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Opening of Bids - Demolition of Rabbi Shulman Apartments Proj No 125-014 - Melching Inc
Project Name Project No. For Bids Due Date: Address: 2/.l Rabbi Shulman Apartment Building Demolition J Z5-014 9:OOam September 9, 2025 PART I du st bbe completed for all bids. Please type or print) _Bidder (Firm)melc�)'All City/State/Zip: dkIA56G� tl9y�l`� Email Address: _Udlc�►r1A[�e �o Telephone Number: ( 4& ) 0 3 7— f a, I q Agent of Bidder (if Applicable): v Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: ql%l . % . _% ♦ A the City �u Bend, Indiana, in accordance with plans and specifications prepared by: J'r and dated e, for the sum of (enter the Total Bid as shown on the Proposal) 11 ,030,000 (Enter sum of Total B9 e Bid plus Alternates shown on Proposal) '' (N m rica 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 Berl If the bid is to be awarded on a unit basis, the itemization of the units shall be shown Q►�a she �aratP gtfta�,An�• The above bid is accepted this Subject to the following conditions: By ACCEPTANCE day of BOARD OF PUBLIC WORKS President Members of Person 20 Version 5/20/2024 Contractor's Bid for Public Works - 2 Project Name: Project Number: For Bids Due: Contractor Name: BASE BID BID/PROPOSAL fw ranee '- CITY OF SOUTH BEND t� Rabbi Shulman Apartment Building Demolition 125-014 9:OOam September 9, 2025 Item No. Description Quantity Unit Unit Price Total Amount Demolish Rabbi Shulman Apartment 1 Buidling at 628 W. Western Avenue, 1 LSUM 13'r�d �( � ®O©4 includingAsbestos Abatement / 2 Environmental Allowance — See Addendum 2 1 LSUM $100,000 $100,000 BASE BID TOTAL 1i �� ad Bidder (Firm): Address: City/State/Zip: , I%taili�o� IML l%/!�l/l�Telephone Number: U 120 nat{ e) (Printed Name of Person Sia Version 1/3/2025 Contractor's Bid for Public Works - 7 c(QiSTH In m MEN 0 O !" Project Name Rabbi Shulman Apartment Building Demolition Project No. For Bids Due 125-014 9:00am September 9, 2025 From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. Proper bid security included. The bidder has the option of providing either a Certified Check or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and Certification of use of United States Steel Products or Foundry Products. Proof of M/WBE Utilization Plans [MBE-1.0 and WBE-1.01. Also provide Evidence of Good Faith Efforts Forms [MBE-2.0 and WBE-2.0] and M/WBE Contacted Forms [MBE-2.1 and WBE-2.1]. Acknowledge Receipt of k Addendum(s) included with the bid. e All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either printed or typed underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: ck end, �C. , Date:a$" a - By Authorized Repr( Signature: Print Name & Title: Version 5/20/2024 Contractor's Bid for Public Works - 1 When the prospective Contractor is linable 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 b t h!5, ) ) SS: S� 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 fine, 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 5/20/2024 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 detenmination 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. 1, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1).1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon. submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder Version 5/20/2024 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 day of SP BOA , 20 a-5 P-)& 166 Contractor/Bi der (Firm) of CWactgn1'dder or Its Agent Printed Name ro(e Subscribed and sworn to before me this D -' " day of Swle4 , 20—�/— My Commission Expires of ry Public QS County of Residence 6.r, _ .�'gSATHgF.. WOODCRIIN,�G„," �Y My .' NOTARY '. �" My COmmis M Expires May 14, 2031 Puei,ic . Counw of Muskegon Acting In the Couary of ._,rye. n jy L , �1 rr r 'f0 ...c (I �N�/!11'IflF11��` Version 5/20/2024 Contractor's Bid for Public Works - 6 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: August 18, 2025 To: All Planholders From Hillary Horvath, Clerk, Board of Public Works Subject Addendum Number: 1 Project Name: 125-014 Project Number: Demolition of Rabbi Shulman Apartments Date Received: ���, 9-0 9� 4;;- 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: Authorized Si; Date: �/ ��a�S� v Version 8/11/2020 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAX 574/235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND, JAMES MUELLER, MAYOR BOARD OF PUBLIC WORDS Date: August 29, 2025 To: All Planholders From Hillary Horvath, Cleric, Board of Public Works Subject Addendum Number: 2 Project Name: 125-014 Project Number: Demolition of Rabbi Shulman Apartments ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: Zg 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. Compe Author Date: Version 8/11/2020 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 "I Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. fi�k2. Attach a listing of public works projects currently in process of construction by your organization. 100. Attach information regarding any failure to complete any work awarded to you and the location thereof. "41, 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.) ��. 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. 01p(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. "i, 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 Ir 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 5/20/2024 Contractor's Bid for Public Works - 3 Completed Projects AMK Properties 493 W 32nd St Holland Demo & Abatement Rockford Meijer #311 TEG GR Demo & Abatement Edwin Allen Homes 3316 68th St - Survey/Abatement/Demo Demo & Abatement Cass County Land Bank Cass County Land Bank Houses (4 ea) Demo & Abatement Padnos Lansing- Padnos Steel Processing Misc steel cutting Franklin Quincy, LLC Quincy Holland - Select Demo Demo Rockford Howmet -Plt 10 Office Renovations Demo Community Devel Neighborhood 516 Orchard Ave Abatement Allen Edwin 7110 W Main St. Demo & Abatement City of Benton Harbor Multiple Homes Demo & Abatement Clifford Buck Construction Grand Have Christian School (Colfax) Abatement Excel Excavating 3529 & 3933 Patterson Demo County of Berrien 122 & 225 Railroad & 708 Red Bud Demo & Abatement Rockford Construction LG BCU removal (Retrofit) ESMI M12 Demo Burke Porter Machinery 730 Plymouth NE GR Demo RT Construction Farm and Fleet Office - Muskegon Shoring Jason Barrix 514 Jackson GH Demo & Abatement Rockford Construction LG ESMI M14 Demo Wood Trucking Beach Pavillion - North Musk Demo Rockford Const LG ESMI M12 Boiler Room Demo Clifford Buck Construction Baker College T Wing Rooms Abatement Rockford Construction Tipp City Meijer 805 Demo Orion Construction Lofts of Muskegon Demo Clifford Buck 1776 Vulcan Abatement Clifford Buck Const Survey at 1902 Grant Ave Abatement Franklin Quincy, LLC 13467 Quincy Phase 2 Demo John Grace Restoration & Const 2865 Dawes Ave SE GR Demo Lambda Energy Scharmen Facility Demo Lambda Energy Edwards Facility Demo &Abatement Clifford Buck Baker College A Wing Abatement DEMOLITION • ENVIRONMENTAL • DEVELOPMENT Work plan for the Rabbi Shulman Apartment Building Demolition This submittal is a demolition and dismantling plan for the removal of the Rabbi Shulman Apartment Building. The onsite foreman will oversee all daily site activities, such as manage the crew members, meet with officials, ensure a safe and organized job site, and manager the site to align with the proposed schedule. In case of any spills, we will have a dedicated spill kit onsite. The foreman will have adequate experience with spill prevention and cleaning up. Incase of a spill we will stop work and focus on stopping and preventing the spread of any contaminants. We will have a dust destroyer on site to mist water during demolition. If needed we can use the hose to direct high flow of water. We will be utilizing Hydraulic excavator to bring down the structures. Additional excavators will be onsite to sort and load out the debris. We will utilize a skid steer to assist with the clean up. Due to the site gradation I do not for see an issue with surface water. If needed we can supply silt fence in areas to prevent sediment leaving the site. Silt sacks will be installed in any catch basin on site. 3662 AIRLINE ROAD MUSKEGON, MI 49444 1 P (616) 837-1214 1 F (616) 837-0109 1 WWW.MELCHINGDEMO.COM A00167466, " DEMOLITION • ENVIRONMENTAL • DEVELOPMENT Equipment list for Rabbi Shulman Apartment Building Demolition We anticipate using our 2020 Kobelco SK550 with a processor attachment, a 2018 Komatsu PC490 with a processor attachment and bucket and thumb. A 2018 John Deere 35OG with a bucket and thumb along with a skidsteer to assist with clean up. We will be using a dust destroyer to keep the dust down. If we come across a situation where we need additional equipment, we can pull from our 10 other excavators in rotation, 5 other skidsteers in rotation and our backup dust destroyer. Alongwith working closely with multiple equipment rental companies. 3662 AIRLINE ROAD MUSKEGON, MI 49444 1 P (616) 837-1214 1 F (616) 837-0109 1 WWW.MELCHINGDEMO.COM u Melching, Inca Financial Statements For the Period Ended December 31, 2024 Prepared by: Aukema & Company, PC Certified Public Accountants Accountants' Compilation Letter Financial Statements: BalanceSheet.......................................................................................................... 4-5 Statement of Retained Earnings............................................................................... 6 Statementof Income................................................................................................. 7 Supplemental Information IncomeStatement suppporting schedules................................................................. 8 Aukema & Company, P.C. 295 120th Ave Holland, MI 49424-2153 616-494-0342 To Management: Melching, Inc. 3662 Airline Road Muskegon, MI 49444 Management is responsible for the accompanying financial statements of Melching, Inc., which comprise the balance sheet as of December 31, 2024, and the related statements of income, and retained earnings for the year then ended in accordance with accounting principles generally accepted in the United States of America. Wehaveperformed acompilation engagement inaccordanee with Statements onStandards forAccounting and Review Services promulgated by the Accounting and Review Services Committee of the AICPA. We did not audit orreview the financial statements, nor were we required to perform any procedures to verify the accuracy or completeness of the information provided by management. We do not express an opinion, or aconclusion, nor provide any assurance on these financial statements. Aukema & Company, P.C. Holland, MI March 12, 2025 • Project Name "Cn��� S l\Ma, -NI,,M,A- A1cyt � CM81���6J� Project No. 1-(.,5'-019 For Bids Due Contractor Name: 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 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 II. PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowled ements: (i) By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. (ii) By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. (iii) By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) By checking this box, I hereby acknowledge and ensure that I and all sub- contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore, I acknowledge my understanding that it is my responsibility to ensure that all sub -contractors have the necessary licenses to undertake the work called for in this bid. If a sub- contractor loses their license at any point, it is the responsibility of that sub- contractor to notify the City. (v) By checking this box, I hereby acknowledge that apprenticeship and training programs that I participate in have graduated at least five (5) apprentices in each of the past five (5) years. (vi) By checking this box, I hereby acknowledge that all subcontractors performing work greater than $250,000 also meet the qualifications of the Responsible Bidder Ordinance. (b) Attachments: (i) Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). List identifying all former business names. Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) (iv) years. Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. (v) 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) 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 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) 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) 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) f� Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. (ix) List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. McdcLcl (Name ofCom any) d g(.tje%�R <<� I l,,_.I �._ (Address of Company) (City) ate^ h `s (State) / if tdILI (Telephone Number) Version 5/20/2024 Michigan Department of Licensing and Regulatory Affairs Bureau of Construction Codes Residentall Builders Section P.O. Box 30254 Lansing, IvIl 48909 MELCHING INC 3662 AIRLINE ROAD MUSKEGON, MI 49444 ichigari Department 4bceiising'and RegujstcryA0a-lra-- Bureau ofConstruction Codes Company Builder License Q,O,- DouglasWillarnMelching MELCHING INC 3662 AIRLINE ROAD MUSKEGON, MI 49444 License No: Explratton Date: 2102135-126 05131/2026 ----------- --- ------- G522052 GRETCHEN WHITMER Michigan Department of Licensing and Regulatory Affairs Governor Bureau of Construction Codes Company Builder License MELCHING INC 3662 AIRLINE ROAD MUSKEGON, MI 49444 Qualifying Officer: Douglas William Matching q Qualifying Officer# 2101191722 MUST BE DISPLAYED IN A CONSPICUOUS PLACE License No. Expiration Date: ThIs document Is duly Issued under the laws of the 2102136128 05/31/2026 State offAlchluan An 4icial website of the United States government. Here's how you know The .gov means it's official. The site is secure. Federal government websites often end in The hops:// ensures that you are .gov or .mil. Before sharing sensitive connecting to the official website and that information, make sure you're on a federal any information you provide is encrypted government site. and transmitted securely. O U.S. DEPARTMENT OF LABOR Occupational Safety and Health Administration CONTACTUS FAQ ATOZINDEX 0 LANGUAGES C° Search Menu OSHA v STANDARDS `/ ENFORCEMENT TOPICS HELP AND RESOURCES V NEWS v CONTACTUS FAQ ATOZ.INDEX LANGUAGES i i i t--j 1 e Case Status: CLOSED Inspection:1529354.015 ® Melchin, Inc. Inspection Information - Office: Michigan Safety Cnst Inspection Nr: 1529354.015 Site Address: Melching, Inc. 200 South Street Big Rapids, MI 49307 Mailing Address: 3662 Airline Road, Muskegon, MI 49444 Inspection Type: Planned Scope: Partial Advanced Notice: N Ownership: Private Report ID: 0552651 Union Status: Nonunion Safety/Health: Health Close Conference: 08/18/2021 Emphasis: P:Construction, S:Construction Case Closed: 11/10/2021 Date Opened: 05/06/2021 SIC: NAICS: 562910/Remediation Services Case Status: CLOSED Violat"`6n Summary Violations/Penalties Serious Willful Repeat Other Unclass Total Initial Violations 1 1 Current Violations 1 1 Initial Penalty $2,000 $0 $0 $0 $0 $2,000 Current Penalty $1,000 $0 $0 $0 $0 $1,000 FTA Penalty $0 $0 $0 $0 $0 $0 Violation Items # Citation Citaton Standard Cited Issuance Abatement Current Initial FTA Contest Latest Event ID Type Date Due Date Penalty Penalty Penalty 1. 01001A Serious 19261101 G04 III 09/01/2021 09/10/2021 $1,000 $2,000 $0 1 - Informal Settl 2. 01001B Serious 19261101 G05 I B 2 09/01/2021 09/10/2021 $0 $0 $0 1 - Informal Settl 3. 01001C Serious 19261101 L02 09/01/2021 09/10/2021 $0 $0 $0 1 - Informal Settl ® la OSHA I Standards I Enforcement I Topics I Media Center Contact Us tit�okv.N'r, or,r �TFo -�i-r r�4r ,r�nrrs oY U.S. DEPARTMENT OF LABOR Occupational Safety and Health Administration 200 Constitution Ave NW Washington, DC 20210 ❑ 1-800-321-OSHA 1-800-321-6742 www.osha.gov FEDERAL GOVERNMENT White House Benefits.gov Coronavirus Resources Disaster Recovery Assistance DisasterAssistance.gov USA.gov Notification of EEO Violations No Fear Act Data An official website of the United States government. Here's howyQu know OThe .gov means it's official. The site is secure. Federal government websites often end in The https:// ensures that you are .gov or .mil. Before sharing sensitive connecting to the official website and that information, make sure you're on a federal any information you provide is encrypted government site. and transmitted securely. ® U.S. DEPARTMENT OF LABOR Occupational Safety and Health Administration CONTACTUS FAQ ATOZINDEX ® LANGUAGES Q Search Menu OSHA °' STANDARDS v ENFORCEMENT `/ TOPICS '/ HELP AND RESOURCES V NEWS v CONTACT US FAQ A TO Z INDEX LANGUAGES Inspection Detail Case Status: CLOSED Inspection: 1599228.015 - Melching, Inc. Inspection Information - Office: Michigan Safety Cnst Inspection Nr: 1599228.015 Site Address: Melching, Inc. 108 West Chicago Road Sturgis, MI 49091 Mailing Address: 3662 Airline Road, Muskegon, MI 49444 Inspection Type: Planned Scope: Partial Advanced Notice: N Ownership: Private Report ID: 0552651 Union Status: NonUnion Safety/Health: Health Close Conference: 08/17/2022 Emphasis: P:Rcs-Nep, N:Rcs-Nep, S:Silica Case Closed: 10/04/2022 Date Opened: 06/01/2022 SIC: NAICS: 562910/Remediation Services Case Status: CLOSED Violation Summary Violations/Penalties Serious Willful Repeat Other Unclass Total Initial Violations 1 1 Current Violations 1 1 Initial Penalty $0 $0 $0 $0 $0 $0 Current Penalty $0 $0 $0 $0 $0 $0 FTA Penalty $0 $0 $0 $0 $0 $0 Violation Items # Citation Citaton Standard Issuance Abatement Current Initial FTA Contest Latest Note ID Type Cited Date Due Date Penalty Penalty Penalty Event 1. 01001 Other 408.22141(2) 09/13/202-2 $0 $0 $0 Z -Issued OSHA I Standards I Enforcement I Topics I Media Center I Contact Us �r�lhlC.N1, of q ? � U 11F5 oS rCN U.S. DEPARTMENT OF LABOR Occupational Safety and Health Administration 200 Constitution Ave NW Washington, DC 20210 L 1-800-321-OSHA 1-800-321-6742 www.osha.gov FEDERAL GOVERNMENT White House Benefits.gov Coronavirus Resources Disaster Recovery Assistance DisasterAssistance.gov USA.gov Notification of EEO Violations No Fear Act Data U.S. Office of Special Counsel OCCUPATIONAL SAFETY & HEALTH DEMOLITION • ENVIRONMENTAL • DEVELOPMENT To Whom it may concern: Melching, Inc employs a sufficient number of employees to complete the work as described in the scope of work. Secondarily, we employ temporary laborers in addition to our employees as needed. i &r4.10 Ic - , F00-0 I Noire Project Manager 3662 AIRLINE ROAD MUSKEGON, MI 49444 1 P (616) 837-1214 1 F (616) 837-0109 1 WWW.MELCHINGDEMO.COM 1%A L . H I" 0EMOLITION - ENVIRONMENTAL • DEVELOPMENT DRUG FREE WORKPLACE POLICY OBJECTIVE: • To take reasonable steps to ensure that the use of alcohol or drugs does not jeopardize the safety of our employees, subcontractors, suppliers and customers. RSTANCE ABUSE POLICY: • No principal, employee, or sub -contractor shall sell, distribute, be under the influence of, or in possession of any form of alcohol or illegal drug: o While on a Melching Inc job site o While driving or operating ANY Melching Inc vehicle or equipment o While on Melching Inc's properties • Any employee who is under the care and supervision of a qualified licensed practitioner and taking a prescription drug that has the capacity to alter mood, perception or judgment must immediately notify his or her supervisor. The employee may be allowed to work on Melching Inc's job sites, if Melching Inc determines that the medication will not inhibit the employee's ability to perform his or her regular assigned duties safely and efficiently. Failure to notify the Melching Inc foreman or supervisor may result in immediate removal from the job site. Drugs (as used in this policy) shall include any substance capable of altering mood, perception, or judgment, including but not limited to: Amphetamines, Cannabinoids, Cocaine, Opiates and Phencyclidines. ALCOHOL and DRUG TESTING POLICY: By accepting employment with Melching Inc or any of its subsidiaries, employees agree to be tested for drugs and alcohol at the Companies' convenience. As part of the testing procedure, employees will be required to sign an Employee Certificate of Agreement/Consent & Release Form. Any employee who refuses to sign this form and/or to cooperate and submit to such as breathalyzer, urine, oral fluids and/or blood testing as directed by the Company may be immediately discharged. ❖ PRE -EMPLOYMENT: All employees will be required to pass an alcohol and/or drug screen prior to becoming a full-time, Melching Inc employee. ❖ EQUIPMENT OPERATORS: Any employee who operates heavy equipment (i.e.; trucks, excavators, lifts, loaders, skid steers) will be subject to frequent and random testing. All CDL licensed drivers will be in the pool for MDOT administered random drug screening program as well as any other jurisdictional screening programs as required by industry standards. 4- ACCIDENTS: Employees receiving medical treatment at a med center or emergency room for a job - related accident may be tested for drugs and/or alcohol. Any employee involved in an accident (or near -miss accident where there is reasonable basis for believing the employee contributed to the incident) will be required to submit for an alcohol and/or drug screen as soon as it is requested by Operation/Safety. 13 a MA L. H I" IDEMOLITION - ENVIRONMENTAL - IDEVELOPMENT JUST CAUSE: An alcohol and/or drug screen may be required where there is an objective basis for believing that the employee has used, possessed, sold, distributed, or been under the influence of alcohol or non -medically prescribed drugs. •:° RANDOM TESTING: The Company will maintain a pool of all active Melching Inc employees and once a month or as the Company determines, a percentage of the pool of eligible names will be drawn. Those selected employees will be required to submit to testing as directed by the Company. Random testing can be completed through the designated collection facility. DISCIPLINARY ACTION: Any employee who fails a company required alcohol or drug screen will be subjected -to disciplinary actions which may include unpaid suspension and or loss of employment. After a minimum of twenty-eight (28) days, any employee suspended or terminated under the terms of Melching Inc Drug Free Workplace Policy may petition the Company for re-employment. If a suitable position compatible with the employee's skills is available and the Company deems it in its best interest to re -hire the suspended/terminated employee, an offer of employment will be extended. At his/her own expense the employee will be required to take an alcohol and drug screen at a Company approved facility. If that test is negative and it has been less than six (6) months from the suspension/termination, the employee will be reinstated as a Melching Inc employee without a break in service. Reinstated employees will be subject to additional testing at the Company's discretion. If a reinstated employee fails a subsequent test, action may be taken that could result in immediate and permanent termination. VOLUNTARY REHABILITATION: An employee who has never been disciplined by the Company for any offense related to the use, sale, distribution, dispensation, manufacture, or possession of alcohol or a controlled substance may seek the Company's assistance for treatment of his/her alcohol and/or drug use problem. The company shall attempt to refer the employee to appropriate medical treatment and counseling, and shall grant the employee a leave of absence, if necessary, to undertake such rehabilitative treatment. Employees granted such a leave of absence will be required by the Company to successfully complete a return service medical examination, including alcohol and/or drug testing. Employees returning to work under this policy will be subject to periodic or random alcohol and/or drug testing, as a condition of reinstatement to work. 14 8 W WESTERN NATIONAL INSURANCE The relationship company, April 10, 2025 Re: Melching, Inc. To Whom It May Concern: This letter is to advise that Western National Mutual Insurance Company is pleased to represent Melching, Inc. We are confident in this firm's ability to perform and recommend them for your favorable consideration. Based on our experience with Melching, Inc., we would favorably consider bonds for single projects up to $5,000,000, with a total backlog in the $10,000,000 range. Our consideration would be based on the satisfactory completion of our normal underwriting requirements, which include, but are not limited to, our satisfactory review and approval of the contract terms and conditions, our contractor's financial condition at that time, its overall work program, verification of project financing and other pertinent underwriting criteria. This letter is intended as a bonding reference only. Under no circumstance should it be interpreted as a commitment to issue a bond, an assumption of liability, or construed as a bid, performance, or payment bond obligation. Our agreement to issue bid, performance, or payment bonds on behalf of Melching Inc., on any project, is subject to the application of our usual and customary underwriting standards and risk selection criteria, and the underwriting conditions which exist at the time a bond is requested. Western National Mutual Insurance's financial rating by A.M. Best is A+ Superior, Financial Size Category X, and our underwriting limitation as stated in the current US Treasury Department Circular 570 exceeds $77 million. Please feel free to contact me with any questions at (952) 303-8786 Sincerely, Robin E. Kinblom AFSB, Regional Underwriting Manager Western National Mutual Insurance Company Western National Insurance Group 1 4700 West 77th Street I Edina, MN 55435-4818 1 (952) 835-5350 or (800) 862-6070 info@wnins.com I www.wnins.com WESTERN NATIONAL MUTUAL I WESTERN NATIONAL ASSURANCE I PIONEER SPECIALTY I UMIALIK I ARIZONA AUTOMOBILE I WESTERN HOME NEVADA GENERAL I MICHIGAN MILLERS (AFFILIATE) lA',.' IM DEMOLITION - ENVIRONMENTAL - DEVELOPMENT 9/8/25 To Whom it May Concern, Melching, Inc has no outstanding or delinquent tax owed to any federal, state or local taxing body. Adam DeJonge Project Manager 3662AIRLINE ROAD MUSKEGON, MI 49444 1 P (616) 837-1214 1 F (616) 837-0109 1 WWW.MELCHINGDEMO.COM INAWA=L� H1"t�r DEMOLITION ENVIRONMENTAL - DEVELOPMENT Major Projects Sandusky Former GM Plant Contract - $3,150,158. Owner — 2509 Hayes, LLC Battle Creek Paper Moll Contract - $4,680,000. Owner — New Mill Capital LG ESMI Contract - $756,800 Owner — LG Chemical Architect — Ghafari Trade References Herc Rentals 7175 Enterprise Dr. Norton Shores, MI 49456 McAllister 6190 Clyde Park Ave SW Byron Center MI 49315 JH Oil PO Box 9464 Wyoming, MI 49509 3662 AIRLINE ROAD MUSKEGON, MI 49444 1 P (616) 837-1214 F (616) 837-0109 WWW.MELCHINGDEMO.COM CD o' c` N O F3 O N P M. z 0 3 (D T c Is 3 N Q. `G 9- `1 z 9 � 3 D > CL © Q m O � �n1 ,.J a n m Ski r q m w ' o 0 =3 CD 0 � 7 (� N O 0 1> m o S 0(D Qo m o o 0 C: 0- N CD (D( o Q Q3 :CD o Q N � o 0 m 3 3 O c Q (D rt Q �o rp m e W � W a o cD 6 0 o� � cfl N CD 1j T CL (D m' c5 0 z c 3 T (� W (D m 0 0 m 0 '0 O 2. z w m c z a K z 0 z 9 m z w �o Uu m Z .n m cn r= ;u m n Z N �mMC Z -um W D®mz z Z n r c z 0 C) r a z 1 DEMOLITION - ENVIRONMENTAL - DEVELOPMENT 9/8/2025 To Whom it May Concern, Melching, Inc will only be subcontracting to DM Contractors and no one else, therefore, we will not be using any woman owed companies as subcontractors. Manager 3662 AIRLINE ROAD MUSKEGON, MI 49444 1 P (616) 837-1214 1 F (616) 837-0109 1 WWW.MELCHINGDEMO.COM CONTRACTOR: (Name, legal status and address) Meiching, Inc. 3662 Airline Rd Muskegon, MI 49444 OWNER; (Name, legal status and address) City of South Bend 227 W Jefferson Blvd South Bend, IN 46601. BOND AMOUNT: si,ioo,000 Western National Mutual Insurance Company Edina MN 55435 SURETY: (Name, legal status and principal place of business) Western National Mutual insurance Company 4700 West 77th Street Edina MN 55435 PROJECT; (Name, location or address, and Project number, if any) Rabbi Shulman Apartment Demo - Demolish of 6 Story Concrete Building, Asbestos Removal and Site Restoration The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein, The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain In full force and effect, The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310, 2016 edition 1 e°°►►►ee►e►eeeeeee 000 Np►�. Mu, err Signed and sealed this Sth day of September 2025 �•` ��� •'' ppp� f • �• •• da W •e 'yi . (Witness) (Witness) Douglas William Melching (Principal) `fSe'�1)•`'°•...••• `.`• rr President O0 e000 eef 44ee010°,°• (Title) Western /National Mutual Insurance Company Nicholas Holton °°►►NIl►eteepel Afv "re +y♦eee•►+ er y •• (tPQ °e• (� rrr ft'NEAU.- v � rr '/ '••+ae M•• •0 The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310, 2010 edition N WKSTeRN NATIONAL ,xeun..Ncn 7fie,eMMtkvuhfp@!' POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Western National Mutual Insurance Company, a Minnesota mutual insurance company, does make, constitute, and appoint: Lyle Klosterman, Nicholas Halton, Amy Grasso, Kellie Warner (Diversified Insurance Group #9832) Its true and lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the Company as surety, to execute and deliver and affix the seal of the Company thereto (if a seal Is required) bond, undertakings recognizances or other written obligations in the nature thereof, (other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, hazardous waste remediation bonds or black lung bonds), as follows: All written instruments in an amount not to exceed an aggregate of Seven Million Five Hundred Thousand and 00/100 Dollars ($7,500,000.00) for any single obligation, regardless of the number of instruments issued for the obligation. and to bind Western National Mutual Insurance Company thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed. This appointment is made under and by authority of the board of directors at a meeting held on September 28, 2010. This Power of Attorney is. signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of Western National Mutual Insurance Company on September 28, 2010: RESOLVED that the president, any vice president, or assistant vice president in conjunction with the secretary or any assistant secretary, may appoint attorneys -in -fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to execute and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and suretyship obligations of all kinds, and said officers may remove. any such attorney -in -fact or agent and revoke any Power of Attorney previously granted to such person. RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (1) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant secretary; or (ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be required) by a duly authorized attorney -in -fact or agent; or (Ill) when duly executed and sealed (if a seal be required) by one or more attorneys-in•fact or agents pursuant to and within the limits of the authority evidenced by the Power of Attorney issued by the Company to such person or persons, RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed, IN WITNESS WHEREOF, Western National Mutual Insurance Company has caused these presents to be signed by Its proper officer and Its corporate seal to be affixed this 1 h day of December , RQZO_. &EA )AZI Jennifer A. Young, Secretary Mark S. Hewitt, Vice President, Surety STATE OF MINNESOTA, COUNTY of HENNEPIN On this 16th day of December, 2020, personally came before me, Jennifer A. Young and Mark S. Hewitt and to me known to be the Individuals and officers of the Western National Mutual Insurance Company who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally dispose and say; that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument Is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation. DEENAAWALIEWFMW NOTARY PUSUO MINNESOTA urCom o„s�r«o+f3+Deena Anjall Entrikin, Notary Public My commission expires January 31, 2024 CERTIFICATE I, the undersigned, Secretary of the Western National Mutual Insurance Company, a Minnesota corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force. �,\oN .....ur . ��sEAri t3th Se tember 2025Jennifer Signed and sealed at the City of Edina, MN this __ h day of _ p enni er . oung, ecre ary BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 08/29/2025 Name Zach Hurst Department DPW BPW Date 09/09/2025 Phone Extension 3057 Review and Approval Required Prior to Submittal to Board Diversity Compliance ❑ Officer Name and Inclusion Officer BPW Attorney ❑ Attorney Name Dept. Attorney ❑ Attorney Name Purchasing ❑ Check the Appropriate Item Type — Required for All Submissions ❑ Professional Services Agreement ❑ Contract ❑ Proposal ❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA ® Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes ❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA ❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution n Other: n Ease./Encroach Information Company or Vendor Name ❑ Yes[] If Yes, Approved by Purchasing New Vendor ❑ No Yes MBE MBE/WBE Contractor Completed E-Verify Form Attached ❑ ❑ No Project Name Demolition of Rabbi Shulman Apartments Project Number 125-014 Funding Source River West DA TIF Account No. PR-00042469 Amount Terms of Contract Purpose/Description Request to open bids to demolish the former Rabbi Shulman Apartments at 628 W. Western Avenue. For Chance Orders Onl Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount $ Increase Current Percent of Change: Decrease New Amount $ Increase Total Percent of Change: Decrease Time Extension Amount: New Completion Date: