HomeMy WebLinkAboutOpening of Bids - Three Twenty at the Cascade Exterior Insulation and Finish System Project No 118-074B-R - Skyline Plastering IncCITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK w.
Project Name Three Twenty at the Cascade —Exterior Insulation and Finish System (E„I,F. ,)
Project No. 118-074 B-R
For Bids Due March 12, 2019
PART I
(Must be completed for all bids. Please type or print)
Date: t" Bidder Firm
Address:
City/State/Zi : " �.— t _..._,
p Telephone Number:2,77 1
Agent of Bidder (if Applicable):
_w
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of:
-� . "
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
�l
and dated P �" ... w for the sum of (enter the Total Bid as shown on the Proposal)
..
^ t
(Enter sum of Total Base Bid shown on P op
.__.. (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 94 separate attachment.
By
r (Signature)
��d e1 � 6V)
(Printed Name at Person Signing)
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
James A. Mueller, Member
Suzanna M. Fritzberg, Member
Therese J. Dorau, Member
Attest: Linda M. Martin, Clerk
Version 7/20/2018 Contractor's Bid for Public Works - 2
`11
BID/PROPOSAL uw rzr`�s
CITY OF SOUTH BEND
Project Name: Three Twenty at the Cascade — Exterior Insulation and Finish System"
Project Number: 118-074 B-R,a�
d,w t F
For Bids Due: March 12, 2019
Contractor Name:
Li
BASE BID
Item No. Description
Exterior Insulation and Finish System
(E.I.F.S.)
1 Texture #1 (Accent Band at Level1 and
Roof Parapet Wall
2 Texture #2 (Main Body at Levels 2-7)
3 Texture #3 (Horizontal Band at Floors
and Band below Roof Parapet Walls)
ALTERNATE #1
Item Description
No.
Exterior Insulation and Finish System
E.I.F.S.
Standard Plaster Finish Applied to
4 DensGlass Substrate at Entry Arch.
Includes Finish Plaster on Concrete
Base. Finish shall be Texture #1.
ALTERNATE #2
Item Description
No.
Exterior Insulation and Finish System
E.I.F.S.)
Vertical Wave Pattern on Field -applied
E.I.F.S. System. E.I.F.S. Finish is
5 Texture #4. Insulation shall be Shop -cut
3D Wave Pattern with 2" Deep Reveal.
Finish is Field-aDDlied.
Quantity Unit Unit
Price
1
Lump
439.00
Sum
1
Lump
Sum
1
Lump
'
Sum
BASE
BID TOTAL
Quantity
1
Unit Unit
Price
Total Amount
Total Amount
Lump a418. 00 �(tl,436-00)
Sum
ALTERNATE #1 TOTAL
Quantity Unit Unit
Price
Total Amount
1 Lump 0+4
Sum
r4onoo
ALTERNATE #2 TOTAL Ua e 1001. GV
Version 7/20/2018 Contractor's Bid for Public Works - 7
BID/PROPOSAIL k,CTIF��
CITY OF SOUTH BEND'`
Three Twenty at the Cascade — Exterior Insulation and Finish System N
Project Name: 10,
E.LF.S.'A
Project Number: 118-074 B-R� -
For Bids Due: March 12, 2019
e
Contractor Name:
� ,. ILS . A
Ci
ALTERNATE #3
Item
[Description Quantity Unit P CeTotal Amount
xterior Insulation and Finish System
E.I.F.S.
Vertical Wave Pattern on Pre -fabricated
Panels in Lieu of Field -applied E.I.F.S.
Panels shall be Shop -cut 3D Wave
6 Pattern with 2" Deep Reveal. Finish is 1 Sump
Applied on Shop -fabricated on Panels.
Finished Panels are Installed in the Field
as a Wall Panel System
ALTERNATE #3 TOTAL
Bidder (Firm):
69
Address: j.-
City/State/Zip: Telephone Number:, } 1 /00
By
(Signature)
(Printed Name of Person Signing)
Version 7/20/2018 Contractors Bid for Public Works - 8
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION
REGARDING INVESTMENT WITH H2AN, 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 1L )
SS:.
4,"J 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:
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
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
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 ventures awarded a contract by the City of
South Bend through its agencies, boards, or commissions shall not discriminate against any employee or
applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions,
or privileges of employment, or any matter directly or indirectly related to employment because of race, sex,
religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or
disability that does not affect that person's ability to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any
combination of the foregoing including, but not limited to, public works contracts awarded under public
bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards,
or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors
certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise
("WBE") as a factor in determining the lowest, responsible, responsive bidder.
In no event shall persons or entities seeking the award of a City contract be required to award a subcontract
to an 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 Contractors Bid for Public Works - 5
may result in forfeiture of contractual payments.
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid
for public works are true and correct.
Dated this 1/ day of &d , 201)
Subscribed and sworn to before me this 11,11
My Commission ExpiresDhA/ 13 02 C�
County of Residence
1T
Cont r< r/Bidder (Firm)
Si nature of Contractor/Bidder or Its Agent
Printed NaUVId Title
day of f
►''1 �.0 m
o Publlle"
V
OFFICIAL SEAL
RUDOLF ENGEL
NOTARY PUBLIC, STATE OF IWNOIS
My Commission Expires Jan. 13, 2020
Version 7/20/2018 Contractors Bid for Public Works - 6
Docum�ent A31OTM - 2010
Conforms with The American Institute of Architects AIA Document 310
Bid Bond
CONTRACTOR:
(;'trine, legals/a/us and address)
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
OWNER:
(Xame, legal slalres and address)
City of South Bend
227 W. Jefferson Blvd, Suite 1316
South Bend, IN 46601
SURETY:
(''nine, legals/a/us avid principal place of huviness)
Old Republic Surety Company
P. O. Box 1635
Milwaukee, WI 53201-1635
Malling Address for Notices
1411 Opus Place, Suite 450
Downers Grove, IL 60515
BOND AMOUNT: $ 5% Five Percent of Amount Bid
PROJECT:
(,Vance, locallon or address. and Project inunher, if aiti j
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.
EIFS Work Three Twenty at the Cascade, 320 E. Colfax Avenue at St. Joseph River, South Bend, IN 46617
- Project# 118-074-B-R
The Contractor and Surety are bound to Ilia Owner in the amount set forth above, for ilia 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 arc 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 1'rgiect 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 perlimn the work covered by.said bid, then this obligation shall be null and void, otherwise to remain in lull lbrce and ellect. The
Surely hereby %vaives any notice ol'un agreement between the Owner and Contractor to extend the line in which the Owner may accept the
bid. Waiver ol'nutice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time liir
acceptance ol'bids speciled in the bid documents, and the Owner and Contractor shall obtain the Surety's consent liir an extension beyond
sixty (60) days.
If this Bond is issued in connection with a subcontractor's bid to n Contractor, the term Contractor in this Bond shall be dccmcd to be
Subcontractor and ilia term Owner shall be dccmcd to be Contractor.
When this Bond has been lurnished 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 requirenienl shall be deenied deleted herelFont and provisions coniimning to such
statutory or other legal requirement shall be deenied incorporated herein. When so furnished, the intent is that this Bond shall be construed
as a statutory bond and not as a connnon law bond.
Signed and scaled this 12th day of March, 2019
(li'llrr
iA4 ra J k*v�
(!f'inresa) Christina L. Garry
Skyline Plastering, Inc.
(P)irrclpal) (Seal)
Old Republic Surety Compan ;
OIIiORAT� o
(Srrr e
n9 rst«p SEAT
!!!plGCI PEiVYO
(7`llle Moore orney-in- ac �,,,w�`
Isll-' /
S-0054/AS 8/10
State of
County of
Illinios
DuPa e
SURETY ACKNOWLEDGEMENT (ATTORNEY -IN -FACT)
I, Christina L. Garry Notary Public of DuPage County, in the State of Illinios ,
do hereby certify that James 1. Moore Attorney -in -Fact, of the Old Republic Surety
Company who is personally known to me to be the same person whose
name is subscribed to the foregoing instrument, appeared before me this day in person, and
acknowledged that she signed, sealed and delivered said instrument, for and on behalf of the
Old Republic Surety Company for the uses and purposes therein set forth.
Given under my hand and notarial seal at my office in the City of Downers Grove in
said County, this 12th day of March 1 2019
J)
Notary Public Christina L. Garry
My Commission expires: January5, 2021
°NOTARYpUav GARRy
hty O �s P�� T� TTI ��c r1
{ � N to 2o'?'
* "LD REPUBLIC SURETY COMPANY
*�
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock Insurance corporation, does make, constitute and
appoint:
James I. Moore
its true and lawful Attorney(s)-in-Fact, with full power and authority, not exceeding $50,000,000, for and on behalf of the company as surety, to execute and
deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof,
(other than ball bonds, bank depository bonds, mortgage deflclency bonds, mortgage guaranty bonds, guarantees of Installment paper and note
guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, asbestos abatement contract bonds, waste
management bonds, hazardous waste remedlation bonds or black lung bonds), as follows: Execution Date: March 12, 2019
Surety Bond number: Bid Bond
Principal: Skyline Plastering, Inc.
Obligee: City of South Bend
and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed.
This appointment is made under and by authority of the board of directors at a special meeting held on February 18, 1982.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD
REPUBLIC SURETY COMPANY on February 18,1982.
RESOLVED that, the president, any vice-president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appoint
attorneys -In -fact or agents with authority as defined or limited In the Instrument evtdencing the appointment in each case, for and on behalf of the company to
execute and deliver and affix the seal of the company to bonds,: undertakings, recoginlzances, and suretyship obligations of all kinds: and said officers may
remove any such attorney -in -fact or agent and revoke any Power of Attorney previously granted to such person.
RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant
secretary; or
(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be
required) by a duly authorized attorney -in -fact or agent; or
(iii) when duly executed and sealed (if a seal be required) by one or more attorneys -in -fact or agents pursuant to and within the limits of the authority
evidenced by the Power of Attorney issued by the company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or
certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the company; and such
signature and seat when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be
affixed this 1 St day of October 2018
OLD REPUBLIC SURETY COMPANY
rORPOR
SEAL
0 nn
Assistant Secretar
STA E OF WISCONSIN, COUNTY OF WA`' * President
UKESHA - SS Btl�9M�
On this 1st day of October 2018 , personally came before me, -- Alan Pavlic
and to me known to be the individuals and officers of the OLD REPUBLIC SURETY COMPANY
who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly swom, did severally depose and say: that
they are the said officers of the corporation aforesaid, and that the seal affixed to the above Instrument is the seal of the corporation, and that said corporate seal
and their signatures as such officers were duly affixed and subscribed to the said Instrument by the authority of the board of directors of said corporation.
r�YQ
" •w , Notary Public
My Commission Expires: September 'S 2022
CERTIFICATE (Expiration of notary's commission does not invalidate this instrument)
I, the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the foregoing and attached
Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of
Attorney, are now in force.
,�pw,rx rr ��d vxi
a wu� ce*rzer,ur,.
ffi SEe'L ,S Signed and sealed at the City of Brookfield, WI this 12th da March 2019
ORSC 22262 (306) �k"*^�ercuR�aarM�N4"w�`�'� �44elv�
Assistant Secretary
1316 C'O N I-Y-0i v B iLDING
227 W..Ya'Ft::RS0N .Boi_lu-NA.RD
SOUTH BEND, fNIDz.lN.a 46601-1930
i "1"td A
I;
i1B�r6
Puo yr 5'74/ 235-9251
FAK 571/235-9ll7ll
TDD 5 74/ 235....5567
CITY OF BEND PETE BU'[TlGfFG, MAYOR
BOARD O:IWORKS
Date: February 7, 2019
To: All Plan Holders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number:
�...�..._..._ �.� �..........w_..ww......� __ _ ..�.�..._..�_���_......����.
tuber: 7
Project Name: Three Twenty at the Ca IT WWW�WWWWWWWWWWWWWWWWWWWWW WW scade —Composite Wall Panels
Project Number: 118-074 C
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received: ebAI&M I 1�4
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: Sk L41 W P
Authorized Signature:
Date: 3111 / I
Version 4/2/2015
AX
13 16 C OUN FY-(-I I Y BtIII,DIN(
227 W..I viiiRSON BOULEVARD
.SOUTFIBF-1 ID INDIANA.466(1I-1930
I1HONE. 574./235-9251
FAX 574/ 23.5-9171
"ll'DD 7 74/ 235•-5.567
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC S
Date:
January 17, 2019
To:
All Plan Holders
From
.......
Linda M. Martin, Clerk, wBoard of Public Works
Subject
_... __............_...................wwwwww
Addendum Number: 6
Project Name: Three Twenty at the Cascade — Composite Wall Panels
Project Number: 118-074 C
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received: Jan AA 18*, /
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy MAST 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:
Authorized Signature:
Date:/l/ //
Version 4/2/2015
1 316 COUNTY -CITY BUILDING
227 W ,YEFFERSON 1L3oullaARD
SOUTH Benin, INDIANA 46601 •-n 830
IN65
PHONE 57 / 23.5•-92.5 4
FAX 57=4/ 235•-9 71
`4 DD 574/ 235•-5.56 7
CITY OF BEND PETE BUTTIGIEG, MAYOR
BOARD i
Date: January4, 2019
To: All Plan Holders
From Linda M. Martin, Clerk. Board of Public Works
Subject Addendum _._......... .. .............. ........_.... _.....
5 ndum Number: ... --................... �_._._..........................................................................
Project Name: Three Twenty at the Cascade — Composite Wall Panels
Project Number: 118-074 C
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received:
411L. ;-r->i
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: Akq li4t
Authorized Signature:
Date: /
i
1316 COUNTY-Cn Y 13r?n.DtNG
227 W. JEFFERSON BouLEVARD
S01TH BizND, INDIANA 46601-1830
PIAI o-
w
Pi iow', 574/ 235-9251
FAN 574/ 235-9171
TDD 5741; 235-5567
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
Date: December 6, 2018
To: All Plan Holders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number: 4....._.......................... WWWWWWWW w----
Project Name: Three Twenty at the Cascade — Composite Wall Panels
Project Number: 118-074 C
ACKNOWLEDGEMENT 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: I^XA e oiks
Authorized Signature:
Date: 3/1C'.
Version 4/2/2015
1 316 C OUNTY-C ri-Y BuH.DfNG
227 W. h.1,FERSON BouLEVARD
So rm BEND, INDIANA 46601-I830
PHOW,, 574/ 235-9251
F,�` 574/ 235-9171
TDD 574/ 235.5567
CITY OF SOUTH BEND PETS BUTTIGIEG, MAYOR
BOARDLIC WORKS
Date: November 20, 2018
To: All Plan Holders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number: 3
Project Name: Three Twenty at the Cascade — Composite Wall Panels
Project Number: 118-074 C
ACKNOWLEDGEMENT MENT OF RECEIPT OF ADDENDUM.
Date Received: Ntid rone,_c210.- ...m. - _�...................... _._ ....
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: 11� F14J1WZP 14C
Authorized Signature:
Date:
Version 4/2/2015
1316 COUNTY —CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOU[H BEND, INDIANA 46601-1830
C'
s^iweac.�
2865
PHONE 574/235-9251
FAX 574/ 235-9171
TDD 574/ 235-5567
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
Date: November 6, 2018
To: All Planholders
From Linda M. Martin, Clerk, Board of P.........
Subject Addendum Number: 2
Project Name: Three Twenty at the Cascade — Composite Wall Panels
Project Number: 118-074 C
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received:
r� �.O 16
_'
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.
TIIS 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:
Authorized Signature..
Date:
Version 4/2/2015
1316 COUNTY -CITY BUILDING
227 w.JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PPACK'
1 .
PHONE 574/235-9251
FAX 574/235-9171
TDD 574/ 235-5567
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
Date:
October 30, 2018
To:
All Plan Holders
From
Linda M. Martin, Clerk, Board of Public Works
_...�..................................................._wmwm mm.
Subject
Addendum Number:
ber: 1
Project Name: Three Twenty at the Cascade — Composite Wall Panels
Project Number: 118-074 C
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUI'1!
Date Received: VyVgr I 1mr 1� �o
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: r / 1 rLC.. ..
Authorized Signature:
Date: -5/ II
Version 4/2/2015
SKYLINE
Project No. 118-074 B-R
Exterior Insulation Finish System by
Skyline Plastering Inc.
232 Westgate Drive,
Carol Stream, IL 60188
(630) 627-1 100
r-1 C1W —LeCa — _D : T"U 3 .4 c. R! C11:-.E F? C r-dEL OF -I TI? F--
File Number 5954 -729-6
r
L of
Office f
Wht AR(retarm of 9:e
ARTICLES OF «Rt OF
SKYLINE PLASTERING, XMC.
XWOOPPOVATMTHE STATE OV _ HAVE BEEN
FILED OF THS SECUtTARY OF STATE RS PROVIDnD BY TOE
BUSINESS CORPORANION ACT OF A.D. 1984.
ilow Therefore,." H. Ryan, Secretaryof
by - of the powers _ r in me by
this !cei-tificate and attach hereto a copyApplication the
aforesaid corpor6tion.
WowingAn 1 o set my hand and cause to be
affixed the Great Sea] of the State of Illinois,
at the City of fI
, this 31ST
day of OCWOBBR A.D. 19-97 andof
the Independence of the United States the two
hundred and 229D
w
Secretary of State
G212.2
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
CHECKLIST FOR BIDDERS
Project Name Three Twenty at the Cascade — Exterior Insulation and Finish System
—(EFI.SJ
Project No. 118-074 B-R
For Bids Due March 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 MBEANBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not
met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted
Form ['MWBE,'-2,1].
Acknowledge Receipt of _ Addendum(s) included with the bid.
V/ 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.
Y This checklist submitted with the Bid.
This checklist is provided for bidder's use in assuring compliance with required
documentation; however, it does not include all specifications requirements and does not
relieve the bidder of the need to read and comply with the specifications.
Bidder: AMR— � � � ��w :�w,� Date: �
By Authorized Representative;
Signature:
Print Name & Title:
Version 7/20/2018 Contractor's Bid for Public Works - 1
'd-av44-
PART II
(For projects of $100,000 or more — IC 36-1-12-4)
These statements to be submitted under oath by each bidder with and as part of his/her/its bid.
Attach additional pages for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
1. Attach information regarding projects your organization has completed for the period of one
(1) year prior to the date of the current bid.
2. Attach a listing of public works projects currently in process of construction by your
organization.
3. Attach information regarding any failure to complete any work awarded to you and the
location thereof.
4. Attach references from private firms for which you have performed work.
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
1. Attach an explanation of your plan or layout for performing proposed work. (Examples could
include a narrative of when you could begin work, complete the project, number of workers,
etc. and any other information which you believe would enable the City of South Bend to
consider your bid.)
2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside
your own firm who have performed part of the work) that you have used on public works
projects during the past five (5) years along with a brief description of the work done by each
subcontractor.
3. If you intend to sublet any portion of the work, attach the name and address of each
subcontractor, equipment to be used by the subcontractor, and whether you will require a
bond. However, if you are unable to currently provide a listing, please understand a listing
must be provided prior to contract approval. Until the completion of the proposed project, you
are under a continuing obligation to immediately notify the City of South Bend in the event that
you subsequently determine that you will use a subcontractor on the proposed project.
4. Attach a listing of equipment you have available to use for the proposed project.
5. Have you entered into contracts or received offers for all materials which substantiate the
prices used in preparing your proposal? If not, attach an explanation for the rationale used
which would corroborate the prices listed.
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said
financial statement as required by statute shall thereby be rendered invalid. The financial
statement provided hereunder to the City of South Bend awarding the contract must be specific
enough in detail so that said City of South Bend can make a proper determination of the bidder's
capability for completing the project if awarded.
Version 7/20/2018 Contractors Bid for Public Works - 3
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CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS "
This completed form should be included as part of the Bids documents related to City of South Bend Public
Works Projects requiring Good Faith Efforts to obtain 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" ),
11
Project Number: Three7Twen at the Cascade — Exterior Insulation Dater
Twenty on and Finis Sy tern
lq
Project Name: (E.I.F.S.)
Bidder:
Contact Person:
Address:
City:
Email:
ax rft L3 ` ___...............
State: L
Im
r"
To determine whether a bidder has demonsatedgood faith efforts to retch the MBENVBE utilization goals set
forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or
commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*:
EVIDENCE OF GOOD FAITH EFFORTS
wwW W.w
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 (hftp://www.in.gov/idoa).
......
ACTION ADVERTISE/CONTACT : In order for our bid to be deemed responsive,
( 1 y p nsive, 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 MBENVBEs of contracting and
subcontracting opportunities.
2. Advertise in general circulation and/or trade association publications concerning subcontracting
opportunities, and allow MBE,IWBEs reasonable time to respond.
Perform any and all necessary steps to provide written notice Ina manner reasonably calculated
to inform MBEIWBEs of subcontracting opportunities and allowed sufficient time for them to
participate effectively,
Utilize fare -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 MBENVBE 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 MBENVBEs,
including providing such MBENVBE's with adequate information about the plans, specifications and other
requirements of the subcontract and did not reject MBENVBEs 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
MBENVBEs in order to increase the likelihood of meeting the MBENVBE goals (including breaking down
contracts into smaller units to facilitate MBENVBE participation)
__ ...._._ ..............
CONTRACT RECORDS: The bidder has maintained the following records for each MBENVBE 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 MBENVBE was unqualified to perform the job,
*Proper demonstration of Good Faith Effort requires your initials next to all 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
L)kF11P
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
a. inn nrx ry,;
FORM MWBE-2.1�
MBE/WBE CONTACTED°
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects
requiring contacted MBEIWBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify
whether any listed minority or woman business meets the qualifications of a Minority or Women's owned
business.
PAGE, OF
Project Number: 118-074 B-R MBE/WBE Participation Goal
Project Name: Three Twenty at the Cascade - Exterior Insulation and Finish System E.I.F.
Bidder:, f P, -1`"^I
By
( g ure) (Title) Date
MBE/WBE Firm ' Iles
-------
Owner or Contact at MBE/WBE Firm ! m C
7—
TeIephone:7Cyg,9Ct!5,,0W/7_4Fax: ° ° qcl5,jEmail:
ed
TYPE OF WORK SOLICITED FOR THIS PROJECT:
... .................................
RESULTS OF CONTACT WITH THE MBENVBE FIRM;
rt
* �� a I + c 1
MBEM/BE Firm AISAI _r/ `oni
Owner or Contact at MBE/WBE Firm r,-A—
Telephone: 4L:30 _9CJ2_— /t601 Fax: /
TYPE OF WORK SOLICITED FOR THIS PROJE T:
RESULTS OF CONTACT WITH THE MBE/WBE FIRM;
-
il: , �l"k�@ pW
Version 7/20/2018 Contractor's Bid for Public Works - 11
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: 2018 Completed Projects
Skyline Plastering has successfully completed the following projects this past year:
Mercy Health Riverside 1136 S Wabash Starbucks Chicago
Campus
Heritage House
Target Broadview
DaVita Whiteside
Target Highland Park
Parkview Elementary
Thomas Jefferson Elementary
Target Norridge
Target Rockford
Burger King
Fifth Third Bank
Blackhawk Bank
Target Glendale Heights
Target Hodgkins
Target Machesney Park
Moxy Hotel
BMW Westmont
Presbyterian Homes
Tierra Linda Apartments
Rolling Meadows High School
1980 N Milwaukee
820 S Michigan Ave
Pepper Chicago Office
Luther Burbank Elementary
Evergreen Park Retail
Woodmans Food Market
Central Campus Health Center
The Hoxton Chicago
CVS New Lenox
McDonalds Lindenhurst
McDonalds Delany Rd
Dick's Sporting Goods
UIC Student Housing
Coopers Hawk New Lenox
Four Winds Casino
West Chicago High School
Marquette University
54 W Hubbard
Old Chicago Post Office
Knollwood Country Club
Lincoln Park Cultural Center
WEC Library
Mount Prospect Library
900 N Michigan
210 N Carpenter Chicago
1115 W Fulton Chicago
833 N Clark St Chicago
GM World
If you have any additional questions regarding our recently completed projects, please feel free to contact
us.
Sincerely,
Peter Klyachenko
President
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: Current Public Projects Under Contract
To Whom It May Concern,
Skyline Plastering is currently under contract for the following projects:
PROJECT CONTRACT DUE DATE COMPLETION
Blue Chip Casino - Michigan City, IN $580,560 711119 0%
CHA Pope - Chicago, IL $600,102 4115119 93%
Skyline Plastering has never defaulted on a contact in all our years of business.
Please let me know if you have any additional questions or concerns at this time.
Sincerely,
Peter Klyachenko Jr.
President
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: 2018 Completed Project - Private Firm References
Skyline Plastering has successfully completed the following projects this past year:
Pepper Construction - Eric Bullion
Mortenson Construction - Neil Wisker
Power Construction - Tim Giegerich
Leopardo Construction - Damian Eallonardo
Linn Mathes Construction - Henry Young
Turner Construction - Tim Makar
Optima, Inc - Matt Cison
Graycor Construction - Andy Bruce
Bear Construction - Christine Lussow
If you have any additional questions regarding our recently completed projects, please feel free to contact
us.
Sincerely,
Peter Klyachenko
President
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: Plan & Equipment for Proposed EIFS Work
Skyline Plastering is proposing to install the EIFS scope of work at the Three Twenty at The Cascade. We
have separated a qualified project manager, field foreman, general superintendent, and sufficient
qualified journeymen laborers / plasterers to perform the work. An executive project manager is already
appointed to oversee and manage the team actively to insure safety, quality, and schedule standards are
met.
We have included a combination of swing stages, aerial and/or scissors lifts, and scaffolding to provide
sufficient manpower and the safest and most competitive means with which to install the EIFS work.
ITEM
DURATION
START DATE
END DATE
Contract Docs
10 Days
3/19/19
3/29/19
Submittals
10 Days
3/19/19
3/29/19
Pre -Construction
5 Days
4/1/19
4/5/19
Mobilization
5 Days
4/8/19
4/12/19
EIFS Installation
55 Days
4/15/19
7/7/19
Close -Out Docs
5 Days
7/10/19
7/14/19
All employees on site will be payroll staff of Skyline, no sub -contractors are planned for the work.
All aerial and scissors lifts are to be rented from either Kropp Equipment or Sunbelt as previously quoted,
All swing stages are to be rented from Prime Scaffold or Designed Equipment as previously quoted.
All Sto materials will be purchased either from FBM or L&W Building Supply as previously quoted.
All starter boards or custom foam panels are to be purchased with Stucco Moulding as previously quoted.
All scaffolding, tools, toolboxes, safety equipment, etc will be provided by Skyline Plastering.
If you have any additional questions regarding our recently completed projects, please feel free to contact
US.
Sincerely,
Peter Klyachenko
President
232 Westgate Drive
SNPiAsTimo Carol Stream, IL 60188
630-627-1100 630-627-7711 Fax
Project Name: Three Twenty at the Cascade
Location: South Bend, IN
Submitted To: Panzica Building Corporation
Address: 41E E Monroe Street, Suite 320
City, State, Zip: South Bend, IN 46601
Date Of Plans: 2/14/19 (Rev S)
System: EIFS
Date: 3/7/19
Attn: Jeffrey S. Novotny
Phone: 574.234.0124
Cell: 574.532.6930
Email: `snovotn Snzicai,n t.
In reference to the above project I would like to submit my quotation on EIFS. Skyline Plastering, INC. proposes to furnish
all materials, union labor, supplies, equipment, insurance, and supervision necessary to perform the EIFS work in accordance manufacturer's
specifications. Proposal EXCLUDES any flashing, weeps or soffit vents unless specified below. Proposal based on regular working hours,
no overtime or shift work. Excluded are permits and permit fees, engineering and engineering fees, shop drawings and as built drawings,
dumpsters and temporary barricades. Proposal is good for 9O days.
Exterior Insulation Finish S steal-StoTherm ci Essence or e ual
>Install EIFS system with 2" EPS insulation, basecoat, mesh, and standard textured finish.
>Standard textures include sand fine, medium, and swirl textures.
>Includes manufacturer's standard fluid -applied air/moisture barrier over substrate behind EIFS.
>Includes EIFS per EIFS texture finish schedule notes 1-4 per plans.
>Includes for sealant joint installation where EIFS meets EIFS or where EIFS meets dissimilar material.
>Figured work to be performed from swingstages, landing platform to be provided by others in advance.
>Sequencing and dimensions must be coordinated with window installer for alignment.
>Excludes caulk joint between metal cap and EIFS.
>Excludes EIFS application over unapproved by manufacturer substrates - see manufacturer's specifications.
>Excludes any walk -way scaffolding.
>Excludes any sidewalk permits, by others.
>Excludes any framing, sheathing, or painting - by others.
>Excludes any metal, coping, flashing, vents, or otherwise.
>Excludes any other areas of alterations.
>System design for a PB system.
>Allteinnate.ff),; Credit for direct applied plaster finish to be applied over densglass substrate by others.
>Alieicn .le #2:. Add for "wavy" pattern EIFS with sand fine finish to be field-appled at north elevation.
>AIlteii nak.l #3: Add for "wavy" pattern EIFS panels with sand fine finish to be appled at north elevation
$ 475,800.00
(1,935.00)
82, 900.00
85, 700.00
Note: Includes 2018-2019 Union Labor Rate.
This proposal does not include any cost for providing temporary heat or enclosure. Additional cost and arrangements must be made by the owner
G General Contractor with SPI. Texture and color to be selected by architect, owner, or general contractor 14 days prior to start date.
Written confirmation is required. Any changes in construction documents involving EIFS scope of work or change orders must be approved by
SPI in writing. Progress payments are due 30 days from invoice.
All payments are to be sent via next day delivery. Responsible to pay reasonable attorney and collection fees if collection services are required.
' ire/rMAK
Skyline Plastering, INC., warrants that its work will be free from defects in workmanship for a period of ONE Year from date of completion.
Peter Klyachenko Jr.
pater i n�i L(L r mm gr
Skyline Plastering, Inc.
PLEASE SIGN AND RETURN VIA FAX TO 630-627-7711
Signature / Title:
Date of Acceptance:
ORGANIZATION INFORMATION
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Phone: 630-627-1100
Fax: 630-627-7711
Website: w_yy,,skvJinep Sri g I,
Date of Incorporation: October 31st, 1997
Organization Type: S-Corporation
Corporate Officers:
• Peter Klyachenko Jr, President
• Vladimir Uspenskiy, Vice President
Geographical Areas of Work: Northern IL, Southern Wisconsin, & Northern Indiana
"Skyline travels for specific clients and projects across the USA and into Canada
Description of Operation:
Commercial Subcontractor specializing in Ornamental Plaster, Acoustical Plaster, Cement Plaster, Gypsum
Plaster, Lime Plaster, Venetian Plaster, Exterior Insulation Finish Systems (EIFS), Direct -Applied Exterior
Finish Systems (DEFS), EIFS Panel Fabrication, Custom EIFS Moldings, Metallic EIFS Finishes, Various Faux
Plaster Finishes, Fluid -Applied Air/Moisture Barriers, Cultured Stone, & Thin Brick
Core Competencies:
We specialize in highly technical and sizable projects using the systems above in the following applications:
• Vertical Buildings (High, Medium, and Low -Rise)
• Historical Renovation & Preservation
• Schedule Driven Projects Requiring Extra Man Power
• High End Commercial
• Higher Level of Detail (Many Cornice & Trims, Excessive Reveals, etc)
• Higher Level of Quality (Smooth Applications, Pearlescent Smooth Metallic Finishes)
• Projects with Difficult Access (Above Adjacent Properties, Railways, Tight Site Footprints)
Types of Buildings:
• Senior Living
• Multi -Family
• Hospitality
• High Rise
• Healthcare & Hospitals
• High End Industrial
• High End Retail & Offices
• Shopping Malls
• Luxury Residential
• Corporate Centers
• Historical Preservation
• College & Universities
• Religious
• Restaurants
• Museums & Libraries
• Education K-12
• Arenas and Stadiums
• Retrofit & Renovation
There are a variety of qualities that separate our firm and below are just a few reasons to work with an
industry leader like Skyline Plastering:
• Experience. Skyline Plastering has successfully installed over 100 million dollars of plaster over the
past 20 plus years on projects of all kinds and size.
• Track Record. Skyline is the most respected union plaster company across Chicagoland, achieving this
accolade took manyyears of hard work but it would not have been possible with out our loyal
customersyear afteryear.
• Craftmanship. It is our attention to detail and training that separates our crews from the rest. Most
of our plasters have been working with Skyline for 10 or moreyears and many all20 plusyears and
counting.
• Safety Record, EMR Rating of.73 as of 2018. Our installers have OSHA 30, swing stage, scaffolding,
and various other job specific training offering you a safe jobsite.
• Relationship. We value return customers and look to build long term relationships spanning multiple
projects. We strongly believe it is important to look beyond just one project
• Service. Our responsive team is eager to assistyour specific needs big or small and with our contacts
within the industry we are able to assist so that no time is lost to paperwork.
• Warranty. We have successfully warranted millions in work through full cycles of warranty as a
business of 20 years. We address warranty issues promptly, thankfully in 20 years none have been a
result offailure in application.
• Assurance. We carry EIFS Insurance (this additional insurance policy specifically excluded from other
GL policies) helping customers limit their long-term risk.
• Innovation. Skyline has been involved in innovation at the manufacture level and continues to uphold
better practices for better performance. We help manage the risk of any cladding application with our
culture of quality.
• Manpower. As the largest plasterfirm in Chicago, we have the manpower to meetyour schedule.
• Insurance. Highest Umbrella Insurance Policy among competitors at 5 mil and GA oft mil.
• Leadership. Skyline leads the industry in both new & restoration work., exterior & interior plaster
work across Chicagoland. Providing detail -oriented quality installation from budgeting to final
product.
FINANCIAL INFORMATION
Federal Tax ID: 36-4197183
Dunn & Bradstreet Number: 11-901-4251
Certified Public Accountant:
Mueller
1707 N. Randall Rd, Suite 200
Elgin, IL 60123
PH 847.649.8173
Bank Contact:
David J Randa
First National Bank
127 South 1st Street, Suite 303
Geneva, IL 60134
Bonding Surety:
Kevin Scanlon
Columbia Agency, a Division of HUB International Midwest Limited
1005 W Laraway Rd
New Lenox, IL 60451
PH 815.215.4711
Insurance Company:
Tim Ohm
Country Financial
245 S Gary Ave,
Carol Stream, IL 60188
PH 630.668.4518
Workers' Compensation Experience Modifier (EMR):
2016 0.73 EMR
2017 0.72 EMR
2018 0.73 EMR
Attorney:
Jeff Keller
Keller Legal Services
620 W Roosevelt Rd, Suite #2
Wheaton, IL 60187
Sales Volume: Three Years' Revenue of $23,400,000
Recently Completed Projects:
Fisher Nuts Corporation, Elgin, IL— Mark 1 Restoration
Fa4ade Renovation, Insulated Cement Plaster $1,700,000
Northwestern Memorial Hospital, Chicago, IL —Thorne & Associates
New Construction, Exterior Insulation Finish System Cladding $550,000
Central DuPage Hospital — Bed Pavilion, Winfield, IL — Pepper Construction
New Construction, Venetian & Marmorino Plaster $800,000
The Strand Hotel — Linn Mathes Construction
Historical Renovation, Ornamental Plaster Restoration $608,0000
Elysian Hotel, Chicago, IL — Bovis Lend Lease
New Construction, Cement Plaster & Limestone Finish $500,000
The Langham Hotel, Chicago, IL — Anning Johnson
New Construction, Venetian, Ornamental, & Acoustical Plaster $450,000
Covenant Village, Northbrook, IL — Leopardo Construction
New Construction, Cement Plaster $400,000
Aurora St. Charles Senior Homes, St. Charles, IL — Linn Mathes Construction
Historical Renovation, Ornamental Plaster & EIFS $406,000
Palmer House, Chicago, IL — Pepper Construction
Historic Renovation, Ornamental Plaster $1,000,000
AMC Oak Brook Mall, Oak Brook, IL — Graycor Construction
New Construction, EIFS $900,000
The Promenade of Oak Brook, Oak Brook, IL — Harbour Contractors
New Construction, EIFS, Fluid -Applied Air & Moisture Barrier, and Cultured Stone $1.3 mil
Our Strategic Accounts:
Walmar:t,
a e money. III,,,ili e Ibetter.
232 Westgate Drive I Carol Stream, IL 60188
Tel: 630.627.1100 1 Fax: 630.627.7711
wmL,'Ay iue'3 I� j.Q arrgc&.w,ma cn
Intricate Ornamental Plaster I Gypsum Plaster I Cement Plaster I Stucco / Hard -coat systems I Exterior Insulation Finish Systems
Acoustical Plaster I Lime Plaster I Thermocromex I Veneer Plaster I Venetian & Marmorino Plaster I TexStone I Fresco Finishes
Armourcoat I Baswaphon I Fellert I Pyrok I StarSilent I Thin Brick & Cultured Stone I Fluid -Applied Air & Moisture Barriers
Historical Plaster Restoration I Insulated Stucco Systems I EIFS Panels by StoLite or Dryvit FedderLite I Pre -Fab EIFS
EIFS Metallic Panels I Dryvit NewBrick I Vapor Barrier Systems
THE RITZ-CARLTON
COMMUNICATIONS
ENABLED
LIFETIME'
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TRADE REFERENCES
Supplier Contact
L&VVBuilding Supply 1O99Greenleaf Ave.
Elk Grove Village, |L60O07
Rod Lopez, Rep
224'325'0958
Westmont Interior Supply House 1030Vandustria|Drive
Westmont, |L605Sg
Jim Dunn, Rep
630'852'4600
Henry FrerkSons 3l35VVBelmont Ave
Chicago |L60618
Matt Wolf, Rep
773'58S'O80O'ext. Ill
Kropp Equipment, Inc. 1OZ0South Kennedy
5chemrviUe,|N46375
Karen Flanagan, Rep
630-289-6666
1061NRaddamRd
Stucco Molding Batavia, |L6O510
Paul K|yachenko,Office Mgr
630~482'2590
Bracing Systems, Inc 4N350Old Gary Ave
Hanover Park, |L6O133
Bob Williams, Rep
630665'2732
Skyline Plastering, Inc. 1 232 Westgate Drive, Carol Stream, IL 60188 1 Tel: 630.627.1100 1 Fax: 630.627.7711 1 www.skylineplastering.com
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CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
RESPONSIBLE BIDDER CHECKLIST
Project Name Three Twenty at the Cascade — Exterior Insulation and Finish System
E.I. F.S.�........_......._._._..... ......
Project No. 118-074 B-R
For Bids Due March 12, 2019
Contractor Name:
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 315t 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
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 considering 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
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, I hereby acknowledge that the City reserves the right to
request supplemental information, additional verification of any information
provided by me, and may also conduct random inquiries of my current and prior
customers.
(b) Attachments:
(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.
Version 7/20/2018 General Conditions - 8
II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED)
(a) Acknowledg ments:
(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) Z 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.
Version 7/20/2018 General Conditions - 9
(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:
(Si n Here)
vi
(Print Name Hery
LA
D' g b
(Address of Compa
(City)
M1
(State)
106
(Telephone Number)
Version 7/20/2018 General Conditions - 10
INBiz: Your one -stop source for your business.
https://bsd.sos.in.gov/publicbusinesssearch
(http://www.INBiz.IN.gov)
Business Search
Business Search Result
PrincipalRegistered
Business
Name
Business ID
Entity Type
Office
Status
Name
Type
Agent Name
Address
232
2014090900576 (/PublicBusinessSearch
WESTGATE
SKYLINE
FOREIGN
Foreign
CORPORATION
/BusinessInformation?businessId=982821&
DR, CAROL
PLASTERING,
LEGAL
For -Profit
SERVICE Active
businessType=Foreign%20For
STREAM,
INC.
NAME
Corporation
COMPANY
Profit%20Corporation&isSeries=False)
IL, 60188,
USA
Page 1 of 1, records 1 to 1 of 1
Return to Search
1 of 1 3/8/2019, 11:22 AM
APPROVED AND FILED
CONNIE LAWSON
INDIANA SECRETARY OF STATE
08/15/2018 12:51 PM
BUSINESS ID
2014090900576
BUSINESS TYPE
Foreign For -Profit Corporation
BUSINESS NAME
SKYLINE PLASTERING, INC.
ENTITY CREATION DATE
09/08/2014
JURISDICTION OF FORMATION
Illinois
PRINCIPAL OFFICE ADDRESS
232 WESTGATE DR, CAROL STREAM, IL, 60188, USA
YEARS 2018/2019
EFFECTIVE DATE 08/15/2018
EFFECTIVE TIME 12:51 PM
REGISTERED AGENT TYPE
Business Commercial Registered Agent
NAME
CORPORATION SERVICE COMPANY
ADDRESS
135 North Pennsylvania Street, Suite 1610, Indianapolis, IN, 46204, USA
- Page 1 of 2 -
APPROVED AND FILED
CONNIE LAWSON
INDIANA SECRETARY OF STATE
08/15/2018 12:51 PM
TITLE
Secretary
NAME
PAUL SAVENOK
ADDRESS
232 WESTGATE DR, CAROL STREAM, IL, 60188, USA
TITLE
President
NAME
PETER KLYACHENKO
ADDRESS
232 WESTGATE DR, CAROL STREAM, IL, 60188, USA
TITLE
Vice President
NAME
VLADIMIR USPENSKIY
ADDRESS
232 WEST GATE DR., Carol Stream, IL, 60188, USA
IN WITNESS WHEREOF, THE UNDERSIGNED HEREBY VERIFIES, SUBJECT TO THE PENALTIES OF PERJURY, THAT THE
STATEMENTS CONTAINED HEREIN ARE TRUE, THIS DAY August 15, 2018.
SIGNATURE PETER KYACHENKO
TITLE President
Business ID : 2014090900576
Filing No.: 7996579
- Page 2 of 2 -
10/26/2018 9:09:52 AM
License $125.00
Check 8385 $125.00
kwidawsk 18047
No. 5828-19 REGISTRATION $125.00
ST. JOSEPH COUNTY AND CITY OF SOUTH BEND, INDIANA
October 26, 2o18
WHEREAS, SKYLINE PLASTERING, INC. having this day paid to the Building Department the
sum of One Hundred Twenty Five Dollars and Zero Cents is hereby REGISTERED to operate in the
unincorporated areas of ST. JOSEPH COUNTY and the CITY OF SOUTH BEND, as a
Building Contractor
I
THIS REGISTRATION EXPIRES: October 11, 2019
Building Commissioner
a a
_ Charles, CAS lota.. —
232 WESTGATE DRIVE
CAROL STREAM, IL 60188
(630)627-1100 THIS REGISTMTION IS NOT TRANSFERABLE
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: Previous Business Names Statement
To Whom It May Concern:
Skyline Plastering has operated under the same business name since our founding on October 31St,1997.
Sincerely,
C�&�
Peter Klyachenko
President
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: No Determinations Against Skyline Plastering
To Whom It May Concern:
Skyline Plastering has no determinations by a court or government 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 -Beacon and related
acts, within the last preceding five (5) years.
Sin �� wel�y,
Peter Klyachenko
President
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 4661S
RE: Statement Regarding Staffing/Labor Resources
To Whom It May Concern,
Skyline Plastering is recognized as a premier union plastering sub -contractor for the Midwest region.
Since October of 1997 we have been signatory to the Plasterers and Laborers Union of Chicago. Our
company has historically and continues to employ 30-40 men in the off season and 40-80 men during our
peak season.
Our staffing labor plan for the Three Twenty at the Cascade is to employ plasterers & laborers from the
following affiliates:
Operative Plasters' & Cement Masons' International Association
• Cement Masons Local #502 Plaster Area #5
• Local #692 State of Indiana
MUNA! - the Laborers' International Union of North America
• Laborers Local #68
• Laborers Local #81
Our current back log allows for more work in the coming months, we currently have access to 20-30
qualified and trained men who we consider a part of our labor force and more through our union
affiliates if necessary. We are confident in our ability to hire and employ properly skilled men in order to
deliver a successful project.
We are excited to offer our services to meet the challenging schedule taken on by Panzica. Please let me
know if you have any additional questions or concerns at this time.
Sind,
Peter Klyachenko Jr.
President
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: Statement of Hiring Individuals and/or Independent Contractors
To Whom It May Concern,
Skyline Plastering will insure all men who are hired or employed by our company will be properly
classified under all federal, state, and local city laws and ordinances.
We do not currently plan to hire any independent contractor for the Three Twenty at The Cascade project
but if required during the project any and all independent contractors will be held to the same standard.
Please let me know if you have any additional questions or concerns at this time.
Sincerely,
r
Peter Klyachenko Jr.
President
"Unifie
OPERATIVE PLASTERERS' AN'� '
OF THE 0hN
739 SOUTH 25th AVL1`
PHONE: 708-5''
March 11, 2019
Reference: Skyline Plastering Inc.
To Whom It May Concern:
fsJ ��o�r
rehgti, bilk 1914
MC:N^wNT'' A60 �N�NTERNATIONAL ASSOCIATION
DO STATES N c)C CANADA
E -�I I LLWOO,, ILLINOIS 60104
100 l�"A: 708�544mm0232
As a signatory contractor with the International Union of Cement Masons' Union Local 502,
Skyline Plastering Inc. is required by Collective Bargaining Agreement to participate in an
applicable Apprenticeship and Training program approved by and registered with the United
States Department of Labor's Bureau of Apprenticeship and Training.
I am submitting this letter, along with our Certificate. Our Apprenticeship Program
11L008820041 is registered with the Department of Labor, Bureau of Apprenticeship and
Training.
If you have any questions, please feel free to call 708-544-9100 Ext. 214.
Sincerely,
Lawrence J. Picardi Sr.
Secretary -Treasurer
91
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SPI management pledges that we will take reasonable action to create and maintain a workplace
free from substance abuse. SPI management will work to increase awareness of the dangers of
substance abuse within our workplace and throughout the construction industry.
232 Westgate Drive I Carol Stream, IL 60188
Tel: 630.627.1100 1 Fax: 630.627.7711
VAA_skynhp AgSjprim ,mp Yj
Installers of: Exterior Insulation Systems I Interior/Exterior Coatings & Finishes
Veneer Plaster I Stucco / Hard -coat systems
TABLE OF CONTENTS
Scope of Policy Page 3
Definitions 3
Policies and Procedures 3
Testing Procedures
I.
Drug Screening of Applicants for Employment
5
II.
Drug Screening of Transferred Employees
7
III.
"For Cause" Testing Procedures
7
IV.
Causal/Incident-Related Testing
9
V.
Random Testing
10
VI.
Reinstatement, Return -to -Duty and Follow -Up
Testing/Rehabilitation Programs
10
VII.
Drug and Alcohol Testing Requirements for
Employees with a Commercial Driver's License (CDL)
10
VIII.
Disciplinary Policies and Procedures
11
IX.
Policy Amendments
12
X.
Confidentiality Statement
12
Drug /Alcohol Test Consent Form
13
SCOPE OF POLICY
This document contains procedures for implementing a drug and alcohol testing
program at Skyline Plastering, Inc. The company prohibits the use, possession,
sale, purchase, manufacture, distribution, transfer or consumption of alcohol and
all illegal drugs, including legally regulated drugs.
This program applies to all employees and potential employees of the company, as
well as subcontractors at all tiers, including non -bargaining and bargaining unit
employees.
DEFINITIONS
Banned Substances: Illegal substances, as defined by federal/state laws, including:
a. Amphetamines
b. Opiates
c. Phencyclidine (PCP)
d. Cocaine
e. THC (Marijuana/Cannabinoids)
f. Intoxicants (drug and alcohol)
g. Synthetic drugs
Third -Party Administrator: The company may retain a third -party administrator to
perform testing and reporting procedures, but is currently handled by the
company's safety manager.
POLICIES AND PROCEDURES
A urine drug screen shall be administered under the following circumstances.
1. Pre -Hire Drug Screening. All potential employees must submit to a urine
drug screen no later than the commencement of employment. Pre -hire drug
screening will test for the presence of illegal drugs and substances and the
illegal use of prescription drugs. This screen does not include an alcohol test.
Potential employees who refuse to submit to this test will not be permitted to
work for the company.
If the employer participates in a pre-screen/certification program through a
collective bargaining agreement (CBA) or other arrangement, and the
potential employee has undergone a prior screening to which, through the
CBA or other arrangement, the company is provided access to the
results/certification, then the potential employee shall be deemed to have
complied with the company's pre -hire drug screening requirements.
2. Testing for Cause. All employees may be tested for cause when a
reasonable suspicion exists that the employee appears to be under the
influence of illegal drugs or illegally using prescription drugs, synthetic
drugs and/or alcohol.
3. Causal/Incident-Related. All employees who are involved with, or may
have contributed to, an incident that results in property damage or requires
treatment beyond onsite first aid are required to submit to a drug screen and
alcohol test. (Note: a company may also require a drug screen and/or
alcohol test for incidents resulting in first aid treatment. Please consult your
state/local laws pertaining to testing procedures to verify if such a practice is
permissible).
4. Random. When permitted by law, employees may be randomly selected for
unannounced drug and alcohol screening using a scientifically/statistically
valid computerized number generation process. Employees are notified of
selection no more than 48 hours prior to testing.
5. Reinstatement, Return -to -Duty and Follow -Up Testing. After signing an
agreement or participating in substance abuse counseling established by the
company, the employee must complete a drug screen before returning to
active employment.
TESTING PROCEDURES
I. Drug Screening of Applicants for Employment
Upon applying for employment, applicants must visit the office of Skyline
Plaster, Inc. They will be advised whether specimen collection will occur at
Northwestern Medicine Central Dupage Hospital located at 25 North
Windfield Rd., Winfield, IL. 0190, or at another approved clinic offsite.
2. Each applicant will read and sign a Drug Screen Consent Form prior to any
test being administered.
3. On a pre-printed, itemized form furnished by the employer, each applicant
will be asked to identify any medication he/she is taking or has taken during
the 30 days preceding the test.
4, A formal chain of custody will be established for every drug screen.
5. A split sample consisting of two urine collection containers sealed in a
plastic container will be furnished to the applicant. (Note: Testing may be
performed by a third -party administrator.) The containers must contain an
amount of urine sufficient for one Enzyme Medical Immunoassay Test
(EMIT) and two Gas Chromatography/Mass Spectrometry (GC/MS) tests
(no less than 2 ounces of urine per container). Each applicant's urine
specimen will be collected and temperature tested for verification. The
second container will be used in the event the first container becomes
contaminated.
6. Before the specimen leaves the applicant's sight, the urine containers will be
sealed with security tape that has been initialed by applicant.
7. Specimens collected onsite will be transported to a laboratory in accordance
with the chain of custody procedures. A portion of the sample will be tested
using the EMIT; if positive, another portion and/or the split sample will be
tested for verification using the GUMS test.
8. The remainder of the urine specimen and split sample will remain at the
laboratory for 30 days following the test.
9. Upon signing a form giving consent to use the urine sample for drug
screening, the applicant is eligible for employment on a 72-hour
probationary basis. This consent form is co -signed by the collection
specialist.
10. Any applicant who refuses to submit to a drug screening will not be eligible
for employment.
11. The employer receives the drug test results within 72 hours. If the
applicant's test results in a confirmed positive, as confirmed by a medical
review officer (MRO), he/she will be terminated immediately and paid for
all hours worked, if permissible by state/local law. The individual will not be
eligible for employment with the employer for a period to be determined by
the employer, not exceeding one year. If hired later by the employer, and
contingent on a negative drug screen, the employee may be tested
periodically without notice for a period of up to one year from the date of
hire.
12. If any individual who has tested positive by the MRO wants to confirm the
results of the GUMS test, he/she may do so by having a GUMS test
performed on the previously collected split urine specimen at a certified
National Institute on Drug Abuse (NIDA) or Substance Abuse and Mental
Health Services Administration (SAMHSA) laboratory of his/her choice.
The specimen will be shipped directly from the employer's lab to the lab of
the employee's choice. The costs of this test will be borne by the employee.
If the results of this test are negative, the individual will be reinstated with
full back pay and benefits, and will be reimbursed for the cost of the test.
The individual must exercise the option of a second GUMS test within 24
hours of being notified of the positive results.
13. Pre hire drug screens include tests for at least the following (a five -panel
drug screen):
a) Amphetamines
b) Opiates
c) Phencyclidine (PCP)
d) Cocaine
e) THC (Marijuana/Canabinoids)
The company reserves the right to administer testing for additional substances (For
more information on seven -panel, 10-panel, 12-panel and hair follicle tests, refer to
the "Best Practices" section of the Construction Coalition for a Drug- and Alcohol -
Free Workplace website at www,dro yfreeeoiistriiction or )-)
II. Drug Screening of Transferred Employees
The procedure for testing employees transferred from another jobsite is the same as
the pre -hire procedure.
III. "For Cause" Testing Procedures
1. All employees working for the company may be tested for illegal drugs,
substances, synthetic drugs and alcohol if there is reasonable suspicion that
the employee is under the influence of alcohol, any of the substances
identified in paragraph 13 or abuse of prescription medication. For the
purpose of this program, the term "reasonable suspicion" shall be defined as
"aberrant behavior or unusual on -duty behavior of an individual employee
who:
(a) is observed on duty by either the employee's immediate supervisor,
higher ranking employee, or other managerial personnel who have been
trained to recognize the symptoms of drug abuse, impairment or intoxication
(observations shall be documented by the observers);
(b) exhibits the type of behavior that shows accepted symptoms of
intoxication or impairment caused by controlled substances or alcohol or
addiction to or dependence upon said controlled substances; and
(c) such conduct cannot reasonably be explained by other causes such as
fatigue, lack of sleep, side effect of prescription or over-the-counter
medications, illness, reaction to noxious fumes or smoke.
2. Testing of this type will not be conducted without the written approval of the
company's superintendent or designated manager. The jobsite
superintendent or designated manager must document in writing who is to be
tested and why the test was ordered, including the specific objective facts
constituting reasonable suspicion leading to the test being ordered, and the
name of any source(s) of this information. One copy of this document shall
be given to the employee before he/she is required to be tested. After
receiving a copy of the document, the affected employee shall be given
enough time to read the document.
3 When a supervisor, higher ranking employee or other managerial personnel
has reasonable suspicion to believe an employee is using, consuming or
under the influence of an alcoholic beverage, non-prescription controlled
substance (other than over-the-counter medication), and/or non -prescribed
narcotic drug while on duty, that person will notify the jobsite
superintendent or designated manager for the purpose of observation and
confirmation of the employee's condition. The employee will be given an
opportunity to explain his/her condition, such as reaction to a prescribed
drug, fatigue, lack of sleep, exposure to noxious fumes, reaction to over-the-
counter medication or illness. If, after this explanation, the jobsite
superintendent or designated manager continues to have reasonable
suspicion that the employee is using, consuming and/or under the influence
of an alcoholic beverage, non -prescribed controlled substance or non -
prescribed narcotic while on duty, then, by a written order signed by the
superintendent or designated manager, the employee may be ordered to
immediately submit to a drug and alcohol screen. Refusal to submit to
testing after being ordered to do so may result in disciplinary action up to
and including discharge.
4. Employee drug screens for cause will include testing for alcohol, as well as
the same drugs as the pre -hire screening test. Each employee will read and
execute a consent form prior to any test being administered. Failure to
execute the consent form will result in termination.
5. Reasonable suspicion testing shall be performed at a NIDA/SAMHSA-
approved clinic. The individual will be immediately accompanied to the
clinic by a company representative. Samples will be taken as per the pre -hire
procedure.
6. An EMIT test and, if positive, a confirming GUMS test, will be performed
on the urine sample. The remainder of the sample and the split sample will
be stored at the laboratory for 30 days.
7. If an employee's test is positive, his/her employment will be terminated
immediately. The employee will be given a copy of the results of the drug
screen. He/she may have the second container tested at his/her own expense
as per the pre -hire procedure.
8. Alcohol detection will be based on an evidential breath alcohol device
approved by the National Highway Traffic Safety Act. If an employee's test
results indicate he/she is legally intoxicated at or above the state of
jurisdiction's legal limit, he/she may be subject to discipline up to and
including discharge.
IV. Causal/Incident-Related Testing
Subject to applicable law and consistent with reasonable suspicion, the company
reserves the right to require its employees to present themselves for testing within
24 hours following an employee's involvement in an accident, near accident or an
incident resulting in lost work time, property damage, and/or injury to any
employee or other person while on the company's premises, on the job or
otherwise working for the company.
V. Random Testing
Subject to applicable law, the company reserves the right to require its employees
to present themselves for random, unannounced testing. The company will adopt
an objective procedure, using a statistically valid number generation process, to
randomly select employees to be tested. Upon anonymous selection, the company
will notify the employee(s) to report immediately for drug testing. The company
solely determines the time and frequency of random drug tests. Any employee may
be selected for random testing in accordance with state/local laws. An employee
could be randomly selected for testing more than once a year.
VI. Reinstatement, Return -to -Duty and Follow -Up Testing/Rehabilitation
Programs
The company maintains a referral relationship with drug and alcohol abuse
services. Additionally, certain health insurance benefits may provide help to
employees who suffer from substance abuse and/or other personal or emotional
problems; however, it is the responsibility of each employee to seek necessary
professional assistance before alcohol and drug problems lead to disciplinary
action.
If the company mandates a sponsored rehabilitation program, the employee will be
subjected to a drug screen following the procedures outlined in Section I (Drug
Screening of Applicants for Employment) prior to reinstatement. In addition, per
post -rehabilitation program monitoring guidelines, the company may subject the
employee to follow-up testing for a period to be determined in cooperation with the
rehabilitation program and employer. Testing will follow the procedures outlined
in Section V (Random Testing).
VII. Drug and Alcohol Testing Requirements for Employees with a
Commercial Driver's License (CDL)
The [Jnited States Department of i-aaisportation (DOT) requires that all employees
maintaining tai iaag a CD . atid operating ec n rnercial tiiotor vehicles be sub ec'ted to the
drug screen policies outlined in the "Testing Procedures" section of this document.
CDL employees, per the DOT, are required to submit to a minimum five -panel
drug screen for the presence of:
1. Amphetamines
2. Opiates
3. Phencyclidine (PCP)
4. Cocaine
5. THC (Marijuana/Canabinoids)
A positive test result requires the employee to be immediately removed from
operating any commercial motor vehicles on public roadways. In addition,
employees whose test produces a positive result must complete return -to -duty and
follow-up testing after completion of an approved rehabilitation program as
prescribed by a substance abuse professional. Follow-up testing must include a
minimum of six unannounced, directly observed drug screens within 12 months of
the initial return -to -duty screen following the procedures outlined in Section V
(Random Testing).
For more information on the DOT's CDL drug screening requirements, visit:
httt)://www.fmcsa.dot.v,ov/documents/DLugAlcohol Test Brochure2009 508com
pliant rev
VIII. Disciplinary Policies and Procedures
For examples of disciplinary procedures and appeals processes, visit the "Best
Practices" section of the Construction Coalition for a Drug- and Alcohol -Free
Workplace website at www.drugfreeconstruction.com.
First Offense
Disciplinary actions defined by the company.
Second Offense
Disciplinary actions defined by the company.
Appealing Disciplinary Action
Appeals process defined by the company.
Substance Abuse Rehabilitation
Following a positive result, the company retains the right to enter the employee
into an approved substance abuse rehabilitation program. Upon completion of the
program, the employee will be subjected to drug screening procedures outlined in
Section VI (Reinstatement, Return -to -Duty and Follow -Up Testing/Rehabilitation
Programs).
IX. Policy Amendments
Review Procedures
The company will undertake a comprehensive review of the policy biennially. A
review panel consisting of senior management, safety professionals and site
employees will assess the relevance and current status of the policy's components,
as well as incorporate updated procedures and requirements that will ensure the
policy meets or exceeds industry requirements. Any policy changes made as a
result of the review will be made available and provided to every employee as an
addendum to the company's Employment Policies and Procedures Handbook.
In addition to the biennial policy update, the company may undertake revisions due
to new regulatory requirements. Any revisions made outside the biennial review
will be provided as a separate addendum to all employees.
X. Confidentiality Statement
Employee information, including drug screen results and rehabilitative programs,
will be treated as medical records and will remain strictly confidential following
HIPAA guidelines for patient confidentiality. Employee requests to release the
results of drug screens to any party outside the company must be made in writing
and given to the employee's immediate supervisor and designated safety and health
officer.
Drug/Alcohol Testing Release Form
Pre Hire
Release form for obtaining urine samples for drug screening and permission
to furnish the results to the company.
For Cause
Release form for obtaining urine samples for drug screening and permission
to furnish the results to the company.
Release form for obtaining NHTSA-approved evidential breath alcohol test
and permission to furnish the results to the company.
Post Incident
Release form for obtaining test samples for drug and alcohol screening
following any incident requiring medical care.
I hereby authorize Skyline Plastering, Inc., its physicians or agents, to take the
indicated sample from me to use for the purposes indicated above. I understand
why these samples are being requested and I give permission for the results to be
released to the company and to my employer (if different).
I further release and hold harmless the owners, the company and its contractors
from any consequences arising out of the drug and/or alcohol test or results
therefrom.
Name (please print)
Signature (required)
Street City
Social Security Number
Date
State Zip
Phone Number ��(with areacode)
............... ���
Witness
Date
Employer Occupation
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Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: Statement of Tax Liabilities
To Whom It May Concern,
Skyline Plastering has not in the past three years and does not currently have any federal, state, or local
tax liens or tax delinquencies owed to any federal, state, or local taxing body at this time.
Please let me know if you have any additional questions or concerns at this time.
Sincerely,
_96�
Peter Klyachenko Jr.
President
Peter Klyachenko Jr.
Skyline Plastering, Inc.
232 Westgate Drive
Carol Stream, IL 60188
Department of Public Works
1316 County -City Building
South Bend, IN 46615
RE: Similar Project Reference List Last Three Years
To Whom It May Concern,
Skyline Plastering has had the pleasure to successfully complete our contracts on the following projects
over the past three years:
Four Winds Casino - South Bend, IN
$356,739
Aloft - South Bend, IN
$235,000
Double Tree Hotel - Evansville, IN
$788,640
Mercy Health Riverside Campus - Rockford, IL
$347,341
The Hoxton - Chicago, IL
$161,005
Moxy - Chicago, IL
$481,360
Hilton Garden Inn - Chicago, IL
$288,801
Home 2 Suites - Chicago, IL
$299,243
820 S Michigan - Chicago, IL
$534,966
AMC Theater & Garage - Oak Brook, IL
$709,958
Tierra Linda - Chicago, IL
$207,757
Optima Tower I - Chicago, IL
$97,314
Optima Tower II - Chicago, IL
$192,739
GM World - Detroit, MI
$201,822
2929 Carlson New Office Building - Hammond, IN
$200,350
Please let me know if you have any additional questions or concerns at this time.
S ricerely,
Peter Klyachenko Jr,.
President