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Home My WebLink AboutOpening of Bids - LaSalle Avenue Streetscape Proj. No. 122-013R - Milestone Contractors North Inc.CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Lasalle Avenue Streetscape Project Project No. For Bids Due 122-013R April 25, 2023 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 MfWBE 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 1 & 2 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.apd comply with the specifications. Bidder: Milestone Contracto By Authorized Represen iv, Signature: Print Name & Title: 11 Inc. irector of Estimatin Version 09/29/2021 Contractor's Bid for Public Works - 1 Date: 4/25/2023 PART II (For projects of $100,000 or more - IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/her/its bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1 Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 09/29/2021 Contractor's Bid for Public Works - 3 When the prospective Contractor is unable to certify 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 alien. Version 09/29/2021 Contractor's Bid for Public Works - 4 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). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder Version 09/29/2021 Contractor's Bid for Public Works - 5 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 25th day of April , 2023 CO......... '• 2p �i C�RP0RA;,e S SEAL..: Subscribed and sworn to before me this 25th My Commission Expires 6/5/2030 County of Residence of Contractor/Bidder or Its Agent /'Dustin P. Hilary. Director of Estimating Printed Name and Title day of AP01 92023 Notary Pu lic AlishaI6ueger LaPorte Y pu ALISHAKRUEGER 20`. Bl% My Comntission Expires * SEAL June 5, 2030 'FUF Commission Number NP06M4 i °•' La Porte County Version 09/29/2021 Contractor's Bid for Public Works - 6 BID/PROPOSAL CITY OF SOUTH BEND Proiect Name: Lasalle Avenue Streetscape Proiect Proiect No.: 122-013R For Bid Due: April 25th. 2023 Contractor Name: Milestone Contractors North, Inc. BASE BID Item No. Description Quantity Unit Unit Price Total Amount 1 MOBILIZATION/DEMOBILIZATION 1 LSUM $ 275,000.00 $ 275,000.00 2 CONSTRUCTION ENGINEERING 1 LSUM $ 100,000.00 $ 100,000.00 3 MAINTENANCE OF TRAFFIC 1 LSUM $ 225,000.00 $ 225,000.00 4 CPM SCHEDULE 1 LSUM $ 12,500.00 $ 12,500.00 5 IVIDEO RECORD 1 LSUM $ 7,500.00 $ 7,500.00 6 CLEARING RIGHT-OF-WAY 1 LSUM $ 825,000.00 $ 825,000.00 7 COMMON EXCAVATION, UNDISTRIBUTED 4360 CYS $ 10.00 $ 43,600.00 8 SURFACE MILLING, ASPHALT, 2 IN 10660 SYS $ 3.00 $ 31,980.00 9 SIDEWALK, CONCRETE, REMOVE 2468 SYS $ 20.00 $ 49,360.00 10 CURB, CONCRETE, REMOVE 3302 LFT $ 10.00 $ 33,020.00 11 TEMPORARY EROSION CONTROL 1 LSUM $ 35,000.00 $ 35,000.00 12 TEMPORARY INLET PROTECTION 81 EACH $ 150.00 $ 12,150.00 13 COMPACTED STRUCTURAL BACKFILL 5365 CYS $ 10.00 $ 53,650.00 14 CONCRETE CURB 1177 LFT $ 50.00 $ 58,850.00 15 CONCRETE CURB & GUTTER 3199 LFT $ 30.00 $ 95,970.00 16 PCCP, PLAIN, 10 IN 1107 SYS $ 145.00 $ 160,515.00 17 PCCP, APPROACH, 9 IN 747 SYS $ 115.00 $ 85,905.00 18 PCCP, COLORED B1, 10 IN 292 SYS $ 200.00 $ 58,400.00 19 CONCRETE, PERVIOUS 35 SYS $ 200.00 $ 7,000.00 20 COMPACTED AGGREGATE BASE, INDOT NO. 53 3336 TON $ 45.00 $ 150,120.00 21 SIDEWALK, CONCRETE, 5 IN 3235 SYS $ 75.00 $ 242,625.00 22 CURB RAMP, CONCRETE 537 SYS $ 160.00 $ 85,920.00 23 HMA SURFACE, TYPE B 1785 TON $ 100.00 $ 178,500.00 24 HMA INTERMEDIATE, TYPE B 987 TON $ 150.00 $ 148,050.00 25 HMA BASE, TYPE B 2429 TON $ 110.00 $ 267,190.00 26 TACK COAT 17179 SYS $ 2.00 $ 34,358.00 27 HMA ASPHALT PATCHING 145 SYS $ 100.00 $ 14,500.00 28 SIDEWALK PAVERS 581 SYS $ 305.15 $ 177,292.15 29 DECORATIVE PAVER BAND 1210 LFT $ 33.25 $ 40,232.50 30 LINE, THERMOPLASTIC, SOLID, WHITE, 4 IN 5217 LFT $ 1.25 $ 6,521.25 31 LINE, THERMOPLASTIC, SOLID, YELLOW, 4 IN 5670 LFT $ 1.25 $ 7,087.50 32 LINE, THERMOPLASTIC, SOLID, WHITE, 24 IN 544 LFT $ 15.00 $ 8,160.00 33 TRANSVERSE MARKING, THERMOPLASTIC, CROSSWALK LINE, WHITE 6 IN 1237 LFT $ 6.00 $ 7,422.00 BIDIPROPOSAL CITY OF SOUTH BEND Protect Name: Lasalle Avenue Streetsca a Protect Proiect No.: 122-013R For Bid Due: April 25th, 2023 Contractor Name: Milestone Contractors North, Inc. RASE BID 34 TRANSVERSE MARKING, THERMOPLASTIC, 314 LFT $ 15.00 $ 4,710.00 STOP LINE, WHITE, 24 IN 35 PAVEMENT MESSAGE MARKING, 12 EACH $ 150.00 $ 1,800.00 THERMOPLASTIC LANE INDICATION ARROW, WHITE 36 PAVEMENT MESSAGE MARKING, 4 EACH $ 400.00 $ 1,600.00 THERMOPLASTIC, PEDESTRIAN SYMBOL 37 TRANSVERSE MARKING, THERMOPLASTIC, 21 LFT $ 15.00 $ 315.00 YIELD LINE, WHITE, 24 IN 38 TRANSVERSE, THERMOPLASTIC, SOLID GREEN 550 SYS $ 20.00 $ 11,000.00 FILL, FULL WIDTH 39 LINE, EPDXY, SOLID, YELLOW, 4 IN 130 LFT $ 6.00 $ 780.00 40 LINE, EPDXY, BROKEN, WHITE, 4 IN 72 LFT $ 6.00 $ 432.00 41 LINE, EPDXY, BROKEN, YELLOW, 4 IN 606 LFT $ 6.00 $ 3,636.00 42 LINE, EPDXY, SOLID, WHITE, 81N 592 LFT $ 8.00 $ 4,736.00 43 LINE, EPDXY, SOLID, YELLOW, 8 IN 795 LFT $ 8.00 $ 6,360.00 44 LINE, EPDXY SOLID, WHITE. 24 IN 165 LFT $ 18.00 $ 2.970.00 45 TRANSVERSE MARKING, EPDXY, CROSSWALK 147 LFT $ 7.00 $ 1,029.00 LINE, WHITE, 6 IN. 46 TRANSVERSE MARKING, EPDXY, CROSSHATCH 343 LFT $ 11.00 $ 3,773.00 LINE, WHITE, 12 IN. 47 TRANSVERSE MARKING, EPDXY, CROSSHATCH 215 LFT $ 11.00 $ 2,365.00 LINE, YELLOW 12 IN. 48 TRANSVERSE MARKING, EPDXY, YIELD LINE, 54 LFT $ 18.00 $ 972.00 WHITE, 24 IN 49 PAVEMENT MESSAGE MARKING, EPDXY 2 EACH $ 500.00 $ 1,000.00 CHEVRON, WHITE 50 PAVEMENT MESSAGE MARKING, EPDXY, 1 EACH $ 500.00 $ 500.00 SHARED LANE 51 LINE, THERMOPLASTIC, SOLID, WHITE, 8 IN 263 LFT $ 2.00 $ 526.00 52 LINE, THERMOPLASTIC, SOLID, YELLOW, 8 IN 754 LFT $ 2.00 $ 1,508.00 53 PAVEMENT MESSAGE MARKING, 1 EACH $ 500.00 $ 500.00 THERMOPLASTIC, ADA ACCESSIBLE SYMBOL, BLUE 54 TRANSVERSE MARKING, THERMOPLASTIC, 13 LFT $ 15.00 $ 195.00 PARKING LINE, BLUE, 4 IN BID/PROPOSAL CITY OF SOUTH BEND Project Name: Lasalle Avenue Streetscape Proiecl Project No.: 122-013R For Bid Due: _ April 25th, 2023 Contractor Name: Milestone Contractors North, Inc. BASE BID 55 PAVEMENT MESSAGE MARKING, THERMOPLASTIC, BYCYCLE SYMBOL 36 EACH $ 500.00 $ 18,000.00 56 PAVEMENT MESSAGE MARKING, THERMOPLASTIC, CONVENTIONAL BYBYCLE SYMBOL 3 EACH $ 500.00 $ 1,500.00 57 TRANSVERSE MARKING, THERMOPLASTIC, CROSSHATCH LINE, WHITE, 12 IN 66 LFT $ 8.00 $ 528.00 58 TRANSVERSE MARKING, THERMOPLASTIC CROSSHATCH LINE, YELLOW, 12 IN 133 LFT $ 8.00 $ 1,064.00 59 HEMISPHERICAL CAMERA DETECTION SYSTEM, LASALLE AVE/HILL ST 1 LSUM $ 30,000.00 $ 30,000.00 60 HEMISPHERICAL CAMERA DETECTION SYSTEM, LASALLE AVE/NILES AVE 1 LSUM $ 30,000.00 $ 30,000.00 61 HEMISPHERICAL CAMERA DETECTION SYSTEM, DR MLK JR BLVD/COLFAX AVE 1 LSUM $ 30,000.00 $ 30,000.00 62 TRAFFIC SIGNAL POLE FOUNDATION 8 EACH $ 2,100.00 $ 16,800.00 63 PAINTING TRAFFIC SIGNAL POLES & MAST ARMS 1 LSUM $ 11,000.00 $ 11,000.00 64 RELOCATE TRAFFIC SIGNAL POLE & MAST ARM 8 EACH $ 1,800.00 $ 14,400.00 65 TRAFFIC SIGNAL PEDESTAL FOUNDATION, TYPE A 20 EACH $ 440.00 $ 8,800.00 66 PEDESTRIAN TRAFFIC SIGNAL PEDESTAL W/BASE 16 EACH $ 1,100.00 $ 17,600.00 67 BIKE TRAFFIC SIGNAL PEDESTAL W/BASE 4 EACH $ 1,500.00 $ 6,000.00 68 TRAFFIC SIGNAL HEAD. 3-SECTION 20 EACH $ 900.00 $ 18.000.00 69 BIKE TRAFFIC SIGNAL HEAD, 3- SECTION 4 EACH $ 980.00 $ 3,920.00 70 "WALK/DON'T WALK" SYMBOL PEDESTRIAN SIGNAL INDICATOR W/COUNTDOWN 16 EACH $ 600.00 $ 9,600.00 71 PEDESTRIAN PUSH BUTTON ASSEMBLY W/SIGN 16 EACH $ 280.00 $ 4,480.00 72 TRAFFIC SIGNAL CABLE 1 LSUM $ 12 200.00 $ 12,200.00 73 TRAFFIC SIGNAL CONDUIT, SCH 80 PVC, UNDISTRIBUTED 100 LFT $ 9.75 $ 975.00 74 TRAFFIC SIGNAL HANDHOLE, UNDISTRIBUTED 4 EACH $ 1,000.00 $ 4,000.00 75 LIGHT STANDARD TYPE B 8 EACH $ 10.600.00 $ 84.800.00 76 ELECTRIC SERVICE POINT, TESCO, DUAL METER 1 EACH $ 9,300.00 $ 9,300.00 77 SOLAR POWERED, FLASHING PEDESTRIAN CROSSING SIGNAGE ASSEMBLY SYSTEM 1 LSUM $ 14,600.00 $ 14,600.00 78 ILIGHT STANDARD, TYPE A 32 EACH $ 7,700.00 $ 246,400.00 BID/PROPOSAL CITY OF SOUTH BEND Project Name: Lasalle Avenue Streetscape Project Project No.: 122-013R For Bid Due: April 25th. 2023 Contractor Name: Milestone Contractors North. Inc. 72 LIGHT STANDARD FOUNDATION 40 EACH $ 1,300.00 $ 52,000.00 73 ELECTRICAL WIRING 3850 LFT $ 12.00 $ 46,200.00 74 PVC SCHEDULE 80 CONDUIT 2 IN 3020 LFT $ 13.00 $ 39.260.00 75 ELECTRIC SERVICE POINT, TESCO, SINGLE METER 2 EACH $ 9,000.00 $ 18,000.00 76 AEP i ITII ITY GONNECT 014 4 EAGH� 77 HANDHOLE LIGHTING 40 EACH $ 975.00 $ 39 000.00 78 MISCELLANEOUS ELECTRICAL EQUIPMENT 1 LSUM $ 2,100.00 $ 2,100.00 79 FIRY HYDRANT ASSEMBLY, REMOVE 5 EACH $ 735.00 $ 3,675.00 80 1 CUT AND CAP WATER MAIN 3 EACH $ 1,000.00 $ 3,000.00 81 12 IN TO 6 IN TAPPING VALVE & SLEEVE 5 EACH $ 8,000.00 $ 40 000.00 82 FIRE HYDRANT ASSEMBLY 5 EACH S 9,000.00 $ 45 000.00 83 STORM SEWER PIPE 12 IN 550 LFT $ 62.00 $ 34 100.00 84 STORM SEWER PIPE, 15 IN 0 LFT $ - $ - 85 CORE AND BOOT AT STORM SEWER STRUCTURE. NDl IB T 2 EACH $ 1,000.00 $ 2,000.00 86 STORM INLET, 2 FT DIA. 29 EACH $ 3,500.00 $ 101 500.00 87 STORM MANHOLE, 4 FT DIA. 6 EACH $ 4,000.00 $ 24.000.00 88 STORM MANHOLE, 5 FT DIA. 4 EACH $ 6,000.00 $ 24,000.00 89 STORM MANHOLE 6 FT DIA. 3 EACH $ 9,000.00 $ 27 000.00 90 STORM MANHOLE, MODIFIED 4 FT DIA. 7 EACH $ 4,400.00 $ 30,800.00 91 STORM MANHOLE. MODIFIED, 6 FT DIA. 3 EACH $ 8,500.00 $ 25 500.00 92 STORM SADDLE MANHOLE, MODIFIED, 4 FT DIA. 2 EACH $ 5,500.00 $ 11,000.00 93 STORM SADDLE MANHOLE MODIFIED, 5 FT DIA. 1 EACH $ 7,500.00 $ 7,500.00 94 STORM SADDLE MANHOLE. 6 FT DIA. 3 EACH $ 10,750.00 $ 32 250.00 95 VIDEO INSPECTION OF STORM SEWER 1910 LFT $ 4.00 $ 7,640.00 96 ADJUST STRUCTURE TO GRADE 59 EACH $ 250.00 $ 14,750.00 97 RECONSTRUCTED STRUCTURE, UNDISTURBED 50 LFT $ 350.00 $ 17,500.00 98 UTILITY RELOCATION ALLOWANCE 1 1 ALLOW $ 25.000 $ 25,000 99 SHEET SIGN, W/ LEGEND, REFLECTIVE 195 SFT $ 16.00 S 3,120.00 100 SIGN POST, SQUARED. TYPE 2 385 LFT $ 12.00 $ 4,620.00 S - BIDIPROPOSAL CITY OF SOUTH BEND Proiect Name: Lasalle Avenue Streetsca a Prole Proiect No.: 122-013R For Bid Due: aril 25th..2023 Contractor Name: Milestone Contractors North, Inc. BASE BID Item No. Description Quantity Unit Unit Price Total Amount 101 OVERSTORY TREE, 2-1/2 IN CALIPER 85 EACH $ 645.00 $ 54,825.00 102 TREE GRATE 37 EACH $ 6,220.00 $ 230,140.00 103 SODDING, NURSERY AND TOPSOIL 1980 SYS $ 35.00 $ 69,300.00 104 TREE WATERING SYSTEM 85 EACH $ 30.00 $ 2,550.00 105 IVAULT CLOSURE- 441 E. LASALLE AVE. 1 LSUM $ 35,000.00 $ 35,000.00 106 PVC SCHEDULE 80 CONDUIT, 3 IN 500 LFT $ 26.00 $ 13,000.00 107 RAILROAD SPUR 4500 LFT $ 9.00 $ 40,500.00 108 RAILROAD TIE 2960 EACH $ 12.00 $ 35,520.00 109 TEMPORARY BUSINESS SERVICE SIGN, UNDISTRIBUTED 10 EACH $ 219.00 $ 2,190.00 110 EPDXY COATING OF STORM INLET INTERIOR, UNDISTRIBUTED 5 EACH $ 2,500.00 $ 12,500.00 111 EPDXY COATING OF STORM MANHOLE INTERIOR, UNDISTRIBUTED 5 EACH $ 2,800.00 $ 14,060.00 112 FLEXIBLE PLASTIC DELINEATOR POST ON TRAFFIC SEPARATOR CURB 51 EACH $ 125.00 $ 6,376.00 113 REMOVE & REPLACE TRAFFIC SIGNAL ROADWAY LOOP DETECTION SYSTEM AT W. APPROACH LASALLE/EDDY ST 1 LSUM $ 4,000.00 $ 4,000.00 114 IWAYFINDING SIGN CONCRETE FOUNDATION 1 EACH $ 5,500.00 $ 5,500.00 115 SIDEWALK, CONCRETE, 5 IN, COLORED 380 SYS $ 115.00 $ 43,700.00 116 ACCENT PAVER BAND 496 LFT $ 13.02 $ 6,457.92 117 EXISTING WATERMAIN JOINT RESTRAINT, UNDISTRIBUTED 50 EACH $ 1,650.00 $ 82,500.00 118 WATER MAIN GRADE PIPE FOR STORM SEWER._ 12 IN 941 LFT $ 85.00 $ 79,985.00 119 WATER MAIN GRADE PIPE FOR STORM SEWER. 15 IN 430 LFT $ 125.00 $ 53,750.00 BASE BID TOTAL $ 5,655,360.32 BIDIPROPOSAL CITY OF SOUTH BEND Project Name: Lasalle Avenue Streetsca a Project Project No.: 122-013R For Bid Due: April 25th, 2023 Contractor Name: Milestone Contractors North, Inc. ALTERNATE DEDUCT 8 SURFACE MILLING ASPHALT, 2 IN 10,660 SYS $ 3.00 $ 31,980.00) 23 HMA SURFACE TYPE B 1108 TON $ 100.00 $ 110 800.00 112 FLEXIBLE PLASTIC DELINEATOR POST ON 51 EACH $ (125.00) $ (6,375.00) TRAFFIC SEPARATOR CURB 113 REMOVE & REPLACE TRAFFIC SIGNAL 1 LSUM $ (4,000.00) $ (4,000.00) ROADWAY LOOP DETECTION SYSTEM AT W. APPROACH LASALLE/EDDY ST ALTERNATE DEDUCT TOTAL $ BID/PROPOSAL CITY OF SOUTH BEND Proiect Name: Lasalle Avenue Streeta.We Project Proiect No.: 122-013R For Bid Due: April 25th, 2023 Contractor Name: Milestone Contractors North, Inc. BASE BID BASE BID $ 5,655,360.32 BASE BID TOTAL $ 5,655,360.32 ALTERNATE DEDUCT ALTERNATE DEDUCT $ (153,155.00) TOTAL ALTERNATE DEDUCT $ 5,502,205.32 The City reserves the right to deduct the Alternate Deduct based on the available budget Bidder (Firm): Address: 24358 SR 23 City/State/Zip: South Bend IN 46614 Telephone Number: By Dustin P. Hilary, Director of Estimati 155.00 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 -owned business meets the MBE qualifications. Project Number: 122-013R Project Name: Bidder: Milestone Contractors North, Inc. Name &Address of MBE Primary Contact Person (Name/Telephone) JBL 2 Signlas & Lighting Tanner Leibovitz 4316 Technology Drive 574-855-2251 South Bend, IN 46628 Submitted by: Dustin P. Hilary. Director of Estimating Print Name Lasalle Avenue StreetscaDe Project Total Bid Amount: $5,502,205.32 MBE Goal: 2.89% Page 1 of 1 Scope of Work to be Performed Dollar Amount of MBE Percentage (Attach scope/schedule if you need additional space) Component of Total Signals & Lighting $813,875.00 Version 09/29/2021 Contractor's Bid for Public Works - 14 4/25/2023 Date 14.79% CITY OF SOUTH BEND Fes:. c` MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN "" y 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: 122-013R Project Name: Lasalle Avenue Streetscape Proiect Bidder: Milestone Contractors North; Inc. - Total Bid Amount: $5,502.205.32 Name & Address of WBE Slusser's Green Thumb, Inc. 125 Montgomery Street Logansport, IN 46947 State Barricading, Inc. 24963 US 20 W. South Bend, IN 46628 Primary Contact Person Scope of Work to be Performed (Name/Telephone) (Attach scope/schedule if you need additional space) I Nelson Slusser Sods/Trees 574-722-3102 James Michalski Maintaining of Traffic 574-287-2078 C.E. Milling Hughes, Inc. d/b/a Nick Relias The Airmarking Company 574-532-9056 1544 N. SR 25 Rochester, IN 46975 LaPorte Construction Co., Inc. Lori Schrad 4999 S. US Hwy 35 LaPorte, IN 46350 Submitted by: Dustin P. Hilary, Director of Estimating Print Name mat Version 09/29/2021 Pavement Markings Temporary Barrier Wall Contractor's Bid for Public Works -15 WBE Goal: 5.23% Page 1 Of 1 Dollar Amount of WBE Percentage of Total Component Rini/PrnnnQn1 $76,383.00 1 1.39% $42,988.00 1 0.78% $150,989.75 1 2.74% $68,000.00 1 1.24% 4/25/2023 Date 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: 122-013R Date: 4/25/2023 Project Name: Lasalle Avenue Streetscape Proiect Bidder: Milestone Contractors North, Inc. Contact Person: Dustin P_Hilary Telephone: 574-288-4811 Address: 24358 SR 23 City: South Bend State: Indiana zip: 46350 Email: dhilarvemilestonelo.com 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*: EVIDENCE OF GOOD FAITH EFFORTS 1 i 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: httu://www.in.Qov/idoa/. 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 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. 1 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 subcontract. I affirm that I have made good faith efforts to assist interested MBEs 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 - 16 CITY OF SOUTH BEND. MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN Y" FORM MBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS i 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 information. Version 09/29/2021 Contractor's Bid for Public Works -17 x� CITY OF SOUTH BEND 1 . MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN wl c �tl 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: 122-013R Date: 4/25/2023 Project Name: Lasalle Avenue Streetscal2e Proiect Bidder: Milestone Contractors North, Inc. Contact Person: Dustin P. Hilary Telephone: 574-288-4811 Address: 24358 SR 23 City: South Bend State: Indiana _ zip: 46614 Email: dhilwy(a7_milestonelp.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*: EVIDENCE OF GOOD FAITH EFFORTS 1 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: hftp:/Awm.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 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.C-ovlidoa). _ 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 �yq 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 - 18 CITY OF SOUTH BEND =� g MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS 1 affirm that I have made good faith efforts to assist interested WBEs in obtaining t necessary equipment, supplies, materials, or related assistances or services, where I appropriate. 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 -19 7H CITY OF SOUTH BEND U` MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN �1; Y 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 1 OF 1 Project Number: -013R MBE Participation Goal 2.89% Project Name: asge Avenue Streetsca a Proeect Bidder: sto ontractors North. Inc. By: Director of Estimating 4/25/2023 ((Oature) Dustin P. Hilary (Title) (Date) N18 Firm JBL 2 Signals & Lighting ,Owner or Contact at MBE Firm Tanner Leibovitz Telephone: 574-288-4811 Fax: 574-289-7174 Email: tannerl@jbisignalsandlighting.co TYPE OF WORK SOLICITED FOR THIS PROJECT: Signals & Lighting RESULTS OF CONTACT WITH THE MBE FIRM: If we're awarded the project, we'll enter into a subcontract with JBL 2 Signals & Lighting, 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 - 20 1 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN �' FORM MBE-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 woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE 1 OF 2 Project Number: 122-013R WBE Participation Goal 5.23% Project Name Las le Avenu�Stree�tsca Pro'ectBidder: Mi tone Colt, Inc. By: n F. Hilary (Title) (Date) vvrjrum Slusser's Green Thumb, W Owner or Contact at BE Firm Nelson Slus: Telephone: 574-722-3102 Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT'. Sod & Trees RESULTS OF CONTACT WITH THE WBE FIRM: Inc. Email: nts@slussers.com If we're awarded the prqject, we'll enter into a subcontract with Slusser's Green Thumb, Inc. WBE Firm State Barricading, Inc. Owner or Contact at WBE Firm James Michalski _ Telephone: 574-287-2078 _ Fax: 574-287-1744 Email: statebarricade_1 Maol.com TYPE OF WORK SOLICITED FOR THIS PROJECT Maintaining of Traffic RESULTS OF CONTACT WITH THE WBE FIRM: If we're awarded the project, we'll enter into a subcontract with State Barriacadi Version 09/29/2021 Contractor's Bid for Public Works - 21 Inc. CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN ^'r FORM MBE-2.1 _rR 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 2 OF 2 Project Number: 2-013R WBE Participation Goal 5.239 Project Nam Lasdlle Avenue Streetscape Project Bidder: ��tone_Con'_tractors North, Inc. By- Director of Estimating4/25/. i ature) Dustin P. Hilary (Title) (Date) 7- Firm C.E. Hughes Milling. Inc. d/b/a The Airmarkinq Company Owner or Contact at WBE Firm Nick Relias Telephone: 574-223-5817 Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT Pavement Markings _ Email: nick airmarkin .corn RESULTS OF CONTACT WITH THE WBE FIRM: If we're awarded the project, we'll enter into a subcontract with C.E.. Hughes Milling, Inc. d/b/a The Airmarking Company. WBE Firm LaPorte Construction Co., Inc. Owner or Contact at WBE Firm Lori Schrad Telephone: 219-393-5555 Fax: Email: Ischrad@laporteconstruction.com TYPE OF WORK SOLICITED FOR THIS PROJECT Temporary Barrier Wall RESULTS OF CONTACT WITH THE WBE FIRM: If we're awarded the project, we'll enter into a subcontract with LaPorte Construction Co., Inc. Version 09/29/2021 Contractor's Bid for Public Works - 21 • l • CONTRACTOR: (Name, legal status and address) Milestone Contractors North, Inc. 24358 State Road 23 South Bend, IN 46614 OWNER: (Name, legal status and address) City of South Bend 227 West Jefferson Blvd. South Bend, IN 46601 BOND AMOUNT: 5% CNASURETY Bond No. Bid Bond SURETY: Continental Casualty Company (Name, legal status and principal place of business) 161 N. Franklin Street 17th Floor Chicago, IL 60606 Five Percent of the Base Bid Plus Any Alternates PROJECT: (Name, location or address, and Project number, if any) LaSalle Avenue Streetscape Project; Project No. 122-013R 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. { 111/l When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the 1�I� any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted heref ` ors provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. W,gA-�o '•;�s furnished, the intent is that this Bond shall be construed as a statutory bond and s a common law bow. o OR Alf o; cW��.� Signed and sealed this 25th day of April 02 L w.A -.. Milestone Copti�actofs North, Inc. Prii{ci al Hilary, Director of ��4�SFCt1�gTS (Title) Andrew A. Lanphere, Atto Printed in cooperation with the American Institute of Architects (AIA). The language in this document conforms to the language used In AIA Document A310 - Bid Bond - 2010 Edition. POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company (herein called "the CNA Companies"), are duly organized and existing insurance companies having their principal offices in the City of Chicago, and State of Illinois, and that they do by virtue of the signatures and seals herein affixed hereby make, constitute and appoint Andrew A. Lanphere , Individually of,lndianapolis, IN , their true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on their behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - Surety Bond No.: Bid Bond Principal: Milestone Contractors North, Inc. obligee: City of South Bend and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Boards of Directors of the insurance companies. In Witness Whereof, the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto affixed on this 16th day of June, 2021. 01 Gtrr Mtsu� o° Continental Casualty Company National Fire Insurance Company of 00WORATe o American lty Company of Re ting, Pennsylvania Qi SEAL attrw t�, t Paul T. Bruflat Ace President State of South Dakota, County of Minnehaha, ss: On this 16th day of June, 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 Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company described in and which executed the above instrument; that he knows the seals of said insurance companies; that the seals affixed to the said instrument are such corporate seals; that they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance companies. F M. BENT NOUN PUB= - —, - M_ &Vnn� My Commission Expires March 2, 2026 M. Bent Notary Public CERTIFICATE 1, D. Johnson, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance Cotttprititieprinted on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said r3sarance%o"es this 25th day of April, 2023. C''S' '' ,ttsl►q„� Continental Casualty Company ,t National Fire Insurance Company of Hartford American Casualty Company of Reading, Pennsylvania tz- s >� u SE L ?c ry- no rjVV •-F D. Johnson Assistant Secretary Form 6853=4I2012 Go to www.cnasuret y.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 Date: To: From Subject Project Name Project No.: PHONE 574/235-9251 FAX 574/ 235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS April 21, 2023 All Planholders Theresa Heffner, Clerk, Board of Public Works Addendum Number: 2 Lasalle Avenue Streetsca a Project Rebid 122-013R ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 4/21 This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by faxing this sheet to the Board of Public Works at (574) 235-9171 within 48 hours of receipt. A copy MUST also be included with your bid package upon submittal. THIS ADDENDUM MAY AFFECT YOUR BID. Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: Milestone Contract( Authorized Signature: Dustin Date: 4/21 /2023 youTh e 1316 CouNTY-CiTy BUILDING '!y PHONE 574/ 235-9251 227 W.JEFFERSON BOULEVARD FAX 574/235-9171 SOUTH BEND, INDIANA 46601-1830 "1 0EACK a TDD 574/ 235-5567 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Date: To: From Subject Project Name Project No.: April 20, 2023 All Planholders Theresa Heffner, Clerk, Board of Public Works Addendum Number: 1 Lasalle Avenue Streetscape Project Rebid 122-013R ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 4/20/2023 This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by faxing this sheet to the Board of Public Works at (574) 235-9171 within 48 hours of receipt. A copy MUST also be included with your bid package upon submittal. THIS ADDENDUM MAY AFFECT YOUR BID. Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: Milestone Authorized Signature: , Director of Estimating Date: 4/25/2023 1316 COUNTY -CITY BUILDING 227 W.IEFFERsoN BOULEVARD SOUTH BEND, INDIANA 46601-1830 Date: April 21, 2023 To: All Plan Holders PHONE 574/235-9251 FAx 574/235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Lasalle Avenue Streetscape Project 122-013 Addendum No. 2 From: Leslie Biek, Project Manager The items in this addendum are to become a part of the original documents as if included therein. Only the noted items are affected, and the remainder of the original contract document is to remain in its entirety. This Addendum modifies the Contract Documents as follows: PART 1 — CLARIFICATIONS PART 2 — SPECIAL PROVISIONS, BID TABS PART 1 - CLARIFICATIONS 1.01 In the case where concrete barriers are not available, as documented by the Contractor, metal barriers will be allowed only when functioning to protect construction areas similar to concrete barriers, without attachment of metal barriers to the pavement. Metal barriers for protection of construction areas shall be allowed but shall not be attached to any pavement. 1.02 The MWBE percentage goals are for the base bid + alternate total. In the case the alternate is not selected, the City shall honor the base bid + alternate goal sheet. PART 2 — SPECIAL PROVISIONS 2.01 SPECIAL PROVISION, BID PROPOSAL 1. REPLACE the previous Bid Tab pages with those attached hereto. Additional changes include removal of line item 76 from the bid and an update correction to an incorrect bid due date. JONES PETRIE RAFINSKI Mark Wilson, PE Registered Professional Engineer END OF ADDENDUM 000," * 80328 STATE OF N low A signed cony of this addendum-shalbKe sAmitted with the Acknowledged by: n P-Hilary, Director Attachments: -This addendum consists of a total 10 pages inclusive of "Acknowledgement of Receipt of Addendum" sheet- 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 Date: April 20, 2023 To: All Plan Holders PHONE 574/235-9251 FAx 574/ 235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND JAWS MUELLER, MAYOR BOARD OF PUBLIC WORKS Lasalle Avenue Streetscape Project 122-013 Addendum No. 1 From: Leslie Biek, Project Manager The items in this addendum are to become a part of the original documents as if included therein. Only the noted items are affected, and the remainder of the original contract document is to remain in its entirety. This Addendum modifies the Contract Documents as follows: PART I — CLARIFICATIONS PART 2 — SPECIAL PROVISIONS, BID TABS PART 3 — CONSTRUCTION DOCUMENTS PART 1 - CLARIFICATIONS 1.01 Please see the attached Pre -bid Agenda and Meeting Minutes 1.02 List of current contractor questions, please see the attached. All questions will be answered with proper callouts and documentation as part of this addenda prior to the bid due date. 1.03 Contact for Corby's Irish Pub is Joe Mittiga, 574-210-0896 or ioe@corbysirishpub.com. 1.04 The AEP plan documents are included with the Construction Documents as a part of this addendum. 1.05 WM storm sewer pipe shall be the 15-inch main line being replaced, west to east, from the St Joseph River to the East Race Bridge, total 430 LFT, and all of the 12-inch crossings of the existing water main, total 941 LFT. Line items in the revised itemized proposal as part of this addendum have been adjusted and included accordingly. 1.06 It is not known if the existing water main is restrained, and it is assumed that it is not restrained. New base bid pay item 117, "Existing Water Main Joint Restraint, Undistributed," per EACH is added to the revised itemized proposal for restraint to be added as approved by the City on a case - by -case basis only. 1.07 Existing water main valves may be temporarily shut off for cutting and capping for Fire Hydrant assembly connections only as approved in advance by the City on a case -by -case basis, and only when not interrupting water service to customers. 1.08 The City will agree to the following revised project timeline: A. November 3, 2023 - Substantial Completion of the road open to traffic, including pavement striping. B. December 1, 2023 - Final Completion for work behind the curb line including utilities, lighting, sidewalks, etc. C. April 26, 2024 — Landscape Completion for all landscape plantings and any remaining paver areas completed. 1.09 The Contractor shall be responsible for planning and properly executing the Contractor's own Maintenance of Traffic Plan for all work to be completed beyond Maintenance of Traffic Phases I, II, and III as shown in the plan drawings. All work shall be in accordance with INDOT standard specifications and the MUTCD. All Maintenance of Traffic costs shall be included in the cost of the established Lump Sum pay item "Maintenance of Traffic." 1.10 Storm Structures do not require vacuum testing per City of South Bend Standard Section 3-3.4. However, compaction, mandrel, and televising tests are required for all storm sewers. 1.11 Native aggregates will be accepted as approved by the City on a case -by -case basis only. 1.12 Recycled concrete will be allowed for use as size No. 53 aggregate for approved sources based on the Contractor's provided testing results for size No. 53 gradation. 1.13 All storm structures labeled 2-foot diameter shall be a 24-inch diameter round inlet per City of South Bend Standard Drawing 3-6. Alternately INDOT's Inlet Type A pre -cast concrete structures would be acceptable. If INDOT's Type A structure is used then a Type 8 Frame with Type 8 Grate and Type 8 Curb Box would be required. 1.14 CZ units are not required for the ends of barrier walls. Barrier wall end alignment shall be tapered per the plan drawings. 1.15 Booting of structures is required for Core & Boot connections of new storm sewer pipes to existing structures according to plan details. 1.16 The Contractor shall order materials ASAP upon awarding the contract. Contractor's shall immediately provide the City with any information in detail involving any anticipated material delivery delay. 1.17 The alternate bid deduct pay item numbers and descriptions have been revised for the bid, see the BID TABS attached hereto. 1.18 There will be no underdrain connected to the storm inlets, the callouts for underdrain have been removed from the plan and profile sheets of the Construction Documents. 1.19 In the case where concrete barriers are not available, as documented by the Contractor, metal barriers will be allowed only when functioning to protect construction areas similar to concrete barrier without and attachment of metal barriers to pavement allowed. 1.20 Regarding storm structures 129 and 147, the entire structure is not to be replaced. The Contractor shall protect the lower portion of the structure at the large diameter storm pipes running north and south. The Contractor shall reconstruct the structure upper portion as needed above the large diameter storm pipes running north and south. 1.21 Regarding storm structure 134, the entire structure is not to be replaced. The Contractor shall protect the lower portion of the structure at the large diameter storm pipes running north and south. 1.22 All pavers shall be purchased by the Contractor, the City does not have any pavers from previous projects remaining. All pavers shall be per make and color specified in the plan documents. PART 2 — SPECIAL PROVISIONS 2.01 SPECIAL PROVISION, XII "PROSECTUTION AND PROGRESS", Item B, No. 1 1. REVISE to read "The project will have a substantial completion date of Friday, November 3, 2023 opening of the roadway to full traffic, including all pavement markings. With a final completion date of Friday, December 1, 2023 for walkways, lighting, and improvements behind the curb. All Landscape improvements shall be installed during the dates identified in the landscape specifications, but must be completed no later than April 26, 2024. The contract time will start when the Notice to Proceed is delivered and signed. 2.02 SPECIAL PROVISION, LXIII "STORM SEWER PIPE", Item B, No. 18 1. ADD pay items: WATER MAIN GRADE PIPE FOR STORM SEWER, 12 IN ............... LFT WATER MAIN GRADE PIPE FOR STORM SEWER, 15 IN ............... LFT 2.03 SPECIAL PROVISION, BID PROPOSAL 1. REPLACE All previous Bid Tabs pages with attached BID TAB document. Line items, item descriptions and quantities have been revised. PART 3 — CONSTRUCTION DOCUMENTS 3.01 SHEET 17, DEMOLITION PLAN I. REPLACE this plan sheet with attached Sheet 17 document. Revisions include correction of storm structure call out to be removed. 3.02 SHEETS 22, 23, and 24 of the PLAN AND PROFILE PLAN 1. REPLACE these plan sheets with attached Sheets 22, 23, and 24. Revisions include removal of underdrain information and addition of structure notations. 3.03 SHEETS 31 AND 32, STRUCTURE DATA TABLE 1. REPLACE these plan sheets with attached Sheet 31 and 32. Revisions include correction of storm structure types and quantities. END OF ADDENDUM JONES PETRIE RAFINSKI � *t...S...... *_ 8328 = yt STATE OF Mark Wilson, PE Registered Professional Engineer A sinned cor)v of this addendum,6hall Wsubmitt#d with the Acknowledged by: Hilary, Director of Estimating Attachments: -This addendum consists of a total 50 pages inclusive of "Acknowledgement of Receipt of Addendum" sheet- Project Name Project No. CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Lasalle Avenue Streetscape Project 122-013 R For Bids Due April 25, 2023 Contractor Name: Milestone Contractors North. Inc. The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 63 of The Responsible Bidding Ordinance No. 10694-18 (hereinafter, "Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders") by December 315t for the upcoming calendar year, or within twelve (12) months of obtaining pre - qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective January 1 of the following year, or immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 02/23/2022 General Conditions - 10 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 PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements: (i) X By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. (ii) X By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (b) Attachments: (i) X Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) X Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. (iii) X List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. (iv) X For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. Version 02/23/2022 General Conditions -12 II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: (i) _ By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) _ By checking this box, I hereby acknowledge and ensure that I and all sub- contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore,. I acknowledge my understanding that it is my responsibility to ensure that all sub -contractors have the necessary licenses to undertake the work called for in this bid. If a sub- contractor loses their license at any point, it is the responsibility of that sub- contractor to notify the City. (b) Attachments: (i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). List identifying all former business names. Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) years. (iv) _ Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. (v) _ Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances. (vi) _ For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. (vii) _ Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. (viii) _ Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. Version 02/23/2022 General Conditions -13 Date: (ix) _ Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. (i) _ List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. rf P. Hilary Name Here) Milestone Contractors North, Inc. (Name of Company) 24358 SR 23 (Address of Company) South Bend (City) (State) 574-288-4811 (Telephone Number) Version 02/23/2022 General Conditions -14 0 Responsible Bidding Practices and Submission Requirements for Pre -Qualified Bidder Checklist (b) Attachments (i) Attached Staffing Capabilities: Milestone Contractors North, Inc. is signatory with the following unions which supply our workforce — Laborers International Union, Teamsters, Operating Engineers and Cement Masons. (iii) See Forms 96 and 96a (iv) All individuals who will perform worn on the public works project on behalf of Milestone Contractors North, Inc. will be properly classified under applicable state and federal laws and local ordinances. , Director of Estimating Dated: April 25�h2023 CITY OF SOUTH BEND JAMES MUELLER, MAYOR DEPARTMENT OF PUBLIC WORKS ERIC HORVATH, DIRECTOR November 18, 2022 Alisha Krueger Milestone Contractors North, Inc. akrueger(@,milestonelp.com RE: Pre -Qualification Verification Dear Ms. Krueger: This letter serves as verification of Pre -Qualification status of your company for bidding with the City of South Bend. This Pre -Qualification status is effective for twelve (12) months from the date of this letter. Thereafter you are required to re -submit a complete application for continuation of pre -qualification status prior to December 31 for the upcoming calendar year. A copy of this Verification Letter must be included with every bid exceeding $150,000 submitted to the City of South Bend Board of Public Works, along with your Pre -Qualified Bidder Checklist and attachments. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, Liz Horvath, Permit Manager Authorizing By -Laws and Resolutions ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY: This Power of Attorney is made and executed pursuant to and by authority ofthe following resolution duly adopted by the Board of Directors ofthe Company at a meeting held on May 12,1995: "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary ofthe Company prior to such execution becoming effective." This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of Continental Casualty Company. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors ofthe Company by unanimous written consent dated the 251 day of April, 2012: "Whereas, the bylaws ofthe Company or specific resolution ofthe Board of Directors has authorized various officers (the "Authorized Officers")to execute various policies, bonds, undertakings and other obligatory instruments of like nature; and Whereas, from time to time, the signature ofthe Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer shall be valid and binding on the Company. " ADOPTED BY THE BOARD OF DIRECTORS OF NATIONAL FIRE INSURANCE COMPANY OF HARTFORD: This Power of Attomey is made and executed pursuant to and by authority ofthe following resolution duly adopted by the Board of Directors ofthe Company by unanimous written consent dated May 10, 1995: "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary ofthe Company prior to such execution becoming effective." This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of National Fire Insurance Company of Hartford. This Power of Attorney is signed and seated by facsimile under and by the authority of the following Resolution adopted by the Board of Directors ofthe Company by unanimous written consent dated the 251 day of April, 2012: "Whereas, the bylaws ofthe Company or specific resolution ofthe Board of Directors has authorized various officers (the "Authorized Officers")to execute various policies, bonds, undertakings and other obligatory instruments of like nature; and Whereas, from time to time, the signature ofthe Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer shall be valid and binding on the Company. " ADOPTED BY THE BOARD OF DIRECTORS OF AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA: This Power of Attomey is made and executed pursuant to and by authority ofthe following resolution duly adopted by the Board of Directors ofthe Company by unanimous written consent dated May 10, 1995: "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary ofthe Company prior to such execution becoming effective." This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of American Casualty Company of Reading, Pennsylvania. This Power of Attorney is signed and sealed by facsimile trader and by the authority of the following Resolution adopted by the Board of Directors ofthe Company by unanimous written consent dated the 251 day of April, 2012: "Whereas, the bylaws ofthe Company or specific resolution ofthe Board of Directors has authorized various officers (the "Authorized Officers")to execute various policies, bonds, undertakings and other obligatory instruments of like nature; and Whereas, from time to time, the signature ofthe Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer shall be valid and binding on the Company. " wy CONTRACTOR'S BID FOR PUBLIC WORK - FORM 96 State Form 52414 (R2 / 2-13) / Form 96 (Revised 2013) Prescribed by State Board of Accounts PART (To be completed for all bids. Please type or print) Date (month, day, year): April 25th, 2023 1 Governmental Unit (Owner): City of South Bend, Indiana 2. County: St. Joseph 3. Bidder (Firm): Milestone Contractors North, Inc. Address: 24358 SR 23 City/State/ZlPcode: South Bend, IN 46614 4. Telephone Number: (574) 288-4811 5. Agent of Bidder (if applicable): Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of LaSalle Avenue Streetscape Project - Project No. 122-013R (Governmental Unit) in accordance with plans and specifications prepared by Jones-Petrie-Rafinski See Attached and dated 11 /8/2022 for the sum of $ See Attached The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the governmental unit. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. The contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant may be regarded as a material breach of the contract. CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS (If applicable) I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation to use steel products made in the United States (I.C. 5-16-8-2). 1 hereby certify that I and all subcontractors employed by me for this project will use U.S. steel products on this project if awarded. understand that violations hereunder may result in forfeiture of contractual payments. ACCEPTANCE The above bid is accepted this . day of following conditions: Contracting Authority Members: PART II (For projects of $150,000 or more — IC 36-1-12-4) Governmental Unit: City of South Bend, Indiana Bidder (Firm) Milestone Contractors North, Inc. subject to the Date (month, day, year): April 25th, 2023 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 November2021 Name and Address of Owner INDOT 10,422,417.00 Resurface 6,800,827.00 Resurface November 2021 Lake County Hwy Dept 2,083,392.00 Resurface November2021 City of Hammond 3,891,896.00 Resurface November2021 INDOT 2. What public works projects are now in process of construction by your organization? Contract Amount Class of Work Sidewalk Replacement Expected Completion Date September 2023 Name and Address of Owner 24,572,623.00 Town of Griffith 13,847,877.00 Resurface Summer 2022 St. Joseph Airport Authority 9,568,000.00 Resurface October 2022 INDOT 2,838,234.00 Reconstruction June 2023 INDOT 3. Have you ever failed to complete any work awarded to you? No 4. List references from private firms for which you have performed work. If so, where and why? Gatlin Plumbing & Heating, Inc. 1111 E. Main St., Griffith, IN Ms. Patti Centrowski Gough, Inc. 2200 E. 88th Dr., Merrillville, IN Mr. Raymond Gough Dyer Construction Co., 1716 Sheffield Avenue, Dyer, IN Ms. Janet Furman Grimmer Construction Co., Inc. 2619 Main St., Highland, IN Mr. Greg Grimmer SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.) As required by owner 2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. See attached list 3. If you intend to sublet any portion of the work, state the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the governmental unit in the event that you subsequently determine that you will use a subcontractor on the proposed project. Will supply upon award of contract 4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit. See attached list 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, please explain the rationale used which would corroborate the prices listed. Yes, we received quotes from potential subcontractors and suppliers SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded. SECTION IV CONTRACTOR'S NON — COLLUSION AFFIDAVIT The undersigned bidder or agent, being duly sworn on oath, says that he has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to include anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. He further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale. SECTION V OATH AND AFFIRMATION I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS AI3,E TRUE AND CORRECT. Dated at South Bend this Mil �O� v tra ct rs��i�� pRP0 y: r F S SEAL /'? STATE OF Indiana COUNTY OF St. Joseph j ss day of April 2023 North, Inc. (Name of Organization) n P. Hilary, Director of Estimating (Title of Person Signing) ACKNOWLEDGEMENT Before me, a Notary Public, personally appeared the above -named Dustin P. Hi swore that the statements contained in the foregoing document are true and correct. Subscribed and sworn to before me this 25th day of April 2023 My Commission Expires: June 5, 2030 County of Residence: LaPorte Notary Public and ALISHA KRUEGER MyCwwdssbnExpires '• SEAL :*= June6,2030 •. z" = Commission Number NP0663544 La Porte County Part of State Form 52414 (R2 / 2-13) / Form 96 (Revised 2013) BID OF Milestone Contractors North, Inc. (Contractor) 24358 SR 23 (Address) South Bend, IN 46614 FOR PUBLIC WORKS PROJECTS OF City of South Bend, Indiana Lasalle Avenue Streetscape Project Proiect No. 122-013R Filed Action taken April 25th 2023 General Form No. 96-a Prescribed by the State Board of Accounts of Indiana. Revised 1949. Standard Questionnaires and Financial Statement for Bidders Prescribed by THE STATE BOARD OF ACCOUNTS OF INDIANA For use in investigating and determining the qualifications of bidders on public construction when the aggregate cost of any such work or improvement will be Five Thousand Dollars or more. These statements to be submitted under oath by each bidder with and as a part of his bid, as provided by Chapter 306, page 1248, Acts of 1947 Submitted to City of South Bend Indiana By Milestone Contractors North, Inc. Address 24358 SR 23, South Bend, IN 46614 Date submitted April 25th, 2023 Filed A.E. BOYCE CO., MUNCIE, IND. IA Corporation 1 Sec. 2 of an Act entitled "AN ACT concerning the awarding of contracts 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." (Approved March 13, 1947.) Sec. 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 judgment 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 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 examination, to be unsatisfactory, the bid submitted by such bidder shall not be considered. (Burns Statutes 1933, Sec. 53-109) Sec. 2, Chapter 306, Acts of 1947. TO THE BEDDER The following forms of questionnaires and financial statement are prescribed by the State Board of Accounts in conformity with the statute set out on the preceding page. These forms, properly filled out and attested, must accompany each bid of five thousand dollars or more on any public work. The forms are designed to cover all contracts for all kinds of work 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. T. M. HINDMAN, State Examiner State of Indiana Office of the Secretary of State CERTIFICATE OF EXISTENCE To Whom These Presents Come, Greeting: I, DIEGO MORALES, Secretary of State of Indiana, do hereby certify that I am, by virtue of the laws of the State of Indiana, the custodian of the corporate records and the proper official to execute this certificate. I further certify that records of this office disclose that MILESTONE CONTRACTORS NORTH, INC. duly filed the requisite documents to commence business activities under the laws of the State of Indiana on March 29, 1966, and was in existence or authorized to transact business in the State of Indiana on April 17, 2023. I further certify this Domestic For -Profit Corporation has filed its most recent report required by Indiana law with the Secretary of State, or is not yet required to file such report, and that no notice of withdrawal, dissolution, or expiration has been filed or taken place. All fees, taxes, interest, and penalties owed to Indiana by the domestic or foreign entity and collected by the Secretary of State have been paid. STATit In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the City of Indianapolis, April 17, 2023 11mil Uw� I DIEGO MORALES SECRETARY OF STATE 194484-057 / 20233133796 All certificates should be validated here: https://bsd.sos.in.gov/ValidateCertificate Expires on May 17, 2023. State of Indiana Office of the Secretary of State Certificate of Amendment of WALSH & KELLY INC I, CONNIE LAWSON, Secretary of State, hereby certify that Articles of Amendment of the above Domestic For -Profit Corporation -have been presented to me at my office, accompanied by the fees prescribed by law and that the documentation presented conforms to law as prescribed by the provisions of the Indiana Code. The name following said transaction will be: I MILESTONE CONTRACTORS NORTH, INC. NOW, THEREFORE, with this document I certify that said transaction will become effective Monday, February 01, 2021. a&Vw In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the City of Indianapolis, February 01, 2021 Cam:, a%- "..... CONNIE t AWSON SECRFTARY OF STAIE 194484.057/8818219 To ensure the certificate's validity, go to htlps://bsd.sos.tn.gov/Public6usiness5earch State of Indiana Office of the Secretary of State Certificate of Assumed Business Name of MILESTONE CONTRACTORS NORTH, INC. I, CONNIE LAWSON, Secretary of State, hereby certify that a Certificate of Assumed Business Name of the above Domestic For -Profit Corporation has been presented to me at my office, accompanied by the fees prescribed by law and that the documentation presented conforms to law as prescribed by the provisions of the Indiana Code. Following said transaction, the above named entity will transact business under the assumed business name(s) of: WALSH & KELLY NOW, THEREFORE, with this document I certify that said transaction will become effective Monday, February 01, 2021. In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the City of Indianapolis. February 01, 2021, &M" 0%- ""M CONNIE i AWSON, SfCRFTAR1 OF SThTF 194484 057 J 88 78 234 To r nsufe the cerifffcate's validity. go to https-//bsd sat In g0vlPub11[Buslness5ea1ch CERTIFICATE OF QUALIFICATION to provide CONSTRUCTION SERVICES for PUBLIC WORKS PROJECTS to the STATE OF INDIANA This Certification Board, having duly considered application for qualification in terms of apparent experience and financial resources; and under the applicable Indiana Code 4-13.6-4 and adopted rules of this Board, hereby issues a Certificate of Qualification to provide construction services to the State of Indiana for Public Works Projects to: MILESTONE CONTRACTORS NORTH INC 1700 E MAIN ST GRIFFITH IN 46319 Phone 219-924-5900 Fax 219-924-8768 Company Official TODD FAWVER for the twenty-seven month period stated herein, unless revoked by this Board for cause, and in the classifications of services stated below_ This certificate supercedes any previous certificate. 1611.01 Concrete Construction of Roads & Curbing 1611.02 Asphalt Construction of Roads and Parking Lots CERTIFICATION DATE 2/112023 EXPIRATION DATE 51112025 THIS CERTIFICATE ISSUED BY THE STATE OF INDIANA, PUBLIC WORKS DIVISION CERTIFICATION BOARD, 402 WEST WASHINGTON STREET, ROOM W467, INDIANAPOLIS, INDIANA 46204, ALSO ACTS AS THE OFFICIAL NOTICE OF EXPIRATION. K—� cl�f • CkZ4-4�-j Tracy L. Cross, Ex , tive Secretary Certification Board DAPW PQ2 State Form 3983R Rev. 07/06 WRITTEN CONSENT TO RESOLUTIONS of the BOARD OF DIRECTORS of MILESTONE CONTRACTORS NORTH, INC. The undersigned, being all of the Directors of MILESTONE CONTRACTORS NORTH, INC., an Indiana Corporation, hereby consent to the following actions to be taken by the Corporation without a meeting of the Board of Directors under the applicable provisions of the Indiana Business Corporation Law, as amended: RESOLVED that the following be, and hereby are, elected officers of the Corporation, to hold the office until the next regular meeting of the Board of Directors and until their successors are duly elected and have qualified: Todd A. Fawver Charles Potts Jr. John P. Vercruysse Mark Andrews David L. Franz John M. Peisker Patrick J. Walters Brad McCall Derek Merida David M. Kozyra Lynn J. Bauer Danielle Payne President Chief Operating Officer, Construction Executive Vice President Executive Vice President Vice President Vice President, Production Vice President, Finance Vice President, Estimating Vice President, Bridge Operations Vice President/Area Manager Griffith Vice President/Area Manager South Bend Assistant Controller, Secretary and Treasurer RESOLVED FURTHER that the above officers be, and they hereby are, authorized to execute all contracts or similar documents on behalf of the Corporation. In addition to the above officers the following are hereby appointed as authorized signers on behalf of the Corporation: David J. Misirly Senior Estimator Gregory A. Hoffinan Director of Estimating, Griffith Dustin P. Hilary Director of Estimating, South Bend Mark E. Krachenfels Construction Manager RESOLVED FURTHER that the actions of the Officers of the Corporation taken since the last meeting of the Board of Directors be, and the same hereby are, fully ratified and approved. RESOLVED FURTHER that this consent shall be in lieu of an annual meeting of the Board of Directors of the Corporation and shall be filed in the minute book of the Corporation in place of any such annual minutes. <<SIGNATURES ON THE NEXT PAGE>> EXECUTED this 26t' day of August, 2021. x1a4 M , I - - Fred Fehsenfeld, Jr. Geoffrey C. Dillon Q, c James ehsenfeld Pu JAA P. Vercruysse P,ij Milestone DATE: May 24, 2022 TO: All Employees RE: EEO Officer Appointment Margaret Garner has been appointed Equal Employment Opportunity Officer for Milestone Contractors. It is her responsibility to coordinate, advise and assist management and supervisors in their responsibilities of assuring all applicants and employees' equal opportunities in all aspects of their employment. She will review complaints that allege discrimination because of race, religion, color, sex, sexual orientation, gender identity, age, national origin, disability, housing status or veteran status. Employees of Milestone Contractors are to submit any issues or concerns to Margaret. We are committed to comply with the provisions of the Civil Rights Act of 1964 and 1991, plus all Executive Orders issued relating to Equal Employment. Margaret's contact information is listed below. Milestone Contractors 5757 Decatur Blvd, Suite 250 Indianapolis, IN 46241 mgamerC rialestone.p (317) 616-4937 CJ Potts, Chief Operating Officer P,i,l Milestone EQUAL EMPLOYMENT OPPORTUNITY/ AFFIRMATIVE ACTION POLICY STATEMENT It is the policy of Milestone Contractors to afford equal opportunity for employment to all individuals regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, housing status, or veterans' status. The corporation is committed to this policy by our status as a federally assisted government contractor. We are far more strongly bound to the policy by the fact that adherence to the principles involved is the only acceptable American way of life. Therefore, it is the policy of this corporation to assure that applicants are employed, and that employees are treated during employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, housing status, or veterans' status. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre - apprenticeship, and/or on-the-job training. The successful achievement of a nondiscriminatory employment program requires a maximum of cooperation between management and employees. In fulfilling its' part in this cooperative effort, management is obliged to lead the way by establishing and implementing affirmative procedures and practices which will ensure our objective, namely equitable employment opportunity for all. (Minority and female employees are encouraged to participate in all company activities and refer applicants.) I have designated Margaret Garner to direct the establishment of and to monitor the implementation of personnel procedures to guide our affirmative action program. This official is charged with designing and implementing audit and reporting systems that will keep management informed on a regular basis of the status of equal employment opportunity and affirmative action. She can be reached at (317)616-4937. Supervision has been made to understand that their work performance is being evaluated based on their equal employment opportunity efforts and results, as well as other criteria. It shall be a responsibility of the supervision to take actions to prevent harassment of employees placed through affirmative action efforts. We shall comply with the Civic Rights Act of 1964, as amended, the Federal Highway Act of 1968, the Executive Order #11246 and #11375, the Rehabilitation Act of 1973, as amended, the Vietnam Era Veterans Readjustment Assistance Act of 1974, as amended, the Indiana Civil Rights Act and other applicable Federal and State Laws and regulations pertaining to equality of Opportunities and Affirmative Action policies. We have developed an Affirmative Action Program for Veterans and Individuals with Disabilities. 2A��l - CJ Potts, Chief Operating Officer Margaret Garner, HR Area Partner/EEO Officer January 2023 trunumir jorf qutaifut-atio Mt7$D BV INDIANAPOLIS, IN October 20, 2022 TO MILESTONE CONTRACTORS NORTH, INC. GRIFFITH, IN who has fried with the D apartment a Contradors MAement of Experience and Financial Condition as raquired ureter Irdiana Care 8-23-10. is t'eneby qualified to bid at any D"rtment of Transportation letting in Classes of Mork and within the grunt and oikter limitation of each dassfocation as listed teloa, far such period as tt+e uroompletted ttiorlc on haW from all sources does not exceed the Aggregate amount. Classification refererces by name or symbol are in accordance with the definitions in the ContWors StatementofExperierrceand RrarciatCordition. This certificalesupersedes any oer6ttcaiie previously issued. but is subject to revision or revocation according to the law, I and when changes in the financial condition of the contrachng firm or other facts justly such revision or revocation. Valid October 20, 2022 Thru September 30, 2023 Aggregate Bidding Capacity: 327,748,000.00 A(B) CONCRETE PAVEMENT: LIMITED................................................................................... $25,000,000.00 B(A) ASPHALT PAVEMENT: W/INDOT CERTIFIED HMA PLANT ............................................. $99,999,999.00 C(B) LIGHT GRADING............................................................................................................... $99,999,999.00 E(E) SMALL STRUCTURES AND DRAINAGE ITEMS.............................................................. $25,000,000.00 E(F) SURFACE MASONRY AND MISCELLANEOUS CONCRETE ........................................... $50,000,000.00 E(G) TRAFFIC CONTROL: PAVEMENT MARKINGS................................................................ $25,000,000.00 E(H) DEEP SEWER AND/OR EXCAVATION.............................................................................. $25,000,000.00 E(Q) CONCRETE PAVEMENT: REPAIRS.................................................................................. $25,000,000.00 E(R) ASPHALT PAVEMENT MILLING....................................................................................... $50,000,000.00 FRErUALlFi A ON ENMEER SUM tForr. 20SM {tom d +-05 PP---f --- -- COMMLSMUER BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 4/17/2023 Name Leslie Biek, PE Department PW BPW Date 4/25/2023 Phone Extension 9323 Review and Approval Required Prior to Submittal to Board Diversity Compliance ❑ Officer Name and Inclusion Officer BPW Attorney ❑ Attorney Name Dept. Attorney ❑ Attorney Name Purchasing ❑ Check the Appropriate Item Type — Required. for All Submissions ❑ Professional Services Agreement ❑ Contract ❑ Proposal ❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA ® Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes ❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA ❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution n Other: n Ease./Encroach Information Company or Vendor Name New Vendor ❑ Yes❑ If Yes, Approved by Purchasing ❑ No MBE/WBE Contractor ❑ MBE Completed E-Verify Form Attached Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description ❑ WBE LaSalle Streetscape 122-013 R, PROJ 317 River East TIF Bond PR - 20064 LaSalle Streetscape Rebid. For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount $ Increase Current Percent of Change: Decrease New Amount $ Increase Total Percent of Change: Decrease Time Extension Amount: New Completion Date: ❑ Yes ❑ No