HomeMy WebLinkAboutOpening of Bids - 2019 Street and Sewer Dept Materials Project No 119-008 - Walsh & Kelly Incµ
CITE' OF SOUTH BEND INDIIANA
SELLER'S BID FOR SALE OR LEASE OF MATERIALS
AND NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND'-<
NON-DISCRIMINATION COMMITMENT FOR SELLERS
BID NAME 2019 Street and Sewer Department Materials
FOR BIDS DUE March 26, 2019, 9:30 a.m., Local Time
Bidder
Date:-3/26/19 (Firm): Walsh & Kelly, Inc. .............. -----
Address: 24358 SR 23
City/State/Zip: South Band, IN 46614 Telephone Number: m(574288-4811 _....................
Agent of Bidder (if Applicable):
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT,
CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT
ELIGIBILITY VERIFICATION, NON-DISCRIMINATION COMMITMENT AND
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY
PRODUCTS
(Must be completed for all quotes and bids. Please type or print)
STATE OF.. Indiana )
SS:
St. Joseph 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
ii. Contractor, its successor or its affiliate, is a financial institution that extends
twenty million dollars ($20,000,000) or more in credit to another person for
forty-five (45) days or more, if that person will (i) use the credit to provides
goods and services in the energy sector in Iran; and (ii) at the time the
financial institution extends credit, is a person identified on list published by
the Indiana Department of Administration.
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor
retain any employee or contract with a person that the Contractor subsequently learns is
an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work
eligibility status of all of Contractor's newly hired employees through the E-Verify
Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and
participation in the E-Verify Program is included and attached as part of this bid/quote;
and
5. Contractor shall require his/her/its subcontractors performing work under this
public contract to certify that the subcontractors do not knowingly employ or contract
with an unauthorized alien, nor retain any employee or contract with a person that the
subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has
enrolled in and is participating in the E-Verify Program. The Contractor agrees to
maintain this certification throughout the term of the contract with the City of South
Bend, and understands that the City may terminate the contract for default if the
Contractor fails to cure a breach of this provision no later than thirty (30) days after being
notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a
contract by the City of South Bend through its agencies, boards, or commissions shall not
discriminate against any employee or applicant for employment in the performance of a
City contract with respect to hire, tenure, terms, conditions, or privileges of employment,
or any matter directly or indirectly related to employment because of race, sex, religion,
color, national origin, ancestry, age, gender expression, gender identity, sexual
orientation or disability that does not affect that person's ability to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment,
materials, or any combination of the foregoing including, but not limited to, public works
contracts awarded under public bidding laws or other contracts in which public bids are
not required by law, the City, its agencies, boards, or commissions may consider the
Contractor's good faith efforts to obtain participation by those Contractors certified by
the State of Indiana as a Minority Business ("MBE") or as a Women's Business
Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive
bidder.
In no event shall persons or entities seeking the award of a City contract be required to
award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate
against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE
Utilization Board shall prohibit that person or entity from being awarded a City contract
for a period of one (1) year from the date of such determination, and such determination
may also be grounds for terminating the contact for which the discriminatory practice or
noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination
commitment shall be made a part of any contract which it may henceforth enter into with
the City of South Bend, Indiana or any of its agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for
employment in the performance of this contract with privileges of employment, or any
matter directly or indirectly related to employment, because of race, religion, color, sex,
gender expression, gender identity, sexual orientation, handicap, national origin or
ancestry. Breach of this provision may be regarded as material breach of contract.
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). 1 hereby certify that I and all subcontractors employed by me for
this project will use steel products or foundry products made in the United States on this
project if awarded. I understand I have an affirmative duty to notify the City in my bid
that my proposal does not include the use of steel products or foundry products made in
the United States. I understand it is my sole obligation and responsibility to provide a
justification to the City, subject to review and approval, why the cost of United States
made steel or foundry products is unreasonable. Prior to award and upon submission of
bid which does not use steel products or foundry products made in the United States, the
City, through its director of public works, shall make a determination if the price of
United States made steel or foundry is unreasonable. I understand that violations
hereunder may result in forfeiture of contractual payments.
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid
for public works are true and correct.
Dated this 26th day of March , 2019
�
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pCO-
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„" ' ORPQRAT� "
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of Contractor/Bidder or Its Agent
Dustin Hilary. VP of South Bend Areawwwww
Printed Name and Title
Subscribed and sworn to before me this 26th day of ;ICc
mITITITITITITIT_m w, f1_N'
My Commission Expires 6/5/2022
Notary1'rAlisha IWueger
County of Residence StJQSeph .._...
ALISHA KRUEGR
' Notary Public, State of Indiin�
St. Joseph County A
"* w n
My Commission Expires
05, 2022
t,.
*
CITY OF SOUTH BEND
BID NAME 2019 Street and Sewer Department Materials
FOR BIDS DUE March 26, 2019, 9:30 a.m., Local Time
DIVISION A - ASPHALT MATERIALS
IOt mar
Mkw,ntiw� t�;,
m
Item
No.
Description
Quantity
Unit
Unit Price
Total
A-1
HMA Surface 11 L
12000
TON
$ 68.00
816,000.00
A-2
HMA Surface 11 L MAC HD
4000
TON
1 $ 70.00
280,000.00
A-3
HMA Surface 11S
1200
TON
$ 68.00
81,600.00
A-4
HMA Binder 8/9
1500
TON
$ 36.00
54,000.00
A-5
HMA Binder 11
4200
TON
$ 55.00
231,000.00
A-6
HMA Binder 11 MAC
3000
TON
$ 56.00
168,000.00
A-7
A-8
HMA Base 5D
CMA Patch AE-300P
1200
500
TON
TON
$ 36.00
$ 90.00
43,200.00
45,000.00
A-9
High Performance Cold Mix
150
EA
$ 105.00
15,750.00
Bidder Name: Walsh & Kelly, Inc.
CITY OF SOUTH BEND
BID NAME 2019 Street and Sewer Department Materials
FOR BIDS DUE March 26, 2019, 9:30 a.m., Local Time
DIVISION B - PCC MATERIALS
Item
No.
Description
Quantity
Unit
Unit Price
Total
B-1
Class A Concrete
2500
CY
No Bid
No Bid
B-2
B-3
Class A High Early
7 Bag Mix - New City Specs
800
600
CY
CY
No Bid
No Bid
No Bid
No Bid
B-4
High Early Concrete w/ Integral Color - Black
200
CY
No Bid
No Bid
B-5
Flowable Fill, Removable
350
CY
No Bid
No Bid
B 6
Non -Chloride Accelerator added to concrete —
0.5%
325
EA CY
No Bid
No Bid
B-7
Non -Chloride Accelerator added to concrete — 1 %
1000
EA CY
No Bid
No Bid
B-8
Non -Chloride Accelerator added to concrete — 2%
2100
EA CY
No Bid
No Bid
Bidder Name: Walsh & Kelly, Inc.
CITY OF SOUTH BEND
BID NAME 2019 Street and Sewer Department Materials
FOR BIDS DUE Mach 26, 2019, 9:30 a.m., Local Time
DIVISION C - AGGREGATE MATERIALS
Item
No.
Description
Quantity
Unit
Unit Price
Total
C-1
No. 23 Sand
5000
TON
No Bid
No Bid
C-2
C-3
No. 53 Gravel
No. 53 Recycled Concrete
1000
7500
TON
TON
No Bid
No Bid
No Bid
No Bid
C-4
No. 53 Slag
1000
TON
No Bid
No Bid
C-5
Topsoil
150
CY
No Bid
No Bid
C-6
No. 11 Slag Chip Stone
1000
TON
No Bid
No Bid
DIVISION D - SEWER MATERIALS - CASTINGS
Item
No.
Description
Quantity
Unit
Unit Price
Total
D-1
Manhole Cover 1020 & Frame
150
EA
No Bid
No Bid
D-2
Manhole Cover 1040 & Frame
150
EA
No Bid
No Bid
D-3
Catch Basin Cover & Frame
300
EA
No Bid
No Bid
Bidder Name: Walsh & Kelly, Inc.
CITY OF SOUTH BEND
BID NAME 2019 Street and Sewer Department Materials
FOR BIDS DUE March 26, 2019, 9:30 a.m., Local Time
DIVISION E - SEWER MATERIALS
WMA
ar �
Item
No.
Description
Quantity_Unit
Unit Price
Total
E-1
MH Riser 20 3/4" D — 1"R — 7/8"L
40
EA
No Bid
No Bid
E-2
MH Riser 20 3/4" D — 1 1/2"R — 7/8"L
40
EA
No Bid
No Bid
E-3
MH Riser 20 3/4" D — 2"R — 7/8"L
20
EA
No Bid
No Bid
E-4
MH Riser 20 3/4" D — 2 1/2" R — 7/8"L
10
EA
No Bid
No Bid'
E-5
MH Riser 21 3/4" D — 1"R — 1 3/8"L
20
EA
No Bid
No Bid
E-6
E-7
MH Riser 21 3/4" D — 1 1/2"R — 1 3/8"L
MH Riser 21 3/4" D — 2"R — 1 3/8"L
30
30
EA
EA
No Bid
No Bid
No Bid
No Bid
E-8
MH Riser 22 1/8" D — 2"R — 1 1/4"L
20
EA
No Bid
No Bid
E-9
MH Riser 22 1/8" D — 3"R — 1 1/4"L
5
EA
No Bid
No Bid
E-10
MH Riser 22 1/4" D — 1"R — 1 1/2"L
30
EA
No Bid
No Bid
E-11
MH Riser 22 1/4" D — 1 1/2" R — 1 1/2"L
30
EA
No Bid
No Bid
E-12
E-13
E-14
MH Riser 23" D — 1"R — 1 3/4"L
MH Riser 23" D — 1 1/2"R — 1 3/4"L
MH Riser 23" D — 2"R —1 3/4"L
30
20
40
EA
EA
EA
No Bid
No Bid
No Bid
No Bid
No Bid
No Bid
E-15
MH Riser 23 5/8" D — 1 1/2" R —1 1/8"L
10
EA
No Bid
No Bid
E-16
MH Riser 23 5/8" D — 2"R — 1 1/8"L
10
EA
No Bid
No Bid
E-17
MH Riser 23 5/8" D — 1"R — 1 1/2"L
20
EA
No Bid
No Bid
E-18
MH Riser 23 5/8" D — 1 1/2" R — 1 1/2"L
25
EA
No Bid
No Bid
E-19
MH Riser 23 5/8" D — 2"R — 1 1/2"L 20
EA
No Bid
No Bid
E-20
MH Riser 23 5/8" D — 2 1/2"R — 1 1/2"L 20
EA
No Bid
No Bid
Bidder Name: Walsh & Kelly, Inc.
BID/PROPOSAL
CITY OF SOUTH BEND
BID NAME 2019 Street and Sewer Department Materials
FOR BIDS DUE March 26, 2019, 9:30 a.m., Local Time
DIVISION F - TRAFFIC MATERIALS
Cf �
Item
No.
Description
Quanti
Unit
Unit Price
Total
F-1
Liquid Thermoplastic Traffic Marking Paint —
2200
GAL
No Bid
No Bid
White
F 2
Liquid Thermoplastic Traffic Marking Paint—
2200
GAL
No Bid
No Bid
Yellow
F-3
Liquid Thermoplastic Traffic Marking Paint —
50
GAL
No Bid
No Bid
Blue
F-4
Liquid Thermoplastic Traffic Marking Paint —
50
GAL
No Bid
No Bid
Green
F-5
Pavement Marking Beads, Standard
40000
LBS
No Bid
No Bid'
Bidder Name: Walsh & Kelly, Inc.
BID/PROPOSAL
CITY OF SOUTH BEND
BID NAME 2019 Street and Sewer Department Materials
FOR BIDS DUE March 26, 2019, 9:30 a.m., Local Time
DIVISION G - SNOW REMOVAL MATERIALS
titsTr.
µe9= OVA(
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Item
No.
Description
Quantity
Unit
Unit Price
Total
G-1
Curved Double Bevel Carbon Steel Underbody
300
EA
No Bid
No Bid
Blade 5'L x 6"T x 5/8"Th
G 2
Curved Single Bevel Carbon Steel Underbody
50
EA
No Bid
No Bid
Blade 5'L x 6"T x 3/4' Th Heat Treated — Hardened
G-3
Curved Single Bevel Carbon Steel Underbody
50
EA
No Bid
No Bid
Blade 6'L x 6"T x 3/4"Th Heat Treated — Hardened
Boss Power V Plow Blade 51" X 6" X'/" Part #
G-4
BAL08858
6
EA
No Bid
No Bid
Passenger Side Edge
G-5
Boss Power V Plow Blade 51" X 6" X'/" Part #
6
EA
No Bid
No Bid
BAL08859 Drivers Side Edge
$ 6" Western MVP Plus Plow Blade Part # 44285-
G-6
4
EA
No Bid
No Bid
G-7
Western Pro Plus Plow Blades 90"L x 6"T x 1/2"Th
4
EA
No Bid
No Bid
DIVISION H - SNOW REMOVAL MATERIALS CONT'D
Item
No.
Description
Quantity
Unit
Unit Price
Total
H-1
3 Cubic Yard General Purpose Bucket with 3-piece
1
bolt kit and hardware
EA
No Bid
No Bid
Case 921 Wheel Loader Bucket Blade Center
H 2
Piece L128861
1
EA
No Bid
No Bid
H-3
iCase 921 Wheel Loader Bucket Blade End Pieces
L128862
2
EA
No Bid
No Bid
Bidder Name: Walsh & Kelly, Inc.
BID/PROPOSAL
CITY OF SOUTH BEND
BID NAME 2019 Street and Sewer Department Materials
FOR BIDS DUE March 26, 2019, 9:30 a.m., Local Time
DIVISION I - ASPHALT MATERIALS CONT-D
Item
No.
Description
Quantity
Unit
Unit Price
Total
1-1
AE-T Tack
25,000
GAL
No Bid
No Bid
1-2
RS-2
25,000
GAL
No Bid
No Bid
1-3
AE90-S CRACKSEAL
30,000
GAL
No Bid
No Bid
1-4
MAC 20 CRACKSEAL
20,000
GAL
No Bid
No Bid
DIVISION J - DELIVERY OF HMA MATERIALS BY TRI-AXLE TRUCK
Item
No.
Description
Quantity
Unit
Unit Price Total
J-1
Driver and Truck
576
PER HR
No Bid No Bid
Bidder (Firm):
Address:
City/State/Zip:
Telephone Number:
By
(S
Walsh & Kelly,Inc.
24358 SR 23
D tin Hilary
( rinted Name)
VP of South Bend Area
(Title)
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Suzanna M. Fritzberg, Member
Laura O'Sullivan, Member
Fax Number: 574-289-7174
Elizabeth A. Maradik, Member
Therese J. Dorau, Member
Attest: Linda M. Martin, Clerk
(To be completed only by Contractors/Bidders claiming to be a "local Indiana business"pursuant to I.C. 36-1-12-22)
INDIANA LOCAL BUSINESS PREFERENCE CLAIM
A "local Indiana business" refers to any of the following.•
(1) A business whose principal place of business is located in an affected county.
(2) A business that pays a majority of its payroll (in dollar volume) to residents of affected counties.
(3) A business that employs residents of affected counties as a majority of its employees.
(4) A business that makes significant capital investments in the affected counties as defined in rules adopted by the political
subdivision.
(5) A business that has a substantial positive economic impact on the affected counties as defined by criteria in rules adopted by
the political subdivision.
An "affected county" refers to St. Joseph County, Indiana, or the following counties located adjacent to St. Joseph County:
Elkhart County, Marshall County, Starke County and LaPorte County
There are the following price preferences for supplies purchased from a local Indiana business:
• 5% for a purchase expected by the purchasing agency to be less than $50, 000
• 3% for a purchase expected by the purchasing agency to beat least $50, 000 but less than $100, 000.
1 /o r�r• a .�t�r t xca+[; � � te.c t�, c,�' by the ptrrt hcts�rr N ......� ............
Date: 3/26/2019
Pursuant to I.C. 5-22-15-20.9, Walsh &ITKelly Inc. claims a local Indiana business
preference for Project mj Street & S, r IQep _gte i t (Project # 119-008 ) located within the City of
South Bend, St. Joseph County, Indiana.
® principal p
The location of the rmci al lace of business is 2435$ SR �.�._�o.f� Bend., IN 46614.
(Address)
® St. Joseph County, Indiana
® The following county located adjacent to St. Joseph County, Indiana: LaPorte
The majority of the business's payroll for the 12 months prior to the date of this Bid is to residents of St.
Joseph County, Indiana or the adjacent county noted above.
The majority of the business's employees for the 12 months prior to the date of this Bid are residents of
St. Joseph County, Indiana, or the adjacent county noted above.
If the business is deemed to be the apparent lowest, responsible, responsive bidder, then it shall provide
supporting documentation for the 12-month period prior to the date of the Bid of (i) the total payroll
amount paid to all employees of the business, and (ii) the total payroll amount paid to employees who are
residents of St. Joseph County and the adjacent county noted above.
WHEN SUPPLYING SUPPORTING PAYROLL RECORDS, BIDDER SHALL REDACTALL
SOCIAL SECURITY NUMBERS.
Dated this _..._26th j s(?[tt.MarCh_ 20 1 ...._..
�'�+'��_�.l0.
.
n Contrac idder in)
s
i x use of ntraclor/Bidder or Its Agent
w in "' usfi Ila% Qf South Bend A
" Printed Name and Title
VSOwCoPn7 V fl.OVYBI"OIf,N:5IK;
SIOUTH BEND- D_ ]INDWNA 466W-VS; O
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
i0* 1 OF PUBLIC VA�M..
August 17, 2018
Mr. Dustin Hilary
Walsh & Kelly, Inc.
24358 SR 12
South Bend, IN 46614
RE: Pre -Qualification Verification — 2018 Street Paving
Dear Mr. Hilary:
FAX 574( 23u 917b
This letter serves as verification of Pre -Qualification status of your company for bidding with the City of South
Bend. This Pre -Qualification status is effective for twelve (12) months from the date of this letter. Thereafter you
are required to re -submit a complete application for continuation of pre -qualification status prior to December 31
for the upcoming calendar year.
A copy of this Verification Letter must be included with every bid exceeding $150,000 submitted to the City of
South Bend Board of Public Works, along with your Pre -Qualified Bidder Checklist and attachments.
If you have any further questions regarding this matter, please call this office at (574) 235-9251.
Sincerely,
Linda M. Margin, Clerk
GAR'y A. Gn,crr DAVW P� R.is�,o^ Eu Rm° AUBFM...I A. MARADM xJAmi-'S A. JN� ➢?1 Q,��. DIFIRESE, J. 1G)ORAU
B Surety O +908.903.3485
202B Halls Mill Road, PO Box 1650 F + 908.903.3656
Whitehouse Station, M 08889-1650
Federal Insurance Company
AIA Document A31OTM - 2010 Bid Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable.
CONTRACTOR
�attte e laistatus and address).
Ual$ Kelly, Inc.
24358 State Road 23
South Bend, IN 46614
OWNER
(Name legal status and address):
City ot" South Bend, Indiana
Board of Public Works, County City Bldg, Room 1316
2227 West Jefferson Blvd.
Bend B VID;�14� AMOUNT
614
In the amount of not less than ten percent (10%) of the bid.
PROJECT
(Name, location or address, and Project number, if any)
2019 Street and Sewer Department Materials
Project No. 119-008
SURETY
(Name, legal status and principal place of business):
Federal Insurance Company
202B Halls Mill Rd., PO Box 1650
Whitehouse Station, rq 08889-1650
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the
Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and
severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor
within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and
Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such
bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted
in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract
and for the prompt payment of labor and material furnished in the prosecution thereof, or (2) pays to the Owner the
difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount
for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this
obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of
an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. waiver
of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for
acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for
an extension beyond sixty (60) days.
If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall
be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.
Printed in cooperation with theAmerican Institute ofArchitects (ALA) by Chubb. The language in this document conforms to the language used in
AM DocumentA310 "r- 2010.
Form 15.02-0575-FED (Rev. 3/17)
When this Bondhas been furnished to comply Frith a statutory or other legal requirement in the location ofthe project,
any provision In this Bond conflicting with said statutory or legal requirement shall be deemed deleted here
from and provWons conforming to such statutory or other legal requirement shall be deemed incorporated herein.
When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law
bond.
Signed and sealed this 26th
(witness) Alisha Krueger
(witness) Lisa M. Becker
day of Bch, 2019.
ri tt1 i actin llti' iry � KEQ����
VPof South Bend Area ()R P O Rq
Mt1e)
.E .A o
III'#$WO
Federal Insurance Company
(attorney -in -Fact) Terry R. Hurst,
Printed in cooperation with theAmerican Institute of Architects ") by Chubb. The language in this document corfbrms to the langua p used in
AM DocutnentAXO DI-2010.
Form M02-MS-FW M". 3/17)
2
Power of Attorney
Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company
Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC
INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Terry R. Hurst
each as their true and lawful Attorney-InµFact'; to execute under such designation In their names and to 'affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than ball bonds) given or executed In the course of business, and any
Instruments amending or altering the same, and consents to the modification oralteration of any Instrument:' referred to in said bonds or obligations,
Surety Bond Number. Bid Bond
Obligee:
In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these
presents and affixed their corporate seals on this 15th day of September, 2018.
Dawn M. Chloros, Assistant Secretary
STATE OF NEW JERSEY
County ofHunterdon SS.
Stephen M. Haney, Vice President
On this 15th day of September, 2018, before me, a Notary Public of New Jersey, personally came Dawn M. Chloros, tome known to be Assistant Secretary of FEDERAL INSURANCE
COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros,
being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY
COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said
Companies; and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that she Is acquainted with Stephen M. Haney, and knows him
to be Vice President of said Companies; and that the signature of Stephen M. Haney, subscribed to said Power of Attorney Is in the genuine handwriting of Stephen M. Haney, and was
thereto subscribed by authority of said Companies and In deponent's presence.
Notarial Seal
KATHERINE J. ADELAAR ^ "
TAIIp
NOTARY PUBLIC OF NEW JERSEY
s-r+
No.2316665 w°
PtIBLt'Cr
w
Commission Etloirsa July 16, 2010 Notarp Pufii9c
�
CERTIFICATION
Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016:
"RESOLVED, that the following authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings, rerognizances, contracts and other written commitments of the Company
entered into in the ordinarycourse of business (each a "Written Commitment"):
(1) Each of the Chairman, the President and the Vice Presidents of the Company Is hereby authorized to execute any Written Commitment for and on behalf of the Company, under the
seal of the Company or otherwise.
(2) Each duly appointed attomLy-In-factof the Company Is hereby authorized to execute any Written Co mitmentforandonbehalfoftheCompany,underthesealoftheCompanyorotherwise,
to the extent that such action 1s authorized bythe grant of powers provided for In such perso-n"s written appointmentas such attorney -in -fact
(3) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authortzed, for and on behaifofthe Company, toappointinwrning any person the anoaneywns.
fact of the Company with full power and authority to execute, for and on behalf of the Company, under the seal of the Company or otherwlso, such Written Commitmens of the
Company as may be specified In such written appointment which specification may be by general type or class of Written Commitments or by specification of one or more particular
Written Commitments.
(4) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to delegate In writing to any other oQlcer of the
Company the authority to execute, for and on behalf of the Company, under the Company's .seal or othainvvise, such Written Commitments of the Company as era spe,clfied In such
written delegation, which specification may be by general typeor classof Written Commitments or hyspectf[cadonofoneorrioropartkularWrtttenComntitmtnts.
(5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, maybe affixed by
facsimile on such Written Commitment or written appointment or delegation.
FURTIIERRESOLVED;, that the foregoing Itesolu'llnn shall not bedeemedtobean ontustye Statement of the powers and authoTity of offeers, employees and other persons to act for and on behalf oftbe
Company, and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested!
I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies'3 do hereby
certify that
(i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and effect,
(11) the foregoing Power ofAttorney Is true, correct and in full force and effect
Given under my hand and seals of said Companies at Whitehouse Station, NJ, this 26th day of P c r, 2019..
FED- VIG-PI (rev. 06-16)
Dawn M. Chloros, Assistant Seattary
Part of State Form52414 (R2 / 2-13) Form 96 (Revised 2013)
3_LZe1�
Walsh & Kelly, Inc.
(Contractor)
(Address)
South Bend IN 46614
FOR
PUBLIC WORKS PROJECTS
OF
logmuzMMOMMEMM
2019 Street and Sewer Department Materials
Project No. 119-006
Filed March 261h 2019
Action taken
State Form 52414 (R 19-10)
Prescribed by 'State Board of 8rcouLits Form No, 96 Revised 01
CONTRACTOR'S BID FOR PUBLIC WORK — FORM 96
PART 1
(To be completed for all bids. Please type or print)
1. Governmental Unit (Owner):
2. County:
3. Bidder (Firm):
Address:
City/State:
4. Telephone Number:
5. Agent of Bidder (If applicable):
Date (month, day, year): March 26 2019
City of South Bend Indiana
St. Joseph ................................
Walsh & Kelly,Inc.
24358 SR 23
South Bend IN 46614
(574) 288-4811
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of --City-of Sot:ith Bend Indiana (Governmental Unit) in accordance with plans and
specifications prepared by City of Soutli Bend Indiana -- Dent. of Public Works Div. of Engineering and
dated March 2019 for the sum of $
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 Governmental Unit. If the bid is to be awarded on a unit basis, the
itemization of the units shall be shown on a separate attachment.
The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or
applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or
indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant
may be regarded as a material breach of the contract.
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS
(If applicable)
I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation
to use steel products made in the United States. I.C. 5-16-8-2. I hereby certify I and all subcontractors employed by me
for this project will use U.S. steel products on this project if awarded. I understand that violations hereunder may result in
forfeiture of contractual payments.
2
ACCEPTANCE
The above bid is accepted this day of ,....,.. , subject to the following conditions:
Contracting Authority Members:
PART II
(For projects of $150,000 or more — IC 36-1-12-4)
Governmental Unit: City of South Bend, Indiana
Bidder (Firm): Walsh & Kelly, Inc.
Date(month, day, year), March 26 2019
These statements to be submitted under oath by each bidder with and as part of his bid. Attach additional pages
for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
What public works projects has your organization completed for the period of one (1) year prior to the date of
the current bid?
................................ ww....._.
Contract Amount
Class of Work
When Com leted
Name and Address of Owner
$12,926,200
_
Reconstruction
October 2017
INDOT
_.. _ ......-.-.._ . ......_.... ....._—
$ 5,970,162
Reconstruction
....
Ma 2017
W W
Town of Merrillville
$ 5,521,779
Resurface
December 2017
City of Mishawaka
$ 2,646,574
Reconstruction
September 2017
St. Joseph Cty Hwy Dept
2. What public works projects are now in process of construction by your organization?
- --
Contract Amount
__.....................
Class of Work
.
When to be Completed
Name and Address of Owner
$10,695, 118
Reconstruction
November 2018
Walsh Construction
$ 8,146,239
1 Resurface
Ma 2018
INDOT
$ 4,073,719
Reconstruction
July 2018
City of East Chica o, IN
$ 2,662,813
Reconstruction
October 2018
INDOT
Have you ever failed to complete any work awarded to you? Now.._._. If so, where and why?
4. List references from private firms for which you have performed work.
Gatlin Pllanibin g 1-1 atiM Iiic, l l l l E. Griffith, 1N Ms. Clara Mtii ili
Gougli, Inc. 2200 E, 88"' Dr. �l Merrillville IN 46410 Mr. Raymond Gough
D er Construction Co. 1716 Sheffield Avenue, Duelµ IN Janet Furman
Grimmer Construction Co. Inc. 2619 Main Street Highland, IN Mr. G Mg Grimmer
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could
begin work, completed the project, number of workers, etc. and any other information which you believe would
enable the governmental unit consider your bid.)
As required by owner
2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have
performed part of the work) that you have used on public works projects during the past five (5) years along with a
brief description of the work done by each subcontractor.
See Attached List
3. If you intend to sublet any portion of the work, state 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 governmental unit in the event that you
subsequently determine that you will use a subcontractor on the proposed project.
Will supply upon award of contract
4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors
may also be required to be listed by the governmental unit.
QUANTITY
ITEM
�...................
DESCRIPTION,
CONDITION
YEARS
PRESENT LOCATION
SIZE, CAPACITY,
OF
ETC.
SERVICE.-
5
Asphalt Plants
Various
Good
Griffith, South Bend,
Valparaiso, Lowell, LaPorte
19
Asphalt Pavers
Various
Good
Griffith, South Bend
4
.......
Sli form Conc. Paver
Various
Good
Griffith, South Bend
3
Road Widener
Various
Good
Griffith, South Bend
5
Motor Graders
CAT/J.D.
Good
Griffith, South Bend
54
Rollers
Various
30
Rubber Tire Loaders
. ......._..--
Various
......
Good
Griffith, South Bend
15
Excavators
Various
Good
Griffith, South Bend
9
Bulldozers
Various
Good
Griffith, South Bend
6
LowBov Tractors
Various
Good
Griffith, South Bend
8
Flatbed Dumps
Various
Good
Griffith, South Bend
48
1/2and 34 ton P�m
Various
Good
Griffith, South Bend
65
1 Ton Crew Trucks
Various
Good
Griffith, South Bend
3
Cold Planers
Wirtgen 1900 _
Good
Griffith, South Bend
DC
3
Tri-Axle Dump
Mack
Good
I South Bend
5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing
your proposal? Otherwise, please explain the rationale used which would corroborate the prices listed.
Yes, we received quotes from potential subcontractors and suppliers
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required
by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding
the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's
capability for completing the project if awarded.
SECTION IV CONTRACTOR'S NON -COLLUSION AFFIDAVIT
The undersigned bidder or agent, being duly sworn on oath, says that he has not, nor has any other member,
representative, or agent of the firm, company, corporation or partnership represented by him, entered into any
combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to
prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference
to any other bid and without any agreement, understanding or combination with any other person in reference to such
bidding.
He further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate,
fee, gift, commission or thing of value on account of such sale
SECTION V OATH AND AFFIRMATION
I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION
CONTAINED IN THE FOREGOING BID FOR PRBLIC WORKS ARE TRUE AND CORRECT.
Dated at South Bend ....�...._ this 26t' day of
��t9ll�flf/����
w� Y L
a a
,. x^
p
" IW D I k\4 ,- IN ACKNO
�'��fflll111®�
STATE OF_................................._Ittdian:a
................................ ..................... ....................................
) ss
COUNTY OF _........ ............. St...JoseDh 1
GEMENT
of Organization)
(Title of Person Signing)
Before me, a Notary Public, personally appeared the above -named Dustin Hilary and
swore that the statements contained in the foregoing document are true and correct.
Subscribed and sworn to before me this 26th day of March, 2019
4LL,)LV_1_J a
Alis a Krueger, Notary Public
My Commission Expires: June 5, 2022
y" ALISHA KRUEGER
County of Residence: St Jose h
PublIc. State of Jn�er�s AL: Et. Joseph
My Commission Expires
`{ June0b 2022
Form 96 Section II, #2
Subcontractors Used on Public Works Contracts During the Past 5 Years
SUBCONTRACTORS
COMPANY ADDRESS CITY/STATE/ZIP PHONE FAX
SEWER
B & D Sewer
Deboer Egolf
Delta III
Dyer Construction
Gatlin Plumbing & Heating
Gough, Inc.
Grimmer Construction
Hasse Construction
HRP Construction
Rex Construction
Wirtz & Yates, Inc
Woodruff & Sons
531 Winston Ct
5772 Melton Road
2063 W 1250 S
1716 Sheffield Avenue
1111 E. Main Street
2200 E. 88th Drive
2619 Main Street
10 Lincoln Avenue
5777 Cleveland Rd.
700 Schiller Avenue
P.O. Box 41
P.O. Box 450
Schererville, IN 46375
Portage, IN 46368
Hanna, IN 46340
Dyer, IN 46311
Griffith, IN 46319
Merrillville, IN 46410
Highland, IN 46322
Calumet City, IL 60409
South Bend, IN 46624
Schererville, IN 46375
Kentland, IN 47951
Michigan City, IN 46361
(219) 322-2300
(219) 763-9700
(219) 797-4004
(219) 865-2961
(219) 924-6972
(219) 756-2200
(219) 924-1623
(219 )932-1611
(574) 271-7800
(219) 322-8090
(219) 474-6542
(219) 872-8605
(219) 865-0065
(219) 763-9703
(219) 797-3008
(219) 865-2963
(219) 924-1401
(219) 756-2202
(219) 924-0328
(219) 932-6829
(574) 271-0524
(219) 322-0031
(219) 8795339
MILLING
C.E. Hughes Milling, Inc.
3113 Holmans Lane
Jeffersonville, IN 47130
(812) 725-8665
(812) 725-8672
Javelina Construction, Inc.
13476 Britton Park Rd.
Fishers, IN 46038
(317) 841-8364
(317) 841-0075
Mid America Milling Co.
6200 W. Hwy 62, Ste 400
Jeffersonville, IN 47130
(812) 282-2751
(812) 283-9846
McCrite Milling
209 Quality Ave. Ste 9
New Albany, IN 47150
(812) 941-0252
(812) 941-0852
Specialties Company
9350 E. 30th St.
Indianapolis, IN 46229
(317) 594-0291
(317) 594-0271
ELECTRICAL INSTALLATION
Hawk Enterprises
Midwestern Electric
S/T Bancroft Electric
Sweney Electric Company
Trans Tech Electric
SIGN INSTALLATION
Hawk Enterprises
Midwestern Electric
RoadSafe Traffic Systems
State Barricading, Inc.
Traffic Control Specialists, Inc
PAVEMENT MARKINGS
The Airmarking Company
Blackout Sealcoating
RoadSafe Traffic Systems
State Barricading, Inc.
Traffic Control Specialists, Inc.
Traffic Management Company
TRAFFIC CONTROL
RoadSafe Traffic Systems
Traffic Control Specialists, Inc.
Traffic Manaaement Company
LANDSCAPE
Great American Landscape
Hubinger Landscape
Slusser's Green Thumb, Inc.
T & J Landscape Service
1850 E. North St
1620 E. Chicago Ave
25020 State Road 2
9111 Louisiana St.
4601 Cleveland Road
1850 E. North St
1620 E. Chicago Ave
3122 Olympia Dr
24963 U.S. Highway 20
1810 W Pacific Avenue
P.O. Box 526
7440 W. 87th Place
3122 Olympia Dr
24963 U.S. Highway 20
1810 W Pacific Avenue
3542 Highway Avenue
3122 Olympia Dr
1810 W Pacific Avenue
3542 Hiqhwav Avenue
P.O. Box 235
210 E. 113th Avenue
125 Montgomery Street
8253 Wicker Avenue
Crown Point, IN 46307
East Chicago, IN 46312
South Bend, IN 46619
Merrillville, IN 46410
South Bend, IN 46619
Crown Point, IN 46307
East Chicago, IN 46312
Lafayette, IN 47909
South Bend, IN 46628
Knox, IN 46534
Rochester, IN 46975
Bridgview, IL 60455
Lafayette, IN 47909
South Bend, IN 46628
Knox, IN 46534
Highland, IN 46322
Lafayette, IN 47909
Knox, IN 46534
Highland, IN 46322
Dyer, IN 46311
Crown Point, IN 46307
Logansport, IN 46947
St. John, IN 46373
(219) 662-8090
(219) 397-4444
(574) 287-6490
(219) 769-6007
(574) 272-9673
(219) 662-8090
(219) 397-4444
(317) 780-1825
(574) 287-2078
(574)772-7001
(574) 223-5817
(219) 864-2300
(317) 780-1825
(574) 287-2078
(574)772-7001
(291) 746-2433
(317) 780-1825
(574)772-7001
(219) 746-2433
(219) 322-7033
(219) 662-9911
(574) 722-3102
(219) 374-9900
(219) 662-8093
(219) 397-8888
(219) 769-0565
(574)271-0144
(219) 662-8093
(219) 397-8888
(574) 772-7002
(574) 223-7959
(708) 430-6910
(574) 772-7002
(574) 772-7002
(219) 322-4419
(219) 662-6206
(574) 722-1628
(219) 374-9950
GUARDRAIL/FENCING
Acorn Fence
C Tech Corporation
James H. Drew Company
Security Industries
Specialties Company
TRUCKING/HAULING
C. Lee Construction Services
Condon Trucking, LLC
Fanio Services
Gilmer Trucking
Material Transfer Inc.
Morris Motor Service, Inc.
P & C Trucking
Superior Construction Co., Inc.
V & R Trucking, Inc.
SRPM'S
K & S Markers, Inc.
UNDERSEAL
Rieth-Riley Construction Co.,
Inc.
TREE REMOVAL
Dave's Tree Service
Homer Tree Service
Timber Masters LLC
LIME STABILIZATION
Mt. Carmel Sand & Gravel
Rock Solid Stabilization
Specialties Company
PIPE LINING
Indiana Reline, Inc.
2041 164th Street
5300 W. 100 North
8701 Zionsville Rd.
1000 Georgiana St.
9350 E. 30th St.
1011 S. Lake St
18245 Amberley Ln
28015 SR 23
20390 New Road
7811 West 101 st Ave.
10525 W US Hwy 30 Bld
7
4410 Ross Road
1455 Louis Sullivan Dr
1845 Elmer St.
2189 N 600 W
Hammond, IN 46320
Boggstown, IN 46110
Indianapolis, IN 46268
Hobart, IN 46342
Indianapolis, IN 46229
Gary, IN 46403
South Bend, IN 46637
North Liberty, IN 46554
South Bend, IN 46614
Crown Point, IN 46307
Wanatah, IN 46390
Gary, IN 46408
Portage, IN 46368
South Bend, IN 46628
IN 46071
2454 West CR 450 North LaPorte, IN 46350
1555 Park West Circle
14000 S. Archer Ave
P.O. Box 245
1611 College Dr.
5104 Mann Drive
9350 E. 30th St.
312 E. Main Street
Munster, IN 46321
Lockport, IL 60441
Dyer, IN 46311
Mt. Carmel, IL 62863
Ringwood, IL 60072
Indianapolis, IN 46229
Sulphur Springs, IN
47388
(219) 844-8400
(317) 835-2745
(317) 876-3739
(219) 942-9447
(317) 594-0291
(219) 888-9554
(574) 360-4326
(574) 233-3236
(574)229-3233
(219) 865-9575
(219) 733-9430
(219) 972-0193
(219) 787-0850
(5741329-2102
(219) 844-8441
(317) 835-2781
(317) 876-3829
(219) 942-9448
(317) 594-0271
(219) 888-9564
(574) 271-8984
482-6184 (765) 482-6284
(219) 362-6178
(219) 922-9829
(815) 838-0320
(219) 864-8733
(618) 262-5118
(815) 653-2585
(317) 594-0291
(219) 922-9843
19) 322-9391
(618) 263-4084
(815) 653-2583
(317) 594-0271
(765) 766-5040 (765) 533-5831
SAW CUTTING
Diamond Coring Co., Inc.
11800 S Ewing Ave
Chicago, IL 60617
(773) 978-5000
Quality Saw & Seal, Inc.
7600 W. 79th Street
Bridgeview, IL 60455
(773) 767-9300
SEAL COATING/STRIPING
Site Services, Inc.
10117 Kennedy Ave
Highland, IN 46322
(219) 924-9944
Blackout Sealcoating
7440 W. 87th Place
Bridgview, IL 60455
(219) 864-2300 (708) 430-6910
UNDERDRAIN
3D Company, Inc.
3200 East CR 350 North
Muncie, IN 47303
(765) 288-3326 (765) 288-3344
9A
General Form No. 96-a
Prescribed by the State Board of
Accounts o1 Indiana. Revised 1949.
tandard Questionnaires
Prescribed by
THE STATE BOARD OF ACCOUNTS OF INDIANA
For use in investigating and determining the qualifications of bidders on public
construction when the aggregate cost of any such work or improvement will be Five Thousand
Dollars or more.
These statements to be submitted under oath by each bidder with and as a part of his bid, as provided
by Chapter 306, page 1248, Acts of 1947
Submitted to Citv South Bend Indiana
By Walsh & Kelly, Inc.
{A Corporation
Address_,,,,,_,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24358 SR 23, South Bend IN,,,46614
........__ WW.............. ........
Date submitted March 26 2019
Filed
Sec. 2 of an Act entitled "AN ACT concerning the awarding of contracts for the performance of public work and
authorizing the board of accounts to prescribe certain forms to be used in ascertaining the responsibility of contractors who
submit bids for the performance of such work, providing for plans and specifications, providing for bids repealing certain laws
and declaring an emergency." (Approved March 13, 1947.)
Sec. 2. Whenever the aggregate costs of any work or improvement will be five thousand dollars ($5,000.00) or more, for
the purpose of enabling such board, commission, trustee, officer or agent to ascertain and determine which of the bidders
submitting bids for the performance of any such public work is, in the judgment of such board, commission, trustee, officer or
agent, the lowest and/or best bidder and to exercise intelligently the discretion hereby conferred on such board, commission,
trustee, officer or agent each bidder shall be required to submit under oath with and as a part of his bid a statement of his
experience, his proposed plan for performing such work and the equipment which he has available for the performance of such
work and a financial statement. The statements hereby required shall be submitted on forms which shall be prescribed by the state
board of accounts. The forms so prescribed shall be designated, respectively, as the experience questionnaire, the plan and
equipment questionnaire and the contractor's financial statement, and shall be based, so far as applicable, on the standard
questionnaires and financial statement for bidders as approved and recommended by the joint conference on construction
practices, for use in investigating the qualifications of bidders on public construction work, and the forms so prescribed are
hereby prescribed as the forms which shall hereafter be used by all such boards, commissions, trustees, officers and agents in
obtaining the information which is required in the administration of this act. If the information submitted by any bidder on the
forms herein prescribed is found, on examination, to be unsatisfactory, the bid submitted by such bidder shall not be considered.
(Burns Statutes 1933, Sec. 53-109) Sec. 2, Chapter 306, Acts of 1947.
111111111 A 1.111) 0 D) tm
The following forms of questionnaires and financial statement are prescribed by the State Board of
Accounts in conformity with the statute set out on the preceding page.
These forms, properly filled out and attested, must accompany each bid of five thousand dollars or
more on any public work.
The forms are designed to cover all contracts for all kinds of work and the bidder is required to
answer such questions as are pertinent to the work upon which he is bidding. The purpose of the
questionnaire and financial statement, as set forth in the law, is to enable the awarding body to determine
the qualifications of the bidder to carry out successfully the contract if the same is awarded to him.
The bidder will find it to his advantage to answer fully all questions coming within the range of the
work upon which he is bidding. Particular attention should be given the "Financial Statement" and the
details relative to the assets and liabilities set out. This form is made in extensive detail so that the bidder
may explain his assets and liabilities in proper sequence and in a uniform manner.
T. M. HINDMAN,
State Examiner
3
Submitted by w..........Walsh & Kelly, Inc. { x A Corporation
Principal Office at 1700 East llama Street Griffith.,1N 46319
To _ City of South Bend Indiana
EXPERIENCE QUESTIONNAIRE
The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers
to interrogatories hereinafter made.
1. How many years has your organization been in business as a general contractor under your present
business name? 53 Years
2. How many years' experience in asphalt, paving construction work has your organization had: (a)
As a general contractor 72 years (b) As a sub -contractor 72 Years
3. What projects has your organization completed?
Contract Amount
Class of Work
When Com leted
Name and Address of Owner
.............
$
.�
6,126 221
...........W ...,
Reconstruction
December 2018
Lake County Hw Dept
$
4,179,989
........ ........_
Reconstruction
October 2018
INDOT
$
8,266,669
Reconstruction
June 2018
... .........
INDOT
$
3,562,804
Resurface
i December 2018
Elkhart County Hwy Dept
3-A. What projects has your organization now in
process of construction?
CONTRACT AMT„
CLASS OF WORK
WHEN TO BE COMPLETED
NAME AND ADDRESS OF OWNER
$
12,073,447
Reconstruction
Aril 2019
Walsh Construction
$
9,312,413
Reconstruction
May 2019
INDOT
$
6,953,756
Resurface
November 2019
INDOT
$
3,090,300
Resurface
November 2019
1 St. Joseph Count
4. Have you ever failed to complete any work awarded to you? No If so, where and why?
Has any officer or partner of your organization ever been an officer or partner of some other
organization that failed to complete a construction contract? No If so, state name of individual,
other organization and reason therefore......................................................................
6. Has any officer or partner of your organization ever failed to complete a construction contract
handled in his own name? No If so, state name of individual, name of owner and reason therefor
7. In what other lines of business are you financially interested?
4
8. For what corporation or individuals have you performed work, and to whom do you refer?_
BP Amoco Whiting, Indiana
Tong & Blank Construction 1623Greenwood Ave., Michl ag�n City, IN 46360
Grimmer Construction Co, Inc. 2619 Main Street Hi hland IN 46322
University of Notre Dame South Bend Indiana
Gough Inc. 1151 E. Summit Crown Point,MIN 46307,......,
9. For what cities have you performed work and to whom do you refer?
Town of Griffith
Director of Public Works
Griffith, IN
Town of Schererville
...____�.._.................__ ...._._
Tow�r�i �'ana er
Schere�ille, I�N
City of Hammond
City Engineer
Hammond IN ..........
Qi1y,of South BBend_....
__ . ty FngWtneer
South Bend IN
Town of St. John
Town Manager
St. John IN
10. For what counties have you performed work and to whom do you refer?
Lake Count
Highwa Su erintendent
Crown Point IN
Porter County
HighwayHighw4y Su erinten&m
Valparaiso, IN
St. Joseph County_._._.__
Hi hway Superintendent ,,,,,,,,,
South Bend, IN
Elkhart Cotjiitv
Highway Superintendent
1 lkhart IN
LaPorte County
Highway Su e�rintendent
LaPorte IN
11. For what State bureaus or departments have you performed work and to whom do you refer?
Indiana QKpa tlnent ol...Trans ortation INDIJT LaPorte District LaPorte IN
Department of Natural Resources Indianapolis, IN
12. Have you ever performed any work for the U.S. Government Yes
If so, when and to whom do you refer?
U.S. Aran Co . s of Engineers Chicago, IL
Indiana National Guard, Dept. of Administration Indianapolis, IN
Federal Highway, Administration .wwww.� Sterling,, ...........
13. What is the construction experience of the priRC;ipal individual of your organization?
INDIVIDUAL'S NAME
PRESENT POSITION OR
YEARS OF
MAGNITUDE AND
IN WHAT CAPACITY
OFFICE
CONSTUCTION
TYPE OF WORK
EXPEREINCE
Kevin J. Kelly
President
34
All T ems
General Manager
.....ww._....
Jeffrey L. Swan
Exec. Vice President
35
All Types
Supt. Engineering
David J. Misirly
Vice President
34
Bituminous Paving
En ineer
Greg A. Ho finan
Vice President
32
Bituminous PavEngineer
John C. Wall
Vice President
42
Al!jXpSs
Engineer
John M. Peisker
Vice President
34
All types
General Manager
J. Michael
Secretary/Treasurer
47
Administration
General Manager
Schaum
Jamie L. Tancos
Controller
15
Administration
General Manager
Lynn J. Bauer
Vice President
24
All types
Engineer
Dustin P. Hilary
Vice President
19
All types
Engineer
Mark E.
Vice President
29
All types
...........
Engineer
Krachenfels
Nicholas G.
Vice President
17
Bituminous Paving
Engineer
Relias
PLAN AND EQUIPMENT QUESTIONNAIRE
The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers
to interrogatories hereinafter made.
1. In what manner have you inspected this proposed work? Explain in detail.
Plans S ecifications and Site Ins ections
2. Explain your plan or layout for performing the proposed work
As directed by owner/en ineer
3. The work, if awarded to you, will have the personal supervision of whom?
Kevin J. Kelly,Jeffrey „L, ry u. David I Misi:rl Gj:c2,gpry A.. Floflirnan, Dustin P,..Hila and Iyt�s� J:
Bauer
4. *Do you intend to do the hauling on the proposed work with your own forces? Yes
g type equipment
If so, give amount and t e of e ui ment to be used As needed
5. *If you intend to sublet the hauling or perform it through an agent, state amount of sub -contract or
agent's contract, and if known, the name and address of sub -contractor or agent, amount and type of
his equipment and financial responsibility
Items 4,5,6 and 7 may not be applicable in all building contracts; if not, omit.
6.• *Do you intend to do the grading on the proposed work with your own forces?
If so, give type of equipment to be used
7. *If you intend to sublet the grading or perform it through an agent, state amount of sub -contract or
agent's contract, and, if known, the name and address of sub -contractor or agent, amount and type of
his equipment and financial responsibility ... ...... ...
8. Do you intend to sublet any other portions of the work? II` so, state
amount of sub -contract, and, if known, the name and address of the sub -contractor, amount, and type
of this equipment and financial responsibility
9. From which sub -contractors or agents do you expect to require a bond? None
10. What equipment do you own that is available for the proposed work?
....................................................................
QUANTITY
...
ITEM
DESCRIPTION,
CONDITION
................................ �.__........................................�...........................................................................
YEARS
PRESENT LOCATION
SIZE, CAPACITY,
OF
ETC.
SERVICE
5
Asphalt Plants
Various
Good
Griffith, South Bend,
Val ar�aiso, Lowell, LaPorte
19
As halt Pavers
Various
Good
Griffith, South Bend
4
Sl�pform Conc. Paver
Various
Good
Griffith, South Bend
3
Road Widener
Various
Good
Griffith, South Bend
5
Motor Graders
CAT/J.D,
Good
Griffith, South Bend
56
Rollers
Various
Good
Griffith, South Bend
32
.........................................................................:......................�..............._.........._
Rubber Tire Loaders
Various
.................................
Good
Griffith, South Bend
17
Excavators
Various
Good
Griffith, South Bend
9
Bulldozers
Various
Good
Griffith, South Bend
6
LowBoy Tractors
Various
Good
Griffith, South Bend
8
Flatbed Dumps
Various
Good
Griffith, South Bend
46
'/z and 3/ ton Picku s
Various
Good
Griffith, South Bend
76
1 Ton Crew Trucks
Various
Good
Griffith, South Bend
3
Cold Planers
Wirtgen 1900
Good
Griffith, South Bend
DC
ITITIT�Mmmmmmm 28m
Quad/Tri-Axle Dumb
Mack
Good
South Bend_
11. What equipment do you intend to purchase for use on the proposed work, should the contract be
awarded to you?
QUANTITY ITEM DESCRIPTION, SIZE, CAPACITY, ETC. APPROXIMATE
COST
None
........�
12. How and when will you pay for the equipment to be purchased?, N/A
13. Do you propose to rent any equipment for this work? No If so, state type, quantity and reasons for
14. Have you made contracts or received firm offers for all materials within prices used in preparing your
proposal?
Do not give names of dealers or manufacturers,
Dated at South Bend this 26t" day
o 9l wl fo
�KE ' �
� 0y,?ORATF
y"M
SE
d�
STATE OF 1ridiallia '�40 11 y.y0 �
ISS.
COUNTY OF St. Joseph
(Name
M
of Person Signing)
Dustin Hilary being duly sworn deposes and says that he is VP of South Bend Area _ of
the above IT Walsh & Kelly Inc.
(Name of Organization)
and that the answers to the questions in the foregoing questionnaires and all statements therein contained
are true and correct.
Subscribed and sworn to before me this 261h day of, March 2019
Misha d4fer,'
My Commission expires June5. 2022 #+armoLI P :!UEGER
NAstale olIndtaris
8 SEAry, * =y 5t. Joseph County
" My Commission Expires
r;ytlw 2
June 05, 207.
State of Indiana
Office of the Secretary of State
'":irl9�•1_"0812X413"0ram
To Whom These Presents Come, Greeting:
I, CONNIE LAWSON, Secretary of State of Indiana, do hereby certify that I am, by virtue of the laws of
the State of Indiana, the custodian of the corporate records and the proper official to execute this
certificate.
I further certify that records of this office disclose that
WALSH & KELLY INC
duly filed the requisite documents to commence business activities under the laws of the State of
Indiana on March 29, 1966, and was in existence or authorized to transact business in the State of
Indiana on March 08, 2019.
I further certify this Domestic For -Profit Corporation has filed its most recent report required by
Indiana law with the Secretary of State, or is not yet required to file such report, and that no notice of
withdrawal, dissolution, or expiration has been filed or taken place. All fees, taxes, interest, and
penalties owed to Indiana by the domestic or foreign entity and collected by the Secretary of State
have been paid.
In Witness Whereof, I have caused to be affixed my
signature and the seal of the State of Indiana, at the City
of Indianapolis, March 08, 2019
a
CONNIE LAWSON
SECRETARY OF STATE
194484-057 / 2019907921
All certificates should be validated here: https://bsd.sos.in.gov/ValidateCertificate
Expires on April 07, 2019.
WRITTEN CONSENT TO RESOLUTIONS
of the
BOARD OF DIRECTORS
of
WALSH & KELLY, INC.
The undersigned, being all of the Directors of WALSH & KELLY, INC., an Indiana Corporation,
hereby consent to the following actions to be taken by the Corporation without a meeting of the Board of
Directors under the applicable provisions of the Indiana Business Corporation Law, as amended:
RESOLVED that the following be, and hereby are, elected officers of the Corporation, to
hold the office until the next regular meeting of the Board of Directors and until their
successors are duly elected and have qualified:
Kevin J. Kelly, President and Chief Executive Officer
Jeffrey L. Swan, Executive Vice President
Jamie L. Tancos, Controller
John M. Peisker, Vice President of Asphalt Operations
David J. Misirly, Vice President
Gregory A. Hoffman, Vice President
John C. Wall, Vice President and EEO Officer
J. Michael Schaum, Secretary and Treasurer, CFO
RESOLVED FURTHER that the actions of the Officers of the Corporation taken since the
last meeting of the Board of Directors be, and the same hereby are, fully ratified and
approved.
RESOLVED FURTHER that the following be, and they hereby are, authorized to execute
all contracts or similar documents on behalf of the Corporation:
Kevin J. Kelly, President and Chief Executive Officer
Jeffrey L. Swan, Executive Vice President
Jamie L. Tancos, Controller
John M. Peisker, Vice President of Asphalt Operations
David J. Misirly, Vice President
Gregory A. Hoffman, Vice President
Dustin P. Hilary, South Bend Area Manager
Lynn J. Bauer, South Bend Operations Manager
John C. Wall, Vice President and EEO Officer
J. Michael Schaum, Secretary and Treasurer, CFO
RESOLVED FURTHER that this consent shall be in lieu of an annual meeting of the Board
of Directors of the Corporation and shall be filed in the minute book of the Corporation in
place of any such annual minutes.
<<SIGNATURES ON THE NEXT PAGE>>
Thomas P. Bertsch
James C. Fehsenfeld
Prom
0%111110100
NO L Y
W,
Kevin J. Kelly
............
of
EXECUTED this 71� day of March, 2017.
IWO?OA. ku
� r
Fred Fehsenfeld, Jr.
Thomas P. Bertsch
Kevin J. Kelly
Jame w. Fehsenfeld
n P. Vercruysse
GRIFFITH SOUTH BEND
Walsh & 1700 East Main Street 24358 SR 23
04
Griffith, Indiana 46319 www.walshkelly.com South Bend, Indiana 46614
Phone (219) 924-5900 Phone (574) 288-4811
Inc, Fax (219) 924-8768 Fax (574) 289-7174
EQUAL EMPLOYMENT OPPORTUNITY POLICY
I. It is the policy of this Company to assure that the applicants and those that are subsequently employed are
treated without discrimination without regard to: their race, religion, sex, gender identity, sexual orientation,
color, national origin, age, association with the Vietnam era or any other war, disability, genetic information,
citizenship status, military status, veteran status, ancestry, or any other status protected under applicable
laws. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment
advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training,
including apprenticeship, pre -apprenticeship, and/or on the job training.
A. The Contractor will work with the State Highway Agency (SHA) and the Federal Government in carrying
out EEO obligations and in their review of his/her activities under the contract.
H. Director of Human Resources; Randall L. Walls, shall be designated as Walsh & Kelly, Inc.'s Equal
Employment Officer. He will be responsible for all activities associated with the implementation of all
policies affecting equal employment opportunity.
III. Walsh & Kelly, Inc. assures nondiscriminatory recruitment by taking appropriate steps such as:
A. Placing employment advertisements in newspapers which serve the largest number of minority and
female groups in the recruiting area.
B. Recruiting through schools and vocational colleges having substantial proportions of minority and
female students.
C. Maintaining systematic contacts with minority, female and human relations organizations leader's
referral of qualified minority applicants.
D. Encourage present employees to refer minority and female applicants.
E. Make it known to all recruitment sources that qualified minority and female members are being
sought whenever there is hiring.
IV. This policy is intended to comply with the Civil Rights Act of 1964, as amended, the Federal Highway Act
of 1968, the Executive Order 11246 and 11375, the Rehabilitation Act of 1973, as amended, the Disabled
Veterans and Vietnam Era Veterans Readjustment Act of 1974, as amended, the Indiana Civil Right Act,
and other Federal and State Laws and Regulations pertaining to Equality of Opportunity and Affirmative
Action Policies.
V. Forms for filing any complaints are available in the Griffith office located at 1700 E. Main Street,
Griffith, IN 46319 or the South Bend office located at 24358 S.R. 23, South Bend, IN 46614. In addition,
employees can call (574) 288-4811, Ext. 211 to report any workplace concerns under this policy.
WALSH & KELLY, INC.
E
mMpd
y;
xW 5 d a
Randall L. Walls, CHRS
,
Director of Human Resources/EEO Offkr
Revised: February 27, 2019
CERTIFICATE OF QUALIFICATION
to provide
CONSTRUCTION SERVICES
for
PUBLIC WORKS PROJECTS
to the
STATE OF INDIANA
This Certification Board, having duly considered application for qualification in terms of apparent experience and financial
resources; and under the applicable Indiana Code 4-13.6-4 and adopted rules of this Board, hereby issues a
Certificate of Qualification to provide construction services to the State of Indiana for Public Works Projects to:
WALSH & KELLY INC
1700 E MAIN ST
GRIFFITH IN 46319
Phone 219-924-5900
Fax 219-924-8768
Company Official
KEVIN KELLY
for the twenty-seven month period stated herein, unless revoked by this Board for cause,
and in the classifications of services stated below. This certificate supersedes any previous certificate.
1611.01 Concrete Construction of Roads & Curbing
1611.02 Asphalt Construction of Roads and Parking Lots
CERTIFICATION DATE 3/14/2018
EXPIRATION DATE 6/14/2020
THIS CERTIFICATE ISSUED BY THE STATE OF INDIANA, PUBLIC WORKS DIVISION CERTIFICATION BOARD,
402 WEST WASHINGTON STREET, ROOM W467, INDIANAPOLIS, INDIANA 46204,
ALSO ACTS AS THE OFFICIAL NOTICE OF EXPIRATION.
"F
� f
Tracy L. Cross, Executive liu6etary
Certification Board
DAPW P02 State Form 3963R Rev. 07/06
�����
Qu alifiruflan
ISSUED BY
14thinna
Brpurlmnd of
INDIANAPOLIS, IN April 19,2018
TO
GRIFFITH, IN
who has filed with, the Department: a Contractor's Statement of Experience and Financial Condition as
required under Indiana Code 8-23-10, is hereby qualified to bid at any Department of Transportation
letting in Classes of Work and within the amount and other limitation of each classification as listed
below, for such period as the uncompleted work on hand from all sources does not exceed the Aggregate
amount. Classification references by name or s mbol are in accordance with the definitions in the
Contractor's Staternent of Experience itind Financiarcondition, This certificate supersedes any certificate
previously Issued, but is subject to revision or revocation according to the law, if and when changes,
in the financial condition of the contracting firm or other facts justify such revision or revocation,
x000Eoyre _--............. _--_---..... ... ---'SnwowITco
A(B) CONCRETE PAVEMENT: LIMITED ..... ............... ...... *25,000,000
oVq ASPHALT PAVEMENT: WuNoozCERTIFIED nwA__-____—_---.......... -..... -...... Somummruo
C(B) LIGHT GoAooNs'...... ......... ........................ -----......... --_---_--... .... .............. $omuMoEo
E(E) SMALL STRUCTURES AND DRAINAGE osMu__..... -______-_-__-___...... __ $25,000,00
E(F) SURFACE MASONRY AND MmcCONCRETE ................... ............................... .......... __--_-. $50,000,00
E(o) TRAFFIC CONTROL: PAVEMENT MARKINGS ..................... .............................. .................. %25,000,00
E(H) DEEP usvm-RmvoxzuEXCAVATION- _--..... ---------_—_-_--_----_... .... $25,000,00
E(Q) CONCRETE PAVEMENT REPAIRS ........... ------------_-___---_-------' 125,000,00
�
COMMISSIONER