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Home My WebLink AboutOpening of Bids - Mishawaka Ave Traffic Signals at Fire Station No 9 Project No 117-120A - Pemberton Davis Electric IncCITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Mishawaka Ave. Traffic Signals at Fire Station No. 9 Project No.-��__-- 117-120A For Bids Due February 12, 2019 PART I (Must be completed for all bids. Please type or print) Date: -m°' —Pq Bidder (Firm); Address: /C 15 Ovk,A!�_ -c— City/State/Zip: Telephone Number. 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: q � "" "t" k' e_ i` the City of South Bend, Indiana, in accordance with plans and specifications prepared by: a and dated for the sum of (enter the Total Bid as shown on the Proposal) (Enter sum of Total Base Bid of Divisions A-B) (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 City of South Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. Z 0 ACCEPTANCE The above bid is accepted this day of Subject to the following conditions: BOARD OF PUBLIC WORKS Qtit� (Signature) .L (Printed Name of Person Signing) 20 Gary A. Gilot, President Suzanna M. Fritzberg, Member Elizabeth A. Maradik, Member Therese J. Dorau, Member Laura O'Sullivan, Member Attest: Linda M. Martin, Clerk Version 7/20/2018 Contractor's Bid for Public Works - 2 117-120A BID/PROPOSAL CITY OF SOUTH BEND Project Name: Mishawaka Ave. Traffic Signals at Fire Station No. 9 Project Number: 117-120A For Bids Due: February 12, 2019 Contractor Name: DIVISION A Item No. Description Quantity Unit Unit Price Total Amount 1 I MOBILIZATION AND DEMOBILIZATION 1 LS sow'-�•� 2 I MAINTANCE OF TRAFFIC 1 LS 304Q-'11 lS�lp•� 3 CONSTRUCTION ENGINEERING 1 LS oo."� 4 CONCRETE SIDEWALK, REMOVE 134 SYS 31.` . �1+5'P.•^ 5 CONCRETE CURB, REMOVE 145 LFT 6 COMMON EXCAVATION 1 LS 7 TRAFFIC SIGNAL EQUIPMENT, REMOVE 2 EA mm... 63C� ._........... 8 PAVEMENT MESSAGE MARKING, 13 EA 31 a Gig' tSp REMOVE 9 TRAVERSE MARKING, REMOVE 2775 LFT 10 CURB RAMP, CONCRETE 63 SYS 23� 1 J,tw 11 SIDEWALK, CONCRETE 71 SYS 12 TOPSOIL AND SOD 50 SYS 13 GROOVING FOR PAVEMENT MARKINGS 3600 LFT . S O TRANSVERSE MARKING, 14 THERMOPLASTIC, STOP LINE, WHITE, 24 112 LFT 3 V / ��5 VV IN. • . TRANSVERSE MARKING, 15 THERMOPLASTIC, CROSSWALK LINE, 756 LFT ` `•�� Z .� WHITE, 6 IN. 16 LINE, THERMOPLASTIC, SOLID, YELLOW, 1960 LFT 4IN. 17 LINE, THERMOPLASTIC, SOLID, WHITE, 4 1649 LFT t, 3C4. F-? IN. e�� PAVEMENT MESSAGE MARKING, 18 THERMOPLASTIC LANE INDICATION 11 EA v ✓ ARROW 19 PAVEMENT MESSAGE MARKING, "ONLY", 8 EA "�• THERMOPLASTIC, WORD — O PAVEMENT MESSAGE MARKING, 20 THERMOPLASTIC, SHARED LANE 4 EA 4V 3� L,p vz % �► MARKING , Oy, 21 SIGN, SHEET, WITH LEGEND, 0.080 IN. 10 SFT ��s, u� Z.6V• 22 SIGN POST, SQUARE, TYPE 2, 18 LFT Lv `�� / go• �d d REINFORCED ANCHOR BASE Version 7/20/2018 Contractor's Bid for Public Works - 7 117-120A BID/PROPOSAL CITY OF SOUTH BEND Project Name: Mishawaka Ave. Traffic Signals at Fire Station No. 9 Project Number: 117-120A For Bids Due: February 12, 2019 Contractor Name: DIVISION A Item No. Description Quantity _ Unit Unit Price Total Amount 23 VIDEO VEHICLE DETECTOR SYSTEM 1 _ EA 24 CONDUIT, PVC, 2 IN. SCHEDULE 80 213 LFT I (S SO 23,5� 25 PEDESTRIAN PUSH BUTTON, APS 14 EACH 7471'T r 26 SIGNAL POLE FOUNDATION 24 IN. X 24 IN. 5 EACH q X 36 IN. 27 SIGNAL POLE PEDESTAL, 4-FT 5 EACH 7 tiW '4� 28 TRAFFIC SIGNAL HEAD, 3 SECTION, 12 10 EACH �L%A.� 7`� 'W�.=o IN. WITH BACKPLATE l 29 TRAFFIC SIGNAL HEAD, 5 SECTION, 12 5 EACH .e. ��.- t3� Sc�. IN. WITH BACKPLATE 30 SIGNAL CABLE, CONTROL, COPPER, 751 LFT 5C/14 GA 31 CONTROLLER CABINET MODIFICATION _ 1 EACH ts�� - & PROGRAMMING @ 20TH ST 32 CONTROLLER CABINET MODIFICATION 1 EACH ISM & PROGRAMMING @ IRONWOOD DR DIVISION A TOTAL 130, OTI Version 7/20/2018 Contractor's Bid for Public Works - 8 117-120A BID/PROPOSAL CITY OF SOUTH BEND Project Name: Mishawaka Ave. Traffic Signals at Fire Station No. 9 Project Number: 117-120A For Bids Due: February 12, 2019 . Contractor Name: DIVISION B Item No. Description Quantity Unit Unit Price Total Amount 1 SIGNAL CABLE, CONTROL, COPPER, 4531 LFT 2 1517 5C/14 GA EMERGENCY VEHICLE PREEMPTION 2 DETECTOR, SINGLE CHANNEL, ONE 3 EACH �S• DIRECTION EMERGENCY VEHICLE PREEMPTION 3 DETECTOR, SINGLE CHANNEL, TWO 2 EACH '' DIRECTION ��'� • 4 EMERGENCY VEHICLE PREEMPTION, 4 EACH EMITTER KIT 5 DETECTOR CABLE 3C/20GA. 853 LFT �,W �� • d;° 6 FLASHING BEACON WARNING SIGN 2 EACH CZ��,tr�' (3u cm ASSEMBLY l 7 CONDUIT, PVC, 2 IN. SCHEDULE 80 135 LFT .v 11 8 PEDESTRIAN PUSH BUTTON, NON-APS 2 EACH 9 SIGNAL CABLE, CONTROL, COPPER 875 EACH S '0 3C/14GA . 10 SIGNAL POLE FOUNDATION 24 IN. X 24 2 EACH O 0 IN. X 36 IN. `rJ�' " DIVISION B TOTAL DIVISION A TOTAL 13o1C-0. V DIVISION B TOTAL q 1 ,,5, SV PROJECT TOTAL - DIVISIONS A-B- Bidder (Firm): o-I hO-s 6ct t4c, Address: , �i w . .. City/State/Zip: Telephone Number: 7 -706 1 (Signature) (Printed Name of Person Signing) Version 7/20/2018 Contractor's Bid for Public Works - 9 117-120A I�zen 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 ) SS: COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. Version 7/20/2018 Contractor's Bid for Public Works - 4 117-120A 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. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder Version 7/20/2018 Contractor's Bid for Public Works - 5 117-120A 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 /Xlv day of �6 , 20 /9 �f—b,t� 14,/ J �Ce�cTGr� Lyt Contractor/Bidder (Firm) ( :S mature of Co ractor/Bidder or Its Agent d -,eeo r Printed Name and Title � Subscribed and sworn to before me this day of 2 l q 9 My Commission Expires' Notary Pule County of Residence - Slate' Notary u 0 O %+ , 22A Version 7/20/2018 Contractor's Bid for Public Works - 6 117-120A X 'wn 14N 1316 CoUt1T5 -C e�w TBUILDING 1• 011 r r PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD � � i� FAX 574/ 235-93 7I SOUM BEND, Itvz IANA 46601-1830 'TDD 574/ 235-5567 CITY OF SOUTH BEND PETE, BUTTIGIEG, MAYOR PUBLICBOARD OF WORKS Date: February 7, 2019 To: All Planholders From Linda M. Martin, Clerk, Board of Public Works Subject Adde..............._........— Addendum ..._.. ._....... m Number: 1 Project Name: Mishawaka Avenue Traffic Signals at Fire Station No. 9 Project Number: 117-120A ACKNOWLEDGEMENT GEMENT OF RECEIPT OF ADDENDUM Date Received: 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: p Authorized Signature: Date: Version 4/2/2015 A Document A310T"" - 2010 CONTRACTOR: SURETY: (Name, legal status and address) (Name, legal status and principal place Pemberton -Davis Electric, Inc. of business) 916 E. McKinley Ave Great American Insurance Company Mishawaka, IN 46546 301 E. 4th Street This document has important legal Cincinnati, OH 45202 consequences. Consultation with OWNER: an attorney is encouraged with respect to its completion or (Name, legal status and address) City of South Bend modification. Any singular reference to Contractor, Surety, Owner or BOND AMOUNT: Five Percent of the Amount Bid other party shall be considered ($ 5% of Bid plural where applicable. PROJECT: (Name, location or address, and Project number, if any) Traffic Signal Mishawaka Ave at Fire Station No. 9, Project No. 117-120 The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. 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 other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed arad.:Walt,d this lzth day of (l�"ittfes.sf.. (ll rtis) Init. AIA Document A310f"" -20W Copyright 019a63, 19 tOand 2010 by The Arner�can lnolMtute of Arc@tbtect%API rights reserved, WVAftl NGThts AIAs Document Is protoctod by U,S. Copyright Law and International Treaties. Unauthorized reproductico or WeIributtorl of this AlA Uncum nt,, or any portion of it, may result In severe civil and cdminal penalties, and will be prosecuted to the maxtraaum extent possible under the law. / Pwurr, hagstro6 are ponnfill to reproduce Ion (I O) couples of tlrls document when completed To report copya%ght violullons of AIA Contract Docurnents, a rwil 'fheAurichcanln5fututoofArckrBt is"legalwur,W,copyrig,ht ala..orY1. 40110 GREAT AMERICAN INSURANCE COMPANY(R) Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 a 513-369-5000 0 FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than ONE POWER OF ATTORNEY No.0 18525 KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attorney -in -fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof, provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power JASON D. CROMWELL NEW ALBANY, INDIANA $100,000,000 This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seat hereunto affixed this 23RD day of JUNE 1 2015 Attest GREAT AMERICAN INSURANCE COMPANY u iwmiuWww WI Assistant Secretary Divisional Senior Vice President STATE OF OHIO, COUNTY OF HAMILTON - ss: DAVID C„ KiTCHw (877-377-2405) On this 23RD day of JUNE 2015 , before me personally appeared DAVID C. KITCHIN, to me known, being duly swom, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authority. r :a This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of GreatAmerican Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them, be and hereby is authorized, from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts ofsuretyship, or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship, or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed this dayof { r Assistant Secretary S1029AF (06/15) CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Mishawaka Ave. Traffic Signals at Fire Station No. 9 Project No. 117-120A For Bids Due February 12, 2019 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 MBE/WBE 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 o ledge Receipt of,/, 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 and comply with the specifications. i Bidder: .7 L I Date: By Authorized Represent Live: Signature: Print Name & T-JIe. Version 7/20/2018 Contractor's Bid for Public Works - 1 117-120A 3. The City shall have first right to salvage all signal equipment. 4. Signal Cable: An additional six (6') feet of wire shall be coiled in each handhole. 5. All new conduit connections to existing hand holes shall be core drilled. 6. All necessary hardware and anchor bolts to install the new signal heads and backplates will be furnished by the Contractor and not paid for directly but included in the various traffic signal items. 7. All signal, power, or fiber optic conduits shall be 2-IN. CONDUIT, PVC, 2-IN, SCHEDULE 80 will be paid for at the contract unit price per LFT installed. The cost of all labor, material, utility and equipment necessary to complete the work shall be included in the unit price. Any required drilling or coring of existing handholes shall be included in the conduit unit price. 8. SIGNAL CABLE 5C/14 and SIGNAL CABLE, 7C/14 shall be paid for at the contract unit price per linear foot (LFT) installed. The cost of all labor, material, utility, and equipment necessary to complete the Work shall be included in the respective contract unit prices for signal wire. XL. UNDISTRUBUTED ITEMS A. Prevailing Specifications: 2018, INDOT Standard Specifications Section B. Additions 1. The items which are indicated herein as undistributed shall be used only as directed by the Engineer. All undistributed items will be field measured by the Engineer to determine the quantity for payment. Quantities of undistributed items needed in addition to those indicated will be paid for at the contract unit price as shown on the Itemized Proposal and Declarations. 2. Undistributed Pay Items and their associated quantity include: a. CONDUIT, PVC, 2 IN. SCHEDULE 80....100 LFT Version 8/16/2018 Special Provisions - 22 117-120A CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM FORM MWBE-1.0 MBE/WBE PARTICIPATION This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications owned business. Project Number: 117-120A Bidder: Name & Address of MBE/WBE Submitted by: Print Name Project Name: Mishawaka Ave. Traffic Signals at Fire Station No. 9 Total Bid Amount: Primary Contact Person (Namelfelephone) Njo Scope of Work to be Performed (Attach scope/schedule if you need additional space) �M Signature Version 7/20/2018 Contractor's Bid for Public Works - 10 117-120A P Dc MBE/ 9 Date V,PC' 1f47 N4,�i CITY OF SOUTH BEND � MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY, �y DEVELOPMENT PROGRAM FORM MWBE-2.0 EVIDENCE OF GOOD FAITH EFFORTScrra 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 MBE/WBE 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: 117-120A Date: Project Name: Mishawaka Ave. Traffic Signals at Fire Station No. 9 Bidder: Contact Person: — a Telephone: Address: City: State: Zip: Email: sW� 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 MBE/WBE 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 (ADVERTISE/CONTACT): 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 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 MBE/WBEs of subcontracting opportunities and allowed sufficient time for them to participate effectively. 4. Utilize pre-existing services of available community organizations, small and/or disadvantaged business assistance offices and other organizations that provided assistance in the recruitment and placement of MBE/WBE firms. **Bidder must circle or otherwise notate which of the two (2) required actions were performed. GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBE/WBEs, including providing such MBE/WBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject 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 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. *Prover demonstration of Good Faith Effort reauires vour initial's 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 - 11 117-120A A-1 Stripe Airmarking Jim Zakrzewski Greg 574-654-86216 574-223-5817 298-7520 574-930-0986 574- 223- 7959 jArneszakrzewski 2 AgLmq i gEM(q),girm ' arlejn 9. —COM State James 574-287-2078 574-300-7721 574- jgq1K �sri��,ichal. sk� ....i .......................... Bafficadin Michalski 287- PMN - —00 m g, Inc. 1744 statebarricadel DBL David 574-968-2028 574-302-7023 574- c9erAuc. S Letcher 255- esinervices, c.com Inc. 8406 RoadSafe Rick Smith 765-471-8891 815-405-7994 219- rsmith(cDroadsaf Traffic 663- etraffic.com Systems 4460 James Oliver Lq-c!2dP—tq anqi.-qA stri sls....O.el ppi Traffic Tracey 574-772-7001 574- N' Lr.rL@ htm g q i a I i traf Control Triska 772- sts. net fic Specialists 7002 con Tanner Leibovitz From: Tanner Leibovitz Sent: Friday, February 08, 2019 9:38 AM To: dave@DBLservicesinc.com Subject: Mishawaka Ave Traffic Signal Dave - Please see the link below. This bids Tuesday next week, Thanks Tanner Leibovitz I Project Manager I Estimator I Traffic Division Pemberton Davis Electric, Inc. Pn. 574-277-7001 1 Fax 574-204-2565 1 Cell 574-229-8163 This message is for the named person's use only. It may contain confidential, proprietary or legally privileged information. No confidentiality or privilege is waived or lost by any mistransmission. If you receive this message in error, please immediately delete it and all copies of it from your system, destroy any hard copies of it and notify the sender. You must not, directly or indirectly, use, disclose, distribute, print, or copy any part of this message if you are not the intended recipient. Tanner Leibovitz From: Tanner Leibovitz Sent: Friday, February 08, 2019 9:36 AM To: greg@airmarking.com Subject: Mishawaka Ave Traffic Signal Greg - Please see the link below. Can I get a quote for the striping? This bids Tuesday next week. 1!t1 ^ wywrw w irw1�!2o&&,, )rn/s1 / 9 vcth, & w 1.1 ra?(.11=0 Thanks Tanner Leibovitz I Project Manager I Estimator I Traffic Division Pemberton Davis Electric, Inc. Pn. 574-277-7001 1 Fax 574-204-2565 1 Cell 574-229-8163 PF.MBJ N D"is This message is for the named person's use only. It may contain confidential, proprietary or legally privileged information. No confidentiality or privilege is waived or lost by any mistransmission. If you receive this message in error, please immediately delete it and all copies of it from your system, destroy any hard copies of it and notify the sender. You must not, directly or indirectly, use, disclose, distribute, print, or copy any part of this message if you are not the intended recipient. Tanner Leibovitz From: Tanner Leibovitz Sent: Friday, February 08, 2019 9:38 AM To: Barry@tcspecialists.net Subject: Mishawaka Ave Traffic Signal Barry - Please see the link below. This bids Tuesday next week. N�iwrN�owd�I,i�AlLr81=. �vl,; ipa'mli Thanks Tanner Leibovitz I Project Manager I Estimator I Traffic Division Pemberton Davis Electric, Inc. Pn. 574-277-7001 1 Fax 574-204-2565 1 Cell 574-229-8163 � , [ 1111 ,, " I ! I This message is for the named person's use only. It may contain confidential, proprietary or legally privileged information. No confidentiality or privilege is waived or lost by any mistransmission. If you receive this message in error, please immediately delete it and all copies of it from your system, destroy any hard copies of it and notify the sender. You must not, directly or indirectly, use, disclose, distribute, print, or copy any part of this message if you are not the intended recipient. Tanner Leibovitz From: Tanner Leibovitz Sent: Friday, February 08, 2019 9:39 AM To: rsmith@roadsafetraffic.com Subject: Mishawaka Ave Traffic Signal Rick - Please see the link below. This bids Tuesday next week. Thanks Tanner Leibovitz I Project Manager I Estimator I Traffic Division Pemberton Davis Electric, Inc. Pn. 574-277-7001 1 Fax 574-204-2565 1 Cell 574-229-8163 P I- M B, FN IN This message is for the named person's use only. It may contain confidential, proprietary or legally privileged information. No confidentiality or privilege is waived or lost by any mistransmission. If you receive this message in error, please immediately delete it and all copies of it from your system, destroy any hard copies of it and notify the sender. You must not, directly or indirectly, use, disclose, distribute, print, or copy any part of this message if you are not the intended recipient. Tanner Leibovitz From: Tanner Leibovitz Sent: Friday, February 08, 2019 9:36 AM To: jameszakrzewski@aol.com Subject: FW: Mishawaka Ave Fire Station #9 Jim - Please see the link below. Can I get a quote for the striping? This bids Tuesday next week. 0 Thanks, Tanner Leibovitz I Project Manager I Estimator I Traffic Division Pemberton Davis Electric, Inc. Pn. 574-277-7001 1 Fax 574-204-2565 1 Cell 574-229-8163 pEms DAVIS This message is for the named person's use only. It may contain confidential, proprietary or legally privileged information. No confidentiality or privilege is waived or lost by any mistransmission. If you receive this message in error, please immediately delete it and all copies of it from your system, destroy any hard copies of it and notify the sender. You must not, directly or indirectly, use, disclose, distribute, print, or copy any part of this message if you are not the intended recipient. CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name Mishawaka Ave. Traffic Signals at Fire Station No. 9 Project No. 117-120A For Bids Due February 12, 2019 Contractor Name: 103,vo C The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 63 of The Responsible Bidding Ordinance No. 10594-18 (hereinafter, "Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders") by December 315' for the upcoming calendar year, or within twelve (12) months of obtaining pre - qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective January 1 of the following year, or immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 7/20/2018 General Conditions - 6 117-120A POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder and all subcontractors on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 7/20/2018 General Conditions - 7 117-120A PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements: (i) ✓ By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. (ii) ✓ By checking this box, 1 hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (b) Attachments: (i) ✓ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) ✓ Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. (iii) ✓ Evidence that I am utilizing a surety company which is on the United States Department of Treasury's Listing of Approved Sureties as required in the bid specifications or contract. (iv) ✓ List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: (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) Attachments: (i) _ 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) List identifying all former business names. (iii) — 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) 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 4-13-18-5 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. (ix) 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 work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. Date: February 12, 2019 (Sig Mere) ohn A. Ferro (Print Name Here) Pemberton Davis Electric, Inc. (Name of Company) 916 E. McKinley Ave. (Address of Company) Mishawaka (City) Indiana (State) (574)277-7001 (Telephone Number) I: BUSINESS INFORMATION CONNIE LAWSON INDIANA SECRETARY OF STATE 11/26/2018 03:28 PM ii//l % r/ Business Name: PEMBERTON-DAVIS ELECTRIC, INC. Business ID: 1997030633 Entity Type: Domestic For -Profit Corporation Creation Date: 03/11/1997 Principal Office Address: POST OFFICE BOX 4577, SOUTH BEND, IN, 46634, USA Jurisdiction of Formation: Indiana Business Status: Active Inactive Date: Expiration Date: Perpetual Business Entity Report Due 03/31/2019 Date: Years Due: Title Name Address President John Ferro 202 S MICHIGAN ST., STE 600, SOUTH BEND, IN, 46601, USA Secretary kent Bertsch 202 S MICHIGAN ST., STE 600, SOUTH BEND, IN, 46601, USA �itat�ht'4tts�rt,�t�CUt?nat�I�blt , .. Name Title Address John B. Ford Incorporator 1800 Valley American Bank Building, 211 W. Washington Street, SOUTH BEND, IN, 46601 - 0000, USA Type: Individual Name: John B. Ford Address: 202 S MICHGIAN ST, STE 600, SOUTH BEND, IN, 46601 - 0000, USA T" I (hftp://www.INBiz.IN.gov) Name History Business Details Business Name: PEMBERTON-DAVIS ELECTRIC, INC. Entity Type: Domestic For -Profit Corporation Creation Date: 03/11/1997 Principal Office POST OFFICE BOX 4S77, SOUTH Address: BEND, IN, 46634, USA Jurisdiction of Indiana Formation: Name History Details Back Return to Search Business ID: 1997030633 Business Status: Active Inactive Date: Expiration Date: Perpetual Business Entity 03/31/2019 Report Due Date: Years Due: Name GRANGER ACQUISITION COMPANY .. ........ . GRANGER ELECTRIC COMPANY Pemberton Davis Electric, Inc. is a union contractor, signatory to the following trade unions: IBEW Local 153 IUOE Local 150 LIUNA Local 645 Our current manpower level is sufficient to meet the requirements of the Howard Park project, . Additional employee needs are filled via the various agreements we have with the trade unions. All work performed on this project within our scope will be performed by qualified full-time employees of Pemberton Davis Electric, Inc. Drug testing of employees is conducted per the terms and conditions of the specific labor agreements we have with the trade unions. All employees not covered by a specific labor agreement are required to adhere to the attached drug testing policy. Great American Alliance Insurance Company (NAIC #26832) BUSINESS ADDRESS: 301 E Fourth Street, Cincinnati, OH 45202. PHONE: (513) 369-5000. UNDERWRITING LIMITATION b/: $2,791,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Ohio. Great American Insurance Company (NAIC #16691) BUSINESS ADDRESS: 301 E Fourth Street, Cincinnati, OH 45202. PHONE: (513) 369-5000. UNDERWRITING LIMITATION b/: $164,046,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, GU, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Ohio. GREAT A ERICAN INSURANCE COMPANY OF NEW YORK (NAIC #22136) BUSINESS ADDRESS: 301 E Fourth Street, Cincinnati, OH 45202. PHONE: (513) 369-5000. UNDERWRITING LIMITATION b/: $4,916,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: New York. Great Midwest Insurance Company (NAIC #18694) BUSINESS ADDRESS: 800 Gessner, Suite 600, Houston, Texas 77024. PHONE: (713) 935-0226. UNDERWRITING LIMITATION b/: $10,697,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NJ, NY, NC, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WA, WV, WI, WY. INCORPORATED IN: Texas Great Northern Insurance Company (NAIC #20303) BUSINESS ADDRESS: 202B Hall's Mill Road, Whitehouse Station, NJ 08889. PHONE: (215) 640-5259. UNDERWRITING LIMITATION b/: $38,173,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Indiana. Guarantee Company of North America USA (The) (NAIC #36650) BUSINESS ADDRESS: One Towne Square, Suite 1470, Southfield, MI 48076 - 3725. PHONE: (248) 281-0281 x-66012. UNDERWRITING LIMITATION b/: $18,995,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, VI, WA, WV, WI, WY. INCORPORATED IN: Michigan. C 3 QgLLUm �mcoo LLLL� oo0�wo UUUmU?,00 kQ�Q W Q� 2 o a0U) O W W z W 2 LL ❑_ ¢ YZQZzzz,zzZ'' QWLLW Q NOW0000 �tn:tntototnz� LLLLLLLLLLLL 00000}00}0}0U�0}00 mgmCDmm 2 �_ 0a0aUda-000 2 F- W 2 Lr W 2❑— F_ Wo— LL z Zmmm 000 QQ O o ❑ wwLlj 2 tntntn LLLLLL ❑ 2 ❑ 2 Z' — Z Z O v Z ZZZZZZ Q LLI ZZZZ Z Z ZZ —--Z— J �;q ci .Z-❑❑0❑ j Qzzzz ❑ z ❑❑❑ ZZZ �: mw�mgmmmm m m'mm WQ to �5m Q — Ito mco� vO)i �U)i� cnttoUSi t(n o z z z m z '0 z a 9 to T U) c9 to a 55 (!) cn 0 z C9 z p zzZ z LZx z z u22 2Q2z m •� UC7U' ,J J. - zi _U' J ��o J U C7 J ❑ ❑ tri tri tri a6 t= to fn v tri dz to tri' Q to to to Q m J J J� U J J� ;TC J Z C�C7t9zoC�'C9LLoC7oC7(7 2 0�0 to U) to V 1 fn to fn J Cn CO. 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