HomeMy WebLinkAboutAward Quote - Installation of Temporary Speed Tables On Call Proj No. 121-042 - Selge Contruction Co., Inc.
ELIZABETH A. MARADIK GARY A. GILOT JORDAN V. GATHERS JOSEPH R. MOLNAR MURRAY L. MILLER
1316 COUNTY-CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/ 235-9251
FAX 574/ 235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
May 25, 2021
Ms. Vicki Priest
Selge Construction Co., Inc.
2833 S. 11th. St.
Niles, MI 49120
jbutler@selgeconstruction.com; vpriest@selgeconstruction.com
RE: Quotation Award – Installation of Two (2) Temporary Speed Tables – On Call
Project No. 121-042
Dear Ms. Priest:
At its May 25, 2021 meeting, the Board of Public Works awarded the above referenced
quotation to you in the amount of $20,000.
Please forward the following documents in one submittal by June 8, 2021 to my
attention for Board of Public Works approval:
3) One (1) signed original of the Contract (enclosed); and
4) Certificate of Insurance naming the City of South Bend as an additional insured.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
/s/ Anne Fuchs
Anne Fuchs, Clerk
Enclosures
AF/lh
ELIZABETH A. MARADIK GARY A. GILOT JORDAN V. GATHERS JOSEPH R. MOLNAR MURRAY L. MILLER
1316 COUNTY-CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/ 235-9251
FAX 574/ 235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
May 25, 2021
Ms. Nancy Knapik
HRP Construction Inc.
5777 Cleveland Rd., PO Box 266
South Bend, IN 46624
joej@hrpconstruction.com
RE: Quotation Award – Installation of Two (2) Temporary Speed Tables – On Call
Project No. 121-042
Dear Ms. Knapik:
At its May 25, 2021 meeting, the Board of Public Works awarded the above referenced
quotation to Selge Construction Co., Inc. in the amount of $20,000.
If you have any further questions regarding this matter, please call this office at (574)
235-9251.
Sincerely,
/s/ Anne Fuchs
Anne Fuchs, Clerk
AF/lh
ELIZABETH A. MARADIK GARY A. GILOT JORDAN V. GATHERS JOSEPH R. MOLNAR MURRAY L. MILLER
1316 COUNTY-CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/ 235-9251
FAX 574/ 235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
May 25, 2021
Mr. Dustin Hilary
Milestone Contractors North, Inc.
24358 State Road 23
South Bend, IN 46614
akrueger@milestonelp.com
RE: Quotation Award – Installation of Two (2) Temporary Speed Tables – On Call
Project No. 121-042
Dear Mr. Hilary:
At its May 25, 2021 meeting, the Board of Public Works awarded the above referenced
quotation to Selge Construction Co., Inc. in the amount of $20,000.
We thank you for quoting and hope you will quote with us again in the future.
If you have any further questions regarding this matter, please call this office at (574)
235-9251.
Sincerely,
/s/ Anne Fuchs
Anne Fuchs, Clerk
AF/lh
ELIZABETH A. MARADIK GARY A. GILOT JORDAN V. GATHERS JOSEPH R. MOLNAR MURRAY L. MILLER
1316 COUNTY-CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/ 235-9251
FAX 574/ 235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
May 25, 2021
Mr. Ruben Alvarado
Rieth-Riley Construction Co., Inc.
25200 State Road 23
South Bend, IN 46614
ralvarado@rieth-riley.com
RE: Quotation Award – Installation of Two (2) Temporary Speed Tables – On Call
Project No. 121-042
Dear Mr. Alvarado:
At its May 25, 2021 meeting, the Board of Public Works awarded the above referenced
quotation to Selge Construction Co., Inc. in the amount of $20,000.
If you have any further questions regarding this matter, please call this office at (574)
235-9251.
Sincerely,
/s/ Anne Fuchs
Anne Fuchs, Clerk
AF/lh
ELIZABETH A. MARADIK GARY A. GILOT JORDAN V. GATHERS JOSEPH R. MOLNAR MURRAY L. MILLER
1316 COUNTY-CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/ 235-9251
FAX 574/ 235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
May 25, 2021
Mr. Blake Marshall
GE Marshall, Inc.
1351 Joliet Rd.
Valparaiso, IN 46385
blake.marshall@gemarshall.com
RE: Quotation Award – Installation of Two (2) Temporary Speed Tables – On Call
Project No. 121-042
Dear Mr. Marshall:
At its May 25, 2021 meeting, the Board of Public Works awarded the above referenced
quotation to Selge Construction Co., Inc. in the amount of $20,000.
If you have any further questions regarding this matter, please call this office at (574)
235-9251.
Sincerely,
/s/ Anne Fuchs
Anne Fuchs, Clerk
AF/lh
INTER-OFFICE MEMORANDUM
DEPARTMENT OF PUBLIC WORKS
DIVISION OF ENVIRONMENTAL SERVICES
TO: Board of Public Works
Anne Fuchs, Clerk
FROM: Leslie Biek, P.E., Assistant City Engineer
Kara Boyles, Ph.D., P.E., City Engineer
SUBJECT: Approval of Quote for the Installation of Temporary Speed Tables
PN 121-042 PR-9540
DATE: 5/25/2021
Engineering is requesting approval of quotes received for the installation of two (2) temporary speed
tables located on residential streets. The contractor would have one week to install the speed tables
once the City gave them the notice to proceed and provided the locations. This would be an on-call
agreement with the contractor that would remain in effect until November 1, 2021. The City would
provide the temporary speed tables to the contractor for installation.
Quotes were by due Monday 5/24/21 by 5pm. One quote was received from Selge Construction Inc
for the price of $20,000.
Funding Source: 251-06-600-506-442001
It is requested the Board of Public Works approve the on-call contract with Selge Construction for the
installation of two (2) temporary speed tables for the contract price of $20,000.
Thank you for your consideration of this request.
25th. May 21
BOARD OF PUBLIC WORKS
CITY OF SOUTH BEND, INDIANA
PUBLIC WORKS CONTRACT
THIS AGREEMENT, made and entered into this 25th Day of May, 2021, by and between, Selge
Construction Co., Inc. 2833 S. 11th. St. Niles, MI 49120, HEREINAFTER called the Contractor,
and the Board of Public Works herein called the "Board".
WITNESSETH: That the Contractor covenants and agrees to make the following improvement,
as fully set out in the Request for Quotations, Standard Specifications, Special Provisions, Plans,
and Bid Proposals, all of which are set forth as a part of this Contract, for:
PROJECT NO. 121-042
DESCRIPTION: INSTALLATION OF TEMPORARY SPEED TABLES - ON CALL
COMPLETION DATE: SEE SPECIFICATIONS
AMOUNT: $20,000
FUNDING: PR-00009540
The unit prices for this improvement were those prices as received and accepted by the Board on
the 24th Day of May, 2021.
The Contractor further agrees to notify the assigned Engineer when this improvement is
completed. This notification shall be in the form of a Project Completion Affidavit, signed by the
Contractor. Upon final acceptance of the improvement by the Engineer, the Contractor’s final
estimate will be presented to the Board for final Payment with one (1) copy of the Project
Completion Affidavit and one (1) copy of a Waiver of Lien.
Each of the Parties, by signing below, represents and warrants to the other Party that he/she/it has
the authority to bind the named person or entity to this Agreement.
BOARD OF PUBLIC WORKS SELGE CONSTRUCTION CO.,
INC,
President Member Printed Name
Member Member Signature
Member Attest: Anne Fuchs, Clerk
INTER-OFFICE MEMORANDUM
DEPARTMENT OF PUBLIC WORKS
DIVISION OF ENVIRONMENTAL SERVICES
TO: Board of Public Works
Anne Fuchs, Clerk
FROM: Leslie Biek, P.E., Assistant City Engineer
Kara Boyles, Ph.D., P.E., City Engineer
SUBJECT: Approval of Quote for the Installation of Temporary Speed Tables
PN 121-042 PR-9540
DATE: 5/20/2021
Engineering is requesting approval of quotes received for the installation of two (2) temporary speed
tables located on residential streets.
Quotes will be due Monday 5/24/21 by 5pm. Engineering will prepare an updated memo with the
quotes that were received with a recommendation for approval prior to the BPW meeting.
Funding Source: 251-06-600-506-442001
Thank you for your consideration of this request.
City of South Bend
Department of Public Works
Division of Engineering
Bureau of Public Construction
227 West Jefferson RM# 1316
South Bend, Indiana 46601
May 20, 2021
HRP Construction Inc.
5777 Cleveland Road, P.O. Box 266
South Bend, IN 46628
RE: Request for Quotations
Installation of Temporary
Speed Humps On Call
Project No. 121-042
Dear Sir or Madam:
The City of South Bend solicits your quotation for on call installation of temporary speed humps in various
locations within the City of South Bend. The selected contractor must mobilize within one week when an
installation is requested by the City. These will be installed on residential streets, so detours will not be
needed. The City will allow and permit full closures for this work. MUTCD guidelines will need to be
followed for the closure, with two barricades on each end. The spec sheet for the temporary speed humps
and the installation guide are included with this quote request. This City will provide the temporary speed
humps to be installed. The temporary speed hump will be 27ft, 10in x 13ft 4in.
Your electronic quote must be on the City of South Bend Contractor’s Quote for Public Work Form,
The Title of the Bid and Project Number as described above must be included in the subject line of the
email to which you have attached your quote. The name of the company/vendor, address, contact email
address and phone number must be included in the body of the email. Please submit quotes to
cbrach@southbendin.gov.
Your quote is due by 5:00 P.M., Local Time, Monday, May 24, 2021. Any quotes received after
this time will not be opened. All quotes received by this time will be opened and read , and an award
is expected to be announced at the Board of Public Works meeting date on May 25, 2021 . This
contract will remain in effect until November 1, 2021.
Upon award, all required documentation must be provided to the Clerk of the Board of Public
Works within seven days.
If you have any questions or concerns, please contact me at (574) 235-9246 or by email at
cbrach@southbendin.gov.
Best Regards,
Charlotte Brach
Project Engineer
Enc.: Installation of Temporary Speed Humps On Call – Quote Form, Spec Sheet and Installation
Guide
c: File
City of South Bend
Department of Public Works
Division of Engineering
Bureau of Public Construction
227 West Jefferson RM# 1316
South Bend, Indiana 46601
May 20, 2021
Milestone Contractors North Inc.
24358 SR 23
South Bend, IN 46614
RE: Request for Quotations
Installation of Temporary
Speed Humps On Call
Project No. 121-042
Dear Sir or Madam:
The City of South Bend solicits your quotation for on call installation of temporary speed humps in various
locations within the City of South Bend. The selected contractor must mobilize within one week when an
installation is requested by the City. These will be installed on residential streets, so detours will not be
needed. The City will allow and permit full closures for this work. MUTCD guidelines will need to be
followed for the closure, with two barricades on each end. The spec sheet for the temporary speed humps
and the installation guide are included with this quote request. This City will provide the temporary speed
humps to be installed. The temporary speed hump will be 27ft, 10 in. x 13ft 4in.
Your electronic quote must be on the City of South Bend Contractor’s Quote for Public Work Form,
The Title of the Bid and Project Number as described above must be included in the subject line of the
email to which you have attached your quote. The name of the company/vendor, address, contact email
address and phone number must be included in the body of the email. Please submit quotes to
cbrach@southbendin.gov.
Your quote is due by 5:00 P.M., Local Time, Monday, May 24, 2021. Any quotes received after
this time will not be opened. All quotes received by this time will be opened and read , and an award
is expected to be announced at the Board of Public Works meeting date on May 25, 2021 . This
contract will remain in effect until November 1, 2021.
Upon award, all required documentation must be provided to the Clerk of the Board of Public
Works within seven days.
If you have any questions or concerns, please contact me at (574) 235-9246 or by email at
cbrach@southbendin.gov.
Best Regards,
Charlotte Brach
Project Engineer
Enc.: Installation of Temporary Speed Humps On Call – Quote Form, Spec Sheet and Installation
Guide
c: File
City of South Bend
Department of Public Works
Division of Engineering
Bureau of Public Construction
227 West Jefferson RM# 1316
South Bend, Indiana 46601
May 20, 2021
Rieth Riley Construction Co., Inc.
25200 State Road 23
South Bend, IN 46614
RE: Request for Quotations
Installation of Temporary
Speed Humps On Call
Project No. 121-042
Dear Sir or Madam:
The City of South Bend solicits your quotation for on call installation of temporary speed humps in various
locations within the City of South Bend. The selected contractor must mobilize within one week when an
installation is requested by the City. These will be installed on residential streets, so detours will not be
needed. The City will allow and permit full closures for this work. MUTCD guidelines will need to be
followed for the closure, with two barricades on each end. The spec sheet for the temporary speed humps
and the installation guide are included with this quote request. This City will provide the temporary speed
humps to be installed. The temporary speed hump will be 27ft, 10in. x 13ft 4in.
Your electronic quote must be on the City of South Bend Contractor’s Quote for Public Work Form,
The Title of the Bid and Project Number as described above must be included in the subject line of the
email to which you have attached your quote. The name of the company/vendor, address, contact email
address and phone number must be included in the body of the email. Please submit quotes to
cbrach@southbendin.gov.
Your quote is due by 5:00 P.M., Local Time, Monday, May 24, 2021. Any quotes received after
this time will not be opened. All quotes received by this time will be opened and read , and an award
is expected to be announced at the Board of Public Works meeting date on May 25, 2021 . This
contract will remain in effect until November 1, 2021.
Upon award, all required documentation must be provided to the Clerk of the Board of Public
Works within seven days.
If you have any questions or concerns, please contact me at (574) 235-9246 or by email at
cbrach@southbendin.gov.
Best Regards,
Charlotte Brach
Project Engineer
Enc.: Installation of Temporary Speed Humps On Call – Quote Form, Spec Sheet and Installation
Guide
c: File
City of South Bend
Department of Public Works
Division of Engineering
Bureau of Public Construction
227 West Jefferson RM# 1316
South Bend, Indiana 46601
May 20, 2021
Selge Construction
2833 S 11th Street
Niles, MI 49120
RE: Request for Quotations
Installation of Temporary
Speed Humps On Call
Project No. 121-042
Dear Sir or Madam:
The City of South Bend solicits your quotation for on call installation of temporary speed humps in various
locations within the City of South Bend. The selected contractor must mobilize within one week when an
installation is requested by the City. These will be installed on residential streets, so detours will not be
needed. The City will allow and permit full closures for this work. MUTCD guidelines will need to be
followed for the closure, with two barricades on each end. The spec sheet for the temporary speed humps
and the installation guide are included with this quote request. This City will provide the temporary speed
humps to be installed. The temporary speed hump will be 27ft, 10in x 13ft 4in.
Your electronic quote must be on the City of South Bend Contractor’s Quote for Public Work Form,
The Title of the Bid and Project Number as described above must be included in the subject line of the
email to which you have attached your quote. The name of the company/vendor, address, contact email
address and phone number must be included in the body of the email. Please submit quotes to
cbrach@southbendin.gov.
Your quote is due by 5:00 P.M., Local Time, Monday, May 24, 2021. Any quotes received after
this time will not be opened. All quotes received by this time will be opened and read , and an award
is expected to be announced at the Board of Public Works meeting date on May 25, 2021 . This
contract will remain in effect until November 1, 2021.
Upon award, all required documentation must be provided to the Clerk of the Board of Public
Works within seven days.
If you have any questions or concerns, please contact me at (574) 235-9246 or by email at
cbrach@southbendin.gov.
Best Regards,
Charlotte Brach
Project Engineer
Enc.: Installation of Temporary Speed Humps On Call – Quote Form, Spec Sheet and Installation
Guide
c: File
City of South Bend
Department of Public Works
Division of Engineering
Bureau of Public Construction
227 West Jefferson RM# 1316
South Bend, Indiana 46601
May 20, 2021
GE Marshall, Inc.
1351 Joliet Rd.
Valparaiso, IN 46385
RE: Request for Quotations
Installation of Temporary
Speed Humps On Call
Project No. 121-042
Dear Sir or Madam:
The City of South Bend solicits your quotation for on call installation of temporary speed humps in various
locations within the City of South Bend. The selected contractor must mobilize within one week when an
installation is requested by the City. These will be installed on residential streets, so detours will not be
needed. The City will allow and permit full closures for this work. MUTCD guidelines will need to be
followed for the closure, with two barricades on each end. The spec sheet for the temporary speed humps
and the installation guide are included with this quote request. This City will provide the temporary speed
humps to be installed. The temporary speed hump will be 27ft, 10in x 13ft 4in.
Your electronic quote must be on the City of South Bend Contractor’s Quote for Public Work Form,
The Title of the Bid and Project Number as described above must be included in the subject line of the
email to which you have attached your quote. The name of the company/vendor, address, contact email
address and phone number must be included in the body of the email. Please submit quotes to
cbrach@southbendin.gov.
Your quote is due by 5:00 P.M., Local Time, Monday, May 24, 2021. Any quotes received after
this time will not be opened. All quotes received by this time will be opened and read , and an award
is expected to be announced at the Board of Public Works meeting date on May 25, 2021 . This
contract will remain in effect until November 1, 2021.
Upon award, all required documentation must be provided to the Clerk of the Board of Public
Works within seven days.
If you have any questions or concerns, please contact me at (574) 235-9246 or by email at
cbrach@southbendin.gov.
Best Regards,
Charlotte Brach
Project Engineer
Enc.: Installation of Temporary Speed Humps On Call – Quote Form, Spec Sheet and Installation
Guide
c: File
Version 2/14/2020 Page - 1 Public Works Quote
CITY OF SOUTH BEND, INDIANA
CONTRACTOR’S QUOTE FOR PUBLIC WORK
PROJECT NAME: Installation of Temporary Speed Humps On Call
PROJECT NO. 121-042
QUOTES DUE Monday, May 24th, 2021 at 5:00pm Local Time
(Must be completed for all quotes. Please type or print)
Date: Firm:
Address:
City/State/Zip: Telephone Number: ( )
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:
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
The City of South Bend, Department of Public Works
and dated for the sum of (enter the Total Quote as shown on the Proposal)
($ )
(Enter Sum of Total Quote plus Alternates shown on Proposal) (Numerical)
If alternative quotes apply, the undersigned submits a proposal for each in accordance with the notice. Any
addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are needed, the cost of units must be the same as that shown
in the original contract if accepted by the City of South Bend. If the quote is to be awarded on a unit basis, the
itemization of the units shall be shown on a separate attachment.
ACCEPTANCE
The above quote 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 Murray L. Miller, Member
Jordan V. Gathers, Member
Attest: Anne Fuchs, Clerk
By
(Signature)
(Printed Name of Person Signing)
Version 2/14/2020 Page - 2 Public Works Quote
QUOTE/PROPOSAL
CITY OF SOUTH BEND
PROJECT NAME Installation of Temporary Speed Humps On Call
PROJECT NO. 121-042
QUOTES DUE Monday, May 24th, 2021 at 5:00pm Local Time
Item
No. Description Quantity Unit Unit Price Total Amount
1
On Call Installation of Temporary
Speed Humps – 27ft 10in x 13ft
4in w/10 arrows (spec sheet
attached)
2 EA $
Total Amount of Quote $
Firm:
Address:
City/State/Zip: Telephone Number: ( )
Fax Number: ( )
By
(Signature)
(Printed Name of Person Signing)
Version 2/14/2020 Page - 3 Public Works Quote
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this A ffidavit.
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 ___________ )
) SS:
COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that:
1. Contractor has not, nor has any other member, representative, or agent of the firm,
company, corporation or partnership represented by him, entered into any combination, collusion
or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent
any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made
without reference to any other bid and without any agreement, understanding or combination with
any other person in reference to such bidding. Contractor further says that no person or persons,
firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift,
commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its
principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency;
and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment
activities in Iran.
a. For purposes of this Certification, “Iran” means the government of Iran and any agency or
instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from
time-to-time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time-to-time, a Contractor is
engaged in investment activities in Iran if either:
i. Contractor, its successor or its affiliate, provides goods or services of twenty million
dollars ($20,000,000) or more in value in the energy sector of Iran; or
ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty
million dollars ($20,000,000) or more in credit to another person for forty-five (45)
days or more, if that person will (i) use the credit to provides goods and services in
the energy sector in Iran; and (ii) at the time the financial institution extends credit, is
a person identified on list published by the Indiana Department of Administration.
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the Contractor subsequently learns is an unauthorized
Version 2/14/2020 Page - 4 Public Works Quote
alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of
Contractor’s newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3.
Contractor’s documentation of enrollment and participation in the E-Verify Program is included
and attached as part of this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public
contract to certify that the subcontractors do not knowingly employ or contract with an
unauthorized alien, nor retain any employee or contract with a person that the subcontractor
subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is
participating in the E-Verify Program. The Contractor agrees to maintain this certification
throughout the term of the contract with the City of South Bend, and understands that the City
may terminate the contract for default if the Contractor fails to cure a breach of this provision no
later than thirty (30) days after being notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by
the City of South Bend through its agencies, boards, or commissions shall not discriminate against
any employee or applicant for employment in the performance of a City contract with respect to
hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly
related to employment because of race, sex, religion, color, national origin, ancestry, age, gender
expression, gender identity, sexual orientation or disability that does not affect that person's ability
to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or
any combination of the foregoing including, but not limited to, public works contracts awarded
under public bidding laws or other contracts in which public bids are not required by law, the City,
its agencies, boards, or commissions may consider the Contractor’s good faith efforts to obtain
participation by those Contractors certified by the State of Indiana as a Minority Business
(“MBE”) or as a Women’s Business Enterprise (“WBE”) as a factor in determining the lowest,
responsible, responsive bidder.
In no event shall persons or entities seeking the award of a City contract be required to award a
subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said
WBE/MBE. A finding of a discriminatory practice by the City’s MBE/WBE Utilization Board
shall prohibit that person or entity from being awarded a City contract for a period of one (1) year
from the date of such determination, and such determination may also be grounds for terminating
the contact for which the discriminatory practice or noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination commitment shall
be made a part of any contract which it may henceforth enter into with the City of South Bend,
Indiana or any of its agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for
employment in the performance of this contract with privileges of employment, or any matter
directly or indirectly related to employment, because of race, religion, color, sex, gender
expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of
this provision may be regarded as material breach of contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-
Version 2/14/2020 Page - 5 Public Works Quote
8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel
products or foundry products made in the United States on this project if awarded. I understand I
have an affirmative duty to notify the City in my bid that my proposal does not include the use of
steel products or foundry products made in the United States. I understand it is my sole obligation
and responsibility to provide a justification to the City, subject to review and approval, why the
cost of United States made steel or foundry products is unreasonable. Prior to award and upon
submission of bid which does not use steel products or foundry products made in the United States,
the City, through its director of public works, shall make a determination if the price of United
States made steel or foundry is unreasonable. I understand that violations hereunder may result in
forfeiture of contractual payments.
***
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public
works are true and correct.
Dated this day of , 20__
Contractor/Bidder (Firm)
Signature of Contractor/Bidder or Its Agent
Printed Name and Title
Subscribed and sworn to before me this day of , 20
My Commission Expires
Notary Public
County of Residence
All RubberForm speed tables are designed for easy installation
and to be maintenance-free. Each module has been carefully
designed to ensure that all pieces fit together without difficulty.
The surfaces of our product exhibits a high quality appearance
with no loose material or fiber-like finishes. Quality, value and
safety are just a few of the many goals we set for our products.
Asphalt speed bumps and speed humps are rarely consistent
heights. They require road closures for installation or
maintenance and are normally removed for road or pavement
repairs. Then are reinstalled causing additional road closures, delays and expenses.
RubberForm products do not require road closures for installation of for removal. They do not require heavy
equipment , large crews or the difficulties associated with delivering proper quantities to the job site in a timely
fashion. They can be easily installed as a permanent fixture, a temporary test or for work zone safety. This versatility
is highly cost effective.
Asphalt speed reducers cause havoc with low riding vehicles and usually slow critical emergency vehicle response
time. Our speed tables are a consistent 3” in height and are designed to have
no effect on low riding vehicles. Minimal Effect if any, on Emergency Vehicle
Response Time!
• Neighborhood, bicycle,
motorcycle and skateboard
friendly
• Versatile arrow configurations
• Modules connect with a
propriety dog bone, no
interlocking puzzle pieces
• Modular design for custom sizing
– widths and lengths
• Longest warranty on the market
• Effectively slow traffic without
damaging tires or vehicles.
• 100% Post Consumer Recycled
Tire Rubber
• Speed Slots for Emergency
Vehicles
• Patented
• Made in U.S.A.
100% Recycled
Material UV Resistant
Made in the
USA
LEED
Certified
Speed Tables
Features:
Tel 716-478-0404 // Fax 716-478-0408 // sales@rubberform.com
RubberForm.com // 75 Michigan St. Lockport, NY 14094
Speed Table Specifications
Tel 716-478-0404 // Fax 716-478-0408 // sales@rubberform.com
RubberForm.com // 75 Michigan St. Lockport, NY 14094
Layout Examples
45 pc - 19ft. 10in. X 10ft
• 2 - RKP-RC (RT CORNERS 15” X 40” )
• 2 - RKP-LC (LT CORNERS 15” X 40” )
• 2 - RKP-SE (SIDE EXTENSIONS 15” x 40”)
• 20 - RKP-C (CENTER RAMPS 16” X 40” )
• 6 - RKP-CA (ARROW RAMPS 16” X 40”)
• 13 - RKP-CE (CENTER EXTENSIONS 16” x 40”)
68 pc - 22ft. 6in. x 13ft 4in.
• 2 - RKP-RC (RT CORNERS 15” X 40” )
• 2 - RKP-LC (LT CORNERS 15” X 40” )
• 4 - RKP-SE (SIDE EXTENSIONS 15” x 40”)
• 22 - RKP-C (CENTER RAMPS 16” X 40” )
• 8 - RKP-CA (ARROW RAMPS 16” X 40”)
• 30 - RKP-CE (CENTER EXTENSIONS 16” x 40”)
105 pc - 27.8ft. x 16.7ft.
• 2 - RKP-RC (RT CORNERS 15” X 40” )
• 2 - RKP-LC (LT CORNERS 15” X 40” )
• 6 - RKP-SE (SIDE EXTENSIONS 15” x 40”)
• 30 - RKP-C (CENTER RAMPS 16” X 40” )
• 8 - RKP-CA (ARROW RAMPS 16” X 40”)
• 57 - RKP-CE (CENTER EXTENSIONS 16” x 40”)
Hardware:
Installation Hardware Kit, includes stainless steel lag bolts,
washers, rubber caps, anchors, connectors and adhesive
22ft. 6in x 13ft. 4in.
19ft. 10in. x 10ft.
27.8ft x 16.7ft
278ft16.7ft13ft. 4in.22ft. 6in.
Can be custom configured for
your street!
Initiate installation, by placing chalk line on pavement to determine cushion and/or table placement.
Starting with a corner module, insert Secure-Loc dual flange connectors
into slots located in the module underside and place it atop pavement
adjoining chalk line.
Select the opposite corner module, insert one Secure-Loc
Dual Flange connector into slot located in the module under-
side so it will align with the initial corner module when set
together. Place this module on pavement and interlock the
two modules.
This will form
one side of
the Cushion
and/or Table
SS Lag Bolts, Washers, Barbed Anchors, Rubber
Bolt Caps and Two-Part Adhesive are supplied
with each cushion. The two-part resin Applicator
Gun as shown, is available as an option.
Begin drilling as shown. Drill holes to a
depth of 10” from module surface
(7” into the pavement). Thorough-
ly blow out holes with compressed
air. Assemble the Lag Bolts,
Washers and Anchors as shown
Connect the static mixer to the adhe-
sive tube and insert into the Resin Gun.
Prime the Applicator Resin Gun until
the resin at the tip is gray. Insert the
mixer into the hole and apply the adhe-
sive (Generally 2 pumps). Warning:
The resin will harden in 15 minutes or
less.
Immediately insert and pound the
anchor/bolt/washer combo into the hole
until the lip of the anchor is at pave-
ment level. Tighten the bolt with the
impact wrench ensuring the washer is
firmly seated. DO NOT over tighten.
Insert the rubber bolt caps in each hole
1
1
2
2
3
3
4
4
TOOL REQUIREMENTS:
9/16” masonry bit (Preferably 18” long)
Heavy duty hammer drill
Long nose air nozzle (or vacuum)
Impact wrench
Resin Applicator Gun for adhesive
Using the same connector insertion technique, continue with
other two center modules and then a third corner module. It
will should look like the photo shown below.
Re-check module alignment and pavement position. Now add
the final row of center modules, then the last corner. Once all
modules are connected, you are now ready to bolt cushion to
the pavement
Take a center module and insert
two Secure-Loc connectors. Place
this module aligning with your
chalk line and abutting the side of
the initial corner module and
interlock the two modules. The
cushion should take on the
appearance of a large “L”.
RFP-Install-042321
ALL RIGHTS RESERVED 75 Michigan St. Lockport, NY 14094 Phone: 716.478.0404
Fax: 716.478.0408 www.rubberform.com sales@rubberform.com
INSTALLATION INSTRUCTIONS
Speed Cushions, Tables, & Humps
Version 3.3 [1/11/2019]
Parking Lane Travel Lane Full Road Closure Alley
Submission Date: Applicant/Company:
Email Address:
Phone #:
Project STREET ADDRESS (eg: 110 W. Smith RD.):
Project Location (Block limits/Streets From and To):
Contractor Performing Work:
On-Site Contact: Phone #:
Reason for Closure:
Affected Customers:ATTACH THE FOLLOWING ITEMS: 1. Traffic Control Plan 2.Detour Plan 3. Barricades, Signs, or Flashers Placement
ENGINEERING OFFICE USE ONLY:
Approved Approved as Noted Revise Not Approved
Comments: ____________________________________________________________________________
_________________________________________________________________________________________
City of South Bend/Engineering Division Authorized Signature Date:
SOUTH BEND,INDIANA 46601 TDD 574/ 235-5567
Reason for Closure:
City of South Bend Public Works
Engineering Division
227 W. Jefferson, County City Building 1316
South Bend, IN 46601-1830
**SUBMIT 5 WORKING DAYS MINIMUM PRIOR TO PROJECT START DATE**
Complete 1 - 5 Incomplete submittals cannot be processed; All submittals require occupancy bond
(Refer to MUTCD for Traffic Control Device Requirements) See reverse for Checklist
Failure to use traffic control for traffic restrictions or closures will result in stop work orders and/or delay in permitting.
Office
Cell
Name:
Office
Cell
Excavation/Boring? > Requires Excavation Form New Approach? > Curb Cut application
1
2
3
4
5
Affected Property Owners:
Applicant agrees to share Project Information with affected Property Owners
TRAFFIC CONTROL AND OCCUPANCY REQUEST
Sidewalk
THIS OCCUPANCY PERMIT REQUEST IS NON-TRANSFERABLE AND A SIGNATURE SUBJECTS THE NAMED CONTRACTOR/PERMITTEE
TO ALL APPLICABLE RULES, DUTIES AND OBLIGATIONS IMPOSED BY THE CITY OF SOUTH BEND MUNICIPAL CODE AND TO ALL
REGULATIONS IMPOSED BY THE SOUTH BEND BOARD OF PUBLIC WORKS.
Applicant Signature _______________________________ Date ________________
**Requested Start & End Dates: Requested Start & End Times:
Occupancy beyond 90 days requires completion of Long Term Occupancy Request Application
Phone: 574.235.9251
Email: rowpermitsoffice@southbendin.gov
Treelawn
TRAFFIC CONTROL CHECKLIST
PURPOSE: SAFETY FOR MOTORISTS, BICYCLISTS, PEDESTRIANS, WORKERS, EMERGENCY
AND ENFORCEMENT PERSONNEL AND EQUIPMENT
•Submit Traffic Control with any Occupancy Request in the City of South Bend.
•Maps shall follow MUTCD Traffic Control Device guidelines, but do not submit
MUTCD examples as your traffic control.
INCLUDE THE FOLLOWING THAT APPLY TO YOUR JOB (COMMUNICATION PLAN REQUIRED FOR ALL):
Communication Plan w/affected adjacent property owners & copy of notification letter
Street map showing CURRENT street status
~ Can show aerial or streets only
Street names
Striping and sidewalks
North Arrow
Location of Activity Area and placement of vehicles and equipment in
the work space
Location of manholes or other facilities within work space
Barricades, signs and/or flasher placement
Taper distance/Advanced warning signage
Traffic detour plan
Examples of simple traffic control:
North
North
Failure to comply with the below checklist may result in a delay of your permits
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 5/25/21
Name Leslie Biek, PE Department PW
BPW Date 5/25/21 Phone Extension 9323
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer Officer Name
BPW Attorney Attorney Name
Dept. Attorney Attorney Name Clara McDaniels
Purchasing Michael Schmidt
Check the Appropriate Item Type – Required for All Submissions
Professional Services Agreement Contract Proposal
Open Market Contract Amendment/Addendum Special Purchase, QPA
Bid Opening Bid Award Req. to Advertise Title Sheet
Quote Opening Quote Award Reject Bids/Quotes
Proposal Opening C/O & PCA No. PCA
Chg. Order, No. Traffic Control Resolution
Other: Ease./Encroach
Required Information
Company or Vendor Name Selge Construction
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name Installation of Temporary Speed Tables- On Call
Project Number PR-00009540 PN 121-042
Funding Source
Account No. 251-06-600-506-442001
Amount $20,000
Terms of Contract On-Call
Purpose/Description Installation of two (2) temporary speed tables
For Change Orders Only
Amount of Increase
Decrease
$
($ )
Previous Amount $
Current Percent of Change:
Increase
Decrease
%
( %)
New Amount $
Total Percent of Change:
Increase
Decrease
%
( %)
Time Extension Amount:
New Completion Date: