HomeMy WebLinkAboutOpening of Bids - Lincoln Way West and Olive Street Intersection Improvement Proj No. 119-108 - Milestone Contrators North, Inc.A)c: it
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
CHECKLIST FOR BIDDERS
Project Name Lincoln Way West and Olive Street Intersection Improvements
Project No. 119-108
For Bids Due May 11, 2021
From time to time the South Bend Board of Public Works finds it necessary to reject a bid because
it does not comply with statutory requirements. In preparing your bid, please use the following
checklist in order to make sure that your bid is done in the proper manner.
Proper bid security included. The bidder has the option of providing either a Certified Check
X or Bid Bond.
Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely
X executed.
Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments
with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and
X Certification of use of United States Steel Products or Foundry Products.
Proof of MBE/WBE 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
X Form [MWBE-2.1].
X Acknowledge Receipt of 1 Addendum(s) included with the bid.
X All required additional information is included with the bid.
Proposal statements and other affidavits all signed by the proper party with name either
X printed or typed underneath signature.
X 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 of the need to read and comply with the specifications.
Bidder:
By Authorized Representativ
Signature:
Print Name & Title: p,
Version 1/13/2021 Contractor's Bid for Public Works - 1
Date: 5/11/2021
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
Project Name
Project No.
May 11, 2021
Lincoln Way West and Olive Street Intersection Improvements
119-108
May 11, 2021
PART I
(Must be completed for all bids. Please type or print)
Date: 5/11/2021 Bidder (Firm)
Address: 24358 SR 23
Milestone Contractors North. Inc.
City/State/Zip: South Bend, IN 46614 Telephone Number: ( 574 ) 288-4811
7oC'TFI
a .
erect' }
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:
Lincoln Way West and Olive Street Intersection Improvements Project No. 119-108
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
Abonmarche Consultants, Inc.
and dated 4/12/2021
for the sum of (enter the Total Bid as shown on the Proposal)
One million seven hundred ninety nine thousand one hundred dollars and zero cents ($ 1,799,100.00 i
(Enter sum of Total Base Bid plus Alternates shown on Proposal) (Numerical)
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in
the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance
with the notice. Any addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are 9fie
06d, the cost of units must be the same as that
shown in the original contract if accepted by the City- ut end. If the bid is to be awarded on a unit
basis, the itemization of the units shall be shown,Qri ep a attachment.
By /
/(Signature)
Dustin P. Hilary. Director of Estimating. South Bend
(Printed Name of Person Signing)
ACCEPTANCE
The above bid is accepted this day of 20
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President Joseph R. Molnar, Member
Gary A. Gilot, Member Jordan V. Gathers , Member
Murray Miller, Member Attest: Anne Fuchs, Clerk
Version 1/13/2021 Contractor's Bid for Public Works - 2
PART II
(For projects of $100,000 or more — IC 36-1-12-4)
These statements to be submitted under oath by each bidder with and as part of his/her/its bid.
Attach additional pages for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
1. Attach information regarding projects your organization has completed for the period of one
(1) year prior to the date of the current bid.
2. Attach a listing of public works projects currently in process of construction by your
organization.
3. Attach information regarding any failure to complete any work awarded to you and the
location thereof.
4. Attach references from private firms for which you have performed work.
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
1. Attach an explanation of your plan or layout for performing proposed work. (Examples could
include a narrative of when you could begin work, complete the project, number of workers,
etc. and any other information which you believe would enable the City of South Bend to
consider your bid.)
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 work) that you have used on public works
projects during the past five (5) years along with a brief description of the work done by each
subcontractor.
3. If you intend to sublet any portion of the work, attach the name and address of each
subcontractor, equipment to be used by the subcontractor, and whether you will require a
bond. However, if you are unable to currently provide a listing, please understand a listing
must be provided prior to contract approval. Until the completion of the proposed project, you
are under a continuing obligation to immediately notify the City of South Bend in the event that
you subsequently determine that you will use a subcontractor on the 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 an explanation for the rationale used
which would corroborate the prices listed.
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said
financial statement as required by statute shall thereby be rendered invalid. The financial
statement provided hereunder to the City of South Bend awarding the contract must be specific
enough in detail so that said City of South Bend can make a proper determination of the bidder's
capability for completing the project if awarded.
Version 1/13/2021 Contractor's Bid for Public Works - 3
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.
Version 1/13/2021 Contractor's Bid for Public Works - 4
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any
employee or contract with a person that the Contractor subsequently learns is an unauthorized alien.
Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's
newly hired employees through the E -Verify Program as defined by I.C. 22-5-1.7-3. Contractor's
documentation of enrollment and participation in the E -Verify Program is included and attached as part of
this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public contract to
certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien,
and that the subcontractor has enrolled in and is participating in the E -Verify Program. The Contractor agrees
to maintain this certification throughout the term of the contract with the City of South Bend, and understands
that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision
no later than thirty (30) days after being notified by the City.
6. Persons, 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 ("MBE") 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 an-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.
1, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1).1 hereby
certify that I and all subcontractors employed by me for this project will use steel products or foundry
products made in the United States on this project if awarded. I understand I have an affirmative duty to
notify the City in my bid that my proposal does not include the use of steel products or foundry products
made in the United States. I understand it is my sole obligation and responsibility to provide a justification
to the City, subject to review and approval, why the cost of United States made steel or foundry products is
unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry
products made in the United States, the City, through its director of public works, shall make a determination
if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder
may result in forfeiture of contractual payments.
Version 1/13/2021 Contractor's Bid for Public Works - 5
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 11th day of May , 20 21
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Subscribed and sworn to before me this 11th
My Commission Expires
6/5/22
County of Residence
Milestone Cl�iitractofs North, Inc.
of Contractor/Bidder or Its Agent
Dustin P. Hilary, Director of Estimating, South Bend
Printed Name and Title
day of May , 20 21
4-'�j.1��.
Notaryu lic Alisha Kruinber
St.
Version 1/13/2021 Contractor's Bid for Public Works - 6
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Version 1/13/2021 Contractor's Bid for Public Works - 6
Contractor's Bid for Public Work - City of South Bend
Project No. 119-108
PROJECT NAME:
PROJECT NO.
DATE
Base
Bid
BID/PROPOSAL
CITY OF SOUTH BEND
Lincoln Way West & Olive St Intersection Improvements
119-108
May 11, 2021
Addendum No. 1
May 2021
Item No.
Description
Quantity
Unit
Unit Price
Total Amount
1.
Construction Engineering
1
LS
2,500.00
$2,500.00
2.
Mobilization/Demobilization (5% max)
1
LS
70,000.00
$70,000.00
3.
Maintenance of Traffic
1
LS
36,866.50
$36,866.50
4.
CPM Schedule
1
LS
65.00
$65.00
5.
Preconstruction Video
1
LS
1,200.00
$1,200.00
6.
Utility Allowance
10,000
DOL
1.00
$10,000.00
7.
Erosion Control
1
LS
1,625.00
$1,625.00
8.
Clearing Right of Way
1
LS
26,200.00
$26,200.00
9.
Common Excavation
825
CYS
72.60
$59,895.00
10.
Structure Backfill
300
CYS
11.50
$3,450.00
11.
Tree, 6", Remove
18
EA
150.00
$2,700.00
12.
Tree, 18", Remove
1
EA
500.00
$500.00
13.
Tree, 30", Remove
1
EA
600.00
$600.00
14.
Traffic Signal Equipment, Remove and Salvage
1
LSUM
1,400.00
$1,400.00
15.
Sheet Sign, Remove
5
EA
65.00
$325.00
16.
Pipe, Remove/Abandon
840
LFT
12.00
$10,080.00
17.
Structures, Remove
16
EA
200.00
$3,200.00
18.
Concrete Curb, Remove
1,620
LFT
6.70
$10,854.00
19.
Concrete Approaches and Sidewalks, Remove
2,020
SYD
6.70
$13,534.00
20.
Concrete Pavement, Remove
660
SYD
14.00
$9,240.00
21.
Milling, Variable Depth
5,180
SYD
5.30
$27,454.00
22.
Coarse Aggregate, No. 8
680
CYD
60.00
$40,800.00
23.
Limestone Aggregate, No. 11
190
SYD
39.65
$7,533.50
24.
Compacted Aggregate, No. 53
600
TON
34.00
$20,400.00
25.
Compacted Aggregate, No. 53 for Patching, Undistributed
180
TON
30.00
$5,400.00
26.
HMA for Patching
290
TON
102.00
$29,580.00
27.
HMA for Patching, Undistributed
180
TON
92.00
$16,560.00
28.
HMA Surface, 9.5mm
505
TON
92.00
$46,460.00
29.
HMA Intermediate, 19.5mm
670
TON
65.00
$43,550.00
30.
PCCP, Colored, 4"
40
SYD
140.00
$5,600.00
31.
PCCP, Colored, 12"
150
SYD
130.00
$19,500.00
Version 1/13/2021 Contractor's Bid for Public Works -7 Bidder's Name: Milestone Contractors North. Inc.
Contractor's Bid for Public Work - City of South Bend
Project No. 119-108
Addendum No. 1
Ma, loll
32.
PCCP, 8"
40
SYD
94.00
$3,760.00
33.
PCCP for Approaches, 8"
805
SYD
77.00
$61,985.00
34.
PCCP for Approaches, 6"
115
SYD
73.00
$8,395.00
35.
Concrete Curb, 6"
730
LFT
50.00
$36,500.00
36.
Concrete Curb and Gutter
1,100
LFT
45.00
$49,500.00
37.
Concrete Ribbon Curb
270
LFT
44.00
$11,880.00
38.
Concrete Header, 12"
360
LFT
45.00
$16,200.00
39.
Concrete Header, 16"
270
LFT
43.00
$11,610.00
40.
Concrete Sidewalk, 4"
2,155
SYD
49.00
$105,595.00
41.
Concrete Curb Ramp
225
SYD
115.00
$25,875.00
42.
Permeable Pavers
190
SYD
136.00
$25,840.00
43.
Geogrid
210
SYD
7.60
$1,596.00
44.
Geotextile Fabric, Type 1
535
SYD
13.00
$6,955.00
45.
Sodding
3,110
SYD
12.05
$37,475.50
46.
Relocate Bus Stop
2
EA
1,200.00
$2,400.00
47.
Tree, Afterburner Tupelo, 2.5"
5
EA
730.00
$3,650.00
48.
Tree, Accolade Elm, 2.5"
36
EA
585.00
$21,060.00
49.
Tree, Kentucky Coffee Tree, 2.5"
2
EA
650.00
$1,300.00
50.
Tree, Skyline Thornless Honey Locust, 2.5"
4
EA
585.00
$2,340.00
51.
Tree, American Hornbeam, 2.5"
5
EA
625.00
$3,125.00
52.
Tree, Hackberry, 2.5"
7
EA
605.00
$4,235.00
53.
Tree, American Linden, 2.5"
5
EA
585.00
$2,925.00
54.
Shrub, Red Chokeberry, 24" Ht.
3
EA
35.50
$106.50
55.
Bike Hitch
6
EA
660.00
$3,960.00
56.
Bench
2
EA
4,700.00
$9,400.00
57.
Concrete Planter, Relocate
2
EA
300.00
$600.00
58.
Curb Identification Marker, Furnish Only
16
EA
35.00
$560.00
59.
Curb identification Marker, Furnish and Install
16
EA
215.00
$3,440.00
60.
Standard Storm Sewer Manhole
17
EA
3,700.00
$62,900.00
61.
Standard Storm Sewer Manhole with 2' Sump
4
EA
3,100.00
$12,400.00
62.
Standard Catch Basin
3
EA
2,300.00
$6,900.00
63.
Yard Drain
3
EA
1,900.00
$5,700.00
64.
Storm Sewer Pipe, 8"
50
LFT
46.00
$2,300.00
65.
Storm Sewer Pipe, 12"
415
LFT
35.00
$14,525.00
66.
Storm Sewer Pipe, Water Main Grade, 12"
335
LFT
45.00
$15,075.00
67.
Storm Sewer Pipe, Perforated, 18"
745
LFT
49.00
$36,505.00
68.
Connect to Existing Storm Sewer
2
EA
800.00
$1,600.00
69.
Adjust Valve to Grade
30
EA
200.00
$6,000.00
70.
Adjust Casting to Grade
21
EA
1,400.00
$29,400.00
71.
TESCO Combination Cabinet on P-1 Foundation
1
EA
9,100.00
$9,100.00
72.
IThermal Detection System
4
EA
2,100.00
$8,400.00
73.
Thermal Detection Camera
4
EA
9,000.00
$36,000.00
74.
Pedestrian Signal Pole Foundation
6
EA
700.00
$4,200.00
75.
Pedestrian Signal Pole
6
EA
1,200.00
$7,200.00
76.
Pedestrian Push Button Assembly, APS
8
EA
925.00
$7,400.00
Version 1/13/2021 Contractor's Bid for Public Works -8 Bidder's Name: Milestone Contractors North, Inc.
Contractor's Bid for Public Work - City of South Bend
Project No. 119-108
Addendum No. 1
Max 2021
77.
Pedestrian Signal Head
8
EA
800.00
$6,400.00
78.
Wiring for Signal
1
LS
2,780.00
$2,780.00
79.
Signal Cantilever Structure, Paint
4
EA
1,250.00
$5,000.00
80.
4-1/c No. 8 Copper Cable
2,940
LFT
6.00
$17,640.00
81.
2" PVC schedule 80 for Lighting
2,940
LFT
8.60
$25,284.00
82.
Light Pole Foundation
35
EA
725.00
$25,375.00
83.
Light Pole and Luminaire, LED, Type I, Furnish
4
EA
5,900.00
$23,600.00
84.
Light Pole and Luminaire, LED, Type I, Furnish and Install
16
EA
6,500.00
$104,000.00
85.
Light Pole and Luminaire, LED, Type II, Furnish
4
EA
8,400.00
$33,600.00
86.
Light Pole and Luminaire, LED, Type II, Furnish and Install
10
EA
9,200.00
$92,000.00
87.
Light Pole and Luminaire, LED, Type III, Furnish
4
EA
7,600.00
$30,400.00
88.
Light Pole and Luminaire, LED, Type III, Furnish and Install
9
EA
8,400.00
$75,600.00
89.
Lighting Handhole
2
EA
825.00
$1,650.00
90.
Miscellaneous Equipment for Lighting
1
LS
5,100.00
$5,100.00
91.
Temporary Lighting
1
LS
20,500.00
$20,500.00
92.
Construction Sign, Wayfinding Sign, Type C
12
EA
119.00
$1,428.00
93.
Sign, Relocate
6
EA
145.00
$870.00
94.
Sheet Sign, 0.080 in.
20
SFT
18.00
$360.00
95.
Sign Post, Square, Type 2, Reinforced Anchor Base
104
LFT
16.00
$1,664.00
96.
Line, Thermoplastic, Solid, White, 4", Grooved
1,845
LFT
3.00
$5,535.00
97.
Line, Thermoplastic, Solid, Yellow, 4", Grooved
2,785
LFT
3.00
$8,355.00
98.
Line, Thermoplastic, Solid, White, 6"
385
LFT
3.25
$1,251.25
99.
Line, Thermoplastic, Broken, Yellow, 4", Grooved
1,285
LFT
3.00
$3,855.00
100.
Transverse Line, Thermoplastic, White, 24", Stop Bar
140
LFT
12.00
$1,680.00
101.
Transverse Line, Thermoplastic, White, 24", Cross Hatch
245
LFT
12.00
$2,940.00
102.
Pavement Message Marking, Thermoplastic, Lane Indication
Arrow
14
EA
160.00
$2,240.00
103.
Pavement Message Marking, Thermoplastic, Bike Symbol and
Arrow, Road
4
EA
495.00
$1,980.00
104.
Pavement Message Marking, Thermoplastic, Bike Symbol and
Arrow, Bike Lane
15
EA
495.00
$7,425.00
105.
Pavement Marking, Thermoplastic, Green, Bike Lane
1,305
SFT
22,25
$29,036.25
106.
Pavement Marking, Remove
1,845
LFT
0.70
$1,291.50
107.
Pavement Message Marking, Remove
4
EA
80.00
$320.00
108.
Geotextile Fabric, Type II
555
SYD
9.00
$4,995.00
Total Amount of Base Bid (Items 1 through 107) 1 $1,799,100.00
Bidder(Firm):
Address:
City/State/Zip
Telephone Number:
Fax Number:
Milestone Contractors North, Inc.
24358 SR 23
South Bend,IN 46614
574-288-4811
574-289-7
By. ZZ _ i
(Signature)
Hilary, Director of Estimating, South Bend
(Printed Name of Person Signing)
Version 1/13/2021 Contractor's Bid for Public Works -9 Bidder's Name: Milestone Contractors North, Inc.
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is
the bidder's sole responsibility to verify whether any listed minority or woman business meets the MBE qualifications.
Project Number: 119-108 Project Name: Lincoln Way West and Olive Street Intersection Improvements
Bidder: Milestone Contractors North, InC. Total Bid Amount: $1,799,100.00 MBE Goal: 2.43%
Page 1 of 1
Primary Contact Person Scope of Work to be Performed Dollar Amount of MBE Percentage
Name & Address of MBE of Total
(Name/Telephone) (Attach scope/schedule if you need additional space) Component o: a n _____i
Master Filter Corporation Ronald Orr
d/b/a Master Enterprises 317-545-3335
P.O. Box 18523
Indianapolis, IN 46218
MBE materials provided for lighting and signal
equipment
Submitted by: Dustin P. Hilary, Director of Estimating,
Print Name South Bend ignature
Version 1/13/2021 Contractor's Bid for Public Works - 10
$48,012.00 1 2.67%
5/11/21021
Date
4
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
FORM MWBE-1.0
T
MWBE UTILIZATION PLAN
)a",. _
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is
the bidder's sole responsibility to verify whether any listed minority or woman business meets the MBE qualifications.
Project Number: 119-108 Project Name: Lincoln Way West and Olive Street Intersection Improvements
Bidder: Milestone Contractors North, InC. Total Bid Amount: $1,799,100.00 MBE Goal: 2.43%
Page 1 of 1
Primary Contact Person Scope of Work to be Performed Dollar Amount of MBE Percentage
Name & Address of MBE of Total
(Name/Telephone) (Attach scope/schedule if you need additional space) Component o: a n _____i
Master Filter Corporation Ronald Orr
d/b/a Master Enterprises 317-545-3335
P.O. Box 18523
Indianapolis, IN 46218
MBE materials provided for lighting and signal
equipment
Submitted by: Dustin P. Hilary, Director of Estimating,
Print Name South Bend ignature
Version 1/13/2021 Contractor's Bid for Public Works - 10
$48,012.00 1 2.67%
5/11/21021
Date
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN = ° ` /
FORM MWBE-1.0
MWBE UTILIZATION PLAN
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE participation. It is
the bidder's sole responsibility to verify whether any listed minority or woman business meets the WBE qualifications.
Project Number: 119-108 Project Name: Lincoln Way West and Olive Street Intersection Improvements
Bidder: Milestone Contractors North, Inc. Total Bid Amount: $1,799,100.00 WBE Goal: 4.94%
Page 1 of 1
N
State B
24963
South
Traffic
1810
Knox, I
ame & Address of WBE
Bend,
W.
Primary Contact Person
(Name/Telephone)
Scope of Work to be Performed
(Attach scope/schedule if you need additional space)
Dollar Amount of WBE Percentage
Component of Total
Bid/Proposal
arricading, Inc.
US Hwy 20 W.
IN 46628
James Michalski
574-287-2078
Maintaining of Traffic
$36,773.50
2.04%
Control Specialists, Inc.
Pacific Avenue
Barry Triska
574-772-7001
Final Pavement Markings
$69,297.50
3.85%
N 46534
Submitted by: Dustin P. Hilary, Director of Estimating,/ _5/11/2021
Print Name South Bendgnature Date
Version 1/13/2021 Contractor's Bid for Public Works - 11
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
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 MWBE participation.
Project Number: 119-108 Date: 5/11/2021
Project Name: Lincoln Way West and Olive Street Intersection Improvements
Bidder: Milestone Contractors North, Inc.
Contact Person: Edward Pilipow Telephone: 574-288-4811
Address: 24358 SR 23
City: South Bend State: Indiana Zip: 46614
Email: epilipowiMmilestonelp.com
To determine whether a bidder has demonstrated good faith efforts to reach the MWBE 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":
Version 1/13/2021 Contractor's Bid for Public Works - 12
EVIDENCE OF GOOD FAITH EFFORTS
MWBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business
Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana
Department of Administration list of Minority and Women Owned Businesses (both certified and non -
certified) found at: http://w Jnx oy/idoa/.
GOOD FAITH EFFORTS TO OBTAIN MWBE PARTICIPATION
The bidder shall initial each item below, as evidence of its good faith efforts to obtain MWBE
participation in the awarded contract.
affirm that I reviewed the City of South Bend's Minority and Women Business Enterprise
Inclusion Program Plan and the Indiana Department of Administration's certified list of
p,
Indiana Minority and Women Business Enterprises, found on their website
(�(hftp://www.in.gov/idoa).
I affirm that I have made good faith efforts to select portions of the contract work to be
performed by MWBEs, including, where appropriate, breaking out contract work items into
economically feasible units to facilitate MWBE participation.
I affirm that I have made good faith efforts to solicit through all reasonable and available
" means the interest of all MWBEs in the scopes of work of the contract.
I affirm that I attended all pre-bid meetings scheduled by the City of South Bend to inform
i L�_ MWBEs of contracting and subcontracting opportunities.
I affirm that I advertised in general circulation and/or trade association publications
subcontract opportunities and allowed MWBEs reasonable time to respond to
fplconcerning
such advertisements.
I affirm that I performed any and all necessary steps to provide written notices in a manner
reasonably calculated to inform MWBEs of subcontracting opportunities and allowed
sufficient time for MWBEs to participate effectively.
I affirm that I followed up on initial solicitations with interested MWBEs.
I
I affirm that I negotiated with interested MWBEs in good faith, including providing such
MWBEs with adequate information about the plans, specifications and other requirements
d of the subcontract.
I affirm that I have made good faith efforts to assist interested MWBEs in obtaining
bonding, lines of credit, or insurance as required by the City or the bidder, where
U appropriate.
Version 1/13/2021 Contractor's Bid for Public Works - 12
13TIT a
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN .; a
..�
FORM MWBE-2.0=
EVIDENCE OF GOOD FAITH EFFORTS
I affirm that I have made good faith efforts to assist interested MWBEs in obtaining
necessary equipment, supplies, materials, or related assistances or services, where
appropriate.
I affirm that I did not reject any MWBEs as unqualified without sound business reasons
based on a thorough investigation of their capabilities.
CONTRACT RECORDS: The bidder has maintained the following records for each MWBE 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
f concluding that the MWBE was unqualified to perform the job.
*Proper demonstration of Good Faith Efforts 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 1/13/2021 Contractor's Bid for Public Works - 13
1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
Date:
To:
From
Subject
May 7, 2021
All Bidders
PHONE 574/235-9251
FAx 574/ 235-9171
TDD 574/ 235-5567
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
Anne Fuchs, Clerk, Board of Public Works
Addendum Number: 1
Project Name:
Project
Number:
Lincoln Way West and Olive Street Intersection Improvements
119-108
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received: 5/7/2021
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. A copy
MUST also be included with your bid package upon submittal.
THIS ADDENDUM MAY AFFECT YOUR BID.
Note:
The attached documents are hereby Add to the Specifications and Contract
Documents and become a part of herein.
Company: Milestone Contra
Authorized Signature:
tin P. Hi
Date: 5/7/2021 �f
Director of Estimating, South Bend
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
-
FORM MWBE-2.1
MBEIWBE CONTACTED
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects
requiring Good Faith Efforts to contact MBEs. It is the bidder's sole responsibility to verify whether any listed
minority or woman business meets the MBE qualifications. Attach additional pages if necessary.
PAGE 1 OF 1
Project Number: 119-108 MBE Participation Goal 2.43%
Project Name: -i Lincoln Wav West and Olive Street Intersection Improvements
Bidder-
BY'
idderBy•
Iestone Contractors Norht, Inc.
South Bend 5/11/2021
gnature) Dustin P. Hilary (Title) (Date)
�j
%,"kE Firm Master Filter Corporation d/b/a Master Enterprises
Owner or Contact at MBE Firm Ronald Orr
Telephone: 317-545-3335 Fax: Email: rorr@masterent84.com
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Materials supplied for lighting and signal equipment
RESULTS OF CONTACT WITH THE MBE FIRM:
If Milestone Contractors North Inc. is awarded the contract we'll utilize these MBE materials installed b
Hawk Enterprises, Inc.
MBE Firm
Owner or Contact at MBE Firm
Telephone: Fax:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBE FIRM:
Email:
Version 1/13/2021 Contractor's Bid for Public Works - 14
CITY OF SOUTH BEND ,es"� r►t\
MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY
DEVELOPMENT PROGRAM
FORM MWBE-2.1 r
MBEIWBE CONTACTED
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects
requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed
minority or woman business meets the WBE qualifications. Attach additional pages if necessary.
PAGE 1 OF 1
Project Number: 119-108 WBE Participation Goal 4.94%
Project Name: J Incoln Way West and Olive Street Intersection Improvements
Bidder:
By:
�Il�tone Contractors North, Inc.
Director of Estimati
5/11/2021
(Sj�re) Dustin P. Hilary (Title) (Date)
WB F (rm State Barricading, Inc.
Owner or Contact at WBE Firm James Michalski
Telephone: 574-287-2078 Fax: 574-287-1744 Email: statebarricade1Caol.com
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Maintaining of traffic
RESULTS OF CONTACT WITH THE WBE FIRM:
If Milestone Contractors North, Inc. is awarded the project, we'll subcontract State Barricading,Inc. for
the maintaining of traffic.
WBE Firm Traffic Control Specialists, Inc.
Owner or Contact at WBE Firm Barry Triska
Telephone: 574-772-7001 Fax: Email: btriska@tcspecialists.net
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Final Pavement Markings
RESULTS OF CONTACT WITH THE WBE FIRM:
If Milestone Contractors North, Inc. is awarded the project, we'll subcontract Traffic Control Specialists, Inc.
for the final pavement markings
Version 1/13/2021 Contractor's Bid for Public Works - 15
CONTRACTOR:
(Name, legal status and address)
Milestone Contractors North, Inc.
24358 State Road 23
South Bend, IN 46614
OWNER:
(Name, legal status and address)
CNASURETY
Bond No. Bid Bond
SURETY: Continental Casualty Company
(Name, legal status and principal place
of business)
City of South Bend, Indiana, Board of Public Works
227 West Jefferson Blvd.
South Bend, IN 46601
151 N. Franklin Street
17th Floor
Chicago, IL 60606
BOND AMOUNT: 5% Five Percent of the Base Bid Plus Any Alternates
PROJECT:
(Name, location or address, and Project number, if any)
Lincoln Way West and Olive Street Intersection Improvements, Project No. 119-108
This document has important legal
consequences. Consultation with
an attorney is encouraged with
respect to its completion or
modification.
Any singular reference to
Contractor, Surety, Owner or
other party shall be considered
plural where applicable.
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the
Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and
severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor
within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and
Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such
bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted
in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract
and for the prompt payment of labor and material furnished in the prosecution thereof, or (2) pays to the Owner the
difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount
for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this
obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of
an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of
notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for
acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for
an extension beyond sixty (60) days.
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 Prwirlw,
any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted heref q %N"4Ctors /
provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. �•''•......,.,0�
furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bonti.�:' QpRAT % ':�s
o ; LOQ f -
Signed and sealed this 11th day of May 1 _ y : �
- M
.; 0
(Wit s) Alisha Krueger B
(Witness) K;56n R. Postma
-• 5EAL:
ntra rs North, Inc.
in P. Hilary, Director of Estimating, South,
Casualty Company s
Printed in cooperation with the American Institute of Architects (AIA).
The language In this document conforms to the language used in AIA Document A310 - Bid Bond - 2010 Edition.
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents, That Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of
Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company (herein called
"the CNA Companies"), are duly organized and existing insurance companies having their principal offices in the City of Chicago, and State of Illinois,
and that they do by virtue of the signatures and seals herein affixed hereby make, constitute and appoint
Angela M. Riley , Individually
of Indianapolis, IN their true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on
their behalf bonds, undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
Surety Bond No.: Bid Bond
Principal: Milestone Contractors North, Inc.
Obligee: City of South Bend, Indiana, Board of Public Works
and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and
all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly
adopted, as indicated, by the Boards of Directors of the insurance companies.
In Witness Whereof, the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto
affixed on this 27th day of February, 2018.
Continental Casualty Company
WET 1NSUR D
'�F National Fire Insurance Company of Hartford
coao:flnr� ,coAmerican Ca lty Company of Re ing, Pennsylvania
SZ 3. J
1897 Paul T. Bruflat VTce President
State of South Dakota, County of Minnebaha, ss:
On this 27th day of February, 2018, before me personally came Paul T. Bruflat to me known, who, being by me duly sworn, did depose and say:
that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of Continental Casualty Company, an Illinois insurance
company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a
Pennsylvania insurance company described in and which executed the above instrument; that he knows the seals of said insurance companies; that the
seals affixed to the said instrument are such corporate seals; that they were so affixed pursuant to authority given by the Boards of Directors of said
insurance companies and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance
companies.
-----------------------
J. MOHR Y2A-�
I- NOTAR9PU9LIC
( SSOIRM DAKOTA
My Commission Expires June 23, 2021 J. Mohr Notary Public
CERTIFICATE
I, D. Johnson, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford,
an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the
Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance
companies printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said
insurance companies this 11 th; day of May; 2021.
Continental CasualtyCom
iMSUR l- ANY ft Company
National Fire Insurance Company of Hartford
coRP:A;rt;r o� ��coAeolrgrfo American Casualty Company of Reading, Pennsylvania
'`� JULY 31,
1893 r � .» �' NAP�F� : ' •
D. Johnson Assistant Secretary
Form 176853 4/2012.
Go to www.cnasu Xoml, Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity.
Authorizing By -Laws and Resolutions
ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY:
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company at a
meeting held on May 12, 1995:
"RESOLVED; That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the
Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be
provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective."
This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on
behalf of Continental Casualty Company.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by
unanimous written consent dated the 25'h day of April, 2012:
"Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute
various policies, bonds, undertakings and other obligatory instruments of like nature; and
Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or
otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer
shall be valid and binding on the Company. "
ADOPTED BY THE BOARD OF DIRECTORS OF NATIONAL FIRE INSURANCE COMPANY OF HARTFORD:
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company by
unanimous written consent dated May 10, 1995:
"RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the
Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be
provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective."
This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on
behalf of National Fire Insurance Company of Hartford.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by
unanimous written consent dated the 25' day of April, 2012:
"Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute
various policies, bonds, undertakings and other obligatory instruments of like nature; and
Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, bard copy format, may be provided via facsimile or
otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer
shall be valid and binding on the Company. "
ADOPTED BY THE BOARD OF DIRECTORS OF AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA:
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company by
unanimous written consent dated May 10, 1995:
"RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the
Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be
provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective."
This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on
behalf of American Casualty Company of Reading, Pennsylvania.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by
unanimous written consent dated the 25"' day of April, 2012:
"Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute
various policies, bonds, undertakings and other obligatory instruments of like nature; and
Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or
otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer
shall be valid and binding on the Company. "
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
RESPONSIBLE BIDDER CHECKLIST
Project Name Lincoln Way West and Olive Street Intersection Improvements
Project No.
For Bids Due
119-108
May 11, 2021
Contractor Name: Milestone Contractors North, 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. Quality
workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet
certain minimum requirements to be responsive and responsible bidders.
THIS FORM MUST BE SUBMITTED WITH YOUR BID.
INSTRUCTIONS:
If you are a pre -qualified bidder, complete Section I only.
If you are not a pre -qualified bidder, complete Section II only.
Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be
considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre-
qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6-
63 of The Responsible Bidding Ordinance No. 10594-18 (hereinafter, "Responsible Bidding Ordinance")
for a period of twelve (12) months.
Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre-
qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified
Bidders") by December 31st for the upcoming calendar year, or within twelve (12) months of obtaining pre-
qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of
the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application
for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal
of the designation, effective January 1 of the following year, or immediately following the twelve (12) months
of pre -qualified standing.
However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works
projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status
is re-established.
Please Note: The City reserves the right to request supplemental information from the bidder,
additional verification of any information provided by the bidder, and may also conduct random
inquiries of the bidder's current and previous customers regardless of pre -qualified standing.
It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to
the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid
opening.
Version 1/13/2021 General Conditions - 6
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, a current written list that discloses the
name, address, licensing status, and type of work for any subcontractor from whom the bidder has
accepted a bid and/or intends to hire on any part of the public work project, including individuals
performing work as independent contractors.
2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty
thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the
Responsible Bidder Ordinance as though it were bidding directly to the City, except that the
subcontractor shall submit the required information (including the name, address, and type of work)
to the successful bidder prior to the commencement of work.
3. Failure of a subcontractor to submit the required information shall not disqualify the successful
bidder from performing work on the project and shall not constitute a contractual default and/or
breach by the successful bidder. However, the City may withhold all payment otherwise due for
work performed by a subcontractor, until the subcontractor submits the required information and
the City approves such information.
4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall
not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another
subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the
name, address, licensing status, and type of work of the substitute subcontractor.
5. The successful bidder and all subcontractors on a public works project are required to submit
certified payroll utilizing the federal form known as WH -347 or a similar form on a bi-weekly basis,
submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall
identify the job title and craft for each employee. Certified payrolls shall be submitted
electronically.
Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in
the automatic disqualification of the bid.
The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into
account all information in the submission requirements, determine whether a bidder is responsive and
responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to
utilize all information provided in the contractor's submission and any information obtained by the City
through its own independent verification of the information provided by the contractor.
Version 1/13/2021 General Conditions - 7
PRE -QUALIFIED BIDDER CHECKLIST
(a) Acknowledgements:
(i) X By checking this box, I hereby acknowledge that I am a pre -qualified bidder with
the City of South Bend and that I have met the pre -qualification requirements within
the last twelve (12) months. A copy of my Pre -Qualification verification letter
is attached.
(ii) X By checking this box, I hereby acknowledge that the City reserves the right to
request supplemental information, additional verification of any information
provided by me, and may also conduct random inquiries of my current and prior
customers.
(b) Attachments:
(i) X Indiana Secretary of State's on-line records (ie. Business verification) dated within
sixty (60) days of the submission of said document showing that business is in
existence, current with the Indiana Secretary of State's Business Entity Report,
and eligible for a certificate of good standing. (Not applicable to individuals, sole
proprietors or partnerships).
(ii) X Statement on staffing capabilities, including labor sources. This statement
indicates and ensures I have sufficient employees on staff to complete the work. It
outlines how I intend to meet the staffing needs of the work.
(iii) X List of projects of similar size and scope of work performed in all areas, including
the State of Indiana, within the last three (3) years.
(iv) X For every project, submit evidence of participation in apprenticeship and training
programs, applicable to the work to be performed on the project, which are
approved by and registered with the United States Department of Labor's Office of
Apprenticeship, or its successor organization.
Version 1/13/2021 General Conditions - 8
PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED)
(a) Acknowledgements:
(i) _ By checking this box, I hereby acknowledge that I am not a pre -qualified bidder
with the City of South Bend.
(ii) _ By checking this box, I hereby acknowledge that the City reserves the right to
request supplemental information, additional verification of any information
provided, and may also conduct random inquiries of my current and prior
customers. The City reserved the right to utilize all information provided in this
submission and all information obtained in inquiries or requests to determine if a
bidder is responsive and responsible. Additionally, I acknowledge that all
information provided to the City shall be regarded as public records.
(iii) _ By checking this box, I hereby acknowledge that copies of all Applicable
apprenticeship certificates or standards for training programs applicable to the
work performed on the project may be requested at any time and shall be furnished
upon request.
(iv) _ By checking this box, I hereby acknowledge and ensure that I and all sub-
contractors, from whom I have accepted a bid and/or intend to hire to perform work
on the public work project, are properly licensed. Furthermore, I acknowledge my
understanding that it is my responsibility to ensure that all sub -contractors have
the necessary licenses to undertake the work called for in this bid. If a sub-
contractor loses their license at any point, it is the responsibility of that sub-
contractor to notify the City.
(b) Attachments:
(i) _
Indiana Secretary of State's on-line records (ie. Business verification) dated within
sixty (60) days of the submission of said document showing that business is in
existence, current with the Indiana Secretary of State's Business Entity Report,
and eligible for a certificate of good standing. (Not applicable to individuals, sole
proprietors or partnerships).
(ii) _
List identifying all former business names.
(iii) _
Any determinations by a court or governmental agency any violations of federal
state, or local laws including, but not limited to, violations of contracting or antitrust
laws, tax or licensing'laws, environmental laws, Occupational Safety and Health
Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5)
years.
(iv) _
Statement about staffing capabilities, including labor sources. This statement
indicates and ensures I have sufficient employees on staff to complete the work I
am bidding on OR outlines how I intend to meet the staffing needs of the work.
(v) _
Statement that individuals who will perform work on the public work project on my
behalf will be properly classified as an employee or as an independent contractor
under all applicable state and federal laws and local ordinances.
(vi) _
For every project, submit evidence of participation in apprenticeship and training
programs, applicable to the work to be performed on the project, which are
approved by and registered with the United States Department of Labor's Office of
Apprenticeship, or its successor organization.
(vii) _
Copy of a written plan for employee drug testing that covers all of my employees
who will perform work on the public work project and meets or exceeds the
requirements set forth in IC 4-13-18-5 or IC 4-13-18-6.
(viii) _
Evidence that I am utilizing a surety company which is on the Bureau of Fiscal
Service "Department of Treasury's Listing of Approved Sureties" as required in the
bid specifications or contract.
Version 1/13/2021 General Conditions - 9
Date:
(ix) _ Written statement of any federal, state or local tax liens or tax delinquencies owed
to any federal, state or local taxing body in the preceding three years.
(i) _ List of projects of 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.
n P. Hilary.
Name Here)
Milestone Contractors North, Inc.
(Name of Company)
24358 SR 23
(Address of Company)
South Bend
(City)
Indiana
(State)
574-2884811
(Telephone Number)
Version 1/13/2021 General Conditions - 10
%v1
Milestone Contractors North, Inc.
GRIFFITH
1700 E. Main St.
Griffith, IN 46319
Phone: (219) 924-5900
Fax (219) 924-8768
SOUTH BEND
24358 SR 23
South Bend, IN 46614
Phone: (574) 288-4811
Fax(574)289-7174
Responsible Bidding Practices and Submission
1. Attached
2. Staffing Capabilities: Milestone Contractors North, Inc. is signatory with the following unions
which supply our workforce — Laborers International Union, Teamsters, Operating Engineers
and Cement Masons.
3. See Attached Forms 96 & 96a
4. Milestone Contractors North, Inc. is signatory with the following unions which supply our
workforce — Laborers International Union, Teamsters, Operating Engineers and Cement
Masons
Dated: Ma,,II.2021
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
DEPARTMENT OF PUBLIC WORKS
ERIC HORVATH, DIRECTOR
September 23, 2020
Mr. Dustin Hilary
Walsh & Kelly, Inc.
dhilary cf-walshkellv.com
RE: Pre -Qualification Verification
Dear Mr. Hilary:
This letter serves as verification of Pre -Qualification status of your company for bidding
with the City of South Bend. This Pre -Qualification status is effective for twelve (12)
months from the date of this letter. Thereafter you are required to re -submit a complete
application for continuation of pre -qualification status prior to December 31 for the
upcoming calendar year.
A copy of this Verification Letter must be included with every bid exceeding $150,000
submitted to the City of South Bend Board of Public Works, along with your Pre -Qualified
Bidder Checklist and attachments.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
Dga,oy:.9nm by � x°rvu,
Liz Horvath
emalL—Ih°rvath@s°ulfibmtlingw,
Dale: 2=0 131152:M—'°d
Liz Horvath, Permit Manager
1/10/2019 2:42 PM FROM: MOEITS TO: 112199248788 P. 3
Z IN7`CRNATIONAL, UNION OF
OPERATING ENGINEERS
¢,
Lnm ~' JAMES M. SWEENEY
p 5• rsevoo+r. wrt.,.ocirmss.».a
N Cti lanuery 10, 2019
rx
Walsh & Kelly
m n ti 1700E Main St.
+II c ; Griffith, IN 46319
Re: ProofofCompliance with 301LCS 5011/30-22(6)
N q p ;MU Our File No. Ml -00321
rn
CO
ti Q A (n ® Dear Sir or Madam:
o h
-0 0 M At the request of Walsh & Kelly Inc, I am providing you with evidence of the Company's
�"'� compliance with the apprenticeship requirements in 30 ILCS 50013 0-2 2(6) ofthe Illinois
� M K Pracumanent Code. 1 um submitting this letter along with apprenticeship certificates
Ip S •� M - 1-1
• � (Nos.(L012020003 and 11-008780173).
a
z = Asa signatory contractor with the International Union of Operating Engineers. Local
9. = t50, AFL-CIO, Walsh & Kelly Inc, is required by Collective Bargaining Agreement to
y N O In ill D 4„1, participate in an applicable apprenticeship and training program approved by and
e . O _ (1) ALV registered with the United States Department of Labor's Bureau of Apprenticeship and
ty ; Q 3 — Q�]{v. Training. The attached certificates are evidence of compliance with the U.S. Department
`�R/Ca 8 0 t0 1-,m O Z y - 4 ' :ice of Labor's apprenticeship requirements.
(n
r "tS "+• Thank you for your cooperation in this matter. If you have any questions or concerns,
please do not hesitate to contact me
QD 1 'e Very truly yours,
A b �• } �t IUOB, Local 150, AFL C10
y O ti t0 to N District 1 dispatch olTce
Caroline Lasnink
Enclosures: Ceniecates
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INDMVA LABORERS'TRAINING TRUSTFUND
S
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RoierrS Wrfgh! .1bA Wirmtm� YY
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P.O. Hox758- Brdfard, lndiam 47421 S.-CwM VAX: (812)279.6505 �• � �.
(812) 279A751 jJ n
January 14,2019 4 "
To Whom it mayCoacem: I
Hila letter is to confirm that "Walab & Kelly Inc. " is a signatory cont wor in good standing
with the Indiana Laborers' Training Trust Fund. C _ .,���:� • °'.� I.
The above mentioned company is a par(icipantt in the Joint Apprenticesbip and Training
4�
Comnatteethroughthis Union and has been an acdveparficipau ingood 9snftgfbreWhofIhB (rjj n o tN c
pest five plus consecutive years, and is coxreaalY eligible to use our appmatiees on a project
P e0 y�
Prather, our otganizetiam's program is approved by the U.S. Veterans Adminishation to � � M � � � ,��' ,,/�41c" . a Q.•`�
participate in the GI educational benefits program. A copy of our approval letters aro aitacbed
along with the collective bargaining agreement atavag the ratios of Journey workers to
Apprentices; which is one (1) Apprentice for every five (5) Journey workers and thereafter may S3
not employ more that (1) Apprentice for every (3) Journey workers.
b�Sean Coakley,
LJheclor
SC:dc
E,
www. ft&anolaborerrtratn ft org .
STATE OF INDIANA
OIPARTh@!f OF VETERANS AFFAIRS Md" R Penin. Gouvnur
STATEAPPROMOAOENCY Jo�M. (Vor,tCaedar -. _.
402 WEfff WASRINWM aTRW
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The Mae
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For emn11m®tu.0cetions seat by mel, addam to the Hduoetion Division u follows:
Depattnent of Vetmens Af iro
9700Page Avenge
Suite 101-1dcmfkon
8t. Laast,M063132.1502
FBS mmmbafm omt1fcall®9:
To Submit OTT/APF documents: 314753.4140
Fadfine W auuta,tthe ladlana State Appmvtog Agmoy with Bob questim.
TamEggen
Prngcon.Comdiatmt
TW— Dgwtment of Vdmam Affdw
402westRMhia am SttmtRMW40
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317-234-6062
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AB cf December 31.2015
APPREMICESHIP YEARLY SUMMARY
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ibis letter is to confnm that "Walab & Kelly, Ina " is a signatory contractor in good etending
2.MA Fqe
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participate is the GI educational benefits program. A copy of our approval letbers are attached
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ibis letter is to confnm that "Walab & Kelly, Ina " is a signatory contractor in good etending
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participate is the GI educational benefits program. A copy of our approval letbers are attached
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not employ more that (1) Apprentice for every (3) Journey workers.
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P.O. Hos 758-Ucdtard, lndiaea 47421 Sean Coa Q Di a.
FAX: 0812)279-5M5
(812)279-9751
SC:dc
Jaavery 14, 2019
$
To Whom it May Concern:
ibis letter is to confnm that "Walab & Kelly, Ina " is a signatory contractor in good etending
wilh dw 1ndiana Iaboras' Training 1hist Fund.
The above mentioned company is a participant to the Joint Apprenticeship and Training
br'
Committee through this Union and has been an active participant in good standing for oath of the
^'
past five plus consecutive years, and is currently eligible to use our epprmtices on a project.
Fwdw, our orgm&ation's program is approved by the U.S. Vdlaans Admimetretion to
participate is the GI educational benefits program. A copy of our approval letbers are attached
along with Ste collective bargaining agreement stating the ratios of Journey workers to
Apprenticas> which is one (1) Apprentice for every five (5) Journey workers and daeattar may
not employ more that (1) Apprentice for every (3) Journey workers.
Sinarelyk
Sem Coakley,
Director
SC:dc
www. Did wudabomrstrabft. org
STATE OF INDIANA.
DWA—mmENT of VEIERANB AFFAIRS MbhselR Pyres, Gvtemy
STATE APFROV0i0AGENV James M. Brmvn, Dheator
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As Of December 31, 2010
APPRENTICESHIP YEARLY SUMMARY
2017
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APPRiNnceampYEARLY SUMMARY
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As o1 December 31.2015
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A3 0f 00CBmbw 31, 2012
APPRENTICESHIP YEARLY SUMMARY
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TOTALS 790 202 16
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;.w- u u
al) c ber31.2013
CONTRACTOR'S BID FOR PUBLIC WORK - FORM 96
State Form 52414 (8212-13)1 Form 96 (Revised 2013)
�F Prescribed by State Board of Accounts
PART
(To be completed for all bids. Please type or prim`)
Date (month, day, year):- 5/11/2021
1. Governmental Unit (Owner): City of South Beni Indiana,
2. County St. Joseph
3. Bidder (Firm): Milestone Contractors North, Inc. _
Address: 24358 SR 23
City/State/ZlPcode:= _South Bend, IN 40-14--
4. Telephone Number: 5747288-011-
5.
74-288 .5. Agent of Bidder (if applicable): _
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete
the public works project of City of South Bend, Indiana - Lincoln Way West &Olive Street Intersecfjan lmpmvements
(Governmental Unit) in accordance with plans and specifications prepared by
Abonmarche Consultants LLC and dated 4/12/2021 for the sum of
See Attached $_ See Attached -
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the
notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the
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 governmental unit. If the bid Is to be awarded on a unit
basis, the itemization of the units shall be shown on a separate attachment.
The contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee,
or applicant for employment, to be employed in the performance of this contract, with respect to any matter
directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry.
Breach of this covenant may be regarded as a material breach of the. contract.
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS
(If applicable)
I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory
obligation to use steel products made in the United States (I.C. 5-16-8-2). 1 hereby certify that I and all
subcontractors employed by me for this project will use U.S. steel products on this project if awarded. l
understand that violations hereunder may result in forfeiture of contractual payments.
The above bid is accepted this _
following conditions: .
Contracting Authority Members:
ACCEPTANCE
day of
PART II
(For projects of $950, 000 or more – !C 36-9-92-4)
subject to the
Governmental Unit: Cit of South Bend .InAiana
Bidder (Firm) Milestone Contractors North, Inc.
Date (month, day, year): —May 11, 2021 _.
These statements to be submitted under oath by each bidder with and as a part of his bid.
Attach additional pages for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
1. What public works projects has your organization completed for the period of one (1) year prior to the
date of the current bid?
Completion
Contract Amount Class of Work Date Name and Address of Owner
9,946,272.00 Reconstruction May 2020 INDOT
4,287,140.00 Resurface_ November 2G20 Lake Coun H _ pt _
4104874.00 Resurface December 2020 St. Joseph County Airport Authority ;
7 3,698,954.00 Resurface October 2020 INDOT
2. What public works projects are now in process of construction by your organization?
Expected
Date
Ma 202
Contract Amount
Class of WorkCompletion
Name and Address of Owner
6,917 653.00 _
Resurface
1
INDOT
6 716 400.00
Reconstruction
December 2021
INDOT
5,126 831.00
Reconstruction i
November2021
INDOT
3,_338,539.00_ ,
Reconstruction/Sewer 1.1,
December 2021
INDOT
3. Have you ever failed to complete any work awarded to you? No If so, where and why?
4. List references from private firms for which you have performed work.
Gatlin Plumbing & Heating, Inc. 1111 E. Main St., Griffith, IN Ms. Patti Centrowski
Gough, Inc. 2200 E. 88th Dr., Merrillville, IN Mr. Raymond Gough
Dyer Construction Co., 1716 Sheffield Avenue, Dyer, IN Ms. Janet Furman
Grimmer Construction Co., Inc. 2619 Main St., H' hiand, IN Mr. Greg Grimmer
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when
you could begin work, complete the project, number of workers, etc, and any other information which you
believe would enable the governmental unit to consider your bid.)
As required by owner
2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm
who have performed part of the work) that you have used on public works projects during the past five (5)
years along with a brief description of the work done by each subcontractor.
See attached list
3. If you intend to sublet any portion of the work, state the name and address of each subcontractor,
equipment to be used by the subcontractor, and whether you will require a bond. However, if you are
unable to currently provide a listing, please understand a listing must be provided prior to contract
approval. Until the completion of the proposed project, you are under a continuing obligation to
Immediately notify the governmental unit in the event that you subsequently determine that you will use a
subcontractor on the proposed project.
Will supply upon award of contract
4. What equipment do you have available to use for the proposed project? Any equipment to be used by
subcontractors may also be required to be listed by the governmental unit.
See attached list
5. Have you entered into contracts or received offers for all materials which substantiate the prices used In
preparing your proposal? If not, please explain the rationale used which would corroborate the prices
listed.
Yes, we received quotes from potential subcontractors and suppliers
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial
statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to
the governing body awarding the contract must be specific enough In detail so that said governing body can make
a proper determination of the bidder's capability for completing the project if awarded.
SECTION IV CONTRACTOR'S NON — COLLUSION AFFIDAVIT
The undersigned bidder or agent, being duly sworn on oath, says that he 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 include 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.
He 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.
SECTION V OATH AND AFFIRMATION
I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION
CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT.
Dated at South Bend this 14th day of May 2021
Milestone or to orth, Inc.
``,��141 (Name of Organization) ~
�`. �tCdCtprs�O/A ' B
DMO iiary
? c ��pORAre Director of EstimatinQ,_Sou#h Bend
_ c _ --
+ •+ Crlde of Person Signing)
����'i • bNblCa� N ACKNOWLEDGEMENT
�Iiii11
STATE OF Indian }
} ss
COUNTY OF St. Joseph
Before me, a Notary Public, personally appeared the above-named Dustin P. Hilary _ and
swore that the statements contained in the foregoing document are true and correct.
Subscribed and sworn to before me this 11 thday of May
Notary Public rrisha Krueger
My Commission Expires: 6/5/22
4•.r ALISHA KRUEGER
County of Residence: St O kph:Notary PuF�Iic, State of Indiana
1 St.JosephCounty
My Commission Expires
.' c°' June 05, 2022
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General Form No. 96-a
Prescribed by the State Board of
Accounts of Indiana. Revised 1949.
Standard Questionnaires and
Financial Statement for Bidders
Prescribed by
THE STATE BOARD OF ACCOUNTS OF INDIANA
For use in investigating and determining the qualifications of bidders on public
construction when the aggregate cost of any such work or improvement will be Five Thousand
Dollars or more.
These statements to be submitted under oath by each bidder with and as a part of his bid, as provided
by Chapter 306, page 1248, Acts of 1947
Submitted to City of South Bend. Indiana
By Milestone Contractors North, Inc.
Address 1700 E. Main St Griffith. IN 46319
Date submitted May 11 lb, 2021
Filed
A.E. BOYCE CO., MUNCIE, IND.
1
IA Corporation
State of Indiana
Office of the Secretary of State
Certificate of Amendment
of
WALSH & KELLY INC
I, CONNIE LAWSON, Secretary of State, hereby certify that Articles of Amendment of the above
Domestic For-Profit Corporation have been presented to me at my office, accompanied by the fees
prescribed by law and that the documentation presented conforms to law as prescribed by the
provisions of the Indiana Code.
The name following said transaction will be:
MILESTONE CONTRACTORS NORTH, INC.
NOW, THEREFORE, with this document I certify that said transaction will become effective Monday,
February 01, 2021.
In Witness Whereof, I have caused to be affixed my
' y signature and the seal of the State of Indiana, at the City
0:. .�' :�� of Indianapolis, February 01, 2021
�.• �`.z
~~' '�.••�. CONNIE LAWSON
••lei SECRETARY OF STATE
194484-057/ 8878219
To ensure the certificate's validity, go to https:j/bsd.sos.in.gov/PublicBijsiness5earch
State of Indiana
Office of the Secretary of State
Certificate of Assumed Business Name
of
MILESTONE CONTRACTORS NORTH, INC.
I, CONNIE LAWSON, Secretary of State, hereby certify that a Certificate of Assumed Business Name of the
above Domestic For-Profit Corporation has been presented to me at my office, accompanied by the fees
prescribed by law and that the documentation presented conforms to law as prescribed by the provisions
of the Indiana Code.
Following said transaction, the above named entity will transact business under the assumed business
name(s) of:
WALSH & KELLY
NOW, THEREFORE, with this document I certify that said transaction will become effective Monday,
February 01, 2021.
i"A'rE... In Witness Whereof, I have caused to be affixed my
signature and the seal of the State of Indiana, at the City of
Indianapolis, February 01, 2021.
•Z
.��•'r~••N•N�N�� �CONNIE I.AW50N
rate SECRETARY OF STATE
194484-057 X8878234
To ensure the certificate's validity, go to https:/lbsd.sos.in.gov/PublicBusinessSearch
State of Indiana
Office of the Secretary of State
CERTIFICATE OF EXISTENCE
To Whom These Presents Come, Greeting:
I, HOLLI SULLIVAN, Secretary of State of Indiana, do hereby certify that I am, by virtue of the laws of
the State of Indiana, the custodian of the corporate records and the proper official to execute this
certificate.
I further certify that records of this office disclose that
MILESTONE CONTRACTORS NORTH, INC.
duly filed the requisite documents to commence business activities under the laws of the State of
Indiana on March 29, 1966, and was in existence or authorized to transact business in the State of
Indiana on April 20, 2021.
I 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 of State
have been paid.
STAT'.
••. �(i In Witness Whereof, I have caused to be affixed my
•ti r� signature and the seal of the State of Indiana, at the City
0,•'• - ��� of Indianapolis, April 20, 2021
~• ~' ••f:W HOLU SULLIVAN
•� Rarara.rr•.r••
SECRETARY OF STATE
194484-057 / 20211975223
All certificates should be validated here: https:/Ibsd.sos.in.gov/VaildateCertificate
Expires on May 20, 2021.
Form WW-- Request for Taxpayer
(Rev. October 2018) Identification Number and Certification
ZWDepartment of the Treasury
WI Revenue Service ► Go to wwwJrs.gov/FlormM for instructions and the latest information.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this fine blank.
MILESTONE CONTRACTORS NORTH, INC.
4 Business nanne/dIsregarded entity name, If different from above
WALSH & KELLY, INC.
m 3 Check appropriate box for federal tax classification of the person whose name is entered on Una 1. Check only one of the
following seven boxes.
C
O
ai
rA
-iS
❑ Individuatkole proprietor or ❑ C Corporation El 5 Corporation ❑ Partnership
aingle-member LLC
❑ Tnustiestate
Give Form to the
requester. Do not
send to the IRS.
)—____.
4 Exemptions (codes apply only to
certain entlHes, not incitvlduale; sea
instructions on page 4
Exempt payee code (If any)
❑ Umlted liability company. Enter the tax dassFflcatlon (C -C corporation, S -S corporation, F6Partnership) 110 -
Note:
Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting
LLC If the LLC Is classified as a shpts -member LLC that is disregarded from the owner unleas the owner of the LLC Is
another LLcoda Pf aC that fe not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that r'y)
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
❑ Other (am Instructions) ► W,4e8 W 6W.00712 mdw~ cub de to us.J
5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional)
1700 EAST MAIN STREET
8 City, state, and 7P code
GRIFFITH, IN 46319
7 Lht account number(,) here (optional)
Identification
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. o r individuals, this LS generally your social security number Bair. However, for a
ro- m -
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I,,later. For other
entities, it Is your employer Identification number (EIN). If you do not have a number, see Now to get a
TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name andirnployer identiffc_ation number
Number To Give the Requesterfor guidelines on whose number to enter. ��
13151 -11 1 1 1 2 1 0 1 6T81 51
JaMULI Ced cation
Under penalties of perjury, I certify that:
1. The number shown on this form Is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because. (a) I am exempt from backup withholding, or (b) I have not been notlW by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I on
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered an this form Of any) indicating that I em exempt from FATCA reporting is correct.
Certification Instructions. You must cross alt item 2 above 9 you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement ORA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign Signature of
H@re U.S. Person ► %Z'1(j( v lam' ► t W� (DVI tn G� Date ► �`, q Zi
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest Information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to wwwJrs.gov1FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
Identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITiN), adoption
taxpayer identification number (AMN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not lirrited to, the following.
• Form 1099 -INT (interest earned or paid)
• Form 1099 -DIV (dividends, Including those from stocks or mutual
funds)
• Form 1099-NpSC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tultion)
• Form 1099-C (canceled debt)
• Form 1 D99 -A (acquisition or abandonment of secured property)
Use Form W-9 oNy it you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do*not ratum Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What Is backup withholding,
later.
Cat. No. 10011X Form W-9 (Rev. 110-2018)
CERTIFICATE OF QUALIFICATION
to provide
CONSTRUCTION SERVICES
for
PUBLIC WORKS PROJECTS
to the
STATE OF INDIANA
This Certification Board, having duly considered application for qualification in terms of apparent experience and financial
resources; and under the applicable Indiana Code 4-13.611 and adopted rules of this Board, hereby issues a
Certificate of Qualification to provide construction services to the State of Indiana for Public Works Projects to:
WALSH - KELLY INC
1700 E MAIN ST
GRIFFITH IN 46319
Phone 219-924-5900
Fax 219-924-8768
Company Official
JOHN PEISKER
for the twenty-seven month period stated herein, unless revoked by this Board for cause,
and in the classifications of services stated below. This certificate supercedes any previous certificate.
1611.01 Concrete Construction of Roads 8r Curbing
1611.02 Asphalt Construction of Roads and Parking Lots
CERTIFICATION DATE 1114/2020
EXPIRATION DATE 2/4/2023
THIS CERTIFICATE ISSUED BY THE STATE OF INDIANA, PUBLIC WORKS DIVISION CERTIFICATION BOARD,
402 WEST WASHINGTON STREET, ROOM W467, INDIANAPOLIS, INDIANA 46204,
ALSO ACTS AS THE OFFICIAL NOTICE OF EXPIRATION.
Tracy L. Cross, Ex tive Secretary
Certification Board
DAPW P02 State Form 3983R Rev. 07106
WRITTEN CONSENT TO RESOLUTIONS
of the
BOARD OF DIRECTORS
of
WALSH & KELLY, INC.
The undersigned, being all of the members of the Board of Directors (the "Board") of Walsh &
Kelly, Inc. ("Company"), hereby consent to the following Resolutions in lieu of a special meeting of the
the Board:
WHEREAS, The Board believes that it is in the best interest of the Company to
amend the Articles of Incorporation to change the name of the Company to Milestone
Contractors North, Inc. ("Name Change");
NOW, THEREFORE, BE IT RESOLVED, that the Board recominends the filing
of the Articles of Amendment to the Articles of Incorporation;
FURTHER RESOLVED, that the Board and/or any officer of the Company,
signing singly, are hereby authorized and directed to file the Articles of Amendment to
the Articles of Incorporation with the Indiana Secretary of State and to execute and
deliver any such additional documents, assignments, instruments and agreements and to
take such further actions as may be deemed necessary or appropriate in cormection with
the Name Change.
RESOLVED, FURTHER, that the Board and/or any officer of the Company,
signing singly, is, hereby authorized and directed to take any and all additional steps and
actions which are necessary and advisable in order to carry out the intent and purpose of
the foregoing resolutions; and
RESOLVED, FURTHER, that this Consent may be executed in one or more
counterparts, each of which shall be deemed an original and all of which together shall
constitute one and the same Consent, and any facsimile or electronic transmission of a
signed counterpart shall be deemed to be an original counterpart and any signature
appearing thereon shall be deemed to be an original signature.
Signature Page Follows
Dated effective as of the 1" day of February, 2021
Fred FehseAFeld,Jr.
AW4 Albert �5 t1g1vlOXg`
Bergh (Mar 26,202120:25 -EDT)
Albert E. VanDenBergh
Geoffrey C. Dillon V
James C. Fehsenfeld
p -
John P. Vercruysse
WRITTEN CONSENT TO RESOLUTIONS
of the
BOARD OF DIRECTORS
of
MILESTONE CONTRACTORS NORTH, INC.
The undersigned, being all of the Directors of MILESTONE CONTRACTORS NORTH,
INC., an Indiana Corporation, hereby consent to the following actions to be taken by the Corporation
without a meeting of the Board of Directors under the applicable provisions of the Indiana Business
Corporation Law, as amended:
RESOLVED that the following be, and hereby are, elected officers of the Corporation,
to hold the office until the next regular meeting of the Board of Directors and until their
successors are duly elected and have qualified:
Todd A. Fawver
Charles Potts Jr.
John P. Vercruysse
Jamie L. Tancos
Albert E.VanDenBergh
David L. Franz
John M. Peisker
Patrick J. Walters
Brad McCall
Derek Merida
Lynn J. Bauer
David M. Kozyra
Mark Andrews
President
Chief Operating Officer, Construction
Executive Vice President
Vice President, Secretary & Treasurer
Vice President
Vice President
Vice President, Production
Vice President, Finance
Vice President, Estimating
Vice President, Bridge Operations
Vice President/Area Manager, South Bend
Vice President/Area Manager, Griffith
Executive Vice President
RESOLVED FURTHER that the above officers be, and they hereby are, authorized to
execute all contracts or similar documents on behalf of the Corporation. In addition to
the above officers the following are hereby appointed as authorized signers on behalf
of the Corporation:
David J. Misirly Senior Estimator
Gregory A. Hoffman Director of Estimating, Griffith
Dustin P. Hilary Director of Estimating, South Bend
Mark E. Krachenfels Construction Manager
RESOLVED FURTHER that the actions of the Officers of the Corporation taken since
the last meeting of the Board of Directors be, and the same hereby are, fully ratified
and approved.
RESOLVED FURTHER that this consent shall be in lieu of an annual meeting of the
Board of Directors of the Corporation and shall be filed in the minute book of the
Corporation in place of any such annual minutes.
-.__--��fGhiA'�UI3F;OI THE NEXT PA
EXECUTED this 2"d day of February, 2021.
Fred Fehsenfeld, Jr.
,411,e1 -e 15Vkoglr,-
Albert EVanOenBer¢hNarM.X." ]2 OT)
Albert E. VanDenBergh
Geoffrey C. Dillon
9— c / �y
James C. Fe senfeld
i2U . iA 4,%A4A Bil i
John P. Vercruysse
PAil Milestone
EQUAL EMPLOYMENT OPPORTUNITY!
AFFIRMATIVE ACTION POLICY STATEMENT
It is the policy of Milestone Contractors to afford equal opportunity for employment to all individuals regardless of
race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, housing status, or
veterans' status. The corporation is committed to this policy by our status as a federally assisted government
contractor. We are far more strongly bound to the policy by the fact that adherence to the principles involved is the
only acceptable American way of life. Therefore, it is the policy of this corporation to assure that applicants are
employed, and that employees are treated during employment without regard to race, color, religion, sex, sexual
orientation, gender identity, national origin, age, disability, housing status, or veterans' status. Such action shall
include: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or
termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre -
apprenticeship, and/or on-the-job training.
The successful achievement of a nondiscriminatory employment program requires a maximum of cooperation
between management and employees. In fulfilling its' part in this cooperative effort, management is obliged to lead
the way by establishing and implementing affirmative procedures and practices which will ensure our objective,
namely equitable employment opportunity for all. (Minority and female employees are encouraged to participate
in all company activities and refer applicants.)
I have designated Margaret Garner to direct the establishment of and to monitor the implementation of personnel
procedures to guide our affirmative action program. This official is charged with designing and implementing audit
and reporting systems that will keep management informed on a regular basis of the status of equal employment
opportunity and affirmative action. She can be reached at (317)616-4937.
Supervision has been made to understand that their work performance is being evaluated based on their equal
employment opportunity efforts and results, as well as other criteria. It shall be a responsibility of the supervision
to take actions to prevent harassment of employees placed through affirmative action efforts.
We shall comply with the Civic Rights Act of 1964, as amended, the Federal Highway Act of 1968, the Executive Order
#11246 and #11375, the Rehabilitation Act of 1973, as amended, the Vietnam Era Veterans Readjustment Assistance
Act of 1974, as amended, the Indiana Civil Rights Act and other applicable Federal and State Laws and regulations
pertaining to equality of Opportunities and Affirmative Action policies. We have developed an Affirmative Action
Program for Veterans and Individuals with Disabilities.
G Poi , Chief Operating Officer
-�' /'=•_,sem• _,�` �-�'� _.�
Margaret Garner, HR Area Partner/EEO Officer
February 2021
EOE MIF/Vets/Dlsabled
Milestone
DATE: February 26, 2021
TO: All Employees
RE: EEO Officer Appointment
Margaret Garner has been appointed Equal Employment Opportunity Officer for Milestone
Contractors. It is her responsibility to coordinate, advise and assist management and
supervisors in their responsibilities of assuring all applicants and employees' equal
opportunities in all aspects of their employment. She will review complaints that allege
discrimination because of race, religion, color, sex, sexual orientation, gender identity, age,
national origin, disability, housing status or veteran status.
Employees of Milestone Contractors are to submit any issues or concerns to Margaret. We are
committed to comply with the provisions of the Civil Rights Act of 1964 and 1991, plus all
Executive Orders issued relating to Equal Employment.
Margaret's contact information is listed below.
Milestone Contractors
7661 N Perimeter Rd, Suite 200
Indianapolis, IN 46241
(317)616-4937
Ci PsiAs, Chief Operating Officer
EOE NI/FNets/Disabled
Canlirw of (uatiru-tim
ISSUED BY
Ila i hi Iii 11 il,' 111J 1 1 J 1
INDIANAPOLIS, IN
TO
WALSH & KELLY INC
May 21, 2020
GRIFFITH, IN
who has filed with the Department a Contractor's Statement of Experience and Financial Condition as
required under Indiana Code 8-23-10, is hereby qualified to bid at any Department of Transportation
letting in Classes of Work and within the amount and other limitation of each classification as listed
below, for such period as the uncompleted work on hand from all sources does not exceed the Aggregate
amount. Classification references by name or symbol are in accordance with the definitions in the
Contractor's Statement of Experience and Financial Condition. This certificate supersedes any certificate
previously issued, but is subject to revision or revocation according to the law, if and when changes
in the financial condition of the contracting firm or other facts justify such revision or revocation.
Valid May 21, 2020 Thru April 30, 2021
AGGREGATE.......................................................................................................................
................ $UNLIMITED
A(B)
CONCRETE PAVEMENT: LIMITED.........................................................................................................
$25,000,000
B(A)
ASPHALT PVMT:W/INDOT CERTIFIED HMA PLANT..........................................................................$UNLIMITED
C(B)
LIGHT GRADING..........................................................................................................................---..........$UNLIMITED
E(E)
SMALL STRUCTURES AND DRAINAGE ITEMS....................................................................................
$25,000,000
E(F)
SURFACE MASONRY AND MISC CONCRETE.......................................................................................
$50,000,000
E(G)
TRAFFIC CONTROL: PAVEMENT MARKINGS......................................................................................
$25,000,000
E(H)
DEEP SEWER AND/OR EXCAVATION....................................................................................................
$25,000,000
E(Q)
CONCRETE PAVEMENT: REPAIRS.........................................................................................................
$25,000,000
E(R)
ASPHALT PAVEMENT MILLING..............................................................................................................
$50,000,000
PREQUALIFICATION ENGINEER
State Form 20508 (R315-05)
COMMISSIONER
PREQUALIFICATION WORKSHEET
ACCT: #35-1120685 ALT ACCT: # 0449 NEW?
SUPP?
NAME: WALSH & KELLY INC
$4,5
------------016
------,18
------ --
-QU---ICK ----- RATIO: -----------------------------------
December 31, 2019
CURRENT
FIXED
------------------------------------------------------------------------------------------------------
ASSETS REPORTED
$47,119,378.00
$10,219,627.00
LIABILITIES REPORTED
($16,158,151.00)
($16,742,213.00)
------------------------------------------------------------------------------------------------------
NET ASSETS REPORTED
$30,961,227.00
($6,522,586.00)
09 OMIT NO DETAIL OR QUANTITY
($4,016,185.00)
$0.00
11 OMIT NO DETAIL
($277,917.00)
$0.00
15 CASH SURRENDER VALUE
$1,390,248.00
($1,390,248.00)
16 OMIT INTANGIBLES
$0.00
($864,210.00)
22 DUE AFTER 24 MONTHS
$0.00
$13,536,060.00
NET FIXED ASSETS
$25,000,000
EQUIPMENT
PRINTED: 5/21/2020
PQA APPROVED: 5/7/2020
APPROVED BY:
DATE: 5/21/2020
$31,032,017.00 VALID: 5/21/2020
EXPIRES: 4/30/2021
$31,032,017.00 DENIAL DATE:
______________________ DENIAL REASON:
$0.00
$0.00
$0.00
$0.00
$0.00
$0
NET FIXED ASSETS EQUIPMENT $0
NET ACCEPTABLE ASSETS $28,057,373 $4,759,016 $31,032,017
RATING FACTORS X 10 X 2 X 8
---------- - - ----------------------------
---------------------------------------------------------------------------
-------
RATING COMPONENTS $280,573,730 $9,518,032 $248,256,136
X 1.5 - $248,256,136
--------------------------
MAXIMUM EQUIPMENT $420,860,595 $0
8.00
$248,256,136 $0
+ $280,573,730
+ $4------16
--------------- --------------------------
$528,829,866 $4,759,016
X 0.25 X 2
MAXIMUM FIXED $132,207,467 ADJ. FIXED $9,,
-------------------------- ------------ - ---- - 518032 --------
BALANCE SHEET ANALYSIS
CURRENT ASSETS:
INVENTORY:
--------------------------------
CURRENT LIABILITIES:
--------------------------------
LONG TERM LIABILITIES:
-------------------
NET WORTH:
--------------------------------
TOTAL LIABILITIES:
NOTES
$47,119,378
CURRENTRATIO:
2.916
$4,5
------------016
------,18
------ --
-QU---ICK ----- RATIO: -----------------------------------
2.668
$16,158,151
---------------------------
WORKING CAPITAL:
-------------------------------
$30,961,227
--------------
$16,742,213
---------------------------
DEBT/NETWORTH:
0.593
$55,470,656
--------------------------
0%
AGGREGATE
----------------------------------------
$32,900,364
---------------------------------------------------------
C(B)
UNLIMITED
COMPONENT
RATING
---------------------------------------------------------
CURRENT
$280,573,730.00
FIXED
$9,518,032.00
EQUIPMENT
$248,256,136.00
MAXIMUM BALANCE
---------------------
$538,347,898.00
STATEMENT TYPE:
AUDITED
EXPER. REDUCTION
0%
AGGREGATE
----------------------------------------
UNLIMITED
---------------------------------------------------------
C(B)
UNLIMITED
B(A)
UNLIMITED
E(F)
$50,000,000
E(E)
$25,000,000
E(R)
$50,000,000
A(B)
$25,000,000
E(Q)
$25,000,000
E(H)
$25,000,000
E(G)
$25,000,000