Loading...
HomeMy WebLinkAbout2019 ContractCITY OF SEBASTIAN—BID ORIGINAL As Needed Concrete Services BID PROPOSAL PRICE After having examined all specifications, Contract/Agreement Documents, and other documents relative to the Invitation to Bid, I the undersigned hereby propose to perform everything required to be performed in strict conformity with the requirements of these documents, and to provide and furnish all the equipment, labor, and materials necessary to provide annual concrete work meeting or exceeding the specifications as set forth herein for the unit prices as stated below. The price quoted below includes any addenda which may be issued. If there is anv item von wish not to bid on olease write "NO BID" in the Price oar Souare Yard column. ANNUAL CONCRETE WORK AS DESCRIBED: Concrete saw and Removal (4") 61-100 SY 3z 's^ I Concrete saw and Removal (4") 101, SY 3 Jo Concrete Ramey@I an reglace W/Fiber(4")" 1- 60 SY Concrete Removal an� replace W/Fiber(4")" 61-100 SY Q Concrete Removal and replace W/Fiber(4")" 101< SY 9 Concrete W/Fiber(4")* 1-60 SY Concrete W/Fiber(4")" 61-100 SY Concrete W/Fiber(4")* 101< SY Concretesawand Removal (6") 1-60 SY 'QS Concretesawand Removal (6") 61-100 1 SY 4 45 Concrete saw and Removal (6") 101< I SY 41� 1 Concrete Removal and replace W/Fiber(6")* 1-60 SY 26815- 5815Concrete ConcreteRemoval and replace W/Fi1ber(6")* 61-100 SY I I E5 Concrete Removal and replace W/Fiber(6")" 101< SY I L I Concrete W/Fiber(6")" 1-60 SY 7.1Q — Concrete W/Fiber(6" )" 61-100 SY Concrete W/Fiber(6" )* 101< Sy MISC Concrete* 1-5 CY 1500 — MISC Concrete* 5.5-10 CY 155p MISC Concrete" 10.5-15 CY 17_"5 — MISC Concrete* 15.5-20 CY IMO — MISC Concrete• 20< CY '4So Driveway Culvert Replacement (S" ADS") 1 LF I S Driveway Culvert Replacement (SO" ADS") 1 LF I S 2 Driveway Culvert Replacement (12" ADS") 1 LF 154— DrivewayCulvert Replacement (15"ADS") 1 LF 166— 1 Driveway Culvert Replacement (Ir ADV) 1 LF I47!to SA A Cw a CaNs ati�n 4 -All concrete is formed, poured in place and finished Per FDOT Standard Specifications 2018 or latest version. By the signature affixed below, the contractor agrees that this bid is made without any other understanding, agreement, or connection with any person, corporation, or fret submitting a bid for the same purpose, and that the bid is in all respects fair and without collusion or fraud. If awarded this bid, I agree to execute/enter into said agreement within (15) consecutive calendar days notice by the City, and agree to all the terms and conditions of all documents stated herein, with the City of Sebastian, for the above stipulated price. 1 , Docks C Rodriguez ^ Au orae Signature ( v Printed Name Santa Cruz Construction, Inc. Firm Name & Address 4205 N. Courtenay Parkway Vice President Title 321-452-3190 Phone Number Merritt Island, FL 32953 Date Signed March 15, 2019 A� ® CERTIFICATE OF LIABILITY INSURANCE I oA 3/142019 N THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DES NOCERTIFICAT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED M ORTANT:. If the ertiFiwm holtler k eREPRESENTATIVE OR PRODUCER ANDo DITIONAL INSURED, tho pollcy(ies) must be endorsed. It SUBROGATION IS WAIVED, Subject to Ne terms and conditions of the policy, certain policies may require an a scone m m. A statement on this cartifiwte does not confer rights W the certificate hold., in It.. asuch end.m m mS,). PNODOOEN Bowen, Middle 8 Britt of Florida, LLC iu°uF.� Heather Camemn 1020 N. Orlando Avenue, SUlte 200 PINME F.A.14071647-1616 iu�c Neef4W1629-1635 Maitland FL 32751 AoonFss: cedifirales@bmbilwcom INSIINEPoSAFFOfltlNOtWf31A6E NNC• wsuAEAA: Berkley Assurance Comoam 461 I 36 WsuFEO swrAueusa CO Inc- OC. WsuREM e: Owners Insurance Comoam 32700 42 5 N.nay Parkon. 4295 N. 4205Co Parkway I wsuseac: National Union Fire In Go of %asbum 19445 Island Merritt Island FL 32953 I wsuAFAo: MS.Rn1E: INSURERi:_ _ _ COVERAGES CERTIFICATE NUMBER:1923112507 REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN MUM TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TEAM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH 'OU :IES. WITS SHOWN MAY HAVE BEEN REDUCED BY PAD MAIMS. LR TYPEOFNSUMNCE � Pm .amass mYrtuLT'afi 1Y JG W I NIYI3 A X COrS4ERm41OENEPALr1AstrY Y Vueda m, 'mm, 10',rAla EACH OCCURRENCE P LIAMSM<oE a DCLUR � I.I¢xlw ::.= S,soom MEO Emumo.an Seme.e I I PE0.mHStSAmeLNYY s,.oaox CBlLAIXFEWTE L&IiMiLHSPFA Ge1FRKAGCiBTATE SI.apOL %T OLS PROXIM-OONROPAW S20 do OTf6f S a AUTOMOSLE UAlmhY Y Y 5141411600 1Mr1a19 Imam -OONNN➢$VPBEDSm Si.QA.Rp X uwurro fwOarnLamTer'so s A1706 _ Al1rOs ISOORY IN (FeetiWY) S X HWE➢AUr05 X NC— P OV mOMwGE a PIP WP¢cn S,e.W3 O UM['AELlAl1A X pOCyR Y Y E&IlSt15f18 101OM8 IV=, EACHOCCUgpQICE S2IXOW] X IXCF96 W1Ja gWA6NA0E I uaaammew szmaA 3 cod lla�aordGsNSAsn _ — --_ __ I �ranrlPl I°aRR` AHOFRPLOYERa'uA@Yry YIN PRYCERINE mWPARmQUcAECUmS. N EL FACHALC.— f OFFICERyIn-H)IXLWOEo] N/A F7 OAeMMryln xNl NEL DISEASE -FA EMFl. � S Hyµ MwSeuMv nESLRFMON OF OPERATONSbIvx ELOI6515E-PoIICYUMM 3 When required written ventrad, those parties Bated M sakl conlrad, including the Celtlfiate, Holder, are added as additional insureds with respect to the General UabMy ncluEthg ongoing and completed operations, Auto Uability, and Excess liability as afforded by the policy andlorendorsemems. When required by written contract, waiver ofsubmgahon is granted with respect to the General Uability, Auto Liability, and Excess Liabi iy to those parties SeeAtadred- ;ERTIFICATE HOLDER CANCELLATION SHCOU) ANY OFTHE ABOVE DUtMBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. "SPECIMEN For Informational Purposes Only AUmORuo WineavrNMIE --- I ®1980-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/Di) The ACORD name and logo are registered marks of ACORD ACCORD® AGENCY Bowen, Midette 8 Bdtt of Flodtla, LLC I ,a.cy Nueaaa cruaua8 AGENCY CUSTOMER ID: SANTACRUZC2 LOC is ADDITIONAL REMARKS SCHEDULE 1a Santa C. Consouction, Inn Naea4205e"aso N. Courlenay Parkway Menti Island FL 32953 xaremoe INTEcrnE an.e ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER 25 FORM 11 1. CERTIFICATE OF LIABILITY IIUS\URANCE listed In said contrast, Including the Certificate Molder. Page 1 of 1 The General Liability rectified herein Is primary and roncantnbutay, to other insurance available, but only to the ezlEnt required by written contract. ACORD 101 (2008101) 02008 ACCORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number, VUMCDO97673 Effective Date: 10/0112018-101012019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTO10ATIC STATUS WHEN REQUIRED IN AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE A. Section II — Who Is An Insured Is amended to include as an additional Insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing that such person or organization be added as an additional insured. Such person or organization is an adddional insured only with respect to liability arising out of your ongoing operations performed for that additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the additional Insured are completed. B. With respect to the insurance afforded to these additional insured(s), the following additional exclusions apply: 1. 'bodily injury or 'property damage' for which the addPJonal insured(e) are obligated to pay damages by reason of the assumption of liability In.a contact or agreement or 2. 'bodily injuryor'properly damage' occurring after.i a. All work, including materials, parts or equipment furnished in connection with such work on the project (other than service,_ maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or It. That potion of your work' out. of which the injury or damage arises has been put to its intended use by any person or organtzalfon other than another contractor or subcontractor engaged In performing operations for a principal as a part of the same project; or ;.' 3. 'bodily injury or'property, damage arising directly or indrectly out of the negligence of the additional insured(s);'or 4. "bodily injury",'property damage", or 'personal or advertising injury arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including, but not limited to: a. The preparing, approving, or failure to prepare or approve maps, shop drawings, opinions, reports, surveys, filed orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engineering activities. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED VCAS2011 11 12 Page 1 of 1 Policy Number. VUMCOD97673 Effective Date: 10MI2019-1010112019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Descrytion Of Completed ODerations As required by written contract executed prior to the Construction project sites at which you performed work - date of occurrence but only to the extent for such additional insured. permitted by law and the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provided for such additional insured. Information mouired to WMDlete this Schedule,"d not shown above. will be shown in the Declarations. Section II — Who Is An Insured is amended to Include as an additional insured the persons) or organization(s) shown in the Schedule; but only with respect to liability for 'bodily injury' or "property damage' caused, -in "ole or in pan, by"your work' --- at the location -designated and described in the schedule of this endorsement pedo-ned for that additional .insured_ and included In the 'produds- completed operations hazard'. CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 CERTIpICATE OF LIABILITY INSURANCE 'as WC 71949 01/012019 0110112020 IXImstien,mNWib I IOR 3/182019 producen Plymouth lnsurence envy I EL Fait P ©dent Tins CeNamm is issue4 as antatter of infomation onlyanGmnfers no 2739 U.S. Highway 19 N. S1,o00,(M rights own me eobRmbeHomer. Tnis remamte dog notameod, ommd Holiday, FL 34691 Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB or ate the coverage afforded by the wades below. (727) 936-5562 Iwrers Affording Coverage NMIZ # Insured: South East Personnel Leasing, Inc. & Subsidiad-Ito,nA 11075 2739 U.S. Highway 19 N. lwvere: Holiday, FL 34691 1'wier0 LmsNB: IreuerE [Coverages TM WOm 0. YneEaYwnons.bLNnM v1swes .5. IV Ow inkyssese IN use ima W9alYnPgaenl Wrna0OWia aN mbanrt OPW O]nnINY MNrnya]b WMAKvWpYllay MlrneyvngpMl MYrenm Noiwbpr pplrAtleaEmlEtl Mamisstgwibf altlm{ ab Wppy6 Vpitl,rplurq Appgys IMtrY—VennenrNralWMddsna. L- R'S'D Type of Insurance Poky Number pyo Pel E�rsecn Limits NwwcDIVV) (MMIDDIYY) GENERAL IIABIUTY Coommefdal General Liebd4y Claims Made ❑ Occur General aggregate Amit apps per. 7 see, ❑ PrvFo ❑ LCL AUTOMOBILE LIABILITY Any Aub All O .d Iwlor Sap Ip NMs Hind ANps unomnd Arne. II EXCE891UMBRELL LIABILITY oar. ❑ GYm WM cs4dals A workers Compensation and Employers' Liabllity Am IXOPdatwiPatTedee�lira olRtmhmtrpr mm tied) NO a Ves, eased» uMer apodal Dto>75ids bawv. t De nno m�mgn m sound preen. n wa ap Penal Adv!ahoy 5 GnenlAWreym s P,ndl,tl5-rAnW W M3 cneoei so,sn uml (Fn Ammna e E dY1Ney [Per Pex4) , beer lriwY' ry Amaenq Pttywtyom9e Ivnnma.ml s EW oma rce Isasresses WC 71949 01/012019 0110112020 IXImstien,mNWib I IOR I EL Fait P ©dent 5a.04o,oA Enpbme S1,o00,(M IELO®'w-En EL Oiseane-Peep tante s?...aoo Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Desmiptions of O"mUonslLo UonsNahicleslEacluslons added by Endomementl6pecial Provisions: Oimt ID: 92a1i cy,,nsee rosy neeine to ow. onowee(s) orSOUK E PeIDNws tease ,Inc 6Sited'ati¢tletare koed bethe(olmiu,'Oien co.,W: Santa Done Con bnu n Inc Coverage en y awes m itQUks vlmtted by seem East Personnel !sang, Inc 85tb9dianes amve e,nproyeMsl, whae wont, In: R fDvemga does not appy In 9sMpy employee(s) or atdepe ort cmwador(s) of Ce d m pee, a any, nine, enft.. A6 of the aoive err*yee(s) lensed m Me 011 Company ran be otttaltei by Noy, a epnee m(717) 937-2139 or email cettlflm@s@9onl%trarceontpam.com pm9wt No. ISSUEO;15-19(M) been pine: 141111017 I CERrMATEWI-DER emc!R-AT e crvoFSEBASTwN slwld.1, m .—b eleomaPdloes dam s ftpsmenn reese nOeb bxe,A l.1. IlnarervAil vA.wm,2l30tlry xntlm nWxroun anlAmte MYMnmeEb Oe INLMMIwb aom Nmlingou rocbAgalin mraGnb e®Y p^i WnOalwrel,bropMvtq,wnlaWee. 1225 MAIN STREET— SEBASTtAN, FL 32950 I A" 4ev.y✓� i u--� ✓ RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY Flonda dL STATE OF FLORIDA DEPARTMENT OF BUSINESS AND- PROFESSIONAL REGULATION CONSTRUC1 IN0US7RY`LI G BOARD THE GENE RECTOR Hif--REN IS CERTIFI UNDERTHE PROVI ��PTER'489FLORIDASSTjf� UTES SANTA CRUZ CONSTRUCTIOIF I 1,WCI<IVADRIVC n= „L4 sr LI E 5 A—M, R CG g,_ 5 EXPIRATI a rid 31, 2020 Always verify licenses online at MyRoridaLicense.com 0° ir.. CV,.O nh Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. DRUG-FREE WORKPLACE FORM The undersigned Contractor, in accordance with Florida Statute 287.087 hereby certifies that Santa Cruz Construction, Inc. 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 terns 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 occuring 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 I through 5. As the person authorized to sign this statement, I certify that this firm complies fully with the above requirements._(��� Data: March 15, 2019 1 )\�\(V3' (J Sigoamte \ I1 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 CRl1v1ES, 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(3xd), 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, m a violation of my 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 my other state or with the United States, including, but not limited to, any bid or Agreement for goods or services to be provided to my public entity or with an agency or political subdivision and involving mtitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. By law no public entity shall accept my bid from, award my Agreement to, or transact my business in excess of the threshold amount provided in Section 287.017, Florida Statutes, for category two (currently $10,000) with my 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(3xf), 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 pro]pJeerrllyee�xecutedW1TL� SWORN T!y��_ � �(�_�_(1_ DO UMENT MAY NECE9 RE CTION O� YOUR OUOT�%N BID-INCLiISION OFTTHI� SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES. ON PUBLIC ENTITY CRIMES 12 THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. I . This sworn statement is submitted with Bid, Proposal or Agreement No. 19-02 for THE CITY OF SEBASTIAN. 2. This swam statement is submitted by Santa Cruz Construction. Inc. (name of entity submitting sworn statement) whose business address is 4205 N. courtenay Parkway Merrill Island. FL 32953 and (if applicable) its Federal Employer Identification (FW is (If the entity has no FEIN, include the Social Securityt _ igning this swom statement: 3. My name is Decks C Rodriquez (please print time of individual signing) and my relationship to the entity named above is Vice President 4. 1 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 many public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, that bribery, collusion, racketeering, conspiracy, or material misrepresentation 5. 1 understand that "convicted" or "conviction" as defined in Paragraph 287.133(1 Xb), Florida Stagy 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 wort of record relating to charges brought by indictment or information after July 1, 1989, as a result of ajury 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(I)(4 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. 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 sbares 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 ajoint 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. 1 understand that a "person" as defined in Paragraph 287.133(lxe), Florida Statutes, means soy 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 tmosacts 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. 13 S. 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.) XXX Neither the entity submitting this sworn statement, nor any officers, directors, 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.) 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.) (Signature) Date: 3 - IS -LI) STATE OF FLORIDA COUNTY OF Brevard The foregoing instrument was acknowledged before me this %C� day of March,201 JdMby Dacks C Rodriguez I Vice President (title) on behalf of Santa cma concoction, Inc. (name of partnership), a partnership. He/she isr )Sonally known to me or has produced as identification and did () did not ()take an oath. �e My Commission Expires: _ mR0TNY0PI0rLE Commission Number Y. �` MPlary Publl"StateolFWida �a o .E*YW III, wnl Mr Comm. Nat Wit Nh III, tmi e,naedtkoyl, Nat Wit Notary,lMn. 14 BIDDER QUALIFICATION QUESTIONNAIRE (This Porro is not required to be included in the bid propose] submittal. However, prior to any Contract Awad. such Bidder Qualification Questionnaire roust be completed and submitted by tlx Bidder, and reviewed and approved by the City.) Submitted by Santa Cruz Construction, Inc. Name of Bidder General Contractor's License # CGC 1510545 (see attached) ( ) An Individual ( ) A Partnership OU A Corporation Federal Identification # Principal Office Address: 4205 N. Courtenay Parkway, Merritt Island, FL 32953 (1) How many years has your organization been in business as a contractor under your present name? 44 (2) How many years experience in road and utility construction work has your organization had as a contractor? 44 As a Subcontractor? 0 (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 Connotation Date Comoletion Date of Owner See Attached Sheet 15 (4) Have you ever failed to complete any work awarded to you? If so, where and why? NO (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. NO (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. NO -------- -- (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. Employees: 10 See Attached Equipment List (8) what is your bonding capacity? $350,000 per projectt$1,000,000 Aggregate (9) what amount of your bonding capacity has been used as of the date of this bid? $69,000 16 (10) How many applications for performance and payment bonds have you made in the last three (3) years? _ (1 t) How many of these applications were not approved? 0 (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.) zi I, the undersigned, do hereby declare that the foregoing 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 non- responsibility with respect to such contractor. x##44}kki4kirt}ttt}yrtir;4ik#}iiiiiirr##i}itixxx#44#}#rt}i}s##+#+ii}fy44+k+rtiitt4 i}} 17 Similar Completed Proiects 4205 N. Courtenay Parkway Merritt Island, Ft. 32953 (321)452-3190 FAX (321) 459-3358 scci@santacnaconstruclion.com Project: E5M60 - Brevard County Sidewalk Inspection and Repair Amount: $841,824 Req'd Comp: August 2013 Actual Comp: August 2013 Owner: FDOT — Cocoa Operations 555 Camp Road Cocoa, FL Mark Harper, 321-634-6076 Project: E5Q32 - Brevard County Sidewalk Inspection and Repair Amount: $569,736 Req'd Comp: August 2016 Actual Comp: August 2016 Owner: FDOT— Cocoa Operations 555 Camp Road Cocoa, FL Mark Harper, 321-634-6076 Project Cedar Lakes RO Association Concrete Driveway Repair Amount: $92,112 Req'd Comp: 2015 Actual Comp: 2015 Owner: Cedar Lakes RO Association c/o Space Coast Property Management 645 Classic Circle Melbourne, FL Cynthia Marrs, 321-508.3846 Project: River Drive Condominium Concrete Driveway Repairs Amount: $239,320 Req'd Comp: March 2016 Actual Comp: March 2016 Owner: 115 River Drive Condominium Association 597 Haverty Court Rockledge, FL Roy Hyatt, 321-633-4050 ESTABUSHM 1975 Smte Cerdjied ad Bond Cmaral Contractor SCCI - EQUIPMENT List Kershaw 1010 Grinding Mowers Kershaw 800 w/ Fae Grinding Head TV 140 Tractor w/ Grinding Head Gehl 6640 Skid Steer w/ Fae Grinding Head Morbark Stump Grinder Track Bandit Chipper (self propelled) Chipper (trailer mounted) Linkbelt 2800 CII Series Excavator Linkbelt 28000 Excavator (longreach) Cat 214 Rubber Tire Excavator Fae Grinding Head (attaches to Excavator) 6" Alamo Tree Trimmer (attaches to Gehl 6640) Rubber Tire Front End Loader 18 cy Dump Truck 8 cy Dump Truck Ford Tractor w/ Lowboy Trailer 3 1 2 1 1 1 1 1 1 1 1 1 2 1 1 rIGNATUREJ�&P) Santa Cruz Construction Inc. (TYPE OR PRINT COMPANY LAME) 4205 N. Courtenay Parkwav, Merritt Island, FL 32953 (TYPE OR PRINT ADDRESS) 18 AGREEMENT THIS AGREEMENT, made this qday of &dl 2D19 2U9, by and between the City of Sebastian, a municipality in Indian River County, Florida (hereinafter called the "City"), and Crdbw oruz rtxis ftmt t Or its successors, executors, administrators, and assigns (hereafter called "Contractor. WITNESSETH: The City and Contractor for good and valuable consideration as hereinafter set forth, do mutually agree as follows: Scope of Services Contractor agrees to furnish concrete work meeting the requirements described in the TECHNICAL SPECIFICATIONS attached hereto as Exhibit "A", on an "as needed" basis in accordance with all applicable codes pursuant to Work Orders issued by the City. 2. Contract Sam and Payment to Contractor: (a) Contract sum: During the term of this Agreement, the city shall pay Contractor the following unit prices for work as proposed in the Contractors bid proposal. (b) The City agrees to make payment within 30 days of proper invoicing. Contractor's Obligations: (a) Contractor shall supervise and have control over means, methods, techniques, sequences and procedures for performing the Work Orders, unless the terms of this Agreement give other specific instructions concerning these matters. (b) Unless otherwise provided in the Agreement, Contractor shall pay all sales, use and other similar taxes and shall secure and pay for all permits and governmental fees, licenses and inspections necessary for proper execution and completion of its obligations hereunder. The failure of any of the parties at any time to require performance of any provision of the Agreement shall in no manner affect the right of such party many later time to enforce or require the same unless waived in writing. No waiver by any party of any condition or breach shall be construed or deemed to be a waiver of any other condition or nay other breach of any term, covenant or warranty contained in the Agreement_ 4. Indemnification and Hold Harmless The Contractor shall indemnify and hold the City harmless from any and all personal injury or property damage claims, liabilities, losses or causes of action which may arise out of the use and occupancy of the property by the Contractor, its family, associates, contractors, agents, employees, customers and attendees. Nothing in this agreement shall be construed as the City waiving its immunity pursuant to §768.28, et seq., Florida Statutes, or any other sovereign or governmental immunity. 19 i. Term of Contract (a) Contract term is for three (3) years, commencing on_Apjj-JQ 7fYI9nd ending on ApdI 9 2021 . At its discretion, The City of Sebastian may offer and with mut lgreement of the Parties, two (2) additional one (1) year extensions to this Agreement under the same terms and conditions. (b) Rate adjustments may he requested one time each year of the agreement based on the Consumer Price Index. The Contractor may request additional rate changes based on extreme circumstances beyond the Contractors control. The City in its sole discretion may approve or deny such request. S. City's Right To Terminate Contract And Complete Work In the event of any default by the Contractor, the City shall have the right to immediately terminate the Contract upon issuance of written notice of termination to the Contractor stating the cause for such action. This Agreement may be terminated by the City without cause provided at least thirty (30) days written notice of such termination shall be given to the Contractor. In the event of terminattom, the City may take possession of the Work and of all materials, tools and equipment thereon and may finish the Work by whatever method and means it may select It shall be considered a default by the Contractor whenever Contractor shall: (a) Declare bankruptcy, become insolvent or assign his assets for the benefit of his creditors. (b) Disregard or violate the provisions of the Contact Documents or City's written instructions, or fail to prosecute the Work according to the agreed schedule of completion including extensions thereof. (c) Fail to provide a qualified superintendent, competent workmen or subcontractors, or proper materials, or fail to make prompt payment for same. 7. Conflict In the event of any conflict between the provisions of this Agreement and any attachments hereto, the provisions of this Agreement shall prevail. 8. Public Records Form Contract Name: As Needed Concrete Services Project Description: As Needed Concrete Services In accordance with the requirements of Chapter 119 Florida statutes, as amended, the contract between the City of Sebastian and the Contractor shall: 20 a) Comply with the public records law of the Sante of Florida, as the same may be amended from time to time. b) Keep and maintain public records that ordinarily and necessarily would be required by the City in order to perform services, and c) Provide the public with access to public records on the same terms and conditions that the City would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law, and e) Meet all requirements of retaining public records and transfer, at no cost, to the City all public records in possession of the contractor upon termination of the contact and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requvemems. All records stored electronically must be provided to the City in a format that is compatible with the information technology systems of the City. 9. Governing LawNenue: This Agreement shall be governed and construed in accordance with Florida Law. In the event that litigation arises involving the parties to this Agreement, venue for such litigation shall be in Indian River County, Florida The parties hereto shall, and they hereby do, waive trial by jury in any action, proceeding or counterclaim brought by either of the parties hereto against the other on any matters whatsoever arising out of or in any way related to this Agreement. 10. Integration: The drafting, execution and delivery of this Agreement by the parties have been induced by no representations, statements, warranties or agreements other than those expressed in it This Agreement including the Contractors Bid Proposal contains the entire agreement between the parties and there we no further or other agreements or understandings written or oral in effect between the parties relating to its subject matter. This Agreement cannot be changed or modified except by written instrument executed by all parties hereto. This Agreement and the terms and conditions hereto apply to, and are binding upon, the legal representatives, successors, and assigns of both parties. 11. Severability: If any term of this Agreement or the application thereof to any person or circumstances shall be determined by a court of competent jurisdiction to be invalid or unenforceable, the remainder of this Agreement, or the application of such term to persons or circumstances other than those as to which it is invalid or unenforceable, shall not be affected thereby, and each term of this Agreement shall be valid and enforceable to the fullest extent permitted by law. Autho ' ,� �— Signa e: 1 y/1 Date; March 19, 2019 Print Decks kdnguez Title: Vice President Company/Firm: Santa Cruz Construction. Inc. (Following Page for Signatures) 21 IN WITNESS WHEREOF, the City has hereunto subscribed and Contractor bas affaed its name on the date fast set forth above. AA///TTEST: / . ' THEE W T OF SEBASTIAN \ /ib2 W L hM4 L/ m ette Wi II iaros,iBMC �aul E. Car' le, City Manager ,ty Clerk Approved as to Form and Legality for Reliance by the City of Sebastian only: Iame�ff Sto�rney CORPORATE SEAL: e�-Dc By: Dacks C Rodriguez, Vie So,;ryLance doguez (Rest of Page Left Intentionally Blank) 22