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C & I CONSTRUCTION AND DESIGNI ck\ , Proposal Submittal Checklist Form 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: X Bid Form I I X Proposal Bond 14 X Performance Bond 16 X Respondents Qualification Statement 20 X Non - Collusion Affidavit 23 X Public Entity Crimes and Conflicts of Interest 25 X Drug Free Workplace 27 X Acknowledgement of Conformance with OSHA Standards 28 X List of Proposed Subcontractors and Principal Suppliers 29 X Related Party Transaction Verification Form 30 X Indemnification and Insurance Documents 68 Submit this checklist along with your proposal indicating the completion and submission of each required forms and /or documents. END OF SECTION tpepe02 -18 -13 Page 10 of 69 qX9107= THIS PROPOSAL IS SUBMITTED TO: Steven Alexander City Manager City of South Miami 6130 Sunset Drive South Miami, FL 33143 RFP Bus Shelters Phase 2 I. If this Proposal is accepted, the undersigned Respondent agrees to enter into a Contract with the City of South Miami in the form included in this RFP Package, 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. 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 90 calendar days after the day of the Proposal Opening. Respondent agrees to sign and submit the Contract, 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: 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: L 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. 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. tpepe02 -18 -13 Page 1 I of 69 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, 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 � � t cents $ o Do 0 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 120 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: tpepe02 -18 -13 Page 12 of 69 RESPONDENT Telephone: Facsimile: l The terms used in this Proposal which are defined in the Contract sbd| have the same meaning as is assigned uz them in the Contract Documpnts, unless specifically defined in this KFPPnckage SUBMITTED THIS )r `-) PROPOSAL SUBMITTED BY: Company Te ephone Number Title - - Fax Number \ y�om Email Address END OF SECTION tpepeOl |D-|] Page 13 uf69 ADDENDUM No. #1 Project Name: Bus Shelters Phase 2 RFP NO. C2013 -07 Date: July 19, 2013 Sent: Fax /E- mail /webpage This addendum submission is _issued to clarify, supplement and /or modify the previously issued Request for Qualifications (RFQ) Documents, and is hereby made part of the Documents. All requirements of the Documents not modified herein shall remain in full force and effect as originally set forth. It shall be the sole responsibility of the bidder to secure Addendums that may be issued for a specific solicitation. Question #I• Is a bid bond required for this project and if so, what is the percentage of the bid bond? Answer to Question #I: No Bid Bond is required. Question #2• What is the budget for this project? Answer to Question #2: The budget for this project is $98,000. Please refer to the "Capital Improvement Program 5- Year Plan," from the City's adopted budget FY 2012- FY 2013, attached to this Addendum. Question #3• Are there restrictions related to traffic while the shelters are under constructions? Pagel of 2 Answer to Question #3: Yes, for the downtown location only, (SE Corner of SW 59 Place and SW 69 Street), traffic cannot be blocked during rush hours; 7:00 AM to 9:00 AM and from 4:00 PM to 6:00 PM and; traffic flow cannot be blocked for more than 4 consecutive hours. The awarded contractor must submit a M.O.T. to the City of South Miami's Public Works Department, Attention Jorge Vera, Capital Improvements Project Manager. Question #4: Is the contractor responsible to provide and install the metal City Seal affixed to the bus shelters? Question #5• No, the contractor is not responsible to provide and install the metal City Seal. The City will provide and install the seal to the completed bus shelters. Question #6: Are permit fees the responsibility of the contractor? Answer to #6: All City of South Miami permit fees will be waived. Other government entity permits, if required, are the financial responsibility of the contractor. Pre - approved City of South Miami permits have been pulled and are waiting for the awarded contractor's signature. Question #7: Does the Bus Shelter require approval from Miami -Dade County's Public Works department? Answer to Question #7: No, both Bus Shelter locations are not located on roadways maintained by Miami -Dade County. IT SHALL BE THE SOLE RESPONSIBILITY OF THE BIDDER TO SECURE ADDENDUMS THAT MAY BE ISSUED FOR A SPECIFIC SOLICITATION. Page 2 of 2 CAPITAL IMPROVEMENT PROGRAM 5 -YEAR PLAN PROJECT DESCRIPTION FUND SOURCE South Miami � i M�AmOticaCllY FY IS FY 16 FY 17 TRAFFIC CALMING 2001 CAPITAL IMPROVEMENT PROGRAM 5 -YEAR PLAN PROJECT DESCRIPTION FUND SOURCE SOURCE FY 13 FY 14 FY IS FY 16 FY 17 TRAFFIC CALMING West Pinecrest Villas Traffic Calming Study and Const PTP $65,000 Pinecrest Villas Traffic Calming Phase 11 PTP $30,000 Bird Estates Traffic Calming Study and Construction LOGT $55,000 SW 64" Street Corridor Improvements Phase 11 CDBG $177,000 63rd Ct. Between Miller & SW 64th St. Traffic Calming PTP $40,000 Mango Terrace Traffic Calming (Construction) LOGT $24,000 60th Ave Traffic Calming PTP $50,000 Manor Lane - Const of Traffic Calming Devices PTP $30,000 DRAINAGE IMPROVEMENTS Citywide Waterman Upgrade Project Ph I (Design) GOB $80,000 Commerce Lane Road and Drainage Improvements SMCRA $150,000 Dorn Ave Road and Drainage Improvements (Design and Construction) LOGT $30,000 SWDTF $60,000 Citywide Stormdrain Cleanout project SWDTF $20,000 Progress Road and Drainage Improvements SMCRA $180,000 FLEET REPLACEMENT PW Fleet Replace -Trash Crane, Truck, Aerial Lift CIP $287,000 PW Fleet Replace- Garbage & Trash Truck Pick Up CIP $372,000 $372,000 6 Police Vehicles and Equipment CIP $161,390 $161,390 $161,390 $161,390 $161,390 Code Enforcement Fuel Efficient Vehicles CIP $15,000 $15,000 $15,000 $15,000 GEM Parking Enforcement Electric Car CIP $14,500 ROAD INFRASTRUCTURE' Citywide Trans Master Plan (Roadway, sidewalks, swales, neighborhood greenways & bicycle plan) PTP $100,000 $50,000 $50,000 $50,000 $50,000 Sunset Drive Improvements - (65 - 67) & (67 -69) OF $100,000 PTP $220,000 SWDTF $100,000 $100,000 $100,000 $100,000 Street Resurfacing Program - Phase III LOGT $75,000 $75,000 $75,000 $75,000 $75,000 57th Avenue Median Improvement PTP $30,000 Citywide Guardrail and Misc Road infrast Repairs LOGT $60,000 CITY OF SOUTH MIAMI BUDGET FY 2012 -2013 South Miami NEW anferica6 >tta� PROJECT DESCRIPTION FUND SOURCE SOURCE FY 13 FY 14 FY IS FY 16 FY 17 PARKS South Miami Park Infrastructure Improvements FRDAP $200,000 $200,000 $200,000 ADA Sidewalk Upgrades at Dante Fascell Tennis Center ADA $10,000 Marshall Williamson Park Improvements SMCRA $50,000 Dog Park CIP $25,000 Citywide Parks Improvement CIP $100,000 Fuchs Park Improvement FRDAP $50,000 CITY FACILITIES City Hall- ADA Improvements ADA $10,000 Citywide Public Facilities Repairs OF $75,000 Centralize Departments in Sylva Martin Bldg CIP $100,000 City Hall- Storage Facilities for Critical Equipment OF $400,000 Van Smith House Demolition & Remediation CIP $20,000 MISCELLANEOUS CRA Street Lighting Project CDBG $170,000 SMCRA $65,000 At -Grade Pedestrian Crosswalk Devices PTP $61,000 $30,000 $30,000 Commerce Lane /Progress Rd. Business District Parking SMCRA $40,000 $160,000 Citywide replace directional street signs & posts PTP $150,000 Citywide Landscaping Program T &SF $10,000 $10,000 $10,000 $10,000 $10,000 Bus Shelters (2) PTP $98,000 Traffic Enforcement Computerized Sign LEFTF $8,500 Improving the Security of the Police Parking Lot LEFTF $300,000 Police Gas Pump Upgrade LEFTF $100,000 HP Designiet T2300e Multifunction Printer CIP $9,450 Three (3) Downtown Informational Kiosks CIP $45,000 Trimble Geocoder GIS Locator CIP $7,695 GIS Data Storage Server CIP $15,855 ONESolution Planning & Zoning Module CIP $36,380 TOTAL CAPITAL IMPROVEMENTS BY YEAR $3,233,770 $1,348,390 $1,328,390 $611,390 $683,390 CITY OF SOUTH MIAMI BUDGET FY 2012 -2013 29 South Miami �� Ln l0Ul CAPITAL IMPROVEMENT PROGRAM (CONT) 5 -YEAR PLAN CODE SOURCE OF FUNDS FY 13 FY 14 FY IS FY 16 FY 17 CIP Capital Improvement Program $535,270 $548,390 $463,390 $176,390 $548,390 LOGT Local Option Gas Tax $244,000 $75,000 $75,000 $75,000 $75,000 PTP I People Transportation Project $874,000 $80,000 $80,000 $50,000 $50,000 SMCRA South Miami CRA $485,000 $160,000 $0 $0 $0 SWDTF Stormwater Drain Trust Fund $180,000 $100,000 $100,000 $100,000 $0 CDGB Comm. Development Block Grant $347,000 $0 $0 $0 $0 OF Unfunded $0 $175,000 $400,000 $0 $0 GOB MDC General Obligation Bond $80,000 $0 $0 $0 $0 FRDAP FL Rec. Develop. Assistance Program $50,000 $200,000 $200,000 1 $200,000 $0 ADA American Disability Act $20,000 $0 $0 $0 $0 LEFTF Law Enforcement Forfeiture Trust Fund $408,500 $0 ; $0 $0 $0 T &S F I Trees & Shrubs Fund $10,000 $10,000 $10,000 $10,000 $10,000 TOTAL BY YEAR $3,233,770 $1,348,390 $1,328,390 $611,390 $683,390 CITY OF SOUTH MIAMI BUDGET FY 2012 -2013 ADDENDUM No. #2 Project Name: Bus Shelters Phase 2 RFP NO. C2013 -07 Date: July 23, 2013 Sent: Fax /E- mail /webpage This addendum submission is issued to clarify, supplement and /or modify the previously issued Request for Proposal (RFP) Documents, and is hereby made part of the Documents. All requirements of the Documents not modified herein shall remain in full force and effect as originally set forth. It shall be the sole responsibility of the bidder to secure Addendums that may be issued for a specific solicitation. Question #I Sheet A -101 for both shelters under General Conditions lists a $900 site visit allowance x 6 visits! Is this for each shelter — so you have 12 visits total = $10,800? Answer to Question #I: Both shelters shall include a total of six (6) visits, or three (3) visits per shelter. Question #2: Is a project sign required or is this optional? Answer to Question #2: The project sign is to be purchased and installed by the City and is not the responsibility of the awarded contractor. Pagel of 3 Question #3• Just wanted to confirm that this project no longer requires a bid bond of 5% per the Addendum #1 dated July 19, 2013. Also, the Proposal Checklist indicates Performance Bond (pg 16) is required in the proposal, but the bid documents say this is only necessary if awarded contract. Please clarify. Answer to Question #3: The Performance Bond is a condition for the awarded contractor. A Performance Bond is not required with the proposal. Question #4: Can we have the specs and fastening details for the SS mesh ? Answer to Question #4: The mesh and attachment is to be stainless steel rust resistant "grid" pattern, architectural mesh with "u frame "' by Cambridge Architectural or approved equal. The mesh is to be installed as per manufactures specification. Awarded contractor to provide shop drawings signed and sealed by Florida registered Engineer Question #5: What type of paint is used on the steel? Answer to Question #5: (1) Roof & Beam finish - Painted finish with Tiger Drylock RAL color 6012 powder coat or approved equal. Awarded contractor must provide sample to the City's Project Manager for approval. (2) Roof System - To be hurricane proof galvanized corrugated metal panels and fasteners by Centria. To be install as per manufacture specifications. Awarded contractor provide shop drawings signed and sealed by Florida registered Engineer Question #6: Is the finish coat applied on the top side of the roof? Answer to Question #6: Yes, finish coat is applied on the top side of the roof. Page 2 of 3 Question #7• Are the existing benches and trash receptacles to be finished? Answer to Question #7: No, the existing benches and trash receptacles are not to be finished. Question #8: Is the slab 4 Inches or 6 inches? Answer to Question #8: The slab is 6" (inches.) Question #9• Will a roofer be involved in this project? Such as permits. Answer to Question #9: No a roofer is not required; this would be up to the contractor. Question #10• Plans call for soil treatment, is it necessary? Answer to Question #10: No, soil treatment is not required. Question #11: Will a final survey be required? Answer to Question #11: No, a final survey is not required. IT SHALL BE THE SOLE RESPONSIBILITY OF THE BIDDER TO SECURE ADDENDUMS THAT MAY BE ISSUED FOR A SPECIFIC SOLICITATION. Page 3 of 3 STATE OF FLORIDA COUNTY OF MIAMI -DADE RFP Bus Shelters Phase 2 KNOW ALL MEN BY THESE PRESENTS, that we, as Principal, and as Surety, are held and firmly bound unto the City of South Miami ( "City "), a municipal corporation of the State of Florida in the sum of Dollars ($ ), lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors jointly and severally, firmly by these presents. /` THE CONDITION OF THIS OBLIGATION IS SUCH that: WHEREAS, the Principal has submitted the accompanying Proposal d ted for the pursuant to an RFP nd a condition precedent to the submission of said Proposal is that a Proposal Bond in the amount of five, ercent (5%) of the Base Proposal be submitted with said Proposal as a guarantee that the Respondent would fulfill the obligations set forth in the RFP and proposal documents; NOW THEREFORE, A. If the principal shall not withdraw said proposal within ninety (90) calendar days after the date for opening of the same, and shall, within ten (10) calendar days after,tlieprescribed forms are presented to it for signature, enter into a written contract with the City in accordance, with the proposal as accepted, and give bonds with good and sufficient surety or sureties, as may be required 'for the faithful performance and proper fulfillment of such contract, and provide proof of insurance as requir, then the above obligations shall be void and of no effect, otherwise to remain in full force and effect. P B. However, in the event of the principal's una utt t , of said proposal within ninety (90) calendar days after the date of the openri"g of the same or the ilure to enter into a written contract with the Owner in accordance with the propos#as accepted, nd /or t failure to provide the City with bonds issued from good and sufficient surety or sureties/, as may be re uired, the faithful performance and proper fulfillment of such Contract and proof of insura"'ce within ten (10) alendar ys after the prescribed forms are presented to it for signature and /or in the event, hat th principal is n awarded the project but fails to waive all claims that arose or might have arisen out of ti�ye RFP roce o ligations shall remain in full force and effect and the bond shall thereafter be disburse, by court rder, to the Owner in the full amount of the bond if the Proposal Documents provide for) i uidated damages un r the circumstance of the case or, if liquidated damages are not applicable, then in an amount that is- adequate to y compensate the Owner for all of its damages incurred due to the breach of the terms of this Bond, including all attorney fees, court costs and legal expense incurred by the City for any and all Etbn taken, whether before or after the commencement of legal proceedings, including proceedings re fired to obtain the court order of disbursement, including the cost of all appeals or other related proceedings, a well as the fees and costs incurred to collect these damages. 1N WITNESS WHEREOF, the above bonded parties have executed this instrument under their seals this day of 20 , the name and the corporate seal of corporate party being hereto affixed and these presents being duly signed by its undersigned representative. tpepe02 -18 -13 Page 14 of 69 SECOND PAGE DFA TWO C0 PAGE PROPOSAL BOND IN PRESENCE OF: (Individual or Partnership Principal) *Impress Corporate Surety Seal IMPORTANT Surety companies executing bonds must appear on the Treasury Department's most current list (circular 570 as amended) and be authorized to transact business in the State of Florida. FAILURE TO COMPLETE, SIGN, & RETURN THIS FORM MAY DISQUALIFY YO By: tycpc02 |8|3 PmDo 15 n/89 FORM OF PERFORMANCE BOND RFP Bus Shelters Phase 2 KNOW ALL MEN BY THESE PRESENTS: That, pursuant to the requirements of Florida Statute 255.05, we, whose business address is and whose telephone number is as Principal (hereinafter referred to as "Contractor "), and , whose business address is and whose telephone number is as Surety, are bound to the City of South Miami whose business address is and whose telephone number is as Obligee, (hereinafter referred to as "City ") in the amount of Dollars ($ ) for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally. WHEREAS, Contractor has entered into a Contract, for the ((PROJECT)), awarded on the day of 20_, under Contract Number by the City for the construction of (brief description of the Work) in accordance with drawings (plans) and specifications prepared by G. Batista & Associates dated 6/10/13 which Contract is hereby made a part hereof by reference, and is hereafter referred to as the "Contract "; THE CONDITION OF THIS BOND is that the Contractor: I. Fully performs the Contract between the Contractor and the City for the within days after the date of Contract commencement as specified in the Notice to Proceed and in the manner prescribed in the Contract; and 2. Indemnifies and pays City all losses, damages (specifically including, but not limited to, damages for delay and other foreseeable consequential damages), expenses, costs and attorney's fees, including attorney's fees incurred in appellate proceedings, mediation and arbitration, if any, that City sustains because of default by Contractor under the Contract or caused by or arising out of any action or proceeding to enforce the Contract or this Bond; and 3. Upon notification by the City, correct any and all patently defective or faulty Work or materials that appear within one (1) year after the issuance of the Certificate of Occupancy, and correct any and all latent defects that are discovered before the expiration of the third (3rd) year following the date of the issuance of the Certificate of Occupancy; and 4. Performs the guarantee of all Work and materials furnished under the Contract for the time specified in the Contract. If all of the forgoing conditions are met, then this Bond is void, otherwise it shall remain in full force and effect. Whenever Contractor shall be, and declared by the City to be, in default for failing to perform in strict accordance with any of the terms of the Contract, the Surety shall promptly remedy the default as well as perform in the following manner: Complete the Contract in accordance with the Contract's terms and conditions provided the City makes available, as Work progresses, that portion of the Contract Price that has not already been paid to, or on behalf of, the Contractor. The City shall not be required to pay any more than the amount of the Contract Price. The surety shall not be obligated to pay more than the maximum amount for which the Surety may be liable as set forth in the first paragraph of this bond. If the Surety fails to commence the Work within thirty (30) days of receipt of the City's declaration of a default or if the Surety fails to man the job with sufficient forces, or suspends the Work, for more than thirty (30) days, either consecutive or in combination with separate occasions, the City shall have the option, in the City's sole discretion, and without waiving its right to any other remedy or damages provided for by this bond, to complete the Work with other forces and the Surety shall pay for the cost to complete the Work. The term "balance of the Contract Price" as used in this paragraph, shall mean the total amount payable by City to Contractor under the Contract and any amendments thereto, less the amount properly paid by the City to the Contractor. tpepe02 -18 -13 Page 16 of 69 No right of action shall accrue on this Bond to or for the use of any person or corporation other than the City named herein. The Surety hereby waives notice of and agrees that any changes in or under the Contract Documents and compliance or noncompliance with any formalities connected with the Contract shall not affect the Surety's obligation under this Bond. IN WITNESS WHEREOF, the above bonded parties have executed this instrument under their several seals on this day of , 20_, the name and the corporate seal of each corporate party being hereto affixed and these presents being duly signed by its undersigned representative. IN PRESENCE OF: OR ATTEST: Secretary IN THE PRESENCE OF: and Attorney -in -fact Signature) (Individual, President, Managing Member or General Partner, etc.) (Business Address) (City /State /Zip) (Business Telephone) (Corporate Name) (President) (Business Address) (City /State /Zip) (Business Telephone) INSURANCE COMPANY: BY: (SEAL) (Business Address) (City /State /Zip (Business Telephone) (Agent STATE OF FLORIDA ) COUNTY OF MIAMI -DADE ) On this, the day of 20 , before me, the undersigned notary public of the State of Florida, the foregoing performance bond was acknowledged by (Corporate Officer), (Title), of (Name of Corporation), a (State of Incorporation) corporation, on behalf of the corporation. WITNESS my hand and official seal. Notary Public, State of Florida NOTARY PUBLIC: SEAL OF OFFICE: (Name of Notary vuonc: vrint, stamp or Type as commissioned.) Personally known to me, or _ Personal identification: _ Type of Identification Produced Did take an oath, or Did Not take an oath. tpepe02 -18 -13 Page 17 of 69 FORM OF PAYMENT BOND RFP Bus Shelters Phase 2 KNOW ALL MEN BY THESE PRESENTS: That, pursuant to the requirements of Florida Statute 255.01, et seq., Florida Statutes, we, , whose business address is and whose telephone number is as Principal, (hereinafter referred to as "Contractor "), and whose business address is and whose telephone number is as Surety, are bound to the City of South Miami, whose business address is and whose telephone number is as Obligee, (hereinafter referred to as "City ") in the amount of Dollars ($ ) for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally. WHEREAS, Contractor has, by written agreement, entered into a Contract for the «PROJECT», awarded on the day of 20 , under Contract Number for the construction of (brief description of the Work) by the City in accordance with drawings (plans) and specifications prepared by G. Batista & Associates dated 6/10113 which Contract is hereby made a part hereof by reference and is hereafter referred to as the "Contract' THE CONDITION OF THIS BOND is that if the Contractor: I. Promptly performs the construction work in the time and manner prescribed in the Contract; and 2. Promptly makes payments to all claimants, as defined in Section 255.05, Florida Statutes, supplying Contractor with labor, materials, or supplies, used directly or indirectly by Contractor in the prosecution of the work provided for in the Contract; and 3. Pays City all losses, damages, expenses, costs, and attorney's fees, including those incurred in any appellate, mediation or arbitration proceedings, if any, that Owner sustains because of a default by Contractor under the Contract; and 4. Performs the guarantee of all work and materials furnished under the contract for the time specified in the contract, then this obligation shall be void; otherwise, it shall remain in full force and effect. Any action instituted by a claimant under this bond for payment must be in accordance with the notice and time limitation provisions in Section 255.05(2), Florida Statutes. The Surety hereby waives notice of and agrees that any changes in or under the Contract Documents and compliance or noncompliance with any formalities connected with the Contract shall not affect the Surety's obligation under this Bond. IN WITNESS WHEREOF, the above bonded parties have executed this instrument under their several seals on this day of 20 , the name and the corporate seal of each corporate party being hereto affixed and these presents being duly signed by its undersigned representative. IN PRESENCE OF: OR ATTEST: Secretary tpepe02 -18 -13 (Individual, President, Managing Member or General Partner, etc.) (Business Address) (City /State /Zip) (Business Telephone) (Corporate Name) (President) (Business Address) (City /State /Zip) Page 18 of 69 (Business Telephone) SECOND PAGE OF A TWO PAGE PAYMENT BOND WHEREBY IS THE PRINCIPAL AND IS THE SURETY IN THE PRESENCE OF: INSURANCE COMPANY: BY: (SEAL) (Agent and Attorney -in -fact Signature) (Business Address) (City /State /Zip (Business Telephone) STATE OF FLORIDA COUNTY OF MIAMI -DADE On this, the day of , 20_, before me, the undersigned notary public of the State of Florida, the foregoing payment bond was acknowledged by (Corporate Officer), (Title), of (Name of Corporation), a (State of Incorporation) corporation, on behalf of the corporation. WITNESS my hand and official seal. Notary Public, State of Florida NOTARY PUBLIC: SEAL OF OFFICE: (Name of Notary Public: Print, Stamp or Type as commissioned.) Personally known to me, or Personal identification: Type of Identification Produced Did take an oath, or Did Not take an oath. *Power of Attorney must be attached. tpepe02 -18 -13 Page 19 of 69 RFP Bus Shelters Phase 2 The response to this questionnaire shall be utilized as part of the CITY'S overall Proposal Evaluation and RESPONDENT selection. I. Number of similar construction projects completed, a) In the past 5 years c- t' C)fi Ctc 3 t W �N In the past 5 years On Schedule Z t } t -ko "Al , } b) In the past 10 years c 4y Qioixm In the past 10 C a�tt }'cli3CC ail' 1 1# >1 1Ci On Schedule 1 ` ai ' A Qk ` �mKcj d i i ti 41 Original Contract Completion Date: Actual Final Contract Completion Date: Original Contract Price: Actual Final Contract Price: b) 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 c) Project Name: Owner Name: Owner Address: Owner Telephone: Original Contract (Days): Completion Time g 'x'01 Ow \sA CW' lrv) OVOIN-N t .- t tpepe02 -18 -13 Page 20 of 69 Original Contract Completion Date: �� `} 'i �- Actual Final Contract Completion Date: , Original Contract Price: Actual Final Contract Price: 3. Current workload 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: a) Bankruptcy petitions filed by or against the Respondent or any predecessor organizations, b) Any arbitration or civil or criminal proceedings, or Suspension of contracts or debarring from Bidding or Responding by any public agency brought c) against the Respondent in the last five (5) years 1. Government References: tpepe02 -18 -13 Page 21 of 69 List other Government Agencies or Quasi-government Agencies for which you have done business within the past five (5) years. Name of Agency: 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: Type of Project: kk tpepe02-18-13 Page 22 of 69 STATE OF FLORIDA COUNTY OF MIAMI -DADE RFP Bus Shelters Phase 2 being first duly sworn, deposes and states that: He /She/They is /are the : (Owner, Partner, Officer, Representative or Agent) of .Cai the Respondent that has submitted the attached Proposal; (2) He /She/They is /are fully informed concerning the preparation and contents of the attached Proposal and of all pertinent circumstances concerning such Proposal; (3) Such Proposal is genuine and is not a collusive or sham Proposal; (4) Neither the said Respondent nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, have in any way colluded, conspired, connived or agreed, directly or indirectly, with any other Respondent, firm, or person to submit a collusive or sham Proposal in connection with the Work for which the attached Proposal has been submitted; or to refrain from Bidding or proposing in connection with such Work; or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or conference with any Respondent, firm, or person to fix any overhead, profit, or cost elements of the Proposal or of any other Respondent, or to fix any overhead, profit, or cost elements of the Proposal Price or the Proposal Price of any other Respondent, 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 Proposal are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the Respondent or any other of its agents, representatives, owners, employees or parties of interest, including this affiant. Date tpepe02 -18 -13 Page 23 of 69 ACKNOWLEDGEMENT STATE OF FLORIDA COUNTY OF MIAMI-DADE On this the 2C; day of t4 20 V , before me, the undersigned Notary Public of the State of Florida, personally appeared (Name(s) of individual(s) who appeared before notary) 1--i, 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. �oaP ?y P FABIENINE A. BERRET MY COMMISSION # EE 186416 NOTARY PUBLIC:� EXPIRES: April 13,2016 SEAL OF OFFICE: topf Bonded Thru Budget Notaty Srk* Thomas F Pepe, 2011 -2013. A11 rights reserved. 6/18/13 s as IJ81ON )eBpn 1 pop Notary *V 3NN319 'd� 7� (Name of Notary Public: Print, Stamp or type as commissioned.) Personally known to me, or Personal identification: Type of Identification Produced Did take an oath, or Did Not take an oath. (0 Page 24 of 69 PUBLIC ENTITY CRIMES AND CONFLICTS OF INTEREST RFP Bus Shelters Phase 2 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 RESPONDENT, 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 [print name of the public entity] [print individual's name and title] for .e7a1_ f [print name of entity submitting sworn statement] whose business address is ( Aoctm wo o '" yy and (if applicable) its Federal Employer Identification Number (FEIN) is • - tcV -7 (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: 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, 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 I, 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 O Thomas F. Pepe, 2011 -2013. AI I rights reserved. 6/18/13 Page 25 of 69 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. S. 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. Based on information and belief, the statement which I have marked below is true in relation 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 I, 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 I CESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES, FOR CATEGO Y O OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. [Signature] Sworn to and subscribed before me this day of rtnar pub * tuY COMM ION # EE 1 416 C Personally known 1t ��?eoF F1.0" knded T Bud et NOiary sere m OR Produced identification Nq /ar Public — Statefd f r (Type of identification) Form PUR 7068 (Rev.06/ 1 1 /92) Thomas F. Pepe, 2011 -2013. All rights reserved. 6/18/13 My commission expires flfed 1 11� (Printed, typed or stamped commissioned name of notary public) Page 26 of 69 ! �' ♦ • AA RFP Bus Shelters Phase 2 Whenever two or more Bids or Proposals 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 or Proposal 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 or Proposals 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: I) 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 nolo contendere to, any violation of Chapter 893 or of any controlled substance law of the United States or any state, for violation occurring in the workplace no later than five (5) business days after such conviction. 5) Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program, if such is available in the employee's community, by any employee who is so convicted. 6) Make a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. RESPONDENT's Signature: Print Name: Date t / Thomas F. Pepe, 2011- 2013. All rights reserved: 6118113 Page 27 of 69 ACKNOWLEDGEMENT OF CONFORMANCE WITH OSHA STANDARDS RFP Bus Shelters Phase 2 TO THE CITY OF SOUTH MIAMI We, 4k c J� on , (Name of CONTRACTOR), hereby acknowledge and agree that as CONTRACTORs for the Bus Shelters Phase 2 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 G. Batista & Associates 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 comply with such act or regulati CONTRACTOR Witness Name Title Thomas F. Pepe, 2011 -2013. All rights reserved. 6/18/13 Page 28 of 69 lliomas F. Pepe, 2011-2013. All rights reserved. 6/18/13 Page 29 of 69 Bus Shelters Phase 2 BIDDER shall list all Proposed Subcontractors to be used on this project if they are awarded the Contract. Landscape Sodding and Turf Work Electrical Irrigation Paving Park Amenities Graphics Utilities Excavation Building Structures Plumbing Painting Testing Laboratory N Soil Fumigator Signs Other: � l�k� �� � This list shall be provided to the City of South Miami by the apparent lowest responsive and responsible Bidder within five (5) business days after Bid Opening. lliomas F. Pepe, 2011-2013. All rights reserved. 6/18/13 Page 29 of 69 RELATED PARTY TRANSACTION VERIFICATION FORM RFP Bus Shelters Phase 2 I cy 0 t'i j°C& individually and on behalf of C41 C fj10olog ( "Firm ")have Name of Representative Company /Vendor /Entity read the City of South Miami ( "City ")'s Code of Ethics, Section 8A -1 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 1, and /or the Firm, am(are) about to perform for, or to transact with, the City, and (2) neither 1 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, [while the ethics code still applies, if the person executing this form is doing soon behalf of a firm whose stock is publicly traded, the statement in this section (2) shall be based solely on the signatory's personal knowledge and he /she is not required to make an independent investigation as to the relationship of employees or those who have a financial interest in the Firm.]; 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: _(use (if necessary, use a separate sheet to supply additional information that will not fit on this line; however, you must make reference, on the above line, to the additional sheet and the 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 (3) shall be based solely on the signatory's personal knowledge and he /she is not required to make an independent investigation as to the relationship of those who have a financial interest in the Firm.], 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; however, you must make reference, on the above line, to the additional sheet and the 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; however, you must make reference, on the above line, to the additional sheet and the 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 (4) shall be based solely on the signatory's personal knowledge and he /she is not required to make an independent investigation as to the financial interest in the Firm of city employees, appointed officials or the immediate family members of elected and /or appointed official or employee.] (5) I 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. O Thomas F. Pepe, 2011 -2013. All rights reserved. 6/18/13 Page 30 of 69 (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; however, you must make reference, on the above line, to the additional sheet and the additional sheet must be signed under oath). X: \Purchasing\Vendor Registration \12.28.12 RELATED PARTY TRANSACTION VERIFICATION FORM [3].docx (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; however, you must make reference, on the above line, to the additional sheet and the 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 (7) shall be based solely on the signatory's personal knowledge and he /she is not required to make an independent investigation as to the relationship by blood or marriage of employees, officers, or directors of the Firm, or of any of their immediate family to any appointed or elected officials of the City, or to their immediate family members]. (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 S% 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; however, you must make reference, on the above line, to the additional sheet and the 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, I 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 the Miami -Dade County Commission on Ethics. Under penalty of perjury, I declare that I have made a diligent effort to investi he matters to which 1 am attesting hereinabove and that the statements made hereinabove are true and, corr to the best of my knowledge, information and belief. Signature: Print Name & Title: 1 fCVViCLfµ' ='�� Date:w ©`Thomas F. Pepe, 201 1 -2013: All rights reserved. 6/18/13 Page 31 of 69 Insurance and Indemnification Insurance and Indemnification Without limiting its liability, the proposing firm shall be required to procure and maintain at its own expense during the life of the Contract, insurance of the types and in the minimum amounts stated below as will protect the proposing firm, from claims which may arise out of or result from the proposing firm's execution of a contract with the City of South Miami for Performance Based Audits, whether such execution by the firm or by any sub - consultant, or by anyone directly or indirectly employed by any of them or by anyone for whose acts any of them may be liable. The CONTRACTOR/COMPANY shall not commence WORK on this Agreement until he has obtained all insurance required by the City. The CONTRACTOR /COMPANY shall indemnify and save the City harmless from any and all damages, claims, liability, losses and causes of actions of any kind or nature arising out of a negligent error, omission, or act of the CONTRACTOR/COMPANY, its agents, representatives, employees, Sub - Contractor, or assigns, incident to arising out of or resulting from the performance of the CONTRACTOR/COMPANY'S professional services under this Agreement. The CO NTRACTO RICO M PANY shall pay all claims and losses of any kind or nature whatsoever, in connection therewith, including the City's attorney's fees and expenses in the defense of any action in law or equity brought against the City arising from the negligent error, omission, or act of the CONTRACTOR/COMPANY, its agents, representatives, employees, Sub - Contractor, or assigns, incident to, arising out of or resulting from the performance of the CONTRACTOR/COMPANY'S professional services under this Agreement. The CONTRACTOR/COMPANY agrees and recognizes that the City shall not be held liable or responsible for any claims, including the costs and expenses of defending such claims which may result from or arise out of actions or omissions of the CONTRACTOR/COMPANY, its agents, representatives, employees, Sub - Contractors, sub - contractors, or assigns. In reviewing, approving or rejecting any submissions or acts of the CONTRACTOR /COMPANY, the City in no way assumes or shares responsibility or liability of the CONTRACTOR/COMPANYS, Sub - Contractors, their agents or assigns. The CONTRACTOR/COMPANY shall maintain during the term of this Agreement the following insurance: A. Professional Liability Insurance on a Florida approved form in the amount of $1,000,000 with deductible per claim if any, not to exceed 5% of the limit of liability providing for all sums which the CONTRACTOR/COMPANY shall become legally obligated to pay as damages for claims arising out of the services or work performed by the CONTRACTOR/COMPANY its agents, representatives, Sub Contractors or assigns, or by any person employed or retained by him in connection with this Agreement. This insurance shall be maintained for four years after completion of the construction and acceptance of any Project covered by this Agreement. However, the CONTRACTOR /COMPANY may purchase Specific Project Professional Liability Insurance, in the amount and under the terms specified above, which is also acceptable. B. Comprehensive general liability insurance with broad form endorsement, on a Florida approved form including automobile liability, completed operations and products liability, contractual liability, severability of interest with cross liability provision, and personal injury and property damage liability with limits of $1,000,000 combined single limit per occurrence and $2,000,000 aggregate, including: ❑ Personal Injury: $1,000,000; Thomas F. Pepe, 2011 -2013. All rights reserved. 6/18/13 Page 68 of 69 ❑ Medical Insurance $25,000 per person; ❑ Property Damage: $500,000 each occurrence; ❑ Automobile Liability: $1,000,000 each accident/occurrence. C. Umbrella Commercial General Liability insurance on a Florida approved form with the same coverage as the primary insurance policy but in the amount of $1,000,000 per claim. The City must be named as additional "named" insured for all except Workers' Compensation, and reflect the indemnification and hold harmless provision contained herein. Policy must specify whether it is primary or excess /umbrella coverage. City must receive 10 days advance written notice of any policy modification and 30 days advance written notice of cancellation, including cancellation for non - payment of premiums. All insurance must remain in full force and effect for the duration of the contract period with the City. The CONTRACTOR/COMPANY must provide not only a "certified copy" of the Binder but also the Policy itself with the name, address and phone number of the agent and agency procuring the insurance. D. Workman's Compensation Insurance in compliance with Chapter 440, Florida Statutes, as presently written or hereafter amended. E. The policies shall contain waiver of subrogation against City where applicable, shall expressly provide that such policy or policies are primary over any other collective insurance that City may have. The City reserves the right at any time to request a copy of the required policies for review. All policies shall contain a "severability of interest" or "cross liability" clause without obligation for premium payment of the City. F. All of the above insurance required to be provided by the CONTRACTOR/COMPANY is to be placed with BEST rated A -8 (A -VIII) or better insurance companies, qualified to do business under the laws of the State of Florida on approved Florida forms. The CONTRACTOR /COMPANY shall furnish certified copies of all "Binders" or certificates of insurance to the City prior to the commencement of operations, which "Binders" or certificates shall clearly indicate that the CONTRACTOR /COMPANY has obtained insurance in the type, amount, and classification as required for strict compliance with this Section and that no reduction in limits by endorsement during the policy term, or cancellation of this insurance shall be effective without thirty (30) days prior written notice to the CITY. Compliance with the foregoing requirements shall not relieve the CONTRACTOR /COMPANY of his liability and obligations under this Section or under any other portion of this Agreement. CONTRACTOR/COMPANY agrees to supply copies of certificates of insurance to the City verifying the above - mentioned insurance coverage. CONTRACTOR/COMPANY agrees to list City as an Additional Insured of the CONTRACTOR/COMPANY's General liability insurance and shall provide the City quarterly reports concerning any and all claims. END OF DOCUMENT Thomas F. Pepe, 2011 -2013. All rights reserved. 6/18/13 Page 69 of 69 LICENSING STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Ta -aC CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 MALDONADO, CARLOS MARIO C & I CONSTRUCTION & DESIGN INC 14031 SW 143RD COURT UNIT #6 MIAMI FL 33186 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. 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. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the 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. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE F. STATE OF FLORIDA (850) 487 -1395 STATE OF FLORIDA�jy# - $~ DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CCC1514770 05/28`/12 118192173 CERTIFIED GENERAL CONTRACTOR MALDONADO, CARLOS MARIO C & I CONSTRUCTION `& DESIGN INC IS CERTIFIED under the provisions of Ch.489 FS Ezpi —tion deter AUG.. 31, 20.14 L12 0 5 2 8 0 0131 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ #L12052800131 DATE BATCHNUMBEFt LICENSE NBR 105/28/20121118192173 CGC1514770 The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 MALDONADO, CARLOS MARIO C & I CONSTRUCTION & ) DESIGN INC` 14031 SW 143RD COURT UNIT #6 MIAMI FL 33186 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REQ(JIRF_D BY LAW FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 641778-6 �-A'Y RENEWAL BUSINESS NAME / LOCATION RECEIPT NO. 668592-0 C & I CONSTRUCTION & DESIGN INC STATE# CGC1514770 14031 SW 143 CT 6 33186 UNIN DADE COUNTY OWNER C & I CONSTRUCTION & DESIGN INC Soc, We of business WORKER/S GENERAL BUILDING CONTRACTOR I'lliSlS ONLY A LOCAL t4 RUsi esS TAX RECEIPT. 11 0"E5 NOT PERWT ?siE imDtli, To VIOLANe ANY EXISTI REC'tij' ATORY OR -ONN '3 LAMS Or H DO NOT FORWARD COUNT'. OR CITIES, MOR DOES ill -ME HOLDER FROM ANY OT f, PERMIT OR 111.5F, REOW0,J) BY L ' ills ls C I CONSTRUCTION & DESIGN INC NOT A CE1,YMM A ON OF, CAV4 HOWER 5 QUALIFICA- CARLOS MALDONADO PRES 14031 SW 143 CT 6 MIAMI FL 33186 MiANN, "COE. COUNTY 'MI, i� t' O Ecroil: 07/11/2012 09010044001 000075.00 SEE OTHER SIDE