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NOTICE OF INVITATION TO BID
SEALED BIDS FOR A LICENSED CONTRACTOR TO PROVIDE "DRAINAGE IMPROVEMENTS
FOR POTOMAC AVENUE" WILL BE ACCEPTED BY THE CITY OF SEBASTIAN, 1225 MAIN
STREET, SEBASTIAN, FLORIDA 32958, UNTIL 2:00 PM ON MARCH 15,2011. BID ENVELOPES
ARE TO BE MARKED AS FOLLOWS:
BID: POTOMAC AVENUE DRAINAGE IMPROVEMENTS
BID SUBMITTAL: March 15, 2011 by 2:00 P.M.
BID OPENING: March 15, 2011. beginning at 2:00 P.M.
The City of Sebastian is seeking bids from licensed contractors to "PROVIDE DRAINAGE
IMPROVEMENTS FOR POTOMAC" at designated location in die City of Sebastian.
The Contractor shall be able to be properly licensed in the City of Sebastian and shall provide proof of
insurance to conduct its business, with all licenses, permits, & certificates as may be required by all local,
State of Florida, and Federal Agencies. The Contractor shall submit a current license from lire State of
Florida must be capable of obtaining die appropriate liccuses and certificates to perform Ute project in
die City of Sebastian.
Contractors interested in submitting a bid may pick up or request a bid package containing instructions
for bidders and specifications from die City Manager's office located at City Hall on the second floor
at 1225 Main Street, Sebastian, Florida 32958. "There is a non-refundable cost of $45.00 for the bid
>^ package. All items bid shall coulinm to the Bid Documents unless specifically approved in advance in
writing by Ute City.
Any person or affiliate who hams been placed on die convicted vendor list following conviction for a
public entity crime may not submit a bid as proscribed by Section 287.133, F.S.
Questions concerning this bier should be directed to Nccl-Schaffer, inc, die City's Engineers of Record
for lliis project, at die Nccl-Schaffer offices located at 1201 19' Place, Suite A-100, Vero Beach, Florida
32960 /Tel (772)-770-4707 /by email: Frank.WalauabeCnnccl-scbafl'er.coni
All questions will be submitted by email to die above email address by February 28, 2011. No
comments will be accepted after Uiat date.
Tlicrc is a mandatory pre-bid conference scheduled to begin at 2:00 P.M. on Wednesday February
23, 2011, at die address stated above in City Hall on die second floor in die conference room. The
meeting will be followed by a Geld visit and further explanation of scope ol'work.
Bids duly submitted will be publicly opened and read aloud at die (late and time specified above in City
Hall. The City reserves die right to rcjccl any and all bids, or to accept any bid or portion dtercof
deemed to be in die best interest of dic City, and to waive any non -substantial irregularities.
BY: City of Sebastian
Al Minner, City Manager
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^ CITY OF SEBASTIAN
INSTRUCTIONS FOR BIDDERS
1. PRE-BID CONFERENCE (ONLY IF CALLED FOR IN THE NOTICE OF INVITATION TO
BID)
A mandatory pre-bid conference shall be held at the City of Sebastian City Hall, 1225 Main Street,
Sebastian, Florida- 32958 at the time and date specified in the Notice of Invitation to Bid. All
prospective bidders are required to attend this conference. Questions concerning the project or bid
requirements may be addressed at this time.
Two (2) sets of bids shall be submitted on the Bid Proposal Price Form provided, including any other
forms, proofs, and documents as required.
3. SEALED BIDS
Bids shall be enclosed in a sealed envelope which shall show (lower left corner) the name of the Bid,
and the date and time of opening. The envelope shall also show the name and address of the Bidder.
The Bid shall be submitted as stipulated in the Notice of Invitation to Bid.
4. BIDS NOT CONSIDERED
p.., Bids not considered are Late Bids, telegraphed or faxed Bids and bids which do not conform to the
instructions contained in the Notice of Invitation to Bid. Bids may be withdrawn by fax or telegraph
provided that such notices are received prior to the date and time specified in the Invitation.
5. BID OPENING
Bidders are welcome to attend the bid opening; however, attendance is not mandatory. Opening of the
Bids will commence at the date and time specified in the Notice of Invitation to Bid, and publicly
read aloud, providing one or more Bidders are in attendance. The Purchasing Agent or his designee
shall be present at all Bid openings.
6. BID EXAMINATION
Bid files may be examined during normal working hours, ten (10) days after bid opening, by
appointment only, by contacting the City Clerk's office at 772-589-5330.
7. REQUIRED INFORMATION
Bidders shall follow all instructions and provide all information requested on the Bid Proposal Price
Form. Bidders wishing to qualify all or any portion of the bid shall provide a hand printed or typed
explanation on the bid or separate attachment to be submitted with the bid.
8. BIDDER QUALIFICATION QUESTIONNAIRE
Bidders shall include the completed Bidder Qualification Questionnaire with the submitted bid
proposal. The submitted Bidder Qualification Questionnaire will be reviewed by the City, if the
bidder is the lowest bidder for this project.
AM% 9. ACCEPTABLE BIDS
Bid proposals shall be typewritten or filled in with ink. Any erasures or corrections must be initialed
by the Bidder in ink.
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10. NEW EQUIPMENT AND MATERIALS
Prices shown on the bids shall be prices for new equipment and materials, and the successful bidder
shall warrant same for a period of not less than one (1) year from the installation date, or as otherwise
stated.
11. SALES TAX
Although the City of Sebastian is exempt from Federal and State Sales and Use taxes, Contractors or
Vendors doing business with the City are not exempted from paying said taxes to their supplier for
goods or services purchased to fulfill the contractual obligations with the City, nor shall any
Contractor or Vendor be authorized to use the City's Tax Exemption Number in securing such
materials.
12. CONFLICT OF INTEREST
Contract Award is subject to provisions of State Statutes and City Ordinances. All Bidders must
disclose with their bid the name of any officer, director, or agent who is also an employee of the City
of Sebastian; further, all Bidders must disclose the name of any City employee who owns, directly or
indirectly, an interest of ten percent (10%) or more in the Bidder's firm or any of its branches.
Should the successful Bidder permanently or temporarily hire any City employee who is, or has been,
directly involved with the Bidder prior to or during performance of the resulting contract, the
Agreement shall be subject to immediate termination by the City.
13. LICENSING, CERTIFICATION, AND/OR REGISTRATION
Contractors must show their current occupational license, as well as any licenses required by Chapter
489, F.S., Section 62C-20 (F.A.C.), and/or by the US EPA, FL DEP or the FL Department of
Agriculture and Community Affairs. All licenses shall be up to date.
Contractors must show their current Contractors license. Prior to start of work, if the Bidder is a State
Certified General Contractor, the Bidder must be registered with the City of Sebastian; if the Bidder is
a State Registered General Contractor, then the Bidder must hold a Competency Card with the City.
In any event, the Contractor shall contact Karen Park, the Administrative Assistant at the Building
Department 772-589-5537 and insure compliance with all City ordinances, rules and regulations,
including Building Permits if required. Lack of knowledge by the Bidder shall in no way be a cause
for relief from responsibility. Failure to comply with the above may result in the rejection of the Bid.
Two (2) copies of any license or certification as required shall be submitted with the bidding
/1, documents.
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A certificate or letter showing compliance with the City's Contract Licensing requirements must be
obtained from the City's Building Department, and is required on this project prior to execution of a
contract, and shall be submitted to the Purchasing & Contract Administrator with any
payment/performance bonds which may be required. In essence, this authorizes you to perform work
in the City of Sebastian. Any Sub-Contractor(s) must also be certified.
14. CORRECTIONS. CANCELLATION, & WITHDRAWAL
A. Bidders may be asked to provide further information after bid opening to determine the
responsibility of the vendor.
B. Waiver of Technicality: Information shall not be considered after the bid opening if it has been
specifically requested to be provided with the bid and becomes a matter of responsiveness. The
bid shall be considered responsive if it substantially conforms to the requirements of the
Invitation to Bid. The City may waive any informality, technicality, or irregularity on any bid.
A minor or non -substantive lack of conformity may be considered a technicality or irregularity
which may be waived by the City.
C. Mathematical Errors: Errors in extension of unit prices or in mathematical calculations may be
corrected. In cases of errors in mathematical computations, the unit prices shall not be changed.
ASON D. Cancellation or Postponement: The Purchasing & Contract Administrator may cancel or
postpone the bid opening or cancel the Invitation to Bid in its entirety.
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E. Withdrawal: Prior to any published bid opening date and time, a bidder may withdraw his or
her bid in writing. A fax is permitted for this purpose, provided a confirming telephone call is
made.
F. Amendments: Prior to any published bid opening date and time, a bidder may amend the
bid provided that it is in writing, in a sealed envelope, and identified.
15. AVAILABILITY OF FUNDS
The obligations of the City of Sebastian under this award are subject to the availability of funds
lawfully appropriated for its purpose by the City Council of the City of Sebastian.
16. PUBLIC ENTITY CRIMES
Any person or firm submitting a bid in response to this invitation must execute the attached
SWORN STATEMENT UNDER SECTION 287.133, FLORIDA STATUTES, PUBLIC
ENTITY CRIMES, including proper check(s) in the space(s) provided, and enclose it with said
bid.
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^ 17. DRUG-FREE WORKPLACE
The Drug -Free Workplace form, as attached hereto, shall be submitted with the bidding
documents.
18. BID GUARANTEE
The Bidder warrants that the unit prices, terms, and conditions quoted in the bid will be firm for
acceptance for a period of not less than sixty (60) days from the bid opening date. Such prices
will remain firm for the period of performance of resulting purchase orders or contracts which are
to be performed.
19. LIQUIDATED DAMAGES
The City shall be entitled to liquidated damages in the amount of one hundred Dollars
($100.00) per day for every day that the Contractor is late in completing the work
requirements for each Phase as stipulated in the agreement, and bidding documents. Said
damages shall be deducted by the City from monies due Contractor.
20. INSURANCE
All bidders shall submit evidence of insurance as follows; Auto Liability, Workers
Compensation, and General Liability. Cost for all insurance shall be born by the bidder. All
insurance shall be acceptable to the City in its sole discretion.
AOWA 21. BID AWARD
The contract/agreement will be awarded to the lowest responsive and/or responsible Bidder
whose bid, conforming to the specifications and Instructions For Bidders, will be most
advantageous to the City in consideration of price, time of performance, and other factors as
determined by the City. The Purchasing Agent shall issue a notice of award, if any, to successful
bidders.
22. REJECTION OF BIDS
The City reserves the right to reject any and all Bids, to waive any and all informalities not
involving price, time, or changes in the work, and to negotiate contract terms with the successful
Bidder, and the right to disregard all non -conforming, non-responsive, imbalanced, or conditional
Bids. More than one Bid from an individual, firm or association under same or different names,
will not be considered. Any or all Bids will be rejected if there is reason to believe that collusion
exists among the Bidders, and no participants in such collusion will be considered in future
proposals for the same work.
23.
F
A list of References is required, but is not required to be submitted with the Bid proposal.
However, a list of References must be provided to the City, prior to any Contract Award.
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^ 24. LIST OF SUB -CONTRACTORS
A list of Sub -Contractors is required, but is not required to be submitted with the Bid proposal.
However, all Sub -Contractors must be approved by the City, prior to any Contract Award.
25. CO-OPERATIVE PURCHASING
It is the intent of the Notice of Invitation to Bid to secure goods or services to be used by the City
of Sebastian. However, by virtue of bidding, the Bidder accepts the right of other Government
Entities to "piggyback" purchase from this proposal by mutual consent. Any such purchase shall
be separate and apart from the City of Sebastian, and said City assumes no liability for such
action.
26. DISCRIMINATION
The Bidder/Contractor shall not practice or condone personnel or supplier discrimination of any
nature whatsoever, in any manner proscribed by Federal or State of Florida laws and regulations.
27. PURCHASING CARD PROGRAM
The City of Sebastian has implemented a purchasing card program through Bank of America,
using the Visa network. Vendors may receive payment through the purchasing card program for
goods and services provided to the City in the same manner as other Visa purchases.
Accordingly, Vendors that wish to accept payments in this manner must indicate that they have
the ability to accept Visa or that they will take whatever steps are necessary to accept Visa before
r the start of the contract. The City of Sebastian reserves the right to revise and/or cancel this
program at any time, and assumes no liability for such action.
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28. PUBLIC RECORDS
Florida law provides that municipal records shall at all times be open for personal inspection by
any person. Section 119.01 F.S., The Public Records Law. Information and materials received by
the City in connection with all Bidder's responses shall be deemed to be public records subject to
public inspection upon award, recommendation for award, or 10 days after the bid opening,
whichever occurs first. However, certain exemptions to the public records law are statutorily
provided for in Section 119.07, F.S. Therefore, if the Bidder believes any of the information
contained in his or her response is exempt from the Public Records Law, then the Bidder must in
his or her response specifically identify the material which is deemed to be exempt and cite the
legal authority for the exemption, otherwise, the City will treat all materials received as public
records.
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"POTOMAC AVENUE DRAINAGE IMPROVEMENTS"
Bid Due: No Later Than 2:00 P.M. on Tuesday, March 15, 2011
Bid Opening: Beginning at 2:00 P.M. on Tuesday, March 15, 2011
BID PROPOSAL PRICE FORM
The undersigned having become thoroughly familiar with all of the Bidding Documents incorporated herein and
having attended a Pre -Bid Conference / Meeting, hereby proposes to perform everything required to be performed
in strict conformity with the requirements of these documents, meeting or exceeding the specifications as set
forth herein for the price(s) quoted below. The price(s) quoted is (are) inclusive of any Addenda which may have
been issued prior to this submittal.
By the signature below, the Vendor agrees that this Bid Proposal is made without any other understanding,
agreement, or connection with any person, corporation, or firm submitting a bid for the same purpose and that the
bid is in all respects fair and without collusion or fraud. If awarded any work under this bid proposal, the Vendor
agrees to enter into said agreement within ten (10) consecutive calendar days notice by the City, and agrees to all
the terms and conditions of all documents stated herein with the City of Sebastian for the below stipulated price
Row, which shall remain firm for sixty (60) days following bid opening date.
OOON
The construction bid items for this project is listed on the following page to be completed and submitted as part of
the bid documents. The City has the right to award this project based on the total bid estimate and other factors to
be considered by the city.
NOTE: VENDOR WARRANTS TOTAL CONTRACT TIME SHALL NOT EXCEED 120 CONSECUTIVE CALENDAR
DAYS.
Name of Firm (Please Type or Print)
Firm's Address:
Telephone Number(s): Fax Number(s): Email Address (es):
Name and Title of Authorized Representative (Please Type or Print)
Signature of Authorized Representative Date Signed
P-/
Potomac Avenue Drainage Improvement — Page 2
,,,, Bid Items to be completed and submitted
BID ITEM #2 - EARTHWORK
Clearing and Grubbing
Remove Existing Roadway Asphalt
Remove and Replace Driveway Concrete
Cut (to be removed for ditch modification)
Stabilized Rock
BID ITEM #3 - PAVING/GRADING
Install AC (Superpave) for Roadway (1.5")
Saw -Cut Existing Pavement (Roseland Rd)
BID ITEM #4 - DRAINAGE
Install Silt Fence
Install Turbidity Barrier
Install 38" x 60" ERCP
Install Junction Box (8'x8'x4') With MIT Ring & Cover
Install Type'1' Junction Box (6'x6') With MIT Ring & Cover
Install Headwall for (38" x 60" ERCP)
s^ Install Nutrient Separating Baffle Box
Install M.E.S. for 18" ADS
Install M.E.S. for 38"x60" ERCP
Install 18" ADS
Install 48" CPP (Extend Ex pipe to new JB)
Install 36" RCP
BID ITEM #5 - LANDSCAPE
Sod all disturbed areas
Sum Total of all Bid Items
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0.1 -AC
$
133-SY
$
17-SY
$
30-CY
S
517 -CF
$
12 -TN
$
114 -LF
$
104 -LF
$
28 -LF
$
125 -LF
$
3 -EA
$
I -EA
$
I -EA
$
1 -EA
$
3 -EA
$
I -EA
$
24 -LF
$
4 -LF
$
14 -LF
$
334-SY $
Total s
^ DRUG-FREE WORKPLACE FORM
The undersigned Contractor, in accordance with Florida Statute 287.087 hereby certifies
that
does:
1. Publish a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace
and specifying the actions that will be taken against employees for violations of such
prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business' policy
of maintaining a drug free workplace, any available drug counseling, rehabilitation,
employee assistance programs and the penalties that may be imposed upon employees for
drug abuse violations.
3. Give each employee engaged in providing the commodities or contractual services that
are under bid a copy of the statement specified in Paragraph 1.
4. In the statement specified in Paragraph 1, notify the employees that, as a condition of
working on the commodities or contractual services that the employee will abide by the
OM terms of the statement and will notify the employer of any conviction of, or plea of guilty
or nolo contendere to any violation of Chapter 1893 or of any controlled substance law of
the United States or any state, for a violation occurring in the workplace no later than five
(5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance
or rehabilitation program if such is available in the employee's community, by any
employee who is so convicted.
6. Make a good faith effort to continue to maintain a drug free workplace through
implementation of Paragraph 1 through 5.
Date:
As the person authorized to sign this statement, I certify that this firm complies fully
with the above requirements.
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Signature
PUBLIC ENTITY CRIMES FORM
Any person submitting a quote, bid, or proposal in response to this invitation or
Agreement, must execute the enclosed form sworn statement under section 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES, including proper check(s), in the
space(s) provided, and enclose it with his quote, bid, or proposal. If you are submitting a quote,
bid or proposal on behalf of dealers or suppliers who will ship commodities and receive payment
from the resulting Agreement, it is your responsibility to see that copy(ies) of the form are
executed by them and are included with your quote, bid, or proposal. Corrections to the form
will not be allowed after the quote, bid, or proposal opening time and date. Failure to complete
this form in every detail and submit it with your quote, bid, or proposal may result in immediate
disqualification of your bid or proposal.
The 1989 Florida Legislature passed Senate Bill 458 creating Sections 287.132 - 133,
Florida Statutes, effective July 1, 1989. Section 287.132(3)(d), Florida Statutes, requires the
Florida Department of General Services to maintain and make available to other political entities
a 'convicted vendor" list consisting of persons and affiliates who are disqualified from public
and purchasing process because they have been found guilty of a public entity crime. A public
entity crime is described by Section 287.133, Florida Statutes, as a violation of any State or
Federal law by a person with respect to and directly related to the transaction of business with
any public entity in Florida or with an agency or political subdivision of any other state or with
the United States, including, but not limited to, any bid or Agreement for goods or services to be
/�A provided to any public entity or with an agency or political subdivision and involving antitrust,
fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.
By law no public entity shall accept any bid from, award any Agreement to, or transact
any business in excess of the threshold amount provided in Section 287.017, Florida Statutes, for
category two (currently $10,000) with any person or affiliate on the convicted vendor list for a
period of 36 months from the date that person or affiliate was placed on the convicted vendor list
unless that person or affiliate has been removed from the list pursuant to Section 287.133(3)(f),
Florida Statutes.
Therefore, effective October 1, 1990, prior to entering into an Agreement (formal
Agreement or purchase order) in excess of the threshold amount of $10,000 to provide goods or
services to THE CITY OF SEBASTIAN, a person shall file a sworn statement with the
Contract/Agreement officer or Purchasing Director, as applicable. The attached statement or
affidavit will be the form to be utilized and must be properly signed in the presence of a notary
public or other officer authorized to administer oaths and properly executed.
THE INCLUSION OF THE SWORN STATEMENT OR AFFIDAVIT SHALL BE
SUBMITTED CONCURRENTLY WITH YOUR QUOTE OR BID DOCUMENTS. NON-
INCLUSION OF THIS DOCUMENT MAY NECESSITATE REJECTION OF YOUR
QUOTE OR BID.
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000% SWORN STATEMENT UNDER SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR
OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS.
This sworn statement is submitted with Bid, Proposal or Agreement No.
for THE CITY OF SEBASTIAN.
2. This sworn statement is submitted by
(name of entity submitting
sworn statement) whose business address is
and (if applicable)
its Federal Employer Identification (FEIN) is (If the entity has
no FEIN, include the Social Security Number of the individual signing this sworn
statement: )
3. My name is (please print name of
individual signing) and my relationship to the entity named above is
4. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida
Statutes means a violation of any state or federal law by a person with respect to and
directly related to the transaction of business with any public entity or with an agency or
political subdivision of any other state or with the United States, including, but not
limited to, any bid or Agreement for goods or services to be provided to any public entity
or an agency or political subdivision of any other state or of the United States and
involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material
misrepresentation.
5. I understand that "convicted" or 'conviction" as defined in Paragraph 287.133(1)(b),
Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or
without an adjudication of guilt, in any federal or state trial court of record relating to
charges brought by indictment or information after July 1, 1989, as a result of a jury
verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.
6. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes,
means:
(1) A predecessor or successor of a person convicted of a public entity crime; or
(2) An entity under the control of any natural person who is active in the
management of the entity and who has been convicted of a public entity crime.
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00% The term "affiliate" includes those officers, directors, executives, partners, shareholders,
employees, members, and agents who are active in the management of an affiliate. The
ownership by one person of shares constituting a controlling interest in another person, or
a pooling of equipment or income among persons when not for fair market value under an
arm's length agreement, shall be a prima facie case that one person controls another
person. A person who knowingly enters into a joint venture with a person who has been
convicted of a public entity crime in Florida during the preceding 36 months shall be
considered an affiliate.
7. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes,
means any natural person or entity organized under the laws of any state or of the United
States with the legal power to enter into a binding Agreement and which bids or applies
to bid on Agreements for the provision of goods or services let by a public entity, or
which otherwise transacts or applies to transact business with a public entity. The term
"person" includes those officers, directors, executives, partners, shareholders, employees,
members, and agents who are active in management of an entity.
8. Based on information and belief, the statement which I have marked below is true in
relation to the entity submitting this sworn statement. (Please indicate which statement
applies.)
Neither the entity submitting this sworn statement, nor any officers, directors,
''N executives, partners, shareholders, employees, members, or agents who are active in
management of the entity, nor any affiliate of the entity have been charged with and
convicted of a public entity crime subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of the officers,
directors, executives, partners, shareholders, employees, members or agents who are
active in management of the entity, or an affiliate of the entity has been charged with and
convicted of a public entity crime subsequent to July 1, 1989, AND (Please indicate
which additional statement applies.)
There has been a proceeding concerning the conviction before a hearing
officer of the State of Florida, Division of Administrative Hearings. The final order
entered by the hearing officer did not place the person or affiliate on the convicted vendor
list. (Please attach a copy of the final order.)
The person or affiliate was placed on the convicted vendor list. There has been a
subsequent proceeding before a hearing officer of the State of Florida, Division of
Administrative Hearings. The final order entered by the hearing officer determined that it
was in the public interest to remove the person or affiliate from the convicted vendor list.
(Please attach a copy of the final order.)
C-3
The person or affiliate has not been placed on the convicted vendor list. (Please
describe any action taken by or pending with the Department of General Services.)
Date:
STATE OF FLORIDA
COUNTY OF
(Signature)
The foregoing instrument was acknowledged before me this day of
2011 by
behalf of
known to me or has produced
take an oath.
(title) on
(name of partnership), a partnership. He/she is personally
as identification and did ( ) did not ( )
My Commission Expires:
Commission Number:
C-4
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I'\
BIDDER QUALIFICATION QUESTIONNAIRE
(This form is not required to be included in the bid proposal submittal. However, prior to any
Contract Award, such Bidder Qualification Questionnaire must be completed and submitted by the
Bidder, and reviewed and approved by the City.)
Submitted by
Name of Bidder
General Contractor's License
Federal Identification #
Principal Office Address:
( ) An Individual
( ) A Partnership
( ) A Corporation
(1) How many years has your organization been in business as a contractor under your
present name?
(2) How many years experience in road and utility construction work has your organization
had as a contractor?
As a Subcontractor?
(3) List below the requested information concerning projects your organization has
completed in the last five (5) years for the type of work required in this project. (Use
additional sheets if necessary). Include the type of work similar to the work included in
this contract if possible.
Project Contract Required Actual Name/Address/Tel
Title Amount Completion Date Completion Date of Owner
B-1
001
(4) Have you ever failed to complete any work awarded to you? If so, where and why?
(5) Has any officer or partner of your organization ever been an officer or partner of some
other organization that failed to complete a construction contract? If so, state name of
individual, name of other organization, and reason therefore.
(6) Has any officer or partner of your organization ever failed to complete any construction
contract handled in his own name? If so, state name of individual, name of owner and
reason therefore.
(7) Give below any information which would indicate the size and capacity of your
organization, including number of employees, equipment owned by your organization,
etc., which are available for utilization on this Contract.
(8) What is your bonding capacity?
(9) What amount of your bonding capacity has been used as of the date of this bid?
a -z
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(10) How many applications for performance and payment bonds have you made in the last
three (3) years?
(11) How many of these applications were not approved?
(12) Have any claims been filed against your surety bond company in the last five (5) years? If
so, describe the nature of the claims and give the names of the surety companies, dates of
each claim, identifying numbers of each claim, amounts of each claim, and the status of
each claim. (Use additional sheets if necessary.)
(13) Have your company been in disputes or litigations in the last five (5) years over
construction projects which are completed or still pending for completion? If so, describe
the nature of the disputes or litigations and state the Owner's Name, Address, Telephone,
and amount of disputes or litigations. (Use additional sheets if necessary.)
B•3
I, the undersigned, do hereby declare that the foregoing
,/"1 statements are true and correct, all as of the date hereinafter
set forth, and that those examining this document have my
permission to contact any or all of those parties listed in this
questionnaire. Incorrect or misleading statements in this
questionnaire shall be grounds for a determination of
nonresponsibility with respect to such contractor.
******************************************************************************
***
(SIGNATURE OF BIDDER)
(TYPE OR PRINT COMPANY NAME)
(TYPE OR PRINT ADDRESS)
e•a
^ STATE OF FLORIDA)
COUNTY OF INDIAN RIVER)
CITY OF SEBASTIAN)
A�%.
KNOWN ALL MEN BY THESE PRESENTS, that
As Principal, and
as Surety, are held and firmly bound unto the City of Sebastian, in the penal sum of
(Dollars) $
lawful money of the United States of America, for the payment of which sum well and
truly to be made, we bind ourselves, our heirs, executors, administrators, and successors,
jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the
Principal has submitted the accompanying bid dated , for:
NOW THEREFORE,
(a) The Principal shall not withdraw said bid within ninety (90) days after date of
opening the same and shall within twenty (20) days after the prescribed forms are
presented to him for signature, enter into a written contract with the City, in accordance
with the proposal as accepted, and give bond with good and sufficient surety of sureties,
as required, for the faithful performance and proper fulfillment of such contract; and,
(b) In the event of the withdrawal of said bid within the period specified, or the
failure to enter into such contract and give bond within the time specified, if the principal
shall pay the City the difference between the amount specified in said bid and the amount
for which the city may procure the required work and supplies, if the latter amount be in
excess of the former, then the above obligation shall be void and of no effect, otherwise
to remain in full force and virtue.
IN WITNESS WHEREOF, the above -bounded parties have executed this
instrument under their several seals, this day of
The name and corporate seal of each corporate party being hereto affixed and these
presents duly signed by its undersigned representative. Pursuant to authority of its
00„` governing body.
WITNESS:
If Sole Ownership or Partner ship, one
(1) Witness is required. If Corporation,
Secretary only will attest & affix seal.)
Surety Secretary
The rate of premium of this bond is
per thousand.
Total amount of premium charges _
PRINCIPAL:
Name of Firm
Affix Seal
(Signature of Authorized Officer)
(Business Address)
(City) (State) (zip)
SURETY:
(Corporate Surety)
Affix Seal
(Signature of Authorized Officer)
(Title)
(Business Address)
(City) (State) (zip)
(Name of Local Insurance Agency)
(Address)
,,.%, (The above must be filled in by Corporate Surety.)
CERTIFICATES AS TO CORPORATE PRINCIPAL
I, , certify that I am the
Secretary of the Corporation named as Principal in the within bond, that
who signed the said bond on
behalf of the principal, was then
of said corporation;
that I know his signature, and his signature hereto is genuine; and that said bond was duly
signed, sealed, and attested fro and on behalf of said corporation of its governing body.
(Corporate Seal)
State of Florida
County of Indian River
City of Sebastian
Before me, a Notary Public duly commissioned, qualified and acting, personally
appeared; to me well
known, who being by me first duly sworn upon oath, says that he is the attorney in fact
for the 'and that he has been authorized
by Contractor named therein favor of the City of Sebastian, Florida.
Subscribed and sworn to before me this day of
Notary Public
My Commission Expires