HomeMy WebLinkAboutOpening of Bids - Gemini at Colfax Exterior Renovations – Proj No. 119-103 - Slatile Roofing & Sheet Metal Co., Inc.le5-
CITY OF SOUTH BEND, INDIANA �w
CONTRACTOR'S BID FOR PUBLIC WORK
CHECKLIST FOR BIDDERS
Project Name Gemini at Colfax Apts. — EXTERIOR RENOVATIONS
Project No. 119-103
For Bids Due February 25, 2020
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
J met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted
Form [MWBE-2.1].
I Acknowledge Receipt of 1,2,3 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.
g 2/24/2020
Bidder: Slatile Roofing and Sheet Metal Co INC. Date:
By Authorized
Signature:
Print Name &
Version 4/2/2019 Contractor's Bid for Public Works - 1
„,4t GPC f
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK`
Project Name Gemini at Colfax Apts. — EXTERIOR RENOVATIONS
Project No. � 119-103
For Bids Due February 25, 2020
PART I _
(Must be completed for all bids. Please type or print)
Date: 2/24/20 Bidder (Firm); Slatile Roofin
and Sheet Metal Co. INC.
Address: 1703 S. Ironwood Dr.
City/State/Zip: South Bend/IN'/40013 Telephone Number:
233-7435
Agent of Bidder (if Applicable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of:
Exterior renovations at the Gemini -Colfax A artment Buildin
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
South Bend Herita a Foundation, Inc.
and dated Januar 17, 20200 for the sum of (enter the Total Bid as shown on the Proposal)
One hundred eighty four thousand six nin t three dollars
A 4.503 0(l )
( Enter sum of Total Division A Base Sid plus positive value
(Numerical)
Alternates shown on Pro osal)_
Three hundred five thousand dollars
B($ 305,00.00 )
(Enter sum of Total Division B Base Bid plus positive value
(Numerical)
- -- Alternates shown on Proposal)
No Bid
D($ No Bid )
(Enter sum of Total Division C Base Bid plus positive value
_ (Numerical)
..... Alternates shown on Proposal
No Bid
D($ No Bid )
(Enter sum of Total Division D Base Bid plus positive value
(Numerical)
Alternates shown on Pro osal
No Bid
E($ No Bid
(Enter sum of Total Division E Base Bid)
(Numerical)
N Bi
E1 No Bud
Division E alternate #1
(Numerical)
No Bid
E2 No Bid
Division E alternate #2
(Numerical)
No Bid
E3
Division E alternate #3
(Numerical)
RQ Bid
E4q No Bid
Division E alternate #4
(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 addenda attached will be specifically referenced at the applicable page.
Version 4/2/2019 Contractor's Bid for Public Works - 2
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 (Sigq mm
nature)
_AA
......
Gerald eret - 'resident
(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 Joseph R. Molnar, Member
Elizabeth A. Maradik, Member Therese J. Dorau, Member
Jordan V. Gathers, Member Attest: Linda M. Martin, Clerk
Version 4/2/2019 Contractor's Bid for Public Works - 3
20
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 Bend awarding the contract must be specific
enough in detail so that said City of South Bend can make a proper determination of the bidder's
capability for completing the project if awarded.
Version 4/2/2019 Contractor's Bid for Public Works - 4
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 �� )
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, firms, or corporation has, have or will receive directly or
indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals
are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency; and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
a. For purposes of this Certification, "Iran" means the government of Iran and any agency
or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as
amended from time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor
is engaged in investment activities in Iran if either:
i. Contractor, its successor or its affiliate, provides goods or services of twenty
million dollars ($20,000,000) or more in value in the energy sector of Iran;
or
ii. Contractor, its successor or its affiliate, is a financial institution that extends
twenty million dollars ($20,000,000) or more in credit to another person for
forty-five (45) days or more, if that person will (i) use the credit to provides
goods and services in the energy sector in Iran; and (ii) at the time the
financial institution extends credit, is a person identified on list published by
the Indiana Department of Administration.
Version 01/29/2020 Contractor's Bid for Public Works - 5
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any
employee or contract with a person that the Contractor subsequently learns is an unauthorized alien.
Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's
newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's
documentation of enrollment and participation in the E-Verify Program is included and attached as part of
this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public contract to
certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien,
and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees
to maintain this certification throughout the term of the contract with the City of South Bend, and understands
that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision
no later than thirty (30) days after being notified by the City.
6. Persons, firms, 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 will consider the Contractor's good faith efforts to obtain participation by those
subcontractors 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.
Contractors seeking the award of a City contract cannot be required to award a subcontract to an-MWBE;
however, they may not unlawfully discriminate against said MBE/WBE. A finding of noncompliance or a
discriminatory practice shall prohibit that Contractor 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 to which the discriminatory practice or noncompliance pertains.
7. The undersigned Contractor agrees that the following nondiscrimination commitment shall be made
a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its
agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the
performance of this contract with privileges of employment, or any matter directly or indirectly related to
employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation,
handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of
contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1).1 hereby
certify that I and all subcontractors employed by me for this project will use steel products or foundry
products made in the United States on this project if awarded. I understand I have an affirmative duty to
notify the City in my bid that my proposal does not include the use of steel products or foundry products
made in the United States. I understand it is my sole obligation and responsibility to provide a justification
to the City, subject to review and approval, why the cost of United States made steel or foundry products is
unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry
products made in the United States, the City, through its director of public works, shall make a determination
if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder
may result in forfeiture of contractual payments.
Version 01/29/2020 Contractor's Bid for Public Works - 6
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 24th day ofPebr'uar ' 20 20
lathe Roofing and Sheet Metal Co, INC.
Contractor/Bidder (Firm)
Signature of Contractor/Bidder ('ls nt -
Gerald Longerot - Presiderd o
Printed Name and Title :-
NAM,.
Subscribed and swornto before me this 24th day of February , 20-2a
My C,
N UBUC Notary Public
SIEAL S�— "
TA OF INI�I�+ unty of I' sidence
My COMMISSION FXpJRE8 DO MI3' 111, 2g27
oM I SIGN NUMLIER t4P07241 7
Version 01/29/2020 Contractor's Bid for Public Works - 7
--SAIA oc eA31 TM -2010
CONTRACTOR:
(Name, legal status and address)
Slatlle Roofing & Sheet Metal Co., Inc.
1703 S. Ironwood Drive
South Bend, IN 46613
OWNER:
(Name, legal status and address)
City of South Bend
227 West Jefferson Boulevard
SURETY:
(Name, legal status and principal place
of business)
Hudson Insurance Company
100 William Street, 51h Floor
New 'York, Nil 10036
South Bend, IN 46601
BOND AMOUNT: ***FIVE PERCENT OF AMOUNT BID***
PROJECT:
(Name, location or address, and Project number, if any)
Gemini at Colfax Exterior Renovations "Division A**
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 ar sealed this 25th day of February 2020
Blaine Roofing & Sheet Metal Co., Inc.
(Witness) m.A,
(Witness)
(Principal) . ._...._� 0i)...
(Title),- 't't5;
Hudson Insur ompan
(Sure
homas 0. Chambers. Attorney -In -Fact
Init AIA Document A310TM — 2010. Copyright 0 1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING: This AIA`
Document Is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIAeDocument or
any portion of It, may result In severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the low.
Purchasers are permitted to reproduce ten (10) copies of this document when completed, To report copyright violations of AIA Contract Documents, e-mall
The American Institute of Architects' legal counsel, copyright(q)aia.org. oeiiia
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That HUDSON INSURANCE COMPANY, a corporation of the State of Delaware, with
offices at 100 William Street, New York, New York, 10038, has made, constituted and appointed, and by these presents, does make, constitute and
appoint
Thomas O. Chambers and Todd Schaap of the state of Wisconsin
Todd Kramer of the state of Iowa
its true and lawful Attorney(s)-in-tract, at New York, New York, each of theta alone to have full power to act without the other or others, to snake„
executo and deliver on its behalf, as Surety„ bonds and undertakings given for any and all purposes., also to execute mid deliver on its bchalf ats
aforesaid renewals„ extensions, agreements,, waivers, consents or stipulations relating to such bonds or undertakings provided, however,that no single
bond or undertaking shall obligate said Company for any portion of the penal sum thereof in excess of the suer of Ten Mfillon Debars
(S10,000,,000.00).
Such bonds and undertakings when duly executed by said Attorney(s)-in-Fact, shall he binding upon said Company as fully and to the same
extent as ifsigned by the President ofsaid Cotttpan,y under its corporate seal attested by its Secretary.
In Witness Whereof, HUDSON INSURANCE COMPANY has caused thcse presents to be of its Senior Vice President thereunto duly
a this
day of , 20 J�9— at New York,'cw York,
& a a' HUDSON INSURANCE COMPANY ,
Attest,...... ....,,,. By....., `,,. ..,.. �. ,.."..., .. .
Dina Daskalalrls Michael P Clfone 4�
Corporate Secretary Senior Vice President
STATE OF NEW YORK
COUNTY OF NEW YORK SS.
On the 4tll ^_ y of Jnl 20 19 before me personally cartie 'Michael P. Cifone to me known, who being by me duly sworn chid
depose and say diat, tic is a Senior Vlot President of HUDSON INSURANCE COMPANY, the corporation described herein and which executed the above instrument,
that he knows the seal of said Corporation,that the stal affixed to said instrunrrast is such corporate seal, that it was so affixed by order of the Board ofDirectors ofsaid
Corporation, and that lie signed leis nsr iygftnsa n4y,like order,
"
VkON Goer
(Noted at Seal) d CAiRON GOURLAY ...„..
x * Notary Public, State of Now York
r"r No. 01006372305
Qualified in New York County
Commission Expires June 4, 2022
CERTIFICATION
STATE OF NEW YORK
COUNTY OF NEW YORK
Tho undersigned Dltm Daslta 11 is illy cadifitsr
That the original resolution, or which the rot lowing is a tnic and correct copy, was duly adopted by unanimous written consent oftho Board of Directors of
Hudson Insurance Coinpany dated hily 270, 2007, and has riot since liccn revoked, amended or modified.
"RESOLVED, that the President, the Executive Vice Presidents„ the Senior Vitt Presidents and the Vice Presidents shalt have die authority and
discretion, to appoint such agent or agents, or attorney or attornoys•in-fact, for the purpose of carrying on this Company's surety business, said to
empower such agent or agents, or attorney or auorucys•in-fhet, to execute and dehvcr, under this Company's seal or otherwise, bonds obligations, and
rccogni:eanccs., whother° made by this Company as surety tbrform or otherwise, indemnity contracts, contracts and certificates, acid any and all oilier
contracts and undertakings made in the course ofihis Company's surety business, said renewals, extensions, agreements, waivers, consents orstipulations
regarding undertakings so made, and
FURTt LR RESOVLED„ that the signature of any sucb Officer of the Company and the Company's seat may be afltxed by faciiasiile to any power
of attorney or certification given for the execution of any bond, undertaking, recaagnizance, contract of indemnity or other written obligation in the nature
thereof or rehiould thereto, sueb signature and seal when so used whether heretofore or hereafter, being hereby adopted' by Elie Company as tfie original
signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and efTect as though.
manually affixed."„
THAT the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and of the whole of the original and that the
said Power of Attorney is still in full force and effect and has not been revoked, and furthermore that the Resolution of the Board of Directors, set forth in the said
Power of Attonicy is now in force.
iaia" ess the hand of the undersigned and the seal of said Corporation this 25th y ua 2020
rP day o� teteJl'AE"_.�
Asia
fwfa By......
Dina Daskalaids, Corporate Secretary
BID/PROPOSAL
CITY OF SOUTH BEND
Project Name: Gemini at Colfax Apts. — EXTERIOR RENOVATIONS
Project Number: 119-103
For Bids Due: February 25, 2020
Contractor Name: Slatile Rooting and Sheet Metal Co. INC
BASE BID — Division A
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
1
Division A: Roof remove and
1
LS
replacement.
$178,830.00
2
Division A: Deck repair
100
SF
$8.63
863.00
3
Clean-up allowance
1
$5,000.00
BASE BID TOTAL m.- $184,693.O,Q
BASE
BID — Division B
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
Division B: Masonry Parapet Rebuild
1
section 1 (see drawing page A2.4) —
1
LS
rebuild parapet including finials &
pedestrian rotections.
$175,00.00
Division B: Masonry Wall Repair section
2
2 (see drawing page A2.4) — repair
1
LS
indicated wall areas including at two
removed fire stairs.
3
Division B: replace additional 5 SF
5
SF
-'Chicago Common' wall veneer brick
77.00
$385.00
Division B: grind and tuck point 1 SF of
4
wall veneer brick adjacent to base bid
1
SF
. rebuilt masonr .
$25.00
$25.00
5
Clean-up allowance
1
$5,000.00
BASE
BID TOTAL
$305,000
.00
BASE BID — Division C
Item Description Quantity Unit Unit Price Total Amount
No.
Division C Base Bid: replace 2 fire stairs
1 on west side of building. Including new 1 LS
conc. piers.
No Bid
BASE BID TOTAL No Bid
(cont. next page)
Version 4/2/2019 Contractor's Bid for Public Works - 8
BID/PROPOSAL
CITY OF SOUTH BEND ,p
Project Name: Gemini at Colfax Apts. — EXTERIOR RENOVATIONS
Project Number: 119-103
For Bids Due: February 25, 2020
Contractor Name: e1a.1-LfLJ1
BASE BID — Division D
Item Description Quantity Unit Unit Price Total Amount
No.
Division D Base Bid: New water service
1 from Washington St. to south building 1 LS No Bid
foundation wall. Landscape repair.
BASE BID TOTAL No Bid
BASE BID — Division E
Item Description
No.
Quantity
Unit
Unit Price
Total Amount
1 Division E Base Bid: Specified window
removal and replacement
1
LS
No Bid
BASE BID TOTAL No Bid
ALTERNATE
ITEMS — Division E
1
Division E: deduct one column of (3)
.....__ ..
1
LS
stacked type C window replacements
No Bid
2'
Division E: deduct one column of (2)
1
LS
stacked type D window replacements
No Bid
3
Division E: deduct one column of (3)
1
LS
stacked t e E window replacements
No Bid
4
Division E. deducmnt one coluof (3)
1
LS
stacked typef window replacements
No Bid
Bidder (Firm): Slatile Roofing and Sheet Metal Co., INC.
Address: 1703 S. Ironwood Dr, mmmm
City/State/Zip: South Bend/IN/46613 Telephone Number: ( 574) 233-7485
By
(Signature)
Gerald Lon erot - President
(Printed Name of Person Signing)
Version 4/2/2019 Contractor's Bid for Public Works - 9
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CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
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 MWBE participation.
Project Number:
Project Name
Bidder:
119-103
Date: 2/24/2020
Gemini at Colfax Apts. - EXTERIOR RENOVATIONS
Contact Person: Wendell Simmons
Address: 1703 S. Ironwood Dr.
City: South Bend State: IN
Telephone: 574-233-7485
zip: 46613
Email: wendells@slatileroofiDg.com.
To determine whether a bidder has demonstrated good faith efforts to reach the MWBE 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
MWBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business
Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana
Department of Administration list of Minority and Women Owned Businesses (both certified and non -
certified) found at: htt ://Www.in.gov/idoal.
GOOD FAITH EFFORTS TO OBTAIN MWBE PARTICIPATION
The bidder
shall initial each item below, as evidence of its good faith efforts to obtain MWBE
participation
in the awarded contract.
.. .......
Iaffirm that I reviewed the City of South Bend's Minority and Women Business Enterprise
Inclusion Program Plan and the Indiana Department of Administration's certified list of
./
Indiana Minority and Women Business Enterprises, found on their website
htt /N ww.in. ovhdoa .
I affirm that I have made good faith efforts to select portions of the contract work to be
Jperformed
by MWBEs, including, where appropriate, breaking out contract work items into
economically feasible units to facilitate MWBE participation.
JI
affirm that I have made good faith efforts to solicit through all reasonable and available
means the interest of all MWBEs in the the
scopes of work of contract.
affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform
MWBEs of
•/I
contracting and subcontracting opportunities.
I affirm that I advertised in general circulation and/or trade association publications
concerning subcontract opportunities and allowed MWBEs reasonable time to respond to
such advertisements.
I affirm that I performed any and all necessary steps to provide written notices in a manner
Jreasonably
calculated to inform MWBEs of subcontracting opportunities and allowed
sufficient time for MWBEs to participate effectively.
J
I affirm that I followed up on initial solicitations with interested MWBEs.
affirm that I negotiated with interested MWBEs in good faith, including providing such
MWBEs with adequate information about the plans, specifications and other requirements
of the subcontract.
I affirm that I have made good faith efforts to assist interested MWBEs in obtaining
bonding, lines of credit, or insurance as required by the City or the bidder, where
appropriate.
Version 01/29/2020 Contractor's Bid for Public Works - 11
,��r4 Epp d,A
CITY OF SOUTH BEND.
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
3�
FORM MWBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS
I affirm that. I have made good faith efforts to assist interested MWBEs in obtaining
necessary equipment, supplies, materials, or related assistances or services„ where
appropriate.
I affirm that I did not reject any MWBEs as unqualified 'without sound business reasons
based on a thorough investigation of their capabilities.
CONTRACT RECORDS: The bidder has maintained the following records for each MWBE 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 MWBE was unqualified to perform the job.
"Pro per demonstration of Good Faith Efforts 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 01/29/2020 Contractor's Bid for Public Works - 12
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
FORM MWBE-2.1:'"''
MWBE CONTACTED
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects
requiring Good Faith Efforts to contact MWBEs. It is the bidder's sole responsibility to verify whether any listed
minority or woman business meets the MWBE qualifications. Attach additional pages if necessary.
PAGE OF
Project Number: 119-103 MWBE Participation Goal 7.87%
Project Name: Gemini at Colfax Apts. - EXTERIOR RENOVATIONS
Bidder: _ RIntilp Rnnfinn and qhpp,t KA t l (n IKI('
By:
President
(Title)
2/24/2020
MWBE Firm A ollos Water LLC
Owner or Contact at MWBE Firm Kristi Snyder
Telephone: 7654636774 _ Fax: Email: a olloswater°l "i @yahoo'. om
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Waste Removal
RESULTS OF CONTACT WITH THE MWBE FIRM:
No Response
MWBE Firm
Owner or Contact at MWBE Firm
Telephone: Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MWBE FIRM:
Version 01/29/2020 Contractor's Bid for Public Works - 13
m
STATE OF WISCONSIN )
COUNTY OF Racine )
ON THIS 25th day of Februa , 2020 ,
before me, a notary public, within and for said County and State, personally appeared
Thomas O. Chambers to me personally known, who being duly sworn,
upon oath did say that he is the Attorney -in -Fact of and for the
Hudson Insurance Company a corporation
of Delaware created, organized and existing under and
by virtue of the laws of the State of Delaware ; that the corporate seal
affixed to the foregoing within instrument is the seal of the said Company; that the seal
was affixed and the said instrument was executed by authority of its Board of Directors;
and the said Thomas O. Chambers did acknowledge that he/she
executed the said instrument as the free act and deed of said Company.
mm
Jacki Shaidcn
Notary Public, Racine County, Wisconsin
My Commission Expires 2/13/2023
--@A1A Document, A310ITM - 2010
i :i i
CONTRACTOR:
(Name, legal status and address)
Slatlle Roofing & Sheet Metal Co., Inc.
1703'S. Ironwood Drive
South Bend, IN 46613
OWNER:
)Vame, legal status and address)
City of South Bend
227 West Jefferson Boulevard
SURETY:
(Name, legal status and principal place
of business)
Hudson insurance Company
110�0 William Street, Sth Floor
New York, NY 10036
South Bend, IN 46601
BOND AMOUNT: ***FIVE PERCENT OF AMOUNT BID***
PROJECT:
(Name, location or address„ and project number, if any
Gemini at Colfax Exterior Renovations "Division 9**
This document has important legal
consequences. Consultation with
an attomey 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 an led this 25th day of February 2020
Slatile Roofing & Sheet Metal Co., Inc.
4AA( itrtess) (prrnrr r Sea!)
Hu dsony Ins Co m n
itn f"rrre
... m
Thomas O. Chambers, Attornev-In-Fact
AIA Document A310TM — 2010. Copyright 1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING: This AW
Init. Document Is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIAe Document, or
any portion of It, may result In severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the lour.
i' Purchasers are permitted to reproduce ten (10) coples of this document when completed. To report copyright violations of AIA Contract Documents, a-mali
The American Institute of Architects' legal counsel, copyright@aia.org. 051113
�I�
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That HUDSON INSURANCE COMPANY, a corporation of the State of Delaware, with
offices at 100 William Street, New York, Now York; 10038, has made, constituted and appointed, and by these presents, does make, constitute and
appoint
Thomas O. Chambers and Todd Schaap of the state of Wisconsin
Todd Kramer of the state of Iowa
its true and lawful Attomey(s)-in-Fact, at New York, New York, each of them alone to have full power to act without the other or others, to make,
execute and deliver on its behalf,. as Surety, bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as
aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no shigle
bond or undertaking shall obligate said Company for any portion of the penal sum thereof in excess of the sum of Tien Million Dollars
($10,1100,000,00).
Such bonds and undertakings when duly executed by said Attomey(s)-in-Fact, shall be binding upon said Company as fully and to the same
extent as if signed by the President of said Company under its corporate seal attested by its Secretary.
In Witness Whereof, HUDSON INSURANCE COMPANY has caused these presents to be of its Senior Vice President thereunto duly
a a this 9th- day of , 20 19 at New York, New York.
HUDSON INSURANCE COMPANY
Attest..................., ........ By.,......p ..,...,
Dina Daskalakis Michael P. Cirone y
Corporate Secretary Senior Vice President
STATE OF NEW YORK
COUNTY OF NEW YORK SS.
On the 9th day of July 20 14 before me personally came Michael P. Cifone to me known, who being by me duly sworn did
depose and say that he is a Senior Vice Prestdtnt of HUDSON INSURANCE COMPANY, the corporation described herein and which executed the above instrument,
that he knows the seal of said Corporation, that the seal affixed to said instrument is such corporate seal, that it was so affixed by order of the Board of Directors of said
Corporation, and that he signed his na nigj%htrsotoppyjjkc order.
9,01NC1 r rd its„�dw .,m.
(Notarial Seal) {, CA 4RON OOURLAY
aQ TA IQ Y•".f ' Notary Public, State of Now York
a No, 01t:306372,305
Qualified in New York County
Commission Expires June 4, 2022
A �G
UBL CERTIFICATION
STATE OF NEW YORK �"+;a�' ,w--.,•''�""
COUNTY OF NEW YORK OFili*"
The undersdgncdDiva Dask 'a )s)rezcbycenillos
That the lifiginalresatution. of which the following is a true and correct oopy, was dimly, adopted by unani'mous written consent of the Boyd of Directi is of
Hudson insurance Company dated July 27s', 2007, and has not since been revoked, amended or modified:
"RESOLVED, that the President„ the Executive Vice Presidents, the Senior Vice Presidcttis and the Vice Presidents shall have the authority and
discretion, to appoint such agent or agents" or attorney or attonteys-in-first, for the purpose of carrying on this Company's surety business, and to
emnpower such agent or agents„ or attorney or atlorne,ys-in-fact, to execute and deliver, under this Company's seal or otherwise, bonds obligations, and
rccog'nixancts, whotlter mnade by this Company as surety thereon or olhcrwisc„ indemnity crogracts, contracts and certificates, and any oud all other
cosatracts and undertakings made in the course of this Company's surety business, mid renewals, extensions, agreements„ waivers, consents or stipulatlons
regarding undcrtakings so made; and
FURTIIEdl tESOVLED, that the signature of any such Officer of the Company and the Company's seal may be aflixed by facsimile to any power
of al'tomcy or certification given for the cxccudon of any'bond, undertakino, rocognirance, contract of indentni'ty or other written obligation in the nature
thereof or related lhercio, such signature and seal when so used whether heretofore or hereafter, being hereby adopted by the Company as the original
signature of such offrcor and file original seal of the Company, to be valid and binding upon kite Company with the same force and affect as though.
manually affixed,"
THAT the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and of the whole of the original and that the
said Power of Anomey is still in full force and tffeet said has not been revoked, and furthermore that the Resolution of the Board of Directors, set forth in the said
Power of Altoincy is now in force.
y�y„nn rss the hand of the undersigned and the seal of said Corporation this 25th day o,(,„,�,„ a Febru�'t 2020
.tr _ m
x" pots
44!tiawa By>,...,,
Dina Daskalulds, Corporate Secretary
STATE OF WISCONSIN )
COUNTY OF Racine )
ON THIS 25th day of Februay 2020
before me, a notary public, within and for said County and State, personally appeared
Thomas O. Chambers to me personally known, who being duly sworn,
upon oath did say that he is the Attorney -in -Fact of and for the
Hudson Insurance Company , a corporation
of Delaware , created, organized and existing under and
by virtue of the laws of the State of Delaware that the corporate seal
affixed to the foregoing within instrument is the seal of the said Company; that the seal
was affixed and the said instrument was executed by authority of its Board of Directors;
and the said Thomas O. Chambers did acknowledge that he/she
executed the said instrument as the free act and deed of said Company.
.. 0-y1-LJ'J1LLZffi
Jaackl IT Sheldon
ota yPublic,Racine County, Wisconsin
My Coniniission Expires 2/1 /202
4W TI t r
1316 COUNTY -CITY BUILDING PUoNE 574/ 235-9251
227 W. JEFFERsoN BOULEVARD Fax 574/ 235-9171
SOUTH BEND, INDIANA 46601-1830 TDD 574/ 235-5567
I dFt'N
CITY OF SOUT H BEND ,1/'sMES MUELLER, MAYOR
BOARDF PUBLIC WORKS
Date:
February 5, 2020
To:
All Planholders
From
Linda M. Martin, Clerk, Board of Public Works
Subject
Addendum Number: 1
Project Name: Gemini at Colfax Exterior Renovations
Project No.: 119-103
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
THIS ADDENDUM MAY AFFECT YOUR BID.
Notes: The bid opening is being postponed from February 1 lth, 2020, until February 25th, 2020.
Revised bid documents will be supplied the week of February 10th. Enclosed is a revised Notice
to Bidders.
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company: Slatile Roofing and Sheet Metal Co., INC.
Authorized Signature:
Date: 2/13/2020
13 16 1 'r:�� t � L.i��°w° 13u�ur.0 gnwo 119s�N��' 574/ 235-9251
227 �, 11.o'�1C RSO BOULEVARD EVA�' D �� � FAX 574/ 235-9171
Sol:.all131m'), W)lANri466 1-1830 �� yam r°r: y�' 1'L" D 574/ 235-5567
IN65
CITY OF SOUTFI BEND JAMES iJF;I.I ER, MAYOR
BOARD
Date: February 13, 2020
To: All Planholders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number: 2
Project Name: Gemini at Colfax Exterior Renovations
Project No.: 119-103
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received:
13 / mad
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 UST, also be included with your
bid package upon submittal.
THIS ADDENDUM MAY AFFECT YOUR BID.
Notes: Revised bid documents are attached herein. These two PDF files replace the original
Plans and Specifications. Changes to documents have been highlighted to note differences from
the on final.
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company: Slatile Roofing and Sheet Metal Co., INC..
P
Authorized Signature:
Date: 2/13/2020
a�+� °1✓
1316 COUNTY-ClTy BUILDING r NoNE 574/ 235-9251
227 W. JEFFERsON L3OULEVARD b °; V FAX 574/ 235-9171
Souni BL'ND, INDIANA 46601-1830 "°" � TDD 574/235-5567
P�II>5
CITY OF SOUTH BEND JAMES MUELLER,MAYOR
BOARD OF PUBLIC WORKS
Date:
To:
From
Subject
February 20, 2020
All Planholders
Linda M. Martin, Clerk, Board of Public Works
Addendum Number: 3
Project Name: Gemini at Colfax Exterior Renovations
Project No.: 119-103
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy
bid package upon submittal.
MUST also be included with your
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.
Company:
Slatile Roofing and Sheet Metal Co., INC.
Authorized Signature: 771�-Q
Date: 2/20/2020
PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED)
(a) Acknowled ements:
(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.
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) Attach en s:
(i)
Indiana Secretary of State's on-line records (ie. Business verification) dated within
sixty (60) days of the submission of said document showing that business is in
existence, current with the Indiana Secretary of State's Business Entity Report,
and eligible for a certificate of good standing. (Not applicable to individuals, sole
proprietors or partnerships).
List identifying all former business names. No other business names have been used
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)
(iv)
years.
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
(vi)
under all applicable state and federal laws and local ordinances.
For every project, submit evidence of participation in apprenticeship and training
programs, applicable to the work to be performed on the project, which are
approved by and registered with the United States Department of Labor's Office of
Apprenticeship, or its successor organization.
(vii)
Copy of a written plan for employee drug testing that covers all of my employees
who will perform work on the public work project and meets or exceeds the
requirements set forth in IC 4-13-18-5 or IC 4-13-18-6.
(viii)
Evidence that I am utilizing a surety company which is on the Bureau of Fiscal
Service "Department of Treasury's Listing of Approved Sureties" as required in the
bid specifications or contract.
Version 5/16/2019 General Conditions - 9
(ix) Written statement of any federal, state or local tax liens or tax delinquencies owed
to any federal, state or local taxing body in the preceding three years.
(i) List of projects of similar size and scope of work performed in all areas, including
the State of Indiana, within three (3) years prior to the date on which the bid is due.
�u
•Here)
Gerald Lon erot
(Print Name Here)
Slatile Roofing and Sheet. M@1@1 Co. INC.
(Name of Company)
1703 S. Ironwood Dr,
(Address of Company)
South Bend
(City)
IN
(State)
574-233-7485
(Telephone Number)
Version 5/16/2019 General Conditions -10
BUSINESS INFORMATION
CONNIE LAWSON
INDIANA SECRETARY OF STATE
02/ 14/2020 08:54 AM
Business Name:
SNLCTILE ROOFING AND SHEET METAL
Business ID: 194439-082
Entity Type:
Domestic For -Profit Corporation
Business Status: Active
Creation Date:
01/08/1965
Inactive Date:
Principal Office Address:
1703 S IRONWOOD DR, SOUTH BEND,
Expiration Date: Perpetual
IN, 46613, USA
Jurisdiction of Formation:
Indiana
Business Entity Report Due 01/31/2021
Date:
IMEMEMSEEMINEEM
Years Due:
Title Name
Address
President LONGEROT.GERALD. E. 1703 S. Ironwood Drive,
SOUTH BEND, IN, 46613, USA
Secretary LONGEROT.ANN.
C. 1703 S. Ironwood Drive,
SOUTH BEND, IN, 46613, USA
Type: Individual
Name: GERALD E LONGEROT
Address: 1703 S. Ironwood, SOUTH BEND, IN, 46613 - 0000, USA
1 4-
September 7, 2018
Slatile Roofing and Sheet Metal Company, Inc.
Attention: Joshua Longerot
1703 South Ironwood Drive
South Bend, Indiana 46613
ERIC J. HOLCOMB, GOVERNOR
Rick J. Ruble, Commissioner
402 West Washington Street, Room W195
Indianapolis, Indiana 46204-2751
Phone: (317) 232-2655
Fax: (317) 233-3790
Re: Inspection Number 318098555 Safety Order and Notification of Penalty
issued on August 6, 2018, to Slatile Roofing and Sheet Metal Company, Inc.
Dear Mr. Longerot:
We are in receipt of the petition for review concerning the above which results from
an inspection conducted May 23 to June 22, 2018. Please be advised that we hereby
affirm the Safety Order and Notification of Penalty and grant your petition for review.
Accordingly, we will certify this dispute to the Board of Safety Review.
Sincerely,
Timothy E aley
Deputy C ission abpr
indiana O HA.
TEM/jts
Certified Mail # 7016 3010 0001 02901616
An Equal Opportunity Employer
TT/Voice: 1 (800) 4 -3333
www.6r co Mol
ERIC HOLCOMB, GOVERNOR
Rick J. Ruble, Commissioner
402 West Washington Street, Room W195
Indianapolis, Indiana 46204-2751
Phone: (317) 232-2655
Fax: (317) 233-3790
September 13, 2018
Sent via U.S. Mail, First Class
Mr. Joshua Longerot
Slatile Roofing and Sheet Metal Company, Inc.
1703 South Ironwood Drive
South Bend, IN 46613
Re: Commissioner of Labor v Slatile Roofing and Sheet Metal Company, Inc
IOSEIA BSR Docket No.18-024
Dear Mr. Longerot:
Please find enclosed a file -stamped copy of my Appearance and Complainant's Witness
and Exhibit Lists, along with a copy of Complainant's First Interrogatories and Requests for
Production of Documents in the above referenced matter. Your responses to the interrogatories
and requests for production of documents must be received by my office within thirty (30) days
of the date of service.
Please contact me if you have any questions or would like to further discuss this matter.
Enclosures
Sincerely,
Al
J. Anthony Hardman
General Counsel
Indiana Department of Labor
An Equal opportunity Employer
TT olos; I (80D) 743-3333
ttn. qy_/d
THE EMPLOYER IS SATISFIED WITH THE AMENDMENTS STATED ABOVE AND
ACCORDINGLY WAIVES ITS RIGHT TO FILE A NOTICE OF CONTEST OF THE
SAFETY ORDERS) AND NOTIFICAT,ION(S) OF PENALTY AS AMENDED AND
AGREES TO WITHDRAW ANY PREVIOUSLY FILED NOTICES OF CONTEST IN THIS
MATTER.
Upon full execution of this Settlement Agreement the Employer will post this Agreement for
three (3) working days or until abatement is completed, whichever period is longer.
The Safety Order(s) and Notification(s) of Penalty are, and shall be, herein a final and
enforceable Order of the Board of Safety Review.
Onless othenvise specified herein, the total AGREED PENALTYis due and pa, yable within
fifteen (15) working dreyr from the Employer's execution of this.Agraeement. The Employer
further agrees that if E nployer fails to make timely payments or fails to pay the frill. total
agreed penalty as stated herein, the full amount of the penalty initially assessed against the
Employer in the Safety Order(s) and Notifrcation(s) of Penaltp which are the subject of this
Agreement, minus any payments already made, is due and payable immediately to the Indiana
Department of Labor. 27.e Commissioner may use every legal remedy available to collect such
unpaid amount, interest shall begin to accrue on said unpaid amount at the rate of 12 % apr
compounded daily, and the Commissioner may collect legal fees from. the Einployerfor any
collection action that may be necessary.
Please make your check or rzzoney order payable to "Indiana DOL DOS.I A," indicate
I0SI3AIs Inspection plumber (indicated above) on your re nnittarzce, and send payments to the
following address:
Indiana Department of Labor
402 West Washington Street —Room W195
Indianapolis, Indiana 46204
Except for this agreement, and matters arising out of this agreement and any other subsequent
IOSHA proceedings between the parties, none of the foregoing agreements, statements, findings,
and actions taken by Employer shall be deemed an admission by Employer of the allegations
contained within the Safety Order(s) and Notification(s) of Penalty. The agreements, statements,
findings and actions taken herein are made in order to compromise and settle this matter
economically and amicably, and they shall not be used for any other purpose, except as herein
stated.
CoAaffsSIONEN OPLABOA
0
Title
MOTM
SETTLEMENT AGREEMENT
The Commissioner of Labor (hereinafter referred to as "Commissioner") and Slatile Roofing
and Sheet Metal Co Inc (hereinafter referred to as "Employer") hereby agree as follows:
The Commissioner amends the Safety Order(s) and Notification(s) of Penalty, IOSHA Inspection
No. 318098555 issued to the Employer on August 30, 2018, in the following manner.
SAFETY ORDER 01:
Item 1: Upheld; penalty reduced to $ 2,250.00.
SAFETY ORDER 02:
Item 1: DELETE; penalty reduced to $ 0.00.
Item 2: Upheld; penalty reduced to $ 1,350.00, abatement has been modified until September
30, 20I8.
In exchange, Tlie Employer agrees. -
I. Refresher training for all employees) ulho have a safety responsible in a limited scope
Construction Fafl Protection and Scaffold safety course, within thirty (30) days of
signed Settlement Agreement. Also provide Competent Person training for superpisors
2. TheEmzzployer shall provide an agenda and the class sign in sheet to IDOL upon
completion of the course.
3. A reed Plan o PA YWNT Employerz* may take up to a total of �I2J consecutive
months to pay the total agreed. penalty. Employer shall make one payment of at least
[$ 300.001 each consecutive month until the total agreed penalty off$ 3,600.00] is paid
in full; true tstpa Bin due vitlu mzz to er's execntlozz o 'this A Bement
Subsequent payments shalt be duce bytha 20"1 daa� �rf aclz cortseczdive rzzorztlt uniffsald
Employer understands that a request must be made in writing to IOSHA for a Petition for
Modification of Abatement prior to the above abatement date if abatement cannot be met by the
respective dates and an extension is required.
above specified amendments all other provisions of Safety Order Number
3I8098555 ar retained intact.
The TOTAL AGREED IENAL i $ 3,600.00
3Do.ti--o , n,,I �-k >C 1Z
r
. .CLOSING -CONFERENCE WORKSHEET
1926 STANDASDq,, CONSTRUCTION., N., SAFETY AHEALTH.
o Slate Form47278 (R14.09)
aro
1.
Safety & Health Provisions.
2.
Environmental Controls
3.
PPE & Life Safety Equipment
4.
Fire Protection
' 5.
Signs, Signals & Barricades
6.
Material Handling
7.
Tools, Hand & Power
8.
Welding & Cutting
Company_ ameo�
9. Electrical
10. Scaffolding
11. Fall Protection
12. Cranes, Derricks & Hoists
13. Motor Vehicles & Mechanical Equipment
14. Excavations
15. Concrete & Masonry
16. Steel -Erection
17.
Underground Construction
18.
Demolition
19.
Blasting & Explosives
20.
Power Transmission
21.
Rollover Protection
22.
Stairways & Ladders
23.
Toxic / Hazardous Substances
24.
General Duty
J. Type oftnspecuon Location V
AIRW .
Hazard s e - - jtivfL�-
Comments
2. Type ofinspec0on Lo ai%n I "'-- ft t
Hazard A'� SL_ -G�_ - _(,Q,�� _ .�'�G�1 _ Ord _r�•_� - - -
YA
I Comments
�;�'tiii�. +� '1.-�� "" �arrarr�a:��ar- ,�.w �,•�,,.�...,,..�....,..,
Hazard
------------------------------------------------------------
Hazard-------------------------------------------------------- - - --
Hazard
------------------------------------------------------------ - - - - --
Comments
The aforementioned hazards were noted bythe IOSHACompliance Officer during the onsite inspection ofyourworksite. The compliance officer's recommendations
regarding the above referenced hazards are subject to review by the (OSHA supervisory personnel. You may receive Safety Orders and Notification of
Penalties related to this (OSHA inspection.
crate (�rurwndr, dey, year)
tteS i d by
MR -TRIM ITION: hite - Employer copy, Canary - Employee Represe tative, Pink - Office
Indiana Department of Labor
Indiana Occupational Safety and Health Administration
402 West Washington St - Room W195
Indianapolis, IN 46204
Phone: (317)232-1979 FAX: (317)233-3790
"AM E
Safety Order and Notification of Penalty
To: Inspection Number: 318098555
Slatile Roofing and Sheet Metal Co Inc CSHO ID: L9647
1703 S Ironwood Dr
Optional Report No.: 08318
South Bend, IN 46613
Inspection Date(s): 5/23/2018 - 6/22/2018
Issuance Date: 8/6/2018
Inspection Site:
2015 Western Ave
The violation(s) described in this Safety Order and
South Bend, IN 46619
Notification of Penalty is (are) alleged to have occurred
on or about the day(s) the inspection was made unless
otherwise indicated within the description given below.
An inspection of your place of employment has revealed conditions which we believe do not comply with
the provisions of the Indiana Occupational Safety and Health Act (Indiana Code Chapter 22-8-1.1) or the
standards or rules adopted thereunder. Accordinglyy, enclosed please find safety order(s) and
notification(s) of penalty describing such violation(s) with references to applicable standards, rules, or
provisions of the statute and stating the amount of any penalty(ies).
Informal Conference - Please be advised that it may be possible to informally settle any
potential dispute without initiating the more elaborate proceedings brought on by a petition for
review. Prior to filing a petition for review, you may request an informal conference concerning
any of the results of the inspection (safety orders, penalties, abatement dates, etc.) by contacting
the Indiana Department of Labor/IOSHA, preferably by telephone, in a prompt manner. Please be
advised that a request for an informal conference cannot extend the fifteen working day period for
filing a petition for review. Informal conferences a uen l resolve'an possible disputes. and.
therefore you are urged to take advents a of this o ortuni - Because of the limited timeperiod
and in order to facilitate scheduling, an re nests for an informal conference should be made
g9m
i2fly a on vour receipt of the safe order and no ' cation s of penalf&
Right to Contest - You are hereby also notified that you are entitled to seek administrative review of
the safety order(s), penalty(ies), or both by filing a written petition for review at the above address
postmarked within fifteen working days of your receipt of the safety order(s) and notification(s) of
penalty. ("Working days" means Mondays through Fridays, but does not include Saturdays, Sundays,
legal holidays under a state statute or days on which the Indiana Department of Labor's offices are closed
during regular business hours). If you do not file such a petition for review (contest), the safety order(s)
Safety Order and Notification of Penalty Pagel of 8 OSHA-2 (Rev 1/14)
and penalty(ies) shall be deemed final orders of the Board of Safety Review and not subject to review by
any court or agency. The issuance of a safety order does not constitute a finding that a violation has
occurred unless no petition for review is filed, or if a petition for review (contest) is filed, it must contain a
statement of its basis and should reference the above inspection number. Upon receipt of your petition for
review, we will aff u4 amend or dismiss the safety order(s) and notification(s) of penalty. If we affirm,
your petition for review will be granted (unless it was not timoly) and the dispute will be certified by the
Board of SafesReview for further proceedings. The Board of Safety Review is an indaendent agency
appointed by the goveaim'- or with authority to conduct hearings and to issue decisions concerning disputed
safety order(s) and notification(s) of penalty. If we amend the safety order(s) or notification(s) of penalty,
your petition for review shall be deemed moot. however, you will then be given an opportunity to file a
petition for review concerning the amended safety order(s) and notifications), of penalty.
Please be advised that an employee or representative of employees may file a petition for review to contest
the reasonableness of the time stated in the safety order(s) for the abatement of any violation.
Posting - Upon receipt of any safety order(s) you are required to post such safety order(s), or a copy
thereof, unedited, at or near each place an alleged violation referred to in the safety order(s) occurred.
However, if your operations are such that it is not practicable to post the safety order(s) at or near each
place of alleged violation, such safety order(s) shall be posted, unedited, in a prominent place where it will
be readily observable by all affected employees. For example, if you are engaged in activities which are
physically dispersed, the safety order(s) may be posted at the location from which the employees operate
to carry out their activities. You must take steps to ensure that the safety order is not altered, defaced, or
covered by other material. Posting shall be until the violation is abated, or for three worldng days,
whichever is longer. Cep A-- Q�A $� 49 �� �-1W �:� ve;'6` e" p eh � PA y
Penalties - Penalties are due within fifteen (1) wording days of receipt of this notification unless
contested. Abatement does not constitute payment ofpenalties.
Abatement - The conditions cited in the safety order(s) must be corrected (abated) on or before the
date shown for each item on the safety order(s) and notification(s) of penalty unless:
(1) You file a petition for review concerning the violation, in which case the full abatement period
shall commence from the issuance of a final decision by the Board of Safety Review or the courts which
requires compliance with the safety order; or
(2) The abatement period is extended by the granting of a petition for modification of abatement
date.
PMAs - The petition for modification of abatement date is a manner in which you may seek additional
time to correct (abate) a violation without having to file a petition for review concerning the safety order,
or. after the expiration of the time period to file such a petition for review when it becomes apparent that
you need extra time to abate the violation. A petition for modification of abatement date shall be in
writing and shall include the following information:
(1) All steps you have taken, and the dates of such actions, in an effort to achieve compliance during
the prescribed abatement period.
Safety Order and Notification of Penalty Page 2 of 8 OSHA-2 (Rev 1/14)
(2) The specific additional abatement time necessary in order to achieve compliance.
(3) The reasons such additional time is necessary, including the unavailability of professional or
technical personnel or of materials and equipment, or because necessary construction or alteration of
facilities cannot be completed by the original abatement date.
- (4) All ava-ilabl 'int "steps being then -to-, safeguard mple ees against the cited hazard during the
abatement period.
(5) A certification that a copy of the petition has been posted, and if appropriate, served on the
authorized representative of affected employees, and a certification of the date upon which such posting
and service was made.
A petition for modification of abatement date shall be filed with the Indiana Department of Labor/IOSHA
no Iater than the close of the next worldng day following the date on which abatement was originally
required. A later -Bled petition shall be accompanied by the employers statement of exceptional
circumstances expl ` ` g the delay. A copy of such petition shall be posted in a conspicuous place where
all affected employees will have notice thereof or near such location where the violation occurred. The
petition shall remain posted until the time period for the filing of a petition for review of the
Commissioner's granting or denying the petition: expires. Where affected employees are represented by an
authorized representative, said representative shall be served a copy of such petition.
Notification of Corrective Action - Correction of the alleged violations which have an abatement
period of thirty (30) days or less should be reported in writing to us promptly upon correction. A "Letter
of Abatement" form and an "Abatement Photographs" worksheet are enclosed for your assistance in
providing adequate documentation of abatement. Reports of corrections should show specific corrective
action on each alleged violation and the date of such action. On alleged violations with abatement periods
of more than thirty (30) days, a written progress report should be submitted, detailing what has been done,
what remains to be done, and the time needed to fully abate each such violation. When the alleged
violation is fully abated, we should be so advised. Timely correction of an alleged violation does not affect
the initial proposed penalty..
Tollowup Inspections - Please.be advised that a followup inspection may be made for the purpose of
ascertaining that you have posted the safety order(s) and corrected the alleged violations. Failure to
correct an alleged violation may result in additional penalties for each day that the violation has not been
corrected.
Employer Discrimination Unlawful - The law prohibits discrimination by an employer against an
employee for filing a complaint or for exercising any rights under this Act. An employee who believes that
he/she has been discriminated against may file a complaint no later than 30 days after the discrimination
occurred with the Indiana Department of Labor/fOSHA. at the address shown above.
Notice to Employees - The law gives an employee or his/her representative the opportunity to object
to any abatement date set for a violation if he/she believes the date to be unreasonable. The contest must
be mailed to the Indiana Department of Labor/IOSHA at the address shown above within fifteen (15)
Safety Order and Notification of Penalty Page 3 of 8 OSHA-2 (Rev 1/14)
M
working days (excluding weekends and State holidays) or receipt by. the employer of this safety order and
penalty.
If you wish additional information, you may direct such requests to us at the address or telep me number
stated above.
Safety Order and Notification of Penalty PageA of 8 OSHA-2 (Rev 1/14)
Indiana Department of Labor
NOTICE TO EMPLOYERS OF INFORMAL CONFE NCE
An informal conference has been scheduled with IOSHA to discuss the safety order(s) issued on 8/6/2018.
The conference will be held at the IOSHA office located at 402 West Washington Street, Room W195,
Indianapolis, IN 46204 on at . Employees and/or representatives of
employees have a right to attend an informal conference.
Safety Order and Notification of Penalty Page 5 of 9 OSHA-2 (Rev 1/14)
Indiana Department of Labor
Occupational Safety acid Health Adminisftation
Inspection Number: 318098555
Inspection Date(s): 5/23/2018 - 6/22/2018
Issuance Date: 8/6/2018
CSHOID: L9647
Optional Report No.: 08318 .
Company Name: Slatile Roofing and Sheet Metal Co Inc
Inspection Site: 2015 Western Ave, South Bend, IN 46619
Safety Order 01 Item 001 Type of Violation: Serious
29 CFR 1926.501(b)(9)(i): Each employee performing overhand bricklaying and related work 6 feet or
more above lower levels was not protected from falling by guardrail systems, safety net systems,
personal fall arrest s stye , or working in a controlled access gone: At (� 1� � � �-�,� � a � ,1 ptneo
� A VI� ��
Roof, south side, 2015 Western Ave, South Bend IN 4 619, on May 23, 2018, during construction 0"0171'
activities, two employees performing overhand brick laying 59 feet above lower level, were not protected
from falls.
Date By Which Violation Must Be Abated: Corrected During Inspection
Proposed Penalty: $35000.00
f
Safety Order and Notification of Penalty Page 6 of 8 OSITA- erg 11l; )
Indiana Department of Labor
Occupational Safety and Health Administration
Inspection Number: 318098555
Inspection Date(s): 5/23/2018 - 6/22/2018
Issuance Date: 8/6/2018
CSHO ID: L9647
Optional Report No.: 08318
Company Name: Slatile Roofing and Sheet Metal Co Inc
Inspection Site: 2015 Western Ave, South Bend, IN 46619
SahLty Order 02 item 001. Type of Violation: Repeat
29 CFR 1926.20(b)(2): The employer's safety and health program did not provide for frequent ad
regular inspectionsof hoM • and equipment r. r Person: p gA!�?C-�q �to;o eeA 005'
ar « y - e
Roof -south side-2015 Western Ave, South Bend IN 46619-On May 23, 2018, during construction
activities, frequent and regular inspections were not made by the employer's designated competent
person, who was on site where employees were exposed to a hazard such as falls
Date By Which Violation Must Be Abated: 813012018
Proposed Penalty: $2s400.00
-il p
13 ce
to
Safety Order and Notification of Penalty Page 7 of 8 OSHA-2 (Rev 1/14)
Indiana Department of Labor Inspection Number: 318098555
Occupational Safety and Health Administration Inspection Date(s): 5/23/2018 - 6/22/2018
Issuance Date: 8/6/2018
CSHO ]D: L9647
Optional Report No.: 08318
Company Name: Slatile Roofing and Sheet Metal Co Inc
Inspection Site: 2015 Western Ave, South Bend, IN 46619
Safet
Y Order 02 Item. 002 Type of Violation: Repeat
29 CFR 1926.503(b)(1): The employer did not prepare a vaitten certiftcation record containbg the. name,
or other idenitytrained, the dates of the training,and + n- of . person whr
conducted the training
dim R., . kw, 6fj
.,
sa A', 7
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'Job2015 * South ai 46U.'lon al ". w during •activities, the employer did not prepare such record/certification.
o P i e-4 cA PoL5 o Yi lgv-3 5 e<��a Z?�</ e -
[� Y-P- 3 fib
Date By Which Violation Must Be Abated:
�f Proposed Penalty:
,s Date �r(,v
j
U/JUW/ ; , 176
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Jc W. der
D otor o Construction Safety
Safety Order and Notification of Penalty Page 8 of 8
OSHA-2 (Rev 1/14)
Miana Department of Labor
Indiana Occupational. Safety and Health Administration
402 West Washington St - Room W195
Indianapolis, IN 46204
Phone: (317)232-1979 FAX: (317)233-3790
INVOICE/DEBT COLLECTION NOTICE
Company Name: Slatile Roofing and Sheet Metal Co Inc
Inspection Site: 2015 Western Ave, South Bend, IN 46619
Issuance Date: 8/6/2018
Summary of Penalties for Inspection Number: 318098555
Safety Order 1, Serious
= $3,000.00
Safety Order 2, Repeat
= $4,200.00
TOTAL PENALTIES
= $7,200.00
Penalties are due within. fifteen (15) working days of receipt of this notification unless contested. Make
your check or money order payable to: "Indiana DOLAOSHM. Please indicate IOSHA`s Inspection
Number (indicated above) on the remiitance.
IOSHA does not agree to any restrictions or conditions or endorsements put on any check or money
order for less than full amount due, and will cash the check or money order as if these restrictions,
conditions, or endorsements do not exist.
Corrective action, taken by you for each alleged violation should be submitted to this office on or about
the abatement dates indicated on the Safety Order and Notification of Penalty.
�opwyofr
sheetK
s een provided to assist in providing the required abatement information. A completed
Ms w�sheet should be posted at the worksite with the safety order(s).
Jerry W. Lander
Dime r of Co:
Safety
Au� I ��6 2of8
Dae
Safety Order and Notification of Penalty Page 1 (Rev 9/13)
Phone 5741233-7485
Fax 574/233-7531
Y� info@slatileroorng.com
www.slatilerooring.com
ROOFING AND SHEET METAL C10, INC.
1703 South Ironwood - South Bend, IN 46613
Indiana Department of Labor
402 W. Washington St.
Indianapolis, IN 46204
RE inspection No. 318098555
We are requesting an informal phone conference. Please contact Jerry Longerot at:
Office: 574-233-7485
Cell: 574-440-2923
Joshua Longerot
Project Manager/Service Department Manager
Slatile Roofing and Sheet Metal Co., Inc.
Phoney (574) 233-7485 ext. 3310
Mobile: (574) 440-5927
"oshual sladleroofin .com
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PHOTO MOUNTING WORK SHEET
State Form 48593 (R J ti-02)
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Date of photo (month, day, year)
Classified material
Safety order number
Location (photograph and photographer)
------------------------------------------------------------------------------
Description of hazard /Abatement
--------------------.,._-.------,..._--.--......_....-._---.----...-__...._--_--.-----------..-.._-_..----_-----,-------w
-^.SHO number
PHOTO MOUNTING WORK SHEET
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p atetand Health Administration
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IOSHA complaint or inspection number
Date of photo (month, day, year) lime,
Classified material
Safety order number Item Instance number
Location (photograph and photographer)
Description of hazard /Abatement
-----------------------------------------------------------------------------------------------------------
CSHO number
THE EMPLOYER IS SATISFIED WITH THE AMENDMENTS STATED ABOVE AND
ACCORDINGLY WAIVES ITS RIGHT TO FILE A NOTICE OF CONTEST OF THE
SAFETY ORDER(S) AND NOTIFICATIONS) OF PENALTY AS AMENDED AND
AGREES TO WITHDRAW ANY PREVIOUSLY FILED NOTICES OF CONTEST IN THIS
MATTER
The Safety Order(s) and Notification(s) of Penalty are, and shall be, herein a final and
enforceable Order of the Board of Safety Review.
Unless othenvisespecriedherein, flee total AGREED PENALTY is due and payable widlin
fifteen (I5) worlcirzg days from the Employer's execution of this Agreemen4 The Employer
further agrees that Mnployerfails to make timely payments or fails to pay the full total
agreed penalty as stated herein, the full arnottnt of the penalty initlally assessed againsttl:e
Amplo per in the Safety Order(s)and Notiftieation() of „penal which are the subject trf Yliis
Agreement, nrrn us any payments already made, is due and payable immediately to the Indiana
Department of Labor. The Commissioner may use every legal remedy available to collect such
unpaid amount, interest shall begin to accrue on said unpaid 41nount at the rate of 1 % apr
compounded daily, and the Commissioner may collect legal fees froin the Employer for any
colli»ctiorz action that may be necessary.
Please makayour check or money orderpayable to ""IndiancrDM/.lIt SHA,11 indicate
IGS ';s byspection Number (indicated above) on your remittance, and send payments to the
fallowing addrev :
Indiana Department of Labor
402 1frest Washington Street —Room WI95
Indianapolis, Indiana 46204
Except for this agreement, and matters arising out of this agreement and any other subsequent
IOSI A proceedings between the parties, none oft e foregoing agreements, statements, findings,
and actions taken by Employer shall be deemed an admission by Employer of the allegations
contained withi n the Safety Order(s) andNotihcation() of Penalty. The agreements, statements,
findings and actions taken herein are made in order to compromise and settle this matter
economically and am icshly, and they shall not be used for any other purpose, except as herein
stated..
Slatile Roofing and Sheet Metal Co Inc
By:
Title:
Date:..
Title:
Date:
February 19, 2020
iv —Key Personnel
• Gerald Longerot; 52 years experience
• Ann Longerot; 36 years experience
• Ken Hoy Jr -Project Manager; 30 years experience
• Wendell Simmons -Project Manager; 27 years experience
• Josh Longerot-Masonry project Manager; 12 years experience
• Jim Polk -Materials manager; 24 years experience
• Michael Albert -Assistant Project Manager; 4 years experience
• Ryan Gramza-Manager of Sheet Metal Shop; 24 years experience
• Sandra Zecchini, BBA- Controller; 20 years accounting experience; with company for 6 months
• Tara Reinhardt -Office Manager; started with company 12/16/2019
• Robert Davis -Superintendent of jobs and workers; 32 years roofer
Field Employees
• Roofers: 35 full time roofers with 84%Journeymen roofers, all are trained through JATC
• Sheet Metal: 4 Full time sheet metal employees, 3 journeymen
• Masonry: 4 fulltime all journeymen masons
• Warehouse and Drivers: We have one full time warehouse employee that is a Journeymen
roofer for 22 years, 2 truck drivers that are CDL Class A drivers, and one mechanic
v—No outside services or contract labor will be used on this job
b
ryW.
a
09/11/2018
To Whom it may concern:
ROOFERS LOCAL 23
1345 NO'BTHSIDE BLVD.
SOUTH BEND, I
46615
Slatile Roofing, Sheet Metal and Masonry is a contractor in good standing,
signatory to the South Bend Roofers Joint Apprenticeship and Training
Committee's (J.A.T.C.) Registered Apprenticeship Program #IN020780008.
Department of Labor
2420 Viridian Drive -Suite G
South Bend, IN 46628
Office of apprenticeship.
C.O. Kathleen Sokolowski
574-236-8295
Derek Carrington
Roofers Local 23
Apprenticeship Coordinator
22990 Ardmore Trail
South Bend, IN 46628
574-968-5500
A�llll�
"��'Fr"pICµ�EkI9aYtlC9kld ,�
October 35, 2018
Sheet Metal Workers Local 20
Apprenticeship &Training Trust
2828 East45th Street, Suite A
Indianapolis, Indiana46205
(317) 541-0050.1-800-835-4531
www.smw20training.com
To Whom It May Concern,
#Mtc..cf.. 11 ...............
5 r+
I am the State Apprenticeship Coordinator for the Sheet Metal Workers' Local #20
Apprenticeship and Training Trust. I am writing this letter on behalf of Slatile Roofing
and Sheet Metal in South Bend; Indiana. They are one of our contractors and have been
in good standing and have been actively participating for well over three consecutive
years; therefore, they are eligible to hire Apprentices through our program. Apprentices
hired by this company are registered with the Bureau of Apprenticeship and Training as
"Sheet Metal" Apprentices.
Additionally, the Sheet Metal Workers' Local # 20 Apprenticeship and Training Trust
has been active for well over three years, in fact dating back to March 5, 1946.
Thank you for your consideration in this matter. If you have any questions, please call
me at your convenience.
Sincerely,
Jason Benson
State Apprentice Coordinator
Sheet Metal Contractors -Sheet Metal Workers Local 20
Evansville -Ft. Wayne -Gary -Indianapolis • Lafayette -South Bend -Terre Haute
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,\^ > ////.\ 4 :��\ CONSTRUCTION
DRUG
&
ALCOHOL
NORTHWEST INDIANA
INDEX
PAGE
Introduction
1
The Policy
1
Definitions
3
Drug Testing
8
Drug Group
9
Alcohol Testing
10
Payment for Testing
10
Initial Testing (Pre -employment)
10
Random Testing
11
Probable Cause Testing
11
Post-Accident/Incident Testing
12
"Emergency" Work Assignment
12
Card System
13
Status Confirmation
13
Insufficient Specimen
14
Diluted Specimen
14
Adulterated, Substituted, &/or Out -of -Temperature Range
14
Consequences for a Positive Test
15
Return -to -Duty Testing
15
Follow-up Testing
16
Disputed Positive Results
16
Appeals & Protections
16
BUILDING AND CONSTRUCTION RESOURCE CENTER, INC.
INTRODUCTION
The labor and management representative of The Building and Construction Industry for
Northwest Indiana have formed an alliance to address the problems caused by drug and
alcohol abuse. Management and labor have created the Building and Construction
Resource Center (hereafter "BCRC") an independent not -for --profit corporation which
offers a wide range of services to its employees in the unionized construction industry,
which include employers, labor union organizations, construction industry and related
workers. It is BCRC's goal to assist employers to establish and maintain workplaces that
are free of destructive effects causes when employees use drugs and/or abuse alcohol.
BCRC's activities are not intended to interfere with normal practices of the unions or
management. BCRC recognizes its responsibility to communicate with and educate its
employees relative to this policy, as well as the harmful effects of drugs and alcohol in
our society and in the workplace. BCRC also recognizes the need to provide a program
of assistance to those persons for whom drugs or alcohol may be causing problems.
Finally, while not wishing to violate the rights or invade the privacy of any employee,
BCRC's drug testing program will seek to identify those employees who are unable or
unwilling to conform to BCRC's program. This program has been established in
accordance with federal guidelines for specimen collection, laboratory analysis and
review, and standards of integrity and confidentiality.
THE POLICY
Person who use illegal drugs or abuse alcohol or other controlled substances, on or off
their jobs, are likely to be less productive, to be less reliable, to be more frequently absent
and to have other work related problems that can cause increased cost, delays, accidents
and injuries. These employees can also damage the health, safety and well-being of other
workers on the job. The unionized construction industry can control and reduce this
problem through recognition of the problem, development of a comprehensive policy and
program of education and information, promotion of an assistance program, and
implementation of fair and respectful drug testing that conforms to federal guidelines for
specimen collection and analysis. All of this is to be done with the utmost confidentiality
and respect for the individual.
In order to enhance substance abuse awareness among all employees, educational
seminars and training programs will be offered. The educational seminars will be
directed toward education about the seriousness of the nationwide problem of drug and
alcohol abuse, and how the use of drugs and alcohol negatively impacts safety,
productivity, and the competitive ability of the American workforce.
Supervisors will be trained to identify employees in potentially difficult situations, and to
recognize signs of impairment, as well as the supervisors' responsibility to document,
intervene and follow up with the troubled individual. These sessions Will be offered as
ongoing training programs.
BCRC encourages all employees troubled by their own, a family member's drug, or
alcohol abuse to seek professional care and treatme
The EAP staff has knowledge of the level and types of benefits available to BCRS
employees. Employees can access the services of the EAP through a hotline that is
staffed twenty-four (24) hours a day, seven (7) days a week, throughout the entire year.
Employees calling the EAP hotline are put in touch with a counselor who will conduct a
professional assessment and who may meet with them to further assess the nature of the
problem in order to provide a referral to the best and most appropriate level of care. The
EAP is staffed by certified and credentialed human service professionals who are
sensitive to the needs of the individual. Individuals who take the initiative to contact the
EAP for assistance do so with the assurance that their calls will be treated respeaffly
and confidentially. The direct services provided by the EAP are sponsored by DCRC.
WIN W C4 W 4 11 A
Adulterated sporimpn means aspocimen that contains a substance that is not
expected to be present in human urine, or contains a substance expected to be present
but is at a concentration so high that it is not consistent with human urine.
ALr blanlf means, in evidential breath testing devices (BBTs) using gas
chromatography technology, a reading ofthe devices internal standard. In all other
E, BTs, a reading of ambient air containing no alcohol.
Al o—hol means the intoxicating agent in beverage alcohol, ethyl alcohol, or other low
molecular weight alcohol including methyl and isopropyl alcohol.
Alcohol ennironfi--nijnn (Quolate�nt means the alcohol in a volume of breath
expressed in terms of grams of alcohol per 210 liters of breath as indicated by an
evidential breath test under this policy (BrAQ.
0 AlcohnIon"firmagn" i-q means a subsequent test using an EBT, following a
screening test with a result of 0.04 or greater, which provides quantitative data about
the alcohol concentration,
0 Alcobnl R,-.rpPnintr n—,.,MJA8D means a breath device, other than an, that is
l
approved by the National 11ighway'1"raffic Safety Admini&ation (NHTSA) and
placed on a conforming products list (CPL) for such devices.
Alcohol screppip- I'-',+ means an analytic procedure to determine whether an
employee may have a prohibited concentration of alcohol in a breath specimen.
employer where employees present
alcohol test.
beverage, liquid mixture or
alcohol.
can means a person, independent contractor; or em
ployer appliesto
become an employee of a BCRC contractor/employer, participant, and includes a
person who has received a job offer made contingent on the person passing a drug
test.
Associatiort means Building and Construction Resource Center, which is the
association formed by labor and management representatives of the building and
construction industry for Northwest Indiana, for the purpose of addressing problems
of drugs and alcohol in the workplace.
• Blinds aecimen or d Derformance test means a specimen submitted
�e ,a,,
n
o tr t purposes,
4 oses, with a'i
f "i control
rf � es g
or quality
n 0
to a laboratory
_ 10c t t it MPI ee specimen. fictitious identifier, so that
the laboratory cannot
distinguish ish from
me employee
I Alcohol
hnjcia T i � person
�c n7 i structs
• Breath co Tec sa who n and assists employees
.n al 0 t .
e testing
ro
Ico 0 tes ng process and operates an Evidential Breath Testing device
in the alcohol tes n ce�� nn�l on _"t w� JO__
(EBT).
* K�aneeled test means a drug or alcohol test that has a problem identified that cannot
be or has not been corrected. A canceled test is neither a positive nor a negative test.
An employer is not permitted to take adverse job action based on a canceled test.
* Cards the individual designated by each employer who has the authority
to access data information that will confirm the status of employees through the call-
in system, through the BCRC scanner by swiping employees' identification cars, or
by electron. e-mail..
• Chain of cust d means the procedure used to document the handling of the
specimen from the time the employee gives the specimen to the collector until the
specimen is destroyed.
• Collection eontainer means a container into which the employee urinates to provide
the specimen for a drug test.
• +Collection site means a place designated by BCRC where individuals present
themselves for the purpose ofproviding a :specimen to be analyzed for the presence of
controlled substances, or for purposes of providing breath sample to be analyzed for
alcohol concentration.
• Collector means a person who instructs and assists employees at a collection site,
who receives and makes an initial inspection of the specimen, provide by those
employees, and who initiates and completes necessary forms.
•oan�anI means an employer who is a member of Building and Construction
Resource Center.
• Confwmation Lor conflrwato dru test means a second (2) analytical procedure
performed on a urine specimen to identify and quantify the presence of a specific
drug or drug metabolite.
• Confirmation or confirmaLmy
J validity test means a second test performed on a
urine specimen to further support a validity test result.
• Confia".rra.ed drru test means a confirmation test result received by a MRO from a
laboratory.
• Conf"armato test
a) For alcohol testing, a confirmatory test is a second test following a screening test
with a result of 0.02 or greater, conducted 15-30 minutes later, that provides
quantitative data of alcohol concentration. This test is conducted on an EBT.
b) For controlled substances testing, a confirmatory test is a second analytical
procedure to identify the presence of a specific drug or metabolite. This
confirmatory test is independent of the initial test and uses a different technique
.and chemical principle from that of the screening test in order to ensure reliability
and accuracy.
• Contractor participant means an employer who is a contributing member of
Building and Construction Resource Center.
• Controlled Substance means marijuana (THC), cocaine, opiates, phencyclidine
(PCP), amphetamines (including metharraphetamines), barbiturates, benzodiazepine,
propo.yphene, methadone and ecstasy.
• DIIHS means the Department of Health and Human Services or any designee of the
Secretary, Department of Health and Human Services.
• DIIHS-appioved laboratory means a laboratory that is certified by the U.S.
Department of Health and Human Services. Drug test under this program will be
performed by a DHHS-certified laboratory.
• Pggggatcd Employer Representative MRameans the Human Resource Manager,
Card Manager, Program Administrator or similar designee of each employer who
shall receive necessary communications related to this program.
.Dilu to s recitrren means a specimen with creatinine and specific
�-°�-- p p gravity values that
are lower than expected for human urine.
® ROT means U.D. Department of Transportation. Many ofDOVs standards and
procedures related to drug and ideohol testing are mirrored in ECRC's drug and
alcohol policy.
® Demean the substances for which tests are required under this policy and include
marijuana (TIdC), cocaine, amphetamines (including m tbamphetamines),
phrensyclidine (PCP), opiates, barbiturates, ben odic epine, propoicyphene,
methadone and ecstasy.
• krgg test means a test conducted for controlled substances.
• LIMPto ee means an employee of a company, or of a contractor/employer participant
who is a member of Building and Construction Resource Center,.
• Em to ee ssistance l' o am KI AF Counselor means a masters -level
professional with an education in psychology, social work, counseling, etc, with
knowledge of and clinical experience in diagnosis and treatment of alcohol and
controlled recommendations concerning education, treatment, follow-up testing and
aftercare.
' mLoyer means a company, or a contractor/employer participant, who is a member
of Building and Construction. Resource Center.
• + vidential Ereath TestinM Deice a Mmeans a device approved by NHTSA for
the evid ntial testing of breath at .0d alcohol concentrations, placed on NHTS A's
Conforming Products mist (CPL) for "Evidential breath Measurement. Devices" and'.
identified on the CPL as conforming with the model specifications available from
NHTSA,.'s Trafc Safety program.
Claus+e means if an ern to ee does not re ort
First i)ccur°rence p y p for a random test,
and it is dae first time the employee has failed to report, the Third party Administrator
(TPIA may allow tyre employee to tale the test without reporting to the EAP for
Ruth review. Employees may utilize this clause only one time.
initial tat L'or drtx s means an " unoassay screen to eliminate negative urine
specimen'§ from further consideration.
• hRI94l valid t heat means the result of a drug test for a urine specimen that contains
an unidentified adulterant or an unidentified interfering substance, has abnormal
physical characteristics, or has an endogenous substance at an abnormal concentration
that prevents the laboratory from completing or obtaining a valid drug test result.
• Dab„ o Mmeans an D.S. laboratory certified by DHHS under the National
Laboratory Certification Program as meeting the minimum standards of Subpart C of
the Dl HS Mandatory Guidelines for Federal Workplace Drug Testing Programs.
• Dicenscd medical a°actitioner means a person who is licensed, certified, and/or
registered, in accordance with applicable Federal, State, local or foreign laws and
regulations, to prescribe controlled substances and other drugs.
1°kedical Eeyiew Officer means a licensed physician responsible for receiving
laboratory results generated by ICRC's drug testing program who has knowledge of
substance abuse disorders and who has appropriate medical training to interpret and
evaluate an individual's confirmed positive test result together with his/her medical
history and any other relevant biomedical information.
° Positive Test alcohol occurs when an employee's confirmatory test result reads
0.04% BrAC or higher.
° Pos!bT test dry Pccurs when an employee's conftmatory test or retest is at or
above cutoff levels specified by DHHS and has been verified by the hMO to be a
positive testa
• 1'ao rarnn dministratormeans the individual who has administrative
responsibilities for overseeing the drug and ,alcohol -testing program for an employer.
The Program Administrator may serve as an employer's DER.
• 1!'ro erg ;means all employer -owner and/or —leased property, including but not
limited to owned and/or leased buildings and other real estate, parking lots and
vehicles, lockers, tools, equipment and desks..
• adom selection means a scientifically valid method for selection of employees to
be tested that result in an equal probability that any employee from a group of
employees subject to the selection mechanism will be selected and does not gave an
employer.discretion to waive the selection of any employee under the mechanism.
Thus, an employee may not be selected more than twice (2) during the year.
• Refuseto submit to an alcohol or controlled substances test means that an
employee:
Fails(ed) to appear for any test (except a pre -employment test) within a reasonable
time, as determined by the policy, after being directed to do so by the policy;
• Fails(ed) to remain at the testing site until the testing process is complete;
• Fails(ed) to provide a urine specimen for any drug test required by this policy;
• In the. case of a directly observed or monitored collection in a drug test, fails to
permit the observation or monitoring of the employee's provision of a specimen;
• Fails(ed) to provide a sufficient amount of urine when directed, and it has been
determined, through a required medical evaluation, that there was no acceptable
medical explanation for the failure;
• Fails(ed) or declines to take a second test the employer or collector has directed
the employee to take;
• Fails(ed) to undergo a medical examination or evaluation, as directed by the MRO
as part of the verification process, or as directed by the policy. In the case of a
pre -employment drug test, the employee is deemed to have refused to test on this
basis only if the preemployment test is conducted following a contingent offer of
employment;
• Fails(ed) to cooperate with any part of the testing process (e.g., refuse to empty
pockets when so directed by the collector, behaves in a confrontational way that
disrupts the collection process, provides incorrect or inaccurate information to the
collection site or on necessary forms, or fails to complete all documents);
• Provides a second (2) specimen that is diluted.
a Screening test or initial test) means:
• In drug testing, a test to eliminate ";negative' urine specimens from further
analysis or to identify a specimen that requires additional testing for the presence
of drugs.
• In alcohol testing, an analytical procedure to determine whether an employee may
have a prohibited concentration of alcohol in a breath specimen.
• Scre xr► Vest Techniciarr S'TT mean§ aperson who instructs and assists
employees in the alcohol testing Process and operates an Alcohol Screening Device
(ASD).
!�! n CORtainer� means a contaitrer that is used. for transporting and protecting
e specimen bottles and associated documents from the collection site to the
laboratory..
• S enhaen ;means a sample of urine, used for analysis and/or diagnosis. For the
purpose Of this policy, specimen is deferred as urine.
• MftAe l ttl aneans the bottle that, after being sealed and labeled according to the
procedures in this policy, is used to hold the urine specimen during transportation to
the laboratory,
• Si Ceimen means apart of the urine specimen that is sent to a first laboratory
and retained unopened, and which is transported to a second laboratory in the event
that the employee requests that it be tested following a verified test of the primary
specimen or a verified adulterated or substituted test result.
• Sxrlrsttrrted s ecirnen means a specimen with creatinine and specific
gravity values
that are so diminished that they are not consistent with human urine.
• 109RUO e!s means levels at or above when; a specimen is determined to be
Positive) and below when a specimen is determined to be negative.
• 't`hxrd par Adrniaistratox" TF means an entity that provides or coordinates one
or more drrrg; and/or alcohol testing tlxe provision of a number of such services to
employers. A typically provides or coordinates the provision of a number of
such services and perforrras administrative taslts concerning the operation of drug and
alcohol testiaag programs far employers. Thi terra includes, but is not limited to,
groups of employers whojoin together to administer, as a single entity, the drug and
alcohol testing programs of its members (e,g., having a combined random testing
pool)..
Yer W'ed test means a drug test result or validity testing result from a D 1S-certified
laboratory that has undergone review and ,final determination by the MRC.
BCRC will provide an identification card to each participant which will reflect the results
of the Drug & Alcohol Screen Test from the laboratory and as confirmed by the Medical
Review Officer C'). To implement an appropriate and acceptable standards
established by the U.S. Department of Health and Human Services (DHHS) Substance
Abuse and Metal Health Services Administration (S SA) for testing mandated: by the
U.S. Department of Transportation. Those safeguards are as follows:
1. The integrity of collected urine specimens will be ensured by utilization of
one collection procedure at all sites. Samples will be collected in accordance
with federal standards that provide for a continuous chain of custody and
which recognize privacy concerns regarding the individuals being tested.
2• Testing will be conducted only by accredited labs that have obtained and
retained DHHS certification,.
3. All specimens that are positive in an initial screen must then be confirmed by
gas chrornatography/rnass spectrometry (GUMS). GC/MS confirmation is
the state-of-the-art drug testing technology, providing a fingerprint of the
detected drug...
4. A Medical Review Officer O) will review all drug test positives prior to
verification of positive test results. The MRO is a physician with specialty
training and expertise in substance abuse and drug testing. The MR0 will
review confirmed positive test results to ensure proper procedure, protocol,
and reporting. The MRO will interview the individual who has a confirmed
positive test result by telephone to investigate whether a legal prescription has
caused the specimen to test positive. Ifthe individual has no legal.
prescription, the MRO will take appropriate steps to report a verified positive
to the BCRC Program Administrator, who will then invalidate the employee's
certification card. All persons who have tested positive must have their return
to work cleared by the EAP.
5. All positive specimens will be retained frozen in a locked facility at the testing
laboratory for one (1) year. The retained specimens will be available should
the results of that test be disputed or should arbitration or litigation arise out of
the actions taken because of the test results.
6: On a periodic basis, BCRC will submit blind pre -tested urine samples with
appropriate documentation to the drug -testing laboratory as a means of
assuring itself of laboratory proficiency.
Drug Group
The drug -testing program will test for the following drugs at these levels:
Analyte
Initial
creenin
Confirmatory
Test
Amphetamines
1000 ng;W
500 ng/Ml
Cocaine
300 ng;W °
150 ng/M1
Marijuana
50 ng/M1
15 ng/Ml
Opiates
2000 ng.Ml
2000 ng/M1
Phencyclidine
25 ng/Ml
25 ng/M1
Barbiturates
300 ng/M1
200 ng/Ml
Benzodiazepines
300 ngW
200 ng/Ml
Methadone
300 ngW
200 ng/Ml
Propoxyphene
300 ng/Ml
200 ng/Ml
A -Analogues (Ecstasy)
250 ng/Ml
200 na/Ml.
Alcohol Testing
/
1. .1/.
�r
PAYMNT rau TvgTIr
Costs related to drug and alcohof testing will be borne by the program except for re-
testing. of disputed test results by an employee. The issue of payment for the employee's
time will be categorized as follows:
1. For new or current union members or employees seeking an initial test, the test is a
condition of employment, and employees in the BCRC Program will not be paid for
their time tin providing a specimen for the initial test.
2. All current employees Who are to test for any of the following: Late Random,
Probable Cause, Post -Accident, Diluted ;lie -Test, Return -to -Duty, or Follow-up
Testing or Detest due to a flowed or rejected test, will not be paid for their time in
providing a specimen for the test..
3. Employees will be paid a (forty -dollar) $40. Stipend by the program for the time
necessary to secure subsequent random testing required by the program. It is
understood that such testing will occur on the employee's time. Test to be taken with
seven (7) days of notice.
4. Non -Bargaining and Pipe fitter's; trade code 14 are exempt from the stipend
reimbursement.
Prospective
i/ employees / current employees
isubject to the BCRC program, All persons who are eligible and who intend to obtai-x a
-
10
BCRC card will be instructed to report to an approved BCRC collection site and to
provide a urine specimen for initial (pre -employment) testing and a clear status before
starting work for any participating employer. The individual will be directed by BCRC
or by their employer, to report to a BCRC approved collection site location. These
selected collection sites will have collection kits, chain -of -custody forms, and all other
necessary supplies.
it7a. t� rr
After the individual's completion of the initial drug test (with a negative result), he/she
will be placed in the Random Pool after which he/she will be notified via U.S. mail to
report to an approved collection site for a random drug test. The individuals chosen for a
random drug test will be selected anonymously, from a computerized selection prograrn.
Fifty percent (0) of the currently active BCRC individual cardholders will be selected
annually for random. testing. Then, on a monthly basis, one -twelfth (1/12) of the selected
employees will be notified to submit to a random test in -order to update their BCRC
identification cards and status. A copy of the form letters notifying individuals of their
selection for this random test appears as an attachment A, B & C at the back of this
booklet.
Employees will be required to report to an approved collection site within seven (7) days
from the date of the Notice for Random Testing letter in order to maintain their BCRC
identification card and status. No employee will be required to submit to a random test
more than twice (2) in a twelve- (12) month period. All employees will be selected for a
random at least one (1) every two (2) years.
If an employee does not provide a sample at an approved collection site within seven (7)
days of having been notified of a random selection, his/her status in the BCRC Substance
Abuse Program will be deemed "Not Available." Employees who fail to report for a
random test in the required time should contact the Third Party Administrator (TPA). If
an erployee does not report for a random test, and it is the first (1) time the employee
has failed to report, the TPA may allow the employee to take the test without reporting to
the EAP for further review. Employees may choose to take a "First Occurrence Clause"
at this time. Employees may utilize this clause only one (1) time. However, once this
"First Occurrence Clause" has been utilized, an employee who fails to report for a
random test at any time in the future will be required to contact to the EAP for evaluation
and to receive instructions on the required procedure(s) for removing the "Note
Available" status from his/her card.
f MR
An employee may be subject to drug and alcohol testing for Probable Cause based on
observed and documented unusual behavior. Circumstances sufficient to lead a
reasonable person to suspect that an employee is under the influence of, or is in
possession of a controlled substance shall be determined by an immediate supervisor and
should be confirmed by one other supervisor whenever possible. The immediate
11 NIGNMEN
To accommodate owners with emergency work, craft Personnel who have not previously
held a BCRC identification card or taken an initial drug test the following provisions will
apply when starting for emergency work assignments.
L Upon arrival at a job location for sing -up, the employer representative (Card
Manager) shall request the employee to present his/her BCRC identification card.
An individual that does not have a BCRC card at the time of hire will be requested
to secure a card and submit to an initial drug test Witbin one (1) day, in order to
comply with the BCRC Policy.
12
2. An employee without a BCRC identification card may work one (1) day. On the
second (2) day, a Chairs of Custody from (as proof ofhaving submitted to a drug
test) or a BCRC card must be presented..
3. An employee who has provided a specimen for testing must bang to the job site
his/her copy of the Chain, ofcustod form
as proof that he/she has submitted t an initial test o him/her by the collection site,
4. If the work assignments are consecutive, the employee will be allowed to work ,for
up to a maximum of four (4) days in order for the employee to receive his CRC
identification card and have the employer Card Manager swipe the card for status
verification.
5. If the member's work assignment is tei hated by his/her employer before the
menzbex's status is verified �e allowable four (4) days for verification, and
the individual is rehired, the member will have to provide the same employee a
BCRC identification card at the second (2)` hiring sign up, and a clear status.
Except in the event that the rehire is less than four (4) days from the initial hire
date, the Individual, Local and Non -Local, BCRC card holder shall accept and
understand that should his/her drug test results be reported as positive, he/she will
be subject to disciplinary action up to and including termination without obligation
for further compensation by the BCRC affiliated employer. Such terauination shall
also be subject to the individuals' right under his/her collective bargaining
agreement.
iA • •
•• ri, o. sl
Categories
Not On File (NOF)
2. Not AvailableA
The card manager, will also have access
to safety training Worination,
downloaded through the Construction Advancement r r Foundation A •accessible
through r email
participating Union.
Participating employers • wr
• • •.
+
• • i • • • • . • «.
:•' i i r
13
When an employee's status is Not Available (NIA) ,A) he/she will be advised to contact the
BCRC office to resolve the "/A status. The individual may be required to foiio r the
consequences for a positive test within the l3Cl Policy.
The employer may verify the employee's card after four (4) days, to reconfirm the status
and if the employee's status is still NIA, the employer may terminate the employee.
An employee who receives a status of :/,. a second (2) time will be dferred to the
Employee Assistance lrogen for assessment, and will be required to follow the
recommendations Of the EAP Counselor before being considered for further assignments.
The status of Clear (CL) will be restored only with written approval of the EAR?",
The procedure will protect the employee's confidentiality' and allow the employer to audit
the status of his/her employees, which may be required by the owner to be submitted.
monthly..
Personr Provides
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w
..w n w w wr w w� w w.w w- • w
w` rw w
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. w •' w w w.
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dilutedAn employee providing a specimenopportunity to return to ,
collection
w w _ r M hours w w w We
w w w w w w w
wr w w w w w w
w :w ww w w
M �
MRien a urine specimen is reported as adulterated, • w _ �. •
raffg—e-fs-16—eFow 90 degrees or above0 degrees employee
have not cooperated with the testing process, w the test VAII be considered a refusal to
tested.be
In addition, w w who lias .d to be # w uses or possesses,�v
counterfeit wrug cardl w_ ww iw w and including
w- w w
Bscharge, subjectto the ropresentationlanguage.
14
I.
An employee who tests positive for drugs and /or alcohol shall be contacted directly
by the Medical review Officer O). If the O verifies the results of the positive
test, the MRO will notify the individual that he or she is ineligible for work and
he/she will be directed to contact the program's Employee Assistance Program (.SAP)
for consultation and review. if the, MRO contacts the individual and tins that there is
a reason for the positive test (an authorized prescriptive medication) the MRO will
downgrade the result to a negative, and the individual's card will be marked "CV".
2. In the case of a confirmed positive drug or alcohol test, the Third Party Administrator
(TPA) will be notified that the employee's status should be marked "NIX. . The
"N/A" status will be effective at the moment that a confirmed positive test is
received.
3. Before returning to work, an employee must (1) complete an evaluation with the
program's Employee Assistance Program. provided by the BCRC EAP Provider, (2)
follow a treatment plain, prescribed by the program's EAP, (3) obtain written
documentation from the program's EAP verifying fitness for duty, and (4) obtain a
negative result on a return -to -duty test.
4. A confirmed positive test or a "N/A" status will not be the sole basis for termination
of employment. Only employees who are in non-compliance with this program, may
be discharged. For the purposes of this provision, "non-compliance") shall :mean one
or more of the following:
• Failure to report to the program's Employee Assistance Program as directed,
• Failure to follow and/or complete a EAP prescribed treatment program,
• Failure to take a return -to: -duty or follow-up test.
• Failure to report for a random test request within seven (7) days,
• Failure to submit to a drug or alcohol test when requested to do so by the EAP
5. An individual testing positive for a third (3) time in a twelve (12) month period shall
not be permitted to take a Return -to -Duty test for one (1) year and his/her BCRC
Substance Abuse Card shall be invalidated for the same time period. The individual
must also complete an EAP prescribed treatment program before returning to work.
For the purposes of this policy, a negative test must occur before any future positive
tests will be counted as additional strikes.
6. An employee whose test results are verified positive will be referred to the EAP by
the MRO. The employee is expected to attend all appointments with the EAP
counselor and to follow the EAP counselor's instructions.
RET" TO-IaI TY Tf+ STIN
The return -to -duty test is required for an employee to be reinstated into the program
following a positive test. The participant must have a negative drug test before resuming
performance of his/her job duties.
15
Follow-up testing for drugs and alcohol is a requirement in order for a returning
employee to stay in compliance with the BCRC Program. Testing shall be determined by
the Employee Assistance Counselor, and will be implemented when the employee retums
to work,
An employee who disputes positive results shall have the right to have his/her initial
sample independently re -tested by a Department of Health and Hurnan Services (DS)
certified laboratory of his/her choice, at his/her own expense, witilin ten (10) working
days of when he/she was notified of the test results. A portion of the initial sample shall
be forwarded under a chain -of- custody directly by .ECUs testing laboratory to the
laboratory performed by a qualified MRO who has been approved by ECRC. If the
second lab report shows the presence of a controlled substance, the test result will be
considered positive. If the second lab report test indicates no presence of a controlled .
substance, then both tests will -be considered negative.
The following section only applies when the employee tests due to Post -Accident or
Probable Cause: If the test is negative, the affiliated employer will reimburse the
individual for compensation lost at the appropriate rate within the collective bargaining
agreement, straight or premium pay, during the period of his/her disciplinary suspension
or termination and will reimburse the individual for the cost of the re -test.
An individual whose test results are verified positive will be referred to the EAP by the
MRO. The individual is expected to attend all appointments with the EAP counselor and
to follow the counselor's recommendations and requirements.
All problem situations shall be resolved in accordance with current guidelines and
standards established by the U.S. DHHS or Department of Transportation.
ALM ALS AND PROM, S
Employees who are subject to this policy continue to have access to the usual protections
provided as a part of their union membership and/or as members of bargaining units
covered by collective bargaining agreements. Such individuals may request that a union
representative be available or present prior to any action taken by an employer, if any, at
any stage of the policy and its administration. If an individual is aggrieved by any action
taken under this Drug an Alcohol Policy and his/her complaint cannot be resolved, the
complaint may, if the individual or Union requests, be referred as a grievance under the
grievance and arbitration provisions of the individual's collective bargaining agreement.
In the event the matter is referred to arbitration, the arbitrator shall be bound
substantively by the provisions of this Drug and Alcohol Policy.
16
(On BCRC Letterhead)
o, V , P11111amnglIT&I
Dear
Your name has been randomly selected by BCRC's computer generated selection
program to take a random drug test in order to maintain your "Clear" BCRC
identification card status. Our computer program selects the names of one -twelfth (1/12)
of 50% of all BCRC cardholders for update each month. No one will be tested in this
system more than twice in a twelve-month period.
You will be required to report to an approved collection site within, seven (7) days from,
the date of this "Notice for Random Testing" letter to stay in compliance with. the BCRC
policy. In order to avoid any potential interruption in the status of your card, you must be
tested no later than midnight the (day) of (month), 2007. This random test is to be taken
on your own time at any of the approved collection sites identified on the enclosed
collection site list. You will be mailed a $40.00 stipend for the time necessary to secure
random testing as long as your test is taken within seven (7) days of this notice.
If you do not fake your random test within seven (7) days of this notice, your BCRC card
status will be deemed "Not Available". Failure to report for a random test in the required
time it will be necessary for you to contact the BCRC office to receive instructions on the
required procedure(s) for removing the "Not Available" status from your card.
Remember it is your responsibility to keep the BCRC informed of any change in your
address or telephone number.
The BCRC has contracted with Perspectives as a fully independent, professional
Employee Assistance Program (EAP) for you and your family. Perspectives' 24 hour, 7
day a week hotline number is (800) 456-6327.
Please contact the BCRC office @ 219-764-9500 or toll free @877-988-5400 if you have
any questions. Thank you for your cooperation.
Sincerely,
James Bohlen
Executive Director
17
Surety Bonds - List of Certified Companies
Page 1 of 112
Official website of the United States Government
Surety Bonds
U.S. DEPARTMENT OF THE TREASURY
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Last updated January 27, 2020
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Updated July 1, 2019
ACCREDITED SURETY AND CASUALTY COMPANY, INC.
(NAIC #26379)
BUSINESS ADDRESS: PO Box 140855, Orlando, FL 32814.
PHONE: (407) 629-2131.
UNDERWRITING LIMITATION b/: $6,684,000.
https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html 2/19/2020
(NAIC #38261)
BUSINESS ADDRESS: One Hartford Plaza, Hartford,
CT 06155 - 0001.
PHONE: (860) 547-5000,
UNDERWRITING LIMITATION b/: $6,398,000.
SURETY LICENSES c,f/: AZ, CT, FL, GA, KS, KY, LA,
MD, MI, MO, PA, SC, TN, TX, UT, VA, WV.
INCORPORATED IN: Connecticut.
Hudson Insurance Company
(NAIC #25054)
BUSINESS ADDRESS: 100 William Street, 5th Floor,
New York, NY 10038.
PHONE: (212) 978-2800,
UNDERWRITING LIMITATION b/: $44,149,000.
SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT,
DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MID,
MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY,
NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT,
VT, VA, WA, WV, WI, WY.
INCORPORATED IN: Delaware.
NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, VT, VA,
WA, WV, WI, WY.
INCORPORATED IN: New Hampshire.
Merchants Bonding Company (Mutual)
(NAIC #14494)
BUSINESS ADDRESS: RO BOX 14498, DES MOINES,
IA 50306 - 3498.
PHONE: (515) 243-8171.
UNDERWRITING LIMITATION b/: $12,476,000,
SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT,
DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD,
MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY,
NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT,
NCORPORATED IN: Iowa.
Merchants National Bonding, Inc.
(NAIC #11595)
BUSINESS ADDRESS: P.O. Box 14498, DES MOINES,
IA 50306 - 3498.
PHONE: (515) 243-8171.
UNDERWRITING LIMITATION b/: $1,722,000.
SURETY LICENSES c,f/: AL, AK, AZ, AR, CO, CT, DE,
DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA,
MI, MN, MS, MO, MT, NE, NV, NJ, NM, NY, NC, ND,
OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA,
WV, WI, WY.
INCORPORATE Translate
Phone 574/233-7485
Fax 574/233-7531
info@slatileroofing.com
www.slatileroofing.com
RO I4G XMIC��°�) S1 INC.
1703 South Ironwood South Bend, IN 46613
February 19, 2020
Slatile Roofing & Sheet Metal Co., Inc does not have any outstanding liens or liabilities for any Federal,
State or Local taxes
Sandra Zecchini
Controller
ESTABLISHED 1924
ROOFING - MASONRY RESTORATION - SHEET METAL
JOBS OF SIMILAR SCOPE
1. IU Kokomo
Indiana University Trustees
2. Liberty Tower (The tower)
Washington Square Development
3. Aloft
Washington Square Development
4. IUSB Northside Hall Phase I & 11; IU Sculpture Studio
IU Trustees
5. PHM 2017 Schumakers; Bitterweet; North Point
PHM School Corporation
6. New York Central Railroad Museum
City of Elkhart
7. Avilla elementary School
C/O Barton Coe
8. New Lincoln Jr High School
Plymouth School Corporation
9. Peru Armory
State of Indiana -Adjunct General
10. Logansport Armory
State of Indiana -Adjunct General
11. Potato Creek State Park
State Department of Natural Resources
12. Grissom Building 668
C/O Aacon Construction
13. Warsaw Water Waste Treatment Plant
Kokosing Industrial
14. Washington Gardens
City of Elkhart
15. Discovery Middle School
Penn Harris Madison
16. Madison Elementary
Penn Harris Madison