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HomeMy WebLinkAboutOpening of Bids - Morris Box Office Renovation – Project No. 121-029C - Gibson-Lewis LLCDate: CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Morris Box Office Renovation Project No. 121-029C For Bids Due July 26, 2022 PART I (Must be completed for all bids. Please type or print) 7/26/2022 Bidder (Firm): Gibson -Lewis, LLC Address: 1001 W. I Ith Street City/State/Zip: Mishawaka, IN 46544 Telephone Number: 574 259-8581 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: Morris Box Office Renovation. Project No. 121-0290 the City of South Bend, Indiana, in accordance with plans and specifications prepared by: Shive-Hatte Inc., 222 Third Avenue SE STE 300 Cedar Rapids, IA 52401 and dated 7/8/2022 for the sum of (enter the Total Bid as shown on the Proposal) (Enter sum of Total Base Bid plus Alternates shown on Proposal) (Numerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are 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 bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. By 7X*V Z;::l (Signature) Robert A. Lin enfelter, President (Printed Dame of Person Signing) ACCEPTANCE The above bid is accepted this day of Subject to the following conditions BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Murray L. Miller, Member 20 Joseph R. Molnar, Vice President Jordan V. Gathers, Member Attest: Theresa Heffner, Clerk Version 09/29/2021 Contractor's Bid for Public Works - 2 Bidder: Gibson -Lewis, LLC PART 11 (For projects of $100,000 or more — IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/her/its bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to imme6ately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attacloment 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. *See attached Financial Statement Version 09/29/2021 Contractor's Bid for Public Works - 3 Bidder: Gibson -Lewis, LLC ACCEPTANCE The above bid is accepted this day of subject to the following conditions: Contracting Authority Members: PART II (For projects of $100,000 or more — IC 36-1-12-4) Governmental Unit: City of South Bend,'Indiana Board of Public Works Bidder (Firm) Gibson -Lewis, LLC Date: July 26, 2022 These statements to be submitted under oath by each bidder with and as a part of his bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. What public works projects has your organization completed for the period of one (1) year prior to the date of the current bid? Contract Amount Class of Work Completion Date Name and Address of Owner 4,374,000 2022 2021 Cleveland Twsp Fire Station - Elkhart, 7,970,000 Mishawaka Town Hall - Mishawaka, rN 2021 Elkhart Comm Schools - Elkhart, IN 2,964,000 Oak Hill HS - Converse, W 2021 2021 PHM Science/Fitness - Osceola, IN Dowagiac Library - Dowagiac, MI 1,119,000 Fairview Elementary - Logansport, M 2. What public works projects are now in process of construction by your organization? Contract Amount Expected Class of Work Completion Date Name and Address of Owner Hanover Elementary - Cedar Lake, W 4,749,000 2022 2,041,000 12022 Mishawaka Town Hall - Mishawaka, rN 3,506,000 2022 Oak Hill HS - Converse, W 3,021,000. 2022 Fairview Elementary - Logansport, M Bidder: Gibson -Lewis, LLC Have you ever failed to complete any work awarded to you? No If so, where and why? 4. List references from private firms for which you have performed work. University of Notre Dame Memorial Hospital of South Bend St. Joseph Regional Medical Center 1st Source Bank - Notre Dame, IN - South Bend, IN - South Bend, IN - South Bend, IN SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.) *Apply adequate personnel to complete the work. 2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. *Please see attached listing. 3. If you intend to sublet any portion of the work, state the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the governmental unit in the event that you subsequently determine that you will use a subcontractor on the proposed project. *Unresolved 4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit. *All necessary 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, please explain the rationale used which would corroborate the prices listed. *No SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded. *See attached Financial Statement F 8771 a SELECTED SUBS FOR FORM 96 RV SUTTON, INC. EXCAVATING RITSCHARD BROS., INC. 160 W RAIL ROAD UNIT 1 1204 W SAMPLE STREET CHESTERTON, IN 46304 SOUTH BEND, IN 46619 WALSH & KELLY PAVING RIETH RILEY CONSTRUCTION 24358 STATE ROAD 23 25200 STATE ROAD 23 SOUTH BEND, IN 46614 SOUTH BEND, IN 46614 ZIOLKOWSKI CONSTRUCTION MASONRY KWIATKOWSKI MASONRY 1005 S LAFAYETTE STREET 1006 N INDIANA AVENUE SOUTH BEND, IN 46601 CROWN POINT, IN 46307 STEVENS IRON WORKS, INC STRUCTURAL STEEL CRANE INDUSTRIAL SERVICES P.O. BOX 730 11035 ANDERSON ROAD DEMOTTE, IN 46310 GRANGER, IN 46530 EC BABILLA ROOFING DUDECK ROOFING & SHEET METAL 3974 HARRISON STREET 1634 SOUTH FRANKLIN STREET GARY, IN 46409 SOUTH BEND, IN 46614 WERNTZ SUPPLY GLASS & GLAZING PRECISION WALL 1002 KERR STREET 3801 S MAIN STREET SOUTH BEND, IN 46601 SOUTH BEND, IN 46614 OVERHEAD DOOR COMPANY OVERHEAD DOOR INDUSTRIAL DOOR OF NORTHERN IN P.O. BOX 907 3839 S. MAIN STREET MISHAWAKA, IN 46546 SOUTH BEND, IN 46614 MASTER TILE FLOORING INTERIOR FINISHES, INC. 1205 WEST LINCOLN HIGHWAY 1616 W THIRD STREET MERRILLVILLE, IN 46410 OSCEOLA, IN 46561 KROPP FIRE PROTECTION FIRE PROTECTION RYAN FIRE PROTECTION 59685 MARKET STREET 9740 EAST 148TH STREET SOUTH BEND, IN 46614 NOBLESVILLE, IN 46060 DA DODD, INC PLUMBING & HVAC EDWARD J WHITE P.O. BOX 430 1011 S. MICHIGAN STREET ROLLING PRAIRIE, IN 46371 SOUTH BEND, IN 46601 MARTELL ELECTRIC ELECTRIC MCMANN ELECTRIC, INC 4601 CLEVELAND ROAD 1454 THIRD STREET SOUTH BEND, IN 46628 OSCEOLA, IN 46561 Bidder: Gibson -Lewis, LLC 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 departr:ient 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: 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 alien. Version 09/29/2021 Contractor's Bid for Public Works - 4 Bidder: Gibson -Lewis, LLC 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. 1, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1).1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder Version 09/29/2021 Contractor's Bid for Public Works - 5 Bidder: Gibson -Lewis, LLC 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 26th day of July , 2022 Gibson -Lewis, LLC Contractor/Bidder (Firm) Signature of Contractor/Bidder or Its Agent Robert A. Lingenfelter, President Printed Name and Title Subscribed and sworn to before me this 2 y of Jul .2o22 My Commission Expires 08/05/2023 N ary Public .lull Hodowaniec County of Residence St. Joseph Version 09/29/2021 Contractor's Bid for Public Works - 6 e •"'••` Notary Public, Stale Of Indiana St Joseph County SEAIL Commission k 671289 ',� .•..* ��+` ''►Or My Cornwsslon Expires °;;; +►'' Augusl 05, 2023 Version 09/29/2021 Contractor's Bid for Public Works - 6 Project Name: Project Number: For Bids Due: Contractor Name: BASE BID BID/PROPOSAL CITY OF SOUTH BEND Morris Box Office Renovation 121-029C July 26, 2022 Gibson -Lewis, LLC Item No Description Quantity Unit Unit Price Total Amount Complete demolition, including: walls (full and partial), doors/windows, 1 concrete step, ceiling systems, 1 LS electrical, and mechanical components as noted on the demolition drawings. New wall infill, new ceiling, and new finishes throughout Box Office Lobby and Box Office (including paint; trim at 2 walls, openings and columns; installation 1 LS of in -stock CPT1; floor leveling at CT2 transition to match existing ramp condition; SS1 at storefront bay ledges) New exterior storefront Box Office 3 window systems (including countertop at 1 LS office desk) New interior Box Office Window system 4 (including countertop and surrounding 1 LS trim) Mechanical work as required in Box 5 Office Lobby (not limited to: rerouting 1 LS ductwork as necessary, etc.) Electrical renovations as required in the 6 Box Office Lobby and Box Office (not 1 LS limited to relocating wiring and access panel, light fixture replacements, etc.) Bidder (Firm): Gibson -Lewis LLC Address: 1001 W. 11th Street City/State/Zip: Mishawaka, IN 46544 Telephone Number: BASE BID TOTAL (574 ) 259-8581 By (Signature) Robert A. Lin enfeltcr President (Printed Name of Person Signing) Version 09/29/2021 Contractor's Bid for Public Works - 7 CITY OF SOUTH BEND _. MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE -1.0 , MBE UTILIZATION PLAN l 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-owned business meets the MBE qualifications. Project Number: 121-029C Project Name: Morris Box Office Renovation Bidder: Gibson -Lewis, LLC Name i Address of MBE ! Primary Contact Person (NamerFelephone) Total Bid Amount: Scope of Work to be Performed (Attach scope/schedule if you need additional space) Submitted by: Robert A. Lingenfelter, President 7e_� _� ;—_ — Print Name Signature Version 09/29/2021 Contractor's Bid for Public Works - 8 MBE Goal: 3.1% Page of Dollar Amount of MBE Percentage Component of Total Bid/ProDOsal 7/26/2022 Date 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 woman -owned business meets the WBE qualifications. Project Number: Bidder: 121-029C Project Name: Morris Box Office Renovation Gibson -Lewis, LLC Total Bid Amount: WBE Goal: 4.4% Page of Submitted by: Robert _A. Lingenfelter, President 5 �y4 Print Name Signature Version 09/29/2021 Contractor's Bid for Public Works - 9 Date 7/26/2022 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: 121-029C Date: 7/26/2022 Project Name: Morris Box Office Renovation Bidder: Gibson -Lewis, LLC Contact Person; Robert A. Li enfelter, President Telephone: 574-259-8581 Address: 1001 W. 11th Street City: Mishawaka State: IN zip: 46544 Email: r1ingenfelterkgl.nceusaxom To determine whether a bidder has demonstrated good faith efforts to reach the MBE 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 Contractor's Bid for Public Works - 10 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: htt ./Iwww.in. oV1idoa/. 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 j� `^ performed by MWBEs, 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. I affirm that I attended all pre-bid meetings scheduled by the City of South Bend to inform MBEs 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 MBEs to participate effectively. (/ 11 I affirm that I followed up on initial solicitations with interested MBEs I affirm that I negotiated with interested MBEs in good faith, including providing such MBEs with adequate information about the plans, specifications and other requirements of the v subcontract. /) I affirm that I have made good faith efforts to assist interested MBEs in obtaining bonding, r lines of credit, or insurance as requires: by the City or the bidder, where appropriate. Version 09/29/2021 Contractor's Bid for Public Works - 10 Bidder: Gibson -Lewis, LLC CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE -2.0 EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested MBEs in obtaining necessary equipment, supplies, materials, or related assistances or services, where appropriate. I affirm that I did not reject any MBEs 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 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. *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 informs tion. Version 09/29/2021 Contractor's Bid for Public Works - 11 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN 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 MWBE participation. Project Number: 121-029C Date: 7/26/2022 Project Name: Morris Box Office Renovation Bidder: Gibson -Lewis, LLC Contact Person: Robert A. Lingenfelter, President Telephone: 574-259-8581 Address: 1001 W. 11th Street City: Mishawaka State: IN zip: 46544 Email: rlin enfelter l.nccusa.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 Contractor's Bid for Public Works - 12 EVIDENCE OF GOOD FAITH EFFORTS WGE 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: httv//www.in.gov/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 SouLn Bend's Minority and Women Business Enterprise Inclusion Program Plan and the Indiana Department of Administration's certified list of ndiana Minority and Women Business Enterprises, found on their website (http:/Avww.in.gov/idoa). I affirm that I have made good faith efforts to select portions of the contract work to be performed by WBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate WBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available means the interest of all WBEs 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 WBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications 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. I 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 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 WBEs in obtaining bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 09/29/2021 Contractor's Bid for Public Works - 12 CITY OF SOUTH BENDi.'1� MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN - r.cr r + FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested WBEs in obtaining necessary equipment, supplies, materials, or related assistances or services, where appropriate. Jn I affirm that I did not reject any WBEs 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 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 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 09/29/2021 Contractor's Bid for Public Works - 13 CITY OF SOUTH BEND 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-owned business meets the MBE qualifications. Attach additional pages if necessary. PAGE OF Project Number: 121-029C MBE Participation Goal 3.1% Project Name: Morris Box Office Renovation Bidder: z bson-Lewis LLC By President 7/26/2022 (Signature) Rober . Lin en eIter (Title) (Date) 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: 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 09/29/2021 Contractor's Bid for Public Works - 14 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE -2.1 �_ ism 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 woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE OF Project Number: 121-029C WBE Participation Goal 4.4% Project Name: Morris Box Office Renovation Bidder: Gibson -Lewis, LLC By President 7/26/2022 (Signature) Robert A. Line nfelter (Title) (date) WBE Firm Owner or Contact at WBE Firm Telephone: Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: WBE Firm Owner or Contact at WBE Firm Telephone: Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM. Email: Email: Version 09/29/2021 Contractor's Bid for Public Works - 15 Document A31 OTM -2010 Conforms with The American Institute of Architects AIA Document 310 CONTRACTOR: (Name, legal status and address) Gibson -Lewis, LLC 1001 West 11th Street Mishawaka, IN 46544 OWNER: (Name, legal status and address) City of South Bend, Indiana - Board of Public Works 227 W. Jefferson Blvd. South Bend, IN 46601 Bond Number: 03992 -CNA -22-107 SURETY: (Nance, legal status and principal place of business) The Continental Insurance Company 151 N Franklin Street Chicago, IL 60606 State of Inc: Pennsylvania BOND AMOUNT: Five Percent of Amount Bid (5%) PROJECT: (Name, location or address, and Project number, if any) Morris Box Office Renovation — Project #121-029C This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. and sealed this 14th day of July r 2022 Gibson -Lewis, LLC (Principal) (Seal) ( tness) Juli Hodowaniec (Title) Robert A. Lingenfe er, President The Continental Insurance Company (Surety)(Seal) (WitneSS) Daniel Machado _ (Title) Ann Mullins, Attorney -in -Fact State of ILLINOIS County of WILL I ss: On July 14, 2022 , before me, a Notary Public in and for said County and State, residing therein, duly commissioned and sworn, personally appeared Ann Mullins known to me to be Attorney -in -Fact of The Continental 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 se , the day and year stated in this certificate above. My Commission Expires 11/02/2023 Aaron D. Griffin Notary Public AARON D GRIFFIN OFFICIAL SEAL Notary Public, State of Illinois My Commission Expires November 02, 2023 R . . POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That The Continental Insurance Company, a Pennsylvania insurance company, is a duly organized and existing insurance company having its principal office in the City of Chicago, and State of Illinois, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Ann Mullins , Individually of Chicago Illinois . its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature — In Unlimited Amounts — Surety Bond Number: 03992 -CNA -22-107 Principal; Gibson -Lewis, LLC Obligee: City of South Bend, Indiana - Board of Public Works and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the insurance company and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Board of Directors of the insurance company. In Witness Whereof, The Continental Insurance Company has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 2nd day of February, 2021. State of South Dakota, County of Minnehaha, ss: The Continental Insurance Company 12Z �r-g"*z- Paul T. Bruflat lVice President On this 2nd day of February, 2021, before me personally came Paul T. Bruflat to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of The Continental Insurance Company, a Pennsylvania insurance company, described in and which executed the above instrument; that he knows the seal of said insurance company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said insurance company and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance company. }4h444hhhh4b44bhh4h44hbbb + a M. BENT f SERI NOTARY PUBLIC 8 3 a SOUTH DAKOTA(M' }hbbhbbbbbbbbbbbbbbbbbbb } My Commission Expires March 2, 2026 M. Bent Notary Public CERTIFICATE I, D. Johnson, Assistant Secretary of The Continental Insurance Company, a Pennsylvania insurance company, do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance company printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance company this 14th day of July , 2022 . Fonn F6850-2-2021 ����•t�5t.k•.: Pi • Mb ^: � r• I ■4 .. i 06 The Continental Insurance Company D. Johnson Assistant Secretary EQUAL EMPLOYMENT OPPORTUNITY POLICY GIBSON-LEWIS, LLC has adopted the following policy on equal employment opportunity: The Company will not discriminate against any employee or applicant for employment because of race, color, religion, sex, age, national origin, disability, citizenship status, genetic information, ancestry, off-duty tobacco use, sealed or expunged arrest or conviction record and veteran status or any other basis protected by state, federal or other applicable law. The company is also committed not to discriminate regarding the following: ■ Referral, Hiring, Placement, Upgrading, Promotion, Transfer, Demotion, or Award of Tenure: ■ Recruitment, Advertising, Solicitation for Employment, or Job Application Procedures; ■ Rates of Pay or other Forms of Compensation and Changes in Compensation; ■ Treatment during Employment; • Job Assignments, Job Classifications, Organizational Structures, Position Descriptions, Lines of Progression, and Seniority Lists; • Leaves of Absence, Sick Leave, or any other Leave; • Fringe Benefits Available by Virtue of Employment, Whether or Not Administered by the Company; • Activities Sponsored by the Company including Social or Recreational Programs; ■ Selection and Financial Support for Training including Apprenticeship, Professional Meetings, Conferences, and other Related Activities and Selection for Leave of Absence to Pursue Training; ■ Layoff or Termination; Right to Return from Layoff, Rehire, and all other Terms and Conditions of Employment The Company further agrees to provide a reasonable accommodation to any otherwise qualified individual with a disability unless the accommodation would cause an undue hardship, as and to the extent required by the Americans with Disabilities Act. The Company also seeks and intends to achieve and maintain full compliance with all other applicable statutes, regulations and executive orders on equal employment opportunity. THE COMPANY EXPECTS ALL EMPLOYEES TO ABIDE BY THIS POLICY. CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Morris Box Office Renovation Project No. For Bids Due 121-029C July 26, 2022 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 M/WBE Utilization Plans [MBE -1.0 and WBE-1.0]. Also provide Evidence of Good Faith Efforts Forms [MBE -2.0 and WBE-2.0] and M/WBE Contacted Forms [MBE -2.1 and X WBE-2.1]. X Acknowledge Receipt of 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: Gibson -Lewis, LLC By Authorized Representative: Signature: Print Name & Title: Robert A. Lin enfelter President Version 09/29/2021 Contractor's Bid for Public Works - 1 Date: 7/26/2022 General Form No, 96-a Prescribed by the State Board of Accounts of Indiana Revised 1949 STANDARD QUESTIONNAIRES AND, FINANCIAL STATEMENT FOR BIDDERS Prescribed by THE STATE BOARD OF ACCOUNTS OF INDIANA For use in investigating and determining the qualifications of bidders on public Finance construction when the aggregate cost of any such work or improvement will be Five Thousand Dollars or more. These statements to be submitted under oath by each bidder with and as a part of his bid, as provided by Chapier 306, page 1248, Acts of 1947. OWNER: City of South Bend, Indiana Board of Public Works 227 W. Jefferson Blvd South Bend, IN PROJECT: Morris Box Office Renovation South Bend, IN SUBMI'T'TED BY: GIBSON-LEWIS, LLC () A Corporation 1001 W. 111h. Street O A Co -partnership Mishawaka, Ind. 46544 () An Individual (X) A Limited Liability Company DATE: July 26, 2022 Filed: TO THE BIDDER — The following forms of questionnaires and ficial statement are prescribed by the State Board of Accounts in conformity with the statute set out on the proceeding page. These forms, properly filled out and attested, must accompany each bid of Five Thousand Dollars or more on any publie work. The forms are designed to cover all contracts for all kinds ofwork and the bidder is required to answer such questions as are pertinent to the work upon which he is bidding. The purpose of the questionnaire and financial statement, as set forth in the law, is to enable the awarding body to determine the qualifications of the bidder to carry out successfully the contract if the same is awarded to him. The bidder will find it to his advantage to answer fully all questions coming within the range of the work upon which he is bidding. Particular attention should be given the "Financial Statement" and the details relative to the assets and liabilities set out. This form is made in extensive detail so that the bidder may explain his assets and Liabilities in proper sequence and in a uniform manner. Section 2 or an Act entitled "An ACT concerning the awarding for the performance of public work and authorizing the board of accounts to prescribe certain forms to be used in ascertaining the responsibility of contractors who submit bids for the performance of such work, providing for plans and specifications, providing for bids repealing certain laws and declaring an emergency". Section 2. Whenever the aggregate costs of any work or improvement will be five thousand dollars ($5,000.00) or more, for the purpose of enabling such board, commission, trustee, officer or agent to ascertain and determine which of the bidders submitting bids for the performance of any such public work is, in the judgement of such board, commission, trustee, officer or agent, the lowest and/or best bidder and to exercise intelligently the discretion hereby conferred on such board, commission, trustee, officer or agent, each bidder shall be required to submit under oath with and as a part of his bid, a statement of his experience, his proposed plan for performing such work and the equipment which he has available for the performance of such work and a financial statement. The statements, hereby required shall be submitted on forms which shall be prescribed by the state board of accounts. The forms so prescribed shall be designated, respectively, as the experience questionnaire, the plan and equipment questionnaire and the contractor's financial statement, and shall be based, so far as applicable, on the standard questionnaires and financial statement for the bidders as approved and recommended by the joint conference on construction practices, for use in investigating the qualifications of bidders on public construction work, and the forms so prescribed are, hereby, prescribed as the forms which shall, hereafter, be used by all such boards, commissions, trustees, officers and agents in obtaining the information which is required in the administration of this act. If the information submitted by any bidder on the forms herein prescribed is found, on exarr ination, to be unsatisfadtory, the bid submitted by such bidder shaIl not be considered. Bidder: Gibson -Lewis, LLC CITY OF SOUTH BEND STATEMENT OF POLICY The Board of Public Works of the City of South Bend has adopted the following policy regarding the receipt of sealed bids: All sealed bids submitted to the Board of Public Works must be received in the Board of Public Works Office, 1316 County -City Building, South Bend, Indiana, no later than the advertised time on the advertised date of the bid opening. It shall be the responsibility of the bidder to see that his/her bid is received prior to the deadline stipulated in the bid advertisement. Bids submitted by mail and received after the advertised time deadline will not be considered by the Board. CITY OF SOUTH BEND BOARD OF PUBLIC WORKS Theresa Heffner, Clerk NOTE: Incoming mail does not reach the Board of Public Works until after 9:00 a.m. Local Time. If you are sending your bid via Federal Express or another overnight source, please confirm that your package will arrive before the bid opening date and time. Version 02/23/2022 General Conditions -1 Bidder: Gibson -Lewis, LLC recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause." "(2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex or national origin." "(3) The contractor will send to each labor union or representative of workers with which i t / he/she has a collective bargaining agreement or other contract of understanding, a notice, to be provided by the agency contracting officer, advising the labor union or workers' representative of the contractor's commitments under Section 202 of Executive Order No. 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment." "(4) The contractor will comply with all provisions of Executive Order No. 11246 of September 24, 1965, and of the rules and regulations, and relevant orders of the Secretary of Labor." "(5) The contractor will furnish all information and reports required by Executive Order No. 11246 of September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders." "(6) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, in this contract may be cancelled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order No. 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked" as provided in Executive Order No 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law." "(7) The contractor will include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions including sanctions for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the contractor may request the United States to enter into such litigation to protect the interests of the United States." The applicant further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work: Provided, that if the applicant so participating is a State or local government, the above equal opportunity clause is not applicable to any agency, instrumentality or subdivision of such government which does not participate Version 02/23/2022 General Conditions - 3 Bidder: Gibson -Lewis, LLC MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN The City of South Bend, Indiana has shown its commitment to addressing Minority and Women's Business Enterprise ("MWBE") participation in public contracting through the adoption of the City of South Bend Ordinance No. 10761-21. Persons, partnerships, corporations, associations, or joint ventures 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 or disability that does not affect that person's ability to perform work. Minority and Women's Business Enterprises are described in the Ordinance. A list of MBEs and WBEs (both certified and non -certified) can be found on the Indiana Department of Administration website: http:/Iwww.in.gov/idoa/. Documentation shall be provided with the bid that states the MBEs and WBEs that will be contracted, the dollar amount of the work that will be performed by the MBEs and WBEs on the project and the percentage of the dollar amount as it relates to the total bid amount by using Form MBE - 1.0, MBE Utilization Plan, and Form WBE-1.0, WBE Utilization Plan. The City, its agencies, boards, or commissions requires the Contractor's good faith efforts to obtain participation by those Contractors classified as MBEs and WBEs. Failure to either meet the MBE and WBE goals or to provide evidence of good faith efforts for the bid will be grounds for rejecting a bid as non-responsive. Bidders shall demonstrate good faith efforts to have active participation from MWBEs on this Project and supply written documentation evidencing such efforts by using Forms MBE -2.0, Evidence of Good Faith Efforts and WBE-2.0, Evidence of Good Faith Efforts and Forms MBE -2.1, MBE Contacted and WBE-2.1, WBE Contacted. Such documentation shall include, but is not limited to, the following items: a. A listing of all M/WBEs contacted including: (1) the name and address of the M/WBE; (2) the date of contact; (3) the type of contact (i.e., phone call, written solicitation, etc.); (4) the nature or type services or goods requested; and (5) the result of the contact. b. Written evidence of outreach and copies of email exchanges inviting and receiving bids, quotes or other responses from M/WBEs or other documentation of efforts to encourage and secure competitive responses from M/WBE and local businesses to be included in the benefits of building this Project. c. Written documentation of letters of introduction, invitations to forging majority/minority strategic alliances for capacity building, including but not limited to, mentoring, extensions of assistance on payroll, insurance, bonding, line of credit, technical skills or business skills. All bidders are actively encouraged to reach out to the M/WBEs in St. Joseph County, Indiana, other Indiana counties, and Berrien County, Michigan to utilize a good faith effort to forge constructive and lasting business partnerships. Notwithstanding the foregoing, the award and performance of all City contracts shall comply with applicable federal, state, and local laws. The City reserves the right to request verification of goal implementation throughout the course of the project. Version 02/23/2022 General Conditions - 5 Bidder: Gibson -Lewis, LLC • The ability or desire of a prime contractor to perform the work of the contract with its own organization team does not relieve the prime contractor of the need to make good faith efforts to use MWBE sub contractors to meet the contract goal. EXAMPLE: Total Project Estimate is $500,000. An MWBE goal of 10% is set for a specific part of the project, i.e., $50,000. Only one MWBE submits a quote to the prime contractor, and it is $50,000. A non MWBE submits a quote of $45,000. Rejecting the MWBE bid may not meet the requirement of making a good faith effort to meet the contract goal because: 1) the MWBE quote is within the goal percentage and dollar amount set for MWBE participation on the project; 2) selection of the MWBE quote guarantees that the contractor meets the set goal and that its bid will be deemed responsive; and 3) the difference between the MWBE and non MWBE quotes is not significant in terms of the overall contract amount (i.e., 1 % of total contract). If the MWBE's quote is $53,000 and the non-MWBE bid is $50,000, it may yet not be demonstrative of a good faith effort to reject the MWBE solely because the MWBE's quote is not the lowest. The excess is not greatly significant to the total contract cost, and it could reasonably be expected to be made up elsewhere in the contract while guaranteeing full goal compliance. The above examples are illustrative only. The City will make a fair and reasonable judgment as to good faith efforts based on all information and documentation provided by bidders and taking into account the Quality Quantity, and Intensity of the efforts made by a contractor to meet the contract goal. Version 02/23/2022 General Conditions - 7 Bidder: Gibson -Lewis, LLC • Proof of communications between the contractor and MWBE regarding negotiations for agreements, and why agreement could not be reached, as stated more specifically in above Subsection (b) (3); • Proof of bids or quotes from MWBE's and those from non MWBE's when non MWBE's bid or quote is used; • Proof of efforts made by contractor to assist MWBE to participate in contract, where appropriate; and ■ Any other information tending to show that Contractor made active, aggressive efforts to meet the MWBE participation goal but despite good faith efforts was unable to do so. Version 02/23/2022 General Conditions - 9 Bidder: Gibson -Lewis, LLC 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 02/23/2022 General Conditions -11 Bidder: Gibson -Lewis, LLC PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: (i) _ By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. (ii) _ By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. (iii) _ By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) _ By checking this box, I hereby acknowledge and ensure that I and all sub- contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore, I acknowledge my understanding that it is my responsibility to ensure that all sub -contractors have the necessary licenses to undertake the work called for in this bid. If a sub- contractor loses their license at any point, it is the responsibility of that sub- contractor to notify the City. (b) Attachments: (i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). List identifying all former business names. (iii) Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) years. (iv) Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. (v) Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances. (vi) For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. (vii) Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. (viii) _ Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. Version 02/23/2022 General Conditions - 13 CITY OF SOUTH BEND JAMES MUELLER, MAYOR DEPARTMENT OF PUBLIC WORKS ERIC HORVATH, DIRECTOR September 14, 2021 Juli Hodowaniec Gibson -Lewis LLC jl1odowanieclC I.nceusa.com RE: Pre -Qualification Verification Dear Ms. Hodowaniec: 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, o4il�iy:g��d ny u: r+orv9m GY.m•lVNemwh.a Liz Horvath—W-d ..� ..d,.,, - ,US Nl,:2021A 14145698-09'00' Liz Horvath, Permit Manager AIA Document A305 Contractor's Qualification Statement 1986 EDITION This form is approved and recommended by the American Institute of Architects (AIA) and The Associated General Contractors of America (AGC) for use in evaluating the qualifications of contractors. No endorsement of the submitting party or verification of the information is made by the AIA or AGC. The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading. SUBMITTED TO: City of South Bend, Indiana Board of Public Works 227 West Jefferson Blvd ADDRESS: South Bend, IN 46601 Corporation SUBMITTED BY; Partnership NAME: Gibson -Lewis, LLC Individual ADDRESS: 1001 W. 11th Street Joint Venture Mishawaka, IN 46544 Other PRINCIPAL OFFICE: Limited Liability Company NAME OF PROJECT: Morris Box Office Renovation TYPE OF WORK: X General Construction _ HVAC Plumbing Electrical Other (Please specify) Copyright yright 1964, 1969, 01986 b The American Institute of Architvms, 1735 New York Avenue, N.W. Washin Ian. C. 20UMP. Kcpro uclian ❑ t se �ntslCPla 15r5 % OrsiFFIInt1 411 Utittioa o IIS proYisiom wlt lout written pcmfissiOu of the AIA violates the copyright laws of the United States and .vi11 be subject to legal prosecution, AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIA® • 0086 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 20006 A305-1986 1 IN fl Gibson -Lewis, LLC 1.6 If the form of your organization is opter than those listed Rbove, describe it and name the principals; Robert A. Lingenfelter - President James E. Nagle - Vice President Nicholas A. Gurbick - Vice President Randall H. Rice - Secretary 2. UCENSING 2.1 List jurisdictions and trade categories In which your organization is legally qualified to do business, and indicate registration or license numbers, if Iippllsable: Indiana and Michigan 2.2 List jurisdictions in which your organization's partnership or trade name is riled. 3. EXPERIENCE 3.1 List the categories of work that your organization normally porforins with its own forces. Metal Framing, Drywall, Drywall Finishing, Insulation, Plastering, Acoustical Ceilings, Firestopping, Concrete, Carpentry, Painting, and Selective Demolition 3.2 Claims and Suits. (inttc•answur to any of IIIc questions below is yes, please attach details.) 3.2.1 Has your organization ever railed to complete any work awarded to it? No 12,2 Are Ihcre any judgments, elaiots, arbitration proccadings or suits pending or outstanding against your organization or it's officers? No 3,23 Has your organization filed any law suits or requested arbitration with regard to - d- s"irubtton coI I CIS wI m -e Iksr-1Tvayears'! Yes, Skanska - ND Morris Inn AIA DOCUMENT A305 -CONTRACTOR'S QUALIFICATIONSTA'IVIMENT • 19351=110N -AIA9O •019110 TIM AMERICANmrn'UTEOrARCHUrnCS,1735NL'WYORK AVENUE.N.W.WASIRKOTON,D.C.20000 A305.1906 3 Gibson -Lewis, LLC 4.3.1 Name of bonding company: The Continental Insurance Company CNA Plaza - Chicago, IL 60603 4.3.2 Name and address of agent: Marsh USA, Inc. Kathy DelGreco One Towne Square, STE 1100 Southfield, MI 48076 5. FINANCING 5.1 Financial Statement. 5.1.1 Attach a financial statement, preferably audited, including your organization's latest balance sheet and income statement showing the following items: Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials, inventory and prepaid expenses); Please see attached Net Fixed Assets; Other Assets; Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, provision for income taxes, advances, accrued salaries and accrued payroll taxes); Other Liabilities (e.g., capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings). 5.1.2 Name and address of firm preparing attached financial statement, and date thereof: Crowe LLP - 330 E. Jefferson Blvd, South Bend, IN 46601 5.1.3 Is the attached financial statement for the identical organization named on page one? Yes 5.1.4 If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent -subsidiary). 5.2 Will the organization whose financial statement is attached act as guarantor of the contract for Construction ? yes AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION - AIA® • 01986 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 20006 A305-1986 5 PRIVATE WORK PERFORMED WITHIN THE PAST FIVE YEARS OVER $150,000.00 IN THE REQUESTED CATEGORIES. Six Digit Name of Private Individual or Firm, Category $ Amount Year Contact Person, Address, Phone No Number StartedlCompleted Martin's Store Mayflower 1542.02 $686,000 Completed 2017 South Bend, Indiana Interior Finishes Office 1542.02 $215,000 Completed 2017 South Bend, Indiana Crossroads Church 1542.02 $176,000 Completed 2017 Plymouth, Indiana Four Winds Casino 1542.02 $1,604,000 Completed 2018 South Bend, Indiana Honeywell Plant#13 1542.04 $199,000 Completed 2018 South Bend, Indiana Fresenius Vascular Hospital 1542.02 $2,535.000 Completed 2018 Mishawaka, Indiana United Federal Credit Union 1542.04 $655,000 Completed 2018 Stevensville, Michigan United Federal Credit Union 1642.04 $575,000 Completed 2018 Berrien Springs, Michigan United Federal Credit Union 1642.04 $207,000 Completed 2018 South Bend, Indiana United Federal Credit Union 1542.04 $199,000 Completed 2018 Mishawaka, Indiana Embassy Suites Eddy St Commons 1542.02 $1,100,000 Completed 2018 South Bend, Indiana First Source Bankmart 1642.02 $368,000 Completed 2018 South Bend, Indiana Wellpet Siding/Roof Replacement 1542.02 $468,000 Completed 2018 Mishawaka, Indiana One National Bank Cascade 1542.02 $207,000 Completed 2019 Grand Rapids, Michigan PRIVATE WORK PERFORMED WITHIN THE PAST FIVE YEARS OVER $160.000.00 IN THE REQUESTED CATEGORIES. Six Digit Name of Private Individual or Firm, Category $ Amount Year Contact Person, Address, Phone No Number StartedlCompleted Ironworks Plaza 1642.02 $690,000 In Process Mishawaka, Indiana United Way of St Joseph County 1642.02 $683,000 In Process South Bend, Indiana Four Winds Casino Buffet/Kitchen 1642.02 $230,000 In Process New Buffalo, Michigan Endeavour Construction -Lot 34 1642.02 $230,000 In Process Elkhart, Indiana OTHER STATE WORK, LOCAL GOVERN MENT WORK AND U.S. GOVERN MENT WORK PERFORMED WITHIN THE PAST FIVE YEARS OVER $160,000.00. Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number StartedlCompleted Memorial Hospital ER Flooring 1642.01 $242,000 Completed 2017 South Bend, Indiana Notre Dame McCourtney Labs 1642.01 $175,000 Completed 2017 Notre Dame, Indiana Beacon Health Systems Energy 1542.01 $369,000 Completed 2017 South Bend, Indiana Mi City Prison Support Services 1542.01 $3.186,000 Completed 2017 Michigan City, Indiana Notre Dame Campus Crossroads 1642.01 $818.000 Completed 2017 Notre Dame, Indiana Notre Dame Hesburgh Concourse 1642.01 $796,000 Completed 2017 Notre Dame, Indiana Elkhart General Hosp-CMS 4th FI 1542.01 $319,000 Completed 2017 Elkhart, Indiana LaPorte Library -Main Branch 1542.01 $1,734,000 Completed 2017 LaPorte, Indiana VA Outpatient Clinic 1542.01 $4,830,000 Completed 2017 Mishawaka, Indiana Memorial Hosp Ronald McDonald 1542.01 $2,061,000 Completed 2017 South Bend, Indiana Rolling Prairie Public Library 1542.01 $1,813,000 Completed 2017 Rolling Prairie, Indiana Coolspring Public Library 1542.01 $1,371,000 Completed 2017 Michigan City, Indiana Memorial Hospital Cath Lab 3 1542.01 $323,000 Completed 2017 South Bend, Indiana Mishawaka Schools Fire Alarms 1642.01 $255,000 Completed 2018 Mishawaka, Indiana Notre Dame Badin Hall 1642.01 $902,000 Completed 2018 Notre Dame, Indiana OTHER STATE WORK, LOCAL GOVERNMENT WORK AND U.S. GOVERN ENT WORK PERFORMED WITHIN THE PAST FIVE YEARS OVER $150,000.00. Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number Started/Completed Valparaiso HS Natatorium 1542.01 $665,000 Completed 2019 Valparaiso, Indiana Brandywine HS Gymasium 1642.01 $1,840,000 Completed 2019 Niles, Michigan Elkhart County Juvenile Center 1542.01 $168,000 Completed 2019 Elkhart, Indiana Notre Dame Utilities Doc 1642.01 $562,000 Completed 2019 Notre Dame, Indiana Starke Co Office Elevator 1542.01 $291,000 Completed 2019 Knox, Indiana Concord Schools Health & Fitness 1542.01 $3,921,000 Completed 2019 Dunlap, Indiana Notre Dame Quarknet 1542.01 $600.000 Completed 2019 Notre Dame, Indiana Beacon Hospital 1542.01 $1,214,000 Completed 2019 Granger, Indiana Notre Dame Maintenance Building 1542.01 $207,000 Completed 2019 Notre Dame, Indiana Memorial Hospital Epworth JC 1542.01 $824,000 Completed 2019 South Bend, Indiana Memorial Hospital ICU Casework 1542.01 $245,000 Completed 2019 South Bend, Indiana Memorial Hospital 3S Patient Tower 1542.01 $759,000 Completed 2019 South Bend, Indiana St Joe Med Center PST Infusion 1642.01 $161.000 Completed 2019 Mishawaka, Indiana St Joe Med Center EMS Conf Room 1642.01 $168,000 Completed 2019 Mishawaka, Indiana Elkhart Gen Hosp IR Remodel 1642.01 $762,000 Completed 2019 Elkhart, Indiana OTHER STATE WORK, LOCAL GOVERN M ENT WORK AND U.S. GOVERN M ENT WORK PERFORMED WITHIN THE PAST FIVE YEARS OVER $150,000.00. Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number StartedlCompleted Beacon Orthopedics 1542.01 $1,922,000 Completed 2020 South Bend, Indiana South Bend Airport Terminal Update 1542,01 $619,600 Completed 2020 South Bend, Indiana Beacon Bristol Street PEDS 1542.01 $152,000 Completed 2020 Elkhart. Indiana M H S B 4th Floor Mother Baby 1542.01 $209,000 Completed 2020 South Bend, Indiana Beacon Ireland Road 1542.01 $225,000 Completed 2020 South Bend, Indiana Notre Dame Fischer Community Center 1542.01 $219,000 Completed 2020, Notre Dame, Indiana South Bend Fire Station #3 & #6 1542.01 $1,000,000 Completed 2020 South Bend, Indiana Elkhart General Cafeteria Remodel 1542.01 $1,017,000 Completed 2020 Elkhart, Indiana Notre Dame McCourtney Labs 1542.01 $3,268,000 Completed 2020 Notre Dame, Indiana Century Center Elevator 1542.01 $168,700 Completed 2021 South Bend, Indiana Beacon Pharmacy 1542.01 $210,000 Completed 2021 Bremen, Indiana Morris Theater 1642.01 $346,000 Completed 2021 South Bend, Indiana Union Substation Upgrade 1542.01 $246,000 Completed 2021 Mishawaka, Indiana Cleveland Twp Fire Station 1542.01 $4,419,000 Completed 2021 Elkhart, Indiana Dowagiac Library 1642.01 $1,236,000 Completed 2021 Dowagiac, Michigan OTHER STATE WORK, LOCAL GOVERN MENT WORK AND U.S. GOVERN M ENT WORK PERFORMED WITHIN THE PAST FIVE YEARS OVER $150,000.00, Six Digit Name of Government Entity Category $ Amount Year (Contact Person, Address, Phone No.) Number StartedlCompleted Notre dame O'Shaughnessy 3rd Flr PLS 1542.01 $737,000 Completed 2021 Notre Dame, Indiana Memorial Hospital IR #2 1542.01 $234,000 Completed 2021 South Bend, Indiana Lakeland Hospital Prep Recovery Demo 1542,01 $2,780,000 In Process St. Joseph, Michigan Homestead High School 1542.01 $837,000 In Process Fort Wayne, Indiana Hanover Elementary School 1542.01 $4,749,000 In Process Cedar Lake, Indiana Three Rivers Andrews & Norton E.3 1542.01 $635,000 In Process Three Rivers, Michigan Three Rivers Park & Hoppins E.S 1542.01 $937,000 In Process Three Rivers, Michigan Mishawaka Town Hall 1642.01 $2,041,000 In Process Mishawaka, Indiana Concord Schools Press Box 1642.01 $433,000 In Process Elkhart, Indiana Juday Creek Water Treatment Plant 1542.01 $260,000 In Process Granger, Indiana Beacon Epworth 3rd Floor 1542.01 $524,000 In Process South Bend, Indiana Lakeland Hospital GME 1542.01 $401,000 In Process Niles, Michigan Oak Hills Schools BB Field Complex 1542.01 $3,506,000 In Process Converse, Indiana Fairview Elementary School 1642.01 $3,021,000 In Process Logansport, Indiana Notre Dame Religious Liberty Clinic 1642.01 $287,000 In Process Notre Dame, Indiana GIBSON-LEWIS, LLC STATEMENTS OF INCOME YEARS ENDING SEPTEMBER 30, 2021 AND 2020 % TO % TO 2021 EARNED 2020 EARNED AMOUNT REVENUE AMOUNT REVENUE EARNED REVENUE $31,772,135 100.00% $37,312,442 100.00% COST OF EARNED REVENUE 28,313,883 89.12% 33,245,835 89.10% GROSS PROFIT 3,458,252 10.88% 4,066,607 10.90% GENERAL AND ADMINISTRATIVE EXPENSE 2,406,651 7,57% 2,392,176 6.41% NET INCOME $1,051.601 3.31% $1,674,430 4.49% Gibson -Lewis, LLC 6. SIGNATURE 6.1 Dated at Mishawaka, IN this 26th day of July, 2022 Name of Organization: Gibson -Lewis, LLC By: lly� Title: Robert A. L genfelter, President 6.2 Robert A. Lingenfelter being duty sworn deposes and says that the information provided herein is true and sufficiently complete as not to be misleading. Subscribed and • orn be a me this 26th day of July, 2022 Notary`s Juli odowaniec My Commission Exp es: 6/05/2023 JULI HODOWANIEC .•' •• h Hatnry PUblIC, State of Indiana :r4►�►• 'k: SI Joseph County Commission N 671289 my Commission Expires AU9us105.2023 AIA DOCUMENT A306 • CONTRACTOR'S QUALIFICA'rION STATEMENT • 1986 EDITION • AIA'O -01986 A305.1986 6 THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVENUE:, N.W. WASHINGTON, D.C. 20006 tx)" �t�iteb tattq Mepartwrut zabolt Office of 21PPrrnt1'rt'5btP Certificate Of Rmt.9tration of Apprmfirt5bip Vrogram INDIANA/KENTUCKY/OHIO REGIONAL COUNCIL OF CARPENTERS J.A.T.F. MERRILLVILLE, INDIANA FOR THE TRADE CLASSIFICATIONS: CARPENTER; MILLWRIGHT; RESIDENTIAL CARPENTER J?e91sfereo(Qs pdrf o'f 1-4�e XQflondlfpprenbcesilp c�ysfem in Qccoro�dnce rvif�2 fie o6QSIC sfdno�zro� of¢�prenflces-lip esf¢%I s�eo6�rf, 1,4-e 6ecrefdry Of La46-or SEPTEMBER 24, 1952 gale Revised: April 2, 2018 IN010520001 -, IA KI `Te9zslrahon X0. 7.( s� 7.(...rslraJor �f�ce -T APONO 'N410 Bureau of Ap prtn#irts4lp anb Draining T.e ff ca#e of Registration INDIANA LABORERS TRAINING TRUST FUND BEDFORD, INDIANA for the trade classification of CONSTRUCTION CRAFT LABORER 2e9isfereof as part of llie Xalional. pprenlicesnip J ro9ram in accoro(ance wild llie basic slano(arofs of apprenlices,6ip eslablis.heof 6y 116e 6ecrelarJr. Ojf Labor Lo) .� December 14, 199594� _ sua�a�yaflaGoz Dale IN040-0528a •Tepilralion Mo. l�ix�ctoa, �uRcau of frh r :i and Rain n9 STATE OF INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W469 INDIANAPOLIS, INDIANA 46204-2738 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton Hill Rd. Bedford, IN 47421 Dear Jeremy Brewer, Eric Holcomb, Governor James M. Brown, Director January 9, 2019 This will acknowledge receipt of your updated Wage Scale for the Construction Craft Laborer program offered by Indiana Laborers Training Trust Fund -Apprenticeship. The State Approving Agency has reviewed the document as listed below: Wage Scale: Construction Craft Laborer FACILITY CODE: 30004114 To the best of my knowledge Indiana Laborers Training Trust Fund -Apprenticeship does not utilize erroneous or misleading advertisement, either by actual statement, omission, orintim.ation. It is understood by Indiana Laborers Training Trust Fund -Apprenticeship that they will maintain a complete record of all advertising utilized by or on behalf of the Indiana Laborers Training Trust Fund -Apprenticeship in regards to their training programs during the preceding 12 months. Indiana Laborers Training Trust Fund -Apprenticeship's advertising will be available for review by any and all future supervisory visits by the SAA, or the U.S. Department of Veteran Affairs. Please Review the entire packet for content and accuracy. Approval is granted pursuant to the provisions of Title 38, U.S. Code 3687, with an effective date of April 1, 2018. If you have any questions, please feel free to give me a call at 317-232-3916 or email me at tgriffin@dva.in.gov. Thank you for what you do for our Veterans, and have a great day! Sincerely, Taniqua Griffin Program Director State Approving Agency Cc: VARO/ELR 1441 Apprentice Status Report By Indenture Date Apprentices Indentured Between 1/1/2017 And 5/13/2020 Apprentice Program: IN2 Year Apprentice Status Apprentices Percentage 2017 2018 Active 156 22.67% Active Duty 1 0.15% Adv. to Journeyman 47 6.830/6 Deceased 4 0.58% Graduated 45 6.54% Inactive 2 0.29% Journeyman 1 0.15% Med. Susp. 4 0.58% Reinstate 2 0.299/6 Suspended 5 0.73% Terminated 396 57.56% Voluntary withdraw 25 3.63 Total Indentured 688 Active 283 32.38% Active Duty 3 0.34% Adv. to Journeyman 47 5.38% Deceased 3 0.34% Graduated 5 0.57% Inactive 10 1.14 % Journeyman 2 0.23% Med. Susp. 4 0.46% Reinstate 15 1.72% Suspended 8 0.92% Terminated 462 52.86% Voluntary withdraw 32 3.66 Total Indentured 874 Printed: Wednesday. May 13, 2020 Page t of 2 Apprentice Status Report By Indenture Date Apprentices Indentured Between 1/1/2020 And 12/31/2020 Apprentice Program: IN2 Year Apprentice Status Apprentices Percentage 2020 Active 537 7885 11/6 Active Duty 2 0.29% Adv. to Journeyman 8 1.17% APPLICANT 1 0.,15% Med. Susp. 3 0,1411/0 Not Registered 6 0.88% Reinstate 27 3,96% Suspended 4 0.59% Terminated 80 11,75% Voluntary withdraw 13 1.910/0 Total Indentured 681 Printed: Tuesday. January 12. 2021 Page Pias#erers' & Cement Mas®ats° Apprenticeship Coordinator Local Union #692 Phone: (219) 707-7767 Email: bkristo 1864 if@plcmlccafs~�2.crg R �ff�NAl A` To Whom it May Concern: March 17, 2022 This letter is to certify that Gibson -Lewis LLC. is and has been a signatory contractor with OPCMIA Local 692 and has participated in the Plasterers & Cement Masons Apprenticeship Training Program for many years. Gibson -Lewis LLC. is a valued Contractor in good standing with Local 692 and the JATC. All our apprentices are registered with the United States Department of Labor. I may be reached at (219) 707-7767 if additional information is needed. Further, our organization's program is approved by the U.S. Veterans Administration to participate in the GI Education Benefit Program. Thank you, Brian Kristoff Apprentice Coordinator Plasterers & Cement Masons 9200 Louisiana Street • Merrillville, Indiana 46410 WWW-PLCMLOcni ane