HomeMy WebLinkAboutS.R. 62 & Utica Sellersburg Rd. Sewer
t'j rJ)
>-. 0
.......
('.
~ W
"""':l
..... ~ 0
~ cr:
s \,a Cl.
0 ~ .~ rJ) L.l..
~ I.l..~ ,~ 0 ,~
13 u 'cr:
., o < ,'-J. I.l.. Co)
;; 0
III Q~ <<1\ "-
~ S
GI ~ ....... , c
CD (f' U Q)
c:i ~ '- .::r::.
i z ~ ~ ::i :s
E ~ c
0 ....... co 0
u. ::J "0 1:5
\--.... 0.. .5!2 <x:
u::
~~
....
o
nl
8-107
~
~,
o
Prescribed by State Board of Accounts
Form No. 96 (Revised 2000)
r> i
CONTRACTORS BID FOR PUBLIC WORK
PART \
(T 0 be completed for all bids)
(Please type or print)
. Date:
'8 "/~"o 7
:r e" f f ,,~ S." ",:/ Ie
2. County:
C.-I", .f
I
(;/0/ J(
7e c..... t.,,., fl'.~}:"'JI ~J"e,
I If 91" EG,'/I't:J.'/ .fA
/fJ,.. , J..jJ . :& tv if 7' 'f J
, ,
",- ;;. CJ 'I'" 1~5 4>
1. Governmental Unit (Owner):
3. Bidder (Firm):
Address:
City/State:
4. Telephone Number:
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 a: 11 0 f "1 t f I (/ J. ^ v" lit
and dated
l: U Ii..)!+' lJ....~...J fiv' /J."J...J N....,1. e: if- $
'. "'1 ~ ... -
~...r...l.
S'" Jo,07
~f. S"oJ
I
for the sum of
(Govemmental Unit) in accordance with plans and specifications prepared by
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 Govemmental Unit. If the bid is to be awarded on a unit
basis, the itemization of the units shall be shoWfl 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 tl1is 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, tl1e 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
0' I
~,i
f; 'i' i
I
I
,
...---1
,q
r'\--
'" 'I "
"'. " .
::~
ACCEPTANCE
i
The above bid is accepted this '"2.. \ ~ day of 4\,,)~.!o. ,..
following conditions: - "-JO~..e -
, ~ ?, subject to the
, .-.. .-.
Contracting Authority Members:..J~ ~ ~
~~~~~.,^~~
t4 ~V'-W4,.J
PART \I
i
, '
(Complete sections I, II, lII, 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: C,' J. '/ . t J t f I fir ) WI oj: J 1(.
I
Bidder (Firm) ~r 0..... ~o"r/'rt i 0''''), J,..L-e
Date:
t;/:)-o;
These statements to be submitted under Oath by each bidder with and as a part of his bid.
A.ttach additional pages for each section as neede9.
SECTION I EXPERIENCE QUEST10NNAlRE
1. What public works projects has your organization completed for the period of one (1) year prior to the
date of the current bid?
When
Contract Amount Class of Work Completed Name and Address of Owner
(7#/ Arr t9' (II ..,t)
I
2. What public works projects are now in process of construction by your organization?
When to be
Contract Amount Class of Work Completed Name and Address of Owner
Pftt !'j111"(Hf CJ
,
8.103
~1,1 i
r"..
~
E'--
f.") I'
I
('I
I
!
'.~.
3.
Have you ever failed to complete any work awarded to you?
tVO
If so, where and why?
4. List referenced from private firms for which you have performed work.
f E /l, If r1 IJ (ff ( .0
SECTION 1\ 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.)
~TItJ(F., S4N'.SEwf-; l,o.tlt,,4~1^,~ T'J~ $~I-'It(t ,2fJ;o(3.4'r,uJO,/
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.
f,; f}fl-o,L,/
4. Have you entered into contracts or received offers for all materials which substantiate the prices used in
preparing your proposal? Otherwise, please explain the rationale used which would corroborate the
prices listed.
y Z,S
8-104
"
01
'"
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.
P rc" '- tl--rn:JUJ'fflJ
SECTION IV OATH AND AFFIRMATION
Dated at IUlJrifJfJis I ~J
I
Av1
LLC
I ~1J7
By
i
ACKNOWLEDGEMENT
STATE OF
/J
~
)
)
)
COUNTY OF
/YI Q.VIN C. La10AlS
~rh~~ Jt(atl4.'1~
(Ti e)
~ being duly sworn, deposes and says that he is
of the above 7lA.m C, ~ /-r4 c-h ~ tj LLL
(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 thi~
J 5f'P day of Av1 ,~7 .
'\ ~. In
lc~ t--C-" ~.. /~
... Notary-Public
My Commission Expires: '2/2...~ 20 D f,
County of Residence: ~Sh...I\€t.l-n-
8-105
r.:: -::--'
r
0\
',~
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 pe~ury that the foregoing facts and information are true and correct to the
best of my knowledge and belief.
Dated at fJ, 4\ I L".lJ l~ this
I
If").
~oo7
By
day of J1.v {.
-
T~ co.... CO" J.'r t J.;,.. J, J.,t, e.
.lk J;:-:~I
o J: ~I'" . 1-... '" J fl ~ '" , ., "....
, (Title of Person Signing)
AC~NOWLEDGEMENT
STATE OF .I AJ
COU NTY OF C l, " /l" I(
)
) S8:
)
fJ (' 1....;'"'\ }., -"'0,", J
O,f,l'. tn(l".I~1"
(Tille)
being duly sworn, deposes and says that he is
of the above je./t'O C""";.".cA-....)1 if., e
(Name of Organization)
and that the statements contained in the foregoing bid, certification and affidavit are true and correct.
A~ A 4
Subscribed and swam to before me thIS /) day of ~.,. { , ' 2.00,/
1/ r r\ '//;r.~\
t~~~,J-t+---2 ( dfL
NOtary1'ublic
My Commission Expires: a -f1. J...DO 6
\"' .-
\ \s\r 'H: . r.Q\ '-'
County of Residence: \J'-"u,.~\.l:...v -'\,4Yi-I.._
) .
,-.
6-106
"t>
f':
12.0 BID FORMS
NOTE:
INSERT AND AIT ACB TO FORM 96, DO NOT USE THE
CONTRACTOR'S BID SECTION ON FORM 96. BE SURE TO SIGN BID,
NOTARIZE BID AND EXECUTE NON-COLLUSION AFFIDAVIT.
CONTRACTOR'S BID FORM
,
JEFFERSONVILLE SEWER BOARD
CITY HALL
500 QUARTERMASTER COURT
JEFFERSONVILLE, INDIANA 47130
RE: UTICA-SELLERSBURG RD./STATE RD. 62
SEWER & WATER LINE EXTENSION
JOB NO. 0546A
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
r' specifications at the unit prices listed herein.
.--
S:\SydneyIWPDOCS\05\0546Alsection A2(a).wpd
A-205
..",
, '..
r\:
UTICA-SELLERSBURG RD.!STATE RD. 62 SEWER & WATER JOB NO. 0546A
.-----------------------------------------------------------------------------------------------
ITEM APPROXIMATE DESCRIPTION WITH UNIT PRICE TOTAL AMT.
NO. QUANTITY uNiiPRICEWRITTEN IN FORBID
IN WORDS NUMBERS ITEM
DMSION A
._---------------------------------~------------------------------------------------------------
I
o TONS
Crushed Limestone
(Misc. S~~~,lt', ^
For .... ..........'...................................
...................................... Dollars
PerTon
2
o TONS
-----------------------------------------------------------------------------------------------
$
,-()-
I~ -
o
Bank Run Sand
F T~,J"'t
or..................... ............................
...................................... Dollars
Per Ton
$
3
lEA
-----------------------------------~------------------------------.----------------------------
$
I;' '!.!
o
lO"x 8" Tapping Sleeve
& 8" Valve
F i 1.,-,. Iy J: 'I /.J.." .I-I
or....................,.............................
...................................... Dollars
Per Each
$
--
.- 3 (, DO -
$ .1, t Of) - $ '-e-
(,
4
OEA
-----------------------------------------------------------------------------------------------
Air Release Valve
For.................................................
.......:............................... Do lIars
Per Each
...
$ ~Ou ;......- $
o
5
766 LF
-----------------------------------------------------------------------------------------------
8" Water Main
F or ............T.':::..~~..7...1.:~.t.......
...................................... Do lIars
Per Linear Foot
6
1 EA
-----------------------------------------------------------------------------------------------
$
;). , 6~
II"
I~ 'J(,.-
$ .eo
Fire Hfdrant Assembly
F or ..........~..:~1...r..~~.~.~..............
.....I:!.'.:...':'!.~~............... Dollars
Per Each
7
2EA
----------------------------------~------------------------------------------------------------
...
$ '3 Jocl-
f
7. ~ t:lt. ~
$ ... t'""
8" Gate Valve & Box,J. J
F o~... ........?:~~l~.t...J~:.~...::~......
.....,.......:T.'::.=:.~..!:/........ Dollars
Per Each
-----------------------------------------------------------------------------------------------
$ r J 0 ---
I, "" r; !.:
$ -&
8 1 EA Type 'A' Manhole
F o]r::::..f;~.1..f.~.:~..............
...................................... Dollars "'.. tt If 11I(:> ....:
Per Each $ It I( rJ r) - $ e-
----------------------------------i------------------------------------------------------------
{\
S:\Sydnoy\WPDOCS\OS\OS46A\seetiDn A2(a).wpd
A-206
"';.t,\
~\
r\
.. .~
UTICA-SELLERSBURG RD.lSTATE RD. 62 SEWER & WATER JOB NO. 0546A
.----------------------------------------.------------------------------------------------------
ITEM APPROXIMATE DESCRJPTIONWITH UNITPRICE TOTALAMT.
NO. QUANTITY UNIT P:r{ICE WRITTEN IN FOR BID
IN WORDS NUMBERS ITEM
.-----------------------------------------------------------------------------------------------
9
1 EA
Type 'B' Manhole
F or.........;...{.'!..~~..t.~.~.~.../~.~J-;
...................................... Do llars
Per Each $ I ') od
It'"
-
$ /7()t7
-----------------------------------------------------------------------------------------------
Type 'c' Manhole J
For......::r.~..~.....T.~'!:..~.~..~.
...................................... Dollars .., . ·
--------------------------------~~!_~~:~----------------------~--~-~~-~-==---~--~-~~-~-~
10
5EA
11
736 LF
15" PVC Gravity Sewer
F or.........f.!.:~..~f....f::.~!:...m.....
...................................... Dollars
Per Linear Foot
.......
$ f./J -
.~
$ 33,';1.D -
-----------------------------------------------------------------------------------------------
I
12
77LF
8" PVC Gravi~ Sewer
F or.......I..~.~~..'l....~:~f.............
...................................... Dollars
Per Linear Foot
IJO
$ -;)'-
1/1.
$ -;2, () (;) ~ -
~
-----------------------------------------------------------------------------------------------
13
1 LS
Debris & Metal Structure
RemovaJ., Replace 611
Concreteo~lab r""q II-J../
F or ......f.~.....!f.....................-.....
...................................... Dollars
Per Lump Sum $
.. ....
l/, ,;J.~" - $ ~;J.~ tJ -
-----------------------------------------------------------------------------------------------
14
4EA
Property Service Connection
Pipe with C1eanout including
Wye F~~~:t~~~'nJ
For ................ .................................
...................................... Dollars
Per Each $
..
~ 'DO -
..
90rJ - $
-----------------------------------------------------------------------------------------------
15
1 EA
cons~cto~ ~n~~~:,..J
For ............................ .....................
Dollars
Per Each $ ~ / flCl ~ $ ~ / () D ~
-~~~-~~;;~-~~~~;;~~-~~~~-~;~~~~~-~~~;~-~~~-------------------$--F-~-S'--~ ~
~~~vv1vu1/~ 1 ~ 2-
/VoW
S:\Sydney\WPDOCS\05\0546Alsection A2(a).wpd
A-207