HomeMy Public PortalAbout173-2021 - Sanitary - New Holland Dealership - Hydraulic Excavator ORIGINAL
AGREEMENT
THIS AGREEMENT made and entered into this Pi day of 'pp C e yyj b, '2021, and
referred to as Contract No. 173-2021 by and between the City of Richmond, Indiana, a municipal
corporation acting by and through its Board of Sanitary Commissioners (referred to as the
"City"), and New Holland Dealership, 3100 W. Industries Road, Richmond, IN 47374
(hereinafter referred to as the"Contractor").
SECTION I. STATEMENT AND SUBJECT OF WORK
City hereby agrees to retain Contractor for the purchase of a New Holland Mini Hydraulic
Excavator with a Swing Boom and Hydraulic Thumb. City previously issued a Price Request,
which sets forth the required specifications of the item to be purchased, which is attached hereto
and incorporated by reference herein as Exhibit "A". Contractor responded to City's Price
Request on October 20, 2021 wherein it provides the specifications of the item to be purchased,
which is attached hereto and incorporated by reference herein as Exhibit"B". Contractor shall be
responsible for all preparation, shipping and handling charges, and shall deliver the item
referenced herein to 2380 Liberty Avenue, Richmond, IN 47374. Said delivery shall by January
15,2022,or as close thereto as reasonably practicable.
Should any provisions, terms, or conditions contained in any of the documents attached hereto
and incorporated by reference herein as Exhibits, conflict with any of the provisions, terms, or
conditions of this Agreement,this Agreement shall be controlling.
The Contractor shall furnish all labor, material, equipment, and services necessary for the proper
completion of all work specified.
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(s)signed by Contractor in accordance with
I.C. § 22-5-1.7-11(a)(2); and
3. A purchase order has been issued by the Purchasing Department.
SECTION II. 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.
SECTION III. COMPENSATION
City shall pay Contractor the sum of sixty-nine thousand ninety-two dollars and 00/100
($69,092.00)as complete satisfaction under this Contract.
SECTION IV. TERM OF AGREEMENT
This Agreement shall become effective when signed by all of the parties hereto and remain in full
force and effect until Contractor completes the services described herein, and within the attached
Exhibit.
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 thirty (30) days written notice specifying the
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effective date and the reasons for termination which shall include but are 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.
This Agreement may also be terminated by either the City or the Contractor, in whole or in part,
by mutual Agreement setting forth the reasons for such termination,the effective date, and in the
case of partial termination,the portion to be terminated.
This Agreement may also be terminated by either the City or the Contractor, without cause, by
giving at least thirty(30)days written notice to the other party.
In the event of termination of this Agreement, 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.
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
B. Employer's Liability $100,000
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
$1,000,000 aggregate
F. Malpractice/Errors&Omissions Insurance $1,000,000 each occurrence
$2,000,000 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.
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 Board determines during the course
of this Agreement that this certification is no longer valid, Board shall notify Contractor
in writing of said determination and shall give contractor ninety (90) days within which
to respond to the written notice. In the event Contractor fails to demonstrate to the Board
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that the Contractor has ceased investment activities in Iran within ninety (90) days after
the written notice is given to the Contractor, the Board may proceed with any remedies it
may have pursuant to IC 5-22-16.5. In the event the Board 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 Board 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 sub-contractor, 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 5-16-6-1,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.
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.
Any person executing this Contract in a representative capacity hereby warrants that he/she has
been duly authorized by his or her principal to execute this Contract.
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 any party by virtue of the authorship of any
of the provisions of this Agreement.
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.
[Remainder of this Page Intentionally Left Blank. Signatures to Follow on Page Six]
"CONTRACTOR"
New Holland D rship
41/
By: ..)
(Printed): re;__. (A.)a1 /kc-
Title: oil a nadts-
Dated: /-9/r3 8 I a 0 a if
"CITY"
The City of Richmond,Indiana,by and
through its Board of Sanitary
Commiss. ners
Sue Miller,President
Dated: /Z
an B , ice President
Dated: 12 -lI,-21
401 ein Member
Dated: /4 / V rZ
APPROVED:
r
avi . Sno , a
Dated: 22407-1
7 Page
.
Exhibit A to Contract: City and New Holland
•
FRICi747 REQUEST
eaccl
F .
*i414
A
CITY OF RICHMON
DEPARTMENT ESANITATION
2380LIB VENURICHMOND,INDIANA47374 THIS IS NOT AN RD 1ER .
PHONE(765)983-7450017AX(765)962 2669
VENDOR INSTRUCTIONS
This is a request for a price for the services of materials
described below. Any additional specifications may be
attached hereto. This is NOT an order and the City reserves
the right to accept all or part, or decline the entire proposal.
Please complete your full name and phone number below
with signature; Itemize all prices and charges where
requested;and attach any explanation for any substitution to
specifications altered. Return in a sealed envelope,In care of
Richmond Sanitary District Board of Commissioners to
the administration building at the address above by the
• specified date and time to be considered.
DATE: REPLY MUST BE IN BY: PAYMENT TERMS: DELIVERY REQUIRED:
October 5,2021 9:00 A.M.on October 26,2021 UPON RECEIPT OF INVOICE DELIVERED
DESCRIPTION
This is a request for quotes to purchase a Mini Hydraulic Excavator with Swing Boom and Hydraulic Thumb. Please
see attached specifications. Please include all warranty information with quote. E-Verify requirements and Indiana
Local Preference Claims will apply to this quote,information enclosed.
Return this sheet and the proposal sheet in a sealed envelope addressed to
Richmond Sanitary District
Denise Johnson,Customer Service Mgr
2380 Liberty Avenue
Richmond,IN 47374
Re: Mini Hydraulic excavator
Quote Valid Until
Questions? Call Jeff Lohmoeller at 765-993-2670 or 765-983-7464.
NAME OF FIRM QUOTING:
BY:
STATE TAX EXEMPTION#003121909-001
AUTHORIZED BY SIGNATURE
TITLE
Richmond Sanitary District DATE PHONE NUMBER
EXHIBIT '/ PAGE. / O. >
•
The Richmond Sanitary District is requesting quotes for a new
Mini Hydraulic Excavator with Swing Boom and Hydraulic Thumb
Minimum Specification for Mini Hydraulic Excavator
1. Control Pattern Changer Yes No Other
2. Alarm Travel Indicator Yes No Other
3. Engine,EPA Tier 4F Rated Net Power @ 2,200 RPM 40.2 Hp
Yes No Other
4. Cab.W/Air Conditioner Yes No Other
5. Seat,Fabric High.Back Suspension Yes No Other
6. Mirror,Cab,Right Yes . No . Other. .
7. Belt,Seat,3"Retractable Yes No Other
8. Hydraulic Thumb for 5-6T Excavator Yes. No Other
9. Must have Service/Repair Center within "50 mile radius" Yes No Other
Minimum Specifications
Engine..
Engine Model* ... Cat C2.4
Rated Net Power @ 2,200 ipm
ISO 9249/EEC 80/1269 30 kW 40.2 hp
Gross Power ISO 14396 31.2 kW 41.8 hp
Bore 87:mm 3.4 in
Stroke . 102.4 mm 4 in
Displacement 2.4 L 146 in3
*Meets.U.S.EPA Tier 4 Final/EU Stage_MA emission standards.
Meets or exceeds specification above: Yes No Other
Weights*
Weight-Canopy,Standard Stick 4975 kg 10,970 lb
Weight—Canopy,Long Stick 5020 kg 11,069 lb
Weight—Cab,Standard Stick 5140 kg 11,334 lb
Weight—Cab,Long Stick 5185 kg 11,443 lb
Weight includes counterweight,rubber tracks,bucket, operator,full fuel in and auxiliary lines.
Meets or exceeds specification above: Yes No - Other
1
• EXHIBIT. PAGE @FrY
Swing System
Machine Swing Speed 10 rpm
Boom Swing—Left* (without stop) 80°
Boom Swing-Left*(with stop) 60°
Boom Swing—Right 500
*Automatic swing brake,spring applied,hydraulic release:
Meets or exceeds specification above: Yes No Other
Travel System
• Travel Speed—High 4.4 km/h 2.7 mph
Travel Speed-Low 2.8 km/h 1.7 mph
Max Traction Force—High Speed 24.1 kN 5,418 lb
Max Traction Force—Low Speed 45.2 kN 10,161 lb •
Ground Pressure—Canopy 29.5 kPa 4.3 psi
Ground Pressure—Cab 30.5 kPa 4.4 psi
Gradeability(maximum) 30°
Meets or exceeds specification above: Yes No Other
Service Refill Capacities
Cooling System 10.5 L 2.8 gal
Engine Oil 9.5 L 2.5 gal
Fuel Tank 63 L 16.6 gal
Hydraulic Tank. 68.3 L 18 gal
Hydraulic System 78 L 20.6 gal
Meets or exceeds specification above: Yes No Other
Hydraulic System
Load Sensing Hydraulics with Variable Displacement Piston Pump
Pump Flow at 2,400 rpm 150 L/min 39.6 gal/mini
Operating Pressure—Equipment 245 bar 3,553 psi
Operating Pressure—Travel 245 bar 3,553 psi
Operating Pressure—Swing 216 bar 3,132 psi •
Auxiliary Circuit—Primary
(186 bar/2,734psi) 80 L/min 21.1 gal/min •
Auxiliary Circuit-Secondary
(174 bar/2,524 psi) 25 L/min 6.6 gal/min
Digging Force-Stick(standard) 24.71tN 5,550 lb
Digging Force—Stick(long) 21.3 kN 4,788 lb
. Digging Force—Bucket 44.7 kN . 10,050 lb
Meets or exceeds specification above: Yes No Other
EXHIBIT 1'�J ._ PAGE 3 M
2
•
II
Blade
Width 1980 mm 78.0 in
Height 375 mm 148 in
Dig Depth 555 mm. 21.9in
Lift Height 405 mm 15.9 in.
Meets or exceeds specification above: Yes No Other
Cab
Dynamic Operator Sound Pressure Level 81 dB(A)
(ISO 6396:2008)
Exterior Sound Power Level 96 c1B(A)
(ISO 6395:2008)*
*European Union Directive"2000/14/EC"
Meets or exceeds specification above: Yes No Other
Certification—Cab and Canopy
Roll Over Protective Structure(ROPS) ISO 12117-2
Tip Over Protective Structure(TOPS) ISO 12117
Top Guard ISO 10262(Level I)
Meets or exceeds specification above: Yes No Other
Operating Specifications
Stick Length—Standard 1350 mm 52 in
Stick Length—Long 1750 mm 67 in
Meets or exceeds specification above: Yes No Other
Undercarriage
Number of Carrier Rollers 1
Number of Track Rollers 4
Track Roller Type Center Flange
Meets or exceeds specification above: Yes No Other
Lift Capacities at Ground.Level*
Lift Point Radius 3000 nun(9'8") 4000 mm(13'1")
Front Side Front Side
Blade Down kg 2340 1200 1260 640
(lb) (5,159)(2,646) (2,646)(1,411)
Blade Up kg 1450 1070 760 570
(lb) (3,197)(2,646) (1,676)(1,257)
*The above loads are in compliance with hydraulic excavator lift capacity rating standard ISO
10567:2007 and they do not exceed 87%of hydraulic lifting capacity or 75%of tipping capacity.The
excavator bucket weight is not included on this chart.Lifting capacities are for standard stick.
Meets or exceeds specification above: Yes No Other
EXHIBIT Ply 3
•
•
Air Conditioning System
The air conditioning system on this machine contains the fluorinated greenhouse gas refrigerant
R134a(Global Warming Potential 1430)The system contains 1.0kg of refrigerant which has a
CO2 equivalent of 1.4 metric tons.
Meets or exceeds specification above: Yes. No Other
Dimensions Standard Stick Long Stick
1 Dig Depth 3280 mm 129 in 3670.mm 144 in
2.Vertical Wall 2320 mm 91 in 2630 mm 104 in
3 Maximum Reach at Ground Level 5330 mm 210 in 5810 mm 229 in
4 Maximum Reach 5600 mm 220 in • 5960 mm 235 in
5 Maximum Dig Height 5250 mm .207 in 5440 mm 214.in
6 Maximum Dump Clearance 3720 mm 129 in 3920 mm 154 in .
7 Boom In Reach 2350 mm 93 in. 2530 mm 100 in
8 Tail Swing 1100 mm 43 in 1100 mm 43 in
9 Maximum Blade Height 405 mm 16 in 405 mm 16 in
10 Maximum Blade Depth 555 mm 22 in 555 mm 22 in
11 Boom Height in.Shipping Position 1750 mm 69 in 2150 mm 85 in
12 0/A Shipping Height 255.0 mm 100 in 2550 mm 100 in
g
13 Swing Bearing Height 615 mm 24 in 615 mm 24 in
14 0/A Undercarriage Length 2580•mm 102 in 2580 mm 102 in
15 0/A Shipping Length 5180 mm 204 in 5290 mm 208 in
16 Boom Swing Right 785 mm 31 in 785 mm 31 in
17 Boom Swing Left 695 mm 27 in 695 mm 27 in
18 Track Belt/Shoe Width 400 mm 16 in 400 mm 16 in
19 0/A Track Width 1980 min 78 in 1980 mm 78 in
Meets or exceeds specification above: Yes No Other
STANDARD EQUIPMENT
ENGINE
Cat,C2.4 diesel engine(meets U.S.EPA Tier 4
Final emission standards for North America
and EU Stage IIIA/Tier 4 Interim emission
standards for all other regions)
Automatic engine idle
Automatic engine shut-off.
Automatic two speed travel
Diesel Particulate Filter(North America only)
Diesel Oxidation Catalyst(North America only)
Fuel and water separator
Power on demand
Meets or exceeds specification above: Yes No Other
EXHIBIT P OF
4
A
OPERATOR ENVIRONMENT
100%pilot control ergonomic joysticks
Adjustable armrests
COMPASS: complete, operation,maintenance,performance and security system o Multiple
languages
Cup holder
Hydraulic neutral lockout bar
Literature holder
Pattern changer(optional in Europe)
Site reference system: leveling
Tool storage area
Travel control pedals with hand levers •
Washable floor mat
Meets or exceeds specification above: Yes No Other
•
ELECTRICAL
12 volt electrical system
60 ampere alternator
650 CCA maintenance free battery
Fuse box
Ignition key start/stop switch
Slow blow fuse
Warning horn
Meets or exceeds specification above: Yes No Other
HYDRAULIC SYSTEM
1-way and 2-way(combined function)
Accumulator
Automatic swing parking brake
Auxiliary hydraulic lines
Adjustable auxiliary relief
Auxiliary line quick disconnects
Cat interlock system:hydraulic lockout
Continuous auxiliary flow
Load sensing/flow sharing
Ecology drain
Hydraulic oil cooler
Meets or exceeds specification above:
Yes No Other
LIGHTS AND MIRRORS
Boom light with time delay capability
Meets or exceeds specification above: Yes No Other
yj
EXHIBIT A.PACE OF /7 5
•
SAFETY AND SECURITY
Anti-theft system(COMPASS)
Caterpillar Corporate"One Key"System
Door locks
Lockable fuel cap
Retractable seat belt
Roll Over Protective Structure(BOPS)(ISO 12117-2)
Tip Over Protective Structure(TOPS) (ISO 12117)
Top guard—ISO 10262(Level 1)
Meets or exceeds specification above: Yes No Other
UNDERCARRIAGE
Dozer blade with float function
Track,rubber belt,400 mm(16 in)width
Tie down eyes on track frame
Towing eye on base frame
Meets or exceeds specification above: Yes No .Other
FRONT LINKAGE
200 degree bucket rotation Certified lifting eye on.bucket linkage
Front shovel capable
Thumb ready stick
Meets or exceeds specification above: Yes No Other
'L
EXHIBIT PAGE;1 OF 6
Proposal'Sheet
Hydraulic Mini Excavator with Swing Boom and Hydraulic Thumb
Awarding dealer is responsible for warranty work during duration of warranty period including
transportation or other expenses incurred if any warranty work is done at any location other than
that of the awarding dealer.
Bid to include all prep,shipping,and handling charges.
Mini Excavator is to be delivered to 2380 Liberty Avenue,Richmond,Indiana 47374
Make andd Model Number:
Total Price of Hydraulic Mini Excavator withSwing Boom and Hydraulic Thumb:
Bid firm for}pow long:
•
Delivery Time after PO has been issued:
Dealer and Salesperson Name:
E-Verification form filled out: Yes. No
Local Preference Claim: • Yes No
Iran Investments: Yes No
•
Exl u 3IT A . PAGE r pic.a
l i
' I
Indiana Local]Preference cClaiim:
•
Definitions: • •
Affected County_Wayne County or an adjacent county.
•
Local Indiana lausiness—A business whose principal place of business is in an Affected County; a
business.that pays a majority of its payroll(in dollar volume)to residents of Affected Counties; or a
business that employees residents of Affected Counties as a majority of its employees.
•
Local?reference Documentation •
If the Bidder is claiming local preference as defined by Indiana Code 5-22-15-20.9,it shall include such
clan►with its Bid. In addition the Bidder shall submit,as a Post-Bid submittal, all documentation
required by the Local Indiana Preference form.
lithe Bidder is a Joint Venture and is claiming local preference pursuant.to•Indiana Code 5-22-15-20.9,
the Bidder shall submit all post bid documentation as required by the Post-Bid submittals. In.
determining whether the Joint Venture qualifies as a Local Indiana Business,as defined by Indiana Code
5-22-15-20.9,the Owner will evaluate the Joint Venture by combining each business's total payroll,
payroll paid to residents of Affected Counties,total number of employees,and total number of
employees who are residents of Affected Counties. Further,each part of the Joint Venture shall submit
the location of it's principal place of business will be a consideration in whether the Joint Venture
qualifies as a local Indiana business; The Owner will determine whether the Joint Venture qualifies as a
Local Indiana business. The total overall Joint Venture must qualify as a Local Indiana Business to •
receive the local preference as defined in Indiana Code 5-22-15-20.9.
Subject to Indiana Code 5-22-1520.9,award of the Contract will be made to the lowest,responsive and
responsible Bidder,where the Bid is reasonable and does not exceed the funds available for the project.
The Owner reserves the right to reject all Bids and may waive or allow a Bidder to correct errors,
omissions or other irregularities in Bid Documents that are found not to have afforded the Bidder a
• substantial competitive advantage over other Bidders.
•
EXHIBIT.. PAGE •
•
•
•
INDIANA LOCAL PI81E+ +RIENCJE CLAIM
(Only fill oat this Part of claiming to'be a Loe• Indiana liminess)
•
Pursuant to Indiana Code.5-22-15-20.9, •
(Name of Business)
Claims a local Indiana business preference for the bid for Project
in Wayne County,Indiana.
(Name of Project)
The Claim of applicability of the Local Indiana Business preference is based upon the following
•
(Check all that apply) •
❑ .1. The location of the Business's principal place of business is:
A) in Wayne County, or
B) in an adjacent county.
❑ 2. The majority of the business's payroll,for the previous twelve(12)months from the
date of this Bid,is to residents in Wayne or an adjacent county.
•
❑ 3. The majority of the business's employee's,for the previous twelve(12)months from
the date of th tc Bid,are residents of Wayne or an adjacent county.
If business is deemed to be the apparent low bidder,business shall provide information pursuant to
Post-Bid submittal(Local Indiana Business Preference),to substantiate the clamp of a local Indiana
business.
EXHIBIT PAGE 1D oFJ/
POST B]UL SUBMITTAL
Local Indiana Business Preference
Pursuant to the City of Richmond Bidding and Contract Requirements,this application for the local
Indiana business,pursuant to Indiana Code section 5-22-15-20.9,is hereby submitted for the Project
listed below by Bidder/Applicant(hereinafter Bidder). (Use additional sheets if necessary.)
Date Bid Submitted: Project Number:
Project Name:
Bidder:
Contact Name: • Phone Number:
Principal Place of Business:
Number of Months Address has been Principal Place of Business:
Number of all Employees for the twelve(12)months prior to the date of Bid submission:
Number of Employees who were residents of Affected Counties for the twelve(12)months prior to
the date of Bide submission:
1. If the Bidder claims it is a local Indiana business because the Bidder's principal place of business
is in Wayne County or an adjacent county,give a statement explaining the reasons the business
considers the location named as the business's principal place of business:
2. In order to claim local preference pursuant to IndianaCode section 5-22-15-20.9,the Bidder
must supply below its total payroll and the amount of the business's payroll paid t residents of
Affected Counties for the previous twelve(12)months from the date of the Bid.
a. Total Amount of payroll paid to all employees of Bidder in the previous twelve(12)
months from the date of the Bid: $
b. Total Amount of payroll paid to residents of affected counties for the previous twelve
(12)months from the date of the Bid:
Bidder shall supply supporting payroll records sufficient for Owner to establish the above
representations. When supplying supporting records, Udder shall redact all Socia➢.Security
Numbers
C�XHIl91Ir PAGEIL
•
•
E-Veiru fy 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 Depart of Homeland Security
or other federal agency authorized to verify the work authorization status of newly hued employees
under the Immigration Reform and control Act of 1986(P.L.99-603).
No performance 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.
aann an anaann awi ann aannannnananna anaaann a aaauanna a nnuannannaannaannaannaanan I7nnt1 a a a a a Anna a Ora
COMPLIANCE WITH INDIANA E-VERIFYPROGRAM 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 hued 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 an 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)clays after the City notifies the Contractor of the violation. If the 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.
EXHIBIT PAGE. 11, 0,0FAZ
Affidavit of Employment Eligibility Verification
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 a.unauthorized alien and shall
not retRin 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 . ,20 .
•
(signature)..
(printed name)
i
EXHIBIT 10 PAGE
•
•
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 determination
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 writtennotice 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.
EXWI(dIT PAS 1I
Exhibit B to Contract: City and New Holland
PRICE Q® EQUEST
J!l
... , O
`I Di •
•
CITY Y OF 11 oND
DEPARTMENT:.OP°SADIITATION
2380.LIBERTY AVENUS.RICHMOND,INDIANA47374 THIS IS NOT AN ORDER
E,JL
PHONE(765)983-7450471&.X(765)962-2669
VENDORINSTRUCTIONS
This is a request for a price for the services of materials
described below. ' Any additional specifications may be
New Holland Dealership attached hereto. This is NOT an order and the City reserves
the right to accept all or part, or decline the entire proposal.
3100 W. Industries Road Please complete your full name and phone number below
Richmond,IN 47374 with signature; itemize all prices and charges where
requested; and attach any explanation for any substitution to
• specifications altered. Return in a sealed envelope,in care of
3s •
Richmond Sanitary District Board of Commissioners to
• the administration building at the address above by the
specified date and time to be considered.
DATE: REPLY MUST BE IN BY: PAYMENT TERMS: DELIVERY REQUIRED:
October 5,2021 9:00 A.M.on October 26,2021 UPON RECEIPT OF INVOICE DELIVERED
DESCRIPTION
This is a request
q t for quotes to purchase a Mini Hydraulic Excavator with Swing Boom and Hydraulic Thumb.Please
see attached specifications. Please include all warranty information with quote. E-Verify requirements and Indiana
Local Preference Claims will apply to this quote, information enclosed. .
Return this sheet and the proposal sheet in a sealed envelope addressed to:
Richmond Sanitary District
• Denise Johnson,Customer Service Mgr
2380 Liberty Avenue
Richmond,IN 47374
Re: Mini Hydraulic Excavator
Quote Valid Until /9/aapi
Questions? Call Jeff Lohmoeller at 765-993-2670 or 765-983-7464.
• NAME OF FIRM QUOTING:
4/e/A) d/la4i A G4,47
STATE TAX EXEMPTION#003121909-001 BY: c;-. ,Z t t:Ql
q AUTHORIZED BY S GNATURE
V TITLE
•-2.—f 7/es"- &SO—P373
Richmond Sanitary District DATE PHONE NUMBER
EXHIBIT _a . PAGE 1 OF.
{
•
The Richmond Sanitary District is requesting quotes for a new
Mini Hydraulic Excavator with Swing Boom and 11 ydraulic Thumb
Minimum Specification for Mini_Hydraulic Excavator:
1. Control Pattern Changer 'So tri-Z Yes VNo Other
2. Alarm Travel Indicator Yes ✓_No Other
3. Engine,EPA Tier 4F Rated Net Power 2,200 RPM 40.2 YHp
es ✓ o Other
N
� _ .�e
4. Cab.W/Air Conditioner Yes 7-No Other
5. Seat,Fabric High Back Suspension Yes 7 No Other
6. Mirror,Cab,Right . Yes 7.No Other
7. Belt,Seat,3"Retractable Yes V No Other
8. Hydraulic Thumb for 5-6T Excavator Yes 7.-No : Other
9. Must have Service/Repair Center within "50 mile radius" Yes /No Other
Minimum Specifications
Engine
Engine Model* Cat C2.4
Rated Net Power @ 2,200 rpm
ISO 9249/EEC 80/1269 30 kW 40.2 hp
Gross Power ISO 14396 31.21cW 41.8 hp
Bore 87 rum 3.4 in
Stroke 102.4 mm 4 in
Displacement 2.4 L 146 in3
*Meets U.S.EPA Tier 4 Final/EU Stage D IA emission standards.
Meets or exceeds specification above: Yes /No Other
• Weights*
Weight—Canopy,Standard Stick 4975 kg 10,970 lb
Weight—Canopy,Long Stick 5020 kg 11,069 lb
Weight-Cab,Standard Stick 5140 kg 11,334 lb
Weight—Cab,Long Stick 5185 kg 11,443 lb
Weight includes counterweight,rubber tracks,bucket, operator,full fuel in
and auxiliary lines.
• Meets or exceeds specification.above: Yes 7 No Other
EXHIBIT_ 13 _PAGE OF 14
Swine System
Machine Swing Speed 10 rpm . 1 aPcn
Boom Swing—Left* (without stop) 80°
Boom Swing-Left*.(with stop) 60°
Boom Swing—Right 50°
'Automatic swing brake,spring applied,hydraulic release.
Meets or exceeds specification above: Yes No / Other
Travel System ,geZ S w;`!t3 Ap2..o.cl Nam._- ;llb c a2.—
Travel Speed-High 4.41cm/h 2.7mph 2; np1
Travel Speed-Low 2.8 km/h 1.7 mph / .6 , pH.
Max Traction Force—High Speed 24.1 kN 5,418 lb
Max Traction Force—Low Speed 45.21cN 10,161 lb
Ground Pressure-Canopy . 29.5 kPa 4.3 psi
Ground Pressure—Cab 30.5 kPa 4.4 psi
Gradeability(maximum) 30°
Meets or exceeds specification above: Yes No 7-
Other
• Service Refill Capacities Ci v.ngi f a 1.9- ba'�'
Cooling System • : 10.5 L 2.8 gal . 2. 6 6a//oi
Engine Oil . . 9.5 L 2.5 gal
Fuel Tank 63 L 16.6 gal
Hydraulic Tank 68.3 L 18 gal
Hydraulic System 78 L 20.6 gal
Meets or exceeds specification above: Yes No V Other
Hydraulic System
S e e...Coo lan.4. 04•i-e,..k60 .
Load Sensing Hydraulics with Variable Displacement Piston Pump
Pump Flow at 2,400 rpm 150 L/min 39.6 gal/min 30.to C,Prh
Operating Pressure-Equipment 245 bar .3,553 psi 3 i 3D p S�
Operating Pressure—Travel 245 bar 3,553 psi
Operating Pressure—Swing . 216 bar 3,132 psi •
Auxiliary Circuit—Primary
(186 bar/2,734 psi) 80 L/min 21.1 gal/min
Auxiliary Circuit-Secondary
(174 bar/2,524 psi) • 25 L/min 6.6 gal/min
Digging Force—Stick(standard) 24.71cN 5,550 lb
Digging Force—Stick(long) 21.3 kN 4,788 lb
Digging Force—Bucket 44.7 kN 10,050 lb
Meets or exceeds specification above: Yes No /Other
Flaw «/iJ pmgcbtre—
p.o 44a Prb
IIBIT g PAGE �,� 2
Blade
Width 1980 mm 78.0 in 7tp"
Height 375 mm 148 in 13,D"
Dig Depth 555 mm. 21.9in
Lift Height 405 mm 15.9 in I e-
Meets or exceeds specification above: �e Yes 'No. +f Other
Cab & '6[C d�t�eriSidhS -1�o,�ar
Dynamic"Operator Sound Pressure Level 81 dB(A)
(ISO 6396:2008)
Exterior Sound Power Level 96 dB(A)
(ISO 6395:2008)*
*European Union Directive"2000/14/EC"
Meets or exceeds specification above: Yes _No Other
Certification—Cab and Canopy
Roll Over Protective Structure(ROPS) ISO 12117-2
Tip Over Protective Structure(TOPS) ISO 12117
Top Guard ISO 10262(Level I)
Meets or exceeds specification above: Yes No Other
Operating Specifications
Stick Length—Standard 1350 mm 52 in
Stick Length-Long 1750 mm 67 in
Meets or exceeds specification above: Yes No Other
Undercarriage
Number of Carrier Rollers 1
Number of Track Rollers 4
Track Roller Type Center Flange
Meets or exceeds specification above: Yes / No Other
Lift Capacities at Ground Level*
Lift Point Radius 3000 mm(9'8") 4000 mra(13'1")
Front Side Front Side
Blade Down kg 2340 1200 1260 640
(lb) (5,159)(2,646) (2,646)(1,411)
Blade Up kg 1450 1070 760 570
(lb) (3,197)(2,646) (1,676)(1,257)
*The above loads are in compliance with hydraulic excavator lift capacity rating standard ISO
10567:2007 and they do not exceed 87%of hydraulic lifting capacity or 75%of tipping capacity.The
excavator bucket weight is not included on.this chart.Lifting capacities are for standard stick.
Meets or exceeds specification above: Yes 7 No Other
EXHIBIT; ,PAGE ,� ) 3
•
Air Conditioning System
The air conditioning system on this machine contains the fluorinated greenhouse gas refrigerant
R134a(Global Warming Potential= 1430)The system contains 1.0kg of refrigerant which has a
CO2 equivalent of 1.4 metric tons.
Meets or exceeds.specification above: Yes l No Other
Dimensions Standard Stick Long Stick
1 Dig Depth 3280 mm 129 in 3670 mm 144 in
2 Vertical Wall 2320 mm 91 in 2630 mm 104 in
3 Maximum Reach at Ground Level 5330 mm 210 in 5810 mm 229 in
4 Maximum Reach 5600 mm 220 in 5960 mm 235 in
5 Maximum Dig Height 5250 mm 207 in 5440 mm 214 in
6 Maximum Dump Clearance 3720 mm. 129 in 3920 mm 154 in
7 Boom In Reach 2350 mm 93 in 2530 ram 100 in
8 Tail Swing 1100 mm 43 in •. 1100 mm 43 in
9 Maximum Blade Height 405 mm 16 in 405 nun 16 iii
10 Maximum Blade Depth 555 mm 22 in 555 nun 22 in
11 Boom Height in Shipping Position 1750 mm 69 in 2150 mm 85 in
12 0/A Shipping Height . 2550 mm 100 in . 2550 mm 100 in
13 Swing Bearing Height 615 mm 24 in 615 mm 24 in
14 O/A Undercarriage Length 2580 mm .102 in 2580 mm 102 in
15 0/A Shipping Length 5180 mm 204 in 5290 mm 208 in
16 Boom Swing Right 785 mm 31 in. 785 mm. 31 in
17 Boom Swing Left .. 695 mm 27 in 695 mm 27 in
18 Track Belt/Shoe Width 400 mm 16 in 400 mm 16 in '1.5"
19 0/A Track Width 1980 mm 78 in .. 1980 mm 78 in. "7(o"
Meets or exceeds specification above: Yes No 7 Other
STANDARD EQUIPMENT
ENGINE .
Cat C2.4 diesel engine(meets U.S.EPA Tier 4
Final emission standards for North America
and EU Stage MA./Tier 4 Interim emission •
standards for all other regions)
Automatic engine idle
Automatic engine shut-off
Automatic two speed travel
Diesel Particulate Filter(North America only)
Diesel Oxidation Catalyst(North America only)
Fuel and water separator
Power on demand
Meets or exceeds specification above: Yes 7 No. Other
EXHIBIT ,PAGE£ .
4
' I
II
OPERATOR ENVIRONMENT
100%pilot control ergonomic joysticks
Adjustable armrests
COMPASS: complete,operation,maintenance,performance and security system e Multiple
languages
Cup holder
Hydraulic neutral lockout bar
Literature holder
Pattern changer(optional in Europe)
Site reference system:leveling
Tool storage area
Travel control pedals with hand levers
Washable floor mat
Meets or exceeds specification above: Yes "No. Other
ELECTRICAL
12 volt electrical system
60 ampere alternator
650 CCA maintenance free battery
Fuse box
Ignition lcey start/stop switch
Slow blow fuse
Warning horn
Meets or exceeds specification above: Yes No Other
HYDRAULIC SYSTEM
1-way and 2-way(combined function)
Accumulator
Automatic swing parking brake
Auxiliary hydraulic lines
Adjustable auxiliary relief
Auxiliary line quick disconnects
Cat interlock system:hydraulic lockout
Continuous auxiliary flow
Load sensing/flow sharing
Ecology drain
Hydraulic oil cooler
Meets:or exceeds specification above: YesNo Other
LIGHTS AND MIRRORS
Boom light with time delay capability
Meets or exceeds specification above: Yes /No Other
EXHIBIT PAGE 6. i F 5
SAFETY AND SECURITY
Anti-theft system(COMPASS)
Caterpillar Corporate"One Key"System
Door locks
Lockable fuel cap
Retractable seat belt
Roll Over Protective Structure(ROPS) (ISO 12117-2)
Tip Over Protective Structure(TOPS) (ISO 12117)
Top guard—ISO 10262(Level 1)
Meets or exceeds specification above: Yes y No Other
• . • UNDERCARRIAGE
Dozer blade with float function.
Track,rubber belt,400 mm(16 in)width f 5" W;41k
Tie down eyes on track frame
Towing eye on base frame
Meets or exceeds specification above: Yes No/ Other
FRONT LINKAGE
200 degree bucket rotation Certified lifting eye on bucket linkage
Front shovel capable
. Thumb ready stick
Meets or exceeds specification above: Yes No Other
•
EXil®IT PAGE / OF l
6
Proposal Sheet•.
- Hydraulic Mini Excavator with Swing Boom and Hydraulic Thumb
Awarding dealer is responsible for warranty work during duration of warranty period including
transportation or other expenses incurred if any warranty work is done at any location other than
that of the awarding dealer.
Bid to include all prep,shipping;and handling charges.
Mini Excavator is to be delivered to 2380 Liberty Avenue,Richmond,Indiana 47374
Make and Model Number: 144 1L IlanA '677 C.-
Total Price of Hydraulic Mini Excavator with Swing Boom and Hy raulic Thu b: 'f l 3' /b '-occke.A6
did �SpA'
$ 4/4 6U,`" 11,07311
Bid firm for how long:
Delivery Time after PO has been issued: Aepcoy a 1I S/aa
Dealer and Salesperson Name: fl& lin a: mo, vdit I kar`
E Verification form filled.out: Yes ✓ No
Local Preference Claim: Yes ./' No
Iran Investments: Yes No /
EXHIBIT,PAGE _. ®`
• 7
•
•
]Indianna.Lacal Preference Clams:
Definitions:
Affected Comity—Wayne County or an adjacent county.-
Local Indiana Business—A business whose principal place of business is in an Affected County; a
tpy majoritypayroll(involume)
business That a s a ma ou of its a oll dollar to residents of Affected Counties; or a
business that employees residents of Affected Counties as a majority of its employees.
Local Preference Documentation •
If the Bidder is claiming local preference as defined by Indiana Code 5-22-15-20.9,it shall include such
claim with its Bid. In addition the Bidder shall submit, as a Post.Bid submittal,all documentation
required by the Local Indiana Preference form.
If the Bidder is a Joint Venture and is claiming local preference pursuant to•Indiana Code 5-22-15-20.9,
the Bidder shall submit all post bid documentation as required by the Post-Bid submittals. In
determining whether the Joint Venture qualifies as a Local Indiana Business,as defined by Indiana Code
5 22-15-20.9,the Owner will evaluate the Joint Venture by combining each business's total payroll,
payroll paid to residents of Affected Counties,total number of employees, and total number of
employees who are residents of Affected Counties. Further, each part of the Joint Venture shall submit
the location of it's principal place of business will be a consideration in whether the Joint Venture
qualifies as a local Indiana business: The Owner will determine whether the Joint Venture qualifies as a
Local Indiana business. The total overall Joint Venture must qualify as a Local Indiana Business to .
receive the local preference as defined in Indiana Code 5 22-15-20.9.
Subject to Indians Code 5-22-15 20.9,award of the Contract will be made to the lowest,responsive and
responsible Bidder,where the Bid is reasonable and does not exceed the funds available for the project.
The Owner reserves the right to reject all Bids and may waive or allow a Bidder to correct errors,
omissions or other irregularities in Bid Documents that are found not to have afforded the Bidder a
substantial competitive advantage over other Bidders.
•
•
I ND IANALOCAL PREFERENCE CLAIM
(Only fill out this Part if claiianiug to beta Local Ladiaina muteness)
Pursuant to Indiana Code 5-22-15-20.9, e vJ 10 f 1an.J R[c 1-;M ,!
(Name of Business) -
Claims a local Indiana business preference for the bid for Project -R ms, n e
INN;fl' Va•1-4/• in Wayne County,Indiana.
(Name of Project)
The Claim of applicability of the Local Indiana Business preference is based upon the following
(Check all that apply) •
5(1. The location of the Business's principal place of business is:
A) in Wayne County, or
B) in an adjacent county
The Majority of the business's payroll,for the previous twelve(12)months from the
date of this Bid,is to residents in Wayne or an adjacent county.
Fi 3. The iajority of the business's employee's,for the previous twelve(12)months from
the date of this Bid,are residents of Wayne or an adjacent county.
If business is deemed to be the apparent low bidder,business shall provide information pursuant to
Post-Bid submittal(Local Indiana Business Preference),to substantiate the claim of a local Indiana
business.
•
EXHIBIT PAGE /b OF
POST BID SUBIVII ITTAL
Local Indiana Business Preference
Pursuant to the City of Richm and Bidding and Contract Requirements,this application for the local
Indiana business,pursuant to Indiana Code section 5-22-15-20.9,is hereby submitted for the Project
listed below by Bidder/Applicant(hereinafter Bidder). (Use additional sheets if necessary.)
Date Bid Submitted: I I(90 at I Project Number: _
Project Name: flfdrmu ( c Al°n: EV 040a.1-cr W 4'1 Sw:4s -1),o,rn Illdre1:� 4..4
Bidder: 0 nt.0 IL lIa w f1 R:(,i. m o A A
Contact Name: 'r;c Wei +14 or Phone Number: 174,6"- %a_-7-73 v
Principal Place of Business: 31b0 iNcks 4,;u„ ,2,. e.,L 4.,fv .. a 1713 z/q v7q
Number of Months Address has been Principal Place of Business: 34 .4-
Number of all Employees for the twelve (12)months prior to the date of Bid submission: 1,1
Number of Employees who were residents of Affected Counties for the twelve(12)months prior to
the date of Bide submission: 1,0
1. If the Bidder claims it is a local Indiana business because the Bidder's principal place of business
is in Wayne County or an adjacent county,give a statement explaining the reasons the business
considers the location named as the business's principal place of business:
2. In order to claim local preference pursuant to Indiana Code section 5-22-15-20.9,the Bidder
must supply below its total payroll and the amount of the business's payroll paid t residents of
Affected Counties for the previous twelve(12)months from the date of the Bid.
a. Total Amount of payroll paid to all employees of Bidder in the previous twelve(12)
months from the date of the Bid: $ I o 0tv, 3 tp B
b. Total Amount of payroll paid to residents of affected counties for the previous twelve
(12)months from the date of the Bid: liq e i 511
Bidder shall supply supporting payroll records sufficient for Owner to establish the above
representations. When supplying supporting records, liddlerr shall redact all Social Security
Numbers
EXHIBIT —PAGE 11.---OF Lq
•
Verify Requirements:
rements:
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 Depart of Homeland Security
Or other federal agency authorized to verify the work authorization status of newly hued employees
under the Immigration Reform and control Act of 1986(P.L. 99-603).
•
No performance 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
noun a aaDnaaaaaaannanaaaaa aaannann nnanaaa aannaannaa aaaa naanna aaanna_aaa aanaaaaanaaa anain
coivriniANcE WITH LIWLLA. A E_VERyFY..PROGRAM
Pursuant to Indiana Code 22.5.1,7,Contractor is required to enroll in and verify the work eligibility .
status of all newly hued employees of the contractor through the Indiana E-Verify program Contractor
is not required tp verify the work eligibility status of all newly hued employees of the contractor through
the Indiana E-Verify program lithe 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 an 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 within the thirty(30)day period provided above,the City shall consider the
Contactor to be in breach of this Agreement and this Agreement will be terminated. if the City
determines that terminating this Agreement would be dehimental 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 Phis 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 _o
•
Affidavit of Employment Eligibility Verification
The Contractor, a 10 . f 1-n aloud (1:el,MOa A , 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 e/0--- day of ar ,4.2r ,20.:Dt.
•
(sign5‘74,
�.� qer
(printed name)
•
•
EXHIBIT PAGE
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 determination
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.
•
•
EXHIBIT_a PAGE OF