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HomeMy WebLinkAboutOpening of Bids - Liberty Tower TIF Project – Parking Garage Proj No. 123-054R - Browning ChapmanCITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Project No. For Bids Due Date Address City/State/Zip Liberty Tower TIF Project — Parking Garage 123-054R December 12, 2023 PART I (Must be completed for all bids. Please type or print) December 11. 2023 Bidder (Firm): Browning Chapman, LLC 2101 Bastian Ct. Westfield, IN 46074 Telephone Number: (317 ) 608-2775 Agent of Bidder (if Applicable): Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: Parking Garage Repairs at Liberty Tower Building — South Bend the City of South Bend, Indiana, in accordance with plans and specifications prepared by: KENNEDY CONSULTING GROUP LLC and dated 11/17/2023 for the sum of (enter the Total Bid as shown on the Proposal) One Million Two Hundred Ninety -Six Thousand Six Hundred Twenty -Three ($ 1,296,623.00 (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 separate achm By (Signature) Allan Browning (Printed Name of Person Signing) /_T4141=I2IF_1►I:Nd 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 Alexandra Dolz-Lane, Member Murray L. Miller, Member Attest: Theresa Heffner, Clerk Version 09/29/2021 Contractor's Bid for Public Work - 2 PLEASE SEE EXHIBIT A 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 Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 09/29/2021 Contractor's Bid for Public Work - 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- DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF Indiana ) ) SS: Hamilton COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Version 09/29/2021 Contractor's Bid for Public Work - 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 09/29/2021 Contractor's Bid for Public Work - 5 may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 11 th day of Dec. 2023 Subscribed and sworn to before me this 11 th My Commission Expires August 22, 2024 County of Residence Browning Chapman, LLC Contractor/Bidder (Firm) a&K&� �- Signature of Contractor/ idder or Its Agent Allan Browning; President Printed Name and Title da f December 20 23 IA Jv X P1 No ary Pubh Madison PETER JAMES LYON NOTARY PUBLIC SEAL MADISON COUNTY, STATE OF INDIANA MY COMMISSION EXPIRES AUGUST 22, 2024 Version 09/29/2021 Contractor's Bid for Public Work - 6 BID/PROPOSAL c CITY OF SOUTH BEND \H x, Project Name: Liberty Tower TIF Project — Parking Garage Project Number: 123-054R For Bids Due: December 12, 2023 Contractor Name: Browning Chapman, LLC BASE BID QUANTITY & UNIT PRICE TABLE ITEM DESCRIPTION QTY. UNITS UNIT PRICE TOTAL 0.1 MOBILIZATION/DEMOBILIZATION 1 LS $30,000.00 0.2 GENERAL CONDITIONS 1 LS $ 64,100.00 0.3 SHORING ALLOWANCE 1 LS $ 25,000.00 0.4 OWNER'S CONTINGENCY 1 LS $ 100,000.00 1 FULL DEPTH SLAB REPAIR @ BEAM /GIRDER 304 SF $ 100.00 $ 30,400.00 2 FULL DEPTH SLAB REPAIR - FORMED 1146 SF $ 100.00 $114,600.0 3 PARTIAL DEPTH FLOOR REPAIR 80 SF $ 60.00 $ 4,800.00 4 CEILING DELAMINATION REPAIR 72 SF $125.00 $ 9,000.00 5 CONCRETE JOIST SPALL REPAIR 200 LF $110.00 $ 22,000.00 6 BEAM /GIRDER SPALL REPAIR 150 SF $ 170.00 $ 25,500.00 7 COLUMN SPALL REPAIR 10 SF $150.00 $ 1,500.00 8 GALVANIC ANODES INSTALLED 200 EA $ 50.00 $ 10,000.00 9 SCALED CONCRETE SURFACE REPAIR 8475 SF $2.00 $ 16,950.00 10 CONCRETE CURB REPAIR 24 SF $100.00 $ 2,400.00 11 EXPOSED CEILING REINFORCEMENT REPAIR 150 LF $ 40.00 $ 6,000.00 12 GRIND EXISTING PATCH PERIMETERS 200 LF $ 20.00 $ 4,000.00 13 CRACK ROUT & SEAL 231 LF $ 8.00 $ 1,848.00 14 CONTROL JOINT SEALANT REPLACEMENT 1,080 LF $ 7.00 $ 7,560.00 15 DECK COATING REMOVAL 63,855 LF $ 3.00 $191,565.0 16 DECK COATING BASE COAT AT FLOOR PATCHES 400 SF $ 20.00 $ 8,000.00 17 DECK COATING RECOAT SYSTEM 24,785 SF $ 2.50 $ 61,962.50 18 DECK COATING FULL SYSTEM 63,865 SF $ 3.50 $ 223,527.5 19 BUMPER WALL JOINT SEALANT 320 LF $ 20.00 $ 6,400.00 20 FLOOR DRAIN GRATE REPLACEMENT 2 EA $ 700.00 $ 1,400.00 21 PEELED CEILING COATING REPAIR 3,690 SF $ 5.00 $ 18,450.00 22 REPAINT PAVEMENT MARKINGS 1 LS $ 1 1,000.00 TOTAL BASE BID E $997,963.00 ALTERNATES ITEM DESCRIPTION QTY. UNITS UNITPRICE TOTAL ALT 1 SECURITY SYSTEM MODIFICATIONS -OPTION 1 1 LSUM $ 82,000.00 ALT 2 SECURITY SYSTEM MODIFICATIONS -OPTION 2 1 LSUM $ 1 1,000.00 ALT 3 LEVEL 7 PLAZA PAVER INSTALLATION 4,470 SF 1 LSUM $ 205,660.0 TOTAL ALTERNATES BID $ 298,660.00 COMBINED BASE BID PLUS ALTERNATES (TRANSFER TO PAGE 2 OF BID FORM) $ 1 ,296,62 TRANSFER TO BID FORM PG 2 .0C<= Version 09/29/2021 Contractor's Bid for Public Work - 7 o;TH BID/PROPOSAL c CITY OF SOUTH BEND N, = i Project Name: Liberty Tower TIF Project — Parking Garage Project Number: 123-054R For Bids Due: December 12, 2023 Contractor Name: Browning Chapman, LLC Bidder (Firm): Address: City/State/Zip Browning Chapman, LLC 2101 Bastian Ct. Westfield, IN 46074 Telephone Number: (317 ) 608-2775 By (Signature) Allan Browning (Printed Name of Person Signing) Version 09/29/2021 Contractor's Bid for Public Work - 8 EXHIBIT PART II (For projects of $100,000 or more — IC 36-1-12-4) Governmental Unit: City of South Bend, Indiana Bidder (Firm) Browning Chapman, LLC Date: December 11, 2023 These statements to be submitted under oath by each bidder with and as a part of his bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE What public works projects has your organization completed for the period of one (1) year prior to the date of the current bid? Contract Amount Class of Work Completion Date Name and Address of Owner $2,852,955 Sealant ReplacemE May 2023 Indiana Finance Authority $892,984 Waterproofing May 2023 Indiana University $3071700 Tuckpointing September 20'd Indiana University 2. What public works projects are now in process of construction by your organization? Contract Amount Class of Work Expected Completion Date Name and Address of Owner $1,177,000 Parking Garage RE December 20Z Purdue University $1,476,550 Parking Garage RE December 202 City of Lafayette, IN 3 Have you ever failed to complete any work awarded to you? No. If so, where and why? 4. List references from private firms for which you have performed work. Tammy.Long - Cushman & Wakefield/FHLBI - tammy.long@fhlbi.com Brent Stutzman - Duke Realty - Brent.Stutzman@dukerealty.com Scott Mingus - Marksmen Construction - scott@marksmenconstruction.com SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.) Browning Chapman, LLC plans to complete the project in the agreed upon timeframe utilizing our own forces. 2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. Phil Devoe Plastering - 290 S. Maple Dr., Albany, IN - EIFS Repairs; Finan Services - 14044 Industrial Ave., Kaleva, MI - Shotblasting Services; Gutknecht Construction - 2280 Citygate Drive, Columbus, OH - PT Cable Repairs 3. If you intend to sublet any portion of the work, state the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the governmental unit in the event that you subsequently determine that you will use a subcontractor on the proposed project. Browning Chapman intends to self perform all work. 4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit. Browning Chapman possesses the necessary equipment to complete the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? not, please explain the rationale used which would corroborate the prices listed. Yes. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded. � SOUTH B�,'U � _ d U C PF. 1['F (� CITY OF SOUTH BEND, INDIANA M65 CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Liberty Tower TIF Project — Parking Garage Project No. 123-054R 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 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-2.0] and M/WBE Contacted Forms [MBE-2.1 and X WBE-2.1]. X Acknowledge Receipt of 0 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: Browning Chapman, LLC By Authorized Represen ive: Signature: Print Name & Title: Allan Browning; Presiden Date: December 11, 2023 Version 09/29/2021 Contractor's Bid for Public Work - 1 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name Liberty Tower TIF Project — Parking Garage Project No. 123-054R For Bids Due December 12, 2023 Contractor Name: Browning Chapman, LLC 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 31st for the upcoming calendar year, or within twelve (12) months of obtaining pre - qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective January 1 of the following year, or immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 02/23/2022 General Conditions - 10 POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder and all subcontractors on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 02/23/2022 General Conditions - 11 I. 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). (ii) _ Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. (iii) _ List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. (iv) _ For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. Version 02/23/2022 General Conditions - 12 II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: (i) By checking this box, I hereby acknowledge that I am not 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) 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: December 11, 2023 r 6��" (Sign ere) Allan Browning (Print Name Here) Browning Chapman, LLC (Name of Company) 2101 Bastian Ct. (Address of Company) Westfield (City) Indiana (State) 317-608-2775 (Telephone Number) Version 02/23/2022 General Conditions - 14 State of Indiana Office of the Secretary of State CERTIFICATE OF EXISTENCE To Whom These Presents Come, Greeting: I, DIEGO MORALES, Secretary of State of Indiana, do hereby certify that I am, by virtue of the laws of the State of Indiana, the custodian of the corporate records and the proper official to execute this certificate. I further certify that records of this''affice disclose that BROWNING CHAPMAN, LLC duly filed the requisite documents to commence business activities under the laws of the State of Indiana on November 05, 2012, and was in existence or authorized to transact business in`the State of Indiana on December 11, 2021 I further certify this Domestic Limited Liability Company has filed its most recent report required by Indiana law with the Secretary of State, or is not yet required to file such report, and that no notice of withdrawal, dissolution, or expiration has been bled or taken place. All fees, taxes; interest, and penalties owed to Indiana by the domestic or foreign entity and collected by the Secretary of State have been paid. In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the City of Indianapolis, December 11, 2023 DIEGO MORALES SECRETARY OF STATE 2012110501232/20233506766 All certificates should be validated here: https://bsd.sos.in.gov/ValidateCertificate Expires on January 10, 2024. j �AB►C Associated Builders and Contractera. Ina ARC OF INDIANA APPRENTICESHIP TRUST 0611712022 5001 North Shadeland Avenue Indianapolis, Indiana 46226 (317) 596-4950 Fax (317) 596-4957 (800)333-9844 www.abcindianakentucky.org To whom it may concern: Browning Chapman is currently an active member of ABC. Browning Chapman has multiple employees enrolled in our apprenticeship program. ABC is a registered DOL apprenticeship program. Feel free to contact me with any questions you may have. Best Regards, ,Lisa Be- pe�z. ✓ wdh evtt t aLppwntkej&p a o4d4wi" / `Ueteaan be`tefU15 aepwiattatiue als6ociated `'3ui cko and eontwctom of JN1X2Y 5UU1 N. Shadetand am uce 9ndian"atb, JN 46226 (317) 596-495V x 119 —Pba&—abcuulianac�u &y# Built on Merit, Performance, and Integrity Training leaders for a better tomorrow. Browning Chapman, LLC DRUG FREE WORKPLACE POLICY Browning Chapman, LLC has adopted the CCS Substance Abuse Program in its entirety. DEFINITIONS TO ENSURE COMMON UNDERSTANDING OF TERMS, THE FOLLOWING DEFINITIONS SHOULD BE CONSISTENTLY USED: Accredited Laboratory (SAMHSA): A federally certified laboratory approved by the Department of Health and Human Services (DHHS) for testing of prohibited items and substances. Accident/Incident: Any event caused by an employee, either directly or indirectly, that results in treatment by a health care provider, or that resulted in damage to property. This would also include any serious near -miss incidents. Adulteration: Tampering with a test sample by the substitution or addition of other ingredients to mask the presence or use of illegal drugs, resulting in a specimen that contains a substance that is not expected to be present in human urine, or contains a substance expected to be present but is at a concentration that it is not consistent with human urine. Annual: Each employee's obligation to be tested at least every 12 months. Card: A CCS card is one that states that it meets the requirements of the CCS substance abuse program, and/or reciprocity with the CCS program, and is verifiable through the construction safe site database located at www.constructionsafesite.or Controlled Substances: Includes all illegal drugs as listed in this policy and per the Department of Transportation (DOT) limits, (including controlled substances, "look alike drugs" and "designer drugs"), prescription drugs used by one for whom they were not prescribed, overuse of prescription drugs prescribed for the user, drug paraphernalia, and alcoholic beverages in the personal possession of or being used by an employee on the premises, or while assigned to work off premises. Confirmation Test: A second test performed by a SAMHSA - certified laboratory, on the same sample used for the screen test, which uses the more complex methodology of GC/MS (gas chromatography/mass spectrometry), that is more precise for the purposes of confirming or refuting screen test results. Contractor: The corporation, company, or entity that performs construction or maintenance work either directly with its own employees or indirectly with employees of subcontractors shall be interpreted to pertain to contractors and/or subcontractors, and/or both, whichever is applicable to the situation. Counterfeit Drug Card: A CCS Substance Abuse Identification Card modified in any manner without authorization from CCS. If the card is part of a program granted reciprocity by CCS, than modifying that card in anyway not authorized by CCS would also be considered as a counterfeit card. Diluted Test: A urine specimen with creatinine and specific gravity values that are lower than expected for human urine. Follow-up Test - An employee who has had a positive test result and is subject to unscheduled follow up testing per SAP requirements will be required to have such test performed upon notification. Payment arrangements for follow up testing are the responsibility of the employee. He/His: As used in this program, the terms "he or his" or similar masculine pronouns shall be construed to include the feminine alternatives of such pronouns. Such terms are used solely for grammatical purposes and shall not be construed to limit this program or its application on the basis of gender. Chapter 5 Page 11 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY Medical Review Officer (MRO): A licensed physician responsible for receiving laboratory results generated by a substance abuse testing program, who has knowledge of substance abuse disorders, and who has received appropriate medical training to interpret and evaluate an individual's medical history, and any other relevant biomedical information, as certified by either the American Medical Association (AMA) or the American College of Occupational and Environmental Medicine (ACOEM). Negative Test: A negative test is obtained if: (1) the screen test indicated the absence of legal or illegal substance in excess of the screen limit; or, (2) the screen test indicates the presence of legal or illegal substances in excess of the screen limit but the confirming test indicates the absence of legal or illegal substance in excess of the confirmation limits; or, (3) the screen test and confirmation test indicated the presence of a legal or illegal substance(s) in excess of the limits but the donor had a valid medical reason for the substance being detected in the specimen. Owner: The Corporation, company, agency, person, or other entity, that hires contractors to perform construction work and/or maintenance work on their premises. Positive Alcohol Test: A positive alcohol test result is obtained if the breathalyzer test, or its equivalent test, indicates the presence of alcohol that meets or exceeds the cut-off limits of the DOT and the Commercial Driver's License (CDL) guideline requirements listed in this policy. Positive Drug Test: A positive test result is obtained if the substance abuse test result indicates the presence of substances that meet or exceed both the screen and confirmation limits listed in this policy, as verified by a Medical Review Officer (MRO), and the MRO has determined that the test results do not stem from use of prescription medicines, over the counter medicines, food, or any cause other than the use of illegal substances. This would also include the illegal use of prescription drugs. Examples would include exceeding the dose of a prescription or over the counter drug and/or using prescription drugs without a prescription. Pre-employment/Pre-Job Site Entry: Screening of prospective employees to ascertain whether an applicant is capable of safely performing his duties and of meeting the pre -requisites for employment. Probable Cause/Reasonable Suspicion: Shall be defined as those circumstances, based on objective evidence about the worker's conduct in the work place, which would cause a reasonable person to believe that the worker is demonstrating signs of impairment due to alcohol or other drugs. It must be based on specific observance(s), which are relative to the current situation/surroundings that concern the appearance, behavior, speech, or body odors of the employee. It is advisable that the objective evidence that gives rise to probable cause is observed by at least two individuals, but it is recognized that in certain circumstances the observation may be made by only one individual. Examples of objective evidence include when a worker shows signs of impairment such as difficulty in maintaining balance, slurred speech, or erratic or atypical behavior. Record of such observation must be documented, and the supervisor must provide the employee with a copy. Random Testing: An unannounced, unscheduled drug and/or alcohol test, pursuant to an objective method for random selection of employees to be tested. The selection must be truly random without discrimination or arbitrary selection. Upon notification the employee must immediately report for testing. Refusal to Test: It is considered a refusal to test if the employee adulterated and/or substituted or refused to provide his urine specimen, or if he failed to appear for testing within a reasonable time, or to remain at the testing site until testing process is complete, or failed to provide a sufficient amount of urine without a medical reason, and/or failed to undergo an MRO directed medical evaluation for such a reason. Failure to cooperate with any part of the testing process, including the use of abusive language or behaving in a threatening manner, or behaving in a confrontational way that disrupts the testing procedure, shall also be considered a refusal to test. A refusal to test will be treated in the same manner as a person who has a positive test result. Chapter 5 Page 12 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY Return to Duty Testing: If an employee has received a positive test result he must take another test, termed a "return to duty test" before he is eligible to return to work, and he must receive a negative result. Payment arrangements for this test are the responsibility of the employee. Substance Abuse Professional (SAP): A licensed physician (Medical Doctor or Doctor of Osteopathy), a licensed or certified psychologist, a licensed or certified social worker, or a licensed or certified employee assistance professional. Additionally alcohol and drug abuse counselors must be certified by the National Association of Alcoholism and Drug Abuse Counselors (NAADAC) Certification Commission, a national organization that imposes qualification standards for treatment of alcohol and/or drug related disorders. All must have knowledge of and clinical experience in the diagnosis and treatment of substance abuse -related disorders. PROHIBITED PRACTICES Browning Chapman, LLC is committed to providing a workplace free of alcohol, drugs, and all other substances that may cause impairment. The following practices are prohibited while employed by Browning Chapman, LLC and violation of these prohibited practices may result in termination. 1. The sale, distribution, or use of drugs and alcohol is strictly prohibited during work. Sale or distribution of drugs is prohibited regardless of whether the distribution takes place on or off company premises or at owner - controlled worksites. 2. Any possession of open alcohol containers while on company or client property is prohibited. 3. Working while impaired due to the use of drugs or alcoholic beverages is prohibited. 4. Use and abuse of prescription of over the counter medication while working and wherein this medication causes impairment and interferes with primary job functions is not allowed. TESTING POLICY AND PROCEDURES A. TYPES AND CIRCUMSTANCES FOR TESTING Contractors are required to send all drug test results, regardless of the reason for testing, to the CCS database. The following is a listing of the types of testing, and required time frames for such testing, as required under this policy: Annual/Pre-employment Testing - Each onsite contractor employee is to be tested or provide documentation of having been tested within the past 12 months, and is to participate in annual testing. To preserve resources of time and money each time an employee is tested, regardless of the reason, the latest test date will become their new annual testing date for purposes of the CCS program. This policy prohibits a contractor from giving any more than 14 days' notice to an employee of annual/pre-employment testing dates. It is not the intent of this policy to punish anyone because of failure to remember their annual test. Therefore, employers should have some type of system to inform employees when their annual test is due. Post -Accident Testing - A substance abuse drug and alcohol test of an onsite contractor employee may be required when they are involved in an accident/incident or event, caused by them either directly or indirectly, that results in treatment by a health care provider, or that results in damage to property, including any serious near -miss incident. The test is administered per the discretion of the company and will only occur if impairment is suspected of contributing or causing the accident or injury. Probable Cause/Reasonable Suspicion Testing with Documentation - A substance abuse drug and alcohol test shall be required at the time of observable probable cause circumstances, based on objective evidence about the worker's conduct in the workplace, that would cause a reasonable person to believe that the worker is demonstrating signs of impairment due to alcohol or other drugs. Job superintendent and foreman are trained in drug and alcohol awareness on the jobsite. Examples of objective evidence include when a worker shows signs of impairment such as difficulty in maintaining balance, slurred speech, or erratic or atypical behavior, etc. Such observation must be documented, and the supervisor shall provide the employee with a copy. Chapter 5 Page 13 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY 4. Random testing - CCS owners are required to perform random drug testing on their contractor employees working on their premises. It is the owner's responsibility to see that their selection is truly random without discrimination or arbitrary selection. Random testing is to be an unannounced, unscheduled drug and/or alcohol test, and upon notification the employee must immediately report to the testing facility. (Owners shall give notification of random testing in sufficient time before the end of the shift so as to accommodate a probability of a 2-hour wait time should an employee be unable to accommodate the test.) 5. Return to Duty Testing — For an employee to be eligible to return to work after having a positive test result, he will be required to take a return to duty test, and the result must be negative. Payment arrangements for a return to duty test are the responsibility of the employee. Follow-up Testing —An employee who is subject to unscheduled follow-up testing, as the result of a SAP requirement, will be required to have such test performed upon notification, and the results must be negative. They will be notified by telephone or letter, that they are required to report for testing the following day after receiving notification. If a worker/employee is unable to complete a required follow-up test due to being laid off or is working out of the area, their CCS card will be made noncompliant until they report for the follow-up test. It will be the responsibility of the worker/employee to contact the third party administrator as soon as they are employed again and/or are back in the local area. The length of time that was designated by the SAP to complete their follow up tests will be extended by the length of time they are noncompliant for not reporting for the test. (The third party administrator will make the determination of the time frame to determine if the employee was unable to report, or refused to report. — IE: they were on vacation at the time the letter arrived, they were not working at the time they were called back, they didn't get the letter for a week, etc.) Payment arrangements for follow-up testing are the responsibility of the employee. B. DRUG TESTING PROCEDURES 1. Specimen Collection: Specimen collection will be conducted in accordance with the Department of Health and Human Services (DHHS) "Mandatory Guidelines for the Federal Workplace Drug Testing Programs," as set forth in the Federal Register, and testing shall only be performed by DHHS-approved laboratories as set forth in the Federal Register. Specimen collection will be conducted in accordance with applicable state and federal law. The CCS program does not follow the complete regulatory testing requirements of the DOT, only the general guidelines. The procedure will be designed to ensure the security and integrity of the specimen provided by each employee and those procedures will follow accepted federal DOT chain -of -custody guidelines. Moreover, every reasonable effort will be made to maintain the dignity of anyone submitting a specimen for this program. If an employee is unable to supply a sample at the time of testing they could be required to wait up to two hours, without leaving the testing facility. Failure to remain and complete the testing procedure could be considered as a refusal to test, which carries the same sanctions as a positive test result. To accommodate this probability notification of random testing shall be given in ample time before the end of the shift. a. The employee will provide a urine specimen for the drug test. An exception to this rule would be if a worker could present written documentation from a medical doctor for his inability to provide an approved specimen. In situations where the worker/employee is not physically able to produce proper urine sample for testing a test may be done using a different testing method (hair, saliva, etc.), if approved by the third party administrator or the CCS substance abuse committee. The worker/employee or company must contact the third party administrator for instruction on obtaining a test by an alternate method. b. A photo ID must be presented at the time of collection to ensure proper identity. c. The donor will be asked to empty his pockets and display them to the collector, as required by Department of Transportation collection rules and regulations. Chapter 5 Page 14 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY A donor will have up to two hours to provide a specimen. If he leaves before two hours and does not give a sample, he will be considered having refused to test. The donor will be afforded privacy for the urine collection unless the collector observes evidence of an employee's attempt to tamper with a specimen, or the temperature range of the original specimen was out of normal range, or the specimen appeared to have been tampered with, or the specimen was determined invalid by the laboratory. e. Upon completion of testing the donor will be given a copy of form CCF (Custody and Control Form) 2. Laboratory Testing Procedures: All substance analysis will be done in SAMHSA laboratories certified by DHHS (Department of Health and Human Services). Laboratory procedures will include: a. Initial screen on each specimen. In the event that the initial test is positive a confirmation test will automatically be performed using the GCMS method. A test is considered positive if the detected level of the drug is at or above the cutoff level listed herein. CCS recommends that no adverse action or discipline be taken against any worker or applicant for employment on the basis of any positive test that has not been "confirmed". b. Validity testing on each specimen will automatically be performed. Each specimen is measured for creatinine level, specific gravity, and pH to determine if any of the following occurred: Adulterants or foreign substance were added to the urine; The specimen was substituted; or, The urine was diluted. c. The laboratory will report all results to the MRO (Medical Review Officer). The MRO will make a final determination as to the verified result and the results will be reported to the designated contractor's employee representative. 3. MRO Procedures: All drug testing shall come under the control and supervision of a physician with confidentiality protected in accordance with state law and the "American Medical Association's Code of Ethical Conduct for Physicians Providing Occupational Medical Services" or the Medical Review Officer Manual, as developed by the National Institute on Drug Abuse (NIDA). All testing results shall be verified by a MRO. The MRO is a licensed physician responsible for receiving laboratory results generated by a substance abuse testing program, who has knowledge of substance abuse disorders, and who has received appropriate medical training to interpret and evaluate an individual's medical history, and any other relevant biomedical information, as certified by either the American Medical Association (AMA) or the American College of Occupational and Environmental Medicine (ACOEM). He provides a medical review on all test results issued by the laboratory as follows: a. If the laboratory result is negative, the review is completed and a negative result is mailed. b. If the laboratory result is positive, adulterated, substituted, or invalid, the MRO will: Make one attempt to contact the donor by telephone to inform him of the results and complete an interview to determine whether a legitimate medical explanation exists for the result reported by the lab. If he was able to leave a message, but unable to talk to the employee by 10:00 AM of the following workday he will call the employer to report the results. In any case, the employee always has the opportunity to discuss the test results with the MRO. c. If the laboratory reports an invalid result to the MRO, the MRO will contact the employee and inquire as to medications the employee may have taken that may interfere with some immunoassay tests. If the employee provides an acceptable explanation, the test will be canceled and no further testing will be required unless a negative result is required to obtain a valid CCS card. If the employee is unable to provide an acceptable explanation and denies having adulterated the specimen, the test will be canceled, and a second collection must take place immediately under direct observation. Chapter 5 Page 15 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY 4. Specimen Retest Protocol: When the MRO has informed the employee of a verified "positive drug test" or "refusal to test" because of adulteration or substitution, the employee/worker has 72 hours from the time of notification to request a retest of his specimen at a different SAMHSA laboratory. The cost of the test will be the responsibility of the employee/worker. The employee may make the request verbally or in writing and make proper arrangements for payment with the MRO service. If the result of the retest is different from the original result, the test will be cancelled, and a recollection will be needed. C. ALCOHOL TESTING PROCEDURES Alcohol testing is required for probable cause, post-accident/incident, and in immediate random testing situations. Tests for alcohol shall be performed using the breath or blood to determine a BAC (blood alcohol content). If possible, a breathalyzer type instrument conforming to DOT standards should be used. If that is not available, then a blood draw may be used. Failure to provide a sufficient breath sample to complete a breath test or refusing to provide a blood sample will be considered a "refusal to test" and have the same consequences as a positive test. All alcohol test results with a confirmation test BAC level of .04 or higher will be considered positive and will require the employee/worker to be removed from the owner's property immediately. This result will also invalidate the employees/workers CCS card, and in order to become eligible for a CCS card again the individual will have to complete the required program of rehabilitation outlined by this policy. All alcohol test results with a confirmation test BAC level of .020 through .039 will require the worker/employee to be removed from the owner's site for twenty-four (24) hours or until his/her next scheduled on duty time, whichever is longer. Any initial test that indicates a BAC of .02 or greater will be confirmed by an EBT operated by a BAT. The confirmation test will be performed no sooner than fifteen (15) minutes and no later than thirty (30) minutes following the completion of the initial test, per present DOT protocol. DRUG TESTING RESULTS AND SANCTIONS/CONSEQUENCES A. CCS IDENTIFICATION CARD AND DATABASE PROTOCOL: 1. Test results from all CCS required testing would be entered into the CCS database. The employee's annual test date will automatically be updated with the entry of a negative result. A CCS card will be issued to the employee with a negative test result. A new card will not be issued each time a test is taken; rather, the card will be issued periodically as is needed to update the employee's photo and/or to replace a worn, unreadable card. The CCS cards will display the employee's picture, name, and a computer generated identification number. If the employee is collected at a location without the capabilities to take photos, the CCS ID card will be issued without a picture. NOTE: All CCS and CCS reciprocity cards must have a photo on them by January 1, 2006, and any cards issued after July 1, 2004 must have pictures on them. If a photo was not taken at the time of testing, Midwest Toxicology can take one for you at a later date and reissue the card. There will be a fee for this service. The CCS Substance Abuse Card is the property of CCS and contractors are asked to make every effort to retrieve the card of any person whose card has become invalid. Contractors are required to send testing results to the database for tests taken for post -accident, annual, probable cause/reasonable suspicion, random, follow-up, and return to duty testing. Chapter 5 Page 16 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY B. EXPLANATION OF DRUG TESTING RESULTS 1. Negative Testing Result — A result is considered negative if the laboratory finds no drug metabolite levels over the confirmed cutoff values. The employee's card will be updated in the CCS database. 2. Positive Testing Result — A result is considered positive if the presence of the drug meets or exceeds both the screening and confirmation levels listed in Appendix B, as verified by a MRO, and the MRO has determined that the test results do not stem from use of prescription medications, over the counter medications, food, or any reason other than the use of illegal substances or controlled substances used illegally. Diluted Specimen - A diluted specimen result will require a retest. The CCS database manager will report the dilute to the designated contractor representative. A detailed explanation of a diluted specimen and instructions regarding recollection procedures are included in Appendix B, and are to be furnished to the employee prior to retesting. A second diluted test without a medical reason carries the same consequences as testing positive. The collection for another test must be done the following morning of the workday after the employee /contractor has been notified, unless there are acceptable circumstances communicated to and approved by the third party administrator. The administrator can at their discretion reject the explanation. If the two parties cannot agree they can contact the CCS Office and the Substance Abuse Committee may consider the matter further. 4. Refusal to Test - Refusal to submit to a test will carry the same consequences as a positive test. It will be considered a refusal to test if the employee: a. Fails to appear for any required test within a reasonable time, or fails to remain at the testing site until the testing process is complete. b. Fails to provide sufficient amount of urine within the required time (2 hours) unless a legitimate medical explanation exists. This determination of whether a valid medical explanation exists rests with the MRO. c. Fails to undergo a medical examination or evaluation to meet medical explanation requirements in item b above. d. Is issued an adulterated or substituted test result e. Fails to cooperate with any part of the testing process (e.g., refuse to empty pockets when so directed by the collector, behaves in a confrontational way that disrupts the collection process). 5. Adulterated Test - If it is determined that a test was tampered with by the substitution or addition of other ingredients to mask the presence or use of illegal drugs as outlined earlier in this program, the test result shall be treated as a positive, and will have the same consequences as a positive test result. When a recollection is required due to various reasons such as but not limited to an adulterated specimen or the temperature of a specimen, etc., it shall be an observed recollection in keeping with DOT protocol. Chapter 5 Page 17 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY C. SANCTIONS/CONSEQUENCES IMPOSED FOR FAILING A DRUG TEST CCS requires contractor employees who test positive or refuse to test, to surrender his CCS Substance Abuse Card. The CCS contractor is required to refer those persons testing positive to a Substance Abuse Professional (SAP) for evaluation and treatment. The CCS website has a listing of various SAP's located in the Indianapolis area, who are familiar with the CCS substance abuse program and are aware of the items required by CCS before the employee can be returned to duty. CCS is not recommending these SAP's, rather making this listing available as a service to our members. The employee must complete a program of rehabilitation to include the following steps to be eligible to return to a CCS owner site: 1. The employee must arrange for an evaluation with a Substance Abuse Professional (SAP). 2. The SAP evaluation must specify that the employee attend education classes and/or treatment, and that the employee be required to perform the actions recommended by the SAP, or his assigned rehabilitation specialists, and also require that the employee be subject to random follow-up testing not less than three times within the next twelve month period from his return to work test. (In cases where the employee was unable to complete a required follow-up test due to being laid off or is working out of town, etc., the length of time that was designated by the SAP to complete their follow-up tests will be extended by the length of time they are noncompliant for not reporting for the test. Additionally the employee will not be allowed to take another CCS drug test for at least 14 days from the date of the first positive test. 3. The employee is required to submit a letter from the SAP to the CCS database, concerning their fitness for duty. The letter from the SAP must state the individual is fit for duty, can be returned to work, and is eligible for the return to duty test. 4. The employee must submit to a return to duty test and receive a negative result and the result must be submitted to the CCS database for entry. 5. The employee must actively complete any ongoing rehabilitation and follow up testing required by the SAP to keep the CCS card valid. 6. Arrangement for all costs of the above items is the responsibility of the employee. 7. An employee/worker testing positive three times within a twelve-month period will not be eligible to retest or obtain a CCS Substance Abuse Card for a period of one year, and will therefore be unable to work on CCS owner's sites during that period. 8. The imposition of any of the above sanctions shall result in the employee/worker surrendering his CCS Substance Abuse Card. The employee's card shall be rendered "invalid" in the database. 9. The result of a person using a counterfeit drug card will be the same as a positive drug test. Chapter 5 Page 18 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY IV. EMPLOYEE RESPONSIBILITIES All contractor employee's have a responsibility to report to work fit for duty, including being in the appropriate mental and physical condition necessary to perform work in a safe, competent manner, free of the influence of drugs and alcohol. He also has an obligation to report to his employer any medications that may impair his job performance and his or others safety. Contractor employee's are expected to consent to and participate in owner/employer required testing and consent to the release of the drug screen results to the employer, and to the CCS database, or for specific purposes as permitted by law. It will be considered a refusal to test if the employee adulterates and/or substitutes or refuses to provide his urine specimen, or fails to appear for testing within a reasonable time, or fails to remain at testing site until testing process is complete, or fails to provide a sufficient amount of urine, without a medical reason, and/or fails to undergo MRO directed medical evaluation. Failure to cooperate with any part of the testing process, including the use of abusive language or behaving in a threatening manner, or behaving in a confrontational way that disrupts the testing procedure, shall be treated in the same manner as a person who has a positive test result, and they shall be ineligible to work on CCS owner sites. V. AUDITING INFORMATION The owner reserves the right, under conditions of strict confidentiality, to inspect contractor's substance abuse testing program records within twenty-four (24) hours of the owner's notification of intent to audit. Owners are required to audit the validity of on -site contractor's employees at time of jobsite entry, and may audit them at any time thereafter through www.constructionsafesite.org. Owners may also request random drug testing of contractor employees working on their site. When requested to take a random drug test, the employee must immediately report for testing. Neither the employee nor the contractor shall receive prior notification of dates or times of random drug testing. However, the owner shall make the request in ample time to allow for a possible two-hour wait as mentioned previously in the Drug Testing Procedures. CCS contractors are required to check the validity of all cards upon hire and/or job site entry. APPENDIX A SAMHSA DRUG SCREEN Drugs of abuse tested in a routine SAMHSA 5-Panel Screen. The CCS program will use the drug screen components and cut-off levels listed below. In addition to these levels and substances the creatinine level and specific gravity of the specimen will be measured. If the creatinine level is less than 20 ml/dl and the Specific Gravity is less than 1.003, the sample will be considered dilute and another collection will be required. The second sample will be requested to be collected the following morning from the time of notification of a diluted sample. Those samples containing adulterants or considered substituted as determined by the laboratory will be considered as a positive test. Type Amphetamines Cocaine PCP — Phencylidine Opiates THC — Cannabinoids Ethanol (Alcohol) (enzyme assay) (GC/FD) Preliminary Confirmation Cut -Off Levels (ne/mh Levels 1000 500 300 150 25 25 2000 2000 50 15 .04% w/vol. .04% w/vol. Chapter 5 Page 19 of 477 © Safety Resources, Inc. 2016 Browning Chapman, LLC DRUG FREE WORKPLACE POLICY ALCOHOL TESTING LEVEL The minimum requirement for a positive test result for alcohol will be a BAC of 0.04% w/vol., a level consistent with Department of Transportation and the Commercial Driver's License Guideline Requirements. New drugs, preliminary cut off and confirmation levels may be modified periodically in order to parallel the Department of Transportation and the Commercial Driver's License guideline requirements. NOTE: The CCS program does not follow the complete regulatory testing requirements of the DOT, only the general guidelines. CCS Program - APPENDIX B INSTRUCTIONS FOR DILUTED SPECIMEN RETEST A diluted specimen result will require a retest, and a second diluted result, without a medical reason; will result in the same consequences as a positive test result.. The CCS database manager will report the dilute result to the employer's representative. The employee is to be provided with the below specific instructions on fluid intake prior to retesting, to prevent another diluted specimen. The collection for another test must be done the following morning of the workday after the employee /contractor has been notified, unless there are reasonable circumstances communicated and approved by the database manager. The database administrator may at its discretion reject the explanation. If the employee or contractor disputes the decision of the database manager the employee/contractor can contact the CCS office and the Substance Abuse Committee may consider the matter further. INSTRUCTIONS TO BE GIVEN TO EMPLOYER PRIOR TO RETESTING 1. Consume no fluids after 9:00 PM the night before collection. 2. Limit fluid intake to a minimum the day of collection. 3. Supervisor will advise the time and location of testing. 4. It is the employee's responsibility to monitor their intake of fluids to prevent another dilute specimen. If the employee has a medical condition that will cause a dilute specimen he will need to have his physician provide medical information to the MRO for evaluation. His physician must provide this information in writing to the MRO for evaluation at Midwest Toxicology Services Inc. The MRO will, after reviewing the information from the physician, issue a final report to his employer. Medical Review Officer FAX 317-262-2222 Midwest Toxicology Services Inc. 603 E. Washington St, Suite 200 Indianapolis, IN 46204 Chapter 5 Page 20 of 477 © Safety Resources, Inc. 2016 Project Reference List Horseshoe Casino Lake Charles Parking Garage and Fagade Restoration Lake Charles, LA PM: Gordon Chapman Completed June 2023 Final Contract Price: $4,658,869.00 Caesars Entertainment / Lemoine Virginia Avenue Parking Garage Concrete Restoration/Waterproofing Indianapolis, IN PM: Gary Chapman Completed December 2021 Final Contract Price: $1,947,791.16 Capital Improvements Board (Indianapolis) Tarkington Parking Garage Repairs Concrete Restoration/Waterproofing Carmel, IN PM: Jeff Browning Completed March 2023 Final Contract Price: $1,075,797.48 City of Carmel — Redevelopment Commission BROWNING CHAPMANI SPECIALTY CONTRACTORS INDIANA/CORPORATE 2101 BASTIAN COURT WESTFIELD, IN 46074 OFFICE: 317.608.2775 FLORIDA 13850 TREELINE AVENUE S SUITE 5 FORT MYERS, FL 33913 OFFICE: 239.674.6584 LICENSE: CGC1530130 OHIO 11785 HIGHWAY DRIVE SUITE 250 CINCINNATI, OH 45241 TEXAS 4419 WESTGROVE DRIVE ADDISON, TX 75001 OFFICE: 972.908.0028 BROWNINGCHAPMAN.COM Statement on Staffing Capabilities Browning Chapman, LLC has a staff of over 100+ project managers, journeymen and laborers to efficiently complete projects and will be able to adequately staff the work we are bidding on. Statement on Individual Employees Browning Chapman, LLC ensures that all persons who will perform work on the public works project will be properly classified as employees or as an independent contractor under all applicable laws and regulations. Determinations by Court or Governmental Agencies OSHA Violations — April 23, 2019 — Fall Protection; May 16, 2019 — Propane Storage Drug Testing Plan Please see attached Drug Testing Plan that covers all Browning Chapman, LLC employees. Surety Company Browning Chapman, LLC utilizes Hudson Insurance Company as a surety: Hudson Insurance Company (NAIC # 25054) BUSINESS ADDRESS: 100 William Street, 5th Floor, New York, NY 10038. PHONE: (212) 978-2800. UNDERWRITING LIMITATION b/: $60,537,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MID, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Delaware. Statement Regarding Tax Liens/Delinquency Browning Chapman, LLC is unaware of any tax liens or delinquency to any federal, state or local taxing body. AIA Document A31 OTM - 2010 CONTRACTOR: SURETY: (Name, legal status and address) (Name, legal status and principal place Browning Chapman, LLC of business) Hudson Insurance Company 2101 Bastian Ct. 100 William Street, 5th Floor This document has important legal Westfield, IN 46074 New York, NY 10038 consequences. Consultation with OWNER: an attorney is encouraged with (Name, legal status and address) respect to its completion or City of South Bend, Board of Public Works modification. 227 West Jefferson Boulevard Any singular reference to South Bend, IN 46601 Contractor, Surety, Owner or BOND AMOUNT: ***FIVE PERCENT OF AMOUNT BID*** other party shall be considered plural where applicable. PROJECT: (Name, location or address, and Project number, if any) Liberty Tower TIF Project - Parking Garage 111 N. Main Street South Bend, IN 46601 Project No. 123-054 The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. 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. Signed and sealed this 12th day of Decem*MQ BroLLC (P(Seal) (Wi iess President (Title) CU Hudson Insuranc om an i _!UAhJd,m(Surety) (Seal)_ (Wih less) ZZ, tr (Title) Todd Schaap, Attorney -in -Fact ' ` i' yVF AIA Document A310— — 2010. Copyright© 1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING::Tt1fs Aft! Init. Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® d'oUm@�; gr any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under ther , Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail y The American Institute of Architects' legal counsel, copyright@aia.org. HUDSON I N S1) IiANCE GROUP POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That HUDSON INSURANCE COMPANY, a corporation of the State of Delaware, with offices at 100 William Street, New York, New York, 10038, has made, constituted and appointed, and by these presents, does make, constitute and appoint Thomas O. Chambers and Todd Schasp of the State of Wisconsin its true and lawful Attorneys) -in -Fact, at New York, New York, each of them alone to have full power to act without the other or others, to make, execute and deliver on its behalf, as Surety, bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no single bond or undertaking shall obligate said Company for any portion of the penal sum thereof in excess of the sum of Twenty Five Million Dollars ($25,000,000.00). Such bonds and undertakings when duly executed by said Attorneys) -in -Fact, shall be binding upon said Company as fully and to the same extent as if signed by the President of said Company under its corporate seal attested by its Secretary. In Witness Whereof, HUDSON INSURANCE COMPANY has caused these presents to be of its Senior Vice President thereunto duly authorized, on this 3rd day of June 2022 at New York, New York. lea HUDSON INSURANCE COMPANY Attest............................................... By................................................................. Dina Daskalakis Michael P. Cifone Corporate Secretary Senior Vice President STATE OF NEW YORK COUNTY OF NEW YORK. SS. On the 3rd day of June , 2022 before me personally came Michael P. Cifone to me known, who being by me duly swom did depose and say that he is a Senior Vice President of HLIDSON INSURANCE COMPANY, the corporation described herein and which executed the above instrument, that he knows the seal of said Corporation, that the seal affixed to said instrument is such corporate seal, that it w s so aIfi (d by order of the Board of Directors of said Corporation, and that he signed his name thereto by like order. ,,,u,I111111IyIII' .............. .. ./.................................. I� (Notarial Se ...... ... ANN MURPHY QT 9O •%` Notary Public, State of New York N �'p� ; y< = No. O1 MU6067553 ;AG c Qualified in Nassau County St. IC :' i Commission Expires December 10, 2025 0^''�°�'{ CERTIFICATION STATE OF NEW YORK COUNTY OF NEW YORK SS. The undersigned Dina Daskalakis hereby certifies: That the original resolution, of which the following is a true and correct copy, was duly adopted by unanimous written consent of the Board of Directors of Hudson Insurance Company dated July 271h, 2007, and has not since been revoked, amended or modified: "RESOLVED, that the President, the Executive Vice Presidents, the Senior Vice Presidents and the Vice Presidents shall have the authority and discretion, to appoint such agent or agents, or attorney or attomeys-in-fact, for the purpose of carrying on this Company's surety business, and to empower such agent or agents, or attomey or attomeys-in-fact, to execute and deliver, under this Company's seal or otherwise, bonds obligations, and recognizances, whether made by this Company as surety thereon or otherwise, indemnity contracts, contracts and certificates, and any and all other contracts and undertakings made in the course of this Company's surety business, and renewals, extensions, agreements, waivers, consents or stipulations regarding undertakings so made; and FURTHER RESOVLED, that the signature of any such Officer of the Company and the Company's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seal when so used whether heretofore or hereafter, being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed." THAT the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and of the whole of the original and that the said Power of Attorney is still in full force and effect and has not been revoked, and furthermore that the Resolution of the Board of Directors, set forth in the said Power of Attorney is now in force. Witness the hand of the undersigned and the seal of said Corporation this 12th day of December 2023 , a�F � ��, l� 1, � • � BY.............. G�`:..................... Dina Daskalakis, Corporate Secretary STATE OF WISCONSIN ) COUNTY OF Kenosha ) ON THIS 12th day of December 2023 , before me, a notary public, within and for said County and State, personally appeared _ Todd Schaap to me personally known, who being duly sworn, upon oath did say that he is the Attorney -in -Fact of and for the Hudson Insurance Company , a corporation of Delaware , created, organized and existing under and by virtue of the laws of the State of Delaware ; that the corporate seal affixed to the foregoing within instrument is the seal of the said Company; that the seal was affixed and the said instrument was executed by authority of its Board of Directors; and the said Todd Schaap did acknowledge that he/she executed the said instrument as the free act and deed of said Company. Kimber . Rasch Notary Public, Kenosha County, Wi�pd .P_R •.Y My Commission Expires 1/22/202�`�9'�; VA Q L I Vn 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: 123-054R Date: December 11, 2023 Project Name: Liberty Tower TIF Project — Parking Garage Bidder: Browning Chapman, LLC Contact Person: Allan Browning Telephone: 317-608-2775 Address: 2101 Bastian Ct. City: Westfield State: Indiana Zip: 46074 Email: abrowning@browningchapman.com To determine whether a bidder has demonstrated good faith efforts to reach the MBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS MBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: htt ://www.in. gv/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 See Belo Indiana Minority and Women Business Enterprises, found on their website (http://www.in.gov/idoa). I affirm that I have made good faith efforts to select portions of the contract work to be performed by MWBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate MBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available means the interest of all MBEs in the scopes of work of the contract. I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform MBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications concerning subcontract opportunities and allowed MBEs reasonable time to respond to such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a manner reasonably calculated to inform MBEs of subcontracting opportunities and allowed sufficient time for MBEs to participate effectively. I affirm that I followed up on initial solicitations with interested MBEs. I affirm that I negotiated with interested MBEs in good faith, including providing such MBEs with adequate information about the plans, specifications and other requirements of the subcontract. I affirm that I have made good faith efforts to assist interested MBEs in obtaining bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 09/29/2021 Contractor's Bid for Public Work - 11 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested MBEs in obtaining necessary equipment, supplies, materials, or related assistances or services, where appropriate. I affirm that I did not reject any MBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each MBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBE was unqualified to perform the job. *Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Browning Chapman intends to self perform all scopes and was unable to identify a MBE line striping company. Version 09/29/2021 Contractor's Bid for Public Work - 12 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN 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: 123-054R Date: December 11, 2023 Project Name: Liberty Tower TIF Project — Parking Garage Bidder: Browning Chapman, LLC Contact Person: Allan Browning Telephone: 317-608-2775 Address: 2101 Bastian Ct. City: Westfield State: I N Zip: 46074 Email: abrowing@browningchapman.com To determine whether a bidder has demonstrated good faith efforts to reach the WBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS WBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: htt ://www.in. gv/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 X Indiana Minority and Women Business Enterprises, found on their website 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 X WBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications concerning subcontract opportunities and allowed WBEs reasonable time to respond to such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a manner X reasonably calculated to inform WBEs of subcontracting opportunities and allowed sufficient time for WBEs to participate effectively. X I affirm that I followed up on initial solicitations with interested WBEs. I affirm that I negotiated with interested WBEs in good faith, including providing such WBEs NA with adequate information about the plans, specifications and other requirements of the subcontract. NA I affirm that I have made good faith efforts to assist interested WBEs in obtaining bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 09/29/2021 Contractor's Bid for Public Work - 13 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 NA necessary equipment, supplies, materials, or related assistances or services, where appropriate. I affirm that I did not reject any WBEs as unqualified without sound business reasons NA based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each WBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MWBE was unqualified to perform the job. *Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 09/29/2021 Contractor's Bid for Public Work - 14 �jlyTN BF CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.1 MBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact MBEs. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. Attach additional pages if necessary. PAGE OFF Project Number: 123-054R MBE Participation Goal 3.4% Project Name: Bidder: By:rrft President December 11, 2023 (Sig re) (Title) (Date) Liberty Tower TIF Project — Parking Garage BrgAQing Chapman, LLC MBE Firm Browning Chapman is self performing all work. Could not locate a line striping MBE Owner or Contact at MBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: MBE Firm Owner or Contact at MBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: Version 09/29/2021 Contractor's Bid for Public Work - 15 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.1 WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE 1 OF 3 Project Number: 123-054R WBE Participation Goal 4.5% Project Name: Liberty Tower TIF Project — Parking Garage Bidderal _ Browning Chapman, LLC M (Signature) President (Title) 12/12/2023 (Date) WBE Firm Morgan's Striping Service, Inc. Owner or Contact at WBE Firm Cheryl Morgan Telephone: 317-776-2116 Fax: Email: morganstrip@att.net TYPE OF WORK SOLICITED FOR THIS PROJECT: Maintenance Painting and Pavement Markings RESULTS OF CONTACT WITH THE WBE FIRM: No response to invitation to submit a budget bid for this project. WBE Firm CE Hughes Milling, Inc. Owner or Contact at WBE Firm Caroline Hughes Telephone: 812-725-8665 Fax: Email: Caroline@hughesmilling.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Maintenance Painting and Pavement Markings RESULTS OF CONTACT WITH THE WBE FIRM: No response to invitation to submit a budget bid for this project. Version 09/29/2021 Contractor's Bid for Public Work - 16 YSiii-irt e . CITY OF SOUTH BEND z 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 2 OF 3 Project Number: 123-054R WBE Participation Goal 4.5% Project Name: Liberty/ Tower TIF Project — Parking Garage Bidder n Browning Chapman, LLC By: (Signature) President (Title) 12/12/2023 (Date) V WBE Firm Hasc:n, Inc:_ Owner or Contact at WBE Firm Carla Merrill Telephone: 317-769-2783 Fax: Email: carla@hascoinc.com hascoinc.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Maintenance Painting and Pavement Markings RESULTS OF CONTACT WITH THE WBE FIRM: No response to invitation to submit a budget bid for this project. WBE Firm Victory Trucking Owner or Contact at WBE Firm Becki Fredrick Telephone: 260-357-3911 Fax: Email: beckif(c_victorytrucking.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Maintenance Painting and Pavement Markings RESULTS OF CONTACT WITH THE WBE FIRM: No response to invitation to submit a budget bid for this project. Version 09/29/2021 Contractor's Bid for Public Work - 16 YSiii-irt e . CITY OF SOUTH BEND z 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 3 OF 3 Project Number: 123-054R WBE Participation Goal 4.5% Project Name: By:By: Liberty Tower TIF Project — Parking Garage Browning Chapman, LLC nun_ President 12/12/2023 (Signature) 1 (Title) (Date) WBE Firm CW Construction Waste Management Owner or Contact at WBE Firm Jacob Cook Telephone: 317-783-1500 Fax: Email: jcook@callcw.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Construction Waste Removal - Roll off Dumpster RESULTS OF CONTACT WITH THE WBE FIRM: Will be utilized for dumpster services. WBE Firm Safetv Resources Owner or Contact at WBE Firm Ian Stacks Telephone: 317-871-8155 Fax: Email: istacks(@_safetyresources.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Safety Compliance RESULTS OF CONTACT WITH THE WBE FIRM: Safety Resources will provide this service. Version 09/29/2021 Contractor's Bid for Public Work - 16 O `�d CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN r`"C` _ FORM MBE-1.0 ' MBE UTILIZATION PLAN This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. Project Number: Bidder: 123-054R Project Name: Liberty Tower TIF Project — Parking Garage Browning Chapman, LLC Base Bid Amount: 1,296,623.00 MBE Goal: 3.4% Page 1 of 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 Browning Chapman, LLC will on the approved vendors list be self performing and did not see any. all scopes of work. Browning Chapman searched for MBE line striping Submitted by: Allan Browning Print Name Signatu Version 09/29/2021 Contractor's Bid for Public Work - 9 December 11, 2023 Date .'of SpUST71 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN'' FORM WBE-1.0 _ 7NIi i 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: 123-054R Project Name: Liberty Tower TIF Project — Parking Garage Browning Chapman, LLC Base Bid Amount: 1,296,623.00 WBE Goal: 4.5% Page 1 of 1 Name & Address of WBE Primary Contact Person Scope of Work to be Performed Dollar Amount of WBE Percentage of Total (Name/Telephone) (Attach scope/schedule if you need additional space) Component Bid/Proposal Safety Resources Ian Stacks Safety Compliance $3,600.00 0.27% 618 N. Davidson Street 317-871-8155 Indianapolis, IN 46202 CW Waste Services Jacob Cook Dumpster Services $5,000.00 0.38% 935 W. Troy Ave. 317-625-3886 Indianapolis, IN 46225 Submitted by: Allan Browning a &K Rv� M �_ Print Name Signature Version 09/29/2021 Contractor's Bid for Public Work - 10 December 11, 2023 Date