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Home My WebLink AboutOpening of Bids - Fellows Booster Pump Station Improvements - Contract A Proj No. 121-070A - EFI-Solutions Inc.CITY OF SOUTH BEND, INDIANA SELLER'S PROPOSAL FOR PUBLIC WORK CHECKLIST FOR PROPOSALS Project Name Fellows Street Booster Station Contract A — Procurement Project No. 121-070A For Proposals Due April 9, 2024 From time to time the South Bend Board of Public Works finds it necessary to reject a Proposal because it does not comply with statutory requirements. In preparing your Proposal, please use the following checklist in order to make sure that your Proposal is done in the proper manner. Proper Proposal security included. The Proposer has the option of providing either a Certified Check or X Proposal (Bid) Bond. X City of South Bend Responsible Proposer Checklist. Proposal prepared on the City of South Bend Seller's Proposal for Public Work Form, completely X executed. Seller's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and Certification of use of United X 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 X Forms [MBE-2.0 and WBE-2.0] and M/WBE Contacted Forms [MBE-2.1 and WBE-2.1]. X Acknowledge Receipt of 0 Addendum(s) included with the Proposal. All required additional information is included with the Proposal, required SRF Forms (including OEE-1, X OEE-2, MWE/WBE Good Faith Effort Worksheet, American Iron and Steel Certificate, etc.) X Performance based certified design submittal and quality control certifications. Proposal statements and other affidavits all signed by the proper party with name either printed or typed X underneath signature. X This checklist submitted with the Proposal. This checklist is provided for Proposer's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the Proposer of the need to read and comply with the specifications. Proposer: EFI-SOLUTIONS INC By Authorized Representative: Signature: Print Name & Title: DAVE EALY C.B.O. / V a—.- TOWNER Version 09/29/2021 Seller's Proposal for Public Works - 1 Date: 04-08-24 CITY OF SOUTH BEND, INDIANA SELLER'S PROPOSAL FOR PUBLIC W 1:71 Project Name Fellows Street Booster Station Contract A —Station Procurement Project No. 121-070A For Proposals Due April 9, 2024 PART 1 (Must be completed for all Proposals. Please type or print) Proposer Date: 04-08-2024 (Firm): Address: P.O. BOX 723 1221 N. ELM ST. City/State/Zip: CENTRALIA, IL 62801 EFI-SOLUTIONS INC Telephone Number: ( 618 ) 533-1351 Agent of Proposer (if Applicable): DAVE EALY Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: Fellows Street Booster Station Contract A — Station Procurement 121-070A the City of South Bend, Indiana, in accordance with plans and specifications prepared by: DONOHUE AND ASSOCIATES and dated APRIL 08, 2024 for the sum of (enter the Total Proposal as shown on the Proposal) Two Million Five Hundred Ninety -Two Thousand Twenty -Five Dollars ($ 2,592,025.00 ) (Enter sum of Total Base Proposal plus Alternates shown on Proposal) (Numerical) The undersigned further agrees to furnish a bond or certified check with this Proposal for an amount specified in the notice of the letting. If alternative Proposals 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 Proposal is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachmer3t. Loan The above Proposal is accepted this Subject to the following conditions: BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Murray L. Miller, Member DAVE EALY C.B.O. /�'dbNER (Printed Name of Person Signing) ACCEPTANCE day of 20 Joseph R. Molnar, Vice President Breana N. Micou, Member Attest: Theresa Heffner, Clerk Version 09/29/2021 Seller's Proposal for Public Works - 2 PART II (For projects of $100,000 or more — IC 36-1-12-4) These statements to be submitted under oath by each Proposer with and as part of his/her/its Proposal. 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 Proposal. 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 Proposal.) 2. Attach a listing of the names and addresses of all sub -sellers (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 sub -Seller. 3. If you intend to sublet any portion of the work, attach the name and address of each sub -seller, equipment to be used by the sub -seller, 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 sub -seller 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 SELLER'S FINANCIAL STATEMENT Attachment of Proposer's financial statement is mandatory. Any Proposal 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 Proposer's capability for completing the project if awarded. Version 09/29/2021 Seller's Proposal for Public Works - 3 When the prospective Seller is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. SELLER'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 Proposals. Please type or print) STATE OF ILLINOIS ) ) SS: MARION COUNTY ) The undersigned Seller, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Seller 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 Proposal by anyone at such letting nor to prevent any person from Proposing nor to induce anyone to refrain from Proposing, and that this Proposal is made without reference to any other Proposal and without any agreement, understanding or combination with any other person in reference to such Proposing. Seller 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. Seller certifies by submission of this proposal that neither Seller 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. Seller has not, nor has any successor to, nor an affiliate of, Seller, 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 Seller is engaged in investment activities in Iran if either: i. Seller, 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. Seller, 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. Seller does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Seller subsequently learns is an unauthorized alien. Seller agrees that he/she/it shall enroll in and verify the work eligibility status of all of Seller's newly hired employees through Version 09/29/2021 Seller's Proposal for Public Works - 4 the E-Verify Program as defined by I.C. 22-5-1.7-3. Seller's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this Proposal/quote; and 5. Seller shall require his/her/its sub -sellers performing work under this public contract to certify that the sub -sellers do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the sub -seller subsequently learns is an unauthorized alien, and that the sub -seller has enrolled in and is participating in the E-Verify Program. The Seller 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 Seller 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 Proposing laws or other contracts in which public Proposals are not required by law, the City, its agencies, boards, or commissions will consider the Seller's good faith efforts to obtain participation by those sub - sellers 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 Proposer. Sellers 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, Sellers are required to either meet both MBE and WBE utilization goals or demonstrate that the Seller has made good faith efforts to obtain participation from MBE and WBE sub -sellers. A finding of noncompliance or a discriminatory practice shall prohibit that Seller 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 Seller 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. Seller 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 Proposer or agent as Seller 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 sub -sellers 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 Proposal 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 Proposal 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 may result in forfeiture of contractual payments. Version 09/29/2021 Seller's Proposal for Public Works - 5 I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing Proposal for public works are true and correct. Dated this 8TH day of APRIL , 20 24 Subscribed and sworn to before me this 8TH My Commission Expires 02-26-2026 EFI-SOLUTIONS INC Seller/Pro o Firm) Signature o e ler/Pro o s Agent DAVE EALY C.B.O. / V. P . / OWNER Printed Name and Title day f APRIL 20 24 Notary Public County of Residence CLINTON, IL Official Seal Gina Marie Fos(e Notary Public State of H, :•^,is My Commission Xnir S L �' _:�26 Version 09/29/2021 Seller's Proposal for Public Works - 6 PROPOSAL CITY OF SOUTH BEND Project Name: Fellows Street Booster Station Contract A — Station Procurement Project Number: 121-070A For Proposals Aril 9, 2024 Due: p Seller Name: ENGINEERED FLUID INC. D.B.A. EFI-SOLUTIONS INC. BASE PROPOSAL Item Description Quantity Unit Unit Price Total Amount No. 1 PRE -PACKAGED BOOSTER PUMP 1 LS 215927025000 21592,025400 STATION Proposer (Firm): Address: City/State/Zip BASE PROPOSAL TOTAL 2,592,025.00 EFI-SOLUTIONS INC. PO BOX 723 1221 N ELM ST. CENTRALIA, IL 62801 Telephone Number: 618) 533-1351 (Sig DAVE EALY C.B.O. / V.P /OWNER (Printed Name of Person Signing) Version 09/29/2021 Seller's Proposal for Public Works - 7 O CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN r PEACE,z FORM MBE-1.0 - x MBE UTILIZATION PLAN 1865 This completed form should be supplied with Proposals that pertain to City of South Bend Public Works Projects involving MBE participation. It is the Proposer's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. Project Number: Proposer: 121-070A Project Name: Fellows Booster Station Contract A -Station Procurement Total Proposal EFI-SOLUTIONS INC. Amount. - 0 MBE Goal: Page_ 0 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 Proposal/ roosal Submitted by: MICHAEL ENGLISH dLWz , 6� Print Name Signature Version 09/29/2021 Seller's Proposal for Public Works - 8 04-08-2024 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 Proposals documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MBE participation. Project Number: 121-070A Date: 04-08-2024 Project Name: Fellows Booster Station Contract A — Station Procurement Proposer: EFI-SOLUTIONS INC Contact Person: Michael English Telephone: 618-533-1351 Address: 1221 N. Elm St., City: Centralia, State: ILLINOIS Zip: 62801 Email: menglish@efi-solutions.com To determine whether a Proposer 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 Proposer 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.gov/idoa/. GOOD FAITH EFFORTS TO OBTAIN MBE PARTICIPATION The Proposer 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 ME 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 ME 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 ME means the interest of all MBEs in the scopes of work of the contract. I affirm that I attended all pre -Proposal meetings scheduled by the City of South Bend to ME inform MBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications ME 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 ME reasonably calculated to inform MBEs of subcontracting opportunities and allowed sufficient time for MBEs to participate effectively. ME 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 ME with adequate information about the plans, specifications and other requirements of the subcontract. Version 09/29/2021 Seller's Proposal for Public Works - 9 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 bonding, ME lines of credit, or insurance as required by the City or the Proposer, where appropriate. I affirm that I have made good faith efforts to assist interested MBEs in obtaining necessary ME 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 ME on a thorough investigation of their capabilities. CONTRACT RECORDS: The Proposer has maintained the following records for each MBE that has Proposal on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the Proposer or sub -seller; 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 Proposal by the Board of Public Works. The City of South Bend reserves the right to request additional information. 4"_4� L'�Lj Version 09/29/2021 Seller's Proposal for Public Works - 10 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN Vt.AVF. -yam FORM MBE-2.1 it sus x WBE CONTACTED This completed form should be supplied with Proposals that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact MBEs. It is the Proposer's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. Attach additional pages if necessary. PAGE 1 OF 1 Project Number: 121-070A MBE Participation Goal O Project Name: Fellows Street Booster Station Contract A — Station Procurement Proposer: EFI-SOLUTIONS INC. By: MICHAEL ENGLISH E.V.P. / OWNER 04-08-2024 (Signature) (Title) (Date) MBE Firm N/A 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 N/A 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 Seller's Proposal for Public Works - 11 WARRANTY STATEMENT The warranty for the booster pumping system is the sole responsibility of the booster pumping system manufacturer and includes the following: 1. The warranty shall be for a period of three (3) years commencing upon station startup. 2. The three (3) year warranty period shall be inviolate regardless of any component manufacturer's warranty for equipment and components within the station. 3. The warranty shall cover all equipment, components and controls, provided under this contract by the booster pumping system manufacturer, exclusive of those components supplied by and/or installed by others independent of the control of the booster pumping system manufacturer. 4. The booster pumping system manufacturer shall bear the full cost of labor and materials for replacement and/or repair of faulty or defective components, or controls, supplied by the booster pumping system manufacturer on site as required so there shall be no cost incurred by the Owner for this work during the warranty period. 5. No assumption of contingent liabilities for any component failure during warranty is made. This warranty is provided by the booster pumping system manufacturer as the single party responsible for warranting all components included with the booster pumping system on site and all aspects of performance as specified. The booster pumping system manufacturer does not utilize "Second Party" or "pass through" warranties. All warranty service will be provided by factory direct booster pumping system manufacturer employees. Dated: 04-08-2024 State of IL County of MARION EFI-SOLUTIONS INC. Company Name Company Officer' ure The above WARRANTY STATEMENT was signed and acknowledged before me on this 8T1-iflay of APRIL , 202 4 by DAVE EALY (Officer), acting in the aforesaid capacity for EFI-SOLUTIONS INC. (Company). official Se7ter NotaryPublic <:;na Marie F Lt vt�Ya; y tlublic Stat,,p Seller's roposal for Public Works 12 CERTIFIED WELDING AND STEEL STATEMENT All capsule, skid, structural, transmission piping, pipe and equipment supports, and restraint, welding; shall only be performed by certified welders. All transmission piping or pressure vessel welding shall be performed by individuals certified to weld carbon steel pipe under ASME CODE SECTION IX. All other welding shall be performed by individuals certified under ASME CODE SECTION IX or by the American Welding Society (AWS) Structural Welding Code, Section 9.10. Prior to welding all structural supports, transmission piping, pipe and equipment supports, and restraints, shall be grit blasted to near white blast cleaning (SSPC-SP10). All steel used for fabrication of the booster pumping system shall be domestic. This includes, but is not limited to, all steel used in fabricating the capsules, skids, all structural steel, all supports and bracing, and all transmission piping, flanges, and fittings. Dated: 04-08-2024 EFI-SOLUTIONS INC. State of I L County of MARIOf� Company Officer' Company Name The above CERTIFIED WELDING aDAVE IEALY before me on this (Officer), acting EFI-SOLUTIONS INC. (Company). i°r6tu re AND STEEL STATEMENT 8TH day of APRIL in the aforesaid � Official Seal UbIIC - Gina Marie Foster Notary Public State of Illinois My Commission ExPires2/26)2026 Seller's Proposal for Public Works 13 was signed and 202 4 by capacity for CORROSION PROTECTION STATEMENT Detailed in this submittal is a complete manufacturing methodology for corrosion protection to be utilized by the booster pumping system manufacturer. Key components of that manufacturing methodology are listed below. SURFACE PREPARATION AND EXTERIOR COATING All surfaces of the entire structure including the entire skid and base plate shall be grit blasted equal to near white blast cleaning (SSPC-SP10). Following blasting and directly before full painting, all weldments will be hand primed with a covering primer coating. The protective coating shall take place immediately after surface preparation. The protective coating shall consist of a two component, high solids, amide -cured epoxy system formulated for high build application having excellent chemical and corrosion resistant properties. The epoxy system shall be self -priming and require no intermediate coatings. The protective coating shall provide in two (2) applications a total dry mil thickness of 8.0 mils minimum, 11 mils maximum. FUSION BONDED EPDXY INTERNAL PIPE COATING The internal surfaces of piping to be fusion bonded coated shall be grit blasted to an SP-10 finish with the finish profile required by the coating material manufacturer. The internal, wetted surfaces of the steel transmission piping shall have applied to it a Fusion Bonded Epoxy Coating on the interior pipe surface. The coating shall be applied and meet the testing requirements of Table 1 and Table 2 with the exception of Table 2 section 7 per AWWA C-213. The powder coating product shall be National Sanitation Foundation (NSF) Standard 61 certified material. Prior to shipment of the station, the station manufacturer shall provide in writing to the Engineer certification that the fusion bonded epoxy coating has been applied to all internal surfaces of the steel piping using the proper method. Said certification shall show under the station manufacturer's letterhead: - Date of application; - Material manufacturer and product designation including a product data sheet for the coating; - Applier of the fusion bonded coating, name, address and phone number; - Notarized signature of an officer of the station manufacturing company stating the fusion bonded epoxy coating was applied to AWWA Standard C213-91 or the latest revision. PIPING Piping shall be steel and conform to material specification ASTM A-53 (CW) for nominal pipe size four (4) inch and smaller and ASTM A-53 (ERW) Grade B for nominal pipe size five (5) inches and larger. Steel butt -welding fittings shall conform to material specification ASTM A-234 Grade WPB and to the dimensions and tolerances of ANSI Standards B1.9 and B16.28 respectively. Forged steel flanges shall conform to material specification ASTM A-105 Class 60 and/or ASTM A- 181 for carbon steel forgings and to the dimensions and tolerances of ANSI Standards B16.5 as amended in 1992 for Class 150 and Class 300 flanges. The piping sizes shall be as shown on the drawing. Size 10 inch and below - Schedule 40 Size 12 inch and above - Standard weight (.375" wall) Seller's Proposal for Public Works 14 All pipe welds shall be performed by certified welders employed by the booster pumping system manufacturer. As part of the equipment submittal, the pumping system manufacturer shall provide copies of the welding certificates of the employees who are to perform the pipe welds. All piping surfaces shall be prepared by sandblasting, or other abrasive blasting, prior to any welds taking place. Piping or 5" diameter and smaller may be cut by saw. Piping of 6" diameter and larger shall be bevel cut, and Oxyfuel or Plasma -arc cutting techniques shall be used to assure and facilitate bevel pipe cuts. No saw cuts or other form of abrasive cut-offs are allowed on 6" and larger diameter pipe. In all cases, short circuit transfer, spray transfer or pulse -arc transfer modes of the gas metal arc welding process shall be applied semi -automatically. When utilizing the short circuit mode, shielding gas shall be used. When utilizing the short circuit mode, shielding gas consisting of 50% carbon dioxide and 50% argon gas shall be used. When utilizing the spray or pulse -arc transfer modes, a shielding gas consisting of 5% carbon dioxide and 95% argon shall be used. In all cases, welding wire with a minimum tensile strength of 70,000 psi shall be employed. All tensile strength of 60,000 psi shall be employed. All flange welds and butt welds of equal size pipe shall be a single continuous nonstop weld around the complete circumference of the pipe. Whenever possible, vertical up weld passes will be applied to all pipe welds. No vertical down weld passes will be allowed. Completed welding assemblies shall create no internal obstruction, restriction or create any unintended sources of water deflection. Piping of six (6) inch diameter and larger shall require a minimum of two (2) weld passes to complete each weld. The first pass, or root pass, shall be applied at the bottom of the bevel cut using the short circuit transfer welding mode, and the second pass, or cap pass, shall be applied over the root pass using the spray or pulse arc transfer welding modes to insure that at a minimum the total weld thickness shall be equal to thinnest of the two (2) pieces being welded together. Dated: APRIL 8. 2024 State of ILLINOIS County of MARION EFI-SOLUTIONS, INC. Company Name The above CORROSION acknowledged before me o DAVID A. EALY (Officer), EFI-SOLUTIONS. INC.(Company). Notary Public PROTECTION I this WSJ-{ acting in re SYSTEM STATEMENT was signed day of APRIL 2024 the aforesaid capacity Official Seal Gina Marie Foster Notary Public State of Illinois rviy Commission Expires 212612026 Seller's Proposal for Public Works 15 and by for FACTORY START-UP AND SERVICE STATEMENT Start-up Cl"d warranty service shall be performed by the booster pumping system manufacturer factory direct employees. No representative, contract service organization or third party of any sort shall be directed to perform such services by the booster pumping system manufacturer. 1. Start-up and warranty service technicians shall be regular factory direct employees. 2. At least one of the following factory direct employees will perform all services and warranty work as required on the booster pump station: EMPLOYEE NAME POSITION YEAR OF SERVICE CHARLES WAGGONER SERVICE MANAGER CODY KEEN SCOTT MOORE ASST. SERVICE MANAGER SERVICE TECHNICIAN SERVICE TECHNICIAN 32 22 LINCOLN DICKINSON SERVICE TECHNICIAN 05 3. One (1) or more of the Service Technicians listed above will perform the required start-up and warranty service on the booster pumping system. 4. A total of two (2) days for start-up and training on site shall be provided. 5. Start-up service to include two (2) bound O&M Manuals for the booster pumping system and one (1) SSD drive with all O&M Manual and approved submittal documents. 6. All start-up or service reports shall be attested to by start-up technician and representatives of Owner or Engineer. 7. Service reports shall be distributed to: a. Manufacturer's File b. Engineer's File c. Contractor's File d. Owner's File Dated: APRIL 8, 2024 State of ILLINOIS County of MA ION EFI-SOLUTIONS Company Name Company Officer's Sign The above FACTORY START-UP AND SERVICE STATEMENT was signed and acknowledged before me on this 8TH day of APRIL 2024 by DAVID A. EALY (Officer), acting in the aforesaid capacity for EFI-SOLUTIONS. INC.(Company), Notary Public -_ Official Seal Gina Marie Faster Notary Public State of Illinois My Commission Expires 2/2612026 Seller's Proposal for Public Works 16 APPLICABLE STANDARDS AND LISTINGS This booster pumping system will be manufactured to pertinent sections of the following standards and listings: 1) Underwriters Laboratories, Inc. (UL) ULQCZJ7 UL5081 UL508SE3 UL58. 2) National Electric Code (NEC) Compliance 3) American Water Works Association 4) Electrical Testing Laboratory (ETL) 5) American National Standards Institute (ANSI) 6) American Society for Testing and Materials (ASTM) 7) American Welding Society (AWS) 8) American Society of Mechanical Engineers (ASME) 9) Society For Protective Coatings (SSPC) (formally Steel Structures Painting Council) 10) National Sanitation Foundation (NSF) 11) Ten States Standard Dated: APRIL 8, 2024 State of ILLINOIS County of MARION EFI-SOLUTIONS, INC. Company Name Company ignature The above APPLICABLE STANDARDS AND LISTING STATEMENT was signed and acknowledged before me on this 8TH day of APRIL 2024 by DAVID A. EALY (Officer), acting in the aforesaid capacity for EFI-SOLUTIONS, INC.(Company). ` Official Seal _ _ Gina Marie Faster Notary Pub is Notary Public State of lilinois My Commission Expires 2126/2026 Seller's Proposal for Public Works 17 CERTIFICATION OF COMPLIANCE We the undersigned booster pumping system manufacturer have reviewed the plans and specifications and herein certify we will bid the project as specified without exception or deviation. We the undersigned booster pumping system manufacturer understand conditional proposals will not be accepted and submission of a proposal by a booster pumping system manufacturer, will constitute an incontrovertible representation by the booster pumping system manufacturer that without exception the proposal is premised upon all work as required by these plans and specifications and will be completed fully as specified. We the undersigned booster pumping system manufacturer understand the Contract Documents are the final authority for acceptance of the work provided. We understand the booster pumping system manufacturer is required to provide the required design with bid submittals. We the undersigned booster pumping system manufacturer understand the Engineer and Owner shall be considered the sole judge of the merits of the manufacturers design with bid submittal. We the undersigned booster pumping system manufacturer understand we are eligible to offer equipment proposals for this work provided no exceptions of deviations are taken to the plan design and product specifications and provided we strictly abide by the requirements set forth in the complete design with bid submittal. We the undersigned booster pumping system manufacturer, understand award of the contract for this work will not be based solely on price. Overall booster pumping system design, price, qualification of the bidder, qualification(s) of subcontractors, and the demonstrated intent by the bidder to adhere to all aspects of these performance plans and specifications will all be factors in determining the award. We the undersigned booster pumping system manufacturer understand this is a performance specification format. Liability for the design and performance of the booster pumping system, telemetry, and SCADA controls as specified herein will remain with the booster system manufacturer. It is the responsibility of the booster system manufacturer to fully understand the application as specified herein and to design and manufacture, the booster pumping system and telemetry / SCADA controls to the specified quality standard, to perform as required by the Engineer and Owner. Dated: APRIL 8. 2024 State of ILLINOIS County of MARION EFI-SOLUTIONS. INC. Company Name Company Offi nature The above Certification of Compliance was signed and acknowledged before me on this 8THday of APRIL 2024 by DAVID A. EALY (Officer), acting in the aforesaid capacity for EFI-SOLUTIONS, INC (Company), Notary Nublic Official Seal Gina Marie Foster Notary public State of Illinois My Commission Expires 2/2612026 Seller's Proposal for Public Works 18 EFI—SOLUTIONS e��-sa��a�s �om CERTIFICATE OF AUTHORIZATION 00 O I, Michael Neudecker, President of EFI-Solutions, a corporation organized under the laws of the State of Delaware, do hereby certify that Michael English, as Vice President of said corporation, is authorized to sign contract documents and act on behalf of Engineered Fluid, Inc. and all its subsidiaries including Applied Hydro Sales and Engineered Solutions Midwest, Inc. ATTEST: Michael Neudecker, President Engineered Fluid, Inc. LISA KOGER Official Seal � NaCary Publie -State of Illinois N1r commission Expires Jul 21, 2025 P.O. Box 723, 1221 N. Elm St., Centralia, IL 62801 ♦ Ph: (618) 533-1351 ♦ Fax: (618) 533-1459 EFI-SOLUTIONS solUtions.com CERTIFICATE OF AUTHORIZATION 00 O I, Michael Neudecl<er, President of EFI-Solutions, a corporation organized under the laws of the State of Delaware, do hereby certify that David Ealy, as Vice President of said corporation, is authorized to sign contract documents and act on behalf of Engineered Fluid, Inc. and all its subsidiaries including Applied Hydro Sales and Engineered Solutions Midwest, Inc. ATTEST: Michael Neudecker, President Engineered Fluid, Inc. LISA KOGER Official Seal N�tarV Public -State of Illinois My Oornmission Expires Jul 21, 2025 P.O. Box 723, 1221 N. Elm St., Centralia, IL 62801 ♦ Ph: (618) 533-1351 ♦ Fax: (618) 533-1459 Engineered Fluid, Inc. is now operating under the d. b. a. of P.O. 723 1311 N. Maple R Centralia, IL 62801 (618) 533 1351 info@engineeredfluid.com www.engineeredfluld.com EFI-SOLUTIONSDO eII"SUIutions.com P rof Engineered Fluid Inc. (EFI) is a privately heldI solely employee -owned company headquartered in Centralia, Illinois. EFI specializes in design, manufacture, service and support of custom, packaged equipment for various utility industries including Municipal, Industrial, Electrical, Mining, Power Generation, etc... Serving all industries that can benefit from intelligent designed, Mechanical & Electrical Packages. Innovator. In EFI's early days the main focus was on the Potable Water Industry, where EFI is the leader and innovator in providing quality to packaged equipment. EFI has made numerous improvements to industry standards to provide its customers with the best solution for their need. Some of these features/methods seem small but they serve a significant function. Single Source Responsibility — No more vendors pointing their fingers at each other. No matter the component included in the package equipment, there is just one call. Polyurea Coating —Applied on steel floors and steel doors. This product is far superior to the epoxy typically used. For moisture insensitive applications, this coating contains a strong chemical resistance that protects various substrates against moisture. UL Electrical Panels —EFI was the first in the industry with a UL shop. Designing Factory -Built Quality iEqui��,�.,�- �� LEADER/INNOVATOR Fusion Bonded Interior Steel Pipe Coating — This baked -on product outperforms the standard two-part epoxy. Lap Joint Steel Vault Construction —While this joint is as strong as "T" weld, the use of the Lap Joint is all about corrosion protec- tion, by keeping the weld above the floor of the capsule. Welded, Steel Supports —Are more sturdy and have less move- ment than the industry standard clamp bracing. EPC &Motor Pads —Cushion the vibration of motors and lessen the torque on the pipeline. Pressure Gauges —Secured on steel plate, off the pipeline for accurate reading and subsequent proper operation. Working Area — EFI's designs always include necessary ample working area. EFI was founded in 1964 by Jack Goodspeed when a customer had a need for packaged equipment. Jack met that customer's need and EFI continues the tradition today. The corporation is headquartered in Centralia, Illinois, where it was originated. A second manufacturing site was added to accommodate EFI's increased product line. EFI started in the Potable Water industry providing custom valve stations, meter stations, and pump stations. Since its conception, EFI has added: - Telemetry and Controls Process Equipment Stations Modular Buildings Multi -Unit Stations - Design/Build - Electrical Enclosures Off -Campus Rapid Response Centers Water Distribution & Other for the Mining Equipment EFI-SOLUTIONS efi- solutions.com 00 O UL 508 ETLW NEC State Building Codes Certifications MSHA OSHA CSA Certified ANSI/AWS ASME Design — EFI's design team of roughly 25 personnel consists of Mechanical, Civil, Electrical, Nuclear Engineers, Designers and Drafters. EFI includes comprehensive submittals and Operational k Maintenance Manuals. Manufacturing —EFI employs about 100 production employees fully trained in their trade. With two manufacturing locations in Centralia, EFI has 151,000 square feet under roof. Production areas include: 1 UL Panel Lab Welding Shop Electric Panel Shop Building Shop`; *•;� Fusion Bonding Shop Telemetry & Controls Shop 3 Paint Bays 8 Fabrication Baysall S{ Welder Areas Tank Build Shop Phosphate Wash Bay Sand Blast Shop Delivery — 97% of EFI's equipment is delivered by EFI person- nel. This means the responsibility of the equipment remains with ' EFI through transport. Installing Contractors have readily avail- able to them, at the job site, a knowledgeable person who has f seen hundreds of installations. Site Project Managers —Where site work is part of EFI's scope, EFI will assign a dedicated Project Manager. Start-up Services/Warranty/Service/Maintenance —Over a dozen Service Personnel are based in various locations across \.-=��. the U.S. with more locations to come. Rai Im EFI -SOLUTIONS efi-solutions.com VAO EFI SOLUTIONS of i- solutI ns.com 00 O Engineered Fluid Inc. dba EFI-Solutions POTABLE WATER SERVICE INSTALLATIONS WESTMORELAND, PA EFI JOB #91814, 92637 DATE OF INSTALLATION: 12/17/15 BOOSTER PUMP STATION DATE OF INSTALLATION: 01/12/16 OWNER: MUNICIPAL AUTHORITY OF WESTMORELAND P. O. BOX 730 GREENSBURG, PA 15601 CONTACT: MR. BRUCE REBRECHT (724) 755 5969 ENGINEER: GIBBON & THOMAS ENGINEERING CO INC 1004 LIGONIER ST LATROBE, PA 15650 CONTACT: BRUCE GRAHAM (724)539 8562 2778 GPM @ 18117DH ER PUMP STATION BOOST 2778 GPM @ 218'TDH LORAIN COUNTY, OH EFI JOB #91895 & 92685 DATE OF INSTALLATION: 08/12/16 WATER -SHED° BOOSTER PUMP STN. 2600 GPM @ 162'TDH DATE OF INSTALLATION: 10/27/16 WATER -SHED° BP/CHEM FEED STN, 1400 GPM @ 120'TDH OWNER: RURAL LORAIN COUNTY WATER AUTHORITY P.O. BOX 567 LAGRANGE, OH 28594 MR. TIM MAHONEY CONTACT: (440) 355-5121 ENGINEER: GRW ENGINEERS 100 E CAMPUS VIEW BLVD COLUMBUS, OH 43235 CONTACT: CRAIG FARRELL (317)347 3650 Page 1 WESTCHESTER, NY DATE OF INSTALLATION: 12/12/2016 OWNER: WESTCHESTER JOINT WATER WORKS 1625 MAMARONECK AVE MAMARONECK, NY 10543 MR. FRANK ACARA CONTACT: (914)698 3500 ENGINEER: H2M ARCHITECTS &ENGINEERS 538 BROAD HOLLOW RD MELVILLE, NY 11747 CONTACT: TIRA MCGUIRE (631)756 8000 AVON LAKE, OH DATE OF INSTALLATION: 11-15-2018 OWNER: AVON LAKE REGIONAL WATER 201 MILLER RD AVON LAKE, OH 44012 CONTACT: RICK EBERLE (440)933 6226 ENGINEER: BURGESS & NIPLE INC 100 WEST ERIE STREET PAINESVILLE, OH 44077 WATER -SHED° BOOSTER PUMP STN, 4167 GPM @ 255'TDH EFI JOB WATER -SHED° BOOSTER PUMP STN. CONTACT: TIMOTHY M. ANTOS P.E. (440)354 9700 AVON LAKE, OH 3000 GPM @ 126'TDH I JOB NO: 93315 DATE OF INSTALLATION: 08/10/2017 WATER -SHED° BOOSTER PUMP STN. ' 2900 GPM 280 @ TDH OWNER: AVON LAKE MUNICIPAL UTILITIES 201 MILLER RD. AVON LAKE, OH 44012 CONTACT: RICK EBERLE (440)933 6226 ENGINEER: GRW ENGINEERS 801 CORPORATE DR. LEXINGTON, KY 40503 CONTACT: MR. MR. MICHAEL JACOBS, P.E. (859)223 3999 PROPOSAL SECURITY (BID BOND) DocuSign Envelope ID: 93698938-95BE-4883-84A3-DE66A8D303C3 BID BOND (PENAL SUM FORM) Bidder Name: Engineered Fluid, Inc DBA EFI-Solutions Address (principal place of business): PO Box 723, 1221 N Elm, Centralia, IL 62801 Owner Name: City of South Bend, IN Address (principal place of business): 227 West Jefferson Blvd, Suite 1300 N South Bend, Indiana 46601 Bond Penal Sum Date• of Bond: $100,000 May Sth, 2024 Surety Name: Travelers Casualty and Surety Company of America Address (principal place of business): One Tower Square, Hartford, CT 06183 Bid Project (name and location): Fellow Street Booster Station Contract A - Station Procurement Project No. 121-070A City of South Bend, Indiana Bid Due Date: 04/02/2024 Surety and Bidder, intending to be legally bound hereby, subject to the terms set forth in this Bid Bond, do each cause this Bid Bond to be duly executed by an authorized officer, agent, or representativef: Bidder Engineered Fluid, Inc DBA EFI-Solutions Bpi �:' ��• Name: Dave Ealy (Printed or typed) Title: C.B.O. / V.P. / Owner MOF Name: Gina Foster (Prin Title: Senior Sales Coordin Surety Travelers Casualty and Surety Company*of America (F II forif emurety) (ccrporate sea!) By: 1 nature Attach Power of Atiorney) Name: Chelsea Eilers 11 (Printed or typed)••..,..•...._.•.. Attorney -in -Fact Title: ,,,,„„�,„„ �,,,,. Attest: I Official Seal Gina Marie Foster Name: or f>fp.�rdj'y Public State of Illinois Commission Expires 212�'i�Fp 6 J' ...(Signature) Scott Voellinger (Printed or typed) anaging Director Notes: (1) Note: Addresses are to be used for giving any required notice. (2) Provide execution by any additional parties, such as joint venturers, if necessary. EJCDCm C-430, Bid Bond (Penal Sum Form). Copyright° 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved. Page 1 of 2 DocuSign -nvelope ID: 93698938-95BE-4883-84A3-DE66A8D303C3 1. Bidder and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assigns to pay to Owner upon default of Bidder the penal sum set forth on the face of this Bond. Payment of the penal sum is the extent of Bidder's and Surety's liability. Recovery of such penal sum under the terms of this Bond will be Owner's sole and exclusive remedy upon default of Bidder. 2. Default of Bidder occurs upon the failure of Bidder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents. 3. This obligation will be null and void if: 3.1. Owner accepts Bidder's Bid and Bidder delivers within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents, or 3.2. All Bids are rejected by Owner, or 3.3. Owner fails to issue a Notice of Award to Bidder within the time specified in the Bidding Documents (or any extension thereof agreed to in writing by Bidder and, if applicable, consented to by Surety when required by Paragraph 5 hereof). 4. Payment under this Bond will be due and payable upon default of Bidder and within 30 calendar days after receipt by Bidder and Surety of written notice of default from Owner, which notice will be given with reasonable promptness, identifying this Bond and the Project and including a statement of the amount due. 5. Surety waives notice of any and all defenses based on or arising out of any time extension to issue Notice of Award agreed to in writing by Owner and Bidder, provided that the total time for issuing Notice of Award including extensions does not in the aggregate exceed 120 days from the Bid due date without Surety's written consent. 6. No suit or action will be commenced under this Bond prior to 30 calendar days after the notice of default required in Paragraph 4 above is received by Bidder and Surety, and in no case later than one year after the Bid due date. 7. Any suit or action under this Bond will be commenced only in a court of competent jurisdiction located in the state in which the Project is located. 8. Notices required hereunder must be in writing and sent to Bidder and Surety at their respective addresses shown on the face of this Bond. Such notices may be sent by personal delivery, commercial courier, or by United States Postal Service registered or certified mail, return receipt requested, postage pre -paid, and will be deemed to be effective upon receipt by the party concerned. 9. Surety shall cause to be attached to this Bond a current and effective Power of Attorney evidencing the authority of the officer, agent, or representative who executed this Bond on behalf of Surety to execute, seal, and deliver such Bond and bind the Surety thereby. 10. This Bond is intended to conform to all applicable statutory requirements. Any applicable requirement of any applicable statute that has been omitted from this Bond will be deemed to be included herein as if set forth at length. if any provision of this Bond conflicts with any applicable statute, then the provision of said statute governs and the remainder of this Bond that is not in conflict therewith continues in full force and effect. 11. The term "Bid" as used herein includes a Bid, offer, or proposal as applicable. EJCDC° C-430, Bid Bond (Penal Sum Form). Copyright° 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved. Page 2 of 2 ATTACHMENT "A" THE LIABILITY OF THE SURETY UNDER ANY WARRANTY PROVISIONS OF THE CONTRACT IS LIMITED TO CORRECTING DEFECTIVE WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FROM THE ACCEPTANCE DATE OF THE PROJECT. NO OTHER IMPLIED OR WRITTEN WARRANTIES ARE EXTENDED BY THE SURETY. �`� CERTIFICATE OF LIABILITY INSURANCE DAT/29/2D/YYYY) 11/29/2023 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 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 CONTACT SRM GROUP, LLC NAME: DBA STRATEGIC RISK MANAGEMENT AIc° No Ext: FAX No: E-MAIL P O BOX 445 ADDRESS: Belleville IL 62220 INSURERS AFFORDING COVERAGE NAIC # INSURERA: TRAVELERS INDEMNITY CO. INSURED ENGINEERED FLUID, INC. INSURERB: TRAVELERS INDEMNITY CO. INSURERC: TRAVELER'S PROPERTY CASUALTY COMPAIt DBA EFI-SOLUTIONS, INC. INSURER D : TRAVELERS INDEMNITY CO. 1221 N. ELM ST INSURERE: ILLINOIS UNION INSURANCE COMPANY Centralia IL 62801 INSURERF: TRAVELER'S PROPERTY CASUALTY COMPANY COVERAGES CERTIFICATE NUMBER: LIBERTY SURPLUS INSURAREVISION 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 INS SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I —XI OCCUR Y-630-5X292933-TIA-23 12/1/2023 12/1/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X I POLICY PRO JECT LOC $ B AUTOMOBILE LIABILITY ANY AUTO 810-5X252609-23-14-G 12/1/2023 12/1/2024 COMBINED SINGLE LIMIT Ea accident 1000 $ , ,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS C X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE CUP-5X294742-23-14 12/1 /2023 12/1 /2024 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED—F7 RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- D AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE UB-5X29224A-23-14-G 12/1/2023 12/1/2024 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 E POLLUTION LIAB CPY G27169156 010 12/1/2023 12/1/2024 $1M/$1M G INSTALLATION FLTR QT-660-5X357905-TIL-23 12/1/2023 12/1/2024 $500,000 H PROFESSIONAL LIAB SAE5NAANB82012 04/25/2023 04/25/2024 $2M/$2M DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) ***FOR BIDDING PURPOSES*** - PROOF OF INSURANCE CFRTIFICATF HOI nFR CANCELLATION ENGINEERED FLUID, INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 723 ACCORDANCE WITH THE POLICY PROVISIONS. Centralia IL 62801 AUTHORIZED REPRESENTATIVE 9)1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Travelers Casualty and Surety Company of America Aftk Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Faul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Chelsea Eilers of BELLEVILLE , Illinois , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WETNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April, 2021. �eS��fYp� g+�ASTr gyas FA p Gy w " a HAHTFORD, , � CONN. c �fi 1:ti vy yDi State of Connecticut By: City ci Hartford ss. Robert L. Rane , enior Vice President On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice 'resident of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN W[rNESS WHEREOF, I hereunto set my hand and official seal. � NQfiAgY #i. My Commission expires the 30th day of June, 2026 =� Anna P. Nowik, Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the CDmpanies, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority my prescribe to sign with the Company's name and seal with the Company'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 or the Board of Directors at any time may renove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or anv Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, an-i Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to an-; Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in- Fa--t for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Atbrney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed anj certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or unlerstanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a true End correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect. Dated this 03 day of March , 2023 4 �NiC $LgFyy gJ�l[Y AHD s "0, W t Kevin E. Hughes, Assi tant Secretary To verify the authenticity of this Power ofAttorney, please call us at 1-800-421-3880. Please refer to the above-namedAttorney(s)-in-Fact and the details of the bond to which this PowerofAttorney is attached. BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date: 03-29-2024 Name: Jacob M. Klosinski Department of Public Works — Engineering Division BPW Date: 04-09-2024 Phone Extension: 9496 Required Prior to Submittal to Board BPW Attorney X Attorney Name Michael Schmidt Dept. Attorney ® Attorney Name Michael Schmidt Purchasing ® Mickey Low / Ron O'Connor Check the Appropriate Item Type — Required. for All Submissions ❑ Professional Services Agreement ❑ Contract ❑ Proposal ❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA ® Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes ❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA ❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution n Other: n Ease./Encroach Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Information ❑ Yes❑ If Yes, Approved by Purchasing ❑ No ❑❑ WBE Completed E-Verify Form Attached ❑❑ Nos Fellows Booster Pump Station — Contract A (Pump Station Procurement) 121-070A / PROJ00000032 State Revolving Fund & Water Capital Fund 622 PR/PO # Special Contract Provisions Indiana Finance Authority Special Provisions and MWBE Goals Purpose/Description Public Works, the Division of Engineering and Division of Water Works requests the Board of Public Works receive and open Public Bids for the Project 121-070A Fellows Booster Pump Station — Contract A (Pump Station Procurement) at its regular meetinL- on 04/09/2024. Amount of Previous Amount ❑ Increase ❑ Decrease Current Percent of Change New Amount Total Percent of Change: Time Extension Amount: New Comnletion Date: For Change Orders Increase % Decrease ( %) Increase % Decrease ( %)