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Home My WebLink AboutBid/Contract t'" : Prescribed by State Board of Accounts Form No. 96 (Revised 2000) 0, CONTRACTORS BID FOR PUBLIC WORK PART I (To be completed for all bids) (Please type or print) Date: /;).-11-07 1. Governmental Unit (Owner): Jt4f'r J~A.J;JI(, S~t...,,/ gl)c".J 5. Agent of Bidder (if applicable): ceo-- I( 7 e....-- (}.,....I......,I: "'II L (.. C. 1'1 ~f~ e.;I,...J Sf. (II,.... ,L: J, ..J,IV 'f?1 'f 3 . '1,').- ~o,'-f"" lJ,rf 1"1 A 2. County: 3. Bidder (Firm): Address: City/State: 4. Telephone Number: Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of (! : 1-, of ~ 1-/,,.. J 0"'''': If" .IIII (Governmental Unit) in accordance with plans and specifications prepared by "JT L l~,'", #,"J, CJ..... /('v;/If, :tAl and dated '-&1./b07 for the sum of 1*' w. /1....,,),.,,1 IV.'... 1-, fu~" lL.,.,~. ..JTL~c. J/-./,.J h."7 rJ.nr...rx ~ c:y '1/ g Y ls;.!!. 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 Governmental Unit. If the bid is to be awarded on a unit basis, the itemization of the 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) r'\ I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation to use steel products made in the United States. I.C. 5-16-8-2. I hereby certify that I and all subcontractors 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. B-102 ~ ACCEPTANCE ~~... The above bid is accepted this 5-rrt day of ~~, 2U;Je; . subject to the following conditions: - N,,~E.- \.., f'1'~01Z ~ ftN \ -pe.es. tut~~~ '13\,^-S~, I Sl~ 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 thousand dollars ($100,000) or more. (IC 36-1-12-4) -;Je If,r Sollv:/lt Sp""".r /oerJ Governmental Unit: T eo..., (\... fr. ~j: II J, J. /" e. I ~.. ,,- 0 7 Bidder (Finn) Date: ~~ These statements to be submitted under oath by each bidder with and as a part of his bid. Attach additional pages for each section as needed. SECTION I 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? When Contract Amount Class of Work Completed Name and Address of Owner A (,"" If t "" t.,. II 2. What public works projects are now in process of construction by your organization? When to be Contract Amount Class of Work Completed Name and Address of Owner ~ y",," pl'f'c ( ,-"t;/' .;:-~. 8-103 ~l .1. Have you ever failed to complete any work awarded to you? ,110 If so, where and why? -~ " / 4. List referenced from private firms for which you have performed work. f,,. /J-fJ"cL,J SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, completed the project. number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.) 1--1~,,11 So_t:~I-, /..C'7 f"/~ Pj, ~..it""f.hV't.li T,,,"lct.. fJ.h~ e,.ft; R 04,. · I-;..^ ~.~\ 2. If you intend to sublet 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. 7b B t !1.I6"" .rrrP 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 governmental unit. f~r /J-{-r..-Co L,) 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. Yfj ~\ r ,I 8-104 ~ cr, SECTION'" CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the 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. ~ r It- -f+ "'c l...1 SECTION IV OATH AND AFFIRMATION I hereby affirm under the penalties of pe~ury 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 /fI,....., L:); .:i:AI this / I t} day of p, e. 2.Q;)7 . f:......f./o-e I:,. By m~.., .J ,...... (Title of Person Signing) ~~;~: :/ \ ACKNOWLEDGEMENT STATE OF COUNTY OF IN CLh~1( ) ) ) tn t.lv: '" L" Ih...o"\ .) 0"", tn,r (Title) . , being duly sworn, deposes and says that he is of the above -r ~ ..... (lC",., 1-,.,.. Co, J: ;'\ ~I L.l.. C!.. (Name of Organization) and that the answers to the questions in the foregoing questionnaires and all statements therein contained are true and correct. Subscribed and sworn to before me this Jr I. t1 /1- day of /-"c. /1 ,/l I ,'VI /l L",I t.j"rV LZ. . fj 2007 , "1"'\ L9;J0~ Notary Public My Commission Expires: ,;{- <,0. - {5< () D '8' , - County of Residence: WtJ..61u rzt) !-{)/'"'[ / ~, 8-105 ~-0 / ~ .r--~ , . .~ NON - COLLUSION AFFIDAVIT The undersigned bidder or agent. being duly sworn on oath, says that he 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 include 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 corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale. OATH AND AFFIRMATION I affirm under the penalties of perjury that the foregoing facts and information are true and correct to the best of my knowledge and belief. (YJ L. !j /) , "", ..) I 1N this / / day of Vi' <:. . I ~~)' t!;e. By ~ - ..1 9 ZO'L o l' ''''. rn · ) ".... I (Title of Person Signing) Dated at 2cb7 ACKNOWLEDGEMENT STATE OF L./\/ c.l..A/l.K ) ) SS: ) COUNTY OF (Title) 1'1 ( 'v.. '" L, "" 0;'1.) 0, ,;". ;n."'J ,/ I ~ being duly sworn, deposes and says that he is of the above If'tt:''''''' Ceo.., j. /rc l "'), L I.- e (Name of Organization) and that the statements contained in the foregoing bid, certification and affidavit are true and correct. Subscribed and sworn to before me this / I b day of p, Co '. '~ ,-;zoo 7 &u~~ 6 (~ . Notary Public My Commission Expires: ~" ~ - 6~ D IJ g County of Residence: b\..) OlS JUllt) +0 /l 8-106 ! .J ~ '- 0 ~ ~ C rn rn ~ 0 ~ t) '0 ro '0 ) V-E ~ M (f) --..) 0 :).... I- " ~ ~ () "-"') ~ -..) - ~ r'" UJ ~ l",,\ -, ~ ~ ~ 0 ....:.: . ~ 'i ....... .. c ~ - a.. - 6 " " ....... 'w r- 0 ~ - - ) 0 ~ ~ U- - () N . ~ - . '0 U- (" ~ 0 0 ) (; \ Q) .) rn o '" ...... ~ (' ..., - ':; "" U- ...... Q) oc::J 0 " ~ ~ . . "'" , .-..,.,/\ <""6 -.a S ~ C'\ co \ 0> OJ ~ .... ... ~ ........ 0 0- f () ~ c z " ... ~ Q) \~ .)- ~ ::J ~ E ro - CO K ..... 0 c u. :J 0 -0 ~ a.. ..!!! u:: ~\ 8-107 ---,'/"" ~,. ~ ,1. .,1 TO THE BIDDER- The following Form 96a is not required by the State Board of Accounts. However, the bidder must either use this form or one similar to it prepared by their accountant. JACOBI, TOOMBS AND LANZ, INC. S:ISydneyIWPDOCSlmlsCellaneousIMASTERldIVB,wpd B-108 .' General Ponn No. 96-1lI Prescribed by the Stllte Board of Accounts of lndillnll. Revised 1'949 STANDARD QUESTIONNAIRES AND FINANCIAL STATEMENT FOR BIDDERS Prescribed by THE STATE BOARD OF ACCOUNTS OF INDIANA For use in investigating and determining the qualifications of bidders on public construction when the aggregate cost of any such work or improvement will be Five Thousand Dollars or more. These statements to be submitted under oath by each bidder with and as a part of his bid, as provided by Chapter 305, page 1248, Acts of 1947. /Ov.-. 0 -P J'~;t 1'1' Jo /l "',' /I~ ,$A1 .. ~ .....- ---.-..- ------- .-..----. -------..... -..-.. .......................... -. .......... ............. ............. ............... .............................. .......... ........-.... .................... By mm..m.......Tr::.~_~.....g~~..~::...~..~f:~~.h....~.~_.~........m......... ~ ~~~~:t:~~hip An individual Submitted to IV ~ fa. e.; Ir o.,J Jf. .................................................................................................................................................................................................-......................-........................................ (Y},,,,,, 71....J ..IN V7/~J ............ m ............./-..m.... ../............. ......................... ................................ ..................... Date submitted ..............................i....~.:.~..~~.~...~..?............................... 20..9..2...... Address Filed At'. BOYCE, MUNCIE, IND ~" S:lSydney\WPDOCS\mlscellaneous\MASTER\dlvB.wpd B-109 Submitted by ...m............m.T::...:~....9~.~.!.~:.~.~~.jL...'-:!:..~..................m... ................................m..... A Corporatio 0- a nershi] An Individual --. ~.r" \",-,J " Princi al Office at I '1 , I ;l eo: / ro .,J J I. p ...... m.......... ............ ...... ................................. ..... ....... .................. ........ ... ......... ..................... ......... ............... ........ ....... I ............. ..... .... .... .._...... ..... ........r!!. ~.:./. .~.~~~!. ...!....~.... ~.?. ~.~. ~... ..... .... .................................................. .............. .u. ..................... EXPERIENCE QUESTIONNAIRE The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatoric hereinafter made. 1. How many years has your organization been in business as a general contractor under your present business name? ............... .................. m.......... .............................. ..fJ...... on.................. m........................................................ ..u...m...... .... .... u..... ...... 2. How many years experience in construction work has your organization had (a) as a general contractor; and (b) as a subcontractor? ....m ...........m................../~mm.........................m.m............ ....... .m.... ...... ... ............ ..... ....... ... ....... ................. 3. What projects has your organization completed? ...................................................................m............................................... CONTRACT AMOUNT CLASS OF WORK WHEN COMPLETED NAME AND ADDRESS OF OWNER .................................................. .... ...........t...~~..... !!.'..!!. .':!...~ .~' ..~.~.... ........................................ ................................................. .. 3a. What projects does your organization now have in process of construction? ~r\ CONTRACT AMOUNT CLASS OF WORK WHEN COMPLETED NAME AND ADDRESS OF OWNER ...................................................... ............ f. ~ ~.. ... ...!!:. .c.~t!:. .:. ~. ~.'!!... ............. ..... ........... no... ..... .. u.... on........................................ 4. Have you ever failed to complete any work awarded to you? If so, where and why. . -.... - - -......... -.............................. -....................... .ytl-7iJ..... .............................,. -. -..... -.... - -........................................................................ 5. Has any officer or partner of your organization ever been an officer or partner of some other organization that failed complete a construction contract? If so, state name of individual, other organization and reason therefor. ........ ......... ........ ..... ................. ..... ....... ... .... ......... .N.'!?.. ........ ...... ........ ............... ....... ....... ......... ...... ........ ...... ............... ... .... ....... ......... 6. H;~.~~y.~ffi~~~..;~.p~~t~~~.;f.y;~~.~~g;~i~~ti~.~.~~~~.f~il~d..t~.~;;~pl~.t~.~.~;;~~t;~~ti~~.~~.~i:~~~t.h;~di~d.i~.hi~7h.~~.~~ name? If so, state name of individual, n~ .ft owner and reason therefor. 7. In what other lines of business are you financiaYl interested? . ...... _.................................................... ........... _.......~. ~......... _............... m...................................................................................... ~\ S:\Sydney\WPDOCS\miscellaneousIMASTERldlvB. wpd B-ll 0 8. For what corporations or individuals have you performed work, and to whom do you refer? ::::::::::~:::::::::::::~::::::::::::::::::::::::::::::::::::::::::::::r.~::::'!.:T.r.~::0!!.::~~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 9. For what cities have you performed work and to whom do you refer? :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::r.f~:::/f-r.!:?!.:~!!.::~!!.:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 10. For what counties have you performed work and to whom do you refer? :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::tt.g:::::?ft.f:?!.~:l!!.?!:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 11. For what State bureaus or departments have you performed work and to whom do you refer? :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::f.:r?:::::::!f.:t!.?!.~!.~I!!..:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 12. Have you ever performed any work for the U.S. Government? If so, when and to whom do you refer? ~,r, ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::r.:f~:::::ifrliJ.(lJ.::~~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ..---......-----..................................................................................................................................................................................................-..........................................................................................................................................................................- 13 What is the construction experience of the principal individuals of your organization? YEARS OF PRESENT POSITION CONSTRUCTION OR OFFICE EXPERIENCE INDIVIDUALS NAME MAGNITUDE AND N WHAT CAPACITY TYPE OF WORI< ..... ... .-... ....... ............ ........... .. ... .... ....... ............ ...... ........ -.. ..fi'i.....;tj.if/4..c.; "f p..... ............. ......... ...... . ............... ... .......... ......... ..... ,,--...r-"\ S:\Sydney\WPDOCS\mlscellaneousIMASTER\divB. wpd B-ll1 PLAN AND EQUIPMENT QUESTIONNAIRE The g),gnatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatorie~ hereinafter made. In what manner have you inspected this proposed work? Explain in detaiL .......................--............--.....--.......;;z.......OIiJ.iTr.e:;.....vi"J.l7.S..--....--..............--...........................--.--........--.................--...--........ ........................................................_........................................____.............................................................................................................u...................................................................----.................................................................................................... .............................................................................................................................................................................................................................................................................................................................................................................................................. ..................................-............................................--.........-.............................-......--......................................................-....................................................................................................-......................................................................................... 2. Explain your plan or layout for performing the proposed work. ........................................................................................................................................................................................................................................................................................................................................................................................................ ...................................... ......... ....J:t.;,;....r i..'..'...'" --....-- .... ... ...m. m'.'. .----......... ....... .............. ................. -- ...... -- ..................................... .................... __............. -- --". -- n..... S -.q~::.o;';'. r............ n --...... m..'" .... m.... ..--. --.. ... ... ........ --...... n. n..................... --.. ..m...... ......... '..'."."."....' ....................... __ __....... ................"i./i-. 'to,,:s, 70. "j!.. 'iii,.' n... o..........m........ n........ m..." n......... --.'.'. --.... n n..................................... m." --.... .... ::::::::::::::::::::::::::::::::::::::::::::::::::~~~~::::~:;:;:~:~:~:~:~:;~:::::~:;:::~;;:;:;:~::~~~;;::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::!l~t:~;::Tt..:::::~:~:~~:?~:~:::~~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: s 1-" d "'-'.5 I- - wJ ....................-..........................................................................................................-..................................................--...................................................................-...................................................-...........................................................' ..........................................................................................................................................................-....................................................................................................................................................................................................................... ............................................................................................................................................................................................................................................................................................................................................................................................... .. ....~~.. ............................ ............. ......................................... ............... ................................. ............................... ................ ................................................................ ...... ..... .............. ............................. ................................ ......... ............................. ...........................................................,.................................................................................................................................................................-..-.................................................................................................................................................................... ..............-....-..-.-...........-............................--..............-........--..............-.........................................................................................................-..................................................................................................-.............-......................-.............. ........................................................................................................................................................................................................................................................................................................................................................................................................ The work, if awarded to you, will have the persqnal supetvision of whom? (Y), Iv~'" L,. '"" ,,~..) 3. A""""'""< ,--" .~ .................................................................................................................................................................................................................................................................................................................................................................................................. , ............................-...................................................................................................................................................................................................................................-................................................................................................................................... 4. * Do you intend to do the hauling on the proposed work with you own forces? If so, give amount and type c . ..__~~~~~.~.~~.~~.~.~..~~.~~'....m........ .m... mr~~......(!..~.:'.:.~...~~.~.....m.......m....m..... ....... ....... ....... "'.". ......... ........ ...... ........ ...... ... ...................................................................................................................................................................................................................................................................................................................................................................................... 5. * If you intend to sublet the hauling or perform it through an agent, state amount of subcontract or agent contract am if known, the name and address of subcontractor or agent, amount and type of his equipment, and financi: responsibility. ..-...............................................................................................................................-...................................................................................................................................................................................................................................................... ...---...........-.........-..............................................................................-................-.........................-.......................................................-..............-...............................................................-.......................................--.................................................... ....................................................................................................................................................................................................................................................................................................................................................................................... 6. * Do you intend to do the grading on the proposed work with your own forces? .......................................................................................................................................--...................................................................................................................................................................................................................................................... ::::::::::::::::::::::::::::::::: ::::::::::::::::::: ::::::::::::::::f tJ::::::::: ::::::: :::::: ::: :::::::::::::::::: ::::: :::::::::::::: :::::::::: ::: :::::::::::::::: ::: :::::::::::: ::::::::: ::::::: :::::: ............................................................................-..................................................................................................................................................................................................................................................................................................... ................................-.................-..................................................................-..........................................-............................................................................................................................................................................................................................. *.......1 ~;;;.. 4: ~;'-6 -;~d. 7" ;';~y" ~;'''( "b~" ;ppl1;~bi~ "i~:;li ~ild"i~g ~~~;~~;;: "ir'" ~-;;t:"~~it:""'''''''''''..''''''''''''''''''.''''''''''''''''''.''.'''''''''''''''''''''''''''''''''''''''''''''.'''''''''''''.''''.''''''''''''''''''''.'''''''''''''''''''''''''''''''''''.'''''.'''''''''''''.''''''''''. . .r--~ S:\Sydney\WPDOCS\mlscellaneousIMASTER\dlvB. wpd B-112 7. * If you intend to sublet the grading or perform it through an agent, state amount of subcontract or agent's contract and, if known, the name and address of subcontractor or agent, amount and type of his equipment and financial re~ponsibllity . ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::~I!:.:::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::: :::::::::::::::::::: ~r ....._-~..............._......................-....................-....-... ................ ........................................ ............. ........................--............................. .......... .......................................... .............. ............................ .............. .............. .............. ........................................... .......... 8. Do you intend to sublet any other portions of the work? If so, state amount of subcontract and, if known, the name and address of the subcontractor, amount and type of his equipment and financial responsibility. ..................................................................................................................................................................................................................................................................................................-...............................................................................................----............. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::7J!.:::::::~~::::::::!.'!.~::~:~:!T..:~:~:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ..-............................................--....................................................................................................-....................................................................................................................................................................................................... 9. F~:;~.:;hi~h.~;b.~.~~t~~~t~~~..~~.~g~~t~.d.~.y~~. .~~p~~t.t~.~~qci~~.~.b~~d?. ... .............. ..................................... ....... ...... ........ ...... ............................................ ....................... ......... .....illii ~i' i:,:...... .................... ........ .............. .............. ....... ........... ........... ........... ......... .. ..........................~........................................ .......... .......................................... ................................................................................ ....................................... .................................................. ....................... ......o................ ................................... ..........................................................................................................................................o............................................................................~............................................................................................................................................................ ..........................-.....................o...................................................................................................................................................................................................................................................................................................................-............. 10. What equipment do you own that is available for the proposed work;> DESCRIPTION, SIZE, CAPACITY, CONDITION ETe. QUANTITY ITEM YEARS OF SERVICE PRESENT LOCATION .... ..-.......... ................ ................................ ................... ........ ......................... ......- .............-................................................. ..........................................................~... ............................... .............. ............. ...... . .............. ................ ........ ........ .............~ P f It, frr r I C {-f f tJ ..._............................................................ ................................................__...... ............l......................._.......................... .................--....................................-- --..............-....................---................. ....................................................................... ........................................................ ........................-............................. .............................................-.................. ..............................-........................... ..............-..............-............................. ............................................................. ~r\ " ...... ............. m.... ..... .. ............ ...... .m' ....... ...... ... ... ....... ..... .............. ..... ..... ...... .............. ..... ................... ..... .......... ...... ... .............. ............. .-..........--...................-..-........................ ..........-........................................... ......................-....-...............-..................... -.............................................................. ......................................................... ............................................................... ..o........................................................... ......................................................... ..................................................................... .........................................-................... ................................-........................... ........-..................................................... ................................ ................... ..... ......o ........ ..................................... ........... ... ................. ..................... ... .................. ........ ..... ...o........... ......................... .......... .. .................. ....... ..................~........... ... ............. ....... ............ ................... ........... .......................................................o............ ........._................................................ ............................-.................................. -........................................................... ............................................................. ................................................................ ............................................................ ............................................................... .......................................................... ................................................................. ............................................................. .................................................................... . .......... ......... ................. .................... ...... ... .......................... ....... ..........- ....-.. .... .............................................. .......... .......... .... .............. .............. .................. ................................. .....~............. ........... .......... ..... ...... ..... ............. ............... .......... .................................................................. ..................................................... ................................................................. ........................................................ ........................................................... ............................................................. ................................-.............................. .....................-................................-.... ........-................................................... .................................................... ....................................................... ............................................................... .............................................................- ...................................-................. .............................................................. .............................................................. ............................................................ ........-..............-............................... ~\ S:\Sydney\WPDOCS\mlscellaneous\MASTERldlvB.wpd B-113 11. What equipment do you intend to purchase for use on the proposed work, should the contract be awarded to you? APPROXIMATE COST ~UANFITY ITEM DESCRIPTION, SIZE CAPACITY, ETe. ----......................................-.......... -.--........................................--.................. ................. .W~..-e;......"..."...".". ........................ ..................... ..... ............ .................. .............--.................................................... ..........---........................-............................ ...............................................................................................................................--..................................---..................................- ................................................................... .........---.................................................... .................................................................. ................................................................................-.......................................................................................................................... ................................................................ ..... -..- -.................................. ~. ~..... ~. ~.. ~ . ~......................_........ ............ -......... ..........~............................ ~............ ................... ................ .......... ..................................................... ......-.. .................. ............ ..... .......... .............................. ..... ..~.......... ............... ................................. .................... ..................................... ..... ............................... ............................. .................................................................~...... ................... ................................... .............................................................. .................................................................. ............................................................ ......................................................................................................................................................................................... ............................................................... .............................................................. ..........................................--................... .......................................................................................................................................................................................... .-................................................-.......... 12. How and when will you pay for the equipment purchased? rv/r+ ................................................................................................................................................................................................................................................................................................................................................................................ 13. Do you propose to rent any equipment for this work? If so, state type, quantity and reasons for renting. .................................................................................................................................................................................-............................................................................................................................................................................ ............................................................................................................................................................................................................................................................................................................................................................................... .................... ............. .......... _... ...........................!J./D............. ..... ... ....... .... ..... ....... ...... ......................... ............ ....... ................. .............. ....................................................................................................................................................................................................................................-.............................................................................................................................................. ............................................................................................................................................--...............................................................-....................-.....................-...................................................................................................................... ---." /". 14. Have you made contracts or received firm offers for all materials within prices used in preparing your proposal? Do m give names of dealers or manufacturers. .................................... .... ............................... y... f...s............ ........................................................................... .......... ............................ ........................................................................................................................................................................................................................................................................................................................................................................... (t1~"'I~..jl ;[..Ai this .. II e da of j}"C, 20 07 .. ............. J................................... ............................................ y ....................... .................................. ..............' Tec.hl CC"'\ J,.. ~ t :")/ /...t."C- By n 0 no_ _...--::-;'"~:-::-::::::--:: ................ ........ ...(!;....~.~.~;il~~~~:S:i~iJ~.-::................ .................. Dated at COUNTY OF ::eN ......... .... ...................... ............. ) CLAeK )5S: ..... .... ............ .......... ................. ) STATE OF ...........__.....I!!.~~..":..;....;.~..-:..~.~.~..............................................being duly sworn, deposes and says that he is a member of ............L~.~:':......~.~...:..~~...:~.:..k...~!:-.~..........................................and that the answers to the questions in the foregoing (Name of Organizahon) ~~ questionnaire and all statements therein containeg are true and correct. p, ~b:~=s~~:ns:o~e~o me ~hi~ ~..~..}j~irzf-.i.......................day of ...........~..:.:...._....................................20 ..9..7................ y p ........................-..................................... . ~ L-~ " fpVJ....-t" I . )1J?"L"t1.._-) ....e.,..._.............,............"...,....... ....,..... ........... ...."...._...................-..._............~ {!/J,ro/ i::>.. ottke S .- Af().J..ar7 S:\Sydney\WPDOCSlmI5cellaneou5\MASTER\dlvB. wpd B-114 !\ ~ r\ ;,:nJ/\'N('~HF.L TI.(JtRACE COMBINED SEW~~R SEPARATION PROJECT, :Y~"t~_~'(). 0720 ~.~..l"~,,....-~- API'ROXlMATlt, DESC1H~!TON WITH UNIT UNJT PRICE IN TOTAL AMOUl'T nn-CM ]'.0. c:; UANTITY PRICEw'6~~~EN IN NUMIH.;RS FOR lltn TTE1\-1 . - ---'-' IS-inch Cured. in-Place Pipe Liner J. . For.w..t. ~~.."/.... 'Y~'.~.~.." ... .. ..... ",...". M........... .Dollars Per Linear Foot 11 ,. t.. ~ Rev. 12/5107 '::":::;;;;~,,;;~.;,;';'7,,~;:;::-.~~.~~ lJf LF $ 'CJ 0'" - $ 0; 3 fY ~ 2 "l1 ( 5 Lf 12-inch Cured.in.Place Pipe Lir~r For...... r.f!.~,~1- P~~".... ..... p~~' I~ i ;;~~; . i.: ~:~~ .... ..Do 11 ars $ Ii J ";: ___.....~_~_.--.___.__._..,._.,_L__.... Suinch Cured-in-Place Pipe ;;~~~.~'... T. ~:~~. 7..... ~.'~ {... ..... Perl :i;~~~;.~~~~~,.....Dollars $ :3' ~ · 34~ 1.F h-""',"",,'.----"""-- I.; 1:';(,1 LF 12-inch Rep ~\orm Se'wer fOf.. fl!:.~~...~... f::,,:~.:..... -0 t. ..... .....t?............. ...Dollars Per Linear Foot $ 9S~ " 19 EA Catch Dasin. Tvpe 'C' J FOL......7 ~.~ .'~~. ./~":.~. ~':"..,. .H' ............ ................ Dollars Per Each .. $ / ~O~ - "',.".,......,.,'''''',~'''',.....,..........-..__.,.,~.,"._--_.,--' ,------ --,...--.---------....- (. 21A Catch Basin Type '.I' . J For... ..1.1:.' #-"',~, ...J:I:.~,,:,:1.:~ ....................... ...Dollars I 3 DO '!.! $ .Co ;1. I ~ r;() - $ '} lIS Pe.r bach D<)watcring for C.I.P.P. Installation (if required) fIoL. ..... .~~..;..,.., .'" .... ........................".. .I)oJ1al's / '!.! .!~~.~._l:.~~J~_~~~_._.._.._~,"_...- Surt~lGe Milling For........Q~. .R.~.!(~"...... . ..t.. .~.. .~~. ~;~t~....BlJll,Jll:s' Per Squair.: Yard S I. ~ $ ... 00 YS: 30.;) - I $ /;1., 3Y8'I/>~ -0 $ JtJ3'3YS~ 'j - $ .. ?- ~ fOe;) - - I $ I~ ;.< 3,'/00 SYS ~;. t:,:!drV''''i't'LH)CS\fn\(,!i'111\hC:C1\~ '","'PD A~209 $ -.f , ..;1 " ~ 7 ,1. BLANCHEL TERRACE COMBINED SEWER SEPARATION PROJECT, JOB NO. 0720 ITEM NO. 9 10 11 12 r''\ '""" 13 14 15 r, APPROXIMATE DESCRIPTION WITH UNIT QUANTITY PRICE WRITTEN IN WORDS 200 TONS INDOT, Surface Type Asphalt S' l- F or............. ~ l." .t. ...........".... ............................. . Dollars Per Ton 1175 LF 6-inch Stand-up Concrete ;~;~.... (... ;,~".~ .~...:... ~..~.. ............................ ..Dollars Per Linear Foot UNIT PRICE IN TOTAL AMOUNT NUMBERS FOR BID ITEM $ ~ () oj; O. $ I ~ (:JDd -- DO $ /~ rSO - O. $ -;l, (7i?D - ...., ClIO . $ tJI'o, t-t70 - 0- $ / yo c - .. $ I, 0 'to - I o. $ I'c.:ro-- $ / r~ 1 LS Traffic Control I For........7:. ":':.~... !..~~.:~........ P~~'L~~~'S~......Dollars $ (;2, Of) r:; ".; Downspout Disconnection @2 Blanchel Terrace Sheet #1 I For..:.:.. :!~~.'1.. ~.:"t........... P~;L~~'S~..."...Dollars $ eJ, &00 ~ Downspout Disconnection @3 Blanche! Terrace ~:;.~~. ~~ f::'J. .~. ~.~~~... !.f.~~~.1 ... ............. ..... ..........Dollars (;. Per Lump Sum $ I fa?- Downspout Disconnection @4 Blanche! Terrace . ~~;~t.~~~...!.~::.~.:.~.~... .............::-~.~.~.........Dollars .. ~ Per Lump Sum $ 1,0'(0- Downspout Disconnection @ 20 Blanche! Terrace Sheet #4 I /J yt/:,..,I-,....}I..... ,.v For..................................... . ....................."."...... .Dollars Per Lump Sum 1 LS 1 LS I LS I LS c;.oC $ I ~ OCl - S :ISydneyIWPDOCSlO7\0720IsecA2. WPD A-210 ry ;J, BLANCHEL TERRACE COMBINED SEWER SEPARATION PROJECT, JOB NO. 0720 APPROXIMATE DESCRIPTION WITH UNIT UNIT PRICE IN TOT AL AMOUNT QUANTITY PRICE WRITTEN IN NUMBERS FOR BID ITEM WORDS r, ITEM NO. 16 17 18 r, 19 20 21 1 LS Downspout Disconnection @21 Blanche! Terrace Sheet #5 For. u. u .~. (.~ /f.. u!.f~.~.... ... u ./1.". ~....":!..... u.... .Dollars Per Lump Sum $ Downspout Disconnection @ 22 Blanche! Terrace Sheet #6 J.. I fi. For.... ..T...:~ ,1... u. ~::~......... ..... H':.,,:.l.~.~.... u..... uDollars Per Lump Sum $ Downspout Disconnection @23 Blanchel Terrace ~:~t/'~ ~ ..!..':::.~.~ :~.'!...... ........... .:'. ~ .~tu... u.. ..Dollars Per Lump Sum $ Downspout Disconnection @35 Blanche! Terrace Sheet #8 ~ /II ." tt. }/... " ,1....y For............:......................... ........................ u.... .Dollars Per Lump Sum Downspout Disconnection @ 730 Park Place Sheet #9 F Tw 0 7J....""~#'...1J or...................................... .... ........ .t:':'..~....... ..... .Dollars Per Lump Sum Downspout Disconnection @411 E. Terrace Heights Sheet #10 /J rCl"'''' 11.",1......, For.... '1'; l.),:.............. u....... .............:......t........ .Dollars Per Lump Sum $ . .. :3 300 - 3 '/120 , lo$'O 9Jt $ Co ~.. 70() -- $ 0&1 3. 100- I 1 LS 1 LS 1 LS 1 LS 1 LS Co" $ ~,DdC) - .c. L/ S"o - $ 3Yoo 1 - Dc,. $ 'I 0 j 0 -- Q, oc. $ fOc:J - oc. $ ;;1., OClCJ - $ 'IS'o o..=. S:\SydneyIWPDOCSlO7\0720IsecA2. WPD A-211 )' f" r" ,i . .. BLANCHEL TERRACE COMBINED SEWER SEPARATION PROJECT, JOB NO. 0720 APPROXIMATE DESCRIPTION WITH UNIT UNIT PRICE IN TOTAL AMOUNT ITEM NO. QUANTITY PRICE WRITTEN IN NUMBERS FOR BID ITEM WORDS 22 1 LS 23 OEA Downspout Disconnection @ 420 E. Terrace Heights Sheet #11;-0...... /t...,t.J For........................ .............. .. ............................ .Dollars Per Lump Sum $ Standard Concrete Splash Block J For.... ...... .T~.':~..y............. .............................. .Dollars Per Each $ 6-inch Corrugated Plastic Pipe For......... .r:: f.~.:. ~.~........... ...... ......................... Dollars Per Linear Foot $ Downspout Elbow, Plastic J f For.... T.~.~:: .f..... :'.~.~.......... P~~'E~~h................Dollars $ ? 5' ~.. e;. 'I pc) - 3 t) o~ 24 OLF "... 0&# I::' - 25 OEA ,J 1>. $ 7 (;7()- $ - 0- $ -0- $ - 0- 26 OEA 27 5 LF Install Concrete Downspout Cap' , /I o "" !fo-";'" . v For..... "f"'" ~...................... .............: ~:.....t....... .Dollars Per Each $ 8" PVC Pipe Section Replacement, Sta. 7+30 to 7+35, If2~:B;/. ....t.,) For..........~........................... P~;r:~~~:F~~~......Dollars $ "3~c ~ _ ot. /~O - $ - 0- 28 1 LS .,. $ I, t,a> - T. V. Inspection Sta. 9+00 to End of Line, Line 'B' T..- 1-1.....1,..; For ....f:..l~ .... .... ............. .... P~~.L~~~.t~.......Dollars $ ~ S- {)f!:: $ ;2.SV~ S:\Sydney\WPDOCS\07\072O\secA2. WPD A-212 f'\ r\ r, 'J; BLANCHEL TERRACE COMBINED SEWER SEPARATION PROJECT, JOB NO. 0720 APPROXIMATE DESCRIPTION WITH UNIT UNIT PRICE IN TOTAL AMOUNT ITEM NO. QUANTITY PRICE WRITTEN IN NUMBERS FOR BID ITEM WORDS Manhole Lid R-1785, Type 'B' Self-sealing ~:~.~~~;4~.~;~.{~.~.~~:!. ..... ...............................Dollars S"O c) d>": Per Each $ $ SUMMATION OF ITEMS 1 THRU 29 = TOTAL BID PRICE = $ 29 3EA ArJ J ." .p... JI, '"' "':J.. AcK ^~ _I,. J)J'" J S:ISydneyIWPDOCSI07\072O\secA2. WPD A-213 I .5"'00 ~ ;;) , cI; '3 If 3 .s:.::.. r\ 1'" .J DIVISION B - CONTRACT FORMS SECTION B-1- CONTRACT DOCUMENTS 1.0 GENERAL 1.1 It is understood that the signature and seal of the CONTRACTOR on a properly completed and executed State Board of Accounts Form 96 indicates the CONTRACTOR's acceptance of all terms as set out in these specifications and documents and his willingness to complete the project as stated herein and shown on the drawings. 1.2 I t is further understood that by the acceptance of, and the proper afftxing of the signatures of the OWNER to the Form 96, that a binding contract exists between the OWNER and the CONTRACTOR. 1.3 After the OWNER signs the Form 96, and notifies the CONTRACTOR of his acceptance, the CONTRACTOR shall proceed to complete the project with the best workmanship possible conforming to all specifications set out herein and to all details, drawings and notes shown on the plans for this project. S:\Sydney\ WPDOCS\07\onO\divB. wpd B-101