1-96 - Contractor Bid for Public Work (Jan 26).pdf

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Attached to
Switchboard/Generator Replacement Project at JMF Education Center
Solicitation number
RFB-27-004
Issued by
Marion County, Indiana

About this file

This is a Contractor's Bid for Public Work form (State Form 52414, Form 96, Revised 2026) prescribed by the Indiana State Board of Accounts for use by Indianapolis Public Schools for the Switchboard/Generator Replacement Project at the JMF Education Center in Indianapolis, Indiana. The form serves as the standardized bidding document for this public works construction project and requires bidders to submit their proposals in accordance with the plans and specifications prepared for the project. For projects valued at $300,000 or more, bidders must complete comprehensive sections including an experience questionnaire detailing public works projects completed within the prior year and those currently under construction, a plan and equipment questionnaire describing the bidder's construction approach and timeline, and a contractor's financial statement demonstrating capability to complete the project if awarded.

The bid submission requires bidders to include a bond or certified check as specified in the notice of letting and must be accompanied by mandatory documentation including a contractor's financial statement, a non-collusion affidavit affirmed under penalties of perjury, and notarized acknowledgement. Bidders must also provide detailed information regarding all subcontractors used during the past five years, equipment available for the project, and certification of intent to use United States steel products as required by Indiana Code 5-16-8-2. The form includes provisions for alternative bids and unit-basis pricing if applicable, with all submissions subject to equal employment opportunity requirements prohibiting discrimination based on race, religion, color, sex, national origin, or ancestry.

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CONTRACTOR'S BID FOR PUBLIC WORK - FORM 96

State Form 52414 (R5 / 01-26) / Form 96 (Revised 2026) Prescribed by State Board of Accounts

PART I

(To be completed for all bids. Please type or print)

Date (month, day, year): _

1. Governmental Unit (Owner):

2. County:

3. Bidder (Firm):

Address:

City/State/ZIP code:

4. Telephone Number:

5. Agent of Bidder (if applicable):

Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of

(Governmental Unit) in accordance with plans and specifications prepared by _ and dated for the sum of

The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page.

If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the governmental unit. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment.

The contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant may be regarded as a material breach of the contract.

OATH AND AFFIRMATION

I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION

CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT.

Dated at this day of

(Name of Organization)

By

(Title of Person Signing)

ACKNOWLEDGEMENT

STATE OF �

) ss

COUNTY OF )

Before me, a Notary Public, personally appeared the above-named and swore that the statements contained in the foregoing document are true and correct.

Subscribed and sworn to before me this day of .

Notary Public

My Commission Expires:

County of Residence:

CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS

(If applicable)

I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation to use steel products made in the United States (1.C. 5-16-8-2). I hereby certify that I and all subcontractors employed by me for this project will use U.S. steel products on this project if awarded. I understand that violations hereunder may result in forfeiture of contractual payments.

ACCEPTANCE

The above bid is accepted this day of ,subject to the following conditions:

Contracting Authority Members:

PART II

(For projects of $300,000 or more- IC 36-1-12-4)

Governmental Unit:

Bidder (Firm)

Date (month, day, year):

These statements to be submitted under oath by each bidder with and as a part of his bid.

Attach additional pages for each section as needed.

SECTION A: EXPERIENCE QUESTIONNAIRE

1. What public works projects has your organization completed for the period of one (1) year prior to the date of the current bid?

Contract Amount Class of Work Completion

Date Name and Address of Owner

2. What public works projects are now in process of construction by your organization?

Contract Amount Class of Work Expected

Completion Date

Name and Address of Owner

3. Have you ever failed to complete any work awarded to you? If so, where and why?

4. List references from private firms for which you have performed work.

SECTION B: PLAN AND EQUIPMENT QUESTIONNAIRE

1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.)

2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor.

3. If you intend to sublet any portion of the work, state the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the governmental unit in the event that you subsequently determine that you will use a subcontractor on the proposed project.

4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit.

5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, please explain the rationale used which would corroborate the prices listed.

SECTION C: CONTRACTOR'S FINANCIAL STATEMENT

Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded.

SECTION D: CONTRACTOR'S NON - COLLUSION AFFIDAVIT

The undersigned bidder or agent, being duly sworn on oath, says that he has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to include anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding.

He further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale.

SECTION E: OATH AND AFFIRMATION

I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION

CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT.

Dated at this day of

(Name of Organization)

By

(Title of Person Signing)

ACKNOWLEDGEMENT

STATE OF �

) ss

COUNTY OF )

Before me, a Notary Public, personally appeared the above-named and swore that the statements contained in the foregoing document are true and correct.

Subscribed and sworn to before me this day of .

Notary Public

My Commission Expires:

County of Residence:

Part of State Form 52414 (R2 / 2-13) / Form 96 (Revised 2013)

BID OF

(Contractor)

(Address)

FOR

PUBLIC WORKS PROJECTS

OF

Filed , Action taken

Date month day year:
1 Governmental Unit Owner:
2 County:
3 Bidder Firm:
Address:
CityStateZIP code:
4 Telephone Number:
5 Agent of Bidder if applicable:
the public works project of:
Governmental Unit in accordance with plans and specifications prepared by 1:
Governmental Unit in accordance with plans and specifications prepared by 2:
and dated:
undefined:
Dated at:
this:
day of:
Name of Organization:
By 1:
COUNTY OF:
Before me a Notary Public personally appeared the abovenamed:
Subscribed and sworn to before me this:
My Commission Expires:
County of Residence 1:
County of Residence 2:
day of_2:
Notary Public:
day of_3:
subject to the:
The above bid is accepted this:
following conditions:
Contracting Authority Members 1:
Contracting Authority Members 2:
Contracting Authority Members 3:
1:
2:
3:
Date month day year_2:
Contract AmountRow1:
Class of WorkRow1:
Completion DateRow1:
Name and Address of OwnerRow1:
Contract AmountRow2:
Class of WorkRow2:
Completion DateRow2:
Name and Address of OwnerRow2:
Contract AmountRow3:
Class of WorkRow3:
Completion DateRow3:
Name and Address of OwnerRow3:
Contract AmountRow4:
Class of WorkRow4:
Completion DateRow4:
Name and Address of OwnerRow4:
Contract AmountRow1_2:
Class of WorkRow1_2:
Expected Completion DateRow1:
Name and Address of OwnerRow1_2:
Contract AmountRow2_2:
Class of WorkRow2_2:
Expected Completion DateRow2:
Name and Address of OwnerRow2_2:
Contract AmountRow3_2:
Class of WorkRow3_2:
Expected Completion DateRow3:
Name and Address of OwnerRow3_2:
Contract AmountRow4_2:
Class of WorkRow4_2:
Expected Completion DateRow4:
Name and Address of OwnerRow4_2:
Have you ever failed to complete any work awarded to you 1:
Have you ever failed to complete any work awarded to you 2:
Have you ever failed to complete any work awarded to you 3:
List references from private firms for which you have performed work 1:
List references from private firms for which you have performed work 2:
List references from private firms for which you have performed work 3:
List references from private firms for which you have performed work 4:
List references from private firms for which you have performed work 5:
believe would enable the governmental unit to consider your bid 1:
believe would enable the governmental unit to consider your bid 2:
believe would enable the governmental unit to consider your bid 3:
believe would enable the governmental unit to consider your bid 4:
believe would enable the governmental unit to consider your bid 5:
years along with a brief description of the work done by each subcontractor 1:
years along with a brief description of the work done by each subcontractor 2:
years along with a brief description of the work done by each subcontractor 3:
years along with a brief description of the work done by each subcontractor 4:
the event that you subsequently determine that you will use a subcontractor on the proposed project 1:
the event that you subsequently determine that you will use a subcontractor on the proposed project 2:
the event that you subsequently determine that you will use a subcontractor on the proposed project 3:
the event that you subsequently determine that you will use a subcontractor on the proposed project 4:
the event that you subsequently determine that you will use a subcontractor on the proposed project 5:
subcontractors may also be required to be listed by the governmental unit 1:
subcontractors may also be required to be listed by the governmental unit 2:
subcontractors may also be required to be listed by the governmental unit 3:
subcontractors may also be required to be listed by the governmental unit 4:
subcontractors may also be required to be listed by the governmental unit 5:
1_2:
2_2:
3_2:
4:
5:
CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT:
day of_4:
undefined_3:
this_2:
Name of Organization_2:
By:
COUNTY OF_2:
Before me a Notary Public personally appeared the abovenamed_2:
Subscribed and sworn to before me this_2:
My Commission Expires_2:
County of Residence:
day of_5:
Notary Public_2:
Contractor:
Address_2:
FOR:
OF 1:
OF 2:
OF 3:
undefined_4:
undefined_5:
undefined_6:
sum:
Text2:
State:
Governmental Unit:
Bidder (Firm):
Yes/No:
State of:
1_3:
Reset Form:

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