HomeMy WebLinkAboutOpening of Bids - Central Fire Station Re-Roofing Proj No. R124-032A - Hoekstra Roofing CompanyCITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
Project Name Central Fire Station Re -roofing
Project No.
For Bids Due
Date:
Address:
City/State/Zip:
R124-032A
November 26, 2024
PART
(Must be completed for all bids. Please type or print)
November 26, 2024 Bidder (Firm): Hoekstra Roofing Company
1963 Olmstead Road
Kalamazoo, MI 49048
Telephone Number: ( 269 ) 343-5536
Agent of Bidder (if Applicable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of:
Re -roofing the South Bend Central Fire Station.
the City of South Bend, Indiana, in accordance with plans and specifications prepared by:
WDi Architecture Inc.
and dated November 1, 2024 for the sum of (enter the Total Bid as shown on the Proposal)
Seven hundred twenty-nine thousand five hundred dollars* ($ 729 500.00* )
*inlcudes $25,000 allowance (Numerical)
(Enter Total For Each Base Bid shown on Proposal. Separate using comma if bidding for both Base Bids)
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in
the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance
with the notice. Any addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are needed, the cost of units must be the same as that
shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit
basis, the itemization of the units shall own on a separate attachment.
By >
(Signature)
Tom Lundquist, CFO
(Printed Name of Person Signing)
ACCEPTANCE
The above bid is accepted this day of 20
Subject to the following conditions:
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
Gary A. Gilot, Member
Joseph R. Molnar, Vice President
Breana N Micou, Member
Murray L. Miller, Member Attest: Theresa Heffner, Clerk
Version 07/19/2023 Contractor's Bid for Public Works - 2
BIDIPROPOSAL
CITY OF SOUTH BEND
Project Name:
Central Fire Station Re -roofing
Project Number:
R124-032A
For Bids Due:
November 26, 2024
Contractor Name:
Hoekstra Roofing Company
Base Bid #A
Item
No.
Description
Quantity
Unit
Unit Price
Total Amount
The complete roof replacement as
1
described by the Contract Documents
1
LSUM
$704,500.00
$704,500.00
utilizing a 60 mil TPO membrane
2
1 Unforeseen Conditions Allowance
1
LSUM
$25,000.00
$25,000.00
Base Bid #A TOTAL $729,500.00
Base Bid #B
Item
No.
Description
Quantity
Unit
U=$25
The complete roofing replacement as
3
described by the Contract Documents
1
LSUM
utilizinga 60 mil PVC membrane.
4
Unforeseen Conditions Allowance
1
LSUM
$
Base Bid #B TOTAL N/A
(Bidder may choose to bid either Base Bid A, Base Bid B, or Both)
Bidder (Firm): Hoekstra Roofing Company
Address: 1963 Olmstead Road
City/State/Zip: Kalamazoo, M149048
Telephone Number: ( 269 ) 343-5536
By
(Signature)
Tom Lundquist, CFO
(Printed Name of Person Signing)
Version 07/19/2023 Contractor's Bid for Public Works - 7
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 11 PLAN AND EQUIPMENT QUESTIONNAIRE
1. Attach an explanation of your plan or layout for performing proposed work. (Examples could
include a narrative of when you could begin work, complete the project, number of workers,
etc. and any other information which you believe would enable the City of South Bend to
consider your bid.)
2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside
your own firm who have performed part of the work) that you have used on public works
projects during the past five (5) years along with a brief description of the work done by each
subcontractor.
3. If you intend to sublet any portion of the work, attach the name and address of each
subcontractor, equipment to be used by the subcontractor, and whether you will require a
bond. However, if you are unable to currently provide a listing, please understand a listing
must be provided prior to contract approval. Until the completion of the proposed project, you
are under a continuing obligation to immediately notify the City of South Bend in the event that
you subsequently determine that you will use a subcontractor on the proposed project.
4. Attach a listing of equipment you have available to use for the proposed project.
5. Have you entered into contracts or received offers for all materials which substantiate the
prices used in preparing your proposal? If not, attach an explanation for the rationale used
which would corroborate the prices listed.
SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said
financial statement as required by statute shall thereby be rendered invalid. The financial
statement provided hereunder to the City of South Bend awarding the contract must be specific
enough in detail so that said City of South Bend can make a proper determination of the bidder's
capability for completing the project if awarded.
Version 07/19/2023 Contractor's Bid for Public Works - 3
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION
REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON-
DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL
PRODUCTS OR FOUNDRY PRODUCTS
(Must be completed for all quotes and bids. Please type or print)
STATE OF Michigan )
) SS:
Kalamazoo COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury
that:
1. Contractor has not, nor has any other member, representative, or agent of the firm, company,
corporation or partnership represented by him, entered into any combination, collusion or agreement with
any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding
nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and
without any agreement, understanding or combination with any other person in reference to such bidding.
Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or
indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals
are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency; and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
For purposes of this Certification, "Iran" means the government of Iran and any agency
or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as
amended from time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor
is engaged in investment activities in Iran if either:
i. Contractor, its successor or its affiliate, provides goods or services of twenty
million dollars ($20,000,000) or more in value in the energy sector of Iran;
or
ii. Contractor, its successor or its affiliate, is a financial institution that extends
twenty million dollars ($20,000,000) or more in credit to another person for
forty-five (45) days or more, if that person will (i) use the credit to provides
goods and services in the energy sector in Iran; and (ii) at the time the
financial institution extends credit, is a person identified on list published by
the Indiana Department of Administration.
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any
employee or contract with a person that the Contractor subsequently learns is an unauthorized alien.
Version 07/19/2023 Contractor's Bid for Public Works - 4
Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's
newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's
documentation of enrollment and participation in the E-Verify Program is included and attached as part of
this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public contract to
certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien,
and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees
to maintain this certification throughout the term of the contract with the City of South Bend, and understands
that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision
no later than thirty (30) days after being notified by the City.
6. Persons, firms, partnerships, corporations, associations, or joint venturers awarded a contract by the
City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee
or applicant for employment in the performance of a City contract with respect to hire, tenure, terms,
conditions, or privileges of contract or employment, or any matter directly or indirectly related to contracting
or employment because of race, sex, religion, color, national origin, ancestry, gender expression, gender
identity, sexual orientation, or due to age or disability that does not affect that person's ability to perform the
work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any
combination of the foregoing including, but not limited to, public works contracts awarded under public
bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards,
or commissions will consider the Contractor's good faith efforts to obtain participation by those
subcontractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business
Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder.
Contractors seeking the award of a City contract cannot be required to award a subcontract to an MWBE;
however, they may not unlawfully discriminate against said MBE/WBE. On goal -eligible contacts,
Contractors are required to either meet both MBE and WBE utilization goals or demonstrate that the
Contractor has made good faith efforts to obtain participation from MBE and WBE subcontractors. A finding
of noncompliance or a discriminatory practice shall prohibit that Contractor fi•om being awarded a City
contact 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 Contactor agrees that the following nondiscrimination commitment shall be made
a part of any contact which it may henceforth enter into with the City of South Bend, Indiana or any of its
agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the
performance of this contract with privileges of employment, or any matter directly or indirectly related to
employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation,
handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of
contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my statutory
obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby
certify that I and all subcontractors employed by me for this project will use steel products or foundry
products made in the United States on this project if awarded. I understand I have an affirmative duty to
notify the City in my bid that my proposal does not include the use of steel products or foundry products
made in the United States. I understand it is my sole obligation and responsibility to provide a justification
to the City, subject to review and approval, why the cost of United States made steel or foundry products is
unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry
products made in the United States, the City, through its director of public works, shall make a determination
if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder
Version 07/19/2023 Contractor's Bid for Public Works - 5
may result in forfeiture of contractual payments.
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid
for public works are true and correct.
Dated this 26th day of November 2024
Hoekstra Roofing Company
Contractor/Bidder (Firm)
Sig�C-ontractor/B dder or is Agent
Tom Lundquist, CFO
Printed Name and Title
Subscribed and sworn to before me this 26th day of November ,20 24
My Commission Expires 08/08/2026-M(� :�jAA wilj A
Notary Public
County of Residence Van Buren, MI
MEEOFVAN
DER
NOTARY PUF MICHIGAN
COUURENMy Commissust 08,2026
Acting in the Cojbn
_
Version 07/19/2023 Contractor's Bid for Public Works - 6
Bid Bond
CONTRACTOR:
(Name, legal status and address)
Hoekstra Roofing Company
1963 Olmstead Road
Kalamazoo, MI 49048
OWNER:
(Name, legal status and address)
CNASURETY
Bond No. Bid Bond
SURETY: Western Surety Company
(Name, legal status and principal place
of business)
151 N. Franklin Street
171h Floor
Chicago, IL 60606
South Bend Fire Station
1222 South Michigan St.
South Bend, IN 46601
BOND AMOUNT: 5% Five Percent of Amount Bid
PROJECT:
(Name, location or address, and Project number, if any)
Central Fire Station Re -Roofing
This document has important legal
consequences. Consultation with
an attorney Is encouraged with
respect to Its completion or
modification.
Any singular reference to
Contractor, Surely, Owner or
other party shall be considered
plural where applicable.
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the
Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and
severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor
within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and
Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such
bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted
in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract
and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the
difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount
for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this
obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of
an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of
notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for
acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for
an extension beyond sixty (60) days.
If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall
be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.
When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project,
any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and
provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so
furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond.
Signed and sealed this 22nd day of November 2024
optra R96rQ 22mpagX
_iMl"?� (Pinci
(seal)
(Witness) (Witness) Melissa Sholander ttille)Phil Wood, ; President F �M"""'•.,ea
yyt IyI// Western Surety Company _NWQ`oPp
OAgr
/' /. rClLtt2eiP�1 (Surety) 3!. S AA a'
(Witness) Catherine M. Krueger By: V�fii�r�7jQ!j*soy Ei
Surety Phone No. 312-822-5000
Printed In coopemllon with the American Institute or Architects (AIA).
The language In this document conforms to the language used In AIA Document A310-Bid Bond - 2010 Edition.
Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
Know All Men By These Preseuls, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its
principal affiee in die City of Sioux Falls, That
State of South Dakota, and dial it does by vhme ofthe signature mid seal herein affixed hereby make, comtitute and appoint
Amy J. Forde , Individually
of Toledo, OH ,its true aid Iawdid Attoruey(s)-m-Fact with fail power mid authority hereby conferred to sigo, seal and execute for mid on its behalf
bonds, undertakings and other obligatory instruments of similar nalme
- In Unitmlted Amounts —
Surety Bond No: Bid Bond
Pt'haripal: Hoekstra Roofing Company
Obligee: South Bend Fire Station
and to bind it thereby as fully and to the same extent as if such iusmmmnn were signed by a duly authorized officer ofthe corporation and all die acts of said Attorney,
Pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made mid executed pursuant to and by authority of the Authorizing By -Laws and Resolutions printed at the bottom of this page, duly
adopted, as indicated, by the shareholders ofthe corporation.
In 1111mem Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on
din IOth day ofJmmmy, 2024.
waE*rP WESTERN SURETY COMPANY
@\ C P N
a a✓'IiUPko
Lary Kasten, Vice President
Stale of South Dakota l
Comity ofMimselWia f as
On this I Oth day of'Jantwy, 2024, before me personally came Larry Kasten, to me knomr, who, being by me duly sworn, did depose and say: Bat be resides in the
City ofSio ix Falls, State of South Dakota; that he is a Vice President of)VESTERN SURETY COMPANY described in and which executed the above instrument; Bat he
knows the seal of said corporation, that die seal affixed to the said instrument is such corporate seal, that it Was so affixed porsuaut to authority given by the Board of
Directors ofsaid corporation and that he signed lips name thereto par ant to like snthority, and acknowledges since to be the act and deed ofsand corporation.
Myconmtission expires ,(�R;sHOT. BENT"
March 2, 2026 'ysES'aJcourx oaxmasar Vf
s...... OUT" ........... s
M. Beat, Notary Public
CERTIPICAIE
I, Paula Kolsrud, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify flat die Power of Attonney herehmbove set forth is still in force, aid
touter cedifythat the By -Law mid Resolutions ofthe corporation printed below this certificate are still fit force. hnfesthuonywlieteoflbaveliereUntosuWribedmymmme
and affixed the seal ofthe said corporation this 22ud day of November , 2024.
�sfT�oo WESTERN SURETY COMPANY n
0
31. SepW�
eSOorMbn+n� Paula KoBtud, Assistant Secretary
Authorizing By -Laws and Resolutions
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power ofAttomey is made mid executed pursuma to and by authority ofthe following By -Law duly adapted by the shareholders of Ilse Company.
Sectiou T AB bonds, policies, Undertakings, Powers ofAttomey, or other obligations ofthe corporation shall be executed in the corporate name ofthe Company by
the President, Secretary, mid Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors nay authorize. The president, any
Vice President, Secretary, any Assistant Secretary, orthe Treasntermayappoful Attorneys inFact moSents who shallhave authority to issue bonds, policies, orundertakings
in the time of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undedakiags, Powers of Attorney or other obligation of the
corporation. The signature ofauy such officer and the corporate seal may be printed by facsimile.
This Poser ofAttonay is signed by Larry Kasten, Vice President, mho has been authorized pursmu t to die above Bylaw, to execute power of attomeys on behalfof Western
Surety Compxuy.
This PowerofAltontey may be sigued by digital signature and sealed by a digital orothensise electronic-formattedcorporate seal tinder mid by the authority ofthe following
Resolution adopted by Ilse Board of Directors ofthe Company by unammmw, written consent dated the 27a day ofApnl, 2022:
"RESOLVED: That it is in the best interest ofthe Company to periodically ratify and confirm any corporate documents sipped by digital signatures and to ratify and
cotSum the use of a digital or otherwise electronic -formatted corporate seal, each to be considered the act and deed ofthe Company."
(io to wraw.eoasuretwcom > Owner I Obligee Semdces > Validate Bond Coverage, Ifs'on waml to verify bond nnlhenticlly.
Fan F41OG a-1013
B'
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
FORM MBE-1.0 -- _�IM
__
MBE UTILIZATION PLAN
This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involvir
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: R124-032A Project Name: Central Fire Station Re -roofing
Bidder: Hoekstra Roofing Company Total Bid Amount: $729,500.00 MBE Goal: 0.6%
Page 1 of 1
Name 8 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
Percentage
of Total
Bid/Proosel
Leon's Roofing LLC
3628 East Tillman Road
Fort Wayne, IN 46816
Omar Leon
260-557-8489
omar.oscar@leonsro
Flat roofing, dyrwall, and powerwashing
)f.corn
$185,000.00
26%
Submitted by: Tom Lundquist, CFO
Print Name Signature
***Goals should be calculated based on the Base Bid only.'**
Version 07/19/2023 Contractor's Bid for Public Works - 8
November 26, 2024
Date
z
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
FORM WBE-1.0
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: RI24-032A Project Name: Central Fire Station Re -roofing
Bidder: Hoekstra Roofing Company Total Bid Amount: $729,500.00 WBE Goal: 2.1%
Page 1 of 1
Name & Address of WBE
Primary Contact Person
(Namelrelephone)
Scope of Work to be Performetl
(Attach scope/schedule if you need additional space)
Dollar Amount of WBE
Componem
Percentage
of Total
Bid/Proposal
None
Submitted by: Tom Lundquist, CFO November 26, 2024
Print Name Signature Date
***Goals should be calculated based on the Base Bid only.***
Version 07/19/2023 Contractor's Bid for Public Works - 9
0SIt'-1,111
CITY OFSOUTH 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: R124-032A Date: November 26. 2024
Project Name: Central Fire Station Re -roofing
Bidder: Hoekstra Roofing Company
Contact Person: Beau Byerly, ProjeGLEstimator Telephone: 616-914-7112 (Beau cell)
Address: 1963 Olmstead Road
City: Kalamazoo State: MI Zip: 49048
Email: beau@hoekstraroofing.com
To determine whether a bidder has demonstrated good faith efforts to reach the MBE utilization goals set forth in
the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions,
REQUIRE ALL of the following Good Faith Efforts as listed in the table below":
EVIDENCE OF GOOD FAITH EFFORTS
MBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise
Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department
of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found
at: htt:l/Www.in. ov/idoa/.
GOOD FAITH EFFORTS TO OBTAIN MBE PARTICIPATION
The biddershall initial each item below, as evidence of its goad 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 websile
htt ://www.in. ovlido) .
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
requirements of the
V
with adequate information about the plans, specifications and other
subcontract. See Questionnaire
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 071IM023 Contractors Bid for Public Works - 10
Fungi
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 07M912023 Contractors Bid for Public Works -11
,�vn,
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN
FORM WBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS
This completed form should be included as part of the Bids documents related to City of South Bend Public
Works Projects requiring Good Faith Efforts to obtain MWBE participation.
Project Number: R124-032A Date: November 26, 2024
Project Name: Central Fire Station Re -roofing
Bidder: Hoekstra Roofing Company
Contact Person: Beau Byerly, Project Estimator Telephone: 616-914-7112 (Beau cell)
Address: 1963 Olmstead Road
City; Kalamazoo State: MI zip: 49048
Email: beau@hoekstraroofing.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 Cily of South Bend's Minority and Women Business Enterprise
Inclusion Program Plan; 2) the listof certified MWBEs provided bythe City; and 3) the Indiana Department
of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found
at: httD://www.in.ciovljdoal.
GOOD FAITH EFFORTS TO OBTAIN WBE PARTICIPATION
The bidder shall initial each item below, as evidence of its good faith efforts to obtain WBE participation
in the awarded contract.
I affirm that I reviewed the City of South Bend's Minority and Women Business Enterprise
Inclusion Program Plan and the Indiana Department of Administration's certified list of
Indiana Minority and Women Business Enterprises, found on their website
htt :/A a .in. ov/idoa .
I affirm that I have made good faith efforts to select portions of the contract work to be
performed by WBEs, including, where appropriate, breaking out contract work items into
economically feasible units to facilitate WBE participation.
1 affirm that I have made good faith efforts to solicit through all reasonable and available
means the interest of all WBEs in the scopes of work of the contract.
I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform
WBEs of contracting and subcontracting opportunities.
I affirm that I advertised in general circulation and/or trade association publications
concerning subcontract opportunities and allowed WBEs reasonable time to respond to
such advertisements.
I affirm that I performed any and all necessary steps to provide written notices in a manner
reasonably calculated to inform WBEs of subcontracting opportunities and allowed
sufficient time for WBEs to participate effectively.
I affirm that I followed up on initial solicitations with interested WBEs.
I affirm that I negotiated with interested WBEs in good faith, including providing such WBEs
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 WBEs 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
`O Q
CITY OF SOUTH BEND
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN x, /
R
FORM WBE-2.0
EVIDENCE OF GOOD FAITH EFFORTS
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
appropriate.
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 07/192023 Contractors Bid for Public Works - 13
Tu
CITY OF SOUTH BEND s'
MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN��/
FORM MBE-2.1
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 1
Project Number: R124-032A MBE Participation Goal 0.6%
Project Name: Central Fire Station Re -roofing
Bidder. Hoekstra Roofing Company
By: Tam Lundquist CFO
MBE Firm Leon's Roofing LLC
Owner or Contact at MBE Firm Omar Leon
Telephone: 260-557-8489 Fax: N/A Email: omar.oscar@leonsroof.com
TYPE OF WORK SOLICITED FOR THIS PROJECT:
Flat roofing, dyrwall, and powerwashing
RESULTS OF CONTACT WITH THE MBE FIRM:
MBE Firm
Owner or Contact at MBE Firm
Telephone: Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE MBE FIRM:
Version 07/19/2023 Contractor's Bid for Public Works -14
CITY OF SOUTH BENDMINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.1
WBE CONTACTED
0�1
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 1
Project Number: R124-032A WBE Participation Goal 2.1%
Project Name: Central Fire Station Re -roofing
Bidder: Hoekstra Roofing Company
y: Tom Lundquist CFO November 26
2024
-
(Signature (title) (Date)
WBE Firm N/A
Owner or Contact at WBE Firm
Telephone: Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE WBE FIRM:
WBE Firm
Owner or Contact at WBE Firm
Telephone: Fax: Email:
TYPE OF WORK SOLICITED FOR THIS PROJECT:
RESULTS OF CONTACT WITH THE WBE FIRM:
Version (17119/2023 Contractor's Bid for Public Works - 15
tip U'ITI /fA.
JQ ,qoa
1316 CouN -Cnv BUILDING C \z1 PHII a 574/235-9251
227 W.IEFnnm BOULEVARD O FAx 574/ 235-9171
Soum BEND, INDIANA 46601-1830 �� TDD 574/235-5567
IX65 -
Date:
To:
From
Subject
Project Name:
Project No.:
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
November 21, 2024
All Planholders
Lidya Abreha, Project Manager
Addendum Number: I
Central Fire Station Reroofing
R124-032A
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received: // /2 L/ r-`/
This addendum is being Forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum by
faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
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:
Authorized Signature: ?�
Date: ///LZAV
1/4
/ OU BF.
e5 �
O
1316 COUNTVLrry BUILDING PHONE 574/235-9251
227 W. JFxtMON BOULEVARD [i O FAX 5741235-9171
Souni BEND, INDIANA 46601-1830 6 I � 211
TDD 5741235-5567
- 1a65
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
Date:
To:
From
Subject
Project Name:
Project No.:
Central Fire Station Reroofing
R124-032A
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM
Date Received:
This addendum is being forwarded to you for the above referenced project.
Please sign below and acknowledge receipt of this Addendum by
faxing this sheet to the Board of Public Works at (574) 235-9171
within 48 hours of receipt. A copy MUST also be included with your
bid package upon submittal.
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: /4-&1*.�+•i+K//�jj Ira.
Authorized Signature: ;Z__
Date: /1 /7/211,Y
1/2
1963 Olmstead Road • Kalamazoo, MI 49048 • (269) 343-5536 • www.hoekstraroofing.com
Pre -Qualification Checklist Attachments
November 26, 2024
Attachments
(i) IN SOS on-line records: See attached
(ii) Former business names: Cooper Roofing
(iii) MIOSHA violations within last five years: 05/04/22 Mobile Equipment
violation, and 10/19/23 Serious Personal Protective Equipment and Serious
Fall Protection violations.
(iv) Statement of staffing capabilities: Hoekstra Roofing Company has the
necessary labor resources to staff and complete the work we are bidding.
(v) Statement that individuals are classified as employees: All individuals who
will perform work on this project will be properly classified as employees or
independent contractors.
(vi) Evidence of training: Not applicable
(vii) Drug testing plan: See attached from our Employee Handbook
(viii) Approved surety company: See attached
(ix) Statement of tax delinquencies: Hoekstra Roofing Company has no federal,
state, or local tax liens or delinquencies in the past three years.
(x) List of completed projects: See attached
t APPROVED AND FILED
DIEGO MORALES
INDIANA SECRETARY OF STATE
04/02/2024 03:40 PM
BUSINESS ID 201805291260310
BUSINESS TYPE Foreign For -Profit Corporation
BUSINESS NAME HOEKSTRA ROOFING CO.
ENTITY CREATION DATE 05/29/2018
JURISDICTION OF FORMATION Michigan
PRINCIPAL OFFICE ADDRESS 1963 Olmstead Road, Kalamazoo, MI, 49048, USA
YEARS 2024/2025
EFFECTIVE DATE 04/02/2024
EFFECTIVE TIME 3:40 PM
REGISTERED AGENT TYPE Business Commercial Registered Agent
NAME C T CORPORATION SYSTEM
ADDRESS 334 North Senate Avenue, Indianapolis, IN, 46204, USA
TITLE
Secretary
NAME
Philip Wood
ADDRESS
1963 Olmstead Road, Kalamazoo, MI, 49048, USA
TITLE
President
NAME
Philip Wood
ADDRESS
1963 Olmstead Road, Kalamazoo, MI, 49048, USA
APPROVED AND FILED
w DIEGO MORALES
INDIANA SECRETARY OF STATE
04/02/2024 03:40 PM
IN WITNESS WHEREOF, THE UNDERSIGNED HEREBY VERIFIES, SUBJECT TO THE PENALTIES OF PERJURY, THAT THE
STATEMENTS CONTAINED HEREIN ARE TRUE, THIS DAY April 2, 2024.
THE UNDERSIGNED ACKNOWLEDGES THAT A PERSON COMMITS A CLASS A MISDEMEANOR BY SIGNING A
DOCUMENT THAT THE PERSON KNOWS IS FALSE IN A MATERIAL RESPECT WITH THE INTENT THAT THE DOCUMENT
BE DELIVERED TO THE SECRETARY OF STATE FOR FILING.
SIGNATURE Thomas D. Lundquist
TITLE CFO
Business ID: 201805291260310
Filing No.: 10279178
1963 Olmstead Road • Kalamazoo, MI 49048 • (269) 343-5536 • www.hoekstraroofing.com
Taken from our Drug Free Workplace Policy
6. Drug and Alcohol Testing
Each employee, as a condition of employment, will be required to participate in pre-
employment, return to work, client required, post significant job -related accident and
reasonable suspicion testing. For CDL drivers, drug and alcohol testing will be performed
based on Dept. of Transportation Title 49, CFR Part 40 requirements. Drug and alcohol
testing may be conducted at HRC, the jobsite, or at a drug testing facility. If an employee is
off on leave for more than 30 days, a return -to -work drug test must be completed and passed
before the employee is allowed to return to work. Some of HRC's customers require drug
and alcohol testing of each employee that will be on their jobsite. Employee consent to
submit to testing as stated above is required as a condition of employment, and the
employee's refusal to consent may result in disciplinary action.
HRC may require a blood test, urinalysis or other drug/alcohol testing. An employee will be
subject to the same discipline as a positive test if he/she refuses the screening or test,
adulterates or dilutes the specimen, substitutes the specimen with that from another person
or sends an imposter, will not sign the required forms or refuses to cooperate in the testing
process in such a way that prevents completion of the test.
Revised: 07/02/2024
52
CNASURETY
Kevin J. Van Otterloo
Underwriting Director
Grand Rapids, MI
Telephone 616-285-2682
800-432-9534 x2682
Email:Kevin.VaoOtterloo@cna.com
March 28, 2024
To Whom it May Concern:
Re: Hoekstra Roofing
Kalamazoo, MI
We are providing this information at the request of our principal
We have been providing surety bonds for Hoekstra Roofing Co. since 1994.
We continue to be confident in Hoekstra's ability to perform. We have
approved bonds for them covering jobs up to $6,000,000 and overall work
programs of $40,000,000. We recommend Hoekstra for your favorable
consideration.
This letter is not to be construed as an agreement to provide surety
bond for any particular project, but is offered as an indication of our
past experience and confidence in this form. Any specific request for
bonds will be underwritten on its own merits.
Western Surety Company (NAIC# 13188) is an underwriting company of CNA
Surety and is an approved surety on the Department of Treasury's Listing
with a current US Treasury Limit of $151,103,000. Western Surety Company
maintains an A (Excellent) AM Best Rating and a financial size of XIV.
Sincerely,
Kevin Van Otterloo
Western Surety Company
CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
RESPONSIBLE BIDDER CHECKLIST
Project Name Central Fire Station Re -roofing
Project No. R124-032A
For Bids Due November 26, 2024
Contractor Name: Hoekstra Roofing Company
The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works
projects by institution of comprehensive submission requirements in compliance with State law. Quality
workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet
certain minimum requirements to be responsive and responsible bidders.
THIS FORM MUST BE SUBMITTED WITH YOUR BID.
INSTRUCTIONS:
If you are a pre -qualified bidder, complete Section I only.
If you are not a pre -qualified bidder, complete Section II only.
Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be
considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre -
qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6-
63 of The Responsible Bidding Ordinance No. 10594-18 (hereinafter, "Responsible Bidding Ordinance")
for a period of twelve (12) months.
Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre -
qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified
Bidders") by December 3111 for the upcoming calendar year, or within twelve (12) months of obtaining pre -
qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of
the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application
for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal
of the designation, effective January 1 of the following year, or immediately following the twelve (12) months
of pre -qualified standing.
However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works
projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status
is re-established.
Please Note: The City reserves the right to request supplemental information from the bidder,
additional verification of any information provided by the bidder, and may also conduct random
inquiries of the bidder's current and previous customers regardless of pre -qualified standing.
It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to
the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid
opening.
Version 07/19/2023 General Conditions - 11
POST BID SUBMISSIONS:
Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding
Ordinance. The post -bid submission requirements are as follows:
1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the
name, address, licensing status, and type of work for any subcontractor from whom the bidder has
accepted a bid and/or intends to hire on any part of the public work project, including individuals
performing work as independent contractors.
2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty
thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the
Responsible Bidder Ordinance as though it were bidding directly to the City, except that the
subcontractor shall submit the required information (including the name, address, and type of work)
to the successful bidder prior to the commencement of work.
3. Failure of a subcontractor to submit the required information shall not disqualify the successful
bidder from performing work on the project and shall not constitute a contractual default and/or
breach by the successful bidder. However, the City may withhold all payment otherwise due for
work performed by a subcontractor, until the subcontractor submits the required information and
the City approves such information.
4. The disclosure of a subcontractor list ("Disclosed Subcontractors)") to the City by a bidder shall
not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another
subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the
name, address, licensing status, and type of work of the substitute subcontractor.
5. The successful bidder and all subcontractors on a public works project are required to submit
certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis,
submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall
identify the job title and craft for each employee. Certified payrolls shall be submitted
electronically.
Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in
the automatic disqualification of the bid.
The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into
account all information in the submission requirements, determine whether a bidder is responsive and
responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to
utilize all information provided in the contractor's submission and any information obtained by the City
through its own independent verification of the information provided by the contractor.
Version 07/19/2023 General Conditions - 12
PRE -QUALIFIED BIDDER CHECKLIST
(a) Acknowledgements:
(i) — By checking this box, I hereby acknowledge that I am a pre -qualified bidder with
the City of South Bend and that I have met the pre -qualification requirements within
the last twelve (12) months. A copy of my Pre -Qualification verification letter
is attached.
(ii) _ By checking this box, I hereby acknowledge that the City reserves the right to
request supplemental information, additional verification of any information
provided by me, and may also conduct random inquiries of my current and prior
customers.
(b) Attachments:
(i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within
sixty (60) days of the submission of said document showing that business is in
existence, current with the Indiana Secretary of State's Business Entity Report,
and eligible for a certificate of good standing. (Not applicable to individuals, sole
proprietors or partnerships).
(ii) _ Statement on staffing capabilities, including labor sources. This statement
indicates and ensures I have sufficient employees on staff to complete the work. It
outlines how I intend to meet the staffing needs of the work.
(iii) _ List of projects of similar size and scope of work performed in all areas, including
the State of Indiana, within the last three (3) years.
(iv) _ For every project, submit evidence of participation in apprenticeship and training
programs, applicable to the work to be performed on the project, which are
approved by and registered with the United States Department of Labor's Office of
Apprenticeship, or its successor organization.
Version 07/19/2023 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) V 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) _S/ 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) -N4 By checking this box, I hereby acknowledge and ensure that I and all sub-
contractors, from whom I have accepted a bid and/or intend to hire to perform work
on the public work project, are properly licensed. Furthermore, I acknowledge my
understanding that it is my responsibility to ensure that all sub -contractors have
the necessary licenses to undertake the work called for in this bid. If a sub-
contractor loses their license at any point, it is the responsibility of that sub-
contractor to notify the City.
(b) Attachments:
(i) Indiana Secretary of State's on-line records (ie. Business verification) dated within
sixty (60) days of the submission of said document showing that business is in
existence, current with the Indiana Secretary of State's Business Entity Report,
and eligible for a certificate of good standing. (Not applicable to individuals, sole
proprietors or partnerships).
(ii) List identifying all former business names.
(iii) Any determinations by a court or governmental agency any violations of federal
state, or local laws including, but not limited to, violations of contracting or antitrust
laws, tax or licensing laws, environmental laws, Occupational Safety and Health
Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5)
years.
(iv) Statement about staffing capabilities, including labor sources. This statement
indicates and ensures I have sufficient employees on staff to complete the work I
am bidding on OR outlines how I intend to meet the staffing needs of the work.
(v) _, Statement that individuals who will perform work on the public work project on my
behalf will be properly classified as an employee or as an independent contractor
under all applicable state and federal laws and local ordinances.
(vi) For every project, submit evidence of participation in apprenticeship and training
programs, applicable to the work to be performed on the project, which are
approved by and registered with the United States Department of Labor's Office of
Apprenticeship, or its successor organization.
(vii) Copy of a written plan for employee drug testing that covers all of my employees
who will perform work on the public work project and meets or exceeds the
requirements set forth in IC 4-13-18-5 or IC 4-13-18-6.
(viii) Evidence that I am utilizing a surety company which is on the Bureau of Fiscal
Service "Department of Treasury's Listing of Approved Sureties" as required in the
bid specifications or contract.
Version 07/19/2023 General Conditions - 14
(ix) Written statement of any federal, state or local tax liens or tax delinquencies owed
to any federal, state or local taxing body in the preceding three years.
(i) List of projects of similar size and scope of work performed in all areas, including
the State of Indiana, within three (3) years prior to the date on which the bid is due.
Date: November 26, 2024
(Sign Here)
Tom Lundquist, CFO
(Print Name Here)
Hoekstra Roofing Company
(Name of Company)
1963 Olmstead Road
(Address of Company)
Kalamazoo
(City)
Michigan, 49048
(State)
269-343-5536
(Telephone Number)
Version 07/1912023 General Conditions - 15
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CITY OF SOUTH BEND, INDIANA
CONTRACTOR'S BID FOR PUBLIC WORK
CHECKLIST FOR BIDDERS
Project Name Central Fire Station
Project No. R124-032A
For Bids Due November 26, 2024
From time to time the South Bend Board of Public Works finds it necessary to reject a bid because
it does not comply with statutory requirements. In preparing your bid, please use the following
checklist in order to make sure that your bid is done in the proper manner.
Proper bid security included. The bidder has the option of providing either a Certified Check
or Bid Bond.
Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely
executed.
Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments
with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and
Certification of use of United States Steel Products or Foundry Products.
Proof of M/WBE Utilization Plans [MBE-1.0 and WBE-1.0]. Also provide Evidence of Good
Faith Efforts Forms [MBE-2.0 and WBE-2.0] and M/WBE Contacted Forms [MBE-2.1 and
WBE-2.1].
A/ Acknowledge Receipt of 2 Addendum(s) included with the bid.
All required additional information is included with the bid.
Proposal statements and other affidavits all signed by the proper party with name either
Vprinted or typed underneath signature.
This checklist submitted with the Bid.
This checklist is provided for bidder's use in assuring compliance with required
documentation; however, it does not include all specifications requirements and does not
relieve the bidder of the need to read and comply with the specifications.
Bidder: Hoekstra Roofing Company Date: 11/26/2024
By Authorized Representative:
Signature:
Print Name & Title: Tom
CFO
Version 07/19/2023 Contractor's Bid for Public Works -1