itb-sw-11-03 - d-10 stormwater control structure...

ITB-SW-11-03 - D-10 Stormwater Control Structure Replacement

Required Submittals Packet

Revised per Addendum 1

1. All addenda (signed and dated)

2. Bid Bond if bid amount is one-hundred thousand dollars ($100,000) or greater

3. The following thirty-one (31) pages (filled out completely) Only the above mentioned items need to be submitted. Please be sure to include the bid name and number, as well as your firm’s name, address and phone number, on the outermost envelope and please mark submittals as “original” and “copy”. Failure to provide all of the required submittals may result in the bid to be considered non-responsive. Confidential Materials: Any materials that qualify as “trade secrets” shall be segregated and clearly labeled in order not to be considered Public Record.

SECTION 00100 BID FORM FOR THE CONSTRUCTION OF

PROJECT NAME:__ D

Bid Form 00100-1

D--1100 SSttoorrmmwwaatteerr CCoonnttrrooll SSttrruuccttuurree RReeppllaacceemmeenntt && MMoossqquuiittoo DDiittcchh WWeeiirr IImmpprroovveemmeennttss CITY PROJECT NO.: ITB-SW-11-03 Name of Bidder: Business Mailing Address: Business Street Address: City/State/Zip: Phone Number: (_______) FAX Number: (________) Contractor License Number: TO: Purchasing and Contacts Management Division of the City of Palm Coast, Florida Pursuant to and in compliance with your notice inviting sealed Bids (Invitation for Bid), Instructions to Bidders, and the other documents relating thereto, the undersigned Bidder, having ensured to its satisfaction that they have familiarized themselves with the terms of the Contract Documents, local conditions affecting the performance of the Work, and the cost of the Work at the place where the Work is to be done, hereby proposes and agrees to perform within the time stipulated in the Contract Documents, including all of its component parts and everything required to be performed, and to provide and furnish any and all of the labor, Material, and tools, expendable Equipment, and all utility and transportation services necessary to perform the Work and complete in a workmanlike manner, all of the Work required in connection with the construction of said Work all in strict conformity with the Plans and Specifications and other Contract Documents, including Addenda Nos. _____________ through_____________, on file at the Purchasing and Contracts Division for the Total Bid (Contract Price) hereinafter set forth.

The CITY will post addenda information on the CITY’S Web Site. All Bidders should check the CITY’S Web Site or contact the CITY’S Purchasing and Contracts Division at least seven (7) calendar days before the date fixed to verify information regarding Addenda. Failure to do so could result in rejection of the proposal as unresponsive. Bidders shall sign, date, and return all addenda with their bid. Addenda information will be posted on the CITY’S Web Site at: www.ci.palm-coast.fl.us/government/departments/purchasing. It is the sole responsibility of the Proposer to ensure they obtain information related to Addenda. Oral and other interpretations or clarifications will be without legal effect.

ITB-SW-11-03 - D-10 Stormwater Control Structure Replacement Required Submittals - Revised per Addendum 1

Bid Form 00100-2

The undersigned Bidder agrees that the Work shall be completed according to the schedule set forth in the Contract Documents. The undersigned Bidder further agrees to pay liquidated damages as described in the Contract Documents. Bid prices must be stated in words in accordance with these Instructions to Bidders in the blank space(s) provided for that purpose. Bidder acknowledges that it has read and fully understands all Sections of the Instructions to Bidders. The undersigned, as Bidder, declares that the only persons or parties interested in this proposal as principals are those named herein; that this proposal is made without collusion with any person, firm or corporation; and he proposes and agrees, if the proposal is accepted, that they will execute an Agreement with the CITY in the form set forth in the Contract Documents; that it will furnish the Contract Security, Insurance Certificates, Endorsements, and Policies, that it is aware that failure to properly comply with the requirements set out in the "Instructions to Bidders" and elsewhere in the Contract Documents may result in a finding that the Bidder is non-responsive and may cause a forfeiture of the Bid Security. Attention: Bids shall only be considered from those Bidders who have obtained these Contract Documents from the CITY directly or via the website (www.ci.palm-coast.fl.us/government/ departments/purchasing).


http://www.ci.palm-coast.fl.us/government/%20departments/purchasing

http://www.ci.palm-coast.fl.us/government/%20departments/purchasing

BID SCHEDULE The Bidder hereby agrees to perform all work as required by the Contract Documents for the following Unit Prices. All work required to be performed by the Contract Documents is to be included within the following Pay Items, inclusive of furnishing all manpower, equipment, materials and performance of all operations relative to construction of the project. Work for which there is not a Pay Item will not be considered incidental to the Contract and no additional compensation will be allowed. Pursuant to and in compliance with your Invitation for Bid, the Instructions to Bidders, and other documents relating thereto, the undersigned hereby agrees to furnish all labor, Materials and Equipment to do the Work in strict accordance with the Contract Documents and all addenda, if any, issued prior to the date of this Bid at the Total Bid herein as follows:

D-10 Weir Replacement

ITEM # ITEM ESTIMATED UNITS

UNIT PRICE TOTAL COST

1 MOBILIZATION 1 $ $ 2 MAINTENANCE OF TRAFFIC 1 $ $ 3 TESTING 1 $ $ 4 SHEET PILE INSTALLATION /LFT $ / LFT $ 5 FILL /CYDS $ / CYD $ 6 BYPASS $ $ 7 DEWATERING 1 $ $ 8 COMPACTION 1 $ $ 9 CONCRETE /YDS $ / YD $ 10 GRADING /SFT $ / SFT $ 11 SOD /SFT $ / SFT $ 12 CONTINGENCY 1 $ $

TOTAL COST $

Mosquito Ditch Weir improvement



13 MOBILIZATION 1 $ $ 14 MAINTENANCE OF TRAFFIC 1 $ $ 15 DEMOLITION 1 $ $ 16 CONCRETE /CYDS $ / CYD $ 17 JOINT SEALING 1 $ $ 18 DEWATERING 1 $ $ 19 BYPASS 1 $ $ 20 CONTINGENCY 1 $ $

TOTAL COST $


Colbert Lane Weir improvement



21 MOBILIZATION 1 $ $ 22 MAINTENANCE OF TRAFFIC 1 $ $ 23 DEMOLITION 1 $ $ 24 CONCRETE /CYDS $ / CYD $ 25 JOINT SEALING 1 $ $ 26 DEWATERING 1 $ $ 27 FENCE REPAIR /LF $ /LF $ 28 BYPASS 1 $ $ 29 CONTINGENCY 1 $ $

TOTAL COST $

Total amount of Bid (Lines 1 – 29) $ (Figures)

(words)


UNIT PRICE SCHEDULE (Unit Prices for Adjustment)

The following unit prices, if approved by the CITY, shall be used for adjusting the Contract price for changes in the work (additions or deletions) in accordance with the provisions of an approved change order and any other modifications of the Contract. The Bidder is required to fill in the prices listed below. FAILURE TO COMPLETELY FILL IN THE LIST SHALL CONSTITUTE A NON-RESPONSIVE BID AND SHALL BE A CAUSE FOR REJECTION. Unit prices shall include all labor, materials, equipment, transportation, and supervision representing an in-place price for each item. Scope or size of each item not otherwise indicated is as described in the construction specifications and drawings. The CITY reserves the right to approve or reject the below list on a line item basis:

Bid Form 00100-5

ADDENDA

The following Addenda, if any, were received:

Addendum No.______________________ Date Received_________________




Addendum No.______________________ Date Received_________________ Bidder Acknowledgements:

1. The Bidder acknowledges that the Total Amount of Bid stated above includes the sum of $250.00 or 1% of the Bid whichever is greater, specific consideration for indemnification.

2. The Bidder acknowledges that the Total Amount of Bid stated above includes compensation for all Work, labor, permits, bonds, equipment, materials, and any and all incidental costs necessary for the proper execution of the required services.

Attention: Bids shall only be considered from those Bidders who have obtained these Contract Documents from the CITY directly or via the website (www.ci.palm-coast.fl.us/government/departments/purchasing).

ITEM DESCRIPTION UNIT UNIT PRICE N/A CY N/A TON N/A LF N/A SF


http://www.ci.palm-coast.fl.us/government/departments/purchasing

Bid Form 00100-6

The Bidder acknowledges the receipt, execution, and return of the following forms:

Section 00100 - Bid Forms Section 00150 - Trench Safety Act Form Section 00160 - Bidder Information Forms (Including Vendor Registration) Section 00300 - Non-Collusion Affidavit of Bidder Form Section 00310 - Certification of Non-Segregated Facilities Form Section 00330 - Drug-Free Workplace Form Section 00335 - Conflict of Interest Statement Section 00336 - Compliance with Public Records Law Section 00337 - Americans with Disabilities Act Affidavit IN WITNESS WHEREOF, BIDDER has hereunto executed this BID FORM this _________ day of ______________, 20_____. ______________________________ _______________________________________ (Name of BIDDER) (Signature of person signing this BID FORM) _______________________________________ (Printed name of person signing this BID FORM) _______________________________________ (Title of person signing this BID FORM) ACCOMPANYING THIS BID IS_________________________________________________________

(insert the word(s) "cashier's check," bidder's bond," certified check," or other security as provided by law, as

the case may be) in an amount equal to at least five percent (5%) of the Total Bid, payable to the

CITY OF PALM COAST, FLORIDA

The undersigned deposits above-named security as a Bid guarantee and agrees that it shall be forfeited

to the CITY as liquidated damages (and not as a penalty in recognition of the complexity and lack of precision

in calculating damages) in case this Bid is accepted by the CITY and the undersigned fails to execute an

Agreement with the CITY as specified in the Contract Documents accompanied by the required Payment and

faithful Performance Bonds with Sureties satisfactory to the CITY, and accompanied by the required

certificates of insurance coverage, and endorsements.

Should the CITY be required to engage the services of an attorney in connection with the enforcement

of this Bid, Bidder promises to pay City’s reasonable attorney's fees and costs (including attorney's fees and

costs on appeals) incurred with or without suit.


Bid Form 00100-7

We, the Undersigned, hereby declare that no person, persons, firm, or corporation, other than the

undersigned are interested in this Proposal as principals and that this Proposal is made without collusion with

any person, firm, or corporation. CORPORATION/COMPANY Company Name: (Seal) By: (Name typed or printed) By: (Name typed or printed) Address: Telephone No.: (___) FAX No.: (___) Florida State Registration Number: Federal I.D. Tax Number: INDIVIDUAL Name: (Signature) (Name typed or printed) (Title) Address: Telephone No.: (___) FAX No.: (___) County/City Registration Number: Social Security Number: Federal I.D. Tax Number: ______


Bid Form 00100-8

Attachments: “A” Material and Equipment List “B” List of Proposed Subcontractors/Shop Fabricators “C” Certificate of Corporation (due upon award of contract) “D” Questionnaire “E” Direct Purchase of Materials All attachments must be completed and attached to Bidders’ Bid Proposal.


Bid Form 00100-9

ATTACHMENT A

MATERIAL AND EQUIPMENT LIST Listed below are items of material and/or equipment proposed for use in the project. The Bidder is required to fill in the manufacturer for each listed piece of material and/or equipment. FAILURE TO COMPLETELY FILL IN THE LIST SHALL CONSTITUTE A NON-RESPONSIVE BID AND SHALL BE A CAUSE FOR REJECTION. BIDDER acknowledges that the bid is based on all of the specified products, unless specifically approved in writing by addendum prior to the bid date. SECTION MATERIAL AND/OR EQUIPMENT MANUFACTURER ____________________ ______ ____________________ ______ ____________________ ______ ____________________ ______ ____________________ ______ ____________________ ______ ____________________ ______ ____________________ ______ ____________________ ______ ____________________ ______ By: _____________________________________________________________ Bidder _________________________________________________________________ Authorized Signature _________________________________________________________________ Date


Bid Form 00100-10

ATTACHMENT B

LIST OF PROPOSED SUBCONTRACTORS/SHOP FABRICATORS PROJECT NAME:__ DD--1100 SSttoorrmmwwaatteerr CCoonnttrrooll SSttrruuccttuurree RReeppllaacceemmeenntt && MMoossqquuiittoo DDiittcchh WWeeiirr IImmpprroovveemmeennttss CITY PROJECT NO.:_ITB-SW-11-03 Work Performed by CONTRACTOR. The CONTRACTOR must perform at least 51_% of the total work as measured by cost (Equipment and labor) within his own organization and excluding Material costs. A failure of the CONTRACTOR to perform the required percentage of Work within his own organization constitutes a Material breach of this agreement. The Bidder expressly agrees that: 1. If awarded a Contract as a result of this Proposal, the major subcontractor and/or shop fabricator used in the prosecution of the work shall be those listed below. Only one (1) subcontractor and/or shop fabricator shall be listed in each category. 2. The following list includes all subcontractors and/or shop fabricators who will perform work. 3. The Bidder represents that the subcontractors and/or shop fabricators listed below are financially responsible and are qualified to do the work required. (Attach additional sheets if necessary.)

PREVIOUS WORK Subcontractor EXPERIENCE % VALUE TOGETHER of total Contract

CATEGORY NAME/ADDRESS YES / NO


Bid Form 00100-11

ATTACHMENT C

CERTIFICATE OF CORPORATION

Please include a copy of your Certificate of Corporation from the State of Florida with this attachment.

STATE OF FLORIDA COUNTY OF I HEREBY CERTIFY that a meeting of the Board of Directors of , a corporation under the laws of the State of , was held on , 20 . The following resolution was duly passed and adopted:

“RESOLVED, that as

President of the corporation is hereby authorized to execute the Contract dated

, 20 , between The City of Palm Coast, a municipal corporation and this corporation,

and that 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 further certify that said resolution is now in full force and effect.

IN WITNESS THEREOF, I have hereunto set my hand and affixed the official seal of the corporation

This day of , 20 . ________________________________________________________________

Corporate Secretary


Bid Form 00100-12

ATTACHMENT D

QUESTIONNAIRE

DATE: ____________________________________________________ NAME OF BIDDER: ________________________________________ BUSINESS ADDRESS: ______________________________________ ___________________________________________________________ PHONE NUMBER: __________________________________________ CONTRACTOR'S FL. LICENSE #: _____________________________ EXPIRATION DATE: ________________________________________ The undersigned warrants the truth and accuracy of all statements and answers herein contained. Include additional sheets if necessary. 1. How many years has your organization been in business as a General Contractor? 2. How many years has your organization been in business as a Subcontractor? 3. Describe in detail and give the date and owner, including phone numbers and contact person(s), of the

last ten (10) projects that you have completed similar in type, size, and nature as the project proposed? (Use additional sheets if needed)

______________ ______________ ______________ 4. Have you ever failed, or been alleged to have failed, to complete work awarded to you? If so, where and

why? ______________ ______________ 5. Have you ever failed, or been alleged to have failed, to complete work within the Contract Time? If so,

where and why? ______________ ______________


Bid Form 00100-13

6.. Have you ever been assessed liquidated damages, or had liquidated damages assessed against you? If so, where and why?

______________ ______________ 7. Have you ever had your bonding restricted or limited? ______________ ______________ 8. Have you ever had a bond or letter of credit called by the owner of a project? If so, when? ______________ ______________ 9. Name three (3) individuals or corporations, not mentioned in 3 above, for which you have performed

work and to which you refer: ______________ ______________ 10. Have you personally inspected the site of the proposed Work? Describe, in full, any anticipated

problems with the site and your proposed solutions? ______________ ______________ 11. What equipment do you own that is available for the Work? ______________ ______________ 12. What equipment will you purchase for the Work? ______________ ______________ 13. What equipment will you rent for the Work? ______________ ______________


Bid Form 00100-14

14. Complete the required disclosure form. 15. Attach a copy of the most current balance sheet (assets and liabilities) for the BIDDER. 16. State the true and exact, correct, and complete name under which you do business. BIDDER is: By (Signature) Seal (Title) 17. Attach the corporate information sheet from the Florida Department of State, Division of Corporation’s,

web site. Sworn and subscribed to before me this day of ,, 20 ,, in the State of ,, County of .. Notary Public My Commission Expires:


Bid Form 00100-15

REQUIRED DISCLOSURE The following disclosure is of all material facts pertaining to any felony conviction or any pending felony charges in the last three (3) years in this State or any other state or the United States against (1) the Bidder, (2) any business entity related to or affiliated with the Bidder or (3) any present or former owner of the Bidder or of any such related or affiliated entity. This disclosure shall not apply to any person or entity which is only a stockholder, which person or entity owns twenty percent (20%) or less of the outstanding shares of the Bidder whose stock is publicly owned and traded: ______________ _______ ______________ _______ ______________ _______ ______________ _______ ______________ _______ ______________ _______


Bid Form 00100-16

ATTACHMENT E

DIRECT PURCHASE OF MATERIALS

DATE: ____________________________________________________ NAME OF BIDDER: ________________________________________ BUSINESS ADDRESS: ______________________________________ ___________________________________________________________ PHONE NUMBER: __________________________________________ CONTRACTOR'S FL. LICENSE #: _____________________________ EXPIRATION DATE: ________________________________________ PART 1 – GENERAL 1.01 It is the intent of the City, being a tax exempt governmental entity, to save the sales tax on the major quantities of materials supplied for this project. PART 2 – PRODUCTS

Table of Potential Items to be Direct Purchased by the City:

The table in Part 2 must be filled out in its entirety upon executed Notice of Award.

Column A

Column B

Column C

Column D

Materials For Potential

Direct Purchase

*Material Invoice Amount

Sales Tax on Material Amount

Contract Reduction Amount (B + C)

N/A –

* Invoices for the material shall be provided to the City.


Bid Form 00100-17

PART 3 – EXECUTION 3.01 For bidding purposes and contract award, the Contractor shall bid the job as they normally would with sales tax included as part of their Bid. The Contractor shall act as the City’s purchasing agent for the purchase of various items enumerated above and thus, the City shall be the buyer in such transactions and, being a tax exempt governmental entity, the purchase transaction shall be tax exempt. However, should the Florida Department of Revenue ultimately conclude that sales tax should have been paid; the City agrees to pay the sales taxes and ensure that the Contractor is not required to pay such taxes. The Contractor shall not be obligated to defend the City against the Florida Department of Revenue for any actions by the Department claiming that sales taxes are due to the State under this Contract. The Contractor shall be responsible to place the order for the material. The Work Order shall be issued by the City with the Contractor’s terms and conditions. Goods shall not be subject to trade discounts. Agreement for the City to purchase to shall be formalized prior to purchase of goods. Shop drawings shall be sent to the Contractor from the Material Supplier for review, checking and coordination. After checking, the Contractor shall be responsible to forward the shop drawings to the ENGINEER for review. After review with the City, the ENGINEER shall return the shop drawings to Contractor to be returned to the Material Supplier. The Contractor shall be responsible to schedule the delivery time for the material. The Contractor shall be responsible to unload and to store the material until it is installed. The Contractor shall be responsible to provide and maintain Builders Risk Insurance on the material until the project is completed and accepted by the City. Invoices for the Material shall be submitted to the City, c/o Contractor. The Contractor shall forward the invoices to the ENGINEER. Once the ENGINEER has reviewed the invoice and the Contractor has confirmed delivery, this information shall then be forwarded to the City for payment. Payment shall be forwarded in accordance with Work Order Terms. A change order shall be negotiated that reduces the Contract Price by the amount of the material cost plus state sales tax credit (6%) and the local sales tax credit (one percent (1%) up to the first five thousand ($5,000). The Contractor shall include in his bid the handling costs, markup and profit that are associated with the installation/handling of the material. The Contractor agrees that the materials listed in Part 2 shall be added to or deleted from at the City’s choosing. The Contractor shall include all costs of administering this direct purchase of material with their bid. The Contractor shall complete all activities and assume all liabilities that are normally involved in material purchase and installation. The only intent of this Section is for the City to purchase the material directly in order to save the sales tax monies.

END OF SECTION


SECTION 00150 TRENCH SAFETY ACT

SECTIONS 553.60-553.64, FLORIDA STATUTES (if applicable for this project)

NOTICE TO BIDDERS: In order to comply with the Trench Safety Act, the Bidder is required to specify the costs of compliance. These costs are not a separate pay item. The Bidder must also reference the Trench Safety Standards which will be in effect during construction, and assure in writing that the Bidder will comply with the applicable Trench Safety Standards. TRENCH SAFETY UNITS OF QUANTITY UNIT EXTENDED MEASURE MEASURE COST COST ________________ ____________ __________ __________ _____________ ________________ ____________ __________ __________ _____________ ________________ ____________ __________ __________ _____________ ________________ ____________ __________ __________ _____________ ________________ ____________ __________ __________ _____________ ________________ ____________ __________ __________ _____________ ________________ ____________ __________ __________ _____________ ________________ ____________ __________ __________ _____________

TOTAL $_____________ _______________________________ _______________________________________ Printed Name Bidder Name _______________________________ _______________________________________ Signature Date

END OF SECTION

Trench Safety Act 00150-1


SECTION 00160 BIDDER INFORMATION

Bidder shall complete the following information and include with their bid submittal.

Bidder Information

_______________________________

CONTRACTING

OFFICER

TITLE

OFFICER'S FULL LEGAL NAME

President

Vice-President

Secretary

Treasurer

Resident Superintendent

Indicate with an asterisk (*) in the first column, which officer will sign the resulting contract. If other than the President, include a copy of the corporate resolution which gives express authority for execution of the specific proposal and contract documents. Each Bidder must assure that the officer information provided is in accordance with the Bidder's corporate registration supplied to the Secretary of State.

Bidder Information 00160-1


Bidder Information 00160-2

EXPERIENCE OF BIDDER

NAME OF BIDDER _____________________________________________________ The Bidder shall provide the following information regarding experience within the past three years in this particular scope of work. Bidder must demonstrate ability to construct projects of similar complexity, nature and size as this project. Under Client's Name and address, please include Contact's Name, Telephone Number and Fax Number. DATE OF CONTRACT

CLIENT’S NAME & ADDRESS: CONTRACT AMOUNT

PH FX $

Project & Location: DATE OF CONTRACT


PH FX $



PH FX $



PH FX $

Project & Location: Do you have any similar work in progress at this time? ____Yes ____No Length of time in business: _______________Years (Minimum three (3) years required) Bank or Financial references: (Include Contact Name and telephone number) _________________________________________________________________________________________ _________________________________________________________________________________________

END OF SECTION


COMMODITY CODES

8721 Accounting & Auditing Services 99837 Electrical Supplies 91501 Advertising Agencies 91438 Electrical Contractors 91807 Advertising Specialties & Novelties 91840 Employee Benefit Program Providers 99803 Aircraft Engines & Parts 96130 Employment Agencies 03520 Airlines & Air Carriers, nec 93831 Engineering Services, Licenses, Professional, nec 57005 Aluminum Sign Blanks & Accessories 96631 Envelope Converters 90607 Architectural Services, Licenses, Professional 92535 Environmental Engineering & Studies Services 96207 Art & Graphic Design Services 97535 Equipment Rental Services 91813 Asbestos Removal Contractors – Certified 98814 Erosion Control Materials 75510 Asphalt Paving Products 91244 Excavation Contractors, includes Tractor & Site Work 96209 Auctioneering Services – Florida Registered 95838 Farm & Garden Equipment & Supplies 88011 Audio-Visual Equipment, Supplies & Service 77015 Fasteners: Bolts, Nuts, Rivets, Washers, etc. 95714 Automobiles & Light Trucks 98815 Fencing Suppliers, & Installers 07006 Auto, Truck, & Motorcycle Rental & Leasing 99840 Fertilizers & Other Agricultural Chemicals 92917 Automotive Shop Equipment 91849 Financial Consultants 97515 Automotive Shop Equipment 94648 Financial Services, Third Party Lease/Purchase 94625 Banks & Depository Institutions 93633 Fire Trucks & Apparatus 99817 Boats, Marine & Diving Equipment & Supplies 93632 Fire Protection Equipment & Supplies 97521 Boats, Used & Salvage 36020 Floor Coverings, all types 71510 Books, Periodicals, & Newspapers 99844 Food & Grocery Products 21015 Brick & Structural Clay Products 96136 Food Service Equipment & Supplies 90922 Building Construction > $200,000 – Bonding Required 91852 Food Service Providers 90923 Building Construction < $200,000 – Bonding Materials 57838 Forestry Services & Supplies, includes Land Mgmt. 90900 Building Construction Services 97108 Building Materials: Brick, Stone, & Related Materials 40509 Fuel Supplier: Gasoline, Diesel, Aviation 91819 Building Materials: Lumber, Plywood, etc. 55736 Fueling Systems, Pumps, Tanks, Equipment & Service 15513 Building Maintenance Services, nec 99846 Furniture: Office 91821 Business Consulting 28539 Generators & Motors (not automotive) 91427 Carpentry Services 91447 Glass & Glazing Services 91009 Carpet & Upholstery Cleaning Services 68052 guns, Ammunition & Related Supplies 481302 Cellular Service Providers, not equipment 99850 Hardware, all types 33533 Chemicals, nec 92645 hazardous Wastes Services 50525 Chlorine, & Related Chemicals 99852 Heating, Ventilation, & Air Conditioning Contractor 99826 Clothing and Apparel, nec 99852 Heating & Air Conditioning Contractor 80540 Coastal Engineering Services 90646 Highway & Street Construction 93442 Commercial Laundry Equipment & Supplies 91551 Information Systems Consultants (no equipment sales) 05264 Commercial Photography Services 95861 Insurance Carriers, Brokers, Agents & Services, all types 70070 Commercial Printing, all types 96248 Interior Design Services 96207 Commercial Art & Graphic Design 47520 Janitorial Chemicals & Supplies 20827 Communications Services, nec 91039 Janitorial Services 91522 Communications Consultants (Radio, Telephone, etc.) 93846 Laboratory Apparatus & Furniture 55919 Communications Equipment & Accessories (not telephone) 98852 Landscape Services, includes Mowing 74017 Compressors, Equipment & Services, (except HVAC) 90656 Landscape Architects 95823 Computer Facilities Management 93442 Laundry Services & Dry Cleaning 91828 Computer Maintenance & Repair, Mainframe 99859 Laundry Equipment & Suppliers, all types 99829 Computer Maintenance & Repair, Micro 96149 Legal Counsel 91830 Computers, Peripherals, & Software, Mainframe 99860 Library Equipment & Supplies 91829 Computers, Peripherals, & Software, Micro 42056 Library Furniture 91430 Concrete Masonry Work, including Sidewalks 42048 Library Shelving 91455 Concrete, Portlands & Masonry 3274 Lime 92930 Concrete, Ready-mix, Block & Brick 91048 Locksmiths & related Products & Services 75030 Concrete Precast Products 95856 Managed Health Care Providers 65834 Concrete Pipe 91875 Management Consulting Services, nec 97524 Construction Equipment 5052 Marine & Underwear Construction 95220 Correctional Institution Equipment & Supplies 42068 Mattresses, Pillows, & Bed Linens 96224 Courier Services, all types 45059 Measuring & Controlling Devices, nec 96124 Court Reporting Services 92567 Mechanical Engineering Services, nec 6371 Deferred Compensation Providers 92939 Medical & Emergency Equipment & Supplies 94828 Dentist Offices 99857 Medical Laboratories 99052 Detective & Investigative Services 95262 Mental Health Service Providers 91558 Direct Mail Services 90921 Metal Building, all types


5714 Draperies, Blinds, Window Coverings, & Upholstery 3441 Metal-Fabricated, all types 5912 Drug Stores & Pharmacies 3399 Metals-Primary Suppliers (iron, steel, alum., etc) 9611 Economic Consultant 92966 Refuse Collection Services, includes recycling collection 96155 Mined or Quarried Materials, all types 14560 Roofing Contractors 99999 Mold Remediation & Drying 77072 Roofing, Siding & Insulation Materials 327208 Monuments & Grave Markers 75077 Sand, Gravel, Rock related products 94664 Mortgage bankers 99889 School Equipment & Supplies 07012 Motorcycles & Parts & Supplies 72554 Security Systems & Services 5112 Office Supplies (not equipment or furniture) 57054 Sheet Metal Work, all types 93959 Office Equipment (not computers or furniture) 90086 Shoes, all types 99874 Oil, Grease & Related Petroleum Products 80150 Signs, all types 64043 Packaging Materials, nec 79050 Sod, Hay, Seeds, Shrubs & Trees, etc. 91461 Painting Contractors (not auto) 99891 Sporting, Athletic, Playground & Recreation Goods 96755 Paints, Varnishes, & Supplies (all types) 65062 Sports Lighting Equipment & Fixtures 70069 Paper Mills & Distributors 99080 Surveying Services 4119 Paratransit Services 91576 Telephone Service Providers, Local & Long Distance 94050 Passenger Transportation Services, all types 72555 Telephone Equipment & Accessories, includes cellular 91885 Personnel & Human Resource Consultants 90783 Testing Services, Engineering (not medical) 91059 Pest Control Services 99882 Tires & Tubes, Sales & Service 99876 Photo Equipment, Film & Supplies 99893 Tires, Sale of Surplus 65804 Pipe: Metal, all types 95387 Title Abstract Services 65858 Pipe: Polyethylene & PVC 95954 Towing Services, Car & Truck 92672 Planning & Zoning Consultants (land use, impact fees, 55089 Traffic Signals, Supplies & Services 98154 Plumbing Supplies 92593 Traffic Engineering Services 91468 Plumbing Contractors 12090 Trailers, all types 57895 Potable Water Services 95290 Training & Development Consultants 99881 Printing Trades Equipment & Supplies 99820 Transit Vehicles: Bus, Coach, Paratransit 8743 Public Relations Services 96178 Travel Agencies 91573 Public Safety Equipment & Supplies 96239 Trucking & Hauling Services (materials, not people) 72056 Pumps & Pumping Equipment 07048 Trucks: Bucket 95883 Real Estate Agencies 07048 Trucks: Catch Basin & Vacuum 91889 Real Estate Appraiser Services 07051 Trucks: Medium & Heavy Duty 57096 Recycled Metal Products 20085 Uniforms, all types 0120 Recycled Paper Products 98587 Voting Machines, Equipment & Maintenance 64066 Recycled Plastic Products 98184 Water, Sewer & Utility Equipment & Supplies 92677 Recycled Products, nec 96896 Water, Sewer, & Utility Construction & Supplies 92677 Recycling Centers & Processors 54596 Water Well Drilling & Supplies 57864 Recycling Equipment & Supplies 96897 Wrecking & Demolition Work 74059 Refrigeration Equipment & Supplies


SECTION 00300 NON-COLLUSION AFFIDAVIT OF BIDDER

STATE OF ) ) ss CITY OF ____________________ ) _______________________________________________, being first duly sworn, deposes and says that: (1) He/She is ___________________________, of _______________________, the Bidder that has submitted the attached Bid; (2) He/She 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, representatives, employees or parties in interest, including this affiant, has 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 Agreement for which the attached Bid has been submitted or to refrain from bidding in connection with such Agreement, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other 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 element of the Bid price or the Bid price of any other Bidder, or to secure through collusion, conspiracy, connivance or unlawful agreement any advantage against the City of Palm Coast City Council, Flagler County, Florida, or any person interested in the proposed Agreement; and (5) The 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 of its agents, representatives, owners, employees or parties in interest, including this affiant. Signed:_______________________________________

Printed Name:________________________________________

Title:_________________________________________

Non-Collusion Affidavit 00300-1


Non-Collusion Affidavit 00300-2

The foregoing instrument was acknowledged before me this _____day of ______________, 20_____, by ____________________________________ who is personally known to me or who has produced ____________________________________ identification. __________________________________________________ Print Name _________________________________________

Notary Public in and for the County and State Aforementioned My commission expires:_________________________ ATTACH AND INCLUDE THIS PAGE OF NON-COLLUSION AFFIDAVIT OF BIDDER AS PART OF BID FORM; FAILURE TO DO SO SHALL BE CAUSE FOR DISQUALIFICATION OF YOUR BID.

END OF SECTION


SECTION 00310 CERTIFICATION OF NON-SEGREGATED FACILITIES

The Bidder certifies that they do not maintain or provide for their employees any segregated facilities at any of his establishments, and that they do not permit their employees to perform their services at any location, under their control, where segregated facilities are maintained. The Bidder certifies further that they will not maintain or provide for their employees any segregated facilities at any location under they 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, time clocks, locker rooms and other storage and dressing areas, parking lots, drinking fountains, recreation or entertainment area, transportation and housing facilities provided for employees which are segregated by explicit directive, or are in fact segregated on the basis of race, color, religious disability or national origin, because of habit, local custom, or otherwise. The Bidder agrees that (except where they have obtained identical certifications from proposed subcontractors for specific time periods) they will obtain identical certifications from proposed subcontractors prior 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 implementations of rules and regulations prescribed by the United States Secretary of Labor are incorporated herein. Date:________________________________ By:____________________________________________ Print Name: _____________________________________ Official Address: Title:___________________________________________ _____________________________________ _____________________________________ _____________________________________ (Include Zip Code)

ATTACH AND INCLUDE THIS PAGE AS PART OF BID FORM. FAILURE TO DO MAY BE CAUSE FOR DISQUALIFICATION OF YOUR BID.

END OF SECTION

Non-Segregated Facilities 00310-1


SECTION 00330 DRUG-FREE WORK PLACE FORM

The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that ___________________________________________does: (Name of Business) 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing,

possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for 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, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations.

3. Give each employee engaged in providing the commodities or contractual services that are proposed 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 proposal, the employee will propose by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contender to, any violation of Chapter 893, Florida Statutes, 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 if 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 the

matters set forth above. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. _______________________________________________

Signature _______________________________________________

Firm _______________________________________________

Date

END OF SECTION

Drug Free Work Place 00330-1 ITB-SW-11-03 - D-10 Stormwater Control Structure Replacement Required Submittals - Revised per Addendum 1

SECTION 00335 CONFLICT OF INTEREST STATEMENT

STATE OF FLORIDA ) ) ss CITY OF ____________________ )

Before me, the undersigned authority, personally appeared ____________________________________,

who was duly sworn, deposes, and states:

1. I am the ___________________________ of __________________________________ with a

local office in ______________________ and principal office in ________________________________.

2. The above named entity is submitting an Expression of Interest for the City of Palm Coast

project described as (ITB-SW-11-03) D-10 Stormwater Control Structure Replacement & Mosquito Ditch Weir

Improvements

3. The Affiant has made diligent inquiry and provides the information contained in this Affidavit

based upon his own knowledge.

4. The Affiant states that only one submittal for the above project is being submitted and that the

above named entity has no financial interest in other entities submitting proposals for the same project.

5. Neither the Affiant nor the above named entity has directly or indirectly entered into any

agreement, 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.

6. Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or

otherwise ineligible from participating in contract lettings by any local, state, or federal agency.

7. Neither the entity, nor its affiliates, nor any one associated with them have any potential conflict

of interest due to any other clients, contracts, or property interests for this project.

8. I certify that no member of the entity's ownership, management, or staff has a vested interest in

any aspect of or Department of City of Palm Coast. Conflict of Interest 00335-1


Conflict of Interest 00335-2

9. I certify that no member of the entity's ownership or management is presently applying for an

employee position or actively seeking an elected position with City of Palm Coast.

10. In the event that a conflict of interest is identified in the provision of services, I, on behalf of the

above named entity, will immediately notify City of Palm Coast in writing.

_______________________________________ Signature of Affiant The foregoing instrument was acknowledged before me this _____day of ______________, 20_____, by Affiant who is personally known to me _______or who has produced _________________________________ identification. _____________________________________________________ Notary Public Signature Print/Stamp Name ______________________________________

Notary Public in and for the County and State Aforementioned My commission expires:_________________________

END OF SECTION


SECTION 00336 COMPLIANCE WITH THE PUBLIC RECORDS LAW

Upon award recommendation or ten (10) days after receiving, submittals become "public records" and shall be subject to public disclosure consistent with Chapter 119, Florida Statutes. Proposers must invoke the exemptions to disclosure provided by law in the response to the solicitation, and must identify the data or other materials to be protected, and must state the reasons why such exclusion from public disclosure is necessary. The submission of a proposal authorizes release of your firm’s credit data to City of Palm Coast. If the company submits information exempt from public disclosure, the company must identify with specificity which pages/paragraphs of their bid/proposal package are exempt from the Public Records Act, identifying the specific exemption section that applies to each. The protected information must be submitted to the City in a separate envelope marked accordingly. By submitting a response to this solicitation, the company agrees to defend the City in the event we are forced to litigate the public records status of the company’s documents. Company Name: _______________________________________________________ Authorized representative (printed): ________________________________________ Authorized representative (signature): ______________________________________ Date: ______________________________ Project Number: ITB-SW-11-03 D-10 Stormwater Control Structure Replacement & Mosquito Ditch Weir Improvements

THIS FORM MUST BE COMPLETED AND RETURNED WITH YOUR PROPOSAL

Public Records 00336-1


SECTION 00337 AMERICANS WITH DISABILITIES ACT AFFIDAVIT

The undersigned CONTRACTOR swears that the information herein contained is true and correct and that none of the information supplied was for the purpose of defrauding CITY. The CONTRACTOR will not discriminate against any employee or applicant for employment because of physical or mental handicap in regard to any position for which the employee or applicant for employment is qualified. The CONTRACTOR agrees to comply with the rules, regulations and relevant orders issued pursuant to the Americans with Disabilities Act (ADA), 42 USC s. 12101 et seq. It is understood that in no event shall the CITY be held liable for the actions or omissions of the CONTRACTOR or any other party or parties to the Agreement for failure to comply with the ADA. The CONTRACTOR agrees to hold harmless and indemnify the CITY, its agents, officers or employees from any and all claims, demands, debts, liabilities or causes of action of every kind or character, whether in law or equity, resulting from the CONTRACTOR's acts or omissions in connection with the ADA. CONTRACTOR: __________________________________________ Signature: __________________________________________ Printed Name: __________________________________________ Title: __________________________________________ Date: __________________________________________ Affix Corporate Seal STATE OF ) ) ss COUNTY OF ) The foregoing instrument was acknowledged before me this ___________ day of_________________, 20____, by___________________________________ of __________________________________________________ (firm), on behalf of the firm. He/She is personally known to me or has produced _______________________________________ identification. _____________________________________________ Print Name

_____________________________________________ Notary Public in and for the County and State Aforementioned My commission expires:_________________________

END OF SECTION

ADA Affidavit 00337-1
