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HomeMy WebLinkAboutBid/Contract r-\ Miller Pipeline Corp. 8850 CRAWFORDSVILLE RD. P.O. BOX 34141 INDIANAPOLIS, INDIANA 46234 TELEPHONE: (800) 428-3742 TELEPHONE: (317) 293-0278 FAX: (317) 295-6410 January 21,2008 City of Jeffersonville City Hall 500 Quartermaster Court Jeffersonville, IN 47130 RE" Eighth Street Emergency Sewer Rehabilitation JTL Job No. 07159 To Whom It May Concern: Please be advised that Miller Pipeline Corporation is in the receipt of Addendum 1 dated January 9, 2008 for the above referenced proj ect. This addendum contained the common construction wage scale to be used on the project. *~ed' Kevin Miller President .~.. r- In case of underpayment of wage to a worker on this project under the contract by the Contractor or any Subcontractor, the Owner shall withhold the difference between the wages required to be paid and the wages actually paid such worker and the Owner may disburse such amount so withheld by it for and on account of the Contractor to employee to whom such amount is due. The amounts withheld shall be in addition to percentages to be retained by the Owner pursuant to other provisions of the contract. This contract is subject to the "Anti-Kickback" (18 USC 874: 40 USC 276 (C)) Statute. r I -! ..6. , i \~.;oI I The prevailing wage scale as fixed and determined for the project may be examined at the Owner's address as given in the "Notice to Bidders" if not attached hereto. A 1 ,...:. I 'y , (" S:\Sydney\ WPDOCS\07\07159\secA2. WPD A-205 ~ 13.0 . BID FORMS ,ill "11 "~ ,. ~'. " CONTRACTOR'S BID FORM JEFFERSONVILLE SEWER BOARD CITY OF JEFFERSONVILLE 500 QUARTERMASTER COURT JEFFERSONVILLE, IN 47130 ~j i:Q 'II .~ \it RE: EIGHTH STREET EMERGENCY SEWER REHABILITATION MORRIS AVENUE TO SHORT JACKSON STREET JOB NO. 07159 .' L Gentlemen: ~ We submit, herewith, our sealed proposal to furnish all necessary labor, material and equipment to construct the above captioned project, in accordance with the subject plans and specifications at the unit prices listed herein. ~ 'wi ... '"'. III ,j -- .~. . - '.1 fjj -,,''4 . '.' S:\Sydneyl WPDOCSI07\07159\secA2. WPD A-206 ~;;i ... ~ ; .. ......... o \r -fI \r'"" .,;,;:. c EIGHTH STREET EMERGENCY SEWER REHABILITATION, JOB NO. 07159 ITEM NO. APPROXIMATE DESCRIPTION WITH UNIT QUANTITY PRICE WRITTEN IN WORDS 1482 LF 24-inch Cured-in-Place Pipe Liner For. N.tP.-.~:tY..7)fJ:Y.~............... .............................. .Dollars Per Linear Foot 30-hicl~ Cured-ih:Place.. . Pipe Liner For. .Que.. E@o.:r.e.o............... . ~~~~y.:: r.~ x~....... .Dollars PerLinear Foot $ 125.00 UNIT PRICE IN TOT AL AMOUNT NUMBERS FOR BID ITEM 1 $ 95.00 2 738 LF $ 140,190. 00 $ 92,250.00 3 1 LS Dewatering for C.I.P.P. Installation (if required) For. .T:w.euty.7.f.i v.e............... ...............................Dollars $ 25.00 4 1 LS Traffic Control For. .T:w.e.:o. ty.. .'Ib.o.v.~.t;l.uo....... ...... ...................... ..Dollars Per Lump Sum $ 20 .000.00 SUMMATION OF ITEMS 1 THRU 4 = TOTAL BID PRICE = S :\Sydney\ WPDOCS\07\07159IsecA2. WPD A-207 I I J $ 25.00 $ 20.000.00 $ 253,065.00 BID FOR: A.~ " "'~ ~J ~ ,~. J II EIGHTH STREET EMERGENCY SEWER REHABILITATION MORRIS AVENUE TO SHORT JACKSON STREET .. JOB NO. 07159 ~ CITY OF JEFFERSONVILLE CLARK COUNTY, INDIANA ~, tl RESPECTFULL Y SUBMITTED, .~ f v Miller Pipeline Corporation NAME OF FIRM PERSON .f: M~Sident u PERSON ~'-~ '--""~~ ATTEST Secretary ..... ..... ;TaYlllFlry ?1. ?ooR DATE rl Accepted this day of , 2008 SEWER BOARD CITY OF JEFFERSONVILLE, INDIANA '.1> ..... t Mayor Thomas R. Galligan, President .~ William A. Saegesser, P.E., P.L.S., Member t' ... / Jeffery A. Caldwell, Member S:ISydneyIWPDOCS\07\071 59IsecA2. WPD A-208 ~ --""" ~, ' r-' !,J p , ~ t i/ r r r", ,. ,.... DIVISION A - BIDDING REQUIREMENTS SECTION A-3 - METHOD OF 1\fEAS,UREMENT AND PAYMENT 'FORBID ITEMS 1.0 UNITS 1.1 1.2 The unit shown for each item on the bid form shall be used for payment purposes. These prices shall be "installed" unit prices. Where no quantity is shown for a particular bid item, a unit price shall be supplied, but will only be used where unanticipated extra or deleted workis called for by job conditions and authorized by change order. These unit prices and items shall not be included in the total price shown on the bid form. 2.0 MEASUREMENT FOR PAYMENT 2.1 The unit price for "cured-in-place pipe liner" (C.I.P.P.) shall include mobilization and demobilization, removal and replacement of all manhole castings and cones if required for liner insertion and its associated excavation, backfill and paving replacement, by-passing of sewage, sewer cleaning and disposal of debris at owner-designated dump site, pre and post inversion CCTVI, C.I.P.P. installation, lateral reinstatements, liner sealing at manholes, testing and sampling, final cleanup, and disposal of all surplus material. Dewatering associated with the installation of the C.I.P.P. shall be paid for under a separate item. 2.2 The lump sum price for "Dewatering for C.I.P.P. Installation" shall include all well installation, pumps, hoses, and any and all other items necessary to lower the groundwater, if necessary, to allow the installation of the C.I.P.P. This pay item will only be used if dewatering is necessary (none expected). 2.3 The lump sum price for traffic control shall include all signs, barricades, detour assemblies, cones, barrels, and any other materials, equipment and labor. INCIDENTAL CONSTRUCTION EXPENSES All incidental construction expenses not mentioned elsewhere shall be included in the appropriate unit prices. S:\Sydney\WPDOCS\07\07159\secAJ, WPD A-301 S:ISydneyIWPDOCSI07\07159IsecA4. WPD ;~' .. "Ill DIVISION A - BIDDING REQUIREMENTS .. SECTION A-4 - WAGE RATE ~ .. .<<( \II TO BE ADDED BY ADDENDUM AFTER 01/09/08 e .. 11 V L '....;,../ '<I ~ "1 ;''lJi -. ~ i .. ....411 -.~ . . .1/ J --....... "'-'\. A-401 ~"". J ., , \ DIVISION B - CONTRACT FORMS SECTIONB-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 It is further understood that by the acceptance of, and the proper affixing 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\07 J S9\divB. wpd B-1 0 1 \ I J .j Prescribed by State Board of Accounts Form No. 96 (Revised 2000) CONTRACTORS BID FOR PUBLIC WORK .~. PART I (To be completed for all bids) (Please type or print) " ., . Date: January 21. 2008 1. Governmental Unit (Owner): City of Jeffersonyille .~.~" . 2. County: 3. Bidder (Firm): r.lFlrk Miller Pipeline Corporation .IJ Address: 8850 Crawfordsyille Rd. Indianapolis. IN 46234 '/ City/State: ..., 4. Telephone Number: 317/293-0278 - 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 Eighth St. Emergency Sewer Rehabilitation JTL #No. 07159 (Governmental Unit) in accordance with plans and specifications prepared by Ci ty of ""'- Jeffersonyille. IN Two Hundred Fifty-Three Thousand Sixty- Fiye Dollars and No Cents and dated 1/4/08 for the sum of $ 253,065.00 ..... 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. /~"~ J. . .'f 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. t " 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 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. 1\ understand that violations hereunder may result in forfeiture of contractual payments. 8-102 ,-" , I I r , ; ( - t N I , ~: v \ r ~ . '" r"'.. f . f ~\ I 1 r t \ ACCEPTANCE The above bid is accepted this , subject to the day of following conditions: , t'_., ._:.,c,,;....... 'od't;.."_"_,,. i' " .'~- ,,',.',,-,,".,n. .,~" ';..,,,,,, -_'~''''''..",..~'~ '" .. i',,,,,;o,:>:vc..,';' --,!,:::"~:"'-'..,., ,..; ,i' , :t"',.,:--,; 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 thousand dollars ($100,000) or more. (IC 36-1-12-4) Governmental Unit: City of Je~fersonville Bidder (Firm) Miller Pipeline Corporation Date: ,TRTIlJRry ::>1 l ::>ooR 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 f6rtheperi6dof one (1) year prior to the date of the current bid? Contract Amount Class of Work When Com leted Name and Address of Owner City ?f Ray City, 704 Main St., $188 544.00 CIPP PO 2. What public works projects are now in process of construction by your organization? Contract Amount Class of Work When to be Com leted Name and Address of Owner Hillsborough Co., 601 E. Kennedy 8-103 3. Have you ever failed to complete any work awarded to you? No If so, where and why? 4. List referenced from private firms for which you have performed work. See Attached 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 govemmental unit to consider your bid.) 2. Mobilize Crew and Equipment to job site. Clean & televise the sewer segments to be lined to verify location of active service laterals. Line the sewer with CIPP. As soon as possible following the completion of the lining, the active lateral connections are cut open and trimmed to reinstate service to the sewer main. 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. None 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. See Attached 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 8-104 'II"""} '., /_.. .., ~ .~ " 4 "'1 .. . .. l >( .... it ,.~ -, '.',',"" hj ., .' ~, . "'>~ .. I.... ~ ~J . SECTION III CONTRACTOR'S FINANCIAL STATEMENT rstateme~r:~~~t7:e~fb~.i~t~f&t~.~h:lft~~r:~~tb~~~~d~redjri~~I~:Tht~~a~~1als~~~~:~t ;:~~~~~ds~:e~~~~~i~~ 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 bATH 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 Indianapols. IN this 21st day of January , 2008 ; Miller Pipeline Corporation . By ;y:. ;prOOl r , President (Title of Person Signing) ACKNOWLEDGEMENT ,.-, I j COUNTY OF Marion ) ) ) STATE OF Indiana , :F "[(pviTl MillpT' being duly sworn, deposes and says that he is President of the above Miller Pipeline Corporation (Name of Organization) (Title) 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 21 day of January 2008 -' ~ 21\. ~F1it~ Notary Public My Commission Expires: ? /14/08 ~\ County of Residence: Hendricks ~. 8-105 -"" ~ 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. ,. dO '" ......-.,. , ~ ii 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. J 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. " '" Dated at Indianapolis. IN this '21st, day of January , 2008 "" """I '5 By Miller Pipeline Corporation (Nam:. o:~izatiOn) ~,~~ President ~ (Title of Person Signing) ... '';1 . ~ ACKNOWLEDGEMENT COUNTY OF M~-ri rm ) ) SS: ) 'IIi' '. STATE OF Indiana << Kevin Miller being duly sworn, deposes and says that he is President of the above Miller Pipeline Corporation (Name of Organization) (Title) and tnatfl'lestafementsconfained In the foregoing bid, certification and affidavit are trUe and correct. "I ',':',i j'~-'.':;'''::iJ Subscribed and sworn to before me this 21st day of January , 2008 t/YY\ fYYY;L ~ ~f~ ~ . .' Notary Public ',.',ij-, -'I .' ,~ it County of Residence: Hendricks ~ " 8-106 'C en 0 Ul '0 2! l!! " 'E " 0 ~ ~ CJ) t- i2" t) H >:1 0 W 6' .r! -, ill ; +> 0 rl 0 oj rl 0 N ~ cd ....::t 0::: .r! al 0 p:; (Y) 5 u.. A OJ a.. Ul ~ ill ~ 0 '5 0 0::: ~ III 0 rl ....::t U. [JJ ~ U rl 0 ~ Cl .r! i2" 0 ill ~ ill :> H U. 0::: <H ci CO q [JJ 0 <H r.:." .r! cd Q) Z rl ~ [JJ $ E Q) 0 .r! 0 A <H rl U. .r! ~ 0 t) p.., ::i ~ a:l (!"" H u ~ CO , Q) c: ~ rl 0 .r! :J Q) rl cd a.. .l<: !.:-;;- .r! CO >:1 CO ~ CO H - c: "0 0 .!Q 13 u: <( (' ~, t f, .-.;,.. ~ ~ 'i ~.. ' ,-.... ~ 8-107 ~ 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:lSydneyIWPDOCSlmIsceUaneousIMASTERldlvB.wpd B-108 . .- .-1 '~ .. .I! "~ 11111 ,c;'..>',. If iJi ". "~ . ;- :...., . .,' 1\ @ .' i''fi . ". . " J .' if .. '= -{. r- t - t t Gcnenl Foan No. 96-a Prescribed by the Stale Board of Accounts of Indian~ Revised 1949 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 tobe submitted under oath by each bidder with and as a part of his bid, as provided by Chapter 305, page 1248, Acts of 1947. r ~ t S ubmi tted to ... n' ..~~::X __.? ~n .<!.::.~~.~E.~.?~ ~~~~::.:.. n~ ~.... .......n. noon... moo.... _.. __ ... __.......00 n' _' By ...................n....Mi-.+.l~.r....:e;l1l.~)j,n.~..J;.2rP.2:;-.~~J2E."............ {~ ~:~~::~ An individual Address 8850 Crawfordsville Rd. ....................~..................................-..-......_.....................................--...............................................-.......-...................................................... Indianauolis IN 46234 .. ......... ....... ........................... L.... ............on ......... ......... n.... n ........ .......... ........ .n.. ..00...... Date submitted ... ..... ...... ~;':l;n ~.?r;y: ..fJ. ....... ......... ................... .00..... __.... 20.l2~.......nn Filed ................................... ..............................._...........................-,~_...............;.............................................-...... .........................................................................................................,............................... ............. ................. ........ ....... ....... ... ....... .,... ........... ......':'.... ~~...... ..,-,.. ..-... ...~~ ...~.,. . A.E. BOYCE, MUNOE, IND ("". ,~ :~f S:\Sydney\WPDOCSlmfsce1laneous\MASTERldlvB.wpd B-109 -= Submitted by.... ........ .......M~.+.*~.r. ..f~E~J:.:h~!:...g.'?!-:p'r;:: !;.t;l;~ .:!:~.~.......................m.......... ...................... ........... ..~ . ~''; Principal Office at .. ....... .~~.~.Q...Q!;.~~ !.?!.'.<?:~;:.~~.~::...~~.:..,...................m.......m.....m................... ................._....._............ .....................-i~ ) ... ............. ........ ....n. .......J.n.9j, g,,:g gP.Q J.J.!=?,. ..llR.. H. Q2.3.~...... ...................................... ................ ....... .......................... ........ .................. ~.~. I. EXPERIENCE QUESTIONNAIRE The signatory of this questionnaixe guarantees the truth and accuracy of all statements and of all answers to interrogatories ., hereinafter made. 1. How many years has your organization been in business as a general contractor under your present business name? . ..... ............5 .!J... .Y.~a:r..s.. ........ ...... ........ ............................ ...................... .... '" ........ ................. .... ........ ....... ......... .... ..... .... .................... ....... How many years experience in construction work has your organization had (a) as a general contractor; and (b) .", as a subcontractor? ......... 2.~.. .y..~~!".~........... ...... ................. ..................... ...... .................................... ...... .......................................... .. What projects has your organization completed? ....S.~~...A:t:!&c;:.hg.9:....................................................................................... 2. 3. CONTRACT AMOUNT CLASS OF WORK WHEN COMPLETED i?i~ . Pi e Burstin 3a. What projects does your organization now have in process of construction? -- WHEN COMPLETED ~.,: CONTRACT AMOUNT CLASS OF WORK NAME AND ADDRESS /'.. OF OWNER .~ 1 Y 0 Hl s orou~ o.~ ....$.g.,.7.9..7.,}9..9..~9.9.................... .........f.S?~g...t;l;~~..r..'?~............. .............m.9.~/..9.2......................... C ~r~f1tfi~~~2~~.~o.:L...~ .. ..$.J.. ,.29..f .,.3.1.9....9.9....... ............. ........ .f.S?.:hs1...~~i..r..<?.!.!P:............. .............. ...9.~ /..9.~.. ................. ...... .. y.~.. .~.~ I9..~. ~~ an 0, TX P rt lJe o Eli 'C"'Wa-ce'r'.'1;;:'Sewf'" 16 1.00 CIPP 02/08 3g N. ~in St, Port \", Have you ever failed to complete any work awarded to you? If so, where and why. . .... ..........NQ............ ...... ........................ ......... ........ ....... .......... .... .................. m........... ..................................... .... ...................................... ... ....... ..... ........ ....... ... .... ....................... ................ ........... ......... ...... ........................... ............. ....... ....... ................ ............... ........... ............ . ~ 5. H~~.~y.~ffi~~.~~.~~;.~f.y~~.~~g;:~~ti~~.~;~~.b~~~..~.~.~ffi~~~.~~.p;rt~~~.~T~.~~.~..~th.~~.~~g~~~ti~~.th~t..f;cl~d.t~ complete a construction contract? If so, state name of individual, other organization and reason therefor. ..~ ..... ......... ~Q.... ................ -- ....... .... ....... .......... ................... ................. .............. ...... ..... .......... ...... ".. ............................. .................... . ..........---- 4. 6. H~~.~y.~ffi~~~.~~.p~~~~.~fy~~.~~g~~~ti~.~.~~~~.f~~d..t~.~~~pl~t~.~.~~~~;;;~ti~~.~~~tr~~t.h~~di~d.~.hi~Jh~~'~:;~ name? If so, state name of individual, name of owner and reason therefor. ) ..... ....... ..No...... ...... .......... ..................................... ................ ............. ....... ................. ........ .......... ............ ............. .................................... 7 . I~.;h~t.~th~~.~~~.~f"b~~~~~~..;;;~.y~-;;.fu~ciilly.~t~~~~.t~d?....................................... ...... .......... ..... ............. .................... ........ ~ None ......................................................................................--.......................................................-.................................................................-.........................................................-..................................................................................... . .............. ." ........... .....m...m.......................... .m........................... .............. ........ ................... .................. ......... .... ............... ....................... "' ,", ;~ /.-.....,,-". - S:\SydneyIWPDOCSlmlscellaneousIMASTERldlvB. wpd B-ll0 ,""'" f f (, 8. For what corporations or individuals have you performed work, and to whom do you refer? ................................................................................................................................................................................................................................................................................................. ; ;~;...........$. ~g,. . At. t.?':Qh~d............... ...................... ....... ......... ......... ............... .......... .......... ....................... .... ............... ....... .......... .......... ................................................................................................................................................................................................................................................................................................... ..................................................................................................................................................................................................................................................................................................... >'.,,:. >.,>.,"." ':.,.....-:' 9 . F;;.;h;t.citi~~..h;;~.y~;:;.p~;f~~~~i";~;k.;~d.t;.:;h~~.d;.ydri.~~f~;?......................... ................................................ .......... ... .......................................................................................................................................................................................................................................................................................................... .............. S. e ~...A tt.ac:: he d............................... ....... .................................................. ................................ ............. :................................. .................................................................................................................................................................................................................................................................................................................................. .........................................................................................-...................................................................~.;.~.;._;.'.';:,.;;,:;.';;~.~,...~;..,.;.';.';;;";..~'...;;,..;.'.'"'.-;;...........';;,..'............c.........'...................................................................................... ............................................................................................................................................................................................................................................................................................................................................ r 10. For what counties have you performed work and to whom do you refer? J. ................................................................................................................................................................................................................................................................................................... , ,", .', ......' . . ........ .........'~.......'..-.-.'~.................................................................................................~;.....;..........;,;;;,;.'......'..........'......'......................... ..................~......................... ............ ....'........ .............'............ .......... .................. .............. S.~~.. .A:t.t. ~~n..~Q............ ........ .................. ......... ................................................................. ....... ................................................. ...........................................................................................................................................................................................................................-............................................................................................. ...............'........................................................................................................................................-..................................................................~..........................;.........-:............................................ r~j . 11. For what State bureaus or departments have you performed work and to whom do you refer? ............ ..S.e e...A.t. tach-ed......... .................. .... ........... .................. ............ .......... ......... ........................... ........ .............. ......... ........ .......... ......................................................................................................................................................................................................................................................................................................... ....................................................................................................................................................................................'.-...............;..-...................................................................................................................... .................................................................................................................................................................................................................................................................................................... .................................................................................................................................................~......................................................................................................................................................... Have you ever performed any work for the U.S. Government? If so, when and to whom do you refer? ..............Depar.tment...oi'...Nav.y:....................................Me.:t.T.Q...W.aghingtQX1. ..Air;P.Qr:t...Al.l.t hQr.ity.. ......................... ......... ............. .B~.t he s.da"...MU............................................... ...R ?-.9.h ;i.,:Ug:t.Q g. ,... p.. Q....... ........................... ....... ........................ ........ .......... ..... .........Shar.on.. Cusi.c................................ .............. .....!5.~ :J:;.t::E~ p. ~ ..~~!?: f.:... ......................... ..... .................................................. ..... n...... .2Q.21.6.85.::-B.211. ............. ....... ......... ............ ........I.Q~.!. ~.~I .':".~ ~ .f?~...................... ................................. ................................. .................................................................................................................................................................................................................................................................................................................................................................. 12. ".c.. \~. r- 13. What is the construction e enence of the rind al individuals of our or ni2ation? YEARS OF INDMDUALS PRESENT POSITION CONSTRUCTION NAME OR OFFICE EXPERIENCE MAGNITUDEAND NWHATCAPACITY TYPE OF WORK \._ J :) ..... ........ ........ ...... ................ .... ~E ~ .~.~~.~~~................. ................ ?~...................... ... ~~.~.~~.~. ~!:.f!: ~.~.?!:...... .. ...~~.~ ~.~~~~!:::............... r-. ..D.a.le..MiJ.le.r.............. ....Cha.ir:m.an..... ........ ...n. .............. ..5.~............. ......... ... AdUJi.ni.at r.ati.Qu..... . ...Manageme.ut...... .... ..... ..!F: ~~!: ~...~.~f.-.~~::'.. ......... .... Y. ~ ~.~... f.::. ~ ~.~~.~.~~..... ...... ........ ..?~.... ............. ..... ... ~.?E!-~.~ ~ .~.~~.~~ ~.? ~...... .,. ..~!':-E. ~g;. ~~.~.~~.......... ..... ..,Mark..lIalle.t:t............ .. ..yicB...Er.es...Op.s....... ...............3.l..................... ...Admi.ni.$.tr.ati.Qn...... .....Ma.nag.em.ent.......... ..... ..P..Q}JK .J?~;r:m1.ng... ........ .... Q];Q i .Qf.9................. ..... .............. ..??...................... ... Mm1;Q j,,9.t.r..1?: t.1 .9.n...... .... M~m.?:g,~.N.~.TIt...... ......... .. ~~~::... ~~ .~.~ ~.~~............ .... f.E. ~lt~~:J:;.. .~.1?:~!,!-.g ~ E... ....... ........??........... ........... ... Y. 5?.+.~... ~!:.?:.. !..?;r:~ ........ .. ...~~J2.~;r:y.~.r:;.~~ p............. ..Ralph. ..Mi.ller...... ...... ....YP-..Safety-.j.HR ...,. .... ...............3-7-...................... ....AQminiR:t.T.~.t.iQ.:u...... ....M?:n?:g~;m~.:ut.. .... .... .n" . .Exian...Smit.b............... ....I?r.o,j .ect...Mgr:.jSuP.t .............. .2.1.m.................. ...R i.:P..~. ..B.l.JX.('l:t.ing. ........ ....S.\lP.e..ry.iRi.QD.... ..., ..... ..~.~!'.!-:.~...~!:.~~.~!"... ......... ....?E.?~t~.S~...~~E!..f?~R!: ..... ..........~.?. ..,.... on..'__ ...... ...~~::.~~?~~...~9.~!: ::....... ....~~R.~.!'.~.~.~~.?!:........ ..... /\ , S:\Sydn~WPDOCS\rniscellaneous\MASTER\dlvB.wpd B-ll1 ._=""~"'.~..~ PLAN AND EQUIPMENT QUESTIONNAIRE . The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatories hereinafter made. .,~ In what manner have you inspected this proposed work? Explain in detail. ........ ........ .W.q.lk.f;. d..:tn.<?..ll.T. Qj.~s;.t....~n sl.. ~ gg;t.11 ~.~!.J11g...r? .+.~p.? ...?:g.9:.. .~.P.~ ~. ~!.~. S:~.t~9.12~........................ ................. ........... '. ~. ...............................................a....................................................................................................................................................................................................................................................... .. ........... ................... ................. ............................. ........... ...... m............ ......................... ....................... .......... ............................. ............. ... ...................................a........................................................................................................................................................................................................................................................a......................... ....................................................................................a.......................................................................................................................................................................................................................................... 2. Explain your plan or layout for performing the proposed work. .................Clean..and..T.Y...the...s.~R~x:..R.E;'!,gm.<?n:t.~...t.Q..J?~..1:j,D:.~g....t.9...y~.!.iJY....JQs;.?:tJ.<.?g...2.:f...~.s:tJ.y.~..,... ............... . service laterals. Line the sewer with CIPP. As soon as possible following ::::~~:::~~:~~~~:ih~:~~9~9~i~iJ:2~::~2i~~~~~~~~ii!i~E~~~;~::!~~:::~~!~y.~:::~~I~~:~~:~:::~~~~~~~~~:~~~:::~~~:::~~~:::::::::::::::::::::::::::: .. .... ...........2P.~!!; ..~!!;~...!: ~.~.~~~...~~... ~.':.~~.~. ~~~::...~.~.~y.~~.~. ..~.?...~~:.. .~.:~ ~.::.. ~~.~.:: ......... ................................. ............... ..... ................................................................................................................................................................................................................................................................................................................................. .~ ............... ...m........... ......... ......................... ............. ....... .......... ....... .............. ......... ......... ............. ....................................... ....................... .. ....................................................................................................................................................................................................................................................................................................................... .............................................. ..................'.................. .................................................................................................... ......................................... .......... ........................~................................................................... ~......... ................ .............. ........... .............. ........ ...................... ......................... ......... ................................... ",' ....... .............................................. . ... .......... a........ ............. ................. ........ ............ ................. ......... ....~... a..... .............. ..... ....... .................~. ~..... ....... ...... ".~........ .........................~............ ~...... ............ ...... ..................... .......... ....... .......... ..a...... .................. ....... . .......................................... .............................................................................................a............................................................. ................................................ .................................................................~......~....................................... ...... ......... .................................. ........... ......... ..... .................... ...... ,.. ....... ......... .............................. .................................. .............. .............. ................~......................................................-............ ............................................................................................................................~.............................. ...............................................................~.......................a........ ........ .......................................................... ......................~ .......... ........................ ......................................................... ........... .......... .................................................. ................................................................'...............a............. 3. The work, if awarded to you, will have the personal supervision of whom? Mark Hallett / . ::::~:~::::::::~::::::~:::::~~::~~::~:::~::::~:~~:::~:~:::::~:::::::~:~::::::::::::~:::::::::::~::::::~::~::~::~::~::~~::~:::::::::::::::::::::::::::~::::::::::::::~:::::::::::::::::::::::::::~:::::::::::..,. 4. * Do you intend to do the hauling on the proposed work with you own forces? If so, give amount and type of equipment to be used. ..J ................ JJ..I.A....... ........................ .................................... .......................................................................................................... ........ ..... ,if. 5. *...Ify~:;;fut~~~i't~.~-;;bi;t.th~.k~.~;p;~f;;~it.ifu:~~gh..~~.~g~~~..~.t~t;.~~~~t.~f.~.;;b~~~tr~~t.~~.~g;~t..~.;~tr~~t.~~.~( ,'. if known, the name and address of subcontractor or agent, amount and type of his equipment, and flnancial. responsibility. .............. ...Iia.. .s.ub .c..on tr.a ~ :t.Qr.:;;......................... ............... ...... ............ ..................... ......................... ..... .............. .............................. ................................................................................... .................... ............... ................ .................................................. .m... ...... ............. ~ ........ ....... ...................... ............................................... ................... ........ '''''' ................... ....................... ......................... .......................... 6. . .............. ................. ......... ... ........... ............... ..................................................................................................... ..... .............. ................. --. "f * Do you intend to do the grading on the proposed work with your own forces? ,( . .... .......... ..N. j.A.............. ........... .................................... ........... ............,.......... .................................................... ............ ........................ __. . --... ................................................... --................................................................ --... ................................... ............................................... I' ................................................................... ................. ...... .................... ......... ................................................................. .......................... ~ ..... ii;;';;'4: S:'6-;';d'':; ';';';y '~~~'b;' ;ppli~;j,k '~;.n i:,".;;idi;,g ~;;~tt;;~i.:'if ~;;~ '~~t"""'''''''''''''''''''''''''''''''''''''''''''' __........................................................................ ....................... ......... ................................ ................................ .... .................. ................. ................................... ........................................ J J :,r-- "" S:\Sydn.Y\WPDOCS\m~cell.neous\MASTER\dIVB.wpd B-112 ~ I fi 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 responsibility. N/A .,.. j .......... ....... .... ...... ......................... ........ ..... ......... ...... ........ ......... ....... ........ ..... ............................................ ....... ........ ........... .......... ............. . 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. ...... ......... ..All.. JtT.or.k.. M. ill..:b a.. sell:::: p.e.r f.armed.............. .................................... .................................................................... <.", .' '." -,'. .. -"''-'' .",.'., -",' .',' -', -," .' ,,-, 'c' ., .' _',,: _.... ,. .... .'.' '..... .. "', .'." ... ", __ ,...... .' ....... """,_ ."" ,',',.' ','._.._..',",,.',.. ".,_ ''',:_',: :.,<;~ ~.' " ,','- ',"L',_",_;"_,,,: ," ..', ___, . .. ...... .'..,:, .'.' ....... :...... ",,_,' _', --, ....... .... .." .. .. '."" ,','" ........................................................... ...............a........................ ................_...............................~....................................-............................~........_........ ........................._............................. 9. From which subcontractors or agents do you expect to require a bond? . ......,.. ..... ..N} 1\........................... ........... ....... ........ ...................... ......... ......................................... ..................................... ................. ........ . ';;';;' ;;:~,.-.-..'..":,;,,,,";;..'. '.-..... ..'... '.'.... .-. ............... ..'.-..........: ..:. ~ .d,:.... .'. ..,......: "':...:........,... .-....~.. ...-__ ...... ............ ........... ...;...:..-.'...,.~-... ...'...;;. ;,:.. '. '.......'.'.. ... '..__ ...:;,: .:.. ..... ..;....,........ .-....,;, '.. '. -.; ~ _. .... .-..... . ....... ........ '.:~'. ....... ..........- .. . . .... .. .'. .-...... ..... .... .'....,;, . ... .'...... '.... .... ..... ............................................................................................................................................................................................................................................................................. 10 What equipment do vou own that is available for the proposed work:> DESCRIPTION, SIZE, CAPACITY, CONDITION ETC. QUANTITY ITEM YEARS OF SERVICE PRESENT LOCATION See Attached r f , f ......... ........ ....... .......... ..................... ........... ..... ................... .............. ................................... .......... ........ ....... .......... .................................... ................................................... ............................................. ......................................................... ................................................. ........................................................ .......................................................... ............................................. ............................................. .................................................... ............................................ ................................................... ..........................................................- .~ ................................................. ................................................ ............................................................ ......................................................... ................................................... ............................................................ ............................................. ............................................... ............................................................. ................................................... ......................................................... ......................................................... r .................................................. ............................................................................................................. ........................................................ ............................................................ ........................................................... . ~ ............................................................... ...................................................... ................................................................ ............................................................. ........................................................... .......................................................... ............................................................ ....................................................... .......................................................... ..................................................... ........................................................... ............................................................ r S:\Sydney\WPDOCSlmlscellaneousIMASTER\divB.wpd B-113 11 What eqU1pment do you Intend to purchase for use on the proposed work, should the contract be awarded to you? APPROXIMATE COST r. QUANTITY ITEM DESCRIPTION, SIZE CAPACITY, ETC. None .......m. .... ...... ........... .... ......... m... .__...... m.... ......................... ... .... ...........m.. m...... ................... ____... ........ m. __....... ... .....m........ ...... no..... --..., ... m..... .... ..mm.. m.... .... .... ............ __.. ....... m..... .. m.. m........... m m... m.m.. ........ .............. ...m................. m........ ..... ..__... .................. __' ... ... m.. --., "t . . ................. ...__ ............. ......m........... m...... ...... ..... ............ .... ................ ..m.......m......... __......... __...............__.. .... --.... "" .................... ....... --. ....., ,41 '.. ..~ .......... .........m m m.... m' .... .m...... m......... ......... .. m........ .... m.... ..... .m. ..... ......m ..... ......... ..... .......... m.............. ............. ................................... . 12. How and when will you pay for the equipment purchased? .. ............. N./.A.... "" .__.... ..... m. .......... ....... ........ ......... ........ .... ... __...... ....... z...... .......... .--.............. ........ .... ..... m... --. on m.............. m................. =:~ 13. D~'y~~' p~~p~~~"t~'~~~t'~~y'~q~p~~~t'f;~--thi;';~~k?"If'~~':'~t~t~'typ'~':'q~;;;tity'~~d'~~;~~~~'f~;.~~~ti;g~.......~....m.......... .. No .. ..m m........m ...... ..... .........m ...... ....... ... ....... ......... .............. ....... m........... .......... ..m...... ..... ........... ...m........ m..... . ........ ............ ....... m ....... .... . 14. Have you made contracts or received firm offers for all materials within prices used in preparing your proposal? Do not ", give names of dealers or manufacturers.. . m........... X.~.8...........m.. m...... ................... m............... ...... ..... ........ m.m. ............__......... .......m ...... ..mm............... ..... ............ ............... ..... . ..__... __ ...... ....... ......... m......... ...__.....................__....... __ .............. .... .__. ..__..... m... .... m... .... __ ............m ... ... ... __. ........................ .............. m... f \IIIIfI!IIJ Dated at ...rJ1Q.j..?J:J-.1?-1!9Jj..~.....JJL__...__... this ..mm?1..:?.t..............m.......m day of ...J.'J?DJ.J.J?..r.Y.. m.m ......__..__.m ......... .... 20 ..Q.a..__....... iif ... .....Mi.1..l~;rmP.:j..1!g.l;i.n..E;...Q.Q;rIlQ;r.?-t.i.QD....____..... .......m.m...mm.m (Name of Otganization) BY.........~.....~........m............m......................, .......?or .e.si.d~:o.. t......................... m............. ........... .__..__..__ .... __" m...... ,~' (fide of Person Signing) . STATE OF .........In.diana........mmmm.. ) ) S5: COUNTY OF ........M~:r.!9.P.:...........mm..m...) ''I .. ;"': ...m.m.........mmm.....m.K~y.:j...n...Mj..l1..~.r.m.......m...........m.......mmmbeing duly sworn, deposes and says that he is a member of .. ...mm........Mi~l.e.r...P.i;p.~l.imLC.QX';p.Q.r..a,:t.iQ:O"...................'...mand that the answers to the questions in the foregoing (Name of Otganization) questionnaire and all statements therein contained are true and correct. bfYV'O-...- 't\ 0~. ~~.. Subscribed and sworn to me this __........?J-.?~__m____.____..__........__.day of ......m.m_.iL~g:!:;~EY........m...__...m__.m.20 .9.?.m......~L..._.......__ My commission expires ....GJ.J.~.!.Q.e..........m....__.....................m. :._ '. r;'..'~t-. "f';;' ~/-/:;~~, J' N' ~v /'.J ~ """1 -----. / -, S:\Sydney\WPDOCS\misceIJaneous\MASTER\dlvB.wpd B-114 .. r---- I ~, CONTRACTOR'S FINANCIAL STATEMENT r' S b d b eKe horn ,. u mitte y ...............MJ1;!-.~E...~te~.~~!?-.~...Q9E.P.:?E~:t?J:?~.......................................................................... { A C~~~:~ership r '\ An Individual With principal office at ...~.?!.2...gE~:::.~:?E~.~.~.~.~~.E?..~.~.~.?....~~9:~~.~~F.~.~.~::??}.~..~.?~.?.~........................._............... ........... ...... To ....... ........... ......... .......Q :i:.~.y.... ?f...;::::. ~.:f.~E.~.9? y..~.~ ;J;..~...... ..~~......................................... ....... .......................... ....... .............. ................. .... Conditions at close of business December 31, 2006 ASSETS Dollars Cts. Cash: (a) on hand l.........................cb) in bank lL................................jc) elsewhere 1...................... SE Ii: Notes receivable (a) due within 90 days ...................................................................._....................... .Il. S. (b) due after 90 days ............................................................................................ (c) past due .......... ... .... ...... ................... .... ... ....... ........................... ................. ....... Accounts receivable from completed contracts, exclusive of claims not approved for payment ............ Sums earned on uncompleted contracts as shown by engineer's or architect's estimate (a) Amount receivable after deducting retainage ............................................. (b) Retainage to date, due upon completion of contracts ........................................ Accounts receivable from sources other than construction contracts ............................................. Deposits for bids or other guarantees (a) Recoverable within 90 days ................................ (b) Recoverable after 90 days ................................ Interest accrued on loans, securities, etc. ........._.................................................................................. Real Estate: (a) Used for business purposes................................................................................... (b) Not used for business purposes ......................................................................... (a) Listed - present market value ............................................................... (b) Unlisted - present value ............................................................... Materials in stock not included in Item 4 (a) for uncompleted contracts (present value) ............ (b) other materials (present value) ........................ Equipment, book value .........................m....... ....... .......................... .... ............. ............_....... ..... ........... Furniture and fi..'ttures, book value Other assets Stocks and bonds: ................ .............. ............ ...... ........ ............... ............. ...... ......... ...... .,... ..... "T~t;J A~~~;;; LIABIliTIES Accounts payable to banks regular ........... ........ ........ ............ .......................... ....... .................... to banks for certified checks ......................................................................... to others for equipment obligations ............................................................... d) to others exclusive of equipment obligations ...................................................... (a) Not past due ...... .................................. .......................... ............................... (b) Past due ........................................... ................................. ........... ....... ....... Real estate encumbrances Other liabilities Reserves Capital stock.p;Jd~p........... ..(~).C;;~~;....:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: (b) Common ............... .... ........ ....... ...................... ................ .................... (c) Preferred ..... ..................... ......................... ....................... .................. (d) Preferred . .................................. ...... .......... ..... ............... ..................... Surplus (net worth) .......... ... ................. ...... _...................... .,... ............... """ ....... ................... ............ ..... Total Liabilities CONTINGENT LIABILITIES Liability on notes receivable, discounted or sold ................................................................................... Liability on accounts receivable, pledged, assigned or sold ............................................................... Liability as bondsman .. ..... ....................... ......................... ................................. ........ ............. ............. Liability as guarantor on contracts or on accounts of others ............................................................... Other contingent liabilities ....... ....... ........ ............................. no.... ............ ....1' ~.t~rCc;~ci;;~~;:t Ii~biliri~~ ................-........................................................................................................-.................................. Notes payable .................-..................................................................................................................................................................... , '. ,..... . ".. ....... ." ,'..-..' . . , ~ .. .... . -- , 7 r-- 1 2 3 4 5 ,.- 1 r, S:\Sydney\WPDOCS\miscellaneous\MASTERldlvB.wpd B-115 (a) on hand ~ ...~...~..........._...... ......................................................-................... ............................................................. ............. $ .......................................................................... 1 Cash (b) deposited in banks named below .................................................................................................... $ ........................................................................ (c) elsewhere - (state where) $ .......................-........................-............................................................................. ......................................................................... NAME OF BANK LOCATION DEPOSIT IN NAME AMOUNT \: .................................................................................... ..............-.................................................................. ......................................................................................... ................................................................................ ..................................................................................... ............................................................................................. ....................................................................................... ............................................................................................ ................................................................................................... ......................................................................................... ..................................................................................... ........................................................................................... (a) due within 90 days ....................................................................................................................... $ ....................................................................... 2* Notes receivable (b) due after 90 days ..................................................................................................................... $ ................................................................. (c) past due ........................................................................................................................................................... $ ..................................................................... RECETV ABLES FROM: NAME AND ADDRESS ROR WHAT DATE OF MATURlTY AMOUNT HOW SECURED ............................................................................................................................................ ............................... ............................................................................. .................................................................... .......................................................................................................................................................... ..................................... ................................................................................... ................................................................... ....................................................................................................................................................... .................................. ....................................................................... ............................................................. DETAILS RELATIVE TO ASSETS If '11 . " - .. Have any of the above discounted or sold? If so, state amount, to whom, and reason. ............. ...... ................................... .......... ...... .... ................ no.............................. .... .............. ............... .......... ........... ..... .... ........ .......... ........ ..... ... "If iii . 3* .., Accounts receivable from completed contracts exclusive of claims not approved for payment .................................. NAME AND ADDRESS OF OWNER NATURE OF AMOUNT OF AMOUNT RECEIVABLE CONTRACT CONTRACT ............................................................................................................... ............................................................. ..................................................................... .................................................................................... ............................................................................................................................... .................................................................. ..................................................................... ............................................................................................. ............................................................................................................"......... ............................................................. ............................................................... .......................................................................................... .......................................................................................................................... ............................................................ ................................................................ ..........................................................................................-........ ".4/ .. ..... Have any of the above discounted or sold? If so, state amount, to whom, and reason. '! . ,................................................................................................................................................................................;.......;........................................................................................................;......................................;....................................... ..:.:1 Sums earned on uncompleted contracts, as shown by engineer's or architect's estimate 4* (a) Amount receivable after deducting retainage $ ............................................................................ ..........................................................'............ (b) Retainage to date due upon completion of contract $ ............................................................ ........... ........ ....,.... ................. DESIGNATION OF AMOUNT OF AMOUNT AMOUNT RETAINAGE AMOUNT CONTRACT AND NAME EXCLUSIVE OF AND ADDRESS OF OWNER CONTRACT EARNED RECEIVED WHEN DUE AMOUNT RETAINAGE ................................................................................ ................................................ ......................................... .............................................. ..................................... .................................... .......................................... ............................................................................. ......................................... ..................................... ............................................. ..................................... .................................... ................................................ ....................................................................................... ........................................................ ...................................... ................................................ ........................................... ........................................ .............................................. .............................................................................. .............................................. ...................................... .......................................... ....................."............. ................................. ............................................. " ~ ,q' .' ,'#/ .. .~'" Ii. Have any of the above been sold, assigned or pledged? If so, amount, to whom and reason. "" ...... .................. ........... ............................. ...... m...... .......... ............. ...... ..... ......... .......... ....., ...,.. ;.;... ...;.... ';m.. ......;.. .;.. .,.~.. ............ m.... oom'. ....... * List separately each item amounting to 10 percent or more of the total and combine the remainder. .;< .. ~'i;1' ., S:lSydney\WPOOCSImJscellaneousIMASTERldlvB.wpd B-116 fill 5* I Accounts receivable not from construction contracts $ .................................................................. ........................................................................ RECEIVABLES FROM: NAME AND ADDRESS FOR WHAT WHEN DUE AMOUNT , "," '" ............................................................................................................................................. .............................................................. .................................................. .......................................................... ........................................................................................................................................................ .................................................................... .............................-.................................. .................................................................... ......................-.................................................................................................................. ................................................. ....................................................... ........................................................ What amount, if any, is past due .......................................................................................................................................................... $ r-, 6* , -cu- ., " Deposits with bids or otherwise as guarantees $ ........................................................................... ................................................................ DEPOSITED WITH: NAME AND ADDRESS FOR WHAT WHEN AMOUNT RECEIVABLE ..........................,..............................................................................................:"....~.....,.......... ............................................................. ............................................................ ............................................................. .;.-................;.;;.....;..............;......:..............;.................;...................................................:.......... ................................................................. .................................................................... .................................................................... ". .... .',' ,. '. "'." ...-.......................;..............................................:....;...........................'...........'.............................................. ............................................................... ..................................................................... ........................................................................ ........................................................................................................................................... ...................................................... .......................................................... ..................................................................... ....... 7 , .'"., ....... .' " ,.. J, "'.. Interest accrued on loans, securities, etc. $ ........................................................................................................ ....................................................................... ON WHAT ACCRUED TO BE PAID WHEN AMOUNT ................................................................................................................................................................................................ ...............................................-......................... ............................................................ .............................................................................................................................................................................-.......................... ................................................................................... ...-.................................................................... ....................................................................................................................................................................;.........:.................... ............................................................................. ............................................................... "'-,..' '...... ...",......,". .',', . . "....,- .-..' ...... . ................................................................................. .....................,........................................ .,;........ ...... ..... ........ ....... ........ ....... ..... ...... ......... ............ ...-........ ........... ......,~ .~.. ...... ....... ............ ........ ..................... .... ......... .................. , . . . '.,' - .'. ',' ....- - . -. ., --' ....... -. ... .. """ -- .. -- .. -... -- . .... ",; C.. ""~ ~ Real (a) used for business ~"c; $ 8 estate { purposes ............................................................................ ................................................................................... book value (b) not used for business purposes $ ...................................................................... ...................................................................... .... " IMPROVEMENTS DESCRIPTION OF PROPERTY NATURE OF TOTAL BOOK IMPROVEMENTS BOOK VALUE VALUE 1 .............................................................................................................................................. ...................................................................... ....................................................... ....."'........................................................... 2 ..........................-................................................ .............................01...................... ....................................................................... ...........................................................................................................................................................-..... 3 .................................................................................................................................................. ........................................................................ ...................................................... ................................................................... 4 ............................................................................................................................................. .................................................................... ................................................. ................................................................... 5 ...................................................................... .................................................. ..................................................................... ...................................................................................................................................... 6 ........................................................................................................................................... .......................................................................... ...........................................-..... .............................................................. 7 ',. " '.' HELD IN WHOSE ASSESSED AMOUNT OF LOCATION '. ". , , '. .. ., NAME VALUE ENCUMBRANCES 1 .. ,'" '" ... . ..................................................................................................................................... .................................................................. .................................................... ............................................................... 2 ................................................................................................................................................ ................................................................ ....................................................... .............................................................. 3 ........................................................................................................................................................- .............................................................................. .......................................................- ................-...............-.............................-.......... 4 ............................................................................................................................................. ................................................................. ..................................................... ................................................................. 5 ..................................................................... ............................................... ................................................................. ........................................................................................................................................ 6 ..............-..............................................................................................................-................................. ................................................................................. ........................................................ ........................................................................ 7 . * List separately each item amounting to 10 percent or more of the total and combine the remamder. r.! r. r- , f. , r. ~. S:\Sydney\WPDOCSlmiscellaneousIMASTER\dlvB.wpd B-117 DETAILS RELATIVE TO ASSETS (Continued) 9 Stocks and bonds (a) Listed - present market value $ ...................................................................... ...................................................................................... (b) Unlisted - present value $ .................................................................................. ....................................................... ..........~...... .......... LIST NT. OR / PRESENT DESCRIPTION ISSUING COMPANY DIY PAID PAR MARKET QUANTITY AMOUNT'! VALUE DATE % VALUE 1 .............................................. ................................... ..................................................... ...................................................................................... ........................................... ....................................... ......................................... 2 .............................................'..........'............. .....................................................................'............................ ......................................... ............................................. ......................................... .......................................... ....................................... 3 .................................... ...................................... .................................... ................................................. ....................................................................... ......................................... ....................................... 4 ..................................... .......................D............. ............................... ............................................. ...............................................................'................. .................................. .................................... 5 ................................................... .................................................................................... ................................. .............................. ........................................ ......................................... ........................................ 6 ....................................................................................... ............................................ ............................................. ..................................... ................................................... ....................................... ....................................... 7 AMOUNT WHO HAS IF ANY ARE PLEDGED OR IN ESCROW, STATE FOR WHOM AND PLEDGED POSSESSION? REASON OR IN ESCROW 1 ........................................................ .................................................................................................................................................................................................................................................. ................................. 2 .............................................. ................................................................................................................................................................................................................................. ..................................... 3 .......................................................... ........................................................................................................................................................................................................................................ .............................. 4 ............................................. ........................................................................................................................................................................................................................... ................................. 5 ...................................... ..................................................... .....................................~....................................,.................................................................................................................................................................................-... 6 ............................................................................................................................................................................................................................... ................................... .................................................. 7 Materials ill stock and not included ill Item 4, Assets: 10 (a) For use on uncompleted contracts (present value) $ ..................................... ......................................................................................../ (b) Other materials (present value) $ ................................................................................. ......................................,.............................................. PRESENT VALUE DESCRIPTION OF lVfATE:RIAL QUANTITY FOR UNCOrMPLETED OTHER MATERIALS CONTRACTS .................................................................................................. ................................................... .............................................................................. .............................................................................. ................................................................................................................ ...................................................... ................................................................................. ........................................................................... ................................................................................................................ ...................................................... ..................-................................................................ ............................................................................................. ............................................................................................................. ......................................................... ........................................................................................... ......................................................................... 11* Equipment at book value $ . ........ ................. ...... ........ ............. ................ ................ ......... ............................................................................. .c. .',"::'. .... ." ...... .;...... _..q_.... "', QUANTITY DESCRIPTION AND CAPACITY OF ITEMS AGE OF PURCHASE DEPRECIATION BOOK ITEM PRICE CHARGED OFF VALUE ........................................ ................................................................................................................................... .......................... .......................................... ....................................................... .......................... ........................................... ................................................................................................................................... ............................. ............................................... .....................................D.............. ........................... .......................................... ..................................................................................................................................... ......................... ............................................ ...................................................... .............................. . I I I >.~ . / i . " ~ . . .. . ~ '-! . ~ ..' '., ., '4t .il .; '4J .. >,'" ..Ii Are there any liens against the above? If so, state total amount .................................................. $ ................................................ 'fl; · If two Of mo'" items are lumped above, give the sum of their ages.. - wi -~,,!, "l . S:lSydneyIWPDOCSlmlsceUaneousIMASTERldlvB.wpd B-118 fill: r DETAILS RELATIVE TO ASSETS (Continued) 12 13 Other assets ....... ..... ....... ...... ...................... 0........ ..............00 .... ............... .......... .... .... ....... $ ...........m............................. ....... '.. ................ . DESCRIPTION .'. AMOUNT Furniture and fixtures at book value $ . . ..................................................................................................................................................................................................................................................... ..............................................................-....................... ...... .,.-........', ....., ...,.......... '" .......... .......................................................................................................:...................'.;..........-.'..'...-..'..'...'........-.......,..-......'............................................................................................. ........................................................................ I Total Assets: ~, . < r- (a) To banks, regular $ ................................................................................................................................................ -........................................................................ 1 { (b) To banks for certified checks $ o blig~ti~~~...~: :::::::::: ::::::: ::::::: ::::::::: :::::::: ::::: ::::::::: . $ ............................................................. (c) To others for equipment ...................................................................... (d) To others exclusive of equipment obligations $ .......................................................... ................................................................... TO WHOM: NAME AND ADDRESS WHAT SECURITY WHEN DUE AMOUNT .......................................................................................................................... .......................................................... .................................................................... ........................................................................................ .................................................................................................................. ......................................................... ............................................................... ...................................................................... 2 { (a) Not past due ................................................................................................................................................. $ .................................................................... (b) Past due $ ..................................................................................................................................................................................... .........................................................................- TO WHOM: NAME AND ADDRESS FOR WHAT DATE PAYABLE AMOUNT .................-..................................................................................................................... ............................................................... .......................-................................................. ..................................................................-..-.................. -.................................................................................................................. ................................................................. .................................................................... ...................................................................................... 3 Real estate encumbrances (see Item 8, Assets) $ .................................................................................... ............................................................................. 4 Other liabilities $ .................-......... ....... ............ .............~ ............ ............................................. ................... ............... ........................ ...... ............................-.................... ......................... ~._.. DESCRIPTION AMOUNT .. , "., "". .... ,..~ ,; " '." . .... ...................................................................................... .............~.. ...................................................................~................................................ ....................................................... ...................................................................................... .............................................................................................................................................................................................................................................................................. ................................................................................ 5 Reserves $ ......................................................................................................................................................................................................... ............................................................................... INTEREST INSURANCE BLDGS & FIX PLANT DEPT. TAXES BAD DEBTS $ $ $ $ $ $ 6 up{ (a) Common $ .................................................................... Capital Stock paid ................................................................................................................... (b) Preferred $ ................................................................................................................................... ........................................................................... 7 Surplus $ .............................................................................................................................................................................................................. ........................................................................................ I Total liabilities: DETAILS RELATIVE TO LIABILITIES r'" r-,~ f'" " r---- t l r-, I r r'-- ~, S:\SydneyIWPDOCSlmlscellaneous\MASTERldivB,wpd B-119 If a corporation, answer this: ,;fJ ., When incorporated .... ....... July.. .1.9. '!>". .lSl9.S,... ............... ....... ......... ........ ................... ................._... '._""" ,. .,........."........ ...... ........ ',' ......... -;.c; '" In what state ......... .._ ... ...... .IJJ.di.an.l2........ ..... ............ ........ ...... ... ........ ........ ... ............... ......................................... .... ...,.. ........... ....... ......... Names and titles of all persons having authority to execute and receipt estimate vouchers and to conduct other business for the corporation, including its officers, the signatures of whom are legally binding. i ., . '......... .... IS; ~y.;\' J1..M.i.;J...::!,~;r...::,. ..J?.r. ~.s.i d.~..n t.................. ......... ..... ........ .................... ....................... ................ .............. .................................. -;$ .' ,......... ....P.2:':l:gJ..t;l;!?..e .:... J?t;l;n..~ ~ Qg.,...~ r.!... ::.. .gJj:;Q 1. Q E.Q................... ........................ ................................. ................................................. '... ....... ...Nina..Manu.. :::...8 e.c.r.e. tar.y. j .Tre.a.slJ.1': e..r........... ......... .............................. ................ ........................ .....,......... .........................., '. ......... ...K~ .:t.t. h. J1JJ l.~:r... -::...Y. i.. ~ ~...r. :rg.9..i.9.~JJ..t....... ........ ..................... ..... ............................ ........... ......... .....,.. .............. ........ ............ .... .-' ....-..................................................................................................................................................................................................................................:......................................................-..........................--........................................................................-............................ Do you have the necessary "certificate of authority" to transact corporate business in this state, under the terms of .. Chapter 215, Acts of 1929, and acts amendatory thereto? ........X~.9............................................................................................... J If a co-partnership, answer this: ~ Date of organization State whether co-partnership is general, limited or association ....................................................................................................... .. Give the names, addresses and proportional interests of all parties ...................................................... . ......................................... '" NAME ADDRESS SHARE $ .................................................................................. $ ................ ............... ..... ~.~..... ~ ........ ..... ~..oo ...... ~.. ~.. ~ ......... ."~ $ .. ~ ~ ~ ~ ........~..oo..oo..... .....~ ~.......oooo....... ~..~........................ $ .. $...................... ..... .......... '" ....... .. .............................................................. $ .................................-..........-.--.........................--.. $ ........................-.............................................................. . .~....... ..............m..................... .r. ... . 'If ....". . ...[? . S:\Sydney\WPOOCS\mtscellaneousIMASTERldlvB, wpd B-120 fill r ~ I . ' ' i The name of the partnership firm under which the above partners kre operating is ............................................................................................................................ ........................................................................................................................................;.................................................................................................................................................... Give names and titles of all persons having authority to execute and receipt estimate vouchers and to conduct other business for the partnership, the signatures of whom are legally binding. ........... ...... ................ ................ ........... .... ............. .................~.... .......... ...... .......... ... ............... .......................... ............................. ........... ..... i ..............................................................................................................................L..................................................................................................................................................................... i i .. :............ ........ ......... ..... ................... .............. .,................ ....... ..,L........... ......... .". ~.. ~.....,... ".., ".;.,. ",.. .... ... ,......... ..................................... ............. The undersigned hereby declares that the foregoing is a true statement' of the financial condition of the individual, co-partnership or corporation herein first named, as of the date herein first given; that this statement is f~r the express purpose of inducing the party to whom it is submitted to award the stibmitter a contract; and that any depository, vendor or other agency herein named is hereby authorized to supply such party with any information n~cessary to verify this statement. ~OTE: A co-partnership must give firm name and signature ot all partners. A corporation must give full corporate name, signature of official and affix corporate seal. ..............................................................................-................................................... ........................................................................................................................... ...................................................................................................................................................... ....................................................................................................................................... Af~davit for Individual COUNTY OF .......... .... .............. ....... ............. ) ) SS: ....... ......... ............ .................... ) STATE OF I I ............. ...................................................................................L......being duly sworn, deposes and says thereof that the foregoing financial statement, taken from his books, is a true and accurate statement of his financial condition as of the date thereof and that the answers to the foregoing interrogatories are true. . ............................................................................................................. (Applicant must sign here) Subscribed and sworn to me this ................................. day of ................... 20 ............. : . ..... . ..' .' .' I .... ...................... .......... .......N ~t;;ry.p;.;.bii~ ...... .......... ........ ..... ...i"........ Affidavit for Co-Partnership COUN1Y OF ............. ........... .... .................... ) ) SS: ....... ...... .... ............... ........... ..... ) r':..- iTAm OF .'..............................................................................................J..........being duly sworn, deposes and says that he is a member of the firm of :..............................................................................................J......."..and that he is familiar with the books of said firm showing its financial condition; that the foregoing financial statement, taken from the books of said firm, is a true and accurate statement of the financial condition of said firm as of the date thereof and that the answers to the foregoin~ interrogatories are true. , ,.-. ........................................................................................................... (Member of firm must sign here) Subscribed and sworn to me this .................................dayof '................... 20 ............. r' i...................................................................-..............................................................i............... Notary Public I Affidavit for Corporation t, COUN1Y OF ...... .In.gj, g.:Q~.... .................... ) ) SS: .......Mar.iQn.......................... ) STAm OF ....................................K~y.:i-.n...:~U.:).1.~.r..................................being duly sworn, deposes and says that he is a member of the corporation of ............Miller...Eipeline...CQ.r.p.o.rati.o.n................J.....described in and which executed the foregoing statement; that he is familiar with the books of said corporation showing its financial conditi;on; that the foregoing financial statement, taken from the books of said corporation is a true and accurate statement of the financial condition of said corporation as of the date thereof and that the answer to the fore ing interrogatories are true.' : ...........~.. .. . . . ............................... i ", ' (Officer ust sign here) Subscribed and~wom to me this ..........~1:..................day Of,.......J.gD............ 20 ...Q~L... i ....................... .:(.'rY::I.~~~~.~...............r..... . fT\ " S:'Sydney\WPDOCS\ml!cellaneousIMASTER\dlvB.wpd B-121 {" Miller Pipeline Summary Miller Pipeline Corporation is one ofthe nation's premier contractors, providing a comprehensive range of pipeline contracting and rehabilitation services for sewer pipelines, water, and gas, as well as specialty products and services for the industrial and telecommunications industries. Miller Pipeline Corporation exceeding $100,000,000 in revenues is owned by a Vectren Corporation, which distribute$ electricity and natural gas to nearly 770,000 business and residential customers with,revenues close to $2.0 Billion. We believe there are many reasons why Miller Pipeline Corporation is regarded as a premier and well-respected national contractor. Certainly our combination of innovative thinking, technical expertise, and customer service have played a big part. We continue to research and improve our products and processes in order to offer our customers cost- effective and value-added products and services. r'\ We pride ourselves in our ability to proyide our customers with a full range of rehabilitation methods to meet individual needs and specific application constraints. I Miller was one of the first contractors t<;> import trenchless technologies from Europe and the Far East. We acquire the latest high-tech equipment that is so vital to doing the job right and in a safe, efficient manner. We realize that our employees are the backbone of our existence. They are never takerf;, for granted. Many of the Miller Pipeline Corporation team started with us. Many others have spent most of their entire career. This lets us know that as a company we are doing something right. This is key to our success and it shows. Miller Pipeline Corporation has been.in the business for 53 years and has demonstrated resilience to economic downturns and will remain secure for the future. Our organization is solid, not only from an economic standpoint, but the issue at hand, demonstrating our knowledge to correct (III) problems and overflows. r: (: (' . I Corporate Experience and Capacity Miller Pipeline Corporation has been praviding aur custo.mers with experience and an admirable list af care capabilities and customer centered salutians since 1953. Miller Pipeline Corporation is headquartered in Indianapalis, IN. and has additianal affices natianwide fram Califarnia to. New Jersey. Currently, the Campany maintains mare than 170 canstructian crews made up af skilled, prafessianal emplayees, many afwham have been with the Camp any their entire careers. We are an arganizatian with aver 1,000 emplayees and an equipment fleet nearing $30,000,000. As a recagnized leader in the industry we attribute much af aur success and langevity to. the quality af wo.rk we pravide to. aur custamers and the professio.nal and stable leadership at all levels within the campany. The values and principals, an which the co.mpany was ariginally faunded, remain taday as the carnerstane af aur co.mmitment to. quality and value-added service. It is in this way aur Co.mpany stays an the leading edge and achieve maximum efficiencies to. pro.vide greater value. At Miller Pipeline Corporation we are co.mmitted to. aut standing perfarmance as well as exceeding client expectatians. The care capabilities o.fMiller Pipeline Corporation include: Gas . Distributian . Main and Service Installatians . New, Replace, and Rehabilitatian . Directio.nal Drilling . Catho.dic Pratectian . Distributian Statians I Fabricatio.n . Vacuum Excavatian . External and Internal Jaint Repair . Internal Jaint Repair Sales . Transmissian . Extensio.ns . Replacement . Rehabilitatian . Relacatian Wastewater . MPC TaughTube™, Cured-In-Place Pipe . Pipe Bursting . High strength PVC Internal Lining Systems . CCTV . Paint Repairs . Manho.le Rehabilitatian Praducts Water . Mainline and Service Installatian . New I Rehabilitatian . Directianal Drilling . HDPE Pipe Expertise . WEKO Internal Jaint Sealing Telecommunications . Trenching . Directianal Drilling . Manhale Installatian . Fiber Optic Installatian . Verificatian and Daylighting Vacuum Excavation . Gas Line Rehabilitatian . External Jo.int Sealing . Utility Verificatian I Daylighting . Cathadic Pro.tectian . Ano.des I Test Statians I Fault Finding Miller Pipeline Corporation acquisitiansafbath Southeastern Infrastructure Systems, Inc., lacated in the City af Atlanta, Geargia as well as Griner's Pipeline Services lo.cated in Mo.unt Dara, Flarida, expand to. aur current capacity far salutians to. Inflo.w and Infiltratian prablems. . . r- ~ ("""ii Action by Written Consent of the Board of Directorsof Miller Pipeline Corporation Effective May 9, 2006 The undersigned, being all of the members of the Board of Directors (the "Board") of Miller Pipeline Corporation, an Indiana corporation (the "Company"), acting by unanimous consent and without a meeting and pursuant to Section 23-1-34-2 of the Indiana Code, hereby waive notice of a meeting of the Board as may be required by law and/or the Company's by-taws and adopt the resolutions as set forth hereinbelow, taking or authorizing the actions specified therein. NOW, THEREFORE, BE IT RESOLVED That the persons whose names are set forth below be and they are hereby duly appointed to the offices in the Corporation set forth below opposite their names, to serve at the pleasure of the Board until its next annual organizational meeting, and until their respective successors shall be duly appointed and shall qualify, or until any such person's earlier resignation or removal from office. Dale R. Miller.......................................... Chairman Douglas S. Banning, Jr........................... Chief Executive Officer and Chief Financial Officer Kevin G. Miller ........................................ President and Chief Operating Officer Mark R. Wallbom..............;...................... Senior Vice President Nina A. Mann........................................... Secretary and Treasurer RESOLVED FURTHER, the Board hereby adopts the forms of any such resolutions that may be required to effect any of the foregoing resolutions. General r... ,. " \i ,.... 'I RESOLVED That any persons hereinabove duly appointed and/or the Board and proper officers of the Corporation be and they are hereby authorized and directed to take or cause to be taken all such further actions, to execute and deliver, or cause to be executed and delivered, all such furth~r agreements, instruments and documents and to incur and payor cause to be paid all such fees and expenses in the name and on behalf of the Corporation as in their judgment shall be necessary or advisable in order to carry out fully the intent and purposes of the foregoing resolutions. #186136 1 '-",i'~ .. RESOLVED FURTHER That all pctions heretofore taken in the name and on behalf of the Corporation by any persons herein above duly appointed by the Board be and the same are hereby approved, ratified, confirmed and adopted in all respects as the actions of the Corporation. F""\ f 2f~ c !jiIL Kevin G. Miller r'il #186136 2 4)~ f(:Yrl; p-~ Dale R. Miller SE\T BY. : \0 I ANAPOL IS :11- 6-95 : 2:55P~ ..A .31i 23i 1000 O~ r\ f'\ r\i OFfICi Of THR SE~ltARY 01 STATE STAT8 OF IHDrAN~ CBRT!F!C~TE OF EXISTENCE To Whom These Presents Came, Greecing; I, SU& ARN~ GI~~OY( 5ecreeary of State oE Indi~na, do hereby certify ~hat I am/ by vlrtue of the la.a ot the State of Indi~na, the custodian of the corporace recor~8 an~ the proper official to execute thi3 certificate. I f~r;her certifJ that record~ of thi~ office disclo~e th~t KILLER PIP!LINE CORPORATION rnea ArtiCles of Incorporation on July 19, 199:', and is a corporation dllll' organi::ed and editing uncilr Ilnd by virtu.. of the lil!J9 of I:.hg St.ate of Indiana. I further certiEy this c:orf'Or"ticn ha:3 filed it3 mos~ H.c:ent Illnnual repcct required by Indi~~~ ld~ with the Secretary ot state, or is not yet .~uicad to rile suet! iionual rl;pOni:, and that i'lc::tcleb or D1ssolution have not been filed. In witn~ss w~acaof, ! ~a~e h.rQ~nto G~t ~i nand and a'f1xed the seal of the State of Indiana. ut the City of Indianapolis, this Sixth day of ~ove.ber, 1995. 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(ii' w~O ;::;:'0 0<;.... :T......::s gal!:: m~"" O::sco ::SOO C1::T co .... ....... _. c.. < '" CIl ::s -. < enQl (1)3. !""'::s ~-IS: --a. CIlC:QI .... -. I ::s ::s Cl) .... - ...... ...... o ...... co :>- I (,/'I .... co 0) w .... ...... co co co I .... .... ...... ...... (\ Miller Pipeline Corp_ TRADE REFERENCES Citizens Gas & Coke Utility 2020 N Meridian Street Indianapolis, IN 46202 (3 I 7)297 -4626 Mike Sullivan Columbia Gas of Ohio 920 W. Goodale Blvd. Columbus,OH 43216 (440)240-6123 Jeff Winterstein r, Louisville Gas & Electric Company 820 W Broadway Louisville, KY 40232 (502)364-8764 PaulStratrnan Alabama Gas Corporation 410 South Tenth Street Birmingham, AL 35233 (205)326-8211 Ed Smith The Peoples Gas, Light, & Coke Company 124 I Division Street Chicago, IL 60622 (773)395-7412 Edward Doerk Baltimore Gas & Electric Company 1699 Leadenhall Street Baltimore, MD 21230 (410)291-4726 Harry LeBrun City of Grand Rapids 1900 Oak Industrial Drive NE Grand Rapids, MI 49503 (616)456-4550 Donald Spencer r\: / City of Baltimore 200 N Holiday Street Baltimore, MD 21202 (410)396-3476 Sam Edorer 8850 CRAWFCRDSVILLf Re. P.O. BOX 34141 INDIANAPOLIS, iNDIANA 46234 TELEPHONE: (317) 293-0278 ~A^: (317) 293-8502 Vectren Energy Delivery 1630 N Meridian Street Indianapolis, IN 46202 (317)321-0767 Alex Ramsey Cinergy 139 E 4th & Main Cincinnati, OH 45202 (513)287-2588 Dennis Westenberg Atrnos Energy - MSVG 4155 Industrial Drive Jackson,MS 39209 (601)961-6788 Jamie McKenzie Missouri Gas Energy 223 Gillis Street Kansas City, MO 64120 (816)472-3463 Gary Williams Public Service Electric & Gas Co 300 Connecticut Drive Burlington, NJ 08016 (609)239-2428 Ed Galarza NIPSCO 5265 Holunan Avenue Hamrnond,IN 46320 (219)477-6303 Tim Dehring City of Greenfield 809 S State Street Greenfield, IN 46140 (317)462-8530 David Scheiter City of PIano 4120 W PIano Parbvay PIano, TX 75086 (972)964-4140 Steve Spencer www.mtubeonline.com May 18, 2007 Mr. Mark Hallett Vice President of Utility Division Miller Pipeline Corporation 8850 Crawfordsville Road Indianapolis, IN 46234 Subject: Manufacturers Certification Dear Mr. Hallett, 160 Corporate Dr. Batesville. MS 38606 Tel: (662) 578-7797 Fax: (662) 578-7798 This Manufacturers Certification docyments that Miller Pipeline Corporation has received MTC installation data and is authorized to install MTube for Cured In Place Pipe (CIPP) rehabilitation. F\ Sincerely, . ~~~-'rff'PkA. Greg Laszczynski Director of Business Development Mississippi Textiles Corporation - MTC (\ April 16, 2007 To: Miller Pipeline ,~\ I Mississippi Textile Corporation hereby certifies the MTube ™ CIPP liners being delivered to your Company have been tested and meet the CIPP chemical resistance requirements of ASTM F1216, ASTM F 1743, and ASTM D 5813. MISSISSIPPI TEXTILES CORPOR,A.TION -----/ 10 L \ . /!..1~{ _~('J5CJo/";7-JK'_4' Greg Laszczynski Director of Business Development WWW.mtubeonline.com 160 Corporate Dr. Batesville, MS 38606 Tel: (662) 578-7797 Fax: (662) 578-7798 CERTIFICATE OF COMPLIANCE Date: April 16, 2007 To: Miller Pipeline Re: CIPP Felt Tube MTC CIPP felt tubes are manufactured in accordance with specifications of MTC and will comply with the guidelines of ASTM F 1216 and ASTM F 1743. All MTC CIPP felt tubes are also manufactur~d in an ISO 9000:2001 certified factory. r\ Mississippi Textile Corporation (~.---t' (~ / . , . _/.:.J;l;t\~t'e::1'Yj~?/Ok> Greg Laszczynski Director of Business Development MTC DISCLAIMER OF WARRANTY: AS INSTA,LLATION CONDITIONS (INCLUDING, AMONG OTHERS, PIPE TYPE & CONDITION, GROlJNDW A TER DEPTH & TEMPERA TlJRE, DEPTH OF COVER & SOIL TYPE, LIVE LOADS, SITE ACCESS AND WEATHER) AND INSTALLER EXPERIENCE, TECHNIQUES AND TYPE OF EQUIPMENT V ARY GREATLY, MTC EXCLUDES ANY WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, WITH RESPECT TO THE GOODS SOLD HERElJNDER AS TO MERCHANTAI?ILITY, FITNESS FOR PARTICULAR USE OR ANY OTHER MATTER WITH RESPECT TO TH~ GOODS WHETHER USED ALONE OR IN COMBINA nON WITH OTHER PRODUCTS. MTC HAS NOT PROVIDED ANY DESIGN SPECIFICA nONS OR COMPUT A nONS, AND ACCORDINGLY, MTC DOES NOT WARRANT THE DESIGN. TNt www.mtubeonline.com 160 Corporate Dr. Batesville, MS 38606 Tel: (662) 578-7797 Fax: (662) 578-7798 CERTIFICATE OF COMPLIANCE Date: April 16, 2007 To: Miller Pipeline Re: CIPP Wetout Tube Alpha Owens Corning (AOC) 1 02T A is a resin that has been approved by MTC for use with MTC tubes in CIPP projects. AOC 102TA has a successful history in both lab conditions and actual field installations and meets the chemical I resistance recommendations of ASTM F1216, ASTM F1743 and 05813. The following physical properties are recommended for CIPP design when using the AOC 1 02T A polyester resin system: r, Flexural Modulus of Elasticity.... .... ..... . ......... ..... ... .. .. .400,000 psi Flexural Strength. ... ... ...... ... .... ..... .... .,. ... ... ... ... ...... ... ..4,500 psi *T ensile Strength ..................................................... ..2,500 psi Flexural Modulus Reduction to Account For Long-Term Effects......................................... ..50% * As stated in ASTM F1216, t~nsile strength is not a parameter that is used in standard gravity flow design. The above values were derived frorT;1 samples tested in accordance with modified ASTM 0-790. Mississippi Textile Corporation \~1GfdYff19kd Greg Laszczynski Director of Business Development DISCLAIMER OF WARRANTY: AS INSTA;LLATION CONDITIONS (INCLUDING, AMONG OTHERS, PIPE TYPE & CONDITION, GROUNDWATER DEPTH & TEMPERATti'RE, DEPTH OF COVER & SOIL TYPE, LIVE LOADS, SITE ACCESS AND WEATHER) AND INSTALLER EXPERIENCE, TECHNIQUES AND TYPE OF EQUIPMENT VARY GREATLY, MTC EXCLUDES ANY WARRANTY OF ANY KINTI, EXPRESS OR IMPLIED, WITH RESPECT TO THE GOODS SOLD HEREUNDER AS TO MERCHANTAI;3ILITY, FITNESS FOR PARTICULAR USE OR AN"Y OTHER MATTER WITH RESPECT TO THE GOODS WHETHER USED ALONE OR IN COMBINATION WITH OTHER PRODUCTS. MTC HAS NOT PROVIDED ANY DESIGN SPECIFICATIONS OR COMPUTATIONS, AND ACCORDINGLY, MTC DOES NOT WARRANT THE DESIGN. I ~.. t r'\ Insituform' Worldwide Pipeline 17988 Edison Avenue Rehabilitation Chesterfield, MO 63005 Tel: (636) 530-8000 Fax: (636) 530-8744 www.insituform.com Cf~i(U! ;I:def fO( the \:/orid May 9, 2007 RE: ~lanufacturcr Certification To Whom it May Concern: Please be advised. that Insituform Techn~)logies, Inc. manufactures and supplies CIPP tube to Mississippi Textiles Corporation, Inc. (MTC). Sincerely, INSlTUFORM TECHNOLOGIES, lNC. ~~ Scot Pearson Director of Marketing ST ATE OF MISSOURI COUNTY OF ST. LOUTS Subscribed and sworn to before me this. 9th day of May in the year 2007 /'t 1 ~l ./1 '";. ... "\ iJo,} ,\.. \ Notary Public ",,,,,,,,;;-- AURA JOYCE f'~;:'."('';;'::-'~ NololY Public. Sto1e of MIssoutl i.:'<:::":~':.~' SL Louis county ~ '--",'... g commission # 06428257 '.......}f;;io~~$;;: My commtnk>n bplloS May 16, 2010 'Iti,;,\~\\'" r\ I Insituform Wllrlihvidl'l'iiJl'iiile i 7991.) hli,on i\vcllUc Tel: Q,\6.'i.l0.8000 Reiwliililulitm Ck,lcrf1cld. MO 63()()5 Fax: 636.530.8744 W\VW.illsituftlrm.com October 13, 2006 To Mississippi Textiles Corporation: (', Insituform Technologies, Inc. (ITI) hereby certifies that the CIPP liners being manufactured under the MTube label for Mississippi Textiles Corporation (MTC) are of identical physical and chemical composition as the Insitutube manufactured by the ITI facility in Batesville, Mississippi. The only difference between MTube CIPP liners and Ins.itutube CIPP liners is the ink jet printed label. Furthermore, lnsituform Technologies, Inc certifies that the materials used in the manufacturing of MTube forMTC have beEmtested and meet the CIPP chemical resistance requirements of the Greenbook "Pickle Jar Test", The testing was conducted using the same resin ancj liner materials that were tested and approved by the City of Los Angeles, Department of General Services, Lab No. 98-514-2, reported on August 22, 1997. Copies of the test results are attached. INSITUFORM TECHNOLOGIES, INC. 3 ~QJ ~--~---- Bill Moore Material Manager f.. I Specifications for Cured-In-Place Pipe (CIPP) Tube 1. INTENT f' r 1.1 This document provides specifications for the tube products used in the reconstruction of pipelines and conduits. Proper installation of a resin-impregnated flexible tube produces a tight forming product within the original conduit The resin is cured using either hot water under hydrostatic pressure or steam pressure within the tube. The Cured-in-Place Pipe (CIPP) will be continuous and permanently fixed within the original pipe. 1.1.1 As installation conditions and experience and techniques differ greatly, Mississippi Textiles Corporation (MTC) excludes any warranty of any kind, express or implied, with respect to the goods sold hereunder as to merchantability, fitness for a particular purpose or any other matter with respect to the goods whether used alone or in combination with other products. MTC has not provided any design specifications; accordingly, MTC does not warrant the design. 2. REFERENCED DOCUMENTS This specification references standards from the American Society for Testing and Materials, such as: ASTM F1216 (Rehabilitation of Existing Pipelines and Conduits by the Inversion and Curing of a Resin-Impregnated Tube) and AS1'M F1743 (Rehabilitation of Existing Pipelines and Conduits by Pulled-in-Place Installation of Cured-in-Place Thermosetting Resin Pipe (CIPP)), which are made a part hereof by such reference and shall be the latest edition and revision thereof. 3. MATERIALS 3.1 Tube - The sewn Tube shall consist of one or more layers of absorbent non-woven felt fabric and shalt meet the requirements of ASTM F1216, Section 5.1 or ASTM F1743, Section 5.2.1. 3.1.1 The Tube shall be manufactured to a size. as specified by the customer. Allowance should be made for circumferential stretching during inversion. Overlapped layers of felt in longitudinal seams that cause lumps in the final product shall not be utUized. 3.1.2 The outside layer of the Tube shall be coated with an impermeable, flexible membrane that will contain the resin ,and allow the resin impregnation (wet out) procedure to be monitored. r 3.1.3 The Tube shall be homogeneous across the entire wall thickness containing no intermediate or encapsulated elastomeric layers. No material shall be included in the Tube that may cause delamination in the cured CIPP. No dry or unsaturated layers shall be evident in the wet out tube. 3.1.4 The wall color of the interior pipe surface of CIPP after installation shall be a relatively light, reflective color so that a clear examination with closed circuit television inspection equipment may be made. 3.1.5 Seams in the Tube shall be stronger than the non-seamed felt material. 3.2 Resin - The resin system shall satisfy the requirements of ASTM F1216 and ASTM F1743. The resin system shall produce a CIPP that will comply with the structural and chemical resistance requirements of the relevant ASTM standards. 4. STRUCTURAL REQUIREMENTS 4.1 The CIPP shall be deSigned by the customer as per ASTM F1216, Appendix X.1. 5. INSTAllATION Tube Design, Installation and Cool Down shall be performed by the contractor in accordance with ASTM F1216 or ASTM F1743. 5.1 CIPP installation shall be in accordance with ASTM F1216, Section 7, or ASTM F1743, Section 6. 5.1.2 Curing is accomplished by utilizing hot water under hydrostatic pressure or pressurized steam in accordance with the resin manufacturer's recommended cure schedule. 5.1.3 Cool down shall be in accordance with ASTM F1216, Section 7, or ASTM F1743, Section 6. '. 160 Corporate Drive. Batesville. MS 38606 Toll Free: 1-877-682-8823 Pi1one: 662-578.7797 Fax 662-5713-7798 EMmafl: info@!:ntut}80nhne.com @ 2005 Mississippi Textiles Corporation 9105 M002 r . 1 MTube" is the industry's higl7est quality cured-in-place pipe (eIPP) tube, ready when you need it. Every CIPP project you undertake has its share of challenges and unexpected obstacles. When you order MTubes for your projects, you can be assured that you are getting the highest quality felt tubes available on the market and that you are getting them on your schedule. Our tubes are specially manufactured to accommodate your installation method whether you use water or steam inversion. MTubes will also handle the unique demands of steam cure. r We understand what it takes to consistently produce high quality MTubes. Over 30 years of experience and state-of-the-art manufacturing techniques ensure that our MTubes are constructed for optimal installation and long-term performance. MTubes are manufactured from premium quality raw materials. The raw synthetic fibers we select to make our MTubes must pass our exacting standards for quality. We then put our MTubes through more than 25 stringent quality checks for weight, thickness, density, strength and elongation. The result is an MTube with superior uniformity. eman Tile heat-banded coating aver the seam seals tfle stitching aM creates a permanent connection at the butt-sewn seam joint. The butted ends of our felt are sewn together. Experience has shown that the strongest tubes are made with butt-sewn seams. The uncoated, butt-sewn seam provides the required strength and produces a smooth, uniform pipe wall around the full circumference of the tube. A heat-bonded coating is extruded over the seam. Extruding hot coating onto the butt-sewn joint seals the outer seams of our MTubes. This seals the stitching and creates a permanent connection at the butt-sewn seam joint. MTubes are avaifable in 6 to 96 irdl diarreters We produce our MTubes to meet your schedules and deadlines. When you encounter the unexpected, you'll appreciate our ability to react to short lead times. Get your next CIPP project off to a great start, order high-quality MTubes from MTC. Stateof'lhe-art manufacturing techniques ensure lliat MTubes are COllstructed Far Quality on Demand, caflllS at 877-MTC-TUBE {877-682-8823}. tor optimal ins/allalion and long-term performance. (\ e- Mississippi Textiles Corporation 160 Corporale Drive. Bat6svi!le. MS 38606 Toil Free: 1-877-682-8823 Phone: 662-578-7797 Fax: 662-578-7798 E-mail: info@mfubeonline.com @ 2005 Mississippi Textiles Corporation 9/05 M001 " f\ Client: Project: Location: r (\ <><><><><><><> CIPP DESIGN <><><><><><><> (as per ASTM F1216) 05/07/07 Conduit \ Condition: Gravity Sewer, Fully Deteriorated 250,000 psi 50 % 4,500 psi 2.0 60.00 inches 58.80 inches 2% 5.00 feet 5.00 feet 120 Ib.lcu.ft. 700 psi 5.8 psi 16,000 Ibs o psf 0.3113 0.8236 0.9879 0.8860 Flexural Modulus Flexural Modulus Reduction to Account for Long-term Effects Flexural Strength Safety Factor for External Loads Mean Diameter Minimum Diameter Ovality Maximum External Water Head to flowline Soil depth at Top of Conduit Soil Density Soil Modulus Total Earth Loading 20,0001bs Highway Live Load per AASHTO includes 1.64 psi Highway surcharge) 2025psf RR Live Load (80,000Ibs per axle or 320,0001bs per truck) (includes 0.00 psi RR surcharge) Thickness Limitations (in inches) ---------------------------------------------- i Maximum compressive hoop stress External pressure buckling Minimum stiffness limitation, deteriorated conduit External pressure, deteriorated conduit (AWWA) inches mm Minimum DesiQn Thickness = 0.99 = 25~ 1 DR = 60.7 Minimum stiffness limitation, deteriorated conduit Mode of Failure: Long-term Deflection = 0.00% Based on Trench Width of (Spangler) 7.5 feet 2.3 meter The input data for this project should be verified in the field prior to construction. Should other conditions exist now or are expected in the field over the d~sign life of this CIPP differing from the information cqntained herein, then appropriate adjustments must be made to the design calculations. This Design Spreadsheet uses the equations from ASTM F1216 Appendix X1.2.2. User is responsible for All input values. Designed by Checked by ".. Client: Project: Location: r\ i CIPP DESIGN <><><><><><><> (as per ASTM F1216) <><><><><><><> Conduit \ Condition: Gravity Sewer, Partially Deteriorated 250,000 psi 50 % Flexural Modulus Flexural Modulus Reduction to Account for Long-term Effects Flexural Strength Safety Factor for External Loads 4,500 psi 2 60.0 inches 58.8 inches 2% Mean Diameter Minimum Diameter Ovality 40.0 feet 0.0 feet Maximum External Water Pressure to flowline Depth at Top of Conduit, soil only Thickness Limitations (in inches) 0.811 1.625 Maximum compressive hoop stress External pressure buckling Minimum Desiqn Thickness 1.62 41.3 36.9 inches mm = Mode of Failure: DR= External pressure buckling The input data for this project should be verified in the field prior to construction. Should other conditions exist now or are expected in the field over the design life of this CIPP differing from the information contained herein, then appropriate adjustments must be made to the design calculations. This Design Spreadsheet uses the equations from ASTM F1216 Appendix X1.2.1. User is responsible for All input values. Designed by Checked by 5/7/2007 '-'-~ C=ertifica tia n A warded 'To INSITUFORM TECHNOLOGIES, INC. SEE j\PPENDLX PACE FOR REGISTFmED LOC\TIONS Bureau Veritas Certification North;\merica, Inc. certifies that the management system of the above organization has been audited and found to be in accordance with the requircrncnts of the management system standards and scope of supply detailed below ___STt\NDART)S-------- ISO 9001:2000 PI': Oi" Sl'PPLY -~...~.,~_._..._-~.~--_._-~.__._--_.._--_..---_. DESIGN, DEVELOPMENT, CORPORATE FUNCTIONS, MANUFACTURING, APPLICATIONS ENGINEERING, PREPARATION AND INSTALLATION OF PRODUCTS FOR TIIE REHABILITATION OF PIPELINES USING THE FOLLO\Xi'ING TRENCHLESS TECHNOLOGIES: . INSITUFORM CURED-IN-PLACE PIPE (CIPP) NUPIPE @ FOLD AND FORMED . THElUvlOPIPETM FOLD AND FORMED. . INSITUFORM ArmorGRiP n1 PANELS Original Approval Date: 24 NOVEi\IT)i':l( 1995 Subject [0 the continued ;;atisfactory operation of the Organizatioll'si\hnagcment System, thIS certificate will remain valid until: 25 FF::BRUi\RY 2008 [:unher clarifications regarding the scope of this certificate and the applicability of the management system requirements may be obtained by consulting the organi7.aticlIl. =~L~tcL:~~Q -- FG)~ Verita~1;~~tiflcation North i\rnerica, Inc. 515 \':/cst 5'" Street, Jamestown, New York, USA w\V\v,certi fica lion. u s, bureau veritas, com Certificate No: 164006 Issue Date: 21 MARCH 2005 r! Aoe 2552 Industrial Drive Valparaiso, IN 46383-95lO (219) 465-1611 :: @ rrol'ld Leader ill RlWill T(!('lmolo{JlJ CERTIFICATE OF ANALYSIS Customer: BLAYLOCK CHEMICAL AOC Order No; 46385 Product: lO2TA Approval Date: 11/13/06 Customer Order No; I 5695{)(i Print Date: III \3/06 Batch No; V961 Control No: 00004143 ! Property Method Description Units Results Low Shear Vise V227.I357 NO 1, 25.0uC, LV !!3L, 0.6 rpm/200 see cP 40500 Viscosity V227.1357 NO 1, 25.0"C, L V#4, 60 rpm/200 see cP 5975 Od Time E613.l357B Sample@25.0'C, ,. 18.4 @ 60.0uC, TempI ~ 32.2'C Temp2"' 82?Or Cd Time F613.13578 Sample @ 25.00C, min 11.7 @ 60.00C, Temp] =, 32.20C, Temp2 7., 82.2OC Initiated StubiJiIY S495.1357B Sample 25.0or hr 20.0 27.8OC INt Pcr Gal 011802 NO?, Wt/Gal Cup, US GAL, 250C Ibfgal 10.752 Prepanu By : Tom Sievers (\ Technical Service Manager : Ed Kleese r STA TElvfENT OF COMPLIANCE: AOC certifies that this shipmcnt meets the defined specifications for Insituform Technologies Inc. AOC Authorized Signature: .______. ---~_....-....--_.....-_...-_.....-....-._----_...---..--_.._-_....-_................................---..-----......................-...---..-..-----------..--..-.._.._---..---..-----_..._......_........__....--.._--_..--~_.. IN:>[TUrORM ACCEPTANCE (to be completed upon delivery of shipment): Temperature A, Receivc:d (bulk only): ........._....__...oF Shipment Disposition: ..___.__.... Accepted Rejected _~......._. Other (explain): Signature of Authorized lnsituform Representative Date @ CO~!f~!NTllESIN &;;; s:= r ACe:. (\ World Leader in Resin Technowgy Product Information 102TAFilled Polyester Resin (lOZTA was/on""rly lO1-FTA) Isophthalic Based Flesin for Underground Sewer Pipe Liners TYPICAL \.IQUID ,R"SI~ f!RQP~RTIf;S", ~ ',J> "" '";~}2:~~:,7;>' '::,,:';::,' i ': :f-,.' Test Method Flexural Strength, PSI/MPa Flexural Modulus, PSI/GPa 4,500131.5 400,000127,6 ASTMD-79O ASTMD-790 -Typical prupertlcl are not to be c':onstrued lIS spcelOcatJODlf. OESQ~~P~IO~ ,'.>~ / :. . ',. , . :~ ,~' /,,It; _ ~~ (~~j ~.: ) ~~' Jr,,~ ;":,:, ~-i;' :~,{:;,~ ;, ~/..'~ :~' ~y:~ \ .::: ~ AOC's I 02T A Filled is a high molerular weight isophthalic unsaturated polyester resin that was developed for Insituform Technologies, Inc. and their licensees. I 02T A Filled provides the corrosion resistance, durability and toughness that is required in this demanding application. Using recommended catalyst systems and r" temperatures, up to 50 hours of catalyzed pot life may be obtained. 1 02T A Filled thixotropic proper ties reduce resin pooling while providing superior PET felt wet-out. alGNIPIOANT OHARAOTERlaTIOB . Excellent catalyzed pot life . Superior mechanical properties . High molecular weight . High heat distortion tempature APPLlOATION . Sewer pipe liners PERPORMANOE GUIDI!LINIIES Consistent shop conditions contribute to consistent gel times. STORAGE sTABlLrTY Resins are stable for three months from date of production when stored in the original containers away from sunlight at no more than 70oF12l .C. After extended storage, some drift may occur in gel time. During the hot summer months, no more than two months stability at 860F/30.C should be anticipated aAPETY See appropriate Material Safety Data Sheet for guidelines. .ao 8002 OERT1f'1llD The Quality Management Systems at ev- ery AOC manufacturingfucility have been certified as meeting ISO 9002 standards. This certification recognizes that each AOC facility bas an internationally ac- cepted model in place for managing and assuring quality. We follow the practices set forth in this model to add value to the resins we make for our customers.