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Opening of Bids - Demolition of South Bend Medical Foundation Proj No. 123-076 - Sabre Demolition
BID/PROPOSAL CITY OF SOUTH BEND Project Name: Demolition of the South Bend Medical Foundation Project Number: 123-076 For Bids Due: 28 May 2024 Contractor Name: Sabre Demolition Corporation BASE BID SOUTH Rr U W Item No. Description Quantity Unit Unit Price Total Amount Demolition of the South Bend Medical 1 Foundation building and site as 1 LSUM $1,773,000 $1,773,000 described in the documents and exhibits. 2 Allowance for unforeseen Hazardous 1 LSUM $100,000 $100,000 Materials not including Asbestos BASE BID TOTAL $1,873,000 Bidder (Firm): Sabre Demolition Corporation Address: 115 Railroad Street City/State/Zip: Warners, NY 13164 Telephone Number: (315) 320-4233 By �9 l' (Signature) Matthew Dixon / President (Printed Name of Person Signing) Version 07/19/2023 Contractor's Bid for Public Works - 9 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 — ) SS: 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 debannent, 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 - 6 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 funding 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). 1 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 Version 07/19/2023 Contractor's Bid for Public Works - 7 violations hereunder may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 24th day of May , 2024 Sabre Demolition Corporation Contractor/Bidder (Firm) Signature of ContractorBidder or Its Agent Matthew Dixon / President Printed Name and Title Subscribed and sworn to before me this day of M CW 20o)� My Commission Expire sPk M 1) Notary ublic County of Residence Amy D. Drozde Polmantee► Notary Public - State of Now York No. 01 DR6373305 Qualified In Cayuga County My Commiaelon Expires 04109/20-4 Version 07/19/2023 Contractor's Bid for Public Works - 8 IHF&C HAYLOR, FREYER & COON' AN ALERA GROUP COMPANY Bonding Specialists AIA DocumentTM A310 —2010 CONTRACTOR: SURETY: (Name, legal status and address) (Name, legal status and principal place Sabre Demolition Corporation of business) 115 Railroad Street Great Midwest Insurance Company Warners, NY 13164 800 Gessner Road, Suite 600 OWNER: Houston, TX 77024 (Name, legal status and address) City of South Bend Board of Public Works, 227 W. Jefferson Boulevard South Bend, IN 46601 BOND AMOUNT: Five Percent of Bid Amount (5%) This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. PROJECT: (Name, location or address, and Project nwnber, if any) Demolition of the South Bend Medical Foundation, 531 N. Main Street, South Bend, IN 46601 Project No. 123-076 The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents. or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the tern Contractor in this Bond shall be deemed to be Subcontractor and the tens Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so ftunished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Si d and sealed this 13th day of May, 2024 Sabre Demolition Corporation (PI" iparl) (Seal) Vitness) (Title) i Great Midwest Insurance Company (Sure (Wi ess) , (Seal) (Title) Corinne E. Yo ey, A to ney-in-Fact CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured. I nit. AIA Document A310- — 2010. Copyright © 1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING: This AIA' Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA' Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. / Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright,aia.org. o61110 POWER OF ATTORNEY Great Midwest Insurance Company KNOW ALL MEN BY THESE PRESENTS, that GREAT MIDWEST INSURANCE COMPANY, a Texas Corporation, with its principal in Houston, TX, does hereby constitute and appoint: Corinne E. Yousey, Trevor A. Hash, James D. Freyer, Paul J. Hagen, Adam J. LaClair, Raechel Eassa, Gia Diep its true and lawful Attorneys) -In -Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or writings obligatory in nature of a bond. This authority is made under and by the authority of a resolution which was passed by the Board of Directors of GREAT MI INSURANCE COMPANY, on the V day of October, 2018 as follows: Resolved, that the President, or any officer, be and hereby is, authorized to appoint and empower any representative of the Company or other person or persons as Attorney -In -Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or other writings obligatory in nature of a bond not to exceed Twenty -Five Million dollars ($25,000,000.00), which the Company might execute through its duly elected officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney -In -Fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. Any Attorney -In -Fact, so appointed, may be removed in the Company's sole discretion and the authority so granted may be revoked as specified in the Power of Attorney. Resolved, that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certificate so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and binding on the Company. IN WITNESS THEREOF, GREAT MIDWEST INSURANCE COMPANY, has caused this instrument to be signed by its President, and its orporate Seal to be affixed this 11th day of February, 2021. GREAT MIDWEST INSURANCE COMPANY BY H.� Mark W. Haushill President ACKNOWLEDGEMENT On this 11th day of February, 2021, before me, personally came Mark W. Haushill to me known, who being duly sworn, did depose and say that he is the President of GREAT MIDWEST INSURANCE COMPANY, the corporation described in and which executed the above instrument; that he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation. ��sY n�� rPu%,, CNRISTINA 131SHQP x°„";�=Notary Public, State of Texas Comm. Explras 04.14-2028 Notary ID 131090488 CERTIFICATE BY V Christina Bishop Notary Public I, the undersigned, Secretary of GREAT MIDWEST INSURANCE COMPANY, A Texas Insurance Company, DO HEREBY CERTIFY that Ethe original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions set forth are now in force. (Signed and Sealed at Houston, TX this 13th Day of May 2024 BY 1104±w— Leslie K. Shaunty Secretary "WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance of clai containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. PRINCIPAL'S ACKNOWLEDGMENT INDIVIDUAL VERIFICATION State of _ County of On this day of , in the year 20 , before me personally came to me known, and known to me to be the person (s) who is (are) described in and who executed the forgoing instrument, and acknowledges to me that he (they) executed the same. (Notary Public) LIMITED LIABILITY COMPANY VERIFICATION State of _ County of On this day of , in the year 20 , before me personally appeared , to me known and known to me to be the person who executed the forgoing instrument, and who being by me duly sworn, deposes and says that (s)he is the of . A Limited Liability Company, and that (s) he executed the forgoing instrument as the act and deed of the said Limited Liability Company. (Notary Public) �j CORPORATE VERIFICATION State of IVQ."v County rofZ On this I3` day of ma in the year 20, before me personally came M Vu vJ N _ to me known, who, being b me duly sworn, deposes and says that (s) he resides in the City of \ N- RJVj that (s) he is the 'sr;rL& I cx-a,nu,e— of the L .o �i , �>a: norcrh'an the corporation described in and whi h executed the forgoing instrument, that (s) he knows the seal of the said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by the order of the Board of Directors of said corporation, and that (s) he signed his/her name thereto by like order. Amy 0. Drown Potmenteer Notary Public - State of New Ya* No. 01DR8373305 aVo &otaryu ic) Qualified in Cayuga 0eG SURETY ACKNOWLEDGMENT State of New York County of Onondaga On this 13th day of May in the year 2024, before me personally came Corinne E. Yousey to me known, who, being by me duly sworn, did depose and say that (s)he resides in Syracuse, NY; that (s)he is the Attorney -in -Fact of the Great Midwest Insurance Company, the corporation described in and which executed the attached instrument; that (s) he knows the corporate seal of the said corporation; that the seal affixed to the said instrument is such corporate seal; and that it was so affixed by order of the Board of Directors of the said corporation; and that (s) he signed his/her name thereto by like order. /Dwl (N tar Public) Paul J. Hagen Notary Public, State of New York Reg. No. 01HAO010784 Qualified in Onondaga ' County, Commission Expires July 10, 20ZLJ Murray L. Miller, Member Attest: Theresa Heffner, Clerk PART II (For projects of $100,000 or more — IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/her/its bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial Version 07/19/2023 Contractor's Bid for Public Works - 4 statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 07/19/2023 Contractor's Bid for Public Works - 5 South Bend Medical Demolition - Part II South Bend Indiana Proposal May 271" 2024 =Arlo= —wo/ \I`is \` D E M 0 L I T 1 0 N Proposal South Bend Medical Demolition South Bend, IN Proposal South Bend Medical Demolition SUBMITTAL Matt Dixon President Sabre Demolition Corporation Direct Line (315) 415-1050 Email: Mdixon(d-)sabredemolition.com Clay Dixon Project Manager Sabre Demolition Corporation Direct Line (315) 901-1458 Email: Cdixon(a)-sabredemolition.com SAFE ■ SECURE ■ STABLE =Arlo= —wo/ \I`is \` D E M 0 L I T 1 0 N Table of Contents A. Part II — Section I Experience Questionnaire A.1 Recently Completed Projects A.2 Current Public Works Projects A.3 Failure to Complete A.4 Private Firm References B. Part II — Section II Plan and Equipment Questionnaire B.1 Plan or Layout for Performing Proposed Work B.2 Subcontractors for Public Works B.3 Subcontractor for This Project B.4 Equipment List 13.5 Quotes Received Proposal South Bend Medical Demolition South Bend, IN 1 1 1 1 1 2 2 2 2 2 3 SAFE ■ SECURE ■ STABLE Proposal Redevelopment University Villas Demolition and c n to to c Statesboro, GA D E M p L I T 1 p N A. Part II - Section I Experience Questionnaire A.1 Recently Completed Projects See attached A.2 Current Public Works Projects Sabre is not currently working on any public works projects A.3 Failure to Complete Sabre has not failed to complete a project in which they were hired to complete A.4 Private Firm References Client Name Address Phone 6401 Wallace Road Extension, Suite 300 Arcadis Scot Lewis Wexford, PA 15090 (724) 742-9180 6402 Wallace Road Extension, Suite 300 Arcadis Mark Hurban Wexford, PA 15090 (724) 742-9180 6403 Wallace Road Extension, Suite 300 Email Arcadis Ryan Kelly Wexford, PA 15090 (724) 513-2840 Ryan.Kelly@arcadis.com 6404 Wallace Road Extension, Suite 300 Arcadis Jamie Briscoe Wexford, PA 15090 (859 839-1971 James.Briscoe@arcadis.com Todd Arcadis Minehardt (518) 744-8687 todd.minehardt@arcadis.com Anchor QEA Luke Jefts (518) 860-2963 Ijefts@anchoraea.com Georgia Pacific LLC Keble Ward Gladieux Metals Recycling Mark Gorman International Pete Paper Maciukiewicz (601) 983-7313 keble.ward@gapac.com (979) 415-1708 mark.gorman@gladieuxmetals.com (706) 236-5335 Pete.maciukiewicz@ipaper.com SAFE ■ SECURE ■ STABLE 1 c n to to c No/ \`91 \W*— D E M 0 L I T I p N Proposal University Villas Demolition and Redevelopment Statesboro, GA B. Part II - Section II Plan and Equipment Questionnaire B.1 Plan or Layout for Performing Proposed Work Sabre plans to begin the work with asbestos removal, gut out of trash and removal of universal wastes. Once complete, Sabre will remove the generator located on the roof and begin above grade demolition and move into slab and below grade demolition and finally backfill and site restoration. Sabre anticipates 145 working days to complete the work. Sabre will fully staff the project with an on -site project manager with a crew of 3-4 operators and 3-6 laborers and burners depending on the activity. B.2 Subcontractors for Public Works Company Name Title Address Phone Email 440 Hancock Street EACI (Environmental Indianapolis, IN Assurance Co. Inc) Jeff Hart Owner 46222 317.636.8500 jhart@eaciusa.com 440 Hancock Street EACI (Environmental Allan Project Indianapolis, IN Assurance Co. Inc) Garnett Manager 46222 317.636.8501 agarnettiii@eaciusa.com 440 Hancock Street EACI (Environmental Dan Project Indianapolis, IN Assurance Co. Inc) Gelbach Manager 46222 317.636.8502 dgehlbach@eaciusa.com B.3 Subcontractor for This Project See above (B.2) for subcontractor proposed for the asbestos removal scope of work. Sabre does not require a bond for subcontractor. B.4 Equipment List OWNED/LEASE EQUIPMENT DESCRIPTION Owned Cat 325 excavator Owned Cat 330 excavator Owned Cat 345 excavator Owned Cat 352 high reach Owned Cat 924G LOADER Owned Hammer Owned Pulverizer Owned Shear Owned UP 25 Owned Bobcat Owned 185 Air compressor Owned MQ 70KW Genset Owned Dust boss Owned Crusher and Screen Machine Owned Support Vehicle (Truck) SAFE ■ SECURE ■ STABLE Proposal University Villas Demolition and Redevelopment c n o io c Statesboro, GA D E M p L I T 1 p N B.5 Quotes Received Sabre has received pricing from contractors and vendors for pricing used on proposal SAFE ■ SECURE ■ STABLE NTRACT ROLE SCHEDULED CONSULTANT OUNT PERFORMED SUBCONTRACTORS OMPLETION BRIEFSCO Abatement of asbestos contianing materials within guard shacks and associated buildings onsite. Demolition of former water Arcadis Abscope: ACM Abatement treatment system and building to 2-feet below grade. Former basin Floors were punctured to promote drainiage. Onsite fill Contact: Todd Minehardt Prime Demolition Darmh Land Surveying: y g' materials were transpoerted and placed over demolished structures. Surveyor performed volumetric survey to quantify International Paper (518) 744-8687 $ 605,500.00 Contractor Topographical Survey & Quantifiable July-22 October-22 materials trucked and placed onsite in addition to topographical survey identifying top of backfill layer. A geotextile identification layer was laced beneat a 1-foot cap of imported topsoil laced upon structure foot y p P P P P P prints. Additional Todd.Minehardt@arcadis.com materials via survey topographical survey was performed to confirm a minimum of 1-foot cap achieved. Final restoration included hydroseeding. All asphalt and concrete areas that remain were broom swept. Arcadis Prime Demolition Utility cutting and capping, universal waste removal, above grade demolition and waste removal of decomissioned garage Bremmag Jamie Briscoe $ 317,000.00 October-22 December-22 unit. Propterty was fenced off from neighbors during demolition. Arcadis responsible for univeral waste disposal. Connex box jbriscoe@arcadis.com Contractor provided for Arcadis. Georgia Pacific EACI: ACM Abatement Removal of processes no longer in operation. Plant is active and traffic control and demarcation of work zones is imperative to Georgia Pacific GAPAC $ 688,826.00 Prime Demolition Legacy Crane: Crane picks for August-22 January-23 succesfull completion. Asbestos abatement, universal waste removal, above grade demolition of structures, conveyors and Shannon Perez Contractor rem oval of conveyors and towers ancillary equipment. Shannon.perez@gapac.com Former iron one processing facility that accepted material via train can, to be stored in silos and processed through a large concentrator building. Byproduct from the activities was stores onsite in large tailings piles. Subcontractors abated asbestos containing materials in addition to abatement under variance in place mechanically due to ERM Abscope: ACM Abatement hardships of building integrity. Additional subcontractors performed clearing and grubbing of trees and vegetation to allow Solvay Contact: Ian Gayman $ 3,828,000.00 Prime Demolition Adirondack Forest Management: February-23 December-23 demolition activities to commence. Grubbing was completed prior to the deadline put in place by NYDEC due to endangered (484)an@er42 Contractor Grubbing and clearing of vegetation. animals Iknown to live within the area. Ian.Gayman@erm.com Crews performed universal and electronic waste removals prior to demolition of multiple silos, conveyors, concentrator, hydroseparator, pump, scale, and thickener structures. Hardscapes generated from work was sized and placed within the former footprint as clean backfill. The concentrator building was demolished under variance via wet methods due to galbestos roofing. NORM contaminated conveyors were segregated and disposed of vs recycling at a salvage vendor. Delsan-Aim Delsan-Aim Contact: Lorenzo Rapattoni $ gg3,728.19 Demolition None March-23 May-23 Demolition of a former peanut processing facility. Facility is decomissioned. Mostly steel structure buildings. Sabre is to Lrapattoni@delsan-aim.<om Subcontractor demolish structures to slab and prepare and load steel for owner. Universal Waste was completed on a T&M basis. Sabre was contracted to perform additional time and materials work (T&M) by the Client to demolish tanks located in a separate work area on the main Facility site. Tanks 61 &62: Sabre utilized burners working at heights from a manlift to cut apart tank steel by rigging, torching, and Anchor CEA displacement to grade via crane. In some areas tank steel was cut up and directed into the confines of the lower tank base as (CONFIDENTIAL) Contact: Luke lefts $ 111,456.11 Prime Demolition None May-23 October-23 containment. The remaining sides of the tank were rigged, cut and picked to grade via crane. Additional burners at grade (518)Luke3 Contractor further downsized plate steel for loading into containers and recycled. Ijefts@anchorqea.com Silane Tank F: Sabre utilized burners working at heights from a manlift to cut apart tank steel by rigging, torching, and displacement to grade via crane. The remaining sides of the tank were rigged, cut and picked to grade via crane. Additional burners at grade further downsized plate steel for loading into containers and recycled. Sabre was contracted to perform cleaning via solidifcation or collection of bulk product remaining withiun tanks and/or lines prioer to demolition of 7-large above grade storage tanks each with a capacity of 8Sk-gallons up to 21M-gallons . Sabre subcontracted with tadebe who performed solidification via use of sawdust, transportation, and disposal of approximately 1501, tons of bulk, solidified number 6 oil. Following bulk solidifcation tanks Tradebe performed a cutter stock rinse prior to final inspeciton via marine Chemist to certify the tank clean for demolition. Tradebe performed inspections and draining of Eastern Generation approximately 19,000-LF of pipe to prepare for demolition. Oswego Harbor Power (OHP) Contact: Kevin Egan $ 8,583,994.96 Prime Demolition Tradebe Environmental: Tank and September-23 August-24 (718) 683-0534 Contractor Pipe Cleaning. Pre -demolition commenced on the tanks via burners accessing from manlifts. Openings were cut into the sides of the tank to kegan@easterngen.com give the CAT 374 with 3rd member shear attachment a point to be gin peeling tank plate back. As Demolition continued in a top -down manner burners were utilized to cut lower tank wall plate due to a resulting thickness of 1.282-inch thick plate. Following demolition of all site features the former earthen berms surrounding each tank was rough graded to promote positive site drainage. Sabre was contracted to perform demolition of a control room within an active work area on -site. Crews utilized Flame GP retardant poly to surround the work area keeping any dust and debris from the adjacent active Facility areas. Cres used Georgia Pacific Jim C Contact:lim Childers $ 185,000.00 Prime Demolition None October-23 October-23 man -lifts and pneumatic jack hammers to break up the concrete roof and pan decking. Scaffold was erected within the control (931) 43 Contractor jim.childers@gapac.com room to further demolish perimeter walls. Debris was moved out of the work area manually and loaded into hoppers for disposal. 4Sp)TH SEA O d ; CITY OF SOUTH BEND �� x MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN eAOE FORM MBE-1.0 x 1865 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: 123-076 Project Name Bidder: Sabre Demolition Corporation Demolition of the South Bend Medical Foundation, 531 N. Main Street, South Bend, IN Total Bid Amount: $1,773,000 MBE Goal: 1.4% Page of Name & Address of MBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of MBE Component Percentage of Total Bid/Proposal Butler Hauling 3039 N Post Rd Indianapolis, Indiana Shenika Butler 317/997-7391 Hauling of Demolition Debris $141,000 7.9% Submitted by: Matthew Dixon Print Name Signature ***Goals should be calculated based on the Base Bid only.*** Version 07/19/2023 Contractor's Bid for Public Works - 10 5/24/2024 Date 4Sp)TH SEA O d ; CITY OF SOUTH BEND �� x MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN�"°� FORM WBE-1.0 x 1865 WBE UTILIZATION PLAN This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE participation. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. ***Goals should be calculated based on the Base Bid only.*** Project Number: Bidder: 123-076 Demolition of the South Bend Medical Foundation, 531 N. Main Street, South Project Name: Bend, IN Total Bid Amount: WBE Goal: 4.7% Page of Name & Address of WBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of WBE Component Percentage of Total Bid/Proposal See good faith section Submitted by: Print Name Signature ***Goals should be calculated based on the Base Bid only.*** Version 07/19/2023 Contractor's Bid for Public Works - 11 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: 123-076 Date: Demolition of the South Bend Medical Foundation, 531 N. Main Street, Project Name: South Bend, IN Bidder: Contact Person: Telephone: Address: City: State: Zip: Email: 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.ggvL/idoa/. GOOD FAITH EFFORTS TO OBTAIN MBE PARTICIPATION The bidder shall initial each item below, as evidence of its good faith efforts to obtain MBE participation in the awarded contract. I affirm that I reviewed the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan and the Indiana Department of Administration's certified list of Indiana Minority and Women Business Enterprises, found on their website (http://www.in.gov/idoa). I affirm that I have made good faith efforts to select portions of the contract work to be performed by MWBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate MBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available means the interest of all MBEs in the scopes of work of the contract. I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform MBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications concerning subcontract opportunities and allowed MBEs reasonable time to respond to such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a manner reasonably calculated to inform MBEs of subcontracting opportunities and allowed sufficient time for MBEs to participate effectively. I affirm that I followed up on initial solicitations with interested MBEs. I affirm that I negotiated with interested MBEs in good faith, including providing such MBEs with adequate information about the plans, specifications and other requirements of the subcontract. I affirm that I have made good faith efforts to assist interested MBEs in obtaining bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 07/19/2023 Contractor's Bid for Public Works - 12 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested MBEs in obtaining necessary equipment, supplies, materials, or related assistances or services, where appropriate. I affirm that I did not reject any MBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each MBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBE was unqualified to perform the job. "Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 07/19/2023 Contractor's Bid for Public Works - 13 CITY OF SOUTH BEND d MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MWBE participation. Project Number: 123-076 Date: Demolition of the South Bend Medical Foundation, 531 N. Main Street, Project Name: South Bend, IN Bidder: Sabre Demolition Corporation Contact Person: Matthew Dixon Telephone: (315) 320-4233 Address: 115 Railroad Street City: Warners State: NY Zip: 13164 Email: mdixon@sabredemolition.com To determine whether a bidder has demonstrated good faith efforts to reach the WBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS WBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: http://www.in.ggy/idoa/. GOOD FAITH EFFORTS TO OBTAIN WBE PARTICIPATION The bidder shall initial each item below, as evidence of its good faith efforts to obtain WBE participation in the awarded contract. I affirm that I reviewed the City of South Bend's Minority and Women Business MD Enterprise 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 MD performed by WBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate WBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available MD means the interest of all WBEs in the scopes of work of the contract. MD I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform WBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications MD concerning subcontract opportunities and allowed WBEs reasonable time to respond to such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a MD manner reasonably calculated to inform WBEs of subcontracting opportunities and allowed sufficient time for WBEs to participate effectively. MD I affirm that I followed up on initial solicitations with interested WBEs. I affirm that I negotiated with interested WBEs in good faith, including providing such MD WBEs with adequate information about the plans, specifications and other requirements of the subcontract. Version 07/19/2023 Contractor's Bid for Public Works - 14 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS � 4SpUTH B��O 2 x� az 1865 MD I affirm that I have made good faith efforts to assist interested WBEs in obtaining bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. MD I affirm that I have made good faith efforts to assist interested WBEs in obtaining / necessary equipment, supplies, materials, or related assistances or services, where V appropriate. MD I affirm that I did not reject any WBEs 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 WBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MWBE was unqualified to perform the job. "Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 07/19/2023 Contractor's Bid for Public Works - 15 CITY OF SOUTH BEND d' MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN��''^�E' FORM MBE-2.1 % 1865 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: 123-076 MBE Participation Goal 1.4% Demolition of the South Bend Medical Foundation, 531 N. Main Street, South Project Name: Bend, IN Bidder: Sabre Demolition Corporation By. - President 5/24/2024 (Signature) (Title) (Date) MBE Firm N/A Owner or Contact at MBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: N/A MBE solicited succesfully and pricing is in proposal 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 - 16 �SpUCH 8E� ;o O CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN;, Cl, FORM MBE-2.1 1865 x WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE OF Project Number: 123-076 WBE Participation Goal 4.7% Demolition of the South Bend Medical Foundation, 531 N. Main Street, South Project Name: Bend, IN Bidder: Sabre Demolition Corporation By: ,/—<, President 5/24/2024 (Signature) (Title) (Date) WBE Firm Five Star Hauling Owner or Contact at WBE Firm Graciela Martinez Telephone: 773 671 3136 Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: Hauling of Demolition Debris RESULTS OF CONTACT WITH THE WBE FIRM: Called 5/24 Stated they do not operate in South Bend WBE Firm Greenfield Triaxle Services LLC Owner or Contact at WBE Firm Jaime Noehre Telephone: (317) 498-6814 Fax: Email: noehre3@gmail.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Backfill and Excavation RESULTS OF CONTACT WITH THE WBE FIRM: Called and emailed on 5/7 No response, Followed up 5/20 Version 07/19/2023 Contractor's Bid for Public Works - 17 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAX 574/ 235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND, JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Date: April 26, 2024 To: All Planholders From Theresa Heffner, Clerk, Board of Public Works Subject Addendum Number: 1 Project Name Project Number: Demolition of South Bend Medical Foundation (531 N. Main St.) 123-076 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 4/26/2024 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: Sabre Demolition Corporation Authorized Signature: Date: 5/23/2024 Version 8/11/2020 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAX 574/ 235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND, JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Date: May 6, 2024 To: All Planholders From Theresa Heffner, Clerk, Board of Public Works Subject Addendum Number: 2 Project Name Project Number: Demolition of South Bend Medical Foundation (531 N. Main St.) 123-076 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 5/06/2024 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: Sabre Demolition Corporation Authorized Signature: Date: 5/23/2024 Version 8/11/2020 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAX 574/ 235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND, JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Date: May 13, 2024 To: All Planholders From Theresa Heffner, Clerk, Board of Public Works Subject Addendum Number: 3 Project Name Project Number: Demolition of South Bend Medical Foundation (531 N. Main St.) 123-076 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 5/13/2024 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: Sabre Demolition Corporation Authorized Signature:7� Date: 5/23/2024 Version 8/11/2020 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAX 574/ 235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND, JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Date: May 22, 2024 To: All Planholders From Theresa Heffner, Clerk, Board of Public Works Subject Addendum Number: 4 Project Name Project Number: Demolition of South Bend Medical Foundation (531 N. Main St.) 123-076 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 5/22/2024 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: Sabre Demolition Corporation Authorized Signature: Date: 5/23/2024 Version 8/11/2020 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name Demolition of South Bend Medical Foundation Project No. For Bids Due Contractor Name: 123-076 May 28, 2024 The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. **THIS FORM ONLY APPLIES TO BIDS GREATER THAN $250,000. ** INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 71 of The Responsible Bidding Ordinance No. 10975-23 (hereinafter, "Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders") within twelve (12) months of obtaining pre -qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre - qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-71 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-71 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 5/20/2024 General Conditions - 11 POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-72 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least two -hundred fifty thousand dollars ($250,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder for projects greater than $250,000 and all subcontractors performing work greater than $250,000 on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 5/20/2024 General Conditions - 12 I. PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements: (i) _ By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. (ii) _ By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (iii) _ By checking this box, I hereby acknowledge that apprenticeship and training programs that I participate in have graduated at least five (5) apprentices in each of the past five (5) years. (iv) _ By checking this box, I hereby acknowledge that all subcontractors performing work greater than $250,000 also meet the qualifications of the Responsible Bidder Ordinance. (b) Attachments: (i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) _ Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. (iii) _ List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. (iv) _ For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. This includes, but may not be limited to, letters from apprenticeship coordinators detailing the bidder's association with the program, and the United States Department of Labor Office of Apprenticeship Certificates of Registration of Apprenticeship Programs for each type of work to be performed on the project. Version 5/20/2024 General Conditions - 13 II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowled ements: (i) By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. (ii) By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. (iii) By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) V By checking this box, I hereby acknowledge and ensure that I and all sub- contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore, I acknowledge my understanding that it is my responsibility to ensure that all sub -contractors have the necessary licenses to undertake the work called for in this bid. If a sub- contractor loses their license at any point, it is the responsibility of that sub- contractor to notify the City. (v) By checking this box, I hereby acknowledge that apprenticeship and training programs that I participate in have graduated at least five (5) apprentices in each of the past five (5) years. (vi) V By checking this box, I hereby acknowledge that all subcontractors performing work greater than $250,000 also meet the qualifications of the Responsible Bidder Ordinance. (b) Attachments: (i) V Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) List identifying all former business names. (iii) Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) (iv) V years. Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. (v) V Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor V under all applicable state and federal laws and local ordinances. (v) For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. This includes, but may not be limited to, letters from apprenticeship coordinators detailing the bidder's association with Version 5/20/2024 General Conditions - 14 the program, and the United States Department of Labor Office of Apprenticeship Certificates of Registration of Apprenticeship Programs for each type of work to be performed on the project. (vi) V Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. (vii) V Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. (viii) V Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. (ix) List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. Date: 5/23/2024 (Sign Here) Matthew Dixon (Print Name Here) Sabre Demolition Corporation (Name of Company) 115 Railroad Street (Address of Company) Warners (City) NY (State) (315) 320-4233 (Telephone Number) Version 5/20/2024 General Conditions - 15 cnooc mmop/ \V ■ D E M O L I T I O N SAFE ■ SECURE ■ STABLE May 23rd, 2024 City of South Bend Indiana Subject: Pre -Qualification Letter To Whom it May Concern, Sabre Demolition (Sabre) is pleased to provide the City of South Bend Indiana with our proposal. Sabre has provided the following within the proposal: 1. Indiana Secretary of State's on-line records (ie. Business verification) (See attached) 2. List identifying all former business names. (No Attachment — No previous names listed) 3. Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) years. (No Attachment — No previous violations) 4. Statement about staffing capabilities, including labor sources. (Sabre has capabilities to fully staff the project) 5. Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances. (Individuals who will perform work on the public work project on Sabre's behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances.) 6. For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project. (Sabre has not participated in apprenticeship or training programs) 7. Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. (Please see attached) 8. Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" (See attached) 9. Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. (Sabre does not have any federal, state or local tax liens or delinquencies) 10. List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. (See attached) 115 Railroad St. 0 Warners. NY 131G4 0 Ph: 315.320.4233 0 Fx: 315.320.4238 0 sabredEmolition.com Closing The Sabre team is ready to assist you with this project to safely and efficiently complete the activities outlined within this cost proposal. We feel that Sabre can implement this scope of work safely and that we are in alignment with your expectations. If you have any questions regarding this proposal, please feel free to contact me at (315) 415-1050. Thank you in advance for your consideration. Respectfully, Matt Dixon President Sabre Demolition Corporation 115 Railroad St. ■ Warners. NY 13164 ■ Ph: 315.320.4233 ■ Fx: 315.320.4238 ■ sabredEmolition.com I BUSINESS INFORMATION DIEGO MORALES INDIANA SECRETARY OF STATE a 05/23/2024 04:00 PM Business Details Business Name: SABRE DEMOLITION CORPORATION Business ID: 1999091586 Entity Type: Domestic For -Profit Corporation Business Status: Active Creation Date: 09/21/1999 Inactive Date: Principal Office Address: 115 USA Railroad Street, Warners, NY, 13164, Expiration Date: Perpetual Jurisdiction of Formation: Indiana Business Entity Report Du: 09/30/2025 Date: Years Due: Governing Person Information Title Name Address President Matthew Dixon 124 Harbor View Lane, Beileair Bluffs, FL, 33770, USA Director Matthew Dixon 124 Harbor View Lane, Belleair Bluffs, FL, 33770, USA Incorporators Information Name Title Address Mr. Jeff Hart Incorporator 137 South Production Drive, INDIANAPOLIS, IN, 46240 - 0000, USA Registered Agent Information Type: Business Commercial Registered Agent Name: C T CORPORATION SYSTEM Address: 334 North Senate Avenue, Indianapolis, IN, 46204, USA Sabre Demolition Corporation Alcohol, Drug, and Contraband Policy Effective Date: 12/1 /2021 Approved By: Matt Dixon For the purpose of this policy "Company' shall refer to: Sabre Demolition Corporation ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 Contents DRUG, ALCOHOL, AND CONTRABAND POLICY...............................................................................1 1) PURPOSE.......................................................................................................................................3 2) DEFINITIONS..................................................................................................................................3 a) Company Personnel: ................................................................................................................... 3 b) Property or Customers Property: ................................................................................................. 3 c) Prohibited Substances: ................................................................................................................ 3 d) Reasonable Suspicion: ................................................................................................................ 3 e) Under the Influence: ..................................................................................................................... 4 f) Contraband: ................................................................................................................................. 4 g) Designated Employee Representative (DER): ............................................................................. 4 h) Disqualified: .................................................................................................................................. 4 i) Stand Down: .................................................................................................................................. 4 J) Medical Review Officer(MRO):......................................................................................................4 k) Prescription Drug: .......................................................................................................................... 4 1) Safety Sensitive Positions: ............................................................................................................. 4 3) PROHIBITIONS...............................................................................................................................4 4) ROLES AND RESPONSIBILITIES.................................................................................................5 a) Designated Employee Representative (DER): ............................................................................. 5 b) Medical Review Officer(MRO):....................................................................................................6 5) SEARCHES AND INSPECTIONS...................................................................................................6 6) TESTING REQUIREMENTS...........................................................................................................6 a) Pre -Access Testing......................................................................................................................6 b) Post -Incident Testing...................................................................................................................7 c) Reasonable Suspicion Testing....................................................................................................8 d) Group Suspicion -based Testing...................................................................................................8 e) Random Testing...........................................................................................................................8 f) Wall -to -Wall Testing/Group Random Testing..............................................................................9 g) Fitness for Work...........................................................................................................................9 7) TESTING PROTOCOL....................................................................................................................9 a) Custody and Control Form (CCF)................................................................................................9 b) Laboratory: ................................................................................................................................... 9 c) Collection Personnel: ................................................................................................................. 10 d) Alcohol: ...................................................................................................................................... 10 8) NON-COMPLIANCE.....................................................................................................................11 9) COMPANY PERSONNEL DISQUALIFIED FROM PERFORMING SERVICES FOR CUSTOMERS.......................................................................................................................................11 10) SUBSTANCE ABUSE AWARENESS..........................................................................................11 11) APPLICABLE LAWS....................................................................................................................11 12) SUPERVISOR TRAINING.............................................................................................................11 13) AUDIT............................................................................................................................................12 ATTACHMENT1..................................................................................................................................14 Acknowledgement of drug and alcohol contraband policy receipt....................................................14 ATTACHMENT2..................................................................................................................................15 1. SUPERVISOR TRAINING.........................................................................................................15 2. EMPLOYEE EDUCATION.........................................................................................................15 ATTACHMENT3..................................................................................................................................16 SUPERVISOR DRUG AND/OR ALCOHOL CHECKLIST.................................................................16 ADDENDUM: EXXONMOBIL SPECIFIC..........................................................................18-29 ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 2 1) PURPOSE To ensure a safe, healthy, and productive work environment for the employees of the company, customers, and others on company or customer property. To protect company and customer property and assets, ensure efficient operations, and meet any specific requirements of customers. Company shall enforce this drug, alcohol, and contraband policy in a fashion consistent with the laws of the states in which the company employees' are employed. 2) DEFINITIONS a) Company Personnel: All company employees, agents, subcontractors or subcontractors' employees performing field operations work on company or customer property, or those being considered for employment by the company. This includes temporary and part-time personnel. b) Property or Customers Property: All real or tangible personal property, including facilities, buildings, vehicles, products and equipment, either owned or controlled by the company or its customers. c) Prohibited Substances: i) Illicit or un-prescribed drugs, controlled substances and mood or mind -altering substances including all forms of naturally occurring and synthetic drugs (for example: any synthetic derivative/product that produces a marijuana -type high and any herbal products not intended for human consumption); ii) Potentially impairing medications (e.g. may be prescription drug or over-the-counter medication or herbal medicine): (1) Used without a prescription, or (2) Used in a manner inconsistent with the prescription or directions for usage, or (3) Used without disclosure to company as provided by Section 3(b)(iii) of this Policy iii) Alcohol; iv) Medical Marijuana/Recreational Marijuana — The use of marijuana for medical or recreational purposes, even if permitted by state law, regulation or ordinance, will not be considered an acceptable explanation for a confirmed positive laboratory report for marijuana and will be reported by the Medical Review Officer (MRO) as a verified positive drug test for marijuana. The company will treat marijuana like they would alcohol; they are not required to tolerate individuals being under the influence while at work, or on customer property. The company will not permit or accommodate the use, consumption, possession, transfer, display, transportation, sale or growing of marijuana in the workplace. *** Please note that the use of CBD oil, which is a cannabinoid extract from marijuana or hemp plants, may cause a positive drug test result, depending on the product used. Furthermore, some CBD products may contain compounds deemed illegal under federal law, and therefore the use of such products would violate the company's substance abuse policy. A positive drug test will not be excused based on an employee's claim that he or she used a CBD product, even if it is for a claimed medical purpose, except as otherwise provided under applicable law. d) Reasonable Suspicion: A belief based on objective and articulable facts sufficient to lead a supervisor to suspect use of prohibited substances. ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 3 For the purposes of this section a supervisor is a company employee acting in an official supervisory capacity who has successfully completed drug and alcohol supervisor training as outlined in this policy. e) Under the Influence: i) The presence of a prohibited substance or metabolites of a prohibited substance in body fluids above the cut-off level established by company's policy or other commonly accepted cut-off level; ii) The presence of a prohibited substance that affects an individual in any detectable manner. The symptoms of influence may be, but are not limited to, slurred speech or difficulty in maintaining balance. f) Contraband_ i) Any drug or alcohol related paraphernalia used or designed for use in testing, packaging, storing, injecting, ingesting, inhaling or otherwise introducing into the human body any Prohibited Substance, or ii) Any paraphernalia or substance used or designed for use to dilute, substitute, or adulterate any alcohol or drug test specimen, or to otherwise obstruct the alcohol or drug testing process or iii) Firearms, ammunition, explosives, and weapons. g) Designated Employee Representative (DER) also referred to as Designated Contractor Representative (DCR): Company personnel with oversight of the company Drug and Alcohol program and authorized by the company to receive test results and make required decisions regarding test results. h) Disqualified: Company personnel are disqualified from performing work if they fail to meet or comply with, or in any way violate this policy and policy of customers. i) Stand Down: The immediate removal of company personnel from performing services for company and /or customers. j) Medical Review Officer (MRO): A licensed or certified physician, designated by the company, responsible for the review and verification of the integrity of drug testing results and for the final interpretation and reporting of drug test results. k) Prescription Drug: A regulated pharmaceutical medicine that requires physician or other qualified healthcare professional authorization before it can be obtained in the jurisdiction where company personnel are performing services for company or customers. The term is used to distinguish it from over-the-counter drugs, which can be obtained without authorization. 1) Safety Sensitive Positions: Any position with job responsibilities such that a lapse by an individual in that position could increase the probability of serious injury, significant environmental or community impacts or significant damage to company or customer assets. 3) PROHIBITIONS Unless specifically authorized in writing by the company and its customers, Sabre Demolition Corporation policy shall prohibit company personnel from the following: a) Using, possessing, selling, manufacturing, distributing, concealing or transporting on company or customer property (including off -duty time) any of the following items: i) Any prohibited substance; or ii) Contraband (except where in violation of state law); or ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 4 iii) Being under the influence of any Prohibited Substance. b) Possessing or using prescription drugs or over-the-counter medication that may cause impairment, except when all of the following conditions have been met, while on company property (unless otherwise provided for under the American's with Disabilities Act): i) Prescription drugs have been prescribed by a licensed physician for the person in possession of the drugs, and; ii) The prescription is not expired and was filled by a licensed pharmacist for the person possessing the drugs, and; iii) The individual notifies their supervisor that they will be in possession of, or using, impairment -causing prescription drugs or over-the-counter medication and appropriate steps are taken to accommodate the possibility of impairment, including but not limited to, removal from work for the period of possible impairment. Note: Discussions between the individual and their supervisor must be limited to the individual's ability to perform essential job functions. iv) Company's health professional has assessed the capability or fitness of personnel to perform safety sensitive duties. c) Being under the influence of prohibited substances while performing any services for the company or their customers. d) Switching, diluting or adulterating any urine, blood or other sample used for testing. e) Refusing to submit to a test for alcohol or drugs. f) Refusing to submit to an inspection as provided for in Section 5 of this Policy. g) Being the subject of a confirmed positive alcohol or drug test. 4) ROLES AND RESPONSIBILITIES a) Designated Employee Representative (DER) also referred to as Designated Contractor Representative (DCR): Designated Employee Representative (DER) should be an employee within the Health, Safety, Security and Environment (HSSE) department who is authorized to receive test results and other communications, take immediate action to remove workers from a company or customer's jobsite and make required decisions in the testing and evaluation process. Specific roles and responsibilities assigned to a DER should include, at a minimum, the following: i) Select and contract with a laboratory or service provider, based on pre -determined criteria, to help implement all or part of the Drug, Alcohol and Contraband Program. ii) Receive general correspondence, newsletter, and announcements from laboratories and service providers. iii) Coordinate reasonable suspicion training for all supervisors and ensure they have signed a document acknowledging completion of the training. iv) Schedule and coordinate drug and alcohol testing activities. v) Maintain confidential files for the Drug, Alcohol and Contraband Program. vi) Monitor non -negative, positive, or invalid test results and results supporting that the specimens have been adulterated or substituted to determine appropriate actions. b) Medical Review Officer (MRO): An MRO is responsible for receiving and reviewing laboratory test results and evaluating medical explanations for certain drug test results. Roles and responsibilities assigned to an MRO typically include the following: i) Serve as an independent party to oversee the accuracy and integrity of the company Drug and Alcohol Testing process (DOT and NON -DOT). ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 5 ii) Review appropriate copies of chain -of -custody forms to determine if problems exist. iii) Conduct verification interviews with workers for non -negative drug test results or results indicating that the specimen has been adulterated or substituted. iv) Interpret drug test results to determine if a legitimate medical explanation exists for a laboratory's confirmed positive, an invalid test result or adulterated or substituted specimen. v) Immediately report verified positive or invalid results, results requiring immediate collection under direct observation, adulterated or substituted specimens, and other refusals to test to appropriate personnel. vi) Report written drug test results in a confidential manner to appropriate personnel authorized to receive such information. 5) SEARCHES AND INSPECTIONS Searches and inspections may be: a) Conducted on company or customer property, at any time, by company or customer supervisors or authorized search and inspection specialists including scent trained animals. b) Unannounced searches or inspections of company or customer personnel and their property, which may include, but is not limited to: wallets, purses, lockers, baggage, offices, desks, toolboxes, clothing and vehicles. c) Employees have the right to refuse being searched or having their personal effects searched or to cooperate in the requested tests; however, refusal to allow such searches or to cooperate in such lawfully permitted searches by any employee will be cause for disciplinary action, up to and including immediate termination. d) If discovery of Prohibited Substances or Contraband cannot be directly associated with individual company personnel, but can be reasonably associated with a defined group of company personnel (e.g. people who use one change room): a. Customers may conduct or require company to conduct an inspection of company personnel group's clothing, wallets, purses, baggage, lockers, work areas, desks, tool boxes, vehicles and any other designations by customers, and/or b. Customers may require company to conduct Group suspicion -based testing of company personnel within this group. 6) TESTING REQUIREMENTS Drug and alcohol testing must meet the requirements of customers: a) Pre -Access Testing i) All company personnel are subject to customer pre -access testing which may mandate that the employee(s) receive a negative result on a drug and/or alcohol test within a customer's specific required amount of time preceding the employee's first access to customer property. Note: Some customers may waive this requirement if employee(s) are currently active in a random testing pool. Annual drug and alcohol testing is also required by specific customers. Upon customer's request, company shall so certify in writing. ii) Company will provide no information to customers identifying individuals who have positive pre -access tests. b) Post -Incident Testing Retaliation against employees who report accidents is strictly forbidden. Any drug and alcohol testing under this section will be applied in a neutral fashion, to foster a safe work environment, and only to identify drug/alcohol use in the recent past. Testing under this section will not be undertaken to retaliate against employees for reporting workplace injuries. ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 6 Immediately following an incident or as soon as possible; company should communicate with the customer and receive confirmation that post -incident drug and/or alcohol testing will be required. i) Company shall remove individuals from customer property and surrender their site credentials to the customers IF; it is determined by the company or customers, from the best information available immediately following a work -related incident, that the performance of one or more company personnel contributed to the incident or cannot be completely discounted as a contributing factor to the incident. ii) Alcohol and drug testing must be completed as soon as possible after the decision to test. If specimen collection is not completed within 2 hours, the reason for delay must be documented. Customers may request to review reasons for the delay and decide if they are acceptable. An individual so removed will be allowed to return to work on customer property only after. (1) company conducts alcohol and drug testing on the individual as soon as possible following the individual's removal from the site, and (2) the company certifies all of the following in writing: (a) the test identification number (b) the individual's 4 digit identifying number (c) the test date and time, and (d) a negative test result (3) On the written certification the company will include a consent signed by the individual permitting disclosure to customers of the test result. iii) If an employee who is subject to post -incident testing is conscious, able to urinate normally (in the opinion of a medical professional) and refuses to be tested, that employee shall be removed from their position and shall be subject to discipline. For the purpose of this part "incident" means: (1) An actual event that caused: (a) Injury requiring medical treatment beyond first aid (b) Environmental impact beyond a small immediate area to: (i) soil/ground-water (ii) marine life, or (iii) impact to nearby habitat, wildlife, livestock, crops or fisheries (c) Process Safety events as determined by the responsible company or customer Supervisor (d) Property damage as determined by the responsible company or customer Supervisor (e) Motor vehicle accident (the operator of the vehicle or other individuals where there is evidence to support that they may have contributed to the incident) ****NOTE: Customers may define more stringent criteria Or (f) An event that had potential for (i) Serious injury/fatality (ii) Environmental impact beyond Company or Customer Premises (iii) Property damage as determined by the responsible Company or Customer Supervisor ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 7 (2) The Company may decide not to conduct a post -incident drug and/or alcohol test if: (a) The best information immediately available after the incident indicates that the employee's performance could not have contributed to the incident, or (b) Because of the time between the performance and the incident, it is not likely that a drug and/or alcohol test would reveal whether performance was affected by drug and/or alcohol use. c) Reasonable Suspicion Testing i) Upon reasonable suspicion of company or customers that company personnel is under the influence of a prohibited substance while on company or customer property (refer to Attachment 3 as a guide to assess whether there is reasonable suspicion for requesting a test), company shall remove the individual(s) from customer property and surrender their site credentials to the customers. Company should conduct alcohol and drug testing on the individual as soon as possible following the individual's removal from the site. If specimen collection is not completed within 2 hours, the reason for delay must be documented. Customers may request to review reasons for delay and decide if they are acceptable. ii) An individual removed from company or customer property for Reasonable Suspicion will be allowed to return to work on customer property only after: (1) Company certifies all of the following in writing: (a) the test identification number (b) the individual's 4 digit identifying number (c) the test date and time, and (d) a negative test result (2) On that written certification the company will include a consent signed by the individual permitting disclosure to customers of the test result. d) Group Suspicion -based Testing i. Group Suspicion -based testing of company personnel may be required without notice on customer premises, based on evidence of Prohibited Substances or Contraband on customer premises that cannot be identified to a specific individual. Group Suspicion - based testing will be limited to the likely affected work group or work area. ii. Company will immediately Stand Down the company personnel. iii. Alcohol and drug testing specimen collection must be completed as soon as possible after the decision to test. If specimen collection is not completed within 2 hours, the reason for delay must be documented. Customers may request to review reasons for delay and decide if they are acceptable. e) Random Testing If specific customers require random drug and/or alcohol testing then the following guidelines will be followed: i) Unless otherwise specified by a specific customer, company personnel shall be subject to: (1) Un-announced random testing. (2) Performed on a quarterly basis (at a minimum). Random tests must not be predictable. (3) That yields a compliance of an annualized rate as determined by the customer operator. ii) If required by the specific customer, a breath alcohol test will be given at the same time as the drug test. ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 8 iii) Upon notification of being selected for a drug and/or alcohol test, company personnel must report to the collection site within 30 minutes, plus travel time. The reason for delay must be documented if unable to arrive within this time frame. iv) Failure to report to the collection site, refusal to test, or adulterating a specimen is considered the same as a positive test and the individual could be denied access to company or customer premises. v) If company personnel are not in the random pool when a random selection is made, they must complete another pre -enrollment test before being re -admitted to the random pool. f) Wall -to -Wall Testing/Group Random Testing Company personnel may be subject to: Un-announced en masse drug and alcohol testing. Such tests are scheduled at the sole discretion of the customers. This includes the determination of the scope and the timing of such testing. iii. Such a group may include all members of the named group on site at the determined time or time period and shall not be determined in terms of named individuals. iv. Such groups may include, but are not limited to, all company personnel on site, or by shift, by crew, by location, by craft, by company or by another similar category, including a random selection based on site access records. g) Fitness for Work After a fitness for work concern is identified, and before the company can return the individual back to perform Safety Sensitive services for customers, the company's health professional must evaluate the individual, clear them to return to work, define restrictions if applicable, and document the conclusion. A fitness for concern may be identified from such events as: MRO review of a laboratory positive test result may lead to a MRO negative determination, but the MRO may identify a fitness for work concern. A required medication disclosure by those in Safety Sensitive positions. 7) TESTING PROTOCOL: Drug and alcohol collections, chain of custody and other related procedures shall be consistent with US DOT or industry practice. For testing purposes, substances and threshold levels will comply, at a minimum, with customer requirements. a) Custody and Control Form (CCF) A CCF is required for every drug test. Alcohol screening test results must be documented on either a CCF or an alcohol testing form. A CCF is required for every blood alcohol confirmation test. For confirmation alcohol tests using a breath alcohol device, result and zero blank printouts must be attached to the CCF or attached to the alcohol testing form. b) Laboratory: Laboratories selected for employee drug testing must be evaluated against the following criteria to help ensure that results obtained from these laboratories will be reliable. i) Laboratories must be certified according to local laws and regulations or industry practices for providing accurate and reliable services. (1) Urine samples: A laboratory must be accredited/certified by either: (a) Department of Health and Human Services under the National Laboratory Certification Program or Substance Abuse and Mental Health Services Administration (SAMHSA), or (b) College of American Pathologists Forensic Drug Testing (CAP-FDT), or ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 9 (c) National Laboratory Certification Program (NLCP) (2) Hair specimens must be analyzed by a Clinical Laboratory Improvement Program (CLIP) accredited laboratory. Note: some customers will not allow hair testing as a means to meet their requirements. ii) Special handling and chain -of -custody procedures must: (1) be written and available, and (2) discuss inspecting, documenting, storing, and transporting specimens. iii) Laboratory management and staff must have appropriate education, experience, and qualifications. iv) Quality -Control procedures must be: (1) written and available, and (2) include testing blank and spiked samples for verification. v) Laboratories must be able to provide technical assistance and advice concerning drug and alcohol testing. vi) Sample supplies appropriate to the type of specimen being collected or the test run must be readily available from the laboratory. vii) Laboratories must be able to generate confidential and accurate reports. c) Collection Personnel: i) Urine specimens must be collected by personnel who have been trained and certified according to the SAMHSA/DHHS guidelines which includes: (1) basic information, (2) qualification training, (3) initial proficiency demonstration, (4) refresher training, and (5) Error correction training. ii) Hair specimens must be collected by personnel that have documentation supporting that they have been trained in: (1) Equipment and procedures used in gathering and collecting hair specimens. (2) Preparing chain -of -custody forms. (3) Preparing the specimen for shipment, and (4) Shipping the sample to an approved laboratory. Note: Hair testing will only be utilized for customer compliance when the customer has authorized this testing method. iii) Breath/Saliva testing shall be conducted utilizing devices approved by the National Highway Traffic Safety Administration or equivalent. All collection and testing procedures shall mirror as closely as possible to US DOT (Department of Transportation) protocols. d) Alcohol: Personnel that have a blood alcohol concentration (BAC) level: i) Personnel that have a blood alcohol concentration (BAC) level equal to or greater than 0.02 during pre -employment confirmation testing are considered to be under the influence of alcohol and will not be eligible to perform services for certain customers. ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 10 ii) Personnel that have a blood alcohol concentration (BAC) level equal to 0.02 and less than 0.04 must be removed from performing safety or security -sensitive activities until the BAC level is below 0.02 (unless customer specifies a more stringent level) and until 8 hours have elapsed. iii) Personnel that have a blood alcohol concentration (BAC) level equal to or greater than 0.04 have violated the Drug, Alcohol and Contraband Program and are subject to disciplinary action up to and including termination (unless customer specifies a more stringent level). 8) NON-COMPLIANCE Company personnel will be found to be in non-compliance if they: • Violate any portion of this policy or the customer's policy, or • Refuse to cooperate with the searches and tests included in this policy or the customer's policy. 9) COMPANY PERSONNEL DISQUALIFIED FROM PERFORMING SERVICES FOR CUSTOMERS With respect to company personnel that are disqualified from performing services for customers: • Company shall immediately remove the individual from customer property. • Company shall immediately notify the customer that the individual is disqualified from performing services. • Company will not assign or reassign the disqualified individual to perform services for the customer or in any other facility of the customer in the future. • Company will immediately review with customer the nature of the work previously performed by the individual. • At customer's request, company shall, at its sole cost and risk, inspect all work in which the individual may have participated and submit a written report to the customer that documents the inspection and any findings and the actions taken to assure all deficiencies have been corrected. **note (Company shall comply with all applicable state and local related laws. If restrictions are placed on employers, who have individuals that violate this policy, company shall contact their customer representative for instructions pertaining to the specific individual.) 10) SUBSTANCE ABUSE AWARENESS Company warrants that company personnel performing work have each been fully informed of the requirements of this policy and customer's policy. Before beginning work on company or customer property, all company personnel must sign a written certification that they have been so informed and agree to be bound by the requirements. See Attachment 1-3. 11) APPLICABLE LAWS Company shall comply with all applicable Federal, State, and local drug and alcohol related laws and regulations applicable to company personnel (e.g., DOT regulations, Department of Defense (DOD) Drug -Free Workplace Policy, Drug -Free Workplace Act of 1988, etc.). ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 11 12) SUPERVISOR TRAINING Company shall provide training/education to company supervisors. The list, at a minimum, should consist of: • Recognition of performance indicators of probable drug and/or alcohol use. • Effects and consequences of drug and/or alcohol use to personal health, safety and the workplace. • 60-minute training session on the specific, contemporaneous, physical, behavioral, and performance indicators of probable drug use. • 60-minute training session on the specific, contemporaneous, physical, behavioral, and performance indicators of probable alcohol use. • Random testing notification process. • Post -incident testing process. • Stand -down process. • Disqualified individual processes, which includes flagging those individuals to ensure they won't be sent back to work for a customer. ** Records of trained individuals (including name and date) must be maintained by the company and available to customers upon request. 13) AUDIT a) Company shall keep records required by this policy available for inspection by customers during the period that the company is performing work for customers and for a period of (3) years after company ceases to perform work for that customer. i) Such records include but are not limited to: (1) Laboratory copies of test results. (2) Chain of custody forms. (3) Copies of signed acknowledge/consent forms from this policy. (4) Random testing notification. (5) Post incident testing. (6) Reasonable suspicion testing. (7) Stand down procedures. (8) TPA contact information (if used). (9) MRO(s) name and contact information. (10) List of collection sites. (11) Records of personnel training and demonstrated competency in drug specimen collection and evidential breathalyzer tester. (12) Laboratory contact information. (13) Written procedure for ensure company personnel, who are disqualified from providing services to customers, continue to be excluded from customers locations. ii) Records can be stored electronically as long as they are accessible upon request. ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 12 b) At their discretion, customers may perform unannounced audits of the company's alcohol and drug program to verify that the company's policy and its enforcement comply with these guidelines. c) At customer's request the company shall: i) Provide separate lists of company personnel (including name and 4 digit identifying number) who were eligible for customers work on a date specified by customers. ii) Provide customers with the following information on each alcohol and drug test conducted for each company personnel identified by customers from those lists: (1) Date of and type of test (e.g. random, pre -access) and; (2) Laboratory chain -of -custody identification number and/or test number. d) Upon submission by customers of a list, or lists, of 4 digit identifying numbers, chain -of - custody ID numbers and test dates, the company shall obtain an agreement with any consortium, laboratory, or Medical Review Officer (MRO) providing drug and/or alcohol testing services for the company to ensure: i) The consortium/laboratory will verify that the tests were conducted as represented, and ii) The consortium/laboratory or company MRO will provide a sworn statement attesting whether or not each of the tests identified by the customer can be confirmed as negative. ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 13 ATTACHMENT 1 Acknowledgement of drug and alcohol contraband policy receipt I hereby acknowledge that I have been provided a copy of the Sabre Demolition Corporation drug/alcohol policy requirements. I understand that disciplinary action up to and including termination, will result if I violate this policy. I also hereby authorize and consent to disclosure by Sabre Demolition Corporation and its agents, including, but not limited to, any collecting and testing agencies, of the drug and alcohol test results and any related information to customers of Sabre Demolition Corporation and its authorized agents, assigns, or representatives. Employee Signature Employee Printed Name Date *** This consent form is for release of NON -DOT tests. Please follow DOT regulations if you choose to submit DOT test results in place of non -dot in order to meet the requirements of a specific client*** ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 14 ATTACHMENT 2 1. SUPERVISOR TRAINING Managers and supervisors must be adequately trained in the topics listed below to ensure they effectively communicate and implement the Drug, Alcohol and Contraband Program. • Rationale for having the Drug, Alcohol and Contraband Program. • Requirements contained in the Program. • Procedures for implementing the Program. • Drug and alcohol abuse terms and symptoms. • Reasonable suspicion that an employee is under the influence of drugs or alcohol. • Documentation of potential drug or alcohol abuse problems. • Protecting employee confidentiality. Training on the recognition of performance indicators of probable drug and/or alcohol use and on its effects and consequences to personal health, safety and the workplace shall be included. It is required that each supervisor who will determine whether an employee must be tested based on reasonable suspicion, receive at least one 60-minute training session on the specific, contemporaneous, physical, behavioral and performance indicators of probable drug and alcohol use. Records of individuals trained (including name and date) must be maintained by the company and available to customers upon request. (See Attachment 3: Supervisor Drug and/or Alcohol Checklist) 2. EMPLOYEE EDUCATION Employee education opportunities must be developed to communicate the Drug and Alcohol Testing Program. Education and communication must include, but are not limited to the following topics: • Requirements contained the Drug, Alcohol and Contraband Program. • Types and effects of drugs, including prescription and over-the-counter medication, and alcohol on employees and the ability to perform their work safely. • Ways to assess whether employees may have drug and alcohol dependency problems or may be under the influence of drugs or alcohol. • Requirement to inform supervisors of reasonable suspicion of an employee being under the influence of drugs or alcohol. • Disciplinary actions for employees failing to comply with the Drug, Alcohol and Contraband Program. ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 15 ATTACHMENT 3 SUPERVISOR DRUG AND/OR ALCOHOL CHECKLIST Supervisor Drug and/or Alcohol Checklist Question Yes No I. Smell of alcohol on breath of person? 2. Speech: • Slurred? ❑ ❑ • Confused? ❑ ❑ • Fragmented? ❑ ❑ • Slow? ❑ ❑ • Unusually soft? ❑ ❑ • Unusually loud? 3. Disorientation — Is the contractor confused about: • Where he or she is? ❑ ❑ • What day it is? ❑ ❑ • What time it is? ❑ ❑ 4. Apparent inability to focus on work? 5. Unusual or unexplained resistance to authority or refusal to follow reasonable directions? 6. Lack of motor coordination? 7. Mood: • Belligerent? ❑ ❑ • Moody? ❑ ❑ • Ecstatic? ❑ ❑ • More nervous than usual? ❑ ❑ • Giddy? F1 ❑ • Talkative? ❑ ❑ • Drowsy? 8. Skin color: • Pale? ❑ ❑ • Flushed? ❑ ❑ 9. Excessive perspiration? 10. Excessive trips to the restroom? 11. Bloodshot eyes? 12. Dilated pupils? 13. Pinpoint pupils? 14. Traces of alcohol in containers? 15. Confession by contractor that he/she was drinking alcohol or ingesting drugs? 16. Confirmation by other contractors or employees? 17. Presence of substances with the appearance of drugs? 18. Presence of drug paraphernalia? 19. Smell of marijuana? 20. Congregation of contractors in remote areas of the companies, facilities, or in areas not ❑ ❑ usually frequented by contractors? 21. Weariness, fatigue, or exhaustion? 22. Deteriorating physical appearance? 23. Yawning excessively? ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 16 Supervisor Drug and/or Alcohol Checklist Question Yes No 24. Blank stare or expression? 25. Sudden and/or unpredictable change in energy level? 26. Unusually energetic? 27. Shaking or trembling of hands? 28. Sunglasses worn at inappropriate times? 29. Changes in appearance after lunch break? 30. Withdrawal and avoidance of peers? 31. Complaints from co-workers? 32. Excessive absenteeism, especially Mondays, Fridays and days before or after holidays or paydays? ❑ ❑ 33. Unusually high incidence of colds, flu, upset stomach, and/or headaches? 34. Unauthorized or unscheduled absences? 35. Breathing or swallowing difficulties? 36. Unusual sneezing / nasal congestion? 37. Needle marks on arms? 38. Prolonged lunch hours? 39. Tardiness? 40. Unexplained departures from work or disappearances from the job area? 41. More than average number of job -related mistakes injuries or accidents? 42. Decrease in efficiency or productivity? 43. Careless operation of equipment? 44. Careless performance of job? ©National Compliance Management Service (NCMS): NCMS Model - Revised June 2021 17 fi scal.treasury. gov/surety-bonds/li st-certified -com pa n ies.htrrl#h 0 Iazar... Q Ariba Network Supp.. 0AP) Search Bids, RFP, RFQ M Personal Banking IF.. ® My GovWin l GovWi... © AMCS I Supplier Inf... ift Utilities Info C01 Login to Canal Cron.. ® Welcome to AIA Co... Great Midwest Insurance Company (NAIC #18694) BUSINESS ADDRESS: 800 Gessner, Suite 600, Houston, TX 77024. PHONE: (713) 973-0226. UNDERWRITING LIMITATION b/: $25,931,000. 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PROJECT NAME OWNER ARCHITECT/CM CONTRACT AMOUNT ROLE PERFORMED START DATE COMPLETION City of South Bend, Indian County -City Building Room $363,571 LUMP SUM Demolition PRIME PARKING GARAGE NO. 2 1316 South Bend, IN 46601 2/4/2004 4/4/2004 Gary Gilot 574-235-9251 90% own forces CONTRACTOR FAX574-235-9171 Shiel Sexton 425 W South Street Indianapolis, Indiana State Convention IN 46225 Tom $6,336,298 LUMP SUM Demolition Prime RCA Dome Bldg Authority c/o Shiel 4/8/2008 2/10/2010 Sexton Scheele/Mark Stanfield 80% own forces Contractor 317-638-3785 Fax 317- 638-3998 Ter Horst, Lamson, & Fisk Inc 8675 Purdue Lilly Corporate Center Road Indianapolis, IN $2,001,354 LUMP SUM Demolition Prime Eli Lilly Indianapolis, IN 46 7/9/2009 8/10/2010 Robert Parish 317-651-4-4340 46268 Mark Fisk 317-334 80% own forces Contractor 1500 ext 113 fax 317-334 1552 Ter Horst, Lamson, & Lilly Corporate Center Fisk Inc 8675 Purdue Indianapolis, IN 46285 Road Indianapolis, IN $786,3 58 LUMP SUM Demolition Prime Eli Lilly Bldgs 348/358 10/10/2010 3/11/2011 Jeffrey Smedley 317-651- 46268 Mark Fisk 317-334 80% Own forces Contractor 4340 1500 ext 113 fax 317-334 1552