Loading...
HomeMy WebLinkAboutContract #: 004380 - From: To: - Exception - Exception1194 ,ane tv f !rGj School Department Administration Building Kang Associates, Inc. North Andover, MA January 2, 2014 FORM OF SUB -BID To All General Bidders Except those Excluded: A. The undersigned proposes to furnish all labor and materials squired for completing, in accordance with the hereinafter described plans, specifications and addenda, all work specified in p . i1. %3 04.� Z.00 C of the specifications and in any plans specified in such section, prepared Q Kang Associates, Inc. for the School Department Administration Building,North Andover, MA for the contract sum of: Coe- hon"r t) iKS sk 7ySr%nA dollars ($ 1 � to, t�m 00 For Alternate #1: Deduct $ din_ -hCn Qom_ dollars ($ For Alternate #2: educ $ E;��OJr ihQYSCMA dollars ($ 01 -00' ) For Alternate #3. I Deduct $ no Chan Q dollars ($ For Alternate ,#4: Deduct $ _ u, Chon dollars ($ For Alternate #5: Deduct $ nochandollars ($ B. This sub -bid includes addenda numbered C. This sub -bid ❑ may be used by any general bidder except: ❑ may only be used by the following general bidders: (To exclude general bidders, insert an W in one box only and fill in blank following that box. Do not answer C if no general bidders are excluded.) FORM OF SUB -BID -1 School Department Administration Building North Andover, MA Kang Associates, Inc. January 2, 2014 D. The undersigned agrees that, if he is selected as sub -bidder, he will within five days, Saturdays, Sundays, and legal holidays excluded, after presentation of a subcontract by the general bidder selected as the general contractor, execute with such general bidder a subcontract in accordance with the terms of this sub -bid, and contingent upon the execution of the general contract, and, if requested so to do in the general bid by such general bidder, who shall pay the premiums therefor, or if pre -qualification is required pursuant to section 44D 3/4, fumish a performance and payment bond of a surety company qualified to do business under the laws of the Commonwealth and satisfactory to the awarding authority in full sum of the subcontract price. E. The names of all persons, firms and corporations furnishing to the undersigned labor or labor and materials for the class or classes or part thereof work for which the provisions of the section of the specifications for this sub -trade requires a listing in this paragraph, including the undersigned if customarily furnished by persons on his own payroll and in the absence of a contrary provisions in the specifications, the name of each such class of work or part thereto and the Bid price for such class of work or part thereof are: Name Class of Work Bid Price (Do not give bid price for any class or part thereof furnished by undersigned.) F. The undersigned agrees that the above list of bids to the undersigned represents bona fide bids based on the hereinbefore described plans, specifications and addenda and that, if the undersigned is awarded the contract, they will be used for the work indicated at the same amounts stated, if satisfactory to the awarding authority. G. The undersigned further agrees to be bound to the general contractor by the terms of the hereinbefore described plans, specifications, including all general conditions stated therein, and addenda, and to assume toward him all the obligations and responsibilities that he, by those documents, assumes toward the owner. H. The undersigned offers the following information as evidence of his qualifications to perform the work as bid upon according to all the requirements of the plans and specifications: 1. Have been in business under present business name I years. 2. Ever failed to complete any work awarded? N O 3. List one or more recent buildings with names of the general contractor and architect on which you served as a subcontractor for work of similar character as required for the above named buildings. Building (a) QC Gymna 5ium Architect . General Contractor Amount of Contract aufnmc4 FcEan S. CoAnckn (nd finder Scn -Tnc SspE t(kicS FORM OF SUB -BID - 2 School Department Administration Building North Andover, MA Kang Associates, Inc. January 2, 2014 (b)O*e a as c�. QC . J • Qnm t-4asac.- 35� dCX) a p 4. Bank reference 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 of subcontracts subject to section 44F. The undersigned further certifies under penalties of perjury that this sub -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 regulation promulgated thereunder. I- zo- !q Date SUB -BIDDER'S CHECKLIST: Addenda Recognized V/ Bid Deposit 3Z DCAM Certificate of Eligibility Sub -Bidder Update Statement Certificate of Corporate Bidder Mu mclo Bros, Gm4fuc-hOn (Name of Sub -Bidder) By: ; Signature id Title Person Signing Bid 13 �Ic r4u(0. Drivt? Business Address n ctmnv+h . MA 02-T-11 City and State FORM OF SUB -BID - 3 School Department Administration Building Kang Associates, Inc. North Andover, MA January 2, 2014 CERTIFICATE OF CORPORATE BIDDER I, Af—Amc) ► 1 (�(� am a C) certify that I am the ?rttsAtn�: of the corporation named as Bidder in the Bid Form, and that HYl-� CX11 C) (��r �rne,l who signed the Bid Form on behalf of the Bidder was then the Rresi d ef± 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. Corporate Seal Se ry-Cle I -aI -IL-1 Date CORPORATE BIDDER -1 V. -AIA k =Bdnd Document A31OTM ®1970 AL L MEN BY THESE PRESENTS, that we kh- ^'insert full name and address or legal title of'Contraetor) Marmelo Bros. Construction Co., Inc. AnnrtioHsAND ntrtrrs ME rtrysea 4 �s - K ,T as ablwe, ltetetn tlvh N. gtnTaelt a oRE in ut>atrfAip t - .. '" x R DINH* brd; iaTgtve , -_ =lists with gt V the me imft eve&of the l WK if the..P?rin, �eaeof tiffi 9bfigee - l bid, them efl?ect. -44 13 Ventura Dr., N Dartmouth, MA 02747Theauthor ofthis docurnenthas addedinformagoon needed for its Iled the Principal, and cornpletion, The auttor may also address of legal title of Surety) have revised the teat of the driginal = The Ohio Casualty Insurance Co.' AIA standard lorm.MACldilrorasand - _ Deletions Rspoitthat notes added -_' Keene, New Hampshire infointatlorfaswetlasrevisions to the standard form text is available Wtinder the laws of the State of N H as Surety, hereinafter from the author and should be firmly bound unto reviewed. A vergew line in the telt or legal title of -owner) margin of this document indicatesudd�ess where the author has added Town of North Andover narasesswinfrxmfltinnm;l.a,a.e the author has added to or deleted 120 Main St., N Andover, MA from the original AiAtext . z the Obligee, in the sum of 5 %$ ), for the payment of This dodurnerd has important legal Almade, the said Principal and the said Surety, bind eansequerlcea Consultation with an `administrators, successors and assigns, jointly and attorney is encouraged with respect w -t.. to its Completion or notification am submitted a bid for Bess and description of project) School Department Administration Building located at 566 Main St., N Andover, MA 042113- Brick Masonry; 047200- Cast Stone Masonry thQblgee Mall accept the bid of the Principal and the antra t!#h the Obligee in accordance with the terms of onusotrtiis as may be specified in the bidding or Contract iQattffitient surety for the faithful performance of such Contract sii labor and material furnished in the prosecution thereof, or NOW incipal to enter such Contract and give such bond or ilea [of the Obligee the difference not to exceed the penalty 1t specified in said bid and such larger amount for which the I contract with another party to perform the Work covered by on shall be null and void, otherwise to remain in full force and AIA Document A310*a — 1970. CopyrightV 1963 and 10,70 byThe American InsitMe pf Arc hiteote. All rights reserved WARM UG: This A10 Document Is protected by U.S. copyright law and Intemdonal Trestles. Unauthorized reproduction or distribution of this A10 Document, or any portion of it, may result In severe civil and criminal penahlea, and will be proses to the maximum extent possible under the law.. This document was produced by 1 AIA software at 15:30:43 on WO1r2009 under Order No, 1000331290 1 which expires on 3/1 212 01 0„ and li: not for resale.. User Holes: (1335b65Q24) l0 E > L O 116. = Z THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. -.5796817 American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire & Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby'name, constitute and appoint, Kathleen S. Nightlinger; Karen Bernier; Lora H. Lowe; Joanne Bretton all of the city of N DARTMOUTH state of - MA > each individually if there be more than one named; its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney, has been subscribed by'.an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 1 st day of December __2012 0 American Fire and Casualty Company The Ohio Casualty Insurance Company Liberty Mutual Insurance Company West American Insurance Company By: STATE OF WASHINGTON ss - Gregory W. Davenport, Assistant Secretary COUNTY OF KING On this 1 st day of December 2012 , before me personally appeared Gregory W. Davenport, who acknowledged himself to be the Assistant Secretary of American Fire and Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Seattle, Washington, on the day and year first above written. >,..; KD Riley, Not Public Sµ This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV- OFFICERS - Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shalt appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII - Execution of Contracts - SECTION 5. Surety. Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations.Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes Gregory W. Davenport; Assistant Secretary to appoint such attomeys-in-fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. ; - Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed..- , 1, David M. Carey, the undersigned, Assistant Secretary, of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 20 day of January -20 14 .v 64 f <~``t • � atr' E'.,e � �I` _ r� Y n4 / i 1 By. David M. Carey' -Assistant Secretary 18 of 100 TIMOTHY P. MURRAY LIEUTENANT GOVERNOR The Commonwealth of Massachusetts Executive CJ. ffice_ for. Administration and Finance Division of Capital asset Management and Maintenance One Ashburton Place Boston, .Massachusetts 0.2108 Tel: (617) 727-4050 Fax: (617) 727-5363 First Amended and Restated GLEN SHOR SECRETARY, ADMINISTRATION & FINANCE CAROLE CORNELISON COMMISSIONER Filed Sub -Bid Certificate of Contractor Eligibility CONTRACTOR IDENTIFICATION NUMBER: IL72 This Amended and Restated Certificate Shall be Used for Submitting sailed Sub -Bids Only The prior Certificate of Contractor Eligibility with an Approval.Pate of 312412013 is hereby superseded, amended and restated by this Certificate with. changes to the information contained in the following Sections): 6 1. CERTIFICATION PERIOD; This Certificate is valid from 3124/2013 to 3124/2014 2. CONTRACTOR'S NAME: Marmelo Bros, Construction Co., Inc. 3. CONTRACTOR'S ADDRESS: 13 Ventura Drive, North Dartmouth, MA 02747 4. WORK CATEGORIES: This Contractor is certified to file Filed Sub -bids under Massachusetts General Laws Chapter 149, Chapter 149A and Chapter 25A in the following checked Categories of work: Acoustical Tile El HVAC ❑ Miscellaneous & Ornamental Iron 0 Electrical Work [I Lathing & Plastering _] Painting Elevators © Marble 0 Plumbing Fire Protection Sprinkler Systems (/] Masonry Work �a Resilient Floors Glass and Glazing [], Metal Windows [; Roofing & Flashing 5. EVALUATIONS: Number of Projects Evaluated: 22 Average Project Evaluation Rating: 95 Number of Projects Below Passing Score: 0 El Terrazzo F file Waterproofing; Damp proofing, and Caulking 6 SUPPLIER DIVERSITY OFFICE CER ICATION: Minority Owned Business Enterprise reya S. Bernstein, Deputy General Counsel, Approval hate for Carole J. Cornelison, Commissioner NOTE TO CONTRACTORS: Complete Applications for Renewal of Contractor Eligibility are due no later than, three roonih� 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. t r, Reviewer's Initials. !� EFFECTIVE MARCH 30, 2010 Commonwealth of Massachusetts Division of Capital Asset Management 0 SUB -BIDDER UPDATE STATEMENT TO ALL SUB -BIDDERS, TRADE CONTRACTORS AND AWARDING AUTHORITIES A COMPLETED AND SIGNED SUB -BIDDER UPDATE STATEMENT MUST BE SUBMITTED WITH EVERY FILED SUB -BID PURSUANT TO M.G.L. c.149, §44F AND EVERY TRADE SUB -BID PURSUANT TO M.G.L. c. 149A. ANY FILED SUB -BID OR TRADE SUB -BID SUBMITTED WITHOUT AN APPROPRIATE SUB -BIDDER UPDATE STATEMENT IS INVALID AND MUST BE REJECTED. Caution: This form is to be used for submitting Filed Sub -Bids and Trade Sub -Bids. It is not to be used for submitting Prime/General Contract bids. AWARDING AUTHORITIES If the Awarding Authority determines that the sub -bidder is not competent to perform the work as specified on the project, it should reject the bid. SUB -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 Sub -bidder Update Statement on behalf of the bidder named below, that I have read this Sub -bidder Update Statement, and that all of the information provided by the bidder in this Sub -bidder Update Statement is true, accurate, and complete as of the bid date. January 21, 2014 Marmelo Bros. Construction Co., Inc. Bid Date Print Name of Sub -bidder or Trade Contractor School Dept. Admin Bldg. Project Number (or name if no number) Town of North Andover Awarding Authority SIGNATURE* 13 Ventura Drive North Dartmouth, MA 02747 Business Address 508-995-6582 Number 1 Kdderjs Authorized Representative ''Information you provide herein must supplement your firDW recent DCAM Application for Sub -Bidder Certificate of Eligibility. You must report all requested information not previously reported on your most recent DCAM Application. Division of Capital Asset Management Page 1 of 15 Sub -bidder Update Statement Effective March 30, 2010 INSTRUCTIONS INSTRUCTIONS TO SUB -BIDDERS This form must be completed and submitted by all Filed Sub -Bidders bidding on projects pursuant to M.G.L. c. 149, §44F and Trade Contractors bidding on projects pursuant to 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 SUB -BIDDER UPDATE STATEMENT IS GROUNDS FOR REJECTING YOUR BID AND FOR DEBARRING YOU FROM ALL PUBLIC CONTRACTING. This Sub -Bidder Update Statement must include all requested information that was not previously reported on the Application used for your firm's most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. The Sub -Bidder Update Statement must cover the entire period since the date of that Application, NOT since the date of your Certification. You must use this official form of Sub -bidder Update Statement. Copies of this form may be obtained from the awarding authority and from the DCAM Web Site: www.mass.gov/dcam If additional space is needed, please copy the appropriate page of this Sub -bidder Update Statement and attach it as an additional sheet. Division of Capital Asset Management Sub -bidder Update Statement Effective March 30, 2010 INSTRUCTIONS TO AWARDING AUTHORITIES Determination of Sub -Bidder Qualifications It is the awarding authority's responsibility to determine each responsible bidder. You must consider all of the information in the bidder's Sub -bidder 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 sub -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 SUB -BIDDER'S ENTIRE CERTIFICATION FILE AT THE DIVISION OF CAPITAL ASSET MANAGEMENT. Telephone (617) 727-9320 for an appointment. Correction of Errors and Omissions in Sub -bidder Update Statements Matters of Form: An awarding authority shall not reject a sub -bidder's bid because there are mistakes or omissions of form in the Sub -bidder Update Statement submitted with the bid pursuant to M.G.L. c.149, §44D, provided the sub -bidder promptly corrects those mistakes or omissions upon request of the awarding authority. [810 CMR 8.13(1)]. Correction of Other Defects: An awarding authority may, in its discretion, give a sub -bidder notice of minor defects and omissions as to form in the Sub -bidder's Update Statement and provide an opportunity to correct its Sub -bidder Update Statement. However, the sub -bidder shall not be allowed to make corrections to a Sub -bidder Update Statement if material information about the sub -bidder was omitted from the Sub -bidder Update Statement filed with the sub -bidder's bid. The Awarding Authority shall advise DCAM of any material omissions in a Sub -bidder's Update Statement.. [810 CMR 8.13(2)]. Page 2 of 15 H W I w LULUH J a c ca co w E� Z O c (U .--, c JujE:3 Z " LU c U L U Q m C Q cn U = O g0Eca N L LLQ`~ N L U- Zc OXY wO Hp m3 cn N Q cn +=z cn E ~ o UN co WD, E0 (D� 2 U ca N 0-0 .r OD � cn ty L C w C cu � -0 o 0 a W 0 0-0 U cu 0 =a)�, jHCU�U) �<� am I—+- C-) LU CO pOLO 1 -- co c6 COCL 0 w0r Q Z J w v- a ��LL O� �QO o'> �Uw Z—FCL - U_ D Q � E �' J Q — U �O� E UJ " a�U °.o J Q � � Q 0 W c F- Uj cu CL J H m Q N a W w �- W c -q C14 C\l C14 04 04 N •- N N �"" J O O O O O O O 04 O C\l O 04 O O O O Qd N M N N N N N O O O N N N N 00 00 N LO U') O r W N_ 00 �- N_ C14 N_ N_ N_ C\l 04 N C\j O ON O O O O O O O N O 0O O � N N N N N N N N C N N Q Cl) M r CO f- (0 O G7 (D O O F- w U o0 —0 0 a 0 00 0T" 00 0 0 0 0 0 o a`no o V- co U ci 0 0 O �j o O O 0) O Q V 00 , O � CO M 10 O O -' O O O O M O O O ti M of 00 M d. O O N pp 00 � � 04 M OD O 00 r Lo N N I- CN 04 Z I• EA N ER Qfl Ef? Efi EA 't EA O tf3 O �} U �O (D 0 O 0 O O O 0 O O O 0 0 O O W rn cn U) cn cn (n cn cn cn 0 w (n cn �Q m m m m m m m m m m m m m U cn Q 00 c — CL �_ a 3 00 c j (D C O 0 O w 0) O J Q 0 0 m U a H EQ �' cn cn O c m m � > 0 m Z W n (n- J (D N m` -Q N c vi m c c c p 06 a °o w _ ° a� N E N c°n °' o 03 0� 0 Q ups _ F- I- (n (n c 0 N U) O Q L0 s 07 c m J = N w = F- y V 0 M N OZS E U Y c O c f 'O 2 Wa =3c = a U cn > U) � a� .r 0 U)_ D En Z = m m _ CD U U) a c O c ` c c 0 E U c Q O a m n 0 M N rn m CL 0 0 N O M L m 2 M M M r O r O r O N N N LO LO O c1r) M M T- o T- O T- O N N N 0 0 O O O O O LON O cyi M f� M ~ O � � r C c c N N N a 2 L 7 O E a 'a cu w z 0 -*-Lr— C: c O c c �+ J M J f0 O f0 E a) N O W j r- c Y Y � c 7 m C3 cu t9 2 2 N N E N m m a 0 M L 2 m 2 N U N 9 rnW c c 2 E m ui c`o" Q � f0 as U� o � a ca Q- .0.0 Mo clU W Q a Z) Q W a r O LO N rn co CL N O U mW c a 2 E a) QM w� av cc CL 00 O N C :o o z Mn�6 O M 0 0 N N N O It O v 0) O W O O qt � O co 1 O O MLO Z O O h O O 6 M O O M M qt M LO N _ N 00 a0 r� N r` U? I EL r- rl- co - N r` r ao r` o w J — CO — CD I- (3 Oo N O O — O o Cn CO W F- CN 0IT N m Q N O O r (L) O Q N Q 0 2 Q O r O CflO L Y 00 Q C a �- Q NO In O - m C C (Yj Q C O ll i a) CN - o d 0 2 `� O O �- 3 Q E Q LO a) m` ° Q — O c Q (D a) m o c Z c�i c cTi c65 o 5 ° �' o Q ° O S E Q a) ° U in a) rn 2 3 cu ` 3 g w rn C a) °' C m z C c z W a m LL a) o m t w 3 N U a) 3 C CL O v Cn (n ami > M M O N LL = - O m C O U cn U) o Q (D M Q o N _ O Q Lo N -a) a) a) F- Z U 0 U 0 O � C) M W U -° C N L fn 0 w y O C 3 L 3 C t° 0) - a) cc 3 � E r � L � C6 U co m o Q _ in = O �n Z U m E a >v w c 00 Cl) U') O 00 M O O m O O c qt O N O O C a) 3 M M L M O M N N M U U')H O U')Cn CO N J N N U T U a) m ai C Ca a) J J o 'V o ° U fJ c E m C ZT E N U U 0 a ° a) m _w to 0 N Y y Q Eo U m Y S w a o O U Q 06 @ 0 WO N m U C c a) c U a) ccnn Q 0 E Cn m Y O C -C O J CD O _o 7 Z 0 �' CD C1 3:2 O to 0- ` O O a1 Ll O a) wO C L Z L (n m U) O E U co C ZT 3 Z C 3 N in Ccm 76 C ll� C Q 0. w O E L •.- O N �. N g C a) 0 co 0 U o z 3 U) �—° o o m E U) (n 06 H � m � O U � m � `0 w a ° w w ( .. w w 0 w w 0 " Co w w 2 w Z CZ`s Cn Z m Z 0 U Z Z (D U U) U W U W U W U W U O CD O 0 CD O 0 CD O 0 CD O 0 C7 Y O` O CO C O O O to a) _ Q d 7501-- °C fn t- Q a) ai c Lao rn .S � U CL c�i � C a) c w o L L tom �p:2 N O Z N CUQ m L =LL p � oc O 0m oc F- a Y _ a a) O m a) = S w r O LO N rn co CL N O U mW c a 2 E a) QM w� av cc CL 00 O N C :o o z Mn�6 O M N M m a 0 0 N O M t m (D U N V cm m ., cc c G E CAN U) ~ Q a� m CL C) o c 0 •N a 5 fn o O O O r. O O o r- T- 0 r- rn IT O v o 0 00 v O O 00 It O o r 0 - 00 r O LO N O (D O r- 'IT (0 CD N O O O r ter• O O 00 r, V n M N M O CD .- M O o pOp to O LO O Lo LO OO 'I M M 00 t i LO 00 Iq 17 M M r, I� O) r - ti Cl) 00 00 O 00 ti 00 r O r- 00 00 r- M O O O M 1- O r T- O r- O O CO L1) LO M O 0 LO O O (D LO O m O Q O O(14 N O mm O m m O O Q Q 00 NOD ti N O O p _ N O p LL t O p t0 co O d r NO C O C N Q O N Q O N N O Q O Q — 0 O N 0) r O) O Q 2 o 0 O Q 0 O Q �; No � (n (n ai �, No � o � Z U 2 Z N m ai m c � •0 Q � +- N fn � � Q � + Q U Y O ++" O Y 3 O c O) c Y 3 O i O M N •C U �— p U m r 2 Lo N W +�. m > O N m 0] V- C14 CN m m (n U) ) N N L N N N N m Q M C) � N N m 2 U) C �C ��A -� cQ N c0) (� C (n 0) ., � , , (n N (n � � to & c6 m � m m m J _ m a m N c a m !n " L- M Cl) m rn coo N Lr)g � w = mv� �, a�w = m� �LO LL c M 000 N N O 00 O O N N N m ?? O 00 O C), O N 07 r J co co O) O Cl) co N O) O 'n O U W> M N O O N r- u O m m (n O C O O is E O C (j C U) Q N Q N U — — .i� N 06 U U C N N 06 U O Y O U U O U L -U C N V ( C U C W w y C m 0 a) O C O U " U > N O N (n U N U Ol :3 a? C O E L U 3� O C - D- m (� c 0 m C C (� a (D c O N c N 4) L O O O -5 0 ca N O cn 0 C d L O Q c U = c Q CN )a Y C a� -1 2 C Z Z p Z W' Z Z Q �- Z E Z LU O p w O m w (� F- w (� z w (� U w (� Z w (� J U zz W U Z W U Z U U z> U >Z U z > O w o cD > O o (D O o (D O w Os 0 > O w o (D > O W U 0 E (D O W o U (� C (n O O cl "o m m C L cn m (A m > E iii i 0) N E Y O Q O °i me di C: U m X �a > -C (A c m m` > m m E U). Y c a CL U �� O U) U- ` N D N N M m a 0 0 N O M t m (D U N V cm m ., cc c G E CAN U) ~ Q a� m CL C) o c 0 •N a 5 fn 0) m a) L > C 0 7 O fo L a a) O O O r N N C N N > c 00 LO N M co 00 'T00 E O N to U o0 N L9 a) V M ti c- m'- M � n. a) LO 0) � C O °U 0000 �U) U) `O Iq arc m d LO a O N N N 00 C L9 lA c L9 L9 E T Il� ti Q .23 c' 0 m ti I- CO (0 (0 O O C0 C0 (0 =a O LO O It 04 C O fA c O to C O N O EE O LL 19 MQ (D O m a) Q Z a) Q Z U N CO 0 O O a) O O O _ m � N m c+�- O O Cn c O O +` N O m d O -0 O a O LL C O _cn E Z (u 0) Z m Z U a) U a) U c a) `- °° o a) >cov m aE >N a o c > O c7ONcn O a- M U) rn O Q 0 rn Q CO m 00 C to c � N S n N a) L U U N E O Q O E co Ou U co E cu oLcu U L V Q O U L- cn co 0(D tz CDO(D a a) � � Z_(D LO (D - � � 3 T- 't T- a 3 CO c0 cn 00 N M SONO N HJ co NON i -J O CO CO �O c E ) c E a) mcl m CL 03 OU O .0 a) > c°n > cn :3 a)QQ mQQ t4 c v7 c N N O N C C: >' O J ,C C O >' O J. .0 c O a) O U U N L U - m c (�6 ZU ZU � E rn O C) O N O t: N E p �c-- b C v c O C N >_ Q ° rya 3 Y—'a 3 °EW v D ofm 2 a) g a) w mW m +->+ W Z cn EW CL Z C (�6 EW Z c N QW W' Z } O > Z U Z T U 0 Z U jO 0) c O Q Q 0 000 (D O Q Q (D O Q (D a) a 23 3N vi O } -c c c c C C O Q c 16 2 a)U)JO (n O JC) a) L �W �cQ NM fo� c G ac)D y a) _0ai•c o cnmE -14 t Q rn (n m a) c E a) o m a) E Y O _ 2 _O W Z 0) m a) L > C 0 7 O fo L a a) m a) EEa E r C'. ns C a) O > c U c cu a LO ° E O o U U r C N a) N U) m'- 0 a) n. a) O 0) � C O °U c� �U) U) `O c arc m oD a c •'o v N C C 0 0 N c E E O c > Q .23 c' 0 m O a <o a) � a =a co c T >, c c co (o Q E o U >' C fo C1 >1 E N 0 O i o >1 `OZ 3z rn® O® c O C U) U) O N CZ E} co} (D M El0 OC El C O a) a) s 3 a) EEa a) C'. ns L E w .fl vci c Cb ''D o ° g E O C N a N U) m'- U a Q N 0.— > E ca) 0.2- a) ?:m a� a c� �U) U) UD loo (10w,o arc c m oD c •'o UN O >' a) n C 0 0 cu L >_ 7 DO E >, m Q .23 z O U H z O w 0 z D U) C2 G 00 Q 2� ~O W U �Y O� 20 OW O = O O F- F- CVS w QLL 0w O = ZV� w O of W 2 _F� JL - >O Z�U) z N� Q li V U C¢7 -� W N w H W Q J 0.< J F - T,, 0 00 a> rn m IL 0 N O M m a) Z2 .-6 U 19 rnW co ., c c 2 E in w Q CLs m a UD 0 0 c v o Mn�6 o� LL H w 0 co co O O OO O OO z W Oo o pM 0 00w J DYx ) co 0o O cr) 0 O oI,- Q 2 LO 0 cliO O 0 U 00 1- U). M 64 - 0 N M N - T- 1- 04 0 6cp 63 w o� o o o o o z a N M r- �° (O IT OD 0)0 0 0 0 0 0 O rn oQ U UO O 0 O O O O9 W N O O O O U M 00 N co 00 00 O O Z a O 00 M0 I' 0) i NT C6 �t or- � N M N I� U cfl c� Nm F» 04 m W J 0 Zoe OW N z a) 0 z v LU o CN 0 0 o O C14 O 04 o 0 04 zw N N N N (0 ti (D O000 co M I I I I I I Q M O N o N — O N O N O NN O O N O N U) LO 00 0000 d) IT LO M NO �O UJ `c c `c c c N c c � c UJ (1) (1) (1)� U) c°n Q U Z O c L Q cY N O Z i c 0 W V/ U O o r �Q c > — OL m Z, a� �� �Q �� ? u oU) aaCL ) c � �—°o W�; c0 W o Y`f. N c > T_m (a) 0 � /vim C .0 m a) Y/ E>� M� � � cn a� y 2� LL � W/ O V / M c f- �x Q - �� m 3 �m �� m 'c O o CD 0)= U >, w of Z a`ni N E o w p N N m 0 N O Z~ c m c m 0 ii U .r a a � T,, 0 00 a> rn m IL 0 N O M m a) Z2 .-6 U 19 rnW co ., c c 2 E in w Q CLs m a UD 0 0 c v o Mn�6 o� W Q IL U) D O\_ w d W 2 H z p w F- U) U J U W � ^w LL w W J Q. O U z 2 U Q W w O LLz O CQ C Qr O LLz w U z W w w LL w w 0 Z O J J O LL w W p Of CL w Z 04 o (.C)0 000 0 m o 0 O O 00 0 (C) LO N LO NT O _ [r - o O N i e- 1 O (O i O CL LO r- N co r C7 000 M OD W 9) M IT 1 IT d 00 00 f� J � 00 OD r 00 �- W Q r r L M LO O r 04 Q 0 (O Iq O O O N N N NO r- (D 0 Q LOQ N x o a) = O O 4+ Ln O C O j N Q Q U Q O Q o Q o Q N o o m > c a) > Q om Zcyi a) *M o c cn L CO (o O > (n m cn 0 c 0 m N a) c t `� a) y (o (n p o o N Wct a) T N a) N Q t N a)LO O F U .: a) c O - a) a) d) 00 + Q U L N C V (i C o) C lie+) (D 0 L cu C M U.) c �e V Mcn W �n �`1V� 1` �f e V_ 75 C E R Zp�ui M a) m /�^�, W > L• Q /CR 0 (3 (D.0 D co co > Z0 m • a G 0��� o0 N N �o OQ O w E �M U .-d J Z N U C- O N U LO N N W LO N Lo � U a) O �F D ; c c Lo - - Q c c Ucm c con cn ui C �.. N C :� O L a) L a) L Q E Q -C m 4)c Q C cU Q U Z >- o > a) fo a o Q cl)+� U 6 a) cu a a) C (o 1- U d 0 Q_ ci C c a) C (o L � D L (i C - Z p (� N > 0 Q f O U C 0 O L cn cn (0 0 N O U Q O Q 'S a) t U c o m c E U U 0) w a) m s- v a) cco 3 Q o (n U a) U c O a) a) o o z L - ci c? a) _ �L >. z E E c U o C7 E E U m_ o .� U vo) a) U o C 00 0 U 0 N a) w o 3 `) o c L Y � -o •_ �, 2 c w O U p m 3 c 3 p ti E lo- U U C� E-0 U m t0 0 0' Z -O C W z W z Q Q' W z cn C W' W z to o w W z W z ,.. w W z Q W 0 J W (� U W (j U W (� U W (D Q W (� m W (D (o m wW 0 U W U W U W U W U W U W U � W U > W U O p (D O p (D O p (D O p (D O p 10 O 10 1 (D O 10 10 O p CD W c N 0 O �' L �p Co >, (pC N v J o =Qc U Q ca ` (D a)_ '- C 0 0 MC) o L �� m0 _a 0 2� a) C - �2 O CL CU �_ U in �� LL C -0 a) E a) 0 2) L U wiA C C 0 o W N N = o W N Y(D CU O) c� o cn N E N _ m 2 O O (� N a) 3 L Lp z a) �t -0 U 0•E Np OL m O C.2 W C cn cn a)3 co U U s C: Qa) m e a a) m 0 ~ (n d N p LL Z rn IL 0 M L U m a� U E NW C c E N 4' N U) Q � N .@. N .a., N CL UD -0 C'D (n.0 U) L- D � ® & � E o 0 / o 2 ■ k c cu E E 0 c c 0 0 £9 ƒ9 �z @ � fb ab cu £y �y ❑❑ @ k � E o 0 cl- dk >%E E 22 0 oq 0 £ C�. j \o k0 cu C : / k k CU & § @ E 0 E 0 u 2 t 2 0 R 0 E ccn, 2£ cE (D d � ) cu § . m M 0 CU ® P 0£ £ a2 0 \ 4- 0 0 00 0� § k % CL o @ >1c@E 0 < 0 it- § & a B k k � 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 the Application for your most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. You must report all requested information not previously reported on that 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 a project? 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 fled 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 had a payment or performance bond invoked? 7. Has your surety made payment to a materials supplier or other party under your ❑ E payment bond on any contract? 8. Has any subcontractor filed a demand for direct payment with an awarding authority ❑ for a public project on any of your contracts? 9. Have any of your subcontractors or suppliers fled 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 your projects? 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 year? Division of Capital Asset Management Page 11 of 15 Sub -bidder 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 Application for your most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. You must report all requested information not previously reported on that DCAM Application. The term "administrative proceeding" as used in this Sub -Bidder 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? SEE ATTACHED 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 12 of 15 Sub -bidder Update Statement Effective March 30, 2010 PART 4 - Legal or Administrative Proceedings; Compliance with Laws (continued) YF.9 Nn 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 federal law regulating labor relations? 8. Have any proceedings by a municipal, state, or federal agency been brought, ❑ 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 SEE NEXT PAGE 11. Has your firm been sanctioned for failure to achieve DBE/MBE/WBE goals, ❑ workforce goals, or failure to file certified payrolls on any public projects? 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? Division of Capital Asset Management Page 13 of 15 Sub -bidder Update Statement Effective March 30, 2010 PART 4 —QUESTION 1 Explanation Project: Bowditch Athletic Complex, Framingham, MA Owner: Town of Framingham On or about November 10, 2011, general contractor Seaver Construction Inc. filed the lawsuit titled Seaver Construction, Inc. v. Marmelo Bros. Construction Co., Inc., Middlesex Superior Court No. 2011-04018-F alleging that Marmelo performed certain defective masonry work and seeking damages of approximately $558,000. Marmelo Bros. Construction denies the allegations in Seaver's complaint, and maintains that Seaver owes Marmelo a subcontract balance of $59,084.42. The suit is pending. PART 4— QUESTION 10 Explanation Project: 333 Aiken Street, Lowell, MA In November 2012, OSHA cited us for 1) Our lull was missing or had unreadable or worn safety decals. We replaced them all. 2) The load chart was missing from our lull. We supplied it. 3) Our hoisting operator did not have the latest hoisting operator safety certification. He attended the class and has the updated certification. 4) We were missing a guardrail. This was corrected immediately. Division of Capital Asset Management Page 14 of 15 Sub -bidder Update Statement Effective March 30, 2010 PART 5 - SUPERVISORY PERSONNEL List all supervisory personnel 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 Antonio Marmelo President see resume Steven Marmelo Vice President/ Estimating see resume 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 ALONG WITH CERTIFICATION PAGE. Attach here a copy of the list of completed construction projects which was submitted with your firm's Application for your most recently issued (not extended or amended) Sub -bidder Certificate of Eligibility. The Attachment should include a complete copy of the entire Section F — "Completed Projects" (Section G — "Completed Projects" for firms certified based upon their Prime/General Application), and the final page — "Certification Page", (Section I in the Sub -bidder Application or Section J in Prime/General Application) containing the signature and date that the Completed Projects list (Section F or G) was submitted to the Division of Capital Asset Management. Division of Capital Asset Management Page 14 of 15 Sub -bidder Update Statement Effective March 30, 2010 I lylo' fdnrl School Department Administration Building Kang Associates, Inc. . North Andover, MA January 2, 2014 FORM OF SUB -BID To All General Bidders Except those Excluded: A. The undersigned proposes to furnish all labor and materials required for completing, in accordance with the hereinafter described plans, specifications and addenda, all work specified in Section 042113 Brick Masonry of the specifications and in any plans specified in such section, prepared by -Kang Associates, Inc. for the School Department Administration Building,North Andover, MA for the contract sum of: One Hundred Fifty–Four Thousand Eight Hundred – – – – – – dollars ($ 154,800.00 ) For Alternate #1: Deduct $ n/a dollars For Alternate #2: )qwx. Forty thousand------------ 40,000.00 Deduct $ dollars ($ ). For Alternate #3: Deduct $ —g/a dollars ($ ). For Alternate #4: Deduct $ n/a dollars ($ ). For Alternate #5: Deduct $ n/a dollars ($ ). B. This sub -bid includes addenda numbered 1 C. This sub -bid ❑ may be used by any general bidder except: ❑ may only be used by the following general bidders: (To exclude general bidders, insert an "X" in one box only and fill in blank following that box. Do not answer C if no general bidders are excluded.) FORM OF SUB -BID - 1 School Department Administration Building North Andover, MA Kang Associates, Inc. January 2, 2014 D. The undersigned agrees that, if he is selected as sub -bidder, he will within five days, Saturdays, Sundays, and legal holidays excluded, after presentation of a subcontract by the general bidder selected as the general contractor, execute with such general bidder a subcontract in accordance with the terms of this sub -bid, and contingent upon the execution of the general contract, and, if requested so to do in the general bid by such general bidder, who shall pay the premiums therefor, or if pre -qualification is required pursuant to section 44D 3/4, furnish a performance and payment bond of a surety company qualified to do business under the laws of the Commonwealth and satisfactory to the awarding authority in full sum of the subcontract price. E. The names of all persons, firms and corporations furnishing to the undersigned labor or labor and materials for the class or classes or part thereof work for which the provisions of the section of the specifications for this sub -trade requires a listing in this paragraph, including the undersigned if customarily furnished by persons on his own payroll and in the absence of a contrary provisions in the specifications, the name of each such class of work or part thereto and the Bid price for such class of work or part thereof are: Name Class of Work Bid Price (Do not give bid price for any class or part thereof furnished by undersigned.) F. The undersigned agrees that the above list of bids to the undersigned represents bona fide bids based on the hereinbefore described plans, specifications and addenda and that, if the undersigned is awarded the contract, they will be used for the work indicated at the same amounts stated, if satisfactory to the awarding authority. G. The undersigned further agrees to be bound to the general contractor by the terms of the hereinbefore described plans, specifications, including all general conditions stated therein, and addenda, and to assume toward him all the obligations and responsibilities that he, by those documents, assumes toward the owner. H. The undersigned offers the following information as evidence of his qualifications to perform the work as bid upon according to all the requirements of the plans and specifications: 1. Have been in business under present business name 39 years. 2. Ever failed to complete any work awarded? 3. List one or more recent buildings with names of the general contractor and architect on which you served as a subcontractor for work of similar character as required for the above named buildings. Building Architect . General Contractor Amount of Contract (a) Wh tiny lle. Dixon—Salo Arch Consigli Const $297,000. Christian school FORM OF SUB -BID - 2 School Department Administration Building North Andover, MA N Andover WI`P Wright— (b) (c) Hanscom AFB 4. Bank reference Pierce Arch Symmes,Maini, M�Kee Assor s Eastern Bank Methuen Const Kang Associates, Inc. January 2, 2014 :1 111 W657al sk in Tol im 1 111 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 of subcontracts subject to section 44F. The undersigned further certifies under penalties of perjury that this sub -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 regulation promulgated thereunder. 1/21/14 Date SUB -BIDDER'S CHECKLIST: Addenda Recognized Bid Deposit DCAM Certificate of Eligibility Sub -Bidder Update Statement Certificate of Corporate Bidder Empire Masonry Corp (Name of Sub -Bidder) By: President Signature and Title of Person Signing Bid 231 Norfolk St Business Address Walpole, MA 02081 City and State FORM OF SUB -BID - 3 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 employed at the worksite and in the work will have completed an OSHA -approved construction safety and health course lasting at least ten (10) hours. Signature - Thomas McCormick. President Print Name & Title Date 1/21/14 Empire Masonry Corp Company Name 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 other organization, entity, or group of individuals. Signature Thomas McCormick, President Date 1/21/14 Empire Masonry Corp Print Name & Title Company Name CERTIFICATE OF TAX COMPLIANCE Pursuant to Chapter 62C of the Massachusetts General Laws, Section 49A (b), I Thomas McCormick authorized signatory for Empire Masonry Corp 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 Commonwealth of Massachusetts, and the Town of North Andover, relating to taxes, permit or other fees, reporting of employees and contractors, and withholding and remitting child support. Signature Date 1/21/14 School Department Administration Building North Andover, MA CERTIFICATE OF CORPORATE BIDDER Sandra McCormick secretary Bid Form, and that Thomas McCormick Kang Associates, Inc. January 2, 2014 certify that I am the of the corporation named as Bidder in the 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. Corporate Seal ecretary-Clerk 1/21/14 Date CORPORATE BIDDER - 1 CONTRACTOR: (.Name, legal status and address) Empire Masonry Corp. 231 Norfolk Street, Walpole, MA 02081 OWNER: (Name, legal status and address) Town of North Andover MA BOND AMOUNT: $ Document A31OTM - 2010 Conforms with The American lbstitute of Architects AIA Document 310 SURETY: (Name, legal status and principal place of business) Western Surety Company 53 State Street Boston, MA 02109 Five Percent of the Attached bid (5%) This document has important legal consequences. Consultation with an attorney 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, if'any) School Department Administration Building, North Andover, MA; Section: 040001 Masonry Work 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 die 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 specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise 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 tern Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement 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 shall be construed as a statutory bond and not as a common law bond. Signed and sealeodis 21st day of January, 2014 Empire Masonry Corp. (Principal) (Seal) (Title) Western Surety Company (Surety) (Seal) (Witness) ) A ("r'itle) AdamA betanctis, A orney-in-Fact Western, Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Gregory D Juwa, Richard F Caruso, James J Axon, Michael F Carney, Wilder Parks Jr, Michael T Gilbert, Adam W De Sanctis, Christine B Gallagher, Bryan F Juwa, Paul A Patalano, David A Boutiette, Judy Dean, Rebecca Shanley, Individually of Woburn, MA, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 12th day of December, 2013. WESTERN SURETY COMPANY °StlR...... ,. _W{4C A?P{Zi 4 >N DPM a ,rp,,,n. 2 aul T. Bruflat, Vice President State of South Dakota I ss County of Minnehaha On this 12th day of December, 2013, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires f"` """""""""""""'""`""°'# J. MOHR June 23, 2015 s AE NOTARY PUBLIC SEAL r t SOUTH DAKOTA +ww CERTIFICATE (1:�)o "A,) J. Mohr, Notary Public I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this 21 day of. as"RETy"' WESTERN SURETY COMPANY • r -i �nmr,uM L. Nelson, Assistant Secretary Form F4280-7-2012 x, Authorizing By -Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders of the Company. Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. J The Commonwealth of Massachusetts Executive Office for Administration and Finance Division of Capital Asset Management and Maintenance One Ashburton Place DEVAL L. PATRICK Boston, Massachusetts 02108 GLEN SNOR GOVERNOR TCI: (617) 727-4050 SECRETARY, ADMINISTRATION 8, TIMOTHY P. MURRAY Fax: (617) 727-5363 FINANCE LIEUTENANT GOVERNOR CAROLE CORNELISON COMMISSIONER Filed Sub -Bid Certificate of Contractor Eligibility CONTRACTOR IDENTIFICATION NUMBER: 1778 This Certificate Shall Be Used for Submittin Filed Sub -Bids Only I. CERTIFICATION PERIOD: This Certificate is valid from 10/5/2013 to 10/5/2014 2. CONTRACTOR'S NAME: Empire Masonry Corp. 3. CONTRACTOR'S ADDRESS: 231 Norfolk Street, Walpole, MA 02081 4. WORK CATEGORIES: _I Acoustical Tile i� Electrical Work _ Elevators Fire Protection Sprinkler Systems El Glass and Glazing S. EVALUATIONS: 6. SUPPLIER DIVERSITY 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: LJ HVAC ❑ Miscellaneous & Ornamental Iron El Lathing & Plastering Painting Ell Marble Plumbing V Masonry Work L ] Resilient Floors Metal Windows ❑ Roofing & flashing Number of Projects Evaluated: 3 Average Project Evaluation Rating: 94 Number of Projects Below Passing Score: 0 FICATION: N/A Freya S. Bernstein, Deputy General Counsel, for Carole J. Cornelison, Commissioner t_ Terrazzo Tile L Waterproofing, Damp proofing, and Caulking Jllv/a Approval Date 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. Reviewer's Initials _S EFFECTIVE MARCH 30, 2010 Commonwealth of Massachusetts Division of Capital Asset Management SUB -BIDDER UPDATE STATEMENT TO ALL SUB -BIDDERS, TRADE CONTRACTORS AND AWARDING AUTHORITIES A COMPLETED AND SIGNED SUB -BIDDER UPDATE STATEMENT MUST BE SUBMITTED WITH EVERY FILED SUB -BID PURSUANT TO M.G.L. c.149, §44F AND EVERY TRADE SUB -BID PURSUANT TO M.G.L. c. 149A. ANY FILED SUB -BID OR TRADE SUB -BID SUBMITTED WITHOUT AN APPROPRIATE SUB -BIDDER UPDATE STATEMENT IS INVALID AND MUST BE REJECTED. Caution: This form is to be used for submitting Filed Sub -Bids and Trade Sub -Bids. It is not to be used for submitting Prime/General Contract bids. AWARDING AUTHORITIES If the Awarding Authority determines that the sub -bidder is not competent to perform the work as specified on the project, it should reject the bid. SUB -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 Sub -bidder Update Statement on behalf of the bidder named below, that I have read this Sub -bidder Update Statement, and that all of the information provided by the bidder in this Sub -bidder Update Statement is true, accurate, and complete as of the bid date. Id Empire Masonry Corp Bid Date Print Name of Sub -bidder or Trade Contractor " / s A r'J.on ui' /a�> ►u3 . /�/ 4 Project Nuffiber (or name if no number) 231 Norfolk St, Walpole, MA 02081 Business Address /©:o.n 01 &ki9 Ai c/o Ile /L— 508-660-1011 Awarding Authority Telephone NNumbe SIGNATURE* Bidder's Authorized Representative Division of Capital Asset Management Page 1 of 10 K W U Z , � 00 0 � w F- p WW J Q aZ W 02 UQ C=0 G C) W LX LL z �W F- 0 w Q 0 Z 0 W � W O tu) 2(/) O -� o~ 0 0W oW (f} LL 0 U) COC G w 4c U� -) D >- 0 0 O J w LLLL V Z W aoLL 0 CUW Z F - Q d Q J Q LL mLLP )OW WU QpW U) 1: 0 J I-- m L 0 W M M M M Y WW's - J O Ln r- M In 3 OO O.- O T- O .- �. E aa) O O E U N w .. �.C 'O (n Q< CM M s- M T- N OC) c\- It r O O O O ''F^ v/ ( o -C 1. U O mn (6 Y -C Q CL f' O O O O O Q LO O CY) O O 00 o R' N U) m r - z a� a-0 0 U 0 O U O Q. O N .L -0 Q �, cn U � o E Y0 af c Q o N :m w O C E N - - Q fl U >Q -> N C -� �:. U C fu O)W c w a) � ... c c m (D C f6 N o O a� 3 Q N Q U J a� m :r= c: L UD w N O >0 2 O E C mh 3 J o to cyi U LLI = cn O 4J H cn O C W- ami U �' � �, C m N LO N ...i: d C O N N Q L 0 C Y O 3 () �. E aa) O E U N .. �.C 'O (n n o c cu Q L O L W_0 ( o -C M O O mn (6 Y -C Q 04-- 0 ch o C o 0 0 a� a-0 E� U 0 O O Q. O N .L -0 Q �, cn U � o E o Co o Q o N C E N M r Q fl U -> N C -� �:. U C fu O)W c w a) � ... c c m (D C f6 N o C= N fn Q N (u cm O U a :r= c: L UD w N O U0, o O cur- C mh 3 Q o to w z O 0 w U) J U w I..L C) w J 0 2 Q w O LL z O O LL z w z w w LL 'w V >z_ 3.0 J 0 W, wQ F C)O Ow CL 0- o L O V C O U M C L M C E O U C C 0 00 c6 �Z �Z -O X X a) 0 W .2: W >11 >,❑ c c E 0 O r. >, U Q. C O L Co Q >C E cn U O L C L 0 0>_. T U L E ._ Q , ow 3 L cn �Lo a) c c M N ca m �0 zm ca a E •N Q C >O A E O (B Q r=+ 0 f6 4- a) t 0 a 3 o E(on aa) C 0_ OL -0 C O N U a) .- -C C :3 0 0-0 + a) L- M U) o W �> 0-0) } C o M O a) C a] U a) (A c� ECL mt c E c a) L 4- U O ° >' N 0 o >, c m E >, U Q U 0 0 0 N 0 M t t6 .. m d U cmW CCU N E (D(D N w N � Q N m .-,o mn U� 0 m ` 0 c � O B •y � p (n �t C) °° a LO 00 N O O o p rn C7 M C0 M l� O N 00 — 00 0 O Lo L( L U) M 00 ( rn tp d m O� to o i _ N Z i M a 00 ti't M to c M _N op - tN M to a o , a. O �- ems- C (� r MO Jto o M ems- C0 LO r c0 0 to ~ LL1 N m c N 7 c 0 L Y J 0 to j a) N C O Z cu ai > c Q N C.0 U 0 co co�� > cv m _ LL ` V O U V 7 N L11 _N W L 5 U 0 ~ U -� N Q N a) 0 CL 0 N Q Q' Q (n Z c L 0.2 .2 _O U a� 06 C 06 U c m 2 ° to N z 3 O to W N o rn _ c �- ai ?+ U) � 2 U o U)i c WC°m° a° U 06— o o G N C rn� N o c m o .°L. Z' V p p C' 0 Y N a) ° U 0) C O cu N C- ° U _Z bc E 6� _ w W () to Q W •� cn �. w z c z cu W z z 0 W z Z 0 Z z U z U z -C.. O,� w b� w b� w d� w v� w v OO p 0 O p 0 O p 0 O p 0 O p 0 JN M Cl)V 07 F- U O O A U m U � c W to m Oma_ > °' N LL c Q N o L O V C O U M C L M C E O U C C 0 00 c6 �Z �Z -O X X a) 0 W .2: W >11 >,❑ c c E 0 O r. >, U Q. C O L Co Q >C E cn U O L C L 0 0>_. T U L E ._ Q , ow 3 L cn �Lo a) c c M N ca m �0 zm ca a E •N Q C >O A E O (B Q r=+ 0 f6 4- a) t 0 a 3 o E(on aa) C 0_ OL -0 C O N U a) .- -C C :3 0 0-0 + a) L- M U) o W �> 0-0) } C o M O a) C a] U a) (A c� ECL mt c E c a) L 4- U O ° >' N 0 o >, c m E >, U Q U 0 0 0 N 0 M t t6 .. m d U cmW CCU N E (D(D N w N � Q N m .-,o mn U� 0 m ` 0 c � O B •y � p (n Z O U Q F - Z O w Z (A Q LL � Q Z) w OU >- Z �W 2� W0 wY O� �O OW 0 0 0 NW EJ9 = LL f— Ow U� W 0 w CL = w3: LL >O uj W W z Q� U_Q J mw -j H Q Q F J F- 0 O Cl) L i f0 U mw C c f6 N aW W a° c0 CL U� o .2 •4 oco W I- w co O O I- _ o 0 W Z J v o 0 0 o O I� Q to L N 0) >OO o w I- h OJ Z LO 0000 co 000 �O U ~ Qw v o O O 0 O 0 0 0 O LO �U F_ M 0 Oa O 00r N NN a U - J Z) O O c 0 = W N >- ? L c U 5 O OU) N Q Q O 00 O M M M M M I— p Q I I O O O N r M O N 0 O U' O U) w CSO O O > Q � U 06-°0 m 0 z o U) M O = c N N p Co v7 c 00 -1 O m M m 'o o m 3: o U _ ca ca ~ $ d O H 0 O Cl) L i f0 U mw C c f6 N aW W a° c0 CL U� o .2 •4 oco Z O I- U Q H Z O W z D U) Q IL D W OU �z W F- 0 W OU wY O� 20 O� W O = O O dw N W t-3 = W W O=> I- U� W 30 Oz w W IL 2 W < LL >O Fx (Z U) W 0 JN�y Q LJ. _UQ J � DO W w -j H J Q Q i- U) J F- 0 0 0 Cl) s L cu U 19 c W ca .. C c 2 E w d N ,0 Q U) N aiu- •a .0 cu n U� o c � o •N a 0U) L-F-w� O 0 o w Z.J 3 0 o P.- Z) X "':� - X00 61 w �w O J O CO z (L 0 O U F- <U ZLO X 0 o O n - U J in C ZO=w � >, U z a M �p I ao w N LL N 0 W F-- (0 � a U I r w w F- z O rn m -' I, U c(D`a 0OJ. (n a U 0 0 0 Cl) s L cu U 19 c W ca .. C c 2 E w d N ,0 Q U) N aiu- •a .0 cu n U� o c � o •N a 0U) LU Z O 0 LLJ U) J U w CL w w J CL O U z 2 Q w O LL z O O LL z LU z LU LU LL w CD >z 0 J 0 LU w O CL w Q 0- U) D O w CL i O N 0, C N O C.A aL. L C O O L- U C O rn N inC � fB C E O c C � 3 C o z z p X X N O w w >,❑ >,❑ c c a � E O U c O cn >' C O O •2 U C0 O `- .1 -C Q 0E �� N i O c O7 O 0 M cn c cn cu E c m m N N >, (n:3 O E o CU CU = 0)m o 3 o E N M cn .C+ C .O N cn O > L O .Q in (a N N -0 Up (0 O C C cm: U � O E O L a M -C O U O O >; C m 0— c —c a) E L N U Q 0 Q X O C O CD a� a� L N O W N O C m N N L O 0 O co L c .? O U 0)W c c E cn Q U) N �6 N Q a cu Q - UD O N O N L 0 L7 M ti M It M 00 O LO 0 o O N Lr)0 M O O q , N CO m 0 N N �- o O 00 Cfl Lr) M O 00 f� 00 O LO r CO O� . N Cfl�c1 LO r (6 CO N p o LO t0 M V N I N N M 00 00 uJ O 0 r- O Cfl r f� f- 00 0 (o O z 00 r- N 00 `t (p CO N O 9 _ � U) r- ado w r� w (o -2 I— CL _0a� o m 0 o c`oco cu Z m >°O > U N m o I �_ 4) o p w o O (0 ; fjA c L ~ _ L •V E w U N N J > N O �' F C N L U 'a w m E o ~ C m a) J w o 0 Q O CIL p U N cn V cn° uS O cn ° Q z cn v Q U +_ L Q L U L Q O U C :3 E 0) Np U) N U U cn C Vi O C c 0) N +- U E O U C O �C cn U) > o�j U O +J a C ` O O Q U LU U 2 cn>� Q C cn Lam` Q CO 0 a N c 0 2 N a ca o Z rn U +L. m 3 H o Z 1 V n orooOU z � 0 L m Q ~ � � Q CL WLU M ct z c w z o z E �z o WW C7 o W>> (D U W C� w CD U O > U >w > W U> W U � W U�WU U O Q 0 0 0 0 0 0 0 0 (9 00 CD w —°0 0 U O VCL � N m a- U LU J 0) cu '0 0) O o c O _ > F- $75 i O N 0, C N O C.A aL. L C O O L- U C O rn N inC � fB C E O c C � 3 C o z z p X X N O w w >,❑ >,❑ c c a � E O U c O cn >' C O O •2 U C0 O `- .1 -C Q 0E �� N i O c O7 O 0 M cn c cn cu E c m m N N >, (n:3 O E o CU CU = 0)m o 3 o E N M cn .C+ C .O N cn O > L O .Q in (a N N -0 Up (0 O C C cm: U � O E O L a M -C O U O O >; C m 0— c —c a) E L N U Q 0 Q X O C O CD a� a� L N O W N O C m N N L O 0 O co L c .? O U 0)W c c E cn Q U) N �6 N Q a cu Q - UD O N O N L 0 L7 W H O W z w W LL W 0 z J 0 W W Q 1:a wD 00 Ow a. EL _ L L O c � rr O U c o rn N cu L cu c E O c >� 3 c O m 3Z �Z aX FuX O O cuw -% W cu c � c a E o U C�• � L . Q' ca =:E >' o co U O cp L +, a) O c L O+ O C.Lr — C :E a) L co O) O O CU CD ccaa) �� E.9 m c > .>, o m o) o 3: O ECU N N O 7 r� O L O =3 C N C a) Q (6 -0 U 00 M L- 0 O CU c -C O U N ECL m O L E c D CD t- o OO O >, L V o L- M c cua A C a)E L 20 Q 0 c m Q. x a) c O cn O- a) L a) O W } 'O a) O c cu a) m O O 0 O Cl) t ca C.> N U 0)W c c 2 E N Q� N •a � N 0' U� w 0 a`) 0 N bin I. N w OU-) n- W N (D Lo LO ; N co C-4 M r- -1 CO L9 ti N c (0 ti ,m V a) U J J z ui N W I-- Q ° CU z o c�a a a z N O U a) J O U c a) Q. O a) a) O c —_ O W a) cc N . Q z U) ° o U w Q w uui w w w O ZZ> > U U W Z z w Of >Z> ZZ> z F W U> 0� W z W U of Z U> z W U U 0 0 0 0 0 0 0 0 0 0 0 0 O o C7 w J w -v F— m F— a) U cv w 070 ) � U _ L L O c � rr O U c o rn N cu L cu c E O c >� 3 c O m 3Z �Z aX FuX O O cuw -% W cu c � c a E o U C�• � L . Q' ca =:E >' o co U O cp L +, a) O c L O+ O C.Lr — C :E a) L co O) O O CU CD ccaa) �� E.9 m c > .>, o m o) o 3: O ECU N N O 7 r� O L O =3 C N C a) Q (6 -0 U 00 M L- 0 O CU c -C O U N ECL m O L E c D CD t- o OO O >, L V o L- M c cua A C a)E L 20 Q 0 c m Q. x a) c O cn O- a) L a) O W } 'O a) O c cu a) m O O 0 O Cl) t ca C.> N U 0)W c c 2 E N Q� N •a � N 0' U� w 0 a`) 0 N bin 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 the Application for your most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. You must report all requested information not previously reported on that Application. Include all details [project name(s) and location(s), names of all parties involved, relevant dates, etc.]. YES NO Division of Capital Asset Management Page ? of 10 Sub -bidder Update Statement -Effective March 30, 2010 1. Has your firm been terminated on any contract prior to completing a project or has e� any officer, partner or principal of your firm been an officer, partner or principal of another firm that was terminated or failed to complete a roject? 2. Has your firm failed or refused either to perform or complete any of its work under �� ❑'. any contractrior to substantial completion? 3. Has your firm failed or refused to complete any punch list work under any contracts: ❑ „' `X, 4. Has our firm filed for bankruptcy or has any officer,principal or individual with a' y P � � ,❑ x, financial interest in your current firm been an officer, principal or individual with a `u financial interest in another firm that filed for bankru tcy? ' f �. Has your surety taken over or been asked to complete any of your work under anyT ❑ 'X contract? X y. g ;, 6. Has a payment or performance bond been invoked against your current firm, or has ❑ any officer,principal or individual with a financial intertest in your current firm been , y an officer, principal or individual with a financial interest in another firm that had a avment or performance bond invoked? 7. Has your surety made payment to a materials supplier or other party under your _ ❑ '. avment bond on any contract?` 8. Has any subcontractor filed a demand for direct payment with an awarding authority ' Y fora public project on any of your contracts?X K❑; 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 suppliedx under any of your contracts? 10. Have there been any deaths of an employee or others occurring in connection with any of your projects? F 11. Has any employee or other person suffered an injury in connection with any of your T ❑ X° projects resulting in their inability to return to work for a period in excess of one r x year? Division of Capital Asset Management Page ? of 10 Sub -bidder 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 Application for your most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. You must report all requested information not previously reported on that DCAM Application. The term "administrative proceeding" as'used in this Sub -Bidder 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 1\O 1. Have any civil, judicial or administrative proceedings involving your firm or a , principal or officer or anyone with a financial interest in your firth 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 _ 3 subcontractors, su Hers or others?� s � k 3 2. Have any criminal proceedings involvingyour firm or principal or officer or <K y p P X r anyone with a financial interest in your firm been brought, concluded, or settled �xF: relating to the procurement or performance of an construction contract including, P Pe y Q but not limited to, any of the following offenses: fraud, graft, embezzlement, forgery, bribery, falsification or destruction of records, or receipt of stolen pro rty? jF I Have any judicial or administrative proceedings involving your firm or a principal v"' or officer or anyone with a financial interest in your firm been brought, concluded, p_ x or settled relating to a violation of anstate's or federal procurement laws arising "Y�s y, p g 3 , out of the submission of bids or proposals? 1�Am 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 8 of 10 Sub -bidder Update Statement Effective March 30, 2010 PART 4 - Legal or Administrative Proceedings; Compliance with Laws (continued) VIE q Division of Capital Asset Management Page 9 of 10 Sub -bidder Update Statement Effective March 30, X010 5. Have any judicial or administrative proceedings involving your firm or a principal Q 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 Q� x or officer or anyone with a financial interest in your firm been brought, concluded, Q ; *h ; or settled relating to a violation of any state or federal lawrohibitin P g discrimination in employment9 Fk� 7. Have any judicial or administrative proceedings involving your firm or a principal``Q 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 federal law regulating labor relations? 8. Have any proceedings by a municipal, -state, or federal agency been brought, [1 >; concluded, or settled relating to decertification, debarment, or suspension of your s 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 y Q X violations of any laws or regulations related to occupational health or safety? Note: F v 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 public projects? yro"s 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 A performance of any construction contract? f' 13. Are there any other issues that you are aware which may affect your firm's [ responsibility and integrity as a building contractor? y ' Division of Capital Asset Management Page 9 of 10 Sub -bidder Update Statement Effective March 30, X010 PART 5 - SUPERVISORY PERSONNEL List all supervisory personnel 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 FllNGTIUN y, ... ._ Thomas McCormick Project mgmt, field supervision and coordination, safety John Powers Estimating, Project mgmt, purchasing, scheduling 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 X 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 ALONG WITH CERTIFICATION PAGE. Attach here a copy of the list of completed construction projects which was submitted with your firm's Application for your.most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. The Attachment must include a complete copy of the entire Section F — "Completed Projects" (Section G — "Completed Projects" for firms certified based upon their Prime/General Application), and the final page —"Certification Page", (Section I in the Sub -bidder Application or Section J in Prime/General-Application) containing the signature and date that the Completed Projects list (Section °F or G) was submitted to the Division of Capital Asset Management. Division of Capital Asset Management Page 10 of 10 Sub -bidder Update Statement Effective March 30, 2010 Part 4 — Legal or Administrative Proceedings: 1. City of Lawrence, Plaintiff, v. Peabody Construction, Defendant and Third -Party Plaintiff, v. Empire Masonry Corp, Third -Party Defendant (and 13 additional 3rd party defendants). In 2001, Empire was the masonry subcontractor on a project known as the Mullaney K-8 School in Lawrence, MA. Peabody was the general contractor. Empire completed its work in July, 2001. In April, 2013, Empire received a Summons naming it as a 3`d party defendant in a case where the Owner is suing the general contractor for "latent material defects" and Peabody, the general contractor, is suing Empire and all other named 3rd party defendants. THOMAS M MCCORMICK PRESIDENT TREASURER EMPIRE MASONRY CORP 231 NORFOLK ST WALPOLE, MA 02081 (508) 660-1011 Education: Providence College, BS Business Administration, 1992 Completed various OSHA Training Courses,. including Competent Person Training. Course Member: Bricklayers' Local #3, Boston Associated Subcontractors of Mass Mason Contractors Association of Mass Secretary/Treasurer: 20.03 — 2006 Vice President: 2007 — 2009 President. September, 2009 - 2011 Experience: Empire Masonry Corp 1994-1997: Bricklayer 1998 - 2001: Project Foreman . Ferryway (Cross St.) School, Malden, Ma Fresh Pond Water Treatment Plant, Cambridge, MA 2001 - present: Project Manager on all ongoing projects. Responsible. for estimating, bidding, material submittals & purchasing; cost management; general contractor ne. gotiations. Supervise, manage & coordinate job. progress and related issues John Powers IIECENT.FXPFRIENCE: 2004 -Present . PCM. Construction Co., Inc. Ayer, MA Estimator/Assistant Project Manager • Conduct a weekly prospective project search which includes identi in and analyzing Profitable projects �' g yi g potentially • Manage project qualification process • Develop and calculate project cost estimates which are utilized in the formal bidding process • Assist with project contract negotiations • Support pre -construction planning process 0 Work with suppliers on material coordination o Develop project schedule • Assist with pre -construction product submittal process • Aid day to day project management duties 1994-2004 PCM Construction Co., Inc. Ayer, MA Safety coordinator Mason/Field Safety coordinator/General Superintendent . • o Weekly equipment inspection o Daily morning safety inspections o Reviewed, edited and implemented existing company safety and hazard communication programs • Gen. Superintendent/Assistant Foreman o Assisted with jobsite coordination of materials, labor and equipment • Journeyman Mason EDU CATION,&_TRA [KING University of Massachusetts, Amherst 1995-1999 • BA Political Science/Socioloay Amherst, MA • Dean 's list Northeastern University 2002-2004 Construction Management Certificate Program Newton, MA Keene St. College O.S.H.A Training Institute Completed Outreach Trainer course for Construction and General Industry Manchester, NH Certified to Conduct 10 and 30 hour Construction outreach training Commonwealth of Massachusetts Department of Public Safety • Hoisting Engineer's License • Aerial lift certified Software • . Tradesmen Master Estimator 0 Masonry estimation software • PlanSwift Professional 9.0 o Construction Estimating Software • . Microsoft office 2007 I. Certification (notarization required) The undersigned, Sandra McCormick hereby certifies: (type name) That I am an owner or principal of Empire .Adasonry Corp (company name) and that all answers and all statements contained in the attached application (including Sections E and F) for certificate of eligibility are true and correct. Providing false or misleading information or failure to provide all required information will be considered grounds for denial, decertification and/or debarment. I attest to the accuracy of all information contained in this application and .verify that the information submitted is in fact accurate and true, under oath. Signed and Sworn under the Pains and Penalties of Perjury. Dated at il30 f*7 This 20th day of June, 2013. By (signature): Print name: Title or position: (T © ss. (county) Sandra McCormick Clerk ffa Z (state) Before me, �ft , personally appeared and (notary public) known to me to be !G� /-1 O f /1�� ,based (name of officer) on satisfactory evidence which was his, her driver's license and acknowledged that he/she is authorized to xecute the f*going and that its execution is his/her free act and deed and the free act and deed of e fldh. is signature) (print name) My commission expires: SCOTT W. GILMOUR Notary Public Massachusetts ssion Expires Dec 21. 2018 "'Upon completion of this Application and the thvo corresponding Excel Spreadsheets, save and email them to CertificationApplication.deam(i�tate.ma.us YY Page 14 of 14 Sub -Bidder Application March 2011 Computer