation in this transaction by any Federal department or agency; and 3, Contractor has not, nor has any successor to, nor an affiliate of, Conti -actor, 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. PA b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote, and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE, A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. 1, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subJect to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this *4- day of -0/1 Ark 2 �or-�qm F--A,, t r eN oLk AA. U-ej Co;ntractor/ffi der (Fifrn) S6 of Contractor/Bidder or Its Agent Rj,r+ 4 — &,'&- Printed Name anTale Subscribed and sworn to before one this My Commission Expires / 0 - 011�' 1� "i County of Residence DESTANIE N. STOUT Seal Notary Public • State of Indiana St Joseph County My Commission Expires Oct 28. 2024 .day of Notary Public S o h BID/PROPOSAL CITY OF SOUTH BEND BIDNAME Spec S�One (1) or More 2018 or Newer Iniorgency Medical Vehicle FOR BIDS DUE A - g a , 28, 2018 ,, 9:30 ., -, Description Year/Ma ke/Mo d e I Unit P,I,. 1404%h LtALKCX— zoaa Year Me ke/Model — Trade I I Uri it Price $ Option# Description Cost Total Bidder (Firm): Address: 3800 City/State/Zip: 0410 4131az,3 Telephone Number: 5'g9eh" FaxNumber-. I.. 62 BOARD OF PUBLIC WORKS ATTEST: Linda M. Martin, Clerk Gary A. Gilot, President James Mueller, Member Therese Dorau, Member Elizabeth Maradik, Member Suzanna Fritzberg, Member 63 NOW,', 574Y 235-9251 ('I'l Y 01-" Sol) 1 it llml) PF rr Bi i i riuirxj, MAYOR hX 574/ 235.9171 BO.ARD OF PUBHC WORKS 1316 CmNry-("rt ry Bufumo 227 W. hTFERSON BOULEVAIW SMMI BEND, INDIANA 4,0601-1830 Date: August 17,2018 'ro: All Planholders From Linda M. Martin, Clerk, Board of Public Works Subject Addendum Number- I I Project Name: Spec S — One (1) or More 2018 or Newer lEmergency Medical Vehicle Project Number: ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM .7Date Receiv,d. 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 48 hours of receipt. A copy MUST also be included with your bid package upon submittal. Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: Avr�a Authorized Signature: D.L,, Version 8/10/2018 PRONE 5741235-9251 CITY OF SOU111 BIN) PE•I k BUITIME6, MAYOR FAX 574/ 235-9171 BOARD OF PUBUC WORKS 1316 C'ouNiy-Crry BUILDING 227 W. JUITERSON 13001-LVA10) SOUM DEND, ITAHAN,N 46001-1830 PROJECT NAME: Spec S — One (1) or More 2018 or Newer Emergency Medical Vehicle ADDENDUM NO. I Date: August 17, 2018 To: All Plan Holders From: Linda M. Martin, Clerk of the Board of Public Works The following information is to be added/changed to the contract documents: Add Alternate I with con-esponding specifications as well as a new bid sheet. You must acknowledge receipt of this addendum by signing the first page, returning it via facsimile to (574) 235-9171, and a copy of the first page must be included with your bid, —This addendum consists of a total of 6 pages -- Alternate 1: Liquid Spring Rear Kneeling A Liquid Spring rear hydraulic strut suspension shall be �YFS, Suspension: installed in, lieu of the standard rear OEM air bag 0 suspension. The suspension company shall be QS9000 and ISO 9001 certified for excellence. The liquid suspension shall be rated at 12,000 pounds CTAWR and installed per Liquid Spring Directions. Suspension Installation instructions and drawings shall be followed. All guidelines regarding chassis and axle capacity ratings as published by chassis manufacturer shall be adhered to. Mechanical The control arms shall be connected to a replacement front Suspension hanger that features tipper and lower control arm pivot &0 Components: points and a connection point for a heavy duty sway bar. Both Liquid Spring struts shall be positioned directly aft of Ithe axle and outboard of frame rails. The designed ride height shall maintain original suspension's drive -line geometry. Tracking Bar: The suspension shall utilize a lateral control rod (tracking bar) to maintain side to side axle position related to the S S 0 chassis frame. Wear shoes, mounted to the sides of the frame rails are not acceptable. Hydraulic All hydraulic lines, fittings, reservoirs and valves shall be System: protected against "stone pecking". Abrasion covers, such ...Is 0 as nylon convolute loorn over the lines are required. The entire assembled system shall be tested for leaks at every fitting connection point. Mechanical Quality All fasteners related to the suspension assembly are considered critical. All fasteners shall be tightened to the 6_>S0 Assurance: manufacturer's recommended torque by the primary installation mechanic. A secondary mechanic shall "put a wrench" and re -torque ALL of the fasteners and then spray a contrasting color of paint onto the heads and nuts of each fastener. Suspension A suspension jounce clearance study shall be performed Jounce Study: throughout the full range of suspension travel to ensure Dso adequate clearance of suspension, frame and brake components. Test results shall be documented and supplied in the owner's manual. Kneeling Feature The rear suspension shall kneel when the triggering device Enable: is activated AND an enable switch, located in the cab D�s / 0 console is activated. Kneeling Feature The kneeling feature shall activate in PARK position only. Activation: The kneeling feature shall NOT activate in any forward o S/ 0 � reverse gear. The above rear suspension shall kneel whc '�9 Ithe trailing rear access door is opened. Liquid Spring Must include tip to 16 hours of training for up to 4 Framing technicians. ES 00 BID/PROPOSAL CITY OF SOUTH BEND BID NAME ISpec S — One (1) or More 2018 or Newer Emergency Medical Vehicle FOR BIDS DUE lAugust 28,2018 Description Year/Make/Model Unit Price Alternate Description'Cost 'I'tatal 1 1. ILiquid Springj$ I$ I Bidder (Firm): 9,0.,/Vq Address: Z000 wZ4,04ta BOARD OF PUBLIC WORKS Gary A. Gilot, President James Mueller, Member Therese Doran, Member Elizabeth Maradik, Member Suzanna Fritzberg, Member ATTEST-. Linda M, Martin, Clerk Version 8/16/2018 NOTICF TO BIDDERS Notice is herebygiven thatthe City cif South Bend, Indiana, will receive sealed bidsatthe Orri— or the Board of Public Works, 13tn Floor, County -City B.mrjlng, Room 1316, 227W.stJefforson, South Bend, Indiana, until the hour or 9:30 AM. L.i Time, or, August 28, 2018, for the following: Sp ou S _One (1) or More 2018 or Newer Emergency M.di..l Vehicle Specifications are available for download by visiting the City of South Bend's web page at www.southbe v: . ncl �n _29 .. • Click on "I'm Looking For" • Click on "Doing Business in South Bend" • Click on "City Contracts — Invitations to Bid" • Click on the Required link to the "Registration Form" and register your company. Yo U must register to receive addenda and updates to the specific bid you are incorested in. Faiwr,4, to do so cou(d render your bid non -responsive to the specifications. All miscellaneous bids and proposals are located at the bottom of the Invitation to Bid page. Click on the link to ARC for construction bids. There is no charge for the specifications. The specifications are also available for review only during regular working hours in the Department of Public Works, 1308 County -City Building, South Bend, Indiana 46601. Bids received after 9:30 AM, L ... i Ti in e, on Ad g u st 28, 2018, will be returned unopened. Bids imust be on the City of South Be n d Bid/Proposall form provided, which inclu des a No n - D.b.r-.nt Arridavit, Nun-Discrirdie.ti-n Commitment form, and a Non -Collusion AffidavitForm, C,.,,iri.d Check or Bid Bond in the amount of not less than 10% n-1 be ..broitted with the bid. A refund of the bid security will be issued upon satisfaction of Bid Award. The Board may—Jectany bid ghat does not. conform to these requirements as --responsive. The Board reserves the right to reject any or all bids or to accept a full or partial award of the bid or bids which, in its judgment, will be to the best interest of the City of South Bend. BOARD OF PUBLIC WORKS Linda M. Martin, Clerk Publish two times: July 27, 2018 August 3, 2018 Document A310 TM -- 2010 Conforms with The American Institute of Architects AiA Document 310 Bid Band CONTRACTOR. (mirmo, legal slalraw and adds us ) Horton Emergency Vehicles 3800 McDowell Road Grove City, OH 43123 SURETY: (Marne, legalstalux and pHnollial pfacc ajhrashloxv) Fidelity and Deposit Company of Maryland 1299 Zurich Way, 5th Floor Schaumburg, IL 60196-1056 OWNER: (Nape, legal slafrrsaxd address) City of South Bend 227 West Jefferson, County -City Building, Room 1316 South Bend, 1N 46601 BOND AMOUNT: $ 10% Ten Percent of Amount Bid PROJECT: (,Vama, locaflon or address, nudllrgjecffurmbor, fam} Supply One (1) Horton Emergency Vehicle This document has Important legal consequences, Consultation with an attorney Is encouraged with respect to Its completion or modiflcation. Any singular roference to Contractor, Surety, Owner or other party shall be considered plural where applicable. The Contractor and Surety are bound to Ella owner in ilia amount sot forth above, for ilia payment of which tho Contractor and Surety bind tilaniselvos, their heirs, oxeoutors, administrators, successors and assigns, jointly and severally, as provided harein. The conditions of this Bond are such that if ilia Owner accepts the bid of fife Contractor ►within tElo time specified in the bid documents, or ►►ithiit such lime period as may be agreed to by ilia Owner and Contractor, and ilia Contractor either (1) enters iiito a contract with ilia Owner in aecordanco with file terms of such bid, and gives such bond or bonds as may be specified in tiro bidding or Coutraet Documents, with a surety admitted ill ilm jurisdiction of ilia 1'roiect and otherwise acceptable to Clio Owner, for ill* faithful performance of such Contract and for ills prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner Elie difference, not to exceed Ilia oniount of this Boad, between the amomit specified in said bid and such larger aniouilt for which the Owner may in good faith contract with anotlier party to pertiirnl tho work covered by said bid, then this obligation -shall be still and void, otherwise to reniain In full force and eliect. The Surety hereby ►wal Eras any Notice oran agreement between the Owner and Contractor to extend the Lillie ill Which the Olvller itlay aacepf the bid. Waiver of notico by the Suretyshall not apply to ally extension exceeding sixty (00) days in the aggregate beyond the time liar acceptance of bids speeified in the bid ductiments, and ilia Owner and Contractor shall obtain the Surety's comont for ail ostsnsiun bayond sixty (Cif) days. If this Bond is issued ill connection with a subcontractor's bid to a Contractor, the tans Contractorin this Bond sliall be decried to be Subcontractor and (lie tart Owner shall be deemed to be Contractor. When this Blind has been l'uraislied to comply with a stattitory or other legal rettuircutcnl in the hwatiou of fl►a Project, any provision in this Bond conflicting withsaid statutory or legal requirement %hull be deemed deleted herefrom and provisilllis coolbrining it) -such titatillory or other legal ragtllreillelli %hall he deemed int urporaled lwrehl. Whon so Itimished, itle intent N that this ilond %hall be construed as a statutory bond and not as a common law bond. Signed and scaled this 28th day of August, &00�� NL xt"t) I 'llness) 2010 vim Horton Emergency Vehicles lPr�rrclpal) (Seal) By: fI fr14) tfVX $ DIP (}�� Fidelity and Deposit Company of Maryland ►, �t�r40 (Sratityj (.Seal A o r� B : 9�sa 1T111e)$t ohanie L. Klearman 'Attorney -in -IF -act 'tF 8•00541AS 8110 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizartces, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointmcnt or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURI TY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duty called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate tuay be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the I Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed: IN TESTIMOIAY WHEREOF, I have ber(LuW subscribed my name and affixed the corporate seals of the said Companies, this day of 20__ a g��—._ nI SI6AL 4,a... '��11:`..,.,..••*+r`�.� +Ian 4r David McVicker, Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT ALL REQUIRED INFORMATION TO: Zurich American hisurance Co. Attn: Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by MICHAEL BOND, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Lisa A. MCALEENAN, Anne M. GLWIDT, Kevin E. MCDANTEL, Stephanie L. KLEARMAN, DeAnna M. MAURER, Kayla A. WOODWARD and Mark R. DUGGAN, all of St. Louis, Missouri, EACH its true and lawful agent and Attorney - in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE. COMPANY at its office in New York, New York„ the regularly elected officers of the COLONIAL. AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT.' COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a tare copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed histher names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 22nd day of August, A.D. 2017, ATTEST: py_:�w. flssistmit Secretary Daniel Lutes ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OIr MARYLAND i i tea ,f ANi awns °'�? ••�t3t Ylce President Michael Bond State of Maryland County of Baltimore On this 22nd day of August, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, MICHAEL BOND, Vice President, and DANIEL LUTES, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that hdshe is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Cotlroratlons. rN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dtmn, Notary Public My Conunission Expires: duly 9, .2019 PDXF 079-0575A 0 AC"R01 CERTIFICATE OF LIABILITY INSURANCE 711/2018 DATE (MMIDDIYYYY) 6/30/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR ZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER Lockton Companies Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314)432-0500 CON NAME: T PHONE E, i Fare No ; _ EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAlC # INSURER A- Great American E & S Insurance Company 37532 INSURED 1330397 Horton Enterprises, Inc. Ilalcore Group Inc., Leader Industries INSURER B : Travelers Property Casualty Co of America 25674 INSURER C : AXIS Su lus Insurance Company AXIS INSURER D : North American Specialty Insurance Co 29874 Horton Emergency Vehicles INSURER E : The Charter Oak Fire Insurance Com an 25615 American Emergency Vehicles 3800 McDowell Road INSURER F rnvcraarFc 11C)t mrwl r`F€>!T1FIr'OTF MIIM€tFR- 1noIA407 REVISION NUMBER,. XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER O POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MWDDIYYYY LIMITS A X COMMERCIAL GENERALLIABILrrY N N PL 1744639 7/1/2017 7/1/2018 =_10CCURRENCE $ 1 000 000 PREM SES Ea occurrence $ iaa 000 CLAIMS -MADE L N] OCCUR MED EXP (Any one person) $ XXY,)CKXX PERSONAL R ADV INJURY $ l 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREOLIE , $ 4000000 PRODUCTS-COMPIoPAGG $ 4 000 000 . X POLICY ElPRO- JECT ❑ LOC $ OTHER: 13 AUTOMOBILE LIABILITY N N TC2JCAP8EO82581TIL17 7/1/2017 7/1/2019 SINGLE LIMIT Ea accident (E accidenNEDt) $ 1 Qaa oQo BODILY INJURY (Per person) $ XXXXXXX X ANY AUTO BODILY INJURY (Par accident) $ XXXXX7CX OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED _ PROPERTY DAMAGE Per accident $ xxx=x AUTOS ONLY AUTOS ONLY �Xd m Coll Ded $ 1,000 Gara a Kce a s* C UMBRELLA LwB X OCCUR N N EAU781897012017 7/1/2017 7/1/2018 EACH OCCURRENCE $ 5 000 000 D A X EXCESS LIAB I I CLAIMS -MADE EXS200016503 XS 1744640 7/1/2017 7/1/2017 7/1/2018 7/1/2018 AGGREGATE $ 5,0001 000 DED RETENTION$ CCSS Liab. $ 20OOa QOO E E WORKERS COMPENSATION N TC20Ui31l81)4882167 7/1/2017 7/i/201R X STATUTE ERH E.L. EACH ACCIDENT $ 1000 000 AND EMPLOYERS' LIABILITY YIN ANFICERI RIE ECUTIVE E.L. DISEASE- EA EMPLOYEE $ 1 000 000 ER EXCTD 44 [—NJ OFLU(Mandatory in NH) NIA E.L. DISEASE - POLICY LIMIT $ 1,000,0 Ifins desori6e under DESCR€PTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached It more space Is required) THIS CERTIFICATE CONFERS NO ADDITIONAL INSURED RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE IS PROVIDED FOR INFORMATIONAL PURPOSES ONLY. 10936407 HORTON EMERGENCY VEHICLES THE E ANY I THE ABOVE DESCRIBED POLICIES WILL ESEDE CANCELLED BEFORE 380a MCDOWELL ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL ESE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. GROVE CITY OH 43123 _ ]AUTHORIZED REPRESENTA�� — jl � ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD All rights reserved. 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 lrirj„aj A ) ) SS: S �, COUNTY } The undersigned Contractor, being duty sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in Non -Collusion Non -Debarment Affidavit Non Iran Form the energy sector in. Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Non -Collusion Non -Debarment Affidavit Non Iran Form Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance: of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. 1, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations, to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to, the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this day ofs 20 Ig of-06 - &Aftu ff*,40w &q y k" 441 Contractor/Bidder Ffm) Signal Contractor7BT—ddff or Its Agent Printed Name and Title Subscribed and sworn to before me this day of AUAIIS4- , 20 My Commission Expires AJ - Notary Public County of Residence S>+ Non -Collusion Non -Debarment Affidavit Non Inin Fonn DDESTANIE N. STOUT Seal Notary Public - SIM of Indiana St Joseph County My Commission Expires Oct 28 2024 M ACC)R® CERTIFICATE OF LIABILITY INSURANCE 7/ 1 /2015 DATE (MMIDDIYYYY) 6/30/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ,BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LOckton Companies Three City Place Drive, Suite 900 St. Louis MO 63141-7081E-MAIL (314)432-0500 CONTACT NAME? PHONE I FAX Ext): -LA—IC.No. ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 9 INSURER A: FirSt Specialty Insurance Corporation 34916 INSURED Horton Enterprises, Inc. 1330397 I-lalcore Group Inc., Leader Industries INSURER B : 2562 INSURER C: AXIS Sul -plus Insurance Company 26620 INSURER D : Travelers Property Casualty Co of America 25674 Horton Emergency Vehicles American Emergency Vehicles INSURER E : The Charter Oak Fire Insurance Company 25615 3800 McDowel I Road INSURER F ; North American Specialty Insurance Co 29874 CC)VERar_Fc I-(c-wF.m n rFRTIFIrATF NI)MRFR: InQ16,4I17 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD iN5D SUBR VWD POLICY NUMBER POLICY EFF MNItDD1YVV POLICY EXP MMIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY � CLAIMS -MADE L:J v IOCCUR N N IRG2001384.01 7/1/2014 7/1/2015 EACH OCCUR E DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 MED EXP An ono arson S 50,000 PERSONAL & ADV iNJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4000000 X POLICY 0 JE'COT D LOG PRODUCTS -COMPIOPAGG QQQ $ 4,00100 $ OTHER: A. AUTOMOBILE LIABILITY N N Y8104052RO29PIIX14 7/I/2014 7/1/2015 (Ea accident) $ 1,000.000 BODILY €NdURY (Per person) $ XXX) xxx_ X ANY AUTO BODILY INJURY Per accident $ XXXX JXX ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED MIRED AUTOS AUTOS X Garage Kce rs* PROPERTY DAMAGE $ XXXXXXX Comp/Coll Ded $ 1,000 C F X UMBRELLA LIAB EXCESS LlAB X OCCUR CLAIMS -MADE N N EAU781897012014 EXS200016500 7/1/2014 7/1/2014 N1/2015 7/1/2015 EACH OCCURRENCE $ 50000Q0 AGGREGATE $ 5,000,000 DEB RETENTION $ cess Liab- $ 20.000400 E L WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y!N ANY PROPRIETORIPARTNERIFXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in N11) N/A N I'C20-U13-1L8D4882-14 7/1/2014 711l2015 X STATUTE ER E.L. EACH ACCIDENT $ 1.000.000 E.L. DISEASE - EA EMPLOYEE S 1 QQQ QQQ If yes, describe under DESCRIPTION OF OPERATIONS below I F DISEASE -POLICY LIMIT $ 1 QQQ QQQ D PROPERTY N N ICTJ-CM13-4072-1169-2-14 7/1/2014 7/1/2015 $150,000,000 Blanket Property Limit Replacement Cost/Agreed Value $100,000 deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedufe, may be attached if more space is required) THIS CERTIFICATE, CONFERS NO ADDITIONAL INSURED RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE IS PROVIDED FOR INFORMATIONAL PURPOSES ONLY. CERTIFICATE HOLDER CANCELLATION 10936407 HORTON EMERGENCY VEHICLES 3800 MCDOWELL ROAD GROVE CITY OH 43123 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - © 1968-2AC, ACORD 25 (2014101) The ACORD name and Ingo are registered marks of ACORD . All rights reserved. a a "orton EMERGENCY VEHICLES It's All About, Safety - SAE J3026 Testing to SAE J3026 is about safety and not just making an untested claim. Background For the last several years the ambulance industry along with NIOSH have been working together to develop test standards to improve ambulance safety. Working with SAE International, SAE. J3026 was released in August of 2014. This SAE Recommended Practice was developed in support of the ambulance industry's need to apply science to the design and testing of the occupant seating and occupant restraint systems for personnel being transported in the patient compartment of an ambulance. This SAE Standard has been adopted by several agencies including GSA (KKK-A-1822F), CAAS (GVS v.1.0), and NFPA (1917 2016 Edition) with the recognition this Standard improves the safety of the people being transported in the patient compartment. No manufacturer has the ability to self -certify to SAE J3026, as this needs to be done in a test facility capable of performing sled testing on a completed assembly. The assembly must include seating, seat belts, walls, cabinets, and padding that the ADT will be making contact so injury values can be recorded. Ask for a statement from a third -party testing facility that the manufacturer has met the requirements of SAE J3026. Photos from early NIOSH testing videos It"s not abet state requirements but what i _ afe for our crew as the a about t�ei� da tc� da mission. You know that you have provided the safest working environment with proven tested equipment. Photos from Hoft Testing You know that your personnel can safely perform the majority of their jobs while seat belted even when the cot is in the side mounted position. W, ,HOrton i5i February 9, 2016 Horton Ernergency Vehicles, in conjunction with 011. Engineering, Inc., Transl,')ortation Research Center, Inc., and Progressive Engineering, Inc., has successfully cornpleted and required tests as set forth in Federal Specification KKK-A-1822F, dated February, 2008, for the below listed vehicles, components and equipment of Horton Emergency Vehicles located at 3800 McDowell Road, Grove City, Ohio 43123. ENGINE FLOOR TYPE CHASSIS WHEELBASE GVWR TYPEISIZE MODUILE SIZE PLANS I FORD F-350 164.E3" 12,500 DIESEL16.01- 403 & 463 A & B I FORD F-450 116407189" 16,500 DIESEI./6.01 453, 457, F603 & F623 A & B I INTERNATIONAL 4300 169" 20,000 DIESEL/Lai" 466 603 A & B I INTERNATIONAL 4300 176" 20,,000 DIESEL/D'I' 466 623 A & B INTERNA"riONAL DIESEL MAXX FORCE I TERRASTAR '18311 19,000 7 60377623 A & B III CIIEV/GMC C-4500/C-5500 165.5" 17,500 DIESEL/6,61- 525 & 555' A & B DIESEL/6.01- & III FORD E..360SD 138" 11.500 GAS/6.81- 403 &453 A & B DIESEL 6,0L & III FORD E-45OSD 158*1 14,050 GAS/6.81- 533 & 553 A & B I DODGE 4500 168.5'7188.5'7192.5"' 16,500 DIESEL 6,71_ 403,453,457,& D623 AIli B III CHEVY/GMG G-4500 139" 12,300 DIESEL/6.611- 403 & 453 A III CI-IEVY/GMG G-4500 1591, 14,200 DIESEI-16,61- 663 A & B I FREIGHTLINIER 168" 20,000 17IESEL/6.7/8"L 603 A & B I FREIGHTLINER '174" 20,000 DIES ELIO, 7/&3L 623 A & 13 Respectfully sonar 717'ftd 7e Dave Marsliml Brand Manager Sworn to and subscril)ed in my presence by"",'_ tfiit� of 2016, CHEWL K EN GARD Notary Public My commission exI pires, Novorflber 1 202 l, In and for tile State of 01110 Notary Public f0, �IL2 My, Conimission Expires 32 Novombor I,, 020 3800 McDowell Road Grove City, Ohio 43123 614-539.8181 0 614,639-8166 Fax Comprehensive Compliance Form (CCF) for Bid on Ambulance NON-DISCRIMINATION Contractor, subcontractor, and bidder declare that they will not discriminate against any employee or applicant for employment in the performance of this contract with respect to hire, tenure, terms, conditions or privileges of employment, or any matter indirectly related to employment because of race, religion, color, sex, disability, national origin or ancestry. Contractor, subcontractor and bidder shall comply with this declaration, and understand that breach of this covenant may be considered a material breach of contract. DISQUALIFICATION OF CONTRACTS DEALING WITH THE GOVERNMENT OF IRAN The undersigned does hereby certify that the person and/or business entity contracting herein has never and currently does not contract with the government of Iran for such business and services as defined in I.C. 5-22-16.5-1 et. seq. Furthermore, the undersigned will take the necessary steps to maintain compliance with this statutory provision throughout the term of this agreement, Failure to comply with this statutory section may result in termination of this agreement. DRUG FREE WORKPLACE Any and all contractors performing work for the Town of New Carlisle shall maintain a drug free work place pursuant to applicable federal and state law regulations. By contracting with the Town of New Carlisle, each contractor hereby certifies and agrees that it will provide a drug free workplace and take all appropriate steps to insure that all applicable federal and state regulations concerning the implementation of such drug free workplace has occurred. OSHA AND IOSHA REGULATIONS It is the policy of the Town of New Carlisle to be in compliance with all federal and state occupational safety and health regulations and/or standards. It is a requirement for any person, company or corporation doing business with the Town of New Cal -lisle to be in compliance with the appropriate OSHA and IOSHA regulations and/or standards. Any person, company or corporation not in compliance shall hold the Town of New Carlisle harmless from any and all injuries, illness and death arising out of non-compliance with the OSHA and IOSHA regulations and/or standards and such non-compliance shall be considered in material breach of any contractual agreement with the Town of New Carlisle, Contractor, subcontractor and bidder shall comply with OSHA and IOSHA regulations and understands that breach of this covenant may be considered a material breach of the contract. EMPLOYMENT ELIGIBILITY VERIFICATION PURSUANT TO I.C. 22-5-1.7 el. seq. The undersigned hereby affirms under the penalties of perjury that they do not knowingly employ or contract with an unauthorized alien. Furthermore, the Contractor shall enroll in and verify (or has enrolled in and verified) the work eligibility status of all of its newly hired employees through the E-Verity program as defined in I.C. 22-5-1,7-3, The Contractor is not required to participate should the E-Verify program cease to exist. Additionally, the Contractor is not required to participate if the Contractor is self- employed and does not employ any employees. The Contractor shall not knowingly employ or contract with an unauthorized alien. The Conti -actor shall require its subcontractors, who perform work under this contract, to certify to the Contractor that the subcontractor does not knowingly employ or contract with an unauthorized alien. The Contractor shall not retain an employee or contract with a person a Contractor subsequently learns is an unauthorized alien, The Contractor shall require its subcontractors, who perform work under this contract, to certify to the Contractor that the subcontractor does not knowing employ or contract with an unauthorized alien and that the subcontractor has em-olled in and is participating in the E-Verify program. The Contractor agrees to maintain this certification throughout the duration of the term of a contract with the subcontractor. The Town may terminate this Agreement for breach of contract/default if the Conti -actor fails to cure a breach of this provision no later than thirty (30) days after being notified of such breach, The undersigned hereby acknowledges, certifies and affirms the above provisions, and agrees that if awarded the contract for the above named project, said provisions will be attached to and incorporated into the fin contract. tract. DESTANIE N. STOUT "IE Company Name: HORTON AMBULANCE STATE OF OHIO Seal SS: contract. Public - State of Indiana c St Joseph Company Address.3800 MCDOWELL ROAD COUNTY OF FRANKLIN My Commission County ssi My Commission Fxpires 0o 28 2024 ore me this f 120 Subscribed and sworn to before day o A44,114 25'1 By (Signature) My commission expires: 12 -JL62'1 Printed Name: ROBERT W BURGH Signed: Title: SALES MANAGER Residing in ST. Jounty' State of INDIANA Date:- 1911116 \} � .. �� � : � f � � § y �.� > . �? :\ E»a ...�<: :�\\\\/y\«: «� ©c ? d����� ca a rell"'I"I Oslo m ,,,,,,6. . iltill, / .. M F, ©�! 's, }? br0i'llmrromum, , rrt' i �ipgy h ran kvi�iivwr �/ r � „rwi Date: February 27, 2018 Re: Horton Emergency Vehicles Grove City OH 431'23 This document confirms that CAPE performed testing under project numbers CTR11862 and CTR12068 to SAE Surface Vehicle Recommended Practice J3058 Ambulance Interior Storage Compartment Integrity, November 2016. This testing utilized the Horton supplied ambulance cabinets shown in the attached table accompanying this letter. During these tests, all SAE J30 8 required test parameters and performance requirements were met and/or exceeded. �. Ryan Hoover„ PE CAPE Technical Director w. it !i. CTR1 1862-003,Iwo 1'! Ir il• CTR1 2068-007-, SAE J3058 NOV .� �. .. �. 1 A 1 i 1 I / 1 4: i / � ! M♦I � 1 'rr � �... N... 1 'i YI.! MA I� iti IW AM �� I� Wi l�I,. NR r f • f ♦ � . s .r +.• .��. i yr r it rl �� r ' �. �� .r • � • s.. � I A i i ` '� IIY w• 'M, M � • • � • � 7 i• � •• ill )1I 1► 1 4 U tiY. 1 M.. 1 ii t /� � 1A �• i�i Y iM ► yw � ♦• • s � +IY 4 � � � � r� Ir i �.. w •• � r it r "� w w • r A. �W: i li f_. r 1"I i �.. � 'r" 11 N. � AI' M iII M If �i 14YI ',. #JI III III IAA 1Aw Kt ', alY li l... '� • � 1. s If • 1 s i r C r 1 w. I »r R . 1. . 1 • 4. I � IMy a r li • s +► . � • M • �� 1 1 k 1 1 1 1 1 1; i i:.. 1 N k d/ 1/ Y. U 1' 1 +. �. ,y.. I r •,. r, * � �..... II � *... f "� A 1 4 1 i i fY' '.� 4 :: i � I � f • • I 1 Y i q ',, 1 f 1 A �� 1 1. y 1 � ® / �.. 1� A f. ♦ ri �, • � I� � +r All ., �..: �..... v . � r ■. A ! I 1 1 A� 1 M 4 1_ i U... 1.., * � r i • 4 w A w .� � 1 Ili "M • Y II 4 • i wr 1. w 1 w A �� 5� � �. 1 ~ A♦Y. I � ti ul• III ~ 1 'i-Y-ogressive (&Ygineerzl�g Progressive Engineering Inc, (accredited by a third -party agency to conform with ISO 17020 and 17025) completed structural testing on a FIEV 623 Module, 96" wide and 173" long. Production Number 15474 on January 24"' of 2013 (PEI Project No. 2012-1663), The following AMD standards are covered in the reports sent to Horton Emergency Vehicles: AMD 001 - Ambulance Body Structure Static Load Test AMD 002 - Oody Door Retention Components Test AMD 003 r Oxygen Tank Retention 8ystern Static Test AMD 004 Litter Retention System Static Test AMD 008 - Patient Compartment Grab Roil Static Load Test The following sections located in N:FPA, 1917-13 are covered in the reports sent to Horton Emergency Vehicles: 6.3 - Structural Integrity - Roof Loading 6.4 - Structural Integrity - Side Loading 6.8 - Handrail "resting 6.9 - Patient Compartment Entry Doors 6.13.7 - Body Floor Structural Integrity 6.22 - Patient Cot Retention 6.28.10 "rank Retention Along with the above testing, FMVSS 207/210 testing was performed on the EMT Seat and FMVSS 210 testing was performed on the CPR Seat and Squad Bench (three (3) designated seating positions). Drawing verifications were also performed as required by the NFPA 1917-13 s4.6_ The above testing and verifications did meet the requirements of the AMD Standards and NFPA 1917-13 sections listed. If you have any questions regarding the tests we have performed, don't hesitate to call. 4 Ra rd 5 ,n Alger4 Project Manager— Vehicle Testing APN%61 Crashi Ttist Documentatio cent er for Advanced produd EyAuadoiA 18881 US 31 North RO, Box 1020 ffinifield, Incharla ,16074- 1020 Phone (317) 896- 95 31 Fax (3 17) 867-2305 M March 14,2007 Mr. Malley Horton Ernergeilcy Vehicles 38,00 McDowell Road Grove City, 01-1. 43123 Dear Mr, Malley N 0� This dOCUment is to confirm that oil February 22, 2007, IMMI's Centel, for Advanced Product Evaluation (CAPE) witnessed the dynarrilc roof pre -load, static roof load and dynamic rear impact tests as regulated by ECE R29, SAEJ2422 and SACS' .12420 on a Horton Emergency Vehicles aunbulance box. The events were docuri'iented with photographs, real-time and high-speed video, vehicle accelerometers, cart accelerometers and a laser speed trap. This CIOCLI111CIlt also reports that the Horton Emergency Vehicles ambulance box is in compliance with the requirements and intent of standards ECE R29, SAE J2422 and SAID J2420, Whereby, the testing with regard to the above-nientioned standards was carried out by CAPE On FebrLiary 22, 2007 at I'MMI's Centel- for Advanced ProdLICt Evaluation in Westfield, Indiana. Sincerely, [am, , R. Chinni E. Director of CAPE Rcf: CTR02181 A OwWon of Indian., N11k and NI0IWIKWIM(J, 111K Rear Impact Test Attendant Seat -- Impact Test Five Point Harness, Bench Seat -- Impact Test Item I Safety Certification The bidder must perform and certify to dynamic sled or impact testing run on the ambulance body to a load of 30 G's. The body tested shall include normally installed components for each of the following areas of the vehicle. The body structure and installed components shall not show evidence of structural failure or separation from its mounted position as a result of the test. All test results must be witnessed and verified by a Registered Professional Engineer. Test Required Date Tested Body Test Signed By Force Applied 1, Body to Chassis Mounting 4/20/06 30 G's a 2. Access Door Latching 4/20/06 30 G's 3. Oxygen Cylinder Mount (Main) 4/20/06 30 G's�y�lhtee, 4. Oxygen Cylinder Mount (Portable) 4/20/06 30 G's 5. Attendant Seat Mount 4/20106 30 G's p .towez.,., 6. Attendant Seat Belt 4/20/06 30 G's 7. CPR Seat Belt 4/20/06 30 G's & Squad Bench Seat Belt 4/20/06 30 G's 9. Retention of Main Cabinet Wall 4/20/06 30 G's 10. Crash Restraint Wall At Head of Bench 4/20/06 30 G's Certification of Registered Professional Engineer I ;V d ( U Joe j Ad S._ attest that 1 am a Registered Professional Engineer registered in the State of —04 r ij . My Registration Number is _Vj� 21p I hereby certify that I and my company, its affiliates and subsidiaries are completely independent.4i'll,, `'`•. manufacturers, suppliers, and vendors tire ambulance industry.. ♦♦••� 0F St1�11alLlre (iJn(� ♦ ,,, /r r t • •' L. GREGORY'• ; �; Company t T�_— L41%I�'e/`I%rJ�l , /d c DUBOIS47216 Date J L./IL 2�.._...206 tD c mm S I �• i, "-. N A L ���. �• Horton Emergency Vehicles 2006 623 Modular Ambulance Flat Frontal Impauct Simulation VI rrech Mounting System Test Numbers. S060420 (To be completer) only by Contraetors/Bidders claiming to be a "local Indiana business"pursuant to LC. 36-1-12-22) INDIANA LOCAL BUSINESS PREFERENCE CLAIM A local Indiana business rcFers to any of the following. (7) Abusiness whose principal place of business is located in an affected county. (L)Abuslness that pays a majority or its payroll (in dollar volume) to residents of affected counties. (3)A buslness that employs residents of affected counties as a majority of its employees. (4)A buslness that makes significant capital investments in the affected counties as defined in rules adopted by the political subdivision. (5)A business that has a substantial positive economic ir»pact on the affected countles as defined by criteria In rules adopted by the political subdivision. An "affected county " refers to St. Joseph County, Indiana, or theme+ following counties located adjacent to St. Joseph County: Elkhart County, Marshall County, Starke County and La Port. bounty There are the fallowing price preferences for supplles purchased from a focal Indiana business. S% far a purchase expected by the purchasing agency to be less th a n $50, 000 • 3%far a purchase expected by the purchasing agency to beat least $50,000 but less than $ 700,000 • I %fora purchase expected by the purchasing agency to beat least $I00, 000. mate. Pursuant to I.C. 36-1-12-22, preference for Project South Bend, St. Joseph County, Indiana. claims a local Indiana business (Project # ) located within the City of ❑ The location of the principal place of business is ❑ St. Joseph County, Indiana ❑ The following county located adjacent to St. Joseph County, Indiana: ❑ The majority of the business's payroll for the 12 months prior to the date of this Bid is to residents of St. Joseph County, Indiana or the adjacent county noted above. ❑ The majority of the business's employees for the 12 months prior to the date of this Bid are residents of St. Joseph County, Indiana, or the adjacent county noted above. If the business is deemed to be the apparent lowest, responsible, responsive bidder, then it shall provide supporting documentation for the 12 month period prior to the date of the Bid of (i) the total payroll amount paid to all employees of the business, and (ii) the total payroll amount paid to employees who are residents of St. Joseph County and the adjacent county noted above. WHEN SUPPL YI NG SUPPORTING PA YROL L RECORDS, BIDDER SHAL L REDACT AL L SOCIAL SECURITY NUMBERS Dated this day of , 20 Contractor/Bidder (Firm) Signature of Contractor/Bidder or Its Agent Printed Name and Title 0 SPECIFICATIONS CITY OF SOUTH BEND BID NAME S,.. S — 0.. (1) — M.— 2018 ar Na war Ern orgo nc y M.d!—c .1,1eC. FOR BIDS DUE A-.-., 28, 2018 at 9:30 PVA 1, 1: Pursuant to notices given, the undersigned offers bid(s) to the City of South Bend in accordance with the following attachment(s) which specify the class or item number or description, quantity, unit, unit price. SPEC S - ONE (1) OR MORE 2018 OR NEWER EMEGENCY MEDICAL VEHICLE It is the intent of these specifications to describe an emergency medical vehicle for the City of South Bend. All units bid must have been manufactured in the U.S.A. The unit shall be bid as a fully equipped complete Emergency Medical Vehicle as described in the following specification, No partial or, split bids will be accented. The City of South Bend reserves the right to reject any and all bids or to accept a full or partial award of the bid or bids and to waive any irregularities or informalities which, in its judgment, will be in the best interest of the City of South Bend. The Board will award the bid to the lowest responsible and responsive bidder. If the bid is not awarded to the lowest bidder, the factors used to justify the awards will be stated in writing at the request of any bidder. These are minimum specifications. Any variation from the specifications must be spelled out on a separate exception list .and attached to your bid in order for the bid to be valid. Any items not listed on the exception sheet will be assumed to be part of the unit. Any exceptions to the following specifications must be noted by the dealer at the time of bidding in order for the bid to be valid. Vendor to complete bid proposal, options, and nondiscrimination commitment contained in this bid specification and attach to the submitted bid. 7