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Home My WebLink AboutOpening of Bids - Drewry’s Brewery Cleanup, Phase I Proj No. 119-031C - Dore & Assoc.CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Drewry's Brewery Cleanup, Phase I Project No. 119-031C For Bids Due Tuesday, March 26, 2024 @ 9:00 A.M. (E.D.T.) Date: Address: City/State/Zip: PART I (Must be completed for all bids. Please type or print) 3/26/2024 Bidder (Firm): Dore & Associates, Inc. PO Box 338 Washington Ave. Bay City, MI 48707 Telephone Number: (989 ) 684-8411 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: Drewry's Brewery Cleanup, Phase I — Outbuildings & Demolition Debris the City of South Bend, Indiana, in accordance with plans and specifications prepared by: City of South Bend, Enqineerinq Division and dated 03/01/2024 for the sum of (enter the Total Bid as shown on the Proposal) Eight hundred twenty two thousand nine hundred dollars and no / 100 ($822,900.00 ) (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.-S uth Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown o -a Brat �'chment. By 7�/ .. (Printed Name of Person Signing) ACCEPTANCE The above bid is accepted this 26th day of March 20 24 Subject to the following conditions: BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Murray L. Miller, Member Joseph R. Molnar, Vice President Breana N. Micou, Member Attest: Theresa Heffner, Clerk Version 07/19/2023 Contractor's Bid for Public Works - 2 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 Michigan ) ) SS: Bay COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Version 07/19/2023 Contractor's Bid for Public Works - 4 Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, firms, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of contract or employment, or any matter directly or indirectly related to contracting or employment because of race, sex, religion, color, national origin, ancestry, gender expression, gender identity, sexual orientation, or due to age or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions will consider the Contractor's good faith efforts to obtain participation by those subcontractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. Contractors seeking the award of a City contract cannot be required to award a subcontract to an MWBE; however, they may not unlawfully discriminate against said MBE/WBE. On goal -eligible contracts, Contractors are required to either meet both MBE and WBE utilization goals or demonstrate that the Contractor has made good faith efforts to obtain participation from MBE and WBE subcontractors. A finding of noncompliance or a discriminatory practice shall prohibit that Contractor from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact to which the discriminatory practice or noncompliance pertains. 7. The undersigned Contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder Version 07/19/2023 Contractor's Bid for Public Works - 5 may result in forfeiture of contractual payments. I hereby affirm under the penalties of peijuiy that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 26th day of March , 2024 Dore & Associates, Inc. C90rac or/Bid e - (Firm)- Si ature oContractor/Bidder or Its Agent Jason C. Dore, President Printed Name and Title Subscribed and sworn to before me this 26th day of March , 2024 My Commission Expires 11 /15/2029 Notary Public County of Residence B Tara L. Wieland Version 07/19/2023 Contractor's Bid for Public Works - 6 BID/PROPOSAL CITY OF SOUTH BEND Project Name: Drewry's Brewery Cleanup, Phase I Project Number: 119-031C For Bids Due: Tuesday, March 26, 2024 @ 9:00 A.M. (E.D.T.) Contractor Name: Dore & Associates. Inc. BASE BID Item No. Description Quantity Unit Unit Price Total Amount 1 Lump Sum price to complete Item 1 as l LSUM $138,700.00 intended b these Specifications 2 Lump Sum price to complete Item 2 as 1 LSUM $78,400.00 intended by these Specifications 3 Lump Sum price to complete Item 3 as 1 LSUM $127,500.00 intended b these Specifications 4 Lump Sum price to complete Item 4 as 1 LSUM $384,600.00 intended b these Specifications 5 Lump Sum price to complete Item 5 as 1 LSUM $68,700.00 intended b these Specifications Environmental Allowance 1 EA $25,000 $25,000 BASE BID TOTAL 822,900.00 ALTERNATE ITEMS Item No. Description Quantity Unit Unit Price Total Amount Lump Sum price to complete Alternate Al Item 1 as intended by these 1 LSUM $15,200.00 Specifications Lump Sum price to complete Alternate A2 Item 2 as intended by these 1 LSUM $29,300.00 Specifications Bidder (Firm): Dore & Associates, Inc. Address: PO Box 338 Washington Ave. City/State/Zip: Bay City, MI 48707 Telephone Number: (989) 6684-8411 By: (Signature) Jason C. Dore, President (Printed Name of Person Signing) Version 07/19/2023 Contractor's Bid for Public Works - 7 /��ljTrf U •�. CITY OF SOUTH BEND, MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-1.0 MBE UTILIZATION PLAN This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. ***Goals should be calculated based on the Base Bid only.*** Project Number: Bidder: 119-031 C Project Name: Dore & Associates, Inc Drewry's Brewery Cleanup, Phase I Base Bid Amount: $822,900.00 MBE Goal: 1.30% Paqe of Name Address of MBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed p (Attach scope/schedule if you need additional space) Dollar Amount of MBE Component Percentage of Total Bid/Proposal 1st Class Logistics, LLC. Please see attached MBE certificate. Submitted by: Jason C. Dore, President Print Name Sig 'turd r ***Goals should be calculated based on the Base Bid only.*** Version 07/19/2023 Contractor's Bid for Public Works - 8 3/26/2024 Date 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: 119-031C Project Name: Drewry's Brewery Cleanup, Phase I Bidder: Dore & Associates, Inc. Contact Person: Jason C. Dore, President Date: 3/26/2024 Telephone: 989-684-8411 Address: PO Box 338 Washington Ave. City: Bay City State: Michigan Zip: 48707 Email: est@doreassoc.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: http://www.in.ggydq22/. 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 X Inclusion Program Plan and the Indiana Department of Administration's certified list of 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 X performed by MWBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate MBE participation. X 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. x 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 x 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 X reasonably calculated to inform MBEs of subcontracting opportunities and allowed sufficient time for MBEs to participate effectively. X 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 X with adequate information about the plans, specifications and other requirements of the subcontract. X 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 07/19/2023 Contractor's Bid for Public Works - 10 CITY OF SOUTH BENDS MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.0r v n; EVIDENCE OF GOOD FAITH EFFORTS X 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. X II affirm that I did not reject any MBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each MBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBE was unqualified to perform the job. *Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 07/19/2023 Contractor's Bid for Public Works - 11 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 OF Project Number: 119-031C MBE Participation Goal 1.30% Project Name--- Brewery Cleanup, Phase I Bidder::! --9orx&Associates. Inc. By: �A i �_ President 3/26/2024 �(Sygnature)" (Title) (Date) MBE Firm 1st Class Logistics, LLC. Owner or Contact at MBE Firm Bernard Coutee Telephone: 574-993-0071 Fax: Email: lstclasslogistics20l3@gmail.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Trucking/Hauling 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 07/19/2023 Contractor's Bid for Public Works - 14 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 Date: To: From Subject PI -IONS 574/ 235-9251 FAX 574/235-9171 TDD 574/ 235-5567 CITY oi, Sou-nI BEND, .TAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS March 19, 2024 All Planholders Theresa Heffner, Clerk, Board of Public Works Addendum Number: 1 Project Name: Drewry's Brewery Cleanup, Phase I — Outbuildings and Demolition Debris Project Number: 119-031C ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 3/19/2024 This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by including with your electronic bid submission. THIS ADDENDUM MAY AFFECT YOUR BID. Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: Dore & Authorized Signa Date: 3/26/2024 ates, Inc. Jason C. Dore, President Version 8/11/2020 i; • Iff=-Z *State of Indiana Certified MBE - DBE* FIN 46-3085979 Date: 3/18/2024 Project: Demolition of Former Fun FX Building Project location: 1000 W Sample St South Bend IN Project Number: 123-014 Quote prepared for: Dore and Associates 2024 Tri-axle hourly rates Regular rate $123.00 Overtime rate $141.00 2024 Quad -axle hourly rates Regular rate $125.00 Overtime rate $143.00 2024 Flatbed hourly rates Regular rate $125.00 Overtime rate $143.00 • Overtime consists of anything over 8 hrs daily and all day Saturday • Travel time added at regular rate to each truck daily timesheet when necessary • 2, 4 and 8 hour rule applies for daily hourly minimums • 4 and 8 hour daily minimums for flatbed hauling, local hauling, legal loads only • Night rates add $12.00 per hour, per truck. 8 hour minimum per truck • Sunday and holiday, add $36.00 per hour, per truck to overtime rates. 8 hr. Minimum • Trucks will be upon availability, 1st Class does not have control of project schedule • To avoid 2 hour show up time please call our office 2 hours before start times for any job cancellations or delays ® 1 st Class shall be compensated for all time spent on the jobsite ® Truck orders requires 48 to 72 hour notice if possible • Fuel surcharge will be applied if diesel cost rise above $4.25 a gallon, based on Midwest PADD 2 • Invoices due NET 30 • Signatory to Teamsters Local 364 Union 2024 Aggregate Prices Fill sand ... $11.50 a ton (meets INDOT B-Borrow specs) Unscreened topsoil ... $13.00 Screened topsoil... $20.00 *State of Indiana Certified MBE - DBE* Date: 3/18/2024 Project: Drewry's Brewery Clean Up Phase 1 Project location: South Bend IN Project Number: 119-031C Quote prepared for: Dore and Associates 2024 Tri-axle hourly rates Regular rate $123.00 Overtime rate $141.00 2024 Quad -axle hourly rates Regular rate $125.00 Overtime rate $143.00 2024 Flatbed hourly rates Regular rate $125.00 Overtime rate $143.00 ® Overtime consists of anything over 8 hrs daily and all day Saturday • Travel time added at regular rate to each truck daily timesheet when necessary • 2, 4 and 8 hour rule applies for daily hourly minimums ® 4 and 8 hour daily minimums for flatbed hauling, local hauling, legal loads only • Night rates add $12.00 per hour, per truck. 8 hour minimum per truck ® Sunday and holiday, add $36.00 per hour, per truck to overtime rates. 8 hr. Minimum • Trucks will be upon availability, 1st Class does not have control of project schedule • To avoid 2 hour show up time please call our office 2 hours before start times for any job cancellations or delays ® 1st Class shall be compensated for all time spent on the jobsite • Truck orders requires 48 to 72 hour notice if possible • Fuel surcharge will be applied if diesel cost rise above $4.25 a gallon, based on Midwest PADD 2 • Invoices due NET 30 0 Signatory to Teamsters Local 364 Union 2024 Aggregate Prices Fill sand... $11.50 a ton (meets INDOT B-Borrow specs) Unscreened topsoil... $13.00 Screened topsoil... $20.00 ACC—PRQY CERTIFICATE OF LIABILITY INSURANCE t*_� DATE(MM/DD/YYl'Y) 1 9/6/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Meadowbrook Insurance Agency of Saginaw 5311 Hampton Place 9• Saginaw MI 48604 License#: PC779010 CONTACT Lisa Stoner PHONE Fes( 989-921-5308 A/c No: 989-60N145O8 E-MAIL ADDRESS, Istoner@meadowbrook.com INSURERS AFFORDING COVERAGE INSURER A; Nautilus Insurance Com an INSURED DORE&AS•02 Dore &Associates Inc. P.O.Box 338 Bay City, Mi 48707 INSURERB: MichI an Millers Mutual Insurance Com an INSURERC: Travelers Indemnity Company 25658 INSURER D : Continental Insurance Company 35289 INSURER E : INSURER F : GUVERAGES CERTIFICATE NUMBER:724509528 REVISION NUMBER' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLIO EFF MMlDDYlYYXYPI' LIMITS A X COMMERCIAL GENERAL LIABILITY F-17 CLAIMS-MADE OCCUR ECP2035829 9/16/2023 9/16/2024 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTEU— PREMISES lEa occurrence) S 100,000 X MED EXP (Any one person) S 5,000 10,000 PERSONAL & ADV INJURY _ $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY D PRO- JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2.000,000 $ OTHER: I B AUTOMOBILE LIABILITY V0513225 1217/2022 12/7/2023 Ee aBINEDISINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY (Per person) S JX OWNED SCHEDULED AUTOSONLY AUTOS BODILY INJURY Per accident ( )HIRED $ X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Per accident $ $ A X UMBRELLA LIAB X OCCUR FFX2035830 9/1612023 9/16/2024 EACH OCCURRENCE $ 5.000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE $ 5,000,000 DED F7RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED7 a N/A 6KUBAN93460-1-23 5/13/2023 5/13/2024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below D Leased & Rented Equip C7039508524 5/26/2023 5/26/2024 $380,000 Limit $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached It more space Is required) I _1n BIDDING PURPOSE ONLY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U 1958-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF QUALIFICATION to provide CONSTRUCTION SERVICES for PUBLIC WORKS PROJECTS to the STATE OF INDIANA This Certification Board, having duly considered application for qualification in terms of apparent experience and financial resources; and under the applicable Indiana Code 4-13.6-4 and adopted rules of this Board, hereby issues a Certificate of Qualification to provide construction services to the State of Indiana for Public Works Projects to: DORE & ASSOCIATES INC 900 TRUMAN PKWY PO BOX 338 BAY CITY MI 48707 Phone 989-684-8411 Fax 989-684-6663 Company Official JASON DORE for the twenty-seven month period stated herein, unless revolved by this Board for cause, and in the classifications of services stated below. This certificate supercedes any previous certificate. 1795.01 Demolition of Buildings and Other Structures 1799.01 Asbestos Remediation CERTIFICATION DATE 4/29/2022 EXPIRATION DATE 7/29/2024 THIS CERTIFICATE ISSUED BY THE STATE OF INDIANA, PUBLIC WORKS DIVISION CERTIFICATION BOARD, 402 WEST WASHINGTON STREET, ROOM W467, INDIANAPOLIS, INDIANA 46204, ALSO ACTS AS THE OFFICIAL NOTICE OF EXPIRATION. STiI..... Tracy L. Cross, Exerltive Secretary Certification Board a/ DAPW PQ2 Stale Form 3983R Rev. 07/06 Nationwide Specialty Contractor - Demolition I Abatement I Remediation b8q,ASS0FC1AT!r=SqjnE. ` R�0�.Box �3'38 • Bay City, I I - MI 1 487 1 0 1 7- 0 1 338 - p I h V, 989.684.8411 • "1 fa I x - 9 1 89 .6 11 8 - 4 1 .666 " 3 • \wm. I d o rea I ss I o c , I com I ALL EQUIPMENT LISTED BELOW IS SOLEY OWNED AND FULLY PAID FOR BY Dore & Associates, Inc. 1 — Volvo EC 400 Ultra High Reach Excavator 2 — Komatsu PC 350-11 2 — CAT 350L Excavators 5 — CAT 345 Excavators BL & C 9 — CAT 330L Excavators B & C 2 — CAT 320L Excavators 1 — CAT 312L Excavator 1 — Link Belt Crane, 70 Ton 1 — Case Vibratory Roller 1 — CAT D4 Bulldozer 1 — CAT IT28 Wheel Loader 18 — Bobcats & 2 — Bobcat Trailers 2 — CAT Mini Excavators 5 — CAT Skid Steer Loaders 2 — Brok Remote Demo Robots 2 — Excel Track Concrete Crusher Plants 2 — Labounty MSD70R Shears 1 — Labounty MSD50R Shear 6 — Excavator Grapples 1 — 60 Ton American 7260 Crane 1 — 1973 GMC Tank Truck (Water) 12 — Excavator Hydraulic Hammers VENDOR NAME: Dore and Associates, Inc Leader/Manager Name Demolition and Asbestos Abatement Jason C. Dore President 30 and Business Administration/Management Arthur M. Dore Principal 45 Demolition and AsbestosAbatement and Chief Estimator Edward M. Dore Treasurer 40 Demolition and Asbestos.Abatement, ; and Chief Superintendent Dennis C. Dore Secretary. 40 Demolition and Ms !e os Abatement, and Waste<Nlanagement Jason C. Dore President Contact P.O. Box 338 Bay City, MI 48707 989-684-8411 Jason@doreassoc.com Key Skills Corporation President Finance & Investment Expert Equipment Acquisition Expert Information Technology Expert Experience Jason started working on demolition and asbestos abatement jobsites initially, until he realized he would rather be on the administrative side of the family business. Jason currently oversees all day to day operations at Dore & Associates, Inc and helps to manage and maintain several administrative avenues within the corporation. With over 30 years of Financial Management Job Cast, Financing & Investment, and Equipment Acquisition Experience, he is a true asset to the corporation. Employer Summary June 1991 - May 2020 - Dore & Associates Contracting Inc. - Demolition and Asbestos Abatement Worker from 91-93. In 93, he began his career in Administration and began working in the Finance Department, May 2020 - Current - Dore Associates, Inc. - In addition to the above, Jason is also the corporation's President, oversees accounts payables/receivables, personnel management, building maintenance management and signs off on all estimations for the corporation. Education • 1989 - 1992 - Western High School - Diploma ® 1993 - 1994 - Northwood University ® 1995 - 1997 - Saginaw Valley State University - Bachelor's Degree - Business Management Arthur M. Dore Principal/Chief Estimator Contact P.O. Box 338 Bay City, MI 48707 989-684-841 1 amd@doreassoc.com Key Skills Demolition Expert Asbestos Abatement Expert Corporation Principal Experience Art has worked for the family business his entire adult life. Starting as a young man doing any job he could to help out, he worked his way from the field to supervision to estimating to his current role as President in 1992. Art manages all aspects of the company as well as producing project estimates. During his career Art has obtained immense experience in the industry and is considered a "Demolition Expert". Many of our complicated and large projects are directed by means and methods developed by Art. Dore's commitment to safety and quality start at the top of the organization and are constantly reinforced under Art's leadership. Employer Summary 1979 - 2020 - Dore & Associates Contracting, Inc. -President of the company responsible for all day-to-day operations. 2020 - present- Dore & Associates, Inc. - Corporation Principal and Chief Estimator 2004 - 2015 - Hooters Restaurants - Owner of 3 restaurants located in Bay City, Saginaw and Traverse City, Michigan. 2006 - 2020 - Tri-City Icehawks - Team Owner of Teir 3 Junior A Hockey Team. Certifications / Affiliations • Georgia Institute of Technology - Asbestos Industry Practices • National Demolition Association • Asset Recovery Association • Michigan Chamber of Commerce • National Safety Council • Bay City Chamber of Commerce • Michigan Business & Professional Association • • lJore Secretary/Waste Management Director Contact P.O. Box 338 Bay City, MI 48707 989-684-8411 Denniscdore@yahoo.com Key Skills Demolition Expert Asbestos Abatement Expert Waste Management Corporation Secretary Experience Dennis has over 40 years of experience in the demolition and asbestos abatement fields. He currently oversees all waste management operations for Dore and Associates, Inc. Dennis manages a team of operators to maintain timely and efficient pick-up and delivery of dumpsters at each job site. He manages the disposal of friable and non -friable ACM while maintain compliance with all federal and state guidelines. Employer Summary 1981 - 2020 - Dore & Associates Contracting Inc. - Job site supervisor and handled waste management for the company. 2020 - Current - Dore Associates, Inc, - In addition to the above, Dennis is also the corporation's Secretary and maintains all corporation meeting minutes and other secretarial duties within the organization. Certifications / Affiliation s • MIOSHA Accredited Asbestos Supervisor • CDL • Aerial Work Platform Permit • Lead Awareness Accreditation Edward M. Dore Treasurer/Chief Superintendent Contact Experience P.O. Box 338 Bay City, MI Ed began his working career in the family business in 1987 48707 as a laborer and quickly moved to a field superintendent 989-684-8411 in 1989, Advancement to General Superintendent came emd@doreassoc.com in 1992 as Dore continued to grow in both the abatement and demolition divisions. Dore began offering hazardous waste remediation in 1993 with Ed serving as the company's remediation specialist. A well- rounded work portfolio in demolition, abatement and remediation allowed Ed to take on further responsibilities of risk management as well as the corporate secretary. Under the watchful eye and leadership of Ed, Dore has projects underway in as many as 10 states on any given day. His ability to manage personnel and Dore's extensive fleet of heavy machinery has allowed the company to grow into the industry leader it is today. Key Skills Employer Summary Demolition Expert 1987 - 2020: Dore & Associates Contracting, Inc. - Asbestos Abatement Expert Laborer and Superintendent for both abatement and Corporation Treasurer demolition. Assumed roles of Risk Manager, corporate Secretary, and Vice President of Operations. Manages an extremely talented team of project managers. Equipment and material logistics. 2020 - current - Dore & Associates, Inc. - Corporation Treasurer, Chief Superintendent, Risk Management, and Safety Officer. Project Highlights • Viking Die Cast, Kalamazoo, Michigan - Project Facilitator, Preparation of Work Plan and Health & Safety Plan. Characterization and verification sampling. Removal and disposal of hazardous sails. • RCS Evans Site, Gagetown, Michigan - Project Facilitator, Preparation of Work Plan and Health & Safety Plan. Characterization and verification sampling. Removal and disposal of 23,000 tons of non -hazardous soil and 2,000 tons of hazardous soil along with building demolition. • Sunrise Landfill, Plainwell, Michigan - Characterization and verification sampling. Removal and disposal of hazardous and non- hazardous soil and drums from former landfill. • Buckeye Oil Field, Glodwin, Michigan - Characterization and verification sampling. Soil washing of soil, solidification and hauling of oil field contaminated soils. Backfill and site restoration. • State of Michigan - Multi -Site - Contract C, Detroit, Michigan - Asbestos Abatement and demolition of former foundry. Characterization and verification sampling and removal of foundry sand. Dewatering of pits and excavations. Solidification of sludge material and site restoration, Certifications /Affiliations • Building Inspector • Supervision of Asbestos Abatement • Supervision of Hazardous Waste Remediation, Certificate of Completion & Approved Trainer • Controlled Substance Abuse & Alcohol Misuse Training for Transportation Supervisors • VICE PRESIDENT -SPECIAL PROJECTS Jeff has provided his immense experience, leadership and impeccable work ethic to the Dore organization for the past 38 years. Our clients have come to expect a safe and predictable result with Jeff at the helm. Difficult abatement and demolition projects all over the world have been successfully completed by Jeff and his resume is second to none in the industry. The challenges of large projects on tight time lines are all in a days work for Jeff. EMPLOYER SUMMARY 2022 to Present — Vice President — Special Projects/Senior Project Manager - Organize, plan, schedule and control field work to expedite large projects to be completed within time and cost limitations. Direct and coordinate the activities of employees and subcontractors in following the engineer's plans and specifications. Responsible for ensuring compliance with quality control goals and safety plans. Empowered for overall responsibility of major projects and exceeding client expectations. 2017 to 2022: Nasdi, U,C - Vice President - Provides leadership and guidance to advance the company's position in the industry. Develops strategies and tactics to increase revenue profitability and organization growth. Oversees corporate operations to ensure efficiency, quality and customer service. Evaluates performance of management and field operations for compliance with policy, procedure and objectives. Responsible for ensuring compliance with quality control goals and safety. 1986 to 2017: Dore & Associates Contracting, Inc. — Vice President — Special Projects/Senior Project Manager. Organize, plan, schedule and control field work to expedite large projects to be completed within time and cost limitations. Direct and coordinate the activities of employees and subcontractors in following the engineer's plans and specifications. Responsible for ensuring compliance with quality control goals and safety plans. Empowered for overall responsibility of major projects and exceeding client expectations. 1984 to 1986: Asbestos Abatement of America, Inc. — Operations Manager. Assembled, reviewed and negotiated government and private contracts. Developed project administration procedures. Implemented safety and training programs for supervisory personnel. Established company procedures to ensure corporate compliance with applicable safety regulations. CERTIFICATIONS University of South Florida, Tampa, Florida Bachelor of Arts/Business Administration University of Maryland, Munich, Federal Republic of Germany Associate in Arts/Business Qualifier for State of Florida Class "A" General Contractor, CJ C057489 Qualifier for State of Nevada Demolition/Asbestos Contractor 0042942 Qualifier for State of North Carolina General Contractor License 17486 State of Indiana Class "A" Wrecking Contractor W0000150 John Bernelis ON -SITE PROJECT MANAGER, SAFETY REPRESENTIVE John brings his 20 years of demolition experience to every project he manages and represents Dore's safety program throughout the Company, John began his career as an industrial supplier and soon became directly involved in safety gear and equipment being properly placed and used on projects, in 2000, John began his "official" safety position as this important role was beginning to be a focus and take on more prominence with contractors, Currently John plays a key role here at Dore as a major project director and our on -site safety representative, He is responsible for consulting on means and methods used for specific demolition projects, writing and enforcing our safety plan and client satisfaction, John's strong communication skills allow him to direct the safety effort to ensure Dore maintains Its stellar safety record, EMPLOYER SUMMARY 2007 to present: Dore & Associates Contracting Inc, Bay City Michigan - Safety Representative/Project Manager, Responsible for safety plan and performance, job audits, rigging, site logistics, field crews and training, Major project involvement for means and methods resulting in safe demolition practices. 1992 to 2006: Bierlein Companies, Midland Michigan -1992; purchasing and warehouse coordinator for construction equipment, safety supplies and materials, 1994; company Safety Representative performing safety audits, maintenance of all metering devices, documentation, safety reviews, safety meetings, and safety plans, 2000: added responsibility of project management for certain projects, 1987 to 1991: Jenlson Industrial Sales, Bay City Michigan, Sales of Industrial hardware to the construction, demolition and Industrial markets across the Midwest region, PROJECT HIGHLIGHTS State of Missouri — St, Louis Psychiatric Rehabilitation Center, Project Involved removal of asbestos containing material, PCBs, CFC's and various hazardous wastes prior to complete demolition of a large Patient building, power plant and stack, Mr, Bernelis performed oversight for the safety program, asbestos abatement and demolition services. Contract amount; $1,290,000.00 Waste Water Treatment Plant, Saginaw Michigan. Safety Representative/Project Manager— Removal of asbestos containing material, preparation and removal of various incinerators and large mechanical components for the Interior renovation, Contract.amount; $112,000,00 Midland Regional Medical Center, Midland Michigan. Safety representative/Project manager— removal of asbestos containing material from an occupied and functioning hospital. All work was performed in a strict and regulated fashion to ensure the non disturbance of patients and staff. Contract amount; $105,000,00 Michigan Sugar Company, Carrollton Michigan, Safety Representative/Project Manager — demolition of various buildings and structures at the operational sugar processing facility, The client needed several pieces of manufacturing equipment salvaged for reuse which were located at various locations throughout the 5 story plant. This requirement resulted in a "surgical" type of extraction and demolition of the 100 year old structure, The project, which lasted one year, was very successful and 100% safe. Contract amount; $2,000,000.00 Ford Motor Company, General Motors, Chrysler Corp, Project Manager and Safety Representative — various projects within the Midwest. CERTIFICATIONS Licensed Asbestos Contractor/Supervisor in Michigan, Ohio, Missouri, Illinois HAZWOPER Training Hazard Communication, lead and Silica Safe2work Safety Training Program CPR and First Aid Training Confined Space and Entry Rescue Training OSHA 510 OSHA 500 MIOSHA 30 hour Great Lakes Safety Training Dow Chemical and Delphi Site Clearance Training Scott Cianek PROJECT SUPERINTENDENT Scott has been a key player on the Dore team for over a decade and has been Involved in dozens of large, complicated projects. Scott has risen through the ranks of our organization staring as a laborer, and now takes on superintendent duties on abatement and demolition projects throughout the country. Many projects have seen Scott as the project manager as he continues his professional development at Dore. A trademark of Scott's projects is his organizational skills, excellent client communication and project delivery within the schedule, EMPLOYER SUMMARY 2001— present: Dore & Associates Contracting, inc., Bay City, Michigan —Superintendent and project management. Responsible for large abatement and demolition projects within the United States, Project safety plan implementation, field crew supervision, sub -contractor management, project logistics, client meetings and documentation. Since joining Dore as a laborer in 2001, Scott has successfully completed over 75 projects in over a dozen states. 1991— 2001: 21" Century Tool + Die, Munger, Michigan — Machine Operator, Operated machine tool equipment, project layout, proto-type, project supervision, shop production, and inventory control, PROJECT HIGHLIGHTS Logansport State Hospital, Logansport, Indiana — Multiple buildings of 5, 3 and 2 stories was removed from the center of this medical campus. In addition, a 150 FT stack from a former boiler was taken down by hand due to its sensitive location, Over 200,000 SF of structures was involved in the project. Contract amount; $1,650,000.00 T.C. Light & Power, Traverse City, Michigan —This water front power producing facility sat near the historic downtown district. Parts of the plant were disassembled and shipped to Guatamalla for re -use, The remainder of the site was recycled and properly converted to public green space. Contract amount; $1,100, 000.00 Champion Paper Company, Hamilton, Ohio - Abatement and demolition of a 3-story,175,000 SF manufacturing facility, At one point In this structures history, locomotives were produced resulting in massive below grade concrete machine pads that had to be excavated. The heavy duty building was constructed of steel and concrete which was recycled and crushed on site. Contract amount; $625,000.00 YMCA, Port Huron, Michigan --As part of a 4 building abatement and demolition project, the 5-story, riverfront structure was demolished and returned to green space, This building was a community landmark for decades, Along with this building, a large ]all facility and 2 administrative buildings were also removed. Contract amount; $615,000.00 indlana University, Gary, Indiana -- In the center of campus was a fine arts and administration building that were 4 stories tall requiring a "surgical' type extraction, The land was reverted back to green space for the University. Not only was this project 100% safe, it was on time and within budget. Contract amount; $650,000.00 Detroit Foundry, Detroit, Michigan — Extensive environmental clean-up was involved with this demolition of the 200,000 SF Industrial structure. Over 60,000 cubic yards of foundry sand had to be remedlated along with asbestos containing materials. The site was one of 4 projects removed for the City of Detroit under the same contract. All sites were returned to green space. Contract amount; $ 2, 000, 000,00.00 CERTIFICATIONS 40-hour Haz-wopper Confined Space Training CPR/First Aid Asbestos Abatement Supervisor- Licensed in Multiple States 05HA 30 Hour Storm Water Management Daniel Dore ABATEMENT PROJECT MANAGER Dan started his career in the asbestos abatement industry as a laborer in 1988, He has learned this business from the ground up and has become an "expert" in the field. Dan advanced within the company as his skills grew and quickly became a supervisor In 1989. Now with 100 projects to his record, Dan is our most seasoned and respected abatement project manager, Dan is known for demanding excellence and performance from his team and keeps a rigorous schedule to ensure safe and on -time results for Dore and our clients, EMPLOYER SUMMARY 1988 to present: Dore & Associates Contracting, Inc., Bay City, Michigan — Project Manager/Abatement Specialist, Responsible for all aspects of commercial/Industrlal abatement projects Including; safety program enforcement, scheduling, field staff, training, equipment, documentation and disposal. Experienced demolition project management on various projects within the United States, 1983 to 1988: US Army, Fort Brag, North Carolina, Berlin, Germany — Computer Technician for historical and administrative support, honorable discharge. PROJECT HIGHLIGHTS Fairview Gardens, Warren, Ohio — Asbestos Abatement of 18 apartment buildings in preparation for demolition. Contract amount: $850,000,00 Mercy Hospital, Joplin, Missouri —Asbestos Abatement of an 8-story, tornado -damaged hospital structure. The remaining structure was demolished. Contract amount: $728,000,00 Industrial Warehouse, Berwick, Pennsylvania —Asbestos Abatement of a 75,000 SF warehouse In advance of demolition, Contract amount: $264,000.00 Springfield High School, Akron, Ohio — Asbestos Abatement of a large high school in preparation of renovation, Contract amount: $400,000,00 General Motors Plant, Dayton, Ohio —Asbestos Abatement of 1,000,000 SF retired auto plant in advance of demolition. Contract amount: $3,000,000,00 Prudential Building, Chicago, Illinois —Asbestos Abatement of downtown landmark skyscraper to prepare for renovation, Contract amount; $1,700,000,00 CERTIFICATIONS Asbestos Hazard Abatement Specialist Certification — Ohio Asbestos Professional license — Illinois, Missouri Asbestos Project Supervisor license — Indiana Asbestos Contractor/SupervlsorAccredited — Michigan Pennsylvania Asbestos Certification Environmental Safety Training Center, Regulation Exam — Missouri 40 —Hour Hazwopper Training Confined Space Training OSHA 30 Hour'Training CPR/Flrst Air/AED Adult Scaffold Training Bond No.: B 1305665 Selective Insurance Company of America 40 Wantage Avenue Branchville, New Jersey 07890 973-948-3000 AIA Document A310 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we Dore & Associates Inc P O Box 338 Bay City, MI 48707 (Here insert full name and address or legal title of contractor) as Principal, hereinafter called the Principal, and Selective Insurance Company of America a corporation duly organized under the laws of the State of New Jersey as Surety, hereinafter called the Surety, are held and firmly bound unto City Of South Bend IN Board Of Public Works 1316 County -City Bldg South Bend, IN 46617 (Here insert full name and address or legal title of owner) as Obligee, hereinafter called the Obligee, in the sum of _T/o Percent of the Total Bid 5 % Percent) for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Demolition of Drewry's Brewery Located at 1408 Elwood Ave South Bend IN 46628 (Here insert full name and address and description of project) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee 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. Signed and Sealed this 26th day of March 2024 (Witness) Dennis C. Dore, (Witness) Dore & Associates Inc cipal) (Seal) Secretary (Title) Jason C. Dore, President SELECTIVE INSURANCE COMPANY OF AMERICA Michael "Printed in cooperation with the American Institute of Architects (AIA) by the Seld'ctive Insurance Company of America. The language in this document conforms exactly to the language used in AIA Document A310, February 1970 edition." AIA DOCUMENT A310•BID BOND-AIA ® • FEBRUARY 1970 ED•THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON, D.C. 20006 B-203 (12/92) Selective Insurance Company of America 40 Wantage Avenue BE UNIQUELY INSUREDS' Branchville, New Jersey 07890 BondNo.B 1305665 973-948-3000 POWER OF ATTORNEY SELECTIVE INSURANCE COMPANY OF AMERICA, a New Jersey corporation having its principal office at 40 Wantage Avenue, in Branchville, State of New Jersey ("SICA"), pursuant to Article VII, Section I of its By -Laws, which state in pertinent part: The Chairman of the Board, President, Chief Executive Officer, any Executive Vice President, any Senior Vice President or any Corporate Secretary may, from time to time, appoint attorneys in fact, and agents to act for and on behalf of the Corporation and they may give such appointee such authority, as his/her certificate of authority may prescribe, to sign with the Corporation's name and seal with the Corporation's seal, bonds, recognizances, contracts of indemnity and other writings obligatory in the nature of a bond, recognizance or conditional undertaking, and any of said Officers may, at any time, remove any such appointee and revoke the power and authority given him/her. does hereby appoint Michael G. Zervos , its true and lawful atto rney(s)-i n -fact, full authority to execute on SICA's behalf fidelity and surety bonds or undertakings and other documents of a similar character issued by SICA in the course of its business, and to bind SICA thereby as frilly as if such instruments had been duly executed by SICA's regularly elected officers at its principal office, in amounts or penalties not exceeding the sum of: $15,000,000.00 Signed this 26th day of March , 2024 STATE OF NEW JERSEY : ss. Branchville COUNTY OF SUSSEX SELECTIVE INSURANCE COMPANY OF By: f Z/ Brian C. Sarisky Its SVP, Strategic Business Units, SEAL On this 26th day of March 2024 before me, the undersigned officer, personally appeared B�i4a Gu$grisky, who acknowledged himself to be the Sr. Vice President of SICA, and that he, as such Sr. Vice President, being do, executed the foregoing instrument for the purposes therein contained, by signing the name of the c�q fion by fi as Sr. Vice President and that the same was his free act and deed aiW the free act and deed of SICA. i440 TAAf- Charlene Kimble NOTARY PUBLIC STATE OF NEW JERSEY ID # N/A Notary Public MY COMMISSION EXPIRES 81 6 '�,�� f� j • � ��jy�.`�` The power of attorney is signed and sealed by facsimile under and by the authority of the following Resolutr611+agup19a by the Board of Directors of SICA at a meeting duly called and held on the 6th of February 1987, to wit: "RESOLVED, the Board of Directors of Selective Insurance Company of America authorizes and approves the use of a facsimile corporate seal, facsimile signatures of corporate officers and notarial acknowledgements thereof on powers of attorney for the execution of bonds, recognizances, contracts of indemnity and other writing obligatory in the nature of a bond, recognizance or conditional undertaking." CERTIFICATION I do hereby certify as SICA's Corporate Secretary that the foregoing extract of SICA's By -Laws and ResoryQt�ii$I: force and effect and this Power of Attorney issued pursuant to and in accordance with the By -Laws is val` SEAL 1Li7rF__Vx� Signed this 26th day of March 2024. �1 �, _ _ F chael H. Lanza, SICA Corporate ecretary ,� Important Notice: If the bond number embedded within the Notary Seal does not match the number in the upper B91 (4-14) right-hand corner of this Power of Attorney, contact us at 973-948-3000. aZ i CITY OF SOUTH BEND, INDIANA1865 CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Drewry's Brewery Cleanup, Phase I Project No. 119-031C For Bids Due Tuesday, March 26, 2024 @ 9:00 A.M. (E.D.T.) 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. X Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and 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 X Faith Efforts Forms [MBE-2.0 and WBE-2.01 and M/WBE Contacted Forms [MBE-2.1 and WB E-2.1 ]. X Acknowledge Receipt of 1 Addendum(s) included with the bid. X All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either X printed or typed underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: Dore & Associates, Inc. By Authorized Repres Signature: Print Name & Title: fJ ason C. Dore, President Date: 3/26/2024 Version 07/19/2023 Contractor's Bid for Public Works - 1 A (Y) u •0' (U C) 4- C 0) -0 0- 4- E r'l -a 0 a) 0 4� 'P a. 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