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12.0 BID FORMS
NOTE:
INSERT AND ATTACH TO FORM 96, DO NOT USE THE
CONTRACTOR'S BlD SECTION ON FORM 96. BE SURE TO SIGN
BID, NOTARIZE BID AND EXECUTE NON-COLLUSION
AFFIDAVIT.
CONTRACTOR'S BID FORM
JEFFERSONVILLE SEWER BOARD
500 QUARTERMASTER COURT
JEFFERSONVILLE, INDIANA 47130
RE: ANNEXATION AREA "C-3" NEW CHAPEL SANITARY SEWERS
JOB NO. 0808
Gentlemen:
We submit, herewith, our seilled 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.
Ad-ci €1\d\M". :\fj - m ocr to \ 200 q
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'ANNEX).TION AREA C-3 NEW CHAPEL SANITARY SEWER JOB NO. 0808 Rev. 5/6/09
ITEl\1 QUANTITY DJ!I:SCRIPTION UNIT PRICE TOTAL AMT.
NO.
1 1 LS Mobilization & Demobilization $ /0 {)()O' 00 $ IO,(;bO .Db
2 , 1 LS Maintenance of Traffic $ d.'l.S4b'Ob $ ~ 1, ~bO'O()
,
3 ! 1 LS Clearing of Right-of-way $ / " I SIJO 'I' $ Ib,5IJO'(Jf)
4 1 LS Construction Stakeout $ 3..~16'H $ 3. ).1S.I)D
5 ~,260 LF 8" Sanitary SDR 35 (Lines A, C, D, E, F, G) $ 5'8' . '"5 $ 30fi,. 39S.lJ{)
6 1,604 LF 8" Sanitary SDR 35 (Line 'H') $ 51'1$ $ i3. DfJ?D/)
7 ; 18 EA Manhole Type 'B' $ ;(, /,5 () ~f){) $ '-/1J 7ot)' 0()
8 ; 8 EA Manhole Type 'C' $ ;) ":5 tJ . DO $ It/I ~O/)'OIJ
9 90 EA Property Service Connections $ I, '300'()O $ 1/1, OPt) 'bb
10 · 925 TON HMA Surface Overlay $ '55 '00 $ 50} 17S'0{)
11 3 LS Connection to ex. MH $ :J.::J. <Xl 00 $ (,. lLtlO "0
12 . LS Asphalt Price Adjustment (-perz-. 'Spec 11,2--) $ 0....... $ v-
TOTAL BID PRICI[ = Total of Items 1 thru 12 = $ ~ Sq . <l5;).'()()
mA(' ('ol'\,~tt'u~h 01\ 4J- fx {I(}lla:hnjJ
Contractor . .1't'\c. .
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A-206
BID FOR:
ANNEXATION AREA "C-3" NEW CHAPEL SANITARY SEWERS
JOB NO. 0808
CITY OF JEFFERSONVILLE
CLARIZ COUNTY, INDIANA
RESPECTFUIL Y SUBMITTED,
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PERSON
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ATTEsT::bo.r--\€1)e 5. Co~"(,aJ\- Coi'p. See.f'e-tar~
m Qlj-l1, 200<=1
DATE
.i\ccepted this
day of
,2009
Se-e.. Mo..ched - ~
(A\-L1-htH'~'''y ;--0
<2> "5n J
SEWER BOARD
CITY OF JEFFERSONVILLE, INDIANA
Mayor Thomas R. Galligan, President
William A. Saegesser, P.E., P.L.S., Member
Dale L. Otero, Member
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A-207
CONTRACTORS STATEMENT OF
UNDERSTANDING OF UTILITY
CONFLICTS & ISSUES
By submitting this bid, we understand the challenges and issues involved with the potential
coJJf1ic(wltl1exlstirig utilities during the execution of this project.
Our bid price takes into consideration the costs required to coordinate the reloc.ation of a..llY
and all affected utilities, and the potential interruption and delays of operation in constructing this
project. However, it is understood that we, the CONTRACTOR, will not be held responsible for
schedule delays attributable to a given utility company's lack of cooperation or completion of
relocation.
SUBMITTED BY:
ty)~ c. COr\~-Tr-\J,.(':\, Of) c\- b ea.url. "'3' 1:t'lc. ,
CONTRACTOR
~ ~ v.??
BY: (P 'uted Name and Titlf) p . d +
Trcw\~O.Ui\{'v.1"'V)(,€. r-es.' €A
ma~ '4 J'lf)()q
DATE
S :\SYDNEY\WPDOCS\08\0808\QUANTITlES(A).DOCX
A-208
1.0
1.1
1.2
1.3
DIVISION B - CONTRACT FORMS
SECTION B-l- CONTRACT DOCUMENTS
GENERAL
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 tenns as set out in these specifications and documents and his willingness to complete the
project as stated herein and shown on the drawillgs.
It is further understood that by the acceptance of,. and the proper affixlng of the signatures of
the OWNER to the Form 96, that a binding contract exists between the OWNER and the
CONTRACTOR.
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, drawillgs and notes shown on
the plans for this project.
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Prescribed by State Board of Accounts
State Form 52414 (10-05)
Form No. 96 (Revised 2005)
CONTRACTOR'S BID FOR PUBLIC WORK - FORM 96
PART I
(To be completed for all bids. Please type or print)
Date:JY)Ov:1~ ) 2 00 q
1. Governmenta', Unit (owner):~ otCf e +te rSOf\V\' \e 1:!k.J
2. County: C,,)a.t"'" ' ,
3. Bidder (Firm):
Address:
MAC CONSTRUCTION & EXCAVATING, mc.
1908 UNRUH COURT
City/State:
NEW ALBANY I
INDIANA 47150
4. Telephone Number:
(812) 941-7895
5. Agent of Bidder (if applicable): N/1\
Pursuant to notices given,"theu-riaersig-nea-o-ffers fu-furnisnli3oorana16f-materlarnecessary toco-mplete--~--u-
the public works project of _~ PJ.v ~\ Sl1J\\;-ll..''j S-etue.r [~'€f\<)~C\ -f4t~ \\ C- 3 "
(Governmental Unit) in accordance with plans and specifications prepared by J ll,rD b; ) \ 0 Of(\'b ~
~ lM~ I If'\C . and dated ---1ft--'1 \ \ ~ I 'lODq-c- for the sum of
S:r.IJ..,....d~ &-'"rk.Jy "':we. ~"S4...J/ ~"f" U".Jred ~~1;-~ ~ .wl . X:cS .6'gcL 4s z.. 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.
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 agaihst 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 (l.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. !
understand that violations hereunder may result in forfeiture of contractual payments.
ACCEPTANCE
The above bid is accepted this
t8T1+
day of d Nt;
, '2txf1 , subject to the
following conditions:
Contracting Authority Members:
~f1(L ~W\-S R .@-Aill~ 11>fl6S
W;"~1 fl'~.i~'*"-
1;:>A1Je L, eru::tA l ~
:a.-v-
~I~-;(.(g)~
PART 1/
(For projects of $1 00,000 or more -Ie 36-1-12-4)
Governmental Unit: tl-t~ cf'3""e#e~&oC)u\ ')p,"IU
Bidder (Firm) MAC CONSTRUCTION & EXCAVATING, INC.
Date: _m(t~~ l'loO q
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?
Completion
Contract Amount Class of Work Date Name and Address of Owner
SEE ATTACH IV ':N' -""'R
2. What public works projects are now in process of construction by your organization?
Expected
Contract Amount Class of Work Completion Name and Address of Owner
Date
SEE ATTA r
3.
Have you ever failed to complete any work awarded to you?
NO
If so, where and why?
4. List references from private firms for which you have performed work.
1.
2.
,.,
0.
4.
5.
PRESNELL ASSOCIATES, 717 W. MAIN ST., LOUISVILLE, KY 40202
KOETrER CONSTRUcrION, 739.3 PETE ANDRES RD. FLOYDS KNOBS, IN 47119
PINNACLE PROPERTIES, P.O. BOX 43957, LOUISVILLE, KY 40253
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
Explain your plan or layout for performing proposed work. (Examples could include a narrative of when
you Gould begin work, complete the project, number of workers, etc. and any other information which you
believe would enable the governmental unit to consider your bid.) /v'f~'8/t./~E. -TJZ.,4F1=/c- ~~~L-
1A./77i4'U ~ rjJ-G: - MAN ih7 ~ - :5~1 Ct;; ~1V~Gcnl>.v 0 -~.s-r;(/ /Z-A'77 01(/ - 'ff"-:>prrl1--Cr
Please list the names and addresses of all subcontractors (Le. persons or firms outside your own firm
who have performed part of the work) that you have used on public works projects during the past five (5)
years along with a brief description of the work done by each subcontractor. SEE ATTACHMENT - ])
If you intend to sublet any portion of the 'v&,fork, state th,e name and address of each subcontractor,
equipment to be used by the. subcontractor, and whether you will require a bond. However, if you are
unable to currently provide a listing, please understand a listing must be provided prior to contract
approval. Until the completion of the proposed project, you are under a continuing obligation to
immediately notify the governmental unit in the event that you subsequently determine that you will use a
subcontractor on the proposed project.~ 15G:,IJ~ lI/1Je'(:> ;a 1Uot'V"7V ~ A;tJ/'j7.0V~
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 ATTACHMENT - E
Have you entered into contracts or received offers for all materials which substantiate the prices used in
preparing your proposal? If not, please explain the rationale used which would corroborate the prices
listed.
YES
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.
SEE ATTACHED - F
SECTION IV CONTRACTOR'S 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, coflusion or agreement WIth any person reiative 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. .
SECTION V OATH AND AFFIRMATION
I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION
CONTAiNED iN THE FOREGOiNG Bib FOR PUBLIC 'v^v'ORKS ARE TRUE AND CORRECT.
By
this ~ day of _lr}(l;~
MAC CONSTRUCTION & EXCAVATING, INC.
W . (Name of Organization)
( lZ/.A//P .
Tr(1Lu\~ O. 1A(}~Llh.. Vt l-e el'~'lde{)t
(Title of Pe~son Signing)
, :2009
Dated at NEW ALBANY, IN
ACKNOWLEDGEMENT
STATE OF INDIANA
COUNTY OF FLOYD
)
\ --
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)
Before me, a Notary Public, personally appeared the above-named T('(1U\ ~ ().l..lc\I'LLh
and
swore that the statements contained in the foregoing document are true and correct.
Subscribed and sworn to before me this
\ 4 -t~
day of --0') 0J.j , ~oo q
(l,oAJJO ~P11/L
. . ry PubliC
My Commission Expires:J\ 0\1. 30 I :2013
County of Residence:-----.F ) D ~ d.
~
MAC
Construction & Excavating, Inc.
_t~.
l~d~flf~tllit~~
~~
May 14,2009
Jeffersonville Sewer Board
500 Quartermaster Court
Jeffersonville, IN 47130
Re: ANNEXATION AREA "C-3"NewChapelSanitary Sewer
Job No. 0808
Gentlemen,
MAC Construction & Excavating, Inc. is conunitted to meeting and/or exceeding the
established 10% participation goalsfor MBE/WB:E Firms certified by IDOA forthe
above project. ' " .
Subsiantiat!ng paperwork can befurnishedupon request.
~ Respectfully,"
MAC Construction & Excavating, Inc.
Gregory A.. Dennis, Civil Estimator
1908 Unruh Court
P.O. Box 6787
New Albany, IN 47151-6787
. Phone 812~941-7895
Fax 812-941-0699
"An Equal Opportunity Employer M/F/DN"