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RP UTILITY BID DORN AVENUE DRAINAGE1 0 Thomas F Pepe, 2011 -2013, All rights reserved, 7111113113 4 ; #L4fd ©� *! ■ <+ : ? »««,< ■ ; ■ Steven Alexander City Manager City of South Miaml 6130 Sunset Drive Sguth Miami. FL 33 1 Page E of 4? 0( Thumm F, Pepe, 2 1l, All hreserved. 7/11113/13 Page 1 f of 0 Thomas F. Pepe, 2411 -2413. All sights reserved. 7,11113113 A Wjj eai mu comileted i ijakdoin, ij 1W.6, Wr 6 n the table shown above Failure to S. The ENTIRE WORK shall be completed, in full, within 30 working days 'from the date stipulated in 69-9 NOTICE TO PROCEED. Failure to complete the entire work during the described time period sh result in the assessment of liquidated damages as set forth 'in the Contract. i M�Mmlwwrm�. � Title Fax Number /Emaill Address Page 12 of 68 9 Thomas F, Pepe, 2011-2011 All rights rocrved, 7/11/13113 The response td this questionnaire shall be utilized as part of the CITY'S overall Proposal Evaluation and CONTRACTOR selection. 1. Number of similar construction projects completed, a) In the Fast S years In the past 5 years On Schedule b) in the past 10 years In the past 10 years On Schedule J4 r- CO Thomas P. Pepe, 2011-2013 All rights reserve; 7/11113/13 Original Contract Price Actual Final Contract Price Project Name t if P Owner Name:8 Original Contract Completion Cate OF Actual Final, Contract Completion Date: Page 20 of b 0 Thomas F. Pepe, 2011 -2013: All rights reserved. 7 /11 /13/13 Original Contract Price: Actual Final Contract Price: 4. The folloWing information shall be attached to the proposal. a) RESPONDEN-rs home office organization chart. b) RESPONDENTs 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 Page 21 of 69 0 Thomas F. Pepe, 2011-2013, All rights reserved: 7/11/13/13 List other Government Agencies or Quasi-government Agencies for which you have done business within the past five (5) years. Name of Agency: Address: Type of Project: Name of Agency: 1- - r4+Tliil"�1�GiYp Telephone No.: Contact Person: Oc Thomas F. Pepe, 2011-2013. All rights reserved. 7111/13/13 � !° 'B"T" STATE OF FLORIDA ) COUNTY OF MIAMI-DADE being first duly sworn, deposes and states that; (1 ) Ike /She/They is /are the zlwmex (Owner, Partner, Officer, Representative or Agent) of Rage 23 of 6 0 Thomas F. Pepe, 2011 -2013: All rights reserved; 711/13113 s� /£k&6WLE6&EMeNT STATE OF FLORIDA d % Thomas K Pepe, 2011-2011 mom reserved, 7/11/0113 . ... iv : — Not Florida \ © »� ©� Type of Identification Produced ^ Did take an tho Did Not oath. : . + i understand that an "affiriate" as defined in Paragraph 287.133 (1) (a), Florida Statutes' me: (a) A predecessor or successor of:a person convicted of a public entity crime; or t (b) An entity under the control 6f any natural person who is active in the managemen :he enti and who has been convicted of a public entity crime. The term "affiliate�' includes those office directors, executives, partners, shareholders, employeesi members, and agents who are active mom= 0 Thomas F. Pepe, 2011-2013, All rigits reserved. 7/11/13/13 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 i one person controls another person. A person who knowingly enters into a joint venture with a person r me i RuNic entj�c i n F! rida during the preceding 36 months shall be considered an affiliate. ` Sworn to and subscri 3 bed before me this day of Personally known OR Produced identification (Type of identification) Form PUR 7068 -(Rev. 6J6 [J92) V Thumas F Pepe, 2011-2013. All rights reserved. 7/11113113 area 20J,± Thomas F. Pepe, 2011 -2013. All rights reserved. 7/11/13/13 ACKNOWLEDGEMENT OF CONFORMANCE WITH OSHA STANDARDS Dom Avenue Drainage Improvements • s + am r T1aa asF Pepe, 2411 -2413: All rights reserved, 7/11/13/13 SUBCONTRACTORS PRINCIPAL LIST OF PROPOSED MMMM C Thomas F. Pate, 2011- 2013: All rights reserved. 7/11113113 Dorn Drainage r Page 30 of 68 0 Thomas F. Pepe, 2011- 20113. All rights reserved, 7)11A"A3 Print Name & Title: � Date: LO Thomas 'F Pepe, 2011 -2013 All rights reserved. 7111113113 Na sib CONSTRUCTION INDUSTRY EXEMPTION This certifies thatthe individual listed below has elected to be a emptfrom Florida Workers' Compensation fear. EFFECTIVE . 101612013 EXPIRAT1 1 016!201 PEREZ RAiDEL 452742507 BUSINESS NAME AND ADDRESS: 4110 SW 110 AV MIAMI ` FL 33165 SCOPES OF BUSINESS OR T OPERATI iSUre Insurance Brokers mmPHONE FAX (Aar N0 : 87110 W. Flac� lee St., Suite 270 P2 No,E ;4); __ — Miami, FL 33174 E -MAIL _._ aDO)zgss; Teresa R. Carlrmna, Agent _ _ INSURERS) AFFORDING COVERAGE NAIC # INSURER A: Endurance American Specialty 41710 INSURED R.P Utility & Excavation Corp INSURER B. Travelers Casualty Ins. CO of Raidei Peru INSURER c Florida Citrus, Business (F 4110 110 AVE _ Miami, FIL 33165 INSURERD: INSURER E; INSURER F.. _. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN; THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .... INSR D L BR ._ LTR TYPE OF INSURANCE I POLICY NUMBER f*QLICY EFF POLICY EXP ` LIMITS hkMADD MMIDDIYYYY _. GENERAL LGABIUTY I.. EACH €OCCURRENCE $.. 1,11110,00. _. . A . COMMERCIAL GENERAL LGAB6LfTY CIQUiNB434 OA AGEET Ii h1�TED I117I201 HJ17Iikt4 PREMISES Earrencei 9l$,Ba ryY CLAIMS- MADE.: ® OCCUR i . ,MED EXP (Any one person) i $ _,... ,00 I :PERSONAL & AiDV INJURY $ 1 000,000 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: ! .:.- CQMCi PAGG 1, B, PI _. ,0 H PRODUCTS . POLICY ;PRO- IOC � CDM8INED SINGLE LIMIT 311, $ AUTOMOBILE LIABILITY ' B1S7 41�d'1 jEa aecidenl ,_ 0510312013 05103120"14 BODILY INJURY (Per person) ,..$ ANY AUTO .: OWNFD SCHEDULED BODILY INJURY (Peer awdent) $ _.. ALL NON -OWNED FS OPERTY bAMAGE HIREDAUTOS 1� AUTOS JPER ACCIPENTL _,y UMBRELLA U g EACH OCCURRENCE $EXCESS j0CCUR LIAB LAIMS -MADE AGGREGATE CEiJ RETE9VTIi7W'�15. �: ;.: v, - _ WG STATD- (3TH° WORKERS COMPENSATION �ORYLIMITSa ER _ AND EMPLOYERS' LIABILITY YIN 105 -51329 C 0111412014 0111412015 E L EACH COIDEIVT $ 1,000,00 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? N t A i . _ _._ DISEASE - EA EMPLOYE $ '1,000,00... (Mandatory in NH) V yes, describe under ._ F DISEASE POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS below _. - _ 1 r DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks. Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITYSOM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of South Miami Fax: 305 -663 -6 6130 Sunset r. South Miami, FL 33143 ADTt1CiRIZEY)REPRESENTATIVE Q�) 1980 -2010 ACORID CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD nerve and logo are registered marks of ACORD