HomeMy WebLinkAboutContract #: 004909 - From: To: - Exception - ExceptionSchool Department Administration Building
North Andover, MA
FORM OF SUB -BID
To All General Bidders Except those Excluded:
Kang Associates, Inc.
January 2, 2014
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
Fire Protection - 210000 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:
�' -t • 1• -�• .. � 111 /1
For Alternate #1:
Deduct $ N/C dollars ($ N/C ).
For Alternate #2:
Add/
Deduct $ N/f: dollars ($ N/C ).
For Alternate #3:
Deduct $ N/C dollars ($ N/C ),
For Alternate 94:
Deduct $ Seventy Four Thousand dollars ($ 74.000.00 ).
For Alternate #5:
Deduct $
N/C
B. This sub -bid includes addenda numbered
1
C. This sub -bid
❑ may be used by any general bidder except:
dollars ($
❑ may only be used by the following general bidders:
N/C
(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 28 years.
2. Ever failed to complete any work awarded?
Im
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) Amesbury High School
Castagna Construction $291,562.75
FORM OF SUB -BID - 2
School Department Administration Building
North Andover, MA
Z
(c)
4. Bank reference
The Provident Bank
Kang Associates, Inc.
January 2, 2014
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.
/12117 Ebacher Plumbing & Heating, Inc
Date t I (Name of Sub -Bidder)
SUB -BIDDER'S CHECKLIST:
X Addenda Recognized
X Bid Deposit
X DCAM Certificate of Eligibility
X Sub -Bidder Update Statement
X Certificate of Corporate Bidder
By. �V�"e + aJ� Li
Signature and Title of Person Signing Bid
40 Portsmouth Road, P.O. Box 548
Business Address
Amesbury, MA 01913
City and State
FORM OF SUB -BID - 3
School Department Administration Building
North Andover, MA
CERTIFICATE OF CORPORATE BIDDER
Richard Ebacher
President
Bid Form, and that Richard Ebacher
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
Secretary -Clerk Richard Ebacher
t/alliq
Date
CORPORATE BIDDER - 1
DEVAL L. PATRICK
GOVERNOR
TIMOTHY P. MURRAY
LIEUTENANT GOVERNOR
The Commonwealth of Massachusetts
Executive Office for Administration and Finance
Division of Capital Asset Management and Maintenance
One Ashburton Place
Boston, Massachusetts 02108
Tel: (617) 727-4050
Fax: (617) 727-5363
GLEN SHOR
SECRETARY, ADMINISTRATION &
FINANCE
CAROLE CORNELISON
COMMISSIONER
Prime/General
Certificate of Contractor Eligibility
CONTRACTOR IDENTIFICATION NUMBER: 1423
This Certificate Shall Be Used for Submitting Prime/General Bids Only
1. CERTIFICATION PERIOD: This Certificate is valid from 1/10/2014 to 1/10/2015
2. CONTRACTOR'S NAME: Ebacher Plumbing & Heating, Inc.
3. CONTRACTOR'S ADDRESS: 40 Portsmouth Road / P.O. Box 548, Amesbury, MA 01913
4. WORK CATEGORIES: This Contractor is certified to file bids under Massachusetts General Laws Chapter 149,
❑Alann Systems
[] Asbestos Removal
❑ Deleading
Demolition
❑ Doors & Windows
❑ Electrical
❑ Electronic Security Systems
S. EVALUATIONS:
6. PROJECT LIMITS:
7. S
for
Chapter 149A and Chapter 25A in the following checked Categories of Work:
Elevators
❑ Energy Management Systems
[] Exterior Siding
[ % Fire Protection Sprinkler Systems
(] Floor Covering
General Building Construction
[ ] Historical Building Restoration
[_] Historical Masonry
❑ Historical Painting
❑ Historical Roofing
❑ HVAC
❑ Masonry
[] Mechanical Systems
Modular Construction/Prefab
Number of Projects Evaluated: 14
Average Project Evaluation Rating: 97
Number of Projects Below Passing Score: 0
] Painting
[V]Plumbing
❑Pumping Stations
❑ Roofing
❑ Sewage & Water Treatment Plants
❑Telecommunication Systems
[] Waterproofing
Single Project Limit (SPL): $600,000.00
Aggregate Work Limit (AWL): $2,000,000.00
General Building Construction Limit: N/A
CE CERTIFICATION: N/A
General Counsel,
rnelison. Commissioner
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 ��
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Aph
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'XIIAN
CONTRACTORS BONDING
AND INSURANCE COMPANY
131W111M
KNOW ALL MEN BY THESE PRESENTS:
Home Office:
3101 Western Ave., Suite 300
Seattle, WA 98121
(800)765-2242
(800) 950-1558 FAX
That we, Ebacher Plumbing & Heating, Inc., as Principal, (hereinafter called the "Principal"), and
Contractors Bonding and Insurance Company of Seattle, Washington, a corporation duly organized
under the laws of the State of Washington, as Surety, (hereinafter called the "Surety"), are held firmly
bound unto Town of North Andover, MA as Obligee, (hereinafter called the "Obligee"), in the sum of
five percent (5%) of attached bid, for the payment of which sum well and truly to be made, the said
Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and
assigns, jointly and severally, firmly by these presents
WHEREAS, the Principal has submitted a bid for School Department Administration Building
North Andover, MA
21.00.01 Fire Protection
NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter
into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as
may be specified in the bidding or contract documents with good and sufficient surety for the faithful
performance of such contract and for the prompt payment of labor and material in the prosecution
thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or
bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between
the amount specified in said bid and such larger amount for which the Obligee 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.
Signed and sealed this 21st day of January A.D. 2014.
Z-1441 " t t Z�
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Witness
i -i H w v t q
Ebacher Plumbing & Heating, Inc. (Seal)
Principal
Title
Surety: Contractors Bonding and Insurance Company
By:
Carl L-
Trama, Attorneyin-Fact
J �
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RLI c
an RLI Compaq y
P.O. Box 3967 1 Peoria, IL 61612-3967
Phone: (800)645-2402 1 Fax: (309)689-2036
Know All Men by These Presents:
. —*"s
POWER OF ATTORNEY
RLI Insurance Company
Contractors Bonding and Insurance Company
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the
approving officer if desired.
That this Power of Attorney may be effective and given to either or both of RLI Insurance Company and Contractors Bonding and
Insurance Company, required for the applicable bond.
That RLI Insurance Company, a Illinois corporation, and/or Contractors Bonding and Insurance Company, a Washington
corporation (as applicable), each authorized and licensed to do business in all states and the District of Columbia do hereby make,
constitute and appoint:
Carl L. Traina, Louis A. Tonry, Jr., Jacauelvnne R. Maloney, iointly or severally
in the City of Quincy , State of Massachusetts , as Attorney in Fact, with full power and authority hereby
conferred upon him/her to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds,
undertakings, and recognizances in an amount not to exceed Ten Million Dollars
( $10,000,000.00 ) for any single obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon this Company as if such bond had
been executed and acknowledged by the regularly elected officers of this Company.
RLI Insurance Company and Contractors Bonding and Insurance Company, as applicable, have each further certified that the
following is a true and exact copy of the Resolution adopted by the Board of Directors of each such corporation, and now in force, to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the Corporation shall be executed in the
corporate name of the Corporation by the President, Secretary, any 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 Corporation. 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 or other electronic image."
IN WITNESS WHEREOF, RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have
caused these presents to be executed by its respective Vice President with its corporate seal affixed this 16th day of December, 2013.
/S .`G AND`„�auuunu���,
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State of Illinois 1
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County of Peoria )tim lit
On this 16th day of December 1 2013 ,
before me, a Notary Public, personally appeared Roy C. Die , who
being by me duly sworn, acknowledged that he signed the above Power of
Attorney as the aforesaid officer of the RLI Insurance Company and/or
Contractors Bonding and Insurance Company, and acknowledged said
instrument to be the voluntary act and deed of said corporation.
M.
"OFFICIAL SEAL"
JACQUELINE M. BOCKLER
COMMISSION EXPIRES 03119114
Notary Public
RLI Insurance Company
Contractors Bonding and Insurance Company
Roy C. Die Vice President
CERTIFICATE
I, the undersigned officer of RLI Insurance Company, a stock
corporation of the State of Illinois, and/or Contractors Bonding and
Insurance Company, a Washington corporation, do hereby certify
that the attached Power of Attorney is in full force and effect and is
irrevocable; and furthermore, that the Resolution of the Company as
set forth in the Power of Attorney, is now in (force: In testimony
whereof, I have hereunto set my hand and''the . seal"of the RLI
Insurance Company and/or Co tractors Bond'n ..and Insurance
Company thisday of�
RLI Insurance Company — -
Contractors Bonding and Insurance Company
Roy C. Die Vice President
2075334020212 A0059913
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.
1/21/14 Ebacher Plumbing & Heating, Inc
Bid Date Print Name of Sub -bidder or Trade Contractor
School Administration
Office Building 40 Portsmouth Road, Amesbury, MA 01913
Project Number (or Business Address
name if no number)
Town of North Andover 978-388-4086
Awarding Authority Telephone Number
SIGNATURE* 61t C a�j
idder' A thorized Representative
Division of Capital Asset Management Page 1 of 10
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/deam.
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 projects 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 10
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M
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
El Z
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?
E
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
❑ z
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
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'sF1
Z
lien against property in connection with workperformed or materials supplied
under any of your contracts?
10.
Have there been any deaths of an employee or others occurring in connection with
❑ Z
any of your projects?
11.
Has any employee or other person suffered an injury in connection with any of your
Q
projects resulting in their inability to return to work for a period in excess of one
yea'?
Division of Capital Asset Management Page 7 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 NO
1. Have any civil, judicial or administrative proceedings involving your firm or a
❑ E
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 stolenproperty?
3. 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's or federal procurement laws arising
out of the submission of bids orproposals?
4. Have any judicial or administrative proceedings involving your firm or a principal
0 M
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)
YES NO
5. Have any judicial or administrative proceedings involving your firm or a principal
❑ 0
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
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
FJ 0
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 9 of 10
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
Richard Ebacher
President / Owner / Estimator
Keith Palmer
Vice President / Estimator
Kevin Palmer
Estimator / Project Manager
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 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