HomeMy WebLinkAboutOpening of Bids - Lafayette Bldg Exterior Renovation - Project No 117-100R - J.W. Werntz & Son Inc�A
= CITY OF SOUTH BEND, INDIANA12.
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CONTRACTOR'S BID FOR PUBLIC WORK rnr„ ".
Project Name Lafayette Building )exterior Renovation
Project No. 117-100R
For Bids Due October 9, 2018
PART I
(us(Vusy be completed for all bids. Please type or print
Date: % z� �' Bidder (Firm): ��� efe
Address:
City/State/Zip: �J% Telephone Number: ( ) pg
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:
o1 uvou r
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
and dated 'A for the s m of (enter the Total Bid as shown on the Proposal) ,
(Enter sum of Total Base Bid ius Alternates shown on Proposal) (Numerical)
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in
the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance
with the notice. Any addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are needed, the cost of units must be the same as that
shown in the original contract if accepted by the Ci of South Bend. If the bid is to be awarded on a unit
basis, the itemization of the units shall be shown on s9parate attachment.
By
ACCEPTANCE
The above bid is accepted this day of
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Elizabeth A. Maradik, Member
(Signature)
me
Suzanna M. Fritzberg, Member
Therese J. Dorau, Member
James A. Mueller, Member Attest: Linda M. Martin, Clerk
20
Version 7/20/2018 Contractor's Bid for Public Works - 2
Project Name:
Project Number:
For Bids Due:
Contractor Name:
BID/PROPOSAL
CITY OF SOUTH BEND
Lafayette Building Exterior Renovation
117-100R
October 9, 2018
(Name Here)y
BASE BID DIVISION A: SKYLIGHT REPLACEMENT
Item
Description
Quantity
Unit
Unit Price
Total Amount
No.
1
Removal and replacement of existing
p
LS
� �23
�}2
Q
skylight at the upper level roof
l
CJ0
2
Allowance for skylight curb
1
LS
$25,000.00
$26,000.00
reinforcement and repair
DIVISION A BASE BID TOTAL
BASE BID DIVISION B: EXTERIOR BRICK AND LIMESTONE MASONRY REHABILITATION
[tom
Na.
Description
Quantity
Unit
Unit Price
Total Amount
Limestone and brick masonry
rehabilitation on north, east, south and
1
west facades of building, includes crack
LS
repair, tuck -point, masonry replacement
and rebuilding, soft control joint
installation, and limestone patching
2
Contigency allowance for Division B
1
LS
$15,000.00
$15,000.00
mason package
DIVISION B BASE BID TOTAL
DIVISION B ALTERNATE #1
Item
Description
Quantity
Unit
Unit Price
Total Amount
No.
1
Masonry Cleaning of East Facade and
LS
North and South Returns
DIVISION B ALTERNATE #1 TOTAL
DIVISION B ALTERNATE #2
Item
Description
Quantity
Unit
Unit Price
Total Amount
Na.
Masonry Cleaning of North, West, and
LS
South Facades
DIVISION B ALTERNATE #2 TOTAL
DIVISION B ALTERNATE #3
Item
Description
Quantity
Unit
Unit Price
Total Amount
No.
1
Water Repellent on East Fagade and
LS
returns at North and South Walls
DIVISION B ALTERNATE 93 TOTAL
Version 7/20/2018 Contractor's Sid for Public Works - 7
BID/PROPOSAL
CITY OF SOUTH BEND
Project Name: Lafayette Building Exterior Renovation
Project Number: 117-1OOR
For Bids Due: October 9, 2018
Contractor Name: (Name Here)
DIVISION B ALTERNATE #4
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
1
Water Repellent on North, West and
LS
South Facades
DIVISION B ALTERNATE #4 TOTAL
DIVISION B ALTERNATE #5
Item
Na.
Description
Quantity
Unit
Unit Price
Total Amount
Restore painted "Lafayette Building" sign
1
on brick masonry at east end of
LS
parapets on north and south walls
DIVISION B ALTERNATE #5 TOTAL
UNIT PRICING
Item
No.
Description
DEDUCTISF
ADD/SF
1
Masonry Brick Tuck -pointing per SF
2
Masonry Limestone repointing per SF
3
Masonry Brick Re-building/Replacement
per SF
4
Brick and Limestone Cleaning (East
Fa ade and NIS Returnsper SF
5
Brick and Limestone Cleaning (West,
South and North Fagadeper SF
6
Water Repellent on East Fagade per SF
7
Water Repellent on North, West and
South Facades per SF
Bidder (Firm):
Address:
City/StatelZip:
Version 7/20/2018 Contractor's Bid for Public Works - 8
tine prospective Contractor is tunable to certify to any of the statements beloip, it shall attach art arplartadan to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION
REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON-
DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL
PRODUCTS OR FOUNDRY PRODUCTS
(Must be completed for all quotes and bids. Please type or print)
STATE OF
_ ) SS:
COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of peijuiy
that:
I. Contractor has not, nor has any other member, representative, or agent of the firm, company,
corporation or partnership represented by him, entered into any combination, collusion or agreement with
any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding
nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and
without any agreement, understanding or combination with any other person in reference to such bidding.
Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or
indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals
are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency; and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
a. For purposes of this Certification, "Iran" means the government of Iran and any agency
or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as
amended from time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor
is engaged in investment activities in Iran if either:
i. Contractor, its successor or its affiliate, provides goods or services of twenty
million dollars ($20,000,000) or more in value in the energy sector of Iran;
or
ii. Contractor, its successor or its affiliate, is a financial institution that extends
twenty million dollars ($20,000,000) or more in credit to another person for
forty-five (45) days or more, if that person will (i) use the credit to provides
goods and services in the energy sector in Iran; and (ii) at the time the
financial institution extends credit, is a person identified on list published by
the Indiana Department of Administration.
Version 712012018 Contractor's Bid for Public Works - 4
r •.
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/leer/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.
C_
In no event shall persons or entities seeking the award of a City contract be required to award a subcontract
to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a
discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from
being awarded a City contract for a period of one (1) year from the date of such determination, and such
determination may also be grounds for terminating the contact for which the discriminatory practice or
noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made
a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its
agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the
performance of this contract with privileges of employment, or any matter directly or indirectly related to
employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation,
handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of
contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-I6-8-1),I hereby
certify that I and all subcontractors employed by me for this project will use steel products or foundry
products made in the United States on this project if awarded. I understand I have an affirmative duty to
notify the City in my bid that my proposal does not include the use of steel products or foundry products
made in the United States. I understand it is my sole obligation and responsibility to provide a justification
to the City, subject to review and approval, why the cost of United States made steel or foundry products is
unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry
products made in the United States, the City, through its director of public works, shall make a determination
if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder
may result in forfeiture of contractual payments.
Version 7/20/2018 Contractor's Bid for Public Works - 5
I hereby affirm under the penalties of peijury that the facts and information contained in the foregoing bid
for public works are true and correct.
Dated this 49 day of , 20 10
Subscribed and sworn to before me this (y TA
My Commission Expires /AZ//c2 y
County of Residence
idder (Firm)
Sig ture of Contractor/B'dder or Its Agent
Prin ed Name and Title
.day of C /U �QL, 20,/?
6 As,-&77L—
f4otamOdM �
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"� HARRY P SiNGLETO, N
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e • " ; Notary
Public. Stale of ;
,OIARr ;
sl. Joseph Coun:
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Commission # 676: ,
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Commission xRilc=
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January 21202A
Version 7/2012018
Contractor's Bid for Public Works - 6
13ohd No.: Bid Bond
Document A310 TM -- 2010
Conforms with The American Institute of Architects AIA Document 310
Bid Bond
CONTRACTOR:
{'17rrurc, Icgrrl e7rrlrrs arrd adcli'c:+:tij
J. W. Werntz & Son, Inc.
1002 Kerr St.
South Bend, IN 46601
OWNER:
(lain, legal smuts and address)
City Of South Bend, Indiana
227 W Jefferson Blvd
South Bend, IN 46601
SURETY:
(:v`tarrac, lcgcd shrlrrs and prlrrcipul place of biai less]
Developers Surety and Indemnity Company
P. O. Box 19725
Irvine, CA 92623
Mailing Address for Notices
BOND AMOUNT: 10% Ten Percent of Amount Bid
PROJECT:
{,Vance, locallorroraddress; andl'rojeclnumber, ij'mnj
This document has Important
legal consequences. Consultation
with an attorney Is encouraged
with respect to Its completion or
modification.
Any singular reference to
Contractor, Surety, Owner or
other party shall be considered
plural where applicable.
Division A -Skylights, Windows, Glazing -Lafayette Bldg, 1 15 S Lafayette Blvd, South Bend, IN
The Contractor and Surcty are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind
thelnsclves, their heirs, executors, administrators, successors and ossigns, jointly and severally, as provided herein. The conditions of this
Bond are such that if the Owner accepts the bid of the Contractor wilhin the time specified in the bid doouments, or within sucll time period
as may be agreed to by the Ova= and Contractor, and ilia Contractor either (1) enters into a contract with the Owner in accordance with
the terns of such bid, And gives such bond or bonds as may be specified in the bidding or Contract Documents, will) a surety admitted ill
ilia jurisdiction of the 11roicct and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt
payment of labor and material furnished in file prosecution Ilhcreof or (2) pays to the Owner the difference, not to exceed the amount of
this Hond, between the amount specified in said bid and such larger amothnt for whiclt the Owner may in good faith contract with another
party to perform the work covered by.said bid, than this obligation shall be null and void, otherwise to remain in fail fierce and ellect. The
Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the tillhe ill which [tie Owner may accept the
hid. Waiver of notice by tale Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond ilia tune lihr
aceeptunce of bids specified in the bid docunhents. and tlhe Owner and Contractor shall obtain the Surety's consent Ibr an extension beyond
sixty (60) days.
If this Bond is issued ill connection ►with a subcontractor`s bid ton Contractor, the tcnn Contractor in this Bond shall be decined to be
Subcontractor and the iornh Owner sliall be deemed to be Contractor.
When this Bond has been [urnislhed to comply with a statutory orother legal requirement in the location of the Project, ally pnlvisioll in
this Bond c1nlllielins with Said staUdory or legal requirement shall be deemed deleted herelbom and provisions conlonning to such
statutory or other legal requirement shall be deemed incorporated herein. When so forms hed, the intent is that this Bond shall be construed
as a statutory bond and not as a c:onnhon lute bond.
Signed and scaled lhis 9th day of October, 2018
n
...... ��ric-irucev f
Developer's S ty and Indemnity Company-`'44'Y4.0;ro°''�'•
Rt�3y�cr�'
rSrucnlj (Saul'
; ta•��ol�
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- _ � ..'`193
rrI Facie House Atforney
S•00541AS 8110
POWER OF ATTORNEY FOR
DEVELOPERS SURETYAND INDEMNITY COMPANY
INDEMNITY COMPANY OF CALIFORNIA
PO Box 19725, IRVINE, CA92623 (949) 263-3300
KNOWALL BYTHESE PRESENTS that except as expressly limited, DEVELOPERS SURETYAND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do each
hereby make, constitute and appoint
Traeto House
as thelrtrue and lawful Attorney-€n-Fact, to make, execute, deliver and acknowledge, forand on behalf of said corporations, as sureties, bonds, undertakings and contracts of
suretyship giv€ng and granting unto said Attorney -in -Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as
each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Aftomey-in•Fact, pursuant to these
presents, are hereby ratified and confirmed.
Bond No. Bid Bond
Principal: J. W. Werntz S Son, Inc.
Obligee; City Of South Bend, Indiana
This Power of Attorney is granted and €s signed by facsimite under and by author€ty of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY
AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st, 200B.
RESOLVED, that a combination of any two of the Chairman of the Board, the President, Executive Vice -President, Senior Vice -President or any Vice President of the
corporations be, and that each of them hereby ls, authorized to execute this Power of Attorney, quat€Eying the altomey• named in the Power ofAttomey to execute, on behalf of the
corporations, bonds, undertakings and contracts of suretyship; and that the Secretary oranyAssislant Secretary of either of the corporations be, and each of them hereby ls, authorized
to attest the execution of any such Power ofAtlomey,
RESOLVED, FURTHER, thatthe signatures of such officers 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 shall be valid and binding upon the corporations when so affixed and €n the future with respect to any bond, undertaking
or contract of suretyship to which €t is attached.
IN WITNESS WHEREOF, DEVELOPERS SURETYAND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by
their respective officers and allested by their respective Secretary or Assistant Secretary this 6th day of February, 2017.
o pAlur
y t `��Y AND ,� G �1+ PO p
B : J4:•''nv oar •. CO �i F0
Daniel Young,SentorVice•President A c+
ct �1
OeT.6 ° o
:Vol
Mark Lansdon,Vice•President
A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the
document to which this certificate Is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Orange
On February fi 2017 _ before me, Lucille Ra mond Nota Public
Dais Haw rased Name andTrde orrne orrwcr
personally appeared _ Daniel Young and Mark Lansdon
Name(sjaiS�ne,tsl
who proved to me on the basis of satisfactory evidence to be the person(s) whose names) €stare subscribed
to the within Instrument and acknowledged to me that helsheAhey executed the same in hisiherltheir authorized
capacity(€es), and that by hislherltheir signature(s) on the instrument the person(s), or the entity upon behalf of
LUCILLE RAYMONO
Commission # 20$1915 which the person(s) acted, executed the Instrument
`
a •� Notary Public - Calif orftla I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is
Z Orange County true and correct.
M Comm. Expires Oct 13, 2018 _
wwwqpw WITNESS my hand and official seal. dR--R—v-7
Place Notary 5eak Above Signature Lucd, Notary Public
CERTIFICATE
The undersigned, as Secretary orAssistant Secretary of DEVELOPERS SURETYAND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA, does hereby
certify that the foregoing Power of Attorney remains In full force and has not been revoked and, furthermore, that the provisions of the resolutions of the respeclNo Boiirda of,0€rectom of
said corporations set forth in the Power ofAttomey are in force as of the date of this Certificate.
01
This Certfioate Is executed In the City of Irvine, California, this 9th day of October , 2018 �.�``Y.....
1936=
_�_.
-w; _
By. CassleJ. rdsford,Assistant Se tary '��''° -
A c�;
'., ��� llFOR,, •tea
ATS-1002 (02117) `�1ju1r11«''
1316 COUNTY -CITY BUILDING
227 W,JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574I235-9251
FAx 574/235-9171
TDD 574/ 235-5567
CITY OF SovTn BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
Date: October 5, 2018
To: All Planholders
From Linda M. Martin, Clerk, Board of Public Works
Subject _Addendum Number: 1
Project Name: Lafayette Building Sk li ht and Masonry Repairs
Project No.: 117-IOOR
ACKNOWLED EMENT OF RECEIPT OF ADDENDUM
Date Received: ��/�Ip --
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.
THIS ADDENDUM MAY AFFECT YOUR BID.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company: v
Authorized Signature:
Date: jQ
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
CHECKLIST FOR BIDDERS
Project Name Lafayette Building Exterior Renovation
Project No. 117-1 OOR
For Bids Due October 9, 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.
f, Proper bid security included. The bidder has the option of providing either a Certified Check
VVV or Bid Bond.
` Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely
y executed.
\ Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments
\y, 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 MBEIWBE Contacted
Form [MWBE-2.1].
Acknowledge Receipt of l 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
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 d comply with the specifications.
Bidder: (� , G Date: /4 e a s _
n
By Authorized
Signature:
Print Name & Title:
Version 7/20/2018 Contractor's Bid for Public Works - 1
PART 11
(For projects of $100,000 or more —I C 36-1-12-4)
These statements to be submitted under oath by each bidder with and as part of his/her/its bid.
Attach additional pages for each section as needed.
\ SECTION 1 EXPERIENCE QUESTIONNAIRE
" I. 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.
v 3. Attach information regarding any failure to complete any work awarded to you and the
\ location thereof.
v 4. Attach references from private firms for which you have performed work.
SECTION 11 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.
V 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.
�i 4. Attach a listing of equipment you have available to use for the proposed project.
V 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 7/20/2018
Contractor's Bid for Public Works - 3
CITY OF SOUTH BEND
: c4souri�H j
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWSE-1.O
MBEIWBE PARTICIPATION
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBEIMBE participation.
It is the bidder's sole responsibility to verify whetherany listed minority orwoman business meets the qualifications of a Minority or Women's
owned business.
Project Number: 117-1ODR Project Name: Lafayette Building Exterior Renovation
Bidder: Total Bid Amount: MBEMlBE Goal:
Page of
Name & Address of M8ENY8E
Primary Contact Person
(Namefrelephone)
Scope of Work to be Performed
(Attach scope/schedule ![you need addiliona€ space)
not18rAmounl of
M85ANBE Component
Percentage
of Total
BidlPra osal
G�11,SURaI
�7tc u,
CA 0JP
_
cc€�S1sTR�Gl��i1!
�J�J O r `'
Submitted by: I ��Ael
Print Name Signature Dat
Version 712012018 Cantractor's Bid for Public Works - s
C
"FU71!`9
CITY OF SOUTH BEND 'n4. a y� •:
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS
This completed form should be included as part of the Bids documents related to City of South Bend Public
Works Projects requiring Good Faith Efforts to obtain MBEIWBE participation. It is the bidder's sole
responsibility to verify whether any lister{ 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: 117-10OR Date: �a
Project Name: Lafa ette Building Exterior Renovation
Bidder:
Contact Person: mmG Telephone:
Address:
City: k,11 State: J Zip:
Email: ceA
To determine whether a bidder has de onstrated good aith efforts to reach the MBEIWBE 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
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 MBEIWBEs of contracting and
subcontracting opportunities.
2. Advertise in general circulation and/or trade association publications concerning subcontracting
opportunities, and allow MBE/WBEs reasonable time to respond.
3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated
to inform MBEIWBEs of subcontracting opportunities and allowed sufficient time for them to
participate effectively.
4. Utilize pre-existing services of available community organizations, small and/or disadvantaged
business assistance offices and other organizations that provided assistance in the recruitment
and placement of MBE/WBE firms.
"Bidder must circle or otherwise notate which of the two (2) required actions were. performed.
GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBEIWBEs,
including providing such MBEIWBE's with adequate information about the plans, specifications and other
requirements of the subcontract and did not reject MBEIWBEs 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 MBEIWBE participation)
CONTRACT RECORDS: The bidder has maintained the following records for each MBEIWBE that has
bid on the subcontracting opportunity:
1. Name, address, and telephone number;
2. A description of information provided by the bidder or subcontractor; and
3. A statement of whether an agreement was reached, and if not, why not, including any reasons for
concluding that the 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 7/20/2018
Contractor's Bid for Public Works -10
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY;' .!
DEVELOPMENT PROGRAM -
FORM MWBE-2.1
MBEIWBE CONTACTED
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects
requiring contacted MBEIWBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify
whether any listed minority or woman business meets the qualifications of a Minority or Women's owned
business.
PAGE OF
Project Number: 117-'IOOR MBEIWBE Participation Goal
Project Nam Lafayette Building Exterior Renovation
Bidder: c
By: o
(Signature) (Title) (Date)
MBEIWBE Firm bzlzyam,
Owner or Contact at MBEIWBE Firm
Telephone: 3744119?,89
Fax: Email'
TYPE OF WORK SOLICITED FOR THIS PROJECT:
GQ OJT
RESULTS OF CONTACT WITH THE MBEIWBE FIRM:
MBEIWBE Firm
Owner or Contact at MBEIWBE Firm �G
Telephone: ;?,5q Fax: Email: s� G 0ni
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBEIWBE FIRM:
OOR A40A141- S11)yY
Version 7/20/2018 Contractor's Bid for Public Works -11
PART II
(For projects of $150,000 or more —IC 36-1-12-4)
These statements to be submitted under oath by each bidder with and as a part of his bid. (Attach
additional pages for each section as needed.)
SECTION I EXPERIENCE QUESTIONNAIRE
1. What public works projects has your organization completed for the period of one (1)
year nrior to the date of the current bid?
Contract Amount
Class of Work
Completion
Name and Address of Owner
( j ()0 0
2AQ yyZ
Date
6f9Tr
J n 00 4
Ls
7- What public works projects are now in process of construction by your organization?
Contract Amount
Class of Work
Completion
Date
Name and Address of Owner
eS- �
mood
zaI v�-2n19
/' C y�f yfr�
3. Have you ever failed to complete any work awarded to you?If so, where and
wiry?
4. List references from private firms for which you have performed work.
V 11 O-t
G of l 1 �C&
TSC 217120 Bid Form Section 00 3100-5
SECTION TI PLAN AND EQUIPMENT QUESTIONNAIRE
1. Explain your plan or layout for performing proposed 'Work. (Examples could include a
narrative of when you could begin, complete the project, number of workers, etc. and any
other information which you believe would enable the governmental unit to consider your
bid.)
iA/�lo�1iSIC�GIG Ar1?�,O��S,��G�
2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside
your own firm who have performed part of the work) that you have used on public works
projects during the past five (5) years along with a brief description of the work done by
each subcontractor.
3. If you intend to sublet any portion of the work, state the name and addresses of each
subcontractor, equipment to be used by the subcontractor, and whether you will required
a bond. However, if you are unable to currently provide a listing, please understand a
listing must be provided prior to contract approval. Until the completion of the proposed
project, you are under a continuing obligation to immediately notify the governmental
unit in the event that you subsequently determine that you will use a subcontractor on the
proposed project.
TSC 217120 Bid Form Section 00 3100-6
4. What equipment do you have available to use for the proposed Project? Any equipment
used by subcontractors may also be required to be listed by the governmental unit.
t
C Abe
5. Have you into contracts or received offers for all materials which substantiate the prices
used in preparing your proposal? If not, please explain the rationale used which
corroborate the process listed.
Ire- r
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 governing body awarding the Contract must be specific
enough in detail so that said governing body can make a proper determination of the Bidder's
capability for completing the Project if awarded.
SECTION IV CONTRACTOR NON -COLLUSION AFFIDAVIT
The undersigned Bidder or agent, being duly sworn on oath, says that he has not, nor has any
other member, representative, or agent of the firm, company, corporation or partnership
represented by him, entered into any combination, collusion or agreement with any person
relative to the price to be bid by anyone at such letting nor to prevent any person from bidding
nor to induce anyone to refrain from bidding, and that this Bid is made without reference to any
other bid and without any agreement, understanding or combination with any other person in
reference to such bidding.
He further says that no person or persons, firms, or corporations has, have, or will receive
directly or indirectly, any rebate, fee, gift, commission, or thing of value on account of such
contract.
TSC 217120 Sid Form Section 00 3100-7
PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED)
(a) Acknoo dgements:
(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) r 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) Attach eats:
0) Indiana Secretary of State's on-line records (i.e. 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,
�_Oi�
and eligible for a certificate of good standing. (Not applicable to individuals, sole
proprietors or partnerships).
List identifying all former business names.List identifying all former business names.(ill) 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.
Statement about staffing capabilities, including labor sources. This statement
indicates and ensures I have sufficient employees on staff to complete the work I
am bidding on OR outlines how I intend to meet the staffing needs of the work.
(v} ____ 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) Evidence of participation in apprenticeship and training programs, applicable to the
work to be performed on the project, which are approved by and registered with
the United States Department of Labor's Office of Apprenticeship, or its successor
organization.
(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 4-13-18-6 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 7/20/2018 General Conditions - 9
r—.
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.
List of projects of similar size and scope of work performed in all areas, including
the State of Indiana, within three (3) years prior to the date on which the bid is due.
(Print Name mere)
(Name of Company)
joo�a ST
(Address of Com any)
(City)
(State)
5-2 q - F�3
(Telephone Number)
Version 7/20/201 S
General Conditions - 10
J.W.WERNTZ & SON INC.
WERNTZ SUPPLY 1 WERNTZ GLASS
1002 KERR ST. SOUTH BEND IN. 46601 574-232-4881, FAX 233-7051
10/05/2018
Proposal for GLASS AND GLAZING
Project: Lafayette Building Exterior Renovation
117-100R
ttachments for prequalification
r. Attached secretary of state records.
ii. There are no former business names
iii. No known violations within the last 44 years.
iv. We are signatory with the glaziers union. we have an unlimited supply of qualified personnel.
v. We have no subcontractors.
vi. We are signatory with the glaziers. And participate in training.
vii. Drug plan attached.
ivii. Surety qualification attached.
x. No known tax liens
, list available. Most recent skylight at Memorial Chiidrens Hospital.
Sincerely.
Patrick Werntz
r J W.Werntz and son Inc.
f
Drug Testing Policy
JW Werntz is a drug -free workplace. As such, we prohibit the use of
nonprescribed drugs or alcohol during work hours. If the employee comes to work under
the influence of drugs or alcohol or uses drugs or alcohol during work time, the employee
will be disciplined in accordance to the policy up to an including termination.
Under JW Werntz's drug testing policy, all current and prospective employees must
submit to the drug testing policy. Prospective employee's will only be asked to submit
to a test once a conditional offer of employment has been extended and accepted. An
offer of employment by JW Werntz is conditioned on the prospective employee testing
negative for illegal substances.
JW Werntz's policy is intended to comply with all state laws governing drug testing
and is designed to safeguard employee privacy rights to the fullest extent of the law.
Before being asked to submit to a drug test, the employee will receive written notice of
the request or requirements. The employee must also sign a testing authorization and
acknowledgement form confirming that he or she is aware of the policy and
employee's rights.
Any drug testing required or requested by JW Werntz will be conducted by a laboratory
licensed by the state. All expenses related to the test will be incurred by the company. The
employee may obtain the name and location of the laboratory that will analyze the
employee's test sample by calling laboratory 24 hours before the employee is scheduled to
be tested.
If the employee receives notice that the employee's test results were confirmed positive,
the employee will be given the opportunity to explain the positive result. In addition, the
employee may have the same sample retested at a laboratory of the employee's choice.
If there is reason to suspect that the employee is working while under the influence of
an illegal drug or alcohol, the employee will be suspended without pay until the results
of a drug and alcohol test are made available to JW Werntz by the testing laboratory.
Where drug or alcohol testing is part of a routine physical or random screening, there
will be no adverse employment action taken until the test results are in.
All testing results will remain confidential. Employee must sign a consent form prior to
the release of results. Test results may be used in arbitration, administrative hearings and
court cases arising as a result of the employee's drug testing. Results will be sent to
federal agencies as required by federal law. If the employee is to be referred to a
treatment facility for evaluation, the employee's test results will also be made available to
the employee's counselor.
BUSINESS INFORMATION
CONNIE LAWSON
INDIANA SECRETARY OF STATE
10/05/2018 02:42 PM
. _N MO r r
1S1ne55 tal�5 -
Business Name: 3 W WERNTZ & SON INCORPORATED
Entity Type: Domestic For -Profit Corporation
Creation Date: 10/19/1927
Principal Office Address: 1002 KERB STREET, SOUTH BEND, IN,
46601, USA
Foreign Legal Name:
Jurisdiction of Formation:
Business ID: 192606-040
Business Status: Active
Inactive Date:
Expiration Date: Perpetual -
Business Entity Report Due Date: 10/31/2019
tPrlltmpalI�nformafion t,<� .���.
TITLE
Secretary
NAME
PATRICK SCOTT WERNTZ
ADDRESS
1627 E WASHINGTON, SOUTH BEND, IN, 46617, USA
TITLE
Vice President
NAME
Robert Werntz
ADDRESS
25965 SR 23, SOUTH BEND, IN, 46614, USA
TITLE President
NAME PATRICK SCOTT WERNTZ
ADDRESS 1627 E WASHINGTON, SOUTH BEND, IN, 46617, USA
Type: Individual
Name: PATRICK SCOTT WERNTZ
Address: 1627 E WASHINGTON ST, SOUTH BEND, IN, 46617 - 0000, USA
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