HomeMy WebLinkAboutOpening of Bids - WWTP Masonry Improvement Gallery Buildings 1-4 Proj No. 120-036 - Slatile Roofing & Sheet Metal Co., Inc.Project Name WWTP Masonry Improvements Gallery Buildings 1-4
Project No. 120-036
For Bids Due October 13.2Q28
Contractor Name: Slatile Roofing and Sheet Metal Co., 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. Oue|Uy
wmrhmonuhip, efficient operetion, yohaty. and timely completion of projects requires that all bidders meet
certain minimum requirements tnberesponsive and responsible bidders.
THIS FORM MUST BE SUBMITTED WITH YOUR BID.
If you are a pre -qualified bkddar complete Section Ionly.
Ifyou are not mpre-qualified bidder, complete Section Qonly.
Section 11 acts as an application for pre -qualification. Submission of Section 11 will allow the bidder to be
considered for pre -qualification for bids with the City of South Band Department ofPublic 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 operiod oftwelve (12) months.
Thereafter, contractors who are pre -qualified must submit acomplete application for continuation of"pre-
qualified" etending, on o 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 Qty. 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
nfthe designation, effective January 1 ofthe following year, orimmediately following the twelve (12)months
ofpre-qualified standing.
However. the "removed" contractor or subcontractor shall still be permitted to bid on City public works
pnojento, though the contractor must submit all required documents underG-G3 until "pre -qualified" status
is re-established.
p]eeme 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 isthe sole responsibility ofthe potential bidder bacomply with all submission requirements applicable to
the bidder in Section 6-83 of the Responsible Bidding Ordinance no later than the date of the public bid
opening.
Version5MO/2O19 GenamlConditiona-O
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, ocurrent written list that discloses the
name, address, licensing status, and type of work for any subcontractor from whom the bidder has
accepted o bid and/or intends to hire on any port of the public work pnoject, including individuals
performing work asindependent contractors.
2. Each aubcunbador, 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)
tothe successful bidder prior hothe commencement ofwork.
3. Failure of subcontractor to submit the required information shall not disqualify the ouocnoefu|
bidder from performing work on the project and shall not constitute a contractual default and/or
breach bythe successful bidder. However, the City may withhold all payment otherwise due for
work performed by suboontnador, until the subcontractor submits the required information and
the City approves such information.
4. The disclosure of subcontractor list ("Disclosed Suboontrecior(e)^) to the City by a bidder shall
not create any rights in the Disclosed Subcontnactor(m). Thuo, 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.
S. 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
Please Note: Submissions deemed inadequate, incomplete, nruntimely by the City may result in
the automatic disqualification of the bid.
The City, after review of complete and timely oubmisokone, aheU, in its sole diaorehon, after taking into
account all information in the submission rmqui/emento, determine whether a bidder is responsive and
reaponoib|e, and provide Pre -Qualification Verification Letter. The City specifically reserves the right to
utilize all information provided in the contractor's submission and any information obtained bythe City
through its own independent verification of the information provided by the contractor.
Vnrsion5/1O/2O1S General Conditions -7
P CHECKLIST (FOR BIDDERS THAT ARE NOT PRE-QVJAUFIE[)
(a) Acknow| ame�s:
W �^
By checking this box, | hereby acknowledge that |emnot opre-qualified bidder
_u�
with the City ofSouth Bend.
00 ��
Bychecking this box, | hereby acknowledge that the City reserves the right to
request supplemental infonnation, additional verification of any information
pruvided, 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, | acknowledge that all
information provided tothe City shall beregarded oepublic records.
(iii) _Z
By checking this box. | hereby acknowledge that copies of all Applicable
apprenticeship certificates orstandards for training programs applicable hothe
work performed on the project may be requested at any time and shall be furnished
_�.
uponvequeot .
(k)
By checking this box. | hereby acknowledge and ensure that | and all sub-
contractors, from whom I have accepted a bid and/or intend to hire to perform work
onthe public work project, are properly licensed. Furthermore, | acknowledge nny
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 sub-
contractor loses their license at any point, it is the responsibility ofthat sub-
contractor tmnotify the City.
(b) Attach
(i) 2
Indiana Secretary of State's on-line records (ie. Business verification) dated within
sixty (GO) days of the submission of said document showing that business is in
existenoe, current with the Indiana Secretary ofState's Business Entity Report,
and eligible fora cedifinoba of good standing. (Not applicable to individua|n, sole
proprietors or partnerships).
List identifying all former business names.
Any determinations by o court or governmental agency any violations of federal
etota, orlocal laws including, but not limited to, violations ofcontracting orantitrust
|ewm. tax orlicensing laws, environmental laws, Occupational Safety and Health
Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5)
(k)
.
years.
Statement about staffing copabi|itiem, including labor sources. This statement
indicates and ensures I have sufficient employees on staff to complete the work I
.�
ambidding onDRoutlines how | intend tomeet the staffing needs ofthe 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
-
underoUapp|icob|oo�nb*andfadena||awmond|ou�|ordinance� .
(vi) ��_
For every pnoject, submit evidence cfparticipation in apprenticeship and training
proQramo, applicable to the work to be pedbnnad on the puojeot, which are
approved by and registered with the United States Department of Labor's Ofrice of
=�r
Apprenticeship, orits successor organization.
(vii) _��
Copy ofawritten plan for employee drug testing that covers all nfmyemployees
who will perform work on the public work project and meets or exceeds the
-u�
requirements set forth in |C4-13-1O-6or|C4-13-18-G'
(viii) ��_
Evidence that | am utilizing o surety company which is on the Bureau of Fiscal
Service "Department of Treasury's Listing of Approved Sureties" as required in the
bid specifications orcontract.
Version5/18/2U19 General Conditions 'S
��
(ix) Written VVhttenatatementofonyfedens|.etateor|nca|bax|ienomrtaxde|inquenniesowed
toany federal, state orlocal taxing body inthe preceding three years.
(i) ' List of projects of similar size and scope of work performed in all areas, including
' the State of Indiana, within three (3) years prior to the date on which the bid is due.
)Date: 10/12/2020
(Sign Here)
(Print Name Here)
Slatile Roofing and Sheet Metal Co., INC.
(Name ofCompany)
1703S. IPDOVVDOd [}[
(Address of Company)
South Bend
5742337485
(Telephone Number)
PEACK
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
CHECKLIST FOR BIDDERS
Project Name WWTP Masonry Improvements Gallery Buildings 1-4
Project No. 120-036
For Bids Due October 13'2O2O
From time to time the South Bend Board of Public Works finds it necessary to reject abid because
it does not comply with statutory requirements. In preparing your bid, please use the following
checklist inorder tomake sure that your bid iadone inthe proper manner.
� Proper bid security included. The bidder has the option ofproviding either aCe�i�adCheck
VnrBid Bond.
Bid prepared onthe City ofSouth Bend Contractor's Bid for Public Work Form, completely
Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding |nvnobnantm
with Iran, Employment Eligibility Verification, Non-D isohminetion Commitment, and
Certification of use of United Sbabae Steel Products or Foundry Products.
Proof of MBEANBE 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 MBE/WBE Contacted
Form[[NVVBE-2.1].
Acknowledge Receipt of2 Addendum(o)included with the bid.
All required additional information is included with the bid.
Proposal statements and other affidavits all signed by the proper party with name either
printed or typed underneath signature.
N/ This checklist submitted with the Bid.
This checklist is provided for bidder's use in assuring compliance with required
documentation; however, it does not include all specifications requirements and does not
relieve the bidder ofthe need toread and comply with the specifications.
Bidder: Sl8[ile Roofing d Sheet Metal Co.,INC. Date: 10-9-2020
BvAuthorized Rep :
Signature:
Print Name &Title: Gerald Loriq8Kot-President
Vorsion4/2/2O19 Contractor's Bid for Public Works -1
RVOIN MET Tin
Project Name
Project No.
For Bids Due
WWTP Masonry Improvements Gallery Buildings 1-4
120-036
PART U
(Must be completed for all bids. Please type orprint)
Date: 10/12/2020 Bidder (Firm): Sl8til8 Roofing and Sheet Metal Co., INC.
Address: 1703 S. I[OOVVDOd [)[
City/State/Zip: South Bend, IKj46613 Telephone Number: 574
Agent ofBidder (if App|kmb|e):
Pursuant to notices given, the undersigned offers to furnish labor and/or material
public dm of:
--',—'---
WWTP Masonry Improvements Gallery Buildings 1-4
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
Kil Architecture
and dated 9/11/2020 for the sum of(enter the Total Bid aeshown onthe Proposal)
Four hundred twenty thousand two hundred eighteen ($ 420,218.00
(Enter sum of Total Base Bid plus Alternates shown on Proposal)
The undersigned furtheragreeatnfumishabondorcertifiedcheokwbhthiabidforanamountspecifiedin
the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance
with the notice. Any addendums attached will be specifically referenced at the applicable page.
Ifadditional units ofmaterial included in the contract are needed, the cost ofunits must bethe same asthat
shown in the original contract if accepted by the
basis, the itemization ofthe units shall
Gerald Lon rot - es
(Printed Name of Person Signing)
ACCEPTANCE
The above bid isaccepted this
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Elizabeth A. Maraclik, Member
JooephR. Molnar, Member
day of
Jordan V. Gathers, Member
Fherese J. Dorau, Member
Attest: Linda M.Martin, Clerk
20
Version 4/2/2019 Contractor's Bid for Public Works - 2
PART 11
(For projects uf$1OO.DOOormore —|C3G'1-12-4)
These statements bJbesubmitted under oath bveach bidder with and os part ofhis/her/itebid.
Attach additional pages for each section moneeded.
SECTION / EXPERIENCE QUESTIONNAIRE
1-Attach information regarding projects yourorgmnizobonhaecomp|etedfortheoeriodofone
(1)year prior tothe date ofthe current bid.
2. Attach olisting ofpublic works projects currently iUprocess Vfconstruction bvyour
organization.
3. Attach information regarding any failure to oonnp|a{e any work mxvanjed to you and the
location thereof.
4. Attach references from private firms for which you have performed work.
SECTION QPLAN AND EQUIPMENT QUESTIONNAIRE
1. Attach an explanation of your plan or layout for performing work. 8Exanlokan could
include e narrative of when you could begin vvo/k. complete the project, number of workers,
etc. and any other information which you believe would enable the City of South Bend to
consider your bid.)
2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside
your own firm who have performed part of the vvodd that you have used on public works
projects during the past five (5)years along with obrief description ofthe work done bveach
subcontractor.
3. Kyou intend tosublet any portion ofthe work, attach the name and address of each
subcontractor, equipment to be used by the auboontractor, and whether you will require a
bond. However. if you are unable bzcurrently provide |istin0, please understand o|iabng
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 osubcontractor onthe proposed project.
4. Attach a listing of equipment you have available to use for the proposed project.
5. Have you entered into contracts or received offers for all materials which substantiate the
prices used in preparing your proposal? If not, attach on explanation for the rationale used
which would corroborate the prices listed.
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment ofbidder's financial statement iSmandatory. 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 oon1nao1 must be specific
enough iDdetail sothat said City OfSouth Bend can make aproper determination Dfthe bidder's
capability for completing the project if awarded.
Version4/2-/201S Contractor's Bid for Public Works '3
When the prospective Contractor is unable to certifyto 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 IN
St. Joseph SS:
COUNTY
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjtuy
that:
1. Contractor has not, nor has any other member, representative, or agent of the firm, company,
corporation or partnership represented by him., entered into any combination, collusion or agreement with
any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding
nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and
without any agreement, understanding or combination with any other person in reference to such bidding.
Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or
indirectly, any rebate, fee, gift., commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals
are presently debarred, suspended, proposed for debarment, declared ineligible., or voluntarily excluded from
participation in this transaction by any Federal department or agency; and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
a. For purposes of this Certification, "Iran" means the government of Iran and any agency
or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as
amended from time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor
is engaged in investment activities in Iran if either:
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 Contractors Bid for Public Works - 4
4. Contractor does not knowingly employ mcontract with an unauthorized alien, nor retain any
employee or contract with a person that the Contractor ouhuoqucody learns is an unauthorized u|icm.
Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all nfContractor's
newly hired employees through the B-Verify Program as defined by I.C. 22'5-1.7-3. Contractor's
documentation ofenrollment and participation inthe G-\/oity Program is included and attached uupart of
this hid/quotn;and
5. Contractor shall require his/her/its suhouukuotorx puc5nonlng xmdk under this public contract to
certify that the subcontractors do not knowingly employ o,contract with an unauthorized alien, nor retain
any employee orcontract with upomou that the subcontractor Subsequently learns is an unauthorized alien,
and that the subcontractor has enrolled inand isparticipating in theE-Verify Program. The Contractor agrees
mmaintain this oouifiouuioothroughout the term nfthe contract with the City ofSouth Bend, and understands
that the City may terminate the contract for default iythe Contractor fails tn cure abreach ofthis provision
nolater than thirty (3O)days after being notified bythe City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City
of South Bend ubmugb its ugouoicu, boando, or commissions xhuU not discriminate against any nmy\cyoo 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, uu1iouul od&io' ancestry, age, gender nxyr*adoo, gender identity, sexual nrluouxinn or
disability that does not affect that poroon'oability tnperform the owrk.
In awarding contracts for the pu/nbcmc of work, labor, aomicro, 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,
orcommissions may consider the Contractor's good faith efforts u`obtain participation hythose Contractors
certified by the State of Indiana as u Minority Business ('^h8BB'`) or as u \Vomco'o 8uuioemo Enterprise
(°9/8B'`)uoafactor imdetermining the lowest, responsible, responsive bidder.
In no event shall persons o,entities seeking the award ofuCity contract horequired maward umubnontraot
to on MBC/\uBS; however, it may not unlawfully diocdooiomu against said \mBS/MQB. A finding of
discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from
being awarded City contract for aperiod ofone (l) year from the date ofsuch 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 thu|dkcto)}owingnoodisoriminatioocommitmcntohu)|bcmado
apart nfany contract which iimay henceforth enter into with the City of South Bend, Indiana orany ofits
agencies, boards nrcommissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the
performance o[this contract with privileges ofemployment, ozany matter directly n,indirectly related to
employment, because of race, religion, color, sex, gender expression, gender identity, oozuo| orientation,
handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of
contract.
J' the undersigned bidder or u&cot as contractor on u public works project, understand my ammmry
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). 1 hereby
oonjfy that l and all subcontractors employed by me for this project will use moc| products or foundry
products made in the Duircd States on this project if awarded. l understand l have on mdimoabve 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 8tu»na. [ understand itismy sole obligation and responsibility ooprovide ujustification
mthe City. subject oureview and approval, why the cost ofUnited States made steel o,foundry products |o
unreasonable. Prior to award and upon submission nfbid which does not use steel products mrfoundry
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
Vemion4/2/2V1S Contractors 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 1 2th day of Oct- 2020
Slatile Roofing and Sheet M ahQ)Q,,, // INC.
Contra or/Bidder (Firin
Signature o ContractorWrd_efer 01. nt its &1(c
Gerald Longerot - PresrqjpN`.
Printed Name and Title Pp
Subscribed and sworn to before me this day of 20�i
My Commission Expires/ 0/1 sla 7 AV.
TARA L REINHARDI Notary Public
L NOTARY PUBWul of
T F ty esidence _'5+ 1,�
SEAL
S "r , FATE OF INDIANA
M Y C (;�m to'! EXPIRES DECEMBER 18, 2op?
"SION NUMBER NP0724157 I
C Nwil- ION NUM
Version 4/2/2019 Contractor's Bid for Public Works - 6
BID/PROPOSAL
CITY OFSOUTH BEND
Project Name: VVVVTP Masonry Improvements Gallery Buildings 1-4
Project Number: 120-036
For Bids Due: October 13'2O2D
Contractor Name: S|808Roofing and Sheet Metal CO.. INC.
DIVISION A: BUILDING 8 (Gallery Building 1)
Item
Description
Quantity
Unit
Unit Price
Total Amount
1
Exterior Masonry Improvements
lot
$39,000
$39,000
DIVISION A:BUILDING OBASE BID TOTAL
DIVISION B: BUILDING 9 (Gallery Building 2)
Item
Description
Quantity
Unit
Unit Price
Total Amount
DIVISION B:BUILDING 9BASE BID TOTAL �ibU'UUU
DIVISION C: BUILDING 10 (Gallery Building 3)
Item
Description
Quantity
Unit
Unit Price
Total Amount
1
Exterior Masonry Improvements
lot
$75,000
$75,000
DIVISION C: BUILDING 10BASE BID TOTAL '51bU'UUU
DIVISION D: BUILDING 14 (Gallery Building 4)
Item
Description
Quantity
Unit
Unit Price
Total Amount
1
Exterior Masonry Improvements
lot
$68,000
$68,000
DIVISION D:BUILDING 14BASE BID TOTAL 131,218
DrN8OND:BUILDING 14ALTERNATE #1
Item
Description
Quantity
Unit
Unit Price
Total Amount
Provide price to install Versico roofing
1
system in lieu of base bid manufacturer
1
33,218.00
33,218.00
DIVISION D: BUILDING 14 ALTERNATE BID TOTAL
Version4/2/2O10 Contractor's Bid for Public Works '7
BID/PROPOSAL
CITY OF SOUTH BEND
Project Name: WWTP Masonry Improvements Gallery Buildings 1-4
Project Number: 120-036
For Bids Due: October 13, 2020
Contractor Name: Slatile Roofina
and Sheet Metal Co., INC
DIVISION D: BUILDING 14 (Gallery Buildina 4) ALTERNATE #2
1865
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
Provide price to remove entire roofing
1
system and all insulation down to decking to
42,218.00
be replaced with new insulation and roofing
system
DIVISION D: BUILDING 14 ALTERNATE #2 BID TOTAL 42,218.00
UNIT PRICES
Item
No.
Description
DEDUCT/SF
ADD/SF
1
Masonry Brick Tuck -pointing per SF
R ab-oo
JN5.00
2
Soft Joint Repointing per LF
—
$P/-00
00
3
-
Masonry Brick Re-building/Replacement
per SF
110, Do
510.00
4
Brick and Limestone Cleaning per SF
42-0a
4 o. 0 C,
5
Concrete roof topping repair per SF
136.00
Bidder (Firm): Slatile Roofing and Sheet Metal Co., INC
Address: 1703 S. Ironwood Dr.
City/State/Zip: South Bend, IN _ Telephone Number: (574 ) 233-7485
46613
By
(Signat
Gerald Longerot - resident
(Printed Name of Person Signing)
Version 4/2/2019 Contractor's Bid for Public Works - 8
CITY OfSOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM KXVVBE-1.0
� ^`
K88E8WBEP4RT|C|PAT|ON
1865�»
I nis completed torm should be supplied with Bids that pertain to City of South Bend Public Works
|tiathe bidde�s sole respunoibiUtybuvorUwhether woman ects
of aK8in MBE/MBE' participation.
It
owned business. —
Project Number: 120-036 Project Name: WWTP Masonry Improvements Gallery Buildings 1-4
Slatile Roofing and Sheet Metal Co., INC. Total Bid Amount: $420,218.00 MBEANBE Goal:
Name & Address of MBE/WB'E
Primary Contact Person
(Name[Telephone)
Scope of Work to be Performed
(Attach scope/schedule if you need additional space)
Dollar Amount of
MBEIWBE Component
Percentage
of Total
Submitted by: Gerald LOOg8rot-President
Print Name
Signature
Verskm4/2/2O19 Contractor's Bid for Public Works 9
10/12/2020
Date
, 61d
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
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:
Project Name:
Bidder:
Contact Person:
Address:
City:
Email:
120-036
Date: 10/12/2020
_WWTP Masonry Improvements Gallery Buildings 1-4
Slatile Roofing and Sheet Metal Co., INC.
Gerald Longerot Telephone: 574-233-7485
1703 S. Ironwood Dr.
South Bend State: IN
as
46613
To determine whether a bidder has demonstrated good faith efforts to reach the MBE/WBE 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 (hftp://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 MBENVBEs of contracting and
subcontracting opportunities.
2. Advertise in general circulation and/or trade association publications concerning subcontracting
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 MBEMBE 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 MBEN\/BEs 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 MBEMBE goals (including breaking down
contracts into smaller units to facilitate MBEN\IBE participation)
CONTRACT RECORDS: The bidder has maintained the following records for each MBEMBE 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 MBEAA/BE was unqualified to perform the job.
*Proper demonstration of 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 4/2/2019 Contractor's Bid for Public Works - 10
uuTn
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY s `
DEVELOPMENT PROGRAM
r i{
FORM MWBE-2.1
MBE/WBE CONTACTED .865
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects
requiring contacted MBE/WBE 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.
PAGE OF
Project Number: 120-036 MBE/WBE Participation Goal
Project Name: WWTP Masonry Improvements Gallery Buildings 1-4
Bi er: a bfing a5 Sheet Metal Co., INC.
By: �� President 10/12/2020
(Signa/t re) (Title) (Date)
MBE/WBE Firm Bulk Transport, Equipment Rental
Owner or Contact at MBE/WBE Firm Bulk Transport, Equipment Rental
Telephone: 2192290442 Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Equipment Rental
RESULTS OF CONTACT WITH THE MBE/WBE FIRM:
No response from Bulk Transport, Equipment Rental
MBE/WBE Firm Creative Custom Finishes and Painting
Owner or Contact at MBE/WBE Firm Creative Custom Finishes and Painting
Telephone: 55748060334 Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Painting
RESULTS OF CONTACT WITH THE MBE/WBE FIRM:
No response from Creative Custom Finishes and Painting
Version 4/2/2019 Contractor's Bid for Public Works - 11
CITY OFSOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM K8VVBE-2j
K0BBWBECONTACTED
This completed form should bnsupplied with Bids that
pertain to City of South Bend Public Works Projects
�
requiring contacted MBEIW8E 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 Minority nrVVnmen'o owned
business.
Project Number:
Project Name:
Bid d��/
PAGE OF
120'036 K8BE8NBEParticipation Goal
VVVVTPMasonry Improvements Gallery Buildings 1-4
latil and heet Metal Co., INC.
MBE8NBEFinn MidVV8�t Rentals
Owner orContact etMBE/NBEFirm Midwest Rentals
Telephone: 7654235541 Fax: Email:
TYPE OFWORK SOLICITED FOR THIS PROJECT:
Equipment Rf@l
RESULTS DFCONTACT WITH THE MBE/WBEFIRM:
No response from Midwest Rentals
MBE8mBEFinn
Owner orContact atMBExNBE Finn
Telephone: Fax: Email:
TYPE DFWORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBEANBE FIRM:
Vamiun4D/2O1S Contractor's Bid for Public Works '11
CERTIFICATE OF EXISTENCE
ToWhom These Presents Come, Greeting:
L CONN|E LAVVSON, Secretary of State of Indiana, do hereby certify that | am, by virtue of the laws of
the State of Indiana, the custodian of the corporate records and the proper nff)da| to execute this
certificate.
I further certify that records of this office disclose that
duly filed the requisite documents to commence business activities under the laws of the State of
Indiana onJanuary 08, 1965, and was in existence or authorized to transact business in the State of
Indiana unSeptember O9,Z03O.
| further certify this Domestic For -Profit Corporation has filed its most recent report required by
Indiana law with the Secretary of State, or is not yet required to file such report, and that no notice of
withdrawal, dissolution, or expiration has been filed or taken place. All fees, taxes, interest, and
penalties owed to Indiana by the domestic or foreign entity and collected by the Secretary nfState
have been paid.
In VVdnea Whereof, | have caused to be affixed my
signature and the seal nfthe State ofIndiana, atthe City
ofIndianapolis, September O9,2O2O
CONN|E LAVV5ON
SECRETARY OF STATE
194439-082/20201613117
All certificates should be validated here: https:Hbsd.sos.in.gov/ValidateCertificate
Expires onOctober O9,2O2U.
Phone:5742337485
Fax: 5742337531
infofslatileroofing.com
www.slatileroofing.com
1703 South Ironwood - South Bend, IN 46613
!a !, �
% /
/�110�, l
-ems
Gerald Longerot - President
10/12/2020
ESTABLISED 1924
ROOFING MASONRY RESTORATION
SHEET METAL
-CLOSING :CONFERENCE WORKSHEET
1926 STANDARDS, CONSTRUCTION, SAFET-Ya HEALTH --
State Form47278 (R/4-D9)
,Ispectlon number Name of Company
664(407 WOVXWel avd,�(hW
i. Safety & Health provisions.
9. Electrical 17. Underground Construction
2. Environmental Controls
3. PPE & Life Safety Equipment
10. Scaffolding 18. Demolition
11. Fall Protection 19. Blasting & Explosives
1. Fire Protection
12. Cranes, Derricks & Hoists 20. PowerTrmsmTs*n
5. Signs, Signals & Barricades
13. Motor Vehicles &Mechanical Equipment 21. Rollover Protection
S. Material Handling
7. Tools, Hand & Power
14. Excavations 22. Stairways & Ladders
15. Concrete & Masonry 23. Toxic/ Hazardous Substances
B. Welding & CuWng
16. Steel -Erection 24. General Duty
Type of TrispeclIon Location
M .49P-412��t
_V
iaza r d
lomments zsi �.q
i. Type ortrispection
Location
Hazard
&Arlo 0 ilyxo"�
:;Dm J3=1 16 V-41 10-CAP d1cot-
(POP
�.Typo7orinsp ecllon � . .... Location
Hazard
Comments
4. TypaofInspection
Location
Hazard
----------------------------------------------------------------------
-
Comments
S. Type offfisparliDn
Location
Hazard
-----------------------------------------------------------------------
Comments
Hazard
I ------------------------------------------ --------------------------
The aforementioned hazards were noted by the IOSHA Compliance Officarduring the onsite inspection ofyourworksite. The complianceoffeWsrecomirnandaWns
regarding the above referenced hazards are subject to review by the IOSHA supervisory personnel. You may receive Safety orders and Notification of
Penalties related to this [OSHA inspection. Dale (nmalh, day, year)
Recalved by
err-ITR_ n TR
IM MON�.hfte - implc�yercopy, Canary - Employee Repre Imes
Phone:5742337485
Fax: 5742337531
info@slatiteroofing.com
www.slatileroofing.com
1703 South Ironwood o South Bend, IN 46613
Statement o staffing capab Vities and
d
c j' tio
on irma n that all
employees be
Key Personnel
0 Gerald Longerot - President - 54 years of experience
0 Ann Longerot - Secretary - 38 years of experience
0 Ken Hoy Jr. - Project Manager - 32 years of experience
® Wendell Simmons - Project Manager - 29 years of experience
0 Josh Longerot - Masonry Project Manager - 14 years of experience
® Jim Polk - Materials Manager - 26 years of experience
® Michael Albert - Assistant Project Manager - 4 year of experience
® Ryan Gramza - Sheet Metal Shop Manager - 26 years of experience
® Robert Davis - Superintendent - 34 years of experience
Field Employees
® Roofers: 27 full time roofers with 84% Journeymen roofers, all are trained through
JATF
® Sheet Metal: 3 Full time sheet metal employees 3 journeymen
® Masonry: 8 full time all journeyman masons
® Warehouse and Drivers: We have one full time warehouse employee that was a
journeyman roofer for 22 years, 1 truck driver that is a CDL Class A driver and one
mechanic
Longerot -President
1011212020
ESTABLISED 1924
ROOFING MASONRY RESTORATION SHEET METAL
loll
08/14/2020
To Whom it may concern:
U1, 0 T1 w
Slatile Roofing and Restoration is a contractor in good standing, signatory to the
South Bend Roofers Joint Apprenticeship and Training Committee's (J.A.T.C.)
Registered Apprenticeship Program #IN020780008.
Department of Labor
2420 Viridian Drive -Suite G
South Bend, IN 46628
Office of apprenticeship.
C.O. Kathleen Sokolowski
574-236-8295
Derek Carrington
Roofers Local 23
Apprenticeship Coordinator
22990 Ardmore Trail
South Bend, IN 46628
574-968-5500
I::i 1►
www.bac4traiiiing.cOm
bac4apprenticeship�t),gmail.com
219-525-4443
Roger Jones - Managing Director
October 9, 2020
C/O Slatile Roofing & Sheet Metal Co., Inc
To Whom It May Concern,
This is a letter of recommendation on behalf of Slatile Roofing & Sheet Metal Co., Inc
The BAC 4 IN/KY Apprenticeship & Training Program is a statewide program that was
established in I994 and is recognized by the U. S. Department of Labor and is considered
in good standing.
Slatile Roofing & Sheet Metal Co., Inc has been a "signatory union contractor" since I980
and currently employ enrolled apprentices. Slatile Roofing & Sheet Metal Co., 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 (2I9)
525-4443.
Sincerely,
Roger Jones
Managing Director
BAC 4 IN/KY Apprenticeship & Training Program
BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL 4 IN/KY APPRENTICE FUND
VALPARAISO, INDIANA
FOR THE TRADE CLASSIFICATIONS: BRICKLAYER; BRICKLAYER, FIREBRICK & REFRACTORY; TILE SETTER; TUCKPOINTER, CLEANER, CAULKER
J'?ey.ts1epeo'-as,pa-r1 of lal'e Xa1Jonaf5,,l ,p 'prenitces,& p 6yslem
in accoro(ance m-tXh1'1h1'e asic slanofaro(s ,p
Of pz-enlicesL�
eslablfishleal-46y I,& 6ecpela-ry of'ca&r
MAY 24,1996
Revised: February 2, 2007
IN001960012
,Wey.,sIralion Xo.
,,k e, N T 0
c5earelay of,6aAor
T—=-7
/0" ollic, lice"S' ;D
TES ES O�'
0�
Sheet Metal Workers Local 201
Apprenticeship & Training TruEE
2828 East 45th Street, Suite A
Indianapolis, Indiana46205
(317) 541-0050 -1-800-835-4531
www.smw20training.com
October 8, 2020
To Whom It May Concern,
I am the State Apprenticeship Coordinator for the Sheet Metal Workers' Local 4120
Apprenticeship and Training Trust. I am writing this letter on behalf of Slatile Roofing &
Sheet Metal in South Bend, Indiana. They are one of our contractors and have been in
good standing and have been actively participating for well over three consecutive years;
therefore, they are eligible to hire Apprentices through Our program. Apprentices hired
by this con-ipany are registered with the Bureau of Apprenticeship and Training as "Sheet
Metal" Apprentices.
Additionally, the Sheet Metal Workers' Local 4 20 Apprenticeship and Training Trust
has been active for well over three years, in fact dating back to March 5, 1946.
Thank you for your consideration in this matter. If you have any questions, please call
me at your convenience.
Sincerely,
( � " 121e"h�_
Jason Benson
State Apprentice Coordinator -
Sheet Metal Contractors -Sheet Metal Workers Local 20
Evansville -Ft.Wayne -Gary -Indianapolis -Lafayette -SouthBend -TerreHaute
Bureau of the Fiscal Service > Sure_ty Bonds > List of Certified Companies
M
Download the complete listing of Certified Cornpanle F, or browse the list below.
Also, see SUr.ir), Le-,maia. LGLiangeaI(LC'ircular 570
.......... -
Last updated July 01, 2020
".1
(NAIC #26379)
BUSINESS ADDRESS: PO Box 140855, Orlando, FL 32814.
PHONE: (407) 629-2131.
UNDERWRITING LIMITATION b/: $6,940,000.
SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MID, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ,
NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY.
R Z rd 0-Toffize- TO.T-,Vd 5 1-0 11 , Nk 9 10311 SM.
r • +' r * R « r'
(NAIL #14990)
BUSINESS ADDRESS: P. O. Box 2361, Harrisburg, PA 17105 - 2361.
PHONE: (717) 234-4941.
r • • � �r « r rrr
SURETY LICENSES c,f/: AL, AS, AZ, AR, CO, CT, DE, DC, FL, GA, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NJ, NM, NY, NC,
OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV.
INCORPORATED IN: Pennsylvania.
(NAIC #18058)
BUSINESS ADDRESS: One Bala Plaza, Suite 100, Bala Cynwyd, PA 19004 - 0950.
UNDERWRITING LIMITATION b/: $230,135,000.
UNDERWRITING LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE,
NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY.
INCORPORATED IN: Pennsylvania.
(NAIC #18619)
err• •� :. •rr .. . r r•rr
• «r: • � rr
UNDERWRITING LIMITATION b/: $5,182,000.
r1 !
1703 South Ironwood m South Bend, IN 46613
FAN
i/ elinquencies',230
Gerald Longerot - President
10/12/2020
ESTABLISED 1924
ROOFING MASONRY RESTORATION
Phone:5742337485
Fax: 5742337531
info@slatileroofing.com
www.slatileroofing.com
SHEET METAL
G101019[il[r
1703 South Ironwood - South Bend, IN 46613
r
I u rsoko
SB irar-Uls"
ESTABLISED 1924
MASONRY RESTORATION
Phone:5742337485
Fax:5742337531
i nfo@slati leroofing.com
www.slatileroofing.com
SHEET METAL
CONTRACTOR:
SURETY:
(Name, legal status and address)
(Name, legal status and principal place
Slatile Roofing & Sheet Metal Co., Inc.
of business)
1703 S. Ironwood Drive
Hudson Insurance Company
This document has important legal
South Bend, IN 46613
100 William St, 5th Floor
Street,
New York, NY reef,
consequences. Consultation with
OWNER:
an attorney is encouraged with
(Name, legal status and address)
respect to its completion or
Board of Public Works, City of South Bend, IN
modification.
227 West Jefferson Boulevard
Any singular reference to
South Bend, IN 46601
Contractor, Surety, Owner or
BOND AMOUNT: ***FIVE PERCENT OF AMOUNT BID***
other party shall be considered
plural where applicable.
PROJECT:
(Name, location or address, and Project number, if any)
WWTP Masonry Improvements Gallery Buildings 1-4
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 Projec ,
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.
Mled this 13th day of Oct
(Witness) pp
tEiatt �rxd stl0i
(I'Vit T
SS)
aber 2020
Slatile Roofing & Sheet Metal Co., Inc.
(Principal) (Seal)
(Title) 6vwro L.oN o3- 9< Pre_.S Q&1V4-
Hudson IraWdrffin-ce Com ny
(Surety) (Se a1)
(Title)
Todd SchaaD, Attorney -in -Fact
AIA Document A310- — 2010. Copyright@ 1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING: This AIAe
Init. Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIAo Document, or
any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law.
t Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail
The American Institute of Architects' legal counsel, copyright@aia.org. 061110
HuDSON
INSURANCt G[toUll
U�' 1,��A
KNOW ALL MEN BY THESE PRESENTS: That HUDSON INSURANCE COMPANY, a corporation of the State of Delaware, with
offices at 100 William Street, New York, New York, 10038, has made, constituted and appointed, and by these presents, does make, constitute and
appoint
Thomas O. Chambers and Todd Schaap of the state of Wisconsin
Todd Kramer of the state of Iowa
its true and lawful Attomey(s)-in-Fact, at New York, New York, each of them alone to have full power to act without the other or others, to make,
execute and deliver on its behalf, as Surety, bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as
aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no single
bond or undertaking shall obligate said Company for any portion of the penal sum thereof in excess of the sum of Ten Million Dollars
($10,000,000.00).
Such bonds and undertakings when duly executed by said Attomey(s)-in-Fact, shall be binding upon said Company as fully and to the same
extent as if signed by the President of said Company under its corporate seal attested by its Secretary.
In Witness Whereof, HUDSON INSURANCE COMPANY has caused these presents to be of its Senior Vice President thcreunto duly
this _9th day of --July 20 19 at New York, New York.
A
S
0 y a
Attest .........
Dina D2skalakis
Corporate Secretary
STATE OF NEW YORK
COUNTY OF NEW YORK SS.
HUDSON INSURANCE COMPANY
By.. ...............
Michael P. I e t
Senior Vice President \1/
On the 9th day of July 20 19 before me personally came Michael P. Cifrine to me known, who being by me duly sworn did
depose and say that he is a SeniorVicc President of HUDSON —INSURANCE COMPANY, the corporation described herein and which executed the above instrument,
that he knows the seat of said Corporation, that the seal affixed to said instrument is such corporate seal, that it was so affixed by order of the Board of Directors of said
Corporation, and that he signed his nnqjtAejvto4y,jike order.
q,0N Go (2
...........
(Notarial Seal)m.
<
C ON GOURIAY
AT iEiR2
, Notary PublicState of New Y ork
TA No. 01006372305
Qualified in New York County
C, Commission Expires June 4, 2022
STATE OF NEW YORK CERTIFICATION
COUNTY OF NEW YORK F A 0Cs %
i a a] NeN
,
The undersigned s ge,1r,c`b`y certifies:
That the original resolution, of which the following is a true and correct copy, was duly adopted by unanimous written consent of the Board of Directors of
Hudson Insurance Company dated July 27", 2007, and has not since been revoked, amended or modified:
"RESOLVED, that the President, the Executive Vice Presidents, the Senior Vice ?residents and the Vice Presidents shall have the authority and
discretion, to appoint such agent or agents, or attorney or attorneys -in -fact, for the purpose of carrying on this Company's surety business, and to
empower such agent or agents, or at(omey or attorneys -in -fact, to execute and deliver, under this Company's seal or otherwise, bonds obligations, and
recognizanccs, whether made by this Company as surety thereon or otherwise, indemnity contracts, contracts and certificates, and any and all other
contracts and undertakings made in the course of this Company's surety business, and renewals, extensions, agreements, waivers, consents or stipulations
regarding undertakings so made; and
FURTHER RESOVLED, that the signature of any such Officer of the Company and the Company's seat may be affixed by facsimile to any power
of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature
thereof or related thereto, such signature and seal when so used whether heretofore or hereafter, being hereby adopted by the Company as the original
signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though
manually affixed."
THAT the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and of the whole of the original and that the
said Power of Attorney is still in fall force and effect and has not been revoked, and furthermore that the Resolution of the Board of Directors, set forth in the said
Power of Attorney is now in force.
�cos the hand of the undersigned and the seal of said Corporation this 13th day of October 2020
jPOq
LPAN
By....... ...... ..........
Dina Daskalakis, Corporate Secretary
STATE OF WISCONSIN
COUNTY OF Kenosha
ON TH IS 13th
.day of October
2020
before me, a notary public, within and for said County and State, personally appeared
Todd Schaap to me personally known, who being duly sworn,
upon oath did say that he is the Attorney -in -Fact of and for the
Hudson Insurance Company , a corporation
of Delaware
by virtue of the laws of the State of Delaware
created, organized and existing under and
that the corporate sea]
affixed to the foregoing within instrument is the sea] of the said Company; that the seal
was affixed and the said instrument was executed by authority of its Board of Directors;
and the said Todd Schaap did acknowledge that he/she
executed the said instrument as the free act and deed of said Company.
Megan 0�0
Notary Public, Kenosha County, Wisconsin
My Commission Expires 3/3/2024
GPV 0
�\OTAR),
. ...........
D" RUG &ALCOHOL
POLICY
"Striving to be Drug Free
for a Safe Industry"
As Revised and Adopted September 19, 2018
m
PAGE
Introduction ..................I
The Policy ....................
2
Definitions ...................
4
Drug Testing .................. 20
Drug Group .................. 22
Alcohol Testing .................
23
Payment for Testing ..............
24
Initial Testing (Pre -Employment) .......
26
Random Testing ................
26
Owner Requested On -site Random Testing ..
27
Probable Cause Testing .............
28
Post-Accident/Incident Testing ........29
Rapid Test Prohibited .............
31
"Emergency" Work Assignments ........
31
Card System ..................
32
Status Confirmation ..............
33
Reporting of Test Results............
34
Insufficient Specimen ..............
35
Diluted Specimen ................
35
Adulterated, Substituted, and/or
Out -of -Temperature Range Specimen ...
35
�N
PAGE
Consequences for a Non -Negative
(i.e., Positive) Test . . . . . . . . . . . . . .
36
Additional Consequences for Multiple
Non -Compliant Events . . . . . . . . . . .
38
Observed Return -to -Duty Testing . . . . . . .
39
Observed Follow-up Testing . . . . . . . . . .
39
Disputed Positive Results . . . . . . . . . . . .
39
Appeals and Protections/just Cause . . . . . .
40
Illinois —"Drug Free Workplace Act"-
30 ILCS 580 . . . . . . . . . . . . . . . .
41
Illinois —"Substance Abuse Prevention Programs
Required"— 820 ILCS 265/15 . . . . . . . .
42
Letters of Notice for Random Testing . . . . .
44
Attachment A — General Trades . . . . . . . .
44
Attachment B — Non -Bargaining . . . . . . .
45
Attachment C — Pipe Fitters Local #597 . . . .
46
Attachment D — BCRC Authorization for
Consent to Drug and Alcohol Analysis &
Authorization For Release of Results . . . . .
47
Attachment E — BCRC Applicant/Cardholder
Drug Test Information &Instruction Sheet..
48
Attachment F — BCRC On -site Substance
Abuse Testing Addendum . . . . . . . . . .
49
BUILDING AND CONSTRUCTION
RESOURCE CENTER, INC.
INTRODUCTION
The Labor and Management representatives of the Building
and Construction Industry for Northwest Indiana have formed
an alliance to address the problems caused by drug and alcohol
abuse. Management and Labor together have created the Building
and Construction Resource Center, Inc. (hereafter "BCRC"), an
independent not -for -profit corporation that offers a wide range
of services to Employees in the unionized construction industry,
which includes Employers, Labor Union organizations. It is
BCRC's goal to assist Employers in establishing and maintaining
workplaces that are free of the destructive effects caused when
Employees use or abuse drugs and/or alcohol. BCRC's activities
are not intended to interfere with normal practices of the Labor
Unions or Management. BCRC recognizes its responsibility to
communicate with and educate Employers and Employees in the
unionized construction industry concerning this policy, as well as
the harmful effects of drugs and alcohol in our society, and in the
workplace. BCRC also recognizes the need to provide a program
of assistance to those persons for whom drugs or alcohol may be
causing problems. Our Employee Assistance Program (EAP)
provides support, counseling, and resources for life issues that can
take a toll on your emotional well-being or take time away from
things you value the most, like work and family. Finally, while not
wishing to violate the rights or invade the privacy of any
Employee, BCRC's drug testing program will seek to
identify those Employees who are unable or unwilling to conform
to BCRC's program. This program has been established in
accordance with Drug and Alcohol Testing Industry Association
(DATIA), Substance Abuse and Mental Health Services
Administration (SAMHSA), and Federal Department of
Transportation Guidelines for specimen collection, laboratory
analysis and review, and standards of integrity and confidentiality.
THE POLICY
Persons who use or abuse drugs and/or alcohol, on or off their
jobs, are likely to be less productive, to be less reliable, to be more
frequently absent, and to have other work related problems that
can cause increased costs, delays, accidents, and injuries.'Ihese
Employees can also risk the health, safety and well-being of other
workers on the job. The unionized construction industry can
control and reduce this problem through recognition of the
problem, development of a comprehensive policy and program of
education and information, promotion of an Employee Assistance
Program (EAP), and implementation of fair and respectfid drug
testing that conforms to Drug and Alcohol Testing Industry
Association (DATIA), Substance Abuse and Mental Health
Services Administration(SAMHSA), and I ederal Department of
Transportation Guidelines for specimen collection and analysis.
All of this is to be done with the utmost confidentiality and
respect for the individual.
All Employers (as defined herein) hereby adopt the following
policy:
No Employee may use, possess, distribute, deliver, or be under the
influence of a drug, or use or be under the influence of alcohol,
while performing any work for the Employer.
In order to enhance substance abuse awareness among all
Employers and Employees, educational seminars and
training programs will be offered.The educational seminars will
be directed toward education in regards to the seriousness of the
nationwide drug and alcohol abuse problem, and how the use of
drugs and alcohol negatively impacts safety, productivity, and the
competitive ability of the American workforce.
Supervisors will be trained to identify Employees in potentially
difficult situations, and to recognize signs of impairment, as well
as the Supervisors'responsibility to document, intervene and
follow-up with the troubled individual. These sessions will be
offered as ongoing training programs.
BCRC encourages all Employees troubled by their own or a
family member's drug or alcohol abuse to seek professional care
and treatment. Early recognition and treatment of alcohol and
drug abuse provides the greatest opportunity for successful
recovery. BCRC provides an Employee Assistance Program
(EAP) for all Employees and their families who need professional
guidance in assessing their substance abuse or alcohol -related
problem and choosing an appropriate course of treatment.
Current Employees will be referred to an EAP representative
as a result of a non -negative (positive) drug or alcohol test, a
non -compliant event, or upon an individual's own request. In
either case, the content of the discussion with the EAP will be
protected and confidential, to the extent allowed by law. A
participant's use of and communications with the EAP are
confidential and information regarding such confidential matters
will not be released to BCRC or any of its subscribing
organizations or participants without written release from the
participant in accordance with the law. Employees, who use the
EAP as a consequence of a non -negative (positive) drug or
alcohol test, or a non -compliant event, will be subject to the
conditions established in the drug testing portion of this policy
and as outlined by the EAP Counselor.
The EAP staff has knowledge of the level and types of
benefits available to BCRC Employees. Employees can access the
services of the EAP through a hotline that is staffed twenty-four
(24) hours a day, seven (7) days a week, throughout the entire
year. Employees calling the EAP hotline are put in touch with a
counselor who will conduct a professional assessment and who
may meet with them to fin-ther assess the nature of the problem in
order to provide a referral to the best and most appropriate level
of care.The EAP is staffed by certified and Masters -level
credentialed human services professionals who are sensitive to
the needs of the individual. Individuals who take the initiative
to contact the EAP for assistance do so with the assurance that
their calls will be treated respectfully and confidentially. The direct
services provided by the EAP are sponsored by BCRC.
In compliance with Public Law 100-690 (The Drug -Free
Workplace Act), which applies only to Employers who have
federal grants or federal contracts of more than $100,000, an
Employee who is convicted of a workplace drug or alcohol
violation and who is employed by a BCRC affiliated Employer
must report this information to his/her immediate supervisor no
later than five (5) days after such conviction. The Supervisor must
report this information immediately to the Employer's Program
Administrator.
DEFINITIONS
• Addendums (i.e., Attachment F) maybe approved by
the Board of Directors on an as -needed basis.
• Adulterated Specimen a specimen that has been altered,
as evidenced by test results showing either a substance
that is not a normal constituent for that type of
specimen or showing an abnormal concentration of an
endogenous substance.
• AjrBlank means, in evidential breath testing devices
(EBTs) using gas chromatography technology, a reading
of the device's internal standard. In all other EBTs, a
reading of ambient air containing no alcohol.
• Alcohol means the intoxicating agent in beverage
alcohol, ethyl alcohol, or other low molecular weight
alcohols including methyl and isopropyl alcohoL
Alcohol Cancentradon (or content) means the alcohol
in a volume of breath expressed in terms of grams of
alcohol per 210liters of breath as indicated by an
evidential breath test under this policy (BrAC).
Alcohol Confirmation Test means a subsequent test
using an EBT, following a screening test with a result of
0.02 or greater, which provides quantitative data about
the alcohol concentration.
• Alcohol ScreeningDevice (ASD) a breath or saliva
device, other than an EBT, that is approved by the
National HighwayTraffic Safety Administration
(NHTSA) and appears on ODAPCs web page for
"Approved Screening Devices to Measure Alcohol in
Bodily fluids" because it conforms to the model
specifications from NHTSA..
• Alcohol ScreeningTest means an analytic procedure to
determine whether an employee may have a prohibited
concentration of alcohol in a breath specimen.
• AleoholTesting Site a place selected by the Employer
where employees present themselves for the purpose of
providing breath or saliva for an alcohol test.
• Alcohol Use means the drinking or swallowing of any
beverage, liquid mixture or preparation (including any
medication), containing alcohol.
• Aliquot means a fractional part of a specimen used for
testing. It is taken as a sample representing the whole
specimen.
• Applicant means a person, Independent Contractor,
or Employer, or person working for an Independent
Contractor, or Employer who applies to become an
Employee of a BCRC Contractor/ Employer
participant, and includes a person who has received a job
offer made contingent on the person passing a drug test.
• Archived Status means a person who has been inactive,
deactivated or otherwise out of the random pool.
• AuthorizedTest means a drug and/or alcohol test
performed in accordance with the provisions of this
Policy and at the request (or direction) of BCRC.
• CRC means Building and Construction Resource
Center, Inc., which is a not -for -profit corporation
formed by labor and management representatives of
the building and construction industry for Indiana &
Illinois, for the purpose of addressing problems of drugs
and alcohol in the workplace.
• BCRC Polio means all of the policies, procedures, and
other matters set forth in this document (i.e., the BCRC
Drug &Alcohol Policy) and all amendments and
addenda to this document.
• Breath Alcohol Technician (BAT) is a person who
instructs and assists employees in the alcohol testing
process and operates an Evidential Breath Testing
device (EBT).
• Canceled Test means a drug or alcohol test that has a
problem identified that cannot be or has not been
corrected. A canceled test is neither a positive nor a
negative test. An Employer is not permitted to take
adverse job action based on a canceled test.
• Card Manager is the individual designated by each
Employer who has the authority to access data
information that will confirm the status of Employees
by electronic e-mail.
• CL or Clear means that an Employee is "cleared",
available for work, and currently compliant with this
Policy when used with respect to the BCRC status of
an Employee.
• Chain of Custodv the procedure used to document the
handling g of the urine specimen from the time the
employee gives the specimen to the collector until the
specimen is destroyed. This procedure uses the Federal
Drug Testing Custody and Control Form (CCF) as
approved by the Office of Management and Budget.
• Collection Container means a container into which
the Employee urinates to provide the specimen for a
drug test.
• Collection Site means a place designated by BCRC
where individuals present themselves for the purpose of
providing a specimen to be analyzed for the presence of
controlled substances, or for purposes of providing
breath sample to be analyzed for alcohol concentration.
• Collector means a person who instructs and assists
Employees at a collection site, who receives and makes
an initial inspection of the specimen provided by those
employees, and who initiates and completes necessary
forms.
• Company means an Employer/Contractor who is a
member of BCRC.
• Confirmation (or confirmatory) DrugTest a second
analytical procedure performed on a different aliquot of
the original specimen to identify and quantify the
presence of a specific drug or drug metabolite.
• Confirmation (or confirmatory)yalidityTest a second
test performed on a different aliquot of the original
urine specimen to further support a validity test result.
• Confirmed DrugTests a confirmation test result
received by an MRO from a laboratory.
• ConfirmatoryTest
a) For alcohol testing, a confirmatory test is a second
test following a screening test with a result of 0.02
or greater, conducted 15-30 minutes later, that
provides quantitative data of alcohol
concentration. This test is conducted on an EBT.
b) For controlled substances testing, a confirmatory
test is a second analytical procedure on the same
specimen to identify the quantitation and
presence of a specific drug or metabolite. This
confirmatory test is independent of the initial test
and uses a different technique and chemical
principle from that of the screening test in order
to ensure reliability and accuracy. (Gas
chromatography/mass spectrometry (GC/MS) is
the only authorized confirmation method for
cocaine, marijuana, synthetic opiates, opioids,
amphetamines and phencyclidine).
-Contractor Participant means an Employer who is a
contributing member of BCRC.
Controlled Substance means marijuana (THC),
cocaine, synthetic opiates, opioids, phencyclidine (PCP),
amphetamines (including methamphetamines),
barbiturates, benzodiazepine, propoxyphene, methadone,
6-acetymorphine and ecstasy.
Designated Employer Representative (DER) an
Employee authorized by the Employer to take
immediate action(s) to remove Employees from
safety -sensitive duties, or cause Employees to be
removed from these covered duties, and to make
required decisions in the testing and evaluation
processes.)he DER also receives test results and
other communications for the Employer, consistent
with the requirements of this policy. Service agents
cannot act as DERs.
Dilute Specimen means a specimen with creatinine
and specific gravity values that are lower than expected
for human urine.
DOT these terms encompass all DOT agencies,
including, but not limited to, the Federal Aviation
Administration (FAA), the Federal Railroad
Administration (FRA), the Federal Motor Carrier
Safety Administration (FMCSA), the Federal Transit
Administration (FTA), the National Highway Traffic
Safety Administration (NHTSA), the Pipeline and
Hazardous Materials Safety Administration (PHMSA),
and the Office of the Secretary (OST). For purposes of
this part, the United States Coast Guard (USCG) in the
Department of Homeland Security is considered to be
a DOT agency for drug testing purposes only since the
USCG regulation does not incorporate Part 40 for its
alcohol testing program. 'These terms include any
designee of a DOT agency.
Drug� mean the substances for which tests are required
under this policy and include marijuana (THC), cocaine,
amphetamines (including methamphetamines),
phencyclidine (PCP), opioids, synthetic opiates,
barbiturates, benzodiazepine, propoxyphene, methadone,
and ecstasy.
Drug test means a test conducted for controlled
substances.
Employee means an Employee of a Company, or of a
Contractor/Employer participant, who is a member
of BCRC.
Employee Assistance Program ") Counselor
means a Masters -level professional with an education in
psychology, social work, counseling, etc. with knowledge
of and clinical experience in diagnosis and treatment
of alcohol and controlled substance related disorders.
The EAP will assess and make recommendations
concerning education, treatment, follow-up testing
and aftercare.
m to er means a Company, or a Contractor/Employer
participant, who is a member of BCRC.
Evidential Breath Testing Device (EBT) means a
device approved by NHTSA for the evidential testing of
breath at the .02 and .04 alcohol concentrations, placed
on NHTSAs Conforming Products List (CPL) for
"Evidential Breath Measurement Devices" and identified
on the CPL as conforming with the model specifications
available from NHTSAs Traffic Safety Program.
• Eirst Occurrence Clause means if an Employee does
not report for a random test, and it is the first time the
Employee has failed to report, the Ihird Party
is
Administrator (TPA) may allow the Employee to take
the test without reporting to the EAP for further review
Employees may utilize this clause only one time.
Observed Follow-UpTesting maybe required, based
on an EAP evaluation for a non -negative or positive test
result, missed random, incomplete test/walk outs as
described in this policy. Follow-up testing will be
administered by the TPA and must be observed.
Gas Chromatography/Mass Spectrometry
Confirmation (GC/MS) is a state of the art drug
testing technology, providing a fingerprint of the
detected drug.
HHS means the Department of Health and Human
Services or any designee of the Secretary, Department
of Health and Human Services.
HHS-Appmved Laborato any U.S. laboratory
certified by HHS under the National Laboratory
Certification Program as meeting the minimum
standards of Subpart C of the HHS Mandatory
Guidelines for Federal Workplace Drug Testing
Programs; or, in the case of foreign laboratories, a
laboratory approved for participation by DOT under
this part.
Initial Test (for dnigd means an immunoassay screen
to eliminate negative urine specimens from fiutber
consideration.
Initial ValidityTest means the first test used to
determine if a specimen is adulterated, diluted, or
substituted.
Invalid DrugTest the result reported by an HHS
11
certified laboratory in accordance with the criteria
established by HHS Mandatory Guidelines when a
positive, negative, adulterated, or substituted result
cannot be established for a specific drug or specimen
validity test.
Laboratory any US. laboratory certified by HHS
under the National Laboratory Certification Program as
meeting the minimum standards of Subpart C of the
HHS Mandatory Guidelines for Federal Workplace
Drug Testing Programs; or, in the case of foreign
laboratories, a laboratory approved for participation by
DOT under this part.
Licensed Medical Practitioner means a person who is
licensed, certified, and/or registered, in accordance with
applicable Federal, State, Local, or Foreign laws and
regulations, to prescribe controlled substances and
other drugs.
Medical Review Officer (MRO) means a Licensed
Physician, registered with the American Association
of Medical Review Officers (wwmaamro.com),
responsible for receiving laboratory results generated by
BCRC's drug testing program who has knowledge of
substance abuse disorders and who has appropriate
medical training to interpret and evaluate an
individual's confirmed positive test result together with
his/her medical history and any other relevant
biomedical information.
N/AorNotAvailable means that an Employee is not
available for work and is not currently compliant with
this Policy when used with respect to the BCRC status
of an Employee. (NOTE: An Employee can be N/A
for several reasons, which may or may not include failing
a drug or alcohol test.).
12
New Employee/Applicant means a person who has not
been previously tested by BCRC and includes a person
referred for pre -employment testing.
NOF or Not on File means that an Employee is not
currently entered into the BCRC database as an
Employee eligible for and subject to the BCRC Policy
when used with respect to the BCRC status of an
Employee. (NOTE: An Employee can be NOF for
several reasons, which may include failure to provide
documentation that the Employee is eligible for and has
agreed to be subject to the BCRC Policy.)
Non -Compliant Event means any of the following -
(a) a Positive Test for alcohol or drugs (which shall
also include any Positive Tests that occur during any
retesting), (b) an Insufficient Specimen if an
appropriate medical professional determines that
there is no legitimate medical reason for the
Insufficient Specimen, (c) a Diluted Specimen if the
Employee fails to provide a subsequent testing
sample within the applicable time period specified
in this Policy or a subsequent testing sample is also a
Diluted Specimen, (d) an Adulterated Specimen,
(e) a Substituted Specimen, (f) an Out -of -
Temperature Specimen that is not promptly resolved
by providing a compliant sample at the time that
the specimen is obtained at the collection site,
(g) any acts by an Employee that compromise the
testing protocol (i.e., washes his/her hands, flushes
the toilet, etc.) prior to being given direction from
the collection professional, (h) a Refuse To Submit
(to an alcohol or controlled substances test), (i) a
failure to submit to Post-Accident/Incident Testing
(which shall include a failure to test resulting from
the Employee leaving the jobsite prior to such
Post-Accident/Incident Testing), and 0) any other
13
act or omission by an Employee that BCRC
determines, in BCRC's sole discretion, to constitute
a substantial or willful non-compliance with the
policies and/or procedures set forth in this Policy.
• Non -Negative a urine specimen that is reported as
adulterated, substituted, positive (for drug(s) or drug
metabolite(s), and/or invalid.
• Out -of -Temperature Specimen means a specimen
that is below 900I' or above 1000I' at the time the
specimen is obtained at the collection site.
• Owner means a large business or firm that hires a
"Contractor Participant" to perform work at their facility.
• Owner Requested job -Site RandomTesting means a
Northwest Indiana Business Roundtable Owner, which
has been approved by the Board of Directors, and may
require a random drug test be done at their facility.
The Employee will test within one hour of notification
of the random test. The test may be performed at the
Owner's facility no more than monthly provided there is
an approved BCRC Collection Site at the facility.
• Positive Test (alcohol) occurs when an Employee's
confirmatory test result reads 0.02 BrAC or higher.
• Positive Test (drug) positive result.The result reported
by an HHS-certified laboratory when a specimen
contains a drug or drug metabolite equal to or greater
than the cutoff concentrations.
• Post-Accident/IncidentTesting means drug and
alcohol tests requested by an Employer following the
occurrence of an accident and/or incident.
14
Probable Cause Testing may be required when a
Supervisor observes and documents unusual behavior
• Program Administrator means the individual who has
administrative responsibilities for overseeing the drug
and alcohol testing program for an Employer.
The Program Administrator may serve as an
Employer's DER.
• ra a means all Employer -owned and/or leased
property, including but not limited to owned and/or
leased buildings and other real estate, parking lots and
vehicles located on parking lots, and Employer -owned
and/or leased vehicles, lockers, tools, equipment and
desks.
• Random Selection means a scientifically valid method
for selection of Employees to be tested that result in an
equal probability that any Employee from a group of
Employees subject to the selection mechanism will be
selected, and does not give an Employer discretion to
waive the selection of any Employee under the
mechanism.
• Refuse To Submit (to an alcohol or controlled
substances test)
• Means that an Employee:
1. Fails(ed) to appear for any test (except a
pre -employment test) within a reasonable time, as
determined by the BCRC Policy, after being directed
to do so by the BCRC Policy;
2. Pails(ed) to remain at the testing site until the testing
process is complete (a walk out);
15
3. Fails(ed) to provide a urine specimen for any drug
test required by this BCRC Policy;
4. In the case of a directly observed or monitored
collection in a drug test, fads to permit the
observation or monitoring of the Employee's
provision of a specimen;
5. Fails(ed) to provide a sufficient amount of urine
when directed, and it has been determined, through
a required medical evaluation, that there was no
acceptable medical explanation for the failure;
6. Fails(ed) or declines to take a second test the Ern
player or collector has directed the Employee to take;
7. Fails(ed) to undergo a medical examination or
evaluation, as directed by the MRO as part of the
verification process, or as directed by the policy. In
the rase of a pre -employment drug test, the
Employee is deemed to have refused to test on this
basis only if the pre -employment test is conducted
following a contingent offer of employment
8. Fails(ed) to cooperate with any part of the testing
process (e.g., refuse to empty pockets when so
directed by the collector, behaves in a confrontational
way that disrupts the collection process, provides
incorrect or inaccurate information to the collection
site or on necessary forms, or fails to complete all
documents);
9. Provides a second (2) specimen that is dilute.
16
ReinstatementTest is the test allowed by BCRC,
which must be consistent with the Policy, to reactivate
an Employee who has been "archived" for sir (6)
months or more.
Rejected for testing the result reported by an
HHS-certified laboratory when no tests are performed
for a specimen because of a fatal flaw or a correctable
flaw that is not corrected.
Reporting Employee is an Employee who reports a
work related injury or illness that was caused by and/
or relates to the accident and/or incident for which the
post-accident/incident drug or alcohol testing is
requested by the Employer.
Observed Return to Du Test is required once an
EAP evaluation has been completed and the counselor
has set a date for the test, because of a non -negative
(positive) test, missed random, walkout or refusal to
submit as described in this policy. This test must be
observed and taken within the time frame specified by
the EAR If the return to duty test is not taken as
directed by the EAP, the participant will be required to
return to the EAR
SAMHSA means Substance Abuse and Metal Health
Services Administration is the agency within the U.S.
Department of Health and Human Services that leads
public health efforts to advance the behavioral health
of the nation.
Safe Site means a URL beginning with "https"which is
a secure site for data transmission.
• ScreeningTest(or initial test
M
• In drug testing, a test to eliminate "negative" urine
specimens from further analysis or to identify a
specimen that requires additional testing for the
presence of drugs.
• In alcohol testing, an analytical procedure to
determine whether an employee may have a
prohibited concentration of alcohol in a breath
specimen.
• ScreeningTestTechnician (STT) means a person who
instructs and assists employees in the alcohol testing
process and operates an Alcohol Screening Device
(ASD).
• Shipping Container means a container that is used for
transporting and protecting urine specimen bottles and
associated documents from the collection site to the
laboratory.
• Sr&cimen means a sample of urine, used for analysis
and/or diagnosis. For the purpose of this policy;
specimen is defined as urine.
• Specimen Bottle means the bottle that, after being
sealed and labeled according to the procedures in this
policy, is used to hold the urine specimen during
transportation to the laboratory.
• Split Specimen means a part of the urine specimen that
is sent to a first laboratory and retained unopened, and
which is transported to a second laboratory in the event
that the Employee requests that it be tested following a
verified positive test of the primary specimen or a
verified adulterated or substituted test result.
im
Substituted Specimen means a specimen with
creatinine and specific gravity values that are so
diminished that they arc not consistent with human
urine.
Testing Levels means levels at or above when a
specimen is determined to be positive, and below when
a specimen is detemuned to be negative.
Third PartyAdministrator ( PA) means an entity that
provides or coordinates one or more drug and/or alcohol
testing services to Employers. A TPA typically provides
or coordinates the provision of a number of such services
and performs administrative tasks concerning the
operation of drug and alcohol testing programs for
Employers. This term includes, but is not limited to,
groups of Employers who join together to administer,
as a single entity, the drug and alcohol testing programs
of its Employees (e.g., having a combined random
testing pool).
Unauthorized Test means a drug and/or alcohol test
that is: (a) not performed in accordance with the
provisions of this Policy, and/or (b) not performed at the
request (or direction) of BCRC. Such tests include
retests initiated by an Employer and/or an Employee
that are not performed at the request (or direction) of
BCRC.
Union means a Labor Organization that represents
Employce(s) who are employed by a Company, or of a
Contractor/Employer participant, who is a member of
Building and Construction Resource Center, Inc.
• Verified Test means a drug test result or validity testing
result from a HHS-certified laboratory that has
undergone review and final determination by the MRO.
19
DRUG TESTING
BCRC will provide an identification card to each participant
which will reflect the results of the Drug &Alcohol Screen Test
from the laboratory and/or as verified by the Medical Review
Officer (MRO). To implement an appropriate and acceptable
program, BCRC has adopted six (6) safeguards that reflect the
standards established by the Drug and Alcohol Testing Industry
Association (DATIA), U.S. Department of Health and Human
Services (HHS) Substance Abuse and Mental Health Services
Administration (SAMHSA) for testing mandated by the U.S.
Department ofTransportation. 'Those safeguards are as follows:
1. The integrity of collected urine specimens will be
ensured by utilization of one collection procedure at all
sites. Samples will be collected in accordance with
federal standards that provide for a continuous Custody
and Control Form and which recognize privacy concerns
regarding the individuals being tested.
2. Testing will be conducted only by accredited labs that
have obtained and retain HHS/SAMHSA certification.
3. All specimens that are positive in an initial screen must
then be confirmed by gas chromatography/mass
spectrometry (GC/MS).
4. A Medical Review Officer (MRO) will review all
non -negative (positive) drug tests in order to verify
positive test results. The MRO is a physician with
specialty training and expertise in substance abuse and
drug testing. The MRO will review lab -confirmed
positive test results to ensure proper procedure, protocol,
and reporting. The IVIRO will make two (2)
documented attempts, within twenty-four (24) hours
of receiving the confirmed positive test result, to
interview the individual who has a confirmed positive
m
test result by telephone to investigate whether a legal
prescription (or other legitimate medical reason) has
caused the specimen to test positive. If the
individual does not consult with the MRO and provide
the necessary information within forty-eight (48) hours
of being contacted by the MRO (delays in responding
caused by verifiable emergency or medical issues will
be given consideration for exception) or he/she has no
legal prescription, the MRO will take appropriate steps
to report a verified positive to the BCRC Program
Administrator, who will then invalidate the Employee's
certification card. All persons who have tested positive
must have their return to work cleared by the EAR.
5. All non -negative (positive) specimens will be retained
frozen in a locked facility at the testing laboratory for
one (1) year. The retained specimens will be available
should the results of the initial test be disputed or should
arbitration or litigation arise out of the actions taken
because of the test results.
21
DRUG GROUP
The BCRC drug -testing program will test for the following
drugs at these levels:
Drug Class Initial Test Confirmatory
Level Test Level
AMPHETAMINES
500 ng/mL
Amphetamine
250 ng/mL
Methamphetamine
250 ng/mL
BARBITURATES
300 ng/mL
Amobarbital
200 ng/mL
Butalbital
200 ng/mL
Pentobarbital
200 ng/mL
Phenobarbital
200 ng/mL
Secobarbital
200 ng/mL
BENZODIAZEPINES
300 ng/mL
Alprazolam Metabolite
200 ng/mL
Oxazepam
200 ng/mL
COCAINE METABOLITES
150 ng/mL
100 ng/mL
MARIJUANAMETABOUTES
50 ng/mL
15 ng/mL
METHADONE
300 ng/mL
200ng/mL
METHAQUALONE
300 ng/mL
200 ng/mL
MDA-ANALOGUES
500 ng/mL
MDA
250 ng/mL
MDMA
250 ng/mL
OPIATES
2000 ng/mL
Morphine
2000 ng/mL
Codeine
2000 ng/mL
OPIATES (SEMI -SYNTHETIC)
300 ng/mL
Hydromorphone
100 ng/mL
Hydmcodone
100 ng/mL
6-ACETYLMORPHINE
10 ng/mL
10 ng/mL
OXYCODONES
100 ng/mL
Oxymorphone
100 ng/mL
Oxycodone
100 ng/mL
PHENCYCLIDINE
25 ng/mL
25 ng/mL
PROPDXYPHENE
300 ng/mL
200 ng/mL
W4
ALCOHOLTESTING
1. Alcohol tests (screening and confirmatory) will be
performed on a device that appears on the National
HighwayTraffic Safety Administration's (NHTSA)
Conforming Products List (CPL) and that meets the
DDT's testing requirements.
2. When a specific time for an Employee's test has been
scheduled, and the Employee does not appear at the
collection site at the scheduled time, the Breath Alcohol
Technician (BAT) will contact the Designated Employer
Representative (DER), who may determine that the
Employee has refused to be tested.
3. For alcohol testing (screening and confirmatory), a
breath sample will be collected and analyzed by a Breath
Alcohol Technician (BAT) using an Evidential Breath
Testing device (EBT). For the screening test, a breath
sample may be collected by the Screening Test
Technician (STT), using an Alcohol Screening Device
(ASD).
4. If the result of the screening test indicates an alcohol
concentration of 0.02 or greater, a Breath Alcohol
Technician (BAT) will perform a confirmatory test, no
less than fifteen (15) and no more than thirty (30)
minutes after the completion of the screening test.
5. If the confirmatory test is positive (0.02 and above,
BrAC), the Breath Alcohol Technician (BAT) shall
immediately notify the BCRC/Employer's DER.
6. Results of additional tests arranged by an Employee,
or requested by a medical practitioner, will not be
considered. This includes testing of blood samples, hair
samples, DNA, or any other testing methods or protocols.
23
PAYMENT FORTESTING
Costs related to an Authorized Test will be paid by BCRC, except
for the following tests:
a. D.O.T.pre-employment testing,
b. D.O.T. Return to Duty Testing
c. D.O.T. Follow Up Testing
d. Industrial cleaning pre -employment testing,
e. Industrial cleaning re -instatement testing,
f. Pre-screening testing of applicants for an
apprenticeship program
g. The following testing for a New Employee/Applicant
whose initial drug test is confirmed as a Positive Test:
(1) Any follow-up testing required by the EAP
(2) Any return -to -duty testing
(3) Any subsequent testing required by the EAP
h. Any other types of testing that BCRC determines, in
its sole discretion, should be paid in a different
manner and/or by a person (or entity) other than
BCRC.
All costs related to an Unauthorized Test and all costs for
re -testing of disputed test results by an Employee will be paid
by the Employer or Employee who initiated such test. The costs
to be paid by the Employer or Employee for such tests will be
determined by BCRC, in BCRC's sole discretion, and shall be
subject to change.
BCRC shall also have the right to terminate and/or restrict the
Card Manager privileges, e-mail status confirmation system
access, and any other access to information contained in any
BCRC database for any Employer who fails to comply with this
Agreement, the BCRC Policy, or any payment obligations to
BCRC.
If an Employee fails to pay for any testing costs and/or other costs
for which the Employee is responsible under this BCRC Policy,
24
then the BCRC status of such Employee shall be listed as "N/A"
unless and until the Employee fully pays all such costs for which
the Employee is responsible under this BCRC Policy.
The policies for payment for the Employee's time for testing are:
1. For new or current union members or Employees
seeking an initial test, the test is a condition of
employment, and Employees in the BCRC Policy will
not be paid for their time in providing a specimen for
the initial test.
2. All current Employees who are to test for any of the
following reasons: late/missed random, probable cause,
post -accident, diluted re -test, return -to -duty, or
follow-up testing, reinstatement test, or retest due to a
flawed or rejected test, will not be paid for their time in
providing a specimen for the test.
3. Employees will only be paid a stipend by BCRC for
submitting to subsequent random testing. (a) required
by the BCRC Policy (see attachments A thru D) (b) in
response to notification (by email, US. Mail or text
message) from the BCRC Office (c) for which the
Employee submits within seven (7) calendar days
including the day BCRC gives notification for such
random testing. It is understood that all testing will
occur on the Employee's time. The Employee must
submit for such testing within seven (7) calendar days
including the day BCRC gives notification for such
random testing. NO EXCEPTIONS!
4. All checks issued for such stipends must be cashed
within ninety (90) calendar days from the date of the
check. If an Employee does not cash a stipend check
within ninety (90) calendar days from the date of the
check, the Employee forfeits his/her right to such
25
stipend, and such stipend check shall be void and shall
not be reissued under any circumstances or for any
reason.
5. D.O.T., Non -Bargaining, Industrial Sector, Slag, and
Pipe Fitter's Local #597 Employees are exempt from the
stipend reimbursement.
INITIA.LTESTING (PRE -EMPLOYMENT)
Prospective Employees and current Employees of BCRC
affiliated Employers and Unions will be subject to the BCRC
program. All persons who are eligible and who intend to obtain
a BCRC card will be instructed to report to an approved BCRC
collection site and to provide a urine specimen for initial
(pre -employment) testing and a dear status before starting work
for any participating Employer. The individual will be directed
by BCRC or by their Employer, to report to a BCRC approved
collection site location. These selected collection sites will have
collection kits, Custody and Control Forms, and all other
necessary supplies.
RANDOMTESTING
After the individual's completion of the initial drug test (with
a negative result), he/she will be placed in the Random Pool
after which he/she will be notified via US. mail to report to an
approved collection site for a random drug test. The individuals
chosen for a random drug test will be selected anonymously, from
a computerized selection program. Fifty percent (50%) of the
currently active BCRC individual cardholders will be selected
annually for random testing. Then, on a monthly basis,
one -twelfth (1/12) of the selected Employees will be notified to
submit to a random test in order to update their BCRC
identification cards and status. A copy of the form letters
26
notifying individuals of their selection for this random test
appears as an attachment A, B, C & D at the back of this booklet.
Employees will be required to report to an approved collection
site within seven (7) days from the date of the Notice for Random
Testing letter in order to maintain their BCRC identification card
and status. No Employee will be required to submit to a random
test more than twice (2) in a twelve (12) month period. Unless
chosen for an on -site random. Employees can be chosen for an
on -site random every month. All Employees will be selected for
random testing at least once (1) every two (2) years.
If an Employee does not provide a sample at an approved
collection site within seven (7) calendar days of BCRC issuing
the notification of a random selection, his/her status in the BCRC
Substance Abuse Program will be deemed "Not Available."
Employees who fail to report for a random test in the required
time forfeit their stipend and should contact the BCRC office. If
an Employee does not report for a random test, and it is the first
(1) time the Employee has failed to report, the TPA may allow
the Employee to take the test without reporting to the EAP for
further review. Employees may choose to take a "First Occurrence
Clause" at this time. Employees may utilize this clause only one
(1) time. However, once this "First Occurrence Clause" has been
utilized, an Employee who fails to report for a random test at any
time in the future will be required to contact the EAP for
evaluation and to receive instructions on the required procedures)
for removing the "Not Available" status from his/her card.
OWNER REQUESTED ON -SITE RANDOMTESTING
An owner may request that an "On -site Random Selection"be
done at their facility. An Owner's request must be approved by the
BCRC Board of Directors and an addendum must be executed by
both parties before the Owner is eligible to do such testing. Each
Contractor or Owner will submit a list of Employees working
27
on -site that day or has access to the Owners' facility to the
BCRC "Safe Site". The BCRC will then generate a random
selection of the submitted pool and return the selections to the
appropriate party. This random maybe done on a monthly basis.
These On -Site Random Selections shall include only those
Employees submitted.
Any confirmed non -negative (positive) test at these facilities
will require an EAP evaluation prior to returning to work. The
testing will be consistent with the Addendum contained herein as
Attachment III.
PROBABLE CAUSETESTING
An Employee may be subject to Probable Cause Testing based
on observed and documented unusual behavior. Circumstances
sufficient to lead a reasonable person to suspect that an Employee
is under the influence of drugs or alcohol, or is in possession of, a
controlled substance shall be determined by an immediate
supervisor and should be confirmed by one other supervisor
whenever possible. The immediate supervisor shall document, in
writing, the incident and the probable cause basis for such testing.
The documentation shall specifically detail the behavior and
conduct of the Employee, the location, date, time, of
observation, conversations, witnesses (if any), and should be
signed by the supervisor who witnessed the incident. Such
Employees may request that a Union Representative be available
or present prior to any action taken by an Employer, if any, at any
stage of the policy and its administration. There is no stipend
for these tests. By referring an Employee for Probable Cause
Testing, the Employer represents to BCRC that the Employer
has complied with these policies and procedures and any other
policies and procedures required by law. BCRC has no obligation
to determine or confirm that that Employer has complied with
such policies and procedures.
RE
POST ACCIDENT / INCIDENTTESTIN
An Employer may require an Employee to submit to
Post-Accident/Incident Testing after the involvement in, or cause
of an accident/incident, that causes injury to the Employee or
another person The Employer may also require an Employee to
submit to Post-Accident/Incident Testing when the
Employee is involved in, or causes an accident and/or incident,
which results in damage or destruction to property.
Post-Accident/Incident Testing must be both a Breath Alcohol
Test (BAT) and Urine Drug Screen (UDS), and must be
completed within two (2) hours of the recorded accidentlincident
if a BCRC testing facility is located on the job site, or within
four (4) hours of the recorded accidentrncident if an Employee
is required to go off the job site to a BCRC testing facility. Any
Employee suspected of unnecessarily delaying the testing process
will be considered to have refused to submit to testing. If an
Employee leaves the jobsite prior to submitting to
Post-Accident/Incident Testing requested by the Employer, then
the Employee will be considered to have refused to submit to
testing, provided, however, this provision shall not apply if the
Employee leaves the jobsite for the purpose of obtaining
emergency medical treatment for the Employee or with the
express authorization of the Employer, and the Employee submits
to such Post-Accident/Incident Testing as soon as reasonably
possible under the circumstances.
In instances of Post-Accident/Incident Testing or Probable Cause
Testing, the Employee will be transported to the testing facility
by the Employer. At the option of the Employer, the Employee
may be suspended pending the test result. In the event a negative
test result is reported, the Employee shall be compensated for all
lost time at the appropriate rate within the Collective Bargaining
Agreement, straight or premium pay.
When an Employee is injured in an accident and/or incident,
priority must be given to the Employee's medical treatment before
29
any consideration is given to collecting a specimen for drug and
alcohol testing. Such Employees may request that a Union
Representative be available or present prior to any action taken
by an Employer, if any, at any stage of the policy and its
administration. If an Employee is aggrieved by any action taken
under this BCRC Drug and Alcohol Policy and his/her com-
plaint cannot be resolved, the complaint may, if the Employee or
Union requests, be referred as grievance under the grievance and
arbitration provisions of the Employee's collective bargaining
agreement. In the event the matter is referred to arbitration,
the arbitrator shall be bound substantively by the provision of
this BCRC Drug and Alcohol Policy:There is no stipend for
these tests.
The following provisions apply to any Post-Accident/Incident
Testing of a Reporting Employee, and shall limit and take
precedence over any other provisions of this BCRC Policy
relating to Post-Accident/Incident Testing. An Employer shall
not refer a Reporting Employee for Post-Accident/Incident
Testing unless the Employer has a reasonable basis for believing
that drug or alcohol use by the Reporting Employee could have
contributed to the injury or illness.
The Employer shall consider the following factors in determining
whether or not the Employer has a reasonable basis for believing
that drug or alcohol use by the Reporting Employee could have
contributed to the injury or illness:
(1) Whether drug or alcohol use could have contributed to
the injury or illness;
(2) Whether the Employer is also requesting that other
employees involved in the accident/incident be tested;
(3) Whether the Employer has a heightened interest in
determining if drug and/or alcohol use could have
contributed to the injury or illness due to the
hazardousness of the work being performed when the
injury or illness occurred; and
(4) All other relevant factors.
30
By referring an Employee for Post-Accident/Incident Testing, the
Employer represents to BCRC that the Employer has complied
with these policies and procedures and any other policies and
procedures required by law. BCRC has no obligation to
determine or confirm that that Employer has complied with such
policies and procedures.
RAPID TEST PROHIBITED
A Rapid Test/Point of Collection Test shall not be used for any
drug and alcohol testing performed for the BCRC Policy.
"EMERGENCY" WORK A8 IGNMENTS
To accommodate Owners with emergency work, craft personnel
who have not previously held a BCRC identification card, or
taken an initial drug test, the following provisions will apply when
starting for emergency work assignments:
1. Upon arrival at a job location for sign-up, the
Designated Employer Representative (Card Manager)
shall request the Employee to present his/her BCRC
identification card.
2. An individual who does not have a BCRC card at the
time of hire will be requested to secure a card and submit
to an initial drug test within one (1) day, in order to
comply with the BCRC Policy.
I An Employee 'vvithout a BCRC identification card may
work one (1) day. On the second (2nd) day, a Custody &
Control Form (as proof of having submitted to a drug
test) or a BCRC card must be presented.
31
4. An Employee who has provided a specimen for testing
must bring to the job site his/her copy of the Custody
& Control Form, given to him/her by the collection site,
as proof that he/she has submitted to an initial test.
5. If the work assignments are consecutive, the Employee
will be allowed to work for up to a maximum of four (4)
days in order for the Employee to receive his BCRC
identification card and have the Employers Card
Manager verify the Employee's status.
If the Employee's work assignment is terminated by
his/her Employer before the Employee's status is
verified within the allowable four (4) days for
verification, and the individual is rehired, the Employee
will have to provide the same Employer a BCRC
identification card at the second (2nd) rehiring sign up,
and a clear status. Except in the event that the rehire is
less than four (4) days from the initial hire date, the
individual, Local and Non -Local, BCRC card holder
shall accept and understand that should his/her drug test
results be reported as positive, he/she will be subject
to disciplinary action up to and including termination
without obligation for further compensation by the
BCRC affiliated Employer. Such termination shall
also be subject to the individual's rights under his/her
Collective Bargaining Agreement.
Employees will be required to give their BCRC Identification
Card Number to their Employer's Card Manager in order for the
Card Manager to access the e-mail status confirmation system.
Inquiries to the status confirmation system will provide the date
of the Employee's last test and one (1) of the following BCRC
status indicators:
32
• NOF meaning "Not on File"
• N/A meaning "Not Available"
• CL meaning "Clear"
Employees can also access their own status and update contact
information through the membership portal under the "Member
Utilities"tab on the wwwbcrcnet.com homepage.
TATUS CONFIRMATION
An Employer may verify the status of all BCRC Employees who
are current Employees of the Employer (or persons offered
immediate employment by the Employer subject to BCRC
employment eligibility verification). This includes any former
Employees who have been recalled for immediate
re-employment by the Employer and any persons who were
referred to the Employer by a participating Union for immediate
employment, subject to BCRC employment eligibility
verification. However, an Employer is not permitted to access
any information from the BCRC database for any individual who
is not a current Employee of the Employer (or a person offered
immediate employment by the Employer subject to BCRC
employment eligibility verification).
The Employer is required to obtain appropriate written
consent from its Employees to access any information about such
Employees from the BCRC database, and is required to comply
with all provisions of this BCRC Policy regarding access to such
information. Such access can be obtained by having their card
status verified on their job site in order to determine if the
Employee is available or not available under the BCRC program.
The Employer may also use the e-mail procedures for verification.
An Employer who accesses any information from the BCRC
database concerning an individual who is not a current Employee
of the Employer (or a person offered immediate employment by
33
the Employer subject to BCRC employment eligibility
verification) violates the BCRC Policy and is subject to
appropriate sanctions for such unauthorized use of the BCRC
database. Such sanctions may include terminating, or at least
limiting, the access of such Employers to information in the
BCRC database.
When an Employee's status is Not Available (N/A), he/she
will be advised to contact the BCRC office to resolve the N/A
status. The individual may be required to follow the protocol for a
non -negative (positive) test as prescribed in the BCRC Policy.
The Employer may verify the Employee's card after four (4) days
to reconfirm the status and if the Employee's status is still N/A,
the Employer may terminate the Employee. Said Employee will
be referred to the Employee Assistance Program for assessment
and will be required to follow the recommendations of the EAP
Counselor before being considered for fiuther assignments.
The status of Clear (CL) will be restored only with written
approval of the EAR This procedure will protect the Employee's
confidentiality and allow the Employer to audit the status of
his/her Employees, which may be required by the owner to be
submitted monthly.
REPORTING OFTEST RESULTS
For all D.O.T. testing, all test results shall be reported to the
Employer and to any other persons and/or entities required
by applicable law and/or regulations. For all On -Site Random
Testing performed pursuant to a BCRC Onsite Substance Abuse
Testing Addendum or other testing agreements with owners,
BCRC shall report test results in accordance with the provisions
of such Addenda and/or Agreements. For all Post -Accident/
Incident Testing and all Probable Cause Testing, BCRC has the
right to provide all test results to the Employer that requested
such testing.
34
INSUITICIENT SPECIMEN
An Employee who provides an insufficient specimen of urine or
breath when required to do so shall be referred to an appropriate
medical professional for evaluation at the participant's expense.
If the medical evaluation fails to reveal an acceptable medical
explanation for the inability to provide a specimen, the donor
shall be considered to have refused to test and shall be subject to
the rules as outlined in this policy. If a legitimate medical reason
is revealed, no action shall be taken.
DILUTE SPECIMEN
An Employee providing a Dilute Specimen will be given the
opportunity to return to a collection site within forty-eight (48)
hours to provide a second (2nd) specimen, on his/her own time.
This second specimen shall be given pursuant to observed
collection protocol and procedures.
Employees should refrain from excessive consumption of fluids
prior to the retest. No adverse action shall be taken against any
Employee based on a first (1) Dilute Specimen, unless the Dilute
Specimen is confirmed to be a Positive Test or the Employee fails
to provide the second (2nd) specimen in compliance with the
forty-eight (48) hour time period and procedures set forth herein.
A second (2nd) diluted specimen, without a valid medical reason,
will be treated as a refusal to submit to testing and a
Non -Compliant Event, regardless of the test results.
ADULTERATED, SUBSTITUTED AND/OR
OUT -OF -TEMPERATURE RANGE SPECIMEN
When a urine specimen is reported as adulterated, substituted,
out of temperature (meaning the specimen is below 900E or
above 1000F) or the Employee compromises the testing protocol
35
(i.e., washes his/her hands, flushes the toilet, etc.) prior to being
given direction from the collection professional, the
Employee will be considered to have not cooperated with the
testing process and the test will be considered a refusal to be
tested. If the temperature is out of range, the Employee will be
offered the opportunity to take an additional observed test prior
to leaving the site. A refusal to submit to the subsequent test will
be considered non-compliance and the Employee will be made
"NIX and referred to the EAR
In addition, the Employee who has refused to be tested, or who
uses or possesses a counterfeit drug card, shall be subject to
Employer discipline up to and including discharge, subject to the
Unions' collective bargaining agreements.
CONSEQUENCES FORANON-NEGATIVE
(i.e., POSITIVE)TEST
An Employee who tests non -negative (i.e., positive) for
drugs shall be contacted directly by the Medical Review
Officer (MRO). If the MRO verifies the results of the
non -negative (positive) test, the MRO will notify the
Employee that he or she is ineligible for work and
he/she will be directed to contact the TPA -The BCRC
will refer the Employee to the program's Employee
Assistance Program (EAP) for consultation and review.
If the MRO contacts the Employee and finds that there
is a reason for the non -negative (positive) test (an
authorized prescriptive medication) the MRO will
downgrade the result to a negative, and the Employee's
card will be marked "CU.
2. In the case of a confirmed non -negative (i.e., positive)
drug or alcohol test, the TPA will be notified that the
Employee's status should be marked "N/A". The "N/A"
status will be effective at the moment that a confirmed
non -negative (i.e.., positive) test is received.
36
3. Before returning to work, an Employee must:
• (1) Complete an evaluation with the programs
Employee Assistance Program provided by the
BCRC EAP Provider
• (2) follow a treatment plan prescribed by the
programs EAP
• (3) Obtain written documentation from the
programs EAP verifying return -to -duty date.
• (4) Obtain a negative result on a Return to Duty
Test."Ihe specimen for all Return to DutyTests shall
be given pursuant to observed collection protocol and
procedures.
4. AWN status will not be the sole basis for termination
of employment. An Employee must contact the BCRC
office to resolve an "N/A" status.
Only Employees who are in non-compliance with this
BCRC Policy may be discharged. For the purposes of
this provision, "non-compliance" shall mean one or more
of the following.
• Failure to report to the programs Employee
Assistance Program as directed,
• Failure to follow and/or complete a EAP-prescribed
treatment program,
• Failure to take an observed return -to -duty or an
observed follow-up test,
• Failure to report for a random test request within
seven (7) days, or
37
• Failure to submit to a drug or alcohol test when
requested to do so by the EAR
5. A New Employee/Applicant whose initial drug or
alcohol test is confirmed as a Positive Test shall pay all
costs for:
• Any follow-up testing required by the EAP
• Any return -to -duty testing
Any subsequent testing required by the EAR
ADDITIONAL CONSEOLM'NCES FOR MULTIPLE
NON -COMPLIANT EVENTS
If any Employee has three (3) or more Non -Compliant Events
within a twelve (12) consecutive month (rolling) period, the
Employee shall not be permitted to take a Return -to -Duty Test
until one (1) year after the most recent Non -Compliant Event
within such twelve (12) consecutive month period and the
Employee' BCRC Substance Abuse Card and status shall be
N/A for the same time period. In addition, such Employee must
complete an EAP-prescribed treatment program before returning
to work.
BCRC also performs on -site random testing pursuant to the
BCRC Onsite Substance Abuse Testing Addendum. The policies
set forth in such Addendum (and/or other testing agreements
with Owners) also impose additional consequences for Positive
Tests and/or other Non -Compliant Events. Such additional
consequences generally apply at the specific plants and locations
covered by such Addenda (and/or other testing agreements with
owners) and are in addition to any additional consequences set
forth in this BCRC Policy.
OBSERVED RETURN-TO-DUTYTESTIN
The Return to Duty test is required for an Employee to be
reinstated into the BCRC program following a positive test,
missed random, walkout, or refusal to submit as described in this
BCRC Policy.The participant must have a negative drug test
before resuming performance of his/her job duties. This test may
not be taken until the Counselor has set a date for the test. The
specimen for all Return to DutyTests shall be given pursuant to
observed collection protocol and procedures.
OBSERVED FOLLOW TESTING
Follow-up testing for drugs and/or alcohol is a requirement in
order for a returning Employee to stay in compliance with the
BCRC Program. Testing shall be determined by the Employee
Assistance Counselor, and will be implemented and monitored by
the TPA (BCRC) when the Employee returns to work. Follow-up
tests must be taken within forty-eight (48) hours from the time
when the TPA attempts to contact or contacts the Employee, or
the Employee will be considered non -compliant, made "N/A", and
returned to the EAP for further evaluation.
A New Employee/Applicant whose initial drug or alcohol test is
confirmed as a Positive Test shall pay all costs for such follow-up
testing required by the EAP and any subsequent testing required
by the EAR The specimen for all Follow -Up Testing shall be
given pursuant to observed collection protocol and procedures.
DISPUTED POSITIVE RESULTS
An Employee who disputes non -negative (positive) results shall
have the right to have his/her initial sample independently
re -tested by a Department of Health and Human Services (HHS)
certified laboratory of his/her choice, at his/her own expense only
when a money order, travelers check or cash is received by BCRC
will testing begin, within ten (10) working days of when he/she
was notified of the test results. A portion of the initial sample (or
split specimen) shall be forwarded under a Custody and Control
Form directly by BCRC's testing laboratory to the HHS
laboratory selected by the Employee. Review of the drug test
result must be performed by a qualified MRO who has been
approved by BCRC. If the second lab report shows the
presence of a controlled substance, the test result will be
considered non -negative (positive). If the second lab report test
indicates no presence of a controlled substance, then both tests
will be considered negative.
'Ihe following section only applies when the Employee tests due
to Post-Accident/Incident Testing or Probable Cause Testing.
If the test is negative, the affiliated Employer will reimburse the
Employee for compensation lost at the appropriate rate within
the Collective Bargaining Agreement, straight or premium pay,
during the period of his/her disciplinary suspension or
termination and will reimburse the Employee for the cost of
the retest.
An Employee, whose test results are verified non -negative
(positive) by the MRO, will be referred to the EAP by the TPA
(BCRC).'Ihe Employee is expected to attend all appointments
with the EAP Counselor, and to follow the Counselor's
recommendations and requirements. A non -negative (positive)
alcohol test conducted on a breath sample cannot be re -tested.
All problem situations shall be resolved in accordance with
current guidelines and standards established by the U.S.
HHS/SAMHSA or U.S. Department of Transportation.
APPEALS AND PROTECTION /LUST CAUSE
Employees who are subject to this BCRC Policy continue to
have access to the usual protections provided as a part of their
40
Union membership and/or as members of bargaining units
covered by Collective Bargaining Agreements. Such Employees
may request that a Union Representative be available or present
prior to any action taken by an Employer, if any, at any stage of
the policy and its administration. If an Employee is aggrieved by
any action taken under this BCRC Drug and Alcohol Policy and
his/her complaint cannot be resolved, the complaint may, if the
Employee or Union requests, be referred as a grievance under the
grievance and arbitration provisions of the Employee's
Collective Bargaining Agreement. In the event the matter is
referred to arbitration, the arbitrator shall be bound substantively
by the provisions of this BCRC Drug and Alcohol Policy.
ILLINOIS--DRUG FREE WORKPLACE ACT"
30 ILCS 580
When working on public projects in the State of Illinois,
Employers must comply with the Illinois Drug Free Workplace
Act. This Act requires Employers to certify that it provides a drug
free workplace by complying with certain steps. Fast, the
Employer must publish a statement to its Employees notifying
them that as a condition of employment, drug possession, use, etc.
is prohibited at work and specify the actions taken if this is
violated. Second, Employers must provide each Emploppec
working in Illinois a copy of this published statement. Ihird,
Illinois requires Employers to provide a drug free awareness
program to inform Employees about drug abuse, the Employee's
drug free policy, the availability of drug assistance programs, and
penalties for drug violations. If the Employer receives notice of an
Employee's criminal drug conviction, the Employer must notify
the Illinois agency in the contract within ten (10) days. Finally, if
an Employee violates the drug free policy, an Employer has thirty
(30) days to take action against the Employee, up to and including
termination or requires the Employee to satisfactorily participate
in an approved drug abuse assistance program.
m
If the Employer fails to follow the Drug Free Workplace Act
provisions, the Illinois agency in the contract may suspend or
terminate the contract. If the violation is serious, the Illinois
agency may recommend debarment, which makes the Employer
ineligible to be awarded any contract or grant by the State of
Illinois for one to five (1-5) years.
For £artier reference, the Drug Free Workplace Act may be found
at 30 ILCS 580; http✓/www.ilga.gov/lcgislation/iilcs/gcs3.asp?Ac-
tID=551&.ChapterID=7.
ILLINOIS'SUBSTANCE ABUSE PREVENTION
PROGRAMS REQUIRED- —820ILCS 265/15
Employers who work on public works projects in Illinois must
have a written substance abuse prevention program that meets or
exceeds the following requirements: (1) at least a 9 panel urine
drug test plus a test for alcohol (NOTE: blood testing may only
be used in post -accident tests); (2) a list of prohibited actions and
conditions listed below; (3) Employees must submit to pre -hire,
random, reasonable suspicion, and post -accident drug and alcohol
testing before the project begins, but not required for an
Employee who has been participating in a random testing
program during the 90 days preceding the date on which the
Employee commenced work on the project; and (4) a procedure
for notifying the Employee of any violations or refusal to submit
to a drug test.
The prohibited Employee actions include using, possessing,
distributing, delivering, or being under the influence of a drug
or alcohol while performing work on a public works project.
Any Employee with a Blood Alcohol Content at or above 0.02
is considered to be under the influence.
This written program must be filed with the Illinois agency and
made publicly available.
Any Employee who violates the drug policy, tests positive for
drugs, or refuses to submit to a drug test may not work on a
public works project until the Employee satisfies the following
conditions: (1) the Employee has tested negative for presence of
drugs and is not under the influence of alcohol; (2) the Employee
has been approved to return to work in accordance with the
Employer's written substance abuse prevention program; and (3)
the testing for drugs and alcohol was conducted in accordance
with laboratory testing and Chain of Custody procedures as
required by the U.S. Department of Health and Human Services.
Upon meeting these conditions, an Employee may return to
work if qualified work remains.
ror further reference, the Substance Abuse Prevention Program
Requirements maybe found at 820 ILCS 265/10, 820 ILCS
265/15, and 820 ILCS 265/20; available at httplhvww.ilga.gov/
legislation/ilcs/ilcs3.asp?ActID=2950&ChapterID=68
43
Attachment A— General Trades:
BCRC LETI'ER HEAD
Letter of Notice for RandomTesting
FMI
You have been selected by BCRC's computer generated random selection to take
a random drug test for BCRC. You must be tested no later than midnight (day) of
(Month), 20 .Our computer program selects the names of BCRC cardholders for
a random each month. You can be sdcctcd up to tMce in a twelve month period.
In order ro stay in compliance with BCRC and possess a dear (CL) BCRC card
status you will be required to report to an approvtd collection site within scorn (7)
days from the date on this "Notice of Random Testing"letter (the dart on this letter
is included in the seven days). Pkase �2rify that the BCRC cod number in the
upper right hand comer of this notice matcha your BCRC card number. If it does
not match }our BCRC card numbe ,please nottfyo. office immediately!
'Ihis random testis to betaken on your ovvn time at any of the BCRC approved
collection sites identified on the enclosed collection site list You will be mailed a
$30.00 stipend for the time necessary to scout random testing only ifyour test is
taken within the allotted seven (7) days of this notice. NO EXCEPTIONS! Failure
to take your tar by the date outlined above will result in your BCRC card status
being deemed "Not Available" (N/A) and willr�qu�rrc that you contact the BCRC
office for instructions on the required procedures) for cotrecdn the"N/A status.
In the event you are taking prescribed medication(s), DO NO1 take them to the
collection site. You will be contacted by our Medical Review Office (MRO), who
till need }ourprescription information for the verification process. Please provide a
legible and accurate tdcphoac number on all forms at the collection site.
Remember, it is your responsibility to keep your contact information current with
BCRC. You can do so through the "Members Utilities" sea= portal on the BCRC
wcbsitc at www.bacnctcom or by calling the BCRC office at the numbers listed
below.
Questions, contact the BCRC office 0 219-764-9500 or toll fiee 0 877-988-5400.
'Ihankyou for}ourcooperadom
Sincerely,
Tish Roach
Executive Director
As a member of BCRC, you and your family have access to Perspectives, a fully
indcprndcn, professional Em loycc Assistance Program (EAP). Pcrspcctivts
twcn -four (24) hour, seven (%) days a week hotline number is (800) 456-6327.
All calls to Perspectives are confidential
44
Attachment B — Non -Bargaining:
BCRC LETTER HEAD
Letter of Notice for RandomTes ft
Dear
You have been selected by BCRCs computer generated random selection to take
a random drug test for BCRC. You must be tested no later than midnight (day) of
(Month), 20 .Our computer program selects the names of BCRC earrlholders for
a random each month. You can be selected up to uvice in a twelve month period.
In order to stay in compliance with BCRC and possess a clear (CL) BCRC card
status you will be required to report to an approved collection site within seven (7)
days from the date on this "Notice of Random Testing"Iota (the date on this letter
is included in the sessn days) Please verify that the BCRC card number in the
upper right hand comer of this notice matcher your BCRC card number, If it does
not match your BCRC card number, please notify our office immediately!
This random test is to be taken on your own time at any of the BCRC approved
collection sites identified on the enclosed collection site list Pailure to take your test
Vhe date outlined above will result in your BCRC cud status being deemed
t
otAvailable"(N/A) and will require that you contact the BCRC office for
instructions on the required pmccdurc(s) for correcting the "N/A"status.In the
event you are taking prescribed mcdication(s), DO NOT take them to the
collection site. You vvill be contacted by our Medical Review Office (MRO),who
will need your prescription information for the verification process. Please provide
a legible and accurate telephone numbcr on all forms at the collection site
Remember, it is your responsibility to keepp your contact information current with
BCRC. You can do so through the "Members Utilities" scare ortal on the BCRC
wcbsite at www.bacnctcom or by calling the BCRC office at the numbers listed
below.
Questions, contact the BCRC office @ 219-764-9500 or toll flee 0+ 877-998-5400.
Thank you for)ourcooperation.
Sincerely,
11sh Roach
Executive Director
As a member of BCRC,you and your family Lunt access to Perspectives, a filly
independent pprofessional Em loyte Assistance Program (EAP). Perspectives
rwrntyfour (24) hour, seven (/) days a week hotline number is (800) 456.6327.
All calls to Perspectives are confidential
45
Attachment C — Pipe Fitters— Local1597.
BCRC LETTER HEAD
Letter ofNotice for RandomTesft
You have been selected by BCRCs computer generated random selection to take
a random drug test for BCRC. You must be tested no later than midnight (day) of
(Month), 2C . Our computer program selects the names of BCRC cardholders for
a random cash month. You can be selected up to twice in a twelve month period
In order to stay in compliance with BCRC and possess a clear (CL) BCRC card
status you will be required to report to an approved collection site within seven (7)
days from the date on this 'Notice of Random Tcsting"letter (the date on this letter
is included in the seven days) Please verify that the BCRC card number in the
upper right hand comer of this notice matches your BCRC card number If it does
not match your BCRC card number, please notify our office immediately!
"This random test can betaken on your own time/taken on your
Emplo}er/Contractor's time at any of the $CRC approved collection sits
identified on the enclosed collection site list Failure to take your test by the date
outlined above will result in your BCRC card status being domed "Not Availabic"
(N/A) and will require thatyou contact the BCRC office for instructions on the
required procedures) for correcting the 'N/A status. In the event you are taking
prescribed medication(s), DO ISO"I take them to the collection site. You will be
contacted by our Medical Review Office (h4RO),who will needyour prescription
information for the verification process. Please provide a legible and accurate
telephone number on all forms at the collection site.
Remcmbc , it is your responsibility to keepp yyoour contact information current
with BCRC. You can do so through the'b4cmbers Utilities* secure portal on the
BCRC wcbsite at wwv.bcrcnct.com or by calling the BCRC office at the
numbers listed below.
Questions, contact the BCRC office 0 219-764-9500 or toll free Cr+ 877-988-5400.
Thank you for your cooperation.
Sincerely,
Tish Roach
Executive Director
As a member of BCRC, you and your family have access to Perspectives, a fully
independent, professional Emjj!toyec Assistance Program (EAP). Perspcctives
twrnty four (24) hour, seven (7) days a w«k hotline number is (800) 456-6327.
All calls to Perspectives are confidential.
46
Attachment D
BUILDING AND CONSTRUCTION RESOURCE CENTER INC.
AUTHORIZATION FOR CONSFNTTO DRUG AND ALCOHOL
ANALYSIS &AUTHORIZATION FOR RELEASE OF RESULTS
I, the undersigned, -do hereby authorize the testing
of my bod} fluids for employment reasons and understand and agree that the results
of any such testing will be turned over to the Building and Constructions Resource
Center, Inc and, hather that the testing procedures will be limited to tests for
prohibited and illegal drugs and commllai substances.
1 understand that the results of these tests may be used for employment and
rl
cU ' linary reasons and hereby authorize the release ofsuch information from
the aboratory and MRO.
I further certify that the urine specimen collected from me is mine and not
adulterated or altered in any manner. I have been advised that matters affecting
me relative to the interpretation or application of the Drug Policy and subject
cxdusively to the grievance and arbitration procedure under my collectivc
bargaining agreement (ifapplicable).
Witness
Datc
emu
Notary public
Commission Expires
Offidal Seal
(Must be tmruized if NO ID)
Signature ofApplicant/Employce
Employees Scdzl Security Number
Employees Telephone Number
Employees Address
City
Statc & Zip Code
47
Attaclunent E
B—CRCAPPLICANT/CARDHOLDERDRUGTESL'
INFORMATIONAND INSTRUCTION SHEET
BCRC is exercising extreme care to ensure that strict quality control measures are
followed in the collection, handling, and analysis of your specimen. You play an
important role in this process and should be certain that you have prodded an
unadulterated specimen to the laboratory. Remember, you arc certifying that the
specimen which you provide is yours and is unadulterated. Any adulteration or
switching ofspccimcn is a breach of BCRCs rules and, ifyou arc employed, may
subject you to discipline up to and including termination by your Employee
For your awn protection and peace of mind, we ask that you:
ProAde a picture identification to the collection site/technician at time
ofarrival;
Be escorted to a coRcction room and asked to provide an unadulterated
specimen in the collection bottle provided. The bottle should be filled
to 45 4-
Return the specimen bottle to the medical technician and witness,
initial and date the integrity seals placed on your specimen;
Verify the proper spelling ofyour name as recorded on the log sheet;
• Verify that your social security number has been properly recorded
Verify that the social security number placed on your specimen bottle
is the same as that recorded on the log shot and the Custody and
Control Form.
IIIAVE READTIIEABOVEAND IIAVETUD AN OPPORTUNITY
TO ASK QUESTIONS REGARDINGTHIS PROCEDURE.
BCRCApplieant/Cvdho1&rSigruture Due
Attachment F
BCRC On -site Substance Abuse Testing Addendum
Effective 20
1) BCRC willcover all outside Contractors,7 non -bargaining personnel,
and/or safety personnel working at heavy industrial Kcilities, light industrial
facilities, health care facilities, and/or any public or private entity in Northwest
Indiana for the purpose of substance testing, tracking and administration under the
terms of this Addendum to the BCRC Policy Testing will include random on -site
testing, Post-Accident/lncidcntTesting, Probablc Cause Testing and Follow -Up
Testing when requinxl.
2) BCRC will identify to the Employer's and/or Otvner's Designated
Employer Representative (DER) anyone that has a non -negative (positive) test
t, mcluding tvallcouts or afusals to test, at the farilitics where this amendment
is adopted. Said participant would be "Not Available" (N/A) for employment at that
facility until the participant has contacted the EAP for evaluation and to receive
instructions on how to resolve their "NIX status. If the result of the cipantIs
Return to Duty testis negative and he/she is and continues to comp
th all
the follow up testing protocol as outlined in the BCRC Polity the partrcipant will
be allowed to return to work BCRC will identify an)une that has tvvo confirmed
non -negative (positive) tests, to include walkouts or refusal to tat, at this facility to
the Employcrs/Owner's DER.
3)The Employer/Ovvncrwill provide BCRCwithalist or"pp0000l"from
which random selections will be drawn.This fist will consist onk of Partidpatin
ph 'call on the Owner's site on the day the random selection is nxlucstc, in
tivill notify the Empl=v�/Owners DER or Cana Manager of the random testing
selections. Upon noti tfcation the selected participant has one hour plus travel time
to report ro an appproved BCRC testing facility. Notification will be k�reen during the
same shift for which the pool was submittcd and a minimum of two hours pprior to
the end of the participant's shift plus swipe time. Although no stipend will be paid,
the test will count as a random tat in the normal BCRC Policy.
4 Employers and Owners will be assisrred a conic number for access to
the BC C e-mail system for verification of availability of patticipants in their
facility and internal auditing requirements.
5) Empplo)v:rs/Owners who require tests to be current within a specified
time fiamc willbe obligated for the administration, implementation and cost of
these tests since these tens arc not consistent with the BCRC Policy.
Example: OwnrrA"rcquira that all Employ}ees have a drug sacen within the
last one hundred eighty daps (180). Any Emplcyce that must tat to be in
compliance can do so provided it is not a violation of the applicable Collective
Bargaining Agrcemcnt.'Rds test will not be at the expense of BCRC.
Crary Kcbcrt, President BCRC Kevin Roach, Secrctary BCRC
Owner Representative
Date
49
Building & Construction Resource Center, Inc.
Board of Directors
MANAGEMENT
Gary Kebert, President
NWI Contractors Association
Bill Walton Jr., Treasurer
Nat? Electrical Contractors Assoc.
Rick Stovall, Finance Committee
NWI Contractors Association
Adam Vidimos, Finance Committee
Northern in Sheet Metal Cont Assoc.
Dewey Pearman
CAF (At Large)
Kelly Keough
Plumbing & Piping Cont. Assoc.
Bob Hoover
Bricklayers Association
Margie Hofmann
NWI Contractors Association
Tom Jarka
NWI Contractors Association
Larry Macuga
NWI Contractors Association
James Mitchell, Sr.
Finishing Contractors Association
Ted Vrehas
NWI Contractors Association
Pete Korellis
Rooting Contractors Association
Bill Hasse
NWI ContractorsAssociation
Kurt Schmiegel
NWI Contractors Association
UNION
Mark McCleskey, Vice President
Cement Finishers' Local 406
Kevin Roach, Secretary
Laborers' Locat 41
Mike Stavitzke, Finance Committee
INKY/OH Regional Council
of Carpenters'
Jeff Hamilton, Finance Committee
Sheet Metal Workers' Local 20
Randy Palmateer
Building Trades Council (At Large)
Sal Espino
Plumbers' Local 210
Jeremy Rivas
Bricklayers' Local 4
Ryan Reithel
IBEW Local Union 697
Ronald Ware, Jr.
Ironworkers' Local 395
John Sorensen
Operating Engineers' Local 150
Shawn Solner
Painters' Local 460
Ted Bilski
Teamsters' Local 142
Joe Pozzi
Roofers' Local 26
Dennis Hahney
Pipe Filers' Local 597
Brad Holzhauser
Technical Engineers' Local 130
Tish Roach
Executive Director
'OPerspective,5
(800) 456-6327
www.perspectivesltd.com
Your Employee Assistance Program (EAP)
txu u./
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date October 5, 2020
Department
Name Jacob M. Klosinski En2ineerin2/Utilities
BPW Date October 13, 2020 Phone Extension Ext. 9496
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer ❑ Officer Name Michael Patton
BPW Attorney ❑ Attorney Name Clara McDaniels
Dept. Attorney ❑ Attorney Name Clara McDaniels
Purchasing ❑ Michael Schmidt
Check the Appropriate Item Type — Reuirec or All Submissions
❑ Professional Services Agreement ❑ Contract ❑ Proposal
❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA
® Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet
❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes
❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA
❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution
n Other: n Ease./Encroach
Company or Vendor Name
New Vendor
MBE/WBE Contractor
Proj ect Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Information
Yes[_] If Yes, Approved by Purchasing
No
El MBE
❑ WBE Completed E-Verify Form Attached ❑❑ Yes
No
WWTP Masonry Improvements Gallery Buildings 1-4
120-03 6
Sewage Works Building Repair and Maintenance Account
641-06-605-514-436001 (PROJ00000217: PR-00003823)
Purpose/Description The Division of Engineering and Division of Utilities requests the Board of
Public Works open and receive bids for the subject project. Refer to
Memorandum for project details (attached).
For Change Orders Only
Amount of ❑ Increase $
❑ Decrease ($ )
Previous Amount
Increase
Current Percent of Change: Decrease
New Amount $
Increase
Total Percent of Change: Decrease
Time Extension Amount:
New Completion Date:
INTER -OFFICE MEMORANDUM
DEPARTMENT OF PUBLIC WORKS
DIVISION OF ENVIRONMENTAL SERVICES
TO: Members of the Board of Public Works
Clara McDaniels, Assistant City Attorney Public Works
Linda M. Martin, Clerk
FROM: Jacob M. Klosinski, P.E., Assistant City Engineer
SUBJECT: 120-036 WWTP Masonry Improvements Gallery Buildings 1-4
(PROJ00000217; PR-00003823)
Agenda Request - Bid Opening
DATE: October 5, 2020
The Department of Public Works Division of Engineering and Division of Utilities request the Board
of Public Works open and read bids for consideration for the subject project at its Regular Meeting
on October 13, 2020.
Background
The existing Gallery Buildings 1, 2, 3, and 4 masonry has deteriorated since their original
construction in 1954 (Gallery 1 and 2) and 1970 (Gallery 3 and 4). This project will address
masonry deficiencies (cracks repairs, joint replacements, lintel restoration / replacement,
window replacements, door replacements, and joint sealants necessary to secure the building
envelope and reduce the entry of moisture and leakage into the buildings during rain events.
Gallery 4 will also receive a new TPO membrane roof. Gallery 1, 2, and 3 roofs were replaced
in 2013-14 and will not require any roof work during construction. In addition to the above
scope of work, abandoned mechanical systems and equipment will be demolished as part of the
renovation work.
This work will follow the new motor control center installations for the WWTP Electrical
Improvements project.
DFO Project: PROJ00000217
DFO Purchase Requisition PR-00003823
Funding: Sewage Works Building Repair and Maintenance Account 641-06-605-514-436001.
Bid Opening Date: October 13, 2020
Bid Award (tentative): October 27, 2020
For questions regarding the subject agenda request, contact Jacob M. Klosinski (Ext. 9496) at
the Division of Engineering.
1316 COUNTY -CITY BUILD NG
221 W. JEFFERSON BOULEVARD
SOUTH BEM}, INDIANA 46601.1830
PHONE 574/235-9251
FAX 574/235-9171
TDD 374/ 233-3367
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF Pi]BLIC WORKS
Date: October 6, 2020
To: All Planholders
From Linda M. Martin, Clerk, Board of Public Works
Subject Addendum Number; I
Project Name: WWTP Masonry Improvements Gallery Buildings 1-4
Project No.: 120-036
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy MUST also be inFluded with your
bid package upon submittal.
THIS ADDENDUM MAY AFFECT YOUR BID.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
latile Roofing and Sheet Metal Co., INC.
Company:
Authorized Signature:-
1 0/7/2020
Date:
1316 COUNTY -CITY 13UILDINO
227 W.JEFFERSON BOULEVARD
SOuT14 SEND, ImANA 4660I-1830
PHONE 574l235-9251
FAX 5741235.9171
TDD 5741235-5567
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
Date: October S, 2020
To: All Planholders
From Linda M. Martin Cleric Hoard of Public Works
Subject Addendum Number: 2
Project Name: WWTP Masonry improvements Gallery Buildings 14
Project No.: 120-036
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
1 0/8/2020
Date Received:
This addendum is being forwarded to you for the above referenced project.
PIease sign below and acknowledge receipt of this Addendum
by faxing this sheet to the Board of Public Works at (574) 235-9I71
within 48 hours of receipt. A copy MUST also be included With your
bid package upon submittal.
THIS ADDENDUM MAX AFFECT YOUR BID.
Notes:
The attached documents are hereby added to the Specifications and Contract
Documents and become a part of herein.
Company: latile Roofing and Sheet Metal Co., INC.
Authorized Signature: ^�Q
Date:0/8/2020