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HomeMy WebLinkAboutOpening of Bids - 2020 Curb & Sidewalk Construction Proj No. 120-001 - Ziolkowski Construction, Inc.WTI CONTRACTOR'S BID FOR PUBLIC WORK CITY OF SOUTH BEND" NNDUANACHECKLIST FOR BIDDERS Project Name 2020 Curb and S,idewalk Construction Project No. 120-001 For Bids Due May 12, 2020 at 9:30am, Local Time From time totime the South Bend Board ofPublic Works finds itnecessary to rejectobid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist inorder 10make sure that your bid |sdone inthe proper manner. Proper bid security included. The bidder has the option ofproviding either oCertified Check X or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely X Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and Certification mfuse ofUnited States Steel Products orFoundry Products. Proof of MVVBE Utilization Plan [K8VVBE-1.0]. If minimum participation goal is not met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MWBE Contacted Form X WA Acknowledge Receipt ofAddandum(s)included with the bid. X All required additional information is included with the bid. Proposal statements and other affidavits all signed bythe proper party with name either ]{ printed nrtyped underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, bdoes not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Ziolkowski Construction, Inc. By Authorized 8' D@tUne: Bill Pr�n[dcm1 Print Nama����e� �^"m� ' Vers|omO1/2S/2D2O Contractor's Bid for Public Works I Date: May 12, 2020 Date: Address'. MEMO= PART I (Must be completed for all bids. Please type or print) May 12, 2020 Bidder (Firm): Ziolkowski Construction, Inc. 4050 Ralph Jones Drive Citylstate/zip: South Bend, IN 46628 Telephone Number: ( 574 ) 287-1811 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: 2020 Curb and Sidewalk Construction. the City of South Bend, Indiana, in accordance with plans and specifications prepared by: Department of Public Works Division of Engineering and dated 3/30/2020 for the sum of (enter the Total Bid as shown on the Proposal) Four Hundred Fifty -Four Thousand Three Hundred Thirteen Dollars 454,313.00 (Enter sum of Total Bid shown on Proposal) (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 addendurns attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment, By Bill Favors, President (Signature) (Printed Name of Person Signing) The above bid is accepted this Subject to the following conditions: 1467.110AX031,201 -4 Gary A. Gilot, President Elizabeth A. Maradik, Member Jordan V. Gathers, Member e 5 � �., I �Lm ME Joseph R. Molnar, Member Therese J. Dorau, Member Attest: Linda M. Martin, Clerk Version 01129/2020 Contractor's Bid for Public Works - 2 K% PART 11 (For projects of $100,000 or more ® IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/her/its bid. Attach additional pages for each section as needed, SECTION I EXPERIENCE QUESTIONNAIRE I . Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. See, Attached 2. Attach a listing of public works projects currently in process of construction by your organization. See [ached 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. N/A 4. Attach references from private firms for which you have performed work. See Amiched 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.) -As directed by the Architect / Construction Manager / Bid Doculnenl,s, 2. Attach a listing of the names and addresses of all subcontractors (Le. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. - If'Subcontractors wfll bC Used "?(" �Nrffl submit this inforniation 24 hoi,jrs after notil-ication. 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. .1 fl'Subcontrnctors Nvill bC LUSed we will submit this infonnation, 24 hours after notificMicm. 4. Attach a listing of equipment you have available to use for the proposed project. - We will use the appropri,ae equipaient re-q[Jired io corniflew ti"le PrU ' jeCir properlyowd on ffine. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. .... . Yes I 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 01/2,9/2020 Contractor's Bid for Public Works - 3 t! 8 ct 0 kc) <5 cn 0 to 0 a, > 0 m 0 cn -tt L) CN 0n a, a C7ti 1 C) cq ko m 00 00 �t rn DO oo Ln 4, 00 CN cl, 00 oc Ln Gq 64 biA UJI C) 0 u 0 Ln En tn 1"4 (/3 0 4-4 Cd UO Q 0 0 Cy Q ya., 0 0 0 uo En 03 CIO -4w Cd cd 4;,o C) bm 15 W 0.4 ti WNW, a) U U u u 00 + d) u rq 00 00 a) 00 t 00 . . rA b,Q ....... . -q Lon ca kn W/k 00 CD CD rq CA cq Ln Lr� 00 Lr) cq 00 kn �' C- ce& Go% bl) 44 V) 0 .0 p- u %Gill0 0 U . .... . . . . . . . . . . . . . . . 7� 44 L t17A IS 00 Construction, inc. General CORStruetion & Design/Build _r S t r o % g' 0" f 'I' sV­'�"Ip's­'Since 1974 University of Notre Dame 200 Facilities Building Notre Dame, IN 46556 Tony Polotto LEER, AP 574-631-4200 City of Mishawaka Ken Prince 574-258-1625 600 East Third Street Mishawaka. IN Fetters Construction, Inc. Steven A. Fetters 260-927-8516 5417 County Road 427 Auburn, IN 46706 Memorial Hospital & Health System Larry Lies 574-647-1000 615 N. Michigan Street South Bend, IN46601 When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF Indiana ) ) SS: St. Joseph COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such ]citing 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 - 4 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5, Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no Iater 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 ate-MWBE; however, they may not unlawfully discriminate against said MBEIWBE. 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-I). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a detennination 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 - 5 I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are trace and correct, Dated this 12th day of May 2020 Subscribed and sworn to before the this My Commission Expires January 28, 2023 Ziolkowski. Construction, Inc. Contractor/Bidder (Finn) Signature of Contractor/Bidder or Its Agent Bill Favors, President Printed Name and. Title lath day of May ,, 20 2a tary Pu is Jennifer Wiest County of Residence St. J 1,e JE NIFER IVIES aw.a:` Notary Public, State of Indiana St. Joseph County "••5��4 Commission # 663344 A �i��N6tAN My Commission Expires "�+arra+� VI January 26, 2023 Version 01129/2020 Contractor's Bid for Public Works - 6 x .7 BID/PROPOSAL CITY OF SOUTH BEND Project Name: 2020 Curb and Sidewalk Construction Project Number: 120-001 May 12, 2020 at 9,30arn Local Time -see J1sotdht)endh gj for For Bids Due, electronic bid submission information Contractor Name: Ziolkowski Construction, Inc. 11v4--9T*1qM Item No. Description Quantity Unit —S Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 350 Sy- —S $ 33.00 $11,550,00 2 CONCRETE SIDEWALK, 4-IN 350 gy- T69.00 $24,150.00 3 CONCRETE CURB, REMOVE 630 LFT $ 18-00 S 11,340.00 4 CONCRETE CURB, MODIFIED 630 LFT $40.00 $25,200.00 —1,375.00 5 CONCRETE APPROACH, REMOVE 25 SYS $ 55.60--T 6 PCCP FOR APPROACHES, 6-IN 25 SYS $ 140-00 $3,500.00 7 TOPSOIL AND SEEDING 28 SYS $76.00 $ 2,128.00 [WTAJ-.-ff 6-N, "I Item No. Description Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 200 SYS $44.00 S 8,80Q.00 2 CONCRETE SIDEWALK, 4-IN 200 SYS $69.00 $13,800.O0 3 CONCRETE CURB, REMOVE 320 LFT $44.00 $ 14,080.00 4 1 CONCRETE CURB, MODIFIED 320 LFT $40.00 $12,800.00 7 TOPSOIL AND SEEDING 180 SYS $32.00 $5,760.00 11 TREE, REMOVE, 30 IN 1 EA $1,810-00 $1,810.00 12 TREE, REMOVE, 48 IN 1 EA $2,660,00 $2,660.00. 13 STUMP, REMOVE 2 EA $483.00 $966.00 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 4 "--dy—S EA $460,00 $1,840.00 15 CURB RAMP, REMOVE 16 $88,00 $1,408,00 17 PAIRED PERPENDICULAR CURB RAMP 16 SYS $235.00 $3,760.00 DIVISION A2 TOTAL $67,684.00 Item No. Description Quantity Unit 1 Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 405 sys $44.00 $17,820.00 2 CONCRETE SIDEWALK, 4-IN 405 SYS $69.00 $27,945,00 3 CONCRETE CURB, REMOVE 2110 LFT $44.00 $9,240.00 4 1 CONCRETE CURB, MODIFIED 210 LFT $40.60 $8,400.00 5 CONCRETE APPROACH, REMOVE 13 SYS 9-11-10.00 $ 1,430.00 6 PCCP FOR APPROACHES, 6-IN. 13 SYS $140.00 $ 1,820,00 7 TOPSOIL AND SEEDING 120 SYS 43.00 $ 5,160.00_ 11 TREE, REMOVE, 30 IN 1 EA $ 1,810.00 $ 1,810,00 13 STUMP, REMOVE 1 EA $483.00 $483.00 15 CURB RAMP, REMOVE 56 SYS 8 0 $4,928.00 17 PAIRED PERPENDICULAR CURB RAMP 40 SYS 0 $9,400.0 DIVISION 131 TOTAL $88,436.00 Version O1/29/2020 Contractor's Bid for Public Works - 7 ," are BID/PROPOSAL �I CITY OF SOUTH BEND` Project Name., 2020 Curia and Sidewalk Construction Project Number: 120-001 For Bids Cue; I .,m I�i�i�irllio 0.1 I t„irds for May 12, 2020 at 9:30am Local Time � see Iif1 ��.w,�I���i�rmtilil, m electronic bid submission infformation Contractor Name: Ziolkowski Construction Inc. p N. No Description Quantity Unit Unit Price �' Total Amount 1 CONCRETE SIDEWALK, REMOVE 70 SYS $ 44.00 $ 3,080.00 2 CONCRETE SIDEWALK, 4-IN 70 SYS $ 69.00 $ 4,830.00 3 CONCRETE CURB REMOVE 100 LFT $ 44.00 $ 4 400.00 4 CONCRETE CURB, MODIFIED 100 LFT $40.00 $ 4,000.00 5 CONCRETE APPROACH, REMOVE 30 SYS $55.00 $ 1,650.00 6 PCCP FOR APPROACHES, 6-IN 30 SYS $ 140.00 $ 4 200.00 7 TOPSOIL AND SEEDING 60 ­SyS7 $44.00 $ 2,640.00 10 TREE, REMOVE, 18 IN 1 EA $ 1,260.00 $ 1,260.00 11 TREE, REMOVE, 30 IN 1 EA $ 1,810.00 $ 1 810.00 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 2 EA $ 402.00 $ 804,00 DIVISION B2 TOTAL $ 28,674.00 Item No. Description Quantity Unit Unit Price Total Amount 1 I CONCRETE SIDEWALK, REMOVE 100 SYS $ 44.00 $4,400.09- 2 CONCRETE SIDEWALK, 4-IN 100 SYS $ 69.00 $6,900.00 3 CONCRETE CURB, REMOVE 140 LFT $ 44.00 $6.160.00 4 CONCRETE CURB, MODIFIED 140 LFT $ 40.00 $ S 600.00 7 TOPSOIL AND SEEDING 80 SYS $ 39.00 $ 3,120.00 10 TREE, REMOVE, 18 IN 1 EA $ 1,260.00 $ 1,260.00 11 TREE, REMOVE, 30 IN 3 EA $ 1,810.00 $5,430.00 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 4 �EA $ 489.aa $ 1,956.015 CURB RAMP, REMOVE 16 YS $ 110.00 $ 1,760.00 16 ONE-WAY PERPENDICULAR CURB RAMP 16 SYS 235.00 3,760.00 DIVISION B3 TOTAL $ 40,346.00 f:, Item No. Description Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 100 SYS $ 44.00 $4,400.00 2 CONCRETE SIDEWALK, 4-IN 100 SYS b9.00 $ 6 900.00 3 CONCRETE CURB, REMOVE 160 LFT $44.00 $7,040.00 4 CONCRETE CURB, MODIFIED 160 LFT $40.00 $ b 400.00 5 CONCRETE APPROACH, REMOVE 20 SYS $ 55.00 $ 1,100.00 6 PCCP FOR APPROACHES, 6-IN 20 SYS 140.00 $ 2 800,00 7 TOPSOIL AND SEEDING 35 SYS $ 98.00 $ 3,430.00 10 TREE, REMOVE, 18 IN 2 EA $ 1,260.00 2,520.00 11 TREE REMOVE, 30 IN 1 EA 1 $ 1,810.00 $ 1 810.00 13 STUMP, REMOVE 1 EA $ 483.00 $483.00 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2,5 IN 4 EA $ 460.00 $ 1,840.00 15 CURB RAMP, REMOVE 16 SYS$88.00 $ 1,480.00 17 PAIRED PERPENDICULAR CURB RAMP 16 SYS $ 3 760.00 DIVISION C1 TOTAL $ 43,891.00 Version 01129/2020 Contractor's Bid for Public Works - 8 /11 BID/PROPOSAL i ✓ . CITY OF SOUTH BEND rv� Project Name: 2020 Curti and Sidewalk Construction „ Project Number: 120-001 For Bids Due: May 12, 2020 at : 0am Local Time — see i�ttt) ma �/���:::tl�Tl�r ul„�I,inq tt 1bL s for electronic bid submission information Contractor Name: Ziolkowski Construction, Inc. Item No. Description Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 180 SYS $44.00 $ 7 920.00 2 CONCRETE SIDEWALK, 4-IN 180 SYS $ 69.00 12,420.00 3 CONCRETE CURB, REMOVE 225 LFT $ 44.00 $ 9,900.00 4 1 CONCRETE CURS, MODIFIED 225 $ 40.00 $ 9,000.00 5 CONCRETE APPROACH, REMOVE 17 88.00 6 PCCP FOR APPROACHES, 6-1N 17 rEA $ 140.00 $ 2 380.00 7 TOPSOIL AND SEEDING 125 $ 33.00 I 4,125.00 11 TREE, REMOVE, 30 IN 4 1,810.00 $ 7 240.00 13 STUMP, REMOVE 1 $483,00 $ 483.00 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 5 EA 437.0Q $ 2,185.00 DIVISION E1 TOTAL $ 57,149.00 Item No. Description Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE.. 150 SYS $ 44.00 $ 6,600.00 2 CONCRETE SIDEWALK, 4-IN 150 SYS $ 69.00 10,350.00 3 CONCRETE CURB, REMOVE 205 LFT $44.00 $9,020.00 4 CONCRETE CURB, MODIFIED 205 LFT $ 40.00 $ 8,200.00 5 CONCRETE APPROACH, REMOVE 14 SY'S $ 88.00 $ 1,232.00 6 PCCP FOR APPROACHES, 6-1N 14 SYS $ 140.00 7 TOPSOIL AND SEEDING 115 SYS $ 35.00 $4,025.00 10 TREE, REMOVE, 18 IN 2 EA $1,260,00 $ 2,520.00 12 TREE REMOVE 48 IN 1 EA $ 2,660.00 $ 2,660.00 13 STUMP REMOVE 1 EA $ 483.00 $ 483.00 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 4 EA $ 460,dIJ $ 1,840.00 Bidder (Firm): Address: City/State/Zip: DIVISION E2 TOTAL $ 48,890.00 Ziollcowski Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 Telephone Number: ( 574 ) 287-1.811 By�:°�. (Signature) Bill Favors, President (Printed Name of Person Signing) Version 01/29/2020 Contractor's Bid for Public Works - 9 4.. 0 E m Z CL 0 u 9 04 V- I I a I ) 220 C 0 '0�' 2-0- 0 T3 EL LLJ m CL E 141) E 0 Qrl� CD CL cn aj.CR N (L -0 :3 ,2 0 Cy CL 0 iw P-4 C) 0 LZ 0 E2 — (D 0 0 C) Co E kf) 0 C, -0 ": a> 0 U) to +, rA 06 7� E z IN' I I 2 a), a 1011 0 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN 14, 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 MBEIWBE participation. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business as defined by the Indiana Department of Administration ("IDOA"). Project Number: 120-001 Date: May 12, 2020 Project Name: 2020 Curb and Sidewalk Construction Bidder: Ziolkowski Construction, Inc, Contact Person: -Adam Bradley Telephone: 574-607-5077 Address: 4050 Ralph Jones Drive City: South Bend State: Indiana zip� 46628 Email: abradley@zbuild.com To determine whether a bidder has demonstrated good faith efforts to reach the MBEANBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS MBEIWBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business X AB Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women Owned Business as found on their website (http://www.in.gov/idoa). ACTION (ADVERTISE/CONTACT): In order for your bid to be deemed responsive, the City of South Bend requires that all perspective bidders complete no less than 2 of the following: 1. Attend all pre -bid meetings scheduled by the City to inform MBEANBEs of contracting and subcontracting opportunities. 2. Advertise in general circulation and/or trade association publications concerning subcontracting • AB opportunities, and allow MBEANBEs reasonable time to respond. 3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated to inform MBE/WBEs of subcontracting opportunities and allowed sufficient time for them to participate effectively. 4. Utilize pre-existing services of available community organizations, small and/or disadvantaged business assistance offices and other organizations that provided assistance in the recruitment and placement of MBENVBE firms. "Bidder must circle or otherwise notate which of the two (2) required actions were performed. GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBENVBES, • AB including providing such MBEANBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject MBEA(VBEs 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 • AB MBE/WBEs in order to increase the likelihood of meeting the MBE/WBE goals (including breaking down contracts into smaller units to facilitate MBEiWBE participation) CONTRACT RECORDS: The bidder has maintained the following records for each MBE/WBE that has bid on the subcontracting opportunity: 1, Name, address, and telephone number • AB 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 MBEiWBE was unqualified to perform the job. *Proper demonstration R Good Faith Effort requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 01/29/2020 Contractor's Bid for Public Works - 11 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 contacted MBEIWBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business. Project Number: Project Name: Bidder By: 120-001 2020 Curb and Sidewalk Construction PAGE OF MWBE Participation Goal Ziolkowski Construction, Inc. Project Manager / Estimator May 12, 2020 (Signature) Adam IM01'ey (I itle) (mate) MWBE Firm Ritschard Bros., Inc. Owner or Contact at MWBE Firm Don Ritschard Telephone: 574-288-4777 Fax: Email: BIT1204@datacruz.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Demolition / Site Prep RESULTS OF CONTACT WITH THE MWBE FIRM: Provided a Bid MWBE Firm LaPotte Construction Owner or Contact at MWBE Firm Jake De Javennnnn Telephoner 219-393-5555 Fax: Email: JDE1-IAVENc3LAPORTECONSTRUCTION.COM TYPE OF WORK SOLICITED FOR THIS PROJECT: Demolition / Site Prep RESULTS OF CONTACT WITH THE MWBE FIRM: �Jf, Version 01129/2020 Contractor's Bid for Public Works - 12 t t __ _ G4+k1�YLT;sppeeChF�maw cl Company ID Number, 466671 THE VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANI]UM OF UNDER -STANDING ARTIOI.E.I PURPOSE AND AUTHORITY Th15 M.erfioraridum of Understanding (MQU) Sets f6rtb the peint!� of agreement biatWeen the Department of Homeland SeG fl` f (DffS) and lkowski Constructim ... be.. (Employer) re�arding the Etnplayr is partioipatlon rn the Employment Eligibility 'Verification Program (E- Verify). This MOU explains certain, features of the E-Variiy pragf�m and. enumerates specific responsibilities of UHS, the Social Security AdminWration (�SA)i and the Employer. E-Verify is a programthat electronically confirms an employee's eligi City to work in the United Stag gAer completion of the Employment Eflgibility VeAcation Form (Vorm 1-9). For covered government contractors, E lerif' is used #averify the empleymenf eligibil.4 of all nev�ly aired employees and all e�istfng employees asslgnod tit` Federal contracts, or to verify the entlre Workforce if the oontraotor so chooses. Authority for the l=-Veri y program- is found In Title IV, Subtitle A, of the ([legal Immigration Reform and immigrant Responsibility Act of 1996 (IIRIRA), Pulp. L.1 04-208; 1 1d...8tat. 50Cl9, as.. amended (8 U,s.C: § 1324a note). Authority for use of the EVe* progrsm by �orieral confraetora and 'subcontractars covered by the ierms of Subpert 22.18, "Employment 81gi�ility Verificatipnv, of the Federal Acgcrisitirron: regulation, (FAR) (herelhaf#er referred'to in this MOU'as a Tederal contiactpr with the FAR [= Verify clause") tp verity the employmeltt eligibift of deffain dinployeas w6rking an Federal contracts is also Mund 1h Subpart 22,18 a6d In keeuitivb Order'12989, as amended: ARTICLE II FUNCTIONS Td. BE PERFORMED A, RESPONSIBILITIES OF SSA 1 SSA agrees firs provide the Employer with available ihformatron that allows the Employer to confiim the accuracy of 8Qcfaf Security Numbers prov$ded by all employees verified. under this MOU and the emp1bymeht authorization of U,S: citizens, 1 SSA agrees to provide to the Eroofoyer eippr`aprlats bsslstanee with operatidnal problems that may arise during the- Employer's participatidn in'the E-Verify- program. SSA agrees to provide the Employer inrith namesi titles,. addresses, and telephone nurttbers of SSA represent-69ves to becontacted during the E-Verify process. 3,, $S,A agrees- to safeguard the Information providad by fbe Em-ployei through the .E1/.'edf prpg.rarrr procedures, and to lin'lif access to such Ififa oration, as is apprclprlatQ y- law, to hidivirlutals resAQnsible for ttte vetificatlon cat Social Security Kumbem arid for' evaluation of the E_Verify program orsuch other persons or entities who may tie authorized by 9SA as governed Page I of•93 I E Vedfy f DIJ for Employer I Rev1E9Db Dat6 ODIG1109 www.dhs.gov/E.Varify. L-F.-Ver cofiipamy W Number. 486671 0; b1ij-11,11 To be accepted as a porUdlpant in E-Veflfy,-you shduld only sign the Efilployar's, SectI.On of the slghature page. if you have -any qu6stlana, cantad E-Vetify at 384 8-464-4218. Eiii0lo;Sr MWOW04- COIF KWO-A, TOO. B01 Fa*or--q Name (pfeasarype or Prfnt7 Eldetronically Signed riffe, D111012012 Data Department pf H911*12'M Secufty — WOW10ft DIVNIO" uscis vorioeafloli DMAOA MMM {pleass Type or print} Electronitally Slea itfe '51patur4 I'Aftatilo'A Required foe the E-Vbdfy Program wormiffliv relAtIng-t6y , r cnmoalfy-, GcofiV Name-. 7-1olkowski Constym-fiDO, W. Company Fqq!& Address- 4060 R*h .Jones Or. I Smith Bend, IN 46620 Company Aitem�;te County of Parish: U-JOSEPH Eniplpyef lqontiffgaflon Number 1364445992 Page 12 of 13 I'EVerIfy MOU for EMpTuyqr I RaWsIm D* 0101109 wW.dhgovlE-Vadfy Compony 10 Number: 486671 .NoIth Arhedcnn IndustrY AdmInIstrator'. dumber of Evnployees: 100 LO 469. Nknbor qf gitos Verified Axe -you YOM' g fair me 6 than 1 WO Uyes, pj6ase prwido the number of sites verfiled for . ym [it each State; MLANA I- sites) Inf6ftation re.latIngto-th.e. Ptogram Admifilstrator(s) forydtfrCbmpany 6VI policy queitiom or operational problems., James keldsen TelophomNihbef. (§74).281 - -ISU W. 363, FagXtmber (514) 344 - 5-533 7-mail Ad kej.jsep@ w dvegs, I _Ai#Idxo Page ia of la I ExVeirry -MOU for Emlytoy er I Revlelori Dati-, 09101/05 P-Nerify - Employer Wizazd Company fnfbmation Page I of 1 E-Verify. E mptayment E11gii Hty Verification 011ck any for help H°me Company Information .��� J 1~ S4!elwme U.ei ID _ LBs%L-cgfn dameslceldsen 12:34 PM - 08012016 Lag Out My Czses New. Casa Company Name: Zlolkowskl Qonsfrurlon, lnc, Mgw Cases 1fI6W edit, Search Cases Company 117 Nermtrsr: 4$Ba71 M 1'rnftfa 13oing B€ksiness As (DSA) Ldlt Pro0a flame: Change password IaUNs Numi�er: Changp Securlly gUBSiiane M9 company Physloal Location: Mailing Address: Ede Company Prcdo. Address 1: 4050 Ralpb Jadds Dr. Address 4: Add New user Address 2: Address 2: V1sw13c ang users City: So4ih Bend City - Close GwnpanyAecount .Stag; 1N 9bf# My ftapprtp zip bads: 46623' Zi¢ Cade. VMew -Reports Covinty: ST JQSE=PH l0y Resources View Esseaal Resources Additional Information: Take-rut❑dal Empioyerldep.Miicat on Number:s59445P92 Vtew User idanual Total f4umber of 1zmplbyees: 100 fo499 `share ideas Parent Organlzatlon- Contact Us Adrniniatrator: orgariization Resignation: Bm ployer Gafegory: None of #mesa categorles apply NAiCS Coda: 236 - CONSTRUCTION 'of BUI LD1140a TntalRiving $it9W 'i Total Poin#s of Goritairt 1 lliavu MOU VieuirJ'~dEti piety i i;'dii: �igW 11=d[t kJ.6,DegafmankolHomlagd5ecurily-wvxLdtfsgov IJ.S.ClilzeppMpand lmrdyailonSeMces-mmwscg-a?V 0bW.nlaa4Vavytrs 144 � Document ru e/ A 3t / ,2 0 CONTRACTOR: (Name, legal status and address) Ziolkowski Construction, Inc. 4050 Ralph Jones Drive South Bend, Indiana 46628 OWNER: (Name, legal status and address) City of South Bend, Board of Public Works 227 West Jefferson Boulevard South Bend, Indiana 46601 BON® AMOUNT: SURETY: (Name, legal status and principal place of business) Liberty Mutual Insurance Company 175 Berkeley Street Boston, MA 02116 Five Percent of Accompanying Bid (5% of Accompanying Bid) PROJECT: (Name, location or address, and Project number, if any) 2020 Curb and Sidewalk Construction Project No. 120-001 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. and sealed this 12th day of May, 2020 ` iskiConstruction, Inc. (Seal) (Title) Liberty Mutual Insurance Company (Su µ�-,a_ Wm...__ (Seal) Johnson w ( itle) Adrienne C. Stevenson, Attorney -In -Fact 11 Sharon Jean Potts , a Notary Public in and for said County, do hereby certify that Adrienne C. Stevenson ­ --------- as Attorney -in -Fact, who is personally known to me to be the same person whose name is subscribed to the foregoing instrument, appeared before me this day in person, and acknowledged that they signed, sealed, and delivered said instrument for and on behalf of for the uses and purposed therein set forth. Given under my hand and notarial seal at my office in the City of Atlanta in said County, this 12 th — day of May A.D. — 2020 . /Iotary Public Sharon Sharon Jean Potts NOTARY PUBUC Fulton county, G-.:EORGIA commission r 0 1 'M My commission Expires 02113M&M] in U a� O cu > N � 02 6 0 CU 0) M Ea -a U M c > a) 0 Z v This Power of Attorney limits the acts of those named herein, and they have no authority to mtl Lib bind the Company except in the manner and to the extent herein stated. erty Mutual. Liberty Mutual Insurance Company —--SIAZET"Y The Ohio Casualty Insurance Company West American Insurance Company Certificate No: 8201331 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Adrienne C. Stevenson all of the city of Atlanta .,state of Georgia each individually if there be more than one named, its true and lawful attomey-in-fact, with full power and authority hereby conferred to sign, execute and acknowledge the above -referenced surety bond. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 30th day of M ya , 2019. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company \Nsbp 01 INS& \wsuq West American Insurance Company ��}\ 4°aPok4 9'LC� GrJP°°aPo�T Apt ��P °°aPor a �2Cti u� � Fo - � �' 1912 n ® 1919 1991 ryrr y' �� SSACHUS� .db ® NAMPS\� ,d$ -e OtA0 Ab David M. Carey, Assistant Secretary STATE OF PENNSYLVANIA ss COUNTY OF MONTGOMERY On this 30th day of Ma 2019, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and WestAmencan Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. COMMONWEALTH OF PENNSYLVANIA Notarial Seal���� Teresa Pastelle, Notary Public s Upper MerionTwp., Montgomery County My Commission Expires March 28, 2021 �y' Teresa Pastella, Notary Public Member, Pennsylvania Association of Notaries This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV— OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation —The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys- infact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, of Liberty Mutual Insurance Company, The Ohio Casualty Insurance Company, and West American Insurance Company do hereby certify that this power of attorney executed by said Companies is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 12th day of May 2020 I Suf�q �01 INS&R \NSUpq h� G°RPo/�,yr �iC� 4J'� G°0.Poq,4'% �Z CIP °°µP°17gr 1912 0 ®$1919w ® � 1991 n � y yqo 0: MAMPS `,d� V A'bIA0 �b Renee C. Llewellyn, Assistant Secretary i Marsh MSurety POA LMIC OCIC WAIC Multi Co_042019 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name 2020 Curb and Sidewalk Construction Project No. 120-001 For Bids Due May 12, 2020 at 9:30am Local Time Contractor Name: Ziolkowski Construction, Inc. The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 63 of The Responsible Bidding Ordinance No. 10594-18 (hereinafter, "Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders") by December 31 st for the upcoming calendar year, or within twelve (12) months of obtaining pre - qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective January 1 of the following year, or immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 01/29/2020 General Conditions - 6 POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder and all subcontractors on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 01/29/2020 General Conditions - 7 PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements: (i) X By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. (ii) X By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (b) Attachments: (i) X Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) X Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. (iii) X List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. (iv) X 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. Version 01/29/2020 General Conditions - 8 CERTIFICATE OF QUALIFICATION to provide CONSTRUCTION SERVICES for PUBLIC WORKS PROJECTS to the STATE OF INDIA.NA This Certification Board, having duly considered application for qualification in terms of agparesrt experience a��d finnnciat resources; acid under the applicable Indiana Code 4-13.6-4 and adopted rules of this Board, hereby issues a Certificate of Qualification to provide comb -action services to the State of Indiana for Public Works Projects to: 4050 RALPH JONES DR ,SOUTH BEND IN 46628 Phone 574-287-1811 Fax 574-234-0151 Company Official BILL FAVORS for the hveDty-seven month period stated hereiu, unless revoked by this Hoard for cause, and in the claasd€catious of services stated below. This certifioatc suporoedes any previous certificate, 1521.00 Apartment Buildings, hotels and Motels 1541,01 Industrial Plants and Warehouses 1541.03 Additions, Alterations, remodeling, and Repair 1542.00A Inst. Bldgs.(Hospitals, Schools, Prisons)>$10,000,000 1642.008 Inst. Bldgs.(Hosp., Schi., Prsn.)'$1,000,000, <$10,000,000 1542,01 Institutional Sldgs (Hospitals, Schools, Prisons) 1642.02 Commercial Buildings (Offices, Stores, Restaurants) 1542.04 Additions, Alterations, Remodeling, and Repair 1721.01 Painting of Buildings & Other Structures 1741.01 Brick and Black Laying 1741.04 Stowe work , 1741.05,1762.01,1752.02,1771.01 CERTIFIGAT1ON DATE 1019/2019 EXPIRATION DATE 11912022 THIS CERTIFICATE ISSULD BY THE STATE OF 1IdDIANA, PUBLIC WORKS DIVISION CERTIFICATION BOARD, 402 WEST WASHINGTON STREET, ROOM W467, INDIANAPOLIS, INDIANA 46204, ALSO ACTS AS THP OFFICIAL NOTICE OF EXPIRATION. Tracy L. Cross, !Wx c;utive Secretary .. Certification Board DAnW P02 State Form 3983R Rov. a7i06 STATE OF MGANA OFFICE OF THE SECRETARY AROF STALTE CERTIFICATE OF WVSTENCE To Whflffi These Presc&fs Come, Greetings: virtuLndiana, thecustodian of the coTorato r¢oords, and groper of cial to exccnte this ceriffluate. I .Buxthar mrtify t$at rcroTds of this offldisDiose that ZIOLKOWSM CON TRIWTIO , INC. dxlu Mod the regtdsite documents to eo=ence business activities under the la- vg of etc of in", na on Dev,=ber 11, 1978, ands -a in e tenoe or anthorazed wo transact business in the State of hidlana on Deomber 02, 2015, I flirther cm4ify this For -Profit Domestic Coiporation has EF-d its rawt recent report recwired by hidiana Ian wn the Secretary of State, or is no yet required io fie such repot and that no rtofice of withdrawal, &solwion or empiraton laa� been filed or men place. Ia Witness'Whereof, I havo harounto get n-y hid and -sfxd the, seal of the State of indima, at the city of Indianapolis, ibis Second Tray e�f December, 2015. i Cori tie Lamon, get retay of, tate 197812-318120151 0203232 .ter° VV construction, Inc. General Construction & Design/Build ASNN�iR� �W"4�fi ^r��Yk W" {N Ri',43Vo11 hiP°1974 May 12, 2020 Subject: Operations Letter Dear Sirs: Ziolkowski Construction, Inc. has been in business since 1974 and operated during that period of time under that name only. Ziolkowski Construction has not violated any federal, state or local laws, including violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA) laws, federal Davis -Bacon Act laws, within the past five years. Ziolkowski Construction, Inc. is proud to employ the industry's top skilled craftsmen. We have a core group of union craftsmen working on our projects and supplement that group with trained skilled workers from the local union halls. We currently have sufficient workers to perform the work that we are bidding for the above project. All individuals performing work for Ziolkowski Construction, Inc. will be properly classified as employees under the federal Fair Labor Standards Act and in line with all Indiana State and local ordinances. Ziolkowski Construction, Inc. had no federal, state or local tax liens or tax delinquencies in any of the preceding three tax years. Respectfully, ZIOLKOWSKI CONSTRUCTION, INC. -,,-0 I -1 JI Bill Favors President & CFO 4050 Ralph_Jones„Dr•, South Bend, IN 46628 Phone 574 287-1811 Fax 574 234-01„61 Committed to professionalism and excellence for the benefit of our clients, employees, and shareholders. M * m SJb sus U O c> O c> 4 4 c> 4 o ¢�'U�nOwN 0�1�n o f 0 0 0 o N o 0 Vl r� Vl N 01 N Vl ,N-i Vl 69 69 69 69 69 69 69 U tz tz �` �` O tz bb cn w bn bp ON N _' m c mu, O N 0' cs N ce v 8 ^' cn �C Nov O V i r M Q M N O•-� l '� 61 4� d '� a1 ,� ,� U d U d U l U 61 U j 61 61 61 61 61 61 a1 O O N N N N N N N CIA N CIA N 3� M 00 O 00 't d M \O l 61 d' N V1 00 61 N � 69 69 69 69 69 69 69 69 69 69 to tc O O cG s O O U s to c`ni wd ! cn cr — � dd " cni cr � d O w¢a aC H CA QU U o O U CO � Q U � Q O }� O x U O }� O O O a. O a O U U 2:1O U .� U CG 4- CMG a U S7 O O O > O O O O O O O � Q O O U O a a x a c � o 0 0 cc c� ccc w cc 4-0 cc o U on ^c man d to o ^c In cc cc cc `04 � cc 4-0 cn cn U °�, A BAC 4: IN/KY r: N,v w-w,,, I),, i c 4, trai nj fIg Com bac4apprenticeship(�-r)giila,il.coiii 219-525-4443 Roger Jones - AfanagingDireefor August 20, 2018 C/o Ziolkowski Construction, Inc. To Whom It May Concern, This is a letter of recommendation on behalf of Ziolkowski Construction, Inc. The BAC 4 IN/KY Apprenticeship & Training Program is a statewide program that was established in 1994 and is recogni-Zed by the U. S. Department of Labor and is considered in good standing. Ziolkowski Construction, Inc. has been a "signatory union contractor" since 2000 and at the present time employ enrolled apprentices. Ziolkowski Construction, Inc. has continued to follow the guidelines set forth in Collective Bargaining Agreement with BAC Local #4 IN/KY meeting the required journeyman/Apprentice ratio on their. jobs. Should you have any further questions please feel free to contact the State office at (219) 52S-4443. Sincerely, Roger Jones Managing Director BAC 4 IN/KY Apprenticeship & Training Program August 23, 2018 ZIOLKOWSKI Construction, Inc, 4050 Ralph Jones Drive South Bend, IN 46628 Re: Proof of Compliance with 30 ILCS 500/30-22(6) Our Idle No. MI-00321 Dear Sir or Madam: At the request of ZIOLKOWSKI Construction, Inc, I am providing you with evidence of the Con-rpany's compliance with the apprenticeship requirements in 30 ILCS 500/30- 22(6) of the Illinois Procurement Code. I am submitting this letter along with apprenticeship certificates (Nos.ILO 12020003 and IL008780173). As a signatory contractor with the International Union of Operating Engineers, Local 150, AFL-CIO, ZIOLKOWSKI Construction, Inc., is required by Collective Bargaining Agreen-ent to participate in an applicable apprenticeship and training program approved by and registered with the United States Department of Labor's Bureau of Apprenticeship and 'Training. The attached certificates are evidence of compliance with the tJ.S. Department of Labor's apprenticeship requirements. Thank you for your cooperation in this matter. If you have any questions or concerns, please do not hesitate to contact me. Very truly yours, IUOL, Local 150, AFL-CIO District I dispatch office Caroline Lesniak Lnclosures: Certificates t�. wf- loo mil r`1 toCD ,I I I 1 TNDIANA LABORERS' TRAINING TRUST FUND David A. Frye Secretary -Treasurer Jerry J. Bolk Chris L. Guerrero Ricky .Henson, Jr. Ramon Mendoza, Jr. Robert S. Wright P.O. Box 758 -Bedford, Indiana 47421 (812)279-9751 August 20, 2018 To Whom It May Concern: Sear? Coakley, Director John P. Brown chairman Kelly Abel Brad Dreibelbis Michael Ferrara Stan Meyer Jim Wiseman FAX: (812) 279-5545 This letter is to confirm that "Ziolkowski Construction, Inc." is a signatory contractor in good standing with the Indiana Laborers' Training Trust Fund. The above mentioned company is a participant in the Joint Apprenticeship and Training Committee through this Union and has been an active participant in good standing for each of the past -five plus consecutive years, and is currently eligible to use our apprentices on a project. Further, our organization's program is approved by the U.S. Veterans Administration to participate in the GI educational benefits program. A copy of our approval letters are attached along with the collective bargaining agreement stating the ratios of Journey workers to Apprentices; which is one (1) Apprentice for every five (5) Journey workers and thereafter may not employ more that (1) Apprentice for every (3) Journey workers. Sincerely, _ {1 Sean Coakley, Director SC:dc www. indianalabarerstraining. org r Aypr YIY � TO WHOM IT MAY CONCERN, Plasterers' & Cement Masons' Apprentice Coordinator of Local Union #692 Phone 317-508-1609 FAX 317-972-4907 hrnai hansen@plcmtoca1692.org m `' 1049-M AUGUST 23, 2018 THIS LETTER IS TO CERTIFY THAT ZIOLKOWSKI CONSTRUCTION INC.HAS BEEN A SIGNATORY UNION CONTRACTOR WITH THE PLASTERERS' AND CEMENT MASONS' JOINT APPRENTICESHIP TRAINING PROGRAM OF LOCAL 692, FOR AT LEAST THE LAST FIVE YEARS, AND IS IN GOOD STANDING. THEY HAVE A SIGNED CONTRACT WITH LOCAL 692 AND IS ELIGIBLE TO USE UNION PLASTERERS' APPRENTICES AND UNION CEMENT MASONS' APPRENTICES. THROUGH THIS CONTRACT AND OTHERS, THE FINANCIAL OBLIGATIONS OF TRAINING AND SAFETY ISSUES ARE MET. ALL OF THE APPRENTICES ARE REGISTERED WITH THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF APPRENTICESHIP AND TRAINING. SINCERELY, PAT HANSEN APPRENTICESHIP COORDINATOR FOR LOCAL 692 220 N. Fulton St. Indianapolis, IN 46202 i U.S. Department of Labor 46 East Ohio St. — Room 511 Phone: 317/226-7001 Indianapolis, IN 46204 Fax: 317/226-7015 OFFICE OF APPRENTICESHIP Employment and Training Administration Date:- r Mr. Pat Hansen, Coordinator Plasterers & Cement Masons Local #692 JATC (mailing)220 N. Fulton Street, Indianapolis, IN 46202 (school) 9200 Louisiana Street -- Merrillville, IN 46410 Re: EEO Compliance Review (and Quality Assessment) Dear Mr. Hansen: Our recent EEO Compliance Review (and Quality Assessment) of your registered apprenticeship program, Plasterers & Cement Masons Local 4692 JATC was conducted on April 11, 2017 and October 5, 2016. This review covered the time period 08/15/2015 (date of your last review) through 10/04/2016. We are writing to inform you that our office found no apparent violations of the requirements governing registered apprenticeship programs as set forth in regulations at 29 CFR Part 29, "Labor Standards for the Registration of Apprenticeship Programs," and Part 30, "Equal Employment Opportunity in Apprenticeship and Training." Based on our review, it appears that your apprenticeship program is snaking good faith efforts to comply with the requirements of 29 CFR Parts 29 and 30. We note, however, that despite these efforts, there exists underutilization of women and minorities in your apprenticeship program and skilled workforce, including journeyworkers. Please be aware that Plasterers & Cement Masons Local #692 JATC remains under an obligation, pursuant to the regulations at 29 CFR Part 30 to continue with its good faith efforts to increase participation of women in its Registered Apprenticeship program. We sincerely appreciate the cooperation and courtesies extended by you and your office to the Department of Labor while we conducted the compliance review. If you have any questions or concerns, please do not hesitate to call. I can be reached at (317) 226- 7003. lye-, f John Delgado State Director cc: Kathleen Sokolowski, ATR J ui LIJ 1� LU CD 4-4� ..► cl- -• UJLLJ C� LLJ C/) W LL. W ,.I + <c < C'i u ti �LO uj d U ui a F-- o �- 4y Qi a U � CS U Q U ti c Y I Iz 0 INDIANAMENTUCKY/01110 REGIONAL COUNCIL OF CARPENTERS JOINT APPRENTICESHIP AND TRAINING FU" 1095 MARINE4 RS DRIVE WARSAW, IN 46582 a ADMINISTRATION OFF ICE 711 Greenwood Springs Drive Greenwoock IN 46143 Phone: 317-807-1112 Fax: 317-807-1115 Ashland Campus 574 Carpenters Way Grayson, XY 41143 Phone: 606-929-1379 Fax: 502-996-8108 Indianapolis Carropus August 20,2018 711 Greenwood Springs Drive Greenwood, IN 46143 Phone; 317-901-1116 Fax: 317-807-1131 Ziolkowski Construction Co. Lafayette Campus 4050 Ralph Jones Drive 2953 South Cressy Lmie Lafayette, IN 47905 South Bend, IN 46628 Phone: 765-447-5959 Fax: 765-447-7676 RE: City of South Bend Bid Louisville Campus 1245 Durrett Lane To Whom It May Concern: Louisville, KY40213 Phone; 502-366.8668 Fox: 502-366-8678 This letter is in response to verification needed by Ziolkowsk! Construction for work to be performed for the City of South Hand/Howard Park project, Zlolkowski regularly Merrillville Campus 1565 East 70th Court employs a number of apprentices affiliated with our apprenticeship program and has Merrillville, IN 46410 done so for more than three years. We are registered with the United States Phone: 219-947-3348 Department of Labor, Bureau of Apprenticeship and Training and our registration Fax: 219-947-1889 number is 020 0537. Our program also participates in the Building Trades Associate Muncie Campus Degree Program with Ivy Tech Community College and has done so since 1996.1 4121 East Centennial Avenue munclu, IN 47303 Phone: 765-288-9015 Ziolkowski Construction Is a bona fide contractor in good standing with the Fax: 765-288-9298 Indiana/Kentucky/Ohio Regional Council of Carpenters Joint Apprenticeship and Training Fund and is eligible to employ apprentice carpenters in the future. I have Newburgh Campus 5400 Covert Court enclosed copies of our certificates from the United States Department of Labor and Newburgh, IN 47630 from the Indiana Department of Veterans Affairs for GI educational benefits. Phone: 812-853-9312 Fax: 812-853-9316 If I can be of further assistance, please do not hesitate to give me a call. Torre haute Campus 1099 South 611t Street Best regards, Terre Haile, IN 47802 Phone: 812466-7899 Fax: $12-466-9840 kxL4—rA�a" Warsaw Campus Dale Newlin 1095 Mariners Drive Warsaw, IN 46582 Area Coordinator Phone:,574-267-5264 IKORCCJATF Fax: 574-269-1464 Warsaw Campus f Hur- ul P-I 11 r) rj Em m