Black Electric Inc SECTION 00310 — BID FORM
CONTRACT NO. 13-009. C RDD
ELECTRICAL CONSTRUC ION SEP 19 2014
BID FORM TOWN OF WAPPINGER
TOWN CLERK
THE TOWN RESERVES THE RIGHT TO REJECT ANY OR ALL BIDS. EACH BID
FORM SHALL BE ACCOMPANIED BY BID SECURITY (AS DESCRIBED IN THE
INSTRUCTION TO BIDDERS).
TO THE TOWN BOARD, TOWN OF WAPPINGER, NEW YORK
Pursuant to and in compliance with your invitation to bid contained in the Notice to
Contractors dated } t , 2.o l 'f
(mom.) (day) (year)
the undersigned hereby proposes to furnish all labor, machinery, equipment, facilities,
tools, transportation, supplies, materials, insurances, permits, certificates, tests,
guarantees, protection of equipment and property and life during construction; as well
as competent and qualified supervision for all phases of the work, and other facilities
and things necessary or proper for or incidental to, Contract No. 13-009EC, UNITED
WAPPINGER WATER DISTRICT ATLAS AND HILLTOP FILTRATION - Electrical "
Construction, as required by and in strict accordance with the plans, specifications and
all other documents relating to Contract No. 13-009EC, for the prices stipulated and as
shown on this bid form.
Name of Bidder: A.OL.C1/K EAC.
(Individual, Partnershi Corporation r LLC)*
* Circle applicable word
The undersigned declares that the bidding and contract documents have been carefully
examined and that all things necessary for the completion of the work shall be provided.
Receipt of the following addenda is hereby acknowledged:
DATE SIGNATURE
ADDENDUM NO. 1 13 /Pt it0
/
ADDENDUM NO. 2 / ///
� L _
ADDENDUM NO. 3
BID FORM 00310-1
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ADDENDUM NO. 4
In consideration of, and to induce the award of this contract to him/her, the bidder
represents and warrants that:
(a) If this bid is accepted by the Town Board, Town of Wappinger, as
evidenced by issuance of a Notice of Award by the Owner, and mailed by
registered mail with return receipt requested to the address of the bidder
as indicated on his/her bid, the bidder will execute a contract on the form
of agreement herein provided and will comply with all provisions of said
Notice of Award.
(b) This bid is made without any understanding, agreement or connection with
any other person, firm or corporation making a bid for the same work, and
that it is in all respect fair and without collusion or fraud.
(c) The bidder has carefully examined and fully understands all of the parts of
the contract documents, and that the bidder will execute the contract and
will completely perform it in strict accordance with the provisions thereof
for the sum set forth on the bid. Unit Prices have been computed in
accordance with the Contract Documents. Bidder.acknowledges that
estimated quantities are not guaranteed, and are solely for the purpose of
comparison of Bids, and final payment for all Unit Price Bid items will be
based on actual quantities, determined as provided in the Contract
Documents.
(d) No officer or employee of the Town Board, Town of Wappinger, or any
person whose salary is payable in whole or in part by the Town Board is,
shall be, or shall become interested directly or indirectly as a contracting
party, partner, stockholder, surety or otherwise in this bid or in the
performance of the contract or in the supplies, materials or equipment, or
to work or labor to which it relates, or in any portion of the profits thereof.
(e) The bidder is not in arrears to the Town Board upon debt or contract and
is not a defaulter as surety, contractor, or otherwise upon any obligation to
the Town Board, Town of Wappinger.
(f) All work shall be completed within the time allotted, from the date specified
in the Notice to Proceed or set by the 'Contract documents, mailed to the
undersigned by registered mail with return receipt requested to the legal
address of the bidder as indicated on his/her bid.
BID FORM 00310-2
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(g) If the bid documents contain any unlawful provision not an essential part
of the bid and which shall not appear to have been a controlling or
material inducement to the making thereof, the same shall be deemed of
no effect and will upon notice by either the Owner or the bidder be
deemed stricken from the bid documents without affecting the binding
force of the remainder.
(h) Each and every provision of any law and clause required by law to be
inserted in the bid documents shall be deemed to be inserted herein and
the bid documents shall be read and enforced as though it were included
herein; and if through mistake or otherwise any such provision is not
inserted or is not correctly inserted, then upon the application of either
party, the bid documents shall forthwith be physically amended to make
such insertion.
(i) The bidder is financially solvent and sufficiently experienced and
competent to perform the work.
(j) The work can be performed as called for by the proposal and that the
plans and specifications are in all respects suitable and adequate for the
work.
(k) The facts stated in his/her bid and the information given by him/her are
- true and correct in all respects.
(I) The bidder is fully informed regarding all the conditions affecting the work
to be done and labor and materials to be furnished for the completion of
this contract, and that his/her information was secured by personal
investigation and research.
(m) In the event of a lawsuit, the bidder agrees that said suit shall be filed in
the same county as the location of the project.
BID FORM 00310-3
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BID FOR CONTRACT WORK:
BASE BID (ELECTRICAL CONSTRUCTION)
1)i Nv� ta-e Twee, Six � s Q $ 326, 5--a)
(in writing) 'Rye_ o-ecQ (and figures)
Dated: /4 , 20 J I
SIGN BID HERE Z6t)C.
Autho ed Signature Title
r7:1\ -S cBl&c
Print Name
Legal Company Name 'c_C T-Cc
Address 7g Freer plat
City, State, Zip Qvv.teli-cps t / i f'r 1N o 3
Telephone No. gys' tfg g7cb
Federal I.D. # I`(^ /Li 89 '73
BID FORM 00310-4
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BASE BID SHEET
ELECTRICAL CONSTRUCTION
CONSTRUCTION BID AND CONTRACT
Contract No. 13-009EC, UNITED WAPPINGER WATER DISTRICT ATLAS AND HILLTOP FILTRATION
ITEM NO./DESCRIPTION EST. PAYMENT UNIT PRICE BID TOTAL
QTY. UNIT PRICE BID
WRITTEN AMOUNT IN FIGURES
1. Furnish and install all materials, -Roo "\
supplies, equipment and other 1 L.S.
facilities as required for construction nt, ' rti4---)\001.50%&
of UNITED WAPPINGER WATER
DISTRICT ATLAS AND HILLTOP 84A-9\r5 ,) q f
FILTRATION -Electrical 2q`7 ��� A(L1 a')
Construction, including all I
incidentals, as shown and as
specified in the Contract Documents.
2. Rock Excavation 30 C.Y. 6 n L
3. Authorized Additional Excavation 30 C.Y. i9,s'CK_ 100 '3 000
4. Lift Station Abandonment 1 EA -
ALLOWANCE#1 $5,000.00
Testing Services ----- - -- – -- ---
ALLOWANCE#2 $20,000.00
Contingency Allowance -- — ---- ---- -----
TOTAL BASE BID 5-0
- END OF SECTION-
-
i
(If bidder is a corporation, fill in the following blanks.)
Organized under the laws of the State of: V ,/ jr i k
Name and Address of President: S(:),. ,5 b�cLtL / P L." c-
F)47\-\\iCkA v'\‘1'' 12 Zzf
Name and Address of Secretary: cp'1„�_ 2.-C '/1-/ f74-14t/Lo.'4ACt.
rS\\Lc��� ' 125ZG(
Name and Address of Treasurer:
•
(If bidder is a Limited Liability Company, fill in the following blanks.)
Organized under the laws of the State of:
Name of Manager or Managing Member:
Agent for Service of Process:
Address for Service of Process:
BID FORM 00310-5
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STATE OF NEW YORK )
ss:
COUNTY OF Ii-hk )
On the / day of - , 20 /q before me, the
undersigned, a Notary Public in and for said State, personally appeared
'76---
personally known to me or proved to me on the basis of satisfactory
evidence to be the individual whose name is subscribed to the within instrument and
acknowledged to me that he executed the same in his capacity, and that by his
signature on the instrument, the individual, or the person upon behalf of which the
individual acted, executed the instrument.
I • CtC ())g-0
NO AR PUBLIC
Down Notary F'ubllc,Lacey or New York
Lic.No.01KR625g680
Qualified in Cutchese County
Commission Expires 04/16,20.to
BID FORM 00310-6
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iii
SECTION 00480-CERTIFICATION OF NON-COLLUSION
iiiiiPill
CERTIFICATION OF NON-COLLUSION BY BIDDER
?PI
The undersigned represents that pursuant to Sections 103-a and 103-b of the General
Municipal Law of the State of New York, no person referred to in the attached proposal
who is the bidder or who is or was a member, partner, director or officer of the bidding
firm or entity under this proposal has refused to sign a waiver of immunity or to answer
any relevant questions relating to any transaction or contract with the State of New
York, any political subdivision thereof, or any public authority, during the period of five
years prior to the date hereof. The undersigned agrees that any contract awarded as a
ill result of this bid may be canceled without penalty upon the grounds set forth in Sections
103-a and 103-b of the said General Municipal Law of the State of New York. The
INnames and addresses of all persons and parties interested in the foregoing bid are as
follows:
—5 `
1101
IN
oi
By submission of this bid, each bidder and each person signing on behalf of any bidder
certifies, and in the case of a joint bid each party thereto certifies as to its own
organization, under penalty of perjury, that to the best of knowledge and belief:
0 1. The prices in this bid have been arrived at independently without collusion,
consultation, communication, or agreement, for the purpose of restricting
is, competition, as to any matter relating to such prices with any other bidder or with
any competitor;
2. Unless otherwise required by law, the prices which have been quoted in this bid
have not been knowingly disclosed by the bidder and will not
y be
disclosed by the bidder prior to opening, directly or indirectly, to any other bidder
0 or to any competitor; and
3. No attempt has been made or will be made by the bidder to induce any other
person, partnership or corporation to submit or not to submit a bid for the
1111 purpose of restricting competition.
iiiii A bid shall not be considered for award nor shall any award be made where 1, 2 and 3
above have not been complied with; provided however, that if in
any case the bidder
CERTIFICATION OF NON-COLLUSION 00480-1
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I
cannot make the foregoing certification, the bidder shall so state and shall furnish with
the bid a signed statement which sets forth in detail the reasons therefore. Where I, 2
and 3 above have not been complied with, the bid shall not be considered for award nor
shall any award be made unless the head of the purchasing unit of the political
subdivision, public department, agency or official thereof to which the bid is made, or his
designee, determines that such disclosure was not made for the purpose of restricting
competition.
The fact that a bidder (a) has published price lists, rates, or tariffs covering items being
procured, (b) has informed prospective customers of proposed or pending publication of
new or revised price lists for such items, or (c) has sold the same items to other
customers at the same prices being bid, does not constitute, without more, a disclosure
within the meaning of subparagraph one.
Any bid hereafter made to any political subdivision of the State or any public
department, agency or official thereof by a corporate bidder for work or services
performed or to be performed or goods sold or to be sold, where competitive bidding is
required by statute, rule, regulation, or local law, and where such bid contains the
certification referred to in subdivision one of this section, shall be deemed to have been
authorized by the board of directors of the bidder, and such authorization shall be
deemed to include the signing and submission of the bid and the inclusion therein of the
certificate as to non-collusion as the act and deed of the corporation.
{
- END OF SECTION -
CERTIFICATION OF NON-COLLUSION 00480-2
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BID BOND
CONTRACTOR: SURETY:
(Name, legal status and address) (Name, legal status and principal place of business)
Black Electric Inc. NGM Insurance Company
766 Freedom Plains Rd. 55 West Street
Poughkeepsie,NY 12603-6357 Keene,NH 03431-3374
OWNER:
(Name, legal status and address)
Town of Wappingers
20 Middlebush Rd.
Wappinger Falls,NY 12590
BOND AMOUNT: Five Percent(5%)of Total Amount Bid----
PROJECT:
(Name, location or address, and Project number, Orally)
Atlas,Hilltop Water Filtration-Contract 13-009 EC Electrical
The Contractor and Surety arc bound to the Owner in the amount set forth above, for the payment of which the Contractor and
Surety bind themselves,their heirs,executors,administrators,successors and assigns,jointly and severally,as provided herein.
The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid
documents,or within such time period as may be agreed to by the Owner and Contractor,and the Contractor either(I)enters
into a contract with the Owner in accordance with the terms of such bid,and gives such bond or bonds as may be specified in
the bidding or Contract Documents,with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the
Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the
prosecution thereof; or(2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount
specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the
work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect. The Surety
hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may
accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate
beyond the time for acceptance of bids specified in the bid documents,and the Owner and Contractor shall obtain the Surety's
consent for an extension beyond sixty(60)days.
If this Bond is issued in connection with a subcontractor's bid to a Contractor, the terms Contractor in this Bond shall be
deemed to be Subcontractor and t:he term Owner shall be deemed to be Contractor.
When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project,any
provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted hcrefrom and provisions
conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intentis
that this Bond shall be construed as a statutory bond and not as a common law bond.
The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310,2010
edition
1
•
Signed and sealed this 11th day of September 2014 .
Black Electric Inc.
(Yrincipar (S'eal)
ciA:14,7()
(!fitness) James R.Bla k,President °I91--;\"
NGM Insurance Company
(Surety) / (Sea!)
Witne w)Victoria Rivera Alissa J. olf, ••orney-in-Frfct
The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310,2010
edition 2
•
ACKNOWLEDGMENT OF PRINCIPAL
STATE OF New York )
SS.:
COUNTY OF Dutchess )
On the l c day of September in the year 2014 , before me, the
undersigned, personally appeared James R.Black , personally known
to me or proved to me on the basis of satisfactory evidence to be the individual whose name is
subscribed to the within instrument and acknowledged to me that he/she executed the same in
his/her capacity, and that by his/her signature on the instrument, the individual, or the person
upon behalf of which the individual acted, executed the instrument.
(7, • 4 Ni
No a Public
ACKNOWLEDGMENT OF SURETYDivan LIMY_
Notary Public,State of New York
Lic.No.01KR8259680
STATE OF New York ) Qualified in Widens County
Commission Expires 04/16,201kv
) SS.:
COUNTY OF Frip
On the 11th day of September in the year 2014 . before me, the
undersigned,personally appeared Alissa J.Wolf , personally known
to me or proved to me on the basis of satisfactory evidence to be the individual whose name is
subscribed to the within instrument and acknowledged to me that he/she executed the same in
his/her capacity, and that by his/her signature on the instrument, the individual, or the person
upon behalf of which the individual acted, executed the instrument.
Ale/A
Notary Public
VICTORIA RIVERA
NOTARY PUBLIC,STATE OF NEW YORK
QUALIFIED IN ERIE COUNTY
My Commission Expires Nov 29,2014
. b
►.._J NGM INSURANCE COMPANY POWER OF ATTORNEY 06-132../8386
A member of The Mein Street America Group
KNOW ALL MEN BY THESE PRESENTS: That NGM Insurance Company,a Florida corporation having its principal
office in the City of Jacksonville,State of Florida,pursuant to Article IV,Section 2 of the By-Laws of said Company,to wit:
“Article IV, Section 2. The board of directors, the president, any:vice president, secretary, or the treasurer
shall have the power and authority to appoint attorneys-in-fact and to authorize them to executeon behalf of
the company and affix the seal of the company thereto, bonds, recognizances, contracts of indemnity or
writings obligatory in the nature of a bond,recognizance or conditional undertaking and to remove any such
attorneys-in-fact at any time and revoke the power and authority given to them. 't
does hereby make,constitute and appoint Lori Fay,Victoria Rivera,Christopher I)Ross,Bradley.1 Hail,
Colleen A Kendziora,Scott T Hoffman,Jack Fuller,Timothy M Toole,Alissa J Wolf ----
its true and lawful Attorneys-in-fact,to make,execute,seal and deliver for and on its behalf, and as its act and deed,bonds,
undertakings,recognizances,contracts of indemnity,or other writings obligatory in nature of a bond subject to the following
limitation:
1. Five Million Dollars($5,000,000.00).
and to bind NGM Insurance Company thereby as fully and to the same extent as if such instruments were signed by the duly
authorized officers of the NGM Insurance Company;the acts of said Attorney are hereby ratified and continued.
This power of attorney is signed and sealed by facsimile under and by the authority of the following resolution adopted by
the Directors of NGM Insurance Company at a meeting duly called and held on the 2nd day of December 1977.
Voted: That the signature of any officer authorized by the By-Laws and the company seal'may be affixed by facsimile to
any power of attorney or special power of attorney or certification of either given for the execution of any bond,
undertaking,recognizance or other written obligation in the nature thereof; such signature and seal,when so used being
hereby adopted by the'company as the original signature of such office and the original seal of the company,to be valid
and binding upon the company with the same force and effect as though manually affixed.
IN WITNESS WHEREOF,NGM Insurance Company has caused these presents to be signed by its Vice President,
General Counsel and Secretary and its corporate seal to be hereto affixed this 20th day of March,2013.
NGM INSURANCE COMPANY By: 6 ,---
r;R'rr,, `I
` � 5 1923 1
Bruce R Fox
Vice President,General ' ''
Counsel and Secretary
State of Florida,
County of Duval.
On this March 20th,2013,before the subscriber a Notary Public of State of Florida in and for the County of Duval duly commissioned and,
qualified, came Bruce R Fox of the NGM insurance Company, tome personally known to be the officer described herein, and who;
executed the preceding instrument, and he acknowledged the execution of same,and being by me fully sworn,deposed and said that he isi,
an officer of said Company,aforesaid:that the seal affixed to the preceding instrument is the corporate seal of said Company,and the said
corporate seal and her signature as officer were duly affixed and subscribed to the said instrument by the authority and direction of the said
Company;that Article IV,Section 2 of the By-Laws of said Company is now in force.
IN WITNESS WHEREOF,I have hereunto set my hand and affixed my official seal at Jacksonville,Florida this 20th day of March,
2013. TASHA PFaPot
NOTARYPOILIC
ilott STATE "SO'
Ef
at,awsr
Ermites101311015
I,Brian J Beggs,Vice President of the NGM Insurance Company,do hereby certify that the above and foregoing is a true and correct copy
of a Power of Attorney executed by said Company which is still in full force and effect.
IN WITNESS WHER OF,I hay hereunto set my hand and affixed the seal of said Company at Jacksonville,Florida this
i / lay of a r C),201y-
WARNING,
Any unauthorized reproduction ox alteration
of this document is prohibited.
TO CONFIRM VALIDITY of the attached bond please call 1-800-225-5646.
t sosniVesH
TO SUBMIT A CLAIM:Send all correspondence to 55 West Street,Keene,NH 03431 Attn:Bond Claims. , F,
(
3.'0.,'494,
flocuGard#04546 contains a security pantograph,blue background,heat-sensitive Ink;coin-reactive watermark and rnierotext printing on border, ,w'rH HEAT a"`�
i'•.
iZi THE MAIN STREET AMERICA GROUP �nraw
I certify that at the Annual Meeting of the Directors of the NGM Insurance Company duly called and held at Jacksonville, Florida on
March 13, 2014 ,the following officers were elected and still remain in office:
THOMAS M. VAN BERKEL CHAIRMAN OF THE BOARD, PRESIDENT AND CHIEF EXECUTIVE OFFICER
EDWARD J. KUHL EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER&TREASURER
STEVEN J. PEETERS.....................................................EXECUTIVE VICE PRESIDENT, CHIEF OPERATING OFFICER
DOUGLAS EDEN,ANTONIA M. PORTERFIELD
MICHAEL D. LANCASHIRE, ..........................................................................................SENIOR VICE PRESIDENTS
BRUCE FOX .......................................................................VICE PRESIDENT, GENERAL COUNSEL&SECRETARY
BRIAN J. BEGGS, DANIEL J. GAYNOR, DAVID S. MEDVIDOFSKY,
JOHN THOMPSON, ROBERT HETZEL, DEBORAH E. MURPHY.......................................................VICE PRESIDENTS
RONALD A. JAMES VICE PRESIDENT&CHIEF INFORMATION OFFICER
THOMAS T. FRAZIER...................................................................VICE PRESIDENT&CHIEF INVESTMENT OFFICER
DEAN P. DORMAN VICE PRESIDENT&CHIEF ACTUARY
RICHARD G. SCHULTZ...... VICE PRESIDENT&CHIEF ACCOUNTING OFFICER
CATHERINE ECHRISTOPHER DEBORAH OJANSEN,SA MUAN, RONALD DEBRA OAIIZR, COX ASSISTANT VICE PRESIDENTS
TIMOTHY O. MUZZEY ASSISTANT VICE PRESIDENTS/ACTUARY
KIMBERLY K. LAW, MARK FRIEDLANDER,
KATHLEEN KILLGORE, NANCY PALMISANO, MICHELE SEYMOUR
ALICE MORIARTY, JEFFREY PRICE ASSISTANT SECRETARIES
REGIONAL PRESIDENTS(Appointed)
MARK BERGER REGIONAL PRESIDENT, NORTHEAST REGION
STEVE BERRY REGIONAL PRESIDENT, NEW ENGLAND REGION
GREGG EFFNER ..................................................................REGIONAL PRESIDENT SOUTHEAST REGION
JEFFREY B. KUSCH REGIONAL PRESIDENT, MIDWEST REGION
I further certify that the following statement of the Company is true as taken from the records of said Company as of December 31,2013.
ADMITTED ASSETS LIABILITIES
Bonds at Amortized Values $1,403,298,752 Reserve for Losses $602,053,162
Stocks at Market Value 296,421,008 Reserve for Loss Adjustment Expenses 114,873,358
First Mortgage Loans 17,336,820 Reserve for Unearned Premiums 480,696,312
Real Estate 4,746,313 Reserve for Other Underwriting Expenses 42,159,321
Cash in Office and Banks 38,025,546 Reserve for Taxes, Licenses, and Fees 8,768,841
Short Term Investments 10,417,373 Loss Drafts in Transit 23,224,703
Agent's Balance(Less than 90 Days) 246,938,580 Other Liabilities 56,642,615
Accrued Interest 13,877,101 Total Liabilities 1,328,418,312
Other Assets 234,240,825 Policyholders'Surplus 936,884,006
TOTAL ADMITTED ASSETS $2,265,302,318 TOTAL................................................ $2,265,302,318
Securities as deposited by law, included above=$ 10,156,431
I further certify that the following is true and exact excerpt from Article IV, Section 2 of the By-Laws of NGM Insurance Company which is
still valid and existing.
"The board of directors, the president, any vice president, secretary, or the treasurer shall have the power and authority to appoint
attorneys-in-fact and to authorize them to execute on behalf of the company and affix the seal of the company thereto, bonds,
recognizances, contracts of indemnity or writings obligatory in the nature of a bond, recognizance or conditional undertaking and to
remove any such attorneys-in-fact at any time and revoke the power and authority given to them."
Subscribed and Sworn to before me on IN WITNESS THEREOF I hereunto subscribe
this 17th day of March, 2014 my name and affix the seal of said company
BHA PFaPOT this 17th day of March,2014
ir)C11-k4,
001--- ,
TANOTARY Pueuc
VPr77�,, NATE OF FLORIQA
."�"•' Cain*
Hares+018/701e V7iitte NW
68-QQ-0002-14
68-1191 (3/13)