HomeMy WebLinkAboutOpening of Quotes - West Side Quiet Zone Improvements - Median & Curb Proj No. 117-114A - Premium Concrete Services, Inc.CITY OF SOUTH BEND, INDIANA z
CONTRACTOR'S QUOTE FOR PUBLIC WORK
W
PROJECT NAME: WEST SIDE QUIET ZONE IMPROVEMENTS - MEDIAN 8 CURB
PROJECT NO. 117-114A
QUOTES DUE December 8, 2020 by 9:00 AM Local Time
(Must be completed for all quotes. Please type or print)
Date: December 8, 2020 Firm:
Premium Concrete Services Inc.
Address: 712 Richmond Street
City/State/Zip: Elkhart/IN/46516 Telephone Number: ( 574 )264-0196
Agent of Bidder (if Applicable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of:
i.J E5T S2o£ QuxE--r zoti-ZmAevJF19EnJT5 - /iEOSAnJ -I- 6,Aa # // 7-11M
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
and dated It 146-12.0 for the sum of (enter the Total Quote as shown on the Proposal)
Nzery-5,Fv"-Zh(�arAA;0 fNREE 460,M0 is 37, ago �o )
(Enter Sum of Total Quote plus Alternates shown on Proposal) (Numerical)
If alternative quotes apply, the undersigned submits a proposal for each in accordance with the notice. Any
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.
By -;;�e
Mature)
(Printed Name of Person Signing)
ACCEPTANCE
The above quote is accepted this day of 20
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Gary A. Gilot, President Member
Elizabeth A. Maradik, Member Jordan V. Gathers, Member
Joseph R. Molnar, Member Attest: Linda M. Martin, Clerk
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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 Dl )
rr�'�,� ) SS:
CLI`NArT COUNTY )
The undersigned Contractor, being duly swom 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 of
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
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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, firms, 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 will consider the Contractor's good faith efforts to obtain
participation by those subcontractors certified by the State of Indiana as a Minority Business
("MSE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest,
responsible, responsive bidder.
Contractors seeking the award of a City contract cannot be required to award a subcontract to arr
MWBE; however, they may not unlawfully discriminate against said MBE/WBE. A finding of
noncompliance or a discriminatory practice shall prohibit that Contractor 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 to which the discriminatory practice
or noncompliance pertains.
7. The undersigned Contractor agrees that the following nondiscrimination commitment shall
be made a part of any contract which it may henceforth enter into with the City of South Bend,
Indiana or any of its agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for
employment in the performance of this contract with privileges of employment, or any matter
directly or indirectly related to employment, because of race, religion, color, sex, gender
expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of
this provision may be regarded as material breach of contract.
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). 1 hereby certify that I and all subcontractors employed by me for this project will use steel
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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 day of dxl.. , 20 db
ALftr6vt COX)--RXrF— `SE.edzCz-s
Contractor/Bidder (Firm)
Signal of Contractor/Bidder or Its Agent
A1.lC 14 3AVLF `l YP
Printed Name and Title
C.
Subscribed and sworn to before me this �t^ day of 20A
My Commission Expires M1 (
County of Residence
nQj� r\ , 30' .
No ry Public
JANEE M TOWNER
NOTARY PUBLIC
SEAL
ELKHART COUNTY, STATE OF INDIANA
)OMMISSION EXPIRES FEBRUARY 12,:
COMMISSION NO. 710399
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qct ynU'I H n
QUOTE/PROPOSAL
CITY OF SOUTH BEND
18,.; ..
WEST SIDE QUIET ZONE IMPROVEMENTS - MEDIAN &
PROJECT NAME CURB
PROJECT NO. 117-114A
QUOTES DUE December 8, 2020 by 9:00 AM Local Time
Base Quote - Ford Street
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
1
Construction Engineering
1
LS/
yU0
$
i
2
Mobilization & Demobilization
1
LS//,2Oa
750
$ 42L
3
Pavement Removal
56
SYS
/D0
$ S1 (000 v�
4
Center Curb, D, Concrete
56
SYS
3,2S
$ /8",200 =
5
Construction Sign, A (W20-1)
3
EACH
/00
$ 3306
6
Construction Sign, B (G20-2) x 3
7
EACH
/0D
$ 7DD
Construction Sign, B (R4-7) x 4
Total Amount of Base Quote
$ a7, '{00
Alternate Quote — Grandview Avenue
Item
No.
Description
Quantit
Unit
Unit Price
Total Amount
1
Construction Engineering
1
LS
750
$ SO'
2
Mobilization & Demobilization
1
LS
6154,)'l7
$
3
Compacted Aggregate, No. 53
34
TON
80
$ 2, 720
4
Compacted Aggregate, No, 73
22
TON
/0
$ o8cj -O—R'
5
Curb, Concrete
57
LFT
70
go -
$ 3�9�0
6
Construction Sign, A (W20-1) x 2
Included in Base Bid
0
EACH
SEE BASE BID
SEE BASE BID
7
Construction Sign, A (W21-5)
1
EACH
ce>
$
8
Construction Sign, B (G20-2) x 2
0
EACH
SEE BASE BID
SEE BASE BID
* Included in Base Bid***
Total Amount of Alternate Quote
$ 9j / 9a
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Firm: ��EMSI �N t l_On t�fG'r� ZJlC�S
Address: ? 12 RL&W-ZOAJD ST
City/State/Zip: )5 4il 97 -DO ' 45-16 Telephone Number:
Fax Number: (577Y ) .?CZ — 5-392
By
(Signature)
^5�1— A Y�1/� r 1>�
(Pdnted Name of Pers n Signing)
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