To All Bidders: Following is Addendum No. 1 for Bid Specification for HARDWOOD GYMNASIUM FLOORS BID # 2012-29 for Consolidated School District 158. Please acknowledge the addendum on your bid form. The bids due date remains the same; 3:00 p.m. prevailing time, on March 26, 2012. We look forward to seeing you at the bid opening. Sincerely, Douglas Renkosik Director of Operations and Maintenance 1. The bid form is changed to the attached. For a complete bid, please use the following form. Page # 1 of 8
To: Consolidated School District 158 650 Academic Drive Algonquin, IL 60102 page # BF 1 of 6 Bidder s Name: Bid For: Refinishing Hardwood Gymnasium Floors Base Bid: Refinish all six gymnasiums hardwood floors listed in scope of work Price includes minor touchup painted lines as needed $ Bidder acknowledges having received and read Addenda(s) thru and understands the bid prices above include all requirements of these addenda. By signing the bid form, the Bidder acknowledges having received, read, and agrees to all the terms and conditions in the bid specifications and the Instructions to Bidders and General Conditions (which is a separate document). In addition, the bidder understands that the bid will be considered incomplete unless the forms which are a part of the Instructions to Bidders and General Conditions are completed and attached to this bid form. Company Name Street Address City, State, Zip Code Telephone Number Officers Signature Officer s Printed Name Officer s Official Title Fax Number Page # 2 of 8
page # BF 2 of 6 CERTIFICATE OF ELIGIBILITY TO BID (contractor), pursuant to Section 33E-11 of the Illinois Criminal Code of 1961 as amended, hereby certifies that neither (he, she, it) nor any of (his, her, its) partners, officers, or owners of (his, her, its) business has been convicted in the past five (5) years of the offense of bid-rigging under Section 33E-3 of the Illinois Criminal Code of 1961 as amended and that neither (he, she, it) nor any of (his, her, its) partners, officers or owners of (his, her, its) business has ever been convicted of the offense of bid-rotating under Section 33E- 4 of the Illinois Criminal Code of 1961 as amended. Date Name of Contractor/Company Street Address City, State, Zip Title of Officer Name of Officer (Please Print) Signature of Officer Page # 3 of 8
page # BF 3 of 6 Certificate of Compliance To the Illinois Department of Human Rights Regulations For this bid to receive consideration by the Board of Education of School District #158, Huntley, Illinois, the following certificate must be signed by an official of your company and returned with your bid. This is to certify that our company is in compliance with the provisions of the Illinois Department of Human Rights Regulations. Signed: By: Title: Signature Printed Name Date: Page # 4 of 8
page # BF 4 of 6 Certificate of Compliance with the Illinois Prevailing Wage Law TO: Mr. Doug Renkosik Director of Operations and Maintenance SCHOOL DISTRICT 158 Dear Mr. Renkosik, This letter is to certify that Name of Company is in compliance with Chapter 48 and all amendments pertaining to the payment of prevailing wages (as established by the Department of Labor) to all laborers, workers and mechanics performing work under this contract. Official Address: City, State County Date Signature Title Telephone Number (with area code) Sworn and subscribed on the day of, 20, before me, notary public, appointed in County for the State of IL Signature of Notary Name Typed or Printed (seal) My commission expires: Month Day Year City of Residence County Page # 5 of 8
page # BF 5 of 6 Name of Contractor (Bidder) EQUIPMENT TO BE UTILIZED FOR THE COMPLETION OF THIS WORK INCLUDES... Equipment Type Quantity to be Provided Manufacturer and Model Age 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. Page # 6 of 8
page # BF 6 of 6 REFERENCE SHEET Name of Contractor (Bidder) Please submit the names of five different School Districts, Colleges or Companies for whom you have done similar work in the last four years. 1. Name 2. Name 3. Name 4. Name 5. Name Page # 7 of 8
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