Original (2) Bid Documentation PW-05-11-07-23 oR l‘ I.i,;A L. . z)
SECTION III
PW 05-11-07-23
CITY OF OK; ECHOBEE 2023 SIDEWALK IMPROVEMENTS
BID DOCUMENTATION
(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 Pro'e•t No. PW 05-11-07-23. I have also received addendum number
O through and ha e included these provisions in my Bid. I have examined both the
Bid documents and the c•nstruction site and submit the following Bid in which I agree:
1. To hold m Bid open until an agreement has been executed between the
City of Okeechobee and accepted Bidder, or until ninety (90) days after Bids
are opener', whichever is longer.
2. Regarding the Disposition of Bid Security: to accept the provisions of the
Instruction.. to the Bidders.
3. To accom.'lish the work included in, and in accordance with the Contract
Document, 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 t is project on a unit price basis as reflected in the Bid Unit Price
Schedule, xhibit B of this agreement. Payment will be made upon invoice
after comp etion of all work. NOTE:The City shall not be liable to pay interest
on any u paid balance. Vendor is solely responsible for all taxes,
withholdin., or social security obligations.
6. Regarding the Award of the Contract: if I am awarded a contract for this
project, I u derstand that the award may be for all or any portion thereof, of
the items ILted under the Bid Unit Price Schedule.
City of Okeechobee Project No. PW 05-11-07-23
Public Works Department 4
r1
Bidder: ,t` / 0,A,TP K. r (f Date: . :.s e
(Company Name)
By: Title: jk
(Signature)
air_r< (—;:t .�.t _ Email: �s+��,.;_a���. .,.s� ( N.o - Dyck
(Printed Name)
Mailing Address: j ?7cr tf Ali +v re:4FF 3-+t"S
Office Number: T _ gyp - Fax Number:
City of Okeechobee Project No. PW 0S-11-07-23
Public Works Department 5
SECTION IV
PW 05-11-07-23
CITY OF OK:ECHOBEE 2023 SIDEWALK IMPROVEMENTS
MINI UM QUALIFICATIONS FOR BIDDERS
Minimum Qualificaf:u
1.0 Experience
1.1 Bidder must 1 ave at least 3 years of experience in providing commercial
concrete servi, es including sidewalks and other flat work, roadway curbing, and
roadway cone ete pavement.
1.2 Bidder has s ,ccessfully completed at least 12 concrete projects including at
least one project in each of the following categories:
1.2.1 Sidi•walk installation
1.2.2 Roadway curbing
2.0 References
2.1 Bidder must •rovide at least 3 verifiable references of similar prior concrete
services including sidewalks and other flat work, and roadway curbing.
2.2 For each refe -nce, 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 pi ovide a written description of the services performed in sufficient
detail as they rirectly relate to the work of this Request for Bid. The description
shall include t e dates of the period that the Bidder provided the services as
well as the co tractual amount of the services provided.
2.4 The City, in itG sole discretion, may reject any and all bids if the City is not able
to verify the erences provided.
3.0 Discriminatory Vendo List
3.1 In accordance with Section 287.134, Florida Statutes, an entity or affiliate who
has been pi-ced on the Discriminatory Vendor List, kept by the Florida
Department o 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 •r perform work as a contractor, supplier, subcontractor or
consultant under a contract with any public entity; and may not transact
business with ny public entity.
4.0 Bidder certifies that
4.1 Bidder meets he qualifications listed in Section IV, 1.0 above.
4.2 Bidder has never failed to complete work awarded under a contract due to
circumstance• that were under Bidder's control.
4.3 The Bidder h.s 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. PAN 05-11-07-23
Public Works Department 6
Bidder: !.-et. I,s=& IZ �r �A '> Date: It. hi, 2: , L =?
(Company Name)
By: Title:
i (Signa.ure)
Email: lkoi_- , yA_
(Printed Name)
Mailing Address: ( 7c c !v . Al y fr t_/ kL s °�' - lci ii,• r--L -L 1
Office Number: �i/:j", 'f b �%t G F Fax Number: :�-
City of Okeechobee Project No. PW 05-11-07-23
Public Works Department 7
EXHIBIT A
PW 05-11-07-23
CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS
GOVERNING SPECIFICATIONS
1.0 ADA Ramp Installation
The scope of this item Df the contract is to install seven (7) ADA sidewalk curb ramps
on SW Park Street in the downtown area of Okeechobee. Minimizing impact to the
existing business owners and customers is of highest priority. The maximum
allowable time for removal, forming and pouring any single ramp located adjacent to
businesses located on the South side of South Park Street is three (3) calendar days.
The contractor is responsible for providing appropriate barricades, signage and other
traffic control devices to assure pedestrian safety always.
All curb ramps will be installed per FDOT indexes 300 - Curb & Curb and Gutter, and
304— Detectable Warnings and Sidewalk Curb Ramps. Concrete shall be 3,000 PSI
with fiber of other appropriate reinforcement material. Detectable warning mat color
shall be brick red.
The locations of the new ramps are as follows:
Number Location Ramp
Type
1 200 block of SW Park St, midblock North side C
2 200 block SW Park St, SW corner of Park 2 L
3 300 block of SW Park St, midblock Northside C
4 300 block of SW Park St, SE corner of Park 3 L
5 300 block of SW Park St, SW corner of Park 3 L
6 400 block of SW Park St, midblock North side C
7 400 block of SW Park St, SE corner of Park 4 L
City of Okeechobee Project No. PW 05-11-07-23
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EXHIBIT B
PW 05-11-07-23
CITY OF OK:ECHOBEE 2023 SIDEWALK IMPROVEMENTS
BID UNIT PRICE SCHEDULE
ITEM UNIT
DESCRIPT ON MEASURE EST.QTY. UNIT PRICE AMOUNT
REMOVE EXISTING SIDEWALI AND INSTALL NEW
ADA CURB RAMP CR-C PER F DOT INDEXES 300
CURB&CURB AND GUTTER, •ND 304 DETECTABLE
WARNINGS AND SIDEWALK I URB RAMPS,
1 EA 3 S •c‘ r
CONCRETE SHALL BE 3,000 P•1 WITH FIBER OF 075, 6-42%
OTHER APPROPRIATE REINFo RCEMENT MATERIAL.
DETECTABLE WARNING MA COLOR SHALL BE
BRICK RED.
REMOVE EXISTING SIDEWAL AND INSTALL NEW
ADA CURB RAMP CR-L PER F Ii OT INDEXES 300 CURB
&CURB AND GUTTER,AND 314 DETECTABLE
2 WARNINGS AND SIDEWALK I URB RAMPS. EA 4 3' 3q 440
CONCRETE SHALL BE 3,000 P I WITH FIBER OF
OTHER APPROPRIATE REINFu RCEMENT MATERIAL.
DETECTABLE WARNING MA COLOR SHALL BE
BRICK RED.
REMOVE AND REPLACE EXIS ING 4-INCH THICK,
3 FIVE(5)FOOT WIDE CONCRE E SIDEWALK.TEN(10) LF 650 70 'rt'sc*.
YARD TOTAL.
REMOVE AND REPLACE EXIS ING 4-INCH THICK
4 FIVE-FOOT-WIDE CONCRETE SIDEWALK.LESS THAN LF 100 •� � 76—,90
TEN(10)YARD TOTAL
REMOVE EXISTING 4-INCH T ICK FIVE(5)FOOT
WIDE CONCRETE SIDEWALK,REPLACE WITH 6-INCH LF 750 4I: 7/, g6 17
THICK CONCRETE SIDEWALK TEN(10)YARD TOTAL
5 REMOVE AND REPLACE EXIS,ING CONCRETE"F" LF 100 va•:�
CURB.TEN(10)YARD TOTAL
6 REMOVE AND REPLACE EXIS ING CONCRETE"F" LF 100 4/J can
CURB.LESS THAN TEN(10)Y RD TOTAL
INSTALL NEW CONCRETE"F"CURB.TEN(10)YARD
7 OR GREATER TOTAL LF 100 �, 0 0e,
8 INSTALL NEW CONCRETE"F' CURB.LESS THAN TEN
(10)YARD TOTAL LF 50
INSTALL NEW CONCRETE"D CURB.TEN(10)YARD
9 OR GREATER TOTAL LF 100 .yid' ;rbi„
INSTALL NEW CONCRETE"D CURB. LESS THAN
10 TEN (10)YARD TOTAL LF 100
11 INSTALL NEW 4-INCH-THI K CONCRETE SLAB SQUARE 100
FOOT �/ //
12 INSTALL NEW 6-INCH-THI K CONCRETE SLAB SQUARE 100
FOOT /3 / 3 cl cy
TOTAL BID AMOUNT f . �. y
(Based on Bid Unit Prices&Estimated Quantities)
City of Okeechobee Project No. PW 05-11-07-23
Public Works Department
42
Bidders Company Name 1:" (.fo N'�'A CT J J� (DIr
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: / 0 a•71.0V-rpr..l, k ) Date: `7 i?s I?-3
(Company Namo)
By: Title: ';ct•;.�a
nature)
jJ :34. / r. 'u & Email: �'`= ix o t.- zlt:4i
(Printed Name)
Mailing Address: 3 gut - 1.ifr:�.:+i r:k �� ,E rVy1A .I ( s` a
Office Number: ql a a ta4,4 Fax Number: ;`,f a
City of Okeechobee Project No. PW 05-11-07-23
Public Works Department
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ATTACHMENT A
PW 05-11-07-23
CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS
NO LOBBYING AFFIDAVIT
STATE OF FLORID
COUNTY OF
This . ,day of _lx1',ice 20:13, jo1/44 being first duly sworn,
deposek and says that he/she is the authorized representative of
a (o.<<.;;e /. (0ts=f) (Name of Contractor, Firm or Individual)
respondent to the attached request for Sid, or qualifications and/or any other solicitation released
by City of Okeechobee, and that the Bidder and any of its agents agrees to abide by the City of
Okeechobee no lobbying restrictions in regard to this solicitation.
Affiartt'
The foregoing instrument was acknowledged before me by means of 1.p15ysical presence or
online notarization, this 2,; day of ..T.,t.1 , 20 ..3, by ;,,,jok.4k .Gs,�,• , who is
personally kn wo o me or produced 1 as identification.
Notary Publi Signature
RK ANTNOW TESTA
COmmiSsiO � "u NA
. Wk.•State of Flonda
c commission 2027
�� '; My Comm,Expires Jan 29,
'''Bonded through
National Notary Assn.
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: �_. . s 11, ar.2 3
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: LAS 'n-tot
Lo
By (printed/typed): '36-c
By (signature):
Title:
Mailing Address: .t.; f f/01-4�,o a 4. > :►
fr.).,
City, State, Zip: j 4\,c.ciA,. 4t 3; .-v-3,
Telephone No.: n173
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 th s 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 # fr 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.
I further certify, under oath, that this proposal is made without prior understanding, agreement,
connection, discussion or co lusion 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 Oat the undersigned executed this Proposer's Certification with full
knowledge an -understanding of the matters therein contained and was duly authorized to do so.
Name of Business F Mailing Address
\sti aa.r.-1 3 S 'v q
City, State&Zip Code
Autho ' S Signature Telephone Number/Fax Numb J
USG (.. .f''l�t i:-�C r ' t 5.
Z.14 a�-��h.'►n' i.i 1--'r,A_(!? AO L _ /Cn“
Name& Title, Typed ` Email Address
STATE OF FLORIDA
COUNTY OF f• l/ : ,,,,,.-k
The foregoing instrument was acknowledged before me by means of►,/phys' I presence or
online notarization, this �, day of _:.w 1 i , 20 y�'S, by J4.�• ir„em,.•. , who
is personally known to me or produced as identification.
Notary blic S'. . ii,"
—
Commission ) o<''v'6i;''•• MARK ANTHONY Tc$FAorida
,
i' ;< o as puU.
Al Commission ft HN 35543602
55432027
%% oF tti°r'' My Comm.Expires Jan 29,
Bonded through National Notary Assn.
City of Okeechobee .j- t o. 'W 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: _.;14 IL-
� ias;i2 ! :N.,5. �1e,- (print lndividual's name and title)for:
(print name of entity submittingsworn statement)whose business address is
and (if
applicable) its Federal Employer Identification Number (FEIN) is: h`>' %4-1-2't.,(>
(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 o`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 pooli ig 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).
Neither the entity scbmitting this sworn statement, nor any of its officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the
management of the entity, nor any affiliate of the entity has been charged with and
convicted of a public entity crime subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the
management of the entity, or an affiliate of the entity has been charged with and convicted
of a public entity crime subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors,
executives, partners, Shareholders, employees, members, or agents who are active in the
management of the entity, or an affiliate of the entity has been charged with and convicted
of a public entity crime subsequent to July 1, 1989. However,there has been a subsequent
proceeding before a Hearing Officer of the State of Florida, Division of Administrative
Hearings and the final Order entered by the Hearing Officer determined that it was not in
the public interest to place the entity submitting this sworn statement on the convicted
vendor list (attach a copy of the final order).
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER
FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 ABOVE iS FOR THAT PUBLIC
ENTITY ONLY AND THAT THIS FORM iS VALID THROUGH DECEMBER 31 OF THE
CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO
INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF
THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR
CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
Signature _
STATE OF FLORIDA
COUNTY OF If L
The foregoing instrument was acknowledged before me by means of physical presence or
online notarization, this d day of j"l_,7 , 20.;>j3, by , who
is personIfttavvn to me or produced as identification.
✓� '' / "/ -
Notary Publ MARK ANTHONY TESTAJ�
•
L�. Notary Public State of 5Florida s
COmrnissio -,��� u a; Commission HH 3 29,32027
'2 ov :a . m *Ru n
Bonded, through National Notary Ass .
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
Name(s) Position(s)
Firm Name: Z.s+ 711T.*tr44ci L [ ,u ap
By (Printed): pA:=
By (Signature): -
Title: ;. .� .,��
Address: ( 70 t Pj :tAtc- "44) r°:�
Phone Number: c- •-p 0 eo
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. Sectio i 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 immigrat on act and subsequent amendments.
Cey-
Company Na310
Sign e/
f'f t.+.
Titer ii
•
Date Is
STATE OF FLORIDA
COUNTY OF k i`; >,�
The foregoing instrument was acknowleed before me by means of -physical presence or
online notarization, this day of it.1: , 20 „ by `-ix ��ZG��;k<_� , who
is personally known to me or produced as identification.
Notary Pu• is Si•natur:Y
•otLYPu' MARK ANTHONY TESTA
Commission Q? Notary Public-State of Florida
Commission 4 HH 355436
orc';°.. My Comm.Expires Jan 29,2027
Bonded through National Notary Assn.
City of Okeechobee Project No. PW 05-11-07-23
Public Works Department
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ATTACHMENT G
PW 05-11-07-23
CITY OF OK ECHOBEE 2023 SIDEWALK IMPROVEMENTS
DRUG-F EE WORKPLACE CERTIFICATION
THE BELOW SIGNED Bicder/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 terns 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: l /� Date:
.lam/
Company: /: ;i.�. �,�,;, f � Name: .L k
Address: j. -iv , A I )„>a; -_ ' Title: t;4<<.Xe_ u
Phone Number: - r; r
City of Okeechobee Project No. PW 05-11-07-23
Public Works Department
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ATTACHMENT H
CITY OF OKEECHOBEE
CITY OF OKEECHOBEE 2023 SIDEWALK IMPROVEMENTS
PW 05-11-07-23
REFERENCE FORM
Client Name: LAS : 4. c
Client Phone Number: - + tom k, et
Client E-mail: G o 5 C n:'.ter ivc_.r;,N k J tt.? • L'%d
Service Dates: Beginning : End 3r
Estimated Annual Contract Amount: .3.
Description of the services performed as they directly relate to the work of this Request
for Bid:
FDO T Egr -- t c;r1.:�.u.Lk Coe 4
F �0 7` - E_ u "
054:iis%s. <.-A+ ii.PL • ( �� S e: Al a!J<�L- - - I ipa; C){%� -t Irv:T t' , !iL1 iA4 \��}1�ts(�!4LL
City of Okeechobee Project No. PW 05-11-07-23
Public Works Department
52
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, LAS Contracting Corp. as
Principal and Merchants Bonding Company (Mutual), as Surety, are held and firmly bound
unto the City of Okeechobee (the "City"), in the penal sum of$ 5% lawful
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 . 20 23,
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 ONJuly 26 , 2023 .
FOR NON-CORPORATE BIDDERS:
By:
(Witness) (Signature of Principal)
(Print Name)
(Print Name and Title)
(Witness)
(Print Name) Business Address
FOR CORPORATE BIDDERS: LAS Contracting Corp.
ATTEST:
41,
ure of Corporate Principal)
sJ 1 f l
Secretary (Print Name and Title)
13701 N.Nebraska Ave.Suite 102 Tampa.FL 33613
Business Address
SURETY: Merchants Bonding Company (Mutual)
ATTEST: 4-X�\
(Corporate Seal) ? �..
(Corporate' Sure )
77t) Tyler D. DeBord, Attorney-In-Fact
(Print Name and Title)
6700 Westown Parkway.West Des Moines.IA 50266
Business Address
300 North Beach Street,Daytona Beach.FL 32114
Florida Address for Service of Process
386-239-5703
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
MERCHANT'S
BONDING COMPANY
POWER OF ATTORNEY
Know All Persons By These Presents that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING. INC..
both being corporations of the State of Iowa.d/b/a Merchants National Indemnity Company(in California only)(herein collectively called the
"Companies")do hereby make.constitute and appoint.individually.
Pamela J Thompson:Steve P Farmer;Tyler D DeBord
their true and lawful Attorney(s)-in-Fact. to sign its name as surety(ies) and to execute. seal and acknowledge any and all bonds. undertakings.
contracts and other written instruments in the nature thereof. on behalf of the Companies in their business of guaranteeing the fidelity of
persons. guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions
or proceedings allowed by law.
This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23. 2011 and amended August 14. 2015 and adopted by the Board of Directors of
Merchants National Bonding.Inc. on October 16.2015.
"The President. Secretary. Treasurer. or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and
authority to appoint Attorneys-in-Fact. and to authorize them to execute on behalf of the Company. and attach the seal of the Company thereto.
bonds and undertakings.recognizances.contracts of indemnity and other writings obligatory in the nature thereof.-
-The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of any bond. undertaking. recognizance. or other suretyship obligations of the
Company.and such signature and seal when so used shall have the same force and effect as though manually fixed."
In connection with obligations in favor of the Florida Department of Transportation only.it is agreed that the power and aut hority hereby given to the
Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by the State of Florida Department of Transportation. It is fully understood that consenti ng to the State of Florida Department
of Transportation making payment of the final estimate to the Contractor and/or its assignee. shall not relieve this surety company of any of
its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only.it is agreed that the power and authority hereby given
to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner-
Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation.
In Witness Whereof.the Companies have caused this instrument to be signed and sealed this 8th day of December . 2022
""""• ...... MERCHANTS BONDING COMPANY(MUTUAL)
•'•p�I�.NAC p�N• ••.CO •.• MERCHANTS NATIONAL BONDING,INC.
GDPP01.q e • ***. P0/14:7; dlbla MERCHANTS NATIONAL INDEMNITY COMPANY
•
cn •C,.
. 2003 :s") •�6 1933 c By
ate•;: :•�6� 1a�:
'•.k/ ...... '.O• . !y Presid/4/7ent
STATE OF IOWA 1^t •
COUNTY OF DALLAS ss. "
On this 8th day of December 2022 before me appeared Larry Taylor. to me personally known. who being by me duly sworn
did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL)and MERCHANTS NATIONAL BONDING. INC.: and that the
seals affixed to the foregoing instrument are the Corporate Seals of the Companies:and that the said instrument was signed and sealed in behalf
of the Companies by authority of their respective Boards of Directors.
Kim Lee
l omm sson
- N +
ti:y Commission Expres \J
�Y,1Fpn 14.2024
Notary Public
(Expiration of notary's commission does not invalidate this instrument)
I.William Warner.Jr..Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING.INC..do hereby
certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies.which is still in full
force and effect and has not been amended or revoked.
In Witness Whereof. I have hereunto set my hand and affixed the seal of the Companies on this 26th day of July 2023
p,'C1ON44 Q. ' t?G CphA.
° � •z i `
a
2003 :s�; ••y 1933 c Secretary
POA 0018 (10/22) "•"