HomeMy WebLinkAboutBid PacketJ
Roundabout Improvements
136th Street and Carey Road
Project No. 16 -ENG -26
Carey Road and Hawthorne Drive
Project No. 16 -ENG -09
Total Base Bid .......................................$ 1,471,824.33
NG1,1
11100
BIDDER'S ITEMIZED PROPOSAL
AND DECLARATIONS
City of Carmel
Instructions To Bidders:
This form shall be utilized by all Bidders. Except as otherwise specifically provided, all Parts
shall be fully and accurately filled in and completed and notarized.
0
Project: Roundabout Improvements 136th Street and Carey Road
Roundabout Improvements Carey Road and Hawthorne
Drive
Proposal For Construction of : Part ]a: 1361h Street and Carey Road Intersection
Reconstruction to a Single Lane Roundabout. -
Part Ib: 130 Street and Keystone Parkway Signal
Metering Installation
Part 2: Carey Road and Hawthorne Drive Intersection
Reconstruction to a Single Lane Roundabout
Date: A rjust 17, 2016
To: City of Carmel, Indiana, Board of Public Works and Safety
7
t
L�
I BID -1
PART 1
BIDDER INFORMATION
(Print)
1.1 Bidder Name: E & B Paving, Inc.
1.2 Bidder Address: Street Address: 17042 Middletem Avemi
City: Noblesville State: -Indiana aria Zip: 46060
Phone: (317) 773-4132 Fax: (317) 773-4137
1.3 Bidder is a/an [mark one]
Individual Partnership M Indiana Corporation
Foreign (Out of State) Corporation; State:
Joint Venture
Oilier
1.4 [The following must be answered if the Bidder or any of its partners or joint venture
parties is a foreign corporation. Note: To do business in or with the City of Carmel,
Indiana, foreign corporations must register with the Secretary of the State of Indiana as
required by the Indiana General Corporation Act as stated therein and expressed in the
Attorney General's Opinion #2, dated January 23, 1958.]
1 Corporation Name:
.2 Address:
.3 Date registered with State of Indiana:
.4 Indiana Registered Agent:
Name:
Address:
° IP
V-11,
PART 2
BID PROPOSAL
2.1 Base Bid
The undersigned Bidder proposes to furnish all necessary labor, machinery, tools,
apparatus, materials, equipment, service and other necessary supplies, and to perform and
fulfill all obligations incident thereto in strict accordance with and within the time(s)
provided by the terms and conditions of the Contract Documents for the above described
Work and Project, including any and all addenda thereto, for the Unit Prices applicable to
the Contract Items as stated in Part 3 hereof, which Unit Prices, when multiplied by
estimated unit quantities for such Contract Items, total cm 1411ion, Fbur Hzmdred seymty�
TIPamnd, Eight Rzered TIwerity Fbur and Mirty-Muree Mars ($ 1,471,824.33 ). The
Bidder acknowledges that evaluation of the lowest Bid shall be based on such price and
further acknowledges that the unit quantities listed in Part 3 of this Proposal are estimates
solely for the purpose of Bid evaluation and Contract award, and are not to be construed
as exact or binding. The Bidder further understands that all Work which may result on
the Contract shall be compensated for on a Unit Price basis and that the OWNER and
ENGINEER cannot and do not guarantee the amount or quantity of any item of Work to
be performed or furnished under the Contract.
_ BID -3
n:
SEAL
PART 3
CONTRACT ITEMS AND UNIT PRICES
Part 1a: 136'" Street & Carey Road Intersection Reconstruction
Contract
Item No.
Description
Estimated Unit
Quantity
Unit Price
Item Total
0001
CONSTRUCTION ENGINEERING
1.00 LS
$
9,500.00
$
9,500.00
0002
INSPECTION HOLE, GREATER THAN 3 FT
2.00 EACH
$
625.00
$
1,250.00 .
0003
INSPECTION HOLE, 3 FT DEPTH OR LESS
2.00 EACH
$
300.00
$
600.00
0004
MOBILIZATION AND DEMOBILIZATION
1.00 LS
$
33,131.07
$
33,131.07
0005
CLEARING RIGHT OF WAY
1.00 LS
$
19,000.00
$
19,000.00
0006
HOUSES AND BUILDINGS, REMOVE
1.00 LS
$
14,000.00
$
14,000.00
0007
EXCAVATION, COMMON
1,555.00 CYS
$
49.00
$
76,195.00
0008
TEMPORARY INLET PROTECTION
14.00 EACH
$
85.00
$
1,190.00
0009
TEMPORARY MULCH
3.00 TON
$
1,000.00
$
3,000.00
0010
TEMPORARY SILT FENCE
470.00 LFT
$
3.00
$
1,410.00
0011
NO 2 STONE
100.00 TON
$
24.00
$
2,400.00
0012
TEMPORARY GEOTEXTILE
235.00 SYS
$
3.00
$
705.00
0013
TEMPORARY SEED MIXTURE
130.00 LBS
$
4.00
$
520.00
0014
SUBGRADE TREATMENT, TYPE IB or IC
2,783.00 SYS
$
25.50
$
70,966.50
0015
STRUCTURAL BACKFILL, TYPE 1
147.00 CYS
$
48.00
$
7,056.00
0016
STRUCTURAL BACKFILL, TYPE 3
84.00 CYS
$
48.00
. $
4,032.00
0017
COMPACTED AGGREGATE, NO. 53
257.00 TON
$
32.00
$
8,224.00
0018
WIDENING WITH PCC BASE, 6 IN
10.00 SYS
$
60.00
$
600.00
0019
MILLING, ASPHALT, 1 1/2 IN
321.00 SYS
$
10.00
$
3,210.00
0020
HMA, SURFACE, TYPE B, 9.5 mm
37.00 TON
$ .
100.00
$
3,700.00
0021
HMA, SURFACE, TYPE C, 9.5 mm
158.00 TON
$
113.00
$
17,854.00
0022
HMA, INTERMEDIATE, TYPE B, 19.0
mtn
31.00 TON
$
90.00
$
2,790.00
0023
HMA, INTERMEDIATE, TYPE C, 19.0
Imm
554.00 TON
$
60.00
$
33,240.00
0024
HMA, BASE, TYPE C, 25.0 mm
720.00 TON
$
60.00
$
43,200.00
0025
JOINT ADHESIVE, SURFACE
436.00 LFT
$
0.10
$
43.60
0026
JOINT ADHESIVE, INTERMEDIATE
392.00 LFT
$
0.15
$
58.80
0027
LIQUID ASPHALT SEALANT
436.00 LFT
$
0.20
$
87.20
0028
ASPHALT FOR TACK COAT
4.00 TON
$
350.00
$
1,400.00
0029
DECORATIVE CONCRETE PAVEMENT, TRUCK
361.00 SYS
$
60.00
$
21,660.00
0030
SIDEWALK, CONCRETE, 4 IN
8.00 SYS
$
42.00
$
336.00
0031
CURB RAMP, CONCRETE
24.00 SYS
$
140.00
$
3,360.00
0032
DETECTABLE WARNING SURFACES
5.00 SYS
$
90.00
$
450.00
0033
HAND RAIL, PEDESTRIAN
58.00 LFT
$
308.00
$
17,864.00
0034
STRAIGHT CONCRETE CURB
108.00 LFT
$
35.00
$
3,780.00
0035
CENTER CURB, TYPE D, CONCRETE
15.00 LFT
$
90.00
$
1,350.00
0036
CURB AND GUTTER CONCRETE TYPE R
975.00 LFT
$
18.00
$
17,550.00
0037
IMODIFIED ROLL CURB
607.00 LFT
$
24.00
$
14,568.00
0038
PCCP FOR APPROACHES, 6 IN
104.00 SYS
$
43.00
$
4,472.00
0039
MAILBOX ASSEMBLY, SINGLE, RESET
1.00 EACH
$
175.00
$
175.00
0040
GEOTEXTILES
16.00 SYS
$
4.00
$
64.00
0041
RIPRAP, REVETMENT
8.00 TON
$
80.00
$
640.00
0042
MOBILIZATION AND DEMOBILIZATION FOR
SEEDING
2.00 EACH
$
250.00
$
500.00
0043
TOPSOIL
163.00 CYS
$
50.00
$
8,150.00
- -I"",
0044
SODDING, NURSERY
1,953.00 SYS
$
3.25
$
6,347.25
0045
IRRIGATION CONTROLLER BOX
1.00 EACH
$
1,000.00
$
1,000.00
0046
FIELD OFFICE, B
4.00 MOS
$
2,100.00
$
8,400.00
0047
PIPE END SECTION, PRECAST CONCRETE, 15 IN
1.00 EACH
$
785.00
$
785.00
0048
JPIPE, CLASS III RCP, CIRCULAR 15 IN
16.00 LFT
$
50.00
$
800.00
0049
PIPE, CLASS III RCP, CIRCULAR 12 IN
501.00 LFT
$
36.00
$
18,036.00
0050
CONCRETE ANCHOR, 12 IN
1.00 EACH
$
800.00
$
800.00
0051
MANHOLE, J10
1.00 EACH
$
4,800.00
$
4,800.00
0052
STORMWATER BMP, 15
1.00 EACH
$
14,000.00
$
14,000.00
0053
INLET, A2
1.00 EACH
$
1,750.00
$
1,750.00
0054
INLET, J10
4.00 EACH
$
2,100.00
$
8,400.00
0055
INLET, M10
2.00 EACH
$
2,100.00
$
4,200.00
0056
MANHOLE, C4
1.00 EACH
$
2,800.00
$
2,800.00
0057
MANHOLE, C2
1.00 EACH
$
2,900.00
$
2,900.00
0058
MANHOLE, C10
3.00 EACH
$
3,100.00
$
9,300.00
0059
AGGREGATE FOR DRAINAGE FILL
15.00 CYS
$
47.00
$
705.00
0060
MODULAR BLOCK WAIL ERECTION
383.00 SFT
$
29.00
$
11,107.00
0061
MODULAR BLOCK WALL WITH GROUND
REINFORCEMENT
383.00 SFT
$
23.00
$
8,809.00
0062
CONSTRUCTION SIGN, C
2.00 EACH
$
280.00
$
560.00
0063
ROAD CLOSURE SIGN ASSEMBLY
10.00 EACH
$
170.00
$
1,700.00
0064
DETOUR ROUTE MARKER ASSEMBLY, MULTIPLE
lROIJTFS
1.00 EACH
$
387.00
$
387.00
0065
DETOUR ROUTE MARKER ASSEMBLY
31.00 EACH
$
129.00
$
3,999.00
0066
CONSTRUCTION SIGN, A
7.00 EACH
$
195.00
$
1,365.00
0067
CONSTRUCTION SIGN, B
33.00 EACH
$
105.00
$
3,465.00
0068
MAINTAINING TRAFFIC
1.00 LS
$
11,945.68
$
11,945.68
0069
BARRICADE, III -A
168.00 LFT
$
10.00
$
1,680.00
0070
BARRICADE, III -B
72.00 LFT
$
11.00
$
792.00
0071
DECORATIVE STREET SIGN ASSEMBLY,
DIRECTIONAL, INSTALLED
3.00 EACH
$
2,337.00
$
7,011.00
0072
SIGN POST, SQUARE, TYPE 2, REINFORCED
ANCHOR BASF
151.00 LFT
$
19.00
$
2,869.00
0073
SIGN, SHEET, WITH LEGEND 0.080"
83.00 SFT
$
17.10
$
1,419.30
0074
SIGN, SHEET, WITH LEGEND 0.100 IN
12.00 SFT
$
19.00
$
228.00
0075
TRAFFIC SIGNAL AND EQUIPMENT, REMOVE AND
RALVAGE
1.00 EACH
$
1,465.00
$
1,465.00
0076
CONDUIT, STEEL, GALVANIZED, 2 I
92.00 LFT
$
26.50
$
2,438.00
0077
CONDUIT, PVC, 4 IN, SCHEDULE 80
136.00 LFT
$
20.80
$
2,828.80
0078
CONDUIT, PVC, 4 IN., SCHEDULE 80 WITH 3-1.25 IN
136.00 LFT
$
35.00
$
4,760.00
0079
HANDHOLE, LIGHTING
2.00 EACH
$
745.00
$
1,490.00
0080
LUMINAIRE, LED, 152 WATT
4.00 EACH
$
3,702.00
$
14,808.00
0081
LIGHTING FOUNDATION, CONCRETE, WITH
GROUNDING, 30 IN X 96 IN
4.00 EACH
$
1,057.00
$
4,228.00
0082
LIGHT POLE, 30 FT E.M.H., 8 FT MAST ARM, DECO
WRAPBASE
4.00 EACH
$
3,997.00
$
15,988.00
0083
SERVICE POINT, II
1.00 EACH
$
7,014.00
$
7,014.00
0084
CABLE, POLE CIRCUIT THWN, NO 10 COPPER,
590.00 LFT
$
0.65
$
383.50
0085
CONNECTOR KIT, UNFUSED
4.00 EACH
$
36.90
$
147.60
0086
CONNECTOR KIT, FUSED
4.00 EACH
$
39.60
$
158.40
0087
MULTIPLE COMPRESSIO1
,.V�
WATERPRO FF \� .; �i�5-
10.00 EACH
$
11.20
$
112.00
0088
INSULATION LINK, NOIy WgTERPROOFED .'; n %
11.00 EACH
$
8.60
$
94.60
0089
INSULATION LINK, WATERP?,O
8.00 EACH
Is
11.30
Is
90.40,
0090
CABLE -DUCT MARKER
4.00 EACH
$ 184.00
$ 736.00
0091
WIRE, NO 10 COPPER, 1/C
3,280.00 LFT
$ 0.65
$ 2,132.00
0092
TRANSVERSE MARKING THERMOPLASTIC
CROSSWALK, WHITE 24 IN
70.00 LFT
$ 10.00
$ 700.00
0093
LINE, THERMOPLASTIC, SOLID, WHITE, 4 IN
156.00 LFT
$ 1.35
$ 210.60
0094
TRANSVERSE MARKING, THERMOPLASTIC, YIELD,
WHITE, 24 IN (SHARKS TEETH)
48.00 LFT
$ 26.00
$ 1,248.00
0095
LINE, THERMOPLASTIC, DOTTED, WHITE, 8 IN (2 FT
LINE, 2 FT GAP)
49.00 LFT
$ 6.00
$ 294.00
0096
LINE, THERMOPLASTIC, SOLID, YELLOW, 4 IN
904.00 LFT
$ 1.35
$ 1,220.40
0097
SNOWPLOWABLE RAISED PAVEMENT MARKER
15.00 EACH
$ 40.00
$ 600.00
0098
2 IN. HDPE SDR 11 FORCE MAIN
251.00 LFT
$ 38.00
$ 9,538.00
0099
2 IN. CONNECTION FO ip111Xkllfilll//
2.00 EACH
$ 300.00
$ 600.00
0100}
�� p /
HYDRANT ASSEM) R>R I1i?Cy AND
ADJUST TO GRA 4(1 • ; �%
2.00 EACH
$ 1,000.00
$ 2,000.00
0101
ITDRTSTVALVeOqAAIA3.00
EACH
$ 85.00
$ 255.00
CA,
Part 1a To al $ 672,182.70
Submitted By: im.
Signature:
ECJyns, Area Mmager
///1111111��
Part Ib: 1361 Street and Keystone Parkway Signal Metering Installation
Contract
Item No.
Description
Estimated
Quantity
Unit
Unit Price
Item Total
1001
MOBILIZATION AND DEMOBILIZATION
1.00
LS
$ 8,183.18
$ 8,183.18
1002
ANCHOR PLATE FOR SIGN MOUTING TO TRAFFIC
BARRIER, DRILL AND EPDXY
1.00
EACH
$ 305.00
$ 305.00
1003
CONTROLLER, RESET TIMING
1.00
LS
$ 6,552.00
$ 6,552.00
1004
MAINTAINING TRAFFIC
1.00
LS
$ 5,541.07
$ 5,541.07
1005
SIGN POST, SQUARE, TYPE 1, REINFORCED
ANC14OR BASE
70.00
LFT
$ 20.00
$ 1,400.00
1006
SIGN, SHEET, WITH LEGEND 0.080"
20.00
SFT
$ 17.90
$ 358.00
1007
HANDHOLE, SIGNAL, TYPE 1
2.00
EACH
$ 1,572.00
$ 3,144.00
1008
CONDUIT, STEEL, GALVANIZED, 2 IN
140.00
LFT
$ 26.50
$ 3,710.00
1009
SIGNAL PEDESTAL FOUNDATION, A
1.00
EACH
$ 893.00
$ 893.00
1010
SIGNAL POLE, PEDESTAL, 4FT
1.00
EACH
$ 2,678.00
$ 2,678.00
1011
SIGNAL POLE, PEDESTAL, 15 FT
4.00
EACH
$ 3,190.00
$ 12,760.00
1012
RECEIVER PROCESSOR
1.00
EACH
$ 7,196.00
$ 7,196.00
1013
WIRELESS MAGNETOMETER DETECTOR
12.00
EACH
$ 789.00
$ 9,468.00
1014
WIRELESS REPEATER
2.00
EACH
$ 2,397.00
$ 4,794.00
1015
TRAFFIC SIGNAL HEAD, 3 SECTION, 12 IN, LED (RED,
IRFD. AMBER)
4.00
EACH
$ 1,416.00
$ 5,664.00
1016
SIGNAL SERVICE
1.00
EACH
$ 1,667.00
$ 1,667.00
1017
SIGNAL CABLE, SERVICE, COPPER. 3C/8GA
15.00
LFT
$ 1.70
$ 25.50
1018
SIGNAL CABLE, CONTROL, COPPER 7C/14GA
314.00
LFT
$ 2.10
$ 659.40
1019
CONTROLLER CABINET FOUNDATION, PI
1.00
EACH
$ 1,536.00
$ 1,536.00
1020
LIGHTING FOUNDATION, CONCRETE, WITH
GROUND, 30 IN X 30 IN X 96 IN
4.00
EACH
$ 1,057.00
$ 4,228.00
1021
TRANSVERSE MARKING MULTI- COMPONENT,
36.00
LFT
Is 50.00
$ 1,800.00
1022 1 HMA PATCHING, TYPE D (UNDISTRIBUTED) 45.00 TON 1 $ 125.001$ 5,625.00
Part lb Total = $ 88,187.15
Submitted By: E &
Signature.
E. , Area Mmiager
Part 1c: Landscaping at 136th Street and Carey Road Roundabout
Contract
Item No.
Description
Estimated
Quantity
Unit
Unit Price
Item Total
1100
EVERGREEN SHRUB, NO.3 CONTAINER
16.00
EACH
$ 42.00
$ 672.00
1101
DECIDIOUS SHRUB, NO.3 CONTAINER
15.00
EACH
$ 41.00
$ 615.00
1102
ORNAMENTAL GRASS, NO l CONTAINER
48.00
EACH
$ 18.00
$ 864.00
1103
PERENNIAL, PLUG CONTAINER
129.00
EACH
$ 4.50
$ 580.50
1104
IRRIGATION SYSTEM
1.00
LS
$ 11,593.41
$ 11,593.41
1105
MASONRY WALL
45.00
LFT
$ 392.67
$ 17,670.15
1106
DECORATIVE CONCRETE %\1111 Il!//
101.00
SYS
$ 111.82
$ 11,293.82
1108
SODDING, NURSERY ��� Q� �1 ///�
-100.00
SYS
$ 0.01
$ (1.00)
1109
DECIDIOUS SHRUB, NO.\ Q➢dTAINER
14.00
EACH
$ 45.00
$ 630.00
1110
HARDWOOD MULCH _;
8.00
CYS
$ 75.00
$ 600.00
1111
TREE AND SHRUBS SOIL -MD,
31.00
CYS
$ 100.00
$ 3,100.00
Part 2 a: Carey Road and Hawthorne Drive Intersection Reconstruction
Part1 e Total = $ 47,617.88
Submitted By: E
Signature:
Area Mmager
Contract
Item No.
Description
Estimated
n1inntitv
Unit
Unit Price
Item Total
2001
CONSTRUCTION ENGINEERING
1.0
LS
$
9,200.00
$ 9,200.00
2002
MOBILIZATION AND DEMOBILIZATION
1.0
LS
$
26,133.48
$ 26,133.48
2003
CLEARING RIGHT OF WAY
1.0
LS
$
16,000.00
$ 16,000.00
2004
HEADWALL, REMOVE
1.0
EACH
$
350.00
$ 350.00
2005
EXCAVATION, COMMON
554.0
CYS
$
90.00
$ 49,860.00
2006
BORROW
440.0
CYS
$
1.00
$ 440.00
2007
SEDIMENT, REMOVE
5.0
CYS
$
55.00
$ 275.00
2008
TEMPORARY CHECK DAM
12.0
TON
$
65.00
$ 780.00
2009
TEMPORARY INLET PROTECTION
8.0
EACH
$
85.00
$ 680.00
2010
INLET FILTERS
8.0
EACH
$
350.00
$ 2,800.00
2011
TEMPORARY MULCH
0.6
TON
$
1,250.00
$ 750.00
2012
TEMPORARY SILT FENCE
1,152.0
LFT
$
1.50
$ 1,728.00
2013
NO.2 STONE
100.0
TON
$
25.00
$ 2,500.00
2014
TEMPORARY SEED MIXTURE
70.0
LBS
$
7.00
$ 490.00
2015
SUBGRADE TREATMENT, TYPE IC
3,564.0
SYS
$
20.00
$ 71,280.00
2016
STRUCTURE BACKFILL, TYPE 1
104.1
CYS
$
50.00
$ 5,205.00
2017
COMPACTED AGGREGATE NO. 53
75.0
TON
$
35.00
$ 2,625.00
2018
HMA, SURFACE, TYPE'C', 9.5mm
225.0
TON
$
83.00
$ 18,675.00
2019
HMA, INTERMEDIATE, TYPE'C',
375.0
TON
$
60.00
$ 22,500.00
2020
HMA, BASE, TYPE'C', 25.Omm
1,027.0
TON
$
50.00
$ 51,350.00
2021
HMA, INTERMEDIATE, TYPE'C', OG, 19.Omm
419.0
TON
$
60.00
$ 25,140.00
2022
JOINT ADHESIVE, SURFACE
1,486.0
LFT
$
0.10
$ 148.60
2023
JOINT ADHESIVE, INTERMEDIATE
1,486.0
LFT
$
0.15
$ 222.90
2024
LIQUID ASPHALT SEALANT
1,486.0
LFT
$
0.20
$ 297.20
2025
ASPHALT FOR TACK COAT
2.7
TON
$ 350.00
$ 945.00
2026
DECORATIVE CONCRETE PAVEMENT, TRUCK
APRON, 7 IN -
192.2
SYS
$ 45.00
$ 8,649.00
2027
SIDEWALK, CONCRETE {4 IN.}
245.0
SYS
$ 37.00
$ 9,065.00
2028
CURB RAMP, CONCRETE
175.0
SYS
$ 122.00
$ 21,350.00
2029
JillDETECTABLE WEARING SURFACE
27.0
SYS
$ 90.00
$ 2,430.00
2030
CURB, CONCRETE
138.0
LFT
$ 30.00
$ 4,140.00
2031
CURB, TURNOUT
6.5
LFT
$ 80.00'
$ 520.00
2032
COMBINED CURB & GUTTER, CONCRETE, TYPE H
1,094.0
LFT
$ 14.00
$ 15,316.00
2033
COMBINED CURB & GUTTER, CONCRETE, TYPE III
243.0
LFT
$ 40.50
$ 9,841.50
2034
ROLLED CURB & GUTTER, CONCRETE, MODIFIED
482.0
LFT
$ 15.00
$ 7,230.00
2035
RIPRAP, REVETMENT
4.2
TON
$ 95.00
$ 399.00
2036
GEOTEXTILES
5.6
SYS
$ 15.00
$ 84.00
2037
MOB. & DEMOB. FOR SEEDING
2.0
EACH
$ 250.00
$ 500.00
2038
WATER
4.1
kGAL
$ 1.00
$ 4.10
2039
SODDING
1,135.2
SYS
$ 3.50
$ 3,973.20
2949
AIDE TVDC Ae 11 CIRC Anf 6IN
73 0
LFLFT$
-
•D $ -
2041
PIPE, RCP, CIRCULAR, 12 IN.
292.0
LFT
$ 37.00
$ 10,804.00
2042
PIPE END SECTION, DIAMETER 12 IN.
1.0
EACH
$ 750.00
$ 750.00
2943
49A
CSS
$ -
$ -
2944
554.2
SYS
$ -
$ -
2045
INLET, J10
4.0
EACH
$ 2,100.00
$ 8,400.00
2046
INLET, M10
2.0
EACH
$ 2,100.00
$ 4,200.00
2047
MANHOLE, C4
3.0
EACH
$ 3,100.00
$ 9,300.00
2048
CASTING, ADJUST TO GRADE - UNDISTRIBUTED
5.0
EACH
$ 365.00
$ 1,825.00
2049
MAINTAINING TRAFFIC
1.0
LS
$ 5,000.00
$ 5,000.00
2050
SIGN POST, SQUARE TYPE 1 REINFORCED ANCHOR
169.0
LFT
$ 19.70
$ 3,329.30
2051
DECORATIVE STREET SIGNS, INSTALLED
4.0
EACH
$ 2,314.00
$ 9,256.00
2052
SIGN, SHEET, WITH LEGEND, 0.080 IN.
49.2
SFT
$ 17.30
$ 851.16
2053
SIGN, SHEET, WITH LEGEND, 0.100 IN.
75.0
SFT
$ 19.00
$ 1,425.00
2054
CONDUIT, STEEL, GALVANIZED, 2 IN.
205.5
LFT
$ 22.50
$ 4,623.75
2055
CONDUIT, PVC 4 IN. SCHEDULE 80
338.5
LFT
$ 20.80
$ 7,040.80
2056
CONDUIT, PVC 4 IN. SCHEDULE 80 WITH 3-1.25 IN.
338.5
LFT
$ 34.40
$ 11,644.40
2057
4-1 C NO. 4 Cu CONDUCTOR IN PLASTIC DUCT
502.5
LFT
$ 11.50
$ 5,778.75
2058
LIGHT POLE, ORNAMENTAL 30 FT. E.M.H., 8 FT.
MAST ARM, DECO WRAP BASE
8.0
EACH
$ 3,997.00
$ 31,976.00
2059
LIGHTING FOUNDATION, CONCRETE, W f
GROUNDING, 30 IN. X 96 IN.
8.0
EACH
$ 1,057.00
$ 8,456.00
2060
LUMINAIRE, LED, 152 WATT
8.0
EACH
$ 3,702.00
$ 29,616.00
2061
HANDHOLE, STREET LIGHTING
1.0
EACH
$ 745.00
$ 745.00
2062
SERVICE POINT, 11, METERED
1.0
EACH
$ 7,014.00
S 7,014.00
2063
IRRIGATION CONTROLLER BOX
1.0
EACH
$ 1,000.00
$ 1,000.00
2064
TRANSVERSE MARKING, THERMOPLASTIC,
CROSSW?XJ W1h1aR/�4 IN.
192.0
LFT
$ 10.00
$ 1,920.00
2065
LINT, 614W.1'0, 9djjD, WHITE, 4 IN.
1,359.0
LFT
$ 1.35
$ 1,834.65
2066
LI1�fE, THV-RMOPLASTIC; D, WHITE, 8 IN.
56.0
LFT
$ 6.00
$ 336.00
2067
TRANSVERSE MARKING, THERMOPLASTIC, YIELD
LINE, WHITE, 24 IN.
64.0
LFT
$ 26.00
$ 1,664.00
2068
LINE, THERMOPLASTIC, SOLID WHITE, 6 IN.
100.0
LFT
$ 2.55
$ 255.00
2069
LINE, THERMOPLASTIC, SOLID, YELLOW, 4 IN.
1,243.0
LFT
$ 1.35
$ 1,678.05
2070
LINE, THERMOPLASTIC, SOLID YELLOW, 8 IN.
208.0
LFT
$ 3.40
$ 707.20
2071
SNOWPLOWABLE RAISED PVMT MARKING (BLUE)
2.0
EACH
$ 70.00
$ 140.00
2072
CENTERCURB, TYPE D, CONCRETE
13.6
SYS
$ 132.00
$ 1,795.20
2073
HYDRANT ASSEMBLY, REMOVE/REPLACE AND
ADJUST TO GRADE
2.0
EACH
$ 1,000.00
$ 2,000.00
-
2074
ADJUST VALVE TO GRADE
4.0
EACH
$ 85.00
$ 340.00
2075
RECTANGULAR RAPID FLASHER BEACON W f
PUSH BUTTON ACTIVATION
4.0
EACH
$ 9,585.00
$ 38,340.00
2076
CABLE, POLE CIRCUIT, THWN, NO. 10, COPPER,
STRANDED, 1 fC
400.0
LFT
$ 0.65
$ 260.00
2077
CONNECTOR KIT, UNFUSED
4.0
EACH
$ 36.90
$ 147.60
2078
CONNECTOR KIT, FUSED
4.0
EACH
$ 39.60
$ 158.40
2079
MULTIPLE COMPRESSION FITTING, NON-
WATERPROOFED
18.0
EACH
$ 11.20
$ 201.60
2080
INSULATION LIN ED
8.0
EACH
$ 8.60
$ 68.80
2081
INSULATION L!�XtERPROOI %
8.0
EACH
$ 11.30
$ 90.40
2082
MILLING, ASP1fALT
412.0
SYS
$ 10.00
$ 4,120.00
ZSFAL
//0011111100
Part 2b: Landscaping at Carey Road and Hawthorne Drive Roundabout
Part 2 Total = $ 612,969.04
Submitted By: E B/Wft,-Rr.
i
Sl- E. : -Area Mffk-gpx
Contract
Item No.
Description
Estimated
Quantity
Unit Unit Price
Item Total
2100
ORNAMENTAL TREE, 8 FT. HEIGHT
2.00
EACH $375.00
$
750.00
2101
EVERGREEN SHRUB, NO.3 CONTAINER
23.00
EACH $44.00
$
1,012.00
2102
DECIDIOUS SHRUB, NO.3 CONTAINER
26.00
EACH $47.00
$
1,222.00
2103
ORNAMENTAL GRASS, NO 1 CONTAINER
86.00
EACH $17.50
$
1,505.00
2104
PERENNIAL, NO. I CONTAINER
487.00
EACH $18.25
$
8,887.75
2105
IRRIGATION SYSTEM
1.00
LS $8,490.64
$
8,490.64
2106
MASONRY WALL
31.00
LFT $459.67
$
14,249.77
2107
DECIDIOUS SHRUB, NO. 1 CONTAINER
50.00
EACH $24.00
$
1,200.00
2108
PERENNIAL, PLUG CONTAINER
186.00
EACH $3.90
$
725.40
2109
HARDWOOD MULCH
27.00
CVS $75.00
$
2,025.00
2110
TREE AND SOIL PLANTING MIX
1 108.00
CYS $100.00
$
10,800.00
Part 2b Total = $ 50,867.56
Submitted By: E
�gnature:
PAY/� iE.ales, Area I�nacs
n�
PART 4
CONTRACT DOCUMENTS AND ADDENDA
4.1 The Bidder agrees to be bound by the terms and provisions of all Contract Documents as
defined in the Standard General Conditions and incorporates such Contract Documents
herein by reference.
4.2 The Bidder acknowledges receipt of the following addenda:
ADDENDUM NUMBER
1
2
BID -12
DATE
8-12-16
8-15-16
PART 5
EXCEPTIONS
Instructions To Bidders:
5.1 The Bidder shall fully state each exception taken to the Specifications or other Contract
Documents in Section 5.3 of this Part.
5.2 Bidder is cautioned that any exception taken by Bidder and deemed by OWNER to be a
material qualification or variance from the terms of the Contract Documents may result
in this Bid being rejected as non-responsive.
5.3 Exceptions:
N/A
i�
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N G,
LU
BID -13
Part of State Form 52414 (R2 12-13) / Form 96 (Revised 2013)
E & B Paving, Inc.
(Contractor)
17042 Middletown Avenue
Noblesville, IN 46060
(Address)
FOR
PUBLIC WORKS PROJECTS
OF
\�\. Ir M�a�t.��=u=u. &: to ,
& Hawthorm rrive
Filed August 17, 2016
Action taken
NE ETFT-
CONTRACTOR'S BfD FOR PUBUC WORK - FORM 96
Stale Form 52414 (R2 / 2-13) / Form 96 (Revised 2013)
Prescribed by State Board of Accounts
l6,G
PART
(To be completed for all bids. Please type or print)
Date (month, day, year):_ AumsL 17, 2016
1. Governmental Unit (Owner) -Board of public Works & Safety, City of Carrrrl, I)a[triltal Co., Tir3iapa
2. County: Imniltcn
3. Bidder (Firm): E & B Paving, Inc.
Address: 17042 Middletown Avenue
City/State/ZlPcode: Noblesville, IN 46060
ZZ W
4. Telephone Number: (317) 773-4132
5. Agent of Bidder (if applicable): Tcny N. Evans �ii�/. .. w
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete
Roundabout Igxove ats 136th SL. & Carey Rd. project No. 16-IlW,26
the public works project of Roxibbout Irazovamnts ley Rd & H%&horne Drive project Nb 16-Eq3- 09
(Governmental Unit) in accordance with plans and specifications prepared by _Struct1ret0iT1t, In
c.
and dated August 2016 for the sum of
- ** Attached Ite zed p3M23W $_ **Sae AttacInd Itettized F
roppEal
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). 1 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.
ACCEPTANCE
The above bid is accepted this day of , subject to the
following conditions:
Contracting Authority Members:
PART II
(For projects of $950,000 or more — /C 36-9-92-4)
Governmental Unit: Bard of Public Works & Safety, City of Can -el, Hitd1torl Co., Trr9iana
Bidder (Firm) E & B Paving, Inc.
/Z�
Date (month, day, year): NgLlst 17, 2016
4u
These statements to be submitted under oath by each bidder with and as a part of hislid. p
Attach additional pages for each section as needed. — ��/'�L
SECTION I EXPERIENCE QUESTIONNAIRE
1. What public works projects has your organization completed for t /1.... ....•....�\"�\\`\\
date of the current bid? p he period of one (1) year pn/cir�Y�hg11��
Contract Amount
14,707,590.00
Class of Work
Road Reconstruction
L,ompietion
Date
2015
Name and Address of Owner
INDOT R-31614- SR 37
15,920,300.00
Road Reconstruction
2015
INDOT R-30362 US 41
6,381,300.00
Road Reconstruction
2015
INDOT R-30185 SR 1
7,576,000.00 1
Road Reconstruction 1
2015
INDOT R-348581-69
What public works projects are now in process of construction by your organization?
Contract Amount
Class of Work
Expected
Completion
Date
Name and Address of Owner
142,865,879.00
Road Reconstruction
2016
INDOT IR -35600 US 31
INDOT IR -33739 1-69 Section 4
99,554,800.00
Road Reconstruction
2016
68,068,000.00
Road Reconstruction
2017
169S t* 5
Have you ever failed to complete any work awarded to you? No If so, where and why?
List references from private firms for which you have performed work.
Beazer Homes - Richard Henderson
Thompson Development - Chris Werth
Pulte Homes - Matt Lohmeyer
Pepper Construction - Paul Riehle
Gradex, Inc. - Jason Dapp
SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE
Explain your plan or layout for performing proposed work. (Examples could include a narrative of when
you could 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.)
Per Plans, Specifications and Accepted Construction Practices
2. Please list the names and addresses of all subcontractors (i.e. 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.
List Provided upon request
\\\1lo111
111,
=W
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 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.
Yes, List Provided upon request
4. 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.
E & R Paving, Inc. has over 1,000 pieces of equipment. List provided upon request.
5. 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
lN G, M/�i,,///�
q. r
....
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 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, 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.
SECTION V OATH AND AFFIRMATION
I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION
CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT.
Dated at Noblesville, IN this 17th day of t 2016
E & B Paving, Inc.
(Name of Organization)
Viae President 0&
(Title of Person Signing)
SEAL
ACKNOWLEDGEMENT
STATE OF Indiana I100\\
) ss
COUNTY OF Hamilton
Before me, a Notary Public, personally appeared the above-named '1my N. Evans and
swore that the statements contained in the foregoing document are true and correct.
Subscribed and sworn to before me this 17th day of AUgust 2016
My Commission Expires:. 6/05/2024
County of Residence: Madison
No ary "ubk
,,uERYM
O10:1�� .��
WOW "Imim1=4
PART 6
FINANCIAL STATEMENT
6.1 Attachment of Bidder's financial statement is mandatory. An Bid submitted without
Y
said financial statement as required by statute shall thereby be rendered invalid. The
financial statement provided hereunder to OWNER must be specific enough in detail so
that OWNER can make a proper determination of the Bidder's capability for completing
the Work/Project if awarded. Information on Bidder's company and financial statement
shall be consistent with the information requested on the State Board of Accounts Forms
#96a and #102, entitled "Standard Questionnaires and Financial Statement for Bidders".
General Form No. 96-a.
Prescribed by the State
Board of Accounts of
Indiana. 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 to be submitted under oath by each bidder with and as
a part of his bid, as provided by Chapter 306, page 1248, Acts of 1947
Submitted to _ Burd of public lv a & Safety, City of Cal , Hamiltm Octmty, Irf3iana
By E & B Paving, Inc.
Address: 286 W. 300 N.
Anderson, IN 46012
Date Submitted: A rgzt 17, 2016
Filed
\\�111111111/%�77�
Submitted by
X .\�\�\\e'pAv�N(�'/i�'�.
Y E & B Paving, Inc. { , P ,a` n, -•'' ,• �i
Principal Office at 286 W. 300 N., Anderson, IN 46012 { ";°.Pa ipZZ
•••
TO { gT=mawai S� q
EXPERIENCE QUESTIONNAIRE
The signatory of this questionnaire quarantees the truth and accuracy of all statements and of all answer •• \�
interrogatories hereinafter made. �p/77��,/II
1 How many years has your organization been in business as a general contractor under your present business name? I I I
48 years
2 How many years experience in Asphalt Resurfacing construction work has your organization had:
(a) As a general contractor _48 years (b) As a sub -contractor _ 48 years
3 What projects has your organization completed?
CONTRACT AMT.
CLASS OF WORK
WHEN COMPLETED
NAME AND ADDRESS OF OWNER
$14,707,590.00
Road Reconstruction
2015
INDOT R-31614 SR 37
$15,920,300.00
Road Reconstruction
2015
INDOT R-30362 US 41
$6,381,300.00
Road Reconstruction
2015
INDOT R-30185 SR 1
$7,576,000.00
Road Reconstruction
2015
INDOT R-348581-69
3-A What projects has your organization now in process of construction?
4 Have you ever failed to complete any work awarded to you? No If so,where and why?
5 Has any officer or partner of your organization ever been an officer or partner of some other organization that failed to
complete a construction contract? No , If so, state name of individual, other oganization and readon therefor:
6 Has any officer or partnet of your organization ever failed to complete a construction contract handles in his own name?
No , If so, state name of individual, name of owner and reaspn therefor:
7 In what other lines of business are you financially interested? _ None
CONTRACT AMT.
CLASS OF WORK
MEN TO BE COMPLETED NAME AND ADDRESS OF OWNER'
$142,865,879.00
Road Reconstruction
2016 INDOT IR -35600 US 31
$99,554,800.00
Road Reconstruction
2016 INDOT IR -33739 1-69 Section 4
$68,068,000.00
Road Reconstruction
2017 1-69 Section 5
4 Have you ever failed to complete any work awarded to you? No If so,where and why?
5 Has any officer or partner of your organization ever been an officer or partner of some other organization that failed to
complete a construction contract? No , If so, state name of individual, other oganization and readon therefor:
6 Has any officer or partnet of your organization ever failed to complete a construction contract handles in his own name?
No , If so, state name of individual, name of owner and reaspn therefor:
7 In what other lines of business are you financially interested? _ None
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PLAN AND EQUIPMENT QUESTIONNAIRE
The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers
to interrogatories herein made
In what manner have you inspected this proposed ►work? Explain in detail.
Personal visual inspection
2 Explain your plan or layout for performing the proposed work.
as per plans and specifications
i
3 The work, if awarded to you, will have the personal supervision of whom?
`6 Do you intend to do the grading on the proposed work with your own forces? Ab
If so, give type of equipment to be used?
'7 If you intend to sublet the grading or perform it through an agent, state amount of sub -contract or agents's contract, and, if known,
the name and address of sub -contractor or agent, amount and type of his equipment and financial responsibility
10 What equipment do you own that is available for the proposed work? List st pruvicled l;pm reqLjest
11 What equipment do you intend to purchase for use on the proposed work, should the contract be awarded to you?
QUANTITY I ITEM I DESCRIPTION, SIZE, CAPACITY, ETC. JAPPROXIMATE COST
12 How and when will you pay for the equipment to be purchased?
13 Do you propose to rent any equipment for this work?
for renting
If so, state type, quantity and reasons
14 Have you made contracts or received firm offers for all materials within prices used in preparing your proposal?
If not give names of dealers or manufacturers
Dated at Anderson, IN this 22nd day of June, 2016
\\\\\\1111111//////
E & B Paving, Inc. \��QP�J1(Vt?,, .�//�i���/
II tName of Organization \\ �, • /�
By ' J.
Sarah M. Shuler, Sec/Treasurer =LJJ- A-
(Title of Person Signing) SE
State of Indiana }
} SS:
County of Madison
Sarah M. Shuter being duly sworn, deposes and says that she is Secretary/Treasurer
of the above E & B Paving, Inc. and that the answers to the questions in the foregoing questionnaires and all statements
therein contained are true and correct.
Subscribed and sworn before me this 22nd day of June. 2016
Anne M. Dellinger, Notary
My Commission expires February 23, 2018*.STA. OFFICIAL SEAL
ANNE DELLINGER
w's,• NOTARY PUBLIC - INDIANA
MADISON COUNTY
6MY COMM. EXPIRES FEB. 23, 2018
X816
Contractor's Financial Statement
Submitted By E & B Paving, Inc.
with principle office at 286 W. 300 N., Anderson, IN 46012
To
Condition at close of business — —ja 5/31/2016
ASSETS
1. Cash: (a) on hand S —0— . (b) in bank _78,741_ Q Elsewhere S — 0
2. Notes receivable (a) Due within 90 days ---------------------------- — ---------------------------------
(b) Due after 90 days --- — ----------- — -------------- — --- ------- — — ----------------
(c) Past due ------------------- — ------- — ------------------------ — ------------------- —
Accounts receivable from completed contracts, enclusive of claims not approved for payment ---
4. Sums earned on uncompleted contracts as shown by engineer's or architect's estimate
(a) Amount receivable after deducting retainage -----------------------------------
(b) Relainage to date, due upon completion of contracts - — -- — ----------------
5. Accounts receivable from sources other than construction contracts - -------------- — — ------------- — ---
6. Deposits for bids or other guarantees: (a) Recoverable within 90 days ------------- — -- — ----------- —
(b) Recoverable after 90 days -----------------------------------
7. Interest accrued on loans, securities, etc ---- — — -- — — ---------------------------- — ------- — -- — — — - — -----
8. Real Estate: (a) Used for business purposes ----------------------- — ------------------------ — --
(b) Not used for business purposes - — — -- — ------- — -------- — ----- — -------- — --
9. Stocks and bonds: (a) Listed - Present market value ----- — ---- — ------------- — ------------------------
(b) Unlisted - present value ------------------------- — — ---- — --- — -- — ---------------
10. Materials in stock not included in Item #4 (a) For uncompleted contracts (present value)
(b) Other materials (present value)
11. Equipment, book value ------ — -----
12. Furniture and fixtures, book value
13. Other assets ----------------- — — ------
CONTINGENT LIABILITIES
1. Liability on notes receivable, discounted or sold ---------------
2. Liability on accounts receivable, pledged, assigned or sold
3. Liability on bondsman -- — - — ----- — -----------------------------------
4. Liability as guarantor on contracts or on accounts of others
5. Other contingent liabilities ---- — ------ — -------------- — ------ — - — --
Total Assets
Total Liabilities
Total contingent liabilities
I N
X'--rp jph
A CQ ft,
— /Ji .*
A3�6-partters
A— tEAL
Ejndivicr�al
Dollars Ce
LIABILTIES
1. Notes payable:
(a) To banks regular — -- — ------ — ------- — -------------
(b) To banks for certified checks ---- — — ------------
(c) To others for equipment obilgations
(d) To others exclusive of equipment obilgations
2. Accounts payable:
(a) Not past due -- — ------ — ---------- — --
(b) Past due --- — -- — — — — — ---- — ----- — -----------------
3. Real estate encumbrances - — -- — — ------ — -- — ---- — -- — --------- — ------------- —
4. Other liabilities --------
— -------- — — ------ — -------- — -- — -------- — - — -- — -------------
5. Reserves ---------------
— — -------- — -------------------------- — — --- — — ---------------
6. Capital stock paid up:
(a) Common ------------- — --------------------------------
(b) Common ------------- — -- — — ------------ — — — — -- — --
(c) Preferred ---------- — — ---- — — -------------------------
(d) Preferred ----------------- — ---------------- — ---- — — --
7. Surplus (net worth) -----
— ---------------------------------------------- — --- ----------
CONTINGENT LIABILITIES
1. Liability on notes receivable, discounted or sold ---------------
2. Liability on accounts receivable, pledged, assigned or sold
3. Liability on bondsman -- — - — ----- — -----------------------------------
4. Liability as guarantor on contracts or on accounts of others
5. Other contingent liabilities ---- — ------ — -------------- — ------ — - — --
Total Assets
Total Liabilities
Total contingent liabilities
I N
X'--rp jph
A CQ ft,
— /Ji .*
A3�6-partters
A— tEAL
Ejndivicr�al
Dollars Ce
DETAILS RELATIVE TO ASSETS
(a) on hand $
q Cash (b) Deposited in banks named below $
( c) elsewhere - (state where) $
NAME OF BANK LOCATION DEPOSIT IN NAME OF AMOUNT
(a) due within 90 days $
2 * Notes Receivable (b) due after 90 days $
( c) past due $
DATE OF
RECEIVABLE FROM: NAME 8 ADDRESS J FOR WHAT I MATURITY HOW SECURED AMOUNT
Have any of the above been discounted or sold?
If so, state amount, to whom and reason
3* (Accounts receivable from completed contracts of claims not approved for payment.
OF
Have any of the above been assigned, sold or pledged?
If so, state amount, to whom and reason .... $
Sums earned on uncompleted contracts, as shown by engineer's or architects estimate:
4* (a) Amount receivable after deducting retainage .............................................. $
(b) Retainage to date due upon completion of contract ..................................... $
DESIGNATION OF CONTRACT ANDNAME AND AMOUNT OF AMOUNT AMOUNT RETAINAGE AMOUNT
ADDRESS OF OWNER CONTRACT EARNED RECEIVED WHEN DUE AMOUNT EXCLUSIVE OF RETA NAGE
Have any of the above been sold, assigned or pledged? if so, state amount, to whom and reason
' List separtely each item amounting to 10 per cent or more of the total and combine the remainder.
8
DETAILS RELATIVE TO ASSETS (Continued)
5* Accounts receivable not from construction contracts ............................................ s
RECEIVABLE FROM: NAME 8 ADDRESS FOR WHAT I WHEN DUE AMOUNT
Whatamount, if any, is past due............................................................................................................ $
6 Deposits with bids or otherwise guarantees................................................................ $
DEPOSITED WITH: NAME AND ADDRESS FOR WHAT WHEN RECOVERABLE AMOUNT RECEIVABLE
7 Interest accrued on loans, securities, etc................................................................. s
ON WHAT ACCRUED TO BE PAID WHEN AMOUNT RECEIVABLE
Real estate { (a) Used for business purposes........................................................ $
Book Value { (b) Not used for business purposes ................................................... S
IMPROVEMENTS TOTAL BOOK
DESIGNATION OF CONTRACT AND NAME AND ru+TURE of IMPROVEMENTS I BOOK VALUE VALUE
List separtely each item amounting to 10 per cent or more of the total and combine the remainder.
9
(a) Listed - present market value ........................................................ ........ $
STOCKS AND BONDS: (b) Unlisted - present value ......... ........................................................ $
LAST INT OR PAR PRESENT
DESCRIPTION ISSUING COMPANY DIV PAID VALUE MARKET QUANTITY AMOUNT
I VALUE
WHO HAS POSSESSION
AMOUNT
IF ANY ARE PLEDGED OR IN ESCROW, STATE FOR WHOM AND REASON PLEDGED OR IN
10
MATERIALS IN STOCK AND NOT INCLUDED IN ITEM #4. ASSETS -
(a) For use on uncompleted contracts (present values) ............................... .............. ... .......................... S
(b) Other materials (present values) ............ ............ ........... .............. .. ............ ... ... .. .... $
DESCRIPTION OF MATERIAL QUANTITY
PRESENT VALUE
FOR UNCOMPLETED OTHER
CONTRACTS MATERIALS
I
Are there any liens against the above?
If so, state total amount ........................................$
'If two or more items are lumped above, give the sum of their ages.
10
DETAILS RELATIVE TO ASSETS (Continued)
1 Furniture and fixtures at book value................................................................... $
13 (Other assets ...........................................
................. $
2 (a) Not past due .......................................................... $
ACCOUNTS PAYABLE (b) Past due................................................................ $
TO WHOM: NAME AND ADDRESS I FOR WHAT I DATE PAYABLE AMOUNT
3 (Real estate encumbrances (See Item 8, Assets)................................................................................ $
AOther
�}
TOTAL ASSETS
DETAILS RELATIVE TO LIABILITIES
((a) To banks, regular........................................................ $
1
NOTES PAYABLE
{ (b) To banks for certified checks .........................................
{( c) To others for equipment obligations ............................
5
Reserves......................................................................................................
{ (d) To others exclusive of equipment obligations .....................
TO WHOM: NAME AND ADDRESS
WHAT SECURITY I WHEN DUE AMOUNT
2 (a) Not past due .......................................................... $
ACCOUNTS PAYABLE (b) Past due................................................................ $
TO WHOM: NAME AND ADDRESS I FOR WHAT I DATE PAYABLE AMOUNT
3 (Real estate encumbrances (See Item 8, Assets)................................................................................ $
AOther
�}
liabilities....................................................................................................
$
DESCRIPTION
AMOUNT
5
Reserves......................................................................................................
5
INTEREST INSURANCE
BLDGNS 8 FIXI PLANT DEPR. TAXES BAD DEBT
$ s
$ s s $
NQ
Capital Stock aid up
{(a) Common...............................................................
$
�\qfi6
{(b) Preferred...............................................................
_ � 1
7
Surplus.............................................................................................................
5
i,
ill
If a corporation answer this:
Amount for which incorporated.........................................................................
$350,000.00
Capital paid in cash...........................................................................................
$350,000.00
When incorporated............................................................................................
9/26/1967
Inwhat state....................................................................................................
Indiana
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.
Larry C miterhary - Prasidmt
,�� p PV Nta iii
'limy Evans - Vice Prrsida-it
Nsrk Jones — Atm Ir
'
Sarah Rnzter - reta>y Treasu=
=_ S El�L
•
Do you have necessary "certificate of authority" to transact corporate business in this state, under the termg:,of \�
Chapter 215, Acts of 1929, and acts amendatory thereto?....................................................................
•'''��
��
Il/e,,,'I IWO\\\\
If a co -partnership answer this:
Dateof organization...............................................................................................................................
State whether co -partnership is general, limited or association.......................................................................
Give the names, addresses and proportinal intersts of all parties:
Name Address
Share
12
The name of the partnership firm which the above partners are 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.
The undersigned herby 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 for the express purpose of inducing the party to whom \\' \o\ITII II I I i//////
it is submitted to award the submitter a contract: and that any depository, vendor or other agency herein named is hereby authorized to supply \� �X `r G, �N /�//
such party with any information to verify this statement.
Note: A co -partnership must give firm name and signatures of all partners,
A corporation must give full corporate name, signature of official and affix
corporate seal.
STATE OF
COUNTY OF
Affidavit for Individual
Uj
Sarah M. Shuter, Sec/Treasurer
til
BEING DULY SWORN, DEPOSES AND SAYS 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.
STATE OF
COUNTY OF
SUBSCRIBED AND SWORN BEFORE ME THIS
DAY OF
Notary Public
(Applicant must sign here)
Affidavit for Co -Partnership
BEING DULY SWORN, DEPOSES AND SAYS THAT HE IS A MEMBER OF THE FIRM OF
THAT HE IS FAMILIAR 1MTH THE BOOKS OF THE SAID FIRM SHOWING ITS FINANCIAL CONDITION; THAT THE FOREGOING
FINANCIAL STATEMENT TAKEN FROM THE BOOKS OF THE SAID FIRM, IS A TRUE AND ACCURATE STATEMENT OF THE FINANCIAL CONDITION OF THE SAID FIRM
AS OF THE DATE THEREOF AND THAT THE ANSWERS TOTHE FOREGOING INTERROGATORIES ARE TRUE.
SUBSCRIBED AND SWORN BEFORE ME THIS
DAY OF
Notary Public
(Member of firm must sign here)
Affidavit for Corporation
STATE OF INDIANA
COUNTY OF MADISON ��\\\\-\1\NIG, 11V,
Sarah M Shuter BEING DULY SWORN, DEPOSES AND SAYS THAT SHE IcSECRETARY ITaweS MR OF \\//yyQ��V • • • • • • /////
E a w A.V1tJ y W THE CORPORATION DESCRIBED IN AND WHICH EXECUTED THE FOREGOING STATEMENT;THAT HE IS FAMILIAR WITH THE BOOKS OF THE
SAID CORPORATION SHOWING ITS FINANCIAL CONDITION; THAT THE FOREGOING FINANCIAL STATEMENT, TAKEN FROM THE BOOKS OF SAID CORPORATION, W
IS A TRUE AND ACCURATE STATEMENT OF THE FINANCIAL CONDITION OF THE SAID FIRM 5 OF THE DATE THEREOF AND THAT THE ANSWERS TO THE i
FOREGOING INTERROGATORIES ARE TRUE. /\ rt r ,�'/1 t '/ ........
SUBSCRIBED
e \\\\\\\
SUBSCRIBED AND SWORN BEFORE ME THISL \\\\\
22ND
DAY OF June, 2016///IIIIII,�
n (Officer must sign here)
M -iii )
Anne M. Dellinger -
e STA- OFFICIAL SEAL
ANNE DELLINGER
„r. NOTARY PUBLIC - INDIANA
MADISON COUNTY
My COMM. EXPIRES FEB. 23r 201I
i laic --- - -_.
PART 7
ADDITI®NAL DECLARATI®NS
7.1 Bidder certifies for itself and all its subcontractors compliance with all existing laws of
the United States and the State of Indiana prohibiting the discrimination against any
employee or applicant for employment or subcontract work in the performance of the
Work contemplated by the Agreement with respect to hire, tenure, terms, conditions, or
privileges of employment or any matter directly or indirectly related to employment or
subcontracting because of race, religion, color, sex, handicap, national origin, ancestry,
age, disabled veteran status or Vietnam era veteran status. The City of Carmel reserves
the right to collect a penalty as provided in IC 5-16-6-1 for any person discriminated
against.
7.2 The Bidder certifies that he/she has thoroughly examined the site of the Project/Work and
informed himself/herself fully regarding all conditions under which he/she will be
obligated to operate and that in any way affect the Work, and knows, understands and
accepts the existing conditions. The Bidder further certifies that he/she has thoroughly
reviewed the Contract Documents, including all Addenda, and has had the opportunity to
m ask questions and obtain interpretations or clarifications concerning Contract Documents.
PART 8
NON -COLLUSION AFFIDAVIT
The individual person(s) executing this Bid Proposal, being first duly sworn, depose(s) and
state(s) that the Bidder has not directly or indirectly entered into a combination, collusion,
undertaking or agreement with any other Bidder or person (i) relative to the price(s) proposed
herein or to be bid by another person, or (ii) to prevent any person from bidding, or (iii) to induce
a person to refrain from Bidding; and furthermore, this Bid Proposal is made and submitted
without reference to any other bids and without agreement, understanding or combination, either
directly or indirectly, with any persons with reference to such bidding in any way or manner
whatsoever.
PART 9
SIGNATURES
[Signature by or on behalf of the Bidder in the spaces provided below shall constitute execution
of each and every Part of this Itemized Proposal and Declarations Document. SIGNATURE
MUST BE PROPERLYNOTARIZED
.J
Bidders Name: E & B Paving, Inc.JUNG, JIV,
\�
Written Signature:
Printed Name: 'my N. Gans -
Title: Viae President
Important - Notary Signature and Seal Required in the Space Below
STATE OF Indiana
SS:
COUNTY OF Hmniltm
Subscribed and sworn to before me this 17th day of August ,
tQ 2016.
ti
My commission expires: 6/05/2024 (Signe
Printed: April N. Ryan
Residing in Madison
County, State of
Indiana
fII� ►1 „I :1'1' ' 1 1, 1.Y
BID BOND
City of Carmel
Instructions To Bidders
Bidders may use this form or other form containing the same material conditions and
provisions as approved in advance by OWEBIObligee.
Bidder/Surety must attach a signed, certified and effective dated copy of the Power of
Attorney or Attorney lh Fact establishing the authority of the persons) signing this Bid
Bond on behalf of the Surety.
The Surety company executing this bond shall appear on the most current list of "Surety
Companies Acceptable on .federal Bonds, " as specified in the U.S. Treasury Department
Circular 570, as amendeel and be authorized to transact business in the State of Indiana
KNOW ALL MEN BY THESE PRESENTS, that the undersigned
"Bidder":
E & B Paving, Inc.
and
"Surety": [Name]
Continental Casualty Company
[Address] 333 S. Wabash Ave.
Chicago, IL 60604 ,
a corporation chartered and existing under the laws of the State of
IL , and authorized to do business in the
State of Indiana,
are held and firmly bound unto the City of Carmel, Indiana ("Obligee") in the full and
just sum equal to ten percent (10%) of the price stated in the Bid proposal described in
Part 2, including accepted alternates, if any, to be paid upon demand of the Obligee,
together with interest at the maximum legal rate from date of demand and any attorney
fees and court costs incurred by Obligee to enforce this instrument, to which payment
well and truly to be made we bind ourselves, our heirs, executors, administrators,
successors, and assigns, jointly and severally and firmly by these presents. Ten percent
(I M) of the price stated in the Bid Proposal is $ 147,182.43
'WHEREAS, the Obligee has solicited Bids for certain work for or in furtherance of
construction of improvements described generally as:
Roundabout Improvements 136th Street and Carey Road, Project No. 16 -ENG -26
Roundabout Improvements Road and Hawthorne Drive, Project No. 16 -ENG -09
pursuant to plans, specifications and other "Contrast Documents" included as parts of and
designated by such solicitation; and
WHEREAS, the Bidder has submitted to the Obligee a Bid proposal to perform such
Work.
NOW THEREFORE: The conditions of this obligation are such that if the Bid proposal
be accepted, with or without conditions, the Bidder shall within such time thereafter as
prescribed by the Contract Documents (i) fulfill all conditions of such award that remain
to be fulfilled, (ii) execute an Agreement in accordance with the Bid proposal and in the
form and manner required by the Contract Documents, and (iii) thereafter provide all
bonds, and other documentation required by the Contract Documents to be delivered to
Obligee prior to commencing work on the project, including without limitation a
sufficient and satisfactory performance bond and payment bond payable to Obligee, each
in an amount of one hundred percent (100%x) of the total project Agreement price as
awarded and in form and with surety satisfactory to said Obligee, then this obligation to
be void; otherwise to be and remain in full force and virtue in law, and the Surety shall,
upon failure of the Bidder to comply with any or all of the foregoing requirements within
the time specified above and as prescribed by the Contract Documents, immediately pay
to the Obligee, upon demand, the amount hereof in good and lawful money of the United
States of America, not as a penalty, but as liquidated damages.
IN TESTIMONY THEREOF, the Bidder and Surety have caused this instrument to be
duly signed and sealed this 17th day o£ August , 2016
This BM Bond shall bind the undersigned ,Surety whether or not also signed by the
Bidder.
"Bidder" E & B Paving, Inc.
By:
Printed: Tmv N. Evans
Vim President
SEAL
49 S=tf'Continental Casualty Company
By:
Printed:Terry R. Hurst Attorney -in -Fact
Countersigned: N/A
(;oFkPcfAare 1-
SEAL,),CA =
DATE: August 17, 2016
TO: City of Carmel, Indiana
RE: CONTRACTOR: E & B Paving, Inc.
BID DATE: August 17, 2016
PROJECT' Roundabout Improvements 136th Street and Carey Road, Project No. 16 -ENG -26 -Roundabout
Improvements Road and Hawthorne Drive, Project No. 16 -ENG -09
The purpose of this letter is to advise that should the captioned contractor be the successful bidder, and enter
Into a contract for the described work, Continental Casualty Company I will provide
appropriate Performance and Payment Bonds, subject to the terms and conditions of the bid
E & B Pavinq, Inc.
Continental Casualty Company
By: t
Terry R. Hurst Attorney-in-factio�
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents, That Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of
Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company (herein called
"the CNA Companies"), are duly organized and existing insurance companies having their principal offices in the City of Chicago, and State of Illinois,
and that they do by virtue of the signatures and seals herein affixed hereby make, constitute and appoint
Liana M. Shelton, Robert M. Rutigliano, Eric M. Wahlstrom, Brian T. Morton, Terry R. Hurst, Individually
of Indianapolis, IN, their true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on their
behalf bonds, undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and
all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly
adopted, as indicated, by the Boards of Directors of the insurance companies.
In Witness Whereof, the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto
affixed on this 8th day of February, 2016.
AS
1 r,ORPGRATF
i
SEAL
1697
,voF Continental Casualty Company
,alb National Fire Insurance Company of Hartford
a'� �Nco�arEo A American Ca lty Company of Re ding, Pennsylvania
JULY 11, M
1902 * �/
Paul T. Bruflat Ace President
State of South Dakota, County of Minnehaha, ss:
On this 8th day of February, 2016, before me personally came Paul T. Bruflat to me known, who, being by me duly sworn, did depose and say: that
he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of Continental Casualty Company, an Illinois insurance company,
National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a
Pennsylvania insurance company described in and which executed the above instrument; that he knows the seals of said insurance companies; that the
seals affixed to the said instrument are such corporate seals; that they were so affixed pursuant to authority given by the Boards of Directors of said
insurance companies and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance
companies.
J. MOHR
i1 -'U— SOUTH DAKOTA
My Commission Expires June 23, 2021 J. Mohr V Notary Public
CERTIFICATE
I, D. Bult, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an
Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the
Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance
companies printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said
insurance companies this 17th day of August, 2016.
cAS A4Ty
coRPORArkt
SEAL 'r
1697
Form F6853-4/2012
Continental Casualty Company
National Fire Insurance Company of Hartford
American Casualty Company of Reading, Pennsylvania
1
f ---) - "., - Q
D. Bult Assistant Secretary
Authorizing Sy -Laws and Resolutions
ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY:
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company at a
meeting held on May 12, 1995:
"RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the
Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be
provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective."
This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on
behalf of Continental Casualty Company.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by
unanimous written consent dated the 25'h day of April, 2012:
"Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute
various policies, bonds, undertakings and other obligatory instruments of like nature; and
Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or
otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer
shall be valid and binding on the Company. "
ADOPTED BY THE BOARD OF DIRECTORS OF NATIONAL FIRE INSURANCE COMPANY OF HARTFORD:
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company by
unanimous written consent dated May 10, 1995:
"RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the
Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be
provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective."
This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on
behalf of National Fire Insurance Company of Hartford.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by
unanimous written consent dated the 25th day of April, 2012:
"Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute
various policies, bonds, undertakings and other obligatory instruments of like nature; and
Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or
otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer
shall be valid and binding on the Company. "
ADOPTED BY THE BOARD OF DIRECTORS OF AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA:
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company by
unanimous written consent dated May 10, 1995:
"RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the
Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be
provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective."
This Power of Attorney is signed by Paul T. Bruflat, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on
behalf of American Casualty Company of Reading, Pennsylvania.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by
unanimous written consent dated the 25'h day of April, 2012:
"Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers")to execute
various policies, bonds, undertakings and other obligatory instruments of like nature; and
Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or
otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer
shall be valid and binding on the Company. "
147orld-Class Solutions at a Local Level"'
April 5, 2016
To Whom It May Concern:
This letter will certify that E&B Paving, Inc. is duly registered to use the E -Verify system and certifies that
E&B Paving, Inc. does not knowingly employ or contract with unauthorized alien workers. Following is
the pertinent information for E&B Paving, Inc,
E&B Paving, Inc
286 W 300 N
Anderson, IN 46012
E -Verify Company ID #: 426977
EEO Officer: Chuck Siegel
Corporate Human Resources Manager/EEO Officer
Phone: 765.374.0350
Fax: 765.643.0699
Email: chuck.siegel@ebpaving.com
This letter meets the requirements for certifying to general contractors E&B Paving's compliance with
Indiana Senate Act 590 (SEA 950). To obtain a complete copy of E&B's E -Verify Memorandum of
Understanding (MOU), please contact our EEO Officer and one will be promptly provided.
Respectfully,
L'
ry Canterbury, Presid t
\\"OXIJ I I I I11////7i/
my •,,
= W
AN EQUAL OPPORTUNITY EMPLOYER
-------------------------------
r
286 W. 300 N. • Anderson, IN 46012 I
PHONE: 765.643.5358 • FAx:765.643.0699 I
f
www.ebpaving.com
■ s o •
y-� MITnP'
Company ID Number: 426977
THE E -VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION
MEMORANDUM OF UNDERSTANDING
ARTICLE I
PURPOSE AND AUTHORITY
This Memorandum of Understanding (MOU) sets forth the points of agreement between the
Department of Homeland Security (DHS) and E&B Paving, Inc. (Employer) regarding the
Employer's participation in the Employment Eligibility Verification Program (E -Verify). This MOU
explains certain features of the E -Verify program and enumerates specific responsibilities of
DHS, the Social Security Administration (SSA), and the Employer. E -Verify is a program that
electronically confirms an employee's eligibility to work in the United States after completion of
the Employment Eligibility Verification Form (Form 1-9). For covered government contractors, E -
Verify is used to verify the employment eligibility of all newly hired employees and all existing
employees assigned to Federal contracts or to verify the entire workforce if the contractor so
chooses.
Authority for the E -Verify program is found in Title IV, Subtitle A, of the Illegal Immigration
Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L. 104-208, 110 Stat. 3009, as
amended (8 U.S.C. § 1324a note). Authority for use of the E -Verify program by Federal
contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility
Verification", of the Federal Acquisition Regulation (FAR) (hereinafter referred to in this MOU as
a "Federal contractor with the FAR E -Verify clause") to verify the employment eligibility of
certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive
Order 12989, as amended.
ARTICLE II
FUNCTIONS TO BE PERFORMED
A. RESPONSIBILITIES OF SSA
1. SSA agrees to provide the Employer with available information that allows the Employer to
confirm the accuracy of Social Security Numbers provided by all employees verified under this
MOU and the employment authorization of U.S. citizens.
2. SSA agrees to provide to the Employer appropriate assistance with operational problems .that
may arise during the Employer's participation in the E -Verify program. SSA agrees to provide
the Employer with names, titles, addresses, and telephone numbers of SSA representatives to
be contacted during the E -Verify process.
3. SSA agrees to safeguard the information provided by the Employer through the E -Verify
program procedures, and to limit access to such information, as is appropriate by law, to
individuals responsible for the verification of Social Security Numbers and for evaluation of the
E -Verify program or such other persons or entities who may be authorized by SSA as governed
Page 1 of 141 E -Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify
ven
Company ID Number: 426977
Nationality Act (INA) and Federal criminal laws, and to administer Federal contracting
requirements.
7. DHS agrees to provide a means of automated verification that is designed (in conjunction
with SSA verification procedures) to provide confirmation or tentative nonconfirmation of
employees' employment eligibility within 3 Federal Government work days of the initial inquiry.
8. DHS agrees to provide a means of secondary verification (including updating DHS records as
may be necessary) for employees who contest DHS tentative nonconfirmations and photo non -
match tentative nonconfirmations that is designed to provide final confirmation or
nonconfirmation of the employees' employment eligibility within 10 Federal Government work
days of the date of referral to DHS, unless DHS determines that more than 10 days may be
necessary. In such cases, DHS will provide additional verification instructions.
C. RESPONSIBILITIES OF THE EMPLOYER
1. The Employer agrees to display the notices supplied by DHS in a prominent place that is
clearly visible to prospective employees and all employees who are to be verified through the
system.
2. The Employer agrees to provide to the SSA and DHS the names, titles, addresses, and
telephone numbers of the Employer representatives to be contacted regarding E -Verify.
3. The Employer agrees to become familiar with and comply with the most recent version of the
E -Verify User Manual.
4. The Employer agrees that any Employer Representative who will perform employment
verification queries will complete the E -Verify Tutorial before that individual initiates any queries.
A. The Employer agrees that all Employer representatives will take the refresher tutorials
initiated by the E -Verify program as a condition of continued use of E -Verify.
B. Failure to complete a refresher tutorial will prevent the Employer from continued use
of the program.
5. The Employer agrees to comply with current Form 1-9 procedures, with two exceptions:
- If an employee presents a "List B" identity document, the Employer agrees to only
accept "List B" documents that
contain a photo. (List B documents identified in 8 C.F.R. § 274a.2(b)(1)(B)) can be
presented during the Form 1-9
process to establish identity.) If an employee objects to the photo requirement for
religious reasons, the Employer
should contact E -Verify at 888-464-4218.
• If an employee presents a DHS Form 1-551 (Permanent Resident Card) or Form 1-766
(Employment Authorization Document) to complete the Form 1-9, the Employer agrees to
make a photocopy of the document and to retain the photocopy with the employee's
Form 1-9. The photocopy must be of sufficient quality to allow for verification of the photo
Page 3 of 14 1 E -Verify MOU for Employer I Revision Date 09/01/09 www.dhs.govlE-Verify
Company ID Number: 426977
uses the E -Verify system for any purpose other than as authorized by this MOU, the Employer
may be subject to appropriate legal action and termination of its access to SSA and DHS
information pursuant to this MOU.
9. The Employer agrees to follow appropriate procedures (see Article III. below) regarding
tentative nonconfirmations, including notifying employees in private of the finding and providing
them written notice of the findings, providing written referral instructions to employees, allowing
employees to contest the finding, and not taking adverse action against employees if they
choose to contest the finding. Further, when employees contest a tentative nonconfirmation
based upon a photo non -match, the Employer is required to take affirmative steps (see Article
M.B. below) to contact DHS with information necessary to resolve the challenge.
10. The Employer agrees not to take any adverse action against an employee based upon the
employee's perceived employment eligibility status while SSA or DHS is processing the
verification request unless the Employer obtains knowledge (as defined in 8 C.F.R. § 274a.1(1))
that the employee is not work authorized. The Employer understands that an initial inability of
the SSA or DHS automated verification system to verify work authorization, a tentative
nonconfirmation, a case in continuance (indicating the need for additional time for the
government to resolve a case), or the finding of a photo non -match, does not establish, and
should not be interpreted as evidence, that the employee is not work authorized. In any of the
cases listed above, the employee must be provided a full and fair opportunity to contest the
finding, and if he or she does so, the employee may not be terminated or suffer any adverse
employment consequences based upon the employee's perceived employment eligibility .status
(including denying, reducing, or extending work hours, delaying or preventing training, requiring
an employee to work in poorer conditions, refusing to assign the employee to a Federal contract
or other assignment, or otherwise subjecting an employee to any assumption that he or she is
unauthorized to work) until and unless secondary verification by SSA or DHS has been
completed and a final nonconfirmation has been issued. If the employee does not choose to
contest a tentative nonconfirmation or a photo non -match or if a secondary verification is
completed and a final nonconfirmation is issued, then the Employer can find the employee is not
work authorized and terminate the employee's employment. Employers or employees with
questions about a final nonconfirmation may call E -Verify at 1-888-464-4218 or OSC at 1-800-
255-8155 or 1-800-237-2515 (TDD).
11. The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section
274B of the INA, as applicable, by not discriminating unlawfully against any individual in hiring,
firing, or recruitment or referral practices because of his or her national origin or, in the case of a
protected individual as defined in section 274B(a)(3) of the INA, because of his or her
citizenship status. The Employer understands that such illegal practices can include selective
verification or use of E -Verify except as provided in part D below, or discharging or refusing to
hire employees because they appear or sound . "foreign" or have received tentative
nonconfirmations. The Employer further understands that any violation of the unfair immigration -
related employment practices provisions in section 274B of the INA could subject the Employer
to civil penalties, back pay awards, and other sanctions, and violations of Title VII could subject
the Employer to back pay awards, compensatory and punitive damages. Violations of either
section 274B of the INA, or Title VII may also lead to the termination of its participation in E -
Page 5 of 14 1 E -Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify
- Ve r I-
ry
��y
Company ID number: 426977
whether or not assigned to the contract. Once the Employer begins verifying new hires, such
verification of new hires must be initiated within 3 business days after the date of hire. Once
enrolled in E -Verify as a Federal contractor with the FAR E -Verify clause, the Employer must
initiate verification of employees assigned to the contract within 90 calendar days from the time
of enrollment in the system and after the date and selecting which employees will be verified in
E -Verify or within 30 days of an employee's assignment to the contract, whichever date is later.
d. Employers that are already enrolled in E -Verify at the time of a contract award but are
not enrolled in the system as a Federal contractor with the FAR E -Verify clause: Employers
enrolled in E -Verify for 90 days or more at the time of a contract award must use E -Verify to
initiate verification of employment eligibility for new hires of the Employer who are working in the
United States, whether or not assigned to the contract, within 3 business days after the date of
hire. Employers enrolled in E -Verify as other than a Federal contractor with the FAR E -Verify
clause, must update E -Verify to indicate that they are a Federal contractor with the FAR E -
Verify clause within 30 days after assignment to the contract. If the Employer is enrolled in E -
Verify for 90 calendar days or less at the time of contract award, the Employer must, within 90
days of enrollment, begin to use E -Verify to initiate verification of new hires of the contractor
who are working in the United States, whether or not assigned to the contract. Such verification
of new hires must be initiated within 3 business days after the date of hire. An Employer
enrolled as a Federal contractor with the FAR E -Verify clause in E -Verify must initiate
verification of each employee assigned to the contract within 90 calendar days after date of
contract award or within 30 days after assignment to the contract, whichever is later.
e. Institutions of higher education, State, local and tribal governments and sureties:
Federal contractors with the FAR E -Verify clause that are institutions of higher education (as
defined at 20 U.S.C. 1001(a)), State or local governments, governments of Federally recognized
Indian tribes, or sureties performing under a takeover agreement entered into with a Federal
agency pursuant to a performance bond may choose to only verify new and existing employees
assigned to the Federal contract. Such Federal contractors with the FAR E -Verify clause may,
however, elect to verify all new hires, and/or all existing employees hired after November 6,
1986. The provisions of Article ILD, paragraphs 1.a and 1.b of this MOU providing timeframes
for initiating employment verification of employees assigned to a contract apply to such
institutions of higher education, State, local and tribal governments, and sureties.
f, Verification of all employees: Upon enrollment, Employers who are Federal contractors
with the FAR E -Verify clause may elect to verify employment eligibility of all existing employees
working in the United States who were hired after November 6, 1986, instead of verifying only
new employees and those existing employees assigned to a covered Federal contract. After
enrollment, Employers must elect to do so only in the manner designated by DHS and initiate E -
Verify verification of all existing employees within 180 days after the election.
g. Form 1-9 procedures for existing employees of Federal contractors with the FAR E -
Verify clause: Federal contractors with the FAR E -Verify clause may choose to complete new
Forms 1-9 for all existing employees other than those that are completely exempt from this
process. Federal contractors with the FAR E -Verify clause may also update previously
completed Forms 1-9 to initiate E -Verify verification of existing employees who are not
completely exempt as long as "that Form 1-9 is complete (including the SSN), complies with
Page 7 of 14 1 E -Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E.Verify
-V(a r WFV
t!I¢a / ` +
` VSA
Company ID Number: 426977
determines that more than 10 days is necessary. The Employer agrees to check the E -Verify
system regularly for case updates.
4. The Employer agrees not to ask the employee to obtain a printout from the Social Security
Number database (the Numident) or other written verification of the Social Security Number
from the SSA.
B. REFERRAL TO DHS
1. If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must print
the tentative nonconfirmation notice as directed by the E -Verify system and provide it to the
employee so that the employee may determine whether he or she will contest the tentative
nonconfirmation. The Employer must review the tentative nonconfirmation with the employee in
private.
2. If the Employer finds a photo non -match for an employee who provides a document for which
the automated system has transmitted a photo, the employer must print the photo non -match
tentative nonconfirmation notice as directed by the automated system and provide it to the
employee so that the employee may determine whether he or she will contest the finding. The
Employer must review the tentative nonconfirmation with the employee in private.
3. The Employer agrees to refer individuals to DHS only when the employee chooses to contest
a tentative nonconfirmation received from DHS automated verification process or when the
Employer issues a tentative nonconfirmation based upon a photo non -match. The Employer will
determine whether the employee contests the tentative nonconfirmation as soon as possible
after the Employer receives it.
4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer will
provide the employee with a referral letter and instruct the employee to contact DHS through its
toll-free hotline (as found on the referral letter) within 8 Federal Government workdays.
5. If the employee contests a tentative nonconfirmation based upon a photo non -match, the
Employer will provide the employee with a referral letter to DHS. DHS will electronically transmit
the result of the referral to the Employer within 10 Federal Government work days of the referral
unless it determines that more than 10 days is necessary. The Employer agrees to check the E -
Verify system regularly for case updates.
6. The Employer agrees that if an employee contests a tentative nonconfirmation based upon a
photo non -match, the Employer will send a copy of the employee's Form 1-551 or Form 1-766 to
DHS for review by;
• Scanning and uploading the document, or
• Sending a photocopy of the document by an express mail account (paid for at
employer expense).
7. If the Employer determines that there is a photo non -match when comparing the photocopied
List B document described in Article II.C.5 with the image generated in E -Verify, the Employer
must forward the employee's documentation to DHS using one of the means described in the
preceding paragraph, and allow DHS to resolve the case.
Page 9 of 14 1 E -Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify
Company ID Number: 426977
D. Nothing in this MOU is intended, or should be construed, to create any right or benefit,
substantive or procedural, enforceable at law by any third party against the United States, its
agencies, officers, or employees, or against the Employer, its agents, officers, or employees.
E. Each party shall be solely responsible for defending any claim or action against it arising out
of or related to E -Verify or this MOU, whether civil or criminal, and for any liability wherefrom,
including (but not limited to) any dispute between the Employer and any other person or entity
regarding the applicability of Section 403(d) of IIRIRA to any action taken or allegedly taken by
the Employer.
F. The Employer understands that the fact of its participation in E -Verify is not confidential
information and may be disclosed as authorized or required by law and DHS or SSA policy,
including but not limited to, Congressional oversight, E -Verify publicity and media inquiries,
determinations of compliance with Federal contractual requirements, and responses to inquiries
under the Freedom of Information Act (FOIA).
G. The foregoing constitutes the full agreement on this subject between DHS and the Employer.
H. The individuals whosesignatures appear below represent that they are authorized to enter
into this MOU on behalf of the Employer and DHS respectively.
Page 11 of 14 1 E -Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify
- V im. r I fy
Company ID dumber: 426977
North American Industry
Classification Systems
Code: 237
Administrator:
Number of Employees: �00 to 499
Number of Sites Verified
for:
kre..you verifying far more than 1 site? If yes, please provide the number of sites verified for
2 each State:
INDIANA I site(s)
Information relating to the Program Administrator(s) for your Company on policy
questions or operational problems -
Nam ' e:
roblems:
Name:
Phillip Dockter
Tele plione Number:
(765) 374 - 0350
E-mail Address:
phil.dockternebpaving.com
Name:
Lori Hughes
Telephone Number:
(765) 643 - 5358
E-mail Address:
lorLbughes@ebpavi.ng.com
Name:
Gayle Behm
Telephone Number:
(765) 374 - 0352
E-mail Address:
gayle.behmL@,ebpaving.com
Name:
Sarah Shuter
Telephone Number:
(765) 374 - 0342
E-mail Address:
sarah.shuter@ebpaving.com
Fax Number: (765) 643 -0699
Fax Number: (765) 643 - 0699
Fax Number: (765) 643 - 0699
Fax Number: (765) 643 - 0699
Page 13 of 141 E -Verify MOU for Employer I Revision Date 09/01/09 www.dhs.g6v1E-Verify_
2/10/2015
IMI Mail -RE: Points on Contact on MOU
�I''t in
Nat6l"Lc' ls, 111Ce Sarah Shuter <sarah.shuter@ebpaving.com>
Group c f Companies
ESE: Points on Connect on MMU
1 message
E-VerifyEmployerAgent <E-VerifyEmployerAgent@uscis.dhs.gov> Wed, Jan 21, 2015 at 2:22 PM
To: Sarah Shuter <sarah.shuter@ebpaving.com>
Good Afternoon,
Thank you for contacting the E -Verify Team. We are happy to address your questions or
concerns.
The information on the E -Verify Memorandum Of Understanding (MOU) cannot be altered from
the information that was entered during the enrollment process. To provide proof of enrollment,
you may print a copy of your `company information' page with the updated data and attach it to
the original MOU.
We hope this information has been helpful to you. If you need additional assistance, please call
E -Verify at 888-464-4218 or email us at E-VerifyEmployerAgent@dhs.gov <mailtc:E-Verify@dhS.gov>
You may speak to a representative Monday—Friday from 8:00 am to 5:00 pm Local Time.
Thank you for allowing us to serve you!
Cordially,
The E -Verify Team
MDS
From: Sarah Shuter(mailto:sarah.shuter@ebpaving.com]
Sent: Friday, January 16, 2015 7:19 AM
To: E-VerifyEmployerAgent
Subject: Points on Contact on MOU
Hello,
have edited the Points of Contact in our Company Information area. I had to remove two users that have
retired. However, when I view my MOU, those users are both still listed. Does it take a certain amount of time
to regenerate this MOU? 1 have also deleted their user accounts.
Thanks,
Sarah Shuter
httpsJ/mail.google.com/mail/u/0/?ui=2&ik=.aadf6gbcfe&view=pt&search=inbox&th=14b0df305f118ed2&sirnl=14bU305f118ed2 1/2
WRITTEN CONSENT TO RESOLUTION OF THE
SOLE SHAREHOLDER AND DIRECTORS OF E & B PAVING, INC.
The undersigned, being the sole shareholder and the director of E & B Paving, Inc., an
Indiana Corporation ("Corporation"), hereby consent to the following action to be taken by the
Corporation in lieu of the annual meeting of the Shareholder and Directors of the Corporation;
RESOLVED, that the following persons are nominated and elected to serve as directors of
the Corporation until their successors are duly elected and qualify;
Earl Brinker and Larry Canterbury,
RESOLVED, that the following persons are nominated and elected to serve in the following
capacities until their successors are duly elected and qualify;
President
Larry Canterbury
Vice -President
John Eller
Vice -President
Tony Evans
Vice -President
Michael Collard
Vice -President
Brad Dreibelbis
Secretary/Treasurer
Sarah M. Shuter
RESOLVED, in order to promptly and efficiently conduct the business of the Corporation, it
is necessary to enter into certain contracts to provide paving products including, but not limited to,
aggregate and asphalt and such other surface and paving products and related services;
RESOLVED, it is necessary that certain officers and employees of the Corporation be
empowered to execute such agreements on behalf of the Corporation, including contracts,
performance, payment and maintenance bonds, bids and related documents;
RESOLVED, the following named officers and/or employees of the Corporation are hereby
authorized and directed individually and without any other officer attesting thereto to execute,
acknowledge and deliver bids, contracts and bonds for and on behalf of the Corporation and to take
such related action not inconsistent with resolution, and not substantially adverse to the Corporation,
and their signature shall be conclusively evidenced by the execution of such contract documents and
bonds; provided however, that such authority of such officers and/or employees on behalf of the
Corporation shall be limited to the extent set forth below as follows:
NA1@'1<E EXTENT OF LIII"'JY')(�T><Ol�l
Larry Canterbury without limitation
Earl Brinker
without limitation
Sarah M. Shuter
without limitation
John Eller
$10,000,000
Tonv Evans
$10,000,000
Brad Dreibelbis
S10,000,000
Spencer B. Coe
$10,000,000
David F. Hardin
$5,000,000
Kenneth "I. Spellman $5,000,000
Todd Hoops
$3,000,000
Chad Hartwick
53,000,000
David Heyde
$2,000,000
,lames Sonntag
$2,000,000
Michael Collard
55,000.000
Douglas .lump
52,000,000
Gregg Koppelmann
$2,000,000
Mark Jones
$2,000,000
Steve Varner
52,000,000
Kip Chandler
$2,000,000
Nick Chapman
$2,000,000
Cam Paddock
$2,000,000
Thane Knox
$2,000.000
RESOLVED, that any and all acts and proceedings of the Directors and Officers of the
Corporation occurring since the last meeting of the Shareholders and Directors be and they hereby
are ratified, confirmed and approved.
RESOLVED, that this written consent be executed in multiple counterparts;
RESOLVED, that this written consent be in lieu of any annual meeting of the Shareholder
and Directors of the Corporation and shall be filed in the minute book of the Corporation in place of
any minutes of any such annual meetings.
Dated this 27th day of April, 2016.
SOLE SHAREHOLDER
IRVING MAT. RIALS, INC.
BY: .
C
Earl Brinker, President
INDIANAPOLIS, IN
I: & B PAVING INC
TO
January 8, 2016
ANDERSON, IN
who has filed with the Department a Contractor's Statement of Experience and Financial Condition as
required under Indiana Code 8-23-10, is hereby qualified to bid at any Department of Transportation
letting in Classes of Work and within the amount and other limitation of each classification as listed
below, for such period as the uncompleted work on hand from all sources does not exceed the Aggregate
amount. Classification references by name or symbol are in accordance with the definitions in the
Contractor's Statement of Experience and Financial Condition. This certificate supersedes any certificate
previously issued, but is subject to revision or revocation according to the law, if and when changes
in the financial condition of the contracting firm or other facts justify such revision or revocation.
Valid February 1, 2016 Thni January 31, 2017
AGGREGATE.......................................................................................................................................
$UNLIMITED
0085
CLHAN/SEAL. CRACKS/JOINTS: PCCP/HMA PVMT..............................................................................
S50,000,000
0194
PAVEMENT SEALING MICROSURFACING...................................................
...... ............... I................... $50,000,000
0230
PVMTGRVING SCARIFICATION RUMBLE STRIPS..............................................................................
$50,000,000
0284
RECYCLING CONCRETE PAVL'•MEN'I.....................................................................................................
$50,000,000
0286
RECYCLING ASPHALT PAVEMENT.......................................................................................................
$50,000,000
0288
PAVEMENT SEALING: SLURRY, FOG AND CHIP.................................................................................
$50,000,000
0289
SEALING PARKING LOTS AND DRIVEWAYS .......................................................................................
$50,000,000
0290
SEWER AND PIPE. CLEANING AND LINING..........................................................................................
$5,000,000
A(A)
CONCRE-1.17 PAVEMENT, GENERAL— ...................................................................................................SUNLIMTTED
A(B)
CONCRETE PAVEMENT, LIMITED.........................................................................................................$UNLIMITED
B(A)
ASPI IALT PAVING: CERTHMA PLANT.................................................................................................$UNLIMITED
C(A)
HEAVY GRADINC..................................--.................................................................................................
$75,000,000
C(B)
LIGHT GRADING........................................................................................................................................
$75,000,000
D(A)
HWY OR RR BRIDGES OVER WATER....................................................................................................
$75,000,000
D(B)
I IWY OR RR BRIDGES OVER IIIGI IWAYS.............................................................................................
$75,000,000
D(C)
HWY BRIDGES RE -0 PROTECTION OF RR-1.11ACKS.............................................................................
$75,000,000
E(E)
SMALL STRUCTURES AND DRAINAGE T17:MS....................................................................................
$50,000,000
F(F)
SURFACE MASONRY AND MISC CONCRETE......................................................................................
$50,000,000
E(Q)
CONCRETE PAVEMENT REPAIRS..........................................................................................................
$50,000,000
E(R)
ROAD MILLING ..........................................................................................................................................
$50,000,000
E(T)
DEMOLITION..............................................................................................................................................
$50,000,000
vk,— ti M-��A
PREQUALIFICATION ENGINEER
Stale Form 20508 (R31 5-05)
��f.OMMISSIONER