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Sunshine Land DesignCITY OF OKEECHOBEE INVITATION TO BID CITY OF OKEECHOBEE TAYLOR CREEK SE 8t" AVENUE STORMWATER CONVEYANCE No. PW 02-00-12-20 FDEP AGREEMENT No. LP47020 OPENING DATE AND TIME: JANUARY 14, 2021 at 3:00 P.M. �-_-`-�.��% �� .��r° �� Prepared by: David Allen, Public Works Director Dated: December 9, 2020 City of Okeechobee Project No. PW 02-00-12-20 Public Works Department CITY OF OKEECHOBEE CITY COUNCIL Bid No. PW 02-00-12-20 FDEP AGREEMENT No. LP47020 CITY OF OKEECHOBEE TAYLOR CREEK SE 8t" AVENUE STORMWATER CONVEYANCE DOWLING R. WATFORD, JR., MAYOR WES ABNEY MONICA CLARK BOB JARRIEL BOBBY KEEFE City of Okeechobee Project No. PW 02-00-12-20 Public Works Department INVITATION TO BID N0. PW 02-00-12-20 CITY OF OKEECHOBEE TAYLOR CREEK SE 8t" AVENUE STORMWATER CONVEYANCE Mandatory Pre-Bid: January 7, 2021, 3:00 PM Opening Date and Time: January 14, 2021, 3:00 PM The City of Okeechobee, Florida is currently soliciting bids to provide construction services needed to construct water quality and baffle box drainage improvements and perform roadway restoration on SE 8T" Avenue, Okeechobee, Floritla 34974. Sealed bids must be received within the General Services Department at City Hall, 55 SE 3�d Avenue, Rm 101, Okeechobee, FL 34974, no later than 3:00 PM EST on or before Thursdav, January 14, 2021. All responses received by the deadline will be opened and recorded in the presence of one or more witnesses within the Council Chambers, Rm 200, at the address listed above. Any bids received after the above noted tlate and time will not be opened or considered. Facsimile or emailed bitls will not be accepted. A MANDATORY Pre-Bid Meeting will be held on Thursdav, January 7, 2021 3:00 P.M. in the Council Chambers. Rm 200, at the address listed above. Bidders MUST attend this meeting in order to submit for this bid. Product specifications are available in the Bid Packets that may be obtained on the City's website: www.citvofokeechobee.com/contractinq-opportunities.html, or from the General Services Department at City Hall during normal office hours, Mon-Fri, 8 AM-4:30 PM, except holidays, or by contacting Patty Burnette, 863- 763-3372 x 9820, or via email at pburnette(�a,cityofokeechobee.com. Questions concerning the scope of work are to be directed to Public Works Director David Allen, dallen(a�citvofokeechobee.com. NOTE: Bonding Requirements Apply to this Bid Opportunity. Bid submittals must be within a sealed envelope and contain two (2) clearly identifietl oripinals and one (1) copy of the bid, with the outsitle of the envelope clearly labeled "BID N0. PW 02-00-12-20 CITY OF OKEECHOBEE TAYLOR CREEK SE 8th AVENUE STORMWATER CONVEYANCE, 01-14-21, 3:00 PM" with the submitting Company Name, and Return Address. Bids may be mailed, hand delivered and/or express mailed to the address listetl above. Firms properly registered in the State of Florida are encouraged to submit their bid for consideration. It is the sole responsibility of the Bidder to deliver personally or by mail, their bid to the General Services Department on or before the closing hour and date for the receipt of bids as noted above. This solicitation does not commit the City of Okeechobee to award any contracts, to pay any costs incurred in the preparation of a response to this bid, or to contract for any services. The City Council reserves the right to reject any or all bids, to waive informalities and to accept or reject all or part of any bid, as they may deem to be in the best interests of the City of Okeechobee. Responses to this bid, upon receipt by the General Services Department, will become public records subject to provisions of Florida Statute Chapter 119 Florida Public Records Law. City of Okeechobee Project No. PW 02-00-12-20 Public Works Department 1 SECTION II PW 02-00-12-20 SUBMISSION REQUIREMENTS The bidder shall submit two (2) oriqinal clearlv identified originals and one copy of the followinq: 1. Bid Documentation Form (Section III) ✓ ✓ 2. Minimum Qualifications for Bidders Form (Section IV) and three (3) references (Attachment H) 3. Bid Bond ,/ 4. Bid Unit Price Schedule (Section VII, Exhibit B) ✓� In addition to the above, please complete the following forms that must be returned with your bid: Attachment A— No Lobbying Affidavit ✓ Attachment B— Anti Collusion Statement and No Gift Statement � Attachment C — Proposer's Certification ✓ Attachment D— Sworn Statement Pursuant to Section 287.133(3)(a), ✓ FL Statutes on Public Entity Crimes Attachment E— Conflict of Interest Disclosure �� Attachment F— Immigration Law Certification --� Attachment G— Drug Free Workplace Certification � Attachment H — Reference Form .,/ City of Okeechobee Project No. PW 02-00-12-20 Public Works Department 3 SECTION III PW 02-00-12-20 BID DOCUMENTATION SUNSHINE LAND DESIGN, INC (BIDDER'S COMPANY NAME) City Council City of Okeechobee 55 S.E. 3rd Avenue Okeechobee, FL 34974 I have received the documents titled CITY OFOKEECHOBEE TAYLOR CREEK SE gtn AVENUE STORMWATER CONVEYANCE, Proiect No. PW 02-00-12-20. I have also received addendum number 1 through 1 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: 1. 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 within 15 calendar days from the Notice to Proceed and there after completing the work within 60 calendar days of commencement of work. 5. Regarding Compensation for the proposed work: if this Bid is accepted, I will construct this project on a unit price basis as reflected in the Bid Unit Price Schedule, Exhibit B of this agreement. Payment will be made upon invoice after completion of all work. 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. 6. 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 02-00-12-20 Public Works Department 4 SUNSHINE LAND DESIGN, INC Bidder: 1.14.21 Date: ( mpa y Name) VICE PRESIDENT By: � Title: (Sig ature) MARGARET FENTON Email: MFENTON@SUNSHINELANDDESIGN.COM (Printed Name) Mailing Address: 3291 SE LIONEL TERRACE, STUART FL 34997 Office Number: 772-2g3-2648 Fax Number: 772-2g3-8944 City of Okeechobee Public Works Department Project No. PW 02-00-12-20 SECTION IV PW 02-00-12-20 MINIMUM QUALIFICATIONS FOR BIDDERS Minimum Qualifications: 1.0 Experience 1.1 Bidder must have at least 3 years of experience in providing commercial storm water improvement services including pipe, and structure installation and roadway restoration. 1.2 Bidder has successfully completed at least 6 asphalt storm water improvement projects in the last three years. 2.0 References 2.1 Bidder must provide at least 3 verifiable references of similar work as referenced in section 1.0 above. 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 Discriminatory Vendor List 3.1 In accordance with Section 287.134, Florida Statutes, an entity or affiliate who has been placed on the Discriminatory Vendor List, kept by the Florida Department of Management Services, may not submit a bid on a contract to provide goods or services to a public entity; may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor or consultant under a contract with any public entity; and may not transact business with any public entity. 4.0 Bidder certifies that 4.1 Bidder meets the qualifications listed in Section IV, 1.0 above. 4.2 Bidder has never failed to complete work awarded under a contract due to circumstances that were under Bidder's control. 4.3 The Bidder has not been placed on the Discriminatory Vender List kept by the Florida Department of Management Services as listed in section 3.0 above. City of Okeechobee Project No. PW 02-00-12-20 Public Works Department 6 1:3t:C -Ca'tii SUNSHINE LAND DESIGN, INC Date: 1.14.21 (Co an Name) By: Title: VICE PRESIDENT (Signat re) MARGARET NTON MFENTON@SUNSHINELANDESIGN.COM Email: (Printed Name) Mailing Address: 3291 SE LIONEL TERRACE, STUART FL 34997 Office Number: 772-283-2648 City of Okeechobee Public Works Department Fax Number: 772-2g3-2648 Project No. PW 02-00-12-20 Suns.hine Land Design, Inc EXHIBIT B BID UNIT PRICE SCHEDULE PW 02-00-12-20 CITY OF OKEECHOBEE TAYLOR CREEK SE 8th AVENUE STORMWATER CONVEYANCE ITEM DESCRIPTION UNIT ESTIMATED UNIT AMOUNT NO. MEASURE QUANTITY PRICE MOBILIZATION / 1 DEMOBILIZATION, PRE- LUMP SUM 1 27,720.00 $27,720.00 CONSTRUCTION VIDEO PER CONSTRUCTION 2 TURBIDITY CONTROLS LUMP SUM PLANSAND $11,760.0 $11,760.00 SPECIFICATIONS PIPING MATERIALSAND PERCONSTRUCTION 3 INLETS (EXCLUDING LUMP SUM PLANSAND $33,624.9 $33,624.98 SEPORATOR SPECIFICATIONS 4 DRAINAGE SEPORATOR LUMP SUM 1 $44,800.0 $44,800.00 5 MAINTENANCE OF TRAFFIC LUMP SUM 1 $16,800.0 $16,800.00 CONCRETE SIDEWALKS, PERCONSTRUCTION 6 CURBING AND DRIVEWAYS LUMP SUM SPECIFICATIONS �55,552.0 $55,552.00 SUBBASE/BASE MATERIAL PERCONSTRUCTION 7 PLACEMENT INCLUDING LUMP SUM PLANSAND $42,784.00 $42,784.00 COM PACTION SPECIFICATIONS PER CONSTRUCTION 8 ROADWAY PAVING LUMP SUM PLANSAND $28,323.5 $28,323.56 SPECIFICATIONS ROADWAY MARKINGS, PERCONSTRUCTION 9 STRIPING AND SIGNAGE LUMP SUM SPECI�FICATIONS �6,720.00 $6,720.00 10 PROJECT STABILIZATION LUMP SUM 1 $17,920.00 $17,920.00 AND CLEANUP 11 CONSTRUCTION LUMP SUM 1 $10,080.00 $10,080.00 LAYOUT/RECORD DRAWINGS TOTAL BID AMOUNT Based on Bid Unit Prices & Estimated Quantities $296,084.5 City of Okeechobee Project No. PW 02-00-12-20 Public Works Department 44 SUNSHINE LAND DESIGN, INC Bidders Company Name 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 percent (5%) Bid Security to this Bid. Bidder: SUNSHINE LAND DESIGN, INC (Compan Na e) By: (Sign ture) MARGARET FETNON 1.14.21 Date: Title: VICE PRESIDENT MFENTON@SUNSHINELANDDESIGN.COM Email: (Printed Name) Mailing Address: 3291 SE LIONEL TERRACE, STUART FL 34997 Office Number: 772-2g3-2648 Fax Number: City of Okeechobee Public Works Department 772-283-8944 Project No. PW 02-00-12-20 45 ATTACHMENT A PW 02-00-12-20 NO LOBBYING AFFIDAVIT STATE OF FLORIDA COUNTY OF MARTIN This 14 day of �ANUARY 20 21 MARGARET FENTON being first duly sworn, deposes and says that he/she is the authorized representative of SUNSHINE LAND DESIGN. INC (Name of Contractor, Firm or Individual) respondent to the attached request for Bid, or qualifications and/or any other solicitation released by City of Okeechobee, and that the Bidder and any of its agents agrees to abide by the City of Okeechobee no lob6ying restrictions in regard to this solicitati n. Affiant The foregoing instrument was acknowledg�ANUARY me by means of,yJ�physical presence or ❑ online notarization, this 14 day of , 20 Z, by MARGARET FENTON , who is personally known to me or produced as identification. Notary Public ignature Commission No. ; o;:pYo, CATHYBUSH `; ' �;: Commiss'an # GG 518508 =;�aa � Expires February 1, 2024 '�FOF F.i� •` gonded Thru Troy fain Insurance 800.3857019 City of Okeechobee Public Works Department Project No. PW 02-00-12-20 48 ATTACHMENT B PW 02-00-12-20 ANTI-COLLUSION STATEMENT AND NO GIFT STATEMENT 1.14.21 Date: 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). SUNSHINE LAND DESIGN, INC Firm Name: By (printed/typed): By (signature): Title: Mailing Address: City, State, Zip: Telephone No.: City of Okeechobee Public Works Department RGARET FENTON VICE PRES�ENT 3291 SE LIONELTERRACE STUART FL 34997 772-283-8944 Project No. PW 02-00-12-20 49 ATTACHMENT C PW 02-00-12-20 PROPOSER'S CERTIFICATION I 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. I acknowledge receipt of the following addenda. Addendum # 1 Date: 1•i2•21 Addendum # Date: Addendum # Date: Addendum # Date: Addendum # Date: Addendum # Date: I 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. I 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. SUNSHINE LAND DESIGN, INC 3291 SE LIONEL TERRACE Name of Business Mailinq Address 1 STURRT, FL 34997 Authorize ignatu MARGA T FENTON - VICE PRESIDENT Name & Title, Typed City, State & Zip Code 772-283-2648 Telephone Number/Fax Number MFENTON@SUNSHINELANDDESIGN.COM Email Address STATE OF FLORIDA COUNTY OF MARTIN The foregoing instrument was acknowledged before me by means of.�physical presence or ❑ online notarization, this 14 day of JANUARY , 20 21 , by MARGARET FENTON , who is personally known to me or produced as identification. `;��PYPU�, CATHYBUSH otary Public ignature �� ";;Commission#GG918508 o; ExpiresFebruary1,2024 ommission No. -.• �� "''•rPOF F�?Q' gpndgd 7tw Troy Fain Insut2nce 800-385-7019 City of Okeechobee Public Works Department Project No. PW 02-00-12-20 50 ATTACHMENT D PW 02-00-12-20 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 OKEECHOBEE, FLORIDA by: MARGARET FENTON, VICE PRESIDENT (print Individual's name and title) for: SUNSHINE LAND DESIGN, INC (print name of entity submitting sworn statement) whose business address is 3291 SE LIONEL TERRACE, STUART FL 34997 and (if applicable) its Federal Employer ldentification Number (FEIN) is: 59-2712892 (If the entity has no FEIN, include the Social Security Number of the Individual signing this sworn statement: - - .) 2. I understand that a"public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or 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. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or nolo contendere. 4. I 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. City of Okeechobee Public Works Department Project No. PW 02-00-12-20 51 5. I understand that a"person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding 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 relation to the entity submitting this sworn statement. (Indicate which statement applies). �] Neither the entity submitting this sworn statement, nor any of its officers, directors, 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. ❑ 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. ❑ 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 ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGORY TWO OF ANY C NGE IN THE INFORMATION CONTAINED IN THIS FORM. Signature STATE OF FLORIDA COUNTY OF MARTIN The foregoing instrument was acknowled� ge�d before me by means of hYsical resence or ❑ online notarization, this 14 day of �AIVUARY 20 21 by MARGAR T FENT�N , who is personally known to me or produced as identification. ........,.�...........� � :�P�o�;•• CATHYBUSH Notary Public Si nature : � ��';: Commission # GG 918508 ;;,�P;� ExpiresFebruary1,2024 Commission No. '••FOF f; °•• Bonded Thru Troy Fain Msurance 800•385-7019 City of Okeechobee Public Works Department Project No. PW 02-00-12-20 52 ATTACHMENT E PW 02-00-12-20 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 Firm Name: By (Printed): By (Signature): r`-�'W VICE PRESIDENT Title: ET FENTON Address: 3291 SE LIONEL TERRACE STUART, FL 34997 Phone Number: Name(s) SUNSHINE LAND DESIGN, INC 772-283-2648 City of Okeechobee Public Works Department NO X Position(s) Project No. PW 02-00-12-20 53 ATTACHMENT F PW 02-00-12-20 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. SUNSHINE LAND DESIGN, INC o ny e VICE PRES� NTe Title 1.14.21 Date STATE OF FLORIDA COUNTY OF FLORIDA The foregoing instrument was acknowledged before me by means of C�hysical presence or ❑ online notarization, this �4 day of JANUARY , 20 21, by MARGARET FENTON Who is personally known to me or produced as identification. `�� Notary Public Sig ature t�,pYPj/q'., CATHYBUSN : � � h*: Commission # GG 918508 �'.�• a; ExpiresFebruary1,2024 COmmisslon No. �'r;�OFF,��p< gondedTiwTroyFainl�surance804385�7019 City of Okeechobee Public Works Department Project No. PW 02-00-12-20 54 ATTACHMENT G PW 02-00-12-20 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 maintain a drug-free workplace through implementation of this section. As the person authorized to sign this statement, I certify that this Firm complies fully with the above require nts. Signature: Date: �ANUARY 14, 2021 Company: SUNSHINE AND DESIGN, INC Name: MARGARET FENTON Address: 3291 SE LIONEL TERRACE STUART, FL 34997 City of Okeechobee Public Works Department Title: VICE PRESIDENT Phone Number: 772-2g3-2648 Project No. PW 02-00-12-20 55 ATTACHMENT H CITY OF OKEECHOBEE CITY OF OKEECHOBEE TAYLOR CREEK SE 8th AVENUE STORMWATER CONVEYANCE PW 02-00-12-20 REFERENCE FORM Client Name: MARTIN COUNTY - LOGAN HUBER Client Phone Number: 772-28$-5932 Client E-mail: LHUBER@MARTIN.FL.US JULY, 2017 APRIL 2018 Service Dates: Beginning End Estimated Annual Contract Amount: $1,280,750.23 Description of the services performed as they directly relate to the work of this Request for Bid: JOB NAME: INDIAN RIVER DRIVE IMPROVEMENTS A RESURFACING AND DRAINAGE IMPROVEMENT PROJECTTHAT INCLUDED; INSTALLATION OF TWO BAFFLE BOXES, EXFILTRATION PIPE, STORMWATER QUALITY RETROFIT IMPROVEMENTS , MILLING AND RESURFACING OF THE ROAD, CURBING, CONCRETE SIDEWALKS, MEDIANS, STRIPING J BIOSWALE EXCAVATION, LANDSCAPING AND OTHER MISCELANEOUS SITE CONSTRUCTION. LENGTH OF PROJECT - 0.36 MILES FDOT, FDEP, SFWMD COMPLIANT City of Okeechobee Public Works Department Project No. PW 02-00-12-20 56 ATTACHMENT H CITY OF OKEECHOBEE CITY OF OKEECHOBEE TAYLOR CREEK SE 8t'' AVENUE STORMWATER CONVEYANCE PW 02-00-12-20 REFERENCEFORM Client Name: MARTIN COUNTY - KATIE FULKS Client Phone Number: ��2-288-5957 Client E-mail: KFULKS@MARTIN.FL.US Service Dates: Beginning �UNE 2018 End �ULY 2018 Estimated Annual Contract Amount: $129,960.00 Description of the services performed as they directly relate to the work of this Request for Bid: PROJECT NAME: VISTA SALERNO NEIGHBORHOOD DRAINAGE IMPROVEMENTS PROJECT FOCUSED ON ENHANCING STORMWATER SYSTEM WHICH INCLUDED , EROSION CONTROL, WELL POINTS, BY PASSING, REPLACING CMP WITH 36" rcp, MODIFYING STRUCTURES, OPEN TRENCH SOME AREAS, SHORING ,SWALE GRADING, NEW DRIVE WAY APRONS, SIDEWALKS, CURB RAMPS, IRRIGATION, SOD AND MOT. City of Okeechobee Public Works Department Project No. PW 02-00-12-20 56 ATTACHMENT H CITY OF OKEECHOBEE CITY OF OKEECHOBEE TAYLOR CREEK SE 8�h AVENUE STORMWATER CONVEYANCE PW 02-00-12-20 REFERENCE FORM Client Name: MARTIN COUNTY Client Phone Number: GEORGE DZAMA - 772-463-2837 Client E-mail: GDZAMA@MARTIN.FL.US Service Dates: Beginning FEBUARY 2016 End APRIL 2016 Estimated Annual Contract Amount: $200,076.00 Description of the services performed as they directly relate to the work of this Request for Bid: PROJECT NAME POINCIANA GARDENS STORMWATER AND ROADWAY IMPROVEMENTS THROUGH OUT POINCIANA GARDENS COMMUNITY. JOB INCLUDED BUT IS NOT LIMITED TO, REMOVAL AND REPLACEMENT OF CMP, REPLACING WITH RCP , DEWATERING, CONNECTING PIPES TO EXISTING INLETS, BYPASSING, PARTIAL ROAD CROSSING, SODDING, SWALE REHAB, MOT, PAVING AND MISCELLANEOUS SITE RESTORATION. City of Okeechobee Public Works Department Project No. PW 02-00-12-20 56 Q��,;ti.l ST�jt �pyf -:4 . � � � <.d�' �'�. 37�� '�`� }d �., �� kCV' � ..�5� h �� ,2r-�_ ,z.y� �^.�-�: ... _ �',AF'ir�g•.� ' �;r�i� ��51L�~`� STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION RICK SCOTf, GOVERNOR JONATHAN ZACHEM, SECRETARY i=�lUi ;c'.�� r CONSTRUCTION INDUSTRY LICENSING BOARD THE UNDERGROUND UTILITY & EXCAVATION CO HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES TAYLOR, TIMOTHY RICHARD SUNSHINE LAND DESIGN, INC. 3291 SE LIONEL TERRACE STUART FL 34997 LICENSE NUMBER: CUC1223792 EXPIRATION DATE: AUGUST 31, 2020 Always verify licenses online at MyFloridaLicense.com D��r � � �S'—T � �� i;�'�� . �❑f4� ' T 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. �� tru- sr�r� RICK SCOTT, GOVERNOR w �; �a „��.` ��.4�._f •.`��, x, °�� _'� � . ,��. ��,� �:, ,,;� JONATHAN ZACHEM, SECRETARY F�OI lC��1 �r STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE GENERAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES TAYLOR, TIMOTHY RICHARD SUNSHINE LAND DESIGN, INC. 3291 SE LIONEL TERRACE � STUART FL 34997 , LICENSE NUMBER: CGC1519137 � EXPIRATION DATE: AUGUST 31, 2020 Always verify licenses online at MyFloridaLicense.com �� ❑ t �, . . T,.•. ! LL • ��+�� ' Do not alter this document in any form. F� fi-��. �' ;: ��.,�T This is your license. It is unlawful for anyone other than the licensee to use this document. �� A�ORO SUNSLAN-03 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 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 R V Johnson Agency, Inc. 2041 SE Ocean Blvd Stuart, FL 34996 INSURED Sunshine Land Design, Inc. 3291 SE Lionel Terrace Stuart, FL 34997 287-3366 'iohnson.com StarStone National Ins Co. Harborside Financial Ctr INSURER F : 287-4255 0190 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. NOTIMTHSTANDING 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 7ypE OF INSURANCE AD�L SUBR ppLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN D WVD MMIDD/YYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ �,OOO,OOO CLAIMS-MADE � OCCUR 72436125 %/$�/202� 7/30/2021 DAMAGETORENTED �DO�QQQ PREMI_SES Ea occurrence $ MED EXP An one erson $ 5,�� PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE g 2,000,000 POLICY � JECT � LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Ee aBadeDtSINGLE LIMIT $ �,OOO�OOO ANY AUTO 02416933-0 7/25/2020 7/25/2021 BODILY INJURY Per erson $ OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ AUTOS ONLY AU�TOS ONL� PROPERTY DAMAGE Per accident S $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE 170854202ALI %/3O/ZOZO 7/30/2021 AGGREGATE g ��OOO�OOO DED X RETENTION $ � O�OOO $ 'I �OOO�OOO D WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY 830-56011 11/1/2020 11/1/2021 STAT TE ER 1'000'000 OFFICERMIEMB�ER/EXCLUDED? ECUTIVE Y� N� A E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ �,��,�� If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERA710NS / LOCA710NS / VEHICLES (ACORD 101, Additional Remarks Schetlule, may be attached if more space Is required� Proof of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t l.' ��%l.(S�- ACORD 25 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ro�, W-9 (Ret�. actober 2018) Departmen� oi ths Treasury Intamal Revenue Service Request for Taxpayer Identif cation Number and Certification ► Go fo www.irs.gov/FormW9 for instructions and the latesf information. Give Form to the requester. Do not send to the IPtS. sho�rrn on your income ta;< return}. Name is required on this line; do not leave this line blank_ SUNSHINE LAND DESIGN, INC 2 8usiness nameldisregarded entity name. if different from above <� w c�s a 0 ai c a o '�' U O �L' C N c a` o U v A � m w � 3 Check apprapriate box for federal tax classificaticn of the person +,vhose name is entered on line i. Chect< oniy one or the 4 F�cemptions (codes apply only to follotvfnn seven boxes. c2rtain entities, not intlividuals; seF instructions on page 3): ❑ Individual/sole proprietor or ❑� C Corporation ❑ S Corooration ❑ Partnership ❑ TrusVestate single-member L�C Exempt payee code (f any) ❑ Limited liability company. Enter tha tax classification (C=C corporation, S=S corporation, P=Partnership) I� Note: Check the appropriate box in the line aBove for the tax classification of the single-member owner. Do not check Exemption from FA7CA reporting LLC if the LLC is ciassiiied as a single-member LLC that is disregarded from the owner unlsss the owner of the LLC is code (it any) another L�C that is not disregarded from the owner for U.S. federal tax purpos2s. Othenvise, a single-member LLC that is disregardeci from the oamer snould check ihe appropriate box for the tax classiiication of its ovmer. Lj Other (see instructions) I► 5 Address (number, street. antl apt, or suite no.) 53e instructions. 3291 SE LIOIVEL TEI2F2ACE 6 G;ty, sta?e. and 21P code STUART, FL 34997 7 List accoun[ number(s� here (optional) lAppl�es (o acca�nts m�tinta�ned oufs%::e : �� ':.t;.: Requester's name and address (optional) Enter your TIN in ihe appropriate box. The TIN provided must match the name given on line 1 to avoid � S backup withholding. For individuals, this is generally your social security number (SSN). However, for a � resident alie�i. sole proprietor, or disregarded entity, see the instructions for Part i, later. For other j entities, it is your employer identification �um6er (EIN}. If you do not have a number, see How to get a �_ TfN, later. pr iVote: if the account is in more than one name, ses the instructions for line 1. Also see What Name and � E fJumber To Give tRe Requesier for guidelines on whose number to enter. � number identification number �0��000� Under penalties or perjury, I certify that: 1. The number shown on this form is my correct Yaxpayer identifiication nurnber (or I am waiting for a number to be issued to me); and 2. I am not subject to backup evithholding because: (a) I am exempt from backup withhoiding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a fiailure to report ali interest or di<<idends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or otner U.S. person {defined below); and 4. The FATCA code(s) entered on this form (if any) indicatinc� that i am exempt from FA7CA reportin� is correct. Certification instn�c4ions. You must cross out item 2 above if you have been notified by the IRS thai you are currently subject Fo backup withholding because you have failed to report ail interest and dividends on your tax return. For real estate transactions. item 2 daes not appiy. For mortgage interest paid, acquisition or abandonmeni oi secured property, cancellation oi debt, contributions to an individual retirement arrangement (IRA), and generaily, payments other than interest and dividends, you are not required to sign the certification. but you must provide your correct TlN. See the instructions for Part II, later. Sl�n Signature of ("�@r2 U.S. person a Ca�ner�9 �nstructions � Section references are to the Internal Revenue Code unless otherwise noted. Future developmen#s. For the latest information abouf developments related to Form V+/-9 and ifs instructions, such as legislafion enacted after they were published, go to www.irs.gov/FormtN9. Purpose of Form An individuai or entity (Form W-9 requester) who is required to file an information retum with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSNj, individual taxpayer identification number QTIN}, adoption taxpayer identification number (ATIfV), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an iniormation return. Examples of information returns include, but are not limited to, the foilowing. • Form 1 �99-INT (interest earned or paid) Date � I , � y � J � � Form 1099-DIV (dividends, inciuding those from stocks or mutuGl funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) � Form t 099-8 (stock or mutuaf fund sales a�d cerFain other transactions by brokers) � Form 1099-S {proceeds from real estate transactionsj • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1088-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) � Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide �our correct TIN. !f you do not return Form W-9 to the requester with a TIN, you might be subject Po backup withholding. See What is backup withholding, later. Cat. No. 70231X Form W-9(Rev. 10-20�81