HomeMy WebLinkAboutOpening of Quotes - North WTP Raw Water Header Improvements Proj No. 119-011A - Zimmerman Industrial Piping, Inc.o; ,;Ksu'�'Et rrrt
CITY OF SOUTH BEND, INDIANA
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C��ACTOR' QUOTE AOR PUBLIC wnQ Y,,
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PROJECT NAME: North Water Treatment Plant Raw Water Header Im rovements
PROJECT NO. 119-011A
QUOTES DUE November 24, 2020
(Must be completed for all quotes. Please type or print)
Date:
Address:
City/State/Zip:
11/23/2020 Firm: Zimmerman Industrial Piping,
Inc.
1117 X...Clay e
et
Mishawaka, IN 46545 Telephone Number: J574 ) 259-3050
Agent of Bidder (if Applicable): ertelse
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of:
Project No. 119-011A
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
The City of South Bend, Department of Public Wnrkc
and dated 11 /23/2020 for the sum of (enter the Total Quote as shown on the Proposal)
Thirty -Four Thousand Eight Hundred Five Dollars
(Enter sum of Total Quote plus Alternates shown on Proposal) ($ 34 (Nu00 )
merlca!)
If alternative quotes apply, the undersigned submits a proposal for each in accordance with the notice. Any
addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are needed, the cost of units must be the same as that shown
in the original contract if accepted by the City of South Bend. If the quote is to be awarded on a unit basis, the
itemization of the units shall be shown on a separate attachment.
The above quote is accepted this
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Elizabeth A. Maradlk, Member
Joseph R. Molnar, Member
By
^1gnature)
Robert Kelse
(Printed Name of Person Signing)
ACCEPTANCE
day of
Therese J. Dorau, Member
Jordan V. Gathers, Member
Attest: Linda M. Martln, Clerk
FR
Version 2/14/2020 page - 10
Public Works Quote
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to
this Affidavit
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT,
CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY
VERIFICATION, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE
OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS
(Must be completed for all quotes and bids. Please type or print)
STATE OF Indiana )
) SS:
St. Joseph COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that:
1. Contractor has not, nor has any other member, representative, or agent of the firm,
company, corporation or partnership represented by him, entered into any combination, collusion
or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent
any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made
without reference to any other bid and without any agreement, understanding or combination with
any other person in reference to such bidding. Contractor further says that no person or persons,
firms, or corporation has, have, or will receive directly or indirectly, any rebate, fee, gift,
commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its
principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency;
and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment
activities in Iran.
a. For purposes of this Certification, "Iran" means the government of Iran and any agency or
instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from
time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is
engaged in investment activities in Iran if either:
i. Contractor, its successor, or its affiliate, provides 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.
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the Contractor subsequently learns is an unauthorized
Version 2/14/2020 Page - 11 Public Works Quote
Products or foundry products made in the United States on this project if awarded. I understand I
have an affirmative duty to notify the City in my bid that my proposal does not include the use of
steel products or foundry products made in the United States. I understand it is my sole obligation
and responsibility to provide a justification to the City, subject to review and approval, why the
cost of United States made steel or foundry products is unreasonable. Prior to award and upon
submission of bid which does not use steel products or foundry products made in the United States,
the City, through its director of public works, shall make a determination if the price of United
States made steel or foundry is unreasonable. I understand that violations hereunder may result in
forfeiture of contractual payments.
I hereby affirm under the penalties ofper ury that the facts and information contained in the foregoing bid for public
works are true and correct.
Dated this 2_____ 3 day of Nov. . , 2(12 0
Zimmerman Industrial Pi in , Inc.
Contractorr/B'dder (Firm)
!`�—
Signature of Contractor/Bidder or Its Agent
Robert Kelsey, President
Printed Name and Title
Subscribed and sworn to before me this 23 day of November 2020
My Commission Expires Feb. 6 2027
14
Notary Public
JENNIFER WEINLEY County of Residence St. Joseph
Notary Public - Seal
St Joseph County - State of Indiana
Commission Number NP0718406
My Commission Expires Feb 6, 2027
Version 2/14/2020 Page -13
Public Works Quote
Item
No.
1
2
K
Firm:
p�SpU'I'H
U �f�
QUOTE/PROPOSAL
PEACE
CITY OF SOUTH BEND
leas
North Water Treatment Plant Raw Water Header
PROJECT NAME -Improvements
PROJECT NO. 119-011A
QUOTES DUE November 24. 2020
Material & Equipment to replace Raw Water
Headers and relocate valve.
Electrical reroute to relocated valve
Labor to replace Raw Water Headers and
relocate valve.
Zimmerman Industrial Pipi
Address: 1117 N Clay Street
intity I Unit I Total Amount
1 I LS I $ 5,045.00
1 I LS I$ 1,700.00
1 I LS
Total A—mount of
Quote
Inc
$ 28,060.00
34,805.00
City/State/Zip: Mishawaka IN 46545 Telephone Number: 1574 ) 259-3050
Fax Number: (574 ) 259-1312
Byl/ l
(Signature
Robert Kelsey
(Printed Name of Person Signing)
Version 2/14/2020 Page - 14 Public Works Quote