Loading...
HomeMy WebLinkAboutAward Bid - 2023 Curb & Sidewalk Program Proj No. 123-001 - Premium Concrete Services1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAx 574/235-9171 CITY OF SOUTH BEND TAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS August 22, 2023 Mr. Max Yeakey Premium Concrete Services, Inc. 712 Richmond St. Elkhart, IN 46516 rbeckergpremiumconcreteonline. com RE: Award Bid — 2023 Curb and Sidewalk Program - Project No. 123-001 Dear Mr. Yeakey: At its August 22, 2023 meeting, the Board of Public Works awarded the above referenced bid to you in the amount of Division A $64,949; Division B $335,583; Division C $246,378; Division D $157,478; Division E $169,030. Enclosed please find a signed Bid/Proposal form. Please forward the following documents in one submittal by September 12, 2023 to my attention for Board of Public Works approval at lhensley(ksouthbendin.gov: 1) One (1) signed original of the Public Works Contract (enclosed) 2) Labor & Material Payment Bond 3) Performance Bond (125% of Bid Amount) 4) Certificate of Insurance naming the City of South Bend as an additional insured 5) Item #4 for all subcontractors that you use. If you have any further questions, please call this office at (574) 235-9251. Sincerely, /s/ Theresa Heffner Theresa Heffner, Clerk Enclosures TH/lh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT ALEXANDRA DOLZ-LANE MURRAY L. MILLER 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAx 574/235-9171 CITY OF SOUTH BEND TAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS August 22, 2023 Mr. Dustin Hilary Milestone Contractors North, Inc. 24358 State Road 23 South Bend, IN 46614 akrueger&mile stonelp. com RE: Bid Award — 2023 Curb and Sidewalk Program - Project No. 123-001 Dear Mr. Hilary: At its August 22, 2023, meeting, the Board of Public Works awarded the above referenced bid to Premium Concrete Services, Inc. in the amount of Division A $64,949; Division B $335,583; Division C $246,378; Division D $157,478; Division E $169,030. Thank you for bidding, and we hope you bid with us in the future. If you have any further questions, please call this office at (574) 235-9251. Sincerely, /s/ Theresa Hefner Theresa Heffner, Clerk Enclosures TH/lh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT ALEXANDRA DOLZ-LANE MURRAY L. MILLER 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAx 574/235-9171 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS August 22, 2023 Mr. Justin Butler Selge Construction Co., Inc. 2833 South I ITH St. Niles, MI 49120 aswinehart&selgeconstruction. com RE: Bid Award — 2023 Curb and Sidewalk Program - Project No. 123-001 Dear Mr. Butler: At its August 22, 2023, meeting, the Board of Public Works awarded the above referenced bid to Premium Concrete Services, Inc. in the amount of Division A $64,949; Division B $335,583; Division C $246,378; Division D $157,478; Division E $169,030. Thank you for bidding, and we hope you bid with us in the future. If you have any further questions, please call this office at (574) 235-9251. Sincerely, /s/ Theresa Hefner Theresa Heffner, Clerk Enclosures TH/lh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT ALEXANDRA DOLZ-LANE MURRAY L. MILLER 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAx 574/235-9171 CITY OF SOUTH BEND TAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS August 22, 2023 Mr. Ruben Alvarado Rieth-Riley Construction Co., Inc. 25200 State Road 23 South Bend, IN 46614 ralvarado&rieth-riley.com; gvWgaskrieth-rile,, RE: Bid Award — 2023 Curb and Sidewalk Program - Project No. 123-001 Dear Mr. Alvarado: At its August 22, 2023, meeting, the Board of Public Works awarded the above referenced bid to Premium Concrete Services, Inc. in the amount of Division A $64,949; Division B $335,583; Division C $246,378; Division D $157,478; Division E $169,030. Thank you for bidding, and we hope you bid with us in the future. If you have any further questions, please call this office at (574) 235-9251. Sincerely, /s/ Theresa Hefner Theresa Heffner, Clerk Enclosures TH/lh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT ALEXANDRA DOLZ-LANE MURRAY L. MILLER INTER -OFFICE MEMORANDUM DEPARTMENT OF PUBLIC WORKS DIVISION OF ENGINEERING TO: Theresa Heffner, Clerk Board of Public Works FROM: Gemma Stanton SUBJECT: 2023 Curb and Sidewalk Pro 123-001 Bid Award DATE: August 14, 2023 On August 8'h, 2023, the Board of Public Works opened and read bids for the above project. The bids were priced as follows: Bidder Division A Division B Division C Division D Division E 1. Premium Concrete $64,949.00 $335,583.00 $246,378.00 $157,478.00 $169,030.00 2. Milestone Contractors $80,708.00 $363,759.00 $260,908.00 $196,380.00 $187,591.00 3. sRiley Construction tru $7g 602.86 $368,102.45 $273,320.71 $163,253.90 $190,076.35 4. Construction $99,863.90 $411,994.85 $301,145.05 $214,084.50 $204,750.65 All bidders completed the Non -Collusion Affidavit and acknowledged the addendum. Bid paperwork contained multiple scrivener's errors on page 13 (Form WBE-1.0) of Addendum 1 that was issued. However, all bidders provided MBE and WBE Utilization Plans with quotes from MBE and WBE subcontractors to satisfy the goals set forth in the project. Engineering recommends award of a contract for all divisions for a total of $973,418.00 to the lowest responsive / responsible bidder, Premium Concrete. While Premium Concrete did submit its bid using forms which reflected the incorrect goal requirements, after review by the City's legal department, it was determined that the incorrect form was provided by the City, but it did not impact Premium Concrete's representation that it will meet or exceed the required Minority and Women Business goals as stated in the addenda. The error was in the form submitted, not the substance of the bid submitted. The incorrect form was provided to all bidders and all bidders were able to meet the M & W goals for this project. The Department of Public Works has appropriated sufficient funds from the Motor Vehicle Highway (202-505-431000) and Maior Moves (412-06-600-506-431000). Please call with your questions. Enclosure Bid Tabulation BID TABULATION 2023 Curb and Sidewalk Project No: 123-001 For Bids Due: August 8th, 2023 DIVISION A BID TABULATION 2023 Street and Sewer Material Bid Project No: 123-019 For Bids Due: March 28, 2023 Engineer's Estimate Premium Concrete Services Milestone Contractors Rieth-Riley Construction Selge Construction quantltv Unit Unit Price Item Total Unit Price Item Total Unit Price Item Total Unit Price Item Total Unit Price Item Total 1 CONCRETE SIDEWALK, REMOVE 133 SY $ 14.00 $ 1,862.00 $ 52.00 $ 6,916.00 $ 55.00 $ 7,315.00 $ 46.32 $ 6,160.56 $ 90.25 2 CONCRETE SIDEWALK, 4-IN 133 SY $ 80.00 $ 10,640.00 $ 80.00 $ 10,640.00 $ 95.00 $ 12,635.00 $ 92.23 $ 12,266.59 $ 145.00 3 CONCRETE CURB, REMOVE 296 LF $ 10.00 $ 2,960.00 $ 35.00 $ 10,360.00 $ 28.00 $ 8,288.00 $ 28.82 $ 8,530.72 $ 62.15 4 CONCRETE CURB, MODIFIED 296 LF $ 56.00 $ 16,576.00 $ 68.00 $ 20,128.00 $ 98.00 $ 29,008.00 $ 88.09 $ 26,074.64 $ 93.25 5 CONCRETE APPROACH, REMOVE 14 SY $ 44.00 $ 616.00 $ 80.00 $ 1,120.00 $ 110.00 $ 1,540.00 $ 103.12 $ 1,443.68 $ 75.00 6 PCCP FOR APPROACHES, 6-IN 14 SY $ 116.00 $ 1,624.00 $ 135.00 $ 1,890.00 $ 215.00 $ 3,010.00 $ 139.91 $ 1,958.74 $ 367.00 7 CONCRETE CURB RAMP, REMOVE 21 SY $ 40.00 $ 840.00 $ 70.00 $ 1,470.00 $ 132.00 $ 2,772.00 $ 214.69 $ 4,508.49 $ 75.00 8 ONE-WAY PERPENDICULAR CURB RAMP 9 SY $ 417.00 $ 3,753.00 $ 250.00 $ 2,250.00 $ 300.00 $ 2,700.00 $ 506.91 $ 4,562.19 $ 442.00 9 PAIRED PERPENDICULAR CURB RAMP 12 SY $ 432.00 $ 5,184.00 $ 250.00 $ 3,000.00 $ 300.00 $ 3,600.00 $ 433.90 $ 5,206.80 $ 417.00 10 TOPSOIL AND SEEDING 205 SY $ 9.00 $ 1,845.00 $ 35.00 $ 7,175.00 $ 48.00 $ 9,840.00 $ 38.49 $ 7,890.45 $ 28.45 11 TREE, REMOVE, 30-IN 0 EA $ - $ - $ - $ - $ - $ - $ - $ - PLAN I, UE(:IOOOL DIVISION ATOTAL $ 12,003.25 $ 19,285.00 $ 18,396.40 $ 27,602.00 $ 1,050.00 $ 5,138.00 $ 1,575.00 $ 3,978.00 $ 5,004.00 $ 5,832.25 $ $ $ $ $ $ $ $ $ $ 45,900.00 $ 64,949.00 $ 80,708.00 $ 78,602.86 $ 99,863.90 DIVISION B Item No. Description Quantity Unit Engineer's Estimate Unit Price Rem Total Premium Concrete Services Unit Price Item Total Milestone Contractors Unit Price hem Total Rieth-Riley Construction Unit Price Item Total Selge Construction Unit Price Item Total 1 CONCRETE SIDEWALK, REMOVE 932 SY $ 14.00 $ 13,048.00 $ 50.00 $ 43,850.00 $ 42.00 $ 36,834.00 $ 41.16 $ 36,097.32 $ 52.75 $ 46,261.75 2 CONCRETE SIDEWALK, 4-IN 953 SY $ 80.00 $ 76,240.00 $ 70.00 $ 62,860.00 $ 85.00 $ 76,330.00 $ 83.98 $ 75,414.04 $ 95.25 $ 85,534.50 3 CONCRETE CURB, REMOVE 1616 LF $ 10.00 $ 16,160.00 $ 25.00 $ 40,400.00 $ 21.00 $ 33,936.00 $ 21.87 $ 35,341.92 $ 45.05 $ 72,800.80 4 CONCRETE CURB, MODIFIED 1616 LF $ 56.00 $ 90,496.00 $ 62.00 $ 100,192.00 $ 72.00 $ 116,352.00 $ 64.25 $ 103,828.00 $ 80.65 $ 130,330.40 5 CONCRETE APPROACH, REMOVE 83 SY $ 44.00 $ 3,652.00 $ 100.00 $ 7,500.00 $ 100.00 $ 7,500.00 $ 96.25 $ 7,218.75 $ 49.00 $ 3,675.00 6 BRICK APPROACH, REMOVE 13 SY $ 43.00 $ 559.00 $ 100.00 $ 1,300.00 $ 100.00 $ 1,300.00 $ 486.51 $ 6,324.63 $ 49.00 $ 637.00 7 ASPHALT APPROACH, REMOVE 21 SY $ 40.00 $ B40.00 $ 100.00 $ 2,100.00 $ 100.00 $ 2,100.00 $ 134.50 $ 2,824.50 $ 30.00 $ 630.00 8 PCCP FOR APPROACHES, 6-IN 103 SY $ 116.00 $ 11,948.00 $ 105.00 $ 9,240.00 $ 160.00 $ 14,080.00 $ 102.36 $ 9,007.68 $ 182.25 $ 16,038.00 9 CONCRETE CURB RAMP, REMOVE 21 SY $ 40.00 $ B40.00 $ 100.00 $ 2,100.00 $ 140.00 $ 2,940.00 $ 229.62 $ 4,822.02 $ 49.00 $ 1,029.00 10 ONE-WAY PERPENDICULAR CURB RAMP 21 SY $ 417.00 $ 8,757.00 $ 245.00 $ 5,145.00 $ 365.00 $ 7,665.00 $ 528.77 $ 11,104.17 $ 247.00 $ 5,187.00 11 TOPSOIL AND SEEDING 1028 SY $ 9.00 $ 9,252.00 $ 32.00 $ 32,896.00 $ 39.00 $ 40,092.00 $ 31.93 $ 32,824.04 $ 23.80 $ 24,466.40 12 TREE, REMOVE, 10-IN 2 EA $ 1,250.00 $ 2,500.00 $ 900.00 1 $ 1,800.00 $ 700.00 $ 1,400.00 $ 2,112.82 $ 4,225.64 $ 725.00 $ 1,450.00 13 TREE, REMOVE, 18-IN 6 EA $ 1,800.00 $ 12,600.00 $ 1,200.00 1 $ 7,200.00 $ 1,000.00 $ 6,000.00 $ 2,912.82 $ 17,476.92 $ 1,050.00 $ 6,300.00 14 TREE, REMOVE, 48-IN 1 EA $ 4,500.00 $ 4,500.00 $ 1,800.00 $ 1,800.00 $ 1,400.00 $ 1,400.00 $ 6,312.82 $ 6,312.82 $ 1,475.00 $ 1,475.00 15 STUMP, REMOVE 2 EA $ 450.00 $ 900.00 $ 500.00 $ 1,000.00 $ 400.00 $ 800.00 $ 125.00 $ 250.00 $ 575.00 $ 1,150.00 16 PLANT, DECIDUOUS TREE, SINGLE STEM. 2-IN TO 2.5-IN 18 EA $ 515.00 $ 10,300.00 $ 900.00 $ 16,200.00 $ 835.00 $ 15,030.00 $ 835.00 $ 15,030.00 $ 835.00 $ 15,030.00 VIVI51014 b 1UTAL 5 zez,ase.uu 5 33o'buJ.UU b 4E4,/0uxt; b sen,11u2.40 b 411,ee4.50 DIVISION C Item No. Description Quantity Unit Engineer's Estimate Unit Price Rem Total Premium Concrete Services Unit Price Item Total Milestone Contractors Unit Price Rem Total Rieth-Riley Construction Unit Price Item Total Beige Construction Unit Price Item Total 1 CONCRETE SIDEWALK, REMOVE 551 SYS $ 14.00 $ 7,714.00 $ 50.00 $ 27,550.00 $ 43.00 $ 23,693.00 $ 42.32 $ 23,318.32 $ 78.75 $ 43,391.25 2 CONCRETE SIDEWALK, 4-IN 551 SYS $ 80.00 $ 44,080.00 $ 70.00 $ 38,570.00 $ 88.00 $ 48,488.00 $ 72.51 $ 39,953.01 $ 106.75 $ 58,819.25 3 CONCRETE CURB, REMOVE 1355 LFT $ 10.00 $ 13,550.00 $ 26.00 $ 35,230.00 $ 19.00 $ 25,745.00 $ 23.18 $ 31,408.90 $ 46.25 $ 62,668.75 4 CONCRETE CURB, MODIFIED 1355 LFT $ 56.00 $ 75,880.00 $ 60.00 $ 81,300.00 $ 64.00 $ 86,720.00 $ 70.25 $ 95,188.75 $ 57.60 $ 78,048.00 5 CONCRETE APPROACH, REMOVE 38 SYS $ 44.00 $ 1,672.00 $ 100.00 $ 3,800.00 $ 125.00 $ 4,750.00 $ 113.98 $ 4,331.24 $ 71.25 $ 2,707.50 6 GRAVEL APPROACH, REMOVE 44 SYS $ 43.00 $ 1,892.00 $ 100.00 $ 4,400.00 $ 125.00 $ 5,500.00 $ 131.25 $ 5,775.00 $ 20.00 $ 880.00 7 PCCP FOR APPROACHES, 6-IN 62 SYS $ 116.00 $ 7,192.00 $ 110.00 $ 6,820.00 $ 200.00 $ 12,400.00 $ 116.00 $ 7,192.00 $ 181.00 $ 11,222.00 8 CONCRETE CURB RAMP, REMOVE 6 SYS $ 40.00 $ 240.00 $ 100.00 $ 600.00 $ 250.00 $ 1,500.00 $ 253.95 $ 1,523.70 $ 71.25 $ 427.50 9 PAIRED PERPENDICULAR CURB RAMP 6 SYS $ 432.00 $ 2,592.00 $ 250.00 $ 1,500.00 $ 365.00 $ 2,190.00 $ 1,442.95 $ 8,657.70 $ 317.00 $ 1,902.00 Page 1 of 2 BID TABULATION 2023 Street and Sewer Material Bid Project No: 123-019 For Bids Due: March 28, 2023 10 TOPSOIL AND SEEDING 769 SYS $ 9.00 $ 6,921.00 $ 32.00 $ 24,608.00 $ 38.00 $ 29,222.00 $ 20.93 $ 16,095.17 $ 25.20 $ 19,378.80 11 TREE, REMOVE, 30-IN 6 EA $ 3,350.00 $ 20,100.00 $ 1,500.00 $ 9,000.00 $ 1,400.00 $ 8,400.00 $ 4,612.82 $ 27,676.92 $ 1,475.00 $ 8,850.00 12 STUMP, REMOVE 2 EA $ 450.00 $ 900.00 $ 500.00 $ 1,000.00 $ 300.00 $ 600.00 $ 250.00 $ 500.00 $ 575.00 $ 1,150.00 13 PLANT, DECIDUOUS TREE, SINGLE STEM. 2-IN TO 2.5-IN 12 EA $ 515.00 $ 6,180.00 $ 1,000.00 $ 12,000.00 $ 975.00 $ 11,700.00 $ 975.00 $ 11,700.00 $ 975.00 $ 11,700.00 DIVISION CTOTAL $ 188,913.00 $ 246,378.00 $ 260,903.00 $ 273,320.71 $ 301,145.05 Engineer's Estimate Premium Concrete Services Milestone Contractors Rieth-Riley Construction Selge Construction DIVISION D 1 CONCRETE SIDEWALK, REMOVE 482 SYS $ 14.00 $ 6,748.00 $ 45.00 $ 21,690.00 $ 62.00 $ 29,8B4.00 $ 38.24 $ 18,431.68 $ 83.50 $ 40,247.00 2 CONCRETE SIDEWALK, 4-IN 480 SYS $ 80.00 $ 38,400.00 $ 75.00 $ 36,000.00 $ 95.00 $ 45,600.00 $ 79.44 $ 38,131.20 $ 99.65 $ 47,832.00 3 CONCRETE CURB, REMOVE 639 LIFT $ 10.00 $ 6,390.00 $ 25.00 $ 15,975.00 $ 24.00 $ 15,336.00 $ 31.11 $ 19,879.29 $ 65.35 $ 41,758.65 4 CONCRETE CURB, MODIFIED 639 LIFT $ 56.00 $ 35,7B4.00 $ 63.00 $ 40,257.00 $ 80.00 $ 51,120.00 $ 50.46 $ 32,243.94 $ 65.25 $ 41,694.75 5 CONCRETE APPROACH, REMOVE 45 SYS $ 44.00 $ 1,980.00 $ 80.00 $ 3,600.00 $ 100.00 $ 4,500.00 $ 96.25 $ 4,331.25 $ 76.00 $ 3,420.00 6 PCCP FOR APPROACHES, 6-IN 34 SYS $ 116.00 $ 3,944.00 $ 100.00 $ 3,400.00 $ 220.00 $ 7,480.00 $ 106.83 $ 3,632.22 $ 197.00 $ 6,698.00 7 TOPSOIL AND SEEDING 558 SYS $ 9.00 $ 5,022.00 $ 32.00 $ 17,856.00 $ 45.00 $ 25,110.00 $ 30.09 $ 16,790.22 $ 26.45 $ 14,759.10 S ITREE, REMOVE, 18-IN 2 EA $ 1,800.00 $ 3,600.00 $ 1,300.00 $ 2,600.00 $ 1,200.00 $ 2,400.00 $ 2,912.82 $ 5,825.64 $ 1,250.00 $ 2,500.00 9 1 TREE, REMOVE, 30-IN 3 EA $ 3,350.00 $ 10,050.00 $ 1,700.00 1 $ 5,100.001 $ 1,600.00 1 $ 4,800.00 1 $ 4,612.82 1 $ 13,838.461 $ 1,675.00 1 $ 5,025.00 10 IPLANT, DECIDUOUS TREE, SINGLE STEM. 2-IN TO 2.5-IN 10 EA $ 515.00 $ 5,150.00 $ 1,100.00 1 $ 11,000.001 $ 1,015.00 1 $ 10,150.00 1 $ 1,015.00 1 $ 10,150.001 $ 1,015.00 1 $ 10,150.00 DIVISION D TOTAL $ 117,068.00 $ 157,478.00 $ 196,380.00 $ 163,253.90 $ 214,084.50 DIVISION E Item No. Description Quantity Unit Engineer's Estimate Unit Price Rem Total Premium Concrete Services Unit Price Item Total Milestone Contractors Unit Price Item Total Rieth-Riley Construction Unit Price Item Total Selge Construction Unit Price Item Total 1 CONCRETE SIDEWALK, REMOVE 394 SYS $ 14.00 $ 5,516.00 $ 45.00 $ 17,730.00 $ 50.00 $ 19,700.00 $ 40.86 $ 16,098.84 $ 79.00 $ 31,126.00 2 CONCRETE SIDEWALK, 4-IN 394 SYS $ 80.00 $ 31,520.00 $ 75.00 $ 29,550.00 $ 85.00 $ 33,490.00 $ 92.48 $ 36,437.12 $ 85.00 $ 33,490.00 3 CONCRETE CURB, REMOVE 728 LIFT $ 10.00 $ 7,280.00 $ 15.00 $ 10,935.00 $ 23.00 $ 16,767.00 $ 23.80 $ 17,350.20 $ 61.10 $ 44,541.90 4 CONCRETE CURB, MODIFIED 728 LIFT $ 56.00 $ 40,768.00 $ 75.00 $ 54,675.00 $ 76.00 $ 55,404.00 $ 66.74 $ 48,653.46 $ 57.00 $ 41,553.00 5 CONCRETE APPROACH, REMOVE 64 SYS $ 44.00 $ 2,816.00 $ 115.00 $ 7,245.00 $ 110.00 $ 6,930.00 $ 91.66 $ 5,774.58 $ 71.50 $ 4,504.50 6 PCCP FOR APPROACHES, 6-IN 64 SYS $ 116.00 $ 7,424.00 $ 115.00 $ 7,245.00 $ 175.00 $ 11,025.00 $ 96.99 $ 6,110.37 $ 202.00 $ 12,726.00 7 CONCRETE CURB RAMP, REMOVE 23 SYS $ 40.00 $ 920.00 $ 100.00 $ 2,300.00 $ 135.00 $ 3,105.00 $ 182.62 $ 4,200.26 $ 71.50 $ 1,644.50 8 ONE-WAY PERPENDICULAR CURB RAMP 12 SYS $ 417.00 $ 5,004.00 $ 250.00 $ 3,000.00 $ 365.00 $ 4,380.00 $ 660.93 $ 7,931.16 $ 257.00 $ 3,084.00 9 PAIRED PERPENDICULAR CURB RAMP 11 SYS $ 432.00 $ 4,752.00 $ 250.00 $ 2,750.00 $ 365.00 $ 4,015.00 $ 438.54 $ 4,823.94 $ 287.00 $ 3,157.00 10 TOPSOIL AND SEEDING 525 SYS $ 9.00 $ 4,725.00 $ 32.00 $ 16,800.00 $ 35.00 $ 18,375.00 $ 31.18 $ 16,369.50 $ 26.95 $ 14,148.75 11 TREE, REMOVE, 6-IN 3 EA $ 850.00 $ 2,550.00 $ 350.00 $ 1,050.00 $ 250.00 $ 750.00 $ 1,962.82 $ 5,888.46 $ 325.00 $ 975.00 12 TREE, REMOVE, 18-IN 3 EA $ 1,800.00 $ 5,400.00 $ 850.00 $ 2,550.00 $ 650.00 $ 1,950.00 $ 2,912.82 $ 8,738.46 $ 700.00 $ 2,100.00 13 PLANT, DECIDUOUS TREE, SINGLE STEM. 2-IN TO 2.5-IN 12 EA $ 515.00 $ 6,180.00 1 $ 1,100.001 $ 13,200.00 $ 975.00 $ 11,700.00 $ 975.00 1 $ 11,700.001 $ 975.00 $ 11,700.00 $ 124,855.00 $ 169,030.00 $ 187,591.00 $ 190,076.35 $ 204,750.65 Non -Collusion Affadavit Y Y Y Y Bid Bond Y Y Y Y M/WBE Inclusion Y Y Y Y Addendum #1 Y Y Y Y I hereby certify that the above truly and accurately represents bids received for this project on August 8, 2023 Gemma Stanton, Project Engineer Page 2 of 2 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WOV-4K Project Dame 2023 Curb and Sidewalk Program Project No. 123-001 For Bids Due August $t", 2023 PART I (Must be completed for all bids. Please type or print) Date: �i''�- Bidder (Firm): 54XV=6£5 Address: %/.2 /q'-r6-1v"4e tw ;- City/State/Zip: 1_,-Z J4MAAT-rN y45/& Telephone Number: (5-7y 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: 2022 Curb and Sidewalk Construction — Round 2 the City of South Bend, Indiana, in accordance with plans and specifications prepared by: City of South Bend Department of Public Works, Division of Engineering and dated for the sum of (enter the Total Bid as shown on the Proposal) NrwF- I/UXPRE d 5,609�:TY fR0104w F"4111 wiflOAAF.10 (s 5'7 3 : yis 2 } (Enter sum of Total Base Bid plus Alternates shown on Proposal) jCted'rrx) (Numerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. By (Signatu Printed Name of Person S gning) The above bid is accepted this ^ Subject to the following conditions: CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS ►l_�r7Y9i9 Elizabeth A. Maradik, President Gary A. Gilot, Member ACCEPTANCE day of Joseph R. Molnar, Vice President Alexandra Dolz-Lane, Member t 20 Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: August 22, 2023 BOARD OF PUBLIC WORKS CITY OF SOUTH BEND, INDIANA PUBLIC WORKS CONTRACT This Agreement is made and entered into this 22nd Day of August, 2023, by and between Premium Concrete Services, Inc., (the "Contractor"), and the Board of Public Works (the "Board"). The Contractor covenants and agrees to make the following improvement, as fully set out in the Request for Quotations, Standard Specifications, Special Provisions, Plans, and Bid Proposals, all of which are set forth as a part of this Contract, for: PROJECT NO. 123-001 DESCRIPTION: 2023 CURB AND SIDEWALK PROGRAM COMPLETION DATE: SEE SPECIFICATIONS AMOUNT: DIVISION A $64,949; DIVISION B $335,583; DIVISION C $246,378; DIVISION D $157,478; DIVISION E $169,030 F1 TNDING- PR-00025739 The unit prices for this improvement were those prices as received and accepted by the Board on the 8th Day of August, 2023. The Contractor further agrees to notify the assigned Engineer when this improvement is completed. This notification shall be in the form of a Project Completion Affidavit, signed by the Contractor. Upon final acceptance of the improvement by the Engineer, the Contractor's final estimate will be presented to the Board for final Payment with one (1) copy of the Project Completion Affidavit and one (1) copy of a Waiver of Lien. Each of the Parties, by signing below, represents and warrants to the other Party that he/she/it has the authority to bind the named person or entity to this Agreement. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member WIN Joseph R. Molnar, Vice President Alexandra Dolz-Lane, Member �4 Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: August 22, 2023 PREMIUM CONCRETE SERVICES, INC. Printed Name Signature CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name 2023 Curb and Sidewalk Program Project No. For Bids Due 123-001 ust 8'", 2023 U1'H g ��O � ����� � sI t '���� z �` `'�_ x ,�4 % Idfi5 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 fallowing 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 v or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and Certification of use of United States Steel Products or Foundry Products. Proof of MIWBE 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 WBE-2.1 ]. Acknowledge Receipt of y Addendum(s) included with the bid. All required additional information is included with the bid. ✓ Proposal statements and other affidavits all signed by the proper party with name either printed or typed underneath signature. C/ This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. J Bidder: �/���+iSCIi''J CdaGR�T� SE.4dzGE 5 Date: ✓�/8/�%7 By Authorized ReprP��^`�+����� Signature: Print Name &Title: Version 09/29/2021 Contractor's Bid for Public Works -1 1316 COUNTY -CITY BUILDING 227 W..iEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAx 574/ 235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND TAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Date: August L, LULS To: All Planholders From Theresa Heffner, Cleric, Board of Public Works Subject Addendum Number: 1 - Project Name: 2023 Curb and Sidewalk Program III Project Number: ACKN" VV JLJ �IG�1V1I1EN lI �lF IEBIEc�]FI[1�� �lF �l���P ll�ll�W Date Received: 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. TI-1dS ��B�1@rUUI@/1[ I�hA��I EOI��'1(J�T �®1UllY �l[jI�< Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: Authorized Si Date: S Version 4/2/2015 AIADocurf ant AM Wm 01 a Bid Bond CONTRACTOR: SURETY: (Name, legal status and address) (Name, legal status and principal place Premium Concrete Services, Inc. of business) Old Republic Insurance Company 712 Richmond St P. O. Box 0941 This document has important legal consequences. Consultation with Elkhart, IN 46516 Brookfield, WI 53008-0941 an allorney is encouraged with OWNER: respect to its completion or (Name, legal status and address) modification. City of South Bend Board of Public Works Any singular reference to County -City Building Room 1316, 227 West Jefferson Blvd Contractor, Surety, owner or South Bend, IN 46601 other party shall be considered BOND AMOUNT: plural where applicable. Five Percent of the Total Bid 5 % of Total Bid PROJECT: (Name, location or address, and Project number, if any) 2023 Curb and Sidewalk Program; Project No. 123-001 The Contractor and Surety are bound to the Owner ur 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 rite 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, slid the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a centurion law bond. Signed and sealed tl's 3rd day of August 2023 t Premium QQncr S ices, 7 r✓ (Princip (Seal) � V1LC "'PvBSP�PfI� (Wi tess) % (Title) Old Republic Insurance Company Y(AA^ AYf �I'� b^i KpFTt t� f V`� (Surety) y7� i (Witness) (Title) nifer L. K sznia, orney-in-Fact CAUTION: You should sign an original AIA Contract Document, on w,ih this text appears in RED. An original assures that changes will not be obscured. Init. AIA Document A310r" — 2010. Copyright ©1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WAR ®ING: This AIA` Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of It, may result In severe civil and criminal penalties, and will be prosecuted to the maximum extent possible antler the law. Purchasers are permitted to reproduce ten (to) copies of this document when completed. To report copyright violations of AIA Contract Documents,°e' mail The American Institute of Architects' legal counsel, copyright@aia.org. ° * OLD REPUBLIC INSURANCE COMPANY ***** - POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania stock insurance corporation, does make, constitute and appoint: NICOLE L BICKNELL, MEGAN E RIESENBERG, MARK EDWARD WOBBE, BARBARA E PEARSON, JENNIFER L KASZNIA, SANDRA L JUNK, WILLIAM J CERNEY, III, WESLEY MANTOOTH, THERESA BURNS, JORDAN SCHEMER, LISA M THOMAS, FAITH HUNT, PAMELA S, HIGGINBOTHAM of SOUTH BEND, IN its true and lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the Company as surety, to execute and deliver and affix the seal of the Company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof, (other than self-insurance workers compensation bonds guaranteeing payment of benefits, or black lung bonds), as follows: ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED TWENTY MILLION ($20,000,000) FOR ANY SINGLE OBLIGATION and to bind OLD REPUBLIC INSURANCE COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed. This appointment is made under and by authority of the board of directors at a meeting held on December 10, 2019. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC INSURANCE COMPANY on December 10, 2019. RESOLVED FURTHER, that the chairman, president or any vice president of the Companys surety division, in conjunction with the secretary or any assistant secretary of the Company, be and hereby are authorized and directed to execute and deliver, to such persons as such officers of the Company may deem appropriate, Powers of Attorney in the form presented to and attached to the minutes of this meeting, authorizing such persons to execute and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and suretyship obligations of all kinds, other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and not guaranty bonds. The said officers may revoke any Power of Attorney previously granted to any such person. RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (i) when signed by chairmen, president or anyvice president of the Company's surety division and attested and sealed (ifa seal be required) by any secretary or assistant secretary; or (ii) when signed by a duly authorized Attorney -in -Fact and sealed with the seal of the Company (if a seal be required). RESOLVED FURTHER, that the signature of any officer designated above, and the seal of the Company, may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF, OLD REPUBLIC INSURANCE COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be affixed this 30th day of November 2022 OLD REPUBLISUI�JA�CE COMPANY 1"y -"d SEAL_ 11 A r r sacrara v_`� Vice President STATE OF WISCONSIN, COUNTY OF WAUKESHA- SS On this 30th day of November , 2022 , personally came before me, Alan Pavllc and Karen J. Haffner tome known to be the individuals and officers of the OLD REPUBLIC INSURANCE COMPANY who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said organization. 9 pU61.x� d Notary Public My Commission Expires: September 28, 2026 CERTIFICATE (Expiration of notary's commission does not invalidate this instrument) I, the undersigned, assistant secretary of the OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force. Signed and sealed at the City of Brookfield, WI this 3rd day of August 2023 45-5314 X1'`/\ ».,nn plant sea , ORSC 1f0381693) GIBSON INSURANCE AGENCY, INC. PART II or 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 Attach an explanation of your plan or layout for performing proposed work. (Examples could cou d begin work, te the etcluand anyr rother informat oonuwh which you believe would eenableproject, workers, the City of South Bend 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.ve pncesyuosed In preparing your proposal? ilfenot offers atta h anall explanration forc he rationaile 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 ity of South Bend awarding the contract must be specific statement provided hereunder to the C h Bend can make a proper determination of the bidder's enough in detail so that said City of Sout capability for completing the project if awarded. Version 09/29/2021 Contractor's Bid for Public Works - 3 Premium Concrete Services, Inc. 712 Richmond Street Elkhart, IN 46516 (574) 264-0196 SECTION I EXPERIENCE QUESTIONAIRE 1) PUBLIC WORKS PROJECTS COMPLETED IN PAST YEAR: $ 657,021.80 CONCRETE ROADWAY $ 250,000,00 CURB & SIDEWALK $ 7740 CURB & SIDEWALK_ 2) PUBLIC WORKS PROJECTS IN PROGRESS: $ 187,300.00 CURB RAMP .i./-$200,000.00 CURB&SIDEWALK +/- $100A00,00 S'rR[ET MATERIALS CITY OP GOSHEN CITY OF MISHAWAKA CITY OF ELKHART SO/2022 CITY OE ELKHART 10(2022 CITY OF MISHAWAKA 10/2022 CITY OF ELKHART 3) HAVE NEVER FAILED TO COMPLETE ANY WORI<7HAT WAS AWFlRDED TO US. 4) REFERENCES: a. NISOURCE - MR. LUI<E BRADLEY--1039 PENNSYLVANIA AVE SOUTH BEND, IN 46601 b, LOZIER MANUFACTURING -MR. KEN MURK-402 N MAIN MIDDLEBURYI IN 46640 Premium concrete Services, Inc. 712 Richmond Street Elkhart, IN 46516 (574)264-0196 SECTION II PLAN AND EQUIPMENT QUESTIONAIRE 1) Project No. ,�rapurb & Sidewalk Construction Round 2 - Schedule: After given the notice to proceed Premium Concrete Services, Inc, will create a letter to hand out to residents with details of upcoming work. PCs will then contact Indiana 811 to locate ail utility lines within construction limits. Layout and staking of site will be next. Then removals, phases excavation, grading & subgrade will begin for concrete work. After excavation and grading p are complete, concrete work will commence. Crews of 4-6 workers will install. Finally top soil and seeding, followed by tree planting at the appropriate time. Project with be completed on schedule. 2) a) State Barricading Inc.-24963 US 20 West South Bend, IN 46628—Traffic Maintenance &Signs b) Acorn Landscaping — 3680 W Sample st South Bend, IN 46619 —Top Soil and Sodding. c) Kachur Tree Service, LLC- 316 Fulkerson Rd Niles, MI 49210-Tree Removal. d) Hawk Enterprises —1850 East North St Crown Point, IN 46307 - Electric e) KC Tree, Inc —8913 East US Hwy 20 New Carlisle, IN 46552—Tree Removal f) A-1 Striping Service Inc. — 56825 Spirea Rd. New Carlisle, IN 46552 — Painting g) Kennedy Expressline Inc. —South Bend, IN 46628 - Hauling h) Traffic Control Specialists —1810 W Pacific Ave Knox, IN 46534 —Traffic Maintenance &signs Premium Concrete Services, Inc. Does not require bonding for its subcontractors 3) Will supply list of subcontractors soon after award of project. 4) Equipment use for project: Skid Steer, Mini Excavator, Excavator, Compactor, Roller, Walk -behind Saw, Cut-off Saw, Friction Screed, Dump Truck. Current plan is to used owned equipment, however depending on workload some rental equipment may be necessary. 5) Yes, Premium Concrete Services, Inc. has quotes for all materials in proposal. premium Concrete Services, Inc. Elkhart, Indiana Annual Report December 31, 2021 Conten#s Report of Independent Flrcouniant en Financial Statement .......................• 1 1=lnanclai Statements Statement of Income and Retained Earnings ................................ 2 BalanceSheet ................................................. 3 Statement of Cash Flows............................................................... 4 Notes to the Financial Statements ................................................. 6 b Supplemental Schedules..................................................... 9 - 10 Ayttl1011y P. D7ibley CPA, P.C. A 3414 County Road 6 V,, I?.8clxart, hrdiann 46514 € (574) 262,,5027 1� ax (574) 264-4558 dibleyepli 1Hilf)lenetaret INDEPENDENT ACCOUNTANT'S REVIEW REPORT To the Board of Directors premium Concrete Services, Inc. Elkhart, Indiana I have reviewed the accompanying financial statements of Premium Concrete Services, Inc. (an S corporation), d Which comprise the balance sheet as of December 31, 2021 and 2020, and the related statements of income and retained earnings and cash flows for the years then ended, and the related notes to the financial statements. A nt's financial data and making inquiries of review includes primarily applying analytical procedures to manageme company management, A review is substantially less In scope than an audit, the objective of which is the expression of an opinion regarding the financial statements as a whole. Accordingly, I do not express such an opinion. Management's Responsibility for the Financial Statements Management is responsible foeneialplyeparation accepted in fair thepUnite IatSiatesthese America; tillsstatements includes the accordance de design, with accounting principles g'tion totem nts that arnd maintenance from mate alien misstatement control whether due to h fraud or error�nd fair presentation of financial Accountant's Responsibility My responsibility is to conduct the review engagement in accordance with Statements it Standards for Accounting and Review Services promulgated by the Accounting and Review Services Committee of the wheAICther Those standards require me to perform procedures to obtain limited assurance as a basis for reporting whether I am aware y atrarficatithat idbe made to pfoil them to be In accordance with of amnted Sates of America believe that theresults of my procedures accounting pricplesqeerally accepiedin the U provide a reasonable basis for my conclusion. Accountant's Conclusion Based on my review, I am not aware of any material modifications that should be made to the accompanying ounting principles generally accepted in the financial statements in order for them to be in accordance with acc United States of America. Supplementary Information The supplementary information Included in Schedules I and II Is presented for purposes of additional analysis and is not a required part of the basic financial statements. The information is the representation of management. I have reviewed the information and, based on my review, I am not aware of any material modifications that should be n the made to the information in order for it to be in accordance wish accounting poi oil express generally option oil such United States of America, I have not audited the Information and, accordingly, information, Anthony P. Dlhtey, CPA, P,C. - Elkhart, Indiana !� February ZA, 2022 When flee prospect)ve Contractor is unable to certify la trr+y of the s[nten+erns belo+v, it shn(1 nflnch nu eep(nnntiov to Ibis Affrr6wit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIMINATION COMMI PRODUCTSOR FOUNDRY PRODUCTSOF UNITED STATES STEEL (Must be completed for all quotes and bids. Please type or print) STATE OFT DlAn1A ) SS: AK, A RT COUNTY ) The undersigned Contractor, being duty sworn upon his/leer/its oath, affirms under the penalties of perjury that: I. Contractor hua• has any other member, representative, or at of the firm, company, as not, combination, corporation partnership represented by him, entered into any n, 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 or 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 sate; 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, "L•an" 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 AdminisG•ation. 4, Conuactor 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 entailment 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 contact o 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 die subcontaetor has enrolled in and is participating in the GVerify Program. The Contactor agrees to maintain this certification throughoutthe term of the contractwith the City of South Bend, and understands that the City may terminate the contact for default if the Contractor fails to cure a breach of this provision no later than thirty (30) clays after being notified by the City. 6. Persons, firms, partnerships, corporations, associations, orjoint venturers awarded a contract by (he 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 (he 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 i❑ 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 fi'om 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 count,itnent 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 ennploynnent in the performance of this contract with privileges of employment, o' 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 Illy statutory obligations to the use of steel products or foundry products made in the United States (LC. 5-16-8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States oilthis 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 njustification 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, n gbh day of Ilui7,,2013 Dated this in1Uc�CbI�P. ► KVICES 1 rJC., Contractor/Bidder (Firm) signature of Contractor/Bidder or Its Agent ft)(yEAKV J. tom. Printed Name and Title Subscribed and sworn to before me this b * day of My Commission Expires ��- County of Residence N ary Public JANEEMTOWNER NOTARY PUBLIC SEAL ELKHART COUNTY, STATE OF INDIANA MY COMMISSION EXPIRES FEBRUARY 12, 2026 COMMISSION NO, 710399 Version 09/29/2021 Contractor's Bid for Public Works - 6 BIDIPROPOSAL CITY OF SOUTH BEND Project Name: 2023 Curb and Sidewalk Project Number: 123-001 For Bids Due: August 81^,2023 Contractor Name: �QE/rt2k/�1 CdNLRETE SER 1trGES DIVISION A Unit Total Item City Unit Price Amount No. Description 133 SY 1 CONCRETE SIDEWALK, REMOVE SY SO 2 CONCRETE SIDEWALK, 4-IN 133 `= 6d ao 3 CONCRETE CURB, REMOVE 296 LF = /2t3 4 CONCRETE CURB, MODIFIED 296 LF ( °" 5 CONCRETE APPROACH, REMOVE 14 SY D 20 6 PCCP FOR APPROACHES 6-IN 14 SY dn" O 7 CONCRETE CURB RAMP, REMOVE 21 SY 740 8 ONE-WAY PERPENDICULAR CURB RAMP 9 SY 9 PAIRED PERPENDICULAR CURB RAMP 12 SY LSD= o0 10 TOPSOIL AND SEEDING 205 SY 3 11 TREE REMOVE 30-IN 0 EA PLANT, DECIDUOUS TREE, SINGLE STEM, 2-IN TO 12 2.5-IN 0 EA DIVISION A (Cl7/ 7 7 C�+ TOTAL � 7 DIVISION DIVISION TOTAL B Unit Total Item Qty Unit Price No. Description 877 SY 5`O�' 1 CONCRETE SIDEWALK, REMOVE 2 CONCRETE SIDEWALK, 4-IN898 SY 7ll MAnt 3 CONCRETE CURB, REMOVE 1616 LF 2S-4 CONCRETE CURB, MODIFIED1616 LF &25 � CONCRETE APPROACH, REMOVE 75 SY bO 00 6 BRICK APPROACH REMOVE 13 SY /Oo = / 00 7 ASPHALT APPROACH, REMOVE 21 SY /00 ao 8 PCCP FOR APPROACHES 6-IN 88 SY — 2 O 9 CONCRETE CURB RAMP, REMOVE 21 SY IoO 10 ONE-WAY PERPENDICULAR CURB RAMP 21 SY 1 11 TOPSOIL AND SEEDING 1028 SY 12 TREE, REMOVE, 10-IN 2 EA 00 — 13 TREE, REMOVE, 18-IN 6 EA ob 14 TREE, REMOVE, 48-IN 1 EA jeco 15 STUMP REMOVE 2 EA = OGIO PLANT, DECIDUOUS TREE, SINGLE STEM. 2-IN TO 16 2.5-IN 18 EA B �35� 5'f33'— Version 09/29/2021 Contractor's Bid for Public Works - 7 BID/PROPOSAL CITY OF SOUTH BEND Project Name: 2023 Curb and Sidewalk Program Project Number: For Bids Due: Contractor Name: 123-00I ust 8,2023 � CpitJG.�E 1 ,QSOU'tli gF4 L p r DIVISION C �c/� � 7B Go TOTAL l DIVISION D S% : 1?g _= TOTAL l f `l Version 09/29/2021 Contractor's Bid for Public Works - 8 BIDIPROPOSAL CITY OF SOUTH BEND Project Name: 2023 Curb and Sidewalk Program Project Number: For Bids Due: Contractor Name: DIVISION E August 8'AU3 He No. 1 Descri tion CONCRETE Slt 2 3 CONCRETE SII CONCRETE CL 4 5 CONCRETE CL CONCRETE AF 6 7 PCCP FOR API CURB RAMP F 8 ONE-WAY PEF 9 PAIRED PERPI 10 TOPSOIL AND 11 TREE, REMOV 12 TREE, REMOV 13 PLANT, DECK 2.5-IN DIVISION E �3�.�i TOTAL Bidder kFirm): �i4,E�/Zla�7 Lo/71C�PE'TF S�`Q✓ICES Address: %/� �y�}iy/O/tl0 ST a D/cif City/State/Zip: jC-Ck1iA�14 Telephone Number: By (Si nature) /114 (Printed Name of Person Signing) Version 09/29/2021 Contractor's Bid for Public Works - 9 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: 123-001 Project Name: 2023 Curb and S Bidder: PRFejfLGwM Ccwyg AEYE Sh'fvs"ce"STotal Bid Amount: Division A —MBE Goal: 3.40% Division A Bid Amount: & 7 / Ll / 2 pages Name &Address of MBE Primary Contact Person (Namelielephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of MBE Component Percentage of Total Bid/Proposal it S" rc n 221 cIcs �trYJar Glv TrUCICi 14 14-493-0071 Kann V EK V* li w• 3z S yr ►1�u5 o rn '1"rvck i �`' n Division B —MBE Goal: 3.72% Division B Bid Amount: 33s, S� 3 Name & Address of MBE Primary Contact Person (NamerTelephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of MBE Component Percentage of Total Bid/Proposal 3 C11=5 ` va 1 !-M-c�11 Trucking �� 2 s� 1 � S s �'"` ss-sesi �rveki n iya Version 09/29/2021 Contractor's Bid for Public Works - 10 �V�B\ '1 CITY OF SOUTH BEND Il MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN--- FORM WBE-1.0�,N� WBE UTILIZATION PLAN /J � Division C —MBE Goal: 5.15% Division C Bid Amount: �! 6 5 Percentage Primary Contact Person Scope of Work to be Performed Dollar Amount of WBE of Total Name & Address of WBE (Name/relephone) (Attach scope/schedule if you need additional space) Component Bid/Proposal ILG„_ _ICE y � ►`4arCus oc Ti'Vc.�Ci �Soe is� .i Aehar ✓914- Q�"19 Division D — WBE Goal: 5.08 % Division D Bid Amount: J� y Percentage Scope of Work to be Performed Dollar Amount of WBE of Total Name & Address of WBE Primary Contact Person P Component (Name/Telephone) (Attach scope/schedule if you need additional space) P Bid/Proposal R�n� eve N�rws " -�r�cki g � 7k - / Division E Bid Amount: ! d3d Division E — MBE Goal: 5.25 % Percentage PrimaryDollar Amount of WBE Contact Person Scope of Work to be Performed of Total Component Name & Address of WBE (Name/Telephone) (Attach scope/schedule if you need additional space) P Bid/Proposal tat MIAL 014-5fuW Submitted b1 1 IrT•l� y��xEY Date 90 3 Print Name Signature Version 09/29/2021 Contractor's Bid for Public Works -13 E,OcTH OC,� ?J CITY OF SOUTH BEND m MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-1.0 feG 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: 123-001 Project Name: 2uzS turn anu �. Bidder.�C��ZUM �S-Q�aceSTotal Bid Amount: Division A — WBE Goal: 5.42% Division A Bid Amount: Primary Contact Person Name & Address of WBE (Name/Telephone) 5 <5 6 n;T61�t►tB �°h- fr)r4cra41% 4W74 772 - 3/0�3 5 AMC 5;y/$= 4A444 4 Pf Division B —WBE Goal: 5.57% Name &Address of WBE S �ay5�e 5 Primary Contact Person (Namelrelephone) �. S X� Scope of Work to be Performed (Attach scopelschedule if you need additional space) z Z Division B Bid Amount: Scope of Work to be Performed (Attach scope/schedule if you need additional space) 2 pages Dollar Amount of WBE Component Percentage Dollar Amount of WBE of Total Component Bid/Proposal S2:yr Version 09/29/2021 Contractor's Bid for Public Works - 12 Division C -MBE Goal: 5.47% "� `',SOL�.H erg\. CITY OF SOUTH BEND I°���' MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN � i i>I FORM WBE-1.0 WBE UTILIZATION PLAN jj n b� Division C Bid Amount: � �=-i .3 !g Name &Address of WBE Primary Contact Person (Namelrelephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of WBE Component Percentage of Total Bid/Proposal 5�Uy5�Q5 �� 12,688 � S,is9a Division D -WBE Goal: 5.39% Division D Bid Amount: lyG i Primary Contact Person Scope of Work to be Performed Dollar Amount of WBE Percentage of Total Name &Address of WBE (Name/Telephone) (Attach scope/schedule if you need additional space) Component Bid/Proposal %� 7, 55's � �o��� ��� Division E -MBE Goal: 5.57% (� Division E Bid Amount: ��1, d �y �� Primary Contact Person Scope of Work to be Performed Dollar Amount of WBE Percentage of Total Name &Address of WBE (Name/Telephone) (Attach scope/schedule if you need additional space) Component B�id^/Proposal op �� -1�/1 C /� J� �) D,O 77 08 7-��0 �/- u/�lac �S7 l'\FF/ Submitted by: �r� ���'!�,� y ��6'-'�---� �/y C Print Name Signature Date Version 09/29/2021 Contractor's Bid for Public Works -13 „o4�vee �F��,. CITY OF SOUTH BEND i � � � d�# MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN �.� _ a�� FORM MBE-2.0 `°u�1ef`' -�'� 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. 8 8 /�3 Project Number: 123-001 Date: Project Name: 2023 Curb and Sidewalk Pro ram RE,v/SG7M CouuEt aur�.E S Bidder: ��c�< /FX Ep-KE y Telephone: � �(v ” Contact Person: nl 7 Address: ��'z /��AJ�ND ST city: �u<I><�.eT- State: -Z� zip: yGS/G Email: f}X � P/ICH72Nr1 �FR✓ZC69 e (�ROuP 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 MBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: htt :/Iwww.in. ov/idoal. 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 Cily of South Bend's Minority and Women Business Enterprise ��/ Inclusion Program Plan and the Indiana Department of Administration's certified list of rIndiana Minority and Women Business Enterprises, found on their website htt :llwww.in. ov/idoa . I affirm that I have made good faith efforts to select portions of the contract work to be ,I� J performed by MWBEs, including, where appropriate, breaking out contract work items into t • r 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 Ilr 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 writortun ties and allowed �nnv reasonably calculated to inform MBEs of subcontracting opp Y. `r sufficient time for MBEs to participate effectively. I•`� I affirm that I followed upon initial solicitations with interested MBEs. I• I affirm that I negotiated with interested MBEs in good faith, including providing such MBEs `�Y�V 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 obtainoinga ending, M� lines of credit, or insurance as required by the City or the bidder, where opp p Version 09/29/2021 Contractor s Bid for Public Works -14 4SHU rH dF�4�... 4 CITY OF SOUTH BEND w > r MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN ,� / , t FORM MBE-2.0 � Hers ,- EVIDENCE OF GOOD FAITH EFFORTS M 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 -15 F�'a4SpU'rH ➢eNOA'"; CITY OF SOUTH BEND e} MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN �� � ,_ Z FORM WBE-2.0 .,� srs '. EVIDENCE OF GOOD FAITH EFFORTS .r.. 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. ep Project Number: 123-001 Date: lJ �/�-3 Project Name: 2023 Curb and Sidewalk Program Bidder: Contact Person: Address: City: Email: l�R�NrT.GrA7 C'oNGIETE SE%1 d.ZcES J�'Jf�-�C yE✓�-/GZ,/ Telephone:C % a1�0/i`�fg� %/ � i�.TGN�oNYJ ST �GKN/iQT State: �',/J Zip: Z/GS� G �'//;<,tC L� iR6�T�� 5EtJscES . GRUu� 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, REr]uIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS WBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: htt ://vvv✓v✓.in. ovlidoal. 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 htt :llwww.in. ov/idoa . I affirm that I have made good faith efforts tc 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 1��1 means the interest of all WBEs in the scopes of work of the contract. /, 4 I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform ,p„ 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 r/ reasonably calculated to inform WBEs of subcontracting opportunities and allowed f sufficient time for WBEs to participate effectively. )/ I affirm that I followed up on initial solicitations with interested WBEs. r 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, �/t�, lines of credit, or insurance as required by the Cily or the bidder, where appropriate. Version 09/29/2021 Contractor's Bid for Public Works - 16 ti S°°'H dFm.,�, a CITY OF SOUTH BEND ' �„ MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN � y- J�J FORM WBE-2.0 ,ers�.�' EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made goad faith efforts to assist interested WBEs in obtaining �/ necessary equipment, supplies, materials, or related assistances or services, where J appropriate. I affirm that I did not reject any WBEs as unqualified without sound business reasons 1M �/ based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records far 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 - 17 l oQroU'at oy'�Q�° CITY OF SOUTH BEND G� � MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN �� w,,��i�a "` �BG' 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 PAGE ary / OF�_ Project Number: 123-001 MBE Participation Goal Varies Project Name: 2023 Curb and Sidewalk Pro ram Bidder: f%R�vyScf•'� C'pNGR�T� S��UL�S � � /-- By: (Date) MBE Firm /5+ CLi}5$ Lp6S3TL'CS LLL Owner or Contact at MBE Firm Q C RNA2D COUTEE Telephone: ��� qp3-dad I Fax: Email: � �-CCAS$ �06Z'STtcS.?o/3 � G'ry��'LP� TYPE OF WORK SOLICITED FOR THIS PROJECT: G .t�G RESULTS OF CONTACT WITH THE MBE FIRM: �vr�L UT�LrzE zF /�w.�7�Co� MBE Firm KEA1/li�i%{� C�P�jE55 Ls.✓E Owner or Contact at MBE Firm /Yf%}QG�tS N6,eT�,!-ER � Telephone: rj'7y $7��8BBl Fax: Email:IGEuvE4YEXf�ES�[trV�,[�yA��.G�M TVPF OF WORK SOLICITED FOR THIS PROJECT: LlnJG RESULTS OF CONTACT WITH THE MBE FIRM: W LL UrtL.LYE SF At,.�.4-Rt��D Version 09/29/2021 Contractor's Bid for Public Works - 18 .� CITY OF SOUTH BEND �u MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN ��� �,��%,�' FORM MBE-2.1 ��� 'sw_ �'� WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any sted woman -owned business meets the WBE qualifications. Attach additional pages if nPAGEa�_OF Project Number: 123-001 WBE Participation Goal Varies Project Name: 2023 Curb and Sidewalk Pro ram Bidder: RE/''fZ'�iA9 CO.U[.4Er�' Spa✓St-�5 r,P B A/a'3 By: WBE Firm ST<}T� 3/}RRrc/eDr.✓G Owner or Contact at WBE Firm /�f/�L1 fl f%�rL�/�}LS� Telephone: C57�i ,287-,b7$ Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT: Rl3FFr� (�N7l3o L Email: 5''y-,�f-E /�,QR.tG4QE„L L /�OL.UJ� RESULTS OF CONTACT WITH THE WBE FIRM: Wiw �tTrcr�� _zF A�W.�Ra� WBE Firm 5L �+55Ea 5 6R�E� Tflitar Owner or Co//ntact at WBE Firm C/�Qp�-�/N S LtlSi�� Telephone:�t 77.?-,?9g3 Fax: Email: ,SNFO �$Lu55�S,CO� TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: WScL. (iiT�GSZE I� Aw/%R06-� Version 09/29/2021 Contractor's Bid for Public Works -19 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name 2023 Curb and Sidewalk Project No. 123-001 For Bids Due August Contractor Name: 2023 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 apre-qualified bidder, complete Section I only. If you are not apre-qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 63 of The Responsible Bidding Ordinance No. 10594-18 (hereinafter, "Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders') by December 3151 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 worl<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 Subcontractors)") 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 perrollsCshall dbeasubm tted identify the job title and craft for each employee. Certified pay 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 aPre-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 apre-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) � 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) %� 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) � 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 apre-qualified bidder with the City of South Bend. (ii) — By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. (iii) _ By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) _ By checking this box, I hereby acknowledge and ensure that I and all sub- contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore, I acknowledge my understanding that it is my responsibility to ensure that all sub -contractors have the necessary licenses to undertake the work called for in this bid. If a sub- contractor loses their license at any point, it is the responsibility of that sub- contractor to notify the City. (b) Attachments: (i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) — List identifying all former business names. (iii) — Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) years. (iv) _ Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. (v) — Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances. (vi) — For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. (vii) — Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. (viii) _ Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties' as required in the bid specifications or contract. Version 02/23/2022 General Conditions - 13 (ix) _, Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. (i) _ List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. Date: �/S /a � _,_ (Sign Here) MAX ���-K%Y (Print Name Here) PR��yu.n Cd NOTE 5�"R ��c.E 5 (Name of Company) 7/,,Z f(y�r�onlb ST (Address of Company) ,E � K N��T -��, y�s� � (city) r� (State) S7y� �t�y-or i� (Telephone Number) Version 02/23/2022 General Conditions - 14 CITY OF SOUTH BEND DAMES MUELLER, MAYOR DEPARTMENT OF PUBLIC WORKS ERIC HORVATH, DIRECTOR May 30, 2023 Rob Becker Premium Concrete Services becker@t)remiumconcretconline.com RE: Pre -Qualification Verification Dear Mr. Becker: This letter selves 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, �11 /'� Theresa Heffner Board of Public Works, Clerk Certified Copies 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 this is a true and complete copy of this 4 page document consisting of the following records filed in this office: Certification Date: May 22, 2023 Business Name: PREMIUM CONCRETE SERVICES, INC. BusinesslD• 2004120100105 Transaction Business Certificate of Assumed Business Name Date Filed Total No. of No. of pages - — 2--- �_ 4 — In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the Citygf Indianapolis, May 22, 2023 DIEGO MORALES SECRETARY OFSTATE All certificates should be validated here 2004120100105/ 15712440 https://bsd.sos.in.gov/ValidateCertificate Expires on June 21, 2023. Pagc I Of 5 CerlificatcID: L5712440 APPROVF,D AND iIL.ED HOLLi SULLIVAN `- INDIANA SECRETARY OF STATE 09/O6/2022 02:25 PM BUSINESS 1D 2004120100 LOS BUSINESS "I'1'PE Domestic PorvProfd Corporation RUSINESS NAME PREMIUM CONCRETE SERVICES, INC. ENTITY CREATTON DATE I I /24/2004 JURISDICTION OR FORMATION Indiana PI21NC1PAl, OFFICE ADDRESS 7l2 RICHMOND ST, ELKHAR'I, IN, 46516, USA YEARS 2022/2023 EFFECTIVE DATE 09/06/2022 EPFEC'CNE TIME 2:25 PM REGISTERED AGENT TYPE Individual NAME MAX A. YEAKBY ADDRESS 712 Richmond Sncel, P,Ikhart, IN, 46516, USA TI'PLE President NAME 6ecky L. Yeakey ADDRESS 712 Richmond Street, Hlldrart, lN, 46516, USA 'PITLG Vice President NAME Max A. Yeakey ADDRESS 712 Richmond Street, Ehdrart, IN, 46516, USA CertificatelD:157 LP24g O I of 2 Page 2 Of 5 APPROVED AND P'ILCD HOLLISULLIVAN �; INDIANA SECRETARY OF STATE 09/06/2022 02:25 PM IN WITNESS WHEREOF, THE UNDERSIGNED HEREBY VERIFIES, SUBJECT "t0 THE PENAL"PIES OF PERJURI', THAT THE STATEMF,NTS CON'PAINED HEREIN ARE TRUE, THIS DAY September 6, 2022. TJdE UNDERSJGNF,D ACKNOWLEDGES THAT A PERSON COMMITS A CLASS A M1SI)EMEANOR BY SIGNING A DOCUMENT'PHA'P THE PBRSON KNOWS IS FALSE IN A MATERIAL RESPECT WITH THE INTENT THAT'FHE DOCUMENT BE DELIVERED TO THE SECRETARY OF STATE FOR FJLJNG. SfGNA'PURG Isl Matthew A. Yeakey 9'ITLL Legal Representative Business ID :2004120100105 Filing No.: 9549531 CertificatelD:157 L2440 Page 3 Of 5 -Page 2 of 2 - � !. �' � �. • 1 -� � • � � t r. � € a . I, HOLLI SULLIVAN, 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 mined entity will transact business under the assumed business names) of: PREMIUM.SERVICES NOW, THEREFORE, with this document I certify that said transaction will become effective Tuesday, October 11, 2022. In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the City of Indianapolis, October 12, 2022. C���������� HOLLI SULLIVAN SECRETARY OF STATE 2004120100105 / 9591594 To ensure the certificate's validity, go to https://bsd.sos.in.gov/PublicBusinessSearch Pagc 4 Of 5 CertificateIDa 5712440 APPROVED AND RILED HOLLI SULLIVAN INDIANA SECRETARY OF STATE J 0/ L 2/2022 08:45 AM _, ,,,; �,. z". CER'1%1FJ'_G'xiPGOIivASSl7,MEDBUSLIII;SSNA147T, ,-; ,.... _,. NA74ik: ANt? 7 RTNCIPAL OT'LiC� ADDRESS %; :: ` ; ,,: <;.. ; , � :'' BUSINESS IU 2004120100105 BUSINESS TYPE Domestic For -Profit Corporation BUSINESS NAME PREMIUM CONCRETE SERVICES, INC. PRINCIPAL OFFICE ADDRESS 712 RICHMOND ST, ELKHART, [N, 46516, USA L"FFE�'I�r6 DAB � �, a; � EFFECTIVE DATE EFFECTIVE TIME 10/I I/2032 04:53PM „�, AS�Yl1YiBD34AiS7E.,�.J�D.,ADA7�CSS ., , _ ". � r ,u u _„ . �,�,�. ,,,.�����. , _ .,,,_,�., „. vv» �„,�.. � ,,, Premium Services 712 Richmond Sri eet, Elkhart, IN, 46516, USA IN WITNESS WIdEREOF, THE UNDERSIGNED HEREBY VERIFIES, SUBJECT "IO THE PENALTIES OF PERJURY, THAT THE STATEMENTS CONTAINED HEREIN ARE TRUE, THIS DAY October 11, 2022. THE UNDERSIGNED ACKNOWLEDGES THAT A PERSON COMMITS A CLASS A MISDEMEANOR BY SIGNING A DOCUMENT THAT THF. PERSON KNOWS [S FALSE [N A MATERIAL RESPECT WITH TI IE INTENT THAT'il IE DOCUMENT BE DELIVERED TO THE SECRETARY OP STATE FOR FILING. SIGNATURE TITLE Saulo 1. Delgada Legal Represeana(ive Business ID : 2004I20100105 Filing No.: 9591594 Page 5 Of 5 Cer'titicatefD: I57124A0 -Page 1 of 1 - o 3. o - � 2 0 0 � - \_ 3 £ - o v n � - - n � F F � � � F - Ra R+ � F v � F 3 3 � F £ F R> R> R� � � � � 2 2 2 2 2 �2 2 2 2 2 2 ? 2 F � F R' A +n v, v. .n .n an .n v+ v. r.. .n .n .n v. v. .n v� .n .n < A n < < v < < n < < _ _ _ _ _ F - 3 n - - F - F - �- - n - E - 3 3 F _ _ _ _ £ _ F _ 3 3 3 3 � � � 2 � x 93 3 F - a F - - i - - - - 3 3 2 2 ' 2 2 2 2 _ £ - _ v a v d = a w a v � - = F F F F F F F = o 3 R,39S14 LaSalle &Maufuette South Bend INDOT $ 210,779.59 Sidewalk, ADA compliant 1902 1-40046-A Traffic Signals Ft, Wayne INDOT $ 199,735.00 Curb, curb & gutter, sidewalks, HMA patching, PCCP patching„ curb ramp, 1914 detectable warning surfaces South Bend Waterworks South Bend CRyof South Bend 3 7%121,00 Various concrete/asphalt utility repair work 1936 R-40913 Howe, IN SR 12 Howe INDOT 5 57,989,85 Concrete A)ubStrUCtUre,Concretee(ootingS, reinforcing bars epoxy coated. 1929 City of Bikhart Various Elkhart City of Elkhart $ 70,171.85 Various concrete curb, sidewalla & sitework 1904 Premium Concrete Services, Inc 712 Richmond St. Elkhart, IN 46516 574-264-0196 fax 574-266-5392 05/23/2023 To Whom it may concern, Premium Concrete Services, Inc. currently employs 56 people, 8 of which are field supervisors, 9 concrete finishers, 19 laborers and 6 heavy equipment operators. We are signatory to the local Cement Masons, Laborers and Operator's unions through which extra employees can be pulled from when needed. Max Yeakey V.P. Premium Concrete Services, Inc. dba Premium Services 712 Richmond Street Elkhart, IN 46516 574-264-0196 fax 574-266-5392 May 23, 2023 To Whom it May Concern, Premium Concrete Services, Inc. has never been identified by any other business name in the past. As of October 12, 2022, as filed with the Indiana Office of the Secretary of State, Premium Concrete Ser 'ces, Inc. Max Yeakey Vice -President also conducts business as Premium Services. Premium Concrete Services, Inc. dba Premium Services 712 Richmond Street Elkhart, IN 46516 574-264-0196 fax 574-266-5392 May 23, 2023 To Whom it May Concern, Premium Concrete Services, Inc. has no violations of federal, state, or local laws, nor have there been any violations in the past. Max Yeakey Vice -President 0002/0008 05/23/2028 11:15 All FAX 8122795545 INDIANA LABORERS' TRAINING TRUU FUND Iravtd A. Frye Secretary- Treasurer Jerty,l• Bolk Chris Brickey Ricky Henson, Jr, Ramon Mendoza, Jr, Brian Short P.O. $ox 738 -Bedford, Indiana 47421 (912)279-9751 May 23, 2023 To Whom It May Concern: ILTI FAX F\S'; Sean Cnnktey, Director Jnlrn P. Brown Chairinan Kelly Abel Michael Perrara Stun Meyer Nick Timmerman Jim Wiseman FAX. (8t2) 279-5545 Toll Free (800) 742-4086 This letter is to oonffrm that "Premium Concrete Services, Inc." is a signatory contractor in good standing with the Indiana Laborers' Training Trust Fund. 'fhe above -mentioned company is a participant in the Joint Apprcntioeship and Training Committee through this Union and has been an active participant in good standing for each of the past five plus consecutive years, and is currently eligible to use our apprentices on a project. Futther, our organization's program is approved by the U.S. Veterans Administration to participate in the 01 educational benefits program. A copy of our approval letters are attached along with the collective bargaining agreement stating the ratios of Journey workers to Apprentices; which is one (1) Apprentice for every five (5) Journcy workers and thereafter may not employ more that (1) Apprentice for every (3) Journey workers. Sincerely,/ 11 r `47 Sean Coakley, Director SC:ap www• indiunulnborer'strctining.or� X e w F a December 14, 1995 rear= IN040-O523 T y zL=Uon Dco_ %er tftra#r n eJL= mt I\DIANA T.UORER`S TRAINING TRUST FUND BEDFQRD, IiIDIANA for the trade classification of CONSTRUCTION CRr��'T LABOREP, eisferee% as p¢rf o i�ie¢fionaf `�pprenlieesip 1 ro�ram in accordance wifni Infe basic sfand Wof o apprenticeship esfab�'sieo(6�y fhe 6ecrefary o�j6a6or c rrSo. 05/23/2020 11:10 AM FAX 8122795595 ILTI FAX QJ0004/0008 STATE OF INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W-469 INDIANAPOLIS, INDIANA46204-2738 Jeremy i3rcwez Apprenticeship Coordinator Indiana Laborers Training Trust Fund-ApprenticeshAp 439 Patton Hill Rd, Bedford, IN 47421 Dear 7eremy 13rcwer, Erlc Holcomb, Governor James M. Brown, Director January 9, 2019 The Indiana State Approving Agency conducted a supervisory visit on OI/8/2019 at Indiana Laborers Training Trust Fund Apprenticeship. The prupose of the visit was to provide training to the Certifying Officials and review enrollment certifications, record retention and reporting procedures. The organization demonstrated proper record maintenance and record maintenance and reporting procedures: During the visit, we discussed the importance of reporting hours on a monthly basis, good record keeping techniques, and how to report a leave of absence or completion via VA Form 22-1999b. We also updated the Certifying Officials via VA Form 22-8794, work processes, and wage scale. If you need any assistance or have any questions re6ardulg this leclmical visit please contact me directly at igriffm@dva.in.gov or (311) 232-3916. Thank you for the courtesy extended during my visit. The education and traii)ing opportunities that your organization continues to provide veterans and their dependents are appreciated. Sincerely, Taniqua Griffin Program. Director Yhone(317)•234-6062 ToIII•'ree(800)-400.4520 Fax (317)-234•R744 05/23/2028 11:10 AM FAX 8122795595 ILTI FAX !a0005/0008 1-1 ATE OF DIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W469 INDIANAPOLIS, INDIANA 48204-2738 Jercmy Brewer Apprenticeship Coordinator Indiana laborers Training Trust Fund -Apprenticeship 439 Patton Hill Rd. Bedford, IN 47421 Eric Holcomb, Governor James M. Brown, Director January 93 2019 Dear Jeremy Brewer, This will acknowledge receipt of your updated 'Wage Scale for the Construction Craft Laborer progrurr offered by Indiana Laborers 'Training Trust Find -Apprenticeship. The State Approving Agency has reviewed the document as listed below: Wage Scale: Construction Craft Laborer FA,CTT,1'1Y' CODE: 30004114 To the best ot'my knowledge Indiana Laborers Training Trust fund -Apprenticeship does not utilize erroneous or misleading advertisement, either by actual statement, omission, or intimatioo, It is understood by Indiana Laborers Training Trust Fund -Apprenticeship that they will maintain a complete record of all advertising utilized by or on behalf of the Indiana Laborers Training Trust Fund -Apprenticeship in regards to their training programs during die preceding 12 rnontbs. Indiana Laborers Training Trust Fund -Apprenticeship's advertising will be available for review by any and all future supervisory visits by the SAA, or the U.S. Department of Veteran Affairs, Please Review the entire packet for content and accuracy. Approval is granted pursuant to the provisions of Title 387 U.S. Code 3687, with an effective date of April 1, 2018, If you have any questions, please fea11'tee to give me a call at 317-232"3916 or email me at tgriffm@dvaJn,gov. Thank you It whtrt you do for our Veterans, and have a great day! Sineexely, 'l'aniqua Griffin Program Director State Approving Agency Cc: VARO/h;I,R, vjl�p /A,II �Ap�RO�NG V 05/23/2023 11:17 Au FAX 8122745545 ILTI FAX I�IOtl00/0008 �roF �Nawwa DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W-469 INDIANAPOLIS, INDIANA 46204-2738 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton Mill Rd. Bedford, IN 47421 Eric Holcomb, Governor James M. Brown, Diractor January 9, 2019 Dear Jeremy Brewer, This will ac)snowledgc receipt 1>f yolu revised Work Processes for the Constructaiort Graft i.aborcr pzobnam offered at Hoosier )✓nergy, located ilr Bedford, Indiana. The State Approving Agency has reviewed the docmnent as listed. below: TItA.1tNTTQG FRUGRAM. LENf�TI� DUT GUll� Construction Craft Labar•er FACILITX GUD�: 30004114 4,000-7800 hours 47�20C1.00 To the best of my knowledge Indiana Laborers Traixing Trust Farad -Apprenticeship does oat utilize erroneous or mislcadItzg advertisement, either by actual statement, olnission, ox intimation. It is urlderslood by Indiana Laborers Traizuu.g't1•llst F`Itnd-Apprenticeship that they will maintain a complete record' of all advertising utilized by or nn behalf of the company in regards to their training programs during the preccdiug 12 mozztkzs. The company's advertising will be available fox review by any and all firture supervisory visits by the SAP.., or the U.S.1)epartment of Veteran Affairs, This approval is made pursuant to and under klle provisions of Title 38, U. S. Code 3687, with an cfibdive date of January 8, 2019. If you have any questions, please contact nxc at 317-232-391.6. Siuccrely, Talliqua Griffin Program l7irector State Approving Agency Cc:VAROBI,R Pho�lo (317)-234-6062 To11 Frce (800)-M10p-4520 Nax (377)-234-37A4 05/23/2023 11:17 AM FAX 8122795545 ILTI FAX 0007/0008 Apprentice Status Report By Indenture Date Apprentices Indentured Between 111/2018 And 711312022 Apprentice Program: IN2 Year Apprentice Status Apprentices Percentage 2018 2019 Active Active Duty 2 0.24 Ady. to 3oumoyman Deceased 5 0.59 % 71. �r�au�t�d :. s:�n_eio Inactive 10 1.18 % ]dui7ieyman ' ' 0,29 Mo Med. Susp. i 0.12 A®1nStake 6 0 71 %, Suspended 7 0.83 % Termlbeted'.,'.' 546 6462::% Voluntary withdraw 381 4,50 % Total indentured 845 'AStlye . 1:65 37�65'Dla. Adv. to Journeyman 72 7.70 d/a tTeceaoed Graduated 51 SAS native Journeyman 12 1.28 °/ Metl::Susp:: :,: Reinstate is 1.60 % Terminated $28 56,97 Voluntary withdraw 66 IF 7.27, °/n Total Indentured 935 nnted� Wednesday, July 13, 2022 Page 1 4f 2 05/23/2023 11:17 AM FAX 8122795545 ILTI FAX 0008/0008 1 [F1'i Za2a gpprentice Status Report By Indenture Date Apprentices Indentured Between 111/201B And 7113/2022 Apprentice Program! IN2 Status Page 2 p/ 2 PrlNed WPMeedey, July 13. 2022 Plasterers & Cement Masons' Apprenticeship Coordinator Local Union #692 To Whom it May Concern: A yoc V O o� l'0 AL ASs�c. Phone: (219)707.7767 Email: bkristoff@plcmlocal692.org May 23, 2023 This letter is to certify that Premium Services, Inc. is and has been a signatory contractor with OPCMIA Local 692 and has participated in the Plasterers & Cement Masons Apprenticeship Training Program for many years. Premium Services Inc. is a valued Contractor in good standing with Local 692 and the JATC. All our apprentices are registered with the United States Department of Labor. I may be reached at (219) 707-7767 if additional information is needed. Further, our organization's program is approved by the U.S. Veterans Administration to participate in the GI Education Benefit Program. Thank you, Brian Kristoff Apprentice Coordinator Plasterers & Cement Masons 9200 Louisiana Street Merrillville, Indiana 46410 WWW.PLCMLOCAL692.ORG '" Plasterers' & Cement Masons' Apprenticeship Coordinator Local Union #692 ANpC � a o - � _ 186 - JAONAI Ass°` Local 692 Apprenticeship Summary Year 1St 2"d 3`d NEW Grads Total 2016 31 14 26 25 3 71 2017 35 20 21 61 20 76 2018 30 36 19 52 16 85 2019 30 26 16 13 13 78 2020 30 34 22 52 15 86 2021 25 28 23 16 12 76 2022 22 35 36 35 10 93 Phone: (219) 707-7767 Email: bkristoff@plcmlocal692.org 9200 Louisiana Street Merrillville, Indiana 46410 WWW.PLCMLOCAL692.ORG ` c.er; yea 7ti y { '"l"y� x Rra,�:,�.wh•Y, �a4.,- : :r'f s A4., ^E miI�l—a^.l' � n ro Y-•r�Y .`'i._-r,,•`",'F'�..(�^�'?� v%.'vriS1"{C�'`s t it?�r�-i����.,tE°,�� ��:o,'`.cm �v�s �..i�"s. � "��. ;ism -,^-r: THE T RADE v,SSSi-': i;.4T:071S: CEa,IENT d�.4SCly. o'_ASTcRc ' �k�i�Fo •t �^,���?, y/�i e�jrt BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date: 7/31 /23 Name: Gemma Stanton Department of Public Works — Engineering Division BPW Date: 8/8/23 Phone Extension: 9083 Required Prior to Submittal to Board BPW Attorney X Attorney Name Michael Schmidt Dept. Attorney ❑ Attorney Name Purchasing ❑ Check the Appropriate Item Type — Re uired or 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 Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Information U Yes❑ If Yes, Approved by Purchasing ❑ No ❑ WBE Completed E-Verify Form Attached ❑ Yes No 2023 Curb & Sidewalk 123-001 Motor Vehicle Highway 202-06-602-505-431000 Purpose/Description Bid opening for 2023 Curb and Sidewalk work related to Council Allocation program. To contain 5 divisions, divisible bid. Note: separate financial requisitions for each division to create separate Purchase Orders for each. 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: BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date: 8/14/23 Name: Gemma Stanton Department of Public Works — Engineering Division BPW Date: 8/22/2023 Phone Extension: 9083 Required Prior to Submittal to Board BPW Attorney X Attorney Name Michael Schmidt 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 ❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes ❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA ❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution ❑ Other: ❑ Ease./Encroach Reauired Information Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Premium Concrete ❑ Title Sheet U Yes❑ If Yes, Approved by Purchasing ® No ❑ WBE Completed E-Verify Form Attached ❑ Yes No 2023 Curb & Sidewalk 123-001 Motor Vehicle Highway / Major Moves 202-06-602-505-431000 / 412-06-600-506-431000 Division A - $64,949; Division B - $335,583; Division C — $246,378; Division D - $157,478; Division E - $169,030 Award bid for 2023 Curb and Sidewalk work related to Council Allocation program. Award all 5 divisions to lowest bidder Premium Concrete. Note: separate financial requisitions for each division to create separate Purchase Orders for each. snoopy— 4� For Change Orders Onl Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount Current Percent of Change New Amount Increase % Decrease Increase % Total Percent of Change: Decrease Time Extension Amount: New Completion Date: