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RPM Bid Documents S. Miami Bus Shelters Rev1Proposal Submittal Checklist For -riiiis 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. Fulffflnnent of all solicitation requirements listed is mandatory for consideration of response to the solicitation. Additional documents may be required arid, if so, they will be identified in an addendum to this RFP. The response shall include the following items: x Non-Collusion Affidavit 23 x Public Entity Crimes and Conflicts of Interest 25 x Drug Free Workplace 27 x Acknowledgement of Conformance with 0SHA Standards 28 x List of Proposed Subcontractors and Principal Suppliers 29 x Related Party Transaction Verification Form 30 x Indemnification and Insurance DoCUrnents 68 Submit this checklist along with your proposal indicating the completion and submission of each required forms and/or documents. END OF SECTION RufflFfflum THIS PROPOSAL 6 SUBMITTED TO- Steven Alexander City Manager City of South Miami 6130 Sunset Drive South Miami, FL 33143 RFP Bus Shelters Phase 2 Addendum No. Dated: Addendum No. Dated: Addendum No, Dated: Page I I of 69 1 & 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. #2 #6 #3 #7 #4 #8 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. S. 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: Page 12 of 69 RESPONDENT: RPM GENE RAL CONTRACTORS, INC. Address: 680 RE —26TR6—URT -C------"" OiO—MPANO ET, FL ROBERT P. MCTEAGUE, JR, 7, The terms used in this Proposal which are deflned in the Contract shall have the same meaning as is assigned to them in the Contract Documents, unless specifically defined in this RFP Package, SUBMrrTEEC THIS 26TH DAY OF JULY PROPOSAL SUBKTTED BY: RPM GENERAL CONTRACTORS, INC. Company PRESIDENT 20 13 , (9 54) 785-8900 Telephone Number (954) 785-4070 --- — Fax — Num�e—r-- RPMGCINC@AOL.COM END OF SECTION tpepe02-19 -1 Page 13 of 69 RPM GENERAL CONTRACTORS, INC. RESPONDENT QUALIFICATION STATEMENT PFP Eras Shelters Phase The response to this questionnaire shall be Utilized as part of the ITY"S overall Proposal Eva €uadon and RESPONDENT selection. SEE ATTACHED FOR ADDITIONAL INFORMATION/QUALIFICATIONS € . Number of similar construction projects completed, RPM GENERAL CONTRACTORS Original Contract Completion Date- ------ Actual Final Contract Completion Date: 07102110 Original Contract Price: $129,150.00 Actual Final Contract Price: _114,446 _q0 S. Current workload 4, The f6flowing information shall be attached to the proposaL a) ESP 3[ horne office organization chart, b) RESPONDENT's proposed project organizationai chart. c) Resumes of proposed key project personnel, inc9uding on-site Superintendent. 5, List and describe any: I. Government References: iY 71,000.00 HL Johnson Elem School District of (561) 882-1920 69,000.00 AI A Restrooms Palm Beach County New Horizons Elern School District of (561) 882-1920 51,000.00 A Restrooms Palm Beach County Acreage Pines Elem School District of 52,000.00 AIWA Restrooms Palm each County (561) 882-1920 City of Sunrise, Repair City of Sunrise, FL (954) 309-4445 T5,00U0 + repairs as Facilities Building Alan Gavazzi needed Houston's Restaurant Hillstone Restaurants (602) 553-2134 25,000-00 Coral Gables Water Featur, J.Alexander's Restaurant J.Alexander's (615) 269-1915 13,000.00 P Patna i GA Patio Renovation Restaurants, Inc. J.A6exander's Restaurant J.Alexander's (615) 269-1915 (615) 269_1915 25,000.00 , L I P i Ft. Lauderdale At Parkin Restaurants, Inc. Restaurants, L 4, The f6flowing information shall be attached to the proposaL a) ESP 3[ horne office organization chart, b) RESPONDENT's proposed project organizationai chart. c) Resumes of proposed key project personnel, inc9uding on-site Superintendent. 5, List and describe any: I. Government References: iY RPM GENERAL CONTRACTORS,INC List other Government Agencies or Quaskgovernment Agencies for which you have done business within the past five (5) years, Name of Agency: NIA Address: Type of Project: Name of Agency: Address: Type of Project: Name of Agency: Address: Telephone No.: Contact Person- NON-COLLUSION AFFIDAVIT STATE OF FLORIDA COUNTY OF MIAMI-DADE RFP Bus Shakers Phase 2 ROBERT P. MCTEA GUE, JR. — being first duly sworn, deposes and states that: Print Name and Title tpepeO2-18-13 Page 23 of 69 A C _K _NQ IL E[) _G_E 1_E N I STATE OF FLORIDA COUNTY OF MIAMI-DA DE On this the 26TH day of JULY 20 12�, before me, the undersigned Notary Pubhc of the State of Florida, personally appeared (Name(s) of individual(s) who appeared before notary) —_ ROBERT P. MCTEAGUE, JR. and whose name(s) is/are Subscribed to the within instrument and he/she/they ackmcwledge that he/she/they executed it. WITNESS my hand and official seal. NOTARY PUBLIC: SEAL OF OFFICE: mot&ry pubtic - state of Amida My Comm. Expires ion 23, 2011 Commission # EE 205993 (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, C 'J'jic)rnas F Npe, 2011-2013, All right, reserved 6/18f 13 Page 24 of 69 PUBLIC ENTITY CRIMES AND CONFLICTS OF INTEREST RFP Bus Sheiters Phase 2 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), EL( R TATUTE5, ON PUBLIC ENTITY CRIMES jaA _ S__ 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 II CITY OF SOUTH MIAMI, FLORIDA [print name of the public entity] by — ROBERT P. MCTEAGUE, JR.-PRESIDENT &int individual's name and tide for M GENERAL CONTRACTOA, INC. [print name of entity submitting sworn statement] whose business address is 680 CIE 26TH COURT POMPANO BEACH, FL 33064 and (if applicable) its Federal Employer Identification Number (FEIN) is 65-0429630 (if the entity has no FEIN, inciude the Social Security Number of the individual signing this sworn stateme= 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 THA7r THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTiTY 9NDENTIFIED 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 HLED. I ALSO UNDERSTAND THAT I AM REQUIRED TO iNFORM THE PUBLIC ENTITY PRIOR TO ENTERING i�NTQ CONTRACT IN EXCESS OF THE 'A - �� T FOR CATEGORY TWO OF ANY THRESHOLD AMOUNT PROVIDED IN SECTION 2.117, FLORIDA JI CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. Sworn to and subscribed before me this .,�4 day of _-I- Personally known OR Produced identification (Type of identification) Form PUR 7068 (Rev.06/11/92) ' 'I hm F ias Pepe, 2011 -2013 AU righis reserved. 6/18/13 Notary Public - State of _fLb(-0, —a- -- ( IRR DRUG FREE WORKPLACE P Bus Shelters Phase 2 RESPO ill ENT's Signature: ROBERT p RES CTEAGUE, JR.- PIDENT Print Name: Date- JULY 26, 2013 , � Thornas F, Pepe, 2011-2013 All ri al �ts resmed 6/18/13 Page 27 of 69 ACKNOWLEDGEMENT OF CONFORMANCE WITH OSHA STANDARDS RFP Bus Shelters Phase 2 TO THE CITY OF SOUTH MIAK to comply with such act or regulation. CONTRACTOR RPM G RAC. CONTRACTORSJNC. BY a m 0 P. me ROBERT P� MCTEAGUE, JR. M it&ne,s Thmnes F. Ppe, 2011-2013, All rights reserved. 18113 Page 28 of 69 RPM GENERAL CONTRACTORS,INC. LIST OF PROPOSED SUBCONTRACTORS AND PRINCIPAL SUPPLIERS Bus Shelters Phase 2 BIDDER shall list all Prcapcased Sub cantractors to be used on this project if they are awarded the Contract. Landscape 1 Sodding and Turf Work RPM GC Electrical N/A Irrigation N/A Paving NIA Park Amenities N/A Graphics N/A Utilities N/A Excavation RPM GC Building N/A 2991 North River Dr. 305-634-2111 Structures C&R METALS, INC. Miami, FL 33142 305-634-9067 Fax Plumbing N/A Painting RPM GC Testing Laboratory NIA Soil Fumigator ------ Signs NIA Other: -------- This list shall be provided to the City of South Kam, by the apparent �lowest �responsive and responsible Bidder within five (5) business days after Bid Opening, 11jas F Pepe, 2011-2013 AH fig its, ieserved, f I f Page 2 9 of 69 RELATED PARTY TRANSACTION VERIFICATION FORM RFP Bus Shelters Phase 2 RPM GENERAL CONTRACTORS, INC. I ROBERT P. MCTEAGU E, JR. individually and on behalf of ("Firrn")have Name of Representative CompanylVendordEntity read the City of South Miami (-City")'s Code of Ethics, 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 6, and/or the Firm, am(are) about to perform for, or to transact with, the City, and (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 disciose 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, 0 fbomas F Pepe, 2011-2013, All rights reserved 6/18,11 _3 i Page 30 of 69 (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 taw. Additionally, violations may be considered by and subject to acdopn�y the Miami-Dade County Commission on Ethics. Under penalty of perjury, I declare that I effort have made a dill effort to investigate the matters to which I am attesting herein above and that the statements made heereirnAje are true and correct to the best of my knowledge, information and belief. r Signatur Date: JULY26,2013 Q.,'Thonias F Pepe., 2011-2013 All rights reserved, 6/ 18! 13 Page 31 of 69 ATTACHED: Sec. 8A- 1 - Conflict of interest and code of ethics ordinance. Municode Page I OM Sec, 8A- I a - Conflict of interest and code of ethics ordinance. C, Thomas F Pepe, 2011-2013, All rights reserved. 6/1 m> Page 34 of 69 (Ord. No, 6-99-1680, § 2, 3-2-99) Editor's note- Ord. No. 6-99-1680, § 1, adopted 3-2-99, repealed §§ SA- I and 8A-2 in their entirety and replaced there with new §§ A -1 and 8A-2. Former §§ 8A-€ and 8A-2 pertained to declaration of poky and definitions, respectively, and derived from Ord. No. 634, §§ I (I A-1), 1 (1 A-2) adopted )an , J 1, 1969, Thomas ['. Pepe, 201 l--10131 All rights resened, 6/1 R� 13 Page 35 of 69 I � Insurance and Indemnification Insurance and Indemnification 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-Vill) or better insurance companies, qualified to do business under the laws of the State of Florida on approved Florida forms. 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