Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Calumet Civil Contractors
BID PROPOSAL SUMMARY PAGE Complete the following information and place as the cover page to your bid packet. Insert all documents into an envelope with project name and your company name clearly marked on the outside. Seal the envelope. The prices indicated on this sheet shall be read aloud during the bid opening and shall match the prices indicated in Part 2 of the Bidders Itemized Proposal and Declarations. Company: Calumet Civil Contractors, Inc. Project Name: Project #16 -SW -08(2) Small Structure Replacement: Culvert 43 — Hoover Road over Clay Creek Culvert 85 -111th Street over U.N.T. of Carmel Creek Date Submitted: August 16, 2017 Base Bid Amount: $ 814, 300.00 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 befully and accurately filled in and completed and notarized. Project: Small Structure Replacements of Culverts 43 & 85 Project Number: 16 -SW -08(02) Proposal For Construction of : The replacement of the existing small structure 43 over Clay Creek on Hoover Road located 455 feet north of Braeburn Drive, And The replacement of the existing small structure 85 over U.N.T. of Carmel Creek on 111"' Street located 100 feet west of Echo Crest Drive W. Date: August 16, 2017 To: City of Carmel, Indiana, Board of Public Works and Safety BID -1 PART 1 BIDDER INFORMATION (Print) 1.1 Bidder Name: Calumet Civil Contractors, Inco 1.2 Bidder Address: Street Address: 4898 Fieldstone Drive City: Whitestown State: IN Zip: 46075 Phone: (317) 769-1900 Fax: (317) 769-7424 1.3 Bidder is a/an [mark one] Individual Partnership X Indiana Corporation Foreign (Out of State) Corporation; State: Joint Venture Other 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: BID -2 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: Base Bid: Eight hundred and fourteen thousand and three hundred dollars. Dollars ($ 814, 300.00 ). 2.2 General The Bidder acknowledges that evaluation of the lowest Bid shall be based on the total of the Base and selected Alternate Bids if applicable. The Bidder acknowledges that the Owner reserves the right to award the Contract for the Base Bid alone, for the Base Bid plus selected Alternate Bids if applicable The Bidder 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 PART 3 rnNTR ACT TTFMIR AND TTNTT PRTC'FS Itemized Proposal Project 16 -SW -08(02) Small Structure Replacements of Culverts 43 & 85 Item # Item Quantity Unit Unit Cost Total Cost 1 Construction Engineering 1 LS 2 Mobilization / Demobilization 1 LS S 3 Clearing Right of Way 1 LS 4 Common Excavation 510 CYS 5 B Borrow 64 CYS 6 Temporary Seeding 232 LBS T 7 Temporary Mulch 2 TON A 8 Temporary Inlet Protection 4 EACH 14 9 Temporary Check Dam 10 TON E 10 Silt Fence 780 LFT D 11 Dewatering 1 LS 12 Structural Backfill, Type 2 1509 CYS 13 Compacted Aggregate, No. 53, Base 606 TON 14 HMA Widening, Type B 17 TON 15 Milling, Transition 322 SYS 16 HMA Surface, Type B 163 TON 17 HMA Intermediate, Type B 210 TON 18 HMA Base, Type B 296 TON 19 Asphalt for Tack Coat 2980 SYS 20 Curb and Gutter, Concrete, Type II 525 LFT 21 HMA For Approaches, Type B 44 TON 22 Handrail 132 LFT 23 Guardrail Transition, TGB 2 EACH 24 Guardrail End Treatment, Type OS 1 EACH 25 Guardrail Terminal End Section 4 EACH 26 W -Beam Guardrail 263 LFT 27 Guardrail, Remove 185 LFT 28 Revetment Riprap 281 TON 29 Uniform Riprap 83 TON 30 Geotextiles 603 SYS 31 Sodding 281 SYS 32 Mulched Seeding, U 2050 SYS 33 Erosion Control Blankets 2050 SYS 34 Structure, Reinforced Concrete Box, 13'x5' 43 LFT 5 Fj Structure, Reinforced Concrete Box, 18'x6' 47 LFT 36 Pipe, RCP, 12" 121 LFT Itemized Proposal Project 16 -SW -08(02) Small Structure Replacements of Culverts 43 & 85 Item # Item Quantity Unit Unit Cost Total Cost 37 Pipe, RCP, 15" 160 LFT 38 Pipe, RCP, 18" 22 LFT 39 Pipe, RCP, 24" 106 LFT 40 Inlet, E7 2 EACH 41 Inlet, J10 1 EACH E 42 Manhole, J8 1 EACH 43 Pipe end section, Diameter 12" 2 EACH 44 Pipe end section, Diameter 18" 1 EACH 45 Pipe end section, Diameter 24" 1 EACH T 46 Adjust Casting to Grade 1 EACH A 47 Adjust Water Valve to Grade 2 EACH C 48 Maintaining Traffic 1 LS 49 Construction Sign, A 6 EACH 50 Construction Sign, B 4 EACH 51 Construction Sign, C 6 EACH 52 Road Closure Sign Assembly 10 EACH 53 Detour Route Marker Assembly 26 EACH 54 Barricade, III -A 120 LFT 55 Barricade, III -B 84 LFT 56 Sign post, square, type 1, reinforced anchor base 23 LFT 57 Sign, sheet, relocate 2 EACH 58 Line, Paint, Solid, White, 4" 435 LFT 59 Line, Paint, Solid, Yellow, 4" 960 LFT 60 Transverse Marking, Paint, Stop Line, White, 24" 16 LFT Total BID -5 PART 3 CONTRACT ITEMS AND UNIT PRICES Itemized Proposal Project 16 -SW -08 (02) Small Structure Replacements of Culverts 43 & 85 Item # Item Quantity Unit Unit Cost Total 1 Construction Engineering 1 LS $ 10,300.00 $ 10,300.00 2 Mobilization / Demobilization 1 LS $ 33,000.00 $ 33,000.00 3 Clearing Right of Way 1 LS $ 42,000.00 $ 42,000.00 4 Common Excavation 510 CYS $ 50.00 $ 25,500.00 5 B Borrow 64 CYS $ 34.00 $ 2,176.00 6 Temporary Seeding 232 LBS $ 1.40 $ 324.80 7 Temporary Mulch 2 TON $ 600.00 $ 1,200.00 8 Temporary Inlet Protection 4 EACH $ 150.00 $ 600.00 9 Temporary Check Dam 10 TON $ 55.60 $ 556.00 10 Silt Fence 780 LFT $ 2.00 $ 1,560.00 11 Dewatering 1 LS $ 28,179.75 $ 28,179.75 12 Structural Backfill, Type 2 1509 CYS $ 36.00 $ 54,324.00 13 Compacted Aggregate, No. 53, Base 606 TON $ 25.50 $ 15,453.00 14 HMA Widening, Type B 17 TON $ 169.00 $ 2,873.00 15 Milling, Transition 322 SYS $ 35.00 $ 11,270.00 16 HMA Surface, Type B 163 TON $ 110.00 $ 17,930.00 17 HMA Intermediate, Type B 210 TON $ 98.00 $ 20,580.00 18 HMA Base, Type B 296 TON $ 83.00 $ 24,568.00 19 jAsphalt for Tack Coat 2980 SYS $ 0.42 $ 1,251.60 20 Curb and Gutter, Concrete, Type II 525 LFT $ 45.00 $ 23,625.00 21 HMA for Approaches, Type B 44 TON $ 140.00 $ 6,160.00 22 Handrail 132 LFT $ 210.00 $ 27,720.00 23 Guardrail Transiton, TGB 2 EACH $ 2,100.00 $ 4,200.00 24 Guardrail End Treatement, Type OS 1 EACH $ 2,600.00 $ 2,600.00 25 Guardrail Terminal End Section 4 EACH $ 50.00 $ 200.00 26 W -Beam Guardrail 263 LFT $ 19.00 $ 4,997.00 27 Guardrail, Remove 185 LFT $ 7.50 $ 1,387.50 28 Revetement Riprap 281 TON $ 53.00 $ 14,893.00 29 Uniform Riprap 83 TON $ 50.00 $ 4,150.00 30 Geotextiles 603 SYS $ 2.45 $ 1,477.35 31 Sodding 281 SYS $ 16.00 $ 4,496.00 32 Mulched Seeding, U 2050 SYS $ 6.00 $ 12,300.00 33 Erosion Control Blankets 2050 SYS $ 1.00 $ 2,050.00 34 Structure, Reinforced Concrete Box, 13' x 5' 43 LFT $ 2,100.00 $ 90,300.00 35 Structure, Reinforced Concrete Box, 18' x 6' 47 LFT $ 5,100.00 $ 239,700.00 36 Pipe, RCP, 12" 121 LFT $ 58.00 $ 7,018.00 Itemized Proposal Project 16-SW-08 (02) Small Structure Replacements of Culverts 43 & 85 Item # Item Quantity Unit Unit Cost Total 37 Pipe, RCP, 15" 160 LFT $ 62.00 $ 9,920.00 38 Pipe, RCP, 18" 22 LFT $ 68.00 $ 1,496.00 39 Pipe, RCP, 24" 106 LFT $ 80.00 $ 8,480.00 40 Inlet, E7 2 EACH $ 1,800.00 $ 3,600.00 41 Inlet, 110 1 EACH $ 2,200.00 $ 2,200.00 42 Manhole, J8 1 EACH $ 3,700.00 $ 3,700.00 43 Pipe end section, Diameter 12" 2 EACH $ 1,200.00 $ 2,400.00 44 Pipe end section, Diameter 18" 1 EACH $ 1,400.00 $ 1,400.00 45 Pipe end section, Diameter 24" 1 EACH $ 2,000.00 $ 2,000.00 46 Adjust Casting to Grade 1 EACH $ 400.00 $ 400.00 47 Adjust Water Valve to Grade 2 EACH $ 430.00 $ 860.00 48 MaintainingTraffic 1 LS $ 21,700.00 $ 21,700.00 49 Construction Sign, A 6 EACH $ 244.00 $ 1,464.00 50 Construction Sign, B 4 EACH $ 86.00 $ 344.00 51 Construction Sign, C 6 EACH $ 270.00 $ 1,620.00 52 Road Closure Sign Assembly 10 EACH $ 193.00 $ 1,930.00 53 Detour Route Marker Assembly 26 EACH $ 146.00 $ 3,796.00 54 Barricade, III-A 120 LFT $ 12.00 $ 1,440.00 55 Barricade, III-B 84 LFT $ 12.00 $ 1,008.00 56 Sign post, square, type 1, reinforced anchor base 23 LFT $ 14.00 $ 322.00 57 Sign, sheet, relocate 2 EACH $ 135.00 $ 270.00 58 Line, Paint, Solid, White, 4" 435 LFT $ 2.00 $ 870.00 59 Line, Paint, Solid, Yellow, 4" 960 LFT $ 2.00 $ 1,920.00 60 Transverse Marking, Paint, Stop Line, White, 24" 16 LFT $ 15.00 $ 240.00 Total I 1 1 $ 814,300.00 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 One Two Three 7/31/17 8/11/17 8/14/17 DATE 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: None BID -7 PART 6 FINANCIAL STATEMENT 6.1 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 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". PART 7 ADDITIONAL DECLARATIONS 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 ask questions and obtain interpretations or clarifications concerning Contract Documents. O • 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 PROPERLY NOTARIZED.] Bidders Name: Written Signature: Printed Name: Title: STATE OF Calumet Civil Contractors, Inc. Brad Rader ice Presid Important - Notary Signature and Seal Rcauired in the Space Below Indiana SS: COUNTY OF Boone Subscribed and sworn. to before me this 16th day of 20 17 . My commission expires: 09/19/2021 Residing in Hamilton Printed: Megan L County, State BID -10 `a�ar��orod®�a gust •O® ? = ,NOTARYen-r•:� .r ohnsou C =* d .P ndianal "'• •.,,,,•�'Q�®p ®®" SOF® 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 OWl'NERIObligee. BidderiSurety must attach a signed, certified and effective dated copy of the Power of Attorney or Attorney -M -Fact establishing the authority of the person(s) signing this Bid Bond on behalf of the Surety, Surety company executing this bond shall appear on the most current list of "Sure)), Companies Acceptable on Federal Bonds, " as specified in the U.S. Treasury Department Circular 570, as amended, and be authorized to transact business in the State of Indiana, KNOW ALL MEN BY THESE PRESENTS, that the undersigned "Bidder": Calumet Civil Contractors, Inc. and "Surety": [Name] Fidelity and Deposit Company of Maryland [Address] 600 Red Brook Blvd., Suite 600 Mills, MD 21117 a corporation chartered and existing under the laws of the State of MD and authorized to do business in the State of Indiana, are held and firmly bound unto the City of Carmel, Indiana ("Obligee") in the fulLand 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 f rmly by these presents. Ten percent (10%) of the price stated in the Bid Proposal is $ 81, 430.00 WHEREAS, the Obligee has solicited Bids for certain Work for or in furtherance of construction of public improvements described generally as Small Structure Replacements of Culverts 43 & 85 Project No. 16 -SW -08(02) The replacement of the existing small structure 43 over Clay Creek on Hoover Road located 455 feet north of Braeburn Drive. And The replacement of the existing small structure 85 over U NT. of Carmel Creek on I I I th Street located 100 feet west of Echo Crest Drive WV, pursuant to plans, specifications and other "Contract 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 a Contract 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 BB -1 Version 2016-08-31 delivered to Obligee prior to commencing Work, including without limitation a sufficient and satisfactory Performance Bond and Payment Bond payable to Obligee, each in an amount of one hundred percent (100%) of the total Contract 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 16th day of August 20.7 This Bid Bond shall bind the undersigned Surety whether or not also signed by fire Bidder. "Bidder" Calumet Civil Contractors, Inc. "Surety" Fidelity and Deposit Company of Maryland By: By: Printed: Brad Rader, Vice PresidentPrinted: Terry R. Hurst, Attorney -in -Fact Countersigned: N/A BB -2 Version 2416-08-31 DATE: August 16, 2017 TO: City of Carmel, Indiana RE: CONTRACTOR: Calumet Civil Contractors, Inc. BID DATE: August 16, 2017 PROJECT: Small Structure Replacements of Culverts 43 & 85, Project No. 16 -SW -08(02) 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, Fidelity and Deposit Company of Maryland will provide appropriate Performance and Payment Bonds, subject to the terms and conditions of the bid Calumet Civil Contractors Inc. Fidelity and Deposit Company of Maryland ��o olePos�� v� fit? By.::2z Terry R. Hurst Attorney-in-fact X890 � f� ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by MICHAEL BOND, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Robert M. RUTIGLIANO, Eric M. WAHLSTROM, Brian T. MORTON, Terry R. HURST, Tia A. BOICE, David M. OLIGER, Christina Marie SCHMITTER and Tina SENEFELD, all of Indianapolis, Indiana, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 28th day of September, A.D. 2016. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND 000y.1 �.•Gpl1 iNBV ., i www � : �3J+'b'�'. o : �Q�;?�oRvop,,rt,'•"•�,� RAL w.. ••77 y 6'.} 1888 ��a 7 Secretary Vice President Eric D. Barnes Michael Bond State of Maryland County of Baltimore On this 28th day of September, A.D. 2016, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, MICHAEL BOND, Vice President, and ERIC D. BARNES, Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ` ( Maria D. Adamski, Notary Public My Commission Expires: July 8, 2019 POA -F 044-0465E W 0 A Q 0 w 00 C1 00 Nt s 5 CONTRACTOR'S BID FOR PUBLIC WORK —FORM 96 State Form 52414 (R2 / 2-13) / Form 96 (Revised 2013) Prescribed by State Board of Accounts PART (To be completed for all bids. Please type or print) Date (month, day year): August 16, 2017 1. Governmental Unit (Owner): City of Carmel 2. County: 3. Bidder (Firm): Address: City/State/Zipcode Hamilton Calumet Civil Contractors, Inc. 4898 Fieldstone Drive Whitestown, IN 46075 4. Telephone Number: (317) 769-1900 5. Agent of Bidder (if applicable): Brad Rader Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of City of Carmel (Governmental Unit) in accordance with plans and specifications prepared by HWC Engineering and dated July 26, 2017 for the sum of Eight hundred and fourteen thousand three hundred dollars and no cents. $ 814,300.00 The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the governmental unit. If the bid is to be awarded on a unit basis, the itemization of 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) 1, 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. The above bid is accepted this conditions: Contracting Authority Members: ACCEPTANCE day of , subject to the following PART II (For projects of $150,000 or more —1C 36-1-12-4) Governmental Unit: City of Carmel Bidder (Firm) Calumet Civil Contractors, Inc. Date (month, day, year): August 16, 2017 These statements to be submitted under oath by each bidder with and as a part of his bid. Attach additional pages for each section as needed. 1. SECTION I EXPERIENCE QUESTIONNAIRE What public works projects has your organization completed for the period of one (1) year prior to the date of the current bid? Contract Amount Class of Work Completion Date Name and Address of Owner 497,020 Asphalt Paving 2015 INDOT 748,159 Asphalt Paving 2015 INDOT 764,090 Asphalt Paving 2015 INDOT 303,854 Asphalt Paving 2015 INDOT 2. What public works projects are now in process of construction by your organization? Contract Amount Class of Work Expected Completion Name and Address of Owner 2,192,866 Asphalt Paving 2016 INDOT 1,063,608 Asphalt Paving 2016 Indianapolis 546,103 Asphalt Paving 2016 Indianapolis 1,227,677 Asphalt Paving 2016 Indianapolis Have you ever failed to complete any work awarded to you? No If so, where and why? 4. List references from private firms for which you have performed work. R. N. Thompson Brenwick Development The Skillman Corporation Duke Construction Management Verkler, Inc. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc, and any other information which you believe would enable the governmental unit consider your bid.) In accordance with the plans and specifications 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 b each subcontractor. Unable to provide a listing at this time 3. 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. Unable to provide a listing at this time 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. As needed to properly perform the work 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing you proposal? If not, please explain the rationale used which would corroborate the prices listed. Yes SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded. SEE ENCLOSED. 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, funis, 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 Whitestown, Indiana this 16th day of August, 2017. Calumet Civil Contractors, Inc. (Name of Organization) By Brad Rader, Vice President (Title of Person Signing) ACKNOWLEDGEMENT STATE OF Indiana ) ) SS COUNTY OF Boone ) Before me, a Notary Public, personally appeared the above-named Brad Rader, and swore that the statements contained in the foregoing document are true and correct. Subscribed and sworn to before me this 16th day of August, 2017. My Commission Expires: 09/19/2021 County of Residence: Hamilton �6YYIV0000� OTARY SEAL .ft* ' PUBLIC �� OF CONTRACTOR'S STATEMENT OF FINANCIAL CONDITION OF Calumet Civil Contractors, Inc. Employer er Identi kation Number Federai Tax Number 3 5— 1 1 5 1 7 7 1 Condition at Close of Business March 31 2017 ASSETS DETAIL TOTALS Current Assets 1. Cash ----------------------------------------------------- $ 574,842 2 Notes Receivable Due Within One Year --------------------------- 3. ________________3. Bid Deposits and Guarantees -_-_-_--___________________________ 4. Accounts Receivable from Completed Construction Contracts ----------- _1,033,883 5 Accounts Receivable from Incomplete Construction Contracts ----------- _1,924,737 6. Costs of incomplete Contracts in Excess of Related Billings -------------- _ _ i 7. Costs and Estimated Earnings in Excess of Billings on Incomplete Contracts _ _ -957.417 8. EgwpmentRentalsand Other Accounts Receivable ------------------- -------------- ------------- - ---------------------- -- 9. Materials in Stock Not Included in Items 4 and 5 --------------------- - ----------------------------------- 10. Stocks, Bonds and Other Securities ------------------------------- ------ ------------------- - - 11- Accrued Interest and Other Currert Assets __________________________ 322.290 Subtotal, Current Assets ----------------------------------- S 4,813,1sa 12 Construction Equipment - Net Book Value----------------------- 2,961,342 Fixed and Other Assets 13 Other Plant and Equipment ______________________ 14 Real Estate------------------------------------------------ 15. --------------------- --------------------15. Cash Surrander Value of Life Ir,s rance Policies ;.,Vet cfpolicy loans) ------_ 16. Other Assets ------------------------------------------------- Subtotal, _ _ _ _ _ i Subtotal, Fixed and Other Assets ___________ Total Assets --------------------------- LIABILITIES AND NET WORTH Current Liabilities 17, Notes Payable and Other Long -Term Liabilities (Due Within One (1) Year) ... $ 18. Accounts Payable ------------------------------------------- 19. _____-------------------------------------19. Billings on Incomplete Contracts in Excess of Related Costs ______________ 20. Billings on Incomplete Contracts in Excess of Costs and Estimated Earnings _ _ 21. Accrued Taxes and Other Liabilities (Cue 'Within One (f) Year) ------__-___ Subtotal, Current Liabilities _________________________________ Long -Term Liabilities 22 Votes Payable and Other Long -Term Liabilities (Balance After One r1) Year) _ _ $ 23 Deferred income Taxes (Non -Current Portion) ....................... Subtotal, Long -Term Liabilities ___--__-_--.------ Net Worth 24. Individual or Partnership Capital _________________________________ $ 25. Capital Stock _-_--_ 26. Additional Paid -in Capital ______________________________________ 27. Retained Earnings ____________________ ----------------------- 28 Other ----------------------------------- 29 Cther ----------------------------- --------------------- Subtotal, Net Worth ------------------------------------- - Totai Liabilities and Net Worth 30 Contingent Liabilities ---------------------------------------- 1,593,779 ____________ ....... ................. 60:035 1_,380,593 t. ........--- ------_......_.. S -------- _ 721 t 5'Z 1,480.734 ----------------------- ----------------------------------- 305,203 432,555 --------- ---- 2,955.949 775,00C $ ---- ---------- ------------------ 536,CC0 —-------------------- s97 5 1.533,779 9,368:290 2,939,644 IMPORTANT: All Items shown in the above FINANCIAL STATEMENT must be detailed in the schedules on subsequent pages. Do not change the descriptive title of any balance sheet item or supporting schedule. For Item(s) not specifically listed, use the applicable schadule(s). Page 9 of 28 DETAILS RELATIVE TO ASSETS Cash: (a) On hand (pelf cash) ------------------------------------------------------ (b) Deposited in banks named below --------------------------------------------- 574,842 Attach the Corresponding reconciled bank statement as supporting documentation. NAME OF BANK TYPE OF ACCOUNT DEPOSITED IN THE NAME OF AMOUNT F&7.ckYards Bank & Trust Co. checking Calumet Civil Contractors, Inc. $ 574,842 i i 2 Notes Receivable Due Within One Year -_--------------------------------------------------- RECEIVABLE FROM FOR WHAT DATE OF HOW SECURED AMOUNT MATURITY � I I Have a -y of the above been, discourted sold or p edged' ❑ Yes ElNo f so, state amount, `,o whom and for .v^at reason: 3 Bill Deposits and Guarantees _ - DEPOSITED WITH I FOR WHAT WHEN AMOUNT RECOVERABLE What amount, if any has been assigned, sold or pledged? ---_----_-__ ----------------------------- --------------------------------------------- Accounts Receivable From Completed Construction Contracts exclusive of --aims not avorove P ( � �d) ---- 1,333,883 INDOT may request corresponding A!R Aging by invoice date as supporting documentation. RECEIVABLE FROM NATURE OF CONTRACT ! AMOUNT AMOUNT DUE OF CONTRACT Town of Nfiitestown $ 87,268 Beaty Construction Inc $ 20,000 Beazer Homes $ 58,004 Boone County S 17,131 Bowen Engineering S 11,275 Town of Brownsburg $ 289,336 City of Carmel $ 3.10.616 Sub -Surface of Indiana $ 28.568 Crider & Crider $ 153,974 --- —� Fox Contractors $ 23,217 Republic Development Corp$ 18,361 i AIR under $10,000 available upon request) i Have any of the above been discounted, sold or pledgedl ❑ Yes [0 No If so. state amount, to whom and for what reason: Page 10 of 28 DETAILS RELATIVE TO ASSETS (continued) 5 Accounts Receivable from Incomplete Construction Contracts (as shown by engineer's or architect's estimate): (a) Amount retained to date, due upon completion of contracts _________________ -------------- (b) Amount receivable after deducting amount retained -------------------------------------- INDOT may request corresponding AIR Aging by invoice date as supporting documentation. $ ---- ------_--....... ......... 578,502 ,- _ _- 1.346.235 DESIGNATION OF CONTRACT AND AMOUNT OF AMOUNT AMOUNT RETAINAGE AMOUNT DUE FOR WHOM PERFORMED CONTRACT BILLED RECEIVED WHEN AMOUNT EXCLUSIVE OF DUE AMOUNT RETAINED Atlas Excavating $ 5,081 $ 3_,038 Beazer Homes I $ 11,466 $01 City of Indianapolis $ 431,041 $ 499,294 Crider & Crider $ 0 $ 30,831 HIS Construction 1 $ 14,154 $ 127,386 i Hunt Construction Group $ 30.458 $ 0 INCOT $ 0 $ 390,688 4sn Construction $ 0 1 $ 317,873 Superior Construction $2.2361 $ 2,125 Towr of Writestown $84,0661 so Allovrarce'cr doubtful accounts -S 25,000 i � I i I i Have any of t:he atove been disccunled. solo cr pledgee? I`1 Yes © No ' If sc. state arnount to vrhom and fcr ,vhw easur; 6 Costs of Incomplete Contracts in Excess of Related Biltngs ____________________ __— --- -- ----- ------ (Completed Contract Method) Amount receivable after dedcting amount retained $ 7 i Costs and Estimated Earnirgs in Excess of Billings on Incomplete Contracts _______________ (Percentage of Completion Method) 957.41. . I Equipment Rentals and Other Accounts Receivable _________ $ RECEIVABLE FROM FOR WHAT WHEN DUE AMOUNT f i I I llmat amount, if ary, is due after one year? _______________________ --- -- $ Assigned, sold or pledged? ----------------------------------------------------------------- S ..._ — -------- Page 11 of 28 UNIT AMUVNI , UNII I AMUVNI 1 If any are pledged or in escrow, state to whom and for what reason Specify co-owner or beneficiary of ncn-negotiables. 11 (Accrued Interest and Other Current Assets------------ ________---------------- --_-_-_-_-322.29G - $ DESCRIPTION AMOUNT ACCOUNTS RECEIVABLE EMPLOYEES S 1,676 RECEIVABLE FROM INDOT PENDING CONTRACT FINALIZATION $.196,397 PREPAID EXPENSE $ 41888 INCOMETAX REFUND RECEM.ABLE $ 80,329 DETAILS RELATIVE TO ASSETS continued jInventory Materials in Stock Not Included In Items 4 and 5: Values: (a) For use on own construction contracts ---------------------------------------- --------•-•-•-•-••-•----------- (b) Non -construction or for sale toothers i.e direct sales _............. •---------------- ...a.. I AttaG`` supporting detail reflecting item quantities and unit values. j �— PRESENT VALUE DESCRIPTION OF MATERIAL QUANTITY FOR INCOMPLETE OTHER CONTRACTS MATERIALS j � I I i i i I i I 10 j Stocks Bonds. and Other Securities (a) Listed - Book Value --------- -------------------------------------- (b) Present Market Value ---------------- No consideration as working capital will be given unless book value and market value, determined or verified b the accountant, is given. j 9 P 9� Y ISSUING COMPANY DESCRIPTION ! OHANTITY I PRESENT MARKET VALUE BOOK VALUE UNIT AMUVNI , UNII I AMUVNI 1 If any are pledged or in escrow, state to whom and for what reason Specify co-owner or beneficiary of ncn-negotiables. 11 (Accrued Interest and Other Current Assets------------ ________---------------- --_-_-_-_-322.29G - $ DESCRIPTION AMOUNT ACCOUNTS RECEIVABLE EMPLOYEES S 1,676 RECEIVABLE FROM INDOT PENDING CONTRACT FINALIZATION $.196,397 PREPAID EXPENSE $ 41888 INCOMETAX REFUND RECEM.ABLE $ 80,329 DETAILS RELATIVE TO ASSETS (continued) 12 CQ.1struCtionEGu!pnent (L,StlttBc/NrPrl trucks lutemotWeS radio eiguipment, bamcade3 Nal BcokVacje _----------------------------- S 2.9si.�:z castrtxt;cr. signs asphalt ;,lan!s. etc ) Attach !fixed asset deprec!abon scsed!.le DESCRIPTION Year Date I If Rebuilt PURCHASE PRICE ACCU67ULATED NET BOOK Number I Purchased -T Encumbrance I (HMd, Capacity, �Nanufacturnr, Etc.) Mfg. Give Date New Sa.,O nd Hand DEPRECIATION ! VALUE I _ (mrnlddr I SE=A WH,70 SCHEDULL _. 1 I I I I i i I i I I � I I ! I' i i I i I I I i I I I ATTACH ADDITIONAL PAGES (F NEEDED. Page 13 of 28 ^'� � f' .! �t '' — — 'J' .S. •i J 1'J. i'J i J —' ,= � �C• ) IC� �� � �� � � - y y � •�� t• r r J _.. ''' is Jr h V � � '� � � _.; � v G- n, '.J „ 1 • y - .. -- - - /moi. •J F• v d _ r _ t C is _ v f .� Cali CD .. ._ _ - - _ _ _ - - - - p _ _ 1 14) -' -_ -•' ' 7'J na SII fj: cc 4�. x i s.. O t7i O L Al '.J•'. - r J !,' 'A J,' llJ: /t'/r n h:J, _ _ Ii Ysl S3: f lot •� .'� - _ In- „-7 fJ [�J-1J'.r LtJ- - r � 'yT'3 r v - J ..IJ IJ t. JI -•L eJ.J :-JI '•' � ! JI J�J / t� �(n� Y. '�i L J ^ •^. L �t 00, m <O y x' `: N • •% •^ 'A '.r i J �Y- J �-.1 ', IJ , -}J � 'JI �Jf -i-• �! •J is �n :r � c7 .___-_<. .-..0��`.<.- �J� .. ...v �%-.1 v_<.�Jr.. __]_�N�%.-... '1.Z_. •J'.!Jx X'n�_ t] C W iy O O _ ^-�/I :n •<. -'. iJl 'Jf �Y---.. "` .J�•... rl �_C J -, 'J. 'Jf ' j. L f < - - ! :-. .e .J = �J I 'Jt J• ^ �-J ' 'Jf '�J x j �CL _ __ - F. �. (.. I-'. 'JffIs v('_' aN'.J •Jl �'S- .-. :--^ tJ .Jr -1 J= ._ I ! •^ v �'� 'J. •N �.-. O �- J i v IJ ^ ^ � .� J '1• +- 1 1 In i^ t s .�.. % ^ {� -J .. .j '•I)<' � .--I %- I IJJ Lr_J✓� 'J� O� tv J.. t-J� r'rJ'.J%_%rr%%!;'J'rrrrrrrr.rl-l:rrJ:rv:rr.r�J+rrr✓.rrJ�rrr��rtrrr � IGS ._• -• - -J '= %f - -J�; T _ _ _ _ .... - _ _ _ _ _ az `: N al '� —!� TT.-�=ice•.. t7 5 � El J _ Vlf - " � J "'f i+' : . 'J1 Id I+•^!(J Jf^rJ J J ^./1 !'h y ZZ Z"J _ x 41 77 n - v _ - - _ - - - - _ - _ - - - _ - - - _ �- - - - - - - - - - - _ - x z 5 _ /Y•, 7.J "/. I- J; 7: r_ "r /.!. i W N Q —1 u w () mi W If n -! r o s to Q N 'N N J N tr l� _ r m n i W N Q —1 u w () mi W TI> iJ r T rC �:! T _ �\ _. 1: - I!' /• I v �r -7 f, .= r, %"1. •nr CD r.1 O. J^72 � 7 --,J-4 J . .r • 1, ^ F �C _ L ^ 1 J fJJ .1J : _J _ J „! Iv _ 'Ji l- '_' .. IJ J, x / L 'J• _ ^ .+ t_ � x 1, fJ' �c �c m W W N Q E, a mi �-0 P <O sox ___-_ _-__.-_ - _ ._ .. - - - - - - ' - - - - - - - - - - - - - - - - - i ^ 'J -'f f J !y J L J IJ r, YS�IL �•..-^JNt�I + /I J -J ;✓'T '.+^/_ d O 1, .� i �_- .�. �� �_. _ -• J 1 ^ _ Im r L Q CD r 7: r X. 'I r s I �/ !/� '/t r 1 r l: '/' ./� f 'r •/r r :r r J - 7: r 'r -, - - - - - - -- I o !� 1,J'. 'Jl m W W N Q E, a mi �-0 L L i-3.. x -= r r� q -'^ O 17� 17 -- - - -- o b� O O 0. I - If iI F. -P cr -►=------_ O Cc, G3 �003 10p O x d � DETAILS RELATIVE TO ASSETS (continued) CARRIED ON 13 Other Plant and Equipment - Net Book Value --------------------------------------------- $ _ _ _60.035 (List office equipment, plant and operating equipment of gravel pits, quarries. commercial concrete products, steel fabrication plants, aircraft, etc. as well as equipment of any non -construction business enterprse, including recreational and pleasure boats. Do not include such items in Schedule 12.) DESCRIPTION YEAR COST ACCUMULATED NET BOOK ACQUIRED DEPRECIATION VALUE ENCUMBRANCE PLEASE SEE ATTACHED SCHEDULE REQUEST FACE VALUE > $2.5 MILLION t i l � I 16 Other Assets --------- ------- --- ----- -- - ..._ - - ....... -------- - - DESCRIPTION 1� Real Estate and Net Book Value of Improvements (including Leasehold Improvements,' ------___-_ 1,38Q593 LOCATION AND DESCRIPTION OF PROPERTY TITLE HELD IN WHOSE NAME NET BOOK VALUE AMOUNT OF ENCUMBRANCES PLEASE SEE ATTACHED SCHEDULE j i I l i I Cash Surrender Value of Life Insurance Policies (exclusive ofloans) ----------------- ---_ $ _ 153.151 COP,PORATIONS - Policies carred o officers or supervisory employees of the corporation, payable to and under control of the c^rcoraticn rJ rxr i wcnbrnra - routes cameo on partners or supernsory empioyeas payacie w arc uneer ccniroi or ire parnersrip INDIVIDUALS - Policies carred or the individual order his exclusive oortrol and payable to ary benefaary, policies carried on supervisory e-rployees_ payable to and under exclusive control of the qualifyirg indi Adual or his estate-, polices arried on members of tre immed ate family, payable to and ,,der exclusive c=trol of the qualifying individual or his estate CARRIED ON BENEFICIARY WHO HAS CONTROL AS TO SURRENDER LOANS OR SURRENDER VALUE AMOUNT OF LOANS VARIOUS . DETAIL AVAILABLE UPON 5 153.151 $ 0 REQUEST FACE VALUE > $2.5 MILLION i l � I 16 Other Assets --------- ------- --- ----- -- - ..._ - - ....... -------- - - DESCRIPTION AMOUNT Page 14 of 28 DETAILS RELATIVE TO LIABILITIES 17 and 22 1 Notes Payable and Other Long -Term Liabilities CREDITOR PAYMENT TERMS/ BEGIN DATE ( DATE OF i MATURITY (mm/dd1YY) (A) A PRINCIPAL DUE WITHIN BALANCE 12 MONTHS (C) (0) = (A) - (B) BALANCE DUE WITHIN AFTER 12 13-24 MONTHS MONTHS (E) (C) - (D) BALANCE AFTER 24 MONTHS CAT FINANCE - 140M ( 1874/MO 5/3112019 $ 46,186 $ 20,811 $ 25,375 $ 21,821 $ 3.554!. CAT FINANCE -CURB MACHINE 4570/MO 8/0512017 $ 22.580 $ 22,580 $ 0 $ 0 $ 0' CAT FINANCE - 2 EXC & GRADER i 6233/MO 5x31/2019 $ 153,555 $ 69,190 i $ 84,365 $ 72,549 $ 11,816', CAT FINANCE D5 DOZER 3734/MO 7/26/2017 $ 14,836 $ 14,836 $ 0 $ 0 $ 0, CAT FINANCE - PAVER AND ROLLER ! 6897/MO 410612020 $ 236,802 S72,3921 $ 164,410 $ 76,893 $ 87,517, KOMATSU - EXCAVATOR i 3444/MO 4/30/2018 $ 44,783 $41,3381 $ 3,445 S 3.445 $ 0 1 STOCK YARDS BANK - MORTGAGE 4065/MO 212 212 0 2 2 $ 1,515.464 S 48,776 $ 1,466,688 S 51,017 $ 1,415,671 CAT FINANCE - TERM 20980/MO 4/30/2019 S 510,895 $ 245.2291 1 $ 265,666 - $ 245,229 1 $ 20,437 NOTE PAYABLE RJE 313l,2019 1 $ 192.000 $ 96,000' S 96,000 $ 96,000 S 0 1 � NOTE PAYABLE NMP 7/31!2023 $ 940,000 S 90,000 $ 850,000 $ 100,000 $750,000 1 i --- ---------------- TOTAL i TOTAL FOR ITEM 17 (TOTAL COLUMN B) TOTAL FOR ITEM 22 (TOTAL COLUMN C) 18 1 Accounts Payable$ PAYABLE TO $ 3.677,101 $ 721,152 $ 2,955,9491 I FOR WHAT $ 666.954. DATE PAYABLE $ 2,288,995' ----- 4 AMOUNT ACE TREE SERVICE SUBCONTRACTOR 512017 $ 32,783 ASSURED PARTNERS VENDOR 412017 $ 31,631 CRIDER & CRIDER SUBCONTRACTOR 6/2017 3 317,243 JAMES H DREW CORP SUBCONTRACTOR 5/2017 $ 366,362 MACALLISTER MACHINERY VENDOR 5/2017 $ 27,69311 MILESTONE CONTRACTORSVENDOR 512017 $ 106,778 MORPHEY CONSTRUCTION SUBCONTRACTOR 6/2017 S 92,673'; NATURAL CONSTRUCTION SUBCONTRACTOR Si2017 ( $ 34,305 SHELBY MATERIALS VENDOR 5/2017 $ 43,884 SIGNAL CONSTRUCTION SUBCONTRACTOR 6/2017 $ 55,043 TRI STATE FORESTRY ISUBCON7RACTOR 6)2017 $ 31,625; i OTHERS LESS THAN $25.000 EACH (DETAILS AVAIL. UPON REQ) S 330,714 1 DETAILS RELATIVE TO LIABILITIES continued 19 Billings on Incomplete Contracts in Excess of Related Costs a) Cost Portion S (Completed Contract Method) (b) Unrecorded earned income $ ,LO Billings on Incomplete Contracts in Excess of Costs and Estimated Earnings _________________________ $-11 (Percentage of Completion Method) 305,203 21 Accrued Taxes and Other Liabilities Due Within One Year ________________________________________ $432555 ---- 432,550 DESCRIPTION DATE PAYABLE AMOUNT Deferred Income Taxes (Current Portion) ACCRUED TAXES AND OTHER WITHHOLDINGS VARIOUS $ 432,555 i 22 Notes Payable and Other Long -Term Liabilities --------------------------------------------- Refer to Schedule 17 and 22 on Page 14 23 Ceferred Income Taxes (Pion-current?crtior). _______________ ---------------------------------- �' _ - 775,000 -- NET WORTH 24ir.divfdual or Partnership Capital --------------__ - --------------- ........ .......•.. r2 Jr 26 Capital Steck (a) Common----------------------------------------------------------- $ (b) Preferred --------------------- --- - - ----------------------- --- $ - - - - - - Additional Paid -in Capital ------------------ $ - - - ------------------------------------------------- 536,000 - - -- -- - — 27 Retained Earnings _______ ------------------------------------------------------------------ r'-------------------- 2,161,697 .._.1,69 I 2p I Oo Other: - - - --- 29 Other. -........ --•---- — - - CONTINGENT LIABILITIES Total Contingent `-iabilities: 30 1 Attach suppierrentary schedule explaining the item(s) listed below ________________________ i $-_____-__--_.-_.----- -------- .__..-__._... On notes receivable, discounted or sold _____________ On accounts receivable. pledged, assigned or sold ____________________________________________________ Asa bondsman---------------------------------------------------------------------------------- As Guarantor on contracts, notes or accounts of others ____________________________ On lawsuits pending but not reduced to judgment _____________________________________________________ Other (specify) Page 16 of 28 Page 17 of 28 CONTRACTOR'S STATEMENT OF EXPERIENCE WORK TYPE CLASSIFICATIONS Check each work type the applicant desires for prequalification. For each work type checked, indicate the years of experience and the total amount of work performed (1,000s) by the company's own forces. Do not include work performed by subcontractors. If other specialty work types are desired, add the corresponding information in the blank spaces provided. New applications should list work for the previous three years. Renewal applicants should list work for the previous year only The experience and total amounts shown here I should be developed in pages 19-20. NOTE: Information regarding specific work type requirements is available or. http.ilvpma m.gov!indot/2740.htm. YEARS OF EXPERIENCE j MAJOR WORK TYPE CLASSIFICATIONS SELF PERFORMED WORK (1,000s) YEAR: I 2016 YEAR: YEAR: ❑ A (a) Concrete Pavement — Genera! ❑✓ 48 A (b) Concrete Pavement — Limited 6535 48 B (a) Asphalt — with Certified HMA Plant 11825 _ ❑Q 18 C (a) Heavy Grading 1980 48 C (b) Light Grading 300 ❑ D (a) Bridges Over Water j d 10 D (b) Highway or Railroad Bridge Over Highway 100 I j ❑✓ j ❑✓ 10 10 ( D (c) E (a) Bridge Involving Protection of Railroad Tracks Traffic Cortroi, Signals and Installations I ❑✓ 48 E (b) Placing Asphalt Pavement ❑ 19 E (c) Bridge Deck Overlay and Minor Bridge Repair 75 j E (d) Traffic Control. S gn Installations ❑✓ 48 E (e) Small Sructares Culverts and Drainage 2324 Items Q 48 E (f) Surface Masonry 15 ❑ E (g) Traffic Control, Pavement Markings ❑ 8 E (h) Deep Sewer C 11 10 E (i) Seeding and Sodding, Top Soil Excavation 280 ❑ j E 0) Landscapirg ❑ E (k) Guard Rail and Fence ' j ❑✓ 8 E (1) Structural Steel Erection ❑ I E(r-) Cleaning and Painting Bridges ❑ E (n) Vegetation Control ✓❑ 48 E (p) Brdge Deck Sealirg ❑ 8 E (q) Concrete Pavement Repairs 120 ElE (r) Road Planing ❑ E (s) Roadside Mowing ❑ E (t) Demolition SPECIALITY WORK TYPE CLASSIFICATIONS (describe or provide work type code) ❑ Page 17 of 28 CONTRACTOR'S STATEMENT OF EXPERIENCE 1 Hew many years has your organization been in business as a contractor (a) under your present business name" 9 _ years (b) Under the name of CALUMET ASPHALT PAVING CO INC _ for 39 years. 2 Hew many years experience in HEAVY HIGHWAY construction work has your organization had j (a) As a general contractor? 48 (b) As a subcontractor? 43 3 What other states are you prequalified to perform highway work? NONE 4 Has your company ever failed to complete any work awarded to it? ❑ Yes ❑ No If so. where and why? i I 5 Has any owner or officer of your organization ever been ar owner or officer of some other organizalian that failed to complete a construction contract? ❑ Yes � No If so, state the name of the individual other organization and reason i o Has any owner or officer of your organization ever failed to complete a construction contract handled in his/her own name? []'Yes Q No If so sate the name of the individual name of owner and reason I 7 Has a. y o (icer. emp cyee or representative of your organization been convicted of a bidding crime (2 d R;qg;Pg RICO) resulting from a jury or bench tra', entered into a plea of guCty or ro'c contende, e. made a pubiic adrr, ss,cn. made a prese^tafoc as an unindcted co-censpiWor, or gave testimony which is protected by a grant o* immunity in any jur,sdiction mthin the past five yeas? Has the applicant, or any o Icer of the applicant, ever been the subject of a suspension or debarment action by any agency of the federal government? ❑ Yes (Z1 No If so provide the date of the Offence and conviction details of the offense court documents and other pertinent information. 8 In what other lines of business are you financially interested? NONE 9 List equipment that you lease on a regular basis Describe each piece by listing manufacturer, kind and capacity, and name and address e` the lessor NONE 10 8nefiy describe the kinds of work you usually perform with your own fcroes. CONCRETE CURB. SIDEWALK, AND PATCHING - ASPHALT PAVING - STORM SEWER 11. Briefly describe the kinds of work you usually subcontract to others. ' TRAFFIC SIGNALS. LANDSCAPE, TRAFFIC MARKINGS., GUARDRAiL ; 12 List owners of the company and any major stockholders. including the percentage owned by each If owned by a parent company show the name of parent and ;ts ownership interest. KEVIN S GREEN 37% JAMES A SYLVESTER 37% JEFFERY THIXTON 19% DAVID THOMAS 7% i �!Irrp , A n+ 7I CONTRACTOR'S STATEMENT OF EXPERIENCE (Continued) 13. Lust names and addresses of all subsidiary and affiliate companies. Check if the company is a subsidiary (SUB) or affiliate (AFF). For purposes of this list, concerns are affiliates of each other (except as otherwise provided in 13 CFR part 121) when, either directly or indirectly: (i) one concern controls or has the power to control the other; or (ii) a third party or parties controls or has the power to control both; or (iii) an identity of interest between or among parties exists such that affiliation may be found. In determining whether affiliation exists, it is necessary to consider all appropriate factors, includin common ownership, common management. and contractual relationships. NAME OF COMPANY ADDRESS SUB AFF NONE ❑ ❑ 11 1:3 15 List the construction experience of the p-incipa! individuals of your ❑ ❑ ( j NAME OF INDIVIDUAL 14 _ st the projects the compary has urder contractor pending award. NOTE: A company prepared list of projects maybe substituted for this questior if it contains all of the required information. CONTRACT PERCENT CONTRACT ID, LOCATION OF WORK TYPE OF WORK AMOUNT COMPLETE AND FOR WHOM PERFORMED I SEE .ATTACHED 0%, 0% 0% 0% 0% 0`/0 0% 20 0% 0%- 0% 0% O%i r� -- 0%: 0% 15 List the construction experience of the p-incipa! individuals of your present organization. NOTE: New aoplicarts should attach resumes. j NAME OF INDIVIDUAL PRESENT POSITION IN YOUR ORGANIZATION YEARS OF CONSTRUCTION EXPERIENCE T WORK i MAGNITUDE AND TYPE OF IN WHAT CAPACITY KEV!N S GREEN PRESIDENT 25 HEAVY HIGHWAY PRESIDENT JAMES A SYLVESTER TREASURER. 20 I HEAVY HIGHWAY OFFICE JEFFEY L THIXTON VICE PRESIDENT 1 20 HEAVY HIGHWAY PROJECT MANAGER 11 DAVID THOMAS PROJECT MANAGER l 30 HEAVY HIGHWAY PROJECT MANAGER � i ! I I J I r I CONTRACTOR'S STATEMENT OF EXPERIENCE (continued) T^is irforrnat on is used to determine wcrk type ratings List all Werk performed by your own forces. ncluding federal. state, county city and private wars The to'.al dollar amounts (1,00Ds) and work item dollar amounts must be listed for each project. Do not irclude work perfercied by subcontractors. If requesting a work type riot listed oelow, add the wcrk type(s) urder the 'OTHER' section Nevi Contractors si'culd list work performed for the last three fiscal years. Rer e,I4 contractors srould list York for the cast fiscal vear MAJOR CATEGORIES OF WORK ( PAVING GRADING BRIDGE MISC OTHER WORK TYPE CLASSIFICATION CODES I A(a,b) E(b; ;� C (a b) E{0) E(f) E(h) D(a,b,c) E(c) E(i) j - Contract 10, PrimelSub (PIS) Deacriptian, � Owner b Date Partormad .� TOTAL (1000's) � i (S) (S) � (S) I I is) I IS) I ($1 � (S) is-! •�"Oi (S) (S) I (S) S) I IS) {S) I f5) , i i i I 0 1 I --A ° � I ° I I I — TOTALIS) ° ( 0 0 0 0 ` ° 0 0 ° 0 ° ° FOR ADDITIONAL PROJECTS OR CLASSIFICATION CODES, ATTACH ADDITIONAL PAGES Page 2C of 26 RECORD OF PAST EXPERIENCE 451 - 360. 10 76 5 15054 R3 566MONONSHERJOAN 200 __5. 30 15059 ST 11-W, W]lfTHRCP 6C3 - _ A Ed C C DA 0103 D8 F(c) � e ) Ffl 333 F(h) TOTAL S'S PCC BITUM EXCAV AGG BASE STR STA DEWATER STR 5M STR MISC _. _FU) _ DEEP SEED SOUND Prciect iC.000'S} PJMT PVMT GRACE &SURF OVER 20 OVER 20 REPAIR &DRAIN CCNC SEWER &SCD - WAP IW62C:r32 001 FROYAVEPATH 451 - 360. 10 76 5 15054 R3 566MONONSHERJOAN 200 170 30 15059 ST 11-W, W]lfTHRCP 6C3 313 290 15067PARr; AT FRES-yocN3277 140 137 15073 CW 10-011 HCOVERRD'NALKS 411 91 30 283 _ 7 15074 5D DU045C H11.41DE ORAINAGE 90 23 67 15076 9331265AFERCUTESBROWNSBURG 443 K 60 15 293 15 15077 R34S26CL1NTONSTRUCTURE 390 iC 15 350 15 15081 8164" PLEASANTRUN P0.RXWAY 36 36 15083 R 34938SP.33 SMALLSTRUCTURE 260 25 206 26 3 15084 A 34506 CR 500 4.nC=. COUnty 1,490 1,02C 250 50 150 20 15086 CR -100& GREEN STREET 1,_554 1,115 310 20 93 16 li088 BRIDGE I6: HAMItieN CDUtfI'Y 119 19 s 93 2 15089 wHrFES7OWN MEDIANS 76 76 13090 w.1k., fo—s sec 15 105 7C 5 _ _ 30 15091 RS3M31iNSTT-JTICNANc1AKS 74 61 14 ---------- 115092 R537033FAIRGRCUNC'S 90 68 2 20 13043 R 343s2136STR FCLNTA�NFOWN ----__. &]4 129 220 _._.._ 23 4CO 7C _ r 16001 R364S5W_.HEASTERN 350 _ 7_6C 25 - -� - 4C_ -� - 25 16DC2 835193 FIRSTSTGAAN-iOUti't 1,446 - _ 371 207 -- 520 308 _ 4C. 16003 AVON A'JE"NE RE3UAFACE 580 490 18 17 55 16004 829654 CRiDC OPER 3IG WA.NVT 37 37 36006 834 -M -ALL STRLICJRE 64 i 1 54 2 16009 R 36CW B :46TH ST TRAIL 335 210 25 50 is 16011 3374U'AADISO11 AVE 34 34 ?6012 R31S36PUTNAMCaUNTY3DK 90 90 :6015 V41-67, ES PRKWY 165 24C IDS 132 16016 GR-:NBUSH ST�IA AYE77E - 131 - I31 1.017 A 34156 MAiSH RCAO 138 138 _---- -- :60:8 a35sd134�vSk rdrw��ks 47 5 42. -.. .6020 !R 356229 iGSN AND 69 1,821 1,4:7 51 SEC21 WILL STREE-.RECGNS74UCTON 244 S5 159 ':6022 CARR ACAD SEPJER SPEW 04 8R 5: 5 31 16024 CN 02-03C GacrBc.wn Side+mlks --_ 715 - -'. a0_ 675 --__-_-- --- _ M5_ 314Z9SAfE RCUTES 014WCDC 157 2C 14' 6 :6027 P.515-404 des�rtac! arra 4 1,586 780 - _ -- 85 674 27 18028 R5 ir- 102 RESUR ACSAP.EAZ 1,401 197 110 _ 30 443 ?6029 R.,AC iECCNS, RUCr'.ON 163_ 36 3C 102 _LME 15031 H NMCKS CCUH'Y BR DGES 123 'S 50 SC 1.033 FRANK:ORT Z016 RESURFACE 614 614 16035 CHEYEFINE!A9E55EC5 169 15037 NCBL-SVIILE ZD76 RhAg2C4 2C 134 16039 17,4 MEET REAUGNME'r 175 134 4 34 3 16040 SVEST CCUNiJI DRIVE 210 210 _ 1604: R 350?8 106711 & CliM8ERL1N0 1,553 973 150 _ 8 -- - - 140 203 -- -- 29 16041 AVCN AVE CaX 30 30 35044 C-�VA HRITRAIL 51 51 -�- - - -_ - - 16046 VHRESTOWt REHABTUR.'i ANDTRAIL 780 434 2C5 '? 105 25 581048 4C1IDA't UNE FAST AND WT 44 44 16049CIN 03-063 DITCH RD WALKS 303 68 62 170 3 16050 RS 3MI 45C 343 10 97 16051 60 19-063 MEAOGWS 0R IMPRGV=, 299i1 284 q 16052 CHATHENI WLLS CLUBHDUSE WALKS 41 41, 16055 RESIDENCES OF IAW414CEVTLIAGE 2 102 9C 22 L6C565T 2S -D9. MFC4IGANSTREE-2 WAY E81 24C i3C 311 23,554 11,395 2,286 - - _ - 33 2,311 5,555 280 - ORGANIZATION AFFIDAVIT FOR APPLICANT (ORGANIZATION) The undersigned, being duly sworn, hereby verifies to the Indiana Department of Transportation that: I . The undersigned is the SECRETARY -TREASURER of CALUMET CIVIL CONTRACTORS, INC. a (CHOOSE ONE: ❑✓ corporation M limited liability company limited partnership general partnership) organized and existing under the laws of the State of INDIANA (the "Company"). 2. The undersigned has personal knowledge that the person executing the attached Certified Copy of Resolutions (Applicant) with effect as of JUNE 20 2017 (the "Resolutions'), has authority to do so on behalf of the Company. 3. That the Company is submitting herewith the Resolutions and the Company's "Contractor's Statement of Experience and Financial Condition" (the "Statement'') to the Indiana Department of Transportation ("INDOT") for the purpose of inducing INDOT to issue a Certificate of Qualification to the Company that would enable the Company to submit bids on (and potentially be awarded) certain future contracts to be entered into by INDOT on behalf of the State of Indiana. 4. That the date of the Statement shall be deemed to be the date that the undersigned has executed and delivered to INDOT this Affidavit. 5. The undersigned has reviewed all of the information in the Statement and has determined (after consultation by the undersigned with any other persons or entities, if necessary) that all such information is complete, accurate, and not materially misleading in any substantive manner as of (a) the date of the Company's audited or unaudited financial statement used for any financial information therein, and (b) as of the date of the Statement for all other information there'n. 5 The current (CHOOSE ONE): El officers [ members ❑ general partners) of the Company are. FULL PRINTED NAME KEVIN S GREEN JAMES A SYLVESTER JEFFREY LTHIXTON BRAD J RADER WILLIAM R REAM TITLE PRESIDENT SECRETARY -TREASURER VICE-PRESIDENT VICE-PRESIDENT VICE-PRESIDENT 7. The undersigned represents to iNDO T that the undersigned has all necessary authority, on behalf of the Company, so that the Company hereby does expressly authorize (a) INDOT to obtain all information considered pertinent with respect to the financial worth and assets and liabilities of the Company from banks or other financial institutions, surety companies, dealers in material, equipment or supplies, as well as all other persons or entities having any business relationship of any nature with the Company (all such persons and entities are, collectively, the "Third Parties"), and (b) each of the Third Parties to furnish all such information requested by INDOT without any further approval or documentation from the Company. Rage 22 �f 28 ORGAMIZATiON AFFIDAVIT FOR APPLICANT (ORGANIZATION) (Irontinueco i 8. The following persons are authorized to execute contracts and all other documents that will bind the Company (*For I each entity listed other than the Company, list the full name of the entity in the FULL PRINTED NAME line and the j individual who,is an authorized signatory in the TITLE line. An Affidavit of Representative Entity AND a Certified Copy of Resolutions (Representative) for each such entity should also be completed and attached to the Statement): FULL PRINTED NAME KEVIN S GREEN JAMES A SYLVESTER JEFFREY L THIXTON BRAD J RADER WILLIAM R REAM DAVID M THOMAS TITLE PRESIDENT SECRETARY -TREASURER VICE-PRESIDENT VICE-PRESIDENT VICE PRESIDENT PROJECT MANAGER IN WITNESS bVIHEREOF. the undersigned has exe�.w ed a id delivered to the Indiana Department of Transportat or t^is Af dawt for Applicant (Organization..) orf°th effect as of this 20TH day of JUNE . 2017 . STATE OF COUNTY OF Before Applicant (Orgy Signa ure �Hta 5�/�vssrr SS�Y. -Teoos w, SS: a of ry blic in and for said State and County, pei tt knc vn to be the . and this ition) on this 0,0dayof 10 lid-IA01 Commission Expiration Date (mm/ddlyy) Ccurty o% silence illy ap9gared I on execu f 2017, for rn foregoing Affidavit for on behalf of such entity. Signature of Notary Public "�- Y;.5'''t Printed Name or Notary Public j � n �� r— t a y ! � I f,i t � • v ORGANIZATION CERTIFIED COPY OF RESOLUTIONS (APPLICANT) The undersigned, being the keeper of the records of CALUMET CIVIL CONTRACTORS, INC a (CHOOSE ONE: [0 corporation ❑ limited liability company ❑ limited partnership general partnership) organized and existing under the laws of the State of INDIANA (the "Company"), do hereby certify that the following is a complete and accurate copy of certain resolutions adopted by (CHOOSE ONE); ❑ the governing body of the Company at a regular or special meeting, at which a quorum was present, or otherwise acting through such body via unanimous consent or otherwise in accordance with all applicable provisions of the organizational documents of the Company. F,� the consent of all owners of the Company, acting in accordance with all applicable provisions of the organizational documents of the Company. 17 some other procedure that validly constitutes the requisite authority of the Company (Explain: ) BE IT RESOLVED that CALUMET CIVIL CONTRACTORS: INC (the "Company") is hereby authorized to submit an application in 2017 to the Indiana Department of Transportation (`INDOT') to request a Certificate of Qualification that would set forth the Company's capacities to bid or contracts that will be entered into by INDOT on behalf of the State of Indiana; and BE IT FURTHER, RESOLVED that the officers. employees, and all third parties (including without limitation, accountants financial institution personnel, vendors, customers, and equipment providers) contacted by INDOT during any investigation or audit of such application are hereby authorized to cooperate with INDOT in providing all information and documents reasonably requested by INDOT to verify any of the informatior provided in such application, and BE IT FURTHER RESOLVED that each of the persons named as potential signatories in the Company's Affidavit for Applicant (Organization) that is an integral part of such application is hereby confirmed and ratified as having all requisite authority to execute contracts with INDOT and to bind the Company thereto; and BE IT FURTHER RESOLVED that the information provided by the Company in such application and in these resolutions shall be deemed to be representations of the Company for the benefit of the State of Indiana that INDOT may rely upon in making its determination with respect to the Company's application and Certificate of Qualification. The undersigned further certifies that (a) the above resolutions of the Company have not been modified in any manner or rescinded; (b) these resolutions are still in full force and effect as the date of this Certificate; and (c) nothing in any of the Company's organization documentation or past action limits the power of the Company's governing body to adopt any of these resolutions for the benefit of INDOT. IN WITNESS WHEREOF, the undersigned has executed and delivered this Certified Copy of Resolutions (Applicant) with effect as of this 20TH d of JUNE 20 17 , — 4A,— Sidnatd4*of,6diWn Making Certification JAMES A SYLVESTER, SECRETARY - TREASURER Printed Name and Title sit 4.00 ,..� X816 Cl/.e )R -F 79 Calumet Civil Contractors, Inc. Local Unions (Laborers, Operators, Teamsters) Substance Abuse Agrement ARTICLE X)Mi SUBSTANCE ABUSE TESTING Section 1. Recognizing that project owners, government regulations, and other external pressures often necessitate substance abuse testing, the Parties mutually- agree to implement the substance abuse program("SAT Program") and perform substance abuse testing in accordance with the SAT Program attached hereto as Exhibit A. Section 2. Each Employer party to this collective bargaining agreement agrees to pay the SAT Program $.03'1aour (3 cents per hour) for each hour worked by each Employee working under this Agreement. The contributions to the SAT Program will be deposited each month, or at such other regular intervals as may be determined by the Highway, Heavy, and utility Division — ICA, Inc. ("Association") to the depository designated by the Association. and such contributions shall be reported on such forms as may be designated by the Association. Section 3. Each Employer party to this collective bargaining agreement agrees that a representative designated by the Association shall be permitted, upon request, to audit the payroll records of the Employer to determine compliance with this Article. In the event a lawsuit is commenced to collect any delinquencies, and a delinquency is determined due then the Employer agrees to be responsible for, and to pay, all expenses and costs of collecting such delinquency including attorneys fees incurred by the Association in pursuit and collection of such delinquency. Section 4. It is expressly agreed and understood that no Employee, Employer, or Union has any vested or proprietary- interest in or right to any monies constituting a part of such Substance Abuse Testing Program. Section 5. The costs of the tests associated with this program will be paid from the contributions identified in Section 2 in accordance with the terms of the SAT Program. il: SUBSTANCE ABUSE TESTING PROGR -M I. POLICY STATEMENT. All signatory Employers to this Agreement and the Union have a commitment to protect people and property, and to provide a safe working environment. The purpose of the following program is to establish and maintain a drug free, alcohol free, safe, healthy work environment for all of its Employees covered by this Agreement. II. DEFINITIONS. a. Accident - Any event resulting in injury to a person or property to which an Employee contributed as a direct or indirect cause, b. Accredited Laboratory - A laboratory certified by the Substance Abuse and Mental Health Services Administration (SANIHSA) for testing of Prohibitive Items & Substances. C. Adulteration - To degrade a test sample by substitution or addition of other ingredients in an effort to mask the presence of unauthorized drugs. An adulterated test shall be considered a positive test. d. Diluted Sample — Urine samples which the laboratory reports as unacceptable with regards to measured levels of creatinine or specific gravity will be considered diluted samples. The Employee shall be required to provide another urine sample for testing. e. Employees — All individuals who are covered by this Agreement, provided that individuals referred for employment by the Union under the hiring provisions of the Agreement are considered "Applicants" until they are hired and put to work by the Employer. f. "5 -panel US DOT" Approved Test — Describes a laboratory test conducted by a SA.'IvIHSA certified laboratory for the presence of one or more of the five drugs or 29 classes of drugs described under the definition of "prohibited items andi`or substances" and listed in Section IV. l .b of the ICI SAT Program. g. Incident — An event which has all the attributes of an accident, except that no harm was caused to person or property, h. "Medical Review Officer (11 0)" — The MRO is a licensed physician who has knowledge of substance abuse disorders and the appropriate medical training to interpret and evaluate positive substance abuse test results together with the individual's medical history and any other relevant biomedical information. The MRO is the individual responsible for receiving laboratory results. Not Suitable for Testing — A urine sample that the Medical Review Officer (vSRO) determines as not meeting the requirements for a valid test After consultation with the Employee, a retest may be required. Premises — All construction job sites for which the Employer has responsibility. This includes all job areas, offices, facilities, land, buildings, structures, and all company vehicles used in the performance of covered work. k. Probable Cause — Probable cause shall be defined as observable abnormal or erratic behavior such as noticeable imbalance, incoherence, and disorientation. Prohibited Items and'or Substances — Prohibited substances include illegal drug drugs (including controlled substances, look alike drugs and designer s), prescription drugs used by one for whom they were not prescribed, drug paraphernalia in the personal possession of or being used by an Employee on the premises. Also prohibited is alcoholic beverages being consumed by an Employee on the premises. M. Random Test - An unannounced test pursuant to an objective method for selection. Cost of such testing will be paid for by the Indiana Constructors, Inc. Substance Abuse Testing Program (ICI SAT Program). n. Rehabilitation Program — An Employer approved confidential counseling service, designed to help Employees resolve problems that involve alcohol or drug abuse, staffed by certified and credentialed human services professionals, o. Reinstatement — Refers to the requirements that a person who tested positive for prohibited items and'or substances under the ICI SAT Program must satisfy before he is eligible to return to work. P. Retest — A second separate test necessitated by an adulterated or intentionally diluted sample or a test considered not suitable for testing. A retest. that is considered as an adulterated or a diluted sample (whether diluted intentionally or unintentionally), or as a test not suitable for testing shall be considered a positive kul test. Costs of retesting necessitated by an unintentionally diluted and/or a test considered not suitable for testing 1xill be paid for by the ICI SAT Program. Costs of retesting an adulterated or intentionally diluted sample will be paid for by the individual. q. Substance Abuse Professional (SAP) A SAP is a licensed physician or a licensed or certified psychologist, social worker, employee assistance professional, or addiction counselor (certified by the National Association of Alcoholism and Drug Abuse Counselors Certification Commission) with knowledge of and clinical experience in the diagnosis and treatment of disorders relating to alcohol and drug abuse. r. Test — Is defined as the collection of an individual's urine specimen and the subsequent 5 -panel US DOT analysis of that specimen, in accordance with federal standards. For alcohol, a test is defined as the collection and analysis of an individual's breath specimen in accordance with federal standards; most often a specimen analyzed by a breathalyzer listed on the US DOT's Conforirling Products List. III. CONFIDENTIALITY. a. All par -des to this program should encourage any Employee -,Nitl-i ,. substance abuse problem to accept assistance in dealing with the problem. All parties will take the necessary actions to assure the problem is handled in a confidential manner. b. When a test is required, the specimen will be identified by a code number associated with a Chain of Custody- Form to insure confidentiality of the Employee. The Employee must witness this procedure. C. Results will be reported to the Employer and the Union by the MRO. W. RULES — DISCIPLINARY ACTIONS —GRIEVANCE PROCEDURES 1. RULES — All Employees must report to work in a physical condition that M11 enable them to perform their jobs in a safe and efficient manner. Employees shat not: a. Use, possess, dispense or receive prohibited substances on or at the job site, or during working hours. b. Report to work with above the measurable amount of the following prohibited substances in their system. 31 DRUG OR TABOLITE INITIAL TEST CONFIR'NL-kTION TEST DETECTED (GCAIS) Amphetamine 500 ng/nil 250 ng/ml (includes Methamphetamine) Cannabinoid 50 ng'ml 15 ng./ml (Marijuana, Hashish) Cocaine 150 ng/ml 100 ng/ml Opiate: Morphine, Codeine 2,000 ng;'ml 2,000 ng/ml 6-Acetylmorphine 10 ng/ml 10 rig/ml Phencvclidine (PCP) 25 ngiml 25 ng/m.1 -MI DMA 500 ng `ml 250 ng!ml Ethanol (Alcohol) .04% w!vol .04% w/vol (enzyme assay) (GC/FD) New drugs may be added as they are determined to be illegal or considered to be prohibited items and'or substances by mutual agreement. 2. Discinline — When the Employer has probable cause to believe an Employee is under the influence of a prohibited substance, for reason of safety, the Employee may be suspended until test results are available. If no test results are received after three (3) working days; the Employee, if available, shall be returned to work ,,,ith back pay subject to the test results. If the test results prove negative, the Employee shall be returned to work with back pay. In all other cases: a. Applicants testing positive for drug use will not be hired. b. Employees who refuse to cooperate with testing procedures will be subject to immediate termination. If an individual does not provide a suitable specimen within two hours (2 hours), it will be considered a refusal and treated as a positive test result and the individual will be subject to immediate termination. C. Employees found to be in the possession of prohibited items and/or substances will be terminated. d. Employees found selling or distributing prohibited items and'or substances will be terminated. e. Employees who test above the measured amount of prohibited items andf'or substances as provided for in IV. Lb while on duty, or while operating a company vehicle, will be subject to termination. 32 f. First Positive Test Result: The provisions below apply to an Employee who is tested pursuant to this policy and who receives a positive test result. 1) Consequence for First Positive Test Result: The Employee is subject to immediate termination, upon notice to the Employer by the MRO, of the positive test result. 2) Reinstatement: Employee is not eligible for work until he has taken, at his own expense, a "5 panel US DOT" approved test, at an approved clinic and the results of this test have been analyzed by a SA_MHSA certified laboratory and the test results must have been reviewed by an MRO and certified as being negative for the prohibited items and/or substances listed in IV.I.b. and the ICI SAT Program; union and Employer have received the certified negative test results. 3) Sporadic Testing of Reinstated Employees: A reinstated Employee, who has previously tested positive, is subject to unscheduled sporadic testing for one year from the date of reinstatement. Cost of such testing will be paid for by the ICI SAT Program. g. Second Positive Test Result: The provisions below apply to an Employee whe has previously tested positive, and tests positive a second time pursuant to such random testing, sporadic testing or any other testing under this policy: 11 Consequence for Second Positive Test Result: The Employee is subject to immediate termination, upon notice to the Employer by the MRO, of tyle positive test result. 2) Reinstatement: Employee is not eligible for work until he has, at his own expense, been evaluated by an accredited SAP, successfully completed an SAP recommended rehabilitation program and the SAP has written a letter releasing the person to return to Rork and the ICI SAT Program, Union and Employer have received the results of a "5 panel US DOT" approved test, a copy of the letter written by the SAP and a copy of the rehabilitation program successful completion letter, taken at an approved clinic, analyzed by a S WHSA certified laboratory and the test results must have been reviewed by an MRO and certified as being negative for the prohibited items and/or substances listed in IV.1.b. 3) Sporadic Testing of Reinstated Employees: A reinstated Employee, who has previously tested positive, is subject to unscheduled sporadic testing for one year from the date of reinstatement. Cost of such testing will be paid for by the ICI SAT Program. 33 h. Third and Additional Positive Test Results: The provisions below apply to an Employee, who tests positive three or more times pursuant to such random testing, sporadic testing or any other testing under this policy: 1) Consequence for Third and Additional Positive Test Results: The Employee is subject to immediate termination upon notice to the Employer by the MRO, of the positive test result and he will not be eligible for reinstatement for a period of six (6) months from date of the positive test. 2) Reinstatement: Employee is not eligible for work until he has, at his own expense, been evaluated by an accredited SAP, successfully completed a SAP recommended rehabilitation program and the SAP has written a letter releasing the person to return to work and the ICI SAT program, the Union and Employer have received the results of a "5 -panel US DOT" approved test; taken at an approved clinic, analyzed by a SAMHSA certified laboratory and time test results must have been reviewed by an MRO and certified as being negative for the prohibited items andlor substances listed in IV. Lb. 3} Sporadic Testing: A reinstated Employee, who has pre�,iously tested positive Care-- (3) or more times, is subject to unscheduled sporadic testing for two (2) years from the date of reinstatement. Cost of such testing will be paid for by the ICI SAT Prograrn. Prescription Drugs — Employees using a prescribed medication which may impair the performance of job duties, either mental or motor functions, must immediately inform their supervisor of such prescription drug use. For the safety of all Employees, the Employer will consult with the Employee to determine if a reassignment of duties is necessary. If a reassignment is not possible, the Employee will be relieved of duties until released as fit for duty by the prescribing physician, at which time the Employee shall be reinstated to his former employment status if work for which he is qualified is available at that time. If the Employee is tested and the test is positive, and the Employee has not previously informed the Employer of the use of prescription drugs, the Employee may be suspended for two weeks and is subject to unscheduled sporadic testing for six months. 4. Grievance - All aspects of this program shall be subject to the grievance procedure spelled out in the Collective Bargaining Agreement. 34 V. DRAG/ALCOHOL TESTING. The parties to this program agree that under certain circumstances the Employer will find that it is necessary for testing to be conducted for prohibited items and/or substances pursuant to the following procedures. a. A pre-employment drug and alcohol test may be administered to all Applicants without a valid ICI SAT identification card. The Applicant will be placed on the payroll and put to work pending receipt of the drug and alcohol test. Such employment shall be probationary in the sense that continued employment of the individual shall be contingent upon successful passage of the drug and alcohol test. b. All Employees shall be subject to random testing. C. A test may be administered in the evert there is probable cause to believe that the Employee has reported to work under the influence of a prohibited item and/or substance, or is or has been under the influence of a prohibited item andlor substance while on the job; or the Employee has violated this drug program. During the process of establishing probable cause for testing, the Employee has the right to request his on-site steward to be present; if available. d. Testing may be required if an Employee is involved in a work place ac-cident'inc i dent or injury. e. Employees may also be tested on a N•oluntary basis. f. Sporadic testing as provided for in IV.2. may be required as part of a follow-up to counseling or rehabilitation for substance abuse; for up to a two (2) year period. Each Applicant or Employee to be tested will be required to sign a consent and chain of custody form, assuring proper documentation and accuracy. If an Applicant or Employee refuses to sign a consent form authorizing the test, ongoing employment by the Employer will be terminated. The Employee shall be paid for the time lost for the following tests to be conducted only if the test results are negative, Random, post Accident, Incident, and probable Cause. The Employer will permit the Employee who is required to tate a drug test to obtain a "split sample," and the Employee may request the laboratory to send the "split sample" to an accredited laboratory of his choosing, at his own expense, as described in IV.2. The test result of the split sample must be released to the Employer within a maximum of five (5) working days. If the split sample test result is negative, the Employee may be returned to work on the same job site providing work for which he is qualified is stall available. Any Employee who successfully challenges the accuracy of a positive test result shall be reimbursed for his cost for the second testing and any time loss from work up to a maximum of five (5) work days. If the split sample tests positive, then the Employee shall be subject to immediate termination. 35 Drug and alcohol testing will be conducted by an accredited laboratory, and may consist of either blood or urine tests, or both, as required. Blood tests (for drugs and alcohol) vill be utilized for post accident investigation only if a urine or breathalyzer test cannot be administered. VI. IDENTTIFICATION CARD. a. An ICI SAT identification card will be issued to each person who tests negative in a valid test. The card gill contain the Applicant's name, photo and a unique ICI SAT database identification number. The ICI SAT card will be valid until the Employee tests positive. The Employee shall carry their valid ICI SAT card whenever they are on a job. Failure to produce the ICI SAT card on request by the Employer or their agent may cause the Employee to be suspended until the card is presented or until it is verified by the testing agency that the Employee's last test was negative. Replacement of a lost or damaged ICI SAT card shall be at the Employee's expense, b. ltiew hires, with an ICI SAT identification card. If an Applicant has a valid Employee ICI SAT card they will present the card for photocopying to the prospective Employer when they present themselves for employment. The Employer shall have the right to further validate the ICI SAT card by contacting the agency responsible for insuring the Employee's ICI SAT card is presently ,,-Lid. The Applicant will be placed on the payroll and put to ,work pending receipt of the result of the inquiry. Employment shall be probationary- and continued employment of the individual shall be contingent upon the validity of the Employee's ICI SAT card being verified. The Employer shall have three days to validate the ICI SAT card. If the ICI SAT card is invalid the Employee will have no right to continued employment and may be terminated. C. 'New hires, without an ICI SAT card. If the Applicant does not have a valid ICI SAT card, employment shall be probationary and continued employment shall be contingent upon successful passage of the drug and alcohol test. d. When tested for any reason, the Employee will surrender the ICI SAT card to the testing agent. If the test is negative, the Employee's valid TCI SAT card will be sent to the Employee. If the test is positive; the ICI SAT card will not be returned. SII. REFLABILITATION kN-D EMPLOYEE ASSISTA- CE PROGR-kN1 Employees are encouraged to seek help for a drug or alcohol problem before it deteriorates into a disciplinary matter. If an Employee voluntarily notifies supervision that he may have a substance abuse problem, the Employer may assist in locating a suitable SAP and rehabilitation program for treatment. The Employer will inform the Employee that medical benefits may be available under the Health and welfare Program. For Benefit information, within Indiana, call 1-800-962-3158. 36 If treatment necessitates time away from work, the Employer may provide for the Employee an unpaid leave of absence for purposes of participation in an agreed upon treatment program. An Employee who successfully completes a rehabilitation program may be reinstated to his former employment status, if work for which he is qualified is available at that time. Employees returning to work after successfully completing the rehabilitation program will be subject to drug tests without prior notice for a period of one year. A positive test will then result in disciplinary action as previously outlined in this program. VM. COST - Except as previously noted the costs of the tests associated with the program will be paid for by the Employer. The cost of a rehabilitation program and consultation with a SAP will be the responsibility of the Employee. IX, SUBSTANCE ABt;SE TESTING PROGRA_-kI a. Each Employer agrees to pay to the Indiana Constructors, Inc. Substance Abuse Testing Program ("ICI SAT") three (S.03) cents for each hour worked by each Employee working under this Agreement, Each Employer who participates in the ICI SAT Program is strongly encouraged to contribu.e to the Indiana Constructors Industry Advancement Fund (ICIAF). b. The contribution to the ICI SAT Program shall be deposited each month, or a regular intervals as mai- be determined by the Highway, Heavy-, and Utility Division — ICA, Inc., to the depository designated by the Highway, Heavy, and Utility- Division — ICA, Inc. and such contributions shall be reported on such forms as may be designated by the Highway, Heave, and Utility Division — ICA. Inc. C. The activities shall be determined by the Highway, Heavy, and Utility Division — ICA, Inc. and shall be financed from the payments provided for herein. The Employer expressly ratifies and adopts the ICf SAT policy. By execution of this Agreement, the Employer ratifies all actions taken by the Highway, Heavy, and Utility Division — ICA, Inc. within the scope of its authority. This Substance Abuse Testing Program has been ratified, signed and sealed as of by the Highway, Heavy, and Utility Division — ICA, Inc. and Local Unions of Laborers' International Union of North America, State of Indiana District Council. 37 SUBSTANCE ABUSE TES'TAi G PROGRAM AUTHORIZATIONi FOR CONSENT TO DRUG AN'D ALCOHOL ANALYSIS AND AUTHORIZATIO'N' FOR RELEASE OF RESULTS I, the undersigned do hereby authorize the testing of my body fluids and/or breath for employment reasons and understand and agree that the results of any such testing will be turned over to the Employer and the union, further that the testing procedures will be limited to tests for prohibited and illegal drugs and controlled substances and alcohol. I understand that the results of these tests may be used for employment and disciplinary reasons and hereby authorize the release of such information from the laboratories to the designated Employer and Union representatives. I further certify that any urine specimen collected from me is mine and not adulterated or altered in any manner. I have been advised that matters affecting me relative to the interpretation or application of the Drug Policy are subject exclusively to the grievance and arbitration procedure under my Collective Bargaining A-eement. Signat,Lre of Prospective Employee i Employee `Fitness Date Time LETTER OF UNDERSTANDING LETTER OF UNDERSTANDD G FOR THE AGREENIEN-T by and between Highway, Heavy, and Utility Division — ICA, Inc, and the Local Unions of Laborers' International Union of forth America State of Indiana District Council concerning the Substance Abuse Testing Program. In regard to the Substance Abuse Testing Program, it is understood between the parties that under this program, the following guidelines will be followed when a person tests positive: First PositN a Test Results in immediate termination. 38 For Reinstatement: + Provide a negative '`5 -panel US DOT" test result as interpreted by an MRO. a Sporadic testing for one (1) year following reinstatement. Second Positive Test Results in immediate termination. For Reinstatement: • Be evaluated by an SAP. a Complete an SAP -recommended rehabilitation program. • Secure written release from the SAP to return to work. • Provide a negative ",;panel US DOT" test result as interpreted by an vaO. • Sporadic testing for one (1) year following reinstatement. Third and Additional Positive Test Results in immediate termination; not eligible for reinstatement for six (6) months. For Reinstatement: + Be e� aluated by an SAP. • Complete an SAP -recommended rehabilitation program. • Secure written release from the SAP to return to work. • Pro`,ide a negative "5 panel US DOT" test result as interpreted by an NMR0. • Sporadic testing for two (2) years following reinstatement. FURTHER it is understood that any costs associated with the SAP, NIRO, Rehabilitador_ Program, and testing required to be reinstated, are the Employee's responsibility. ARTICLE SAV EFFECTIVE DATE THIS AGREENIEN'T shall be in full force and effect from March 1, 2012 when ratified by a majority of the Parties of the First Partand the duly authorized representative of the Party of the Second Part; State of Indiana District Council and continue for the period next ensuing, expiring as of March 31, 2017. This agreement may be re -opened to negotiate adjustments in economics, if and when Federal Davis Bacon Law or the Indiana State Prevailing Wage Law is repealed or modified to the extent that it would be a detriment to signatory contractors in being competitive on Highway, Bridge, Utility and Railroad projects. It is meed that prior to re -opening the agreement either Party may request, in writing, a joint meeting between the "Employers" and the "union". This meeting shall take place within seven (7) days. After seven (7) days if no agreement has been agreed upon, then 39 an -time thereafter a five (S) day advanced written notice may be given of desire to re- open the contract by either party, The parties shall have sixty (60) days Eom that date of notice to reach an agreement. If at the end of the sixty (60) day period no agreement has been agreed upon the contract shall expire on the next anniversary date. Each party shall have reserved to itself its' ful economic and legal options, including but not limited to strike or lockout. THIS AGREE'NIE=vT has been ratified, signed and sealed as of February 22, 2012 by the following: PARTY OF THE FIRST PART, HIGHWAY, HEAVY, AND UTILITY DIVISION — ICA, M. Steven . Crider, Chairman. -s /Z Highway; Heavy, and Utility Di-v4sion—ICA, Inc, J,) Charles V. K 3 S'/ Highway, Heavy, and Utility Division — ICA. Inc. PARTY OF THE SECOND PART, LOCAL ]UNIONS OF LABORERS' INTERNATIONAL UNION OF NORTH AMERICA, STATE OF LNDLA7tiA DISTRICT COLS CIL A - jzz;�� David- azvj A. Frye, President 446J&A1416�:: Frank DeGraw, Secretary - Treasurer & Business Manager Highway, Heavy, and Utility Division — ICA, Inc, 1 North Capitol Ave Suite 1000 Indianapolis LL 46204 Phone (317) 472-6777 Fax (3 17) 472-6767 40 PA RT`r' OF THE FIRST PART '-EMPLOYERS" American Contracting & Services, Inc. Anlaan Corporation MK Betts Engneering & Contracting, Inc. Bowen Engineering Corporation Brooks Construction Co., Inc. Calumet Civil Contractors, Inc. Crider & Cr --der. Inc. C -Tech Corporation, Inc. De -,g Bros. Lumber & Construction Co., Inc. James H. Drew Corpo:atior E & B Paving, Inc. Earth Images, Inc. Far West Construction, Inc. Feuu Contractors, Inc. Fox Contractors Corp. Gaun: & Son Asphalt, lnc. Gradex, Inc. Grand River Construction, Inc. Grimmer Corsmiccon, Inc. Harmor. Construction, Inc. HIS Constructor, Inc. Hi -Way Paving, Inc. 1nsitufcr1n TechacloQics USA, Lnc. JBI Constrsction, L;.. LaPorte Construction. Co., Iac. LICA Construction Corporation Lutgring Bros., Inc. Martel; Eleet,-ic, LLC R. L. N'Iecoy. Inc. Mid-America Milling Co., LLC (M_AMCO) Midwest :dole. Inc. Morphey Constriction, Inc. Phend & Brow -n, Inc. Poindexter Excavating. Inc. Rieth-Riley Construction Co,, Inc. J. H. Rudolph & Co., Inc. Schutt-Lookabili Co., Inc. Shelly & Sands, Inc. Sims and Pedigo Co., Inc. Slussefs Green Thumb, Inc. Specialties Company, LLC ST Construction, Inc. Superior Construction Company, Ir_c. The Hoosier Company. Inc. The Hunt Pa,,i-ig Company, hic. Walsh & Kelly, Inc. Walsh Construction Company Walsh Construction Company II, LLC WB Koester Conssuctior., LLC Weddle Bros. Higaway Group, LLC 41