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Contract #: 005075 - From: To: - Exception - Exception
C;' School Department Administration Building North Andover, MA Kang Associates, Inc. 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 22 00 00 -Plumbing 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: Eighty eight thousand eight hundred and eighty dollars ----- dollars ($ $88,880.00 For Alternate #1: Deduct $ N/A dollars ($ N/A For Alternate #2: DeduN/A ct $ N/A dollars ($ For Alternate #3: Deduct $ N/A dollars ($ N/A For Alternate #4: Deduct $ N/A dollars ($ N/A For Alternate #5: Deduct $ N/A dollars ($ N/A 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 "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 N/A (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 40 years. no 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 (a) East Boston High School Architect City of Boston General Contractor Amount of Contract Commercial Construction $112,000.00 FORM OF SUB -BID - 2 School Department Administration Building North Andover, MA (b) Mass Maritime Academy Maguire Group Contractors Network (c) Framingham State University PRA Architects 4. Bank reference Kang Associates, Inc. January 2, 2014 $101,740.00 Consigli Construction $21,700.00 Brian Sheehan, Eastern Bank, 781-581-4217 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. January 21, 2014 Date SUB -BIDDER'S CHECKLIST: Addenda Recognized ✓ Bid Deposit DCAM Certificate of Eligibility ✓ Sub -Bidder Update Statement ✓ Certificate of Corporate Bidder Robert W. Irvine & Sons (Name of Sub -Bid r , Vice President Title of Person Signing, Bid 147 Blossom Street Business Address Lynn, MA 01902 City and State FORM OF SUB -BID - 3 School Department Administration Building North Andover, MA CERTIFICATE OF CORPORATE BIDDER April Young Clerk Bid Form, and that Joseph Moleti 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 Vice 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 Clerk April jYo9uetary rk January 21, 2014 Date CORPORATE BIDDER - 1 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 otherAganization, entity, or group of individuals. S Jpsep clbti, Vice President Prin Narne & Title Date January 21, 2014 Robert W. Irvine & Sons Inc. Company Name CERTIFICATE OF TAX COMPLIANCE Pursuant to Chapter 62C of the Massachusetts General Laws, Section 49A (b), I Joseph Moleti , authorized signatory for Robert W. Irvine & Sons Inc. Name of individual Name of contractor do hereby certify under the pains and penalties of perjury that said contractor has complied with all laws of the Commonwealth of Massachusetts, and the Town of North Andover, relating to taxes, permit or other fees, reporting of employees and contractors, and withholding and January 21, 2014 Date CERTIFICATION LABOR HARMONY AND OSHA TRAINING REQUIREMENTS The undersigned certifies under penalties of perjury that he is able to furnish labor that can work in harmony with all other elements of labor employed or to be employed at the work and that all employees to be employed at the worksite and in the work will have completed an OSHA -approved construction , Vice ?resident Print Name'& Titie health course lasting at least ten (10) hours. Date January 21, 2014 Robert W. Irvine & Sons Inc. Company Name DEVAL L. PATRICK GOVERNOR TIMOTHY P. MURRAY LIEUTENANT GOVERNOR Tlie Comiponwealth of Massachusetts Executive Once for Administration and Finance Division of Capital Asset Management and Maintenance One Ashburton Place Boston, Massachusetts 02108 Tel: (617) 7274050 Fax: (617) 727-5363 Filed Sub -Bid Certificate of.Contractor Eligibility CONTRACTOR IDENTIFICATION NUMBER: 1169 GLEN SHOR SECRETARY, ADMINISTRATION & FINANCE CAROLE CORNELISON COMMISSIONER This Certificate Shall Be Used for Submitting Filed Sub -Bids Only 1. CERTIFICATION PERIOD: This Certificate is valid from 3/23/2013 to 3/23/2014 2. CONTRACTOR'S NAME: Robert W. Irvine & Sons, Inc. 3. CONTRACTOR'S ADDRESS: 147 Blossom Street, Lynn, MA 01902 4. WORK CATEGORIES: This Contractor is certified to file bids under Massachusetts General Laws Chapter 149, Chapter 149A and Chapter 25A in the following checked Categories of Work: S. EVALUATIONS'. Number of Projects Evaluated: 52 Average Project Evaluation Rating: 92 Number of Projects Below Passing Score: 0 6. SUPPLIE j; DIVERSITY OFFICE CERTIFICATiqN: N/A Freya S Bernstein, Deputy General Counsel, Approval Date for Carole J. Cornelison, Commissioner NOTE TO CONTRACTORS: Complete Applications for Renewal of Contractor Eligibility are due no later than three months PRIOR to the Expiration Date of the Certification Period shown above. Failure to submit Completed Applications timely may result in a gap in Certification or a lapse in Certification altogether for your company. Reviewer's Initials Q HVAC ❑ Miscellaneous & Ornamental Iron ❑ Terrazzo ❑ Acoustical Tile ❑ Electrical Work ❑ Lathing & Plastering E] Painting © Plumbing Tile ❑ ❑ Waterproofing, Damp ❑ Elevators ❑ Fire Protection Sprinkler Systems ❑ Marble ❑ Masonry Work ❑ Resilient Floors proofing, and CauWn P g' g ❑ Glass and Glazing ❑ Metal Windows E] Roofing &Flashing S. EVALUATIONS'. Number of Projects Evaluated: 52 Average Project Evaluation Rating: 92 Number of Projects Below Passing Score: 0 6. SUPPLIE j; DIVERSITY OFFICE CERTIFICATiqN: N/A Freya S Bernstein, Deputy General Counsel, Approval Date for Carole J. Cornelison, Commissioner NOTE TO CONTRACTORS: Complete Applications for Renewal of Contractor Eligibility are due no later than three months PRIOR to the Expiration Date of the Certification Period shown above. Failure to submit Completed Applications timely may result in a gap in Certification or a lapse in Certification altogether for your company. Reviewer's Initials Document A310 TM - 2010 Conforms with The American Institute of Architects AIA Document 310 Bid Bond CONTRACTOR: (IMmme, legal statics and address) Robert W. Irvine & Sons, Inc. 147 Blossom Street Lynn, MA 01902 OWNER: (Name. legal status and address) Town of North Andover 120 Main Street North Andover, MA 01845 SURETY: Nance, legal stains mid pi nelpal place a f biaimesq) Fidelity and Deposit Company of Maryland 1400 American Lane, Tower I, 18th Floor Schaumburg, IL 60196-1056 Mailing Address for Notices 600 Red Brook Boulevard Owings Mills, MD 21117-5153 BOND AMOUNT: $ 5% Five Percent of Amount Bid PROJECT: (Nance, location or address and ltroject number, if an}) School Department Administration Building; Division 22 - Plumbing 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. 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 thernschcs. their heirs, executors, administrators, successors and assigns. jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Uwwer and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, mrd 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 mid otherwise acceptable to the 0%-.mcr, 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 Oivner 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 perlbrm the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full Buse and ellect. The Surety hereby waives any notice ol'an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver ornotice by the Surety shall not apply to any extension exceeding Sixty (60) days in the aggregate beyond lite time fiir acceptance ol'bids Specified in the bid documents, and the Ommer and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been rumished to simply iwith a statutory or other legal requirement in the location orthe Project, any prevision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted hererrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so I'umished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and scaled this 20th day of January, 2014 Robert W. Irvine & Sons, Inc. (Principaq (Seal) (11'Itricss) 4PVL YOUR B- tle MARK J. IRVINE, PRESIDENT 0�'Mv�0 pEPp�� Fidelity a d Deposit Co any of Maryland Z(.Buren'(Seer ,�►By. S-0054/AS 8110 Bond Number: Bid Bond Obligee: Town of North Andover ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by Geoffrey Delisio, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Nicole Roy its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland, in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 17th day of May , A.D. 2012 ATTEST: 27 Assistant Secretary Gerald F. Haley ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND •ir SEAL E' n" �� yea tOQB i / 6/ j ".e�, Vice President Geoffrey Delisio State of Maryland County of Baltimore On this 17th day of May , AD. 2012 , before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Geoffrey Delisio, Vice President and Gerald F. Haley, Assistant Secretary of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. >>µtttrrttlln A. 0. � Z Constance A. Dunn, Notary Public My Commission Expires: July 14, 2015 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attomeys-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attomey-in-fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any rime." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney ...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 20th day of January 2014 �oyo�crof�i r1r1AN1, err O BSAL s6t tpp� j i/ X777 G16 d. Thomas 0. McClellan, Vice President 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 Robert W. Irvine & Sons, Inc. Bid Date Print Name of Sub -bidder or Trade Contractor North Andover School Department Administration Building Project Number (or name if no number) Town of North Andover 147 Blossom Street, Lynn, MA 01902 Business Address 781-581-0464 Awarding Authority Telephone Numt SIGNATURE* Bi // " // ' _�, Vice Pre s—A—u"thho !zed Representative ph Moleti Division of Capital Asset Management Page 1 of 10 k< 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 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)]. 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N N U a) W c c 2 E z 2 N 2 c� Q� CL° � a U� o c a o Z MO •� � 0 cn 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.]. 1. Has your firm been terminated on any cl any officer, partner or principal of your another firm that was terminated or fail 2. Has your firm failed or refused either to any contract prior to substantial comple 3. Has your firm failed or refused to comp 4. Has your firm filed for bankruptcy, or h financial interest in your current firm b financial interest in another firm that f. 5. Has your surety taken over or been ask( contract? 6. Has a payment or performance bond be any officer, principal or individual wit: been an officer, principal or individual had a payment or performance bond it 7. Has your surety made payment to a ma payment bond on any contract? 8. Has any subcontractor filed a demand for a public project on any of your cor 9. Have any of your subcontractors or sul lien against property in connection wi under any of your contracts? 10. Have there been any deaths of an em any of your projects? 11. Has any employee or other person su your projects resulting in their inabili -"A vaari viiv 7 v...• . YES NO :)ntract prior to completing a project or has L firm been an officer, partner or principal of ed to complete a project? [ perform or complete any of its work under ;tion? Tete any punch list work under any contract? [ gas any officer, principal or individual with a een an officer, principal or individual with a led for bankruptcy? [ A to complete any of your work under any ;en invoked against your current firm, or has [ h a financial interest in your current firm . with a financial interest in another firm that evoked? .terials supplier or other party under your for direct payment with an awarding authority [ itracts? ?pliers filed litigation to enforce a mechanic's th work performed or materials supplied ployee or others occurring in connection with ffered an injury in connection with any of ty to return to work for a period in excess of Page 7 of 10 Division of Capital Asset Management 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 or officeror limposing penalcourts, or (ii) tiesafines or taken by a governmental agency, dep other sanctions for failure to comply with any such legal or contractual requirement. The term "anyone with a financial interest in your firm" as used in this Section "I", shall mean any person and/or entity with a 5% or greater ownership interest in the applicant's firm. If you answer YES to any question, on a separate page provide a complete explanation of each proceeding or action and any judgment, decision, fine or other sanction or result. Include all details (name of court or administrative agency, title of case or proceeding, case number, date action was commenced, date judgment or decision was entered, fines or penalties imposed, etc.). YES NO 1. Have any civil, judicial or administrative proceedings involving your firm or a principal or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to the procurement or performance of any construction contract, including but not limited to actions to obtain payment brought by subcontractors, suppliers or others. 2. Have any criminal proceedings involving your firm or a principal or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to the procurement or performance of any construction contract including, but not limited to, any of the following offenses: fraud, graft, 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? Page 8 of 10 Division of Capital Asset Management 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 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 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? r13.Are there any other issues that you are aware which may affect your firm's rPcnnn-,ibility 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 Mark J. Irvine FW—illiam M. Gillespie TITLE OR FUNCTION President Vice President 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 ALONG WITH TO THE DIVISION OF CAPITAL ASSET MANAGEMENT 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 ` Mark J. Irvine, President, Treasurer, 100% Owner & Project Manager Education High School Diploma Five Years Plumbing School Massachusetts Plumbing Continuing Education Work Experience September 1973 to Present 40 Years of Construction Experience both in the Field and Office Estimating Projects, Purchasing Materials, Running the Labor Force in the Field. Project Manager, President and Treasurer of Robert W. Irvine & Sons Inc. Licenses Held Journeyman Plumber 17816 Master Sheet Metal 2605 Refrigeration Contractor Journeyman & Contractor Sprinkler SJ 001419, SC 001361 Certificate for Titeflex Interior Gas Piping System WILLIAM M. GILLESPIE9 Vice President & Management Education High School Diploma Work Experience Franklin Institute (Plumbing Theory) North East Regional Tech. Vocational School Massachusetts Plumbing Continuing Education 27 Years of Experience Construction Experience 4 Years in the Field as Foreman/Supervisor 23 Years in the Office as Estimator, purchasing Agent and Project Manager Started with the Firm in 1990 Licenses Held Journeyman Plumber 20480 Master Plumber 10865 Master Sheet Metal 2152 Certificate of Plumbing Corp. 2531c W U of A � � R o ;" U O N O C C o ' a 0 0 0 0 o 0 0 0�pp 0 0 0 0 o S S o r aVyF m y�N� N 0 O a V pp OO �Ny n n N om :wn Wr m p d W �i 117 ::?•0 ..a � O ci r O O O O p m pO wry d N ppb {tO�y a C w U3 d o LL . 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CL x ` > m ril Q b d V) N N e- c r 'c o c r�11 N O b m N n n PP 5 m m x c c s m w .. -M(10 m J m L U J U y J K � N U H. 2. I 9 n. 7 General Performance ons by using your cursor to click YES or N0. Information is to cover the Answer the following questi hast five years prior to the date of submission of this application. For Sections "H" and "I", if you answer YES to any question, please provide on a separate page a complete explanation. Include all details [project name(s) and location(s), names of all parties involved, relevant dates, etc.]. YES NO Has your firm been terminated on any contract p ior to n an officer, pltingpartner orprinject cipals U any officer, partner or principal of your firm b another firm that was terminated or failed to com Tete a roject? ❑ Has your firm failed or refused either to perform or complete any of its work under any contractprior to substantial completion. pun list work under any contract? ❑ Has your firm failed or refused to complete any p or individual with a ❑ Has your firm filed for bankruptcy, or has any officer, principal financial interest in your current firm been an offic, pincipal or individual with a financial interest in another firm that filed for bankruptcy? Has your surety taken over or been asked to complete any of your work under any C contract? 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? Has your surety made payment a materials supplier or other party under your a ment 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 file f rmed or materials supplietigation to enforce a d lien against property in connection with workp under any of your contracts? 10. Have there been any deaths of an employee or others occurring in connection with E of your projects? h erson suffered an injury in connection with any of 11. Has any employee or of et p your projects resulting in their inability to return to work for a period in excess of one Year? Prime/General Revised March 2011 Computer Page 13 of 16 I, Legal or Administrative Proceedings; Compliance with Laws Please answer the following questions. Information is to cover all judicial and administrative proceedings involving applicant's firm, which were instituted or concluded (adversely or otherwise) within the past five years prior to the date of submission of this application. The term "administrative proceeding" as used in this application for certificate of eligibility 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 "an- one 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 (nature or basis of claim, 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. Within the past 5 years have any civil, judicial or administrative proceedings with a interest in firm or a principal or officer or anyoneto Li I� involving your or the your firm been brought, concluded, or settled relating p contract, including but not limited to actions to performance of any construction obtain Dayment brought by subcontractors, suppliers or others? have any criminal proceedings involving your firm or a ❑ 2. Within the past 5 years or officer or anyone with a financial interest in your firm been brought, principal concluded, or settled relating ri o he performance including, but not limited to, any of offenses: construction contract fraud, graft, embezzlement, forgery, bribery, falsification or destruction of records, or receipt of stolen pro erty? 3. Within the past 5 years have any judicial or administrative proceedings involving l interest nor ur firm El your firm or a principal or officer or anyone with any state's federal been brought, concluded, or settled relating to aiolation of procurement laws arising out of the submission of bids or proposals? have any judicial or administrative proceedings involving ❑ 4. Within the past 5 years firm your firm or a principal or officer or anyonewith a financial to a violation of M.G.L. in yoChap er 268A, relating been brought, concluded, or settled the State Ethics Law? Page 14 of 16 Prime/General Revised March 2011 Computer YES NO 5. Within the past 5 years have any judicial or administrative proceedings involving interest in your withviolation LI your firm or a principal or officer or anyone of any tate or federial been brought, concluded, or settled relating to al law regulating hours of labor, unemployment compensation, minimum wages, ay, child labor or worker's com ensation? revailin wages, overtime pay, e ual 6. Within the past 5 years have any judicial or administrative proceedings involving ❑ your firm or a principal or officer or anyone with a financial interest l law of any state or federam been brought, concluded, or settled relating to a violation prohibiting discrimination in employment? El7. Within the past 5 years have any judicial or administrative proceedings involving with a financial interest in your firm your firm or a principal or officer or anyone been brought, concluded, or settled relating to a claim of repeated or aggravated violation of any state or federal law regulating labor relations? 8. Within the past 5 years have any proceedings by a municipal, state, or federal ❑ agency been brought, concluded, or settled relating to decertification, debarment, or icer or anyone with a financial suspension of your firm or any principal or interest in your firm from public contracting? ❑ 9. Within the past 5 years have any judicial or administrative proceedings involving with a fin interestncial your firm or a principal or officer or anyone been brought, concluded, or settled relating to a violation of state federal law regulating the environment? 10. Within the past 5 years has your firm been fined by OSHA or any other state federal agency for violations of any laws or regulations related to occupationall be obtained from OSHA's Web Site at health or safety? Note: this information may www.osna.gvv 11. Within the past 5 years 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, within the past 5 years 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 rP.cnnngihility and integrity as a building contractor? Page 15 of 16 Prime/General Revised March 2011 Computer • J. Certification (notarization required) The undersigned, Mark J.Irvine hereby certifies: (type name) That I am an owner or principal of Robert W Irvine & Sons.Inc., (company name) and that all answers and all statements contained in the attached application (including Sections F and G) for certificate of eligibility are complete, 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 complete, accurate and true, under oath. Signed and Sworn under the Pains and Penalties of Perjury. Dated at 147 Blossom Street This 10th day of December, 2012. By (signature): Type name Title or position: ESSEX ss. (county) Before me, APRIL D. YOUNG (notary public) known to me to be MARK J • IRVINE (name of officer) Mark J.Irvine President MASSACHUSETTS (state) personally appeared and based on satisfactory evidence which was his/her driver's license and acknowledged that he/she is authorized to execute the foregoing and that its execution is his/her free act and deed and the free act and deed of the firm. C ( My commission expires: JULY 11, 2014 not publi ignature)) APRIL D. YOUNG (print name) **Upon completion of this Application and the two corresponding Excel spreadsheets, save and email them to CertificationApplication dcam(&state.ma.us ** Page 16 of 16 Prime/General Revised March 2011 Computer 9126/13 Inspection Detail ................ _._ ... r ` A to Z Index En espariol ;Contact Us j FAQs I About OSHA OSHA •rIMNewsietter MRSS Feeds G Print This Paye a lonext Size *Was this page helpful? Data & Statistics Training p What's New Offices ccupativnal Safely &Health Administration We Can Help.-......- __ ---- - __, ..-- _ - —. -.. -- - Publications i New, Small Business Home Workers ;I Regulations Gjq { Enforcement J _ _........ ...._.. _.... . Inspection: 311596688 - Robert Irvine And Sons, Inc. inspection Information - Office: NDrth Boston Nr: 311596688 Report ID:0134000 Open Date: 11/28/2007 Robert Irvine And Sons, Inc. 44 Windsor Avenue Swampscott, MA 01907 Union Status: Nonunion SIC: 1711/Plumbing, Heating and Air -Conditioning 44 4000 NAICS: 238220/ Plumbing, Heating, and Air -Conditioning Contractors Mailing: 147 Blossom Street, Lynn, MA 01902 6000 Inspection Type: Referral 2.01002 Serious 19260403 B02 Scope: Partial Advanced Notice: N Ownership: Private Safety/Health: Safety Close Conference: 11/28/2007 S: Electrical,S: Fall From k Ridendal Close Case: 04/30/2008 Emphasis. Heig , . es Constr,L:Fall Optional Information: Type ID Value N 1 311596688 Related Activity: Type ID Safety Health Referral 202579090 Yes Accident Investigation Summary Summary Nr: 200774974 Event: 11/28/2007 Employee Fractures Vertebra In Fall Down Stairwell On November 28, 2007, Employee #1 was on the second floor of a structure, measuring for placement of an HVAC unit and creating a materials list for future work. He was using a flashlight to check around the area when he lost his footing and fell into the stairwell to the first floor. He sustained a fractured vertebra and was hospitalized for several days. The employer did not ensure that guardrails and handrails were in place before work was started. Keywords: construction, fall, vertebra, fracture, poor visibility, lost balance, stair landing, work rules, guardrail, handrail Inspection Degree Mture Occupation 1 311596688 Hospitalized injury Fracture Occupation not reported Freellom of Information Act i Privacy &. Security Statement Discla€mImportant er$ ( Web Site Notices Internatiwnal i Contact U$ U.S. Department of Labor I Occupattbnal Safety & Heat 800-321-OSHAhAd m6742)t InT1 00 Constitution Ave., NW, Washington, DC 20210 Tel www.OSHA.gov 1/1 https://www.osha.g ov/pls/imis/establishment.inspection_detaiI?id=311596688 Violation Summary Wilful Repeat Total aSerious !OtlherUnclass 4 44 4000 Current Penakyl 30001 1 13000 6000 FTA Amount 2.01002 Serious 19260403 B02 03/24/2008 03/28/2008 Accident Investigation Summary Summary Nr: 200774974 Event: 11/28/2007 Employee Fractures Vertebra In Fall Down Stairwell On November 28, 2007, Employee #1 was on the second floor of a structure, measuring for placement of an HVAC unit and creating a materials list for future work. He was using a flashlight to check around the area when he lost his footing and fell into the stairwell to the first floor. He sustained a fractured vertebra and was hospitalized for several days. The employer did not ensure that guardrails and handrails were in place before work was started. Keywords: construction, fall, vertebra, fracture, poor visibility, lost balance, stair landing, work rules, guardrail, handrail Inspection Degree Mture Occupation 1 311596688 Hospitalized injury Fracture Occupation not reported Freellom of Information Act i Privacy &. Security Statement Discla€mImportant er$ ( Web Site Notices Internatiwnal i Contact U$ U.S. Department of Labor I Occupattbnal Safety & Heat 800-321-OSHAhAd m6742)t InT1 00 Constitution Ave., NW, Washington, DC 20210 Tel www.OSHA.gov 1/1 https://www.osha.g ov/pls/imis/establishment.inspection_detaiI?id=311596688 Violation Items # ID Type Standard Issuance Abate Curr$ Init$ Ra$ Contest Last Event 1.()1001 Serious 19260404 B01 103/24/2008 03/28/2008 $750 $1500 $0 I - Informal Settlement 2.01002 Serious 19260403 B02 03/24/2008 03/28/2008 $750 $1500 $0 I - Informal Settlement 3. 01003 Serious 19260403 DOL 03/24/2008 03/28/2008 $750 $1500 $0 I - Informal Settlement', 4. 01004 Serious 19261052 C01 03/24/2008 03/28/2008 $750 $1500 $0 I - Informal Settlement Accident Investigation Summary Summary Nr: 200774974 Event: 11/28/2007 Employee Fractures Vertebra In Fall Down Stairwell On November 28, 2007, Employee #1 was on the second floor of a structure, measuring for placement of an HVAC unit and creating a materials list for future work. He was using a flashlight to check around the area when he lost his footing and fell into the stairwell to the first floor. He sustained a fractured vertebra and was hospitalized for several days. The employer did not ensure that guardrails and handrails were in place before work was started. Keywords: construction, fall, vertebra, fracture, poor visibility, lost balance, stair landing, work rules, guardrail, handrail Inspection Degree Mture Occupation 1 311596688 Hospitalized injury Fracture Occupation not reported Freellom of Information Act i Privacy &. Security Statement Discla€mImportant er$ ( Web Site Notices Internatiwnal i Contact U$ U.S. Department of Labor I Occupattbnal Safety & Heat 800-321-OSHAhAd m6742)t InT1 00 Constitution Ave., NW, Washington, DC 20210 Tel www.OSHA.gov 1/1 https://www.osha.g ov/pls/imis/establishment.inspection_detaiI?id=311596688 CITATION FOR VIOLATION OFMASSACHUSETTS WAGE AND HOUR LAWS Marls J, Irvine, individually and Robert 'W. Itvine & Sons, Inc. 147 Blossom Street Lynn, MA 01902 The Commonwealth of Massachusetts Office of the Attorney General Fair Labor Division One Ashburton Place, 12m. 1813 Boston, IMA 02108 ❑ Order of Restitution $ © Civil Penalty 5500.00 Total Due $500.00 ©You are hereby ordered to rectify all infractions irtrrnediately and to comply %ith all provisions al'Massachusetts General Laws, Chapters 149 and 151. 0 Second or subsequent offense © Paid Direct 5597.95 Fair Labor Division, you have been found ill violation of the following provision(s) After an investigation by the of the Massachusetts General haws: M G.1, c. 149, § 27 Failure to pay prevailing tij'ages for work performed.from 11/1/07 to 12/31/09 on the Waltham flousin r Authori Sharon Housing Authori . ° McGoverntrans ortation Salem liousinc Authority public works projects in 'Waltham, Sharon, Haverhill & S MA. Violation l; I. M Employee: Robyn Walsh`.- Restitution: _L$ 149.G0pd dir)_.._____ 2, D Employee: Keith --__- C�cstitution; ($257,25-p6dir) 3, O Employee; _G�pello - --Restitution; Bennett $3G_6012d $j3 -A9 -2L q, ® Employee: _Daniel Steven Brackett Restitution: $1 11.75 d dirt -5---�'---�-----. 5. 0 Employee: Robert Kane Restitution: ---� $1235 �d du.j_ 6. ❑ Employee: Restitution;____--- ❑ Willful Max Non -willful ❑ See attached for list of additional violations, pursuant to M,G.I.,, c, 149, section 270(b)(2), in determining the amount of the civil penalty (if any), the following factors have been taken into consideration where the information was available and where applicable: previous violations (if any), the employer's intent, the number of employees affected, the monetary extent of the violation(s), and the total monetary amount of the public contract or payroll involved. Inspector' By Certified Mail # tion 4 8110046 and P Date issued: 4/22/.1 1- 1',irst Class Mail; 4/-2—Z I_ w CITA'T'ION FOR VIOLATION OF MASSACHUSETTS WAGE, AN 1) HOOR LAWS � Marls J. Irvine,. Individually and Robert W. Irvine &; Sons, Inc. 147 Blossom Street Lynn, MA 01902 The Commonwealth of Massachusetts Office of the Attorney General Fair Labor Division One Ashburton Place, Rm, 1813 Boston, MA 02108 ❑ Order of Restitution $ © Civil Penalty $1,000.00 Total Due $1,000.00 ©You are hereby ordered to rectify all infractions immediately and to comply with all provisions of Massachusetts General Laws, Chapters 149 and 151. ❑ Second or subsequent offense After an investigation by the Fair Labor Division, you have been found in violation of the following provision(s) of the Massachusetts General Laws: ❑ M,C.L c. 149, § 2713 Failure to submit certified payroll records to the awarding authority on a weekly basis for work performed from / / to 1 / on the public worlts project. ❑ Willful ❑NDII-Willful Penalty S © M.G.L, c. 149, § 27B Failure to submit true and accurate certified payroll records for work performed from 11/1107 to 12/31/09 on Waltham Housiniz Authority, Sharon Housine Authority, McGovern Transportation and Salem Housing Authority public works projects in Waltham, Sharon, Haverhill & Salem, MA. ❑ Willful ®Non -willful Penalty .$.000.00 ❑ M.C.L. c. 149, § M 'Failure to furnish certified payroll records for inspection to a representative of the Attorney General for work performed from / / to / / on the public works project. ❑ Willful ❑Non -willful Penalty $— Pursuant to M.G,L. c. 149, section 27C(b)(2), in determining the an-tount of the civil penalty (if any), the following factors have been taken into consideration where the. information was available and where. applicable; previous violations (if any), the employer's intent, the number of employees affected, the monetary extent of the vloiation(s), and the total monctaryAnount of the public contract or payroll involved. 'itation #1'12110047 Inspector:___Nuno Montrond. ,AM Date issued; 4122/1.1 13y Certified Mail V 701 1 0110 0001 98-2 2794 and First Class ?hail; 4;22/1.1 ayrnent Innstrucuons