Company Form 16 for Lake County Indiana
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LAKE COUNTY FORM 16: July 1, 2020





FUND # _______________ , DEPARTMENT # _________________ , ACCOUNT # ____________ .










1. Potential offeror may contact the __________________________________________________

2. The description of the public work required by these specifications is outlined in the Attachment.

3. The General Instructions to Offerors and County Forms 1, 2, 3, 4, 5, 6 and 7 are made a part of these specifications as if fully set out herein.

4. All offerors shall examine the specifications thoroughly to familiarize themselves with the requirements and type of public work requested.

5. The offeror must utilize State Form 96 specified by the State Board of Accounts in addition to the required Lake County forms.

6. The following pertain to the submission of an offer:

A. The offeror shall submit a bond or certified check in the amount of five (5%) percent of the offer for offers over one hundred thousand ($100,000.00) dollars.

1) The bond or certified check shall be for the benefit of or be made payable to “The Board of Commissioners of the County of Lake, State of Indiana.”

2) All certified checks of unsuccessful offerors shall be returned upon selection of the successful offeror. If the successful offeror has posted a certified check, this shall be held until the performance bond is posted.

B. The County of Lake is committed to the principle of Affirmative Action. Each offeror must execute an affidavit on a form provided by the County of Lake acknowledging that the offeror has its own affirmative action program that is in compliance with any and all applicable federal/state/local laws and interpretive court decisions.

C. The County hereby affirms its policy that no vendor, contractor, grant recipient, or anyone receiving public funds or benefits of any kind shall discriminate on the basis of race, religion, color, disability, sexual orientation, gender identity, national origin, ancestry, age, or United States military service status, and any breach of this Policy shall continue to be considered a material breach of the relationship with the County.

D. The County is committed to providing equal employment opportunities for all applicants and employees. Employment decisions shall be made without regard to sexual orientation or gender identity.

E. Lake County Non Discrimination and Equal Employment Policy. In accordance with Federal and State Law, Lake County hereby requires the following from each contractor or subcontractor who is awarded a public works contract.

1) Non Discrimination.

a) That with respect to hire, tenure, terms, conditions, or privileges of employment of employees for performance of work under this Contract or any subcontract hereunder, no contractor, subcontractor, nor any person acting on behalf of such contractor or subcontractor shall, by reason of race, color, religion, sex, national origin, or ancestry discriminate against any citizen qualified to do the work to which the employment relates.

b) That no contractor, subcontractor, nor any person on his behalf shall, in any manner, discriminate against or intimidate any employee hired for the performance of work under this contract on account of race, color, religion, sex, national origin, or ancestry.

c) That this contract may be cancelled or terminated by the owner, and all money due or to become due hereunder may be forfeited for a violation of the terms or conditions of this section of the contract.

2) Women and Minority Employment Goals.

a) That through the use of its purchasing dollars the Board of Commissioners shall ensure that women and minority employees and/or minority owned businesses are involved in public works projects performed by County contractors and subcontractors.

b) That the policy will apply to both direct employment of women and minorities as employees and to the percentage of subcontractor and suppliers of contractors who are minority business enterprises or women business enterprises.

F. Executive Summary of Goals.

1) Employment - The contractor shall have a goal of Thirty-Four (34%) Percent of minority work force participation (as a percentage of the total number of employees or the total number of hours worked on the project, whichever is greater) and 6.9% for work force participation by women (as a percentage of the total number of employees or the total number of hours worked on the project, whichever is greater), if available.

2) Subcontractors and Suppliers - A goal of Thirteen (13%) Percent for MBE participation and Two (2%) Percent for WBE participation (as a percentage of the total contract amount) is hereby set for the project.

G. The offeror must execute the noncollusion affidavit on the forms specified for use by the State Board of Accounts.

H. The offeror shall submit with their offer packet a photocopy of the “State of Indiana Office of the Secretary of State Certificate of Existence” indicating that they have filed their most recent annual report as required by Indiana law.

I. The offeror shall include in their offer packet the original offer and one photocopy of the offer.

7. These provisions apply to the successful offeror:

A. The successful offeror shall file a performance bond and contractors payment bond with the Lake County Auditor’s Office within ten (10) days of letting the offer, if their offer total exceeds two hundred thousand ($200,000.00) dollars.

1) A performance bond is the approved form of security, furnished and executed by the offeror and its surety or sureties, guaranteeing complete execution of the contact, as defined herein, and for the payment of all legal debts pertaining to the construction of the project. The performance bond will be in effect after both parties have signed the contract.

2) A performance bond in the amount of one hundred (100%) percent of the offer is required.

3) The performance bond and payment bond shall be for the benefit of “The Board of Commissioners of the County of Lake, State of Indiana.”

4) The Auditor’s Office shall forward the performance bond to the Board of Commissioners of the County of Lake, who shall either accept or deny the bonds at their next scheduled public meeting.

5) No payments will be made to the successful offeror under the contract until the performance bond is filed with the Lake County Auditor’s Office.

6) A performance bond is required in accordance with I.C. 36-1-12-14 (e) equal to the offer if the offer is in excess of two hundred thousand ($200,000.00) dollars. If the offer is more than two hundred thousand ($200,000.00) dollars but less than two hundred fifty thousand ($250,000.00) dollars, an irrevocable letter of credit issued in accordance with I.C. 36-1-12-14 (h).

B. The successful offeror shall:

1) Have workmen’s compensation coverage as required by State Law.

2) Have public liability insurance meeting the maximum dollar limits as specified in I.C. 34-4-16.5-4 as follows: Seven Hundred Thousand Dollars ($700,000.00) for injury or death to one person in any one occurrence, Five Million Dollars ($5,000,000.00) for injury to or death of all persons in that occurrence, and One Million Dollars ($1,000,000.00) for property damage liability.

3) Indemnify and hold harmless any and all entities to include but not limited to the County of Lake, The Board of Commissioners of the County of Lake, it’s elected officials, it’s appointed officials, it’s officers, it’s employees, and or its agents for any and all expenses or charges to include attorney fees which these entities or persons might have to pay by virtue of the successful offerors actions, non-actions, or performance.

4) As an independent contractor, the vendor accepts all responsibility for injuries and accidents that meet the definition of “reportable” as defined by OSHA. Further, the vendor shall report to IOSHA, via a first report, and list on the contractor’s annual OSHA 300 Report, all accidents that occur while performing services for or to Lake County.

C. The successful offeror shall comply with the anti-discrimination provisions of I.C. 5-16-6 and I.C. 22-9-1-10.

D. A payment bond is required on offers exceeding two hundred thousand ($200,000.00) dollars in accordance with I.C. 36-1-12-13-1.

E. The board shall withhold final payment to the contractor in accordance with I.C. 36-1-12-12 to facilitate payment of any subcontractors, material suppliers, laborers or those providing services.

F. No change order shall be undertaken or approved other than in accordance with I.C. 36-1-12- 18. These terms shall be strictly construed.

G. If the offer is more than two hundred thousand ($200,000.00) dollars, the provisions of I.C. 36-1-12-14 shall apply. This requires provisions on retainage and the use of an escrow agent and agreement for most public works projects.

8. Where language of these specifications conflicts with any requirements previously established by the Board of Commissioners of the County of Lake, the terms of these specifications shall apply.

9. The provisions of I.C. 36-1-12-1 to 20 apply if applicable to the type of project and/or offer.

10. The contract will be let to the lowest responsible and responsive offeror. If the board awards the contract to a offeror other than the lowest offeror, the board must state in the minutes or memoranda, at the time the award is made, the factors used to justify the award, and the board shall keep a copy of the minutes or memoranda available for public inspection.

11. The general contract (and all independent subcontracts, I.C., subcontracts not included within a general contract and regardless of tier) shall be awarded to the lowest responsible and responsive offeror complying with the conditions and requirements provided in these Instructions, the offers, forms and other specific documents. A responsible and responsive offeror is one demonstrably possessing the skill, ability and integrity necessary to faithfully perform the work called for by the contract, based upon a determination of competent workmanship and financial soundness in accordance with I.C. 36-1-9-3 or any successor statute. An eligible offeror is one who is not debarred from participating under any applicable law, and which shall certify that it is able to furnish labor that can work in harmony with all other elements of labor employed on the project.

12. The winning offeror cannot assign without the written approval of the County of Lake.

13. The Lake County Council has enacted an ordinance that requires that all public works projects be performed by union labor.

ALL OF WHICH IS APPROVED THIS_________DAY OF __________________, 20_______


______________________________________________           VENDOR SIGNATURE:______________________________________________

______________________________________________           BY:______________________________________________________________



LAKE COUNTY AUDITOR: ______________________________________________