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HomeMy WebLinkAboutOpening of Quotes - 100 S. Michigan Tree Grates Proj No. 121-037 - Acorn Landscaping & Excavation LLCCITY OF SOUTH BEND, INDIANA CONTRACTOR'S QUOTE FOR PUBLIC WORK PROJECT NAME: 100 S Michigan Tree Grates PROJECT NO. 121-037 QUOTES DUE October 26th, 2021, 9:00 A.M. Local Time to bawbids0southbendin nov (Must be completed for all quotes. Please type or print) Date: October 25, 2021 Firm: Acorn Landscaping LLC Address: 3680 W. Sample St. City/State/Zip: South Bend, IN 46619 Telephone Number: (574) 288-6950 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: 100 S Michi an Tree Grates 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 October 25, 2021 for the sum of (enter the Total Quote as shown on the Proposal) One hundred one thousand, two hundred and forty-four dollars and thirty-six cents ($ 101,244.36 ) (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 t s to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. 4 A The above quote is accepted this Subject to the following conditions: BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Murray L. Miller, Member By ACCEPTANCE day of Joseph R. Molnar, Member Jordan V. Gathers, Member Attest: Anne Fuchs, Clerk 20 Version 09/29/2021 Page - 14 Public Works Quote 3680 W. Sample St., SoutA 133end, IN 46619 AFFIRMATIVE ACTION PROGRAM Acorn Landscaping, LLC Equal Employment Opportunity Policy 1. Acorn Landscaping, LLC does not discriminate against anyone because of race, color, religion, sex, age, disability, natural origin, handicap, association with the Vietnam era or any other war or disabilities. Discrimination is not permitted in hiring, upgrading, transfer, demotions, recruitment, advertising, layoff or termination, rate of pay or other forms of compensation or selection of training. 2. The Title, Treasurer: Name, Andrea M. Ritschard, shall be designated as Acorn Landscaping, LLC Equal Employment Officer. She will be responsible for all activities associated with the implementation of all policies affecting equal employment opportunity. 3. Acorn Landscaping, LLC assures nondiscriminatory recruitment by taking appropriate steps such as: A. Placing employment advertisements in newspapers which serve the largest number of minority group people in the recruiting area. B. Recruiting through schools and vocational colleges having substantial proportions of minority students. C. Maintaining systematic contacts with minority and human relations organizations leaders referral of qualified minority applicants. D. Encourage present employees to refer minority applicants. E. Make it known to all recruitment sources that qualified minority members are being sought whenever there is hiring. 4. Acorn Landscaping, LLC assures non-discriminatory placement and promotion by taking appropriate steps such as: A. Instructing personally those of our staff who make decisions on placement and promotion that minority employees are to be considered without discrimination and that job areas in which there is little or no minority representations should be reviewed to determine whether this results from discrimination. B. Making it known to all lower paid employees, inquiring as to their interest and skills with respect to any of the higher paid jobs, followed by assistance, counseling and effective measures to enable employees with interest and potential to qualify themselves for such jobs. Phone: 574-288-6950 Fax: 574-289-1096 Mobile: 574-292-6519 5. Acorn Landscaping, LLC Goals and Timetables for 2020--2021. Acorn Landscaping, LLC assures that on any of the their job turnover it may have within the next year, they will seek to fill at least one half the vacancy with minority workers. 6. We submit the above plan to comply with the Civil Rights Act of 1964, as amended, the Federal Highway Act of 1968, the Executive Order 11246 and 11375, the Rehabilitation Act of 1973, as amended, the Disabled Veterans and Vietnam Era Veterans Readjustment Act of 1974, as amended, the Indiana Civil right Act, and other Federal and State laws and Regulations pertaining to Equality of Opportunity and Affirmative Action Policies. 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. 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 09/29/2021 Page - 23 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, 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 contract or employment, or any matter directly or indirectly related to contracting or employment because of race, sex, religion, color, national origin, ancestry, gender expression, gender identity, sexual orientation, or due to age 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. On goal -eligible contracts, Contractors are required to either meet both MBE and WBE utilization goals or demonstrate that the Contractor has made good faith efforts to obtain participation from MBE and WBE subcontractors. 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. Version 09/29/2021 Page - 24 Public Works Quote 1, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16- 8-1).1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the Un ited 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 25 day of October 2021 Acorn Landscaping & Excavating LLC Co _ r Bidder (Firm) Sign3*WdT Contractor/Bidder or Its Agent Jeff Ritschard, Owner Printed Name and Title Subscribed and sworn to before me this �J day v� My Commission Expires 04 ..p % .&p 41 Notary Public `� County of Residence L Forrest �P061 to — Indiana St Joseph County Commission s 710303 Version 09/29/2021 Page - 25 Public Works Quote QUOTE/PROPOSAL CITY OF SOUTH BEND PROJECT NAME 100 S Michigan Tree Grates PROJECT NO. 121-037 October 26th, 2021, 9:00 A.M. Local Time to QUOTES DUE bpwbids(&southbendin.00v Item No. Description Qty Unit Unit Price Total Amount 1 CONSTRUCTION ENGINEERING 1 LS $ 4,685.00 $ 4,685.00 2 MOBILIZATION & DEMOBILIZATION 1 LS $ 6,654.00 $ 6,654.00 3 CONCRETE SIDEWALK, REMOVE 42 SY $ 144.00 $ 6,048.00 4 CONCRETE PLANTER CURB/WALL, REMOVE 302 LF $ 39.68 $ 11,983.36 5 COMMON EXCAVATION 13 CY Is 629.00 $ 8,177.00 6 TREE, REMOVE, 6 IN 10 EA $ 435.00 $ 4,350.00 7 ELECTRICAL OUTLET PEDESTAL, REMOVE 2 EA $ 825.00 $ 1,650.00 8 TREE GRATE AND FRAME, 5'x5' 5 EA $ 2,634.00 $ 13,170.00 9 CONCRETE SIDEWALK, 4 IN 120 SY $ 185.10 $ 22,212.00 10 TREE, DECIDUOUS, SINGLE -STEM, 3IN, B&B 5 EA $ 1,328.00 $ 6,640.00 11 QUAZITE BOX 2 EA $ 2,475.00 $ 4,950.00 12 RECEPTACLE IN TREE GRATE, CONDUIT, AND WIRING 5 EA $ 2,145.00 $ 10,725.00 Total Amount of Quote $ 101,244.36 Firm: Address: City/State/Zip: Acorn Landscaping LLC 3680 W. Sample St. South Bend, IN 46619 Telephone Number: ( 574 ) 292 - 6519 F By Version 09/29/2021 Page - 26 Public Works Quote iii •. I'. _ CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE -1.0 MBE 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: 121-037 Project Name: 100 S Michigan Tree Grates Acorn Landscaping LLC Total Bid Amount: 101,244.36 MBE Goal: 1.6% Page 1 of 1 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 V and R Trucking 1845 N. Elmer St. South Bend, IN 46628 Veda L. Godette Trucking of Demo Material $ 2,080.00 a 2.05/o Submitted by: Jeff Ritschard Print Name Signature October 25, 2021 Date Version 09/29/2021 Page - 27 Public Works Quote CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN _ FORM WBE-1.0 WBE UTILIZATION PLAN This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE participation. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the WBE qualifications. Project Number: Bidder: 121-037 Acorn Landscaping LLC Project Name: 100 S Michigan Tree Grates Total Bid Amount: 101,244.36 WBE Goal: 3.7% Page 1 of 1 Jeff Ritschard Submitted by: Print Name W Signature October 25, 2021 Date Version 09/29/2021 Page - 28 Public Works Quote Primary Contact Person Scope of Work to be Performed Dollar Amount of WBE Percentage of Total Name 8 Address of WBE (Name/Telephone) (Attach scope/schedule if you need additional space) Component Bid/ProposalT Premium Concrete Services, Inc. Concrete Sidewalk 712 Richmond St. #A Rob Becker $ 14,250.00 14.07% Elkhart, IN 46516 574-612-3709 Becky Yeakey, Owner Jeff Ritschard Submitted by: Print Name W Signature October 25, 2021 Date Version 09/29/2021 Page - 28 Public Works Quote CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE -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 MBE participation. Project Number: Project Name: Bidder: Contact Person: Address: City: Email: 121.037 100 S Michigan Tree Grates Date: October 25, 2021 Acorn Landscaping LLC Jeff Ritschard Telephone: (574) - 292 - 6519 3680 W. Sample St. South Bend State: Indiana Zip: 46619 jeffritschard@yahoo.com To determine whether a bidder has demonstrated good faith efforts to reach the MBE utilization goal 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 09/29/2021 Page - 29 Public Works Quote EVIDENCE OF GOOD FAITH EFFORTS MBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: hftr)://www.in.aov/idoat. GOOD FAITH EFFORTS TO OBTAIN MBE PARTICIPATION The bidder shall initial each item below, as evidence of its good faith efforts to obtain MBE 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 Indiana Minority and Women Business Enterprises, found on their website (http://www.in.gov/idoa). I affirm that I have made good faith efforts to select portions of the contract work to be performed by MBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate MBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available means the interest of all MBEs in the scopes of work of the contract. Sa 1 affirm that I attended all pre-bid meetings scheduled by the City of South Bend to inform VMBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications concerning subcontract opportunities and allowed MBEs reasonable time to respond to such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a manner reasonably calculated to inform MBEs of subcontracting opportunities and allowed sufficient time for MWBEs to participate effectively. V I affirm that I followed up on initial solicitations with interested MBEs. .SQ—, I affirm that I negotiated with interested MBEs in good faith, including providing such MBEs V with adequate information about the plans, specifications and other requirements of the subcontract. Vlines I affirm that I have made good faith efforts to assist interested MBEs in obtaining bonding, City the bidder, where appropriate. of credit, or insurance as required by the or Version 09/29/2021 Page - 29 Public Works Quote CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE -2.0 EVIDENCE OF GOOD FAITH EFFORTS per 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 09/29/2021 Page - 30 Public Works Quote {9_ / 1 affirm that I have made good faith efforts to assist interested MBEs in obtaining necessary V equipment, supplies, materials, or related assistances or services, where appropriate. Aq-/ 43 I affirm that I did not reject any MBEs as unqualified without sound business reasons based V on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each MBE 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 MBE was unqualified to perform the job. per 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 09/29/2021 Page - 30 Public Works Quote CITY OF SOUTH BEND z MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN :tet >� FORM WBE-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 WBE participation. Project Number: 121-037 Date: October 25, 2021 Project Name: 100 S Michigan Tree Grates Bidder: Acorn Landscaping LLC Contact Person: Jeff Ritschard Telephone; (574) - 292 - 6519 Address: 3680 W. Sample St. city: South Bend state: Indiana Zip: 46619 Email: jeffritschard@yahoo.com To determine whether a bidder has demonstrated good faith efforts to reach the WBE 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 09/29/2021 Page - 31 Public Works Quote EVIDENCE OF GOOD FAITH EFFORTS WBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: hftr)://www.in.ciov/idoa/. GOOD FAITH EFFORTS TO OBTAIN WBE PARTICIPATION The bidder shall initial each item below, as evidence of its good faith efforts to obtain WBE 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 Indiana Minority and Women Business Enterprises, found on their website (http://www.in.govAdoa), I affirm that I have made good faith efforts to select portions of the contract work to be breaking out contract work items into performed by WBEs, including, where appropriate, economically feasible units to facilitate MWBE participation. Ste_ / I affirm that I have made good faith efforts to solicit through all reasonable and available V means the interest of all WBEs in the scopes of work of the contract. 44. 1 affirm that I attended all pre-bid meetings scheduled by the City of South Bend to inform WBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications / V concerning subcontract opportunities and allowed WBEs reasonable time to respond to such advertisements. • I affirm that I performed any and all necessary steps to provide written notices in a manner reasonably calculated to inform WBEs of subcontracting opportunities and allowed sufficient time for WBEs to participate effectively. S� 1 affirm that I followed up on initial solicitations with interested WBEs. I affirm that I negotiated with interested WBEs in good faith, including providing such WBEs Jwith adequate Information about the plans, specifications and other requirements of the subcontract. I affirm that I have made good faith efforts to assist interested WBEs in obtaining bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 09/29/2021 Page - 31 Public Works Quote CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS `Proper demonstration of Good Faith Efforts requires your initials next to all of theabove 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. _...i I'r..- Version 09/29/2021 Page - 32 Public Works Quote Vnecessary I affirm that I have made good faith efforts to assist interested WBEs in obtaining equipment, supplies, materials, or related assistances or services, where appropriate. 5_ / I affirm that I did not reject any WBEs as unqualified without sound business reasons V based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each WBE 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 WBE was unqualified to perform the job. `Proper demonstration of Good Faith Efforts requires your initials next to all of theabove 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. _...i I'r..- Version 09/29/2021 Page - 32 Public Works Quote }ir ri7 ti�Ij; CITY OF SOUTH BEND �al MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE -2.1 =- MBE 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 I OF I Project Number: 121-037 MBE Participation Goal 1.6% Project Name: 100 S Michigan Tree Grates Bidder: Acorn Landscaping LLC By: Jeff Ritschard Owner October 25., 2021 MBE Firm V and R Trucking Owner or Contact at MBE Firm Telephone: 574-234-1268 Veda L. Godette Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT tuate/ Email: rfiightingirish@aol.com RESULTS OF CONTACT WITH THE MBE FIRM: Received Quote and Plan to use company. 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 09129/2021 Page - 33 Public Works Quote CITY OF SOUTH SEND l MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.1�% WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the WBE qualifications. Attach additional pages if necessary. PAGE_L_OF Project Number: 121-037 WBE Participation Goal 3.7% Project Name: 100 S Michigan Tree Grates Rlrlrlrar•/ 1 Acorn Landscaping LLC By: Jeff Ritschard, Owner October 25, 2021 WBE Firm Premium Concrete Services, Inc. Owner or contact at WBE Firm Becky Yeakey (Owner) / Rob Becker (Contact) Telephone: 574-612-3709 Fax: Email: rbecker@premiumconcreteonline.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Concrete Sidewalk RESULTS OF CONTACT WITH THE WBE FIRM: Received Quote and Plan to use company. WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: Version 09/29/2021 Page - 34 Public Works Quote ACORLC1 '4lkse O CERTIFICATE OF LIABILITY INSURANCE °10125/2021AM Y 1or2srzozl THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 847-303-6800 Dohn & Maher Associates 4811 Emerson Avenue, Suite 102 Palatine, IL60067-7416 CONTACT PHONE 647-303-6800 FAX 847-303-6963 INC. No, Ed): A/c, Na): E-MAIL . certificatesgoohn.com William P. Maher INSUREFUSI APFORDWG COVERAGE NAIC 0 INSURER A: Westfield Insurance 24112 EACH OCCURRENCE S 1,000,000 INSURED Acorn Landscaping, LLC 3680 W Sample St South Bend, IN 46619 INSURER B: INSURER C : INSURER 0: . INSURER E: 04/0112022 INSURER F: r•nveo An_ce CCGTICICATF NIIMRFR• RFVIRI()N NI IMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI TYPEOFINSURANCE JAWL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCNALGENERALLIASILITY EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED SIFa �nG $ 500,000 CLAIMS -MADE EKOCCUR CWP015513X 0410112021 04/0112022 ME EXP Any one arson S 5'000 PERSONAL a ADV INJURY S 1'000'000 L AGGREGATE LIMIT APPLIES PER: POLICY ❑X jE LOC 7THER: GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMPIOP AGG 5 2,000,00 0 A AUTOMOBILELIASIUTY COMBINED SINGLE LIMB E 1,000,000 WI X X ANY AUTO AUTEOE��S ONLY AUTOSSUWLEEp❑ Z'Rs ONLY X ATOS ONLY CWPOISS13X 04/0112021 04101120221 BODILY INJURY Per arson BODILY INJURY Perieccidenl S PRLOPERQ 1 AMAGE S. A X UMBRELLA UAB EXCESS LIAS X OCCUR CLAIMS44ADE CWP015513X 04101/2021 0410112022 EACH OCCURRENCIE s 5'000'000 AGGREGATE 5'000'000 DED X RETENTIONS O A A WORKERS COMPENSATION AND EMPLOYERS' UASILRY y/ OFFICERME,MBOER EXRCwOE�, ECUTIVE M (Mandkdmy MNH) If jes. desvibe under p CRI TI N OF OPERATIONS b I Installation FIDECWP015513X NIA WCP015556V 04/01!2021 04/0112021 04/01/2022 04/01/2022 X I PER OTH 1,000,000 EL EACH ACCIDENT S E DISEASE - EA EMPLQYEEI S 1,000,000 - POL Y IMn 1,000,o00 Limit 10,000 A Leased/Rented Eq CWP016613X 04/0112021 04/01/2022 Limit 150,000 DESCRIPTION OF OPENATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If mors space is required) The following are included as Additional Insured to General Liability (coverage form attached as required by written contract with respects to work performed by the Named Insured: City of South Bend. CTYSOBE City of South Bend 227 W. Jefferson Blvd. South Bend, IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016103) v TBaa-tuTo (A1.ufcu a.vrcrvrwl Ivn. .,II ,.yl. o ,e��, The ACORD name and logo are registered marks of ACORD Acorn Landscaping LLC POLICY NUMBER CWP 015513X COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations All persons or organizations when you have All Locations agreed in writing in a contract or agreement that such persons or organizations be added as an additional insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section tl - Who Is An Insured is amended to Include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and adver- tising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing oper- ations for the additional insured(s) at the location(s) designated above. However: 1, The insurance afforded to such additional insured only applies to the extent per- mitted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following addi- tional exclusions apply: This insurance does not apply to "bodily in- jury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the addi- tional Insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the ap- plicable limits of insurance. QQ insurance Services Office, Inc., 2019 CG 20 10 12 19 Acorn Landscaping LLC POLICY NUMBER: CWP 015513X COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) And Description Of Covered Operations All persons or organizations when you have All Locations agreed in writing in a contract or agreement that such persons or organizations be added as an additional insured. information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, In whole or in part, by "your work" at the location desig- nated and described in the schedule of this endorsement performed for that additional Insured and included in the "products - completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent per- mitted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured Is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the ap- plicable limits of insurance. O Insurance services office, Inc., 2018 CG 20 37 12 19