HomeMy WebLinkAboutOpening of Bids - Century Center North Restroom Renovation Project No 118-104C - Brown & Brown General Contractors4b 1.S'Y rr pR,r
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CITY OF SOUTH BEND, INDIANA�:
CONTRACTOR'S, BID FOR PUBLIC WORK
Project Name Century Center North Restroom Renovation
ProjectNo.. .....104C ..a�.��.� ... �......w_ ..,. �_............_��..... mU
For Bids Due August 27, 2019
PART I
(Must be completed for all bids. Please type or print)
Date: AugustBidder (Firm): Brown & Brown General Contractors, Inc.
..........
27, 2019
_a-.._.��. ...._.
Address: 124 S. Elkhart St., PO Box 487
City/State/Zip: Wakarusa, IN 46573 Telephone Number: 574m 862-2171
(m ._..._
Agent of Bidder (if Applicable):
Public nt to noticestiproject of:
the undersigned offers to furnish labor and/or a tJi(� -' t m—pl ���—"
given, 9 and/or material necessary to complete the
P P 1
Century Center North Restroom Renovation, Project No. 118-104C
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
Structurepoint Inc.
Total Bid as shown on the Proposal) 60
( . ......_ Ww
(umerical)
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in
the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance
with the notice. Any addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are needed, the cost of units must be the same as that
shown in the original contract if accepted by the City of South Bend'. If the bid is to be awarded on a unit
basis, the itemization of the units shall be shown on a separate dchment.
c
By .�m _ m...
k_ ..-.
iCgr krtu e�
Eric Brown,. President
(Printed Name of PersonSigning)
ACCEPTANCE
The above bid is accepted this day of
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Gary A. Gilot, President��������
Eliiabeth"A.... MaradIk Member �
Genevieve E. Miller, Member
erese J. Dorau, Member
Laura L. O'Sullivan, Member Attest: Linda M. Martin, Clerk
Version 4/2/2019 Contractor's Bid for Public Works - 2
20
BID/PROPOSAL
CITY OF SOUTH BEND
Project Name: Century Center North Restroom Renovation
_... �,-.�_ ....��,....�................� ..................
Project Number: 118-104C
For Bids Due:.� August 27,2019
1
Contractor Name: Brown &Brown General Contractors,
,_...
ontractors, Inc.
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BASE I
No.
Description � � � uanti ni '""Unit rice Total ount
ELL W
Bidder (Firm): Brown & Brown General Contractors, Inc.
Address: 124 S. Elkhart St., PO Box 487
... �.. _ .._.....,.
City/State/Zip: 8-0487 Telephone Number: 574 862 2171
c
BY n......4 _... (Signature)
Eric Brown, President
(Printed Name of Person Signing)
Version 4/2/2019 Contractor's Bid for Public Works - 7
1'11/acaa //rearow/rertausc Contractor is arrrr///c to cr*re%P?ar to an ��"//te.�ntztrra�raa 6e/ara, /a� s/rr// artrdci/ta c�.°/a/err�aRa/r�rr rrr f//, �rl1f//asp/L
C"+t MFRAC°I OIVS NON -COLLUSION AND NON' -DEBARMENT AFFIDAVIT, .FyIITIFIC,"A°I''ION
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:
Elkhart 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 4/2/2 19 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 aerces that
newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's
this bid/quote; and
5. Contractor shall require his/her/its subcontractors perfon-ning work under this public contract to
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P
N) I�AYAAA AN eekifiC264,11 tkrm!�,k+ut t%e termiftke-otaract with the Cityif Sivyth Befi-t, atytzntZ�Tstants-
no later than thirty (30) days after being notified by the City,
6. Persons, partnerships, corporations, associations, orjoint venturers awarded a contract by the City
of South Bend throLmh its aeencies boards or commissions s�all -ff4it,hRcriff i-ra . 111aiia 4
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 tinder public
bidding laws or other contracts in which v,,ublic bids are not revuired bk,, Ww Ahg -Citi* its agencil;i;�L
mr @tfnxiissitis :%,%y oiixsi�er f2itk effiXY-&iwVt2i7. ��,awticiX?tilin Vy th+se Cvintract+rs
certifieAi 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.
to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/K4BE. A finding of a
.F-V1,1ft1aUL ITT d POIFITA UL 'WILC kLJ J1Zd1F IFUM Ln-e-O-M-01 Sucu cleterminatLon, ana sucn
-leteri-nination 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.
1, 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 ajustification
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 4/2/2019 Contractor's Bid for Public Works - 5
UM
Us= . Na7e-Wri . 1 1
for public works are true and correct.
Dated this 27th m ay of 20 19
Zfffl MITI,
My Commission Expires 4/3/2025
Brown & Brown General Contractors, Inc.
— . ................ . ..... ...
Contractor/13,wilder (Firn,
ture 'Onlracto'j' M I cc or Its I gem
Eric Brown, President
iriin't—edNa—me a"nd"T-"—itle-
,day of August 20 19
e
. . . ............ . . . Notary Public Todd A. Marek
Marshall Co., Indiana
Todd!' A
'
Ma
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k
Notary Public
SEAL
Marshall County, State o
f Indiana diana
My Commisalon r�pIas April 3, 2o
25
Co'Imissican NUMhor'6=907SP
Version 4/2/2019 Contractors Bid for Public Works - 6
Init.
: • : • 1 •
CONTRACTOR:
(Name, legal status and address)
Brown & Brown General Contractors, Inc.
P. O. Box 487
Wakarusa, IN 46573-0487
SURETY:
(Name, legal status and principal place
of business)
Philadelphia Indemnity Insurance Company
Bala Cynwyd, PA
OWNER:
(Name, legal status and address)
City of South Bend Board of Public Works
County -City Building Room 1316, 227 West Jefferson Blvd
South Bend, IN 46601
BOND AMOUNT:
Five Percent of the Total Bid
PROJECT:
(Name, location or address, and Project number, if any)
Century Center North Restroom Renovation
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
5% of Total Bid w plural where applicable.
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the
Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and
severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor
within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and
Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such
bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted
in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract
and for the prompt payment of labor and material furnished in the prosecution thereof, or (2) pays to the Owner the
difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount
for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this
obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of
an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of
notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for
acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for
an extension beyond sixty (60) days.
If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall
be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.
When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project,
any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted heretcom and
provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so
furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond.
Sigm�,and sealed this 26th day of August 2019
�� ... ro&Brown _.. a Contractors, Inc
- .-_
l......(Principal) (Sea)
(Witness)
(Title)
-- .
Philadelphia Indemnity Insurance Company
.....—_ (Surety)(Seal)
(Witness)
..
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CMtTlt*l an eawgrwit�al Atai't Contract Documentorlii wt `IN:s teiol appears aua Illtllli::ll An w° dgn nat ltssiures 1ilhirat
at1h ariges s�wiilllt taai Ilh:�oe i wbwsw� osteclll.
mm. Copyright 1963 1070 and 20i3O by The American laastwlute of Architects. All rights reservers, ssAtttspb....
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AtA t7owuumotrt A�R!0 raa .. ,ttY1 tb C A This At6wkNe
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Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail
The American Institute of Architects' legal counsel, copyright@aia.org. 061110
PHILADELPHIA INDEMNITY WSIIRAINC'E COMPANY
One Bala Plaza, Suite 100
Bala Cynwyd, PA 19004-0950
Power of Attorney
KNOW ALL PERSONS B1 TIIESL PRESEIN'N': That PHILADELPHIA WDEM'NI°ITY INSO ANf°.7E COMPANY (the Company), a corporation organized and
existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint .B:rrlaa ea e9 e e la 14Iar k
jvobbe, M ego a Riesenhere. Nisakrlm n jjdK# jM111j, "' x s VWes'e r IN antoot Williamand e o Gibson Insurance
A enc ,•Inc. its true amid lawful Attorney -an -fact with full audwrit;y to excAnite on its bebalf bonds, madxrtak'hrgs, rccognixranc4m and other contracts of indemnity
and wt-starvgi obligatory in the nurture thcrcof, issared in the course of ids business and to bind the Company thereby, in an amount no( to exceed U0,0(i,�hN Y90M
TlaLs Power of Attorney is granted and is signed and scaled by facsimile under and by the authority ofthe following Rcasolution adoplcd by the Board of Directors of
Pll"ILAl)1ai.,Pl'°IIA IND'ENWII"Y INSIJR,AN'C1w COM'PAINY on the 10 of November, 2016,,
RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the
Company: (1) Appoint Attorney(s) in Fact and authorize the Attomey(s) in Fact to
execute on behalf of tile Company bonds and of indenxnity acid
other writings obligatory in the nature thereof and to attach the seal of the Company
thereto; and (2) to remove, at any time, any such Attorney-in-l'-act and revoke the
authority given. And, be it
FURTHER
RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any
such Power of Attorney or certificate relating thereto by facsimile, and any such Power of
Attorney so executed and certified by facsimile signatures and facsimile seal shall be
valid and binding upon the Company in the future with respect to any bond or
undertaking to which it is attached.
1N TESTIMONY WHEREOF, PHILADELPHIA lN'lIl•;MN'1TY INSURANCE COMPANY HAS CAUSED '1"111,S INSTRUMENT TO BE SZGNED AND 11-S
CORPORATE SEALTO BE AFFDCED BY ITS AUTHORIZED OFFICE THIS 27 ra DAY OF OCTOBER, 2017.
f^�
9 t
lr•777) t
(Seal)
Robert D. O'Leary Jr., President & CEO
Philadelphia Indemnity Insurance Company
On this 27`s day of October, 2017, before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said
that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSU RANCE COMPANY; that the seal affixed to said instrument is
the Corporate seal of said Company; that the said Corporate Seal and his signature were duly affixed.
s oMM w i
ravrrva nm
W-oV°m Notary Public:
6 awarwaw�m N yr, r�wrvasm.yaaauw
FAgewamnmGxum awc,Wa5 fl2iq rldN9
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residing at:
(Notary Seal)
My commission expires:
7na•�..`1�,9 � _
Bala Cygwyd, PA
Sep tprrrFvar25,?U 1 ...... .......................
1, Edward Sayago„ Corporate Sccm ary of PHILADELPHIA INDEMNITY iNS'TIRA ^NC"li COMPANY, do hereby certify that the foregoing resolution of the Boardof
Directors and the Power of Attorney issued pursuant thereto on the 27ie day of October, 2017 are true and correct and are still in full force and effect. I do further certify
that Robert D. O'Leary Jr., who executed the Power of Attorney as President, was on the date of execution of the attached Power of Attorney the duly elected President
of PHILADELPHIA INDEMNITY INSURANCE COMPANY.
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this d& day of .. 2019
u�✓',r
Edward Sayago, Corporate Secretary
;; PHILADELPH1A INDENINI IN IN rI1RA.NCE COMPANY
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CITY'OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
rm<,
CHECKLIST FOR BIDDERS
Project Name Century Center North Restrootn Renovation
Project No. 118-104C
For Bids Due August 27, 2019
From time to time the South Bend Board of Public Works finds it necessary to reject a bid because
it does not comply with statutory requirements. In preparing your bid, please use the following
checklist in order to make sure that your bid is done in the proper manner.
Proper bid security included. The bidder has the option of providing either a Certified Check
or Bid Bond.
Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely
executed.
Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments
with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and
Certification of use of United States Steel Products or Foundry Products.
Proof of MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not
met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted
Form [MWBE-2.1].
Acknowledge Receipt of 1 Addendum(s) included with the bid.
All required additional information is included with the bid,
Proposal statements and other affidavits all signed by the proper party with name either
printed or typed underneath signature.
This checklist submitted with the Bid.
This checklist is provided for bidder's use in assuring compliance with required
documentation; however, it does not include all specifications requirements and does not
relieve the bidder of the need to read and comply with the specifications.
Contractors, Inc.Date: August Bidder: Brown & Brown General Contraae: 27, 2019
� �
By Authorized Representative:
Signature:
Print Name & Title: Eric Brown, President
Version 4/2/2019 Contractor's Bid for Public Works -1
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 4/2/2019 Contractor's Bid for Public Works - 3
The above bid is accepted this
following conditions:
Contracting Authority Members:
ACCEPTANCE
day of
PART II
(For projects of $150,000 or more — IC 36-1-12-4)
Governmental Unit: City of South Bend, IN, Board of Public Works
Bidder (Firm) Brown & Brown General Contractors, Inc.
Date month, day, ear Au ust 27, 2019
subject to the
These statements to be submitted under oath by each bidder with and as a part of his bid.
Attach additional pages for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
What public works
projects has your organization
completed for
the period of one (1) year prior to the
date of the current
bid?
._. .......
Completion
�.........,u . ..._ �....._
Contract Amount
Class of Work
D. _ ... M ...
P. _ _... Address
3,481,450.00
renovation
2017
..w�... - w
Indiana University, Bloomington, IN
226,429.00
renov/addition
2018
Elkhart Comm Schools, Elkhart, IN
1,141,066.00
new
2018
—Walkerton Lincoln TWp Library, Walkerton, IN
6,109,490.00
new
2018
WaNee Comm Schools, Nappanee, IN
What public works projects
are now in process
of construction
by your organization?
Expected
Contract Amount
Class of Work
Completion
Name and Address of Owner
_
Date
,
.1,213,300.00
renovation
2019
Concord Comm Schools, Elkhart, IN
2,985,000.00
new
2019
Elkhart Comm'Schools, Elkhart, IN
7,550,000.00
new
2019
Elkhart Co Bd of Comm, Goshen, IN
359,400.00
renovation
2018
Mishawaka Penn Hells Pub Llb, Mishawaka IN
Have you ever failed to complete any work awarded to you? no If so, where and why?
4. List references from private firms for which you have performed work.
Dick Belcher, First Federal Savings Bank, Rochester, IN
John Metzger, Culver Duck Farm, Middlebury, IN
Jeff Ewing, 2nd AP Company L.P., Woburn, MA
Samantha Hale, Holladay Properties, South Bend, IN
Patti Toering, Matthews LLC, Notre Dame, IN
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
Explain 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 governmental unit to consider your bid.)
All work to be completed in a professional, workmanlike manner according to applicable
plans, specifications and addendum.
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.
Art Mosaic & Tile, South Bend, IN - specialized floor finishes
Interior Finishes, South Bend, IN - floor finishes
Edward J. White, South Bend, IN - mechanical
DeMuyt Masonry, Rome City, IN - masonry
Martell Electric, South Bend, IN - electrical
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
iminediately notify the governmental unit in the event that you subsequently determine that you will use a
subcontractor on the proposed project.
Names and addresses of subcontractors to be furnished as specifications require
Equipment to be used by them is unknown to us.
Bonds from subcontractors to be determined
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.
Trucks, skid loaders; anything else we do not have will be rented.
5. Have you entered into contracts or received offers for all materials which substantiate the prices used in
preparing your proposal? If not, please explain the rationale used which would corroborate the prices
listed.
Yes
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.
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CITY OF SOUTH BEND ,W lot":�
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS
This completed form shouldbe included as part of the Bids documents related to City of South Bend Public
Works Projects requiring Good Faith Efforts to obtain MBEIWBE participation. It is the bidder's sole
responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority
or Women's owned business as defined by the Indiana Department of Administration ("IDOA").
Project Number: 1 6-104C......._._w�.�„,.......n..W....._......_
Date: Aug. 27, 2019
Project Name: Centur)/ Center North Restroom Renovation
Bidder: Brown & Brown General Contractors, Inc.
Eric Brown 574-862 2171
Contact Person: Telephone:
Address: 124 S. Elkhart St., PO Box 487�-
City: Wakarusa State: IN zip: 46573-0487
Email: eric@bbec.us
To determine whether a bidder has demonstrated good faith ............--_. i goals�--efforts to reach the MBENVBE utilization ion set
forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or
commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below`:
EVIDENCE OF GOOD FAITH EFFORTS
MBEIWBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business
Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women
Owned Business as found on their website (http://www.in.gov/idoa).
ACTION (ADV � . -.. .._....... .. ..._...-.�.
ERTISEICONTACT): In order for your bid to be deemed responsive, the City of South
Bend requires that all perspective bidders complete no less than 2 of the following:
1. Attend all pre -bid meetings scheduled by the City to inform MBENVBEs of contracting and
subcontracting opportunities.
2. Advertise in general circulation and/or trade association publications concerning subcontracting
opportunities, and allow MBE/WBEs reasonable time to respond,
3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated
to inform MBENVBEs of subcontracting opportunities and allowed sufficient time for them to
participate effectively.
4. Utilize pre-existing services of available community organizations, small and/or disadvantaged
business assistance offices and other organizations that provided assistance in the recruitment
9
and placement of MBE/WBE firms.
"*Bidder must circle or otherwise notate which of the two (2) required actions were performed.
mH, GOOD FAITH NEGOTIATIONS: The bidder negotiatedµ in goodfaithwith interested MBENVBEs,
including providing such MBENVBE's with adequate information about the plans, specifications and other
requirements of the subcontract and did not reject MBE/WBEs as unqualified without sound business
reasons based on a thorough investigation of their capabilities. _
SMALL ONTidder selected specific
MBENVBEs in
to increase the l kelih od of meeting the oMBENVBEtgoa s (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.
omissions shall be considered grounds for rejection of the bid City "Pro er demonstration of Good Faith Effort requires our Initials next to all of the above boxes. Any
by the Board of Public Works. The Ci of
South Bend reserves the right to request additional information.
Version 4/2/2019 Contractor's Bid for Public Works - 9
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITYr
DEVELOPMENT PROGRAM41
'm"a
FORM MWBE-2.1
MBEIWBE CONTACTED
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects
requiring contacted MBE/WBE 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.
Project Number:
Project Name:
Bidder:
By:
PAGE OF.
118-104C MBE/BE Participation Goal
N troom Renovation
_....en urn Center North Res.._...,.,.�..w��..�___.......__...����.......„�._._._
Cotractors, Inc. Br°wn ;�„ rown General .._..�...... _...... ._
President
RESULTS OF CONTACT WITH THE MBE/WBE FIRM:
MBENVBE Firm
Owner or Contact at MBENVBE Firm
Telephone: Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBE/WBE FIRM:
Version 4/2/2019 Contractor's Bid for Public Works - 10
,August 27„ 2019
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
RESPONSIBLE BIDDER CHECKLIST
Project Name Century Center North Restroom Renovation
h .. ..... ..._ __w� ------ .___
W.�
Project No. 118-104C
For Bids Due August 27� ._-...
... .e....
.............
..__.......................................................
2019
Contractor Name: rown & B
�.. -�-.Brown general cttor,.nc��.�. ... _. �....... .. ......... .... .....�.
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 319t 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 5/16/2019 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 taking into
account all information in the submission requirements, determine whether a bidder is responsive and
responsible, and provide a Pre -Qualification Verification Letter, The City specifically reserves the right to
utilize all information provided in the contractor's submission and any information obtained by the City
through its own independent verification of the information provided by the contractor.
Version 5/16/2019 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.
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) X 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) X w 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) _ 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.
(iv) XFor every project, submit 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.
Version 5/16/2019 General Conditions - 8
PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED)
(a) Acknowledgements:
(i) _ By checking this box, I hereby acknowledge that I am not a pre -qualified bidder
with the City of South Bend.
(ii) _ By checking this box, I hereby acknowledge that the City reserves the right to
request supplemental information, additional verification of any information
provided, and may also conduct random inquiries of my current and prior
customers. The City reserved the right to utilize all information provided in this
submission and all information obtained in inquiries or requests to determine if a
bidder is responsive and responsible. Additionally, I acknowledge that all
information provided to the City shall be regarded as public records.
(iii) _ By checking this box, I hereby acknowledge that copies of all Applicable
apprenticeship certificates or standards for training programs applicable to the
work performed on the project may be requested at any time and shall be furnished
upon request.
(iv) _ By checking this box, I hereby acknowledge and ensure that I and all sub-
contractors, from whom I have accepted a bid and/or intend to hire to perform work
on the public work project, are properly licensed. Furthermore, I acknowledge my
understanding that it is my responsibility to ensure that all sub -contractors have
the necessary licenses to undertake the work called for in this bid. If a sub-
contractor loses their license at any point, it is the responsibility of that sub-
contractor to notify the City.
(b) Attachments
(i)
Indiana Secretary of State's on-line records (ie. Business verification) dated within
sixty (60) days of the submission of said document showing that business is in
existence, current with the Indiana Secretary of State's Business Entity Report,
and eligible for a certificate of good standing. (Not applicable to individuals, sole
proprietors or partnerships).
List identifying all former business names.
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) -,,, ,,
For every project, submit 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 5/16/2019 General Conditions - 9
Ox) Writteir staternent Many tederal, sit�ate or local tax fiens or tax delinquencles owed
to any federal,, state or local taxkig body in the preceding three years.
(1) 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:, August 26, 2019
..........
. . ......... .
(Sign Here)
Marita Kreps
(print me —Here
Brown & Brown General Contractors, Inc.
(Name of Company)
124 S. Elkhart St., PO Box 487
(Address of Company)
Wakarusa
(CRY)
IN
(State)
574-862-2171
(Telephone Number)
Version 5/16/2019 General Conditions - 10
l�-flCl/'I�Ik�t�l�l
•
.W�rownArown
/
P.O. DOX
/,'
PHONE.1,
Statement of staffing capabilities:
In-house Eric Brown, President
Morita Kreps, Vice -President
Bradley Romine, Project Manager
Todd Marek, Project Manager
On -site Eric Romine, Site Superintendent
Adam Loucks, Site Superintendent
Matthew Hilty, Site Superintendent
James Downing, Site Superintendent
Rob Reinhold, Site Superintendent
Labor sources: Carpenter's local 413
Cement finishers local 101
Painters local 91
1A III Lr1'71"FW Jt t%-
rown rown
",
P.0, BOX
WAKARUSA, INDIANA 46573-0487
PHONE:0
Attachments:
(i) Indiana Secretary of State on line record - ATTACHED
(ii) No former business names
(iii) No determinations by a court or government agency for any violations of
federal, state or local laws.
(iv) Staffing capabilities - ATTACHED
(v) Statement is ATTACHED
(vi) Evidence of apprenticeship participation is ATTACHED
(vii) Employee drug testing written plan is ATTACHED
(viii) Evidence of Surety Company is ATTACHED
(ix) No federal, state or local tax liens are owed
(x) List of projects is ATTACHED
BUSINESS INFORMATION
COMIE LAWSON
INDIANA SECRETARY OF STATE
10/0 1/2018 10:33 AM
'0=57-7/77,
Business Name: BROWN & BROWN GENERAL Business ID: 194303-158
CONTRACTORSINC
Entity Type: Domestic For -Profit Corporation Business Status: Active
Creation Date: 06/02/1960 Inactive Date:
Principal Office Address: 124 S. Elkhart St., Wakarusa, IN, 46573 - Expiration Date: Perpetual
0487, USA
Jurisdiction of Formation: Indiana Business Entity Report Due 06/30/2020
Date:
Years Due:
IN
MEN
.......... . . . . ......
mffi
00,I/
M, I M if'rij
EN
Title Name
Secretary Hannah M Aitken
President Eric Brown
Type: Individual
Address
PO Box 487, WAKARUSA, IN, 46573. USA
Address: 124 S. ELKHART ST., WAKARUSA, IN, 46573 - 0487,USA
INDIANA/ KENTUC K Y/OH 10 REGIONAL COUNCIL OF CARPENTERS
JOINTAPPRENTICESH IP AND TRAINING FUND
11195 MARINERS DRIVE
WARS�%W IN 46582 C1
ADMINISTRATION OFFICE
711 Greene and Springs Drive
Greenwood, IN 46143
llhonc; 317-807-1112
Fax; 317-807-1115
Ashland Campus
574 Cirpenteri Way
Graysnn, KY 41143
Phoyw: 606-929-1378
Vix:502-996-8108
Indianapolis Canopus
October 31, 3018
711 Greenwood Springs Drive
Greenwooci, IN 46143
Phone; 317-807. 1116
Fax: 317-807-1131
Lafayette Campus
Brown & Brown General Contractor
2953 South Creasy Lane
P.O. Box 487
Lafayette, I N 47905
Wakarusa, IN 46573
Phone: 765-447-5959
I"'ix: 763-447-7676
RE: City of South Bend Bid
Louisville Campus
1245 Morro( Lane
Louisville, KY 40213
To Whom It May Concern-,
Phone: 502-366-3668
Flux: 502-366-8678
This letter is in response to verification needed by Brown & Brown for work to be
Merrillville Campus
performed for the City of South Bend. Brown & Brown regularly employs a number of
1565 East 70dt COUrt
apprentices affiliated with our apprenticeship program and has done so for more than
Merrillville, IN 46410
Phone: 2 19-947-3348
three years. We are registered with the United States Department of Labor, Bureau of
Fax: 219-947-1889
Apprenticeship and Training and our registration number is 020 0537. Our program also
participates in the Building Trades Associate Degree Program with Ivy Tech Community
Muncie Campus
College and has done so since 1996,
4121 East Centennial Avenue
Muncie, IN 47303
Phonci 765-288-9015
Brown & Brown is a bona fide contractor in good standing the
rax; 765-288-9298
with
Ind iana/Kentucky/Ohio Regional Council of Carpenters Joint Apprenticeship and
Newburgh Campus
Training Fund and is eligible to employ apprentice carpenters in the future. I have
5400 Covert Court
enclosed copies of our certificates from the United States Department of Labor and
Newburgh, IN 47630
from the Indiana Department of Veterans Affairs for GI educational benefits.
Phone: 8 12-853 -9312
Pau: 812.853.9316
If I can be of further assistance, please do not hesitate to give me a call.
Terre Haute Campus
3099 South 6th Street
rcrre Haute, IN 47802
Best regards,
Phone: 8 12-466-7899
Fax: 812-466-9840
Warsaw Campus
1095 Mariners Drive
Dale Newlin
Warsaw, IN 46582
Area Coordinator
Phone: 574-267-5264
Fax: 574-269-1464
IKORCCJATF
Warsaw Campus
P14.3L Ul
«
ww,w
f la teirears' & Ceini nt Masons,
Appi- ntic 000-dinstor
(14,
Local Union #692
Eniu H hlh,uimoff
To Whom it May Concern:
November 2, 2018
Brown and Brown Construction is a signatory contractor, with Local 692, and participates in the
Plasterers & Cement Masons Apprentice Program. I may be reached at (219)707-7767 if
Additional information is needed.
Thank You,
Brian Kristoff
Apprentice Coordinator/Instructor
Plasterers & Cement Masons
r
11 c/ Finishing Tradles Institute
S
Of District Council 91
Merrillville - Indianapolis - Evansville
Office: (219) 246-4210
!wlk��9w 0"",re�au^Pmro,n Erre�`mor
November 5, 2018
Contractors,RE: Brown & Brown General
'• Box 487
R
To Whom It May Concern,
Please be advised that Brown & Brown General Contractors, Inc.is a signatory contractor, in good
standing with Painters Local 1118/District Council 91 and has been for numerous years. The
apprenticeship program that they participate in is the Finishing Trades Institute of District Council 91,
FTI of DC91, which is registered with the Department of Labor. I am providing a copy of our Certificate
of Registration for your records.
The above mentioned company is a participant in the Apprenticeship and Training Program through this
District Council and is eligible to use our apprentices on projects.
Please call if you need further information or have questions.
Respectfully,
Dam Barajak
Danielle Barajas
Administrator
Finishing Trades Institute of District Council 91
aww
1
P.O.
K46573-0487
,,
List of Projects in past three years
Description Amount
Walkerton Library, Walkerton, IN . . . ...... . .... . .. . . . . ......... .
$1,143,906
IUSB Riverside Hall, South Bend, IN ............. . . .... . .. , „ . , .....
3,254,451
IUSB Northside Hall, South Bend IN .. , ... , . , .. , „ .. , „ . „ . ... , .....
3,482,671
Elkhart Memorial High School Commissary, Elkhart, IN .... . . . . .....
1,164,280
Howard Ellis Elementary, Niles, MI , .... , . „ ... , ........ „ ..............
935,100
Ring Lardner Middle School, Niles, MI ...... „ ........... , . „ .........
765,272
Northwood High School Athletic Center, Nappanee, IN . ....... . ....
$6,104,700
Woodlawn Hospital Pharmacy, Rochester, IN . , ... , , . , . , „ , , .. , , , . , ..
„ 286,229
Watervliet Middle & High Schools, Watervliet, MI .......... „ . „ .... ,
.. 557,494
Elkhart Public Library, Elkhart, IN „ , ... , ...... . .... . . . ...
o . 979,298
Culver Duck Farm, Middlebury, IN .............. . . . . . „ . „ p ... „ „ . a
, w . 112,316
Peru Housing Authority, Peru, IN .. . . . . ... . .............. . ... . .., ...
342,533
Pennway Alternative School, Osceola, IN .................... . ... .
... 119,299
Stratford Commons, Elkhart, IN ........... . . . . . ............ . „ , .
, 1,014,298
Buchanan Middle School, Buchanan, MI .... . , . , .. , .. , . „ „ . , u , .. , ....
1,025,471
Gurley Leep Kia, Mishawaka, IN ...... „ . ,. , , ... . . . .............. . .
.. 358,939
St. Joseph County PSAP, Mishawaka, IN ....... , . , ....... . .......... ,
. „ 587,494
Success Academy, South Bend, IN .... , ........ . .....................
209,905
Knox Elementary School, Knox, IN ............ „ , ..... , ... „ ..... , ...
1,523,524
Ar, ow -n
,,
124 S. y
P.O.
BOX 487
46573-0487
1
Section (v)
This is our 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.
1 0 go . will 11.161Q I I �
Ti compuance w11M11e4MTe-d-STaTe—s kepartment of Treasury's Listing of Certiti?7
Companies, this letter will serve to confirm that at this time the surety company
ff,hiladelphia Indemnity Insurance Company is listed widi the United States
Department of Treasury's Listing of Approved Sureties according to Department
Circular 570. 1
1:9:11
2
Jennifer L. Kaszrlia
Attorney in Fact
jw
re
9
www.Gibsoitins.com
t (800) 814-2122
1 (000) 836-2122
Mm
South Bend, IN
Plymouth, IN
Indianapolis, IN
Fort Wayne, IN
Elkhart, IN
Kalamazoo, MI
M
PHILADELPHIA INDEMNITY INSURANCE COMPANY
One Rain Plaza, Suite 100
Bala Cynwyd, PA 19004.0950
1Z2ZNa=
KNOW ALL PERSONS BY THESE PRESENTS: That PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company), a corporation organized and
existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint Ila rba j tgprk
Avocy. Inc. its true and lawful Attomey-in-fact with full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity
and writings obligatory in the nature thereof, issued in the course of its business and to bind the Company thereby, in an amount not to exceed .5 nQq L M ".0
This Power of Attorney is granted and ri signed and scaled by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of
PHILADELPHIA INDEMNITY INSURANCT COMPANY on the 10 of November. 2016.
RESOLVED- That the Board of Directors hereby authorizes the President or any Vice President of the
Company: (1) Appoint Attomey(s) in Fact and authorize the Altomey(s) in Fact to
execute on behalf of the Company bonds and undertakings, contracts or indemnity and
other writings obligatory in the nature thereof and to attach the seal of the Company
thereto; and (2) to remove, at any time, any such Attorney- in -Fact and revoke the
authority given. And, be it
FURTHER
RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to ally
such Power of Attorney or certificate relating thereto by facsimile, and any such Power of
Atlomey so executed and certified by facsimile signatures and facsimile seal shall be
valid and binding upon the Company in the future with respect to any bond or
undertaking to which it is attached.
11KCH 01 MON 0 M W.1 Of 1143HIMA gi a P;4;1 jj.rd I &V 0 0 (01 1,4 1FA M IZO] 0 2 [11111M III 6ftilililll 0TX&*1 UZ41" 1401 -1:911M.411
19217
Robert D. O'Leary Jr., President & CEO
Philadelphia Indemnity Insurance Company
On this 27' day of October, 2017, before line came the individual who executed the preceding instrument, to me personally known, and being by me duly swom said
that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY; that the seat affixed to said instrument is
the Corporate seal of said Company; that the said Corporate Seal and his signature were duly affixed.
Notary Public:
residing at:
(Notary Seal)
My commission expires:
1� NIT
R_qla QMnd_ PA
1, Edward Sayago, Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY. do hereby certify that the foregoing resolution of the Board of
Directors and the Power of Attorney issued pursuant thereto on the 27s' day of October, 2017 are live and correct and are still in full force and effect. I do further certify
that Robert D. O'Leary Jr., who executed the Power of Attorney as President, was on the date of execution of the attached Power ofAttomey the duly elected President
of PHILADELPHIA INDEMNITY INSURANCE COMPANY.
In 'fesfinlony whorer I havequbicdbod my nanicarld affixed lite facsimilt seal of cacti C."onipawly this day or, r 20
wy Edward Sayago, Corporate Secretary
PHILADELPHIA INDEMNITY INSURANCE COMPANY
1316 FOUNT -0i'y BUILDING
227 W. J EFFERSON BOULEVARD
D
SOUl'FIFd BEND. ➢NDIANA, 46601-1830
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD 1 OF PUBLIC 1'
November 16, 2018
Mr. Eric Brown
Brown & Brown General Contractors, Inc.
124 S. Elkhart St., PO Box 487
Wakarusa, IN 46573
RE: 2019 Pre -Qualification Verification
Dear Mr. Brown:
PHONE 574/235-9251
FAX 574/ 23.5-9171
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 the year 2019. 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. Martin, Clerk
GARY A, G1u.O'T DAVID P. RE➢ OS E➢ IZABETii A. MARADIK JAMEs A. M➢ilE➢..➢ ER THERESE DO A,UJ