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Leed Construction RFP PR2015-09EXHIBIT Stand Remodeling at Palmer Paris" RFP PR2015 -10 WAXImm THIS PROPOSAL IS SUBMITTED TO: Steven Alexander City Manager City of South Miami 613€1 Sunset Drive South Miami, FL 33 143 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, including as set forth in Exhibit 1, Attachment A and, Attachment 3 (Scope of Services) for the Proposed Price as set forth below, 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 Solicitation and Instructions to Respondents, including without limitation those dealing with the disposition of Proposal /Bid Bond, if required_ This Proposal will remain subject to acceptance for [80 calendar days after the day of the Proposal Opening. The Respondent, by signing and submitting this proposal, agrees to all of the terms and conditions of the form of contract that is a part of the RFP package with appropriate changes to conform to the information contained in this Bid Form. Respondent agrees to sign and submit the Bonds, if required by this RFP, required insurance documents, and other documents required by the RFP, including the Contract if not already submitted, 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. 1 & 2 Dated: 5114/15 & 5/29/15 b. Respondent has familiarized himself with the nature and extent of the Contract Documents, the proposed work, site, locality, and all local conditions and laws and regulations that in any manner may affect cost, progress, performance or furnishing of the Work. c. Subsurface conditions: If applicable to this RFP, the Respondent represents that: i. Respondent has studied carefully all reports and drawings, if applicable, of subsurface conditions and drawings of physical conditions. ii. Respondent has obtained and carefully studied (or assumes responsibility for obtaining and carefully studying) all such examinations, investigations, explorations, tests and studies in addition to or to supplement those referred to in this paragraph which pertain to the subsurface or physical conditions at the site or otherwise may affect the cost, progress, performance, or the furnishing of the Work at the Contract Price, within the Contract Time and in accordance with the other terms and conditions of the Contract Documents. The Respondent hereby acknowledges that no additional examinations, investigations, explorations, tests, reports or similar information or data are, or will, be required by Respondent for any reason in connection with the Proposal. The failure of the Respondent to request a pre -bid marking of the construction site by any or all utility companies shall create an irrefutable presumption that the Respondent's bid, or proposal price, has taken into consideration all possible underground conditions and Respondent, if awarded the contract, shall not be entitled to a change order for any such condition discovered thereafter. iii. Respondent has correlated the results of all such observations, examinations, investigations, explorations, tests, reports and studies with the terms and conditions of the Contract Documents. iv. Respondent has reviewed and checked all information and data shown or indicated in the RFP Package or in the Contract. Documents with respect to existing Underground Facilities or conditions M1 at or contiguous to the site and assumes responsibility for the accurate location of all Underground Facilities and conditions that may affect the Work. No additional examinations, investigations, explorations, tests, reports or similar information or data in respect to any Underground Facilities or conditions 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 unless the Proposal specifically states that the contract price is subject to adjustment for future discovery of underground facilities and /or conditions that affect the cost of the Work and unless the respondent makes a written request to the City for additional information prior to submitting the bid or proposal as required in subsection ii above, 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 S. services necessary to provide a complete, in place, Project for the Proposal Price of. LUMP SUM BASE PRICE- 125,731 dollars and Q -ZERO cents One Hundred Twenty Five Thousand, Seven Hundred Thirty One Alternates: rl #2 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. b. The ENTIRE WORK shall be completed, in full, within 43 working days from the commencement date set forth 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 may be set forth in the Contract. 6. Insert the following information for future communication with you concerning this Proposal: RESPONDENT: Leed Construction Group Address: 624 Desoto Drive, Miami Springs, FL 33166 Telephone: 305-803-5932 Facsimile: NIA - leedoonstruction@,yahoo.com Contact Person Eduardo Gil 7. The terms used in this Proposal which are defined in the Contract shall have the same meaning as is assigned to them in the Contract Documents, unless specifically defined in this RFP Package - 8. By submitting this proposal, 1, on behalf of the business that I represent, hereby agree to the terms of the form of contract contained in the RFP package and I agree to be bound by those terms, with any appropriate blank boxes, if any, checked and any blank lines filled in with the appropriate information contained in the Solicitation Documents and this Proposal, or such information that the City and I have R1 agreed upon in the course of contract negotiations and which have been confirmed by the City in writing, including e -mail confirmation, if any. SUBMITTED THIS 8 DAY OF June PROPOSAL SUBMITTED BY: Leed Construct' n Group Company Eduardo iI Name of Person tl orized Submit Proposal Signature President Title 2015 305- 803 -5932 Telephone Number Fax Number ieedconstruction ahoo.com Email Address END OF SECTION 02 Proposal Submittal Checklist r1 "Concession Stand Remodeling at Palmer Park" REP PR2015 -10 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 Indemnification and Insurance Documents. EXHIBIT 2 x Bid Form See EXHIBIT 3 Signed Contract Documents (A" — including General Conditions and Supplementary Conditions if attached) EXHIS1T(s) 4, 5, & 6 x Respondents Qualification Statement x Non - Collusion Affidavit x List of Proposed Subcontractors and Principal Suppliers x Public Entity Crimes and Conflicts of Interest v A Drug Free Workplace x Acknowledgement of Conformance with OSHA Standards x Affidavit Concerning Federal & State Vendor Listings x Related Party Transaction Verification f=orm M Presentation Team Declaration /Affidavit of Representation Submit this checklist along with your proposal indicating the completion and submiss "son of each required forms and /or documents. END OF SECTION fG RESPONDENT QUALIFICATION T T T "Concession Stand Remodeling at Palmer Park" 1RFIP #PR20 15 -10 The response to this questionnaire shall be utilized as part of the CITY'S overall Proposal Evaluation and RESPONDENT selection. 1. Number of similar construction projects completed, a) In the past 5 years In the past 5 years On Schedule b) In the past 10 years In the past 10 years On Schedule Z. List the last three (3) completed similar projects. a) Project Name: Owner Name: Owner Address: Owner Telephone: Original Contract Completion Time (Days): 1 1 1 Village of.Palmetto ». 1 5 East Hibiscus PD—EL 305-2,59-1234 Original Contract Completion Date: 2/23115 Actual Final Contract Completion Date: 2/23/15 Original Contract Price: $119,500 Actual Final Contract Price: $119,500 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 Completion Time (Days): Original Contract Completion Date: Actual Final Contract Completion Date: Original Contract Price: Actual Final Contract Price: 3. Current workload Palmetto Bay Park Batting Village of Palmetto Bay 305-259-1234 $119,500 Cages /Storage Rooms 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: N/A IN r A LEER CONSTRUCTION GROUP, LLC. PHONE: 305 -803 -5932 .EEDCON STRUCTION (a'YAHOO.COM �: I- �, 111A 1A }9� t££D CONSTRUCTION G20£3 LLC PHON 305$033932 t££»CONSTRUCTIOakYAHOO. c0-ivi Project O)\ 7 :I(2 7 }( %l\ Chart 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 6. Government References: (Eduardo Gil working under FL Construction) List other Government Agencies or Quasi - government Agencies for which you have done business within the past five (5) years. Name of Agency: Port of Miami Address: _ 1007 N America Way Miami, Fl- 33132 Telephone No.: 305 - 347 -5508 Contact Person: Pedro Roman Type of Project: Interior Build out Name of Agency: Miami Dade County Parks Address: 275 NW 2nd Street Miami, FL 33128 Telephone No.: 305 -375 -3022 Contact Person: Leroy Garcia Type of Project: Aquatic Center Name of Agency: MDC Internal Services Address: 111 NW 1st Street Miami, FL 33128 Telephone No.: 305 -375 -3082 Contact Person: Taha Type of Project: Culmer Center 13 LIST OF PRO. ': TORS AND PRINCIPAL SVPPLIERS "Concession Stand Remodeling at Palmer Park" 0. IM STATE OF FLORIDA COUNTY OF MIAMI -DADE Eduardo Gil being first duly sworn, deposes and states that: (I) He /She/They islare the President (Owner, Partner, Officer, Representative or Agent) of Leed Construction Group 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; (S) 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- Signed, sealed and delivered in the presence of: _ff Witnes 64w- W tness STATE OF FLORIDA COUNTY OF MIAMI -DADE By: Signature Eduardo Gil - President Print Name and Title 618115 Date ACKNOWLEDGEMENT On this the day of aU0 e-- , 20 6 V , before me, the undersigned Notary Public of the State of Florida, personally appeared (Name(s) of individual(s) who appeared before I notary) e I G E (— and whose name(s) is/are Subscribed to the within instrument, an he shelthey acknowledge that he/she/they executed 1221 WITNESS my hand and official seal. NOTARY PUBLIC: SEAL OF OFFICE: �'` : "ke•,, ZOILA P. REYES ' += My CONUSSIOI # FF 16M • - EXPIRES: February 12, 2019 11f,!ls Bor#d V. W.M PuV. U,,d.. . iI9 Z's (Name of Notary Public_ Print, Stamp or type as commissioned.) — L----P-1-rsonaliy known to me, or Personal identification: Type of Identification Produced Did take an oath, or Did Not take an oath. 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. I. This sworn statement is submitted to City of South Miami [print name of the public entity] by Eduardo Gil - President [print individual's name and title] for Leed Construction Group [print name of entity submitting sworn statement] whose business address is 624 DeSoto Drive Miami Springs, FL 33166 and (if applicable) its Federal Employer Identification Number (FEIN) is 27- 1969899 (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. 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. I 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 M 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. 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 lega[ 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.] X 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 Juiy 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 [-Tearing 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 IhtDENTIFIED IN PARAGRAPH I (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY, AND T AT THIS FORM 15 VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED, I ALSO DERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO FA CONT CT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUT S FOR TEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. ` Sworn to and subscribed before me this day of Personally known OR Produced identification (Type of identification) Form PUR 7068 (Rev.0611 1192) R REYES E gNotaq l01d 4 FF 1682M Publi cU ors IN [Signature] f a— 20 Notary Public— State of My commission expires .&I A- -o' i (Printed, typed or stamped commissioned name of notary public) 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 a violation occurring in the workplace no later- than five (S) 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. b) Make a good faith effort to continue 1p maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statem3n ce that this firm complies fully with the above requirements. RESPONDENT's Signature: _ Print Name: Eduardo Gil Date: 6/8115 go TO THE CITY OF SOUTH MIAMI We Leed Construction Group , (Name of CONTRACTOR), hereby acknowledge and agree that as CONTRACTOR for the Concession Stand Remodeling at Palmer t=arp project as specified have the sole responsibility for compliance with all the requirements of the Federal Occupational Safety and Health Act of 1970, and all State and local safety and health regulations, and agree to indemnify and hold harmless the City of South Miami and MF. Chisholm Architects (Consultant) 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 regulation. CONTRACTOR Leed Construction Grou BY: Eduardo Gil Name President Title 20 Wi e s s N/A i> &MAIMA 10: The person, or entity, who is responding to the City's solicitation, hereinafter referred to as "Respondent ", must certify that the Respondent's name Does Not appear on the State of Florida, Department of Management Services, "CONVICTED, SUSPENDED, DISCRIMINATORY FEDERAL EXCLUDED PARTIES and COMPLAINTS VENDOR LIS"T"INGS "_ If the Respondent's name Does appear on one or all the "Listings" summarized below, Respondents must "Check if Applies" next to the applicable "Listing." The "Listings" can be accessed through the following link to the Florida Department of Management Services website: htt :! /wwvr.drms. orida.cor tJbusiness operationsJstare put asin . /vend r informz nlconvicted sum ended discs +minato. c oI m hints vendor lists DECLARATION TENDER PENALTY OF PERJURY 1 (hereinafter referred to as the "Declarant') state, under penalty of perjury, that the following statements are true and correct: (1) 1 represent the Respondent whose name is (2) 1 have the following relationship with the Respondent (Owner (if Respondent is a sole proprietor), President (if Respondent is a corporation) Partner (if Respondent is a partnership), General Partner (if Respondent is a Limited Partnership) or Managing Member >(if Respondent is a Limited Liability Company). (3) 1 have reviewed the Florida Department of Management Services website at the following URL address: http: / /www.dms.myforida.com /business operationsfstate _purchasing/ vendor_ information /convicted_suspended _ di scriminatory_complaints _ vendor _lists (4) 1 have entered are "x" or a check marls beside each listing/category set forth below if the Respondent's name appears in the list found on the Florida Department of Management Services website for that category or listing. If I did not enter a marl: beside a listing/category it means that I am attesting to the fact that the Respondent's name does not appear on the listing for that category in the Florida Department of Management Services website as of the date of this affidavit. Check if Applicable _ Convicted Vendor List Suspended Vendor List Discriminatory Vendor List Federal Excluded Parties List Vendor Complaint List ACKNOWLEDGEMENT STATE OF FLORIDA COUNTY OF MIAMI -DADE On this the day of appeared following identification foregoing Affidavit as the Declarant. By: (Print name of Declarant) (Signature of Dcdarant) 20 , before me, the undersigned authority, personally who is personally know to me or who provided the and who took an oath or affirmed that that helshelthey executed the WITNESS my hand and official seal. NOTARY PUBLIQ SEAL 21 Notary Public, State of Florida. (Name of Notary Public: Print, Stamp or type as commissioned.) fflml4fljdil�l 3 ? I Eduardo Gil - President , individually and on behalf of _ Leed Construction Group ( "Firm ")have Name of Representative Company /VendorlEntity 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 1, and/or the Firm, am(are) about to perform for, or to transact with, the City, and (2) neither I nor any employees, officers, directors of the Firm, nor anyone who has a financial interest greater than 5 015 in the Firm, has any relative(s), as defined in section 8A- I, 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 so on 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: X _(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 ft 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 (57.) 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) 1 and the Firm further agree not to use or attempt to use any knowledge, property or resource which may come to us through our position of trust, or through our performance of our duties under the terms of the contract with the City, to secure a special privilege, benefit, or exemption for ourselves, or others. We agree that we may not disclose or use information, not available to members of the general public, for our personal gain or benefit or for the personal gain or benefit of any other person or business entity, outside of the normal gain or benefit anticipated through the performance of the contract. (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 W 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:1PurchasingWendor 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: X 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 5% in the Firm, or any member of those persons' immediate family (i.e. spouse, parents, children, brothers and sisters) have also responded, other than the following: (if necessary, use a separate sheet to supply additional information that will not fit on this line; 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 me a or any penalties allowed by law. Additionally, violations may be considered by and subject to action by th Ka r- ade County Commission on Ethics_ finder penalty of perjury, I declare that I have made a diligent effor o in v s igate the matters to which I am attesting hereinabove and that the statements made hereinabove area and o rect to the best of my knowledge, information and belief. Signature: 1 v \U Print Name & Title: Eduardo Gil - President Date: 6/8115 MJ Sec. 8A - €. - Conflict of interest and code of ethics ordinance. (a) Designation. This section shall be designated and known as the "City of South Miami Conflict of Interest and Code of Ethics Ordinance." This section shall be applicable to all city personnel as defined below, and shall also constitute a standard of ethical conduct and behavior for all autonomous personnel, quasi - judicial personnel, advisory personnel and departmental personnel. The provisions of this section shall be applied in a cumulative manner. By way of example, and not as a limitation, subsections (c) and (d) may be applied to the same contract or transaction. (b) Definitions. For the purposes of this section the following definitions shall be effective: (1) The term "commission members" shall refer to the mayor and the members of the city commission. (2) The term "autonomous personnel` shall refer to the members of autonomous authorities, boards and agencies, such as the city community redevelopment agency and the health facilities authority. (3) The term "quasi- judicial personnel" shall refer to the members of the planning board, the environmental review and preservation board, the code enforcement board and such other individuals, boards and agencies of the city as perform quasi-judicial functions. (4) The term "advisory personnel" shall refer to the members of those city advisory boards and agencies whose sole or primary responsibility is to recommend legislation or give advice to the city commission. (5) The term "departmental personnel" shall refer to the city clerk, the city manager, department heads, the city attorney, and all assistants to the city clerk, city manager and city attorney, however titled_ (6) The term "employees" shall refer to all other personnel employed by the city. (7) The term "compensation" shall refer to any money, gift, favor, thing of value or financial benefit conferred, or to be conferred, in return for services rendered or to be rendered. (8) The term "controlling financial interest" shall refer to ownership, directly or indirectly, of ten percent or more of the outstanding capital stock in any corporation or a direct or indirect interest of ten percent or more in a firm, partnership, or other- business entity at the time of transacting business with the city. (9) The term "immediate family" shall refer to the spouse, parents, children, brothers and sisters of the person involved. (10) The term "transact any business" shall refer to the purchase or sale by the city of specific goods or services for consideration and to submitting a bid, a proposal in response to a RFP, a statement of qualifications in response to a request by the city, or entering into contract negotiations for the provision on any goods or services, whichever first occurs. (c) Prohibition on transacting business with the city. No person included in the terms defined in paragraphs (b)(1) through (6) and in paragraph (b)(9) shall enter into any contract or transact any business in which that person or a member of the immediate family has a financial interest, direct or indirect with the city or any person or agency acting for the city, and any such contract, agreement or business engagement entered in violation of this subsection shall render the transaction voidable. Wiliful violation of this subsection shall constitute malfeasance in office and shall affect forfeiture of office or position. Nothing in this subsection shall prohibit or make illegal: (1) The payment of taxes, special assessments or fees for services provided by the city government; (2) The purchase of bonds, anticipation notes or other securities that may be issued by the city through underwriters or directly from time to time. Waiver of prohibition. The requirements of this subsection may be waived for a particular- transaction only by four affirmative votes of the city commission after public hearing upon finding that: (1) An open -to -all sealed competitive proposal has been submitted by a city person as defined in paragraphs (b)(2), (3) and (4); (2) The proposal has been submitted by a person or firm offering services within the scope of the practice of architecture, professional engineering, or registered land surveying, as defined by the laws of the state and pursuant to the provisions of the Consultants' Competitive Negotiation Act, and when the proposal has been submitted by a city person defined in paragraphs (b)(2), (3) and (4); (3) The property or services to be involved in the proposed transaction are unique and the city cannot avail itself of such property or services without entering a transaction which would violate this subsection but for waiver of its requirements; and (4) That the proposed transaction will be in the best interest of the city. This subsection shall be applicable only to prospective transactions, and the city commission may in no case ratify a transaction entered in violation of this subsection. Prmdsions cumulative. This subsection shall be taken to be cumulative and shall not be construed to amend or repeal any other law pertaining to the same subject matter. (d) Further prohibition on transacting lousiness with the city. FM No person included in the terms defined in paragraphs (b)(1) through (6) and in paragraph (b)(9) shall enter into any contract or transact any business through a firm, corporation, partnership or business entity in which that person or any member of the immediate family has a controlling financial interest, direct or indirect, with the city or any person or agency acting for the city, and any such contract, agreement or business engagement entered in violation of this subsection shall render the transaction voidable. The remaining provisions of subsection (c) will also be applicable to this subsection as though incorporated by recitation. Additionally, no person included in the term defined in paragraph (b)(1) shall vote on or participate in any way in any matter presented to the city commission if that person has any of the following relationships with any of the persons or entities which would be or might be directly or indirectly affected by any action of the city commission: (1) Officer, director, partner, of counsel, consultant, employee, fiduciary or beneficiary; or (2) Stockholder, bondholder, debtor, or creditor, if in any instance the transaction or matter would affect the person defined in paragraph (b)(1) in a manner distinct from the manner in which it would affect the public generally. Any person included in the term defined in paragraph (b)( 1) who has any of the specified relationships or who would or might, directly or indirectly, realize a profit by the action of the city commission shall not vote on or participate in any way in the matter. (E) Gifts. (f)Defnition. The term "gift" shall refer to the transfer of anything of economic value, whether in the form of money, service, loan, travel, entertainment, hospitality, item or promise, or in any other form, without adequate and lawful consideration. (2)Exceptfons. The provisions of paragraph (e)(1) shall not apply to: a. Political contributions specifically authorized by state law; b. Gifts from relatives or members of one's household, unless the person is a conduit on behalf of a third party to the delivery of a gift that is prohibited under p2ragraph(3); c. Awards for professional or civic achievement; d. Material such as books, reports, periodicals or pamphlets which are solely informational or of an advertising nature. (3) Prohibitions. A person described in paragraphs (b)(1) through (6) shall neither solicit nor demand any gift. It is also unlawful for any person or entity to offer, give or agree to give to any person included in the terms defined in paragraphs (b)(1) through (6), or for any person included in the terms defined in paragraphs (b)(1) through (6) to accept or agree to accept from another person or entity, any gift for or because of: a. An official public action taken, or to be taken, or which could be taken, or an omission or failure to take a public action; b. A legal duty performed or to be performed, or which could be performed, or an omission or failure to perform a legal duty; c. A legal duty violated or to be violated, or which could be violated by any person included in the term defined in paragraph (b)(1); or d. Attendance or absence from a public meeting at which official action is to be taken. (4) Disclosure. Any person included in the term defined in paragraphs (b)(1) through (6) shall disclose any gift, or series of gifts from anyone person or entity, having a value in excess of $25.00. The disclosure shall be made by fling a copy of the disclosure form required by chapter 112, Florida Statutes, for "local officers" with the city clerk simultaneously with the filing of the form with the clerk of the county and with the Florida Secretary of State. (f) Compulsory disclosure by employees of firms doing business with the city. Should any person included in the terms defined in paragraphs (b)(1) through (6) be employed by a corporation, firm, partnership or business entity in which that person or the immediate family does not have a controlling financial interest, and should the corporation, firm, partnership or business entity have substantial business commitments to or from the city or any city agency, or be subject to direct regulation by the city or a city agency, then the person shall file a sworn statement disclosing such employment and interest with the clerk of the city. (g) Exploitation of official position prohibited. No person included in the terms defined in paragraphs (b )(1) through (6) shall corruptly use or attempt to use an official position to secure special privileges or exemptions for that person or others. (h) Prohibition on use of confidential information. No person included in the terms defined in paragraphs (b)(1) through (6) shall accept employment or engage in any business or professional activity which one might reasonably expect would require or induce one to disclose confidential information acquired by reason of an official position, nor shall that person in fact ever disclose confidential information garnered or gained through an official position with the city, nor shall that person ever use such information, directly or indirectly, for personal gain or benefit. 25 (i) Conjlicting employment prohibited. No person included in the terms defined in paragraphs (b)(1) through (6) shall accept other employment which would impair independence of judgment in the performance of any public duties. (j) Prohibition on outside employment. (1) No person included in the terms defined in paragraphs (b)(6) shall receive any compensation for services as an officer or employee of the city from any source other than the city, except as may be permitted as follows: a. Generally prohibited. No full -time city employee shall accept outside employment, either incidental, occasional or otherwise, where city time, equipment or material is to be used or where such employment or any part thereof is to be performed on city time. b. When permitted. A full -time city employee may accept incidental or occasional outside employment so long as such employment is not contrary, detrimental or adverse to the interest of the city or any of its departments and the approval required in subparagraph c. is obtained. c. Approval of department head required. Any outside employment by any full -time city employee must first be approved in writing by the employee's department head who shall maintain a complete record of such employment- d. Penalty. Any person convicted of violating any provision of this subsection shall be punished as provided in section 1 -1 1 of the Code of Miami -Dade County and, in addition shall be subject to dismissal by the appointing authority. The city may also assess against a violator a fine not to exceed $500.00 and the costs of investigation incurred by the city. (2) All full -time city employees engaged in any outside employment for any person, firm, corporation or entity other than the city, or any of its agencies or instrumentalities, shall file, under oath, an annual report indicating the source of the outside employment, the nature of the work being done and any amount of money or other consideration received by the employee from the outside employment. City employee reports shall be filed with the city clerk. The reports shall be available at a reasonable time and place for inspection by the public. The city manager may require monthly reports from individual employees or groups of employees for good cause. (it) Prohibited investments. No person included in the terms defined in paragraphs (b)(1) through (6) or a member of the immediate family shall have personal investments in any enterprise which will create a substantial conflict between private interests and the public interest. (II) Certain appearances and payment prohibited. (1) No person included in the terms defined in paragraphs (b)(1), (5) and (6) shall appear before any city board or agency and make a presentation on behalf of a third person with respect to any matter, license, contract, certificate, ruling, decision, opinion, rate schedule, franchise, or other benefit sought by the third person. Nor shall the person receive any compensation or gift, directly or indirectly, for services rendered to a third person, who has applied for or is seeking some benefit from the city or a city agency, in connection with the particular benefit sought by the third person. Nor shall the person appear in any court or before any administrative tribunal as counselor legal advisor to a party who seeks legal relief from the city or a city agency through the suit in question. (2) No person included in the terms defined in paragraphs (b)(2), (3) and (4) shall appear before the city commission or agency on which the person serves, either directly or through an associate, and make a presentation on behalf of a third person with respect to any matter, license, contract, certificate, ruling, decision, opinion, rate schedule, franchise, or other benefit sought by the third person. Nor shall such person receive any compensation or gift, directly or indirectly, for services rendered to a third party who has applied for or is seeking some benefit from the city commission or agency on which the person serves in connection with the particular benefit sought by the third party. Nor shall the person appear in any court or before any administrative tribunal as counselor legal advisor to a third party who seeks legal relief from the city commission or agency on which such person serves through the suit in question. (rte) Actions prohibited when financial interests involved. No person included in the terms defined in paragraphs (b) (1) through (6) shall participate in any official action directly or indirectly affecting a business in which that person or any member of the immediate family has a financial interest_ A financial interest is defined in this subsection to include, but not be limited to, any direct or indirect interest in any investment, equity, or debt. (n) Acquiring financial interests. No person included in the terms defined in paragraphs (b)(I) through (6) shall acquire afiinancial interest in a project, business entity or property at a time when the person believes or has reason to believe that the financial interest may be directly affected by official actions or by official actions by the city or city agency of which the person is an official, officer or employee. (0) Recommending professional services. 26 No person included in the terms defined in paragraphs (b)(1) through (4) may recommend the services of any lawyer or law firm, architect or architectural firm, public relations firm, or any other person or firm, professional or otherwise, to assist in any transaction involving the city or any of its agencies, provided that a recommendation may properly be made when required to be made by the duties of office and in advance at a public meeting attended by other city officials, officers or employees. (p) Continuing application after city service. (1) No person included in the terms defined in paragraphs (b)(1), (5) and (6) shall, for a period of two years after his or her city service or employment has ceased, lobby any city official [as defined in paragraphs (b)(1) through (6)j in connection with any judicial or other proceeding, application, RFp, RFQ, bid, request for ruling or other determination, contract, claim, controversy, charge, accusation, arrest or other particular subject matter in which the city or one of its agencies is a party or has any interest whatever, whether direct or indirect Nothing containers in this subsection shall prohibit any individual from submitting a routine administrative request or application to a city department or agency during the two -year period after his or her service has ceased. (2) The provisions of the subsection shall not apply to persons who become employed by governmental entities, 501(c)(3) non - profit entities or educational institutions or entities, and who lobby on behalf of those entities in their official capacities. (3) The provisions of this subsection shall apply to all persons described in paragraph (p)(1) whose city service or employment ceased after the effective date of the ordinance from which this section derives. (4) No person described in paragraph (p)(1) whose city service or employment ceased within two years prior to the effective date of this ordinance shall for a period of two years after his or her service or employment enter into a lobbying contract to lobby any city official in connection with any subject described in paragraph (p)(1) in which the city or one of its agencies is a party or has any direct and substantial interest; and in which he or she participated directly or indirectly through decision, approval, disapproval, recommendation, the rendering of advice, investigation, or otherwise, during his or her city service or employment A person participated "directly" where he or she was substantially involved in the particular subject matter through decision, approval, disapproval, recommendation, the rendering of advice, investigation, or otherwise, during his or her city service or employment. A person participated "indirectly" where he or she knowingly participated in anyway in the particular subject matter through decision, approval, disapproval, recommendation, the rendering of advice, investigation, or otherwise, during his or her city service or employment. All persons covered by this paragraph shall execute an affidavit on a form approved by the city attorney prior to lobbying any city official attesting that the requirements of this subsection do not preclude the person from lobbying city officials. (5) Any person who violates this subsection shall be subject to the penalties provided in section 8A -2(p). (q) City attorney to render opinions on request. Whenever any person included in the terms defined in paragraphs (b)(1) through (6) and paragraph (b)(9) is in doubt as to the proper interpretation or application of this conflict of interest and code of ethics ordinance, or whenever any person who renders services to the city is in doubt as to the applicability of the ordinance that person, may submit to the city attorney a full written statement of the facts and questions. The city attorney shall then render- an opinion to such person and shall publish these opinions without use of the name of the person advised unless the person permits the use of a name. (Ord. No. 6 -99 -1680, § 2, 3 -2 -99) Editor's note- Ord. No. 6 -99 -1680, § I, adopted 3 -2 -99, repealed §§ 8A -I and 8A -2 in their entirety and replaced them with new §§ 8A -1 and 8A -2. Former §§ 8A -1 and 8A -2 pertained to declaration of policy and definitions, respectively, and derived from Ord. No_ 634, §§ 1 (1 A -1), 1 ([ A -2) adopted Jan. 11, 1969. 27 N/A PRESENTATION TEAM DECLARATIONIAFFIDVAIT OF REPRESENTATION This affidavit is not required for compliance with the City's Solicitation; however, it may be used to avoid the need to register members of your presentation team as lobbyists. Pursuant to City Ordinance 28-14 -2206 (c)(9), any person who appears as a representative for an individual or firm for an oral presentation before a City certification, evaluation, selection, technical review or similar committee, shall list on an affidavit provided by the City staff, all individuals who may make a presentation. The affidavit shall be filed by staff with the Clerk`s office at the time the committee's proposal is submitted to the City Manager. For the purpose of this subsection only, the listed members of the presentation team, with the exception of any person otherwise required to register as a lobbyist, shall not be required to pay any registration fees. No person shall appear before any committee on behalf of an anyone unless he or she has been listed as part of the firm's presentation team pursuant to this paragraph or unless he or she is registered with the City Clerk's office as a lobbyist and has paid all applicable lobbyist registration fees. Pursuant to '92.525(2), Florida Statutes, the undersigned, makes the following declaration under penalty of perjury: Listed below are all individuals who may make a presentation on behalf of the entity that the affiant represents. Please note, No person shall appear before any committee can behalf of anyone unless he or she has been listed as part of the firm's presentation team pursuant to this paragraph or unless he or she is registered with the Clerk's office as a. lobbyist and has paid all applicable lobbyist registration fees. NAME TI"C"S. For the purpose of this Affidavit of Representation only, the listed members of the presentation team, with the exception of any person otherwise required to register as a lobbyist, shall not be required to pay any registration fees. The Affidavit of Representation shall be filed with the City Clerk's office at the time the committee's proposal is submitted to the City as part of the procurement process. Under penalties of perjury, I declare that I have read the foregoing declaration and that the facts stated in it are true and specifically that the persons listed above are the members of the presentation team of the entity listed below Executed this day of , 20 Signature of Representative Print Name and Title Print name of entity being represented END OF SECTION 28 Sou 71,E t:�1Y Ur IUA,", NY UV[Nt� R. r A -aI >rl I u In smaj Project Name: Concession Stand Remodeling at Palmer Park RFP NO. PR20 IS- 10 Date: May 14, 2015 Sent: Fax/E- mail /webpage This addendum submission is issued to clarify, supplement and/or modify the previously issued Solicitation, 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. What is the budget for [RFP #PR2015 -10] this? Answer to-Question #1 Please refer to the City's Adopted Budget for FY 2014 -2015, "Capital Improvement Program — 5 Year Plan, under Parks. The budget for Palmer Park Concession Stand Renovation is combined with an additional project; therefore there is no line item budget amount for the Palmer Park Concession Stand Renovation. The Adopted Budget is posted on the City's website, a link is below: http:// www_ southmiamifl.gov /index.aspx ?NID =142 Page 1 of 1 h T}9E illll C-F , iF;i4:64T �Nf,,ZC-- Project (dame: Concession Stand Remodeling at Palmer Park Date: May 29, 2015 Sent: Fax /E- retail /webpage This addendum submission is issued to clarify, supplement and/or modify the previously issued Solicitation, 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. uestion !_: Is the project site available for site visits? Answer to Question _ 1: Yes, interested parties may visit the project site_ The following dates and times are available, no appointment is necessary. A park attendant will be on site to ensure the facility is open. The dates and times are below: ® Friday, May 29, 2015: 11 AM to 2 PM • Saturday, May 30, 2015: 11 AM to 2 PM • Monday, June 1, 2015: 8 AM to boon. The facility will be open for site visits only. Questions should be submitted in writing by June 2, 2015 at 10 AM. Page T of 1 t nvFRAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. DATE(BJF9IDDJYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ARID CONFERS NO RIGHTS UPON THE CERTIFICATE }MOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTAiiVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holler is an ADDMNAL INSURED, the policy(Les) must be endorsed. If SUBROGATION IS WAIVED, SUbjectto the terms and conditions of the policy, certain polices may require an endorsement. A statement on this cortificato does riot conrer rights to the certificate holder in lieu of such endorserrent(s). PRODUCER CONTACT Kim Ameen Price My Policy PRONE - (954) 977 -1551 FAX No): (954) 975 -7085 E'MtuL kim @pnoemypolicy.com 100 North State Road 7 Suite 202 INSURER 5 AFFORDING COVERAGE NAIC is Margate, FL 33063 INSURER A : Preferred Contractors insurance Company 5 50 000 00 Phone (954) 977 -1551 Fax (954) 975 -7065 INSURED INSURER B : S 1,000,000.00 INSURER C: GENERALAGGREGATE LEED CONSTRUCTION GROUP, INC INSURER D: PRODUCTS- COMPJOPAGG 624 DESOTO DRIVE INSURERE: S MIAMI, FL 33166 (305) 803 -5932 AUTOM06I LE LIABILITY ❑ ANY AUTO ALLOWNED ❑ AUTOSULED ❑ AUTOS NOiJ -OWNED ❑ HIREOAUTOS ❑ AUTOS ❑ INSURER F: t nvFRAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 TYPE OF INSURANCE ADD UDR POLICY NUMBER POLICY )YYYY �FOAI D EXP U14ITS A GENERALLIABILITY 0 COMMERCIAL GENERAL LIABILITY E] ❑ CLAIMS -MADE ® OCCUR ❑ PCO006930 -00 08105 {2014 08f05 {2{)15 EACH OCCURRENCE S 1,000,000.00 DAMM T ENT ED PR t�tI SES Ea occurrence 5 50 000 00 MED EXP (Any one pefson S 5,000.00 PERSONAL& ADV INJURY S 1,000,000.00 ❑ GENERALAGGREGATE S 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER; ® POLICY ❑ PR4 ❑ LOC PRODUCTS- COMPJOPAGG S 1,000,000.00 1€lfltideductible S AUTOM06I LE LIABILITY ❑ ANY AUTO ALLOWNED ❑ AUTOSULED ❑ AUTOS NOiJ -OWNED ❑ HIREOAUTOS ❑ AUTOS ❑ COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per per -on) S BODILY 1NJURY(PeraWdenl) S ,UPER Yn1DAMAGE S S ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DED F1 RETENTIONS 5 WORKERS COMPENSATION AND E€7PLOYERS` LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTWE OFFICERIM EMBER EXCLUDED? (Mandatory in NH) El If yes, describe under OF OPERATIONS belmi NIA WC STATU- OTH- E -L, EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE S E.L. [DISEASE- POLICY LIMIT I S 7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 141, Additional Remarks Schadula, IF more spaeo Is required) General Contractor Additional insured applies only if required by written contract CERTIFICATE HOLDER CANCELLATION Village of Palrnatto Bay 9705 E. Hibiscus Street Palmetto Bay, FL 33157 ACORD 25 (2010105) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE `7 y 1LL-a'r, CP 1938-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 334F, s�� JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 81612013 EXPIRATION DATE: 816!2015 PERSON: GIL EDUARDO F FEIN: 271969899 BUSINESS NAME AND ADDRESS: LEED CONSTRUCTION GROUT 624 DESOTO DRIVE MIAMI SPRINGS FL 33166 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only vAlhin the scope of the business or trada listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the fling of the notice or the issuance of the certificate, the perwri named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate The department shat€ revoke a certificate at any time for failure of the person named on the certficate to meet the requirements of thls secton. DFS- F2 -0WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07 -12 QUESTIONS? (850)413 -1649 ,I ja� x STATE ?F' FLORIDA DEPARTMENT OF BUSWESS AND PROFESSIONAL REG ULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 FORTH MONROE STREE T TALLAHASSEE FL 32399 -0783 GIL, EDUARDO F LI=ED CONSTRUCTION GROUP LLC 624 DESOTO DRIVE MIAMI SPRINGS FL 33166 Gong ratulatio nst With this Iiuen- yowbecome -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 WVVW.myfloridalicense.corn. There you can find more information about our divisions and the reguiations that impact you, subscribe to department newsletters and learn more about the Department's i11 itiatives- Our mission at the Department is: License Efficiently, Regulate Fairly. Vde constantly strive to serve you better so that you can serve your customors, Thank you for doing business in Florida, and congratulations on your neLu license! DETACH HERE RICK SCOTT, GOVERNOR (350) 407 -1395 .T STATE OF FLORIDA X�7 DEPARTMENT OF BUSINESS AND 4� .' PROFESSIO;[UAL. RF-GULATION CGC1 519032 ".t.SSUEP :.. 08/14/2014 CERTIFIED GENERAL..ONTRACTOR GIL, EDUARD0 t LEEDCONsTRucTlCOh (3F(]UP'LLG, Is CERTIFIED alder the pr vissoov of c:z.aee rs. +UG31,2016 ITAM14d0175y KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICE SING BOARD cGc1519o32 The GENERAL GUN 1 HAU t UK NEIrnad below IS CERTIFIED Linder the provisions of Chapter 489 FS. Expiration state: AUG 31, 2016 43tg M ' ��'� � _ ti 3 £g.s #{xc f CA NA .{ _ f5 4t i R.0 i'<l] i pe n t 3 3 g 3 al r < T a cad Business Tax Recel, Miami -Dade County, State of;Rorida - `HISiS NOT ABILL, 00N'07rAy :. L B. 585?t3��N }} A.. c t.:CGl. TI 6' PECO-Ir -T .(to - P:1RES LEE© CONSTRUCTION GROUP RENI=LitriL SEPTEMBER 3t3 2015 LLC 712ii4�3 ; 624 DE SQTO' DR Mu rlt" tiee, tuy �a4rn� nPtr .;rzGss MIAMI SPRINGS. EL 33166 �utauatxttD�atY,t� 01' CSiCiER ���- P-9 SUSftlECZ LEES? CON STPUCTIO N GROUP LLC 196 GEIJERAL SWL DiNG CONTRACTOR' S.f)tl Cs t343l201 t ?I�rker(sj 1 CGC151IM2 43232 -14- 005415 ihia? �; �! 8u- �in�. �sTaxf2= ��i�c�YyccaF °rr:��a}rrcrte:th�tccss�u.an "Ta�."fY,�eciptisrrfiaiiG:rt ^, . :rTtif, grace i ^caiic,ryd "n- ,Pd deer q.ui"c f°?^,,,icda ar. wlVde; ms 5ca ?ywiu'r::.m c.�c�. ;ri: ctu arc: �r: rrr�: tair�taryl�vsandre�ur�rc 'rCsr�icN,ap41yf�3iY^N�v�ra?�., ' 7! ®F�rifaix a > t da �'rxir lc rrrsrria{icl� P.Sm�- CeCaPa- -'r`cx rsicr:r Fc, n- creWc.riraiicn %i it "'I 4n icy c� ,� Eduardo F. Gil D Soto Drive Miami p: `. 305-803-5932 2013- Present LEER Construction Groum-L.L.C. Miami Springs, Florida President 2007-2013 Florida Construction & Engineering, Inc. Miami Springs, Florida. Estimating, Scheduling, Project Documents, Office Manager 2002 -2007 Zell's Ace Hardware Gainesville, Florida Store Manager 2000 -2002 immon's Builders Medley, Florida Carpenter, Skilled Laborer 2005 -2007 University of Florida Gainesville, Florida Bachelor's Degree in liberal Arts & Science, Minor in City Planning 2005 -2005 Santa Fe Community Coll= Gainesville, Florida Associates of Arts Degree General Contr etor's License CGC 1519032