HomeMy WebLinkAboutAgreementAGREEMENT
for
PROFESSIONAL ENGINEERING SERVICES
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THIS AGREEMENT, entered into this 0 day of -J,2017 by and between CITY
OF SEBASTIAN, a Florida Municipal Corporation (Ci , and Dredging & Marine
Consultants (DMC) (ENGINEER).
That the CITY and the ENGINEER, in consideration of their mutual covenants, herein
agree with respect to the performance of professional engineering services by the ENGINEER
and the payment for those services by the CITY, as set forth below and in individual Work
Orders.
The ENGINEER shall provide the CITY with professional engineering services and such
other related services as defined in a Work Order(s), in all phases of the subject project unless
specified otherwise. The ENGINEER shall serve as the CITY'S professional representative for
the project as set forth in the Work Order, and shall give professional advice to the CITY during
the performance of the services to be rendered and as to the fulfillment of project requirements.
The ENGINEER is retained by the CITY to perform Design Engineering Services related to the
Earth Embanlanent Design Project as defined in RFQ #17-14.
SECTION I— SCOPE OF SERVICES
The Scope of Services shall be identified in a Work Orders prepared by the ENGINEER
and approved by the CITY. Work Order(s) will be sequentially numbered and initiation of work
thereunder shall be subject to a Notice -to -Proceed being issued by CITY.
Basic services required of the ENGINEER for the project will be described in other
appropriate sections of this Agreement and in a Work Order(s).
SECTION II - CITY OBLIGATIONS
The CITY agrees to provide the following material, data, or services as required in
connection with the work to be performed under this Agreement:
A. Provide the ENGINEER with a copy of any pertinent preliminary data or reports
available to the CITY.
B. Provide the ENGINEER with all available drawings, surveys, right-of-way maps,
and other documents in the possession of the CITY that are pertinent to the project.
C. The CITY shall be responsible for obtaining only those permits delineated in the
individual Work Order(s) or those required to complete the project only if such permit
requirements are made into law and established by regulatory agencies after the effective date of
the Work Order.
D. The CITY shall make all provisions for the ENGINEER to enter upon public or
private property as reasonably required for the ENGINEER CONSULTANT to perform its
services.
E. The CITY will promptly execute all completed permit applications necessary to
expedite the acquisition of any local, state or federal permits made necessary by the project.
SECTION III - SCOPE OF SERVICES
The ENGINEER agrees to perform all necessary professional engineering services,
project design services, construction phase services (if any), design -build services (if any),
and/or other services in connection with the assigned project(s) as required and as set forth in the
following:
A. General
1. The ENGINEER CONSULTANT will endeavor not to duplicate any previous
work done on any project. Before issuance of a Work Order and written authorization to proceed,
the ENGINEER shall consult with the CITY to clarify and define the CITY'S requirements for
the project(s) and review all available data.
2. The ENGINEER shall attend conferences with the CITY and its representatives,
upon request.
3. In order to accomplish the work described under this Agreement under the time
frames and conditions set forth in this Agreement, the ENGINEER shall observe the following
requirements:
a. The ENGINEER shall complete its work on the project(s) within the time
allowed by maintaining an adequate staff of registered engineers, draft
person(s), and other employees and/or sub consultants on the work at all
times.
b. The ENGINEER shall comply with all federal, state, and local laws
applicable to the project(s). The ENGINEER's work product shall conform
with all applicable federal, state and local laws applicable to the project(s).
C. The ENGINEER shall prepare and complete all necessary sketches, permit
application drawings, calculations, and application forms to accompany
the CITY's applications for any required federal, state, or local permits.
The ENGINEER shall reply to all permitting agency's requests for
additional information related to a permit application.
d. The ENGINEER shall cooperate fully with the CITY in order that all
phases of the work may be properly scheduled and coordinated.
e. The ENGINEER shall provide the appropriate quantities of complete
preliminary sets of construction plans to any city, county, state or federal
regulatory agency from which a permit or other approval is required, prior
to final approval of the design by the CITY MANAGER or his/her
designate, and shall coordinate the project design with all agencies.
f. The ENGINEER shall contact all utility companies having installations in
the vicinity of the proposed work to determine accurate locations and
consider relocation of utilities, if necessary. The ENGINEER
CONSULTANT shall provide the CITY with all known information
relative to any required utility adjustments, relocations and installations,
and shall show all known above and below ground utilities on the final
design plans.
g. The ENGINEER shall report the status of the project(s) to the CITY
MANAGER or his/her designee upon request and hold all drawings,
calculations, and related work open to the inspection of the CITY
MANAGER or his/her authorized agent at any time, upon reasonable
request.
h. Unless otherwise specified, the ENGINEER shall be considered the
Engineer -of -Record for the project(s) in accordance with all legal and
administrative requirements and criteria
4. The ENGINEER shall furnish additional copies of reports, drawings, specifications,
bidding, and other pertinent items as required by federal, state and local agencies from which
approval of the project(s) must be obtained, prospective bidders, material suppliers, and other
interested parties, but may charge only for the actual cost of providing such copies. The
ENGINEER shall finish to the CITY the necessary number of sets of the drawings, bidding and
construction contract documents, specifications, reports, and other pertinent items as set forth in
individual Work Orders. The cost of these sets of documents are not included in the basic
compensation paid to the ENGINEER, but will be paid as a direct expense. All original
documents, survey notes, field books, tracings, and the like, including all items fiunished to the
ENGINEER by the CITY pursuant to this Agreement, are and shall remain the property of the
CITY, and shall be delivered to the CITY upon completion of the work or at any time upon
request. All items prepared by the ENGINEER shall be created, maintained, updated, and
provided in the format as specified by the CITY.
5. All construction drawings prepared by the ENGINEER shall be of sufficient detail
to permit the actual location of the proposed improvements on the ground by a third party (i.e.
the third party shall be able to accurately locate the proposed improvements on the ground using
only the information contained in the ENGINEER's drawings).
6. The ENGINEER acknowledges that preparation of all applicable permits for the
CITY's submittal to governmental regulatory agencies, and the ENGINEER's written responses
to all regulatory agencies' questions, are included within the scope of basic compensation in each
particular Work Order. Any additional work required by regulatory agencies which establish
such regulations after the effective date of the particular Work Order, shall be an additional
service, and the CITY shall compensate the ENGINEER in accordance with the fee schedule in
an approved Work Order. Approval by the CITY shall be required prior to commencement of
any additional work.
7. If the CITY proposes to construct the any improvements in a phased manner, the
ENGINEER shall prepare detailed master plan drawings as required by the applicable Work
Order.
8. Compensation to the ENGINEER for basic services shall be in accordance with
each Work Order, as mutually agreed upon by the ENGINEER and the CITY. A schedule of
approved hourly billing rates will be included as part of each Work Order when approved.
SECTION IV - TIME FOR COMPLETION
The time for completion shall be defined in the Work Order.
SECTION V — COMPENSATION
The CITY agrees to pay, and the ENGINEER agrees to accept, for services rendered
pursuant to this Agreement, fees in accordance with the following:
A. Professional Services Fee
The basic compensation shall be mutually agreed upon by the ENGINEER and the CITY
prior to issuance of each Work Order and the amount shall be included in the Work Order to be
formally approved by the CITY.
B. Direct Payment for Additional Services
The CITY agrees to pay on a direct basis for services or goods provided by others
working in conjunction with the ENGINEER, as follows:
1. Printing and Reproduction. The CITY shall make direct payment to the ENGINEER
for the cost of printing project plan sheets. The maximum cost allowed per blueprint, mylar,
sepia, and/or other media utilized for this purpose shall be set forth in the Work Order.
2. CITY does not foresee, nor intend paying, ENGINEER any travel expenses under
this Agreement. Any such payment shall not be made except as specifically authorized in
extraordinary circumstances by prior approval of the CITY and, in any such case, bills for any
travel expenses shall be submitted in accordance with the CITY travel policy as adopted by
Resolution.
SECTION VI - ADDITIONAL WORK
Additional work occurs when the CITY requests changes after it has formally approved a
Work Order. Additional work shall not commence until a further Work Order for the additional
work has been formally issued by the CITY, and the additional work shall be performed in
accordance with the fee schedule set forth in that Work Order.
SECTION VII — PAYMENTS
The CITY shall make monthly partial payments to the ENGINEER as provided for in the
Work Order. Unless otherwise stated in the Work Order, the ENGINEER shall submit duly
certified monthly invoices to the CITY MANAGER or his/her designee or such City Staff or
City Representative as designated by the CITY MANAGER.
The Agreement shall be divided into units of deliverables, which shall include, but not be
limited to, reports, findings, drawings, and drafts, that must be received and accepted by the
CITY MANAGER or his/her designee prior to payment.
SECTION VIII - RIGHT OF DECISIONS
All services shall be performed by the ENGINEER to the satisfaction of the CITY
MANAGER or his/her designee who shall decide all questions, difficulties, and disputes of
whatever nature which may arise under or by reason of this Agreement, according to the
prosecution and fulfillment of the service hereunder, and the character, quality, amount and value
thereof. The CITY MANAGER or his/her designee's decision upon all claims, questions, and
disputes shall be final, conclusive, and binding.
Adjustments of compensation and contract time because of any major changes in the
work that might become necessary or be deemed desirable as the work progresses shall be
reviewed by the CITY MANAGER or his/her designee, and require that a Change Order (a
further Work Order) be processed in accordance with the CITY'S legal and administrative
procedures. If the ENGINEER does not concur in the judgment of the CITY MANAGER or
his/her designee as to any decisions made by him/her, it shall present written objections to the
City Manager, who shall make a decision, and the ENGINEER shall abide by the CITY
MANAGER's decision.
SECTION DC - OWNERSHIP AND REUSE OF DOCUMENTS
A. Ownership and Copyright
Ownership and copyright of all reports, tracings, plans, specifications, field books, survey
information, maps, contract documents, and other data developed by the ENGINEER pursuant to
this Agreement, shall be vested in the CITY. Said materials shall be made available by the
ENGINEER at any time upon request of the CITY. On or before the tenth day after all work
contemplated under a Work Order is completed, all of the above materials shall be delivered to
the CITY MANAGER or his/her designee.
B. Reuse of Documents
All documents, including but not limited to reports, drawings and specifications, prepared
by the ENGINEER pursuant to this Agreement, are related exclusively to the services described
herein. They are not intended or represented to be suitable for reuse by the CITY or others on
extensions of this project or on any other project. The CITY's reuse of any document or drawing
shall be at the CITY'S own risk.
SECTION X - NOTICES
Any notices, reports or other written communications from the ENGINEER to the CITY
shall be considered delivered when posted by certified mail or delivered in person to the CITY
MANAGER or his/her designee. Any notices, reports or other communications from the CITY to
the ENGINEER, shall be considered delivered when posted by certified mail to the ENGINEER
at the last address left on file with the CITY or delivered in-person to said ENGINEER or its
authorized representative. Any notices in either direction made by email transmittal shall be
considered delivered as of the time of transmittal upon confirmation of the receipt of such email
transmittal.
SECTION XI — TERMINATION
Either party may terminate this agreement upon seven (7) days' written notice to the other
party, except that in the event ENGINEER terminates this agreement such termination shall not
be effective, absent the CITY'S consent, until ENGINEER's completion, to the CITY's
satisfaction, of any pending Work Order.
SECTION XII - AUDIT RIGHTS
The CITY reserves the right to audit the records of the ENGINEER related to this
Agreement at any time during the prosecution of the work included herein and for a period of
three years after final payment is made.
SECTION XIII — SUBLETTING / OUTSOURCING / TRANSFER
The ENGINEER shall not sublet, assign, outsource or transfer any work under this
Agreement without the written consent of the CITY. When applicable and upon receipt of such
consent in writing, the ENGINEER shall cause the names of the engineering and/or surveying
firms responsible for the major portions of each separate specialty of the work to be inserted on
the reports or other data. Any such assignment / outsourcing shall not release the ENGINEER
from its role, duties, responsibilities, and obligations as Engineer -of -Record for the project work
performed.
SETION XIV — WARRANTY
The ENGINEER warrants that it has not employed or retained any company or person
other than a bona fide employee working solely for the ENGINEER, to solicit or secure this
Agreement, and that it has not paid or agreed to pay any company or person other than a bona
fide employee working solely for the ENGINEER any fee, commission, percentage fee, gift(s) or
any other consideration(s), contingent upon or resulting from the award or making of this
Agreement. For the ENGINEER's breach/violation of this warranty, the CITY shall have the
right to annul this Agreement without liability.
SECTION XV - DURATION OF AGREEMENT
This Agreement shall remain in full force and effect for a period of one (1) year after the
date of execution thereof, or until completion of all project phases as defined by the CITY
MANAGER or his/her designee, whichever occurs first, or unless otherwise terminated by
mutual consent of the parties hereto, or terminated pursuant to Section XI. This Agreement may
be extended for a period of one (1) year at the discretion of the CITY.
SECTION XVI — INSURANCE
At. least ten days prior to commencement of the first work authorization, ENGINEER
shall provide the CITY with a certificate of insurance from a company rated A+ VII or better, per
the Best's Key Rating Guide for the following:
1) Worker's Compensation — Coverage to apply to all employees for Statutory
Limits in compliance with the applicable state and federal laws. In addition, the policy
must include Employer's liability with a limit of $1,000,000 each accident and disease.
2) Commercial General Liability — Coverage must be afforded on a form no more
restrictive than the latest edition of the Commercial General Liability Policon an
occurrence basis, filed by the Insurance Services Office and must inch de:
Minimum limits of $1,000,000 per occurrence combined single limit for Bodily
Injury Liability and Property Damage Liability.
Premises and Operations.
Independent Contractors
Products and completed Operations — Consultant shall maintain in force until at
least five (5) years after completion of all services required under the Contract, coverage
for products and completed operation.
Broad Form Contractual Coverage applicable to this specific Contract, including
any hold harmless and/or indemnification agreement.
3) Business Auto Policy — Coverage must be afforded on a form no more restrictive
than the latest edition of the Business Auto Policy filed by the Insurance Services Office
and must include:
Minimum limits of $1,000,000 per occurrence combined single limit for Bodily
Injury Liability and Property Damage Liability.
Owner Vehicles
Hired and Non -Owned Vehicles.
4) Professional Liability — The Consultant shall maintain a professional liability
insurance policy in the amount $1,000,000 during the term of this Contract. Such
coverage shall be maintained for a period of five (5) years following completion and
acceptance of any work performed under this agreement. In the event the Consultant
fails to secure and maintain such coverage, Consultant shall be deemed the insurer of
such professional liability insurance and shall be responsible for all damages suffered by
the City as a result thereof, including attorney's fees and costs. In the event an atypical
large-scale project is proposed, the individual work order for the project may designate
that a higher liability policy be obtained.
5) Additional Insured — The City is to be specifically included as an additional
insured. Consultant's insurance including that applicable to the City as an Additional
Insured shall apply on a primary basis and any other insurance maintained by the City
shall be in excess of and shall not contribute with Consultant's insurance. Consultant's
insurance shall contain a severability of interest provision, providing that, except with
respect to the total limits of liability, the insurance shall apply to each Insured or
Additional Insured in the same manner as if separate policies had been issued to each.
6) Notice of Cancellation and/or Restriction — Each policy must be endorsed to
provide the City with a minimum of forty-five (45) days notice of cancellation and/or
restriction.
7) Certificates of Insurance — Certificates of insurance evidencing the Insurance
coverage specified in this section shall be filled with the City before operations are
begun. The required certificates of insurance shall name the types of policies provided. If
the initial insurance expires prior to the completion of the work, renewal certificates of
insurance and required copies of policies shall be furnished thirty (30) days prior to the
date of their expiration.
SECTION XVII — INDEMNIFICATION
The ENGINEER shall Indemnify and hold harmless the CITY, and the CITY's officers
and employees, from liabilities, damages, losses, and costs, including, but not limited to,
reasonable attorneys' fees, to the extent caused by the negligence, recklessness, or intentionally
wrongful conduct of the ENGINEER and other persons employed or utilized by the ENGINEER
in the performance of this contract agreement.
The CITY shall Indemnify and hold harmless the ENGINEER, and the ENGINEER
officers and employees, from liabilities, damages, losses, and costs, including, but not limited to,
reasonable attorneys' fees, to the extent caused by the active negligence, recklessness, or
intentionally wrongful conduct of the CITY and other persons employed or utilized by the CITY
in the performance of this contract.
SECTION XVIII — SAFETY
The ENGINEER is responsible for safety training for the ENGINEER's employees and
their activities on the CITY'S property and construction sites. However, in accordance with
generally accepted practices, the ENGINEER may report any observed job site safety violations
to the CITY.
SECTION XIX - CHOICE OF LAW AND VENUE
This Agreement shall be governed by the laws of the State of Florida. Venue for any
lawsuit brought by either party against the other party or otherwise arising out of this Contract
Agreement shall be in Indian River County, Florida, or in the event of a federal jurisdiction, in
the United States District Court for the Southern District of Florida. The parties hereto
specifically waive any and all rights to trial by jury.
SECTION XX - ENTIRETY OF AGREEMENT
This writing embodies the entire Agreement and understanding between the parties
hereto, and there are no other Agreements and understandings, oral or written, with reference to
the subject matter hereof that are not merged herein and superseded hereby. No alteration,
change, or modification of the terms of this Agreement shall be valid unless made in writing and
signed by both parties hereto.
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SECTION XXI — SEVERABILITY
In the event any provision, section, or paragraph of this agreement is determined by a
court of competent jurisdiction to be void, illegal, or unenforceable, the remaining portions not
found to be void, illegal, or unenforceable, shall remain in full force and effect.
W ESS WHEREOF the parties hereto have executed these presents thisN day of
2017.
ATTEST (SEAL-):
rtette';{li3ms CMC
ty Clerla
Approved as to form and legality for
reliance by the City of Sebastian only:
4 4'-1-
Robert A. Ginsburg, City At orney
FOR ENGINEER CONSULTANT: DMC
Attest:
THE CITY OF SEBASTIAN
t
Jose riffin, ity Manager
SHAt t,6.fH K. PATE L
Title: tA^MAGrn1G MEMBER
an.,
SEBASTIAN
HOME OF PELICAN ISLAND
June 7, 2017
City of Sebastian
1225 Main Street
Sebastian, FL 32958
(772)388-8228
fax: (772) 388-8248
ADDENDUM NO.1— Earth Embankment Design Request for Qualifications (RFQ 17-14)
The following will be considered as Addendum No.l.
1. City of Sebastian will hold a mandatory pre -submittal meeting at 10:00 a.m., on Tuesday
June 13, 2016 at Sebastian City Hall, City Council Chamber, 1225 Main Street, Sebastian, FL
to provide information on the RFQ.
Please sign and return this Addendum No. I with the bid package due on June 29, 2017.
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6/28/2017
Signature Date
Page 1 of I
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DRUG-FREE WORKPLACE FORM
The undersigned Contractor, in accordance with Florida Statute 287.087 hereby certifies
that Dredging & Marine Consultants, LLC.
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
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.
As the person authorized to sign this statement, I certify that this firm complies fully with
the above requirements.
Date: 6/28/2017
Signature
City of Sebastian Page 5
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
Stales, including, but not limited to, any bid or Agreement for goods or services to be 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 for category two, 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 property 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 WITI4 YOUR QUOTE OR BID DOCUMENTS. NON-INCLUSION OF THIS
DOCUMENT MAY NECESSITATE REJECTION OF YOUR QUOTE OR BID.
City of Sebastian Page 6
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
17-14 for THE CITY OF SEBASTIAN.
This sworn statement is submitted by Dredging & Marine
Consultants. LLC. (name of entity submitting
sworn statement) whose business address is
4643 S. Clyde Morris Blvd., Unit 302 Port Orange, FL 32129 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 Shallesh K. Patel (please print name of
individual signing) and my relationship to the entity named above is
President/ Managing Member
4. 1 understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida
Statutes, means a violation of any stale 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 Slates and involving
antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material
misrepresentation.
S. 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 stale 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 conlendere.
6. 1 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. 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. 1 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
City of Sebastian Page 7
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.)
VNeither 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 Dep0ment of General Services.)
(Signature)
Date: 6/28/2017
STATE OF FLORIDA
COUNTY OF Volusia
The fqq���egoigg instrument y as cknowledged before me this 28 day of June
2017, by j ,I ; I p �� J� f < 4-2c. Gln✓ (title) on
behalf of * M�w*� CagteIbfjbqnPssW, i . He/she is personally
Known to me Whdd produced as identification and did O did not ( )
take an oath.
Name: .d`µ,'tt, ROSALEEQWIGGWS
MY COMUSION t FF978W
My Commission Expires: EXPIRES. Dwft a 201
Commission Number: IR %*dThMBW9 a Wft
City of Sebastian Page 8