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Contract #: 005228 - From: To: - Exception - Exception
EFFECTIVE MARCH 30, 2010 Commonwealth of Massachusetts Division of Capital Asset Management SUB -BIDDER UPDATE STATEM ENT 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 Charles M. Moran Plumbinq & Heating, Inc. Bid Date Print Name of Sub -bidder or Trade Contractor School Department Administration Buildinq 54 Allen St, Clinton, MA 01510 Project Number (or Business Address name if no number) Town of North Andover 978-368-0355 Awarding Authority Telephone Number SIGNATUREb i"i Bidder's Auth ri d 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/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 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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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 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 ❑ E 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 parry under your ❑ E payment bond on any contract? 8. Has any subcontractor filed a demand for direct payment with an awarding authority ❑ fora public project on any of your contracts? 9. Have any of your subcontractors or suppliers filed litigation to enforce a mechanic's ❑ lien against property in connection with work performed or materials supplied under any of your contracts? 10. Have there been any deaths of an employee or others occurring in connection with ❑ E any of your projects? 11. Has any employee or other person suffered an injury in connection with any of your ❑ E projects resulting in their inability to return to work for a period in excess of one year? 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 ❑ M principal or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to the procurement or performance of any construction contract, including but not limited to actions to obtain payment brought by subcontractors, suppliers or others? 2. Have any criminal proceedings involving your firm or a principal or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to the procurement or performance of any construction contract including, but not limited to, any of the following offenses: fraud, graft, embezzlement, forgery, bribery, falsification or destruction of records, or receipt of stolen property? 3. Have any judicial or administrative proceedings involving your firm or a principal ❑ M 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 ❑ 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 ❑ 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, ❑ M 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 ❑ M 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 Michael J Moran President Paul J Moran 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 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 E ){ \k \j 8 _ | < - ! ci� ci� § � �, |! � %\§ � » t c�p* � & ( � k = 2 \ � t - IE E ) Ls t�!! ! I|t%!ii{I E \ . < a` a a' `m O E V g E i `o L 0 p P� J4Q Poe n P /P /P/ �, o S o4 J'J s� �J JJ. �J 04 6 �O. Jv/Y v m V m 9 N si a `P PP J� • m Q N u) m N m a � e4 P4o � n w eimyao V :/Pt � SPti PDJJ • v L - z $J 3 E x a o l m m P� d. P e 7 s,J Om s4mJ o m X� E = E o c U - m' P� Ja K ¢ R 0 P� a E lLL QbP � x m v N 6 a N a � ` J. Certification (notarization required) The undersigned, Michael J Moran hereby certifies: (type name) That I am an owner or principal of Charles M Moran Pltanbh!g & Heating, 1)7c, (company name) and that all answers and all statements contained in the attached application (including Sections F and G) for certificate of eligibility are complete, true and correct. Providing false or misleading information or failure to provide all required information will be considered grounds for denial, decertification and/or debarment. I attest to the accuracy of all information contained in this application and verify that the information submitted is in fact complete, accurate and true, under oath. Signed and Sworn under the Pains and Penalties of Perjury. Dated at 5-23-2013 This 23rd day of Mav. 2013. B (signature): By : g } Type name: Michael J. Moran Title or position: President a4�x*atxat o$�c aF oc�*�sF*sek rF $c rx;ekx�3,c �4 �t $cx*�;ex�, $e���$xxx3�xs; >,4x ;exx>',exxx�$xa$x ;e �F >F re h4 ak u�;e se fie $exx���x lk) &l i✓ SS. (&1 ( 1 S (county) (state) Before me, �a�L, e;C (�� , personally appeared and (h6tdry public) known to me to be Z j/I/l ol';od j�Qjsr b�4brdsed (name of officer) 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. _My commission expires:1/ (G A S. COTTER !Votary Public MJH OF AU SACHUSms U Vt My Comrni481o9 Expires (p ' t name) ie; ioia **Upon completion of this Application and the two corresponding Excel spreadsheets, save and email them to CertificationAtrnlication.deamOwstate.mams ** Page 16 of 16 Prime/General Revised March 2011 Computer Michael J Moran 6 Lorraine Avenue, Clinton, MA 01510 978-368-0355 Education Graduation from Clinton High School, Clinton, MA 1976 Leominster Trade School, Plumbing Licensing Requirements 1977-81 Rensselear Polytechnic Institute (RPI), School of management 1977-79 Worcester Polytechnic Institute (WPI), Management Engineering 1979-81 Northeastern University, Fire protection engineering 1983-84 Work experience: Apprentice plumber Charles M Moran Plumbing & Heating Inc 1977-80 Journeyman plumber for Charles M Moran Plumbing 1980-82 Office manager, estimator, purchasing supervisor 1982-84 President Corporation 1984 -present Member of MA-PHCC and national PHCC since 1986 Licenses Held: Journeyman Plumber MA# 18626 Sprinkler Contractor MA#1157 Paul J Moran 5 Fitch Farm Road, Sterling, MA 01564 978-368-0355 Education Graduation from Clinton High School, Clinton, MA 1978 Leominster Trade School, Plumbing Licensing Requirements 1976-79 Northeastern University, Fire protection engineering 1983-1984 Work experience: Apprentice plumber Charles M Moran Plumbing & Heating Inc 1973-76 Journeyman plumber for Charles M Moran Plumbing & Heating Inc 1976-78 Master Plumber & field supervisor 1978-86 Master plumber, Field supervisor of all employees, Project manager Medical gas certification holder 1992 to present Vice president and treasurer of Corporation 1986 to present Licenses Held Master Plumber MA #9509 Sprinkler contractor MA#1039 Massachusetts Plumbing Corporation #1438 John C Moran 90 Otter River Road, Gardner, MA 01440 Education: Graduation from Clinton High School 1980 Leominster Trade School- Plumbing Licensing requirement -Journeyman plb 1984-85 Leominster Trade School -Plumbing Licensing requirement -Master plb 2002-03 Work experience: Apprentice Plumber -C Moran Plb& Htg 1981-85 Journeyman Plumber -C Moran Plb&Htg 1985-03 Master plumber -C MoranPlb& Htg 2003 -present Licenses Held: Journeyman plumber MA#20055 Master plumber MA#13524 David Moran 80 Redstone Hill Road, Sterling, MA 01564 978-422-0101 Education Graduation from Clinton High School 1986 Leominster Trade School Plumbing Licensing requirement- Journeyman plumber Leominster Trade School, Plumbing Licensing requirement -Master plumber Work experience: Apprentice plumber- C. Moran Plb&Htg Journeyman plumber -C Moran Plb & Htg Master plumber- C Moran Plb & Htg Licenses Held: Journeyman plumber MA#21795 Master plumber MA# 12440 1994-96 1986-88 1988-96 1996 -present Richard A Moran 9 Milton Avenue, Clinton, MA 01510 978-365-7189 Education: Clinton High School 1977-1981 Leominster Trade School Journeyman Plumber program 1982-1984 Work Experience: Charles M Moran Plumbing & Htg Inc 1982 to present Peter W Moran 9 Milton Avenue, Clinton, MA 01510 978-368-0355 Education Graduation from Clinton High School, Clinton, MA 1984 Leominster Trade School, Plumbing Licensing Requirements Leominster Trade School Master Plumber education 1991-92 Work experience: Apprentice plumber Charles M Moran Plumbing & Heating Inc 196-89 Journeyman plumber for Charles M Moran Plumbing & Heating Inc 1989-92 Master Plumber & field supervisor 1992 to present Licenses Held Master Plumber MA # 11777 Journeyman Plumber MA#21904 Rick Knoll Mount View Drive, Clinton, MA 01510 Education: Leominster Trade School, Plumbing Licensing requirement Journeyman plumber program Leominster Trade School, Plumbing licensing requirement Master plumber program Work experience: Apprentice plumber Charles M Moran Plumbing & Htg Journeyman plumber Charles M Moran Plumbing & Htg Master plumber Charles M Moran Plumbing & Htg Licenses Held Journeyman plumber MA# 19673 Master plumber MA# 10198 1982-83 1984-85 1981-83 1983-85 1985 -present Kenneth Poulin, Jr 58 Mount View Drive, Clinton, MA 01510 Education: Graduation from Clinton High School Leominster Trade School- Plumbing Licensing requirement -Journeyman plb Leominster Trade School -Plumbing Licensing requirement -Master plb Work experience: Licenses Held: Apprentice Plumber -C Moran Plb& Htg Journeyman Plumber -C Moran Plb&Htg Master plumber -C MoranPlb& Htg Journeyman plumber MA#22055 Master plumber MA41.1881 1982 1988-89 1991-92 1987-89 1988-92 1992 -present Daniel Brodmerkle 263 Randall Road, Berlin, MA 01503 Education: Nashoba Regional High School 1965-1969 Leominster Trade School 1970-1972 Journeyman Plumber program Work Experience: Journeyman Plumber C. Moran Plumbing & Heating Inc 1981-2010 Licenses Held Journeyman plumber MA#17342 Journeyman.sprinkler fitter