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PURCHASE ORDER
CITY OF OKEECHOBEE
55 S.E.THIRD AVENUE
OKEECHOBEE, FLORIDA 34974-2903
Te1:863/763-3372 Fax:863/763-1686
� To: �,1/�/, Roberts C;�r�t�acting inc
806 P1V�J �h Street
C�keechobee, �I_ 34�J?2
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THIS ORDER SUBJECTTO CONDITIONS ON FACE. NO
CHANGES MAY BE MADE WITHOUT WRITTEN PERMISSION
OF PROCUREMENT MANAGEMENT.
DATE
2/7 ��2i}2`9
ITEM
NO.
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VENDOR NO. I DELIVERY DATE
ACCT. NUMBER I QUANTITY � UNIT
301-549-63d1
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SHIP TO:
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� �5 SE 3rd Avenue
� �keechob�e, F!. 34974
INVOICE IN DUPLICATE:
� � City of Okeechc�bee
55 SE 3rd Avenue
� Qkeechobee, FI. 34974
SHIP VIA BEST WAY
DESCRIPTION
P�W 05-'10-09-20 SE 3rd ,4venue
Pa�ement Improvements
�id a�vard 12/1 /2020 by City� Council
DRAVIIS
Ti�TAL
Amendment #1 dated 08/11/21
Estimated vs Actual cost for projec
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CITY OF OKEECHOBEE IS EXEMPT FROM FEDERAL EXCISE AND TRANSPORTATION
TAXES AND STATE SALES TAX. DO NOT INCLUDE THESE TAXES IN YOUR INVOICE.
EXEMPTION CERTIFICATE WILL BE SIGNED UPON REQUEST
STATE SALES TAX EXEMPTION 85-8012621656C-6.
FEDERAL I.D. 59-6000393.
RECEIVING RECORD
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UNIT
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AMOUNT
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$139.848.50
��7,248.0
$147,096.50
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PURCHASE REQUISITION
CITY OF OKEECHOBEE
55 S.E. Third Avenue
Okeechobee, FL 34974-2903
Tel: 863-763-3372
Fax: 863-763-1686
C.W. Roberts Contracting Inc.
806 NW 9th Street
Okeechobee, FL 34972 ���v��'��°�=-
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THIS ORDER SUBJECT TO CONDITIONS ON FACE.
NO CHANGES MAY BE MADE WITHOUT WRITTEN
PERMISSION OF PROCUREMENT MANAGEMENT.
Req. No. 16475
Important: This number must
be shown on all invoices,
packages, cases, tickets and
correspondence.
SHIP TO:
City of Okeechobee
55 SE Third Avenue
Okeechobee, FL 34974
INVOICE IN DUPLICATE:
DATE VENDOR NO. DELIVERY DATE SHIP BEST F.O.B. DEST. TERMS
08/11/21 N/A N/A N/A N/A NET 30
ITEM NO ACCT. NUMBER QTY UNIT DESCRIPTION AMOUNT
1 301-549-6301 Amendment to PO No. 5023 $7,248.00
for adjustment due to the difference
between the estimated and actual
amounts used for the project.
8/3/21 City Council approval for
additional funds
TOTAL $7,248.00
CITY OF OKEECHOBEE IS EXEMPT FROM FEDERAL EXCISE AND TRANSPORTATION
TAXES AND STATE SALES TAX. DO NOT INCLUDE THESE TAXES IN YOUR INVOICE.
EXEMPTION CERTIFICATE WILL BE SIGNED UPON REQUIEST.
STATE SALES TAX EXEMPTION NO. 85-8012621656C-6 � J
FEDERAL I.D. NO 59-6000-393 /� � � / _�1__
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AUTHORIZED SIGNATURE
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RECEIVING RECORD
❑ PARTIAL X FINAL
o�.oKEF�y pURCHASE ORDER
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DATE
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CITY OF OKEECHOBEE IS EXEMPT FROM FEDEF4AL EXGSE AND TRANSPORTATION
TAXES AND STATE SALES TAX. DO NOT INCLUDE THESE TAXES IN YOUR INVOICE.
EXEMPTION CERTIFICATE WILL BE SIGNED UPON REQUEST
STATE SALES TAX EXEMPTION 85-8012621656C-6.
FEDERAL I.D. 59-6000393.
F.O.B. DESTINATION
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PURCHAS� ORDER
CITY OF OKEECHOBEE
55 S.E. THIRD AV�NUE
OKEECHOB�E, FLORIDA 3�974-2903
Tel: $63/763R3372 Fax: 863/763-1686
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THIS ORDER SUBJEC7 TO CONAITIONS ON FACE. NO
CHANGES MAY BE MADE WITMOUT WRITTEN PERMISSION
OF PROCUREMENT MANAG�M�NT,
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TAXES AND STATE SALES TAX. DO NQT INC4UDE THESE TAXE3 IN YOUR INVOICE.
�XEMPTION CER7I�ICAT� WII.L BE SIqNED UPON REQUEST
STATE SALES 7AX EXEMPTION 85-9012621656C-6.
FED�RAL I.D. 59•6000393.
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PURCHASE REGIUISITION
CITY OF OKEECHOBEE
55 S.E. Third Avenue
Okeechobee, FL 34974-2903
Tel: 863-763-3372
Fax: 863-763-1686
Req. No. 16468
C. W. Roberts Contracting, Inc.
806 NW 9th Street
Okeechobee, FL 34972
THIS ORDER SUBJECT TO CONDITIONS ON FACE.
NC� CHANGES MAY F�E MAQE WITFlOUT l�!RlTTE�1
PERMISSION OF PROCUREMENT MANAGEMENT.
Important: This number must
be shown on all invoices,
packages, cases, tickets and
correspondence.
SHIP TO:
City of Okeechobee
55 SE Third Avenue
Okeechobee, FL 34974
INVOICE IN DUPLICATE:
DATE VENDOR NO. DELIVERY DATE SHIP BEST F.O.B. DEST. TERMS
02/08/21 N/A N/A N/A N/A NET 30
ITEM NO ACCT. NUMBER QTY UNIT DESCRIPTION AMOUNT
1 301-549-6301 PW 05-10-09-20 Southeast 3rd Avenu $139,848.50
Pavement Improvements
Bid awarded 12/1/20 by City Council
Drawdowns
TOTAL $139,848.50
�.i i r vr �nCc�nvrsct is r.xtmr i rnum rtutHa� ExCISE AND TRANSPORTATION
TAXES AND STATE SALES TAX. DO NOT INCLUDE THESE TAXES IN YOUR INVOICE.
EXEMPTION CERTIFICATE WILL BE SIGNED UPON REQUIEST.
STATE SALES TAX EXEMPTION NO. 85-8012621656C-6 �1
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FEDERAL I.D. N0 59-6000-393 \ , -
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AU HORIZED SIGNATURE
RECEIVING RECORD
❑ PARTIAL X FINAL
rF�;
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`�.; .-�;= � Checklist for Purchase RequisitionslPurchase Orders
Today's Date:
,�.�, �d (
Vendor 1 !'� . � � Origtnating
�E < e � ,�Fs � c�� f��_ef�;�� ,�te:
� ��h
'!'�c?cC�`1c F�P, �� •" 44"lc?
Section I.
Please mark eacfi item YES or NO to determine if the checklist of minimum requirements for an item and
service is needed for your department prior to ordering/purchasing the item/service. If the answer is YES
any of the below, please include the items listed in Section I I.
Is it a professional service?
other than
for
D. Is the
Section II.
G:lIN01A101fice Fortns\ProcedureslChecklist 3 Revised da(e: 2019 09 12
NOTICE OF AWARD PW 05-90-09-20, SOUTHEAST 3Ro AVENUE PAVEMENT IMPROVEMENTS
FDOT FPN 440372-1
December 3, 2020
C. W. Rob�rts Contrac�ing, Inc.
Affin: Mr. Todd Castleberry
806 NW 9�h Sfre�i
Okeechobe�, FL 3�.972
D�ar Mr. Castleberry,
T'ri� Ciry Councii avuarded ihe PW 05-10-09-20, SOUTHEAST 3^� �V�NU� f'AVEMEi�T ii�IPROVEf�IENTS 6id io your
company, C. W. Rob�r'rs Contracfing, Inc., ai the D�cember 1, 2020 City Council Meefing in the amount of $939,848.50. In order �to
proceed wirh �he project, you will need to provid� Yhe Ci4y of Okeecho6ee wiih the following by Friday, Decembe� 11, 2020:
v A cer�i�i�d copy of ihe insurance policies wi�h the declara�ion pages for the General Liability and Commercial Auto Insurance.
The insurance agen� can use a sfamp and sfate that i� is a true and original copy and then sign and date it or they can wrife
som�thing to the fact on their let�erhead listing the policy numbers, signing and dafing iY. The Cify ofi Okeechobee and the Florida
Deparfinenf of Transporiaiion both need Yo be lisfed as addi�ional insured wiih the limifs specified per S�cfion Vo'rthe bid packe�,
pag�s 8-15.
• Workers Comp�nsation Insurance certificate wifh th� limits specified per Section V ofi fhe bid pac{cet, pag�s 8-15.
�. a Copy of Florida Depariment of Transportafion Certifcaie ofi Qualifiica�ion.
o Copy ofi Sfate License.
�. v Copy of City and County oF Okeecho6�e Business Tax Receip4s.
,' �, W-9.
_� o Tvuo origirnal executed se•ts o�f the a��ache� Agree�nen�. One se� will be refurned to you af4er ex�cu7ed by �he Ci��.
We look forward to working with you on this projecf. Should you hav� any qu�sfions pleas� feel free to confact me per my contaci
informa�ion b�low.
Since,r,cl�, "
..w.ti-_�� , '�:�.�--_
` D�ui� Allen
Public Works Director
Cify of Okeechobee
55 SE Third Avenue
Okeechobee, FL 34974
Tel�: 863-763-9790 Fax: 863-763-1686
d�!l�r�tc�city�fokeecho�ee.eQm
FQo-r
Floridc� IJ►epa,�tment of Transportatior�
RQl4 D�SAi*ITIS SO l N Broadway A�venue KEVIN J.1'HIB��:L1'; P.E.
GOVERNOR B2�io'�v, I'"L, i�'i',�O SECR�T�R"Y
December 18, 2020
David Allen
Public Worlcs Director
City of Olceechobee
55 SE 3�d Ave
Olceechobee FL, 34974
RE: N�'g'Il�� �'� PIl���IEEgD — ��NSB'12gJCTION ��-1[t�S� SIEIl�V��ES
FM #: 440372-1-58-01
Agency: Cit}� ef Okeechobee
Contract No.: GOT44
Description: SE 3rd Ave from SR 70 (ParIc St) to SE 4th St.
Dear Mr. Allen:
In accordance with the State Funded Grant Agreement, executed on January 10, 2018 between the
Department and City of Olceeehobee for SE 3rd Ave from SR 70 (Paric St) to SE 4th St. }v�rr rrre Irerc>b}�
uu[/aori�c,�� tu pruceed ���id/a t/re co�estr•uelinn ��l�r�se of rleis /lroject.
Upon project completion the Department requests, when available, the City to provide final as-built
record drawings signed and sealed by a Professional Engineer registered in the State of Florida and
Exhibit D Notice of Completion. Also, it is the City's responsibility to provide construction engineering
inspection to verify the project is constructed according to the approved plans and specifications.
It is also the City's responsibility to coordinate with the Olceechobee Operations Center Office during
construction and prior to opening the road to traffic. Finally, once lcnown, please notify my office and
Randall James at the Olceechobee Operations Center of the time and date of the pre-construction meeting
and the anticipated construction start date and schedule.
If I can be of further assistance, please give me a call at (863) 519-2324 or Rebecca Milam at (863) 519-
2542.
Sincerely,
�b ��=,,. ��i.xl,•c�n,.
Jobin Abraham
Local Program Coordinator
FDOT, District One
�iY7��f'71Ji?,�C1J'.;i}% .�i''Y,?�`.•'C8�'_�' I � .�, r . � '}�' . .� : .?,. ,°. ,�,',:?:?
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NOTICE TO PROCEED
PW 05-10-09-20
FDOT FPN 440372-1
Dat�: February 8, 2021
To: ����, Ro��rts Contrac��r l�c.,
Contracfor.
SUQJECT PROJECT: PW 05-10-09-20 Southeast 3�d Avenue Pavement Improvemerris
You are hereby notifiied to proceed with the Work on the subject Projecf on or after, February 8, 2021 and
to complete the same within 60 cal�ndar days.
The complefion dafe �or th� Work shall 6e: April 9, 2021.
OWNER: BY: , =--
�, . {� �..Q.t; f_ %
CITY OF OKEECHOBEE - ; ,�r� K�•T'`�.�`^�....._._..�..� _._
55 SE TNIRD AVENUE dDavi�'�lilen �
OKEECHOBEE, FL 3497� Public Works Direcfor
CONTR,4CTOR'S ACKNOWLEDGME9VT OF RECEIPT OF NOTICE
CONTRACTOR:
Name: , � r'. � �� � ���, Dafie: :.' . � . , .
Address �_' a �:., �,.> ��: i �i 1� � r - Signature: .• �' ,: ' ,;. , �
c ���� �_ �., ..y. ,> ,� Title: �:: � r :), :, �_..
SECTION VII
PW 05-10-09-20
AGREEMENT FOR SERVICES
This AGREEMENT is dated as of the 1st day of December in the year 2020, between the
City of Okeechobee (CITY) and C.W. Roberts Contracting Inc., (CONTRACTOR). CITY and
CONTRACTOR, in consideration of the mutual covenants hereinafter set forth, agree as
follows:
ARTICLE 1. SCOPE OF WORK
The following Exhibits are attached and are a part of this Agreement.
Exhibit A — Governing Specifications
Exhibit B— Bid Unit Price Schedule
The work is described as fol[ovvs: Pr�vicle constri�ction services needed to do pavemen±
improvements including milling, resurfacing, and concrete sidewalk ADA ramp
construction on SE 3�dAvenue from North P�rk Street (SR 70) to SE 4�hStreet, within the
City of Okeechobee.
The selected Contractors will be responsible for the entire scope of work, hiring licensed
Subcontractors, and paying for all plans and permits from the City of Okeechobee and/or other
agencies.
ARTICLE 2. PUBLIC WORKS DIRECTOR
2.1. PUBLIC WORKS DlP.ECTOR as nam�d i� the Contract Dc�uments shall
mean:
City of Okeechobee
Public Works Director
55 S.E. 3�dAvenue
Okeechobee, FL 34974
ARTICLE 3. CONTRACT TIME
3.1 The work shall be completed within the Sixty (60) calendar days specified on the
Notice to Proceed for each project assigned.
ARTICLE 4. CONTRACT PRICE
4.1 CITY shall pay CONTRACTOR for perFormance of the work in accordance with the
unit prices listed in Exhibit B
4.2 CITY shall pay the CONTRACTOR, or receive as credit, for changes or
adjustments in the work made in accordance with the General Conditions,
based on the unit prices indicated on the Bid form.
City of Okeechobee
Public Works Department
Project No. PW 05-10-09-20
��
ARTICLE 5. MEASUREMENT AND PAYMENT
5.1 The City will not pay for any item that is not specifically set forth in the Bid
Schedule.
5.2 The total Unit Bid Price for each project shall cover all work required by the
Contract Documents. All costs in connection with the proper and successful
completion of the work, including furnishings all materials, equipment, supplies,
and appurtenances; providing all construction equipment, and tools; and
performing all necessary labor and supervision to fully complete the Work, shall be
included in the Unit Bid prices. All related and necessary work not specificallv set
forth as a pav item in the Bid shall be considered a subsidiary obliqation of
CONTRACTOR and all costs in connection therewith shall be included.
5.3 Payment for all work done in compliance with the Contract Documents, inclusive
of furnishings all manpower, equipment, materials, and performance of all
operations relative to construction of this project, will be made under the Unit Bid
Price.
5.4 Contractor shall submit Applications for Payment monthly after work has been
completed. A monthly invoice shall 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
pertormed from September 15t through September 30th. The invoice is to be
received by the City no later than October 9th, and payment should be made by
October 30'h. 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.
5.5 Quantities necessary to complete the work as shown on the Drawings or as
specified herein shall govern over those shown in the Bid Documents. The
CONTRACTOR shall take no advantage of any apparent error or omission in the
Drawings or Specifications, and the Public Works Director shall be permitted to
make corrections and interpretations as may be deemed necessary for fulfillment
of the intent of the Contract Documents.
5.6 The quantities for payment, other than Final Payment, under this Contract shall be
determined for actual measurement of the completed items, in place, ready for
service and accepted by the CITY, in accordance with the applicable method of
measurement therefore contained herein. A representative of the CONTRACTOR
shall witness all field measurements.
5.7 All estimated quantities stipulated in the Bid Form or other Contract Documents
are approximate and supplied for the sole purpose of providing Bidder with a basis
which will be used to determine the Base Bid and to obtain unit prices for approvals
of progress payments for the Work done. Actual quantities which will be ordered
by CITY may vary from those on the Bid Form(s). The CONTRACTOR'S attention
is directed to the items of work for which no unit price is set. All work shown on the
drawinqs as outlined in the specifications is to be completed in all respects and
the cost of all miscellaneous and associated work to anv specific items shall be
included in the Unit Prices.
5.8 All quantities, for the submittal of payments, shall be measured and tabulated by
both the Public Works Director, or representative, and CONTRACTOR. Requests
for payment and supporting data shall be prepared by the CONTRACTOR and
given to the Public Works Director su�ciently in advance of payment date to permit
thorough checking of all quantities.
5.9 The CONTRACTOR shall furnish the Public Works Director whatever assistance
is required, laborers, clerks and records that will enable the Public Works Director
City of Okeechobee
Public Works Department
Project No. PW 05-10-09-20
27
to expeditiously check all estimates and especially the final quantities of the
project.
ARTICLE 6. CONTRACTOR'S REPRESENTATIONS
In order to induce CITY to enter into this Agreement, CONTRACTOR makes the following
representations:
6.1 CONTRACTOR has familiarized himself with the nature and extent of the Contract
Documents. Work locality, weather, and with all local conditions and federal, state,
and local laws ordinances, rules, policies, and regulations that in any manneraffect
cost, progress, or pertormance of the work.
6.2 CONTRACTOR has studied carefully all reports of investigations and tests of
subsurface and latent physical conditions of the site or otherwise affecting cost,
progress, or performance of the work which were relied upon by the Public Works
Director in the preparation of the Drawings and Specifications.
6.3 CONTRACTOR has made or caused to be made examinations, investigations, and
tests, and studies of such reports and related data, in addition to those referred to
in Paragraph 6.2 above as he deems necessary for the performance of the work
at the contract price, within the contract time, and in accordance with the other
terms and conditions of the contract documents, and no additional examinations,
investigations, tests, reports or similar data are/or will be required by the
CONTRACTOR for such purposes.
6.4 CONTRACTOR has correlated results of such observations, examinations,
investigations, tests, reports, and data with the terms and conditions of the contract
documents.
6.5 CONTRACTOR has given Public Works Director written notice of all conflicts,
errors, or discrepancies that he has discovered in the contract documents, and the
written resolution thereof by Public Works Director is acceptable to the contract.
ARTICLE 7. EARLY TERMINATION
7.1 Should CONTRACTOR violate any provision of this contract, or if the level of
service and pertormance being provided by CONTRACTOR does not meet the
expectations of the CITY after providing attempts at curing such defects, the CITY
may cancel this contract upon thirty (30) days written notice to CONTRACTOR
without further liability therefore.
City of Okeechobee
Public Works Department
Project No. PW 05-10-09-20
28
ARTICLE 8. CONTRACT DOCUMENTS
The contract documents which comprise the entire agreement between the CITY and the
CONTRACTOR are made a part hereof and consist of the following:
• This Agreement
• Certificates of Insurance
• Payment Bond and Performance Bond
• Notice of Award
• Notices to Proceed
• General Conditions
• Govi rning Specifications attached as Exhibit Addenda numbers � to
, inclusive.
• CONTRACTOR'S Bid Forms (including documentation accompanying the Bid
and documentation prior to Notice of Award).
• Documentation submitted by CONTRACTOR prior to Notice of Award.
• Any modification, including Change Orders and Field Orders, duly delivered
after execution of Agreement.
• Call for Bids, Instructions to Bidders, Bid Forms, Payment and Performance
Bonds, and Application for Payment.
There are no contract documents other than those listed above in this Article 8. The contract
documents may only be altered, amended, or replaced by a modifiication (as defined in Section 1
of the general condiiions).
ARTICLE 9. GENEI�AL PROVISIONS
9.1 Complaance with Laws
The Contrac#or, its em���yees, su�contractors ar assigns, shali comply wiih all
a�plicable federal, state, and locai laws, regulations, and requirements relating to
the performance of this Contract.
9.2 Applicable Laws and Venue
The laws of the State of Florida shall govern all aspects of this Contract. In the
event it is necessary for either party to initiate legal action regarding this Contract,
venue shall be in the Nineteenth Judicial Circuit for claims under state law and in
the Southern District of Florida for any claims which are justiciable in federal court.
9.3 Indemnification.
Contractor shall defend, indemnify and hold harmless the CITY and all of the
CITY's officers, agents, and employees from and against all claims, liability, loss
and expense, including reasonable costs, collection expenses, attorneys' fees,
and court costs which may arise because of the negligence (whether active or
passive), misconduct, or other fault, in whole or in part (whether joint, concurrent,
or contributing), of Contractor, its officers, agents or employees in performance or
non-performance of its obligations under the Agreement. Contractor recognizes
the broad nature of this indemnification and hold harmless clause, as well as the
provision of a legal defense to the CITY when necessary, and voluntarily makes
this covenant and expressly acknowledges the receipt of such good and valuable
consideration provided by the CITY in support of these indemnification, legal
defense and hold harmless contractual obligations in accordance with the laws of
the State of Florida. This clause shall survive the termination of this Agreement.
City of Okeechobee
Public Works Department
Project No. PW 05-10-09-20
29
Complianc� wi�th any insurance requirements required elsewhere wifhin �his
Agreemen�t shall no�� relieve Contracfor of i��s liability and obliga4ion to defiend, hold
harml�ss and ind�mniFy ��h� CITY as s�f forih in this article of the Agreemen�.
Noihing h�r�in, shall be construed io e;�cend the CITY's liabili�iy b�yond �thai
provided in S�c�ion 768.28, Florida S�a�u�ies.
To the fiullest exien�i permi�rted by law, �he Recipi�nt's contracior/consul�tanf shall
indemnifiy and hold harmless the Recipi�n�t and the S�ate ofi Florida, Departmerr�
o�f Transpor�atior�, including �he Depariment's o�icers and employees, frorri
liabili��ies, damages, loss�s and cos�s, including, bui no� limi�red to, reasonable
a�ttorney's fi��s, to �ihe e�cten� caus�d by the negligence, recklessness or in�ienfional
wrongfiul misconduct of 4he con'�ractor or consul�canf and persons employed or
ufilized by the coniractor or consul�an�r in ��he performance of fhis Agreem�nt.
This indemni�fic���ion shall surviv� �the fermination o�� this Agreemen�i. Rloihing
contained in this paragr�ph is in��nd�d to nor shall i�i constitute a waiver ofi the
Stat� of Florida or the Recipienf's sovereign immunity.
9.� v�'�iv�rr �� Juan,� 7'a�a�a
Each party, to th� e�cf�nt permi�ied by law, knowingly, volun�arily, and
inientionally waives i�s right to a trial by jury in any ac�iion or oth�r legal
proceeding arising out o�f or relating �o this Contrac� and the transacfions iY
contemplates. This waiver applies �o an action or legal proceeding, whether
sounding in con�rac�, for� or o�h�rwis�.
9.5 N� D6��a�iu�uo�2���B�uu
Con�iractor and i�s ag�n�s will no'c discrirninat� against any p�rson on the grounds
o�f race, color, creed, n��ional origin, handicap, age, orsex, in any activiry under4his
Contract.
9.6 �90 Lo&��yi�¢�
Pursuanr to Chapf�r 216.3�7, F.S., the Contractor is prohibi��d from th�
expendi�ure ofi any �funds under �his Contract to lobby the Legislature, the judicial
branch or ano�her siar� ag�ncy.
9.7 E-Veu�u�y
CONTRACTOR has v�rifiied tha�t its employees are authorized to work in th� U.S.
and cerfiFies that a good fai7h e�ffiorr has been made to prop�rly id�ntify employe�s
by iimely reviewing and com{ole�iing appropriate documentation, incluoling but no�i
limited to the Dep�rtmerrt of Homeland Security, U.S. Cifizenshi�, and
Immigra�ion Services Form I-9. Answers to questions regarding E-Verify as well
as ins�truc�rions on enrollmerrt may be found at the E-Veri�fy websi��e:
www.��scis.aov/e-verifv. CONTRACTOR shall expressly require any
subcontractors p�rforming work or providing services pursuant to this contraci to
likewise utilize th� U.S. D�partm�nt o'f Homeland Securi�ty's E-Veri�fy system to
verify the employmen4 eligifoility o�� �II new employees hired by the subcontracfor
during the con�ract term.
9.8 Contracto�'s Duto�s Regau�ofeu�g f'u&�Sa� Recorols
A. GorropEiance wfii9� �@oriola L�vars
Contrac�or musi provid� public access to all records concerning this Contraci
according to applicable Florida laws including Chapter 119, Florida
Statu�es. I�f Contractor ass�rts any exemptions to Florida's public records
laws, Con2racfor has the burden of establishing and defending ihe
City of Olceechobee
Public Works Department
Projec't No. PW 05-10-09-20
30
exempfion. Confractor's fiailure to comply wi�ih this section is a breach oT
fhis Contract. The records subjec� to Chap�er 119 may include, in addition
�to prepared docurnents, such communication as e-mails, fex� m�ssag�s,
in�er-ofifice memorandums, social media, and pho�tographs or images; a
p�rson or entity may reques� public recorcls via e-mail, or by oral or wrifien
request, and a response fo such a requ�st mus�� be prompt; i�r is the
responsibilify o�f �he CONTRACTOR to establish an in-house policy in
re�Ference to such records, and to id�n�i�Fy and re#ain such comrriunications
in �ihe normal course ofi busin�ss in the ev�n�t � reguest is made to produce
these records.
�. !� Th1E CONTRACI'OR I�B4S C��E�T9��9� REGARDIN�
iFi� A�PLICATI��9 OF C��A��'�6� �39, F'LORI�A
aJ 1 dl A td 1��y 1� 1 f7� io�YV A Il���l0���9� �YoA 1 A 1�
PR�VIDE PIJ�LI� REC06��� �����9�9Ca TO TF�IS
Lo�XV 9�d'yi� 1 y ���li 1 91�� 9 1�� ��9� 0����AV �� ��ID�L�Ib
����u��� �� ��������� ���I ���� ����� 0 ���� sl�y
E�T. 9�14, E��aa� AD��ESS:
L.GAM(OTEA(a�?CITYOF4KEECHUBEE.CONf, AND
99i�d�99�BN� e4DDRES�: 55 S� TH��� ���, �G�EECFiO�EE
F�, 3�4�74.
..
9.9G
�9� T�aarr�9-�a��y �eraefici�o�i��
This Con�ract is solely for the benefiit o� ihe Contractor and th� City. No person
or en�ii'ry oih�r than the Contractor or the CITY shall have any righis or privil�ges
under this Confracf in any capacity wha�tsoever, eith�r as 4hirol-par'ry beneficiary or
o�therwis�.
�i5so�iri�'Yi�uii
Corriracfor shall no�t assign, delegate, subl�ase or o�th�rwise transfier any portion ofi
i�s rights �nd obligations as s�� forth in this Contract wi�hou�i prior wrii�en cons�nt of
th� Cify. Any afiiempted assignmen� in viola�ion ofi ihis provision shall be void.
9.11 6�lJ�Av�rr
No waiver ofi any term of this Confract constiiufies a waiver of any oth�r provision,
whether similar or dissimilar. No waiver of any term consti'cutes a continuing waiver.
No waiver is binding unless signed in writing by th� waiving pariy.
9.12 Sever�bali��y
I� any term ofi this Contract is for any reason invalid or un�rrforceable, the resf o�f
the Contract remains fully valid and enforceabl�.
9.13 Enti�� Gou�$ract
This Contract constitutes ihe entire agreement between �ihe parties and
sup�rsedes all prior and contemporaneous agreem�ni, representations, and
undertaking. No supplement, modification, or amendm�n� o�f this agreement will
be binding unless it is in writing and signed by both parties.
9.14 In���pre�a��ion
Unless the context requires otherwise: The term "including" contemplates
"including but nof limiied to."
City of Okeechobee
Public Worl<s Department
Project No. PW OS-10-09-20
31
9.15 Survival
All provisions of this Contract which by their terms bind either party after the
expiration or termination of this Contract shall survive the expiration or termination
of this Contract.
9.16 Force Majeure
Notwithstanding any provisions of this Contract to the contrary, the Parties shall not
be held liable for any failure or delay in the pertormance of this Contractthatarises
from fires, floods, strikes, embargoes, acts of the public enemy, unusually severe
weather, outbreak of war, restraint of Government, riots, civil commotion, force
majeure, act of God, or for any other cause of the same character which is
unavoidable through the exercise of due care and beyond the control of the
Parties. Failure to perform shall be excused during the continuance or as a
result of such circumstances, but this Contract shall otherwise remain in effect.
This provisionshallnotapplyifthe"StatementofWork"ofthisContractspecifies that
performance by the Contractor is specifically required during the occurrence of any
of the events herein mentioned.
9.17 Inspector General Cooperation
Contractor und�rstands an� agrees that it ��ii� co���y vdith Sactio� 20.055(5),
Florida Statutes which provides, "It is the duty of every state officer, employee,
agency, special district, board, commission, contractor, and subcontractor to
cooperate with the inspector general in any investigation, audit, inspection,
review, or hearing pursuant to this section."
9.18 Public Entity Crime
As required by Florida Statute 287.133(2)(a), a person or affiliate who has been
placed on the convicted vendor list following a conviction for a Public Entity Crime
may not submit a Bid on a contract with a Public Entity for the construction or
repair of a public building or a 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, Subcantractor, or consultant under a contract with any Public Entity, an�
may not transact business with any Public Entity in excess of the threshold
amount provided in F.S. 287.017 for Cateqory Two for a period of thirty-six (36)
months from the date of being p�aced on the convicted vendor list. Any person
must notify the City within thirty (30) days after a conviction of a Public Entity
crime applicable to that person or to an affiliate of that person.
9.19 State Funded Grant Agreement
The Contractor, its employees, subcontractors or assigns, shall comply with all
terms and conditions of the State Funded Grant Agreement for the project.
(Attachment I)
ARTICLE 10. PUNCHLIST PROCEDURES
Further to Florida Statutes §218.735(7)(a)(I), Punchlist procedures to render the work complete,
satisfactory and acceptable are established as follows:
10.1 Within five (5� days of Substantial Completion of the construction services purchased
as defined in the Contract, CONTRACTOR shall schedule a walkthrough with CITY
("Initial Walkthrough" a/k/a "IW"). The purpose of the IW is to develop a preliminary
checklist ("ChecklisY') of items to be performed by the CONTRACTOR, based upon
observations made jointly between the CONTRACTOR and CITY during the IW. The
IW is to occur within ten (10) days of Substantial Completion of the work as defined by
the Contract, again predicated upon the CONTRACTOR'S timely initiation of a request
City of Okeechobee
Public Works Department
Project No. PW 05-10-09-20
32
10.2
10.3
10.4
10.5
10.6
10.7
10.9
10.10
for the IW. At its option, CITY may conduct the IW with its Field Inspector.
CONTRACTOR shall endeavor to address and complete as many items as possible
noted on the Checklist either during the IW itself, or thereafter for a period of fifteen
(15) days from the date of the IW.
No later than fifteen (15) days following the scheduled IW, CONTRACTOR shall again
initiate and request a second walkthrough of the Project with the CITY. The purpose
of this second walkthrough is to identify which items remain to be performed from the
IW Checklist and to supplement that list as necessary (based, for example, upon work
which may have been damaged as a result of the CONTRACTOR'S performance of
completion of items contained on the IW Checklist) and for the purpose of developing
a joint Final Punchlist.
The intent of this section is for the CITY and the CONTRACTOR to cooperate to
develop a Final Punchlist to be completed no later than five (5) days from the date of
reaching Substantial Completion of the construction services purchase as defined in
the Contract.
In no event may the CONTRACTOR request payment of final retainage under Florida
Statutes §218.735(7)(d) until the CONTRACTOR considers the Final Punch list to be
one hundred percent (100%) complete.
CONTRACTOR agrees t� complste ±he Fina! Punchlist items within fifteen (15) days
of the date of its issuance by the CITY.
CONTRACTOR acknowledges and agrees that no item contained on the Final
Punchlist shall be considered a warranty item until such time as (a) the Final Punch
list is one hundred percent (100%) complete, and (b) the CITY has been able to
operate or utilize the affected Punchlist item for an additional period of fifteen (15)
days.
CONTRACTOR acknowledges and agrees that the CITY may, at its option, during
performance of the work and prior to Substantial Completion, issue lists of identified
non-conforming or corrective work for the CONTRACTOR to address. The intent of
any such the CITY generated lists prior to Substantial Completion is to attempt to
streamline the Punchlist process upon achieving Substantial Completion, and to allow
f�r the CONTRACTOR to auuress needed areas oi corrective work as they may be
observed by the CITY during performance of the Work.
CONTRACTOR acknowledges and agrees that in calculating one hundred fifty percent
(150%) of the amount which may be withheld by the CITY as to any Final Punchlist
item for which a good faith basis exists as to it being complete, as provided for by
Florida Statutes §218.735(7)(d), the CITY may include within such percentage
calculation its total costs for completing such item of work, including its administrative
costs as well as costs to address other services needed or areas of work which may
be affected in order to achieve full completion of the Final Punchlist item. Such
percentage shall in no event relate to the schedule of value associated with such Work
activity, but rather total costs are based upon the value (i.e. cost) of completing such
work activity based upon market conditions at the time of Final Punchlist completion.
City of Okeechobee
Public Works Department
Project No. PW OS-10-09-20
33
6�9 9�49'G�f��S 1NHEREOF, the parties here�o have signed two (2) copies ofi this agre�ment. At
leas� on� counterpari each has been delivered to the CITY and CONTRACTOR. All por�ions of
�h� con�rrac7 documents have b�en signed or idenfi'ried by CITY and CONTRACTOR or by Pu[olic
Works Director on th�ir behal'r.
This Agreem�nt will be efiFec'cive on •`'� �
CITY , A
. J
� _ . , �.: f `�:
B�� � /��.. �' � . I_1
r�owling, R. V`la�iford, Jr. ti�ayor
z. �
,� �
A'tfes�t: 1 ;���` �� i' �f (��'��?-'`
Lane �Gamiotea, �iMC, CITY Clerk
�. �
CONTRACTOR 1 r;""
' . i . F7
By."' � � .'Y'\s' ,� �`�
Name: �.� ..i•�.t��i� (`c� `_;� (:� �� . , r`�-�
Titl�'��.�e�a�9ai'�`�� pg�r°; .7
,�4� -... a �� �
,��,�'� �'{'r,`��''�3�.a° '6�.d' �
. _ �_,t.:..eYY i��.':�` :,�'.� .. L �
Addresses for giving notices:
CIiY
Ci�y ofi Okeecho(oee
55 SE 3rd Avenue
Oke�chok�ee, FL 3�97��
_ " '{�" :f�7 � ..
i�+/ .y�1
��e. 2 �I��.`� wY..i� L�.aZ.,Grl.l. :. .��..
.�.. Q� ; p1 (..��" � ,e� �
o '�
w d
d ,�
el,�,�Orat�°��a�l�.• • �ti'`
'�a�,�' ����a�9��e�
CONTRACTOR
��'�"_��L -i�.ai.: ...r� L-�h.��iCR.-I:Y�Y4id.� 1.f�'�{� '
, � lr. �t�� ��i f `�-r' .�`�' f �
� ,� � �. � � �,:� : �= � � �r<�.
L_.. � i C � .'�i � �.: . �
Floric�a State Confractors License No
Approve�..�a-#o orm..a�ad legalit�for the use and reliance ofi the Ci�iy o�F Okeechob�e only.
�
�` �' • •
.- _ _ ' �
� � .�__,,,,_
�
Carf�iri H. Kowalsky, Attorney
City of Okeechobee
Public Worl<s Department
Project No. PW 05-10-09-20
3�1
ACO � ������8���� �F 6I/'I�IL�I� I I1Va7�R�^10'i��� DATE(MMIDDlYWY)
� 12/9 4/2020
THIS CERTIFICATE IS ISSUED AS e4 MAT7E92 OF INFORMATION ONLY AND CONFERS NO RIGhITS UPON TH�C CERTEFICATE F10LDE62. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY 062 PIEGATIVELY AMEIVD, EXTEND OR ALTER TH� COVERtaGE 41FFORD�D BY TF1� POLICIES
BELOW. THIS CERTIFICATE OF INSUGZG�iVCE DOCS P10T CONSTITUTE A CONTRACT BETNUEEIV TFI� ISSUIRIG INSUREF2(S), AU"fWOF21ZED
REPRESEPITATIVE OR PRODUCE63, AWDiFiE CERTIFICd1'iE NOLDER.
IMPORTANT: Ir' the certiticate holder is �n d�DDITION,�1L INSUF2ED, the policy(ies) mus4 have %1DDITION,4L INSURED provisions or be �ndorsed.
I�F SU6ROGATION IS WAIVED, subjec4 ko 4he 4erms and condi4ions of 4he policy, cer4ain polici¢s may reyuire an ¢ndorsemen4. A sta4emen4 on
this certifiica4e does no4 confer rights 40 4he c¢rQi?icaie hold�r in lieu of such endorsement(s).
PRODUCER CONTACT Maffha Lee Hawkins
MCGRIFF, SEIBELS & WILLIAMS, INC.
NAME:
P.O. Box 10265 a�NNo Ext : 800-476-2211 ac No :
Birmingham, AL 35202 E-MAIL
ao�R�ss� mhawi<ins@mcgriff.com
INSURED
C.W. Roberts Contracting, Inc.
Post Office Box 1994
806 NW 9th Street (zip 34972)
Olceechobee, FL 34973-1994
INSURER A :A�Ch
INSURER B:
INSURER D :
INSURER E :
COVERAGE
NAIC {I
11150
COVERAGES CEFi�fIFICd1TE PJIJM�EFZ:KS6DT2S8 Pd�VISIOP! P1UM�EP:
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 AL L THE TFRMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAV� Q�EN RF_DUCED F3Y PAIp CL/aIMS.
IPISR Typ� OF INSURANCE ADDL S 6R POLICY EFF POLICY E:(f�
LTR INSD WVD POLICYNUMBER MM/DD/YYYY MMIDDIYYW LIMITS
A %� COMMERCIAL GENERAL LIABILRY 31PKG8930305 70/01/2020 10/Ol/2021 2,000,000
EACH OCCURRENCE $
CLAIMS-MADE X❑ OCCUR DAMA EN ED 100,000
PREMISES Ea occurrence 8
MED EXP (Any one persan) $ 5,000
PERSONAL & ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
POLICY X PRO• PRODUCTS - COMP/OP AGG $
JECT � LOC 4,000,000
OTHER: $
A AUTOMOBILE LIABILIi'V 31PKG89 3 5 10/Ol/2020 10/01/2021 COMBINED SINGLE LIMIT
Ea accident $ 2,000,000
X ANY AUTO BODILY INJURY (Per persan) $
OWNED SCHEDULED BODILY INJURY Per accident
AUTOS ONLY AiJTOS ( ) $
HIRED NON-OWNED PROPERTYDAMAGE
AUTOS ONLY AUTOS ONLY Per accidentl $
$
A UMBRELLALIAB X OCCUR 31UFP8970400 10/01/2020 10/01/2027 EACHOCCURRENCE $ 3,000,000
X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 6,000,000
DED RETENTION $ $
A WORKERS COMPENSATION 31 WCI8930205 10l01/2020 10/01l2021 � PER OTH-
AND EMPLOYERS' LIABILITY V�� �� STATUTE ER
ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? ❑ N /A
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
$
$
$
$
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attaehed if more spaee is required)
ITB No. PW OS-10-09-20, FDOT FPN 440372-1, Southeast 3rd Avenue Pavement Improvements
City of Okeechobee and Florida Department of Transportation are Additional Insureds with respect to General Liability, Automobile Liability and Excess Liability as required
by written contract. Excess Liability follows form of underlying General Liability, Automobile Liability and Employers' Liability.
CERTIFICATE HOLDER _ CANCELLATION
SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED �EFORE
THE EXPIRATION DATE TFIE62EOF, NOTICE WILL BE DELIVEF2ED IN
ACCORDANCE WITHTNE POLICY PROVISIONS.
City of Okeechobee
55 SE 3rd Avenue
Olceechobee, FL 34974
ACORD 25 (2016/03)
AUTHORIZED REPRESENTATIVE
`���fi��
Page 1 of 1 O 1988-2015 ACORD CORPORATIOFl. All rights reserved.
ihe ACORD name and logo are registered marks of ACORD
�� �
�'� w 1 ��
December 10, 2020
City of Okeechobee
Okeechobee, FL
RE: PW 05-10-09-20, Southeast 3rd Avenue Pavement Improvements
To who�n i�t �ay �once�n:
The financial strengths of the insurance carriers and limits for C.W. Roberts Contraciing, Inc. are
as felloTnrs:
➢ Arch Insurance Company:
(Auto Liability) $2,000,000 Combined Single Limit (BI/PD)
(General Liability) $2,000,000 Per Occurrence/$4,000,000 General Aggregate
(Employers' Liability): $1,000,000 Each Accident/$1,000,000 Disease-Each Employee/
$1,000,000 Disease-Policy Limit
*Higher Limits are attainable.
Please find attached advanced copies of the General Liability and Automobile Liabiliiy declaration
�ages. Ii you need f-ui�thex ii�forinatiox�, �lease ao noi: nesitace ia contact ine.
Kind Regards,
%�
, `, _:; J,'" : ° %'
�. ,-,._, .. . _ :,.: �..�ti_.
David D. Nichols
Senior Vice President
Construction Risl< Services
Email: cinicho.ts -C��arc�iil:.co�n
P11one: 205-492-7609 Fax: 205-583-9551
2211 7th Avenue South � Birmingham, Alabama 35233
McGriff Insurance Services, Inc. McGriff, Seibels & Wllliams, Inc.
Poficy Numk�er
:�1 �'6«f#93U�05
C�iliIM�P� �0�6CY ��C�.�TOOPlS
���� D��i������ �������
Named insured CONSTRUCTION PARTNERS, INC. Effective Daie: 10-01-20
12:01 A.M., Srandard Time
Agenf Name MCGRIFF SEIBELS AND WILLIAMS Agent No. 0064 8
I��em 9. Named Insured and Mailing Address Agent Name and Address
CONSTRUCTION PARTNERS, INC. MCGRIFF SEIBELS AND WILLIAMS
(SEE BROAD FORM NAMED INSURED ENDT) 2211 7TH AVE SOUTH
290 HEALTHWEST DRIVE BIRMINGHAM AL 35233
SUITE 2
DOTHAN AL 36303
Ag�nt No.00648
I�ie�n2. Policy Period From: 10—01-2020 To: 10-01-2021
a� �2:0� sRfU3., ��t��ael�v�o1 �"ia�oe a�iyoaar rr�i0ing ad�l�ess showoa ��o�.
1���3. Business ��scription: ROAD CONSTRUCTION, ASPHPLT PRODUCTION, PAVING
Form of Business: CORPORATION
I�a-n �!. In return for the paymen� of the pr�mium, and subj�ct to all the terms of this policy, we agree with you fo
provide the insurance as sta�ed in this policy.
This policy consisis of the following coverage parts for which a premium is indicated. Where no premium is shown,
there is no coverage. This premium may be subject fo adjustment.
Go�rer�� ���t(s) Preerr�iaar�a
Commercial Property Coverage Part NOT COVERED
Commercial General Liabili�iy Coverag� Part $
Commercial Crime Covera e Part NOT COVERED
Commercial Inland Marine Coverage Part NOT COVEF.ED
Gommercia! Auio �GSI!IeSS O:' Tf!.ICiC�fS ,�'..0.!�f^u�� PBrt $
Commercial Garage Coverage Pari NOT COVERED
TO�I POS9Cj/ PP��Plll.lO'Yl $
I�rr+ 5. Forms and Endorsements
Forms(s) and Endorsement(s) made a part of this policy at time of issue:
Sez Schedu6e o�f Forms an�1 En�lor�rroenis
c;ountersfgned:
Date: 12-09-20
�� �
By: ���;
Autho ized R�preseniative
THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S), TOGEfHER WITH THE COMMON POLICY CONDITIONS,
COVERAGE PART(S), COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IFANY, COMPLETE THE ABOVE NUMBERED POLICY.
FA1C-SKL�US-CPD (6/01)
POLIGY N!J NfBER: �;1 ��F�;C 8 � 3 U � 0_; COMNIER�IA�.. i�l�i0
,:�-,�-,- �` ' IJ��,�.1��1- ���il� f'�/�.I.`,'
97EfV1 OPl�
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Pff30DlICER:
MCGRIFF SEIBELS AND WILLIAMS
NAM�D IR9S�D��: CONSTRUCTION PARTNERS, INC.
(SEE BROAD FORM NAMED INSURED ENDT)
fV1�19�IRlCz���S�: 290 HEALTHWEST DRIVE
SUITE 2
DOTHFN, AL 36303
6�O�I�Y P�fR���: From 10-01-2020 to 10-01-2021 at 12:01 A.M. Standard Timeat your
mailing address shown above
�6�lfi0�9S �0�9CY Pl9911���R: 31 PKG8 9 3 0 3 0 4
�oo-z�n o� �a�sow�ss:
X❑ CORPORATION
� P�-1RTNERSHIP
a LIMITED LIABILITY COMPANY � INDIVIDUAL
� OTHER
IN RETURN FOI� THE PAYMENT OF Ti-IE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY,
1N� �G��E� WI`fH YOU TO PROVIDE THE INSURANCE AS STAI ED IN THIS POLICY.
SEE SCh#EDUL.E OF FORMS �P+lD EWDOaZSEM�NTS
�
COUNTERSIGNED gy -��,;-'
(Date) r (Auihorized Representaiive)
faU-DEC C/V!! �0 93 p�ge Z
EPlDO�Z�IEPUiL�P�TS �1�'i"ACH�D i0 TF99S PO�BCV:
IL 00 'i7 -Common Policy Condiiions (IL 09 �io in Washington)
IL 002� -Broad Form Nuclear Exclusion (not Applicable in New York) (I� 0'1 9� in Washing4on)
ITEM TWO
Schedule Of Coverages And Covered Autos
This policy provides only those coverages where a charge is shown in the premium column below. Each of these
coverages will app�y only to those "autos" shown as covered "autos". 'Autos" are shown as covered '�utos" for a
particular coverage by the entry of one or more of the symbols from the Covered Autos section of the Business
Auto Coverage Form next to the name of the coverage.
COVERED
COVERAGES AUTOS LI MIT PRE MI U M
COVERED AUTOS LIABILITY 1 $ 2, 0 0 0, 0 0 0 SEE
PERSONAL INJURY SEPARATELY STATED IN EACH P.I.P.
PROTECTION (or equivalent 5 ENDORSEMENT MINUS
No-fault Covera e DEDUCTIBLE.
ADDED PERSONAL INJURY SEPARATELY STATED IN EACH ADDED P.I.P.
PROTECTION (or equivalent ENDORSEMENT. PREMIUM
Added No-fault Coverage)
SEPARATELY STATED IN THE PROPERTY
PROPERTY PROTECTION PROTECTION INSURANCE ENDORSEMENT
INSURANCE (Michigan only) MINUS DEDUCTIBLE
��7R EACH ACCID�NT.
AUTO MEDICAL PAYMENTS 2 $ 5, 000 EACH INSURED COMPUTATION
MEDICAL EXPENSE AND SEPARATELY STATED IN THE MEDICAL
INCOME LOSS BENEFITS EXPENSE AND INCOME LOSS BENEFITS
(Virginia only) ENDORSEMENT.
UNINSURED MOTORISTS ENDORSEMENT
UNDERINSURED
MOTORI STS
(When not included in
Uninsured Nbtorists Coverage)
ACTUAL CASH VALUE OR COST OF REPAIR,
PHYSICAL DAMAGE �NNICHEVERIS LESS, MINUS $ 5, 000
COMPREHENSIVE DEDUCTIBLE FOR EACH COVERED AUTO, BUT
8, 10 NO DEDUCTIBLE APPLIES TO LOSS FOR PREMIUM
COVERAGE CAUSED BY FIRE OR LIGHTNING.
See ITEM FOUR For Hired or Borrowed Autos.
PHYSICAL DAMAGE ACTUAL CASH VALUE OR COST OF REPAIR,
SPECIFIED WHICHEVER IS LESS, MINUS
CAUSES OF LOSS DEDUCTIBLE FOR EACH COVERED AUTO FOR
COVERAGE LOSS CAUSED BY MISCHIEF OR VANDALISM.
See ITEM FOUR For Hired Or Borrowed Autos.
ACTUAL CASH VALUE OR COST OF REPAIR,
PHYSICAL DAMAGE 8� 1 O WHICHEVER IS LESS, MINUS $ 5, 000 DETAILS
COLLISION COVERAGE DEDUCTIBLE, FOR EACH COVERED AUTO.
See ITEM FOUR For Hired Or Borrowed Autos.
PHYSICAL DAMAGE FOR EACH DISABLEMENT
TOWING AND LABOR OF A PRIVATE PASSENGER AUTO.
TAX/SURCHARGE/ FEE
PREMIUM FOR ENDORSEMENTS
*ESTIMATED TOTAL PREMIUM
� ���� Nv��cy rnay oe suo�ect to rinai auait.
AU-DEC C/W 10 13 Page 2
ITEM THREE
SCHEDULE OF COVERED AUTOS YOU OWN
DESCRIPTION TERRITORY
Year, Model, Trade Name, Body Type Town 8� State Where The
Covered Serial Number(S) Vehicle Identification Covered Auto Will Be
Auto No. Number(VIN) PrincipallyGaraged Original Cost New
CLASSIFICATION EXCEPT For Towing,
All Physical Damage
Loss Is Payable To
Size You And The Loss
Business Use G� Payee Named Below
�
GCW Or Accorclin� To Their
Radius s= service Vehicle Interests In The Auto
Covered Of r= retail Seating Age At The Time Of The
Auto No. Operation c=commercial Capacity Group SecondaryRating Classifcation Code Loss:
COVERAGES — PREMIUMS, LIMITS AND DEDUCTIBLES
(Absence of a deductible or limit entry in any column below means that the limit ordeductible entry
in the comes ondin ITEM TWO column a lies instead.
COVERED AUTOS PERSONAL INJURY PROPERTY PROTECTION
LIABILIIY PROTECTION ADDED P.I.P. (Michigan Only)
Limit Stated Limit Stated
In Each P.I.P. Premium For In P.P.I.
Endt. Minus Limit Stated In Endt. Minus
Covered Deductible Each Added Deductible
Auto No. Limit Premium Shown Below Premium P.I.P. Endt. Shown Below Premium
TOtaI - � � `�'�� F�€`-A°r���^� � .'".?' -s, �,,r �,� ; �, e � '.:,
Premium ;� X �' � � � ;� ,�:� r � �
AU-DEC C/W 1013 Page 3
ITEM THREE
SCHEDULE OF COVERED AUTOS YOU OWN (Continued)
COVERAGES — PREMIUMS, LIMITS AND DEDUCTIBLES
(Absence of a deductible or limit entry in any column below means that the limit ordeductible entry
in the corres ondin ITEM TWO column a lies instead.
AUTO MEDICAL MEDICAL EXPENSE AND
PAYMENTS INCOME LOSS BENEFITS UNDERINSURED
i inia Onl UNINSURED MOTORISTS MOTORISTS
Limit Stated
In The Medical
Expense and
Income Loss
Limit Benefits
Covered Each Endorsement
Auto No. Insured Premium ForEach Person Premium Limit Premium Premium
Total
Premium
COVERAGES — PREMIUMS, LIMITS AND DEDUCTIBLES
(Absence of a deductible or limit entry in any column below means that the limit ordeductible entry
in the corres ondin ITEM TWO column a lies instead.
SPECIFIED CAUSES
COMPREHENSIVE OF LOSS COLLISION TOWING 8� LABOR
Limit Limit Limit
Stated In Stated In Stated In
ITEM TWO ITEM TWO ITEM TWO
Minus Minus Minus
Deductible Deductible Deductible
Covered Shown Shown Shown Limit Per
Auto No. Below Premium Befow Premium Below Premium Disablement Premium
Total
Premium
' p.
AU-DEC C/ W 10 13 Page 4
ITEM FOUR
SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS
COVERED AUTOS LIABILITY COVERAGE —Cost Of Hire Rating Basis for Autos Used In Your
Motor Carrier Operations (Other Than Mobile Or Farm Equipment)
COVERED AUTOS ESTIMATED ANNUAL
ABILITY COVERAGE STATE COST OF HIRE FOR EACH STATE PREMIUM
Primary Coverage
Excess Coverage
TOTAL HIRED AUTO PREMIUM
For "autos" used in your motor carrier operations, cost of hire means:
1. The total dollar amount of costs you incurred for the hire of automobiles (includes "trailers" and
semitrailers), and if not included therein,
2. The total remunerations of all operators and drivers' helpers, of hired automobiles whether hired with a driver by
lessor or an "employee" of the lessee, or any other third party, and
3. The total dollar amount of any other costs (i.e., repair, maintenance, fuel, etc.) directly associated with operating
the hired automobiles whether such costs are absorbed by the "insured", paid to the lessor or owner, or paid to
others.
COVERED AUTOS LIABILITY COVERAGE — Cost Of Hire Rating Basis for Autos NOT Used In Your
Motor Carrier Operations (Other Than Mobile Or Farm Equipment)
COVERED AUTOS ESTI MATED ANN UAL
LIABILITY COVERAGE STATE COST OF HIRE FOR EACH STATE PREMIUM
Primary Coverage
ExcessCoverage ALL IF ANY INCL
iOT'AL HIRED AU70 P12�MIUM
For "autos" NOT used in your motor carrier operations, cost of hire means the total amount you incur for the hire of
"autos" you don't own (not including "autos" you borrow or rent from your partners or "employees" or their family
members). Cost of hire does not include charges for services performed by motor carriers of property or passengers.
AU-DEC C/W 1013 Page 5
ITEM FOUR
SCHEDULE OF F�I�2ED OR BORROW�D GOVERED AUTO CO!/��G� e4PdD PFtEMIUil/IS (Cont'd)
Physic�l Darr�-ag� CovePages — Cos't O�F Hir� Fta�ting �asis For All Autos
(Okh�r Than Mobil� or Farm Equipment)
ESTI NL4TED
AId YV U�4L
COST OF HiRE
FOF2 EACH STATE
(Excluding Autos
Hired Wiih
COVE�GE STATE LIMIT OF IPISU�CE A Driver) PREMIUP►!i
ACTUAL CASH VALUE O{� COST OF
COM�PiEfI�PVSIi//� ALL REPAIR, WHICHEVER IS LESS, MINUS IF ANY INCL
$ 5 0, 0 0 0 DEDUCTIBLE FOR
EACH COVERED AUTO, BUT NO
DEDUCTIBLE APPLIES TO LOSS
CAUSED BY FIRE OR LIGHTNING.
ACTUAL CASH VALUE OR COST OF
S��G����� REPAIR, WHlCHEVER IS LESS, MINUS
CAUS�S DEDUC i IBLE FOR EACH
O� LOSS COVERED AUTO FOR LOSS CAUSED BY
MISCHIEF OR VANDALISM.
COLLISION ACTUAL CASH VALUE OR COST OF IF ANY INCL
ALL REPAIR, WHICHEVER IS LESS, MINUS
$ 5 0, 0 0 0 DEDUCTIBLE FOR EACH
COVERED AUTO.
TOTAL HIRED AUTO PREMaUIVI
For Physical Damage Coverages, cost of hire means the total amount you incur for the hire of "autos" you don't own
(not including "autos" you borrow or rent from your partners or "employees" or their family members). Cost of hire does
not include charges fior any "auto" thai is leased, hired, renfed or borrowed wiih a driver.
AU-DIEC C/ W 10 13 page 6
ITEM FOUR
SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS (Cont'd)
Cost Of Hire Rating Basis For Mobile Or Farm Equipment — Other Than Physical Damage Coverages
ESTIMATED ANNUAL pREMIUM
COST OF HIRE FOR EACH STATE
COVERAGE STATE Mobile Farm Mobile Farm
Equipment Equipment Equipment Equipment
Covered Autos Liability —
Primary Coverage
Covered Autos Liability —
Excess Coverage
Personal Injury Protection
Medical Expense Benefits
(Vrginia Only)
Income Loss Benefits
(�/rginia Only)
Auto Medical Payments
TOTAL HIRED AUTO PREMIUM
Cost of hire means the total amount you incur for the hire of "autos" you don't own (not including "autos" you
borrow or rent from your partners or "employees" or their family members). Cost of hire does not include charges for
services performed by motor carriers of property or passengers.
AU-DEC C/W 10 13 Page �
ITEM FOUR
SCHEDULE OF HIRED OR BORROWED.COVERED AUTO COVERAGE AND PREMIUMS (Cont'd)
Cost Of Hire Rating Basis For Mobile or Farm Equipment -- Physical Damage Coverages
ESTI MATED AN N UAL
COST OF HIRE
FOR EACH STATE
(Excluding Autos Hired
With A Driver PREMIUM
Mobile Farm Mobile Farm
COVERAGE STATE LIMIT OF INSURANCE Equipment Equipment Equipment Equipment
ACTUAL CASH VALUE
OR COST OF REPAIR,
WHICHEVER IS LESS,
MI N US
DEDUCTIBLE FOR
COMPREHENSIVE EACH COVERED
AUTO, BUT NO
DEDUCTIBLE APPLIES
TO LOSS CAUSED BY
FIRE OR LIGHTNING.
ACTUALCASH VALUE
OR COST OF REPAIR,
WHICHEVER IS LESS,
SPECIFIED MINUS
CAUSES DEDUCTIBLE FOR
OF LOSS EACH COVERED AUTO
FOR LOSS CAUSED
BY MISCHIEF OR
VAN DAL IS M.
ACTUALCASH VALUE
OR COST OF REPAIR,
WHICHEVER IS LESS,
COLLISION MINUS
DEDUCTIBLE FOR
EACH COVERED
AUTO.
TOTAL HIRED AUTO PREMIUM
For Physical Damage Coverages, cost of hire means the total amount you incur for the hire of "autos" you don't own
(not including "autos" you borrow or rent from your partners or "employees" or their family members). Cost of hire does
not include charges for any auto that is leased, hired, rented or borrowed with a driver.
AU-DEC C/W 10 13 Page g
ITEM FOUR
SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS (Cont'd)
Rental Period Rating Basis For Mobile Or Farm Equipment
ESTIMATED
NUMBER OF DAYS pREMIUM
EQUIPMENT WILL
TOWN AND STATE BE RENTED
WHERE THE JOB SITE Mobile Farm Mobile Farm
COVERAGE IS LOCATED Equipment Equipment Equipment Equipment
Covered Autos Liability —
Primary Coverage
Covered Autos Liability —
Excess Coverage
Personal Injury
Protection
Medical Expense
Benefits (Urginia Only)
Income Loss Benefits
(Virginia Only)
Auto Medical Payments
TOTAL HIRED AUTO PREMIUMS
ITEM FIVE
SCHEDULE FOR NON-OWNERSHIP COVERED AUTOS LIABILITY
NAMED INSURED'S
BUSINESS RATING BASIS NUMBER PREMIUM
Other Than Garage Service NumberOf Employees IF ANY INCL
Operations And Other Than
Social Service Agencies Number Of Partners
(Active and Inactive)
Garage Service Operations Number Of Employees Whose
Principal Duty Involves
The Operation Of Autos
Number Of Partners
(Active and Inactive)
Social Service Agencies Number Of Employees
Number Of Volunteers Who
Regularly Use Autos
To Transport Clients
Number Of Partners
(Active and Inactive)
TOTAL NON-OWNERSHIP COVERED AUTOS LIABILITY PREMIUM INCL
AU-DEC C/W 10 13 Page 9
ITEM SIX
SCHEDULE FOR GROSS RECEIPTS OR MILEAGE BASIS
Type Of Risk (Check one): � Public Autos � Leasing Or Rental Concerns
Rating Basis (Check one): � Gross Receipts (Per $100) � Mileage (Per Mile)
Estimated Yearly (Check One): � Gross Receipts (Per $100) � Mileage
Premiums
Covered Autos Liabili
Personalln'u Protection
Added Personal In'u Protection
Pro e Protection Insurance Michi an Onl
Auto Medical Pa ments
Medical Ex ense And Income Loss Benefits vr inia Onl
Com rehensive
S ecified Causes Of Loss
Cai�isi�� �
Towing And Labor
When used as a premium basis:
FOR PUBLIC AUTOS
Gross receipts means the total amount earned by the named insured for transporting passengers, mail and
merchandise.
Gross receipts does not include:
1. Amounts paid to air, sea or land carriers operating under their own permits.
2. Advertising revenue.
3. Taxes collected as a separafie i�em and paid directly to tne government.
4. C.O.D. collections for cost of mail or merchandise including collection fees.
Mileage means the total live and dead mileage of all revenue producing "autos" during the policy period.
FOR RENTAL OR LEASING CONCERNS
Gross receipts means the total amount earned by the named insured for the leasing or renting of "autos" to
others without drivers.
Mileage means the total live and dead mileage of all "autos" you leased or rented to others without drivers.
AU-DEC C/W 10 13 Page 10
Pt�lo�y Ne�t�o&��e•
3'� �KG893�3U�
�O@AiV1c�dC�� G�Pl�� LB�ILI I�( COi/�&ZAG� �'�f
��DF�P��M�NiA� D�C�1f�Aii�ftfS
���Q� ��������� �������
Named Insured CONSTRUCTION PARTNERS, INC .
Agent Name MCGRIFF SEIBELS AND WILLIAMS
I�i�rr� 1. Business Descripiion: ROAD CONSTRUCTION,
I•berri 2. Limi�s of Insurance
Coverage
Aggregate Limits of Liability
Coverage A- Bodily Injury and Property
Damage Liab�lify
Damage To Premises
Ren ied To You
Coverage B - Personal and
Advertising Injury
Liability
Coverage C - Medical Payments
Effective Date: 10 - O 1- 2 0
12:01 A.M., Standartl Tirne
Agenf No. 00648
ASPHALT PRODUCTION, PAVING
Limit of Liabili�iy
Products/ Completed
Operations �ggregate
General Aggregate (other fhan
Produc�s/Complefed Operafions
any one occurrence sublect to
ihe Products/Complefed
Operations and General
Aggregate Limi�s of Liability
any one premises subjec� to the
Coverage A occurrence and the
General Aggregafe Limifs ofi
100, 000 Liability
any one person or organization
subject to the General Aggregate
2, 000, 000 Limits of Liability
any one person subject to �he
Coverage A occurrence and the
General Aggregate Limits of
� . �JO� Liabili¢��
14�m 3. R�troactive Date
Coverage A of this Insuranc� does not apply to "bodily injury" or "property damage" which occurs befiore the
Re4roactive Date, if any, shown here:
(Enter Date or "None" if no Retroactive Date applies)
I�i�m 4. Form ofi Business and Location of Premises
�orms of Business: CORPORATION
Locaiion of All Premises You Own, R�nt or Occupy:
See Schedaa�e ofi Locai�ons
I�iem 5. Forms and Endorsements
Form(s) and Endorsem�nt(s) made a part of this policy at time of issue:
See Sch��fuEe o�� Forms an� �n�foa��rrten�s
IUem 6. Premiums
Coverage Part Premium: $
O'�her Premium:
Total Premium: $
$ �,000,000
$ �' , 000 , 000
$ 2,000,000
THESE DECL4RATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD.
F�c-s��us-cG���c �6ioa�
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��:a ��5�ar� ��s �as sL,s.�«�,r��� s«��P� iiE�'II'Y J. T�3B .��.T, �.�.
�.�?�s�lG���3; 'T�ll.aliassee, �� 32;9;'_�J'�SC� S��CP�:`�:��t�'
January 30, 2020
C.W. ROBERTS CONTRACTING, INC.
3372 CAPITAL CIRCLE NE
TALLAHASSEE, FLORIDA 32308
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 e:cpir� �/30/2021. However, the n�w application is due 1/32J2021.
In accordanc� wif.h 5.337.1n (1) F.S. your next applica�cion must be filed within (4)
mon�ths o:c' the ending date oi the applicant's audi•ted annual iinancial s�tatemen'ts.
Is your company's maximum capacity has been revised, you can access ir by logging into
the Contractor Prequali£ication Applicaf.ion Syscem via �the following linlc:
HTTPS://rdotwpl.dot.state.fl.us/ContractorPreQualiricatcion/
Onc� locJged in, select "View" ror �he mos�t recently approvcd application, ancl thcn
clicic 'the "Manage" and "t�pplica�t; on Summary" tabs .
FDOT APPROVED WORR CLASSES:
DRAINAGE, FENCING, FLEXIBLE PAVING, GRApTNG, GRA.SSrNG, SEEDING AND SODDING, GUARDRAIL,
HOT PLANT-MIXED BITUM. COURSES, INTERMEDIATE BRIDGES, MINOR BRIDGES, PORTLAND CEMENT
CONCRETE ROADWAY PAVING, ROADWAY SIGNING, SIDEWALK, Curb & Gutter, Driveways, Milling,
Reinforced Earth Walls, Rip Rap Rubble, 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.
f ��� �
ff/�s' � �
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Sincerely,
.. --�`: �� _
:%"
Alan Autry, M::nager
Contracts A��ministration Office
AA:cj
�R��VW.�C�Oi.�OV
�
Ron DeSantis, Governor
Halsey Beshears, Secretary
� Flonda
��
ST/�TE OF F`LORIDA
JE�PARI`MEN�' O�' BU5INESS AND PROFES�IORIAL REGULAI'!O�
N
CONSTRUCTION 1�1=D1JrSTR1� L,I�;ENS[NG BOARD
THE GENERAL CQNTRACTC3R H;�R�IN IS C_ERT1'�BED UNDER THE
PROVIS101�1S OF �CHAPTER�'48-9,i�,LORID,�. StATUTES
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(863)763-73?3
Addrsss: 80� �ibV 9Ti-� S; R�ET
C7KEECGI-IC�Ei��, FL 34974
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(Rev. Octob2r 209 8)
Cepartmant of the'Trsasury
Intemal s�evanue Servics
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)► Eifl 3o Vn�uu�� €rs.�ov/F�rmLY�J �or i;�stvuciians ar.�7 ik�o taiza2 intormaiian.
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2 Eusiness name/disrega�ded eniiiy name, ii difierent from above
3 Chec{< appropriaie uox fior federal tax classirfcation of the person whose namo (s entered on line �I . Chec1< only ona of �he
iollowinc� sevan boxes.
❑ Individual/saleproprietoror
sfnc�le-rneinoer LLC
Q C Corporation � S Corporation ❑ Parinership
❑ i'rusE/astate
�3 Exempifons (cod¢s apply only to
cartain en4ities, no2 individuals; sea
instruciions on paga 3):
Exampt payee code (if any)
❑ limi4ed liabilily company. Enter the ta;c classifiication (C=C corporafion, S=S corporation, P=Parinership) i
Tioia: Ch2c1< tha appropriate bo„ in the line above for ths tax classification of ihe single-m2mber owner. Do noi chec!< �xempilon trom F.A i CA reportinc�
LLC ii the LLC 'ss classiiied as a single-member LLC that is disregarded from the owner uniess ihe o�rmer ofi the LLC is code Qi any)
anothzr LLC tnat Is �oi disrsgzrdaci from ihe owner 1ov U.S. federal ian purpos�s. Otiier,vlse, a single-member ! LC that
is clisragarded trom 2he osvner shou!d chec': 2he ap�ropriaYe oo;; fio� the tax classliicatfon of its owner.
J Other (sse instructions)>
Address {nunhsr, streeY, and aQt. or suita no.) See instnictions.
6 Cily, state, and Zi�
�as�e�, r(oriela �2309
aacount .yumhc.(s) hdru (cpt;cnal)
(�pp/las to occaunfs moinfo/nod oulsldo 18o U.S.J
Aequesier's name 2nd address (o�tional)
Cnte� yo»r 71r1 in �ne approp� iata box. The TI�1 provided must rnatch tho name given on line 1 to avoic7 � Sooia3 s�aurik�j nt;mh$r �
Uac(:up ��vithholdinc�. For incJividuals, ihis is genoraily your social s3curity numbar (SS�1). hlowevzr, for a (�� _� � m
resici2n2 alie�, sol2 proQrietor, or disregard�d eniity, soe 2h2 ins3ruc4ions for Part !, laior. For othar � I
en'riiios, ii is your em�loyer ideniificaFion numbor (EIN). li you do not have a nurnoer, see How Po get a ��
TIN, laiar, or
�fo4�: li ihe accoun� is i� more ihan one nam�, se� t�o insiruaiions `ror line �I. ,!11so s2e NJhat !�lame and �fnQ)oyar ic3onti4ication numbmr
Number To Gi�ie tne Rec/uesier for guidelines �n whose r�umber 4� 2nier.
� 9 —') o� 3�J 5 9
Unde�• penalii�s of peijwy, I certi"ry 4naf:
1. Tiie number sho�ron on tiiis iorm is m� correct 9a; pay�r iden'rifiicaiion number {or I am waiiing io� a number to ba issued 4o ma); and
'L. I am no4 subjact to baelsup N�ithhoiding oec�uso: (a) I �m exenpf frorn oaci<up witiiholding, or (bj I hava nof b�an noCiti2d by t�he Intemal Rovanuo
Sei viea (1FlS) tha4 I am subjact io bacicu� withnolciing as a rosult oi` a zallure �o re�or•t all interesi or dividands, or (e) thE IRS has noiifiad me �hat I am
no lo�g2r suojec4 to �aacicup �,viihnolding; and
9. I am a U.S. citizen or o�hey U.S. person (daimad 9�eiow); ancl
4, Th3 FATCA coda(s) 2nferecl on ii�Is iorm (ir any) indica�ing fhat I am oxempt irom FA i CA roporiinc� is eorrect.
Corkiiica�iion lns4ructio�s. You must cross out ii�m 2 auovo if you have been notiiied by th3 IRS thai you 1re currently subject io bacl<up withholding 6ecauso
you havz fai�ed to r�pori ali iitorest and dividznds on your iax roturn. For real estato transactions, item 2 doas not a�ply. For mortgage in@erest paid,
acquisiiion o�• abandonmenr oi securzcl prop�rty, canceilation of dobt, contributions 4o an individual retiremont arrangement {!Ra), and genaraliy, payments
other ihan interesi and dividends, you are not required to sign ihe ce�ciiication, but you must provicle your corrsc2 71N. Sea 4he insiructions ior Part II, laier.
���� Sic�nafure of
ii�P�H U.S. per�on �
C;�ner�i 1n�t��ctic��s
Section references are to the Intsrnal f�evenue Codo unless o4heiwise
noted.
Fuiure davelopmen4s. For the latesi inform�tion aboui dev�lopments
related to Form W-9 ancl its Itisiructions, such as legislafion enac3ecl
aiter they were publisfiad, go to www.irs.gov/rormN3.
�urpos� �of For�
An individual or enii4y (Form W-9 requaster) who Is requfi�od to file an
inform�tion roturn �Niih ihe IRS must obtaii� your corroct iaxpayer
identification num6er (fIN) which may be your social secur(ty number
(SSNj, individual ta;<payer ideniiticafion nunber (ITIN), adoDtion
iaxpayer identification number (ATIN), or empioyer ideniirica@ion numbei•
(cIN), to report on an in%rmaiion reiurn 4h3 amouni paicJ to you, or other
amouni reportable a� an information return. Examples oi in'rormation
re3urns include, but are not limit�d to, the foilowinc�.
� Form 1099-INT (in4erest earnsd or paid)
Date � � -- / 5 --
� Form 1099-DIV (dividends, including ihose from stocics or muival
iunds)
� Form 1099-N11SC (various types o'r incoma, prizes, awards, or gross
proceeds)
a Form 10�9-E3 (stocic or muival fund sales and c�riain other
transaciions by 6rol<ers)
4 Form 1099-5 (proceeds irorn real esia2a iransacpions)
� Form '1099-K (merchant card and third pariy network transacfions)
� Form 1098 (home morigage interest), 9098-E (studeii4 loan interest),
�i098-T (tuition)
� Form 1099-C (canceled deut)
� Form 7099-A (acquisition or abandonmeni oi secured propeiiy)
Uso Form W-�J only if you aro a U.S. poi•son (including a resident
alion), 4o provicl2 your corroct TIiV.
li you do noP return Form W-9 Po ?he roquesf�r wii�l� a TIN, you might
be subjeci #o backup withholciing. See What is bac!<up withholding,
latsr.
Cat. iVo. 10231X Form ��� (Rov. 10-201F3)
119
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CITY OF OKEECHOBEE, FLORIDA
DECEM�ER 1, 2020, REGULAR CITY COUNCIL
IVIEETING MINUTES
CALL TO ORDER
Mayor WatFord called the regular meeting of the City Council for the City of Okeechobee
to order on Tuesday, December 1, 2020, at 6:00 P.M. in the City Council Chambers,
located at 55 Southeast 3rd Avenue, Room 200, Okeechobee, Florida. The invocation
was offered by Mayor Watford, followed by the Pledge of Allegiance by Council Member
Keefe.
11. ATTEMDAMICE
To establish a quorum, roll was taken by City Clerk Lane Gamiotea. Members present:
Mayor powling R. Watford, Jr., Council Members Wes Abney, Bob Jarriel, and Bobby
Keefe. Council Member Monica Clark was in attendance via Zoom.com.
III. p.GENDA AND PUBLIC COMMENTS
A. A revised proposed Resolution No. 2020-20, Exhibit 2 was distributed together
with a newly proposed Resolution No. 2020-21, all related to New Business Item
VI.A.
�.
C.
Mo4ion by Council Member Jarriel, seconded by Council Member Keefe to
approve the agenda as amended. Motion CarPied Unanimously.
There were no comment cards submitted for public participation for issues not on
the agenda.
IV. CONSENT AGENDA
Motion by Council Member Abney, seconded 6y Council Member Jarriel to approve
consent agenda item A, November 5, 2020 Town Hall Meeting and Regular Meeting
minutes. Motion Carried Un�nimously.
V. MAYOR WATFORD OP�NED THE PU�LIC HEARING AT 6:04 P.M.
A. Motion by Council Member Jarriel, seconded by Council Member Ke�fe to read
proposed Ordinance No. 1220 by title only, regarding Abandonment of Right-of-
Way Petition No. 20-002-SC. Motion Carried Unanimously.
Attorney Fumero read proposed Ordinance No. 1220 by title only as follows: "AN
ORDINANCE OF THE CITY OF OKEECHOBEE, FLORIDA; VACATING AND
ABANDONING A PORTION O� SOUTHWEST 4TH STREET (f/Wa FIFTH
AVENUE) AND A PORTION OF SOUTHWEST 5TH STREET (f/k/a FOURTH
STREET) MORE PARTICULARLY DESCRIBED HEREIN, LYING WITHIN THE
CITY OF OKEECHOBEE, ACCORDING TO THE PLAT THEREOF AS
RECORDED IN PLAT BOOK 5, PAGE 5, PUBLIC RECORDS OF
OKEECHOBEE COUNTY, FLORIDA (PETITION NO. 20-002-SC); RESERVING
UNTO THE CITY, ITS SUCCESSORS AND ASSIGNS A NON-EXCLUSIVE
EASEMENT FOR PUBLIC UTILITIES PURPOSES; DIRECTING THE CITY
CLEf�K TO RECORD THE ORDINANCE IN THE PUBLIC RECORDS OF THE
CLERK OF THE CIRCUIT COURT IN AND FOR OKEECHOBEE COUNTY,
FLORIDA; PROVIDING FOR CORIFLICT; PROVIDING FOR SEVERABILITY;
PROVIDING FOR AN EFFECTIVE DATE."
Mr. Steve Dobbs noted his attendance on behalf of the applicant. No other public
comments were noted. Motion by Council Member Keefe, seconded by Council
Member Jarriel to adopt proposed Ordinance No. 1220. Motion Carried
Unanimously.
MAYOR WATFORD CLOSED THE PUBLBC HEARING AT 6:09 P.M.
VI. NEW BUSINESS
A. Motion by Council Member Keefe, seconded by Council Member Jarriel to adopt
[revised] proposed Resolution No. 2020-20 regarding the 2020 General Election
and Terms of Office for City Council Member Monica Clark.
December 1, 2020, Regular Meeting, Page 1 of 2
120
Vi. Y�9�W BUSINESS GORlYIWU�D
ITEM A. CONTINUED: �12torney Fumero read revised proposed Resolufion No.
202Q-20 by 'ciile only as follows: "A RESOLUTION OF THE CITY 0�=
OKEECH0f3EE, FLORIDA; ACCEPTING THE OFFICIAL RESULTS FOR TNC
2020 GENERAL CITY ELECi"IOfV; PROVIDIi�G FOf� iERMS OF OFFICE TO
BE hdELD BY MONICA McCARTF-iY CLARK, AS AN ELECTED CI"f'Y COUNCIL
MEMBER; PR01/IQING FOR THE CITY CLERK TO ISSUE A CERTIFICATE OF
ELECTION; PROVIDIh1G FOR CO�IFLICT; PROVIDING FOR SEVERABfLITY;
AND PROVIDING FOR AiV EFFECTIVE DATE."
I!liEo'tion Car�^B�ci Ua��naproously.
Moiion by Council Memb�r Keefe, seconded by Councif Member Jarriei to adopi
proposed Resolution Rlo. 2020-21 accep�ing ihe unconditional resignation of
Council Member Eleci Russ Cafe.
Attorney Fumero read proposed Resolufion No. 2020-21 by title only as foilows:
"A RESOLUTION OF THE C{TY OF OKEECHOBEE, FLORIDA; ACCEPTING
THE UNCOI�DITIONAL RGSIGN�ITION OF RUSS CtaLE FROM THE OFFICE
OF CITY COUiVCIL; PROVlDING FOR CONFLICT; PROV{DING FOR
SEV�RABILITY; AND PROVIDlNG FOi� AN EFFECTIVE DATE."
Nio�i�n Carri�d Ur�ani�nously.
B. Mo4ion by Council Member Jarrie(, seconded by Councii Member Keeie 40
approve an agreement for services wi'th eSCR16E SoFcwar� Ltd. [in ihe amount
ofi$16,668.00] for webcasting and auiomaYed closed captiioning. Iltlotion Carrri�d
Unanirna�usly.
C. Motion by Council Member Abney, seconded 6y Council Member Keefe io award
Bid No. PW 05-10-09-20 Soufheast 3'd Avenue Pavemeni Improvements to C.W.
Roberts Contraciing, Inc. in the amouni o�F $139,848.50. Ma�ian Carried
Unanimously.
D. Mofion by Council Member Abney, seconded by Council Member Jarriel to
approve Centennial Park Pavilion Rules ancl Reservation Fe� Applica�ion.
!�Jl�t�o� Garr9e� Ln����Qa�sly.
�. Mo4ion by Council Member Jarriel, seconded by Council IViemi�er Keer'e to ratifiy
the Inferlocal Agreement fior Fire Services beiween Okeechobee County and ghe
City of Okeechobee, including all euhibits. iUlo�ion C�rrPued �o�ar to One.
VII. CI"�Y ATT012fVEY UPD�4TE
City A�torney Fumero reported he will 6e working wiYh City Clerk Gamiotea on the
Special Election to replace Mr. Cale; and on updating the City's public records policy to
give sp�cirir. procedures for r�iaining electronic records and researching possible
technology applications to assist the City Council in retaining their public records.
VIIO. COl1WCIL COMMENTS
Council Memb�r Jarriel welcomed ciiizens to be present at meetings and voice their
opinions and/or concerns. His comments were echoed 6y Council Member Keefe.
Council Mem6er Clark explained her intent for limi•ring public atYendance to the tree
lighting ceremony.
IK. Mayor Watford adjourned the meeting �� 6:54 P.M.
Submiit�d 8y: ,
�,_%�� �( : y � '
�F L . � ��C c.,. , � .� ..
Lan� Gamio��a, CfUIC, •City Clerk
Please ta{ce no4ice and be advised thafi when a person decides Yo appeal any decision made by the�City Council
with respecf to any matter considered at this meeting, he/she may need to ensure that a vertiafim record of the
proceeding is made, which record includes the testimony and evidence upon which.the appeal is to be based.
Cify Clertc media are for the sole purpose of bacKup for o�cial records of the Clerl<., .
December 1, 2020, Regular Meefing, Page 2 of 2
�, C� v{
�,�. Okeech�be�
- _J�'1� PLORIDA • Faunded I915
To:
From:
Date:
Marcos Montes De Oca
David Allen, Public Works Director
11/20/2020
CITY OF OKEECHOBEE, PUBLIC WORKS
1 ' •
Exhibit 4
12/01 /2020
Re: Requestst for award of SE 3�d Avenue Paving Improvements Project to CW Roberts
Inc.
___ __ __ _ _ _
Public Works is requesting the approval to award a contract for paving services, PW 05-10-09-20, FDOT
FPN 440372-1 to CW Roberts Contracting Inc. in the amount of $139,848.50.
Four bids were received for the project. The total bid amount for each of the vendors is:
CW Roberts Contracting Inc. $139,848.50
Florida Blacktop Inc. $152,141.89
Ranger Construction $153,332.00
Hardrives Inc. $168,919.50
A detailed bid tabulation for the project along with the actual bid documents from CW Roberts are
attached.
This project is a FDOT SCOP-Communities funded project. The grant amount form FDOT is $123,531.00.
The difference of $16, 317.50 will be funded from the existing Public Works budget under the
$80,000.00 allocation for asphalt and roadway reconstruction, line item 301-549-6300.
� Given the approximate nature of asphalt work, it is also requested that the City Administrator be
authorized to approve adjustments to the final project cost not to exceed $10,000.00 to reflect the
actual amounts used for the project.
CITY OF OKEECHOBEE
PW 05-10-09-20 October 22, 2020 3:00 PM Bid Opening
Okeechobee Southeast 3rd Avenue Pavement Improvements
CONTRACTOR:
Florida Blacktop, Inc. Hardrives, Inc. C. W. Roberts Contracting ir
ITEM UNIT EST. UNIT EST. UNIT EST.
NO. MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNIT PRICE
MOBILIZATION / DEMOBILIZATION LUMP LUMP
1 LUMP SUM 1 $ 10,383.43 $ 10,383.43 SUM 1 $ 10,000.00 $ 10,000.00 SUM 1 $ 8,500.00
MAINTENANCE OF TRAFFIC LUMP LUMP
2 LUMP SUM 1 $ 1,657.74 $ 1,657.74 SUM 1 $ 8,000.00 $ 8,000.00 SUM 1 $ 2,300.00
INLET PROTECTION SYSTEM
3 EACH 10 $ 174.72 $ 1,747.20 EACH 10 $ 250.00 $ 2,500.00 EACH 10 $ 235.00
MILL EXISTING ASPHALTIC PAVEMENT,
1" AVERAGE DEPTH SQUARE SQUARE SQUARE
4 YARD 8742 $ 3.05 $ 26,663.10 YARD 8742 $ 2.25 $ 19,669.50 YARD 8742 $ 1.75
SUPERPAVE ASPHALTIC CONCRETE,
5 TRAFFIC C(SP-9.5) TON 750 $ 110.00 $ 82,500.00 TON 750 $ 135.00 $ 101,250.00 TON 750 $ 104.00
REMOVAL OF EXISTING SIDEWALK, LUMP LUMP
6 CURB AND GUTTER LUMP SUM 1 $ 5,894.02 $ 5,894.02 SUM 1 $ 7,500.00 $ 7,500.00 SUM 1 $ 4,600.00 .
SIDEWALK CURB AND RAMP, FDOT
� INDEX 304, CR-F EACH 10 $ 1,514.24 $ 15,142.40 EACH 10 $ 1,500.00 $ 15,000.00 EACH 10 $ 2,200.00 :
DETECTABLE WWARNING MAT- BRICK SQUARE SRUAaE SQUARE
g RED FOOT 200 $ 40.77 $ 8,154.00 FOOT 200 $ 25.00 $ 5,000.00 FOOT 200 $ 34.00 ;
TOTAL BID AMOUNT $ 152,141.89 $ 168,919.50
t''05IeQ Ofl VCiODC'f LL, LVLU ai 4:UV p.Rl.
To be removed on November 2, 2020 at 4:00 p.m.
��7r��
C�'J.�
Patty Burnette
From:
Sent:
To:
Cc:
Subject:
Attachments:
Importance:
Patty Burnette
Thursday, July 22, 2021 11:40 AM
Gary Ritter (gritter@cityofokeechobee.com)
Robin Brock
Bids that need to go back to Council
8-3-21 CC Agenda Item SE 3rd Avenue.pdf; 8-3-21 CC agenda Item SE 6th Street.pdf
High
Gary,
Attached above is the information for the two bids that need to go back before Council (for the 8/3/21
meeting) for approval for additional funds. I have highlighted the paragraph that originally was included in
the exhibit materials but somehow was overlooked during the discussion and not included in the motion.
These were the ones you were going to check with John on. There should probably be some type of new
memo provided to Council so there isn't any confusion. Please let me know if you need for me to provide
anything else.
Thank you for taking care of this.
Patt� M. Burnette
C'j. enera�Services Coordinator
Cit� of O�eec�o6ee
SS S� 3Yd Avenue
O�eec�o6ee, �FL 34974
P�ione: (863� 763-3372 ext. g82o
Direct: (863� 763-g8zo
�'ax: (863� 763-1686
e-mail• �L�Lirnet�te@citti��fo(eec6i.o6ee.co��i
we6site: vvww.citi�o�o�eec�.o6ee.co�ni
_�
� C1� •il}' jF.;.
_' �
� ^Y'�
Under Florida law, email addresses are public records. If you do not want your email address released in
response to a public records request, do not send electronic mail to this entity. Instead, contact this office by
phone or in writing, Florida Statute 668.6076.
CG� d�
Okeechobee
� FLORIDA • hnunde:l 1915
To:
From:
Date:
Re:
Marcos Montes De Oca
CITY OF OKEECHOBEE, PUBLIC WORKS
Memo
David Allen, Public Works Director
11/20/2020
Requestst for award of SE 3�d Avenue Paving Improvements Project to CW Roberts
Inc.
Exhibit 4
12/01 /2020
Public Works is requesting the approval to award a contract for paving services, PW 05-10-09-20, FDOT
FPN 440372-1 to CW Roberts Contracting Inc. in the amount of $139,848.50.
Four bids were received for the project. The total bid amount for each of the vendors is:
CW Roberts Contracting Inc. $139,848.50
Florida Blacktop Inc. $152,141.89
Ranger Construction $153,332.00
Hardrives Inc. $168,919.50
A detailed bid tabulation for the project along with the actual bid documents from CW Roberts are
attached.
This project is a FDOT SCOP-Communities funded project. The grant amount form FDOT is $123,531.00.
The difference of $16, 317.50 will be funded from the existing Public Works budget under the
$80,000.00 allocation for asphalt and roadway reconstruction, line item 301-549-6300.
Given the approximate nature of asphalt work, it is also requested that the City Administrator be
authorized to approve adjustments to the final project cost not to exceed $10,000.00 to reflect the
actual amounts used for the project.
CITY Of OKEECHOBEE
PW 05-10-09-20 October 22, 2020 3:00 PM Bid Opening
Okeechobee Southeast 3rd Avenue Pavement Improvements
CONTRACTOR:
Florida Blacktop, Inc. Hardrives, Inc. C. W. Ro6erts Contracting Inc. Ranger Construction
ITEM UNIT EST. UNIT EST. UNIT EST. UNIT EST.
NO. MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNR PRICE AMOUNT MEASURE QTY. UNIT PRICE AMOUNT
MOBILIZATION / DEMOBILIZATION LUnnP LUMP
1 LUMPSUM 1 $ 10,383.43 $ 10,383.43 SUM 1 $ 30,000.00 $ 10,000.00 SUM 1 $ 8,500.00 $ 8,500.00 LUMPSUM 1 $ 11,500.00 $ 11,500.00
MAINTENANCE OF TRAFFIC ��MP LUMP
2 LUMPSUM 1 $ 1,657.74 5 1,657.74 SUM 1 5 8,000.00 $ S,OOO.OD SUM 1 $ 2,300.00 $ 2,300.00 LUMPSUM 1 $ 9,600.00 $ 9,600.00
INLET PROTECTION SYSTEM
3 EACH 10 5 174.72 $ 1,747.20 EACH 10 $ 250.00 $ 2,500.00 EACH 1Q $ 235.00 $ 2,350.00 EACH 10 $ 109.00 $ 1,090.00
MILL EXISTING ASPHALTIC PAVEMENT,
1��AVERAGE DEPTH SQUARE SQUARE SQUARE SQUARE
4 YARD 8742 $ 3.05 $ 26,663.10 YARD 8742 5 2.25 $ 19,669.50 YARD 8742 $ 1.75 $ 15,298.50 YARD 8742 $ 2.25 $ 19,669.50
SUPERPAVE ASPHALTIC CONCRETE,
5 TRAFFIC C(SP-9.5) roN �so S iio.00 S az,soo.00 rory �so S i3s.00 5 ioi,zso.00 roN �so 5 ioa.00 5�s,000.00 roN �so $ i1z.55 5 aa,aa�.so
REMOVAL OF EXISTING SIDEWALK, ��Mp LUMP
6CURBANDGUTTER LUMPSUM 1 $ 5,894.02 $ 5,894.02 SUM 1 S 7,500.00 $ 7,500.00 SUM 1 $4,600.00 $ 4,600.00 LUMPSl1M 1 $ 6,825.00 $ 6,825.00
SIDEWALK CURB AND RAMP, FDOT
� INDEX 304� CR-f EACH 10 S 1,514.24 S 15,142.40 EACH 10 S 1,500.00 $ 15,000.00 EACH SO $ 2,200.00 S 22,000.00 EACH 10 $ 3,095.00 S 30,950.00
DETECTABLE WWARNING MAT-BRICK 54unRE SQUARE SQUARE SQUARE
g RED FOOT 200 $ 40.77 $ 8,154.00 F00T 200 $ 25.00 $ 5,000.00 F00T 200 $ 34.00 $ 6,800.00 f00T 200 5 46.OD $ 9,200.00
TOTAL BID AMOUN7 $ 152,141.89 $ 168,919.SD $ 139,848.50 $ 153,322.00
Posted on October 22, 2020 at 4:00 p.m.
fo be removed on November 2, 2020 at 4:00 p.m.
,
� �,'
@72. 619��f�P B�Y�16lI��� �G�biR �96�9�9�E�
ITEM �1. CON i lNUED: �iYorney Fui�ero re�d revisec� pro�osecl �esolu�iion No.
2020-20 by 'ciife only as r'olfows: "!-1 t��SOLU i ION OF ThIE CI I Y Oi=
OKEECHOf3EE, FLORIDA; ACC��' I IIVG i H� OF�IGIAL RESULTS �OR iN�
2020 G�N��i�1L CI I Y ELECI'ION; PROVIDING F'O� TE�MS OF OFFICE TO
B� FdELD �Y MONICA McGARTi-iY CLARK, !�S �N EL�CTED Ci7Y COUfVCIL
MEMB�R; PROVIDING �O� T{-!E CITY CLERK i O ISSUE � CER71FlC�1 I E OF
ELGC i ION; �t�OV1DING �OR CDiVFLICT; t�ROVIDfIVG FO� SEVEi�Af31Ll i Y;
�-,IVD P�OVIDING FOf� AP1 E�=FECiIV� DATE."
flf����;i��o G�Y�•u��1 l9oaaeuurr��unsUry.
Moiion by Council Member ��ee�e, seconded by Councii Mernber Jarri�l �o aciop'c
�ro�oseci R�solu�iion No. 2020-2'i acce�;ing 4h� uncondi��ional r�signacion of
Counci! Mernber Eleci Russ Cale.
A'r�orney �umero read �Oroposed Resolurion No. 2020-21 by ziile only as follows:
"A RESOLUTIOf�f O� 1 H� C1 I'� O� O�EECf �OS�c, FLORIDA; ACC�P I IIVG
T�-IE UNCOI�tDITfONAL f��S(GNATION O{= RllSS C!-1L� F�OM I Fi� O�=FICE
Of= CITY COU�lCIL; Pt�OVlDING FOI� CONI=�IC7; E'ROV{DlNG FO�
SCVERAf31LI�iY; Af�D PS�OVIDlNG i=0� AN CF��C I iVE DF1T�.,'
41��v,ie� irn G���u��9 L��u�r�9�'�1o�s9�,
23. Motion 6y Council M�mi�er Jarriel, s�conded by Council M�mber Keeie ito
aparove an ayreernen4 for services with ESCRIQE So•Ycwar� Lfd. [in the amoun�
or $96,668.00] fior webcasfing and aui:ornaied closed canfioning. 6��i �26��a �arrrrBero9
99ua�a��c�a��ns��.
�: . Nietian by Counci! Member Aaney, second�d 6y Council Member �:eefie �o award
Bic� No. P1rV 05-90-09-20 Souiheast 3'd Avenue t'avernent Improvemen2s 7o C.W.
Robcres ConY�aczinc�, !c�c. in 4fie a�no�ni �i ��39.848.5C�. R.�1�fi4�r� �ar�iad
"��5�c^.r7'166'did3A,tiSd j .
�. Mofion by Council Member Abney, secondeel F�y Councii Member Jarriel to
apprave Ceniennial Park Pavition Rules ancl �;�s�rvafion �'�� Ap�iicarion.
�2::�9*�.*� ��Yf9om7 ��7����Q?�95��.
�. Moiion by Council Me�f�er Jarriel, seconded 6y Council Memk�er Keer'� io ra2ir"y
the In4erlocat Agreem�n2 For Fire Services �eiwe�n Okeechobee CounYy and 4he
City ofi Okeecho6ee, inclucling all eschi6iis. PJdo•cu��u C�rr�Bes� �Qaarr 4� Oaa�.
@0�0. C0�'9f ATi T04'�E�9�°�P �P�r'�'d'�
Ciiy Anorney Furnero re�Oor'ced he will 6e wor{;ing wiih Ciry Clerk GamioY�a on 'ihe
Special Elec2ion io replace Mr. Cale; anrJ on upda'ting fhe City's pub[ic records poficy fo
give speciiic procedures ror r�raining elecrronic records and resea�•ching possible
t�chnology applications to assisY �he Ciiy Council in r�i�ining iheir public records.
1/BUV. �O�l�R9CY� C�61�6lla�A9 i �
Counci� M�mber Jarri�l welcomed ci'ciz�ns io 6� present ai meetings �nd voice f(�eir
opinions and/or conc�rns. Flis commenfs wer� �cho�d by Council Member Keefe.
Council Mem��r Clark explain�d her inr�n� ior limi�iing �Oublic atY�nd�nce ro fhe free
lighfing cer�rr�ony.
IeC. Mayor Waciord adjou�-ned fhe meet`ing ��i 6:54• P.M.
Su6rnicced f3�: . , ,
, `.� /' , �l� Y S`•�'f ..
r�,/ ;--�
./ Y.r.'�%i.:� .i "� a�� ( � ��.,�..�
L�ne Gamiofea, Ci17IC,��:.iiy CIer6:' ..
Pfease Qalce noFice and be advised 4hat when a person decides to appeal �ny ciecision made 4.y 4iie�Ciiy Council
wifh resp�cr to any matFer considered ai this meetiny, he/she may need to ensuce 4ha2 a VerEiaum record of the
proceedinc� is made, which record includes fhe tesYimony and evidence upon u'vfiich..Ehe appeal is to �e based.
Cify Clerlc media are for Qhe sole purpose of bacicup for o�cial records of Yhe Clerl<., ..
necemh�r 1. 2020. Re�ular MeeYin�. Paee 2 or'2
Patty Burnette
From: Sherri Lewis <slewis@cwrcontracting.com>
Sent: Wednesday, luly 21, 2021 8:18 AM
To: Patty Burnette
Subject: RE: SE 3rd Ave
Great! Thank you for your follow up, you are a pleasure to work with. Q
Sherri Lewis
Asst. Contracts Administrator
C.W. Roberts Contracting, Inc.
8530 SW Jayme Way � Palm City, FL 34990
O 772.288.0951 � F 772.288.0983
C'�.�i�
CC�€'�lTRACTIfVG, IE'�r"C.
From: Patty Burnette <pburnette@cityofokeechobee.com>
Sent: Wednesday, July 21, 2021 8:13 AM
To: Sherri Lewis <slewis@cwrcontracting.com>
Subject: RE: SE 3rd Ave
ICAUTION: This is an EXTERNAL email. Do not click links or open attachments unless you recognize the sender and know
the content is safe.
Good Morning.
Given there are additional funds owed for the project then what was awarded, it will need to go back
before City Council for approval. We are hoping to have the item on the next Agenda for the August 3rd
meeting.
Regards,
Patt� 2V1. Burnette
C'j, enera�Services Coord�inator
Cit� of O�eec�o6ee
55 SE 3r`� Avenue
O�eec�o6ee, rFL 34974
P�one: (863� 763-3372 ext. g8zo
Direcfi (863� 763-g82o
�Fax: (8 63� 763 -168 6
i
e-mai� k���r�nette@c�i:t�,�ofolieec(�o�ee.corri.
-we6site: �vw.citti�ofo�eecl�.o6ee.cv��i
_ - �f;:; .
���. _
4 �
Under Florida law, email addresses are public records. If you do not want your email address released in
response to a public records request, do not send electronic mail to this entity. Instead, contact this office by
phone or in writing, Florida Statute 668.6076.
CITY OF OKEECHOBEE ELECTRONIC DEVICE DISCLAIMER: Florida has a very broad public records law.
Most written communications to or from local officials regarding city business are public records available to
the public and media upon request. Your correspondence via e-mail, text message, voice mail, etc., may
therefore be subject to public disclosure.
From: Sherri Lewis <slewis(a�cwrcontracting.com>
Sent: Tuesday, July 20, 20214:13 PM
To: Patty Burnette <pburnetteC�citvofokeechobee.com>
Subject: RE: SE 3rd Ave
Patty,
Please update me on the status of this revised invoice submittal that you requested. Thank you.
Thank you.
Sherri lewis
Asst. Contracts Administrator
C.W. Roberts Contracting, Inc.
8530 SW Jayme Way � Palm City, FL 34990
O 772.288.0951 � F 772.288.0983
���
C�iti;T6?ACTI t�G. If�C.
From: Sherri Lewis
Sent: Wednesday, July 7, 2021 10:39 AM
To:'Patty Burnette' <pburnetteC�cityofol<eechobee.com>
Subject: SE 3rd Ave
Patty,
I apologize for the delay in getting these back to you. My Corporate office just sent me the release, please let me know
if there is anything else you need.
Thank you.
Patty Burnette
From:
Sent:
To:
Subject:
Attachments:
Sherri Lewis <slewis@cwrcontracting.com>
Wednesday, July 7, 2021 10:39 AM
Patty Burnette
SE 3rd Ave
20210702134615262.pdf; OKE 1511725-1 R2 SIGNED BEN.pdf
Patty,
I apologize for the delay in getting these back to you. My Corporate office just sent me the release, please let me know
if there is anything else you need.
Thank you.
Sherri Lewis
Asst. Contracts Administrator
C.W. Roberts Contracting, Inc.
8530 SW Jayme Way � Palm City, FL 34990
O 772.288.0951 � F 772288.0983
C �'��
COir:TRACTI NG. I�'C.
Patty Burnette
From:
Sent:
To:
Cc:
Subject:
Sherri Lewis <slewis@cwrcontracting.com>
Tuesday, June 8, 2021 4:06 PM
Patty Burnette
David Allen; Kay Matchett; Yesica Montoya; Benjamin Baummier; Monica Raulerson
RE: SE 3rd Avenue Pay Application
Patty,
As discussed in our telephone call, I will make the revisions to the pay app for the $1 difference in the detectable mat
unit pricing and update the release to have resigned. We are in the middle of cost calls this week with our corporate
office and it will be next week until I can get everything back to you. Please let me know if you need anything else in the
meantime.
Monica,
This will be a$200 decrease adjustment to the final bill for SE 3rd Ave.
Thank you.
Sherri Lewis
Asst. Contracts Administrator
C.W. Roberts Contracting, Inc.
8530 SW Jayme Way � Palm City, FL 34990
O 772.288.0951 � F 772.288.0983
� �
���
COf�lTRACTING, IE'��.
From: Patty Burnette <pburnette@cityofokeechobee.com>
Sent: Thursday, June 3, 20214:43 PM
To: Sherri Lewis <slewis@cwrcontracting.com>
Cc: David Allen <dallen@cityofokeechobee.com>; Kay Matchett <kmatchett@cityofokeechobee.com>; Yesica Montoya
<ymontoya@cityofokeechobee.com>; Benjamin Baummier <bbaummier@cwrcontracting.com>
Subject: RE: SE 3rd Avenue Pay Application
Thank you for the update Sherri
Patt� 1V1. Burnette
C'j, enera�Services Coorc�inator
Cit� of O�eec�o6ee
SS S� 3'"`� Avenue
O�eec�o6ee, rF'.L 34974
P�one: (863� 763-3372 ext. g8�o
D� ;�
�` ` C�`p-�J� i l � �
APPLICATION AND CERTIFICATION FOR PAYMENT AIADocvMElvTG�o2 PAGEONEOF 2 PAGES
TO OWNER:
CITY OF OKEECHOBEE
55 SE THIRD AVENUE
OKEECHOBEE, FL 34974
FROM CONTRACTOR:
C. W. RobeRs Contracting, Inc.
PROJECT: SE 3RD AVENUE
VIA ARCHITECT:
$ 139,848.50 ✓ CONTRACTOR: C. W. Roberts Contracting, Inc.
$ 0.00 Benjamin B DigitallysignedbyBenjamin8
� 139,848.50 ✓ Baummier
$ 147,216.50 $y: BaUITICT�Ie� Date:2021.052413:11:15-04'00' Date:
Project Manager
3372 Capital Circle NE PROJECT NOS: 1511725
Tallahassee, FL 32308
CONTRACT FOR: CONTRACT DATE: 2/8/2021
CONTRACTOR'S APPLICATION FOR PAYM ENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Condnuation Sheet, AIA Document G703, is attached. completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for �vhich previous CeRificates for Payment were issued and
paymen[s received from the Owner, and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM
2. Net change by Change Orders
3. CONTRACT SUM TO DATE (Line 1 t Z)
4. TOTAL COMPLETED & STORED TO
DAT'E (Column G on G703)
5. RETAINAGE:
a. 0
(Colum
b.
(Colum:
Total Re
Total in
6. TOTAL EA]
(Line 4
7. LESS PREV
PAYMENT
8. CURRENT _
9. BALANCE'
(Line 3
CHtI
Total change
in revious r
Total a ro�
TOTALS
NET CIIAN
AIA DOCUMEM G7i
Users may ot
�� � �
u��°�,s
tI� �� f � � �� � �-t-� =- � �i
�
AMOIJNT CERTIFIED . . . . . . . . . . . $ $ I47,216.50
(Attach explanation if amount certified differs.%rom the amo:mt applied Initia! all,rgures on this
Application and onthe Contin:ration Sheet that are changed to conjorm with the amotmt certified.)
ARCHITECT:
By:
Distribution to:
�* OWNER
�ARCHITECT
�CONTRACTOR
� ENGINEER
0
Date:
This Certificate is not negotiable. The AMOIJNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
D407 - Certification of DocumenYs Authenticity from the Licensee.
APPLICATION NO: 1 R
PERIOD FROM: 2/22/2021
PERIOD TO: 4/21{2021
State of: County of.
Subscribed a�d sworn to before me this day of
Notary Public:
My Commission expires:
o.00 ARCHITECT'S CERTIFICATE FOR PAYMENT
147,216.50 In acwrdance with the Contract Documents, based on on-site observations and the data
comprising the application, the Architect certifies to the Owner that to the best of the
i Architect's knowledge, information and belief the Work has progressed as indicated,
' 0.00 the quality of the Work is in accordance with the Contract Documents, and the Contractor
147,21630= is entitled to payment of the AMOtJNT CERTIFIED.
ESTIMATE OF CONSTRUCTION FOR
CONTRACTOR : C. W. ROBERTS CONTRAC7ING, INC.
ADDRESS : 3372 CAPITAL CIRCLE NE
TALLAHASSEE. FLORIDA 32308
TELEPNONE: (850�385-5060
CONTACT: ToddCastleberry
EMAIL : tcasuebertvscwrcontract no co
TELEPHONE: (772�288-0951
PROJECT NAME :
OWNER/GC :
OWNER PROJECT NO.:
FINANCIAL PROJECT ID :
F. A. P. NO. :
ENGINEER :
ADDRESS :
ATfENTION :
EMAIL :
TELEPHONE :
SE 3RD AVENUE .
CITY OF OKEECH08EE _ - �.
PW 05-10-09-20 - .
"_ s �,� �
-:_�: ,.e'�
SS SE THIRD AVENUE -'"�%� �� y_� `�.=:� �
OKEECHOBEE, F134974 G _
DAVIDALLEN . " ' _
DA'_'._E1�,CIiY0-0C_EC,:OY=-CON, . � . .-- �
�;��� ��' � � ` -
�1� ��� �
����� � ' - ,�
� nd l�C.l i Ct� d� ��
! �` �i
� ', :``� �` `:"' ` r r`` ;.
A � a
\'��''�,' � � 1 ,
� � `.
CWR PROJECT NO.: 7511725
BEGIN PAY PERIOD : 2/22/2p21
END PAY PERIOD : 4/21 /2021
PAY REQUEST NO.: 1 R
ORIGINAL CONTRACT AMOUNT : 139.848.50 -
CHANGE ORDERS ( ), ( ), ( ) ; 200.00 - ��� }` ��
FUEL 3 BITADJUSTMENTS: 0.00 ��� � r %
PRESENiCONTRACTAMOUNT: 140,048.50 ''�il��l
EARNINGS TO - DATE : 147.216.50 147,216.50
LESSRETAINAGE: 0.00 0.00
IESS PREVIOUS AMOUNT PAID : p,pp
NET DUE THIS REQUEST : 147.216.50 147,216.50
CWR REVENUE: 147,216.50
Conditional Final Release of Lien
The undersigned lienor, in consideration of the sum of $147,216.00 upon receipt, hereby waives
and releases its lien and right to claim a lien for labor, services or materials furnished to Citv of
Okeechobee. on the job of SE 3rd Avenue to the following described property:
SE 3�d Avenue Pavement Improvements
FDOT FPN 440372-1
I hereby acknowledge that the statements contained in the foregoing waiver and release of lien
are true and correct.
C.W. Roberts Contracting, Inc.
Address: 8530 SW Jayme Way
Palm City, FL 34990
Dated on: 05/20/2021 By: / `
Printed Name: %��rt�T /� � S ��
State of: Florida
County of: Leon
The foregoing instrument was acknowledged before me this � day of May, 2021 by
�2�'" � D who is personally known to me. �
��,�„�� �� � ��,,,,,,,
`�.����EWOp�'�.,,� ��'�-.'�'—`-'�,�6L�.��I�ACJI(/"
``,v�� � O TA � ���0 "=
' Notary Public
; My Comm. Expires ,�� -
_� Juae05,2o2� � My Commission Expires: �(0 (�Gj��?./
- ' No. GG 111739 , -
,
J'� ,' .
�"',;�9j��'�UB LIC, . ��Q-�,� _
',,,,, o� r-Lo�,.,,'.
--�,,,,,,,,,,,,,,,,
CITY OF OKEECHOBEE
PW 05-10-09-20 October 22, 2020 3:00 PM Bid Opening
Okeechobee Southeast 3rd Avenue Pavement Improvements
CONTRACTOR:
Florida Blacktop, Inc. Hardrives, Inc. C. W. Roberts Contracting Inc. Ranger Construction
ITEM UNIT EST. UNIT EST. UNIT EST. UNIT EST.
NO. MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNIT PRICE AMOUNT
MOBILIZATION / DEMOBILIZATION LUMP LUMP
1 LUMP SUM 1 $ 10,383.43 $ 10,383.43 SUM 1 $ 10,000.00 $ 10,000.00 SUM 1 $ 8,500.00 $ 8,500.00 LUMP SUM 1 $ 11,500.00 $ 11,500.00
MAINTENANCE OF TRAFFIC LUMP LUMP
2 LUMP SUM 1 $ 1,657.74 $ 1,657.74 SUM 1 $ 8,000.00 $ 8,000.00 SUM 1 $ Z,300.00 $ 2,300.00 LUMP SUM 1 $ 9,600.00 $ 9,600.00
INLET PROTECTION SYSTEM
3 EACH 10 $ 174.72 $ 1,747.20 EACH 10 $ 250.00 $ 2,500.00 EACH 10 $ 235.00 $ 2,350.00 EACH 10 $ 109.00 $ 1,090.00
MILL EXISTING ASPHALTIC PAVEMENT,
1" AVERAGE DEPTH SQUARE SQUARE SQUARE SQUARE
4 YARD 8742 $ 3.05 $ 26,663.10 YARD 8742 $ 2.25 $ 19,669.50 YARD 8742 $ 1.75 $ 15,298.50 YARD 8742 $ 215 $ 19,669.50
SUPERPAVE ASPHALTIC CONCRETE,
5 TRAFFIC C(SP-9.5) TON 750 $ 110.00 $ 82,500.Q0 TON 750 $ 135.00 $ 101,250.00 TON 750 $ 104.00 $ 78,000.00 TON 750 $ 112.65 $ 84,487.50
REMOVAL OF EXISTING SIDEWALK, LUMP LUMP
6 CURB AND GUTTER LUMP SUM 1 $ 5,894.02 $ 5,894.02 SUM 1 $ 7,500.00 $ 7,500.00 SUM 1 $ 4,600.00 $ 4,600.00 LUMP SUM 1 $ 6,825.00 $ 6,825.00
SIDEWALK CURB AND RAMP, FDOT
� INDEX 304, CR-F EACH 10 $ 1,514.24 $ 15,142.40 EACH 10 $ 1,500.00 $ 15,000.00 EACH 10 $ 2,200.00 $ 22,000.00 EACH 10 $ 1,095.00 $ 10,950.00
DETECTABLE WWARNING MAT - BRICK SQUARE SQUARE SQUARE SQUARE
g RED FOOT 200 $ 40.77 $ 8,154.00 FOOT 200 $ 25.00 $ 5,000.00 FOOT 200 $ 34.00 $ 6,800.00 FOOT 200 $ 46.00 $ 9,200.00
TOTAL BID AMOUNT $ 152,141.89 $ 168,919.50 $ 139,848.50 $ 153,322.00
F'OSieQ Ofl VCiOfJef LL, LULU ai 4:UU j�.171.
To be removed on November 2, 2020 at 4:00 p.m.
� �
Florida Depa�tment of Transportation
RON DESANTIS 605 SuWannee Street KEVIN J. THIBAULT, P.E.
GOVERNOR Tallahassee, FL 32399-0450 SECRETARY
February 2, 2021
C.W. ROBERTS CONTRACTING, INC.
3372 CAPITAL CIRCLE NE
TALLAHASSEE, FLORIDA 32308
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 3/30/2022. However, the new application is due 1/31/2022.
In accordance with 5.337.14 (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, FENCING, FLEXIBLE PAVING, GRADING, GRASSING, SEEDING AND SODDING, GUARDRAIL,
HOT PLANT-MIXED BITUM. COURSES, INTERMEDIATE BRIDGES, MINOR BRIDGES, PORTLAND CEMENT
CONCRETE ROADWAY PAVING, ROADWAY SIGNING, SIDEWALK, Curb & Gutter, Driveways, Milling,
Reinforced Earth Walls, Rip Rap Rubble, 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.
Sincerely,
T�a/.� .Ah:c�a.i.d�ri, for
Alan Autry, Manager
Contracts Administration Office
AA:cg
Improve Saf'ety, Enhcrrace Mobiliry, Inspii•e Innovation
www.fdot.gov
Patty Burnette
From:
Sent:
To:
Cc:
Subject:
Attachments:
Sherri Lewis <slewis@cwrcontracting.com>
Thursday, June 3, 2021 3:41 PM
Patty Burnette
David Allen; Kay Matchett; Yesica Montoya; Benjamin Baummier
RE: SE 3rd Avenue Pay Application
OKE 1511725-1 Rsigned.pdf; FDOT - Certificate of Qualification - exp 03-30-22.pdf
I am still waiting on the releases from our Corporate office, as soon as I receive them I will send them over to you. This is
everything else you needed. Please let me know if I can be of more assistance.
Sherri Lewis
Asst. Contracts Administrator
C.W. Roberts Contracting, Inc.
8530 SW Jayme Way � Palm City, FL 34990
O 772.288.0951 � F 772.288.0983
� �
���
C.�}E�TE�ACTI fVG: I tiC.
From: Patty Burnette <pburnette@cityofokeechobee.com>
Sent: Thursday, June 3, 2021 2:23 PM
To: Sherri Lewis <slewis@cwrcontracting.com>
Cc: David Allen <dallen@cityofokeechobee.com>; Kay Matchett <kmatchett@cityofokeechobee.com>; Yesica Montoya
<ymontoya @cityofokeechobee.com>
Subject: FW: SE 3rd Avenue Pay Application
Importance: High
CAUTION: This is an EXTERNAL email. Do not click links or open attachments unless you recognize the sender and know
the content is safe.
Good Afternoon Sheri,
Just following up on this item to get a status.
Thank you,
Patty M. Burnette
C'j. enera�Services Coord�inator
Cit� of O�eec�o6ee
55 S� 3rd Avenue
O�eec�o6ee, �'L 34974
P�one: (8 63� 763 -3372 ext. g82 0
i
�� � ►�� �� �--
Patty Burnette
From: Patty Burnette
Sent: Wednesday, May 19, 2021 2:25 PM
To: slewis@cwrcontracting.com
Cc: Kay Matchett (kmatchett@cityofokeechobee.com); David Allen
(dallen@cityofokeechobee.com); Yesica Montoya
Subject: FW: SE 3rd Avenue Pay Application
Attachments: OKE 1511725-1 R(004)signed.pdf; Exhibit B.pdf
Importance: High
Good Afternoon Ms. Sherri.
I need a revised pay application sent to me as the original contract sum was for $139,848.50. The
attached application indicates $140,048.50. I have attached a copy of Exhibit B-Bid Unit Price Schedule
from the Bid Documents for your reference. In addition,"'�will need an updated copy of the Certificate of
Qualification from FDOT, as the copy we have expired on 3/31/21. Lastly, will need a Final Waiver and
Release of Lien that indicates the end pay period date noted on the AIA.
Should you have any questions, please just let me know.
Regards,
Patt� �Vl. Burnette
Genera�Services Coorc�inator
Cit� of O�eec�to6ee
SS S� 3Y`� Avenue
O�eec�o6ee, rFL 34974
P�one: (863� 763-3372 ext. g8�o
Direct: (863� 763-g8�o
�Fax: (863� 763-1686
e-mai� �6u�r�iette@citti�ofo(eec�io6ee.co�r�i
tive6site: tivw�N.citi�o�olieec�.o6ee.co��i
��
� `�. C15�� �C IA'1 f`�-.;`:�,.
'�<_
_ � ;�� 7
.�,'vi' -" _ _
Under Florida law, email addresses are public records. If you do not want your email address released in
response to a public records request, do not send electronic mail to this entity. Instead, contact this office by
phone or in writing, Florida Statute 668.6076.
CITY OF OKEECHOBEE ELECTRONIC DEVICE DISCLAIMER: Florida has a very broad public records law.
Most written communications to or from local officials regarding city business are public records available to
the public and media upon request. Your correspondence via e-mail, text message, voice mail, etc., may
therefore be subject to public disclosure.
From: David Allen <dallen@cityofokeechobee.com>
Sent: Wednesday, May 19, 2021 1:59 PM
To: Patty Burnette <pburnette@cityofokeechobee.com>; Kay Matchett <kmatchett@cityofokeechobee.com>
Subject: Fwd: SE 3rd Avenue Pay Application
Get Outlook for iOS
From: Sherri Lewis <slewis@cwrcontractin�.com>
Sent: Tuesday, May 18, 2021 11:11:08 AM
To: David Allen <dallen@citvofokeechobee.com>
Cc: Benjamin Baummier <bbaummier@cwrcontractin�.com>
Subject: SE 3rd Avenue Pay Application
Good Morning David,
Attached is the revised pay application for SE 3`d Ave. Please let me know if you have any questions. Q Have a great
day.
Sherri Lewis
Asst. Contracts Administrator
C.W. Roberts Contracting, Inc.
8530 SW Jayme Way � Palm City, FL 34990
O 772.288.0951 � F 772.288.0983
+�: �'`.��
�C?�'.T��.GTI�f��G, IE�C.
APPLICATION AND CERTIFICATION FOR PAYMENT AIADocuMENT��o2 PAGEONEOF 2 PAGES
TO OWNER:
CITY OF OKEECHOBEE
55 SE TT�RD AVENi.JE
OKEECHOBEE, FL 34974
PROJECT: SE 3RD AVENUE
APPLICATION N0: 1R
PERIOD FROM: 2/22/2021
PERIOD T0: 4/21/2021
Distribution to:
�* OWNER
QARCHITECT
QCONTRACTOR
�ENGINEER
�
FROM CONTRACTOR:
C. W. Roberts Contracting, Inc.
VIA ARCHITECT:
3372 Capital Circle NE PROJECT NOS: 1511725
Tallahassee, FL 32308
CONT`RACT FOR: CONTRACT DATE: 2/8/2021
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best ofthe Conuactor's knowledge,
Application is made for payment, as sho��n below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet, AIA Document G703, is attached. completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and
payments received from the Owner, and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM
2. Net change by Change Orders
3. CONTRACT SUM TO DATE (Line 1 f 2)
4. TOTAL COMI'LETED & STORED TO
DATE (Column G on G703)
5. RETAINAGE:
a. 0% of Completed Work $
(Column D + E on G703)
b. % of Stored Material $
(Column F on G703)
Totai Retainage (Lines Sa+ Sb or
Total in Column I of G703)
6. TOTAL EARNED LESS RETAINAGE
(Line 4 Less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificate)
8. CURRENT PAYMENT DUE
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)
$ 140,048.50
$ 0.00
$ 140,048.50
$ 147,216.50
0.00
$ 0.00
$ 147,216.50
$ 0.00
$ 147,216.50
-7,168.00
CONTRACTOR: C. W. Roberts Contracting, Inc.
Benjamin B Digitaltysigned by Benjamin B
Baummier
By Baummier Date:2021.05.1807:13:18-04'00� Date:
Project Manager
State of: County of.
Subscribed and swom to before me this day of
Notary Public:
My Commission expires:
ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data
comprising the application, the Architect certifies to the Owner that to the best of the
Architect's Imowledge, information and belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor
is entitled to payment of the AMOiJNT CERTIFIED.
AMOiJNT CERTIFIED . . . . . . . . . . . $ $ 147,216.50
(Attach explanadon if amovnt certified difj'ers, from the amo:�nt applied. Initial all, ftgimes on this
Application and onthe d�ation Sheet that are changed to conform with the amoamt certified.)
ARCHITECT: �'��i�� 5 - ) `j — Z �
By:
Date:
This Certificate is not negotiable. The AMOCTNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUMENT G702 � APPLICATION AND CERTIFICATION FOR PAYMENT � 1992 EDITION � AIA � OO 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 2000G5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.
ESTIMATE OF CONSTRUCTION FOR
CONTRACTOR : C. W. ROBERTS CONTRACTING, INC.
ADDRESS : 3372 CAPITAL CIRCLE NE
tALLAHASSEE, FLORIDA 32308
TELEPHONE: (850) 385-5060
CONiACT: Todd Castleberry
EMAII: �castle6errvscwrcontractina.com
TELEPHONE: (772) 288-0951
PROJECT NAME :
OWNER/GC :
OWNER PROJECT NO.:
FINANCIAL PROJECT ID :
F. A. P. NO.:
ENGINEER:
ADDRESS :
ARENTION :
EMAIL :
TELEPHONE :
SE3RD AVENUE
CITY OF OKEECH08EE
PW OS-10-09-20
55 SE THIRD AVENUE
OKEECHOBEE, FL 34974
DAVID ALLEN
DALLENSCIIYOfOKLFCI10BfF C:OM
CWR PROJECT NO. : 1511725
BEGIN PAY PERIOD : 2/22/2021
END PAY PERIOD : 4/21 /2021
PAY REQUEST NO. : 1 R
EARNINGS TO - DATE : I 47,216.50 147,216.50
LESSRETAINAGE: 0.00 0.00
LESS PREVIOUS AMOUNT PAID : D.00
NET DUE THIS REQUEST: 147,216.50 147,216.50
CWR REVENUE: 147,216.50
ORIGINAL CONTRACT AMOUNT: 0.00
CHANGE ORDERS ( ), ( ), ( ) : 140,048.50
FUEL S BIT ADJUSTMENTS : 0.00
PRESENT CONTRACT AMOUNT: 140,048.50
,��,, C��� v�
..�. Okeechobee
�� FLORIDA • ; o�,indcd 1915
To:
From:
Date:
Re:
Marcos Montes De Oca
CITY OF OKEECHOBEE, PUBLIC WORKS
Memo
David Allen, Public Works Director
11/20/2020
Requestst for award of SE 3`d Avenue Paving Improvements Project to CW Roberts
Inc.
Exh�bii 4
� Z�o � i�o�o
Public Works is requesting the approval to award a contract for paving services, PW 05-10-09-20, FDOT
FPN 440372-1 to CW Roberts Contracting Inc. in the amount of $139,848.50.
Four bids were received for the project. The total bid amount for each of the vendors is:
CW Roberts Contracting Inc. $139,848.50
Florida Blacktop Inc. $152,141.89
Ranger Construction $153,332.00
Hardrives Inc. $168,919.50
A detailed bid tabulation for the project along with the actual bid documents from CW Roberts are
attached.
This project is a FDOT SCOP-Communities funded project. The grant amount form FDOT is $123,531.00.
The difference of $16, 317.50 will be funded from the existing Public Works budget under the
$80,000.00 allocation for asphalt and roadway reconstruction, line item 301-549-6300.
Given the approximate nature of asphalt work, it is also requested that the City Administrator be
�y authorized to approve adjustments to the final project cost not to exceed $10,000.00 to reflect the
actual amounts used for the project.
CITY OF OKEECHOBEE
PW 05-10-09-20 October 22, 2020 3:00 PM Bid Opening
Okeechobee Southeast 3rd Avenue Pavement {mprovements
CONTRACTOR:
Florida Blacktop, Inc. Hardrives, Inc. C. W. Roberts Contracting Ir
ITEM UNIT EST. UNIT EST. UNIT EST.
NO. MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNIT PRICE AMOUNT MEASURE QTY. UNIT PRICE
MOBILIZATION / DEMOBILIZATION LUMP LUMP
1 LUMP SUM 1 $ 10,383.43 $ 10,383.43 SUM 1 $ 10,000.00 $ 10,000.00 SUM 1 $ 8,500.00
MAINTENANCE OF TRAFFIC LUMP LUMP
2 LUMP SUM 1 $ 1,657.74 $ 1,657.74 SUM 1 $ 8,000.00 $ 8,000.00 SUM 1 $ 2,300.00
INLET PROTECTION SYSTEM
3 EACH 10 $ 174.72 $ 1,747.20 EACH 10 $ 250.00 $ 2,500.00 EACH 10 $ 235.00
MILL EXISTING ASPHALTIC PAVEMENT,
1" AVERAGE DEPTH SQUARE S4UARE SQUARE
4 YARD 8742 $ 3.05 $ 26,663.10 YARD 8742 $ 2,25 $ 19,669.50 YARD 8742 $ 1.75
SUPERPAVE ASPHALTIC CONCRETE,
5 TRAFFIC C(SP-9,5� TON 750 $ 110.00 $ 82,500.00 TON 750 $ 135.00 $ 101,250.00 TON 750 $ 104.00
REMOVAL OF EXISTING SIDEWALK, LUMP LUMP
6 CURB AND GUTTER LUMP SUM 1 $ 5,894.02 $ 5,894.02 SUM 1 $ 7,500.00 $ 7,500.00 SUM 1 $ 4,600.00 .
SIDEWALK CURB AND RAMP, FDOT
� INDEX 304, CR-F EACH 10 $ 1,514.24 $ 15,142.40 EACH 10 $ 1,500.00 $ 15,000.00 EACH 10 $ 2,200.00 :
DETECTABLE WWARNING MAT- BRICK SQUARE SQUARE SQUARE
g RED FOOT 200 $ 40.77 $ 8,154.00 FOOT 200 $ 25.00 $ 5,000.00 F00T 200 $ 34.00 ;
TOTAL BID AMOUNT $ 152,141.89
$ 168,919.50 �
1''05iGQ Ofl VGLODef LL, LVLU dl'�:UU FJ.fTI.
To be removed on November 2, 2020 at 4:00 p.m.
;_' '�,
i�8. P9Elfl/ �U�IRI��� G�d�9 �BVi9�.9��
IiEM A. CON i INUED: �1�itomey Fumero read r�vised proposed ResoluYion IVo.
2020-20 6y fiile only as r'ollows; "A R�SOLUiIOfV OF Tf-�E C17Y OF
OKEECHOf3EE, FLOf�IDA; ACCEPTING TH� OFFICIAL F2ESULTS �OR iN�
2020 G�NE�,�1L CI I Y ELEC I IOiV; PROVIDIIVG FOf� TERMS OF OFFICC TO
BE FdELD �Y MONICA McCARTI-IY CLARK, AS AiV EL�CTED CIT`( COUfVCIL
MEMB�R; PROViDIIVG FOf� TF�E CIiY CLERK TO ISSU[ � CERTI�lC�17E OF
ELECTION; PI�OVIDIiVG FOR CONFLICT; f'ROVIDING �OR SEVERAt3(LITY;
�ND PROVIDiNG FOR AN LFFECTIVE DATE."
flf9o�io�o Gae�c^ue�1 Uo��wuaa��ans9y.
Moiion by Council Memb�r l�eefe, seconded by Councif Member Jarriel 2o aciop'c
proposed Resolu�iion No. 2020-21 acce�aing the uncondi�iional resignaiion oF
Council Mernber Eleci Russ Cale.
AY[orney Fumero read proposed Resolufion No. 2020-29 by firle only �s foliows:
"A RESOLUTION O� THE CITY OF OKEEC«OB�E, FLORIDA; ACC�CP�'fIVG
TFIE U��C01�1DITIOIVAL {�GSIGiVATION OF RUSS Cl-�LE FROM Ti-IE OFFICE
OF CITY COUi�SCiL; Pt�ZOVIDIf\IG FOR CONI=LICT; �ROV{D{NG FOR
SEV�RAC3ILITY; Ai�D {'ROVILIl�IG �O� AN �FFECTIVE i7�'fE.°
�l�iat�i,@a�C9 �'a��f�'9S?4� �94�9fra4�40.Nsg;r,
B. Moiion by Council Member Jarriel, seconded by Council M�mber Ke�r'e fo
ap�rove an agreemen� for sen�ices wich eSCRIQE So��'cwar� Ltd. [in the amounf
or $16,668.00)'ror webcas4ing and auromaied closed ca�fioning. V�d��aora Cavrr6��1
l9e�asroar�a�aas9�.
C. Motion by Counci! Mem6er Abney, seconded 6y Council Memf�er Keefe io award
Bic� fVo. PVV 05-10-09-20 Sou�h�as� 3'd Avenue Pavernen� Improvemen4s fo C.W.
Robens Con4racfing, l��c. in Yhe amounf o�f $939,8�8.50. �(io�ior� Car�is�1
d.�naa�iaaiousdy.
�. Moiion by Council Member Abney, seconded by Council Member Jarriel to
a�prove Ceniennial Park P�vilion F2ules ancl �eservation Fe� Application.
P.���'s�� Garyg�� 19���s9�ve's9;�.
�. Mo2ion by Council MeenFier Jarriel, seconded 6y Council Mem�er Keer'� to rati�y
4he Inferlocal Agreement'ror Fire Services t�e�vve�r� Okeechobee County and Yhe
City o� Okeechob�e, including all euhibi�rs, flfiotuora C�irr�oed �o�arr �� Oaae.
16BB. CB'Q'Y 61'�'i01�919�CV l9�'�x1�'E
City AY�orney Fumero reported he will be working wifh Cify Clerk Gamiotea on ihe
Special El�czion io r�place Mr. Cale; and on updating 4he City's public recorcls poticy to
give specir"u: procedures ror r�iaining elecironic records �nd resea�•ching possible
t�chnology applications 4o assis3 the Ciiy Council in r�taining fheir public records.
VBOB. COd961��i1. CO�idfliB�BU i 5
Council Member Jarriel welcomed citizens io 6e preseni a4 meetings and voice tlieir
opinions and/or conc�rns. His commen�s were echoed 6y Council Member Kee�e.
Council Member Clark explained her infent %r limi�ting public a3f�ndance to the free
lighting ceremony.
I:(. Mayor WaYord adjourned fhe m�eCing ai 6:5a P.M.
Stabmi�Yed By: , : � .
�� .
/+ i( r �„�- .
�.% ,''.1�. � - �����C c 1>-��!,�� '
Lan� Gamio4ea, CM�, -C4ty Clerk
Please ialce noYice and b� advised 4ha4 when a person decides Yo ��peal any deaision made �Oy 4he'Cify Council
wifh respecf to any mafiier considered ai Yhis meeting, he/she may need to �nsure 4haY a Jerbafim record of the
proceeding is made, which �•ecord includes the Festimony and evidence upon utrk�ich,Yhe appeal is to be based.
Cify Clerl< media are for the sole purpose of backup Por official records of @he Clerlc., ...
December 1, 2020, Regular MeeYing, Page 2 of 2
163
VII. NEW BUSINESS CONTINUED.
E. Interim Administrator Ritter requested a presentation of the scope and design of
Cattlemen's Square in Flagler Park be provided by the Landscape Architect,
Calvin, Giordano, and Associates (CGA). Mr. Gianno Feoli, Director of
Landscape Urbanism and Design for CGA provided a 54-slide presentation with
3-D renderings which have been considered and discussed in detail over several
meetings with the Flagler Park Design Review Advisory Committee (FPDRAC).
The design budget projections provide for demolition and site preparation, new
concrete waikways, brick paver and flagstone areas, sculpture foundations,
boulders, six benches, three picnic tables, fencing, a ranch entrance from South
Park Street, 15 sculpture signs, lighting throughout the landscaping, sculptures
and walkways, plantings, sod, and irriyation, with the idea that long-term
durability with low maintenance be priority when considering materials. The main
reason for the presentation was to obtain budgetary guidance from the Council.
Page 55 of the presentation tisted the breakdown of the proposed $1,169,391.94
budget for this block/park [as presented in Exhibit 6J. The Council was clearly
taken aback with the proposed costs based on statements made that the design
was too elaborate.
The reason for beginning the Cattlemen's Square is this block/park was already
approved for Okeechobee Main Street (OKMS) to insta�l their art project featuring
a life-size cattle drive that has been funded by local ranchers and private
donations. Mrs. Bridgette Waldau, OKMS Culture and Alliance Committee Chair,
cautioned the Council on further delaying the project. The outcome of the
discussion was that Interim Administrator Ritter would meet with
representatives of OKMS and CGA to scale back the design for this block
with the understanding that the sculptures be installed properly once they
are shipped, ar�d that additional amenities may be added as necessary or
when additional funding/grants provide for them. The revised plan and
budget will be resubmitted to the FPDRAC and City Council.
FPDRAC Members Tewksbury and Scott were present and conveyed their
concerns over the costs versus wanting to create a design within Flagler Park
that would draw people to the downtown area, stimulate economic development,
and be low maintenance yet high quality to last many years. The discussion
touched on the perception of who would be funding the revitalization of FLAGLER
PARK once the master plan was adopted. It was made clear by the Council that
multiple resources and funding would be needed to see the project to fruition.
G. Council Member Clark moved to approve to adjust the final cost of [Bid No. PW
05-10-09-20 aw�rded to CW Roberts Contracting, Inc. for] Southeast 3rd Avenue
paving not to ex.ceed $7,248.00 bringing the total completed cost from $139,
848.50 to $147,096.50 [as presented in Exhibit 7]; seconded by Council Member
Keefe. Motion Carried Unanimously.
H. Motion by Council Member Keefe, seconded by Council Member Clark to
approve to adjust the final cost of [Bid No. PW 01-10-11-20 awarded to
Excavation Point, Inc, for] Southeast 6th Street paving not to exceed $4,413.61
bringing the total completed cost from $38,924.00 to $43,337.61 [as presented in
Exhibit 8]. Motion Carried Unanimously.
Council Member Keefe moved to approve the designation of India Riedel as the
City's Representative and Board Member and Gary Ritter as Alternate to the
Public Risk Management Property and Casualty Insurance Trust pursuant to the
requirements of Article 6.1 of the Bylaws [as presented in Exhibit 9]; seconded
by Council Member Clark. Motion Carried Unanimously.
J. Motion by Council Member Keefe, seconded by Council Member Chandler to
appoint Mayor Watford and Council Member Clark to the Okeechobee Utility
Authority (OUA) Work Group. Motion Carried Unanimously.
K. Council Member Keefe moved to approve disposa► of Fire Department equipment
as listed and presented in Exhibit 10 [based on the provisions in the Agreement
with Okeechobe� County for Fire Services in the City]; seconded by Council
Member Chandler. Motion Carried Unanimously.
AUGUST 3, 2021, CITY COUNCIL MINUTES, PAGE 4 OF 5
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APPLICATION AND CERTIFICATION FOR PAYMENT AIADOCUMENTG702 PAGEONEOF 2 PAGES
TO OWNER:
CITY OF OKEECHOBEE
55 SE THIRD AVENUE
OKEECHOBEE, FL 34974
FROM CONTRACTOR:
C. W. Roberts Contracting, Inc.
Pltc>II ('T: tili ?RD :\�"I[\l'Ii
VIA ARCHITECT:
APPLICATION NO: 1 R2
PERIOD FROM: 2/22/2021
PERIOD T0: 4/21 /2021
Distribution to:
�OWNER
�ARCHITECT
�CONTRACTOR
� ENGINEER
0
3372 Capitaf Circle NE PROJECT NOS: 1511725
Tallahassee, FL 32308
CONTRACT FOR: CONTRACT DATE: 2/8/2021
CONTRACTOR'S APPLICATION FOR PAYMENT TheundersignedContractorcertifiesthattothebestof[heContractor'sknowledge,
Application is made for payment, as shown below, in connection witlt tlie Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet, AIA Document G703, is attached. completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and
payments received from the Owner, and that current paymen[ shown herein is now due.
1. ORIGINAL CONTRACT SUM
2. Ne[ change by Change Orders
3. CONTRACT SUM TO DATE (Line 1 t 2)
4. TOTAL COMPLETED & STORED TO
DATE (Column G on G703)
5. RETAINAGE:
a. 0% of Completed Work $
(Column D + E on G703)
b. % of Stored Material $
(Column F on G703)
Total Retainage (Lines Sa + Sb or
Total in Column I of G703)
6. TOTAL EARNED LESS RETAINAGE
(Line 4 Less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificate)
8. CURRENT PAYMENT DUE
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)
$ ]39,848.50 v
$ 0.00
$ 139,848.50 t%�
$ 147,096.50
0.00
$ 0.00
$ 147,096.50
$ 0.00
� 149,096.50
-7,248.00
CONTRACTOR: C. W. Roberts Contracting, Inc.
Digitally signed by Benjamin B
Benjamin B Baummier ga�mm�e�
By: Date: 2021.06.22 09:12:15 -04'00' j�ytC: o610812021
Pro�ect Manager
State of: County of:
Subscribed and swom to before me this day of
Notary Public:
My Commission expires:
ARCHITECT'S CERTIFICATE FOR PAYMENT
[n accordance with the Contract Documenu, based on on-site observations and the data
comprising the application, the Architect certifies to the Owner that to the best of the
Architect's knowledge, information and belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor
is entitled ro payment of the AMOiJNT CERTIFIED.
AMOLINT CERTIFIED . . . . . . . . . . . $ $ 147,096.50
(Attach expinnalion ifomouret certired diffeis.jrom the amount app/ied. lnitial all.�gures on thrs
Applicalion nnd onthe Cyntin`uatlon Sheet lhat nre changed to conform wid� !he amoam! cerfified.)
ARCHI�CT: �`---`d, �, f
BY: V i�i ��.� -- __�> Date �`.t.�.e -'�r
. — ¢
This Certificate is not gotiable. The AMOLJNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of tl�e Owner or Contractor under this Contract.
AIA DOCUMENT G702 � APPLICATION AND CERTIFICATION FOR PAYMENT � 1992 E�ITION � AIA ��01992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW VORK AVE., N.W., WASHINGTON, DC 2000G5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of DocumenYs Authenticity from the Licensee.
�-i 1
ESTIMATE OF CONSTRUCTION FOR
CONTRACTOR : C. W. ROBERTS CONTRAC7ING. INC.
ADDRESS : 3372 CAPITAL CIRCLE NE
TALLAHASSEE. FLORIDA 32308
TELEPHONE: (850) 385-5060
CONTACT: ToddCpstleberry
EMAIL: icasiicbemi��o�.rcorJrarnr.a.<c�n
TEtEPHONE : �772) 28&-0951
PROJECT NAME :
OWNER/GC :
OWNER PROJECT NO.:
FINANCIALPROlECTID:
F. A. P. NO.:
ENGINEER :
AODRE55 :
ATTENTION :
EMAIL :
7ELEPHONE :
SE 3RD AVENUE
CITY OF OKEECHOBEE
PW OS-10-09-20
55 SE THIRD AVENUE
OKEECH08EE. FL 3a974
DAVID AILEN
v,-..:.,. sr�� v:1"X" i-_I �lr�' �1'(i��n
CWR PROJECT NO.: 1511725
BEGIN PAY PERIOD : 2/22/2021
END PAY PERIOD : 4/21 /2021
PAY RE�UEST NO. : I R2
EARNINGS TO - DATE : 147,096.50 147,096.50
LESSRETAINAGE: 0.00 0.00
LESS PREVIOUS AMOUNT PAID : 0.00
NET DUE THIS RE�UEST: 147,096.50 147.096.50
CWR REVENUE: 147,096.50
ORIGINAL CONiRACT AMOUNT : 139,848.50
CHANGE ORDERS ( ), ( ), ( ) : 50.00
. FUEL 3 61T ADJUSTMENTS : 0.00
. PRESENT CONTRACT AMOUNT: 139,848.50
Conditional Final Release of Lien
The undersigned lienor, in consideration of the sum of $147,096.50 upon receipt, hereby waives
and releases its lien and right to claim a lien for labor, services or materials furnished to Citv of
OI<eechobee. on the job of SE 3�d Avenue to the following described property:
SE 3�d Avenue Pavement Improvements
FDOT FPN 440372-1
I hereby acl<nowledge that the statements contained in the foregoing waiver and release of lien
are true and correct.
C.W. Roberts Contracting, Inc.
Address: 8530 SW Jayme Way
Palm City, FL 34990
Dated on: 07/2/2021
State of: Florida
County of: Leon
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By: �`" �=%�y.,�` r---- — _ � ..
Printed Name: Matthew Steele
The foregoing instrument was acicnowledged before me this 2nd day of July, 2021 by Matthew
Steele who is personally known to me.
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Notary Public
My Commission Expires: �'',�' " , -'C� � �
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Final Release of Lien
The undersigned lienor, in consideration of the sum of $147,096.50 upon receipt, hereby waives
and releases its lien and right to claim a lien for labor, services or materials furnished to Citv of
Okeechobee on the job of SE 3rd Avenue Improvements to the following described property:
SE 3rd Avenue Improvements
OI<eechobee, FL
I hereby acknowledge that the statements contained in the foregoing waiver and release of lien
are true and correct.
C.W. Roberts Contracting, Inc.
Address: 8530 SW Jayme Way
Palm City, FL 34990
Dated on: 09/21/2021 By; � ,
Printed Name: Robert Delisle
State of: Florida
County of: Leon
The foregoing instrument was acknowledged before me this 215t day of September, 2021 by
Robert Delisle_who is personally I<nown to me.
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