Building G Gymnasium Upgrades

Transcription

1 PROJECT MANUAL ISSUED FOR BID: May 15, 2017 Building G Gymnasium Upgrades for Moraine Valley Community College 9000 West College Parkway Palos Hills, Illinois N. Halsted Street, Suite 301 Chicago, Illinois P F DKA Project Number:

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3 DIVISION 0 - PROCUREMENT AND CONTRACTING REQUIREMENTS Advertisement for Bids Instructions to Bidders MVCC Firearm Concealed Carry Notice Bid Form MVCC Project Certification & Non-Collusion Affidavit MVCC Substitute W9 & Vendor Authorization Form MBE/FBE/PBE/DBE Proposed Supplier/Sub-Contractor Form Bid Bond Substitution Sheet Bidder Eligibility and Non-Collusion Affidavit General Conditions of the Contract for Construction Exhibit A Insurance Requirements Prevailing Wage Requirements... 8 DIVISION 1 - GENERAL REQUIREMENTS Project Summary Alternates Substitution Procedures Contract Modification Procedures Payment Procedures Project Management and Coordination Construction Progress Documentation Submittal Procedures Quality Requirements References Temporary Facilities and Controls Product Requirements Execution Closeout Procedures Operation and Maintenance Data Project Record Documents... 5 DIVISION 2 - EXISTING CONDITIONS Selective Structure Demolition... 6 DIVISION 7 - THERMAL AND MOISTURE PROTECTION Joint Sealants... 5 DIVISION 8 OPENINGS Hollow Metal Doors and Frames Aluminum-Framed Entrances and Storefronts Door Hardware Glazing... 9 DIVISION 9 - FINISHES Wood Athletic Flooring Resilient Sheet Flooring Interior Painting... 5 TABLE OF CONTENTS Building G Gymnasium Upgrades Page 1 of 1

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5 SECTION ADVERTISEMENT FOR BIDS 1 BID INFORMATION Sealed Bids will be received by Moraine Valley Community College, on or before Tuesday, June 6, 2017 at 2:00 p.m., prevailing time for the Building G Gymnasium Upgrades for Moraine Valley Community College. B. Lump sum bid proposals will be received for this project at the scheduled time of receipt of bids and will be publicly opened at that time. C. Bid security in the form of a bid bond, certified check, or cash in an amount equal to ten percent (10%) of the base bid amount shall be submitted with the bid. Should a bid bond be submitted, the bid bond shall be payable to the Board of Trustees, Moraine Valley Community College. D. Bids shall be submitted on or before the specified closing time in an opaque sealed envelope addressed to: Ms. Jane Bentley, Purchasing Director, 9000 West College Parkway, Room L-187, Palos Hills, Illinois E. A mandatory Pre-Bid Meeting will be held on Tuesday, May 23, 2017 at 2:00 p.m. in the Building P Conference Room, Moraine Valley Community College, 9000 W. College Parkway, Palos Hills, IL Representatives from the College and the Architect s office will be present to answer questions regarding bidding procedures and project requirements. F. The College reserves the right to reject any or all bids or parts thereof, or waive any irregularities or informalities, and to make the award in the best interest of the College. Decisions of the College will be final. G. Minority and Women Owned Businesses are highly encouraged to participate. H. Bidding documents are on file and may be obtained upon receipt of a refundable deposit in the amount of $ for one set of bidding documents consisting of two sets of plans and one Project Manual from: Cross Rhodes Repro, 30 Eisenhower Lane North, Lombard, Illinois Phone: ; Fax: I. This Contract calls for the construction of a public work, within the meaning of the Illinois Prevailing Wage Act, 820 ILCS 130/.01 et seq. ( the Act ). The Act Requires contractors and subcontractors to pay laborers, workers and mechanics performing services on public works projects no less than the prevailing rate of wages (hourly cash wages plus fringe benefits) in the county where the work is performed. For information regarding current prevailing wage rates, please refer to the Illinois Department of Labor s website at: All contractors and subcontractors rendering services under this contract must comply with all requirements of the Act, including, but not limited to, all wage, notice, record keeping duties, and related Equal Employment Opportunity Laws. Failure to comply with said Act will result in penalties and fines. END OF SECTION Building G Gymnasium Upgrades ADVERTISEMENT FOR BIDS Section Page 1 of 1

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7 SECTION INSTRUCTIONS TO BIDDERS Sealed proposals are invited for the Building G Gymnasium Upgrades for Moraine Valley Community College pursuant to specifications. Contractors who do not submit a bid or who do not respond with a "no bid" will be removed from our contractor list for this item. PROPOSALS: Proposals will be received and publicly read aloud by Moraine Valley Community College at the place, date, and time hereinafter designated. You are invited to be present if you so desire. PLACE: Moraine Valley Community College Room L West College Parkway Palos Hills, IL DATE: Tuesday, June 6, 2017 TIME: 2:00 p.m. prevailing time (FAXES ARE NOT ACCEPTABLE) Proposals received after this time will not be accepted. Proposals must be made in accordance with the instructions contained herein. They shall be submitted on the forms furnished in a sealed envelope, plainly marked, with the Bidder's Name and Address and the notation: BID: Building G Gymnasium Upgrades Moraine Valley Community College TAX EXEMPTION: Moraine Valley Community College is exempt from Federal, State, and Municipal taxes. SIGNATURE ON BIDS: Moraine Valley Community College requires the signature on bid documents to be that of an authorized representative of said company. Each bidder, by making his bid, represents that he has read and understands the bidding documents and that these instructions to bidders are a part of the specifications. BIDDING PROCEDURES: No bid shall be modified, withdrawn, or cancelled for ninety (90) days after the bid opening date without the consent of the College Board of Trustees. Changes or corrections may be made in the bid documents after they have been issued and before bids are received. In such case, a written addendum describing the change or correction will be issued by the College to all bidders of record. Such addendum shall take precedence over that portion of the documents concerned, and shall become part of the bid documents. Except in unusual cases, addendum will be issued to reach the bidders at least five (5) days prior to date established for receipt of bids. Each bidder shall carefully examine all bid documents and all addenda thereto, and shall thoroughly familiarize themselves with the detailed requirements thereof prior to submitting a proposal. Should a bidder find discrepancies or ambiguities in, or omissions from documents, or should they be in doubt as to their meaning, they shall, at once, and in any event, not later than ten (10) days prior to bid due date, notify the College who will, if necessary, send written addendum to all bidders. The college will not be responsible for any oral instructions. After bids are received, no allowance will be made for oversight by bidder. Building G Gymnasium Upgrades INSTRUCTIONS TO BIDDERS Section Page 1 of 4

8 Bidders shall submit three (3) complete copies (one original and two copies) of the Bid Forms including the following documents: Document Bid Form 2. Document MVCC Project Certification/Non Collusion Affidavit Form 3. Document MVCC Substitute W-9 & Vendor Authorization Form 4. Document MBE/FBE/PBE/DBE Proposed Supplier/Sub-Contractor Form 5. Document Bid Bond 6. Document Substitution Sheet 7. Document Bidder Eligibility and Non-Collusion Affidavit SITE EXAMINATION: Bidder shall examine the project site before submitting a bid. A visit to the project site may be arranged for Bidders by contacting Mr. Rick Brennan, Director of Facilities; All bidders must attend a mandatory Pre-Bid Meeting to be held on Tuesday, May 23, 2017 at 2:00 p.m. prevailing time in Building P, Conference Room, at Moraine Valley Community College, 9000 West College Parkway, Palos Hills, IL Representatives from the College and the Architect s office will be present to answer questions regarding bidding procedures and project requirements. The project site will be available for review after the meeting. SUBSTITUTIONS: Each bidder represents that his bid is based upon the materials and equipment described in the bidding documents. Any dealer bidding an equal product must specify brand name, model number, and supply specifications of product. The Board shall be the sole judge of whether an article shall be deemed to be equal. A bidder's failure to meet the minimum specifications as listed may result in disqualification of his bid. REJECTION OF BIDS:The bidder acknowledges the right of the College Board to reject any or all proposals and to waive informality or irregularity in any proposal received and to award each item to different bidders or all items to a single bidder. In addition, the bidder recognizes the right of the College Board to reject a proposal if the proposal is in any way incomplete or irregular. The College Board may also award, at its discretion, only certain items quoted on. The College Board also reserves the right to reject the proposal of a Bidder who has previously failed to perform properly or complete on time contracts of a similar nature, or a bid of a Bidder when investigation shows that Bidder is not in a position to perform the contract. ACKNOWLEDGEMENT OF ADDENDA: Signature of company official on original document shall be construed as acknowledgement of receipt of any and all addenda pertaining to this specific proposal. Identification by number of addenda and date issued should be noted on all proposals submitted. FAILURE TO ACKNOWLEDGE RECEIPT OF ADDENDA ON PROPOSAL SUBMITTED MAY RESULT IN DISQUALIFICATION OF PROPOSAL. SAMPLES: Bidder may be required to furnish samples upon request and without charge to the College. BID SECURITY: A certified check or bank draft or bid bond, made payable to Moraine Valley Community College, shall be submitted with the bid in the amount of ten (10) percent of your total bid. The bid security will be forfeited by the successful bidder in the event of the bidders failure to enter into a contract. Checks or drafts of unsuccessful bidders will be returned as soon as practicable after opening and checking the bids. INSURANCE: The successful bidder will be required to furnish a certificate of insurance in accordance with the General Conditions. Building G Gymnasium Upgrades INSTRUCTIONS TO BIDDERS Section Page 2 of 4

9 PERFORMANCE BONDS: The successful bidder on this proposal must furnish a performance bond and a labor and material payment bond made out to Moraine Valley Community College, prepared on an approved form, as security for the faithful performance of their contract, within ten (10) days of their notification that their bid has been accepted. The surety thereon must be such surety company or companies as are authorized and licensed to transact business in the State of Illinois and have an minimum A-VI best rating. Attorneys in fact who sign bid bonds must file with each bond a certified copy of their power of attorney to sign said bonds. The performance and payment bonds shall be issued in an amount equal to one hundred percent (100%) of the contract sum. Such bonds shall be in force from the date of signing of the contract until one year after issuing of final certificate of payment. The cost of the bonds shall be included in the bidder s proposal. LAWS AND ORDINANCES: In execution of the work, the Contractor shall comply with applicable state and local laws, ordinances and regulation, the rules and regulations of the Board of Fire Underwriters, and OSHA standards. DAMAGE AND NEGLIGENCE: The Contractor agrees to indemnify and save harmless the College and employees from and against all loss, including costs and attorney s fees, by reasons or liability imposed by law upon the College for damages because of bodily injury, including death at any time resulting there from, sustained by any person or persons or on account of damage to property including loss of use thereof as provided in the General Conditions and Supplementary Conditions. College shall not be responsible for damages, delays, or failure to perform on its part resulting from acts or occurrences of force majeure. Force majeure means any (a) act of God, landslide, lightning, earthquake, hurricane, tornado, blizzard, floods and other adverse and inclement weather conditions; (b) fire, explosion, flood, acts of a public enemy, war, blockade, insurrection, riot or civil disturbance; (c) labor dispute, strike, work slow down, picketing, primary boycotts, secondary boycotts or boycotts of any kind and nature, or work stoppages; (d) any law, order, regulation ordinance, or requirement of any government or legal body or any representative of any such government or legal body; (e) inability to secure necessary materials, equipment, parts or other components of the project as a result of transportation difficulties, fuel or energy shortages, or acts or omission of any common carriers; or (f) any other similar cause or similar event beyond the reasonable control of College. INVESTIGATION OF BIDDERS: The College will make any necessary investigation to determine the ability of the bidder to fulfill the proposal requirements. Moraine Valley Community College reserves the right to reject any proposal if it is determined that the bidder is not properly qualified to carry out the obligation of the contract. CONTRACTOR REQUIREMENTS: The General Contractor and subcontractors (all tiers) must have an office location within a 75 mile radius of the project site. Joint Ventures will not be accepted by the College. The General Contractor shall employ a full-time superintendent to manage the day-to-day activities of the project. The superintendent shall be on-site at all times when subcontractors are working on-site. The superintendent shall be responsible to coordinate and manage all subcontractor work and shall have the authority to make decisions on behalf of the General Contractor. General Contractors submitting a bid shall provide an 'AIA A305 - Contractor s Qualification Statement Form' upon request of the College immediately after the bid opening. References for a minimum of five (5) projects of similar scope and value completed within the past five (5) years. References shall include project name, owner contact information, architect s contact information, project scope, contract value, and date of completion. General Contractors must state on the Bid Form all subcontractors intended to be used for this project. FAILURE TO DO SO MAY BE CAUSE FOR REJECTION OF BID. Building G Gymnasium Upgrades INSTRUCTIONS TO BIDDERS Section Page 3 of 4

10 PREVAILING WAGE RATE: The successful bidder must pay not less than the prevailing hourly wage rate determined by the Illinois Department of Labor for the county where the contract is executed and the craft or type of worker needed to execute the contract. See the prevailing wage scale attached. If, during the course of work under this contract, the Department of Labor revises the prevailing rate hourly wages to be paid under this contract for any trade or occupation, Owner will notify Contractor and each Subcontractor of the changes in the prevailing rate of hourly wages. Contractor shall have the sole responsibility and duty to ensure that the revised prevailing rate of hourly wages is paid by contractor and all Subcontractors to each worker to whom a revised rate is applicable. Revisions to the prevailing wage as set forth above shall not result in an increase in the Contract Sum. ILLINOIS STEEL PRODUCTS PROCUREMENT ACT: To the extent permitted by law, the project will be subject to all provisions of the "Steel Products Procurement Act" (30 ILCS 565 et. seq.) as it may be amended from time to time. OTHER: Sex Offender Registration Requirement Notification: Illinois Compiled Statutes (730 ILCS 150 3) requires that any person who is required by law to register as a sex offender and who is either a student or an employee at an institution of higher education, must also register with the Office of Public Safety of the institution they are employed by or attending. For purposes of this act, a student or employee is defined as anyone working at or attending the institution for a period of five (5) days or an aggregate period of more than thirty (30) days during a calendar year. THIS INCLUDES PERSONS OPERATING AS OR EMPLOYED BY AN OUTSIDE CONTRACTOR AT THE INSTITUTION. Anyone meeting the above requirements is required to register within five (5) days of enrolling or becoming employed. Persons failing to register are subject to criminal prosecution. Substance Abuse Prevention: The successful bidder must comply with the Substance Abuse Prevention on Public Works Act (Public Act ) The Act requires that every party to a public contract and every eligible bidder have a written substance abuse prevention program in place. By signing the bid form, the bidder certifies compliance to the conditions of this Act. Human Rights Act: The College complies with the Human Rights Act (Public Act ) The Act requires that every party to a public contract and every eligible bidder have written sexual harrassment policies as described in this Act. By signing the bid form, the bidder certifies compliance to the conditions of this Act. Concealed Carry Act: The College has established rules and regulations in accordance with the "Illinois Firearm Concealed Carry Act." See section for detailed information. BID QUANTITIES: The College Board will reserve the right to increase or decrease, within reasonable limits, such quantities as need requires and at the unit price stated. BID AWARDS: The successful contractor, and/or any contractor shall not proceed on this bid until it receives a Notice to Proceed from the college. Failure to comply is the risk of that contractor. END OF SECTION Building G Gymnasium Upgrades INSTRUCTIONS TO BIDDERS Section Page 4 of 4

11 1 Moraine Valley Community College Policy Establishing Rules and Regulations in Accordance with The Illinois Firearm Concealed Carry Act Notice to All Bidders, Vendors and Contractors It shall be the responsibility of all Vendors and Contractors working on any of the Moraine Valley Campus locations: Palos Hills, Tinley Park or Blue Island, to insure they, their employees and subcontractors are aware and adhere to the provisions of the Concealed Carry Board Policy and the Illinois Concealed Carry Act. Support Services Policy Establishing Rules and Regulations in Accordance with the Illinois Firearm Concealed Carry Act I. Introduction and Statement of Purpose 6539 The Illinois General Assembly has adopted Public Act , The Firearm Concealed Carry Act (the Act ). Subject to the overall supervision and regulation of the Illinois State Police, the Act authorizes qualified individuals to carry a concealed firearm. A concealed firearm is a loaded or unloaded handgun carried on or about that person completely or mostly concealed from view of the public, or is within a vehicle owned by that person. This Policy has the following purposes: To reaffirm the Board s position that the presence of firearms on campus, in any of the College buildings, or in any of the College s facilities is dangerous and contrary to the mission of the College. B. To recognize that the Act affords certain limited rights to individuals possessing a valid license to carry a concealed firearm (such qualified individual is referred to in this Policy as a Licensee ). C. To clearly delineate the rights and responsibilities of Licensees on College property. D. To set forth consequences and penalties for a violation of this Policy on the part of Licensees and non-licensees alike. II. Reaffirmation of Prohibition Except as provided elsewhere in this Policy, no individual shall possess, carry, or have control of a firearm either on his or her person or in his or her vehicle on any property owned or otherwise controlled by the College. This prohibition includes the College s main campus in Palos Hills, as well as the Blue Island and Tinley Park Centers. This prohibition includes, without limitation, the following areas: p Any building or portion of a building under the control of the College. B. Anywhere on the grounds of the College. C. Anywhere on the College s parking areas, sidewalks, and common areas. Building M Demonstration Kitchen DKA Project No.: MVCC CONCEALED CARRY ACT Section Page 1 of 3

12 D. Any property on campus where the College grants permission for a public gathering, such as Palos Fest or the JDRF Walk-A-Thon. III. Special Regulations Applicable to College Employees No firearm may be carried or transported in any motor vehicle owned by the College. B. Members of the College Police Department are authorized to carry firearms in accordance with the state law and department regulation. C. Subject to Board approval, firearm use or possession may be permitted where such use or possession is part of a course curriculum. IV. Special Regulations for Licensees A Licensee entering the College s Palos Hills campus in a motor vehicle has two options: Immediately upon parking the vehicle in any of the College s designated parking spaces, the Licensee must immediately either (a) store his or her firearm or ammunition in a secure case or locked container out of plain view within the vehicle, or (b) store the firearm within the vehicle s trunk. In the event the Licensee stores the firearm in the Licensee s trunk, the Licensee must ensure that the firearm is unloaded at the time the Licensee exits the vehicle. 2. In the alternative, upon entering the campus, the Licensee shall immediately proceed to the Police Department and tender the firearm to the Police Department for storage and safekeeping. Pedestrian Licensees entering the campus shall immediately proceed to the Police Department and tender the firearm to the Police Department for purposes of storage and safekeeping. B. A Licensee entering the Tinley Park campus in a motor vehicle has two options: Immediately upon parking the vehicle in any of the College s designated parking spaces, the Licensee must (a) immediately store his or her firearm or ammunition in a secure case or locked container out of plain view within the vehicle, or (b) immediately store the firearm within the vehicle s trunk. In the event the Licensee stores the firearm in the Licensee s trunk, the Licensee must ensure that the firearm is unloaded at the time the Licensee exits the vehicle. 2. Should the Licensee desire to turn the firearm into the College Police Department for safekeeping, the Licensee shall first secure the firearm in accordance with subsection 1 above. The Licensee then shall immediately contact a police officer on duty and request storage. The police officer will thereupon accompany the Licensee to the Licensee s vehicle. The officer will assume control of the firearm, and place it in a secure facility in the building for safekeeping. Pedestrian Licensees entering the campus shall personally contact a police officer on duty and request storage. The police officer will assume control of the firearm, and place it in a secure facility in the building for safekeeping. C. The College s Blue Island facility has no College-owned parking area. Licensees are subject to applicable laws and regulations of the City of Blue Island regarding parking lot storage.

13 V. Penalties for Violation Persons who violate any of the terms of this Policy shall be subject to all civil and criminal penalties as provided by law. In addition: Any student found to be in violation of this Policy is subject to suspension or expulsion from the College. B. Any College employee found to be in violation of this Policy is subject to suspension or termination of employment. C. Any third person (meaning, an individual who is neither an employee nor a student) found to be in violation of this Policy is subject to exclusion from any College property or facility for a period of not less than one (1) calendar year. Policy Adopted: 9/17/13 Palos Hills, Illinois *Criminal Violations of this policy and state statute will be investigated and prosecuted by the Moraine Valley Police Department.

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15 SECTION BID FORM To: Project: Date: Moraine Valley Community College 9000 West College Parkway Palos Hills, IL Building G Gymnasium Upgrades Submitted by: (Full name and address) PART 1 - OFFER Having examined the site and having familiarized itself with the conditions affecting the cost of the work associated with the project and with the bidding documents, Bidder herby proposes to perform everything required and to furnish all labor, materials, necessary tools, expendable equipment, and transportation services necessary to complete in a workmanlike manner the subdivision of work stated above in accordance with the bidding documents for the following sums: Base Bid: We have included, attached herewith, the Security Deposit as required by the Instructions to Bidders. All federal taxes, State of Illinois taxes, and local municipal taxes as applicable are included in the Bid Sum. The Bidder agrees to perform the work for the lump sum amount of: TOTAL BASE BID $ (in figures) (in words) Allowances: The undersigned hereby states that the Lump Sum Base Bid amount indicated above includes all Allowance amounts as described in Section Alternate Bids: The undersigned hereby states the net amount of decrease or increase to the Lump Sum Base Bid for the following Alternates as described in Section ALTERNATE NO. 1: Deduct from the Lump Sum base bid to eliminate the Liquidated Damages clause from the Contract. Total, Alternate No. 1: $ Building G Gymnasium Upgrades BID FORM Section Page 1 of 4

16 PART 2 - ACCEPTANCE This offer shall be open to acceptance and is irrevocable for thirty (90) days from the Bid closing date. If the bid is accepted by the Owner within the time period stated above, we will: Execute the Agreement within ten (10) days of receipt of Notice of Award. B. Furnish the required bonds within ten (10) days of receipt of Notice of Award in the form described in the Supplementary Conditions. C. Furnish the required Certificate of Insurance within ten (10) days of receipt of Notice of Award in the form and amounts described in the Supplementary Conditions. D. Commence work as established by the written Notice to Proceed. If this Bid is accepted within the time stated, and we fail to commence the Work or we fail to provide the required Bonds(s), the Security Deposit shall be forfeited as damages to the Owner by reason of our failures. In the event our Bid is not accepted within the time stated above, the required security deposit shall be returned to the undersigned, in accordance with the provisions of the Instructions to Bidders; unless a mutually satisfactory arrangement is made for its retention and validity for an extended period of time. PART 3 - CONTRACT TIME If the Bid is accepted, we will: Complete the work in manner consistent to meet the requirements of the schedule. B. Contractor has examined the Schedule included in these documents and takes no exception, or records the following exceptions: PART 4 - CONTRACTOR S FEES FOR CHANGES IN THE WORK Lump Sum or Time and Materials Changes: We, the undersigned bidder, agree that the following percentages for overhead and profit shall be added to costs for the net amount of work added to, or deleted from, the contract by written lump sum or time and material change orders recommended by the Architect and approved by the Owner: On Contractor's direct net cost: 15%, with a minimum fee of one hundred dollars ($100.00). B. On first-tier Subcontractor's net cost: 5%, with a minimum fee of fifty dollars ($50.00). Net cost includes all sub-subcontractors work, and excludes subcontractors (all tiers) overhead and profit amounts. Note: Insurance, bond, and taxes are considered as job cost items and are included in the percentages listed above. Building G Gymnasium Upgrades BID FORM Section Page 2 of 4

17 PART 5 - ADDENDA The following Addenda have been received. The modifications to the Bid Documents noted therein have been considered and all costs thereto are included in the Bid Sum. Addendum # Dated Addendum # Dated Addendum # Dated Addendum # Dated PART 6 - SUBCONTRACTORS Identify below which work will be completed by the General Contractor s own forces and which work will be completed by first tier Subcontractors. Include Subcontractors name and estimated contract amount. Scope of Work GC/Sub. Name Est. Contract Amount Building G Gymnasium Upgrades BID FORM Section Page 3 of 4

18 PART 7 - BID FORM SIGNATURE(S) The Corporate Seal of: (Bidder please print the full name of your Proprietorship or Corporation) Was hereunto affixed in the presence of: (Authorized signing officer) (Title) (Seal) END OF SECTION Building G Gymnasium Upgrades BID FORM Section Page 4 of 4

19 SECTION MVCC PROJECT CERTIFICATION/NON COLLUSION AFFIDAVIT FORM Per the Moraine Valley Community College Board of Trustees, a responsible bidder is defined by meeting the following criteria and is able to submit evidence of such compliance upon immediate request. By signing this required form, the undersigned agrees that said bidder is responsible as defined below. NOTE: THIS INFORMATION WILL BE USED AS A CRITERIA IN THE EVALUATION OF VENDORS. FAILURE TO COMPLY WITH ANY OF THE BELOW MAY RESULT IN DISQUALIFICATION OF YOUR BID. MINORITY AND WOMAN OWNED BUSINESSES ARE ENCOURAGED TO APPLY. -Bidder is licensed to perform work in Illinois Yes No -Bidder has provided Federal Employer Tax Identification Number Yes No -Successful Bidder will submit a certificate of insurance indicating the coverage required by bid specifications Yes No -Bidder and all subcontractors will comply with all provisions of the Illinois Prevailing Wages Act. Yes No -The supplier/contractor certifies that the contractor is not barred from bidding on the subject contract as a result of a conviction for either bid rigging or bid rotating under Article 33E-3 or 33E-4 of the Criminal Code of 1961 Yes No -Bidding company, having 25 or more employees, does hereby certify pursuant to section 3 of the Illinois Drug-Free Workplace Act (Chapter 30 ICLS 580) that (he, she, it) shall provide a drug-free workplace for all employees engaged in the performance of work under the contract by complying with the requirements of the Illinois Drug-Free Workplace Act and, further certifies, that (he, she, it) is not ineligible for award of the contract by reason of debarment for a violation of the Illinois Drug-Free Workplace Act Yes No N/A The Undersigned states that the signature of the person on the signature page is the signature of a person who is authorized to sign the bid proposal. Such proposal is genuine and bidder has not directly, or indirectly, conspired, combined or agreed with any other person, officers, agents or committee of any entity to prevent free competition in the letting of the contract for the work covered by aforesaid proposal, or to fix the bid price or any item or factor thereof, or to induce any person not to enter into such competition. DATE: SIGNED: (Authorized Agent) NAME: TITLE: (Please Print) (Authorized Agent) COMPANY NAME: ADDRESS: PHONE NUMBER: FAX NUMBER:

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21 Form W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) 5 Address (number, street, and apt. or suite no.) 6 City, state, and ZIP code 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) Requester s name and address (optional) 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number or Employer identification number Part II Certification Under penalties of perjury, I certify that: The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Signature of U.S. person General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: Form 1099-INT (interest earned or paid) Form 1099-DIV (dividends, including those from stocks or mutual funds) Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) Form 1099-S (proceeds from real estate transactions) Form 1099-K (merchant card and third party network transactions) Date Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) Form 1099-C (canceled debt) Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. By signing the filled-out form, you: Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. Cat. No X Form W-9 (Rev )

22 Form W-9 (Rev ) Page 2 Note. If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: An individual who is a U.S. citizen or U.S. resident alien; A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States; An estate (other than a foreign estate); or A domestic trust (as defined in Regulations section ). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States: In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity; In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a saving clause. Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments. This is called backup withholding. Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part II instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See Exempt payee code on page 3 and the separate Instructions for the Requester of Form W-9 for more information. Also see Special rules for partnerships above. What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code on page 3 and the Instructions for the Requester of Form W-9 for more information. Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account; for example, if the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return. If this Form W-9 is for a joint account, list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name as shown on your social security card, and your new last name. Note. ITIN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application. b. Sole proprietor or single-member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line You may enter your business, trade, or doing business as (DBA) name on line 2. c. Partnership, LLC that is not a single-member LLC, C Corporation, or S Corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2. d. Other entities. Enter your name as shown on required U.S. federal tax documents on line This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2. e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a disregarded entity. See Regulations section (c)(2)(iii). Enter the owner's name on line The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name is required to be provided on line If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, Business name/disregarded entity name. If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN.

23 Form W-9 (Rev ) Page 3 Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2. Line 3 Check the appropriate box in line 3 for the U.S. federal tax classification of the person whose name is entered on line Check only one box in line 3. Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a partnership for U.S. federal tax purposes, check the Limited Liability Company box and enter P in the space provided. If the LLC has filed Form 8832 or 2553 to be taxed as a corporation, check the Limited Liability Company box and in the space provided enter C for C corporation or S for S corporation. If it is a single-member LLC that is a disregarded entity, do not check the Limited Liability Company box; instead check the first box in line 3 Individual/sole proprietor or single-member LLC. Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space in line 4 any code(s) that may apply to you. Exempt payee code. Generally, individuals (including sole proprietors) are not exempt from backup withholding. Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends. Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. Corporations are not exempt from backup withholding with respect to attorneys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC. The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space in line 4. 1 An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2) 2 The United States or any of its agencies or instrumentalities 3 A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities 4 A foreign government or any of its political subdivisions, agencies, or instrumentalities 5 A corporation 6 A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession 7 A futures commission merchant registered with the Commodity Futures Trading Commission 8 A real estate investment trust 9 An entity registered at all times during the tax year under the Investment Company Act of A common trust fund operated by a bank under section 584(a) 11 A financial institution 12 A middleman known in the investment community as a nominee or custodian 13 A trust exempt from tax under section 664 or described in section 4947 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for... THEN the payment is exempt for... Interest and dividend payments All exempt payees except for 7 Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to Barter exchange transactions and patronage dividends Payments over $600 required to be reported and direct sales over $5,000 1 Payments made in settlement of payment card or third party network transactions Exempt payees 1 through 4 Generally, exempt payees 1 through 5 2 Exempt payees 1 through 4 1 See Form 1099-MISC, Miscellaneous Income, and its instructions. 2 However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 6045(f), and payments for services paid by a federal executive agency. Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATC These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with Not Applicable (or any similar indication) written or printed on the line for a FATCA exemption code. A An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) B The United States or any of its agencies or instrumentalities C A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities D A corporation the stock of which is regularly traded on one or more established securities markets, as described in Regulations section (c)(1)(i) E A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section (c)(1)(i) F A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state G A real estate investment trust H A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I A common trust fund as defined in section 584(a) J A bank as defined in section 581 K A broker L A trust exempt from tax under section 664 or described in section 4947(a)(1) M A tax exempt trust under a section 403(b) plan or section 457(g) plan Note. You may wish to consult with the financial institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed. Line 5 Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mail your information returns. Line 6 Enter your city, state, and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on this page), enter the owner s SSN (or EIN, if the owner has one). Do not enter the disregarded entity s EIN. If the LLC is classified as a corporation or partnership, enter the entity s EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at You may also get this form by calling Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling TAX-FORM ( ). If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write Applied For in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering Applied For means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8.