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HomeMy WebLinkAboutItem 08 Consideration to Award Bid #B05-10, Replacement of Community Center Air Conditioning System center of Good Lw /f ) AGENDA ITEM COVER SHEET Meeting Date: 7/05/05 Item # 8 Reviewed By: Contact Name: Joyce Tolbert Department Director: ,,wile/ .4.r -ft Contact Number: 1516 City Manager: //�� , Subject: Award of Bid #B05-10 Replacement of Community Center Air Conditioning System Background Summary: The scope of work includes removal of the existing three (3) 7.5-ton units and appurtenances, and installation of three (3) new 7.5 ton Trane or equal units and appurtenances. The budget includes $30,000 for this project. Issue: Award the bid for the Replacement of the Community Center Air Conditioning System to Apple Air Conditioning & Heating, Inc. Recommendations Staff recommends that the City Commission award Bid#B05-10 to Apple Air Conditioning & Heating, Inc. in the amount of $24,630.00; and authorize Staff to issue a purchase order once the required insurance coverage has been obtained from the Contractor. Attachments: 1. Apple Air Bid 2. Econo Air Bid 3. Perkins Bid 4. Air Ideal Bid 5. Tobo Bid 6. Invitation to Bid #B05-10/Specifications 7. Bid Tabulation 8. Recommendation memo Financial Impact: Project cost $24,630, budgeted $30,000 Type of Item: ❑ Public Hearing For Clerk's Dept Use: ❑ Ordinance First Reading ❑ Consent Agenda ❑ Ordinance First Reading ❑ Public Hearing ❑ Resolution El Regular Agenda ® Commission Approval O Discussion& Direction ❑ Original Document/Contract Attached for Execution by City Clerk ❑ Original Document/Contract Held by Department for Execution Reviewed by City AttorneyElN/A Reviewed by Finance Dept. 1147) %/ ' ❑ N/A Reviewed by ( ) ❑ N/A Mayor ecenter of Good Commissioners S. Scott Vandergriftry. g Danny Howell, District 1 Scott Anderson, District 2 City Manager :, ' Rusty Johnson, District 3 Robert Frank !' � "'� Nancy J. Parker, District 4 STAFF REPORT TO: The Honorable Mayor and City Commissioners FROM: Joyce Tolbert, Purchasing Agent DATE: June 27, 2005 RE: Award of Bid #B05-10 Replacement of Community Center Air Conditioning System ISSUE Award the bid for the Replacement of the Community Center Air Conditioning System to Apple Air Conditioning & Heating, Inc. BACKGROUND/DISCUSSION The scope of work includes removal of the existing three (3) 7.5-ton units and appurtenances, and installation of three (3) new 7.5 ton Trane or equal units and appurtenances. The budget includes $30,000 for this project. The bid was publicly advertised on May 15, 2005 and opened on June 15, 2005. There were five (5) responses to this bid: Annual 1. Apple Air Conditioning & Heating, Inc. $24,630.00 2. Econo-Air Corp. $34,974.00 3. Perkins Mechanical, Inc. $36,400.00 4. Air Ideal, Inc. $43,434.00 5. Tobo Development & Construction, Inc. $49,987.56 Attached is a copy of the specifications for this project, and the bids from each bidder, along with the bid tabulation. All bids are available in the Finance Department for review. The Public Works Department and Finance Department have reviewed all bids. Staff recommends awarding the bid to Apple Air Conditioning & Heating, Inc. as the most responsive and responsible bidder, per the attached memorandum from Bob Zaitooni, Public Works Director. e Center of Good Liv Mayor Commissioners S. Scott Vandergrift a Danny Howell, District 1 Scott Anderson, District 2 City Manager Rusty Johnson, District 3 Robert Frank - Nancy J. Parker, District 4 MEMORANDUM TO: Joyce Tolbert, Finance FROM: Bob Zaitooni,Public Works 0111V DATE: June 22,2005 RE: Recommendation for Award—Bid#B05-10 Replacement of Community Center AC System Public Works reviewed bids from the following bidders: Company Bid Amount Delivery Time Apple A/C &Heat, Inc. $24,630.00 7 days Econo-Air Corp. $34,974.00 60 days Perkins Mechanical, Inc. $36,400.00 14 days Air Ideal, Inc. $43,434.00 30 days Tobo Development& Construction Inc. $49,987.56 15 days Based on our evaluation, we recommend award of the bid to the following most responsive bidder: Apple A/C & Heath, Inc. If you have any questions or require additional information, please contact me at extension 6002. Cc: Terry Reed, Facilities Supervisor The City of Ocoee Public Works•301 Maguire Road•Ocoee,Florida 34761 phone:(407)905-3170•fax: (407)905-3176•www.ci.ocoee.fl.us r z u) rn 73 v " oo n v -I 00 n 0 c .0 <D CD a 3 3 3 -o. 3.o co n z m r WI m tor 9° 'g 73 _+ 3 x cn CO N N m c ,. 3 O' 03 = v d � �4 s ,q,',.71)*. a -1. 73 .c .c •c ..c •c 'p N 9) N CD CD N W A " rp. m Min '..,,'•,,„›.Ir C1 O D A- o �.� 0 °. . m k- 3 m .< ? 0 Z W 1p' 0 N Vii !A N N CD cr) to A .t;T. y 0 CD 8, T. m on O ,,'4 O n . cru ,; 3 v CD co i11 co 0 co co com cp CD CD UI '.,.:..0!: m cmO C 0• A* On * r Nmw > m m L O 3 coo m m m `•< •= rn w 00,3 3 y O T co N Ul fn U) fn `GO ,�P}Q O -' CD •o n i 0X Z v 03 ,.:",,,i,w � _ � = W w w e� Z U) ) = o = O fU) N O 0 ..:0,.: E:,. cm O apt CI) m ,,;fit ,:, v,.,7,,',- K sy"�r ar, q" N ' .fp CITY OF OCOEE INVITATION TO BID #B05-10 ' REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM BID FORM Please note that the above specifications are intended as minimum and preferred guidelines. Please submit a bid on only one (1) type of system that best meets the specifications. ITOTAL LUMP SUM BID $ Q? ?, C 3 D. D V Tw.,k,, I--TA dollars and t. cents I Delivery Time: 17 calendar days after receipt of City Purchase Order. A PP(e R/c & kcc:6 ;, Company Name �' RIC r l Or . Authorizes Officer(print) edr11.11 Authorizeddor ao e 6://S/0 6 Dat B05-10 21 CITY OF OCOEE INVITATION TO BID #B05-10 REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM BID FORM Please note that the above specifications are intended as minimum and preferred guidelines. Please submit a bid on only one (1) type of system that best meets the specifications. TOTAL LUMP SUM BID $ . JR' ' h A ., _��.�l 1 ,, ' dol ars and cents Delivery Time: ‘C) calendar days after receipt of City Purchase Order. ECO/l) ©—A( CcycO . Company Name 1Q CPC`)4544A- J Authorized Officer(print) # 4., • i'o ed Signature Date B05-10 21 CITY OF OCOEE INVITATION TO BID#BO5-10 REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM BID FORM Please note that the above specifications are intended as minimum and preferred guidelines. Please submit a bid on only one(1)type of system that best meets the specifications. TOTAL LUMP SUM BID $ 3 6, 41i-00 • 00 1."4-717 -s'Jr it. tAsa..o/ /1 dollars and cents Delivery Time: /if calendar days after receipt of City Purchase Order. ie ;vs /'c//tea et ,G,9/ 1 ti c. Company Name A-.4. DYE =,2k.�r Authorized Officer(print) Authorized afore I 6 - Is - OS" Date B05-10 21 1 CITY OF OCOEE INVITATION TO BID#B05-10 REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM BID FORM Please note that the above specifications are intended as minimum and preferred guidelines. Please submit a bid on only one(I)type of system that best meets the specifications. TOTAL LUMP SUM BID $ 4-3, +34 t�Q-T•4 Tf->sA-.-S47 F-DvCZ "`.rp U 94-1 rw(Z dollars and K1c cents Delivery Time: 3 0 calendar days after receipt of City Purchase Order. k LR 1 t r►c Company Name 1`'t .r CAA 4 Mk - R-A-%J-r Authorized Officer(print) A--4, 0,—tAuthorized Signature (Db 1. l �S Date B05-10 21 CITY OF OCOEE INVITATION TO BID #B05-10 REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM BID FORM Please note that the above specifications are intended as minimum and preferred guidelines. Please submit a bid on only one(1) type of system that best meets the specifications. TOTAL LUMP SUM BID $ �1 I y T - Lc-6 G t rvtan,o�� ,I4tb11ars and " cents Delivery Time: t ' calendar days after receipt of City Purchase Order. DupAq1 / rr 4 (0(1 'iaJ' 0^ 'N Company Name ) J� ,) r„ ) e Authorized Officer(print) <-4 0( • Authorized Signature 6 - 6) 5 Date B05-10 21 da CeiAter of Good Liv Mayor Commissioners S. Scott Vandergrift t Danny Howell, District 1 ea Scott Anderson, District 2 City Manager ,, Rusty Johnson, District 3 Robert Frank � ,. Nancy J. Parker, District 4 - .) 1111 CITY OF OCOEE INVITATION TO BID #B05-10 REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM • a a w a It a di City of Ocoee• 150 N Lakeshore Drive • Ocoee,Florida 34761 a phone: (407)905-3100 • fax: (407)656-8504 • www.ci.ocoee.fl.us w h • BID DOCUMENTS ' 3 Legal Advertisement 4 thru 6 Invitation to Bid#B05-10 7 thru 16 General Terms & Conditions 17 Subcontractors/Equipment Listing 18 References/Summary of Litigation ge SCOPE OF WORK/BID FORM 19 thru 20 Scope of Work/Special Conditions 21 Bid Form 22 Company Information/Signature Sheet a a a di END OF TABLE OF CONTENTS a a ril7i B05-10 2 Tit LEGAL ADVERTISEMENT CITY OF OCOEE Bid #B05-10 "a' REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM • Ocoee City Commission a Sealed bids will be accepted for Bid #B05-10, REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM, no later than 2:00 PM, local time, on June 15, 2005. Bids received after that time will not be accepted or considered. No exceptions will be made. The City reserves the right to reject any and all bids and waive informalities. a The City of Ocoee, Florida, in conformance with the policies and procedures of the City of Ocoee (City) is soliciting bids for the material, equipment, labor, and permits for the replacement of the Community Center Air Conditioning System. Project includes removal of the existing a three (3) 7.5 ton units and appurtenances, and installation of three (3) new 7.5 ton Trane or Equal units and appurtenances. a There will not be Pre-Bid Conference for this bid. Any questions or concerns regarding this bid must be received no later than June 8, 2005. a A Bid Security in the amount of 5% of the bid price must accompany each bid. The successful bidder will not be required to furnish performance and payment bonds for this di project. All bids shall be submitted as one (1) original and two (2) copies of the required submittals, in a sealed envelope plainly marked on the outside with the appropriate bid number and opening date and time. Bids will be received in the City of Ocoee, Attn: Purchasing Agent, 150 N. Lakeshore Drive, Ocoee, Florida 34761-2258. Bids will be publicly opened and read aloud in the City Hall Conference Room on the above-appointed date at 2:01 PM, local time, or as soon thereafter as possible. Interested firms may secure a copy of the bid documents through Demandstar by accessing the City's website at www.ci.ocoee.fl.us under Finance/Purchasing, or copies are available from the Purchasing Agent for a non-refundable reproduction and/or administrative fee of $20.00. Checks should be made payable to the City of Ocoee. Copies via e-mail are not available and partial sets of bid documents will not be issued. No fax or electronic submissions will be accepted. City Clerk May 15, 2005 do I B05-10 3 CITY OF OCOEE INVITATION TO BID #B05-10 REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM INTENT: Sealed bids for Bid #B05-10 will be received by the City of Ocoee, hereinafter called "The City", by any person, firm, corporation or agency submitting a bid for the work proposed, hereinafter called"Respondent". a The proposed Contract will be for the labor, supervision, materials, equipment, supplies and incidentals for the Replacement of the Community Center Air Conditioning System for the City of Ocoee as listed under the "Scope of Work/Bid Form" section of this Invitation to Bid. BIDDING INSTRUCTIONS: A. Each respondent shall furnish the information required on the bid form supplied and each accompanying sheet thereof on which an entry is made. Bids submitted on any other format shall be disqualified. Please check your prices before submission of bid as no changes will do be allowed after bid opening. Bids must be typewritten or handwritten using ink. Do not use pencil. No erasures permitted. Mistakes may be crossed out and the correction typed adjacent and must be initialed and dated by person signing the bid. Bid documents must be signed by a legally responsible representative, officer, or employee and should be properly witnessed and attested. All bids should also include the name and business address of any person, firm or corporation interested in the bid either as a principal, member of a firm or general partner. do If the respondent is a corporation, the bid should include the name and business address of each officer, director, and holder of 10% or more of the stock of such corporation. B. Any questions or concerns regarding this bid should be addressed in writing to the Finance do Department, City of Ocoee, FL, Attention: Joyce Tolbert, Purchasing Agent (407)905-3100, extension 1516 and fax (407)656-3501, not later than June 8, 2005. Any clarifications/changes will be through written addenda only, issued by the Finance Department. Respondents should not contact City staff, with the exception of the Buyer, or other City consultants for information before the bid award date. Any contact with any other member of the City Staff, City Commission, or its Agents during this time period may be grounds for disqualification. C. This bid must be received as one (1) original and two (2) copies of the required submittals only, by the Finance Department not later than 2:00 P.M., local time, on June 15, 2005. Bids received by the Finance Department after the time and date specified will not be considered, but will be returned unopened. "Postage Due" items will not be accepted. Bids transmitted by fax or e-mail will not be accepted. Bids shall be delivered in a sealed envelope, clearly marked with the bid number, title, and opening date and time to: City of Ocoee Finance Department Attention: Purchasing Agent 150 N Lakeshore Drive Ocoee, FL 34761-2258 4 D. Bids will be publicly opened and read aloud in the Ocoee City Hall Conference Room, 150 N. Lakeshore Drive, Ocoee, Florida 34761-2258 at 2:01 P.M., or as soon thereafter as B05-10 4 •d • possible on the above-appointed date. Respondents or their authorized agents are invited to be present. Please be aware that all City Commission meetings are duly noticed public meetings and all documents submitted to the City as a part of a bid constitute public records under Florida law. E. All respondents shall thoroughly examine and become familiar with the bid package and carefully note the items which must be submitted with the bid, such as: air a) Bid Security in the form of a Cashier's or Certified check or Bid Bond; b) Bid Form; c) List of References/Experience; d) List of Subcontractors/Temporary Worker Agencies; e) Equipment Listing; '• f) Summary of Litigation; g) Bidder must provide a copy of appropriate contractor's license with bid. h) Any other information specifically called for in these Bid Documents. F. Submission of a bid shall constitute an acknowledgment that the respondent has complied with Paragraph E. The failure or neglect of a respondent to receive or examine a bid document shall in no way relieve it from any obligations under its bid or the contract. If "NO BID", so state on face of envelope or your company may be removed from the City's vendor list. No claim for additional compensation will be allowed which is based upon a lack of knowledge or understanding of any of the Contract Documents or the scope of work. All items quoted shall be in compliance with the bid documents/scope of work. G. There will not be a Pre-Bid Conference for this project. Please contact the Purchasing di Agent to arrange for a site visit, if desired. H. Any response by the City to a request by a respondent for clarification or correction will be made in the form of a written addendum which will be mailed, e-mailed or faxed by Demandstar, or the City if applicable, to all parties to whom the bid packages have been issued. The City reserves the right to issue Addenda, concerning date and time of bid di opening, clarifications, or corrections, at any time up to the date and time set for bid opening. In this case, bids that have been received by the City prior to such an addendum being issued, will be returned to the respondent, if requested, unopened. In case any respondent fails to acknowledge receipt of any such Addendum in the space provided on the Addendum and fails to attach the Addendum to the respondent's bid, its' bid will nevertheless be construed as though the Addendum had been received and acknowledged. Submission of a bid will constitute acknowledgment of the receipt of the Bid Documents and all Addenda. Only interpretations or corrections provided by written Addenda shall be binding on the City. Respondents are cautioned that any other source by which a respondent receives a information concerning, explaining, or interpreting the Bid Documents shall not bind the City. I. Any of the following causes may be considered as sufficient for the disqualification of a respondent and the rejection of its bid: a) Submission of more than one (1) bid for the same work by an individual, firm, partnership or corporation under the same or different name. For purposes of this subparagraph, firms, partnerships or corporations under common control may be considered to be the same entity; b) Evidence of collusion between or among respondents; c) Being in arrears on any of its existing contracts with the City or in litigation with the City or having defaulted on a previous contract with the City; da B05-10 5 d) Poor, defective or otherwise unsatisfactory performance of work for the City or any other party on prior projects which, in the City's judgment and sole discretion, raises doubts as to Respondent's ability to properly perform the work; or 'i" e) Any other cause which, in the City's judgment and sole discretion, is sufficient to justify disqualification of Respondent or the rejection of its bid. a' No bid may be withdrawn for a period of ninety (90) days after the time and date scheduled for the bid opening. The City reserves the right to accept or reject any or all bids, to waive informalities or irregularities, to request clarification of information submitted in any bid, or to readvertise for new bids. The City may accept any item or group of items of any bid, unless the respondent qualifies his/her bid by specific limitations. Award, if made, will be to the most responsible and responsive respondent whose bid, in the City's opinion, will be most advantageous to the City, price and other factors considered. The City reserves the right, to aid it in determining which bid is responsible, to require a respondent to submit such evidence of respondent's qualifications as the City may deem necessary, and may consider any evidence available to the City of the financial, technical, and other qualifications and abilities of a respondent, including past performance (experience) with the City and others. The City Commission shall be the final authority in the award of any and all bids. sir a 111 a B05-10 6 GENERAL TERMS & CONDITIONS: 1. BID SECURITY: at a) Each bid must be accompanied by a Cashier's/Certified Check upon an incorporated bank or trust company or a Bid Bond in an amount equal to five percent (5%) of the amount of the bid. A combination of any of the former is not acceptable. Cash will not be accepted as Bid Security. The cashier's check or Bid Bond is submitted as a guarantee that the respondent, if awarded the Contract, will after written notice of r' such award, enter into a written Contract with the City and as a guarantee that the respondent will not withdraw its bid for a period of ninety (90) days after the scheduled closing time for the receipt of bids, in accordance with the accepted bid and bid documents. b) In the event of withdrawal of said bid within ninety (90) days following the opening of bids, or respondent's failure to enter into said contract with the City or failure to provide the City with other requirements of the contract documents or the bid invitation after issuance of Notice of Intent to Award by the City, then such respondent shall be liable to the City in the full amount of the check or bid bond and the City shall be entitled to retain the full amount of the check or to demand from the Surety the penal sum of the bid bond as liquidated damages and not a penalty. c) Surety companies executing bonds shall be duly insured by an insurer or corporate a' surety acceptable to the City and authorized to do business in the State of Florida and signed by a Florida licensed resident agent who holds a current Power of Attorney ,err from the surety company issuing the bond. d) The cost of the required bond and required insurance coverage is to be included in the respondent's overhead and is not eligible for reimbursement as a separate cost by the City. 46 e) The checks of the three (3) most favorable respondents will be returned within three (3) days after the City and the successful respondent have executed the contract for work. The remaining checks will be returned within thirty (30) days after the opening is of bids. Bid Bonds will be returned upon request following the same criteria as a check. 2. PERFORMANCE AND PAYMENT BONDS ,w Not Required. 3. DEFAULT: As a result of bids received under this Invitation, the award of the contract may be based, in whole or in part, on delivery and specification factors. Accordingly, should the Contractor not meet the delivery deadline(s) set forth in the specifications or should the Contractor fail to perform any of the other provisions of the specifications and/or other contract documents, the City may declare the Contractor in default and terminate the whole or any part of the contract. Upon declaring the Contractor in default and the contract in whole or in part, the City may procure and/or cause to be delivered the equipment, supplies, or materials specified, or any substitutions thereof and the Contractor shall be liable to the City for any excess costs resulting therefrom. In the B05-10 7 gib event the Contractor has been declared in default of a portion of the contract, the Contractor shall continue the performance of the contract to the extent not terminated under the provisions of this paragraph. Where the Contractor fails to comply with any of the specifications, except for delivery deadline(s), the City may, in its discretion, provide the Contractor with written notification of its intention to terminate for default unless prescribed deficiencies are corrected within a specified period of time. Such notification shall not constitute a waiver of any of the City's rights and remedies hereunder. 4. PATENT INDEMNITY: Except as otherwise provided, the successful respondent agrees to indemnify the City and its officers, agents, and employees against liability, including costs and expenses for infringement upon any letters patent of the United States arising out of the performance of this Contract or out of the use or disposal by or for the account of the City or supplies furnished or construction work performed hereunder. 5. PRICING: "r' Pricing should be provided as indicated on the Scope of Work/Bid Sheet attached, to include any alternate bids. Please note that alternate bids will not be accepted unless specifically called for on the Scope of Work/Bid Sheet. A total shall be entered for each item bid. In case of a discrepancy between the unit price and extended price, the unit price will be presumed to be correct. Cost of preparation of a response to this bid is solely that of the bidder and the City assumes no responsibility for such costs incurred by the 'r' bidder. By submission of this bid, the Respondent certifies, and in the case of a joint bid, each party thereto certifies as to its own organization, that in connection with this procurement: dd a) The Respondent represents that the article(s) to be furnished under this Invitation to Bid is (are) new and unused (unless specifically so stated) and that the quality has not deteriorated so as to impair its usefulness. b) The prices in this bid have been arrived at independently, without consultation, communication, or agreement for the purpose of restriction competition, as to any matter relating to such prices with any other respondent or with any competitor; c) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the Respondent and will not knowingly be disclosed by the Respondent prior to opening, directly or indirectly to any other respondent or to any competitor; d) No attempt has been made or will be made by the Respondent to induce any other person or firm to submit or not to submit a bid for the purpose of restricting competition. Every contract, combination or conspiracy in restraint of trade or commerce in this State is unlawful (Florida SS 542.18 and all applicable federal • regulations); e) Respondent warrants the prices set forth herein do not exceed the prices charged by the respondent under a contract with the State of Florida Purchasing Division; and f) Respondent agrees that supplies/services furnished under this quotation, if awarded, shall be covered by the most favorable commercial warranties the Respondent gives ,rw B05-10 8 • to any customer for such supplies/services and that rights and remedies provided herein are in addition to and do not limit any rights offered to the City by any other provision of the bid award. Air 6. DISCOUNTS: ar a) Trade and time payment discounts will be considered in arriving at new prices and in making awards, except that discounts for payments within less than 30 days will not be considered in evaluation of bids. However, offered discounts will be taken for less than 30 days if payment is made within discount period. b) In connections with any discount offered, time will be computed from date of delivery and acceptance at destination, or from the date correct invoice is received in the office of Finance, whichever is later. Payment is deemed to be made, for the purpose of earning the discount, on the date of City Check. 7. SAMPLES: Samples of items, when required, must be furnished free of expense to the City and if not X01 called for within fifteen days from date of bid opening, same will be disposed of in the best interest of the City. 8. AWARD CRITERIA: The contract will be recommended to be awarded to the overall lowest most responsive and responsible bidder according to the following criteria: • Compliance with specifications, terms, and conditions • Bid price • Warranty offered a • Delivery Time • Experience with similar work • Features of system a • Successful reference check air 9. LITERATURE: If required by the Bid Schedule, or the specifications, descriptive literature/brochures shall be included with this bid in order to properly evaluate make/model offered. Bids submitted without same may be considered non-responsive and disqualified. K�y 10. BID PROTESTS: The City's Finance/Purchasing Department will consider Bid Protests seeking contract award, damages, and/or any other relief. Any Bidder seeking to file Bid Protest SHALL use the following procedures: 1. A bidder SHALL file a written Bid Protest under this Article, or be barred any relief. •a B05-10 9 rlr 2. A Bid Protest: (a) must be in writing (oral protests will NOT be acknowledged); (b) the content of the Bid Protest shall fully state the factual and legal grounds for the protest and the legal basis for the relief requested; and (c) The Bid Protest shall be filed with the Purchasing Agent not later than three (3) calendar days after the posting of the notice of intent to award or recommendation of award by staff. 3. After a Bid Protest has been properly filed with the City, the City, by and through its Finance/Purchasing Department shall make a determination on the merits of the protest not later than five (5) business days after receipt of the protest. If the City denies the protest, the City may proceed with award of the Contract unless enjoined by order of a Court of competent jurisdiction. 4. A Bid Protest SHALL be limited to the following grounds: (a) issues arising from the procurement provisions of the Project Manual and/or the Bid Package or Contract Documents; and/or (b) applicable federal, state or local law. No Bid Protest may be based upon questions concerning the design documents. The Bidder shall clarify all such questions concerning the design of the project prior to submitting its bid. oto 11. PAYMENT TERMS: Payment for work completed will be made within (30) days of approved invoice. No payment will be made for materials ordered without proper purchase order authori- al zation. Payment cannot be made until materials, goods or services, have been re- ceived and accepted by the City in the quality and quantity ordered. Any contract resulting from this solicitation is deemed effective only to the extent of appropriations available. as The City of Ocoee, Florida has the following tax exemption certificates assigned: • Florida Sales & Use Tax Exemption Certificate No. 58-00-094593-54C; and err • The City is exempt from federal excise, state, and local sales taxes. 12. CONTRACT: • The successful Respondent, hereinafter referred to as "Contractor" will be required to enter into a contract with the City. The Contract shall mean a City issued purchase order. • The City may in its sole discretion award any additional work, whether in the existing areas, or in any additional area, or any additional area, to any third party, or such work may be performed by the City's employees. Contractor will be expected to cooperate with any or all other Contractors who may be performing work for the City. di 13. SAFETY REQUIREMENTS: The Respondent guarantees that the services to be performed and the goods to be provided herein, shall comply with all applicable federal, state and local laws, ordinances, regulations, orders and decrees, including without limitation such of the following acts as B05-10 10 imp may be applicable: Federal Consumer Product Safety Act, Federal Fair Labor Standards Act, Occupational Safety and Health Act, Federal Hazardous Substances Labeling Act, Federal Flammable Fabrics Act, and any applicable environmental regulations. a) All contractors are required to comply with the Congressional Federal Register(CFR) of the U.S. Department of Labor, Occupational Safety and Health Administration (OSHA) Construction Industry, Part 1926, and CFR 1910, General Industry Standards, that are applicable in construction work. b) The prime contractor is not only responsible for the safety aspects of his operation and employees, but also that of all subcontractors on the job site. c) Assure that a certified first aid person is designated, phone numbers of physicians, hospital and ambulance services are posted (copy to Personnel Director, City of r" Ocoee) and that a first aid kit is available. d) All individuals are required to wear hard hats on all construction sites. e) Provide personal protective equipment that may be required for jobs in progress (e.g.: ' " hard hats, safety glasses, respirators, ear protection, long pants and shirts, etc.). f) Observe the speed limit on City property. g) Construction areas cleaned daily; excavations must be barricaded or flagged until backfilled. In some cases, bracing, shoring and sloping may be required. h) Scaffolds shall have guard rails on all open sides and secured to prevent displacement. i) Powder actuated stud guns or low velocity and/or similar powder actuated tools require eye and ear protection as well as to ensure that all unauthorized personnel are well clear. j) Welding and cutting - a fire watch and appropriate fire extinguisher shall be provided and combustible materials cleaned up. k) All heavy equipment must have, where applicable, (a) back-up alarms, (b) boom angle indicator, ( c ) load chart, (d) reeving, (3) fire extinguisher, (f) condition of hook and other items in accordance with OSHA 1926.550 and ANSI B30.5. 1) Construction material shall not be stored so as to block exits. m m) Ground fault circuit interrupters are required on all electrical circuits not part of the permanent wiring of the building. n) Personal fall protection must be provided at elevations exceeding ten (10) feet. o) Per City Ordinance, any Contractor using construction dumpsters within the City of Ocoee must obtain these services through Superior Waste Services of Florida, Inc. 14. DRUG-FREE WORKPLACE: If applicable, provide a statement concerning the Respondent's status as a Drug-Free Work Place or evidence of an implemented drug-free workplace program. 15. CERTIFICATION OF NON-SEGREGATED FACILITIES ow The Respondent certifies that the respondent does not and will not maintain or provide for the respondent's employees any segregated facilities at any of the respondent's establishments and that the respondent does not permit the respondent's employees to 40 perform their services at any location, under the respondent's control, where segregated r B05-10 11 wr facilities are maintained. The Respondent 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 room, work areas, time clocks, locker rooms and other storage and dressing areas, parking lots, drinking facilities provided for employees which are segregated on the basis of race, color, religion, national origin, habit, local custom, or otherwise. The Respondent agrees that (except where the respondent has obtained identical certification from proposed contractors for specific time periods) the respondent will obtain identical certifications from proposed subcontractors prior to the award of such contracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause, and that the respondent will retain such certifications in the respondent's files. The non-discriminatory 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 implementations of rules and regulations prescribed by the U.S. Secretary of labor, are incorporated herein. "* 16. STATEMENT OF AFFIRMATION AND INTENT: The respondent declares that the only persons, or parties interested in their bid are those named herein, that this bid is, in all respects, fair and without fraud and that it is made without collusion with any other vendor or official of the City of Ocoee. Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, "i. participated in any collusion, or otherwise taken any action in restraint of free competitive pricing in connection with the entity's submittal for the above project. This statement restricts the discussion of pricing data until the completion of negotiations and execution of the Agreement for this project. The respondent certifies that no City Commissioner, other City Official or City employee directly or indirectly owns assets or capital stock of the bidding entity, nor will directly or $. indirectly benefit by the profits or emoluments of this proposal. (For purposes of this paragraph, indirect ownership or benefit does not include ownership or benefit by a spouse or minor child.) The respondent certifies that no member of the entity's ownership or management is presently applying for an employee position or actively seeking an elected position with the City. In the event that a conflict of interest is identified in the provision of services, the respondent agrees to immediately notify the City in writing. The respondent further declares that a careful examination of the scope of services, instructions, and terms and conditions of this bid has occurred, and that the bid is made according to the provisions of the bid documents, and will meet or exceed the scope of services, requirements, and standards contained in the Bid documents. die Respondent agrees to abide by all conditions of the negotiation process. In conducting negotiations with the City, respondent offers and agrees that if this negotiation is accepted, the respondent will convey, sell, assign, or transfer to the City all rights, title, and interest in and to all causes of action it may now or hereafter acquire under the Anti- • B05-10 12 die trust laws of the United States and the State of Florida for price fixing relating to the particular commodities or services purchased or acquired by the City. At the City's discretion, such assignment shall be made and become effective at the time the City tenders final payment to the respondent. The bid constitutes a firm and binding offer by the respondent to perform the services as stated. 4111' 17. PUBLIC ENTITY CRIME STATEMENT: All invitations to bid as defined by Section 287.012(11), Florida Statutes, requests for a proposals as defined by Section 287.012(16), Florida Statutes, and any contract document described by Section 287.058, Florida Statutes, shall contain a statement informing persons of the provisions of paragraph (2)(a) of Section 287.133, Florida Statutes, which a reads as follows: "A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold "ue amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." ' All respondents who submit a Bid or Request for Proposal to the City of Ocoee are guaranteeing that they have read the previous statement and by signing the bid documents are qualified to submit a bid under Section 287.133, (2)(a), Florida Statutes. a 18. PERMITS/LICENSES/FEES: a) Any permits, licenses or fees required will be the responsibility of the contractor; no separate payments will be made. de b) The City requires a City of Ocoee registration if permitting is required. Please contact the City's Protective Inspections Department at (407)905-3100 extension 1000, directly for information concerning this requirement. c) Adherence to all applicable code regulations (Federal, State, County, and City) is the responsibility of the contractor. a 19. INSURANCE TERMS & CONDITIONS: .w The Contractor shall not commence any work in connection with an Agreement until all of the following types of insurance have been obtained and such insurance has been approved by the City, nor shall the Contractor allow any Subcontractor to commence work on a subcontract until a all similar insurance required of the subcontractor has been so obtained and approved. Policies other than Workers' Compensation shall be issued only by companies authorized by subsisting certificates of authority issued to the companies by the Department of Insurance of Florida which maintain a Best's Rating of "A" or better and a Financial Size Category of "VII" or better rr B05-10 13 a • according to the A.M. Best Company. Policies for Workers' Compensation may be issued by companies authorized as a group self-insurer by F.S. 440.57, Florida Statutes. • a) Loss Deductible Clause: The City shall be exempt from, and in no way liable for,any sums of money which may represent a deductible in any insurance policy. The payment of such • deductible shall be the sole responsibility of the General Contractor and/or subcontractor providing such insurance. 40 b) Workers' Compensation Insurance: The Contractor shall obtain during the life of this Agreement, Worker's Compensation Insurance with Employer's Liability Limits of $500,000/$500,000/$500,000 for all the Contractor's employees connected with the work of this project and, in the event any work is sublet, the Contractor shall require the subcontractor similarly to provide Workers' Compensation Insurance for all of the latter's employees unless such employees are covered by the protection afforded by the Contractor. Such insurance shall comply fully with the Florida Workers' Compensation Law. In case any class of employees engaged in hazardous work under this contract for the City is not protected under •' the Workers' Compensation statute, the Contractor shall provide, and cause each subcontractor to provide adequate insurance, satisfactory to the City, for the protection of the Contractor's employees not otherwise protected. `¢$ • Include Waiver of Subrogation in favor of the City of Ocoee c) Contractor's Public Liability and Property Damage Insurance: The Contractor shall obtain during the life of this Agreement COMMERCIAL AUTOMOBILE COVERAGE, this policy should name the City of Ocoee as an additional insured, and shall protect the Contractor and the City from claims for damage for personal injury, including accidental death, as well as claims for property damages which may arise from operations under this Agreement whether to such operations be by the Contractor or by anyone directly or indirectly employed by the Contractor, and the amounts of such insurance shall be the minimum limits as follows: oio 1) Automobile Bodily Injury Liability& Property Damage Liability • $1,000,000 Combined single limit per occurrence(each person, each accident) • All covered automobile will be covered via symbol 1 • Liability coverage will include hired & non-owned automobile liability • Include Waiver of Subrogation in favor of The City of Ocoee • 2) Comprehensive General Liability (Occurrence Form) - this policy should name the City of Ocoee as an additional insured and should indicate that the insurance of the Contractor is primary and non-contributory. • $2,000,000 GENERAL AGGREGATE • $2,000,000 PRODUCTS-COMPLETED OPERATIONS AGGREGATE to • $1,000,000 PER OCCURRENCE • $1,000,000 PERSONAL&ADVERTISING INJURY • Include Waiver of Subrogation in favor of the City of Ocoee 3) Subcontractor's Comprehensive General Liability, Automobile Liability and Worker's Compensation Insurance: The Contractor shall require each subcontractor to procure and maintain during the life of this subcontract, insurance of the type specified above or insure the activities of these subcontractors in the Contractor's policy, as specified above. 4) Owner's Protective Liability Insurance: As applicable for construction projects, providing coverage for the named insured's liability that arises out of operations performed for the named insured by independent contractors and are directly imposed because of the named • insured's general supervision of the independent contractor. The Contractor shall procure and furnish an Owner's Protective Liability Insurance Policy with the following limits: • aw B05-10 14 S se $1,000,000, and per occurrence, $2,000,000. Aggregate and naming the City of Ocoee as the Named Insured. 5) Contractual Liability: If the project is not bonded, the Contractor's insurance shall also include contractual liability coverage to insure the fulfillment of the contract. NOTE: PUBLIC LIABILITY INSURANCE AND AUTOMOBILE LIABILITY INSURANCE, THE CITY SHALL BE NAMED AS ADDITIONAL INSURED. • $1,000,000 PER OCCURRENCE • $2,000,000 AGGREGATE 6) Commercial Umbrella: • $1,000,000 PER OCCURRENCE • $2,000,000 Aggregate • Including Employer's Liability and Contractual Liability 7) Builders Risk: • $100,000 Any(1) Location • $1,000,000 Any (1)Occurrence 8) Certificates of Insurance: Certificate of Insurance Form (see sample attached), naming the City of Ocoee as an additional insured will be furnished by the Contractor upon notice of award. These shall be completed by the authorized Resident Agent and returned to the Office *w of the Purchasing Agent. This certificate shall be dated and show: 9) The name of the Insured contractor, the specific job by name and job number, the name of the insurer,the number of the policy, its effective date, its termination date. 10)Statement that the Insurer shall mail notice to the Owner at least thirty (30) days prior to any 40 material changes in provisions or cancellation of the policy, except ten (10) days written notice of cancellation for non-payment of premium. • 411 4111 nr B05-10 15 WM ACORD_ CERTIFICATE OF LIABILITY INSURANCE OP ID JC °A"'"/04/04' YIUPID 11/04/04 PRODUCER THIS CERTIFICATE II ISSUED AS A MATTER OF INFORMATION IV ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE I HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR • ALTER THE COVER/11E AFFORDED BYTNE POLICIES BELOW. NSURERS AFFORDING COVERAGE NMC 5 Bel A la hot arms.,A.R Sets. I. INSURER t 1 AddressC�q tractor I a Naw fit; POURERo7. V!x`:. POURER E: 4110 COVERAGES 154E PR%OI[$OF INSURANCE LIVED BELOW HAVE BEEN GED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTYTWTANOINO ANY REaAPBAENT,TERM OR CORONION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T IS CERTIFICATE MAY SI OWED OR WAY MOWN,THE INSURANCE AFFORDED E POMO*°ESCROW HERON IS SUBJECT TO ALL 114E TERM EIICLUSONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LAM SOWN MAY HAVE SEEN REDUCED sY PAID CLAYO. TYPE OF BNRMMCE POLCY IOImER I DATE MGT) PagWI LERB MORAL moor EACH OCCURRENCE $1,000,000 X ©COMMERCIAL GENERAL UAsam PROBSES ITNI sewfsmaj $50,000 11111111WHO MAOE 0OCCUR IMED ECP(Any NH.P. I $5,000 ■ PERSONALS ACV NEWT $1,000,000 GENERAL AGGREGATE s 2,000,000 COWL AGGREGATE LEFT APPLIES PERPRODUCTS-COMP/OP AGO $2,000,000 Ifil, POLICY n n WC AUTOMOBILE WALT' 'Q�SSOLE LIMIT 11,000,000 NY X Amoo OS ALL OWNED AUTOS SOOLY INJURY 1 IIIP 111SCNEDUIED AUTOS ©/WED AUTOS SOOLYNRRIY I 0 NOMOWNED AUTOS (ro.HWINO ■ PROPERTY DAMAGE(PN.NaN,R1 f ,y� •sawnUABLTY AUTO ONLY.EA ACCIDENT $ 7� --ANY AUTO OTHER THAN EA ACC I AUTO ONLY. AGO I a�BSSRRNBRELLA LIABILTY EACH OCCURRENCE $1,000,000 X ---IOCCUR El WaalMADE i AGGREGATE $2,000,000 I $ • I 1 DEDULE I 1 '[ C' TBRETENTION II WORKERS CO$SENBATON AND IJOT'a=41 l ER BPLOYEN LIMBRYFI EACH ACCIDENT 1 500,000 I ANYOFFICEFUMEMSER EL.DISEASE• MP EA EMPLOYEE s 500,000 Ili $ 5 I EL OISEABE•FOLRCY UAW $500,000 Builders Risk I Any 1 Loc 100,OOD 1 Any 1 0cc 1,000,000 DESCRIPTION W OPERATIONS/LOCATIONS/VESICLES I OCCLUSIONS ADDED IT ENDORSEMENT'SPEW PROVISIONS 41. The insurance evidenced by this certificate shall name the certificate holders as an additional insured on the General Liability i Umbrella Liability. Workers' Compensation, Saiployers' Liability G General Liability shall contain a Waiver of Subrogation in favor of the certificate holder. The certificate bolder is added as a Rigid ixnmi$!BAlcUm Rim. di CERTIFICATE HOLDER CANCELLATION OCOSSO1 SHOULD AMY OF THEAOWI OSSCRISED POUCRO BE CANCEL-SD WORE THE!VENATION. DATE THBIBOP,THE MSUNG mutat WILL ENDEAVOR TO MAL 10 own WRTTB/ ,}, NOTICE TO TE CERTIFICATE GOLGERR NAKED TO THE LIFT,BUT FAILURE TO DO SO ENALL City of Ocoee WON NO OmJWTON OR LUMPUTY OF ANY IOD UPON THE INSURER ITS AGENTS OR 150 N. Lakeshore Drive sMREeaTATMVEB ' Ocoee FL 34761-2258 AUTHORESDRSPIOSENTATAE ACORD 25(2001104) SEP O ACORO CORPORATION 195$ sfrwt pc. & T 0 da e 5e B05-10 16 AP 20. LIST OF SUBCONTRACTORS: SUBCONTRACTOR and/or TEMPORARY WORKER AGENCY NAME/ADDRESS/FEDERAL I.D. NO./CONTACT PERSON/PHONE #: rw r (Attach additional sheets if necessary) The respondent certifies that the respondent has investigated each subcontractor/temporary worker agency listed and has received and has in the respondent's files evidence that each subcontractor/temporary worker agency maintains a fully-equipped organization capable, technically and financially, of performing the pertinent work and that the subcontractor/temporary agency has done similar work in a satisfactory manner. It is further acknowledged by the contractor that any CHANGE or OMISSIONS in the subcontractors listed above shall require the City of Ocoee's approval before any work shall commence by the additional subcontractor on this project. rr 21. EQUIPMENT LISTING: Please list year, make & model of all equipment that will be used on City of Ocoee properties, including whether owned or leased. If leased please provide name of lessor. 4. vie rr • de d+r B05-10 17 ar 22. REFERENCES/EXPERIENCE OF RESPONDENT WITH SIMILAR WORK The Respondent shall complete the following blanks regarding experience with similar type of work, INCLUDE AT LEAST THREE (3) MUNICIPAL GOVERNMENT REFERENCES. Respondent must demonstrate ability to perform services of similar complexity, nature, and size of this project within past three years. DATE OF CONTRACT/AMOUNT OF PROJECT/CLIENT'S NAME AND ADDRESS/ TELPHONE NUMBER/EMAIL ADDRESS/NAME OF CONTACT to rr "er Have you any similar work in progress at this time? Yes_ No _. Length of time in business • Bank or other financial references: (Attach additional sheets if necessary) 23. SUMMARY OF LITIGATION: Provide a summary of any litigation, claim(s), bid or contract dispute(s) filed by or dio against the respondent in the past five (5) years which is related to the services that the respondent provides in the regular course of business. The summary shall state the nature of the litigation, claim, or contact dispute, a brief description of the case, the outcome or projected outcome, and the monetary amounts involved. If none, please so state. de +rr B05-10 18 CITY OF OCOEE B05-10 SCOPE OF WORK/SPECIFICATIONS REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM r ,4. Project Location: City of Ocoee Community Center 125 North Lakeshore Drive Ocoee, FL 34761 a The City of Ocoee requires replacement of the existing three (3) 7.5 ton units and appurtenances, and installation of three (3) new 7.5 ton Trane or Equal units and r appurtenances. The scope of work shall include, but is not limited to the following, for a complete installation and successful operation of the system: a 1. Remove and dispose of 3 existing 7.5 ton Evaporator Coils and Condensing Units. 2. Remove existing return box and platform at each location. 3. Furnish and install 3 new 7.5 ton TRANE or Equal Condensing Units and Evaporator .r Coils as required. 4. Two (2) Condensing Units, systems # 1 and# 2, to be installed in new locations, near northwest corner of the building, by the existing air handler equipment room. City will provide concrete pads as required for the new locations. 5. One (1) condensing unit, system # 3, to be re-piped and re-wired in original location. 6. Install 3 new 3-phase out-door disconnects. Provide main power feed as required. 7. New air handlers to be installed on factory sub-bases with open return panel in front, accessible for filter changes. 8. Each unit to be supplied with 20 KW @ 208/3/60 Electric Resistance Heat and Single Point Electrical Connections. 9. Re-wire interior units through the existing 100 amp disconnect panel adjacent to each air handler. .e 10. Furnish and install ICM 450, 3-Phase Voltage Monitors or Equal at each condensing unit and each Air Handler Unit (6 total). 11. Each individual unit (3 unit)to be controlled by a Honeywell or Equal Digital 7-day Programmable Thermostat. 12. All new units shall have overflow drain pans with shut-off safety switch. 13. Contractor shall inspect the existing ductwork for any leakage or deterioration and replace as necessary. 14. Spray Anti-Bacterial and Anti-Microbial disinfect throughout existing duct system. Special Conditions A. The vendor shall provide a one (1) year parts and labor warranty on all units and repairs in addition to any manufacturer's warranty. B. Bid shall be for a complete operating installation for all 3 units as described �r above. B05-10 19 a C. Bid shall include all costs including but not limited to delivery, installation, disposal, and any modifications that may be required and authorized by the City of Ocoee. D. Contractor shall be responsible for any damage caused to City property during delivery and installation. E. Contractor shall provide a time schedule for the procurement and installation for each unit and the overall work. F. Building will be accessible by appointment, Monday through Friday, 7:30 AM to 4:00 PM for inspection of the existing system prior to bid. G. Contractor shall provide shop drawings, as-build and coordination drawings as required for permitting. H. Contractor shall apply for a City permit and provide all required electrical and AC schematics as required. Permit fee is waived. I. Bidder must provide a copy of appropriate contractor's license with bid. J. The City requires the successful Contractor to provide a current Certificate of va Insurance outlining the coverage required in the bid documents. a Remainder of Page Left Blank Intentionally a ar r a a a a -Y: a • a B05-10 20 e CITY OF OCOEE INVITATION TO BID #B05-10 REPLACEMENT OF COMMUNITY CENTER AIR CONDITIONING SYSTEM BID FORM Please note that the above specifications are intended as minimum and preferred guidelines. Please submit a bid on only one (1) type of system that best meets the specifications. 'n' TOTAL LUMP SUM BID $ dollars and cents a 4, a Delivery Time: calendar days after receipt of City Purchase Order. a a a Company Name Authorized Officer(print) a Authorized Signature do Date a B05-10 21 Bid#B05-10 COMPANY INFORMATION/SIGNATURE SHEET FAILURE TO COMPLY WITH THESE BID INSTRUCTIONS WILL RESULT IN DISQUALIFICATION OF YOUR BID. PLEASE SIGN BELOW ATTESTING THAT YOU HAVE READ AND UNDERSTAND ALL BID INSTRUCTIONS AND THAT THE PRICES REFLECTED ON THE "SCOPE OF WORK/BID FORM"ARE ACCURATE AND WITHOUT COLLUSION. COMPANY NAME TELEPHONE(INCLUDE AREA CODE) FAX (INCLUDE AREA CODE) a E-MAIL ADDRESS 111 IF REMITTANCE ADDRESS IS DIFFERENT AUTHORIZED SIGNATURE(manual) FROM PURCHASE ORDER ADDRESS, PLEASE INDICATE BELOW: a NAME/TITLE(PLEASE PRINT) 'i STREET ADDRESS CITY STATE ZIP a FEDERAL ID# Individual Corporation Partnership Other(Specify) a Sworn to and subscribed before me this day of ,20 . Personally Known or a Produced Identification Notary Public- State of (Type of Identification) County of a Signature of Notary Public • Printed,typed or stamped Commissioned name of Notary Public a ar .atr B05-10 22