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Res No 113-12-13670RESOLUTION NO. 1 1 3 -12 -13 6 7 0 A Resolution authorizing the City Manager to disburse the sum of $11,699.00 to Dash Door and Closer Service, Inc. for the installation of two (2) automatic door enclosures for the North and East entrance to City Hall building to be ADA complaint and charging this disbursement to account 114 - 3800 -545 -34500 WHEREAS, the local governments must follow the requirements of the 2010 ADA Standards for Accessible Design; and WHEREAS, the installation of the North and East entrance to City Hall facility two (2) automatic door enclosures to meet ADA compliance; and WHEREAS, the City solicited for bids and obtained two bids of which Dash Door and Closer Services, Inc. was the lowest bidder. WHEREAS, the funds for the door installation work are being allocated from Miami Dade County Grant Fund under Account No. 114- 3800 -545 -3450 in the amount of $1109.00 which has current balance of $12,617.00. NOW THEREFORE BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF SOUTH MIAMI, FLORIDA; Section 1. The City Manager is hereby authorized to enter into a contract with and to pay Dash Door and Closer Services, Inc. the sum of $11,699.00 from Account No. 114- 3800 -545- 3450for the installation of City Hall's North and East entrance door. Section 2. This resolution shall become effective immediately upon adoption by vote of the City Commission, PASSED AND ADOPTED this 1 5th day of ATTEST: ORM, May , 2012. COMMISSION VOTE: 5 -0 Mayor Stoddard: Yea Vice Mayor Liebman: Yea Commissioner Newman: Yea Commissioner Harris: Yea Commissioner Welsh: Yea CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER - OFFICE MEMORANDUM To: The Honorable Mayor & Members of the City Commission Via: Hector Mirabile, PhD, City Manager Y From: Date: Kelly Barket Jr., Chief Superintendent of Public Works May 15, 2012 Agenda Item No.: To execute a contract with Dash Door and Closer Services, Inc. for the Subject: installation of two (2) automatic door enclosures for the North and East entrance to City Hall. Background: A Resolution authorizing the City Manager to execute a contract with Dash Door and Closer Services, Inc. for a total amount of $11,699.00 and charging Account No. 1 14- 3800 -545 -34500 2010 ADA Standards for Accessible Design requires local governments to meet their program accessibility requirements. The installation of two (2) automatic door enclosures for the North and East entrance to City Hall will meet ADA compliance. Expense: $11,699,00 Account: Miami Dade County Grant Fund with a current balance of $12,617.00. Invitation to Quote Pre -Bid Conference Sign -In Sheet Proposals Backup of awarded proposal Support: - Miami -Dade County Award letter FY08 -09 Miami -Dade Interlocal Agreement General Affidavit 2009 between Miami -Dade County and City of South Miami Account Activity Listing / CITY OF SOUTH MIAMI �`. PUBLIC WORKS AND CENTRAL SERVICES Y INVITATION TO QUOTE LUMP SUM PROPOSAL SUBMITTED TO: Public Works Department PROJECT: NAME: Kelly Barket, Jr. ADDRESS: ADDRESS: 4795 SW 75th Avenue CITY /STATE: CITY /STATE: Miami, Florida 33155 DATE: PHONE: 305- 403 -2063 E -MAIL: MANDATORY PRE -QUOTE MEETING Lig'sday;AprHp,2QL� „1Os�`A(3I DUE DATE: Swlil is • zoua ADA Door Installation & Magnetic Lock 6130 Sunset Drive Miami, Florida 33143 Wednesday, April, 4, 2012 kbarket0 southmia mifl.sov ¢f=rtdyrA�ri '? ,012;t;1011Y14 QUOTE SUBMISSION REQUIREMENTS: All bidders must attend Mandatory Pre -bid Meeting (If Applicable) to submit a quote. Quotes submitted after 10:00am on the due date will not be accepted unless otherwise specified in the quote document of a time change. All quotes will be submitted to the City Clerks Office in a sealed envelope. The label on the envelope needs to read as follows. City of South Miami Maria M. Menendez, CMC 6130 Sunset Drive South Miami, Fl, 33143 Project Name: Must input project name. If label does not have all information above your quote will not be accepted. INSURANCE REQUIREMENTS: The CITY'S insurance requirements are attached (Exhibit 1). As a condition of award, the awarded vendor must provide a certificate of insurance naming the city as additional insured. SCOPE OF WORK DESCRIPTION (TO BE COMPLETED BY CITY): Installation of two (2) automatic door enclosures for the north entrance to City Hall to meet ADA compliance. All exterior doors must comply with Section 11 -4.13 thru 11- 14.13.12 FBC. IT Scope to include magnetic lock on North and East entrance of City Hall. DESCRIPTION OF WORK TO BE PERFORMED BY CONTRACTOR (LUMP SUM): and all associated labor. Item Number Item Description Unit Qty Amount LUMP SUM TOTAL NOTES: Contractor shall furnish all materials and equipment necessary to secure completion of the work. Contractor shall be compensated according to the quote submitted. Field meeting shall be conducted on Tuesday, April 10, 2012 at the site. Contractor may choose to submit a quote on company letterhead but must be attached with this form. Deadline to submit is Friday, April 13, 2012 at 10:00 AM, Signature: Title: Print/Type Name: E -mail: Firm Name: Address: Phone: Fax: F.E.I.N. No.: ! / ! / / / ! City: State: THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF PROPOSER TO BE BOUND BY THE TERMS OF ITS PROPOSAL. FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE BY AN AUTHORIZED REPRESENTATIVE SHALL RENDER THE PROPOSAL NON - RESPONSIVE. THE CITY MAY, HOWEVER, IN ITS SOLE DISCRETION, ACCEPT ANY PROPOSAL THAT INCLUDES AN EXECUTED DOCUMENT WHICH UNEQUIVOCALLY BINDS THE PROPOSER TO THE TERMS OF ITS OFFER. THE CITY'S REQUEST FOR QUOTES IS FOR THE LOWEST AND MOST RESPONSIVE PRICE. THE CITY RESERVES THE RIGHT TO AWARD THE PROJECT TO THE FIRM CONSIDERED THE BEST TO SERVE THE CITY'S INTEREST. EXHIBIT #1 Insurance and Indemnification I. Insurance and Indemnification Without limiting its liability, the proposing firm shall be required to procure and maintain at its own expense during the life of the Contract, insurance of the types and in the minimum amounts stated below as will protect the proposing firm, from claims which may arise out of or result from the proposing firm's execution of a contract with the City of South Miami for Performance Based Audits, whether such execution by the firm or by any sub - consultant, or by anyone directly or indirectly employed by any of them or by anyone for whose acts any of them may be liable. The CONTRACTOR/COMPANY shall not commence WORK on this Agreement until he has obtained all insurance required by the City. The CONTRACTOR/COMPANY shall indemnify and save the City harmless from any and all damages, claims, liability, losses and causes of actions of any kind or nature arising out of a negligent error, omission, or act of the CONTRACTOR/COMPANY, its agents, representatives, employees, Sub - Contractor, or assigns, incident to arising out of or resulting from the performance of the CONTRACTOR/COMPANY'S professional services under this Agreement. The CONTRACTOR/COMPANY shall pay all claims and losses of any kind or nature whatsoever, in connection therewith, including the City's attorney's fees and expenses in the defense of any action in law or equity brought against the City arising from the negligent error, omission, or act of the CONTRACTOR/COMPANY, its agents, representatives, employees, Sub - Contractor, or assigns, incident to, arising out of or resulting from the performance of the CONTRACTOR/COMPANY'S professional services under this Agreement.. The CONTRACTOR/COMPANY agrees and recognizes that the City shall not be held liable or responsible for any claims, including the costs and expenses of defending such claims which may result from or arise out of actions or omissions of the CONTRACTOR/COMPANY, its agents, representatives, employees, Sub - Contractors, sub - contractors, or assigns. In reviewing, approving or rejecting any submissions or acts of the CONTRACTOR/COMPANY, the City in no way assumes or shares responsibility or liability of the CONTRACTOR/COMPANYS, Sub- Contractors, their agents or assigns. The CONTRACTOR/COMPANY shall maintain during the term of this Agreement the following insurance: A. Professional Liability Insurance on a Florida approved form in the amount of $1,000,000 with deductible per claim if any, not to exceed 5% of the limit of liability providing for all sums which the CONTRACTOR/COMPANY shall become legally obligated to pay as damages for claims arising out of the services or work performed by the CONTRACTOR/COMPANY its agents, representatives, Sub - Contractors or assigns, or by any person employed or retained by him in connection with this Agreement. This insurance shall be maintained for four years after completion of the construction and acceptance of any Project covered by this Agreement. However, the CONTRACTOR/COMPANY may purchase Specific Project Professional Liability Insurance, in the amount and under the terms specified above, which is also acceptable. B. Comprehensive general liability insurance with broad form endorsement, on a Florida approved form including automobile liability, completed operations and products liability, contractual liability, severability of interest with cross liability provision, and personal injury and property damage liability with limits of $1,000,000 combined single limit per occurrence and $2,000,000 aggregate, including: • Personal Injury: $1,000,000; • Medical Insurance $25,000 per person; • Property Damage: $500,000 each occurrence; • Automobile Liability: $1,000,000 each accident/occurrence, C. Umbrella Commercial General Liability insurance on a Florida approved form with the same coverage as the primary insurance policy but in the amount of $5,000,000 per claim. The City must be named as additional "named" insured for all except Workers' Compensation, and reflect the indemnification and hold harmless provision contained herein. Policy must specify whether it is primary or excess /umbrella coverage. City must receive 10 days advance written notice of any policy modification and 30 days advance written notice of cancellation, including cancellation for non - payment of premiums. All insurance must remain in full force and effect for the duration of the contract period with the City. The CONTRACTOR/COMPANY must provide not only a "certified copy" of the Binder but also the Policy itself with the name, address and phone number of the agent and agency procuring the insurance. D. Workman's Compensation Insurance in compliance with Chapter 440, Florida Statutes, as presently written or hereafter amended. E. The policies except for Section 10 A shall con City where applicable, shall expressly provide primary over any other collective insurance that the right at any time to request a copy of the policies shall contain a " severability of interest" obligation for premium payment of the City. tain waiver of subrogation against that such policy or policies are City may have. The City reserves required policies for review. All or "cross liability" clause without F. All of the above insurance required to be provided by the CONTRACTOR/COMPANY is to be placed with BEST rated A -8 (A -VIII) or better insurance companies, qualified to do business under the laws of the State of Florida on approved Florida forms. The CONTRACTOR/COMPANY shall furnish certified copies of all "Binders" or certificates of insurance to the City prior to the commencement of operations, which "Binders" or certificates shall clearly indicate that the CONTRACTOR/COMPANY has obtained insurance in the type, amount, and classification as required for strict compliance with this Section and that no reduction in limits by endorsement during the policy term, or cancellation of this insurance shall be effective without thirty (30) days prior written notice to the CITY. Compliance with the foregoing requirements shall not relieve the CONTRACTOR/COMPANY of his liability and obligations under this Section or under any other portion of this Agreement. CONTRACTOR/COMPANY agrees to supply copies of certificates of insurance to the City verifying the above - mentioned insurance coverage. CONTRACTOR/COMPANY agrees to list City as an Additional Insured of the CONTRACTOR/COMPANY Is General liability insurance and shall provide the City quarterly reports concerning any and all claims. Exhibit # 2 Florida Building Code served by the elevators, the corresponding numerals shall i.l- luminate, and an audible signal shall sound. Numerals shall be a minimum of /2 inch (12.7 mm) high. The audible signal shall be no less than 20 decibels with. a frequency no higher than 1500 Hz. An automatic verbal announcement of the floor number at which a car stops or which a car passes may be substituted for the audible signal. 1.1- 4.1.11.14 Emergency communications. If provided, emergency two -way communication systems between the elevator and a point outside the hoist way shall comply with ASME A 17.1 -1990. The highest operable part of a two -way eornmunieation system shall be a maximum of 48 inches (1219 min) from the floor of the car..It shall be identified by a raised symbol and lettering complying with 11 -4.30 and located adjacent to the device. if the system uses a handset then the length ofthe cord from the panel to the handset shall be at least 29 inches (735 itim). If the system is located in a closed compartment the compartirient door hardware shall conform to Section 11 -4.27, controls and operating mecha- nisms, The emergency intercommunication system shall not require voice communication. 11 -4.11 Platform lifts (wheelchair lifts). 11- 4.11.1. location. Platform lifts (wheelchair lifts) permit- ted by Section 11 -4.1 shall comply with the requirements of Section 11 -4,11. 11- 4.11.2 Other requirements. If platform lifts (wheel- chair lifts) are used, they shall comply with Sections 11- 492.4, 11 -4.5, 1.1. -4.27, and ASME A17.11 Safety Code fbr•.131evators and Escalators, Section Xx, 1990, 11- 4.11.3 Entrance..lfplatform lifts are usedthen they shall facilitate unassisted entry, operation, and exit from the lift in compliance with Section 11.-4.11.2. 114.12 Windows. 214.12.1 General. Reserved, 114.13 Doors. 11- 4.1.3.1 General. (1) Doors retuired to be accessible by Section 11 -4.1 shall comply with the requirements of Section 11-4.13, 11- 4.13.2 Revolving doors and turnstiles. (1) Revolving doors or turnstiles shall. not be the only means of passage at an accessible entrance or along an accessible route. An. accessible gate or door shall be provided adjacent to the turnstile or revolving door and shall be so designed as to facilitate the same use pattern, (2) Turnstiles shall not be used n ; Occupan6i6s 41iicli "serve fewer than' I00.net•sons_ but turnstiles may he 114.13.3 Gates. Gates, including ticket gates shall meet all applicable specifications of Section 11 -4.13. 114.1.3.4 Double-Ieaf doorways.If doorways have two in dependently operated door leaves, then at least oneeafshall meet the specifications in Section 11- 4.1.3.5 and Section 1.1- 4.13.6.. That leaf shall be an active leaf. 114.13.5 Clear width. Doorways shall have a minimum clear opening.of 32 inches (813 mm) with the door open 90 degrees, measured between the face of the door and the op- posite. stop [see Figure 24(a), Figure 24(b); Figure 24(c), and:Figure.24(d)]. Openings more than 24 inches.(610 mm) in depth shall comply with Sections 114.2:1 and 114.33 [sec.Figure 24(e)]. Exception: Doors not requiring full user passage, such as shallow closets, may have the clear opening reduced to 20 inches (5 10 inm) minimum, 114.13.6 Maneuvering clearances at doors. Minimum maneuvering clearances at: doors that. are not automatic ar power- assisted shall be as shown in Figure 25. The floor or. ground area within. thexequi. red clearances slrall be level and clear. Exception: Entry doors to acute care hospital bedrooms for in- patients shall be exempted from the requirement for space. at the latch side of the door (see dimension. x in Figure. 25) if the door is at least 444 inches (1120 min) wide. 114.13.7 Two doors in series: The minimum space be- tween two hinged or pivoted doors in series shall be 48 inches (1219 nam) plus the width of any door swinging into rection or away`from the space between the doors [see Fig- ure 26(a)]. 11- 4.1:3.8 Thresholds at doorways: Thresholds at door- ways shall not exceed' /4 inch (19 min) in height for exterior sliding doors or 1/2 inch (12.7 mm) for other types of doors. Raised thresholds and floor level changes at: accessible doorways shall be beveled with a slope no greater than 1:2 (see Section 11- 4.5:2), 11 -4.139 Door hardware. Handles, pulls, latches, locks, and other operating devices on accessible doors shall have a shape that is easy to grasp with one Band and does not re- quire tight grasping, tight pinching, or twisting of the wrist to operate. Lever - operated mechanisms, push -type mecha- nisms, and Lt- shaped handles are acceptable designs. When sliding doors are fully open, operating hardware shall be ex- posed and usable from both sides. Hardware required for ac- cessible door passage shall be mounted no higher than 48 inches (1219 mm) above finish floor. 11- 4:13.10 Door closers. If a door has a closer, then the sweep period of the closer shall be adjusted so that from an open position of 70 degrees, the door will take at least 3 see- 11.28 2007 FLORIDA BUILDING CODE — BUILDING onds to move to a point 3 inches (76 mm) from the latch, measured to the leading edge of the door. 11- 4.13.11 Door opening; force. '.l'he maximum force for pushing or pulling open a door shall, be as follows: (1) Fire doors shall have the minimum opening force al- lowable by the appropriate administrative authority. (2) Other doors. (b) Interior hinged doors: 5 lbf {22.2 N) (c) Sliding or folding doors: 51bf (22.2 N) 'T'hese forces do not apply to the force required to re- tract latch bolts or disengage other devices that may hold the door in a closed position.. 114.13.12 Automatic doors and power assisted doors. If an . autonat[ti.c door is used, their it shall comply with ANSI /1314MA A156.1.0 -1985. Slowly opening, low -pow- cred, automatic doors. shall comply with ANSI A156.19 -1984. Such doors shall not open to back check faster than. 3 seconds and shall require no more than 15 l.bf (66.6 N) to stop door movement..lfa power- assisted door is used, its doom- opening force shall comply with Section 11- 4.1.3.11 and its closing shall conform to the requirements in ANSI A156.19 -1984, 11.4.14 Entrances. 114.14.1 Minitnum number. Entrances required to be ac- cessible by Section 1.1 -4.1 shall be part of an accessible route complying with Section 1.1 -4.3. Such entrances shall be connected by an accessible route to public transportation stops, to accessible parking and passenger loading zones, and to public streets or sidewalks if available [see Section 11- 43:2(1 )]. They shall also be connected by an accessible or facility. 11- 4.14.2 Service entrances. A service entrance shall not be the sole accessible entrance unless it is the only entrance to a building or facility (for example, in a. factory or garage ): 11 -4.15 Drinking fountains and water coolers. 11- 4.15,1 Minimum number. Drinking fountains or water coolers required to be accessible by Section 11. 4.1 shall comply with. Section 1.1- 4.1.51 11.4.15.2 Spout.heigltt. Spouts shall be no higher than 36 inches (91.5 mm ), measured from the floor or ground sur- faces to the spout outlet [see figure 27(a)]. 11.461.53 Spout location. The spouts of drinking fountains and water coolers shall be at the front of the unit and shall di- rect the water flow in a trajectory that is parallel or nearly parallel to the front of the unit. The spout shall provide a flow of water at least 4 inches (102 man) high so as to allow the insertion of a cup or glass under the flow ofwater. On an accessible drinking; fountain with a round or oval bowl, the spout must be positioned so the flow of water is within 3 inches (76 mm) of the front edge of the fountain. 11- 4.15.4 Controls. Controls shall comply with Section 114.27.4: Unit controls shall be front mounted or side mounted near the front edge. 11- 4.15.5 Clearances. (1) Wall- and past - mounted cantilevered units shall have a clear knee space between the bottom of the apron and the floor or ground at least 27 inches (685 min) high, 30 inches (760 mm) wide, and 17 inches to 19 inches (430 mm to 485 mm) deep (see Figure 27(a) and Figure 27(b)]. Such units shall also haven mini- mum clear floor space 30 inches by 48 inches (760 mm by 1219 mm) to allow a person in a wheelchair to approach the unit facing; forward. (2) Free - standing or built -in. units not having a clear space under them. shall have a clear floor space at least 30 inches by 48 inches (760 mm by 1239 mm) that allows a person in a wheelchair to make a parallel approach to the unit [see Figure 21(c) and Figure 27(d)]. This clear floor space shall comply with Section 11-4.2.4. 11 -4.16 'eater closets. 114.16.1 General. Accessible water closets shall comply with Section 1.1-4.16. 114.16.2 Clear floor space. Clear flesh space for wager closets not in stalls shall comply with Figure 28. Clear floor space may be arranged to allow either a left- handed or right - handed approach. 114.16.3 Height. The height of water closets shall be 17 inches to 19 inches (430 rnm to 485nrn) pleasured to the top of the toilet seat [see Figure 29(b)]. Seats shall notbe sprung to return to a lifted position. 11- 4.16.4 Grab bars. Grab bars for water closets not lo- cared in stalls shall comply with Section 11 -4.26 and Figure 29. The grab bar behind the water closet shall be 36 inches * . <. 1.1- 4.1.6.5 Flush controls. Flush controls shall be. hand op- erated or automatic and shall comply with Section 11- 4.27.4. Controls for flush valves shall be mounted on the wide side of toilet areas no more than 44 inches (1120 rnm) above the floor. 11- 4.16.6 Dispensers. Toilet paper dispensers shall be in- stalled within reach, as shown. in Figure 29(b). Dispensers that control . delivery, or that do not permit continuous paper flow, shall not be used. 11 -4.17 Toilet stalls. 114.17.1 Location. Accessible toilet stalls shall be on an. accessible route and. shall meet the requirements of Section 1.1-4.1.7. 114.17.2 Water closets. Water closets in accessible stalls shall comply with Section 11 -4.16. 11- 4.1.7.3 .Size and arrangement. The size and arrange- ment of the standard toilet stall shall comply with Figure 30(a), Standard Stall. Standard toilet stalls with a minimum depth of 56 inches (1420 mm) [see Figure 30(a)] shall have vvvall- mounted water closets. If the depth of a standard toilet 2007 FLORIDA BUILDING CODE— BUILDING 11.23 Date: ITQ Title: ITQ Not. Please Print Cleadv Pre -Bid Conference Sign -In Sheet April 1.0, 2012 ADA Door Installation and Magnetic Lock N/A XA\Purchasing,Vnvitation to Quote\ADA Door\ADA Door Pre -Sid Meeting Sign -In Sheet 4,10.12.doe Name/Title Company Name/ E"mail Address Telephone No. • _r S � 1 -- -- �NNU ✓/� KKK t;1 /6/L.�/ .�/ IIn //'v 1 & CIO t..�x"r -, ..:. r)1 xi?5 r e # ste t t rS +>' w v" ..: 3--- !Fs;e:T'.F 4 .Ytt:. 9`Ll al V -u4 • i i . i.>t�r }rn. {.F![.y •f .. 4 -Y f� rL :yr5 x 3 - •!reS. .].. rx<. Fi Vie^ \yr+ '.:R:+3, u: cR\4 i� r. '>!. ><•.. 'KiS$ )r-Y� { >as;w•!1�i} ,..TiS TE f k.. .} ai,[: j f% . s'S.t!:xel. \ 3 £ Y L'C i 7C �t �l f.. IYf$1 .d o-i J{. V P. N I'S m '}+' . lYa_tY �� :�%3f�. ;F ti >!i..,� L � '�..h . 44 �:.. 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Aada: i.5 _ ^ . -,: .. � r:n -r.: .>., c .:,. - :. :<� i< 1 11 XA\Purchasing,Vnvitation to Quote\ADA Door\ADA Door Pre -Sid Meeting Sign -In Sheet 4,10.12.doe DASH DOOR AND CLOSER SERVICE, INC. AUTOMATIC DOORS/ BUILDING/ GLASS/ GLAZING /LOW VOLTAGE SPECIALTIES CC # 02E000932 — 02BS00932 7809 NW 29 STREET, MIAMI FL, 33922. PHONE (305) 477 -9964 FAX (305) 749 -8353 edrod@dashdoor.com May 1, 2012 City of South Miami Attn: Maria M. Mendez, CIVIC / Kelly Barket 6130 Sunset Drive South Miami, FL 33143 Project: ADA Door Installation & Magnetic Lock. / REV.iI We agree to the following scope of work. East Side Entrance- ADA Door: Furnish and install one (1) 72" surface mounted "Sr -Sw ng" #9550 ADA header /operator manufactured by Ingersoll Rand /LCN. To includ 'two (2) push arms, o l (1) on -off toggle switch. Interior activation by one (1) surface mounted remote pu -p7at ,,FAOrior ton by one (1) surface mounted remote push plate mounted on a bollard post. Finish: clear aluminum anodized. North Side Entrance- (Double) ADA & DOOR REPAIR. Furnish and install two (2) sets of top and bottom pivots, two (2) Jackson panic devices, one (1)72 11 surface mounted "Sr- Swing" #9550 ADA header /operator manufactured by Ingersoll Rand /LCN. To include: two (2) push arms, one (1) on -off toggle switch. Activation by one (1) set of surface mounted remote push plate. Finish: clear aluminum Sequence of operation, Day -time: Regular Hours, Interior /Exterior: Magnets are disengaged. Switch turned to on. Actuate push plate, doors will open automatically or manual push /pull door. After Hours, Police Department to engage magnets, operator switch turned off. Operator activation will be off. Manual push or pull door. Electrical: Provide electrical conduit to power two (2) ADA operators 110V. Power to be pull from above ceiling. Junction box and switch provided. Total Contract Price $11,699.00 I 1 One year warranty on parts and labor. Terms: Net 30 days. Exclusions: • Misc. paint and patching if any. • Permit, fees and engineering. • Electrical or mechanical lock interface. • Door repairs or any items not specifically mentioned above. Thank you for choosing Dash Door for this estimate. Ed Rodriguez Sales Manager N B & B Rolling Door Co., Inc. 1601 N.W. 97th Ave. Miami, FL 33172 TEL: 305- 594 -1900 FAX: 305 -594 -9100 www,floridadoorservice.com PROPOSAL Date: Customer: CITY OF SOUTH MIAM FAX: ATT: REF: ADA DOOR We are pleased to submit the following specification and cost estimate: Job Description: CITY OF SOUTH MIAMI,6130 SUNSET DR. SOUTH MIAMI, FL, 33143 Item Description Unit Price Total Furnish and install the following equipment: STANLEY 1 REMOVEALL 4 DOORS AND CUT BOTTOM. INSTALL 2 CONTINUOUS GEAED HINDES. ADJUSTED AS NEEDED. 2 INSTALL MAIN ENTRANCES, 1 (ONE) 39" RH HEADER, POST, SS/ PUSHPLATE,. INSTALL SIDE ENTRANCES, 1 (ONE)75" RH AND LH HEADER . SS/ PUSHPLATE, 3 -MAGIC FORCE OPERATORS - 1- POST, 4 -SS/ PUSHPLATE,.3- ARMS, 4 CONTINUOUS GEARED HINGESS, ELECTRICAL WIRING -(2 ENTRANCE) 39" HEADER 75" HEADER IN US 28 1- CUSTOM CUT RAMP THRESHOLD ( MAIN ENT.) $11,706.00 Current equipment lead -time is 2 -4- weeks By others : All necessary structural support,120 Volts AC to operator Total $11,706.00 locations, conduit and control wiring. Preparation of Rough Opening. Painting, Patching & Flooring Work. Permits Work by others: 115 VAC electrical to Header. Deposit May Be Required. By B & B Rolling Door Co., Inc. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado, and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. AUTHORIZED SIGNATURE: Joe Rosario THIS PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED WITHIN 30 DAYS. ACCEPTANCE OF PROPOSAL---The prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature: Date: A z ^ Y V �g � N N N �r d ❑O NOOtl d0 d01 z O WOUd .9L /G-1 00 rt EE -z, u Oo w 3w ❑ W • ,° a F W Y ¢ O w0 z� ¢ 02 z s d N Qp 2 Op t1 LL 1 O LL O p w y .l .9/9•S M .b1E-9 z F- x LL� ko Oa ma � �- - - - -- -- - \ o I N \ I �Q \ N \ I o z \ \ ivanaa I 2Q =gym p O\� �I z LD �Ow =al a Q (A W Q p w i/ o°o I 00 °c W // a0 I 9 .n / w I / ¢ I ma O `�----- 1�51 - - - - -- 0 Z 2❑ o pQ,wmt9 . Ll° WM a Z Mw °wyw w NU U)mm m N cnNy203 ° a LL e 5 z w° > 00 w k m0 o❑ a ¢ <0 >ri 08 O p0 M0 OO W OW w ccn 2 p p' O Q W y 2 > o z m w o LLO 0 0i - iImI °- O O Q p ONO W y 2 Z 2 ppp 3 F' w w > U¢' O¢ j 0¢ O w> 2 O w Q JQ z¢ Q Y2y ww<w ❑ Ow jK fC 'fir y w 2_NILO p x3 u.pz0 ¢ ww w�a❑F -^ ❑ w a a¢Od < <M¢ MW z2wC7 Z V i Z y�� v~i J<W o as 0 / \ o \ O / OPERATOR MOUNTS SIMULTANEOUS PAIR, SURFACE MOUNT *PULL SIDE PUSH SIDE DOUBLE EGRESS *PULL SIDE mount shown ► 9550 series operator is shipped with motor gearboxes, control box, arms, header, and mounting hardware. ► Simultaneous pair, surface mounted. ► Meets ADA requirements (power mode only). ► Handed product. ► Pull, Push or Double Egress applications available. ► 72" header length is standard. Specify other length 60" to 98 ". Consult factory regarding this option. ► Adjustable hold -open period of 2 to 32 seconds in automatic or manual mode. Fit, Wiwi If The 9550 SENIOR SWING® by LCN is an ADA door operator that is a two -in- one swing door operator, SENIOR SWING' operators when activated, opens doors automatically for wheelchair access, yet allows for manual operation for regular pedestrian traffic. ► Push'N Go permits non - switch activation ► Power Boost provides additional latching force ► Electromechanical unit with microprocessor control ► Fast and easy installation ► Digital keypad for easy setup ► Tested internally to over 10,000,000 cycles ► Meets International Building Code requirements and ANSI A156.19 ► UL approved for fire doors 9550 Series is fully compliant with UL 325 & UL 1998 and meets the provisions of ANSI A 156.19, The 9550 Series is UL listed for fire -rated applications. The 9550 Series also meets the provisions of the Americans with Disabilities Act. HANDING FINISH COVER ARM FUNCTION 0 AVAILABLE Q NOT AVAILABLE LCN CLOSERS 121 W. RAILROAD AVE. 127 P.O. BOX 100 PRINCETON, IL, USA 61356.0100 PHONE 800- 526 -2400 FAX 800- 248 -1460 www.Icnclosers.com 6/06 C/a LAJ con TOP JAMB SIMULTANEOUS PAIR (OFFSET PIVOT /BUTT o HINGE, PUSH) MOUNTING t 0 TOP JAMB SIMULTANEOUS PAIR (OFFSET PIVOT /BUTT HINGE, PULL) MOUNTING MAXIMUM OPENING Template allows 90 degree power opening and 90 degree manual opening. Special Templates Customized installation templates or products may be available to solve unusual applications. Contact LCN for assistance. LCN® a 1n- } &SWING t SWING 6a%b L15�-MD]DIIIIATOR OVTISTG01NG 171 MM 17N6'Fmm top of d" OFFSET PIVOT 251AM a GIRT SWING INGES SECONDARY IINN DIflAA�CTION 2 V4' 70 MM DOOR X. FRAMDOOR 5' -0' R GAMIN.) E EXTERIOR 4th- 14 MM 6'.IY DOOR OPENING MA %. 5'•0' DOOR OPENING (MIN.) 175re' 111M• 5y4• i MM 291 MM 2�, 55p' 146MM $WWG 70 MIA Ili MM OPERATOR I�FPULLUC I L4NNEL rlN�rMlNa ING OFFSET PIVOT °f 1MIT 25MM I I film 49 MM PULLARM HINGES ASSY PULL CHANNEL ERIOINfgMING SWI NG 4a MM tip... -. DOOR INTERIOR ► Butt Hinges should not exceed 5" (127 mm) in width. ► Reveal for push installations should not exceed 10" (254 mm) for REGULAR ARM and 20" (508 mm) for LONG ARM. ► Reveal for pull installations should not exceed 4" (102 mm). ► Reveal for double egress installations should not exceed 4" 0 02 mm). ► Head Frame minimum 13/4" (44 mm). Face frame 6 3/4" (171 mm) total operator clearance. ► Top Rail minimum 2 3/4" (70 mm). ► Opening & Closing Time are variable by adjustments to the electronic control box. Maximum hold -open time adjustable up to approximately 32 seconds. ► System Diagram see "POWER OPERATORS" section pages 26 -27 for typical system wiring and page 30 for electrical data. ► Please consult your local SSC representative or LCN for assistance with specific installations and material requirements. LCN CLOSERS PHONE 800-526-2400 121 W. RAILROAD AVE. FAX 800- 248.1460 1 n Q P.O. BOX 100 www.lenclosers.com L Q PRINCETON, IL, USA 61356 -0100 6 /06 LCM 1��j � �j,� III •I 41 41A I14 YAR 4. ' I 114 MM _ _ S3'f SWING KMM 6 &1' 171 MM 14 M OPERATOR t>D a' FROM K'NOHOPEf8i4 MAX / 5Y1' TOP OF DOOR 6vfg 7 WO SWM6 6Y4N(1 'M'q'%M gSM1WC(WN.) 197 MM 1K� fil 2Yi I n$ >O MV 15 MM HEEL I qIR rvo 6111NO T NYGFb SWING 01 — OIfl ION SEOONDARYLIN9( 1. DOOR FOR 30'-35. THE CONTROL 75 AAA FRPIAE 73 Aal MUST RE MOUNTED E%TERNPLIY EXTERNALLY AL IIvf DOOR EXTERIOR LCM 1��j � �j,� III •I IYf 41A I14 YAR 4. ' I KMM K'NOHOPEf8i4 MAX / 5Y1' 6vfg SWM6 6Y4N(1 'M'q'%M gSM1WC(WN.) ■ ► Butt Hinges should not exceed 5" (127 mm) in width. ► Reveal for push installations should not exceed 10" (254 mm) for REGULAR ARM and 20" (508 mm) for LONG ARM. ► Reveal for pull installations should not exceed 4" (102 mm). ► Reveal for double egress installations should not exceed 4" (102 mm). ► Head Frame minimum 13/4" (44 mm). Face frame 6 3/4" (171 mm) total operator clearance. ► Top Rail minimum 2 3/4" (70 mm). ► Opening & Closing Time are variable by adjustments to the electronic control box. Maximum hold -open time adjustable up to approximately 32 seconds. ► System Diagram see "POWER OPERATORS" section pages 26 -27 for typical system. wiring and page 30 for electrical data. ► Please consult your local SSC representative or LCN for assistance with specific installations and material requirements. LCN® 129 9550 SERIES TOP JAMB SIMULTANEOUS PAIR (BALANCE DOOR, PUSH) MOUNTING Consult factory for all balance door installations. TOP JAMB SIMULTANEOUS PAIR (RH DOUBLE EGRESS) MOUNTING MAXIMUM OPENING Template allows 90 degree power opening and 90 degree manual opening. Special Templates Customized installation templates or products may be available to solve unusual applications. Contact LCN for assistance. LCN CLOSERS 121 W. RAILROAD AVE. P.O. BOX 100 PRINCETON, IL, USA 61356.0100 PHONE 600- 526 -2400 FAX 600.248 -1460 www.lcnclosers.com coo miiwoij 6/06 H ^W^ ^`V V r IYf 41A I14 YAR 4. ' I KMM K'NOHOPEf8i4 MAX / 5Y1' 6vfg SWM6 6Y4N(1 'M'q'%M gSM1WC(WN.) FULL.NM I 1K� fil 2Yi I n$ >O MV I qIR rvo 6111NO 5111\G NYGFb — PUSl1MM 1. f. 75 AAA 73 Aal IIvf L- PIIILMM 9DrT fr Ram 1 )oNAI Asst =� KN s s3%aEao, DOOR f.IMM�`RL FUSNARM FMME 6WWO C00 AS4y ffi- i=ROPBi fml gRHTpI FRUIE WNW q%M1 O.PEGIKN DOOR / INMWR ► Butt Hinges should not exceed 5" (127 mm) in width. ► Reveal for push installations should not exceed 10" (254 mm) for REGULAR ARM and 20" (508 mm) for LONG ARM. ► Reveal for pull installations should not exceed 4" (102 mm). ► Reveal for double egress installations should not exceed 4" (102 mm). ► Head Frame minimum 13/4" (44 mm). Face frame 6 3/4" (171 mm) total operator clearance. ► Top Rail minimum 2 3/4" (70 mm). ► Opening & Closing Time are variable by adjustments to the electronic control box. Maximum hold -open time adjustable up to approximately 32 seconds. ► System Diagram see "POWER OPERATORS" section pages 26 -27 for typical system. wiring and page 30 for electrical data. ► Please consult your local SSC representative or LCN for assistance with specific installations and material requirements. LCN® 129 9550 SERIES TOP JAMB SIMULTANEOUS PAIR (BALANCE DOOR, PUSH) MOUNTING Consult factory for all balance door installations. TOP JAMB SIMULTANEOUS PAIR (RH DOUBLE EGRESS) MOUNTING MAXIMUM OPENING Template allows 90 degree power opening and 90 degree manual opening. Special Templates Customized installation templates or products may be available to solve unusual applications. Contact LCN for assistance. LCN CLOSERS 121 W. RAILROAD AVE. P.O. BOX 100 PRINCETON, IL, USA 61356.0100 PHONE 600- 526 -2400 FAX 600.248 -1460 www.lcnclosers.com coo miiwoij 6/06 H ^W^ ^`V V r coo MOTOR GEARBOX KMW MOTOR GEARBOX (STANDARD FORCE) — SENIOR SWING, 9550 -3454 oC Driving mechanism for operator. Provides 15lbs opening force. Handed. coo GEARBOX (REDUCED FORCE) — SENIOR SWING, 9550- 34541`11` coo LJMI Driving mechanism for operator. Provides 11lbs opening force. Handed. cwz MOUNTING BRACKETS MOUNTING BRACKET - 23/4", 9550 -275 Motor gearbox mounting bracket for 2 3/4" offset pivot or butt hinge installations. Front bracket. REAR MOUNT BRACKET, 9550 -3018 Motor gearbox mounting bracket. Rear bracket. ANGLED BRACKET, 9550 -3341 Mounting bracket for surface applications. CONTROL BOXES CONTROL BOX — SENIOR SWING, 9550 -3462 Electronic controlling device for Senior Swing. i v HEADER, 955042HL Standard, mounting header. Pair door, two operators. Specify length 60 to 98" maximum. CABLES COMPANION CABLES, 9550 -982 Cable that allows one control box to run two motor gear boxes. Companion cable. For use with Senior Swing. END CAPS HEADER ENDCAPS, 9550134 End cap with openings for wiring. END DRESS PLATE, 9550 -334 -2 Metal finish end cap. TRACKS TRACK 9550 -3038 Standard non - handed track. TRACK END CAP 9550 -73 Black plastic end caps. ARMS STANDARD ARM, 9530 -3077T Handed arm. Track roller not included. REGULAR ARM, 9540 -3077 Handed arm. LONG ARM, 9540 -3077L Handed long arm. INDIVIDUAL ARMS COMPONENTS MAIN ARM, 9550 47 Handed arm attaches to motor gearbox LINKAGE ASSEMBLY —15 ", 9550 -79 Threaded rod attaches to door. Extends from main arm. LINKAGE ASSEMBLY — 32", 9550 -79LR Threaded long rod attaches to door. Extends from main arm. LCN9 130 LCN CLOSERS 121 W. RAILROAD AVE. P.O. BOX 100 PRINCETON, IL, USA 61356 -0100 PHONE 800 - 526 -2400 FAX 800 -248 -1460 www.Icnclosers.com 6/06 INSTALLATION ACCESSORIES ROLLER, 9550 -3034 Quiet low friction roller assembly. SPINDLE PLATE — 2 3/4", 9550 -11A Hides bottom of motor gearbox. Completes header box. Cutout allows for motor gearbox shaft. For 2 3/4" offset pivot or butt hinge installations. FILLER PLATE BLANK, 9550 -12 Completes length of header box. MOUNTING PLATE, 9550 -18 Optional mounting plate for standard hollow metal door frames. Specify length 30" to 98 maximum. L.CK 131 LCN CLOSERS 121 W. RAILROAD AVE. P.O. BOX 100 PRINCETON, IL, USA 61356 -0100 PHONE 800- 526 -2400 FAX 800. 248.1460 www.Icnclosers.com 6/06 0 W cc 0 0 coo W �7 v MCC _ TABLE OF SIZES --- *-Indicates recommended range of door width for operator. Note: For All Senior Swing Series Simultaneous Pair— Width per leaf 30" minimum to 48" maximum DOOR WIDTH Minimum Door Width HOW-TO-ORDER 9550 SERIES OPERATORS 1. SPECIFY HAND ❑ RH ❑ LH 2. SPECIFY FINISH. ❑ Standard Anodized Finish Aluminum or Dark Bronze Operator will be shipped with: - STANDARD MOTOR GEARBOX (SP) (2 ea) - STANDARD CONTROL BOX (SC) -72" METAL COVER (72HL) . - REGULARARM(2 ea) -2 3/4 "PIVOT POINT - MACHINE SCREW PACK OPERATOR OPTIONS MOTOR GEARBOX ❑ Reduced Force Motor Gearbox (RF) HEADER ❑ 72HL_ (Specify length 60" to 981 MOUNTING PLATE ❑ Plate,. (Specify Length 30" to 98 ") ARM • Standard Arm (2 ea) w /Standard Track (2 ea) • Double Egress Includes Standard Arm w/Track (1 ea) & Regular Arm (1 ea) • Long Arm (3077L) FINISH ❑ Custom Anodized Finish ❑ Custom Painted Finish SPECIAL TEMPLATE ❑ ST- LCN CLOSERS 121 W. RAILROAD AVE. P.O. BOX 100 132 PRINCETON, IL, USA 61356 -0100 PHONE 800 - 526 -2400 FAX 800. 248.1460 www.icnclosers.com 6 /06 Office of County Manager 111 NW 1 st Street • Suite 2910 Miami, Florida 33128 -1994 T 305- 375 -5311 miamidade.gov ADA Coordination Agenda Coordination Art in Public Places W. Ajibola Balogun, City Manager Audit and Management Services City of South Miami Aviation Office . of the City Manager •1 ;* - OuildingCodeCompliance 6130 Sunset Dr. Building South Miami, FL 33143 � q Business Development CI{l i / MANAGER'$OFFICP Capital improvements -Dear Mr. Balogun. Citizen's Independent Transportation Trust Communications I am pleased to advise you.that- Miami -Dade County is commencing the process for Community Acato "Agency the Fiscal Year 08 -09 Parking Fines: Reimbursement Program. As a result of. your Community.& Economic Development submittal of an executed Interiocal AgreementIwith Miami-Da . de County. last year, you Community Relations need only submit an Affidavit (see enclosed template) to participate. The Affidavit Consumer Services states that the funds reimbursed shall be used to improve accessibility and equal Corrections & Rehabilitation - Caunty:videHealthcarePlanning opportunity to qualified persons who have disabilities in the municipality and to CulturalAf(airs conduct disability public awareness. programs. Elections Emergency Management' It is our goal . to increase participation in the program in order to get these monies Employee Relations back into the communities where they can be used' to fund, programs for persons with Enterprise Technology Services disabilities. Additionally, it is hoped that more reimbursements create additional Environmental Resources Management incentives to enforce the accessible parking laws, thus freeing up more spaces for Fair Employment Practices those who are entitled to use them. Finance fire Rescue The combination of fines collected in the previous fiscal year, and unspent funds General ServlcesAdrninistralior, from other municipalities, makes available an amount of $12,617.00 for which the Historic Preservation City of :South Miamii may apply. The deadline for submission of the affidavit is Homeless Trust June 30, 2009. Housing Agency Housing FinanceAuihority Reimbursements to municipalities are based on a percentage of revenue Human Services collected during: Fiscal Year 07 -08 that is determined by calculating the total Independent Review Panel amount paid on. tickets issued in a municipality divided by the total: numbe.r.of tMernational Trade Consortium tickets :paid countywide. Funding estimates include a percentage of the juvenile Assessment Center carryover monies that were not distributed to any municipalities in the previous Medical Examiner "ea. r Metropolitan Planning Organization J Park and Recreation In accordance with .Section 30-447 of the Code of Miami -Dade County, parking Planning and Zoli fine ne money generated --from the misuse of marked spaces for people with Police Procurement disabilities is used in the following manner: Properly Appraiser Public Library System One -third of the. money ,'is used to defray Clerk of Courts' administrative Public Works expenses; and Safe Neighborhood Parks Seaport Solid Waste Management Strategic Business h4anagemeni - Team Metro .. Transit Urban Revitalization Task Force Vizcaya Museum and Caniens Water and Sewer (�rri`r!i<f Parking Fines Reimbursement Program Page 2 • Two - thirds of the money: is used to provide funds to improve accessibility and equal opportunity to qualified physically disabled persons and to provide funds. to conduct public awareness programs concerning physically disabled persons. Of this amount, 30 percent is retained by the County for :countywide purposes; in accordance with State law, and 70 percent is allocated to the governmental entity having jurisdiction over the violation. If you need additional information regarding the Parking Fines Reimbursement Program,: please contact. Office of ADA Coordination Director Heidi Johnson - Wright at 305 - 375 -3566, 111 N.W. 1 Street, Suite 348, 12� Floor, Miami, Florida 33128, County Manager Enclosure C: Wendi J. Norris, Director,'General Services Administration Jennifer Glazer -Moon, Director, Office of Strategic Business Management PUERLOCAZ A,GIREEMIENT This agreement is entered into this ''/ day of ` year, by and between Miami Dade County, Florida, a political subdivision of the Siatp of Florida (the "County") and the "municipality"), a municipal corporation organized and existing under the laws ofthe State of Florida. WITNESSETH WHEREAS, Section 316.008 Florida Statutes, and Section 30447. Code of Miami -Dade County, authorizes the charging of fines for misuse of specialty marked parking spaces for people with disabilities, and W>ri'EREM, Miami Dade County proposes to distribute said fines under the provisions of Section 30-447 of the Code of Miami Dade County, Florida. follows NOW THEREFORE in consideration of the covenants contain herein, the patties agree as 1. This agreement shall become effective upon its execution by the authorized officers of the parties and will continue annually upon agreement by both parties. 2. The allocation of the disabled parking fine monies shall be used to provide funds to improve accessibility and equal opportunity to qualified physically disabled persons and to provide funds to conduct public awareness programs concerning physically disabled persons. 1 3. The parties shall annually submit an affidavit sworn by the chief administrative official of the municipality to the MiamiQade County Office of Americans with Disabilities Act Coordination, hereinafter known as the "ADA Office ". 44 The affiant will affirm that expenditures meet the following criteria: a. The funds reimbursed shall be used to improve accessibility and equal opportunity to qualified persons who have disabilities in the municipality and to conduct public awareness programs in the municipality concerning persons who have disabilities. b. If only a portion of the project or program is being promoted to benefit people with disabilities, then only that portion of the project or program may be funded with these monies. S. The parties agree to follow the terms and conclusions regarding payment as follows: a. The percentage for distribution shall be calculated by the County annually. Each year the County shall notify all municipalities of the percentages of distribution of the disabled permit parking fine money for the upcoming annual period. The percentage for distribution to the County and to the municipalities is based on a percentage of total revenue which is determined by calculating the total number of fines paid county -wide. Funding estimates include a percentage of the monies which were not distributed to any municipalities in the previous year: 2 b. The County agrees to pay the municipality under this agreement based on a payment schedule agreed upon by the Off-ice of ADA Coordination, accompanied by such documentation as requested. c. In no event shall County funds be advanced to any subcontractor hereunder. d. The parties shall return funds to the Clerk of the Board if the project is not successfully completed and shall allow the Office of ADA Coordination to audit projects and conduct site visits. Any such audits or inspections shall be conducted in such manner and at such times so as not to unreasonably interfere with the day- today operation of the parties. e. The County may amend the terms ofthis agreement from time to time, as it may IN WJTNESS WHEREOF, the parties have caused this agreement to be executed by their respective and duly authorized officers on the date hereinabove first mentioned. A'T'TEST: AUAMI -DADS COUNTY, FLORIDA Harvey Ruvin, lerk Carlos Alvarez, Mayor 3 A'I"I`EST0 City Clerk (Official Seal) CITY OF v L`�.QRillA By: '1 _ 11 : .• (Date) GENEM AFFIDAVIT before whom affidavi the undersigned Is sworn], on this _ VAA Notary, [name of Notary [day of month] day of [month], A 2t� , ,personally known to sworn, on JL this of• =6 [name of afftantll, of lawful age, who being by we first duly her] oath, deposes and says; The municipal parking fines funds reimbursed shall be used to improve accessibility and equal opportunity to qualified persons who have disabilities in the municipality and to conduct public awareness programs in the municipality concerning persons who have disabilities. If only a portion of the project or program is being promoted to benefit people with disabilities, then only that portion of the project or program will be funded with these monies. The municipality shall return funds to the Clerk of the Board if the project is not successfully completed and shall allow the Miami -Dade County Office of ADA Coordination to audit projects and conduct site visits. Any such audits or inspections shall be conducted in such manner and at such times so as not to unreasonably interfere with the day -to -day operation of the parties. (set forth affiant's statement of facts] MT �a (signature of aff ant] 1 40. ` & [typed n re of affiant, j address of afant, line IJ . k1i fir; 3113 [address of of ant, line 2] State of Mori a _ �� County of Swok to (or affirmed) any subseri ed be£ re e this .� " - ` day o maki (year), by (n of person ng state ent). Public - State of Florida) (Print, Type, or Stamp Conmissioned Name of Nolary Public) Personally Known 4CoZ OR Produced Identification Type of Identification .Produced H ! 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