Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Opening of Bids - Fire Station No 3 & 6 Renovations Proj No 118-047 - Gibson Lewis
CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name FIRE STATION 3 & 6 RENOVATIONS Project No. 118-047 For Bids Due Tuesday, October 81h, 2019 at 9:30am local time PART (Must be completed for all bids. Please type or print) Date: 10/8/19 Bidder (Firm): Gibson -Lewis, LLC Address: 1001 W. 1 lth Street p 574 259-8581 City/State/Zip: Mishawaka. j� 46�44 Telephone Number: Agent of Bidder (if Applicable): Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: Fire Station 3 & 6 Renovations Project #118-047 the City of South Bend, Indiana, in accordance with plans and specifications prepared by: Shive-Hattely, Inc. and dated 9/18/19 for the sum of (enter the Total Bid as shown on the Proposal) (Enter sum of Total Base Bid plus Alternates shown on Proposal) (Numerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a partite attachment. By ( nature, Robert A. Lirt enfelter, President (Printed Name of Person signing) ACCEPTANCE The above bid is accepted this day of Subject to the following conditions: BOARD OF PUBLIC WORKS Gary A. Gilot, President Elizabeth A. Maradik, Member Genevieve E. Miller, Member Therese 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 BIDIP RO POSAL CITY OF SOUTH BEND Project Name: FIRE STATION 3 & 6 RENOVATIONS Project Number: For Bids Due: Contractor Name: BASE BID 118-047 Tuesday, October 81h, 2019 at 9:30am local time Gibson -Lewis. LLC Item No. Description Quantity Unit Unit Price Total Amount BB Base Bid scope of work as shown in the drawings ands specifications. 1 LS a d •�l� BASE BID TOTAL • + pp� ALTERNATE #1 Item No. Description Quantity Unit Unit Price Total Amount Station #3: Polished hed Concrete 1 LS ALTERNATE #1 TOTAL ALTERNATE #2 Item No. iDescription Quantity Unit Unit Price Total Amount A2 Station #3: Resinous Flooring 1 LS dl Additive Alternate ALTERNATE #2 TOTAL (� ALTERNATE #3 Item Description Quantity Unit Unit Price Total Amount A3 Station #3: LED Lighting 1 LS « Additive Alternate 5� ALTERNATE #3 TOTAL _. ALTERNATE #4 Item No. Description Quantity Unit Unit Price Total Amount A4 Station #3: Parking Expansion Additive Alternate)z�, 1 LS IIyJ ALTERNATE #4 TOTAL Zy,10� Version 4/2/2019 Contractor's Bid for Public Works - 7 BIDIPROPOSAL�,,', CITY OF SOUTH BEND Project Name: FIRE STATION 3 & 6 RENOVATIONS Project Number: 118-047 ` For Bids Due: Tuesday, October 8'h, 2019 at 9:30am local time Contractor Name: Gibson -Lewis LLC ALTERNATE #5 Item Description Quantity Unit Unit Price Total Amount No. A5 Station #3: North Man Door 1 LS 1 Replacement Additive Alternate ' ALTERNATE #5 TOTAL ALTERNATE #6 Item Description No. Quantity Unit Unit Price Total Amount A6 Station #6: Exterior Exit Stairway Additive 1 LS �S Alternate ALTERNATE #6 TOTAL (oS bdta ALTERNATE #7 Item Description No. Quantity Unit Unit Price Total Amount A7 Station #6: West Exterior Window 1 LS S, Replacement Additive Alternate uou ALTERNATE #7 TOTAL S U:� -- ALTERNATE #8 Item IDescription No. Quantity Unit Unit Price Total Amount AB Station #6: LED Lighting 1 LS Additive Alternate ALTERNATE #8 TOTAL Bidder (Firm): Gibson -Lewis, LLC Address: 1001 W. 11th Street City/State/Zip; MiSlIaMM,kA, IL 4 Telephone Number; 574 259- 81 By (Signature) Robert A. Lingenfelter, President (Printed Name of Person Signing) Version 4/2/2019 Contractor's Bid for Public Works - 8 Bidder: Gibson -Lewis, LLC 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 ) ST. JOSEPH ) SS: COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor not 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, Version 4/2/2019 Contractor's Bid for Public Works - 4 Bidder: Gibson -Lewis, LLC 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. 1 understand that violations hereunder Version 4/2/2019 Contractor's Bid for Public Works - 5 may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 8th�_ day of Octobex 2019 Gibson -Lewis, LLC Contractor/Bidder (Firm) Signs re of Con ractorBidder or Its Agent Robert A. Linizenfelter, President Printed Name and Title Subscribed and sworn to before me this 8th of October , 20 19 My Commission Expires _ 08/05/2023 Notar Public Juli Hodowaniec County of Residence St, Joseph Version 4/2/2019 Contractor's Bid for Public Works - 6 Docum!ent A31 OTM — 2 Conforms with The American Institute of Architects AIA Document 310 CONTRACTOR: (Name, legal status and address) Gibson -Lewis, LLC 1001 West 11th Street Mishawaka, IN 46544 OWNER: (Name, legal status and address) City of South Bend 227 West Jefferson Blvd. South Bend, IN 46601 Bond Number: 03992-CNA-19-086 SURETY: (Name, legal status and principal place of business) The Continental Insurance Company 151 N Franklin Street Chicago, IL 60606 State of Inc: Pennsylvania BOND AMOUNT: Five Percent of Amount Bid (5%) PROJECT: (Name, location or address, and Project number, if any) Fire Stations 3 & 6 Renovations This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Si,go °d and se<c0a t' this 2nd day of October 2019 Gibson -Lewis !,LC LPrinciP) (Seal)al ( (Wilt ess) Juli Hod:o�r��nie (Title) Rober A. Lingenfelter, President d The ConUrlental Insurance Come t (.rety) (Seal) ( t a s)�., Tull Kathy. DeIG ct .. �» �� y reco„ Attorney -in -Fact POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That The Continental Insurance Company, a Pennsylvania insurance company, is a duly organized and existing insurance company having its principal office in the City of Chicago, and State of Illinois, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Kathy L. DelGreco , Individually of Southfield, Michigan , its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seat and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature — In Unlimited Amounts — Surety Bond Number: 03992-CNA-19-086 Principal: Gibson -Lewis, LLC Obligee: City of South Bend and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the insurance company and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Board of Directors of the insurance company. In Witness Whereof, The Continental Insurance Company has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 3rd day of June, 2015. " . The Continental Insurance Company ■r i W"od«�«"" Pa ° ul I .Bruflat ice "�'..._. � .. �.-..._�.� ...... _. President State of South Dakota, County of Minnehaha, ss: On this 3rd day of June, 2015, before me personally came Paul T. Bruflat to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of The Continental Insurance Company, a Pennsylvania insurance company, described in and which executed the above instrument; that he knows the seal of said insurance company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said insurance company and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance company. q••w••.•*rwr•«..w..r•aarmr•.aw•w 4 . Eli t �••r••r•••rrrrrrr•r••r•• tMtQTAIW r"U t $utn DAKOTA Ij . ..... ........... My Commission Expires February 12, 2021 S. Eich Notary Public CERTIFICATE I, D. Bult, Assistant Secretary of The Continental Insurance Company, a Pennsylvania insurance company, do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance company printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance company this 2nd day of October 2019 ANSI, ". The Continental Insurance Company NOW D. Bult Jass�sttittt =. ccrelary A°'ryirtm E'F�'.>4D...�-PQJV2 1316 COUNTY —CITY BUILDING �i,"4'M /' / (� PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD G/ +w4 FAX 574/ 235-9171 SOUTH BEND, INDIANA 46601-1830 I4tb TDD 574/ 235-5567 ^Fnirnarati :.a.:, CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS Date: October 2, 2019 To: All Plan holders From Linda M. Martin, Clerk, Board of Public Works Subject Addendum Number: 1 Project Name: Fire Stations 3 & 6 Renovations Project Number: 118-047 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 10/3/19 This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by faxing this sheet to the Board of Public Works at (574) 235-9171 within 48 hours of receipt. A copy MIST 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: Gibson -Lewis, LLC Authorized Signature: —pf\h A. Lingenfelter, President Date: 10/3/ 19 Version 4/2/2015 I� 1',;N ,. 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAX 574/ 235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS Date: October 4, 2019 To: All Plan holders From Linda M. Martin, Clerk, Board of Public Works Subject Addendum Number: 2 Project Name: Fire Stations 3 & 6 Renovations Project Number: 118-047 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by faxing this sheet to the Board of Public Works at (574) 235-9171 within 48 hours of receipt. A copy M fJST 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: Gibson -Lewis, LLC Authorized Signature: Date: 10/7/19 Version 4/2/2015 M Robert A. Lingenfelter, President Bidder: Gibson -Lewis, LLC 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. *See attached Financial Statement Version 4/2/2019 Contractor's Bid for Public Works - 3 Bidder: Gibson -Lewis, LLC 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, M Bidder (Firm) Gibson -Lewis, LLC Date (month, day, year): 10/8/19 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 Contract Amount Class of Work Date Name and Address of Owner 3,921,000.00 2018 Charles Black Center- South Bend, IN 3,366,000.00 2018 Firestation #4 - South Bend, IN 2,627,000.00 2018 ND McCourtney - Notre Dame, IN 1,229,000.00 2018 City Parking Garage - South Bend, 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 1,949,000.00 2020 Purdue Bioscience - West Lafayette, IN 3,737,000.00 2020 Lake Michigan College - St. Joseph, MI 10,281,000.00 2020 Lincoln JHS, PI mouth, IN 4,261,000.00 2020 Columbia City HS - Columbia City, IN Bidder: Gibson -Lewis, LLC 3. 4. 1. 2. Have you ever failed to complete any work awarded to you? No List references from private firms for which you have performed work. University of Notre Dame If so, where and why? - Notre Dame, Indiana Memorial Hospital of South Bend - South Bend, Indiana St. Joseph Regional Medical Center - South Bend, Indiana 1st Source Bank - South Bend, Indiana 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.) Apply adequate personnel to complete the work 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. Please see attached listing RV SUTTON, INC. 160 W RAIL ROAD UNIT 1 CHESTERTON, IN 46304 WALSH & KELLY 24358 STATE ROAD 23 SOUTH BEND, IN 46614 ZIOLKOWSKI CONSTRUCTION 1005 S LAFAYETTE STREET SOUTH BEND, IN 46601 STEVENS IRON WORKS, INC P.O. BOX 730 DEMOTTE, IN 46310 EC BABILLA 3974 HARRISON STREET GARY.IN 46409 WERNTZ SUPPLY 1002 KERR STREET SOUTH BEND, IN 46601 OVERHEAD DOOR COMPANY P.O. BOX 907 MISHAWAKA, IN 46546 MASTER TILE 1205 WEST LINCOLN HIGHWAY MERRILLVILLE, IN 46410 KROPP FIRE PROTECTION 59685 MARKET STREET SOUTH BEND, IN 46614 DA DODD, INC P.O_ BOX 430 ROLLING PRAIRIE, IN 48371 MARTELL ELECTRIC 4601 CLEVELAND ROAD SOUTH BEND, IN 46628 EXCAVATING RITSCHARD BROS., INC. 1204 W SAMPLE STREET SOUTH BEND, IN 46019 PAVING RIETH RILEY CONSTRUCTION 25200 STATE ROAD 23 SOUTH BEND, IN 46614 MASONRY MCLAUGHLIN MASONRY 56110 TIMOTHY ROAD NEW CARLISLE, IN 46552 STRUCTURAL STEEL CRANE INDUSTRIAL SERVICES 11035 ANDERSON ROAD GRANGER, IN 46530 ROOFING DUDECK ROOFING & SHEET METAL 1634 SOUTH FRANKLIN STREET SOUTH BEND, IN 46614 GLASS & GLAZING PRECISION WALL 3801 5 MAIN STREET SOUTH BEND, IN 46614 OVERHEAD DOOR INDUSTRIAL DOOR OF NORTHERN IN 3839 S. MAIN STREET SOUTH BEND, IN 46614 FLOORING INTERIOR FINISHES, INC. 1616 W THIRD STREET OSCEOLA, IN 46561 FIRE PROTECTION RYAN FIRE PROTECTION 9740 EAST 148TH STREET NOBLESVILLE, IN 46060 PLUMBING & HVAC EDWARD J WHITE 1011 S. MICHIGAN STREET SOUTH BEND. IN 46601 ELECTRIC MCMANN ELECTRIC, INC 1454 THIRD STREET OSCEOLA, IN 46561 Bidder: Gibson -Lewis, LLC 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. Unresolved 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. All necessary 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. No 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. *Please see attached Financial Statement y W W w ag w� Cw OO0 =Na O Z Z N W O m 0. 0 U2> OW G z Q O z_ O d CmE ao IZ a- m0 CL O C_ mm o tm C_ C O a:+ � O C U .0 d c 'O cr � N a� N O d � C 0.. ') v� CD C m 0 'r E 3 0 0 y 0 O U c c � H a ++ C t � m t 3� a> a W = d B O C j O r U) U! � 2 0 0W � aNi N � C G d uty N H C N E m z N 0 a N 4 Q r r ,6 rn a yj a w �a c v o 9 N a oa) 75 n� a I c 0 Lo CD o Ti rn o% U C v IL W 0o O v` Q d E m z 01 00 0 w f0 0 W CD 0 0 N c 0 E ear CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM FORM MWBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MBENVBE 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: 118-047 Date; 10/8/19 Project Name: FIRE STATION 3 & 6 RENOVATIONS Bidder: Gibson -Lewis, LLC Contact Person: Robert A. Lin enfelter President Telephone; 574-259-8581 Address: 1001 W. 11th Street City: Mishawaka State: IN zip: 46544 Email: rtit1getaf Neiµ C l.nC ttSa.COIII To determine whether a bidder has demonstrated good faith efforts to reach the MBE/WBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below": EVIDENCE OF GOOD FAITH EFFORTS MBENVBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women Owned Business as found on their website (http://www.in,gov/idoa). ACTION (ADVERTISE/CONTACT): In order for your bid to be deemed responsive, the City of South Bend requires that all perspective bidders complete no less than 2 of the following: 1. Attend all pre -bid meetings scheduled by the City to inform 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 and placement of MBE/WBE firms. "Bidder must circle or otherwise notate which of the two (2) required actions were performed. GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBE/zNBEsq including providing such MBE/WBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject MBE/WBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. SMALL CONTRACT(S): The bidder selected specific portions of the work to be performed by MBENVBEs in order to increase the likelihood of meeting the MBE/WBE goals (including breaking down contracts into smaller units to facilitate MBENUBE participation) CONTRACT RECORDS: The bidder has maintained the following records for each MBENUBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBENVBE was unqualified to perform the job. "Proper demonstration of Good Faith Effort requires your Initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 4/2/2019 Contractor's Bid for Public Works - 9 CITY OF SOUTH BEND�'`�""'� MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM 1a i FORM MWBE-2.1�"'° MBEIWBE CONTACTED,w«,„�,,'`"� This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring contacted MBEIWBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business. PAGE OF Project Number: 118-047 MBENVBE Participation Goal Project Name: FIRE STATION 3 & 6 RENOVATIONS Bidder: Gibson -Lewis,, LLC By: President 10/8/ 19 (Signature) j bbert A. Lin enf'elter (Title) (Data) MBEM/BE Firm --Dp, �oDD Owner or Contact at MBE/WBE Firm Telephone:Z9_ 11 g - y 3oZ Fax: 719 - l,()- i - 11,2y Email: CC.,6X `� d4 r1 c1 • cam TYPE OF WORK SOLICITED FOR THIS PROJECT: • RESULTS OF CONTACT WITH THE MBE/WBE FIRM: MBE/WBE Firm rn C ro V, C~ Owner or Contact at MBE/WBE Firm Tele hone y -(,� y _S7y g Fax: Sly _ G74 573) Email: 5-E1/d MC,fh1%hn� m ►hA nn p 5� 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 µyrS' ry 4 CITY OF SOUTH BEND, INDIANA f NAMN CONTRACTOR'S WORK HECKLISTFOR BIDDERS Project Name FIRE STATION 3 & 6 RENOVATIONS Project No. 118-047 For Bids Due Tuesday, October 8t", 2019 at 9:30am local time 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 X or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely X executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and X 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 X met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBEM/BE Contacted Form [MWBE-2.1 ]. X Acknowledge Receipt of 1Z_ Addendum(s) included with the bid, X All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either X printed or typed underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use In assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: Gibson -Lewis, LLC Date: 10/8/19 By Authorized Represent Signature: Print Name & Title: Robert A. Lin enfelter, President Version 4/2/2019 Contractor's Bid for Public Works - 1 General Form No. 96-a Prescribed by the State Board of Accounts of Indiana Revised 1949 STANDARD QUESTIONNAIRES AND FINANCIAL STATEMENT FOR BIDDERS Prescribed b THE STATE BOARD OF ACCOUNTS OF INDIANA For use in investigating and determining the qualifications of bidders on public Finance 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. OWNER: PROJECT: Submitted by: The City of South Bend, IN 227 West Jefferson Blvd South Bend, IN 46601 Fire Station 3 & 6 Renovations Project #118-047 South Bend, IN GIBSON-LEWIS, LLC 1001 W. 11th. Street Mishawaka, Ind. 46544 DATE: October 8, 2019 Filed: () A Corporation () A Co -partnership () An Individual (X) A Limited Liability Company • 01, Ci•• The following forms of questionnaires and financial statement are prescribed by the State Board of Accounts in conformity with the statate set out on the proceeding 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 thework 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 det=mIne the qualifications of the bidder to cant' out successfully the contract if the same is awarded to him. The bidder will find it to his advantage to answer fally all questions coaxing 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 rnanncr. Section 2 of an Act entitled "An ACT conceming the awarding 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"'. Section 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 detee which of the bidders submitting bids for the performance of any such public work is, in the judgement 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, n,, 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 the bidders as roved. 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. Submitted by Gibson -Lewis, LLC ❑ A Corporation ❑ A Co -partnership An hidivkho l Principal Office at 11t treet, Mishawaka, IN �Inlite Liability Company To City of South Bend, IN 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? 2. How many years' experience in Special _ construction work has your organization had: (a) As a general contractor Forty (40) years 3. What projects has your organization completed? (b) as a sub -contractor Fifty -One (51) years CONTRACT AMOUNT CLASS OF WORK WHEN COMPLETED NAME AND ADDRESS OF OWNER 3,921,,000 2018 Charles Black Center - South Bend, IN 3, 66,000 2018 Fire Station #4 - South Bend, IN 2,627,000 2018 ND McCoUrtnC - Notre Dame M 1,22 ,000 1 2018 Cit Patrkin r Gara e - South Bend, I . 3A What projects has your organization now in process of construction? CONTRACT1' AMOUNT CLASS OF WORK WHEN TO BE COMPLETED NAME AND ADDRESS OF OWNER 1,949,000 2020 Purdue Bioscience - West Lafayette, IN 3,737,000 2020 Lake Michigan College - St. Joseph, MI 10,281,000 2020 Lincoln JHS lei n outh 1N 4,261 000 1 2020 Columbia City HS - Colunbia City, IN 4. Have you ever failed to complete any work awarded to you? No If so, where and why? 5. Has any offer 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 therefor„ 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 therefor. -2- Gibson -Lewis, LLC 7. In what other lines of business are you financially interested? 8. For what corporation or individuals have you performed work, and to whom do you refer? Memorial Hospital of South Bend IN Lar Lies - 574-647-1474 Indiana University - South Bend Mike Prater- 574-520-4319 First Source Bank, South Bend, IN Doug Way - 574-235-2015 9. For what cities have you performed work and to whom do you refer? South Bend Indiana (County -City Building) 574-235-9554 Mishawaka, Indiana 574-258-1607 LaPorte, Indiana 219-326-6808 Elkhart, Indiana 574-535-6775 10. For what countries have you performed work and to whom do you refer? .......................... St. Joseph County 574-235-9554 Elkhart County 574-535-6775 11. For what State bureaus or departments have you performed work and to whom do you refer? Purdue University, - Indiana 765-494-7342 Indiana University - South Bend, Indiana 574-520-4319 12. Have you ever performed any work for the U.S. Government? Yes If so, when and to whom do you refer? Hammond Courthouse & Andrews Library was a federal building 13. What is the construction experience of the principal individual of your organization? YEARS OF INDIVIDUAL'S NAME PRESENT POSITION CONSTRUCTION MAGNITUDE AND IN WHAT CAPACITY OR OFFICE EXPERIENCE TYPE OF WORK Ro ert A. LingenfdlterPresident - 29 Supv. & Mgmt upery S r-n -- James Nagle Vice President 33 Supv. & Mgmt Supervision Nicholas Gurbick Vice President 6 Supv. & Mgmt Supervision Randall H. Rice Secretary 33 Su v. & M mt Su ervtlsl'on Eric Becker Superintendent 13 Supv. & Mgmt Suoervision -3- Gibson -Lewis, LLC 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. Site Visit 2. Explain your plan or layout for performing the proposed work Review shipping dates for all material suppliers and subcontractors and develop a detailed construction schedule. Provide sufficient qualified manpower to meet the schedule. 3. The work, if awarded to you, will have the personal supervision of whom? A Foreman/Superintendent will be drawn from our ool of uaied ersonnel when a start date is established * 4. Do you intend to do the hauling on the proposed work with your own forces? If so, give amount and type of equipment used Undetermined until detailed * 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. -4- Gibson -Lewis, LLC * 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 subcontract 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? If so, state amount of sub -contract, and if known, the name and address of the sub -contractor, whether subcontract is a minority and/or women's business enterprise, amount, and type of his equipment and financial responsibility, 9. From which sub -contractors or agents do you expect to require a bond? 10. What equipment do you own that is available for the proposed work? QUANTITY ITEM DESCRIPTION, SIZE CAPACITY, ETC. CONDITION YEARS OF SERVICE PRESENT LOCATION 2 2 Fork Lifts Skid Streer Shop,Type 4 Wheel Drive Good Good Various I Various Warehouse Various Jobs 1000 10 1 Scaffold Sets Trucks All Terrian Fork Lift Various Various 22' RWD Good Good Good Various Various Various Various Jobs Various Jobs Various Jobs 1 1 1 Laser Screed Reach Forklift Street Sweeper —Co —pp er h ea 44" Reach 4WD Skid Steer Attachment Good Good God Various Various Various Various Jobs Various Jobs Various Jobs -5- Gibson -Lewis, LLC 11. What equip nent do you intend to purchase for use on theSr�posed work, should the contract be awarded to oat? QtJANTrry 1'111`M DESCRIPTION, SIZE, CAPACITY, ETC. APPROXIMATt; COST 12. How and when will you pay for the equipment to be purchased? 13. Do you propose to rent any equipment for this work? if so, state type, quantity and reasons for renting. 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 15. List all permits, licenses, or registrations, which you have and are required by law to maintain in order to bid on this work. Please include the type of the permit, license, or registration; the name of the issuing entity; the number of the licenses, permit, or registration; and the expiration date„ Dated at Mishawaka IN this STATE OF INDIANA 8th day of October s 20 19 Gibson -Lewis, LLC tewl'Organization) By Robert A. Lingenfelter, President COUNTY OF ST. JOSEPH SS: (Title of Person Signing) Robert A. Lin enfelter Being duly sworn, deposes and says that he is President of the above Gibson -Lewis, LLC the above (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 swom to before me this My Commission expires 8/05/2023 Residing in St. Joseph County 8th day f Oc�t� e . ,„ 20 19 b�& _3� __1 --------------- Notary Public -6- Juli Hodowaniec CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name Fire Station 3 & 6 Renovations Project No. 118-047 For Bids Due Tuesday, October 8t^, 2019 at 9:30am Local Time Contractor Name: Gibson -Lewis, LLC 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 3181 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 Bidder: Gibson -Lewis, LLC 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 bl-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electron Ically. 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) X By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter Is attached. (ii) _ By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (b) Attachments: (i) 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 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) X 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) X 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. (ii) Gibson -Lewis, LLC will provide qualified leadership and tradesman from a pool of experienced employees to meet the requirements of the projects. Long standing relationship with various craftsman unions including carpenters, laborers, cement masons, plasterers and painters. Version 5/16/2019 General Conditions - 8 Bidder: Gibson -Lewis, LLC 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 (ix) Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. (i) _ List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. Date: 10/8/19 w Aeio S-1, (Sign Here) Robert A. Lingenfelter, President (Print Name Here) Gibson -Lewis, LLC (Name of Company) 1001 W. 1 Ith Street (Address of Company) Mishawaka (City) Indiana, 46544 (State) 574-259-8581 (Telephone Number) Version 5/16/2019 General Conditions -10 Business Name: GIBSON-LEWIS, LLC Entity Type: Domestic Limited Liability Company Creation Date: 05/24/1995 Principal Office Address: 1001 USA W. 11th, MISHAWAKA, IN, 46544, BUSINESS INFORMATION CONNIE LAWSON INDIANA SECRETARY OF STATE 07/31/2019 11:24 AM Business ID: 1995051381 Business Status: Active Inactive Date: Expiration Date: Perpetual One Towne Square, Suite 1075 Southrield, Mt 48076-3732 Subject: Gibson -Lewis, LLC To Whom It May Concern: We are providing this information at the request of our principal. We have been providing surety bonds for Gibson -Lewis, LLC and its parent company, National Construction Enterprises, Inc. since 1974. We have approved bonds for them covering jobs up to $65,000,000 and potential work programs of $250,000,000. We continue to be confident in Gibson -Lewis, LLC's ability to perform and we recommend them for your favorable consideration. This letter is not to be construed as an agreement to provide surety bonds for any particular project, but is offered as an indication of our past experience and confidence in this firm. Any specific request for bonds will be underwritten on its own merits. The Continental Insurance Company A.M. I st Rated A XV sC y L QelGreco, Attorney -in -Fact MA Document A305 .Oft 1 dractor',s Qualification Statement 1986 EDITION This form is approved and recommended by the American Institute of Architects (AIA) and The Associated General Contractors of America (AGC) for use in evaluating the qualifications of contractors. No endorsement of the submitting party or verification of the information is made by the AIA or AGC, The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading. SUBMITTED TO: City of South Bend ADDRESS: 1,316 County City Building Scatty Bend, IN 46601-1110 SUBMITTED BY: NAME: ADDRESS: PRINCIPAL OFFICE: NAME OF PROJECT: TYPE OF WORK: Gibson -Lewis, LLC 1001 W. 11th Street Mishawaka, IN 46544 X General Construction Plumbing Other (Please specify) Corporation Partnership Individual Joint Venture Other Limited Liability Company HVAC Electrical co a ri lit 1964, 196-1), 01986 tI The American Institute of Atchitetrts, 1735 New York Atomic, N.9 Woshiti �dton �D,6r cpro a uutlo0 v t he—io6writil heroin or suRlaruiul quotation of its Provisions wtt Toutwwritten ponnisxton o. the AIA violates the copyright laws of the United States and wilt ltc subject to legal prosecution, AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIA® • 01986 THE AMERICAN INSTITUTE, OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 20006 A305-1986 1 Gibson -Lewis, LLC 1. ORGANIZATION 1.1 How many years'has your organization been in business as a Contractor? 51 years 1.2 How many years has your organization been in business under its present business name? 24 years 1.2.1 Under what other former names has your organization operated? Gibson -Lewis, Inc. was incorporated into LLC in 1995 1.3 If your organization is a Corporation, answer the following: 1.3.1 Date of incorporation: 1.3.2 State of incorporation: 1.3.3 President's name: 1.3.4 Vice-president's name: 1.3.5 secretary's nar)tc: 1.3.6 Treasurer's nanic: 1.4 If your organization is a partnership, answer the following: 1.4.1 Date of organization: 1.4.2 Type of partnership: 1.4.3 Name(s) of general partner(s): 1.5 If your organization is individually owned, answer the following: 1.5.1 Date of organization: 1.5.2 Name of owner: AIADOCUMENT A106 - ONI'KAC'roar'sQuna.[I'TCAl'[(,INSaA'IaNar;tal -1986 JAIIttra -AIA* -AN9 6 A305.1986 2 THE,AMERICAN INSIATUTEOF ✓ KCJtt'N UCTSr 4 )15 NFW YORK AVENaJtr", NR W. We SiIIN"ilON. a).C.ZWO6 Gibson -Lewis, LLC 1.6 If the form of your organization is other than those listed above, desorlbe it and Name the principals: Robert A. Lingenfelter - President James E. Nagle - Vice President Randall H. Rice - Secretary 2. LICENSING 2.1 List jurisdictions and trade categories In which your organization is legally qualified to do business, and indicate registration or license numbers, if applicable: Indiana and Michigan 2.2 List jurisdictions in which your organization's partnership or trade name Is tiled. 3. EXPERIENCE 3.1 List the categories of work that your organization normally performs with its own forces. Metal Framing, Drywall, Drywall Finishing, Insulation, Plastering, Acoustical Ceilings, Firestopping, Concrete, Carpentry, Painting, and Selective Demolition 3.2 Claims and Suits. (111thc answor to any of the questions below is yes, please attach details,) 3.2.1 Has your orgunirutlou ever railed to cornpletc any work awarded to It? No 3.2.2 Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your organization or It's officers? No 3.2.3 Has your organization filed any law suits or requested arbitration with regard to 01Ns uc Iotl cote red s w1 trn IiaC 1 C ilve yoarrs Yes, Skanska - ND Morris Inn AIA DOCUMENT A800 - CONTRACTOR'S QUALIFICATION TI'A'IVMENT - 19861ID11ION • AIAV • 019a6 TIMAMERICANINS'rn'UTEOil ARCHrrGCr8,1735NLWYORKAVr.NUE,N.W.WASnINOTON,O.C.20006 A30.5.1986 3 Gibson -Lewis, LLC 3.3 Within the last five years, has any officer or principal of your organization ever been tan officer or Principal of another organization when it failed to complete a construction contract? (if the answer is yes, please attach de(alts.} No 3.4 On a separate sheet, list major construction projects your organization has in progress, giving the name of project, owner, architect, contract amount, percent complete and scheduled completion date. Please see attached 3.41 State total worth of work in progress and under contract: 3.5 On a separate sheet, list the major projects your organization has completed in the past five years, giving the name of project, owner, Architect, contract amount, date of completion and percentage of the cost of work performed with your own forces. Please see attached 3.5.1 State average annual amount of construction work performed in the past live years: 3.6 List the construction experience and present commitments of the key individuals of your naganization. Please see attached 4. REFERENCES 4.1 Trade References: Foundation Building Materials 5203 Division avenue Grand Rapids, MI 49548 Old Fort Building Supply PO Box 2586 South Bend, IN 466 Big C Lumber Company 50860 Princess Way Granger, IN 46530 4.2 Bank References: Wheaton Bank & Trust 211 South Wheaton Avenue Wheaton, IL 60187 Office: 630-456-7853 Fax: 630-690-7715 4.3 Surety: Phone: 616-534-4904 Fax: 616-724-2651 Phone: 574-289-5566 Fax: 574-289-5569 Phone: 574-277-4670 Fax: 574-271-3834 AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIAG • 01986 TFIGAMERICANINSTITUTEOFARCnITECII,1735NEW YORKAVEWF,N.W.WASWINOTON,D.C.2QO06 A305-198� 4 Gibson -Lewis, LLC 4.3.1 Name of bonding company; The Continental Insurance Company CNA Plaza - Chicago, IL 60603 4.3.2 Name and address of agent: Marsh USA, Inc. Kathy DelGreco One Towne Square, STE 1100 Southfield, MI 48076 5. FINANCING 5.1 Financial Statement. 5.1.1 Attach a financial statement, preferably audited, including your organization's latest balance sheet and income statement showing the following items: Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials, inventory and prepaid expenses); Please see attached Net Fixed Assets; Other Assets; Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, provision for income taxes, advances, accrued salaries and accrued payroll taxes); Other Liabilities (e.g., capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings). 5.1.2 Name and address of firm preparing attached financial statement, and date thereof: Crowe, Horwath, LLP - 330 E. Jefferson Blvd, South Bend, IN 46601 5.1.3 Is the attached financial statement for the identical organization named on page one? Yes 5.1.4 If not, explain the relationship and financial responsibility of the organization whose fmancial statement is provided (e.g., parent -subsidiary). 5.2 Will the organization whose financial statement is attached act as guarantor of the contract for Construction 7 yes AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIA® - 01986 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 20006 A305-1986 5 MEN" PERSONNEL # of Years Officer Title Experience Robert A. Lingenfelter President 29 Years James E. Nagle Vice President 33 Years Randall H. Rice Secretary 33 Years Six Digit Name of Private Individual or Firm, Category $ Amount Year Contact Person, Address, Phone No. Number Started/Completed Data Realty 1542.02 $606,000 Completed 2013 South Bend, Indiana Mt Carmel Missionary Baptist Church 1542.02 $190,000 Completed 2013 South Bend, Indiana Habitat for Humanity Restore 1542.02 $362,000 Completed 2013 Mishawaka, Indiana Martin's #10 1542.02 $421,000 Completed 2013 South Bend, Indiana University Center Fagade 1542.02 $419,000 Completed 2013 South Bend, Indiana Schererville Shops 1542.02 $1,255,000 Completed 2014 Schererville, Indiana University Park Mall Renovations 1542.04 $719,000 Completed 2014 Mishawaka, Indiana Meijer Store 1542.02 $261,000 Completed 2014 Middlebury, Indiana Press Ganey Renovation 1542.04 $1,832,000 Completed 2015 South Bend, Indiana St Vincent De Paul Store 1542.02 $166,000 Completed 2015 South Bend, Indiana Martin's Store #27 1542.04 $275,000 Completed 2015 Goshen, Indiana Honeywell Remodel 1542.04 $166,000 Completed 2015 South Bend, Indiana Martin's #16 1542.02 $152,000 Completed 2016 Granger, Indiana MORIRYDE Office 1542.02 $221,000 Completed 2016 South Bend, Indiana Six Digit Name of Private Individual or Firm, Category $ Amount Year Contact Person, Address, Phone No. Number Started/Completed Martin's Store #6 1542.02 $764,000 Completed 2016 Concord, Indiana Schererville Shops Ph2 1642.02 $299,000 Completed 2016 Schererville, Indiana Martin's Store Mayflower 1542.02 $686,000 Completed 2017 South Bend, Indiana Interior Finishes Office 1542.02 $208,000 Completed 2017 South Bend, Indiana Crossroads Church 1542.02 $176,000 Completed 2017 Plymouth, Indiana Four Winds Casino 1542.02 $1,504,000 Completed 2018 South Bend, Indiana Honeywell Plant #12 1542.02 $199,000 Completed 2018 South Bend, Indiana Fresenius Vascular 1542.02 $2,535,000 Completed 2018 Mishawaka, Indiana United Fereral Credit Union 1542.02 $555,000 Completed 2018 Stevensville, Michigan United Fereral Credit Union 1542.02 $575,000 Completed 2018 Berrien Springs, Michigan United Fereral Credit Union 1542.02 $207,000 Completed 2018 South Bend, Indiana United Fereral Credit Union 1542.02 $199,000 Completed 2018 Mishawaka, Indiana Embassy Suites 1542.02 $1,100,000 Completed 2018 South Bend, Indiana First Source Bankmart 1542.02 $358,000 Completed 2018 South Bend, Indiana Six Digit Name of Private Individual or Firm, Category $ Amount Year Contact Person, Address, Phone No. Number Started/Completed Wellpet Roof Repair 1542.02 $468,000 Completed 2018 Mishawaka, Indiana Old National Bank 1542.02 $206,000 In Progress Grand Rapids, Michigan Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number Started/Completed Hansel Center Gen Trades 1542.01 $1,581,000 Completed 2013 South Bend, Indiana Hansel Center Interiors 1542.01 $261,000 Completed 2013 South Bend, Indiana Memorial Hospital Flooring Projects 1542.01 $298,000 Completed 2013 South Bend, Indiana Notre Dame Sculpture Park 1542.01 $510,000 Completed 2013 Notre Dame, Indiana Notre Dame Cushing/Fitzpatrick Halls 1542.01 $1,166,000 Completed 2013 Notre Dame, Indiana Ivy Tech college 1542.01 $3,737,000 Completed 2013 South Bend, Indiana Notre Dame Morris Inn 1542.01 $5,313,000 Completed 2013 Notre Dame, Indiana Grissom AFB Hanger 200 1542.01 $184,000 Completed 2013 Peru, Indiana Elkhart General Hosp-Outpatient 1542.01 $168,000 Completed 2013 Elkhart, Indiana Hammond Career Ctr-Welding Shop 1542.01 $446,000 Completed 2013 Hammond, Indiana Ivy TechCollege Renovation 1542.01 $676,000 Completed 2013 Michigan City, Indiana St Joseph Medical Center Coffee Bar 1542.01 $312,000 Completed 2013 Mishawaka, Indiana Plymouth HS/Lincoln JHS-Renov 1542.01 $735,000 Completed 2014 Plymouth, Indiana IUSB Northside Hall 1542.01 $1,359,000 Completed 2014 South Bend, Indiana Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number Started/Completed Memorial Hospital Skyway 1542.01 $787,000 Completed 2013 South Bend, Indiana St Joseph Reg Med Ctr-Cardiology 1542.01 $129,000 Completed 2013 Plymouth, Indiana St Joseph Reg Med Ctr-HIE 1542.01 $140,000 Completed 2013 Plymouth, Indiana Andrews Public Library 1542.01 $454,000 Completed 2014 Andrews, Indiana Elkhart Schools Commissary 1542.01 $841,000 Completed 2014 Elkhart, Indiana St Joseph Reg Med Ctr-MOB 1542.01 $344,000 Completed 2014 Plymouth, Indiana Memorial Hospital Nuclear Medicine 1542.01 $206,000 Completed 2014 South Bend, Indiana Peru JHS Locker Rooms 1542.01 $535,000 Completed 2014 Peru, Indiana Notre Dame Lyons Hall Chapel 1542.01 $142,000 Completed 2014 Notre Dame, Indiana Memorial Hospital Interventional 1542.01 $275,000 Completed 2014 South Bend, Indiana IUSB Northside Hall Restrooms 1542.01 $246,000 Completed 2014 South Bend, Indiana Memorial Hospital Summit Center 1542.01 $410,000 Completed 2014 South Bend, Indiana Notre Dame Jordan Auditorium 1542.01 $265,000 Completed 2014 Notre Dame, Indiana Elkhart Memorial HS Cafeteria 1542.01 $274,000 Completed 2014 Elkhart, Indiana Century Center Elevator 1542.01 $158,000 Completed 2015 South Bend, Indiana Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number Started/Completed Whiting Community Center 1542.01 $1,401,000 Completed 2015 Whiting, Indiana Demotte Elementary School 1542.01 $350,000 Completed 2015 Demotte, Indiana St Joseph Reg Med Ctr-Chapin Clinic 1542.01 $962,000 Completed 2015 South Bend, Indiana St Joseph County Courts 1542.01 $2,298,000 Completed 2016 South Bend, Indiana Andrews -Dallas Township Public Library 1542.01 $454,000 Completed 2014 Andrews, Indiana Memorial Hospital Cancer Care 1542.01 $162,000 Completed 2015 South Bend, Indiana Memorial Hospital Hospitalists 1542.01 $347,000 Completed 2015 South Bend, Indiana PSAP-911 Call Center 1542.01 $3,826,000 Completed 2015 Mishawaka, Indiana Elkhart Schools Security Upgrade 1542.01 $6,314,000 Completed 2015 Elkhart, Indiana Starke County Courthouse 1542.01 $197,000 Completed 2015 Knox„ Indiana Memorial Hospital ER Triage 1542.01 $412,000 Completed 2015 South Bend, Indiana Memorial Hospital 8E/8S Remodel 1542.01 $284,000 Completed 2015 South Bend, Indiana LaPorte Courthouse 2nd Floor Remodel 1542.01 $169,000 Completed 2015 LaPorte, Indiana Notre Dame Morris Inn Kitchen 1542.01 $330,000 Completed 2015 Notre Dame, Indiana St Joseph Reg Med Ctr-Pediatrics 1542.01 $332,000 Completed 2015 Mishawaka, Indiana New Prairie HS Restrooms 1542.01 $276,000 Completed 2015 New Carlisle, Indiana Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number Started/Completed IUSB University Center Restrroms 1542.01 $177,000 Completed 2015 South Bend, Indiana South Bend Regional Airport -Anti Pass 1542.01 $266,000 Completed 2016 South Bend, Indiana Notre Dame McCourtney Hall 1542.01 $3,740,000 Completed 2016 Notre Dame, Indiana St Joseph Reg Med Ctr-Fetal Med 1542.01 $221,000 Completed 2016 Mishawaka, Indiana Memorial Hospital Cafeteria Renov 1542.01 $533,000 Completed 2016 South Bend, Indiana New Prairie HS Restrooms 1542.01 $251,000 Completed 2015 New Carlisle, Indiana Memorial Hospital 8e/8s Remodel 1542.01 $311,000 Completed 2016 South Bend, Indiana LaPorte Courthouse 2nd Floor 1542.01 $174,000 Completed 2016 LaPorte, Indiana Three Creeks Elementary 1542.01 $511,000 Completed 2016 Lowell, Indiana Penn HS Softball Fields 1542.01 $190,000 Completed 2016 Mishawaka, Indiana Beacon Health Admin Office 1542.01 $827,000 Completed 2016 South Bend, Indiana Notre Dame McKenna Restrooms 1542.01 $645,000 Completed 2016 Notre Dame, Indiana Portage Police Station Renovation 1542.01 $2,566,000 Completed 2016 Portage, Indiana Elkhart General Hosp-CMS 1542.01 $265,000 Completed 2016 Elkhart, Indiana St Joseph Reg Med Ctr-Cardiac 1542.01 $408,000 Completed 2016 Mishawaka, Indiana St Joseph Reg Med Ctr-Kelly Ctr 1542.01 $1,739,000 Completed 2016 Mishawaka, Indiana Six Digit Name of Government Entity Category (Contact Person, Address, Phone No.) Number Elkhart General Hosp-Gift Shop 1542.01 Elkhart, Indiana South Bend Police Substation 1542.01 South Bend, Indiana South Bend Parking Garage 1542.01 South Bend, Indiana Memorial Hospital CVIICU Remodel 1542.01 South Bend, Indiana Notre Dame North Dining Hall 1542.01 Notre Dame, Indiana South Bend Firestation #4 1542.01 South Bend, Indiana Caston Education Center Kitchen 1542.01 Fulton, Indiana Maconaquah Middle School 1542.01 Bunker Hill, Indiana Elsie Rogers School Improvements 1542.01 Mishawaka, Indiana Memorial Hospital Main Lobby 1542.01 South Bend, Indiana Mishawaka Schools Vestibules 1542.01 Mishawaka, Indiana Northwood HS Auditorium 1542.01 Nappanee, Indiana Notre Dame Hesburgh Library Ph 4 1542.01 Notre Dame, Indiana Mishawaka Schools Vestibule Alarms 1542.01 Mishawaka, Indiana Columbia City High School 1542.01 Columbia City, Indiana $ Amount Year Started/Completed $222,000 Completed 2017 $1,584,000 Completed 2017 $1,229,000 Completed 2018 $189,000 Completed 2017 $226,000 Completed 2017 $3,366,000 Completed 2018 $1,737,000 Completed 2017 $1,351,000 Completed 2017 $268,000 Completed 2017 $366,000 Completed 2017 $1,392,000 Completed 2017 $748,000 Completed 2017 $1,393,000 In Progress $265,000 Completed 2017 $8,660,000 In Progress Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number Started/Completed Memorial Hospital Cancer Pharmacy 1542.01 $287,000 Completed 2016 South Bend, Indiana Beacon Health & Fitness 1542.01 $1,055,000 Completed 2016 South Bend, Indiana Memorial Hospital ER Flooring 1542.01 $242,000 Completed 2017 South Bend, Indiana Notre Dame McCourtney Labs 1642.01 $175,000 Completed 2017 Notre Dame, Indiana Beacon Health Systems Energy 1542.01 $369,000 Completed 2017 South Bend, Indiana Mi City Prison Support Services 1542.01 $3,186,000 Completed 2017 Michigan City, Indiana Notre Dame Campus Crossroads 1542.01 $818,000 Completed 2017 Notre Dame, Indiana Notre Dame Hesburgh Concourse 1542.01 $796,000 Completed 2017 Notre Dame, Indiana Elkhart General Hosp-CMS 4th FI 1542.01 $319,000 Completed 2017 Elkhart, Indiana LaPorte Library -Main Branch 1542.01 $1,734,000 Completed 2017 LaPorte, Indiana VA Outpatient Clinic 1542.01 $4,815,000 Completed 2017 Mishawaka, Indiana Memorial Hosp Ronald McDonald 1542.01 $2,061,000 Completed 2017 South Bend, Indiana Rolling Prairie Public Library 1542.01 $1,813,000 Completed 2017 Rolling Prairie, Indiana Coolspring Public Library 1542.01 $1,371,000 Completed 2017 Michigan City, Indiana Memorial Hospital Cath Lab 3 1542.01 $323,000 Completed 2017 South Bend, Indiana IUSB Northside Hall Remodel 1542.01 $362,000 Completed 2017 South Bend, Indiana Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number Started/Completed Mishawka Schools Vesibule Alarms 1542.01 $255,000 Completed 2018 Mishawaka, Indiana Notre Dame Badin Hall 1542.01 $902,000 Completed 2018 Notre Dame, Indiana Elkhart General Hosp-3NE 1542.01 $344,000 Completed 2018 Elkhart, Indiana Notre Dame Blagg/O'Brien Labs 1542.01 $2,627,000 Completed 2018 Notre Dame, Indiana Notre Dame Hesburgh Library 1642.01 $356,000 Completed 2018 Notre Dame, Indiana Charles Black Center 1542.01 $3,922,000 Completed 2018 South Bend, Indiana Mishawka Schools Elevator Upgrades 1542.01 $294,000 Completed 2018 Mishawaka, Indiana Notre Dame Basilica 1542.01 $376,000 Completed 2018 Notre Dame, Indiana LaPorte County Probation Office 1542.01 $194,000 Completed 2018 LaPorte, Indiana Memorial Hosp LIN ACC 1542.01 $482,000 Completed 2018 South Bend, Indiana Memorial Hosp PET CT 1542.01 $506,000 Completed 2018 South Bend, Indiana Memorial Hosp CT SIM 1542.01 $343,000 Completed 2018 South Bend, Indiana Notre Dame Charron Commons 1542.01 $293,000 Completed 2018 Notre Dame, Indiana Beacon Health Systems 1542.01 $446,000 In Progress South Bend, Indiana Notre Dame Rolf Practice Facility 1542.01 $685,000 In Progress Notre Dame, Indiana Elkhart Aquatics 1542.01 $2,168,000 In Progress Elkhart, Indiana Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number Started/Completed Dowagiac Union Schools 1542.01 $1,840,000 In Progress Dowagiac, Michigan Lincoln JHS 1542.01 $10,319,000 In Progress Plymouth Indiana Valparaiso HS Natatorium 1542.01 $549,000 In Progress Valparaiso, Indiana Brandywine HS Gymasium 1542.01 $1,806,000 In Progress Niles, Michigan Notre Dame Utilities DOC 1542.01 $675,000 In Progress Notre Dame, Indiana Lake Michigan College 1542.01 $3,755,000 In Progress St Joseph, Michigan Starke County Courthouse Elevator 1542.01 $289,000 In Progress Knox, Indiana Concord Schools Health & Fitness 1542.01 $3,906,000 In Progress Dunlap, Indiana Notre Dame Decio 1542.01 $685,000 In Progress Notre Dame, Indiana Purdue Bioscience Building 1542.01 $1,949,000 In Progress West LaFayette, Indiana Notre Dame Quarknet Relocation 1542.01 $568,000 In Progress Notre Dame, Indiana Notre Dame Maintenance Center 1542.01 $185,000 In Progress Notre Dame, Indiana Eddy St Parking Garage 1542.01 $358,000 In Progress South Bend, Indiana Notre Dame Corby Hall 1542.01 $2,869,000 In Progress Notre Dame, Indiana Memorial Hospital Casework 1542.01 $231,000 In Progress South Bend, Indiana Gibson -Lewis, LLC 6. SIGNATURE 6,1 Dated at Mishawaka, IN this Name of Organization: Gibson -Lewis, LLC BY: Title: Ro e�AUngenfelter, President 6.2 8th day of October, 2019 Robert A. Lingenfelter being duly sworn deposes and says that the infonnation provided herein is true and sufficiently complete as itot to be misleading. Subscribed and swo- ere me this 8th Notary Pub �. Juli Hodowaniec My Commission 1?sl free. 8/05/2023 AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIAe • 01986 THE AMERWAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 2OW day of October, 2019 MIN, JUII ilODIIANIE Notary ►utmc. state o+ WWAOM Couniv y Pr" Jtet« w ft Joseph Cammluloc a eJlSltft commllxloro Il�r ae My Au USt it . A305-1986 6 INDIANA/KENTUCKY/OHIO REGIONAL COUNCIL OF CARPENTERS JOINT APPRENTICESHIP AND TRAINING FUND 1565 EAST 70TH COURT MERRILLVILLE, IN 46410 ADMINISTRATION OFFICE 711 Greenwood Springs Drive Greenwood, IN 46143 Phone:317-907-1112 Fax: 317-807-11 l5 Ashland Campus 574 Carpenters Way Grayson, KY 41143 Phone: 606-929-1378 Fax:502-996-8108 Merrillville Campus 1565 East 70th Court Merrillville, IN 46410 Phone: 219-947-3348 Fax:219-947-1889 Indianapolis Campus 711 Greenwood Springs Drive Greenwood, IN 46143 Phone:317-807-1116 Fax:317-807-1131 Lafayette Campus 2953 South Creasy Lane Lafayette, IN 47905 Phone:765-447-5959 Fax:765-447-7676 Louisville Campus 1245 Durrett Lane Louisville, KY 40213 Phone: 502-366-8668 Fax:502-366-8678 Muncie Campus 4121 East Centennial Avenue Muncie, IN 47303 Phone: 765-288-9015 Fax:765-288-9298 Newburgh Campus 5400 Covert Court Newburgh, IN 47630 Phone:812-853-9312 Fax: 812-853-9316 Terre Haute Campus 3099 South 6th Street Terre Haute, IN 47802 Phone:812-466-7899 Fax: 812-466-9840 Warsaw Campus 1095 Mariners Drive Warsaw, IN 46582 Phone: 574-267-5264 Fax:574-269-1464 October 3, 2019 Gibson Lewis, LLC 1001 W. 11' Street Mishawaka, IN 46544 To Whom It May Concern: This letter is in response to verification needed by Gibson Lewis, LLC for work to be performed on the Fire Station 3 & 6 Renovations in South Bend Indiana. Gibson Lewis, LLC regularly employs a number of apprentices affiliated with our apprenticeship program and has done so for more than four years. We are registered with the United States Department of Labor, Bureau of Apprenticeship and Training and our registration number is 1205-0223. Our program participates in the Building Trades Associate Degree Program with Ivy Tech Community College and has done so since 1996. Gibson Lewis, LLC is a bona fide contractor in good standing with the Indiana/Kentucky/Ohio Regional Council of Carpenters Joint Apprenticeship and Training fund and is eligible to employ apprentice carpenters in the future. I have enclosed a copy of our certificate from the United States Department of Labor. If I can be of further assistance, please do not hesitate to give me a call. Sincerely, Dale Newlin Area Training Coordinator IKORCCJATF — Merrillville, Lafayette & Warsaw Campuses DN/rlb I m rn D N N O —31 OD m K 0o X N co U1 N Z Ztoo# ° f�Tl o ti = z --i C rzl A v O �rn m z Dip c� A Z F D �m Mel mn �. Z OC A Z mtz QL z F mDp A n» ti m z mm X c � D INDIANA LABORERS' TRAINING TR UST FUND David A. Fow Secretary -Treasurer Jerry J: Bolk Chris L. Guerrero Ricky Henson, Jr. Ramon Mendoza, Jr. Robert S. Wright P.O. Box 758 - Bedford, Indiana 47421 (812)279-9751 August 1, 2019 To Whom It May Concern: Sean Coakley, Director John P. Brown Chairman Kelly Abel Brad Dreibelbis Michael Ferrara Stan Meyer Jim Wiseman FAX: (812) 279-5545 This letter is to confirm that "Gibson -Lewis, LLC is a signatory contractor in good standing with the Indiana Laborers' Training Trust Fund. The above mentioned company is a participant in the Joint Apprenticeship and Training Committee through this Union and has been an active participant in good standing for each of the past five plus consecutive years, and is currently eligible to use our apprentices on a project. Further, our organization's program is approved by the U.S. Veterans Administration to participate in the GI educational benefits program. A copy of our approval letters are attached along with the collective bargaining agreement stating the ratios of Journey workers to Apprentices; which is one (1) Apprentice for every five (5) Journey workers and thereafter may not employ more that (1) Apprentice for every (3) Journey workers. Sincerely, Scan Coakley, Director SC:dc www. indianalaborerstraining. org M MANNA N, =0 21 DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W469 INDIANAPOLIS, INDIANA 46204-2738 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton Hill Rd. Bedford, IN 47421 Dear Jeremy Brewer, Eric Holcomb, Governor James M. Brown, Director January 9, 2019 This will acknowledge receipt of your updated Wage -Scale for the Construction Craft Laborer program offered by Indiana Laborers Training Trust Fund -Apprenticeship. The State Approving Agency has reviewed the document as listed below: Wage Scale: Construction Craft Laborer FACILITY CODE: 30004114 To the best of my knowledge Indiana Laborers Training Trust Fund -Apprenticeship noes not utilize erroneous or misleading advertisement,, either by actual statement, omission, or intimation. It is understood by Indiana Laborers Training Trust Fund -Apprenticeship that they will maintain a complete record of all advertising utilized by or on behalf of the, Indiana Laborers Training Trust Fund -Apprenticeship in regards to their training programs during the preceding 12 months. Indiana Laborers Training Trust Fund -Apprenticeship's advertising will be available for review by any and all future supervisory visits by the SAA, or the U.S. Department of Veteran Affairs. Please Review the entire packet for content and accuracy. Approval is granted pursuant to the provisions of Title 38, U.S. Code 3687, with an effective date of April 1, 2018. If you have any questions, please feel free to give me a call at 317-232-3916 or email me at tgriffin@dva.in, gov. Thank you for what you do for our Veterans, and have a great day! Sincerely, Taniqua Griffin Program Director State Approving Agency Cc: VARO/ELR tNar�N 2�IJ,g �Ncq STATE OF IN IANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W-469 INDIANAPOLIS, INDIANA 46204-2738 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton Hill Rd. Bedford, IN 47421 Dear Jeremy Brewer, Eric Holcomb, Governor James M. Brown, birector January 9, 2019 The Indiana State Approving Agency conducted a supervisory visit on 01/8/2019 at Indiana Laborers Training Trust Fund -Apprenticeship. The purpose of the visit was to provide training to the Certifying Officials and review enrollment certifications, record retention and reporting procedures. The organization demonstrated proper record maintenance and record maintenance and reporting procedures. During the visit, we discussed the importance of reporting hours on a monthly basis, good record keeping techniques, and how to report a leave of absence or completion via VA Form 22-1999b. We also updated the Certifying Officials via VA Form 22-8794, work processes, and wage scale. If you need any assistance or have any questions regarding this technical visit please contact me directly at tgriffm@dva.in.gov or (317) 232-3916. Thank you for the courtesy extended during my visit. The education and training opportunities that your organization continues to provide veterans and their dependents are appreciated. Sincerely, Taniqua 'Griffin Program Director Phone (317)-234-6062 Toll Free (800)-400-4520 Fax (317)-234-8744 " OF INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W-469 INDIANAPOLIS, INDIANA 46204-2738 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton Hill Rd. Bedford, IN 47421 Dear Jeremy Brewer, Eric Holcomb, Governor James M. Brown, Director January 9, 2019 This will acknowledge receipt of your revised Work Processes for the Construction Craft Laborer program offered at Hoosier Energy, located in Bedford, Indiana. The State Approving Agency has reviewed the document as listed below: TRAINMGPROGRAM LENGTH DOT CODE Construction Craft Laborer FACILITY CODE: 30004114 4,000-7800 hours 47-2061.00 To the best of my knowledge Indiana Laborers Training Trust Fund -Apprenticeship does not utilize erroneous or misleading advertisement, either by actual statement, omission, or intimation. It is understood by Indiana Laborers Training Trust Fund -Apprenticeship that they will maintain a complete record of all advertising utilized by or on behalf of the company in regards to their training programs during the preceding 12 months. The company's advertising will be available for review by any and all future supervisory visits by the SAA, or the U.S. Department of Veteran Affairs. This approval is made pursuant to and under the provisions of Title 38, U. S. Code 3687, with an effective date of January 8, 2019. If you have any questions, please contact me at 317-232-3916. Sincerely, Taniqua Griffin Program Director State Approving Agency CC:VARO/ELR Phone (317)-234-6062 Toll Free (800)-400-4520 Fax (317)-234-8744 L A 01 N Cn -i N A W A O wt� .,.at',rrc�.�r x�a res,..rm '^��.umw •mzrr�sa��amtau � m N N Q co N W O CDW m W A N a o K rl ear.. a.� •^,5rs a,'eurt. �,....w, r�,�uxxM •.A :�Ile, 11';. z N O O O O O O O p N O O y 00 co ]� 6 a W O .A O N: m . m,'=. "a"mummuzz In y �+ O 0) O N W —i C31 Ch 0 a �=4 rIWA . zm=Av 7=wmz•...—,om arc ,m, w W��� avarxnt> vww 00 N O O O O O W 'U CL 00 O N O O O p N s c� , t' ol � Iv O CO � N V N V W V N e C031 W W O 00 O V W ---* O \ n, n N CJl W A c0 V V p V c Q "o a a � s -A O N m W M A �W N O e a e r+ p O O O O O O O O O O O c A e Q '. ::mu,<ve a w.,uxream n au i nwom 'pmwvi r 0 N s cp N rn s (D W s � y P. (no) On y CNO A D m m Z C) N '�7 O � V �jyTryj DN cn C . �� .. .�,� . ., 0. c � C: � Q) N m W '� G 00 CY) i W pry1 ,p b W N N -4 N uY 9 -, N y O co (D �D (D W m W a 0 1 0 0 N Cl 0 0 Ca 0 '... 'A (DD 0 s G) W Co W N to CI co H m o i� •_ VI..�,, 0�--ti Fu „. `' Iv 0 0 a o s W N 0 p m Oo s O N C, O O C] NCD "✓,am_..., mmw,- . n. F.- ! T-.FI rb vmM'm. I'�x, a«.,h .e. kR nC,h.Y1,v�. �¢d.,. ,�.m, 'V CJI Cb pp n � N j Ch W U1 lO C±t 0 0 U1 tl0 b W p 00 *r o. fii co O A A m CD 0) Ut -4 y p 1 ,p aY ' O C7 O O Q O C} O O O a 10 Q ,p 9 1 � c Id. ti W N t3y N W O 00 {� V N P O .. (O O Oi C5 �., W ,y (D r„�-;m�sr� � ..._. r.. ,m��a; ., ,�_... � ., ... .a..-er ,.� av .arw ,r„ ,, ,�, ,.'�.. :., „r,„*•r :.., m.ryr na�'.arrxn.�,ro,� .rr '. r 19 O 0 m 07 CD W N O cin ,y iP' , Vrn• 7,70 '211r"ZT ""�"u 6 �.,,� 9�°"' . i'.� .. IT ..l ✓.N!' e4^" N-jr,IM'�78k NIT, ✓ 1 ��.na J'Yw^,..:; ....,�J ['r`7 Oc C C C C C C C C C n � 1 0 Cl1 3 • A W �? i uurzMVro l PI&MM MOM - . - � mFIP=A m"OOMM 4 C �'d 0 CA p W w Ky p �Afl P 6NJ O (Oi1 toN � � N n M � L4 W N cn i CD Ln N o� --AZ W N O C M 7y `� Ul O O O 1 O O O O O O n Q t�arvrr:".°'. n . max n�...,mam,�.�� �'�' �✓r��:;.,. ��w•av ,: i ��,r�m amw:.�� .araw°^-.,m --- .. �. _, ��sisw_ r 1U W co co OD O co co H M A a ro W 0 � C.p _y 0) 0 v, co mmomm m9mm, W-m :ate. Cl m • r, 1 �c O N W i co O i w Fn �, _ wm :. Q Q Q b (d 0 o c .w ., 2?0,WW Vr r ... N w W i f C) N 01 W N CA i a Cn 0) W W Oo W Oo y 00 o G rb n N co N j cTi p cn 4hA -th. a �o w a 'd b � n � Cn w N N i on N co co 0 1•+ MO' N O O O i O O O O O oo F+ 0 i ^Yp„. ;'MfL .. �ma,�m�:_� �� � man. �: ., - .. .. ' � .." ,.. II, b C O N CO W O i 00 N co y W O s N o i i ,:�, a: wu^ ,...: •,.x� ,mt. .,. t. ,:rzrs a�rcTA M, Vmw A L P � .a � O Q m W N J OD i i .► ra i p. N W i O N ad a a, cl N a W A O m in 0<0 # C <p �p pD a W Acn a � p N O N N N � ut 0 w q C7 d a V �.. Io Ia IN 10 10 to I- IQ IN I© 4— N O 0 m m 3 O w O CL-4 C G C C C C C 4 V w N K)) -+ � A N No sVI N "i,� c*.. V O w f0 O O W ' y 0) V O Ncn 00 N N O O -' P V w CO 00 (A O O O N O O O O m O ? t* � tz,4l I' N al V ONO Ul w N O O z m GO O N O CDO N -` O w w � C O h z J �►Cy O W (m0) rJ 00 � W W 11 [�7 awe u Rftwg4k ll,mua W w O P W cn MCI Ln w OD 0 d i� 00 b a o w N w 0 C w cD O C5i a) W ' Ul N N fV N) �$ w 00 W CD N CO e .d p. co --► O W v 0) P Ul W W 01'` v w�y C7 C O N V j Ul Ul W s -A O $ O b O d d 1W 4h. O W W 0) -1 Ul W cn O N a O w 00 O O O O s O O -a O ,P O N 0) IO 1O �N IO 1Q lO I— MO �'IN 1O lO10<1 ps C SHAWN SOLNER Suslness Manager SecretaryMeasurer INDIANA PLU #47— Indianapolis PLU p60 — Lafayette PLU #15e — Evansville PLU #197—Terre Haute PLU 0460 —NW Indiana PLU #469 — Fort Wayne PLU #669 —Chesterfield PLU k1116 — South Band KENTUCKY PLU fr116 — Loulsvllle PLU #800— Paducah TENNESSEE PGLU #456— Clarksville INDIANA, ILLINOIS KENTUCKY GLU#1165 Evansville Fort Wayne Gary Indianapolis South Bend Vincennes 750 Gibson -Lewis, LLC 1001 W. 10, Street Mishawaka, IN 46544 To Whom It May Concern: Gibson -Lewis, LLL. is a local signatory contractor with the International Union of Painters and Allied Trades, District Council 91, Local 111 B, anti is in good standing. through the date of this letter. Shawn Solver Business Manager/Secretary Treasurer IUPAT DC 91 dtP E� � � w 0 0 b c floes v,Wo� dj 4 F�1 1yN w � 0 v Plasterers' & Cement Masons' Apprenticeship Coordinator Local Union #692 To Whom it May Concern: Phone: (219) 707.7767 Email: bkristoffCpicmlocal692.org August 1, 2019 Gibson & Lewis, LLC. is a signatory contractor with Local 692 and participates in the Plasterers & Cement Masons Apprenticeship Training Program. I may be reached at (219) 707-7767 if additional information is needed. Thank you, Brian Kristoff Apprentice Coordinator Plasterers & Cement Masons 9200 Louisiana Street- Merrillville, Indiana 46410 WWW.PLCML0CAL692.ORG 1- GIBSON-LEWIS, LLC CONTRACTORS 'i m West i l th Street Mishawaka, IN 46544 P.0 . Box 488 Mishawaka, IN 46546 �v(574) 259-8581 (574) 258-0932 FAX www.gibson-lewis.c om Drug Alcohol Free Workplace. The Company is committed to the establishment and maintenance of a safe and efficient work environment for all employees free from the effects of alcohol, illegal drugs, and other controlled substances and prohibited items. Section 1. Policy The Company is committed to providing its employees with a workplace that is safe, productive and free of substance abuse. The company will take reasonable measures to insure that employee alcohol or drug use does not jeopardize the safety of other employees, does not impair their ability to operate efficiently and insures compliance with drug testing programs mandated by state or federal agencies. Section . Prolijbitiye Conduct Drugs The use, manufacture, distribution, dispensation, sale or possession of illegal drugs at any time or place, whether on or off duty is strictly prohibited. Legal Drugs — The use of legal. drugs (over the counter or prescription medication) in accordance with doctor's orders or manufacturer's recommendations, is not prohibited as long as your Supervisor is notified. Excessive use beyond that prescribed or recommended or abuse of such drugs, however, shall be considered use of illegal drugs under this policy. Section-, , Prohibitive, Conduct .Alcohol The unauthorized use or possession of alcoholic beverages while at the workplace or performing company business, is prohibited. The term "work place" as used in this policy includes company premises, jobsites, worksites, parking areas and company vehicles. The use of alcohol off premises in any manner which results in intoxication or impairment on the job or which adversely affects attendance or job performance, is prohibited. Appearing for work or performing any job duties or company business while intoxicated or impaired by alcohol is strictly prohibited. This may be an abbreviated version of the company's drug and alcohol free work place policy. Check with your supervisor or person providing the new hire orientation for further details. A NATIONAL CONSTRUCTION ENTERPRISES COMPANY CIBSO N - LEWIS, LLC CONTRACTORS 1001 West lOhStreet Mishawaka, IN 46544 P.O. Box 488 Mishawaka, IN 46546 To all 1UPAT[Members Gibson -Lewis Employees, In order to meet the expectations of the General Contractors, Construction Managers, and Building Owners, we at Gibson -Lewis, LLC effective immediately, are implementing that we will be following the BCRC (Building and Construction Resource Centers) guidelines for drug testing. BCRC is an Alliance between the labor and the managernent representatives for Local union # 460, and now 4 1118. Their goal is to assist employers with establishing and maintaining workplaces that are free from destructive effects caused when employees use drugs and/or abuse alcohol. What does this can as a Gibson -Lewis Employee? Each and every employee with in the union should have received a letter in January from the BCRC (Building and Construction Resource Centers) along with a card and an LD number, This is your ID card for identifying yourself as the person who received it from the BCRC_ I will be attachinn, with this letter a copy of the letter sent to you back in 0 January, along with the phone number of how to contact the BCRC, All Gibson -Lewis, LLC employees must have this drug testing procedure finalized by No Later then, April 17th, 2009. If not completed by this time, employees will be unable to come into work until the test has been completed. Where can I take this drug test? Any Med-Point clinic offers this drug test for the BCRC requirements. Check with nearest Med-point clinic to sot -up an appointment. We at Gibson -Lewis, LLC want all of our employees to be safe everyday and be able to work in a safe enviroment. Each day, our employees, along with you make a difference to setting standards of being a safe company. By implementing this program, we are not only taking this next step to being an elite company, we are taking a step towards an injury free workplace. Please contact me with any questions, @ 317-696-7112. Respectfully, 0af'el'y Dlrc'c�"'r INDEX PACE Introduction 2 The Policy 3 Drug Testing 5 Drug Group 6 Definitions B Initial Testing 11 Random Testing 12 Probable Cause 12 Disputed Positive Results 14 Craft Personnel Work Assignment 15 Status Confirmation 16 Card Manager 17 BCRC Guidelines for obtaining a Urine Specimen for an is Applicant or Current BCRC Cardholder at Collection Site Protocol for a Positive Test 19 U.S. Department of Transportation Rules and Regulations 21 regarding the Misuse of Alcohol and Use of Controlled Substance Testing Procedure for BCRC Identification Card Form 23-25 Attachment I 26 BCRC Applicant/Cardholder Drug Test Information and Instruction Sheet Attachment II 27 BCRC Authorization for Consent to Drug and Alcohol ArWlysis and Authorization _ _ _ Deleted: s For Release of Results Attachment ID "Post Accident" Revision of Clarification 28-30 BUILDING AND CONSTRUCTION R.IKSOURCE CENTER, IN(.,�, I'he kbor and niare1q,lyerrient representatives of Ilic, 'Budduilg and in(Jusuy for Northwest Indiana have fbi-med ati a[fiance to address the piableins caused by (hug and aicohol MonAvfnirer qn6l kdior tv.iVe rreatq-d V11ue T jj�(ro Jy �a -t�j 1 -3.1.1.1.3 —1 .. ('rntor (hei.eafito "BCI?,.C")ai-Lin.deperi(.Jcfttnot.-fc)i-prc..rfitcorpo-ati(.)n awiide rangeofservdces to its participants dm the unionized consaucdon industry, which anchxle contractors, kibor union or.-arrizations and construction industry and re]ale¢l workerrs, IL is B(.,R.(,"s purpose to provide as vehicde to help establlish, and ntantain a workpiace tree of the destructive eff,cts caused by the U,'."e of dMigs and akmhifl B(-lT"k."S arc rhot intended to interf it, with aonn,cM cy'Ltht Ull[dOM or management BCR.0 irc copp ,thzes its responsilrility to corrununticate with and educate dls pmdc.dpairls rekitive to this poicand the harinfiAll effiecls ofchwn and akx.)iuA ill (Air soiset Iy — y and workplace, BCKC also recogtiizes the need to provide a pmgratu of assistance to (hose ptn-sons fin Maoru drutis or alcohcd may L)c causinv nroblerns. Fina@[,y. wlifle nut wisllNng to vioiate tune nights or invade tfw privacy of any ptuticipaint, BC RC's drug testing progurrarn Mil detect those parficipallts W1110 are UmNe or rumilling to confomi to 113(1: ,C's established progjam. I his prograrn has been established irii acc.ordance with fpderamidefines f'br urinc c6tection. and confidendaUry, .1 N 'HIE' POLICY Persons who use illegal drugs or abuse alcohol or other controlled substances, on or off their jobs, are likely to be less productive, to be less reliable, to be more frequently absent, and to have other work related problems that can cause increased cost, delays, accidents, injuries, and may damage the health, safety and well-being of other workers on the job. The unionized construction industry can control and reduce this problem through recognition of the problem, development of a comprehensive policy and program of education and information, promotion of an assistance program, and implementation of fair and respectful drug testing that conforms to federal guidelines for urine collection. All of this to be done with the utmost confidentiality and respect for the In order to enhance substance abuse awareness among all those involved, educational seminars and training programs will be offered. The educational seminars will be directed toward education of all participants about the seriousness of the problem of drug and alcohol abuse in this country, and how the use of drugs and alcohol negatively impacts safety, productivity, and the competitive ability of the American workforce. Training of participants who may serve in supervisory positions will be directed towards assisting those participants in identifying problem situations and/or warning signs of impairment, as well as their responsibility to document, intervene and follow up with the troubled individual. These sessions will be offered as ongoing training programs. N encmmages all parficipants trcmbled 1),y their own or a fimrilly tw-mbez's dmg or ,Acx.flhoalbuse to seek prof�ssiorial care ar�d h-catment, Eafly recogrfition and treatui:ment of aloolholl aod drug abuse provedes ffie greatest opportrtirdtyrfoir successfid recovery, BCRC provides, an Employce Assistance Proq-,-uo (FIAP) for A participmts and their fiaunihes who uWed pyofs ssional gifidance in Rsses'sing V.116r SUbsuince abuse our aicoho-related proWent and cliociishig an appropiHate com-se of treamc.,,tic, C'urr�,.m,A. paiticipa!Its tniflf rpren-red to an I.E.-AY representative as a result of a positi%,e driag test or iapon an illdMdUal's (..)wn reqt.[est, In cithew case, the con(ont ofthe dkcuswaurit with the EA.11 will be totaHy pirotecled and: conlidontul, A par6cipaia who seeks the services off the IFAP on his/her owil, kvffl m.,,ver have his/her use of The prognarn brought to flae attenfion nf BCRC, or any of its su.bi,,scrirnng or-anizaintis or parlacipwits. IndMduak who use the EAP as a coris�.,,qucnce of a jjposdfive dmg ¢est wiB be subject to Ute conditions estabHshed in the ditig testnig portion of ihf s policy, The Eimployee Amistance Progmyn (EAP) is, a rnember resource spottsored by (--,'RC, The FA.P pmvHes confidential ,issistance to pardeipants who are expe[iencung substance abUSC or allcohr,.)11- related proWerns in their own lives, ot who Iliave family merribers wrh a sonflar problIern that wquilcs ".Meinl�orl' The StaCi of the EAP have kmMedge of (lie �evel and types ofbcmefits avaflable. to BC. RC paiticipants, Piaui k.opants can access the services of the EAP throuoi as hodine tll'iatis staffied twenty- four (24) h(,.)uirs -a day, seven (7) days a week, thf011ghOLA the entire year ParU61.)mils caffing the E-All hodine are punt dD LOUCh With a counselor who will conduct a profi,.,ssioinat assessinent and rnay nieet wiffi drom to further assess the nature of the problem in order to provido m the best and most appropriate level of care. The EAP is staffed by certified and credential human services professionals who are sensitive to the needs of the individual. Individuals who take the initiative to contact the EAP for assistance do so with the assurance that their calls will be treated respectfully and confidentially. The direct services provided by the EA P are sponsored by BCRC. In compliance with Public Law 100-690 (The Drug -Free Workplace Act), which applies only to employers who have Federal grants of more than $100,000, any participant who is convicted of a drug or alcohol violation occurring in the workplace and who is employed by a BCRC affiliated employer must report this information to his/her immediate supervisor no later than five (5) days after such conviction. The supervisor must report this information immediately to the funding agency. lmuc jjg_ BCRC will provide an identification card to each participant which will reflect the results of the Drug & Alcohol Screen Test from the laboratory. BCRC shall not assume nor bear any liability or responsibility for the testing, the results, the certification or anything related to the foregoing. To implement an appropriate and acceptable program, BCRC has adopted six (6) safeguards that reflect the standards established by the U.S. Department of Health and Human Services (1)[THS) and the National institute of Drug Abuse (NIDA) for testing mandated by the Nuclear Regulatory Cormnission and Department of Transportation regulated entities. Those safeguards are as follows: The integrity of collected urine specimens will be insured by utilization of one collection procedure at all sites. Samples will be collected in accordance widl M feder,fl ma inch that Odc Tawkinum ME orMody and YdOch rmxWnizc, PhWT cams"s MpnUg we A10hys kog WOM, 2 Fesfing will be conductod lby carefii.fly srAxAcd accredited labs that also obtained and retained Dill -IS cettifleafloni All kog SM seven jushh,e mum Jw consymed by gm chmmajmiqjnw,�s spectrornetry (CiCzAls). GC/M.'S coafimia�ion is thu stateof-khe--aift clyug testing te,chnolop"Y' provkfing as fingeqnant of(he dotcccd drug, 4, A Medic,d lkcn,icw Officer (MRO) wdl re0ew ad drttg ws( prmlivcs prior to umblicadmi of poWn ten rcmdw. 'rhe MKO k a OWBAn with spe6ttity traininr,,' and expadsc W subsWce abuse and drug 9exkug� Tlw MR0 Mlli rcvrcw plesunriptive, posdJVC lest results to uosure than prolwr prucedure, protocol, and rcjpoo�rq, ts donc� l he ARO �)�R kitc�rvicw thu person with positive test rcsUftS by 0(,Acpp onc. l,o asses's Whe'dwr any pnp.aaun,aJ)kp explanuLion exists I'm thic, druqj, ust. po,sitive ffno ve6fluble, cXP1BJW1fi01111 CMSt, RW 010 JMSAfW (It-Ug gnat, d1c' MRO )NM ulkea; appropHate Mcps to trivaWate tfie minployc,,'u, ccrOficf.aion card. AM pelsons, who lt!�I,Ve ft"Med posn6VC uonust havt their xehun to work clew'EA by the MRO. �5, A111 drUg t(",A t?0NbfVC sarnpics, wlfl be retanncd k a kicked firozen fiaizflfty at the IMNg Wmwq Ir mw Wari Me rotaincd urnic stunplesn',fll bc, av"11"a Mmid I the resuAs of tbiat test be dispuited oi shouid adWration or ktigaGon arise OW Of the ackris taken because of the test results, 6. On as periodic bmis, 13CRC wiH subimil Nod pre -tested ul-me Sarriq*s w�th appropiate docunlentation to thC, drUg WSflylp!, laboratory as a mwans of' assining itsell'ofilaboratory poficiency, %—I'.1tAr'wwbkTv, .. 'and pc,)l N jhv (k) C U kl I f, I I I I I I I 1-`�: R: j in a, cepluNe _V . ..... tP vi JY @A It 111 N" C,111"vtlrt the momhv,A� be o,o ko l, uvfw'cd to �uhnm jQ s. t'.'%w, undol We blasi 4A not te.stwL, ............ .. .. ... . .. .... ... A mi:m0k:1. vdiki:,4: 0:,Mh tl w he 1w�k)(t 1: be.p,"�ort""d to w O' e nol li) . ..... .. ...... (j li[udivkluals subJect to thk policy coutinue to have access to the usuM protections pro-vided a's a pailt of tlhei�, undon iTternbership autd/or as imnit)ers of tmrgafiatn.,, units c,overed by colkxtrivc bargapj.dllg agreements, Such 4idviduals nizy requusL that as ullpon represerytati-ve be availartAle or present prior to any action. takon by an employer, if any, at any stage of the poky and its admiT]jStfatio¢1L 11fan jinfivt(ItO is aggfieved by any cwhon taken under tl u s Dnmg 11oh(.y and hi,,Acr ,minphiint carmat be, n-Aea Q ampAir may, pf 0-c iin(fividumd or Union requests, be rcR.,ircd as a gtievance. undeir Ke WIMMm wW Mvbm rmwisims oFTv WHAMs coMfive bargaining agieenwilt, In the nwa Ow nMwr ls MaW to imp, hatioYL Q AM"- sball he hmmml submantivey by the YOMMUdds Mug Poky, As a fiArlheir provx16oin ID dw A (0 hmod mIgMs wd the iqxmwnaAm &mAwd aNse, 1WRC wM conirict the sic.oviccs of a MM16M aW Mcr aMrWdMr !Mcpmdmt pmANAmals ro Fhicp.iiiposeofrhis awfit ,shaft be to onsLuC thArl r�uidefincs devrJolmd w pmwu to hdWmh KQMq he homm of' BOU.'and all thiose arffiflWed whh Ke THTC am r4omuMy ardhoted to, Itil "Idditi,011" th("JUdit ofthe Wommy hy UmM&N whh ywcMu w6i cxpilke and tnpedena! MH Ulm hamv that those promMuics imed to con= dmg kANg amdmc M nwo or mmal the NimcWtods of perhimunec OWN Ws * Mal wdowws, I he, dii,ig testing proparn wM be Wrend a dw dm"bn eat" up FrAlowing driugs at, thcsc estaNished pcvcls� M Drug or meta- Initial Test GONIS PLUZ Group bolite detected level Amphetamine Amphetamine 1000 ng/ml 500 ng/nil Methamphemmine 1000 ng/ml 500 righnL Cocaine Benzoylecgominc 300 ng/ml 150 ng/ml metabolites Marijuana Delta-9-THC- 50ng/ml 15 ng/ml metabolites 9-COOH Opiate Codeine 2000 ng/ml 2000 ng/ml metabolites Morphine 2000 ng/ml 2000 ng/ml Phencyclidine PCP 25 ng/ml 25 ng/ml Alcohol Alcohol Breathalyzer 04 BAC DEFINITIONS '�kdultc Inell spccij^flejj substance that is not expected tag be prew"Ilt in litumin w1rie, or colitains a sobsUanoe expected to be present but is W a So high dial, at is riot consistent with human urine. ALc(Lho means the intoxicating agent in beverage alcoho, ethyl alcohol, or other low 11101CCU1,11- weight alcohols including methyl and isopropyl alcohol. Mcotrol means the alcohol in a volume ol'breath expressed in wrens of'prams o('alcohot per 210 liters ofbrcath as indicatcd by an evidential breath test (BrAC). Alcohol Screeni evi nicans a breath or saliva device, other than an EBT, thin rs,,il)pwvvd by the National I fighway'll-affic Safety Administration (NI-ITSA) and placed on a conforming products list (CPI,) for such devices. �Vcotjol screcitiog lest' mearrs an winlytic proce(,kire to deiennine whether an elyll-stoycc rriay li"we a prolubised co ncci it ration of alcohol in a breath or saliva specimen. 0 A koh of use means the drinking or swallowing of any beverage, liquid mixture or preparation (including any medication), containing alcohol. 9 III(nalls Qa 1xison, contractor, or pet'son 6work6l'4a fiia all dmlvpoldq.'r111 who applies lo beuoinr;� a enipoyo,,.� ofa B( ' 'R("' t-,oirllractor par'66pamand includes a pe.rson who has rc'-ceived a job) offemade� Cointillgent On 1he pmon passing a Olug test -Ass'qcia n Be i lofing '-ad 'C"'noU R tsourct, Ctntec, v,,htch is V hd by klbo� and m'amqpnnerit of111c Bujddj ng, wid COUSNIALlioh k1dustry Rri, NorthwQst Indiana, for (Ile Purpose, ofaddressing probierns, And ialcohel hi the work1flace SAE 4, L, 1. 11 U. U B. '11! A� k an i ndlividuai whc, Q cicrt;-ej "a - -' ' -M � V mc Lo operate all Evidennai Breath Testing device, (M-11) al"I w1w is proficitnit in br ath- testing Procedures (1:1neeled (est rneans a drao or, ab...ohot test thoI has a gape obl[cyn udonfified that cannor C, be or has not been corrected, A c'AmOod tc'st is neidlel, a posi6ve nor a nvgadvc test An employer is not pernlitted to adwi-se pob a2 km bascd Oil a czallcvked WM' C2I I? .1n Elgy nrlle"..Ins an ernpk..yc.x who n r a menibel URUiiduFug and C."onsh-Liction JR,.esource C.'enteir, 0,011tv'fion, 'dw menil" °� ph"le-C dignaod by M'I' C 'xhery indi"'Idw.0s, 111'c"w1W flwal"'(Avcs R)r pllqwse a.-Jrpl'oviljing a sp'�e�fllcll oC Ou...41. In'llie 10 be, lrnAy'zC%J Cor that; pret CIICC ash cmamhed or f1bl'psuagtaarsw. u'j Pl'ovidilly, a Saliva "n, tmm1h salnpe to be analyzed F(.rr aicoh.oj cojncejjtnatjjotj, mmms �dl t''mplOyz.T-Owlwd amd'or dea�'wd incimfimg but m'A hiliked to wxlwd am.J./or k-ased I iufldnigs mid up her aapanh c-Ame, parkmgfret and k)'.I'tted ("m pal king Ws' "Ind w6viled almlor -least-ad whildes, h)ckers, and desks. ('61111i'lliatory test a) For alcoho� testing, a confirinatoiry test is as secorid test faflowIing a sc ', . recifing icst with a iiesult of 0,02 or gleater, condUCted 15 30 minutes tat(,-,r, that provides quaitfitafive data of Mcohol con.cclitration, This, test is Q.onductedl on ar.11 EB L b) For cmitroHed substances testing, as cor�tjtrjtatmy test Is as second am'fly6cml plceedurc C, to idVillify Ole Plesonce or"i spevitic drug or inewholite, This col&fitnitoty test is andependent of the initial test and Ust-.s a diffelen t. tectinique and cheniical[ principie FroftI that ofthe screeitifig tu,'rin riMej. U.) ensare t&Uabfflty( and accuiracy.- an cmphyerwho is a contributing neernber or' 51-U,illding and (..;(.rnstruction R.erOUrce Center Cojj—(Q( 1—h14 SM, bstay oq tiwait, rylart ttaria (THI"), cocainc, opkates, phencyclidine (PC11) and lif-Ouding, mol [arilph eta m hws. ) barbourates diwxse, benzodiazelpine, oxazepain, rtlethadonc. • PjjUS-aJ)j)jrqVIW 111j)(Oratory ukeans a kiboratory that is certified under the US. Depamilent of Health and I lumail Services Matidatory Guidelines for federal workplace drug testing programs. • jEflute Lirnt it means a specimen with creatinine and specific gravity values that are lower than expected for human urine, • L) Uj j g tes! rneans a test conducied for controlled substances, including marijuana, cocaine, arnphetamines, opiates, and ph,encyclidine, barbiturwes diverse, berv.odiazepine oxazeparn, methadone. • ILwpI()Xee means an employee of a company, or of a contractor participant who is a member of Building and Construction Resource Center. L Lniployer means a company, or a contractor participant, who is a member of Building and Construction Resource Center. • Initial test (for drugs) means an in-ununoassay screen to eliminate "negative" urine speciniens from further consideration, • LmAttl �CaL!f�eyi(Nv O�frtcer l"Illysician rest, linsihh'a for rece iving, kiborauaiy rcstflts gencrawd by BC R(s ditig testing pj`ogr'Ofli Who has knowledge of subsmricc abuse dssorders "and who hasappropriate incdicd naining up hiterprei and evaluate an individual's confirmed positive test result together with hisiher medical history and any other relevant biomedical information. occurs when a employee's confirmatory test result reads 0,04% BrAC or higher. • s Lo �ftivtjtq ij( rj .A)occw urs hen acmptoyee's confirmatoryconfirmatorytest or retest result is at or above cutt dT levels specified by Df It IS in DO-r rules and regulations, and has been verified by the MRO to be a positive test. • Random selection nicans a scientificalty valid method liar selection of employees to be tested that rosults in an equal probability that any employee from a group of employees subbed to the selection nio.-h-,"nsm will be selectol, and does not give an employer discretion to waive the selcution of any enmh,)yec undcr the mechanism. Thus, an employee might be selected more than once during a year. • Lt�Lusal to stitfL)Ilt tar a required Aco-holtest inclUdes, taflujiv to appear For any lest, faiku-c to proO&a breath or kira, required test, failure to ronIIIIIII tit Itic testing situ unOl the testing ploces"', is compIctc, faflurc to pn:wide ua wufficien( breath specimen %vithout 'a medical expUiation, t',iilinv W undergo to riwdicnl ex ajvjinat ion tiAlowing inabOily to provide as sufficient breath spechrien, 1,06sal pul sign Step 2 of the Alcohol Testing Form, and failure to cooperate with the testing process. ReRtsal to submit to a required drug test includes failure ta.r appear for any te-il within a rcasoiiable time, Failure to reinain at the collection site mitil the testing process is complete, refusal to provide a Urine specimen for a required drug test, flaflure to peorynt as directly obSel-Yed Of MOTIAlored collection when requ�red, farlure to provide, a suff-kierit arnoum. of uurhl e w4liout a medical uxplauiaHon, flailure to take a second test wvlh.ua rtLpLllirtd by as coflectoir or by his,htr empiloyer, faiture to undergo an medrcal examination fiAlowing u.qabflity to pr(Mde ',.I SUffiCICRt Lidne sanojAe, and flaflure to cooperate with the cAcc6oTt/tesUng pi ocess GncWing ief'Osirig to e#.npty Pookets at the cr-)Hectioll sfte,), :aft — 'I jselior rmeans a tiriasler" level educated professo�nal with an education in psychology, social work, coullsehng, etc wrth knowledge of and ehneal experienee in diagnosis and treatkinevit ofafcuhA and c,ontroHed siabstance rekted c4o;oiirders -11'he F'AP vvM Lwsess and make recollijuendmions educatioro, treatment, fOHOW-Up teStill[g Uld ttftel- CWC aS meded. 'ei"llml Imeeans a specimen with creatinine and specific gravity vakws thm are so dimikiished that they airc not consktent with huiman u6ne nwmvis levek estabtished by the BUdding and C.awi�strucfion Resource Center, at which as spe6rneu, oi sarnple is determincd to be either negative or posftfve, according to tk BuHding and Constrmfion Resciurce Center, workplace t iuc..t and AAcolh.rd rr,,;mjng Pokoy I IN I ITAI, A I'llSTINI",' Plogiectivc, emjrjkYYCcS arld "icLual enill-doyccs of, BICIU, Rilifiab'd e lj[jjjjjsyra�,�uo Wjj be subjjeclr tom djc� M"'W" Ivograna, AH Oh�Al kNrffl he iirism.wtvd. h, I'll 16 r r 1"', AoJu to report aIod jrF'()VolC 81 LAillhYllnph,,vvkliiri a q�ccHk,,d trine peflod (3 days) "I'lhese coUccfion siles wflH havc; on himid coftefion hts, Rmno, and A otrhe,r nccesswy AAjjpku�, Whcvlevel aril iirnkfovuadn.ra l ri dlwctxJ to o trite dfldi)JAW may 4� 0 �t IjR 4:1 1� xt�,, �v,� �, �vl � a_p rcl 8l I vC �d i JJ Old Dplllotedwho aim efig0fle mind Um�i,s m DcleteqM TUC hLdiv Huall WiR bo dhVef'A by MARC ,N rli[6f cm1floymr, ro cWhor rq,)ir6 ka sp,,-ificd OmVog appulnvcd kK:WiOfll Ddeted: sde,�ed thloc ("U days o� It' hu, (,4t I wt U I u I Irl, R�Iit N.Cae anti,,, ""Hilfloycc RANDOWFES"FING , After the individual's successful con'Pletion of the initial drug test, he/she wiH be placed in the Random Pool after which he/she may be notified via mail to report to an approved collection site for an at-randoni drug test. The individuals chosen for an at -random drug test wM be selected anonymously, from a cornputerized selection prograrn. The annual computerized seiection at - random selects a total of 50% of the currently active BCRC individual cardholders for the at - random testing, On a monthly basis, one -twelfth (t/12) of 50% of active individuals chosen and notified frorn each BCRC affiliated organization will report to take the above described test in order to update their BCE identification cards and status. at all}4iws --n -- ----- b", than, jn addifkt L �'WPl I ti 'I C .�J 1 (11 "1 mcnlb,n attj,,t h ooc akl thc prQgl:mIi_ A copy of the form letters notifying individuals of their selection for Deletedi this at ;i random test appears, a.s an attachment at the back of this booklet, An V J7Ndf net qdk'dion_�Ae k"v ��ty,, 'j I 1w kkq n, -v ;hp P -FAP w. detetm� ic it 6111c ft�trnv to subrilit 1�p ...... M- IN chcmal AC .-.TsILWL!kM ffld, ""o av"aie [hal .w w:a r qu�l� mc!, 111'ROBABLE (III USA: An Eniipoyce may also be tested. it'drwrx... is 'prohaNe cause" to ouspeo. that ain ondivnhg0s, work perflarrnance car on-tho-job behavioi is affbcted in any iway by y chugs cull alcohoL The "probN ae d� causu" stan&ird is appflcabkN to, but. is vat. Emittd to, any on- the job acci.dent, Ip,,nticaupaarIIy where (her� is a fatality, serioUsr bodily injt.n:-y orsignificain propen.y darnage, 1"YPTCA, 1, GE' tqI R.AI. EXAMPLES 01" AN ON-1111'..."4013 ACCIDE'NTS WIRCH DO AND DO N01' IUQILJIRE POST ACCIDI..,,"N'rTES]ING ARE I ISTED IN A.7-I'ACHMENT RIT 1" 01C E I'Iff" CONTRACIIJAI., AGRI-I MEN'r BET'WEEN IIIE 110ST F'IMPLOYER (OWNER), C(.)N't'RA.C'IM.E.NIBER, PRIME OR ORIIGINAIL CON-fR.ACTOR., AND YOUR CTJR.R.F,Nf' EMPIL.OYER MAY ST.fPFRCFDF -IIIESE E)i.ANIPLES AND Wfl-1, R.I.,"QUI.R.L." A POST' AC(ADF,),Tf"I'FS'F FOR. ALL ON IT TE JOB ACCIDENI'S. ProbabIle cause testing oir testing based on abnorrmil or unusual behavior or other circumstances suaf.fff%c ent. to lead a reasonable person to sa,i[spect that an indivdual who hss a IBCRC card is under the urIf]Uer]Ce Of" Olt as in poSSOSSb)n. of, an intoxicant sh911 be established by an immediate supel-visoil and should be confitmied by one other Aipervpsor whenevef possible, '11-je immediate sup.erysor sliaH document, III wdiing, the incident and the probaHe causo basis, floir sta. bi. testing. I'lie 14 documentation shall specifically detail the actions of the individual, the location, date, time, length of observation, any witnesses, and should be signed by the supervisor who witnessed the incident. Individuals working under the collective bargaining agreements of local unions affiliated with the BCRC and those who are union members subject to this policy continue to have access to the Usual protections provided as a part of their union representation/membership. Such individuals may request that a union representative be available or present prior to any action taken by an employer at any stage of the policy and its administration. If an individual is aggrieved by any action taken under this Drug Policy and his/her complaint cannot be resolved, it may, if the individual or Union requests, be referred as a grievance under the grievance and arbitration provisions of the individual's collective bargaining agreement. The arbitrator shall be bound substantively by the provision of this Drug Policy. Refusal to take the urine drug test for any of the described reasons, or failure to sign those forms necessary for testing, review by the NIRO, and result reporting, are all grounds for the non -issuance of a BCRC card or its revocation and may result in the employed individual being disciplined up to and including discharge by his/her BCRC affiliated employer, All BCRC affiliated ia ers e resented by , iliated employers have agreed that for those individuals who are inei b ol7r p BCRC affiliated local unions and who, as a result of drug testing for probable cause, lose time from work while awaiting the drug test results, and who are found to be negative or below the established levels of prohibited substance in their specimen, shall be reimbursed at their applicable to of pay for lost time from work by the employee's respective employer. Other employees of BCRC affiliated contractors shall likewise be subject to the same policies. E Ano ErnpIloyee who disputes JI 1-cstillis have tht, ngyln to hve lius/hcr it sampk IndepaWndy m-temad by as IMES cerfified labor-utoiry otlhisJK.,,r cMce, nit itis/her owun cxpcuse, vvithn ten working, cloys of whmi he/she wus noliNed of the ICM resuh. A. padimi of dw Wkill smnpk, shafl be forwarded UH&W chAwakustody dimedy by IEdd 1 t `°w tentInf,.r, IMI to dhe I'd-.oiretcry svlcc.ed by the indivnillial Evulu"on of the du g tcst nust 1-re perfmtried by as quallified MRO approved by 13CRC'. Tf ft.,, second lah repan tea reveMs ncgalke Mts, ten bwh tests CHI be considered iiiiegativa Updcr then ckeumstmees, the affifiated confl'actor v,111 re,6i.-&utse the dndrivOuat !bii- compefisation Ian t citning the pedud or Wher dWWWry suspuwimi or am-ndnation and wflp refinbuirsu O'w WMW Wthe mmofth smmd Mo A.n iwfivi(kai[ whose pt)sihve tCSL t-CSLOIS w-C confluawd whil be irldmd M tM EAP by the IMIRU ihe indiVidL11d rS CXPOCt.ed to aftclul ".1111 appointTillents rividl fibe, F,All' counsLdoiir &nd to fi.)flow the cmMus" AmMms The EKTRC rnhtudw Whe posiflon. diat add croft person.nd are sublieci Lc dhe poIlicy and rcquirernen.ts h,ei-&0lb[-C filAcd, filehidlNg to Dmgrl.'est provisicmt,"', l'o twcoll-nmodate craft porsound who have ne'vell lilt,111 a 111CIRC kle..�ntificafion card or taken an hnftrzfl drug test Ow lblH[ovvfiig proviskms- wifl gply whev AwKW to wmk aNgtment, 1. VIM WON W job kwadon Ir sigmp, the unphyer sepmsemadve (emml managm-) ShAl Wo UeSt the WllpII()yek.- to pirwra JdAcu BURC caid, All iTlLfividuzd a that does not have a BCRC card at the time of hire may work for up to three (3) days. On the fourth day, a chain of custody or a BCRC card must be presented. The employee will be requested to secure a card and take an initial drug test within 3 days to comply with the BCRC Policy. 2. Upon completion of the drug screen, the employee is to provide evidence to the employer of the Chain of Custody form givers to him by the collection site. 3. The employee will be allowed to work temporarily for the employer pending a receipt of his/her BCRC identification card and its status verification of the initial drug screen. 4. If the work assignments are consecutive, the employee will be allowed to work tbr up to a maximum of 7 days in order for the employee to receive his BCRC identification card and have the employer card manager swipe the card for status verification. 5. If the member's work assignment is terminated by his/her employer before the member's status is verified within the allowable seven days for verification, and is rehired, the member will have to provide the same employer a BCRC identification card at the second (2) rehiring sign up, and a clear status. Except in the event that the rehire is less then seven days from the initial hire date, the Individual, Local and Non -Local, BCRC card holder shall accept and understand that should his/her urine test results be reported as positive for any heretofore listed prohibitive substance, his/her employment may be terminated or disciplined without obligation for further compensation by the BCRC affiliated employer (contractor). Such termination shall also be subject to the individual's rights under his/her collective bargaining agreement. M S"Tevi I us coN Parkipating connactors may, a.)n the 23"1 of each month (or the next workkik g verify thie status of afl 13CRC participants, Who are working, by having their cards swiped on theirjoh. site in order to detem�iine if the errip�oyee is availlaHe nir nou, available under the BC'RC pm,grarn (Contiractor tnay use theIlhone in SysAern Whe does not have a scarmer), Whem an ernpoyce's status as N/A., he/stre will be a6ked to comtact the 13CRC office to resolve the N(..WAvaiabllc status, The kidMduap may be rLqthred to rep cmt the initW test. proceduic for non (;a:)kijiiphance with the randorn test reqUiYeMents, or IbHow the protocul for 1 positi)r,e test w4fiin the .BCRC Policy, The emp*yer may reswipe the ernployee's card allersevert days to recontlarn, the status and ifthe employee's status is still N/A, the empk)yer may ternidnate the ernpoyce. This pirocedLI11'e Wflll prittea the enrployee',s anfidenflahty and Mow the employer to aucht the status offiis emph)yees which may be required by tine ovoier to be submitted. monthIly, Fach BCIR.0 participating ernjj.')Io.yer wifl designate as person as card mariager who wffl. be able to access data b4t)irrnadon which wiU confirm tire status of employees fl-iirc)ugh the caM in systern, or the, BCR(..,scuTrner by swiping his iden.fificadon card for E 1. Not On File (NOF) 2. Not Available (N/A) 3. Clear (CL) 4. Safety training information which has been downloaded through the CAF and accessible through the BCRC scanner. The card manager shall maintain the strictest confidentiality of the BCRC membership. When a member is not in possession of his/her BCRC identification card, the card manager may request to use the member's social security number to secure the employee's status but must receive permission from the individual through written consent which is kept on file and good for that date only. 13 C!C;' ( , I J 11) 11, LIN E'S F0 It 09 1 Al�il tali APPLIC'AN] (Al —01LIUMS—A-Wilill's 11141 N E PILL, h 1.0 The BCRC applicant/cardholder will be asked to provide a picture identification (Company identification card, driver's license, etc.) to the medical attendant. 1.1 Applicants/cardholders who want a hard copy of their results may come to the BCRC office and sign an authorization for release of results. (Attachment #2). M j Ullive, Collection PlroceSS WiH fi)HOW W Lfw extant and in Ore martner providcd in if OF agency relgIflatiorrs, M ff the drug test is (or piobafth." Cause puq)oSes And not ple-crq.,)loymev[t or at araundoxun teskng, the supetvisor of another tuanageir may be reqt.dred to accompany ffie employev, tc) the sjpe�..,irnerl coHtxtion fmation, A anion representative may accompany the, einfflovec,,, if' pne or �Jv.- sm I 1pon aaivaf at thk location, the folHowing procechnes appy- 3, After the appropriate specimens have been coHected, the� coirnparry supeivisor wifl then take the ernffloyce littrae or to anothcr saR,. &ce, fn an wist,,.ince shouki the, emipioyeo be aflowed to driv lhorne on his or her own AH reasonable efTort, sfiHmi oftbree, should be used to convince the employee diat fit-, or she shoulld be takein honie, inctuding contact vvith firmily merinbeirs, taxi service, etc. If it appears that tine ernp�oyec WiN attempt to Openate a atotoir vehicle, and alt n-asonable attenipts shon of force flaw." fdHed to dissuade the employee, ffie proper aatbofitits shoLdd be capped and advised OfthC SillUllion, 12 Immediately after- rcturn to the work station, the company supervtsor slliotfld prepaic a report (,A'aR of the events wlh[[G:,h occuaed ftorn the triftW obseirvatiori of probable cause through tine testing J.:mlrocess and dwe chsposition ofthe ernpioyec. The report should be sent to his or her immediate supervisor directly following the incident or in any event on the same day. PRO"MC01, FOR A �PIINJTIVE 1NE,4 1. __--.-.Upon determining that a drug test is a legitimate "positive", the MRO will recommend to the individual that lie/she contact the EAR The 800 number will be given to the member. The MRO will communicate to the individual that a recommendation for return to work, if the individual was or would be working for a BCRC affiliated employer, must be given by the EAP to the MRO before the MRO can decide whether the individual can return to work. If the individual chooses not to utilize the EAP or not to follow the EAP's recommendation, he/she will be required to wait for 30 days from the date of initial contact with the MRO before being allowed to test again. During this 30-day waiting period, the individual's BCRC cardholder status will be "not available". hriadahuori, th,h,s ind4i&lal %iH be IS wwwhs kdloO�ili,! hk ItA F&UM to dUtV, Deleted: Upon making the phone call to the EAP, the individual will be set up for. an evaluation appointment During the evaluation, the EAP counselor will request that the individual sign a release authorizing EAP communicafion with the IARO. If the individual chooses not to utilize the EAP or not to follow the EAP's recommendation, lie/she will be required to wait for 30 days from the date of initial W Q0iflWJ 9,vp.apa thr Yvlfpt.O bdbm beWg allowW w Wm agAm WOng IWs 30 day v,,iwkmg perkiot, ttle SIWAIS 's'njj jju,- ➢VraIV<ij_fljCjj ASSWIP41B LIVA III c indiividaaNis sJpicd the aRm;qw&N; Same and allor he evaRm6oill is cofnpk,Icd, dic, 11,AP kw At conisict dic NWO I() dkCUSS MIC 1(',GDIoHTll(NldCd Gurcimul to Won", dWLAMINStAM (Ile fij,�S , a w,; or axt rqymmu day hg med as one New A Tc nNum Lo WM* WKWIL MmWd W WM Pmve Owp&m% Me MRO MH omr Qkm" wout Illo compiwN foll, flids fi0', idlu,ucaL Vac, MYO ma he NMWU NO hao we pnwns wkh he Oemmume of a Sompetit posftuvc" cm ilt thc EAP (MmAnn Im A WOOW ho jw"wWmmj w THmy dirrmigh wdifil iD Vdndl CMC the FAll vvdt have the ablAily k) caH die NIHO ID Omms be pw%hy a Rmmkg to wwommN BOU, cardholdur sunus to "not FAA, Can conNcl the m](0 rcgar(fing pmAl rummals cif work staws (piascd an �aclk �)[ fiflu)�IjV ojfij LAP Iccoilmliclidations) fm up W one (1) yewr n(mn die hxhvkhwFs odwilsMon, chw% 'k, "Al[Q �fltx' I tali lov"M Sllth, WK K , DAMY kw pw wd :1 no 0, 1 yyy m ;P kv to , can& it coar ciqj, A asnmak" cwir kcWAaA wkm& ow vulmin qj . . .......... MISUSE OF ALCOHOL and RS1 NACI',S The U.S. Department of Transportation (DOT) requires the following employers to comply with federal regulations related to alcohol misuse and controlled substance use, and testing: LCA(ma—I —Nim)(0—r—c—ar—rimr —Isa—feu �Adnd "i, Itration �FMCISAI Employers whose employees are required to have a Commercial Driver License (CDL) and who drive a Commercial Motor Vehicle (CMV), in accordance with definitions established in 49 CFR Part 382. L4(_warch lmuswm�cjall'ro �,ranks flLS_UkJ Operators of pipeline facilities subject to 49 CFR Parts 192, 193, or 195. Employees who meet the definitions of either of these transportation administrations are first and foremost subject to BCRC's and their employer's Drug and Alcohol Policy for DOT - covered employees. However, in circumstances that are not addressed in DOT regulations, DOT -covered employees are also subject to BCRC's policy for all employees, including drug and alcohol testing, under BCRC's and their employer's independent authority, including those circumstances that are not addressed or covered by DOT rules and regulations. W "DOT GLIP.A.]., INE'S I J]PPLEM ENTBI00KIETUPON R.I..-,QUFSTT0 BCMC� BCRC 6030 sounWORT ROAD IMIE NB 1WIMI 0401ANA 1636,"3t IT= 219461.9WO "T(Al Free�: 8'77-988-.5400 Fav 219-764-9505 Ymm mnw hm pawn mn&mt picked by BCRCJ cmqmWr gowmWd SmUcin pmWBm to wS a chug tat as soon as possible in omkT to update yuur BCRC Wentification W. 01W COMPLUer pmgmm Seas Q nomm of arm-tw6tith (1/4) of 5W% of aap.lh BCR.(--' cardholda-,s, fhT update ectch MWIth, 0 m OR VW4 m 10 do" o q din "m "-,,Ah. I�onWcr kq� an �qua� �qwn "too - -4, MY � cor o be MIJ, dw mmz wia whinh you initiady toolk when you received. youf 1.3CR.(.. cari:L In Wow awAd a, puterdat haumiphan rn the status of ymr eard, you MUSI It tested by ru) later thmi tho 150 of QvIMIJ 2N, 'Fests are, to be taken cm ymu EmWayeWwwwMS Lilate, at thlo C"olk"Coma Wky or FWAs wkuied NOTTI the ulUtched lit by )mui EmpkyWintmewr On the 23" of each (MAJ all BCRC pwicipwas who are wookIng lichly havt thelt-BCR.0 c,,nds `swujped" on Ch(-.,,irjobs in arder to cleteaTnine. if they arcs'avaflable" or "not a vaflable" under the BCRC Program. T'hos procedure vKH powo empW cmldwWahty. 2 �F If you cannot take your test prior to the 15th then you should do so as soon as possible thereafter to minimize interruption to your card status. Please feel free to contact me if you have any questions. Thank you for your cooperation. R� PS: Remember it is your responsibility to keep the BCRC informed of any change in your address or telephone number. PPS: Also remember the BCRC offers a fully dependent, profession Employee Assistance Program (EAP) for you and your family. The EAP's 24 hour, 7 day R week hotline number is 1(800) 456- 6327. Lx±Le_V(AA_oL1Ce for UWA Your name has been randomly picked by BCRC's computer generated selection program to take a drug test as soon as possible in order to update your BCRC identification card. Our computer program selects the names of one -twelfth (1/12) of 50% of all BCRC cardholders for update each month. No one will be tested in this system more than once per calendar year.. We want to re- emphasize that your selection for a test is purely a random one. You will be taking the same test which you initially took when you received Your BCRC card. In order to avoid any potential interruption in the status of your card, you must be tested by no later than the 15th of (Month), 200. On the 23 rd of each (Month), (or the next work day) all BCRC participants who are working may have their BCRC cards "swiped" on their jobs in order to determine if they are "available" or .'not available" under the BCRC Program. This procedure will protect everyone's confidentiality. M 11' voti cariant take your test prior to the I 5th th011 YOU ShOUN dO 10 aS soon as possiNle thereafter w unilifflMe h-ft1TUPtrOfl 10 Your card staws, Please feel firee to conuau acne df you have any qUeSflORS. Thank you fOrYOUr COOPC!Iahon. v IV James BUIdM EXOGUtiVC; IDnectaru lls: Rernernber t is YOUIF ['eSV)MSibHity tc, keel.) [he BC'RC infor"ttd ol, any chanoe in yni[rr addl vr,.ro_,, uji 001pinme nuallbe�'. IIPS: Ako reneembeir the BCRC offers as Rdly dependeTilL, j.)r0f'CSStOF1 EniIII Assistance Progiarn (EAP) tbii you and yow filrudy. The EAP's 24. hour, 7 day as week horline. number Is 1(800) 456- 632T D Yoiin, narne has been nandorydy pIicked by BCTU_,"s coniputer generated, sepectkrn prograrn to take a divig as svon as pos-siUle i" o� do- to upchae your BCRC i(Icnfification card. Our cornputei. program s,&Iects the nairnes of onetweHAh (1/12) of 50% uFaR BCR.0 cardholders Jrx- update each nionth. No one will be tested un this system n-wm than once per calendar year".. We want to re- eniphasize that YOUr selection. for a test is purOy a randorn one. You will be taking the same test M,ficllu you initially took. Aflien you aecerved your B(,'RC eard, In order Ici avoid any poteritW 61tenaq.-j,6orr ini tfie status of your card, YOU. triust be tested by nc) later than the i5th of(tvlonth), 200 . Tests are to be taken MI YOU11- On/11 time at ,.-,tny one of t1te fiacilifies identified on the attached Hst. Yotii will be mailed a $30.00 BCIII expense retrnbursement check after you have taken youf test. On the 23"' ofeach month (of the next work day), alIll 13CRC participants who are working na,ay have their BCR.0 cavds "s,,viired"' on theuJobs in. order to detenviiine if they me "avaflalHu" or "not avarialfle" undeir tht, PjCRC Prograrn, 1'Ns piroceduto MH protect everyone's confidentiality. M If you cannot take your test prior to the 15th then you should do so as soon as possible thereafter to minimize interruption to your card status. Please feel free to contact me if you have any questions. Thank you for your cooperation. PS: Remember it is your responsibility to keep the BCRC infortned of any change in your address or telephone number. PPS, Also remember the BCRC offers a fully dependent, profession Employee Assistance Program (EAP) tbr you and your family, The EAP's 24 hour, 7 day a week hotline number is 1(800) 456- 6327. AT" TACHME NT I RCIRC XPPLIC�� I)AIG i L ' Uk'S V IN l'OlZNIYVFION ANf—IJWf RUC --N— I Iv BCRC is exercising extreme care to insure that strict quality control measures are, followed in the collection, handling, and analysis of your urine specimen. You play an important role in this process and should be certain that you have provided an unadulterated urine specimen to the laboratory. Remember, you are certifying that the urine specimen which you provide is yours and is unadulterated. Any adulteration or switching of urine is a breach of BCRC's rules and, if you are employed, may subject you to discipline up to and including termination by your employer. For your own protection and peace of mind, we ask that youo 0 Provide a picture identification to the collectionsite/teclinician at time of arrival; M * Be escorted to a cohecti()i[I a,(�orn and mked to pirovkie ai[t unaduherated u.n ns, rope cin-leas in uhc, wHevion botfl,, pro�Jdedl Fhe bo0e' shouht N., 1"Ned to 60mk * Return flne spec4n.cn botdk.: to the nic.,dical techniciall wild Wtn(.,Ns, initnfl and date; die ultegrity Seals pkced 0111 your qxuinlejl, the:; pwGpXy SPCHng ofyour nanic an record.ed onthe log t, VC -TIN ffiat 1�'4)Citfl security o,unnbeir has V--�neon prq.,)(:,i-Jy recorded Vuriiy that the socials sc�ctniiy number IpLmed ou vo�,iir spe.cirnen bmde is the Sayre th"111 uccordcd on thou per, sheet and dn, chall of"i)(18ses"Jon (Jonn, I HAVT RLAD -11 HE ABOW', ANL) HAVE HAID AN OPPORTUNITY TO ASK Q[JE' TIONS THIS D "al C: A,rTACHMEN'r u BURA)ING AND CONS1 RUC 110N 141,;SQURCE CENTER IN(' :�I;"9"@IQRJZATJQN FOR CONSENTTO DRUG AN[) ALCM-101, _Nlt, 1, S Is 4Nl) 1. A 11,10 It -o R F 1'. EA sli, () r, I z 1,,s I " 1 :vs, L the undersigned, do hereby authorize the testing of my body fluids for employnaent reasons and understand and a�grce that the results of any such ttsting wiH be lumed over to the Buildin,- and Consnuction Resource Center, hic. and, further that the testing procedures will be hiniled to tests for prohibited and illegal dritgs and controlled substances. I undenstand that the results of these tests may be used for eniployment and disciplinary rc"Lsonsand hereby awhorize-the retelse ofstoch inn ormation fironi die Moratory and MRO, t further certify that the urine specimen collected front me is mine and not adulterated or altered in any manner. I have been advised that matters affecting rne relative to the interpretation or application of the Drug Policy are subjCCt eXClUSiVC1y co the grievance and arbitration procechire under my collective bargaining agreement (if applicabie). 0 winless Your Signature Date Social Security Number Time 'I'derlholic Number City State & Zip Code SubjecL Revision of Clarification of "Post Accident"memo-dated 03-20-1998 I'he definition of"Tost Accident Testing" as utilized in BCRC's policy statement, ft,om time to time requires dairification as to the application of testing to accident situations. The BC.RC policy booklet, in the section entitles DRUG TESTING, states: The '"Probable cause" standard is applicable to, but is not limited to, apey on. -the - .job accident, particular4y where there is a ftitality, serious bodibinjury or slgnficant property danwage. M Probable cauve oa,s;hnw or testing bcv,'od On abnorenal op upudspwl behavior or other cwcwtr�aanca,,, vqfflcwt,,,t ro aead as roesonable p(-.,r,,fon to tUv)("cr lhr,al alindivichw" who a B(,,'R(,' rawd is under the influence, ojt� Or is in posseeswn ark' an grata vicant cchull flv,? cbtablishcd b; an r'nwnedirwc vwwWwr wW skwlel be coeVirnwd py mm whw sVm4wr Ae AntaMac dmumwK M ;Wng the MrWmw (md Me PMWNO am. %6for iwh tew0a',', j he dovuntenlaiwn "hall vpecfir-,uflv dwalil Ow" of ,,(I.:. wdh,el,xo lngihdvci) e wki Mho be Qwd 4 Me ngemownMo wwamd the wnWmi, In(hviduaty ivorking under Niv cothec"live &vgcdning, agreenv"nt ol iccal wvum' rq,�/Uav,4 r,iQ,h the BCRC and thove AO a1v arson rarer thery ;ub/ce'l R() das pobq,, connnue ro have, (a"c'ess to, Ole "."wal (e,r a parof theiv Awion Yoch indh4durd,,; pmr�ta requev that, as undon &"r avadr.thle err preser,,1prior to any aakn Wen 0, an empOpr at aq) smge j"My pWky and is adnWnWwwn. Y un WSW it aggNowd ly am; wvAn Qwv� under ehv>' Awg llohro and iAhur coinplam(' cannar be izvohTa"R mqm V Me hWrlual or Unkw reqww, be refcrred a5 as gricvince under rhir, grievance and arbdrenion prolvi.vions Of Char: individuals wllcctivo! lxvgawing, agreem"t Ike aMhMwr,3hall be tr'"y dwplvl,4,,,wn of thi"Drug Policy , enwkyee A Iml,wi in a °Iearlev bender " accident Srlch a.n, accident sl'on(hng, Clione, doea� nw avarrruu drarg h"'ath,ze lxceve5e ihere, ei, ne) probable, cauvc" • Wlwn the contractor's emjployee gets out of his truck, there are witneg'se5 who report that the driver had liquor on his breath or could not walk in astraight line, acted in an irrational manner, etc:. This would be the basisfor a "prohable cause "findinAy, big it still must be properly documented in cwcordance with the above paragraphs in thesection entitledDRUG TESTING. A Cr(Me Opera&,'yr is rnosving a hoaej juu�j 44 piece qftsweedjedls out of the lame Wrikin't, and h#tiring an hedivithled lvorkhg up rhe vichlil 7he "pred5able lent is Properl ' v �'bwuoneniext lherte uvendd be fro "probable cutc,�w "fin- raviing the iqjfsred empl?)Yec' thlu to'Y his, aar x"edenr "I ff"hen as finWX"'n: Parfich"fiell, heto t1w e ' ve q(the oj'r4vrahw (V'cr grinder, he, or she 1'wohabh" has elope flolhing do confriblae to the Inedlod (II(ention Testing should acil be refluired fin, Superficial Onwill" inifirter"I 'Vqjuries ". THE COAURACTUAL AGRFEMENT BETWFLIV 771C .110,37' EMPLOYER (OWIVER), (.."oN7'j?A NTRA 7 R. J? C7' AWL, ]IRDWE OR GEVERAL CO C 'OR, AM YOU C( f REW7 EMPLOYER MAY SUPERCEED 7HESEEMMPLFS AND WILL REQuIRE A POSTACCIDENI' TESTFOR ALL ON IIIE"JOB ACCIDENTS, Probable cause testing, or testing bmed on abnormal or UDUSUM behaviow or other cirourn.stances sufficient to lead a reasonable person to suspect that an individua� is under the influence of, or is the possession of., an intoxicant should be performed only when these criteria are niet based upon the documentation identified in the BCRCs policy, Cet-tainly, the individWIPS rights and dip ,,nity should 31, Voln ji, (0" hI �!W 'h I I 011 'Tos� Ac� Idolll I i Is I pu