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HomeMy WebLinkAboutOpening of Bids - JC Lauber Site Improvements Proj No 118-083B - Indiana Earth IncCITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Project No. For Bids Due JC Lauber Site Improvements 118-083B September 20, 2018 PART I (Must be completed for all bids. Please type or print) Date: ? Bidder (Firm): �,, — Address: / C u& in l 141, City/State/Zip: OS(-'e //, 171)ht-,�- (- i Telephone N u m s? 6� 6Ygl 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: x C the City of South Bend, Indiana, in accord nce with plans and specifications prepared by: } and dated % - p for the sum of (enter the Total Bid as shown on the Proposal) i, rec h (E� Pus d, @..._ Gi n � Y1; n • � rt c �I1�,S...� "?,�.d �,��,i ��., ,� � + � . (Enter sum of Total Base id Alternates shown on Proposal) Se ��, Xy �, } �„ (Numerical) r(.f 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, t cost of units st be the same as that shown in the original contract if accepted by the City of South P6nd. If the bid to be awarded on a unit basis, the itemization of the units shall be shown on a separaJad attachment The above bid is accepted this Subject to the following conditions: BOARD OF PUBLIC WORKS Gary A. Gilot, President Elizabeth A. Maradik, Member By (Printed Name ACCEPTANCE day of S7J I r J er'f '( IL� on Signing) 20 Suzanna M. Fritzberg, 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 Project Name JC Lauber Site Improvements Project No. 118-083D For Bids Due September 20, 2018 Item No. Description Quantl! Unit Unit Price Total Amount 1 MOBILIZATION/DEMOBILIZATION 1 LS 2 CONSTRUCTION ENGINEERING -MAINTENANCE 1 LS /w goc OF TRAFFIC: 3 SIGNAGE, BARRICADES, 1 LS. DETOUR, ETC. INCLUDING (, 14, PERMIT FEES G 4 NILES AVE. PAVEMENT 169 SY REMOVAL' . 4A NILES AVE. PAVEMENT 169 SY REPLACEMENT COMMERCIAL DRIVEWAY 37 SY REMOVAL , ;i',, c Y 5A COMMERCIAL DRIVEWAY 37 SY REPLACEMENT / 70- of 6 STD, SIDEWALK REMOVAL 20 SY `QD 6A STD. SIDEWALK REPLACEMENT 20 SY 4 PERVIOUS CONCRETE 7 SIDEWALK REPLACEMENT (IF 100 SY REQ'D) A 3, 00 8 ON -SITE PAVEMENT REMOVAL 160 SY a4 40 8A ON -SITE PAVEMENT REPLACEMENT 160 SY .off CUT EXISTING SANITARY 9 LATERAL & HOOK UP NEW 1 LS LATERAL INCLUDING TAP FEES. Rl _ u f C? 10 4" SANITARY LATERAL 20 LF 11 6" SANITARY LATERAL 90 LF 12 1,000 GAL. GREASE TRAP 1 LS 13 SEWER CLEAN -OUT 3 EA (100, c�J 14 3" WATER TAP IN EXISTING 1 EA MAIN, INCLUDING; TAP FEES � � L) � 7 ` 15 6"' WATER TAP IN EXISTING MAIN, INCLUDING TAP FEES 1 EA �` �', 16 3" D.I.P. 110 LF 17 3" WATER SHUT-OFF VALVE 1 EA � v- Sbv 18 6" D.I.P. 65 LF 19 6" WATER SHUT-OFF VALVE 'I EA 6" TAP INTO EXISTING STORM 20 SEWER FOR NEW LATERAL, 1 LS INCLUDING TAP FEES j U 21 6" STORM SEWER 68 LF 22 ON -SITE WORK 1 LS [::2:3:,l EXCAVATION OF UNSUITABLE SOILS 25 CYS 3c�.v�i �_5C7,vJ BASE BID TOTAL $ 3 73, s nju ALTERNATE #1 Item No. Description P Quantity unit Emit Price Iota! Amount 1 ORNAMENTAL FENCE AND GATES 1 LS i� '3CXa u , C ALTERNATE #2 ALTERNATE TOTAL Item No. Description Quantity Unit Unit Price Total Amount 1 CONCRETE PARKING LOT 1 LS8, ALTERNATE #3 ALTERNATE TOTAL Sly, eWl , vb Item No. Description Quantity Unit Unit Price Total Amount 1 ASPHALT PARKING LOT 1 LS ALTERNATE TOTAL Co w, w Bidder (Firm): T.-I Address: 1 d 9 L1 _ CitylStatelZip: e u c�,� Telephone Number. M (Signature) k�. ) (Printed Name of Person Signi g) 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 ) } COUNTY SS: ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1, Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation: has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -titre, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. Version 10117/2017 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. F Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's E 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. b. Persons, partnerships, corporations, associations, or joint ventures 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 MBEAVBE; 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. 5-1 b-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 Version 10/17/2017 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 ` day of V23 0 la SEAL Contractor idler (Firm) 7 S ,gna r� of ontr r/Bidder or Its Agent Printed Name and Title 4�l� Subscribed and sworn to before me this �,,,oav of - -(20 My Commission Expires � UZ l", County of Residence Version 10117/2017 Contractor's Bid for Public Works - 6 13,16 COUNTY-CiTy BUILDING PHONF 574/235-9251 227 W. JEFFFRSON BOULEVARD "P" FAX 574/ 235-9171 Sotn'Fi BEND, INDIANA 46601-1830 TDD 574/ 235-5567 CITY OF SOUTH BEND FETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS Date: To: From Subject Project Name: Project No.: September 18, 2018 All Planholders Linda M. Martin, Clerk, Board of Public Works Addendum Number: I J.C. Lauber Site Improvements 118-083B "14"[1111i 0 01 Date Received: q- /9-/S, 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: Authorized Signature: Date: B SI Document 31 ��' - 201 . d"1?y Y CONTRACTOR` SURETY: (Name, legal shirts and address) (Neune, legal sialrrs mtd pi-hicipal ploee Indiana Earth, Inc. ofbttshiess) 10343 McKinley Highway North American Specialty Insurance Compa p g his dacumenl has Important legal Osceola, IN 46561 650 Elm Street Manchester, NH 03101 consequences. Consultation with q OWNER., an attorney is encouraged with (Maine, legal stains and adelr ess) respect to its completion or City of South Bend modification. 227 West Jefferson Boulevard Any singular reference to South Bend, IN 46601 Contractor, Surety, Owner or BOND AMOUNT: ***FIVE PERCENT OF AMOUNT BID*** other party shalt.be considered plural where applicable. PROJECT: (Name, location or address, and Pr•ojeci number, If anj) J.C. Lauber Site Improvements Project #119-083B 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 ofsuch Contract and far the prompt payment of labor and material furnished in the prosecution thereof, or (2) pays to the Owner the difference, not to exceed the amount of this Sand, betiveen 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 aegregate beyond the time for acceptance of bids specified in tine bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. ff 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. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or outer legal requirement shall be de,pKed incorporate50ierein. When so furnished, the intent is that this Bond shall be construed as a statutory bondXhd not as a comry6n law bond. Signed and sealed this 20th day of September Indiana (seal) North American Specialty Insurance Compan . /ry Thomas 0. Chambers, Attarne - mFaut� ti O �' �..• -a trait AIA document A3101A1— 2010. Copyrfrght ® 1963, 19T0 and 2010 by The American Institute of Architects. All rights reserved. WARNfi Document is protected by U.S. Copyright Lase and International Treaties. Unauthorized reprodur[lon or distribution of this AIA" any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under Purchasers are permitted to reproduce ten 110) copies of this document when completed. To report copyright violations of AIA Contract D. The American institute of Architects' legal counsel, copyrght@aia.org. Al u { t, orp '"A, I `N .. , t6 y "I if I. I I ,I, - SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS; THAT North American Specialty Insurance Company, a corporation July organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Overland Park, Kansas, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland Park, Kansas, each does hereby make, constitute and appoint: THOMAS O. CHAMBERS, TODD SC14AAP and KIMBERLY S. RASCH JOINTLY OR SEVERALLY Its true and lawful Attorneys) -in -Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalfof each of said Companies, as surety, on contracts of suretyship as are or maybe required or permitted by lose, regulation, contract or otherwise, provided dial no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION (S50,000,06D.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington Intemational Insurance Company at meetings duly called and held on the 9ih of May, 2012: "RESOLVED, that any live of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying llte attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts ofsurcty, and that each or any of them hereby Is authorized to attest to the execution of any such Power ofAttorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached;" 10 tRutr�J�i,,i 3�y4.•� �•iiiiif.G$y 19.X j si. t 4 fl:.'Pi• 2 By tcJ"�of�a+Ri�G M SFJQI• 3 Steam P. Andcrson,&nler Vice Praldeat of Waabingm international tmuraner company Z�1• $,Q��`?ye 4 senior Vice Praldmt.rNcrth Aentrinn specfaltyfnsorsace Company ��t rmf NO 10 By M1ffehnelA.lie, nneST9tnPr�fn'deo or ivilsaineIar, memalono osoranrl c�mpsoy' & senior, vie. rretldent arNat7h Americah spactalfy fnaunar. Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 1 Ith day of April , 2018 , North American Specialty Insurance Company WaAington International Insurance Company State of Illinois County of Cook ss: On this 1lth day of April 201. 8 , before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michacl A. ito . Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowlcdged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFF€CIALSEAL ILL KENNY •`J��"'� `� Notary Public • stale of arn.'a - Alyc—afarei. pim M. Kcnny, Notary Public I, Jeffrey Goldberg . the duly elected Assistant SecretalEy of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify ghat the above and foregoing is a true and correct copy ofa Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals oflhe Companies this 20th day of September , 2018 ,4 lefrmy Goldberg, Vice Prctldcm da Acsinant secoamy or Warhingt.a livemadonal ImurmmCaapmy S Noak America, 59c6Ay ronlranco Company STATE OF WISCONSIN ) COUNTY OF Kenosha } ON TI-IIS 20th day of September , 2018 , before me, a notary public, Within and for said County and State, personally appeared Thomas O. Chambers to the personally known, who being duly sworn, upon oath did say that he is the Attorney-itt-Fact of and for the North American Specialty Insurance Company , a corporation of New Hampshire T , created, organized and existing under and by virtue of the laws of the State of New Hampshire that the corporate seal affixed to the foregoing within instrument is the seal of the said Company; that the seal was affixed and the said instrument was executed by authority of its Board of Directors; and the said Thomas 0. Chambers did acknowledge that he/she executed the said instrument as the free act and deed of said Company. Notary Public, Kf My Commission CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name JC Lauber Site Improvements Project No. 118-083B For Bids Due September 20, 2018 From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. Proper bid security included. The bidder has the option of providing either a Certified Check or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and Certification of use of United States Steel Products or Foundry Products. Proof of MBEIWBE 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 Form [MWBE-2.1]. Acknowledge Receipt of # I Addendum(s) included with the bid. ✓ All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either —'y printed or typed underneath signature. ✓ This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: _L„ �'nu By Authorized Representative: Signature: !1 Print Name & Title: I' e. Version 10/17/2017 Contractor's Bid for Public Works - 1 Date: CM/_' C f r, '7`An t c-e, PART II .(For projects of $100,000 or more— IC 36-1-124) 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 II 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. 5. 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 10/17/2017 Contractor's Bid for Public Works - 3 IL PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowled menu: (i} By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. (ii) _� 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) 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) 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) Attachment (i) _.7 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) P. List identifying all former business names. (iii) NA 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. (iv) _V Statement about staffing capabilities, including labor sources. This statement indicates and ensures 1 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. (v) t� 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. (vi) V 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 Jorganization. (vii) 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. (viii) Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. Version 4/1712015 General Conditions - 9 (ix) KA- 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. (i) List of projects of similar size and scope of wort: performed in all areas, including the State of Indiana, within. three (3) years prior to the date on which the bid is due. kc: e- rv-4j r (Print Name Here) (J a (Name of Company) to 3 y ^-ki /e fir~ (Address of Company) VSc e ct✓a (City) -77tj (State) sp�� (Telephone Number) Version 4/17/2015 General Conditions -10 BUSINESS INFORMATION CONNIE LAWSON INDIANA SECRETARY OF STATE 09/20/2018 07:33 AM L Business Name: INDIANA EARTH, INC. Business ID: 1990031137 Entity Type: Domestic For -Profit Corporation Business Status: Active Creation Date; 03/22/1990 Inactive Date: Principal Office Address: 10343 MCKINLEY HWY., OSCEOLA, IN, Expiration Date: Perpetual 46561 - 9756, USA Jurisdiction of Formation: Indiana Business Entity Report Due 03/31/2020 Date: Years Due: 111 Title Name Address President MARK L OSLER 10343 McKinley Hwy,, Osceola, IN, 46561, USA Egg ggg� Type: Individual Name: MARK OSLER Address: 10343 MCKINLEY HWY., OSCEOLA, IN, 46561 - 9756, USA J.C. Lauber Building Pre -qualification, checklist items: w Indiana Earth has the crew and staff to complete this project. • Those that work on this project will he employees of Indiana Earth or of a hired subcontractor which are under all applicable state and federal laws and local' ordinances. • Apprentice programs are managed through operator and labor unions that wveare signatory vv/mm. • Drug testing |maccomplished through the unions ofoperators, laborers and teamsters, for our employees. • Indiana Earths surety company isapproved. • Projects similar tothis one. o Indiana Department of Corrections o County Road 3B o Nappanee Waste Water Treatment Plant o StMan/sCollege n Northwood High Schmo,| o Warsaw High School o Laporte Intermediate School u Concord High school u Penn High School o Portage, |MPolice Station o Discount Tire ofWarsaw u P|eetonSchoo[ o Bell Tire ufSouth Bend o Bell Tire VfMishawaka n B and Bmanufacturing o Central Park in Mishawaka CITY OF SOUTH BEND �...c," os` MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM y/E dY FORM MWBE-2.0'LY EVIDENCE OF GOOD FAITH EFFORTS" This completed form should be included as part of the Bids documents related to City of South Send Public Works Projects requiring Good Faith' Efforts to obtain MBEIWBE participation. It is the bidder's ' sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business as defined by the Indiana Department of Administration ("IDOA"). Project Number: 118-083B Date: /` f ?"r2? Project Name: Bidder: Contact Person: JC Lauber Site Im Address: 10 3' (4,A City: 01 L c�lc Telephone: S' 7y — 6 764_y?,? State: Zip: Email: W. c_ 0 An! 1 To determine whether a bidder has demonstrated good faith efforts to reach the MBE/WBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS MBEIWBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business ' T ' Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women Owned Business as found on their website (http://www.in.gov/idoa). ACTION (ADVERTISEICONTACT): In order for your bid to be deemed responsive, the City of South Bend requires that all perspective bidders complete no less than 2 of the following: 1. Attend all pre -bid meetings scheduled by the City to inform MBE/WBEs of contracting and subcontracting opportunities. 2. Advertise in general circulation and/or trade association publications concerning subcontracting L. opportunities, and allow MBE/WBEs reasonable time to respond. 3 Perform any and all necessary steps to written in provide notice a manner reasonably calculated to inform MBEIWBEs of subcontracting opportunities and allowed sufficient time for them to participate effectively. 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 MBE/WBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. SMALL CONTRACT(S): The bidder selected specific portions of the work to be performed by 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 J 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 MBE/WBE was unqualified to perform the job. *Proper demonstration of Good Faith Effort requires your Initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 10/17/2017 Contractor's Bid for Public Works - 11 F� W W U) R a13 (aw0 IL 0 z N Lu U. Om0. 00 z Q O z 2 c !) C. O m O a m' m � O � C 0 O a'w > R C d � 17" To a Y rN+ E IU .CZ C 9 a m � p 03 o` o O 2 E c � a CL N M 40 � mr CL 3 3 m� d� 0 7 CL O N O N U) N fA Q. fA Ewa U f/1 n c h ''-' O m i" 9 co O co c 0 E Q O ro O W o 2� o as � o b O U u! 0 Q o w Q N N C 'p ,P .p 41 m a- N C O T O N 41) U 4 � U r N m ,43) T +mod c o a r EZ m V c� ti f Ar a E C d as 7 0 n 0 N r 0 O CITY OF SOUTH BEND;Sou_ 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: 11B-083B Project Name: JC Lauber Site Improvements MBEIWBE Participation Goal Bidder: (Si ure) itle) (Date) MBEANBE Firm Vt-k r%Puc1K,'n Owner or Contact at MBE/WBE Firm �g, Telephone: S JY_d,3�. Idrv� Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT: Email: ( ry k J RESULTS OF CONTACT THE M/BEIWBE FIRM: +WITH �e- C i' ftI ti � d �J' MBEMBE Firm Owner or Contact at MBE/WBE Firm Telephone: Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT: Email: — RESULTS OF CONTACT WITH THE MBE/VIBE FIRM: e— G r` -e—k e A y is _[ Version 10/17/2017 Contractor's Bid for Public Works - 12 INDIANA EARTH, INC. 10343 MCKINLEY HWY OSCEOLA, IN 46561 Section 1 Public Projects completed: 1) Excavation & Utility —St Marys College, South Bend, IN $900,000 Fall 2017 2) Northwood High School Phase B — Nappanee, IN $168,900 Fall 2017 3) Excavation & Utility CR 38 — City of Goshen, IN $2,491,277 Spring 2018 4) Utility— Nappanee WWTP, Nappanee, IN $519,020 Summer 2017 Public Works in Process: 1) Northwood High School Athletic Center, Nappanee, IN $1,233,500 Fall 2018 2) Excavation and Utility— Laporte Intermediate School $1,531,400 Fail 2017 3) Excavation and Utility -- Concord High School $451,100 Summer 2018 4) Excavation and Utility — Warsaw High School $612,400 Summer 2018 5) Excavation and Utility— Penn High School $219,400 Summer 2018 Completed all work awarded to our firm. References of Private Firms 1) Rieth Riley Construction 574-288-8321 2) Gibson Lewis LLC 574-259-8581 3) Larson Danielson 219-362-2127 4) Holladay Group 574-234-2073 5) Robert Henry Const. 574-232-2091 Section 2 Plan of proposed work 1) Pre -construction meeting 2) Mobilization 3) Strip topsoil 4) Removals 5) Place barricades 6) Install underground utilitys 7) Earthwork 8) Place curbs 9) Place stone 10) Place pavement 11) Place sidewalks and pavers 12) Landscaping 13) Pavement markings Subcontractors Utilized on Past Projects 1) Hydroseed — Osceola, IN, Hydro seeding 2) HydroTek — Nappanee, IN, Hydra seeding 3) Weaver Boos South Bend, IN, Compaction Testing 4) Bob's Landscaping —Granger, IN, Sodding 5) JPR —South Bend, IN, Surveying 6) Rieth Riley —Goshen, IN, Paving Subcontractors to Utilize on this Project — Possible subs listed, will determine prior to contract approval 1) JPR--Surveying 2) Rieth Riley 3) Furbringer Landscaping 4) Al striping 5) Ziolkowski Construction List of our Equipment Owned: 1) 13 Excavators 2) 4 Dozers 3) 3 Dump Trucks 4) 2 Semi Trucks with dump trailers 5) 2 Rollers 6) 5 Loaders i) 2 Skidsteers We have received pricing for services and materials by potential subcontractors.