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HomeMy WebLinkAboutOpening of Bids - Cleanup of South Bend Range, Phase I Proj No 125-020A - Adamo DemolitionCITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Cleanup of South Send Range, Phase I Project No. 125-020A For Bids Due Tuesday, August 12, 2025 @ 9:00 A.M. (E.D.T.) PART I (Must be completed for all bids. Please type or print) Date: 8/12125 Bidder (Firm): Adamo Demolition Co. Address: 320 E. Seven Mile Rd. City/State/Zip: Detroit, MI 48203 Telephone Number: ( 313 ) 892-7330 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: Cleanup of South Bend Range, Phase I — Building Demolition the City of South Bend, Indiana, in accordance with plans and specifications prepared by: City of South Bend, Engineering Division and dated 07/11/2025 for the sum of (enter the Total Bid as shown on the Proposal) One million one hundred fifty five thousand and two hundred forty dollars (Enter sum of Total Base Bid plus Alternates shown on Proposal) $1,155,240.00 (Numerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be s7�;E ttachment. By Z4 (Signature) Adamo (Printed Name of Person Signing) The above bid is accepted this Subject to the following conditions: BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member ACCEPTANCE day of 20 Joseph R. Molnar, Vice President Breana N. Micou, Member Murray L. Miller, Member Attest: Hillary Horvath, Clerk Version 07/19/2023 Contractor's Bid for Public Works - 2 0���°� Jl d CITY OF SOUTH BEND, INDIANA �dei CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Cleanup of South Bend Range, Phase I Project No. 125-020A For Bids Due Tuesday, August 12, 2025 @ 9:00 A.M. (E.D.T.) From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. Proper bid security included. The bidder has the option of providing either a Certified Check X or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely X executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and X Certification of use of united States Steel Products or Foundry Products. Proof of MIWBE Utilization Plans [MBE-1.0 and WBE-1.0]. Also provide Evidence of Good Faith Efforts Forms [MBEs-2.0 and WBE-2.0] and MIWBE Contacted Forms [MBE-2.1 and X WBE-2.1]. X Acknowledge Receipt of 1 Addendum(s) included with the bid. X All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either X printed or typed underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: Adamo Demolition Co. By Authorized Signature: Print Name & Title: RICTrar'd M. Adamo, President Date: 8/12/25 Version 07/19/2023 Contractor's Bid for Public Works - 1 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 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: Wayne COUNTY The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Version 07/19/2023 Contractor's Bid for Public Works - 4 Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, firms, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of contract or employment, or any matter directly or indirectly related to contracting or employment because of race, sex, religion, color, national origin, ancestry, gender expression, gender identity, sexual orientation, or due to age or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions will consider the Contractor's good faith efforts to obtain participation by those subcontractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. Contractors seeking the award of a City contract cannot be required to award a subcontract to an MWBE; however, they may not unlawfully discriminate against said MBE/WBE. On goal -eligible contracts, Contractors are required to either meet both MBE and WBE utilization goals or demonstrate that the Contractor has made good faith efforts to obtain participation from MBE and WBE subcontractors. A finding of noncompliance or a discriminatory practice shall prohibit that Contractor from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact to which the discriminatory practice or noncompliance pertains. 7. The undersigned Contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder Version 07/19/2023 Contractor's Bid for Public Works - 5 may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 12th day of August, 2025 Subscribed and sworn to before me this 12th My -Commission -Expires 1/26/30 County of Residence Adamo Demolition Co. Contractor/Bidder (Fir/m)) V ate( /Y(Fit Sig ure of Contractor/Bidder or Its Agent Richard M. Adamo, President Printed Name and Title day of August 2025 Notary Public Oakland SHARON L DANIS Notary Public - State of Michigan County of Oakland My Commission Expires Jan 26, 2030 Acting in the County or Version 07/19/2023 Contractor's Bid for Public Works - 6 THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, that we Adamo Demolition Company 320 East Seven Mile Road,Detroit, MI 48203 as Principal, hereinafter called Principal, and Liberty Mutual Insurance Company 175 Berkeley Street,Boston, MA 02116 a corporation duly organized under the laws of the State of rylassachusetts as Surety, hereinafter called Surety, are held and firmly bound unto City of South Bend Indiana Dept. of Public Works 1316 County City Bldg. 227 W. Jefferson Blvd.,South Bend, IN 46601 as Obligee, hereinafter called Obligee, in the sum of Five Percent of Accompanying Bid Dollars (5% of Bid for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind oursewes, uu1 heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for (Here insert full name, address and description of project) 125-020A - Clean up of South Bend Range, Phase 1 - Bldg. Demo NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party t I orm the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effedt. yoSg- y Signed and sealed this 12th day of August 2025 Adamo Demolition Company _ v R i r��. & f rincijoal) v �K*" ` (Witness) sident '�• r' (Title) Liberty Mutual Insurance Company (Surety) (Title) Holly Nichols Attorney in Fact ,7 '11 AIA DOCUMENT A310-BID BOND -AIAOO-FEBRUARY 1970 ED-THEAMERICAN INSTITUTE OF ARCHITECTS, 1735 N.V. AVE., N.W., WASHINGTON, D.C. 20006 '0� Libert�y7 POWER OF ATTORNEY MUi . Liberty Mutual Insurance Company SURETY The Ohio Casualty Insurance Company West American Insurance Company Certificate No: 8213450-013068 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the Stale of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the 'Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Nicholas Ashburn; Robert D. Ilcuer; Paul 11. Hurley Michael D. Lochner, Mark Madden; Richard McGregor; I lolly Nichols; Jason Rogers all of the city of Rochester state of MI each individually if mere be more than one named, its true and lawful attorney-m-tact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 25th day of March , 2025 . W c m `m State of PENNSYLVANIA County of MONTGOMERY ss 0 Liberty Mutual Insurance Company Wsuq �1Y INsp d Wsuq The Ohio Casualty Insurance Company tiJp'°°a°oya q'r'n yJp'°oaP°R7,Rvy Vp' oar°RyrgdC West American Insurance Company f s1912e° � oU 1919� n s f 1991ea S , W o a 2(iI dal saceusErpD =0 ekH4MP5H dD3 !'s �NOIAa> dD qxy + *xa �qt . 1•N qM . F� By: Nathan J. Zangerle, Assistant Secretary aS On this 25th day of March , 2025 before me personally appeared Nathan J. Zangerle, who acknowledged himself to be the Assistant Secretary of Liberty Mutual m Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the therein contained by signing on behalf of the corporations by himself as a duly authorized officer. m IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above written. N N 0O tr Pqg Q�y se°rnr T p <f y C°mmonweanaol Pennsylvania -Notary Seal Teresa Pesreller Notary Public erye°anry Mslon cr ex March B Y My commmini r11260a.2o29 nnumbpires lion , Parrasionnumber of MemMq Pennsylvania A55ocielion al Notaries r�r 9D rue This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV— OFFICERS: Section 12, Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surely obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such allomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes Nathan J. Zangede, Assistant Secretary to appoint such attorneys -in -fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization —By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American !nsurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 12th day of August 2025 . Ps'tY INSU d \NSUgq (0(0(9 4n yJ °°avoggr'P9y VP°°avoxgr '4n en UP `"o m � Fo ra ? 3 0 0 1919 f 1991 �J/�a.LLy► 3 Z s i� t 3 BY � DO �AHgMess dD�rs x"mna> dDRenee C. Llewell n, Assistant Secwfa a'qt : l.N dM ,r ti� Y ry LMS-12873 LMIC OCIC WAIC Mull, Ca 02124 Project Name: Project Number: For Bids Due: Contractor Name: BASE BID �, q If Rt I� BID/PROPOSAL - „— CITY OF SOUTH BEND - Cleanup of South Bend Range, Phase I 125-020A Tuesday, August 12, 2025 @ 9:00 A.M. (E.D.T.) Adamo Demolition Co. Item No. Description Quantity Unit Unit Price Total Amount Lump Sum price to complete building 1 demolition, asbestos abatement, and 1 LSUM $1,130,240.00 $1,130,240.00 fence removal and replacement as intended by these Specifications 2 Environmental Allowance 1 EA $25,000 $25,000 BASE BID TOTAL $1,155,240.00 Bidder (Firm): Adamo Demolition Co. Address: 320 E. Seven Mile Rd. City/State/Zip: Detroit, MI 48203 Telephone Number: __( 313) 892-7330 BYaZO/�'9 (Signature) Richard M. Adamo (Printed Name of Person Signing) Version 07/19/2023 Contractor's Bid for Public Works - 7 .ail' I l l !lf `t j. CITY OF 5OUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-1.0 MBE UTILIZATION PLAN This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. ***Goals should be calculated based on the Base Bid only.*** Project Number Bidder: 126-020A Project Name: Adamo Demolition Co Cleanup of South Bend Range, Phase I Base Bid Amount: $1,130, 240.00 MBE Goal: 1.3% Page of Name &Address of MBENamefTele Primary Contact Person hone ( p ) Scope of Work to be Performed (Attach scopefschedule if you need additional space) Dollar Amount of MBE Component Percentage of TotalgidlPro osai 1st Class Logistics LLC Bernard Coutee 517-993-0071 Trucking/Material Supply $60,800.00 5.4% Submitted by: Richard M. Adamo Print Name Si na re ***Goals should be calculated based on the Base Bid only.*** Version 07/19/2023 Contractor's Bid for Public Works - 8 8//1 2/25 Date aQ-[fi 11F, ;4 `L 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: 125-020A Project Name: Cleanup of South Bend Range, Phase I Base Bid Amount: $1,130,240.00 WBE Goal: 4.7% Bidder: Adamo Demolition Co. of Page Name & Address of WBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed (Attach scope/schedule if you need additionaE space) Dollar Amount of WBE Component =Bid/Pro TBD Trucking $60,500.00 5.3% Submitted by: Richard M. Adamo 8/12/25 Print Name Siqkte Date ***Goals should be calculated based on the Base Bid only.*** Version 07/19/2023 Contractor's [aid for Public Works - 9 i •��l 'l Ff I1�:,� 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: 125-020A Date: 8/12/25 Project Name: Cleanup of South Bend Range, Phase Bidder: Adamo Demolition Co. Contact Person: Richard M. Adamo Telephone: Address: 320 E. Seven Mile Rd. City: Detroit State: MI zip: 48203 Email: radamo@adamogroup.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 ://www.in. gv/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 RMA Indiana Minority and Women Business Enterprises, found on their website (http://www.in.gov/idoa). A 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. RMA 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. A 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 RMA 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 RMA reasonably calculated to inform MBEs of subcontracting opportunities and allowed sufficient time for MBEs to participate effectively. RMA 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 N/A 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, RMA lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 07/19/2023 Contractor's Bid for Public Works - 10 CITY OF SOUTH 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 RM A equipment, supplies, materials, or related assistances or services, where appropriate. A 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 - 11 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: 125-020A Date: 8/12/25 Project Name: Cleanup of South Bend Range, Phase I Bidder: Adamo Demolition Co. Contact Person: Richard M. Adamo Telephone: Address: 320E. Seven Mile Rd. City: Detroit State: MI zip: 48203 Email: radamo@adamogroup.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: htt ://www.in. gv/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 Enterprise Inclusion Program Plan and the Indiana Department of Administration's certified list of RMA 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 RMA performed by WBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate WBE participation. A 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. RM A 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 N/A 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 A reasonably calculated to inform WBEs of subcontracting opportunities and allowed sufficient time for WBEs to participate effectively. RM A 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 RM A with adequate information about the plans, specifications and other requirements of the subcontract. N/A 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 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested WBEs in obtaining N/A necessary equipment, supplies, materials, or related assistances or services, where appropriate. RMA 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 - 13 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN i11' 4=- FORM MBE-2.1 .h. 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: 125-020A MBE Participation Goal 1.3% Project Name: Cleanup of South Bend Range, Phase I Bidder: Adamo DsLnofifion Co. By: President 8112/25 ( ture) (Title) (Date) MBE Firm Clean Air Systems Inc. Owner or Contact at MBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: Asbestos and Abatement RESULTS OF CONTACT WITH THE MBE FIRM: Considered for abatement contract MBE Firm 1st Class Logistics LLC Owner or Contact at MBE Firm Bernard Coutee Telephone: 574-993-0071 Fax: Email: lstclasslogistics20l3@gmail.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Trucking and Material supply RESULTS OF CONTACT WITH THE MBE FIRM: Being considered for subcontract work Version 07/19/2023 Contractor's Bid for Public Works - 14 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN -� r FORM MBE-2.1 n, " 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: 125-020A WBE Participation Goal 4.7% Project Name: ByBy:: Cleanup of South Bend Ran e, Phase I Adamo Demolition Co. tz�Anature) (I Itle) (Date) WBE Firm Plina Inc. Owner or Contact at WBE Firm Telephone: 219-473-2929 Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: Trucking RESULTS OF CONTACT WITH THE WBE FIRM: unable to contact due to phone number out of service. WBE Firm Al Excavating Owner or Contact at WBE Firm Telephone: 812-508-1129 Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: Trucking RESULTS OF CONTACT WITH THE WBE FIRM: They do not work in South Bend area. Version 07/19/2023 Contractor's Bid for Public Works - 15 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: July 29, 2025 To: All Planholders From Hillary Horvath, Clerk, Board of Public Works Subject Addendum Number: 1 Project Name: 125-020A Project Number: Cleanup of South Bend Range, Phase I — Building Demolition ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 7/29/25 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: Adamo Demolition Company Authorized Signature: Date: 7/29/25 Version 8/11/2020 CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name Cleanup of South Bend Range, Phase I Project No. 125-020A For Bids Due Tuesday, August 12, 2025 @ 9:00 A.M. (E.D.T.) Contractor Name: Adamo Demolition Co. 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 II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: (i) X By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. (ii) X 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) X 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) X 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) X 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) X 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) X 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) X List identifying all former business names. (iii) X 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) X 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 x 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. (v) X 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) x 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) X 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) nn/a 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) x 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: 8/12/25 (Sig e) Richard M. Adamo (Print Name Here) Adamo_ Demolition Co. (Name of Company) 320 E. Seven Mile Rd. (Address of Company) Detroit MI (State) 313-892-7330 (Telephone Number) Version 5/20/2024 General Conditions - 15 V) C 0 4-J ro V f6 �A L Adamo Demolition Co. 4 320 East Seven Mile Rd. Detroit, Michigan 48203 Statement of Qualifications for Demolition Services Date: 8/12/25 Contractor: Adamo Demolition Co. 320 East Seven Mile Rd. Detroit, Michigan 48203 Submitted to: Department of Public Works City of South Bend, IN Project No. 125-020A This Statement of Qualifications (SOQ) is submitted for your consideration of Adamo for your anticipated future projects. Thank you for the opportunity to provide this information for your review and consideration. Statement of Qualifications - 2025 Adamo Demolition Co. 320 E. Seven Mile Rd., Detroit, MI 48203 (313) 892-7330 rick.c@adamogroup.com www.adamogroup.com Date: 8/12/25 Reference: Cleanup of South Bend Range, Phase I - Building Demo Project No. 125-020A Good afternoon: NANO DETRDIT, MI Adamo Demolition Co. is pleased to present its proposal to you. Adamo is captained by its President, Richard M. Adamo, who has a team of industry experts attending to the variety of project details and management, completing an average of $50M decommissioning and demolition work per year. Our Project Managers and Estimators average 24 years of experience and our key Operating Engineers average over 17 years of experience, vastly enhancing the quality of work Adamo affords its clients. Adamo has performed decommissioning and demolition projects throughout the U.S. since 1964. Demolition projects typically involve complexities of working in a variety of environments, which are addressed by Adamo through in-house authored project specific plans. These plans address all facets of the projects, which may include managing work zone safety, pedestrian traffic, transportation safety routes, soil erosion and sedimentation, fugitive dust, noise and vibration, environmental cleaning, work zone air monitoring, among many other subjects. Adamo understands the economic advantage of maximizing the recycling efforts on large scale decommissioning and demolition projects. Our clients benefit from the firms Adamo partners with across the U.S. to maximize the value of the ferrous and non-ferrous materials to the project. Adamo has provided its specialty services to a variety of commercial, municipal, private and heavy industrial customers, completing a great number of demolition projects in its 59+ year history. Adamo has demolished thousands of structures totaling over 200 million square feet of building area. Adamo's strength has been the ability to employ and utilize only the most skilled workers and the latest equipment. Adamo currently owns two (2) CAT Ultra -High Reach Demolition (UHD) excavators. These machines can be configured to reach 85' to 140' and carry tool weights more than 15,000 lbs. allowing for precise, controlled demolition of large heavy structural members. In addition, our fleet of primary demolition equipment exceeds 200 pieces in total. Of great importance to many customers today is the utilization of minority and women business enterprises on our projects. We have standardized goals to utilize and support Minority / Women Business Enterprises (MBE/WBE) through subcontracting, mentoring and Joint Venture opportunities. Every Adamo project performed involves the utilization of either an MBE or WBE business. We continually exceed the goals set forth by our customers and governmental entities in this regard. We are confident in our ability to deliver the safest, most cost-effective solutions to your projects. We have compiled this information to demonstrate the capabilities of our firm. We would welcome the opportunity to meet with you to discuss your anticipated project needs and the expert service we are prepared to provide you. Thank you for reviewing our proposal. We look forward to working together on future projects. Best Regards, Ri,cly Rick Cuppetilli Executive Vice President SECTION 1 General Company Introduction Company Name: Adamo Demolition Co., dba Adamo Group Company Type: S-Corp, Privately Held Headquarters: 320 East Seven Mile Rd., Detroit, Michigan 48203 Phone: (313) 892-7330 DUNS No.: 84-708-0405 CAGE Code: 3CGV9 NAICS: 238910 The Adamo family, whose name is synonymous with both demolition and environmental abatement on some of Michigan's highest profile projects, has been active throughout the U.S. performing demolition, decontamination, asset recovery, and related services since 1964. Our team of support personnel has a combination of higher education and hands-on field experience to enhance the services we offer. This combination allows us to address problems our industry presents by applying practical engineering knowledge. Adamo's technical ability within the desired scope of work consists of its ability to deliver an end - to -end solution which consists of a full facility decommissioning process from the remediation of environmental concerns to the facility demolition and restoration of the site and surrounding landscape to a marketable quality. State of Michigan Licensing Michigan Residential Builders License No. 2102128736, expires 05/31/2026. General Information Adamo Demolition Co. (Adamo) is a privately held corporation, 100% owned by Richard M. Adamo, who is the President of the Corporation. Also serving as executives of the company are Tim Gunn, CPA, who serves as our Chief Financial Officer, and Rick Cuppetilli, our Executive Vice President. Adamo is a Florida corporation, with a date of incorporation of 10/21/92. Staffing Adamo has 74 employees as of January 1, 2025 and 34 employees on staff as of May 1, 2025 Between May 1, 2025 and the date of this qualification our staff has increased and is back to 75 employees as more of our projects are continually being released for continued operations following the Covid temporary shutdowns. Statement of Qualifications - 2025 Equipment The heavy equipment required for demolition is generally equipped with specialty attachments not readily available in a rental fleet. For this reason, Adamo primarily utilizes owned equipment, supplementing its fleet as required with rental equipment, locally sourced when practical. Adamo is also proud of its partnerships with Michigan CAT and Alta equipment, which have resulted in an in-house maintenance program, utilizing Caterpillar and Volvo trained mechanics, optimizing the up time for our equipment. We are equally proud of our real-time equipment tracking program designed and developed by our team of professionals. Adamo also uses this state-of-the-art technology to track the location of valuable reclaimed materials during transit from the demolition site to the scrap yard. Adamo's total equipment value is $27,927,976.00. .- of Equipment Compactors Cranes Dozers # of Pieces 3 1 8 Excavators 42 Forklifts 2 Loaders 26 Material Handlers 5 Trailers 48 Off -Road Trucks 2 Trucks 24 Attachments 240 Statement of Qualifications - 2025 SECTION 2 Demolition Experience Experience and Ability to Perform the Work Adamo has performed decommissioning and demolition projects throughout the Midwest since 1964. We understand the complexities of working in a variety of environments and will prepare project specific plans for managing asbestos abatement, site decommissioning, work zone safety, pedestrian traffic, transportation safety routes, soil erosion and sedimentation, fugitive dust, noise and vibration and other facets of the work, tailored specifically to the project specific scope of work. Through our history we have been called upon to design and perform workable solutions to many challenging projects. We have been called upon to demolish grain elevators with head houses 280 feet in height in a tight urban setting. We have designed and implemented critical lift plans for vessels and structures inside active operating manufacturing facilities. We have removed an eight -story precast parking structure immediately adjacent to a one-story church building. We have carried out the safe and successful removal of a fifteen -story commercial building immediately adjacent to a three-story, downtown building housing an active business. We have designed and implemented the safe felling of water towers, stacks, powerhouses, coal hoppers, slab mills, foundry cupolas and melt shops, conveyors, silos, and various high-rise commercial structures. Our staff has the capabilities to design and implement demolition work plans that combine our engineering knowledge and practical application experience into proven solutions. When working at any site, whether it is inside an active facility such as a utility, manufacturing facility, petrochemical plant, or industrial foundry; or in an urban environment, on a university campus, inside a hospital complex or other operation, we take every precaution to avoid interrupting the activities essential to our client's operation and the local environment. Adamo has completed a great number of demolition projects in its history, and it is not uncommon for those projects to include the remediation of hazardous or regulated materials, such as asbestos, PCBs and other regulated wastes. We pre-screen and employ the services of reputable subcontractors experienced in their specialty for the handling of such regulated materials. We manage their work and foster accountability through the project -specific plans designed for every Adamo project. Our subcontractors' task -specific work plans are incorporated into the overall project documents, and every subcontractor is held to the same level of standards that Adamo demands of its own workforce. Statement of Qualifications - 2025 We do have a great deal of experience with explosive demolition, with the actual explosion performed by the experts in that field, with our assistance with the building preparation. More common than explosive demolition is the controlled felling or tipping of large structures, which is common practice on many of our industrial projects. In addition to cost considerations, a structure's location on the work site, proximity to other structures and the building structure are all deciding factors when considering whether to use conventional or explosive demolition. We currently have ongoing projects in Michigan, Ohio, and Texas. Many of these projects are immediately adjacent to or within active facilities, and we have not interfered with or hindered active client operations in any way through the performance of our work. Statement of Qualifications - 2025 SECTION 3 Corporate Safety Program Safety Program Adamo is committed to the health and safety of its employees, the employees of our client, our subcontractors, and the public. Safety is of paramount importance and is the first consideration in the operation of our business. It is our goal to establish and maintain safety policies and practices which afford our employees a safe and healthy work environment, and are in full compliance with all applicable federal, state and local laws. To ensure that the Adamo Work - Safe CHSP is a success, Adamo management provides constant scrutiny and interpretation of Federal, State, Local and the client's health and safety regulations, so that a safe work environment can be maintained for all parties. However, Adamo does not relieve any contractor or subcontractor from their responsibility and obligation to provide for their own employees and the public's safety. Our ultimate Work -Safe goal is zero accidents and injuries. Adamo is proud to maintain a health and safety program that meets or exceeds the best current practices in our field. For the Work - Safe Corporate Health and Safety Program (CHSP) to continually succeed, we must all remain constantly alert to working conditions that can have an impact on health and safety, and we must all be active participants in monitoring and correcting safety concerns. This means that proper attitudes regarding illness and injury prevention must be developed and maintained with all personnel. This requires constant daily communication and cooperation between all team members, not only from and between the employer and employees, but between all participants on a job site team, including contractors and subcontractors. Site Safety The safety team on a typical demolition project is fulfilled by both onsite personnel as well as office personnel. The onsite personnel include the Site Project Manager, Site Superintendent and a Site -Safety Representative. The corporate Executive Vice President, Project Manager and Safety Director perform periodic inspections of the site prior to and during the operations phase right up through the demobilization phase. The site -safety representative is responsible for the site orientation training, site badging, assisting in the daily pre -task plan review, making certain the onsite personnel are tested as required prior to arrival onsite, weekly toolbox talks, and safety data recording and reporting. Statement of Qualifications - 2025 The testing includes but is not limited to drug screening, respirator fit testing, medical physical testing, hearing testing, blood lead level and ZPP testing and any other site -specific testing required. It should be noted no individuals can be onsite without first having had a passing 10 panel drug screening completed. The site -safety representative typically has only site safety responsibilities and performs very few, if any, non -safety related responsibilities. The Site Project Manager oversees the site -safety representative and site superintendent and does periodic safety inspections during each shift. The superintendent performs the daily pre -task plan review, completes the weekly toolbox talks, acts as the competent individual for such things as confined space, man -lift operations, scaffolding use and any other specialized operation required. Safety Data Sheet (SDS) information is kept onsite in the offices and has specific reference documents for all chemicals in use on the project. Corporate Safety Adamo employs a Corporate Safety Director, Jeff Brown, who has been with the company for eight years. Jeff oversees the adherence to corporate safety standards on all our projects and plays a pivotal role in the development and implementation of on -site demolition work plans and safety protocols. He performs planned and random safety audits at our project sites. We train all supervisors as safety representatives for our safety program. On small to mid -size projects, the site superintendent may act as the site -safety representative, but on large scale, complex projects a dedicated site -safety representative is assigned and can be an on -staff site - safety representative or a safety professional from a third -party agency. On large-scale projects, or in conformance with contract requirements, it is common for us to employ the services of third -party safety professionals for implementing and monitoring adherence to the safety standards and protocols in place for the project. During the planning phase of a project a site -specific Health, Safety and Operations Plan (HSOP) will be developed through the collaboration of the team members. The document will outline specific guidelines for tasks such as jobsite safety management and administration, a task -based risk assessment and hazard control plan, demolition work plan, site and building preparation, spill prevention plan, fugitive dust control plan, removal, handling and consolidation of waste materials plan, loading, off -site transportation and disposal plan, universal wastes, lighting and signage. The site staff will also refine and finalize the Method Statements for anticipated project tasks. These statements will be shared with all project team members to provide a clear understanding of the objectives for the project. Pre -Task Plans, Job Safety Analysis Plans and Daily Safe Cards will be prepared by the Site Safety Manager with input from the On -Site PM and Superintendent. These documents for an integral part of our Site Safety Management. Statement of Qualifications - 2025 Adamo encourages safety communication in all forms. Safety policies and procedures are defined in writing and expressed verbally through training and toolbox talk sessions. In addition, Adamo understands and promotes all communication methods for raising safety awareness. These standards include the use of daily and weekly toolbox talks, one-on-one jobsite contact, the use of specialized training venues and opportunities, and other types of media when appropriate. Additionally, all employees are encouraged to use whatever means necessary to communicate concerns regarding immediate danger, including all verbal and physical methods that are available. Organization Chart — Internal Health & Safety Safety of Subcontractors Adamo addresses the program for managing the safety of subcontractors in our Corporate Health and Safety manual. Our subcontractors must go through safety clearance before being allowed on site, and it is supplemented by safety audits and notices of safety non-compliance. Statement of Qualifications - 2025 Personnel Resumes Organization Chart Rick Cuppetilli Executive Vice President Br:aq Hal= fstknat3Is Al Paned VKy P:S.6e9L si EsLirrLOGIIS �rajecL #.iana Asset Managwrn9i SECTION 4 Richard M-Adarno President r Gunn cialOfficer Id B-31M Ar flung stafr £ara<: -U—' `sircLy 3rle Salsty A�res�laLirc Genera: Manager Statement of Qualifications - 2025 If- JDAMO DETRi31T, Nil Richard M. Adamo - President For over thirty years Richard has been involved in the family demolition and construction business. He holds a Bachelor of Science Degree in Building Construction Management from Michigan State University with an emphasis on management, estimating, scheduling and economics. Through his experience Richard has developed the knowledge and expertise to manage any size project to completion. He has served a project manager on numerous projects in the last twenty years, including, Arvin Meritor (former Ternstedt Manufacturing) Demolition, GM Military Warehouse Demolition, Dupont Testing Facility Demolition, Severstal Stack House Demolition, Ford Buffalo Stamping Plant Press Extraction, Michigan Dept. of Transportation Bridge Demolition, Detroit Public Schools (various) Demolition, City of Detroit Citywide Residential & Commercial Demolition Program, demolition of the former Wonderland Mall and Site Utility Installation, demolition and remediation of the former 8 Mile Tank Armory, demolition of the former McLouth Steel Blast Furnaces, Ovens and Hi -line Rail and the Harbor Lights demolition, just to name a few. Richard currently serves on the National Demolition Association, a former Chairman of Environmental Affairs and still actively participating with the Awards and Convention committee. Rick Cuppetilli — Executive Vice President For over 50 years Rick has been involved in the demolition industry with experience at the supervisory field level, in estimating and project management. He has developed considerably expertise in industrial and automotive total and selective demolition, taking responsibility for all major demolition project functions from the bidding process, subcontract negotiation, project management, and on -time, within budget project close-out. Rick has managed such projects as Ford Dearborn Truck Plant Fast -Track Selective Demolition for changeover to the aluminum body, Ford Kentucky Truck Plant Fast -Track Selective Demolition for changeoverto the aluminum body, GM Orion Assembly Body Shop and General Assembly Selective Demolition (simultaneous projects), 14- Story Lafayette Building Abatement and Demolition, Bayer Crop Science Kansas City MPP Building, Sencor Silo and K4 Equipment Demolition, Severstal Slab Mill and Oxygen Tank Demolition, GM Wilmington Assembly Selective Demolition, GM Doraville Assembly Selective Demolition, Bechtel Construction Waste Incinerator Demolition, Ford Windsor Assembly Plant Selective Demolition, City of Detroit Commercial Demo/Strip-Out Program, State of Michigan Jackson Iron Foundry, the Georgia Dome, Pontiac Silverdome, and Joe Louis Arena. Rick, is currently the Executive Vice President for the Adamo Group, supervising the Estimators and Project Managers as well as estimating and managing large industrial, automotive and manufacturing projects for Adamo Group. Tim Gunn - CFO Tim, a Certified Public Accountant, is the Chief Financial Officer for Adamo Group. He is responsible for all financial reports including monthly, quarterly and annual financial statements. He directs the organization's financial goals, objectives, and budgets. He monitors job costs, oversees the investment of funds and manages the associated risks. He oversees cash flow planning and asset management. He represents the company to financial partners, including financial institutions and outside auditors. He oversees the accounting department to ensure proper maintenance of all accounting systems. He ensures maintenance of appropriate internal controls and financial procedures. If- JDAMO 131ETROIT, ➢ II Brian R. Haller LEED AP. VP of Estimat Brian holds a Bachelor of Science Degree in Building Construction Management from Michigan State University with heavy emphasis on process management and communication. With over 27 years of global experience in the construction and demolition industry Brian's background is very diverse. Brian has estimated and managed projects in the industrial, commercial, residential, civil, and institutional markets, ranging in size from $2M to $130M. Brian has an excellent background in estimating, accounting, and project management and is a proven field manager. As a LEED AP he has participated in multiple LEED projects in many different capacities. Since joining Adamo, Brian has successfully delivered complex large scale demolition projects such as the Kmart World Headquarters, Eastland Mall, and LC Smith Terminal. From estimate to close out, Brian has guided his team through numerous projects for clients such as the University of Michigan, Eastern Michigan University, General Motors and Ford Motor Company. Jeffrey Green —Sr. Project Manager/ Estimator Jeff has over 25 years' experience in site decommissioning and demolition of industrial and commercial buildings, including environmental compliance audits, physical condition assessments, and asset reclamation. Jeff is familiar with required local and state certifications, licensing and protocol requirements related to demolition and environmental work essential to site decommissioning and dismantlement. Dan Baker — Sr. Project Manager / Estimator Throughout Dan's 35-year career, he has worked on demolition projects ranging from small residential structures to industrial projects up to 2 million square feet in size. Dan is knowledgeable in all aspects of demolition and oversight activities including environmental remediation and mitigation, asset recovery, historical preservation, utility disconnects and relocation, logistics for neighborhood traffic impacts, noise and dust control, site security and ensuring compliance with all technical and/or environmental specifications. Dan has guided the demolition of multiple blocks of structures up to 22 stories tall and managed the removal of single and multi -family residential structures throughout entire blighted neighborhoods. Adam Tupancy — Estimator / Project Manager Adam entered the field of civil engineering in 2010 as a field inspector, where he was lead inspector on jobs such as street sectioning, sewer replacement, and full road reconstructions. He has worked in the areas of consulting engineering, water resources, environmental engineering, structural engineering and construction scheduling. Adam is a graduate of Michigan Technological University with a degree in Civil Engineering and has received his 40 Hour NDA Certificate (Foundations of Demolition). Jeff Brown — Corporate Safety Director Jeff Brown, Corporate Safety Manager, is responsible for field safety supervision and project safety management. Jeff possesses considerable expertise in construction and in Safety Management and Plan Development for total and selective demolition, construction, installation, and similar projects, taking responsibility for all project safety functions from project inception to project close-out. Jeff oversees and maintains all aspects of and managed successful safety programs for demolition projects including the K-Mart Headquarters, University of Michigan Demolition of the Central Campus Recreation Building, and other various demolition and construction safety programs. Additionally, Jeff currently works on the Safety Committee for the National Demolition Association. DAMOA K ETROIT, W11 Sean Louwers — Corporate Safety Manager Sean Louwers, Corporate Safety Manager, holds 17 years' of construction experience in a field management role. Sean has also worked in law enforcement for over 13 years as a deputy for the Macomb County Sheriff Office. Sean completes site safety audits, holds jobsite safety meetings, and develops site specific health and safety plans for demolition projects. Sean ensures training, certifications, and testing is current for all employees as mandated by MIOSHA and Standards set by Adamo Group. Adam Packala - Superintendent Adam, Superintendent, has over 24 years' experience in the demolition and asbestos abatement industries and 5 years in general construction. Adam is responsible for overseeing various demolition projects including selective demolition, strip outs and large blight removal projects. Adam coordinates the trucking and plans the use of equipment and manpower for all his projects. In addition, he trains and supervises field operators and laborers. Jared Barnes - Superintendent Jay, Superintendent, Laborer Foreman, has over 25 years' experience in the demolition industry. Jay has field supervisory experience in both selective and total demolition and is an experienced Site Safety Representative forourfirm, having served in that capacity on many fast- track, selective demolition projects and the decommissioning and demolition of industrial facilities such as the Caterpillar BB Engine Plant and the Georgia Pacific Particle Board Mill Plant. Larry Carpenter - Superintendent Larry, Superintendent, has over 25 years' experience in the demolition industry. Larry, a Field Superintendent oversees the day-to-day field operations from start to finish. He is well versed in handling both partial and complete demolition of commercial, industrial, and institutional projects. Larry works "hands on" and possesses in-depth knowledge in working with subcontractors and laborers to insure successful completion of projects. Randy Schuler- Superintendent Randy, Superintendent, has over 17 years' experience in the demolition industry. Randy has supervisory field experience in total demolition, primarily municipal residential and institutional projects and is an experienced Site Safety Representative for our firm. Sam Harmon - Superintendent Sam, Project Superintendent, has over 35 years' experience in the demolition industry. Sam is assigned to complex, fast - track total and selective demolition projects. Sam's expertise is in the proper and thorough planning of his projects, recognizing and anticipating the equipment, manpower and logistics required to complete the project in a timely and efficient manner. Organizational Chart — Key Personnel Project Executive The Project Executive is responsible for the administration and proper implementation of all policies and work practices to ensure compliance with the contract documents. He will provide high-level executive oversight of the work and adjust equipment and staff as necessary to guarantee that Caterpillar is afforded the optimum effort to a successful project. The Project Executive is also charged with the recovery and sale of project assets, maximizing the recycling effort on the project and marketing the assets for the highest value return to the project. Project Manager The Project Manager establishes the necessary policies, procedures, and resources for implementing an effective work plan and accident prevention process at the project level. The Project Manager with the management team will lead by example, modeling the behavior expected from all employees performing work. The Project Manager is the "competent person" responsible for all activities on his project including the development and conveyance of the work plans and site -specific Health and Safety Program. Responsibilities include, but are not limited to: 1. Project pre -construction services, including project coordination, commitments, pre - demolition survey, work plans, hazard analysis documents, and permitting. 2. Project scheduling, schedule updates, schedule management, and documentation. 3. Quality control of all work on assigned projects, including quality assurance that all construction activities meet or exceed the contract, specifications, plans, and codes. 4. Accurate and on -time projected cost reporting, budgeting, cost tracking, cost analysis, and cash flow projections. Statement of Qualifications - 2025 5. Awarding and issuing accurate, timely, complete, cost-effective subcontracts and purchase orders. 6. Subcontract administration and control. 7. Project documentation, correspondence, records, paperwork, shop drawings, submittals, approvals, etc. 8. Project communication, meetings, agendas, minutes, reports, confirmations, and coordination. 9. Attend all meetings with clients as required or requested. 10. Project start-up, project manual and project close-out. 11. Project safety and overall responsibility for Field Safety Program, training and implementation. Superintendent In coordination with the Project Manager, the Superintendent will plan and secure the necessary labor and equipment to effectively complete the project. The Superintendent is the "competent person" responsible for all activities on the project including the general administration of the Health and Safety Program and has the stop work authority in the event of an emergency. The Superintendent is responsible for reporting to the Project Manager all day—to-day operations in the field. It is the responsibility of the Superintendent to meet or exceed the Project's overall goals and objectives in the areas of schedule, quality, customer satisfaction, and safety. His duties include: 1. Review new project and project manual with Project Manager prior to commencement of any work activity. 2. Actively participate with the development of the project schedule with the Estimator and Project Manager. Project scheduling, coordination, and field commitments. 3. Project quality and quality assurance that construction meets or exceeds the plans, specifications, codes, approved shop drawings, submittals, and expected quality. 4. All Project Safety requirements. 5. Field records, reports and documentation. 6. Always maintain project cleanliness. 7. Make certain all proper signage is always on the project site. 8. Make certain that Company Safety and Health Standard Operating Procedures and Personnel Protective Equipment requirements are being met. 9. Always attend Project pre -construction and weekly meetings. 10. Responsible for job -site organization and compliance with Standard Operating Procedures. 11. Project field communications, meetings, and coordination. 12. Advisor to Project Manager in all aspects regarding field operations. 13. Review project activity with Project Manager daily. Statement of Qualifications - 2025 SECTION 6 Licensing Evidence of Authority to do Business Adamo Demolition is licensed in Michigan, Georgia, Louisiana, Tennessee, Virginia, West Virginia, Florida and District of Columbia. Contractor's License Michigan Residential Builders License No. 2102128736, expires 05/31/2026 Statement of Qualifications - 2025 �zp 01 GUY HURLEY INSURANCE & SURETY SERVICES June 30 , 2025 RE: Principal: Adamo Demolition Company To Whom It May Concern: Adamo Demolition Company is a highly regarded and valued client of Liberty Mutual Insurance Company and has been for over 22 years. Liberty Mutual Insurance Company has a $100,000,000 single project and $200,000,000 aggregate backlog line of credit in place. Individual projects or work programs in excess of these amounts would be favorably considered subject to current and satisfactory underwriting information at the time of such request. If awarded a contract it is the present intention of Liberty Mutual Insurance Company to provide required performance & payment bonds conditioned upon a satisfactory review of the contract terms and conditions and receipt of current and acceptable underwriting information from our client. Liberty Mutual Insurance Company is listed on the U.S. Treasury Department's Listing of Approved Sureties and is rated A (FSC XV) by A.M. Best Company. Sincerely, LIBERTY MUTUAL INSURANCE COMPANY ,ney-in-Fact DIRECT 248.519.1400 1 FAX 248.519.1401 1 989 E. South Boulevard, Suite 200 1 Rochester Hills, MI 48307 State of Indiana Office of the Secretary of State CERTIFICATE OF EXISTENCE To Whom These Presents Come, Greeting: I, DIEGO MORALES, Secretary of State of Indiana, do hereby certify that I am, by virtue of the laws of the State of Indiana, the custodian of the corporate records and the proper official to execute this certificate. I further certify that records of this office disclose that ADAMO DEMOLITION COMPANY duly filed the requisite documents to commence business activities under the laws of the State of Indiana on January 24, 2003, and was in existence or authorized to transact business in the State of Indiana on July 15, 2025. I further certify this Foreign For -Profit Corporation has filed its most recent report required by Indiana law with the Secretary of State, or is not yet required to file such report, and that no notice of withdrawal, dissolution, or expiration has been filed or taken place. All fees, taxes, interest, and penalties owed to Indiana by the domestic or foreign entity and collected by the Secretary of State have been paid. In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the City /of Indianapolis, July 15, 2025 / DIEGO MORALES SECRETARY OF STATE 2003021100267/20254522352 All certificates should be validated here: https://bsd.sos.in,gov/ValidateCertificate Expires on August 14, 2025. / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 5/28/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher Risk Management Services, LLC 22930 Nine Mile Road Saint Clair Shores MI 48080 CONTACT NAME: Meagan Bush PHONE FAX A/C No Ext : 586-774-5300 A/C No): 586-778-2814 ADDRESS: meagan_bush@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: National Union Fire Insurance Company of Pittsburg19445 INSURED ADAMDEM-02 INSURERB: HDI Specialty Insurance Company 16131 Adamo Demolition Company dba Adamo Group Inc. 320 East Seven Mile Rd INsuRERc: Everest Indemnity Insurance Company 10851 INSURERD: Arch Specialty Insurance Company 21199 Detroit, MI 48203 INSURER E : Endurance American Specialty Ins Co 41718 INSURER F : COVERAGES CERTIFICATE NUMBER:933504150 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 7042948 6/1/2025 6/1/2026 EACH OCCURRENCE $5,000,000 CLAIMS -MADE � OCCUR TED PREMISES (Ea oDAMAGE TO ccurrence) $ 300,000 X MED EXP (Any one person) $ 10,000 XCU PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY jE LOC PRODUCTS - COMP/OP AGG $ 5,000,000 $ OTHER: A AUTOMOBILE LIABILITY AL 4629259 6/1/2025 6/1/2026 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY B UMBRELLA LAB X OCCUR CLXD6559701S 6/1/2025 6/1/2026 EACH OCCURRENCE $5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 13188178 6/1/2025 6/1/2026 X PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 5,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 5,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 5,000,000 C Excess - second layer GB3EX00014251 6/1/2025 6/1/2026 Each Occ/ Agg $5M / $5M D E Excess - second layer Excess - third layer UXP105580801 ELD30087885400 6/1/2025 6/1/2025 6/1/2026 6/1/2026 Each Occ/ Agg Each Occ/ Agg $5M / $5M $5M / $5M DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Equipment - Leased or Rented - $1,500,000 limit; 6/1/2025-6/1/2026; Aspen Specialty Insurance #IM011 DC25 Contractors Pollution & Professional Liability - $5,000,000 limit; 6/1/2025-6/1/2026; Lloyds of London & Hudson Excess #ENVP000048125 SAMPLE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. SAMPLE CERTIFICATE AUTHORIZED REPRESENTATIVE I I I 10flIwIll I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD P � P �ETRO[T� Mli THE mU Management &Unions Serving Together DRUG AND ALCOHOL SCREENING PROGRAM Adamo CHSP Section 10.0 Drug -Free Workplace 3 February 2023 Issue Table of Contents Sub -Section 1 Introduction Sub -Section 2 Commitment to Confidentiality Sub -Section 3 Card Identification System Sub -Section 4 Types of Testing Sub -Section 5 Illegal Drugs and Substances Sub -Section 6 Procedure for Initial, Random and Periodic Drug Screening Sub -Section 7 Prerequisites for a Drug/Alcohol Test for Cause Sub -Section 8 Prerequisites for Post -Accident Screening Sub -Section 9 Procedure for Cause & Post -Accident Drug Screening Sub -Sec. 10 Screening for Alcohol Sub -Sec. 11 Employer Responsibilities Sub -Sec. 12 Employee Responsibilities Sub -Sec. 13 General Principles Sub -Sec. 14 Medical Review Officer Responsibilities Sub -Sec. 15 Consequences of a Positive Drug or Alcohol Test Sub -Sec. 16 Negative Dilute Sub -Sec. 17 Tampering with a Test Sub -Sec. 18 Resolution of Disputes Sub-Sec.19 Reciprocity Sub-Sec.20 Definitions Sub -Sec. 21 Drug Screen Consent Form Sub -Sec. 22 Drug Information Chart - Appendix A Adamo CHSP Section 10.0 Drug -Free Workplace 4 Page 5 5 6 7 8 8 10 11 12 13 14 14 14 15 15 17 17 17 18 19 21 22 February 2023 Issue Sub -Section 1. INTRODUCTION (a) This document contains procedures to be utilized to conduct testing for illegal drugs, substances and alcohol on unionized construction projects. When implemented, this Program applies to all employees and potential employees of contractors and subcontractors at all tiers, including bargaining unit and non - bargaining unit employees. (b) This policy contains the following minimum standards: a. Nine (9) Panel Drug Screening (values listed in Appendix A) b. Provides for Initial, Annual, Random, For Cause, Post -Accident and Return to Duty Screening. c. Designated Medical Review Officer (MRO) d. Bona Fide Dispute Resolution Process e. Bona Fide Method of Discipline f. Addresses Means and Methods for Employee Rehabilitation. g. Addresses Training for Reasonable Cause Screening (c) Specimens shall be collected in accordance with the procedures set forth in DOT Urine Specimen Collection Guidelines for the U.S. Department of Transportation Workplace Drug Testing Programs including, but not limited to, those procedures governing the use of split samples and those establishing a formal chain of custody. (d) Only approved evidential breath testing devices (EBT) and non -evidential devices for conducting alcohol testing shall be used. These devices are listed on NHTSA's Conforming Products List (CPL). All equipment shall have a quality assurance plan approved by the NHTSA and shall not be used in the event that the device does not meet the specified quality controls. Sub -Section 2. COMMITMENT TO CONFIDENTIALITY (a) Protecting the confidentiality of the employee is a primary interest of labor, owners, and contractors. Towards that end, there will be a single Medical Review Officer (MRO) for the entire area covered by the M.U.S.T. Program. The MRO will be the sole individual who has access to employee medical records and drug testing results. (b) The MRO will only be allowed to advise a designated contractor representative that the employee is either current, not current, pending or ineligible with the M.U.S.T. Drug and Alcohol Screening Program. No information about the test results, the substance that an employee may have tested positive for, levels of testing, or any other specific information will be shared. (c) Contractors will designate a specific representative as the contact person who will be the only individual to receive information from the MRO. Adamo CHSP Section 10.0 Drug -Free Workplace 5 February 2023 Issue (d) The following procedures and guidelines regarding confidentiality will be strictly observed: (1) All test results will be considered medical records and held confidential to the extent permitted by law. (2) All actions taken in connection with the Program will remain confidential. (3) The Medical Review Officer will be the only individual who has detailed information concerning employee drug testing. (4) The Medical Review Officer may disclose to the contractor only whether an employee is current or not current with the Program. (5) Medical personnel, the contractor, its supervisors, or any other personnel will not disclose any information regarding the testing of an employee to the owner, contractor, or any other party. (6) Contractor management or supervision shall not request information from the MRO or medical staff regarding any employee's test or type/level of substance. (7) Information may be divulged for grievances, arbitration, and/or litigation with respect to these matters to the extent permitted by law. Sub -Section 3. CARD IDENTIFICATION SYSTEM (a) Only employees who have been issued an appropriate Identification Card, or who are in the process of being issued the Card, and who are current with the M.U.S.T. Drug and Alcohol Screening Program may be employed for work on a project requiring this program. (b) To obtain the card, the individual must have a Report Manager complete the Member Registration Form through our Program administrator's website. (c)An individual's social security number will be used when first registering in the system. A unique identifying number will then be assigned by the administrator for verifying an individual's status in the system. (d) Any employee who refuses to obtain a card will not be permitted to work on projects covered by this Policy. (e) When a potential employee reports for work and is not enrolled in the program, he/she will proceed to the appropriate contractor's field office to be signed up for employment for a probationary period, pending results of the initial drug screening. Adamo CHSP Section 10.0 Drug -Free Workplace 6 February 2023 Issue Sub -Section 4. TYPES OF TESTING A urine drug screen and/or breathalyzer alcohol test shall be administered under the following circumstances: (a) Initial Drug Screening: All potential employees of all contractors at all tiers who work at the Project and who are not current with the M.U.S.T. Program shall submit to an Initial Drug Screening. The Initial Drug Screening will test for the presence of illegal drugs and substances. This screen will not include an alcohol test. Any potential employee refusing to submit to this test will not be permitted to work on any Project covered by this Program. (1) Existing Employees Transferred From Another Location to Work on a Project Covered by this Program : All employees in this classification must obtain an Identification Card and become current with the Program. Any employee who is not current with the Program will not be permitted to work on the Project. (b) Random Testing: Twenty-five percent (25%) of the workforce employed on M.U.S.T. Program Jobs shall be tested at random annually or as mandated by law. The selection of employees for random testing shall be determined exclusively by the Program administrator through its computer -generated, random -number generating program to ensure complete impartiality and objectivity. Selection of employees for random testing shall not be conducted by any contractors or employers. Random testing shall screen for illegal drugs and substances as well as alcohol. The MUST Joint Drug Testing Board will periodically review the effectiveness of the program and modify the percentage to be randomly tested based on the level of positive results. The random testing procedure is more effective when all of the following occur: (1) The contracting party audits/monitors for contract compliance where the MUST program has been specified; (2) Contractors are monitored for compliance with the MUST program; (3) Access is denied to contractors not in compliance with the MUST program; and (4) Contractors utilize technology to continuously update eligible employee information. (c) Periodic Testing: All employees will be tested a minimum of once every twelve (12) months to maintain their status as current with the Program. A random test will be counted in determining whether an employee has been tested within the previous twelve (12) months. Employees who have not been tested within the previous twelve (12) months will submit to a screening test when Adamo CHSP Section 10.0 Drug -Free Workplace 7 February 2023 Issue directed to do so. Periodic testing shall include screening for illegal drugs and substances. This screen will not include an alcohol test. (d) Testing for Cause: All employees may be tested for cause for illegal drugs and substances as well as alcohol when a reasonable suspicion exists that the employee appears to be under the influence of illegal drugs or substances and/or alcohol. (e) MRO Directed Testing: After a positive test employees are subject to unannounced testing for illegal drugs and substances as well as alcohol as directed in the discretion of the Medical Review Officer. (f) Post Accident Testing. An employee with a chargeable accident shall be required to submit to post -accident screening for the use of illegal drugs or substances and/or alcohol as set forth in Section 9 of this Policy. Sub -Section 5. ILLEGAL DRUGS AND SUBSTANCES (a) Testing under the M.U.S.T. Drug and Alcohol Program includes screens for: Amphetamines Barbiturates Opiates Benzodiazepines Phencyclidine Cocaine Propoxyphene (Darvon) Methadone THC (Marijuana and Cannabinoids) (b) A screening test will be considered positive when it shows the presence of illegal drugs/substances in the body at or above cutoff levels stated on the Drug Information Chart contained in Appendix A. Sub -Section 6. PROCEDURE FOR INITIAL, RANDOM AND PERIODIC DRUG SCREENING (a) Specimen collection may occur on -site or at an off -site clinic provided no loss of wages results. (b) Each individual will read and sign the attached Drug Screen Consent Form prior to any test being administered. Failure to do so constitutes refusal to submit to a test. (c) A formal chain of custody will be established for every drug test. (d) A split sample consisting of two urine collection containers sealed in a plastic container will be furnished to the individual. The containers must contain an amount of urine sufficient for one Enzyme Medical Immunoassay Test (EMIT) test and two Gas Chromatography Mass Spectrometry (GC/MS) tests, but in no event less than two (2) ounces per container. Each individual's urine specimen will be collected and temperature tested for verification. The second container Adamo CHSP Section 10.0 Drug -Free Workplace 8 February 2023 Issue will be used in the event the first container has become contaminated. Both samples are to be sent to the testing laboratory. (e) Before the specimen ever leaves the individual's sight, the urine container will be sealed with security tape which has been initialed by the individual. (f) Specimens collected on -site will be picked up by courier and transported to the laboratory for testing. A portion of the sample will be tested using the EMIT test and if positive, another portion will be tested for verification using the GC/MS test. (g) The remainder of the urine specimen will be maintained at the laboratory for thirty (30) days following the date of the test. (h) After having submitted an acceptable sample, an individual submitting for the Initial Drug Screen will then be given a form stating that he/she has consented to and given urine sample for drug screening and is available for employment for a probationary period, pending results of the initial drug screening. This form will be signed by the attending medical personnel and a supervisor of his/her employer. (i) Any individual who refuses to take a drug test will not be eligible for employment by any contractor at Projects covered by the M.U.S.T. Drug and Alcohol Screening Program. 0) The results of the drug test will be posted on the individuals Report Card. If the individual has tested positive or has otherwise become ineligible with the Program the results of the drug test will be communicated to the contractor's designated representative by the MRO, he/she will be removed from the Project immediately and paid for all hours worked. The individual will not be eligible for employment with any employer on Projects covered by this Program in accordance with Section 15 contingent on a negative drug screen. (k) The individual will be provided a copy of positive test results by the MRO, if requested. (l) Retesting: Retesting provides the opportunity to confirm a positive test result by having a GC/MS test performed on the split sample previously collected at a SAMHSA (Substance Abuse and Mental Health Services Administration) certified laboratory of their choice. The following procedures shall apply: (1) Within five (5) work days of being notified of the positive test results, such individual must submit a letter to the MUST Program Manager requesting confirmation of the positive test. (2) The above letter must include the name, address and telephone number of the SAMHSA laboratory of their choice. Only SAMHSA certified laboratories may be utilized. An individual Adamo CHSP Section 10.0 Drug -Free Workplace 9 February 2023 Issue should consult with the MRO for a current list of SAMHSA certified testing facilities. (3) The above letter must include a money order in the amount of $150.00. The specimen will be shipped directly from the program administrator's laboratory to the laboratory of the employee's choice. If the test results are negative, the $150.00 will be reimbursed and the individual will be reinstated with full back pay and benefits. If the results remain positive, an additional $55.00 money order must be sent for a retest of the individual which will occur after the applicable period of exclusion from MUST projects. A Chain of Custody form will be provided by the MUST Program Manager for the individual to use at an approved collection site. Sub -Section 7. PREREQUISITES FOR A DRUG/ALCOHOL TEST FOR CAUSE (a) Existing employees working at the Project may be tested for illegal drugs, substances and alcohol if there exists a reasonable suspicion that the employee is under the influence of alcohol or any of the substances identified in Section 5. For the purpose of this Program, the term "reasonable suspicion" shall be defined as aberrant or unusual on -duty behavior of an employee who: (1) is observed on -duty by either the employee's immediate supervisor, higher ranking employee, or other managerial personnel of the contractor who has been trained to recognize the symptoms of drug abuse, impairment or intoxication, which observations shall be documented by the observer(s); (2) exhibits the type of behavior which shows accepted symptom(s) of intoxication or impairment caused by controlled substances or alcohol or addiction to or dependence upon said controlled substances or alcohol; and (3) Such conduct cannot reasonably be explained as resulting from other causes, such as fatigue, lack of sleep, side effect of prescription or over- the-counter medications, illness, reaction to noxious fumes or smoke. (b) Drug testing of this type will not be conducted without the written approval of the contractor's job superintendent or designated manager. The job superintendent or designated manager must document in writing who is to be tested and why the test was ordered, including the specific objective facts constituting reasonable suspicion leading to the test being ordered, and name of any source(s) of this information. One copy of this document shall be given to the employee before he/she is required to be tested, and one copy shall immediately be provided to the Union steward, if requested by the employee. After being given a copy of the document, the affected employee shall be allowed enough time to be able to read the entire document. Failure to follow any of these procedures shall result in the elimination of the test results as if no test had been Adamo CHSP Section 10.0 Drug -Free Workplace 10 February 2023 Issue administered. The test results shall be destroyed, and no disciplinary action shall be taken against the employee. (c) When a supervisor, higher ranking employee or other managerial personnel has reasonable suspicion to believe that an employee is using, consuming, or under the influence of an alcoholic beverage, non -prescribed controlled substance (other than over-the-counter medication), and/or non -prescribed narcotic drug while on duty, that person will notify the job superintendent or designated manager for the purpose of observation and confirmation of the employee's condition. (d) The employee will be offered an opportunity to give an explanation of his condition, such as reaction to a prescribed drug, fatigue, lack of sleep, exposure to noxious fumes, reaction to over-the-counter medication or illness. A Union steward or designee shall be present if appropriate and requested during such explanation and shall be entitled to confer with the employee before the explanation is presented. (e) If after this explanation the job superintendent or designated manager, after observing the employee, has reasonable suspicion to believe that the employee is using, consuming and/or under the influence of an alcoholic beverage, non - prescribed controlled substances, or non -prescribed narcotic while on duty, then, by a written order signed by the job superintendent or designated manager, the employee may be ordered to submit to a drug and alcohol screen. Refusal to submit to this testing after being ordered to do so will result in the employee being ineligible for employment by any contractor at Projects covered by the Program. Sub -Section 8. PREREQUISITES FOR POST -ACCIDENT SCREENING (a) PostAccident: An employee with a chargeable accident shall be required to submit to post -accident screening for the use of illegal drugs or substances and/or alcohol. The screening will take place as soon as possible after the accident but in no case later than thirty-two (32) hours after the accident. (b) A chargeable accident is defined as: (i) An accident involving the death of a human being or (ii) An accident that results from the employee's negligence and results in the property or vehicular damage of one thousand dollars ($1,000) or more. (a) Testing will not be required of an injured employee if it reasonably appears that the employee was injured solely as the result of another employee's action, Adamo CHSP Section 10.0 Drug -Free Workplace 11 February 2023 Issue (b) If an employee involved in an accident is not injured, no test will be required unless probable cause, as defined in this Policy, exists. (iii) An accident requiring any medical treatment other than first aid as defined by MIOSHA. (c) An employee who is seriously injured and cannot provide a specimen at the time of the accident shall consent to a blood test or provide the Medical Review Officer the necessary authorization for obtaining hospital reports and other documents that would indicate whether there were illegal/controlled drugs or substances and/or alcohol in their system. If an employee refuses to comply with this provision, the MRO shall note such refusal and such refusal shall be considered a positive result under Section 15, and the employee will be classified as "ineligible". Sub -Section 9. PROCEDURE FOR CAUSE AND POST -ACCIDENT DRUG SCREENING (a) Employee drug screens for cause and post -accident will include testing for the same drugs as identified in Section 5, but also will include testing for alcohol. (b) Each employee will read and sign the attached Drug Screen Consent Form prior to any test being administered. Failure to do so constitutes refusal to submit to a test. (c) For cause and post -accident screening shall be performed at the appropriate jobsite trailer or at a designated off -site clinic. The individual may be accompanied to an off -site clinic by a contractor representative (company policy will dictate). A split sample consisting of two urine collection containers sealed in a plastic container will be furnished to the employee. A minimum sample of two (2) ounces per container must be collected. All other security procedures as listed in Section 6 shall be followed, including chain of custody and a listing of any medication the employee has used in the preceding thirty (30) days. (d) The Union steward or designee, if appropriate and requested by the employee, may witness the sample sealing procedure at the first aid trailer or the off -site clinic. (e)An EMIT test and, if positive, a confirming GC/MS test will be performed on the sample. The remainder of the sample will be stored at the laboratory for thirty (30) days. (f) An employee will be suspended from the project until the return of their test results. If the results are negative, the employee will be paid for all lost hours and returned to work. Adamo CHSP Section 10.0 Drug -Free Workplace 12 February 2023 Issue (f) If the employee's test is positive, they will remain suspended from the Project, compensated for all hours worked and remain suspended from all MUST Projects as defined in Section 15 of this policy. The employee will be presented with a copy of the results of the drug screen. He/She will have the option to have a portion of the remainder of the sample tested at his/her own expense at a SAMHSA certified laboratory of his/her own choice. The screen will consist of a GUMS test. The sample will be shipped directly from the Program administrator's laboratory to the laboratory of the individual's choice. (g) If the test conducted pursuant to Paragraph (f) of this Section is negative, the employee will be reinstated with full back pay and benefits, and will be reimbursed for the cost of the test by the employer. The individual must exercise the option of a second GUMS test within five (5) workdays of being notified of the positive test results. (h) Any employee whose test is positive will not be eligible for employment on Projects covered by this Program in accordance with Section 15 contingent on a negative drug screen. (i) Any employee whose test is positive is subject to unannounced testing for illegal drugs and substances as well as alcohol as directed in the discretion of the Medical Review Officer. Sub -Section 10. SCREENING FOR ALCOHOL (a) Alcohol detection will be based on a breathalyzer. If an employee's test results indicate that he/she has exceeded the policy's .04% blood alcohol limitation, he/she will be considered ineligible and will not be eligible for employment on Projects covered by this Policy in accordance with Section 15. (b) An employee who tests positive will be removed from the Project immediately and paid for all hours worked. (c) Any individual who refuses to take an alcohol test will be considered "ineligible". (d) Any employee whose screening is positive, is subject to unannounced screening for illegal drugs and substances as well as alcohol, as directed in the discretion of the Medical Review Officer. (e) Zero Tolerance Alcohol Policy — As an alternative to the above Alcohol Screening Procedures, an owner may adopt a Zero Tolerance Alcohol Policy for a particular project or several projects, provided that: (1) The owner requires all individuals entering the site(s) to conform to the Zero Tolerance Alcohol Policy; (2) The owner enters into a Project Labor Agreement (PLA) for the project(s) subject to the Zero Tolerance Alcohol Policy with the appropriate Building Trades Council. Adamo CHSP Section 10.0 Drug -Free Workplace 13 February 2023 Issue Sub -Section 11. EMPLOYER RESPONSIBILITIES (a) Each employer working on a site requiring this program must be registered in the program. (b) Each employer will enroll and process the initial drug screening if employee has not already been enrolled into the program (c) Each employer will submit a monthly listing of employees eligible for random screening (d) Failure of the employer to comply with the program will be grounds to relinquish their access to the system and thus access to projects requiring this program. (e) Each employer will monitor its employees for behavior that may indicate drug or alcohol misuse or abuse. (f) Each employer will provide training to its supervisors to enable them to identify behaviors exhibited by persons who are under the influence of drugs or alcohol. Sub -Section 12. EMPLOYEE RESPONSIBILITIES (a) Each employee shall have his/her Identification Card in his/her possession. (b) Each employee shall report for testing as instructed. Failure to report will be considered a refusal to submit to the test. Sub -Section 13. GENERAL PRINCIPLES (a) All results of tests included in this Program shall be considered medical records and held confidential to the extent permitted by law. However, this information may be divulged for grievances, arbitration, and/or litigation with respect to these matters. (b) The testing laboratory for this Program must be a laboratory certified by SAMHSA. (c) It is understood that neither M.U.S.T. (Management and Unions Serving Together), and/or their constituent member organizations and affiliated Unions, shall be responsible for ascertaining or monitoring the drug -free or alcohol -free status of any employee or applicant for employment. (d) No employee or employer may modify any document involved with the administration of this program. Adamo CHSP Section 10.0 Drug -Free Workplace 14 February 2023 Issue Sub -Section 44. MEDICAL REVIEW OFFICER RESPONSIBILITIES (a) The Medical Review Officer shall: (1) Maintain confidentiality on all levels. (2) Review and verify a positive test. (3) Notify a tested employee of a positive test. (4) Provide the employee an opportunity to explain a positive test. (5) If an employee has appropriate documentation for use of prohibited drug and the MRO determines legitimate use, the employee will continue to be classified as current with the Program. (6) Review employee's medical records made available to him. (7) Notify the designated contractor representative when an employee is ineligible under the Program. (8) Advise the employee of his right to request a second test of the split sample. (9) Process request for retest of original sample. (10) Participate in return to work decisions as required, noting employee's ability to return to work with or without restrictions. (11) Refer employees who test positive to appropriate medical evaluation and make recommendations. Sub -Section 15. CONSEQUENCES OF A POSITIVE DRUG OR ALCOHOL TEST (a) If test is positive, the individual will be removed from the Project immediately and paid for all hours worked. The individual will not be eligible for employment as provided in Paragraphs (d), (e), (f) and (g) of this Section, unless regulated by Department of Transportation or Nuclear Regulatory Commission regulations. (b) Individuals who test positive shall have the right to secure a copy of all data relating to the test procedures and results provided. These costs are to be paid by the individual in advance. (c) All employees must be current with the M.U. S. T. Drug and Alcohol Screening Program in order to be employed on a covered Project. (d) First Violation of Program: An employee who tests positive for the first time Adamo CHSP Section 10.0 Drug -Free Workplace 15 February 2023 Issue will be ineligible for employment on all Projects covered by this Program for Adamo CHSP Section 10.0 Drug -Free Workplace 16 February 2023 Issue thirty (30) days, contingent on a negative drug/alcohol test and approval by the MRO. (e) Second Violation of Program: An employee who tests positive for the second time will be ineligible for employment on all Projects covered by this Program for ninety (90) days, contingent on a negative drug/alcohol test and approval by the MRO. (f) Third Violation of Program: An employee who tests positive for the third time will be ineligible for employment on all Projects covered by this Program for one year, contingent on a negative drug/alcohol test and approval by the MRO. (g) Violations of the Program Greater than Three: Each positive result greater than three will result in an additional one year ineligible period for each violation, contingent on a negative drug/ alcohol test and approval by the MRO. (h) The MRO may, in his discretion, modify the ineligibility periods in Section 15 (d), (e), (f) and (g). (i) An individual who has tested positive will have the results of the positive test expunged from their record four (4) years after reinstatement into the program, provided that there are no positive tests within that four (4) year period. 0) Return To Work Procedure: After an individual has been reported ineligible and has completed the above suspension periods, the employee must: (1) Follow all MRO recommendations. (2) Forward a cashier's check or money order to MUST Drug Testing for the amount necessary for re-entry screening. The current amount is $55.00 (Fifty -Five Dollars). Please call the MUST Program Manager for information. (3) Receive a Custody of Control (COC) form from the MUST office for re-entry screening. A contractor's COC will not be acceptable. (4) Submit a urine sample at an approved collection site. (k) Substance abuse can become an illness and require professional intervention. The intent of this program is to provide for safer construction sites and not to eliminate job opportunities for those addicted to substances. Ask your employer or union representative about the Employee Assistant Program (EAP) that may be available to you. If you have tested positive, don't assume you can handle your problem, have a Substance Abuse Professional evaluation today. Adamo CHSP Section 10.0 Drug -Free Workplace 17 February 2023 Issue Sub -Section 16. NEGATIVE DILUTE (a) A dilute specimen is a specimen with creatinine and specific gravity values that are lower than expected for human urine. (b) If the MRO informs you that a negative drug test was dilute, you must direct the employee to take another test immediately. Such recollections shall not be collected under direct observation, unless there is another basis for use of direct observation. (c) The retest will stand as the test of record. If the results are negative or negative dilute, current status will be posted. If the results are positive the applicable consequence will be enforced. Sub -Section 17. TAMPERING WITH A TEST (a) Any employee who attempts to introduce a substituted or altered specimen shall be classified as "ineligible" with the program, as if the test were positive. Sub -Section 18. RESOLUTION OF DISPUTES (a) The following procedure shall be used to resolve all disputes relating to the Program with the exception of those disputes involving employees covered by a collective bargaining agreement that references the M.U.S.T. Drug and Alcohol Screening Program. The parties to such a collective bargaining agreement should use the dispute resolution procedure contained in that collective bargaining agreement. However, the parties to such a collective bargaining agreement, at their discretion, may use the following procedure, or any portion thereof, in any particular dispute if so agreed by all parties to the dispute. (b) When a dispute arises pertaining to the administration of the MUST Drug and Alcohol Screening Program, it shall be the responsibility of the Local Union and the Employer to attempt to resolve the matter. If the employee is not covered by a collective bargaining agreement, the employee and the employer will attempt to resolve the matter. In both cases, the parties may consult with the Program Manager of MUST to assist in resolving the matter. (c) Joint Committee. If the matter is not resolved by the Local Union/ unrepresented employee and the Employer as indicated in Step 1, the parties will have 5 days to refer the problem to the MUST Joint Drug Testing Board. This Board will consist of equal numbers of Union and Contractor representatives, with each side having 3 members. The Board will attempt to reach consensus and shall be chaired by the Program Manager of MUST, who will serve as the tiebreaker in case a vote is necessary to reach closure. The Board will convene a meeting within 10 days of receipt of a request from a Local Union, unrepresented employee or Employer. The Board will accept Adamo CHSP Section 10.0 Drug -Free Workplace 18 February 2023 Issue verbal and written statements, review testimony and exhibits, and will render a recommendation as to the merit of the grievance within 5 days of the meeting. The Board's recommendation is not binding on either party but may be used to determine whether or not to advance the matter to the next step. (d) Arbitration. Either party may file a request for arbitration by submitting a Request for Arbitration form to American Arbitration Association (AAA), accompanied by the appropriate administration fee. AAA will provide the parties with lists of appropriate arbitrators from which to select; AAA will administer the arbitration process in an expeditious fashion, including arbitrator selection, agreement on a hearing date, and all arrangements necessary for conduct of the arbitration hearing. The parties agree to be bound by the final decision of the arbitrator. The Arbitrator will render his/her decision within 30 days, and shall include the rationale for making his/her decision. Cost of the arbitration will be born equally by the parties. In the event that the arbitrator finds that the employee was improperly removed and suffered an inappropriate loss of wages and benefits as a result, the Arbitrator may order such losses to be repaid to the employee. Sub -Section 19. RECIPROCITY The MUST Drug and Alcohol Screening Program can meet its goal of providing all employees at unionized construction projects a safe work place and a drug free work environment by recognizing similar efforts, either on a regional or national basis. A regional or national program can obtain the granting of reciprocal status when all of the following conditions are satisfied: (a) The program is embodied in a written policy. (b) A similar level and panel of drugs is tested. (c) The program implements similar procedural safeguards to ensure the integrity of the testing process, including the use of a Medical Review Officer (MRO). (d) The program utilizes a bona fide method of reinforcement (discipline) that imposes similar consequences for failing a drug and/or alcohol test. (e) The policy provides for initial applicant testing, annual testing, random testing, for cause testing, post accident testing, return to duty testing and follow up testing. (f) The policy contains a bona fide dispute resolution process. (g) The policy addresses employee rehabilitation through a Employee Assistance Program (EAP) as the result of a failed drug and/or alcohol test. Adamo CHSP Section 10.0 Drug -Free Workplace 19 February 2023 Issue (h) The policy addresses training for substance abuse awareness as it pertains to for cause testing. (Section 7 (a) (1). (i) An agreement is established between MUST and the other program that enforcement shall follow the individual (an employee shall be restricted under the terms of the program where the positive test occurred until that employee satisfies the conditions for reinstatement). Sub -Section 20. DEFINITIONS ANNUAL DUE: Drug screening test date will expire in 30 days. CALL M.U.S.T. OFFICE: Contact needs to be made with the M.U.S.T. Program Manager because there is no billing code associated with the test. When the donor or contractor calls in, the M.U.S.T. office enters the proper contractor, location and/or fund through the administrator interface and the status gets displayed. CHARGEABLE ACCIDENT: An accident involving the death of a human being, an accident that results from the employee's negligence and results in the property or vehicular damage of one thousand dollars ($1,000) or more or an accident requiring medical treatment other than first aid as defined by MIOSHA. CHAIN OF CUSTODY: Handling samples in a way that supports legal testimony to prove that the sample integrity and identification of the sample have not been violated, as well as documentation describing the procedures. CONFIDENTIALITY: Knowledge that a specific individual is to be or has been screened for alcohol/substance abuse shall be limited to the Medical Review Officer, personnel of the testing facility, the contractor's designed program administrator, the employee and, if the employee chooses, a representative of the union. To the extent that statistical data regarding the workforce and/or a portion of the workforce are collected, details of the testing may be included as long as the identity of the employee is protected. CONFIRMATION: A second test by an alternate chemical method to positively identify a drug or metabolite. Confirmation is carried out on presumptive positive from an initial screen. CURRENT: Employees with current status are eligible to work on projects requiring compliance with the MUST Drug & Alcohol Screening Program. DRUG and ALCOHOL SCREENING: The testing of urine and/or a breath alcohol sample to identify individuals using prohibited substances. IMPAIRED FROM ALCOHOL: If an employee's test results indicate that he/she exceeded the policy's .04% blood alcohol limitation, he/she will not be considered current with the Policy. Adamo CHSP Section 10.0 Drug -Free Workplace 20 February 2023 Issue INELIGIBLE: Employees with Ineligible status are not eligible to work on projects requiring compliance with the MUST Drug and Alcohol Screening Program until the date shown, pending a negative drug and alcohol screening and release by the MRO. MEDICAL REVIEW OFFICER: A physician whose medical training includes certification in toxicology and drug treatment. The MRO shall have sole access to drug testing results. NEGATIVE DILUTE: A dilute specimen is a specimen with creatinine and specific gravity values that are lower than expected for human urine. NOT CURRENT: Employees with not current status shall submit to a drug screening if they wish to be eligible to work on projects requiring compliance with this program. PENDING: Employees with pending status are eligible to work on projects requiring compliance with the MUST Drug and Alcohol Screening Program. The MRO has been in communication with the employee and is requiring further documentation before providing current or ineligible status. PENDING — CALL PEMBROOKE: Contact needs to be made with the Pembrooke office at 800-733-1676 because the employer and/or fund requesting the test has delinquent drug testing invoices. POST ACCIDENT SCREENING: Drug and/or alcohol screening performed as the result of an accident involving the death of a human being, an accident that results from the employee's negligence and results in the property or vehicular damage of one thousand dollars ($1,000) or more or an accident requiring medical treatment other than first aid as defined by MIOSHA. REASONABLE SUSPICION: A belief that an employee shows signs of possible intoxication, use or being under the influence of drugs or alcohol. "Reasonable suspicion" may also be defined as a belief drawn from specific and particular facts and reasonable inferences that an employee is using illegal drugs or alcohol. SCREENING FOR CAUSE: Having a chemical screen done when an employee's fitness for duty is in question. TEST EXPIRED: Drug screening test expiration date has passed. WRITTEN CONSENT FORM: A form to be signed by the employee prior to submitting to a drug or alcohol screen. Adamo CHSP Section 10.0 Drug -Free Workplace 21 February 2023 Issue DRUG / ALCOHOL SCREEN CONSENT FORM RELEASE FORM FOR OBTAINING URINE AND/OR BREATHALYZER SAMPLES FOR DRUG AND/OR ALCOHOL SCREENING AND PERMISSION TO FURNISH THE RESULTS TO THE EMPLOYER. I authorize (insert name of your employer), the M.U. S. T. Drug and Alcohol Screening Program, and any authorized collection site or agent to take urine and/or breathalyzer samples from me for use in a drug or alcohol screening. I understand why these samples are being requested and I give permission for the results to be sent to the Medical Review Officer (MRO). The MRO may communicate my status, to my employer, in accordance with the M.U.S.T. program. I further release and hold harmless M.U.S.T. (Management and Unions Serving Together), including their constituent member organizations and affiliated Unions, as well as their officers and directors from any consequences arising out of the drug and/or alcohol test or results there from. Name (Please Print) Address City Social Security Number Signature State Zip Code Area Code/Phone Number Witness Adamo CHSP Section 10.0 Drug -Free Workplace 22 February 2023 Issue Date Dat