HomeMy WebLinkAboutAnnex Area 6 Candy Ln./Sellers Ct.
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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:~ 22. I 7...00, .
1. Governmental Unit (Owner): J~PP~OUVIu.E S""ev~~A.b
2. County: Cl...AZK
3. Bidder (Firm): 7€API &M.1~7JAk,. LL L.
,
Address: RD. Bo.Jt 243 1/'/'7/2- h/t.Ra,40 ::;-lJi!t!lJr
/
City/State: ~EAP;/IS J :;Z;;.;>/.QAJ4 ~1<13
4. Telephone Number: (BIZ) 2';"- /2S8
5. Agent of Bidder (if applicable): tJ i4
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete
the public works project of Jg:::FelS0/I..)lt'1 LLt! <;'e\Ue>t. ~~
(Governmental Unit) in accordance with plans and specifications prepared by
~~.do~ )Tr.::oM.i3'S. "t\...A~"2.. ) The... and dated AmlL. 2c::', Zoo 7 for the sum of
~ U/<Jlr ~U5' ~Pc.S4C- $ Si-e air .#UC.e' ~POS"',-
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the
notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the
notice. Any addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract .are needed, the cost of units must be the same as
that shown in the original contract if accepted by the Governmental Unit. If the bid is to be awarded on a unit
basis, the itemization of the units shall be shown on a separate attachment. .
The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee,
or applicant for employment, to be employed in the performance of this contract, with respect to any matter
directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry.
Breach of this covenant may be regarded as a material breach of the contract.
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS
(If applicable)
I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory
obligation to use steel products made in the United States. I.C. 5-16-8-2. I hereby certify that I and all
subcontractors employed by me for this project will use U.S. steel products on this project if awarded. I
understand that violations hereunder may result in forfeiture of contractual payments.
8-102
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ACCEPTANCE
The above bid is accepted this
~ ' day of '" &.JIJ e....
. -z.co"'1. subject to the
following conditions:
- ~e....-
rity embers: ....Jew=<Lta..N. rl., ~ ~~./
J.
PART \I
(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 ($100,000) or more. (IC 36-1-12-4)
Governmental Unit: Jet=f".€)t.SuNVIL..Le" S-tM'e>c..~
Bidder (Firm) -zi-4,q tb,,;~7JA)6. LL C.
I
Date: HAy' 22/ 2007
These statements to be submitted under oath by each bidder with and as a part of his bid.
Attach additional pages for each section as needed:
SECTION I EXPERIENCE QUESTIONNAIRE
1.
What public works projects has your organization completed for the period of one (1) year prior to the
date of the current bid?
When
Contract Amount Class of Work Comoleted Name and Address of Owner
~..., C;-c.-\-. e.L\ L.'\..,. \ - r...L1. -.~
2.
What public works projects are now in process of construction by your organization?
When to be
Contract Amount CI'ass of Work Comoleted Name and Address of Owner
~ SJ.,,~JJ\Q. ~. 7-- ~~., \"..
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3.
Have you ever failed to complete any work awarded to you?
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No
If so, where and why?
4. List referenced from private firms for which you have performed work.
h7.M &c"'lDt..f Cwl7tt<<.ncJu;tlk-. RtJ. &:.K 3~oG..S" Lcvlfy/u...eJ jC.y 0/02.32 J/~ pj~
llJ. R..v06:L. 5;.//l-Z{' ,.:E1JC. n30 z:;:;c,wllJ1k. I..ov/iy; I/~: kr' ~UG. ~~ S#tGa-'"
l1eitCf5JlI/"".&~ .j.),P':V~/~C. waSlbPG4eUvJlZ...I2J. LO(}/~i/; Ik; K'I yoz/8 Ro~c::IL1"P/~cd
}l.bc.41/ ~o.PllJen~ /.:J:'NC-. P.D."2::0)(. \2.aS JaFt!>tS.:wtll~ ,.'LJJ 'l1 l31 ~a.LS. AJOlAIJ
He aw~aW"" rIJtc' IGl'v1 P~llW Rd. L.Ol.JI$'y.; lie, jC.y 90 Z72.- ])0;1/ Z;;AlW.6~
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when
you could begin work, completed the project, number of workers, etc. and any other information which
you believe would enable the governmental unit to consider your bid.) frC:V'ot1 /I'1AnnttU- oS..,I",",/,I,.!S;'
'b#I6/4> l..A1OV Ij Ot..t:fYo}!l. ~ 4<<.e'Ss /lC),tN;) i .w~i~~ ..g~4SS" 126#1); 8c6-M.I 5"6'N.Je,- 47d/N" Psc..
IhS,TPu..Anwvi .i3e:"&-uo/ PAvtn"1MI an/l!~nc)t<>, J26,Hl>;e- AIC<:~S ~. nA'sA ~ht.lj.
/21:f'S1'IIt--AI?i.W/ C:,~//- ~ h/k./ t!L<?t;,A? ~ '. '.
2. If you intend to sublet any portion of the work, state the name and address of each subcontractor,
equipment to be used by the subcontractor, and whether you expect to require a bond. However. if you
are unable to currently provide a listing, please understand a listing must be provided prior to contract
approval.
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.
s~ 'S;~ed.o.)\e ~o."3 - A.~q)
4. Have you entered into contracts or received offers for all materials which substantiate the prices used in
preparing your proposal? Otherwise, please explain the rationale used which would corroborate the
prices listed.
Yes
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SECTION III CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial
statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to
the governing body awarding the contract must be specific enough in detail so that said governing body can make
a proper determination of the bidder's capability for completing the project if awarded.
SECTION IV OATH AND AFFIRMATION
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid
for public works are true and correct to the best of my knowledge and belief.
II .r::: h 22@ d f 1 1 .
Dated at..t:le-M.flW~SJ .oi)~ t is ay 0 IV~
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By
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C)peJCA1n.AJG ~N;46111t.
(Tille of Person Signing)
ACKNOWLEDGEMENT
STATE OF X,.Jb\~/U.A
COUNTY OF c..L.4&W
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Mc!!)..J/,N C. LtfMoe.)c; } .\..,
{JPtflL4n"-'b P/AAJt4tnell
(Title)
being duly sworn, deposes and says that he is
of the above
~.-#'I t2w/7fAcn:Vc; . LLC
(Name of Organization)"
and that the answers to the questions in the foregoing questionnaires and all statements therein contained are
true and correct.
Subscribed and sworn to before me this
2Z~ day of ~y , 2007
0ILV~ ~
Notary Public
My Commission Expires: ~~ 2. Za.::> 8
I
County of Residence: LJ/9S1../,'-vt.TMJ
B-105
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NON - COLLUSION AFFIDAVIT
!
The undersigned bidder or agent, being duly sworn on oath, says that he has not, nor has any other
member, representative, or agent of the firm, company, corporation or partnership represented by him, entered
into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such
letting nor to prevent any person from bidding nor to include anyone to refrain from bidding, and that this bid is
made without reference to any other bid and without any agreement, understanding or combination with any other
person in reference to such bidding.
He further says that no person or persons, firms, or corporation has, have or will receive directly or
indirectly, any rebate, fee, gift, commission or thing of value on account of such sale.
OATH AND AFFIRMATION
I affirm under the penalties of perjury that the foregoing facts and information are true and correct to the
best of my knowledge and belief.
D d i A . -' thO Z? "'b day of I ~ ""..
ate at JV\~\s"l ..l..>~\~Ao IS L- I"'\_::::!
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By Y'aZ:/ ~':) /
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OAJ1t,A1TJAJ(, ~~/-/
(Title of Person Signing)
,~Ol.
ACKNOWLEDGEMENT
..,...... - .
STATE OF J-N,.O /4tlf"J
COUNTY OF ~~
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) 88:
)
HEL//';,; e. leMONS )..h
o P8!,ffJ)A.)& M IQtV /J67:i\...
(Title)
being duly sworn, deposes and says that he is
of the above ~.4M &v~lJ:Vu . LtC
(Name of Organization)
and that the statements contained in the foregoing bid, certification and affidavit are true and correct.
Subscribed and sworn to before me this 22& day of dy , 2007
~/~~
My Commission Expires: ~An1 '2.)"Zco 3
County of Residence: /A...-hSI//:V(".~
8-106
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.\NNF.X ARFA 6 SANIT ARV SF.\VF.RS .JOB NO. H70H-'~-21
----------..--- .--------...--.-.-------------------------------..-------------------...-.---.--
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APPROXiMATE
Q lJAN TIT\'
DEfSCRlPTION WITU
tIN IT PRICE WRlTT.lf.N.
IN WORDS
lINIT PRICE
IN
N 11MB.E.RS
TOTALAMT.
FORum
ITEM
-----~----~-_._------------_._---------------------------------------------------------~.--_.-
1>"lSTON .\.
-
() T( >NS Crushed l.imeslone
(M isc Sl'le~)
For ............................................_.........
;iM..t:1:.#f..-:2.....==... T lollarI'
---------.---- .------------- .-~:~~~~~~------------__________:\; ___J ~____.:~___~__ .__.._
2 (J TONS Rank Run SJ.nd
For.......................................................
.&(.f.~~'1....~ T )ollars
Per Ton $ \ ~ ~ $ ()
-------...----. -------------- --------------------------------------------------...-...-----
~
() I~Y
Fmmed Concrele
Non-l~einfmced '.
F elr .......................................................
...7:#.1.1:..0...................... 1 lollarI'
Per Cuhic Yard
$ 50 C!2
$
()
------------_. --------------- -------------.------------------------.----------------...--.--
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N un-FU1'11l1..:d CUIll..:n.11;;
~ ull-Rl.:infurl,;\,;t!
1" or .a~.~.!:k~L-!.-:.!:!................
.?.I:!!t.'5?!!..f.1:::...!i(.,{;..... Dolliu's
Pl.;l Cubit: Yard
$ 115~ $
()
------ -------- -------------- --------------------...----------------------------....-.---
::-> 0 . ~13S Rl,.;infu1\;ing St..:d
1 'lit' ...Q!.-:!.~...t._::.':it.e.~....=...
.p.~~:.p.~~~.~~~I....._........... Dollm's $ \ $.9, $ (I
----- ---.----. -------------- ----------------------------------------------------, .-----
(; 0 .;\" Sod
1: or .........._...........................................
.../:i:I(..f!............................ Dolhu's c CO
Pl.;r Squan.: Ym-tl $ -.J - $ 0
---------------------------------------------------.-------------------------------------.------
-.
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Sl.;l.;d, h.1"tiliz i,."!'
tUtti !\1 ukhing
11' LIt' ......................................................
....(?tY..~............................ Dullm's
p 1.;1' Slluan.: Y;u'd
$
()
$ 1~
---.- ._..~ - --.---- --------------- ----------------------....-:------------------~-----------;---. ._----
/""""" \
8 5' lj! Typ..: 'D' l\LUll111k
1: or .t:H..{..~..?JL~~~!2.........
"&.t.?..!.b.'!.t!:..r:..:!:........... Dollal"~ 0:>
, P1.1' La~h $ 32.J::::x:J $ J ~ (Ila? -
-----------. -------------- ----------------------------------l.--------____J.___...__.__
::.. ':-: :. .:.-,) :..:: ['.i',"..!) i..... :\.o:..\.I:\.:\::t) -.,.' , '."~:
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:\N;\"FX :\RF,\ 6 SANITARY SF.'VERS
.fOB NO. H7(JH-'~-21
--------....----...------------. .------------------------------------------------------ ---...
iTS'1
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APPROXLVL-\TE
l)U.\NTITY
TOTALAM.T.
l~'O R fill)
ITEM
DJ!:S CRlPTION WITH
llNlT PRICE "'RlTTlt"J
L"J "'0 RIJ S
lINIT PRICE
iN
NllMBlfRS
._---~-_.._--_.~------------_._----------------------------------------------------------.-----
9 3 EA Type 'c" 1\fanhole. '
F l)r _rUP.'n17h?~~__1!."!.~.,u""""
SJ.:v.~l-k~~,~.",___ T )ollars
Per Each $ 2 ~ (X) co $ '8 1 ex::::> ~
------------. .-------------- .------------------------------------~--------------.f.J---..--..-
1 ('I I fA Type 'E' 1\r anholc
F or ..."lJAe.~~~~'Z...........
~(/'!...M-~~~.......... T )oHm's
Per Each $ 3"1 tx::::> ce $ 2 -, ocs<e
--- -..-., -------- --------------- --------------------------------------t--------------~,...L:_ ---.--
11 2-.635 T.F g" JIve Ora"jly Sewer
. F l)r..&~_~.-:.:~;-!..u-~m..........
nU"u ,,__.__._____un....."". .....".. T)o II ar s
------------ .-_____________ ._T..r:~~~~~~_~:)~~_______________ $ ____J~ c:___.:~.22~1(QQ-ce
1:' '30 F..-\ Propeny ServIce Connection
PIpe wilh Cleanoul including
Wve FiUingat 'fain
F 0; ..&e:..ikt!.!!-:.~.d....(5J;,7
............................................ T )ollars op
.------- --.---- .-------------- __2~~~~:::.c~~-----------__________~___~~ ::___.:~_J.:t)_':l QJ~?_~
13 2 LA COrlstru\;tion Lntl';Ull:i.:
11.Ol..1iv..P..~~~?.~irl!f/bJ,j~
,yLM.~.:.~~.... Dollars
--------------.---------------~:~~~~:~~------------------____~__~_~:Jq~~-~~- ~t:J~~~
J4 \ U; lG' Wid\; T'..illpOl',uy .!\~l:I,;SS
Ruad
1" ur ..1H.(&r.;.:::~.9..7i1.P..':1.~,!,P
.....................................::=.. Dulhu's
_________.____ .______________ __~:1~~~:~:.:~~~:_______________~__~_~1~=_.:~_2~9c:?2=
1 ~ 24~ TONS H1\{..\ Suriace, Type 'Ii'
Fm
~~Y..~'1.I::+..................... Do [ lar ~
Per TOil $ 109;> $ It \'So
--- .------.---- .-------------- ---------------------------------------------------~-_. .--.--
J( S<t4 TONS lli\L \ IllT<.:nn;.:diat\;. Typ\":
'D'
1" LIL..(#i.l?,!.C?-.:&t:.:::::::::::....
- Dulhu's
~
___.______.____ _______________ ._!..~1_~~~~_____________~_________~..__~:L~___.:~_tt2)_.w lk_.:'
TOTAL BID PRlCEFORIIlVlSlON A: Item:s 1 0111.116= $3q<1~OC::Oo.:
..~! .' ~\ >:';1. : .:. ..\,~.: 2; '1 ~'::'j" lI:'L\':J..~J:\.:o.::(1 ::;1)";' ....1:<
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BID FOR:
ANNEX AREA 6 SANITARY SEWERS
JOB NO. 8708-S-21
CITY OF JEFFERSONVILLE
CLARK COUNTY, INDIANA
RESPECTFULLY SUBMITTED,
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DATE
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