HomeMy WebLinkAboutOpening of Bids - O’Brien Recreational Center Renovation Proj No. 118-091 - Ziokowski Construction, Inc.CHECKLIST FOR BIDDERS
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Proper bid security included. The bidder has the option of providing either a Certified Check
X or Bid Bond.
Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely
X executed.
Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments
with Iran, Employment Eligibility Verification, Non -Discrimination Commitment and
X Certification of use of United States Steel Products or Foundry Products.
Proof of MBENVBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not
met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBEIWBE Contacted
X Form [MWBE-2.1].
X All required additional information is included with the bid.
Proposal statements and other affidavits all signed by the proper party with name either
printed or typed underneath signature.
X This checklist submitted with the Bid.
MI'll- 1"M SIRRIMV011114 i
Bidder: Zillcowsld Constructionm Inc. Date: 9/22/2020
Signature:
Print Name & Title: Kristin Kromcr, Contract Administrator
Version 4/2/2019 Contractors Bid for Public Works - 1
PEACE
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
Project Name O'Brien Recreational Center Renovations
Project No. 118-091
For Bids Due September 22, 2020 - 9:30 a.m. EST
PART I
(Must be completed for all bids. Please type or print)
Date: September 22, 2020 Bidder (Firm): Ziolkowski Construction, Inc.
Address: 4050 Ralph Tones Dr.
City/State/Zip: South Bend, IN 46628 Telephone Number ( 574 287-1,911
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:
City of South Bend, Indiana, Department of Public Works
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
Forum Arcbitects, LLC
and dated AU ust 14 2020 for the sum of (enter the Total Bid as shown on the Proposal)
F( LAI' OTl A i. v, d )IS-A-AA0 L/V- (s
(Enter sum of Total Base Bid plus Alternates 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 notige,,Anywad,
d9ndurns attached will be specifically referenced at the applicable page.
"-' () j V
Iflcluded in the contract are needed, the cost of units must be the same as that
'fjf accepted by the City of South Bend. If the bid is to be awarded on a unit
is shall be shown on a separate attachrrjQpt.
BY 02d
(Signature)
Bill Favors, President
4(Printed Name of Person Signing)
1
ACCEPTANCE
The above bid is accepted this 22nd day of
Subject to the following conditions:
Gary A. Gilot, President
September — 20 20
Jordan V. Gathers, Member
Therese J. Dorau, Member
Attest: Linda M. Martin,
Version 4/2/2019 Contractors Bid for Public Works - 2
F i i I � � I � I I I 1
Attach addiitional 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.
Z Attach a l�isting of public works projects currently in process of construction by your
organization.
1 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.
P, I "i 'N't
Z Z Z
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.) To use ttiei:�vail��,blen'liii.ipoweia�ndw(�)�rk with othey.
trades to maintain schedule,
2. Attach a listing of the names and addresses of all subcontractors (ie. 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 contract is ami,rded, subcontractors witi be provided.
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 roposed roject.
ffisubcontractors are used and we are awar'ded the ptoject, a list witlpe provi(feld.
J, Attach a listing of equipment you have available to use for the proposed project.
What is required to coni.plete the pro)ect pr-operly and o n tiale-
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 use*
which would corroborate the prices listed. Yes
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 412/20191 Contractor's Bid for Public Works - 3
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ZIOLKOWSKI
Construction, Inc.
General Construction & DeSig"Mild
OuNdInn SU'0119 Reladonsl'Aps, Since 1974
J '4
... .. . .....
University of Notre Dame
Tony Polotto
574-631-4200
200 Facilities Building
LEED, AP
Notre Dame, M 46556
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, [N46601
When the prospective Contractor is unable to certify to any of tit 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 Bids.„']ease type or print)
STATE OF Indiana
SS:
�t ®
St. Josepht COUNTY ) aS E (D
1:A - 4
The undersigned Contractor, being duly sworn i*ofherlits® Firms under the penalties of perjury
x l
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 parsons, 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 § 5-22-16.5-5, 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.
Version 4/2/2019 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 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.
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 of public works, shall make a determination
if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder
Version 4/2/2019 Contractor's Bid for Public Works - 5
may result in forfeiture of contractual payments.
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 22nd day of Sept. , 20 20
,M9,il
Ziolkowsld Construction, Inc.
Contractor/Bidder (Firm)
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Signature of Contractor/Bidder or Its agent
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Hill Favors President
Printed Name and. Title
Subscribed and sworn to before me this
22nd ay of , e to ber, ,� 2 20
y Commission Expires ;January 28. 2023
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County of Residence St. Joseph.
fVwaiV Public, Sate of Indiana
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Version 4/2/2019 Contractor's laid for Public Works - 6
BID/PROPOSAL
CITY OF SOUTH BEND
Project Name: O'Brien Recreational Center Renovations
Project Number: 118-091
For Bids Due: September 22, 2020 at 9:30 a.m. EST
Contractor Name: Zill,
— owsld Construction, Inc.
Item
No.,
Description
Total Amount
Renovation of existing main level areas into new locker rooms, relocation of
1
existing lower level saunas to the new locker rooms and required renovations
L,l 16Z 0%
to install new cross corridor separation doors.
2
1 Utility Allowance for Unseen Conditions
BASE BID TOTAL cul (M
Item
No.
Description
Total Amount
A
Add amount to the base bid to renovate existing open office space into the
new family toilet room.
B
Add amount to the base bid to renovate existing lobby/corridor area into the
4 1
?�OQI
new reception/check-in area
C
Add amount to the base bid to remove existing flooring and base in Fitness
e
Rooms #1 and #2 and install new athletic flooring and base
D
Deduct amount to the base bid to install metal lockers in lieu of phenolic
lockers in the new main level locker rooms
I
E
Deduct amount to the base bid to install metal toilet partitions in lieu of I
phenolic toilet partitions in the new main level locker rooms
L
Deduct amount to the base bid to eliminate the tile wainscot in the ne-w�-
F
locker rooms except at the wet walls of the lavatories, water closets, urinals
64 1
and shower walls
G
Deduct amount to the base bid to eliminate the relocation of the lower level
ca
saunas to the new main level locker rooms
Deduct amount to the base bid eliminate the removal of the existing cross
H
corridor doors, frame and wall at the junction of the main level south and
east corridors
Deduct amount to the base bid to not install new lockers in the new main
level locker rooms
Bidder (Firm): ZioJJrowsJri Construction, Inc.
Address: 4050,Ralph Jones Dr.
CitylState/Zip: SQUflLBend,,,.J Telephone Number: ( 574 ) 287-1811
By
(Signature)
Bill FLvors, President
(Printed Niame of Person Signing)
I
Version 4/2/2019 Contractor's Bid for Public Works - 7
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CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS
-N "Noll" I 101111�12�1 IgA Im kiln]' Ill [tit galwwtir,-] 11,4116111
Project Number: 118-091 Date: September 22, 2020
�71 0
1111 Iri RIMINI tillill 11111
Bidder: Ziolkowski Construction, Inc.
Contact Person:
Address: — 4050 Ralph Jones Dr.
Telephone: 574-287-1811
City: South Bend State: IN Zip: 46628
Email:
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 EFFORTS
MBE/WBE 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.gov/idoa).
ACTION (ADVERTISEICONTACT): In order for your bid to be deemed responsive, the City of South
Bend requires that all perspective bidders complete no loss than 2 of the following:
1. Attend all pre,bid meetings scheduled by the City to inform MBE/WBEs of contracting and
subcontracting opportunities.
2. Advertise in general circulation and/or trade association publications concerning subcontracting
opportunities, and allow MBE/WBEs reasonable time to respond.
3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated
to inform MBE/WBEs. of subcontracting opportunities and allowed sufficient time for them to
participate effectively.
4. Utilize pre-existing services of available community organizations, small and/or disadvantaged
business assistance offices and other organizations that provided assistance in the recruitment
and placement of MBENVBE firms,
"Bidder must circle or otherwise notate which of the two (2) required actions were performed.
GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBE/WBEs,
including providing such MBE/WBE's with adequate information about the plans, specifications and other
requirements of the subcontract and did not reject MBEANBEs 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
MBE/WBEs in order to increase the likelihood of meeting the MBEANBE goals (including breaking down
contracts into smaller units to facilitate MBE/WBE 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;
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 MBEANBE was unqualified to perform the job.
WV70TOT-wo fig,
it'
South Bond reserves the right to request additional information.
Version 412/2019 Contractor's Bid for Public Works - 9
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.1
MBEIWBE CONTACTED
This completed form should supp ith Bids that pertain to City o outh en u c or s rojec
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
-ress.
Project Number: 118-0911
Project Name:
Bidder:
By:
(Signatui
MBEANBE Firm
Ziolkowski Construction, Inc,
Owner or Contact at MBENVBE Firm
Telephone: Fax:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBEANBE FIRM:
MBEANBE Firm
Owner or Contact at MBEANBE Firm
Telephone:
Fax:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBENVBE FIRM:
(Title)
Email:
Email:
�Mp
(Date)
Version 4/2/2019 Contractor's Bid for Public Works - 10
Conforms with The American Institute of Architects AIA Document 311
i air
CONTRACTOR:
(Name, legal status and adrl'ress)
Ziolkowski Construction, Inc.
4050 Ralph J',ones thrive
South Bend, IN 46628
OWNER:
(Naive, legal status and address)
City of South Bend, Indiana - Board of Pubiic Works
227 W. Jefferson Blvd.
South Bend, IN 46601
SURETY:
(Name, legal status and principal place of business)
Liberty Mutual Insurance Company
175 Berkeley Street
Boston, MA 02116
State of Inc: Massachusetts
BONDAMOUNT: Five Percent of Amount Bid (5%q)
PROJECT:
(Nanxe, location or address, and Project number, if any)
O'Brien Recreational Center Renovations; Project No. 118-091
This document has important legal
consequences. Consultation with
an attorney is encouragedwith
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.
P1 B11'1'1 ..M1Pf
�,�w
If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in t14t q€ C alaM
deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. "3, 0
When this Bond has been furnished to comply with a statutory or other legal requirement in the lo�t
any provision in this Bond conflicting with said statutory or legal requirement shall be deemed ddle c he' f Ingn "
provisions conforming to such statutory or other legal requirement shall be deemed incorporated bgr°gib.
furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common 1A, " W
Signd s ne e led his 8th day bf •w September 2020
Ziolkcwskt ConstructioiY,,A rc.
Witness) Kristin Zrorner
(Seal)
(Title) Bill Favors, President.
tMutual Insurance Comp
„ 1 ' (S
, .., ul ) Liberty M any
_w (Seal)
(Witnes,) Maria Concepcion
( itle) Adrienne C. Stevenson, Attomey-in-Fact
State of Georgia
County of Fulton ss:
(}n September s, 2020 , before me, a Notary Public in and for said County and State„ residing
therein, duly comynissioned and sworn, personally appeared
Adrienne C. Stevenson
known to me to be Attorney -in -Fact of Liberty Mutual lnsurance Company
the corporation described in and that executed the within and foregoing instrument, and known to me to be the person who executed
the said instrument in behalf of the said corporation, and he duly acknowledged to me that such corporation executed the same..
IN WTl'NESS WHEREOF, i have hereunto set my hand and affixed my official seal, the day and year stated in this certificate above.
My Commission Expires February 13, 2022
Sharon Jean Potts Notary Public
Sharon Jean Potts
dVQTARY PtJLlC
Fulton County, C QRGIA
iy Camrnission Rxplres 0
2/1
/0
This Power of Attorney limits the acts of those named herein, and they have no authority to
L*be r V bind the Company except in the manner and to the extent herein stated.
•••///
Mutual. Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company Certificate No: 8201331
SURETYThe
American Insurance Company
POWER OF ATTORNEY
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 aftomey-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 aff cer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 301h day of May, 2019.
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
Pv lrtsu'ea Poo INS& 1Nsu,p West American Insurance Company
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1912 o_ z 1919 w o a 1991 o By: 1.
��ss0�nu6�`Cda yp'khan+V,4" bL� !s �N01A0 ate
David M, Carey, Assistant Secretary
STATE OFPENNSYLVANIA ss
of COUNTY OF MONTGOMERY
m
CD On this 30th day of Ma r, 2019, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The
MOhio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained
cc by signing on behalf of the corporations by himself as a duly authorized officer,
m
aa) 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.
O 'P PA q8 , COMMONWEAI-TN OF PENNSYLVANIA
Notarial Seal
.
N or Teresa Pastella, Notary Public
Upper Merlon Twp., Montgomery County B
yuths' �, My Commission Expires March 28, 2021 y
pCr�Ny pUMember, Pennsylvania Association of Notaries Teresa Pastella, Notary Public
`0 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
o Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
e ARTICLE IV— OFFICERS: Section 12, Power of Attorney,
p1 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 attorneys -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 attorneys -in fact, subject to the limitations set forth in their respective powers of attorney,
O E 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
E - 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
o @ provisions of this article maybe 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 forthat purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
o shall appoint such attorneys -in fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and aft undertakings,
Z bonds, recognizances and other surety obligations. Such attameys-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 m 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 8th day of September , 2020
V 1TtSUR �I,( INSV � WSW?
J =4°Rpo�yr�Qynfi 3°oRpoRyroyyn `VP=onao��Ayfi
1912 0�1919A,0 1991 a By:
�q+ssACHus�h�as' y0 �hgnps"�d YS 401m%P aa$ Renee C. Llewellyn, Assistant Secretary
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CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
RESPONSIBLE BIDDER CHECKLIST
Project Name O'Brien Recreational Center Renovations
Project No. 118-091
For Bids Due September 8, 2020 - 9:30 a.m. EST
Contractor Name: .Ziolkowski Construction, Inc.
The City seeks to enhance its ability to identity 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 11 only.
Section ll 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 roust 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 3V 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.
POST BID SUBMISSIONS:
Post -bid submissions roust 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.
Version 5/16/2019 General Conditions - 6
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 5/16/2019 General Conditions - 7
PRE -QUALIFIED BIDDER CHECKLIST
(a) Acknowledgements:
(€) 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 fast twelve (12) months. A copy of any Pre -Qualification verification letter
is attached.
00 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:
(€) 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.
pi) 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.
(€v) 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 5/16/2019 General Conditions - 8
PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED)
(a) Acknowledgements:
(I) By checking this box, I hereby acknowledge that I am not a pre -qualified bidder
with the City of South Bend.
(ii) _ By checking this box, I hereby acknowledge that the City reserves the right to
request supplemental information, additional verification of any information
provided, and may also conduct random inquiries of my current and prior
customers. The City reserved the right to utilize all information provided in this
submission and all information obtained in inquiries or requests to determine if a
bidder is responsive and responsible. Additionally, I acknowledge that all
information provided to the City shall be regarded as public records.
(III) _ By checking this box, I hereby acknowledge that copies of all Applicable
apprenticeship certificates or standards for training programs applicable to the
work performed on the project may be requested at any time and shall be furnished
upon request.
(Iv) By checking this box, I hereby acknowledge and ensure that I and all sub-
contractors, from whom I have accepted a bid and/or intend to hire to perform work
on the public work project, are properly licensed. Furthermore, I acknowledge my
understanding that it is my responsibility to ensure that all sub -contractors have
the necessary licenses to undertake the work called for in this bid. If a sub-
contractor loses their license at any point, it is the responsibility of that sub-
contractor to notify the City.
(b) Attachments:
(i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within
sixty (60) days of the submission of said document showing that business is in
existence, current with the Indiana Secretary of State's Business Entity Report,
and eligible for a certificate of good standing. (Not applicable to individuals, sole
proprietors or partnerships).
(ii) _ List identifying all former business names.
(III) Any determinations by a court or governmental agency any violations of federal
state, or local laws including, but not limited to, violations of contracting or antitrust
laws, tax or licensing laws, environmental laws, Occupational Safety and Health
Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5)
years.
(IV) Statement about staffing capabilities, including labor sources. This statement
indicates and ensures I have sufficient employees on staff to complete the work I
am bidding on OR outlines how I intend to meet the staffing needs of the work.
(v) Statement that individuals who will perform work on the public work project on my
behalf will be properly classified as an employee or as an independent contractor
under all applicable state and federal laws and local ordinances.
(VI) For every project, submit evidence of participation in apprenticeship and training
programs, applicable to the work to be performed on the project, which are
approved by and registered with the United States Department of Labor's Office of
Apprenticeship, or its successor organization.
(vii) _ Copy of a written plan for employee drug testing that covers all of my employees
who will perform work on the public work project and meets or exceeds the
requirements set forth in IC 4-13-18-5 or IC 4-13-18-6.
(viii) _ Evidence that I am utilizing a surety company which is on the Bureau of Fiscal
Service "Department of Treasury's Listing of Approved Sureties" as required in the
bid specifications or contract.
Version 5/16/2019 General Conditions - 9
(N) Written statement of any federal, state or local tax liens or.tax delinquencies owed
to any federal, state or local taxing body in the preceding three years.
(i) List of projects of sirnilar size mrd scope of work loerforr-ned in all areas, including
the State of Indiana, within three (3) years prior to the date on which the bid is due.
Cate; ALtember 22020
(Sign Here)
Bill Favors
(Print Nanne Here)
Ziolkoivski COTIStRICtI1011, IIIC
(Narne, of Company)
_AQf,O RL,11ph )Li�� Dr.
JL —
(Address of Corrrparry)
South Bejid
(City)
Indiana
(State)
574-287-181,1
Telephone NUmber
Version 5/16/2019 General Conditions - 10
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MAIM O�F PUW[JK_'W1ORI<S
September 17, 2019
Bill Favors
ZiolkowsId Construction, Inc.
4050 Ralph Jones Drive
South Bend, N 46628
RE: Pre -Qualification Verification
Dear Mr. Favors:
` 7 1 2 35- 1) 2,",5 1
This letter serves as verification of Pre -Qualification status of your company for bidding with the City of South
Bend, This PI-C-QUalification status is effective for twelve (12) months from the date of this letter. Thereafter you
are required to re -submit a complete application for continuation of pre -qualification status prior to December 31
for the upcoming calendar year.
A copy of this Verification Letter must be included with every bid exceeding $150,000 submitted to the City of
South Bend Board of Public Works, along with your Pre -Qualified Bidder Cheeldist and attachments,
If you have any further questions regarding this matter, please call this office at (5,74) 235.9251.
Sincerely,
Linda M. Martin, Clerk
�%. 01 i) I vunv8. F.'YN � [+' NIARAIAK � AIRA 1- ON,JA WAN 'I 0101IRM
C'RTiFTCATE OF QUALIFICATION
to provide
CONSTRUCTION S19RVICES
for
PUBLIC WORKS PROJECTS
to the
STATE OF MIANA
This Certifioation Board, }raving duly considered applioatlon fi r gtralilioau4n in terms of apparent experience and iinanoW
resources; and under the applicable Indiana Code 4 13.6-4 and adopted rules of1his Board, hereby Issues a
Certificate ofQualification to provide construction services to lice State oMdiana for Public Works Projects Ur
ZIOLKOWSKI CONSTRUCTION INC
4050 RALPH JONES OR
SOUTH BEND IN 40625
Rhone 574-287-1811
Fax 574--234-0151
company Official
BILL FAVORS
for the twenty-seven month period statecl heroin, artless rovolred by flits Board for cause,
and In the classifications of services stated below, This certiftoatc suporoedes any previous certificate.
1521.00 Apartment Buildings, Hotels and Motels
1641,01 Industrial plants and Warehouses
1541.03 Additions, Alterations, Remodeling, and Repair
1842.00A Inst, Bidgs.(Haspitals, Schools, Prhpotts)>$10,000,000
1642.005 Inst Btdgs.(Hose., Sohl., Prsn_)>$1,000,000, -<$10,000,000
1542.01 Institutional Bldgs (Hospitals, Schools, Prisons)
1542.02 Commercial Buildings (offices, Stoma, Restaurants)
1642.04 Additions, Alterations, Remodeling, and Repair
1721.01 Fainting of Buildings & Other Structures
1741,01 Brick and Stock Laying
1741.04 Stone work
1741-06, 1762,01, 1752.02, 1771.01
CI�.R'TIFICATION DATE 10/9/2019 EXPIRATION DATE 119/2022
THIS CERTMICATE ISSUED BY THE STATE OF INDIANA, P'UBLLC WORKS DIVISION MTIEICATIOTT HIDARD,
402 'WEST WASHINGTON STRI;E'P, ROOM W467, INDIANAPOLIS, INDIANA 46204,
AI SO ACTS AS THE OFRCTAL NCYrICR OF EXP113ATION.
Tracy I.. Crass, Ex utive Secretary
Certtflcatlon Hoard
4AFW PQ2 Slat® Form 81JM Rov. 07100
�[Ij
STATE OF MUN&
OF)ffCg 0-F THE SECRETARy of sTATE
RTMCATE OF F"TKNCR
To Whom Thm, -Presents Come, Oreeti p:
1, QMllie LamsP4 omtW of StMe ofinc.�[�°am, do hereby -e * ffiat Z am, by virWo of the laws of the Stair of l zdz ,ire
custodian of the corporate records, and prop" o 1. to execute this cerMatc.
I hr iier oertafy, that records of this of Ge disclme that
ZIOL OWM CONSTRUFCTION, INC,
daily z"i1.ed -.e requite documents to commence business actMties under the lama of gtafo of Indiana on. December 11, l 979,
and wag in existence or authorized to tract buff npzs in the State of hidiaua on Dec ba 02, 2015,
I furti cr oor6fy this For -Profit Mumqtiv Corparat%an has filed its roost xecent report icquired by Ana Im brit. the
Secretary of Staba, or is riot yet required to, f It miGh rgpoz� and that no wtice of w the raw4 dissolution or exph7afion Ws
been Med or taken pfacv.
1n iNittws "Whemat i have hemunto set my hand
and affixed the seal of the Mate of Iudiam, at the
city of Indianapolis, ffii.9 Second Day of December, 2015.
CmAie Lawson, Se=fmy of Staff
197812-318120151202D3232
BUSINESS INFORMATION
CONNIE LAWSON
INDIANA SECRETARY OF STATE
09/21/2020 06:06 PM
Business Name: ZIOLKOWSKI CONSTRUCTION, INC. Business M: 197812-318
Entity Type: Domestic For -Profit Corporation Business Status: Active
Creation Date: 12/11/1978 Inactive Date:
Principal Office Address: 4050 RALPH JONES DR, SOUTH BEND, Expiration Date: Perpetual
IN, 46628, USA
Jurisdiction of Formation: Indiana Business Entity Report Due 12/31/2020
Date:
Years Due:
ZIOLKOWSKI
Construction, Inc.
Generall Construction & Deslori/Build
esMdWig Strong l�eNflonshlps SWce,1974
September 22, 2020
City of South Bend, Indiana
Department of Public Works
Department of Venues, Parks and Arts
Subject: O'Brien Recreational Center Renovations
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.
Bill Favors
President & CFO
10Jonas ,J;r ,Sqgi JBeJNt Fax
Committed to professionalism and excellence for the benefit of our clients, employees, and shareholders.
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Construction, Inc.
General Construction & Design/Build
Building Strong Relationships Since 1974
Completed Projects 2017-2020
--------- --
Project
Job No.
Amount
Date Completed
Ballard Community Schools
16879
$990,917
Aug-20
Stonewater at Riverwalk
17506
$1,957,854
Jul-20
Milt at ironworks Plaza
17547
$3,654,4-87
Aug-20
Central Park Band Shell
17460
$888,525
Jan-261
Erskine Clubhouse Renovations
17668
$1,101,342
20-Jan
6owntown Cross Street, Phase 1
24649
$92,676
19-Mar
Cass County Jail, Phase 1
24675"
$127,000
Aug-19
Merrifield Park
24484
$183,267
Aug-18
Battell Center Renovation
16442
$3,126,818
Mar-17
Starke County Courthouse
16774
$1,7S9,806
Sep-17
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ZIOR-KOWSKM
Construction, Inc.
0� General Construction & DesigN Build
EMAkIng Straqig� Uvre 1974
September 22, 2020
City of South Bend
Board of Public Works
Reference: Drug Testing of Employees of Public Works Contractors
This letter is to certify our ability to comply with the required drug testing of our employees as
required by IC 4-13-18 for your project.
The collective bargaining agreement that covers our employees for this type of project in this area does
not contain a provision for random drug testing of employees. However, it is our policy as a contractor
to comply with any owner -required or state -mandated drug testing provisions on projects where we
perform work. The Ziolkowski Construction, Inc Health and Safety Manual has a section which
highlights this policy, a copy of which is available for your review. Ziolkowski Construction, Inc does
drug test our employees through collective bargaining agreements that meet the requirements of IC 4-
13-18-5. This is for employees working in other areas that utilize programs administered by the
Indiana Union Construction Substance Abuse Trust (IUCSAT) and the Building Construction
Resource Center, Inc. (BCRQ.
If awarded this contract Ziolkowski Construction, Inc will utilize a drug testing program which
complies with IC 4-13-18-6 Employee Drug Testing Program Requirements.
If you have any questions, please contact me for clarification.
Sincerely,
ZIOLKOWSKI CONSTRUCTION, INC.
James Keldsen
Safety Director
Ziolkowski Construction, Inc
574-246-4204 x. 368
A)U[J]d"Con'l
4050 Ralph Jones Drive - South Bend, W. 46628 - Phone (574) 287-1811 Fax (574) 234-0151
Committed to professionalism and excellence for the benefit of our clients, employees, and shareholders
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Adrienne C. Stevenson
Vice President
Marsh USA Inc.
540 West Madison Street
Chicago, IL 60661-3630
adrienne. c.stevensun@mars h, cam
+1 312 627 6772
www ,marsh cam
September 22, 2020
City of South Bend Public or
Liberty Mutual Insurance Company (Liberty) is the surety for Ziolkowski Construction, Inc,
and Marsh USA, Inc. is their surety agent,
Liberty Mutual Insurance Company i's listed on the Department of Treasury's Listing
Certified Companies, I
Sincerely,
Liberty Mutual Insurance Company
Adrienne G. Stevenson
Attorney- in -Fa ct
MARSH & 10CLENINAN
COMPIPAN11k,�S
%—ICU1 Nating tenter Page 1 of
t
Liberty Mutual Insurance Company
AMB #: 002283 , NAIC #: 23043 FEIN #: 041543470
Domiciliary Address
175 Berkeley Street
Boston, Massachusetts 02117
United States
Web: www.LibertyMutualGroup.com
Phone: 617-357-9500
Fax: 617-574-5955
AM Best Rating Unit: AMB #: 000060 - Liberty Mutual Insurance Companies
Assigned to insurance companies that have, in our opinion, an excellent ability to meet their R„a„aiws6e„g►h Rating'
,
ongoing insurance obligations. weeST
A McqWlant
View additional news, reports and products for this company.
Based on AM Best's analysis, 051114 - Liberty Mutual Holding Company Inc. is the AMB Ultimate Parent and
identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure.
Best's Credit Ratings
Financial Strength Rating View Definition
Rating:
A (Excellent)
Affiliation Code:
p (Pooled)
Financial Size
XV ($2 Billion or
Category:
greater)
Outlook:
Stable
Action:
Affirmed
Effective Date:
June 26, 2020
Initial Rating Date:
June 30, 1922
Long -Term Issuer Credit Rating View
Definition
Best's Credit Rating Analyst
Rating Office: A.M. Best Rating Services, Inc,
Senior Financial Analyst: Elizabeth Blambie
Director: Jennifer Marshall, CPCU, ARM
Note. See the Disclosure information Form or
Press Release below for the office and analyst at
the time of the rating event.
Disclosure Information
Disclosure Information Form
View AM Best's Rating Disclosure Form
3ttP://ratings.ambest.com/SearchResults.aspx?SR= 1
9/4-/2020
Liberty Mutual Insurance Company - Company Profile - Best's Credit Rating Center
Guarantor(s) - also see the Rating Disclosure
Form for the following companies, as they
guarantee rated debt issues for this company.
Long -Term: a (Excellent)
Outlook: Stable 051114 - Liberty Mutual Holding Company
Inc.
Action: Affirmed
Effective Date: June 26, 2020 Press Release
Initial Rating Date: November 23, 2004 AM Best Affirms Credit Ratings of Liberty
Mutual Holding Company Inc. and Its
Subsidiaries
u Denotes Under Review Best's Rating June 26, 2020
Rating History
AM Best has provided ratings & analysis on this company since 1922.
Financial Strength Rating Long -Term Issuer Credit Rating
Page 2 of 5
Effective Date
Rating
Effective Date
Rating
6/26/2020
A
6/26/2020
a
5/30/2019
A
5/30/2019
a
5/16/2018
A
5/16/2018
a
3/8/2017
A
3/8/2017
a
10/8/2015
A
10/8/2015
a
http://ratings.ambest.com/SearchResults.aspx?SR—I 9/4/2020
1316
22`1 VVJFIFFFJzsoti Rou'u-NARD
SOO H I 1IFNI), NDIAINA4660 I d,430
PIUMF 574/235-9251
FA X 574,/ D5-9171
FIN) 574/ 235-5567
CITY OF So(,�'J'H BEND, JANIES MUELLER, MAYOR
BOARD OF PUBI-XWORKS
Date: August 26, 2020
To: All Planholders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number: I
Project Name: O'Brien Recreation Renovation
Project Number: 118-091
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9'171
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company: L10166SK' 6QV)SJ-VV(,UVi
Authorized Signature:
Date: q
Version 8/11/2020
13 16 Ilk m,iwq(,�
227 W, 1GJT1,,,'RS( N BOJILEVARD
Soun'8 NNrx, k111MA NA416601-HUO
574/ 235-9251
IFAX 574/ 23 5-917 q
FDD 5741235 -5567
(.11T5"OF 'JOUTH PEND, JANNES MIJELLFR, MAYOR
BO,ARID 0F.PUBILIC WORKS
Date: Angust28,2020
To: All Planholders
From Linda M. Marlin, Clerk, Board of Public Works
Subject Addendum Number: 2
Project Name: O'Brien Recreation Renovation
Project Number: 118-091
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9171
w *thin 48 hours of receipt. A copy MUST also be included with your
I -
bid package upon submittal.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company:
Authorized Si
Date: S Lu
Version 8/11/2020
1316 COUNTY -CITY MAIMING
227 W. JEFFERSON BOULEVAIU)
SMM-i BEND, INDIANA 46601-1830
PHoN-F, 574/ 235-9251
FAX 5741235-9171
TDD 574/ 235-5567
CITY OF SOUTH BEND, JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
Date: September 3, 2020
To: All Planholders
From Linda M. Marth), Clerk, Board of Public Works
Subject Addendum Number: 3
Project Name: O'Brien Recreational Center Renovations
Project Number: 118-091
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company:
Authorized Signature:
M
W-11 MIzWI
Version 8/11/2020
13 16 CWNFY-CTVV BUILD I NG
227 V JFF1:ERSCA'4 BOULEVARF)
SOUFH BVIND, IN DIAN A 466(H .1 UO
fllwj* 5`14/ 235-9251
FAX 57-4/ �235-917 I
574 / 2 35-5 5 67
(71TY Of," SOLY1.1i BEND, JAMES MJJELLER, MAYOR
BOARD OF PUBLIC WORKS
Date: September 16, 2020
To: All Planholders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number: 4
Project Number: 118-091
J
JIN
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company:
Authorized Signature:
Version 8/11/2020
FY x
Compaqy TO Numb6n, 498671
THE E -VERFY PROGRANI FQR EMPLOYMENT T VERIPIQATION
MEMORANI]UM OF IIWERSTAI MNG
ART19LELI
PURP..095- AND AUTHORITY
*i, McMoratrdurn of tWerstandhi' g (MPU) %eis Wth the points of agreement blusreen the
i�apartr PIA of Hontalartd Se-Weiiiy (ifiS) and 1koWskt� Cnnst-MO Ax tic. (rllliloyer)
regarding the Ernpldyefs part€Opaflon ra the- Emplayment ElIgIbillty Viftafion ftgT-am {I "
Vdrif ,). This MOU explaina certdirj. features of the E-Vari y prdgNm and, onurrrerate ; specit'ic
resporrsfilf lees of DH8, the Social Seaullly Adm€nlstration { SA)i and the Employer.. Verify is
o pragrarrrthat electrooloal(y canflnns an ernployoe'a olig�ilty to work In the United Stgt9e gifer
wrnpletlon of tl q Employment �-r€gibto
Vb0fleation Form �" 144), F'or covered govatnmarlt
c6ntractare, EcVerify is used to•verify employment ejjgibil€ty of aQ newly filrbd polployees and
all e.Ating errrployees a'ssigrrad t& Fedp4 contra*, or to verify the eilfira workirforc% it tlhe
contractor so ohovw%
Authority for the l -Verify program- Is. found h, Title 1V5 Subtitle A, of the Illegal Immigration
Reform grid Immigr9nt Resporisil�iiity Act of '1908 (!(RIBA), Pub. L.104-20% 11 0 tat. ZOO9, as,
amended U, .O: I3 a nab}', A Yl on r for use of the 1ler proarc m icy F 3er i
�rirz*rs and -aul3ac�ntractc�rs Covered by the terms of ftbppri 29,•l8, "Erhployment Ellgfhi[lty
VdMeaf' iv, of the Federal Acquisitlo n; Rag ulailon, (FAR) (hereifte'terraferred"ta in thin MOU'as
a °Federal continotor with the FAR C- eflfy clarlsc") tp verity the drrfptoyrn�jkt of€gtbility of
6eitain dmployees waridrig an Federal contraota is also found €€i SubpaiM;18 and -Ira F �iti�d
Order 12989, as arnendedr
ARTICLE IIII
FUNCTIONS TQ-EEPI AFORMED,
.A, RESFa'Dl+ SIB LITIES OF SSA
, S-SA agrees to prmdga thee. Eitp oyer with available irlforrnatton that allows the Crnpinyer to
c€ nfjkrx the accuracy of ftfat Security Numbers prided by all emp*oea varie( under this
MW and tiro empIdymegt p► ftorization of Ut6; oifa-ens,
2. SSA adreha to lirovido to the I=mpfoyer apprsdpriate asslatanr?e w ih operational problems that
rn�iy arise during the Employefs par Mpatidn €n the E Verlf� progt'am 5SA agreds~ to provide
tfh tho Employar iA names, titles). addteww, and telephone nutabers of SSA re0reseritMv69 to
be contacfed during the E Vsrifir procesa.
3,, SSA agrE�aa• to safeguard the infarmatiorl provided by tha t mploYer through fhb t~-Varliy
pE gr r17 procedures, ertd to liriftu cress to such lrrfc5airlatTr}ri, s Ts apl�roprlat� py Ir w, to
iridivldr�r i respgnsibEe fir tie verlfiaafil n + F�ociai $ c011 Mumbem arid f0ea•:valuatian oftlte
E-Ver€ty program of suGh other pensions or enttflos who may U0 author€z&d by,9sA as Witarned
Wage• 1 uf131 E-Verlry 19OU for 15tnpkoyer I RWRiA Date 09101109 uuWu�l.dtt,5,�ov1� ��ri�
. ! .
GofrvpAny ID Nurnbar, 48GB71
To be acceptod as a porUCIpant in E Verlf ►G*you shduId only sign the Employer's Sed on
of the sighature page. Ifyou have any quastloins, cctntad l- Verify at B$SW4W918.
itmployer Z6ftwAld cwgt"Oldfk, .
1M T.a)rors
Ame tvCeas0-75y— 0 ae Pirnr
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ale
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ama (Plsaae Type ur PitrM
ElebtronlM.1 5l ned
�'tt7i1;2i 2
Ignatum
lAtmatim Required fbr the i^ -V-6 f]l PregraM
Ihformatlbn retatin -to ' r Campali
Con; ii' dame:
'ol��ws3�lai�r�sttlan,,liari.
Comp art FadIfy Address;
4060 "Ply JQFi9e dr.
,etitlr t €nil, IN 4 "s
OgmpgN AlblkmW
Addross:
Cotinty orPatish;
T'408EPH
Erj1p1pyaf is m0gation
Number.
56144502
Page 12 ef!3 j &Vadfy MPU fat' Empin" C RaIMOP r* WO1J09 uutnrgv dtfq gOv1 ~ Var 1fY
Col piny €D Number: 486871
Nat€h AfhadrAn 1liduaW
plas4flaatfon Systems-
'
Administrator.
Number of Employees,
figs to 449
Numbor qf SNr, Verified
fan
Are-yo-ft Yofflftg. for mEors fW I RiteI If yes PRWO pravide thIg number of sites �er'llcd ror
€ru each Staid;
I�DUWA x- SM(a)
lntaftation relating to. the- program Admidlatrato*) for ybOr Company on polloy
t1w tfnns_ or operattonal pr9bloms:
�`e��Iioae�7a fiber; 7� �7.-18I1 f.358. P"unber, 04)34.4- M3
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Emptoyment-OgtbUity lleriftoation
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