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2023-07-18 VII. E. Bid No. PW 04-10-5-23, Exhibit 9 • • Revised Exhibit 9 v6 CITY OF OKEECHOBEE, PUBLIC WORKS 7/18/2023 ityOkeechobee Memo FLORIDA•founded 1915 To: Gary Ritter,City Administrator From: David Allen, Public Works Director Date: 7/5/2023 Re: Request for award of SE 4th Street Drainage improvements Project PW 04-10-05-23 to Johnson-Davis Inc The Public Works Department is requesting a Purchase Order in the amount of$218,500.00 to Johnson- Davis Inc for construction services needed to install a stormwater hydrodynamic separator on the 48" stormwater main line in the 500 block of SE 4th Street.The hydrodynamic separator is being installed to provide water quality improvements to the stormwater being discharged into Taylor Creek. Two bids were received for the project.The total bid amount for each of the vendors is: Johnson-Davis Inc. $190,000.00 Boromei Construction Inc $277,900.00 A detailed bid tabulation for the project, along with the actual bid documents from Johnson-Davis Inc. are attached.The Purchase order request for the project includes a 15% contingency for the potential need for additional concrete around the hydrodynamic separator.The separator to be used for the project was changed during the bid process.The contractor selected identified an alternate structure which was evaluated by the engineer. It was determined that alternate structure was both more cost effective and provided better nutrient reduction.The engineer is working with the hydrodynamic separator manufacturer to determine if additional concrete will be needed. This project is a Florida DEP Stormwater improvement funded project.The grant amount from FDEP is $300,000.00 • • BID TABULATION SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 Johnson-Davis Inc Boromei Construction Inc ITEM NO. DESCRIPTION UNIT MEASURE EST.QTY. UNIT PRICE AMOUNT Unit price AMOUNT 1 MOBILIZATION LS 1 $10,000.00 $10,000.00 $25,000.00 $25,000.00 2 PROFESSIONAL VIDEOTAPING OF SITE CONDITIONS LS 1 $1,000.00 $1,000.00 $2,500.00 $2,500.00 3 SURVEY LAYOUT AND RECORD DRAWINGS LS 1 $2,000.00 $2,000.00 $6,500.00 $6,500.00 4 MAINTENANCE OF TRAFFIC LS 1 $2,000.00 $2,000.00 $5,000.00 $5,000.00 5 HYDRODYNAMIC SEPARATOR LS 1 $150,000.00 $150,000.00 $235,000.00 $235,000.00 6 45'RCP LS 1 $5,000.00 $5,000.00 $400.00 $400.00 7 SITE RESTORATION LS 1 $20,000.00 $20,000.00 $3,500.00 $3,500.00 TOTAL BID AMOUNT (Based on Bid Unit Prices&Estimated Quantities) $190,000.00 $277,900.00 Posted: June 22,2023 @ 4:00 P.M. To be removed : July 3,2023 @ 4:00 P.M. • • Johnson-Davis,Inc. OREM 19 604 Hillbrath Lantana,FLL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT A CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 NO LOBBYING AFFIDAVIT STATE OF FLORIDA COUNTY OF Palm Beach This 14th day of June , 2023 , Wm. Clark C. Cryer being first duly sworn, deposes and says that he/she is the authorized representative of Johnson-Davis, Incorporated (Name of Contractor, Firm or Individual) respondent to the attached request for Bid, or qualifications and/or any other solicitation released by City of Okeechobee, and that the Bidder and any of its age. ag -es to abide by the City of Okeechobee no lobbying restrictions in regard to this solicit- ion. A •-nt The foregoing instrument was acknowledged before me by means of 0 physical presence or 0 online notarization, this iLi�?f day of .v$ , 20 z , by G✓.t�;:,f,,:.. CA view , who is personally known to me or produced as identification. 1. . 4if JAMESPATRICKAAISLER 1 N Ty Public Signature !feel Notary Public•State of Florida Commission 4 HH 254617 1 c� My Comm.Expires Aug 11,2026 ► Commission No. dot/ Bonded through Natioral Notary Assn. 1 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 247 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT B CITY OF OKEECHOBEE SE 41." STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 ANTI-COLLUSION STATEMENT AND NO GIFT STATEMENT Date: 6/14/2023 Anti-collusion statement: The below-signed Bidder has not divulged to, discussed, or compared his/her Bid with other Bidders and has not colluded with any other Bidder or parties to a Bid whatsoever. No gifts statement: No premiums, rebates, gifts or gratuities are permitted with, prior to, or after submission of the Bid. Any such violation will result in rejection of the Bid and removal from the Bid list(s). Firm Name: Johnson-Davis, Incorporated By(printed/typed): Wm. Clark-C; Cryer By(signature): (Wm.Clark C.Cryer ice President) Title: Vice Pre ' ent Mailing Address: • 604 Hillbrath Drive City, State, Zip: Lantana, FL 33462 Telephone No.: (561) 588-1170 • City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 248 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT C CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 PROPOSER'S CERTIFICATION I have carefully examined this Request for Bid (BID)/Request for Proposals (RFP)/ Request for Qualifications (RFQ), which includes scope, requirements for submission, general information and the evaluation and award process. I acknowledge receipt of the following addenda. Addendum# 1 Date: 6/5/2 0 2 3 Addendum # Date: Addendum # 2 Date: 6/9/2 0 2 3 Addendum# Date: Addendum # Date: Addendum # Date: I hereby propose to provide the services requested in the City's BID/RFP/RFQ and, if awarded, to enter into the attached draft contract. I agree that the terms and conditions of the City's BID/RFP/RFQ shall take precedence over any conflicting terms and conditions submitted with my proposal and agree to abide by all conditions of the BID/RFP/RFQ, unless a properly completed Exceptions to BID/RFP/RFQ form is submitted. I acknowledge that the City may not accept the proposal due to any exceptions. I certify that all information contained in my proposal is truthful to the best of my knowledge and belief. I further certify that I am duly authorized to submit this proposal on behalf of the Company as its agent and that the Company is ready, willing and able to perform if awarded a contract. I further certify, under oath, that this proposal is made without prior understanding, agreement, connection, discussion or collusion with any other person, Company or Corporation submitting a proposal for the same product or service; no gratuities, gifts or kick-backs were offered or given by the Bidder or anyone on its behalf to gain favorable treatment concerning this procurement; no City Council member, employee or agent of City of Okeechobee or of any other Company is interested in said Bid; and that the undersigned executed this Proposer's Certification with full knowledge and understanding of the matters therein contained and was duly authorized to do so. Johnson-Davis, Incorporated 604 Hillbrath Drive Na o siness Mailing Address Lantana, FL 33462 City, State &Zip Code f L-✓L___ (561) 588-1170 / (561)585-3252 Authoriz Signature Telephone Number/Fax Number Wm. ark C. Cryer, Vice President ccryer@johnsondavis.com N�at6e &Title, Typed Email Address STATE OF FLORIDA COUNTY OF 61s.:K gh'e ea./ The foregoing instrument was acknowledged before me by means of 0 physical presence or 0 online notarization, this i'/?2? day of ,,z , 202; , by 1-t1--44saR.: , who is personally known to me or produced as identification. JAMES PATRICK MSLER ' Notary Public•State of Florida tary Public Signature , , Commifsion x NH 254617 Commission No. il�1 ..,''''''' My Comm.Expires Aug 11,2026 Bonded through National Notary Assn. City of Okeec Project No. PW 04-10-05-23 Public Works Department 249 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT D CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 SWORN STATEMENT PURSUANT TO SECTION 287.133 (3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to CITY OF OKEECHOBEE, FLORIDA by: Wm. Clark C. Cryer, Vice President (print Individual's name and title)for: Johnson-Davis, Incorporated (print name of entity submitting sworn statement) whose business address is 604 Hillbrath Drive, Lantana, FL 33462 and (if applicable) its Federal Employer Identification Number(FEIN) is: 59-1753888 (If the entity has no FEIN, include the Social Security Number of the Individual signing this sworn statement: - - .) 2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or of the United States, including but not limited to, any Bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentations. 3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989,as a result of a jury verdict, non jury trial, or entry of a plea of guilty or nolo contendere. 4. I understated that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means: a. A predecessor or successor of a person convicted of a public entity crime; or b. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 250 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which Bids or applies to Bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term"person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. 6. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Indicate which statement applies). XI Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. 0 The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However,there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list (attach a copy of the final order). I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGO t 0 io F ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. Signature (Wm.Clark C.'ryer,Vice President) STATE OF,FL• IDA COUNTY • The foregoing instrument was acknowledged before me by means of 0 physical presence or❑ online notarization, this i9! day of , 2023 , by ui./r«rar, vele , who is personally known to me or produced as identification. ;:'4 7r; Notary Public JAMES 5 tATRICK o Florida tab ary blic Signature �'' Commission*NH 2546'7 or M. My Comm.Expires Aug t+,2026 Bonded through National notary Assr. ' Commission No. 444, City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 251 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT E CITY OF OKEECHOBEE SE 4T" STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all Bidders must disclose if any City of Okeechobee employee(s), elected official(s), or any of its agents is also an owner, corporate officer, director, agent, employee, etc., of their business. Indicate either"yes" (a City employee, elected official or agent is associated with your business), or"no". If yes, give person(s) name(s) and position(s)with your business. YES NO X Name(s) Position(s) Firm Name: Johnson-Davis, Incorporated By (Printed): Clar C. Cryer By(Signature . (Wm.Clark ryer,Vice President) Title: Vice President Address: 60 Hi rath Drive, Lantana, FL 33462 Phone Number: (561) 588-1170 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 252 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT F CITY OF OKEECHOBEE SE 4111 STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 IMMIGRATION LAW CERTIFICATION City of Okeechobee will not intentionally award City contracts to any Contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324 a(e) (Section 274a(e) of the immigration and nationality act ("INA")). City of Okeechobee may consider the employment by any Contractor of unauthorized aliens a violation of Section 274A(e) of the INA. Such violation by the recipient of the employment provisions contained in Section 274A(e) of the INA shall be grounds for unilateral cancellation of the contract by City of Okeechobee. Respondent attests that it is fully compliant with all applicable immigration laws, specifically relating to the 1986 immigration act and subsequent amendments. J so Davis, Incorporated Company Name 'gnature (Wm.Clark C.Cryer,Vice President) ice President Title 6/14/2023 Date STATE OF FLORIDA /� COUNTY OF /'.�Cw, 1"5a�'.cTc..c,' The foregoing instrument was acknowledged before me by means of 0 physical presence or 0 online notarization, this /40.Y day of , v , 2024, by ts".4t�.7,0,,-, , who is personally known to me or produced as identification. 1>rtary Public Signature ( i►01 JAMES PATRICK AMSLER •$ -`F.:\ Notary Public•State cf Florida r � > `= Commission=NH 254617 Commission No. //4% 2 G•'a ? � or My Comm.Expires Aug l t.2026 P Bonded through National Notary Assn. 0 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 253 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 ATTACHMENT G Fax: (561)585-3252 CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 DRUG-FREE WORKPLACE CERTIFICATION THE BELOW SIGNED Bidder/proposer CERTIFIES that it has implemented a drug-free workplace program. In order to have a drug-free workplace program, a business shall: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violation of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace,the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under quote a copy of the statement specified in subsection 1. 4. In the statement specified in subsection 1, notify the employees that, as a condition of working on the commodities or contractual services that are under quote, the employee will abide by the terms of the statement and will notify the employer of any conviction or plea of guilty or nolo contendere to any violation occurring in the workplace no later than five (5) days after,such conviction. 5. Impose a sanction on, or require the satisfactory participation in, drug abuse assistance or rehabilitation program if such is available in the employee's community, by an employee who is convicted. 6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign this statement, I certify that this Firm complies fully with the above require nts.��/'Signature. Date: 6/14/2023 (Wm lar .Cryer,Vice President) Company: Jo on-Davis, Incorporated Name: Wm. Clark C. Cryer Address: 604 Hillbrath Drive Title: Vice President Lantana, FL 33462 Phone Number: (561) 588-1170 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 254 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT H CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 REFERENCE FORM Client Name: Martin County Board of County Commisoners Client Phone Number: (772) 288-5400 Client E-mail: lhuber@martin. fl . us Service Dates: Beginning 12/2017 End 8/2018 Estimated Contract Amount: $7 0 4, 675 . 00 Description of the services performed as they directly relate to the work of this Request for Bid: Install three baffle boxes . City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 255 • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT H CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 REFERENCE FORM Client Name: Hardrives Client Phone Number: 561-737-3555 Client E-mail: info@hardrivespaving. com Service Dates: Beginning 4/2015 End 4/2015 Estimated Contract Amount: $10, 660 . 00 Description of the services performed as they directly relate to the work of this Request for Bid: Install Baffle Box. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 255 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT H CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 REFERENCE FORM Client Name: Town of Sewalls Point Client Phone Number: (772) 287-2455 Client E-mail: jcapra@gocaptec . corn Service Dates: Beginning 10/2020 End 9/2022 Estimated Contract Amount: S1, 079, 337 . 30 Description of the services performed as they directly relate to the work of this Request for Bid: Refurbish two existing Baffle Boxes with materials provided by EcoSense . City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 255 • • EXHIBIT B CITY OF OKEECHOBEE SE 4th STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 BID UNIT PRICE SCHEDULE ITEM NO UNIT DESCRIPTION MEASURE EST.QTY. UNIT PRICE AMOUNT 1 MOBILIZATION LS 1 10, 000 10, 000 . 00 2 PROFESSIONAL VIDEOTAPING OF SITE CONDITIONS LS 1 1, 000 1 . 000 . 00 3 SURVEY LAYOUT AND RECORD DRAWINGS LS 1 2, 0 0 02 , 000 . 00 4 MAINTENEANCEOFTRAFFIC LS 1 2, 000 2, 000 . 00 5 HYDRODYNAMIC SEPARATOR LS 1 150, 000 150, 000 . 00 6 48"RCP LF 1 5, 000 5, 000 . 00 7 SITE RESTORATION LS 1 20, 000 20, 000 . 00 TOTAL BID AMOUNT (Based on Bid Unit Prices&Estimated Quantities) 190, 000 . 00 Bidders Company Name Johnson-Davis Incorporated NOTE: This Bid is on a unit price basis. The total estimated amount is for Bid comparison purposes only. The Contractor should field verify the actual site conditions prior to time of bidding and before submitting the Bid proposal. The Contractor should read the special conditions and the requirements for insurance before submitting a Bid proposal. The Contractor shall furnish the City of Okeechobee with a Payment and Performance Bond in 100 percent (100%) of the total estimated amount of the contract. The Payment and Performance Bond shall continue in effect for one (1) year after completion and acceptance of the work as guarantee against construction defects. The Contractor in his Bid shall include the cost of said bond. I have attached the required 5 percent (5%) Bid Security to this Bid. Bidder' Cason-Davis Incorporated Date: 6/21/2023 { (Company Name) By: Title: Vice President (Signature) am Cryer Email: ccryer@johnsondavis . com (Printed Name) Mailing Address: 604 Hillbrath Drive, Lantana, FL 33462 Office Number: 561-588-1170 Fax Number: 561-585-5252 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 213 • • Johnson-Davis,Inc. 604 Hil!brath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 SECTION I CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 GENERAL INFORMATION All responses which comply with the requirements of this Bid will be considered. Submittals must be made in the official name of the Firm or Individual under which business is conducted (showing official business address)and must be signed in ink by a person duly authorized to legally bind the person, Partnership, Company, or Corporation submitting the response to this Bid. Two clearly identified originals and one copy of your bid submittal are required. Bid submittals will be received by the General Services Department until 3:00 p.m. on June 14, 2023. Bid submittals are to be mailed, hand-delivered, and/or Express Mail to: City of Okeechobee General Services Department 55 S.E. 3rd Avenue, Room 101 Okeechobee, FL 34974 The submitting offeror is required to have printed on the sealed envelope or wrapping containing their submission their Company name and return address, the Bid Number, Title, Opening Date and Time. Bids received after the date and time specified above shall be returned to the sender unopened. Facsimile or emailed bids will not be accepted. All bids shall remain in effect for a period of ninety(90)days after the last day on which bids must be submitted. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 2 • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 SECTION II CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 SUBMISSION REQUIREMENTS The bidder shall submit two (2) original clearly identified originals and one copy of the following: 1. Bid Documentation Form (Section III) 2. Minimum Qualifications for Bidders Form (Section IV) and three (3) references (Attachment H) 3. Bid Bond 4. Performance Bond 5. Bid Unit Price Schedule (Section VII, Exhibit B) In addition to the above, please complete the following forms that must be returned with your bid: Attachment A— No Lobbying Affidavit Attachment B—Anti Collusion Statement and No Gift Statement Attachment C—Proposer's Certification Attachment D—Sworn Statement Pursuant to Section 287.133(3)(a), FL Statutes on Public Entity Crimes Attachment E—Conflict of Interest Disclosure Attachment F— Immigration Law Certification Attachment G—Drug Free Workplace Certification Attachment H— Reference Form City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 3 • • Johnson-Davis,Inc. 604 Hil!brath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 SECTION III CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS, FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 BID DOCUMENTATION Johnson-Davis, Incorporated (BIDDERS COMPANY NAME) City Council City of Okeechobee 55 S.E. 3rd Avenue Okeechobee, FL 34974 I have received the documents titled CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS, FDEP GRANT AGREEMENT LPQ0007, Project No. PW 04-10-05-23. I have also received addendum number j through 1 and have included these provisions in my Bid. I have examined both the Bid documents and the construction site and submit the following Bid in which I agree: 1. To hold my Bid open until an agreement has been executed between the City of Okeechobee and accepted Bidder, or until ninety(90)days after Bids are opened, whichever is longer. 2. Regarding the Disposition of Bid Security: to accept the provisions of the Instructions to the Bidders. 3. To accomplish the work included in, and in accordance with the Contract Documents, if this Bid is accepted. 4. To start work within 60 calendar days from the Notice to Proceed and there after completing the work within 60 calendar days of commencement of work. 5. Regarding Compensation for the proposed work: if this Bid is accepted, I will construct this project on a unit price basis as reflected in the Bid Unit Price Schedule, Exhibit B of this agreement. Payment will be made upon invoice after completion of all work. NOTE:The City shall not be liable to pay interest on any unpaid balance. Vendor is solely responsible for all taxes, withholding, or social security obligations. 6. Regarding the Award of the Contract: if I am awarded a contract for this project, I understand that the award may be for all or any portion thereof, of the items listed under the Bid Unit Price Schedule. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 4 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Bid hnson-Davis, Incorporated Date: 6/14/2023 (Company Name) By: Title: Vice President (Signature)(Wm.Clark C.Crier,VP) Wm. Clark C. Cryer Email: ccryer@johnsondavis.com (Printed Name) Mailing Address: 604 Hillbrath Drive, Lantana, FL 33462 Office Number: (561) 588-1170 Fax Number: (561) 585-3252 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 5 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 SECTION IV CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 MINIMUM QUALIFICATIONS FOR BIDDERS Minimum Qualifications: 1.0 Experience 1.1 Bidder must have at least 3 years of experience in providing commercial storm water improvement services including pipe, and structure installation and site restoration. 1.2 Bidder has successfully completed at least 6 storm water improvement projects in the last three years. 2.0 References 2.1 Bidder must provide at least 3 verifiable references of similar work as referenced in section 1.0 above. 2.2 For each reference, Bidder shall submit a completed Reference Form provided in Attachment H. provide the client name, client phone number, and client e- • mail address. 2.3 Bidder shall provide a written description of the services performed in sufficient detail as they directly relate to the work of this Request for Bid. The description shall include the dates of the period that the Bidder provided the services as well as the contractual amount of the services provided. 2.4 The City, in its sole discretion, may reject any and all bids if the City is not able to verify the references provided. • 3.0 Discriminatory Vendor List 3.1 In accordance with Section 287.134, Florida Statutes, an entity or affiliate who has been placed on the Discriminatory Vendor List, kept by the Florida Department of Management Services, may not submit a bid on a contract to provide goods or services to a public entity; may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor or consultant under a contract with any public entity; and may not transact business with any public entity. 4.0 Bidder certifies that 4.1 Bidder meets the qualifications listed in Section IV, 1.0 above. 4.2 Bidder has never failed to complete work awarded under a contract due to circumstances that were under Bidder's control. 4.3 The Bidder has not been placed on the Discriminatory Vender List kept by the Florida Department of Management Services as listed in section 3.0 above. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 6 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Bidder: son-Davis, Incorporated Date: 6/14/2023 ' (Company Name) By: Title: Vice President (Signature)(Wm.Clark C.Cryer,VP) 6. m. Clark C. Cryer Email: ccryer@johnsondavis.com (Printed Name) Mailing Address: 604 Hillbrath Drive,Jupiter, FL 33462 Office Number: (561) 588-1170 Fax Number: (561) 585-3252 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 7 • ivnnomrvavia,nw. 411 N/A Per Section 5.02 of Bid Documents Proposal is Under $200k 60 Lantana,FL 4Hiabrath 3346Dr.2 COMMON LAW PERFORMANCE BOND Phone:(561)588-1170 Fax: (561)585-3252 BY THIS BOND, know that as Principal, herewith called [CONTRACT, -], Business Address , Business Phone , and , as , hereinafter called SURETY, Surety Address Surety Phone Number , are bound to City of Okeechobee, as Obli• e, herein called CITY, in the amount of Dollars ($ ) for paym• nt of which CONTRACTOR and SURETY bind themselves, their heirs, personal representativ: , executors, administrators, successors and assigns, jointly and severally, with reference to a writ -n CONTRACT entered into by CONTRACTOR and CITY, for the following: Contract Number: PW 04-10-05-23 Contract Title: CITY OF OKEECHOBEE SE 4TH STREET DRAIN • E IMPROVEMENTS, FDEP GRANT AGREEMENT LPQ0007 General Description of Project: The Contractor shall furnish all labo• and materials necessary to perform the hydrodynamic separator installation, as shown on the pl. s in Okeechobee, Florida. The project shall include all piping, fittings, accessories and appurtena-ces, site restoration for all work, temporary provisions to maintain functionality of the drainage syst- , all testing, removal of the existing piping as specified, compliance with permit conditions, byp.ss pumping for stormwater mains, maintenance of traffic in accordance with City standards, an• any other items as described in these documents to provide a complete and functional system. Directions: THE CONDITION OF THIS BOND is that if the [CO RACTOR]: 1. Performs said contract in accordance with its t-rms and conditions; and 2. Pays CITY all losses, damages (direct and ••nsequential including delay or liquidated damages), expenses, costs, and attorney's fees, inci •ing appellate proceedings, that CITY sustains because of a default by CONTRACTOR under the CONTRACT; and 3. Pays CITY any and all other amou due CITY by CONTRACTOR because of a default by CONTRACTOR under the CONT' 'T; and 4. Performs the warranty, extended .rranty and guarantee of all work and materials furnished under the CONTRACT for the time sp- ified in the CONTRACT; THEN THIS BOND IS VOID, 0 ERWISE, IT REMAINS IN FULL FORCE. If there is no CITY defaul , the SURETY's OBLIGATIONS UNDER THIS BOND shall arise after SURETY has received no e of CITY's declaration of default of CONTRACTOR in accordance with the terms and conditions of e CONTRACT (including notice and cure periods), so that within 20 days of CITY's declaration CONTRACTOR's default, SURETY shall either (1) arrange for the CONTRACTOR, wi the written consent of the CITY, to timely perform and complete the contract or (2) undertake to mely perform and complete the contract either by retaining another contractor approved by the CITY or undertaking to do the contract itself. SURETY shall be liable for any and all delays cause• •y the CONTRACTOR, SURETY, and/or the replacement contractor(s) provided by the SURETY. RETY's failure to take such action shall be deemed to be a default on this Bond, thus entitling t - CITY to complete the contract with another contractor and recover all resulting damages, includins, but not limited to, all direct and consequential damages including delay or liquidated damages, engineering and architectural fees, as well as any and all legal costs and attorney's fees. y of Okeechobee Project No. PW 04-10-05-23 .ublic Works Department 18 • • bU4 nmoram ur. Lantana,FL 33462 Phone:(561)588-1171 Any changes in or under the Contract Documents do not affect the Surety's obligation undtartM Flarnb Surety hereby waives notice of any alteration or extension of time made by the Owner. Any suit un•-r this bond must be initiated before the expiration of the limitation period applicable under FI• ida Statutes. IN WITNESS WHEREOF, this instrument is executed this day of , 2$_ WHEN THE PRINCIPAL IS AN INDIVIDUAL: Signed and delivered in the presence of: By: By: (Witness) Individual P ncipal WHEN THE PRINCIPAL OPERATES UNDER A TRADE NAME: Signed and delivered in the presence of: By: By: (Witness) Signature of Individual By: (Witness) WHEN A PARTNERSHIP: Signed and delivered in the presence of: By: By: (Witness) Partner By: (Witness) WHEN THE PRINCIPAL IS A C• -PORATION: ATTEST: By: (Type Corporate Princip. Name) President By: (Secretary) SURETY: ATTEST: (Surety Seal By: (Type Corporate Surety Name) SURETY By: (Secretary) ty of Okeechobee Project No. PW 04-10-05-23 Public Works Department 19 • • Johnson-Davis,Inc. 604 Hillbrath Dr. ATTORNEY-IN-FACT Lantana,FL33462 Phone:(561)588-1170 Fax: (561)585-3252 By: Name NOTE 1: Surety shall provide evidence of signature authority, i.e., a certified copy of Power o Attorney. IMPORTANT: Surety companies executing BONDS must appear on the Treasury Devartment's most current list (Circular 570 as amended) and be authorized to transact business in the tate of Florida. ATTACH a certified copy of Power-of-Attorney appointing individual Attorney-in act for execution of Performance Bond on behalf of Surety. The Common Law Performance Bond and the Payment Bond and the co -red amounts of each are separate and distinct from each other. y of Okeechobee Project No. PW 04-10-05-23 •ublic Works Department 20 • 4'- Liberty:' Liberty Mutual Surety P_ . Mut.UaL April 17, 2023 Re: Johnson-Davis Incorporated- Surety Capacity To Whom It May Concern: Johnson-Davis Incorporated is a highly regarded and valued client of Liberty Mutual Insurance Company ("Liberty Mutual"). It has been our privilege to provide surety bonds for Incorporated for over 25 years. Currently,we provide a bond program of$50,000,000 per project,with an overall backlog of $150,000,000. We are confident in their ability to perform. Liberty Mutual is an A(Excellent)A.M. Best rated insurance company in Financial Size Category XV($2 Billion or greater). Please note that the decision to issue performance and payment bonds is a matter between Johnson- Davis Incorporated and Liberty Mutual,and it will be subject to standard underwriting at the time of the final bond request,which will include but not be limited to the acceptability of the contract documents, bond forms and financing. We assume no liability to third parties or to you if for any reason we do not execute said bonds. If you have any questions or need any additional information, please do not hesitate to contact me at (612)349-2464. Sincerely, Liberty Mutual Insurance Company Ted Jorgensen Attorney-in-Fact Member of Liberty Mutual Group • • sr This Power of Attorney limits the acts of those named herein,and they have no authority to r bind the Company except In the manner and to the extent herein stated. ��1•c% Liberty Liberty Mutual Insurance Company Pitk .Mutual. The Ohio Casualty Insurance Company Certificate No:8207173-190054 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duty organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the'Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint. Brian J. Ocstreich;C.White;Emily White;Joshua R.Loftis;Lin Ulven;Melinda C.Blodgett;Nathan Weaver,Nicole Stillings;R.C.Bowman;R.W.Frank;Rachel Thomas; Ross S.Squires;Sandra M.Engstrom;Tcd Jorgensen;Tina L.Domask all of the city of Minneapolis slate of MN each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 24th day of January , 2022 . Liberty Mutual insurance Company v*MU& vt'r IN, , trisu p The Ohio Casualty Insurance Company �op�oaa0,2 rA.f� yJQ`03'0,4-cfy `c,P�oPPoo,�r44 West American Insurance Company S . ot1+ c3 6r+ d:• :' fret,ilk vi ;1912y c c 1919 n a 1991 o viE y Y4- s cHose as y�=Py q,Mr3'�aa�o P� kaoH� a�$ RYtBy: ��js �_U to David M.Carey,Assistant Secretary c 0 State of PENNSYLVANIA ' 5 County of MONTGOMERY ss o b. , 0 On this 24th day of January , 2022 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance ) o co Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes 2 0 > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. >a m cc at.0 IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. cn in n' O C Q 1.. y,AHr•ti• ComKx.veatrh 01 Pennsykanlr•Notary SOW T= W .. 4f.f Teresa Platens.Notary P,Mo N.Ea .m. C + t v MNegnmcry County ��2 oE E OF M9 canrnesbn exWres March 28,2025 By: N g, T Comm asronnumber 112a014 �- y.. lb).Iwo.-_.N Malodor.lvTe; arnaUncialrti a rrobrp 4astia,Notary Public o coy 4rry v� °v •C.. This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company,Liberty Mutual 3 op o,E Insurance Company,and West American Insurance Company which resolutions are now in full farce and effect reading as follows: est ao. Y. ARTICLE IV—OFFICERS:Section 12.Power of Attorney. ao 0En. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the m . c President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety g= its m any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall c la, o' have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such�o a Z 0instruments shell be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the I3 arei provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. ti a ARTICLE XIII—Execution of Contracts:Section 5.Surety Bonds and Undertakings. 1 Any officer of the Company authorized for that purpose in writing by the chakman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surely obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such Instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attomeys.in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds.recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanicatiy reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 17th day of April .2023 • 1NSU �tg IN,N a 048UR oppo tl'�yOm 4iJ AwPO t^ro�y� �.%% *pea -4-% Y s.1912 0,.. 1919 e o s 1991 0 C.G 4'r, B r4:4) 14)6/i7 o'4Pumvsa i 'rs ern,."r- aD� y Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co 02/21 • • Johnson-Davis, Incorporated 604 Hillbrath Drive Lantana, FL 33462 Phone: (561)588-1170 Fax: (561)585-3252 Surety Company(Bonding Company): 4, Liberty Mutual Insurance Company 3011 Sutton Gate Dr.,Suite 300,Suwanee,GA 30024 Brad Schramm,(678)735-1181 Surety's resident agent for service of process: 4, CURRENT: Ted Jorgensen,CSDZ,225 South 6th Street,Suite 1900,Minneapolis,MN 55402,D:(612)349-2464 Kim Niv,Liberty Mutual Insurance Company,620 N.Wymore Road,Suite#200,Maitland,FL 32751, D:(407)478- 6836(Florida Resident Agent)(as of 12/17/2021) • Bonding Agent: 1 CSDZ 1 1600 Aspen commons,Suite 990, Middleton,WI 53562 -Primary Contact: Nicole Stillings,Surety Service Advisor/Team Lead,(608)242-2551, NStillings@csdz.com -Secondary Contact:Ted Jorgensen,Client Executive/Shareholder, (612)349-2464, TJorgensen@csdz.com • Jonnson-Loaves,Inc. 604 Hillbrath Dr. ACORD CERTIFICATE OF LIABILITY INSURANC antana FL 33462 DATE(MWDDIYYYY) hone:(561)588-117t 08/11/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS l' ii fICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME CT Harrison Vaughn Vaughn Risk Management IaHCNN.Ext), (561)289-0586 FAX(Am.No): (561)768-4958 222 US Highway 1 St 208D noo ass; harrisonv@vaughnrm.com INSURER(S)AFFORDING COVERAGE NAIC# Tequesta FL 33469 INSURER A: NATIONAL FIRE INS CO OF HARTFORD 20478 INSURED INSURER B: CONTINENTAL INS CO 35289 Johnson-Davis Incorporated INSURER C: VALLEY FORGE INS CO 20508 604 Hillbrath Drive INSURER : HOMELAND INS CO 38210 INSURER E Lantana FL 33462 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP w LIMITS LTR INSD vD POLICY NUMBER IMM/DD/YYYY1 IMM/DDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO D CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 15.000 A x x 7033967643 07/01/2022 07/01/2023 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X WI: LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000.000 (Fa accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident B AUTOS ONLY AUTOS X x 7033968744 07/01/2022 07/01/2023 ) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY __ AUTOS ONLY (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS UAB CLAIMS-MADE X x 7033984636 07/01/2022 07/01/2023 AGGREGATE $ 10,000,000 DED X RETENTION$ 0 PR/COMP OPS AGG $ 10,000,000 WORKERS COMPENSATION X STATUTE W- AND EMPLOYERS'LIABILITY - C OANY FFICER/MEMBER EXC EXCLUDED?ECUTIVE YN" NIA x 7033972535 07/01/2022 07/01/2023 E.L EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Dyes, IPTI t:e under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 Pollution Liability D 7930119810000 07/01/2022 07/01/2023 Each Occurrence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is listed as an additional insured with respect to General Liability for ongoing and completed operations,Automobile Liability and Umbrella Liability on a primary noncontributory basis when required by written contract.A waiver of subrogation In favor of additional insureds applies to Workers Compensation,General Liability,Automobile Liability,Umbrella Liability when required by written contract.Umbrella coverage is follow form to the GL. 30 day notice of cancellation, 10 day notice for non-payment. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Johnson-Davis,Inc. 604 Hillbrath Dr. AUTHORIZED REPRESENTATIVE Lantana FL 33462 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • • Johnson-Davis,Inc. 604 Hillbrath Dr. CNA Fax: (56na, )585-32 Business Auto Policy Phone:(561)588-1170 Fax: (561)585-3252 Policy Endorsement I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILITY COVERAGE A. Who Is An Insured The following is added to Section II, Paragraph A.1., Who Is An Insured: 1. a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the date of inception of this Coverage Form; provided that, b. The insurance afforded by this provision A.1. does not apply to any such entity that is an insured under any other liability "policy" providing auto coverage. 2. Any organization you newly acquire or form, other than a limited liability company, partnership or joint venture, and over which you maintain majority ownership interest. The insurance afforded by this provision A.2.: a. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier. b. Does not apply to: (1) Bodily injury or property damage caused by an accident that occurred before you acquired or formed the organization; or (2) Any such organization that is an insured under any other liability "policy" providing auto coverage. 3. Any person or organization that you are required by a written contract to name as an additional insured is an insured but only with respect to their legal liability for acts or omissions of a person, who qualifies as an insured under SECTION II — WHO IS AN INSURED and for whom Liability Coverage is afforded under this policy. If required by written contract, this insurance will be primary and non-contributory to insurance on which the additional insured is a Named Insured. 4. An employee of yours is an insured while operating an auto hired or rented under a contract or agreement in that employee's name, with your permission, while performing duties related to the conduct of your business. "Policy", as used in this provision A. Who Is An Insured, includes those policies that were in force on the inception date of this Coverage Form but: 1. Which are no longer in force; or 2. Whose limits have been exhausted. B. Bail Bonds and Loss of Earnings Section II, Paragraphs A.2. (2) and A.2. (4) are revised as follows: 1'. In a.(2), the limit for the cost of bail bonds is changed from $2,000 to $5,000; and 2. In a.(4), the limit for the loss of earnings is changed from $250 to $500 a day. Form No: CNA63359XX(04-2012) Policy No:BUA 7033968744 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:07/01/2022 Endorsement No: 11;Page: 1 of 4 Policy Page: 82 of 250 Underwriting Company: The Continental Insurance Company, 151 N Franklin St,Chicago, IL 60606 c Copyright CNA All Rights Reserved. Includes copyrighted material of the • • Johnson-Davis,Inc. CNA 604 Hillbrath Dr. Business Auto Policy Lantana,FL 33462 Phone:e:(5(561)588-1170 Policy Endorsement Fax: (561)585-3252 (4) Your employees may know of an accident or loss. This will not mean that you have such knowledge, unless such accident or loss is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. The following is added to Section IV, Paragraph A.2.b.: (6) Your employees may know of documents received concerning a claim or suit. This will not mean that you have such knowledge, unless receipt of such documents is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. B. Transfer Of Rights Of Recovery Against Others To Us The following is added to Section IV, Paragraph A.5. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have, because of payments we make for injury or damage, against any person or organization for whom or which you are required by written contract or agreement to obtain this waiver from us. This injury or damage must arise out of your activities under a contract with that person or organization. You must agree to that requirement prior to an accident or loss. C. Concealment, Misrepresentation or Fraud The following is added to Section IV, Paragraph 8.2.: Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not prejudice you with respect to the coverage afforded provided such failure or omission is not intentional. D. Other Insurance The following is added to Section IV, Paragraph B.5.: Regardless of the provisions of Paragraphs 5.a. and 5.d. above, the coverage provided by this policy shall be on a primary non-contributory basis. This provision is applicable only when required by a written contract. That written contract must have been entered into prior to Accident or Loss. E. Policy Period, Coverage Territory Section IV, Paragraph B. 7.(5).(a). is revised to provide: a. 45 days of coverage in lieu of 30 days. V. DEFINITIONS Section V. paragraph C. is deleted and replaced by the following: Bodily injury means bodily injury, sickness or disease sustained by a person, including mental anguish, mental injury or death resulting from any of these. Form No: CNA63359XX (04-2012) Policy No:BUA 7033968744 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:07/01/2022 Endorsement No: 11; Page:4 of 4 Policy Page:85 of 250 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Includes copyrighted material of the • • CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors -with Products-Completed Operations Coverage Endorsement Johnson-Davis,Inc. This endorsement modifies insurance provided under the following: 604 Hillbrath Dr. Lantana,FL 33462 COMMERCIAL GENERAL LIABILITY COVERAGE PART Phone:(561)588-1170 Fax: (561)585-3252 It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part,but only with respect to liability for bodily injury,property damage or personal and advertising injury caused in whole or in part by your acts or omissions,or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract;or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products-completed operations hazard,and only if: 1. the written contract requires you to provide the additional insured such coverage;and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition,or 10-01 edition of CG2010,or under the 10- 01 edition of CG2037;or B. additional insured coverage with"arising out of'language;or C. additional insured coverage to the greatest extent permissible by law; then paragraph I.above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy,including the limits of insurance,the Insurer will not provide such additional insured with: 0, A. coverage broader than required by the written contract;or B. a higher limit of insurance than required by the written contract. g IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury,property damage,or personal and advertising injury arising out of: A. the rendering of,or the failure to render,any professional architectural, engineering,or surveying services, including: 1. the preparing,approving,or failing to prepare or approve maps,shop drawings,opinions, reports,surveys, field orders,change orders or drawings and specifications;and 2. supervisory, inspection, architectural or engineering activities;or B. any premises or work for which the additional insured is specifically listed as an additional._insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS,the Condition entitled Other Insurance is amended to add the following,which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX(10-16) Policy No: 7033967643 Page 1 of 2 Endorsement No: 23 Nat'l Fire Ins Co of Hartford Effective Date: 07/01/2022 Insured Name: JOHNSON—DAVIS, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. • • Johnson-Davis,Inc. CNA PARAMOUNT CNA 604 n , ath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement Primary and Noncontributory Insurance With respect to other insurance available to the additional insured under which the additional insured is a named insured,this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured;or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above,this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement,the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence,Offense,Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim,or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received,and otherwise cooperate with the Insurer in the investigation, defense,or settlement of the claim;and 3. make available any other insurance,and tender the defense and indemnity of any claim to any other insurer or self-insurer,whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory,this paragraph 3.does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement,the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy;and B. was executed prior to: 1. the bodily injury or property damage;or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below,and expires concurrently with said Policy. CNA75079XX(10-16) Policy No: 7033967643 Page 2 of 2 Endorsement No: 23 Nat'1 Fire Ins Co of Hartford Effective Date: 07/01/2022 Insured Name: JOHNSON-DAVIS, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. • • Johnson-Davis,Inc. 604 Hillbrath Dr. CNA Lantana,FL 33462 CNA PARAMOUNT Phone:(561)588-1170 a�: ( 6� $ 5-3 2 Contractors' General i,.lagl i / extension Endorsement B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE — ELEVATORS Provision, the Other Insurance conditions is amended to add the following paragraph: This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis that is Property insurance covering property of others damaged from the use of elevators. 23. SUPPLEMENTARY PAYMENTS The section entitled SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is amended as follows: A. Paragraph 1.b. is amended to delete the$250 limit shown for the cost of bail bonds and replace it with a $5,000. limit;and B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a $1,000.limit. 24. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named Insured's Coverage Part,the Insurer will not deny coverage under this Coverage Part because of such failure. 25. WAIVER OF SUBROGATION -BLANKET Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the following: The Insurer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury or damage arising out of: 1. the Named Insured's ongoing operations;or 2. your work included in the products-completed operations hazard. However,this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in a written contract or written agreement,and only if such contract or agreement: 1. is in effect or becomes effective during the term of this Coverage Part;and 2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the claim. 26. WRAP-UP EXTENSION:OCIP, CCIP,OR CONSOLIDATED(WRAP-UP)INSURANCE PROGRAMS Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up) insurance program by applicable state statute or regulation. If the endorsement EXCLUSION — CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance Programs(C.C.I.P.)is attached,then the following changes apply: A. The following wording is added to the above-referenced endorsement: With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or was involved, this exclusion does not apply to those sums the Named Insured become legally obligated to pay as damages because of: 1. Bodily injury,property damage,or personal or advertising injury that occurs during the Named Insured's ongoing operations at the project, or during such operations of anyone acting on the Named Insured's behalf; nor CNA74705XX(1-15) Policy No: 7033967643 Page 16 of 17 Endorsement No: 9 Nat'l Fire Ins Co of Hartford Effective Date: 07/01/2022 Insured Name: JOHNSON-DAVIS, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. • • Johnson-Davis,Inc. 604 Hillbrath Dr. CNA Lantana,FL 33462 CNA Paramount Excess and Umbrella Liability IZ Phone:(561)588-1170 C3li Fax: (561)585-3252 Y or organization which may be liable to the Insured because of injury or damage to which this insurance may also apply; and vi. will not voluntarily make a payment, except at its own cost, assume any obligation, or incur any expense, other than for first aid, without the Insurer's prior consent. 3. Cooperation With respect to both Coverage A - Excess Follow Form Liability and Coverage B — Umbrella Liability, the Named Insured will cooperate with the Insurer in addressing all claims required to be reported to the Insurer in accordance with this paragraph O. Notice of Claims/Crisis Management Event/Covered Accident, and refuse, except solely at its own cost, to voluntarily, without the Insurer's approval, make any payment, admit liability, assume any obligation or incur any expense related thereto. P. Notices Any notices required to be given by an Insured shall be submitted in writing to the Insurer at the address set forth in the Declarations of this Policy. Q. Other Insurance If the Insured is entitled to be indemnified or otherwise insured in whole or in part for any damages or defense costs by any valid and collectible other insurance for which the Insured otherwise would have been indemnified or otherwise insured in whole or in part by this Policy, the limits of insurance specified in the Declarations of this Policy shall apply in excess of, and shall not contribute to a claim, incident or such event covered by such other insurance. With respect to Coverage A — Excess Follow Form Liability only, if: a. the Named Insured has agreed in writing in a contract or agreement with a person or entity that this insurance would be primary and would not seek contribution from any other insurance available; b. Underlying Insurance includes that person or entity as an additional insured; and c. Underlying Insurance provides coverage on a primary and noncontributory basis as respects that person or entity; then this insurance is primary to and will not seek contribution from any insurance policy where that person or entity is a named insured. R. Premium All premium charges under this Policy will be computed according to the Insurer's rules and rating plans that apply at the inception of the current policy period. Premium charges may be paid to the Insurer or its authorized representative. S. In Rem Actions A quasi in rem action against any vessel owned or operated by or for a Named Insured, or chartered by or for a Named Insured, will be treated in the same manner as though the action were in personam against the Named Insured. T. Separation of Insureds Except with respect to the limits of insurance, and any rights or duties specifically assigned in this Policy to the First Named Insured, this insurance applies: 1. as if each Named Insured were the only Named Insured; and 2. separately to each Insured against whom a claim is made. U. Transfervof Interest Form No:CNA75504XX (03-2015) Policy No:CUE 7033984636 Policy Page: 21 of 32 Policy Effective Date:07/01/2022 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Policy Page: 36 of 63 0 Copyright CNA All Rights Reserved. • Johnson-Davis,Inc. 604 Hillbrath Dr. CNA Lantana,FL 585-325233462 CNA Paramount Excess and Umbrella Liability Phone:(561)588-1170 Fax: (561) Policy Assignment of interest under this policy shall not bind the Insurer unless its consent is endorsed hereon. V. Unintentional Omission Based on Insurer's reliance on the Named Insured's representations as to existing hazards, if the Named Insured should unintentionally fail to disclose all such hazards at the effective date of this Policy, the Insurer will not deny coverage under this Policy because of such failure. W. Waiver of Rights of Recovery The Insurer waives any right of recovery it may have against any person or organization because of payments the Insurer makes under this Policy if the Named Insured has agreed in writing to waive such rights of recovery in a contract or agreement, and only if the contract or agreement: 1. is in effect or becomes effective during the policy period; and 2. was executed prior to loss. VII.DEFINITIONS For purposes of this Policy, words in bold face type, whether expressed in the singular or the plural, have the meaning set forth below. Advertisement means a notice that is broadcast or published to the general public or specific market segments about the Named Insured's goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: A. notices that are published include material placed on the Internet or on similar electronic means of communication; and B. regarding web-sites, only that part of a web-site that is about the Named Insured's goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. Aircraft means any machine or device that is capable of atmospheric flight. Arbitration proceeding means a formal alternative dispute resolution proceeding or administrative hearing to which an Insured is required to submit by statute or court rule or to which an Insured has submitted with the Insurer's consent. Asbestos means the mineral in any form whether or not the asbestos was at any time airborne as a fiber, particle or dust, contained in or formed a part of a product, structure or other real or personal property, carried on clothing, inhaled or ingested, or transmitted by any other means. Authorized Insured means any executive officer, member of the Named Insured's risk management or in-house general counsel's office, or any employee authorized by the Named Insured to give or receive notice of a claim. Auto means: A. a land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment; or B. any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However, auto does not include mobile equipment. Bodily injury means bodily injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of the bodily injury, sickness or disease. Claim means a: A. suit; or Form No:CNA75504XX (03-2015) Policy No:CUE 7033984636 Policy Page: 22 of 32 Policy Effective Date:07/01/2022 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Policy Page: 37 of 63 Copyright CNA All Rights Reserved. • • Johnson-Davis,Inc. CNA Lantana,a athFL 3 Dr. Workers Compensation And Employers Insurance FL 33462 PLiability Phone:(561)588-1170 Policy Endorsement Fax: (561)585-3252 I We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement. The premium charge for the endorsement is reflected in the Schedule of Operations. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, j takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. • Form No:WC 00 03 13(04-1984) Policy No:WC 7 33972535 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:07/01/2022 Endorsement No: 4; Page: 1 of 1 Policy Page:35 of 49 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Copyright 1983 National Council on Compensation Insurance. • • Johnson-Davis,Inc. • 604 Hillbrath Dr. • Lantana,FL 33462 • Phone:(561)588-1170 Fax:(561)585-3252 STATE OF FLORIDA DEPARTMENT OF STATE • DIVISION OF CORPORATIONS • I certify that the following is a true and correct copy of • CERTIFICATE OF INCORPORATION • OF JOHNSON - DAVIS INCORPORATED • filed in this office on the 6th day of July 19 77. Charter Number: 5 3 8 7 7 2 • o f THE srgr GIVEN under my band and the Great 'p y�e 1 -17 "n Seal of the State of Florida, at Tallahassee, the Capital, this. the 4. � 7th day of July Goa w>3•col • 19 77. • • 63:2340 • SECRETARY OF STATE • CORP.101(Cosy.94) 7.13-7 6 • • Johnson-Davis,Inc. 604 Hilibrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 State of Florida Department of State I certify from the records of this office that JOHNSON -DAVIS INCORPORATED is a corporation organized under the laws of the State of Florida, filed on July 6, 1977. The document number of this corporation is 538772. I further certify that said corporation has paid all fees due this office through December 31, 2021, that its most recent annual report/uniform business report was filed on November 9, 2021, and that its status is active. I further certify that said corporation has not filed Articles of Dissolution. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Seventh day of December, 2021 'ems y?0,0111W Secretary of State Tracking Number:0516866656CU To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. h ttps://services.sunbiz.org/Filings/CertificateOfStatus/CertificateAuthentication • •Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-117 Form W-9 Request for Taxpayer Fax: (561)585-3252 Give Form to the (Rev.October 2018) identification Number and Certification requester.Do not Department of theTr'ac,ay send to the IRS. internal Revenue Service ►Go to www.irsgov/FormW9 for Instructions and the latest information. I Name(as shown on your income tax return).Name is required on this Tine;do not leave this line blank. JOHNSON-DAVIS INCORPORATED 2 Business name/disregarded entity name,if different from above 3 Check appropriate box for federal tax classification of the• mperson whose name is entered on Tine 1.Check only one of the 4 Exemptions(codes apply only to 05 following seven boxes. certain entities,not individuals;see o. instructions on page 3): o ❑ IndividuaVsole proprietor or 0 C Corporation 0 S Corporation 0 Partnership 0 Trust/estate single-member LLC Exempt payee code(if any) ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► o` 2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code'if any) a another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. ❑ Other(see instructions)► (Apples to accounts mainrah,ed outside the U.S.) IAA 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional) 604 Hillbrath Drive 6 City,state,and ZIP code Lantana,FL 33462 7 List account numbers)here(optional) Part I Taxpayer Identification Number(TiN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number backup withholding.For individuals,this is generally your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other — - entities,It Is your employer identification number(EIN).If you do not have a number,see How to get a TIN,later. or Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and I Employer identification number Number To Give the Requester for guidelines on whose number to enter. 5 9 — 1 7 5 3 8 8 8 Part II Certification Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)i have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3.1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification Instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign th certification,but you must provide your correct TIN.See the Instructions for Part II,later. Sign Signature of Here us.person► Date► /4"7J22.... General instructioris •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of Income,prizes,awards,or gross noted. proceeds) Future developments.For the latest Information about developments •Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which may be your social security number •Form 1099-C(canceled debt) (SSN),individual taxpayer identification number OTIN),adoption (acquisition.Form 1099-A ac taxpayer identification number(ATIN),or employer identification number ( q on or abandonment of secured property) (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest eamed or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.10-2018) • • Johnson-Davis,Inc. 604 Hillbrath Dr. --t'Alm, Lantana,FL 33462 # Phone:(561)588-1170 II} e, Fax: (561)585-3252 t 1 0 JOHNSON-DAVIS INC. "Construct with Confidence" CERTIFICATE OF AUTHORIZATION RESOLUTION The undersigned hereby certifies as follows: 1) That at a meeting of the Boar; ;of Directors duly noticed and held on January_, 2023 all of the directors of the Company unanimously adopted the resolutions; a. That William C. Cryer is elected or appointed as an officer of the Company with the title of Vice President—Estimating. b. That in addition to any other authorized officer of the Company, William C.Cryer is authorized to execute and deliver for and on behalf of the Company, bids, estimates, contracts, loan documents and general authorizations relating to the Company's providing of goods and services for underground utilities construction, or other services related to the operation of business and bind the Company accordingly;and that,third parties shall be entitled to rely upon a certified copy of this resolution until written notice of modificationior rescission of same has been furnished to and received by any such third party. 4 2) That the above resolutions arletrue and accurate copies of the orig' I r sol tions on file in the corporate record book of the 1Company and that said resolutions ai n ull force and effect. Date this II day of j a l�tv.�� , z 3 . By S tt Johnson—Pr ident l STATE OF FLORIDA )ss COUNTY OF PALM BEACH P ?i! On this I( day of J4,4 'a'`/ ' . Before me personally appeared A 1,,, To me known to be the persoi who executed the foregoing acceptance and acknowledged-that He/She executed the same as His/Her free act and deed. r ,,�� NOTARIAL !my commission as Notary Public in/24., County SEAL4�YP�a LARISADITUPELKEY expires,-7j 22 (— ,,,r.,sir * * Commission�HHi78i11 �---)� �r N Y Ex resJanua 22,2026 ignature -":u PI rY p4OF 6L°q £andod"Mu Budget Notary Setvicas A .A ift, u • Q( 247P/. .,-,,.Uf -teciLIJlG • gilee ' .(weree ata • al ri> r ,Y Main office:604 Hillbrath.Drive-Lantana,FL 33462•Phone:561-588-1171•Fax:561-585-5252 o w,_„�+6 • 5/14/23,7:22 PM Detail by Entity Name DIVISION OF CORPORATIONS Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 t Vcii01; of / ifora c rvr,cr)r r) ,fr ri e".."1/..1,..02;r: ur _L_IV f:j •1,•!r,4 Qapartment of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Florida Profit Corporation JOHNSON-DAVIS INCORPORATED Filing Information Document Number 538772 FEI/EIN Number 59-1753888 Date Filed 07/06/1977 State FL Status ACTIVE Principal Address 604 HILLBRATH DRIVE LANTANA, FL 33462 Changed:04/01/1986 Mailing Address 604 HILLBRATH DRIVE LANTANA, FL 33462 Changed:04/01/1986 gggjstered Agent Name&Address JOHNSON,SCOTT J 604 HILLBRATH DRIVE LANTANA, FL 33462 Name Changed:03/20/1996 Address Changed: 12/18/2009 Officer/Director Detail Name&Address Title P. JOHNSON,SCOTT J. 18843 SE JUPITER RIVER DR JUPITER, FL 33458 Title TS https://search.sunbiLorg/Inquiry/CorPorationSearch/SearchResultDetail?inquirytype=EntityName&directionType=lnitial&searchNameOrdertJOHNSO... 1/3 • • 5/14/23,7:22 PM Detail by Entity Name Johnson-Davis,Inc. 604 Hilibrath Dr. JOHNSON,CHRISTOPHER Lantana,FL33462 7541 BRIAR CLIFF CIR Phone:(561)588-1170 Fax: (561)585-3252 LAKE WORTH, FL 33467 Title VP CRYER,WILLIAM 170 RIVER DRIVE TEQUESTA, FL 33469 Title CHIEF FINANCIAL OFFICER STANLEY,JOHN 4110 NW 10TH STREET DELRAY BEACH, FL 33445 Annual Reports Report Year Filed Date 2022 01/05/2022 2022 10/27/2022 2023 01/04/2023 Document Image 01/04/2023—ANNUAL REPORT View Image in PDF format 10/27/2022—AMENDED ANNUAL REPORT View Image in PDF format 01/05/2022—ANNUAL REPORT View image in PDF format 11/09/2021—AMENDED ANNUAL REPORT View image in PDF format 07/02/2021—AMENDED ANNUAL REPORT View image in PDF format 01/13/2021—ANNUAL REPORT View image in PDF format J 03/25/2020--AMENDED ANNUAL REPORT View image In PDF format 01/07/2020—ANNUAL REPORT View image in PDF format 01/02/2019—ANNUAL REPORT View image in PDF format 01/05/2018—ANNUAL REPORT View image in PDF format 01/06/2017—ANNUAL REPORT View image in PDF format 01/14/2016—ANNUAL REPORT View image in PDF format 01/07/2015—ANNUAL REPORT View image in PDF format 01/03/2014—ANNUAL REPORT View image in PDF format 01/02/2013—ANNUAL REPORT View image in PDF format 01/04/2012--ANNUAL REPORT View image in PDF format 07/01/2011—ANNUAL REPORT View image in PDF format !( 01/04/2011—ANNUAL REPORT View image in PDF format 01/05/2010—ANNUAL REPORT View image in PDF format 01/08/2009—ANNUAL REPORT View image in PDF format 01/07/2008—ANNUAL REPORT View image in PDF format 01/10/2907—ANNUAL REPORT View image in PDF format 01/12/2906--ANNUAL REPORT View image in PDF format 02/12/2005--ANNUAL REPORT View image in PDF format httnrJ/caarnh cunhiz.nrn/Innuirv/CnrnnratinnSAarrh/.S'AarnhRAcult1lAta119innuirvtvnp=PntituNamRAdiractinnTvnc InitialftsparrthNa mArlrripm.10HASO 21 • • 5/14/23,7:22 PM Detail by Entity Name ionnson-uavis,inc. 604 Hilibrath Dr. 02/04/2004—ANNUAL REPORT View image in PDF format Lantana,FL 33462 Phone:(561)588-1170 02/10/2003—ANNUAL REPORT View Image in PDF format = Fax: (561)585-3252 03/15/2002—ANNUAL REPORT View image in PDF format 01/25/2001--ANNUAL REPORT View image In PDF format 04/03/2000—ANNUAL REPORT View image in PDF format 03/24/1999--ANNUAL REPORT View image in PDF format 01/29/1998--ANNUAL REPORT View image in PDF format 01/28/1997—ANNUAL REPORT View image in PDF format 03/20/1996—ANNUAL REPORT View Image in PDF format 03/20/1996—Reg,Agent Change View image In PDF format 03/24/1995—ANNUAL REPORT J View image in PDF format Rorie,G..:..:rtn:.:nr.+.i Str::: Dra,tr,n r4 Cr.•p.�r:;So, httos://search.sunbiz.oro/Inauirv/CoroorationSearch/SearchResultDetail?Inouirvtvoe=EntitOlame&directionTvoe=Initial&searchNameOrder=JO H NSO... 3/3 • • a 7 Johnson-Davis,Inc. Ji' D 604 Hillbrath Dr. Lantana,FL 33462 A , Major Equipment List Phone.(561)588-1170 All OWNED by Johnson-Davis, Inc. Fax: (561)585-3252 14. ._ ,:�PESC, . . ,, .max .:t ,, VIN# � - ,. .r 1D ?, tiS=,A,DESG` z .. j x.tti ;‘_,s . ..VIN , :a;; Category:10 WELLPOINT PUMPS 10-0084 10"Wellpoint Pump 14270 10-0001 10 IN.WELLPOINT PUMP 7105 10-999 Rental Pump 10-0003 10 IN.WELLPOINT PUMP 7568 Category:11 VACUUM PUMPS 10-0011 10 IN.WELLPOINT PUMP 7130 10-0100 M5 VAC PUMP 10-0013 WELLPOINT PUMP 6 IN. NONE 10-0164 M-3 VACUUM PUMP 10-0016 WELLPOINT PUMP 10 IN. 8460 11-0005 M-2 VACCUM PUMP 00050 10-0019 WELLPOINT PUMP 10 IN. 7505 11-0053 M-2 VACUUM PUMP 0053 10-0020 WELLPOINT PUMP 10 IN. 8334 11-0100 M10 VACUUM PUMP 100 10-0026 HYDRAULIC PUMP 6 IN. 5654 11-0101 VACUUM PUMP 101 10-0028 JET PUMP,4 IN.DIESEL 6J66 11-0102 M10 VACUUM PUMP VP102 10-0030 DOUBLE DIAPHRAGM 4DDL335 11-0131 M5 VACUUM PUMP FOR 10-76 010131 10-0031 WELLPOINT PUMP 10 IN. J0946068 11-1016 M3 VACUUM PUMP 101689 10-0033 WELLPOINT PUMP 6 IN. 6951033 11-1036 10 INCH VACUUM PUMP 1036 10-0035 WELLPOINT PUMP 8 IN. US97362X 11-1037 C10 VACUUM PUMP 1037 10-0036 HYDRAULIC PUMP 4 IN. H-25-D-349 11-1190 M2 VACUUM PUMP 1190 10-0038 WELLPOINT PUMP 8 IN. U640528Y 11-1240 M3 VACUUM PUMP 1240 10-0040 JET PUMP 4 IN. None 11-1357 M10 VACUUM PUMP 1357 10-0041 WELLPOINT PUMP 8 IN. H-40WPLR-D-139 11-1381 M10 VACUUM PUMP 1381 10-0043 TEST PUMP 11-1386 VACUUM PUMP 1386 10-0045 JET PUMP 4 IN. C.M.E.8291 11-1387 M10 VACUUM PUMP 1387 10-0046 WELLPOINT PUMP 8 IN. 9037 11-1390 M2 VACUUM PUMP 1390 10-0048 6 IN.TRASH PUMP 9065 11-1711 M3 VACUUM PUMP 1711 10-0049 WELLPOINT PUMP 8 IN. 9064 11-1923 M-3 VACUUM PUMP 1923 10-0050 HYDRAULIC PUMP 4 IN. 2657 11-1924 M3 VACUUM PUMP 1924 10-0051 JETPUMP ON WHEELS 4 IN. 4219 11-1941 M3 VACUUM PUMP 1941 10-0052 8 IN.WELLPOINT PUMP 9159 11-2341 M3 VACUUM PUMP 2341 10-0054 8 IN.WELLPOINT PUMP 9181 11-3044 M3 VACUUM PUMP 3044 10-0055 12 IN.HYDRAULIC PUMP D12SG068T1210 11-3049 VACUUM PUMP 3049 10-0056 8 IN.HYDRAULIC PUMP 325 11-3605 M-10 VACUUM PUM 3605 • 10-0058 10 IN.WELLPOINT PUMP 9293 11-3737 M2 VACUUM PUMP 3737 10-0059 10 IN.WELLPOINT PUMP 11-3750 M-2 VACUUM PUMP 3750 10-0060 4 IN.HYDRAULIC PUMP U797253C 11-4268 M3 VACUUM PUMP 4268 10-0061 4 IN.HYDRAULIC PUMP 708 11-4297 VACUUM PUMP 4297 10-0062 8 IN.WELLPOINT PUMP 9220 11-4371 M-3 VACUUM PUMP 4371 10-0063 8 IN.WELLPOINT PUMP 9239 11-4636 VACUUM PUMP 4636 10-0064 4 IN.HYDRAULIC PUMP 11-4840 M-3 VACUUM PUMP 4840 10-0065 WELLPOINT PUMP 6 IN. 6PW-019 11-4841 M3 VACUUM PUMP 4841 10-0066 10 IN.HYDRAULIC PUMP 11-4923 M3 VACUUM PUMP 10-0067 4 IN.HYDRAULIC PUMP LD44369U146539 11-5445 M5 VACUUM PUMP 544515 10-0068 4"HYDRAULIC PUMP ON WHEELS F.P.8-20 11-6917 C 10"VACUUM PUMP 6917 10-0069 4"HYDRAUIC PUMP ON WHEELS F.P.8-19 11-9305 M-3 VACUUM PUMP 9305 10-0070 3"HYDRAULIC PUMP 10HPU-58 11-9487 10"VACUUM PUMP 9487 10-0071 2.5"x 4"JET PUMP ON WHEELS 9500 11-9494 M5 VACUUM PUMP 9494 10-0073 10 inch Roto Flo Wellpoint Pump 26109642 1.1 11-9602 M3 VACUUM PUMP 9603 10-0074 6"Trash Pump 12001 11-9607 M3 VACUUM PUMP 9607 10-0075 8 inch Roto Flo Welipoint Pump 9010 11-9615 M10 VACUUM PUMP 9615 10-0077 6 INCH HYDRAULIC PUMP POWER UNIT 1318-C 11-9616 C-10 VACUUM PUMP 9616 10-0078 8"HYDRAULIC PUMP 142-C 11-9617 C-10 VACUUM PUMP 9617 10-0079 8"Wellpoint Pump 14237 11-9716 #10 VACUUM PUMP 9716 10-0080 8"Wellpoint Pump 14238 Category:20 BACKHOES 10-0081 8"Wellpoint Pump 14239 20-0039 1997 DEWATERING TRENCHER 097022 10-0082 8"Wellpoint Pump Quiet Pack 14235 20-0040 LIEBHERR BACKHOE 417-4205 10-0083 10"Wellpoint Pump 14269 20-0044 LIEBHERR BACKHOE 651-8110 Johnson-Davis,Inc. • 604 Hillbrath Drive • Lantana,FL 33462 • Ph.(561)588-1170 Fx.(561)585-5252 page 1 of 2 • • iD = - ...f ill N# aD UESC r 20-0050 LIEBHERR BACKHOE 924-13441 Johnson-Davis,Inc. 20-0056 KOMATSU BACKHOE 30099 604 Hillbrath Dr. 20-0059 Caterpillar Crawler Excavator CAT0328DCGTN Lantana,FL 33462 Caterpillar Crawler Excavator CAT0336DEW3K Phone:(561)588-1170 20-0060 Fax: (561)585-3252 20-0063 2012 JOHN DEERE RUBBER TIRE 1 FF220DWHBD4 20-0068 Komatsu PC390LC-10 Excavator A30203 20-0069 Komatsu PC240LC-11 EXCAVATOR 95106 20-0070 Komatsu PC390LC-11 Excavator 30425 20-0071 Komatsu PC390LC-11 Excavator A74180 20-0072 Komatsu PC138USLC-11 50542 20-0073 KOMATSU PC290LC-11 EXCAVATOR A27538 20-0074 Komatsu PC138USLC-11 Excavator 50845 20-0075 Liebherr A900C 66375 20-0077 Cat 323 Excavator RAZ00754 20-0078 Cat 325FLCR Excavator NDJ20187 20-0079 Komatsu PC-238 Excavator 05489 20-0080 Komatsu PC-138 Excavator 52349 20-0081 Cat 307E2 Mini-Excavator 307-KC901075 20-0082 John-Deere 350G Excavator 1FF350GXLHF81 20-999 Rental Backhoe WR-BH01 Volvo Backhoe(Wakefield Road Boring) Category:25 COMBINATIONS 25-0051 CAT COMBO BACKHOE BLN11885 25-0052 CAT COMBO BACKHOE BML05166 25-0067 2013 CAT COMBINATION BACKHOES 420 F CAT0420FHJWJO Category:30 LOADERS 30-0032 LIEBER LOADER 443-11966 30-0033 VOLVO LOADER L70E L70EV60803 30-0038 2009 KOMATSU LOADER 65858 30-0039 2009 KOMATSU LOADER 65939 30-0040 950H CATTERPILLAR LOADER CAT0950HVK5K0 30-0042 WA320-6 KOMATSU LOADER A35279 30-0043 WA-380-7 KOMATSU LOADER A64171 30-0044 WA200PZ-6 KOMATSU RUBBER TIRE LOAC KMTWA105C010 30-0045 WA-320-7 KOMATSU LOADER 80194 30-0046 938K CATERPILLAR LOADER SWL01382 30-0047 WA200-7 KOMATSU LOADER 80392 30-0048 WA380-8 KOMATSU LOADER A74013 30-0049 Komatsu WA-380-8 Wheel Loader A74180 30-0050 Cat 906M Wheel Loader CAT906MCH6600 30-0051 Komatsu WA320-8 85209 30-0052 Komatsu WA270-8 Wheel Loader A28201 30-0053 Cat 930M Wheel Loader KTG03806 30-0054 Cat 930M Wheel Loader KTG04062 30-0055 John-Deere 524L Wheel Loader IDW524LKLZLKF 30-0056 John-Deere 544L 1DW544LZCKF6 30-999 Rental Loader Category:35 SPECIALIZED EQUIPMENT 35-0001 CRAWLER DOZER T065HX898018 35-0027 2001 LOADER/BOBCAT 514147010 35-0041 T300 BOBCAT 525415212 35-0061 KUBOTA BACKHOE 30767 35-0064 2012 KUBOTA EXCAVATOR W/RUBTKS/4P 141826 35-0066 2013 KUBOTA EXCAVATOR 74888 35-0067 Cat 305E2 Excavator H5M07145 35-0068 John-Deere 325G Compact Track Loader 1T0325GMJKJ34 35-999 Rental Mini Johnson-Davis,Inc. • 604 Hillbrath Drive • Lantana,FL 33462 • Ph.(561)588-1170 Fx.(561)585-5252 page 2 of 2 • • ,. �ti . �tt pp. ref` -= TTRI n.• '�C+ L ...Tr i.41 ri A•• A''.i- 'i'-.-:;.- 't li...i.'.f 'I...°1 i 417 = p 73 C R7a Z D o vl v z o 3 v' m� oz Z oO C o VI r'l (7) v =r+ °' L O C _' 0 5, e hz i r j F • 4`. • m -i% v U! 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Q. ro • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 ��= a, Fax: (561)585-3252 A NN EM M. GAN NO N P.O.Box 3353,West Palm Beach,FL 33402-3353 "*LOCATED AT" `� CONSTITUTIONAL TAX COLLECTOR www.pbctax.com Tel:(561)355-2264 `.. i ':? Serving Palm Brach Comity 604 HILLBRATH DRIVE LANTANA, FL 33462-1656 Serving you. . TYPE OF BUSINESS OWNER CERTIFICATIONS RECEIPTS/DATE PAID AMT PAID BILL* 23-0137 CW UNDERGROUND UTILITY 8 JOHNSON SCOTT J CUC043087 622,602590-07/11/22 S185.85 840130693 This document is valid only when receipted by the Tax Collector's Office. STATE OF FLORIDA PALM BEACH COUNTY 2022/2023 LOCAL BUSINESS TAX RECEIPT JOHNSON DAVIS INC LBTR Number: 199306318 JOHNSON DAVIS INC EXPIRES: SEPTEMBER 30, 2023 604 HILLBRATH DRIVE LANTANA,FL 33462-1656 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. coatcrt .{��.--..',= A N N E M. G AN N O N ;� P.Q.Box 3353,West Palm Beach,FL 33402-3353 **LOCATED AT** g CONSTITUTIONAL TAX COLLECTOR www.pbctax.com Tel:(561)355-2264 604 HILLBRATH DRIVE ::'• a_,f'rt` Serving Palm Reach County 4, .,-' LANTANA, FL 33462-1656 Serving you. TYPE OF BUSINESS OWNER CERTIFICATION S RECEIPT#/DATE PAID AMT PAID BILL S 23-0097 UNDERGROUND UTILITY 8 EXCAVATION JOHNSON SCOTT J CUC043087 822.602591-07/11/22 $99.00 640130692 This document is valid only when receipted by the Tax Collector's Office. STATE OF FLORIDA PALM BEACH COUNTY 2022/2023 LOCAL BUSINESS TAX RECEIPT JOHNSON DAVIS INC LBTR Number: 199306319 JOHNSON DAVIS INC EXPIRES: SEPTEMBER 30, 2023 604 HILLBRATH DRIVE LANTANA,FL 33462-1656 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public, • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 *`� �''� Fax: (561)585-3252 :'" A N_N_G_M. AN'N O N_ P.O.Box 3353,West Palm Beach,FL 33402-3353 **LOCATED AT"' x ilk CONSTITUTIONAL TAX COLLECTOR WWWpbctax.com Tel:(561)355-2264 604 HILLBRATH DRIVE `r,' -,;"/; Serving Palm Beach County `" ``' LANTANA, FL 33462-1656 Serving you. • TYPE OF BUSINESS OWNER CERTIFICATION# RECEIPT MATE PAID AMT PAID BILL# 23-0097 UNDERGROUND UTILITY&EXCAVATION CRYER WILLIAM CLARK CLIFFORD CUC1225299 022.602594-07/11/22 S27.50 B40170245 This document is valid only when receipted by the Tax Collector's Office. STATE OF FLORIDA PALM BEACH COUNTY 2022/2023 LOCAL BUSINESS TAX RECEIPT JOHNSON DAVIS INC LBTR Number: 2020125387 JOHNSON DAVIS INC EXPIRES: SEPTEMBER 30, 2023 604 HILLBRATH DRIVE LANTANA,FL 33462-1656 This receipt grants the privilege of engaging in or managing any business profession or occupation within Its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. • 'cute ." + ''4` ANNE M. GANNON P.O.Box 3353.West Palm Beach,FL 33402 3353 *'LOCATED AT'* • n CONSTITUTIONAL TAX COLLECTOR www.pbctax.com Tel:(561)355-2264 =,-'��-_. ;[' Serving Palm BcachhCounty 604 HILLBRATH DRIVE _ 0- LANTANA, FL 33462-1656 Serving you. TYPE OF BUSINESS OWNER CERTIFICATION# RECEIPT#/DATE PAID AMT PAID BILL# 23-0137 CW UNDERGROUND UTILITY& CRYER WILLIAM CLARK CLIFFORD CUC1225299 B22.602595-07111/22 S185.65 840170244 This document is valid only when receipted by the Tax Collector's Office. STATE OF FLORIDA PALM BEACH COUNTY 2022/2023 LOCAL BUSINESS TAX RECEIPT JOHNSON DAVIS INC LBTR Number: 2020125388 JOHNSON DAVIS INC EXPIRES: SEPTEMBER 30, 2023 604 HILLBRATH DRIVE LANTANA,FL 33462-1656 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Johnson-Davis, Inc. Harassment, Discrimination and Retaliation Policy Johnson-Davis, Inc. is committed to a work environment in which all individuals are treated with respect and dignity. Each individual has the right to work in a professional atmosphere that promotes equal employment opportunities and prohibits discriminatory practices, including harassment. Therefore, Johnson-Davis, Inc. expects that all relationships among persons in the office will be business-like and free of bias, prejudice and harassment. Equal Employment Opportunity It is the policy of Johnson-Davis, Inc. to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, religion, sex, sexual orientation, age, disability, marital status, citizenship or any other characteristic protected by law. Johnson-Davis, Inc.prohibits any such discrimination or harassment. Retaliation Is Also Prohibited Johnson-Davis, Inc. encourages reporting of all perceived incidents of discrimination or harassment. It is the policy of Johnson-Davis, Inc. to investigate such reports. Johnson- Davis, Inc. prohibits retaliation against any individual who reports discrimination or harassment or participates in an investigation of such reports. Definitions of Harassment 1) Sexual harassment constitutes discrimination and is illegal under federal, state and local laws. For the purposes of this policy, sexual harassment is defined, as in the Equal Employment Opportunity Commission Guidelines, as unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature when, for example: submission to such conduct is made either explicitly or implicitly a term or condition of an individual's employment; :- submission to or rejection of such conduct by an individual is used as the basis for • employment decisions affecting such individual; or r such conduct has the purpose or effect of unreasonably interfering with an individual's work performance or creating an intimidating, hostile or offensive working environment. • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Sexual harassment may include a range of subtle and not so subtle behaviors and may involve individuals of the same or different gender. Depending on the circumstances, these behaviors may include, but are not limited to: unwanted sexual advances or requests for sexual favors; sexual jokes and innuendo; verbal abuse of a sexual nature; commentary about an individual's body, sexual prowess or sexual deficiencies; leering, whistling or touching; insulting or obscene comments or gestures; display in the workplace of sexually suggestive objects or pictures; and other physical, verbal or visual. conduct of a sexual nature. 2) Harassment on the basis of any other protected characteristic is also strictly prohibited. Under this policy, harassment is verbal or physical conduct that denigrates or shows hostility or aversion toward an individual because of his /her race, color, religion, sex, sexual orientation, national origin, age, disability, marital status, citizenship or any other characteristic protected by law or that of his/her relatives, friends or associates, and that: r has the purpose or effect of creating an intimidating, hostile or offensive work environment; has the purpose or effect of unreasonably interfering with an individual's work performance; or i- otherwise adversely affects an i.ndividual's employment opportunities. Harassing conduct includes, but is not limited to: epithets, slurs or negative stereotyping; threatening, intimidating or hostile acts; denigrating jokes; and written or graphic material that denigrates or shows hostility or aversion toward an individual or group and that is placed on. walls or elsewhere on the employer's premises or circulated in the workplace. Individuals and Conduct Covered These policies apply to all applicants and employees, whether related to conduct engaged in by fellow employees or someone not directly connected to Johnson-Davis, Inc. (e.g., an outside vendor,consultant or customer). Conduct prohibited by these policies is unacceptable in the workplace and in any work- related setting outside the workplace. such as during business trips, business meetings and business-related social events. 2 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Reporting an Incident of Harassment,Discrimination or Retaliation Johnson-Davis, Inc. encourages reporting of all perceived incidents of discrimination, harassment or retaliation, regardless of the offender's identity or position. Individuals who believe that they have been the victim of such conduct should discuss their concerns with their immediate supervisor or the Director of Human Resources. See the Complaint Procedure described below. In addition, Johnson-Davis, Inc. encourages individuals who believe they are being subjected to such conduct promptly to advise the offender that his or her behavior is unwelcome and request that it be discontinued. Often this action alone will resolve the problem. The Company recognizes, however, that an individual may prefer to pursue the matter through informal or formal complaint procedures. Complaint Procedure Informal Procedure If for any reason an individual does not wish to address the offender directly, or if such action does not successfully end the offensive conduct, the individual should notify his/her immediate supervisor or the Director of Human Resources who may, if the individual so requests, talk to the alleged offender on the individual's behalf. In addition, there may be instances in which an individual seeks only to discuss matters with one of the Company's designated representatives,and such discussion is encouraged. An individual reporting harassment, discrimination or retaliation should be aware; however, that Johnson-Davis, Inc. may decide it is necessary to take action to address such conduct beyond an. informal discussion. This decision will be discussed with the individual. The best course of action in any case will depend on many factors and, therefore, the informal procedure will remain flexible. Moreover, the informal procedure is not a required first step for the reporting individual. Formal Procedure As noted above, individuals who believe they have been the victims of conduct prohibited by this policy statement or believe they have witnessed such conduct should discuss their concerns with the Director of Human Resources Johnson-Davis, Inc. encourages the prompt reporting of complaints or concerns so that rapid and constructive action can be taken before relationships become irreparably strained. Therefore, while no fixed reporting period has been established, early reporting and intervention have proven to be the most effective method of resolving actual or perceived incidents of harassment. 3 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Any reported allegations of harassment, discrimination or retaliation will be investigated promptly. The investigation may include individual interviews with the parties involved and, where necessary, with individuals who may have observed the alleged conduct or may have other relevant knowledge. Confidentiality will be maintained throughout the investigatory process to the extent consistent with,adequate investigation and appropriate corrective action. Retaliation against an individual for reporting harassment or discrimination or for participating in an investigation of a claim of harassment or discrimination is a serious violation of this policy and, like harassment or discrimination itself, will be subject to disciplinary action. Acts of retaliation should be reported immediately and will be promptly investigated and addressed. Misconduct constituting harassment, discrimination or retaliation will be dealt with appropriately. Responsive action may include, for example, training, referral to counseling and/or disciplinary action such as warning, reprimand, withholding of a pay increase, reassignment, temporary suspension without pay or termination, as Johnson- Davis,Inc. believes appropriate under the circumstances. If a party to a complaint does not agree with its resolution, that party may appeal to the President of the Company. False and malicious complaints of harassment, discrimination or retaliation as opposed to complaints which, even if erroneous, are made in good faith, may be the subject of appropriate disciplinary action. Conclusion. Johnson-Davis,Inc.has developed this policy to ensure that all its employees can work in an environment free from harassment, discrimination and retaliation. The Company will make every reasonable effort to ensure that all concerned are familiar with these policies and aware that any complaint in violation of such policies will be investigated and resolved appropriately. Any employee who has any questions or concerns about these policies should talk with the Director of Human Resources. 4 • Johnson-Davis,Inc. 604 Hilibrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Finally, these policies should not, and may not, be used as a basis for excluding or separating individuals of a particular gender, or any other protected characteristic, from participating in business or work-related social activities or discussions. In other words, no one should make the mistake of engaging in discrimination or exclusion in order to avoid allegations of harassment. The law and the policies of Johnson-Davis, Inc. prohibit disparate treatment on the basis of sex or any other protected characteristic, with regard to terms, conditions, privileges and perquisites of employment. The prohibitions against harassment, discrimination and retaliation are intended to complement and further those policies,not to form the basis of an exception to them. Employee Acknowledgement: Employee Signature: Date: Witness: Date: 5 • • Johnson-Davis,Inc. n 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 JOHNSON-DAVIS INC. "Construct with Confidence" EXECUTIVE SUMMARY Johnson-Davis Inc. is a full-service underground utility contractor specializing in projects such as water, sewer, and storm drainage systems, as well as highway and road construction usually associated with the utility construction. Our work expertise also includes installation of steel sheeting and dewatering systems. There is no other company in the south and central Florida region that can boast our experience and proficiency in this area. We are able to maintain long-term relationships with prime contractors, governmental agencies, consulting engineers, customers, and suppliers because we are dependable and strive to deliver superior customer service. Johnson-Davis believes that maintaining our credibility and integrity within the industry is our main concern. Johnson-Davis was founded in 1977 when Herb Johnson envisioned the need in Florida for a reputable specialty contractor. Herb and his sons, Scott and Chris, worked only in Palm Beach County, were based in Herb's garage, and had only three leased pieces of heavy equipment to their name. Based in Palm Beach County for more than 40 years, Johnson-Davis has worked continuously and successfully with County Governments and Utility Authorities. More than 40 years later, the Johnson-Davis name is now synonymous with quality work as well as tremendous experience, resources, and knowledge. The company has since transitioned to Scott and Chris Johnson. The corporate headquarters is in Lantana and covers more than four acres of land, and we have a small office in Fort Pierce. Our project teams are located in these two offices. Johnson- Davis has more than 15 crews and owns the equipment that supports these crews. Johnson-Davis is privately-held, owned by Scott Johnson, Chris Johnson, and Jeanne (Johnson) Cummings. Scott Johnson, President, and Bob Hopler, Vice President, both earned their Bachelor of Science degrees in Civil Engineering from Bucknell University in 1976. As engineers, they enjoy projects that are technically challenging. They are both involved in projects at the executive level. Our Construction Manager, Robert Ueltschi, has 40 years of construction experience. He earned his Bachelor of Science in Civil Engineering Technology from Western Kentucky University. His extensive experience and knowledge support the Superintendents and Project Managers, and ensures crews are optimally scheduled and properly performing their duties, all while ensuring the highest levels of quality, safety, and customer satisfaction. 4o6ANto, Q ,,'aiv7 �ip'o�natir-i is • CUC043087 • 9inc e xouarei9Alr4.es V !MI Main Office:604 Hillbrath Drive-Lantana,FL 33462•Phone:561-588-1170 •FAX 561-585-5252 'Pe Ft.Pierce Office:863 S.Kings Hwy-Ft.Pierce,FL 34945•Phone:772-468-9200•FAX 772-468-9202 4' • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 JAIFax: (561)585-3252 JOHNSON-DAVIS INC. "Construct with Confidence" Our Superintendents oversee multiple crews and have been involved in utility construction for a combined total of 152 years. Having worked with the local utility authorities for many years, they are aware of the daily challenges faced by the crews. Senior Superintendent Leonard Dennis and Superintendents Robert Earnest, Richard Heller III, Thomas Linsley, Edric Martin, and J.R. Martin ensure their crews have the resources necessary to maintain their schedules. They are also tasked with ensuring the quality of the work meets or exceeds expectations. Our Project Managers hold an impressive 133 years of experience amongst them. They act as the main interface between the customer and Johnson-Davis. Chuck Cameron, Matt Crist, Rich Heller Jr, Doug Ipolito, and Edwin Jacobs have the primary responsibility to ensure projects are completed on time and within the budget. Andy Thomson, Safety Director, has 34 years of safety and operations and previously served as a Health and Safety Director and Operations Manager. He holds many certifications including OSHA 500 authorized and 10 & 30 hours construction safety trainer under OSHA. His knowledge and experience help Johnson-Davis Inc. maintain a safety culture that makes safety the responsibility of every employee. Ilene Passler, Human Resources Director, has worked in construction for 21 years, and the majority of her experience is with federal and municipal contractors. She holds her Master of Business Administration from Wake Forest University and SHRM-Senior Certified Professional and Senior Professional in Human Resources certifications. Our Estimating Team's focus on customer service and detail helps limit the need for change orders by addressing potential issues during the bidding process. Secretary/Treasurer Chris Johnson, Jim Amsler, Clark Cryer, and Walter Pfaffenberger have over 81 years of experience, and Scott Johnson is also actively involved in the Estimating process. We enjoy an excellent relationship with our bonding company, Liberty Mutual Insurance Co., with a single project capacity of$35,000,000 and an aggregate capacity in excess of$80,000,000. Our financial strength, technical expertise, and history of success in working with the FDOT have earned us a capacity rating in excess of$80,000,000 for underground utility work. We have also been listed in Engineer New Record's Top 600 Specialty Contractors nationwide for many years. It is clear that Johnson-Davis ha's both the experience and the key personnel necessary to successfully perform underground utility projects of all sizes and difficulty. 7 ea 'oorakeicct`ian • CUC043087 • arc ixy,311.9 /i ey Main Office:604 Hillbrath Drive-Lantana,FL 33462•Phone:561-588-1170 •FAX 561-585-52529 0441.na Ft.Pierce Office:863 S.Kings Hwy-Ft.Pierce,FL 34945•Phone:772-468-9200•FAX 772-468-9202 • • Johnson-Davis, Inc. e mo Re: Notice of Random Drug Screening In compliance with the Johnson-Davis, Inc. Drug-Free Workplace Policy, each employee, as a condition of continued employment, is subject to medical or physical examination or tests, including urine drug screen. An employee, who refuses to submit to drug testing, as provided for in this Policy, will be asked to leave the office or project site immediately and the employee will be discharged. Please complete and sign the attached acknowledgement and authorization form and return to your foreman and/or superintendent. You must proceed to a LabCorp testing center in your local area upon receipt of this notice. (See superintendent for LabCorp locations). A copy of the Johnson-Davis, Inc. Drug-Free Workplace Policy is also attached for your information and reference. Please keep a copy of this policy along with your employee handbook. Thank you for your cooperation. 1 • • JOHNSON-DAVIS,INC. 604 Hillbrath Drive Lantana,FL 33462 Phone: (561)588-1170 Fax:(561)585-3252 WHAT TO DO ABOUT HARASSING CONDUCT . . . An employee who believes he or another Company employee has been subjected to harassing conduct should immediately contact the Human Resources Director. A prompt investigation will be conducted of each and every complaint and appropriate action will be taken. Employees are required to participate in all J-D investigations. Complaints will be handled confidentially, to the extent possible. The Human Resources Director has the responsibility for investigating and resolving complaints of harassment. In the event of a complaint involving the Human Resources Director, J-D's President should be notified and he will fulfill the investigatory role in this process. No Retaliation or Reprisals Employees have a duty to report any harassment they either experience or observe, regardless of whether the alleged harassment is being perpetrated by a J-D employee or any other third party. Under no circumstances will a person be retaliated against because of a bona fide report of harassing conduct. Drug-Free Workplace J-D is committed to protecting the safety, health, and well-being of its employees and all individuals who come into contact with its workplace and property, and/or use its products and services. As part of this mission, J-D is committed to maintaining a Drug-Free Workplace. Substance abuse, which includes the possession, use or sale of illegal drugs or the unlawful use or misuse of lawful substances, including alcohol and prescription drugs, will not be tolerated. J-D also prohibits the illicit use, possession, sale, attempted sale, purchase, attempted purchase, conveyance, distribution, cultivation or manufacture of illegal drugs, intoxicants, or controlled substances in any amount or in any manner. It is a condition of employment at J-D to refrain from using illegal drugs and unlawfully using lawful substances, including alcohol and prescription medicines, and to abide by the guidelines of the Company's Drug-Free Workplace Policy. 3 e um • /11\11 11 Tbyel _ JOHNSON-DAVIS' INC. Est. 1977 ge-i- 1 ,40 `yT "Construct with Confidence" ,-.i.,-,:,-;i4E- i,s,-„,,,,,,,,..,- ,,,,,,,,,_ :;,,,„,„„,,,„:„.,,:e.., , ,,,, „...„ „„:,,, ,,T,„,„_ ,,,, .:,_—..7.,,,,, ,, 7-1-7 ,t,,,,:_:-I,T,;,,•4,:-'isi-,,,,,,--.-..i'e,-..,7,.. SAFETY PUNCTUALITY 01 We value the safety of our employees and 08 = We honor our commitments timely.These our community above all else. Safety is commitments include project completion, everyone's responsibility. billing, being prompt for our work shifts and meetings, and vendor payments. FAMILY VALUES O2 Family values are the foundation upon which RESPECT our company was built. We care about the wellbeing of our employees and their families, 1, 09 We have respect for our work,for the work as they are part of our family. We look out for - and ideas of others, and for all those with each other. whom we interact. We support each other in a positive way. RESOURCES COMMUNICATION 03 The backbone of our company is our experienced, creative, and long-term . 10 We expect and deliver truthful messages workforce. Our financial stability, timely, accurately,and respectfully. infrastructure, and other resources allow us to We attentively listen to and recognize the take on and successfully complete challenges. ideas and feelings of others. ACCURACY TEAMWORK 04 We perform quality work the first time and 11 We are all part of the process. We all share review it for completeness and accuracy. We ;: in our successes and challenges. do not take short cuts. I We recognize the needs of and provide support to one another. INTEGRITY&ACCOUNTABILITY — COMMUNITY - 05 , We stand behind our word and honor our commitments. When mistakes occur, we 12 We are committed to improving the acknowledge our mistakes and constructively communities in which we work and live participate in the resolution. through our construction projects and personal involvement. RELATIONSHIPS APPEARANCE COUNTS 06 s'= We have established relationships with customers, engineers, government entities, 13 ,' We take pride in the appearance of vendors,coworkers, our industry,and the ourselves and our work environment. general public. We foster these relationships We keep our work and work environment for mutual success. neat and organized. r DEPENDABILITY MENTORING O7 We do what we say we are goingto do for . 14 We lead and train fellow employeeski-iiii...-- our customers and our coworkers. allowing them to reach their highest potential. .:;.:, :f:i.,:i;:,,,:::::-,1:-f;1:::';-::,/,',-„,:. -;..,--,,,--,,--: ,_._ . : ; , - www iohnsondavis.com .- • • SECTION VII CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 AGREEMENT FOR SERVICES This AGREEMENT is dated as of the 034h day of �t.t IY in the year 20 2.3., between the City of Okeechobee (CITY) andJohr►nck1- idts tic ptar x ra (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 Exhibit C— Project Plans Exhibit D—FDEP Grant Agreement LPQ0007 The work is described as follows: The Contractor shall furnish all labor and materials necessary to perform the hydrodynamic separator installation, as shown on the plans in Okeechobee, Florida. The project shall include all piping, fittings, accessories and appurtenances, site restoration for all work, temporary provisions to maintain functionality of the drainage system, all testing, removal of the existing piping as specified, compliance with permit conditions, bypass pumping for stormwater mains, maintenance of traffic in accordance with City standards,and any other items as described in these documents to provide a complete and functional system. 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 DIRECTOR as named in the Contract Documents shall mean: City of Okeechobee Public Works Director 55 S.E. 3ro Avenue Okeechobee, FL 34974 ARTICLE 3. CONTRACT TIME 3.1 This contract will be in force for a period of one (1) year. 3.2 To start work within 60 calendar days from the Notice to Proceed and there after completing the work within 60 calendar days of commencement of work. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 26 • • 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. 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 specifically set forth as a pay item in the Bid shall be considered a subsidiary obligation 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 performed from September 1st through September 30t". The invoice is to be received by the City no later than October 9th, and payment should be made by October 30th. 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 drawings as outlined in the specifications is to be completed in all respects, and the cost of all miscellaneous and associated work to any specific items shall be included in the Unit Prices. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 27 • i 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 sufficiently 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 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 manner affect cost, progress, or performance 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 performance 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. 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: City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 28 • • • This Agreement • Certificates of Insurance • Payment Bond and Performance Bond • Notice of Award • Notices to Proceed • General Conditions • Governing Specifications attached as Exhibit Addenda numbers I to 2 , 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 modification (as defined in Section 1 of the general conditions). ARTICLE 9. GENERAL PROVISIONS 9.1 Compliance with Laws The Contractor, its employees, subcontractors or assigns, shall comply with all applicable federal, state,and local 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. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve Contractor of its liability and obligation to defend, hold harmless and indemnify the CITY as set forth in this article of the Agreement. Nothing herein, shall be construed to extend the CITY's liability beyond that provided in Section 768.28, Florida Statutes. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 29 • • To the fullest extent permitted by law, the Recipient's contractor/consultant shall indemnify and hold harmless the Recipient and the State of Florida, Department of Transportation, including the Department's officers and employees, from liabilities, damages, losses and costs, including, but not limited to, reasonable attorney's fees,to the extent caused by the negligence, recklessness or intentional wrongful misconduct of the contractor or consultant and persons employed or utilized by the contractor or consultant in the performance of this Agreement. This indemnification shall survive the termination of this Agreement. Nothing contained in this paragraph is intended to nor shall it constitute a waiver of the State of Florida or the Recipient's sovereign immunity. 9.4 Waiver of Jury Trial Each party, to the extent permitted by law, knowingly, voluntarily, and intentionally waives its right to a trial by jury in any action or other legal proceeding arising out of or relating to this Contract and the transactions it contemplates. This waiver applies to an action or legal proceeding, whether sounding in contract,tort or otherwise. 9.5 No Discrimination Contractor and its agents will not discriminate against any person on the grounds of race,color,creed,national origin,handicap,age,or sex, in any activity under this Contract. 9.6 No Lobbying Pursuant to Chapter 216.347, F.S., the Contractor is prohibited from the expenditure of any funds under this Contract to lobby the Legislature, the judicial branch or another state agency. 9.7 E-Verify CONTRACTOR has verified that its employees are authorized to work in the U.S. and certifies that a good faith effort has been made to properly identify employees by timely reviewing and completing appropriate documentation, including but not limited to the Department of Homeland Security, U.S. Citizenship, and Immigration Services Form 1-9. Answers to questions regarding E-Verify as well as instructions on enrollment may be found at the E-Verify website: www.uscis.ciov/e-verify. CONTRACTOR shall expressly require any subcontractors performing work or providing services pursuant to this contract to likewise utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term. 9.8 Contractor's Duties Regarding Public Records A. Compliance with Florida Laws Contractor must provide public access to all records concerning this Contract according to applicable Florida laws including Chapter 119, Florida Statutes. If Contractor asserts any exemptions to Florida's public records laws, Contractor has the burden of establishing and defending the exemption. Contractor's failure to comply with this section is a breach of this Contract. The records subject to Chapter 119 may include, in addition to prepared documents, such communication as e-mails, text messages, inter-office memorandums, social media, and photographs or images; a person or entity may request public records via e-mail, or by oral or written request, and a response to such a request must be prompt; it is the responsibility of the CONTRACTOR to establish an in-house policy in City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 30 • • reference to such records, and to identify and retain such communications in the normal course of business in the event a request is made to produce these records. B. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT TELEPHONE NUMBER: (863) 763-3372, EXT. 9814, EMAIL ADDRESS: LGAMIOTEA c1.CITYOFOKEECHOBEE.COM, AND MAILING ADDRESS: 55 SE THIRD AVE, OKEECHOBEE FL, 34974. 9.9 No Third-Party Beneficiaries This Contract is solely for the benefit of the Contractor and the City. No person or entity other than the Contractor or the CITY shall have any rights or privileges under this Contract in any capacity whatsoever, either as third-party beneficiary or otherwise. 9.10 Assignment Contractor shall not assign,delegate,sublease or otherwise transfer any portion of its rights and obligations as set forth in this Contract without prior written consent of the City. Any attempted assignment in violation of this provision shall be void. 9.11 Waiver No waiver of any term of this Contract constitutes a waiver of any other provision, whether similar or dissimilar. No waiver of any term constitutes a continuing waiver. No waiver is binding unless signed in writing by the waiving party. 9.12 Severability If any term of this Contract is for any reason invalid or unenforceable, the rest of the Contract remains fully valid and enforceable. 9.13 Entire Contract This Contract constitutes the entire agreement between the parties and supersedes all prior and contemporaneous agreement, representations, and undertaking. No supplement, modification, or amendment of this agreement will be binding unless it is in writing and signed by both parties. 9.14 Interpretation Unless the context requires otherwise: The term "including" contemplates "including but not limited to." 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. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 31 • • 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 performance of this Contract thatarises 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 provision shall not apply if the"Statement of Work"of this Contract specifies that performance by the Contractor is specifically required during the occurrence of any of the events herein mentioned. 9.17 Inspector General Cooperation Contractor understands and agrees that it will comply with Section 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(3)(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,Subcontractor,or consultant under a contract with any Public Entity,and may not transact business with any Public Entity in excess of the threshold amount provided in F.S. 287.017 for Cateaory Two for a period of thirty-six(36) months from the date of being placed 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. ARTICLE 10. INSPECTION AND CORRECTIVE ACTION PROCEDURES 10.1 The CONTRACTOR is responsible for providing the CITY's designated representative with a written report of the work performed during the week each Friday to the CITY utilizing the form provided by the CITY as Exhibit D. 10.2 CITY shall provide CONTRACTOR notice of any deficiency in CONTRACTOR's performance of the Services (a "Deficiency Notice") within five (5) calendar days of CONTRACTOR's completion of all or a portion of the Services during any month. 10.3 Upon receipt from CITY of a Deficiency Notice, CONTRACTOR shall correct said deficiency within five(5) calendar days. 10.4 Failure by the CONTRACTOR to submit the required written work report or to perform any corrective actions specified in the "Defiance Notice" withing the time frame noted above shall result in the CITY withholding payment for the affected bid item for that month. 10.5 Upon discovery of any deficiency resulting in the CITY withholding payment in CONTRACTOR's performance of the Services on more than three (3) occasions during the term of this Agreement, CITY may elect not to provide CONTRACTOR a Deficiency Notice and may instead terminate this Agreement as set forth in the sub-section titled "Termination for Cause". City of Okeechobee Project No.PW 04-10-05-23 Public Works Department 32 • • IN WITNESS WHEREOF, the parties hereto have signed two (2) copies of this agreement. At least one counterpart each has been delivered to the CITY and CONTRACTOR. All portions of the contract documents have been signed or identified by CITY and CONTRACTOR or by Public Works Director on their behalf. This Agreement will be effective on . CITY CONTRACTOR By: By: Dowling R. Watford, Jr. Mayor Name: Attest: Title: Lane Gamiotea, CMC, CITY Clerk Attest: Title: Corporate Seal Addresses for giving notices: CITY CONTRACTOR City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 Florida State Contractors License No Approved as to form and legality for the use and reliance of the City of Okeechobee only. John J. Fumero, Attorney City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 33 • ADDENDUM NO. 1 CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS Project No. PW 04-10-05-23 Issue Date, June 5, 2023 The answers to the questions posed at the May 31,2023 Pre-bid meeting for the above project are as follows: Questions received in Meeting (Including field): 1. Is there an Engineering Estimate(Cost)?: a. City Response:The grant funding available is$300K 2. Was a geotechnical report done on the site? a. KH Response: No. 3. What is the structure lead time? a. KH Response: 10 weeks. 4. The deadline is dependent on the Leadtime of the manufacturer. a. KH/City Response:The current lead time is 10 weeks.The current schedule is beginning construction within 60 days of NTP and completing construction within 60 days of start date.That allows 6 weeks for construction,so the deadline of 12/31/2023 should be achievable. 5. How to connect to existing structure?Pending response. 6. Will you require collars?Pending Response. 7. If no collars and go up to next pipe length, is it acceptable to have the bell of the pipe in an opposing direction?Pending Response. 8. There is plus/minus noted on the invert locations. a. KH Response:We took the closest upstream and downstream inverts to and calculated approximate inverts. The plus and minus is added wherever we perform calculations like this. 9. Will the City reimburse permit fees? a. City Response: No ROW permit is required. 10. Will the City/Engineer require Densities to be checked? a. KH Response:This is typically a part of the contract with the contractor. Specs will be reviewed to confirm. 11. What are the inspection requirements?Acceptance requirements? a. KH/City Response: KH will be onsite during the bulk of the construction and for all construction milestones. Questions received via Email: 1. If by-passing is necessary would it be possible to by-pass from the existing nutrient box to CB#2 instead of having to cross the street from CB#1?Pending Response. • • ADDENDUM NO. 2 CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS Project No. PW 04-10-05-23 Issue Date, June 9, 2023 Revised Bid Opening Date and Time 1. The bid opening date ant time have been changed to Thursday June 22, 2023,3:00 PM. The bid opening location remains the same.See attached revised invitation to bid. Alternate Structure Approved 1. The approved Hydrodynamic Separator has been changed to Ecosense Denitra Valult. Requests for Information 1. Please use the responses below to replace responses in Addendum 1. Response to RFIs: Requests-for-Information: 1. Is there an Engineering Estimate(Cost)? a. There is$300K available in grant funding for design and construction. 2. Was a geotechnical report done on the site? a. No. 3. What is the structure lead time? a. The manufacturer's anticipated lead time is 6 weeks. 4. How to connect to existing structure?Will you require collars?If no collars and go up to next pipe length, is it acceptable to have the bell of the pipe in an opposing direction? Installation of drainage structure and connection to existing pipe shall be in accordance with specification 02607 Inlets, Manholes, and Drainage Pipe. 5. Will the City reimburse permit fees? a. No ROW permit is required. 6. Will the City/Engineer require Densities to be checked? a. See specification 01410 Testing Laboratory Services. 7. What are the inspection requirements?Acceptance requirements? a. Construction observation will be performed by the engineer and/or City. Construction elements requiring observation will be reviewed at the preconstruction meeting. 8. If by-passing is necessary,would it be possible to by-pass from the existing nutrient box to CB#2 instead of having to cross the street from CB#1? a. Yes, provided existing structure is not damaged during pumping operation. 2. Revised Technical Specifications. Please include the following summary of changes: a. 01020—Maintenance& Protection—Strikethrough of reference to Appendix • • b. 01060 Regulatory Requirements and Notifications—Strikethrough of reference to Appendix c. 02200—Earthwork Excavation and Backfill—Strikethrough of reference to Appendix d. Appendix A—Replaced e. Appendix B—Removed from specifications. 3. Revised Plans: a. G-1 Cover sheet—Note of Bid Addendum Change b. C-i Drainage Plan—Bid Addendum Change—Revision of notes(clouded) • • Exhibit 9 te_.41°' C D CITY OF OKEECHOBEE, PUBLIC WORKS 7/18/2023 ,� t Okeechobee Memo FLORIDA•Founded 1915 To: Gary Ritter, City Administrator From: David Allen, Public Works Director Date: 7/5/2023 Re: Request for award of SE 4th Street Drainage improvements Project PW 04-10-05-23 to Johnson-Davis Inc The Public Works Department is requesting a Purchase Order in the amount of$218,500.00 to Johnson- Davis Inc for construction services needed to install a stormwater hydrodynamic separator on the 48" stormwater main line in the 500 block of SE 4th Street.The hydrodynamic separator is being installed to provide water quality improvements to the stormwater being discharged into Taylor Creek. Two bids were received for the project. The total bid amount for each of the vendors is: Johnson-Davis Inc. $190,000.00 Boromei Construction Inc $277,900.00 A detailed bid tabulation for the project, along with the actual bid documents from Johnson-Davis Inc. are attached.The Purchase order request for the project includes a 15%contingency for the potential need for additional concrete around the hydrodynamic separator.The separator to be used for the project was changed during the bid process.The contractor selected identified an alternate structure which was evaluated by the engineer. It was determined that alternate structure was both more cost effective and provided better nutrient reduction. The engineer is working with the hydrodynamic separator manufacturer to determine if additional concrete will be needed. This project is a Florida DEP Stormwater improvement funded project.The grant amount from FDEP is $300,000.00 • • BID TABULATION SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 Johnson-Davis Inc Boromei Construction Inc ITEM NO. DESCRIPTION UNIT MEASURE EST.QTY. UNIT PRICE AMOUNT Unit price AMOUNT 1 MOBILIZATION LS 1 $10,000.00 $10,000.00 $25,000.00 $25,000.00 2 PROFESSIONAL VIDEOTAPING OF SITE CONDITIONS LS 1 $1,000.00 $1,000.00 $2,500.00 $2,500.00 3 SURVEY LAYOUT AND RECORD DRAWINGS LS 1 $2,000.00 $2,000.00 $6,500.00 $6,500.00 4 MAINTENANCE OF TRAFFIC LS 1 $2,000.00 $2,000.00 $5,000.00 $5,000.00 5 HYDRODYNAMIC SEPARATOR LS 1 $150,000.00 $150,000.00 $235,000.00 $235,000.00 6 45'RCP LS 1 $5,000.00 $5,000.00 $400.00 $400.00 7 SITE RESTORATION LS 1 $20,000.00 $20,000.00 $3,500.00 $3,500.00 TOTAL BID AMOUNT (Based on Bid Unit Prices&Estimated Quantities) $190,000.00 $277,900.00 Posted: June 22,2023 @ 4:00 P.M. To be removed : July 3,2023 @ 4:00 P.M. • • Johnson-Davis,Inc. ORM 604 lbr 3 Lantana,FLL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT A CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 NO LOBBYING AFFIDAVIT STATE OF FLORIDA COUNTY OF Palm Beach This 14th day of June , 2023 , Wm. Clark C. Cryer being first duly sworn, deposes and says that he/she is the authorized representative of Johnson-Davis, Incorporated (Name of Contractor, Firm or Individual) respondent to the attached request for Bid, or qualifications and/or any other solicitation released by City of Okeechobee, and that the Bidder and any of its age ag es to abide by the City of Okeechobee no lobbying restrictions in regard to this solicit ion. A nt The foregoing instrument was acknowledged before me by means of ❑ physical presence or ❑ online notarization, this i'i%" day of , 20 2; , by ist/.4d2_4.:.. C.iv , who is personally known to me or produced as identification. �,r JAMES PATRICK AMSLER 1 N0 Cry Public Signature 0 ;a• ': Notary Public•State of Florida 4 -N®` Commission 4 HH 25A617 orr• My Comm.ExpiresAug 11,20I6 Commission No. 0-14/ Bonded through National Notary Assn. 1 • City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 247 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT B CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 ANTI-COLLUSION STATEMENT AND NO GIFT STATEMENT Date: 6/14/2023 Anti-collusion statement: The below-signed Bidder has not divulged to, discussed, or compared his/her Bid with other Bidders and has not colluded with any other Bidder or parties to a Bid whatsoever. No gifts statement: No premiums, rebates, gifts or gratuities are permitted with, prior to, or after submission of the Bid. Any such violation will result in rejection of the Bid and removal from the Bid list(s). Firm Name: Johnson-Davis, Incorporated By(printed/typed): Wm. lark-C, Cryer By(signature): (Wm.Clark C.Cryer ice President) Title: Vice Pre 'dent L. Mailing Address: 604 Hillbrath Drive City, State, Zip: Lantana, FL 33462 Telephone No.: (561) 588-1170 • City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 248 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT C CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 PROPOSER'S CERTIFICATION I have carefully examined this Request for Bid (BID)/Request for Proposals (RFP)/ Request for Qualifications (RFQ), which includes scope, requirements for submission, general information and the evaluation and award process. I acknowledge receipt of the following addenda. Addendum# 1 Date: 6/5/2 0 2 3 Addendum # Date: Addendum # 2 Date: 6/9/2 0 2 3 Addendum # Date: Addendum # Date: Addendum# Date: I hereby propose to provide the services requested in the City's BID/RFP/RFQ and, if awarded, to enter into the attached draft contract. I agree that the terms and conditions of the City's BID/RFP/RFQ shall take precedence over any conflicting terms and conditions submitted with my proposal and agree to abide by all conditions of the BID/RFP/RFQ, unless a properly completed Exceptions to BID/RFP/RFQ form is submitted. I acknowledge that the City may not accept the proposal due to any exceptions. I certify that all information contained in my proposal is truthful to the best of my knowledge and belief. I further certify that I am duly authorized to submit this proposal on behalf of the Company as its agent and that the Company is ready, willing and able to perform if awarded a contract. I further certify, under oath, that this proposal is made without prior understanding, agreement, connection, discussion or collusion with any other person, Company or Corporation submitting a proposal for the same product or service; no gratuities, gifts or kick-backs were offered or given by the Bidder or anyone on its behalf to gain favorable treatment concerning this procurement; no City Council member, employee or agent of City of Okeechobee or of any other Company is interested in said Bid; and that the undersigned executed this Proposer's Certification with full knowledge and understanding of the matters therein contained and was duly authorized to do so. Johnson-Davis, Incorporated 604 Hillbrath Drive Na o siness Mailing Address Lantana, FL 33462 City, State &Zip Code L (561) 588-1170 / (561)585-3252 Authoriz Signature Telephone Number/Fax Number Wm. ark C. Cryer, Vice President ccryer@johnsondavis.com Nine &Title, Typed Email Address STATE OF FLORIDA COUNTY OF /a/1LJn ':d• cll.' The foregoing instrument was acknowledged before me by means of 0 physical presence or 0 online notarization, this iyyri day of dux , 202; , by G/rrxe , who is personally known to me or produced as identification. JAMES PATRICK AMSLER ;�`'�'`' Notary Public•State of Florida I tary Public Signature � Cammifsion Y HH 254617 Commission No. i/fr 2.sw6/"7 15'•Fp, My Comm.Expires Aug 11,2026 I Bonded through National notary Assn. I City of 0 keeclireoirm Project No. PW 04-10-05-23 Public Works Department 249 i • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT D CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 SWORN STATEMENT PURSUANT TO SECTION 287.133 (3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to CITY OF OKEECHOBEE, FLORIDA by: Wm. Clark C. Cryer, Vice President (print Individual's name and title)for: Johnson-Davis, Incorporated (print name of entity submitting sworn statement) whose business address is 604 Hillbrath Drive, Lantana, FL 33462 and (if applicable) its Federal Employer Identification Number(FEIN) is: 59-1753888 (If the entity has no FEIN, include the Social Security Number of the Individual signing this sworn statement: - - .) 2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or of the United States, including but riot limited to, any Bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentations. 3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989,as a result of a jury verdict, non jury trial, or entry of a plea of guilty or nob contendere. 4. I understated that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means: a. A predecessor or successor of a person convicted of a public entity crime; or b. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 250 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which Bids or applies to Bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. 6. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Indicate which statement applies). • Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. ❑ The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. O The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However,there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list (attach a copy of the final order). I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGO 0 F ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. Signature (Wm.Clark C.'ryer,Vice President) STATE OF FL• '.IDA COUNTY • The foregoing instrument was acknowledged before me by means of D physical presence or D online notarization, this%"!u day of , 202. , by 41./2.4.44f GzeYte.ie , who is personally known to me or produced as identification. I aii ►"'• JAMES PATRICK AMSLER I "'' I ;F; � Notary Public•State of Florida ( ot� Public Signature � ` Commission d NH 2546'7 ';•'or d My Camm.Expires Aug t .2026 o Bonded through National Notary Assn. ' Commission No. .fit✓ 2 .z!G/'7 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 251 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT E CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all Bidders must disclose if any City of Okeechobee employee(s), elected official(s), or any of its agents is also an owner, corporate officer, director, agent, employee, etc., of their business. Indicate either"yes" (a City employee, elected official or agent is associated with your business), or"no". If yes, give person(s) name(s) and position(s)with your business. YES NO X Name(s) Position(s) Firm Name: Johnson-Davis, Incorporated By (Printed): . Ciar C. Cryer By(Signature . (Wtn.Clark ryer,Vice President) Title: Vice President Address: 6061i rath Drive, Lantana, FL 33462 Phone Number: (561) 588-1170 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 252 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 ATTACHMENT G Fax: (561)585-3252 • CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 DRUG-FREE WORKPLACE CERTIFICATION THE BELOW SIGNED Bidder/proposer CERTIFIES that it has implemented a drug-free workplace program. In order to have a drug-free workplace program, a business shall: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violation of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace,the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under quote a copy of the statement specified in subsection 1. 4. In the statement specified in subsection 1, notify the employees that, as a condition of working on the commodities or contractual services that are under quote, the employee will abide by the terms of the statement and will notify the employer of any conviction or plea of guilty or nolo contendere to any violation occurring in the workplace no later than five (5) days after.such conviction. 5. Impose a sanction on, or require the satisfactory participation in, drug abuse assistance or rehabilitation program if such is available in the employee's community, by an employee who is convicted. 6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign this statement, I certify that this Firm complies fully with the above require nts.) Signature. Date: 6/14/2023 (Wm Jar .Cryer,Vice President) Company: Jo on-Davis, Incorporated Name: Wm. Clark C. Cryer Address: 604 Hillbrath Drive Title: Vice President Lantana, FL 33462 : Phone Number: (561) 588-1170 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 254 • • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT H CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 REFERENCE FORM Client Name: Martin County Board of County Commisoners Client Phone Number: (772) 288-5400 Client E-mail: lhuber@martin. fl . us Service Dates: Beginning 12/2017 End 8/2018 Estimated Contract Amount: $704, 675 . 00 Description of the services performed as they directly relate to the work of this Request for Bid: Install three baffle boxes . City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 255 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT H CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 REFERENCE FORM Client Name: Hardrives Client Phone Number: 561-737-3555 Client E-mail: info@hardrivespaving. com Service Dates: Beginning 4/2015 End 4/2015 Estimated Contract Amount: $10, 660 . 00 Description of the services performed as they directly relate to the work of this Request for Bid: Install Baffle Box. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 255 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT H CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 REFERENCE FORM Client Name: Martin County Board of County Commisoners Client Phone Number: (772) 288-5400 Client E-mail: lhuber@martin. fl . us Service Dates: Beginning 12/2017 End 8/2018 Estimated Contract Amount: $704, 675 . 00 Description of the services performed as they directly relate to the work of this Request for Bid: Install three baffle boxes . City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 255 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT H CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 REFERENCE FORM Client Name: Hardrives Client Phone Number: 561-737-3555 Client E-mail: info@hardrivespaving. corn Service Dates: Beginning 4/2015 End 4/2015 Estimated Contract Amount: $10, 660 . 00 Description of the services performed as they directly relate to the work of this Request for Bid: Install Baffle Box. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 255 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 ATTACHMENT H CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 REFERENCE FORM Client Name: Town of Sewalls Point Client Phone Number: (772) 287-2455 Client E-mail: jcapra@gocaptec .com Service Dates: Beginning 10/2020 End 9/2022 Estimated Contract Amount: $1, 079, 337 . 30 Description of the services performed as they directly relate to the work of this Request for Bid: Refurbish two existing Baffle Boxes with materials provided by EcoSense . City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 255 • • EXHIBIT B CITY OF OKEECHOBEE SE 4th STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 BID UNIT PRICE SCHEDULE ITEM NO. UNIT DESCRIPTION MEASURE EST.QTY. UNIT PRICE AMOUNT 1 MOBILIZATION LS 1 10, 000 10, 000 . 00 2 PROFESSIONAL VIDEOTAPING OF SITE CONDITIONS LS 1 1, 000 1 , 000 . 00 3 SURVEY LAYOUT AND RECORD DRAWINGS LS 1 2, 000 2, 000 . 00 4 MAINTENEANCE OF TRAFFIC LS 1 2, 0 0 02, 000 . 00 5 HYDRODYNAMIC SEPARATOR LS 1 150, 000 150, 000 . 00 6 48"RCP LF 1 5, 000 5, 000 . 00 7 SITE RESTORATION LS 1 20, 000 20, 000 . 00 TOTAL BID AMOUNT (Based on Bid Unit Prices&Estimated Quantities) 190, 000 . 00 Bidders Company Name Johnson-Davis Incorporated NOTE: This Bid is on a unit price basis. The total estimated amount is for Bid comparison purposes only. The Contractor should field verify the actual site conditions prior to time of bidding and before submitting the Bid proposal. The Contractor should read the special conditions and the requirements for insurance before submitting a Bid proposal. The Contractor shall furnish the City of Okeechobee with a Payment and Performance Bond in 100 percent (100%) of the total estimated amount of the contract. The Payment and Performance Bond shall continue in effect for one (1) year after completion and acceptance of the work as guarantee against construction defects. The Contractor in his Bid shall include the cost of said bond. I have attached the required 5 percent (5%) Bid Security to this Bid. Bidder son-Davis Incorporated Date: 6/21/2023 (Company Name) By: Title: Vice President (signature) 7n am Cryer Email: ccryer@ johnsondavis . com (Printed Name) Mailing Address: 604 Hillbrath Drive, Lantana, FL 33462 Office Number: 561-588-1170 Fax Number: 561-585-5252 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 213 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 SECTION I CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 GENERAL INFORMATION All responses which comply with the requirements of this Bid will be considered. Submittals must be made in the official name of the Firm or Individual under which business is conducted(showing official business address)and must be signed in ink by a person duly authorized to legally bind the person, Partnership, Company, or Corporation submitting the response to this Bid. Two clearly identified originals and one copy of your bid submittal are required. Bid submittals will be received by the General Services Department until 3:00 p.m. on June 14, 2023. Bid submittals are to be mailed, hand-delivered, and/or Express Mail to: City of Okeechobee General Services Department 55 S.E. 3rd Avenue, Room 101 Okeechobee, FL 34974 The submitting offeror is required to have printed on the sealed envelope or wrapping containing their submission their Company name and return address, the Bid Number, Title, Opening Date and Time. Bids received after the date and time specified above shall be returned to the sender unopened. Facsimile or emailed bids will not be accepted. All bids shall remain in effect for a period of ninety(90)days after the last day on which bids must be submitted. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 2 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 SECTION II CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 SUBMISSION REQUIREMENTS The bidder shall submit two (2) original clearly identified originals and one copy of the following: 1. Bid Documentation Form (Section III) 2. Minimum Qualifications for Bidders Form (Section IV) and three (3) references (Attachment H) 3. Bid Bond 4. Performance Bond 5. Bid Unit Price Schedule (Section VII, Exhibit B) In addition to the above, please complete the following forms that must be returned with your bid: Attachment A—No Lobbying Affidavit Attachment B—Anti Collusion Statement and No Gift Statement Attachment C—Proposer's Certification Attachment D—Sworn Statement Pursuant to Section 287.133(3)(a), FL Statutes on Public Entity Crimes Attachment E—Conflict of Interest Disclosure Attachment F—Immigration Law Certification Attachment G— Drug Free Workplace Certification Attachment H — Reference Form City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 3 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 SECTION III CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS, FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 BID DOCUMENTATION Johnson-Davis, Incorporated (BIDDER'S COMPANY NAME) City Council City of Okeechobee 55 S.E. 3rd Avenue Okeechobee, FL 34974 I have received the documents titled CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS, FDEP GRANT AGREEMENT LPQ0007, Project No. PW 04-10-05-23. I have also received addendum number 1 through 1 and have included these provisions in my Bid. I have examined both the Bid documents and the construction site and submit the following Bid in which I agree: 1. To hold my Bid open until an agreement has been executed between the City of Okeechobee and accepted Bidder, or until ninety(90)days after Bids are opened, whichever is longer. 2. Regarding the Disposition of Bid Security: to accept the provisions of the Instructions to the Bidders. 3. To accomplish the work included in, and in accordance with the Contract Documents, if this Bid is accepted. 4. To start work within 60 calendar days from the Notice to Proceed and there after completing the work within 60 calendar days of commencement of work. 5. Regarding Compensation for the proposed work: if this Bid is accepted, I will construct this project on a unit price basis as reflected in the Bid Unit Price Schedule, Exhibit B of this agreement. Payment will be made upon invoice after completion of all work. NOTE:The City shall not be liable to pay interest on any unpaid balance. Vendor is solely responsible for all taxes, withholding, or social security obligations. 6. Regarding the Award of the Contract: if I am awarded a contract for this project, I understand that the award may be for all or any portion thereof, of the items listed under the Bid Unit Price Schedule. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 4 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Bid hnson-Davis, Incorporated Date: 6/14/2023 (Company Name) By: Title: Vice President (Signature)(Wm•Clark C.Cryer,VP) Wm. Clark C. Cryer Email: ccryer@johnsondavis.com (Printed Name) Mailing Address: 604 Hillbrath Drive, Lantana, FL 33462 Office Number: (561) 588-1170 Fax Number: (561) 585-3252 • City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 5 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 SECTION IV CITY OF OKEECHOBEE SE 4TH STREET DRAINAGE IMPROVEMENTS FDEP GRANT AGREEMENT LPQ0007 PW 04-10-05-23 MINIMUM QUALIFICATIONS FOR BIDDERS Minimum Qualifications: 1.0 Experience 1.1 Bidder must have at least 3 years of experience in providing commercial storm water improvement services including pipe, and structure installation and site restoration. 1.2 Bidder has successfully completed at least 6 storm water improvement projects in the last three years. 2.0 References 2.1 Bidder must provide at least 3 verifiable references of similar work as referenced in section 1.0 above. 2.2 For each reference, Bidder shall submit a completed Reference Form provided in Attachment H. provide the client name, client phone number, and client e- • mail address. 2.3 Bidder shall provide a written description of the services performed in sufficient detail as they directly relate to the work of this Request for Bid. The description shall include the dates of the period that the Bidder provided the services as well as the contractual amount of the services provided. 2.4 The City, in its sole discretion, may reject any and all bids if the City is not able to verify the references provided. • 3.0 Discriminatory Vendor List 3.1 In accordance with Section 287.134, Florida Statutes, an entity or affiliate who has been placed on the Discriminatory Vendor List, kept by the Florida Department of Management Services, may not submit a bid on a contract to provide goods or services to a public entity; may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor or consultant under a contract with any public entity; and may not transact business with any public entity. 4.0 Bidder certifies that 4.1 Bidder meets the qualifications listed in Section IV, 1.0 above. 4.2 Bidder has never failed to complete work awarded under a contract due to circumstances that were under Bidder's control. 4.3 The Bidder has not been placed on the Discriminatory Vender List kept by the Florida Department of Management Services as listed in section 3.0 above. City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 6 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Bidder: on-Davis, Incorporated Date: 6/14/2023 / i (Company Name) By: Title: Vice President (Signature)(wm.Clark C.Cryer,VP) • m. Clark C. Cr er . ccr er ohnsondavis.com y Email: y @� (Printed Name) Mailing Address: 604 Hillbrath Drive,Jupiter, FL 33462 Office Number: (561) 588-1170 Fax Number: (561) 585-3252 City of Okeechobee Project No. PW 04-10-05-23 Public Works Department 7 • • wnnaun vavia,uw. N/A Per Section 5.02 of Bid Documents Proposal is Under $200k 604HiltbrathDr. Lantana,FL 33462 COMMON LAW PERFORMANCE BOND Phone:(561)588-1170 Fax: (561)585-3252 BY THIS BOND, know that as Principal, herewith called [CONTRACT► -], Business Address , Business Phone , and , as , hereinafter called SURETY, Surety Address Surety Phone Number , are bound to City of Okeechobee, as Obli• e, herein called CITY, in the amount of Dollars ($ ) for paym•nt of which CONTRACTOR and SURETY bind themselves, their heirs, personal representativ: , executors, administrators, successors and assigns, jointly and severally, with reference to a wri -n CONTRACT entered into by CONTRACTOR and CITY, for the following: Contract Number: PW 04-10-05-23 Contract Title: CITY OF OKEECHOBEE SE 4TH STREET DRAIN E IMPROVEMENTS, FDEP GRANT AGREEMENT LPQ0007 General Description of Project: The Contractor shall furnish all labo• and materials necessary to perform the hydrodynamic separator installation, as shown on the pl. s in Okeechobee, Florida. The project shall include all piping, fittings, accessories and appurtena,ces, site restoration for all work, temporary provisions to maintain functionality of the drainage syst- , all testing, removal of the existing piping as specified, compliance with permit conditions, byp.ss pumping for stormwater mains, maintenance of traffic in accordance with City standards, an, any other items as described in these documents to provide a complete and functional system. Directions: THE CONDITION OF THIS BOND is that if the [CO.. RACTOR]: 1. Performs said contract in accordance with its t-rms and conditions; and 2. Pays CITY all losses, damages (direct and ,•nsequential including delay or liquidated damages), expenses, costs, and attorney's fees, incl •ing appellate proceedings, that CITY sustains because of a default by CONTRACTOR under the CONTRACT; and 3. Pays CITY any and all other amou due CITY by CONTRACTOR because of a default by CONTRACTOR under the CONT A r T; and 4. Performs the warranty, extended .rranty and guarantee of all work and materials furnished under the CONTRACT for the time sp- ified in the CONTRACT; THEN THIS BOND IS VOID, 0 ERWISE, IT REMAINS IN FULL FORCE. If there is no CITY defaul the SURETY's OBLIGATIONS UNDER THIS BOND shall arise after SURETY has received no e of CITY's declaration of default of CONTRACTOR in accordance with the terms and conditions of e CONTRACT (including notice and cure periods), so that within 20 days of CITY's declaration CONTRACTOR's default, SURETY shall either (1) arrange for the CONTRACTOR, wi the written consent of the CITY, to timely perform and complete the contract or (2) undertake to mely perform and complete the contract either by retaining another contractor approved by the CITY or undertaking to do the contract itself. SURETY shall be liable for any and all delays cause• •y the CONTRACTOR, SURETY, and/or the replacement contractors) provided by the SURETY. RETY's failure to take such action shall be deemed to be a default on this Bond, thus entitling t - CITY to complete the contract with another contractor and recover all resulting damages, includins, but not limited to, all direct and consequential damages including delay or liquidated damages, engineering and architectural fees, as well as any and all legal costs and attorney's fees. y of Okeechobee Project No. PW 04-10-05-23 .ublic Works Department 18 • • 131/4 nworatn ur. Lantana,FL 33462 Phone:(561)588-117' Any changes in or under the Contract Documents do not affect the Surety's obligation undtorthWilaftti Surety hereby waives notice of any alteration or extension of time made by the Owner. Any suit un•-r this bond must be initiated before the expiration of the limitation period applicable under FI• ida Statutes. IN WITNESS WHEREOF, this instrument is executed this_day of , 21_ WHEN THE PRINCIPAL IS AN INDIVIDUAL: Signed and delivered in the presence of: By: By: (Witness) Individual P ncipal WHEN THE PRINCIPAL OPERATES UNDER A TRADE NAME: Signed and delivered in the presence of: By: By: (Witness) Signature of Individual By: (Witness) WHEN A PARTNERSHIP: Signed and delivered in the presence of: By: By: (Witness) Partner By: (Witness) WHEN THE PRINCIPAL IS A C• 'PORATION: ATTEST: By: (Type Corporate Princip. Name) President By: (Secretary) SURETY: ATTEST: (Surety Seal By: (Type Corporate Surety Name) SURETY By: (Secretary) . ty of Okeechobee Project No. PW 04-10-05-23 Public Works Department 19 • • Johnson-Davis,Inc. 604 Hillbrath Dr. ATTORNEY-IN-FACT Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 By: Name NOTE 1: Surety shall provide evidence of signature authority, i.e., a certified copy of Power o Attorney. IMPORTANT: Surety companies executing BONDS must appear on the Treasury Detartment's most current list (Circular 570 as amended) and be authorized to transact business in the tate of Florida. ATTACH a certified copy of Power-of-Attorney appointing individual Attorney-in act for execution of Performance Bond on behalf of Surety. The Common Law Performance Bond and the Payment Bond and the co -red amounts of each are separate and distinct from each other. • ' y of Okeechobee Project No. PW 04-10-05-23 Public Works Department 20 • • %4'' Libertyr Liberty l<�utual Surety rf ` Mutual April 17, 2023 Re: Johnson-Davis Incorporated- Surety Capacity • To Whom It May Concern: Johnson-Davis Incorporated is a highly regarded and valued client of Liberty Mutual Insurance Company ("Liberty Mutual"). It has been our privilege to provide surety bonds for Incorporated for over 25 years. Currently,we provide a bond program of$50,000,000 per project,with an overall backlog of $150,000,000. We are confident in their ability to perform. Liberty Mutual is an A(Excellent)A.M. Best rated insurance company in Financial Size Category XV($2 Billion or greater). Please note that the decision to issue performance and payment bonds is a matter between Johnson- Davis Incorporated and Liberty Mutual,and it will be subject to standard underwriting at the time of the final bond request,which will include but not be limited to the acceptability of the contract documents, bond forms and financing. We assume no liability to third parties or to you if for any reason we do not execute said bonds. If you have any questions or need any additional information, please do not hesitate to contact me at (612)349-2464. Sincerely, Liberty Mutual Insurance Company Ted Jorgensen Attorney-in-Fact Member of Liberty Mutual Group • • ar. This Power of Attorney limits the acts of those named herein,and they have no authority to ..., bind the Company except in the manner and to the extent herein stated. VAL- Liberty Liberty Mutual Insurance Company Pry' Mutual The Ohio Casualty Insurance Company Certificate No:8207173-190054 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the'Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint. Brian J. Ocstrcich;C.White;Emily White;Joshua R.Loftis;Lin Ulven;Melinda C.Blodgett;Nathan Weaver,Nicole Stillings;R.C.Bowman;R.W.Frank;Rachel Thomas; Ross S.Squires;Sandra M.Engstrum;Tcd Jorgensen;Tina L.Domask all of the city of Minneapolis slate of MN each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 24th day of January , 2022 . Liberty Mutual Insurance Company Py INSO.j Pvvi iNsp %HSUR9 The Ohio Casualty Insurance Company 45 4oPPo4\y • oa°OR.v� uP opPORgr 4. West American Insurance Company 3 4ocfr+ 43` q,t �` e Aon7. o r 41912cyo 31�1919`4�a s 1991 0 4/74. y N dJ,�'r4eey5%3a ° l'N,wv3`�., vo "ra.n,- ,air. `v ' oh—.AT-0 �ylk0 ''M * 1-# By: .=its N David M.Carey,Assistant c CD State of PENNSYLVANIA • 5 rn County of MONTGOMERY Ss a .-= On this 24th day of January , 2022 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance (33 a2 o co> Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes 2-11 ,. therein contained by signing on behalf of the corporations by himself as a duty authorized officer. >0 a)v IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at IGng of Prussia,Pennsylvania,on the day and year first above written. c.0 a_O P Sr PA Q�y vputy- F{ Con m onweatet of PeensykaNa•Notary Seal >,_ W of a<A t Teresa Pestette,Notes!"Puttee C.� OF- •,, OP s •� MnNgnmcry Cearty +-- I Me commission aspires March20.202b By: G o) W '4. �,T Carnm�ssronnur�er112801� =... CD a1 l ri 0�� Member nZaykm rwcnec 2,a netece3 eresa Pastella,Notary Public c'5 co Fig This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company,Liberty Mutual o cv E.6 Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: rl cn ARTICLE IV—OFFICERS:Section 12o Ea. .Power of Attorney. o 0 My officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the v a President mayprescribe,shall appoint such attorneys-In-fact,as be to act In behalf of the CorporationRs m ppomay necessary to make,execute,seal,acknowledge and deliver as surety to e RI C any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall- Es, have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such o a) Z c15 0i instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the a is; provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. ti a ARTICLE XIII—Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of arty power of attorney issued by the Company in connection with surety bonds,shall be vatid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 17th day of April 2023 • Pv INSV,� *�SY ills& N RISU,pq °opP.714%+ip ,"P°144'9y0 ,?`epvon4�y° 3 4 _1912 n c s1919� c a 1991� c ,.6407(C.41, cjr�+ Yd fs4s,,us u L° S°elkfim Ps"$Df 'C *ammo- tr By: fig•: v *• 4/ IA s4, 0- Renee C.Llewellyn,Assistant Secretary rr LMS-12873 LMIC OCIC WAIC Mutti Co 02/21 • • Johnson-Davis, Incorporated 604 Hillbrath Drive Lantana, FL 33462 Phone: (561)588-1170 Fax: (561)585-3252 Surety Company(Bonding Company): 4, Liberty Mutual Insurance Company 3011 Sutton Gate Dr.,Suite 300,Suwanee,GA 30024 Brad Schramm, (678)735-1181 Surety's resident agent for service of process: 4, CURRENT: Ted Jorgensen,CSDZ,225 South 6th Street,Suite 1900,Minneapolis, MN 55402,D:(612)349-2464 Kim Niv,Liberty Mutual Insurance Company,620 N.Wymore Road,Suite#200,Maitland,FL 32751, D:(407)478- 6836(Florida Resident Agent)(as of 12/17/2021) • Bonding Agent: 4, CSDZ 1600 Aspen commons,Suite 990, Middleton,WI 53562 -Primary Contact: Nicole Stillings,Surety Service Advisor/Team Lead,(608)242-2551, NStillings@csdz.com -Secondary Contact:Ted Jorgensen, Client Executive/Shareholder, (612)349-2464, TJorgensen@csdz.com • IIIJonnson-uaVls,Inc._ AC�® 604 Hillbrath Dr. CERTIFICATE OF LIABILITY INSURANCEpha� (561)588�117( DATE(MM/DD/YYYY) �/ b� 08/11/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UFtgI GI Hg Vi-FliVICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME CT Harrison Vaughn Vaughn Risk Management ( cc.PHONE.Ext&. (561)289-0586 I VA.Not: (561)768-4958 222 US Highway 1 St 208D E- L harrisonv vau hnrm.com g Y ADDRESS: @ 9 INSURER(S)AFFORDING COVERAGE NAIC# Tequesta FL 33469 INSURER A: NATIONAL FIRE INS CO OF HARTFORD 20478 INSURED INSURER B: CONTINENTAL INS CO 35289 Johnson-Davis Incorporated INSURER C: VALLEY FORGE INS CO 20508 604 Hillbrath Drive INSURER 0: HOMELAND INS CO 38210 INSURER E: Lantana FL 33462 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INS° WVD POLICY NUMBER (MMIDD/YYYYI (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY _EACH OCCURRENCE S 1,000,000 D CLAIMS-MADE Xi OCCUR PREM PREMISES Ea occurrence)AMAGE TO $ 100,000 MED EXP(Any one person) $ 15,000 A x x 7033967643 07/01/2022 07/01/2023 PERSONAL E.ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 _ POLICY X jE3T LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBaccident)INED SINGLE LIMIT $ 1,000,000 (Ea X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED X X 7033968744 07/01/2022 07/01/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY ^ AUTOS ONLY (Per accident) $ X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESSLIAB CLAIMS-MADE X X 7033984636 07/01/2022 07/01/2023 AGGREGATE $ 10,000,000 DED X RETENTION$ 0 PR/COMP OPS AGG s 10,000,000 WORKERS COMPENSATION X STATUTE OTH- ER AND EMPLOYERS'LIABILITY C ANY OFFICER/MEMBER EXCLUDED?ECUTNE YNN NIA x 7033972535 07/01/2022 07/01/2023 E.L EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000,000 Pollution Liability D 7930119810000 07/01/2022 07/01/2023 Each Occurrence 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is listed as an additional insured with respect to General Liability for ongoing and completed operations,Automobile Liability and Umbrella Liability on a primary noncontributory basis when required by written contract.A waiver of subrogation in favor of additional insureds applies to Workers Compensation,General Liability,Automobiie Liability,Umbrella Liability when required by written contract.Umbrella coverage is follow form to the GL. 30 day notice of cancellation, 10 day notice for non-payment. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Johnson-Davis,inc. ACCORDANCE WITH THE POLICY PROVISIONS. 604 Hillbrath Dr. AUTHORIZED REPRESENTATIVE Lantana FL 33462 L- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • • Johnson-Davis,Inc. 604 Hlllbrath Dr. C'NA Lantana,FL 33462 Business Auto Policy Phone:(561)588-1170 Fax: (561)585-3252 Policy Endorsement e THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILITY COVERAGE A. Who Is An Insured The following is added to Section II, Paragraph A.1., Who Is An Insured: 1. a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the date of inception of this Coverage Form; provided that, b. The insurance afforded by this provision A.1. does not apply to any such entity that is an insured under any other liability "policy" providing auto coverage. 2. Any organization you newly acquire or form, other than a limited liability company, partnership or joint venture, and over which you maintain majority ownership interest. The insurance afforded by this provision A.2.: a. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier. b. Does not apply to: (1) Bodily injury or property damage caused by an accident that occurred before you acquired or formed the organization; or (2) Any such organization that is an insured under any other liability "policy" providing auto coverage. 3. Any person or organization that you are required by a written contract to name as an additional insured is an insured but only with respect to their legal liability for acts or omissions of a person, who qualifies as an insured under SECTION II — WHO IS AN INSURED and for whom Liability Coverage is afforded under this policy. If required by written contract, this insurance will be primary and non-contributory to insurance on which the additional insured is a Named Insured. 4. An employee of yours is an insured while operating an auto hired or rented under a contract or agreement in that employee's name, with your permission, while performing duties related to the conduct of your business. "Policy", as used in this provision A. Who Is An Insured, includes those policies that were in force on the inception date of this Coverage Form but: 1. Which are no longer in force; or 2. Whose limits have been exhausted. B. Bail Bonds and Loss of Earnings Section II, Paragraphs A.2. (2) and A.2. (4) are revised as follows: 1. In a.(2), the limit for the cost of bail bonds is changed from $2,000 to $5,000; and 2. In a.(4), the limit for the loss of earnings is changed from $250 to $500 a day. Form No: CNA63359XX(04-2012) Policy No:BUA 7033968744 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 07/01/2022 Endorsement No: 1 1; Page: 1 of 4 Policy Page: 82 of 250 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 0 Copyright CNA All Rights Reserved. Includes copyrighted material of the • . Johnson-Davis,Inc. CNA 604 Hillhrath Dr. Business Auto Policy Lantana,FL 33462 Phone:(561)588-1170 Policy Endorsement Fax: (561)585-3252 (4) Your employees may know of an accident or loss. This will not mean that you have such knowledge, unless such accident or loss is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. The following is added to Section IV, Paragraph A.2.b.: (6) Your employees may know of documents received concerning a claim or suit. This will not mean that you have such knowledge, unless receipt of such documents is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. B. Transfer Of Rights Of Recovery Against Others To Us The following is added to Section IV, Paragraph A.S. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have, because of payments we make for injury or damage, against any person or organization for whom or which you are required by written contract or agreement to obtain this waiver from us. This injury or damage must arise out of your activities under a contract with that person or organization. You must agree to that requirement prior to an accident or loss. C. Concealment, Misrepresentation or Fraud The following is added to Section IV, Paragraph B.2.: Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not prejudice you with respect to the coverage afforded provided such failure or omission is not intentional. D. Other Insurance The following is added to Section IV, Paragraph B.S.: Regardless of the provisions of Paragraphs 5.a. and 5.d. above, the coverage provided by this policy shall be on a primary non-contributory basis. This provision is applicable only when required by a written contract. That written contract must have been entered into prior to Accident or Loss. E. Policy Period, Coverage Territory Section IV, Paragraph B. 7.(5).(a). is revised to provide: a. 45 days of coverage in lieu of 30 days. V. DEFINITIONS Section V. paragraph C. is deleted and replaced by the following: Bodily injury means bodily injury, sickness or disease sustained by a person, including mental anguish, mental injury or death resulting from any of these. Form No: CNA63359XX (04-2012) Policy No:BUA 7033968744 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:07/01/2022 Endorsement No: 11; Page:4 of 4 Policy Page:85 of 250 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 c Copyright CNA All Rights Reserved. Includes copyrighted material of the • • CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors -with Products-Completed Operations Coverage Endorsement Johnson-Davis,Inc. This endorsement modifies insurance provided under the following: 604 Hillbrath Dr. Lantana,FL 33462 COMMERCIAL GENERAL LIABILITY COVERAGE PART Phone:(561)588-1170 Fax: (561)585-3252 It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part,but only with respect to liability for bodily injury,property damage or personal and advertising injury caused in whole or in part by your acts or omissions,or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract;or B. in the performance of your work subject to such written contract,but only with respect to bodily injury or property damage included in the products-completed operations hazard,and only if: 1. the written contract requires you to provide the additional insured such coverage;and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition,or 10-01 edition of CG2010,or under the 10- 01 edition of CG2037;or B. additional insured coverage with"arising out of'language;or C. additional insured coverage to the greatest extent permissible by law; then paragraph I.above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy,including the limits of insurance,the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract;or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury,property damage,or personal and advertising injury arising out of: A. the rendering of,or the failure to render,any professional architectural, engineering,or surveying services, including: 1. the preparing,approving,or failing to prepare or approve maps, shop drawings,opinions, reports,surveys, field orders,change orders or drawings and specifications;and aM 2. supervisory, inspection,architectural or engineering activities;or B. any premises or work for which the additional insured is specifically listed as an additional_insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS,the Condition entitled Other Insurance is amended to add the following,which supersedes any provision to the contrary in this Condition or elsewhere in this coverage i_ part: CNA75079XX(10-16) Policy No: 7033967643 Page 1 of 2 Endorsement No: 23 Nat'l Fire Ins Co of Hartford Effective Date: 07/01/2022 Insured Name: JOHNSON—DAVIS, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. • Johnson-Davis,Inc. CNA PARAMOUNT CNA Hillbrath Dr. Lantana,Fl.33462 Phone:(561)588-1170 Fax: (561)585-3252 Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement Primary and Noncontributory Insurance With respect to other insurance available to the additional insured under which the additional insured is a named insured,this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured;or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above,this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement,the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence,Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim,or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received,and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim;and 3. make available any other insurance,and tender the defense and indemnity of any claim to any other insurer or self-insurer,whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory,this paragraph 3.does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement,the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy;and B. was executed prior to: 1. the bodily injury or property damage;or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers,takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below,and expires concurrently with said Policy. CNA75079XX(10-16) Policy No: 7033967643 Page 2 of 2 Endorsement No: 23 Nat'l Fire Ins Co of Hartford Effective Date: 07/01/2022 Insured Name: JOHNSON—DAVIS, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. • • Johnson-Davis,Inc. Phone:a( 6 3388- CNA PARAMOUNT CNA (561)588-1170 a�: ( 6� �5853 2 Contractors' General basal Ity extension Endorsement B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE — ELEVATORS Provision, the Other Insurance conditions is amended to add the following paragraph: This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis that is Property insurance covering property of others damaged from the use of elevators. 23. SUPPLEMENTARY PAYMENTS The section entitled SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is amended as follows: A. Paragraph 1.b. is amended to delete the$250 limit shown for the cost of bail bonds and replace it with a $5,000. limit;and B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a $1,000.limit. 24. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named Insured's Coverage Part,the Insurer will not deny coverage under this Coverage Part because of such failure. 25. WAIVER OF SUBROGATION -BLANKET Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the following: The Insurer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury or damage arising out of: 1. the Named Insured's ongoing operations;or 2. your work included in the products-completed operations hazard. However,this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in a written contract or written agreement,and only if such contract or agreement: 1. is in effect or becomes effective during the term of this Coverage Part;and 2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the claim. 26. WRAP-UP EXTENSION: OCIP,CCIP,OR CONSOLIDATED(WRAP-UP)INSURANCE PROGRAMS Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up) insurance program by applicable state statute or regulation. If the endorsement EXCLUSION — CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance Programs(C.C.I.P.)is attached,then the following changes apply: A. The following wording is added to the above-referenced endorsement: With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or was involved, this exclusion does not apply to those sums the Named Insured become legally obligated to pay as damages because of: 1. Bodily injury,property damage,or personal or advertising injury that occurs during the Named Insured's ongoing operations at the project, or during such operations of anyone acting on the Named Insured's behalf;nor CNA74705XX(1-15) Policy No: 7033967643 Page 16 of 17 Endorsement No: 9 Nat'l Fire Ins Co of Hartford Effective Date: 07/01/2022 Insured Name: JOHNSON-DAVIS, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. • Johnson-Davis,Inc. 604 Hillbrath Dr. CNA Lantana,FL 33462 CNA Paramount Excess and Umbrella Liability Phone:(561)588-1170 Policy Fax (561)585-3252 Y or organization which may be liable to the Insured because of injury or damage to which this insurance may also apply; and vi. will not voluntarily make a payment, except at its own cost, assume any obligation, or incur any expense, other than for first aid, without the Insurer's prior consent. 3. Cooperation With respect to both Coverage A - Excess Follow Form Liability and Coverage B — Umbrella Liability, the Named Insured will cooperate with the Insurer in addressing all claims required to be reported to the Insurer in accordance with this paragraph O. Notice of Claims/Crisis Management Event/Covered Accident, and refuse, except solely at its own cost, to voluntarily, without the Insurer's approval, make any payment, admit liability, assume any obligation or incur any expense related thereto. P. Notices Any notices required to be given by an Insured shall be submitted in writing to the Insurer at the address set forth in the Declarations of this Policy. Q. Other Insurance If the Insured is entitled to be indemnified or otherwise insured in whole or in part for any damages or defense costs by any valid and collectible other insurance for which the Insured otherwise would have been indemnified or otherwise insured in whole or in part by this Policy, the limits of insurance specified in the Declarations of this Policy shall apply in excess of, and shall not contribute to a claim, incident or such event covered by such other insurance. With respect to Coverage A — Excess Follow Form Liability only, if: a. the Named Insured has agreed in writing in a contract or agreement with a person or entity that this insurance would be primary and would not seek contribution from any other insurance available; b. Underlying Insurance includes that person or entity as an additional insured; and c. Underlying Insurance provides coverage on a primary and noncontributory basis as respects that person or entity; then this insurance is primary to and will not seek contribution from any insurance policy where that person or entity is a named insured. R. Premium All premium charges under this Policy will be computed according to the Insurer's rules and rating plans that apply at the inception of the current policy period. Premium charges may be paid to the Insurer or its authorized representative. S. In Rem Actions A quasi in rem action against any vessel owned or operated by or for a Named Insured, or chartered by or for a Named Insured, will be treated in the same manner as though the action were in personam against the Named Insured. T. Separation of Insureds Except with respect to the limits of insurance, and any rights or duties specifically assigned in this Policy to the First Named Insured, this insurance applies: 1. as if each Named Insured were the only Named Insured; and 2. separately to each Insured against whom a claim is made. U. Transfeeof Interest Form No:CNA75504XX(03-2015) Policy No:CUE 7033984636 Policy Page: 21 of 32 Policy Effective Date:07/01/2022 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Policy Page: 36 of 63 0 Copyright CNA All Rights Reserved. • • Johnson-Davis,Inc. 604 Hillbrath Dr. CNA Lantana,FL CNA Paramount Excess and Umbrella Liability Phone:(561)588-1170 Fax: (561))585-3252 Policy Assignment of interest under this policy shall not bind the Insurer unless its consent is endorsed hereon. V. Unintentional Omission Based on Insurer's reliance on the Named Insured's representations as to existing hazards, if the Named Insured should unintentionally fail to disclose all such hazards at the effective date of this Policy, the Insurer will not deny coverage under this Policy because of such failure. W. Waiver of Rights of Recovery The Insurer waives any right of recovery it may have against any person or organization because of payments the Insurer makes under this Policy if the Named Insured has agreed in writing to waive such rights of recovery in a contract or agreement, and only if the contract or agreement: 1. is in effect or becomes effective during the policy period; and 2. was executed prior to loss. VII.DEFINITIONS For purposes of this Policy, words in bold face type, whether expressed in the singular or the plural, have the meaning set forth below. Advertisement means a notice that is broadcast or published to the general public or specific market segments about the Named Insured's goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: A. notices that are published include material placed on the Internet or on similar electronic means of communication; and B. regarding web-sites, only that part of a web-site that is about the Named Insured's goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. Aircraft means any machine or device that is capable of atmospheric flight. Arbitration proceeding means a formal alternative dispute resolution proceeding or administrative hearing to which an Insured is required to submit by statute or court rule or to which an Insured has submitted with the Insurer's consent. Asbestos means the mineral in any form whether or not the asbestos was at any time airborne as a fiber, particle or dust, contained in or formed a part of a product, structure or other real or personal property, carried on clothing, inhaled or ingested, or transmitted by any other means. Authorized Insured means any executive officer, member of the Named Insured's risk management or in-house general counsel's office, or any employee authorized by the Named Insured to give or receive notice of a claim. Auto means: A. a land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment; or B. any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However, auto does not include mobile equipment. Bodily injury means bodily injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of the bodily injury, sickness or disease. Claim means a: A. suit; or Form No:CNA75504XX (03-2015) Policy No:CUE 7033984636 Policy Page: 22 of 32 Policy Effective Date:07/01/2022 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Policy Page:37 of 63 Copyright CNA All Rights Reserved. • • Johnson-Davis,Inc. CNA Lan e:brath(56 ) 8 Workers Compensation And Employers LiabilityInsurance Lantana,FL33462 p Phone:(561)588-1170 Policy Endorsement Fax: (561)585-3252 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement. The premium charge for the endorsement is reflected in the Schedule of Operations. All other terms and conditions of the policy remain unchanged. i This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. • Form No:WC 00 03 13(04-1984) Policy No:WC 7 33972535 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:07/01/2022 Endorsement No: 4; Page: 1 of 1 Policy Page:35 of 49 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Copyright 1983 National Council on Compensation Insurance. • Johnson-Davis,Inc. 609 Hillbrath Dr. • • Lantana,FL 33462 Phone:(561)588-1170 Fax:(561)585-3252 STATE OF FLORIDA • DEPARTMENT OF STATE • DIVISION OF CORPORATIONS I certify that the following is a true and correct copy of • CERTIFICATE OF INCORPORATION OF JOHNSON -- DAVIS INCORPORATED • • flied in this office on the 6th day of July 19 77. Charter Number: 538772 coUEsr,. GIVEN under my band and the Great u a '"o Seal of the State of Florida, at �v$ Tallahassee, the Capital, this. the * 7th day of July coo tvs ve • st 19 77. • gC (S21.44•—• • SECRETARY OF STATE cone.101(corp.94) 1.13-76 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 State of Florida Department of State I certify from the records of this office that JOHNSON -DAVIS INCORPORATED is a corporation organized under the laws of the State of Florida, filed on July 6, 1977. The document number of this corporation is 538772. I further certify that said corporation has paid all fees due this office through December 31, 2021, that its most recent annual report/uniform business report was filed on November 9, 2021, and that its status is active. I further certify that said corporation has not filed Articles of Dissolution. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Seventh day of December, 2021 */#111/W „rs Secretary of State Tracking Number:0516866656CU To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. h ttps://services.sunbiz.org/Filings/CertificateofStatus/CertificateAuthentication • •Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 w Phone:(561)588-117 Form ■■-9 Request for Taxpayer Fax: (561)585.3252 Give Form to the (Rev.October 2018) identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name(as shown on your Income tax return).Name Is required on this line;do not leave this line blank. JOHNSON-DAVIS INCORPORATED 2 Business name/disregarded entity name,if different from above m 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to C following seven boxes, certain entities,not Individuals;see instructions on page 3): o 0 IndividuaVsoie proprietor or 0 C Corporation 0 S Corporation 0 Partnership ❑Trust/estate single member LLC Exempt payee code(if any) 0 ..°o ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► 0 2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting II. LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that code(if any) is disregarded from the owner should check the appropriate box for the tax classification of its owner. g ❑ Other(see instructions)► (Applies toecrnmrsmainlvkedourskle the US,) y 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional) 604 Hillbrath Drive 8 City,state,and ZIP code Lantana,FL 33462 7 List account number(s)here(optional) Part I Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid )Social security number backup withholding.For individuals,this is generally your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other - - entities,It is your employer identification number(EIN).If you do not have a number,see How to get a TIN,later. or Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and I Employer identification number Number To Give the Requester for guidelines on whose number to enter. 5 9 — 1 7 5 3 8 8 8 Part II Certification Under penalties of perjury,I certify that: 1.The number shown on this form Is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that!am no longer subject to backup withholding;and 3.1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage Interest paid, acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than Interest and dividends,you are not required to sign th certification,but you must provide your correct TIN.See the instructions for Part II,later. H Signature of �r p / Here us.person► ,/� Date► �O7//� General instructions •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest Information about developments •Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TiN)which may be your social security number •Form 1099-C(canceled debt) (SSN),individual taxpayer identification number(1TIN),adoption .Form 1099-A(acquisition or abandonment of secured property) taxpayer identification number(ATIN),or employer identification number P P rty) (FIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(Interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.10-2018) • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 rp! Fax: (561)585-3252 • i I / I JOHNSON-DAVIS INC. "Construct with Confidence" CERTIFICATE OF AUTHORIZATION RESOLUTION The undersigned hereby certifies as follows: 1) That at a meeting of the Boar; of Directors duly noticed and held on January 2023 all of the directors of the Company unanimously adopted the resolutions; • a. That William C. Cryer is:elected or appointed as an officer of the Company with the title of Vice President—Estimating. b. That in addition to any other authorized officer of the Company, William C. Cryer is authorized to execute<and deliver for and on behalf of the Company, bids, estimates, contracts, loan documents and general authorizations relating to the Company's providing of goods and services for underground utilities construction,or other services related to the operation of business and bind the Company accordingly; and that,third parties shall be entitled to rely upon a certified copy of this resolution until written notice of modificationior rescission of same has been furnished to and received by any such third party. 2) That the above resolutions arip true and accurate copies of the orig' I r sol tions on file in the corporate record book of the Company and that said resolutions ai n ull force and effect. Date this II day of J a Pv.��- , z.st,z3 By S tt Johnson—Pr ident I STATE OF FLORIDA )ss COUNTY OF PALM BEACH On this lU day of.(�s�`k" . Before me personally appeared �y To me known to be the perso i who executed the foregoing acceptance and acknowledge heat He/She executed the same as His/Her free act and deed. NOTARIAL iVly commission as Notary Public ingt County SEALp� expires - / 21i- 2,G i* LARISADITUPELKEY * Commission#HH 178111 Cr,ei1414 Expires January 22,2026 `~ %nature 14454°k Eandod lieu Budget Nolary Servloes Os .�'4c, A gfl,. ccM�cr • 4Geaysv >nftcl�lttr�io�i. • lfi� rroos�r+.. /f�i,�.a�Ceo- • (6-5-10 f, � Main office:604 Hilibrath.Orive-Lantana,FL 33462•Phone:561-588-1171•Fax:561-585-5252 0^ - . • 5/14/23,7:22 PM Detail by Entity Name DIVISION OF CORPORATIONS Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 t / _7_ VEOSOI Of --•,^ !VP rg iri !t?! 1:!,o/t!!•! •I,!ft' Department of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Florida Profit Corporation JOHNSON-DAVIS INCORPORATED filing Information Document Number 538772 FEI/EIN Number 59-1753888 Date Filed 07/06/1977 State FL Status ACTIVE Principal Address 604 HILLBRATH DRIVE LANTANA, FL 33462 Changed: 04/01/1986 Mailing Address 604 HILLBRATH DRIVE LANTANA, FL 33462 Changed:04/01/1986 aggistered Agent Name&Address JOHNSON,SCOTT J 604 HILLBRATH DRIVE LANTANA, FL 33462 Name Changed:03/20/1996 Address Changed: 12/18/2009 Officer/Director Detail Name&Address Title P. JOHNSON, SCOTT J. 18843 SE JUPITER RIVER DR JUPITER, FL 33458 Title TS https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype.EntityName&directionType=lnitial&searchNameOrder=JOHNSO.„ 1/3 • • 5/14/23,7:22 PM Detail by Entity Name Johnson-Davis,Inc. 604 JOHNSON, CHRISTOPHER Lantanlbrath Dr. Lantana,FL 33462 7541 BRIAR CLIFF CIR Phone:(561)588-1170 LAKE WORTH, FL 33467 Fax: (561)585-3252 Title VP CRYER,WILLIAM 170 RIVER DRIVE TEQUESTA, FL 33469 Title CHIEF FINANCIAL OFFICER STANLEY,JOHN 4110 NW 10TH STREET DELRAY BEACH, FL 33445 Annual Reagita Report Year Filed Date 2022 01/05/2022 2022 10/27/2022 2023 01/04/2023 Document Imago. 01/04/2023—ANNUAL REPORT View image in PDF format 10/27/2022—AMENDED ANNUAL REPORT View Image in PDF format 01/95/2022—ANNUAL REPORT View image in PDF format 11/09/2021—AMENDED ANNUAL REPORT View image in PDF format 07/02/2021—AMENDED ANNUAL REPORT View image in PDF format { 01/13/2021—ANNUAL REPORT View image in PDF format 03/25/2020--AMENDED ANNUAL REPORT View image In PDF format 01/07/2020—ANNUAL REPORT View Image In PDF format 01/02/2019—ANNUAL REPORT View image in PDF format 01/05/2018—ANNUAL REPORT — View image in PDF format 01/06/2017—ANNUAL REPORT View image in PDF format 01/14/2016—ANNUAL REPORT View image in PDF format 01/07/2015—ANNUAL REPORT View image in PDF format 01/03/2014—ANNUAL REPORT View image In PDF format 01/02/2013—ANNUAL REPORT View image in PDF format 01/04/2012--ANNUAL REPORT View image in PDF format 07/01/2011—ANNUAL REPORT View image in PDF format j 01/04/2011—ANNUAL REPORT View image in PDF format 01/05/2010—ANNUAL REPORT View image in PDF format 01/08/2009—ANNUAL REPORT View image in PDF format 01/07/2008—ANNUAL REPORT View image in PDF format 01/10/2007—ANNUAL REPORT View image In PDF format 01/12/2006—ANNUAL REPORT View image in PDF format 02/12/2005—ANNUAL REPORT View image in PDF format hang://soamh s inhi7.nra/Innuirv/CmmoratinnSoarrh/SoarrhRosultf)otail9innuindvnoaFntitvNamofCdirar•.tinnTvne=inifiatRcaarchNampOrliar_.inkmA f 9/R • • i nnson-uavis,inc. 5/14/23,7:22 PM Detail by Entity Name 604 Hilibrath Dr. Lantana,FL 33462 02/04/2004--ANNUAL REPORT View Image in PDF format Phone:(561)588 1170 02/10/2003—ANNUAL REPORT View Image in PDF format Fax: (561)585-3252 03/15/2002—ANNUAL REPORT View image in PDF format 01/25/2001--ANNUAL REPORT View image In PDF format 04/03/2000—ANNUAL REPORT View image in PDF format 03/24/1999—ANNUAL REPORT View image in PDF format 01/29/1998--ANNUAL REPORT View image in PDF format l 01/28/1997—ANNUAL REPORT View image in PDF format 03/20/1996—ANNUAL REPORT View Image in PDF format 03/20/1996—Reg,6gent Changg View image In PDF format 03/24/1995—ANNUAL REPORT View image in PDF format Rom:,G,:.artn Cm.i;trr,r4 C,i:par:oro httos://search.sunbiz.ora/Inouirv/CoroorationSearch/Search ResultDetail?inauirvtvoe=EntitvName&directionTvoe=Initial&searchNameOrder--JOH NSO... 3/3 • • II Johnson-Davis,Inc. 604 Hillbrath Dr. 1 Lantana,FL 33462 `�"!•` �• Major Equipment List Phone:(561)588-1170 All OWNED by Johnson-Davis, Inc. Fax: (561}585-3252 JD1.,' : 4• a{f lr,, , . ;. ? , K„ r ;K,.,,, ,a..S.�, ,ll�'.le,()7,-,;.. .-e.A; ID Ak }.w,. .DESC J.., ,di `,,,J,, ..Y.Y,. rt_i . - ..,<,s i.'.,,,, Category:10 WELLPOINT PUMPS 10-0084 10"Wellpoint Pump 14270 10-0001 10 IN.WELLPOINT PUMP 7105 10-999 Rental Pump 10-0003 10 IN.WELLPOINT PUMP 7568 Category:11 VACUUM PUMPS 10-0011 10 IN.WELLPOINT PUMP 7130 10-0100 M5 VAC PUMP 10-0013 WELLPOINT PUMP 6 IN. NONE 10-0164 M-3 VACUUM PUMP 10-0016 WELLPOINT PUMP 10 IN. 8460 11-0005 M-2 VACCUM PUMP 00050 10-0019 WELLPOINT PUMP 10 IN. 7505 11-0053 M-2 VACUUM PUMP 0053 10-0020 WELLPOINT PUMP 10 IN. 8334 11-0100 M10 VACUUM PUMP 100 10-0026 HYDRAULIC PUMP 6 IN. 5654 11-0101 VACUUM PUMP 101 10-0028 JET PUMP,4 IN.DIESEL 6J66 11-0102 M10 VACUUM PUMP VP102 10-0030 DOUBLE DIAPHRAGM 4DDL335 11-0131 M5 VACUUM PUMP FOR 10-76 010131 10-0031 WELLPOINT PUMP 10 IN. JD946068 11-1016 M3 VACUUM PUMP 101689 10-0033 WELLPOINT PUMP 6 IN. 6951033 11-1036 10 INCH VACUUM PUMP 1036 10-0035 WELLPOINT PUMP 8 IN. US97362X 11-1037 C10 VACUUM PUMP 1037 10-0036 HYDRAULIC PUMP 4 IN. H-25-D-349 11-1190 M2 VACUUM PUMP 1190 10-0038 WELLPOINT PUMP 8 IN. U640528Y 11-1240 M3 VACUUM PUMP 1240 10-0040 JET PUMP 4 IN. None 11-1357 M10 VACUUM PUMP 1357 10-0041 WELLPOINT PUMP 8 IN. H-40WPLR-D-139 11-1381 M10 VACUUM PUMP 1381 10-0043 TEST PUMP 11-1386 VACUUM PUMP 1386 10-0045 JET PUMP 4 IN. C.M.E.8291 11-1387 M10 VACUUM PUMP 1387 10-0046 WELLPOINT PUMP 8 IN. 9037 11-1390 M2 VACUUM PUMP 1390 10-0048 6 IN.TRASH PUMP 9065 11-1711 M3 VACUUM PUMP 1711 10-0049 WELLPOINT PUMP 8 IN. 9064 11-1923 M-3 VACUUM PUMP 1923 10-0050 HYDRAULIC PUMP 4 IN. 2657 11-1924 M3 VACUUM PUMP 1924 10-0051 JETPUMP ON WHEELS 4 IN. 4219 11-1941 M3 VACUUM PUMP 1941 10-0052 8 IN.WELLPOINT PUMP 9159 11-2341 M3 VACUUM PUMP 2341 10-0054 8 IN.WELLPOINT PUMP 9181 11-3044 M3 VACUUM PUMP 3044 10-0055 12 IN.HYDRAULIC PUMP D12SG068T1210 11-3049 VACUUM PUMP 3049 10-0056 8 IN.HYDRAULIC PUMP 325 11-3605 M-10 VACUUM PUM 3605 • 10-0058 10 IN.WELLPOINT PUMP 9293 11-3737 M2 VACUUM PUMP 3737 10-0059 10 IN.WELLPOINT PUMP 11-3750 M-2 VACUUM PUMP 3750 10-0060 4 IN.HYDRAULIC PUMP U797253C 11-4268 M3 VACUUM PUMP 4268 10-0061 4 IN.HYDRAULIC PUMP 708 11-4297 VACUUM PUMP 4297 10-0062 8 IN.WELLPOINT PUMP 9220 11-4371 M-3 VACUUM PUMP 4371 10-0063 8 IN.WELLPOINT PUMP 9239 11-4636 VACUUM PUMP 4636 10-0064 4 IN.HYDRAULIC PUMP 11-4840 M-3 VACUUM PUMP 4840 10-0065 WELLPOINT PUMP 6 IN. 6PW-019 11-4841 M3 VACUUM PUMP 4841 10-0066 10 IN.HYDRAULIC PUMP 11-4923 M3 VACUUM PUMP 10-0067 4 IN.HYDRAULIC PUMP LD44369U146539 11-5445 M5 VACUUM PUMP 544515 10-0068 4"HYDRAULIC PUMP ON WHEELS F.P.8-20 11-6917 C 10"VACUUM PUMP 6917 10-0069 4"HYDRAUIC PUMP ON WHEELS F.P.8-19 11-9305 M-3 VACUUM PUMP 9305 10-0070 3"HYDRAULIC PUMP 10HPU-58 11-9487 10"VACUUM PUMP 9487 10-0071 2.5"x 4"JET PUMP ON WHEELS 9500 11-9494 M5 VACUUM PUMP 9494 10-0073 10 inch Roto Flo Wellpoint Pump 26109642 1.1 11-9602 M3 VACUUM PUMP 9603 10-0074 6"Trash Pump 12001 11-9607 M3 VACUUM PUMP 9607 10-0075 8 inch Roto Flo Welipoint Pump 9010 11-9615 M10 VACUUM PUMP 9615 10-0077 6 INCH HYDRAULIC PUMP POWER UNIT 1318-C 11-9616 C-10 VACUUM PUMP 9616 10-0078 8"HYDRAULIC PUMP 142-C 11-9617 C-10 VACUUM PUMP 9617 10-0079 8"Wellpoint Pump 14237 11-9716 #10 VACUUM PUMP 9716 10-0080 8"Wellpoint Pump 14238 Category:20 BACKHOES 10-0081 8"Wellpoint Pump 14239 20-0039 1997 DEWATERING TRENCHER D97022 10-0082 8"Wellpoint Pump Quiet Pack 14235 20-0040 LIEBHERR BACKHOE 417-4205 10-0083 10"Wellpoint Pump 14269 20-0044 LIEBHERR BACKHOE 651-8110 Johnson-Davis,Inc. • 604 Hillbrath Drive • Lantana,FL 33462 • Ph.(561)588-1170 Fx.(561)585-5252 page 1 of 2 • • ID DESC VIN# ID DESC, , > ,'VIN# 20-0050 LIEBHERR BACKHOE 924-13441 Johnson-Davis,Inc. 20-0056 KOMATSU BACKHOE 30099 604 Hillbrath Dr. 20-0059 Caterpillar Crawler Excavator CAT0328DCGTN Lantana,FL 33462 20-0060 Caterpillar Crawler Excavator CAT0336DEW3K Phone:(561)588-1170 Fax: (561)585-3252 20-0063 2012 JOHN DEERE RUBBER TIRE 1FF220DWHBD4 20-0068 Komatsu PC390LC-10 Excavator A30203 20-0069 Komatsu PC240LC-11 EXCAVATOR 95106 20-0070 Komatsu PC390LC-11 Excavator 30425 20-0071 Komatsu PC390LC-11 Excavator A74180 20-0072 Komatsu PC138USLC-11 50542 20-0073 KOMATSU PC290LC-11 EXCAVATOR A27538 20-0074 Komatsu PC138USLC-11 Excavator 50845 20-0075 Liebherr A900C 66375 20-0077 Cat 323 Excavator RAZ00754 20-0078 Cat 325FLCR Excavator NDJ20187 20-0079 Komatsu PC-238 Excavator 05489 20-0080 Komatsu PC-138 Excavator 52349 20-0081 Cat 307E2 Mini-Excavator 307-KC901075 20-0082 John-Deere 350G Excavator 1FF350GXLHF81 20-999 Rental Backhoe WR-BH01 Volvo Backhoe(Wakefield Road Boring) Category:25 COMBINATIONS 25-0051 CAT COMBO BACKHOE BLN11885 25-0052 CAT COMBO BACKHOE BML05166 25-0067 2013 CAT COMBINATION BACKHOES 420 F CAT0420FHJWJO Category:30 LOADERS 30-0032 LIEBER LOADER 443-11966 30-0033 VOLVO LOADER L70E L70EV60803 30-0038 2009 KOMATSU LOADER 65858 30-0039 2009 KOMATSU LOADER 65939 30-0040 950H CATTERPILLAR LOADER CAT0950HVK5K0 30-0042 WA320-6 KOMATSU LOADER A35279 30-0043 WA-380-7 KOMATSU LOADER A64171 30-0044 WA200PZ-6 KOMATSU RUBBER TIRE LOAC KMTWA105C010 30-0045 WA-320-7 KOMATSU LOADER 80194 30-0046 938K CATERPILLAR LOADER SWL01382 30-0047 WA200-7 KOMATSU LOADER 80392 30-0048 WA380-8 KOMATSU LOADER A74013 30-0049 Komatsu WA-380-8 Wheel Loader A74180 30-0050 Cat 906M Wheel Loader CAT906MCH6600 30-0051 Komatsu WA320-8 85209 30-0052 Komatsu WA270-8 Wheel Loader A28201 30-0053 Cat 930M Wheel Loader KTG03806 30-0054 Cat 930M Wheel Loader KTG04062 30-0055 John-Deere 524L Wheel Loader 1DW524LKLZLKF 30-0056 John-Deere 544L 1DW544LZCKF6 30-999 Rental Loader Category:35 SPECIALIZED EQUIPMENT 35-0001 CRAWLER DOZER T065HX898018 35-0027 2001 LOADER/BOBCAT 514147010 35-0041 T300 BOBCAT 525415212 35-0061 KUBOTA BACKHOE 30767 35-0064 2012 KUBOTA EXCAVATOR W/RUBTKS/4P 141826 35-0066 2013 KUBOTA EXCAVATOR 74888 35-0067 Cat 305E2 Excavator H5M07145 35-0068 John-Deere 325G Compact Track Loader 1T0325GMJKJ34 35-999 Rental Mini Johnson-Davis,Inc. • 604 Hillbrath Drive • Lantana,FL 33462 • Ph.(561)588-1170 Fx.(561)585-5252 page 2 of 2 • • 3: l r: .::::.!..:' ,...-'1' .t4r''11: --IT* 67ii 0133� I 73 m m o �' z '0 o �,• 0 D 3 O m 72 rt o p o 77 m to Z o rn CD D C Z —I cn p 70 Tv. fto .� t Y d Z V —< I O mEr o a b .Z r' `+ -rt — V! 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T. -.y `f ,'''''`* 4 ( `'�':Ym�...` + m film m fD n W (Njy T 4 ,+i , , . , i ^ iir � N N ,^ k4 et ..t� q 1ct ;l l -7 ,,� es, 3 -I, ` -�-I m id 1Z ix) til _i cD `� tit ?> 7v Cn v m 7v 74 DO I C ri- CD m Z eD :z r+ r • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 you=� Phone:(561)588-1170 �,�to. Fax: (561)585-3252 AN N EM M. GAN N O N P.O.Box 3353,West Palm Beach,FL 33402-3353 **LOCATED AT•• i" '`- CONSTITUTIONAL TAX COLLECTOR www.pbctax.com Tel:(561)355-2264 604 HILLBRATH DRIVE +t 4 Serving Palm Beach County a ro s`• LANTANA, FL 33462-1656 Serving you. . TYPE OF BUSINESS OWNER CERTIFICATIONX RECEIPT$/DATEPAID AMT PAID BILLC 23-0137 CW UNDERGROUND UTILITY 8 JOHNSON SCOTT J CUC043067 B22.602590-07/11122 $185.85 B40130693 This document is valid only when receipted by the Tax Collectors Office. STATE OF FLORIDA PALM BEACH COUNTY 2022/2023 LOCAL BUSINESS TAX RECEIPT JOHNSON DAVIS INC LBTR Number: 199306318 JOHNSON DAVIS INC EXPIRES: SEPTEMBER 30, 2023 604 HILLBRATH DRIVE LANTANA,FL 33462-1656 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. tiocr.c,.ro `.7, A N N E M. GAN NO N P.O.Box 3353,West Palm Beach,FL 33402-3353 **LOCATED AT" _`� ,X CONSTITUTIONAL TAX COLLECTOR www.pbctax.com Tel:(561)355-2264 604 HILLBRATH DRIVE 4`'"Y ' Serving Palm Beach County LANTANA, FL 33462-1656 Serving you. TYPE OF BUSINESS OWNER CERTIFICATION 9 RECEIPT C/DATE PAID AMT PAID BILL C 23-0097 UNDERGROUND UTILITY 8 EXCAVATION JOHNSON SCOTT J CUC043087 B22.602591-07/11/22 599.00 B40130692 This document is valid only when receipted by the Tax Collector's Office. STATE OF FLORIDA PALM BEACH COUNTY 2022/2023 LOCAL BUSINESS TAX RECEIPT JOHNSON DAVIS INC . LBTR Number: 199306319 JOHNSON DAVIS INC EXPIRES: SEPTEMBER 30, 2023 604 HILLBRATH DRIVE LANTANA,FL 33462-1656 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and In such a manner as to be open to the view of the public. • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 ...1.• 6Ltf CJ �.. A N N E M. CANNON P.O.Box 3353,West Palm Beach,FL 33402-3353 **LOCATED AT" Fax: (561)585-3252 2` CONSTITUTIONAL TAX COLLECTOR www•pbctax.com Tel:(561)355-2264 _ `�` Serving Palm Beach Couuh� 604 HILLBRATH DRIVE £',-;.• ``' LANTANA, FL 33462-1656 Serving you. , TYPE OF BUSINESS OWNER CERTIFICATION# RECEIPT#/DATE PAID AMT PAID BILL# 23-0097 UNDERGROUND UTILITY&EXCAVATION CRYER WILLIAM CLARK CLIFFORD CUC1225299 B22.602594-07/11/22 527.50 840170245 This document is valid only when receipted by the Tax Collector's Office. STATE OF FLORIDA PALM BEACH COUNTY 2022/2023 LOCAL BUSINESS TAX RECEIPT JOHNSON DAVIS INC LBTR Number: 2020125387 JOHNSON DAVIS INC EXPIRES: SEPTEMBER 30, 2023 604 HILLBRATH DRIVE LANTANA,FL 33462-1656 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. cause Y, ''` A N N E M. GAN N O N P.O.Box 3353,West Palm Beach,FL 33402-3353 **LOCATED AT'* ti`:: =`c CONSTITUTIONAL TAX COLLECTOR www.pbctax.com Tel:(561)355-2264 <' a-/txr Serving Palm Bead,County 604 HILLBRATH DRIVE �. LANTANA, FL 33462-1656 Serving you. TYPE OF BUSINESS OWNER CERTIFICATION# RECEIPT#/DATE PAID AMT PAID BILL# 23-0137 CW UNDERGROUND UTILITY& CRYER WILLIAM CLARK CLIFFORD CUC1225299 822.602595-07/11/22 5185.85 B40170244 This document is valid only when receipted by the Tax Collector's Office. STATE OF FLORIDA PALM BEACH COUNTY 2022/2023 LOCAL BUSINESS TAX RECEIPT JOHNSON DAVIS INC LBTR Number: 2020125388 JOHNSON DAVIS INC EXPIRES: SEPTEMBER 30, 2023 604 HILLBRATH DRIVE LANTANA,FL 33462-1656 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. • . Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Johnson-Davis, line. Harassment, Discrimination and Retaliation Policy Johnson-Davis, Inc. is committed to a work environment in which all individuals are treated with respect and dignity. Each individual has the right to work in a professional atmosphere that promotes equal employment opportunities and prohibits discriminatory practices, including harassment. Therefore, Johnson-Davis, Inc. expects that all relationships among persons in the office will be business-like and free of bias,prejudice and harassment. Equal Employment Opportunity It is the policy of Johnson-Davis, Inc. to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, religion, sex, sexual orientation, age, disability, marital status, citizenship or any other characteristic protected by law. Johnson-Davis, Inc.prohibits any such discrimination or harassment. Retaliation Is Also Prohibited Johnson-Davis, Inc. encourages reporting of all perceived incidents of discrimination or harassment. It is the policy of Johnson-Davis, Inc. to investigate such reports. Johnson- Davis, Inc. prohibits retaliation against any individual who reports discrimination or harassment or participates in an investigation of such reports. Definitions of Harassment 1) Sexual harassment constitutes discrimination and is illegal under federal, state and local laws. For the purposes of this policy, sexual harassment is defined, as in the Equal Employment Opportunity Commission Guidelines, as unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature when, for example: r submission to such conduct is made either explicitly or implicitly a term or condition of an individual's employment; submission to or rejection of such conduct by an individual is used as the basis for employment decisions affecting such individual; or :- such conduct has the purpose or effect of unreasonably interfering with an individual's work performance or creating an intimidating, hostile or offensive working environment. • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Sexual harassment may include a range of subtle and not so subtle behaviors and may involve individuals of the same or different gender. Depending on the circumstances, these behaviors may include, but are not limited to: unwanted sexual advances or requests for sexual favors; sexual jokes and innuendo; verbal abuse of a sexual nature; commentary about an individual's body, sexual prowess or sexual deficiencies; leering, whistling or touching; insulting or obscene comments or gestures; display in the workplace of sexually suggestive objects or pictures; and other physical, verbal or visual. conduct of a sexual nature. 2) Harassment on the basis of any other protected characteristic is also strictly prohibited. Under this policy,harassment is verbal or physical conduct that denigrates or shows hostility or aversion toward an individual because of his /her race, color, religion, sex, sexual orientation, national origin, age, disability, marital status, citizenship or any other characteristic protected by law or that of his/her relatives, friends or associates, and that: r has the purpose or effect of creating an intimidating, hostile or offensive work environment; has the purpose or effect of unreasonably interfering with an individual's work performance; or otherwise adversely affects an individual's employment opportunities. Harassing conduct includes, but is not limited to: epithets, slurs or negative stereotyping; threatening, intimidating or hostile acts; denigrating jokes; and written or graphic material that denigrates or shows hostility or aversion toward an individual or group and that is placed on walls or elsewhere on the employer's premises or circulated in the workplace. Individuals and Conduct Covered These policies apply to all applicants and employees, whether related to conduct engaged in by fellow employees or someone not directly connected to Johnson-Davis, Inc. (e.g., an outside vendor,consultant or customer). Conduct prohibited by these policies is unacceptable in the workplace and in any work- related setting outside the workplace, such as during business trips, business meetings and business-related social events. • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Reporting an Incident of Harassment,Discrimination or Retaliation Johnson-Davis, Inc. encourages reporting of all perceived incidents of discrimination, harassment or retaliation, regardless of the offender's identity or position. Individuals who believe that they have been the victim of such conduct should discuss their concerns with their immediate supervisor or the Director of Human Resources. See the Complaint Procedure described below. In addition, Johnson-Davis, Inc. encourages individuals who believe they are being subjected to such conduct promptly to advise the offender that his or her behavior is unwelcome and request that it be discontinued. Often this action alone will resolve the problem. The Company recognizes,however, that an individual may prefer to pursue the matter through informal or formal complaint procedures. Complaint Procedure Informal Procedure If for any reason an individual does not wish to address the offender directly, or if such action does not successfully end the offensive conduct, the individual should notify his/her immediate supervisor or the Director of Human Resources who may, if the individual so requests, talk to the alleged offender on the individual's behalf. In addition, there may be instances in which an individual seeks only to discuss matters with one of the Company's designated representatives,and such discussion is encouraged. An individual reporting harassment, discrimination or retaliation should be aware; however, that Johnson-Davis, Inc. may decide it is necessary to take action to address such conduct beyond an informal discussion. This decision will be discussed with the individual. The best course of action in any case will depend on many factors and, therefore, the informal procedure will remain flexible. Moreover, the informal procedure is not a required first step for the reporting individual. Formal Procedure As noted above, individuals who believe they have been the victims of conduct prohibited by this policy statement or believe they have witnessed such conduct should • discuss their concerns with the Director of Human Resources Johnson-Davis, Inc. encourages the prompt reporting of complaints or concerns so that rapid and constructive action can be taken before relationships become irreparably strained. Therefore, while no fixed reporting period has been established, early reporting and intervention have proven to be the most effective method of resolving actual or perceived incidents of harassment. 3 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Any reported allegations of harassment, discrimination or retaliation will be investigated promptly. The investigation may include individual interviews with the parties involved and, where necessary, with individuals who may have observed the alleged conduct or may have other relevant knowledge. Confidentiality will be maintained throughout the investigatory process to the extent consistent with adequate investigation and appropriate corrective action. Retaliation against an individual for reporting harassment or discrimination or for participating in an investigation of a claim of harassment or discrimination is a serious violation of this policy and, like harassment or discrimination itself, will be subject to disciplinary action. Acts of retaliation should be reported immediately and will be promptly investigated and addressed. Misconduct constituting harassment, discrimination or retaliation will be dealt with appropriately. Responsive action may include, for example, training, referral to counseling and/or disciplinary action such as warning, reprimand, withholding of a pay increase, reassignment, temporary suspension without pay or termination, as Johnson- Davis,Inc. believes appropriate under the circumstances. If a party to a complaint does not agree with its resolution, that party may appeal to the President of the Company. False and malicious complaints of harassment, discrimination or retaliation as opposed to complaints which, even if erroneous, are made in good faith, may be the subject of appropriate disciplinary action. Conclusion. Johnson-Davis,Inc.has developed this policy to ensure that all its employees can work in an environment free from harassment, discrimination and retaliation. The Company will make every reasonable effort to ensure that all concerned are familiar with these policies and aware that any complaint in violation of such policies will be investigated and resolved appropriately. Any employee who has any questions or concerns about these policies should talk with the Director of Human Resources. 4 • • Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 Finally, these policies should not, and may not, be used as a basis for excluding or separating individuals of a particular gender, or any other protected characteristic, from participating in business or work-related social activities or discussions. In other words, no one should make the mistake of engaging in discrimination or exclusion in order to avoid allegations of harassment. The law and the policies of Johnson-Davis, Inc. prohibit disparate treatment on the basis of sex or any other protected characteristic, with regard to terms, conditions, privileges and perquisites of employment. The prohibitions against harassment, discrimination and retaliation are intended to complement and further those policies,not to form the basis of an exception to them. Employee Acknowledgement': Employee Signature: Date: Witness: Date: 5 • • Johnson-Davis,Inc. fj 604 Hillbrath Dr. • Lantana,FL 33462 Phone:(561)588-1170 Fax: (561)585-3252 JOHNSON-DAVIS INC. "Construct with Confidence" EXECUTIVE SUMMARY Johnson-Davis Inc. is a full-service underground utility contractor specializing in projects such as water, sewer, and storm drainage systems, as well as highway and road construction usually associated with the utility construction. Our work expertise also includes installation of steel sheeting and dewatering systems. There is no other company in the south and central Florida region that can boast our experience and proficiency in this area. We are able to maintain long-term relationships with prime contractors, governmental agencies, consulting engineers, customers, and suppliers because we are dependable and strive to deliver superior customer service. Johnson-Davis believes that maintaining our credibility and integrity within the industry is our main concern. Johnson-Davis was founded in 1977 when Herb Johnson envisioned the need in Florida for a reputable specialty contractor. Herb and his sons, Scott and Chris, worked only in Palm Beach County, were based in Herb's garage, and had only three leased pieces of heavy equipment to their name. Based in Palm Beach County for more than 40 years, Johnson-Davis has worked continuously and successfully with County Governments and Utility Authorities. More than 40 years later, the Johnson-Davis name is now synonymous with quality work as well as tremendous experience, resources, and knowledge. The company has since transitioned to Scott and Chris Johnson. The corporate headquarters is in Lantana and covers more than four acres of land, and we have a small office in Fort Pierce. Our project teams are located in these two offices. Johnson- Davis has more than 15 crews and owns the equipment that supports these crews. Johnson-Davis is privately-held, owned by Scott Johnson, Chris Johnson, and Jeanne (Johnson) Cummings. Scott Johnson, President, and Bob Hopler, Vice President, both earned their Bachelor of Science degrees in Civil Engineering from Bucknell University in 1976. As engineers, they enjoy projects that are technically challenging. They are both involved in projects at the executive level. Our Construction Manager, Robert Ueltschi, has 40 years of construction experience. He earned his Bachelor of Science in Civil Engineering Technology from Western Kentucky University. His extensive experience and knowledge support the Superintendents and Project Managers, and ensures crews are optimally scheduled and properly performing their duties, all while ensuring the highest levels of quality, safety, and customer satisfaction. •4N6 'Bi »�C Cpaoz67ixa awa • CUC043087 • taienracuirigl 'es a Main Office:604 Hillbrath Drive-Lantana,FL 33462•Phone:561-588-1170 •FAX 561-585-5252 VRa '9i�y + Ft.Pierce Office:863 S.Kings Hwy-Ft.Pierce,FL 34945•Phone:772-468-9200-FAX 772-468-9202 • • Egn Johnson-Davis,Inc. 604 Hillbrath Dr. Lantana,FL 33462 Phone:(561)588-1170 JAI/ Fax: (561)585-3252 JOHNSON-DAVIS INC. "Construct with Confidence" Our Superintendents oversee multiple crews and have been involved in utility construction for a combined total of 152 years. Having worked with the local utility authorities for many years, they are aware of the daily challenges faced by the crews. Senior Superintendent Leonard Dennis and Superintendents Robert Earnest, Richard Heller III, Thomas Linsley, Edric Martin, and J.R. Martin ensure their crews have the resources necessary to maintain their schedules. They are also tasked with ensuring the quality of the work meets or exceeds expectations. Our Project Managers hold an impressive 133 years of experience amongst them. They act as the main interface between the customer and Johnson-Davis. Chuck Cameron, Matt Crist, Rich Heller Jr, Doug Ipolito, and Edwin Jacobs have the primary responsibility to ensure projects are completed on time and within the budget. Andy Thomson, Safety Director, has 34 years of safety and operations and previously served as a Health and Safety Director and Operations Manager. He holds many certifications including OSHA 500 authorized and 10 & 30 hours construction safety trainer under OSHA. His knowledge and experience help Johnson-Davis Inc. maintain a safety culture that makes safety the responsibility of every employee. Ilene Passler, Human Resources Director, has worked in construction for 21 years, and the majority of her experience is with federal and municipal contractors. She holds her Master of Business Administration from Wake Forest University and SHRM-Senior Certified Professional and Senior Professional in Human Resources certifications. Our Estimating Team's focus on customer service and detail helps limit the need for change orders by addressing potential issues during the bidding process. Secretary/Treasurer Chris Johnson, Jim Amsler, Clark Cryer, and Walter Pfaffenberger have over 81 years of experience, and Scott Johnson is also actively involved in the Estimating process. We enjoy an excellent relationship with our bonding company, Liberty Mutual Insurance Co., with a single project capacity of$35,000,000 and an aggregate capacity in excess of$80,000,000. Our financial strength, technical expertise, and history of success in working with the FDOT have earned us a capacity rating in excess of$80,000,000 for underground utility work. We have also been listed in Engineer New Record's Top 600 Specialty Contractors nationwide for many years. It is clear that Johnson-Davis has both the experience and the key personnel necessary to successfully perform underground utility projects of all sizes and difficulty. at1 Big G•1dayeiy Tpoor.owc-G,an • CUC043087 • GfirukirrraernI Main Office:604 Hillbrath Drive-Lantana,FL 33462•Phone:561-588-1170 •FAX 561-585-5252 %unto' Ft.Pierce Office:863 S.Kings Hwy-Ft.Pierce,FL 34945•Phone:772-468-9200•FAX 772-468-9202 4. •+�J • • Johnson-Davis, Inc- e mo Re: Notice of Random Drug Screening In compliance with the Johnson-Davis, Inc. Drug-Free Workplace Policy, each employee, as a condition of continued employment, is subject to medical or physical examination or tests, including urine drug screen. An employee, who refuses to submit to drug testing, as provided for in this Policy, will be asked to leave the office or project site immediately and the employee will be discharged. Please complete and sign the attached acknowledgement and authorization form and return to your foreman and/or superintendent. You must proceed to a LabCorp testing center in your local area upon receipt of this notice. (See superintendent for LabCorp locations). A copy of the Johnson-Davis, Inc. Drug-Free Workplace Policy is also attached for your information and reference. Please keep a copy of this policy along with your employee handbook. Thank you for your cooperation. 1 • • JOHNSON-DAVIS,INC. 604 Hillbrath Drive Lantana,FL 33462 Phone: (561)588-1170 Fax:(561)585-3252 WHAT TO DO ABOUT HARASSING CONDUCT . . . An employee who believes he or another Company employee has been subjected to harassing conduct should immediately contact the Human Resources Director. A prompt investigation will be conducted of each and every complaint and appropriate action will be taken. Employees are required to participate in all J-D investigations. Complaints will be handled confidentially, to the extent possible. The Human Resources Director has the responsibility for investigating and resolving complaints of harassment. In the event of a complaint involving the Human Resources Director, J-D's President should be notified and he will fulfill the investigatory role in this process. No Retaliation or Reprisals • Employees have a duty to report any harassment they either experience or observe, regardless of whether the alleged harassment is being perpetrated by a J-D employee or any other third party. Under no circumstances will a person be retaliated against because of a bona fide report of harassing conduct. Drug-Free Workplace J-D is committed to protecting the safety, health, and. well-being of its employees and all individuals who come into contact with its workplace and property, and/or use its products and services. As part of this mission, J-D is committed to maintaining a Drug-Free Workplace. Substance abuse, which includes the possession, use or sale of illegal drugs or the unlawful use or misuse of lawful substances, including alcohol and prescription drugs, will not be tolerated. J-D also prohibits the illicit use, possession, sale, attempted sale, purchase, attempted purchase, conveyance, distribution, cultivation or manufacture of illegal drugs, intoxicants, or controlled substances in any amount or in any manner. It is a condition of employment at J-D to refrain from using illegal drugs and unlawfully using lawful substances, including alcohol and prescription medicines, and to abide by the guidelines of the Company's Drug-Free Workplace Policy. 3 _ • • 'r a + - JAN :,:fir: �4x JOHNSON-DAVIS INC. Est. 1977 `` r h zj, `k 7 Construct with Confidence" SAFETY ,,--;',12:Z8,, PUNCTUALITY ` We value the safety of our employees and 08 We honor our commitments timely.These 01 - our community above all else. Safety is commitments include project completion, ' everyone's responsibility. billing, being prompt for our work shifts and meetings, and vendor payments. 1 FAMILY VALUES i O2 Family values are the foundation upon which RESPECT r,,': our company was built. We care about the wellbeing of our employees and their families, 09 We have respect for our work,for the work as they are part of our family. We look out for .; and ideas of others, and for all those with each other. whom we interact.We support each other in a positive way. RESOURCES COMMUNICATION A 03 The backbone of our company is our s experienced, creative, and long-term 10 We expect and deliver truthful messages workforce. Our financial stability, timely, accurately,and respectfully infrastructure, and other resources allow us to We attentively listen to and recognize the take on and successfully complete challenges. ideas and feelings of others. ACCURACY TEAMWORK 04 We perform quality work the first time and 11 We are all part of the process. We all share review it for completeness and accuracy. We -. °' in our successes and challenges. do not take short cuts. We recognize the needs of and provide support to one another. INTEGRITY &ACCOUNTABILITY COMMUNITY 05 We stand behind our word and honor our commitments. When mistakes occur, we 12 We are committed to improving the acknowledge our mistakes and constructively communities in which we work and live participate in the resolution. through our construction projects and personal involvement. RELATIONSHIPS 06 APPEARANCE COUNTS We have established relationships with customers, engineers,government entities, 73 r 1 We take pride in the appearance of vendors, coworkers, our industry,and the ourselves and our work environment. general public. We foster these relationships We keep our work and work environment for mutual success. neat and organized. ,. DEPENDABILITY MENTORING 07 We do what we say we are going to do for 14 We lead and train fellow employees, our customers and our coworkers. allowing them to reach their highest potential. vcwww.iohnsc�ndav s.com