HomeMy WebLinkAboutContract #: 005596 - From: To: - Exception - ExceptionMFP_�
School Department Administration Building Kang Associates, Inc.
North Andover, MA January 2, 2014
FORM OF SUB -BID
To All General Bidders Except those Excluded:
A. The undersigned proposes to furnish all labor and materials required for completing, in accordance
with the hereinafter described plans, specifications and addenda, all work specified in
Division 26 Electrical 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:
Dile 8u4ard/line7y Fou," -rho v -5.4#1 /`x; l'9Y,e0e' --, �
dollars ($� ).
For Alternate #1:
Deduct $ NA
dollars ($
0.00 )
For Alternate #2:
Add/
Deduct $ NA
dollars ($
0.00 )
For Alternate #3:
Deduct $ NA
dollars ($
0.00 )
For Alternate #4:
Deduct $ One Thousand One Hundred Fifty.
dollars ($
1,150.00 )
For Alternate #5:
Nineteen Thousand Two Hundred Fifty
Deduct
19,250.00
$
dollars ($
).
B. This sub -bid includes addenda numbered 1.
C. This sub -bid
❑ may be used by any general bidder except:
❑ may only be used by the following general bidders:
(To exclude general bidders, insert an "X" in one box only and fill in blank following that box. Do not
answer C if no general bidders are excluded.)
FORM OF SUB -BID - 1
School Department Administration Building
North Andover, MA
Kang Associates, Inc.
January 2, 2014
D. The undersigned agrees that, if he is selected as sub -bidder, he will within five days, Saturdays,
Sundays, and legal holidays excluded, after presentation of a subcontract by the general bidder
selected as the general contractor, execute with such general bidder a subcontract in accordance
with the terms of this sub -bid, and contingent upon the execution of the general contract, and, if
requested so to do in the general bid by such general bidder, who shall pay the premiums therefor,
or if pre -qualification is required pursuant to section 44D 3/4, furnish a performance and payment
bond of a surety company qualified to do business under the laws of the Commonwealth and
satisfactory to the awarding authority in full sum of the subcontract price.
E. The names of all persons, firms and corporations furnishing to the undersigned labor or labor and
materials for the class or classes or part thereof work for which the provisions of the section of the
specifications for this sub -trade requires a listing in this paragraph, including the undersigned if
customarily furnished by persons on his own payroll and in the absence of a contrary provisions in
the specifications, the name of each such class of work or part thereto and the Bid price for such
class of work or part thereof are:
Name
Class of Work
Bid Price
(Do not give bid price for any class or part thereof furnished by undersigned.)
F. The undersigned agrees that the above list of bids to the undersigned represents bona fide bids
based on the hereinbefore described plans, specifications and addenda and that, if the undersigned
is awarded the contract, they will be used for the work indicated at the same amounts stated, if
satisfactory to the awarding authority.
G. The undersigned further agrees to be bound to the general contractor by the terms of the
hereinbefore described plans, specifications, including all general conditions stated therein, and
addenda, and to assume toward him all the obligations and responsibilities that he, by those
documents, assumes toward the owner.
H. The undersigned offers the following information as evidence of his qualifications to perform the
work as bid upon according to all the requirements of the plans and specifications:
1. Have been in business under present business name 28 years.
2. Ever failed to complete any work awarded?
No
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
(a) Methuen Central School KBA
MCM USA
FORM OF SUB -BID - 2
Amount of Contract
174,570.00
School Department Administration Building
North Andover, MA
(b) Lexington Town Hall Reno
()Chelmsford Town Hall
4. Bank reference Sovereign Bank
Kang Associates, Inc.
January 2, 2014
M. O'Connor Contracting $131,420.00
M. O'Connor Contracting 8523.652.00
The undersigned hereby certifies that he is able to furnish labor that can work in harmony with all
other elements of labor employed or to be employed on the work; that all employees to be employed
at the worksite will have successfully completed a course in construction safety and health approved
by the United States Occupational Safety and Health Administration that is at least 10 hours in
duration at the time the employee begins work and who shall furnish documentation of successful
completion of said course with the first certified payroll report for each employee; and that he will
comply fully with all laws and regulations applicable to awards of subcontracts subject to section
44F.
The undersigned further certifies under penalties of perjury that this sub -bid is in all respects bona
fide, fair and made without collusion or fraud with any other person. As used in this subsection the
word "person" shall mean any natural person, joint venture, partnership, corporation or other
business or legal entity. The undersigned further certifies under penalty of perjury that the said
undersigned is not presently debarred from doing public construction work in the commonwealth
under the provisions of section twenty-nine F of chapter twenty-nine, or any other applicable
debarment provisions of any other chapter of the General Laws or any rule or regulation
promulgated thereunder.
1/21/2014 MEF Controls and Electrical Services, Inc.
Date (Name of Sub -Bidder)
By. —
Signature and Title of Person Signing Bid
Mark E Fowler: President
SUB -BIDDER'S CHECKLIST:
x Addenda Recognized
x Bid Deposit
x DCAM Certificate of Eligibility
x Sub -Bidder Update Statement
Certificate of Corporate Bidder
69 Ash Street
Business Address
West Newbury, Ma 01985
City and State
FORM OF SUB -BID - 3
® THE MAIN STREET AMERICA GROUP
NGM Insurance Company • Old Dominion Insurance Company
Main Street America Assurance Company • MSA Insurance Company
Information Systems and Services Corporation
Bid Bond
KNOW ALL MEN BY THESE PRESENTS, that we (Here insert full name and address or legal title of Contractor)
MEF Controls and Electrical Services, Inc.
69 Ash Street, W. Newbury, MA 01985
as Principal, hereinafter called the Principal, and (Here insert full name and address or legal title of Surety)
NGM Insurance Company
55 West Street
Keene, NH 03431
a corporation duly organized under the laws of the State of Florida
as Surety, hereinafter called the Surety, are held and firmly bound unto (Here insert full name and address or legal title of Owner)
Town of North Andover
as Obligee, hereinafter called the Obligee, in the sum of Five Percent of Bid Amount
Dollars ($ ), 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 (Here insert full name, address and description of project)
School Department Administration Building
Sub -Bidder: Division 26 - Electrical
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 furnished in the prosecution thereof, or in the event of the failure of the Principal to enter
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
itn ss)
, 2014.
MEF Controls and Electrical Services Inc.
>(,,r,nci al),, (Sear
( ltle)
NGM Insurance Company_
ty) ; .ai / (Seal)
IDbb6rah L. Burn'
(Title) Attorney-in-fact
Printed in cooperation with the American Institute of Architects (AIA) by the NGM Insurance Company of
4601 Touchton Road East, Suite 3400, Jacksonville, FL 32256 904-739-0873. The language in this document conforms exactly to the
language used in AIA Document A310, February, 1970 edition.
68-5302(05/2006)
m NCM INSURANCE COMPANY POSER OF ATTORNEY
- A member of The Main Street America Group
r�$ SENSITIVE Sy�C
O
DOCUGard #204346 contains a security pantograph, blue background, heat senslttvE Ini� cote reactive watermark, and tnlcrate printing on border. o�s"'rh HEAT oP`�JUr
�_ _ —
CERTIFICATE OF VOTE
At a duly authorized meeting the Board of Directors of the MEF Controls & Electrical Services, Inc
held on 1/20/14 it was
VOTED, THAT
Mark E Fowler
President
(Name) (Officer)
MEF Controls and Electrical
Of services, Inc. be and hereby is authorized to execute contracts and bonds in
the name and on behalf of said Corporation , and affix its corporate seal hereto;
MEF Controls and Electrical
and such execution of any contract or obligation in the name of ser-v}ees, !no , on
MEF Controls and Electrical
its behalf by such officer under seal of services, Inc. , shall be valid and binding
upon signature of Mark E Fowler
MEF Controls and Electrical
I hereby certify that I am the clerk of the above named lev=ees, !n6. and
that Mark E Fowler
is the duly elected officer as above of said
Corporation , and that the above vote has not been amended or rescinded and
remains in full force and effect as the date of this contract.
1/20/14 P,/,GVZ,
(Date) Z ark E Fowler:(Clerk)
Certification of the Corporate Clerk
CERTIFICATIONS
CERTIFICATE OF NON -COLLUSION
The undersigned certifies under penalties of perjury that this bid or proposal has been made and
submitted in good faith and without collusion or fraud with any other person. As used in this
certification, the word "person" shall mean natural person, business, partnership, corporation,
committee, union, club or other organization, entity, or group of individuals.
/Ax"elz
Signature
Mark E Fowler: President
Date 1/21/14
MEF Controls & Electrical Services, Inc.
Print Name & Title Company Name
CERTIFICATE OF TAX COMPLIANCE
Pursuant to Chapter 62C of the Massachusetts General Laws, Section 49A (b), I
Mark E Fowler- Pr ci do nt , authorized signatory for MFF Control-, & Electrical Servires, 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
remitting child support.
1/21/14
Signature Date
CERTIFICATION
LABOR HARMONY AND OSHA TRAINING REQUIREMENTS
The undersigned certifies under penalties of perjury that he is able to furnish labor that can work
in harmony with all other elements of labor employed or to be employed at the work
and
that all employees to be employed at the worksite and in the work will have completed an
OSHA -approved construction safety and health course lasting at least ten (10) hours.
Signature -e l�l---- Date 1/21/14
Mark E Fowler: President MFF con rots k Flectriral rvicPs. Tnr.
Print Name & Title Company Name
The Commonwealth of Massachusetts
Executive Office for Administration and Finance
Division of Capital Asset Management and Maintenance
One Ashburton Place
CONTRACTOR IDENTIFICATION NUMBER: 1637
This Certificate Shall Be Used for Submitting Filed Sub -Bids Only
1. CERTIFICATION PERIOD: This Certificate is valid from 1/15/2014 to 1/15/2015
2. CONTRACTOR'S NAME: M.E.F. Controls & Electrical Services, Inc.
3. CONTRACTOR'S ADDRESS: 69 Ash Street, West Newbury, MA 01985
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:
] Acoustical TileHVAC I j Miscellaneous & Ornamental Iron [ Terrazzo
�i Electrical Work ;._ Lathing & Plastering :1 Painting [Tile
;Elevators J Marble Plumbing 1-1 Waterproofing, Damp
Fire Protection Sprinkler Systems❑Masonry Work El Resilient Floors proofing, and Caulking
l_ ;Glass and Glazing [ I Metal Windows ❑ Roofing &Flashing
S. EVALUATIONS: Number of Projects Evaluated: 6
Average Project Evaluation Rating: 91
Number of Projects Below Passing Score: 0
6. SUPPLIER-9ibf..R%TYGFICE CERTIFICATION: N/A
t
T anrigsby, General Counsel, Approval Date
for Ca le J. Cornelison, Commissioner
NOTE TO CONTRACTORS: teaItfete 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 " y
result in a gap in Certification or a lapse in Certification altogether for your company.
Reviewer's Initials
Boston, Massachusetts 02108
DEVAL L. PATRICK
GLEN SHOR
GOVERNOR
Tel: (617) 727-4050
SECRETARY, ADMINISTRATION a
Fax: (617) 727-5363
FINANCE
TIMOTHY P. MURRAY
CAROLE CORNELISON
LIEUTENANT GOVERNOR
COMMISSIONER
Filed Sub -Bid
Certificate of Contractor Eligibility
CONTRACTOR IDENTIFICATION NUMBER: 1637
This Certificate Shall Be Used for Submitting Filed Sub -Bids Only
1. CERTIFICATION PERIOD: This Certificate is valid from 1/15/2014 to 1/15/2015
2. CONTRACTOR'S NAME: M.E.F. Controls & Electrical Services, Inc.
3. CONTRACTOR'S ADDRESS: 69 Ash Street, West Newbury, MA 01985
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:
] Acoustical TileHVAC I j Miscellaneous & Ornamental Iron [ Terrazzo
�i Electrical Work ;._ Lathing & Plastering :1 Painting [Tile
;Elevators J Marble Plumbing 1-1 Waterproofing, Damp
Fire Protection Sprinkler Systems❑Masonry Work El Resilient Floors proofing, and Caulking
l_ ;Glass and Glazing [ I Metal Windows ❑ Roofing &Flashing
S. EVALUATIONS: Number of Projects Evaluated: 6
Average Project Evaluation Rating: 91
Number of Projects Below Passing Score: 0
6. SUPPLIER-9ibf..R%TYGFICE CERTIFICATION: N/A
t
T anrigsby, General Counsel, Approval Date
for Ca le J. Cornelison, Commissioner
NOTE TO CONTRACTORS: teaItfete 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 " y
result in a gap in Certification or a lapse in Certification altogether for your company.
Reviewer's Initials
14
EFFECTIVE MARCH 30, 2010
Commonwealth of Massachusetts
Division of
Asset Management
i
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.
01/21/14 MEF Controls & Electrical Services, Inc.
Bid Date Print Name of Sub -bidder or Trade Contractor
School Department Administration Building _
69 Ash Street W. Newbury, MA 01985
Project Number (or Business Address
name if no number)
Town of North Andover 978-363-2421
Awarding Authority Telephone Number
SIGNATURE*
Bidder's Aut orized 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._qov/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)].
Page 2 of 10
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PART 3 - PROJECT PERFORMANCE
For Parts 3 and 4, if you answer YES to any question, please provide on a separate
page a complete explanation. Information you provide herein must supplement the
Application for your most recently issued (not extended or amended) Sub -Bidder
Certificate of Eligibility. You must report all requested information not previously
reported on that Application. Include all details [project name(s) and location(s),
names of all parties involved, relevant dates, etc.].
YES NO
1.
Has your firm been terminated on any contract prior to completing a project or has
❑
any officer, partner or principal of your firm been an officer, partner or principal of
another firm that was terminated or failed to complete aproject?
2.
Has your firm failed or refused either to perform or complete any of its work under
❑
any contract prior to substantial completion?
3.
Has your firm failed or refused to complete any punch list work under any contract?
❑
4.
Has your firm filed for bankruptcy, or has any officer, principal or individual with a
❑ N
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
❑ 11
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
❑
for a public project on any of your contracts?
9.
Have any of your subcontractors or suppliers filed litigation to enforce a mechanic's
❑
lien against property in connection with work performed or materials supplied
under any of your contracts?
10.
Have there been any deaths of an employee or others occurring in connection with
❑ ❑
any of yourprojects?
11.
Has any employee or other person suffered an injury in connection with any of your
❑
projects resulting in their inability to return to work for a period in excess of one
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
❑
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
0
anyone with a financial interest in your firm been brought, concluded, or settled
relating to the procurement or performance of any construction contract including,
but not limited to, any of the following offenses: fraud, graft, embezzlement,
forgery, bribery, falsification or destruction of records, or receipt of stolen property?
3. Have any judicial or administrative proceedings involving your firm or a principal
❑
or officer or anyone with a financial interest in your firm been brought, concluded,
or settled relating to a violation of any state's or federal procurement laws arising
out of the submission of bids or proposals?
4. Have any judicial or administrative proceedings involving your firm or a principal
or officer or anyone with a financial interest in your firm been brought, concluded,
or settled relating to a violation of M.G.L. Chapter 268A, the State Ethics Law?
Division of Capital Asset Management Page 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
❑ z
officer or anyone with a financial interest in your firm been brought, concluded, or
settled relating to a violation of state or federal law regulating the environment?
10. Has your firm been fined by OSHA or any other state or federal agency for
❑
violations of any laws or regulations related to occupational health or safety? Note:
this information may be obtained from OSHA's Web Site at www.osha.gov
11. Has your firm been sanctioned for failure to achieve DBE/MBE/WBE goals,
❑
workforce goals, or failure to file certified payrolls on any publicprojects?
12. Other than previously reported in the above paragraphs of this Section I, have any
❑
administrative proceedings or investigations involving your firm or a principal or
officer or anyone with a financial interest in your firm been brought, concluded, or
settled by any local, state or federal agency relating to the procurement or
performance of any construction contract?
13. Are there any other issues that you are aware which may affect your firm's
❑
responsibility and integrity as a building contractor?
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.
I NAME I TITLE OR FUNCTION
Mark E Fowler
Owner: 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
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