8THE CITY OF PLEASANT LIVING
To:
FROM:
Via:
DATE:
SUBJECT:
BACKGROUND:
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
The Honorable Mayor & Members of the City Commission
Steven Alexander, City Manager
Quentin Pough, Director of Parks & Recreation
Agenda Item No.: g August 16, 2016
A Resolution authorizing the City Manager to expend an amount not to exceed
$5,550 to Tropical Landscaping and Lawn Maintenance, Inc. for the supply and
installation of new trees at Dante Fasce" Park.
The City desires to plant two (2) bridal veils, three (3) yellow tabebuias, and
eight (8) Japanese ferns at various locations, including along the jogging/walking
trail at Dante Fasce" Park.
The City submitted an Invitation to Quote (ITQ) #PR2016-17 on Wednesday, July
20, 2016 for "Supply and Insta" New Trees at Dante Fasce" Park". Five (5)
proposals were received; Tropical Landscape and Lawn Maintenance, Inc. is the
lowest bidder and in compliance with the terms of the ITQ.
VENDORS &
PROPOSAL AMOUNT: Please find below a breakdown of a" submitted proposals.
FUND&
ACCOUNT:
ATTACHMENTS:
VENDORS AMOUNT
TROPICAL LANDSCAPE & MAINT., INC. $5,550
LAWN KEEPERS OF SOUTH FLORIDA, INC. $8,375
MTC SERVICE, LLC $8,515
PLANT PROFESSIONALS, INC. $9,037.50
CRODON, INC. $10,422
The total expenditure shall be charged to the Tree Planting CIP, account number
301-1730-541-6450, which has a balance of $40,000 before this request was
made.
Resolution
Bid Opening Report
Tropic Landscape and Lawn Maintenance, Inc. Proposal
Sun-Biz Report -Tropic Landscape and Lawn Maintenance, Inc.
Minimum Qualification Summary
Demand Star Results
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RESOLUTION NO.: _____ _
A Resolution authorizing the City Manager to expend an amount not to exceed $5,550 to Tropical
Landscaping and Lawn Maintenance, Inc. for the supply and installation of new trees at Dante
Fascell Park.
WHEREAS, the City desires to install/plant two (2) bridal veils, three (3) yellow tabebuias, and eight
(8) Japanese ferns at various locations, including along the jogging/walking trail at Dante Fascell Park; and
WHEREAS, the City submitted an Invitation to Quote (ITQ) #PR2016-17 on Wednesday, July 20, 2016
for "Supply and Install New Trees at Dante Fascell Park"; and
WHEREAS, five (5) proposals were received; Tropical Landscape and Lawn Maintenance, Inc. is the
lowest bidder ($5,550) and in compliance with the terms of the ITQ; and
WHEREAS, the City desires to provide a contingency of $750 over the proposal amount for unknown
factors that may arise during the work; and
WHEREAS, the total expenditure shall not to exceed $6,300.
NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF
SOUTH MIAMI, FLORIDA THAT:
Section 1: The City Manager is authorized to expend an amount not to exceed $5,550 to Tropical
Landscaping and Lawn Maintenance, Inc. for the supply and installation of Yellow Tabebuias, Bridal Veil, and
Japanese ferns at Dante Fascell Park. The City Manager is also authorized to expend an additional $750 over
the proposal amount of $5,550 for unknown factors.
Section 2: The total expenditure shall be charged to the Tree Planting CIP, account number 301-
1730-541-6450, which has a balance of $40,000 before this request was made.
Section 3: If any section clause, sentence, or phrase of this resolution is for any reason held invalid
or unconstitutional by a court of competent jurisdiction, the holding shall not affect the validity of the
remaining portions of this resolution.
Section 4: This resolution shall become effective immediately upon adoption.
PASSED AND ADOPTED this ___ day of _____ -', 2016.
ATTEST:
CITY CLERK
READ AND APPROVED AS TO FORM
LANGUAGE, LEGALITY AND EXECUTION
THEREOF
CITY ATTORNEY
APPROVED:
MAYOR
COMMISSION VOTE:
Mayor Stoddard
Vice Mayor Welsh
Commissioner Edmond
Commissioner Liebman
Commissioner Harris
BID OPENING REPORT
Bids were opened on: Wednesday, August 3, 2016 after: 10:00am
For: ITO # PR 2016-17 Supply & Install New Trees at Dante Fascelll)ark
COMPANIES THAT SUBMITTED PROPOSALS:
1. CRC)DON, INC ....................................................... .
2. LAWN KEEPERS OF SOUTH FLORIDA, INC ............... .
3. MTC SERVICE, LLC ................................................ .
4. PLANT PROFESSIONALS, INC ................................. .
5. TROPICAL LANDSCAPING & LAWN MAINT., INC ...... .
AMOUNT:
,-f{ I/), I-/.J.:l.. eIJ>~
?, 37 S; (I~
~ S-/5;".!
ql () 3 7, .s-~
_ tP 0
0; 55"~, ~
THE ABOVE IUDS HAVE NOT BEEN CHECKED.
THE BIDS ARE SUBJECT TO CORRECTION AFTER THE BIDS HAVE BEEN COMPLETELY REVIEWED.
City Clerk: /Y!a rit! JI. /I1e#fflJe :2
P,in' Nam, ~ 4 ~
Witness: .J-!:....f.,VVl.,."U
Print Name
Witness: ____________ _
Print Name Signature
81312016 Detail by Entity Name
Detail by Entity Name
Florida Profit Corporation
TROPIC LANDSCAPING & LAWN MAINTENANCE, INC.
Filing Information
Document Number
FEI/EIN Number
Date Filed
State
Status
Principal Address
17973 SW 248 ST
HOMESTEAD, FL 33031
Changed: '05/02/1997
Mailing Address
P.O. BOX 901368
HOMESTEAD, FL 33090
Changed: 05/0211997
S99368
65~0315410
12/10/1991
FL
ACTIVE
Registered Agent Name & Address
SANTANA, YOLANDA
17973 SW 248 STREET
HOMESTEAD, FL 33031
Address Changed: 04/09/2001
Officer/Director Detail
Name & Address
Title P
SANTANA, YOLANDA
17973 S.W. 248TH STREET
HOMESTEAD, FL 33031
Title VP
SANTANA, DAVID
78 S.W. 18th RD.
http://search.sunblz.org/lnqulry/CorporatlonSearchiSearchResultDelail?inqulrytype=EntityName&directionType=lnltial&searchNameOrder=TROPICLANDSC...1/2
81312016
Miami, FL 33129
Annual Reports
Report Year
2014
2015
2016
Document Images
Filed Date
04/24/2014
04/20/2015
04/19/2016
Detail by Entlly Name
04/19/2016 --ANNUAL REPORT . _____ Vlewl'!"~~~ f~~!:l~ __ .~._J
04/20/2015 --ANNUAL REPORT ___ ~~~~~mage_!.."-"DF form~!....., __ ,_J
04/24/2014 --ANNUAL REPORT View image in PDF format I ._J
04/04/2013 --ANNUAL REPORT View image in PDF format J
04/1112012 --ANNUAL REPORT ___ . View ima~!2~PDF fo~~ ___ J
04/06/2011 --ANNUAL REPORT View image in PDF format .J
04/16/2010 --ANNUAL REPORT View image in PDF format I
04/29/200a --ANNUAL REPORT View image In PDF format J
04/24/2008 --ANNUAL REPORT . ___ View.image in_PDF fo~~. __ . __ J
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04/08/2005 --ANNUAL REPORT View image in P~F format J
03/29/2004 --ANNUAL REPORT _._ .•.. Yiew Image~ PDF format .J
04/14/2003 --ANNUAL REPORT ,... View image in PDF format __ J
04/21/2002 --ANNUAL REPORT . _____ '!..!ew._i.~ag!.!~_~p!. .. t.0~~~_ ...... _ .. ..1
Q4/09/2001 --ANNUAL REPORT _... View l!:'lage In pp!._!ormat .. ,_._ .. ...l
05/03/2000 -. ANNUAL REPORT .. ____ .-'!..!ew image in PD!.!.C:?rma!. ___ .. _..1
04/2Q/19a9 --ANNUAL REPORT View image in PDF format I
__ ._.......... .. .. ..""" ........ .",1
Q4/Q1/1a98 --ANNUAL REPORT View image In PDF format ~J
Q5/02/1 a97 --ANNUAL REPORT View Image In PDF format !
.. '" ........ --... ----...... -... "'.....--..... -."'-'''''.........-"''''' ............ Q,.r-,.." ................ ~'-'" ... I
Q5/01/1 a96 --ANNUAL REPORT View image in PDF format I
_~ ••• _. _~_ ..... _._ .... _. ____ ......... __ •• _~ •• __ •• , .. __ •• ~ ......... ~_. " _ •.• _ ..••.• J
.;~ :
http://search.sunbiz.orgllnquiry/CorporationSearchlSearchResultDetail7inquirytype=EnlilyName&directlonType=lnitlal&searchNameOrder=TROPICLANDSC... 212
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2016 FLORIDA PROFIT CORPORATION ANNUAL REPORT
DOCUMENT# S99368
Entity Name: TROPIC LANDSCAPING & LAWN MAINTENANCE, INC.
Current Principal Place of Business:
17973 SW 248 ST
HOMESTEAD, FL 33031
Current Mailing Address:
P.O. BOX 901368
HOMESTEAD, FL 33090 US
FEI Number: 65·0315410
Name and Address of Current Registered Agent:
SANTANA, YOLANDA
17973 SW 248 STREET
HOMESTEAD, FL 33031 US
FILED
Apr 19, 2016
Secretary of State
CC9845659741
Certificate of Status Desired: No
The above named entity submits this statement for the PUrpOS8 of changing Its registered office or registered agent, or both, In the State of Florida.
SIGNATURE:
Electronic Signature of Registered Agent
Officer/Director Detail :
Title
Name
Address
P
SANTANA, YOLANDA
17973 S.W. 248TH STREET
Clty-State-ZIp: HOMESTEAD FL 33031
Title
Name
VP
SANTANA, DAVID
Address 78 S.W. 18TH RD.
Clty-State-Zip: MIAMI FL 33129
Date
I hereby certify that the Infol1llatlon Indicated on this report or sUPplemental report Is true and accumte and that my electronIc sIgnature shall have the same legal effect as If made under
oath; that I am an officer or dime/or of the corpomtion or the rec8iwr or trustee empowered to execute this report as required by Chapter 607, Ftorlda Statutes; and thet my name appears
ebova, or on an attachment with e/l other like empowered.
SIGNATURE: YOLANDA SANTANA PRESIDENT 04/19/2016
Electronic Signature of Signing Officer/Director Detail Date
ITQ PR2016·17 DANTE FASCELL TREE PROJECT
NOTE: RESULTS ARE NOT FINAL UNTIL AN AWARD RECOMMENDTIONBY THE CITY MANAGER
Public
Lump Sum Non Coli. Entity Drug free Fed. State Related Presentation Insurance Signed Bidder Crimes and OSHAStds Condition Sun Biz Bid Price Affidavit Conflicts of Workplace listings Party Declaration of Award Contract
Interest
Tropical
Landscaping & $5,550.00 x x x X x X N/A N/A N/A X
Lawn Mtce.
Lawn Keepers $8,375.00 X X X X X X X N/A Included, Not X
of 50. Fla. Signed.
MTCService $8,515.00 X X X X X X Included, Not N/A X Signed.
Plant $9,037.50 Professionals
X X X X X X X N/A X
CRODON, INC. $10,422.00 X X X X X X X N/A Included, Not
Signed.
Member Name City of South
Bid Number ITQ-ITQ
Bid Name
IISupply &
Install New
Trees at Dante
Fascell Park"
2 Document(s) found for this bid
5 Planholder(s) found.
Supplier Name Address 1
ARAZOZA POBOX
BROTHERS 924890
ConstructConn 3825 Edwards
ect Rd
Construction 400SW7th
Journal, ltd. Street
link Systems 5870
llC Hummingbird
POBox
MCTService 163203
Address 2
15901SW
242nd Street
Suite 800
City State Zip Phone Attributes
1. Hispanic
HOMESTEAD Fl 33031 3052463223 Owned
Cincinnati OH 45209 8772271680
Stuart Fl 34994 8007855165
1. Small
Titusville Fl 32780 4074010031 Business
Miami Fl 33176 3059226844
SUBMITTEOTOI City Clerk
N~~E; Maria Menendez, eMe
CITVOf $QUTt(MIAMI
INVITAtlOI\l lOQUOTE
ITq I#PR2~16,;17
LUMflSiJM PROPOSAL
PRO!ECT;
ADDRESS: 6i3()SLlriset [mye' ~~~~~~--~--------~~----CITY/$TATEt. Mlami,Florlda3M34
PHONE: 3()S,663.6339
MANDATORY PRE·Q.::.IJ.;::;O::-TE:..:M;,:;.·,.,:;EET.::::;::.:IN..".G,...l ....... ---"'-iII .... Q....,"e....,$ .... ~h;,..e...,d-ul....,ed..,.. ----.--!itUl~ti\~j~)1
QUOTE SUBMISSION REqUIREMENTS:
SupplV& Install New TI'Clf!nt /)Clnte .fasceU
.Park
Quotes' SI,I\)i\1ltte:dafter 10AMQn the: due:date will not be actepted (In less otherwise specified hi theqoot~ document
pfa tli'necnange.AII quote~wlIl bes\lbmlttec! to the qtyCferl!'sofficefnasealede:nyeIQPe. Tb'e.labelonthe Qn the
enllelopeneet1S to read as f6uQws:
(:1~'Qf$ou~hMIClml
Mattai.tvI.Me:neijil~, eMe
$.Ull,S:~os,etJ~'t!~.e
sQuth Mi~ml!.i.FI;,~3149
Projf.!~H·ii)me.:'Supplv& lilftall New Trees a! Dante Fai~ellParlt
MUst Input prOjec.(hame.lf label does nathalie' all information aboveyqur quaff.! will 'lot beaccefl~e~,
, -' '-" ,
INS",RANCER£9UIREM~NTSl
TheCiTY'~.i~i~ianc¢. ~~q\liietne!\t$ are ahaehed(~xhl~it 1;. As II condltlCihohward! tfieaWafdedVelidorMustptaVide a
. cettificate6flt\surlll)ce natnlngthe city as additloo'al ihsurecj,
AfFIDAViTS Rl1qOIRED(WITlfSOBMltTA(: (l1xhlblt· 2)
ReSPMdehts hiu~t.c.oi'npleteandsubi'njt With 'IOUI' qUote affidavifsprovided II'IE)(hibit 2.
'(H~ElC~CIl119NO'THIS fQ8M~QI:I~m!,I1:ESTH~.ONEll,l)IYl)tiI~OFJ:EI\ Of'~ROPOS~/I TO 8ESOUNO S'i'rflE'rEAMS oflTJi PROPOSAL..FAILUR~TO$IGNTHISSOLl~Ii'ATjON WiiEl!~ IrjOI(AT~O!,\8QV~ llYN"
AUTI:IO~I~£O I\EpIIESE.NTMIlit $IIA~L ~~ND.ER rlia PRQPOSI\(NON,~ESPONsjVE •. MelT:" MAY; H(jW~ER.IIN I'I'Hoil! bISCRETibN, A¢EPT-jiNVPI\!lPOSAL Tl:\AT IN~WDES A.N E~~~U~O O~U.M.ENT
wllfcH ONEQ.UIIfOl!l\U.V.~INO$iTHI! ~~OP()SER10 THE.TeRMS·OFIT$ OfFER •. tile CITV'S R~qumfoli QuarEs 1$ FOil Tl:\ElOWI:ST ANDMQ~RESPOIllSIVE PI\I~E~TH~ (flV RES~I\VES THERIGHT19AWARO
. titE PROJECT TO .THe fiRM C()N'$fQERl;o THE Bi;5tYO sEt\\rti THIfCI1Y'S INTEREJr. .
RiiSt>ONbENtAtcEPTSA1.l· OPl'f/liieRMs ANa C;(lNDrtlONS.OfTHESQlIClTA1101ll ANt:! QUQT!iSQBMISSIQN REQUIIIEMeNrS, ,(illS PI\OPOSAl. W.lk~ REMAINsulIJeCJ: TO AC~EPTAN:CE FOit1lio¢,\lENOAR
01. YSAFTER THE PROp(jSAL OPEN.ING. TII.£ RES.PQ.NQ~T.IIY SI§IIlJN.G NlD, SQBM!TIING THISPROPQ$A~,N;~E~STOAl( THE 1ERMS'AND CONOITlOi'l$ OF, ttlll'I'ORriI CONTRACT.l'HI\T ISA PAIIT OF tHE'
SOUCITATloN PACKAGE WITH !'\PPR9~IAre: C!lANGES;TQ.eONfO~MrOWE IrlFQI(MATION COI:ITi\ltiEi,1IN titrS Itil/iTAliON To.BUOTE.
SPI;CI.ES
Table~us
Bridal\Vells
..
Sc:;ope of Services and Bid Form
Attachment .8
"Supply &·lnstalJ New Tree$ilt bante Fascell Park"
ITQ#PR2016 .. 17
BID .FORitII
UNIT COST OF Q.'UANTITY
TREES
~ $ '1(75.0 .. z
l.lJMP SUM INSTALlATION:
TOTAL:
TOTAL COST OF
TREES
... '.:,.J .. ' .... .'.V . 5~·O· .~ ...•.... ~ .. S 556f°C) .. $ I ;.;;",4 • .1
. ...... . 0
$ DtCQ.50.0 . ,."
NotE.: THE CITY ReSERVES THE RiGHT TO PURCHASE THE TREES ATTHE QUOTED PRICES
PROVIDeD BYrHE~E~SPONDENTSTO THISSQLlCITATION. THEREFORE, RESPONDENTS ARE TO
QU01'ETHE. COST OF THE TREESANl) INSTALLATION.
to I r;.
PR.OPOSAL.SU~MITTED BY: T~c ·~J~I>'A~..t, to!A)~ Mo;.,,+acWJtl.,'~ lPJ. r ., ..
Ema.II.: . Qdr~ss
n~le ...
NON COLLUSION AFFIDAVIT
STATE Of FLORIDA )
)
COUNTY OF MIAMI-DADE )
_' ..... 6~D:::t:::;AwllJ~' .so.ot)~SL-' ...:~=.' .::;;~.t.Il,v.::::.,.%t"AN.":"":::;"::;:' ~:...::. __________ being first duly, SWOrn, deposes and states that;
(2)
(3)
(4)
(5)
H~JShelThey is/arE! thEl P.etJ'GIi> e'lV7
(pWIi~r, P~rtnel".Offi<;«;!r.~¢prElSEmtatIVEl or ~ent) pf
*I/tCif:)IC-th""44C~~JIJC.. + i4MN tH811tlr:@HtVCtt r IN~ the Respondent that has sllbrnittecl the
attached Proposal; ,
HelSMryhe~lsl~re. flilly InfQ@¢d, CQnCElrniQ~the preparation andcontent$, ,of tne atta~he<l Proposal
and ohll pertinent ¢lrQlmSp,nCEis coi1cEfr!lli:lgslIcirProPQsalj
Such ProPQ,sall~ gEinulneand ISl')ot a coUllsi~~Qr~MmPropo~i';
Neither thEisaid Respondent nor any,otlt,soffl,CEir~,p~ri:Mr'$.Q~nef$ia~n£,$,repre~ent<\tlves,
'employees or, parties Inh'ltlilre!ltt IhdudiQ& t~l{aifiant, haveJo any ~y cpnuded!conspi~e<l!corii'iiVEid
Qrweecl. dii:'¢ctly'or,\nQirectiy. wltha,rY~t):ler'Re~PQnd~n~ffrm;or"persQntQSu,l)irlita collusive 61'
sham: PrQBo~al :tnconl1~Ctton:wJ~~ thl(! WotI<:J9t'V:/hl¢b th~~t~che<l prop'()~~l h~$'l>.e7~Sl!l)l)1ltted; or
tat'efrain ff'qrri Bidding 6rproposlngin. C9!lnla,<i¥(on w!~b$u&hy:vork; ()fti~Y~;jn~M' rraOner;c{lrect!y
or indirectly, sQ~ght by 'agr~ernentQti i~~I\!Jslon! orcOi)1,munlcatlon;qrconference with . aoy
~esPQnclent •... firm. 'or"persoll to' flxanyo,,¢rh,ea~i . profit. or . co~t elen:rei1~softhe' prqposalor· Qf .any
other. ~espoDdent, or tq·ll.>< any o\ierbead •. 'pr61lt.or cqst~l~mE:lnts6f tbe Proposal Price or the
PropoS'al Prlce .of aliy. ·CithEW B.esP9nqeh~j 6rtp$ecure thro~gbaoy ¢ollllSIQn. conspiracy. coonivance,
()r unlaWfulagreemsnt ahY 'adVaiitag~ agaIQ~t(~¢ciplen~). or'arW petsonlnt¢t'¢stedi)i) dIe proposed
W~· , .~ .. , '"
The price Qr. pricesquotecf in. theatfached Proposal are fall'aM'proper' and!\rerlot tainted QY any
coUU~i6n,c6n$pira:cy; c6!:1r1iyal1CEli Qtunlaw{LJI ~greement on tile part of tbe R~sPlimdent or any otber
ofits:agents, l"ePf'esenfa~lyes. QWners, employees 0'" parties of.interesJ;.includltigthill affiant,
Signed, sealedancl.delivered· In the presence of:
STATE of FLORJOA
COUNTY OFMIAMI"DADE
$lgh~N/'e.~ ..
. ~t-,., ",'ptA $~#Arf'1, tte'''9-.
Print: Name.and Title
&(i /t?':l. i,a,
Date
ACKNQWLEDGEMENT
)
)
)
.' Ontnis th.·.e ZrJ da. y ofA~~\ ..10.''J>. ' .. (.befo. re rne. the undersigned Notary Public ofthe State
. of Florida, pers n~Jlyappear.ed (Na e(s) of individUal(s) ..... !:Io appeared before
notary) 0.\-. and whoseharne(S) is/are Subscribed to tbe
within instrument. and h he hey acknowledge that belshe/they executed it.
Thomas.F. Pepe
02·23·15 15
WITNESS my handalid official seal.
NOTARY PUBLIC:
SEAL OF OFFICE:
.~.~ ... ~ ....•..... ':
.~)
.. ~01.~
Thomas. F, Pepe
02·23·15 16
Persortalidentification:
type ~~Identification Produced
",":" .
Dld take ali. oath, or .v. Did N6t'take an oath.
J'
PUBLIC ENTITY CRIMES AND CONFLICTS OF INTEREST
Pursuant to the provisions of Paragraph (~) (a) or Secti6n287, 133,. Florida Stat~ Statutes ~ "A person or affiliate
who has been placed on the convicted vendor list foUowlnga>conviction ,fof a publicentit)' crime may 1'10t,$Ublllit a
Proposal or bid on a Contract to provide any goods or services taa public entitYi,May not submit a Bid or
proposal for a Contract wlth a pllblic entity for the cOl'1strllctioJ) 9trepair ora public bllildin~orpl!bllc work, May
nOtsubmft bids Qrproposals on leases or reai property toa Pll~lic~ntity, may not be awarded t~ perform Work
as a RESPONDENT. Sub-contractor. supplier. Si.lb"consul~rlt;or· Con~urtant ",nclef" aContrac;t with any Pllblic
entity, and may not transact business With any public endty in,~xc.ess Qf the thre~hoid amount Categ0tY Two of
Section 287.017, Florid.a Statutes. for thirty six (36) months from.the,.date of being placed on the convicted vendor
Ii$t", . . . .
The award of Mycontracthereurtder is subject to toe pr~Xisiotis of Ch!(pter 112, Florida State Statutes,
Respondents mustdlsclos~ with their Proposals, the nameofanyofflcer," director. (rartner, associate ot".agentwho
Is also an offlceror employee of the City of SQuth MiaJ'):'lI or luageOCies.
SWORN S'fATEMENTPURSUAN'f TO'SEC'fION 28.7J33 ()) (a)"
FLOBIPASTATUTES\ ON PlJahl~I~NTITY CRIMES
THIS i=OP,M MUST ~ESIQNED ANP SWORN TO IN Tblii PRESENCE OF ANOTARY PUBLIC OR OTHER
OFFICtALAU'fHOP,IZED TOAPMINISrER OATHS~.' .
I. This swot'. nstatement. is submitted.to ........... .... .. . .. ... /J '
rtlZ''i t>E· $/)l.;iJrH {vIIAMI
2. I understand that a "public entity crime" .3.$ de'nflfad in Paragraph 2a7~ 133 (1)(g),Elorlda Statutes.,
means a violation of any st:ateor federal law by a (5erson with respe¢t to and directly relat~d to the
transactlr;lr)of business with any public entity or with.an ag~ncy or political subdivision of any other state
or ofthelJni~ed States, iocludll'1g.butno.t limited to ,any bid, proposal or contractforgpods.or services.
to . be provlcled toaily public entity oranag~ncy or political. subdiVision of any other state or of the.
United States and involying 3.lltiti'~st, fi'aud. theft,· brlbety, CQUUSloil, racketeeril'1g. conspiracy, or material
Misrepresentation.
). I I,mderstand that "convicted"or "conviction" as defined ill Paragraph 287.133 (1) (b),.~
Statutes. me;lQ$il fil'1ding or guilt ora conviction. ofa public entity crime,. With or Without an adjudica:tlon
of gWlt,in aoY fe~e~!orState tri.al court of record rel;ltlng to charges brQught by indictment or
information after July I, 1989, a~a result of a ll/ry ve:rdiilt, non-jury tri;d, or entry of a pl~a of guilty or
nolo contendere ..
4. I unders.tand that. an "affiliate"as defined in Paragraph 28.7.133 (I) (a), Florida Statut~s, means;
(a; ~ A predecessor Qr l;UcceSS'Or of a person,convicted of a public entity crime; or
(b) An entity uncler (he control of any natural person who is active in the management of the entity
and whe> has. been ~ol'lvic.ted ota pubfiC:: entity crime, The term "afflliate" includes those officers,
directors, executives, partners, share~ofder~, empioyee~. members, and agents who are ac.tive in
Thomas F, Pepe
02·23-15 17
s.
6.
the management ohn afflliate. The ownership by Qneperson of shares C(lOStiMli),acontroiling
interest iO any person. or a pooling ofequfpment 01" income. among persons when not for fail"
market vafueunder an armis length agreement, shall. be a prtr:nll facie case that one person
cbi:ltrols another person .. A person who knowingly enters into a joint venture with a p.erson
who has been eOhVicted of !ipubljc entity crime ill Florida during theprecec!ing ~.~. m¢nths shall
be cOhsldered an affiliate. . .
f lInderstaodthat it "person" as defined in Paragraph 28'7.' 33 (I) (e), FIQrida Statutes! means any
natulill persQll or ehti~ Qi'p,nized .I.!ncfer the laws of any state or of thElUnlted States with the legal
power to enter into a binding contract and Whi.clibids or proposal or applies to bid or proposal on
contracts for the proVision of go ods orservi<:es let by a PlibUe entity. (WWhich otherwise tran.$M;t~or
applies to transact busin~$$ with a. public entity,. The· term"persoil" Inchld es those officers,directors.
e>,<ecut!ves, partrlers,shareholdersi employeej, members,andagelTts who are active In management of an
entity.
Based on Informatioil: .al'\d belief, the statemMt whiCh I have marked' b~'pw IS trUe In relation to the
entity submitting this sworn statement. [Indicate whlchstatement appi,e~:l ... . .
.1 Neither the. ¢ntity $uomitti!)g~h!s $\Vorry,stat,en1ent, nor any of it$. offlcers, . dIreccors,l'll<ecutives,
partners, shareholders. e~ployeest members, or agentsWh9 are a,ctive in the manage:ment of.the entity.
nor any affll.iate of the entity has been'tharged wltniand cOrIvicted of a, [5ubIiCEint.lty ctil'heSu,bsequEli'IUo
July I.. 1989; .
__ The entity Slll;;itllttingthi$$WQrnstatemen~ or one Or nioreo! its officers. directors. executives,
partners, sharehoh:lers, employees. members, or <tg'eflts who a~~ active in tHe management of the entity;
or an afflliateof the. entity haS been charged with arid tonvlCt~dofapubllq entity <:rlll'ie sUbseC!uenHoJuly
1,1989, '
_ .• _. _ The entity $ubmlttlog this sworn statement, or one or morl:) ohts officers. dir.ectors, executives,
partners, shareholders •. employees, roerobi~.r$j or agents who ate ac:;tiye in the management of the entity.
or anafflJiate~ot the entity has been chargeClWith ~na cc>nvl(:~ed <>f ap'uQlic>entitycrirn~~ub,seqpel:wofJ!.Ily
I. 1989; However, there has been a ~UbSeqUehtprO.c~ec:lingbefbrea Hearing Offf~erof~be Sti.1t¢ qf
florida; Division of Administrative Hearings and th!:lFlnal Order entered by the Hea:ringQfflcer
~et~rlJ"lil1ed thatci~ was not in the public;lntere~t tc> placeih.eentlty ~ubmlttlng this svv,ot'nstatement on
the c()nYlc~ed venc:!or nst. [ilttath il I;Qi?tofthecfinal order.] .
I UNDERSTANP T~AT THE: SVaMISSIQt-I OF THIS ·FORM Tc;>tl:fECQNTR.ACTING 0FFIC.~R· FOR THEPVBLIC ENTITY .
INPENTtFI~P IN PAAA(3R.APH I (ONS} AeOVe IS FOR tHAt PUBLIC ENl'lTY ONLY, AND THAT THIS r(jRMIS VALID
THRO(.lOH DeCEMBER 31 O.i=·THE CALE:NOAR'Y'EAR. IN.WI4ICHII: 'Iti:O. I ALSOVNOERSTANOTHAT lAM
REQVIRED. TO INFORM THE PUBLIC ENTITYPRlb~ Te) ENTJt { P AcoNtBAcr INaxCE.SS OF THE
'rHRESHOt:D AMO\)Nr PROYIPEolN SeC'(IPN 281.017, .. .. ',.. r FO~C'" ... TWO OF ANY
CHANGe. IN THE INFPRMATION CONTAINEO IN THIS, FORM, .
~;e~~~e~~~~
Sworn to aodsUbsctibed before me this ,{,.:,day of~.p!I.=\~~ ___ "",--__ -'
Personallykno'Ni'i ... vC,,-:-··_·. ___ --~ __ _,_
OR Produced identif'lcatlbn ______ _
(typeofiden~iflcation)
Ponn PUR 7068 (Rey,0'61I1/92)
T!loma~ F. Pepe
Ol~13·15
Ndtl~ ~u~!c.$!a('OIFlqrida·
Karen M Loria
My.CoJ'/linlaalQIi Ff013496
SliI!/re&.06/28120t7
DftUG FftEE WOftKPLACE
Wlumeyer ~o or more Bids orPt9posals whlc:h are (!qY'al With r~spect: to prICe. quality and service are. received
by the State or by any po(iticillsllbdlvlsiohs for the procurement of commodities or c6ntractual·seryices~ aBi(j or
Proposal received from a. business that certifies that It has implemented a drug-free workplace ptograrnshilU Q6
given preference In the award process. Established procedures fot pt'Qcesslngtie ~ld$ or Proposals shall be
followed if none: of the tied vendors have a drug-free workplace program. fnorderto have a drug-free workplace
pt'0grilO'l, a busine:Ss shall~ .
I) Publish a statement notlfyfng:employees that the unlawful manufaclture,4i~trlbutlon~t:lisper'!sthg;
possession,or useo{a controlledsubstanceJs ptohibitedir:\tne workplace and .specifying the
.acti.ons that.sbaU be taken,aga;inst eitiploye:esfor \liol~tlons of $llchJ?rohlbition. . .
2) !nfotm efiiploy.ee~ about: thedatigets of drug abuse in the w~rkplate, the business? policy of
maintll1nlnga drug~free workplace,anyavailable di'Lig counseling, rehabilitation,anden'lployee
assistance programs, and .the'penalties thatrriilybe Imposed upon: employees. (or drugabu~e
violations.
3) Give each employee engaged In provid(ngt~Ei <ioh1mQditie$pr c.oiltractua[ services thatare under
Bid a ¢opy ¢f th~staterherlt ~pe~iftE!d in Su~~Eictioo 0).
4) (h,the stat~me!1t~pedfiedinSubsectioh (1).n9tify the: employees, that, as a: con~ltrori o( w~rking
afthe c0l'l1moditlesorcontractualservices thatare underBid; he·employee$hall~bid.e by the
terms af'tne statement and shall n'Otifytheemployee ofanyconvlctlOh of; or plea bfg\lilty ()i'
nQiQ coit~ender.e; to, al1yviolatlon 0.1 Chal>t~r ~C)~ or Of a:nycQl'ltroUed substance law ofthe Uhited
$tat¢~ ¢raI)Y: sta~i. for· a itiot#ion o.cCl.lfrh'8 in'the wcirkplace no latet'tha,nflve (5) bus.inessday&
a~rsuch conviction. . .
5) Impose a sanction. on, orreq!Jire the satisfactory participation in a. drug ab.u.se a$sista~ce or
rehabilitation pr.ogram, if such is avanilbl~ in .tlieeroj?loyeeis cornmuo1tj. by any employee: Who i~
sq COQvicted,
6) Make a.goQd fa:ithl:lffort to <:Ontinlle.~o rna:intaina drllg~free WOr'kplacethroughlmplementati.on
of this sectio .... .., .
As the person authorized to S'r'! the's.. ~I\ls firm complies fully with the above requirements,
RESPONDEN'ps Signature, Cl.~~~~~fLf-1»....&~~~fi!:IoL
Pril'ltNl\mef . ~lAt.Jtj4
Date: -~I-'~~f,....2.W!I)~'1=':;.... _______ -_~
T"~n!;t$ F. Pepe
02.2HS 19
ACKNOWLEDGEMENT OF CONFORMANCE WITH OSHASTANDAR.DS
TO THE CITY OF SOUTH M.IAMI
-r~o~c:.lA~l')$CAO)~q 4-
W~'~~'. M.~\NTE~~/I~o. (Nam~ of CO NTRACTO 1'). h~reby ac;koowl~dgE! and agreetha~ as
CONTRACTQI\ fOr th.e IIwitatlQ'11 QUote proje(t ~s specifle<:\ In the SCi licitation: documents have the. sole
'respol'Isibility f¢r ¢ompllance With ;lll~he requirements of the: Federal dccupatlomJ Safety and Health /Act (If 1970;
aMa[IStatE! and local safetyal1d health regulation's, and agree to IndemrMy anci hold ,harmless theCity'o,South
M.ia.rniand~(Con$ultant) against any and allliabilityi. claims; damagl'ls, Jossesaod e~peP$e~, ~hey may incut due
to the failure of (Sub-contractors names):
t@::.:: .•. p,.'.IY~r::UCh :.,,~e.~lmort.
r~4~~UrlA)
. '
. ' .. ',
BY: ':o.IQLb..~'OA SAfi)''t'~~
'Name
t>test'i2 ~,T"
Tide '
AFFIDAVITCOftlCeRftllNG
FeDERAL AND STATE VeNPOR LISTlNGS
The person, or entity. who is respc:>ooing to the City's ,solicil:ation, l1ereina~.r referred to as iiR,esp9 nde nt';, I'IiU~St
eetilfytliatthe'Respondent's nallle Does Not appearoii the Stllte of Fiorlda. Department of, ManagementSerVh::e~.
"CONVICTED, SUSPENDED, DISCRIMINATORY FEDERAL EXCLUDED PARTies and COMPLAINTS VENDOR
LISTINGS",
IftheResponclent;'sname Does appear <mone or all the "listings" summarized belQW. Respondents must "Check
if Applie$"j ne,~t:tQthe applicable I'li~titjg;" The il~l$tings"ca,n beaq:essed through the following link to the F,lorida
Department Qf M!1t1agementServi<::es website:
httP;Ilti'lffltdmstQ1)ifl~dg!u;otn{business ,operatioo§{stiJ,te purcha~log!yendor InfQrmMiorilconylcted ,$YsP
tmded)i$~ri[!!lnatoryyomplaro~~odQrllst~ ," , " ,
tl t I .• .1 ... <.D';';'-ARATION UNPJ!i\ PI;~AI;,TYOF PEi\JUi\Y
II vb ~.~. ~(hereinaftel"' referred toasthe "Declarant") state. under penalty ofperjury;
thatthe foUowing$tatemtmtS 'arf;! trU~ ancl'c;otrec;t: . ' ... ,. '. ". .... ..' . " '. . •
(I) I represent the. ResponcienP whose name is -r~~t. . ~~l?$~t.\j/!fpq ~l~t:)MA' ~"'Q.)~~C6t ,tJ(.
(2) '.' IliaveJlief"UoWro~ reJatioosliip'With theR.es'PQndeot~~tQ~ . (OWner'WResppnden~;isa
$olepropri!'!,tor), Presldeht(i{ Respondent i~ lj. (?Qrpor~tlon) Pllrt,,~i' (If Resp.pndent is a parthership),Genel'al
Partner (if Respondent is' a Umited Partnership) Or Managing Member>{if ReS"pondent is a LimIted Liability
Company).
(3). r have revlewec;\ tl1~ fl~>riclaJ):~partmentof ~anagemen~ $ervi<;e$ website at the followlng't.JP..~address:
ht4?:llwww;dms.My,fIorlcla.r:.om/bl!$J~e$$.,..;operatlon,sJ$tat~ .... pur\::has1nglVEmdor _inf()rmatioh/convrctect...;sYspeh~e:d_dl
s<;rlminatqry...co(npl!l,iot;S_vendQr::..Jists
(4)/ have Mteted an "x" or'a check .mark beside e,llen US1;ing/c:ategoi'yset forth below if the Respondent's
nameappeCirsih the. list found on the Florida: Department of ManagemerttServices website for that category 01"'
listing. 1ft did not enter a mark besiaea listing/category it means that.( amat,testingt9 the faGt that the
R.esp¢ndent~s name does not; appear 00. the IistlngJor that category inth~ Florida DepartMent of Management
Service$websjte as of the dat~, of thi~ atficlaY.it~.
Clletkif
Applicable
Convicted Vendor Li$t
Suspende~ Yendor list
·Oiscriminatory V¢ttdor.List
Federal ExdudeciPartles List
Vendor Complil:lntList
ACKNOWLEDGEMENT
STATE OF: FLOJtIDA .. l
cout'iTY Or: f1fAMI~[)ADJ; )
. O. ~~.?£tdaY ~ . 2n.l!L.,bolo e.,lgnodauthority. p'I'SOI\~ly
appeared . '. QJ.l··· . \);.. 3::.:=;;;: who i ersonally know to m or who provided the
following idertti I<;ation . and who took an oath fa Irme "t at t at he she/they executed the
foregoing Affldavitas the PeGlarant.
WITNESS my hand ahd c)fflc:ial seal.
Thomas F. Pepe
02-23-15
!'lOf/lrv Public Stale 0' Flo,(jqa. !<.aren ML.otia
MyC:ommlsslon FF 0.134.96
l;)<pilYt.OGI28/2017
( .ame 6fNotary Put!· c; Print,
. S~mp or type.a~commlssioned.)
2i
RELATED PARTY TRANSACTION VERIFICATION FORM
I 'k,lANUA . ..a,AJT8~A' ,individually and on behalf of ~PIC. .lJt~~Pt«t/,Ul ... U. (f.lA,A)T&J)~p;i,t,I~'
("Fi.~m")h,aV, e NameO~Represent,Clt,jve C, o~pa,nYlVe(ldorIEntitf. read, t,;he City 0, fSO,utht:1l!iml ("~ityll)'s Code ofEth, jes, '
Section SA· I of the City'S Code of OrdlOances and I hereby certify. under penalty of perjury that to the best ~f my
knowledge. information ai1d belief;, ' ' , , ,
(I) neither I nor the Firm have any conflict of interest (as defined in section SA· I ) with regard to the contrac.!: Qr
business that I, and/orthe Firm, am(are) abou!: to perform for, or to transactwith, the
Cityi and
(11 neitHer I ,rtorarty etr\ployees. offiCers, directors ohlle Firm, IiOrar'lyo'ne who ,has a flnancialintere:st.greater
than 5% In the Firm; hanny relative:(S). as' defined. in sect!oIi8A"I, Who is an emplQyee of the City orwho isfare)
an appointed or elected official of the City; or who IS (are) a member of anypl.lblic.body, created by the City ,
Commi$sjoni i.e., ,a board or cllmmitteeoftheCity, ('{{nife theethit:s c()de stjllapplies. if thepers()nrelXe¢,Uting t~is
form Is doing So Oli ~ehalf ora fi.rmW~Il.s~ stQck. i~ publicly t"~ded, th¢ stl!.t~mendnthrs ~ectfon (2) shall be based
solefyolithesjgnatory'sper~onal khowledg¢ and he/she is liot;'~quiredto make an independent inVestigation as to
the relationship of employees or those Who have a flnan.dallnterest in the Firm.]; .and
(~) neither I nOr the Firm,noraliyone whQ ha~ a fiMn(lial loWest. greil:ter thil.ii S% .ir't tl1.e Firill. nOl"iI,h)' mel'nbE)t of
those pel"sOil$' iillmedlatefllmi!y O.e" SP04$~,. parents; chjldrell, brother$at1~ sisters); has: transacted or entered
Intb ahY eontract{s) With the City .orhas.aTtn!lnciallntere!!t; dlre.ctor indil"e<:t,in any business being transacted
with the ci~y, or witilr ~~y. person or agency acting for the city, other than as follows; .
~(use(ifMcessary;u$e a separate sheet. to supplyadditiqMI infor~ati9h th!lt wiilrtot lit on tl1is Une:hI;iWever, you
rm.lst m!lke referen.::e. orl'.the ab.ove lioe, toth:e ac:lditl.onal sh.eet,aodthe .addltional' sl1eet mus~ De.slgrle'd under
Qath).[wl'i)le the' ethic!! cQde'stiOapplies.ihhe perSOn eXec(lting thldorm i$doingsoon behalf of a firm Whose
sto.ck Is pUblicly traded. the statement in this section (3) Shall be based solely on the slgnatory's per~C;>hal
knowl~d~e and. he/$he is not required to makeanlndepeO,dent, Investigation as: to the relationship .ohhose who
havea.flnanclal tnterestJn the Firm:]i and
(4} no electEld, aoc!/ora~pointe~ ()ffici~1 Ql'empiCWee<?ithe City ()fSo\ith Mlaml,orany of thatr immediate family
metrlbers (I.e.,spou$e,parelits, children, brothersanc! Sisters) nasa flnancialintereSt,dlrettiyorindirectly; intne
contract between you and/Or yo.ur Firm and the: City other than the followin, individuals Whose interest is set
forth following their use: a separ.ate,names} . .... .... . '. . ,
.. Qf,necessaryv use a sQPl(I'atesheElt. tosuppl~additiQnat information thatwillliOt fit on this line: h()weverT y'QU mUst
m~~e l"E:lference, Oil the·al:\ove lilJa, totnellc!qltlol1al Sheet:ilt'lc! the additional sheet mUSt be signed under oath);
Th$ naO'lesofall City employees and thatofallelectedand/or appaintedcity: offiCials or' board members, Who
OWI\ c,lirectly or indirectly, aninterest,of flve:perCEllit (5%) or m6re:of the total assets of capital· stock in the flrm
are asfi:lllows:
Qf n¢C;El$sa~;, useaSeparlJ.t~ sMettQ$4pplY addi~iQri~1 informati~1l tha~ Wi.11 not~t oli thiS Hhet hOWever, ybUiTlQ~t
make r~ferencll, orrthe above line. to thea:dditi.Mal sheet and the additlonalsheet.must be 'llgned under.oath).
[while the ethiCS codestlllappiles., If tne person executing this farm is doings'O on behalf of aflrm wh'Ose stock is
publicly traded, the statement in this secti.on· (4) shall be ba~eds()lely on the signatory's personal knowledge and
he/she is noireq\.lired to make an independent Investiga1;!oOaS' t'O the flnan<:;lal. interest in the Firm of city
employees, appointed officials or the immediate tamlly, members of elected. and/orappointed official Or employee.]
(5) I and the Firm ft,lrther ~reehottou.seor attempt to u§e any knOWledge, prQperty or resoUl"ce which may
come to uS through OUi" pOSitiOn oftr'ust, or through QUI' petformanceof our duties under the terms of tne
contract with the City; to secur.e aspedal privilege; benefit. or exemption ·for ourselves, or others. We agree that
we may not disclose or use information, not available. to members ofthe general publlc. for our personal gain or
beneflt odor the personal gain or benefit ofanyother person Or business «:lntity; outside .of the normal gain or
benefit antiCipated through~heperformance' of the, ¢ontrat;:t'.
(6) I and the Firm hereby acknowledge that We haye not contractedc;>r transacted any business with the City or
any person or agency actil}gJor the City. and that We nave not appear-ed in representation of any third party
before any board.comniissilln or agen.::y of tihe City within the past two years other than as
Thomas F; Pepe
0'2·23~1$
~~ .. '. ." ....~
necessary, use a~eparate sheetto supply additionallnformadon tbat will not fit on this line; however, you must
make reference, on the abOVE! Iloe; tQ the additional sheet and the addltiQnal sheet must be ~Jgne,d uf')cfer oath), ,
X:\P~rcha!ling\Vendor RegistrationHl,2S.12 Re~ATl:D PART'( TRANSACTION VERIFICATION FORM' D).docK
(1) Neither I nor any empLoyees, officers. or directors of the t=lrm. 11.017 any of their immediate family (i.e., as,a
SlloUse. son. daughtel'; parent. brother or sister),s related by bl.oodor marriag$ to:(i)aflY memberofthEtClty
C:ommisskm; (Ii) any city employe¢For (ill) any member of any board or agericyof tl)eC(tr otherth~oas follows:
. .... . (ifnecessary.use>a separate shee~tosupplyaQditl(mal
ii1formatloothatwill not fit on this linej hCiwever,}'9\.1 mi.ls~ make reference, c;m: theatlqve line, to ~headdtti()har
sheeUhd the additional sheet must be signed .onder oa~h).;(whflethee~hlcs·code still applies; If th~p;er$OO
e>tecuting this form. is, doing ;so on. b,ehalf ofafirm. whose stock is, p~~ljdr traq~d. the $tatementjnthisJ~cti?n (7)
shall be, based solely Ol'itM slgnatory'spe:rsorialknowledge and.he/shE!' IS:~O~i'eq,l!'regtClmak~ an h'lcfependent
investigation as tottle relationship. by blood or marria~e 'pf employees, officers., or directors ()f ~he Flrm,orofany
6ftheir immediate family toanY'appbinted ()r elected officiiill! ofthe City; Qrto their ihlmedlate famllYr'I')embel'!s],
.(8) No OthE!r Fltin, nor a.nYQffk~rs Or directors Qf that Other Plrtil or' ~!1yo.fl·e Who has a .~naodal. interest greater
than 5% JnthatOther Flrrn. oor any member of those persons'immMlate-family (i.e.,sp~use, parei:)~,<ihildren,
brothers ,and sisterS) riorany of my Immea,liit¢ fa!TIl1Ynleinbers(hereinaft;er ~efei'red t6as "Relate~P~ttie$")has
resp6ridedtQa solicitation by the City in WhiCh J o~ the Firoithat Irepresel')t or anyone who has af'ihancial
interestgr~aterth'an 5% In the' Firm, or ~ny, membet of}hosepersqris'iromed1ate family (te.$pouse, r.>~rents.
childtell,brotners .. a.nd sl$t;er~) have also responded. other than the foUoWihg:
~.' , .. '" ",' . ,,, " ('of
.. ': .. , ..: '. '. ' .. : " ...... " .' ',' .. ' .'. ,. ". I
flElcessaQ'j' use a' sep~rate. sheet to $uppiy adclI~lqnal.iriformatiQn that wIn not fit on this line; however~ YOt.! ml.!st:
miJ,ke refet¢ncEl,Qn the abov~ .fine, to. tne~ddltional~he.e.t and the aMitional sheetmust be. signed under oath).
[whil~ .. tnE!ethi¢s .co,dE!still~ppJies .. ifthe;personeXec:utjng;thi~ form is dofng SO Qob!Ooalf of a firm whOSE! stock is
puqlicly traded.Jhe$te.meot.!n thissectidn (~) shllU be basEld sQlefYQn~he;$ignatQt'ys Ilersorial knoWledge and
he/she. is not required to r\Jakeaj1ij1l;!ependent investigation Into the Other Firm;, or the Flfl't\ nelshe represents. as
tqtheirQfflcers,directors or anyone having a financial intere~t in those Firms or any of their any m!'!rnbe.r of thQse;
persorisijmmedia:tefamily.] . ' " '
(9) I and:t;herirmagreetha.t we are obligated to supplementthis Veriftctttio!t Form and inform the City of a'oy
change in 'Circu'mstances that WQIJIl;i Change our an.s,,:",ers t9 this document;. $pedflc:all),\, after the. opening ofany
responses to a soli.citation, I andt.he Firm have anobUgation.to supplement this Veriflclltion rq:rm with the name of
all Refated Parties Who have alsO' respondec!to the same solicitation. and to dl sclosetherelationshill of those
partles~o. me and the Firm; ... . .._ .. '.
(10) AVioladon ()f the Cityis EtniC$ Code. the giving of any fal~e informcttion or the. (ailure to supplement this
VerifltatianForm, may subject me or tne FJrmto immediate terminatioh of any ~~reement wii~ the City. and the
imp.Qsi~iori o.f toe rn~imumflnea:ndjor'ai'iY P!3n.aiti!3s allow.ed bylaw;. Adcfitlonally, violatiOl'lsmaYQe C!on~iderecdb,y
ahdsubjett tQ acti()D byfhe Miamj·DadeC{')untyCommis~IQn Qn,EthicS:. Under penalty of perjury, I de¢larethat I
have made a dil' ..... .... to Investigate the'q1atters to which I aOHttesting hereinabove and that thestatements
made herelh·· Q'v~ tru' ~hd¢ot're" .' ebe~t of myknowledge, information and belief;
Signature:.L:JH~p=~~~~,+-~;:If/.~"~r..c.u~
Date:~\~'1.:Q1 (;.
Thomas F. Pepe
02-23·/$ 23