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Home My WebLink AboutOpening of Bids - Kizer Mansion Window Repair Project No 119-024R - Ziolkowski Construction IncV1, CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Kizer Mansion Window Repair ��.._.. ___ ...... Project No. 119-024R ......................�....�.�.�.�..............._.-._.......... ...��.................................. For Bids Due October 22, 2019. ....... .. .................. PART I (Must be completed for all bids. Please type or print) Date: October 22, 2019 Bidder (Firm): Ziolkowski Construction, Inc. Address: 4050 Ralph Jones Drive City/State/Zip: South Bend, IN 46628 Telephone Number: ( 574 ... )_287-1811 Agent of Bidder (if Applicable): n/a Pursuant to notices given, the undersigned offers o furnish labor ...........ssary t......m_ t sh labor and/or material necessary to complete the public works project of: Kizer Mansion Window Repair the City of South Bend, Indiana, in accordance with plans and specifications prepared by: Kil Arch itectu re/Plann ing and dated for the sum of (enter the Total Bid as shown on the Proposal) Enter sum of Total Base Bid plus Alternates shoes ( p non oposatl (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 separate attachment. BY .__ n (Signature) Bill Favors, 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 Therese J. Dorau, Member Genevieve E, Miller, Member Laura L. O'Sullivan, Member Attest: Linda M. Martin, Clerk N Version 7/20/2018 Contractor's Bid for Public Works - 2 BID/PROPOSAL, CITY OF SOUTH BEND�� Bid Form -Rev.1 Mar, Project Name: Kizer Mansion Window Repair Project Number: 119-024R ............. For Bids Due: October 22, 2019 Contractor Name: Ziolkowski Cons ruction Inc. BASE BID Item No. Description _ Quantity Unit Unit Price Total Amount Provide rehabilitation construction of exterior historic window sash, frame, Lump1 trim repair and replacement, re- iazin9� Project Sum each � sealant, weather-stripping, and hardware repair/replacement per specs Hardware Material Allowance for Each 2 weather stripping, new sash chain, pulls 63 Window $100.00 i and pulley 3 Construction Contingency Allowance Project Sum $8.000.00 1 4 Sash Lock Hardware Allowance Project Sump $1,500.00 l BASE BID TOTAL i ALTERNATE #1 Item Description No. 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 ALTERNATE #1 TOTAL Bidder (Firm): Ziolkowski Construction, Inc. Address: 4050 Ralph Jones Drive City/State/Zip: South Bend, IN 46628Telephone Number: ( 574) 287-1811 �uV%h%%%%kYdi pGS,W;gp B �.� �C � �"'m y 41 (Signature) Bill Favors President i SE � c � (Printed Name of Person Signing) When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF Indiana ) SS: St Joseph COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, fnms, 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 enrolhnent 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. I 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 perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this ,...,,._22nd day of October2019 Subscribed and sworn to before me this 22nd My Commission Expires. March 1, 2020 County of Residence Ziolkowski Construction, Inc. C( titrac . t0 tdde�r (Firm) Si rtature of Contractor/Bidder or Its Agent Bill Favors, President Printed Name and Title day of October w 2019 � w Notary Public Shannon eI en ach St Joseph =REIDENBACHBACHSealnaMar 1, 2020 Version 7/20/2018 Contractor's Bid for Public Works - 6 Document A31 OITM-2010 Conforms with The American Institute of Architects AIA Document 310 CONTRACTOR: (Name, legal status and address) Ziolkowski Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 OWNER: (Name, legal status and address) City of South Bend, Board of Public Works 1316 County -City Building South Bend, IN 46601 Bond Number:001 SURETY: (Name, legal status and principal place of business) Liberty Mutual Insurance Company 175 Berkeley Street Boston, MA 02116 State of Inc: Massachusetts BOND AMOUNT: Five Percent of Amount Bid (5%) PROJECT: (Name, location or address, and Project number, if any) Kizer Mansion Window Repair, Project No. 119-024R 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. Signed and sealed this 18th day of October , 2019 Ziolkowski Prinel t� — (Seal) _._.......... _. __ .. _ ... _. (Witness) Sbannon Tte3.clertah (Tr'tP)�mW'�� ors, President J,f d Ubertv Mdual Insurance Comm eg C g 64 A Xe ) ,i(Witraess) Silvia Kozubowski �_.._..-.�. title ""� (TWO) Aaron D. Griffin, Attorney -in -Fact 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. Libicrt, Liberty Mutual Insurance Company Mutual. 'rhe Chira CaSualI;y insurance Company Certificate No:8202195-972216 SURETYWest American Insurance Company POWER OF ATTORNEY 1<NOWN ALL, PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporahon duly organized under the laws or the State of New Hampshire, that L f%erli Ntutual Insurance Company is a corporal'pon duly orgganized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duuly orgmized pr ul^wrtedhe taws of the rState of incf�wna(herein cotuectiv lwyai allCvisthe'tcowenpani s') pursuantto and by authority therein set forth does hereby name, constitute and appoint„ John K, llu1s execute, seal acknowledge and e' �' v y .., III rat toe cit of� Chicago state of f thnurus each individually rf there be more thar�u one named, its truue and -lawful attorney-Irn-fact to make, ex g deliver, for and on Its behalf as surety and as Riact -and deed„ any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. N 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 23rd day of September , 2019 to N c m tale ofPENNSYLVANIA County ofMONTGOMERY Liberty Mutual Insurance Company rgl t, ,,, op, I w tstr The Ohio Casualty Insurance Company aPt a°",� 7 otu tro � "r roepopepp� WestAmenran Insurance Company 19 0; 1919, 1991 Dry u. p A01 wuaCa -rIMu` b +r�rAt 7x r r µ 6ajy%ydrBy: dC �Md �r wn B y................-.. David M. Carey, Assistant Secretary fin rn N C N .Q ao On this 23rd day of St glrr°ta7tatru 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o 2 Company, The Ohio Casualty Company' and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes N > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 8 Lu 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, r ,ply �r _. COMMONWEALTH ast IIaON.�peMN�YV,.Va'y,Ml�dk Notarial Seel wl- ego Public 4erasa Upper Merion Twp., Montgomery CountyBy My Commission Expires March 282021 Pastelfa„ Notary Public Member, or Notaries 9u �� This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual 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. Arty officer or ollner official of true Corporation authorized for that puul'pose In writing by the Chairman or the President, and subject to such limitation asthe Chairman or the President unay prescribe, shall appoint such attorneys-Infiact„ as may be necessary to act in behalf of the Corporation to make, execute„ seal, acknowledge and deliver as surety any and at undertakings bond's„ recognizances and other surety obligations. Such attorneys•in-fdol, subject to the Iiimitahotns set forth In their respective powers of attorney, $ball have full power to bind the Corporation by their signature and execution of any such instruments and to, attach thereto the seat of the Corporation, When so executed, such instruments shall be as binding as if signed by the President and attested to by the Sernetacy, Any power or authority granted to any representative or aftorney-in•fact under the provisions of Ibis arficle unay be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such poweror authority. ARTICLE fttfl - Execution of Contractsu Section 5. Surety Bonds and Ltndertakings, 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 tine president may I'rresodbe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seat aclinowledge and deliver as surety any, and att 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 Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so exec: rod such instruments shaft 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 attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization - By unanimous consent of the Cornpany's Board of Directors, the Company consents that fan $bents or mechanically reproduced signature of any assistant secretary of the Connpany, 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, The Ohio Casualty Insurance Company, Liberty Mrntuat Insurance Company, and West American Insurance Company do tiereby certify that the original power of attorney of which the foregoing is a frill true and correct copy of the 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 seats of said Companies this zym day of ,. iNs P I,(INS&� '4� w,;a�r'"o��F� �rt"��mra,�,��"�+tt` ` a as a yam s1912 0 1919 1991 0 a ey, Cs B yw .... �"v7 � p,'� �.t � h�� a"� � ��'� Precise . Llewellyn, Ass"rstant Secretary LMS-12873 LMIC OCIC WAIC Multi Co_062018 O m 0 i3 C:a � - to M O tP7 O rn 0 ,41 as >O 04 0t 000 M C:00 O o� 1316 COUNTY -CITY BUILDING % PHONE 574/ 235-9251 227 W. IEFFE[tSORT BOULEVARD FAX 574/ 235-9171 SOUTH BEND, INDIANA 46601-1830 � "�� TDD 574/ 235-5567 CITY OF SOUTH BEND PETE BUT'T'IGIEG, MAYOR BOARDUT LIC 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 Re air Project No.: 119-024R ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: -. 1'�6' — 1 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� '"'�l"" also be included with your bid package upon submittal. THIS ADDENDUM MAY AFFECT YOUR :BID. Notes: Please see attached pages. The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. ® c)I U Company, Authorized Signature:-- ' Date: /0 / /'�- ( ", BEND, INDIANA CONTRACTORS BICITY OF D OR PUBLICWORK 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. 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 MBE/WBE Contacted Form [MWBE-2.1]. X Acknowledge Receipt of 1 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: Ziolkowski Construction, Inc. Date: October 22, 2019 By Authorized Representative: Signature: Print Name & Title: Bill Favors, President Version 7/20/2018 Contractor's Bid for Public Works - 1 W W IL z wLU � O wz� o¢ mw0 V-a �U) mc� �wF- zw Nma �w O O o0 ww LL V � > W m p � 0 z a F- 2 O z co O U w m w m a 6 m U z c 0 C O O a U U) C O U Y N 3 O O T .O r- N N N rn_ w w6 N 0 c o 0 ° t: L dO .6 m c C 0 2 7 E EO Qw 0 0 �m 0 ca CL co a o Ev (U � IL a) m C_ -0 0 O T Y w O N N t 0 N U) O_ U 0 co U Q r_ E2 N C Q. o t m m 0t0 U aD m m � Z a w w w m 0 0 0 Q o6 N E IV z IFA d� 0 N N N L O U Al u Vi E M U) a) 7 co c a) E w z c Q_ CD 7.1 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 MBE/WBE 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: 119-024R Date: October 22 2019 Project Name: Kizer Mansion Window Repair Bidder: Ziolkowski Constructionr Inc. Contact Person: Ml hae Qus b way � Telephone: -74-28 -1611 Address: 4050„Ralph Jones Drive City: South Bend state: Indiana Zip: 46628 Email: mcushway@zbuild.com 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 �_ ............................................................ ............................ MBE/WBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business X Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women Owned Business as found on their website (hftp://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 MBE/WBEs of contracting and subcontracting opportunities. 2. Advertise in general circulation and/or trade association publications concerning subcontracting X 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 actions were d. _.�._._. wo () required 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 MBE/WBE 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"U'�'w MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM �'� FORM MWBE-2.1 MBE/WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring contacted MBE/WBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business. PAGE OF Project Number: 119-024R _ MBEANBE Participation Goal Project Name: Kizer Mansion Window Repair Bidder: Slol owskl Construction, Inc. J. itrBY: (gantur (Title) (Date) MBE/WBE Firm Owner or Contact at MBE/WBE Firm Telephone: Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE/WBE FIRM: Email: MBE/WBE Firm ........... Owner or Contact at MBE/WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE/WBE FIRM: Version 7/20/2018 Contractor's Bid for Public Works - 10 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. Please See Attached 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 our pid.) Xs directed by the Arch itect/Construction Manager 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. If Subcontractors will be used we will submit this information 24 hours after notification. 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. If Subcontractors will be used we will submit this information 24 hours after notification. 4. Attach a listing of equipment you have available to use for the proposed project. Whatever is required to complete the project properly and on time. 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. Yes SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the 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 INDIANA LABORERS' TRAINING TRUST FUND David A. Frye Secretary -Treasurer Jerry J. Bolk Chris Z. Guerrero Ricky Henson, Jr. Ramon Mendoza, Jr. Robert S. Wright P.O. Bog 758 - Bedford, Indiana 47421 (812) 279-9751 August 20, 2018 To Whom It May Concern: yg� 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 "Ziolkowski Construction, Inc." 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, Sean Coakley, Director SC* www. indianalaborerstraining. org IFI rre flow ti J I ro U) c3C 4N Z w W U z w A.. Q MaUAM7MA1934ifFEP'WARa11 dYt7xWJ+yRA+' pVdiAv% tngi Al ' W,6T" b•Pfwww9' .P,pg,B%groji �I"YYdA49";,vV r"b"d. YF�9' 'irnM�dd��n a uJ. 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Y N N QI LO W (0 (0 LO } q C7 T N d T C3 o O N d LO C o Qµ' Z LU co T" U LU Of ; CY) M r- ip M Q iO M p m Ow in 01) En V) Cwi ~ C� .ram+ SN9 m O M � � v— m Lo (OR N O �e 0 ley ' O W N � �7 �1 u U V # * �' a - .7 r rf i+1 of � N 4 — N P) 'o r .� pp d? yIt r r � N 91t A N W U � p A Y7 W 7c 7C N N Cf i!! �,. p .. _.. N I .,gyp �Y co r N CA. N N l7 p Cy' r p d O l 4k irk 7 51 'ti OI dl NI Op OI Q� r✓ (p N O d O r Q O r- d O d q ap Y N LO M h U] M c7 O er rN] [7 � I R C Q r T M m 10 r- h N O T Q Ca � x a : O a r rM Ch u] <t UJ I� M c� T O e I PL�e N N N 0 r M CO� O T co � Q tx7 T et W M co M M O ,- M N CV .- r .. r] o p O r n O pI Im CL N 2 a a� Op LO cn '', M Cl)U) tY r M s- �} O M T M W> C�V U llf F r- ap r N ^ N LL Qwow— www"Ammomi d O ow ��jj � M T M d r Q N O O T d r N r rL E- h W Q F < I o r 0 r Q M r N Ir Nf co 12 ai n T o O 1� N O C) O L Z lf] MT co N M T N N N M N e Gam. N 0 N O co r• yNti, P �� t� i� a/' J J J J Q p o O o N wo � °a l � N ►D ' aN„ ' Ci o eq � ' ' � c 0 low p0 o G) IA Cn N Le) tC rkor M G7 C � I M e p� Oto CQa-ltr co Nm qp Lo cq r IA c �r O `oa d� O N N GO tD (O N © q C~7 I Y r N� 44. M P i.) N r N !rto 40 Q CO OMD t� a h d N r ct iLl U a �j o,to r n �► r N 1 A N a LL ¢ Q > F E v- 0 CA O C) u7 r r r N 6 6 dC V N i17 O� N r O In F� Imo., F4 R _ d0 O O O k N F cm I Cf .- Poo OQ t. r N 0 r 1D 1`tl O i 4 STATE OF INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STRIw0' Room W 450 IND[ANAPQLIS, INDIANA 46204-2738 October 25, 2016 Certifying official; �MIchael R. Pence, Governor James M. Brawn, Director The Indiana State Approving Agenq would like to inform you that the Department of Veterans Affairs ,St. Loans Regional Office has relocated For enrollmeut certiflo Lions sent by mail, address to the Bducation Division as follows: Depaftent of Veterans Affairs 9700 Page Avenue Suite 101 — Education, St. Louis, MO 63132-1502 Fax number for certifications; To Submit OJT/APP documents: 314-253-4140 Feel free to contact the fudi na State Approving Agency with any quesi#on,s. Tara Eggen Program Coordinator State Approving Agency Indiana Departtuent of Veterans Affairs 402 West Washington. Street RM W469 Jndianapalis IN 46204 317-234.6062 Teggoal@dva.in.gov STATE OF INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 302 WEST WASHINGTON STREET Room 5-120 INDIANAP01-15, INDIANA 46204-2738 Renae Sullivan Indiana. Laborers Training Trust Fund — Apprent, PO Box 758 Bedford, TN 4742'1-0758 Dear NIs, Sullivan: Michael R. Pence, Governor James M. Brown. 01rector January 27,2015 I recently conducted a compliance survey at your jiisi-,itution, I appreciated the professionalism, courtesy and assistance you and your staff extended to me) your Program Director with the Indiana State Approving Agency, This lottitr will discuss the'pwrpose of a compliance survey, what I review during a survey and my findings, What T,-; The PurposejLf A SurvgX? A compliance survey is periodically conducted for the following two reasons: (1) To ensure that.Departmeja of Veterans Affairs (PVA) payments to veterans and eligible dependents enrolled in the training programs are based upon proper and correct em-olfinent information furnisbed by the school (2) Assist school officials and students in understanding the requirements of the law jr, order to prevent deficiencies or violations that could develop because of misunderstandings or misinterpretations of the law, What Do T'Review Dori A Sure � '! 1y Tbe information and data reviewed durfilg the survey includes, but is not limited to, curriculum requirements, prior credit evaluations,, written agreements bet pTeen the, student and the facility, copies of the application and enrollinent celt-floations, and copies of the progress reports, Th, wage scales and work k processes are alsoxeyiewed. Advertising materials are teviewrd to ensure no erroneous, misleading, or deceptive information is conveyed to the students. One discrepancy, or reporting error, was found in the record-% reviewed for this survey, The discrepancy is as follows: There were zero discrepancies found in the -records reviewed during the compliance survey, Xf 'ou 1"+N ked .si.stattc This concludes the preliminary findings of our Compliance Survey. If you need any assistance or have questions regarding tMs. survey, please contact :me directly, by email, at I�l�ood � � ,inky. Tfyau cannot email me, you can leave a voice mail message at (317)232-3916. The education and training opportunities that your apprenticeship continues to provide veterans and their dependents are appreciated. Kimberly l loodg0 4--.... Program Director State Approving Agency Phone; (317) 232-3910, Toll -Free (800) 400-4620 • Fax; (317) 232-7721 Website Address; win. ovlvet g eran August 23, 2018 ZIOLKOWSKI Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 Re: Proof of Compliance with 30 ILCS 500/30-22(6) Our File No. MI-00321 Dear Sir or Madam: At the request of ZIOLKOWSKI Construction, Inc, I am providing you with evidence of the Company's compliance with the apprenticeship requirements in 30 ILCS 500/30- 22(6) of the Illinois Procurement Code. I am submitting this letter along with apprenticeship certificates (Nos.IL012020003 and IL008780173). As a signatory contractor with the International Union of Operating Engineers, Local 150, AFL-CIO, ZIOLKOWSKI Construction, Inc., is required by Collective Bargaining Agreement to participate in an applicable apprenticeship and training program approved by and registered with the United States Department of Labor's Bureau of Apprenticeship and Training. The attached certificates are evidence of compliance with the U.S. Department of Labor's apprenticeship requirements. Thank you for your cooperation in this matter. If you have any questions or concerns, please do not hesitate to contact me. Very truly yours, IUOE, Local 150, AFL-CIO District 1 dispatch office Caroline Lesniak Enclosures: Certificates ml cw Mnmlv , MIN I wow � MI �Jylll+ ljjjj 0 I V �f 1 Plasterers' & Cement Masons' Apprentice Coordinator of Local Union #692 Phone 317-508-1609 FAX 317-972-4907 Email hansen@plcmlocal692.org ®1049•M TO WHOM IT MAY CONCERN, AUGUST 23, 2018 THIS LETTER IS TO CERTIFY THAT ZIOLKOWSKI CONSTRUCTION INC.HAS BEEN A SIGNATORY UNION CONTRACTOR WITH THE PLASTERERS' AND CEMENT MASONS' JOINT APPRENTICESHIP TRAINING PROGRAM OF LOCAL 692, FOR AT LEAST THE LAST FIVE YEARS, AND IS IN GOOD STANDING. THEY HAVE A SIGNED CONTRACT WITH LOCAL 692 AND IS ELIGIBLE TO USE UNION PLASTERERS' APPRENTICES AND UNION CEMENT MASONS' APPRENTICES. THROUGH THIS CONTRACT AND OTHERS, THE FINANCIAL OBLIGATIONS OF TRAINING AND SAFETY ISSUES ARE MET. ALL OF THE APPRENTICES ARE REGISTERED WITH THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF APPRENTICESHIP AND TRAINING. SINCERELY, PAT HANSEN APPRENTICESHIP COORDINATOR FOR LOCAL 692 220 N. Fulton St. Indianapolis, IN 46202 U.S. Department of Labor 46 East Ohio St. — Room 511 Phone: 317/226-7001 Indianapolis, IN 46204 Fax: 317/226-7015 OFFICE OF APPRENTICESHIP Employment and Training Administration Date xX,,4/,� Mr. Pat Hansen, Coordinator Plasterers & Cement Masons Local #692 JATC (mailing)220 N. Fulton Street, Indianapolis, IN 46202 (school) 9200 Louisiana Street — Merrillville, IN 46410 Re: EEO Compliance Review (and Quality Assessment) Dear Mr. Hansen: Our recent EEO Compliance Review (and Quality Assessment) of your registered apprenticeship program, Plasterers & Cement Masons Local 4692 JATC was conducted on April 11, 2017 and October 5, 2016. This review covered the time period 08/15/2015 (date of your last review) through 10/04/2016. We are writing to inform you that our office found no apparent violations of the requirements governing registered apprenticeship programs as set forth in regulations at 29 CFR Part 29, "Labor Standards for the Registration of Apprenticeship Programs," and Part 30, "Equal Employment Opportunity in Apprenticeship and Training." Based on our review, it appears that your apprenticeship program is making good faith efforts to comply with the requirements of 29 CFR Parts 29 and 30. We note, however, that despite these efforts, there exists underutilization of women and minorities in your apprenticeship program and skilled workforce, including journeyworkers. Please be aware that Plasterers & Cement Masons Local #692 JATC remains under an obligation, pursuant to the regulations at 29 CFR Part 30 to continue with its good faith efforts to increase participation of women in its Registered Apprenticeship program. We sincerely appreciate the cooperation and courtesies extended by you and your office to the Department of Labor while we conducted the compliance review. If you have any questions or concerns, please do not hesitate to call. I can be reached at (317) 226- 7003. 41c�4�y, Jol�n Delgado State Director cc: Kathleen Sokolowski, ATR (n " - UJ UJ Q� a I LL. t C.-) LL! Z orb W Q F- 3.► cr-I U W _I cn •+_• a J d J CL U w Oi LD 4t � Q w O i=- n o U- a a a a � d '~ a i A I l.)ac4al)p elltl esll. p(e'r'gl i�lzl.coill 219-525-4443 Rogc T Jones - 3anagi g Director August 20, 20I8 C/O Ziolkowski Construction, Inc. To Whom It May Concern, This is a letter of recommendation on behalf of Ziolkowski Construction, Inc. The BAC 4 IN/KY Apprenticeship & Training Program is a statewide program that was established in I994 and is recognized by the U. S. Department of Labor and is considered in good standing. Ziolkowski Construction, Inc. has been a "signatory union contractor" since 2000 and at the present time employ enrolled apprentices. Ziolkowski Construction, Inc. has continued to follow the guidelines set forth in Collective Bargaining Agreement with BAC Local #4 IN/KY meeting the required Journeyman/Apprentice ratio on their jobs. Should you have any further questions please feel free to contact the State office at (2I9) 525-4443. Sincerely, I Roger Jones Managing Director BAC 4 IN/KY Apprenticeship & Training Program 1 REGIONAL COUNCIL �w 1a 1095 MARINERSDRIVE., ., ADMINISTRATION OFFICE 711 Greenwood Springs Drive Greenwood, IN 46143 Phone:317-807-1112 Fax:317-807-1115 Ashland Campus 574 Carpenters Way Grayson, KY 41143 Phone: 606-929-1378 Fax:502-996-9108 IndlanapoNs Campus August 20, 2018 711 Greenwood Springs Drive Greenwood, IN 46143 Phone:317-807-1116 Fax:317-807-1131 Ziolkowski Construction Co. Lafayette Campus 2953 South Greasy Lane 4050 Ralph Jones Drive Lafayette, IN 47905 South Bend, IN 46628 Phone: 765-447-5959 Fax: 765-447-7676 RE: City of South Bend Bid Loulsville Campus 1245 Durrett Lane To Whom It May Concern: Louisville, KY 40213 Phone: 502-366-8668 Fax: 502-366-8678 This letter is in response to verification needed by Ziolkowski Construction for work to be performed for the City of South Bend/Howard Park project. Ziolkowski regularly Merrillville Campus 1565 East 70Ih Court employs a number of apprentices affiliated with our apprenticeship program and has Merrillville, IN 46410 done so for more than three years. We are registered with the United States Phone:219-947-3348 Department of Labor, Bureau of Apprenticeship and Training and our registration Fax: 219-947-1889 number is 020 0537. Our program also participates in the Building Trades Associate Muncie Campus Degree Program with Ivy Tech Community College and has done so since 1996. 4121 East Centennial Avenue Muncie, tN47303 Phone; 765-268-9015 Ziolkowskl Construction Is a bona fide contractor in good standing with the g g Fax: 765-289-9298 Indiana/Kentucky/Ohio Regional Council of Carpenters Joint Apprenticeship and Training Fund and is eligible to employ apprentice carpenters in the future. I have Newburgh Campus s400 covert Courtof enclosed copiesp our certificates from the United States Department of Labor and Newburgh, IN47630 from the Indiana Department of Veterans Affairs for GI educational benefits. Phone:912-853-9312 Fax: 812-853-9316 If I can be of further assistance, please do not hesitate to give me a call. Torre Haute Campus 3099 South 61h Street Best regards, Tl;rne Haute, IN 47802 -7899 Fax: 8 Fax: 812-466-9840 � /j '� l�l.'4 -466-9 Warsaw Campus 1095 Mariners Drive Dale Newlin Warsaw, IN 46582 Area Coordinator Phone: 574-267-5264 I KORCC JATF Fax: 574-269-1464 Warsaw Campus rmur- PJl �I �a �s i P SECTION I EXPERIENCE QUESTIONNAIRE I . What public works projects has your organization completed for the period of one (1 ) year prior to the date of the current bid? Completion r-w Contract Amount Class of Work Date Name and Address of Owner $27,366,910 General 05/2016 Purdue University North Central $21,355,975 General 06/2015 Armed Forces Reserve Center $9,020,000 General 10/2016 South Bend Airport- New Arrivals Tern3i tal $15,964,580 General 12/2016 Renaissance District -Phase I 2_ What public works projects are now in process of construction by your organization? Contract Amount ..... Class of Work Expected Completion Date me and Address of Owner PUND $6,528,402 General 6/2018 Walsh Hall Selective Renovations $5,139,150 General 8/2018 La orte High School - Performin Arts C $13,208,000 _.. General 8/2019 Laporte Intermediate on the Kesling Can $3,472,000 ��....®. ..mom..,.. General 8/2018 ...... PHM Schools - Football Stadium Improv rater is nests 3. Have you ever failed to complete any work awarded to you? No If so, where and why? 4, Dist references from private firms for which you have performed work. University of Notre Dame, Tony Polotto, L,EED, AP, 200 Facilities Bldg., Notre Dane, IN 46556 574-631-4200 City of Mishawaka, Ken Prince, 600 East Third Street, Mishawaka, IN 574-258-1625 Fetters Construction Inc., Steven A. Fetters, 5417 County Rd 427, Auburn, Indiana 46706 260-927-8516 Memorial Hospital & Health System, Larry Lies, 615 N Michigan St., South Bend, IN 46601 574-647-1000 Company ID Number, 48667.1 THEE VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANDUM OF UNDERSTANDING ARTICLE I PURPOSE AND AUTHORITY e • � rwr � �' r - r ■I Rxime TiffIN a w► w - • _ r - M a *1 i:111 11CWIT 111jeu E311 contractorall oisting employees assigned to Federal contracts or to verif� the entire wor orcei If the • choosRs, Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal Immigration Reform and Immigranfi Responsibility Act of 1996 (IIRIRA), Pub. L.1C µ2 8, 11g Stat, 300 , a . amended (8 U.S.e. § 1324a note). Authority for use of the F-Vprify program by Federal contractors and subcontractors covered by the terms of Subpart 22.18, `�Employr°nent Eligibility Verification", of the Federal Acquisition. Regulation (FAR) (hereinafter referred to in this M06 as A "Federal contractor with the FAR E-Verify clause") to verify the employment eligibility of certain employees working on Federal contracts Is also found in Subpart 22.19 and in Executive Order 12989, as amended. ARTICLE If FUNCTIONS TO BE PERFORMED A. RESPONSIBILITIES OF SSA 1. SSA agrees to provide the Employer with available iinformation that allows the Employer to confirm the accuracy of Social Security Numbers provided by all employees verified under this MOU and the employment authorization of U.S: citizens. 2. SSA agrees to provide to the Employer appropriate assistance with operational problems that may arise during the Employer's participatio"n in the C Verify program. SSA agrees to provide the Employer with names, titles,, addresses„ and telephone numbers of SSA representatives, to be contacted during the E-Verify process. 3. SSA, agrees to safeguard the information provided by tile, Employer through the Verify program procedures, and to limit access to ,such Infrirrnation, as i`s appropriatle y law, to individuals responsible for the verification of Social Security' Numbers and for evaluation of the E-Verify program or such other persons or entities who may be authorized by SSA as governed Page 1 of 13 1 E-Verify f OU for Employer I Revision M6 09/01109 www.dhs.gov1E-Ver1fy i Gorimpany !D Number. 486671 To be accepted as a participant In E-Verify, you should only sign the Employer's- Section of the signature page. if you have any questions, contact E-Verify at 888-464-4218. Em-lo�.er. �io�o's .__.. �. . m�.�.... Employer s t CbO tmvefioio, Inc. Bill Favors Name (Please Type or Print) itEe Electronicall SI rieol _ ITITITITITIT_ 1/10/2012 Signature Date Department of Homeland Security — Verification Division . M-- Verification Division Name (Please Type or Print) "fide Eiectronicalir S Wined 1110120 I2 ignature Date Information Required for the E-"Warily Program Information reign !dour Company: Gobi .an y Name: `olkowskl Construction,, Inc. Company Fadli Address:4050 Ralph Jones dr. Sorlth Benii, IN 466213 Company A.ltemate Address: County or Parish: TJOSEPH Employer" Identif cati an Number 35145592 Page 12 of13 I E-l/edfy MOU for Employer I Revision hate 09/01/09 www.dhs.gov/E-Verify Company ID Number: 486671 North American Industry Classification Systems Code. '36 Administrator: Number of EmNovees. 100 to 499. Number of Sites Vetifled for. Are -you verifying for more than 1 site? If yes, please provide the number of sites verified ed for in. each State, W ANA 1. sife(s} Inforination relating- to the. Program Administrators) for your Company on policy questions: or operational problems: Namez James Xeldsen Telej)hone Number: (574)287 -1811 ext 368 Fax Number, {574) 344 - 5533 E-mail Address: jke.Idsen@zbOjd.corO Page -l3 of 13 I E-Verify MOU for Employer j Revision Date 09J01109 vuwW,dlis.gov/E-Verffy E-Verify - Employer Wizard - Company Infolmation Page I of 1 E-Veroffy ERiployment Eligibility Verific.aflon C.Itick any Q for help ONN,v L it J�%� 1,41co.. Wer ID Logl6j James Keldsen 6210111MA, 1234 PM - 06012016 Log Out Horne Company Information My Cases New. base Company Name- Ziolkowsid Constructlon, Inc. View Cases Search Cases Company 10 NumlYer: 48BB71 My profile !Doing Business As (I)SA) Edit Profife Name: Change Password DUNS Number: Change Sequdly Questions MY Company Physical Location: Edit Company Profile. Address 1: 4050 Ralph Jones Dr. Add New User Address 2-, ViewFAsfing Users City SWAth Bend Close CompsnyAecount state. IN My Reports Zip Code: 46626 View Reports County: STJOSEPH My Resources View Esserrial Resources Additional Information: Take Tulorlal Employer Identification Number: 351445992 Mew User Manuel Total Number of Employees: 100 to 499 Spare Ideas Parent Organization-. Contact Us Administrator Orgainizatlori Designation: Employer Cqt6gory; None of these categories apply Mailing ing Address: Address 1. Address 2: Cltr. Slate: zip Code: NAILS Code: 23B - CONSTRUCTION OF BUILDINGS Total Kiring Sites: Total Points of Contact: I I view"Mou 1, View! Edit FVieW / Edit View.! Edit U.9, Depariment of Horn -land Security- vvvm4dhg.qDv U.S. Ukenship and hrmraflon Services-- mmuscis.gnY Enable AccessibilityDoW.nloaoViewers . CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORT RESPONSIBLE BIDDER CHECKLIST Project Name Kizer Mansion Window Repair Project No. 119-024R For Bids Due October 22, 2019 Contractor Name: Ziolkowski Construction, Inc. 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 31st 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 I. 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) X 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 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) 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. 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: October 22, 2019 (Sign Here) Bill Favors, President (Print Name Here) Ziolkowski Construction, Inc. (Name of Company) 4050 Ralph Jones Drive (Address of Company) South Bend (City) Indiana (State) 574-287-1811 (Telephone Number) Completed by: Shannon Reidenbach (sreidenbach@zbuild.com) 574-287-1811 ext 271 Version 7/20/2018 General Conditions -10 1316 COUNTY -CITY BUILDING PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD �� ° ;' FAX 574/ 235-9171 SDI rrHBEND. INDIANA46601-1830 AC � yyy JA fA6 C1'1'yOF OUT1113END PEDT.13u1"r1.G E(Y', MAY01t BOARD OFPUBLIC WORKS' September 17, 2019 Bill Favors Ziolkowski Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 RE: Pre -Qualification Verification Dear Mr. Favors: This letter serves as verification of Pre -Qualification status of your company for bidding with the City of South Bend. This Pre -Qualification status is effective for twelve (12) months from the date of this letter. Thereafter you are required to re -submit a complete application for continuation of pre -qualification status prior to December 31 for the upcoming calendar year. A copy of this Verification Letter must be included with every bid exceeding $150,000 submitted to the City of South Bend Board of Public Works, along with your Pre -Qualified Bidder Checklist and attachments. If you have any further questions regarding this matter, please call this office at (574) 235-9251. Sincerely, , -�X—�/q a-x - Linda M. Martin, Clerk 5�� L ,K ��, construction, 101 General Construction & Design/Build IBulliding Strong Relationships Slince 1974 October 22, 2019 City of South Bend Board of Public Works Subject: Operations Letter Dear Sirs: Ziolkowski Construction, Inc. has been in business since 1974 and operated during that period of time under that name only. Ziolkowski Construction has not violated any federal, state or local laws, including violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA) laws, federal Davis -Bacon Act laws, within the past five years. Ziolkowski Construction, Inc. is proud to employ the industry's top skilled craftsmen. We have a core group of union craftsmen working on our projects and supplement that group with trained skilled workers from the local union halls. We currently have sufficient workers to perform the work that we are bidding for the above project. All individuals performing work for Ziolkowski Construction, Inc. will be properly classified as employees under the federal Fair Labor Standards Act and in line with all Indiana State and local ordinances. Ziolkowski Construction, Inc. had no federal, state or local tax liens or tax delinquencies in any of the preceding three tax years. Respectfully, ZIOLKOWSKI CONSTRUCTION, INC. Bill Favors President & CFO ............4050,Ralph Jones,..Dr., South,.,Bend,rlN 46628 Phone (574� 287-181.1 Fax. (574) 234-01„51.... Committed to professionalism and excellence for the benefit of our clients, employees, and shareholders. Adrienne C. Stevenson Vice President Marsh USA Inc. 540 West Madison Street Chicago, IL 60661-3630 adrienne.c.stevenson@marsh.com +1 312 627 6772 www, marsh. com October 22, 2019 City of South Bend Public Works Re: Ziolkowski Construction, Inc. To Whom It May Concern: Liberty Mutual Insurance Company (Liberty) is the surety for Ziolkowski Construction, Inc. and Marsh USA, Inc. is their surety agent. Liberty Mutual Insurance Company is listed on the Department of Treasury's Listing of Certified Companies, Sincerely, Liberty Mutual Insurance Company Zr , ... Adrienne C. Stevenson Attorney -in -Fact I' ARS11 I LIA,NNAN LEAIDIE So Hrl, KiNOWLE.Ii:GIE, SOLUTiONS— our LDNDii,.. „ :�, MPANIE!' STATE OF ILLINOIS COUNTY OF COOK l C.R. Hernandez, a Notary Public in and for said County, do hereby certify that Adrienne C. Stevenson as Attorney -in -Fact, who is personally known to me to be the same person whose name is subscribed to the foregoing instrument, appeared before me this day in person, and acknowledged that they signed, sealed, and delivered said instrument for and on behalf of LIBERTY MUTUAL INSURANCE COMPANY for the uses and purposed therein set forth. Given under m� hand and notarial seal at my office in the City of Chicago in said County, this, 22" day of August A.D. 201 otary C R HERNANDEZ Official Seal V Notary Public • Stale of Illinois My Commission Expires Jun R, 2020 THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. 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. Certificate No 8055500 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 Casually Insurance Company is a corporation duly organized under the laws of the Slate of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the Stale of Massachusetts, and West American Insurance Company Is a corporation duly organized under the laws of the Slate of Indiana (herein collectively called the 'Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, John K Jahnsorr Adngnne C, Stovenson rigjy lrr r am. HernITand z;_ brir�B J a�¢t� ...._ _ ._..._....... _... ....... ..._.. all of the city of CHICAGO„ _._„ stale of IL each Individually if there be more than one named, its true and lawful Ilt4nrney in act to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. 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 5th day of April 2018 ad �10rN ty ; IC& rrep,i �„�` rYYrwdld,Npow,� The Ohio Casualty Insurance Company , r Lubeaty Mutual Insurance Company d i 1912 1991 WEStnlel'I$tfl Insurance Company C ,y,. r David M Car " i_�� ..._ STATE OF PENNSYLVANIA s A irirti Secrets COUNTY OF MONTGOMERY c On this 5th day of April 2018 , before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company. The Ohio Casually Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes (herein 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 r�rq ..... .,.W .� Notary ., r"r�MMe1i7N4�Ir�,rkanTH �11 I iWNNSMt 1i.,..,.: a'�N'IdL Notanal Seal Toresa Pasteila, NoW Public By Upper MenonTwp, Montgomery County Teresa Paslella, Notary Public ti My Commission Expires March 28 2021 i i h MamLer. Pennsylvania Association of Nolorios This Power of Attorney is made and executed prursua t to and by authority of the following By-laws and Authorizations of The Ohio Casually Insurance Company, Liberty Mutual 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 fair Rml, purpose in writing by the Chatrlltain air the President, and subject tri such f mitation as the Chairman or the President may prescribe, shall apimittt such anomeys-in-fact, as fray be necessary to act in behalf of the Corporabon to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such allomeys-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 attomey-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 altomeys-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 attorneys -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 attorneysAn- fact as may be necessary to act on behalf of the Company to make, execute. seal, acknowledge and deliver as surely any and all undertakings, bonds, recognizances and other surely 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 The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the 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 lhis22nd day of ,__ — m,_ —, , 20 18 ON iN~ 51, 10 N!G` geH � d7 "?�'�ra,pr,�^^y 191 w 1991 By .-_ Renee C, I.tev ssistarai Secretary m t; Or "�*�r"N;i��f4 yak". "�'✓p �' !w`!�!�� h•. � v;�,',ci,�r„,„ 83 of 250 LMS_12673_022017 SIATE OF 1NDI NA OFFICE OF THE SECRETARY OF STATE CERTIFICATE OF EXISTENCE To Whom These Presents Come, Greetings: I, Catmi : Lawson, Secretary of State ofindiana, do bereby certify that I am, by virtue of the lags of the State of Indiana, the custodian of the corporate records, and proper official to execute this certificate. I further certify that records of this office disclose that ZIOLKOWSKI CONSTRUCTION, INC. duly -led the requisite documents to cammente, business activides under the lames of State of Indiana on December 11, 1978, and vas in existence or authorized to transact business in the State of Indiana on December mber 02,, 201. . I further certify this For -Profit Domestic Corporation has filed its most recent report rewired by Indiana law with the Secretary of State, or is not yet required to file such report, and that no notice of withdrawal, dissolution or expiration has been filed or taken place. In Witness Whereof, I have hercunttset my hand and affixed the seal of the State of Indiana, at the city of Indianapolis, this Second Day of December., 2015. Connie Lawson, Secretary of State 197812-31812015120203232 JOB LISTING Company: Al ZIOLKOWSKI CONSTRUCTION, INC. Jobs Active Since: 0 1 /0 1/1990 Thru Month Ending: 10/31/2019 Open Jobs Only Billed Under Job Number Type Job # Customer Name 16879 Q Ballard Elementary/Berrien 17036 Q LaPorte Comm School Corp****** 17152 Q Memorial / Skyway Parking Lot 17175 NTE Oliver Mansion -House Re -wire 17234 Q 33286 New Prairie School/Laporte**** 17283 Q LaPorte Comm School Corp/Lap** 17351 Q Penn -Harris -Madison*********** 17363 Q D.A.Dodd Inc./Mish Pool HVAC 17398 Q City of S.B. Board of Pub. Wks 17434 Q 24617 Eddy Street Commons - Phase 11 17448 TM Bamber's / Flooring 17460 Q City of Mishawaka/Central Park 17474 Q Concord Comm. Schools 17475 Q Clay Intermediate School****** 17476 TM Cost Tracking (Garage Work) 17506 Q Flahery & Collins - Stonewater 17514 Q ND-Mendoza/2nd Floor Reno. 17517 Q Ideal Consolidated, Inc. 17527 Q Performance Services/VAV 17547 Q Ironworks********************* 17643 TM H & G Services 17668 Q Erskine Clubhouse Renovation 17672 Q Sisters of the Holy Cross 17696 Q PorterCnty Annex- 17703 Q ND-Jenkins/Area Way Access 17727 Q ND-Nieuwland/ Spectrometer Bse 17735 TM ND-Nieuwland/ 288 Clean Room 17765 Q StMaryCollege- Clock Tower 17780 Q ND-DeBartolo/Barrier Removal 17787 Q CitySB-InstNewTrenchDrain 17788 NTE DC COOK- Misc T&M Work 17802 Q Elkhart High School 17811 Q Ideal-UND/ D&F Toliet Modicatn 17823 Q STJRMC- Dermatology Reno 17840 TM ND-Maint/2019 Carpenter Shop 17846 Q LAKEVILLE FIRE STATION***** 17848 Q City of SB-WWTP Admin********* 17849 Q ND- SDI/ Pizza Pi 17850 Q ND-Hesburgh/ Garbanzo 17851 Q ND-Men'sDorm/ Site Concrete 17852 Q UND - Corby Hall Carpentry 17872 Q ND -Eck/ Stairwell Railings 17873 Q ND-Rolfs/ Stairwell Railings 17877 Q ND-LaFortune/Vestibule Doors 17880 Q Chandler Elementary - Goshen 17882 Q Honeywell- AO Char 10 Fumance 17898 TM Internal Tracking Simons Panel 17902 Q St.JoeAirport- TSAIntcriorReno 17904 TM StJoeMedCntr-Respite/InterReno Page: 1 10/15/2019 08:27 am Contract Number Px Job Description P1703IM003 C/O #3 SCHMIDT PROM 217073.00 EC18-003E02 401990 41036175 BC-1 Gen Trades 1915338-001 1918641-006 247394 1592424 REL 7 ND01856 OCS5510 118-087 0610 CARPENTE 1933270-001 6400413844 Niles Community Schools Memorial Hospital of South Bend Performance Svcs/Selective Demo BP 2.6 Kesling Intermediate School Football Stadium Improvements Mishawaka Pool RVAC Fire Station #9 Building Concrete Flooring Band Shell Concord High School 2018 Additions & Renovations Building Improvements & Modifications Cost Tracking (Garage Work) Concrete Building & Site UND HHW Tunnel Additions Saint Joe CountyNAV Replacement Slabs & Sitework Concrete Transformer Pad Erskine Clubhouse Renovation Convent Window Replacement Porter County North Annex- General Trades LAKEVILLE FIRE STATION SB WWTP ADMIN MASONRY CHANDLER ELEMENTARY SUMMER RENO Company: Al ZIOLKOWSKI CONSTRUCTION, INC. Jobs Active Since: 01/01/1990 Thru Month Ending: 10/31/2019 Open Jobs Only Billed Under Job Number Type Job # Customer Name Contract Number PM Job Description 18086 TM ND -Galvin/ Water Leak 1955493-001 AB 18088 Q ND -DeBartolo/ 3rdFILBarrierRem 1955925-002 AB 18097 TM ND-Duncan/Recycler 1956269-001 AB 18098 TM ND -Galvin/ Ceiling Rework 2002272-002 AB 18100 Q ND -Fischer/ Stair Repairs 1954307-001 AB 18103 Q -Morns Inn/ Rohr's Reno BB 18105 TM -Mendoza/ Suite 101/102 AB 18106 TM -Mendoza/ Team Rooms AB 18107 TM -Stayer/ Misc Reno AB 18108 TM -PwrPlnt/ Misc Concrete AB 18114 TM ND-Nieuwland/Observatry Raiing 2003236-001 AB 18116 TM ND-Snite/ Dock Doors 1839904-002 AB 18117 Q UND Sports Field Specialites BB 18121 Q Zentis- Shipping Office 45953034 AB 18122 TM ND -Jordan/ 319-319A Cabinet 2003955-002 AB 18123 TM ND -McCourtney/ 153 Cabinet 2004072-001 AB 18125 TM -Cushing/ 112 Bench 2004407-001 AB 18126 TM -Hammes/ 119A Sheetrock 2004599-002 AB 18128 TM ConcordPerformingArt-WaterLeak TM 18130 TM Ideal -ND -Crowley/ Access Panel 10746 AB 18131 Q Stafford -Bethel/ CeilingRemval AB 18132 Q Zentis- Concrete Repairs 45954000 AB 18133 Q Martins -Goshen/ ConcreteRepair AB 18134 TM SisolyCross-Ceiling Repair B 18137 Q ConcordSchools- Office Reno 066088 TM 18139 TM -WSOA/ Patch & Paint AB 18140 TM BUSF ISHIG-ND/ WSOA Markb AB 19141 TM -Stepan/ 387 Cabinet 2005431-001 AB 18142 TM -Nieuwland/ 4th Floor Wall 2004810-003 AB 18143 TM ND-Nieuwland/ 4thFlrStairwell 2004810-004 AB 18144 Q LoganCenter- SAGA Classroom AB 18145 TM FederalMogul-EntranceDoors ZK00334436 AV 18146 Q ND- Robinson Community Center AV 18147 TM 1stSource-Dollar General Clean AB 18148 TM -McCourtney/De1ValleLabReno 2007360-002 AB 18149 TM -Fitz. 356 Water Leak 2006576-001 AB 18150 TM R&R- - Grotto/ Rails 4275 AB 18152 Q ND-esLibrary/ Dock Fence P 1952420 AB 18153 Q UND - Dillion Hall - 2019 0719.106 TB 18154 TM Ideal -ND -Cushing/ Door Removal AB 18155 TM ND -Stepan/ 1st Floor Ceilings AB 18156 TM IstSource-Niles/Ceilinglnslutn AB 18157 TM Keybank-Ireland/ Roof Leak AB 18158 TM -Sitework/ Misc Benches 2008262-002 AB 18159 TM ND-FootballFac/ Misc Concrete AB 18160 TM -SDH/ Pizza Pi Umbrella Base AB 18161 TM -Jordan/ Entry Repairs 2008514-002 AB 19162 Q Zentis- Breakroom Repairs 45957352 AB 18163 NTE KW-MotorShop/ Doors AB Film Platform Concrete Foundation Andre House- Living Room Page: 3 10/15/2019 08:27 am Company: Al ZIOLKOWSKI CONSTRUCTION, INC. Jobs Active Since: 01/01/1990 Thru Month Ending: 10/31/2019 Open Jobs Only Billed Under Job Number Type Job # Cuntomr Name Contract Number PM Job Description 18214 Q BrotherHolyCross- RestroomReno JW 18215 Q ND -Jordan/ 319 Reno AB 18216 TM ND -McCourtney/ Lab 363 Misc 2015685-001 AB 18217 Q ND-Rolfs/ Fencing P1959028 AB 18218 Q SC- Balcony Railing Repair 41038840 BH Sisters of Holy Cross 18219 TM I stSource-Valpo/PaintDoors AB 18220 TM ND -Cushing/ 103A & 103B 2015850-001 AB 18221 Q ND -Grace/ Guardrail 2016153-001 AB 18222 Q ND-LaFortune/Ceiling Replacernt 2014721-002 AB 18223 Q ND -Main/ 311 Infill 2016725-001 AB 18224 TM ND -Galvin/ VPP Anchor Points 2016507-001 AB 18225 Q ND -Siegfried/ Wardrobe Closets AB 18226 Q DcCook- Fab Shop Door Replace 1592424 REL 15 BH 18227 Q DcCook- MOF Door Replacement 1592424 REL 15 BH 18228 Q DcCook- Training Cntr Door Rep 1592424 REL 15 BH 18229 TM I stSource- Banker Trays AB 18230 Q Ideal-ND[Walsh- Vestibule FCU 10768-145 AB 18231 Q Ideal-ND/Walsh-AV Cooling Unit 10769-145 AB 18232 TM ND -Facilities/ Door Repair 2018089-001 AB 18233 TM ND-WestLake/ Railing -Safety 2017993-001 AB 18234 Q AM General- Drywell Sealing 4300002163 AB 18235 Q AM General- Concrete Repair 4300002164 AB 18236 TM ND -Jordan/ Water Damage 2017915-001 AB 18237 Q ND -Alumni/ Counter Rework AB 18238 Q ND -Security/ Office 214/219 AB 18239 NTE I stSource-Main/ 5th Flr Office AB 18240 TM ND -Galvin/ 033 Fume Hood 2018640-001 AB 18241 Q ND-McGlinn/Weight Room 2018549-002 AB 18242 TM ND-SDH/ Window 2016834-001 AB 18243 Q ND -Stinson/ 324 Reno 2014701-001 AB 18244 Q DCCook- OCC/ Add Window 1592424 BH 18245 Q AmericanLegion- Front Handrail AV 18246 TM ND-CatalogCnrt/ Roof Protean AB 18247 Q 10 11 -KeyBank/Conerete Repair AB 18248 Q ND-FisherGrad/ Replace Doors 2019254-001 AB 18249 TM ND -Cushing/ 123 Reno 2019416-001 AB 18250 TM ND -Galvin/ 313 Renovation 2016632-002 AB 18251 TM ND -Galvin/ 105 B-C-D Reno 2016633-003 AB 18252 TM ND-TunncY Concrete Lids AB 18253 TM ND-DeBartolo/Scaffolding 2019692-001 AB 18254 TM ND-Nieuwland/ 093 Stairs 2019633-001 AB 18255 TM ND -Cushing/ Shelves 2019592-001 AB 18256 TM ND -Galvin/ 266 Reno 2016938-002 AB 18257 TM ND-Reyniers/ Rohr's Shelves 193654-012 AB 18258 TM ND-CedarHouse/ New Door 2019898-001 AD 18259 TM ND -Fitzpatrick/ 150 Renovation 1942451-003 AB 18260 Q TomWaIz- Facade Reno BH 18261 TM SHC- Smoke Seals 41038999 BH 24400 Q Handley Elementary/Laporte"" 56365/fl-2 CS Larson Danielson Page: 5 10/15/2019 08:27 am JOB LISTING Company: Al ZIOLKOWSKI CONSTRUCTION, INC. Jobs Active Since: 01/01/1990 Thru Month Ending: 10/31/2019 Open Jobs Only Page: 7 10/15/2019 08:27 am Billed Under Job Number Type Job # Customer Name Contract Number PM Job Description 24740 Q 17850 ND-Hesburgh/ Washing Concrete CK 24741 Q 17848 SBWWTP- Masonry Restoration"* BD 24743 Q 24733 Study Elem. School/Wndw Infill RU Masonry Window Infill 24747 Q MemorialHosp-CaulkingStonePtch BD 24749 Q 17851 ND-MensResidence/ Brick Pavers RU 24753 Q KankakeeMiddle-2019 Flashing CS 24754 Q 17850 ND-Garbanzo/ Enlarge. HVACOpenn CS 24755 Q 24753 KankakeeMiddle- Masonry Repair BD 24757 Q 24736 LakevilleFire-Masonry Clean*** CK CLEAN & CAULK 24760 Q IIJ-Kokomo-Student Cnter******* 19-07-002 D2 NEW STUDENT ACTIVITY CENTER 24766 Q 17935 ND -Siegfried/ 2019 Hall Reno TE 24768 Q Tipton County Jail 2019-010 SS 24772 Q St.MattsCathedral-Masonry Rep BD 24775 Q Porter Co N Annex Bid Pkg # 2 190087 CS 24776 TM ND-GUG/ Clean Stain South Door 1943635-001 CK 24779 Q Delphi Watermain 1419029 SS 24787 Q Honeywell-NcwCharl0FurnaceFrbk 50.466529 RU 24794 Q MorrisPerformingArts-Caulking 119-050 CK 24798 Q LIBERT TOWER*************** 19001-06 RU EnvirGlass-LibTwr/BaseReplacmt 24800 Q ScottFordRes- Paver Repair BD 24802 Q 18056 Mish-Ironworks-Beer Garden PLT- 19-005 TE 24803 Q GoshenTheater Reno Phase I 180249-ziolk BD 04-020 Masonry 24806 Q 18048 SBCSC-Clay Int'l - Phase 11 RU 24809 Q IPC Water Treatment 70647 SS IPC Water Treatment 24812 Q St.Mary-HolyCross/TuckpntBnmt BD 24813 Q 18058 ConcordHS-Performing Arts CS 24816 Q StMonicaSch- Tuckpoint Masonry BD 24818 Q 18070 GEMarshall-ND/FS Bench Pavers RU 24824 Q 24813 ConcordHS- Performing Arts BD Clean Masonry and Caulking 24925 TM PennHS- Extra Work TE 24827 Q Steinberger/Masonry 190044-07 SS Anderson Hammermill Clymens 24828 Q Steinberger-Subaru/ServiceReno 180432-09 Ss 24829 Q 18072 StMarys-McCandless/ Reno P0027142 CS 24831 Q 18077 ND-Decio/ 4th Flr Reno TE 24833 Q Rensselaer Hosp - Flashing 702674 CK 104ft second floor and 100 ft third floor 24835 Q 18072 StMarys-LeMans/ Hall Reno CS 24839 TM ND-Hesburgh/RmveGrout&Recaulk 2003018-001 CK 24840 Q 17852 ND-Corby/Acoustical Sealant BD 24842 Q 18121 Zentis- Shipping Office 45999953034 CS 24844 Q St. Boniface Chruch BD 24845 TM Skillman -Niles Schools TE Northside & Southside Schools 24848 TM 18026 ND -Jordan/ Brick Paver Repair RU 24849 Q First Farmer Bank BD 24850 Q 18146 ND -Robinson Community Center D2 24851 Q 18162 Zentis- Breakroorn Repairs CS 24852 TM GEMarshall-ND/ CMU Tunnel RU 24853 Q Tecton-Tipp County Commisions 4B MASONRY SS 24854 Q 18153 UND-Dillon Hall/ Renovations CS 24855 TM UND- Dillon/ Extra -Tracking CS Company: Al ZIOLKOWSKI CONSTRUCTION, INC. Jobs Active Since: 01/01/1990 Thm Month Ending: 10/31/2019 Open Jobs Only Billed Under Job ftb.. Type Job # Customer Name Contract Number PH Job Description 33398 Q 18038 ND- LaFortune/ Suite 200 Reno M 33399 TM 18029 MartellElectric- Carpet M 33400 Q 18052 ND -Morris/ B70 Carpet M 33401 TM 55631 ND -Fitzpatrick/ 275A Carpet M 33402 Q 19037 ND -Grace/ Stairwell Flooring M 33403 Q 18036 ND -Grace/ 1st Floor Lobby M 33404 Q AMG-2019 Shutdown Carpet 4300001738 M 33405 Q ND-Arlotto/RubberFloorReplmnt M 33406 Q ND -Debartolo/ Carpet Replacernt 1942390-001 M 33407 TM ND-Rolfs/ Carpet Repairs 1845962-012 M 33408 TM 18105 ND-Mendoza/I 0 1 - 102 Carpet M 33409 TM 18106 ND -Mendoza/ Team Rm Carpet M 33410 TM 18107 ND -Stayer/ Carpet M 33412 TM Gibson-ND-Hessert/Flooring M 33413 TM Gibson-ND-Pangbom/Flooring M 33414 TM Gibson-ND-O'Shag/ Flooring M 33415 TM Gibson-ND-Decio/ Flooring M 33416 Q 18144 LoganCntr- SACA Classroom M 33417 TM GibsonLewis-ROTC/ Rm 112 M 33418 TM Gibson-BreenPhillips/Flooring M 33419 TM 55692 ND -Fitzpatrick/ 267 Carpet 2007082-001 M 33420 Q ND -Dry Dive/ Carpet M 33421 TM Gibson- MorseColeman/ Carpet M 33422 TM 18180 ND -Fitzpatrick/ 173 Carpet M 33423 Q COOK- STOCK CARPET M 33424 Q BremenElementary/ Flooring M 33425 Q ND-Hagger/ 216 Carpet P1958464 M 33426 TM 18185 ND -Fitzpatrick/ 256C Carpet M 33427 Q ND -Hammes/ 214 Carpet M 33428 Q 18225 ND -Siegfried/ Wardrobe Closet M 33429 Q 18215 ND -Jordan/ 319 Carpet M 33430 TM 18200 MidlandEng/ Office Carpet M 33431 Q ND -Legends/ Carpet Replacement 2019627-001 M 33432 Q CleanRms-MerrilL/ Vinyl Floo 58315 M 33433 Q AM General- Carpet Replacment M 55108 Q Ballard Elementary/Berrien 214173-05 M11 Paint Niles Comm Schools 55297 Q 33286 New Prairie Schools -Painting" JG 55353 Q 24605 Indiana State Prison/Mich City JG Various Painting 55356 Q New Lincoln JHS JG 55377 Q 17460 Central Park/Band Shell MH Band Shell 55413 Q Robert Henry (Siernan's) JG 55415 Q 17474 Concord High School JG Additions & Renovations 55425 TM 17175 Martell/Copsholm/House Wire JG 55438 Q 17398 City of SB/Fire Station #9 JG 55443 TM ND-McCourtney/DA Dodd JG Water Damage (Robert Henry) 55460 Q Logan Center/Autism Center JG 55474 Q Honeywell -Meter Lab Floor MH 55476 Q 17668 ErskineClub-Painting & Taping JG 55480 Q 17527 PerfServofStJoe-VAV Replacenurt JG Page: 9 10/15/2019 08:28 am JO� LISTING Company: Al ZIOLKOWSKI CONSTRUCTION, INC. Jobs Active Since: 01/01/1990 Thru Month Ending: 10/31/2019 Page: I I Open Jobs Only 10/15/2019 08:28 am Billed Under Job Number Type Job # customer Name Contract Number PM Job Description 55655 TM ND -Galvin/ Paint RM 244 2002272-004 JG 55656 TM ND -Hayes/ RM 230 Wall 2002475-002 JG 55657 Q 18100 ND-FischerGrad/ Stair Repairs JG 55658 Q 18033 SisHolyCross/ Guest House JG 55661 TM Weigand-StMary/AngelaTchup JG 55662 Q 18080 ND-Zahm-Badin/ Handrails JG 55665 Q St.Marys[LeMans-Ceiling Repair P0027221 JG Stapleton Lounge 55666 TM 18116 ND-Snite/ Exterior Doors 1839904-002 JG 55667 TM 18107 ND -Stayer/ Mise Reno JG 55668 TM 18106 ND -Mendoza/ Paint Team Rooms JG 55669 TM 18105 ND -Mendoza/ Suite 10 1 - 102 Reno JG 55671 Q 18072 StMarys-McCandles-LeMans- Reno JG 55672 TM AEP-Bentonffbr/ Ext Doors JG 55673 TM AEP-Buchanan/ Ext Doors JG 55676 TM 18126 ND -Hammes/ 119ATape&Paint JG 55678 Q St.Mary-LeMans/SFoyerCeilingRp JG 55679 Q StMary-LeMan/GrandLobbyCeiling JG 55690 Q 17880 Chandler/ Patch&PaintRockWall JG 55681 TM ND-Nieuwland/StairwayEfisRep 2004810-004 JG 55682 Q StMarys-MainFIrWoodStain P0027207 JG 55683 Q StMarys-Dining&CyberCafe JG 55684 TM AEP-BffntonHarbor/ Dock Lines JG 55686 TM 18128 Concord -PAC/ Insurance Work JG 55687 Q 18144 Logan Center -SAGA Patch & Prit JG 55688 TM 18139 ND-WSOA/ Patch & Paint JG 55691 Q StMary-LeMan/Exterior Vents P0027267 JG 55692 TM ND -Fitzpatrick/ 257C5 Paint 2007082-001 JG 55693 TM ND -Cushing/ 106C Touchups 2007281-001 JG 55694 TM 17852 ND -Corby Hall/ Refinish Doors JG 55695 TM ND- Stepan/ Hallway Touchups 1942248-012 JG 55696 TM ND -Jordan/ S Entrance Touchups 2008514-001 JG 55697 Q 18056 Mishawka-Beer Garden Painting JG 55699 TM ND-Nieuwland/ 372 Paint &Patch 2004810-006 JG 55700 Q ND-FisherGrad/ Light Poles JG 55701 TM Weigan- BerrienSprings/ Taping JG 55702 Q WalshKelly- Eifis Repair JG 2930 MCKINLEY AVE. SOUTH BEND, IN 55703 TM ND-CedarHouse/ Deck Staining 1908849-002 JG 55704 Q 18146 ND -Robinson Community Center 18146-04 JG 55706 Q 18173 ND-JACC/ C108 Reno JG 55708 TM StMary-AngelaAthletie/Wall&Bse JG 55709 ND -Galvin/ Roof Doors 2002608-004 JG 55710 TM ND-Nieuwland/ Hallway Tchups 2004810-009 JG 55711 TM ND -Maintenance/ Patch & Paint 2011292-001 JG 55712 TM ND -Fitzpatrick/ B06 Paint 2011005-001 JG 55713 TM 18188 ND-WSOA/ P&P Tackboards JG 55714 TM 18187 ND -PE/ Paint New Door & Frame JG 55716 TM 18185 ND -Fitzpatrick/ 257 Reno JG 55717 Q CenturyCenter/Ext Skywalk JG City of South Bend 55718 TM ND-Haggar/ B 020c Touchups 2005937-001 JG