HomeMy WebLinkAboutOpening of Bids - Kizer Mansion Window Repair Project No 119-024R - JW Werntz & Son Inc" CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
Project Name
Project No.
For Bids Due
Date:
Address:
Kizer Mansion Window Repair
119-024R
October 22, 2019
PART I
( be completed for all bids.
07, zust 2 i�— Bidder (Firm).:
L rt
Please type or print) -,,-
City/State/Zip: 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 olt ) �i
the City of South Bend, Ind na„ in accord@'nce with plans and specifications prepared by:
he sum of e' er the Total Bid as shown on the Proposal)
shown on Proposal) (N merical)
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�n separate attachment.
BY _..�
(Signature)
..._..... ...
Op-rfritfid Name of Person Signing)
ACCEPTANCE
The above bid is accepted this
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Elizabeth A. Maradik, Member
Therese J. Dorau, Member
Version 7/20/2018
day of
Genevieve E, Miller, Member
Laura L. O'Sullivan, Member
Attest: Linda M. Martin, Clerk
Contractor's Bid for Public Works - 2
20
Project Name:
Project Number:
For Bids Due:
Contractor Name:
BASE BID
BID/PROPOSAL
CITY OF SOUTH BEND
Bid Form -Rev.1
Kizer Mansion Window Repair
119-024R
Octoher 22. 2019
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
Provide rehabilitation construction of
1
exterior historic window sash, frame,
trim repair and replacement, re -glazing,
Project
Lump
each
000
Sum
sealant, weather-stripping, and
hardware re air/re lacement per specs
Hardware Material Allowance for
Each
2
weather stripping, new sash chain, pulls
63
Window
$100.00,
and pulley
3
Construction Contingency Allowance
Project
Lump Sum
$8.000.00
a
4
�..
Sash Lock Hardware Allowance
_. _.....
Project
..
Lump
Sum
-...
$1,500.00
w1
—
BASE BID TOTAL 0
I_1N0:1:7kiF-1119 4.131
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
As
1
Storm Window Alternate for the Carriage
Scheduled,
Lump
each
House per Drawings and Specifications
Carriage
Sum
House
ti, .... mmm::.m
Bidder Firm):
Address
City/State/Zip: �� � _���'�,���°_ Telephone Number:
s
By_.... ............
TERNATE #1 TOTAL
0
I
�S oata�re
(Printed Name of Pe on Signing)
When the prospective Contractor is unable to certify to auy of the statements below, it shall attach an evplarration 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 d )
SS:
jo:L_ COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury
that:
1. Contractor has not, nor has any other member, representative, or agent of the firm, company,
corporation or partnership represented by him, entered into any combination, collusion or agreement with
any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding
nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and
without any agreement, understanding or combination with any other person in reference to such bidding.
Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or
indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals
are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency; and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
a. For purposes of this Certification, "Iran" means the government of Iran and any agency
or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as
amended from time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor
is engaged in investment activities in Iran if either:
i. Contractor, its successor or its affiliate, provides goods or services of twenty
million dollars ($20,000,000) or more in value in the energy sector of Iran;
or
ii. Contractor, its successor or its affiliate, is a financial institution that extends
twenty million dollars ($20,000,000) or more in credit to another person for
forty-five (45) days or more, if that person will (i) use the credit to provides
goods and services in the energy sector in Iran; and (ii) at the time the
financial institution extends credit, is a person identified on list published by
the Indiana Department of Administration.
Version 7/20/2018 Contractor's Bid for Public Works - 4
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any
employee or contract with a person that the Contractor subsequently learns is an unauthorized alien.
Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's
newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's
documentation of enrollment and participation in the E-Verify Program is included and attached as part of
this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public contract to
certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien,
and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees
to maintain this certification throughout the term of the contract with the City of South Bend, and understands
that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision
no later than thirty (30) days after being notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City
of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or
applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions,
or privileges of employment, or any matter directly or indirectly related to employment because of race, sex,
religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or
disability that does not affect that person's ability to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any
combination of the foregoing including, but not limited to, public works contracts awarded under public
bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards,
or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors
certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise
("WBE") as a factor in determining the lowest, responsible, responsive bidder.
In no event shall persons or entities seeking the award of a City contract be required to award a subcontract
to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a
discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from
being awarded a City contract for a period of one (1) year from the date of such determination, and such
determination may also be grounds for terminating the contact for which the discriminatory practice or
noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made
a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its
agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the
performance of this contract with privileges of employment, or any matter directly or indirectly related to
employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation,
handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of
contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1).1 hereby
certify that I and all subcontractors employed by me for this project will use steel products or foundry
products made in the United States on this project if awarded. I understand I have an affirmative duty to
notify the City in my bid that my proposal does not include the use of steel products or foundry products
made in the United States. I understand it is my sole obligation and responsibility to provide a justification
to the City, subject to review and approval, why the cost of United States made steel or foundry products is
unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry
products made in the United States, the City, through its director of public works, shall make a determination
if the price of United States made steel or foundry is unreasonable. 1 understand that violations hereunder
Version 7/20/2018 Contractor's Bid for Public Works - 5
may result in forfeiture of contractual payments.
I hereby affirm under the penalties of pefjury that the facts and information contained in the foregoing bid
for public works are true and correct.
Dated this I9 _ day of 6 , 20_0
WE
Sig lure of Contractor/B' lder or Its Agent
All
/A..��
Print d Name and lit e
Subscribed and sworn to before me this-,)/J- / day of )C- / „ 20 IP
My Commission Expires /1a2/zjy
County of Residence
Notary PARC
.�
HARRY P SINGLETON
Notary Public, State of Indiana
St. Joseph County
Commission # 678559
My Commission Expires
January 21, 2024
Version 7/20/2018 Contractor's Bid for Public Works - 6
,Bond No.: Bid Bond
Document A310 TM - 2010
Conforms with The American Institute of Architects AIA Document 310
Bid Bond
CONTRACTOR:
¢'1`roue, legal.clalrrs nrrd rrddi•ess)
J. W. Werntz & Son, Inc.
1002 Kerr St.
South Bend, IN 46601
OWNER:
(Xaarrc, legal slalrrs and address)
City Of South Bend, Indiana, Board of Public Works
227 W Jefferson Blvd
South Bend, IN 46601
SURETY:
(Xinne, legal slalrrs and principal place of haoin ss)
The Ohio Casualty Insurance Company
175 Berkeley Street
Boston, MA 02116
Mailing Address for Notices
BOND AMOUNT: $ 5% Five Percent of Amount Bid
PROJECT:
(Manic, location or address andl'rojeclaxonber, ifaittj
Kizer Mansion Window Repair -Window Renovation
This document has important
legal consequences. Consultation
with an attorney is encouraged
with respect to its completion or
modification.
Any singular reference to
Contractor, Surety, Owner or
other party shall be considered
plural where applicable.
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payntont of which the Contractor and Surety bind
themselves, their licirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this
Bond arc such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such tine 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 inay 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 tine 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 perlunn the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full three and effect. The
Surety hereby waives any notice ol'an agreement between the Owner and Contractor to extend the lime in which the Owner may accept the
hid. Waiver ol'notice by the Surcty shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time lbr
acceptance ol'bids speci lied in the bid documents; and the Owner mid Contractor shall obtain the Surety's consent liar an extension beyond
sixty (60) days.
If this Bond is issued in connection with a subcontractor's bid ton Contractor, the tcnu Contractor in this Bond shall be decmcd to be
Subcontractor and the teran Owner shall be decmcd to be Contractor.
When this Bond has been litrnished to comply with a statutory or other legal requirement in the location of the Project, any provision in
this Bond conllicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions cunibrining to such
statutory or other legal requirement shall be deemed incorporated herein. When so lumished, the intent is that this Bond shall be construed
US a statutory bond and not as a common law• bond.
Sinned and scaled this 22nd day of October, 2019
w
J. W. Werntz & Son, Inc.
! !fir a a l a!) (Seal)
!il llraessl � ,
t'l�fllat)
JVNSU
The Ohio Pasualty Insurance Company Con
lrS
lld l arr
� )alevw
so
illeit racieS -I
S-0054/AS 8110
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Not
valid for mortgage, note, loan, letter of credit, bank deposit, currency rate, interest rate or residual value guarantees. To confirm the validity of this Power of Attorney call
610.832.8240 between 9:00 am and 4:30 pm EST on any business day.
'kill I
mutudle
SURETY
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty
Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under
the laws of the State of Indiana (herein collectively called the "Companies'), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Trade House
�..., — �of the city of Soulh Bend , stale of IN its true and lawful attorney -in -fact, with full power and authority hereby conferred to sign,
execute and acknowledge the following surety bond:
Principal Name: J. W. Wel & Son Inc.
Bend, Indiana Board of Public Works
Obligee Name C!. Qf South, . � . ... ...�.�.........—..--_......... �...� --_— �._-�.
Surety Bond Number: Bid Bond Bond Amount: See Bond Form
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 12!h day of December,, 201&
y INS11 arms %Nstl�.. The Ohio Casualty Insurance Company
* 0004, (, "I �_ �� wfra , f. Liberty Mutual Insurance Company
o 00 Wes merican Insurance Company
' 1912' x 1919 1991
caru°��a�� �rvit�v`� vr �ofAtt,f� By:
w
David I 'Cafoy, Assistant Secretary
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY
On this 12!h day of Decombor, 2018, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company,
The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrumentfor the purposes therein contained
by signing on behalf of the corporations by himself as a duly authorized officer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written.
p, P15 COMMONW"v!EAITr1OPr"CNNNYLUANf,A,
Pvoawt^r v' Notarial Seal
7 Teresa Pastella, Notary Public
OF Upper MerionTwp.. Montgomery County By:
My Commission Expires March 28, 2021 Teresa Paste la. OtBCy-0�bfi0
Member, Pennsylvania Association of Notaries
This Power ofAttomey isTr- 0 e and executed pursuant to and by authority of the following By-laws and Authorizations of Liberty Mutual Insurance Company, The Ohio Casualty Insurance
Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
ARTICLE IV — OFFICERS — Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and
subject to such limitation as the Chairman or the President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute,
seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their
respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.
When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -
in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII — Execution of Contracts — SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,
and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute,
seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their
respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When
so executed such instruments shall be as binding as if signed by the president and attested by the secretary.
Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in-
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and al I undertakings, bonds, recognizances and other surety
obligations.
Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, of Liberty Mutual Insurance Company, The Ohio Casually Insurance Company, and West American Insurance Company
do hereby certify that this power of attorney executed by said Companies is in full force and effect and has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 22nd day of October 2019
INSU,Q IIIlNsU 10l,�
r;jltPo ' 'fw " ` Po' s, ND
I c u o f; By:
1912 1919 1991 aor eo C. Llu atq Assiwlant Secretary
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: 10/18/2019
To: All Planholders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number: 1
Project Name: Kizer Mansion Window Repair
W�WWW�
Project No.: 119-024R
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum by
faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
THIS ADDENDUM MAY AFFECT YOUR BID.
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company:
Authorized Signature:
Date: : )
_..,...e....... -—
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-1.0
MBEIWBE PARTICIPATION"s
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE/MBE 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.
Project Number. 11.0241 Project Name Kizer Mansion Window Repair
aITIT mm mmm_
Bidder: TotlBid Amount: MBE/WE Goal:
I; -
Page —of m w ITIT.IT._._ITITITITmm
Name 8 Address of MBEM/BE
Primary Contact Person
Scope of Work to be Performed
�.. _....._._....
Dollar Amount of
_................_..... ....
Percentage
of Total
(NamerTelephone)
(Attach scope/schedule if you need additional space)
MBEM/BE Component
Bid/Pro osal
�....
l
.................
. .................................
l
Submitted by;
Version 7/20/2018
Contractor's Bid for Public Works - 8
Date E'
q�yLkTa!
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY�t�
DEVELOPMENT PROGRAM
FORM MWBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS,r„r�
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 MBEIWBE participation. It is the bidder's sole
responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority
or Women's owned business as defined by the Indiana Department of Administration ("IDO ' ).�
Project Number: 119-024R _ Date
Project Name: Kizer M ns on I indow Repa r
Bidder:
Contact Person: V I ,..,, Telephone: "7
Address:
City: State: Zip:
Email:
r
To determine whether a bidder has demoo-r4trated good faith e arts "rea.
g oh 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
MBEIWBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business
Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women
Owned Business as found on their website (http://www.in.gov/idoa).
ACTION (ADVERTISEICONTACT): 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 MBE/WBEs 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 MBE/WBEs 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/WBEs,
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
MBE/WBEs in order to increase the likelihood of meeting the MBE/WBE goals (including breaking down
contracts into smaller units to facilitate MBE/WBE participation)
... ............................. ............... ...........
CONTRACT RECORDS: The bidder has maintained the following records for each MBE/WBE 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 MBEANBE 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 7/20/2018 Contractor's Bid for Public Works - 9
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.1
MBEIWBE CONTACTED
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects
requiring contacted 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: 119-024R MBEIWBE Participation Goal
Project Name: _KJzeT,,Mansi0n Window Repair,- , _ ,.I ........ � Bidder:
(Signatule) ` (Title) (Date)
MBEIWBE Firm
Owner or Contact at MBEIWBE Firm
...... ...... .......
Telephone:) Fax: Email:'
��.
TYPE OF �JORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBEIWBE FIRM:
MBEIWBE Firm
Owner or Contact at MBEIWBE Firm
Telephone:
Fax:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBEIWBE FIRM:
Email:
Version 7/20/2018 Contractor's Bid for Public Works - 10
PART 11
(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
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.
Have you entered into contracts or received offers for all materials which substantiate the
prices used in preparing your proposal? If not, attach an explanation for the rationale used
which would corroborate the prices listed.
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said
financial statement as required by statute shall thereby be rendered invalid. The financial
statement provided hereunder to the City of South Bend awarding the contract must be specific
enough in detail so that said City of South Bend can make a proper determination of the bidder's
capability for completing the project if awarded.
Version 7/20/2018 Contractor's Bid for Public Works - 3
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
RESPONSIBLE BIDDER CHECKLIST
Project Name Kizer Mansion Window Repair
Project No. 119-024R
For Bids Due October 22, 2019
Contractor Name: )IAJ _W
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 31 st for the upcoming calendar year, or within twelve (12) months of obtaining pre -
qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of
the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application
for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal
of the designation, effective January 1 of the following year, or immediately following the twelve (12) months
of pre -qualified standing.
However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works
projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status
is re-established.
Please Note: The City reserves the right to request supplemental information from the bidder,
additional verification of any information provided by the bidder, and may also conduct random
inquiries of the bidder's current and previous customers regardless of pre -qualified standing.
It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to
the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid
opening.
Version 7/20/2018 General Conditions - 6
POST BID SUBMISSIONS:
Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding
Ordinance. The post -bid submission requirements are as follows:
1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the
name, address, licensing status, and type of work for any subcontractor from whom the bidder has
accepted a bid and/or intends to hire on any part of the public work project, including individuals
performing work as independent contractors.
2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty
thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the
Responsible Bidder Ordinance as though it were bidding directly to the City, except that the
subcontractor shall submit the required information (including the name, address, and type of work)
to the successful bidder prior to the commencement of work.
3. Failure of a subcontractor to submit the required information shall not disqualify the successful
bidder from performing work on the project_ and shall not constitute a contractual default and/or
breach by the successful bidder. However, the City may withhold all payment otherwise due for
work performed by a subcontractor, until the subcontractor submits the required information and
the City approves such information.
4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall
not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another
subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the
name, address, licensing status, and type of work of the substitute subcontractor.
5. The successful bidder and all subcontractors on a public works project are required to submit
certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis,
submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall
identify the job title and craft for each employee. Certified payrolls shall be submitted
electronically.
Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in
the automatic disqualification of the bid.
The City, after review of complete and timely submissions, shall, in its sole discretion, after 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 7/20/2018 General Conditions - 7
PRE -QUALIFIED BIDDER CHECKLIST
(a) Ackn ' �vgements:
(i) By checking this box, I hereby acknowledge that I am a pre -qualified bidder with
the City of South Bend and that I have met the pre -qualification requirements within
the last twelve (12) months. A copy of my Pre -Qualification verification letter
is attached.
(ii) By checking this box, I hereby acknowledge that the City reserves the right to
request supplemental information, additional verification of any information
provided by me, and may also conduct random inquiries of my current and prior
customers.
(b) Attach rtNts:
(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).
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.
Evidence that I am utilizing a surety company which is on the United States
Department of Treasury's Listing of Approved Sureties as required in the bid
specifications or contract.
(iv) List of projects of similar size and scope of work performed in all areas, including
the State of Indiana, within the last three (3) years.
1Al 61IS-1 r
Version 7/20/2018 General Conditions - 8
II. 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).
(ii)
List identifying all former business names.
(iii)
Any determinations by a court or governmental agency any violations of federal
state, or local laws including, but not limited to, violations of contracting or antitrust
laws, tax or licensing laws, environmental laws, Occupational Safety and Health
Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5)
years.
(iv)
Statement about staffing capabilities, including labor sources. This statement
indicates and ensures I have sufficient employees on staff to complete the work I
am bidding on OR outlines how I intend to meet the staffing needs of the work.
(v)
Statement that individuals who will perform work on the public work project on my
behalf will be properly classified as an employee or as an independent contractor
under all applicable state and federal laws and local ordinances.
(vi)
Evidence of participation in apprenticeship and training programs, applicable to the
work to be performed on the project, which are approved by and registered with
the United States Department of Labor's Office of Apprenticeship, or its successor
organization.
(vii)
Copy of a written plan for employee drug testing that covers all of my employees
who will perform work on the public work project and meets or exceeds the
requirements set forth in IC 4-13-18-5 or IC 4-13-18-6.
(viii)
Evidence that I am utilizing a surety company which is on the Bureau of Fiscal
Service "Department of Treasury's Listing of Approved Sureties" as required in the
bid specifications or contract.
Version 7/20/2018 General Conditions - 9
(ix) Written statement of any federal, state or local tax liens or tax delinquencies owed
to any federal, state or local taxing body in the preceding three years.
(i) List of projects of similar size and scope of work performed in all areas, including
the State of Indiana, within three (3) years prior to the date on which the bid is due.
Date: 11�
AIX 04
(Sign Here)
(Print Name Here) I
(Name of Company)
(Address of Compa y)
(City)
\1(State)
I'"/
(Telephone Number)
Version 7/20/2018 General Conditions - 10
DEPARTMENT OF PUBLIC WORKS
CITY OF SOUTH BEND, INDIANA
SPECIAL PROVISIONS
Kizer Mansion Window Repair
Project No. 119-024R
PROJECT DESCRIPTION
Work to be performed shall include furnishing all labor, services,
equipment to provide and install rehabilitation construction of exterior historic window sash, frame,
hardware, weather-stripping, exterior trim repair and re -glazing and storm window alternate for the
Carriage House at 801 West Washington Street in South Bend, IN, with improvements all more
particularly described prepared according to the intent of the plans and specifications by Kil
Architecture/Planning, phone (574) 288-2654._
II. PREVAILING SPECIFICATIONS AND DESIGN & CONSTRUCTION STANDARDS
The City of South Bend's PREVAILING SPECIFICATIONS, most recent version, and DESIGN &
CONSTRUCTION STANDARDS, most recent version, are to be used on this project.
Each Bid provider is specifically instructed to become completely familiar with the most recent
version of the PREVAILING SPECIFICATIONS and the DESIGN & CONSTRUCTION
STANDARDS prior to submitting a Bid.
Wherever the PREVAILING SPECIFICATIONS refer to "State Specifications," it shall mean the
2018 INDOT Standard Specifications for the letting effective after September 1, 2017.
These SPECIAL PROVISIONS will list only "Additions" or "Deletions" to the PREVAILING
SPECIFICATIONS and are to be used only in conjunction with the PREVAILING
SPECIFICATIONS.
In the event of conflict between the SPECIAL PROVISIONS and the PREVAILING
SPECIFICATIONS, the SPECIAL PROVISIONS will govern.
III. BIDDING REQUIREMENTS
A. Prevailing Specifications; 2018, INDOT Standard Specifications Section 102
B. Additions:
1. Each Bid provider shall completely execute and submit the following documents with the
Bid:
a. City of South Bend Contractor's Bid for Public Work Form
b. Bid Bond stating 5% of the total Bid or Certified Check of 5% of the bid.
c. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding
Version 8/16/2018 Special Provisions - 1
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
CHECKLIST FOR BIDDERS
Project Name Kizer Mansion Window Repair
Project No. 119-024R
For Bids Due October 22, 2019
From time to time the South Bend Board of Public Works finds it necessary to reject a bid because
it does not comply with statutory requirements. In preparing your bid, please use the following
checklist in order to make sure that your bid is done in the proper manner.
n Proper bid security included. The bidder has the option of providing either a Certified Check
or Bid Bond.
Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely
executed.
Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments
with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and
Certification of use of United States Steel Products or Foundry Products.
Proof of MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not
met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted
Form [MWBE-2.1].
P Acknowledge Receipt f Addendum(s) included with the bid.
All required additional information is included with the bid.
Proposal statements and other affidavits all signed by the proper party with name either
printed or typed underneath signature.
This checklist submitted with the Bid.
This checklist is provided for bidder's use in assuring compliance with required
documentation; however, it does not include all specifications requirements and does not
relieve the bidder of the need to read and comply with the specifications..
Bidder: �. Date
rv%
By Authorized ,;epl
Signature:
Print Name & Title:
Version 7/20/2018 Contractor's Bid for Public Works - 1