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Opening of Bids - City of SB Wayfinding Signage Prog. Phase III Proj No. 123-013 - Geograph Industries, Inc.
CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name City of South Bend Wayfinding Signage Program Phase 3 Project No. 123-013 For Bids Due December 12, 2023 PART I (Must be completed for all bids. Please type or print) Date: 12-1 W102S Bidder (Firm): Gsixmeii trJtu-,Tmes;S JWC. Address: 415- IW0V$ R_iAL M. City/State/Zip: HAAR%5014, Oi-i LC5030 Telephone Number: ( S13 } 207-9200 Agent of Bidder (if Applicable): NSA► Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: C: r N at: SaN LA ► BCtAO W 14y F rht©i 146, '&6, ,i A(,C Paw-Ayn PHO Slz 3 PLL;Sse'T Nu . i Z-1 01 3 the City of South Bend, Indiana, in accordance with plans and specifications prepared by: '3'bt4r,,s FMF- "r-iNsKI and dated for the sum of (enter the Total Bid as shown on the Proposal) ;vM-Aut4wOFOUR-THoUsP)LJr> i HR0-NuN�T�vL ar�D 00/ao $ 2Dw, 3 12, w (Enter sum of Total Base Bid plus Alternates shown on Proposal) (Numerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a eparate attachment. By efi, - ignature) ��G c Fed-00IG i R. MSrCQJC (Printed Name of Person Signing) The above bid is accepted this Subject to the following conditions: BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member ACCEPTANCE day of 20 Joseph R. Molnar, Vice President Allie Dolz-Lane, Member Murray L. Miller, Member Attest: Theresa Heffner, Clerk Version 07/19/2023 Contractor's Bid for Public Works - 2 ,4 lbw CITY OF SOUTH BEND, INDIANA `x 1ae_ CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name City of South Bend Wayfinding Signage Program Phase 3 Project No. 123-013 For Bids Due December 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 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 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 MNIIBE Contacted Forms [MBE-2.1 and WBE-2.1]. Acknowledge Receipt of O 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. ✓ 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: G"r PIS fn10• i t4C • _ By Authorized Representative: Signature: _ C Print Name & Title: 6R94 �_�:-,�4����_sioGWT" Date:-11-Zo2 Version 07/19/2023 Contractor's Bid for Public Works - 1 PART II (For projects of $100,000 or more — IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/her/its bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 07/19/2023 Contractor's Bid for Public Works - 3 When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIIVIINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF 6"1D ) ) SS: NAmtuw- l COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Version 07/19/2023 Contractor's Bid for Public Works - 4 Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, firms, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of contract or employment, or any matter directly or indirectly related to contracting or employment because of race, sex, religion, color, national origin, ancestry, gender expression, gender identity, sexual orientation, or due to age or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions will consider the Contractor's good faith efforts to obtain participation by those subcontractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. Contractors seeking the award of a City contract cannot be required to award a subcontract to an MWBE; however, they may not unlawfully discriminate against said MBE/WBE. On goal -eligible contracts, Contractors are required to either meet both MBE and WBE utilization goals or demonstrate that the Contractor has made good faith efforts to obtain participation from MBE and WBE subcontractors. A finding of noncompliance or a discriminatory practice shall prohibit that Contractor from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact to which the discriminatory practice or noncompliance pertains. 7. The undersigned Contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder Version 07/19/2023 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. pfir- 10- Dated this I I day of 20 23 Q,EoGRAPja t nitJ s-M—tES` Contract Bidder (Firm) C Signature of Contractor/Bidder or Its Agent GRFfi C F4a.tt>l6M , PR Save lr Printed Name and Title Subscribed and sworn to before me this tfi t day of QCC4J1K310L , 20—Zl My Commission Expires .Z S.Za2 _ Notary ublic County of Residence 140rn1Ln>_0 Gc.. GREGM J FREUDIGER Notary PUW, State of Ohio My Co m"m E*M: 02-25.2025 Version 07/19/2023 Contractor's Bid for Public Works - 6 BID/PROPOSAL CITY OF SOUTH BEND Project Name: City of South Bend Wayfinding Signage Program Phase 3 Project Number: 123-013 For Bids Due: December 12, 2023 Contractor Name: BASE BID Item Description Quantity Unit Unit Price Total Amount No. 1 MOBILIZATION AND 1 LS 4,®^crJ �, y,o25.m DEMOBILIZATION 2 COMMON EXCAVATION, 38 CYS UNDISTRIBUTED 3 Gx-1, VEHICULAR GUIDE 6" SIGN 3 EACH c% �i S- ' 2 7,9 L15 , ASSEMBLY 4 CONCRETE FOUNDATION 6 EACH INCIDENTAL 0 WBREAKAWAY .2 PER SIGN TO ITEM 3 5 Gx-3, VEHICULAR GUIDE 4" SIGN 8 EACH ao �'��� css a ASSEMBLY 6 SIGN POLE FOUNDATION 8 EACH INCIDENTAL 0 TO ITEM 5 7 Gx-5, VEHICULAR TRAILBLAZER SIGN 1 EACH ON EXISTING POLE)2'��'� 8 Gx-5a VEHICLUALR TRAILBLAZER 1 EACH 1,650.00 1.5, 0•`A SIGN SIGN ONLY 9 EXISTING SIGN AND FOUNDATION 2 EACH 1`y�"ty REMOVAL 10 I-1 PRIMARY GATEWAY SIGN 2 EACH 1.7 035 co ' 34, 0?p-' ASSEMBLY ALTERNATE #1 — MCKINLEY GATEWAY SIGN Item Description No. 1.1 EXISTING SIGN AND FOUNDATION REMOVAL 2.1 COMMON EXCAVATION, UNDISTRIBUTED 3.1 I-1 PRIMARY GATEWAY SIGN ASSEMBLY BASE BID TOTAL N 901.0`1 Quantity Unit Unit Price Total Amount 1 LS j, 340,E j, 3� -4D 4 CYS 2$8.°g' i d ,& ." 1 EA ALTERNATE #1 TOTAL AC61� a % k 1865 Version 07/19/2023 Contractor's Bid for Public Works - 7 cl BIDIPROPOSAL a CITY OF SOUTH BEND Project Name: City of South Bend Wayfinding Signage Program Phase 3 186. x Project Number: 123-013 For Bids Due: December 12, 2023 Contractor Name: ALTERNATE #2 - WESTERN GATEWAY SIGN Item Description Quantity Unit Unit Price Total Amount No. 1.2 EXISTING SIGN AND FOUNDATION 1 LS VAL 2.2 COMMON EXCAVATION, 4 CYS UNDISTRIBUTED 3.2 I-1 PRIMARY GATEWAY SIGN 1 EA 17, D35-da 17 ASSEMBLY ALTERNATE #2 TOTAL: R,567.' Al TGRAIATF f!4 — A R T% rATFWAY AMN Item Description Quantity Unit Unit Price Total Amount No. 1.3 COMMON EXCAVATION, 4 CYSg cip it 52 c� ' UNDISTRIBUTED 2.3 I-1 PRIMARY GATEWAY SIGN 1 EA ASSEMBLY ALTERNATE #3 TOTAL , E 8, j On .1 ALTERNATE #4 - SOLAR POWER SIGN LIGHTS FOR GATEWAYS IN BASE BID Item Description Quantity Unit Unit Price Total Amount No. 1.4 SOLAR POWERED SIGN LIGHT 3 EA o, ALTERNATE #4 TOTAL 270,"f ALTERNATE #5 - SOLAR POWER SIGN LIGHTS FOR GATEWAYS IN ALTERNATES Item Description Quantity Unit Unit Price Total Amount No. 1.5 SOLAR POWERED SIGN LIGHT 3 EA JC>,c-0 $ 270 .t Q, ALTERNATE #6 - IRONWOOD SIGN 36 Item Description No. 1.6 Gx-5a VEHICLUALR TRAILBLA SIGN ON 2" SQUARE POST) ALTERNATE #5 TOTAL S 2 70.`a Quantity Unit Unit Price Total Amount :ER 1 EA ALTERNATE #6 TOTAL S i Sso ,eA Version 07/19/2023 Contractor's Bid for Public Works - 8 W Project Name: i Project Number: For Bids Due: Contractor Name: BID/PROPOSAL CITY OF SOUTH BEND City of South Bend Wayfinding Signage Program Phase 3 123-013 December 12, 2023 Gg0GeAPH IRVUSTEiES�11,k. BASE BID TOTAL N4,901. °i ALTERNATE #1 TOTAL 19. ALTERNATE #2 TOTAL 19, S67. ALTERNATE #3 TOTAL ALTERNATE #4 TOTAL ALTERNATE #5 TOTAL 2'70. ALTERNATE #6 TOTAL !, 550.°D PROJECT TOTAL WITH ALL ALTERNATES 20q,'3 VZ-, Bidder (Firm): (,Lv�,GWaeH 1rJDL)5 (Z t&,, sfJG Address: LOS 1 tifoumi ES I t4c City/State/Zip: HQf4Ac4,-41 OH 45030 Telephone Number: -6GOg By _ X61 � - (Signature) 6MG C- Kx&016flz. (Printed Name of Person Signing) Version 07/19/2023 Contractor's Bid for Public Works - 9 CITY OF SOu H BEND wi f d 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. ***Goals should be calculated based on the Base Bid only.*** Project Number: Bidder: 123-013 Project Name: City of South Bend Wayfinding Si na a Program Phase 3 GfLOCSRAPN 1 KJPuSe IZtES, in1G. Total Bid Amount: 2-0y,312- MBE Goal: 0.82% Page 1 ofi� Name & Address of MBE Primary Contact Person Namefrele hone ( p ) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of MBE Component Percentage of Total Bid/Proposal C.LSE cot457VLLC,n04 Si tCSAW" EXPRVS6100F /SIC. ��� r�x�A�Anr� CS 2IR-$S8 qs S-7y-gy7(._S BIZ-��-6 y ICAtiTACTD -n4ESE 3 CzMPAWIES g J Dp n(OT NA tE PF.pPU L6COTD G9 t�s�vrW 6rzNp GE _: 62014 W 1u. 5U(1FLy ALL LQ&Z�2 i D E)v-Rv -ATE ALL S Fou NfDanaK6 Submitted by: Gca,,a tin )aeP_ Print Name Signature ***Goals should be calculated based on the Base Bid only.*** /2-/1-?13Z3 Date Version 07/19/2023 Contractor's Bid for Public Works - 10 CITY OF SOu H BEND U MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-1.0 WBE UTILIZATION PLAN \ x biers„`` - 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. ***Goals should be calculated based on the Base Bid only.*** Project Number: 123-013 Project Name: City of South Bend Wayfinding Si na a Program Phase 3 Bidder: GE040?14 to OJSMIES,111k• Total Bid Amount: Zt3Lf, i2 ,WBE Goal: 3.36% Page J of i Name & Address of WBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of WBE Component Percentage of Total Bid/Pro osal 5� t�RSL1CAO11.1G, i nIC, ��96 v5 rac�l 2a 3 ilili gtv 1p y 1 rJ u6b2 $ SlaMFS IhfC1�tALS+C 574-2�3i- 2d7S TRAFFIC CONTROL. COlz 51 G)1 Ftxria 11,1STRLLAT 16J Jr � �� Submitted by: CSOR6S rn KLUQ16f1Z Print Name Signature ***Goals should be calculated based on the Base Bid only.*** is -/r-2aZ3 Date Version 07/19/2023 Contractor's Bid for Public Works - 11 THE CINCINNATI INSURANCE COMPANY • 0J CONTRACTOR (Name, legal status and address): Geograph Industries Inc 475 Industrial Drive Harrison, OH 45030 OWNER (Name, legal status and address): CITY OF SOUTH BEND 227 W JEFFERSON BLVD SOUTH BEND, IN 46601 BOND AMOUNT: 5% of bid SURETY (Name, legal status and principal place of business): THE CINCINNATI INSURANCE COMPANY 6200 S. GILMORE ROAD FAIRFIELD, OHIO 45014-5141 PROJECT (Name, location or address, and Project number, if any): This document has important legal consequences, Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. City of South Bend Wayfinding Signage Program Phase 3 The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) days to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the any 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 the 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 requirements shall be deemed incorporated herein. When so fumished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 12 day of December, 2023 Geograph Industries Inc ln�- f=l 4 (Principal) G216 C l4lWpi6l[a (Seal) (Witness) P DAS I 06;qT' _ (Title) r THE CINCINNATI INSURANCE COMPANY ran (Sure" hl (Seal)(Witness) A 'I"? ■n " I I A A A / // n-Fact The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310, 2010 Edition. S-2000 AIA (11/10) PUBLIC THE CINCINNATI CASUALTY COMPANY Fairfield, Ohio POWER OF ATTORNEY KNOWALL MEN BY THESE PRESENTS: That THE CINCINNATI INSURANCE COMPANY and THE CINCINNATI CASUALTY COMPANY, corporations organized under the laws of the State of Ohio, and having their principal offices in the City of Fairfield, Ohio (herein collectively called the "Companies"), do hereby constitute and appoint Gregg L Grimes, Michael T Long, Thomas J Galloway, Jeffrey S Gephart, Ronald O Sparks, Andy Martin, Jr., Benjamin West, Shaun LeSance, Melanie D Blair, Jennifer Garrison, Marchia N Bullock, Barbara Blankenship, Sharon Lambert, Paula Farley of MIDDLETOWN, OH their true and legal Attorneys) -in -Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and deliver on behalf of the Companies as Surety, any and all bonds, policies, undertakings or other like instruments, as follows: Five Million Dollars and 00/100 ($5,000,000.00) This appointment is made under and by authority of the following resolutions adopted by the Boards of Directors of The Cincinnati Insurance Company and The Cincinnati Casualty Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the President or any Senior Vice President be hereby authorized, and empowered to appoint Attorneys -in -Fact of the Company to execute any and all bonds, policies, undertakings, or other like instruments on behalf of the Corporation, and may authorize any officer or any such Attorney -in -Fact to affix the corporate seal; and may with or without cause modify or revoke any such appointment or authority. Any such writings so executed by such Attorneys -in -Fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. RESOLVED, that the signature of the President or any Senior Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the signature of the Secretary or Assistant Vice -President and the Seal of the Company may be affixed by facsimile to any certificate of any such power and any such power of certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and sealed shall, with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Company. IN WITNESS WHEREOF, the Companies have caused these presents to be sealed with their corporate seals, duly attested by their President or any Senior Vice President this 16th day of March, 2021. c �f l:;fYldq�q `Op��\CitVd//Y G o o dc`CCRPOAATE CORPORATE ; =SEAL "SEAL' On 0 OHIO STATE OF OHIO )SS: COUNTY OF BUTLER ) THE CINCINNATI INSURANCE COMPANY THE CINCINNATI CASUALTY COMPANY On this 16th day of March, 2021 before me came the above -named President or Senior Vice President of The Cincinnati Insurance Company and The Cincinnati Casualty Company, to me personally known to be the officer described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of said Companies and the corporate seals and the signature of the officer were duly affixed and subscribed to said instrument by the authority and direction of said corporations. Keith C91rett, Attorney at Law Notary Public — State of Ohio My commission has no expiration date. Section 147.03 O.R.C. I, the undersigned Secretary or Assistant Vice -President of The Cincinnati Insurance Company and The Cincinnati Casualty Company, hereby certify that the above is the Original Power of Attorney issued by said Companies, and do hereby further certify that the said Power of Attorney is still in full force and effect. Given under my hand and seal of said Companies at Fairfield, Ohio, this 12th day of December , 2023 e 2 a"SEALOHIO BN-1457 (3/21) - SLAM ►T W/13 I D CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name C,ITlI a Sau—, W &iWV WAyFiW01N6 5;4+siAG.E PR-06MM PAA-SIF3 Project No. JZ ?}— For Bids Due Vrkc Pme,(R 12, Z.o23 Contractor Name: (, pGr.,A Pp i NtuSTR i ES) 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 "1 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. 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. Al bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)°) to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder and all subcontractors on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result In the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City I through its own independent verification of the information provided by the contractor. PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements: (i) _ By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. (ii) _ 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). 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. 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. II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowled ments: (i) By checking this box, I hereby acknowledge that 1 am not a pre -qualified bidder with the City of South Bend. (ii) ✓ By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. (iii) Z 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) +r 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) 7 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 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. (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: (Sign Here) G�R1,�C m f4�VOtGUt (Print Name Here) ��62�PN �Nr�UST124ESj1n1C.. (Name of Company) 479 w>os-`u AL Oat. (Address of Company) 14At21%asbrJ dW y563.6 (City) 6V4re> (State) Sr3�2®2-9Zz=o e : 513-2b6-S?b114 (Telephone Number) EXPERIENCE STATEMENT: The bidder is required to state in detail, in the space provided below, what work of a character similar to that included in the proposed contract he has done, to give reference and such other detailed information as will enable the Owner to judge of his responsibility, experience, skill and financial standing. Among other things, this statement shall include the following: Evidence to the effect that the bidder maintains a permanent place of business; has adequate construction facilities and equipment available for the work under the proposed contract; evidence to the effect that the bidder has a suitable financial status to meet obligations incidental to the work; evidence to the effect that the bidder has appropriate technical experience and has in his employ a sufficient number of skilled and trained workmen to carry to completion, within the contract time, the work to be done under. this contract. REfMOCEs- to RIMO TLY.RS &AP4F%4NW_, Sj<�NAGF_ PRo3E.r POG-. CHAO 05`rPA+4ce- PHoarL 972-DM-S341 TaML PPPPSEc"r%/RUJfz.s �9°-f8,�1�1 °i �mPiE710N vAM1 1-3o>2.q WORk = 126 TZ>TT)L wQYHtJ V1 JG ske-►JS McKR Cg-IIOQ 41lo WS 710A INCLUDING 25 i XMr L&A- 17045 Z, ASHP-VIU.E WAy F1t-tDA6 S16o1AGCz PcC, KirnBERLY fUP-YEF& PNoNrr, : S2$-210 Z72q T Mt. PRosa4r VAWE-t A gZoAco oD ccmPumon► up -me, o+3c�,G SCoK of v-MK: 011160146 wAq(i Ma AS S&4AGE f20ssc-r WjMJLn KE PoAsr S (2-26owItiIiN . i N ;�Iz�i � rHF-u 7W--A�4 -3- 'XiM ZkRfn WAyF%r 1>Jv46 S1614AGE. fbc= KAt g- 6r'rSRM14 PMUsr.: -309-83S-0173 7 >11A , PRaz'EcT' JAWS : 3 rnrt,UpN tamRrDc44 OtUO146r SMK of t,,)DRK: 61%1Galt46 WA ftrjt>it1G PR0'SG-Cr w%MULT►Ptlz PNASf S OG6iv Wtt,1G i&I 201S THRV MVI*i BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date: December 5, 2023 Name: Leslie Biek, PE Department of Public Works — Engineering Division BPW Date: December 12, 2023 Phone Extension: 9323 Required Prior to Submittal to Board BPW Attorney X Attorney Name Michael Schmidt Dept. Attorney ❑ Attorney Name Purchasing ❑ I Check the Annronriate Item Tvne — Reauired for All Submissions I U Professional Services Agreement U Contract U Proposal ❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA ❑ Bid Opening ❑ Bid Award X 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 Purpose/Description uired Information U Yes❑ If Yes, Approved by Purchasing ❑ No F] MBE ❑ WBE Completed E-Verify Form Attached El Yes ❑ No CoSB Wayfinding Signage Program PH III 123-013; PROJ 400 PR-28908 101-439300 Open bids for the City of South Bend Wayfinding Signage Program Ph III Iff 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: