HomeMy WebLinkAboutBid Opening - Fire Service, Inc. - Two (2) More or Less 2016 or Newer Refurbished Medic UnitslotI &Far
SPECIFICATIONS rA
CITY OF SOUTH BEND
lkAS
BID NAME: Spec AA —Two (2) More or Less 2016 or Newer Refurbished Medic Units
FOR BIDS DUE: July 26, 2016; 9:30 a.m., Local Time
Pursuant to notices given, the undersigned offers bid(s) to the City of South Bend in accordance
with the following attachment(s) which specify the class or item number or description, quantity,
unit, unit price.
SPEC AA — TWO (2) MORE OR LESS 2016 OR NEWER REFURBISHED MEDIC
UNITS
It is the intent of these specifications to describe a vehicle or piece of equipment for the City of
South Bend. The unit shall be bid as a fully equipped complete unit as set out in the attached
specifications. No partial or split bids will be accepted. Unit to be bid with and without trade-in
if applicable. Vendor to complete bid proposal contained in this bid specification and attach to
the submitted bid.
These are minimum specifications. Any variation from the specifications must be spelled out on
a separate deviation list in order for the bid to be valid. Any items not listed on the deviation
sheet will be assumed to be part of the unit.
Proprietary products or specific manufacturers may be referenced herein. Such references are
only made to demonstrate minimum scope, quality, and style of the equipment desired.
Equipment that is bid pursuant to these specifications shall be of equal quality and size, or
greater, to those referenced, and are subject to approval by the South Bend Board of Public
Works.
Vendor shall provide all information requested in specifications to qualify for bid. If information
on brochure submitted does not completely cover specifications requested, it shall be typed and
attached to brochure.
If an alternate is included within these specifications, please be advised that, alternate items
placed in the specifications are to determine the best configuration of the item within a budgeted
amount and may be included in the award criteria. If the Board elects to award one or more (s),
the base bid price and the alternate bid price(s) will be totaled and compared for all bidders
offering the final configuration. Award will be made based on the lowest responsible/responsive
bid prices submitted for the base bid with selected (s), if applicable. Failure to submit a bid on
an alternate may result in the entire bid being non -responsive, depending on the final
configuration of the product.
Payment will be processed once the unit is inspected and accepted as to meeting the
specifications by the Division of Central Services. This will include all manuals and warranty
documentation.
Bidder must state as accurately as possible an intended delivery date from the date of the
bid award. Due to the age of the City's existing fleet, it is imperative that the unit's be
delivered as quickly as possible. Stated delivery lead time may be included as an integral
part of our bid selection process. FOB Central Services. The unit and all related paperwork is
to be delivered to:
Central Services Division
1045 West Sample Street
South Bend, Indiana 46619
All Certificates of Origin/Title Work shall list the owner as:
The City of South Bend
1045 West Sample Street
South Bend, Indiana 46619
The Board will award the bid to the lowest responsible and responsive bidder. If the bid is not
awarded to the lowest bidder, the factors used to justify the awards will be stated in writing at the
request of any bidder.
The Board reserves the right to reject any and/or all bids or portions thereof and to waive any
irregularities or informalities.
Chassis:
20,000. G.V.W,R., Geared Speed 84 MPH.
YES O
Front Axle:
I -Beam Type: 8,000 lb capacity. King pin bushings to be
ES O
brass.
Rear Axle:
Bidder responsible for correct axle width to fit module,
YES O
17,500 lb capacity, Ratio: 4.56.
Front
8,000 lb. capacity, heavy duty shock absorbers.
Y /NO
Suspension:
Spring pins rubber bushings, maintenance free.
Rear
Air Ride optimized suspension; 12,000 lb. capacity, 5.3"
E O
Suspension:
ride height, with shock absorbers.
Engine:
Diesel powered, 250 HP, 660 lb. ft. torque. (Maximum).
60NO
Engine block heater 120 volt/1,250 watt. Block heater
socket receptacle type; mounted below driver's door. Air
cleaner to be dry type single element. Engine control,
remote mounted provision for; includes wiring for body
builder installation of PTO controls; with ignition switch
control Throttle, hand control engine speed control;
electronic, stationary variable speed; mounted on steering
wheel. Must have 5 year 200,000 mile warranty that
10
includes turbo, fuel injectors, and complete fuel system.
Includes:
*Gauge, Air Cleaner Restriction - Air Cleaner Mounted
*Cruise Control - Electronic; Controls Integral to Steering
Wheel
*Wet Type Cylinder Sleeves
*Engine Shutdown - Electric, Key Operated
*Governor - Road Speed, Electronic
*Engine Oil Drain Plug - Magnetic
*Oil Filter, Engine - Spin -On Type
*Engine Oil Change System - 30 Quart Capacity
*Damper, Crankshaft - Viscous
*Fan - Optimized Position
*Fuel Filter - Engine Mounted
*Fuel Water Separator
Transmission:
Automatic: (2500 EVS Series) 6 speed (package 119),
Es O
w/overdrive, less retarder, 64 teeth/20 degree pressure
angle 6.9 pitch spur gear. Oil filter, mounted on
transmission. Transmission temp gauge, dash mounted,
auxiliary oil cool.
Includes:
*Transmission Oil Pan - Magnet in Oil Pan
*Oil Filter, Transmission - Mounted on Transmission
*Synthetic Oil
*Allison P-3 extended service coverage - 5 year unlimited
miles shall be included.
Electrical:
12 volt 270 AMP alternator with self -diagnostic regulator
Y O
system. 3 = 1950 CCA maintenance free 12 volt 1950
CCA batteries. Body building wiring back of cab at frame,
includes sealed connectors for tail/amber turn/marker/back
up/accessory power/ground and sealed connector for
stop/turn. AM/FM radio, CD changer, weather band,
clock w/alarm, includes multiple coaxial speakers. Back
up alarm. Cigar lighter, 2 electric horns. Multi speed
windshield wipers w/delay. Circuit breakers w/manual
reset (main panel) SAE type III with trip indicators,
replaces all fuses except 5 AMP fuses.
Includes:
*Fuses, Electrical SAE - Blade - Type
*Turn Signal Switch - Self -Cancelling, Headlight Dimmer
(w/Flash-To-Pass Feature)
*Parking Light - Integral w/Front Turn Signal and Rear
Tail Light
11
*Stop, Turn, Tail & B/U Lights - Dual, Rear, Combination
w/Reflector
*Starter Switch - Electric Key Operated
*Turn Signals, Front - Flush Mounted Include Reflectors
and Auxiliary Side Turn Signals, Solid State Flashes.
*Data Link Connector - In Cab For Vehicle Programming
and Diagnostics
*Windshield Wipers - Single Motor, Electric, Cowl
Mounted
*Windshield Wiper Switch - 2 Speed Integral w/Turn
Signal Switch w/Wash and Intermittent Feature.
*Wiring, Chassis - Color Coded and Continuously
Numbered
Frame:
Frame rails high strength low alloy steel (80,000 PSI yield)
)/NO
9.125" x 3.062" x 0.312" (231.8 mm x 77.8 mm x 8.0 mm)
388.4" (9864 mm) maximum OAL; for LP chassis.
855,000 RBM, 10.7 Section Modulus
Wheel Base:
169", CA: 101.9, Axle to Frame: 63
E O
Cooling:
Radiator HD (Modine) aluminum, 2 row, cross flow, over
/NO
under system, 516 sq. in. louvered, w/270 sq. in. charge air
r-
cooler. 3.5" core. Heater and air conditioner. Bug screen
between grille and radiator.
Tires:
Front: (2) 245/70R19.5 G647RSS (Goodyear) 12 ply.
/NO
Rear: (4) 245/70R19.5 G622RSD (Goodyear) 537 12 ply.
Steering:
Power assist, tilting column, 2 spoke, 18" diameter wheel'WN
O
Cab:
Conventional steel or aluminum.
YE /NO
Includes:
*Premium Interior Trim
Arm Rest - (2) Molded Plastic, Smoke Gray, One Each
Door. Arm Rest Right Side of Divers Seat and Left Side
Passenger Seat
*Floor Covering - Rubber, Black
*Coat Hook - Located on Rear Wall, Centered Above Rear
Window
*Grab Handle, Cab Interior - (1) "A" Pillar Mounted,
Passenger Side
*Grab Handle, Cab Interior - (2) `B" Pillar Mounted, One
Each Side.
*Step - (2) One Step Per Door
*Glass, All Windows - Tinted, Power Windows
*Chrome Front Bumper
*Gauge Cluster - English w/En lish Electronic
12
Speedometer
*Front Tow Hooks
*Stationary Grille
*Odometer Display - Miles, Trip, Miles, Engine Hours,
Trip Hours, Fault Code Readout
* Warning System - Low Fuel, Low Oil Pressure, High
Engine Coolant Temp, and Low Battery Voltage (Visual
and Audible)
*Gauge Cluster Gauges - (5) Engine Oil Pressure
(Electronic), Water Temperature (Electronic), Fuel
(Electronic), Tachometer (Electronic), Voltmeter
*Gauge, Oil Temp, Allison Transmission
*Seat, Drive - (National) Air Suspension, High Back
w/Integral Headrest, Vinyl, Isolated, w/2 Position Front
Cushion Adjustment, 6 to 17 Degree Seat Back
Adjustment, Air Lumbar Support
*Air Suspension Dump Valve
*Exterior Grab Handles - w/Anti Slip Rubber Inserts, Both
Left and Right Sides
*Mirrors - Exterior, Both Heated and Powered wBright
Finish on Mirrors and Brackets. (2) (Lang Mekra)
Rectangular, 7.44" x 14.84", Brackets Breakaway Type,
w/102" Wide Spacing, w/7.44" sq. Convex Both Sides.
*Seat Belt - 3 Point, Lap and Shoulder Belt Type
*Seat, Passenger - (National) Air Suspension, High Back
w/Integral Headrest, Vinyl, Isolated, w/2 Position Front
Cushion Adjustment, 6 to 17 Degree Seat Back
Adjustment, Air Lumbar Support
*Instrument Panel - Center Section, Flat Panel
*Air Conditioner - (International Blend Air) w/Integral
Heater & Defroster
*Refrigerant - Hydro fluorocarbon HFC-134A
*Heater Hoses - Premium
*Fresh Air Filter for HVAC
Gray wBlack Netting Over Storage Pockets
* "A" Pillar Cover - Molded Plastic, Smoke Gray
*Head liner - Printed Cloth
*Instrument Panel Trim - Molded Plastic, Drawbridge
Gray wBlack Center Section, Hidden Cup Holder and Ash
Tray (Pull -Out)
*Dome Light, Cab - Rectangular, Center Mounted,
Integral to Console Door Activated, Timed Theater
Dimming.
*Sun Visor - (2) Padded Vinyl Integral to Console w/Toll
Ticket Strap and w/Integral Extenders
*Storage Pocket, Door - (1) Molded Plastic, Smoke Gray,
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Driver Door.
FFull-Length,
*Cab Interior Trim Panels - Molded Plastic, Full Height,
All Exposed Interior Sheet Metal is Covered
*Door Trim Panels - (2) Molded
Wheels:
Polished aluminum front and rear inner and outer.
A/NO
Exhaust:
Single, horizontal muffler and short tail pipe, aluminized
E O
steel; frame mounted left side at 45' angle.
Brakes:
Air brakes ABS (Bendix anti -lock brake system) full
ES O
vehicle wheel control system (4 channel) air dryer,
automatic drain valve w/heater for air tank. Front, air cam
S-cam; 15.0" x 4.0"; includes 20 sq. in. MGM long stroke
brake chambers. Rear, air cam 16.5" x 7.0"; includes
MGM TR3030 long stroke brake chamber and heavy duty
spring actuated parking brake, 13.2 CFM air
Chassis Add-
Roadmaster front #1209-116 and rear #1209-106 HD sway
E /NO
Ons:
bars. New Grover Emergency Stutter Tone Air Horns
include air line, fittings and valve. New cast products
SAD/SAP3805-09M2-1 siren speakers through the front
bumper. New auto reset back-up alarm with cancel switch.
New 125" ADP RH side running board/cab step, LH side
battery with slide out tray and cab steps. New brushed
stainless steel DEF tank shroud/cover. New 125"
aluminum switch, siren and radio console/map box line X
covered (color match to cab interior). New Federal Signal
PA300 200 watt siren.
Module Body
Remount Tl Medtech modular body. Includes: new cab to
E /NO
Exterior:
module accordion boot, body to chassis mounting pucks
and modification for side body fuel fill. Remove all
exterior doors, hinges, lights and accessories. New
windows (2) rear entry doors fixed mirror tint, (1) side
entry door sliding with mirror tint and (1) side body mirror
tint. Paint— sand blast module, repair corrosion, repair
with PPG 6 step process of base of base coat/clear coat,
wet sand and buff to high gloss finish. Module base color:
red (paint code: PPG#907239) match chassis red cab color:
L2684EB red elite BC. Remove and polish all stainless
steel door hinges. Reinstall with 3M corrosion barrier
between hinge/door and hinge/body. New Trimark door
handles (4) keyed locking, (1) non -locking interior. New
compartment door lower rotary latches (12) adjust and
insure timing on all. New module entry door rotary latches
(6) adjust and insure timing on all. New doorjamb Nader
pins (18). Inspect all compartments for proper venting and
drainage. Replace all exterior compartment and entry door
14
seals with a closed cell automotive door seal. New
Ziamatic model #VS-24-9 retractable side door entry step.
New ADP corner guards, kick plate panels, stone guards,
rub rails including stainless steel door sill thresholds for all
compartments. New heavy duty rear bumper steel sub -
frame with aluminum diamond plate bumper pods and
punched surfaced flip -up step. Provide and install new
frame mounted heavy duty tow hooks. New black rubber
fenderettes. New polished extruded aluminum "C"
channel rub rails. New cast license plate bezel with LED
to lights (high polished). New cast products fuel fill bezel
(high polished) with brushed stainless steel spillway. New
cast products rear door grabber hold opens (2 sets). New
brite finished aluminum drip rails.
Heat and A/C:
New ACC high output heating and AC unit. Heat BTU:
S O
43,600 AC BTU: 32,000 CFM: 620.
Electrical:
Test and reuse electrical system (including rear switch
E O
panel). New front cab switch panel including all switches.
New TST commander 357 battery timer switch, hour
meter, voltage/AMP inductive pick-up. New
chassis/engine harness color coded SXL or GXL insulated
wiring in heat resistant automotive loom. New Kussmaul
20-1050 Lifestar inverter/charger with LSIR inverter and
LSCR charger panels. Replace interior hi/lo Halogen
domes to new TecNiq 8" 31 LED hi/lo domes (6).
Replace interior 39" fluorescent lights with new TecNiq
18" LED panel lights (4). (Each light includes an
individual switch).
Department 2
Reinstall department mobile radios and intercom system
ES O
Way Radios:
(1) front console (1) primary action area.
DOT and
New Bullseye LED ICC lights with chrome guard (14) (7)
czENO
Emergency
amber (7) red. New Whelen 700 chrome bezels for
Lighting:
existing LED grille lights. New Whelen 700 series red
super LED intersection lights with chrome bezels (2).
New Whelen 900 series super LED front body lights (7)
R/W/R/W/R/W/R (removed front light bar). New Whelen
900 series super LED upper rear body lights (3) R/A/R.
(Remove rear light bar). New Whelen 900 series LED
gradient opi-scene and load lights with chrome flanges (8).
Whelen 5 mm strip-lites in "C" channel rub rails (3) each
side R/W/R. New Whelen light chrome flanges (6) 900
series (4) 700 series (8) 600 series. Polish all light lenses
to like new appearance.
Module
Remove old floor covering material, replace with new
YE O
Interior:
Lonseal floor, Lonplate II — gunmetal #424. Replace all
15
vinyl with new EVS seamless vacuum formed, including
set bottoms, backrest cushions and trim. Color: Gunmetal.
New EVS 1880 hi back seamless, child safety seat with 3
point belting harness with new SB-2-2 position swivel
base. New stainless steel entry door thresholds includes
rear and side with safety grip tape. New stainless steel
lower module entry door panels (3). Provide and install a
new safety net at head of squad bench. Provide and install
new retaining net on ALS cabinet opening. Inspect all
cabinet walls, seats, cabinet hardware for missing screws
and rivets, adjust and replace as necessary. Provide and
install a Smithworks 12 volt IV warming late.
Medical
Test oxygen system, lines and outlets. Repair any leaks.
/NO
Equipment:
Provide and install a new S-Scort VX-2 suction unit with
charging retention bracket.
Graphics:
Department lettering, door seals, striping, SQL's and (2)
U&NO
3M diamond grade, full rear body Chevron.
Color:
Cab red, Chassis White
/NO
Quantity:
Two (2) more or less.
ENO
Trade -In:
Med 4, 2010 Freightliner Ambulance,
E /NO
VIN# 1 FVAC WDT9ADAU 1912
Med 11, 2010 Freightliner Ambulance,
V IN# 1 FVAC WDT7ADAU 1911
Alternate 1: Liquid Spring
Rear Kneeling
A Liquid Spring rear hydraulic strut suspension shall be
E /NO
Suspension:
installed in lieu of the standard rear OEM air bag
suspension. The suspension company shall be QS 9000
and ISO 9001 certified for excellence. The liquid
suspension shall be rated at 12,000 pounds GAWR and
installed per Liquid Spring Directions. Suspension
Installation instructions and drawings shall be followed.
All guidelines regarding chassis and axle capacity ratings
as published by chassis manufacturer shall be adhered to.
Mechanical
The control arms shall be connected to a replacement front
Suspension
hanger that features upper and lower control arm pivot
Components:
points and a connection point for a heavy duty sway bar.
Both Liquid Spring struts shall be positioned directly aft of
the axle and outboard of frame rails. The designed ride
height shall maintain original suspension's drive -line
eometry.
Tracking Bar:
The suspension shall utilize a lateral control rod (tracking
E /NO
bar) to maintain side to side axle position related to the
chassis frame. Wear shoes, mounted to the sides of the
frame rails are not acceptable.
Hydraulic
All hydraulic lines, fittings, reservoirs and valves shall be
YE O
protected against "stone pecking". Abrasion covers, such
16
System:
nylon convolute loom over the lines are required. The
[as
ntire assembled system shall be tested for leaks at every
ittin connection point.
Mechanical
All fasteners related to the suspension assembly are
Quality
considered critical. All fasteners shall be tightened to the
Assurance:
manufacturer's recommended torque by the primary
installation mechanic. A secondary mechanic shall "put a
wrench" and re -torque ALL of the fasteners and then spray
a contrasting color of paint onto the heads and nuts of each
fastener.
Suspension
A suspension jounce clearance study shall be performed
E O
Jounce Study:
throughout the full range of suspension travel to ensure
adequate clearance of suspension, frame and brake
components. Test results shall be documented and
supplied in the owner's manual.
Kneeling
The rear suspension shall kneel when the triggering device
E /NO
Feature
is activated AND an enable switch, located in the cab
Enable:
console is activated.
e kneeling feature shall activate in PARK position only.
ES O
=onreverse
e kneeling feature shall NOT activate in any forward or
gear. The above rear suspension shall kneel when
trailing rear access door is opened.
17
pl,yFf'j1^
j _ p
BID/PROPOSAL r z
CITY OF SOUTH BEND
JNf>
BID NAME: Spec AA — Two (2) More or Less 2016 or Newer Refurbished Medic Units
FOR BIDS DUE: July 26 2016 9:30 a.m. Local Time
Description Year/Make/Model Unit Price
Re -Mount 2017 Freightliner/M2/FSI Remount $ 184,486.00 ea
Year Make/Model — Trade In Unit Price
2010 Med 4, Freightliner Ambulance,
VIN#1FVACWDT9ADAU1912 $ (5,500.00)
2010 Med 11, Freightliner Ambulance, (5,500.00)
VTN#1FVACWT)T7AT)ATI1911 S
Alternate #
Description
Cost
Total
1
Liquid Spring
$ 9125.00 ea
$ 9125.00 ea
Estimated number of days for delivery from award date. I 180-210
Bidder (Firm):
Address:
Fire Service Inc.
9545 N Industrial Dr
City/State/Zip: St. John, IN 46373
Telephone Number: (219) 365-7157 Fax Number: 219 _365-8572
By
Sign lure)
Shawn Dunker
(Printed Name)
VP
BOARD OF PUBLIC WORKS
Gary A. Gilot, President Elizabeth A. Maradik, Member
David P. Relos, Member Therese J. Dorau, Member
James Mueller, Member Attest: Linda M. Martin, Clerk
18
Document A31OTM - 2010
Conforms with The American Institute of Architects AIA Document 310
Bid Bond
CONTRACTOR:
(N'amo, legalsiatrisandaddrexry
Fire Service, Inc.
9545 North Industrial Drive
St. John. IN 46373
OWNER:
(None, legal slams and address)
City of South Bend
227 West Jefferson Boulevard
South Bend, IN 46601
BOND AMOUNT: $ 10%
SURETY:
(Maroe, legalsvalus andprincipalplac•e rfhueiness)
RLI Insurance Company
9025 N. Lindbergh Drive
Peoria, IL 61615
Ten Percent of Amount Bid
PROJECT:
(Name, location or address and Pro%ectmunber, ifani)
Supply One (1) or More Freightliner Type 1 Ambulance
This document has important
legal consequences. Consultation
with an attorney is encouraged
with respect to Its completion or
modification.
Any singular reference to
Contractor, Surety, Owner or
other party shall be considered
plural where applicable.
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 lmirs, 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 llie Contractor either (I) enters into a contract with the Owner in accordance with
the terms of such bid, and gives such bald 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 aniount of
this Bond, between the amount specified in said bid and such larger aniount for which the Owner may in good faith contract with another
party to perlbnn Ilia work covered by said bid, then this obligation shall be null and void, otherwise to remain in full lire and ellbcl. The
Surety hereby waives any notice of an agreement between ilia Owner and Contractor to extend the time in which Ilia Owner rally accept the
bid. Waiver ol'notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time liar
acceptance of bids specified In ilia bid dnennients, and Ilia Owner and ClIllivactor shall obtain Ilia Slnely's consent for all extension beyond
sixty (60) days.
If this Bond is issued in connection with a subcontractor's bid ton Contractor, the temi Contractor in this Bond shall be doomed to be
Subcontractor and the tcnn Owner shall be downed to be Contractor.
When Ihis Bond has been lurnished 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 herefrum and provisions coniimning to such
statutory, or other legal requirement shall be deemed incorporated herein. When so ILmished, ilia intent is that this Bond shall be construed
US a statutory bond and not as a conunon law bond.
Signed and scalcd this 26th day of July.2016
(�'fniess)
�jt.G�, U ✓�'
lIJ'iaressy
Fire Service, Inc.
(Principal) (seal)
By
(Till)
RLI Insurance Company
(Surer}) (Sett)
By:
(Tfrt)DeAffna M. Maurer Atto ney-in-Fact
S-0054/AS 8/10
RL I ® RLISurety
902
9025 N. Lindbergh Dr. I Peoria, II.61615
Phone:(800)645-24021 Fm:(309)689-2036
w .rlicorpxom
Know All Men by These Presents:
POWER OF ATTORNEY
RLI Insurance Company
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the
approving officer if desired.
That RLI Insurance Company, an Illinois corporation, does hereby make, constitute and appoint:
Lisa A. McAleenanAnne M. Gliedt Teresa M. Sheppard Kevin E. McDaniel Stephanie L. KlearmanDeAnna M. Maurer Kayla
Woodward, jointly or severally
in the City of Saint Louis State of Missouri its true and lawful Agent and Attorney in Fact, with full
power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, the following described
bond.
Any and all bonds provided the bond penalty does not exceed Twenty Five Million Dollars ($25,000,000.00).
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon this Company as if such bond had been
executed and acknowledged by the regularly elected officers of this Company.
The RLI Insurance Company further certifies that the following is a true and exact copy of the Resolution adopted by the Board of Directors
of RLI Insurance Company, and now in force to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of
the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board
of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint
Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate
seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The
signature of any such officer and the corporate seal may be printed by facsimile."
IN WITNESS WHEREOF, the RLI Insurance Company has caused these presents to be executed by its Vice President with its
corporate seal affixed this 23rd day of March , 2016
ooaPOnArt -•'
SEAL...:'
State of Illinois
SS
County of Peoria
On this 23rd day of March 2016 , before me, a Notary Public,
personally appeared Barton W. Davis , who being by me duly sworn,
acknowledged that he signed the above Power of Attorney as the aforesaid
officer of the RLI Insurance Company and acknowledged said instrument to
be the voluntary act and deed of said corporation.
JacquA<� Notary Public
OFFICIAL SEAL"
CJACQUEUNE M. BOCKLER7
C
\u uuuuuuu�u��uual
RLI Insurance Company
By: �CJ'w
Barton W. Davis Vice President
CERTIFICATE
I, the undersigned officer of RLI Insurance Company, a stock
corporation of the State of Illinois, do hereby certify that the attached
Power of Attorney is in full force and effect and is irrevocable; and
furthermore, that the Resolution of the Company as set forth in the
Power of Attorney, is now in force. In testimony whereof, I have
here to sgLmy hand and a seal RLI Insurance Company
this da—y of
RLI Insurance Company
By: /,
Barton W. Davis Vice President
2463207020212
A0058514
O� rL
CITY OF SOUTH BEND, INDIANA
SELLER'S BID FOR SALE OR LEASE OF MATERIALS
NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND
NON-DISCRIMINATION COMMITMENT FOR SELLERS
BID NAME: Spec AA — Two (2) More or Less 2016 or Newer Refurbished Medic Units
FOR BIDS DUE: July 26, 2016; 9:30 a.m., Local Time
Bidder
Date: July 25, 2016 (Firm):
Address: 9545 N Industrial Dr
Fire Service Inc.
City/State/Zip: St. John, IN 46373 Telephone Number: (219 ) 365-7157
Agent of Bidder (if Applicable): Shawn Junker
When the prospective Contractor is unable to certify to any ofthe 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 Indiana )
) SS:
Lake 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. 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, 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 employment,
or any matter directly or indirectly related to employment because of race, sex, religion,
color, national origin, ancestry, age, gender expression, gender identity, sexual
orientation 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 may consider the
Contractor's good faith efforts to obtain participation by those Contractors certified by
6
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.
In no event shall persons or entities seeking the award of a City contract be required to
award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate
against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE
Utilization Board shall prohibit that person or entity 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 for 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 on this project if awarded. I
understand that violations hereunder may result in forfeiture of contractual payments.
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid
for public works are true and correct.
Dated this 25 day of July 20 16
RACHEL K. SUGGS
Notary Public- Seal
State of Indiana
My Commission Expires Jul 10, 2020
Fire Service Inc.
Contractor/Bidder I irm)
Signature of Contract dder or Its Agent
Shawn Junker VP
Printed Name and Title
Subscribed and sworn to before me this v2S day of JLJ V 201(,e
My Commission Expires :It,! id
Notary Public —�
County of Residence L A, do G
(To be completed only by ContractorsBidders claiming to be a "local Indiana business"pursuant to I.C. 36-1-12-22)
IiNUTAINA LUUAL 1SUNINENJ
A "local Indiana business" refers to any of thefollowing:
(I) A business whose principal place of business is located in an affected county.
(2) A business that pays a majority of its payroll (in dollar volume) to residents of affected counties.
(3) A business that employs residents of affected counties as a majority of its employees.
(4) A business that makes significant capital investments in the affected counties as defined in rules adopted by the political
subdivision.
(5) A business that has a substantial positive economic impact on the affected counties as defined by criteria in rules adopted by
the political subdivision.
An "affected county" refers to St. Joseph County, Indiana, or the fallowing counties located adjacent to St. Joseph County:
Elkhart County, Marshall County, Starke County and LaPorte County
There are the following price preferences for supplies purchased from a local Indiana business:
• 5%for a purchase expected by the purchasing agency to be less than $50, 000
• 3%for a purchase expected by the purchasing agency to be at least $50, 000 but less than $100, 000.
• I %for a purchase expected by the purchasing agency to beat least $100, 000.
Date:
Pursuant to I.C. 36-1-12-22,
preference for Project
South Bend, St. Joseph County, Indiana.
claims a local Indiana business
(Project # ) located within the City of
❑ The location of the principal place of business is
(Address)
❑ St. Joseph County, Indiana
❑ The following county located adjacent to St. Joseph County, Indiana:
❑ The majority of the business's payroll for the 12 months prior to the date of this Bid is to residents of St.
Joseph County, Indiana or the adjacent county noted above.
❑ The majority of the business's employees for the 12 months prior to the date of this Bid are residents of
St. Joseph County, Indiana, or the adjacent county noted above.
If the business is deemed to be the apparent lowest, responsible, responsive bidder, then it shall provide
supporting documentation for the 12 month period prior to the date of the Bid of (i) the total payroll
amount paid to all employees of the business, and (ii) the total payroll amount paid to employees who are
residents of St. Joseph County and the adjacent county noted above.
WHEN SUPPLYING SUPPORTING PAYROLL RECORDS, BIDDER SHALL REDACT ALL
SOCIAL SECURITY NUMBERS.
Dated this day of
PTO]
Contractor/Bidder (Firm)
Signature of Contractor/Bidder or Its Agent
Printed Name and Title