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Home My WebLink AboutContract #: 004060 - From: To: - Exception - Exceptionr School Department Administration Building North Andover, MA FORM OF GENERAL BID To the Awarding Authority: Kang Associates, Inc. January 2, 2014 A. The undersigned proposes to furnish all labor and materials required for the School Department Administration Building, North Andover, Massachusetts, in accordance with the accompanying plans and specifications prepared by Kang Associates, Inc. for the contract price specified below, subject to additions and deductions according to the terms of the specifications. B. This bid includes addenda numbered 1, 2, 3 C. The proposed contract price is: " f wo w,r llco�. }-wu Lxtrrwl ANd niAz4 jnU1 L,-+La,ar4dollars g Raj. t/00. 00 I'ovr uhdrr-J ($ c T� ). For Alternate #1: Deduct $ 51i +�OIJJAN ro'ir 4 ar£A dollars ($ (0,A00 -0L) ) For Alternate #2: Deduct $rwtn f�1o�1f thous t. Fout Lunclrf� dollars ($ �Lt . g3o.00 ). NN 4, +r� For Alternate #3: Deduct $ IWO i-�ouSANa dollars ($ ,000.00 j. For Alternate #4: Deduct $ Siuc.nLI S f X +h021tgn�� dollars ($ %-000.0U ), For Alternate #5: Deduct $ Z'ahf f£N f �oulg�U� dollars ($ D. The subdivision of the proposed contract price is as follows: Item 1. The work of the general contractor, being all work other than that covered by Item 2: Item 2. Sub -bids as follows: Bond req'd Sub -trade Name of Sub -Bidder Amount Yes/No Mason 04.21.1 Brick Masonry LAL Masonry 99.800 No 04.72.00 Cast Stone Masonry y $ Roofing: 07.31.13 Asphalt Shinggles MDM En ineerin 74.000 No 07.53.00 Elastomeric IUembrane Roofing g $ 09.51.23 Acoustical Tile Ceilings K&K Acmistical Ceilings$ 16,570 - FORM OF GENERAL BID -1 School Department Administration Building Kang Associates, Inc. North Andover, MA January 2, 2014 09.90.00 Painting and Coating 0 Byrne Painting $ 28,700 vPG 14.42.16 Vertical Wheelchair Lifts Division 21 Fire Protection Division 22 Plumbing Division 23 HVAC Division 26 Electrical Division 28 Fire Alarm Eagle Elevator $ 26,963 Yes Ebacher Plumbing & Hta $ 74,000 No LaPan Mechanical $ 58.000 Yes Thomas E Snowden $ 324,000 No Wayne J Griffine Elec $ 215,000 No Total of Item 2: $ 917,033 E. The undersigned agrees that, if he is selected as general contractor, he will within five days, Saturdays, Sundays and legal holidays excluded, after presentation thereof by the awarding authority, execute a contract in accordance with the terms of this bid and furnish a performance bond and also a labor and materials or payment bond, each of a surety company qualified to do business under the laws of the commonwealth and satisfactory to the awarding authority and each in the sum of the contract price, the premiums for which are to be paid by the general contractor and are included in the contract price; provided, however, that if there is more than 1 surety company, the surety companies shall be jointly and severally liable. The undersigned hereby certifies that he is able to furnish labor that can work in harmony with all other elements of labor employed or to be employed on the work; that all employees to be employed at the worksite will have successfully completed a course in construction safety and health approved by the United States Occupational Safety and Health Administration that is at least 10 hours in duration at the time the employee begins work and who shall furnish documentation of successful completion of said course with the first certified payroll report for each employee; and that he will comply fully with all laws and regulations applicable to awards made subject to section 44A. The undersigned further certifies under the penalties of perjury that this bid is in all respects bona fide, fair and made without collusion or fraud with any other person. As used in this subsection the word "person" shall mean any natural person, joint venture, partnership, corporation or other business or legal entity. The undersigned further certifies under penalty of perjury that the said undersigned is not presently debarred from doing public construction work in the commonwealth under the provisions of section twenty-nine F of chapter twenty-nine, or any other applicable debarment provisions of any other chapter of the General Laws or any rule or r ation promulgated thereunder. January 30, 2014 SPAVPr ronQtruc Date (Name of General By: Scott L. Seaver, President Signature and Title of Person Signing Bid 215 Lexington Street Business Address Woburn, MA 01801 City and State FORM OF GENERAL BID - 2 School Department Administration Building North Andover, MA GENERAL BIDDER'S CHECKLIST: Addenda Recognized Bid Deposit Certificate of Corporate Bidder DCAM Eligibility Update Statement Certificate of Non -Collusion and Certificate of Tax Compliance Certification of Labor Harmony and OSHA Training Requirements FORM OF GENERAL BID - 3 Kang Associates, Inc. January 2, 2014 CERTIFICATIONS CERTIFICATE OF NON -COLLUSION The undersigned certifies under penalties of perjury that this bid or proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word "person" shall mean natural person, business, partnership, corporation, committee, union, club or oforganization, entity, or group of individuals. ki Scott L. Seaver, President Print Name & Title Date January 30,; 2014 Seaver Construction, Inc. Company Name CERTIFICATE OF TAX COMPLIANCE Pursuant to Chapter 62C of the Massachusetts General Laws, Section 49A (b), I Scott L. Seaver , authorized signatory for Seaver Construction, Inc. Name of individual Name of contractor do hereby certify under the pains and penalties of perjury that said contractor has complied with all laws of the Commonwealtlof Massachusetts, and the Town of North Andover, relating to taxes, permit or other fees, eporting of employees and contractors, and withholding and remitting child support. January 30, 2014 Signature Date CERTIFICATION LABOR HARMONY AND OSHA TRAINING REQUIREMENTS The undersigned certifies under penalties of perjury that he is able to furnish labor that can work in harmony with all other elements of labor employed or to be employed at the work and that all employees to be emplo at the worksite and in the work will have completed an OSHA -approved constructio safety and health course lasting at least ten (10) hours. Signature Scott L. Seaver, President Print Name & Title Date January 30, 2014 Seaver Construction, Tnr_ Company Name CERTIFICATE OF VOTE At a duly authorized meeting the Board of Directors of the Seaver Constructions, Inc. held on January 29, 2014tWas VOTED, THAT Scott L. Seaver (Name) Scott L. Seaver (Officer) of Seaver Construction, In@e and hereby is authorized to execute contracts and bonds in the name and on behalf of said Scott L. Seaver , and affix its corporate seal hereto; and such execution of any contractor obligation in the name of Seaver Construction, rn@n its behalf by such officer under seal of Seaver Construction, Ipehall be valid and binding upon Scott L. Seaver I hereby certify that I am the clerk of the above named Seaver Construction, InQnd that Scott L. Seaver is the duly elected officer as above of said Seaver Construction, Inc and that the above vote has not been amended remains in full force and effect as the date of this contract. January 29, 2014 (Date) Certification of the Corporate Clerk Scott L. Seaver (Clerk) inded and ` f a School Department Administration Building North Andover, MA Scott L. Seaver President CERTIFICATE OF CORPORATE BIDDER Kang Associates, Inc. January 2, 2014 certify that I am the of the corporation named as Bidder in the Bid Form, and that Scott L. Seaver who signed the Bid Form on behalf of the Bidder was then the President of said corporation and that I know his signature; that his signature thereto is genuine and that the Bid Form was duly signed, sealed and executed for and in behalf of said corporation by authority of its governing body. Scott L. Seaver Secretary -Clerk January 30, 2014 Date CORPORATE BIDDER - 1 WEEKLY PAYROLL RECORDS REPORT & STATEMENT OF COMPLIANCE In accordance with Massachusetts General Law c. 149, §2713, a true and accurate record must be kept of all persons employed on the public works project for which the enclosed rates have been provided. A Payroll Form has been printed on the reverse of this page and includes all the information required to be kept by law. Every contractor or subcontractor is required to keep these records and preserve them for a period of three years from the date of completion of the contract. In addition, every contractor and subcontractor is required to submit a copy of their weekly payroll records to the awarding authority. This is required to be done on a weekly basis. Once collected, the awarding authority is also required to preserve those records for three years from the date of completion of the project. Each such contractor or subcontractor shall furnish to the awarding authority directly within 15 days after completion of its portion of the work, a statement, executed by the contractor, subcontractor or by any authorized officer thereof who supervised the payment of wages, this form. STATEMENT OF COMPLIANCE January 30 , 2014 I, Scott L. Seaver President (Name of signatory party) (Title) do hereby state: That I pay or supervise the payment of the persons employed by Seaver Construction, Inc. ontheSchool Department Adminstration (Contractor, subcontractor or public body) (Building or project) ilding , No. An and that all mechanics and apprentices, teamsters, chauffeurs and orers employed on said project have been paid in accordance with wages determine under the provisions of sections twenty-six and twenty-seven of chapter one hundred d forty nine of the General Laws. Signature / //V -`- Title t 09/11 School Department Administration Building North Andover, MA FOREIGN CORPORATIONS CERTIFICATION AFFIDAVIT OF COMPLIANCE Form AF -4A 1/78 EXECUTIVE OFFICE FOR ADMINISTRATION AND FINANCE The Commonwealth of Massachusetts X Massachusetts Business Corporation Non-profit Corporation Foreign (non -Massachusetts) Corporation I, Scott L. Seaver Kang Associates, Inc. January 2, 2014 X President Clerk of Seaver Construction, Inc! (Name of Corporation) whose principal office is located 215 Lexington, Street, Woburn, MA 01801 do hereby certify that the above named Corporation has filed with the State SecretarX all certificates and annual reports required by Chapter 156B, Section 109 (Business Corporation), by apter 181, Section 4 (Foreign Corporation), or by Chapter 180, Section 26A (non-profit Corporation) a Massachusetts General Laws. SIGNED UNDER THE PENALTIES OF PERJURY this —30 day of Signature of responsible Corporate Officer FOREIGN CORP - 1 20 14 DEVAL L. PATRICK GOVERNOR. TIMOTHY P. MURRAY LIEUTENANT GOVERNOR The Commonwealth of Massachusetts Executive Of ce fol• Administration and Finance Division of Capital Asset Management and Maintenance One Ashburton Place Boston, Massachusetts 02108 Tel: (617) 727-4050 Fax: (617) 727-5363 Prime/General GLEN SHOR SECRETARY, ADMINISTRATION & FINANCE CAROLE CORNELISON COMMISSIONER Certificate of Contractor Eligibility CONTRACTOR IDENTIFICATION NUMBER: 1153 This Certificate Shall Be Used for Submitting Prime/General Bids Only 1. CERTIFICATION PERIOD: This Certificate is valid from 2/16/2013 to 2/16/2014 2. CONTRACTOR'S NAME: Seaver Construction, Inc 3. CONTRACTOR'S ADDRESS: 215 Lexington Street, Woburn, MA 01801 4. WORK CATEGORIES: This Contractor is certified to file bids under Massachusetts General Laws Chapter 149, Chapter 149A and Chapter 25A in the following checked Categories of Work: Alarm Systems [] Asbestos Removal ❑ Deleading Demolition [] Doors & Windows Electrical E]Electronic Security Systems S. EVALUATIONS: 6. PROJECT LIMITS: Elevators Energy Management Systems �] Exterior Siding r Fire Protection Sprinkler Systems Floor Covering Ii General Building Construction Historical Building Restoration Historical Masonry Historical Painting Historical Roofing HVAC [] Masonry EJ Mechanical Systems Modular Construction/Prefab Number of Projects Evaluated: ^,4 Average Project Evaluation Rating: 92 Number of Projects Below Passing Score: 1 Painting Plumbing Pumping Stations Roofing [] Sewage & Water Treatment Plants [] Telecommunication Systems Waterproofing Single Project Limit (SPL): $9,991,000.00 Aggregate Work Limit (AWL): $35,000,000.00 General Building Construction Limit: $9,991,000.00 7. SUPPLIP DIVERSITY OFFICE CERT C TION: NI Fre) S. Bernstein, Deputy General Counsel, Approval Date for Carole J. Cornelison, Commissioner NOTE TO CONTRACTORS: Complete Applications for Renewal of Contractor Eligibility are due no later than three months PRIOR to the Expiration Date of the Certification Period shown above. Failure to submit Completed Applications timely may result in a gap in Certification or a lapse in Certification altogether for your company. 1� S Reviewer's Initials CONTRACTOR: (Name, legal status and address) Seaver Construction, Inc. 215 Lexington St., Woburn, MA 01801 OWNER: (Name, legal status and address) Town of North Andover MA BOND AMOUNT: $ Document A31OTM - 201U Conforms with The American Institute of Architects AIA Document 310 SURETY: (Name, legal status and principal place of business) North American Specialty Insurance Company 160 Gould Street, Suite 118 Needham, MA 02494 Five Percent of the Attached bid (5%) This document has important legal consequences. Consultation with an attomey is encouraged with respect to its completion or modification. Any singular reference to ' Contractor, Surety, Owner or other party shall be considered plural where applicable. PROJECT: (Name, location or address, and Project number, Jany) Demolition of the Old Police Station Building and Construction of a New School Department Administration Building on the Same Site. The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specked in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and othenvise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. L:'her. this Bond has beer fur;ishcd to comply sv;+:h a s'.z;»utory or other legal re4uirer hent in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond sball be construed as a statutory bond and not as a common law bond. Signed and sealed this 39th day of January, 2014 Seaver Constructs , Inc. (Principal) (Seal) (Title) North American Specialty Insurance Company (Surety) (Seal) (Witness) A', (Title) Ada W. DeSanctis, Attorney -in -Fact NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: JAMES J. AXON, GREGORY D. JUWA, MICHAEL F. CARNEY, WILDER PARKS, JR., PAUL A. PATALANO, ADAM W. DESANCTIS, MICHAEL T. GILBERT, CHRISTINE B. GALLAGHER, BRYAN F. JUWA, DAVID A. BOUTIETTE, RICHARD F. CARUSO and REBECCA SHANLEY JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9d' of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." `tiniallghxamaw V`1J1•Yyy7/iGi� BYE:• cSEALT`� Steven P. Anderson, senior Vice President d Washington International Insurance Company 2 in & Senior Vke President of north American specialty insurance Company /lufmnnu�t By_� David M. Layman, Vice Proident of Washin=ton Wkrdhtional Insamace Company & Vice President orNorth American specialty insurance Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this20th day of June 12012 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss: On this 20th day of June 201 2 , before me, a Notary Public personally appeared Steven P. Anderson -,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman , Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly swom, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. "OFFICIALSEAL" ��rrA dl./. '"AZ DONNA D. SKLENS Notary Public, State of Illinois Donna D. Sklens, Notary Public My CommissiooExpim 10/0612015 I, Jeffrey Goldberg the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this rday ofkknao , 201q, Jeffrey Goldberg, vice President & Assistant Secretary of Waehino on International Insurance Company & North American specialty insurance Company EFFECTWE MARCH 30,201D * Commonwealth of Massachusetts Division of Capital Asset Management PRIME/GENERAL CONTRACTOR UPDATE STATEMENT TO ALL BIDDERS AND AWARDING AUTHORITIES A COMPLETED AND SIGNED PRIME/GENERAL CONTRACTOR UPDATE STATEMENT MUST BE SUBMITTED WITH EVERY PRIME/GENERAL BID FOR A CONTRACT PURSUANT TO M.G.L. c.149, §44A AND M.G.L. c. 149A. ' ANY PRIME/GENERAL BID SUBMITTED WITHOUT AN APPROPRIATE UPDATE STATEMENT IS INVALID AND MUST BE REJECTED. Caution: This form is to be used for submitting Prime/General Contract bids. It is not to be used for submitting Filed Sub -Bids or Trade Sub -Bids. AWARDING AUTHORITIES If the Awarding Authority determines that the bidder does not demonstrably possess the skill, ability, and integrity necessary to perform the work on the project, it must reject the bid. BIDDER'S AFFIDAVIT I swear under the pains and penalties of perjury that I am duly authorized by the bidder named below to sign and submit this Prime/General Contractor Update Statement on behalf of the bidder named below, that I have read this Prime/General Contractor Update Statement, and that all of the information provided by the bidder in this Prime/General Contractor Update Statement is true, accurate, and complete as of the bid date. 1 - o - k Bid Date Bid Number (or name if no number) Tpuj o of •Q t-�►�c�� 2 Awarding Authority SIGNATUREb Seaver Construction, Inc. 215 Lexington Street, Woburn, MA 01801 781-935-0130 Bidder Authorized R presen tive Division of Capital Asset Management Prime/General Contractor Update Statement Effective March 30, 2010 P/ J. INSTRUCTIONS TO BIDDERS • This form must be completed and submitted by all Prime/General contractors bidding on projects pursuant to M.G.L. c. 149, §44A and M.G.L. c. 149A. • You must give complete and accurate answers to all questions and provide all of the information requested. MAKING A MATERIALLY FALSE STATEMENT IN THIS UPDATE STATEMENT IS GROUNDS FOR REJECTING YOUR BID AND FOR DEBARRING YOU FROM ALL PUBLIC CONTRACTING. • Information you provide herein must supplement your firm's most recent DCAM Application for Prime/General Contractor Certificate of Eligibility. You must report all requested information not previously reported on your most recent DCAM Application. • You must use this official form of Update Statement. Copies of this form may be obtained from the awarding authority and from the Asset Management Web Site: www.mass.gov/dcam. • If additional space is needed, please copy the appropriate page of this Update Statement and attach it as an additional sheet. • See the section entitled "Bidding Limits" in the Instructions to Awarding Authorities for important information concerning your bidding limits. INSTRUCTIONS TO AWARDING AUTHORITIES Determination of Bidder Qualifications It is the awarding authority's responsibility to determine who is the lowest eligible and responsible bidder. You must consider all of the information in the low bidder's Update Statement in making this determination. Remember: this information was not available to the Division of Capital Asset Management at the time of certification. The bidder's performance on the projected listed in Parts 1 and 2 must be part of your review. Contact the project references. AWARDING AUTHORITIES ARE STRONGLY ENCOURAGED TO REVIEW THE LOW BIDDER'S ENTIRE CERTIFICATION FILE AT THE DIVISION OF CAPITAL ASSET MANAGEMENT. Telephone (617) 727-9320 for an appointment. Bidding Limits Single Proiect Limit: The total amount of the bid, including all alternates, may not exceed the bidder's Single Project Limit. Aggregate Work Limit: The annual value of the work to be performed on the contract for which the bid is submitted, when added to the annual cost to complete the bidder's other currently held contracts, may not exceed the bidder's Aggregate Work Limit. Use the following procedure to Division of Capital Asset Management Prime/General Contractor Update Statement Effective March 30, 2010 Work Limit: Step 1 Review Update Statement Question #2 to make sure that all requested information is provided and that the bidder has accurately calculated and totaled the annualized value of all incomplete work on its currently held contracts (column 9). Step 2 Determine the annual dollar value of the work to be performed on your project. This is done as follows: (i) If the project is to be completed in less than 12 months, the annual dollar value of the work is equal to the full amount of the bid. (ii) If the project will take more than 12 months to complete, calculate the number of years given to complete the project by dividing the total number of months in the project schedule by 12 (calculate to 3 decimal places), then divide the amount of the bid by the calculated number of years to find the annual dollar value of the work. Step 3 Add the annualized value of all of the bidder's incomplete contract work (the total of column 9 on page 5) to the annual dollar value of the work to be performed on your project. The total may not exceed the bidder's Aggregate Work Limit. Correction of Errors and Omissions in Update Statements Matters of Form: An awarding authority shall not reject a contractor's bid because there are mistakes or omissions of form in the Update Statement submitted with the bid, provided the contractor promptly corrects those mistakes or omissions upon request of the awarding authority. [810 CMR 8.05(1)]. Correction of Other Defects: An awarding authority may, in its discretion, give a contractor notice of defects, other than mistakes or omissions of form, in the contractor's Update Statement, and an opportunity to correct such defects, provided the correction of such defects is not prejudicial to fair competition. An awarding authority may reject a corrected Update Statement if it contains unfavorable information about the contractor that was omitted from the Update Statement filed with the contractor's bid. [810 CMR 8.05(2)] PART 3 - PROJECT PERFORMANCE For Parts 3 and 4, if you answer YES to any question, please provide on a separate page a complete explanation. Information you provide herein must supplement your firm's most recent DCAM Application for Prime/General Contractor Certificate of Eligibility. You must report all requested information not previously reported on your most recent DCAM Application. Include all details [project name(s) and location(s), names of all parties involved, relevant dates, etc.]. YES NO 1. Has your firm been terminated on any contract prior to completing a project or has ❑ any officer, partner or principal of your firm been an officer, partner or principal of another firm that was terminated or failed to complete aproject? 2. Has your firm failed or refused either to perform or complete any of its work under ❑ any contract prior to substantial completion? 3. Has your firm failed or refused to complete any punch list work under any contract? ❑ 4. Has your firm filed for bankruptcy, or has any officer, principal or individual with a ❑ financial interest in your current firm been an officer, principal or individual with a financial interest in another firm that filed for bankruptcy? 5. Has your surety taken over or been asked to complete any of your work under any ❑ contract? 6. Has a payment or performance bond been invoked against your current firm, or has ❑ any officer, principal or individual with a financial interest in your current firm been an officer, principal or individual with a financial interest in another firm that hada payment or performance bond invoked? 7. Has your surety made payment to a materials supplier or other party under your ❑ payment bond on any contract? 8. Has any subcontractor filed a demand for direct payment with an awarding authority ❑ fora public project on any of your contracts? .9. Have any of your subcontractors or suppliers filed litigation to enforce a mechanic's ❑ lien against property in connection with work performed or materials supplied under any of your contracts? 10. Have there been any deaths of an employee or others occurring in connection with ❑ any of yourprojects? 11. Has any employee or other person suffered an injury in connection with any of ❑ your projects resulting in their inability to return to work for a period in excess of one year9 Division of Capital Asset Management' Page 9 of 12 Prime/General Contractor Update Statement Effective March 30, 2010 PART 4 - Legal or Administrative Proceedings; Compliance with Laws Please answer the following questions. Information must supplement all judicial and administrative proceedings involving bidder's firm, which were instituted or concluded (adversely or otherwise) since your firm's most recent DCAM Application for Prime/General Contractor Certificate of Eligibility. You must report all requested information not previously reported on your most recent DCAM Application. The term "administrative proceeding" as used in this Prime/General Contractor Update Statement includes (i) any action taken or proceeding brought by a governmental agency, department or officer to enforce any law, regulation, code, legal, or contractual requirement, except for those brought in state or federal courts, or (ii) any action taken by a governmental agency, department or officer imposing penalties, fines or other sanctions for failure to comply with any such legal or contractual requirement. The term "anyone with a financial interest in your firm" as used in this Section "I" shall mean any person and/or entity with a 5% or greater ownership interest in the applicant's firm. If you answer YES to any question, on a separate page provide a complete explanation of each proceeding or action and any judgment, decision, fine or other sanction or result. Include all details (name of court or administrative agency, title of case or proceeding, case number, date action was commenced, date judgment or decision was entered, fines or penalties imposed, etc.). YES NO 1. Have any civil, judicial or administrative proceedings involving your firm or a ❑ principal or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to the procurement or performance of any construction contract, including but not limited to actions to obtain payment brought by subcontractors, suppliers or others? 2. Have any criminal proceedings involving your firm or a principal or officer or ❑ anyone with a financial interest in your firm been brought, concluded, or settled relating to the procurement or performance of any construction contract including, but not limited to, any of the following offenses: fraud, graft, embezzlement, forgery, bribery, falsification or destruction of records, or receipt of stolen property? 3. Have any judicial or administrative proceedings involving your firm or a principal ❑ or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of any state's or federal procurement laws arising out of the submission of bids or proposals? 4. Have any judicial or administrative proceedings involving your firm or a principal ❑ or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of M.G.L. Chapter 268A, the State Ethics Law? Division of Capital Asset Management Page 10 of 12 Prime/General Contractor Update Statement Effective March 30, 2010 PART 4 - Legal or Administrative Proceedings; Compliance with Laws (continued) YES NO 5. Have any judicial or administrative proceedings involving your firm or a principal ❑ or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of any state or federal law regulating hours of labor, unemployment compensation, minimum wages, prevailing wages, overtime pay, equal pay, child labor or worker's compensation? 6. Have any judicial or administrative proceedings involving your firm or a principal ❑ or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of any state or federal law prohibiting discrimination in employment? 7. Have any judicial or administrative proceedings involving your firm or a principal ❑ or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a claim of repeated or aggravated violation of any state or N; I federal law regulating labor relations? 8. Have any proceedings by a municipal, state, or federal agency been brought, ❑ 4 concluded, or settled relating to decertification, debarment, or suspension of your firm or any principal or officer or anyone with a financial interest in your firm from public contracting? 9. Have any judicial or administrative proceedings involving your firm or a principal ❑ or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of state or federal law regulating the environment? 10. Has your firm been fined by OSHA or any other state or federal agency for ❑ violations of any laws or regulations related to occupational health or safety? Note: this information may be obtained from OSHA's Web Site at www.osha.gov 11. Has your firm been sanctioned for failure to achieve DBE/MBE/WBE goals, ❑ workforce goals, or failure to file certified payrolls on any publicprojects? 12. Other than previously reported in the above paragraphs of this Section I, have any ❑ administrative proceedings or investigations involving your firm or a principal or Officer or anyone with a financial interest in your firm been brought, concluded, or settled by any local, state or federal agency relating to the procurement or performance of any construction contract? 13. Are there any other issues that you are aware which may affect your firm's ❑ responsibility and integrity as a building contractor? 1 Division of Capital Asset Management Page 11 of 12 Prime/General Contractor Update Statement Effective March 30, 2010 4 PART 5 - SUPERVISORY PERSONNEL List all supervisory personnel, such as project managers and superintendents, who will be assigned to the project if your firm is awarded the contract. Attach the resume of each person listed below. NAME TITLE OR FUNCTION Tony Salvati Project Superintendent Steve Quinlan Project Superintendent Jon Gansenberg Project Superintendent Steve Bowie Project Superintendent Joe Pocaro Project Superintendent Mark Lucas Project Superintendent John Johansson Project Manager Sid Massaro Project Manager Duane Levy Project Manager JoAnn Darrigo Project Manager Peter Tummino Project Manager Kevin Foley Project Manager Division of Capital Asset Management Page 12 of 12 Prime/General Contractor Update Statement Effective March 30, 2010 PART 6 - CHANGES IN BUSINESS ORGANIZATION OR FINANCIAL CONDITION Have there been any changes in your firm's business organization, financial condition or bonding capacity since the date your current Certificate of Eligibility was issued? ❑ Yes ® No If YES, attach a separate page providing complete details. PART 7 - LIST OF COMPLETED CONSTRUCTION PROJECTS SUBMITTED TO THE DIVISION OF CAPITAL ASSET MANAGEMENT WITH FIRM'S MOST RECENT APPLICATION FOR CERTIFICATION ALONG WITH CERTIFICATION PAGE. Attach here a copy of the list of completed construction projects which was submitted with your firm's most recent Application for Prime/General Contractor Certificate of Eligibility to the Division of Capital Asset Management. The Attachment should include a complete copy of the entire Section G — "Completed Projects" and the final page —"Certification" (Section J) containing the signature and date that the Completed Projects list (Section G) was submitted to the Division of Capital Asset Management. 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