Okaloosa County BOCC — February 18, 2014 — Repair & Paint Countryview & Bluewater Tanks — reading text

Venture Joint Venturer Names: ___ (SEAL) By: (Signature of joint venture partner) Name (typed or printed): Title: Business address: Phone No.: FAX No.: Joint Venturer Name: (SEAL) By: (Signature) Name (typed or printed): Repair & Paint Countryview & Bluewater Tanks (2014) 00300-7 Job No. 41-459 Title: Business address: Phone No.: FAX No.: Phone and FAX Number, and Address for receipt of official communications: wt (Each joint venturer must sign. The manner of signing for each individual, partnership, and corporation that is a party to the joint venture shall be in the manner indicated above.) Repair & Paint Countryview & Bluewater Tanks (2014) 00300-8 Jub Nu. 41-459 vi 1€ ATTACHMENT “A” CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all bidders/proposers must disclose if any Okaloosa County employee(s), elected official(s), or if any of its’ agencies is also an owner, corporate officer, agency, employee, etc., of their business. Indicate either “YES” (a county employee, elected official, or agency is also associated with your business), or “NO”. If yes, give persons name(s) and position(s) with your business. YES __ NO NAME(S) and POSITIONS(S): FIRM wantin Mh onan BY (printed): Pon foling’ BY (inure; Lame Ex OG TITLE: Paesclen + appress: 0836 Schiller &. rad iedene _Ohm YS34I PHONE: ey, E4F- PEDS Repair & Paint Countryview & Bluewater Tanks (2014) 00300-9 Job No. 41-459 oem Ld ATTACHMENT “B” DRUG-FREE WORKPLACE CERTIFICATION THE BELOW SIGNED BIDDER CERTIFIES that it has implemented a drug-free workplace program. In order to have a drug-free workplace program, a business shall: 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. Inform employees about the dangers of drug abuse in the workplace, the business’s 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. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection 1. In the statement specified in subsection 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. Impose a sanction on, or require the satisfactory participation in drug abuse assistance or rehabilitation program if such is available in the employee’s community, by any employee who is convicted. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign this statement, I certify that this firm complies fully with the above requirements. DATE: U3 0/2014 SIGNATURE: COMPANY: Amerjcan Santrafe NAME: Ron NG ADDRESS: $36 Sc/ullee Kal __ (Typed or Printed) elasey / Ohro 4YS34¢) TLE: Desi d ent- PHONE: $37- SY9- GB Repair & Paint Countryview & Rluewater Tanks (2014) 00300-10 Job No. 41-459 ATTACHMENT “C” INDEMNIFICATION AND HOLD HARMLESS To the fullest extent permitted by law, CONTRACTOR shall indemnify hold harmless OWNER, its officers and employees from liabilities, damages, losses, and costs including but not limited to reasonable attorney fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the CONTRACTOR and other persons employed or utilized by the CONTRACTOR in the performance of this Agreement. American Sutras} Cb.Ina Kon. bkf Bidder’s Company Name Authorized Signature - Manual /b§36 Schiltee Koad, Ron Boling er ddress Authorized Signature ~Ty ‘yped jane ay ° Pe esident Mailing Address Title 739-241-145 BI 849- 9Y Phone Number FAX Number 939- FIBNVS IFV- BIZ-NUS Cellular Number After-Hours Number(s) / / 30 [ro if Date ' (REVISED: JANUARY 12, 2001) Repair & Paint Countryview & Bluewater Tanks (2014) 00300-11 Job No. 41-459 i’ : aad ATTACHMENT “D” INSURANCE COMPLIANCE This form is to be completed and signed by you certifying that your policy either meets the insurance requirements as specified in Bid No. 4/- 4ASY , or that the insurance company has reviewed the bid requirements and certifies that you were quoted any price increase due to required coverage. CONTRACTOR I certify that the insurance requirements have been reviewed. Company Name Ameri ican Sunaratt Co. Lrc. Address /0 §3(6 Sch) her Be Qa od Medway, Ohio 4534! serene Don baling | | VA % i Title Paes dlent- Phone Number 93 q- g Y q-F YTS Repair & Paint Countryview & Bluewater Tanks (2014) 000300-12 Job No. 41-459 American Suncraft Co., Inc. 10836 Schiller Road, Medway, Ohio 45341 Phone (937) 849-9475 Fax (937) 849-9474 Specializing in Water Storage Tank Maintenance - American Suncraft FC22 Projects Indiana American Water Clearwater 1 MG Tank, Noblesville, indiana Patrick Brown, PE, TIC 317-271-3100 Roy Francis, PE, Indiana American Water 317-885-2417 Indiana American Water Barberry 500,000 Gallon Tank, West Lafayette, indiana Patrick Brown, PE, TIC, 317-271-3100 Roy Francis, PE, Indiana American Water 317-885-2417 ilinois American Water Route 116 Tank, Hanna City, [Illinois Lori Horstman, Water Superintendent, 309-303-0826 Michael Jackson, PE, 617-830-1771 West Virginia American Water KVWTP Clarifier No. 3, Charleston, WV Patrick Brown, TIC — 317-271-3100 Shelley Porter, WVAW ~ 304-340-2974 West Virginia American Water Cross Lanes Tank, Cross Lanes, WV Patrick Brown, TIC — 317-271-3100 Shelley Porter, WVAW, 304-340-2974 Aqua Ohio, Inc. Bunker Hill Tank, 2,920,000 MG Tank Ashtabula, Ohio Patrick Brown, PE, TIC 317-271-3100 Joe Flahiff, Plant Manager 440-964-8114 American Suncraft Co., Inc. 10836 Schiller Road, Medway, Ohio 45341 Phone (937) 849-9475 Fax (937) 849-9474 Salietua ga Water Specahzing in Water Storage Tank Maintenance _ American Suncraft Projects List for 2013 City of Columbus, Ohio Rome Hilliard East & East Broad North Interior Tank Painting Contract Price: $919,875.00 — 99% Complete Cindi Fitzpatrick, P.E., 614-645-6802 Delco Water 2013 Tank Project Tank 11 Scioti JCF Tank 26 Stelzer Court Contract Price: $474,225.00 - 100% Complete Shane Clark, P.E., 740-272-2220 City of Dayton, Ohio Airport Tank Contract Price: $331,395.00 — 99% Complete Jeff Dahlin, P.E., 937-902-7787 illinois American Water Aldrich Units 5&6 Contract Price: $684,980.00 — 100% Complete Michael Jackson, P.E., 618-239-3238 Indiana American Water Kokomo North Tank Contract Price: $632,530.00 — 99% Complete Roy Francis, P.E., 317-885-2417 Kentucky American Water Tates Creek Tank Contract Price: $495,375.00-- 90% Complete Zach Dukes, P.E., 859-268-6352 Okaloosa County Water and Sewer System - 2012 Okaloosa, Florida Lead Abatement Contract Amount: $1,418,350.00 100% Complete Contact: Beth Brant, P.E. - Polyengineering 850-609-1100 2012 Potable Water Tanks Modifications & Repairs Birmingham, Alabama Three Tanks, Contract Amount: $1,307,302.00 100% Complete Robert Lang, P.E., City Engineer 205-244-4211 City of Dayton, Ohio 2 MG Tank - Mt. Auburn 100% Complete Contract Amount: $1,193,324.00 Steve Tiefert, P.E., 937-333-6134 Aldrich Units 1,2,3,4 HWlinois American Water Contract Amount: $1,395,880.00 100% Complete TIC - Patrick Brown, P.E. 317-271-3100 Illinois American Water, Michael Jackson, P.E. 618-239-3238 American Suncraft Co., Inc. 10836 Schiller Road, Medway, Ohio 45341 Phone (937) 849-9475 Fax (937) 849-9474 Specializing in Water Storage Tank Maintenance References for American Suncraft 2011 - Public Works Projects City of Amarillo, Texas — 2011 Repainting and Restoration of Water Storage Tanks 1 2MG Elevated Storage Tank (Soncy) 1 2MG Ground Storage Tank (Osage) 1 2MG Gallon Ground Storage (Masterson #13) 1 1MG Ground Storage (Masterson #12) 100% Complete $1,709,475.00 Contact: Jonathan Gresham, P.E., City of Amarillo 806-378-4265 Water Works Board of the City of Birmingham 2011 Potable Water Tanks Modifications & Painting (4 Tanks) $1,824,525.00 100% Complete Robert Lang, P.E., City Engineer 205-244-4211 City of Dayton, Ohio - 2011 Strand Water Storage Improvements 2 MG Elevated Tank Contract Amount: $2,500,000.00 — 100% Complete Contact: Steve Tiefert, P.E, City of Dayton, Ohio 937-333-6134 City of Dayton, Ohio - 2011 Repainting of the Lime Sludge Tanks, Wash Water Tank and Canopy Miami Water Treatment Plant Contract Amount: $378,994.00 — 100% Complete Contact: Steve Tiefert, P.£, City of Dayton, Ohio 937-333-6134 City of Springfield, Missouri — 2011 Rehabilitation of One 4 MG Southwest Ground Storage Tank No. 1 Contract Amount: $916,202.00 — 100% Complete Contact: James Okumu, P.E., Project Manager 417-831-8843 American Suncraft Co., Inc. 10836 Schiller Road, Medway, Ohio 45341 Phone (937) 849-9475 Fax (937) 849-9474 Specializing in Water Storage Tank Maintenance References for American Suncraft Company Virginia American Water — 2010 Rehabilitation of 1MG Elevated Tank (Minnieville Tank) Contract Amount: $819,019.00 100% Complete Contact: Janet Rogel, P.E. 804:239-2010 Kentucky American Water - 2010 (Two 1MG Gallon Tanks), Cox Street Ground and Cox Street Elevated Contract Amount $593,335.00 100% Complete Contact: Patrick Brown, P.E. - TIC 317-271-3100 lowa American Water -- 2009/2010 Two 1MG Tanks Bettendorf and Harrison Street Tanks Contract Amount: $1,800,000.00 100% Complete Contact: Patrick Brown, P.E. - TIC 317-271-3100 City of Dayton, Ohio — 2010 Burkhardt 1MG Standpipe Contract Amount: $521,099.00 — 100% Complete Contact: Steve Tiefert, PE, City of Dayton, Ohio 937-333-6134 City of Dayton, Ohio - 2010 Nordale 2MG Elevated Water Tower Contract Amount: $963,469.00 — 100% Complete Contact: Steve Tiefert, PE, City of Dayton, Ohio 937-333-6134 Mobile Area Water and Sewer System — 2010 Mississippi Street Water Tank — 500,000 Gallion Tank, 100% Complete Contact: Bryan V. Peacock, P.E., Volkert Engineering 251-450-0819 vIOL-S9Z-F19 ‘a'd ‘207 "y erey yoejyu07) yu] pareaaly Uolley) 000‘SZT URL, payeaaly UoTey 000'SL s}uawaaoiduyy uraysAsS UONGLYSIG 1378, Y1eg ayeis yaar) 1esae) £002 - (sad.1mosay fe.mjeN jo yuaUn.Ledag O1YQ) OFYO Jo a7e}5 OZ772-ZLZ-OFL Suliaaulsugq “Ag ‘YrepD aueys :39e U0) (quowiajeqy pee) yur, ole) 000‘0ST - Yue] peoy a7eI5 PIO (quaurayeqy peay) xu], OTe) 000‘00Z - peoy auloH 800Z - “ou ‘Aueduio7 1338 0-[9q VVSP-ISE-OEE ‘Ad ‘Aawery ‘W ppoy :39e3u07 (quawazeqy peat) yur payeaayy volley 000‘0SZ JaJUaD [0.4U0) UOnNT[Og 1a7e A, 800Z - OTYQ ‘dojQUR: Jo ARID 02272-ZLZ-00L Sullaauisuy “q'q ‘Yael aueYs RU Quaurayeqy pea) yue], voTTeD OOO‘OST - HURL peoy ayers PIO Quoeurayeqy pes) yuel uoTeD 000‘00Z - peoy euoH 800Z - “au ‘Aueduio7 1338 05-[9q 2089-SP9-FT9 :ou0Ud “A'd ‘Yoaedzy1y [pur :joejuoD ue L UOTeD 000000 ‘T - 398.05 peoig iseq que L UOlTeD 000'000'Z - swioy paren 800Z — OFYO ‘snquinjo) jo AW1D O22?-72LZ-00L suLaaulsug “A'q ‘Yre[D aueys :39eqU07 Qquawayeqy pea) yue], uoleD 000'0SZ - yuk] asel[IA 1aqUe7) 600Z - ‘2Uy ‘Auedui0) 12384 075-[aq Z089-SP9-PL9 ‘auoUd “aq ‘YoMedzHYy Ipury 392105 YUP] 000‘000'T - 388M OTL 600Z -OFYO ‘snquinjo> Jo A315 V9ZT-809-LE6 :auoug JostAjadns soUueUaUIep] - SUTIN assaf pe WO? Qquawiazeqy peat) xue 1, uoTTeD 000'000'T 600Z - O1YO ‘B.nqsturelp Jo A115 SdDUdIIJOyy] yeuNs uedteury ATTACHMENT “E” f REFERENCES - (Attach reference list as specified in Instructions to Bidders u - Section 00100 Article 3 -