HomeMy WebLinkAboutOpening of Quotes - Hydrant Flow Testing Project No 119-041R - Shambaugh & Son LPQUOTE/PROPOSAL
CITY OF SOUTH BEND.
PROJECT NAME Hydrant Flow Testing
......... ........ .
PROJECT NO 119-041 R
2019, 9:30am„ Local Time QUOTES DUE June 11„ me
Address:
City/State/Zip. I
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CITY OF SOUTH BEND, INDIANA .x.`
CONTRACTOR'S -QUOTE FOR PUBLIC WORK
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PROJECT NAME: Hydrant Flow Testi
PROJECT NO. 119-041 R
QUOTES DUE June 11, 2019, 9:30am Local Time
(Must be completed for all quotes. Please type or print)
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
City of South Bend, Department of Public Works e ..,,..—--------- ................--
and dated ®1i for the sum of (enter the Total Quote as shown on the Proposal)
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1 (Enter Quote shown on Pr ,h. ($ 00
(Proposal)�10//
(Numerical)
If alternative quotes 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 quote is to be awarded on a unit basis, the
itemization of the units shall be shown on a separate attachrn - nt,
By........... -
Printed Na Nc r� �ture)
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( e art I (6t,66t Signing)
The above quote is accepted this
Subject to the following conditions
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Elizabeth A. Maradik. Member
Laura L. O'Sullivan, Member
ACCEPTANCE
day of 20
Genevieve E. Miller, Member
Therese J. Dorau, Member
Attest: Linda M. Martin, Clerk
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When the prospective Contractor is unable to cerhfy 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 MOW )
) SS:
ST COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that:
1. Contractor has not, nor has any other member, representative, or agent of the firm,
company, corporation or partnership represented by him, entered into any combination, collusion
or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent
any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made
without reference to any other bid and without any agreement, understanding or combination with
any other person in reference to such bidding. Contractor further says that no person or persons,
firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift,
commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its
principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency;
and
3. Contractor has not; nor has any successor to, nor an affiliate of, Contractor,. engaged in investment,
activities in Iran.
a. For purposes of this Certification, "Iran' means the government of Iran and any agency or
instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from
time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is
engaged in investment activities in Iran if either:
i. Contractor, its successor or its affiliate, provides goods or services of twenty million
dollars ($20,000,000) or more in value in the energy sector of Iran; or
ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty
million dollars ($20,000,000) or more in credit to another person for forty-five (45)
days or more, if that person will (i) use the credit to provides goods and services in
the energy sector in Iran; and (ii) at the time the financial institution extends credit, is
a person identified on list published by the Indiana Department of Administration.
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
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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 ("BE") 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
subcontract to an MBE/WBE; however, it may not unlawfully discriminate against sa
WBE/MBE. A finding of . practice by i i . ! r!.
shall prohibit that person or entity from being awarded a City contract for a period of one (1) ye
from . of determination,and such determination t also be grounds
contactthe . practice • !' i
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.
expression,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
•er identity, sexual orientation,handicap, national origin or ancestry. Breach
obligations
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 /0 day of e , 20
r/
Subscribed and sworn to before me this 497'4� , day of 20
My Commission Expires Z
Notary Pu uc
County of Residence
Notary P Sao
My com
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1316 CouNrv-(Tjr , BUILDING
227 W. BcnUI_EVAxn
So[, rr? BLND. 1NDIAr A 46601-1830
PHo.Nt' 574/ 235 925.1
FAX 574/ 235-9171
TDD 574/ 235-5567
CITY of SOU-ni BEND PETS BLJ'1'T'1G1EG, MAYOR
BOARD OF PUBLIC WORKS
Date: June 7, 2019
To: All Planholders
From Linda M. Martin, Clerk, Board of Public Works
.........
Subject Addendum Number: 1
Project Name: Hydrant Flow Testing
Project Number: 119-041 R
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 copyMUST 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
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