MNAW Imaging Renovation Furniture, Fixtures & Equipment (FF&E)- Bid Package #3 Imaging Equipment= - MONMTSKMM
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Specifications
MNAW Imaging Renovation
Furniture, Fixtures & Equipment
(FF&E)- Bid Package #3
Imaging Equipment=
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SECTION 00 01 01
PROJECT MANUAL TITLE AND REGISTRATION SHEET
MNAW HUMAN SERVICES IMAGING
FURNITURE, FIXTURES & EQUIPMENT- BP#3- IMAGING EQUIPMENT
CLOQUET, MINNESOTA
DATE: January 18, 2022
INTERIOR DESIGN
DSGW ARCHITECTS, INC.
2 West First Street
Suite 201
Duluth, MN 55801
CONTACT: Carlie A. Kemp, Senior Interior Designer
(218) 727-2626 phone
(218) 722-7467 fax
PROJECT NO.: 0021076.00
© DSGW. All rights reserved.
The interior design and architectural works depicted herein are the sole property of DSGW and may not be
constructed or used without its express written permission. No permission to modify or reproduce any of these
interior design or architectural works, including without limitation the construction of any building, is expressed or
should be implied from delivery of preliminary drawings or unsealed construction drawings. Permission to construct
the building depicted in sealed construction drawings is expressly conditioned on the full and timely payment of all
fees otherwise due DSGW and, in the absence of any written agreement to the contrary, is limited to a one-time use
on the site indicated on these plans.
END OF SECTION
21076.0 / MNAW Imaging
Renovation 00 01 01 - 1 PROJECT MANUAL TITLE
FF&E- BP#3 AND REGISTRATION SHEET
SECTION 00 01 10
TABLE OF CONTENTS
MNAW IMAGING RENOVATION
FURNITURE, FIXTURES & EQUIPMENT- BID PACKAGE # 3- IMAGING EQUIPMENT
CLOQUET, MINNESOTA
DIVISION 0 PROCUREMENT AND CONTRACTING REQUIREMENTS
00 01 01 PROJECT MANUAL TITLE AND REGISTRATION SHEET
00 01 10 TABLE OF CONTENTS
00 11 13 ADVERTISEMENT FOR BIDS
00 21 13 INSTRUCTIONS TO BIDDERS (AIA A701, 1997)
00 22 13 SUPPLEMENTARY INSTRUCTIONS TO BIDDERS
00 41 12 BID FORM INSTRUCTIONS
00 41 13 BID FORM – STIPULATED SUM
00 43 25 REQUEST FOR APPROVAL OF SUBSTITUTION
00 50 00 LIST OF CONTRACT FORMS
00 72 00 GENERAL CONDITIONS (AIA A251, 2007)
00 73 00 SUPPLEMENTARY CONDITIONS
1. #12-94 TRIBAL EMPLOYMENT RIGHTS ORDINANCE
2. #5-84 BUSINESS LICENSE ORDINANCE COMPLIANCE PLAN
3. CONTRACTOR TESTING REQUIREMENTS
4. ST3 MINNESOTA REVENUE CERTIFICATE OF EXEMPTION
5. TRIBAL AND FEDERAL BIDDING CONDITIONS
6. CONSTRUCTION CONTRACTING CONDITIONS
7. FDL VENDOR SCREENING GUIDELINES
DIVISION 1 GENERAL REQUIREMENTS
01 10 00 SUMMARY OF THE WORK
01 20 00 PRICE AND PAYMENT PROCEDURES
01 23 00 SUBSTITUTIONS
01 33 00 SUBMITTALS
01 45 00 QUALITY CONTROL
01 50 00 TEMPORARY FACILITIES AND CONTROLS
01 60 00 MATERIAL AND EQUIPMENT
01 74 00 CLEANING
01 77 00 CONTRACT CLOSE-OUT
01 78 23 OPERATING & MAINTENANCE DATA
DIVISION 11 EQUIPMENT
11 77 00 RADIOLOGY EQUIPMENT
CUTSHEETS
R100 XRAY SYSTEM
R100 REQUIRED FEATURES & VENDOR RESPONSE FORM
R200 MAMMOGRAPHY SYSTEM
R200 REQUIRED FEATURES & VENDOR RESPONSE FORM
DRAWINGS (8-1/2” X 11”)
1 FF&E LAYOUT PLAN- BP#3
END OF SECTION
21076.0 / MNAW Imaging 00 01 10 - 1 TABLE OF CONTENTS
Renovation FF&E- Bid Package #3
SECTION 00 11 13
ADVERTISEMENT FOR BIDS
MNAW IMAGING RENOVATION
FURNITURE, FIXTURES, AND EQUIPMENT- IMAGING EQUIPMENT
CLOQUET, MINNESOTA
Notice is hereby given that bids will be received by DSGW Architects, Inc. on behalf of the Owner by e-
mail only until 11:00 AM, prevailing time, on February 4, 2022 for the MNAW Imaging Renovation
FF&E- Bid Package #3- Imaging Equipment. Bids will be reviewed and referred to the Tribal Council for
consideration.
Bid Documents (specifications, cutsheets, and drawings) will only be available electronically. Free access
via ShareFile may be obtained by contacting the Architect: DSGW Architects, Inc., 2 West 1st Street,
Suite 201, Duluth, MN 55802, or by phone (218) 727-2626.
No Bidder shall modify, withdraw, or cancel his Bid or any part thereof for thirty (30) days after the time
designated for the receipt of bids. The Owner reserves the right to reject any and all proposals or bids
and to waive any defects, irregularities or information in any proposal or bid, and to award the contracts to
other than the lowest bidder, if in their discretion the interests of the project will be best served thereby.
All bids shall be accompanied by a certified check or bid bond in the amount of five (5) percent of the
amount of the gross bid payable to the Fond du Lac Reservation, as liquidated damages for breach of
contract if the bidder refuses or neglects to enter into the contract as per his bid.
Performance/Payment Bonds are required.
Wage Rate Requirements will be required for all workers employed at the site.
The Fond du Lac Reservation is a tax exempt entity; no sales tax shall be included in the contractors bid
amounts. The Owner will furnish the Low Bidder with a letter describing the tax exempt status and
procedures to be followed regarding sales tax exemption.
The Fond du Lac Reservation requires that the work force employed at the site shall conform to the
TERO Policy. There is a 25% TERO employment goal for this project.
E-mail bids will be accepted on or before the date and time of the Bid Closing. E-mail bid shall be sent
to: DRowan@dsgw.com.
END OF SECTION
21076.0 / MNAW Imaging 00 11 13 - 1 ADVERTISEMENT FOR BIDS
Renovation FF&E- Bid Package #3
SECTION 00 21 13
INSTRUCTIONS TO BIDDERS
PART I GENERAL
1.01 INSTRUCTIONS TO BIDDERS
A. The "Instructions to Bidders", pages one through six inclusive, AIA Document No. A701, 1997
Edition, as published by the American Institute of Architects, Article 1 thru 8, inclusive, are hereby
made a part of the Contract Documents to the same extent as if bound herein and as
supplemented hereinafter. A copy of A701 is on file in the Architect's office.
B. The “Supplementary Instructions to Bidders”, Section 00 22 13, shall modify, replace or define
portions of AIA A701, Instructions to Bidders, 1997 Edition.
END OF SECTION
21076.0 / MNAW Imaging 00 21 13 - 1 INSTRUCTIONS TO BIDDERS
Renovation FF&E- Bid Package #3SECTION 00 22 13
SUPPLEMENTARY INSTRUCTIONS TO BIDDERS
THE FOLLOWING SUPPLEMENTARY INSTRUCTIONS TO BIDDERS SHALL MODIFY, REPLACE, OR
DEFINE PORTIONS OF THE A.I.A. INSTRUCTIONS TO BIDDERS, A701, 1997 EDITION. THOSE
PORTIONS OF THE A.I.A. INSTRUCTIONS TO BIDDERS, A701, WHICH ARE NOT ALTERED BY
THESE SUPPLEMENTARY GENERAL CONDITIONS SHALL REMAIN IN EFFECT AS PUBLISHED.
1. ARTICLE 1 - DEFINITIONS
ADD the following Paragraph:
1.10 The word "product" herein means any material, equipment, assembly, manufacturer,
brand, trade name, element, item or similar description as applicable. Wherever a
product is named on the Drawings or in the Specifications, the phrase "or acceptable
substitute in the opinion of the Architect" shall be implied throughout the Specification,
whether specifically noted or not.
2. ARTICLE 3 - BIDDING DOCUMENTS
ADD the following Subparagraphs after paragraph 3.1as follows:
3.1.5 Drawings and Specifications may be examined at the locations listed in the Advertisement
for Bids, Section 00 11 13.
3.1.6 Additional sets of Bidding Documents may be purchased from the Architect upon
payment of the sum noted in the Advertisement for Bids, Section 00 11 13. This amount
is not refundable.
ADD paragraph 3.2.4 as follows:
3.2.4 It is the Bidder's (and Contractor's) responsibility to bring all discrepancies, ambiguities,
omissions, or matters in need of clarification to the attention of the Architects and/or
Interior Designer for interpretation and decision.
ADD the following Subparagraphs after paragraph 3.3.1:
3.3.1.1 Any product or manufacturer used as basis of the Specifications shall generally set the
criteria. It shall be expressly understood that any other product or manufacturer listed in
the Specification or any addenda as acceptable will be acceptable provided they fully
comply with the requirements and match the basic and essential criteria of the product
used for base Specification, including the level of workmanship quality, as determined by
the Architect. For final acceptance for use in the work, the Architect shall have the right to
accept or reject proposed deviations. Should a proposed product be unable to meet
requirements, the product shall not be used.
3.3.1.2 Where two or more products are shown or specified, the Bidder and Contractor has his
option of which to use, provided the product proposed will meet all requirements of the
Specifications and the design criteria. The right is reserved by the Architect to accept or
reject proposed deviations in design, function, construction or similar differences that will
affect design intent or quality.
3.3.1.3 For any same or like product for this Project, only one brand, manufacturer, source or
type shall be used, as approved by Architect.
3.3.1.4 For products specified or shown by describing proprietary items, model numbers, catalog
numbers, manufacturers, trade names or similar reference, each Bidder obligates himself
to submit bids and accept awards of a contract based upon the use of such products.
The reference is intended to establish the measure for the quality which has been
determined as requisite and necessary for the Project.
21076.0 / MNAW Imaging 00 22 13 - 1 INSTRUCTIONS TO BIDDERS
Renovation FF&E- Bid Package #3REVISE paragraph 3.3.2 as follows:
3.3.2 No substitutions will be considered prior to receipt of bids unless written request for
approval has been received by the Architect at least seven (7) days prior to the Date for
receipt of Bids...
ADD the following at the end of paragraph 3.3.3:
...If a written reply is required, the Contractor shall furnish two (2) copies of the request
and a self-addressed, stamped envelope. FAX REQUESTS WILL NOT BE ACCEPTED.
ADD paragraph 3.3.5 as follows:
3.3.5 The supplier or manufacturer providing any acceptable product shall bear the cost of any
required modifications to spaces, services, utilities and other features as the result of the
use of his product, including but not limited to, larger capacity mechanical or electrical
service, devices or utilities resulting from acceptance of the product for bidding purposes,
as well as to pipes, conduits, ducts, and controls for conveying, distributing, and
controlling those services or utilities; as well as insulation, wrapping, coatings, or other
integral features of the lines or items conveying those lines, and additional costs of the
products installation.
3. ARTICLE 4 - BIDDING PROCEDURES
4.1 FORM AND STYLE OF BIDS
ADD the following at the end of paragraph 4.1.1:
. . . . . Photocopies of these forms are acceptable. DO NOT REMOVE BID FORMS FROM
BIDDING DOCUMENTS.
4. ARTICLE 6 – POST BID INFORMATION
ADD the following paragraph:
6.4 TIME AND COMPLETION
6.4.1 Each Bidder agrees to commence work on or before a date to be specified in a written
“Notice to Proceed” signed by the Owner, and to fully complete the project as stipulated in
Section 01 10 00.
5. ARTICLE 7 - PERFORMANCE BOND AND LABOR AND MATERIAL PAYMENT BOND
7.1 BOND REQUIREMENTS
ADD the following paragraph:
7.1.4 Each Contractor shall furnish both a Performance Bond and Labor and Material
Payment Bond. The Performance Bond to cover the all guarantees during their entire
term. See also Section 00 73 00, Article 14.3.
21076.0 / MNAW Imaging 00 22 13 - 2 INSTRUCTIONS TO BIDDERS
Renovation FF&E- Bid Package #36. ADDITIONAL LAWS AND REGULATIONS
A. The Bidder's attention is directed to the fact that all applicable State laws, County and
municipal ordinances and the Rules and Regulations of all authorities having jurisdiction
over the construction of the project shall apply to the contract throughout and they will be
deemed to be included in the Contract the same as though written. Refer to section 00
31 00 for further Tribal Conditions applicable to this project.
B. Sales Tax: This project has sales tax exempt status. Bidders shall not include sales
tax amounts for materials in their bids. Contractual requirements for sales tax
exemption will be provided by the Owner.
END OF SECTION
21076.0 / MNAW Imaging 00 22 13 - 3 INSTRUCTIONS TO BIDDERS
Renovation FF&E- Bid Package #3SECTION 00 41 12
BID FORMS - INSTRUCTIONS
Loose copies or photo copies of the bid form following this Section shall be used by the bidder in
submitting his bid (do not remove the attached forms from this document).
The Bidder shall complete all the following items or the bid may be rejected. (See Sections 00 21 13 and
00 22 13 for additional requirements).
1. Date the Bid.
2. Provide firm name, address, and contact person, phone and fax numbers in each area indicated.
3. Clearly state the amount of the Base Bid(s), for which the contractor is submitting a price, in
Written and Numerical Form.
4. Complete itemization pricing schedule. The total of your itemized bid shall equal the Base Bid
listed.
5. Acknowledge receipt of all Addenda.
6. Sign form with typed or printed name, signature and title.
7. Complete and provide any remaining required items.
8. NO FAX BIDS WILL BE ACCEPTED.
9. Complete Compliance Plan included in Section 00 31 00 and include with submitted bid.
10. Complete Item R100 & R200 Required Features & Vendor Response forms and include with
submitted bid.
END OF SECTION
21076.0 / MNAW Imaging 00 41 12 - 1 BID FORM INSTRUCTIONS
Renovation FF&E- Bid Package #3SECTION 00 41 13
BID FORM – STIPULATED SUM
PROJECT: MNAW IMAGING RENOVATION – FF&E BID PACKAGE #3- IMAGING EQUIPMENT
CLOQUET, MINNESOTA
ARCHITECTURE AND INTERIOR DESIGN:
DSGW ARCHITECTS, INC.
2 WEST FIRST STREET
SUITE 201
DULUTH, MINNESOTA 55802
DATE
PLEASE TYPE
OFFICIAL FIRM NAME:
OFFICIAL STREET ADDRESS:
CONTACT PERSON:
TELEPHONE NUMBER:
FAX NUMBER:
E-MAIL:
PROPOSAL
The undersigned, having carefully examined the site, local and all conditions affecting the Work, the
Drawings, Specifications, and Cutsheets, Addenda and Information to Bidders (referred to herein collectively
as the Contract Documents) hereby agrees to enter into a Lump Sum Contract in accordance with the
Contract Documents to furnish all labor, materials, equipment, and other items of expense necessary to
perform and complete the work contained in the bid sections, as enumerated hereinafter for the total sum (in
lawful money of the United States of America) set forth opposite the respective bid section.
BASE BID: SEE SECTION 01 23 00 ALTERNATES & SUBSTITUTIONS FOR DESCRIPTIONS:
BASE BID:
FOR THE SUM OF
DOLLARS ($ ).
21076.0 / MNAW Imaging 00410 - 1 BID FORM
Renovation FF&E- Bid Package #3ITEMIZED BIDS:
ITEM CODE QUANTITY PRODUCT BID PRODUCT EXTENDED
COST EACH ITEM COST
R100 1
R200 1
OTHER COSTS All items N/A
INSTALLATION All items N/A
LABOR
TOTAL N/A N/A N/A
COMPLETION TIME:
If awarded the contract, the undersigned agrees to commence work within seven days of receipt of the Notice
to Proceed. See Section 01 10 00 for intended completion of the specified work of this Contract. Specific
completion dates will be coordinated with the General Contractor.
WITHDRAWAL OF BID:
The undersigned recognizes that the Owner has expanded a great deal of time, effort and money in analyzing
the undersigned Bid and that the Owner is working on a tight time schedule, and accordingly, that the Owner
will be relying on the undersigned’s Proposal. In consideration of each of the aforementioned, the
undersigned agrees that the undersigned will not withdraw his Proposal for a period of sixty (60) days. The
undersigned agrees that neither the rejection by the Owner of this Proposal nor any other action or inaction of
the Owner’s during the aforementioned period shall entitle the undersigned to withdraw this Proposal.
PROOF OF COMPETENCY:
The undersigned agrees to furnish evidence satisfactory to the Owner that he/she and his/her subcontractors
have sufficient means and expertise to assure completion of the contract in satisfactory manner, and to
furnish such evidence within five (5) days of receipt of a written request.
OWNERS RIGHT TO REJECT OR ACCEPT:
In submitting this Bid, the Bidder understands that the right is reserved by the Owner to reject any and all Bids
for any reason including funding, and to waive any informalities in the bidding. If written notice of acceptance
of this Bid is mailed, telegraphed or delivered to the undersigned within forty-five (45) days after the opening
thereof, or at any time thereafter before his Bid is withdrawn, the undersigned agrees to execute and deliver
an Agreement in the prescribed form, and furnish the required Performance and Payment Bonds as required
by the Supplemental Conditions.
ADDENDA:
The following addenda to the Contract Documents are acknowledged:
Addenda Addenda Addenda Addenda
Date Date Date Date
21076.0 / MNAW Imaging 00410 - 2 BID FORM
Renovation FF&E- Bid Package #3OFFICIAL FIRM NAME:
Signed:
By:
Name and Title:
END OF BID FORM
21076.0 / MNAW Imaging 00410 - 3 BID FORM
Renovation FF&E- Bid Package #3SECTION 00 43 25
REQUEST FOR APPROVAL OF SUBSTITUTION
Damberg Scott Gerzina Wagner Architects, Inc DATE:
MNAW IMAGING RENOVATION NO.: 21076.0
FURNITURE, FIXTURES & EQUIPMENT- BP#3
IMAGING EQUIPMENT
CLOQUET, MINNESOTA BID DATE:
We hereby submit for your consideration the following product to replace the specified item for the above project.
ITEM CODE SPECIFIED ITEM
Proposed Substitution:
[ ] Complete catalog and technical data and a picture must be attached.
Does the substitution affect dimensions shown on Drawings? [ ] Yes [ ] No
If Yes Describe:
Will the undersigned pay for changes to the FF&E design caused by the requested substitution?
[ ] Yes [ ] No
Does substitution affect other trades? [ ] Yes [ ] No
If Yes Describe:
Manufacturer's guarantees of the proposed and specified items are different? [ ] Yes [ ] No
(Explain on attachment)
Submitted By: RESPONSE OF SPECIFIER*
[ ] Request is approved subject to
Signature compliance with the Specification
and an Addendum will be issued.
Firm [ ] Approval cannot be granted because
this request did not reach this office
within the specified time.
Address
[ ] Approval cannot be granted at this time.
Date: [ ] Prior Approval for this substitution
is not required by the Specification
Telephone:
By:
*Written response will be made if stamped Signature
self-addressed envelope is submitted with
this request. Date:
END OF SECTION
21076.0 / MNAW Imaging 00 43 25 - 1 REQUEST FOR APPROVAL
Renovation FF&E- Bid Package #3 OF SUBSTITUTIONSECTION 00 50 00
LIST OF CONTRACT FORMS
PART 1: GENERAL
1.01 FORMS INCLUDED
A. The following is a list of contract forms applicable to this project.
1. Agreement: The Contract form will be AIA Document A151, Owner & Vendor for FF & E
– Stipulated Sum, 2007 Edition. Copies will be furnished by the Architect.
2. Insurance: Certificate of Liability Insurance, as provided by Contractor’s insurance
company.
3. Performance Bond and Labor and Material Payment Bond: Standard bond form
conforming to Minnesota statutes (AIA Document A312, 1984 Edition, preferred but not
required) provided by Surety. Submit in two copies with proper Power of Attorney and
acknowledgments.
4. Revisions to Agreement: The contract revision form will be AIA Document G701, Change
Order, 2001 Edition. Copies will be furnished by the Architect.
5. Application for Payment: The contract application for payment form will be AIA Document
G702 & G703. Copies will be furnished by the Architect.
END OF SECTION
21076.0 / MNAW Imaging 00 50 00 - 1 LIST OF CONTRACT FORMS
Renovation FF&E- Bid Package #3SECTION 00 72 00
GENERAL CONDITIONS
PART 1GENERAL
1.01 GENERAL CONDITIONS
A. The "General Conditions of the Contract for Furniture, Furnishings and Equipment (AIA Document
A251, 2007 Edition), as published by the American Institute of Architects are hereby made a part
of the Contract Documents to the same extent as if bound herein and as supplemented
hereinafter. A copy of A251 is on file in the Architect's office.
B. The Conditions of this section shall apply to all Sections of this project.
C. The "Supplementary General Conditions", Section 00 73 00, shall modify, replace or define
portions of AIA A251, General Conditions of the Contract for Furniture, Furnishings and
Equipment, 2007 edition.
END OF SECTION
21076.0 / MNAW Imaging 00 72 00 - 1 GENERAL CONDITIONS
Renovation FF&E- Bid Package #3SECTION 00 73 00
SUPPLEMENTARY GENERAL CONDITIONS
1. SCOPE
A. Supplementary General Conditions cover conditions of a general nature peculiar to a project
which may or may not be related to subjects included in the standard AIA General Conditions of
the Contract for Furniture, Furnishings and Equipment, A251, 2007 Edition or Division 1 - General
Requirements.
B. The conditions of this Section shall apply to the technical sections of Divisions 2 through 16.
2. BASIC DEFINITIONS
Article 1.1 of the General Conditions shall be supplemented as follows:
1.1.9 ADDENDA
Addenda record modifications to the working drawings and specifications made prior to
the signing of agreement for the construction of the project by the Owner and the
Contractor.
3. CORRELATION & INTENT OF THE CONTRACT DOCUMENTS
ADD the following after subparagraph 1.2.1:
1.2.1.1 By executing the Contract or a subcontract on this Work. Contractor or subcontractor
warrants that he has reviewed the Contract Documents and that his products shall be
installed satisfactorily (including features unique to a specific product or assembly not
specifically indicated on the Drawings and Specifications, or different from those
indicated), including the payment of the cost of additional work of others as may be
necessary to bring the Work into conformance with the unique requirements of any such
products.
1.2.1.2 If there is an inconsistency in the quality or quantity of Work required by the
Contract Documents, the greater quality or quantity of Work indicated shall be
provided in accordance with the Architect's interpretation, and no change in the
Contract Sum will be permitted.
Article 1.2 of the General Conditions shall be supplemented as follows:
1.2.4 The Precedent of the Construction Documents is in the following sequence:
1. Addenda or modifications of any nature to the drawings and specifications take
precedence over the original contract documents.
2. Specifications and cutsheets shall take precedence over working drawings. Where
specified but not shown on the drawings, the Contractor shall be responsible for the
furnishing and installation of the item(s) as specified.
3. The Drawings: Precedent shall be drawings of larger scale over those of smaller,
figured dimensions over scaled dimensions, and noted materials over graphic
indications. Where installation is shown or noted but not specified, the Contractor
shall be responsible for furnishing and installation of the item(s) shown.
4. When material or equipment occurs on plans but is not covered in Specifications, the
material or equipment and its related installation shall be furnished and installed by
the Contractor or Subcontractor who is primarily responsible for other work of similar
nature indicated in the Drawings or Specifications.
5. When duplication of material or equipment occurs in plans or specification in
separate contracts, contractor shall assume they are furnishing this material or
equipment.
21076.0 / MNAW Imaging 00 73 00 - 1 SUPPLEMENTARY GENERAL
Renovation FF&E- Bid Package #3 CONDITIONS4. OWNER
Paragraph 2.1 shall be supplemented as follows:
...The term "Authorized Representative" is expanded to include any consultant(s)
employed by the Owner to carry out the work of the project.
ADD 2.1.1 OWNER'S RIGHT TO CARRY OUT THE WORK
2.1.1 If any Contractor defaults or neglects to carry out the work in accordance with the Contract
Documents and fails within forty-eight (48) hours after receipt of written notice from the
Owner, to commence and continue correction of such default or neglect with diligence and
promptness, the Owner may, and without prejudice to any other remedy the Owner may have,
make good such deficiencies. In such case, a change order shall be issued deducting from
the payments then or thereafter due to the Contractor, the cost of correcting such
deficiencies, including compensation for the Architect's additional services made necessary
by such default, neglect or failure. If payments then or thereafter due the Contractor are not
sufficient to cover such amount, the Contractor shall pay the differences to the Owner.
5. VENDOR
After paragraph 3.2.5, ADD the following:
3.2.6 No change in the Contract Sum will be allowed on account of minor difference between
actual field conditions and the Contract Documents.
ADD the following Subparagraphs after Paragraph 3.4.2:
3.4.2.1 After the Contract has been executed, the Owner and Architect will consider requests for
the substitution of products in place of those specified only under the conditions set forth
in the General Requirements (Division 1 of the Specifications). By making requests for
substitutions, the Contractor:
.1 represents that it has personally investigated the proposed substitute product and
determined that it is equal to superior in all respects to that specified;
.2 represents that it will provide the same warranty for the substitution as it would have
provided for the product specified.
.3 certifies that the cost data presented is complete and includes all related costs for the
substituted product and for Work that must be changed as a result of the substitution,
except for the Architect’s redesign costs, and waives all claims for additional costs
related to the substitution that subsequently become apparent; and
.4 shall coordinate the installation of the accepted substitute, making such changes as
may be required for the Work to be complete in all respects.
3.4.2.2 The Owner shall be entitled to reimbursement from the Contractor for amounts paid to the
Architect for reviewing the Contractor’s proposed substitutions and make agreed-upon
changes in the Drawings and Specifications resulting from such substitutions.
ADD the following after 3.5:
3.5.1 Sales Tax: This project has sales tax exempt status. Contractor shall not include
sales tax amounts for materials in their contract. Contractual requirements for sales
tax exemption will be provided by the Owner.
6. INSURANCE
Paragraph 13.1.2 shall be supplemented as follows:
13.1.2.1 All insurance companies writing coverage for this project shall be approved or licensed to
operate within the State in which this project is located and shall hold a general
policyholder's rating of A and a financial rating of AAA as rated in the most current
available Best's insurance report. Written certification of this requirement shall be
presented to the Owner and Architect.
13.1.2.2 The insurance required by Sub-Paragraph 11.1.1 shall be not less than the following:
21076.0 / MNAW Imaging 00 73 00 - 2 SUPPLEMENTARY GENERAL
Renovation FF&E- Bid Package #3 CONDITIONSA. WORKMEN'S COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE:
Workmen's Compensation and Occupational Disease Insurance as
statutory limits as provided by the State in which this Contract is performed
and Employer's Liability Insurance at a limit of not less than Five Hundred
Thousand Dollars ($500,000.00) for all damages arising from each
accident or occupational disease.
B. COMPREHENSIVE GENERAL LIABILITY INSURANCE COVERING:
1. Operations - Premises Liability: Including, but not limited to: Bodily injury,
including death at any time resulting therefrom, to any person or property
damage resulting from execution of the work provided for in this contract or
due to or arising in any manner from any act or any omission or negligence
of the Contractor and any Subcontractor, their respective employees or
agents.
2. Elevator Liability: Including, but not limited, bodily injury, including death at
any time resulting therefrom, to any person or property damage resulting
from operation of or use of any elevator or hoist, if either or both are
operated or used in connection with execution of this contract.
3. Contractor's Protective Liability: Including, but not limited to, bodily injury,
including death at any time resulting therefrom, to any person or property
damage arising from acts or omissions of any Subcontractor, their
employees or agents.
4. Products - Completed Operations Liability: Including, but not limited to,
bodily injury including death at any time resulting therefrom to any person or
property damage because of goods, products, materials, or equipment
used or installed under this contract or because of completed operations
which may become evident after acceptance of the building, including
damage to the building or its contents. Shall be kept in force for at lease
two years after date of final completion.
5. Contractual Liability: Each and every policy for liability insurance, carried by
each Contractor and Subcontractor as required by this Article shall
specifically include contractual liability (hold harmless clause) coverage with
respect to Article 3.18 of the AIA General Conditions.
6. Special Requirements: The insurance required under 11.1.1 of this Article
shall specifically include the following special hazards:
a. Personal injury liability with employment exclusions deleted.
b. Property damage liability coverage shall be broad form coverage,
including completed operations.
c. "Occurrence" bodily injury coverage in lieu of "Caused by Accident."
7. Limits of Liability: The insurance under 1.1.1 of this Article shall be written
in the following limits of liability as a minimum:
BODILY INJURY
$1,000,000 each occurrence
$1,000,000 aggregate
PROPERTY DAMAGE
$1,000,000 each occurrence
$1,000,000 aggregate operations
$1,000,000 aggregate protective
$1,000,000 aggregate products
$1,000,000 aggregate contractual
PERSONAL INJURY LIABILITY
$1,000,000 each person aggregate
$1,000,000 each occurrence
$1,000,000 general aggregate.
C. COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE COVERING:
21076.0 / MNAW Imaging 00 73 00 - 3 SUPPLEMENTARY GENERAL
Renovation FF&E- Bid Package #3 CONDITIONS1. All owned, hired, or non-owed vehicle used to carry out work of this project
including the loading or unloading thereof.
2. Special Requirements: The insurance required under 11.1.2 C of this Article
shall specifically include the following special hazards:
a. "Occurrence" bodily injury in lieu of "Caused by Accident."
b. "Occurrence" property damage in lieu of "Caused by Accident."
3. Limits of Liability: The insurance under 11.1.2. C of this Article shall be written
in the following limits of liability as a minimum:
AUTOMOBILE BODILY INJURY
$1,000,000 each person
$1,000,000 each occurrence
AUTOMOBILE PROPERTY INJURY
$1,000,000 each occurrence
D. Umbrella Clause: If an umbrella clause is written to implement the above prime
coverages, the umbrella clause shall specifically state that the policy is written on
an "occurrence" basis. Any combination of underlying premium with excess or
umbrella coverage will satisfy the total liability limits required in the agreement.
E. The Architect and the Owner assume no responsibility in the event the limits set
above are not adequate.
ADD the following after Paragraph 13.1.3:
13.1.3.1 No Contractor shall commence work under this Contract until he has obtained all
insurance required under this Section and such insurance has been approved by the
Owner and Architect, nor shall any Contractor allow any Subcontractor to commence
work on his subcontract until the same insurance has been obtained by the
Subcontractor. Unless exception are noted or specified, each and every Contractor and
Subcontractor shall maintain all insurance required under 11.1.1, and 11.1.2 of this
Section for not less than one year after completion of the Contract.
13.1.3.2 Each Contractor shall file with the Owner and Architect two copies of a Certificate of
Insurance on standard AIA-AGC Joint Committee forms. Any certificate submitted and
found to be incomplete will be returned as unsatisfactory. Certificates of Insurance shall
contain a clause stating that coverage afforded by the policies listed will not be canceled
or materially altered, except after 45 days advance written notice to the Owner, and
Architect, mailed to the addresses listed herein.
13.1.3.3 If requested by the Owner, Contractor shall furnish the Owner with true copies of each
policy required of him or his Subcontractors.
13.1.3.4 Each Contractor shall secure the following endorsements to each of the above policies:
"It is understood and agreed that the insurance company will give not less than forty-five
(45) days advance written notice of any cancellation nor material change under any of
these policies to the Owner."
"In the event that such Notice is not given to the Owner at least forty-five (45) days prior to
cancellation or material change, the policy will continue in full force and effect for the
benefit of the Owner as if such change or cancellation had not occurred."
13.1.3.5 The Architect and Owner shall be named as Additionally Insured on the Contractor's
Certificate of Insurance.
21076.0 / MNAW Imaging 00 73 00 - 4 SUPPLEMENTARY GENERAL
Renovation FF&E- Bid Package #3 CONDITIONS7. MISCELLANEOUS PROVISIONS
Article 14 shall be supplemented as follows:
14.3 BONDS
14.3.1 The Owner will require the Contractor to furnish a Performance Bond and a Labor
and Material Payment Bond, in the amount of 100 percent of the Contract Price, in
the form of AIA Document A312, latest edition. Performance Bond shall cover all
guarantees during their entire term. Premium for these Bonds, shall be paid by the
Contractor and be included in the Contract Sum. Said Bonds must be delivered to
the Owner prior to commencement of any work.
14.3.2 The failure of the successful bidder to execute the contractor agreement to supply the
required bond or bonds within ten days after the prescribed forms are presented for
signature or within such extended period as the Owner may grant, based upon reasons
determined sufficiently by the Owner, shall constitute a default, and the Owner may either
award the Contract to the next lowest responsible bidder or re-advertise for bids, and may
charge against the bidder the difference between the amount of the bid and the amount
for which a contract for the work is subsequently executed, irrespective of whether or not
the amount thus due exceeds the amount of the Bid Bond. If a more favorable bid is
received by re-advertising the defaulting bidder shall have no claim against the Owner.
14.4 PARTIAL OCCUPENCY OR USE
14.4.1 If the Work is not complete by the Date of Substantial Completion, but the Work is to a
state of readiness to permit partial or full use or occupancy by the Owner, the Owner
reserves the right, without negating or abridging any rights of the parties, upon notice to
the Contractor, to enter into, occupy, or make use of those parts that are suitable for his
needs. The Contractor shall cooperate with the Owner in the use of the Work and
coordinate his operations with the Owner.
14.4.2 The Owner's beneficial use or occupancy, as provided for in 9.9.4 and 9.9.5 shall not be
construed as acceptance of the Work or any of its materials and equipment. Such use
and occupancy shall be subject to any corrections of deficiencies, damage, or omissions
noted. Damage not caused by the Contractor, occurring after occupancy, will be the
responsibility of the Owner.
14.4.3 To the extent applicable to the Project, as determined by the Architect, the Contractor
shall conform to the provisions of this subparagraph. Upon occupancy by the Owner,
complete and usable facilities necessary for safety, comfort, and Owner's functions shall
be available at all times, so the Owner can use the Project or the Work without hazards,
discomfort or inconvenience. After occupancy by the Owner, his program, functions or
normal use shall not be unnecessarily interrupted or permitted. The Contractor shall
schedule and arrange his Work to accomplish this objective and if necessary, work shall
be scheduled at times when the Project is not in use by the Owner, without additional cost
to Owner.
14.4.4 The Owner reserves the right to enter into the Project at all times and make installations
of his equipment as work progresses and to install his furnishings as space becomes
substantially complete. The Contractor shall cooperate and coordinate his work with
workmen of the Owner.
8. ADDITIONAL REQUIREMENTS
ADD ARTICLE 15 AS FOLLOWS:
15.1 WAGE RATES
A. Prevailing wages shall be included. See also Tribal Bidding Requirements.
21076.0 / MNAW Imaging 00 73 00 - 5 SUPPLEMENTARY GENERAL
Renovation FF&E- Bid Package #3 CONDITIONSADD ARTICLE 16 AS FOLLOWS
16.1 TRIBAL BIDDING REQUIREMENTS
A. The following Tribal Bidding Requirements are appended to this Section:
#12-94 Tribal Employment Rights Ordinance
#5-84 Business License Ordinance
Compliance Plan
Contractor Testing Requirements
ST3 Minnesota Revenue Certificate of Exemption
Tribal and Federal Bidding Conditions
FDL Vendor Screening Guidelines
END OF SECTION
21076.0 / MNAW Imaging 00 73 00 - 6 SUPPLEMENTARY GENERAL
Renovation FF&E- Bid Package #3 CONDITIONSORDINAI{CE #5/84, as amended
FOND DU LAC BAIiID OF LAKE SUPERIOR CHIPPEWA
BUSTNESS LICENSE ORDINAIICE
Adopted on ,June 2L, l-984 by Resolution #L29/84 of the ReservaLion Busj.ness
Committee.
Amended on November 21, l-991-by Resolution #1re0/91 of the Reservation Business
Commit,Eee.
Amended on Decembelr 7, 1995, by Ordinance #08/95, adopted by ResoluEion #1416/95
of t,he Reservation Business Committee.
Amended on September 22, 2009 by ResoluEion #1368/09 of the ReservaEion Business
CommiEtee.TABI,E OF CONTEMfS
Section 1 Trade, Business, or Professional License--Entities
Required to Obtain
Sectlon 2 Procedures
Section 3 Dncrf i rrrr
Section 4 Duration
Section 5 Failure to Apply for License
Section 5 $anctions
Section z Amendments or Recission1. TRADE, BUSINESS OR PROFESSIONALLICENSE.-ENTITLES REOUIREDTO
OBTAIN
(a) Every entity, including, but not limited Lo, an
individual, a group of individuals, a sole p r o p r i e t o r s h i p ,
part,nership, association, joint venture, or corporation, which,
prior to the effect.ive date of this code, was engaged in a trade,
business, or profession, or commercial activity of any sort within
the exterior boundaries of t h e F o n d d u L a c R e s e r v a tion (hereinafter
rrReservation" or Fond du Lac'r) shaLl, prior to August 31, 1985, (30
days after approval by the Secretary of InLerior) and prior to
January 3l- of each calendar year thereafter, file with the Fond du
Lac Reservation Business Committee (hereinafter r r F o n dd u L a c " ) , a n
application for a business l-icense which, upon issuance, shall
entitle such entity to engage in the kind(s) of Business activity
at the location(s) Iisted in the application.
(b) Every entity, including but not limited Lo, an
individual, group of individual-s, sole p r o p r i e t o r s h i p , p a r t n e r s h i p ,
association, joint venture or corporation, intending to engage in
a trade, business, profession, or commercial activity of any sort
within the exterior boundaries of the Reservation, but which was
not engaged in such activity prior to August 31, 1985, shaII, prior
to commencing busj.ness within the exterior boundaries of the
Reservation, and prior to.Tanuary 3l- of each calendar year
thereafter, file with Fond du Lac, an application for a business
Jicense, which, upon issuance shall entitle said entity to engage
in the kind(s) of business activity at the location(s)Iisted in the
appl- icat ion .
(c) Each application shall be accompanied by a $50.00 payment
which shal-I constitute the non-refundable application fee.
(d) (1) No Jicense shall be required:
(A) of any person engage in the ministry of
healing by purely spiritual- means or other
religious activity;
(B) of any entity 51t or more cwned by the Fond du
Lac Reservation Business Committee or the
Minnesota Chippewa Tribe;
(c) of any person under the age of l-B who conducts
any activities which grosses less than three
thousand dollars ($3,000) in the prior
calendar yeart
(D) of any person who is engaged in the production
of the traditiona] craf ts of the Oj ibwe in t.he
traditional manner provided the sal-es of such
crafts is less than ten thousand dollars
($l-0,000) in the prior calendar year;(E) of any person who engaged in the harvesting or
processing of ''Wild Rice" in the traditional
manner of the Ojibwe;
(F) of any person who engaged in a business
operated entirely from their place of
residence which grosses l-ess than three
thousand dollars ($3,000) in the prior
calendar yeari or
(2) \To officer or employee of any government and no
individual in private or puhlic employment which is
compensated for services performed by him as an employee
by his employer, shalI, for such employment, be required
tro obtain a license; in the case of a partnership,
association or joint venLure, f,o license shall" be
required of any partner, associate or joint venture who
does not engage in or conduct a trade, business or
professional- activity of the p a r t n e r s h i p , a s s ocj-atj-on or
joint venture on the Reservation.
(e) A copy of the license application form may be obtained
during regular b u s i n e s s h o u r s a t t h e o f f i c e s of the Fond du Lac
Reservation Business Committee. The I i c e n s e required to be
obtained under the provisions of this subsection shall be in
addition to all- other licenses, fees and permits required by Iaw.
2. PRQEEDI]REE
(a) within 10 working days after receipt of an application
and fee, as prcrrided in Section L, the F o n d d u Lac Reservation
Business Committee shall issue to said appficant a l-icense to
engage in it.s business activity on the Reservation. Said license
shalI indicate the kind(s) and locations(s) of business activity
for which the entity has been }icensed.
(b) Notwithstanding subsection (a) of this secLion, no
Iicense shall be granted to any entity until it has presented proof
to t.he Fond du Lac Reservation Business Committee that it has
complied with all tribal requirements established a s c o n d i t i o n s of
commencing business on the Reservation, including, but not l i m i t e d
to, the following:
(1) Pursuant to the Tribe's contracL and emplolrment
preference code, evidence that the entity has submitted to the
appropriate tribal enforcing agency the compliance plans
required by those ordinances and has had such plans approved
by the enforcing agency(s).
(2) If subject to the corporate code of the Fond du Lac
Band of Lake Superior Chippewa has fiLed the proper documents
authorizirtE it to conduct business as a corporation.(3) If applicant's business activities on the Reservation
involve contracting or subcontracting, rro license shall be
issued under this Ordinance in the name of a corporation or
partnership unless (1) a copy of a certified corporate charter
or certified partnership agreement has been filed with the
Fond du Lac Registrar's Office, and ( 2 ) doeumentation of the
entity's federal employer and staLe taxpayer identification
numbers have been filed with the Fond du Lac Registrar's
office.
(c) Notwithstanding subsection (a) of this section, where the
Fond du Lac Reservation Business Committee has reason to believe
that. an entity apptying for a License, pursuant to Section L,
shal1, if permitted to commence business on the Reservation,
present a danger to the political- integrity, economic securj-ty,
health, safety, welfare, or morals of residents of the residents of
the Reservation, the Fond du l,ac Reservation Business Committee
shall, within l-0 working days, provide said entity with a written
notice setting out the reason it believes the entity presents such
a danger and noticing a date for a hearing, said hearing to be held
not later than l-0 working days after the delivery of said notice.
At said hearing the entity shaIl be given an opportunity to
demonstrate that its business activity does not present a danger to
the political integrity, economic security, health, safety,
wel-fare, or moral-s of the residents of the Reservation. The Fond
du Lac Reservation business Committee shall- establish necessary
procedures for said hearing that comply with the requirements of
due process. However, the formal rules of evj-dence shal1 not
appIy. If the Executive Director or his authorized delegate of the
Fond du Lac Reservation Business Commit.tee flnds, by a
preponderance of the evidence, that a danger does exist, he shall,
within 2 working days, so notify said entity, in writing, stating
the reasons for his finding. Said entity may appeal the Director's
decision to the tribal court and shall be entitled t,o an expedited
hearing on the matt.er. If the Director finds there is no danger,
he shall cause Lo issued within 2 working days, a business license
to said entity.
3. POSTING
Every entity issued a license pursuant to Section 2 shall- post
it in a conspicuous place at the business l-ocation listed on the
Iicense, or, if it lists more than one Jocation, it shall post a
notice indicatinq the location at which the license is posted.4. DS8A:IIpN
All Iicenses issued under this Code shall remain in effect for
the duration of the calendar year for which issued unless revoked
as provided in this Code or under the provisions of any other
Tribal Code and shall expire at Midnight on the 3l-st day of
December of each year. No license may be transferred to any other
partry.
5. FAII,I]RE TO APPLY FOR LICENSE
(a) An entit.y doing business on the Reservation which fails
to obtain a l-icense as provided for in the Code shal1, in addition
to being required to immediately obtain such a license and pay the
requisite fee, be fined $50 per day for each day it operated on the
Reservation without a license, unless good cause is shown to the
Executive DirecLor as to why such a Jicense had not been obtained
in a timely manner. If the Executive Director or his authorized
delegate becomes aware that an entj-ty i s conducting business on the
Reservation without a license, he shall del-iver, by hand, or by
registered mail (return receipt requested), a notice to the entity
informing it that it is operating on the Reservation in violation
of this code and that it shall, wit.hin 2 working days, obLain such
a license and pay such f ines as are indica[ed in the let.t.er.
However, where the Director has reason to bel-ieve that the
political integrity, economie security, health, safety, welfare or
morals of resiclents of the Reservat j-on are endangered by the
continuation of such business activity, t h e D i r e c t o r m , a yo r d e r s u c h
business to terminate all business activity until it has obtained
a license.
(b) Any entity doing business on the Reservation without a
license which fails to obtain a license within the time period
required by the Executive Director or his authorized del-egate of
the Fond du Lac Reservation Business Committee as prcvided for in
subsection (a) above, or any entity whose license to do business
has been revoked by any court or agency of competent jurisdiction
pursuant to any provision of this Code or any other Tribal Code,
shall immediately cease to carry out business on the Reservation;
provided that, upon a showing of good cause, the Executive Director
or his authorized delegate of the Fond du Lac Reservation Business
Committee or the Tribal Court may grant the entity a reasonable
period during which to conclude his business so long ds, during
that time, the continuation of such business does not endanger the
political integrity, economic security, health, safety, welfare, or
morals of residents of the Reservation. Where notice to cease
business i s i s s u e d by the E x e c u t i v e D i r e c t o r o r h i s a u thorized
delegate, it shall be sent by certified mail- ( r e t u r n receipt
requested), or hand delivered by an employee of the Fond du Lac
Reservation Business Committee.6. SAI{CTIONS
(a) If an entity doing business on the Reservation t.hat has
been directed by the Executive Director or his authorized delegate
of the Fond du Lac Reservation Business Committee or the Tribal
Court to cease doing business on the Reservatj.on, either pursuant
to Section 5 of this Code or pursuant to the revocation of its
l-icense to do business on the Reservat,ion under any other Tribal
Code, fails to comply, the Executive Director or his authorized
delegate shaLf petition the court for a show cause order as to why
said business shal-I not be excluded from the Reservation. Where
the Executive Director or his authorized delegate alleges that the
business present.s a danger to the political integrity, economic
security, health, safety, welfare, or morals of residents of the
Reservation, the Court shall hotd an expedited hearing. If said
entity fails to appear or f a i l s t o s h o w g o o d c a u s e , t h e Tribal
Court, shall order to the Fond du Lac Conservation Department or
other authorized Office to take appropriate action:
(1) V ' I h e r et h e p e r s o n o r p e r s o n s e n g a g i n g i n b u s i n e s s a r e
not members of the Minnesota Chippewa Tribe, the court shall
order the police to physically remove all such persons from
the Reservation along with any personal property used in the
conduct of said business that can be removed without causing
permanent damage to it. For property which cannot be so
removed, such as a building, the court shall order, Lhe polrce
shalI implement, the incapacitation of said property by
padlocking or other means so that it can no longer buy used to
carrv out business.
(2) Where the person or persons doing business in
viol-ation of this Code are tribal members they shall be
prosecuted for criminal contempt of court and al-I persona] and
real property used in the conduct of said business shall be
impounded, padlocked, or otherwise incapacitated so that it
cannot be used to carry out further business on the
Reservation. A corporation, partnership or other entity shall
be considered a tribal r r m e m l o e r .f o r p u r p o s e s o f t h i s s e c t i o n
only if 518 or more of the entity is owned by tribal members.
(b) An entity may recover all- such property incapacitated or
impounded under this section by paying to the Tribe the costs
incurred by the Tribe in carrying out these legal proceedings as
weII as a fine not to exceed $500 per day for each day that has
passed since it was ordered by the executive Director or his
authorized delegate of the Fond du Lac Reservation Business
Committee or the tribal court to obtain the tribal license.
(c) An entity excluded or incapacitated under this provision
shall be g r a n t e d a new license to engage in business activity on
the Reservation only if:(1) no less than six months have passed since the date
of the exclusion order and all outstanding fees and fines are
paid; and
(2) the entity has paid all costs incurred by the Tribe
in carrying out the excl-usion or incapacitation order and has
paid such fine as the court deems appropriate, but not to
e x c e e d $ S O O0, 0 0 . 0 0 .
(3) Notwithstanding the provisions of subsections (1)
and (2) of this section, the Executive Director or his
authorized delegate of the Fond du Lac Reservation Business
Committee or the court, m61rr for good cause, deny such an
entity a new l-icense, or may waive or mitigate the provisions
of subsections (1) and ( 2 ) of this section.
7 . OR RESCISSION
AMENDMEMT
The provisions of this Ordinance may be amended or rescinded
bv Resolution of the Fond du Lac Reservation Business Committee.
EEETIEIEA:T:IQN
We do hereby certify that the foregoing Ordinance was duly adopted
b y R e s o l u t i o n # T 2 9 / 8 4 o n l T u n e 2 I , l -9 8 4 b y a v o t e o f 2 f o r , 0
against, with a quorum of 3 being present at a Regular Meeting of
the F o n d du Lac ReservaLj-on Business Committee held on June 2I,
l-984 at Cloquet, Minnesota; and subsequently amended by Resolution
#rr+0/9r on November 2I,1991; Ordinance #08/gs adopted by
R e s o l - u t i o n # L 4 I 5 / 9 5 o n D e c e m b e y7 , 1 9 9 5 ; a n d R e s o l u t i o n # 1 3 6 8 / 0 9 o n
September22, 2009.
Ka*en R. Diver Ferdinand Martinea
Secretary/Treasurer
laws:84 5 (062184;II?191,'t?0795;092209)Fond du Lac Band of Lake SuperiorChippewa
1720Big LakeRoad,Cloquet,MN 55720
BusinessLicenseApplication
For the Calendar Year 2
Nameof Business:
TelephoneNumber: ContactPerson'sName:
Mailing Address: Zip Code:
Form of Business:(Corporation,Partnership, SoleProprietorship,
etc):
If corporationor paf,tnership, whereregistered:
(Attach a certified copy of the Articles of Incorporationand/orPartnershipAgreement)
2. Type(s)of Business:
3. Businesslocation(s)within the boundariesof the Fonddu Lac Reservation:
4. Descriptionof activitiesto be conductedby the applicantbusinesswithin the boundariesof the Fonddu
Lac Reservation:
5. Owner(s)NameandAddress: Tribal Member nYes flNo
Owner(s) Name and Address: Tribal Member nYes lNo
6. Will the applicantengagein any contractingor subcontractingactivity? trYes nNo
If yes, the applicant must submit a plan to the Executive Director of the Fond du Lac Reservation
BusinessCommitteeoor his designee,in compliancewith the Fond du Lac Tribal EmploymentRights
Ordinance,FDL Ord. #12194.Applicantherebyacknowledges that the issuanceof a businesslicenseis
contingentupon its compliance with FDL Qrd. #12194,and faihue to remaincompliantwill resultin the
revocationof its businesslicense.
Contractorsand Subcontractors: Pleaseattacha completedW-9 form (a copy can be downloadedfrom
website:www.irs.gov)and a copy of documentationfrom the Statewhere your businessis registered
evidencingthe taxpayeridentificationnumberissuedby saidState.Applicant hereby agreesto comply wittr all applicabletribal laws and policies in its conduct of businesson the
Fond du Lac Reservation, and further acknowledgesthat it must comply with any contractual dnrg and alcohol
testing requirementswhen contractingwith the Fond du Lac ReservationBusinessCommittee,or any corporate
entity or subdivision of the Fond du Lac Band, and that failure to comply will result in the revocation of its
businesslicense. Applicant hereby gives consentto the Fond du Lac ReservationBusinessCommittee, or its
designees,to accessinformation its deemsnecessaryto veriff the legitimacy of its businessthrough any state,
federal,or local recordssystems.
on behalfof
hereby certiff that the information provided in this application is tnre and complete to the best of my knowledge
and belief. I firther herebycertiff that I have read the Ordinance5/84 of the Fond du Lac ReservationBusiness
f,emmittee and do herebysubmit to thejurisdiction provided for therein.
Signahrre Date
t An applicationfee of $50.00must accompanythis application.
t Faihue to attachrequireddocumentationwill result in the rejectionof this applicationand forfeiture of the
applicationfee.
Returnto: Office of the Regisftar
Fond du I-ac Band of Lake Superior Chippewa
1720Big Lake Rd
Cloquet,MN 55720ST3
Certificate of Exemption
Purchaser: Complete this certificate and give it to the seller.
Seller: If this certificate is not fully completed, you must charge sales tax. Keep this certificate as part of your records.
This is a blanket certificate, unless one of the boxes below is checked, and remains in force as long as the purchaser continues
making purchases, or until otherwise cancelled by the purchaser.
Check if this certificate is for a single purchase and enter the related invoice/purchase order # .
If you are a contractor and have a purchasing agent agreement with an exempt organization, check the box to make multiple
purchases for a specific job. Enter the exempt entity name and specific project:
Exempt entity name Project description
Name of purchaser
Business address City State Zip code
Please print
Purchaser’s tax ID number State of issue Country of issue
If no tax ID number, FEIN Driver’s license number/State issued ID number
enter one of the following: state of issue number
Name of seller from whom you are purchasing, leasing or renting
Seller’s address City State Zip code
Type of business. Circle the number that describes your business.
01 Accommodation and food services 11 Transportation and warehousing
02 Agricultural, forestry, fishing, hunting 12 Utilities
Type of business
03 Construction 13 Wholesale trade
04 Finance and insurance 14 Business services
05 Information, publishing and communications 15 Professional services
06 Manufacturing 16 Education and health-care services
07 Mining 17 Nonprofit organization
08 Real estate 18 Government
09 Rental and leasing 19 Not a business (explain)
10 Retail trade 20 Other (explain)
Reason for exemption. Circle the letter that identifies the reason for the exemption.
A Federal government (department) I Industrial production/manufacturing
Reason for exemption
B Specific government exemption (from list on back) J Direct pay permit #
K MPU exemption
Multiple is no
points of use longerdigital
(services, valid;goods, or
C Tribal government (name) repealedsoftware
computer Marchdelivered
8, 2008electronically)
D Foreign diplomat # L Direct mail
E Charitable organization # M Other (enter number from back page)
F Religious or educational organization # N Percentage exemption
G Resale Advertising (enter percentage) %
H Agricultural production Utilities (enter percentage) %
I declare that the information on this certificate is correct and complete to the best of my knowledge and belief. (PENALTY: If you
try to evade paying sales tax by using an exemption certificate for items or services that will be used for purposes other than
Sign here
those being claimed, you may be fined $100 under Minnesota law for each transaction for which the certificate is used.)
Signature of authorized purchaser Print name here Title Date
Stock No. 2100030 (Rev 7/09) Forms and fact sheets are available on our website at www.taxes.state.mn.usYou can also read
