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HomeMy WebLinkAboutOpening of Bids - 2021 Curb and Sidewalk Proj No. 121-001 - Ziolkowski Construction, Inc.4 SOUTR1 J P ACE d CITY OF SOUTH BEND, INDIANA 111865 CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name 2021 Curb and Sidewalk Construction Project No. 121-001 For Bids Due June 8, 2021 at 9:00am Local Time to bpwbids(cDsouthbendin.gov 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 MWBE Utilization Plan [MWBE-1.0]. If minimum participation goal is not met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MWBE Contacted Form X [MWBE-2.1]. X Acknowledge Receipt of 0 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: Ziolkowski Construction, Inc. Date: 6/8/2021 By Authorized Representative: Signature: Print Name & Title: Bill Favors, President Version 01/13/2021 Contractor's Bid for Public Works - 1 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name 2021 Curb and Sidewalk Construction Project No. 121-001 For Bids Due June 8, 2021 at 9:00am Local Time. Sealed electronic bids shall be submitted tobidsoc�thbend'm.cov. PART 1 (Must be completed for all bids. Please type or print) Date: 6/8/2021 Bidder (Firm): Ziolkowski Construction, Inc. Address: 4050 Ralph Jones Dr. City/State/Zip: South Bend, IN 46628 Telephone Number: ( 574 ) 287-1811 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. - South Bend, Indiana 2021 Curb and Sidewalk Construction the City of South Bend, Indiana, in accordance with plans and specifications prepared by: City of South Bend, Department of Public Works and dated 01/13/2021 for the sum of (enter the Total Bid as shown on the Proposal) SiX hUkIdred -thiIN- tight -Uasand Hine hwuOeal ($ 12Z 970. ) (Enter sum of Total Bas6 Bidq6lus Alternates shown on Proposal) Sexes% (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 aPPIY, the undersigned submits a proposal for each%i q4 ceb_ with the notice. Any addendums attached will be specifically referenced at the applicabler'eag�°°° If additional units of material included in the contract are needed, the cost of units mustie' : en .°�- shown in the original contract if accepted by the City of South Bend. If the bid is to be aN�ar�fed oon"u it basis, the itemization of the units shall be shown on a separate attachm t. ri GSEAL By oe e® y (Signature) Bill Favors, President (Printed Name of Person Signing) ACCEPTANCE ---------- The above bid is accepted this Subject to the following conditions. - BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member day of Joseph R. Molnar, Member Jordan V. Gathers, Member Murray L. Miller, Member Attest: Anne Fuchs, Clerk Version 01/13/2021 Contractor's Bid for Public Works - 2 20 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 11 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.) Use the available manpower and work with construction manager and other trades to maintain schedule. 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. A list of subcontractors will be submitted when awarded project. 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. Most work is self -performed. If subs are used, a list will be provided when contract is awarded. 4. Attach a listing of equipment you have available to use for the proposed project. Whatever equipment is necessary to complete the project properly and on time. 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. Yes, we recieve pricing on the day of the bid./ 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 01/13/2021 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 01/13/2021 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. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder may result in forfeiture of contractual payments. Version 01/13/2021 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 8th day of June 2021 5 _v Am Ziollcowski Construction Inc. Contractor/Bidder (Firm) �R42 o a ignature of Contractor/Bidder or -Its". j ° ° Bill Favors, President Printed Name and Title Subscribed and sworn to before me this 8th day of Tune , 2021 My Commission Expires January 28, 2023 Not Public County of Residence St. Joseph ho, s,;?•��� JENNIFER WIEST ' Notary Public, state of Indiana s ,•'NOTARY. SEA St. Joseph County *, : Commission # 663344 U��11t,`��.` 4•T1TT¢¢�� My Commission Expires January 28, 2023 Version 01/13/2021 Contractor's Bid for Public Works - 6 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: Bidder: 121-001 Project Name: 2021 Curb and Sidewalk Construction Ziolkowski Construction, Inc. Total Bid Amount: MBE Goal: 3.7% Page 1 of Name & Address of MBE Y\ Scope of Work to be Performed (Attach scope/schedule if you need additional space) oYti�urir`U CITY OF SOUTH BEND Ritschard Bros., Inc. 1204 W Sample St. South Bend, IN 46619 MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MWBE-1.0 yt ril •\-1H6„ MWBE UTILIZATION PLAN 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: Bidder: 121-001 Project Name: 2021 Curb and Sidewalk Construction Ziolkowski Construction, Inc. Total Bid Amount: MBE Goal: 3.7% Page 1 of Name & Address of MBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of MBE Component Percentage of Total Bid/Proposal Ritschard Bros., Inc. 1204 W Sample St. South Bend, IN 46619 574-288-4777 Earthwork Submitted by: Bill Favors 06/08/2021 Print Name Ignature Date Version 01/13/2021 Contractor's Bid for Public Works - 10 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: 121-001 Date: 6/8/2021 Project Name: 2021 Curb and Sidewalk Construction Bidder: Ziolkowski Construction, Inc. Contact Person: Mike Cushway Telephone: 574-287-1811 Address: 4050 Ralph Tones Drive City: South Bend State: IN Zip: 46628 Email: mcushwayC@zbuild.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 01/13/2021 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 X Department of Administration list of Minority and Women Owned Businesses (both certified and non - certified) found at: hftp://www.in.gov/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. I 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 MC 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 MC performed by MWBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate MWBE participation. MC 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 MC MWBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications concerning subcontract opportunities and allowed MWBEs reasonable time to respond to such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a manner MC reasonably calculated to inform MWBEs of subcontracting opportunities and allowed sufficient time for MWBEs to participate effectively. MC I affirm that I followed up on initial solicitations with interested MWBEs. I affirm that I negotiated with interested MWBEs in good faith, including providing such MC MWBEs with adequate information about the plans, specifications and other requirements of the subcontract. I affirm that I have made good faith efforts to assist interested MWBEs in obtaining MC bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 01/13/2021 Contractor's Bid for Public Works - 12 O�SOUIH CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MWBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS "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 01/13/2021 Contractor's Bid for Public Works - 13 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 MC appropriate. MC 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 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 01/13/2021 Contractor's Bid for Public Works - 13 �Sogrh 9Fti. `0 L CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN = f> FORM MWBE-2.1 ,H:; MWBE 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 OF Project Number: 121-001 MBE Participation Goal 3.7% Project Name: Bidd By: 2021 Curb and Sidewalk Construction MBE Firm Ritschard Bros., Inc. Owner or Contact at MBE Firm Telephone: 574-288-4777 Fax: Email: rit1204gdatacruz.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Earthwork RESULTS OF CONTACT WITH THE MBE FIRM: MBE Firm Owner or Contact at MBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: Version 01/13/2021 Contractor's Bid for Public Works -14 BID/PROPOSAL CITY OF SOUTH BEND Project Name: 2021 Curb and Sidewalk Construction Project Number: 121-001 For Bids Due: June 8, 2021 at 9:00am Local Time to bpwbids(a�southbend in.gov Contractor Name: DIVISION Al Item No. Description Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 205 SYS 53.37 $10,939 2 CONCRETE SIDEWALK, 4 -IN 205 SYS 54.92 $11,258 3 CONCRETE CURB, REMOVE 365 LFT 4.20 $1,532 4 CONCRETE CURB, MODIFIED 365 LFT 20.22 $7,378 5 CONCRETE APPROACH, REMOVE 22 SYS 69.64 $1,532 6 PCCP FOR APPROACHES, 6 -IN 22 SYS 64.41 $1,417 7 TOPSOIL AND SEEDING 200 SYS 15.08 $3,016 8 TREE, REMOVE, 6 IN 1 EA 1,856.00 $1,856 10 TREE, REMOVE, 18 IN 1 EA 1,856.00 $1,856 13 STUMP, REMOVE 1 EA 406.00 $406 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 3 EA 673.00 $2,019 15 CURB RAMP, REMOVE 16 SYS 81.25 $1,300 17 PAIRED PERPENDICULAR CURB RAMP 16 SYS 61.50 $984 DIVISION Al TOTAL $45,493 DIVISION 131 Item No. Line Item Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 320 SYS 53.37 $17,076 2 CONCRETE SIDEWALK, 4 -IN 320 SYS 51.03 $16,327 3 CONCRETE CURB, REMOVE 575 LFT 81.20 $46,690 4 CONCRETE CURB, MODIFIED 575 LFT 20.04 $11,520 7 TOPSOIL AND SEEDING 320 SYS 11.60 $3,712 11 TREE, REMOVE, 30IN 2 EA 928.00 $1,856 13 STUMP, REMOVE 2 EA 203.00 $406 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 4 EA 673.00 $2,692 15 CURB RAMP, REMOVE 5 SYS 696.00 $3,480 16 ONE-WAY PERPENDICULAR CURB RAMP 5 SYS 292.60 $1,463 DIVISION B1 TOTAL $105,222 DIVISION B2 Item No. Line Item Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 170 SYS 53.37 $9,072 2 CONCRETE SIDEWALK, 4 -IN 170 SYS 52.08 $8,852 3 CONCRETE CURB, REMOVE 240 LFT 81.20 $19,488 4 CONCRETE CURB, MODIFIED 240 LFT 20.62 $4,948 5 CONCRETE APPROACH, REMOVE 90 SYS 69.60 $6,264 6 PCCP FOR APPROACHES, 6 -IN 90 SYS 61.27 $5,514 7 TOPSOIL AND SEEDING 135 SYS 18.57 $2,506 10 TREE, REMOVE, 18 IN 2 EA 928.00 $1,856 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 1 2 EA 673.00 $1,346 DIVISION B2 TOTAL $59,846 Version 01/13/2021 Contractor's Bid for Public Works - 7 BID/PROPOSAL CITY OF SOUTH BEND Project Name: 2021 Curb and Sidewalk Construction Project Number: 121-001 For Bids Due: June 8, 2021 at 9:00am Local Time to bpwbids�southbendingov Contractor Name: DIVISION B3 Item No. I Line Item Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 240 SYS 53.37 $12,807 2 CONCRETE SIDEWALK, 4 -IN 240 SYS 51.14 $12,273 3 CONCRETE CURB, REMOVE 145 LFT 81.20 $11,774 4 CONCRETE CURB, MODIFIED 145 LFT 19.98 $2,897 7 TOPSOIL AND SEEDING 80 SYS 23.20 $1,856 8 TREE, REMOVE, 6 IN 1 EA 1,856.00 $1,856 9 TREE, REMOVE, 10 IN 1 EA 1,856.00 $1,856 10 TREE, REMOVE, 18 IN 1 EA 1,856.00 $1,856 13 STUMP, REMOVE 1 EA 406.00 $406 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 4 EA 673.00 $2,692 15 CURB RAMP, REMOVE 10 SYS 69.60 $696 16 ONE-WAY PERPENDICULAR CURB RAMP 10 SYS 63.30 $633 DIVISION B3 TOTAL $51,602 DIVISION C1 Item No. Line Item Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 240 SYS 53.37 $12,807 2 CONCRETE SIDEWALK, 4 -IN 240 SYS 53.00 $12,719 3 CONCRETE CURB, REMOVE 405 LFT 81.20 $32,886 4 CONCRETE CURB, MODIFIED 405 LFT 20.52 $8,308 7 TOPSOIL AND SEEDING 225 SYS 15.08 $3,393 10 TREE, REMOVE, 18 IN 2 EA 928.00 $1,856 11 TREE, REMOVE, 30 IN 1 EA 1,856.00 $1,856 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 3 EA 673.00 $2,019 15 CURB RAMP, REMOVE 16 SYS 69.63 $1,114 17 PAIRED PERPENDICULAR CURB RAMP 16 SYS 55.07 $881 DIVISION C1 TOTAL $77,839 DIVISION D1 Item No. Line Item Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 425 SYS 54.46 $23,142 2 CONCRETE SIDEWALK, 4 -IN 425 SYS 54.57 $23,192 3 CONCRETE CURB, REMOVE 675 LFT 81.20 $54,810 4 CONCRETE CURB, MODIFIED 675 LFT 20.20 $13,635 5 CONCRETE APPROACH, REMOVE 75 SYS 69.60 $5,220 6 PCCP FOR APPROACHES, 6 -IN 75 SYS 59.91 $4,493 7 TOPSOIL AND SEEDING 375 SYS 11.60 $4,350 11 TREE, REMOVE, 30 IN 1 EA 1,856.00 $1,856 12 TREE, REMOVE, 48 IN 1 EA 1,856.00 $1,856 13 STUMP, REMOVE 1 EA 406.00 $406 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 3 EA 673.00 $2,019 15 CURB RAMP, REMOVE 15.5 SYS 69.62 $1,079 16 ONE-WAY PERPENDICULAR CURB RAMP 9 SYS 68.45 $616 18 DEPRESSED CORNER CURB RAMP 6.5 SYS 94.77 1 $616 DIVISION D1 TOTAL $137,290 Version 01/13/2021 Contractor's Bid for Public Works - 8 BID/PROPOSAL CITY OF SOUTH BEND Project Name: 2021 Curb and Sidewalk Construction Project Number: For Bids Due: Contractor Name: DIVISION D2 121-001 June 8, 2021 at 9:00am Local Time to bl2wbidsAsouthbend in. gov Item No. Line Item Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 90 SYS 53.37 $4,803 2 CONCRETE SIDEWALK, 4 -IN 90 SYS 56.04 $5,043 3 CONCRETE CURB, REMOVE 225 LFT 81.20 $18,270 4 CONCRETE CURB, MODIFIED 225 LFT 20.21 $4,547 7 TOPSOIL AND SEEDING 136 SYS 18.571 $2,525 DIVISION D2 TOTAL $35,188 DIVISION E1 Item No. Line Item Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 105 SYS 53.37 $5,603 2 CONCRETE SIDEWALK, 4 -IN 105 SYS 56.59 $5,941 3 CONCRETE CURB, REMOVE 200 LFT 81.20 $16,240 4 CONCRETE CURB, MODIFIED 200 LFT 20.08 $4,016 7 TOPSOIL AND SEEDING 110 SYS 19.73 $2,170 12 TREE, REMOVE, 48 IN 1 EA 1,856.00 $1,856 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 1 EA 754.00 $754 DIVISION E1 TOTAL $36,580 DIVISION F1 Item No. Line Item Quantity Unit Unit Price Total Amount 1 CONCRETE SIDEWALK, REMOVE 255 SYS 53.37 $13,607 2 CONCRETE SIDEWALK, 4 -IN 255 SYS 56.39 $14,378 3 CONCRETE CURB, REMOVE 400 LFT 81.20 $32,480 4 CONCRETE CURB, MODIFIED 400 LFT 20.08 $8,032 5 CONCRETE APPROACH, REMOVE 75 SYS 69.60 $5,220 6 PCCP FOR APPROACHES, 6 -IN 75 SYS 60.60 $4,545 7 TOPSOIL AND SEEDING 225 SYS 15.08 $3,393 10 TREE, REMOVE, 18 IN 1 EA 1,856.00 $1,856 11 TREE, REMOVE, 30 IN 1 EA 1,856.00 $1,856 13 STUMP, REMOVE 2 EA 203.00 $406 14 PLANT, DECIDUOUS TREE, SINGLE STEM, 2- IN TO 2.5 IN 4 EA 673.00 $2,692 15 CURB RAMP, REMOVE 10 SYS 69.60 $696 16 DEPRESSED CORNER CURB RAMP 10 SYS 74.90 $749 Bidder (Firm): Address: City/State/Zip: DIVISION F1 TOTAL $89,910 Telephone Number: ByAff J&414 A �I��yoK'S! a��!i'�Qi� l (Printed Name of Person Signing) Version 01/13/2021 Contractor's Bid for Public Works - 9 Document A310TM -2010 Conforms with The American Institute of Architects AIA Document 310 CONTRACTOR: (Name, legal status and address) Ziolkowski Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 OWNER: (Name, legal status and address) City of South Bend, Indiana, Board of Public Works 227 West Jefferson Boulevard South Bend, IN 46601 SURETY: (Name, legal status and principal place of business) Liberty Mutual Insurance Company 175 Berkeley Street Boston, MA 02116 State of Inc: Massachusetts BOND AMOUNT: Five Percent of Amount Bid (5%) PROJECT: (Name, location or address, and Project number, if any) 2021 Curb and Sidewalk Construction, Project No. 121-001 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 Bon(°1 ttx)}:kV,. deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.°°peSt° C 0 :='^.�^ Yee.•••..: � `n��''n, When this Bond has been furnished to comply with a statutory or other legal requirement in the locatjon'ofdbe P y Y g q ° ��.a� any provision in this Bond conflicting with said statutory or legal requirement shall be deemed dela L��p m -an a provisions conforming to such statutory or other legal requirement shall be deemed incorporated hkr�drf Wheiryy� o � furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common laV; bd4* . SEAL 1`i. ° ,SigilheiLed his 8th day of June 2021 Ziolkowski ConstruCtion;rlric•.,, °.• � ,� (Prin i al Seal) WOWS') r i Siivi Ky Wlt.1� (Title) 13i 11 FaVoirs, 'RIes ie l Y) Liberty Mutual Insurance Company (Sure t ` (Seal) (Witnes�S) Maria Concepcion ✓{J X,/- L� (Title) Adrienne C. Stevenson, Attorney -in -Fact State of Georgia County of Fulton ss: On June s, 2021 , before me, a Notary Public in and for said County and State, residing therein, duly commissioned and sworn, personally appeared Adrienne C. Stevenson known to me to be Attorney -in -Fact of Liberty Mutual Insurance Company the corporation described in and that executed the within and foregoing instrument, and known to me to be the person who executed the said instrument in behalf of the said corporation, and he duly acknowledged to me that such corporation executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the day and year stated in this certificate above. My Commission Expires February 13, 2022 Sh0o Jean Potts Notary Public Sharon Jean Potts NOTARY PUBLIC Fulton County, GEORGIA My Commission Expires 02/13/2022 60 O � (0 ai a1 a1 W O,C E `OM U o� Z O This Power of Attorney limits the acts of those named herein, and they have no authority to Liberty bind the Company except in the manner and to the extent herein stated. Mutual. Liberty Mutual Insurance Company SURETY The Ohio Casualty Insurance Company Certificate No: 8204866 West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the Stale of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Adrienne C. Stevenson all of the city of Atlanta , state of Georgia each individually if there be more than one named, its true and lawful attomey-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 15th day of February, 2021. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company P� %NSURq P'11 INS& INSU'D West American Insurance Company J FPO Z J RPO q P FPOq �Jr J 20o Ramo �,m r°o �f�Q yc+ `G ac. qr�c dv19SS1A9CH1U2S�.ab 0 1NA9M1P9S�`,aL 1991 By:44 �O David M. Carey, Assistant Secretary STATE OF PENNSYLVANIA ss COUNTY OF MONTGOMERY On this 15th day of February, 2021, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and yearfirst above written. Gip` PAgT 44,nh�oww£sc��f Commonwealth of Pennsylvania - Notary Seal 1 Teresa Pastella, Notary Public ?Q/� OF Montgomery County y wrrsl'�yPwcG My commision Commis on number res March 28, 2025 By: mber 1126044 Teresa Pastella, Notary Public OTgRY Fua~ Member, Pennsylvania Association of Nolades This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV— OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of allomey, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized forthat purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation —The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys- infact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surely any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, of Liberty Mutual Insurance Company, The Ohio Casualty Insurance Company, and West American Insurance Company do hereby certify that this power of attorney executed by said Companies is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 8th day of June 2021 INSUR -t1 INSG a 1NSUR j =�oarartarogl� C, r., `VP?oNPD�rFyn 91912�y 3 i z� 1919 o Q 1991 o By:CIA - d. Ss4clwsa. da O 4.NamPSaD is �NDIANP ds Renee C. Llewellyn, Assistant Secretary Marsh MSurety POA LMIC OCIC WAIC Multi Co_022021 vi E mo C U c � c E o a� a0 47 � Q `O 0 C) o ,t a) N ao ON aco I 00 0— a: CD — cCD m— 'v s o 0) �o o a> U- n ZIOLKOWSKI Construction, Inc.. General Construction & Design/Build Building Strong Relationships Since 1974 Completed Projects 2020-2021 Contract Amount Class of Work Completion Date Name and Address of Owner LaPorte Community School Corporation $14,814,127 School November 2020 1000 Harrison St., LaPorte, IN 46350 Flaherty & Collins Properties $3,654,487 City Park August 2020 211 N. Pennsylvania St., #300, Indianapolis, IN 46204 Elkhart Community School Corporation $7,777,960 School December 2020 2720 California Rd., Elkhart, IN 46514 Plymouth Community School Corporation $6,185,921 School February 2021 611 Berkley St., Plymouth, IN 46563 Current Projects 2020-2021 Contract Amount Class of Work Estimated Completion Date Name and Address of Owner St. Joseph County Public Library $3,090,507 Library May 2021 304 S. Main St., South Bend, IN 46601 Elkhart Community School Corporation $4,504,000 School June 2021 2720 California Rd., Elkhart, IN 46514 South Bend Board of Public Works $7,334,832 City Park July 2022 227 W. Jefferson Blvd., South Bend, IN 46601 Goshen Health Systems $4,247,944 Hospital I October 2022 200 High Park Ave., Goshen, IN 46526 ZIOLKOWSKI Construction, Inc. General Construction & Design/Build Building Strong Relationships Since 1974 References Company Name / Address Contact Name Phone No. University of Notre Dame 200 Facilities Building Notre Dame, IN 46556 Tony Polotto LEED, AP 574-631-4200 City of Mishawaka 600 East Third Street Mishawaka, IN Ken Prince 574-258-1625 Fetters Construction, Inc. 5417 County Road 427 Auburn, IN 46706 Steven A. Fetters 260-927-8516 Memorial Hospital & Health System 615 N. Michigan Street South Bend, IN46601 Larry Lies 574-647-1000 ZIOLKOW,SKI Construction Inc. cl erai Constrvcdon & DeslgrV Baud $uUdktg Strong Rela wah" Since 1974 FINANCIAL STATEMENTS December 31, 2020 and 2019 ZIOLKOWSKI CONSTRUCTION, INC. South Bend, Indiana FINANCIAL STATEMENTS December 31, 2020 and 2019 CONTENTS INDEPENDENT AUDITOR'S REPORT............................................................................................. 1 FINANCIAL STATEMENTS BALANCESHEETS..................................................................................................................... 3 STATEMENTS OF INCOME AND RETAINED EARNINGS....................................................... 4 STATEMENTS OF CASH FLOWS............................................................................................. 5 NOTES TO FINANCIAL STATEMENTS..................................................................................... 6 Crowe Crowe LLP 'n Peper&nl Ntr&t -r C=Ae Glehrl INDEPENDENT AUDITOR'S REPORT Board of Directors and Shareholders Ziolkowski Construction, Inc. South Bend, Indiana Report on the Financial Statements We have audited the accompanying financial statements of Ziolkowski Construction, Inc., which comprise the balance sheets as of December 31, 2020 and 2019, and the related statements of income and retained earnings, and cash flows for the years then ended, and the related notes to the financial statements. Management's Responsibility for the Financial Statements Management is responsible for the preparation and fair presentation of these financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation, and maintenance of internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error. Auditor's Responsibility Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free from material misstatement. An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditor's judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity's preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity's internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion. (Continued) 1. Opinion In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Ziolkowski Construction, Inc. as of December 31, 2020 and 2019, and the results of its operations and its cash flows for the years then ended in accordance with accounting principles generally accepted in the United States of America. Crowe LLP Oak Brook, Illinois March 11, 2021 2. CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name 2021 Curb and Sidewalk Construction Project No. 121-001 For Bids Due June 8, 2021 at 9:00am Local Time to bpwbids(dsouthbend in.gov Contractor Name: Ziolkowslci Construction, 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 31 st 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 01/13/2021 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 01/13/2021 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 01/13/2021 General Conditions - 8 II. 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. 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. 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). List identifying all former business names. 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 01/13/2021 General Conditions - 9 (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. Date: Tune 8. 2021 JAj (S1gn Here) ® ) Bill Favors o �� l (Print Name Here) ,oSIM ° ° Ziolkowski Construction Inc. (Name of Company) 4050 RalDh Tones Dr. (Address of Company) South Bend (City) (State) 574-287-1811 (Telephone Number) Version 01/13/2021 General Conditions - 10 CITY OF SOUTH BEND .LAMES MUELLER, MAYOR DEPARTMENT OF PUBLIC WORKS ERIC HORVATH, DIRECTOR November 16, 2020 Ms. Kristin Kromer Ziolkowski Construction, Inc. kkromer@zbuild.com RE: Pre -Qualification Verification — O'Brien Recreation Renovation Project No. 118-091 Dear Ms. Kromer: 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, Liz Horvath, Permit Manager BUSINESS INFORMATION HOLLI SULLIVAN INDIANA SECRETARY OF STATE 06/08/202107:54 AM Business Details Business Name: ZIOLKOWSKI CONSTRUCTION, INC. Business ID: 197812-318 Entity Type: Domestic For -Profit Corporation Creation Date: 12/11/1978 Principal Office Address: 4050 RALPH JONES DR, SOUTH BEND, IN, 46628, USA Jurisdiction of Formation: Indiana Business Status: Active Inactive Date: Expiration Date: Perpetual Business Entity Report Due 12/31/2022 Date: Years Due: Principal Information Title Name Address President Bill Favors 4050 Ralph Jones Dr., South Bend, IN, 46628, USA Registered Agent Information Type: Individual Name: BILL FAVORS Address: 4050 RALPH JONES DR, SOUTH BEND, IN, 46628 -1000, USA ZIOLKOWSKI Construction, Inc. General Construction & Design/Build Building Strong Relationships Since 1974 January 1, 2021 Subject: Pre -Qualification Letter Dear Sirs: Ziolkowski Construction, Inc. has been in business since 1974 and operated during that period of time under that name only. Ziolkowski Construction has not violated any federal, state or local laws, including violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA) laws, federal Davis -Bacon Act laws, within the past five years. Ziolkowski Construction, Inc. is proud to employ the industry's top skilled craftsmen. We have a core group of union craftsmen working on our projects and supplement that group with trained skilled workers from the local union halls. We currently have sufficient workers to perform the work that we are bidding for the above project. All individuals performing work for Ziolkowski Construction, Inc. will be properly classified as employees under the federal Fair Labor Standards Act and in line with all Indiana State and local ordinances. Ziolkowski Construction, Inc. had no federal, state or local tax liens or tax delinquencies in any of the preceding three tax years. Respectfully, ZIOLKOWSKI CONSTRUCTION, INC. Bill Favors President & CFO 4050 Ralph Jones Dr., South Bend, IN 46628 Phone (574) 287-1811 Fax (574) 234-0151 Committed to professionalism and excellence for the benefit of our clients, employees, and shareholders. ZIOLKOWSKI Construction, Inc.. General Construction & Design/Build Building Strong Relationships Since 1974 Completed Projects 2020-2021 Contract Amount Class of Work Completion Date Name and Address of Owner LaPorte Community School Corporation $14,814,127 School November 2020 1000 Harrison St., LaPorte, IN 46350 Flaherty & Collins Properties $3,654,487 City Park August 2020 211 N. Pennsylvania St., #300, Indianapolis, IN 46204 Elkhart Community School Corporation $7,777,960 School December 2020 2720 California Rd., Elkhart, IN 46514 Plymouth Community School Corporation $6,185,921 School I February 2021 611 Berkley St., Plymouth, IN 46563 Current Projects 2020-2021 Contract Amount Class of Work Estimated Completion Date Name and Address of Owner St. Joseph County Public Library $3,090,507 Library May 2021 304 S. Main St., South Bend, IN 46601 Elkhart Community School Corporation $4,504,000 School June 2021 2720 California Rd., Elkhart, IN 46514 South Bend Board of Public Works $7,334,832 City Park July 2022 227 W. Jefferson Blvd., South Bend, IN 46601 Goshen Health Systems $4,247,944 Hospital October 2022 200 High Park Ave., Goshen, IN 46526 August 20, 2020 BAC 4 IN/KY Apprenticeship & Training Program www.bac4training.com bac4apprenticeship(ct gmail.com 19-5-25-44,431 Roger Jones - Mant-iging Director C/O Ziolkowski Construction, Inc. To Whom It May Concern, This is a letter of recommendation on behalf ofZiolkowski Construction, Inc. The BAC 4 IN/KY Apprenticeship & Training Program is a statewide program that was established in I994 and is recognized by the U. S. Department of Labor and is considered in good standing. Ziolkowski Construction, Inc. has been a "signatory union contractor" since 2000 and at the present time employ enrolled apprentices. Ziolkowski Construction, Inc. has continued to follow the guidelines set forth in Collective Bargaining Agreement with BAC Local #4 IN/KY meeting the required Journeyman/Apprentice ratio on their jobs. Should you have any further questions please feel free to contact the State office at (2I9) 525-4443. Sincerely, Roger Jones Managing Director BAC 4 IN/KY Apprenticeship & Training Program niteb �'tate� rpartme�t effirp of O[pprpnttrpqbt'p certificate of Rrgi!gtration of Apprrutt"tobip Program BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL 4 IN/KY APPRENTICE FUND VALPARAISO, INDIANA FOR THE TRADE CLASSIFICATIONS: BRICKLAYER; BRICKLAYER, FIREBRICK & REFRACTORY; TILE SETTER; TUCKPOINTER, CLEANER, CAULKER 2eyl'sfere0(¢s pori of%�2e Xafionaj,2-pprenlices�2ip 6Jr. sfem in accoro�ance wifhl' h�e 4asic sfanofaro(s of apprenfices"ip esiaais eo(�� I,& c5ecrefary of ca&r MAY 24, 1996 Dale Revised: February 2, 2007 IN001960012 J�eyislrabon Xo. .Z` cSecrelary ofGa6or 5UMIi islralor, Off'ae pprenl�ces�iip �:� TES pE INDIANA/KENTUCKY/OHIO REGIONAL COUNCIL OF CARPENTERS JOINT APPRENTICESHIP AND TRAINING FUND m 1095 MARINERS DRIVE WARSAW, IN 46582 ADMINISTRATION OFFICE 711 Greenwood Springs Drive Greenwood, IN 46143 Phone: 317-807-1112 Fax: 317-807-1115 Ashland Campos 574 Carpenters Way Grayson, KY41143 Phone: 606-929-1378 Fax: 502-996-8108 Indianapolis Campus 711 Greenwood Springs Drive Greenwood, IN 46143 Phone: 317-807-1116 Fax: 317-807-1131 Lafayette Campus 2953 South Creasy Lane Lafayette, IN 47905 Phone: 765-447-5959 Fax: 765-447-7676 Louisville Campus 1245 Durrett Lane Louisville, KY 40213 Phone: 502-366-8668 Fax: 502-366-8678 Merrillville Campus 1565 East 70th Court Merrillville, IN 46410 Phone: 219-947-3348 Fax: 219-947-1889 Muncie Campus 4121 East Centennial Avenue Muncie, IN 47303 Phone: 765-288-9015 Fax: 765-289-9298 Newburgh Campus 5400 Covert Court Newburgh, IN 47630 Phone: 912-853-9312 Fax, 812-853-9316 Terre Haute Campus 3099 South 6th Street Terre Haute, IN 47802 Phone: 812A66-7899 Fax: 812-466-9840 Warsaw Campus 1095 Mariners Drive Warsaw, IN 46582 Phone: 574-267-5264 Fax: 574-269-1464 August 20, 2020 Ziolkowski Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 To Whom It May Concern: Ziolkowski Construction reguarly employs a number of apprentices affiliated with our apprenticeship program and has done so for many years. We are registered with the United States Department of Labor, Bureau of Apprenticeship and Training and our registration number is 020 0537. Our program also participates in the Building Trades Associate Degree Program with Ivy Tech Community College and has done so since 1996. Ziolkowski Construction is a bona fide contractor in good standing with the Indiana/Kentucky/Ohio Regional Council of Carpenters Joint Apprenticeship and Training Fund and is eligible to employ apprentice carpenters in the future. I have enclosed copies of our certificates from the United States Department of Labor and from the Indiana Department of Veterans Affairs for GI educational benefits. If I can be of further assistance, please do not hesitate to give me a call. Dale Newlin Area Coordinator IKORCC JATF Warsaw Campus vf,Aw=ffm4ip t iA of 'NDIA.NAIKENTUCKY REOIONA L .COUNCIL OF CARPENTERS ' ARSAW9 INDIANA J.A.T.F. FOR THE TRADE CLASSIFICATIONS, CARPENTER, MMLWRIGHTT, BLooR "yK �e9rsfer'eo�as p�f Q'��e �'+�c��rar�ct�'�ppj'enfices�ai p ���rarn Zn dccort�crrrce wi,�e ��sic sfana� c��pp j„enficeshr` es of s eo Ise c3ecreA2r o 'rr P or OCTOBER 109,, 1989 Ea. RevIBe : pIZ IN0208900og x : . '.''Q''_� `.: '� ' '�d►iieiulnr/or, .'��py/w1/cs�P :7viweb � 16 . 9 P yrr andGc6a. cSrrrroes II 111 TO WHOM IT MAY CONCERN, Plasterers' & Cement Masons' Apprentice Coordinator of Local Union #692 Phone 317-508-1609 FAX 317-972-4907 Email hansen@plcmlocal692.org Q) � 1049-M THIS LETTER IS TO CERTIFY THAT ZIOLKOWSKI CONSTRUCTION INC.HAS BEEN A SIGNATORY UNION CONTRACTOR WITH THE PLASTERERS' AND CEMENT MASONS' JOINT APPRENTICESHIP TRAINING PROGRAM OF LOCAL 692, FOR AT LEAST THE LAST FIVE YEARS, AND IS IN GOOD STANDING. THEY HAVE A SIGNED CONTRACT WITH LOCAL 692 AND IS ELIGIBLE TO USE UNION PLASTERERS' APPRENTICES AND UNION CEMENT MASONS' APPRENTICES. THROUGH THIS CONTRACT AND OTHERS, THE FINANCIAL OBLIGATIONS OF TRAINING AND SAFETY ISSUES ARE MET. ALL OF THE APPRENTICES ARE REGISTERED WITH THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF APPRENTICESHIP AND TRAINING. SINCERELY, PAT HANSEN APPRENTICESHIP COORDINATOR FOR LOCAL 692 220 N. Fulton St. Indianapolis, IN 46202 c, > 0 CL — CL 41 2i .L1 1 S��IiI. 1�1 lureau of App' ruts-ceo4fli nub 01raining Ter#if tate of rgistrttttou LOCAL #692 PLASTERERS $ CEMENT MASONS J. A. T. C. LAFAYETTE, INDIANA FOR THE TRADE CLASSIFICATIONS OF PLASTERER; CEMENT MASON -Weyisfereo( as part 0'/f ie �afionaf : p enficesnfip J ro9 ram in accoro(anee wilh fie basic slanofarol o�apprenficesnfi esfa6lishecf 6y 1nie cSecrelary of Labor 1 -LAY 22, 1995 Del. �,-------- -- 9eryil/ry/ion 7%. 2!�..reuu o/zu�ti::c: INDIANA LABORERS' TRAINING TRUST FUND Dav&A. Frye Secretary -Treasurer Jerry J.. Bolk Chris L. Guerrero Ricky Henson, Jr. Rmnon Mendoza, Jr. Robert S. Wright P.O. Bos 758 - Bedford, Indiana 47421 (812) 279.9751 To Whom It May Concern: Sean Coakley, Director John P. Brown Chairman Kelly.Abel Brad Dreibelbis Michael Ferrara Stan Meyer An Wiseman FAX: (812) 279-5545 This letter is to confirm that "Ziolkowski Construction, hic." is a signatory contractor in good standing with the Indiana Laborers' Training Trust Fund. The above mentioned company is a participant in the Joint Apprenticeship and Training Committee through this Union and has been an active participant in good standing for each of the past five plus consecutive years, and is currently eligible to use our apprentices on a project. Further, our organization's program is approved by the U.S. Veterans Administration to participate in the GI educational benefits program.. A copy of our approval letters are attached along with the collective bargaining agreement stating the ratios of Journey workers to Apprentices; which is one (1) Apprentice for every five (5) Journey workers and thereafter may not employ more that (1) Apprentice for every (3) Journey workers. SincerelN71'41; Sean Coakley, Director SC:dc www. indianalaborerstraining. org .ttateo �e�rttrtrr�e�r Bureau of Avvrmtt-rts4t-v'nnb' &afninp Tntiffiratr of Registration INDIANA LABORER'S TRAINING TRUST FUND BEDFORD, INDIANA for the trade classification of CONSTRUCTION CRAFT LABORER i J2y1�2r2� av �7ar�e JY, ajlor2a rpprenlrces.6ap %�ro�nra in accoro(ance a)A-4 • nfe basic siano(aro(s o/ appreniices6iip esfa61isheor 6y I& cSecrefary of sa6or December 14, 1995 /oale IN040-0528 ✓�feyislrolion 19co. OCCRLEQ•U/ Or! QUOS 1J [wCf4 i� 1]4wQLL pf PT�SLl:�C: �2 alt6 �'Lallt(RC� ZIOLKOWSKI Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 Re: Proof of Compliance with 30 ILCS 500/30-22(6) Our File No. MI -00321 Dear Sir or Madam: At the request of ZIOLKOWSKI Construction, Inc, I am providing you with evidence of the Company's compliance with the apprenticeship requirements in 30 ILCS 500/30- 22(6) of the Illinois Procurement Code. I am submitting this letter along with apprenticeship certificates (Nos.IL012020003 and I1,008780173). As a signatory contractor with the International Union of Operating Engineers, Local 150, AFL-CIO, ZIOLKOWSKI Construction, Inc., is required by Collective Bargaining Agreement to participate in an applicable apprenticeship and training program approved by and registered with the United States Department of Labor's Bureau of Apprenticeship and Training. The attached certificates are evidence of compliance with the U.S. Department of Labor's apprenticeship requirements. Thank you for your cooperation in this matter. If you have any questions or concerns, please do not hesitate to contact me. Very truly yours, IUOE, Local 150, AFL-CIO District 1 dispatch office Caroline Lesniak Enclosures: Certificates ��ite� �'tate� �e�artrr�P�� ofd 4 office of appuntitt6blyp t Catiftratle of Rmi4trattlon of O(Pprmthobip-joriogram Operating Engineers Loca(150,�qpprenticeship Fund wrmington, lxln s �'or the trade -- Operating Engineer (Meavy Equipment Technician) eyrslereorasnzf o i e ¢fionfen.l cesSilc�r�sfem ii2 ¢ccorofance will-, lSe �'Qssc sldno� ros ofgpprenficesh�p esfa4�'sleo(W %,ie -6ecrelaz of &' 'or la 5 2002 Q?§vise ,dune 21, 2011 IL 012 020003 OSS", op ,vwla, -0arygFFia6ar a � 4 �`� `.1idnnir/ra/or��'ca of�ippren/iat�ip ttgWtratw"n Df ZIPPry 1p �xA�C�.ltt Operating engineers Locall50Apprenticeship Fund ImfMington, Ifil'i s !°orthe Trade -- Operating Engineer 5?e ssfereoras,palrf of �'e gCaj ona.�,9pprenfice&40 63rd em 9 . sn accoro�an ce wAS IZe �7as rc sfan throes o)Appren feces ip esfa�][isZeo(6 fSe c5ecrefary of Decem6er31 178 - q?§vised,7une 23, 2011 ' TLOO8780173 r opt V m of t- �EL`�I.tI��tE Dt October 13, 2020 Painters Local Union 1118 1345 Northside Blvd, South Bend, IN 46615 Telephone: 219-246-4235/fax: 317-522-4907 To whom it may concern: Ziolkowski Construction is currently in good standings with IUPAT District Council 91 Local 1118 out of South Bend, Indiana. They are up to date on all of their union contributions to all funds. If you should have any further questions, please feel free to contact my office. Respectfully yours, Lisa Earls Administrative Assistant IUPAT District Council 91/LU 1118 e.Lw{iopim ]I�pttttt�P�tf��` gratmug"gWyloger nub phorSrMas �urrnu ,ofrenf'rrrshi�r nub graming dnfifirafr of �rglsfrnfiou Finishing Trades Institute of District Council 91 Evansville, Indiana for the trade classifications of Painter (Construction), Glazier, Drywall Applicator, Hydro BlasterNacuum Technician e� s ereo'as pa-rf of f�'e ezroar f 57p.ps.I'2 sn ezecororarPce mi'r` e basic slano�zrol ,fa pprenlicesSp esla, 6-f s-SeoT�� ZSe cSecrelarr�. of.'a�or ,/larch 9, 2009 T.7, IN -070 092065 -WagiTl,va/ion Co. C4 1 ;} cSecrchwy of,6a O o, ��nini:/ra/or; ✓rlppr_n/me.,� Jrvininy, l vnp/oyer andi-Ga6or cScr ,incl