Fort Walton Beach Council agenda — 02-26-13--regular — reading text

1 S, OO I S I( O V TOTAL ALTERNATIVE BID ITEMS 2 Sod NOTENOTE 1:1: ALLALL ITEMS ITEMS QUOTEDQUOTED MUSTMUST BEBE ININ COMPLIANCECOMPLIANCE WITHWITH THETHE SPECIFICATIONS.SPECIFICATIONS. IFIF YOUYOU AREARE TAKING TAKING EXCEPTION,EXCEPTION, INDICATEINDICATE THOSETHOSE EXCEPTIONSEXCEPTIONS ONON COMPANYCOMPANY LETTERHEADLETTERHEAD ANDAND ATTACH ATTACH TOTO THISTHIS INVITATIONINVITATION TOTO BID.BID. PagePage 2424 ofof 2828  BwpueT Md It? > 1300 BwISIx3 IF, Iuawaoelckrd £ IO-£ L Bit : ZOZZ) auuep,I wea - 018 £ t0-£ t : IuawyoellV aaiv a m;NA(: r.MRNT OF EXISTING ImArDOCKA I FONT" OXON IANDING INVITAl' IUN'[ OSID' I" M SECTION 2. 1 BIDDER' S CERTIFICATION - ITB 13 -013 v ala 1 have carefully examined the Invitation to bid, Instructions to bidders, General and Special Conditions, Vendor' s Notes, Specifications, proposed agreement and any other documents accompanying or made a part of this Invitation. I hereby propose to furnish the goods or services specified in the Invitation at the prices or rates quoted in my bid. I agree that my bid will remain firm for a period of up to nine 90 days in order to allow the City adequate time to evaluate the bids. I ccrtify that all information contained in this bid is truthful to the best of my knowledge and belief. I further certify that I am duly authorized to submit this bid on behalf of the vendor /contractor as its act and deed and that the vendor /contractor is ready, willing and able to perform if awarded the bid. I further certify that this bid is made without prior understanding, agreement, connection, discussion, or collusion with any other person, firm or corporation submitting a bid for the same product or service; no officer, employee or agent of the City of For Walton Beach or of any other bidder interested in said bid; and that the undersigned executed this bidder' s Certification with full knowledge and understanding of the matters therein contained and was duly authorized to do so. V2,a-w\ ` V lCi(' LYVQ- eYV1C.L.`yiyyf NAME OF BUSINESS ( 1 BY: W\As `\/ Signature Lem V\ koC̀ L Y,\ YYZA t NAME & TITLE ( type or print) X15A VZ\ yez' vt r MAILING ADDRESS 5 r -\ 3tiL7it) CITY, STATE, ZIP CODE 1( 41) a- a \9l,n TELEPHONE NUMBER 1ylt FAX NUMBF,R DATE Page 5 of 28  6uipuel M=I le A > oq 6upslx3 ; o luawaoeldaa ELO-£ L 811 : ZOZZ) ouheyl wea - 016 ELO-£ L quawyoeIIV riv a imm.\( FNirN I or rxi6riNc i1(). \' r mu K A' r FORT \\': \ I: rO \' 1. \ NDIRf. INV IT A TION ro PID g li SECTION 2. 2 ADDENDUM PAGE —ITB 13. 013 v am The undersigned acknowledges receipt of the following addenda to the Documents ( Give number and date of each): Addendum No. A all Dated Addendum No. Dated Addendum No. Dated Addendum No. Dated FAILURE TO SUBMIT ACKNOWLEDGMENT OF ANY ADDENDUM THAT AFFECTS THE BID PRICES IS CONSIDERED A MAJOR IRREGULARITY AND WILL BE CAUSE FOR REJECTION OF THE BID. NAME Of BUSINESS( BY: Signature NAME & TITLE ( type or print) 1 r V \ . rV taw clr MAILING ADDRESS 3okoy\ s F\ 3 l 1S CITY, STATE, ZIP CODE NUMBER TELEPHONpEp 944)'{ l9(P 6og1 ' FAX NUMBE DATE Page 6 of 28  6wpue-i Md le>foo0 6upspr3 ; o luawooeldob ELO- EL 911: ZOZZ) auuepl web - 018 £ LO- EL quawyaelly m n a rsn; n. ecFarsuror r.zisrwc un,n' nncn, a' rom o'ncrou I, nnawr. wvrrnnoN TU wioo-ri.nu SECTION 2. 3 REFERENCES —ITB 13 -013 am Bidder shall submit as a part of the bid package, four ( 4) business references with name of the business, address, contact person, and telephone number. All references shall be for similar work that has been performed within the last fire (5) years. REGARDING PROPOSER / BIDDER: 2C W tM.. e_' e.R11,C —CS Name: Name: FQ-- AA'z-S Con[ ct , Contact U Tk V 11' f' U Qddr,ree pp Address: 1 ` t' t-t' \ S"' N6 Telephone: _ Tel hone: Facsimile: S nl - - 6 b \-12,1 Facsimile Name: Name: M2 2 7\ VYV>, UV r 0. r_ Col Co\ C,jntact t \, C S ca \ Address: Address: 4SNS _ c\- 1 a5a z cep C- f?- o 3 a rasoka l 3 iZ k Telephone: \ Telephone: l 351 SS y y1 — Ss yS-L Facsimile: Facsimile y 1 3rJ' j 93\ g Page 7 of 28  fiulpue-1 M=l le gao0 6ullslxg jo luawaaelday £ LO -£ L ell : ZOZZ) ouuew weU - ale £ lo-£ l, : luawgoeliv r odf arn ai :rLpery wrnror ezrsrvc nnnr DOVE :rrFORT wacrou i. arvuwr,. INVITATION ro Sao iaa, ir y SECTION 2. 5 DRUG -FREE WORKPLACE FORM v am The undersigned vendor, on ] 2013, in accordance with Section 287. 087, Florida tatutes, certifies that ( business] does: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will 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, 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 Paragraph 1. 4. In the statement specified in Paragraph 1, notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer 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 (5) days after such conviction. S. Impose a sanction on, or require the satisfactory participation in a drug assistance or rehabilitation program if such is available in the employee' s community, by any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug -free workplace through implementation of Paragraphs 1 through 5. Check o As the person authorized to sign this statement, I certify that this firm complies fully with above requirements. As the person authorized to sign this statement, this firm does not comply fully with the above requirements.