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BIDDER CASTLE USA, CORPProposal Submittal Checklist Form I%— This checklist indicates the forms and documents required to be submitted for this solicitation and to be presented by the deadline set for within the solicitation. Fulfillment of all solicitation requirements listed is mandatory for consideration of response to the solicitation. Additional documents may be required and, if so, they will be identified in an addendum to this RFP, The response shall include the following items: Bid Form Proposal Bid Bond Performance Bond Power of Attorney BIDDER Qualification Statement Non - Collusion Affidavit Public Entity Crimes and Conflicts of Interest Drug Free Workplace N/A F/ Acknowledgement of Conformance with OSHA Standards List of Proposed Subcontractors and Principal Suppliers Related Party Transaction Verification Form Indemnification and Insurance Documents Note: A Proposal Bid Bond is NOT required for the project. Submit this checklist along with your proposal indicating the completion and submission of each required forms and /or documents. END OF SECTION C) Thomas F. Pepe, 2014 4/28/2014 Page 1 I of 73 L0 1 BID FORM THIS PROPOSAL IS SUBMITTED TO: Steven Alexander City Manager City of South Miami 6130 Sunset Drive South Miami, FL 33143 I. If this Proposal is accepted the undersigned Respondent agrees that by signing this Bid Form, the Respondent is agreeing to each and every term, provision and condition contained in the form of the Contract that is included in this RFP Package ( "the RFP Contract'), and to perform and furnish all work as specified or indicated in this RFP for the Proposed Price, within the Contract Time and in accordance with the other terms and conditions of the RFP Package and the RFP Contract. The Respondent agrees that if the contract is awarded to the Respondent, the signature of the Respondent, or the signature of its authorized representative, on this Bid Form shall be the same as a signature on the RFP Contract. 2. Respondent accepts all of the terms and conditions of the Advertisement, RFP, Invitation for Proposals and Instructions to Respondents, including without limitation those dealing with the disposition of Proposal Bond /Security, This Proposal will remain subject to acceptance for 180 calendar days after the day of the Proposal Opening. Respondent agrees to sign and submit the Contract with the Bonds, Insurance Policy with appropriate endorsements, Insurance Certificate and other documents required by the RFP within ten (10) calendar days after the date of the City's Notice of Award. 3. In submitting this Proposal, Respondent represents that: a. Respondent has examined copies of all the RFP Documents and of the following Addenda, if any (receipt of all which is hereby acknowledged.) Addendum No. Dated: U c!5 A Addendum No. Dated: Addendum No. Dated: Addendum No. Dated: Addendum No. Dated: Addendum No. Dated: b. Respondent has familiarized himself with the nature and extent of the Contract Documents, the proposed work, site, locality, and all local conditions and laws and regulations that in any manner may affect cost, progress, performance or furnishing of the Work. c. Subsurface conditions: If applicable to this RFP, the Respondent represents that: i. Respondent has studied carefully all reports and drawings, if applicable, of subsurface conditions and drawings of physical conditions. ii. Respondent has obtained and carefully studied (or assumes responsibility for obtaining and carefully studying) all such examinations, investigations, explorations, tests and studies in addition to or to supplement those referred to in (c) above which pertain to the subsurface or physical conditions at the site or otherwise may affect the cost, progress, performance, or the furnishing of the Work at the Contract Price, within the Contract Time and in accordance with the other terms and conditions of the Contract Documents. The Respondent hereby acknowledges that no additional examinations, investigations, explorations, tests, reports or similar information or data are, or will, be required by Respondent for any reason in connection with the Proposal. The failure of the Respondent G Thomas P. Pepe, 2014 4/28/2014 Page 12 of 73 2 00' , to request a pre -bid marking of the construction site by any or all utility companies shall create an irrefutable presumption that the Respondent's bid, or proposal price, has taken into consideration all possible underground conditions and Respondent, if awarded the contract, shall not be entitled to a change order for any such condition discovered thereafter. iii. Respondent has correlated the results of all such observations, examinations, investigations, explorations, tests, reports and studies with the terms and conditions of the Contract Documents. iv. Respondent has reviewed and checked all information and data shown or indicated in the RFP Package or in the Contract Documents with respect to existing Underground Facilities at or contiguous to the site and assumes responsibility for the accurate location of all Underground Facilities. No additional examinations, investigations, explorations, tests, reports or similar information or data in respect to any Underground Facilities are, or will be, required by Respondent in order to perform and furnish the Work at the Contract Price, unless the respondent makes a written request to the City for additional information prior to submitting the bid or proposal as required in subsection ii above, within the Contract Time and in accordance with the other terms and conditions of the Contract Documents. d. Respondent has given the City written notice of all conflicts, errors or discrepancies that it has discovered in the Contract Documents and, if any conflicts, errors or discrepancies have been found and notice given, the Respondent represents, by submitting its proposal to the City, that the Respondent has received sufficient notice of the resolution thereof from the City, that such resolution is acceptable to Respondent and that the Respondent waives any claim regarding the conflicts, errors or discrepancies. e. This Proposal is genuine and not made in the interest of or on behalf of any undisclosed person, firm or corporation and is not submitted pursuant to any agreement or rules of any group, association, organization, or corporation; Respondent has not directly or indirectly induced or solicited any other Respondent to submit a false or sham Proposal; Respondent has not solicited or induced any person, firm or corporation to refrain from responding; and Respondent has not sought by collusion or otherwise to obtain for itself any advantage over any other Respondent or over the CITY. 4. Respondent understands and agrees that the Contract Price is the amount that it needs to furnish and install all of the Work complete and in place. The Schedule of Values, if required, is provided for the purpose of Proposal Evaluation and when initiated by the CITY, it shall form the basis for calculating the pricing of change orders. The Contract Price shall not be adjusted in any way so as to result in a deviation from the Schedule of Values, except to the extent that the CITY changes the scope of the Work after the Contract Date. As such, the Respondent shall furnish all labor, materials, equipment, tools, superintendence and services necessary to provide a complete, in place Project for the Proposal Price of: LUMP SUM BASE PRICE: dollars and Alternates: C Thomas F. Pepe, 2014 4/28/2014 / cents #I #5 ,J #2 #6 #3 #7 #4 #8 Page 13 of 73 A fee breakdown, if applicable, for each task must be completed in the table shown above. Failure to complete this information shall render the proposal non - responsive. 5. The ENTIRE WORK shall be completed, in full, within 60 working days from the date stipulated in the NOTICE TO PROCEED. Failure to complete the entire work during the described time period shall result in the assessment of liquidated damages as set forth in the Contract. 6. Communications concerning this Proposal shall be addressed to: RESPONDENT: Address: Telephone: Facsimile: Attention: 7. The terms used in this Proposal which are defined in the Contract shall have the same meaning as is assigned to them in the Contract Documents, unless specifically defined in this RFP Package. SUBMITTED THIS .2_ DAY OF 4\Q G_�} Sj 20 1 Z� PROPOSAL SUBMITTED BY: C &AL! Company Name of Per orized to Submit Proposal 'Signs*, r Cc) Thomas F. Pepe, 2014 4/28/2014 Telephone Number Fax Number C01 61 �c) (A J �4 Email Address END OF SECTON Page 14 of 73 -1r The response to this questionnaire shall be utilized as part of the CITY'S overall Proposal Evaluation and CONTRACTOR selection. 1. Number of similar construction projects completed, a) In the past 5 years In the past 5 years On Schedule b) In the past 10 years In the past 10 years On Schedule MMMMM a) Project Name: Owner Name: 05 Owner Address: Owner Telephone: b) Project Name: Page 21 of 73 co'noinas F. Pepe, 2014 4/28/2014 Actual Final Contract Completion ZZ 1 112- Date: Original Contract Price: Actual Final Contract Price ZMEMMM NoM vo '� C)5 - _P3- r>, I Original Contract Completion Time (Days): Original Contract Completion Date: Actual Final Contract Completion ff Date: 46, 05 O'Z 0 Page 22 of 73 (0 Thomas F. Pepe, 2014 4/28/2014 Original Contract Price: Actual Final Contract Price: 7 '744 4. The following information shall be attached to the proposal. a) RESPONDENT's home office organization chart. b) RESPONDENT's proposed project organizational chart. c) Resumes of proposed key project personnel, including on-site Superintendent. 5. List and describe any: • Iii i .11, 1 # MMRMMIMM�_ � Suspension of contracts • debarring from Bidding or Responding by any public agency brought c) against the Respondent in the last five (5) years 1. Government References: (D Thomas F. Pepe, 2014 4/28/2014 List other Government Agencies or Quasi - government Agencies for which you have done business within the past five (5) years. Name of Agency: Address: �`7 lJkcwm' rFLIWEED Telephone No.: 30 5, 'zF)q r C'yC'C7 Contact Person: 9 cCc •- e_ L YES `- Type of Project: S 4 cAm S anc %wwous V Name of Agency: k o'Aln t �Q C s V V C40 Address: Ski e�:2 Aqc- , a- Telephone No.: 55Z- E�)RQ 3 Contact Person: 1`4 ICjQ`Q -( � L Type of Project: �,� l �J�6�� �()VP3Ct1AI(2f v Name of Agency: C6 �`C`°f -u , (x f Q.J� j FL Address: v) � Telephone No.: (� 54 — ✓K�G ° -- 4-0 9iRj 41GV Tc (Zs Contact Person: Type of Project:��c -� Page 24 of 73 (0 Thomas F. Pepe, 2014 /= 428/2014 List other Government Agencies or Quasi - government Agencies for which you have done business within the past five (5) years. Name of Agency: Address: Z. :I OIQ N'01) e�i &a Telephone No.: �©s -_ 4 C( - F_)52 Contact Person: t l �- _ V I C C.tc_ Q..� Type of Project: _%1 CC WA (1_UPVV Name of Agency: RDC EC( Address: M., ShG &) \kA 03 Telephone No.: Contact Person: Type Project:'i�nr�c of Name of Agency: Address: Telephone No.: Contact Person: Type of Project: Page 24 of 73 0 Thomas F. Pepe, 2014 4/28/2014 D PUBLIC ENTITY CRIMES AND CONFLICTS OF INTEREST Pursuant to the provisions of Paragraph (2) (a) of Section 287.133, Florida State Statutes – "A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Proposal or bid on a Contract to provide any goods or services to a public entity, may not submit a Bid or proposal for a Contract with a public entity for the construction of repair of a public building or public work, may not submit bids or proposals on leases or real property to a public entity, may not be awarded to perform Work as a CONTRACTOR, Sub - contractor, supplier, Sub - consultant, or Consultant under a Contract with any public entity, and may not transact business with any public entity in excess of the threshold amount Category Two of Section 287.017, Florida Statutes, for thirty six (36) months from the date of being placed on the convicted vendor list ". The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Respondents must disclose with their Proposals, the name of any officer, director, partner, associate or agent who is also an officer or employee of the City of South Miami or its agencies. SWORN STATEMENT PURSUANT TO SECTION 287.133 (3) (a), FLORIDA STATUTES. ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. This sworn statement is submitted to �i © r � � t ouayl [print name o the public entity] by . S Q — � .4 for �� `C [print individual's name and title] �. �, -,(� Q_ [print name of entity submitting sworn statement] business address is and (if applicable) its Federal Employer Identification Number (FEIN) is (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: 2 l ���3'zv c . fit? �� [`Z `z- -•) I understand that a "public entity crime" as defined in Paragraph 287.133 (1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or of the United States, including, but not limited to , any bid, proposal or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. I understand that "convicted" or "conviction" as defined in Paragraph 287.133 (1) (b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non -jury trial, or entry of a plea of guilty or nolo contendere. 4. 1 understand that an "affiliate" as defined in Paragraph 287.133 (1) (a), Florida Statutes, means: (a) A predecessor or successor of a person convicted of a public entity crime; or (b) An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, Page 27 of 73 C) Thomas F. Pepe, 2014 4/28/2014 p0 directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in any person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. I understand that a "person" as defined in Paragraph 287.133 (1) (e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or proposal or applies to bid or proposal on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. 6. Bas s on information and belief, the statement which 1 have marked below is true in relation to the entit ubmitting this sworn statement. [Indicate which statement applies.] Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent of July I, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. [attach a copy of the final order.] I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY INDENTIFIED IN PARAGRAPH I (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY, AND THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATU ES FOR CATEGORY, YWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS F ' gnature] Sworn to and subscribed before me this day of 20• Personally known r r OR Produced identification (c �� Notary Public — State of I L U `� (} �) My commission expires ( L� (Type of identification) (Printed, typed or stamped commissioned Form PUR 7068 (Rev.06l1 1192) name of notary public) r�rsArr�rr�s.1`r SUZETTE GONZALEZ Notary Public - State �aF ar 73 • My Comm. Expires Jule, 017 CC Thomas F. Pepe, 2014 = Commission # FF 034235 4'28/2014 9, opt• ••�, 90nM Through National Notary Assn av-ANIAiol Page 25 of 73 Thomas F. Pepe, 2014 4/28/2014 FM rd R my 19 3��M C Thomas F. Pepe, 2014 4/28/2014 A {Name of Notary Public: Prieit, Stamp or type as commissioned.) Personally known to me, or Personal identification: C o I nj Type of Identification Produced it Did Not take an oath. SUZETTE GONZALEZ ���0 «����"'� bonded Through National Notary Assn C Thomas F. Pepe, 2014 4/28/2014 A {Name of Notary Public: Prieit, Stamp or type as commissioned.) Personally known to me, or Personal identification: C o I nj Type of Identification Produced it Did Not take an oath. ACKNOWLEDGEMENT OF CONFORMANCE WITH OSHA STANDARDS TO THE CITY OF SOUTH MIAMI We, (t�q��� � - , (Name of CONTRACTOR), hereby acknowledge and agree that as CONT ACTORS for the project as specified have the sole responsibility for compliance with all the requirements of the Federal Occupational Safety and Health Act of 1970, and all State and local safety and health regulations, and agree to indemnify and hold harmless the City of South Miami and against any and all liability, claims, damages, losses and expenses they may incur due to the failure of (Sub- Contractor's names): to' cor4jy with such o regulation. �P� f Witnes A ck L 1 Title CC Thomas F. Pepe. 2014 4/28/2014 Page 30 of 73 LIST OF PROPOSED SUBCONTRACTORS AND PRINCIPAL SUPPLIERS BIDDER shall list all ProDosed Subcontractors to be used on this project if they are awarded the Contract. Classification of Work Subcontractor Name Landscape I A Address Email Sodding and Turf Work O A Electrical�t�5 Irrigation Ivl Paving Park Amenities Graphics�N Utilities k \/ Excavation G C Building Structures -- Plumbing U 705— E 3 ' "ZZ Painting GC Testing Laboratory wicc TeS Soil Fumigator All I U� �C-�, 1j 71j5 - - xcl Signs �) `� S5_2�.j,- 5:C3314- This list shall be provided to the City of South Miami by the apparent iowest responsive ana responsiDie aIDDer within five (5) business days after Bid Opening. Page 31 of 73 v Thomas P. Pepe, 2014 4/28/2014 c, RELATED PARTY TRANSACTION VERIFICATION FORM 1-jjg4 r2f-IC C O �� 1 L t C� individually and on behalf of �—Us+l e ( "Firm ")have Name of Representative CompanylVendorlEntity read the City of South Miami ( "City ") 's Code oEthics, Section 8A -I of the City's Code of Ordinances and I hereby certify, under penalty of perjury that to the best of my knowledge, information and belief. (1) neither I nor the Firm have any conflict of interest (as defined in section 8A -1) with regard to the contract or business that I, and/or the Firm, am(are) about to perform for, or to transact with, the City, and (2) neither I nor any employees, officers, directors of the Firm, nor anyone who has a financial interest greater than 5% in the Firm, has any relative(s), as defined in section 8A -1, who is an employee of the City or who is(are) an appointed or elected official of the City, or who is(are) a member of any public body created by the City Commission, i.e., a board or committee of the City[See Note #1 below], and (3) neither I nor the Firm, nor anyone who has a financial interest greater than 5% in the Firm, nor any member of those persons' immediate family (i.e., spouse, parents, children, brothers and sisters) has transacted or entered into any contract(s) with the City or has a financial interest, direct or indirect, in any business being transacted with the city, or with any person or agency acting for the city, other than as follows: necessary use a separate sheet to supply additional information that will not fit on this line but make reference on the line above to the separate sheet, i.e., "see attached additional information" and make reference to this document and this paragraph on the additional sheet which additional sheet must be signed under oath). [See Note #I below]; and (4) no elected and /or appointed official or employee of the City of South Miami, or any of their immediate family members (i.e., spouse, parents, children, brothers and sisters) has a financial interest, directly or indirectly, in the contract between you and /or your Firm and the City other than the following individuals whose interest is set forth following their use a separate names: (if necessary use a separate sheet to supply additional information that will not fit on this line but make reference on the line above to the separate sheet, i.e., "see attached additional information" and make reference to this document and this paragraph on the additional sheet which additional sheet must be signed under oath). The names of all City employees and that of all elected and /or appointed city officials or board members, who own, directly or indirectly, an interest of five percent (5%) or more of the total assets of capital stock in the firm are as follows: (if necessary use a separate sheet to supply additional information that will not fit on this line but make reference on the line above to the separate sheet, i.e., "see attached additional information" and make reference to this document and this paragraph on the additional sheet which additional sheet must be signed under oath). [See Note #1 below] (5) 1 and the Firm further agree not to use or attempt to use any knowledge, property or resource which may come to us through our position of trust, or through our performance of our duties under the terms of the contract with the City, to secure a special privilege, benefit, or exemption for ourselves, or others. We agree that we may not disclose or use information, not available to members of the general public, for our personal gain or benefit or for the personal gain or benefit of any other person or business entity, outside of the normal gain or benefit anticipated through the performance of the contract. Page 32 of 73 Co Thomas F. Pepe, 2014 4/28/2014 (6) 1 and the Firm hereby acknowledge that we have not contracted or transacted any business with the City or any person or agency acting for the City, and that we have not appeared in representation of any third party before any board, commission or agency of the City within the past two years other than as follows: (if necessary use a separate sheet to supply additional information that will not fit on this line but make reference on the line above to the separate sheet, i.e., "see attached additional information" and make reference to this document and this paragraph on the additional sheet which additional sheet must be signed under oath). (7) Neither I nor any employees, officers, or directors of the Firm, nor any of their immediate family (i.e., as a spouse, son, daughter, parent, brother or sister) is related by blood or marriage to: (i) any member of the City Commission; (ii) any city employee; or (iii) any member of any board or agency of the City other than as follows: (if necessary use a separate sheet to supply additional information that will not fit on this line but make reference on the line above to the separate sheet, i.e., "see attached additional information" and make reference to this document and this paragraph on the additional sheet which additional sheet must be signed under oath). [See Note #1 below]; and. (8) No Other Firm, nor any officers or directors of that Other Firm or anyone who has a financial interest greater than 5% in that Other Firm, nor any member of those persons' immediate family (i.e., spouse, parents, children, brothers and sisters) nor any of my immediate family members (hereinafter referred to as "Related Parties ") has responded to a solicitation by the City in which I or the Firm that I represent or anyone who has a financial interest greater than 5% in the Firm, or any member of those persons' immediate family (i.e. spouse, parents, children, brothers and sisters) have also responded, other than the following: (if necessary use a separate sheet to supply additional information that will not fit on this line but make reference on the line above to the separate sheet, i.e., "see attached additional information" and make reference to this document and this paragraph on the additional sheet which additional sheet must be signed under oath). [while the ethics code still applies, if the person executing this form is doing so on behalf of a firm whose stock is publicly traded, the statement in this section (8) shall be based solely on the signatory's personal knowledge and he /she is not required to make an independent investigation into the Other Firm, or the Firm he/she represents, as to their officers, directors or anyone having a financial interest in those Firms or any of their any member of those persons' immediate family.] (9) 1 and the Firm agree that we are obligated to supplement this Verification Form and inform the City of any change in circumstances that would change our answers to this document. Specifically, after the opening of any responses to a solicitation, 1 and the Firm have an obligation to supplement this Verification Form with the name of all Related Parties who have also responded to the same solicitation and to disclose the relationship of those parties to me and the Firm. (10) A violation of the City's Ethics Code, the giving of any false information or the failure to supplement this Verification Form, may subject me or the Firm to immediate termination of any agreement with the City, and the imposition of the maximum fine and /or any penalties allowed by law. Additionally, violations may be considered by and subject to action by t i -Dade County Commission on Ethics. Under penalty of perjury, I declare that I ,hav made a diligent or investigate the matters to which I am attesting hereinabove and that the statements made'- hereinabov are and correct to the best of my knowledge, information and belief. Signature:' Name& Title: Date: ZW v Thomas F. Pepe, 2014 4/28/2014 , , 4,d�c) Page 33 of 73 Castle USA Corp / Hernando Castillo - References - Dec 2013 Name: Company: Position: Phone: Type of project Raul Gonzalez ACI Cargo, Inc President 786 - 412 -0050 Import - Export Alfredo Martinez Engineering Contractors President 305- 972 -7647 Commercial Engineering and Construction Arturo Abreu Miami Dade Fire Department Construction Direct 786 - 331 -5275 Hurricane Shutters - Logistic Building Benigno Garcia Miami Dade Water & Sewer Project Engineer 305 - 496 -8239 Industrial - Digester Tank # 3, District South, Roof Reggie Pares Marathon Airport - Marathon City Airport Manager 305 - 289 -6002 Marathon Airport - Wind Protection Improvements Andres Gutierrez URS Corporation - Engineering Sr Project Mgr 305 - 262 -7466 Marathon Airport - Wind Protection Improvements Joseph Bernard Miami Dade Water & Sewer Plant Superitend 786 -552 -4043 Commercial - Structural Miguel Hernandez Miami Dade Water & Sewer Project Mgr. 786- 552 -8803 Commercial - Structural Eduardo Caballero Cedar West Estates, LLC V President 305 - 389 -5294 Residential - New construction Abel Ramirez Jaxi Builders President 786 -512 -7200 Residential - Remodeling & New construction 305 - 216 -8475 Martha Pine Pilar Homes Developers V. President 786- 295 -7893 Residential - New construction 305 - 822 -8979 German Cuesta VAC Builders, LLC President 305 - 333 -5478 Commercial - New Construction German Cuesta VAC Builders, LLC President 305 - 333 -5478 Residential - Remodeling & New construction Trades references Name: Company: Position: Phone: Jorge Lopez Florida Land Developers President 305- 283 -8402 Developer Ivan Robledo Alufab Hurricane Shutters Bussines Devel. 954- 650 -1131 Hurricane Shutters 305 - 688 -4701 Sirous Javadian Set Engineering & Test Labs. Engineer /Mgr. 305 - 594 -4396 Engineering Laboratories 305- 219 -3767 Alvaro Duque Duqter Corp. President 305 - 255 -2221 Roofing 305 - 796 -6489 Loly Lopz Tri- Couinty Engineers & Architects V. President 305 - 823 -3737 Architects & Engineering Services Horacio Moncada Architec President 954 - 638 -7971 Architects & Engineering Services Luis Polo Polhertile & Marbel President 786- 306 -0501 Tiles & Marble Antony Pou ACM Corporation - Plumbing President 305 - 819 -5010 Plumbing 305- 216 -8822 Delfin Pernas Persant Construction Co. President 305 - 221 -2281 Site Works 305- 609 -1905 Teresita Vasquez Arkitere - Architects President 305 - 971 -9902 Architects & Engineering Services 305 - 281 -8666 Alvaro Contreras American Engineering Contractor, I President 786 - 797 -4949 General Contractors Jorge Antonijuan Aelor Air Conditioning, Inc. Sales Rep. 305- 986 -4015 Air Conditoning & Mech works T STATE OF FLORIDA R DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION F F CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET oWS TALLAHASSEE FL 32399 -0783 CASTILLO, HERNANDO CASTLE USA CORPORATION 5620 NW 113 PL DORAL FL 33178 3 , *0 S7ATE OF FLORIDA AC# Congratulationsl With this license you become one of the nearly one million DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. CGC1514321 08/16/12 128042408 Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com, CERTIFIED GENERAL CONTRACTOR There you can find more information about our divisions and the regulations that CASTILLO, HERNANDO impact you, subscribe to department newsletters and learn more about the CASTLE USA CORPORATION Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We Constantly strive to serve you better so that you can serve your customers. IS CERTIFIED under the provisions of Ch.489 Fs Thank you for doing business in Florida, and congratulations on your new license! Expiration date: AvG 31, 2014 L12081601819 DETACH HERE ia.,; t . , I €4 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L12081601819 LICENSE NBR DATE BATCH NUMBER 08j16/2012 128042408 CGC1514321 The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 CASTILLO, HERNANDO CAS'T'LE USA CORPORATION 3321 NW 82 AVE DORAL FL 33122 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 07/14/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemengs). PRODUCER ALL CITY INSURANCE INC - ACI 275 FONTAINEBLEAU BLVD, SUITE 190 MIAMI FL 33172 CONTACT CARMEN RODRIGUEZ PHONE 305 463 -9431 FAC N.):(305) 436 -6797 EMAIL GMAIL ALLCITYINS.COM INSURERS AFFORDING COVERAGE NAIC# INSURER AMID- CONTINENT CASUALTY CO 23418 INSURED CASTLE USA CORPORATION 5620 NW 113TH PLACE DORAL FL 33178- INSURER B 423/201406/23/2015 INSURER C: EACH OCCURRENCE I SuRERD____ -____ TO I DAMAGES( RENTED MED FXP An one person)__ INSURER E: $EXCLUDED INSURER F $ 1,000,000 COVERAGES CERTIFICATE NUMBER: 01 REVISION NuivI 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF INSURANCE ADDL SUBR LICY EFF POLICY EXP LIMITS -I A GENERAL LIABILITY X COMMERCIALGENERALLIABILITY __ CLAIMS -MADE OCCUR I 04GL905753 423/201406/23/2015 EACH OCCURRENCE $ 1,000,000 TO I DAMAGES( RENTED MED FXP An one person)__ $ 100 ,000 $EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY PRO LOC PRODUCTS- COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE Ix LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIR ED AUTOS AUTOS 04GL905753 06/23/201406/23/2015 COMBINED SINGLE LIMIT 1 000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ $ UMBRELLA LIAB EXCESS LIAB OCCUR HCLAINIS-MADE EACH OCCURRENCE $ AGGREGATE $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUFHVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below N /A WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) GENERAL CONTRACTOR /11 J I-1t'W rT 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF POMPANO BEACH ACCORDANCE WITH THE POLICY PROVISIONS. 100 WEST ATLANTIC BLVD POMPANO BEACH FL 33060- AUTHORIZED REPRESENTATIVE } /) ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/06) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE Date 5/9/2014 Producer: Lion Insurance Company This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. Holiday, FL 34691 rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. (727) 938 -5562 Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & Subsidiaries Insurer A: Lion Insurance Company 11075 Insurer B: 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL I INSRD Type of Insurance Policy Number Policy Effective Date Policy Expiration Date Limits (MM /DD /YY) (MM /DD /YY) ENERAL LIABILITY Each Occurrence Commercial General Liability Claims Made ❑ Occur Damage to rented premises (FA occurrence) Med Exp Personal Adv Injury General aggregate limit applies per: Policy ® Project ® LOC General Aggregate Products - Comp /Op Agg AUTOMOBILE LIABILITY Combined Single Limit (EA Accident) Any Auk Bodily Injury All Owned Autos (Per Person) Scheduled Autos Bodily Injury Hired Autos Non -Owned Autos (Per Accident) Property Damage (Per Accident) EXCESS /UMBRELLA LIABILITY Each Occurrence Aggregate Occur ❑ Claims Made Deductible A Workers Compensation and WC 71949 01/01/2014 01/01/2015 X I WC Statu- OTH- Employers' Liability tory Limits ER E.L. Each Accident $1,000,000 Any proprietor /partner /executive officer/member E. L. Disease - Ea Employee 31,000,000 excluded? NO If Yes, describe under special provisions below. E. L. Disease - Policy Limits $1.000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /Locations[Vehicies /Exclusions added by Endo rsement/Speciai Provisions: Client ID: 80 -65 -182 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company ": Castle USA Corporation Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s;, while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. Project Name: ISSUE 5 -09 -14 (MT) Be in Date 4/28/2014 CERTIFICATE HOLDER CANCELLATION CITY OF POMPANO BEACH Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. 100 W. ATLANTIC BLVD POMPANO BEACH: FL 33060 /� r