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HomeMy WebLinkAboutStone Materials •iii,,, ELIZABETH A.NEVILLE,MMC f�® • 4 Town Hall,53095 Main Road TOWN CLERK �` K< P.O. Box 1179 °s : " , Southold,New York 11971 REGISTRAR OF VITAL STATISTICS " 0 • �� Fax(631)765-6145 MARRIAGE OFFICER ? ``® �° �� �� -�:. �"�® `� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER : °I ,/,d www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER ,,•// OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD August 20, 2015 David Bruno Eco-Logical Organics LLC 956 W. Jericho Tpke. Smithtown, NY 11787 Dear Mr Bruno: At the regular Town Board meeting held on July 28, 2015, the Town Board accepted the bid of East Coast Mines & Materials and A & R Materials for supplying and delivering Stone Materials. A certified copy of the resolution is enclosed. Thank you for your bid. Very truly yours, r \JI �rn Lynda M Rudder Deputy Town Clerk Ens. ELIZABETH A. NEVILLE,MMC o ,;;' x e� Town Hall,53095 Main Road TOWN CLERK �' ':.=: :' = P.O Box 1179 c� g� "' Southold,New York 11971 REGISTRAR OF VITAL11971 REGISre) ;r� �� Fax(631)765-6145 MARRIAGE OFFICER .60 "• "�®�'i���� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ��� www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER ••,,•,,,,, OFFICE OF THE T a•WN CLERK TOWN OF SOUTHOLD August 20, 2015 John Tintle East Coast Mines & Minerals Route 2 Lewis Road East Quogue, NY 11942 Dear Mr Tintle: Congratulations. At the regular Town Board meeting held on July 28, 2015, the Town Board accepted the bid of East Coast Mines & Materials and A & R Materials for supplying and delivering Stone Materials. A certified copy of the resolution is enclosed. Thank you for your bid. Very truly yours, Lynda M Rudder Deputy Town Clerk Ens. ELIZABETH A.NEVILLE,MMC �� <, Y, `s . ` Town Hall,53095 Main Road ' 11° k P.O. Box 1179 e=oTOWN CLERK c s K . k t t t Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax�� Fax(631)765-6145 MARRIAGE OFFICER \4% �0 r.:.,, ®�' 10 Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER 41 .1° www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER •••�,,,,,�� OFFICE OF THE TOWN CLE"K TOWN OF SOUTHOLD August 20, 2015 Dawn Thatcher A & R Materials 72 Union Avenue Ronkonkoma, NY 11779 Dear Ms Thatcher: Congratulations. At the regular Town Board meeting held on July 28, 2015, the Town Board accepted the bid of East Coast Mines & Materials and A & R Materials for supplying and delivering Stone Materials. A certified copy of the resolution is enclosed. Thank you for your bid. Very truly yours, CAN-k\I\C\ Lynda M Rudder Deputy Town Clerk Ens. Southold Town Board - Letter Board Meeting of July 28, 2015 ` ° RESOLUTION 2015-671 Item# 5.7 `e.,* ADOPTED DOC ID: 11041 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-671 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 28, 2015: RESOLVED that the Town Board of the Town of Southold hereby accepts the bids of East Coast Mines &Materials and A & R Materials to supply and deliver to the town Stone Materials, all in accordance with the Town Attorney, as follows: East Coast Mines & Materials Item#1 Fine Aggregate $ 45.95/ton Item#2 Coarse Aggregate $ 43.95/ton Item#3 River Gravel $ 41.95/ton A& R Materials Item#4 Bedding Stone $ 48.00/ton Item#5 Armor Stone $ 55.00/ton And be it further RESOLVED that Supervisor Scott A. Russell is authroized and directed to enter into an agreement with East Coast Mines & Materials and A & R Materials. • aje41146neetem Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Louisa P. Evans, Justice SECONDER:Robert Ghosio, Councilman AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell Generated July 31, 2015 Page 16 Southold Town Board - Letter Board Meeting of June 30, 2015 SFFQ,r RESOLUTION 2015-607 Item# 5.27 Ai) ADOPTED DOC ID: 10980 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-607 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 30,2015: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs the Town Clerk to advertise for bids for the following items for 2015: Armor Stone Rip-rap Filter Cloth ;„116;?a?e,.&,,,,2to ,gyp Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Robert Ghosio, Councilman SECONDER:Louisa P. Evans, Justice AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell Generated July 1, 2015 Page 48 Rudder, Lynda From: Collins, Michael Sent: Monday,July 20, 2015 10:32 AM To: Rudder, Lynda Cc: Duffy, Bill; Krauza, Lynne; Richter,Jamie Subject: RE: Emailing: bid results-stone materi_20150716143945 Please prepare a resolution awarding the bids for Items 1, 2 &3 to East Coast Mines and Materials and awarding the bids for Items 4&5 to A& Materials. Thank you. Michael Original Message From: Doroski, Bonnie Sent:Thursday,July 16, 2015 4:09 PM To: Collins, Michael; Dinizio,James; Doherty,Jill; Ghosio, Bob; Louisa Evans; Russell, Scott; Standish, Lauren; Tomaszewski, Michelle;William Ruland Subject: Emailing: bid results-stone materi_20150716143945 Bid Results 7/16/15 Bonnie J. Doroski Deputy Town Clerk Your message is ready to be sent with the following file or link attachments: bid results-stone materi_20150716143945 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 „, /r ELIZA':ETH A.NEVILLE,MMC �® �4, Town Hall,53095 Main Road TOWN CLERK 1 P.O. Box 1179 CD Southold,New York 11971 REGISTRAR OF VITAL STATISTICS �� Fax(631)765-6145 MARRIAGE OFFICERQ 0. Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER _ ' www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER .< ,,,,,•� OFFICE OF T: E TOWN CLERK TOWN OF SOUTHOLD Bid Opening on Supply and Delivery of Stone Materials July 16, 2015 2:00 PM Eco-Logical Organics LLC East Coast Mines & Minerals 956 W. Jericho Tpke. Route 2 Lewis Road Smithtown, NY 11787 East Quogue,NY 11942 (631) 831-0200 (631) 653-5445 Item# 1 $61.25/ton 15 days Item# 1 $45.95/ton no delivery date Item#2 $63.00/ton 15 days Item # 2 $43.95/ton no delivery date Item# 3 $60.50/ton 15 days Item # 3 $41.95/ton no delivery date Item#4 $54.00/ton 15 days Item# 4 $54.95/ton no delivery date Item# 5 None Given Item# 5 $95.00/ton no delivery date A & R Materials 72 Union Avenue Ronkonkoma,NY 11779 (631) 585-5736 Item# 1 $56.00/ton no delivery date Item# 2 $57.00/ton no delivery date Item# 3 $54.00/ton no delivery date Item # 4 $48.00/ton no delivery date Item # 5 $55.00/ton no delivery date BIDDER'S CHECK LIST Your response to our above referenced bid will be considered unresponsive and will be rejected if the following forms are not included at the time of the bid opening. E� Notarized Affidavit of Non-Collusion as required by NYS Law. /" Vendor Information Sheet and Address Record Form. As per specifications, the Town of Southold requires a current insurance certificate,with the Town of Southold listed as additional insured,to be on file in the Purchasing Department. You will be given ten (10) business days from notice of award to supply this form or the bid will be rescinded. VENDOR NAME: . aJ', /11c ede - VENDOR INFORMATION SHEET TYPE OF ENTITY:CORP._.. PARTNERSHIP INDIVIDUAL - FEDERAL EMPLOYEE ID #: 1/ - 31zji 8 OR SOCIAL SECURITY #: �_.-._ ...... ....... DATE OF ORGANIZATION: 1912 IF APPLICABLE: DATE FILED: STATE FILED: Al ._. .._. If a non-publicly owned Corporation: CORPORATION NAME: L'At/ eoaj-/ Min ci (Ha/ ' l LIST PRINCIPAL STOCKHOLDERS: (5% of outstanding shares) v 4/'1.11..__ .._..77,7 le ..' .-eet®!''�.� LIST OFFICERS AND DIRECTORS: / NAME TITLE JD .,C;e3.140 Pr filen1`_ Proposal Package 2 of 10 1.f' vaEtnership: PARTNERSHIP NAME: _......_.__—_— LIST PARTNERS NAMES: ADDRESS RECORD FORM MAIL BID TO: VENDOR NAME:._..._._ aS`...C'oas-A /1 ?-e.i- ...../14teerc4.._._._.._...._..._.._._ -- ..._.. _..._.__.. ADDRESS:... Z.___Lee:lel' CONTACT: Jo/ n -77Z-ile_--_. ____..._._. TELEPHONE: �G 3..).._6•_.-3-SyY.r FAX: 43_0..-._..ars 5283 E-MAIL: ✓ Aelimaii__e - -. ONLY if different - MAIL PURCHASE ORDER TO: ADDRESS: _._. .__. .__._. _....._._...__.-..___.... CONTACT: ._...._.__.-. TELEPHONE: _.._.... —.. _FAX: E-MAIL: ONLY if different - MAIL PAYMENT TO: ADDRESS: _._.._.....__..._. TELEPI IONS: FAX:..., ..... CONTACT: E-MAIL: Proposal Package 3 of 10 VENDOR NAME: E4kri4 (c241 /'/maei' ASSUMED NAME CERTIFICATION *If the business is conducted under an assumed name, a copy of the certificate required to be filed under the New York general business law must be attached. ASSUMED NAME:__...---_._.._.-....___..__.._..._.-__.__._..._ If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid or previously filed with the Purchasing Agent. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: In the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that individuals working for the Town of Southold or other municipality bid on contracts only that such interest be revealed when they do bid.) INSURANCE STATEMENT Bidder agrees as follows - please mark appropriate box: Insurance Certificate as requested is attached I certify that I can supply insurance as specified if awarded the bid Insurance Certificate filed on DATE FAILURE TO PROVIDE SPECIFIED INSURANCE SHALL DISQUALIFY BIDDER. i / AUTHORIZED SIGNATURE Proposal Package 4 of .10 AFFIDAVIT OF NON-COLLUSION I hereby attest that I am the person responsible within my firm for the final decision as to the prices(s) and amount of this bid or, if not,that I have written authorization, enclosed herewith, from that person to make the statements set out below on his or her behalf and on behalf of my firm, I further attest that: 1. The price(s) and amount of this bid have been arrived at independently, without consultation, communication or agreement for the purpose of restricting competition with any other contractor, bidder or potential bidder. 2. Neither the price(s), nor the amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder on this project, and will not be so disclosed prior to bid opening. 3. No attempt has been made or will be made to solicit, cause or induce any firm or person to refrain from bidding on this project, or to submit a bid higher than the bid of this firm, or any intentionally high or non-competitive bid or other form of complementary bid. 4. The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from any firm or person to submit a complementary bid. 5. My firm has not offered or entered into a subcontract or agreement regarding the purchase of materials or services from any other firm or person, or offered, promised or paid cash or anything of value to any firm or person, whether in connection with this or any other project, in consideration for an agreement or promise by an firm or person to refrain from bidding or to submit a complementary bid on this project. 6. My firm has not accepted or been promised any subcontract or agreement regarding the sale of materials or services to any firm or person, and has not been promised or paid cash or anything of value by any firm or person, whether in connection with this or any project, in consideration for my firm's submitting a Complementary hid, or agreeing to do so, on this project. 7. I have made a diligent inquiry of all members, officers, employees, and agents of my firm with responsibilities relating to the preparation, approval or submission of my firm's bid on this project and have been advised by each of them that he or she has not participated in any communication, consultation, discussion, agreement, collusion, act or other conduct inconsistent with any of the statements and representations made in this affidavit. The person signing this bid, under the penalties of perjury, affirms the truth thereof SWORN TO BEFORE ME THIS Je—tr L f,naature&Company Position (/c Art..._.._—rot$hP !/`PJ_.._... / DAY OF 20 LT-- Type Name&Company Position C J L'®ash H metrita16, Company Name NOTi„.:d aL1C; 7 O• /S/f RER:.;-;TETTE DeANGELIS NOTARY PUBLIC,STATE OF NEW YORK Dare Signe( - No.01 DE4750311 SUFFOLK COUNT 1/ — 3/ z f,61/ Commission Expires June 30,204.. Federal I D.Number Proposal Package 5 of 10 1 THE PROPOSAL FORM Supply ,&Delivery of Stone Materials VENDOR NAME: as ef®a.r? tP 44. /4/e.</4.f VENDOR ADDRESS: £1° 2 LegaZt. __ _ .6-4/ .Qvare Mvz TELEPHONE NUMBER: �43) GS3—S44'.S FAX: ay) The undersigned bidder has carefully examined the Bid Specifications and will supply all necessary labor, equipment and incidentals as necessary to supply and deliver stone materials as called for in the said Bid Specifications in the manner prescribed therein, and in accordance with the requirements of the Engineer, at the prices listed on the attached Bid Proposal Form. If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, the bid must be signed by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid documents. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: In the event that any Town Officer has any such interest, the hall nature thereof should be disclosed below. It is not forbidden that such individuals working for the Town of Southold or other municipalities bid on contracts, but only that such interest be revealed when they do bid.) The undersigned hereby acknowledges receipt of the following Addenda (if none were issued please write N/A below): Addendum,No. Dated Proposal Package 6 of 10 • THE PROPOSAL FORM FOR THE SUPPLY & DELIVERY OF ARMOR STONE, BEDDING STONE AND GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: UNIT PRICE QUOTES (COST/TON) FOR SUPPLY& DELIVERY OF STONE MATERIALS TO THE TOWN OF SOUTHOLD. ALL PURCHASE ORDERS FOR STONE MATERIALS SHALL BE FOR A FULL TRACTOR TRAILER LOAD OF STONE MATERIALS. ITEM#1 FINE AGGREGATE: j FURNISH AND DELIVER FINE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF: AWL de d44 d 9r/,t qc /5700 (writ n in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM#2 COARSE AGGREGATE:: FURNISH AND DELIVER COARSE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF: fa//4cJ 95/6® 4 413. 947,E(writi in words) COST PER TON _^ (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM #3 RIVER GRAVEL: FURNISH AND DELIVER RIVER GRAVEL TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF' feKly one ®/4®r 6 7./WEI Of/ q/, 9 c/,may (writtefi words) COST PER TON (written In numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM#4 BEDDING STONE: FURNISH AND DELIVER BEDDING STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED'UNIT COST"OF: raw d�/4'if r 9 fa . v sq. 9 shop (written words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. Proposal Package 9 of JO PROPOSAL FORM CONTINUED: ITEM#5 ARMOR STONE: FURNISH AND DELIVER ARMOR STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST" OF: irv," 6'®/46.5 r /_eef °.E"er0 ___� �... ..� __.. �(writn in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. _- AUTHORIZED SIGNATURE PRINT NAME Nz4/fri pi 731 X/067 TITLb .___..__...__ _._-.....__ti121e:f(V0087._...._ DATE7 r/L --.--._....__..._.. .___ .----.. ._. .._..._._...._.___._ ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF ) ss.: On the (',C-clay of in the year 2015 before me, the undersigned, personally appeared, _(tµ,.Tf.: TC.e_..__ ....._.__.-_...-_.... personally known to me or proved to me on the basis of satisfactory evidence to be' the individual(s) whose narne(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument,the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. NO RY PUBLIC BERNADETTE DeANGELIS NOTARY PUBLIC,STATE OF NEW YORK' No.01 DE4750311 SUFFOLK COUN Y Commission Expires June 30,20-27 Proposal Package 10 of 10 • t . 1 BIDDER'S CHECK LIST Your response to our above referenced bid will be considered unresponsive and will be rejected if the following forms are not included at the time of the bid opening. L4' Notarized Affidavit of Non-Collusion as required by NYS Law. Vendor Information Sheet and Address Record Form. 14 As per specifications,the Town of Southold requires a current insurance certificate,with the Town of Southold listed as additional insured,to be on file in the Purchasing Department. You will be given ten(10)business days from notice of award to supply this form or the bid will be rescinded. VENDOR NAME: ._. _.._ G _ VENDOR INFORMATION SHEET TYPE OF ENTITY:CORP. PARTNERSHIP INDIVIDUAL FEDERAL EMPLOYEE ID#: I - 312. \2,13_ OR SOCIAL SECURITY#: DATE OF ORGANIZATION: Vi qI t q-+T D IF APPLICABLE: DATE FILED: II � 19q STATE FILED: . iq _._.� ( (It`_..._.___._......_..__._ If a non-publicly owned Corporation: I, fa_ L - CORPORATION NAME: Lan \S\0\l a S�'u�x14xT1r s ,UsAc_Mak/411s LIST PRINCIPAL STOCKHOLDERS: (5% of outstanding shares) LIST OFFICERS AND DIRECTORS: NAME TITLE _. \aL � �dam- ._ ... ... Proposal Package 2 of 10 . . . Iyupartnership: PARTNERSHIP NAME: LIST PARTNERS NAMES: _ ______ - -__-_ A4pREss RECORD MAIL BID TO: VENDOR NAME; � \/��A �- \�\ s ADDRESS: ���° TELEPHONI 5? - 5 -13(Q_ FAX: L.,(9- ss>s E-MAIL: _04111Y1 atfY\OS . Coviti ONLY if different- MAIL PK)RcHA5E ORDER ADDRESS: CONT/LCT:__________�_________�__________ ___ TELEPHONE: FAX: E-MAIL: ONLY if different- MAIL PAYMENT TO: ADDRESS: TELEPHONE: FAX:________ CONTACT:_______ Proposal Package 3 of 10 VENDOR NAME: A k' e qeAke.ACECL ASSUMED NAME CERTIFICATION *If the business is conducted under an assumed name, a copy of the certificate required to be filed under the New York general business law must be attached. ASSUMEDAME: NAME: ��►1 hACdJfGS If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid or previously filed with the Purchasing Agent. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: In the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that individuals working for the Town of Southold or other municipality bid on contracts only that such interest be revealed when they do bid.) INSURANCE STATEMENT Bidder agrees as follows-please mark appropriate box: Insurance Certificate as requested is attached I certify that I can supply insurance as specified if awarded the bid 'IY ( :) Insurance Certificate filed on DATE FAILURE TO PROVIDE SPECIFIED INSURANCE SHALL DISQUALIFY BIDDER. ,_4 I .„ ill rel RUTH ..RIZE ri IGNATURE Proposal Package 4 of 10 S S :P., eS':`". DEPARTMENT OF STATE 13th `OJ?T`OF CORPORATIONS ALBANY, NY 12231-0001 FILING RECEIPT ENTITY NAME : LONG ISLAND SOUND TRANSPORT INC. DOCUMENT TYPE : ASSUMED NAME CERTIFICATE SERVICE COMPANY : HUBCO CODE: 29 FILED: 12/10/1999 CASH# : 939532 FILM# : C282230-2 PRINCIPAL LOCATION 25A MILL ROAD ,C 0 BOX 373 .. RONKONKOMA NY 11779 x , COMMENT: ASSUMED NAME A & R MATERIALS FILER * FEES 75 . 00 PAYMENTS : 75 . 00 * FILING : 25 . 00 CASH * COUNTY : 25 . 00 CHECK 75 . 00 * COPIES : . 00 MAYER & COMPANY * MISC 100 -J E. JEFRYN BLV * HANDLE : 25 . 00 * REFUND: DEER PARK NY 11729 DO3HD1Q4 DOS-281 (8/98) B2Gnow Page 1 of 2 December 26, 2012 File ID: 52841 Elta Bergold Long Island Sound Transport Inc DBA A R Materials 72 Union Avenue Ronkonkoma, NY 11779 Dear Elta Bergold: The New York State Department of Economic Development, Division of Minority and Women's Business Development(DMWBD) has completed its review of your application for State Certification as a Women Business Enterprise (WBE)and has determined that your firm meets eligibility requirements for certification, pursuant to Executive Law,Article 15-A. On behalf of the DMWBD,we are pleased to inform you that the firm of Long Island Sound Transport Inc DBA A R Materials has been granted status as a Women Business Enterprise(WBE). In our effort to help you have the broadest possible reach,your business will be listed in the State's Directory of Certified Businesses with the codes listed on the following page Certification status is not intended to imply that the State of New York guarantees your company's capability to perform on State contracts, nor does it imply that your company is guaranteed any State business. Be advised that your certification expires 3 years from the date of this letter or unless you are contacted by this Office for recertification. Please remember that any changes in your company that affect ownership, managerial and/or operational control, must be reported to this Office within thirty(30)days of such changes; including changes to company name, business address,telephone numbers, principal products/services,and bonding capacity.At such time as it is necessary for your company to be recertified,you will be notified by this office. If your certification is questioned by any public or private entity, please direct the inquiry to this Office for clarification.Thank you for your cooperation. On behalf of the State of New York, I wish you luck in your business endeavors, particularly those involving State agencies. Yours sincerely, Scott Munson Director of Certification 633 Third Avenue New York New York 10017 Tel 212 803 2414 Web Site:www.esd.ny.gov/MWBE/html https://ny.newnycontracts.com/Functions/Certification/Communications/LetterApproval... 12/27/2012 1,320now Page 2 of 2 New York State Department of Economic Development `• Development 633 Third Avenue New York New York 10017 Tel 212 803 2414 • • '4 Web Site:www.esd.ny.gov/MWBE/html December 26, 012 File ID; 52841 Elta Bergold Long Island Sound Transport Inc DBA A R Materials 72 Union Avenue Ronkonkoma, NY 11779 Long Island Sound Transport Inc DBA A R Materials will be listed in the State's Directory of Certified Businesses with the following list of codes for products and services: ESD-F-0164: CONSTRUCTION MATERIALS AND SUPPLIES ESD-F-0574:SAND AND GRAVEL DEALERS , ESD-F-0641: SUPPLIES,CONSTRUCTION ESD-G-0080: BUILDING MATERIALS DEALERS ESD-G-2066: CONSTRUCTION &DRAINAGE MATERIALS NAICS-484110:TRANSFER(TRUCKING)SERVICES, GENERAL FREIGHT, LOCAL https://ny.newnycontracts.com/Functions/Certification/Communications/LetterApproval.,. 12/27/2012 • AFFIDAVIT OF NON—COLLUSION I hereby attest that I am the person responsible within my firm for the final decision as to the prices(s) and amount of this bid or, if not,that I have written authorization, enclosed herewith,from that person to make the statements set out below on his or her behalf and on behalf of my firm. I further attest that: 1. The price(s) and amount of this bid have been arrived at independently, without consultation, communication or agreement for the purpose of restricting competition with any other contractor,bidder or potential bidder. 2. Neither the price(s), nor the amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder on this project, and will not be so disclosed prior to bid opening. 3. No attempt has been made or will be made to solicit, cause or induce any firm or person to refrain from bidding on this project, or to submit a bid higher than the bid of this firm, or any intentionally high or non-competitive bid or other form of complementary bid. 4. The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from any firm or person to submit a complementary bid. 5. My firm has not offered or entered into a subcontract or agreement regarding the purchase of materials or services from any other firm or person, or offered, promised or paid cash or anything of value to any firm or person, whether in connection with this or any other project, in consideration for an agreement or promise by an firm or person to refrain from bidding or to submit a complementary bid on this project. 6. My firm has not accepted or been promised any subcontract or agreement regarding the sale of materials or services to any firm or person, and has not been promised or paid cash or anything of value by any firm or person, whether in connection with this or any project, in consideration for my firm's submitting a complementary bid, or agreeing to do so,on this project. 7. I have made a diligent inquiry of all members, officers, employees, and agents of my firm with responsibilities relating to the preparation, approval or submission of my firm's bid on this project and have been advised by each of them that he or she has not participated in any communication, consultation,discussion, agreement, collusion, act or other conduct inconsistent with any of the statements and representations made in this affidavit. The on signi g this bid,under penalties of peijury, affirms the truth thereof SWORN TO BEFORE MI',THIS S _natur+e�&Compa y scion 4, 44,at. _. �`krx.._. �� ..t ._()_Sres . 0.3 DAY OF 20 ype Name&Companyr • on 1 1 -141C Company Nypame - (3 — a-0\ F :^.. .Aa.,.s Date signed ;'�b.�, ELIZABETH G BROSSEAU r t...._3 i_VPublic-State of New York ,,; Notary_._. .._ . _�. Federal LI) Number e NO. 01BR4966952 9ualifiecl In tiCounly Mv Commission Expires Proposal Package 5 of 10 THEPROPOSAL FORM Supply &Delivery of Stone Materials AS VENDOR NAME: e _ , 0sS VENDOR ADDRESS: TELEPHONE NUMBER ,236 5gS ' S 3 t4 FAX: C(236 5 g S " 5 7 c2 0 The undersigned bidder has carefully examined the Bid Specifications and will supply all necessary labor, equipment and incidentals as necessary to supply and deliver stone materials as called for in the said Bid Specifications in the manner prescribed therein, and in accordance with the requirements of the Engineer, at the prices listed on the attached Bid Proposal Form. If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, the bid must be signed by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid documents. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note. In the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that such individuals working for the Town of Southold or other municipalities bid on contracts,but only that such interest be revealed when they do bid.) • The undersigned hereby acknowledges receipt of the fallowing Addenda (if none were issued please write N/A below): Addendum No,. Dated Proposal Package 6 of 10 . . . . . THE PROPOSAL FORM FOR THE SUPPLY & DELIVERY OF ARMOR STONE, BEDDING STONE AND GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: UNIT PRICE QUOTES (COST/TON) SUPPLY& DELIVERY OF STONE MATERIALS TO THE TOWN OF SOUTHOLD. ALL PURCHASE ORDERS FOR STONE MATERIALS SHALL BE FOR A FULL TRACTOR TRAILER LOAD OF STONE MATERIALS. ITEM#1 FINE AGGREGATE: FURNISH AND DELIVER FINE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED 'UNIT COST"OF: k-5 �_- tIkyyy _-_— (writtenm��' -rd ' COST PER TON (writtenin nvmopn,) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM#2 COARSE AGGREGATE: FURNISH AND DELIVER COARSE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF: 13 '6- (w,|u6nm�urus) COST�s�TON '-- <w:G���numbe��COST PER TON- Max# of Days for Delivery After Purchase Order Is Issued by lOS. RIVER GRAVEL: FURNISH AND DELIVER RIVER GRAVEL TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF. Not.� (written in °,`s) COST PER TON (written In numbers) COST P"R TON Max# m Days for Delivery After Purchase Order Is Issued by T.O.S. BEDDING STONE: FURNISH AND DELIVER BEDDING STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES TED FO T|PUL COST"OF n6��in ords) 1ST i:,E12 w -- (written in m/m6�m)'COSTPER TON Max# of Days for Delivery After Purchase Order Is Issued by 1.0.5. Proposal Package� 9 of .10��u,u uo PROPOSAL FORM CONTINUED: ITEM#5 ARMOR STONE: FURNISH AND DELIVER ARMOR STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST' OF: --R- , 4- --5- ,x`c /-6,, (written in w rds) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. AUTHORIZED SIGNATURE _,,,d / f . # --I PRINT NAME 'I TITLEPfei_.. J DATE _..—... j 1L... ai. .- ��__...._... — --- — — — — _____________ - ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF.._&JJ ) ss.: On the \3 day of ___-. ._,.__-,__ _in the year 2015 before me, the undersigned, personally appeared, ___.E..-oc _ Q personally known to me or proved to me on the basis of satisfactory evidence b he individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument,the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. \ \ \ it.4'.' • NOTAR P I'. 1Q,1"---- ELIZABETH G BROSSEAU , Notary Public-State of New York € NO. 01BR4966952 Qualified In Suffolk County Proposal Package 10 of 10 `;i My Commission Expires -4 e,:A CONTRACT AGREEMENT THIS AGREEMENT made this day of AD Two Thousand and Fifteen by and between te ;Town of Southold, party of the first part (hereinafter called the Owner), and � .? kA Pd_i_S'3.,4__ , party of the second part(hereinafter called Contractor). WITNESSETFI: That for and in consideration of the premises and the agreements herein contained, and the payments herein provided to be made, the parties hereto agree as follows: FIRST: The Contractor shall furnish all the materials specified by within a Town Purchase Order for the "Supply and Delivery of Stone Materials" and shall coordinate the deliveries with the Town Engineering Department at 631-765-1560. AS DESCRIBED IN THE Contract Docume pts made and prepared by the Town of Southold, and (FILL IN FIRM NAME)At Qlsktheakthe project engineers, and as set forth in the Contractor's Bid dated , and in strict and entire conformity and in accordance with the Notice to Bidders, Instructions to Bidders, Proposal Form (Bid), Material Specifications, Addenda, and this Agreement, hereto annexed and made a part hereof, and hereinafter collectively referred to as "Contract Documents". SECOND: In Consideration of the Contractor performing this Contract in the manner herein stated and as stated in the Contract Documents, the Owner promises and agrees to pay or cause to be paid to the Contractor the sums of money mentioned in said Contract Documents in the manner and under the conditions therein provided. THIRD: The Contractor covenants and agrees that, anything in this Contract or in the Contract Documents to be contrary notwithstanding, or regardless of any matter, thing, contingency of condition unforeseen or otherwise, present or future, the Contractor shall not be entitled to receive any additional or further sums of money than the amounts in said Contract Documents provided; and the failure of the Owner or its agents to insist upon strict performance of any of the terms, covenants, agreements, provisions or conditions in this Agreement or in the Contract Documents, on any one or more instances, shall not be construed as a waiver or relinquishment for the future of any such terms, covenants, agreements, provisions and conditions and the same shall be and remain in full force and effect with power and authority on the part of the Owner to enforce the same or cause the same to be enforced at any time, without prejudice to any other rights which the Owner may have against the Contactor under this Agreement or the Contract Documents. A-1 • Neither Owner nor Contractor shall, without the prior written consent of the other, assign or sublet in whole or part his interest under any of the Contact Documents; and, specifically, Contractor shall not assign any monies due or to become due without the prior written consent of the Owner. Owner and Contractor each binds himself, his partners, successors, assigns and legal representatives of the other party hereto in respect to all covenants, agreements and obligations contained in the Contract Documents. The Contract Documents constitute the entire agreement between Owner and Contractor and may only be altered, amended or repealed by a duly executed written instrument signed by both parties. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. Total Bid Dollars Written in Words Written in Figures TOWN OF SOUTHOLD CONTRACTOR BY Scott A. Russell, Supervisor €, 6 ^ sak,, Pres BY William Duffy,Town Attorney (CORPORATE SEAL) A,2 ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF.--G....�..n.. .._..._)ss.: On the t`j clay of � , � in the year 2015 before me, the undersigned, personally appeared, +,, , , , personally known to me or proved to me on the basis of sans actoi evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted,executed the instrument. 46 Ivry ELIZABETH G BROSSEAU,. N'� • t 1 1\181ry Public-Store of Nev York 1, NO. 01 BR49'66952, >' Ouotfied in Suffolk County My Commission Expires 5S.atkv-Fs- 49 STATE OF NEW YORK, COUNTY OF )ss.: On the day of _in the year 2015 before me, the undersigned, personally appeared, . personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (arc) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. NOTARY PURI IC A-3 BIDDER'S CHECK LIST Your response to our above referenced bid will be considered unresponsive and will be rejected if the following forms are not included at the time of the hid opening. Notarized Affidavit of Non-Collusion as required by NYS Law. H Vendor Information Sheet and Address Record Form. As per specifications,the Town of Southold requires a current insurance certificate,with the Town of Southold listed as additional insured,to be on file in the Purchasing Department. You will be given ten(10)business days from notice of award to supply this form or the bid will be rescinded. VENDOR NAME: C Q-_... ra_.._...___-_._. 4 /G .s' / C • VENDOR INFORMATION SHEET TYPE OF ENTITY:CORP. PARTNERSHIP INDIVIDUAL FEDERAL EMPLOYEE ID#: 02 6 oa=7_o 7/ 7 OR SOCIAL SECURITY#: DATE OF ORGANIZATION: S_ 1 - a 00 7 — IF APPLICABLE: DA 1'E FILED: S - � 0100 7 __- v STATE FILED:.._-....__...N-e-0 If a non-publicly owned Corporation: CORPORATION NAME: c e . o4_/c'c, // D�._ �(/�S / Z C LIST PRINCIPAL STOCKHOLDERS: (5% of outstanding shares) (3. .ce _.... .._ ...._ u ._ ......_..... LIST OFFICERS AND DIRECTORS: NAME TITLE uid Proposal Package 2 of 10 If a partnership: PARTNERSHIP NAME: LIST PARTNERS NAMES: AD TRESS RECO 1 FORM MAIL BID TO: VENDOR NAME: ADDRESS: 1E7 CONTACT: TELEPHONE: 1/- g /- [9.2 o 6 FAX: 6 2 /- 3(-73- 2/ 7/ E-MAIL: ?L‘,. e cc9 —49,-ca/0 /Cf. ONLY if different- MAIL PURCHASE ORDER TO: ADDRESS: CONTACT: • TELEPHONE: FAX: E-MAIL: ONLY if different- MAIL PAYMENT TO: ADDRESS: TELEPHONE: FAX: CONTACT': E-MAIL: Proposal Package 3 of 10 VENDOR NAME: 'IC U Z7i(c 7 0,71 GE 4 (CS ZZC ASSUME P NAME CE TIFICATFSN *If the business is conducted under an assumed name, a copy of the certificate required to be filed under the New York general business law must be attached. ASSUMED NAME; If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid or previously filed with the Purchasing Agent. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: In the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that individuals working for the Town of Southold or other municipality bid on contracts only that such interest be revealed when they do bid.) INSURANCE STATEMENT Bidder agrees as follows-please mark appropriate box: Insurance Certificate as requested is attached I-1 I certify that I can supply insurance as specified if awarded the bid Insurance Certificate filed on ._._._._._._.. ..,. DATE FAILURE TO PROVIDE SPECIFIED INSURANCE SHALL DISQUALIFY BIDDER. -'4: 7) , /12\---- --------- � AUTHORIZED SIGNATURE Proposal Package 4 of 10 AFFIDAVIT OF NON-COLLUSION I hereby attest that I am the person responsible within my firm for the final decision as to the prices(s) and amount of this bid or, if not,that I have written authorization, enclosed herewith,from that person to make the statements set out below on his or her behalf and on behalf of my firm. I further attest that: 1. The price(s) and amount of this bid have been arrived at independently, without consultation, communication or agreement for the purpose of restricting competition with any other contractor,bidder or potential bidder. 2. Neither the price(s), nor the amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder on this project, and will not be so disclosed prior to bid opening. 3. No attempt has been made or will be made to solicit, cause or induce any firm or person to refrain from bidding on this project, or to submit a bid higher than the bid of this firm, or any intentionally high or non-competitive bid or other form of complementary bid. 4. The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from any firm or person to submit a complementary bid. 5. My firm has not offered or entered into a subcontract or agreement regarding the purchase of materials or services from any other firm or person, or offered, promised or paid cash or anything of value to any firm or person,whether in connection with this or any other project, in consideration for an agreement or promise by an firm or person to refrain from bidding or to submit a complementary bid on this project. 6. My firm has not accepted or been promised any subcontract or agreement regarding the sale of materials or services to any firm or person, and has not been promised or paid cash or anything of value by any firm or person, whether in connection with this or any project, in consideration for my firm's submitting a complementary bid, or agreeing to do so,on this project. 7. I have made a diligent inquiry of all members, officers, employees, and agents of my firm with responsibilities relating to the preparation, approval or submission of my firm's bid on this project and have been advised by each of them that he or she has not participated in any communication, consultation,discussion, agreement,collusion, act or other conduct inconsistent with any of the statements and representations made in this affidavit. Th•• ••son signing this • ,under the penalties of perjury, affirms the truth thereof ���4.rV ' ® SWORN TO BEFORE ME THIS gnature&Company Position 15 DAY OF 20 Woks" Type Name&Company Position 1 ________________ I .\1� Company Name ''' 'I.-" . LI Date Signed n/ r� ELIZABENH G BROSSEAU I`otary PubliCoin-1 Stote of New York ±. _..._....__.. NO. BR4966952 Federal I.I) Number Qualified Suffolk County fi Idly Commission Expires r Proposal Package 5 of 1.® T H FJ PROPOSAL FORM Supply &Delivery of Stone Materials VENDOR NAME' ._._ C Q --- 4,5ILciZ 0"/6`1 /c 1 , C VENDOR ADDRESS: 7 � 4✓ . Je``f e4 /.J 4 s„,,,,14 7.4),fro /Li y //28 7 TELEPHONE NUMBER: C 3�:g3/ 002-®' FAX: G I( V- / - 7/ 7/ 3 y3 The undersigned bidder has carefully examined the Bid Specifications and will supply all necessary labor, equipment and incidentals as necessary to supply and deliver stone materials as called for in the said Bid Specifications in the manner prescribed therein, and in accordance with the requirements of the Engineer, at the prices listed on the attached Bid Proposal Form. If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, the bid must be signed by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid documents. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: in the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that such individuals working for the Town of Southold or other municipalities bid on contracts, but only that such interest be revealed when they do bid.) The undersigned hereby acknowledges receipt of the following Addenda(if none were issued please write N/A below): Addendum,No Dated Proposal Package 6 of JO THE PROPOSAL FORM FOR THE SUPPLY &DELIVERY OF ARMOR STONE, BEDDING STONE AND GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: UNIT PRICE QUOTES (COST/TON)FOR SUPPLY& DELIVERY OF STONE MATERIALS TO THE TOWN OF SOUTHOLD. ALL PURCHASE ORDERS FOR STONE MATERIALS SHALL BE FOR A FULL TRACTOR TRAILER LOAD OF STONE MATERIALS. ITEM#1 FINE AGGREGATE: FURNISH AND DELIVER FINE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE IPULATED"UNIT COST"OF: 5:1:6 Na/41. C ( 5 4%, 15 cAyi ( itt w t eniln words) COST PER TON (written in numbers) COST PER TON Max# of Days for -7:t/14 !,,e Cawfs Delivery After Purchase Order Is Issued by T.O.S. ITEM#2 COARSE AGGREGATE: FURNISH AND DELIVER COARSE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR TH STIPULATED"UNIT COST"OF .-a/- 7b /4,1 6 3. 00 10 /i) / 5f4.Gs (wri ten' words) COST PER TON (written in numbers) COST PER TON Max# of Days'for Delivery After Purchase Order Is Issued by T.0,5. ITEM#3 RIVER GRAVEL: FURNISH AND DELIVER RIVER GRAVEL TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIO S WRITTEN HEREIN THE ABOVE REFERENCED ACTIVITIES WILL/BE COMPLETED FOR T STIPULATED"UNIT COST"OF: 71 * 6 a 5o .X e,li / 4ti (writte in words) COST PE TON . (written in numbers) COST PER TON Max# of Days for Civil / Delivery After Purchase Order Is Issued by T.O.S. ITEM#4 BEDDING STONE: FURNISH AND DELIVER BEDDING STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITI S WILL BE COMP ETED FOR THE STIPULATED"UNIT COST"OF: �o, V-5- �co DD;,,=' 1 $/4 S (written n words) COST PER TON (written in numbers) COST ER TON Max# of DaysAor Delivery After Purchase Order Is Issued by T.O.S. Proposal Package 9 of .10 4 PROPOSAL FORM CONTINUED: ITEM#5 ARMOR STONE: FURNISH AND DELIVER ARMOR STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF: (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. (I' AUTHORI7ED SIGNA RE �.-, _ PRINT NAME TITLE DATE ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF-_ . k ) ss.: SAOn the"c.) day of_ .__. _ . . to the year 2015 before me, the undersigned, personally appeared, ___ _-,d am. _.__... ..._._. .... .. personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument,the individual(s), or the person upon behalf of which the individual(s) acted,executed the instrument. I . \ \, 11111 6 •. IC Q7,.,- * -. - ,., -e",7 -,.may + ELIZABETH G BROSSEAU ;S �� Notary Public-State of New York ,. NO. 01 BR4965952 1Qualified In Suffolk County " tMy Commission Expires ' . Proposal Package .1,0 of 10 CONTRACT AGREEMENT 'PHIS AGREEMENT made this day of AD Two Thousand and Fifteen by and between the Town of Southold, party of the first part (hereinafter called the Owner), and _.. , party of the second part(hereinafter called Contractor). WITNESSETH: That for and in consideration of the premises and the agreements herein contained, and the payments herein provided to be made, the parties hereto agree as follows: FIRST: The Contractor shall furnish all the materials specified by within a Town Purchase Order for the "Supply and Delivery of Stone Materials" and shall coordinate the deliveries with the Town Engineering Department at 631-765-1560. AS DESCRIBED IN THE Contract Documents made and prepared by the Town of Southold, and (FILL IN FIRM NAME) . the project engineers, and as set forth in the Contractor's Bid dated and in strict and entire conformity and in accordance with the Notice to Bidders, Instructions to Bidders, Proposal Form (Bid), Material Specifications, Addenda, and this Agreement, hereto annexed and made a part hereof, and hereinafter collectively referred to as "Contract Documents". SECOND: In Consideration of the Contractor performing this Contract in the manner herein stated and as stated in the Contract Documents, the Owner promises and agrees to pay or cause to be paid to the Contractor the sums of money mentioned in said Contract Documents m the manner and under the conditions therein provided. THIRD: The Contractor covenants and agrees that, anything in this Contract or in the Contract Documents to be contrary notwithstanding, or regardless of any matter, thing, contingency of condition unforeseen or otherwise, present or future, the Contractor shall not be entitled to receive any addition l or further sums of money than the amounts in said Contract Documents provided; an the failure of the Owner or its agents to insist upon strict performance of any of the terms, covenants, agreements, provisions or conditions in this Agreement or in the Contract Documents, on any one or more instances, shall not be construed as a waiver or relinquishment for the future of any such terms, covenants, agreements, provisions and conditions and the same shall be and remain in full force and effect with power and authority on the part of the Owner to enforce the same or cause the same to be enforced at any time, without prejudice to any other rights which the Owner may have against the Contactor under this Agreement or the Contract Documents. A-1 • Neither Owner nor Contractor shall, without the prior written consent of the other, assign or sublet in whole or part his interest under any of the Contact Documents; and, specifically, Contractor shall not assign any monies due or to become due without the prior written consent of the Owner. Owner and Contractor each binds himself, his partners, successors, assigns and legal representatives of the other party hereto in respect to all covenants, agreements and obligations contained in the Contract Documents. The Contract Documents constitute the entire agreement between Owner and Contractor and may only be altered, amended or repealed by a duly executed written instrument signed by both parties. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. Total Bid Dollars Written in Words Written in Figures TOWN OF SOUTHOLD CONTRACTOR G o Scott A. Russell, Supervisor 'ITT BY William Duffy,Town Attorney (CORPORATE SEAL) A-2 I • •' ,k ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF_ 4,3kk.____.__,. )ss.: On the \6 day of_,_ili _ _ __________in the year 2015 before me, the undersigned, personally appeared, Alio, 'i Cm. . , _ , personally known to me or proved to me on the basis o satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. (1 ELIZABETH G BROSSEAU 1, Notary Public-State of New York p, , ,1�M'1.� ITS � NO. 01 BR4965952 NO R P1:141- '' -4' Qualified in Suffolk County ' My Commission Expires .._ STATE OF NEW YORK, COUNTY OF )ss.: On the day of ._•_.___.______. .in the year 2015 before mc, the undersigned, personally appeared, , personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. NOTARY PUBI,IC A-3 #12328 STATE OF NEW YORK) ) SS: COUNTY OF SUFFOLK) Karen Kine of Mattituck, in said county, being duly sworn, says that she is Principal Clerk of THE SUFFOLK TIMES, a weekly newspaper, published at Mattituck, in the Town of Southold, County of Suffolk and State of New York, and that the Notice of which the annexed is a printed copy, has been regularly published in said Newspaper once each week for 1 week(s), successfully commencing on the 2nd day of July, 2015. Principal Clerk Sworn to before me this �0 day ofJ' 2015. • VENDORS MUST SUBMIT BIDS IN ' SEALED ENVELOPES — — PLEASE PRINT ON THE FACE OF LEGAL NOTICE ENVELOPE: - INVITATION TOBID 1)NAME&ADDRESSOFBIDDER CHRISTINA VOLINSKI NOTICE IS HEREBY GIVEN THAT 2)BIDNAME NOTARY PUBLIC-STATE OF NEW YORK SEALED PROPOSALS ARE SOUGHT It is the bidder's responsibility to read AND REQUESTED FOR THE FOL- the attached Bid-Specifications, Instruc- No, 01V06105050 LOWING: tions to Bidders,and General Conditions, Qualified In Suffolk County BID NAME: "SUPPLY & DELI`'- which outline bidding rules of the Town of My Commisslan Expires February 28, 2016 ERY OF STONE MATERIALS" Southold. Upon submission of bid,it is un- Definite specifications way be ob- derstood that the bidder has read,fully un- tained-at the Southold Town Clerk's Of- derstands and will comply with said GEN- Hee beginning July 2,2015 ERAL CONDITIONS and specification PLACE OF OPENINGS: requirements. TOWN OF SOUTHOLD The Town of Southold requires that this TOWN CLERKS OFIFICE document be returned intact and that it 53995 MAIN ROAD be filled out completely.Please do not re- SOUTHOLD,NY IlIl971move any pages from this bid package,and DATE OF OPENINGS: make a copy of the bid document for your ' July 16,2015 records. TIME OF OPENINGS: The Town of Southold welcomes and 2:00 PM encourages minority and women-owned CONTACT PERSON: - businesses to participate in the bidding Michael Collins,P.E. process lbwn of Southold,631-765-1560 12328-1T 7/2 Rudder, Lynda From: Reisenberg, Lloyd Sent: Friday,June 26, 2015 8:52 AM To: Rudder, Lynda Subject: RE: Stone Materials Bid 2015.doc for publication Posted Lloyd H. Reisenberg Network and Systems Administrator Town of Southold,New York www.southoldtownny.gov Iloydr(asoutholdtownny.qov 0: 631-765-18911M:631-879-15541F: 631-765-5178 • CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication From: Rudder, Lynda Sent: Friday,June 26, 2015 8:08 AM To: Collins, Michael; Richter,Jamie;Jim Dinizio; Beltz, Phillip; Cushman,John; Doherty,Jill; Duffy, Bill; Ghosio, Bob; Kiely, Stephen; Krauza, Lynne; Louisa Evans; Michaelis,Jessica; Reisenberg, Lloyd; Russell, Scott; Standish, Lauren; Tomaszewski, Michelle;Tracey Doubrava (tdoubrava@timesreview.com); William Ruland Subject:Stone Materials Bid 2015.doc for publication Please publish in the July 2 edition of the Suffolk times and the Town Website 1 STATE OF NEW YORK) SS: COUNTY OF SUFFOLK) ELIZABETH A. NEVILLE,Town Clerk of the Town of Southold, New York being duly sworn, says that on the 26th day of June , 2015, she affixed a notice of which the annexed printed notice is a true copy, in a proper and substantial manner, in a most public place in the Town of Southold, Suffolk County,New York, to wit: Town Clerk's Bulletin Board, 53095 Main Road, Southold,New York. Rebid of Stone Materials lizabeth A. Neville Southold Town Clerk Sworn before me this 26th day of June , 2015. otary Public �r ,DA W.RUDDER M121 ®.o1State of RU6020932 ve 4�ce�3 ®uaV%fied is Suffolk COun tr e0mmiss1081 Expires March 8Q 20� TOWN OF SOUTHOLD 53095 MAIN ROAD, SOUTHOLD, NEW YORK 11971 PHONE: 631-765-1560 / FAX: 631-765-9015 INVITATION TO BID NOTICE IS HEREBY GIVEN THAT SEALED PROPOSALS ARE SOUGHT AND REQUESTED FOR THE FOLLOWING: BID NAME: "SUPPLY & DELIVERY OF STONE MATERIALS" Definite specifications may be obtained at the Southold Town Clerk's Office beginning July 2,2015 PLACE OF OPENINGS: DATE OF OPENINGS: TIME OF OPENINGS: TOWN OF SOUTHOLD July 16, 2015 2:00 PM TOWN CLERKS OFFICE 53095 MAIN ROAD SOUTHOLD,NY 11971 CONTACT PERSON: Michael Collins, P.E. Town of Southold, 631-765-1560 VENDORS MUST SUBMIT BIDS IN SEALED ENVELOPES. PLEASE PRINT ON THE FACE OF ENVELOPE: 1)NAME &ADDRESS OF BIDDER 2) BID NAME It is the bidder's responsibility to read the attached Bid Specifications, Instructions to Bidders, and General Conditions, which outline bidding rules of the Town of Southold. Upon submission of bid, it is understood that the bidder has read, fully understands and will comply with said GENERAL CONDITIONS and specification requirements. The Town of Southold requires that this document be returned intact and that it be filled out completely. Please do not remove any pages from this bid package, and make a copy of the bid document for your records. The Town of Southold welcomes and encourages minority and women-owned businesses to participate in the bidding process. 46) T[ '';':--"' rvi -1; -iJitifit rt i--.. ,1,144,) ) i ow 4-41 il if -07' FOR THE SUPPLY & DELIVERY OF STONE A TERIALS TO THE TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK July 2, 2015 .., „ TWN ...• F 6..4t UTO-1L Scott A. Russell, Supervisor 'i OGI-•V i VY DiErv1FOT , E NT Vincent Orlando, Highwas Superintendent EP GO f',.EONG il, EPA; :MIRE '‘;T Michael Collins, Town Engineer TABLE OF CONTENTS TOWN OF SOUTHOLD SUPPLY & DELIVERY OF STONE MATERIALS Title Page Table of Contents ------ Invitation to Bid Instructions to Bidders 1B-1 thru IB-3 Standard Insurance Requirements SIR 1 thru SIR 2 Proposal Form Package Proposal Form Package Pages 1 thru 10 Contract Agreement A-1 thru A-3 TOWN OF SOUTHOLD 53095 MAIN ROAD, SOUTHOLD, NEW YO=' 11971 PHONE: 631-765-1560 /FAX: 631-765-9015 INVITATION TO BID NOTICE IS HEREBY GIVEN THAT SEALED PROPOSALS ARE SOUGHT AND REQUESTED FOR THE FOLLOWING: BID NAME: "SUPPLY & DELIVERY OF STONE MATERIALS" Definite specifications may be obtained at the Southold Town Clerk's Office beginning July 2,2015 PLACE OF OPENINGS: DATE OF OPENINGS: TIME OF OPENINGS: TOWN OF SOUTHOLD July 16,2015 2:00 PM TOWN CLERKS OFFICE 53095 MAIN ROAD SOUTHOLD,NY 11971 CONTACT PERSON: Michael Collins, P.E. Town of Southold, 631-765-1560 VENDORS MUST SUBMIT BIDS IN SEALED ENVELOPES. PLEASE PRINT ON THE FACE OF ENVELOPE: 1)NAME&ADDRESS OF BI.DDER 2)BID NAME It is the bidder's responsibility to read the attached Bid Specifications, Instructions to Bidders, and General Conditions, which outline bidding rules of the Town of Southold. Upon submission of bid, it is understood that the bidder has read, fully understands and will comply with said GENERAL CONDITIONS and specification requirements. The Town of Southold requires that this document be returned intact and that it be filled out completely. Please do not remove any pages from this bid package, and make a copy of the bid document for your records. The Town of Southold welcomes and encourages minority and women-owned businesses to participate in the bidding process. INSTRUCTIONS TO BIDDERS INDEX 1. Receipt and Opening of Bids 2. Form,Preparation and Presentation of Proposal 3. Rejection of Bids 4. Bidders Responsibility 5. Bid Reservations 6. Non-Collusive Statement 7. Addenda and Interpretations 8. Method of Award 9. Single Price Bid Analysis 10. Municipal Exempt Status 11. Insurance Required by the Town of Southold 12. Quantities 1. RECEIPT AND OPENING OF BIDS The Town of Southold invites bids on the forms herein provided to supply and deliver stone materials to the Town of Southold,New York. Sealed bids shall be received by the office of the Southold Town Clerk, 53095 Route 25 Southold, New York 11971, no later than 2:00 PM prevailing time on July 16,2015, at which time they will be opened and publicly read aloud. All bids received after the time stated for the opening in the Notice to Bidders may not be considered and will be returned unopened to the bidder. The bidder assumes the risk of any delay in the mail or in the handling of the mail by employees of the Town. Whether sent by mail or by means of personal delivery, the bidder assumes responsibility for having his bid deposited on time at the place specified. Faxed bids will not be accepted. 2. FORM,PREPARATION AND PRESENTATION OF PROPOSAL The Proposal Form as issued by the Town shall be completely filled in, in black ink or typed on - the original bid form. No photocopies will be accepted. All blank spaces for bid prices must be filled in, in both words and figures, with a unit cost per ton for which the bid is made. All lines must have an indication of the bidder's response whether it be "0", "N/A", "No Charge", or a dollar figure. All lines must be filled in to indicate bidder's acknowledgement of the request. Bids that do not have all applicable lines filled in on the bid proposal form may be disqualified as a non-responsive bid. We cannot assume there is "no charge" when lines are left empty. Bids that contain any omission, erasure, alteration, addition or items not called for in the itemized bid form or that contain irregularities of any kind will not be accepted. In case of discrepancy between the unit price and total amount bid for any item, the unit price, as expressed in words, shall govern. lB - 1 INSTRUCTIONS TO BIDDERS 3. REJECTION OF BIDS (a) The TOWN BOARD reserves the right to reject any bid if unfavorable evidence comes to light or is submitted to the Town or if an investigation of such bidder fails to satisfy the TOWN BOARD that such bidder is properly qualified to carry out the obligations of the Contract and to complete the work contemplated therein. Conditional bids will be considered informal and will be rejected. (b) The TOWN BOARD reserves the right to reject any and all bids, in whole or in part, to waive any informality in any or all bids, and to accept the bid or part thereof which it deems most favorable to the Town after all bids have been examined and/or checked. 4. BIDDERS RESPONSIBILITY (a) Bidders are cautioned not to submit bids until after having fully examined the bidding requirements for the delivery of stone materials and having made themselves familiar with local conditions. (b) The submission of a bid will be construed to mean that the bidder is fully informed as to the extent, cost, and character of the materials to be supplied and delivered in accordance with the Bidding Requirements, including all other expenses incidental thereto. 5. BID RESERVATIONS Bids submitted shall remain in effect for forty-five (45) days past the date of bid opening. This period may be extended, for the benefit of the Town, by mutual agreement between the Bidder and the Purchasing Agent. 6. NON-COLLUSIVE STATEMENT The form of non-collusion bidding certification contained in the proposal package must be executed by the Bidder and submitted with the proposal. The submission of this statement certifies that the prices in this bid have been arrived at independently without collusion, consultation, communication, or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor. 7. AI)IWADA AND INTERPRETATIONS I'ATIONS Every request for information or interpretation of the Bidding Requirements must be addressed in writing to the Town Engineering Department of Southold - 53095 Route 25, P.O. Box 1179, Southold, New York 11971 or fax 631-765-9015, and to be given any consideration, must be received at least five (5) days prior to the date fixed for the opening of bids. Any such interpretations or supplemental instructions will be in the form of written addenda, and will be mailed or faxed to all prospective bidders. The failure of any bidder to receive any such addenda will not relieve the bidder of any obligation under his bid as submitted. Any addenda so issued shall become part of the Contract Documents. IB -2 INSTRUCTIONS TO BIDDERS 8. METHOD OF AWARD The bid will be awarded to the lowest responsive, responsible bidder, as will best promote the public interest, taking into consideration the reliability of the bidder, the quality of the materials, and conformity with the specifications. 9. SINGLE PRICE BID ANALYSIS In the event a single bid is received, the Town will conduct a price analysis of the bid price prior to the award of the contract. 10. MUNICIPAL EXEMPT STATUS The Town is exempt from the payment of Federal, State and local taxes. Taxes must not be included in proposal prices. 11. INSURANCE REQUIRED BY THE TOWN OF SOUTHOLD The successful bidder will be required to procure and pay for the following types of insurance,as set forth in more detail herein following the Instructions to Bidders in the Standard Insurance requirements Section. (a)Comprehensive Automobile Policy (b)Comprehensive General Liability (c)Excess/Umbrella insurance (d)Owner's and Contractor's Protective Liability (e)Workmen's Compensation Insurance (f)Disability Insurance and Unemployment Insurance 12. QUANTITIES Any quantities referenced, discussed or set forth in the bid specifications are approximations only. No guarantee is made for any quantities stated. Payment shall be on the basis of actual quantities supplied at the unit prices quoted. LB - 3 STANDARD INSURANCE REQUIREMENTS TOWN OF SOUTHOLD CONTRACT INSURANCE REQUIREMENTS INSURANCE IDENTIFICATION• THE BID NUMBER IS TO APPEAR ON ALL INSIRANCE CERTIFICATES INDEPENDENT CONTRACTOR: The Corporation/Contractor/Agency/Consultant, is an independent contractor and covenants and agrees that it, its agents, servants and/or employees will neither hold itself/themselves out as, nor claim to be an employee, servant or agent of the TOWN OF SOUTHOLD, and that it, its agents and employees will not make claim, demand or application to or for any right or privilege applicable to an officer or employee of the TOWN OF SOUTHOLD including, but not limited to Worker's Compensation coverage, Unemployment Insurance benefits, Social Security coverage or retirement membership or credit. INSURANCE: Contractor/vendor shall not commence work under this contract until he has obtained all insurance required under the following paragraphs, and the Town of Southold has approved such insurance. WORKERS'_CQMPENSATION; Contractor/vendor shall take out and maintain during the life of this contract, such insurance as will protect both the owner and the contractor from claims under worker's compensation acts and amendments thereto and from any other claims for property damage and for personal injury including death, which may arise from operations under this contract, whether such operations by contractor or by any other party directly or indirectly employed by the contractor. Copy of Certificate to be provided to the Town of Southold. DISABILITY INSURANCE & UNEMPLOYMENT INSURANCE: Contractor/vendor shall take out and maintain during the entire term of the contract any disability benefits and unemployment insurance as required by law. Copy of Certificate to he provided to the Town of Southold. GENERAL LIABILITY INSURANCE: The contractor/vendor shall take out and maintain during the life of the contract, such bodily injury liability and property damage liability insurance as shall protect him and the Town from claims for damages for bodily injury including accidental death, as well as from claims for property damage which may arise from operations under this contract,whether such operations be by himself or by any subcontractor or by anyone directly or indirectly employed by either of them. It shall be the responsibility of the contractor/vendor to maintain such insurance in amounts sufficient to fully protect himself and the Town, but in no instance shall amounts be less than those set forth below. These amounts are specified only to establish the minimum coverage acceptable. Bodily injury liability and property damage liability insurance in an amount not less than $1,000,000 (one million dollars) for damages on account of any one accident, and in an amount of not less than $2,000,000 (two million dollars) on account of all accidents(general aggregate). OTHER CONDITIONS OF COMMERCIAL GENERAL LIABILITY INSURANCE: 1. Coverage shall be written on commercial general liability form. 2. Coverage shall include: A. Contractual liability 13. Independent contractors C. Products and completed operations SIR - 1 STANDARD INSURANCE REQUIREMENTS AUTOMOBILE LIABILITY INSURANCE: Automobile bodily injury liability and property damage liability insurance shall be provided by the contractor/vendor with a minimum combined single limit(CSL) of$1,000,000(one million dollars). OTHER CONIDITIONS OF AUTOMOBILE LIABILITY INSURANCE: 1. Coverage shall include: A. All owned vehicles B. Hired car and non-ownership liability coverage C. Statutory no-fault coverage ADDITIONAL CONDITIONS OF INSURANCE: 1, Contractor/vendor shall submit copies of any or all required insurance policies as and when requested by the Town. 2. If any of the contractor's/vendor's policies of insurance are cancelled or not renewed during the life of the contract, immediate notice of cancellation of non-renewal shall be delivered to the Town no less than 10 days prior to the date and time of cancellation or non-renewal. CERTIFICATE OF INSURANCE: The contractor/vendor shall file with the Town of Southold prior to commencing work under.this contract,a certificate of insurance. 1. Certificate of insurance shall include: A. Name and address of insured B. Issue date of certificate C. Insurance company name D. Type of coverage in effect E. Policy number F. Inception and expiration dates of policies included G. Limits of liability for all policies on certificate. included on certificate Description of operations/locations/etc. Box must include the statement: "THE TOWN OF SOUTHOLD IS LISTED AS ADDITIONAL INSURED" CERTIFICATE HOLDER SHALL BE LISTED AS: TOWN OF SOUTHOLD 53095 ROUTE 25, P.O. BOX 1179 SOUTHOLD,NY 11971 2. If the contractor's/vendor's insurance policies should be non-renewed, cancelled or expire during the life of the contact, the Town shall be provided with a new certificate indicating the replacement policy information as requested above. Thirty days (30) prior written notice to the Town of Southold for cancellation is applicable. SIR - 2 'town if S •et thold "Supply ,\ elivery of Stow" ;°aerials" PASAPSSA rACE GE IID TENS: June 18, 2015 REMINDER AEU!: VENDORS MUST RETU ' THIS DOCUMENT INTACT AND FILLED OUT COMPLETELY! ! All line items on the Proposal Form must be filled in! All lines must have an indication of the bidder's response whether it is a dollar figure of No Bid. Please DO NOT remove any pages from this bid package! ! ! Thank you! Proposal Package 1 of 10 BIDDER'S CHECK LIST Your response to our above referenced bid will be considered unresponsive and will be rejected if the following forms are not included at the time of the hid opening. Cl Notarized Affidavit of Non-Collusion as required by NYS Law. Vendor Information Sheet and Address Record Form. I As per specifications, the Town of Southold requires a current insurance certificate,with the Town of Southold listed as additional insured,to be on file in the Purchasing Department. You will be given ten(10)business days from notice of award to supply this form or the bid will be rescinded. VENDOR NAME: VENDOR INFORMATION SHEET TYPE OF ENTITY:CORP. PARTNERSHIP INDIVIDUAL FEDERAL EMPLOYEE ID #: OR SOCIAL SECURITY#: DATE OF ORGANIZATION: IF APPLICABLE: DATE FILED: STATE FILED: If a non-publicly owned Corporation: CORPORATION NAME: LIST PRINCIPAL STOCKHOLDERS: (5% of outstanding shares) LIST OFFICERS AND DIRECTORS: NAME TITLE Proposal Package 2 of 10 If:) partnership: PARTNERSHIP NAME: LIST PARTNERS NAMES: ADDRESS RECO .1 FORM MAIL BID TO: VENDOR NAME: ADDRESS: CONTACT: TELEPHONE: FAX: E-MAIL: ONLY if different - MAIL PURCHASE ORDER TO: ADDRESS: CONTACT: TELEPHONE: FAX: E-MAIL: ONLY if different - MAIL PAYMENT TO: ADDRESS: TELEPHONE: FAX: CONTACT: E-MAIL: -- ._..._.. Proposal Package 3 of 10 VENDOR NAME: ASSUMED NAME CERTIFICATION *If the business is conducted under an assumed name, a copy of the certificate required to be filed under the New York general business law must be attached. ASSUMED NAME: If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid or previously filed with the Purchasing Agent. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: In the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that individuals working for the Town of Southold or other municipality bid on contracts only that such interest be revealed when they do bid.) INSURANCE STATEMENT Bidder agrees as follows - please mark appropriate box: Insurance Certificate as requested is attached I—I I certify that I can supply insurance as specified if awarded the bid LI Insurance Certificate filed on DATE FAILURE TO PROVIDE SPECIFIED INSURANCE SHALL DISQUALIFY BIDDER. AUTHORIZED SIGNATURE Proposal Package 4 of 10 AFFIDAVIT OF NON-COLLUSION I hereby attest that I am the person responsible within my firm for the final decision as to the prices(s) and amount of this bid or, if not,that I have written authorization, enclosed herewith, from that person to make the statements set out below on his or her behalf and on behalf of my firm. I further attest that: 1. The price(s) and amount of this bid have been arrived at independently, without consultation, communication or agreement for the purpose of restricting competition with any other contractor,bidder or potential bidder. 2. Neither the price(s), nor the amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder on this project, and will not be so disclosed prior to bid opening. 3. No attempt has been made or will be made to solicit, cause or induce any firm or person to refrain from bidding on this project, or to submit a bid higher than the bid of this firm, or any intentionally high or non-competitive bid or other form of complementary bid. 4. The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from any firm or person to submit a complementary bid. 5. My firm has not offered or entered into a subcontract or agreement regarding the purchase of materials or services from any other firm or person, or offered, promised or paid cash or anything of value to any firm or person, whether in connection with this or any other project, in consideration for an agreement or promise by an firm or person to refrain from bidding or to submit a complementary bid on this project. 6. My firm has not accepted or been promised any subcontract or agreement regarding the sale of materials or services to any firm or person, and has not been promised or paid cash or anything of value by any firm or person, whether in connection with this or any project, in consideration for my firm's submitting a complementary bid, or agreeing to do so, on this project. 7. I have made a diligent inquiry of all members, officers, employees, and agents of my fine with responsibilities relating to the preparation, approval or submission of my firm's bid on this project and have been advised by each of them that he or she has not participated in any communication, consultation, discussion, agreement, collusion, act or other conduct inconsistent with any of the statements and representations made in this affidavit. The person signing this bid, under the penalties of perjury, affirms the truth thereof. SWORN TO BEFORE ME THIS Signature&Company Position DAY OF 20 Type Name&Company Position Company Nam NOTARY PUBLIC Date Signed _ Federal I.D.Number Proposal Package 5 of 10 THE PROPOSAL FORM Supply i er Materials VENDOR NAME: VENDOR ADDRESS: TELEPHONE NUMBER: FAX: The undersigned bidder has carefully examined the Bid Specifications and will supply all necessary labor, equipment and incidentals as necessary to supply and deliver stone materials as called for in the said Bid Specifications in the manner prescribed therein, and in accordance with the requirements of the Engineer, at the prices listed on the attached Bid Proposal Form. If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, the bid must be signed by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid documents. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: In the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that such individuals working for the Town of Southold or other municipalities bid on contracts, but only that such interest be revealed when they do bid.) The undersigned hereby acknowledges receipt of the following Addenda (if none were issued please write N/A below): Addendum No. Dated Proposal Package 6 of 10 BIDDING It l� QUIREMTENTS FOR THE SUPPLY & DELIVERY OF ARMOR STONE, BEDDING STONE A;°'D GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: BID SPECIFICATIONS Under this Item, the Contractor shall furnish and place clean stone and/or granular fill material in accordance with the Bid specifications and/or as directed by the Town Engineer. Contractor may bid on any one or all bid items listed herein. MATERIALS Under this item, clean stone materials shall consist of; Fine & Coarse Stone Aggregates, Bedding Stone and Armor Stone. All material shall be sound, hard, durable bank run gravel, field stone and/or rough unhewn quarry stone. The stone shall be sound, tough, dense, and resistant to the action of air and water. Gradation shall be as follows: #1 FINE AGGREGATE Fine aggregate shall consist of natural gravel having clean, durable, hard, uncoated particles, free from dirt, wood, paper, fiber and all other foreign material. Sieve Size Percent Passing by Weight 3/8-inch 100% 1/4-inch 0% #2 RIVER GRAVEL River Gravel shall consist of natural gravel having clean, durable, hard, uncoated particles, free from dirt, wood, paper, fiber and all other foreign material. Sieve Size Percent Passing by Weight 1.0-inch 100% 3/4-inch 0% #3 COARSE AGGREGATE Coarse aggregate shall consist of crushed stone, natural gravel or other inert materials of similar characteristics having clean, durable, hard, uncoated particles, washed to remove clay, loam and dust. The aggregate shall be free from dirt, wood, paper, fiber and all other foreign materials. Sieve Size Percent Passing by Weight 3.0 — inch 100% 2-1/2-inch 0% #4 BEDDING STONE Bedding stone shall range from 8" to 12" of hard natural stone material. The stone shall consist of field stone or rough unhewn quarry stone. The stone shall be sound, tough, dense, and resistant to the action of air and water. Not more than 10 percent of the total weight of the riprap may be in individual pieces weighing less than twenty (20 #'s) pounds each. Proposal Package 7 of 10 BIDDING REQUIREbI[TENTS CONT. FOR THE SUPPLY & DELIVERY OF ARMOR STONE, BEDDING STONE AND GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: #5 ARMOR STONE Armor stone shall range from One (1) Ton to Five (5) Tons in size and consist of a hard natural stone material. The Armor stone shall consist of field stone or rough unhewn quarry stone. The stone shall be sound, tough, dense, and resistant to the action of air and water. The Town Engineer reserves the right to randomly test for conformance any material that arrives at the site. DELIVERY DETAILS The Contractor shall furnish and place all Stone Material referenced herein as directed by the Town Engineer. The stone materials shall be, ordered and delivered, based on a full Tractor Trailer Load consisting of approximately 38 Tons per Trailer Load. The final location and placement of stone materials delivered to the Town of Southold shall be specified under a Town Purchase Order and shall be specified as a single location for each Trailer Load. Locations may vary from; the Town Highway Department yard on Peconic Lane, individual Town Road Ends and/or any other location in the Town where the material is required. METHOD OF MEASUREMENT The Contractor shall receive payment for the cost of furnishing clean stone and/or granular fill material based on delivery weight tickets for each Trailer load delivered to the Town. Prior notification of delivery, at least 24 hours in advance, must be given to the Town Engineering Department at 631-765-1560 to coordinate the delivery & placement of all stone materials. PROCEDURES FOR SUBMISSION AND PAYMENT The Contractor shall deliver his request for payment by submission of a proper invoice to the office of the Engineer. A proper invoice shall include a numbered & dated contractor's invoice including a copy of all weight tickets to be processed for payment. The submission for payment shall also include a completed / signed Town Voucher. LENGTH OF AGREEMENT This unit price bid will be in effect for a period of Two (2) years from the date of acceptance by the Town. Upon mutual agreement, this contract agreement may be extended for a period of one (1) year. END OF SECTION: Proposal Package 8 of 10 THE PROPOSAL FORM FOR THE SUPPLY & DELIVERY OF ARMOR STONE, BEDDING STONE AND GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: UNIT PRICE QUOTES (COST/TON) FOR SUPPLY& DELIVERY OF STONE MATERIALS TO THE TOWN OF SOUTHOLD. ALL PURCHASE ORDERS FOR STONE MATERIALS SHALL BE FOR A FULL TRACTOR TRAILER LOAD OF STONE MATERIALS. ITEM#1 FINE AGGREGATE: FURNISH AND DELIVER FINE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF: (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM#2 COARSE AGGREGATE: FURNISH AND DELIVER COARSE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OE (written in words) COST PER TON (written in numbers) COST PER TON Max P. of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM#3 RIVER GRAVEL: FURNISH AND DELIVER RIVER GRAVEL TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM#4 BEDDING STONE: FURNISH AND DELIVER BEDDING STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST"OF: (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. Proposal Package 9 of 10 PROPOSAL FORM CONTINUED: ITEM#5 ARMOR STONE: FURNISH AND DELIVER ARMOR STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED "UNIT COST" OF: -1111—MC words)(wn�eni^ u� COSTpsnrow h°, nionumunm) COST PER TON �_ of Days for— Delivery Purchase Order Is Issued by T.O.S. AUTHORIZED SIGNATURE PRINT NAME TITLE ___ - DATE ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF ) ss.: On the day of _ in the year 2015 before me, the undersigned, personally appeared, _ _ . permouaUknown me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their xiEuoiurc(d on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. _ _ NOTARY PUBLIC Proposal Package 10 of 10 CONTRACT AGREEMENT EMENT THIS AGREEMENT made this day of AD Two Thousand and Fifteen by and between the Town of Southold, party of the first part (hereinafter called the Owner), and _.. , party of the second part (hereinafter called Contractor). WITNESSETH: That for and in consideration of the premises and the agreements herein contained, and the payments herein provided to be made, the parties hereto agree as follows: FIRST: The Contractor shall furnish all the materials specified by within a Town Purchase Order for the "Supply and Delivery of Stone Materials" and shall coordinate the deliveries with the Town Engineering Department at 631-765.4560. AS DESCRIBED IN THE Contract Documents made and prepared by the Town of Southold, and (FILL IN FIRM NAME) _ , . the project engineers, and as set forth in the Contractor's Bid dated and in strict and entire conformity and in accordance with the Notice to Bidders, Instructions to Bidders, Proposal Form (Bid), Material Specifications, Addenda, and this Agreement, hereto annexed and made a part hereof, and hereinafter collectively referred to as "Contract Documents". SECOND: In Consideration of the Contractor performing this Contract in the manner herein stated and as stated in the Contract Documents, the Owner promises and agrees to pay or cause to be paid to the Contractor the sums of money mentioned in said Contract Documents in the manner and under the conditions therein provided. THIRD: The Contractor covenants and agrees that, anything in this Contract or in the Contract -Documents to be contrary notwithstanding, or regardless of any matter, thing, contingency of condition unforeseen or otherwise, present or future, the Contractor shall not be entitled to receive any additional or further sums of money than the amounts in said Contract Documents provided; and the failure of the Owner or its agents to insist upon strict performance of any of the terms, covenants, agreements, provisions or conditions in this Agreement or in the Contract Documents, on any one or more instances, shall not be construed as a waiver or relinquishment for the future of any such terms, covenants, agreements, provisions and conditions and the same shall be and remain in full force and effect with power and authority on the part of the Owner to enforce the same or cause the same to be enforced at any time, without prejudice to any other rights which the Owner may have against the Contactor under this Agreement or the Contract Documents. A-1 Neither Owner nor Contractor shall, without the prior written consent of the other, assign or sublet in whole or part his interest under any of the Contact Documents; and, specifically, Contractor shall not assign any monies due or to become due wi_bout the prior written consent of the Owner. Owner and Contractor each binds himself, his partners, successors, assigns and legal representatives of the other party hereto in respect to all covenants, agreements and obligations contained in the Contract Documents. The Contract Documents constitute the entire agreement between Owner and Contractor and may only be altered, amended or repealed by a duly executed written instrument signed by both parties. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. Total Bid Dollars Written in Words • Written in Figures TOWN OF SOUTHOLD CONTRACTOR BY BY Scott A.Russell, Supervisor _ . ... �. TITLE BY William Duffy,Town Attorney (CORPORATE SEAL) A-2 ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF )ss.: On the day of in the year 2015 before me, the undersigned, personally appeared, , personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. NOTARY PUBLIC STATE OF NEW YORK, COUNTY OF )ss.: On the day of _.V. in the year 2015 before me, the undersigned, personally appeared, personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. NOTARY PUBLIC A-3 ,',,,ilii,__>__ ELIZABETH A.NEVILLE,MMC 4/07- e, Town Hall,53095 Main Road TOWN CLERK d 1 P.O.Box 1179 Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS to , 0 4''0 Fax(631)7E5-6145 MARRIAGE OFFICER =�_ `�s�,Ls3 ,05'.0 Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER �� . ;,0i www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER ,>,,,,,,•0 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD BID OPENING 2015 Stone Materials Bid Opening 6/18/15 2:00 P.M. No bids received #12273 STATE OF NEW YORK) ) SS: COUNTY OF SUFFOLK) Karen Kine of Mattituck, in said county, being duly sworn, says that she is Principal Clerk of THE SUFFOLK TIMES, a weekly newspaper, published at Mattituck, in the Town of Southold, County of Suffolk and State of New York, and that the Notice of which the annexed is a printed copy, has been regularly published in said Newspaper once each week for 1 week(s), successfully commencing on the 4th day of June, 2015. c>/-7/14..A-L-4,----_9e,i,e__,,e7 Principal Clerk • . Sworn to before me this 2 day of % 15. i() 0 LEGAL NOTICE TOWN OF SOUTHOLD 53095 MAIN ROAD,SOUTHOLD, NEW YORK 11971 PHONE:631-765-1560/FAX:631-765- C RISTIIVA VOLII�ISKI 9015 �Iot,•" PUBLIC-STATE OF RI�VV YORK IPTVITATION TO HID NOTICE IS HEREBY GIVEN �t7, O 1 VO6105050 THAT SEALED PROPOSALS ARE 9t�aliried In Suffolk County SOUGHT AND REQUESTED FOR THE FOLLOWING: tbliiPn13stOn Ekplres February 28, 2016 BID NAME:"SUPPLY&DELIVERY OF STONE MATERIALS" Definite specifications may be ob- tained at the Southold Town Clerk's Of- fice beginning June 4,2015 PLACE OF OPENINGS: TOWN OF SOUTHOLD TOWN CLERK'S OFFICE 53095 MAIN ROAD SOUTHOLD,NY 11971 DATE OF OPENINGS: Dane 18,2015 TIME OF OPENINGS: 2:00 PM CONTACT PERSON: Michael Collins,P.E. Town of Southold,631-765-1560 VENDORS MUST SUBMIT BIDS IN SEALED ENVELOPES. PLEASE PRINT ON THE FACE OF ENVELOPE. 1) NAME & ADDRESS OF BID- DER 2)BID NAME ' It is the bidder's responsibility to read the attached Bid Specifications,Instruc- tions to Bidders,and General Conditions, which outline bidding rules of the Town of Southold.Upon submission of bid,it is understood that the bidder has read,fully understands and will comply with said GENERAL CONDITIONS and specifi- , cation requirements. The Town of Southold requires that this document be returned intact and that it be filled out completely.Please do notIrecie - - remove any pages from this bid package, _,`sJ = c u - and make a copy of the bid document for '- 'f _ -- your records. • - - - The Town of Southold welcomes and - encourages minority and women-owned _ -- ;- businesses to participate in the bidding ,• --_- — - .- - process. - _ ELIZABETH A.NEVILLE -- - SOUTIIOLD TOWN CLERK -- _ - 12273-1T 6/4 TOWN OF SOUTHOLD 53095 MAIN ROAD, SOUTHOLD, NEW YORK 11971 PHONE: 631-765-1560 / FAX: 631-765-9015 INVITATION TO BID NOTICE IS HEREBY GIVEN THAT SEALED PROPOSALS ARE SOUGHT AND REQUESTED FOR THE FOLLOWING: BID NAME: "SUPPLY & DELIVERY OF STONE MATERIALS" Definite specifications may be obtained at the Southold Town Clerk's Office beginning June 4, 2015 PLACE OF OPENINGS: DATE OF OPENINGS: TIME OF OPENINGS: TOWN OF SOUTHOLD June 18, 2015 2:00 PM TOWN CLERKS OFFICE 53095 MAIN ROAD SOUTHOLD,NY 11971 CONTACT PERSON: Michael Collins, P.E. Town of Southold, 631-765-1560 VENDORS MUST SUBMIT BIDS IN SEALED ENVELOPES. PLEASE PRINT ON THE FACE OF ENVELOPE: 1)NAME & ADDRESS OF BIDDER 2) BID NAME It is the bidder's responsibility to read the attached Bid Specifications, Instructions to Bidders, and General Conditions, which outline bidding rules of the Town of Southold. Upon submission of bid, it is understood that the bidder has read, fully understands and will comply with said GENERAL CONDITIONS and specification requirements. The Town of Southold requires that this document be returned intact and that it be filled out completely. Please do not remove any pages from this bid package, and make a copy of the bid document for your records. The Town of Southold welcomes and encourages minority and women-owned businesses to participate in the bidding process. ELIZABETH A. NEVILLE SOUTHOLD TOWN CLERK -- PLEASE PUBLISH ON June 4, 2015 AND FORWARD ONE (1) AFFIDAVIT OF PUBLICATION TO ELIZABETH NEVILLE,TOWN CLERK, TOWN HALL, PO BOX 1179, SOUTHOLD, NY 11971. Copies to the following: The Suffolk Times Town Board Members Town Attorney Dodge Reports Brown's Letters Burrelle's Information Services Town Clerk's Bulletin Board Engineering Q°l RESOLUTION 2015-185 ADOPTED DOC ID: 10563 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-185 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON FEBRUARY 10, 2015: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs the Town Clerk to advertise for bids for the following items for 2015: Armor Stone Rip-rap Filter Cloth Heavy Equipment with Operator Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Robert Ghosio, Councilman SECONDER:Louisa P. Evans, Justice AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell Rudder, Lynda From: Cerria Torres <ctorres@timesreview.com> Sent: Wednesday, May 27, 2015 1:16 PM To: Rudder, Lynda;Jim Dinizio; Beltz, Phillip; Cushman, John; Doherty, Jill; Duffy, Bill; Ghosio, Bob; Kiely, Stephen; Krauza, Lynne; Louisa Evans; Michaelis, Jessica; Reisenberg, Lloyd; Russell, Scott; Standish, Lauren; Tomaszewski, Michelle; Tracey Doubrava, William Ruland Cc: Richter, Jamie; Collins, Michael Subject: Re: for publication I have scheduled the two notices to publish in the Suffolk Times on 6/4/2015. Thank you KIES REVIEW y n. sr MEDIA GROUP Cerria Orientale Torres Display Ad Coordinator 631.354.8011 (D) ctorres@timesreview.com legals@timesreview.com www.timesreview.com From: <Rudder>, Lynda Rudder<lynda.rudder@town.southold.ny.us> Date: Wednesday, May 27, 2015 1:13 PM To:Jim Dinizio <iim(a@iamesdinizio.com>, "Beltz, Phillip" <Phillip.Beltz@town.southold.ny.us>, "Cushman,John" <John.Cushman@town.southold.ny.us>, "Doherty,Jill" <fill.doherty@town.southold.ny.us>, "Duffy, Bill" <billd(a@southoldtownny.gov>, "Ghosio, Bob" <bob.ghosio@town.southold.ny.us>, "Kiely, Stephen" <stephen.kiely@town.southold.ny.us>, "Krauza, Lynne" <lynne.krauza@town.southold.ny.us>, Louisa Evans <Ipevans06390Ca@gmail.com>, "Michaelis,Jessica" <iessicam@southoldtownny.gov>, "Reisenberg, Lloyd" <Lloyd.Reisenberg@town.southold.ny.us>, "Russell, Scott" <Scott.Russell@town.southold.ny.us>, "Standish, Lauren" <Lauren.Standish@town.southold.ny.us>, "Tomaszewski, Michelle" <michellet@town.southold.ny.us>,Times Review <tdoubrava@timesreview.com>, William Ruland <rulandfarm@yahoo.com> Cc: "Richter,Jamie" <Jamie.Richter@town.southold.ny.us>, "Collins, Michael" <michael.collins@town.southold.ny.us> Subject: for publication Please publish in the 6/4/15 edition of the Suffolk times and the town website 1 S DJLU ID F. oiRm FOR THE SUPPLY & DELIVERY OF STONE MATERIALS TO THE TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK June 18, 2015 es® F- US067 TOWN OF SOUTHOLD Scott A. Russell, Suupervns®m HIGHWAY DEPARTMENT Vincent Orlando, Highway Superintendent ENGINEERING DEPARTMENT Michael Collins, Town Engineer TABLE OF CONTENTS TOWN OF SOUTHOLD SUPPLY & DELIVERY OF STONE MATERIALS Title Page Table of Contents Invitation to Bid Instructions to Bidders IB-1 thru IB-3 Standard Insurance Requirements SIR 1 thru SIR 2 Proposal Form Package Proposal Form Package Pages 1 thru 10 Contract Agreement A-1 thru A-3 TOWN OF SOUTHOLD 53095 MAIN ROAD, SOUTHOLD, NEW YORK 11971 PHONE: 631-765-1560 / FAX: 631-765-9015 INVITATION TO BID NOTICE IS HEREBY GIVEN THAT SEALED PROPOSALS ARE SOUGHT AND REQUESTED FOR THE FOLLOWING: BID NAME: "SUPPLY & DELIVERY OF STONE MATERIALS" Definite specifications may be obtained at the Southold Town Clerk's Office beginning June 4,2015 PLACE OF OPENINGS: DATE OF OPENINGS: TIME OF OPENINGS: TOWN OF SOUTHOLD June 18, 2015 2:00 PM TOWN CLERKS OFFICE 53095 MAIN ROAD SOUTHOLD,NY 11971 CONTACT PERSON: Michael Collins, P.E. Town of Southold, 631-765-1560 VENDORS MUST SUBMIT BIDS IN SEALED ENVELOPES. PLEASE PRINT ON THE FACE OF ENVELOPE: 1)NAME &ADDRESS OF BIDDER 2) BID NAME It is the bidder's responsibility to read the attached Bid Specifications, Instructions to Bidders, and General Conditions, which outline bidding rules of the Town of Southold. Upon submission of bid, it is understood that the bidder has read, fully understands and will comply with said GENERAL CONDITIONS and specification requirements. The Town of Southold requires that this document be returned intact and that it be filled out completely. Please do not remove any pages from this bid package, and make a copy of the bid document for your records. The Town of Southold welcomes and encourages minority and women-owned businesses to participate in the bidding process. INSTRUCTIONS TO BIDDERS INDEX 1. Receipt and Opening of Bids 2. Form,Preparation and Presentation of Proposal 3. Rejection of Bids 4. Bidders Responsibility 5. Bid Reservations 6. Non-Collusive Statement 7. Addenda and Interpretations 8. Method of Award 9. Single Price Bid Analysis 10. Municipal Exempt Status 11. Insurance Required by the Town of Southold 12. Quantities 1. RECEIPT AND OPENING OF BIDS The Town of Southold invites bids on the forms herein provided to supply and deliver stone materials to the Town of Southold,New York. Sealed bids shall be received by the office of the Southold Town Clerk, 53095 Route 25 Southold, New York 11971, no later than 2:00 PM prevailing time on May 18,2015, at which time they will be opened and publicly read aloud. All bids received after the time stated for the opening in the Notice to Bidders may not be considered and will be returned unopened to the bidder. The bidder assumes the risk of any delay in the mail or in the handling of the mail by employees of the Town. Whether sent by mail or by means of personal delivery, the bidder assumes responsibility for having his bid deposited on time at the place specified. Faxed bids will not be accepted. 2. FORM,PREPARATION AND PRESENTATION OF PROPOSAL The Proposal Form as issued by the Town shall be completely filled in, in black ink or typed on the original bid form. No photocopies will be accepted. All blank spaces for bid prices must be filled in, in both words and figures, with a unit cost per ton for which the bid is made. All lines must have an indication of the bidder's response whether it be "0", "N/A", "No Charge", or a dollar figure. All lines must be filled in to indicate bidder's acknowledgement of the request. Bids that do not have all applicable lines filled in on the bid proposal form may be disqualified as a non-responsive bid. We cannot assume there is "no charge"when lines are left empty. Bids that contain any omission, erasure, alteration, addition or items not called for in the itemized bid form or that contain irregularities of any kind will not be accepted. In case of discrepancy between the unit price and total amount bid for any item, the unit price, as expressed in words, shall govern. IB - 1 INSTRUCTIONS TO BIDDERS 3. REJECTION OF BIDS (a) The TOWN BOARD reserves the right to reject any bid if unfavorable evidence comes to light or is submitted to the Town or if an investigation of such bidder fails to satisfy the TOWN BOARD that such bidder is properly qualified to carry out the obligations of the Contract and to complete the work contemplated therein. Conditional bids will be considered informal and will be rejected. (b) The TOWN BOARD reserves the right to reject any and all bids, in whole or in part, to waive any informality in any or all bids, and to accept the bid or part thereof which it deems most favorable to the Town after all bids have been examined and/or checked. 4. BIDDERS RESPONSIBILITY (a) Bidders are cautioned not to submit bids until after having fully examined the bidding requirements for the delivery of stone materials and having made themselves familiar with local conditions. (b) The submission of a bid will be construed to mean that the bidder is fully informed as to the extent, cost, and character of the materials to be supplied and delivered in accordance with the Bidding Requirements, including all other expenses incidental thereto. 5. BID RESERVATIONS Bids submitted shall remain in effect for forty-five (45) days past the date of bid opening. This period may be extended, for the benefit of the Town, by mutual agreement between the Bidder and the Purchasing Agent. 6. NON-COLLUSIVE STATEMENT The form of non-collusion bidding certification contained in the proposal package must be executed by the Bidder and submitted with the proposal. The submission of this statement certifies that the prices in this bid have been arrived at independently without collusion, consultation, communication, or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor. 7. ADDENDA AND INTERPRETATIONS Every request for information or interpretation of the Bidding Requirements must be addressed in writing to the Town Engineering Department of Southold - 53095 Route 25, P.O. Box 1179, Southold, New York 11971 or fax 631-765-9015, and to be given any consideration, must be received at least five (5) days prior to the date fixed for the opening of bids. Any such interpretations or supplemental instructions will be in the form of written addenda, and will be mailed or faxed to all prospective bidders. The failure of any bidder to receive any such addenda will not relieve the bidder of any obligation under his bid as submitted. Any addenda so issued shall become part of the Contract Documents. IB -2 INSTRUCTIONS TO BIDDERS 8. METHOD OF AWARD The bid will be awarded to the lowest responsive, responsible bidder, as will best promote the public interest, taking into consideration the reliability of the bidder, the quality of the materials, and conformity with the specifications. 9. SINGLE PRICE BID ANALYSIS In the event a single bid is received, the Town will conduct a price analysis of the bid price prior to the award of the contract. 10.MUNICIPAL EXEMPT STATUS The Town is exempt from the payment of Federal, State and local taxes. Taxes must not be included in proposal prices. 11. INSURANCE REQUIRED BY THE TOWN OF SOUTHOLD The successful bidder will be required to procure and pay for the following types of insurance, as set forth in more detail herein following the Instructions to Bidders in the Stancard Insurance requirements Section. (a)Comprehensive Automobile Policy (b)Comprehensive General Liability (c)Excess/Umbrella Insurance (d)Owner's and Contractor's Protective Liability (e)Workmen's Compensation Insurance (f)Disability Insurance and Unemployment Insurance 12. QUANTITIES Any quantities referenced, discussed or set forth in the bid specifications are approximations only. No guarantee is made for any quantities stated. Payment shall be on the basis of actual quantities supplied at the unit prices quoted. IB - 3 STANDARD INSURANCE REQUIREMENTS TOWN OF SOUTHOLD CONTRACT INSURANCE REQUIREMENTS INSURANCE IDENTIFICATION: THE BID NUMBER IS TO APPEAR ON ALL INSURANCE CERTIFICATES INDEPENDENT CONTRACTOR: The Corporation/Contractor/Agency/Consultant, is an independent contractor and covenants and agrees that it, its agents, servants and/or employees will neither hold itself/themselves out as, nor claim to be an employee, servant or agent of the TOWN OF SOUTHOLD, and that it, its agents and employees will not make claim, demand or application to or for any right or privilege applicable to an officer or employee of the TOWN OF SOUTHOLD including, but not limited to Worker's Compensation coverage, Unemployment Insurance benefits, Social Securiy coverage or retirement membership or credit. INSURANCE: Contractor/vendor shall not commence work under this contract until he has obtained all insurance required under the following paragraphs, and the Town of Southold has approved such insurance. WORKERS' COMPENSATION: Contractor/vendor shall take out and maintain during the life of this contract, such insurance as will protect both the owner and the contractor from claims under worker's compensation acts and amendments thereto and from any other claims for property damage and for personal injury including death, which may arise from operations under this contract, whether such operations by contractor or by any other party directly or indirectly employed by the contractor. Copy of Certificate to be provided to the Town of Southold. DISABILITY INSURANCE & UNEMPLOYMENT INSURANCE: Contractor/vendor shall take out and maintain during the entire term of the contract any disability benefits and unemployment insurance as required by law. Copy of Certificate to be provided to the Town of Southold. GENERAL LIABILITY INSURANCE: The contractor/vendor shall take out and maintain during the life of the contract, such bodily injury liability and property damage liability insurance as shall protect him and the Town from claims for damages for bodily injury including accidental death, as well as from claims for property damage which may arise from operations under this contract,whether such operations be by himself or by any subcontractor or by anyone directly or indirectly employed by either of them. It shall be the responsibility of the contractor/vendor to maintain such insurance in amounts sufficient to fully protect himself and the Town, but in no instance shall amounts be less than those set forth below. These amounts are specified only to establish the minimum coverage acceptable. Bodily injury liability and property damage liability insurance in an amount not less than $1,000,000 (one million dollars) for damages on account of any one accident, and in an amount of not less than $2,000,000 (two million dollars) on account of all accidents (general aggregate). OTHER CONDITIONS OF COMMERCIAL GENERAL LIABILITY INSURANCE: 1. Coverage shall be written on commercial general liability form. 2. Coverage shall include: A. Contractual liability B. Independent contractors C. Products and completed operations SIR- 1 STANDARD INSURANCE REQUIREMENTS AUTOMOBILE LIABILITY INSURANCE: Automobile bodily injury liability and property damage liability insurance shall be provided by the contractor/vendor with a minimum combined single limit (CSL) of$1,000,000(one million dollars). OTHER CONDITIONS OF AUTOMOBILE LIABILITY INSURANCE: 1. Coverage shall include: A. All owned vehicles B. Hired car and non-ownership liability coverage C. Statutory no-fault coverage ADDITIONAL CONDITIONS OF INSURANCE: 1. Contractor/vendor shall submit copies of any or all required insurance policies as and when requested by the Town. 2. If any of the contractor's/vendor's policies of insurance are cancelled or not renewed during the life of the contract, immediate notice of cancellation of non-renewal shall be delivered to the Town no less than 10 days prior to the date and time of cancellation or non-renewal. CERTIFICATE OF INSURANCE: The contractor/vendor shall file with the Town of Southold prior to commencing work under:his contract,a certificate of insurance. 1. Certificate of insurance shall include: A. Name and address of insured B. Issue date of certificate C. Insurance company name D. Type of coverage in effect E. Policy number F. Inception and expiration dates of policies included G. Limits of liability for all policies on certificate. included on certificate Description of operations/locations/etc. Box must include the statement: "THE TOWN OF SOUTHOLD IS LISTED AS ADDITIONAL INSURED" CERTIFICATE HOLDER SHALL BE LISTED AS: TOWN OF SOUTHOLD 53095 ROUTE 25, P.O. BOX 1179 SOUTHOLD, NY 11971 2. If the contractor's/vendor's insurance policies should be non-renewed, cancelled or expire during the life of the contact, the Town shall be provided with a new certificate indicating the replacement policy information as requested above. Thirty days (30) prior written notice to the Town of Southold for cancellation is applicable. SIR - 2 Town of Southold "Supply & Delivery of Stone Materials" PROPOSAL PACKAGE BID OPENS: June 18, 2015 REMINDER NOTE!! ! : VENDORS MUST RETURN THIS DOCUMENT INTACT AND FILLED OUT COMPLETELY! ! All line items on the Proposal Form must be filled in! All lines must have an indication of the bidder's response whether it is a dollar figure or No Bid. Please DO NOT remove any pages from this bid package! ! ! Thank you! Proposal Package 1 of 10 BIDDER'S CHECK LIST Your response to our above referenced bid will be considered unresponsive and will be rejected if the following forms are not included at the time of the bid opening. Notarized Affidavit of Non-Collusion as required by NYS Law. Vendor Information Sheet and Address Record Form. As per specifications, the Town of Southold requires a current insurance certificate, with the Town of Southold listed as additional insured, to be on file in the Purchasing Department. You will be given ten (10)business days from notice of award to supply this form or the bid will be rescinded. VENDOR NAME: VENDOR INFORMATION SHEET TYPE OF ENTITY:CORP. PARTNERSHIP INDIVIDUAL FEDERAL EMPLOYEE ID#: OR SOCIAL SECURITY#: DATE OF ORGANIZATION: IF APPLICABLE: DATE FILED: STATE FILED: If a non-publicly owned Corporation: CORPORATION NAME: LIST PRINCIPAL STOCKHOLDERS: (5% of outstanding shares) LIST OFFICERS AND DIRECTORS: NAME TITLE y Proposal Package 2 of 10 If a partnership: PARTNERSHIP NAME: LIST PARTNERS NAMES: ADDRESS RECORD FORM MAIL BID TO: VENDOR NAME: ADDRESS: CONTACT: TELEPHONE: FAX: E-MAIL: ONLY if different - MAIL PURCHASE ORDER TO: ADDRESS: CONTACT: TELEPHONE: FAX: E-MAIL: ONLY if different - MAIL PAYMENT TO: ADDRESS: TELEPHONE: FAX: CONTACT: E-MAIL: Proposal Package 3 of 10 VENDOR NAME: ASSUMED NAME CERTIFICATION *If the business is conducted under an assumed name, a copy of the certificate required to be filed under the New York general business law must be attached. ASSUMED NAME: If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid or previously filed with the Purchasing Agent. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: In the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that individuals working for the Town of Southold or other municipality bid on contracts only that such interest be revealed when they do bid.) INSURANCE STATEMENT Bidder agrees as follows -please mark appropriate box: Insurance Certificate as requested is attached I certify that I can supply insurance as specified if awarded the bid Insurance Certificate filed on DATE FAILURE TO PROVIDE SPECIFIED INSURANCE SHALL DISQUALIFY BIDDER. AUTHORIZED SIGNATURE Proposal Package 4 of 10 AFFIDAVIT OF NON-COLLUSION I hereby attest that I am the person responsible within my firm for the final decision as to the prices(s) and amount of this bid or, if not, that I have written authorization, enclosed herewith, from that person to make the statements set out below on his or her behalf and on behalf of my firm. I further attest that: 1. The price(s) and amount of this bid have been arrived at independently, without consultation, communication or agreement for the purpose of restricting competition with any other contractor, bidder or potential bidder. 2. Neither the price(s), nor the amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder on this project, and will not be so disclosed prior to bid opening. 3. No attempt has been made or will be made to solicit, cause or induce any firm or person to refrain from bidding on this project, or to submit a bid higher than the bid of this firm, or any intentionally high or non-competitive bid or other form of complementary bid. 4. The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from any firm or person to submit a complementary bid. 5. My firm has not offered or entered into a subcontract or agreement regarding the purchase of materials or services from any other firm or person, or offered, promised or paid cash or anything of value to any firm or person, whether in connection with this or any other project, in consideration for an agreement or promise by an firm or person to refrain from bidding or to submit a complementary bid on this project. 6. My firm has not accepted or been promised any subcontract or agreement regarding the sale of materials or services to any firm or person, and has not been promised or paid cash or anything of value by any firm or person, whether in connection with this or any project, in consideration for my firm's submitting a complementary bid, or agreeing to do so, on this project. 7. I have made a diligent inquiry of all members, officers, employees, and agents of my firm with responsibilities relating to the preparation, approval or submission of my firm's bid on this project and have been advised by each of them that he or she has not participated in any communication, consultation, discussion, agreement, collusion, act or other conduct inconsistent with any of the statements and representations made in this affidavit. The person signing this bid, under the penalties of perjury, affirms the truth thereof SWORN TO BEFORE ME THIS Signature&Company Position DAY OF 20 Type Name&Company Position Company Name NOTARY PUBLIC Date Signed Federal 1.D.Number Proposal Package 5 of 10 THE PROPOSAL FORM Supply &Delivery of Stone Materials VENDOR NAME: VENDOR ADDRESS: TELEPHONE NUMBER: FAX: The undersigned bidder has carefully examined the Bid Specifications and will supply all necessary labor, equipment and incidentals as necessary to supply and deliver stone materials as called for in the said Bid Specifications in the manner prescribed therein, and in accordance with the requirements of the Engineer, at the prices listed on the attached Bid Proposal Form. If the bidder is an individual, the bid must be signed by that individual; if the bidder is a corporation, the bid must be signed by an officer of the corporation, or other person authorized by resolution of the board of directors, and in such case a copy of the resolution must be attached; if a partnership, by one of the partners or other person authorized by a writing signed by at least one general partner and submitted with the bid documents. The submission of this constitutes a certification that no Town Officer has any interest therein. (Note: In the event that any Town Officer has any such interest, the full nature thereof should be disclosed below. It is not forbidden that such individuals working for the Town of Southold or other municipalities bid on contracts, but only that such interest be revealed when they do bid.) The undersigned hereby acknowledges receipt of the following Addenda (if none were issued please write N/A below): Addendum No. Dated Proposal Package 6 of 10 RIDDING REQUIREMTENTS FOR THE SUPPLY & DELIVERY OF ARMOR STONE, BEDDING STONE AND GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: BID SPECIFICATIONS Under this Item, the Contractor shall furnish and place clean stone and/or granular fill material in accordance with the Bid specifications and/or as directed by the Town Engineer. Contractor may bid on any one or all bid items listed herein. MATERIALS Under this item, clean stone materials shall consist of; Fine & Coarse Stone Aggregates, Bedding Stone and Armor Stone. All material shall be sound, hard, durable bank run gravel, field stone and/or rough unhewn quarry stone. The stone shall be sound, tough, dense, and resistant to the action of air and water. Gradation shall be as follows: #1 FINE AGGREGATE Fine aggregate shall consist of natural gravel having clean, durable, hard, uncoated particles, free from dirt, wood, paper, fiber and all other foreign material. Sieve Size Percent Passing by Weight 3/8-inch 100% 1/4-inch 0% #2 RIVER GRAVEL River Gravel shall consist of natural gravel having clean, durable, hard, uncoated particles, free from dirt, wood, paper, fiber and all other foreign material. Sieve Size Percent Passing by Weight 1.0-inch 100% 3/4-inch 0% #3 COARSE AGGREGATE Coarse aggregate shall consist of crushed stone, natural gravel or other inert materials of similar characteristics having clean, durable, hard, uncoated particles, washed to remove clay, loam and dust. The aggregate shall be free from dirt, wood, paper, fiber and all other foreign materials. Sieve Size Percent Passing by Weight 3.0 — inch 100% 2-1/2-inch 0% #4 BEDDING STONE Bedding stone shall range from 8" to 12" of hard natural stone material. The stone shall consist of field stone or rough unhewn quarry stone. The stone shall be sound, tough, dense, and resistant to the action of air and water. Not more than 10 percent of the total weight of the riprap may be in individual pieces weighing less than twenty (20 #'s) pounds each. Proposal Package 7 of 10 BIDDING REQUIREMTENTS CONT. FOR THE SUPPLY & DELIVERY OF ARMOR STONE, BEDDING STONE AND GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: #5 ARMOR STONE Armor stone shall range from One (1) Ton to Five (5) Tons in size and consist of a hard natural stone material. The Armor stone shall consist of field stone or rough unhewn quarry stone. The stone shall be sound, tough, dense, and resistant to the action of air and water. • The Town Engineer reserves the right to randomly test for conformance any material that arrives at the site. DELIVERY DETAILS • The Contractor shall furnish and place all Stone Material referenced herein as directed by the Town Engineer. The stone materials shall be, ordered and delivered, based on a full Tractor Trailer Load consisting of approximately 38 Tons per Trailer Load. The final location and placement of stone materials delivered to the Town of Southold shall be specified under a Town Purchase Order and shall be specified as a single location for each Trailer Load. Locations may vary from; the Town Highway Department yard on Peconic Lane, individual Town Road Ends and/or any other location in the Town where the material is required. METHOD OF MEASUREMENT The Contractor shall receive payment for the cost of furnishing clean stone and/or granular fill material based on delivery weight tickets for each Trailer load delivered to the Town. Prior notification of delivery, at least 24 hours in advance, must be given to the Town Engineering Department at 631-765-1560 to coordinate the delivery & placement of all stone materials. PROCEDURES FOR SUBMISSION AND PAYMENT The Contractor shall deliver his request for payment by submission of a proper invoice to the office of the Engineer. A proper invoice shall include a numbered & dated contractor's invoice including a copy of all weight tickets to be processed for payment. The submission for payment shall also include a completed / signed Town Voucher. LENGTH OF AGREEMENT This unit price bid will be in effect for a period of Two (2) years from the date of acceptance by the Town. Upon mutual agreement, this contract agreement may be extended for a period of one (1) year. END OF SECTION: Proposal Package 8 of 10 THE PROPOSAL FORM FOR THE SUPPLY & DELIVERY OF ARMOR STONE, BEDDING STONE AND GRANULAR FILL MATERIALS TO THE TOWN OF SOUTHOLD: UNIT PRICE QUOTES (COST/TON) FOR SUPPLY& DELIVERY OF STONE MATERIALS TO THE TOWN OF SOUTHOLD. ALL PURCHASE ORDERS FOR STONE MATERIALS SHALL BE FOR A FULL TRACTOR TRAILER LOAD OF STONE MATERIALS. ITEM # 1 FINE AGGREGATE: FURNISH AND DELIVER FINE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST" OF. (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM #2 COARSE AGGREGATE: FURNISH AND DELIVER COARSE AGGREGATE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED "UNIT COST" OF: (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM #3 RIVER GRAVEL: FURNISH AND DELIVER RIVER GRAVEL TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED "UNIT COST" OF: (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. ITEM #4 BEDDING STONE: FURNISH AND DELIVER BEDDING STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED"UNIT COST" OF. (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. Proposal Package 9 of 10 PROPOSAL FORM CONTINUED: ITEM #5 ARMOR STONE: FURNISH AND DELIVER ARMOR STONE TO THE TOWN OF SOUTHOLD TO MEET THE REQUIREMENTS OF THE SPECIFICATIONS WRITTEN HEREIN. THE ABOVE REFERENCED ACTIVITIES WILL BE COMPLETED FOR THE STIPULATED "UNIT COST" OF: (written in words) COST PER TON (written in numbers) COST PER TON Max# of Days for Delivery After Purchase Order Is Issued by T.O.S. AUTHORIZED SIGNATURE PRINT NAME TITLE DATE ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF ) ss.: On the day of in the year 2015 before me, the undersigned, personally appeared, personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. NOTARY PUBLIC Proposal Package 10 of 10 CONTRACT AGREEMENT THIS AGREEMENT made this day of AD Two Thousand and Fifteen by and between the Town of Southold, party of the first part (hereinafter called the Owner), and , party of the second part (hereinafter called Contractor). WITNESSETH: That for and in consideration of the premises and the agreements herein contained, and the payments herein provided to be made, the parties hereto agree as follows: FIRST: The Contractor shall furnish all the materials specified by within a Town Purchase Order for the "Supply and Delivery of Stone Materials" and shall coordinate the deliveries with the Town Engineering Department at 631-765-1560. AS DESCRIBED IN THE Contract Documents made and prepared by the Town of Southold, and (FILL IN FIRM NAME) , the project engineers, and as set forth in the Contractor's Bid dated , and in strict and entire conformity and in accordance with the Notice to Bidders, Instructions to Bidders, Proposal Form (Bid), Material Specifications, Addenda, and this Agreement, hereto annexed and made a part hereof, and hereinafter collectively referred to as "Contract Documents". SECOND: In Consideration of the Contractor performing this Contract in the manner herein stated and as stated in the Contract Documents, the Owner promises and agrees to pay or cause to be paid to the Contractor the sums of money mentioned in said Contract Documents in the manner and under the conditions therein provided. THIRD: The Contractor covenants and agrees that, anything in this Contract or in the Contract Documents to be contrary notwithstanding, or regardless of any matter, thing, contingency of condition unforeseen or otherwise, present or future, the Contractor shall not be entitled to receive any additional or further sums of money than the amounts in said Contract Documents provided; and the failure of the Owner or its agents to insist upon strict performance of any of the terms, covenants, agreements, provisions or conditions in this Agreement or in the Contract Documents, on any one or more instances, shall not be construed as a waiver or relinquishment for the future of any such terms, covenants, agreements, provisions and conditions and the same shall be and remain in full force and effect with power and authority on the part of the Owner to enforce the same or cause the same to be enforced at any time, without prejudize to any other rights which the Owner may have against the Contactor under this Agreement or the Contract Documents. A-1 Neither Owner nor Contractor shall, without the prior written consent of the other, assign or sublet in whole or part his interest under any of the Contact Documents; and, specifically, Contractor shall not assign any monies due or to become due without the prior written consent of the Owner. Owner and Contractor each binds himself, his partners, successors, assigns and legal representatives of the other party hereto in respect to all covenants, agreements and obligations contained in the Contract Documents. The Contract Documents constitute the entire agreement between Owner and Contractor and may only be altered, amended or repealed by a duly executed written instrument signed by both parties. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. Total Bid Dollars Written in Words Written in Figures TOWN OF SOUTHOLD CONTRACTOR BY BY Scott A.Russell, Supervisor TITLE BY William Duffy,Town Attorney (CORPORATE SEAL) A-2 ACKNOWLEDGMENT STATE OF NEW YORK, COUNTY OF ) ss.: On the day of in the year 2015 before me, the undersigned, personally appeared, , personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. NOTARY PUBLIC STATE OF NEW YORK, COUNTY OF )ss.: On the day of in the year 2015 before me, the undersigned, personally appeared, , personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. NOTARY PUBLIC A-3 ACCPREY CERTIFICATE OF LIABILITY INSURANCE DATE (M/201YYYY) 05119!2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone. (631)298-4700 Fax (631)298-3850 CONTACT Elizabeth Coleman NAME, ROY H REEVE AGENCY,INC. PHONE PO BOX 54 (AIC.No Ea) (631)298-4700 FAX Nal (631)298-3850 E-MAIL 13400 MAIN ROAD ADDRESS, MATTITUCK NY 11952 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A Gen Cas Co.of Wis(0310761) 24414 INSURED - LATHAM SAND&GRAVEL INC INSURER B Gen Cas Co.of Wis(0310761) 24414 P.O.BOX 608 _INSURER C PECONIC NY 11958 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 58789 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ILIRNSR— TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS —P BIM/ODPYYYyI IMM/DD/YYYY) B X COMMERCIAL GENERAL LIABILITY CCI0397011 05/15/15 05/15/16 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE I X OCCUR DAMAGE TO RENTED PREMISES(Ea occurence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 4,000,000 PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS ^ AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (per accldenl) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE 5 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE I i E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A E L DISEASE-EA EMPLOYEE $ (Mandatory n NH) If yes,descnbe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 10-I,Additional Remarks Schedule,may be attached it more space is required) Town of Southold is included as an additional insured with respect to General Liability as per the terms and conditions of form CG81051205-Contractors Blanket Additional Insured Endorsement-New York as required by written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 53095 Main Road ACCORDANCE WITH THE POLICY PROVISIONS Southold,NY 11971 AUTHORIZED REPRESENTATIVE -'---------CCWAtip3 A.-sarlitt,-.--_,.._ Attention: Thomas A.Dickerson ACORD 25(2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of AGORD faWs sl New York State Insurance Fund Workers'Compensation&Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 Phone (631)756-4300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 112503744 LATHAM SAND&GRAVEL INC PO BOX 608 PECONIC NY 11958 POLICYHOLDER CERTIFICATE HOLDER LATHAM SAND&GRAVEL INC TOWN OF SOUTHOLD PO BOX 608 53095 MAIN ROAD PECONIC NY 11958 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE 1553 671-9 975992 03/15/2015 TO 03/15/2016 8/31/2015 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 553 671-9 UNTIL 03/15/2016, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS COMPENSATION UNDER THE NEW YORK WORKERS COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELLED,OR CHANGED PRIOR TO 03/15/2016 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITHTHIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND Vikx....H.mk-H4tae--- DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https//www.nysif.com/cert/certval.asp or by calling(888)875-5790 VALIDATION NUMBER 775648567 U-26.3 Client#:55186 EASTCOAI0 ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)9/01/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMECONTACT Cook Maran&Associates Southampton Commercial PHONE (A/C,No,Ext) 631 390-9700 FAx (A/C,No) 631 390-9790 Cook Maran&Associates UDAF1ss. certificates@cookmaran.com 300 Hampton Road INSURER(S)AFFORDING COVERAGE NAIC# Southampton, NY 11968 INSURER A Phoenix Insurance Company 25623 INSURED INSURER B Travelers Indemnity Company 25658 East Coast Mines&Materials Corp. Route 2 Lewis Road INSURER C 41 Lewis Road INSURER D East Quogue,NY 11942 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTRINSR WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) A GENERAL LIABILITY Y630347X1085PHX14 10/28/2014 10/28/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES RENTED occurrence) $100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 7 POLICY PRO- JECT B AUTOMOBILE LIABILITY Y1 N810585K2133IND1 10/28/201410/28/2015EOaocldDqINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) B x UMBRELLA LIAB X OCCUR ZUP11T5479214NF 10/28/2014 10/28/2015 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED X RETENTION$10000 $ A WORKERS COMPENSATION UB7651M985PHX14 11/01/2014 11/01/2015 X TORYLIMITS ETH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y N E L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) **Supplemental Name** East Coast Mines&Materials Corp. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 Route 25 PO Box 1179 ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED� R EPREE S E N TATV I E 40r � ,� �CLkl. A.d. ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #5826508/M826507 SR4