HomeMy WebLinkAboutOpening of Quotes - 2023 Microsurfacing Proj No. 123-023 - Asphalt Restoration Servs.I -
SCOPE OF WORK
F SOUTH 13ENQ
PROJECT NO. 123-03
QUOTES DUE July 111th, 2023 at 9;00arn Locat TImo. GIUM05 are to be submitted
L P—BOJECT DFSRI .-11CIN
X The pro t includes tho furnishing of 211 equIpment, matertaIF Insurance, grid Iabar to perform
a ppmxl m ately 16,840 -square yards of asphalt micros urfacI ng at various lorati c ns withln the City of
South Bend,
II. FREVAILINGSPECiriCATIONS AND CONSTRUCTION STANDARDS AND SPECIFICATIONS
The City of South Send's PREVAILING SPEOIMATIO N , rm o st rem nt Yers i o r1, and
DD KS TRU CTI ON STANDARD S AN D SPEC 1 FICATIONS, rrlc st rece rat Vers i on, a re to b e u s ed on th is
pm1
8. Each Quote provider is specifically instructed to become completely familiar With the most recent
ver,51on of the PREVAILING SPECIFICATIONS and the CONSTRUCTION STANDARDS AND
SPECIFICATIONS prior to submitting a quote-
C.
Wherever the PI EVAIL1NO S PECIF ICATION S refer to "Stale S pecifoaticns,' it shalI mean tP4e 2022
INDOT Standard S cif i catio n s for the letting effective after Septem ber 1, 2021.
D_ These SPECIAL_ PROVISIONS Will list only "Additions" or "Deletions" to the PREVAILING
P E C I F I CAT1 0 N S and are to be Used only in conjunction with the PREVAILING SPECIFICATIONS.
E. I n the eve rnt of conf i:ct betwe en the S P E C IAL PROVISIO N S an d tth e P R EVAILINO S P EC I F1 CATIO Ns.
the S EECLAL PRCVIS10NS will go -
ear -
Ill. TEFL, "OR EQUAL"
A. Prevailing pecifpcatons: None
B. Addik.ivs
I- Where the term "or eq uar' Is used in these s peCAC,21ons, the Q Uete provider d eviafing from
specified item shall file with his�her, lts Quow a letter fully explaining and justifying hisAvrfits
proposed a r#ro1 a or equ al. The Cat} of Sou the Be nd shall b e the sole Judg e 1 n determl nin g if the 'or
eq ualm offered meets the specif cabon.
IV. TAX EXEMPT
A` Prevailing Specifications: none
9. Additions
1. Materials and p rope r1 es purchased under co n Lract with the Owner that becomes a pe rm3 ne rat part
of th a st r uctu re u r lac i I i ties = nstrueted are net subject to the I r) die na G ros s R e!,M I a x (Sa;e s Tax).
The exemption number Will be furnished to the Contractor upon award.
V. 1N DEr.'1N1F1CAT10N
A Prevailing Sp i ficabons ; None
D. Ad-11tions
1. ontra ct)r agrees to indemnity. defend and hold hamnl ass the City of South Send, its a n-nt s,
officers an d err ployees, from all cos ts, I csse s, cla ims and s u its, i ncludin g court costs, a Ftorr :e y rc e s,
a nd othe r exile nse s, arising from o r oot of th a rl eg 11 gen t pe rformance of th} I s C ontract by C or tracts r,
VeT 51 o n 2J14,2022 F.@e - 1 Pul is Forks Ourito
Iq
w bwaLw Of wQ i Of eny defta in the ids, mawnais or a supphad by V* Ckxft
PMlyder.
1WSURALNCE
A PtvVa :-,I SPeCffC40nS-'2022. INDOT Standard S Secton 103
B_ +4d,,
1- All CwtrACWS 2M subcontrawx,3 doing busnes.s , of South Sena shell prat .2
Certftgft of insures shoe coveraVe in ft *AkwMg Mi OF arrxxxt
--r-
71 P4* :1ii
Jim
t i I a t.F
�.� * -4 .t _ F i r■ i ■ i --1 4--yUl Iy t-
VIL COWROL OF WORK
A_ Prevafing SPeclkaWm-2022, IN DOT Standard SpeafKzbons Secom 105
1. The =VWte mWWS&MY kit M Word lies Drtackm of PLbk Ykwks of CMj of SouM
Sew. (rda'a "h his auft¢ed •
cwwPicbw EnPmenng - The Contra r sw Pvvide all the
eq�wt svpphes to perform aii mqunder fis i There wiff be , no � I
For Item. �
3 The cimitractor is respon-sii* tt�omaintain t#� sft w � b o# �i
is nte,d t0; d
y
V*xk hours for the ect shall be kom 7:00 a fn. through 6.00 p m_. MOndW hUQh Friday- No
irk shad be permded onwmkends, Hdodays, Or after hours unMss appmvW by CdyofSouM
Bend Depart mni of PUbfic ykeks.
V11I_ LEGAL RELATION
A. PrevMfing s: 2022. INDOT Standam Spec&jcafions S&%Oa 107
e Addwns:
I TM Owner, where n'*n bwed in the doairnents, is ft ih+ of SocM Bend. TIC raw . �+t'rerre
rrterti� in these docurr�eft r 1 the of $end l of PU ems, Engi
Dais,
2 The C4ftaCW shall appiy fbr and obtain any and all requirW p@trrft for "work from Jul,ItMe,
arMd federig agercses and shall oompty wth pew require nts. i t io"ph C0U*
f City of Sovth &nd Bukling Departirrmt
3. If tt rded this c&*= L$ Fmt -9 reskiW of Indm dw^&0
� '
II ProMe llsir Owl w {� � �YS f th4t 1� e o ti a tr iS d* r gUSKM 5i QrW � Vf '
I aer ry of $tom of Indiana try '
� arts w�thirr � Ire_ ;
4. The ntrac sha I Comply Wth all PMvlmns of Indiam Code 1 & 13, as igniff%%d. Ths finer
reSeries the right to immediately terminarle the public wwk pmpwt awwmWft C'
W fund 10 be m mIaklon cf any prOvis*n of Indiana C4de 5-16-13 and
in the f rture Of ntrW s Pftftmanm bond 6n the owrW, w
IX. PROSECUTION AND PROGRESS
A Pt"ling !Sp rfic:atiops 2M IFOOT Standard
8 Addmms
WWI ki 1}Q
y. The project gill have a Wmplotion date of 8apternb*r 8' 2023 for all work. Ttno contract b" YAR
start when the Doti ce to Proceed i s de I ivored and sig ned.
2, The City, Engineer, and Contractor` will hold a pre- nstructlon meet, 9 fello�vin� award of the
contract. The date of the Notice to Proceed writ be agreed at that meeting.
3. Contractor shall provide a schedule to the own er prior to leg In ning an Y work on th o el Ila-
, CHANGE OF CONTRACI TIME
A, Prevailing pecifi bons: 2022, INDOT Standard Specifications Section 108
B. Additions
1. The Contract Time may only be changed by Chango Order. Any Claim roc an exre-nsi o n in the
Contract Time shall be based on written notice delivered to the Departrwint of Public VVOrks within
seven (7) ralernd ar days of the occurrence of the event grvi ng rise to the claim. Notice of the extent
of the claim with supporting data shall be detivere d within fourteen (14) na I e nd a r days after such
ufrenco unle ss an official of the P u blic Works De partmen t a I laws an additi o nal peri od of ti me to
a scerta in more a ccurate data. Th a Contract T ime vwklt be o xte nd ed i n an am oun t eq ual to tim lost
to delays beyond the wntrol of the Contractor if a claim is made in a rdan with this provision.
Such delays shall include act$ of negleot by the Public Works ernployees, or to fires; flood. labor
d isputes, a pi -de m ics, ab norma I weather cord it ions, g ogre rn me nta I procedu res, ov acts of God .
2. Unless otherwise provided, the Contract time is teased upon normal weather conditions. An
extension i s granted for weather coriddi on s s ignifican k Iy more serve re th a n no(mal if the Contractor
der noftrates to the satisfaction of the City that the delay In the progress of the work was due to
such weather. The basis to defino normal weather wl.th be the data compiled by the United Mates
De partme rn I of Com merce, N atienal Ocean k� a nd Atmos pheri c Adm i nistratiorn (NOAA) ,
3, No extension of time will be granted if the Contractor, by hisiherfits awn action or In action, includrrig
fa ul t or neg I igence of Contractor's subcontractors, caused the d e lay, or fo r which any rem ed ies a re
provided and er an y othe r provision of this ag reeme nt.
4 Xh e g rant of a n e xternsion of time uncle r th is Section in no way constitutes a waiver by the C its+ of
and+ rights or remedies existing rundor this contract at law cr 1r) equity.
X1, 0EFAUJ AND TERMINATIC N
A Prevailing Specifications; 2022, 1NDOT Standard Speclllcations Section 10B
E Additions:
1 Events of Default shall Include Contractor's fa i I ure to perform any of its obligations under this
con tract includii ng fa i I ure to commence work at the time specified, failure to perform the wv r k in
e rdance wi th t h ese s pocifi cation-s. unauttn ari zed d is h Li ni}ation of the work, fa i I u re to Ca rry c ut
iho work in a manner acceptable to the City, failure to observe Federal. Mate, or 10ral lam or
requ la taons, a nd feilu re to co m ply with a ny other term o f th is coat ract ,
. If an Event of Default eccufs, the City shall provide Contractor written, notice and rr ay permit
Gon t ractor ten (10) r.:a lendar d ays a filer t he date of the notice to cu re the defy ult. I f the defau It i s
nol cured within the tern (10) day cure period, the City may at any tima thereafter terminate th i s
contract in w+rhlch case the termination shall be final and orfective,
3. Uport an Even t of D efa ult, th a C ity may linyok a th a followi ng re medies i n add i tie n to those re mid ins
provided under separate provisions of lhtirs contract, the right of set- f against any payments due
a to became due to the Contractor agalnst the retalnage, the fight to tak-0 over and co mpl eta the
V+or k . I f the C i ly nolifie 5 Contractor tha I D i ty is 1 nvok I rig its rl ght to mpl ete the Work. a I I rig hts that
the Cori tractor has in order under Contractors subcontracts are assigned to the City, subject to the
ity'a right to lake assignment of all or only selected su bcontracts at the City's discretion. The sale
obligation ac pted by the City under such Subcontracts Is to pay for' ark satisfactorily perfor"d
a Aker I he d ate of the a ssigrrmern I. I n the even It a coed itiona I as s ignmen t h as not bee n exec uteri. th e
D ontre c for shall a xecuto or cause to be a xecuted an y+ assig n me nt, agave me rat, or tithe r docu ment
1 ha k may he n ssa r y in the sale opinion of legal counsel to the C ity's Board of Public Darks to
evidence comp l lanca with ibis provi $ Ian . The Contractor shall promptly deliver such locum-e nts
upon the ity's request. In the case of s uCh as $ ign me nt, unless otherm'Se agreed 'in writing, The
Contractor rernaIns liability to subcornIra ctors for any payment already involved, and for any claim,
Su It or Cou se of anti a rn based u porn or resu I ti ng from any a rro r, or nission, neg I i gence or other br:eac h
Verity lot~ V t 42 Page - 3 Public Works Quote
-of contract by the Contractor, its officers, employees, or agents arising prior to the date of
3:�S ignment to the city.
lt, LIQUIDATED DAMAGE
A. Prevailing Specifications; 2022, INCCT Standard SpecififiWS:Secfion 108
B, Add ikions: ;.
1.' The contractor shall proceed with the work at su-h rake of progress to insure full completl-0n Vathin
the Oontmcft Time. ItiS expressly understood and agreed, by and between the Contractor and the
Owner, that the C ontract Time for corn plet ion of th a work descri led here i n is a reasonable ti me,
taki rig into consi deration the ave rage climatic and eoonorn is core diti ores and other factors prevail i ng
in the loratity of the work, and excludes the time to r unavoidable delays which were beyond the
control and without the feu It of the Contractor. t _
2. If the Connoor Shall IMI to complete the wok within the Contract Time, or eAensiorx of time
granted by the Amer, they, the ContraUor will pay to the owner the amount for liquidated damages
a sum of five hu ndred dol lars (5 00.00) for eac h calenda r day that the Con Mtor shall re mein i n
default after tM time of completio n stip ulated in the Contract Docur ne nts. -
, The Contractor shall not be charged %ith liquidated darnages cr any excess cost when the delay
in completion of the work is due to the folk w fng and the ootractef has promptly given written
nice of such delay to the Owner and Engineer/Ar h itect
a. To any preferen ce, pdofity, or a I Iocatkon order du ly issued by the O ne r.
b,' To unfore,5eeabla causes beyond the wntml and without the fault or negligence of the
Contractor, ind Wing but not restri to acts of God, a of public, enemy, acts of the Owner,
' 1
r auts of another Contractor in the peJormanw of a ConUwt with the Owner, hires, flues,
c , epidemics, . quarandw restrictions, strilkes, freight . embargoes, and abnormal and
unforeseeable weather.
+ UL RETAINA E AND FINAL PAYMENT
A. Pr i li rig peclflc tM cn s: 2022, I DOT Standard Speciftations Section 109 r _
S. Add iti
ons: .
I. • Paym wil I be made every th irty (30) c:ale ndar d arys F
1. Ccn!siStentwith prWsions of IC 35-1-1 -14, the Board of Pub['Lc Works shah retain i percentage of
payfmnts throughout the duration of the project,
3. • Before final payment and retainage are released the Contractor must Satisfy the folkywing,
ar. All parts and labor rneet raquirernents stated in the 6pecificaborl5.
b. Provide cop ies of test reports or cut s h7 nets o n all M:ateri alS Sc ppl iar d_
c. Provide As-Suilt drawings in acwrdance with the City of South Bend Prevailing 3 peaifications
for Public Works. .
d. On (1) copy of ft City of South Bend Completion Affidavit and one (1) copy of a Final Waiver
of Lien_ ,
t
XrV. WAR RAN TY `
A- Prevailing pe0cations, None
S. Additions
1, . All Parts Shall include the fallowing:
e- Performance speofflcations
b. Bill of t' akerials
C. Warranties on all paw
d_ Installation and safety} requirements .
� r y
Version 2114 0 PW } d4 Public works Q
7
i
XV. OTHER UTILITIES
k Prevailing Specifications: None
1D. }addlfions.
1. Th e Contra-ctor sh all - verify th a locations of all u tilitles by cc r4acll ng I nd iana811 by cal ling 811 (1 n
Indiana) or i -BOO-38 3-5544 (outside of Indiana). or vl a at least two ()
Yncking days, not counting Saturdays, Sundays or federal and state holidays before proceeding
with con strut don, 1 t s ha I I also be th a Ca ntra ctoft respcn s i bility to ccntaa ray oth e r uti I ity that is
not contacted by Indiat) a311 and verify the utility locallons,
2. The Contractor sh all be respo,nsi bhe for woOng nth th a other utili tl es, Le., g as ale Uri o, tele ph o n e,
etc. In order to assure that all utlllfies that need to be replaced -Dr relocated can he done with a
m i nirnurn disturbance to servire, The Contractor shall also be responsible for coordinating
schedules with the various utilities such that they can proceed with their relocation wart as
efficiently as possible. _ -a-'
8_ If the odor of natural gas is ducted in a work area at any ti r'n" O during the wurse of work, the
ontr-aaQr shall immediately notify NIPSCO at 1 M-3 524. The Coritrwtor shall also
- immediately notify the residents of adjacent properties, The Contractor shall advise the residents
to evacuate thel r homes 1 mrrmed Italy if the od r 1 s pm sent YAthln the dwelling .
4, Restoration of spdrikler systems damaged by the Contractors operations shall be repaired by the
Contractor at no additiional cost to the City or the Comer of the system. " J' ` ' .
Vl. MelN- TENAN E OF TRAFFIC
_ •' � +•� —,_ , 1 .`�• -, $ ti ; I'.� � �ti sir'
A. Prevailing pedfica iris: 2022, INDOT Standard Specifications Sections 105 1 � .
F
1. Maintenance of traffic dunng construction shall conform to the "Indiana Manual an Uniform Trafft
r Contr6 Detirices" and the City of South Bead Design and ons"Oian Standards.' ~_
2. The Traffic C osure Request' form is 10 be used For any lane restrlctrons or closures and r quired
i to be filled out and sent to the Department of Public Works. _
8_ The Contractor s htia11 arrange and prosecute the work speci lied for th i s contract in such a ma nn e r
Y that traffio on existing streets is unrestricted throughout the Project. The Engineer shall approve
t the method of traffic control. No construction equipment, vehicles, materials, supplies or ternporary
facilities shall to left unattended in the right-of-way of any street or left panted overnight without,
proper marking and IIghtinG.
4. After the award of the contraa and before beginning the work, the ContmcWr shall submit his/herfits
proposed schedule of operations for the review of the Engineer. The schedule of operations as
feMewed by the Engin eer s h all be mat nta4n ed at a I I ti mes.
` 6. Project s[gr 5 will be req uired o n loth ends of the project once traffic co ntrol has been placed prior
to microsurfacing and shall remain until the road is open to traffic or as directed by the City
RepreseritaWe. The City wi I I pride two () 24" x W Rebu ilding Ou r Streets project sig ns a nd
the Contractor shall place the suns on A -frames with sandbags and plaice them to the side of the
road fn advance of the project limits Mhout impeding traffic or pedestrian aucess, The
Contractor -shall be requ 1 red to move these sig ns once traffic I s open to new streets that are bet ng
:surfaced. The signs gill become property of the C ity on-ce the project is czrriplete.
8. There wi 11 be no direct paynne nt forth is work. ` ' . v -
XVIl, DESCRIPF10N OF WORE(
A. Prevailing Sp Ml9catlons* Acne
13, Additions
1, Work to ba peffbimed sh all Include fium l shing all labor, se rvices, materials, Ins urance a nd
eq ulpment to pe rform as pha It m i cresurftc i n g at various locations with I n the City of South
Send.
'Ven*m 14*M Page - 5 Public Works Quote
2. The streets segments for the base and both a [te rnate$ art SUMM21fted belOW
Illinois street from Linden Avenue to Westem Avenue
i owa Street from Washin gto rt Street to Weste m Aven ue
i ertmc rye Street from LI nd e n Ave nu a to Washin gten Street
Kenmore Street from Jefferson Boulevard to Western Avenue
dw
Ll
IThe
Contractor shall preserve and protect all au r rou nding prope rtY, structures, to na nts, visitors and
th e i r prop" from da mage cau sed by the Contractors c perati on s.
I I L ASPHALT M I ROSURFA IN i
A, Preva i lira S pecifimUc ns' 2022, IN DOT to ndard Specifi ntons S a oti on s 411, g0
r 1y
Asphalt mica-surfiace material shall rneet the standa rd speofcatr'ans-of ASTM D809911D8099M-17.
2.
The Cc ntracter shal l be res ponsi hl a for al I su dace preparation necessa ry to meet th a performa ma nce
r
requ ire meats for ors rre nted micro -surfacing . All casting s an d dete r hous i n gs sha [l be protected
prior to Me appl i cation of materia I i n a=rdanoa with [NID OT 404.0-7, exempt th at ra [sed pavement
markers shall be r *moved, There will I>e no d i rect pay r i ens. for thi s work. .
3.
C racks in the pavement in excess of 114 in. vVidth shall to fiIfed in acoordanw with INDOT 4D8 prior
_
to pla rnent of pro rra n ted m ions urfaci ng, Them wi I I be no direr Ra rnerlt fair th i s we .
4.
Existing curb Maces,, approaches, stormwater inlets, gross, artd o of features subject to
a.. , • :
000rdi nation +with the Engi weer 5 hall p retested frorn and kept c lea n of all a shalt micro-surfaoe
f'
S .
Squeegees, bru5hes,- and track -mounted applicators shail be permitted for this work Only
•
appRmtion by hand squeegee or brush shall be use-d In the vicinity of sensitive features as identified
in XVIII,4 to prevent contamination.
6.
Asphalt micro -surface shall not be applied when ambient temperature is betow WF nor* when
ambient temperature is expected to drop b-elow 507 wfthin 24 hours 0f:81;>P1[Cati0nr
7.
Asphalt micro-su dace shall be applied in two coats. The oppl icabon rate of each coat shall be
between 3 D to 40 square feet per gollon _ .
8.
The first ooat of rnicro`surface shall be dry prior~ to appiication of the send coat
9. a
_
Existin g page meat rr° *in gs, inolud i ng but n of I i rmited to painted crossv al ks and stop Cirres+114rf le e
pawed over by asphalt micro -surface, shall be reapplied wfth traffic paint. There gill be no direct
payment for this word.
10.
Al I inci dental work, i nclu d i ng feu t n at I i mated to surface preparati on, i nlet a nd casCng protecton, and
pavement markiN s, shall be inci ud ed in the cost of the asphalt rnicrosurfacing pay stern;
I
ASPHALT III ROSURFA IN ..,.._,,..,.,,..Y............*.af+.+t.Y...r....,...................�`f�
•
i
I. PLANS
ON.
_ A P revailing Speci fications: City of S o uth 8 end Deli g n an d ConstN ct[on Stan d a rds
B, Addition s: -
_ I.
The plans cc nsist of 3 Sheets de[Ineating prof ect IiMilts.
. 'Pi 2.
The work skull conform to the plans.
S.
The drawings are schernatic [n mature,
4, .
The CONTRACTOR Is responsible for estimating dimensions and quantities of materials.
v
b.
In the event that the pec[a l Provisions and the Plans conflict, the Special Provi sions s hal l gore m.
Version V114=22 Page - 6 Public Works Quote
CITY OF SOUTH BEND.I DIA A +'
MUM OW .
P RGJ E CT NAME: 20 23 M lerosurfaoln r'
PROJECT NO. 123-023 -
QUOTE IDUE ,duly 11 th, 2023 at 9:00am Locial The. ouotes are to be submitted
rr -
elect nica 1 #
(M u st be cc rnpleted for all quotes. Pie a e type or prints
Date: + �'`
Firm.
Address-+ i +
' —
ityl tatef i p; Telephone Nu rater
Agent of bidder cif Applicable):
Pursuant to mt; s given. the undersign -offer to furnish�bor and/or r�ateri�l ne st !� �let� #fie
public woi ks project of
2D23 film&ur#aein_
the City of S outh Dead, Indiana, In a0mrdarice with plans and specifications prepared
The C ity of South Be n d Deporbrnent of P ubl is Wo rks t ,
and -dated A O for the sum n of (enter #t16 TOtal Quote as shown on the Prop l]li
anp hunar�a 9,!Ah-� e-M Ajo=&na Mf- ri (s I Iff, coo A
(Eater Sum o4otall Quote:5hown on Proposal) de - ' '(Numerical) +
If alternative quotes apply, the undersigned submits a proposal for each in a=rdanoe with the notice. Any
addendums attached will be!5ific4ly refe reoced at the applicable page -
If addibenal units of material included in the contract are needed, the cost of units rnust be the same as that shorn
in the original contract if a epted by the City of SOuth Bend. If the quote is to be awarded on a unit basis, the
itei''M'lizabo 7 of the u n I is sbal C to shown on a sepa rate a ktaO Man t+
Flyi M
�., (SI ature)
ACCEPTANCE
20
The above quote is accepted this r
SLibiect to following cond itporrs=
2
Elizabeth A. IY a acilk, President
nary A. Gilot, Member
Joseph R, Molnar, Vice President
,Jordan V, Gathers, Member
Murray Miller, lamb :,.,• - .. r fittest; �t�eresa Flcffner, clerk
r,
Version t 41= pop+ 7 Public Works Quote
CITY OF SOUTH BEND
EQUA L EM P LOYMENT 0 P PORTUNiTY Co NTRA CTING
PROVISIONS DIVER ITY UTIL17ATION
the City of South Send to Pravl de equal ernployment and business epportun for
1i p and cerp�r 90n s In a erdar with the rules, r ulat� ons and
perms, fi
al; r . MP19 �
�� � iblo federal, or
and +Deal laws, This policy of equal erriPla�rr�erlt and business
guidelines �
or su b�ent� cter Kidd I n� o r holding p ublio contract � the City
opportunityshall a to every contractor
of South SeM.
rtu r�i Clauses are he re �� m�ada a part �f eves
the J I Equ al opt
infiUrthe�n of th is � Ie+ty of SouthBerxd and .911 subcontractors entered Into pursuant
strM.�n ',tta� entered into �� �� i
bD any such COntr�
d the b;dW hereby cc rt&e 5 that lVh efs he wi I I abfd a by these provision s.
h against ap lioar�t or er'a�Pl0jee be use ra ,
The Gwbwader wilt r di r7mknate
miler, religion,
e na�ena I eri� i s � �f handi�sp� the contractor v�l I to Re affi rrns�ve action
all a li.r�l.5 or ern�i��+ee � are treated fal rl�r �n d lrr��kior� � � transfer,
h action
to ensure that P
shall Odude but not W jrnited to the follcming: hIrarr . offerdemotion
or compensation
re • adve ruing, lay -oft or to rm. iriti011, rates of p } y
and &ajecw w training Including Wrenticeshaip programs* • a
shall agree to post In �picueUS places available to a I r at ca
and
Thetrar n Clause•~
appl ,tits, ra ces to be provided sot rig forth the Rrovl s Ione of the Nan*� I s�rErr�
will+ In all ficilMons or sd►�erUsaM me for arnployao3 placed by or ebe rlt
T li . n!� wl I f reoel�re n s id a rs tlorr for eP y
of VW ��� �l�W that ��I qu�lklied spp r ,
ti khvA regard to r`a , Ic,r, rel I pion, x, or nadonal OKIG I n,The corAracw `
[I send to each labor union or rapresentatfye of workers with whIoh
it/Wsho has a bargaining a greernont or ether contract or u nderstan d fn g h0 contractor's
pry, aW gI rip the la bcr u n-ton OF WOrkers r~epre s entativaa Of
' c4 n rrri#r rrt under thlo section, and shall post oapiei of the notices In con s pl OWu s pIiaca s
avaiwt 10 a ppflca ntr and employees.
�
Ths C*Wr wlfl comply 011 all proylsions of exacuilva Order 11240 (as smanded by
11 5) and of tt rules, fog Ula n s and relevant orders of th-e Do partMortt Of LAW
bu b part s co n tractors` Ag rse manta
Sac, 202 r ExMpt in ova% oxarn d In a=dance with Gection 204 -of th I a War, a I l Gleye rn meat
rrir3cofg sger�OW$ sholl irdude In every Govamrnent contratt h e re I n afte r e rate(ed Into the follOwl M 9
Pr ,WM:
-Du&vjrwp&forMsnoe Of this contrwL the contractor sgroas at ibllows:"
t
11) The coj*&cw of rta d1oilminato against any employee or a p p I Ir a rat for employment
�L4@ of r p cola , r0glonj "Xj or nipl!Jonoll Crlolnl The contreoter will take Mrnallao
*con to onsura that s ppfaco nli are employed, and lh o t a rnpl byaos are tro ated a p u s I ry
dung ompWnwrtk w4houl regard 0 LhoJr rant color} rallglen# tag or netlonal odgim Ruch
wom wo mduds, W inot be IlrMl-od to MO folf m; employrnwent,. upgredlnq, donioklen, or
IfInifor, level nt cf (scrultment advarUs.1- g; layoff or tefrnJnaklon; rates of pay or Whar
forms of compensalion, and selaclJon for Ira InIn g p including a ppre nticeshlp, The 0 Q nlraolat
iviro.s to post In omIplouauf pie 1, a+va l l able to or n p Ioyaes and b pelican to for
omp0ymM, rotkss to W pf ovIded by 1ho ountfsotlnU oMosr IaI[In g forth U19 provIi1cni of 11,11.11
�ioJm�n�t�n Gl'e�rs#r� -
") TJ'w wdiaw WIl, J;n all joilIcMIa ll'uns or odysillesments for ornployoao plaood by or on
httf c4 Ov WnlimwVt #fix# that oll quoU led appikonli wJJ1 roc&10 conoldvrallon fbr
offlAoymoni WlthM regard to to , collof, rellpIon, @sx at notional orhgIn,u
erWA 14*i Paul a 6 1'UM10Moks Quote
"() The cmtractor will send to each labor urn I on or representative of workers with which
t t I hefshe has a cc ifective ba rg ai n i ng a g nee me n t or uth er oontraat of and erstand i ng, a notice,
to be provided by the agency contracting officer, a dvl si ng the labor u nlQn o r workers!
representative of the ntra a ds ccrnm itm eras under Section 202 of Executive Order No,
11246 of September 24, 1965, and shall post oapies of the notice In conspicuous places
avai ra We to employees a nd a pp] Icants fo r e m ploy me nt"
"(4) Th e co ntra ctor will corn p I y W th as I provisions of Exe c u five Order N o. 11246 of a pternber
4, 1965, a nd of the rules and reg utations, a nd re I eva nt o rd ers of the 6 ecneta ry of Last r+"
"( 5) The contractor Wit fum i s h a I l ilnforrnat on and rem required by E xecubve Order No.
11246 of Septe mber 24, 1955. a n d by the pules, reg ul anon s, and ord ers of th a Secreta ry
of Labor, or pursuant thereto, and vAJ I permit amass to his books, tecc rds, and a u nts by
the 0ontracting agency and the Secretary of Labor for purposes of investigation to ascertain
compliance Zvi th such ru les, reg relations, an d crd ers."
"(6) In the event of the oen tractors noncompliance with the nondiscrimination clauses Of
this contract or with any of such rules, regulatlons, or orders, in this contract may be
canoelled, terminated or suspended in whole or in part and the contractor may be declared
ineligible for further Govemnnent contracts in accordance W#h prcczdures authorized in
ecu ti ve Order No, 11246 of September 24, 1966, and such tither sanct tins may be
imposed and remedies invoked* as provided ire Executive Order No 11246 of September
4, 196 5, or by rul e4 reg u lab ons, or ord er of the Secrets ry of Labor, or a s oth erwise provid e d
by I.41
"(7) Th a contractor wi I I incl ude the porn on of the sente nce i rn med iiatelly precod ing parag r aph
(1) and the provisions of paragraphs (1) through (7) in every sut ontract or purchase
order unless exempted by rules, regulations, or orders of the Secretary of Labor [ssuad
pursuant to won 204 of Executive Order 11246 of September 24, 1965, so that such
provisions will be t0ding upon each subcontractor or vendor. The contractor will to k-e such
action with respect to any su bcontiract or purchase order as th a adm in isten ng agency may
direct as a means of enfbrciing such provisions including sanctions for noncompliance:
Provided, however, that in the event a contractor becomes involved in, or is threatened
Wth, ling ati o n with a subcontraMr or vendor as a result of such direction the
ad m Carl ster i dig a gency the contractor ma y request the U n Ited States to enter i nto s uch litigation
to pi of t the interests of the U nited States,"
Th e a pp] icant fu rther ag roes that it wi I I be be u nd by the a bove eq ual op portu nity cla use with
respect to its mn employment practices when it parti of pates in federally assisted
construc-Con work- Provided, that if the appl kca nt so participating is a State or local
-government; the above equal opportunity clause is not applicable to any agency,
instrumentality or subd ivi s ion of such g ovem rnent which does not participate in work on or
under the oontract,
The applicant agrees th iat It will assist and cooperate actively with the administering
agency and the Secretary of Labor In obtaining the Compliance of contractors and:
subwntractors with the equal opportunity clause and the rules, regulations, and relevant
orders of the Secretary of Labor, that it wi I l fu mish the adm i nisteiri ng agency and the
Secretary of Labor such information as they may require for the supervision cf such
m p I is nce, and that it w ii i other i se assist the admin iste r•i ng ag ency in the d is harp a of the
ag ency"s p rimary res po ns ibil ity for seou d ng com pl i a nee.
The applicant further agrees that it will refrain from entering into any contract or contract
modification subject to Executive Order 11246 of September 24, 1965, with a contractor
debarred m, or who has not demonstrated eligibility for, Government contracts and
federally assistiM construction contracts pursuant to the Executive Order and will carry out
such sanclJons. and penalties for victabon of the equal opportunity clause as may be
imposed upon contractors and subcontractors by the administering agency or the Secretary
of Labor pursuant to Part 11, Subpart D of the Executive Order, In addition, the appricant
a-grees that if it fails or refuses to comply ► ith these undertakings, the administering aganr
Version M02-2 Page - 9 Pub Iis Works Quote
May take any or all of the roll owl ng a0on!s, Cancel' terminate, or suspend In whole or In
part this Grant (OontraoL loan, insurance, gusronte a); refrain from extending any tort e r
aSS stance to the applicant under the program with respect to wh[ch the failure or refund
Occunped until satlsfactory assurance of future compliance has been received from such
app [i =rit; and re re r th a ca s e to the Depai trne nt of JusUce for a p propriate 1 ega I proceed inks.
* Coated fo ad "invokedf In the original fex f Miq wordwonvolvedw was plated In en -or,
. � 7
VersiDn 2114= Page - 10 Pub I iu Works Quote
MINORM AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
The City Of South Bend Indiana has shown Its Comrrwitrngnt to eddrassing Minority and Women"s Business
Enterprise CM E-) partIclpation In pubilc contracting through the adopOiDn of fe City of South Bend Ordinance
o. 1 g.3-1 g. Pemcns, partnerships, corporatlons, asscolatro ns, cr;ol nt ventures awarded a oontraCt by the City
Of Booth D cnd thr ovg h Its agencies, boards, or eommIsslonS sha I I r 10 t discd minate eg a I n 5t any employee or
applicant far employment In the perftmance of a CRY contract W th respect to h fre, tenure, to rrn s, card i tl'o ns, or
privi teges of employments or an y matter directly or i nd l re ctly ref ated to ern pioyme nt becau se of ra ce, sex, felig ion,
Color., n atic nel Origin, ancestry, age or disability that does not affect that pe rson's a bi I I ty to pe r forr n work.
Min" and VAr'orrrerV Business Ente rises (MVBEs) are described In the o rdin a naa, A list of M Fs (both
Certified and non -Certified) can be found on the l ndia n;a I)e par trnent of Administration we bsite{
h", fM , 11n42Yk0 - Dacurnen kati on sha I I be prov[ded Frith the bid #hit states the MWBE s tha t wi 11 be can traded,
the dollar amount of the work that will be performed by the M WEj Es on the project and the pementage of the dollar
amount as it relates to the total bid amount by us-irrg Fer-n ME,1.0, M EE Utilization Plan.
The City., ifs agencies, boards, orcomm issions requires the Contrgotges good faint efforts to obtain participation bey
those ntractors classified as M Es,
Bidders shall demonstrate good faith efforts to have active participation from MWBEs on this Projed and supply
writmini documentaton evIdencin g surh efforts by usi ng Farm M VVB E-2 _ g, EvIdenim of Good Faith Efforts a rid Form
VWBE- .1, NIM Es Contacted, 8 uch documentafion shall i lude, but is neat iirnited to, the following items:
a, A listing of all MWBES oontacted including: (1) the name and address of the MWBE,, () the date of contact:;
(3) the type of contact (i.e.. phone ca ii, mnitten sorrcitation, et-G.); (4) the nature or hypo services or goods
mquested,, and (5) the result of the owtact
b. Mtten evidence of outreach and copies of email exchanges inviting and receiving bids, uotes or other
responses from M W13 Es or other documentation of effort to enoou rage and secu re cc r npetiUve fftpons es
Bryn MWSE and low I businesses to be included in the benefits of building this I ra ject , ,
C. Kitten documentation of letters of introduction, invitations to forging majority1mi nOty stmteg is alliances
far~ rapacity buildi ng, including but not I i rn ited to, rn e n torin g, extension s of assistant ce on payroll. i nsu ranee,
bonding, Mice of credit. technical skills or business skills_ - f
A.II bidders are actively encouraged to reach out to the MVVBEs in SL Joseph County}, Indiana, other local Indiana
untes, and Berrien County, Michigan to u [ze a goad fal th effort to fb r ge constructive and lasting business
partner5hips.
NoWxh stand i rig th a foregoing, the a s rd and performance of all City con tracts shal I writ ply with applicable federal,
stater and 110ca I laws.
The City reserve s th a ri ght to req ue st verification of g oc I irnpl ementation th roughout the cou rse of the proj ect.
Vemion 2JI412022 Page -11 P LjblfC Works QtMa
t r scfiv+ ' rr�`r cfar ��o f r c i �' I.Orly cphes&je Sao bdow, it shall anach an explarraflon to this Af ulavk
eirCONTRA TO W S NO N-COLLWON AND NON -DEBARMENT AFF1 DAVIT,
CERTIFICATION REG ARD INC,I.N STMENT III FRAN7 EM PL OYMENT ELI G 1131 LIT
ERI FICATION., NOK-DI sc R1 m I NATION OXM I T .ENT AND CERTIFI AT'I0 N OF US E
F UNITEDSTATE- TELL PRODUCTS OR FOUNDRY PRODUCTS
s .
ihd ids. Please type or print)
(Must be completed f�r,�l � . _
i 1
i It �r a
STATE OF
+... . _
i
i _ •
The undersign Contractor, being daty sworn u a hi fits oath, aff" sunder the p alties f pc that:
If • Contractor has nod' nor has any other member,' represet�tativ�� a er�t �f the irrrt}
company, corporation or partnership represented by him, entered into any combination, collusion
or agreement with any person relative to the price to bid b anyone at such letting nor to prevent
any person from bidding nor to induce anyone refrain from bidding, and that this bid is trade
Without reference to any other bid and without any agreement, understanding or ccmb[nation with
any other person in reference to such bidding, Contractor finer says that no person or persons,
firs or oorporati on' has, have'or will t eive directly or i ndirecdy, any rebate, fee, gift,
f such Safe and . w � ", . . .s r �, *.
x
. n r thing of value on ac c out `�'� y . .. ' '
�orruruss�o o �
. Contractor eertsies by submission of this proposal that neither contractor nor any of its
principals are presently deb d,• suspended.,' proposed for debarmen� declared ineligible, or
voluntarily excluded from participation in this tmnsa tion by any Federal d partrrient or agency;
and '
3.: Contractor has nod nor has any successor to, nor an affiliate of, Connetor, engaged in investment
-activities in Irm.
a, FDr P arpoyes of this Certification, ;Iran'' means the govenunent of Iran and any agency or
iagri.wne##nttaIivy of tank or as otherwise defrmed at Ind. Code § 5- 2-I 6.5-5, as amended from
• �Lrrl4-��`�7.r. y
b, As provided by Ind. Code 5--I6f5-8, as amendcd from tame -to -time. a Contractor is
engaged irk investment activiti in liran if either: .
i. ontractar` successor or its afl'�1 i ate} pro�r ides foods or sear ices of twe nth million
do] lags ( 2 D, 000.00 0) or more in value in the energy wcwr of I ; or
ii. Contractor, its successor or its affiliate, is a financial institution that extends tymaty
mill ion dollars ($20,000,000) or more in crcdit to another person for fort,} -five (45)
days or more, if that person will (i) use the credit to provides goads and ser-vices in
the energy sector in frar- and 00 at the time the #inancW 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
array employee or contract with a person that the Contractor subsequently tears is an unauthodzed
VeMbn 2114r2O22 Page - 12 PubHc Works Qualn
alien. 0ontractor agrees that he/she/it shall enroll in and vedfy the work eligibility statm of all of
enttactor's newly hired employees through the E-VeflfProgram as defined by I.C. 2- -1.7- .
O ractor's dortunentation of enrollment and parti-cipation in the B- crify Peon is included
and attached as Part of Us bid/quote; and
5• contractor sha 1 regulxe his/her/itssubcontra rs performing work under this public
on of to Cerdf that the sukonttacters do not knowingly employ or contract with an
unauthorized alien, nor retain any employee or contract with a peen that the suboontractor
subsequendy le�ms 2s an unauthorized amen and that the subcontt'acWr has enrolled in and is
r
} Participating - the E-Verify Program. 'die Contractor, agrees, to Maintain this certification
n111youghout the term cf the oonl t Frith the city of South Bend, and and t ds that the City
may ter Wtta#e the Contract for defaWt if the Contractor fans to cure a breach of Us provision no
... later that Wrty 30) days after behig notified by the City. '
. Persons, partnerships, corporations, as sociations, or joint venturers awarded a contract by
the City of South Bend throughits agericie�k boards, or ca�t�issions shall not discriminate against
any employee or appl icarit for empleyment in the performance of a pity contract with respectto
tenure, terms} conditions, or privileges of employB]e�#; or any matter directly or indirectly
_ related to employment because of race, sex, religion, color, natiOnn] origin, ancestry, age, gender
e press; r gender identity, sexual orientation or disabiliry that does not affect fiat persan's ability
10 perform the work. -
y
Jn awarding Contracts for the pumhaqe of work, labor, smkgs, supplies, equipmen4 materials, or
any combination of the foregoing including, but not li mitid to, public works contras awarded
render public bidding laws or other contracts in which public bids are net required by law, the City,
its agencies, boards or comnussiom may consider the Contractor's good faith eff'oTts to obtain
participation by those Contractors certified by the Sate of Indi r a as a Minority Business
("MBE") or as a Women's Business Enterprise C WBF')'as a factor in +�g the lowest
responsible, responsive bidder.
In no event s1 1 pemns or entities seeking the award of a City centmt be required to award a
subco ntraot to an BF fBE; however, it may not wd awfully di scrim.; rage against said
BFRI B. A finding of a discriminatory practice by the City s MB E/WB E Utilization Board
steal l proNbit that person or ent ity from being awarded a C i ry contract for a period of one (1) year
from the date of such determination, and such deterztinatien may also be grounds for terniinating
the contact for wl�ch the discriminatory practice ornoncompltanee pertains.
. ' le undersigned contractor agrees that the foIIowU1g nondiscrimination ccmn , t lent shall
be rnade a part of any contract which it may henceforth enter into with the City of South Bend,
;hdiara or any of its agencies, boards or commissions.
onLrmctor agrees riot to discrtriunate against orintmiidate any employee or applicant for
empjoymerit in the performance of this contract with prtviieges of employment, or MY matter
directly or indirectly related to employment, because of ,race religion, color, sex, gender
expression, gender identity, sexual orientation, handicap, ]rational cngin or ancestry, Bread, of
tHs provision may be regarded as mated al breach of contract.
I* the undersigned bidder or agent as contractor on a public works project, understand my statutory
oblf gatf ()D5 to the use of steel products or foundry products made in the United States (I- C, 5_ 16-
8- l ). I hereby certify that I and all subcontractors employed by me for this projectill use steel
l r,i,n 14 02_2 Pa - 13 PWbhQ Works Quote
products or foundry products made in the United States oa this prof-cct if a ardtd. I understand I
have an &fFirm a five duty to no if the Cityin ray bid that my proposal does not inc Wdc the use of
steed produce or foundry products made in the United State. I undcrstand it is my sale obligation
and re sponsi W iity to pro vide a j usti f icnti on to th a Ci t , "b j cd to revicw and approv al, why the
cost of United States made steel or foundry produce is unreasonable, Prior to award and upon
suhmisstoa 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 nuke a dr-tcrmioation if the Fuca of UniW
States made steel or foundry is u=easonable. I understood that vtalattons helruadff ray result in
forfeit= of contractual pa can.
I b=by affirm under the penalties of p cjury that the facts and infom4on COntained in the fosegoiDg bid fog public
works tnie and cc act.
Dated t i day of 20 )
O'ea Par
ntrA ctc 6B i dd (Firm)
inturc of Contactor[Bidder or Ets Agtml
Oe
Wr O' ?-- f & —
0 W11 �Ler
Printed Namt and Title
-t-
Sub s cr: b ed are d swom to befo c m c this Y of 2 O
11/(/4�/
'IY a -�Sioo Eypires
untie0fMAcacc
S
kYAN P.UY
Nolary lm-- - Si a.1 u d h6-ara
SL
i-On Ex piFps APN 9. 2 �24
Z.
i` 4
e
CITY OF SOUTH 13Dle
PROJECT NAME 2023 MicrosurfachO
PROJECT NO. 123-023
j1 3 t 9: o0a m Local Tim a. NOW W t* b*
MOTES DUE submittad electronleal-9 tO � � ''�_��: � f *. � r �� �1 �-�•�
Id Quote
Item
0. ntity Unit unit Prito Total Amount
ASPHALT MICROSURFACING 16,840 SYD
Firn AdC��--�v5�ora�io iee LLC.
Ad -dress:
Telephone urn lr `�
Fax Numt%--'-. 1A-
I
Jt��c .
(PrknLed Nam* -DO P-wr:�,on 5-9nInga
V.;, ,hrjr, 7}i Ai- � 22 Page - 15 Plot hC Wurk s Ounjoi
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAID
FORM M BE-1,0
MWBE UTILIZATION PLAN
This completed form should be suppiled with Bids that pertain to City iDf South 13end Public Works Projects Invoiving MVVBB parb6pation. It
Is the bidder's sole reepor' sibl11 1t to verity whether any listed minorlty or woman business meets the MWBE qualifications.
Projeo1 Number- 123-023
Proleo'l Name-, 2023 Microsurfacing --
Bidder. Total Bid Amount; MWBE Goa]' NA
Page of
Name & Addrel5 of ~E
P r ms ry Co�nr&ck P*rwn
(N■rn4dTe leoone)
S ■ oll Work to bo IN rformad
(AUch l .@ d ule if you no ed iddil ion-0 E ikpaob)
M mar A mourg of WWSE
i+gym pang ni
P r
a t To1a
S, d� pry -�a I
Slopialure
Date
Verslan V14 022
Page - 16
Public Works Qljote
CITY OF SOUTH BEND
MINORITY
AND WOMEN BUSINESS ENTERPRISE INCLUSION USION PROGRAM PLAN
FORM MB -. 0
EVIDENCE OF GOOD FAITH EFFORTS end Public
Th IsPl et" fob should I ncl ud od gs part crf the Bids d oc�i ren 1 f lit # I $
Wen
d
projo I m'W rtn Q Good Fel th Eftrts to ob#sl rt AMBS peril I~ 1patierl.
Pmjed Numbs, 121-0
Pqect Name- 2 23 Nlleremurfocln
Bidder;2E
Contact Person.
Address= -P, n L4 5FL
City .
AP_
T6ephI — r7 Il!.— IkM6
AMP
Email: 191.
L nt,
f
TO determine nth u a bidder h a Is demonstrated good faith efforts 10 reach tho M BE ubku lion goals set fir 6)
th" City of South Befnd Public Works project.SpadtcaIlIjons, the City and its age, boards, or conirvrUSUMS.
R CQUIR E ALL of [he Im i n 9 Good Fa ilh E ffods as fi sled in th a to b!e beio .
INITLkLS I EMDENCE OF GOOD FAITH EFFORTS
MWSE UST(S). the bidder reviewed 1) tho City of SotM Send's Minorrtr and VVorreft
Eriterpri!IIII.@ Inclusion Program Blaa; the list of oeified MEs prarided by the City-, and 3)1* Indi
Ve`part"nt of AdministratiDrr list of M i ncr ity and VVarnen CNvned Businesses (booth oNtfired aM nor
Oertrfi found a httD-fAyww in.acvridoal,
GOO D FA TH EFFORTS TO 0 BTAJ N MWI PARTICI PATION
The udder shall initial each item below, as evderlI of ft gad fI effoft to obtain MME
partidp,ati n in the awarded oantraut.
I affirm thel I reviewed the CIty of SOM Bend's IVlfnorrt}+ and VVwmn Buskness Enter se
Inclusion Prograrn Plan and the Indiana Departs "I of Adminis"Uon's certified list of
Indiana Miniarity and Mmen Eusiness Enter-pnises. found an Uh-eir websrte
f h ttv lfw~�w. i n . oo�r#rdoa3 .
I afflrm that I have made good faith efIC05 to select portions of the contract work to be
performed by MWI including. where approprtato. breaking Out contract worm biers info
economically feasible units to faciritate MIKE parti6pation.
I sf l rm thai I have made gao,d fei th efforts to s01 icrt th rough e U reasonable and ave i lable
urea ris the inle rest of all A� W9 E s in the mopes of worm of th, a contreot.
I afflrm thad f stud erl pre -bid meetir wed ule-d by the C ity of South B e n d tD inform
M Es of cwVacflng and subcontracting 0pportuntCies-
I affirm that I advertised In general circulation ancYor trade assc6ation pubii�tions
oonawrn i ng subcontract opportunitie s an I e llawed MWI reasonable lim a to re spond to
such adverti se rnenls,
I sftlrrn that I performed any and an n essary sleps to provide writlen notices in o mannor
reasonably cal cul al ed 10 inf arrn MVI cf suboon tracti ng o p po.-#u n lti es and allowed
suffrciord lime for MVVI3Es to participaleeffedively-
1 jtfflrm thal I followed up cm inilial solid atkns with intorest$d MVI
I affirm that I negoliallad with Interested MMEs In good iarih. Eneluding praviding such
MWB Es with ad eq uel s Inf orrnation a Idol th a plans. spec fioa ions s rid other requirerne I
of the subconlract.
I affirm that I have made good faith efforts to a� s ist inter$ �ted l� �s in -obtain' Eg
bonding, lines of cmdi 1. or insurance as required by the C or the bidder, where
spprcPnale.
Version 2J14/2022
Rag &- 17 PLtbIic Works Quote
CITY OF SOUTH BEND
lIN
CTY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
FORM MWBE-10
EVIDENCE OF GOOD FAITH EFFORT
IT I I afflrrn that I have grade rid (; i h efforts to assist interested MVVBEs in -obtaining
necessafy equipment, supplies. materwis, or related aWstar $ or serums, where
appropriate-
1 0 M ran that l d id not rejed any MA13 Es a s unq uaf ified wmumA wund business reasons
based on a thofough investigation of their capat�ilrtdies_
ONTRACT RECORDSr The bidder has maintsinFed the IN lcwrg reeds for eaCh KWE Dial -has bA
On Ul a subomtradrig op rlun*..
1. Name, address, and telephwe number;
2- A desuipiion of infoamabon prided by the biddef or subcolArador. and
I A 15tatemerrt 01 whether an ag r rnent was readied. and d ncA. why not. irdud inq any r-ea sons for
eorxl ud ing that the M Z was unqu alif �d to perform t Pb. _
*Properdemanstr2tJcn of Good Faith Efforts requires your initials mextto -MII of above toAos. Any
cmlWons shalt be ccnaldered grounds for rejmtlon of the bld by the Ord of PublIc Works. The City of
South Bend rose rves the d gbi to req uest i2 dd I U0 nal IrdorMaftn.
page = t�
er�,ur) 2}1+f t 2 li I A!s o+.4o'te
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
FORM 111E-.1
MW13E CONTACTED
Thl8 cum P lstwd form s ho ul d be suppl I ed wKh Did s that Pe rta I" W ItY Of O �� �u bJ IG oeks Pro] *eta
requ Irtng Good t~ a Ith Efforts W contact h+ WSFA. It [a the bldde rre s u is rsspo ns 1b Ia Its+ W we r#ly whathor s ny Elet
minQPity or wo Mtn business M&ete the MWBE qw-1IMfl"ttons, Attach add ltlonaI Rages 11 r$s sea .
PAGED F�-
Project Name:
Bidder
123-0,
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IVVVIBE Firm
Owner or Cn n lact at MVV13E Firm
6h
(Tale)
IVWBE Parb0pabon Goal NIA
Telephone; Fax: Email:
TYPE O F WO RK S 0 LICIT Ea FOR TH I S PROJECT;
RE:SW-TS OF CONTACT WITH THE
m BE Firm
Owner or Contad at MvV3E F i
Telephone:
Fax.
FIRM.
TYPE OF ARK 0LCGITED I" ' THIS PROJECT.
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