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Opening of Bids - VPA 2023 Splashpad Renovations Proj No. 123-044 - Premium Concrete
CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Splashpad Renovations Project No. For Bids Due September 12, 2023 From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. Proper bid security included. The bidder has the option of providing either a Certified Check X or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely X executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and X Certification of use of United States Steel Products or Foundry Products. Proof of M/WBE Utilization Plans [MBE-1.0 and WBE-1.0]. Also provide Evidence of Good Faith Efforts Forms [MBE-2.0 and WBE-2.01 and M/WBE Contacted Forms [MBE-2.1 and X WBE-2.11. X Acknowledge Receipt of 1 Addendum(s) included with the bid. X All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either X printed or typed underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: Premium Concrete Services Inc. By Authorized Representative: g Sinature: Print Name &Title: Austin Reddiuc✓ Estimator/PM Date: 9/12/23 Version 09/29/2021 Contractor's Bid for Public Works - 1 =:_CAI Document A310T"' - 2010 Bid Bond CONTRACTOR: (Name, legal status and address) Premium Concrete Services, Inc. 712 Richmond St Elkhart, IN 46516 OWNER: (Name, legal status and address) City of South Bend Board of Public Works SURETY: (Name, legal status and principal place of business) Old Republic Insurance Company P. O. Box 0941 Brookfield, WI 53008-0941 County -City Building Room 1316, 227 West Jefferson Bivd South Bend, IN 46601 BOND AMOUNT: Five Percent of the Total Bid PROJECT: (Name, location or address, and Project number, if any) Splashpad Renovations, Project No. 123-044 This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surely, Owner or other party shall be considered of Total Bid plural where applicable. 5% The Contractor and Surety are bound to [he Owner in the uuoun[ set forth above, for the payment of which tire 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 fidl force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety sliall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond.IF Sigt d and Bead this 7th day of fitness) & September 2023 Conc etc S (P(Seal) Idw� (Title) �O%sunAnN (Witness) rincip• (l'itl ennifer L. t7asznia, /jfCorney-in-Fact ��em„ CAUTION: You should sign an original AIA Contract Document, o ich this teat appears in RED. An original assures that chances will not be obscured. AIA Document AM"' —2010. Copyrlght ©1963, 1970 and 2010 by The AmericanInstitute of Architects. All rights reserved. WARNING: This AleDocument Is protected by U.S. Copyright Law and International Trestles. Unauthorized reproduction or dishibudon of this AIA Document, or any portion of It, may result In severe civil and criminal penanles, and will be prosecuted to the maximum extent possible under the law. Purchasers are perm ed to reproduce ten (10) copies of this document when completed. To repon copyright violations of AIA Contract Documents, a -mail The American Institute of Architects' legal counsel, copyright@aia.org. 061110 AIA Document AM"' —2010. Copyrlght ©1963, 1970 and 2010 by The AmericanInstitute of Architects. All rights reserved. WARNING: This AleDocument Is protected by U.S. Copyright Law and International Trestles. Unauthorized reproduction or dishibudon of this AIA Document, or any portion of It, may result In severe civil and criminal penanles, and will be prosecuted to the maximum extent possible under the law. Purchasers are perm ed to reproduce ten (10) copies of this document when completed. To repon copyright violations of AIA Contract Documents, a -mail The American Institute of Architects' legal counsel, copyright@aia.org. 061110 * 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 (awful 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 Company's surety division, in conjunction with the secretary m 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 (if a seal be required) by any secretary or assistant secretary; or (if) 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 REPUBLICESUXACE COMPANY LA SEAT. "--Agsis ent see�et�� 0 Vice President STATE OF WISCONSIN, COUNTY OF WAUKESHA- SSm" On this 30th day of November 2022 , personally came before me, Alan PavIIC 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. /// OK �• � i i i•. Afro L�� 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. it 8 Signed and sealed at the City of Brookfield, WI this nth day of September 2023 45-5314N SA ORSC IiWil(6-93) ' Assistant Secs L y GIBSON INSURANCE AGENCY, INC. CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Project No. For Bids Due Date: Address: Renovations ifkErLl:I September 12, 2023 PART (Must be completed for all bids. Please type or print) 9/12/23 712 Richmond Street Bidder ): PremiC um oncrete Ser (Firmvices Inc. City/State/Zip: Elkhart/IN/46516 Telephone Number: ( 574) 264-0196 Agent of Bidder (if Applicable): 6100 Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: ialashoad Renovations the City of South Bend, Indiana, in accordance with plans and specifications prepared by: WBK Engineering, LLC and dated 9/12/23 (Enter sum of Total Base for the sum of (enter the Total Bid as shown on the Proposal) &Z au 4440 AA?EAQAWe/JiEU"Tr- q68. 9 25' on Proposal) APO 5-oJ,tot2 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 0. nI (Signature Austin Redding Estimator/ 6. (Printed Name of Person Signing) ACCEPTANCE The above bid is accepted this day of Subject to the following conditions: BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member 20 Joseph R. Molnar, Vice President Jordan V. Gathers, Member Murray L. Miller, Member Attest: Theresa Heffner, Clerk Version 09/29/2021 Contractor's Bid for Public Works - 2 t Premium Concrete Services, Inc. 712 Richmond Street Elkhart, IN 46516 (574) 264-0196 SECTION I EXPERIENCE QUESTIONAIRE 1) PUBLIC WORI<5 PROJECTS COMPLETED IN PAST YEAR: CONTRACT AMOUNT COMPLETIO N DATE OWNER $ 187,300.00 CURB & SIDEWALK 11/10/22 CITY OF ELKHART $ 387,923.00 CURB & SIDEWALK 11/14/22 CITY OF SOUTH BEND $ 217,860.00 CONCRETE PROJECTS 12/31/22 CITY OF ELKHART 2) PUBLIC WORKS PROJECTS IN PROGRESS: CONTRACT AMOUNT COMPLETI ON DATE OWNER $ 570,000.00 STREETSCAPE 6/2/23 CITY OF ELKHART $ 568,005,00 CURB & SIDEWALK 6/16/23 CITY OF SOUTH BEND $ 481,500.00 CURB RAMPS & SIDEWALK 5/26/23 CITY OF ELKHART 3) HAVE NEVER FAILED TO COMPLETE ANY WORK THAT WAS AWARDED TO US. 4) REFERENCES: a. NISOURCE-MR.LUKEBRADLEY-1039PENNSYLVANIAAVESOUTHBEND,IN46601 bI COZIER MANUFACTURING -MR. KEN MURR-402 N MAIN MIDDLEBURY, IN 46540 Premium Concrete Services, Inc. 712 Richmond Street Elkhart, IN 46516 (574) 264-0196 SECTION II PLAN AND EQUIPMENT QUESTIONAIRE 1) Project: Splashpad Renovations —Site Worl<#123-044-Schedule: After given the notice to proceed, Premium Concrete Services, Inc. will review, establish work area and layout area. We will then contact Indiana 811 to locate all utility lines within construction limits. Next will be erosion control, inlet protection, removals, excavation, grading, and underground work with a 3-man crew. Then layout with 2-man crew. Forming, doweling, and pouring of concrete will be next with a 5-man crew. We will also utilize subcontractors for hauling. Multiple crews may be working at the same time. Subcontractors will follow installing signs and applying markings and striping. 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) 1s` Class Logistics — 2213 St Charles Ave South Bend, IN 46614 - Trucking 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 — 4324 Ashard Dr South Bend, IN 46628 —Trucking 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, Wall -behind Saw, Cut-off Saw, Friction Screed, Dump Trucl<I 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. Pien the prospective Contractor is unable to certify to mtp of the statements below, it shall attach an eeplanation to this Affirlrndt. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH ❑RAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNFPED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) sTATe of �N > SS: St. Joe COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: I. Conhactor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding 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 sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency; and 3. Conll-actor has noT, nor has any successor to, nor an affiliate of, Contractor, engaged in nvestment activities in Iran. a. For purposes of this Certification, "Iran" means the government of h-an and any agency CA r 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,OOQ000) or more in value in the energy sector of Iran; or Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($2Q000,000) 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 hran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Version 09/29/2021 Contractor's Bid for Public Works - 4 may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the Man information contained in the foregoing bid for public works are true and correct. Dated this 12th day of Sept. 20 23 Premium Concrete Services Inc. Contractor/Bidder (F' n) Signature o Contractor/Bidder or Its Agent Max Yeakey, Vice President nted Name and Title Pri Subscribed and sworn to before me this I �* day or PT 20 a3 My Commission Expires 1� Nc ary Public I.. County of Residence Lkgfi a J NOTARYU BLIOR SEAL ELKHART COUNTY, STATE OF INDIANA MY COMMISSION EXPIRES FEBRUARY 12, 2026 COMMISSION N0.710399 Version 09/29/2021 Contractor's Bid for Public Works - 6 BID/PROPOSAL CITY OF SOUTH BEND Project Name: Splashpad Renovations Project Number: 123-044 For Bids Due: September 12, 2023 Contractor Name: Premium Concrete Services Inc. SOUTHEAST -BASE BID Item Description Quantity Unit Unit Price Total Amount No. 1 MOBILIZATION AND DEMOBILIZATION 1 LS 7Y 2y S"od 2 CONSTRUCTION ENGINEERING AND 78'� STAKING 1 LS 7SS0 3 TREE PROTECTION 60 LIFT /V 4 TEMPORARY CONSTRUCTION FENCE 265 LIFT e7S (o7ST TEMPORARY GRAVEL CONSTRUCTION cam. 06 5 ENTRANCE 55 SYS (v0 J�3 6 TEMPORARY INLET PROTECTION 1 EACH o2z5-92 225 !E!a 7 TEMPORARY SILT FENCE 0 LIFT $ EX. SPLASHPAD AND EQUIPMENT, REMOVE 50 SYS yC�'—" S� �CO 9 REMOVE AND REPLACE WOOD POST EACH 10 EARTH EXCAVATION, EMBANKMENT AND r22 Oo J$ �./w REMOVAL 0CYS 11 COMPACTED AGGREGATE NO, 53 9 CYS 12 EXISTING CONCRETE SIDEWALK, REMOVE 0 SYS 13 ASPHALT PATH REMOVE AND REPLACE 30 SYS J 3 co 14 SIDEWALK, CONCRETE, 4" 7 SYS (03 ov 7,21 o= 15 SIDEWALK, CONCRETE, 4", W/WELDED WIRE FABRIC 645 SYS 16 SPLASHPAD, CONCRETE, 6", REINFORCED 505 SYS COORDINATION W/SPLASHPAD O aG 17 CONTRACTOR 1 LS (o?d0'�6 G700 18 SLEEVE, PVC, 6" 30 LIFT 1,20 3660'' 19 SLEEVE, PVC, 10" 30 LIFT /5W3 D 20 ELECTRIC SERVICE, COMPLETE 1 LS 7/eo OD ce—P o' 21 ELECTRICAL BONDING, COMPLETE 1 LS ro Gb 22 WATER SERVICE, TYPE K COPPER, 2" 105 LIFT 23 RPZ, COMPLETE 2 EACH ?j700 ao (t7 24 DRINKING FOUNTAIN, COMPLETE 1 EACH 05R:0 GSbO m 25 METER VAULT, COMPLETE 1 EACH 1,52/O✓//! 25 DRAIN PIPE, PVC SCH. 8% 2" 20 LFT 33 :� lD %O 27 DRYWELL, COMPLETE 1 EACH Version 09/29/2021 Contractor's Bid for Public Works - 7 BID/PROPOSAL CITY OF SOUTH BEND Project Name: Splashpad Renovations Project Number: 123-044 For Bids Due: September 12, 2023 Contractor Name: Premium Concrete Services Inc. SOUTHEAST -BASE BID 28 SANITARY SEWER PIPE, PVC SDR 35, 6" 25 1 LFT 7 7 ; 2s 29 CORE AND BOOT EXISTING STRUCTURE 0VEACH r-�� 'e" 30 CLEANOUT, PVC, 6" 1 S:�7S 31 FURNISHED AND PLACED TOPSOIL 35 0o �b po 5ro 32 EROSION CONTROL BLANKET 27033 SEEDING 27034 SODDING 0 O6 SOUTHEAST BASE BID TOTAL ,l ?K 01 l�nnl 111 1 ARr1 _ R4CF Rln Item Description Quantity Unit Unit Price Total Amount No. 1 1 LS / c MOBILIZATION AND DEMOBILIZATION 2 CONSTRUCTION ENGINEERING AND 3�� 3�bb STAKING 1 LS 3 TREE PROTECTION 0 LFT •!290' 4 TEMPORARY CONSTRUCTION FENCE 420 LFT -7S 5 TEMPORARY GRAVEL CONSTRUCTION ENTRANCE 45 SYS .2 7w 6 TEMPORARY INLET PROTECTION 1 EACH "?25oe 7 TEMPORARY SILT FENCE 365 LFT B '� D II 8 EX. SPLASHPAD AND EQUIPMENT, REMOVE 80 SYS 60, 9 REMOVE AND REPLACE WOOD POST 2 EACH75-t% o_ c 10 EARTH EXCAVATION, EMBANKMENT AND REMOVAL 85 CYS 11 COMPACTED AGGREGATE NO, 53 5 CYS $D � 2$0 12 EXISTING CONCRETE SIDEWALK, REMOVE 11 SYS 13 ASPHALT PATH REMOVE AND REPLACE 0 SYS 14 SIDEWALK, CONCRETE, 4" 0 SYS 15 SIDEWALK, CONCRETE, 4", W/WELDED 78 SYS po Q po WIRE FABRIC 16 SPLASHPAD, CONCRETE, 61, REINFORCED 140 SYS 17 COORDINATION W/SPLASHPAD 1 LS p (f G6 CONTRACTOR Version 09/29/2021 Contractor's Bid for Public Works - 8 BID/PROPOSAL CITY OF SOUTH BEND SpuTu oc I ll ;i Project Name: Splashpad Renovations Project Number: 123-044 For Bids Due: September 12, 2023 Contractor Name: Premium Concrete Services Inc. SOUTHEAST -BASE BID 18 SLEEVE, PVC, 6" 0 LFT 19 SLEEVE, PVC, 10" 0 LFT-- 20 ELECTRIC SERVICE, COMPLETE 1 LS S 21 ELECTRICAL BONDING, COMPLETE 1 LS m &coo co 600 22 WATER SERVICE, TYPE KCOPPER, 2" 40 LFT �o Do ?jS� 23 RPZ, COMPLETE 0 EACH 469� 24 DRINKING FOUNTAIN, COMPLETE 0 EACH 25 METER VAULT, COMPLETE 0 EACH 26 DRAIN PIPE, PVC SCH. 80, 2" 0 LFT 27 DRYWELL, COMPLETE 0 EACH 28 SANITARY SEWER PIPE, PVC SDR 35, 6" 90 LFT 29 CORE AND BOOT EXISTING STRUCTURE 1 EACH /000 10G7 0_ 30 CLEANOUT, PVC, 6" 1 EACH O 5730-' 31 FURNISHED AND PLACED TOPSOIL 40 CYS 32 EROSION CONTROL BLANKET 0 SYS —'-- `--' 33 SEEDING 0 SYS 34 SODDING 360 p SYS 30 COQUILLADM BASE BID TOTAL ALTERNATE #1 Item Description Quantity Unit Unit Price Total Amount No. 4 TEMPORARY CONSTRUCTION FENCE 25 LFT 25- 637 10 EARTH EXCAVATION, EMBANKMENT AND r�?So REMOVAL 10 CYS 11 COMPACTED AGGREGATE NO. 4 CYS voJae OSl' .29 14 SIDEWALK, CONCRETE, 4" 60 SYS 31 FURNISHED AND PLACED TOPSOIL 5 CYS _O 20 34 SODDING 41 SYS O ALTERNATE #1 TOTAL � 11. 7o7 � Version 09/29/2021 Contractor's Bid for Public Works - 9 0imBID/PROPOSALCITY OF SOUTH BENDProject Name: Splashpad Renovations Project Number: 123=044 For Bids Due: September 12, 2023 Contractor Name: Premium Concrete Services Inc. Bidder (Firm): Premium Concrete Services Inc. Address: 712 Richmond Street CitylState/Zip: Elkhart/IN/46516 Telephone Number: (574) 264-0196 By V (Signature) Austin Redding (Printed Name of Person Signing) Version 09/29/2021 Contractor's Bid for Public Works - 10 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN ?' FORM MBE-1.0 a ies 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: Bidder: fi[.Zc�iLLf Project Name: Premium Concrete Services Inc. as pa Renovations Total Bid Amount: 0� y(oog, MBE Goal: 1.61% T Page 1 of 1 Name & Address of MBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of MBE Component Percentage of total Bid/Proposal Kennedy Expressline Marcus Northern Construction Dump Trucking 7(0� 4 / gg Austin Reddin (n 9/12/23 Submitted by: 9 Print Name Signature o Date 0 Version 09l29/2021 Contractor's Bid for Public Works - 11 CITY OF SOUTH BEND ° MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN z' FORM WBE-1.0 WBE UTILIZATION PLAN This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE participation. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Project Number: Bidder: 123-044 Project Name: Premium Concrete Services Inc. Total Bid Amount: 71001 7 f7 WBE Goal: 3.83% Page of 1 Name &Address of WBE Primary Contact Person (Namefrelephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of WBE Component Percentage of Total Bid/Proposal Submitted by: Austin Redding, Print Name Signature Version 09/29/2021 Contractor's Bid for Public Works - 12 9/12/23 Date T CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN > FORM MBE-2.0 , EVIDENCE OF GOOD FAITH EFFORTS This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MBE participation. Project Number: 123-044 Date: 9/12/23 Project Name: Splashpad Renovations Bidder: Premium Concrete Services Inc. Contact Person: Austin Redding Telephone: 574-264-0196 Address: 712 Richmond Street city: Elkhart State: IN Zip: 46516 Email: austin@premiumservices.group 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, REODIRE ALL of the followinc 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: http7//www.in.gov/idoa/. GOOD FAITH EFFORTS TO OBTAIN MBE PARTICIPATION The bidder shall initial each item below, as evidence of its good faith efforts to obtain MBE participation in the awarded contract. I affirm that I reviewed the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan and the Indiana Department of Administration's certified list of Indiana Minority and Women Business Enterprises, found on their website X htt://www.in. ov/idoa . I affirm that I have made good faith efforts to select portions of the contract work to be performed by MWBEs, including, where appropriate, breaking out contract work items into X economically feasible units to facilitate MBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available X 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 X 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 X such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a manner reasonably calculated to inform MBEs of subcontracting opportunities and allowed x sufficient time for MBEs to participate effectively. I affirm that I followed up on initial solicitations with interested MBEs. X I affirm that I negotiated with interested MBEs in good faith, including providing such MBEs with adequate information about the plans, specifications and other requirements of the X subcontract. I affirm that I have made good faith efforts to assist interested MBEs in obtaining bonding, X lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 09/29/2021 Contractor's Bid for Public Works - 13 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.g EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested MBEs in obtaining necessary X 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 X 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 mmais next to an or the above oozes. 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 - 14 CITY OF SOUTH BEND i MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN 4w FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MWBE participation. Project Number: Project Name: Bidder: Contact Person: Address: City: Email: Splashpad Renovations Premium Concrete Services Inc. Austin Redding 712 Richmond Street Elkhart State: IN austin@premiumservices.group Date: 9/12/23 Telephone: 574-264-0196 Z;p: 46516 To determine whether a bidder has demonstrated good faith efforts to reach the WBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS 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: htti)://www.in.gov/idoa/. GOOD FAITH EFFORTS TO OBTAIN WBE PARTICIPATION The bidder shall initial each item below, as evidence of its good faith efforts to obtain WBE participation in the awarded contract. I affirm that I reviewed the City of 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 X htt ://www.in. ov/idoa . I affirm that I have made good faith efforts to select portions of the contract work to be performed by WBEs, including, where appropriate, breaking out contract work items into X economically feasible units to facilitate WBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available X means the interest of all WBEs in the scopes of work of the contract. I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform y 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 X such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a manner reasonably calculated to inform WBEs of subcontracting opportunities and allowed X sufficient time for WBEs to participate effectively. I affirm that I followed up on initial solicitations with interested WBEs. X 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 x subcontract. I affirm that I have made good faith efforts to assist interested WBEs in obtaining bonding, X lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 09/29/2021 Contractor's Bid for Public Works - 15 '' �9pHTH Q O CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested WBEs in obtaining necessary equipment, supplies, materials, or related assistances or services, where X appropriate. I affirm that I did not reject any WBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. X CONTRACT RECORDS: The bidder has maintained the following records for each WBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MWBE was unqualified to perform the job. *Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 09/29/2021 Contractor's Bid for Public Works - 16 VTH ^�4 a CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2. I e� MBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact MBEs. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. Attach additional pages if necessary. PAGE,J.OF 1 Project Number: 123-044 MBE Participation Goal 1.61% Project Name: ❑;A�or- MBE Firm Splashpad Renovations Premium Concrete Services Inc. Owner or Contact at MBE Firm Telephone: Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT Email: RESULTS OF CONTACT WITH THE MBE FIRM: MBE Firm Newspaper Advertisement South Bend Tribune Owner or Contact at MBE Firm N/A Telephone: (800) 220-7378 Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: All Scopes RESULTS OF CONTACT WITH THE MBE FIRM: NO seekers to the advertisement Version 09/29/2021 Contractor's Bid for Public Works - 17 CITY OF SOUTH BEND'. MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN; FORM MBE-2.1 WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE I OF 3 Project Number: 123-044 WBE Participation Goal 3.83% Project Name: Splashpad Renovations Bidder: Premium Concrete Services Inc. By:Estimator/PM 9/12/23 WBE Firm Hawk Enterprises Inc. Owner or Contact at WBE Firm Caylee Carlson Telephone: (219) 662-8090 Fax: (219) 662-8093 Email: Caylee@hawk-inc.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Electrical RESULTS OF CONTACT WITH THE WBE FIRM; NOt In OUr SCOpe Of Work. WBE Firm BUC Construction Supply Owner or Contact at WBE Firm Teresa Butler Telephone: (765) 412-3484 Fax: Email: tC@bucconstructionsupply.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Construction Materials RESULTS OF CONTACT WITH THE WBE FIRM: Email with read receipt and n0 reply. Version 09/29/2021 Contractor's Bid for Public Works - 18 ��u'rrr PFN , o CITY OF SOUTH BEND G'+ MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.1 WEE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE 2 OF 3 Project Number: 123-044 WBE Participation Goal 3.83% Project Name: Splashpad Renovations Rirlrlor Pramium Concrete Services Inc. wBE Firm Anderson Concrete Pumping Owner or Contact at WBE Firm N/A Telephone: (219) 841-9371 Fax: Email: dispatch@andersonpump.com TYPE OF WORK SOLICITED FOR THIS PROJECT: COnCrete PUmpinq RESULTS OF CONTACT WITH THE WBE FIRM: No reply-10,I91 lai,'.t here WBE Firm Newspaper to +kouBend Tribune Owner or Contact at WBE Firm N/A Telephone: (800) 220-7378 Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: All scopes RESULTS OF CONTACT WITH THE WBE FIRM: No seekers t0 the advertisement Version 09/29/2021 Contractor's Bid for Public Works - 18 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN J FORM MBE-2.1 WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE___3__OF 3 Project Number: 123-044 WBE Participation Goal 3.83% Project Name: Rirlrlor Splashpad Renovations PrAn him C:nnrrr:fe Services Inc. WBE Firm Slussers Green Thumb Inc. Owner or Contact at WBE Firm Carollyn Slusser Telephone: (219) 326-8010 Fax: Email: nts@slussers,com TYPE OF WORK SOLICITED FOR THIS PROJECT: Restoration RESULTS OF CONTACT WITH THE WBE FIRM: NoReply WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: Version 09/29/2021 Contractor's Bid for Public Works - 18 Austin Redding From: Austin Redding Sent: Monday, August 28, 2023 11:34 AM To: nts@slussers.com Subject: Request for Quote - South Bend Splashpad Renovations Hello, We would like to request a quote for restoration for the project in the link below. We would appreciate a proposal no later than Sept. 8". If you choose not to we would also appreciate that you could let us know that as well. https•//www dropbox com/scl/fo/oiux9zbgvlfao608g24t6/h?rlkey=stzpa74gdg5b9awwui4pfciad&dl=0 Thanl<you i{ustia Austin Redding Estimator/Project Manager Premium Services 712 Richmond St. Elkhart, Indiana 46516 office: (574) 264.0196 Cell: (574)370.7909 Fax:(574)266-5392 http://www.premiumservices.group/ Find Us On The Following Platforms: 14YC'Lt8 I Austin Redding From: Austin Redding Sent: Monday, August 28, 2023 11:41 AM To: tc@bucconstructionsupply,com Subject: RFQ - VPA Splash Pad COSB Teresa, We are bidding a project and if you could provide us any material for the project in the link below we would appreciate. https://www dropbox com/scl/fo/oiux9zbgvlfao608g24t6/h?rlkey=stzpa74gdg5b9awwu'4pfcoad&dl=0 If you choose not to quote let us know, otherwise we would appreciate the quote no later than Sept. 8`h Let me know if you have any questions. Thanks �{ustia Austin Redding Estimator/Project Manager Premium Services 712 Richmond St. Elkhart, Indiana 46516 office: (574) 264-0196 Cell: ( 574)370-7909 Fax:�574)266-5392 http://www.premiumservices.group/ Find Us On The Following Platforms: #ERo Austin Redding From: Austin Redding Sent: Thursday, August 31, 2023 8:08 AM To: dispatch@andersenpump.com Subject: Contact for quote Could you please put me in contact with someone who can provide a quote for a project that requires a WBE for the City of South Bend. Thanks �ustiy Austin Redding Estimator/Project Manager Premium Services 712 Richmond St. Elkhart, Indiana 46516 office: (574) 264-0196 Cell: (574) 370-7909 Fax: (574) 266-5392 http://www.premiumservices,group/ Find Us On The Following Platforms: .11�. .,fir"vr�w Austin Redding From: Caylee Carlson <caylee@hawk-inc.com> Sent: Friday, September 8, 2023 1:44 PM To: Austin Redding Subject: RE: South Bend Splashpad Renovations Hi Austin, That's not our scope of work. We appreciate the opportunity to bid Thank you! Caylee Carlson Hawk Enterprises, Inc. 1850 E North St Crown Point, IN P 219-662-8090 F 219-662-8093 From: Austin Redding <Austin@premiumservices.group> Sent: Friday, September 8, 2023 10:59 AM To: Caylee Carlson <caylee@hawk-inc.com> Subject: South Bend Splashpad Renovations Caylee, I was curious if you guys had any quotes for the attached project in regards to the electrical work or if you wou Id want too. It bids next Tuesday. Its not too much work. Bonding and running a 120 circuit from an existing with a ground box. Thanks Ageo Austin Redding Estimator/Project Manager 00 Premium Services 712 Richmond St. Elkhart, Indiana 46516 Office: (574) 264-0196 Cell: (574) 370-7909 Fax: (574) 266-5392 4324 Ashard Drive •South Bend, Indiana 46628 TELEPHONE: (574) 876-8881 • FAX: (574) 272-2302 EMAIL: kennedvexpressline@vahoo.com WEBSITE: www.kennedvexpressline.com DBE/MBE Certified September 1, 2023 Austin Redding Premium Concrete Services 712 Richmond Street Elkhart, Indiana 46516 Rr✓, : City of South Bend Splashpad Renovations Dear Mr. Redding, Kennedy Expressline Trucking was established in 2002 and has been serving the South Bend/Mishawaka region (Michiana Area) for over twenty years. Our regular rate is $121/hr. If overtime is needed, it will be an additional $17 for a total of $138/hr. Quad rates will be $131/hr. If overtime is needed, it will be an additional $17 as well, for a total of $148/hr. Our MBE/DBE rates are $125/hr. If overtime is needed, it will be an additional $15 for a total of $140/hr. Quad rates will be $135/hr. If overtime is needed, it will be an additional $15 as well, for a total of $150/hr. In addition, when driving over fifteen (15) miles, we require thirty -minute drive time to the job site, and thirty -minute drive time returning to South Bend, equaling a total of one (1) hour drive time. These are our 2023 rates. Prices are negotiable. Thank you for this opportunity to collaborate with you. If I can be of any further assistance, please feel free to contact me. Sincerely, Marcus Northern Owner LOCALiQ South Bend Tribune I The Herald Times The Times -Mail I Evening World The Reporter Times Account Number: 1020398 Customer Name: Premium Services Customer Address: Premium Services 712 Richmond ST Elkhart IN 46516-3785 Contact Name: Staci Froman Contact Phone: Contact Email: staci@premiumservices.group PO Number: Product #Insertions Start -End Category SBN South Bend Tribune 2 09/06/2023 - 09/10/2023 Public Notices SBN southbendtribune.com 2 09/06/2023 - 09/10/2023 Public Notices Order Confirmation Not an Invoice Date: 08/31/2023 Order Number: 9233758 Prepayment Amount: $ 0.00 Column Count: 1.0000 Line Count: 21.0000 Height in Inches: 0.0000 Order Confirmation Amount $85.16 ' 1/2 Ad Preview BID NOTICE SEEKING MBE/WBE Subcontractors Premium Concrete Services, Inc. DBA Premium Services, an EEO Employer, is seeking proposals from qualified MB E/WB E subcontractors and suppliers for the following project: VPA Splashpad Reno- vations, Project No. 123-044 for the City of South Bend. All proposals must be received prior to 2:OOPM on Monday, September 11th, 2023. Anyone interested in bidding on this proiect please call: (574) 264- 0196 or email. austin@premiumservices.group for plans and specifications. Hspaxlp 2x 9:6 9:10 • •' t 1 V v Project Name Splashpad Renovations Project No. 123-044 For Bids Due September 12, 2023 Contractor Name: Premium Concrete Services Inc. The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 63 of The Responsible Bidding Ordinance No. 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 31"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 s re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 02/23/2022 General Conditions - 10 POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder and all subcontractors on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and esponsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 02/23/2022 General Conditions - 11 PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements: (i) X By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. X By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (b) Attachments: (i) X Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) X Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. (iii) X List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. (iv) X For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. Version 02/23/2022 General Conditions - 12 II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: (i) _ By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) _ By checking this box, I hereby acknowledge and ensure that I and all sub- contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore, I acknowledge my understanding that it is my responsibility to ensure that all sub -contractors have the necessary licenses to undertake the work called for in this bid. If a sub- contractor loses their license at any point, it is the responsibility of that sub- contractor to notify the City. (b) Attachments (i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (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: 9/12/23 (Sign Here) Austin Redding (Print Name Here) Premium Concrete Services Inc. (Name of Company) 712 Richmond Street (Address of Company) Elkhart Indiana (State) 574-264-0196 (Telephone Number) Version 02/23/2022 General Conditions - 14 CITY OF SOUTH BEND 1AMES MUELLER9 MAYOR DEPARTMENT OF PUBLIC WORKS ERIC HORVATH, DIRECTOR May 30, 2023 Rob Becker Premium Concrete Services rbecker(cre,premiumconcreteonl ine.com RE: Pre -Qualification Verification Dear Mr. Becker: This letter serves as verification of Pre -Qualification status of your company for bidding with the City of South Bend. This Pre -Qualification status is effective for twelve (12) months from the date of this letter. Thereafter you are required to re -submit a complete application for continuation of pre -qualification status prior to December 31 for the upcoming calendar year. A copy of this Verification Letter must be included with every bid exceeding $150,000 submitted to the City of On Bend Boatd 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, /ate 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 2 page document consisting of the following records filed in this office: Certification Date: September 12;'2023 Business Name: PREMIUM CONCRETE SERVICES, INC. BusinesslD; 2004120100105 -, Transaction 1- Date Poled f No. of pages Business Entity Report 09/06/2022 � 2 Total No of pages � 2 In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the City;of Indianapolis, September 12, 2023 DIEGO MORALES SECRETARY OFSTATE 2004120100105/ 16010784 All certificates should be validated here: https://bsd.sos.in.gov/ValidateCertificate Expires on October 12, 2023. Page 1 Of 3 CertificnlelD:16010784 APPROVCll AND C'ILED FIOLLt SULLIVAN i INDIANA SECRETARY OF STATE 09/O6/2022 02:25 PM _ ;' Bt7SINES� E11�'i'111?EPORT , , ,. ., iVA�i>;"ANDP1tINGIPAL OFF.ICP ADUR>`SS BUSINESS ID 2004120100 LOS BUSINESS'P)'PE Domestic For -Profit Corporation BUSINESS NAME PREMIOM CONCRETE SERVICF,S, INC. ENTITY CREATION DATE II/24/2004 JUR1SDiCTION OE FORMATION Indiana PRINCIPAL OFFICE ADDRESS 712 RICIiMOND S'f, ELICHART, IN, 46516, USA YEARS EFFECTING DATE EFFECTIVE'PIMG 2022/2023 09/06/2022 2:25 PM w REGIST>;�D OEhLCE�ND.�TDliD65 �.., 7. „, �� .. -� , � �. „ ,. , ., , ....., ,. �. ,...�' ., REGISTGRCD AGENT TYPE InAicidual NAME MAX A. YEAKEY ADDRESS 712 Richmond Street, Elkhart, IN, d6S16, USA GO_Y_�,BNI�1T0�7GI2�ON rv� RyAMA't'ION � l r TITLE President NAME ADDRESS 'PPI'LE NAMI? ADDRESS I3ecky L. Yeakey 712 Richmond Street, Etkhart, IN, 46516, USA Vice President Max A. Yeakey 712ltichmond Street, Elkhart, IN, 4651G, USA Page 2 Of 3 CcrtificaLeID:16010734 - Page l of 2 - APPI20VCD AND F[I_,GD HOLLI SULLiVAN INDIANA SPCRETARY OF STATE 09/O6/2022 02:25 PM IN WITNESS WHEREOF, THE UNDERSIGNED HE,12413Y VERIFIES, SUR.IECT TO THE PENALTIES OF I'EI2JURY, THAT THE STATEMEN'PS CONTAINED HP_REIN ARE TRUE, THIS DAY September 6, 21122. THE UNDERSIGNED ACKNOWLEDGES THAT A PERSON COMMITS A CLASS A MISllEM EANOR HY SIGNING A DOCUMENT TiIAT'I'HE PERSON KNOWS IS FALSE IN A MATERIAL RESPECT WITH 'PHE INTENT TI(A'I"PHE DOCUMENT 6E Df?LI VERED TO TH8 SECRETARY OF STATE FOR FILING. SIGNA'PURG /sl Matlbem A. Yenkey 'IT'CLg Legal Representative [3usincss ID : 2004120100105 Filing No.: 9549531 Page 3 Of 3 CertificatelD:16010784 -Page2of2- Certificate of Assumed Business Name of HAMIUMAAA-1121 WE 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 named 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. HOLLI SULLIVAN SECRETARY OFSTATE 2004120100105/9591594 To ensure the certificate's validity, go to https://bsd.sos.in.gov/PublicBusinessSearch Page 4 Of 5 Cer[ificateID:15712440 APPROVED ANll AILED HOLLI SULLiVAN INDIANA SECRETARY OF STATE 10/l2/2022 08:45 AM 1VAil4E -�'� CERTiFICA'FGOP A�SSTIN7Eri,=BDSZIYGSS :%:„.. ?v ;-.: � , �. �, .. ,;: < .�;,. IN'i1MN, A,NA PRINCIPAL OOErd^ICG x1UpR1~:SS BUSINESS 1D 2004I20100105 BUSINESS'CYPE Domestic Por-Profit Corporation BUSINESS NAME PREMIUM CONCRETE SERVICES, INC. PRINCIPAL OFFICE ADDRESS 712 RICHMOND ST, ELKHART, 1N, 4(516, USA EFFECTIVE UATE EFFECTIVE TIME 10/I I/2022 04:58VM ASSIF,�4CD�rAM�u13�`llAUD13LS$ i-�' ,�„_,..,,,., „„1 ,.,y...,._.., ,, _.._..,.,. ,„ ..",, �,� .,, _,... �,,. .., r.�, ,�, .... ., „ y��. _, . Premium Services 712 Richmond Sveet, Elkhart, IN, 4b516, USA SZGILA'PDRP, � � ,,, IN WITNESS WHEREOF, THE UNDERSIGNED HEREBY VERIFIES, SUEJECT TO THE PBNALTIES OF PERJURY,'I'HAT THE STATEMENTS CONTAINED HEREIN ARE TRUE, THIS DAY October• I I, 2022. ThdE UNDERSIGNED ACKNOWLEDGES THAT A PERSON COMMITS A CLASS A MISDEMEANOR BY SIGNING A DOCUMENT THAT THE PERSON KNOWS IS FALSE IN A MATERIAL RESPECT WTTH TFIE INTENT'CHAT THE DOCUMENT AE DELIVERED TO TI-]E SECRETARY OF STATE FOR FILING. SIGNATURE TITLE Saulo 1. Delgado Legal Representative Business ID : 2004120100105 Filing No.: 9591594 Page 5 Of 5 CertificateLD: 15712440 -Page I of I - D F - F - 3 � 3 E F £ (N R+ R � F F w £ _ a nm n a d = v v v a F F _ F 3 R-39514 LaSalle &Marquette Southeend INDOT $ 210,779.59 Sldewallc,ADAcompBant 1902 T-40046 A Traffic Signals Ft, Wayne INDOT $ 199,735.00 Curb, curb & gutter, sldewaiks, HMA patching, PCCP patching, curb ramp, 1914 detectable warning surfaces South Bend Waterworks South Bend City of South Bend S 79,121A0 Various concrete/asphalt utility repair work 1936 R-40913 Howe, IN 5R12 Howe 114DOT S 57,989,85 ConcreteAsubstructure,Concrete0footings, reinforcing bars epoxy coated. 1929 Cityof Elkhart -Various Elkhart Cityof Elkhart $ 70,171.05 Various concrete curb, sidewalk &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. also conducts business as Premium Services, Max Yeakey Vice -President 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 05/23/2023 11:15 AM FAX 8122795545 ILTI FAX INDIANA LABORERS' TRAINING TRUNT.FUND 0002/0008 Da A, Frye Secretary-Treaxnrer lerryJ. Bolk Chris Brickcy Ricky Henson, Jr, Raman Mendoza, Jr. Brian Short P.O. Box 758 -Bedford, )!ndtana 4742f (812)279-9751 May 23, 2023 To Whom It May Concern: Sean Coakley, nirectnr Jnhn P. Brown Chairman Kelly Abel Michael Ferrara Staa .Meyer Nick Timmerman Jun Wiseman FAX: (8t2) 279-5545 Toll Free (800) 742-4086 This letterrs to confftm that "Premium Concrete Services, inc." is a signatory contractor 1n good standing with the Indiana Laborers' Training Trust Fund. "fhe above -mentioned company is a participant in the Joint Apprenticeship and Training Committee through this Union and has been an active participant in good standing for each of the past five phis consecutive years, and is currently eligible to use our apprentices on a project. Further, our organization's program is approved by the U.S. Veterans Administration to participate in the GI 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) Journey workers and thereafter may not employ more that (1) Apprentice for every (3) Journey workers. Sincerely 1 Sean Coakley, Director SC:ap www.lndianalaborerslrainir:g. nrg a 0 0 0 0 i JO Ag CS Q t61 a anio lurammt (fiertiffratt of Y 1 10 1' I,1'ALANA T•ARORER`5 TRElIhING TRUST FUNi3 EEDFORD, INDIAPiA for the trade classification of COtVSTRt;CTIflIr' CRAFT i.kROREA ✓�e�isfereo� as parf o� lie `�'afionat� ✓,xppren�ices�ip � ro�ram in accorotance wAnf fnfe basic s2(rtnoGr4dsr of apprenlicesAip esfa6.1is.6edr 6y the c5ecrefary o� La6or December i4, 1995 Det I_V040-0523 .� y::7mson a,:o. �. XL c�� y rain. Liueh�% a,,Qu of d'i,Spxrs� 05/23/2023 11:16 AM FAX 8122795545 ILTI FAX OG04/0008 STATE F INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W-460 INDIANAPOLIS, INDIANA 46204-2739 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund-Apprcnticesbip 439 Patton Hill Rd, Bedford, IN 47421 Dear 7eremy 13rcwer, Erlc Holcomb, Governor James M. Brawn, Diroctor ^� 7anuary 9, 2019 The Indiana State Approving Agency cozlductcd a supervisory visit on 01/$/2019 at Jndiana Laborers Training Trust Fund Apprenticeship. The purpose 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 maintenatce 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-$794, work processes, and wage scale. If you need any assistance or have any questions rel;alding this technical visit please contact me directly at igriffm( dvaan.gov or (317) 234-3916. Thank you for the courtesy extended during my visit. The education and training opportunities that your organization continues to provide veterans and their dependents are appreciated. Sincerely, Tanigtta Griffin Program.l�irector Phone (317)-234-6062 Toll Free (800)-400.4520 Fax (317)-234-R744 05/23/2023 11:16 AM FAX 8122795545 ILTI FAX Irj.0005/0008 STATE UF IN IN DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W469 INDIANAPOLIS, INDIANA 45204=2738 Jercmy Brcwer Apprenticeship Coordinator Indiana Laborers Training Trust rwrd-Apprenticeship 439 Patton Hill Rd, Bedford,1N 47421 Dear Jeremy Brewer, Eric Holcomb, Governor James M. Brown, Director January 93 201> This wi11 acknowledge receipt of yout updated Wage Scale for the Construction Craft !Laborer prograaxz offered by Indiana Laborers 'Training Trust Fund -Apprenticeship. The State Approving Agency has reviewed the document as listed bolow: Wage Scale: Construction Craft :Laborer FACiI,l'1'Y CODE: 30004114 To the best ol:•my larowledge Indiana Laborers Training Trust Fund -Apprenticeship does not utilize erroneous or misleading advertisement, either by actual statement, orrzission, or mtimation, It is understood by Indiana Laborers Training Trust riin l-Apprenticeship that they will maintain a complete record of all advertising utilized by or on behalf of the Indiana Laborers !'raining Trust Fund -Apprenticeship in regards to their training programs during the preceding 12 months. Indiana Laborers Training '!'rust Fund-Apprenticeship`s advertising will be available for review by any and all firture supervisory visits by the SAA, or the U.S. Department of Veteran Affairs, Please Review the entire packet ien• contezrt and accuracy. Approval is granted pursuarrt to the provisions of Title 38, tJ.S. Code 3687, with an e.Ffective date of April 1, 2018. Tf you have any questions, please feel f$ee to give me a call at 317-232�3916 or email me at tgriffur@dva.in,gov. Tharrk you fiat what you do fot our Veterans, and have a great day! Sincerely, 'i'aniqua Griffin Program Director State Approving Agezrcy Cc: VAR0/HT,R. 57q �J �AAnRo�NG 05/23/2023 11:17 AM FAX 8122795545 ILTI FAX @1oo06/0008 STATE OF INDINA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W-409 INDIANAPOLIS, INDIANA 46204-2738 .Teremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton Hill Rd. Bedford, IN 47421 Deu• Jeremy Brewer, Eric hlolcomb, Governor James M. Brown, Dimc.tor January 9, 2019 This wiil acknowledge receipt ofyoru• ravised •Work Processes for the Construction C1•aff Laborer program offered at Hoosier Energy, located in Bedford, Indiana. The State Approving Agency has reviewed the docwvent as listed below: TRAINING PROGRAM LENGTii DOT CUDE Construction Craft Laborer FACILITX CUI]E: 30004114 4,000-7800 howl 47�2061.00 To th.e best of rrty knowledge Indiana Laborers Training Trust Fund -Apprenticeship does not utilize erroneous or misleading advertisement, either by actual statement, omission, or intimation. It is understood by Indiana Laborers Training'ITrust FTtnd-Apprenticeship that they will maintain a complete record' of all advertising utilized by or on behalf of the company in .regards to their training programs during the preceding 12 months.The company's advertising will be available fox review by any and all future supervisory visits by the SAA, or the U.S. Department of Veteran Affairs, This approval is made pursuant to and under'tlte provisions of Tille 38, U. S. C.ode 3687, with art effective date of January 8, 2019. If you have any questions, please contact me at 317-232"3916. Sincerely, Taniqua GriffinGriffinProgram lairector State Approving Agency Ce:VARO/F.I.R - 7^ i� Jq TQ; 40 <62/ IL a Phono (3l7)-294-6Uf2 To11 Frce (800)-400-A.520 Nax (377)-234-8744 05/23/2023 11:17 All FAX 8122795545 ILTI FAX 4407/0008 Apprentice Status Report By Indenture Date Apprentices Indentured Between 1/1/2018 And W1312022 Apprentice Program: IN2 Year Apprentice Status Apprentices Percentage zuIU 2019 AEtiye. 1 4 IF fi8 i 1 8.05%. Active Duty 2 0,24 % Adv. to Jommeyman r 89. ' ,,, iO:Sd'%, Deceased 5 0,59 % GraduatedI IF I 71 8.4D 00 ... -. Inactive 10 9oGYIleVman::. '.. 2Med. Susp, i 6uspended 7..hated;.,'.oluntary 1OM withdraw 38 TotalIndentured 845 Adv. to Journeyman 72 7.70 % Graduated 51 5,45 % IF InaetFYL., Journeyman 12 118 % IF IF 2 Reinstate 15 OFF 1.60 F Via I IF Or IF Terminated 528 56,47 % voiun[ary wtcngraty 6.8 7.27 TotalYndentured 935 noted: Wednesday, July 73, 2022 Page 1 of 2 05/23/2023 11:17 AM FAX 8122795545 ILTI FAX @J0008/0008 Apprentice Status Report By Indenture Date Apprentices Indentured Between 111/201 B And 7/13/2022 Apprentice Program: IN2 Year Apprentice Status Apprentices Percentage 2020 2021 2oa2 Act ve: :.:..:::. ... .. : 242::.. L Adv. to Journeyman 33 4,95 % Deceased , .. .... 2 .: ' ' 0301% Graduated 3 0.45 % Journeyman . .. 1 A l5. °1a Med. Susp. 4 0,60 NQt:ReBISICCCd. , . 1 '. ....:..' D YS Reinstate 12 1,800/0 SuspOnAAA . ; .... :.:....:. ... ..... 3 ,'...-: 0.45.% Terminated ....�W...__.........._..._... .._�,�...._ 3291 4933 % Voluntary withdraw FF37 5655 "/a Total Indentured 687 Active Duty 1 0,13 % Adu: to 7oumeyman 23 197 % Deceased 2 0.26 Metl, silsp:. .... " 3 . 0.39,%q Reinstate 20 2.58 % Suspended. ' 2 0 2fs:°7o Terminated 220 28.39 % voluntary wtNd�aiei.:':.: 4.13'!yo Tvital Indentured 77S ' Adv. to Journeyman 4 0,65 /° GOdiiated F, FF L IF F FF FF'L' 0.16 %, Med. Susp. 2 032 % Not Registered, 5.. 0681.4(°vwppqq Reinstate 1 331 5,32 % ...: Terminated. '; 32 5.16 % Voluntary withdraw 5 0,81 % Total Indentured 620 Prlmed: Wpdnesdny, July 13. 2022 Page 2 0! 2 Plasterersat cement Masons' Apprenticeship Coordinator Local Union #692 To Whom it May Concern: Phone: (mj t07-7767 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 -,� Plasterersat Cement Masons' Apprenticeship Coordinator Local Union #692 Local 692 Apprenticeship Summary Year 1St 2nd 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: kMj ,07-7767 Email: bkristoff@plcmlocal692,org 9200 Louisiana Street Merrillville, Indiana 46410 WWW.PLCMLOCAL692.ORG ° N yhi wvv PILL Aj7p ' N 4A Ad 'IN fi 1 �Tp� # 1 td y O" g 4� Tr. NN�A '� V�t� Y zs ;'gib 2G� f ��,j- 6-I,�".. a, -L'-� 1 '� .Y �.y�`.Y a`' ...4 �r f .v, i sue- ,. �2.. ` r„J" i& PT =Dr THE TRADE C_AsSIFICA ONS. cHsnE-n-'-,� SCN: P�s.sTERER l' �,O4SptiTII A 1316 COUNTY -CITY BUILDING a414x PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD IflR� °� FAX 574/ 235-9171 SOUTHBEND, INDIANA46601-1830 TDD 574/235-5567 CITY OF SOUTH BEND, JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Date: September 7 2023 To: All Planholders From Theresa Heffner, Clerk, Board of Public Works Subject Addendum Number: I Project Name: Project Number: VPA 2023 Splashpad Renovations ACKNOWILIE�G�jEMEN'I' Date Received: G / /-7 [ /Z3 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) 2354171 within 48 hours of receipt. A copy MUST also be included with your bid package upon submittal. TffiS ADDENDUM MAY AFFECT YOUR SID. Notes: The attached documents ale hereby added to the Specifications and Contract Documents and become apartrt of herein. Company: Authorized Si Date: / Version 4/2/2015 i.i it • : 9���1[a�l■C�cNI PREMIUM CONCRETE SERVICES, INC. Elkhart, Indiana DECEMBER 31, 2022 Page Number INDEPENDENT ACCOUNTANTS' REVIEW REPORT .............................................. 1 FINANCIAL STATEMENTS BalanceSheets.................................................................................................... 3 Statements of Income and Retained Earnings...................................................... 5 Statements of Cash Flows.................................................................................... 6 Notes to the Financial Statements........................................................................ 7 SUPPLEMENTARY INFORMATION Schedule I — Direct and Indirect Contract Costs ................................................... 13 Schedule II — General and Administrative Expenses ............................................ 14 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 09/07/2023 Name Patrick Sherman Department Public Works BPW Date 09/12/2023 Phone Extension 5601 Review and Approval Required Prior to Submittal to Board Diversity Compliance ❑ Officer Name and Inclusion Officer BPW Attorney ® Attorney Name Dept. Attorney ❑ Attorney Name Purchasing ® Mickey Lovy Check the Appropriate Item I Professional Services Agreement ❑ Contract ❑ Open Market Contract ® Bid Opening ❑ Quote Opening ❑ Proposal Opening ❑ Chg. Order, No. I-1 Other: Michael Schmidt ❑ Amendment/Addendum ❑ Bid Award ❑ Quote Award ❑ C/O & PCA No. ❑ Traffic Control Information All Submissions U Proposal ❑ Special Purchase, QPA ❑ Req. to Advertise ❑ Title Sheet ❑ Reject Bids/Quotes ❑ PCA ❑ Resolution Ease./Encroach Company or Vendor Name TBD ❑ Yes❑ If Yes, Approved by Purchasing New Vendor ❑ No ❑❑ MBYes MBE/WBE Contractor E Completed E-Verify Form Attached ❑ No Project Name VPA 2023 Splashpad Renovations Project Number PROJ00000446 Funding Source PR-00026702 Account No. 456-10-101-121-444000--PROJ00000446 Amount TBD Terms of Contract Project Bid Purpose/Description Construction for two splashpads in City parks at Coquillard Park and Southeast Park. For Change Orders Only 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: