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HomeMy WebLinkAboutDorner 2024 Bidder's Proof of ResponsibilityCITY OF OSHKOSH Osp lKosp, BIDDERfS PROOF OF RES�ANSIBILITY FOR CONSTRUCTION YEAR 2024 City ofw Oshkosh. ALL BIDDERS ON PUBLIC WORKS CONTRACTS SHALL PROVIDE PROOF OF RE, SPONSIBILITY IN ACCORDANCE WITH SECTION 66.0901(2), wiscoNsvv.sTATE,sTAn7E-s, RETURN QUESTIONNAIRE TO, DIRECTOR Or, PUBLIC WORKS CITY:14ALL, ROOM 30-1 215 CHURCH AVENUE PO BOX 1130 OSHKOSH, WI 549(13-1130 8-MAIL- ttavloffki.oshkosluvlm,� NOTEi THE CONTENTS OF THIS QUES'l-IONNAIRE SHALL BE CONFIDENTIAL FOR THE EXCLUSIVE USE OF THE CONTRACTING AGENCY AND SHALL NOT BE MADE PUBLIC EXCEPT BY WRITTEN PERMISSION OF TH E PROSPECTIVE BIDDER. (REVISED OCTOBER 9,2023) PREQUALIFICATION STA.T& MENI There is submitted herewith for yotir consideration, pursuant to Section 66,0901(2), Wisconsin State Statutes, a statement of qualifications of the undersigned to furnish the necessary labor, materials, and skills required to enter upon and cornplete Public Works Contracus to be let by the City of Oshkosh. I. IDENTIFICATION A. Official Firm Name Dorner Inc. 11 General Telephone 920-845-2442 FAX 920-845-2458 C. Mailing Address E606 Luxemburg Rd, PO Box 129 (Street) Luxemburg VVI 54217 (City) (State) (Zip Code) D. General E-Mail Address dornerJnc@dorner1nc,,rom E. Number of year inbuslness tinder present firn-1 name 20 years Please check (1), (2) or (33) (1) A Corporation or LLC El (2) A Co -Partnership, n (3) An Individt.161 G, Principal IndividuaI5: (if a Corporation or LLC, answer below) President D8niel Dorner Vice Ares, Todd Dorner secretary Tina Aschenbrenner Treasurer Tina Aschenbrenner H. If a Corporation or LLC,, answer below: (If a Co-Paxt-nership, answer below) Name, of Partner Name of Partner (if a Sole Trader, answer below) Name of Sole Trader (1) Wlieii incorporated .1979 In what State Wisconsin (Revised 1019/,23) Pa8e I of 16 1. Contact information for questions regarding this form: Person's Name Tina Aschenbrenner Telephone 920-845-2442 FAX 920-845-2458 E-Mail Address fine.asch@dornerinc.com Total Contract Ainount for which firm is seeking prequalification, Firm must have been the Prime Contract or and have completed at I least two (2) contracts/projects of similar Scope/type wi R I iin the last three hree (3) years with a Total Contract Amount of at least the amount for which firm is ,seeking prequalification. if approved, Contractor will be automatically approved for all lower amounts. 0 $1'500,000 $3,000"000 $5,000,000 In Excess of $7,0.00,000 {Revised 10/9/23) Nge 2 of 16 Class of work in which firm is secRing prequalification (check below —may check multiple boxes), STREET, UTILITY, & SITE CONSTRUCTION GENERAL BUILDING CONSTRUCTION Roadway Grading Building Construction, Renovation, or Remodeling E] Concrete Pavement Construction, including Grading SPECIFIC CATEGORIES OF r] Bituminous Paving BUILDING CONSTRUCTION n Bittiminow Street Construction, F1 Building Den-tolition including Concrete Curb and Gutter, and Roadway Grading and Graveling n Elevator Ej Mudjacking ❑ Electrical F] joint Scaling ❑ Heating, Ventilating, and Air Conditioning ❑ Sidewalk Construction ❑ Nin ting Sanitiry and Storm Sewer Cot , Istruction, El Plumbing: Site Grading Pump Flouses and Lift Stations Street Lighting E] Roofing F] Reinforced Concrete Construction, F] Riverwall< Constniction i.e. Foundations, Storm Drainage Structures, Retaining Walls Pq Landscaping OTHER MISCE UANEOUS CATEGORIES F] Bridge Painting Detention Ponds Water Main Construction F] Boring or Tunneling El Sanitary and Storm Sewer Trenchless El Rehabilitation (Revised 10/9/23) Page 3 of 165 II. EXPERIENCE A. What is the construction experience of the principal individuals, including superintendents and/or Present Mines of Individual's Position of Years' of Magnitude & . Previous Name Individual Construction Typi of Work, Employers Employers for in Your Experience 191-1 What Capacity Past 10 Years* Organization Please see atta-chment *If I this is I their current employer, so state. Averagenumber of employees during the last 12 monfhs; Office 7 Skilled 60 Unskilled - B. WORK ON HAND Lis I t below the pre8ent contracts held by you (not as subcontractor). If none, Please enter "NONE'. Attach additional sheets, if necessary. Additional sheets must contain same infonnation as listed oil this page, ded Anticipated Owner/ percent Anticipated Cost of Work Date AwarLocati I oil Type of Work Coi completed Please see attachtherit C. PREVIOUS CONTRAM List below constructiori contracts held by the company completed for the last three (3) years (not as subcontractor). Attach additional sheets, if necessary. Additional sheets must contain scone information as listed on this page. Date Awarded Owner/Location Type of Work Cost of Work Please see attach r ient D. Are you currently pre quallfied by the WDOT? Yes D No If yes, please submit a copy of the WDOT Notice of Contractor's Prequalification, (Ravised 1019/23) Page 4 of 16 111. EQUIPMENT A. List below major piece . s of equipment currently owned andavailable when needed for proposed work, or submit a cur I rent copy of your depreciation scliedule. All columns must be completed. Attach additimial sheets, if necessary. Addition sheets incontaineontain sameinformation as thi6 DESCRIPTION, PRh �SENT NUMBERS SIZE, ORIGINAL ACCUMULATED YEARS OF BOOK OF ITEM CAPACITY, COST DEPRECIATION SERVICE ETC1. VALUE IPlease See4ttachment I IF - -- ---- -- i I II llevlsed 10/9/21) page 5 of 16 IV. CONTRACTUAL RESPONSIBILITY Answering "yes" to any of the followin questions will disqualify a company from becomingap 9 _proved to bid by the City of Oshkosh. However, failure to answer truthfully may result in disqualificationfor the entire year. A. Has your firm or any officer or partner of your firm ever been debarred, suspended, or disapproved by the State of Wisconsin qg: the Federal Highway Administration in the past ten ('10) years? Yes 2 No It so, state: Date, Project Owner:, Project Owner's Mailing Address: (At that time or preferably now, if there is a difference) Full particulars in each instance- (Including type of work, ainount of contract, cause of violation, and resolution), BHas your firm or any officer or partner of your firm ever been debarred, suspended, disapprovedl or not n (10) years? El Yes LZ No pre qualified by any government entity in the past te If so, 'state, Da - te: Project Owner: Project Owner's MailingAddress; (At that t . ime or preferably now, it there is, a difference) Full part I iculars in each instance: (including type of work, amount of contract, cause of violation, and. resolution): (Revised 1019M3) Page 6 of 16 C a Has your firm or any officer or partner of your firm had any type of business, contracting, or trade license, certification, or registration revoked or suspended in the past ten (10) years? Yes EZ No If so, state:* Date: Project Owner: Project Owner's Mailing Addres&- At that time or preferably now, if there is a difference) 'FUl particulars in each instance: (including type of work, amount of contract, cause of violation, and resolution): Has your firm or any officer or partner of your firm ever committed a violation of federal, state, or local government safety or environmental laws as determined by a fine, settleinenti administrative order, or final decision of a court or government agency authority in the past ten (10) years? This includes, but Is riot limited to, any OSHA or WDNR violations. JZ Yes EINO If so, state: Date: Pr:oj ect Owner, Project Owner's Mailing AddTess: (At that time or preferably now, if there is a difference) Full particulars ii-te u tance: (including typ e of work, amount of contract,, cause of violation, and resolution): (Revised 10/9/23) Page 7 of 10 E. Does your firm or any officer or partner of your firm have an open or ongoing investigation of a violation of federal, state, or local government safety or environmental laws? This includes, but is not limited. to, any OSHA or WDNR violations. F] Yes P1 No If so, state., Date: Project Owner: Project Owner's Mailing Address: (At that time or preferably now, if there is a difference) Full particulars In each instance: (including type of work, amount of contract, cause of violation, and resolution): Has your firm ever worked on any contract or work awarded to it that resulted 11-16 lawsuit in the past ten (.10) years?E] Yes EZ No If so, state; Date: Project Owner: Project Owner's Mailing Address: (At that time. or preferably now, if there is a difference) Full particulars in each instance: (including type of work, amount of contract, cause of violation, and resolution): (Revised 10/9/23) Page 8 of 16 G. Has I your firm or any officer or partner of your firm ever declared bankruptcy while performing Work ona contract or work awarded to it, or while an officer or partner of another firm in the past ten (10) years? El Yes EZ No If go, state: Date: Project Owner. Project Owner's Mailing Address: (At I that time or preferably now, if there is a difference) Full particulars in each instance, (including type of worX amount of contract, and resolution)- H. Has your firni ever defaulted on or failed to complete any contract or we awarded to it in the past tell (10) years? n Yes 2 No If so, state: Date, Project Owner: Project Owner's Mailing Address, (At that time or preferably now, if there is a difference) Full particulars in cacti instiince. (including type of work, amount of contract, cause of violation, and resolutiony (Reylsed 10/9/23) Page 9 of 16 I. Has your firm ever been assessed liquidated damages or other penalties for failure to meet the Contract requirements for work awarded to it in the past ten (10) years? Yes [A No If so, state: Date: Project Owner, Project Owner's Mailing Address-. (At that time or preferably now, if there is a difference) Full particulars in each. instance-, (including type of work, amount of contract, cause of violation, resolution, and amourif of penalties assessed),, Has any, officer or partner of your firm ever defaulted or failed to complete a Construction contract handled in their own name in the past ten (10) years? F] Yes 2 No If so, state: bate:. Name of Officer/Partner: Project Owner. P roject Ow I ner's Mailirig Addrem. (At that time or preferably now, if there is A difference) Full particularsI in each instance, (including type of work, amount of contract, Cause of violation, :and resolution): (Revised 10 /9/23) Pige 10 of 16 K Has any officer or partner of your,firm ever been an officer or partner of some other organization that defaulted or failed to complete a construction contract in the last ten (10) years? [] Yes E,Z No If so, state; Date- Name of Officer/Partner: Name and Mailing Address of Organization., Name and Mailing Address of Project Ownev. (At that time (:)): preferably now, if there is a difference) Full particulars in each. instance: (friplUding type of work, amoant of contract, cause of violation, and resolution): L. Has your firm or any officer or partner of your firm asked tube relieved from a bid submitted by it to a public awarding authority in the past ten (10) years? [-]Yes 0 No If so, statC4 Date: - Project Owner; Project Owner's Mailing Address: (At [hat time or preferably now, if there is a difference) Pull particulars in each instance: (bidillding type of work, amount of contract, cause of violation, ,and, resolution): (Revised. 1019123) Page 11 of 16 M. Has your firm or any officer or partner of your firm ever been c I harged with or convicted of a violation of any wage schedule hi the past ten (10) years? R Yes 2 No If so, state: late: claimant: Claimanrs Mailing Address: (At that time or preferably now if there is a difference) Full particulars in each instance: (including type of work, amount of contract, cause of violation, and resolution). N. Has your firm; any of its owners; a subsidiary or corporate parent, or any officer, director, or partner thereof, been convicted. of violat4ig Section 133.03 Wisconsin Statutes (Unlawful Contracts: Conspiracies) in the last ten (10) years? El Yes 0 No If so, state: Date: Claimant: Claimant's Mailing Address, (At that time or preferably now, Ifthere is a difference-) Full particulars in each instance: (Inc I luding type of work, amount of contract, cause of violation, and resolution); (1teviged 10/9/23)1 Page 12 of 16 V. A. [0 m SAFETY Does your firin require the following safety training programs: 1. Right to Know/1-lazard Communication 0 Yes El No 2. Fite Prevention Yes ❑ No 3. Hot Work Perm fts Yes j No 4, Fn vironmental. Compliance Yes ❑ No 5. FXcavationjreriching Yes Q No 6, Working at Elevation > our feet (4') Yes No 7. Confined Space, Entry [Z Yes E] No 8. control Hazardous Energy (Lockout) 0 Yes 0 No 9, Operation of Powered Equipment/Vehicles 0 Yes El No 10. Working with Hazardous Voltages EZ Yes El No 11, Per,s'onal Protective E(juipment 0 Yes E] No 12. Process Safety [Z Yes [j No If you answered NO to any of theabove, please comment: Arethe trairiing records available upon request? 0 Yes El No Please provide your Total OSHA Incident Rate and Lost Workday Rate for each of the last three (3) years by con-VIefing the table below: 1. Year 2022 2021 2020 2.. Number of Employee Hours Worked _85322 96474 83140 3. Number of Lost Workday Cases 1 3 4 4. Number of Cases Due to Injury or Illness Defined as Recordable 0 2 0 5. Tom, I Number of Recordable Cases (Add 3 and 4 Above) 1 5 4 (Revised 1019j23) Page 13 of 16 6. Calculate Your Incident Rate by Using the Following formula: Total Cases on Line 5 x 200,000 Hours Employee Hours on Line 2 2.34 10.37 9.62 D. Please provide Name and Telephone Number for Individual Responsible for: 1. Safety Coordination: Todd Darner 920-609-7614 Name Telephone 2, Environmental Issues: Todd Dorner 920-609-7614 Name Telephone Vt. BONDING RESPONSIBILITY A. Provide the name of your bonding company and your firm!s current limit of Payment and Performance Bonds - Name: Fidelity and, Deposit Company of Maryland Dollar Limit; $50 million Names and addresses of all b'orkdiag companies other than. those listed in 'A" above which have written bid and security bonds during the last five (5) years: B, Attach a current letter of reference froni your principal batik. Include your current line of credit, iff you have a line of credit. Ilie submission of only, your line of credit documentation is not sufficient. (Revved 10/91 . 23) Page 14 of 16 C. Has any bonding company ever taken over a contract or made payments because of your firm's failure to carry out a contract? El Yes 0 No If so, State; Date: Name of Bonding Company: Bonding Company's Mailing Address: P r$ � u, ult Partie in each instance, (hiel ding type of work,amount of contract, cause of violation, , ula and resolution): VII. CONTRACTOWS FINANCIAL STATEMENT A, Attach your firm's latest complete fina nciall. report (including Balaace Sheet, Income Statement, and Statement of Cash. Flows) -with the name of the Accountant wh(j Prepared it. A, Are any of your assets assignedIf so, which are assigned? No B, For what purpose are they assigned? (Revised 10/9/23) Page 15 of 16 VIII, AFFIDAVIT STATE OF Wisconsin _) COUNTY Op Kewaunee -Daniel Dorner I being duly sworn, deposes and says that he/she (Name of Officer/Owner) is the President of Corner (tic. (Title) (Na m6of Firm) and that the answers to the foregoing questions and. all statements therein contained are tme and correct, and that arty owner, bonding company, or other agency herein named is hereby authorized to supply the Municipality, City of Oshkosli, with any information deemed necessary to verify this statement. (Signature of Officer/Owner) Subscribed and sworn before me this- 10 day of Lj dy_L 2031., Notary Public - County State My Commission Expires for Contracts with Preqvalification APPROVED Limits of Not More Than: Date �a -�T - �23 �S�o�O Did Director of Public Works Date, City Manager (Revised 10/9123) Pige 16 of 16 DORNER INC. E606 LUXEMBURG RD. P.O. BOX 129 ,UXEMBURG, W1. 542'17-01�9 Phone, (920) 846-2442 EXPERIENCE OF PRINCIPLE PERSONNEL I. Daniel Dorner President since 1979, duties include bidding, supervisory, management, inventory, overall construction layout, over 40 years sewer construction experience. 2, Todd Darner Vice- President, Construction Surpervisor, Estimator, Jobsite Co-ordinator, safety Coordinator; with our company since 8115188. 3 Terry Dart Foreman of one working crew; with our company since 6/21/76. 4. Donald Darner Sackhoe operator, foreman of one working crew, with our company since 6/617 . 5 Brian Corner Heavy equipment operator, foreman of one working crew, with our company since 8/14/78, 6. Doug Vickman Heavy equipment operator, with our company since 412/90. 7 Tony Heurkens Heavy equipment operator, foreman of one working crew, with our company since 3/14194. Justin Ledvna Heavy equipment operator, foreman of one working crew, with our company since 1018/05 9 Tim Aschenbrenner Foreman of one working crew, with our company since 4/1111 10 Todd Vandenpias Heavy equipment operator, foreman of one working crew, with our company since 1/1/15 11 Adam Enderby Project Engineer, assistant to the. President, Construction Spervisor, Estimator; with our company since 1/21/19 12 Matt Athey Project Engineer, Assistant to the President, Construction Supervisor, Estimator; with our company since 111121 DORNER INC. E606 Luxemburg Rd. - P.O. Box 1,29 - Luxemburg, Wl. 64217.0129 Phone., ( 920 8454442 Fax., 920 ) 846-2468 WORK ON HAND ,-L Pgm':As Of: 1 D1912623 - Customer Number Current Received Completion Percent Job Number Contract Billed to Date to Date Date complete Town of Ahnapee 2023 Washington Rd Culvert $ 298,847= $ $ 61112024 oko% Contract 6395-23-01 City of Algoma 2023 Utility System improvements $ 485,704,00 $ 53,14100 $ 11/1/2023 10.94% Contract 2929-23-03 Village of Bellevue Sanitary Sewer Recontruction $ 1,063,284.70 $ - $ 3/112024 0.00% Contrct E-23 City of Gillett E Washington St Recon $ 2,622,709.10 $ 1,702,793.00 $ 546,162.36 12/1/2023 64.92% .Project No, 25-0293.00 City of Green Bay Resurfacing 1-28 $ 2,416,8%87 $ 1,418,652.00 $ 833,655.30 12/112023 59.69% Village of Mount Pleasant KR Lift Station/Forecernan $ 3,114,318.75 00 $ 2,465,978.00 $ 1,524t207,131 511/2024 78-86% Prqject No, 21 M 102,01 City of Sheboygan Indiana Ave Reconstruction $ 2,591,631.00 $ 1,321,681.00 $ 971,03171 1211314023 50,99% Bid No. 2477-23 Village of Suamico E Deerfield. Sewer Ext. $ 1,010,21210 $ 526,574.00 $ 288,536.41 12/31/2023 44.62% Contract S-2221 TOTAL JOBS: $ 13,663,518.12 $ 7,5JO,720.00 $ 4,10,096,09 DORNER INC. E506 Luxemburg Rd, - P. 0. Box 129 - Luxemburg, Phone: { 920) e4&2442 TROOF OF RESPONSIBILITY' W1. 54217-W 29 WORK COMPLETED IN 2020 DATE FINAL FINAL CONTRACT OWNER. OF PROJECT RETAINAGE RECEIVED AMOUNT Village of Allouez , 10119120 32,450,285.22 GontractAL-2019-01 City of Appleton 5126124 $9p3,b55 JiD Pro ect linitT=19 Baileys Harbor 1212120 $49,370,00 Blue Skj Herb or Broom County 8117/20 $5,946,811.17 Pr ect #2317 Vlllago of Bellevue 12126/20 $1,900,005.00 Willow Glen Subdivision \Allagef Bellevue 7111120 $554,936:20 Grintr act F-19 City of Depere" 10/9120 $2,076,029.53 Project 19A1 City of bepore 9126120 $227,440.04' Project 19-14 Elkhart Lake: 1211/20 $9671796= Victo Rack Subdivision City of Franklln 1124/20' 1,858,551.67 Rawson Hones 8, Drainage Village of Fox Crossing 12/17/20 $47,935,00 Stroeba Island Causeway Culvert Village of Fox Crossing 10130/20 $1,689,389.71 Jacobson Rd Reconstruction Vinage of Grafton - 1212120 12,539,333.07 Street Reconstruction - City. or Green Bay 8120/20 $104,583.80 Sewers 1-20 City of Green Bay: 1Yf6120 $300,607.50 Sewers 3-10, Part City of Green Bay 10130120191,Z92.20 Sewers 5-19, Hingham 716/20 $0,641,00 Windridoe Drive Sewer Howard 8/3120 $347,545.15 The. Lon. Ants; Village of Luxernburg 12/11/20 $457,053.04 2026 Utility' Reconstruction City of Manitowoc wn/20 $769,373:70 Sanitaty Sewer Construction City.of Neenah 11/14120 $539,480 70 Project 7«19 Village of Qastburg 91t7120 $V36,710,$2. Utility Replacement City of Oshkosh 3/6t20 $1,520,195.65 city Contract 1 &12 City of Oshkosh 6/25120 $3,7191177.99 Pity Contract 18=44 City of Oshkosh 7122120 $1,664,77g.51 C Ity Contract 19-07 St. Joseph Reel Estates Services 716120 $348,590.16 Green Say Diocease'Campus City of §heboygan . 12/31120 $1,523,130,00 2020 Street Improvements City of Sheboygan Fails 11121120 $364,959.95 2620 Utility : Improvements City of.Two wo Rivers ,improvements 7111/20 $977,193.05 Street & Utility City of West Bend 12111120 $1,418147.52 Contract 20.01 City of West 12111120 $$42,582,02 Contract 20-02 Village of Wrightstown 10/23120 $1,377,208,73 2019.11tilit and Street Reconstruction DORNER INC. E506 Luxemburg Rd. P. 0. Box'129 - Luxemburgf'Vt1'1. 64217-0129 Phone_; (920) 845-2442 "PROOF OF RESPONSIBILITY" WORK COMPLETIED IN 2021 L DATE FINAL FINAL CONTRACT OWNER OF PROJECT RETAINAGE RECEIVED AMOUNT Village of Aliouex Bethel Pond Contract 1/8121 $574,668.90 A0012A9-19-00400 Fox Crossing utilities Strobe Island WM Reconstruction 7115/21 $546,271.60 Contract F0058-9-20-00161 Fox Crossing Utilities Shady Loge Phase 2 9/17/21 $686,102.55 Contract F0058-9-19-00818 City of Gillett 2020 Street and Utility I rovements 8/20/21 $2,017,674,63 City of Green Bay Pavement 4420 9l9/2�1 $3,644,0413,97 Doty St Reconstruction Town of Greenville STH 15 Sanitary Sewer and Water Relocation 7/21121 $532,747.50 Contract D-20 ............. Village of Little Chute Moasis Drive Water Main Reconstruction 218/21 $654;980.95 Pro'ect #2020004 Village of Luxemburg/Kewaunee County 2021'CTH "AR" and'CTH'A" Improvements; 10/26/21 $781,183.45 Contract No. 1658-21-01 Manitowoc Public Utilities Menasha Ave Watermain Replacement 9/15121 $416,906.30 #MPUW20-05 Racine Water Utility 42" Transmission Watermain 2/2/21 $2,597;280.58 Pro ect #WR19-�16 Town of Red River Thi Daems Road Culver Replacement 8/23121 $240"559.56 Sister Say Utilities 2020 Little Chute Road Utility Extension 1111121 $159,212.00 DORNER INC. E506 Luxemburg Rd. - P. 0. Box 129 Luxemburg, WI. 54217.0129 Phone: 92a 845-2442 ......._.... WORK COMPLETED IN '2022 DATE FINAL _ FlltiAL CONTRACT OWNER OF PROJECT RETAINAGE RECEIVED AMOUNT City of :Appletan Sewer and Water Construction No.1 2128/22 $31*076,637.06 Project W-21 Yawn of-ailey's Harbor 7/28122 $65,74170 Ward St Sanitary Sewer Bellevue - Village Creek Estates 217/22 271,939.�2 City of Cedarburg 2022 Street and Utility 11/15/22 $2,455,440.73 Project 2022-01 Horsebay Farm Association '2/22/22 $8$;41.8M Cobblestone Cottages, City of Lepers _ Sewers and Water Relay 7/22/22 $1,414,402,53 Ci Project #2101 Vllee of Egg Harbor Church Street Reconstruction 1118122 $2,661,113.91. Contract No. E0003-08-19-0021 City of Fond du Lac` 2021 Street & Utility 7/11/22 $4,651,81.6.90 File No: 2021-0.19 City of Green Bay 9/1/22 $360,650.72 Sewers 4-21 Mini Sewers Duquatne Development 3128/22 $274,822:55' Howard Alliance Securit Blvd Village of Howard Evergreen Rd Reconstruction 9130/22 $949,871.08 Project #21014 Village of Lena Maple_ Street Improvements 12116/22 $1,361,582.66 Village of Little Chute, Vandenbroek pond Construction 12124/22 $436,252,1.5. PLo ect#202100 Village of Luxemburg 2020 Utility and Street Extensions 11/25122 2,534,887.03 Contract #253r20-03 Village of Luxemburg Heritage Road Improvements 11/25/22 $434,429.25 contract #253-21-01 Village of Menomonee Falls County Lino Road Sanitary,Sewer"& Water 2128/22 $2,094,634.31 Project #73042' pity of Oshkosh West 9th Ave Reconstruction 11125/22 $5,125,188,43 City Contract 21-04 Random Lake Woodland View Subdivision 12/15122> $828,896.97 Town of Sheboygan' 12112/22 $1,056,076, 4 Stonebrook Crossing Subdivision Sheboygan County 12112122 $52127223 OTH V Road/Brill a Improvements NO ��Scy-ms/ Tony Evers, Governor Craig Thompson, Secretary Division of Transportation System Development Bureau of Project Development, Room ' 4822 Madison Yards Wa mtem*cwlgc!20gI0d!g.ggy Madison.w* ,3706 Telephow 608466�1631 Domer, Inc, P.O. Box 129 Expiration Date: May1,2O24 The Experience Questionnaire and Financial Statement submitted by you for the purpose of obtaining prequalification ratings to permit bi dding on work,let under the direofion of the Division of Transporta . tion System Development hav6 been reviewed. On the basis of the information contained In the statement, notification is hereby given that the following ratings have been assigned to you: (A) General ComutrVcMoo.._............. ^......... _.__.^~,^^'..~''^ � (K) Incidental Construction.... ............ ~~.,.,....... ^_~,,^_._,__.�1 The above ratings will remain In effect until the indicated expiration - date unless revised or terminated prior to that date. Sincerely, - Chief -_�Proposal Management Engineer _-- JJF:Vnkw ZORNER INC. 4--506 Luxemburg Rd. - P.O. Box 129 - Luxemburg, Wl. 64217-0129 Listed below are the Major pieces of equipment owned and available when needed for proposework.- ITEM NO . ACQUIRtD MOIYR DESCRIPTION ...._... ORIGINAL COST ACCUMULATED I DEPRECIATION BOOK 'VALUE §F:NT YEARS OF SERVICE 413 11/93 E120B Cat Backhoe $ 18,760.00 $ 718,760.00 FPRE $ 261/2 417 6194 lD7H Cat Dozer $ 110,250.00 $ 110,260,00 $ 26 421 6/94 940 Mustang Skidder $ 9,976,00 $ 9,975.00 26 426 312.Cat Backhoe 101,70 0.00 $ 101,700.00 $ - 251/2 427 10/94 563 Cat Compactor $ 94,300,00 $ 94,300.00 $ - 26172 /2 428 8/94 375 Cat Backhoe 664,600,60 $ 654,600.00 $ 26 436 6/95 940 Mustang $kidder $ 19.75535 $ 19,755.76 $ T 25 , 439 12/95 490D John Deere 37,485.00 $ 37,485.00 $ 24112 447 8196 940 Mustang $kidder $----21,000.00 $ :21,000,00 $ 24 2016 6/97 1690 John Deera Excavator $ 93,450-00 $ 93,460.00' = 23 2018 6197 16500 J/Deere Crawler Dozer $ 9$.460,00 $ 03,00.00 $ 23 2042 10/97 120LC John Deere Excavator $ 83,30$5.60 $ 83,388.60 $ 22112 2050 3198 D6M-LGP Cat Dozer $-- 150,109,00 $ 150,109,00 $ 22 2052 3/98 — D300E 6 Wheel Drive Off -Road Truck $ , 237,874,00 $ 237,374.00 $ k 2078 5199 772BH John Deere Grader 46,200:00 $ 46,200.00 $ 21 2090 IM 330 Cat Excavator 215,250,00 $ 215,250.00 $ 211/2 2100 10199 John Deere 120 - 10OLC Excavator 119,595,00 119,595100 $ 20 V2 2110 no John Deere MLO Excavator $231,000.00 $ '231,000.00' 11112 214 1 4/00 John Deere 380LC.Excavator 230,500.Q0 $ 230,500.00 11112 2102 7100 John Deere 624H Wheel Loader $ 122,647,63 $ 122,647.63 $ 11 2104 7/00 John Deere 644H Wheel Loader. $ 166,096.85 :$ 166,096.85, $ 2105 WOO, John Deere 16OLC.Crawler Excavatot $ 122,647,52 1 122,647.62 $ 2106 8/00 9500 Gat Wheel Loader 169,075,00 $ 159,075.00 $ 19112 2107 10/00 Mustang 2042 Skidsteer :$ 41200,00 4,200.00, $ - 19112 2129 8/01 John Deere 410 Wheel Loader Hoe $ 80,677.50 $ 80*677.50, $ - 18112 2139 4102 963C Cat Track Loader $ 2160500.00, 41 2115500.00 2142 '6/02 271 Cat Skidsteer $ 47,290.0 $ 47,290.00 $ 18 . 2158 12/02 320CL Cat Hydraulic Excavator A 132,300.00 1,32,300.00 $ 17112 2165 6/03 700H LGP 395 John Deere Dozer $ 124.950,00 $ 124X0.00 $ 17 2180 10/03 225 John Deere Excavator 149j720.00 $ 149,720.00 $ 16112 2187 4104 267 Oat Multi Terrain SkWsteer $ 31,800.00 $ 1.111,37,00.00 $ 16 2193 6104 644J John Deere Loader 154,350,00 $ 154,350.00 $ 16, 2216 1 10104 IZX225 Hitac I hl Excavator $ 178,462.50 $ 178,462.60, $ 15112 DORMER INC. Pane 2 ITEM NO., ACQUIRED MOiYR DESCRIPTION ORIGINAL COST ACCUMULATED DEPRECIATION PRE BOOK `ENT VALUE YEARS OF SERVICE 2242 2i05 644J John Deere Loader $ 136,600.00 136,606-100.$ - 15 2233 6/06 EX200LCm-3 Hitachi 48,487.19: $ 48,487.19 $ 15 2263 10/05 Volvo L120E I Wheal Loader $ 178,600.00 $ 17,8,500.00 $ 14112 2266 10/06 226CLO John Deere Backhoo $ 132,826,00 132,826,00 $ 14112 2273 2287 3/06 3/06 D6G Cat Dozer 350D John Deere HLdraulic Excavator 63,750,00$ $ 237,074M 6317%00 $ 237,074,00 $ $ 14 14 2288 3106 1450CL John Deere HLdraulic Excavator $ 299,971,00 $ 299,971.00 $ 14 2289 3106 Z60OX Hitachi Hydraulic Excavator. $ 459,632.00 $ 459,632.00 $ 14 2280 7106 257 Cat Skidsteer $ 46,200,00 $ 46,200.00 $ m 13112 2302 4/07 216B Cat Skidsteer $ 21,630:00 $ 21,630.00 $ IS 2327 4/12 350 DLC Excavator 252,330,51, $ 95,324.64 15-7 ,005.67 8 3061 3064 4/13 5/14 LOW Volvo Loader 700K John Deere Crawler Dozer $ 186,600.00 $ 120,600.00 $ 66,083.3$ $ 28,006-00 12f $ 9 i,546.67 000.00> 7 2 3055 1116 262D Cat Skidsteer $ 62,160,00 $ 10,560j01 $ 6 3075 1/15 350GLd John Deere Excavator $ 261,436,00 $ 401382,17 $ 21AAZ83 6 3076 3078 4/15 3/16 644K John Deere Wheel Wader 335F Cat Excavator $ 255,666.00 $ 299,160.00 $ 42,610.83 $ 34,900,83 $ 21,-"054,17 $ 264,249,17 6 4 3079 3/16 1-1201-1-1 Volvo Loader 256,200,00 $ 29,890.00 22E,310.00 3080 3/16 Z135 Hitachi Excavator $ 166,512:00 $ 19;426.40 $ 14, 085.60 3081 4116 257B2 Skidsteer $ 42,500.00 $ 4,958.33 $ 37,641. 4 1/17 245E John Deere Excavator $ 193,506,00 3 1117 ZX226 Hitachi Crawler Excavator 75"060.00 $ 75,000,00 3 6117 L120H2 Volvo Loader 263,600-00 $ 253.500M -;—::-5, 2112 12/17 1259D Cat Skidsteer 55,00 . 0.001 000,00 2 DORMER INC. E 506 LUXEMBURG RD, P.O. BOX 129 LUXE'MBURGj WT. 54217-0129 Phone: (920) 845-2442 - Fax: (920) 8,45-2458 D. Has your firni ever committed a violation of federal, state or local government safety or environment, laws as determined by a settlement, administrative order, or final decision of court or government agency authority in the past 10 years? YES September 24,2018 City of Oshkosh PO Box 1136 Oshkosh, Wl 54903 City Contract 18-12 Contract Price - $1,558,016.08 1. Using a damaved GME Model TRI OSW Trench Box and no tabulated data was available to ensure the shield was still viable I UtiUing a GME Trench'Box and did not have any data or manufacturer certification to verify the rated capacity of the trench box 3. GME Trench Shield, Model TRI OSW, Serial #94081115 had a damaged shield wall 4. Employees were working in a trench shield that was installed 1 V7' of exposed dirt above the upper edge of the trench box 5. Trench Box was installed in the north section of the.trench and had excavations 3' below the base of the trench shield • Paid the fine • Took the damaged trench boxes to salvage yard • Have all required, paperwork- on, hand fies: August 28,2019 City of Oshkosh PO Box 1130 Oshkosh, Wf 54903 City Contract 19-07 Water Main and Lateral Relay 1823 Plymouth St, Oshkosh, WI Contract Price - $1,724,852.90 1. Each Employee in an excavation was not protected from cave-ins by an adequate protective system designed in accordance with 29 CPR 1926,6529bO or 1926,652(c). Paid the Fine Hosting a trenching/excavation safety awareness seniinar "An 1AIiial Opportunity Employei" July 12,2019 Village of Grafton 675 N Green Bay Road Grafton, WI 53024 Contract 19-02 Street Reconstruction Intersection of Bridge Street and 17111 Ave Contract Price - $2i592,176.13 1. Competent person allowed an employee to use a concrete cutting saw to cut an underground electrical wire without ensuring deenergization. 2, Removing Water and Sewer lateral. at 7' in depth was not adequately protected from cave in, thereby exposing the employee to struck-by/crushing hazards. * Paid the fine, December 2, 2020 Village of Menomonee Falls W 156 N8480 Pilgrim Road Menomonee Falls, WI 53051 County Line Road Sanitary Sewer and Watennain Conversion Project No. 73042 Contract Price - $1,871,844.00 1. AnEmployee was uncovering the water main in an approx. 7.7' deep excavation without adequate cave- in protection; exposing to a struck-by/crushing ha7ard * Paid the fine November 2, =2 Town of Grand Chute 1900 Grand Chute Blvd Grand Chute, WI 54913 Orion Pond and Ston-ri Sewer Contract No. 2022-14 Contract Price - $1,8011,788,21 1. Utilized a ladder as access and egress a trench. that was not extended 3 feet above the upper landing surface. * Paid the fine NO injuries occurred as a result of the citations noted above. Dorner, Inc.'s worker's comp experience mod is below the industry average. Donner;Doer, Inc. has retained an independent safe( . y consultant to perform random, surprise inspections of its worksites. "An Equnl Opportunity Employee, RE: Darner Inc. To Whom It May Concerny October 47, 2023 We are pleased to confirm that we continue to provide an operating line of Credit to Dornor lnc., in the amount of $3,0001,000 under the, terms and conditions outlined within our loan agreement, The. line currently has an outstanding balance of $0,00, All payments have been handled In a timely fashion. In addition, we can confirm that the company maintains deposit accounts with our batik, with average balances in the six figure range. I The Bank of Luxemburg considers Dorner Inc. a valuable customer. If you have any questions please do not hesitate to call the at, 920-845.1974 or emall me at KenRehn@bankoflux.com. Kind regards, Ken Rohn AVP Commercial Banking 0 1 ank of Luxemburg IDORNER, INC. AND SUBSIDIARIES CONSOLIDATED BALANCE SHEETS DECEMBER 31, 2022 AND 2021 (SEE INDEPENDENT ACCOUNTANTS' REVIEW REPORT) LLB 2022 2021 ASSETS CURRENT ASSETS Cash $ 90,316 $ 1,129,4218 Contract Rec6rvables 3,46037 1,898,569 Contract Assets 1 396,439 180,518 Inventory 236,244 913,269 Total Current Assets 4,186,536 3,306,784 PROPERTY AND EQUIPMENT Hauling Equipment 3,630,835 3,201,344 ouipment Construction Equipment 15,868,292 15,114,650 Automotive Equipment 1,445,663 11464,9918 Office Equipment 62,340 62,340 Buildings 223,661 223,561 Leasehold Improvements 127,605 121,506 Subtotal 21,358,196 20,194,398 Less: Accumulated Depreciation 13,976,756 13,009,975 Total Property and Equipment 7,382,440 7,184,423 Operating Right -of -Use Assets 156,71.6 OTHER ASSET Cash Value of Life Insurance Total Assets 911,432 1,014,381 $ 12,636,123 _588 See accompanying Notes to Consolidated Financial Statements. (3) DORNER, INC. AND SUBSIDIARIES CONSOLIDATED BALANCE SHEETS (CONTINUED) DECEMBER 31, 2022 AND 2021 (SEE 1NDEPEN01:14T ACCOUNTANTS' REVIEW REPORT) LIABILITIES AND EQUITY CURRENT LIABILITIES. Accounts Payable Current Maturities of Long -Term Debt Dote Payable - Stockholder Lease Liability --'Operating Contract Liabilities Other Accrued Expenses Total Current Liabilities LONO�Tf RM LIABILITIES I -Ong -Term Debt, Less Current Maturities Taal Liabilities EQUITY Controlling Interest; Stockhokcleris' Equity; Class A Voting Common Stock, No Par Value; Authorized 2,000 Shares, Issued 175 Shares; {outstanding 61 Shares Class B Nonvoting Common Stock, No Par Value, Authorized 12,000 Shares; Issued and Outstanding 369 Shares Retained Earnings Treasury Stock, 114 Class'AA Shares, at Cost Total Equity n Controlling Interest Noncontrolling Interest Total Equity Total Liabilities and Equity See accompanying Notes to Consolidated Financial Statements. (4) 2022 2021 $ 1,418,864 1,390,600 155,715 249,,420. 80,601 31294'600 $. 1,197,945 860,469 340,000 15,470 43,044 2,456,928. 469,466 849,156 5,764,056 34,300 2'18,700 10,70 ,774 (2,105,74t7} 8,854,034 18,033 3,306,084 34,300 218,700 10,036,73$ (2,105,749 8,1$2,998 16,506 8,199,504 $ 12,635,123 $ 11,605,588 DORNER, INC, AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF INCOME YEARS ENDED DECEMBER 31, 2022 AND 2021 (SEE INDEPENDENT ACCOUNTANTS' REVIEW REPORT) REVENUE EARNED COST OF REVENUE EARNED GROSS PROFIT OPERATING EXPENSES INCOME (LOSS) FROM OPERATIONS OTHER INCOME (EXPENSE) Other Income Gain on Disposal of Property and Equipment Interest Ex I I , pense Gain on Sale of Real , Estate Hold for Development Other Income, Net CONSOLIDATED NET INCOME Less Net Income (Loss) , Npncontrolling Interest NET INCOME FROM CONTROLLING INTEREST See accompanying Notes to Consolidated Finanoial Statements. (6) 2022 2021 $ 36,246,020 $ 31,404,866 30,126,793 2,209,313 1,278,063 1541,895 1,306,353 667,418 (28,290) 20,776 106,538 12,400 18,000 (28,031) (23,583) 10,386 5,145 113291 672,563 85,001 1,627 (233) $ 671,036 85,234 --- ------ - �: t = �=-- DORNER, INC, AND SUBSIDIARIES CONSOLIDATE© STATEMENTS OF CASH FLOWS YEARS ENDED DECEMBER 31, 2022 AND 2021 (SEE INDEPENDENT ACCOUNTANTS' REVIEW REPORT) 2022 2021 CASH FLOWS FROM OPERATING ACTIVITIES Consolidated Not Income $ 572,563 S 85,001 Adjustments to Reconcile Consolidated Net Income to Net Cash Provided by Operating Activities: Depreciation 1,021,123 995,648 Gain on Disposal of Property and Equipment (12,400) (18,000) Gain on Salo of Reap Estate Field for Development - (10,336) Cash Value of Life Insurance 102,949 (9017) Changes in Assets and Liabilities: Contact Receivables (1,564,968) 280,128 Contract Assets (215,921) 453.855 Inventory (137,975) 132,626 Accounts Payable 220,919 78,701 Contract Liabilities 233,050 (5,867) Other Accrued Expenses 37,657 {11,0,085) Net Cash Provided by Operating Activities 357,797 1,783,260 CASH FLOWS FROM INVESTING ACTIVITIES Property and Equipment Purchases (958,003) (1;045,087) Proceeds from Disposal of Property and Equipment 12,400 8,000 Net Proceeds From Salo of meal Estate Held for Development 81,819 Not Gash Used by Investing Activities (945,603) (955,268) CASH FLOWS FROM FINANCING ACTIVITIES Not Proceeds on Long -'Term Debt - Line of Credit 800,000 Payments on Note Payable - Stockholder (340,000) {300,000) Net Principal Payments on Long -Term Debt (911 306) {972,737) Partial Redemption of Stockholder (840,000) Distributions to Stockholders (130,894) Net Cash Used by Financing Activities (451,306) (1,743,631) NET DECREASE IN CASH (1,039,112) (915,649) Cash - Beginning of Year 1129,428 2,045,077 CASH - END OF YEAR $ 90,316 $ 1,120,428 See accompanying Notes to Consolidated t tnancial Statements. (7) DORMER, INC. AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF CASH FLOWS (CONTINUED) YEARS ENDED DECEMBER 31, 2022 AND 12021 (SEE INDEPENDENT ACCOUNTANTS' REVIEW REPORT) SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION 2022 — 2021 Cash Paid During the Year: Interest 28,031 $ 23,583 SUPPL5M ENTAIL. DISCLOSURES OF NONCASH INVESTING AND FINANCING ACTIVITIES Property and Equipment Purchases via Issuance of Long -Term Debt $ 261,137 $ 686,370 Partial Redemption of Stockholder via Issuance of Note Payable $ - $ 340,000 Soo accompanying Notes to Consolidated Financial Statements,