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Citywide Rd. Resurf. Proj. #2BIDDER QUALIFICATION STATEMENT Citywide Road Resurfacing Project The BIDDER's response to this questionnaire shall be utilized as part of the CITY'S overall Bid Evaluation and Contractor selection. 1. Number of similar construction projects completed, In the past 5 a) years On Schedule 1 In the past 10 b) years On Schedule 2. List the last three (3) completed similar projects. a) Project Name: Owner Name: Owner Address: Owner Telephone: Original Contract Completion Time (Days): Original Contract Completion Date: Actual Final Contract Completion Date: Original Contract Price: Actual Final Contract Price: 1002W } t4. C.GL^P—V'Vlt CA —tA'S M. 345 4(0 re - 15q Q0 q MAY Mkt I;*. /;a y) 1'q Ce . 6 X1.35 Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 19 of 120 b) Project Name: Acq, Owner Name: Owner Address: vJ0 50 W% 0"M IL MC`1"fk -3. �� 'B-5 34%81 Owner Telephone: Original Contract Completion Time (Days): Q t Original Contract Completion Date: Actual Final Contract Completion Date:• to Original Contract Price: Actual Final Contract Price: .�sCe ! I 2 C) Project Name: tQw qTI% Ai t ^ 7-Z-c-3,(,P G Owner Name: Owner Address: � � �E - 9-C �� ' N_• VKt0CMl , ,V;I 3015 ........_ Owner Telephone: Original Contract Completion Time (Days): Original Contract Completion Date: ® crL -3a Actual Final Contract Completion Date: Original Contract Price: cm's Actual Final Contract Price: Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 20 of 120 4. The following information shall be provided for this project. a) Estimated total demolition man -hours b) Percent man -hours to be performed by Contractor's permanent staff C) Permanent man -hours to be performed by direct hired employees for this project d) Percent man -hours to be performed by Subcontractors 5. The following information shall be attached to the bid. a) Contractor's home office organization chart. Sc�F b) Contractor's prW osed project organizational chart. Resumes of proposed Key project personnel, including on -site C) Superintendent. 11oLeh:e er Se5� /4:5;, 4:5-- 2_4C_ Citywide Road Resurfacing Project No. SM- 2011 -07 -PST 21 of 120 .w U R C 0 c� N .E L O v O 0 E 0 CL 0! otS CV 0 cm 0 a 2 j- ,. H &R Paving Job Site Organizational Chart a. City of South Miami City Wide Road Resurfacing Project No. SM- 2099 -07 -PW Abe Rodriguez General Manacrer William Glenn Arnold Carrillo Philip Johnson roject Manager Superintendent QC Manager Benito Davila Graveran Tauflk Guillermo Goizueta aving Foreman Paving Foreman Milling Foreman QC Specialist Date Printed: 81912019 Page 2 of 2 (�6 William Glenn EDUCATION 2004-2007 Florida Atlantic University Fort Lauderdale, FL • Master of Business Administration (MBA) • Real Estate Specialization 1998 -2000 University of Florida Gainesville, FL ■ Master of Science in Building Construction Thesis Title: "Safety in Construction" 1994 -1998 University of Florida Gainesville, FL • Bachelor of Science in Design (Architecture) • Graduated with Honors and a Minor in Business EXPERIENCE March 2009 - Current H &R Paving, Inc. Miami, FL Project Manager • Project Manager of 9.2 mile Turnpike and other FDOT milling and resurfacing projects. • Coordinate subcontractor trades, macro - scheduling and administrate accounts payable. • Supervised work crews and subcontractors on a micro- management level. June 2007 -March 2009 Turner Construction Miami, FL Project Lead Estimator • Supervised subcontractors, processed change orders and created and updated schedules. • Estimated high end interior commercial and state university projects. • Obtained new contracts from owners, negotiated subcontracts and purchase orders. • Supervised estimating staff, engineering of project submittals, permits and hand -off to operations. August 2004 -June 2007 APAC /Oldcastle Miami, FL Project Manager • Project Manager of million dollar site development & DOT projects. • Coordinate contractor administration, estimates, payment applications and financial reports. • Negotiate subcontractor contracts, and review quality control and safety issues. January 2002 - August 2004 Turner Construction Miami, FL Project Manager • Project Manager of Civil Underground ($37M) & Pre- Conditioned Air & Electrical ($20M) contracts. • Engineering support of eight various projects involving multiple contractors and architects. • Analyze field conflicts, administrative review of change orders, quality control and safety. • Organized tasks and managed workload in a professional manner for members of the team. LICENSE 2005- General Contractor (Statewide) OSHA 30 Hour SKILLS Miami, FL Microsoft Office Suite, Prolog Administration, Auto CAD, Primavera Project Planner (P3), Primavera Expedition, and Timberline Estimation Software 46ee".- U c, — 6. List and describe any: Bankruptcy petitions filed by or against the BIDDER or any predecessor a) organizations, �f �V b) Any arbitration or civil or criminal proceedings, or j Orj.e Suspension of contracts or debarring from Bidding by any public agency brought against C) the BIDDER in the last five (5) years. &J a 01 7. Government References: List other Government Agencies or Quasi- government Agencies for which you have done business within the past five (5) years. Name of Agency: P L L S — Address: Telephone No.: Contact Person: Type of Project: Name of Agency: Address: Telephone No.: Contact Person: Type of Project: Name of Agency: Address: Telephone No.: Contact Person: Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 22 of 120 Citywide Road Resurfacing Project STATE OF FLORIDA COUNTY OF MIAMI -DADE �,4vt, (;a ri being first duly sworn, deposes and says that: (1) 9She/They islare the V o (Owner, Partner, Officer, Representative or Agent) of 1_ PA V I,IJ 6 i -�V - the BIDDER that has submitted the attached Bid; (2) ee She/They islare fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid; (3) Such Bid is genuine and is not a collusive or sham Bid; (4) Neither the said BIDDER nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affant, have in any way colluded, conspired, connived or agreed, directly or indirectly, with any other BIDDER, firm, or person to submit a collusive or sham Bid in connection with the Work for which the attached Bid has been submitted; or to refrain from Bidding in connection with such Work; or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or conference with any BIDDER, firm, or person to fix any overhead, profit, or cost elements of the Bid or of any other BIDDER, or to fix any overhead, profit, or cost elements of the Bid Price or the Bid Price of any other BIDDER, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the proposed Work; (5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the BIDDER or any other of its agents, representatives, owners, employees or parties of interest, including this affiant. Signed, sealed.. red in the presence of: r= Witness Witness L D � C- _U Z, By: X Signature 41;L— Print Name and Title / Date Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 23 of 120 ACKNOWLEDGEMENT STATE OF FLORIDA ) } COUNTY OF MIAMI -DADE ) On this the 711!° day of k6C"'� , 2011, before me, the undersigned Notary Public of the State of Florid persoPally ap ared (Name(s) /of individual(s) who appeared before notary) ice- Z�lo�' �— and whose name(s) is /are Subscribed to the within instrument, and he /she /they acknowledge that he /she /they executed it. WITNESS my hand and official seal. NOTARY PUBLIC: SEAL OF OFFICE: o,Is ;,?`;e�� IQSEAt>�E41T4CHAGQIENd�CA$ r M DD 7 2984 EXPIRES.Oci�f 2i, �rvice� oe blic, State of Florida (Name of Notary Public: Print, Stamp or type as commiss] d.} Personally known to me, or Personal identification: Type of Identification Produced Did take an oath, or Did Not take an oath. Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 24 of 120 Citywide Road Resurfacing Project 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 Bid on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a public entity for the construction of repair of a public building or public work, may not submit bids on leases or real property to a public entity, may not be awarded to perform Work as a Contractor, supplier, Subcontractor, or Consultant under a Contract with any public entity, and may not transact business with any public entity in excess of the threshold 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. BIDDERS must disclose with their Bids, 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. I . This sworn statement is submitted to Sic T7 print name of the public entity] by A4r L Go tv 2-4-1-c z, [print individual's name and title] for V [print name of entity submitting sworn statement] whose business address is V Y *'—o and (if applicable) its Federal Employer Identification Number (FEIN) is ��7 I ����- (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 25 of 120 2. 1 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 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. 3. 1 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, 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. 5. 1 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 applies to bid 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. Citywide Road Resurfacing Project No. 5M- 2011 -07 -PW 26 of 120 6. Bas on information and belief, the statement which I have marked below is true in relatio to the entity submitting 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 STATUTES, FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FO i Citywide Road Resurfacing Project No. SM- 2011.07-PW 27 of 120 MW Sworn to and subscribed before me this v day of f��� 201 I . Personally known OR Produced identification Notary Public -- State of F=L-- My commission expires (Type of identification) (Printed, typed or stamped commissioned name of notary public) Form PUR 7068 (Rev.06 /1 1192) ot�R;,;��,� ,1Q5EAlBtiS�QCHAGQVEN•LIIGAB _ � MY C6MMl5SlON # tiD 7198A7 Wks-. October 2t, 2Q1 t ,g roe 5,adedii�u8ud9etNotasY5et4ices ROOF "� PQ 6 L I*C, kQ� A. c H4-66 Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 28 of 120 197:i9Ies ;W 14 Citywide Road Resurfacing Project Whenever two or more Bids which are equal with respect to price, quality and service are received by the State or by any political subdivisions for the procurement of commodities or contractual services, a Bid received from a business that certifies that it has implemented a drug - free workplace program shall be given preference in the award process. Established procedures for processing tie Bids shall be followed if none of the tied vendors have a drug -free workplace program. In order to have a drug -free workplace program, a business shall: 1) Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that shall be taken against employees for violations of such prohibition. 2) Inform employees about the dangers of drug abuse in the workplace, the business' policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3) Give each employee engaged in providing the commodities or contractual services that are under Bid a copy of the statement specified in Subsection (1). 4) In the statement specified in Subsection (1), notify the employees, that, as a condition of working of the commodities or contractual services that are under Bid, he employee shall abide by the terms of the statement and shall notify the employee of any conviction of, or plea of guilty or polo contenders to, any violation of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. S) Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program, if such is available in the employee's community, by any employee who is so convicted. 6) Make a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 29 of 120 BIDDER'S Signature: Print Name: 24,AJ i-- 60 Date: _ kc,'�i4,l e04'q N Citywide Road Resurfacing Project No. SM- 2011 -07 -PW 30 of 120