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HomeMy WebLinkAboutOpen Market Contract – Upgrade and Modernize Century Center Elevator; No Bids Received - Gibson-Lewis, LLC1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 CITY OF • 1` JAMES MUELLER, MAYOR BOARD OF i March 24, 2020 Mr. Robert A. Lingerfelter Gibson -Lewis, LLC 1001 W. I Ith. St. Mishawaka, IN 46544 RE: Open Market Contract Dear Mr. Lingerfelter: PHONE 574/235-9251 FAX 574/235-9171 The Board of Public Works, at its meeting held on March 24, 2020, approved the above referenced open market contract to upgrade and modernize the Century Center elevator in the amount of $168,700. Enclosed please find a copy of the contract for your records. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, Linda M. Martin, Clerk Enclosure GARY A. G1LOT ELIZABETH A. MARADIK THERESE J. DORAU JORDAN V. GATHERS JOSEPH R. MOLNAR `�'a✓t INTER -OFFICE MEMORANDUM DEPARTMENT OF PUBLIC WORKS DIVISION OF ENGINEERING TO: Linda M. Martin, Clerk Board of Public Works FROM: Becca Plantz, Project Engineer SUBJECT: Award Project No. 118-104D Century Center Elevator Renovation DATE: March 16, 2020 O�Ni814'N.IlN1WY ,. m�tav YAYnAnxntxrcrcrcrcoAnwnnid�.vniwmmn�,vitdomw�;ry1A'�MvuNf�61M tlmmrtrrMNvnU�pttlMAfN/ot�lRlftl�Mk,M.'eS"iUIbNNN6�NXW"w�fNN�6NMiWN�2' fn��n�.'S itli 01�Wa�z�mmv.� �xvst���m'muNln�4AG'�'.+NmM0�44NYtNiNfhY!6YMmi�IOYN�iCMWPVA4�N1MdNilrervn Nm,MWtu00uNvwM,1lvpmm anal�¢¢YYWq,�Y1nnnNa4wC�v4Pprcv The opportunity to bid on the Century Center Elevator Renovation was opened on October 22, 2019. Board of Public Works did not receive quotes for the above project and was recommended for special purchasing. The project was advertised and opened prior to the release of Ordinance 10693-19, so it does not integrate the updated language on the MWBE disparity study. The quoters ranked as follows: Quoter w_ .,�.......... .....a Total Quote Amount 1. Gibson -Lewis, LLC $168,700 I recommend award of a contract for Century Center Elevator Renovation to the lowest responsive / responsible quoter, Gibson -Lewis, LLC in the amount of $168,700. Sufficient funds have been appropriated from Hotel Motel Tax Fund, 7304.42010.000.0099. Please call with your questions (5998). Enc. Quote Tabulation ayKb6Yr 44 CITY OF SOUTH BEND, INDIANA rwmti'I CHECKLIST FOR BIDDERS Project Name Century Center Elevator Renovation Project No. 118-104D For Bids Due 22 leer- 040 February 27, 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. X Proper bid security Included. The bidder has the option of providing either a Certified Check _ or Bid Bond. X 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 X 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 X met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted Form [MWBE-2.1]. X.__ Acknowledge Receipt of Addendum(s) included with the bid. X All required additional information is included with the bid.. X Proposal statements and other affidavits all signed by the proper party with name either printed or typed underneath signature. X This checklist submitted with the Bid, This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: Gibgon-I c wis, LLC Date: 2/27/2020 By Authorized Represent Signature: _ ......�.._._ ...... .. __... ............... ... ....__ . Print Name & Title: Robert A. Lingenfelter, President Version 4/2/2019 Contractor's Bid for Public Works - 1 CITY OF SOUTH BEND, INDIANA r� .� ik Project Name Century Center Elevator Renovation Project No. 118-104D For Bids Due -2440 February 27, 2020 PART I (Must be completed for all bids. Please type or print) 2/27/2020(Firm): Gibson -Lewis. LLC Date: ,-_-,-,-_Bidder Firm : Gi wis. ... Address: 1001 W. 11th Street - ,. .,µ11-11_ 4 Telephone Number: 574 � 259-8581 City/State/ZiP lis'h a%va a, IN 4654 _. ... Agent of Bidder (If Applicable): Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the Public project gi Century Center ElevatorUpgrades Pro ect #118-104D the City of South Bend, Indiana, in accordance with plans and specification _.. -"..._...m...____. s prepared by: American Structurepoint Inc., 7260 Shadeland Station, Indianapolis, IN 46256 and dated 9/9/2019 for the sum of � � (enter the Total Bid as shown on the Proposal) ev (Enter sum tat (Iiurrical):,,, Ko` The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified In the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend, If the bid is to be awarded on a unit _ basis, the Itemization of the units shall be shown saattachment. � W 4 nt. By W (Signature) Robert A. Lingenfelter, President -....--..m--- _. ( f Person Signing ACCEPTANCE The above bid is accepted this day of � ...__ 2,g 0 Subject to the following conditions: BOARD OF PUBLIC WORKS aryl , Hot Presid f if, G , Mew be-r O " �f'c�GtYl (� Li�l1Ci'� i za eth A. fallaradik Member Tha se J rau, falleml er w o D :S�`at'�V1 R N'1�1+1Gii'z IM�lA?&9�)' est,L'andalwf,IwAa In, Ce Version 4/2/2019 Contractors Bid for Public Works - 2 Bidder: Gibson -Lewis, LLC PART II (For projects of $100,000 or more - IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/her/its bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION It PLAN AND EQUIPMENT QUESTIONNAIRE 1. Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. *Please see the attached Financial Statement Version 4/2/2019 Contractors Bid for Public Works - 3 Bidder: Gipson -Lewis, LLC When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF INDIANA ) ) S& 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 goads 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. Verslon 4/2/2019 Contractor's 61d for Public Works - 4 Bidder: Gibson -Lewis, LLC 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as t art of this bid/quote;and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsil+le, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subctntract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE, A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. 1, 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 ofpublic works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereu ider Version 4/2/2019 Contractor's Bid for Public Works - 5 may result. in forfeiture of contractual payments. *r� 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 27th dayof February , 2020 Gibson -Lewis, LLC Con,"ctt ',11oIFinn) ligmaatur of"antra torlickdcr or Its Agent Robert A. Lingenfelter, President Printed Nano and Title Subscribed and swam to before me tlki q lei"` da f „F"Airl'arY 2020 My. yExpires_023 Gommissi4n m yy0t3105/2„ l'at' .Y Public Juli Hodowaniec Count of Residence - J9sc h Y �.-._�...�.....�l? e.am..A..A....ee.,m....N.� Version 4/2/2019 Contractors Bid for Public Works - 6 BIDIPROPOSAL�o�� CITY OF SOUTH BEND Project Name Century Center Elevator Renovation Project Number. 119-104D For Bids Due: -OotobeF2040 February 27, 2020 40 Contractor Name: Gibson -Lewis, LLC BASE BID Item Description No _ 1 Renovation of Elevator No. PE-2 Bidder Quantity Unit Unit Price I Total Amount 1 LS BASE BID TOTAL , Gibson -Lewis, LLC (Firm): _ Address: 1001 Street, Mishawaka, IN Cityl9tatelZip: 46544 Telephone Number: („ 574.....)........�...25.9-858„1 ww� By ._(Signature) re Robert A Lin�enfe tern President _ (Printed Name of Person Signing) Version 41212019 Contractors Old for Public Works - 7 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY. DEVELOPMENT PROGRAM. FORM MWBE-1.0 MBEN SE PARTICIPATION This 4irmplatsd form should be suppllod with Blde that pertain to City of South Beryl Public Works Projects involving MBEIMBE partlolpatlom It Is the bidtler's sole responslblllly to vodfy whether any listed minority or women business meets the quagRoellons of a Minority or Women's owned business. Project Number. 118-104D Project Name: Bidder: Gibsolt.L..mis t.j f total Bid Amount: MBFJW13EGoal: Pape of Names ddreas of MBENME t eConleolPereon Scope or%wk to be Performed DoAsrAmoualof afToeaa (AltachawpePoclmdulairyou need addiliorml space) MBPAMIE Cumponent dF Tnla1 Pr NBRI IFolephonel.. �__s...„u„_..,v. ,............ �„�,� ......�.� _�..._...,._�..w.... ... ....�.,,�....�..,n� _.m., . �.�!?!�9il�_ i Submitted by: R0hL''1( 1, N 11�"evdwPsv.+idc nt """ 2/27/2020 Print Name St.w. .�s_.�� �,. ..�..� .... ....�.. .�.. ..M. .._.�.......�.�.� ignature Data Version 4/?V1018 Contractors Bid for Pubile Wake -9 CITY OF SOUTH SEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM 6�, »..nP FORM MWBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS ur"' J This completed farm should be included as part of the Bide documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MBEWBE participation. It is the bidders sole responsibility to verity whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business as defined by the Indiana Department of Administration ("IDOA"). Project Number: -i 40 Date: 2/27/2020 Project Name: C_entury Center Elevator Renovation Bidder: Gibson -Lewis, LLC Contact Person: Robert A. Lingenfelter, p President m Telephone: 574 259-8581 , , Address: 1001 W. llth Street City: Mishawaka State: IN Zip: _. 46544 Email: rlin enf - elter�c l.nceusa.com ..... To determine whether a bidder has demonstrated good faith efforts to reach the MBENVBE 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 EFFORrs MBEIWBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women Owned Business as found on their website (http://Www.in.govAdoo). ACTION (ADVERTISEICONTACT): In order for your bid to be deemed responsive, the City of South Bend requires that all perspective bidders complete no lose than 2 of the following: 1. At end all re•bld et s schoduled by the City to inform MBEIWBEs of contracting and su oontrar ing p r un l��a. 2. Advertise in general circulation and/or trade association publications concerning subcontracting opportunities, and allow MBE/WBEs reasonable time to respond. 3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated to inform MBENVBE., of subcontracting opportunities and allowed sufficient time for them to psaticipato effecti vel y. 4. Utilize, pre-existing services of available community organizations, small and/or disadvantaged business assistance offices and other organizations that provided assistance in the recruitment and placement of M'BEAfV BE firms. *"Bidder must cirde or otherwise notate which of the two (2) required actions were performed. GOOD FAITH NEGOTIATIONS: The bidder nego'lated In good faith with interested MBEIWBEs, including providing such MBENVBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject MBENVBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. SMALL CONTRACT(S): The bidder selected specific portions of the work to be performed by MBENVBEa In order to increase the likelihood of meeting the MBENVBE goals (including breaking down contracts into smaller units to facilitate MBENVBE participation) CONTRACT RECORDS: The bidder has maintained the following records for each MBENVBE 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 MBEIWBEwas unqualified to perform the job. *Proper demonstration of Good Faith Effort requires your initials next to all of the above bones. 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 4012019 Contractor's Bid for Public Works - 9 Bidder: Gibson -Lewis, LLC CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITYr, DEVELOPMENT PROGRAM° :b FORM MWBE-2.1> MBE/WBE CONTACTED This completed form should be supplied with Bids that psri^sin G City of South Bend Public Works Projects; requiring c-ontacted MBENYBE to obtain Good Faith Efforts. It Is the bidder's sots responsibility to verify whether any listed minorlly or woman bualness masts the qualifications of a Minority or Women's owned business. PAGE ------- OF --- Project Number: 118-1 L4 MBE/WBE Participation Goal Project Name: Century Center EleVllitor Ren vati n Bidder. Gibson -Lewis„ LLC 2/27/2020 President ._.(Sign.. )Robert A. Lapp (Title) � ._, ._ i 11er () MBE/WBE Firm Owner or Contact at MBENVBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED F CT: FOR PROJECT: RESULTS OF CONTACT WITH THE MBENVBE FIRM: MBE/WBE Firm Owner or Contact at MBE/WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FORT THIS PROJECT: .._�...-W RESULTS OF CONTACT WITH THE MBENVBE FIRM: Version 4/2/2019 Contrectors Bid for Public Works -10 u c men A 1 TM - 201 Conforms with The American Institute of Architects AIA Document 310 Bond Number: 03992-CNA-20-043 CONTRACTOR: (Name, legal status and address) Gibson -Lewis. LLC 1001 West 11th Street Mishawaka, IN 46544 OWNER: (Name, legal status and address) City of South Bend, Indiana 227 West Jefferson Blvd. South Bend, IN 46601 SURETY: (Name, legal status and principal place of business) The Continental Insurance Company 151 N Franklin Street Chicago, IL 60606 State of Inc: Pennsylvania BOND AMOUNT: Five Percent of Amount Bid (5%) PROJECT: (Name, location or address, and Project number, if any) Century Center Elevator Renovation Project No. 11 B-104D 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 ail 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 l'ogk-hed, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. and %ilyd this 24th day of February P 2020 Juli Hodowaniec Gibson -Lewis, LLC _. �. .__...... .... .-..� (Principal) ���� (Sea)) (Title) Robert A. "„ (ernfelter, President -Cite Continental Insurance Cornoanv (Seal) Lisa Pettineo C .• ""t— . ' e" (Tttl Latrecia R. Scott, Alt rney in Fact ACKNOWLEDGMENT OF SURETY STATE OF MICHIGAN ) COUNTY OF OAKLAND ) On this lay 0 f� A � ........... _ ._........2020, before note personally is an Attorney-in-Facty- Y �� came _ of the—Nab.who, being b me duly sworn, did depose and say that she and knows the corporate seal thereof, that the seal affixed to said annexed instrtinietl is such corporate seal, and was thereto affixed by authority of the Power of Attorney of said Company, of which a Certified Copy is hereto attached, and that she signed said iit&ti Unleiil as an Attorney - in -Fact of said Company by like authority. Acknowledged and Sworn to before me on the date above written My Commission Expires Kathy DelGreco Notary Public, Oakland County, Michigan My Commission Expires: September 3 2020 POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That The Continental Insurance Company, a Pennsylvania insurance company, is a duly organized and existing insurance company having its principal office in the City of Chicago, and State of Illinois, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Latrecia R. Scott , Individually of Southfield I Michigan , its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, sea[ and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature — In Unlimited Amounts — Surety Bond Number: 03992-CNA-20-043 Principal: Gibson -Lewis, LLC Obligee: City of South Bend, Indiana and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the insurance company and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority ofthc By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Board of Directors of the insurance company. In Witness Whereof, The Continental Insurance Company has caused these presents to he signed by its Vice president and its corporate seal to be hereto affixed on this 3rd day of June, 2015. , INS M * The Continental Insurance Company ,•� ... "CC'. _ �-. .. � Paul Bruflat . .o....m. m.� .� 4.... .w � ..m._.. ice President State of'South Dakota, County of Minnehaha, ss: On this 3rd day of June, 2015, before me personally came Paul T, Bruflat to me known, who, being by me duly swum, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President ofl'he Continental Insurance Company, a Pennsylvania insurance company, described in and which executed the above instrument; that he knows the seal of said insurance company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors ofsaid insurance company and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance company. ra,Mr i"44'MM M+'b Y'x+.h M+`.4hti'•xwrew.vti'« 'Y' (y1 S. I H tttrrARY PUMIC sOUTH 0AX0rn E M® A k' ti�wMM k M Commission Expires F y p February 12, 2021 E i S, Eich Notary Public CERTIFICATE I, D. Butt, Assistant Secretary of The Continental Insurance Company, a Pennsylvania insurance company, (to hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance company printed on the reverse hereof is still in force, In testimony whereof I have hereunto subscribed my name and affixed the seal ofthe said insurance company this 24th day of February 1 2020 The Continental Insurance Company a r X + l w*� U It ltiisltltll a ucN'apnN'y U^'�rirnuu 1�Qi13 nQ7i_ry..J'.(1 V.2 General Form No 96-a Prescribed by the State Heard of'/acanmts of Indiana Revised 1949 STANDARD QUESTIONNAIRES AND FINANCIAL, STATEMENT FOR BIDDERS Prescribed b THE STATE BOARD OF ACCOUNTS OF INDIANA For use in investigating and determining the qualifications of bidders on public Finance construction when the aggregate cost of any such work or improvement will be Five Thousand Dollars or more. These statements to be submitted under oath by each bidder with and as a part of his bid, as provided by Chapter 306, page 1248, Acts of 1947. OWNER: PROJECT: Submitted by: City of South Bend, Indiana 227 West Jefferson Blvd South Bend, IN 46601 Century Center Elevator Renovation — Project #118-104D South Bend, IN GIBSON-LEWIS, LLC 1001 W. 111h. Street Mishawaka, Ind. 46544 DATE: February 27, 2020 Filed: () A Corporation O A Co -partnership O An Individual (X) A Limited Liability Company Gibson -Lewis, LLC The following forms of questionnaires and financial statement are prescribed by the State Board of Accounts in confomnity with the statute set out on the proceeding page. These forms, properly filled out and attested, must accompany each bid of Five Thousand Dollars or more on any public work, The forms am designed to cover all contracts for all lands of work and the bidder is required to answer such questions as are pertinent to the work upon which he is bidding. The purpose of the questionnaire and financial statement, as set forth in the law, is to enable the awarding body to determine the qualifications of the bidder to carry out successfully the contract if the same is awarded to him. The bidder will find it to his advantage to answer fiilly all questions coming within the range of the work upon which he is bidding. Particular attention should be given the ' Financial Statrune it " and the details relative to the assets and liabilities set out. This form is made in extensive detail so that the bidder may explain his assets and liabilities in Proper sequence and in a uniform manner. Gibson -Lewis, LLC Section 2 of an Act entitled "An ACT concerning the awarding for the performance of public work and authorizing the board of accounts to prescribe certain forms to be used in ascertaining the responsibility of contractors who submit bids for the performance of such work, providing for plans and specifications, providing for bids repealing certain laws and declaring an emergency". Section 2. Whenever the aggregate costs of any work or improvement will be five thousand dollars ($5,000.00) or more, fror the purpose of enabling such board, commission, trustee, officer or agent to ascertain and determine which of the bidders submitting bids for the performance of any such public work is, in the judgement of such board, conunission, trustee, officer or agent, the lowest and/or best bidder and to exercise intelligently the discretion hereby conferred on such board, coma ssion, trustee, officer or agent, each bidder shall be required to submit under oath with and as a part of his bid, a statement of his experience, his proposed plan for performing such work and the equipment which he has available for the performance of such work and a financial statement. The statements, hereby required shall be submitted on forms which shall be prescn'bed by the state board of accounts. The forms so prescribed shall be designated, respectively, as the experience questionnaire, the plan and equipment questionnaire and the contractoes financial statement, and shall be based, so far as applicable, on the standard questior maires and financial statement for the bidders as approved and recommended by the joint conference on construction practices, for use in investigating the qualifications of bidders on public construction work, and the forms so prescribed are, hereby, presmbed as the forms which shall, herettfieer, be used by all such boards, commissions, trustees, officers and agents in obtaining the information which is required in the administration of this act. If the information submitted by any bidder on the forms herein prescribed is found, on examination, to be unsatisfadtory, the bid submitted by such bidder shall not be considered. Bidder: Gibson -Lewis, LLC The above bid is accepted this following conditions: Contracting Authority Members: ACCEPTANCE day of PART I I (For projects of $150,000 or more — IC 36-1-12-4) , subject to the Governmental Unit: ....City of South Bend. Indiana ..._..__..._.,_._ ........._...�.� ..� ..���.................................................._... Bidder (Firm) LC Gibson -Lewis,............... _.I------.........._.............................._.......... ..._._.—Date (month, (month, day, year): February 27, 2020 These statements to be submitted under oath by each bidder with and as a part of his bid, Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. What public works projects has your organization completed for the period of one (1) year prior to the date of the current bid? Contract Amount Class of Work Date Name and Address of Owner _ 2019 -3,828,000.00 IN Concord Health/Wellness Dunlap, 1,854000.00 Brandywine iGy -Niles, I . 2,648,000.00 2099 ElkhartAquatics Center - Elkhart, W . 1,459,000 00 ND Hesibua�-NoreDarme,IN 2. What public works projects are now in process of construction by your organization? Contract Amount Class of Work Completion Name and Address of Owner �-- - ..............��,v eA..� Date — 1,949,000.00 2020 Purdue Bfoaclence- West Lafayette, IN 3,737,000.00 � .. 2020 take Michigan College - St. Joseph, MI y - � __Lincoln 10,281,000.00 2020 wwww JHS --Plymouth, IN 4,261,000.00 2020 Columbia City HS -Columbia City, IN Bidder: Gibson -Lewis, LLC 3, Have you ever failed to complete any work awarded to you? a„ No m mmm If so, where and why? 4. List references from private firms for which you have performed work. University of Notre Dame - Notre Dame, Indiana Memorial Hospital of South Bend - South Bend, Indiana St. Joseph Regional Medical Center - South Bend, Indiana list Source Bank - South Bend, Indiana SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.) Apply adequate personnel to complete the work 2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. Please see attached Gibson -Lewis, LLC Submitted by,_. ...........www_ ❑ A Corporation ......._......�.�....�........____......��,�,�, ❑ A Co -partnership An Individoal Principal Office at 1 W. 11t Street Mishawaka, IN Limited Liability Company To City of South Bend, Indiana EXPERIENCE QUESTIONNAIRE The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatories hereinafter made. 1. How many years has your organization been in business as a general contractor under your present business name? 2. How many years' experience in ,_SeCialty construction work has your organization had: Forty -One (41) yearsFifty-Two_(52) years (a) As a general contractor. w_ .....__ (b) as asub-contractor 3. What projects has your organization completed? CONTRACT AMOUNT CLASS OF WORK WHEN COMPLETED NAME AND ADDRESS OF OWNER _�..._ .- .._ � � ... ..d _ ��.....�.....�... ........unl�t,, IN --_. ......_._ .....�_ ...._�_ 1,8 4,000 ... _. �2019m....m................_� Nilcs Bratid wine ti m -Niles I 2,48,(100 _. .. 2019 lakhart Aquatics Center -Elkhart. IN 1,459,000 2019 ND 1 lesburgh - Notre Dame. IN 3A What projects has your organization now in process of construction? t ON IZACT AMOUNT CLASS OF WORK wxEN TO at; COMPLE ED NAME AND ADDRESS OF OWNER 1,949,000 2020 Purdue Bioscience - West 1 aLii a llc�9 W.. _._........... ..._...__W ._ _____...................... w.. _..... _.. _...mMichigan lm..m._ MI ,7 7,000 2020 Lake C'oll�, � St lt`��c Alt, 10,281,000 2020 Lincoln NyLnou1h, CPS hN .mmm 4„20 1,000 2020 ....... ..... wwColumbia Cile� HS -Columbia C�i� 1N 4. Have you ever failed to complete any work awarded to you?-- No If so, where and why? 5. Has any offer or partner of your organization ever been an officer or partner of some other organization that failed to complete a construction contract? No It"so, state name of individual, other organization and reason therefor. 6. Has any officer or partner of your organization ever failed to complete a construction contract handled in his own name? No If so, state name of individual, name of owner and therefor, -2. Gibson -Lewis, LLC 7. In what other lines of business are you financially interested? 8. For what corporation or individuals have you performed work, and to whom do you refer? Memorial Hospital of South Bend INW Tom,_,Jordan mmm- 574-647-7052 y - Mike Prater- 574-520-4319 Indiana Universit South Bend, M�.N......_.............��...�..........�._._.._.e. _..._w.��..�..................__....... _...... University of Notre Dame - Notre Dame, IN Tony Polotto - 574-631-4205 9. For what cities have you performed work and to whom do you refer? ........ ,.o._. ._..... , _.._.... � _.__..�._. �....�. _ 74-235-9554 Sout Bend Indiana County City Buildin 5............................___�. m_ ,. �� Mishawaka, Indiana 574-258-1607 . ..w , ___.... - ........... ...... LaPorte, Indiana 219-326-6808 Elkhart, Indiana 574-535-6775 10. For what countries have you performed work and to whom do you refer? .. .,__......... ....... St. . .....__ Elkhart County 574-535-6775 11. For what State bureaus or departments have you performed work and to whom do you refer? ...... _....... Purdue University - Indiana 765-494-7342 Indiana University - South Bend, Indiana 574-520-4319 12. Have you ever performed any work for the U.S. Government? Yes--, . If so, when and to whom do you refer? Andrews Library was a federal building Hammond Courthouse & A ................................... ­. 13. What is the construction experience of the principal individual of your organization? YEARS OF INDIVIDUAL'S NAME PRESENTPOSITION CONSTRUCTION MAGNITUDE AND IN WHAT CAPACITY Olt OFFICE EXPERIENC E TYPE OF WORK ttrot rk W,W l itt -e.... er w g President 30 Su .............................. pv. & Mgmt u'peiv s orl fames E. Na-le g Vlce President 34 ....... 5u ,.� pv. & Mgmt Supervision r—supervislon Nicholas A. Gurbick Vice President 7 Supv. & Mgmt .-�. Randall hl. R'ice .IT.......... Secretary 34 ...._ �. -ITmm Su & mt v. M . , m.A , 'Si1er�+;isdre�, Eric Becker Superintendent 14 Supv. & Mgmt Suoervislon Gibson -Lewis, LLC PLAN AND EQUIPMENT QUESTIONNAIRE The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatories hereinafter made. 1. In what manner have you inspected this proposed work'? Explain in detail. Site Visit 2. Explain your plan or layout for performing the proposed work _.w Review shipping dates for all material suppliers and subcontractors and developa detailed ........_. wm. construction schedule. Provide sufficient qualified manpower to meet the schedule. 3. The work, if awarded to you, will have the personal supervision of whom? „A Foreman/Superintendent will be drawn from our pool of qualified personnel when a start date is established * 4. Do you intend to do the hauling on the proposed work with your own forces? If so, give amount and type of equipment used Undetermined until detailed * 5. If you intend to sublet the hauling or perform it through an agent, state amount of sub -contract or agent's contract, and if known, the name and address of sub -contractor or agent, amount and type of his equipment and financial responsibility * Items 4, 5, 6, and 7 may not be applicable in all building contracts; if not, omit. •4- Gibson -Lewis, LLC * 6. Do you intend to do the grading on the proposed work with your own forces? If so, give type of equipment to be used * 7, If you intend to sublet the grading or perform it through an agent, state amount of subcontract or agent's contract, and if known, the name and address of sub -contractor or agent, amount and type of his equipment and financial responsibility, 8. Do you intend to sublet any other portions of the work? w_ _.................. .. If so, state amount of sub -contract, and if known, the name and address of the sub -contractor, whether subcontract is a minority and/or women's business enterprise, amount, and type of his equipment and financial responsibility._,,, 9. From which sub -contractors or agents do you expect to require a bond? 10. What equipment do you own that is available for the proposed work? QUANTITY I ITEM n^^^n ­_-CAPACITY, �PACIT®tTa iS � CONDITION 2 Fork Lifts 2 Skid S 1000 . ..._ Scaffold Sets 10 Trucks 1 All Terrian Fork Lift 1 . _ w.1-1-11-- Laser Screed 1 Reach„Forkhft_ 1 Street Sweeper Shot? .._............ Good A.MeeLlDriye Good Various Good Good _Various 22' RWD... _ Qwd copperhead Good 44" Reach 4WD Good Skid Steer Attachment rnnri -5� YEARS OF PRESENT LOCATION SERVICE _.........._._...._� Various .-._w........... ------------........ Warehouse Various Various Jobs Various Various Jobs��� Various !Jarioris,Jobs _ww Jobs ,various ........................... ............. _Various Various Various Jobs _c1 lok S.. _ Various Jobs .. .. vnrini ic Various Jobs Gibson -Lewis, LLC 11. Whatcquilment do you intend to i.14tAM 11 " I ITEM for use on the DESCRIPTION 12. How and when will you pay for the equipment to be purchased? 13. Do you propose to rent any equipment for this work? should the contract be awarded to you? CAPACITY. ETC APPROXIMATE COST if so, state type, quantity and reasons for renting. 14. Have you made contracts or received firm offers for all materials within prices used in preparing your proposal? Do not give names of dealers or manufacturers 15. List all permits, licenses, or registrations, which you have and are required by law to maintain in order to bid on this work. Please include the type of the permit, license, or registration; the name of the issuing entity; the number of the licenses, permit, or registration; and the expiration date. Dated at Mishawaka, IN this 27th day of Februa 20 20 Gibson -Lewis, LLC (Name of Organization) By STATE of INDIANA.__._ T�^ITITm m Robert A. Lin enfelter�www President ��.�..._ ri ��._.. (Title of Person Signing) COUNTY of w ST JOSEPH SS: Robert A enfelter ................ Ling .a_ a ....... ....Being duly sworn, deposes and says that he is President m.. of the above n„Gibson Lewis LLC oftheabove Gibson Lewis LLC �.. .., r (Name of Organization) and that the answers to the questions in the foregoing questionnaires and all statements therein contained are true and correct. Subscribed and sworn to before me this 27th tGwly al m...._l ltt tB n y 20 20 MyCommission expires $ .. .w /05 2023 .............._.�_._...�.�„ ]Ulu Hodowanl�..�'"",�,��:�,,,..�.._._....H�....�m........._... eC Notary Public Residing in St. Joseph County CONTRACTOR'S FINANCIAL STATEMENT Submitted by.. GIbSOrILEWIS, LLC �w ACorporation Ej ........ , ...a. , ..... A Co -partnership n Individual Principal Office at 1001 W mm1Ith Street Mich W al I N 46544 X Limited Liability Company To Citv of South Bend, Indiana Condition at close of business September 30 p _20 19 37700 1. Cash: (a) On Hand' (b) In bank $ ASSETS (c) Elsewhere ;i 2151� 2. Notes receivable (a) Due within 90 days _..... ._ITITITmmmmIT_� ,,,,,mmmm mmmmmITITm (b) Due after 90 days ..., (c) Past Due 3. Accounts receivable from completed contracts exclusive of claims not approved p pp for payment ..10 5 07 1 3 U 00 4. Sums earned on uncompleted contracts as shown by engineer's or architect's estimate (a) Amount receivable after deducting retainage p , 00eee, w (b) Retainage to date, due upon completion of contracts 5. Accounts receivable from sources other than construction contracts ..., .. 7 _ 6. Deposits for bids or other guarantees: (a) Recoverable within 90 days „ ..... (b) Recoverable after 90 days .w w , , , , .. . 7. Interest accrued on loans, securities, etc 8. Real Estate: (a) Used for business purposes _ _ (b) Not used for business purposes 9. Stocks and bonds: (a) Listed - - present market value (b) Unlisted - - present value 10. Materials in stock included in Item 4 (a) For uncompleted contracts (present value) (b) Other materials (present value) m_mm ........... _ ., M 5m 8 3 0 00 11, Equipment, book value _,,,..... 12. Furniture and fixtures, book value 13, Other Assets -7- Gibson -Lewis, LLC LIABILITIES 1. Notes payable (a) To banks regular.,_,,,,,,,,,,,,, (b) To banks for certified checks (c) To others for equipment obligations (d) To others exclusive of equipment obligations 2. Accounts payable (a) Not past due (b) Past due, 3. Real estate encumbrances 4. Other liabilities 5. Reserves 6. Capital stock paid up: (a) Common (b) Common (c) Preferred ........................ r —.... ........................... (d) Preferred ..... 7. Surplus net worth Total liabilities 1 CONTINGENT LIABILITIES 1. Liability on notes receivable, discounted or sold 2. Liability on accounts receivable, pledged, assigned or sold 3. Liability as bondsman 4. Liability as guarantor on contracts or on accounts of olliers 5. Other contingent Total contingent liabilities -8- Gibson -Lewis, LLC (a) on hand e.m$ Cash (b) deposited in banks named below .......... . ....... . .... ........ - - ----- (c) elsewhere - - (State where) .. ...... . .... .............. ........... . . . . ..... _ _ ... ............ ........ . . .. . . ........ . . .. . . ..... ......... . . .... 0196MMIXIM 3* Accounts receivable from completed contracts exclusive of claims not approved for payment $,10,507,130.00 AMOUNTOF AMOUNT I L��JLO D ADDRESS 0 F CoNrRJ�Ej CONTRACT RECEIVABLE is .......... NAME AND O��nL— Vii �7,130-ff— Have any of the above been assigned, sold, or pledged? ___ If so, state amount, to whom and reason 4* Sums earned on uncompleted contracts, as shown by engineer's or architect's estimate: (a) Amount receivable after deducting retainage ..................................... ... . ...... . ........ $ N (b) Retainage to date due upon completion of contract .. . ... DESIGNATION OF CONTRACT' AND NAME AMOUNT OF �� AMOUNT I AMOUNT RETAINAGE AMOUNT' EXCLUSIVE AND ADDRESS OF OWNER CONTRACT EARP RECEIVED WHEN F—AMOUNT OF RETAINAGE Have any of the above been sold., assigned, or pledged? _ If so, state amount, to whom, and reason *List gepw-atcly each item amounting to 10 percent or more of the total and combine the remainder, -9- Gibson -Lewis, LLC DETAILS RELATIVE TO ASSETS (continued) 5* Accounts receivable not from construction contracts .. ._._...._µ $ 732,758.00 R,bCE1VABLE. NAME AND ADDRESS FOR WHAT WHEN DUF. AG�I�1'I1 T What amount, if any, is past due 6 l Deposits with bids or otherwise as guarantees 7 Interest accrued on loans, securities, etc. ON WHATACCRUFED 8* Real estate (a) Used fur business purposes Book value I11 Not used for business a'tlr )o' ,;es IMIROVIMFINTS DESCRIPTION OF PROPERTY NATURE OF IMPROVEMENTS [ BOOK VALUE LOCATION i HELD IN WHOSE'NAME I ASSESSED VALUE 9 $ N/A NSA......... .... 7 TOTALBOOK VALUE, AMOUNT OF FNCI.1MBFRANCES Gibson -Lewis, LLC DETAILS RELATIVE TO ASSETS (continued) 9 Stocks and bonds (a) Listed - - present market value $ N/A b) Unlisted - present value . ............ LAST INT. PRESENT DESCRIPTION ISSUING COMPANY QR'PiyYAlP PAR MARKET � QUAN- AMOUNT DATE % VALUE VALUE T ITY WHO HAS POSSESSION I IF ANY ARE PLEDGED OR IN ESCROW, STATE FOR WHOM AND REASON 10 Materials in stock and not included in Item 4, Assets: (a) For use on uncompleted contracts (present value) lr ,Other materials (Wresent value) ._WWWWWWWWWWWWWWWWWWWW QUANTITY DESCRIPTION OF MATERIAL I 11 Equipment at book value__ QUAN- DESCRIPTION AND CAPACITY OF ITEMS TITY FORUNCOM- PLETED s 5,83Q!90 OI'HER MATERIALS 5,830.00 $21-7,04-0 AGE OF ITEMS PURCHiVEPRICR I DEPRECIATION CHARGED OFF BOOK VALUE 217,084�00 Are there any liens against the above? If so, state total amount—,,,,,,,,.— iftwo or more items are lumped above, give the Burn of their ages. Gibson -Lewis, LLC T1rTATT c DTJ A-r7v1r'Fn Aeer're 12 Furnil 13 Other DETAILS RELATIVE TO LIABILITIES 1 Notes payable (a) To banks, regular (b) To banks for certified checks (c) To others for equipment obligations �d To others exclusive ofea ui Mient obli ,:rl ons TO WHOM; NAME. AND ADDRESS I WHAT SECURITY 2 Accounts payable (a) Not past due (b) Past Due TOWHOM: N+itw P AND ADDRESS Various�� 3 1 Real estate encumbrances (sane Item Ii', Ass ts)n,,,, 4 1 Other liabilities. ....... ��. �...,.. DESCRIPTION .. ................ �. �...� Various 5_1 Resci ves [INTEREST iNSU NCE BLDCiS. 6c F7)C'I', PLANT I)EPR. tA7 ES BA $ $ $ $ 6 I Capital stock paid up (a) Common (b) Preferred -12- $ N A_ AMOUNT 10,103,135.00 DATEPAYABLE I AMOUNT' $ i3, 00 AMOUNT 87,544.00 Gibson -Lewis, LLC If a corporation answer this: *We are a Limited Liability Company Amount for which incorporated, Organized _ $ 2,719,610.00 Capital paid in caslw. v __...... When incorporated, Or anized I 4 1995 - I laitalized as an LLC t....,.....� _... .......... In what state Indiana Names and titles of all persons having authority to execute and receipt estimate vouchers and to conduct other business for the corporation, including its officers, the signatures of whom are legally binding. National Construction Enterprises, Inc. Member Robert A. Lingenfelter President James E. Nagle Vice President Nicholas A. Gurbick Vice President Do you have necessary certificate of existence" or certificate of authorization for a foreign corporation) to transact an a ce acre ry y ry " ( g rp rp corporate business in this state, under the terms of Public Law 149, Acts of 1986, and acts amendatory thereto? If a co -partnership answer this: Date of organizatinn State whether co -partnership is general, limited or association Give the names, addresses and proportional interests of all parties: Name Address Share The name of the partnership firm under which the above partners are operating is Give names and titles of all having authority to execute and receipt estimate vouchers and to conduct other business for the partnership, the signatures of whom are legally binding. -13- Gibson -Lewis, LLC The undersigned hereby declares that the foregoing is a true statement of the financial condition of the individual, co -partnership, or corporation herein first named, as of the date herein first given; that this statement is for the express purpose of inducing the party to whom it is submitted to award the submitter a contract; and that any depository, vendor or other agency herein named is hereby authorized to supply such party with any information necessary to verify this statement. NOTE: A co -partnership must give fine name and signatures of all partners. A corporation must give full corporate name, signature of official and affix corporate seal. Affidavit for Individual STATE OF COUNTY OF SS; _ being duly sworn, deposes and says that the foregoing financial statement, taken from his books, is a true and accurate statement of his financial condition as of the date thereof and that the answers to the foregoing interrogatories are true. Subscribed and sworn to before me this (Applicant must sign here) day of 20 Notary Public A Ifidavil for Co -Partnership STATE OF COUNTY OF l SS: __---,, being duly sworn, deposes and says that he is a member of the firm of _ _ _ _ that he:; familiar with the books of the said firm showing its financial condition; that the foregoing financial statement, taken from thebooksof said firm, is a true and accurate statement of the financial condition of the said firm as of the date thereof and that the answer to the foregoing interrogatories are true. Subscribed and sworn to before me this (Member of firm must sign here) day of . _.. 20 Notary Public Affidavit for Corporation STATE of INDIANA COUNTY OF ST. JOSEPH I r SS: Robert A. Lin enfelter ........ _ ...being duly sworn, deposes and says that he is President _ _ _ ...... g g of the 4i1"16 Le f lS LLC described in and which executed the fore oin statement, that he is Familiar with the books the said corporation showing its financial condition; that the foregoing financial statement, taken from the books of the said corporation, is a true and accurate statement of the financial condition of said corporation as of the date thereof and that the answers to the foregoing interrogatories are true. 11 imi .b t Ilily Company Subscribed and sworn to before me this 27th day of Febntary........�...�.�...�........�.�e_..........�.�..�..______.......... —._.-- Notary My Commission Expires: 8/05/2023 -14- Residing in St. Joseph County tit t titttss writ[ tsc.ret Robert fit„ inget ct t eater, Preside lade: it Hodowaniec f RV SUTTON, INC. EXCAVATING RITSCHARD BROS,, INC. 160 W RAIL ROAD UNIT 1 1204 W SAMPLE STREET CHESTERTON. IN 46304 SOUTH BEND, IN 46619 WALSH & KELLY PAVING RIETH RILEY CONSTRUCTION 24358 STATE ROAD 23 25200 STATE ROAD 23 SOUTH BEND, IN 46614 SOUTH BEND, IN 46614 ZIOLKOWSKI CONSTRUCTION MASONRY MCLAUGHLIN MASONRY 1005 S LAFAYETTE STREET 56110 TIMOTHY ROAD SOUTH BEND, IN 46601 NEW CARLISLE, IN 46552 STEVENS IRON WORKS, INC STRUCTURAL STEEL CRANE INDUSTRIAL SERVICES P.O. BOX 730 11035 ANDERSON ROAD DEMOTTE, IN 46310 GRANGER, IN 46530 EC BABILLA ROOFING DUDECK ROOFING & SHEET METAL 3974 HARRISON STREET 1634 SOUTH FRANKLIN STREET GARY, IN 46409 SOUTH BEND, IN 46614 WERNTZSUPPLY GLASS & GLAZING PRECISION WALL 1002 KERR STREET 3801 S MAIN STREET SOUTH BEND, IN 46601 SOUTH BEND, IN 46614 OVERHEAD DOOR COMPANY OVERHEAD DOOR INDUSTRIAL DOOR OF NORTHERN IN P.O. BOX 907 3839 S MAIN STREET MISHAWAKA, IN 40546 SOUTH BEND, IN 46614 MASTER TILE FLOORING INTERIOR FINISHES, INC. 1205 WEST LINCOLN HIGHWAY 1616 W THIRD STREET MERRILLVILLE, IN 46410 OSCEOLA. IN 46561 KROPP FIRE PROTECTION FIRE PROTECTION RYAN FIRE PROTECTION 59685 MARKET STREET 9740 EAST 148TH STREET SOUTH BEND, IN 46614 NOBLESVILLE, IN 46060 DA DODD, INC PLUMBING & HVAC EDWARD J WHITE P.O. BOX 430 1011 S. MICHIGAN STREET ROLLING PRAIRIE, IN 48371 SOUTH BEND. IN 46601 MARTELL ELECTRIC ELECTRIC MCMANN ELECTRIC, INC 4601 CLEVELAND ROAD 1454 THIRD STREET SOUTH BEND, IN 46628 OSCEOLA. IN 46561 Bidder: Gibson -Lewis, LLC 1 If you intend to sublet any portion of the work, state the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the governmental unit in the event that you subsequently determine that you will use a subcontractor on the proposed project. Unresolved 4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit. All necessary 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, please explain the rationale used which would corroborate the prices listed. No SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded. *See attached Financial Statement BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 03/16/2020 Name Becca Plantz mmmITITIT Department Public Works BPW Date 3/24/2020 Phone Extension 5998 ................ Review and Approval Re wired Pnor to Submittal to Board ._. _ wwwww Diversity Compliance [] Officer Name Michael Patton and Inclusion Officer BPW Attorney Attorney Name Clara McDan els Dept. Attorney [] Attorney Name Purchasing Check the Appropriate Item I' 1 a Professional Services Agreement F-I Contract Z Open Market Contract ❑ Amendment/Addendum [] Bid Opening [] Bid Award ❑ Quote Opening [] Quote Award EJ Proposal Opening F] C/O & PCA No. El Chg. Order, No. ❑ Traffic Control Other: Retircd Information All Submissions LJ Proposal Special Purchase, QPA EJ Req. to Advertise Reject Bids/Quotes [] PCA F] Resolution [] Ease./Encroach ❑ Title Sheei Company or Vendor Name Gibson -Lewis, LLC .a...W _ .. [] _m.......... Yes If Yes, Approved by Purchasing New Vendor [] No ❑ MBE MBE/WBE Contractor Completed E-Verify Form Attached ❑ No Project Name Century Center Elevator Renovation Project Number 118-104D Funding Source Hotel Motel Account No. 7304.42010.000.0099 Amount $168,700.._......�._���_��������__....................... .... Terms of Contract Lum Sum Purpose/Description _Upgrade and modernize the passenger elevator in the North end of the Century Center building. .... ........ ...... ..... ..... ......M.... For ChangewOrders Only Amount of F-1 increase $ _�.. ... ___._._.............. Decrease Previous Amount $ Increase % Current Percent of Change: Decreasemm_% New Amount $ Increase % Total Percent of Change: Decrease (w Time Extension Amount: . New Conviction Date: