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HomeMy WebLinkAboutOpening of Quotes - Tree Nursery ReQuote Proj No 125-017R - Acorn Landscapingo� tint' Tyr e�; CITY OF SOUTH BEND, INDIANA w CONTRACTOR'S QUOTE FOR PUBLIC WORK 1865 PROJECT NAME: PROJECT NO. QUOTES DUE Date: Address: City/State/Zip Urban Tree Nursery Site Improvements 125-017R Tuesday, July 8, 2025 at 9:30am (Must be completed for all quotes. Please type or print) 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: the City of South Bend, Indiana, in accordande with plans and specifications prepared by: The City of South Bend, Department of Public Works and dated 7 — 7 �� S� ] for the sum of (enter the Total o�e as shown on the Proposals 00 d�lu.nG((4d n/4-�-n�1�P%iter�Sar�C� Or1p huI,d�ec��¢�teti`(('A,� ars ($ oC l 7 / ) (Enter Sum of Total Quote plus Alternates shown on Proposal) (Numerical) If alternative quotes 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 quote is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attaghment. By /eb n�w4d, r n� & ,(Signs ure) (Printed Name of Person Signing) ACCEPTANCE The above quote is accepted this day of Subject to the following conditions: BOARD OF PUBLIC WORKS President Members 20 Version 1/3/2025 Page - 20 Public Works Quote 'ot fllbE QUOTEIPROPOSAL CITY OF SOUTH BEND f NAS PROJECT NAME Urban Tree Nursery Site Improvements PROJECT NO. 125-017R QUOTES DUE Tuesday, July 8, 2025 at 9:30am Base Bid Items: Utility Connections and Grading Work Item No. Description Quantity Unit Unit Price Total Amount 1 Mobilization ! Demobilization 1 LS $ 2 Excavation / Grading (Pavilion, Staging 1 LS ao2 $ g0 ZOZ Areas and Includes tillin Grow Rows 3 Concrete, 4" (Under Pavilion) 93 Sys 75, $ MIS 0 F�7Pavilion #53 Compacted Aggregate (Under 210 TON //�o� S- $ // o 3(v5� and Staging Areas —10 900SF lS� ALLOWANCE #1: Irrigation Hook -Up Item No. Description Quantity Unit Unit Price Total Amount Allowance 1: Connect to existing 2" irrigation main at the Half Moon site, including a new controller. Water connections and controls to be located at the Northeast corner of the site. 5 Bidder shall provide price to provide and 1 LS $25.000 install PVC Water Lines from Irrigation Main to Growing Rows. Bidder shall provide price to provide and install Drip Irrigation Hoses from PVC Connections at Growing Rows ALLOWANCE #1 TOTAL $25,000 BASE BID TOTAL j3q _Q:V_ Alternate 1: Block Wall Storaae Corral Item No. Description Quantity Unit Unit Price Total Amount Concrete Block Wall: Bidder shall provide 6 price to provide and install "Concrete 1 LS //-- 430 Ip�(9S $ ad 2— 6o S Block" walls 6'x2'x2' Block). Total Amount for Alt. 2 Quote $ I Z&,5- Alternate 2: Raised Beds Item No. Description Quantity Unit Unit Price Total Amount Wolmanized Wood (Raised Beds): Bidder o shall provide price to provide and install Wolmanized wood raised beds, including all 00 //�� 7 1 LS 3��W� $ associated framing, fasteners, filter fabric, )= and structural support as identified in the tans. 5 Beds — 4'xl D'x10" 8 Pea Gravel (Raised Beds) 15 TON 3 a Y `7 r Total Amount for Alt. 3 Quote $ S�{C,i b O Alternate 3: Geotextile Fabric Item No. Description Quantity Unit Unit Price Total Amount Geotextile Fabric, Staging Areas: Bidder 9 shall provide price to provide and install 10,070 SF $ geotextile fabric at staging areas as identified in the plans. Geotextile Fabric, Growing Rows: Bidder 10 shall provide price to provide and install 45,600 SF $ U geotextile fabric at growing row as identified in the plans. Total Amount for Alt. 4 Quote S Alternate 4: Pavilion Item No. Description Quantity Unit Unit Price Total Amount 11 Pavilion, Monoslope 20'x30' 1 EA $ Total Amount for Alt. 5 Quote $ 6 ° Alternate 5: Tree Placement Item No. Description Quantity Unit Unit Price Total Amount Tree Placement — Transport of 100 nursery 12 trees from Elbel Nursery, repotting, and 1 LS / g n�/ oo $ placinginto Grow Rows. O C7 (s� Total Amount for Alt. 6 Quote $ 8 Firm: COf- (� LaV ,, ((, DOAC, L( C Address: S680 W eE pp City/StatelZip: oLk� k &,A N Telephone Number: Fax Number: (Signature) (Printed Name of Person Signing) When the prospective Contractor is unable to certify to any of the statements below, it shall atlacls 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 ,st os h ) SS: COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affairs 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 investmcnt 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 activitics 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 version 1/3/2025 Page - 29 Public Works Quote alien. 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 LC, 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, firms, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of contract or employment, or any matter directly or indirectly related to contracting or employment because of race, sex, religion, color, national origin, ancestry, gender expression, gender identity, sexual orientation, or due to age or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions will consider the Contractor's good faith efforts to obtain participation by those subcontractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. Contractors seeking the award of a City contract cannot be required to award a subcontract to an MWBE; however, they may not unlawfully discriminate against said MBE/WBE. On goal -eligible contracts, Contractors are required to either meet both MBE and WBE utilization goals or demonstrate that the Contractor has made good faith efforts to obtain participation from MBE and WBE subcontractors. A finding of noncompliance or a discriminatory practice shall prohibit that Contractor from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact to which the discriminatory practice or noncompliance pertains. 7. The undersigned Contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract Version 1IM025 Pape - 30 Public Works Quote 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 may result in forfeiture of contractual payments. I hereby alTtrin under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this M daN of , 20A5 r7 Contractor/Bidder (Finn)— &WAid, ,Q y�,, /L�✓ Signature of Contractor/Bidder or Its Agent _Aridrm 4fs hard Mimhe - Printed Name and Title If Subscribed and sworn to before me this day of k , 202E My Commission Expires _ Notary Public n County of Residence (` Mezand,aa Harnendez Notary Public Sabi tStata of Indian■ 6L joppn Cwnty CommllNon NumbetWOTIa11 my Con iris oe Ex" IM2017 Version 113=25 Papa , 31 Public Works Quote J A Ili R� CITY OF SOUTH BEND = r MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN _ FORM WBE-2.1 WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It Is the bidder's sole responsibility to verify whether any listed minority or woman business meets the WBE qualifications. Attach additional pages If necessary. PAGE OF �Project Number: 125-017R WBE Participation Goal Project Name: Urban Tree Nursery Site Improvements Bidder BYn an a Q l n Q I n M Q�- &o(o,A } (Signature) iUe (Date) WBE Firm _k—) �-S C1'`E,4-rJ 8 To S. I C . Owner or Contact at WBE Firm Telephone S )C- o2 0'V —17ax: N I Email �C/ LA 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: Gc-,-' �x nl ti CITY OF SOUTH BEND �. MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN - V FORM WBE-2,0 w , 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 WBE participation. Project Number 125-017R Date Project Name. —Urban Tree Nurse Site Improvements Irl Bidder: end'y\ Contact Person. eaa P ksc,ar Telephone: S 7{-,?8� ­69s0 Address: SG gb City: State. Zip: Email: /n7CD LACGy"nlQn SC'Gt�GYY) 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 M WBEs 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: h :l/www.in. ovfidoa/. 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. /� AMP __i[http_-//www_in.gov/idoa) 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 I affirm that I have made good faith efforts to select portions of the contract work to be &kl performed by WBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate MWBE participation. I 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� 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 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS W— 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. 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 WBE 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. 'J CITY OF SOUTH BEND yf, 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 minority or woman business meets the WBE qualifications. ***Goals should be calculated based on the Base Bid only.*** Project Number. 125-017R Project Name: Urban Tree Nursery Site Improvements Total Bid -�7 a o Bidder. F ,LLCAmount: 3Y� �36 / WBE Goal: c2,q IO 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/Proposa I 1 �ro5 �61 42 P999rga I&,,ely Id g0`71,3Z 3. do 3/ Submitted by: A lhmwJAdIA 1eL&JA1t6C_ 7/-7/�Oa5 Print Name Signature Date ***Goals should be calculated based on the Base Bid only.*** ,111 AE 1 I, CITY OF SOUTH BEND �± MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN ;Q - FORM MBE-2.1 MBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact MBEs. It Is the bidder's sole responsibility to verity whether any listed minority or woman business meets the MBE qualifications. Attach additional pages If necessary. PAGE OF )— Project Number: 125-017R MBE Participation Goal o Project Name: Urban Tree Nurse Site Improvements Bidder. By �� /� �./C/a / I �Q i1Q Ill rA (L%1'LK/r?% _ I/ o a , (Signature) 4TitIeV (Date) MBE Firm 14 C la �' -�-, l 14-�a 1 c- h`�(_ e- Owner or Contact at MBE Firm j� ,0 r-,, Telephone:%(! �3 QQ71 Faux -�7�� TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: MBE Firm Owner or Contact at MBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: 1� 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 particlpatlon. _ Project Number 125-017R Date �' 'v? S Project Name Bidder. Urban Tree Nursery Site Improvements Contact Person f1'1drea- /z, 1,yMwV J Address. C Telephone l r City° ��^ State 7 A Trp; Email, i n r66) Gi Cprn/Qn ,ScCcnQf'f. CDC To determine whether a bidder has demonstrated good faith efforts to reach the MBE utilization goal set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, RE43UIRE 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 Enterpnse 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: httJlwww in govAdoaf. GOOD FAITH EFFORTS TO OBTAIN MBE PARTICIPATION The bidder in the awarded shall initial each item below, as evidence of its good faith efforts to obtain MBE participation contract. I affirm that I reviewed the City of South Bend's Minority and Women Business Enterpnse Inclusion Program Plan and the Indiana Department of Administration's certified list of Indiana Minority and Women Business Enterpnses, found on their website httl/www in ovlidoa . �N I affirm that I have made good faith efforts to select portions of the contract work to be performed by MBEs, 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. �'JilfV 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 �I concerning subcontract opportunities and allowed MBEs reasonable time to respond to such advertisements. PO 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 MWBEs 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 subcontracL nA . 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. 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. 9. Name, address, and telephone number, Z 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. .a i\ ill Gf, a CITY OF SOUTH BEND !J� MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-1.0 MBE UTILIZATION PLAN This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the MBE qualifications. ***Goals should be calculated based on the Base Bid only.*** Project Number Bidder: 125-017R Project Name Urban free Nursery Site Improvements Total Bid Amount: `� ?j�% 3� 7 MBE Goal: /o 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 Gomponert Percentage of Total BkUProposal -Mvl-C SL� C C-0��� �e e ?S Submitted by: & ire r Scv�GI'/'C1�/ `'"'" _ 7�7��,�� Print Name Signature Date ***Goals should be calculated based on the Base Bid only.*** Date: Name: BPW Date: 7/8/2025 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM 6/30/2025 Gemma Stanton Department of Public Works — Engineering Division Phone Extension: 9083 Required Prior to Submittal to Board BPW Attorney X Attorney Name Dept. Attorney ❑ Attorney Name Purchasing ❑ Check the Appropriate Item Type — Required. for All Submissions ❑ Professional Services Agreement ❑ Contract ❑ Proposal ❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA ❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ® Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes ❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA ❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution F-1 Other: I -I Ease./Encroach Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Special Contract Provisions Purpose/Description Information ❑ Yes ❑ If Yes, Approved by Purchasing ❑ No Yes ❑ WBE Completed E-Verify Form Attached ❑❑ No Urban Half Moon Tree Nursery n/a USDA Urban & Community Forestry Grant - 212-10-101-132-439300 PR#00040816 Unit Open quotes for revised project For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount Current Percent of Change New Amount Increase Decrease Increase Total Percent of Change: Decrease Time Extension Amount: New Comnletion Date: