HomeMy Public PortalAbout161-2019 - Mendenhall and Associates - Administrative ServicesAGREEMENT
THIS AGREEMENT is made and entered into this day of- 6eC , 2019, by
and between the City of Richmond, Indiana, a municipal corporation acting by and through its
Board of Sanitary Commissioners, 50 North 51 Street, Richmond, Indiana 47374 (hereinafter
referred to as the "City") and Mendenhall & Associates, LLC, P.O. Box 428, Arcadia, IN 46030
(hereinafter referred to as the "Contractor").
SECTION I. STATEMENT AND SUBJECT OF WORK
City hereby retains Contractor for the assistance of a professional labor standards administrator to
provide all Davis -Bacon wage scale compliance reviews and certifications for the WM. E. Ross
Wastewater Treatment Plant Phase I Improvements as required by the State of Indiana Finance
Authority SRF Program and/or Federal Government.
City sent a Request for Proposal on September 19, 2019, seeking the assistance of a professional
labor standards administrator to provide all Davis -Bacon wage scale compliance reviews and
certifications for the Wm. E. Ross wastewater Treatment Plant Phase I Improvements project as
required by the State of Indiana Finance Authority SRF Program and/or Federal Government.
The Request for Proposal of ten (10) pages is attached hereto and incorporated herein by
reference as Exhibit "A".
The response of Contractor, dated September 26, 2019, is contained in Exhibit "B", consisting of
fifteen (15) pages, which Exhibit "B" is attached hereto and incorporated herein by reference and
made a part of this Agreement.
Should any provisions, terms, or conditions contained in any of the documents attached hereto as
Exhibits, or in any of the documents incorporated by reference herein, conflict with any of the
provisions, terms, or conditions of this Agreement, this Agreement shall be controlling.
The Contractor shall, when requested, provide its phone or cell phone number, text message or
email specified by City.
No performance of services shall commence until the following has been met:
1. The City is in receipt of any required certificates of insurance and/or
warranties;
2. The City is in receipt of any required affidavit signed by Contractor in
accordance with Indiana Code 22--5--1.7--11(a)(2);and
3. .A purchase order has been issued by the Purchasing office.
SECTION H. STATUS OF CONTRACTOR
Contractor shall be deemed to be an independent contractor and is not an employee or agent of
the City of Richmond. The Contractor shall provide, at its own expense, competent supervision
of the work.
Contract No. 161--2019
Page 1 of 6
SECTION III. COMPENSATION
City shall pay Contractor a sum not to exceed Fifteen Thousand Dollars and No Cents
($15,000.00) for complete and satisfactory performance of the work required hereunder for the
term of this contract.
SECTION IV. TERM OF AGREEMENT
This Agreement shall run through the completion of all construction and administration
associated with the WM. E. Ross Wastewater Treatment Plant Phase I Improvement Project.
Notwithstanding the term of this Agreement, City may terminate this Agreement in whole or in
part, for cause, at any time by giving at least five (S) working days written notice specifying the
effective date and the reasons for termination which shall include but not be limited to the
following:
a. failure, for any reason of the Contractor to fulfill in a timely manner
its obligations under this Agreement;
b. submission of a report, other work product, or advice, whether oral or written, by the
Contractor to the City that is incorrect, incomplete, or does not meet reasonable
professional standards in any material respect;
c. ineffective or improper use of funds provided under this Agreement;
d. suspension or termination of the grant funding to the City under which this Agreement
is made; or
e. unavailability of sufficient funds to make payment on this Agreement.
In the event of such termination, the City shall be required to make payment for all work
performed prior to the date this Agreement is terminated, but shall be relieved of any other
responsibility herein.
This Agreement may also be terminated, in whole or in part, by mutual Agreement of the parties
by setting forth the reasons for such termination, the effective date, and in the case of partial
termination, the portion to be terminated.
SECTION V. INDEMNIFICATION AND INSURANCE
Contractor agrees to obtain insurance and to indemnify the City for any damage or injury to
person or property or any other claims which may arise from the Contractor's conduct or
performance of this Agreement, either intentionally or negligently; provided, however, that
nothing contained in this Agreement shall be construed as rendering the Contractor liable for acts
of the City, its officers, agents, or employees. Contractor shall as a prerequisite to this
Agreement, purchase and thereafter maintain such insurance as will protect it from the claims set
forth below which may arise out of or result from the Contractor's operations under this
Agreement, whether such operations by the Contractor or by any sub --contractors or by anyone
directly or indirectly employed by any of them, or by anyone for whose acts the Contractor may
be held responsible.
Coverage Limits
A. Worker's Compensation & Statutory
Disability Requirements
Page 2 of 6
B. Employer's Liability
C. Comprehensive General Liability
Section I. Bodily Injury
Section 2. Property Damage
D. Comprehensive Auto Liability (if applicable)
Section I. Bodily Injury
Section 2. Property Damage
$1003000
$1,000,000 each occurrence
$2,000,000 aggregate
$1,000,000 each occurrence
$1,000,000 each person
$1,000,000 each occurrence
$1,000,000 each occurrence
E. Comprehensive Umbrella Liability $1,000,000 each occurrence
$2,000,000 each aggregate
SECTION VI. COMPLIANCE WITH WORKER'S COMPENSATION LAW
Contractor shall comply with all provisions of the Indiana worker's Compensation law, and shall,
before commencing work under this Agreement, provide the City a certificate of insurance, or a
certificate from the industrial board showing that the Contractor has complied with Indiana Code
Sections 22--3-2-5, 22--3--5-1 and 22-3-5-2. If Contractor is an out of state employer and therefore
subject to another state's worker's compensation law, Contractor may choose to comply with all
provisions of its home state's worker's compensation law and provide the City proof of such
compliance in lieu of complying with the provisions of the Indiana worker's Compensation Law.
SECTION VII. COMPLIANCE WITH INDIANA E-VERIFY PROGRAM
REQUIREMENTS
Pursuant to Indiana Code 22-5-1.7, Contractor is required to enroll in and verify the work
eligibility status of all newly hired employees of the contractor through the Indiana E-Verify
program. Contractor is not required to verify the work eligibility status of all newly hired
employees of the contractor through the Indiana E-Verify program if the Indiana E-Verify
program no longer exists. Prior to the performance of this Agreement, Contractor shall
provide to the City its signed Affidavit affirming that Contractor does not knowingly employ
an unauthorized alien in accordance with IC 22-5-1.7-11 (a) (2). In the event Contractor
violates IC 22-5-1.7 the Contractor shall be required to remedy the violation not later than
thirty (30) days after the City notifies the Contractor of the violation. If Contractor fails to
remedy the violation within the thirty (30) day period provided above, the City shall consider
the Contractor to be in breach of this Agreement and this Agreement will be terminated. If
the City determines that terminating this Agreement would be detrimental to the public
interest or public property, the City may allow this Agreement to remain in effect until the
City procures a new contractor. If this Agreement is terminated under this section, then
pursuant to IC 22-5-1.7-13 (c) the Contractor will remain liable to the City for actual
damages.
Page 3 of 6
SECTION VIII. IRAN INVESTMENT ACTIVITIES
Pursuant to Indiana Code (IC) 5-22-16.5, Contractor certifies that Contractor is not engaged
in investment activities in Iran. In the event City determines during the course of this
Agreement that this certification is no longer valid, City shall notify Contractor in writing of
said detennination and shall give contractor ninety (90) days within which to respond to the
written notice. In the event Contractor fails to demonstrate to the City that the Contractor has
ceased investment activities in Iran within ninety (90) days after the written notice is given to
the Contractor, the City may proceed with any remedies it may have pursuant to IC 5--22--
16.5. In the event the City determines during the course of this Agreement that this
certification is no longer valid and said determination is not refuted by Contractor in the
manner set forth in IC 5-22--16.5, the City reserves the right to consider the Contractor to be
in breach of this Agreement and terminate the agreement upon the expiration of the ninety
(90) day period set forth above.
SECTION Ix. PROHIBITION AGAINST DISCRIMINATION
A. Pursuant to Indiana Code 22-9--1--10, Contractor, any subcontractor, or any person acting
on behalf of Contractor or any sub -contractor shall not discriminate against any employee
or applicant for employment to be employed in the performance of this Agreement, with
respect to hire, tenure, terms, conditions or privileges of employment or any matter
directly or indirectly related to employment, because of race, religion, color, sex,
disability, national origin, or ancestry.
B. Pursuant to Indiana Code 5-16-6-I, the Contractor agrees:
1. That in the hiring of employees for the performance of work under this
Agreement of any subcontract hereunder, Contractor, any subcontractor, or any
person acting on behalf of Contractor or any sub -contractor, shall not
discriminate by reason of race, religion, color, sex, national origin or ancestry
against any citizen of the State of Indiana who is qualified and available to
perform the work to which the employment relates;
2. That Contractor, any sub -contractor, or any person action on behalf of Contractor
or any sub -contractor shall in no manner discriminate against or intimidate any
employee hired for the performance of work under this Agreement on account of
race, religion, color, sex, national origin or ancestry;
3. That there may be deducted from the amount payable to Contractor by the City
under this Agreement, a penalty of five dollars ($5.00) for each person for each
calendar day during which such person was discriminated against or intimidated
in violation of the provisions of the Agreement; and
4. That this Agreement may be canceled or terminated by the City and all money
due or to become due hereunder may be forfeited, for a second or any subsequent
violation of the terms or conditions of this section of the Agreement.
C. Violation of the terms or conditions of this Agreement relating to discrimination or
intimidation shall be considered a material breach of this Agreement.
Page 4 of 6
SECTION X. RELEASE OF LIABILITY
Contractor hereby agrees to release and hold harmless the City and all officers, employees, or
agents of the same from all liability which may arise in the course of Contractor's performance of
its obligations pursuant to this Agreement.
SECTION xI. MISCELLANEOUS
This Agreement is personal to the parties hereto and neither party may assign or delegate any of
its rights or obligations hereunder without the prior written consent of the other party. Any such
delegation or assignment, without the prior written consent of the other party, shall be null and
void. This Agreement shall be controlled by and interpreted according to Indiana law and shall
be binding upon the parties, their successors and assigns. This document constitutes the entire
Agreement between the parties, although it may be altered or amended in whole or in part at any
time by filing with the Agreement a written instrument setting forth such changes signed by both
parties. By executing this Agreement the parties agree that this document supersedes any
previous discussion, negotiation, or conversation relating to the subject matter contained herein.
This Agreement may be simultaneously executed in several counterparts, each of which shall be
an original and all of which shall constitute but one and the same instrument.
The parties hereto submit to jurisdiction of the courts of Wayne County, Indiana, and any suit
arising out of this Contract must be filed in said courts. The parties specifically agree that no
arbitration or mediation shall be required prior to the commencement of legal proceedings in said
Courts. By executing this Agreement, Contractor is estopped from bringing suit or any other
action in any alternative forum, venue, or in front of any other tribunal, court, or administrative
body other than the Circuit or Superior Courts of Wayne County, Indiana, regardless of any right
Contractor may have to bring such suit in front of other tribunals or in other venues.
In the event of any breach of this Agreement by Contractor, and in addition to any other damages
or remedies, Contractor shall be liable for all costs incurred by City in its efforts to enforce this
Agreement, including but not limited to, City's reasonable attorney's fees.
In the event that an ambiguity, question of intent, or a need for interpretation of this Agreement
arises, this Agreement shall be construed as if drafted jointly by the parties, and no presumption
or burden of proof shall arise favoring or disfavoring anyparty by virtue of the authorship of any
of the provisions of this Agreement.
Any person executing this Contract in a representative capacity hereby warrants that he or she has
authorization, in writing, by his or her principal to execute this Contract on behalf of the
Contractor and that such authorization has not been revoked or rescinded.
IN WITNESS WHEREOF, the parties have executed this Agreement at Richmond, Indiana, as of
the day and year first written above, although signatures may be affixed on different dates.
Page 5 of 6
"CITY"
THE CITY OF RICHMOND,
INDIANA by and through its
Board of Sanitary Commissioners
By:
ue iller, President
Aman B591 i, Vice --President
By: X.,
6;p'-C�15 Member
APPROVED: l
avid M. Snow
City of Richmo d, Indiana
Date: tl �
Page 6 of 6
"CONTRACTOR"
MENENHALL & ASSOCIATES, LLC
By:
Printed: h C�. � • /men d ei5 6 P1
Title: ?re5 / G{ ���
Date: /'r2 - � � —1 I
Rrc
DAVE SNOW
d Mayor
BRYAN ). ERVIN
��D 1 P►��' Director
CITY OF RICHMOND
DEPARTMENT .OF SANITATION
2380 LIBERTY AVENUE*RICHMOND, INDIANA 47374
PHONE (769) 983-7450•FAX (765) 9f 2669
September 19, 2019
ti
Mendenhall & Associates
,Attn: Tina Henderson.
PCB BOX -428
Arcadia, IN 46030
Re: Request- for Proposals
WM. E. Ross wastewater Treatment Plant Phase I. Improvements
Davis -Bacon Wage Scale Compliance Review and Certification
The Richmond Sanitary District is seeking the assistance of a professional labor standards
administrator to provide all Davis -Bacon wage scale compliance reviews and certifications for
the wlV.i. E. Ross wastewater Treatment Plant Phase I Improvements Project as required by the
State of Indiana Finance Authority SRF Program and/or Federal Government. Please review the.
attached RFP. and, if interested in this worlt, please present a proposal as butlined.
Thanks,
Elioah W. welch, P.E.
'District Engineer
Richmond Sanitary District
EXHIBIT 'A'
PAGE IOF10
t
Richmond Sanitary District
Request for Proposal
WM. E. Ross 'wastewater Treatment Plant Phase 1 Improvements
Davis -Bacon Wage Scale Compliance Review and Certification
The Richmond Sanitary District is seeking the assistance of a professional labor standards administrator
(Herein after referred to as LSA) to provide all Davis -Bacon wage scale compliance reviews and
certifications for the WM. E. Rass Wastewater Treatment Plant Phase I Improvements as required by the
State of Indiana Finance Authority SRF Program and/or Federal Government.
Part 1: Project Information
The Richmond Sanitary District (RSD) is in the process of awarding the WM. E. Ross Wastewater
Treatment Plant Phase I Improvements Project to Kokosing Industrial Inc. of Westerville, OH. The project
is being funded by the Indiana Finance Authority SRF loan program and requires Davis -Bacon Wage scale
to be used. The below is a general summary of project information:
Contractor:
Kokosing Industrial Inc.
6325 Westerville Rd.
Westerville, OH 43081
Construction Contract Amount:_ $13,875,000.00 (see attached bid schedule)
Subcontractor's listed on Form 96 as submitted by contractor at time of bid: 8 (see attached)
Time allowed per contract documents for completion of project:
Substantial Completion: 578 days
Final Completion: 60 days from Substantial Completion
Project Description:
The Project consists of constructing new primary pumps and VFDs, a new aeration flow splitter structure,
aeration tank modifications including diffusers, mixers, dissolved oxygen control, miscellaneous piping and
valves, and other miscellaneous improvements. The Project also consists of constructing new aeration
blowers, and final clarifier improvements for all four final clarifiers including replacement of effluent weirs,
scum baffles, and sludge collection mechanisms and construction of new effluent launders. Additionally, the
Project involves creating RAS flow control improvements, miscellaneous PLC replacements, and
miscellaneous sitework, piping, structural, plumbing, heating, ventilation, air conditioning, electrical, and
instrumentation and control.
Project Start Date: November 2019 (estimated)
Part 2: Proposed Scope of Work
The LSA will be responsible for all aspects of Davis --Bacon wage scale compliance as required for the
owner (City of Richmond/Richmond Sanitary District) by the State of Indiana Finance Authority SRF
Program and/or Federal Government. The attached documents show a brief overview of information as
related to the Davis -Bacon wage scale compliance requirements.
Part 3: Deliverables
All records associated with compliance review and certifications shall be provided as obtained during the
project as well as in aggregate at the end of construction and final compliance review.
Part 4 --Content of Proposal (Response to RFP)
EXHIBIT 'A' PAGE 2 OF 10
Respondents to this RFP shall submit a proposal which shall- include information as follows:
1. Proposed Scope of Services
2. Fee Tabulation for all work associated with this project
3. List. of 3 recent. IFA SRF projects showing history of work with this agency and ability to complete
this specific type of work
4. Appropriate insurance will be required prior to approval of contract but is not required at time of
submittal
5. Affidavit of 9-verify will be required prior to approval of contract but is not- required at time of
submittal
Part 5 -- Submittal Requirements
The proposal shall be submitted to the Richmond Sanitary District no than 12:00pm Friday, September
279 2019. Proposals shall be delivered by email to Elijah welch, District Engineer at
ewelch(c�.richmondindiana.gov. Appropriate insurance will be required prior to approval of contract.
Questions shall be directed to Elijah welch at ewelch ,n. chmondindiana.gov or 765-983-7483.
The Richmond Sanitary District reserves the right to reject any parts of and/or your entire proposal.
EXHIBIT 'A'
PAGE 3 OF 10
! t
S
Insurance Coverage Requirements'
coverage.
Limits
A.
Worker's Compensation &
Statutory
Disability Requirements
B.
Employer's Liability
$1005000
C.
Comprehensive General Liability
Section 1. Bodily Injury
$1,000,000 each occurrence
$2,000,000 aggregate
Section 2. Property Damage
$1,000,000 each occurrence
D.
Comprehensive Auto Liability
Section 1. Bodily Injury
$1,000,000 each person
$1,000,000 each occurrence
Section 2. Property Damage
$1,000,000 each occurrence
E.
Comprehensive Umbrella Liability
$1,000,000 each occurrence
$2,000,000 each aggregate
F.
Malpractice/Errors & omissions
$1,0'00,000 per claim
Insurance
$2,000,000 each aggregate
EXHIBIT 'A'
PAGE 4 OF 10
SUBCONTRACTOR LISTING
The forjoviiing is a listing of proposed Subcontractors having a direct contract with the Contractor.
. Drilled Pile sub - Grout Systems
Bypass Pump sub - Sunbelt Rentals
3. Coatings sub - Howard Painting
4. Concrete Repair sub - Lithko Restoration Technologies, LLC.
5. Rebar sub - Black Swamp Steel
6. Geofiil sub - Mix On site
7. HVAC sub - Koehring & Sons
$. ElectricaI sub - Lake Brie Electric
0
Donohue & Associates, Inc.
Protect No. 13451
EXHIBIT 'A'
BID FORM
PAGE 5 OF 10 00411-11
UNIT PRICE SCHEDULE
No.
Section
Item
City
Unit
Bid Unit Price
Bid Price
1
A11
Sections
All Work Except For
items No. 2 throng
1
LS
$ OM; I_� ' per LS
$ ZZ eL7.A °
No. 4
2
01270 _
Final Clarifier
Concrete Topping
EA
$f L per EA
$ �'
Removal and
Replacement
3
01270
Rehabilitation of
Cast -In -Place
11200
SF
$ p
Concrete Repair
4
01270 and
Structure 250
all
Primary Pump
Sections
Building
and parts
of
Sections
A11 work on the
c 0�
'100
�
a
applicable
PP
250-series
'i
IS
$ r��.er LS
P
$
to the
Drawings torthe
Structure
Structure 250
250
Primary Pump
Primary
Building
Pump
Building.
i
TOTAL OF ALL BID PRICES (Sum of Bid Price for Each Item) $
(f igures)
7 /� � Dollars �W
(w ords)
Qty = Estimated Quantity
Estim ated Price (for each Item) = Qty x Unit Price (for each item)
LS = Lump Sum
SF = Square Foot
EA = Each
Unit Prices have been computed in accordance with paragraph 13.03 of the General Conditions.
Bidder acknowledges that estimated quantities are not guaranteed, and are solely for the purpose
of comparison of Bids, and final payment for all Unit Price Bid items will be based on actual
quantities, determined as provided in the Contract Documents.
Donohue & Associates, Inc.
Project No. 13451
BID FORM
PAGE 6 OF 10 0041-5
EXHIBIT 'Al
E-Verify Requirements:
Definitions:
E-Verify Program — A electronic verification of work authorization program of the Illegal
Immigration Reform .and Immigration Responsibility Act of 1996 (P.L. 104-208), Division C,
Title IV, s.403 (a), as amended, operated by the United States Department of Homeland Security
or successor work authorization program designated by the United States Department of
Homeland Security or other federal agency authorized to verify the work authorization status of
newly hired employees under the Immigration Reform and Control Act of 1986 (P.L. 99-603).
No perfomance of services shall commence until the following has been met:
1. The City is in receipt of any required certificates of insurance;
2. The City is.in receipt of any required affidavit signed by Contractor in accordance with
Indiana Code 22-5-1.7-11 (a) (2); and
3. A purchase order has been issued by the Purchasing Department.
COMPLIANCE WITH INDIANA E-VERIFY PROGRAM REQUIRMENTS
Pursuant to Indiana Code 22.5.1.7, Contractor is required to enroll in and verify the work .
eligibility status of all newly hired employees of the contractor through the Indiana E-Verify
program. Contractor is not required to verify the work eligibility status of all newly hired
employees of the contractor through the Indiana E-Verify program if the Indiana E-Verify
program no longer exists. Prior to the performance of the Agreement, Contractor shall provide
to the City its signed Affidavit affirming that Contractor does not knowingly employ and
unauthorized alien in accordance with IC 22-5-1.7 (a) (2). In the event Contractor violates IC
22-5-1.7 the Contractor shall be required to remedy the violation no later than thirty (30) days
after the City notifies the Contractor of the violation. If the Contractor fails to remedy the
violation with the thirty (30) day period provided above, the City shall consider the Contractor to
be in breach of this Agreement and Agreement will be terminated. If the City determines that
terminating this Agreement would be detrimental to the public interest or public property, the
City may allow this Agreement to remain in effect until the City procures a new contractor. If
this Agreement is terminated under this section, then pursuant to IC 22-5-1.7-13 (c) the
Contractor will remain liable to the City for actual damages.
EXHIBIT 'A' PAGE 7 OF 10
Affidavit of Employment Eligibility Verification (E-Verify)
The Contractor, affirms under the penalties of perjury that
Contractor does not knowingly employ an unauthorized alien. If Contractor is self-employed and
does not employ any employees, Contractor verifies he or she is a United States citizen or
qualified alien.
The -Contractor has not knowingly employed or contracted with an unauthorized alien and shall
not retain an employee or contract with.a person that the Contractor subsequently learns is an
unauthorized alien. Pursuant to Indiana Code 22--5--1.7, Contractor has enrolled in and verified
the work eligibility status of all newly hired employees of the contractor through the Indiana E-
Verify program.
The Contractor has required Contractor's subcontractors to certify to the Contractor that the
subcontractor does not knowingly employ or contract with an unauthorized alien and that the
subcontractor has enrolled and is participating in the E--Verify program. The Contractor will
maintain this certification throughout the duration of the term of a contract with a subcontractor.
I hereby verify under the penalty of perjury that the foregoing statement is true.
Dated this day of 920
(Signature)
(Printed Name)
EXHIBIT 'A'
PAGE 8 OF 10
Federal Davis Bacon Act Requirements
1. Bid process -- include wage rates and contract conditions as outlined in SRF Front End documents (link). Federal wage
Determinations on line: http://www.wdol.go�l
2. During Construction the Loan Recipient will be responsible for the following:
a. OBTAIN WEEKLY PAYROLL AND STATEMENT OF COMPLIANCE.
Certified payrolls are to be submitted weekly by the prime contractor. The prime contractor is responsible to collect
and submit the subcontractor payrolls and statement of compliance weekly to the Loan Recipient.
Prior to submitting a disbursement request to the IFA for construction costs, the Loan Recipient should have all
Certified payrolls from the prime contractor and subcontractors and conduct payroll verification and employee
interviews as described in this section to ensure compliance with state and federal requirements. Recommended
forms are provided with Front -End Document Addenda (WH-347 .
b. VERIFY JOB SITE POSTINGS ARE IN PLACE.
The prime contractor is responsible to post the following at the construction site:
"Notice to All Employees" poster the required federal Poster (WH 1321).
c. VERIFY COMPLIANCE WITH PREVAILING WAGE REQUIRE, MENTS.
The Loan Recipient or their representative must periodically conduct spot checks of a representative sample of
weekly payrolls, verify fringe benefits, and conduct employee interviews to ensure that the contractor/subcontractor
is complying with requirements and paying the appropriate wage rates.
Establish and follow a payroll review and employee interview schedule based on an assessment of the risks of
noncompliance & length of contract. Conduct more frequent spot checks if risks are higher or if
contractor/subcontractor noncompliance.
Conduct immediate interviews in response to an alleged violation of the prevailing wage requirements.
Conduct employee interviews in confidence. Form SF 1445 or equivalent document for the interviews is required to
memorialize interviews.
Verify evidence of fringe benefit plans and payments of these plans by contractors and subcontractors who claim
credit for fringe benefit contributions.
Periodically review contractors and subcontractors use of apprentices and trainees. Verify registration and
certification of apprentices and trainees with respect to apprenticeship and training programs approved by US Dept.
of Labor or a state program; that contractors- and subcontractors are not using a disproportionate number of laborers,
trainees and apprentices. Conduct these reviews in accordance with the payroll and employee interviews.
Maintain all labor standards records, including information on any restitutions (underpayments to laborers), on file.
NOTE: Employees home address and social security number should not be on the certified payrolls.
Loan Recipients must immediately report potential violations of the DB prevailing wage requirements to the EPA
DB contact listed above and to the appropriate DOL wage and Hour District Office listed at
hllp://dol.gov/whd/america2.htm.
3. Project Completion
a. Submit a FINAL FEDERAL LABOR STANDARDS REPORT to IFA at project completion. The form can be
found on the IFA website here.
b. Maintain labor standards records (certified payrolls, employee interviews, records of wage incidents,
correspondence, debarment, search results, etc.) with the project files at the Loan Recipient's office for a period of
three years after construction completion. Such records shall be available on request of the IFA or EPA.
EXHIBIT 'A' PAGE 9 OF 10
Final Federal Labor Standards Compliance Certification
Please submit this form to the Indiana Finance Authority when each construction contract is completed.
Loan Recipient Name:
SRF Loan Number:
Wage Decision followed for this Project- IN with modifications
Construction Complete Date:
NAME OF GENERAL CONTRACTOR:
LIST OF SUBCONTRACTORS (enter all)
Questions — If the answer to any of these items is "None" or "No" please explain in comments below:
1. Number of Interviews completed:
2. Were the required postings (posters, decisions) observed on site? Yes ❑ No [_1
3. Have all payrolls been received? Yes ❑ No ❑
4. Are all payroll submissions complete and compliant? Yes ❑ No ❑
5. Were wage interviews compared to payroll submissions? Yes ❑ No ❑ n/a ❑
6. Have all known labor standards non -compliances been resolved? Yes R No ❑ n/a ❑
7. Have all known restitutions been received by employees? Yes D No D n/a R
8. _ Has a record of all wage incidents been maintained? Yes D No El n/a R
9. Were willful violations or complaints forwarded to IFA or DOL? Yes ❑ No ❑ n/a ❑
Final Report Comments (if anv):
CERTIFICATION:
I certify to the best of my knowledge that all laborers and mechanics employed by this construction contract
were paid in accordance with Federal labor provisions. There are no outstanding or unresolved Federal
labor standards underpayments, complaints or disputes on this contract.
Signature: Date:
Title: Organization:
Individual signing here should be the one responsible for payroll review and monitoring.
Please return the completed Certification to Amy Henninger at 100 N. Senate Aver IGCN
1275, Iudianapolis1.IN 46204 or ahenning(&,ifa.in.gov.
EXHIBIT 'A' PAGE 10 OF 10
Mendenhall &�
Associates, uc
CITY OF RX 'HMOND
DEPARTMENT OF SANITATION
RICHAMOND SANITARY DISTRICT
WM E. Ross
Wasfiewater Treatment Plant
Phase I Improvement Project
LABOR STANDARDS
PROPOSAL
eptei� be'r 25120 �.9
P.O. Box 428 •Arcadia, I 46030 • PH: 317-9848639 • FX: 317-984-7459
EXHIBIT'B' PAGE 1 OF 15
r
Mendenhall &_
Associates, LAC-__r
September 25, 2019
Elijah W. Welch.' P.E.
District Engineer
Richmond Sanitary District -
2380 Liberty Avenue
Richmond, Indiana 47374
RE: Labor Standards Administration, WM E. Ross Wastewater. Treatment Plant Phase 1
Improvements
Dear Mr. Elijah We' lch:
Mendenhall & Associates,- L.L.C. appreciates the recent request for proposal for labor -
standards administrative. services pertaining to the - wastewater improvement project for
WM E Ross Wastewater Treatment PIant Phase I project,
Our- firm has .been established for twenty years and: with our teams experience and our
staff of knoVVledgeable professionals that have interest and insight of communities
.throughout Indiana, we are confident that we can carry out the requirements of this SRF
project.'
Attached to this. -letter is our proposal with Mendenhall and Associates, L.L.C. project expe-
rience, references, the scope of work and fees to meet the State of Indiana Finance Au-
thority SRF program -requirements for labor standards. for this project.
While you are reviewing our proposal,, please contact us at'(317) 984-8639 if you have any
Y � p p
questions.
Sincerely,
dV14
Tina Mendenhall, Henderson.
Grant Administrator
P.O. B ox. 428 • Arcadia, IN 46030 - -PH: 317-984-8639 • FX: 317-984-7459
EXHIBITS' PAGE 2 OF 15
Mendenhall &'�
Associates, uc.....
SCOPE of WORK
Descriptionpof Anticipated;Wor'k Iteri�s
WM E-s' Ross Wastewater Treatment Plant Phase I Improvement' Project
Labor -Standards Administration" $15COO&300:
rn
Mendenhall ,and Associates will ensure the projects are compliant With federal regulations concern-
ing all aspocts of Labor Standards requirements to meet the State Revolving Loan Fund. We have,
based our fee on the total SRF Loan of $13,875,000.00 for both Division ' A and B of this
wastewater ,improvement project.
Scope of Work:
• Determine/ Review type of Wage Decision
Review of the current Wage Decision :issued
Request conformance Rates from US Department of Labor. when Applicable.
4 Assist with the Pre -construction conference
4 obtain all forms related to Davis Bacon and help contractors and subcontractors to stay in
compliance,
Obtain and review all necessary ,State and Federal Forms from the Prime contractor and all
Subcontractors throughout the project.
• Distribute applicable job site posters to the prime contractor (Davis -Bacon poster, EEO
poster, IOSHA , poster,,etc,),
• Validate all -Prime/sub-contractors through www:Sams.gov to conf_rm that they are eligible
to work on federally funded projects.,
• Verify Fringe Benefit Funds of all contractors.
Monitor weekly contractor and Sub contractor Payrolls.
• Resolve unsatisfactory payroll findings, and report violations to owner and SRF.
Verify all apprentices on jobsite -
• conduct on -site employee interviews with at least lo% of each Worker classification from
each contractor/subcontractor.
• Frequent updates to the owners.
• copy/supply all files at the end of the project to the owner.
Attend any Audits/Inspections performed by Sate or Federal Agencies that may be''n'e'flt
from our attendance.
•. Provide any documents requested through the Freedom of Information Pict if requested by
owner or funding agency.
*Total contract time is 578 calendar da s
*DBEIWBE certification Attached
P.O. Box 428 - Arcadia, IN 45030 • PH: 317-984-8639 * FX: 317-9844459
EXHIBIT V
PAGE, 3GF15
Mendenhall &-
Associates, uc .
REFERENCES
Am Hennin er SRF cvrri �iarice �f�ce Indiana Finance. A" thori
= Contact:317-232-6555
Project: various throughout Indiana
Sandy Proctor, _clerk_ Treasurer, Town of Mh, netown;,
r
Contact: 755-234-2154
Project: Waynetown Wastewater Improvement Project
All Stong.1 Prdsildent Prio'eft Marla g er -'.cnmmvnWea ith En - ineers Inc.:
Contact: 317-8 8 8--117 7
Project: Crown Point, Fairmount, CulMew Subdivision and Terre Haute
.Eii`ah W, Weich R.E. I District.En 'ineer Richrnand Sanita ' District
Contact: 765-983 -7483
Project: Richmond NW 13th Street Interceptor Replacement
P.O. Box 428 • Arcadia, IN 46030 • PH: 317-984-8639 • Fx: 317-984-7459
EXHIBITS' PACE 4 of 15
Mendenhall
Associates, «c
Name:
Mendenhall & Associates;' 'L. L. C.
2019: DBE/WBE Certified
Address:.
Brief description -of the firm:
P.O. Box 428
Mendenhall & Associates has pleasure
..the
of helping.communities write and adminis--
Arcadia, Indiana 45030
ter private, state, and federal funds for in-
frastructure projects. Primarily our grant
administration services are provided to
communities throughout Central Indiana.
Key Personnel;
ring Al 'eneSonIeO.Afanagor
- - -- . - - -.
Grant Application Coordinator
Public Hearing Conductorjr
Project Manager
Financial Management
Obtains Release. of Funds
Labor Standards =
=
Interviews
Closeout
�y
alleen Fre0rnan--rAdMirristr4tive Coordinator.
Mendenhall
�.
Semi -Annual Reports
Financial Management — Process of -Clams
Prepare Close-out Documents
Somer,AgfiP iens� tabor.�n�fards Special►st
i
'
Weekly Payrolls
Davis Bacon page -Compliance
?-'=-- - - -
Typing of Meeting Minutes
Public Hearing Advertisements
P.0. Box 428 • Arcadia, I 46430 • PH: 317-984-8639 • FX: 317-984-7459
EXHIBIT'B'
PAGE 5 OF 15
Mendenhall &
Associates, -LLB_ � � _ Tina Mendenhall Henderson
Mendenhall & Associates, L.L.C.
EDUCATION:
Vincennes University, Associates in Science
Purdue University, Speech Pathology
EXPERIENCE:
rrent: Certified saot Blok- Grant AdMinistrator:139 CuCrnv
•� During this time Tina has managed over 500 million dollars of federal funding.
1000- current: Tina Wenderson I's the-' President=of Mendenhall and' AS-S'oclattis:
• Tina -Henderson established this company to help communities throughout Indiana meet_ state
and federal funding requirements.
This .involves grant writing, grant management, .financial management, environmental : reviews, .
project planning, labor standards compliance and file management.
200— Ciii rent: Indiana Finance Autfiorih& Northwest Labor 'Standards Administrator:
Indiana Finance Authority hired Tina Henderson as. project manager along with ' Mendenhall and.,
Associates, to serve as the Northwest Labor Administrator for the State Revolving, Loan Fund
(SRF) Program.
This contract allows our company to over see approximately $200 million dollars in federal EPA
loan funds -for a variety of water, wastewater, stormwater and Combined Sewer overflow pro-
jects.
:• . The primary responsibility of this contract -was administering labor standards that started at the
bid process and ended once the project was 100% complete.
2003-Current; In i na �r�awnfields .Labor.Aidministrator:
• Indiana Brow' nflelds hired Tina Henderson as. the Project Manager along with Mendenhall and
.Associates to complete labor standards administration for the Indiana Brownfield program.
: This contract allows Mendenhall and Associates to work across the State of Indiana helping com-
munities to environmentally cidan up designated, brownfield projects.
• . The primary responsibility of this contract was administering labor standards that started_ atAhe
bid process and- ended once the project was 100% complete.
2010-2016: Indiana Office of Communft and Rural Affairs .Instructor: -
Tina Henderson was selected ' as an instructor to . certify grant administrators for' the community
Development Block Grant Program. =
2018-2026-"DIG INDY" LASaR ADMINISTRATOR .FOR CITIZE14S ENERGY .GROUN'
Tina Henderson was selected and is serving as the Labor Administrator,, Project Manager for -the.,
Dig Indy --Deep Tunnel project.
P.O. Box 428 • Arcadia, IN 46030 • PH: 317-984-8539 • Fx: 317-984-7459
EXHIBIT U PAGE 6 OF 15
I"
7
.Mendenhall & = �_
Associates, uc ..
Somer Stephens
Mendenhall & Associates. L. L.C.
EDUCATION:
Ball State University, Muncie, Indiana
Bachelor of Arts -- Pre --Professional English
Indiana Office of Community and Rural Affairs
CDBG Grant Accreditation course -- certified Grant. Administrator Since 2009
KEY QUALIiFICATION
Experience working with. the Indiana Finance -Authority (IFA) through the State Revolving- Loan Fund
(SRF) with :funds made available through the American Recovery and Reinvestment Act (ARRA).
Key responsibilities include completing and reporting labor standards forms, tracking payroll activi-
ties on- contractors and subcontractors including wage compliance, benefits, apprenticeships and
employee interviews.
RECENT, PR03 ECT"'EXPERI EN CE:
Town ,o_ f LadlogaL.The Town of Ladoga was awarded $506,000 through SRF for a Sanitary Sewer
System Rehabilitation project.
City. cif Lafayette_ The city of Lafayette was awarded $2,,552,,500 through SRF for a waste water
Treatment Plant' Improvements project.
dly of East. Chica o: The City of East Chicago was awarded $54-400,,000 through SRF for a new
Water Treatment Plant.
Cof Hammond: The city of Hammond was awarded $1,,072,,682 through ' SRF for a Water - Fil-
tration Plant Exterior Restoration project.
..Citv of Mishawaka: The city of Mishawaka was awarded $4,,120,,000 through SRF for a waste
Water Treatment Plant .Improvements and Force Main Rehabilitation project,
ilty of Rdn elear: :The city of Rensselear was awarded $3,780.,000 through_ - SRF for a Waste
Water Treatment Plant Improvements project.
C,j.of S0.herervi1le:-- The City of Schererville was awarded $8,,885,668 through SRF for a Waste
Water Treatment Plant and Collection System Upgrade project.
Cif of South =Ben+ The City of South Bend was awarded $813,530 through SRF for a Drinking
Water project and $2,,066,100 for a waste water project.
Town- of -Hebron: The Town of Hebron was awarded $255,,000 through SRF for an Ultraviolet Dis-
infection System project.
City .of V616a'rai.%0:. The City of Va Ipa ra iso was awarded $307,.000 through SRF .for a Sewer Re -
The City project. -
Cily of Goshen: The City of Goshen was awarded $35,,160,000 through SRF for Sewer and waste
Water System Improvements.
:Citizens En@r�y, Group ,Citizens Energy Group was awarded over 1 biIlion dollars in federal EPA
funds through SRF to complete the "Dig Indy— Deep Tunnel System project. This project is slated to
end in 2026.-- -
P.o. Box 428 v Arcadia, III 4.6030 • PH: 317-984-8639 • FX: 317-984-7459
EXHIBIT U PAGE 7 OF 15
Mendenhall &
Colleen Freeman
Associates, LLc.
Mendenhall & Associates, L.L.C.
CDBG Grant Accreditation course —Certified Grant Administrator Since 2000
K-EY!QUAL1Ai'It�H :
Colleen has more than eighteen years of experience with the community Development -Block Grant
• program, financial management. She maintains several financial records, and has prepared the fol-
lowing communities fora State- Board of Account Audit: Sheridan, Windfall, Howard county, Rus-
siaville, Sandborn; Arcadia, Atlanta, waynetown, Clinton- county, Elkhart, Carroll county, Marion,
Fairmount, Michigantown, Kempton and Colfax.
KtCEN't PROJECT EJ{PERIENCE:
Town of Sheridan: 'The Town of Sheridan received $500,,000.00 in CDBG grant to make improve-
ments to -their Stormwater System.
Town .of'iehigantowr:. The Town of Michiga ntowri received a $600,,000.00..rant from the Indl-
ana Office of Community and Rural Affairs to improve the Town"s wastewater System.
own df �Fairmm�unfunding through.
t:• The Town .af Fairma_ unt has received a $500,000.00 grant
the Indiana Office of community and Rural Affairs for the. Town's Main'Street Revitalization project.
Itand ly: Randolph county has received two. grants from the Indiana. Office of. Communi-
ty and Rural Affairs. Randolph county received a $250,,000.00 workforce Development grant and- a
$500,,000.00 grant to build a Fire Station.'
:City .of Wabash_: The city of Wabash received $1,700,000.00 stellar grant for the Eagles Theatre
Improvements project.
Town cif Cicero: The Town of Cicero received a $400,000.00 CDBG grant from the Indiana Office
of community and Rural Affairs for their Downtown • Revitalization project.
Tbvvn of Wa etown: The Town of waynetown received a $500,,000.00 CDBG,grant from the
Indiana Office of community and Rural Affairs to improve their Drinking !hater within the Town lim-
its.
How- and ,C6unjif: Howard county received $500,000200 in CDBG grant to make -improvements to
New London's Wastewater.
2014 -1017 .CDBG_ -Planning, Grants: Town - of Galveston,, Town of Converse,
Town of Sheridan, Town of Miehigantown, -Town of Springport
P.O. Box 428 • Arcadia, IN 46034 • PH: 317-984-8639 • FX: 317-984-7459
EXHIBIT'B' PAGE 8 OF 15
r Mendenhall&
Associates, LLC
LIST OF :PRO;ECT'SSHOWING EXPERIENCE WITH LABOR STANDARDS:
Town of Amo -- Interurban Station
Howard County - Taylor.Twp Sewer- Project
Town of LaGro - Water Project
City of Wabash -- Downtown Revitalization
Town of veedersbu rg- ' Wastewater Improvement Project
Town of Reynolds -'Sewer Project
'Town of Sandborn -- Wastewater Project
Town of Bunker Hill -- Wastewater
Clinton Country- Library _
Carroll County,-- Carroll Manor Renovations
Waynetown -- Water
Town of North Manchester -- Downtown Revitalization
-Town of Clayton-- Stormwater
City of Marion- Splash Park -- Program Income Project
Town of Advance Water Project
-Town of -Atlanta- Stormwater PIanning grant
city .of Marion Splash. House =
city of East Chicago- Labor. Standards
City of Goshen-- Labor Standards
.City of Richmond- Labor Standards
city of Tipton -Labor Standards
Montgomery County-- Labor Standards
St. Joseph county-- Labor Standards
City of Mishawaka- Labor Standards
City of Connersville- Labor Standards
Town of Breman- Labor Standards
City of Angola- Labor Standards
City of - Shelbyville- Labor Standards
City of Columbus Labor Standards
City of Princeton, Brownfelds- Labor Standards
City of Portland, Brownfelds-- labor Standards
..�Town of Chesterfield, Brow_nfelds- Labor Standards-
P.O. Box 428 • Arcadia, IN 46030 - PH: 317-984-8639 • FX: 317-9"7459
- EXHIBIT'B' PAGE 9 of 15
Or
Mendenhall &
Associates, LLC
LIST PROJECT CONTINUED:- .
North Manchester- wastewater Improvement Project
North Manchester-- Stormwater Improvement Project
Town of Atlanta- Stormwater Improvement Project
Town of Atlanta- wastewater Improvement Project
Town of Clayton- wastewater Improvement
Town of Advance- Wastewater Improvement
Town of Sheridan wastewater Improvement Project
Town of Waynetown- wastewater ' Improvement Project
Town of Michiganto►nrn- Wastenrater Improvement Project
Howard County/City of Kokomo- Installations of Sanitary Sewers for Darrough Chapel
Town of Atlanta- Stormwater
City of Crown Point— Labor Standards
City of Rensselaer —Labor Standards
Town of Chesterton— Labor Standards
City of Hammond— Labor Standards
City of Jeffarsonviile--- Labor Standards . .
City of Terre Haute— Labor Standards
City of Winchester— Labor Standards
City of west Lafayette— Labor Standards
Town of Schererville-- Labor Standards
City of Michigan City-- Labor Standards
City,.of -Logansport Labor Standards
City of Valparaiso— Labor Standards
City of Lake Station— Labor Standards
Henry County, Fire Station-- Labor Standards
Randolph County, Fire Station— Labor Standards _
Town of Arcadia, wastewater— Labor Standards
Town of Cicero Facades— Labor Standards
City of Wabash., Brownfields Labor Standards
City of Alexandria, Brownfields— Labor Standards
City of Indianapolis, Brownfields Labor Standards
-_ --Qt Brownf eids : 1abor Standards
P.o. Box 428 a Arcadia, I N 46030 a PH: 317-984-8639 FX: 317-984-7459
EXHIBIT'B' PAGE 10 of 15
-CC>REF ,� CERTIFICATE O� LIABILITY�N�L�RANCE
DATE (hrlWDDIYYW)
8113/2019
THIS CERTIFICATE IS ISSUED AS A FATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE -OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: `if the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies} must have ADDITIONAL INSURED -provisions or b6widorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCECONTAGI
R
Dan Shields insurance Y A enc
g
616 Marion Ave P.O. Box 501
Arcadia IN 46030
NAME:'Steve Squklo�k
PHDR5FAX
Ext .. -,•(3i7) 984-3628 AlC�No ; 3179842304
Al No .
ADDRESS:: secs'Crishieid:iturnc.egm:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: SELECTIVE INS CO OF SC
19259
INSURED
MENDENHALL & ASSOCIATES LLC.
PO -BOAC 428
ARCADIA IN 46030-0428
INSURER B : SELECTIVE INS CO OF AMER
12572
INSURER C :- STARSTONE SPWALTY INSURANCE COMPANY
44776
INSURER D'.
INSURER E.I
INSURER F ;
CC]VFRAnFR r.FRTIF[CATF IU[ IMRFR■ RFVISIrlM I1II IFARFR-
THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOR13E❑ BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
LTR
TYPE OF INSURANCE
INSD
"WVD
POLICY NUMBER
(MWDDIYYYYI
(MMMDTYYYY).
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F)CI OCCUR
S 2349324
09/20/2018
09/20/20,19
EACH OCCURRENCE
$ 2,000,000
PREMISES.Ma o=rrencel
S 5001000.
ME❑ EXP (Any one person)
$ 153000
PERSONAL 8 ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY 5c] EKLDC
PRo-OTHER:
GENERAL AGGREGATE
S 4,000,000
PRODUCTS - COMPlOP AGG
$ 4,000,000
$
A
AUTOMOBILE LIAHIUTY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY K AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
S 2349324
.09/20/2018
09/20/2019
WMUINtU MNUIE CIR 1 -
(Es accident),-:'>
$ 1 000 000
>
BODILY INJURY [Per person]
$
80011:Y INJURY (Per accident)
$
Per acaiden1
$
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
S
AGGREGATE'.H
S
DED RETENTION $
$
H
aRKERS COMP�MArraN - .. -
D EMPLOYERS' LIABILITY YIN
r-FF ICER)MEMMBER X LU0_EDD? CUTfVE 1_I
t � In�N
s:de�be r rider
CRIPTIONCIF OPERATIONS below
N1A
WC 9055890
09/20/2018
09/20/2019
-
STATUTE. ER
E`L' EACH ACCIaENT
$dl
E,L. DISEASE - EA EMPLOYEE
$ 5003000
E,L ❑ISEASE - POLICY LIMIT
$ 500,000
C
nvironmental and Energy Errors and-
Omissions Liability
185125180aem
09/20/2018
09/20/2019
Errors & Ornissions
Aggregate
5,000,000
DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES (ACORD 101, AddltIonal Remarks Schedule, may be attached IF mare space Is required)
CERTIFICATE HOLDER CANCELLABON
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
5�;�,�. �g�i►r�
Q1988-2015 ACORD CORPORATION. All rights reserved.
ACORD.25 (2016103) . The ACORD name and logo are registered marks of ACORD-
EXHIBIT'B' PAGE 11 OF 15
Affidavit of Employment EIigibility Verification (E-Verify)
AA
The Contractor, .t- -.I�Lvdc affirms under the penalties of perjury that
Contractor does not knowingly employ an unauthorized alien. If Contractor is self-employed and
does not employ any employees., Contractor verifies he or she is a United States citizen or
qualified alien.
The Contractor has not .knowingly employed or contracted with an unauthorized alien and shall
not retain an employee or contract with a person that the Contractor subsequently learns is an
unauthorized alien. Pursuant to Indiana Code 22-5-1.7, Contractor has enrolled in and verified
the work eligibility status of all newly hired employees of the contractor through the Indiana E-
Verify program.
The Contractor has required Contractor's subcontractors to certify to the Contractor that the
subcontractor does not knowingly employ or contract with an unauthorized alien and that the
subcontractor has enrolled and is -participating in the E--Verify program. The Contractor will
maintain this certification throughout the duration of the term of a contract with a. subcontractor:
I hereby verify under the penalty of perjury that the foregoing statement is true,
�I
Dated this day of . �/1'1(� � r 20A
.�-gnature) - }
evicltrson,
(Printed Name)
EXHIBIT 'B' PAGE 12 of 15
IIM1��� i�ETIF�'-�F Si1TtM
Driving Indidi a s Economic Growth
100 North Senate Avenue PHONE: (317) 2334664 Eric Holcomb, Governor
-Room N750 FAX, (317) 233-0891 - Joe MCGUInnesp,
Indianapolis, indivna 4620d CoMmIssloner- •
_ 02/06/2019
Mendenhall & Associates LLC
27110 Startsman Road
Arcadia, IN.46030
'Dear Tina: Henderson,' President:
Subject: DBEIACDBE Certification Letter
-The Indiana Department of Transportation (INDOT) thanks you For submitting an application For certification as a
Disadvantaged Business Enterprise (DBE):
We are pleased to inform you, based upon our review of the information submitted, your company is hereby certified to bid and participate :as_a:DBE firm on -State of Indiana federally -funded transportation -related contracts.
Your company is certifled'as a DBE only in the areas fisted on the attachment to this letter. This sheet also shows the NAICS
Codes we have assigned to the areas of work in which you are certified:
Please review the list of DBE Codes that can be accessed via link on the INDOT DBE =
:website: '�► - T to ensure that -the proper -code -has been assigned- for the type of work that -you
have been certified to perform. Please note that the DBE Codes are very general and are used only to assist our customers
in searching the. INDOT DBE Directory for certified. firms to meet the contract goal. INDOT-will. assign the NAICS Code _
appropriate for your firm. If you disagree with our NAICS Code assignment, you may contact. us to request reconsideration:
If your business should develop the resources and expertise, including -.equipment and personnel, to work in other fields and
you wish to be certified In- those areas, you must request an additional certification determination from this offlce:prior to
performing those functions for DBE credit. Such a. request may require you to provide additional -documentation and receive
an additional site -visit, Conversely,: if your business no longer has the ability to -perform certaain.types of work -or loses its
:pre-quallfication status in certain areas, INDOT must be -notified of those changes within (?) business days of the change.
To maintain your DBE:stetus,- you must -notify INDOT Imnedlately of any change In location or contact Information, including
an updated email address. You must also inform INDOT in writing of any change in circumstances affecting your ability to
meet size, disadvantaged status ownership, or control requirements or any material change to the information provided In
.your application. The information above must be received -by INDOT within seven business days of the change. Failure to do
so may result in revocation :of your firafs certification.
This certifcation status with INDOT, remains effective provided there are no changes in your firm pertinent to your certification
eligibility. You will be asked to submit an annual affidavit certifying that there have been no such changes.
INDOT reserves the right to rescind this certification if any of the following are found to -be true: 1) the above requirements are
not met; 2) the information upon which the certification is based proves to be false, Inaccurate or misleading; 3) other just
cause. is determined through established investigative procedures.
This certification is separate from INDOT`s determination of contractor qualification pursuant to its Prequalification Program
Indiana Code 8-23-2 6, 105 IAC11-1-1 et seq., and does:not guarantee.[NDOT prequaiiftcation status. Also, this, certification
Is not necessarily accepted by other states and does not validate the capability or capacity..of your firm to perform in the
area(s) for which•yon have been certified.
Please address questions -regarding this certification to the Indiana Department of Transportation, .Economic Opportunity
Division, atdb eeriiilcatlon ...1.. doll., ov
w&vW in go vlda d
: An Egpat Opportunity Employer Indiana
I;r— Ef
', ou
EXHlB1T'B' PAGE-13 OF 15
I EENT-OFT►._-� �M
Driving IndianA"s Economic Growth
_ 100 North Senate Avenue PHONE: (317) 233-4684
:rg�Room NTSG - � FAX: (31Tj 233-oeg� ErinHnlcnmb, OnvArnor .
Joe McGuinness,
- tndlemapnils, Indiana 48204; Commissioner
Sincer6ly,
derrick Casson
Certification Manager, Economic Opportunity Division
Indiana Department of Transportation
cc: fife
t%vw, in go v1dotl
An Equal Opportunity Empiayer
EXHIBIT'B'
` 1nd!ana.
PAGE '14OF'15
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492110
Couriers and Express
Deliver Files, Posters,
Services
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Cities, Towns, and Counties
0055.25P
Administrative Management
541611
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Labor Standards/Davis Bacon,
& General Management
and General Management
General Construction
Consulting
Consulting Services
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Renews, Financial
Management, Project
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4055,137P
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541990
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0053.95G
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Services
Servio®s
Bacon, Civil Rights, Land
Conversions_ , Acquisitions,
Community Planning,
Procurement
0055.120P
Professional & Management
611430
Professional and
Instructonai Training and
Development Training
Management Development
Seminars
Training
0053.157G
Other General Government
921190
Other General Government
Public Audits and Hearings,
Support
Support
Community Liaison, Financial
& Escrow Management, Public
Relations
EXHIBIT'B'
PAGE 15OF15