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HomeMy WebLinkAboutOpening of Bids - Main & Colfax Parking Structure Proj No 119-078R - T. George Podell & Co. -Bid security check submittedDate: Address: CITY OF SOUTH BEND, INDIANA ONTRACTOR'S BID FOR PUBLIC W Project Name M..�olfax Parking Structure Paint Removal Poject No. 9-078R For Bids Due November I 19 PART I (Must be completed for all bids. Please type or Bidder (Firm): C 0 rz i, IN65 City/State/Zip: 9.,Ak-6 --- ,,4A k�Telephone Number: Agent of Bidder (if Applicable): Pursuant to notices iven. the g public works Project of: ed o furnish labor andio`r­m-'a erial necessary to complete the the City Of South Bend, Indiana, in accords with plans and specifications prepared by: and dated for the sum of (enter the Total Bid as shown on the Proposal) (N L�W(e nca The undersigned further agrees to furnish a bond or certified check with this bid for an amounts pecified 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 separat )attach �ent By ie of Person Igning) The above bid is accepted this ACCEPTANCE Subject to the following conditions: day of BOARD OF PUBLIC WORKS Gary A. 6iF6t,­j5residen—t Elizabeth A'. -—a--"-- a;ardik, Member Laura L. -b`§6-hivan, Member Genevieve ­ff.-Miller,—Me - rn r.. be _ r Therese J. Dorau, Member Attest: Linda'­M­­ — — . Martin, die—rk Version 4/2/2o1g Contractor's Bid for Public Works - 2 20 BID/PROPOSAL CITY OF SOUTH BEND Project Name: Parking Structure Paint Removal Project Number: Main 9.... .._ _.._...__ For Bids Due: No 12 2019 Contractor Name: � � __,...,...... ... �� .. C - BASE BID LIte Description No. 1 Remove Ceiling Coating Quantit y Unit Unit Price Total Amount 1 LS BASE BID TOTAL y Bidder (Firm): @,, c� n e- ._.. Address: City/State/Zip `.. y� -- Telephone l l l �.....__.��.�..�, pone Number: By .....� Q... 19nare)._...t�..e (Printed Name o�ersort Signing) Version 4/2/2o19 Contractor's Bid for Public Works - 7 When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit .ff az CON RAC: TOICS NON-COI,I,LISION AND NON -DEBARMENT AFF1DA V11°, CERTIFIC'ATICDN REGARDING INVP',S 1'M�ENT 'ITH IAN, EMP1.OVMENI FL,IIG,v VERIFICATION, RIFIC TION, ION - DISC IMIN.ATION COMM ITMEN'I ANID C E1�" 1FICA 1 rON OF 11L, PRODUCTS OR FOUNDRY PrlODUC II OFU L�i'$SI"I"hD STATES STEEL (Must be completed for all quotes and bids. Please type or print) STATE OF 11 COUNTY SS: Tile undersigned , Contractor, being duly sworn upon his/her/its oathaffirms under the penalties ofperjur that: y 1. Contractor has not, nor lr,rs any other iarerrrbe representative or argent of' the 11rrn, company, rxrrl rar<rtiora or frartareiship represented fly bill", entered into any col'llbin`tion,, c�:ollusicrrr or agreement will) Y 1 l taro farevent an arson any person relative to Ilre price to be lard by anycarac irr such letting taiir Mn. irr aarrlrrcc arryorrc irr arcfrarrr b riar Iyrdrlatag arrd that this bid is made witlroout rcftrenae�to spry catlrcr brelrar11 without any agrcerrrent, understanding or coinhination with any other person in reference to such bidding. C,"ontr rctor lauthcr ^gays Chart no person or persons, firms, or corporGitarwn has, have or will receive directly a��ar indirectly, any rebate, fee„lib r crrnwurssion or° thing ofvalue oan �rlcc()Unt of such gale; rrn(f pare2� Contractor certrllcs by submission of Ibis proposal that ncithe r�� Contractor nor any of its lariracilrrrfs ipali l in Illrrieel srarlaerrde(l, proposed for debarrne�rrt, dccfa'ri°carf irrc�ligilrlc, or voluntarilyexcleacled ficrnr pr�trticrpal'iorr in tlir`s taarrsrrction by any Federal dcpartrnerrt <°d agcrary; arrel 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investmentactivities in Iran. a. I rrr ptii Doses Cal this Certification, `Iran,, paeans t:lie government of Iran and any agency oi• ii1str-trtrtentmrlily of Iran, or as rather isc deflrred at Ind. Code § 5-22-16. -5„ as datraended 1'ron'tinge-to-trine. b. As provided by Ind. ode § . , 2-16.5-8, as ararended from time -to -time, a Contractor is engagecl in investment activities in Iran if either: i• Contractor-, its successor or its arI'fiiliaatc, provides goods or se�r,vi�ce�s twenty or million dollars ($20,000,000) or tno,re ila vailue in the energy sector of Iran: twen ii. Contractor, its successor or its affiliate, is a Iinancial institution that extends IWen ty million dollars ($20,000,000) ot. more it) credit to anotherperson1<;rr frarty-irvc (45) (lays or' more, rl thal pe.rse�in will ere (il use tlrcredit to provides goods and services ill tiae er°rergy sector in Iran; and (ii) at the Orne the financial institution extends credit, is ar person identified on list pnblishcd by the Indiana I cpar~ttncnt ol'Administratiora. Version 4/2/2019 Contractor's Bid for Public Works - 4 1. ('orrlr-actoa does not knowingly eraalaftayce or artatrr ict walla «a� ltersort thaat ithe Conrtractorosubse< ueTit6yaalcM�a°ln�a rs �raalia ra, nary ternary arty C,raratractaar aw r°ca s firer lrcdslac,/i1 shall enroll in aatal wrer rfy flee wrra°', eligibility unit'aathor ized �ahc rl. arewly hired eiralalcayecslaraeuh rite f Verily rrcras�aaa as ale("rrterl b l.( status of all of Contractor's dociratrcrat�atiraat of crart:allrateaat grad articala,rlrcara irr rlae II. Vcrrf l'rof,rtarra is irrelrrrled .rrar l�rrt�ta.�z�<.ontrlacto (of this bid/aluotc; and as 5. Contractor shall require ltis/I�rcrMs Subcontractors performingwear➢c arrtdei` rites public aonta°.rct to certify that the subctarrta actors d(,r atnt lertowuapy a aatltltay art contract with ar.0 unaartltcar"i�eal alien, attar retail) any halal e Sti of contract with, as person rlatitt t�lie snbcontractcn° subsequently learns is all unauthorized aaliora, araaf fleet flee stil contr�acfoa Maas enr(alled in and is participating iara� rile I__ Veral� l�r°o��rraraa. °'fife C"�tal.t"zrcrraa° to raaaaiai airy rites certification tI'rragrees .oaraliotrt: rile terau ofthe contra ct will( rile City trf"rant la f'catd, aaacf ruacler°st�ancls that tire, arty stay tcrattinate the contract for default irthc Contw'tha° lads y l'S a h Ben of"thus provision a racy latter than t.Iaiaty (30) al"ays after being notified fry rile (rty, (r. Persons, lazirtncrshilas, cor}aorations arssociations tar crint war.*nturers awarded a contract by the City of South IAcud thr0119I1 its agencies boards or corrtnrissious shall not discrintinale ar �arinst are afaflicant Iorera ployrnent in thellerforntarrcc ofa f ity contraact: wwillt raslaect t(:) l�lirc, teaat,uc, terrrrs, conditions, Y cntlal(rycc ttr�. or lei orl, cs ,, national c ri oa-any entry, dircetly of irreuraeetly related rta erirfslcryitaeut ecauwc all"race„ o , rclrfuaiir, color, riatiatia�tl taa'a irr, ancestry, gage„ gender OriI cirectlyrel gender icLloyit disability that. aloes riot affect that per;,ctn's arlarlit�y to r�fexpbrm rlre w Faark identity, sexual orientation or bidawarding contracts far- (lie fauachaase of work„ hrbor, services, supplies, c�a�iifitrenr„ raaat.cwiiaals, (,ra' any oielrdintartuoar ol'the fivegoing iaatlaaalirtg hart not lrirrited to, lai�ablic works contracts a�rwarded aanc'er lsralallc liia Iaws Or catltci cttnta,tc,rs it) which public beefs are not requiredby law, t'rc City, its rrgeiallud bta�ublic or cttiaairaissriaras may coatsrt'er the (onrractor s good f«ritlt c l"f(rrrs 1tr arlttaaiaw laartaeil�aal rcrrt by those Contractors certified Ia i Che t etc tad hatiiairra ,as a inor ity fftisirress ("MBE") or aas a W't`rrttert's f3aasri�tess Enterprise °"�� 131r:"' ,,is �a leaf tree ail t'ctermining the h;awest, a'eslaaarasablc, responsive bicldea, lea no evcnt shall persons or entities seeking the award of'aa City ccaritr ict lac aetluiraad l(a award as sarbaa(arrtract 10 cur 13.I /' HE- ltowevcr, ft ntay not unlawfully disaNr-iiarrnaatc Orgarnst e said Uired l :wa subc tr,,ic discrrrttaitaatoay larf it actice by the City'S Bf.?lNlfE Utilaration Board it period of (rrashall prohibit hat llersorr oa~ entity entity trr:ratt being awarded aCity contract liar r, f" I) yea'rr` from rite date art" such alutcrrttiiratican, arty' such cfeteantin<itiori may also be grounds RV terminating (Ile eontact �fiar which flue daserht��thratoi°y rarctit„e oa~ nonc,ortafaliance pertains. The undersigned ecrntraat0r ,'agrecs that the firlhtwhag nondiscrimivartictrt cornnitraacut shall be naaatle a part of away contract whaclt it array henceforth cater into with the City of �Soutlt Bent', laacliaaa�aa or any ta'f its a f oracies, boards of, Commissions, Contractor a,grccs not art discriminate rminarte against or intiutrdate ally Cartlaloyce� ctraltlr�Iieaartt fiat crarPloyi7acrtt ill rltu faerf«�rm l('11t of this ccairtr«act wetly ltr ivala,ges (rf"cntfalaaynaent or any artalter directly or indirectly related to carrlaltayntcrtt ltcaaau�sc trf ratcc, relitaarr color, sex,crtcicr crlaaussicarr, gertalc identity, handicap, (rational origin car ancestry. Ilr°caatla taf"this l-rrovision rttay'ae regarded as ataaaicrialaltw�ach(ot' e(iattr.tet, I, the aaitticrsahrtc,(I bidder- oi" agenfl, as ccrrttr"actor late as faarl�lic works rojeCt„ rartticrstautd rta tafrlgg�atattns to t�r� use of"steel laatatlticts or lKttandry products ittitcle irr t.hc Cfrtrt '1 States (l C'". 5-1 (r I ),1 laerclay y statlartor-y cc,rrrd"ar rltrrt l terra' call wtabc�taaatr�as„ttra�s� errtlaloyccl by rate tor this l�a`jcel will rrsc astcel products car• �liaariatlry laa(adrrcts iuradc rya rite United States cart gltis laictlectl ifawvardecl I arrrt'crstaaacl l ltarwrc an "a rrraratiwe cleat t�rt notify flee City ill my ball tlai��at fray far°�olaosaal does not include the rise of steel products or Ibundry products uaade in tits f,iaaated AStrtes l understand it is rtay� sole obligation and reslaonsibilhy t�o larowr,i(�fe a la4 tllfic;aatri�rrt rt) t'ac City, SarlaPri rca review Atn(l alalri~cawaal, why the coast of,``C/rtited States auade steel tar lbnndry laroducts is rodu (rrarrbla•. Prior to award "tart' upon subaarission of laid which toes not use steel products oa. foundry products m�ulc in flee I_Inilcd States, the (`aty, throrrglr its director of l)ubhc works, shall make a de�terntina[ion it-tlte Price taf`frrmitcd Stites made steel or fbundry is unmasonable, f understand rinit vicrhat-ions hereunder Version 4/2/2019 Contractor's Bid for Public Works - 5 may result in forfeiture of contractual payments. l hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid forpublic works are true and correct. Dated this day of_V\rrJ ZpA-eL trtattta of C t�tttrat totIiddet or It. s Agent � PrintedName and Title, Subscribed and sworn to before me this 2) day of �....:: My Commission Expires (J K r Public �, COuntY of Residence ��- dh 611A &] CHRISTINE L JOHNSON Notary Public SEAL State of Indiana MY Commission Expires August 26, 2023 Version 4/2/2019 Contractor's Bid for Public Works - 6 CITY OF SOUTH BEND+a MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM FORM MWBE-1.0 MBE/WBE PARTICIPATION' This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE/MBE participation„, It is the bidder's sole responsibility to verify whether any listed minority orwoman business meets the qualifications of a Minority or Women's owned business. Project Number: 119-078 Pro)ect�Name kin Struucture Patt Renj Main8 Crrmoar�_.ovql.. Bidder: _ Total Bid t _ MBE/VVBE Goal �alv Ww Page o Name &Address of MBEIWBE �_... mary Contact �Pr'e (Name(felephone)on ry Scope of Performed (Attach sc pe/schedule�if you bn need additional space) Amount MBE/WBE Comp nfent odDollar e m QnA,C-Q. . 6ev ^^^X Sar+a� lGS z .ems �Ass� �� e 00 tPdofit _ `1 �CvEe� �'�_ k c e um .j� cY c2 c'I c�`� ._._a Submitted by: lt, �d� ^ ����� t q Print Name.. .. _ alit�iu�re . Date _— ... _... ...,, Version 4/2/2019 Contractor's Bid for Public Works - 8 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY A DEVELOPMENT PROGRAM ,w 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 Pu11 blic 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"). 9-07Date: ^ \ Project Number: 11 8R � \,pl Project Name: � Main r � Colfax Parkin Structure Paint _ � � Removal Bidder: �.� �....._..,.�� .....� ..... .�.. � t W� Contact Person: Telephone: Address: P 31 +� City: State: �+� Zip .�J......w. To determine whether a bidder demon .t y.lC� co demonstrated good fail efforts to . gal t forth o in the City t of South Bend UIRE ALL of the Works Project Specifications, the City and itsB agencies, es utilization or se the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS Enterprise Diversity D y Minority and Women Business MBE/WBE LISTS evelopThe lment Program, whicdder reviewed the h the ID � approved OA a list of Minority and Women h Bend' tt P.//www m gov/idoa). Owned Business as found on their website (h (ADVERTISE/CONTACT): P P In orderer your bid to be deemed responsive, the City of South ACTION'_ outh Bend requires that all perspective bidders complete no less than 2 of the followin 1. Attend all pre -bid meetings scheduled by the City to inform MBE/WBEs of contracting and subcontracting opportunities. 2. Advertise in general circulation and/or trade association publications concerning subcontracting opportunities, and allow MBE/WBEs reasonable time to respond. 3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated to inform MBE./WBEs of subcontracting opportunities and allowed sufficient time for them to participate effectively. 4. Utilize pre-existing services of available community organizations, small and/or disadvantaged business assistance offices and other organizations that provided assistance in the recruitment and placement of MBENVBE firms. Bidder must circle or otherwise notate which of the two (2) required actions were performed. including providing such MBE/WBE s with adequate information about the plans, specifications ` GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBElWBEs, cations 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. m m.�__.� portions of ..,....�... . �_ ...�...�_. SMALL CONTRACT(S): The bidder selected specific the work to be performed by MBE/WBEs in order to increase the likelihood of meeting the MBEM/BE goals (including breaking down contracts into smaller units facilitate MBE/WBE participation) its to bid on the subcontracting ' The bidder has maintained CONTRACT RECORD �� aired the following records for S� each MBE/WBE that has rig 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 con as unqualified to perform the job. omissions shall tr ti considered t the d Faith Effort requires concluding ing that w.. ... idered rounds f fires our initialsnextto all of ' f Goo or rejection of the bid b the Board of Public Works. The City the above boxes An g � y of South Bend reserves the right to request additional information. Version 4/2/2019 Contractor's Bid for Public Works - 9 CITY OF SOUTH BEND'c 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 1.1 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 MBEM/BE Participation Goal � olo Project Number: 119 078R..... ,....... - .........._�... _...... Project Name: Ma in & Colfax Parkin Structure Paint Removal ........ .....m..,........... —._.,.�.....4 Bidder: � � ���:r t � � ..�®�, z_;� � � -�c , _._ .....s �. By: -w - �a gr�atarr� :..Tit�e�'� ( ) (Date) MBENVBE Firm c7 r cam^ Owner or Contact at MBE/WBE F irm �' �� TYPE OF -��.q..��.... �.( : Telephone kFax: mail ! � � �. . _ ��p Q l (. C, � WORK SOLICITED FOR THIS PROJECT: _ L 4� RESULTS OF CONTACT WITH THE MBENVBE FIRM: 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: r Version 4/2/2019 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. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE Attach an explanation of your plan or layout for performing proposed work. (examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which You believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside Your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work„ attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if You are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project„ you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the City of South Mend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 4/2/2019 Contractor's Bid for Public Works - 3 cnia'u. CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK'°` CHECKLIST FOR BIDDERS Project Name Main & Colfax Parking Structure Paint Removal Project No. 119-078R ........... For Bids Due- November 12....2019 ...... From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. Proper bid security included. The bidder has the option of providing either a Certified Check or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely _. executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and Certification of use of United States Steel Products or Foundry Products. Proof of MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted Form [MWBE-2.1]. Acknowledge Receipt of Z . Addendum(s) included with the bid. All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either printed or typed underneath signature. This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: �- t[ ��� __: �. m�." ........ .w n .. Date:...... m ... �-¢ .-��� By Authorized Representative; Signature---0��..,......".... ....... Print Name & Title: v.®►,l Gib � f Version 4/2/2019 Contractor's Bid for Public Works - 1 Western Surety Company CONTINUATION CERTIFICATE Western Surety Company hereby continues in force Bond No. 62275878 briefly as Principal, in the sum of $ FIVE THOUSAND AND N01100, Dollars, for the term beginning 2019 , and ending Nwem)20r 14 ,, 2020 , subject to all the covenants and conditions of the original bond referred to above. This continuation is issued upon the express condition that the liability of Western Surety Company under said Bond and this and all continuations thereof shall not be cumulative and shall in no event exceed the total sum above written. Dated this day of NQXP.Mber , 2019 o-ar��sv WESTERN URETY COMPANY M �x By ";- Paul T. Br at, Vice President oc w. r, 4P THIS "Continuation Certificate" MUST BE FILED WITH THE ABOVE BOND. Forth 90-A-8-2012 Western Siurety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America, does hereby make, constitute and appoint Paul T. Bruflat of Sioux Falls a State of South Dakota , its regularly elected Vice President as Attorney -in -Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, the following bond: RM I -INS! � I +I +7 iI4Tu`" + Il[ ! tl ', +l u� 1 w A411. FM ; bond with bond number for as Principal in the penalty amount not to exceed: $ 5 . U00.00 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force, to -wit: Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys -in -Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Vice President with the corporate seal affixed this 6th day of November 2019 ATTEST W E N S U R CO FAN Y By L. Nelson, Assistant Secretary Pau' Bruflat, Vice President STATE OF SOUTH DAKOTA' Ss COUNTY OF MINNEHAHA On this 6th day of November 2019 , before me, a Notary Public, personally appeared Paul T. Bruflat and L. Nelson who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as Vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument be the voluntary act and deed of said Corporation. +xoh�i h5�ih�ahhh�ahyhyhy'a"r + br S to J. 1VIUMN 8 a NOTARY PUBLIC s SOUTH DAKOTA s U Notary Public + My Commission Expires June 23, 2021 To validate bond authenticity, go to .cn r xa > Owner/Obligee Services > Validate Bond Coverage. Form F1975-1-2016 0 Entity Type: Domestic For -Profit Corporation Creation Date: 03/28/1983 Principal Office Address: 1400 S MAIN ST, SOUTH BEND, IN, 46613, USA Jurisdiction of Formation: Indiana Title Name Address Business Status: Active Inactive Date: Expiration Date: Perpetual Business Entity Report Due 03/31/2015 Date: Years Due: 2015/2016, 2017/2018, 2019/2020 President GEORGE T PODELL 17470 SKYLINE DR, SOUTH BEND, IN, 46614, USA Secretary Janet L. Podell 17470 Skyline Dr., SOUTH BEND, IN, 46614, USA Type: Individual Name: T. GEORGE PODELL Address: 1400 S MAIN ST., SOUTH BEND, IN, 46613 - 0000, USA hereby give my consent to authorize my employer known as T. George Podell & Co., Inc. and the testing laboratory designated to conduct analytical and random tests deemed necessary, on an ongoing basis, to determine the absence or the presence of Alcohol, Amphetamines, Cocaine, Opiates (2000 ng/ml), PCP & THC in my body through the use of urine, hair, blood, breath or any sample as specified by statute and regulation. I give my consent to release the results of the test(s) and other medical information from the laboratory to T. George Podell & Co., Inc. pursuant to statute or regulation with the condition that the results may not be used in any criminal proceeding. If employee fails drug test, that employee will be subjected to the items listed below. After a first positive test, an employee must be: • suspended from work for ninety (30) days; • directed to a program of treatment or rehabilitation; and • subject to unannounced drug testing for one (1) year, beginning the day the employee returns to work. After a second positive test, an employee must be: • suspended from work for ninety (90) days; • directed to a program of treatment or rehabilitation; and • subject to unannounced drug testing for one (1) year, beginning the day the employee returns to work, After a third or subsequent positive test, an employee must be: • suspended from work for one (1) year; • directed to a program of treatment or rehabilitation; and • subject to unannounced drug testing for one (1) year, beginning the day the employee returns to work. T. George Podell & Co., Inc. may request proof that I am taking a controlled substance as directed pursuant to a lawful prescription issued in my name. If requested, I agree to provide such proof within 72 hours. I have the right to request a re -test of the initial specimen at a licensed laboratory of my choice if and when I have a positive test for drugs. All requests for a re -test of the sample must be made within ten (10) working days of the receipt of the original positive test result. The results of the samples must be forwarded to me by the appointing authority of the licensed laboratory. I further understand that a positive test, refusal to authorize this form, refusal to take the test, or failure to produce a specimen, may result in disciplinary action up to and including dismissal in accordance with any local, State, or Federal statute, regulation, and policy. Employee Signature Date Print T. George Podell & Company, Inc. 23146 West Ireland Rd, South Bend IN, 46614 www.tgeorgepodell.com Owner: Thomas George Podell Capabilities: Sandblasting / Pressure Washing/ Waste Water Recovery & Recycling Co -Owner: Chris Podell Capabilities: Sandblasting / Pressure Washing/ Waste Water Recovery & Recycling Employee: Brian Starr Capabilities: Sandblasting / Pressure Washing/ Waste Water Recovery & Recycling Employee: Mike Hakes Capabilities: Sandblasting / Pressure Washing/ Waste Water Recovery & Recycling Employee: David Spilski Capabilities: Sandblasting / Pressure Washing/ Waste Water Recovery & Recycling Employee: Ron Simpson Capabilities: Sandblasting / Pressure Washing/ Waste Water Recovery & Recycling Employee: Joe Johnson Capabilities: Sandblasting / Pressure Washing/ Waste Water Recovery & Recycling PHONE (574)233-9111 "Since 1975" FAX (574) 233-3899 T. George Podell & Company, Inc. 23146 West Ireland Rd, South Bend IN. 46614 www.tgeorgepodell.com Projects: Project Name: Rig Mat Washer - Sterling Year: 2016 Amount: $468,270.00 Project Name: Sandblasting — ]gown & Brown Year: 2016 Amount: $13,720.00 Project Name: Sandblasting — :parson Danielson Year: 2017 Amount: $8,320.00 Project Name: Sandblasting — Vt Response Year: 2017 Amount: $6,600.00 Project Name: Sandblasting — Metalstamp Year: 2019 Amount: $8,320.00 PHONE (574)233-9111 "Since 1975" FAX (574) 233-3899 CONTRACT DOCUMENTS AND SPECIFICATIONS FOR Main & Colfax Parking Structure Paint Removal Project No. 119-078R October 2019 Prepared for CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Department of Public Works Division of Engineering ��,�h�kollI,IId t1 T. IV4 % 0ZZ w, N0, 60016991 STATE OF Roger T. Nawrot Registered Professional Engineer State of Indiana No. 60016991 FOR BIDS DUE: 9:30 a.m., November 12, 2019 City of South Bend, Indiana Department of Public Works Main & Colfax Parking Structure Paint Repairs Project No. 119-078R Notice to Bidders General Conditions Special Provisions Appendix [or Other/Additional Sections] City of South Bend Contractor's Bid for Public Work Form Version 1/11/2017 Table of Contents 1 Page 10 Pages 9 Pages 72 Pages 10 Pages NOTICE TO BIDDERS Notice is hereby given that the City of South Bend, Indiana, Board of Public Works will receive sealed bids at the Office of the Board of Public Works, County -City Building Room 1316, 227 West Jefferson Blvd, South Bend, Indiana, 46601 until the hour of 9:30 a.m., Local Time, on November 12, 2019 for the following: Main & Colfax Parking Structure Painting,Removal. Project No. 119-078R Work includes paint removal from the ceiling on the first four floors at the Main & Colfax Parking Structure in South Bend, all more particularly described in plans and specifications prepared by Department of Public Works, Division of Engineering, phone (574)235-9251. The Contract Documents are on file and available for public inspection commencing on the first advertise date during regular working hours at the Department of Public Works (1316 County -City Building, South Bend, Indiana), and at MACIAF 3215-A Sugar Maple Court, South Bend, IN 46628. Additionally, the Contract Documents will be available that same day for inspection or purchase at American Reprographics Company ("ARC", located at 1303 Northside Blvd., South Bend, Indiana, 46615), http://www.e-arc.com, (574) 287-2944, toll free at (800) 783-7231. There will be a non-refundable charge for reproduction as set by ARC for every set of documents for all bidders. Bids must be on the City of South Bend Contractor's Bid for Public Work Form, accompanied by a Certified Check or Bid Bond in the amount of not less than five percent (5%) of the base bid plus any alternates, in a sealed envelope noting the project name, number and your company's information on the front. Each bidder or contractor (hereinafter the contractor) must comply with "City of South Bend EEO Contracting Provision Diversity Utilization" included in the specifications as to each construction trade it intends to use on this construction contract and all other construction work (both federal and non-federal) in the St. Joseph County area during the performance of this contract or subcontract. The contractor commits itself to the goals for minority manpower and all other requirements, terms and conditions of these bid conditions by submitting a properly sealed bid. Woman and Minority -Owned Business Enterprises (W/MBE) are encouraged to respond to this notification. 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 Bidder Ordinance no later than the date of the public bid opening. Please note: The City reserves the right to request supplemental information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified status. A Pre -Bid Conference will be held on October 30 2019 at 11:00 an, Local Time at the Office of the Board of Public Works, County -City Building, 13th Floor Conference Room, 227 West Jefferson Blvd, South Bend. Any questions about bidding conditions must be addressed to the Owner in writing no later than November 7, 2019, end of day. The Board reserves the right to reject any or all bids or to accept a full or partial award of the bid or bids which, in its judgment, will be to the best interests of the City of South Bend. If the Board elects to award the base bid plus an alternate(s), the Board will look at the totality of the cost when determining the lowest, responsive and responsible bid. BOARD OF PUBLIC WORKS Linda M. Martin, Clerk Publish two (2) times: October 11, 2019 October 18, 2019 Notice to Bidders CITY OF SOUTH BEND STATEMENT OF POLICY The Board of Public Works of the City of South Bend has adopted the following policy regarding the receipt of sealed bids: All sealed bids submitted to the Board of Public Works must be received in the Board of Public Works Office, 1316 County -City Building, South Bend, Indiana, no later than the advertised time on the advertised date of the bid opening. It shall be the responsibility of the bidder to see that his/her bid is received prior to the deadline stipulated in the bid advertisement. Bids submitted by mail and received after the advertised time deadline will not be considered by the Board. CITY OF SOUTH BEND BOARD OF PUBLIC WORKS Linda M. Martin, Clerk NOTE: Incoming mail does not reach the Board of Public Works until after 9:30 a.m. Local Time. If you are sending your bid via Federal Express or another overnight source, please confirm that your package will arrive before the bid opening date and time. Version 3/19/2019 General Conditions - 1 CITY OF SOUTH BEND EQUAL EMPLOYMENT OPPORTUNITY CONTRACTING PROVISIONS DIVERSITY UTILIZATION It is the policy of the City of South Bend to provide equal employment and business opportunity for all persons, partnerships, companies, and corporations in accordance with the rules, regulations and guidelines of the applicable federal, state and local laws. This policy of equal employment and business opportunity shall apply to every contractor or subcontractor bidding or holding a public contract with the City of South Bend. In furtherance of this policy, the following Equal Opportunity Clauses are hereby made a part of every construction contract entered into by the City of South Bend and all subcontractors entered into pursuant to any such contract and the bidder hereby certifies that it/he/she will abide by these provisions. The contractor will not discriminate against any applicant or employee because of race, color, religion, sex, national origin, or handicap. The contractor will take affirmative action to ensure that all applicants or employees are treated fairly and equitably. Such action shall include but not be limited to the following: hiring, up- grading, demotion or transfer, recruitment, advertising, lay-offs or termination, rates of pay or other forms of compensation and selection for training including apprenticeship programs. The contractor shall agree to post in conspicuous places available to employees and applicants, notices to be provided setting forth the provisions of the Non -Discrimination Clause. The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. The contractor will send to each labor union or representative of workers with which it/ he/she has a bargaining agreement or other contract or understanding, a notice to be provided, advising the labor union or worker's representatives of the contractor's commitment under this section, and shall post copies of the notices in conspicuous places available to applicants and employees. The contractor will comply with all provisions of Executive Order 11246 (as amended by 11375) and of the rules, regulations and relevant orders of the Department of Labor. Subpart B --Contractors' Agreements Sec. 202. Except in contracts exempted in accordance with Section 204 of this Order, all Government contracting agencies shall include in every Government contract hereinafter entered into the following provisions: "During the performance of this contract, the contractor agrees as follows:" "(1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated equally during employment, without regard to their race, color, religion, sex or national origin. Such action will include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or Version 3/19/2019 General Conditions - 2 recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause." "(2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex or national origin." "(3) The contractor will send to each labor union or representative of workers with which it/ he/she has a collective bargaining agreement or other contract of understanding, a notice, to be provided by the agency contracting officer, advising the labor union or workers' representative of the contractor's commitments under Section 202 of Executive Order No. 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment." "(4) The contractor will comply with all provisions of Executive Order No. 11246 of September 24, 1965, and of the rules and regulations, and relevant orders of the Secretary of Labor." "(5) The contractor will furnish all information and reports required by Executive Order No. 11246 of September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders." "(6) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, in this contract may be cancelled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order No. 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked* as provided in Executive Order No 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law." "(7) The contractor will include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions including sanctions for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the contractor may request the United States to enter into such litigation to protect the interests of the United States." The applicant further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work: Provided, that if the applicant so participating is a State or local government, the above equal opportunity clause is not applicable to any agency, instrumentality or subdivision of such government which does not participate Version 3/19/2019 General Conditions - 3 in work on or under the contract. The applicant agrees that it will assist and cooperate actively with the administering agency and the Secretary of Labor in obtaining the compliance of contractors and subcontractors with the equal opportunity clause and the rules, regulations, and relevant orders of the Secretary of Labor, that it will furnish the administering agency and the Secretary of Labor such information as they may require for the supervision of such compliance, and that it will otherwise assist the administering agency in the discharge of the agency's primary responsibility for securing compliance. The applicant further agrees that it will refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for, Government contracts and federally assisted construction contracts pursuant to the Executive Order and will carry out such sanctions and penalties for violation of the equal opportunity clause as may be imposed upon contractors and subcontractors by the administering agency or the Secretary of Labor pursuant to Part II, Subpart D of the Executive Order. In addition, the applicant agrees that if it fails or refuses to comply with these undertakings, the administering agency may take any or all of the following actions: Cancel, terminate, or suspend in whole or in part this grant (contract, loan, insurance, guarantee); refrain from extending any further assistance to the applicant under the program with respect to which the failure or refund occurred until satisfactory assurance of future compliance has been received from such applicant; and refer the case to the Department of Justice for appropriate legal proceedings. * Corrected to read "invoked". In the original text the word "involved" was printed in error. Version 3/19/2019 General Conditions - 4 MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM The City of South Bend, Indiana has shown its commitment to addressing Minority Business ("MBE") and Women's Business Enterprise ("WBE") participation in public contracting through the adoption of the City of South Bend Ordinance No. 10081-11. Persons, partnerships, corporations, associations, or joint ventures 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 or disability that does not affect that person's ability to perform work. Minority and Women's Businesses are described on the Indiana Department of Administration website: 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. Documentation shall be provided with the bid that states the MBE/WBE that will be contracted, the dollar amount of the work that will be performed on the project and the percentage of the dollar amount as it relates to the total bid amount by using Form MWBE-1.0, MBEM/BE Participation Form. The City, its agencies, boards, or commissions requires the Contractor's good faith efforts to obtain participation by those Contractors classified as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE"). Failure to provide ALL the required evidence of good faith efforts with the bid will be grounds for rejecting a bid as non -responsive. The requirements that bidders shall supply as good faith efforts to have active participation from MBEs and/or WBEs on this Project is written documentation evidencing the efforts by using Form MWBE-2.0, Evidence of Good Faith Efforts and Form MWBE-2.1, MBE/WBE Contacted. Such documentation shall include but is not limited to the following items: a. A listing of all MBE/WBEs contacted including: (1) the name and address of the MBE/WBE; (2) the date of contact; (3) the type of contact (i.e. phone call, written solicitation, etc.); (4) the nature or type services or goods requested; and (5) the result of the contact. b. Written evidence of outreach and copies of email exchanges inviting and receiving quotes or other responses from MBE/WBE businesses or other documentations of efforts to encourage and secure competitive quotes from MBE/WBE and local businesses to be included in the benefits of building this Project. c. Written documentation of letters of introduction, invitations to forging majority/minority strategic alliances for capacity building including but not limited to mentoring, extensions of assistance on payroll, insurance, bonding, line of credit, technical skills or business skills. All bidders are actively encouraged to reach out to the MBE/WBE businesses in St. Joseph County, Indiana and other local Indiana counties to utilize a good faith effort to forge constructive and lasting business partnerships. Notwithstanding the foregoing, the award and performance of all City contracts shall comply with applicable federal, state, and local laws. Version 3/19/2019 General Conditions - 5 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name Main & Colfax Parking Structure Paint Removal Project No. 119-078R For Bids Due November 12, 2019 Contractor Name: C C- The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 63 of The Responsible Bidding Ordinance No. 10594-18 (hereinafter, "Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders") by December 31 st for the upcoming calendar year, or within twelve (12) months of obtaining pre - qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective January 1 of the following year, or immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 3/19/2019 General Conditions - 6 POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder and all subcontractors on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 3/19/2019 General Conditions - 7 II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: °�By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. (ii) V"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) I�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) a By checking this box, I hereby acknowledge and ensure that I and all subcontractors, 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 subcontractor loses their license at any point, it is the responsibility of that subcontractor to notify the City. NOTE: All T. George Podell & Co., Inc employees are trained in-house. (b) Attachments: (i) ZIndiana 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, sale proprietors or partnerships). (ii) �st identifying all former business names. - Company name has always been T. George Podell & Co., %ny (iii) 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, with in the preceding five (5) years. — Never have had any violations. (iv) 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 intendto eet the staffing needs of the work. 7 (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) ZFor every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. - All T. George Po I & Co., Inc employees are trained in-house. (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) �idence 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. (ix)NJ± 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) ZList 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: (Sign Here) (Print Name Here) Thomas George Podell (Name of Company) T. George Podell & Co. (Address of Company) 23146 Ireland Rd (City) South Bend (State) Indiana