Hudsonville Filter First - CM MANUAL (1).pdf

HUDSONVILLE PUBLIC SCHOOLS

DISTRICT WIDE FILTER FIRST

CONSTRUCTION MANAGER’S

PROJECT MANUAL

February 18, 2025

Construction Manager:

Owen-Ames-Kimball Co.

126 Ottawa Ave NW, Suite 600

Grand Rapids, MI 49503

616.456.1521

Send RFIs and Substitution Requests to: Megan Wilson, meganw@oakmi.com

Hudsonville Public Schools, District Wide Filter First www.owen-ames-kimball.com

Construction Management Project Manual Index

Bidding Requirements

Advertisement for Bids

Instruction to Bidders

Statement of Participation

Certificate of Insurance and Endorsement

Bid Form

Familial Disclosure Statement, Affidavit of Compliance

Safety Data Questionnaire

General Conditions

Specifications

Project Scope List

Preliminary Construction Schedule

Subcontractors should begin work as soon as possible. Work is to be completed August 2025.

Subcontractor Submittal Form

Referenced Documents Available for Online Viewing

AIA A132 – 2009 – Standard Form of Agreement Between Owner and Contractor:

https://tinyurl.com/yckmwphe

Owen-Ames-Kimball Co. Safety Manual:

https://tinyurl.com/34zxyj49

ADVERTISEMENT FOR BIDS

BID PROPOSAL

Sealed bids, in triplicate, for the District Wide Filter First, Hudsonville Public Schools, will be received until 2:00PM local time, Thursday, March 13, 2025, at 3886 Van Buren St, Hudsonville, MI 49426. Bids received after this time will neither be considered nor accepted.

All proposals received by the time and date stated above will be opened and read publicly at 2:00PM local time, Thursday, March 13, 2025, at Hudsonville Public Schools Administration Building, 3886 Van Buren St, Hudsonville, MI

49426. You may attend in person.

Bids may be mailed to Hudsonville Public Schools Administration Building, 3886 Van Buren St, Hudsonville, MI 49426.

Mailed bids must be received prior to the bid due time and date stated above. FAXED, EMAILED OR UPLOADED TO

BUILDING CONNECTED BIDS WILL NOT BE ACCEPTED.

In accordance with Section 1267 of the Revised School Code each bid must be accompanied by a sworn and notarized Familial Disclosure Statement completed by the bidder disclosing any familial relationship between the

Owner or any employee of the Bidder and any member of the District’s Board of Education or the Superintendent of the District.

SITE INSPECTION

A construction pre-bid meeting will be held virtually (https://us06web.zoom.us/j/88490242410) at, 2:00PM local time, Wednesday, February 26, 2025. All bidders are encouraged to attend.

BID DOCUMENTS

The Bidding Documents may be examined at the following locations:

• Owen-Ames-Kimball Co. Website: http://www.owen-ames-kimball.com/subcontractors/

• Builders Exchange plan rooms in Grand Rapids, Kalamazoo, Lansing and Traverse City.

BIDDER QUALIFICATIONS

Bidders submitting a Bid for this Project shall have qualifications as follows:

a. Shall be a reputable, recognized organization, with at least five (5) years successful experience on work of this type and scope of this project.

b. Shall have a license where required by public authorities having jurisdiction.

c. Shall have ample financial resources for work of this magnitude.

BID SECURITY - PERFORMANCE BONDS

Each bid shall be accompanied by good and sufficient bid security or bid bond in an amount not less than 5% of the

Bid amount and shall secure the Owner from loss or damage by reason of the withdrawal of the Bid by a Bidder or by failure of the successful Bidder to enter into a Contract with the Owner if his Bid is accepted by the Owner.

Bid securities will not be released or returned until the bid “hold-firm” date or a subcontract has been successfully executed for the specific bid category of work, whichever occurs first.

Bid security may be provided by furnishing a bond from a surety company having a rating of A- or better or certified check. Owen-Ames-Kimball is not responsible for the loss of bid security if provided by certified check.

The successful Bidder will be required to secure Performance, Labor and Material bonds for all contracts exceeding

$50,000, from a surety company having a rating of A- or better, for the full amount of the Contract.

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SUPPLEMENT TO INSTRUCTIONS TO BIDDERS

STANDARD AIA FORMS

The Instructions to Bidders (AIA Document A701-2018 Edition), Articles 1 through 8, and as herein amended or added to, are a part of the Contract Documents, and shall apply to all Contractors, and/or Subcontractors.

ARTICLE 1 – DEFINITIONS Add Subparagraph 1.10 as follows:

1.10 All references made to Owner shall be implied to refer to the Construction Manager.

ARTICLE 3 – BIDDING DOCUMENTS

3.1 Distribution Add Subparagraph 3.1.6 as follows:

3.2 MODIFICATION OR INTERPRETATION OF BIDDING DOCUMENTS Revise Subparagraph 3.2.2. as follows:

Line 2 shall read “…ten days…”

ARTICLE 4 – BIDDING PROCEDURES

4.1 PREPARATION OF BIDS Revise Subparagraph 4.1.1. and Add Subparagraph 4.1.6.1, 4.1.9 and 4.1.10 as follows:

Bids shall be submitted, in triplicate, on the Bid Proposal Form included within the bidding Documents.

4.1.6.1 Proposals will be accepted for one (1) Bid Category only, or a combination of two (2) or more Categories. If the Bidders wish to have their combined bid considered for separate categories, they must submit separate proposals for the individual category along with their combined bid proposal.

4.1.9 A Pre-Bid Conference will be held in accordance with the following schedule:

Date: February 26, 2025

Place: https://us06web.zoom.us/j/88490242410

Time: 2:00PM local time

4.1.10 In accordance with Section 1267 of the Revised School Code each bid must be accompanied by a sworn and notarized Familial Disclosure Statement completed by the bidder disclosing any familial relationship between the Owner or any employee of the Bidder and any member of the District’s Board of Education or the

Superintendent of the District.

4.2 BID SECURITY Add Subparagraphs 4.2.1.1, 4.2.1.2 and Revise Subparagraph 4.2.3 as follows:

4.2.1.1 Bid security shall be required for each bid tendered.

4.2.1.2 Bid security shall be in the form of either a CERTIFIED or CASHIER’S CHECK on an open and solvent bank or bid bond issued by surety company payable to the Owner in an amount equal to five percent (5%) of the base bid.

4.2.3 Revise Lines 1 and 2 to read “If a surety bond is provided the attorney-in-fact who …”.

4.3 ADDENDA Revise Subparagraph 4.3.3 as follows:

4.3.3 Addenda will be issued no later than two days prior to the date for receipt of Bids except an Addendum withdrawing the request for Bids or one which includes postponement of the date for receipt of Bids.

4.4 MODIFICATION OR WITHDRAWAL OF BIDS Revise Subparagraph 4.4.3 as follows:

4.4.3 After the time and date of receipt of Bids, a bid may not be modified, withdrawn or cancelled by the Bidder for sixty (60) days.

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ARTICLE 5 – CONSIDERATION OF BIDS

5.3 ACCEPTANCE OF BID (AWARD) Revise Subparagraph 5.3.2 and add Subparagraph 5.3.4 as follows:

5.3.2 Revise Line 1 to read “…right to accept Mandatory and Voluntary Alternates in any order…”

5.3.3 Owner reserves the right determine which bidders are considered the lowest qualified bidder and to award to said bidder.

5.3.4 After the Owner has awarded the Bid Categories the Construction Manager will prepare and send a Notice of

Pending Award to the successful Bidders.

ARTICLE 6 – POST-BID INFORMATION

6.1 CONTRACTOR’S QUALIFICATION STATEMENT Revise Subparagraph 6.1 as follows:

The Owner, Architect and Construction Manager may make such investigations as they deem necessary to determine the ability of the Bidder to perform the work. The Bidder shall furnish all such information and data for this purpose as the Construction Manager may request within twenty-four (24) hours, including, but not limited to, lists of projects completed, financial statements for the past two (2) years, a current list of work in progress. The Owner reserves the right, based on the advice of the Construction Manager and

Architect, to reject any bid if the evidence submitted, or investigation of such Bidder, fails to prove that such

Bidder is properly qualified to carry out the obligations of the contract and to complete the work contemplated therein.

6.3 SUBMITTALS Revise Subparagraph 6.3.1, replace Subparagraphs 6.3.1.1 thru 6.3.1.3 and add

Subparagraphs 6.3.1.4 thru 6.3.1.6 as follows:

6.3.1 The Bidder shall within ten (10) days upon issuance of a Notice of Pending Award furnish to the Owner through the Construction Manager the following:

6.3.1.1 The necessary insurance forms as specified in the Bidding Documents.

6.3.1.2 A cost breakdown on the continuation sheets of the “Application and Certificate for Payment”, AIA

Document G703 showing all major work items, separated by both material and labor.

6.3.1.3 A list of the work which will be performed with the Bidder’s own forces, a list of their subcontractors and a list of work that will be performed by the subcontractor’s forces.

6.3.1.4 Names of the manufacturer’s, products and suppliers of principle items, materials or systems proposed for the work.

6.3.1.5 Schedule information.

6.3.1.6 The Bidder will be notified in writing if any of the above items are not acceptable.

ARTICLE 7 – PERFORMANCE BOND AND PAYMENT BOND

7.1 BOND REQUIREMENTS Revise Subparagraph 7.1.1 as follows and Delete Subparagraph 7.1.3

7.1.1 For Contracts exceeding $50,000 the Bidder shall furnish separate Performance and Payment Bonds covering the faithful performance of the Contract and the payment of all obligations arising thereunder in an acceptable form to the Owner and the Construction Manager. Such bonds can be secured through the

Bidder’s usual sources provided that they fulfill requirements specified elsewhere in these Documents. The cost of such bonds shall be paid for by the Bidder. A space has been provided on the Proposal Form for the

Bidder to identify the amount that shall be added to their proposal should the bonds be required. Should they be required the Bidder shall deliver the bonds to the Construction Manager not later than the date of execution of the Contract.

7.2 TIME OF DELIVERY AND FORM OF BONDS Delete Subparagraph 7.2.2

ARTICLE 8 – ENUMERARTION OF THE PROPOSED CONTRACT DOCUMENTS

8.1 Revise sentence to read: Copies of the proposed Contract Documents will be made available to the Awarded

Bidder as modified and would include but not limited to the following documents as issued by the Construction

Manager.

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ARTICLE 9 – INSURANCE

9.1 INSURANCE REQUIREMENTS The required insurance will name Owen-Ames-Kimball Co., Owner and

Architect, along with their respective officers, agents and employees are named as additional insureds for the auto liability and general liability on a primary and non-contributory basis for ongoing and completed operations. The ONLY acceptable endorsement for the additional insureds requirements is ISO form CG 20

37 07 04.

9.1.1 Commercial General Liability – ISO Occurrence form CG 20 10 07 04 and CG 20 37 07 04 are the required forms.

ARTICLE 10 – DESCRIPTION OF WORK Add paragraph 10.1 and 10.2

10.1 BID CATEGORIES Add Subparagraphs 10.1.1, 10.1.1.1., 10.1.1.2, 10.1.1.3 as follows:

10.1.1 Bid Categories have been established to guide Bidders in determining scope of work where trade jurisdiction is not clearly defined. These descriptions are not meant to be all inclusive of work to be included in the Bid.

If a conflict in the assignment of work exists between the Bidding Documents and the descriptions of these bid categories, the requirements of the bid category description(s) shall take precedence and the

Construction Manager shall immediately be notified of the conflict. Bidders are to familiarize themselves with all Bid Categories.

10.1.1.1 Requirements for a specific Bid Category, trade or contract will generally be described in that portion of the

Specifications or Drawings related to that trade or contract. Such requirements may, however, be described in other sections of the contract documents. Contractors will be held responsible for having carefully examined all drawings and read all divisions of the specifications and all contract documents to avoid omissions or duplications and to ensure a complete job.

10.1.1.2 There is not necessarily a direct relationship between the Bid Category numbers or names and the

Specification Division or Section numbers.

10.1.1.3 Unless specifically noted as being furnished only, scopes include the complete installation including materials, labor, equipment, interface with the work of other trades, etc.

10.2 INDEX OF BID CATEGORIES Add paragraph 10.2

Bid Category No. 01 - Mechanical/Plumbing

10.3 BID CATEGORY DESCRIPTIONS Add paragraph 10.3

Bid Categories have been established to guide Bidders in determining scope of work where trade jurisdiction is not clearly defined. These descriptions are not meant to be all inclusive of work to be included in Bid.

Unless specifically noted as being furnished only or install only, scope includes complete installation including all labor, material, equipment, etc.

Bidders are required to familiarize themselves with all Bid Categories and Alternates.

BID CATEGORY NO. 01 - MECHANICAL/PLUMBING

Include:

1. Complete plumbing, mechanical and Filter First work as required per the Clean Drinking Water Access Act, 2023

PA 154, and amendments to the Child Care Organizations Act, 1973 PA 116, also known as Filter First, in the locations listed on the Project Scope List.

2. Take field measurements, onsite surveys and inspections required for the ordering and/or installations of items provided under their scope of work.

3. Fire resistant joint sealers for all mechanically associated penetrations.

4. Provide barricades for your work.

5. Applicable fees, permits, inspections, etc. as required for the completion of the work in this bid category.

Hudsonville Public Schools, District Wide Filter First - Page 4 of 8

GENERAL COMMENTS

Support for Building Systems/Components:

1. Any component of the building construction that requires support and/or blocking that is not shown in the

Documents shall be provided by the contractor that is responsible for the installation of the component.

Demolition:

1. Dumpsters provided by the Construction Manager for use during construction shall not be available for the disposal of the following items: debris resulting from architectural, structural, mechanical, or electrical demolition operations; site related materials; paint products, hazardous materials. Contractors generating such materials shall provide dumpsters for them and legally dispose of them off site.

2. Unless specifically noted otherwise the division of demolition work shall be as follows: sitework contractor – site demolition; general trades contractor – architectural and structural demolition; mechanical/plumbing contractor –

HVAC and plumbing demolition; fire protection contractor – fire protection demolition; electrical contractor – electrical demolition.

General Safety:

1. Your Firm, all employees, subcontractors, and material suppliers onsite will comply with Owen-Ames-Kimball

Co.’s Safety Policy and Requirements, INCLUDING BUT NOT LIMITED TO THESE HIGHLIGHTED ITEMS:

a. Hard hats are required.

b. Contractor safety manuals/books will be kept on-site.

c. Contractors must provide their own first aid and fire protection equipment.

d. Contractors are responsible for providing the necessary barricades for their work.

e. Contractors are responsible for their own fall protection.

f. Contractors must comply with the "Right to Know" law.

g. Contractors must comply with O.A.K.'s substance abuse policy.

h. No Smoking, Tobacco, or E-Cigarettes on School Property.

i. A designated competent/qualified person shall be required to be on site for the following but not limited to structural demolition, scaffolding, fall protection & excavations.

j. Contractors shall furnish a written job specific Silica Exposure Plan per MiOSHA requirements.

k. Contractors required to work in a masonry restricted zone must have proper training.

2. Owen-Ames-Kimball Co. Safety Manual can be viewed in its entirety here:

https://tinyurl.com/34zxyj49

End of Instruction Bidders

Hudsonville Public Schools, District Wide Filter First - Page 5 of 8

STATEMENT OF PARTICIPATION

Owen-Ames-Kimball Co. strives to recognize and represent the community in which you reside and serve through continuous efforts to encourage local participation and inclusive practices on all our construction projects.

Owen-Ames-Kimball Co. encourages local participation. We believe we have a responsibility to support the growth of the businesses within the community in which the project resides.

Owen-Ames-Kimball Co. practices inclusion. These inclusive practices are established within our organization and in our business endeavors, and strongly promoted on our jobsites. We encourage all of our subcontractors to implement inclusive practices within their organizations and through partnering efforts on our projects.

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SUBMIT IN TRIPLICATE

BID FORM

BID TO: Hudsonville Public Schools

3886 Van Buren St

Hudsonville, MI, 49426

BID FROM: _________________________________________

PROJECT: District Wide Filter First

Ladies and Gentlemen:

The undersigned, having familiarized themselves with the local conditions affecting the cost of the Work and having examined the site, and Bidding Documents, and hereby propose to furnish all labor, material, equipment, taxes and services required for the proper completion of each of the following categories for this Project, including all addenda issued thereto, for the sum of:

Bid Category No.____________ Title

Dollars ($ _ ), Said amount constituting the Base Bid.

TOTALS BY LOCATION: Base bid is split by location as follows:

South Elementary: $

Forest Grove Elementary: $

Riley Street Middle School: $

Jamestown Lower Elementary: $

Baldwin Street Middle School: $

The 5/6 Building @ Georgetown: $

Georgetown Elementary: $

Alward Elementary: $

Bauer Elementary: $

Athletic Stadium Concessions/Bathrooms: $

High School: $

Early Childhood Center: $

Park Elementary: $

Jamestown Upper Elementary: $

Food Service: $

Total $

TAXES: Bid sum includes all applicable taxes, including Michigan Sales Tax. Confirm that your company can pay Michigan Sales and Use Tax: ☐ Yes ☐ No

ALLOWANCES: Base bid includes applicable allowance cost(s) as set forth in Section 01020 of the General

Requirements and as identified in the Instruction to Bidders Bid Category Descriptions.

COST OF BONDS: Bid sum includes cost of furnishing a Performance Bond and Labor and a Material

Payment Bond, each in the amount of 100% of Base Bid.

ACKNOWLEDGEMENT OF ADDENDA

The following addenda have been received, are hereby acknowledged, and their execution is included in the above Base Bid:

Addendum No. Dated Addendum No. Dated Addendum No. Dated_________

Addendum No. Dated Addendum No. Dated Addendum No. Dated_________

BID SECURITY

Accompanying this Bid, as required by the Instructions to Bidders, is a bid security in the form of

(Certified Check/Cashier's Check/Bidder's Bond) in the amount of:

Dollars ($ _______ ), payable to the Owner, which it is agreed, shall be retained as liquidated damages, not as a penalty, by the

Owner, if the undersigned fails to execute the Contract in conformity with the form of Contract incorporated in the Contract Documents and fails to furnish specified bonds within ten (10) days after date of issuance of Letter of Intent to the undersigned.

If awarded the Contract, the undersigned agrees to commence Work within ten (10) days after date of issuance of Notice of Pending Award, which shall be considered as the notice to proceed, and agrees to complete the Work in accordance with the Construction Progress Schedule.

CONSTRUCTION PROGRESS SCHEDULE

If awarded this Contract, the undersigned:

Endorses the Construction Progress Schedule:

Amends the Construction Progress Schedule as follows:

INSURANCE AND ENDORSEMENTS REQUIREMENTS:

(Samples are attached to the Supplement to Instructions to Bidders)

Acknowledged By:___________________________________________________________________________________________

UNIT LABOR RATES

The undersigned further proposes and agrees that should the amount of work required be increased or decreased where unit prices have not been established, the following labor rates will be the basis for any change order proposal. Labor rates are to include all direct costs without mark-up as defined in Article 7.3 of the General Conditions. Prior to contract award, if requested by the Construction Manager, the successful bidder shall provide documentation substantiating the proposed labor rates.

FEES FOR ADDITIONAL WORK

1. There will be a fee of 10% applied to the total cost of materials purchased and work completed by a contractor’s own forces. This percentage represents both overhead and profit.

2. There will be a fee of 5% applied to the total cost of work completed by a subcontractor. This percentage represents both overhead and profit.

CREDIT FOR WORK DELETED

Should any work be deleted from Contract by order of the Owner, full cost savings realized thereby will be credited to Owner.

FAMILIAL DISCLOSURE

See Page 5 of this Bid Form for required statement.

AFFIDAVIT OF COMPLIANCE

See Page 6 of this Bid Form for required statement.

SAFETY SUPPLEMENT FORM

The apparent low bidder(s) will be required to complete this form and submit to the project manager no later than (3) days after the bid opening or at the time of the post bid interview. Based on the information supplied

Owen-Ames-Kimball Co. may require further safety measures at no additional cost prior to award if warranted.

AGREEMENT

The undersigned agree(s) to provide the post-bid information required within (10) days after notification of

Job Hourly Benefits Employer's Payroll Total

Classification Rate Liability Taxes the Notice of Award and to execute an agreement for work covered by this Proposal on AIA Document

A132-2019, Standard Form of Agreement Between Owner and Contractor Where the Basis of Payment is a Stipulated Sum.

In submitting this bid, it is understood that the Owner reserves the right to reject any or all bids. It is further agreed that this bid is binding for a period of sixty (60) days from the opening thereof.

Respectfully submitted, Date , 2025

Firm Name

By

Signed

Title

Official Address

(If a corporation, affix seal)

Telephone No. ( ) ext. ___

E-Mail Address

Contact Information if there are questions about bid:

Name:_____________________________________________

Direct or Mobile Phone:__________________________

E-Mail:____________________________________________

Familial Disclosure Statement

(Must be completed for bid to be considered)

In accordance with Section 1267 of the Revised School Code this bid must be accompanied by a sworn and notarized statement disclosing any familial relationship between the Owner or any employee of the

Bidder and any member of the District’s Board of Education or Superintendent of the District.

___ No, there is not a familial relationship between the Owner or any employee of the Bidder and any member of the District’s Board of Education or Superintendent of the District.

___ Yes, there is a familial relationship between the Owner or an employee of the Bidder and a member of the District’s Board of Education or Superintendent of the District. The person(s) and relationship are as follows:

Owner/Employee Name BOE member or Superintendent Name Familial Relationship

Contractor: _________________________________________________________________________________________________

(Name of Contractor)

By: _______________________________________________________________

Title: _______________________________________________________________

Date: _______________________________________________________________

County of: _______________________________________ State of: _______________________________________

This instrument was acknowledged before me on the ____________day of ____________________________, 2025, by,_________________________________________________________________________________, Notary Public

__________________________________________ County, ________________________________.

My Commission Expires: ____________________________________________

Acting in the County of: ____________________________________________

Affidavit of Compliance – Iran Economics Sanctions Act

(Must be completed for bid to be considered)

Michigan Public Act No. 517 of 2012

The undersigned, the owner or authorized office of the below-named contractor (the “Contractor”), pursuant to the compliance certification requirement provided in the Hudsonville Public Schools (“the

School District”) Request for Proposals For District Wide Filter First (“the RFP”), hereby certifies, represents and warrants that the Contractor (including its officers, directors, employees) is not an “Iran linked business” within the meaning of the Iran Economics Sanctions Act, Michigan Public Act No.517 of 2012

(“the Act”), and that in the event Contractor will not become an “Iran linked business” at any time during the course of performing any services under this contract.

The Contractor further acknowledges that any person who is found to have submitted a false certification is responsible for a civil penalty of not more than $250,000.00 or 2 times the amount of the contract or proposed contract for which the false certification was made, whichever is greater, the cost of the School

District’s Investigation, and reasonable attorney fees, in addition to the fine. Moreover, any person who submitted a false certification shall be ineligible to bid on a request for proposal for three (3) years form the date determined that the person had submitted the false certification.

Contractor:

(Name of Contractor)

By: _______________________________________________________________

Title: _______________________________________________________________

Date: _______________________________________________________________

County of: _______________________________________ State of: _______________________________________

This instrument was acknowledged before me on the ____________day of ____________________________, 2025, by,_________________________________________________________________________________, Notary Public

__________________________________________ County, ________________________________.

My Commission Expires: ____________________________________________

Acting in the County of: ____________________________________________

Safety Data Questionnaire Supplement to Bid Form

The Safety data listed below shall be submitted no later than three (3) days after the bid opening by the apparent low bidder, or as requested by O-A-K for evaluation. Further documentation may be requested as a part of the evaluation process. Information specified below must be current and accurate.

COMPANY INFORMATION

Company Name:

Company Type:

Address:

City: State: Zip:

Name of your Safety and Health Officer responsible for this project:

Safety Accreditations:

Length of experience in this role:

Safety and Health Officer E-mail:

Safety and Health Officer Phone:

Does your company have a written procedure to ensure that adequate safety and health program resources, such as budget, equipment, training, and manpower are included in your bid?

YES □ NO □

Does your company have a written construction safety program? YES □ NO □

I acknowledge that my company will provide a written Site-Specific safety plan? YES □ NO □

Does your company have a written Accident/Incident Investigation Procedure? YES □ NO □

Does your company provide training and proper equipment for fall protection as required by MIOSHA?

Does your company have a safety training program? YES □ NO □

What mandatory training topics have been covered in the past year?

What percent of your company’s employees have OSHA Training Certification? _______ %

Does your company have a written drug and alcohol-free workplace program that includes drug testing? YES □

NO □

Does your company conduct post-Incident drug and alcohol testing? YES □ NO □

Has your company ever been removed from a project due to safety concerns within the last 3 years?

YES □ NO □ If yes, please briefly explain:

Does your company have a written procedure to screen subcontractors based on their past safety performance and history? YES □ NO □

Explain how you will ensure that subcontractors are following the same safety standards and expectations as your company?

Please list the PPE that your company will require while on site of all of your company’s employees and subcontractors:

I acknowledge that my Employees, Company, and/or Subcontractors can be removed from the project if safety standards and requirements are not being followed. YES □ NO □

Has your company received any citations or violations from MIOSHA in the past three (3) years?

YES □ NO □ If yes, please list:

Has your company received any willful safety violations from MIOSHA in the past five (5) years?

List your company’s Workers Compensation Experience Modification Rate for each of the last three (3) years.

20____________ 20____________ 20____________

List the number of man-hours your company worked in each of the last three (3) years.

List the OSHA recordable injuries your company experienced in each of the last three (3) years.

List the Total Recordable Incident Rate (TRIR) your company experienced in each of the last three (3) years.

Calculation: TRIR = (number of OSHA Recordable Incidents) x 200,000 / Total Number of man-hours worked

PROJECT SPECIFIC

How often will your company perform documented job site safety Inspections?

Daily □ Weekly □ Bi-Weekly □ Monthly □

Does your company conduct toolbox safety talks or weekly safety huddles? YES □ NO □

Does your company have a written procedure to ensure that only employees who are qualified by training and experience are allowed to operate equipment, tools, machinery and vehicles? YES □ NO □

Do you see any potential safety hazards on this project that your company does not have experience with or are concerned about? YES □ NO □ If yes, please explain:

COMPANY ACKNOWLEDGEMENT

I certify that my response and the information provided are true and correct to the best of my personal knowledge and belief and that I have made no willful misrepresentations in the questionnaire, nor have I withheld any relevant information in my statements and answers to questions. I am aware that any information given by me in this questionnaire may be investigated and I hereby give my full permission for and such investigation and I fully acknowledge that any misrepresentations or omissions in my response and information my cause my bid to be rejected.

Furthermore, I acknowledge that O-A-K may, at no additional cost or increase to the bid, require the contractor to perform additional safety requirements if the above information is deemed incomplete, Insufficient, below industry standard, or not to level of safety commitment expected. This may include but not be limited to additional site safety audits and inspections, full time safety supervisor, etc.

Bidders full name and entity status:

Signature

Authorized Representative of Company

Printed Name

Authorized Representative of Company

Title Date