HomeMy WebLinkAboutOpening of Quotes - 1201 Western Ave. Sidewalk Vault Repair Proj No. 120-019 - Premium Concrete Services, Inc.CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S QUOTE FOR PUBLIC WORK
PROJECT NAME: 1201 Western Ave. Sidewalk Vault Repair
PROJECT NO. 120-019
QUOTES DUE Seplember 8, 2020
(Must be completed for all quotes. Please type or print)
Data: All�"'� Lz 0 Firm.
Address:
City/State/Zip: �(, It/1 1', '14;, 5A Telephone Number: (51q) V-e,'0�(,,
s
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:
1201 Western Ave. Sidewalk Vault Repair
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
L
and dated (_5 for the sum of (enter the Total Quote as shown on the Proposal)
'jw"'T'i;ry -'LgL?cd� (s 36,
(Enter Sum of Total Quote plus Alternates shown on Proposal) (Numerical)
If alternative quotes 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 quote is to be awarded on a unit basis, the
iternization of the units shall be shown on a separate attachment.
By
(Signature)
(Printed Name of Person Signing)
The above quote is accepted this
Subject to the following conditions:
Gary A. Gilot, President
Elizabeth A. Maraclik, Member
Joseph R. Molnar, Member
Version 2/14/2020
ACCEPTANCE
day of
20
Therese J. Dorau, Member
Jordan V. Gathers, Member
Attest: Linda M. Martin, Clerk
Page - 7 Public Works Quote
When the prospective Contractor is enable to certify to trey 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 aN I )
) SS:
1AA RX COUNTY )
The undersigned Contractor, being duly sworn upon his/]per/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 no#, 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 § 5-22-16.5-5, 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.
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4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the Contractor subsequently learns is an unauthorized
alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of
Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3.
Contractor's documentation of enrollment and participation in the E-Verify Program is included
and attached as part of this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public
contract to certify that the subcontractors do not knowingly employ or contract with an
unauthorized alien, nor retain any employee or contract with a person that the subcontractor
subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is
participating in the E-Verify Program. The Contractor agrees to maintain this certification
throughout the term of the contract with the City of South Bend, and understands that the City
may terminate the contract for default if the Contractor fails to cure a breach of this provision no
later than thirty (30) days after being notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by
the City of South Bend through its agencies, boards, or commissions shall not discriminate against
any employee or applicant for employment in the performance of a City contract with respect to
hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly
related to employment because of race, sex, religion, color, national origin, ancestry, age, gender
expression, gender identity, sexual orientation or disability that does not affect that person's ability
to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or
any combination of the foregoing including, but not limited to, public works contracts awarded
under public bidding laws or other contracts in which public bids are not required by law, the City,
its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain
participation by those Contractors certified by the State of Indiana as a Minority Business
("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest,
responsible, responsive bidder.
In no event shall persons or entities seeking the award of a City contract be required to award a
subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said
WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board
shall prohibit that person or entity from being awarded a City contract for a period of one (1) year
from the date of such determination, and such determination may also be grounds for terminating
the contact for which the discriminatory practice or noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination commitment shall
be made a part of any contract which it may henceforth enter into with the City of South Bend,
Indiana or any of its agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for
employment in the performance of this contract with privileges of employment, or any matter
directly or indirectly related to employment, because of race, religion, color, sex, gender
expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of
this provision may be regarded as material breach of contract.
Version 2/14/2020 Page - 9 Public Works Quote
1, the undersigned bidder or agent as contractor on a pliblic, 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 01' 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 [lie use of
steel products or foundry products Made in the United States. I understand it is my sole obligation
and responsibility to provide ajUStification to the City, subject to review and approval, why the
cost of' United States made steel Or foundry products is unreasonable, Prior to award and upon
Submission of bid which does not use Steel products or foundry products made in the United States,
the City, through its director Of public works, shall make a determination if the price of United
States made steel or foundry is unreasonable, I Understand that violations hereunder May result in
forfeiture of contractual payments.
I hereby affil-111 Under the penalties Of PCIjUl'y that the facts and information contained in the foregoing bid to[- public
works are true and correct.
C -1
f"T , 20,')0 Dated day of — �Z
.,tA, L
Contractor/Bidder (Firm)
sigAt"L11'e of Contractor/Bidder or Its Agent
Printed 'Name and"Fitle
-ibcd and sworn to bef�ore me this day of Subsci 20
My Commission Expires ()D. I I'), I "),C) I
Notary Public
COL111ty of Residence de
JANEE M TOWNER
NOTARY PUBLIC
SEAL
ELKH AFIT COUNTY, STATIC OF INDIANA
MY COMMISSION EXPIRES FEBRUARY '12,2026
COMMISSION NO, 710399
Version 2114/2020 Page - 10 Public Works Quote
wall"'N
PROJECT; NAME 1201 Western Ave. Sidewall( Vault Repair
PIOJECT NO 120-019
QUOTES DUE --Augttst-2&,-m1(� September 8, 2020
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
Mobilization
1
LS
$ "o f,
2
mo"r
1
LS
$
3
Demolition, saw cutting concrete,
33
Ton
a.s
steel and concrete disposal.
4
Temporary bracing.
13
EA
2
5
CMU infills at common basement
244
SF
$
-
wall, including reinforcing
6
Patching of existing wall, sealing
400
sl-
$
cracks, waterproofing.
7
DrOl / Punch holes in vaunt floor
40
EA
$
8
Filter fabric, gravel fill, compact
169
CY
....... . .. ...
..... .
$
9
Repair back of curb & gutter, new
73
SY
$
concrete sidewalk.
10
Water Service Relocation
1
EA
$
11
Demobilization
1
EA
$
'total Amount of Quote I $
. . ...... ..........
1
k,
Firm: 11111 "X""fat. 0, PA c-, iz -,,, r
, ) I . . . .......
Address,
City/State/Zip- Telephone Nurnber:
Fax Number:
By
(Signature)
At",1
(Printed Name of Person Sig,nin
Version 2/14/2020 Page - 11 Public Works Quote
,4,1i . H .. t r,
d>
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM'
FORM MWBE-1.0
MWBE PARTICIPATION
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE/IWBE
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.
Project Number: 120-019 _ Project Name: 1201 Western Ave,,Sidewalk Vault Repair
Bidder: V,'Cloq'
? MWBE Coal:
y1al Bid Amount:
Pageof
Name & Address of MVVBE
Printary Contact Person
(Naeffelephorre)
rn
Scope of Work to he Performed
(Attach scope/schedule if you nadditional space�
Doflar Amount of MVVBE
C,
Component
cent
Percentage
of Total
117
Submitted by: I
Pr nt Name Si
ature
Date
Versicn 2/1412020 Page - 12 PUblic Works Q1,10fe
crry OF SOUTH BEND
ff 1 [0, 0 T11 TY71, 0 0 WO M E
F#RM ff,717 A*-2.0
This completed form should be included as part of the Bids documents related to City of South Bend Public
Works Projects requiring Good Faith Efforts to obtain MWBE participation.
Project Number: 120-019 Date:
Project Name: 1201 Western Ave. Sidewalk Vault Repair
Bidder: I zt)zcz
Contact Person: PIA '/6,.-_A K k" Telephone: 1, vCf
Address:
City: State: Zip:
Ernaij: r-c
To determine whether a bidder has demonstrated good faith efforts to reach the MWBE utilization goals set forth in
the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions,
REQUIRE ALL of the following Good Faith Efforts as listed in the table below*:
EVIDENCE OF GOOD FAITH EFFORTS
MWBE LISTS): The bidder reviewed 1) the City of South Bend's Minority and Women Business
Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City-, and 3) the Indiana
Department of Administration list of Minority and Women Owned Businesses (both certified and non -
certified) found at: http://vvww,in.- ov/idoa/.
GOOD FAITH EFFORTS "to OBTAIN MWBE PARTICIPATION
The bidder shall initial each item below, as evidence of its good faith efforts to obtain MWBE
participation in the awarded contract.
I affirm that I reviewed the City of South Bend's Minority and Women Business Enterprise
Inclusion Program Plan and the Indiana Department of Administration's certified list of
Indiana Minority and Women Business Enterprises, found on their website
(http://www,in.gov/idoa).
l affirm that I have made good faith efforts to select portions of the contract work to be
performed by MWBEs, including, where appropriate, breaking out contract work items into
economically feasible units to facilitate MWBE participation.
I affirm that I have made good faith efforts to solicit through all reasonable and available
means the interest of afl MWBEs in the scopes of work of the contract.
I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to, inform
MWBEs of contracting and subcontracting opportunities.
I affirm that I advertised in general circulation and/or trade association publications
concerning Subcontract opportunities and allowed MWBEs reasonable time to respond to
such advertisements.
I affirm that I performed any and all necessary steps to provide written notices in a manner
reasonably calculated to inform MWBEs of subcontracting opportunities and allowed
sufficient time for MWBEs to participate effectively.
I affirm that I followed up on initial solicjtatlons with interested MWBEs.
t affirm that I negotiated with interested MWBEs in good faith, including providing such
MWBEs with adequate information about the plans, specifications and other requirements
of the Subcontract.
I affirm that I have made good faith efforts to assist interested MWBEs in obtaining
bonding, lines of credit, or insurance as required by the City or the bidder, where
appropriate.
Version 2114/2020 Page - '13 Public Works, Quote
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
FORM MWBE-2.0
i affirrn that I have made good faith efforts to assist interested MWBEs in obtaining
necessary equipment, SLIPPHes, materials, or related assistances or services, where
appropriate
I affirm that I did not reject any MVVBEs as unqualified without sound business reasons
iF based on a thorough investigation of their capabilities.
CONTRACT RECORDS: The bidder has maintained the following records for each MWBE that has bid
on the subcontracting opportunity:
1. Name, address, and telephone number;
2. A description of information provided by the bidder or subcontractors and
3. A statement of whether an agreement was reached, and if not, why not, including any reasons for
concluding that the MVVBE was unqualified to perform the job.
*Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any
omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of
South Bend reserves the right to request additional information.
Version 2/14/2020 Page - 14 Public Works Quote
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 orks Projects
requiring Good Faith Efforts to contact MWBEs. It is the bidder's sole responsibility to verify whether any listed
minority or woman business meets the MWBE qualifications. Attach additional pages if necessary.
PAGE OF
Project Number:
MWBE Participation Goal
Project Name: 1201 Western Ave. Sidewalk Vault Repair
Bidder:
By: e" 7,
('Signature) (Title) (Date)
MWBE Firm
Owner or Contact at MWBE Firm
Telephone: Fax:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
bd4A`11'X(,,_A49,9 "13
RESULTS OF CONTACT WITH THE MWBE FIRM:
/15 00
... .........
MWBE Firm
Owner or Contact at MWBE Firm
Telephone: Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MWBE FIRM:
Version 2/14/2020 Page - 15 Public Works Quote