Fort Walton Beach Council agenda — 02-23-2010 Regular — reading text

SIG ATI NAME & TITLE, TYPED OR PRINTED: ' 26-  VENDOR QUESTIONNAIRE 1. How long has your company been in business as a licensed grounds maintenance vendor? 3. How many grounds maintenance contracts do you currently have? 3. Is your business located within the City limits of Ft. Walton Beach? If so please provide the business address. 4. Is your business Certified by the state of Florida as a Certified Minority Business Enterprise? Please provide proof of Certification with bid. 5. Has your company ever had a contract canceled by a customer? If so please provide details. 6. If awarded this contract, how will you meet the manpower requirements: Use current staff of company employees Hire additional staff of regular employees Use contract temporary labor providers --' j 7. How many full -time employees does your company employ? t Part -time ? 0__ 8. Please provide your company license numbers: kQ- C'jC>C-;02:!'h9 County: Q\4( AAraC Pt- County: 9. If awarded this contract where will your base of operations be located? tIF, TEL& 10. is someone on your staff licensed for chemical applications? License# 11. If awarded this contract how will you meet the equipment requirements? Use currently owned equipment: Lease equipment to meet requirements: Purchase additional equipment: s/ 12. What equipment do you own that can be utilized on this contract? ( Attach list) NOTE: COMPLETING THIS QUESTIONNAIRE IS MANDATORY FOR ALL BIDDERS. 27_ L Trucks 2_ Spray 'Trucks 3.. Mowers 4. Edges 5 Trailers 6. Backpacks 7.. Blower 8. Aerator 9. Spreaders 28_  REFERENCES 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 five (5) years. Name: t Name: tV A Po s., Contact: C Address:2, \` 044N Q Address:--Jr.., rk Telephone: ()%So\ 9S Z-% Telephone: -) Facsimile: Facsimile Name: CE Name: c Contact: Contact: --- Address: 3 Address: Tele honer 9 oS' l Telephone: Facsimile: Facsimile 29_  I / 2M U Ij. Lib L__ J4- -3bI '- - 04 ib U ' LAI_ 1UUI E-` S: t i F 11Etl xssue pate r 03:/ 37/ 1¢ PrQ;} lger o.._...__ TRIG. C8R.TIFIJ: A - `E IS tSSUED $ S: A NL T1; I2. OV 11STFOPMAT1109 C' Nt,,X. ARID . t3" AT SCOrl IN8LT_RANCP,, INC. 121$ I90i_r¢ CON ER8 NO IRICNT'S Ur:.ON T?lTr 41?RTIF',FCATE 14OLDLR_ THIS CER' IfiIC1'. rTa Ptl: IC6Vej, ate. 2: 8A L?4L$ NOT Ai IIsTv'f7, I h"P . Nk t- ALTLR " iiiL Ct)Vt;} tsn,. AFI'OR]] Fi Por„ Y TTdP, MyeT-8, Fri 33961- 8302 POLZCIES R.i -LQNT Phone: 3g_ rg2 -3 • 00 / SUQ F 7.1: i 2 ir7ttrr rg Ar tixdiri_r 23 LL561 - 0+? c1wt+ l. ttinat r; znct , cam In-surer A; , 4t̀arlint Insurance € "cmnany In avrer 2. ADV * 1C'] D r..AWN CONTROL, INC. Tnaur &r Cr 3 CACKSON STrZRAIT F" I', WALTON SEA( Ni, RTx, 32540- -49 , 1 rnattrrlr D:: Xnaurer P; THE PO.LICIL'S OR Iti$CifiANCFs L)- IIELOW IiAvR tAtN ISSUxi? NOTWITHSTANDIM AIVY REQUIREMENT, ` CPPM TO TH155 IN9DR731? NAMED AL-K} VM FOR Tin; POLICY PERIOD INT.IICATEb, OR. COIQD.T.rPt( LtiT OF 71nr3f CON? IZD.t'T CSR OTIiEI2 bOGsC'@= T PazTli I ak'TyCT TO WHIC'If THra C2R7' 1FI0A °! i MAY BE 19,SUED OR MAY I?ERTAIN, THE T > SRM , THE INgLn-tANCE. ApF'ORDED BY TF3N paLICTFS D'ESCAT)3TD fTEREIN ' IS SUBJECT t'0 ALL EXLMUSIONO , A•T,TD CCNDITIQNS OF wtlrii. POLICTES. ACWREGZNTR LINITE'- MAY KAVL BEIM A" I UCED 2"'' PAID, CLAIMS. Co LLr € Pa1. Fil_ nxp. nsurat ce FuJicy Number Da,+, Limits Of 1 A iliLy mineral Liability Pa' 0DD2Y165- U5 09/ 3D/ U0 ne2al Aggregate A, 000, 1300 [ 09 / 3b / ID COtmerial Genezal Liabi3.1ty t, omp / 3P{ AqJ $ 3, D06, fiOD Gra ms Mi do t$ i' O4taurrenco Personal, Adv In jury $ 500, 006 Rach Oemirrenee $ 500' 000. Pi.re Damage Any One ftre_) $ 100, 000 Medical Est, rs sfl Arty One. Pet1dQn) $ 5., U00 Ru1; QmOlYils` Lf7biiif_y Combined Single Limit $ Q' Q COmpxohenaive. Det3. $ 0 73at3i3y Injury ( per porsonJ Cl C0111-8i0h bed. $ 0 t Q tad A, toe PQdi.ly Injury (.pd.r .I.ccident 0 Non- Owned Autos Autesta S eei.f ied u F Qlit c u;ie property l7ttma3 c $ D. Excess Liability B }.ch Q tdmbrella 1' 8trn OcguY.r8i2`•e 13,+ 1rr3g - te 0 other Than rnbrellaa Form 0 $ D PPorkr..r, 9* C, mnenr.. nriall