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VII (B) Approval and Authorization of Financial Assistance from the City to Help Ocoee Little League and the Ocoee Bulldogs Complete Their Field of Dreams Project
Agenda 6-02-2004 Mayor eCenter of�0od Lt� Commissioners Item VII B S. Scott Vandergrift �b e DannyHowell, District 1 �- ~ Scott Anderson, District 2 CityManager ' g Rusty Johnson, District 3 Jim Gleason Nancy J. Parker, District 4 STAFF REPORT 8 ! • The Honorable Mayor and City Commissioners fi Johnny Farmer, Parks and Recreation Director • E: May 24 2004 ' : Ocoee Little League and Ocoee Bulldogs Funding ISSUE Should the Mayor and City Commission consider contributing funds to help Ocoee Little League and the Ocoee Bulldogs complete their Field of Dreams projects. BACKGROUND/DISCUSSION Both Ocoee Little and the Ocoee Bulldogs submitted grant requests to Orange County Parks and Recreation Field of Dreams, and both organizations received $59,287.81 to assist with improving the facilities they utilize. Ocoee Little League wants to add lights to the Junior Field at the Sorenson Field Complex and the Ocoee Bulldog wants to replace the press box and add restrooms on the visitor's side at the Bulldog Field. Both of these projects could be over the amount awarded to these groups, and they are seeking financial assistance from the City to complete these project. Ocoee Little League is short $44,392.19, but is still trying to get this done for a lower price. The Ocoee Bulldogs are in the process of obtaining quotes for their project at this time. At the present time, according to the Finance Department,there is approximately $26, 277 in the Commission Contingency and $147,790 in the General Contingency that could be utilized to assist these groups. • RECOMMENDATION Staff is very proud of both the Ocoee Little League and the Ocoee Bulldogs for seeking grant funds to help make improvements to their playing areas, and if funds are available, supports assisting them in any way possible. Cc: Gene Williford, Acting City Manager Wanda Horton, Finance Director Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint Lloyd H Waldorff, Dale Waldorff, Beverly R Crews, Benjamin H French, Pamela L Jarman, Paul A Locascio,Individually of Gainesville,FL,its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds,undertakings and other obligatory instruments of similar nature -In Unlimited Amounts- and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof,WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to be hereto affixed on this 2nd day of September,2003. ,praEryG WESTERN SURETY COMPANY t0 Ott"t;'}Tf wa %TM 00 Paul .Bruflat,Senior Vice President State of South Dakota ss County of Minnehaha On this 2nd day of September,2003,before me personally came Paul T.Bruflat,to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is the Senior Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said corporation. My commission expires + +...++ D. KRELL f f/ November 30,2006 RyWOCZf SOUTHfARY PUBLICDAKOTA ate' 11(Qi4 + + D.Krell,No Public CERTIFICATE I,L.Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal Of the said corporation this 12th day of Nay , 2004 • • .00t`T''° WESTERN SURETY COMPANY a� t g 31,'��, nom'~ C Form F4280-01-02 L.Nelson,Assistant Secretary SECTION 00480 NONCOLLUSION AFFIDAVIT STATE OF FLORIDA ORANGE) ss COUNTY OF JOHN W. GIBBS , being first duly swore deposes and says that: 1. He(it)is the PRESIDENT (Owner, Partner,Office,Representative or Agent) of GIBBS & REGISTER, INC. , the Bidder that has submitted the attached Bid; 2. He is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid; 3. Such Bid is genuine and is not a collusive or sham Bid; 4. Neither the said Bidder nor any of its officers,partners, owners, agents,represeitatives, employees, or parties in interest, including this affidavit, have in any way, colluded conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted; or to refrains from bidding in connection with such Contract; or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or confeence with any Bidder, firm, or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix any overhead, profit, or cost elements of the Bid price or the Bid price in any other Bidder, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the proposed Contract; 5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion,conspiracy, connivance, or unlawful agreement on the part of the Bidder or any other of its agents r entatives, owners, employees or parties in interest, including his affidavit. /� By: - 1A-4 Title: J N W. GIBBS, PRESIDENT Sworn and subscribed to before me this 12TH day of MAY 2004,44 , in the State of FLORIDA , County of ORANGE ►�"' Emelinda MoJjica. Notary Public Yp Commission#DD303244 ��MMLL � �IOJCQ 24 08 �iyCor�nrrttsston press / a: .� Ex fires:Mar 24,2008 p Bonded Thr ",Pi"" Atlantic Bonding Co.,Inc. END OF SECTION 00480-1 SECTION 00481 CERTIFICATION OF NONSEGREGATED FACILITIES The Bidder certifies that he does not maintain or provide for his employees any segregated facilities at any ofhis establishments, and that he does not permit his employees to perform their services at any location, under this control, where segregated facilities are maintained. The Bidder certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location under his control where segregated facilities are maintained. The Bidder agrees that a breach of this certification will be a violation of the Equal Opportunity clause in any contract resulting from acceptance of this Bid. As used in this certification, the term "segregated facilities"means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage and dressing areas,parking lots, drinking fountains,recreation or entertainment area, transportation, and housing facilities provided for employees on the basis of race, color, religion, or national oigin, because of habit, local custom, or otherwise. The Bidder agrees that(except where he has obtained identical certification from proposed subcoiractors for specific time periods)he will obtain identical certifications from proposed subcontractors pior to the award of subcontracts exceeding$10,000 which are not exempt from the provisions of the Equal Opportunity clause, and that he will retain such certifications in his files. The nondiscriminatory guidelines as promulgated in Section 202, Executive Order 11246, and as amended by Executive Order 11375 and as amended, relative to Equal Opportunity for all persons and implemenations of rules and regulations prescribed by the United States Secretary of Labor are incorporated herein. Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. Date MAY 12, 2004 , g9C GIBBS 5 :EGISTER, INC. / / Official Address By: (including Zip Code): J�. N W. GIBBS, PRESIDENT (Ti . 530 S. MAIN STREET WINTER GARDEN, FL 34787 ATTACH AND INCLUDE AS PART OF PROPOSAL FORM; FAILURE TO DO SO MAY BE CAUSE FOR DISQUALIFICATION OF YOUR BID. END OF SECTION 00481-1 SECTION 00482 (Page 1 of 2) SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to City of Ocoee, Florida by JOHN W. GIBBS, PRESIDENT (Print individual's Name&Title) whose business address is 530 S. MAIN STREET WINTER GARDEN, FL 34787 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 with 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, faud, theft, bribery,collusion, racketeering,conspiracy,or material representation. 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 came, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictnent or information after July 1, 1989, as a result of a jury verdict,nonjury trial,or entry of a plea of guilty or nolo coitendere. 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 isactive 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 anaffiliate. 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. 5. I understand that a "person" as defined in Paragraph 287.133(I)(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 forthe 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. (please indicate which statement applies). XX Neither 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 management of the entity, 00482-1 nor any affiliate of the entity have been charged with and ccnvicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of this entity has been charged with and convicted of a public entity crime subsquent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of this entity.has been charged with and convicted of a public entity crime subsquent to July 1, 1989. However, there has been a subsequent proceeding concerning tit conviction before a Hearing Officer of the State of Florida, Division of Administrative Hearings. The fmal 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. (Please attach a copy of the final order.) I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIHbD IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND,THAT THIS FORM IS VALID THROUGH ► ye Cr . 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 CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. (Signature) JOHN W. GIBBS, PRESIDENT Date: MAY 1 2004 GIBBS & REGISTER, INC. Name of Bidder(Contractor) STATE OF FLORIDA COUNTY OF ORANGE JOHN W. GIBBS, PRESIDENT PERSONALLY APPEARED BEFORE ME,the undersigned authority, who, after first being sworn by me, affixed his/her signature in the place provided above on this 12TH day of MAY, 2004 Emelinda MoJ'ica Commission#DD303244 Notary Public EMEL I NDA MOJ I CA _ 4Expires:Mar 24,2008 poi Bond`d Then 3/24/04 ",,,iws Atlantic Bonding Co.,Inc. My Commission Expires: END OF SECTION 00482-2 SECTION 00483 CERTIFICATION OF NONDISCRIMINATORY LABOR PRACTICES This certification relates to a construction contract proposed by the City of Ocoee. Equal Opportunity Employment: The Contractor shall not discriminate on the basis of race, color, national origin, gender, age, handicapped status, veteran status, and/or religion in performing the work governed by this contract. The City is an Equal Opportunity Employer (EOE) and as such encourages all contractors to comply with EOE regulations. Any subcontract the Contractor may enter into shall include this clause with the same degree of application being encouraged. I am the undersigned prospective construction contractor or subcontractor. I certify that ... (1) I XX have/ have not participated in a previous contract or subcontract subject to the Equal Opportunity CIause and (2) If I have participated in a previous contract or subcontract subject to the EqualOpportunity Clause,I have/ XX have not filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirement. I understand that, if I have participated in a previous contract or subcontract subject to the Equal Opportunity Clause and have failed to file all reports due under the applicable filing requirements, I am not eligible, and will not be eligible, to have my bid or offer considered, or to enter into the proposed contract or subcontract, unless and until I make an arrangement regarding such reports that is satisfactory to the office where the reports are required to be flied. I agree that I will obtain identical certifications from prospective lower-tier construction subcontractors when I receive bids or offers or initiate negotiations for any lowestier construction subcontra w' a price exceeding $10,000. I also agree that I will retain such certifications in my Date MAY 12, 2004 , 119K By: (Signature of Authorized Official) JOHN . GIBBS, _RESTDENT GIBBS & REGISTER, INC. (Name of Prospective Construction Contractor or Subcontractor) 530 S. MAIN STREET (Address of Prospective Construction Contractor or Subcontactor) WINTER GARDEN, FL 34787 407-654-6133 59-3026022 (Telephone Number) (Employer Identification Number) END OF SECTION 00483-1 GIBBS & REGISTER, INC. ��R 530 South Main Street 1 l Winter Garden,Florida 34787 Telephone:(407)654-6133 Facsimile:(407)654-6134 Gibbs & Register, Inc. Professional Client References 1. Seminole County 2. City of Winter Haven Contact: Frank Van Pelt Contact: Mike McMahon 520 W. Lake Mary Blvd., Suite 200 C.O.L. Convention Center Sanford, FL 32773 210 Cypress Garden Blvd. (407) 665-5703 Winter Garden, FL 33880 (863) 291-5664 3. City of Altamonte Springs 4. Brevard County Contact: Nicholas McRay Contact: George Clark 225 Newburyport Ave. Facilities Engineering & Construction Altamonte Springs, FL 32701 2725 Judge Fran Jamieson Way (407) 571-8345 Building A Viera, FL 32940 (321) 633-2050 5. City of Apopka 6. City of Inverness Contact: Bob Elmquist Contact: Ken Koch 748 E. Cleveland Street 212 West Main Street Apopka, FL 32704 Inverness, FL 34450 (407) 703-1731 (352) 726-2611 6. City of Longwood Contact: John Drago 174 W. Church Avenue Longwood, FL 32750 (407) 260-3480 N:1Company Files',Forms.Proiect Admin Folder\CLIENT REFERENCES doc GIBBS & REGISTER, INC. PROJECT REFERENCES 2004 1.) Project Name: CDBG Road Projects Owner: City of Titusville Engineer/Architect: Honeycutt &Associates, Inc. Contract Value: $296,000.00 Completion Date: Work in progress Contact Name: Marie C. Engblom Telephone Number: (321) 383-5779 Project Description: Neighborhood road improvements, storm drainage, water mains, curb &sidewalk 2.) Project Name: First Baptist Church of Windermere Owner: First Baptist Church of Windermere Engineer/Architect: PBS &J Engineers Contract Value: $2,500,000.00 Completion Date: Work in Progress Contact Name: Steve Marcereau Telephone No.: (407) 876-2234 Project Description: Site and infrastructure including but not limited to waterlines, streets, retention ponds, utilities 3.) Project Name: Seminole County Miscellaneous Sidewalks Owner: Seminole County Engineer/Architect: None Contract Value: $1,500,000.00 Completion Date: Work in Progress Contact Name: Jose Perez Telephone No.: (407) 665-8000 Project Description: Sidewalk repairs throughout county 4.) Project Name: Lake County Judicial Center Owner: Lake County Engineer/Architect: Risdoli Sosa Architect Contract Value: $1,175,000.00 Completion Date: Work in progress Contact Name: Leeland Shelton Telephone No.: (352) 253-4948 Project Description: Reconstruct various easements of existing parking lot & retention pond 5.) Project Name: Central Avenue &Central Park Improvement Owner: City of Winter Haven Engineer/Architect: Envisors Contract Value: $2,500,000.00 Completion Date: Job currently in progress Contact Name: Mike McMahon Telephone No.: (863) 291-5600 Project Description: Streetscape, water main & roadway construction 6.) Project Name: Blounts Ridge Road Dirt Road Paving Project Owner: Brevard County Engineer/Architect: Russen Mauer Engineering Group, Inc. Contract Value: $633,000.00 • Completion Date: Job currently in progress _. Contact Name: ,Harriet Raymond _ . Telephone No.: (321) 617-7202 • Project Description: Construct roadway, storm &swales 7.) Project Name: Quail Hollow Pump Station Improvements Owner: Orange County Engineer/Architect: Rockett &Associates Contract Value:. $216,000.00 Completion Date: Job currently in progress Contact Name: Don Hatto Telephone No.: (407) 894-3804 Project Description: Replace existing Sanitary sewer pump station with a new pump station for Orange County Utilities 8.) Project Name: Installation of Storm Sewer/Erosion Control (Brevard County) FDOT Owner: Florida Department of Transportation Engineer/Architect: Department of Transportation Contract Value: $215,698.00 Completion Date: Job currently-in progress Contact Name: • Jim Connelly Telephone No.: (321) 634-6592 • Project Description: • Installation of 60"storm drainage from 2"d street and US 1 9.) Project Name: Construct Concrete Ditch Pavement(Marion County) FDOT Owner: Florida Department of Transportation Engineer/Architect: Department of Transportation Contract Value: $200,000.00 Completion Date: Job currently in progress • Contact Name: Charlie Wells Telephone No.: (352) 620-7489 Project Description: Ditch paving on row • 10.) Project Name: Bank of America—Waterford • Owner: Centex Construction Company Engineer/Architect: Kelly, Collins &Gentry Contract Value: $251,248.00 - Completion Date: September 2003 • Contact Name:. John McNary Telephone No.: (407) 226-9819 Project Description: Site improvement, excavation, grading, utilities &roadway 11.) Project Name: Edgewood Drive Roadway Improvements Owner: City of Lakeland Engineer/Architect: . TBE Group • Contract Value: $2,142,056.00 Completion Date: - .. March 2003 • Contact Name: Greg James Telephone No.: (863) 834-6040 Project Description: Roadway improvement, excavation, grading, roadway & storm 12.) Project Name: Pine Forest Park • Owner: Lake County Engineer/Architect: Lake County Contract Value: $188,000.00 Completion Date: October 2003 Contact Name: - John Bringard Telephone No.: (352) 357-2738 • Project Description: Excavation, grading, roadway landscaping/irrigation 13.) Project Name: Florida Avenue Roadway Improvements Owner: City of Rockledge Engineer/Architect: Jones Edmunds &Associates Contract Value: $316,500.00 Completion Date: Job currently in progress Contact Name: Steve Szabo Telephone No.: (321) 269-2950 • Project Description: Road widening and utility adjustments of Florida Avenue for the City of Rockledge 14.) Project Name: CR-452(Lakeshore Dr.)Widening &Resurfacing Phase II Owner: Lake County - Engineer/Architect: VHB—Vanbec Haagen Brustlin, Inc. Contract Value: • $950,990.00 Completion Date: Job-currently in progress - Contact Name: Leeland Svielton - Telephone No.: (352) 253-4948 Project Description: Reconstruct roadway, add storm & reconstruct swales &driveways 15.) Project Name: Pennsylvania/Lake Sue/Winter Park Road Corridor Improvement Owner: City of Winter Park • Engineer/Architect: Jack Jennings &Sons Contract Value: $540,480.00 Completion Date: Job currently in progress Contact Name: Troy Adaway . Telephone No.: (407) 623-3292 Project Description: Pennsylvania, Lake Sue &Winter Park Road corridor improvements • 17.) Project Name: Brevard County Schools Owner: Brevard County/ 3D International Engineer/Architect: 3D International V Contract Value:. $1,600,000.00 Completion Date: Job currently In Progress Contact Name: David Cassady Telephone No.: (321) 751-6898 Project Description: Site work and grading associated with 10 schools 18.) Project Name: Merritt Island Airport—West Apron Rehabilitation Owner: Titusville-Cocoa Airport Authority Engineer/Architect: Airport Engineering Company Contract Value: $380,790.00 Completion Date: October 2003 Contact Name: Brian Pendelton Telephone No.: (321) 633-3034 Project Description: Asphalt apron rehabilitation 19.) Project Name: Lift Station No.2 Replacement Owner: City of Cocoa Engineer/Architect: DCR Engineering Services, Inc. . Contract Value: $419,000.00 Completion Date: September 2003 • Contact Name: Peggy Turner _ Telephone:No.: (321) 639-7678 Project Description: Lift station replacement • 20.) Project Name: South Water Reclamation Facility Owner: CDM/Sverdrup Engineer/Architect: CDM/Sverdrup . _. . .- Contract Value: $5,107,099.00 Completion Date: Job currently in progress . . Contact Name: Roy Schultz Telephone No.: (407) 903-0237 Project Description: Existing treatment plant upgrade, structure upgrade • 21.) Project Name: Downtown Redevelopment Project Owner: City of Inverness Engineer/Architect: BCI Engineers &Scientists, Inc. Contract Value: $939,976.60 Completion Date: August 2003 Contact Name: Ken Kock Telephone No.: (352)726-2611 • Project Description: Community development block grant downtown redevelopment 22.) Project Name: Sawyer Avenue Paving &Drainage Improvements Owner: Brevard County Engineer/Architect: Stottler Stagg &Associates Contract Value: $477,000.00 Completion Date: Job currently in progress Contact Name: •George Clark • Telephone No.: (321) 633-1703 Project Description: Neighborhood..roadway improvements 23.) Project Name: Cranes Roost Boulevard Widening Owner: City of Altamonte Springs Contract Value: $1,128,452.00 Completion Date: November 2003 . Contact Name: Nick McRay Telephone.-No.: (407) 571-8345 _ • Project Description: Construction of new road, utility modifications and existing road expansion 24.) Project Name: Seminole Wekiva Trail Owner: Seminole County Contract Value: $2,364,050.00- • Completion Date: August_2002 Contact Name: Frank Van Pelt Telephone No.: (407) 665-5703 Project Description: 8 mile asphalt bike trail with paving, grading, drainage, exfiltration system, fishing piers, pedestrian traffic control, signalization . 25.) Project Name: US 90 Weigh Station Owner: The Haskell Company -- Contract Contract Value: $1,283,700.00 Completion Date: October 2002 Contact Name: Melinda Leahy Telephone No.: (904) 791-4500 Project Description: FDOT truck weigh station, earthwork, drainage, concrete, paving structural concrete, lift station, site utilities • 26.) Project Name: Osceola Road Landfill Roadway Owner: Seminole County Engineer/Architect: Metric Engineering, Inc. Contract Value: $491,000.00 Completion Date: August 2003 Contact Name: Al Tehrani Telephone No.: (407) 644-1898 Project Description: New road construction at the Osceola Road Landfill 27.) Project Name: LBV Daycare. •Owner: Knuth Construction Contract Value: $63,450.00- - • Completion Date: September 2002 - Contact Name: Dan Knuth . , • Telephone No.: (407) 877-9991 . . Project Description: Site work excluding sewer system, potable water:- system, sodding, Seeding, mulching, landscaping and fencing 28.) Project Name: SR 15/600 (US 17/92) at South Park Drive Owner: Florida Department of Transportation . Contract Value: $262,821.00 . :. • Completion Date: October 2002 . Contact Name: Kara Adams Telephone No.: (407) 482-7825 Project Description: Projectconsists of road expansion and signalization upgrades 29.) Project Name: Construction Package 5-14: LV8 Hardscape&Electrical Owner: PCL Contract Value: . $66,500.00 Completion Date: September 2002 Contact Name: • Kit Wilburn Telephone No.: (407) 566-2326 Project Description: Construction of new sidewalks 30.) Project Description: Water and Sewer Service to the: Public Works Office Complex Owner: City of Ocoee Contract Value: $61,145.00 Completion Date: June 2002 • Contact Name: David Wheeler Telephone No.: (407) 905-3100 Project Description: Installation of new water and sewer service 31.) Project Name: Ocoee Sidewalks Owner: City of Ocoee Contract Value: $46,553.00 Completion Date: January 2002 -• Contact Name: • Buddy Elmore Telephone No.: (407) 905-3100 Project Description:. 3 year continuing contract installing sidewalks in various - locations - - .. -- 32.) Project Name: New High School #1— Dr. Phillips/West Orange Rol ief Owner: Centex Rooney Construction Company • Contract Value: $70,960.00 Completion Date: January 2002 Contact Name: Rick Romoser • Telephone No.: - • (407) 226-9819 Project Description: Retention pond modifications . 33.) Project Name: Altamonte Sidewalks Owner: City of Altamonte Springs Contract Value: . $16,000.00 Completion Date: December 2001 Contact Name: Roger Willis Telephone No.: (407) 571-8341 Project Description: 4 year continuing sidewalk installation contract 34.) Project Name: Altamonte Sidewalks Owner: City of Altamonte Springs Contractor Value: $80,164.00 Completion Date: October 2000 Contact Name: Nick McRay Telephone No.: (407) 571-8740 Project Description: Continuing sidewalk installation contract rr ,�-�l�qU"'�_.-L�f V - �J �•(�•f)'��^`lr-L!1' �1 �l V' 1J- •' 'ti r y�//� cra1Sr l:d��lti 1114 77l lsnn%eiib Ndila, a Ct\'v,,[ "-dill Si!L vIalkW�/iM '� �Nr N O� --d MI{,-� !� ■sl'cl�tiT,017%r!'Lrf1�a�1tiJ,�1s.:.�1M� �1RA+�►:car©^C J 1(/' JIt- d te ° MI6 Or 1 r 11` 's% St . t i s ,;. „I a 1. 41► . xE 3 • cKO oo w °uy. Nrr A- Bkvartrcurtt ref tatz. JsJ . • L I .�t i •}i Il. I•certify from the records of this office that GBS & REGISTER, INC. is a P • t . corporation organized under the laws of the State of Florida,filed on September F- 17, 1990 , effective September13, 1990. . The document number of this corporation is S02325. • I further certify that said corporation has paid all fees due this office through ,s •December 31, 2002, that its most recent annual report/uniform business'report. G t • was filed on March 12, 2002, and its status is active. t. I further certify that said corporation has not filed Articles of Dissolution. • • • • • Given under my hand and the 04 Great Seal of the State of Florida:•,,= - •W..c., o„t,. at Tallahassee, the Capitol, this the ;.,:',- -- --74 Eighteenth day of March, 2002 1:41r-- ,,it-,4 . . • X.71.6reine(}Tirr---zi rT2TEI'C CR2E022 (t-89) �$rrrztttrg $± .����� J/ 41 �)�1iM fy`/J.f�^.�wo•Tc:3•G�'Il _,Ar-Ak ie.f.Altv7^V topt-d 1L�V5,iCVfal.'r17a11✓SC <____ H1'1t�1� Ii" • � J<i t�/- Yi-�.f�© `-o va -��� V© ")- `/ l-f��'•� ii- •_ l ©. ����nt ��tilRsr• -�i1�..r .�rns:�:�:��s::n��n�.:,!.�:�rn L„f\ \�J +r�l�-!��: !a� Utl�lvr(�lti:!i r./slz �1naL!\- - t� n�� `:'07602$ • STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDTJSTRY LICENSING' BOARD SEQ#. o 2 o s o o c DA7E= (: F .-, - r SC'F.N,^,7 ,- 1_9417/20n9. ,2O0076171 f''f;r7n6294 The GENERAL CONTRACTOR . Named below IS CERTIFIED Under the provisions of Chapter 4B S FS . Expiration date: AUG 31, 2004 • • REGISTER, GARY EVANS• - ALLRTST INC •• 438 DIAD WINTER GARDEN FL • • • JBH BUSE •GOVERNOR •DISPLAY AS REQUIRED BY LAW S KIM ECRETy_SEYE2 SECRETARY • • • • • • • • t . • • • • • • • • • • • • • • • • • • • • • • • • y*2003 *** OEXPIRES04 ORANGE COUNTY OCCUPATIONAL LICENSE 1801-078550 Earl K.Wood,TAX COLLECTOR ORANGE COUNTY,FLORIDA UCENSE IS IN ADDmON TO AND NOT IN LIEU OF ANY OTHER LICENSE REQUIRED BY LAW OR MUNICIPAL ORDINANCE.IT IS SUBJECT TO REGULATION OF ZONING,HEALTH AND ANY OTHER LAWFUL AUTHORITY.IT IS VALID FROM OCTOBER 1 THROUGH SEPTEMBER SO OF LICENSEYEAR.DELINQUENT PENALTY IS ADDED OCTOBER 1. lot CONTR-GENERAL BUILDER 40 s . 1I WORKERS )00 BUSINZSS OFFICE • C©� 10 WORKERS • �• P • • TOTAL TAX 70.00 / -,r �:5 Z±i G tiTER I NC TOTAL PAID 70.00- . I z, G ER +•A E • TRANS FEE 7.00 • TOTAL DUE 7. 00 *F; INTE" G' "Q FL 34787-L3535 • 0021-0 Vii. btINTER GARDEN . PLORt01?" • REG ISTER ,GARY E • • THIS FORM BECOMES A RECEIPT WHEN VALIDATED BY THE TAX COLLECTOR. **2003***. EXP I RES ORANGE COUJNTY:OCCUPATIONAL LICENSE 3004--078551 3RIGINAL 09/30/2004 • Earl lC.. tcod,TAX:COLLECTOR • •ORANGE couNDri,fko a . THIS LICENSE IS IN ADDITION TO AND NOT IN LIEU OF ANY OTHER LICENSE REQUIRED.BY LAW OR MUNICIPAL ORDINANCE.If IS SUBJECTTO REGULATION OF ZONING,HEALTH AND ANY OTHER LAWFUL AUTHORITY.IT IS VALID FROM OCTOBER 1 THROUGH SEPTEMBER SO,OF LICENSE YEAR.DELINQUENT PENALTY IS ADDED OCTOBER 1. 104 PROF-ENGINEER 30 100 BUS I NESS OFF I CE• -i=''t ao, . I O -WORKERS TOTAL TAX 60.CO •& REG TER CONSULTING IN TOTAL PAID, . BO 00-. • e - - . .J4 . TOTAL. DUE. :3.0..00 • ••301,S• .AIN • . y I ITE 3 �FL 34767 . • oo 30 S PLAIN ST t • t=41• • 01� RDEN . . � WINTER GA i. °RID GIBES JOHN W • • • THIS FORM BECOMES A RECEIPT WHEN VALIDATED BYTHETAX COLLECTOR. DATE SUBMITTED: 12 May 2009 NAME OF BIDDER: Gomez Construction Company SECTION 00300 BID FORM SUBMrI1t:D: 12 May 2004 (Date) PROJECT IDENTIFICATION: CITY OF OCOEE,FLORIDA MCKEY STREET IMPROVEMENTS NAME OF BIDDER: Gomez Construction Company BUSINESS ADDRESS: 750 Jackson Avenue PHONE NO.: (407) 628-4353 CONTRACTOR'S FLORIDA LICENSE NO.: CGC005258 THIS BID IS SUBMITTED TO: City of Ocoee, Florida(hereinafter called Owner) 1. The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Ownerin the form included in the Contract Documents, to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid Form and the Agreement, and in accordance with dr other terms and conditions of the Contract Documents. 2. Bidder accepts all of the terms and conditions of the Bidding Documents including without limitation those dealing with the disposition of Bid Bond. This Bid will remain open for ninety (90) caledar days after the day of Bid opening. BIDDER will sign and deliver the Agreement with the Bonds and other documents required by the Bidding Requirements within ten(10)days after the date of OWNER'S Notice of(Intent to)Award. 3. In submitting this Bid,Bidder makes all representations required by the Instructions to Bidders and the Agreement and further warrants and represents that: a. Bidder has examined copies of all the Bidding Documents and of the following Addenda: No. I Dated Ch/c)I- No. Dated No. 2- Dated //D/04--No. Dated No. Dated No._ Dated No. Dated No. Dates! (Receipt of all which is hereby acknowledged)and ako copies of the Invitation for Bids and the Instructions to Bidders. b. Bidder has familiarized itself with the nature and extent of the Contract Documents,Work,site, locality, and all local conditions, ordinances, laws and regulations that in any matner may affect the cost, progress, performance or furnishing the Work. c. BIDDER has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to exiling surface of subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in paragraph 4.2.1 of the General Conditions. BIDDER accepts the determination set forth in paragraph SC-4.2 of the Supplementary Conditions of the extent of the "technical data"contained in 00300-1 DATE SUBMITTED: 12 May 2009 NAME OF BIDDER: Gomez Construction Company 4. All bid items shall include all materials, equipment, labor, permit fees, taxes, tests, miscellaneous costs of all types, overhead, and profit for the item to be complete, in place, and ready for operation in the manner contemplated by the Contract Documents. Bidder submits the following TOTAL BID OR TOTAL BASE BU) to perform all the Work as required by the Drawings and Specific/ions. 5. In accordance with Article 17 of the Instructions to Bidders, if the Contract is to be awarded, it will be awarded by considering the lowest "Total Base Bid" after adjustments for additive or deductive alternates. Additive or deductive alternates (if any) will be considered in determining the lowest responsive, responsible Bidder. The Owner reserves the right to accept any or all additive or deductive alternates, in his sole discretion, prior to the award of the Contract. The Owner also reserves the right to delete any portion of the Work as shown in the bid schedule prior to award and adjust each bidder's"Total Bid"accordingly. 6. The following documents are made a condition of this Bid: a. Bidding Documents and shall include the following: 1. Bid Forms(entire Section 00300,00301,00301A and 00301B) 2. Bid Bond(Surety Bond or Cashier's Check). (Section 00410) 3. Corporate Authority to execute Bid 4. Power of Attorney (for Surety Bond only) 5. Noncollusion Affidavit(Section 00480) 6. Certification of Nonsegregated Facilities (Section 00481) 7. Sworn Statement on Public Entity Crimes(Section 00482) 8. Certification of Nondiscriminatory Labor Practices(Section 00483) 9. References (On company letterhead) (Remainder of Page Left Blank Intentionally.) 00300-3 DATE SUBMITTED: 12 May 2004 NAME OF BIDDER: Gomez Construction Company SCHEDULE OF BID ITEMS CITY OF OCOEE MCKEY STREET IMPROVEMENTS NOTE: BIDS shall include sales tax and all other applicable taxes and fees, NO. Item Units Unit Price Amount Total Price 1. City of Ocoee Permit Fee's _1_ $10,000.00 $10,000.00 (Allowance) 2. Orange County Permit Fee's 1_ $1,000.00 $1,000.00 (Water and sewer) (Allowance) //��� DB 3, Mobilization, Demobilization, 1_ $ $ T Bonds and Permits —T (Maximum of 5% of Total Bid) 4. General Requirements- $ $ tY a6 0 Division I(except as follows under this item) � 5. Field Engineering and $ $•7`b.c° Exploratory Excavation 6. Record Drawing Preparation $ $ 2>,2b 0 7. Color Audio-Video $ $ 570 • Preconstruction Record:. 8. Clearing and demolition a. Clear and Grub $ $ 0 74A b. Tree protection $ $ ♦N f- 9. Underground Utilities-M_�E _ a. Potable Water 8". iC $ $ ,556 10. Stormwater System .1)• a. 1 8" RCP $ $ 3 0, 23/ b. 12" RCP $ $ C. 15"RCP $ $ t , D 00300-5 SIGNATURE 12 May 2004 DATE • (Page Left Blank Intentionally.) 7 OE-CCS-A/ DATE SUBMITTED: 12 May 2004 NAME OF BIDDER: Gomez Construction Company Instructions: Strike out(X)nonapplicable signature block and complete applicable block. (ALL SIGNATORIES MUST HAVE THEIR NAMES PRINTED OR TYPED BELOW THEIR SIGNATURES) If Bidder is: SOLE PROPRIETORSHIP -- -- — —(SEAL) (Individual's Signature) (Individual's Name) i doing business as Business Address:__— Phone No.:_—__. Florida License No.: •A PARTNERSHIP —— —_-_-(SEAL) (Partnership Name) (General Partner's Signature) (General Partner's Name) Business address: Phone No.: Florida License No.: 00300-9 DATE SUBMI FIED: 12 May 2004 NAME OF BIDDER: Gomez Construction Company Instructions: Strike out(X)nonapplicable signature block and complete applicable block. (ALL SIGNATORIES MUST HAVE THEIR NAMES PRINTED OR TYPED BELOW THEIR SIGNATURES) If Bidder is: A JOINT VENTURE By .. 9 (Name) (Address) By. (Name) (Address) Business Address: Phone No.: Florida License No.: I (Each joint venturer must sign. The manner of signing for each individual,partnership,and corporation that is a party to the joint venture should be in the manner indicated above.) Florida License No.: 12. List the following in connection with the Surety which is providing the Bid Bond: Surety's Name: Travelers Casualty c/o Nielson & Company, Inc. Surety's Address: 5979 NW 151st Street, Suite 105 Miami Lakes, FL 33014 Name and address of Surety's resident agent for service of prmess in Florida: Nielson & Company, Inc. 5979 NW 151st Street, Suite 105, Miami Lakes, FL 33014 END OF SECTION 00300-11 SECTION 00301 QUESTIONNAIRE DATE: 12 May 2004 PROJECT IDENTIFICATION: CITY OF OCOEE,FLORIDA McKey Street Improvements NAME OF BIDDER: Gomez Construction Company BUSINESS ADDRESS: 750 Jackson Avenue Winter Park, FL 32789 Phone No. (407)628-4353 CONTRACTOR'S FLORIDA LICENSE NO. CG0005258 The undersigned warrants the truth and accuracy of all statements and answers herein contained. Include additional sheets if necessary. 1. Complete the following Table reganiing experience with projects similar to the work contemplated under this Construction Agreement. . pate ofClient's-Name:&:Address.=(Include. Amount:of. :T':Colntt act . Name of Project:&Location.. Contact Nam&and Phone-#) Contract See Attached. 00301-1 • 750 Jackson Avenue • Winter Park,Florida 32789 407-628-4353 Fax-645-2499 • Gomez Construction Company REFERENCES City of Clermont City of Kissimmee 1 Westgate Plaza 320 E.Monument Avenue Clermont, FL 34711 Kissimmee, FL 34741 Wayne Saunders Gail Hamilton 352-394-4081 407-518-2544 City of Orlando City of Winter Park 400 South Orange Avenue 401 Park Avenue South Orlando, FL 32802 Winter Park, FL 32789 Rick Howard James English 407-246-3222 407-599-3424 City of Winter Garden Greater Orlando Aviation Authority 251 W. Plant Street One Airport Boulevard Winter Garden, FL 34787 Orlando, FL 32827 Marshall Robertson Darrell Wagner 407-656-2875 407-825-2466 Rollins College Orange County Government 1000 Holt Avenue-2717 Public Works Dept—Engr. Division Winter Park, FL 32789 4200 S.John Young Parkway George Herbst Orlando, FL 32839 407-646-2117 Juan Curl 407-836-7713 General Contractors and Construction Managers GOMEZ CONSTRUCTION COMPANY CENTRAL FLORIDA URBAN AND STREETSCAPE PROJECTS Original Actual Original Change Final Year Protect title Owner Contact (former Project Mgr) Phone# Completion Completion Contract Amt. Orders Cont.Amt 1993 Westmoreland Tree. City of Orl Al Campbell 246-3758 Feb-93 Feb-93 $116,934.00 $0.00 $116,934.00 1993 Misc Concrete 1993 City of Orl. Scott Werley 246-3759 Jan-94 Nov-93 $533,260.00 ($6,042.00) $527,218.00 1993 West Church St. City of Orl. Charlie Conklin Davey Mateo 246-3182 Jun-93 Jun-94 $281,291.00 $30,330.00 $311,621.00 1993 Lake Eola Park Exp. City of Orl. Scott Werley 246-3759 Sep-93 Nov-93 $1,318,000.00 $474,410.00 $1,792,410.00 1994 Lake Rowena Facility City of Ori Al Campbell 246-3758 Jan-95 Jan-95 $475,000.00 $51,793.00 $526,793.00 1995 Gaston Edwards Park City of Ori. Scott Werley 246-3759 May-95 May-95 $163,400.00 $0.00 $163,400.00 1995 Bicycle Trail City of Orl Steve Frey 246-3755 Mar-96 Apr-96 $288,443.00 $28,559.00 $317,002.00 1995 Mis.Conc H.C.Ramps City of Orl Steve Frey 246-3755 Oct-96 Oct-96 $225,980.00 $97,574.00 $323,554.00 1995 W,Church St.Street. City of Orl Charlie Conklin Davey Mateo 246-3182 Aug-96 Nov-96 $582,000.00 $94,384.00 $676,384.00 1996 Church St Ped Way City of Orl Charlie Conklin Davey Mateo 246-3182 Aug-96 Nov-96 $381,000.00 $147,073.00 $528,073.00 1996 Church St.Vendor City of Orl Charlie Conklin Davey Mateo 246-3182 Aug-96 Nov-96 $300,100.00 $26,427.00 $326,527.00 1997 Amelia St.Widening City of Orl Charlie Conklin Davey Mateo 246-3182 May-97 Sep-97 $585,078.00 $121,235.00 $706,313.00 1997 Lake Lawsona St. City of Orl Scott Werley 246-3759 Nov-97 Nov-97 $152,006.00 ($1,234.00) $150,772.00 1997 Thornton Ave.Brick St. City of Orl Charlie Conklin James Salter 246-3182 Jun-97 Jun-97 $102,099.00 $6,779.00 $108,878.00 1998 Park Ave Enhancement City of Winter Pk Joe Serrano 599-3424 Aug-98 Oct-98 $814,400.00 $139,922.21 $954,322.21 1998 Westmoreland Brick City of Orl Charlie Conklin 246-3182 Feb-99 Jun-99 $99,556.20 $371,639.94 $471,196.14 1999 Park Ave Phase I) City of Winter Pk Joe Serrano 599-3424 Sep-99 Aug-99 $1,165,327.70 $328,731.91 $1,494,059.61 2000 Park Avenue Phase III City of Winter Pk Joe Serrano 599-3424 Sep-00 Sep-00 $1,058,898.51 $35,929.63 $1,094,828.14 2000 Central Blvd Streetscape City of Orl Charlie Conklin Davey Mateo 246-3182 Dec-00 Dec-00 $557,800.30 $24,905.55 $582,705.85 2000 Sidewalk Safety Inititiative City of Orl Dennis Tipton 246-3232 Dec-01 Jan-02 $2,840,568.00 $871,409.68 $3,711,977.68 2001 Orange County Sidewalks Orange County Juan Curl 836-7713 Sep-01 Feb-02 $947,056.00 ($2,077.08) $944,978.92 2001 Lk Lawsona Rebrlcking City of Orl Charlie Conklin 246-3182 Nov-01 Dec-02 $588,347.46 $128,314.62 $716,662.08 2001 McKean Gateway Rollins College George Herbst 646-2117 Jun-01 Aug-01 $250,857.99 $0.00 $250,857.99 2001 GOAA Brick Paver Replace Greater On Aviation Auth Darrell Wagner 825-2466 Nov-01 Mar-02 $119,200.00 $20,844.68 $140,044.68 2002 Plant Street Streetscape City of Winter Garden Marshall Robertson 656-2875 Oct-02 Nov-02 $1,597,807.58 $402,503.09 $2,000,310.67 2002 Clermont Streetscape City of Clermont Wayne Saunders 352-394-4081 Dec-02 Nov-02 $1,188,000.00 $0.00 $1,188,000.00 2002 Park Ave&Fairbanks Intersection City of Winter Park Joe Serrano 599-3424 Aug-03 Aug-03 $210,200.00 $0.00 $210,200.00 2003 Winter Park Rose Garden City of Winter Park Joe Serrano 599-3424 Feb-03 May-03 $375,000.00 ($37,310.00) $337,690.00 2003 City of Kissimmee City of Kissimee Gail Hamilton 518-2544 Jun-03 Oct-03 $750,800.00 $14,992.94 $765,792.94 2003 Winter Garden Phase III City of Winter Garden Marshall Robertson 656-2875 Mar-03 Jul-03 $1,292,173.78 $129,770.68 $1,421,944.46 2003 Winter Garden Phase II City of Winter Garden Marshall Robertson 656-2875 Jul-03 Oct-03 $1,238,115.14 $104,781.18 $1.342.896.32 TOTALS $16,732,410.74 $3,393,412.23 $20,125,822.97 5. List the names and addresses of the subcontractors to be used for the portions of the contemplated work listed above. Subcontractor Certification Subcontract Name and Address of Subcontractor Registration No. &Name Underground White' s Site Development State of FL Utility & 4000 NyahWhite Cove CUC056792 Excavating Sanford, FL 32771 Zap Electric Service, Inc. State of FL Electrical 1326 35th Street EC0000690 Orlando, FL 32839 I 00301-3 SECTION 00301-A COMPLIANCE WITH FLORIDA TRENCH SAFETY ACT (90-96,LAWS OF FLORIDA) Bidder hereby acknowledges that all costs for complying with the Florida Trench Safety Act are included in the various items of the bid and in the Lump Sum Total Bid Price shown in Section 00300-Bid Form, "Schedule of Bid Items". For informational purposes only,the bidder is required to further identify these costs in the summary below. Trench Safety Unit of Measure Measure Unit Unit Extended (Description) (LF,SY) (Quantity) Cost Cost A $ $ B $ $ C $ $ D $ $ TOTAL $ BIDDER: Gomez Construction Company SIGNED: BY: Orlando Gomez, Jr. (Print or type name) TITLE: Vice President DATE: 12 May 2004 THIS IS NOT A PAY ITEM: The purpose of this form is to gather information on the costs associated with trench safety measures and to insure that the Bidder has considered these costs and included them in the Lump Sum Total Bid price. Contractor will not receive additional payment if actual quantities differ from those estimated or if the Contractor uses a safety measure different than those listed. (Failure to Complete This Form May Result in the Bid Being Declared Non-Responsive.) END OF SECTION 00301A-1 SECTION 00301-B DRUG-FREE WORKPLACE CERTIFICATION IDENTICAL TIE BIDS: Preference shall be given to businesses with drugfree workplace programs. Whenever two or more bids which are equal with respect to price, quantity, and service are received by the State or by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing tie bids will be followed if none of the tied vendors have a drugfree workplace program(Florida Statutes Section 287.037). In order to ha'e 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 actionsthat will be taken against employees for violations 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, and 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 bid 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 bid,the employee will abide by the terms of the statement and will notify the employer of any conviction of, or pleas of guilty or nolo contendere to, any violation of Chapter 893 or of any controlled substance law of the United States or any state, for a 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 a drug abuse assistance or rehabilitation program is such is available in the employee's community, by any employee who is so 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 the statement, I certify that this firm complies fully with the above requirements. Bidder: Gomez C struction Company Signed: L� By: Orlando Gomez, Jr. (Print or Type Name) Title: Vice President Date: 12 May 2004 END OF SECTION 00301-B-1 SECTION 00480 NONCOLLUSION AFFIDAVIT STATE OF Florida ss COUNTY OF Orange Orlando Gomez, Jr. , being first duly swore deposes and says that: 1. He(it)is the Vice President (Owner, Partner,Office, Representative or Agent) of Gomez Construction Company ,the Bidder that has submitted the attached Bid; 2. He is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circunstances respecting such Bid; 3. Such Bid is genuine and is not a collusive or sham Bid; 4. Neither the said Bidder nor any of its officers,partners, owners, agents, represeitatives, employees, or parties in interest, including this affidavit, have in any way,colluded conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted; or to refrains from bidding in connection withsuch Contract; or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or confeence with any Bidder, firm, or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix any overhead, profit, or cost elements of the Bid price or the Bid price in any other Bidder, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the proposed Contract; 5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the Bidder or any other of its agents, repreentatives, owners, employees or parties in interest, including his affidavit. a. By: Orlando Gomez, Jr. Title: Vice President Sworn and subscribed to before me this 12th day of May , 1Xx 2004 in the State of Florida ,County of Orange 4940"y Karen D Rose Air( 4', otary Public My Commission D0043781 -S-0‘till Expires Aug usl 22,21105 My ommission Expires: OP/.)10dr - END OF SECTION 00480-1 SECTION 00481 CERTIFICATION OF NONSEGREGATED FACILITIES The Bidder certifies that he does not maintain or provide for his employees any segregated facilities at any ofhis establishments, and that he does not permit his employees to perform their services at any location, under this control, where segregated facilities are maintained. The Bidder certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location under his control where segregated facilities are maintained. The Bidder agrees that a breach of this certification will be a violation of the Equal Opportunity clause in any contract resulting from acceptance of this Bid. As used in this certification, the term "segregated facilities"means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eatiig areas, timeclocks, locker rooms and other storage and dressing areas,parking lots, drinking fountains,recreation or entertainment area, transportation, and housing facilities provided for employees on the basis of race, color, religion, or national oigin, because of habit, local custom, or otherwise. The Bidder agrees that(except where he has obtained identical certification from proposed subcomractors for specific time periods) he will obtain identical certifications from proposed subcontractors p for to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause, and that he will retain such certifications in his files. The nondiscriminatory guidelines as promulgated in Section 202, Executve Order 11246, and as amended by Executive Order 11375 and as amended, relative to Equal Opportunity for all persons and implememations of rules and regulations prescribed by the United States Secretary of Labor are incorporated herein. Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. Date 12 May 2004 , 19c Gomez Construction Company Official Address By: (including Zip Code): Orlando Gomez, Jr. Vice President (Title) 750 Jackson Avenue Winter Park, FL 32789 ATTACH AND INCLUDE AS PART OF PROPOSAL FORM; FAILURE TO DO SO MAY BE CAUSE FOR DISQUALIFICATION OF YOUR BID. END OF SECTION 00481-1 SECTION 00482 (Page 1 of 2) SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to City of Ocoee, Florida by Or]ando Goni'z. Jr.., Vire PrPGident (Print individual's Name&Title) whose business address is 750 Jackson Avenue Winter Park, FL 32789 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 with 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 or the United States and involving antitrust, faud, theft, bribery, collusion,racketeering,conspiracy,or material representation. 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 indictnent or information after July 1, 1989, as a result of a jury verdict,nonjury trial,or entry of a plea of guilty or nolo coitendere. 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 isactive 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. 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 forthe 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. (please indicate which statement applies). X Neither 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 management of the entity, 00482-1 SECTION 00483 CERTIFICATION OF NONDISCRIMINATORY LABOR PRACTICES This certification relates to a construction contract proposed by the City of Ocoee. Equal Opportunity Employment: The Contractor shall not discriminate on the basis of race, color, national origin, gender, age, handicapped status, veteran status, and/or religion in performing the work governed by this contract. The City is au Equal Opportunity Emplo}er (EOE) and as such encourages all contractors to comply with EOE regulations. Any subcontract the Contractor may enter into shall include this clause with the same degree of application being encouraged. I am the undersigned prospective constructioncontractor or subcontractor. I certify that ... (1) I X have/ have not participated in a previous contract or subcontract subject to the Equal Opportunity Clause and (2) If I have participated in a previous contract or subcontract subject to the EqualOpportunity Clause, I y have/ have not filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements. I understand that, if I have participated in a previous contract or subcontract subject to the Equal Opportunity Clause and have failed to file all reports due under the applicable filing requirements, I am not eligible, and will not be eligible, to have my bid or offer considered, or to enter into the proposed contract or subcontract, unless and until I make an arrangement regarding such reports that is satisfactory to the office where the reports are required to be filed. I agree that I will obtain identical certifications from prospective lower-tier construction subcontractors when I p receive bids or offers or initiate negotiations for any lowentier construction subcontracts with a price exceeding $10,000. I also agree that I will retain such certifications in my files. Date 19 May 2004 , __ By: (Signature of Authorized Official) Orlando Gomez, Jr. Gomez Construction Company (Name of Prospective Construction Contractor or Subcontractor) 750 Jackson Avenue (Address of Prospective Construction Contractor or Subcontractor) Winter Park, FL 32789 (407)628-9353 59-1524446 (Telephone Number) (Employer Identification Number) END OF SECTION 00483-1 SECTION 00410 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned, GOMEZ CONSTRUCTION COMPANY as Principal, and Travelers Casualty and Surety Company of Amerjlc urety, are hereby held and firmly bound unto the City of Ocoee, Florida, as Owner in the penal sum of five percent of the Contract Bid ---Five Percent of Amount Bid---- ($ 5% ) for payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, successors and assigns. Signed, this 12th day of May , F9 2004 The condition of the above obligation is such that whereas the Principal has submitted to the City of Ocoee, Florida a certain Bid, attached hereto and hereby made a part hereof to enter into a contract in writing, for the City of Ocoee McKey Street Improvements. • NOW THEREFORE 1. Bidder and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to pay to Owner upon default of Bidder any difference between the total amount of Bidder's bid and the total amount of the bid of the next lowest, responsible and responsive bidder as determined by Owner for the Work required by the Contract Documents, provided that: 1.1. If there is o such next lowest, responsible and responsive bidder, and Owner does not abandon the Project, then Bidder and Surety shall pay to Owner the penal sum set forth on the face of this Bond, and 1.2. In no event shall Bidder's and Surety's obligation hereunder exceed the penal sum set forth on the face of this Bond. 2. Default of Bidder shall occur upon the failure of Bidder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Amendment to the Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents and Contract Documents. 3. This obligation shall be null and void if: 3.1. Owner accepts Bidder's bid and Bidder delivers within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Amendment • to the Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents and Contract Documents, or 3.2. All bids are rejected by Owner, or 3.3. Owner fails to issue a Notice of Intent to Award to Bidder within ninety (90) days from the time and date fixed for the opening of Bids (or any extension thereof agreed to in writing by Bidder and, if applicable, consented to by Surety when required by paragraph 5 hereof). 4. Payment under this Bond will be due and payable upon default by Bidder and within thirty (30) calendar days after receipt by Bidder and Surety of written notice of default from Owner, which notice will be given with reasonable promptness, identifying this Bond and the Project and including a statement of the amount due. • 00410-1 BIDDER: trike out (X) non- applicable signature block and complete applicable block. All signatures ust have their names printed or typed below their signature. If Bidder is SOLE PROPRIERTORSHIP, complete this signature block T (1) (Individual's Signature) (Witness) (2) (Individual's Name) (Witness) doing business as • (SEAL) (Business Address) (Telephone No.) (Florida License No.) If Bidder is PARTNERSHIP,complete this signature block. (I) :• (Partnership Name) (Witness) (2) (General Partner's Signature) (Witness) (General Partner's Name) (SEAL) (Business Address) (Telephone No.) (Florida License No.)- 00410-3 • SURETY: WITN .S: (If A,e t is not .orporat'. Travelers Casualty and Surety Company of America / g diey (Surety Business Name) I 6.0 (Witness One Tower Square (2) (Witness) Hartford, Connecticut 06183 Principal Place of Business) ATTEST: (If Agent is a Corporation) (Surety Agent's Signature-See Note 2) Charles D. Nielson (Surety Agent's Name) (Corporate Secretary Signature) • Attorney—in—Fact and Florida Resident Agent (Surety Agent's Title) (Corporate Secretary Name) Nielson, Alter & Associates, Inc. (Business Name of Local Agent for Surety) 5979 Northwest 151st Street, 4105 (CORPORATE SEAL) Miami Lakes, Florida 33014 (Business Address of Local Agent) ( 305) 822-7800 589-16-3622 (Telephone No.) (Florida License No.) NOTES: (1) Complete and attach "Corporate Authority to Execute Documents" if executed by any corporate employee other than president or vice-president. (2) Complete and attach a certified copy of "Power-of-Attorney" prepared by Surety appointment individual "Attorney-in-Fact" for execution of Bid Bond on behalf of Surety and corresponding notarized "Attorney- in-Fact". (3) Above addresses are to be used for giving required notice. • (4) Any singular reference to Bidder, Surety, Owner or other party shall be considered plural where applicable. (5) Surety companies executing bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the state where the project is located. 00410-5 Travelers IMPORTANT DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE On November 26, 2002, President Bush signed into law the Terrorism Risk Insurance Act of 2002 (the "Act"). The Act establishes a short-term program under which the Federal Government will share in the payment of covered losses caused by certain acts of international terrorism. We are providing you with this notice to inform you of the key features of the Act, and to let you know what effect, if any, the Act will have on your premium. • Under the Act, insurers are required to provide coverage for certain losses caused by international acts of terrorism as defined in the Act. The Act further provides that the Federal Government will pay a share of such losses. Specifically, the Federal Government will pay 90% of the amount of covered losses caused by certain acts of terrorism which is in excess of Travelers' statutorily established deductible for that year. The Act also caps the amount of terrorism-related losses for which the Federal Government or an insurer can be responsible at $100,000,000,000.00, provided that the insurer has met its deductible. Please note that passage of the Act does not result in any change in coverage under the attached policy or bond (or the policy or bond being quoted). Please also note that no separate additional premium charge has been made for the terrorism coverage required by the Act. The premium charge that is allocable to such coverage is inseparable from and imbedded in your overall premium, and is no more than one percent of your premium. IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrument to be signed by their Senior Vice President, and their corporate seals to be hereto affixed this 1 1th day of October, 2000. STATE OF CONNECTICUT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY }SS. Hartford FARMINGTON CASUALTY COMPANY COUNTY OF HARTFORD K G 9 e.OP.PCINA):'• ,........47C---- "3 FiA---N, W HARTFORD. K u '1 g'g 2�' o By COt CONN. n T I� ►l fb` ' George W. Thompson �o d1 Fey• `' �`' Senior Vice President On this 11th day of October, 2000 before me personally came GEORGE W. THOMPSON to me known, who, being by me duly sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, the corporations described in and which executed the above instrument; that he/she knows the seals of said corporations; that the seals affixed to the said instrument are such corporate seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing Resolutions thereof. • 14,0,117‘ ,* C * areuo •MYEf7C�� , My commission expires June 30, 2001 Notary Public Marie C.Tetreault CERTIFICATE I, the undersigned, Assistant Secretary of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, stock corporations of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and furthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the Certificate of Authority,are now in force. Signed and Sealed at the Home Office of the Company,in the City of Hartford, State of Connecticut. Dated this 12 th day of May ,20 04 , •• w HARTFOR0.I W HARTFORD. `1 a 1982- 6 B y s� +•�, CONN. o :y` s-D Kori M. Johanson t.�~..���` I`6. ��{'! 6. -Lb • ox Assistant Secretary, Bond DATE SUBMITTED: .MAX_ .2_, 200 __. _ NAME OF BIDDER: . PERRI BUILDERS, INC. SECTION 00300 BID FORM SUBMITTED: _MAY 12, 2 0 0 4 (Date) PROJECT IDENTIFICATION: CITY OF OCOEE,FLORIDA MCKEY STREET IMPROVEMENTS NAME OF BIDDER: PERRI BUILDERS,_INC. 524 N. MISSION RD. �— — BUSINESS ADDRESS: ORLANDO, FL 32B0'8IONE NO.: 407-292-2128 CONTRACTOR'S FLORIDA LICENSE NO.: CGC0113 0 9 THIS BID IS SUBMITTED TO: City of Ocoee, Florida(hereinafter called Owner) 1. The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Ownerin the form included in the Contract Documents, to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid Form and the Agreement,and in accordance with the other terms and conditions of the Contract Documents. 2. Bidder accepts all of the terms and conditions of the Bidding Documents including without limitation those dealing with the disposition of Bid Bond. This Bid will remain open for ninety (90) calatdar days after the day of Bid opening. BIDDER will sign and deliver the Agreement with the Bonds and other documents required by the Bidding Requirements within ten(10)days after the date of OWNER'S Notice of(Intent to)Award. 3. In submitting this Bid, Bidder makes all representations required by the Instructions to Bidders and the Agreement and further warrants and represents that: a. Bidder has examined copies of all the Bidding Documents and of the following Addenda: No... 1 _ Dated_5/7/0 4 No. Dated No. 2 DatedS/10/0 4 No. Dated No. __ Dated No. Dated No. Dated" No. Dated (Receipt of all which is hereby acknowledged) and aho copies of the Invitation for Bids and the Instructions to Bidders. b. Bidder has familiarized itself with the nature and extent of the Contract Documents, Work,site, locality,and all local conditions, ordinances, laws and regulations that in any tanner may affect the cost, progress, performance or furnishing the Work. c. BIDDER has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to exiling surface of subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in paragraph 4.2.1 of the General Conditions. BIDDER accepts the determination set forth in paragraph SC-4.2 of the Supplementary Conditions of the extent of the"technical data" contained in 00300-1 DATE SUBMITTED: MAY 12, 2 0 0 4 NAME OF BIDDER: PERRIBUILDERS, INC. such reports and drawings upon which BIDDER is entitled to rely as provided in paragraph 4.2 of the General Conditions. BIDDER acknowledges that such reports and drawings are not Contract Documents and may not be complete for BIDDER's purposes. BIDDER acknowledges that OWNER and Engineer do not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Bidding Documents with respect to Underground Facilities at or contiguous to the site. d. BIDDER has obtained and carefully studied(or assumes responsibility for having done so)all such additional or supplementary examinations, investiga.ions, explorations,tests, studies and data concerning conditions (surface, subsurface and Underground Facilities) at or contiguous to the site or otherwise which may affect cost progress, performance or furnishing of the Work or which relate to any aspect of the means, methds, techniques, sequences and procedures of construction to be employed by BIDDER and safety precautions and programs incident thereto. BIDDER does not consider that any additional examinations, investigations, explorations, tests, studies or data are necessary for the determination of this Bid for performance and furnishing of the Work in accordance with the times, price and other terms and conditions of the Contract Documents. e. BIDDER is aware of the general nature of Work to be performed by OWNER ani others at the site that relates to Work for which this Bid is submitted as indicated in the Contract Documents. f. BIDDER has correlated the information known to BIDDER, information and observations obtained from visits to the site, reports and drawinf5 identified in the Contract Documents and all additional examinations, investigations,explorations, tests, studies and date with the Contract Documents. g. BIDDER has given ENGINEER written notice of all conflicts, errors, ambiguities or discrepancies that BIDDER has discovered in the Contract Documents and the written resolution thereof by ENGINEER is acceptable to BIDDER, and the Contract Documents arc generally sufficient to indicate and convey understanding of all terms and conditions for performing and furnishing the Work for which this Bid is submitted. h. This Bid is genuine and not made in the interest of or on behalf of any undisclosed person, firm or corporation and is not submitted in conformity with any agreement or rules of any group, assoiation, organization or corporation; BIDDER has not directly or indirectly induced or solicited any other Bidder to submit a farce or sham Bid; BIDDER has not solicited or induced any person, firm or corporation to refrain from bidding; and BIDDER has not sought by collusion to obtain for itself any advantage over any other Bidder or over OWNER. i. BIDDER hereby agrees to commence WORK under this contract on or before a date to be specified in the NOTICE TO PROCEED and to fully complete all work of the PROJECT within the Contract Time. Completion Schedule 1) The Project shall be substantially complete (successful pressure testing and bacteriological testing of completed water mains) in One Hundred Twenty (120) consecutive calendar days from the official Notice to Proceed. 2) The Project shall be finally complete(Completed and Ready for Final Payment)in one hundred twenty (180)clays from the official Notice to Proceed. 3) The Contractor may earn a bonus of$20,000 for achieving final conpletion of the Project on or before November 30, 2004 as provided in the Agreement (Section 00500). The City may assess liquidated damages of$1,000/day for late completion as provided in the Agreement (Section 00500). 00300-2 DATE SUBMITTED: MAY 12, 2004 _ NAME OF BIDDER: PERRI BUILDERS_ INC. 4. All bid items shall include all materials, equipment, labor, permit fees, taxes, tests, miscellaneous costs of all types, overhead, and profit for the item to be complete, in place, and ready for operation in the manner contemplated by the Contract Documents. Bidder submits the following TOTAL BID OR 'TOTAL BASE BID to perform all the Work as required by the Drawings and Specificaions. 5. In accordance with Article 17 of the Instructions to Bidders, if the Contract is to be awarded, it will be awarded by considering the lowest "Total Base Bid" after adjustments for additive or deductive alternates. Additive or deductive alternates (if any) will be considered in determining the lowest responsive, responsible Bidder. The Owner reserves the right to accept any or all additive or deductive alternates, in his sole discretion, prior to the award of the Contract. The Owner also reserves the right to delete any portion of the Work as shown in the bid schedule prior to award and adjust each bidder's "Total Bid" accordingly. 6. The following documents are made a condition of this Bid: a. Bidding Documents and shall include the following: 1. Bid Forms(entire Section 00300,00301, 00301A and 00301B) 2. Bid Bond(Surety Bond or Cashier's Check). (Section 00410) 3. Corporate Authority to execute Bid 4. Power of Attorney (for Surety Bond only) 5. Noncollusion Affidavit(Section 00480) 6. Certification of Nonsegregated Facilities(Section 00481) 7. Sworn Statement on Public Entity Crimes(Section 00482) 8. Certification of Nondiscriminatory Labor Practices(Section 00483) 9. References(On company letterhead) (Remainder of Page Left Blank Intentionally.) 00300-3 DATE SUBMITTED: MAY 12, 2 0 0 4 NAME OF BIDDER: PERRI BUILDERS INC. (Page Left Blank Intentionally.) 00300-4 DATE SUBMITTED: MAY 1 2 , 2 0 0 4 NAME OF BIDDER: PERRI BUILDERS, INC. SCHEDULE OF BID ITEMS CITY OF OCOEE MCKEY STREET IMPROVEMENTS I, II NOTE: BIDS shall include sales tax and all other applicable taxes and fees. NO. Item Units Unit Price Amount Total Price II 1. City of Ocoee Permit Fee's 1_1.5 $10,000.00 $10,000.00 (Allowance) 2. Orange County Permit Fee's 1_(.$ $1,000.00 $1,000.00 (Water and sewer) (Allowance) r- ! 3. Mobilization, Demobilization, � j,$ $(.(34-1/ $T 1),i rr • Bonds and Permits (Maximum of 5% of Total Bid) 4. General Requirements- ILS $ $ 3)",orb Division 1(except as follows under this item) ,r 5. Field Engineering and 14. $ Ar;COO $ fix= Exploratory Excavation 6. Record Drawing Preparation 4-5 $ .1r l.�1"b a $ S aro 7. Color Audio-Video / L.S $ 11 Ov® $ /04,70 Preconstruction Record 8. Clearing and demolition a. Clear and Grub / 4-S $ f�� " S (2,2),a>0 b. Tree protection Q $ -- - $ ---- 1, 9. Underground Utilities-MEP a. Potable Water 8' g ! $ ?/ - $ 92z> 10. Stormwater System "Dz a. 18" RCP v 4F $ -34 $ 1.Zt:' b. 12" RCP 22- $ _ $ (07 Z - c. 15" RCP 197 $ .d'.� ' , $ iL917 00300-5 ii d. Inlet-Type V ? LG $3 Z $ 27- e. Inlet-Type 9 /f4 $ 24'.0.2- $ f/ ..s - ,f f. Manhole(P8) / E4 $ 2?a•0 ' $ vitt) 11. Grading a. Final Grading . /45 $ (=7O" - $ 4=704) b. Fill(64c,41,16447-0434z.) r' C.1 $ 7i7.u00 $ Z.-?,SGV c. Turbidity Barrier 0 $ --- $ — d. Silt Fence /Sex) C $ ( _ $ /l'b7 12. Pavements with curbs a. Asphalt 2 .V $ 12 $/41% ;) b. giant A" ( /'$Plc'sy $ /a $1.37Io c. Type"D"curb /07 4c $ // $ t,/77 d. Decorative Paving(Pedestrian)/i1/44 S $ e3 - $ /7.7,4_,P0 ' e. Decorative Paving(Vehicular)//9O SY $ 78 " $ 92-,biiv 13. Landscape Planting / 45 $ 44v c. $ ilv cc,6 ' (Incl.all soil amendments,sodding and seeding not necessary for grading stabilization, - ,�„ fine grading,guying I staking, and all other materials and labor necessary for a complete 4, Ap7-'f% si-'U 1 4 V2. 1& ( 94-b installation) ‘,- D. C f6. 'PittF f4 /cc.,_/L� / 2 14 Irrigation system ( 45 $/3,F $ /3,efe.... lbk.0.4YC�i? 8J'3 44 /�,3 /l osg " (including all heads,piping,valves,fittings,controllers,wiring,and all other materials f. q'' cr/C, St,J .34--.S , ,3 /VSJ" ^ f and labor necessary for a fully operational system) r. 6,n CO,JC 5.4., Sof S( x `jyS Z ' D.D5t 1" Siff --l�cbe_� g �.,�s��f•�'t�,c�f ria, ZD 3 �� _�� 93'8" $ ,r. Spaiii�y, l -/Z" , /SSVC?' 5-- Z.c .,_,,e -, t P4 ntcrPots- i i 4 4--- $ -=e/:f ` ,....,,,,,z.,„<„,,,„.. SIS - /r j 16. Compliance with Florida ,��� � $ l $ 7,3 'Trench Safety Act 17. All other items required (List other items individually as required to provide a complete streetscape as described on the A . �awjngs and specificatiqns) _ ov7'$462-4016 '5,ldl / CS $ y,C $ 6.41 64, 0 'rt,1 .i9u4SCftw. ' , l es" $ /03,Girw - $la3,GA0 - 771 , 5 ' c �p• r.. TOTAL OF LUMP SUM BA BID $ 3 6( 4604, 6 OE-CC SIGNA �r r i. 1.... II 1y~-� j f Z r C:7 DATE (Page Left Blank Intentionally.) 7 0E-CCS-:' DATE SUBMITTED: _MAY _1.21 2 0 0 4 NAME OF BIDDER: ___PERRI BUILDERS, INC. 7. The terms used in this Bid, which are defined in the General Conditions or Instructions of the Construction Contract, included as part of the Contract Documents have the meanings assigned to them in the General Conditions or Instructions. 8. The work shall be performed under a Florida Contractor's License. Contract shall not be awarded unless proof of valid license(s)is provided. 9. It is understood that where quantities for unit price work have been presented in the foregoing Schedule of Bid Items, they are approximate only and are solely for purpose of facilitating the comparison of bids,and that the Contractor's compensation will be computed upon the basis as described in the measurement and payment clauses in the specifications contained herein. 10. BASE BID-SCHEDULE OF MANUFACTURERS/SUPPLIERS If the foregoing Schedule of Bid Items is presented in a Base Bid format,the undersigned as Bidder agrees that the Contract,if awarded,will be on the basis of the materials and equipment named in the Contract Documents in accordance with Article 9 of the Instructions to Bidders. The undersigned as Bidder also agrees that for the "Base Bid" equipment and material items listed below the Bidder will provide one of the listed manufactur- ers/suppliers, by circling "A", "B",or"C". if the Bidder desires to propose an alternate manufacturer/supplier, he may write in the name of such alternate in the substitution list included within this Bid Form, but he must, nevertheless, also circle one of the listed manufacturers/suppliers. If the proposed alternate manufactur- er/supplier is determined "not equivalent"by the Engineer, the Bidder must furnish equipment and/or material items by the circled manufacturer/supplier. If the Bidder fails to indicate which listed manufacturer/supplier he intends to use if an alternate is rejected,he must use the manufacturer/supplier listed as"A". Also,if the Bidder circled more than one listed manufacturer/supplier, he must use the first manufacturer/supplier circled(unless an alternate is approved). I I. SUBSTITUTIONS AND"OR EQUAL" The undersigned as Bidder agrees that substitutions or "or-equal" items will not be considered until after the "Effective Date of the Agreement"and will be evaluated in accordance with paragraphs 6.7.], 6.7.2,and 6.7.3 of the General Conditions. In addition to the reimbursement required under the General Conditions, the Contractor shall also reimburse the Owner for any engineering costs directly attributable to the change in manufacturers/suppliers, caused by the acceptance of proposed alternates,such as;additional field trips for the Engineer, additional redesign costs, and additional review costs, etc. Other costs directly attributable to the change in manufacturers/suppliers caused by the acceptance of proposed alternates,such as;increased electrical requirements,larger building,additional pumps or tankage,etc.,shall be borne by others and not the Owner. If Bidder intends to propose substitutions or "or-equal" items after the "Effective Date of the Agreement", it is agreed that these items will be listed on the Substitution List included within this Bid Form,with a deductive amount representing 50 percent of the total savings between the named Base Bid item and the proposed item. Base Bid" item substitutions providing to the Owner an equipment or material cost savings of less than$1,000 will not be considered. The undersigned as Bidder, also agrees that if a substitution or"or-equal" item is not listed on the Substitution List included with the Bid, all of the savings between the named item and the proposed item will go to the Owner if the Owner accepts the proposed item in accordance with paragraphs 6.7.1., 6.7.2, and 6.7.3 of the General Conditions. The Owner may request,and the undersigned Bidder shall supply, complete: information on proposed substitutions. Such information shall be the manufacturer's current published or preprinted information for the specific substitution. 12. As BIDDER, I hereby certify that. 1 am aware and understand that the City of Ocoee at its sole discretion reserves the right to waive technicalities or irregularities, to reject any or all Bids, and/or to accept that Bid which is in the best interest of the City. The Award of this Rid, :f made,may be based on considerations other than total cost, and may be awarded based oti various considerations, including but not limited to: RI)DER experience and whether the Bid, in the judgement of the City, is the most responsive to City needs. The City of Ocoee cncournges the use of minorities and women-owned businesses as subcontractors. 00380-'t DATE SUBMITTED: ZIAY12' 2084 NAME 0PBIDDER: _ RERRI BUILDERS, INC. met iou.s. Strike out(X)nonappl'cable signature block and complete applicable block. (ALL SIGNATORIES MUST HAVE THEIR NAMES PRINTED OR TYPED BELOW THEIR SIGNATURES) 11 Bidder is: SOLE PROPRETORSHIP (Individual's Name ) doing business e____ ______ Business Address: ---- Phone No.: Honda License No.: A PARTNERSHIP | ---------- - ----- -------�- __- (SEAI.) (Partnership Name) __'--__---. (General Pariner'syinature) _ (General,,Artner's Name) Business address: ________ Phone No.: _ Elorida License No.: —_-_' 00300-9 DATE SUBMITTED: y�\Y 12, 2O04 NA��BOFBIDDER: ��RRI 0C. bumuctkm.s: Strike out(X)nonapplicable signature block and complete applicable block. (ALL SIGNATORIES lfBidder is: MUST HAVE THEIR NAMES PRINTED 0DTYPED BELOW THEIR SIGNATURES) AcOyPO&AIIO@ DEB8I BDILDEBS, INC. (Corporation------------- - ----- - ---- _ _ _ FLORIDA (Sm/ro/uxcoxnmn)--------------------__--'____ yvJOSEPH C. PERRI (Name vfposono"om,uedmsign) ��--- ---- - --'------- PRESIDENT i - -- ------ -- ------ (Title) ----'-- �--�-- | � ' ----- -- °/ ' • °'' �-c~«.�^�, | '---- ` �`---'---' (Corporate Seal) >f9~~4-7z_._ Attest ---- _ J�J�L��� ����---� ----' (Secretary) Business -- ---�---- mn.ves`,oun,*: 524 N. MISSION ROAD ORLANDO FLORIDAI2QO8 Phone wv.: ___ ____________ 407-292-2I28 Corporation President : ------- �1lSEPH'C. PElRI _ Florida License No.: CGCUll3O� —___~_- _ - � DATE SUBMITTED: MAY 12, 2004 NAME OF BIDDER: PERRI-_BUILDERS,_ INC. Instructions: Strike.out(X)nonapplicable signature block and complete applicable block. (ALL SIGNATORIES MUST HAVE.THEIR NAMES PRINTED OR TYPED BELOW THEIR SIGNATURES) If Bidder is: A JOINT VENTURE By -- — — — — — -- - -(Name) ------ ------- ---.—.._ --- —- - -- --- (Address)_."7 - ---- — --- ,(Name) rr (Address) ----- / Basiness Address:-- - -j — —-- — Phone No.: Florida License No.: ,' (Each joint venturer mdst sign. The manner of signing for each individual,partnership,and corporation that is a party to the joint venture shoyld be in the manner indicated above.) Florida License/No.: — -- -- — — — — — — — — — — — — — — a 12. List the following in connection with the Surety which is providing the Bid Bond: Surety's Name: RLI INSURANCE COMPANY Surety's Address: 9025 N. LINDBERGH DRIVE, .PEORIA, ILL 61615 Name and address of Surety's resident agent for service of prrcess in Florida: FLORIDA SURETY BONDS, INC. —_—.___.. . — 417 CENTER POINTE CIRCLE, SUITE 1701 ------- -- ___ALTAM_ONTE SPRINGS[ FLORIDA 32701 END OF SECTION 00300-l1 SECTION 00301 QUESTIONNAIRE DATE: MAY 12, 2004 PROJECT IDENTIFICATION: crux OF OCOEE,FLORIDA McKey Street Improvements NAME OF BIDDER: PERRI BUILDERS, INC. BUSINESS ADDRESS: 524 N. MISSION ROAD, ORLANDO, FL 32808 — -- ------- Phone No. 407-292-2128 CONTRACTOR'S FLORIDA LICENSE NO. CGC011309 The undersigned warrants the truth and accuracy of all statements and answers herein contained. Include additional sheets if necessary. I. Complete the following Table regarding experience with projects similar to the work contemplated under this Construction Agreement. Date of Client's Name&Address:(Include Amount of •Contract Name of-Project.&Location Contact Name and Phone 4E) Contract OLD WINTER GARDEN RD ORANGE COUNTY HIGHWAY $4,300,000 1999 IVY LANE TO FERGUSON MIKE WEHRFRITZ . 87 MILES 407-836-7884 2001 HAMPTON PARK HOUSING AUTHORITY $1 ,805,830 ORLANDO COLONIALTOWN COMM.BLDRS ROBERT ANSLEY (407-648-1623) 2002 ORANGE AVE.&PRINCETCN ST. IMPROVEMENTS CITY OF ORLANDO $4,200,000 JON HINE 321-229-0271 2003 SIDEWALK,DRAINAGE, CITY OF APOPKA $ 734,844 WATERMAIN IMPROV. KEN GATTON CITY OF APOPKA 407-703-1731 2003* LANCASTER RD. RECONST &DRAINAGE IMPROV ORANGE COUNTY HIGHWAY $6,780,000 OBT TO ORANGE AVENUE MIKE WEHRFRITZ ORLANDO 407-836-7884 A *CURRENTLY 80% COMPLETE – EXPECT FINAL COMPLETION 12/31/04 003011 Date of Client's Name& Address(include Amount�� ----� ContractContractName of Project & Location Contact Name and Phone ft) Contract 2. Have you ever faiJed to complete work awarded to you? If so, where and why? NO -- _—_--_—_-__ --__--_ -----_-- ------�—____ 3. Dave you personally inspected the general alignments of the various utility improvements propxnduod this o YES — NO PROBLEMS ANTICIPATED 4. Will you Subcontract any part of the work involving the construction of underground utilities? If describe which portions. u`. ,�zm ELECTRIC, CABLE & TRAFFIC SIGNAL CONDUIT _ __ ________ ____ 5. List the names and addresses of the subcontractors to be used for the portions of the contemplated work listed above. Subcontractor Certification Subcontract Name and Address of Subcontractor Registration No. &Name LANDSCAPE & AZALEA OAKS, INC. IRRIGATION P.O. BOX 400153 LEESBURG, FL 34748 ASPHALT RANGER CONSTRUCTION PAVING 1200 ELBOC WAY WINTER GARDEN, FL 34787 UTILITY CHINCHOR ELECTRIC CONDUITS & P.O. BOX 4311 FITTINGS ENTERPRISE, FL 32725 PAVEMENT FAUSNIGHT MARKINGS 910 CHARLES ST. LONGWOOD, FL 32750 CONCRETE ACME CONCRETE CURBS 1261 SUTTON ROAD LAKELAND, FL 33810 r — 00301-3 G. Disclosure (Section 00100, Article 20). Complete and attach "Sworn Statement on Public Entity Crimes" (Section 00482). 7. State the true and exact,correct, and complete name under which you do business. BIDDER IS: PERRI BUILDERS, INC. END OF SECTION 00301-4 SEUL ION 00301-A COMPLIANCE WITH FLORIDA TRENCH SAFETY ACT (90-96,LAWS OF FLORIDA) Bidder hereby acknowledges that all costs for complying with the Florida Trench Safety Act arc included in the various items of the bid and in the Lump Sum Total Bid Price shown to Section 00300- Bid Fonn, "Schedule of Bid Items". For informational purposes only,the bidder is required to further identify these costs in the summary below. Trench Safety Unit of Measure Measure Unit Unit Extended (Description) (LF,SY) (Quantity) Cost Cost A 5.63> c1 .. 739 $ / $ 7,9 B $ $ C $ $ D $ $ TOTAL $ 79- I3IDDER: PERRI BUILDERS, INC c, SIGNED:_ ,i _ BY: ROBERT P. CERLINI (Print or type name) TITLE: ESTIMATOR DATE: 5/12/04 TIUS IS NOT A PAY ITEM: The purpose of this form is to gather information on the costs associated with trench safety measures and to insure that the Bidder has considered these costs and included them in the Lump Sum Total Bid price. Contractor will not receive additional payment if actual quantities differ from those estimated or if the Contractor uses a safety measure different than those listed. (Failure to Complete This Form May Result in the Bid Being Declared Non-Responsive.) ENI)OF SEC11ON 0030 I A-1 SECTION 00301-B DRUG-FREE WORKPLACE CERTIFICATION IDENTICAL TIE BIDS: Preference shall be given to businesses with drug-free workplace programs. Whenever two or more bids which are equal with respect to price, quantity, and service arc received by the State or by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing tie bids will be followed if none of the tied vendors have a drugfree workplace program(Florida Statutes Section 287.037). In order to have a drug-free workplace program, a business shall: . Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actionsthat will be taken against employees for violations 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, and available drug counseling, rehabilitation, andemployee 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 bid a copy of the statement specified in subsection(1). 4. In the statement specified in subsection (I), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or pleas of guilty or nolo contendere to; any violation of Chapter 893 or of any controlled substance law of the United States or any state, for a 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 a drug abuse assistance or rehabilitation program is such is available in the employee's community, by any employee who is so 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 the statement, I certify that this firm complies fully with the above requirements. Bidder: PERRI BUILDERS, INC. Signed: 6 . By: JOSEPH C. PERRI (Print or Type Name) Title: PRESIDENT Date: MAY 12, 2004 END OF SECTION 00301-B-1 SECTION 00480 NONCOLLUSION AFFIDAVIT STATE OF FLORIDA) ss COUNTY OFORANGE) JOSEPH C. PERRI , being first duly swore deposes and says that: I. He(it)is the _PRES IDENT (Owner, Partner,Office, Representative or Agent) of PERRI BUILDERS, INC. , the Bidder that has submitted the attached Bid; 2. He is fully informed respecting the prepanhion and contents of the attached Bid and of all pertinent circumstances respecting such Bid; 3. Such Bid is genuine and is not a collusive or sham Bid; 4. Neither the said Bidder nor any of its officers, partners, owners, agents, represerlatives, employees, or parties in interest, including this affidavit, have in any way, colluded conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted; or to refrains from bidding in connection withsuch Contract; or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or confecnce with any Bidder, firm, or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix any overhead, profit, or cost elements of the Bid price or the Bid price in any other Bidder, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the proposed Contract; 5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion,conspiracy, connivance, or unlawful agreement on the part of the Bidder or any other of its agents, repreentatives, owners, employees or parties in interest, including his affidavit. By: Title: 'RESIDENT Sworn and subscribed to before me this 12 day of MAY ,?,9 B 4 , in the State of FLORIDA , County of ORANGE F�°. ,DARLENE M.RHODES ti n My Commission Expires: I MMISSONt*DD 070475 EXPIRES:March 3.2006 'i ,"nvn So Med Thai Moe(Nobry Services 4 END OF SECTION 00180-1 SECTION 00481 CERTIFICATION OF NONSEGREGATED FACILITIES The Bidder certifies that he does not maintain or provide for his employees any segregated facilities at any ofhis establishments, and that he does not permit his employees to perform their services at any location, under this control, where segregated facilities arc maintained. The Bidder certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location under his control where segregated facilities are maintained. The Bidder agrees that a breach of this certification will be a violation of the Equal Opportunity clause in any contract resulting from acceptance of this Bid. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage and dressing areas,parking lots,drinking fountains, recreation or entertainment area, transportation,and housing facilities provided for employees on the basis of race, color, religion, or national oigin, because of habit, local custom, or otherwise. The Bidder agrees that (except where he has obtained identical certification from proposed suhcoEractors for specific time periods) he will obtain identical certifications from proposed subcontractors pior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause, and that he will retain such certifications in his files. The nondiscriminatory guidelines as promulgated in Section 202, Executive Order 11246, and as amended by Executive Order 11375 and as amended, relative to Equal Opportunity for all persons and implemenations of rules and regulations prescribed by the United States Secretary of Labor are incorporated herein. Note: The penalty for making false statements in offers is prescribe. in 18 U.S.C. 1001. Date MAY 12 0 4 — ..!id• P JOSEPH C. PERRI Official Address By: (including Zip Code): PRESIDENT (Title) ---_---- PERRI BUILDERS, INC. V. MISSION ROAD ORLANDO, FLORIDA 32$08 ATTACH AND INCLUDE AS PART OF PROPOSAL FORM; FAILURE TO DO SO MAY BE CAUSE FOR DISQUALIFICATION OF YOUR BID. END OF SECTION 00481-1 SECTION 00482 (Page 1 of 2) SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to City of Ocoee, Florida by PERRI BUILDERS, INC. JOSEPH C. PERRI, PRESIDENT (Print individual's Name&Title) whose business address is 524 N. MISSION ROAD ORLANDO, FLORIDA 32808 ._ 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 anyother state or with 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, laud, theft, bribery, collusion, racketeering,conspiracy,or material representation. 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 cfrne, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictnent or information after July 1, 1989, as a result of a jury verdict,nonjury trial, or entry of a plea of guilty or nolo cattcndere. ' 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 isactive 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 anaffliate. 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. 5. [understand that a "person" as defined in Paragraph 287.133(1)(c),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 forthe 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, aid 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. (please indicate which statement applies). X Neither 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 management of the entity, 00482-1 nor any affiliate of the entity have 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 the officers, directors, executives, partners, shareholders, employees,members, or agents who are active in management of the aitity, or an affiliate of this entity has been charged with and convicted of a public entity crime subseluent to July I, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of this entity.has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding concerning dr conviction before a Hearing Officer of the State of Florida, Division of Administrative Hearings. 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 vendoi list. (Please 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 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY • AND, THAT THIS FORM IS VALID THROUGH . 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 INSECTION 287.017, FLORIDA STATUTES FOR CATEGORY TWO OF CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. (Signature) Date: MAY 12, 2004 PERRI BUILDERS, INC. Name of Bidder(Contractor) STATE OF FLORIDA COUNTY OF ORANGE PERSONALLY APPEARED BEFORE ME, the undersigned authority, JOSEPH C. PERRI who, after first being sworn by me, affixed his/her signature in the place provided above on this 12 day of MAY ,200.4 Notary Public DARLENE PA.RHODES MY COMMISSION#DD 070475 II * EXPIRES:mare".2006 My Commission Expires:-- ' ,rndouattet vservices.- ' -- - - - END OF SECTION 004 82-2 SECTION 00483 CERTIFICATION OF NONDISCRIMINATORY LABOR PRACTICES This certification relates to a construction contract proposed by the City of Ocoee . Equal Opportunity Employment: The Contractor shall not discriminate on the basis of race, color, national origin, gender, age, handicapped status, veteran status, and/or religion in performing the work governed by this contract. The City is an Equal Opportunity Emplo}er (EOE) and as such encourages all contractors to comply with EOE regulations. Any subcontract the Contractor may enter into shall include this clause with the same degree of application being encouraged. I am the undersigned prospective constructioncontractor or subcontractor. I certify that ... (1) I_,. X have/ have not participated in a previous contract or subcontract subject to the Equal Opportunity Clause and (2) If I have participated in a previous contract or subcontract subject to the EqualOpportunity CIause, I X have/_ have not filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable tiling requirement. • I understand that, if I have participated in a previous contract or subcontract subject to the Equal Opportunity Clause and have failed to file all reports due under the applicable filing requirements, I am not eligible, and will not be eligible, to have my bid or offer considered, or to enter into the proposed contract or subcontract, unless and until I make an arrangement regarding such reports that is satisfactory to the office where the reports are required to be filed. I agree that I will obtain identical certifications from prospective lower-tier construction subcontractors when I receive bids or offers or initiate negotiations for any lowef tier construction subcontracts with a price exceeding $10,000. I also agree that I will retain such certifications • my files. Date MAY 12 _, 1B004 By: �r ignature of Authorized Official) JOSEPH C. PERRI PERRI BUILDERS, INC. (Name of Prospective Construction Contractor or Subcontractor) 524 N. MISSION ROAD (Address of Prospective Construction Contractor or Subcontractor) ORLANDO, FLORIDA 32808 407-292-2128 _ 59-1709768 , (Telephone Number) (Employer Identification Number) END OF SECTION 00483-1 [1PERRI BUILDERS INC.?' 524 NORTH MISSION ROAD • ORLANDO, FLORIDA 32808-7729 • 407-292-2128 • FAX 407-292-2137 REFERENCES Mr.Ken Gatton City of Apopka 407-703-1731 Mr.Frank Brown Orange County 407-836-7995 Mr. Mike Wehrfritz Orange County 407-836-7884 Mr. Abe Jardaneh City of Orlando 407-246-3183 Mr. Earl Lawson Florida Dept. of Transportation 386-258-4464 Mr. Terry Phillips Florida Dept. of Transportation 386-258-4453 Mr. Bob Frincke Colonialtown Community Builders, OHA 407-648-1623 THE ATTACHED TERRORISM RIDER FORMS AND BECOMES A PART OF THIS BOND. Executed in 2 Counterparts Bid#B04-07 .SECTION 00110 art)BOND KNOW AI.L MEN DY THESE PRESENTS,that we,the undersigned,... Perri Builders,Inc. 0.s pritx:ipal,and... RLI Insurance Company , as Surety, are hereby held and thinly bound unto the City of Ocoee.Florida,as Owner in the penal sum of live percent of the Contrnct Did Five Percent of Amount Bid ____..___�_________ __ 5%---.— payment of which, well and truly to be made, we hereby jointly and severalty bind ourselves, seeeeasora and assigns. Signed,this. 12th day of_May , 1 2004 The condition of the above obligation is such that whereas the Principal has submitted to the City of Ocoee, Florida a certain Did,attached hereto and hereby made a part hereof to enter into a contract in writing, far the City of Ocoee McKey Street Intprovetments, NOW THEREFORE !. Ridder and Surety, jointly std severally, Mud thcnaetvcs, their heirs. exceutors, administrators, successors and assigns to pay to Owner upon default of[odder any difference between the total ainnent of Bidder's bid and the total amount of the hid of the next lowest, responsible and responsive bidder as determined by Owner fur the Work required by the Contract Documents,provided that: t.t. If there is u such next lowest, responsible and responsive bidder, and Owner does not abandon the Project,then Ridder and Surety shall pay to Owner the penal sum set forth on the fox of this Bond,and 1.2. lit no event shall Bidder's and Surety's obligation hereunder exceed the penal sum set forth on the lace of this Bond. 2. Default of Bidder shall occur upon the failure of Ridder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to In writing by Owner) the executed Amendment to the Agreement required by the Ridding Documents and any performance and payment bonds required by the Bidding Document,and Contract Documents. 3. This obligation shall be null and void If: 3.1. Owner accepts Bidder's bid anti Bidder delivers within the time required by the Ridding Documents (or any extension thereof agreed to in writing by Owner)the executed Amendment to the Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Document;and Contract Documents,ur 3.2. All bids are rejected by Owner,or 3.3. Owner fails to Issue a Notice of Intent to Award to Bidder within ninety(90)days from the time and date fixed for the opening of Bids(or any extension thereof agreed to in writing by Bidder and,If applicable,consented to by Surety when required by paragraph S hereof). 4. Payment under this Bond will be due and payable upon default try Bidder and within thirty(Si.))calendar drys atter receipt by Bidder and Surety or written nutlet:of default from Owner, which notice will be given with reasonable promptness,idendfying this Bond and the Project and including a statement of the amount due. 00110.1 5. Surety waives notice of any and all defenses based un ur:rising out of any time extcnshm to issue muse: of award agreed to in writing by Owner and Bidder, provided that the total time for issuing notice of award including extensions shall nut in the aggregate exceed 120 days from Bic! clue Dare without Surety's written consent. G. Nu suit or action Shall he cutruneoced under this bond prior to Std calendar days after the antics of default required in paragraph 4 above is received by Bidder and Surety and in no case later titan one year after Bid Due Date. 7 Any suit or action under this Bond shall be commenced only in a court of competent jurisdiction located in the stifle in which the Project is located. K. Notices required hereunder shall be in w;;,,,.,.;i;;d ae<tt til Bidder and Surety Al their respective Addresses shown in the face of this Rontl. Surest notices may be sent by personal delivery,commercial unifier or by United State P.:livered or Certified Mail, return receipt requested, postage prepaid, and shall be dcettld to be effective upon receipt by the party concerned. 9. Surety shall cause to be attached to this Bond. a current and effective Power of Attorney evidencing the authority,of the officer, agent or representative who executed this Bond on behalf of Surety to execute, seal and deliver such Bond and bind the Surety thereby. 10. 'this Bond is intended to conform to all applicable statutory requirements. Any applicable requirement of any applicable statute that has been omitted Iron this bond shall he deemed to be included herein as ifset forth at length. if any provision of this Bund conflicts wilit any applicable provision of any applicable statute, then the provision of said statute shalt govern and the temninder of this Mond that is not in conflict therewith shall continue in full force nod effect. I I. The term"bid"u used herein includes a bid,otTer or proposal as applicable. IN WITNESS WHRRBOP, the Principal and the Surety have hereunto set their hands and seals,and such of them as are corporations have caused their corporate seats to be hereto affixed and therm presents to be signed by their proper officers,the day and year first set forth above. • 00410-2 LUIOOER: Wks:out (X) nun• applicable signature block and complete applicable block. All signatures list have their names printed or typed below their signature. _ If Bidder is SOLE PROPRIEI('PORSHIP,complete this signature:block -_ prtritylotas Slir igee) - (Wlsueu) (Inl)r 'sN.me) (WiU%il). doing business ae__.. .. _... (SBAL) +. (Business Address) Bu ( ).. (telephone No.) (florid;License-Nn.) Jr Didder t+PAKtNEIt5HIP,unnplete this dinoiure blocs. _. _ .. .. (U..._. _, (Pertnerihip risme) (Witness) (Orners1 Passer's rine (Witness) ((ienept Ps s Name) - _._ (SISAL) (Business Address) (Tetephons Nu.) (Florida License No.) 00410-3 .... E.(Oder Is 4 CORMRATION.atm km this t1.111are hind. A'rt.Ps-r; • Perri Builders, Inc. /.1— C /27 Woroomioa Homo--•. •' ..;2,01 44616— c /7-1k.„..--24 I (Corpora*Secretary,Signatum) . .Florida ., . (saw or loco-I:potation) I—Us.%-4 r i.- f.: . jr i --7--- (commie Scurclaty Hanle) Dy: J°56,64 e• 4 aiete I (Niime 0 person so rind iesIgn•sce Note 1) (N.) I) , ,,,,,e ( ,iA--7- (Authorised Sighsturc) .:Z C. "WIA'"' (CORPORATE SEAL) y — (Corp:MOM Prisltkor) 524 North Mission Road Orlando,Florida 32808-7729 (Dulintis Addre.to) 1 SQL). 292-2128 e6-?o7/1()Iii (Totephosse luu.) (PlorWo Limn°No.) 1)04101 SLAM Y: . WrtNliws: or Axaa is on,a Corpotatiun) RLI Insurance Company_ (Sorely Uosinrss Niunc) (Wuoess) 9025 N.Lindbergh Drive �) - •_ (wimp) Peoria,Illinois 61615 'Q (Principen Mims ut BaMcu))ti 1!L#T�f • CaR���"'_ ATTEST: Agent ire Curporaiieu) (Surety Allen's SICe$Nto-Ste Nola t) Leslie M.Donahue (407 786-7770 °`-`! L- (Surny Agenic Mame) (Cugwrue Sccrchr),Siaaarure Attorney in Fact&FL licensed Resident Susaj,..,,Reich _ (Surety Arans'e Tide) Agent (eerporale Secretary Wane) Florida Surety Bonds,Inc. tfustoess Nome of meal Agent toe Surely) 417 CenterPointe Cr.,Ste 1701 (t:ORPORATII SEAL) Altamonte Springs, Florida 32701 (busincrs Adriress of Wall Ayenr) (30!) 692-100Q(Surety) D038384(Leslie (Tdc ane Nn.) (Melds License No.) NOM'S: (1) Complete and attach "Corporate Authority to Execute Documents"if executed by any corporate employee other than president or vice-president. (2) Complete and attach a certified copy of"Puwer-of-Attorney"prepared by Surety appointment Individual "Attorney-in-Pact" for execution of Bid fond on behalf of Surety and corresponding notarized "Attorney- -et-Pact". Attorney-et-react". (3) Above addresses ate to be used for giving requited notice. . (4) Any singular reference to Bidder, Surety, Owner or ottier party shall be considered plural where applicable. (5) Surety companies executing bonds must appear on dm Treasury Deparnnent's most current lint(Circular 570 as amended)ntul he euthorired to transact business in the state where the project it located. 00410.5 CORPORATE AU'ITIORITY TO F,XECU'I'1 r)ocuM►:N'rs I HEREBY c:EitTIFY that o meeting of the Board of Directors of PERRI BUILDERS a INC. tura:) a corporation soder the laws of the State of FLORIDA �,held on the__1.2. day of MAY _. 120.0_4 the following restitution wa duly passed and adopted: "RESOLVED,that .r JOSEPH C. PERRI tog .I ui,„Wd) • • (ir,na ire or Wl.Id I) __ ._. as PRESIDENT, of the corporation,is hereby authorized to execute and all documents required to be signed by an officer of the Corporation in order to submit a valid hid,contract and bond for MCKEY STREET IMPROVEMENTS B04-07 INu'aN•,n,nq • On between the CITY OF OCOCE,a municipal corporation, and this corporation,and that his execution thereof, attested by the Secretary of the corporation and with corporate seal Affixed shall be the official act and deed of this corporation." I f'URTHER CERTIFY that said revolution is now in full force and effect. IN WITNLSS WHE!RI3OF, E have hereunto tel my hand and affixed the official seal of the corporation This 12 day of. M'Y.. ... .._ lig 90.4 (CORPORATE SEAL) FLORIDA (Corporate Secretary) S PATE OF COUNTY ort ORANGE The foregoing instrument was acknowledged heti)rc me this_12 day of MAYr 2004 by JOSEPH C. PERRI r PRESIDENT (name of officer or agent, title of officer or agent), of.-. B( ERRITILDERS, INC. (name of corporation acknowledging), a FLORIDA (state or place of incorporation),corporation,on behalf of the corporation. Hu/She is personally known to me or has produced identifications _.� _(type or Identification)as Identification and did/did not take an oath. (Notary Public) My Commission L _ a�`a•`°�o DARLENE M.RHODES ;...;t' ;_7 * MY COMMISSION#D0070475 f " ' EXPIRES:March 3,2006 Nle 40,noi Bonded Nu Budget Notary Services ,'! 00410-6 ATTORNEY-IN-FACT AFFIDAVIT STATE OR COMMONWEALTH OF FLORIDA ss COUNTY OR CITY OP ALTAMONTE SPRINGS Before me,a Notary Public,personalty name Leslie M. Donahue known to me,and(mown to be the.attorney-in-Fact of RLI Insurance Company ,a (Surety Company) Illinois Commotion.which executed the attached bond u surety,who deposed and said that his (State) signature and the corporate seal of said RLI Insurance Company were axed by (Surety Company) order and authority of said Company's Board of Directors,and that the execution of the attached bond is the free act and dad of RLI Insurance Company (Surety Company) Given underhand and seat this 12th day of May 20 04 JANET L. CARET` Notary Public, State of r Fonda • ci ± Cts My Comm, exp. Sept. 6,2005 (Notary Public) Janet L. rey :;nmrn. No. 1)0 055231 My Commission Expires: 9/6/05 END OF SECTION 00410-7 TERRORISM RIDER NOTICE-FEDERAL.TERRORISM INSURANCE COVERAGE AND DISCLOSURE OF PREMIUM Any loss applicable to a peril covered under this bond that is caused by a certified act of terrorism pursuant to the terms of the Terrorism Risk Insurance Act of 2002 ("the Act,"), will be partially reimbursed by the United States under a formula established by federal law. Under this formula,the United States pays 90%of covered terrorism losses exceeding a statutorily established deductible to the insurance company providing this bond. The portion of your annual premium attributable to certified acts of terrorism under this bond is S1.00 COVERAGE LIMITATIONS Payment for a loss will not exceed the limit of liability under this bond. This bond will not pay for any portion of certified terrorism loss beyond any applicable annual liability cap set forth in the Act. The terms of this rider do not provide coverage for any loss that would otherwise be excluded by the terms of this bond. „ow, JrEPOWER OF ATTORNEY D I V I S I N RLI Insurance Company RL.I Surety A Division gfRL,i Insurance Company P.O.Box 3967 Peoria,IL 61612-3967 Phone: 309.692-1000 Fax: 309-692-5637 Know Al!Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company, an Illinois corporation,does hereby make,constitute and appoint: JEFFREY W. REICH, SUSAN L. REICH. KIM E.NW. TERESA L.ROBINSON_LESLIE M. DONAHUE, PATRICIA L.SLAUGHTER,J.GREGORY MACKENZIE, JOINTLY OR SEVERALLY in the City of Altamonte Springs , State of Florida its true and lawful Agent and Attorney in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety,the following described bond. Any and all bonds, undertakings,and recognizances in an amount not to exceed Ten Million Dollars($10,000,000)for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon this Company as if such bond had been executed and acknowledged by the regularly elected officers of this Company. The RLI Insurance Company further certifies that the following is a true and exact copy of the Resolution adopted by the Board of Directors of RLI Insurance Company, and now in force to-wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation.The signature of any such officer and the corporate seal may be printed by facsimile.” IN WITNESS WHEREOF, the RLI Insurance Company has caused these presents to be executed by its President with its corporate seal affixed this 14th day of January , 2004 . •.A' RLI Insurance Company GpRPOR r •:9y• : . SEAL . = g,,. i State of Illinois Jonatr, tc ael President County of Peoria SS •��°,••Lr�1N�OVfoss . CERTIFICATE On this 14th day of January , 2004 , before me, a Notary Public, f, the undersigned officer of RLI insurance Company, a stock personally appeared Jonathan E. Michael , who being by me duly sworn,acknowledged that he signed the above Power of corporation of the State of Illinois.do hereby certify that the attached Attorney as the aforesaid officer of the RL1 Insurance Company and Power of Attorney is in full force and effect and is irrevocable;and acknowledged said instrument to be the voluntary act and deed of said furthermore,that the Resolution of the Company as set forth in the corporation. Power of Attorney, is now in force. In testimony whereof, I have hereunto set my hand and the seal of the RLI Insurance Company this 1 2thday of May ,2004 . By: ///. RLI Insurance Company Jacque 'ne M.Bockle Notary Public `OFFICIAL SEAL" By: /244/5 *•^ an tchael President JACQUELINE M.BOCKLER Jonat F, COMMISSION EXPIRES 03/0146 ,uveas 0922656030108 A00591)03 , . figkiNkt,,,, DATE SUBMITTED: gafff NAME OF BIDDER: SECTION 00300 f BID FORM SUBMITTED: ) zoo4 (Date) PROJECT IDENTIFICATION: CITY OF OCOEE,FLORIDA MCKEY STREET IMPROVEMENTS I NAME OF BIDDER: � VJCon 1flG • dl A BUSINESS ADDRESS: 0* t P r L�1UI PHONE NO.: "I b7 8505 Z I 1r. I Ma. ' -;�I` I CONTRACTOR'S FLORIDA LICENSE NO.: P' P 2(p ITHIS BID IS SUBMI I"1'bD TO: City of Ocoee, Florida(hereinafter called Owner) 1. The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Ownerin i the form included in the Contract Documents, to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid Form and the Agreement, and in accordance with tie other terms and conditions of the Contract Documents. I 2. Bidder accepts all of the terms and conditions of the Bidding Documents including without limitation those dealing E with the disposition of Bid Bond. This Bid will remain open for ninety (90) calendar days after the day of Bid opening. BIDDER will sign and deliver the Agreement with the Bonds and other documents required by the r Bidding Requirements within ten(10)days after the date of OWNER'S Notice of(Intent to)Award. !1 3. In submitting this Bid, Bidder makes all representations required by the Instructions to Bidders and the Agreement and further warrants and represents that: a. Bidder has examined copies of all the Bidding Documents and of the following Addenda: I No. Dated No. Dated No. Dated No. Dated No. Dated- No. Dated No. Dated No. Dated (Receipt of all which is hereby acknowledged)and ato copies of the Invitation for Bids and the Instructions to Bidders. b. Bidder has familiarized itself with the nature and extent of the Contract Documents, Work,site, locality,and I mauler local conditions, ordinances, laws and regulations that in any maer may affect the cost, progress, performance or furnishing the Work. c. BIDDER has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to exiting surface of subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in paragraph 4.2.1 of the General Conditions. BIDDER accepts the determination set iforth in paragraph SC-4.2 of the Supplementary Conditions of the extent of the "technical data"contained in 00300-1 I • va..\,kot", DATE SUBMPfTED: 4 I —I2V tif NAME OF BIDDER: lktiaot SECTION 00300 BID FORM y.-, SUBMITTED: `�l�1-1(1/(X)4 (Date) PROJECT IDENTIFICATION: CITY OF OCOEE,FLORIDA MCKEY STREET IMPROVEMENTS �c . x Cm _C* s I nc . At� NAME OF BIDDER: t��OO QQ����-j '7BUSINESS ADDRESS: .i 1 V 4( /dSPHONE NO.: &b7) W 0/ ' t 7 ` CONTRACTOR'S FLORIDA LICENSE NO.: Kt 02-(f I ITHIS BID IS SUBMITTED TO: City of Ocoee, Florida(hereinafter called Owner) 1. The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Ownerin 1 the form included in the Contract Documents, to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid Form and the Agreement,and in accordance with tin other terms and conditions of the Contract Documents. 2. Bidder accepts all of the terms and conditions of the Bidding Documents including without limitation those dealing with the disposition of Bid Bond. This Bid will remain open for ninety (90) calendar days after the day of Bid opening. BIDDER will sign and deliver the Agreement with the Bonds and other documents required by the 1 Bidding Requirements within ten(10)days after the date of OWNER'S Notice of(Intent to)Award. 3. In submitting this Bid, Bidder makes all representations required by the Instructions to Bidders and the Agreement and further warrants and represents that: Ia. Bidder has examined copies of all the Bidding Documents and of the following Addenda: i No. Dated No. Dated No. Dated No. Dated No.— Dated No. Dated No. Dated No. Dated I (Receipt of all which is hereby acknowledged)and ago copies of the Invitation for Bids and the Instructions to Bidders. b. Bidder has familiarized itself with the nature and extent of the Contract Documents,Work,site,locality,and 1 all local,conditions, ordinances, laws and regulations that in any mamer may affect the cost, progress, performance or furnishing the Work. I c. BIDDER has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to exiling surface of subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in paragraph 4.2.1 of the General Conditions. BIDDER accepts the determination set i forth in paragraph SC-4.2 of the Supplementary Conditions of the extent of the"technical data" contained in 00300-1 f DATE SUBMITTED: J 12 00 NAME OF BIDDER: riot 'i0' ACIIXS\nc, such reports and drawings upon which BIDDER is entitled to rely as provided in paragraph 4.2 of the General Conditions. BIDDER acknowledges that such reports and drawings are not Contract Documents and may not be complete for BIDDER's purposes. BIDDER acknowledges that OWNER and Engineer do not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Bidding Documents with respect to Underground Facilities at or contiguous to the site. d. BIDDER has obtained and carefully studied (or assumes responsibility for having done so) all such additional or supplementary examinations, investigations, explorations,tests, studies and data concerning conditions (surface, subsurface and Underground Facilities) at or contiguous to the site or otherwise which may affect cost progress, performance or furnishing of the Work or which relate to any aspect of the means, methmis, techniques, sequences and procedures of construction to be employed by BI.DDER and safety precautions and programs incident thereto. BIDDER does not consider that any additional examinations, investigations, explorations, tests, studies or data are necessary for the determination of this Bid for performance and furnishing of the Work in accordance with the times, price and other terms and conditions of the Contract Documents. e. BIDDER is aware of the general nature of Work to be performed by OWNER ani others at the site that relates to Work for which this Bid is submitted as indicated in the Contract Documents. f. BIDDER has correlated the information known to BIDDER, information and observations obtained from visits to the site, reports and drawing identified in the Contract Documents and all additional examinations, investigations,explorations, tests, studies and date with the Contract Documents. g. BIDDER has given ENGINEER written notice of all conflicts, errors, ambiguities or discrepancies that BIDDER has discovered in the Contract Documents and the written resolution thereof by ENGINEER is acceptable to BIDDER, and the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performing and furnishing the Work for which this Bid is submitted. h. This Bid is genuine and not made in the interest of or on behalf of any undisclosed person, firm or corporation and is not submitted in conformity with any agreement or rules of any group, assoiation, organization or corporation; BIDDER has not directly or indirectly induced or solicited any other Bidder to submit a farce or sham Bid; BIDDER has not solicited or induced any person, firm or corporation to refrain from bidding; and BIDDER has not sought by collusion to obtain for itself any advantage over any other Bidder or over OWNER. I. BIDDER hereby agrees to commence WORK under this contract on or before a date to be specified in the NOTICE TO PROCEED and to fully complete all work of the PROJECT within the Contract Time. Completion Schedule 1) The Project shall be substantially complete (successful pressure testing and bacteriological testing of completed water mains) in One Hundred Twenty (120) consecutive calendar days from the official Notice to Proceed. 2) The Project shall be finally complete(Completed and Ready for Final Payment)in one hundred twenty (180)days from the official Notice to Proceed. 3) The Contractor may earn a bonus of$20,000 for achieving final conpletion of the Project on or before November 30, 2004 as provided in the.Agreement (Section 00500). The City may assess liquidated damages of$1,000/day for late completion as provided in the Agreement(Section 00500). 00300-2 I DATE SUBMI ITED: &X VIIe `^' 'tt ntwzrs I nc • NAME OF BIDDER: 51)2-, I 4. All bid items shall include all materials, equipment, labor, permit fees, taxes, tests, miscellaneous costs of all types, overhead, and profit for the item to be complete, in place, and ready for operation in the manner contemplated by the Contract Documents. Bidder submits the following TOTAL BID OR TOTAL BASE BID to perform all the Work as required by the Drawings and Specifncaions. 111 5. In accordance with Article 17 of the Instructions to Bidders, if the Contract is to be awarded, it will be awarded by considering the lowest "Total Base Bid" after adjustments for additive or deductive alternates. Additive or deductive alternates (if any) will be considered in determining the lowest responsive, responsible Bidder. The Owner reserves the right to accept any or all additive or deductive alternates, in his sole discretion, prior to the award of the Contract. The Owner also reserves the right to delete any portion of the Work as shown in the bid schedule prior to award and adjust each bidder's "Total Bid" accordingly. 6. The following documents are made a condition of this Bid: a. Bidding Documents and shall include the following: 1. Bid Forms (entire Section 00300, 00301, 00301A and 0030113) 2. Bid Bond(Surety Bond or Cashier's Check). (Section 00410) 3. Corporate Authority to execute Bid 4. Power of Attorney(for Surety Bond only) 5. Noncollusion Affidavit(Section 00480) 6. Certification of Nonsegregated Facilities (Section 00481) 7. Sworn Statement on Public Entity Crines(Section 00482) 8. Certification of Nondiscriminatory Labor Practices(Section 00483) 9. References (On company letterhead) I (Remainder of Page Left Blank Intentionally.) I I I I I 00300-3 a DATE SUBMITTED: 5 1i e ir NAME OF BIDDER: yr cfrbvs Inc • SCHEDULE OF BID ITEMS CITY OF OCOEE MCKEY STREET IMPROVEMENTS NOTE: BIDS shall include sales tax and all other applicable taxes and fees. NO. Item Units Unit Price Amount Total Price 1. City of Ocoee Permit Fee's 1_ $10,000.00 $10,000.00 (Allowance) 2. Orange County Permit Fee's 1 $1,000.00 $1,000.00 (Water and sewer) (Allowance) 3. Mobilization,Demobilization, 1_ $Z 2' �- $ Bonds and Permits (Maximum of 5% of Total Bid) 4. General Requirements- $ cer.? $ Division 1(except as follows under this item) 5. Field Engineering and 1 $2:7104-z), $ x? Exploratory Excavation .-- 6. Record Drawing Preparation $ 7a -'' . $Z 7i 7. Color Audio-Video $ � �, $ f,5 e-), Preconstruction Record 8. Clearing and demolition .�- a. Clear and Grub N (,5 $ c r $ ge-,,e4t5, b. Tree protection 1 L 5 $ $ �.- 9. Underground Utilities-MEP a. Potable Water 8" PVC gSc(,P $ - $ 10. Stormwater System era --• a. l 8" RCP $ j t.—~ $ t �•.. -- b. 12"RCP c'.SL+: $ $ '700. c. 15"RCP _ E 75 /_r $ 00300-5 d. Inlet-TypeV Icer $5(c+0. $Z .7 : . --- e. Inlet-Type 9 4 et.,_ $ <. `' $ cra f. Manhole(P8) � t3., $ ( xc �, r- $ 6 „_r 11. Grading a. Final Grading i LS $ (3 ors $ ($�cno,. b. Fill / L`. $(5 cxx.• $/F,Aicr�, c. Turbidity Barrier 7c LJ' $ (G: - $ z -r..D. d. Silt Fence G-.riZ-,t..F $ Z.,'zX? $el 1`=cr,. 12. Pavements with curbs a Asphalt -3C D 5(c $ _Fs� $78,crx.), b. Soil Cement 3 5-,s- $ il..-" $%, 0 c. Type"D"curb Zgap (_1F $ (i. $3Z ,/tri d. Decorative Paving(Pedestrian).;? $ c q,"" $_144)6i .j4 e. Decorative Paving(Vehicular)/f;,c> -$ C, _ ~' $€.?'JCO. 13. Landscape Planting { i 5 $c 7. . $77e 4'-- , (Incl. all soil amendments,sodding and seeding not necessary for grading stabilization, fine grading,guying/staking,and all other materials and labor necessary for a complete installation) — 14. Irrigation system /C..S $z5,Cxle:".. $2."'S'i6c`C_ (including all heads,piping,valves,fittings,controllers,wiring, and all other materials and labor necessary for a fully operational system) 15. Site Furnishings Benches $� Trash Receptacles $ $ Planter Pots $ ,S--#- 16, Compliance with Florida -.-, Trench Safety Act 14-5 $ 'expo.— S icW, 17. All other items required (List other items individually as required to provide a complete streetscape as described on the drawings and specifications) 5-4-7-rec <ii 24'L. / LS $ ?5 C:7 .._ $35<c) r TOTAL OF LUMP SUM BASE BID $• —) .''l • 6 OE-CC 1.1101 MEM tiles mover MM. Was. ate.. w. i %MIR-• wer+r- nava. 1 SIGNA ICY7 1 v DATE (Page Left Blank Intentionally.) 7 OE-CCS-A/ 14 DATE SUBMITTED: J #0 } t NAME OF BIDDER: V k 1 rj tV 1 no - '7. The terms used in this Bid, which are defined in the General Conditions or Instructions of the Construction Contract, included as part of the Contract Documents have the meanings assigned to them in the General Conditions or Instructions. 8. The work shall be performed under a Florida Contractor's License. Contract shall not be awarded unless proof of valid license(s)is provided. 9. It is understood that where quantities for unit price work have been presented in the foregoing Schedule of Bid Items,they are approximate only and are solely for purpose of facilitating the comparison of bids, and that the Contractor's compensation will be computed upon the basis as described in the measurement and payment clauses in the specifications contained herein. 10. BASE BID-SCHEDULE OF MANUFACTURERS/SUPPLIERS If the foregoing Schedule of Bid Items is presented in a Base Bid format, the undersigned as Bidder agrees that the Contract,if awarded,will be on the basis of the materials and equipment named in the Contract Documents in accordance with Article 9 of the Instructions to Bidders. The undersigned as Bidder also agrees that for the "Base Bid" equipment and material items listed below the Bidder will provide one of the listed manufactur- ers/suppliers,by circling "A", "B", or"C". If the Bidder desires to propose an alternate manufacturer/supplier, he may write in the name of such alternate in the substitution list included within this Bid Form,but he must, nevertheless, also circle one of the listed manufacturers/suppliers. If the proposed alternate manufactur- er/supplier is determined"not equivalent" by the Engineer,the Bidder must furnish equipment and/or material items by the circled manufacturer/supplier. If the Bidder fails to indicate which listed manufacturer/supplier he intends to use if an alternate is rejected,he must use the manufacturer/supplier listed as"A".Also,lithe Bidder circled more than one listed manufacturer/supplier, he must use the first manufacturer/supplier circled(unless an alternate is approved). 11. SUBSTITUTIONS AND"OR EQUAL" The undersigned as Bidder agrees that substitutions or "or-equal" items will not be considered until after the "Effective Date of the Agreement" and will be evaluated in accordance with paragraphs 6.7.1,6.7.2,and 6.7.3 of the General Conditions. In addition to the reimbursement required under the General Conditions, the Contractor shall also reimburse the Owner for any engineering costs directly attributable to the change in manufacturers/suppliers,caused by the acceptance of proposed alternates,such as;additional field trips for the Engineer, additional redesign costs, and additional review costs, etc. Other costs directly attributable to the change in manufacturers/suppliers caused by the acceptance of proposed alternates,such as;increased electrical requirements,larger building,additional pumps or tankage,etc.,shall be borne by others and not the Owner. If Bidder intends to propose substitutions or "or-equal" items after the "Effective Date of the Agreement", it is agreed that these items will be listed on the Substitution List included within this Bid Form,with a deductive amount representing 50 percent of the total savings between the named Base Bid item and the proposed item. "Base Bid"item substitutions providing to the Owner an equipment or material cost savings of less than$1,000 will not be considered. The undersigned as Bidder, also agrees that if a substitution or"or-equal"item is not listed on the Substitution List included with the Bid, all of the savings between the named item and the proposed item will go to the Owner if the Owner accepts the proposed item in accordance with paragraphs 6.7.1., 6.7.2, and 6.7.3 of the General Conditions. The Owner may request,and the undersigned Bidder shall supply,complete information on proposed substitutions. Such information shall be the manufacturer's current published or preprinted information for the specific substitution. 12. As BIDDER, I hereby certify that I am aware and understand that the City of Ocoee at its sole discretion reserves'the right to waive technicalities or irregularities, to reject any or all Bids, and/or to accept that Bid which is in the best interest of the City. The Award of this Bid,if made,may be based on considerations other than total cost, and may be awarded based on various considerations, including but not limited to: BIDDER experience and whether the Bid,in the judgement of the City, is the most responsive to City needs. The City of Ocoee encourages the use of minorities and women-owned businesses as subcontractors. • 00300-8 DATE SUBMITTED: &..)1 'U v1 ( 11 1 a'c a V`C NAME OF BIDDER: 5/"-1 Zo4 Instructions: Strike out(X)nonapplicable signature block and complete applicable block. (ALL SIGNATORIES MUST HAVE THEIR NAMES PRINTED OR TYPED BELOW THEIR SIGNATURES) If Bidder is: SOLE PROPRIETORSHIP (SEAL) (Individual's Signature) (Individual's Name) doing business as Business Address: Phone No.: Florida License No.: A PARTNERSHIP • (SEAL) (Partnership Name) (General Partner's Signature) (General Partner's Name) Business address: Phone No.: Florida License No.: 00300-9 DATE SUBMI I'I'BD: 5 II/ 0J NAME OF BIDDER: I'S Instructions: Strike out(X)nonapplicable signature block and complete applicable block. (ALL SIGNATORIES MUST HAVE THEIR NAMES PRINTED OR TYPED BELOW THEIR SIGNATURES) If Bidder is: A CORPORATION &yu1e Coi1 In-6 (Corporation Name) late of Inc ation) By 1 )coia14< /plate 0.70 (Name of person author' - o n) • i'tle) (Authorized Signatur. (Corporate Seal) 'rlllt11 Attest PA( _.s... Ei �� (Secretary) � j Business address: 1t" t '�(S.. Ict I�^ r 1s ie. • Ov aYctn ./ R-- si (K> -- Phone No.: 401) 5J" !2 Corporation President: poi Scmuitw Florida License No.: C6C0t_/tl/! I 00300-10 DATE SUBMITTED: `/ Z U(/ NAME OF BIDDER: ractots 10 Instructions: Strike out(X)nonapplicable signature block and complete applicable block. (ALL SIGNATORIES MUST HAVE THEE NAMES PRINTED OR TYPED BELOW THEIR SIGNATURES) If Bidder is: A JOINT VENTURE By _ (Name) (Address) By (Name) (Address) Business Address: Phone No.: Florida License No.: _ (Each joint venturer must sign. The manner of signing for each individual,partnership,and corporation that is a party to the joint venture should be in the manner indicated above.) Florida License No.: 12. List the following in connection with the Surety which is providing the Bid Bond: � Surety's Name: \)ntleCt ua liv eqj Surety's Address: Name and address of Surety's resident agent for service of prmess in Florida: F' be tda goreJA-1 . S Lill knitrporofe C t. - 1A to /01 END OF SECTION 00300-11 SECTION 00301 . QUESTIONNAIRE DATE: PROJECT IDENTIFICATION: CITY OF OCOEE,FLORIDA McKey Street Improvements NAME OF BIDDER: ►V Il )( Notvacitks I I c BUSINESS ADDRESS: 6/0 Pry s - a & ) Pi' i m , - LC4 t Phone No. �� '- CONTRACTOR'S FLORIDA LICENSE NO. C..&c OLpic1 I The undersigned warrants the truth and accuracy of all statements and answers herein contained. Include additional sheets if necessary. 1. Complete the following Table regarding experience with projects similar to the work contemplated under this Construction Agreement. _:Dnte:ofClient!sNames&Addri;�5,(Include: Amount Contract Name or Project Rt,Location::. Contaet-Mine:and Pli btie_#) Contract, try) t 1 11/ • Q-(:::5"6/6/ Ifs 00301-1 D1fe.of. . Client's Name& elude. ,. Amount of Coi tv'a'ct Name of Project&Location- Contact-Name and:Ptidli&O'_•°t:' ;Contract I I I 2. Have you ever failed to complete work awarded to you? If so,where and why? - • I 1 3. Have you personally inspected the general alignments of the various utility improvements propsed under this Construction agreement? Describe any anticipated problems with the sites and your proposed solutions. _ I f‘P- 4. Will you Subcontract any part of the work involving the construction of underground utilities? If so, describe which portions. 00301-2 5. List the names and addresses of the subcontractors to be used for the portions of the contemplated work listed above. Subcontractor Certification Subcontract Name and Address of Subcontractor Registration No. &Name 1(1 00301-3 6. Disclosure (Section 00100, Article 20). Complete and attach "Sworn Statement on Public Entity Crimes" (Section 00482). 7. State the true and exact, correct, and complete name underwhich you do business. BIDDER IS: 3uexCOfl1YaLtN C flG i " PriC1W/c Pe• a&land0; F4-- /'D7 END OF SECTION 00301-4 SECTION 00301-A COMPLIANCE WITH FLORIDA TRENCH SAFETY ACT (90-96,LAWS OF FLORIDA) Bidder hereby acknowledges that all costs for complying with the Florida Trench Safety Act are included in the various items of the bid and in the Lump Sum Total Bid Price shown in Section 00300-Bid Form, "Schedule of Bid Items". For informational purposes only,the bidder is required to further identify these costs in the summary below. Trench Safety Unit of Measure Measure Unit Unit Extended (Description) (LI+,SY) (Quantity) Cost Cost A $ $ B $ $ D $ $ TOTAL $1 tie) BIDDER: A, .1',1. /A . SIGNED: 1111 NMI • BY: % L . / /l.` , (P t or type name TITLE: &flf er-- DATE: 57/. //°471°,1 TIIIS IS NOT A PAY ITEM: The purpose of this form is to gather information on the costs associated with trench safety measures and to insure that the Bidder has considered these costs and included them in the Lump Sum Total Bid price. Contractor will not receive additional payment if actual quantities differ from those estimated or if the Contractor uses a safety measure different than those listed. (Failure to Complete This Form May Result in the Bid Being Declared Non-Responsive.) END OF SECTION 00301A-1 SECTION 00480 NONCOLLUSION AFFIDAVIT STATE OF FIDC ss COUNTY OF DOM& AKandl, , being first duly swore deposes and says that: I. He(it)is the 1/ui' i' hipn a/ Nfe"._ / /�/ Owner Partner, Office, Representative or Agent) of �L�,.��/u► 1 �����4a� ,�, the Bidder that has submitted the attached Bid; 2. He is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circunatances respecting such Bid; 3. Such Bid is genuine and is not a collusive or sham Bid; 4. Neither the said Bidder nor any of its officers, partners, owners, agents, represertatives, employees, or parties in interest, including this affidavit, have in any way, colluded conspired, connived or agreed,directly or indirectly, with any other Bidder, finn or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted; or to refrains from bidding in connection with such Contract; or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or confeence with any Bidder, firm, or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix any overhead, profit, or cost elements of the Bid price or the Bid price in any other Bidder, or to secure through any f collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the proposed Contract; 5. The price or prices quoted in the attached Bid are fair and proper and . : . ainted y collusion, conspiracy, connivance, or unlawful agreement on the part . . • Bidder or an I . er of a •, representatives, owners, employees or parties in interest, including his aida '. By: I ► .+f itr Title: it if:i , JL "Ai 11 t� Sworn and subscribed to before me this /2- day of ////41 ,20 1r , in the 'tate of Ft_ of tr !/may► r County . �..., Aimee 1:oUfl in %51 1 ""' 48515 �. ;ytt Ple!,,;C mrnisstone°09 200? i !� + 0.r„� _. ;: Expires.Sel. ro Ai 441 i r i.Fdotary ' bile ��oartss pttent Bonding co,,Inc f I\ y ommission E pir,..: END OF SECTION 00480-1 SECTION 00431 CERTIFICATION OF NONSEGREGATED FACILITIES The Bidder certifies that he does not maintain or provide for his employees any segregated facilities at any ofhis establishtnents, and that he does not permit his employees to perform their services at any location, under this control, where segregated facilities are maintained. The Bidder certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location under his control where segregated facilities are maintained. The Bidder agrees that a breach of this certification will be a violation of the Equal Opportunity clause in any contract resulting from acceptance of this Bid. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eatiig areas, timeclocks, locker rooms and other storage and dressing areas,parking lots,drinking fountains,recreation or entertainment area, transportation,and housing facilities provided for employees on the basis of race, color, religion, or national oigin, because of habit, local custom, or otherwise. The Bidder agrees that(except where he has obtained identical certification from proposed subco>bractors for specific time periods) he will obtain identical certifications from proposed subcontractors pior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause, and that he will retain such certifications in his files. The nondiscriminatory guidelines as promulgated in Section 202, Executve Order 11246, and as amended by Executive Order 11375 and as amended, relative to Equal Opportunity for all persons and implememations of rules and regulations prescribed by the United States Secretary of Labor are incorporated herein. Note: The penalty formakingfalse statements in offe s is prescribed in 18 U.S.0 00 . %c . Date tI� , I �. ��� /If' l/. � Official Address By IV P �� . (including Zip Code): 111 / / ( itle) bit gPriat,'iit e . al` o ' . 441 ATTACH AND INCLUDE AS PART OF PROPOSAL FORM; FAILURE TO DO SO MAY BE CAUSE FOR DISQUALIFICATION OF YOUR BID. END OF SECTION 00481-1 1 SECTION 00482 (Page 1 of 2) SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES,ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to City ofOcoee, Florida by �t� C 1 A T ' (Pr t One& }moo /fir . whose business address is /i.�i���G pi`s 2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(8), 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 with 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, faud, theft, bribery,collusion, racketeering,conspiracy, or material representation. 3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(I)(b),Florida Statutes, means a finding of guilt or a conviction of a public entity cime,with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indict-nein or information after July 1, 1989, as a result of a jury verdict,nonjury trial,or entry of a plea of guilty or nolo co tendere. 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 isactive 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 anatfiliate. 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. 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 forthe 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, awl 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. (please indicate which statement applies). Neither 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 management of the entity, 00482-1 nor any affiliate of the entity have been charged with and cmvicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of this entity has been charged with and convicted of a public entity crime subsquent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of this entity.has been charged with and convicted of a public entity crime subsquent to July 1, 1989. However, there has been a subsequent proceeding concerning th conviction before a Hearing Officer of the State of Florida, Division of Administrative Hearings. 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 vendoi list. (Please 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 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND,THAT THIS FORM IS VALID THROUGH . 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 CHAN I THE INFORMA N 0 •INE 0 FORM. .1 i (Si nature) Date: _ ' / 600111126M1/5 tic . fi-graflO ame of Bidder(Contractorea- fJ y}‘ F1 pec et I STATE OFn • COUNTY OF Oy, ° PERSONALLY APPEARED EFORE ME, the undersigned authority, /it. ne ( °I-2:7 who, after first being sworn by me, affixed his/her signature in the place provided above on this day of nalifi-N‘ 10 ji / / drif / IP —21.`•_, Notary ' .iii �;#'%er4 Aimee Fountain '; ; Commission#DD248515 . . ''i Expires:Sep 09,2007 My Commission Expires: -74i, •.00 Bund d inn, Atlantic Bonding Co.,Inc. END OF SECTION 00482-2 • SECTION 00483 CERTIFICATION OF NONDISCRIMINATORY LABOR PRACTICES This certification relates to a construction contract proposed by the City of Ocoee. Equal Opportunity Employment: The Contractor shall not discriminate on the basis of race, color, national origin, gender, age, handicapped status, veteran status, and/or religion in performing the work governed by this contract. The City is an Equal Opportunity Employer (EOE) and as such encourages all contractors to comply with EOE regulations. Any subcontract the Contractor may enter into shall include this clause with the same degree of application being encouraged. I am the undersigned prospective constructioncontractor or subcontractor. I certify that ... (1) 1 have/ have not participated in a previous contract or subcontract subject to the Equal Opportunity Clause and (2) If I have participated in a previous contract or subcontract subject to the EqualOpportunity Clause, I have/ have not filed with the Joint Reporting Committee, the Director of the Office of Federal ;<<;;' Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirement. I understand that, if I have participated in a previous contract or subcontract subject to the Equal Opportunity Clause • and have failed to file all reports due under the applicable filing requirements, I am not eligible, and will not be eligible, to have my bid or offer considered, or to enter into the proposed contract or subcontract, unless and until I make an arrangement regarding such reports that is satisfactory to the office where the reports are required to be filed. I agree that I will obtain identical certifications from prospective lower-tier construction subcontractors when I receive bids or offers or initiate negotiations for any lowertier construction subcontracts with a price exceeding $10,000. I also agree that I will retain such certifications in my files. Date 5 By: (Signature of Authorized Officio WrOc1 wn V t Vt11MitraveDIn (Name of Prospective Construction Contractor or Subcontractor) it�t'N ( \ CSC (Address r of Prospective Construction Contractor or SSubcontractor) bilM610 € t 5 )(1 (tfert)515D- 2.1_. 59- 3 V 0 • (Telephone Number) (Employer Identification Number) END OF SECTION 00483-1 Executed in 1 Counterpart Bid#B04-07 SIC ION(9110 IIlO 0OND KNOW M t MEN BY TIICiSE PRFSENTS,that we,the undersigned, Schuller Contractors_, Inc. o+prix cipal,and_ United Fire&Casualt Company as Surety, are hereby held and firmly bound unto the City of Ocoee, Florida, as Owner in thy penal stun of live percent of the Coniract Bid Five Percent of Amount Bid— _ _ 5%. at which, well and tarty to be made, we hereby -- —s fur payment jointly and severalty bind ourselves, successor* and assigns. Signed, this 12th day of_May }p 2004 The condition of the above obligation is such that whereas the Principal has submitted to the City mf Ocoee, Florida a certain Did.attached hereto and hereby made a part hereof to enter into a contract in writing,for the City of Ocoee McKey Street Improvements. NOW THEREFORE, I. Ridder and Surety, jointly and severally. hind themselves, their heirs, executors, administrators, suceesanrs and assigns to pay to Owner upon default of Bidder any difference between the total amount of Kidder's hid and the total amount of the hid of the next lowest, responsible and responsive bidder as determined by Owner fur the Work required by the Contract Document*,provided that; 1.1. If there is u such next lowest,responsible and responsive bidder, and Owner aloes not abandon OW Project,then Bidder and Surety shall pay tu Owner the penal sum set forth on the face of this Bond,and 1.2. In tin event shall Kidder's and Surety's obligation hereunder exceed the penal sum six forth on the face of this Bond. 2. Default of Bidder shall occur upon the failure at'Ridder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Amendment to the Agreement required by the Ridding Documents and any performance and payment bonds required by the Bidding Documents and Contract Documents. 3, This obligation shall be null and void if: 3.1. Owner accepts Bidder's hid and Bidder delivers within the time required by the Bidding Document*(or any extension thereof agreed to in writing by Owner)the executed Amendment to the Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents:and Contract Documents,or 3.2. All bids are rejected by Owner,or 3.3. Owner fails to Issue a Notice of Intent to Award to Bidder within ninety(90)days from die time and date fixed for the opening of Diads(or any extension thereof agreed to in writing by Bidder and,if applicable,consented to by Surety when required by paragraph 5 hereof). 4, Payment under this Flood will be due and payable upon default by bidder and within thirty(30)calendar days ager receipt by Bidder and Surety of written notice of default from Owner, which notice will be given with reasonable promptness,identifying this Baud and the Project and Including a statement of the amount due. 004 h0•i 5. Surety waives notice of any anti all defenses based on or nrishtg out of any time extension to issue notice of award agreed to in writing by Owner and Bidder, provided that the total time for Issuing notice of award including extensions .shalt not in the aggregate exceed 120 days front Bid Dice Date without Surety's written consent. No suit or action shall be commenced mule; this botal prior to 30 calendar days atter the notice of default required in paragraph 4 above is received by Bidder nod Surety and in no case later than one year after Bid Ouc Date. 7 Any suit or action under this Bond shad be commenced only hi a court or competent jurisdiction located in the mac in which the Project is located. It. Notices required hereunder shall be in writing and sent to Bidder and Surety at their respective addresses shown on the face of this Bond. Such notices may be sent by personal delivery, commercial courier or by United Stales Registered or Certified Mail, return receipt requested. postage prepaid. and shall be deemed to be effective upon receipt by the party concerned. 9. Surety shall cause to be attached to this liond. :t current and effective Power of Attorney evidencing the authority,of the officer, agent or representative who executed this Bond on behalf of Surety to execute, seal and deliver such Bond and bind the Surety thereby. 10. This Bond is intended to conform to all applicable statutory requirements. Any applicable requirement of any applicable statute that has been omitted Not this Bond Shall be deemed to be included herein as if set forth at length. If any provision of this Bund cuntliets with any applicable provision of any applicable statute, then the provision of said statute shall govern and the remainder of this Bond that is not in conflict therewith shall continue in full force mid effect. l t. 11tc tens"bid"as used herein includes n bid,offer or proposal as applicable. IN WITNESS WHBRBOP, the Principal and the Surety have hereunto set their hands and seals,and such of them as are corporations have caused their corporate seals to be hereto affixed and theso presents to be signed by their proper officers,the dAy and year first set forth above. 00410-2 • L 1.111)DER: tau out (X) nun- upplicuble sigouture block and complete applienbIe block. All signatures UM have their norms printed or!Heti below their signature. 11 Bidder is S01.11 PROPRIEIVrOltSHIP,complete this Signature block XXXXXXXXXXXXXXX (I) XXXX ..._....__ __. .—.... ._ .. . . ..—.......—._..–____. ..... orsrlivihal's Signotere) (Winless; Cl) __, ?<XX )(XXXXXXXX)KX on-7th,kliiiiii Ni7Ene)---- (Witnce4) Fining business 33 --___..---....-----... MAO (Bounced Address) -----. . ,.. __ — (Telephone No.) (Florida License Nn.) If IlIddet IA PARTNERSHIP,complete!!file 01111411110 block. l' (I), . . )000000p000( (Psrinerohip Niime) .._ — mules') .,.. .._._ _ ... (2) ..&MSN9c2 )0005.XXXXXXXXXX2cX (General Pial;r3Sisnoure) (Mows) tricetrat Palletel HMO _ --..--.....— (SI1AL) (13ustoese Afton) l_____) • (Telephone Ni,.) (Floritlo Limes No.) 00410-3 I(Lildder ti 3(;ORPORAi ION,Complctr.Iii is eigioture htnck. Arrrsr: y."'"") Schuller Contractors Inc., • (C rpo;aoNome) - I_ i . ,Ifi (C• * . eeeury,Sryu;Nn:) - , Florida / , (SLOG of hswrporatka) T II I , (Corporate Secretary Name) Dyc Nuup(r rrl aahoriate)ActAnCia?...- Num 4-0..ii -tea sac /01..df 1 , f ft-- v In.1 iff � � �P 'Rr.ri:ed •S ,Mr` •. • (CORPORATE SCAB) lII ( . /C.l . ..� (C, poralian Pretkkrle) 8046-A President's Drive, __ Orlando, Florida 32809 (Duitnaa Adam.) • i (407 855-5572 (Ccleptsoue Ni,). (Florida Lkcnsa Nn.) 1iO4IO'l Stlk 2'l'Yt WI't•NI:Sti: (1f ARciu is cwt t Corvmoiun) "'— United Fire&Casualty Company__..._....... ti) (5urtty Uusines Num) �Winea)118 Second Avenue SE (2) • (Witnese) Cedar Rapids,IA 52401 (Prineipsi Piwas of Bus/nett) ATTEST; (If A eat is it Corporation) (Surety Allen's Slgnsture-Set Note 2) Deborah Mahi (407)786-777Q - (Surety Ageni'e Nem) — 7 (Curputew Secretary Signature) Attorney in Fact&FL Licensed Resident Agent _ Susan L.Reich Amines(surety Title) (Corporal*Secretary Name) Florida Surety Bonds,Inc. (Elusbxss Nemo of Loci%Arent foe Surely) 417 CenterPointe Circle,Suite#1701 (CORPORATE SEAL) Altamonte Springs, Florida 32701 (buainrss Address of WA Arent) (311) 388-5700(Surety) E051208(Debbie (Tetephone Na.) (IftorWe Demo No.) rrort;s: (t) Complete and attach "Corporate Authority to Execute Documents"if executed by any corporate employee other thon president or vice•president. (2) Complete and attach a certified copy of"Power•of-Attorney"prepared by Surety appointment individual "Attorney-in-Pact" for execution or OW Bond on behalf of Surety and corresponding notarized "Attorney it-Fact", (3) Above addresses are to be used for giving required notice. (4) Any singular reference to Bidder, Surety, Owner or other patty shall be considered plural where applicable, (5) Surety companies executing bonds must appear ou the Treasury Depar'tment's moat current list(Circular 370 as amended)mud he uuthorized to transact buatitesa in the orate where tint project is located. 004I0.5 ATTORNEY-IN-FACT AFFIDAVIT STATE OR COMMONWEALTH OF FLORIDA ss COUNTY OR CITY OF ALTAMONTE SPRINGS B bore me,a Notary Public,personalty earns Deborah Mahl known to me,and known to be the Attorney-in-Fact of United Fire&Casualty Company ,a (Surety Company) Iowa Corporation,which executed the attached bond u surety,who deposed and said that hts (State) signature and the corporate seal of said United Fire&Casualty Company were affixed by (Surety Corrpaoy) order end authority of said Company's Board of Directors,and that the execution of the attached bond is the free act and deed of United Fire&Casualty Company (Surety Company) Given under my hand and seal this 12th day of. May ,20 04 (Notary Public) Teresa L.Robinson My Co>rrrtisston Expires: 2/22/07 TERESA L ROBINSON Notary Public, State of Florida MY comm. exp. Feb, 22,2007 END OF SECTION Comm. Nn. DD 182403 00410-7 • • UNITED FIRE&CASUALTY COMPANY ' HOME OFFICE-CEDAR RAPIDS,IOWA CERTIFIED COPY OF POWER OF ATTORNEY ' (Original on file at Home°Office of Company-See Certification):•_: : ' . • KNOW ALLMEN::BY:THESEPRESENTS, That the UNITED FIRE;&CASUALTY COMPANY, a corporation duly organized arid existing - .. under the laws:ofthe State of Iowa, and having its principal Offce iirt Cedar Rapids, State of Iowa,does snake;constitute and:appoint •;.: LESLIE K. DONAHUE, OR KIM:E. NIV. -OR JEFFREY:W. RE C13., OR SUSAN L. •REICH, OR.'.TERESA L. .ROBINSON,. ,OR: PATRICIA L.'SLAUGHTER, OR J. GREGORY:MACKENZIE, OR°DEBORAH MARL, OR WALTER N. 'MlfERSM-ALL • ' INDIVIDUALLY of ALTAMONTE SPRINGS FL . •• . - . . • •its true and lawful Attomey(s)-in-Fact with powerand.authority hereby conferred to sign, seal and.execute in its.behalf all lawful bonds, undertakings and other obligatory instruments of similar nature as.follows: Any and All Bonds: and to bind UNITED FIRE&CASUALTY COMPANY:thereby es fully and to the same extent as'if such instruments were signed by the.• • duly authorized officers of UNITED FIRE&CASUALTY COMPANY and ail the acts of said:Attorney,pursuant to the authority hereby given are hereby ratified and confirmed. - _ The Authority hereby granted is continuous and shall remain in full force and effect until revoked by UNITED FIRE& : •• CASUALTY COMPANY. . .= • • This power of,�Attorney is made and.executed pursuant to end by authority of the following ..By-Law dulyadopted.by:Board of`.-: Directorsiof heCompany:on April 18, 1873. ' ' . : . "Article V.-Surety Bonds and Undertakings Section 2,Appointment of Attorney-in-Fact: 'The President or any Vice President, or any other.officer of the Companymay;, :- from time to time appoint by written certificates attorneys-in-fact to act in behalf of the Companyin.the executionof policies of :- . . insurance, bonds,undertakings and:Other obligatory instruments of like nature. The signature of any°officerauthOriZed`hereby.� and the Corporate seal, may be affixed facsimile to any power of attorney-or special power of attorney orcertifcation*of • either.authorized hereby;such signature-and seal;.when=so•used,:being:adopted by the Company as the original signature:of_ such_officer'and the original seal of the.company;tp;be valid and binding.upoB the Companywith''the same force arid.effectas.'.. though manually affixed. Such attorneys-in fact;.subject to_the:limitations:set:forth in their`respective certificates of authority •:: shall•have full power to bind the Company=by theirsignature and execution=of-any such instruments.and to attach theseal of • - the C Mpanythereto: The President_or.any Vice resident;the Board of Directors or any other Officerof the Company:may at.` .;'; any time:revoke all power and authority previously_given id any attorney-in-fact: ' • . IN WITNESS WHEREOF,:the•UNITEp IRE&&CASUALTY COMPANY has caused these presents-to be'signed'by ' its vice president and its corporate seal,to be he_retoaffixed this 5th.-day_ of March, 2003 • - - ) ::: . • - - 2-7: '-- - ...r,... - • --- -: UNITED FIRE&CASUALTY COMPANY • _ - = B Vice President. State of Iawa,,County of Linn, ss: -- --- i On 5th day of March, 2003, before me personally _ele.Randy A. Ram1d to me known,who being by me duly sworn, did depose;and say;,that he resides in CedarRapids, State of Iowa;that he is a Vice- •-• - President of the UNITED FIRE&CASUALTY COMPANY,'the corporation described in and-which executed the above instrument;that he knows.the.seal of said corporation;that the seal affixed to the said instrument is such corporateseal;thatit was soaffixed pursuant . : . to authority given by the Board of Directors of said corporation and that he signed•his.name thereto pursuant to like authitir. , and.; : :' acknowledges'.same.to be the act and deed of-:said`corporation. - _ - -- ti *��,. .. ° r . Notary PtttrtlC .* .� MARY A.JANSEN My commissio exp1 $: 10/26/2004 i , cow/I' -nN NUMBER 7132731 '' ._- - MYC�- ' 'S IRE$, , I,the undersigned:officer of the UNITED.FIRE&CASUALTY..COMPANY, do hereby certify.that I have compared the foregoing.copy of: .; the Power of Attorney and affidavit, and the copy of the Section of the by-laws of saidCompany'as set forth in said Power ofAttorney, • with the ORIGINALS-ON FILE IN THE HOME OFFICE•OF.SAID COMPANY,'and that the same are correct transcripts thereof,a'nd°of the whole ofthe_Saki originals, and that the.said'.Power of Attorney has not been revoked_and is now infull force and effect.' •:- ;'...: In testimonywhereof I have hereunto subscribed my name and affixed the corporate seal of the said Company. 12t - this_ dayof .. May, . 20 04 CO3►01lR1 i re 52441-. . `.:_ _ -,.•,,. :,:•••. , /e:1-"' . ....;': Secretary UND32$6$::. Schuller , Contractors Incorporated DRUG-FREE WORKPLACE FORM The undersigned vendor, in accordance with Florida Statute 287.087 hereby certifies Schuller Contractors Incorporated does: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing,possession, or use of a controlled substance is prohibited in the workplace specifying the actions that will be taken against employee for violations of such prohibition. 2. Informs employees about the dangers if drug abuse in the workplace, the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, employee assistance programs and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in Paragraph 1. 4. In the statement specified in Paragraph 1,notifies the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of,or plea of guilty or nolo contendere to, any violation of Chapter 893 or of any controlled substance law of the United States or any state,for a violation occurring in the workplace no later than five(5) days such conviction. 5. Imposes a sanction on,or requires the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, by any employee who is so convicted. 6. Makes a good faith effort to continue to maintain a drug-free workplace through implementation of Paragraphs 1 thru 5. As the person authorized to '. •. statement, ertify that •. irm complies fully with above requirements. 41. Auth7 ze.\':•.7re I ' 1Ala ate 8046A Presidents Drive,Orlando,Florida 32809 407/855-5572 407/855-4922 ONE-r1ATlON INDNTSiBLE ti-Writtlit ,: : ,.... - ' ----- . ,-, elettioxer .tk---1 0 ,:., 0 ,-, •:- Contracum Ineerperated SCHULLER CONTRACTORS INCORPORATED PROJECT REFERENCES 1. Project Name: Three Year Term Contract Concrete Sidewalks Project No. Y1-144 Start Date: April 30, 2001 Owner: Orange County Government Contact: Mike Wehrfritz, Engineer II Address: 400 E. South Street, 2nd floor Orlando, FL 32802 Telephone: 407/836-7884 Original Contract: $630,575.00 Change Orders: 0 Final Contract: Ongoing Completed on Schedule: n/a Date: Ongoing Project Description: Clearing Grubbing, sub grade preparation,construction of concrete forms,reinforcing steel placement,installation of concrete sidewalks, curbs and driveways. 2. Project Name: Lake Conway Project No. Y1-743 Start Date: July 9,2001 Owner: Orange County,Environmental Protection Division Contact: Ron Novy, Sr Environmental Specialist Address: 800 Mercy Drive, Suite 4 Orlando, FL 32808 Telephone: 407/836-1409 Original Contract: $336,446.00 Change Orders: $268,554.00 Final Contract: $605,000.00 Completed on Schedule: Yes Date: March 4,2002 Project Description: Perform hydraulic and mechanic dredging to canals. Clean and remove muck from canals located in and around Lake Conway, Little Lake Conway and Lake Gatlin. Schuller Contractors Incorporated-Project References 1 e.% .',I ,A licRialler n. 0 3. Project Name: Construction of Moss Park Infrastructure, Project No. Y9-785 Start Date: November 14,2000 Owner: Orange County Government,Department of Capital Projects Contact: Dave Wing Address: 400 E. South Street, 5th Floor Orlando, FL 32802 Telephone: 407/836-0050 Original Contract: $825,000.00 Change Orders: $14,730.36 Final Contract: $839,730.36 Completed on Schedule: Yes Date: 2/28/02 Project Description: Installation of water, sewer, storm water,and electric at Moss Park Recreational Center. Includes construction of roadway and fifty campsites with water, sewer and electric. 4. Project Name: LaCosta Ditch Closure Project No. 2371 Start Date: October 15, 2001 Owner: City of Orlando t Contact: Silke Smith Address: 400 South Orange Avenue Orlando, FL 32802 Telephone: 407/246-3264 Original Contract: $358,925.00 Change Orders: $5,439.15 Final Contract: $364,364.15 Completed on Schedule: Yes Date: January 5,2002 Project Description: 1200 Lineal Feet of 72"/ 84"Stormwater. 65,000 CY fill dirt. Refurbish the surrounding area(grassing). Project Description: Construction of 800 lineal meters of four lane divided asphaltic concrete. Construct 6120 lineal feet of 36"DIP and directional drill of 600 lineal feet of 36"HDPE. Construct 3000 lineal feet on 5"to 42"RCP Stormwater, including inlets and manhole structures. Demolition of useless water pipe. Schutter Contractors Incorporated-Project References 2 ,\,:-',.:3k :''.. tiabuirtt 0 L': Li (2, Contractors Istoorrsrated 5. Project Name: Primary Drainage Structure Maintenance Program, Project No. YO-717 Start Date: February 15, 2000 Owner: Orange County Government Contact: Mike Wehrfritz, Engineer II Address: 4200 S. John Young Parkway Orlando, FL 32839 Telephone: 407/836-7880 Original Contract: $600,000.00 Change Orders: $134,000.00 Final Contract: $734,000.00 Completed on Schedule: Yes Date: November 15, 2000 Project Description: Correct deterioration of Structures needed for drainage. 6. Project Name: Clarcona-Ocoee Road Water Main and Force Main Extension, Project No. Y9-776 Start Date: January 3,2000 Orange County Government Contact: Charlyn Watts,Chief Utilities Inspector Address: 109 E. Church Street, Suite 300 Orlando,FL 32801 Telephone: 352/383-8706 Original Contract: $652,574.00 Change Orders: ($6,721.35) Final Contract: $645,852.65 Completed on Schedule: Yes Date: August 15, 2000 Project Description: Construction of 6,500 lineal feet of 12"PVC Water Main and 6,500 lineal feet of 16" DIP Force Main. 100' Jack and Bore. Schuller Contractors Incorporated-Project References ® Ceatractoris Incearpented 7. Project Name: Clear Lake Retrofit, Phase I Project No. Y9-730 Start Date: March 24, 1999 Owner: Orange County Government Public Works Division,Highway Construction Department Contact: Mr. Steve Stokes,Inspector H Address: 4200 John Young Parkway Orlando,FL 32802-1393 Telephone: 407/810-6209 Original Contract: $728,000.00 Change Orders: ($20,000.00) Final Contract: $708,000.00 Completed on Schedule: Yes Date: August 24, 1999 Project Description: Construct 2 Retention Ponds Including, structures,pipe and restoration of sod and sidewalk. 8. Project Name: Term Contract for Underdrains Project No. Y2-1105 Start Date: August 29,2002 Owner: Orange County Government Public Works Division, Highway Construction Department Contact: Mr. Mike Baker, Engineer II Address: 4200 John Young Parkway Orlando, FL 32802-1393 Telephone: 407/836-7936 Original Contract: $2,216,000.00 Change Orders: ($457,450.00) Final Contract: $2,673,450.00 Completed on Schedule: n/a Date: Ongoing Project Description: Construct and install under drain Piping,Remove and Replace Concrete Driveways,and Sidewalk, Remove and Replace Sprinklers in various locations. Schuller Contractors Incorporated-Project References 4 +l♦Z+!a�'-_ V' JkC.V'r.;eNv1V It-YvirJlvY-YUk.9�j+�1Vk-�`�/l ill�l,'ri�1�,�tiVL�1viU`i IG�SVk-yUllvk=Sl�j�.�•.tiU%.YUkYvG�alvI-al r✓•`�r'd,, s ` C4nt 4-�Q� Oc'ObOO�%UC>0OOOG>OO\OOOVc $;.Pf 14- tl r,r Wiwt`a r safilRva!sr e R w N-41vin4(rlhfli w\ /71,Ne ,fiat,INATA-4l•V eLrlr-41.s-A•iv i.1%anN-4.NaCrl r Wi.NA IF 0 f fr ;) 410; * q te . • 10p f _ 1 kl fsis....) ta ... ,,,__, ____ ...; ....... 4,i b I" „...,,0;_ ,..,..,,, ,.• • .40 , nr Al: , conwc s+ s- X Ar '...)t. Deportment of Otate4,,,,.„, It D-3 a , -'1 I certify from the records of this office that SCHULLER CONTRACTORS INCORPORATED is a corporation organized under the laws of the State of Q8, t Florida, filed on June 8, 1998. f'01 u.aC.1 •OA s The document number of this corporation is P98000052167. .;‘. I further certify that said corporation has paid all fees due this office through "' December 31, 2004, that its most recent annual report/uniform business report 0, was filed on January 6, 2004, and its status is active. ;wedI further certify that said corporation has not filed Articles of Dissolution. z • .- ,{g1 Eri RA PO :4_,A.00 r Given under my hand and the ;'OLA ' Great Seal of the State of Florida ' at Tallahassee, the Capitol, this the y ®v �� . Sixth day of January, 2004 1 `e. RIC 4; 8� ` • t,,,,ziti ii ;�,E011,, > �.a',,��i�„!: � . . J^ ;mak, , .4,-- .-4:;::,:.,,7:- . . 4 (Rental`f_Anoh 1q"'M 6Fa CR2E022 (2-03) c,. e.c etMrg1 rtfAute 4.1'4 P>'gb !Q1. �.w�i�._t...�. /�vmwey U�k�4,,,,Iwy r r� V ek-v tti y�[sp., -rye ,,,�t 4 e,� S r kv v uy T Ysi r�� .,v , 7 ii,er 3 I•�ac� A -.r✓ w (=>. 1�'r•�� N M•r�•I !41•��.N-y* �,�` ���/��V 9 R1� ,�rV1111* �*� 6.,„(: ),,,C),%.4� �aW •. f R NRi.,�-4n�Wn�'in r rtn �, � R,n\r. n W145\ 'nh1 f WIOW( n R1l - ,, 44442003*** EXPIRES ORANGE COUNTY OCCUPATIONAL UCENSE 1801-000684 ORIGINAL 09/30/2004 Earl K.Wood,TAXCOLLECTOR ORANGE COUNTY,FLORIDA THIS LICENSE 13 NN ADDITION TO AND NOT IN LIEU OF ANY OTHER LICENSE REQUIRED BY LAW OR MUNICIPAL ORDINANCE.IT IB SUSJECTTO REGULATION OF ZONING,HEALTH ANO ANY OTHER LA 1FUL AUTHOR1rY.IT Is VAUD FROM OCTOBER 1 THROUGH SEFTEMSEIT 80 OF LICENSE YEAR.DELINQUENT PENALTY 18 ADDED OCTOBER 1. 1801 GENERAL CONTRACTOR ,..3,4-.:00,:-•:-.7z:-.. 8 WORKERS //042.t" .. TOTAL TAX 30.00 /j (J • Y, .ti LLER, C FRACTORS ': TOTAL PAID 30.00- NCa POR TE TOTAL DUE .00 1 , SCRU LER TI OTHY A s. \ l at'L NDOP L/ 2809-764 7 '�:` : ' 8046 PRESIDENTS DR ' --.•:-- ', U - ORLANDO ~� i�?`��1t�': ;'%/ -�..� SCHULLER TZ IOTHY A • PAID: 30.00 99-184944 8/18/2003 THIS FORM.BECOMES A RECEIPT WHEN VALIDATED!WPM TAX COLLECTOR. 1 }t DZP�OP EU8I80S8 AND PROVESSICOML ISIOULATION • * • . LIC2I081310 30118D (850) 487-1395 1 ao4o ��� aarm+o1 es�ssr ?ALL11BA88Sli FL 33399-0763 • BCRDLL118, TtMiD1'a3' A • SQ4 APS PL 32809 1 • WARMFORAMMA A01046445D or =mow MD Illt0F1282011111. 11,1101M220111 { 090036261 06/37/02' 0 149713 j aslmeatiSCIWIZIeRas RAC' .ca ' =RPMA zsoo ampoiume • • • I ` illadriltimadates sso 31, 2004 ea4 FinaOsaiusaF • { • . . • HERE DETACH. \E I • c10469450 • - . STATE FLORID/11i • • DEPARTIMENT OF BIIIMIESS AND PBOFita� ""mar' ''" MON sEA61oa.sai. C41NSTRUCTION LS_S,Ia 3Q1349 iliTarte mirk 8a/z7/2ttns n1ua87i2 ,aereib2ai Th. dao— *L ooll'raat.x & Mord b.lon Is Cl rrtPzuD Nadas tbe provisions of Cl Ater 489 P8. 1 scpirstion data: A O 31, 2000 8046 & P'r: _.4., .: ORLUIDO 32809 1 Min1 XIX fizatuar-srate DISPLAY AS REQUIRED BY LAW SISOISTART