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HomeMy WebLinkAboutOpening of Applications - Water Works Utility Service Line Repair Program - Bob Frame Plumbing Services, Inc.IN LICENSE NO. PC88700840 cot PLUMBING SERVICES 2442 JACLYN COURT, SOUTH BEND, INDIANA 46614-3700 Telephone (574) 291-7511 FAX (574) 299-1297 December 3, 2020 Board of Public Works County City Building, Room 1316 227 W. Jefferson Blvd. South Bend, IN 46601 pbwbids(@southbendin.gov Re: Water Works Utility Service Line Repair Program To Whom It May Concern: Bob Frame Plumbing Services, Inc. is currently in your Water Works Utility Service Line Repair Program and have been for many years. We have read the 4 -page attached letter"Request For Applications" and meet the minimum specifications listed. Enclosed you will find the following: • Plumbing Corporation License #C081053737 • Plumbing Contractor Licenses for David P. Frame #PC88700840/Tyler M. Frame #PC11200080 • Copy of Performance Bond for $25,000 • Certificate of Insurance • Non -Collusion Affidavit, Non -Debarment Affidavit, Employment Eligibility Verification, and Non - Discrimination Commitment Form. Bob Frame Plumbing Services, Inc. is interested in continuing the program and accepts the stated conditions/requirements. Thank you for your time and consideration. Sincerely, Tyler IVY Frame, President Indiana Professional Licensing Agency 402 W. Washington Street, W072 Indianapolis, IN 46204 Plumbing Corporation License Number Expire Date 0081063737 12/31/2021 Bob Frame Plumbing Services, Inc Indiana Professional Licensing Agency C,\a Indiana Plumbing Commission 402 W. Washington Street, W072 Indianapolis, IN 46204 Iel6 Plumbing Corporation License Number Expire Date C081053737 12131/2021 Bob Frame Plumbing Services, Inc Eric J. Holcomb Deborah J. Frye Governor Executive Director State of Indiana Indiana Professional Licensing Agency Indiana Professional Licensing Agency 402 W. Washington Street, W072 Indianapolis, IN 46204 Plumbing Corporation License Number Expire Date 0081063737 12/31/2021 Bob Frame Plumbing Services, Inc 12/1/2020 Details State of Indiana DEMOGRAPHIC INFORMATION Name: DAVID P FRAME ADDRESS INFORMATION City/State/Zip: LAKEVILLE IN 46536 County: St. Joseph LICENSE INFORMATION Lic #: PC88700840 Profession: Plumbing Commission Type: Plumber Contractor Status: Active Issued: 5/26/1987 Expiration: 12/31/2021 Method: Examination DISCIPLINE INFORMATION RELATED LICENSES Secondary: Lic #: C081053737 Name: Bob Frame Plumbing Services, Inc License Type: Plumbing Corporation License Status: Active Relationship: Manager Lic #: PA21200241 Name: Claeys -Smith, Adam C License Type: Plumbing Apprentice License Status: Expired Relationship: Employer/Employee Lic #: PA20802079 Name: Frame, Tyler M. License Type: Plumbing Apprentice License Status: Expired Relationship: Employer/Employee Lic #: PA20802042 Name: Palmer, Steve A. License Type: Plumbing Apprentice License Status: Expired Relationship: Employer/Employee DOCUMENTS No Public Documents Available https://mylicense.in.goviEVerifcationIDetails.aspx?result=9491406e-88cl-42b7-892e-4c7bi9419675 1/1 12/1/2020 Details State of Indiana DEMOGRAPHIC INFORMATION Name: Tyler M. Frame ADDRESS INFORMATION City/State/Zip: South Bend IN 46614 County: St. Joseph LICENSE INFORMATION Lic#: PC11200080 Profession: Plumbing Type: Plumber Commission Contractor Status: Active Issued: 11/9/2012 Expiration: 12/31/2021 Method: Examination DISCIPLINE INFORMATION RELATED LICENSES DOCUMENTS No Related Licenses No Public Documents Available Secondary: htips://mylicense.in.gov/EVerification/Dotails.aspx?result=f29911 b6-e29b-4d97-b906-e188ad6c18b0 1/1 Continuation Certificate IN CONSIDERATION of the payment of a premium of $ 100,00 Federated Mutual Insurance Company hereby continues in force to 07-12-2021 Its bond No, 6075769 effective 07/12/2018 , In the sum of TWENTY-FIVE THOUSAND AND NO/1 00-- Dollars ($ 25,000.00 ), on behalf of BOB FRAME PLUMBING SERVICES INC represented by (if applicable) Principal, in favor of CITY OF SOUTH BEND BOARD OF PUBLIC WORKS Obligee subject to all its terms, conditions and limitations as set forth and expressed in said bond. This certificate is executed upon the express condition that the Company's liability under said bond and this and all continuation certificates issued in connection therewith shall not be cumulative, and shall not in any event exceed the amount set forth in said bond, or said amount as it may have been increased or decreased by any rider(s) or endorsement(s) properly issued by the Company. Dated this 8TH day of JUNE 2020 Federated Mutual insurance Company SARAH DWINNELLAttorney-n-Fact " if Renewai' Not Desired, Please Return Original Continuation Certificate with Power of Attorney Upon Receiving in Order to Return Premium FEDERATED INSURANCE® PO Box 328 Owatonna, MN 55060 BF -22 Ed. e1-18 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That FEDERATED MUTUAL INSURANCE COMPANY, a corporation duly organized and existing under the laws of the State of Minnesota, and having its principal office in the City of Owatonna, State of Minnesota, does hereby constitute and appoint: of SARAH DWINNELL of the City of OWATONNA State MINNESOTA its true and lawful attorney for the following purposes; To sign its name as surety to, and to execute, affix the seal, acknowledge and deliver any and all surety bonds and penalties not exceeding: ONE HUNDRED THOUSAND DOLLARS ($100,000) EACH BOB FRAME PLUMBING SERVICES INC SOUTH BEND, IN The execution of such bonds or undertakings in pursuance of these presents shall be binding upon the Company as if they had been executed and acknowledged by the regularly elected officers of the Company. This Power of Attorney granted by Federated Mutual Insurance Company shall terminate when the designee ceases to be: 1) Employed by Federated Mutual Insurance Company or 2) Employed by Federated Mutual Insurance Company in a job for which such Power of Attorney is required. IN WITNESS WHEREOF, the said FEDERATED MUTUAL INSURANCE COMPANY has caused this instrument to be signed and its corporate seal to be affixed by its Executive Vice President and Assistant Secretary this the 1ST day of FEBRUARY 1 2020 FEDERATED MUTUAL INSURANCE COMPANY BY / '4. z6nz (SEAL)Executive Vice President and BY As ' tant Secretary STATE OF MINNESOTA COUNTY OF STEELE On this 1ST day of FEBRUARY, 2020 personally appeared before me, the undersigned notary public, James A. Thon and Jonathan R. Hanson to me personally known, who, each being duly sworn by me, did say that they are respectively the Executive Vice President and Assistant Secretary of the FEDERATED MUTUAL INSURANCE COMPANY and that the seal affixed to this instrument is the corporate seal of said Corporation and that this instrument was signed and scaled of behalf of said Corporation by authority of its Board of Directors and said James A. Thon and Jonathan R. Hanson acknowledge said instrument to be the free act and deed of said corporation. KELLY J. HAQEN NOTARY POOUO • MINNESOTA (SEAL) YyCamitloat3ykec,gn.l1,7DT5 COPY OF RESOLUTION "BE IT RESOLVED that the President or any Vice President in conjunction with the Secretary is hereby authorized and empowered under the corporate seal of the Company, to appoint any person or persons as attorney or attomeys-in-fact, or agent or agents of the Company, in its name and as its act to execute and deliver, anywhere in the United States or Canada, any and all bonds and undertakings of suretyship and other documents that the ordinary course of surety business may require." "BE IT FURTHER RESOLVED that the Power of Attorney or other document appointing such person or persons as attorney or attorneys -in -fact or agent or agents of the Company may either be personally signed by the President, any Vice President, the Secretary or may be executed by said officers by means of facsimile signatures. The said personal signatures or facsimile signatures shall not require the Company seal or any other seal and shall be valid and binding on the company if executed either by personal signature or facsimile signature and with or without the Company seal being affixed thereto." I, the undersigned, hereby certify that I am a Executive Vice President of the FEDERATED MUTUAL INSURANCE COMPANY, a Corporation duly organized and existing under the laws of the State of Minnesota and that the foregoing is a true and complete copy of the original Power of Attorney given by said Company to: SARAH DWINNELL of OWATONNA, MINNESOTA authorizing and empowering such person to sign bonds as therein set forth, which Power of Attorney has never been revoked and is still in full force and effect. I further certify that said Power of Attorney was given in pursuance of a resolution adopted at a regular meeting of the Board of Directors of said Company duly called and held at the office of the Company in the City of Owatonna, Minnesota on the 201h day of A"t , 19 82 at which meeting a quorum was present and that the foregoing is a true and correct copy of said resolution, and the whole thereof as recorded in the minutes of the said meeting. PURSUANT to the By -Laws of Federated Mutual Insurance Company, Article 8, Section 1; in the absence of or inability of the Secretary to act, his duties shall be performed by the Assistant Secretaries in the order of their rank. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed die seal of the FEDERATED MUTUAL INSURANCE COMPANY this the 8TH day of JUNE _ 2020 (sEAL) , FEDERATED MUTUAL INSURANCE COMPANY ceP /Executive Vice President ACOR130 L. CERTIFICATE OF LIABILITY INSURANCE BA E (MMR 0 YWV) 07/1 1 2 0 2 0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the polictt(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such entlorsement s . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 OWATONNA, MN 55060 NAME'CT CLIENT 99NTACT CENTEE Pn/cNNo Est): 888-333-4949 A/c met; 507-446-4664 aoON s: CLIENTCONTACTCENTER FEDINS.COM INSURER(S) AFFORDING COVERAGE NAICN N INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 04/01/2020 INSURED 264-429-2 INSURER B: INSURER C: BOB FRAME PLUMBING SERVICES INC 2442 JACLYN CT SOUTH BEND, IN 46614-3700 INSURER D: AGGREGATE $2,000,000 INSURER E: INSURER F: f`FDTICtr`ATG NUMBED. GG REVISION NUMBER:0 V THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IRT R TYPE OF INSURANCE DAL NA SUER POLICY NUMBER POLICY EFF POLICY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y N 9403507 04/01/2020 04/01/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $100,000 PR ISES Ea oc ce MED EXP (Any one person) EXCLUDED AUTHORIZED REPRESENTATIVE PERSONAL a ADV INJURY $1,000,000 JOE'L AGGREGATE $2,000,000 AGGREGATE LIMIT APPLIES PER:GENERAL POLICY ❑PRO ❑LOC /ECT OTHER: PRODUCTS - COMP/OP AGO $2,000,000 A AUTOMOBILE X LIABILITYIEOMBINED ANY AUTO OWNED AUTOS ONLY SCHEDVLED AUTO6 NON -OWNED HIRED AUTOS ONLY AUTOS ONLY N N 9403507 04101/2020 04/01/2021 SINGLE LIMITso en $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per actldenp PROPERTY DAMAGE accMen A X UMBRELLA LIAR E%CESS LIAR X OCCUR CLAIMS -MADE N N 94035014 04/01/2020 04/01/2021 EACH OCCURRENCE $2,000,000 AGOREGATE $2,000,000 DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EX ------y E: (Mandatory in NH) Il yes. desttlbeunder DESCRIPTION OF OPERATIONS below NIA N 9403509 04/01/2020 04/01/2021 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 51 DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addlbonel Remarks Schedule, may be exeebed If more space Is required) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERSt LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. TE NOER CANCELLATION CERTIFICA LD 264-429-2 22 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SOUTH BEND THE EXPIRATION DATE THEREOF, NOTICE WILL DE DELIVERED IN 227 W JEFFERSON BLVD SOUTH BEND, IN 46601-1830 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE • I , © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. © Insurance Services Office, Inc., 2012 Page 1 of 2 CG 20 33 04 13 Policy Number: 9403507 Transaction Effective Date: 04-01-2020 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of 'your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 33 04 13 Policy Number: 9403507 Transaction Effective Date: 04-01-2020 CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS REQUEST FOR APPLICATIONS Notice is hereby given that the City of South Bend, Indiana, will receive electronic sealed applications at bpwbids(d7soutltbendin.2ov, until the hour of 9:00 a.m. Local Time, on December 8, 2020 for the following: WATER WORKS UTILITY SERVICE LINE REPAIR PROGRAM The Title of the Application as described above must be included in the subject line of the email to which you have attached your application. The name of the company/vendor, address, contact email address and phone number must be included in the body of the email. Detailed instructions and information, including the link to the Reserved Mailbox for electronic bid submittals, is available at southbendin.Yoy/bids. SUMMARY: The Board of Public Works of the City of South Bend ("City"), on behalf of the Water Works Utility is soliciting applications from qualified vendors to serve as preferred vendors for its Service Line Repair Program at the rates herein for one calendar year. The City is authorized by Sections 17-49 through 17-55 of the City's Municipal Code to offer this Service Line Repair Program to repair water service line leaks located between the house or building and the water main line which would otherwise be the sole responsibility of the property owner. It is the purpose of this request to establish a list of qualified vendors who will repair water service line leaks at the rates established herein. Complete application instructions are available for download by visiting the City of South Bend's web page at southbendin.eov: X Click on "I'm Looking For" X Click on "Doing Business in South Bend" X Click on "City Contracts —Invitations to Bid" X Click on "REQUIRED: Registration Form" to register your company. X Select and Print or Download the specifications You must register to receive addenda and updates to the specific bid/proposal you are interested in. Failure to do so could render your bid non-responsive to the specifications. There is no charge for the specifications. Questions should be directed by email to Darric Cole, at dcole@SOLtthbeiidin.gov. The City reserves the right to review and audit all documents related to this application and to request additional information as determined necessary. Failure to comply with the City's request may be deemed grounds for dismissing the application. Applications must include the Non -Collusion Affidavit, Non -Debarment Affidavit, Employment Eligibility Verification, and Non -Discrimination Commitment Form. BOARD OF PUBLIC WORKS Linda M. Martin, Clerk Publish two (2) times: 11/13/2020 11/20/2020 Applications must meet the minimum specifications as provided herein. There is no scoring matrix as all qualified vendors whose applications meet the minimum specifications and who meet and accept the following required conditions will be accepted into the program: • Plumber Contractor License in Indiana; and • Worker's Compensation Insurance; and • Performance bond in the amount of $25,000 or cash bond in the amount of $25,000; and • Proof of Commercial General Liability Insurance per Person in the amount of $50,000; and • Proof of Commercial General Liability Insurance per Occurrence in the amount of $1,000,000 • Three (3) year warranty on all work performed through this program. • Must follow City of South Bend Department of Public Works Design & Construction Standards. • Availability for on-call emergency response scheduled on a weekly rotation which includes before/after normal business hours, weekends and holidays. Emergency repairs require completion within 24 hours. Regular repairs require completion within five working days. • Ability to work in year-round adverse weather conditions. • Must follow IUPPS 811 compliance prior to and throughout all excavation work performed. • Customer contact prior to repairs with account information provided by the Water Works Utility. • Responsible for the planning, set-up and removal or subcontracting of all necessary traffic control according to INDOT requirements found in the Indiana Manual on Uniform Traffic Control Devices and the ability to work safely on heavily trafficked streets. • Ability to pinpoint water leaks and trace water service lines. • Must be fully equipped to work safely in underground excavations five feet deep or greater in compliance with OSHA trenching and excavation safety requirements. Company safety manual must be followed and a minimum requirement of two qualified persons for all excavations. • Ability to temporarily freeze water service lines to replace inoperable and/or leaking curb valves. • Must have experience working on water lines in the City of South Bend including new service line installation using open trench excavation and trenchless ground piercing methods. New service line installation will be paid per foot for one -inch service line and only Type K copper tubing pipe is allowed. The water line shall have a minimum earth cover of five feet and a maximum of six feet. • Responsible for the preparing and pouring or subcontracting of all sidewalk, driveway and street cuts, according to City specifications. Four inches of depth for sidewalks, six inches of depth for driveway and driveway approaches. Street cuts must match existing depth, but not be less than eight inches minimum. • Responsible for repairing all grass/sod property damage caused by excavation work by spreading topsoil and grass seed within two calendar weeks of leak repair. A list of all repairs completed in grass during the winter season must be kept for returning to complete the topsoil and grass seed work at the start of the spring season. • A Plumber Inventory Tracking Form must be e-mailed to Water Works Utility management staff with details for each leak repair performed within one calendar week of repair date. • Invoices (two copies required) for work performed must be delivered to 915 S. Olive St. by the fifth day of the following month. All material provided by the Water Works Utility must be indicated on the invoices. City inspection and approval prior to payment being remitted within 45 days of receipt. A Plumber Material Request Sheet must be e-mailed to Water Works Utility management staff when requesting provided parts. All material requests must be picked up at 915 S. Olive St. the following business day between the hours of7:30am and 3:OOpm unless otherwise specified by Water Works Utility management staff. Flat Rate for Ston Box Repairs: Applicants will unearth a single excavation up to five cubic feet in grass for a flat rate of $425. For stop box repairs that require the removal of a hard surface, such as asphalt or concrete, the flat rate is increased to $525. This flat rate will include all equipment, material and labor necessary to replace the stop box and rod. This flat rate will be used for all emergency repairs made during normal business hours. A curb valve found to be inoperable and/or leaking must be replaced, and the repair is billed as a basic service leak at the rates described herein. Flat Rate for Basic Service Leak Repairs: Applicants will unearth a single excavation up to five cubic feet in grass for a flat rate of $1,450. For basic leak repairs that require the removal of a hard surface, such as asphalt or concrete, the flat rate is increased to $1,550. This flat rate will include all equipment, material and labor necessary to replace the curb valve, stop box and rod or repair a single leak on a three -feet or less section of the service line. This flat rate will be used for all emergency repairs made during normal business hours. Repairs that require exceeding these specifications to complete must be reported to Water Works Utility management staff to determine if a leak repair is not considered basic repair due to special circumstances. Any special circumstance requires City approval and the repair is billed for equipment, material and labor at the rates described herein. Special Circumstance Plumber Rates for Equipment, Material and Labor: Equipment Rates per Job: Pneumatic Ground Piercing Mole $150 Trench Shoring/Shield Box $130 Arrow Board $125 Air Compressor $110 Hammer/Rotary Drill $95 Partner Saw $90 Barricades $85 Freeze Kit $80 Plate Compactor $75 Trash Water Pump $50 Work Truck $40 Equipment Rates per Hour: Vactor $300 Backhoe $120 Dump Truck/Trailer $70 Material Rates per Job: #53 Recycled Concrete Backfill $90 Black Dirt & Seed $90 Labor Rates per Hour: Plumber $80 Laborer $60 Special Circumstances include, but are not limited to: • Any leak repair that requires subcontracting for heavy traffic control. • Any leak repair that requires more than a single excavation. • Any leak repair that requires excavating greater than a five feet square area. • Any leak repair that requires excavating greater than five feet of depth and must have trench shoring or a shield box installed for OSHA compliance. • Any leak repair that requires a portion of the street to be removed. • Any leak repair that requires extensive landscape removal, • Any leak repair involving the foundation of the structure. • Any service line repair that requires more than a single leak to be repaired. • Any leak repair that requires replacing any length of the service line greater than three -feet. • Emergency leak repair designated by the Water Works Utility to be completed before/after normal business hours, weekends and holidays. The successful applicants shall comply with the City's ordinance and all other federal, state and local laws and regulations governing nondiscrimination in employment. The City reserves the right to accept, negotiate scope, or reject any or all applications. 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 Jnd ang— ) ) SS: S3 . &L -_AW 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 Nan -Collusion Non-Dcbanaenl Affidavit Non Iran Form 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 alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E -Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E -Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E -Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Nan -Collusion Non -Debarment Affidavit Non Iran Form Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a 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 of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this t3`3 day of 20 Ab Q-60� 91LxnLlrn SAS-Uius, Zly Contractor/Bidder (Firm) Signat a of Contractor/Bidder or Its Agent Printed Name and Title Subscribed and sworn to before me this -�a day of VJ-AtArr 4aay , 20 'AD My Commission Expires '`-1 I l,a I hp2 R County of Residence Non-C011osion Non -Debarment Affidavit Na. han Fmm Notary Public NOTP3Cf SEPL FUSUO