07.0 - Bid form.pdf

BID FORM PAGE 1 OF 4

TO:

Kelly McDermott, President & CEO

New Samaritan Corp.

127 Washington Avenue, Fifth Floor East

North Haven, CT 06473

Project: LEVEL 2 ALTERATIONS FOR THE WILLIAM H. WARNER VILLAGE

Submitted by:

(full name)

(full address)

1. OFFER

Pursuant to and in compliance with the Invitation to Bid relating thereto, the undersigned, Has familiarized himself/herself with the conditions present and carefully examined all the Documents (including the drawings and specifications dated October 26, 2026, as prepared by Quisenberry Arcari Architects, LLC), Instructions to Bidders, Supplementary

Instructions to Bidders, Bid Bond Form, Non Collusive Affidavit, Statement of Bidder’s

Construction Experience, Previous participation Certificate, Representations, Certifications and Other Statements of Bidders, form of Contract, Notice to Proceed, Performance and Payment Bond, General Conditions of the Contract for Construction, Supplemental General Conditions of the Contract for Construction, together with all

Addenda issued and received prior to closing time for receipt of Bids hereby offers and agrees as follows:

To provide all materials, all labor and all else whatsoever necessary to erect and properly finish all work in accordance with said Documents for the above mentioned project(s) to the satisfaction of the Architect and Owner for the Stipulated Sum of:

BASE BID FOR THE SUM OF:

(Indicate the dollar amount of the bid using written words)

(Indicate same amount using figures)

In the case of a discrepancy, the bid amount shown in words will prevail.

BID FORM PAGE 2 OF 4

UNIT PRICES:

Unit Prices: Unit prices include all preparatory and incidental work to provide a complete installation in full accordance with specifications.

All State of Connecticut Taxes are excluded from the Bid Sum. Contractor shall be required to obtain and pay for all Permits required as part of the Work.

Small, Minority, Women-Owned Business Concern Representation

The bidder represents and certifies as part of its bid / offer that it –

(a) ( ) is, ( ) is not a small business concern. “Small business concern” as used in this provision, means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding, and qualified as a small business under the criteria and size standards in 13 CFR 121.

(b) ( ) is, ( ) is not a women owned business. “Women-owned business enterprise,” as used in this provision, means a business that is atleast 51 percent owned by a woman or women who are

U.S. citizens and who also control and operate the business.

(c) ( ) is, ( ) is not a minority business enterprise. “Minority business enterprise,” as used in this provision, means a business which is at least 51 percent owned or controlled by one or more minority group members or, in the case of a publicly owned business, at least 51 percent of its voting stock is owned by one or more minority group members, and whose management and daily operations are controlled by one or more such individuals. For purpose of this definition, minority group members are:

(check the block applicable to you)

( ) Black Americans ( ) Asian Pacific Americans ( ) Hispanic Americans

( ) Asian Indian Americans ( ) Native Americans ( ) Hasidic Jewish Americans

BID FORM PAGE 3 OF 4

(d) ( ) is, ( ) is not a bonafide Section 3 Company, and that it meets ( ), does not meet ( ) the following definition of a Section 3 Business:

1. 51% or more of the ownership of this company is owned by Section 3 residents, as defined by HUD.

2. Currently, at least 30% of the employees of the company are Section 3 residents, as defined by HUD.

3. At least 30% of the employees of the company were Section 3 residents, as defined by HUD, within three years of the date of first employment with this company.

4. I commit to subcontract at least 25% of the total value of this contract to Section 3 subcontractors, as these companies are defined above, and to provide the necessary evidence to substantiate this, prior to award of the contract.

The apparent low bidder will be required to submit documentation from a Certified Agency for any of designations noted in the affirmative above prior to the award of the contract.

The Contract Award shall be made on available funds; The New Samaritan Corp. / Elderly Housing

Management, Inc.reserves the right to add/deduct work based on the availability of funds.

2. ACCEPTANCE

This offer shall be open to acceptance for sixty ( 90 ) days from the bid opening date.

If this Bid is accepted by the Owner within the time period stated above, undersigned will:

Execute this Agreement within ten days of receipt of acceptance of this Bid.

Furnish the required bonds(s) within ten days of receipt of acceptance of this Bid.

Commence work within seven days after written Notice to Proceed.

If this bid is accepted within the time state, and the Undersigned fails to provide the required Bond(s), the Owner may charge against the Undersigned the difference between the amount of this bid and the amount for which a contract for the work is subsequently executed, irrespective of whether the amount thus due exceeds the amount of the bid guaranty.

In the event this Bid is not accepted within the time stated above, the required security deposit shall be returned to the undersigned, in accordance with the provisions of the

Instructions to Bidders; unless a mutually satisfactory arrangement is made for its retention and validity for an extended period of time.

BID FORM PAGE 4 OF 4

3. CONTRACT TIME

If this Bid is accepted, the Undersigned will Complete all the work within 365 calendar days from Notice to Proceed. It is additionally understood that liquidated damages, in the amount of $500.00 per day, will be assessed for failure to complete the project within the above time period as described in the General Conditions.

4. CHANGES TO THE WORK

Equitable adjustments for Changes in the Work will be net cost plus a percentage fee in accordance with AIA A201 General Conditions and Supplementary General Conditions.

5. ADDENDA

The following Addenda have been received. The modifications to the Bid Documents noted therein have been considered and all costs thereto are included in the Base Bid.

Addenda # , ,

6. BID FORM SIGNATURE (S)

The Corporate Seal

(Bidder – please print the full name of your Proprietorship, Partnership, or Corporation)

Was hereunto affixed in the presence of:

(Authorized signing officer) (Title)

Contact Information

Contact:

Phone: Email:

END OF BID FORM