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Prescribed by ~he State Booard of Accounts
Form No. 96 (Revised 2000)
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CONTRACTORS BID FOR PUBLIC WORKS
PART I
(To be completed for all bids)
(Please type or print)
Date: . 5/18/06
1, Governmental Unit (Owner):
CITY OF JEFFRRSONVTT.T.F.
2. County:
CLARK
3. Bidder. (Firm):
E H CONSTRUCTION, LLC
Address:
1188 E. BLUELICK ROAD
SHEPHERDSVILLE. KY. 40165
City/State:
4. Telephone Number:
(502) 957-7471
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5. Agent of Bidder (if applicable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to
complete the public works project of CITY OF JEFFERSONVILLE - KEN ELLIS SENIOR CENTER
(Governmental Unit) in accordance with plans and specifications prepared by THE ESTOPINAL
GROUP and dated APRIL. 2006 for the sum of
~~~I (V~ ~ rJ~~~ qOI. CJ7S".aD
The undersigned further agrees to furnish a bond or certified check with this bid for an amountspecified 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 the units must be the same
as that shown in the original contract if accepted by the Government Unit. If the bid is to be awarded on a unit basis,
the itemization of ~he units shall be shown on a separate attachment.
The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee,
or applicant for employment, to be employed in the performance of this contract, with respect to any matter directly
or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this
covenant may be regarded as a material breach of the contract.
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS
(If applicable)
I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory
obligationto use steel products made in the United States. I.C. 5-16-8-2. I hereby certify that I and all subcontrac-
tors employed by me for this project will use U.S. steel products on this project if awarded. I understand that
violations hereunder may result in forfeiture of contractual payments.
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NON-COLLUSION AFFIDAVIT
The undersigned bidder or agent, being duly sworn on oath, says that he has not, nor has any other mem-
ber, 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 leUing nor to
prevent al')Y perso.n 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.
He further says that no person or persons, firms, or yorporatiion has, have or will receive directly or indi-
rectly, any rebate, fee, gift, commission or thing of value on account of such contract.
OATH AND AFFIRMATION
[ affirm under penalties of perjury that the foregoing facts anq information are true and correct
to the best of my knowledge and belief.
Dated at
OFFICE
STATE OF KENTUCKY
. COUNTY OpBULLITT
JAKES A. HALL
this
18TH day of KAY.. 2006
(Title of Person Signing)
ACKNOWLEDGMENT
55:
being duly sworn, deposes and says that he is
and
MANAGER of the above E H CONSTRIJCTTON U C .'
(THle) (Name of o~ganizaiion)
that the statements contained in the foregoing bid, certification and affidavit are true and correct.
Subscribed and sworn to before me this
My Commission Expires:
4/02/2010
County of Residence:
BULLI'IT
. 18TH
day of ~
~
Notary Public
ACCEPTANCE
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The above bid is accepted this
conditions:
day of
. subject to the following
Contracting Authority Members:
PART II
(Complete sections I, II, III and IV for all state and local public works projects as required
by statutes if project is one hundred thousanddollars ($100,000) or more. (IC 36-1-12-4)
Governmental Unit:
CITY OF JEFFERSONVILLE - KEN ELLIS SENIOR CENTER
Bidder (Firm):
E H CONSTRUCTION~ LLC
Date:
5/18/06
These statements to be submitted under oath by each bidder with and as a part of his bid Attachadditional
pages for each section as needed. '
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SECTION 1 EXPERIENCE QUESTIONNAIRE
1. What public works projects has your organization completed for the period of one (1) year prior to the date
of the current bid?
Contract Class of Work When Completed Name and Address of Owner
Amount
II.
St. 725.000 NEW BLDG MAY~ 2005 1020 HENRY CLAY ST.. 'SHELBYVILLE, Kr
TWIN LAKES REGIONAL HED.lCAL .
lot Ii Q1 ~ ':t!.? ION JANUARY. 200. 910 WALLACE AVE LEITCHFIELD~ KY. 4~'
40065
754
2. What public works projects are now in process of construction by your organization?
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Contract Class of Work When to be Name and Address of Owner
Amount Completed
$3~131~855 RENOVATION JULY~ 2006 CITY OF JEFFERSONVILLE
IOUARTERMASTER JEFFERSONVILU
~ IN.
3. Have you ever failed to complete any work awarded to you?
NO
If sO,where and why?
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4. List references from private firms for which you have performed work.
SEE LETTERS ATTACHED
SECTION II PLAN AND EQUIPMENT QUESTONNAIRE
1. Explain 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 governmental unit to consider your bid.)
BEGIN VITH THE S;rTE DEKOLITIONAND GRADING VORK TO GET THE BUILDING PAD READY.
INSTALL FOOTINGS AND FOUNDATIONS~ FOLLOWED BY STRUCTURAL STEEL ERECTION AND
KETAL STUD GRADING. THE NEXT STEP WOULD BE TO COMPLETE THE MASONRY, ROOFING
AND WINDOWS TO GET WEATHER TIGIIT.
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2. If you intend to subject any portion of the work, state the name and address of each subcontractor,
equipment to be used by the subcontractor, and whether you expect to require a bond. However, if you are
unable to currently provide a listing, please understand, a listing must be provided prior to contract.
approval. . .
A SUBCONTRACTOR LIST WILL BE PROVIDED WITH THE BID, AS WELL AS A BID BOND.
3. What equipment do you have available to use for the proposed project? Any equipment to be used by
subcontractors may also be required to be listed by the govermental unit.
BACKHOE, SKIDSTEER, DUMP TRUCK~ SCISSOR LIFTS, SKYTRACK & ETC.
.
4. Have you entered into contracts or received offers for all materials which substantiate the prices used in
preparing your proposal? Otherwise, please explain the rationale used which would corroborate the prices
listed.
YES
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SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial state.
ment as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to
the governing body awarding the contract must be specific enough in detail so that said governing body can
make a proper determination of the bidder's capability for completing the project if awarded.
SECTION IV OATH AND AFFIRMATION
I hereby affirm under the peni3.lties of perjury that the facts and information contained in the foregoing bid
for public works are true and correct to the best of my knowledge and belief.
Dated at
OFFICE
this 18TH day of KAY
2006
E H CONSTRUCTION.. LLC
(Name of Organizati
(Title of Person Signing)
ACKNOWLEDGEMENT
STATE OF KENTUCKY
) .
) SS:
)
COUNTY OF BULLITT'
JAMES A. HALL
MANAGER
being duly sworn, deposes and says that he is
of the above E H CONSTRUCTTON, U.C
(Title) ( Name of Organization)
and that the answers to the questions in the foregoing Questiohnaire and all statements therein contained
are true and correct.
Subscribed and sworn to before me this 18TH
dayof MAY, ?noli.
~~.~
Notary Public 1
My Commission Expires:
4/02/2010
County of Residence:
BULLITT
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