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Heavy Civil Inc.SECTION III PW 03-11-08-20 BID DOCUMENTATION City Council City of Okeechobee 55 S.E. 3rd Avenue Okeechobee, FL 34974 ORIGINAL fl—ca v 1 Inc (BIDDER'S COMPANY NAME) I have received the documents titled OKEECHOBEE 2020 SIDEWALK AND ROADWAY CONCRETE IMPROVEMENTS, Project No. PW 03-11-08-20. 1 have also received addendum number_ through and have included these provisions in my Bid. I have examined both the Bid documents and the construction site and submit the following Bid in which I agree: To hold my Bid open until an agreement has been executed between the City of Okeechobee and accepted Bidder, or until ninety (90) days after Bids are opened, whichever is longer. 2. Regarding the Disposition of Bid Security: to accept the provisions of the Instructions to the Bidders. 3. To accomplish the work included in, and in accordance with the Contract Documents, if this Bid is accepted. 4. To start work on the first day of the month following the date of the Notice to Proceed. This contract will be in force for a period of one (1) year. This contract may be extended beyond the initial one (1) year. Each extension period will be for an additional one (1) year and may be renewed thereafter on an annual basis. It may be under the same or superior terms and conditions as this bid. This shall be accomplished by mutual written agreement/acceptance between the vendor and the City. 5. Payment will be made on a monthly cycle after work has been completed. A monthly invoice will be submitted on or before the 9th day of each month for payment. The invoice will be processed through our regular cycle with payment usually made by the end of the following month. Example: Work performed from September 1st through September 301h. The bill is to be received by the City no later than October 91h, and payment should be made by October 30th. NOTE: The City shall not be liable to pay interest on any unpaid balance. Vendor is solely responsible for all taxes, withholding, or social security obligations. Regarding the Award of the Contract: if I am awarded a contract for this project, I understand that the award may be for all or any portion thereof, of the items listed under the Bid Unit Price Schedule. City of Okeechobee Project No. PW 03-11-08-20 Public Works Department 4 Bidder: CIXJI�VIC, (Company Name) By: igna re) (Printed Name) Mailing Address: Sa Y jV�l n I � Office Number: ��� `� q4 Date: ° ` Z DZCS Title: PfC/--,J-e,04- Email: ;(UGC I( fjCA Vq (iil V, `I r) G C UM -�, S+< 3 C� � Pamix;n� Fax Number: City of Okeechobee Public Works Department Project No. PW 03-11-08-20 SECTION IV PW 03-11-08-20 MINIMUM QUALIFICATIONS FOR BIDDERS Minimum Qualifications: 1.0 Experience 1.1 Bidder must have at least 3 years of experience in providing commercial concrete services including sidewalks and other flat work, roadway curbing, and roadway concrete pavement. 1.2 Bidder has successfully completed at least 12 concrete projects including at least one project in each of the following categories: 1.2.1 Sidewalk installation 1.2.2 Roadway curbing 1.2.3 Roadway concrete pavement 2.0 References 2.1 Bidder must provide at least 3 verifiable references of similar prior concrete services including sidewalks and other flat work, roadway curbing, and roadway concrete pavement 2.2 For each reference, Bidder shall submit a completed Reference Form provided in Attachment H. provide the client name, client phone number, and client e- mail address. 2.3 Bidder shall provide a written description of the services performed in sufficient detail as they directly relate to the work of this Request for Bid. The description shall include the dates of the period that the Bidder provided the services as well as the contractual amount of the services provided. 2.4 The City, in its sole discretion, may reject any and all bids if the City is not able to verify the references provided. 3.0 Bidder certifies that ItTorem 3.1 Bidder meets the qualifications listed in Section IV, 1.0 above. 3.2 Bidder has never failed to complete work awarded under a contract due to circumstances that were under Bidder's control. (Cpmpany Name) By: 1 (Signature) To (Printed Name) Date: "l ' 1, w W Title: Proms 1 J eof Email: Y U dV 6b btav Y6 V1 IIY C • Lnrw Mailing Address: 15D Ea SaWlpl-P- -RDGCI s �3���P6MDana 86" �U am�,, / 2 3 3oc� Office Number: 99q— �)qq— 443 Fax Number: I1 l�6, City of Okeechobee Public Works Department Project No. PW 03-11-08-20 ATTACHMENT H CITY OF OKEECHOBEE OKEECHOBEE 2020 SIDEWALK AND ROADWAY CONCRETE IMPROVEMENTS PW 03-11-08-20 REFERENC Client Name: Phi L (YA I 1'N Client Phone Number:U� Client E-mail: C \-/C4 l� J � � (wide - �C�L�� , Service Dates: Beginning I G End Z% Estimated Annual Contract Amount: # 3 Description of the services performed as they directly relate to the work of this Request for Bid: City of Okeechobee Project No. PW 03-11-08-20 Public Works Department 67 ATTACHMENT H - CITY OF OKEECHOBEE OKEECHOBEE 2020 SIDEWALK AND ROADWAY CONCRETE IMPROVEMENTS PW 03-11-08-20 REFERENCE Client Name: L1 s" P I r) el Vy " Client Phone Number: 2(0 3 ` ;7-13 14D 5(a Client E-mail: eOUS&V) y�� J D Sf�T� • I ` LA S Service Dates: Beginning _� a End Estimated Annual Contract Amount: 4 3 U 5, 0 0 0 Description of the services performed as they directly relate to the work of this Request for Bid: City of Okeechobee Project No. PW 03-11-08-20 Public Works De artment _ ATTACHMENT H CITY OF OKEECHOBEE OKEECHOBEE 2020 SIDEWALK AND ROADWAY CONCRETE IMPROVEMENTS PW 03-11-08-20 REFERENCE Client Name: �-V �� �� a CA c7> Client Phone Number: 1 Client E-mail: Service Dates: Beginning End Estimated Annual Contract Amount: �-�q , Description of the services performed as they directly relate to the work of this Request for Bid: A IL 5�(wA z 1 on - City of Okeechobee Project No. PW 03-11-08-20 Public Works De artment BID BOND 10;Q 1f ALL MEN BY THESE PRESENTS, that we, Heavy Civil lnc. as Princlpal and Frankenmuth Mutual Insurance Company, as Surety,. are. held and firmly bound canto the City of C?%hobee (the "City"); in the, penal sum of $ 5% of Amount Bid lawful moaoay Of tho uni $totes, for t1 to payment; of which. sum, well arrrl tru r'to be made; we find euroiv;: our hairs, eutal, adminlstratcyrs, and successors, jaln€I and see'vaniiil*, firmly bY these presents. 'THE CONDITION OFF THE OBLIGATION IS SUCH, that whereas the Principal has stbmitfedtlxea+errtpanying bid, dated September 1 st forthe Contract -.Documents: Coritractmow. O.1(EECHOBEE 2026 SIDEWALK AND ROADWAY CONCRETE IMPROVEMENTS +Con=tractNNtumber PW $-11.08.20 NOW, THEREFORE, 1.. if the Princlpei,. a. tIfi(101nsevlen '(7) business days after the date of the Notice of Apparent Low Sidde, provides a. :Statutory Payment Band and a Common Law Performance Bond as specified In the General "Terms & Conditions or, in Jim, of the Statutory Payment Bond or Common ;Law Performance Bond,. proldes an aitemate form of security as specified in the CO tract Dctcui 6hi -, and provides the Insurance certificate required under the or=tcuCtents, completed by a lawfully authorized insurance agent; a b. Wthheaven=(7) business days of receipt of the Contract Documents, enters Ir a w ftwcontractwith the,City,;in accordance,with the Bid, as accepted, then Ahe.above obligations of tfie Principal and Surety -shall be null and veld. 2. kH, owever, should the. Pnndlpat fail to fully comply with the c onditlorts of ragraph above, thrwra`°#tre Principal any! Surety, jointly and severally,; shall be liable to ti e:City forihe full penal sum of this Bond which shall be far -Mod 10 the Cl as liquidated damage, ,but not a penalty, as a result of the 'Ondpsii's failure, to comply with the bid instructions and conditions, regardless of, whether 1he. City ultimately decides to change the project oquirerftnts or resolicit bids. .3.The rr~smedlesprovided herein sire not o be construed as the Cjty's oxclasive idles for #fie .principal's failure to. enter into a. contract with, the City but .shall I* deemed supplemental to all remedies available to the City at law or otherwise. City of Okeechobee Project No. PW 03-11w0l&-20 Public Wofks"cepartment is DATED ON September 1st (UUitness) riff Name) BOOS (WntNan i) ram. �oDE�r� (Signature of Principal) {Prinfiq lrne and Title) Business Address FOR CORPOR `iE OIDDERSs Heavy Civil Inc. SURETY' A�iE$,As Per Attached Power of Attorney (0-OrPorate Seal). � /I 150 East Sample Road, Unit 310, Pompano Beach, FL. 33064 Business Address Frankenmuth utual Insurance Company 46.1 to ;retyj_ _ Mai Warfe . After, Attorney -In -Fact 1 _Mutual Avenue..Frankenmuth, MI. 48787 Business Addr6ss 5979.,NW 151st Street, #202, Miami Lakes, FL. 33014 Fiortd , Address, for ISO rVice cif Prb ess (989) 652-6121 T lephorre Number ("ty $ha# proVIde- evidende of signalUxe authority such as a certifled" copy of Power of Attorney, CRY of Okeechobee Project No. PWO341-08 20 Public Works Department 26 FRANKENMUTH MUTUAL INSURANCE COMPANY POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that Frankenmuth Mutual Insurance Company (the "Company"), a corporation duly organized and existing under the laws ofthe State of Michigan, having its principal office at I Mutual Avenue, Frankenmuth, Michigan 48787, does hereby nominate, constitute and appoint: Warren M. Alter, Jonathan A. Bursevich, David T. Satine, Dawn Auspitz Their true and lawful attorney(s)-in-fact, each in their separate capacity if more than one is named above, to make, execute, seal, acknowledge and deliver any and all bonds, contracts and undertakings of suretyship, with the exception of Financial Guaranty Insurance, provided, however, that the penal sum of any one such instrument shall not exceed the sum of: Fifty Million and 00/100 Dollars (S50,000,000) This Power of Attorney is granted pursuant to the following Resolution duly adopted at a meeting of the Board of Directors of Frankenmuth Mutual Insurance Company: "RESOLVED, that the President, Senior Vice President or Vice President and each of them under their respective designations, hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer of the Company, qualifying the attorney(s) named in the given power of attorney, to execute on behalf of, and acknowledge as the act and deed of Frankenmuth Mutual Insurance Company on all bonds, contracts and undertakings of suretyship, and to affix the corporate seal thereto." IN WITNESS WHEREOF, the Company has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 10th day of September, 2018. Frankenmuth Mutual Insurance Company _ Fred crick A. Edmond, Jr., — President and Chief Operating Officer -STATE Ox MI&HIGAI4-� .� COUJ"ITY OF SAGINA-W :) ss: Sworn to before me, a Notary Public in the State of Michigan, by Frederick A. Edmond, Jr., to me personally known to be the individual and officer described in, and who executed the preceding instrument, deposed and said the Corporate Seal and his signature as Officer were affixed and subscribed to said instrument by the authority of the Company. - IN TESTIMONY WHEREOF, I havesetmy hand, and affixed my Official Seal this loth day of September, 2018, (Seal) - \' Dianne L. Voss, Notary Public - - Saginaw County, State of Michigan My Commission Expires July 23, 2024 I, the undersigned, Vice President of Frankenmuth Mutual Insurance Company, do hereby certify that the foregoing is a true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded and is in full force and effect as of this date. 1st September 2020 IN WITNESS WHEREOF, I have set my hand and affixed the Seal of the Company, this day of a,J.- �- �,� Andrew H. Knudsen, Vice President ALL CORRESPONDENCE RELATED TO BOND VALIDATION AND/OR A CLAIM SHOULD BE DIRECTED TO THE DIRECTOR OF SURETY, 701 US ROUTE ONE, SUITE I, YARMOUTH, ME 04096 EXHIBIT B BID UNIT PRICE SCHEDULE PW 03-11-08-20 OKEECHOBEE 2020 SIDEWALK AND ROADWAY CONCRETE IMPROVEMENTS EST. ITEM DESCRIPTION UNIT CITY UNIT AMOUNT NO. MEASURE PRICE POUR EIGHT (8) INCH CONCRETE ROADWAY SLAB TWENTY-FOUR (24) FEET ONE HUNDRED -FIFTY (150) FEET, 3,000 PSI MINIMUM W/6 INCHES X 6 INCHES-1.4 X 1.4 WWF REINFORCEMENT ON NW 10TH STREET. CITY 1 TO REMOVE EXISTING ASPHALT AND EXCAVATE EACH 1 31, m)-it 'koo , ui> EXISTING ROAD BASE AND PROVIDE NEW SUBBASE. WORK TO BE PERFORMED IN TWO SEGMENTS TO MAINTAIN ACCESS TO APARTMENT COMPLEX ON NORTH SIDE OF 10TH STREET. POUR EIGHT (8) INCH CONCRETE ROADWAY SLAB TWENTY-FOUR (24) FEET ONE HUNDRED -FIFTY (150) FEET, 3,000 PSI MINIMUM W/6 INCHES X 6INCHES -1.4 2 X 1.4 WWF REINFORCEMENT ON NW 10TH STREET. CITY EACH 1 ✓I� bpi , 3I, GUCS UfU TO REMOVE EXISTING ASPHALTAND EXCAVATE EXISTING ROAD BASE AND PROVIDE NEW SUBBASE. WORKTO BE PERFORMED IN TWO SEGMENTS TO MAINTAIN ACCESSTO DIAMOND R FERTILIZER. REMOVE EXISTING SIDEWALK AND INSTALL NEW ADA CURB RAMP CR-B PER FDOT INDEXES 300 CURB & CURB AND GUTTER, AND 304 DETECTABLE WARNINGS AND 3 SIDEWALK CURB RAMPS. CONCRETE SHALL BE 3,000 EACH 1 c ff oyo • blrJO Q PSI WITH FIBER OF OTHER APPROPRIATE REINFORCEMENT MATERIAL. DETECTABLE WARNING MAT COLOR SHALL BE BRICK RED. REMOVE EXISTING SIDEWALK AND INSTALL NEW ADA CURB RAMP CR-C PER FDOT INDEXES 300 CURB & CURB AND GUTTER, AND 304 DETECTABLE WARNINGS AND SIDEWALK CURB RAMPS. CONCRETE SHALL BE 3,000 4 PSI WITH FIBER OF OTHER APPROPRIATE EACH 7 3j51�'3tcx. REINFORCEMENT MATERIAL. DETECTABLE WARNING MAT COLOR SHALL BE BRICK RED. WIDTH TO VARY FROM 6 FEET TO 8 FEET DEPENDING ON LOCATION. RAMP WIDTH TO MATCH WIDTH OF EXISTING PAVER SIDEWALK. City of Okeechobee Public Works Department Project No. PW 03-11-08-20 54 n�coi� Livi lyl( REMOVE EXISTING SIDEWALK AND INSTALL NEW ADA CURB RAMP CR-L PER FDOT INDEXES 300 CURB & CURB AND GUTTER, AND 304 DETECTABLE WARNINGS AND 5 SIDEWALK CURB RAMPS. CONCRETE SHALL BE 3,000 EACH 2 cx--, �U� 000- lib PSI WITH FIBER OF OTHER APPROPRIATE /ty;b• REINFORCEMENT MATERIAL. DETECTABLE WARNING MAT COLOR SHALL BE BRICK RED. 6 REMOVE AND REPLACE EXISTING FIVE (5) FOOT WIDE LINEAR 100 CONCRETE SIDEWALK. TEN (10) YARD TOTAL. FOOT 7 REMOVE AND REPLACE EXISTING FIVE -FOOT -WIDE LINEAR 50 OC)bd �J, Cob `Ue) CONCRETE SIDEWALK. LESS THAN TEN (10) YARD TOTAL FOOT 8 REMOVE AND REPLACE EXISTING CONCRETE "F" CURB. LINEAR 100 TEN (10) YARD TOTAL FOOT 9 REMOVE AND REPLACE EXISTING CONCRETE "F" CURB. LINEAR 100 5�1, Gj boo, up LESS THAN TEN (10) YARD TOTAL FOOT 10 INSTALL NEW FIVE (5) FOOT WIDE CONCRETE LINEAR 500 '(,�5L �� j; . �� SIDEWALK. TEN (10) YARD TOTAL FOOT 11 INSTALL NEW FIVE (5) FOOT WIDE CONCRETE LINEAR 100 -3a I) (S , b� SIDEWALK. LESS THAN TEN (10) YARD TOTAL FOOT 12 INSTALL NEW CONCRETE "D" CURB. TEN (10) YARD OR LINEAR 100 Uc) ®U GREATER TOTAL FOOT 13 INSTALL NEW CONCRETE "D" CURB. LESS THAN TEN LINEAR 50 (10) YARD TOTAL FOOT 14 INSTALL NEW CONCRETE "F" CURB. TEN (10) YARD OR LINEAR 100 zrJ,. �lG� 50U vc, GREATER TOTAL FOOT 15 INSTALL NEW CONCRETE "F" CURB. LESS THAN TEN (10) LINEAR 50 �j- �, ( SUp, v' YARD TOTAL FOOT 16 INSTALL NEW 4-INCH-THICK CONCRETE SLAB SQUARE FOOT 500 l' 7 17 INSTALL NEW 6-INCH-THICK CONCRETE SLAB SQUARE 500 , ,iZ) �� bOU : U FOOT TOTAL BID AMOUNT (Based on Bid Unit Prices & Estimated Quantities) !Lt9?061 V City of Okeechobee Public Works Department Project No. PW 03-11-08-20 S5 Bidders Company Name C"I' V 1.1 V t v) C'. NOTE: This Bid is on a unit price basis. The total estimated amount is for Bid comparison purposes only. The Contractor should field verify the actual site conditions prior to time of bidding and before submitting the Bid proposal. The Contractor should read the special conditions and the requirements for insurance before submitting a Bid proposal. The Contractor should verify the quantities to be included in the construction contract. The Contractor shall furnish the City of Okeechobee with a Payment and Performance Bond in 100 percent (100%) of the total estimated amount of the contract. The Payment and Performance Bond shall continue in effect for one (1) year after completion and acceptance of the work as guarantee against construction defects. The Contractor in his Bid shall include the cost of said bond. I have attached the required 5 per ent (50/() Bid Security to this Bid. Bidder: t i(1 C Date:'I I - 9L o ( mpa Name) By: Title: 1-0d (Jv� (Printed Name) Mailing Address: 1 5() G - Ja Office Number: q ✓ `C - 5ciq' 6443 City of Okeechobee Public Works Department Email:)CL4 6- uwl -, 3(0 Fax Number: o jam; , T:� 33()i�4 Project No. PW 03-11-08-20 56 ATTACHMENT A PW 03-11-08-20 NO LOBBYING AFFIDAVIT STATE OF FLORIDA COUNTY OF t) W avG This day of , 20 '70, TD6 (�V1t4A being first duly sworn, depo9?-(AYJ s and sa s that bWshe is the authorized representative of %1'q i l I V)ii• (Name of Contractor, Firm or Individual) respondent to the attached request for Bid, or qualifications and/or any other solici tion r leased by City of Okeechobee, and that the Bidder and any of its agents agre i e by e City of Okeechobee no lobbying restrictions in regard to this solicitation. Affiant The foregoing instrument Was acknowledged before me by means of Yphysical prese e or ❑ online notarization, this � day of c✓ , 20 ZU, by 1 ©c+Q (�(Iv�t 7-who is personally known to me or produced as iden 'fication. ysi'►�+,, TIFFANY KESTER '+F • Notary Public • State of Florida ®��a' Commission ? CC,280548 Notary IC Si t e N cr"my Comm. Expires Nov 29, 2022 Bonded through National Notary Assn. Commission No. IUUV&W gq LD 2-2- City of Okeechobee Public Works Department 59 Project No. PW 03-11-08-20 ATTACHMENT B PW 03-11-08-20 ANTI -COLLUSION STATEMENT AND NO GIFTS STATEMENT Date: 5 . ` 'ZO ?. - Anti -collusion statement: The below -signed Bidder has not divulged to, discussed, or compared his/her Bid with other Bidders and has not colluded with any other Bidder or parties to a Bid whatsoever. No gifts statement: No premiums, rebates, gifts or gratuities are permitted with, prior to, or after submission of the Bid. Any such violation will result in rejection of the Bid and removal from the Bid list(s). Firm Name: d "(-Uyr,I Ci 1 l i n C' . By (printed/typed): By (signature): Title: 1, �i✓� i ci -XTfi Mailing Address: 150 E, rn DI e I Roe , 31 d City, State, Zip: Po wp ant) �U L. ��'. �L 33064 Telephone No.: "I 5 4' J� �/ q q ?J City of Okeechobee Public Works Department 60 Project No. PW 03-11-08-20 ATTACHMENT C PW 03-11-08-20 PROPOSER'S CERTIFICATION have carefully examined this Request for Bid (BID)/Request for Proposals (RFP)/ Request for Qualifications (RFQ), which includes scope, requirements for submission, general information and the evaluation and award process. acknowledge receipt of the following addenda. Addendum # Date: Addendum # Date: Addendum # Date: Addendum # Date: Addendum # Date: Addendum # Date: hereby propose to provide the services requested in the City's BID/RFP/RFQ and, if awarded, to enter into the attached draft contract. I agree that the terms and conditions of the City's BID/RFP/RFQ shall take precedence over any conflicting terms and conditions submitted with my proposal and agree to abide by all conditions of the BID/RFP/RFQ, unless a properly completed Exceptions to BID/RFP/RFQ form is submitted. I acknowledge that the City may not accept the proposal due to any exceptions. I certify that all information contained in my proposal is truthful to the best of my knowledge and belief. I further certify that I am duly authorized to submit this proposal on behalf of the Company as its agent and that the Company is ready, willing and able to perform if awarded a contract. further certify, under oath, that this proposal is made without prior understanding, agreement, connection, discussion or collusion with any other person, Company or Corporation submitting a proposal for the same product or service; no gratuities, gifts or kick -backs were offered or given by the Bidder or anyone on its behalf to gain favorable treatment concerning this procurement; no City Council member, employee or agent of City of Okeechobee or of any other Company is interested in said Bid; and that the undersigned executed this Proposer's Certification with full knowledge and understanding of the matters therein contained and was duly authorized to do so. Wc,(4V Liy j I `�D C> �a�D I L- i�0cc). G-fc31y Name of Business ✓ Mailing Address Authorized Signature Name & Title, Typed STATE OF FLORIDA COUNTY OF 0C 0V J6-YJ City, State & Zip Code c1�q_ 5c1`7- (�443 Telephone Number/Fax Number aAdy, v h-euvv6 vi Iiri com Email Address The foregoing instrument was acknowledged before me by means of online notarization, this � day of 6CID-k • 20 W, by �Tvte- is personally known to me or produced TIFFANY KESTER Notary P I SI( • .w�, Notary Fubiir- -State of Florida 7tf Commission; GG 280548 Commission No. ' My Comm. Expires Nov 29, 2022 Banded thrcugh National of Assn. ical presence or who as idenfifi ation. 2— . Z Z) 2,2- City of Okeechobee Project No. PW 03-11-08-20 Public Works Department 61 ATTACHMENT D PW 03-11-08-20 SWORN STATEMENT PURSUANT TO SECTION 287.133 (3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. This sworn statement is submitted to CITY OF O EECHOBEE, FLORIDA by: Ode! I�t/ �C P,St pritt Individual's name and title) for: nG: (print name of entity submitting sworn statement) whose business address is j G16; � y -'bcl ' It -Ro6d o 7 � .? f®. Famp6ilno Vt'ack FL, � 3UP and (if applicable) its Federal Employer Identification Number (FEIN) is: 5 517/rl/ (If the entity has no FEIN, include the Social Security Number of the Individual signing this sworn statement: 2. 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 of the United States, including but not limited to, any Bid or contract 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 misrepresentations. 3. 1 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, non -jury trial, or entry of a plea of guilty or nolo contendere. 4. 1 understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means: a. A predecessor or successor of a person convicted of a public entity crime; or b. 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. Project No. PW 03-11-08-20 City of Okeechobee Public Works Department 62 5. 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 contract and which Bids or applies to Bid on contracts 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. 6. Based on information and belief, the statement which I have marked below is true in r lation to the entity submitting this sworn statement. (Indicate which statement applies). , Neither the entitysubmitting this sworn statement, nor an of its officers, directors, 9 Y executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. I The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the 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. 1 The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the 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. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list (attach a copy of the final order). I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC - NTITY,IPRI TO ENTERING INTO A CONTRACT IN EXCESS OF STATUTES F CATEGORY TWO THE O A YNAN PROE IN THE INFORMATION CONTAINED [DIED IN SECTION 287.017, FLORIDIN THIS ORM OR Signature STATE OF FLORIDA COUNTY OF &rb 'Jay d_ The foregoing instrument was acknowledged before me by means of ❑✓phys cal prese ce or ❑ online notarization, this -si'day of 20L0*, b0c!z ,li who is personally known to me or produced 4 as idenbficAion. ;io • ��Lr TIFFANY NESTER NotarI Public -Mate Of FiOridd Commission GG 280548 y' q? My Comm. Expires Nov 29, 2022 Bonded t,,Cugh Naftnal Notary Assn. Notary IP.dlflic 1 irgoature Commission No. Noy-e—mb-ex Zit Z6 — - City of Okeechobee Public Works Department 63 Project No. PW 03-11-08-20 ATTACHMENT E PW 03-11-08-20 CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all Bidders must disclose if any City of Okeechobee employee(s), elected official(s), or any of its agents is also an owner, corporate officer, director, agent, employee, etc., of their business. Indicate either "yes" (a City employee, elected official or agent is associated with your business), or "no". If yes, give person(s) name(s) and position(s) with your business. YES NO Y Name(s) Position(s) Firm Name: 0 "cad/ U C i V t By (Printed): Tod �4), e, l By (Signature): r LIZ Title:rcl, -P.{rl Address: O �JG Inn p j-� -K6 6 J Phone Number: q 5 4— 5 -1 - w `T 4 3 City of Okeechobee Project No. PW 03-11-08-20 Public Works Department 64 ATTACHMENT F PW 03-11-08-20 IMMIGRATION LAW CERTIFICATION City of Okeechobee will not intentionally award City contracts to any Contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324 a(e) (Section 274a(e) of the immigration and nationality act ("INA")). City of Okeechobee may consider the employment by any Contractor of unauthorized aliens a violation of Section 274A(e) of the INA. Such violation by the recipient of the employment provisions contained in Section 274A(e) of the INA shall be grounds for unilateral cancellation of the contract by City of Okeechobee. Respondent attests that it is fully compliant with all applicable immigration laws, specifically relating to the 1986 immigration act and subsequent amendments. �(,av ' lv l 1 InG Company -Nam' Signatur ��T�itlm 1- _ Date ►�-�1 STATE OF FLORIDA COUNTY OF &Q AX J_ The foregoing instrument was acknowledged before me by means of vVph sical presence or ❑ online notarization, thisrday of �, 20zD, by `T"od �c►'�elS�i ,who is personally known to me or produced 1 �. aside ification. n E TIFFANY KESTER NotaryPublic - State of Florida Commivon 4 GG 280548 My Comm,Expires Nov 29, 2022onded through National Notary Assn. City of Okeechobee Public Works Department NotaryPAVic Sftnature Commission No. O)Vembe)✓ Zq, wZZ' Project No. PW 03-11-08-20 65 ATTACHMENT G PW 03-11-08-20 DRUG -FREE WORKPLACE CERTIFICATION THE BELOW SIGNED Bidder/proposer CERTIFIES that it has implemented a drug -free workplace program. In order to have a drug -free workplace program, a business shall: 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 violation of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation and 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 quote a copy of the statement specified in subsection 1. 4. In the statement specified in subsection 1, notify the employees that, as a condition of working on the commodities or contractual services that are under quote, the employee will abide by the terms of the statement and will notify the employer of any conviction or plea of guilty or nolo contendere to any 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, drug abuse assistance or rehabilitation program if such is available in the employee's community, by an employee who is convicted. 6. Make a good faith effort to continue to implementation of this section. As the person authorized t this above requirements. Signature / Company: I �e�v�1 Li V l I'1G ( Name: T(UCAJ KoCA 5Zd Address: "� �(;,rn ijI , Title: 3— 069 T Phone Number: ntain a drug -free workplace through certify that this Firm complies fully with the City of Okeechobee Public Works Department Date: - d , I ' Project No. PW 03-11-08-20 3- HEAVCIV-01 KATEW i ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE DATE(MM/DDlYYYY)8/24/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 958967 Johnston Lewis Associates, Inc. 5600 New King, Ste. 210 Troy, MI 48098 NAn°MEnCT Katheryn Walrad PHONE FAX (A/C, No, Ext); (A/C, No): n oRE s: katew jlains.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:OhiO Security Insurance Company 24082 INSURED Heavy Civil, Inc. 150 East Sample Road Suite 310 Pompano Beach, FL 33064 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR L TYPE OF INSURANCE ADDL INSD SUBR POLICY NUMBER POLICY EFF MIDD/YYYY POLICY EXP MMI D LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR BKS58347963 3/26/2020 3/26/2021 EACH OCCURRENCE $ 1,000,000 DAMAGETO S(RENTED PREM SET Ea occurrence) 300,000 $ MED EXP (Any oneperson) $ 15,000 GEN'L PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY FX] jECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNAUTOS ONLY AUTOS OS AUTOS ONLY X AUTOS ONE Ix BKS58347963 3/26/2020 3/26/2021 COMBINED SINGLE LIMIT Ea accide 1,000,QQ0 $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ Perr accident AMAGE $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE US058347963 3/26/2020 3/26/2021 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DIED X RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A XWS58347963 3/26/2020 3/26/2021 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 500,000 $ E.L. DISEASE - EA EMPLOYE SOO,000 $ E.L. DISEASE - POLICY LIMIT 500,000 $ A A Equipment Floater General Liability BKS58347963 BKS58347963 3/26/2020 3/26/2020 3/26/2021 3/26/2021 Equipment Floater Rented Equipment 500,000 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required RE:Job Number: PW 03-11-08-20, Job Name: Okeechobee 2020 Sidewalk & Roadway Concrete Improvements, Job Address: Okeechobee CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Okeechobee Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 55 SE 3rd Avenue - Room 101 Okeechobee, FL 34974 AUTHORIZED REPRESENTATIVE/-1• ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Ron DeSantis, Governor Halsey Beshears, Secretary STATE OF FLQRIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER: CGC1528801 EXPIRATION DATE: AUGUST 31, 2022 THE GENERAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489; FLORIDA STATUTES' a 5 > � �i..• � �,�_� +Y qs` nay k � � 4•. r g STEIER, THOMAS R SR "° '~� • �� HEAVY CIVIL INC. 18158 NE19TH AVE .' • NORTH MIAMI FL 33162 � w ISSUED: 08/14/2020 Always verity' licenses online at MyFloridal-icen5e.com Do riot,alter this.document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. Florida Department of Transportation RON DESANTIS 605 Suwannee Street KEVIN J. THIBAULT, P.E. GOVERNOR Tallahassee, FL 32399-0450 SECRETARY April 27, 2020 HEAVY CIVIL INC 18158 NE 19 AVENUE NORTH MIAMI BEACH, FLORIDA 33162 RE: CERTIFICATE OF QUALIFICATION Dear Sir/Madam: The Department of Transportation has qualified your company for the type of work indicated below. Unless your company is notified otherwise, this Certificate of Qualification will expire 6/30/2021. However, the new application is due 4/30/2021. In accordance with S.337.14 (1) F.S. your next application must be filed within (4) months of the ending date of the applicant's audited annual financial statements. If your company's maximum capacity has been revised, you can access it by logging into the Contractor Prequalification Application System via the following link: HTTPS://fdotwpl.dot.state.fl.us/ContractorPreQualification/ Once logged in, select "View" for the most recently approved application, and then click the "Manage" and "Application Summary" tabs. FDOT APPROVED WORK CLASSES: DRAINAGE, FLEXIBLE PAVING, GRADING, GRASSING, SEEDING AND SODDING, SIDEWALK, Concrete Barrier Wall, Underground Utilities (Water & Sewer). You may apply for a Revised Certificate of Qualification at any time prior to the expiration date of this certificate according to Section 14-22.0041(3), Florida Administrative Code (F.A.C.), by accessing your most recently approved application as shown above and choosing "Update" instead of "View." If certification in additional classes of work is desired, documentation is needed to show that your company has done such work with your own forces and equipment or that experience was gained with another contractor and that you have the necessary equipment for each additional class of work requested. All prequalified contractors are required by Section 14-22.006(3), F.A.C., to certify their work underway monthly in order to adjust maximum bidding capacity to available bidding capacity. You can find the link to this report at the website shown above. AA:cs Sincerely, Alan Autry, Manager Contracts Administration Office www.fdot.gov BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2020 THROUGH SEPTEMBER 30, 2021 DBA: Owner Name: THOMAS R STEIER SR Business Location: 150 E SAMPLE RD STE 310 POMPANO BEACH Business Phone:954-597-6443 —f'. —GENERAL CONTRACTOR (CERT Business Type:GENERAL CONTRACTOR ) Business Opened:o8/17/2020 State/County/Cert/Reg:CGC 15 2 8 8 01 Exemption Code: Rooms Seats Employees Machines Professionals 10 For Vending Business Only Numher of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 1 0.00 1 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: HEAVY CIVIL INC. Receipt #WWW-19-00204064 150 E SAMPLE RD STE 310 Paid 08/17/2020 27.00 POMPANO BEACH, FL 33064 2020 - 2021 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2020 THROUGH SEPTEMBER 30, 2021 DBA: HEAVY CIVIL INC. Business Name: Owner Name: THOMAS R STEIER SR Business Location: 150 E SAMPLE RD STE 310 POMPANO BEACH Business Phone:954-597-6443 Receipt #: 180-307832 Business Type: GENERAL CONTRACTOR (CERT GENERAL CONTRACTOR ) Business Opened: 0 8 / 17 / 2 0 2 0 State/County/Cert/Reg: CGC1528801 Exemption Code: Rooms Seats Employees Machines Professionals 10 Signature For Vending Business Only NumhAr of Mar_hinas� Vendlno TYDe: Tax Amount ---------- -------------- 1 Transfer Fee NSF Fee =Penalty Prior Years Collection Cost I Total Paid 27. ODJ 0.001 0.00 0.00 0.00 0.00 27.0o Receipt #WWW-19-00204064 Paid 08/17/2020 27.00