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Copy of Submittal PW-05-11-07-23 (ADEC)
a02j SECTION III PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS BID DOCUMENTATION American Design Engineering Construction Inc BIDDER'S COMPANY NAME) City Council City of Okeechobee 55 S.E. 3rd Avenue Okeechobee, FL 34974 I have received the documents titled CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS Project No. PW 05-11-07-23. I have also received addendum number 0 through 0 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 in accordance with the start date specified in the Notice to Proceed. 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 05-11-07-23 Public Works Department 4 American Design Engineering Bidder: Construction Inc Date: 7/25/2023 (Company Name) By: c��r.�r� � Title: VP ( ignature) Yainier Steven Espinal Email:steven.espinal©adeconstructioninc.com (Printed Name) Mailing Address: 2200 N Commerce Parkway Suite 200 Weston Fl 33326 Office Number: 954 740 7777 Fax Number: City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 5 SECTION IV PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS MINIMUM QUALIFICATIONS FOR BIDDERS Minimum Qualifications: 1.0 Experience 1.1 Bidder must have at least 3 years of experience in providing commercial concrete services including sidewalks anc other flat work, roadway curbing, and roadway concrete pavement. 1.2 Bidder has successfully completed at least 12 concrete projects including at least one project in each of the following categories: 1.2.1 Sidewalk installation 1.2.2 Roadway curbing 2.0 References 2.1 Bidder must provide at least 3 verifiable references of similar prior concrete services including sidewalks and other flat work, and roadway curbing. 2.2 For each reference, Bidder shall submit a completed Reference Form provided in Attachment H. provide the client's 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 c:Y'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 Vendor List kept by the Florida Department of Management Services as listed in section 3.0 above. City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 6 American Design Engineering Bidder: Construction Inc Date: 7/25/2023 (Company Name) By: 3- e-r."-¢a-z- Title: VP Signature) Yainier Steven Espina! Emall:steven.espinal@adeconstructioninc.com (Printed Name) Mailing Address: 2200 N Commerce Parkway Suite 200 Weston Fl 33326 Office Number: 954 740 7777 Fax Number: City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 7 BID BOND American Design Engineering KNOW ALL MEN BY THESE PRESENTS. that we, Construction, Inc. as Principal and Frankenmuth Insurance Company , as Surety, are held and firmly bound unto the City of Okeechobee (the "City"), in the penal sum of$5°ro of Amount Bid lawfu'_ money of the United States, for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THE OBLIGATION IS SUCH, that whereas the Principal has submitted the accompanying bid, dated July 26 , 2023. for the Contract Documents: Contract Number: PW 05-11-07-23 Contract Title: CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS NOW, THEREFORE, 1. If the Principal, a. Within seven (7) business days after the date of the Notice of Apparent Low Bidder, provides a Statutory Payment Bond and a Common Law Performance Bond as specified in the General Terms & Conditions or, in lieu of the Statutory Payment Bond or Common Law Performance Bond, provides an alternate form of security as specified in the Contract Documents; and provides the insurance certificate required under the Contract Documents, completed by a lawfully authorized insurance agent; and b. Within seven (7)business days of receipt of the Contract Documents, enters into a written contract with the City, in accordance with the Bid, as accepted. then the above obligations of the Principal and Surety shall be null and void. 2. However, should the Principal fail to fully comply with the conditions of paragraph 1 above, then the Principal and Surety, jointly and severally, shall be liable to the City for the full penal sum of this Bond which shall be forfeited to the City as liquidated damage, but not a penalty, as a result of the Principal's failure to comply with the bid instructions and conditions, regardless of whether the City ultimately decides to change the project requirements or resolicit bids. 3. The remedies provided herein are not to be construed as the City's exclusive remedies for the principal's failure to enter into a contract with the City but shall be deemed supplemental to all remedies available to the City at law or otherwise. City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 16 DATED ON July 25 , 2023 . FOR NON-CORPORATE BIDDERS: By: (Witness) (Signature of Principal) (Print Name) (Print Name and Title) (Witness) (Print Name) Business Address FOR CORPORATE BIDDERS: American Design Engineering Construction, Inc. ATTEST: (Signature of rrporate Principal) Yainier Steven Espinal VP Secretary (Print Name and Title) 2200 N Commerce Parkway Suite 202, Weston.Fl 33326 Business Address SURETY: ATTEST: (Corporate Seal) Frankenmuth Insurance Company (Corporate Surety) As Per Attached Power of Attorney , ; .L Secretary (Print Name and Title) �`��pRATfdF COQ f � One Mutual Avenue,Frankenmuth,MI 48787 186a Business Address 4,70.404 5979 NW 151 st ST,Suite 202,Miami Lakes,FL 33014 Florida Address for Service of Process 305-517-3803 Telephone Number (Surety shall provide evidence of signature authority such as a certified copy of Power of Attorney.) City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 17 FRANKENMUTH INSURANCE COMPANY POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,that Frankenmuth Insurance Company(the"Company"),a corporation duly organized and existing under the laws of the State of Michigan, having its principal office at 1 Mutual Avenue, Frankenmuth, Michigan 48787, does hereby nominate,constitute and appoint: Warren M. Alter, Jonathan A. Bursevich. David T. Satine. Dawn Ausoitz Their true and lawful attorney(s)-in-fact, each in their separate capacity if more than one is named above, to make, execute, seal, acknowledge and deliver any and all bonds, contracts and undertakings of suretyship, with the exception of Financial Guaranty Insurance,provided,however, that the penal sum of any one such instrument shall not exceed the sum of: Fifty Million and 00/100 Dollars($50,000,000) This Power of Attorney is granted pursuant to the following Resolution duly adopted at a meeting of the Board of Directors of Frankenmuth Insurance Company: "RESOLVED, that the President. Senior Vice President or Vice President and each of them under their respective designations, hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may he attested or acknowledged by any officer of the Company, qualifying the attorney(s) named in the given power of attorney, to execute on behalf of, and acknowledge as the act and deed of Frankenmuth Insurance Company on all bonds,contracts and undertakings of suretyship,and to affix the corporate seal thereto." IN WITNESS WHEREOF,the Company has caused these presents to be signed and attested by its appropriate officers and its corporate seal herautitiiAtocl this 15th day of December. 2022. '' Frankenmuth Insurance Company C—BY-__Y_AtSte F 4,\ 's� �►ri ' Frederick A. Edmond.Jr., SI TE .I111 lf)'A President and Chief Executive Officer 04CCO Y OF AW ) ss: Sworn to before me,a Notary Public in the State of Michigan,by Frederick A. Edmond,Jr.,to me personally known to be the individual and officer described in.and who executed the preceding instrument, deposed and said the Corporate Seal and his signatulyf`01j '-p were affixed and subscribed to said instrument by the authority of the Company. 40, qzr IN TESTIMONY WHEREOF, I have set my hand,and affixed my Official Seal this 15th day of December, 2022:O (Seal) X y: 2 . 44. Susan L. Fresorger,Notary Pu lie O Saginaw County.State of Michigan - ' 4 - My Commission Expires: April 3,2028 S I, the undersigned,Executive Vice President of Frankenmuth Insurance Company,do hereby certify that the foregoing is a true,correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded and is in full force and effect as of this date. 25th 2023 IN WITNESS WHEREOF. I have set my hand and affixed the Seal of the Company, this day of July Andrew H. Knudsen,Executive Vice President, Chief Operating: Officer and Secretary ALL CORRESPONDENCE RELATED TO BOND VALIDATION AND/OR A CLAIM SHOULD BE DIRECTED TO VP SURETY, 701 U.S.ROUTE ONE,SUITE 1, YARMOUTH,ME 04096 Frankenmuth Insurance Company FcankeriinutliAnsurAmerica Patriot Life Insurance Company INSURANCE Patriot Insurance Company SURETY BOND SEAL ADDENDUM Frankenmuth Insurance Company Due to logistical issues associated with the use of traditional seals during the COVID-19 pandemic, Frankenmuth Insurance Company has authorized its Attorneys-in-Fact to affix Frankenmuth Insurance Company's, corporate seal to any bond executed on behalf of Frankenmuth Insurance Company, by any such Attorney-in-Fact, by attaching this Addendum to said bond. Through December 31, 2023,to the extent this Addendum is attached to a bond that is executed on behalf of Frankenmuth Insurance Company, by its Attorney-in-Fact, Frankenmuth Insurance Company, hereby agrees that the seal below shall be deemed affixed to said bond to the same extent as if its raised corporate seal was physically affixed to the face of the bond. 25th Dated this day of July, 2023. F �86$ \\s,................... ��c�raGRN Sign: -``)->C Attorney-in-fact Jonathan A. Bursevich 1 Mutual Avenue Frankenmuth,MI 48787 General:989.652.6121 Toll Free:800.234.1133 Claims:800.234.1133 www.fmins.com EXHIBIT B PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS BID UNIT PRICE SCHEDULE ITEM NO UNIT DESCRIPTION MEASURE EST.QTY. UNIT PRICE AMOUNT REMOVE EXISTING SIDEWALK AND INSTALL NEW ADA CURB RAMP CR-C PER FDOT INDEXES 300 CURB&CURB AND GUTTER,AND 304 DETECTABLE WARNINGS AND SIDEWALK CURB RAMPS. $7,150.00 $21,450.00 1 EA 3 CONCRETE SHALL BE 3,000 PSI WITH FIBER OF OTHER APPROPRIATE REINFORCEMENT MATERIAL. DETECTABLE WARNING MAT COLOR SHALL BE BRICK RED. REMOVE EXISTING SIDEWALK AND INSTALL NEW ADA CURB RAMP CR-L PER FDOT INDEXES 300 CURB &CURB AND GUTTER,AND 304 DETECTABLE WARNINGS AND SIDEWALK CURB RAMPS. 2 CONCRETE SHALL BE 3,000 PSI WITH FIBER OF EA 4 $7,150.00 $28,600.00 OTHER APPROPRIATE REINFORCEMENT MATERIAL. DETECTABLE WARNING MAT COLOR SHALL BE BRICK RED. REMOVE AND REPLACE EXISTING 4-INCH THICK, 3 FIVE(5)FOOT WIDE CONCRETE SIDEWALK.TEN(10) LF 650 $50.00 $32,500.00 YARD TOTAL. REMOVE AND REPLACE EXISTING 4-INCH THICK 4 FIVE-FOOT-WIDE CONCRETE SIDEWALK.LESS THAN LF 100 $70.00 $7,000.00 TEN(10)YARD TOTAL REMOVE EXISTING 4-INCH THICK FIVE(5)FOOT WIDE CONCRETE SIDEWALK,REPLACE WITH 6-INCH LF 750 $50.00 $37,500.00 THICK CONCRETE SIDEWALK.TEN(10)YARD TOTAL REMOVE AND REPLACE EXISTING CONCRETE"F" 5 CURB.TEN(10)YARD TOTAL LF 100 $40.00 $4,000.00 REMOVE AND REPLACE EXISTING CONCRETE"F" 6 CURB.LESS THAN TEN(10)YARD TOTAL LF 100 $60.00 $6,000.00 INSTALL NEW CONCRETE"F"CURB.TEN(10)YARD 7 OR GREATER TOTAL LF 100 $35.00 $3,500.00 8 INSTALL NEW CONCRETE"F" CURB. LESS THAN TEN LF 50 $60.00 $3,000.00 (10)YARD TOTAL 9 INSTALL NEW CONCRETE"D"CURB.TEN (10)YARD LF 100 $35.00 $3,500.00 OR GREATER TOTAL 10 INSTALL NEW CONCRETE"D"CURB. LESS THAN LF 100 $65.00 $6,500.00 TEN(10)YARD TOTAL 11 INSTALL NEW 4-INCH-THICK CONCRETE SLAB SQUARE 100 $25.00 $2,500.00 FOOT 12 INSTALL NEW 6-INCH-THICK CONCRETE SLAB SQUARE 100 $30.00 $3,000.00 FOOT TOTAL BID AMOUNT $159,050.00 (Based on Bid Unit Prices& Estimated Quantities) City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 42 Bidders Company Name American Design Engineering Construction Inc 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: American Design Engineering Construction Inc Date: 7/25/2023 (Company Name) By: Title: VP ( ignature) Yainier Steven Espinal Email: steven.espinal@adeconstructioninc.com (Punted Name) Mailing Address: 2200 N Commerce Parkway Suite 200 Weston Fl 33326 Office Number: 954 740 7777 Fax Number: City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 43 ATTACHMENT A PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS NO LOBBYING AFFIDAVIT STATE OF FLORIDA COUNTY OF Broward This 26 day of July , 20 23 , Yainier Steven Espinal being first duly sworn, deposes and says that he/she is the authorized representative of American Design Engineering Construction Inc (Name of Contractor, Firm or Individual) respondent to the attached request for Bid, or qualifications and/or any other solicitation released by City of Okeechobee, and that the Bidder and any of its agents agrees to abide y the City of Okeechobee no lobbying restrictions in regard to this solicitation. o _''' Aft rapiMA! . Affiant The foregoing instrument was acknowledged before me by means of M'physical presence or I 1 online notarization, this 26 day of July , 20 23 , by Yainier Steven Espinaj who is personally known to me or produced Driver License / as identification. �\" AL';;;y ,, �;. oTARy;F.p�; Nota i Signa ` ►/11-1 13)3 - My Comm.Expires;m ;December 13,2024: Commission No. - .• No.HH 71323 � — City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 44 ATTACHMENT B PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS ANTI-COLLUSION STATEMENT AND NO GIFT STATEMENT Date: July 26, 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: American Design Engineering Construction Inc By (printed/typed): Yainier Steven Espinal By (signature): Title: VP Mailing Address: 2200 N Commerce Parkway Suite 200 City, State, Zip: Weston Fl 33326 Telephone No.: 954 740 7777 City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 45 ATTACHMENT C PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS 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 # 0 Date: Addendum # Date: Addendum # Date: Addendum # Date: Addendum # Date: Addendum # Date: I hereby propose to provide the services requested in the City's BID/RFP/RFQ and, if awarded, to enter into the attached draft contract. I agree that the terms and conditions of the City's BID/RFP/RFQ shall take precedence over any conflicting terms and conditions submitted with my proposal and agree to abide by all conditions of the BID/RFP/RFQ, unless a properly completed Exceptions to BID/RFP/RFQ form is submitted. I acknowledge that the City may not accept the proposal due to any exceptions. I certify that all information contained in my proposal is truthful to the best of my knowledge and belief. I further certify that I am duly authorized to submit this proposal on behalf of the Company as its agent and that the Company is ready, willing and able to perform if awarded a contract. 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. American Design Engineering Construction Inc 2200 N Commerce Parkway Suite 200 Name of Business ; Mailing Address Weston Fl 33326 City, State & Zip Code 954 740 7777 Authorized Signat re Telephone Number/Fax Number Yainier Steven Espinal VP steven.espinal(a�adeconstructioninc.com Name & Title, Typed Email Address STATE OF FLORIDA COUNTY OF Broward The foregoing instrument was acknowledged before me by means of Vphysical presence or online notarization, this 26 day of July , 20 23, by Yainier Steven Espinal , who is personally known to me or produced Driver License ,as identification. ) • TR y' ;7,� Notary Publ. Si nytir � EXP;�es: Commissidn No. l 35 • } :My Gomm 13,2024• ▪ t Deoem NN 71323 No. Q • • P -- C.) •O City of Okeechobee . •., '• •..g ' Project No. PW 05-11-07-23 Public Works Department 46 ATTACHMENT D PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS 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: Yainier Steven Espinal VP (print Individual's name and title) for: American Design Engineering Construction Inc (print name of entity submitting sworn statement) whose business address is 2200 N Commerce Parkway Suite 200 Weston Fl 33326 and (if applicable) its Federal Employer Identification Number (FEIN) is: 26-0713097 (If the entity has no FEIN, include the Social Security Number of the Individual signing this sworn statement: - - .) 2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or of the United States, including but not limited to, any Bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentations. 3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or nolo contendere. 4. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means: a. A predecessor or successor of a person convicted of a public entity crime; or b. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 47 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). IV Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list (attach a copy of the final order). I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGORY OF AN_2CHANG 'IN THE INFORMATION CONTAINED IN THIS FORM. Signature ) /. , r STATE OF FLORIDA COUNTY OF Broward The foregoing instrument was acknowledged before me by means of IVphysical presence or online notarization, this 26 day of July , 20 23, by Yainier Steven Espinal , who is personally known to me or produced Driver License as ides tification. o111111//o,0 „y� S�....... .e�F ��'. Notary Public Si ature My Comm.Expires; _ Commission No December 13,2024: No.HH 71323 City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 48 ATTACHMENT E PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS 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: American Design Engineering Construction Inc By (Printed): Yainier Steven Espinal By (Signature): � Title: VP Address: 2200 N Commerce Parkway Suite 200 Weston Fl 33326 Phone Number: 954 740 7777 City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 49 ATTACHMENT F PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS 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. Ameri an Design Engineers Construction Inc ompa /l me .1/W? 42GY Signature 9 VP Title July 26, 2023 Date STATE OF FLORIDA COUNTY OF Broward The foregoing instrument was acknowledged before me by means of('physical presence or -- online notarization. this 26 day of July , 20 23, by Yainier- teven Espinal , who is personally known to me or produced Driver License as identification. Nottilifelii >`�. •'pTARy:•.-9 S Notary Pu 'c ig at % • Comm.Expires Commission No December 13,2024• No.HH 71323 : Q • Q ,, TF'• •'moo `�. ,1,,/i, O� +o,0 City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 50 ATTACHMENT G PW 05-11-07-23 CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS 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 requirements. Signature: � Date: July 26, 2023 Company: American Design Engineering Construction Inc Name: Yainier Steven Espinal Address: 2200 N Commerce Parkway Suite 200 Title: VP Weston Fl 33326 Phone Number: 954 740 7777 City of Okeechobee Project No. PW 05-11-07-23 Public Works Department 51 ATTACHMENT H CITY OF OKEECHOBEE CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS PW 05-11-07-23 REFERENCE FORM Client Name: City of Auburndale, Fl Client Phone Number: Steve Lawson 863 618 6207 Client E-mail: SLawsonauburndalefl.com Service Dates: Beginning 2018 End 2018. Estimated Annual Contract Amount: $164,000.00 Description of the services performed as they directly relate to the work of this Reaues for Bid: Grading, Sidewalk Improvement City of Okeechobee Project No. PW 05-11-07-2 ' Public Works Deoartmen- ATTACHMENT H CITY OF OKEECHOBEE CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS PW 05-11-07-23 REFERENCE FORM Client Name: FDOT Central OfficeT1791 Client Phone Number: Tracy Fluke 863 581 0024 Client E-mail: Tracy.Fluke©dot.state.fl.us Service Dates: Beginning 2021 End 2021 Estimated Annual Contract Amount: $600,000.00 Description of the services performed as they directly relate to the work of this Reaues` for Bid: Grading, Sidewalk Improvement, Pipe & Structures, Flexible Paving, Pavement Markings, Sign Installation, Sod City of Okeechobee Project No. PW 05-11-07-2 ' Public Works Deoartmerr 5� ATTACHMENT H CITY OF OKEECHOBEE CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS PW 05-11-07-23 REFERENCE FORM Client Name: City of Miramar Client Phone Number: Leah DeRiel 305 219 4035 Client E-mail: Ideriel(c�miramarfl.gov Service Dates: Beginning 2022 End 2022 Estimated Annual Contract Amount: $190,000.00 Description of the services performed as they directly relate to the work of this Reaues' for Bid: Grading, Sidewalk Improvement, Pipe & Structures, Flexible Paving, Pavement Markings, Sign Installation, Sod City of Okeechobee Project No. PW 05-11-07 Public Works Departmer: FDC.T1 Florida Department of Transportation RON DESANTIS 605 Suwannee Street JARED W.PERDUE,P.E. GOVERNOR Tallahassee, FL 32399-0450 SECRETARY May 17,2023 AMERICAN DESIGN ENGINEERING CONSTRUCTION INC. 2200 NORTH COMMERCE PARKWAY WESTON, FLORIDA 33326 RE: CERTIFICATE OF QUALIFICATION The Department of Transportation has qualified your company for the type of work indicated below. FDOT APPROVED WORK CLASSES: DRAINAGE, FLEXIBLE PAVING, GRADING, GRASSING, SEEDING AND SODDING, PAVEMENT MARKING, ROADWAY SIGNING, SIDEWALK, Curb & Gutter, Driveways, Retaining wall, Tree Removal. Unless notified otherwise, this Certificate of Qualification will expire 6/30/2024. In accordance with Section 337.14(4) , Florida Statutes, changes to Ability Factor or Maximum Capacity Rating will not take effect until after the expiration of the current certificate of prequalification (if applicable) . In accordance with Section 337.14 (1), Florida Statutes, an application for qualification must be filed within (4) months of the ending date of the applicant's audited annual financial statements. If the company's maximum capacity has been revised, it may be accessed by logging into the Contractor Prequalification Application System via the following link: HTTPS://fdotrpi.dot.state.fl.us/ContraotorPreQualification Once logged in, select "View" for the most recently approved application, and then click the "Manage" and "Application Summary" tabs. The company may apply for a Revised Certificate of Qualification at any time prior to the expiration date of this certificate according to Section 14-22.0041(3) , Florida Administrative Code (F.A.C.) , by accessing the most recently approved application as shown above and choosing "Update" instead of "View." If certification in additional classes of work is desired, documentation is needed to show that the company has performed such work. All prequalified contractors are required by Section 14-22.006(3) , F.A.C., to certify their work underway monthly in order to adjust maximum bidding capacity to available bidding capacity. You can find the link to this report at the website shown above. Sincerely, 9a441,42.d.- -7,�43z as James E. Taylor II, Prequalification Supervisor Contracts Administration Office JTII:cg Improve Safety, Enhance Mobility, Inspire Innovation www.fdot.gov