Okaloosa County BOCC — April 1, 2014 — Health Department Modular Bldg Modifications Supporting Documents — reading text

Blvd., Fort Walton Beach, FL 32547 as Principal, hereinafter called the Principal, and Merchants Bonding Company (Mutual), 2100 Fleur Drive, Des Moines, IA 50321 a corporation duly organized under the laws of the State of lowa as Surety, hereinafter called the Surety, are held and firmly bound unto Okaloosa County Board of County Commissioners, 302 N. Wilson Street, #203, Crestview, FL 32536 as Obligee, hereinafter called the Obligee, in the sum of __FIVE Percent of the amount bid Dollars ($ for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Repairs and Additions to the Okaloosa County Health Department Modular Building NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 5th day of March , 2014. (Witness) immy Henderson, PBsesident \ Merchants Bonding Company (Mutual ne WU (NL, (Surety) (Seal) if YAAK (( Luts “Abe \AL, bal] z lle A. (Witness) Clyde ili Attérney-in-Fact & Florida Licensed Resident Agent AIA DOCUMENT A310 - BID BOND - AIA - FEBRUARY 1970 ED - THE AMERICAN INSTITUTE OF ARCHITECTS 1735 N. Y. AVE. N. W. WASHINGTON, D. C. 20006 G-23248-A MERCHANTS, BONDING COMPANY: POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., botly being corporations duly organized under the laws of the State of lowa (herein collectively called the “Companies”), and that the Companies do hereby make, constitute and appoint, individually, Benjamin H. French, Wayne Walker, Pamela L. Jarman, Dale Waldorff, Paul A. Locascio, Clyde D. Hare, Rebekah Wolf of Fort Walton Beach and State of Florida their true and lawful Attomey-in-Fact, with full power and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any such Instrument shall not exceed the amount of: FIVE MILLION ($5,000,000.00) DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signéd by the duly authorized officers of the Companies, and all the acts of sald Attorney-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This Power-of-Attomey is made and executed pursuant to and by authority of the following By-Laws adopted by the Board of Directors of the Merchants Bonding Company (Mutual) on April 23, 2011 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 24, 2011. “The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Aitomeys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof. The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transrnission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other'suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 7th day of May , 2013 . gnnrttlenyy pbmrrag nioiiac® 7 ihe Cage, MERCHANTS BONDING COMPANY (MUTUAL) MERCHANTS NATIONAL BONDING, INC. STATE OF [OWA “ay / COUNTY OF POLK ss. Hees veeeattt President On this 7th day of May , 2013 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of the MERCHANTS. BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies; and that the safd instrument was signed and séaled in behalf of the Companies by authority of their respective Boards of Directors, In Testimony Whereof, | have hereunto set my hand and affixed my Official Seal at the City of Des Moines, lowa, the day and year first above written. fe | leaccl fen cht Commission Explres My gomms 2014 p Notary Public, Polk County, fowa STATE OF IOWA COUNTY OF POLK ss. |, William Wamer, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full force and effect:and has not been amended or revoked. In Witness Whereof, ! have hereunto set my hand and affixed the seal of the Companies on this 5th dayof March, 2014 RL ee oe Wh Wd, ot RN carrie . ome ORO Ae 7 if Secretary 2005 fe POA 0014 (11/11) ADDENDUM ACKNOWLEDGEMENT The bidder acknowledges that he/she has received the following addendum: ADDENDUM NO. ADDENDUM NO. ADDENDUM NO. ADDENDUM NO. ADDENDUM NO. 4 patep__S~ 7- 204 DATED. DATED. DATED DATED. Bidder Firm Name: ( “dina Hordorain | | (relent) Address: Title: Phone #: FAX No.: melts) (cb ars Aulbvael ine Lb Part FF 3x Draavley\b (960) Hot 3u (PSC) Pio] B10 21 BIDDER SURVEY (Please fill out and return with your bid) BID #: HD 32-14 sipitem: /\ivoc Re pai cs dol AM: tens tp the Okaloosa Coun by Hea tH Cpt. 1. HOW DID YOU LEARN ABOUT THIS BID? Modilae Bldg. Newspaper Classified Plan Room Bid Net X County Website Other, explain: 2. HOW DID YOU OBTAIN A COPY OF THIS BID? From Dept. Xx From Website/E-mail From Consultant Other, explain: 3i IF YOU HAD QUESTIONS ABOUT THIS BID, WERE YOU ABLE TO GET ANSWERS? X Yes No a. Did you get answers from: _X Consultant ______ Purchasing Requesting Dept. 4. IF THERE WAS A PRE-BID MEETING, DID YOU ATTEND? _X. Yes______—sNo a. If so, was the meeting worthwhile? xX Yes__——sNo b. Would you make any changes to the meeting format? _ Yes _X___ No If yes, please elaborate. 3. IS THE BID DOCUMENT FORMAT EASY TO READ? x ves No a. If you could improve or change the document, what would you change? 6. DID THE BID TIMELINE GIVE YOU ENOUGH TIME FOR YOU TO PREPARE A BID? x Yes No Please list any suggestions you have that could improve our service to you or your department: 29 RECYCLED CONTENT FORM RECYCLED CONTENT INFORMATION AY /!: A 1. Is the material in the above: Virgin, x or Recycled, (Check the applicable blank). If recycled, what percentage %. Product Description: Is your product packaged and/or shipped in material containing recycled content? Yes, No. Specify: Is your product recyclable after it has reached its intended end use? Yes. No Specify: The above is not applicable if there is only a personal service involved with no product involvement. Name of Bidder: _( aww Handa , I/ (ol GHUCHOW| longriny E-Mail: HOY A Linde LOASE (aw? 22 “NO CONTACT CLAUSE” The Okaloosa County Board of County Commissioners have established a solicitation silence policy (No Contact Clause) that prohibits oral and written communication regarding all formal solicitations for goods and services (formal bids, Request for Proposals, Requests for Qualifications) issued by the Board through the County Purchasing Department. The period commences when the procurement document is received and terminates when the Board of County Commissioners approves an award. When the solicitation silence period is in effect, no oral or written communication is allowed regarding the solicitation between prospective bidders/proposers and members of the Board of County Commissioners, the County Administrator or members of the Board Approved Review Committee. All questions or requests for information regarding the solicitation must be directed to the designated Purchasing Representative listed in the solicitation. Any information thought to affect the committee or staff recommendation submitted after bids are due, should be directed to the Purchasing Director or his appointed representative. It shall be the Purchasing Director's decision whether to consider this information in the decision process. Any attempt by a vendor/proposer to influence a member or members of the aforementioned shall be grounds to disqualify the proposer from consideration during the selection process. All proposers must agree to comply with this policy by signing the following statement and including it with their submittal. 1 LLU preventing oi Heaveren /pvititchon) 2 Signature Company Name Hereby agree to abide by the County's “No Contact Clause” and understand violation of this policy shall result in disqualification of my proposal/submittal. 20 FEDERAL E-VERIFY COMPLIANCE CERTIFICATION In accordance with Okaloosa County Policy and Executive Order Number 11-116 from the office of the Governor if the State of Florida, Proposer hereby certifies that the U.S. Department of Homeland Security's E-Verify system will be used to verify the employment eligibility of all new employees hired by the contractor during the contract term, and shall expressly require any subcontractors performing work or providing services pursuant to the contract to likewise utilize the U.S. Department of Homeland Securities E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term; and shall provide documentation such verification to the COUNTY upon request. As the person authorized to sign this statement, | certify that this company complies/will comply fully with the above requirements. DATE: J) 6) fa SIGNATURE: Sette NAME: Loew FEA TITLE: feo tae E-MAIL: PAY Oyinows bond POSE ca) COMPANY: ( ADDRESS: PHONE NO.: 24 INDEMNIFICATION AND HOLD HARMLESS To the fullest extent permitted by law, CONTRACTOR shall indemnify and hold harmless COUNTY, 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 intentional wrongful conduct of the CONTRACTOR and other persons employed or utilized by the CONTRACTOR in the performance of this Agreement. Treen 1 Hendotan Ml w/a QJ : Je Bidder's Company Name Authorizéd Signature — Manual ‘a = ’, qd IR Rb Sikes lO iol Physical Address Authorized Signature — Typed EQhnolt Mailing Address Title bL HBO Pu -5ulee aoe ae 3/5 | ie avtubardenannst aw DATE 25 REFERENCE DATA SHEET NAME OF CUSTOMER ADDRESS PHONE NUMBER PERSON TO CONTACT NAME OF CUSTOMER ADDRESS PHONE NUMBER PERSON TO CONTACT NAME OF CUSTOMER ADDRESS PHONE NUMBER PERSON TO CONTACT NAME OF CUSTOMER ADDRESS PHONE NUMBER PERSON TO CONTACT NAME OF CUSTOMER ADDRESS PHONE NUMBER PERSON TO CONTACT HEALTHSOURCE CHIROPRACTIC 431 HOLLYWOOD BOULEVARD, MARY ESTHER OFFICE: (850) 864-0800 SHAWN OR SARAH LEATHERMAN TSA