Fort Walton Beach Council agenda — 03-12-13--regular — reading text

I further certify, under oath, that this proposal is made without prior understanding, agreement, connection, d iscussion, at collusion with any other person, firm or corporation submilti ng a proposal for the same product of service; no officer, employee or agent of the C ity of Fort Walton Beach or of any other proposer interested in said proposal; and that the undersigned exeemed this Proposer' s Certification with full knowledge and understanding ofthe matters therein contained and was duly authorized to do so. GSC Systems, Inc. NAME OF BUSINESS SIGNATURE ( ORIGINAL —bloc or black ink) Caralee M. Gibson, President NAME & TITLE ( typem prinQ c. gi bson- 15 @gscsys tem s. net I'. MAII. ADDRFSS ( Type or print) 15 Industrial Street NW MAILING ADDRESS Fort Walton Beach, FL 32548 CI I Y. STATE, ZIP CODE 850 t 243 -8812 L8-50 ) 2442530 TP.LEPBONP. NUMBER FAX NUMBER Acknowledged & subscribed before me on the _ 5th day of February 2011 by Caralee M. Gibson as the President of business]. , I Signature of Nook), Notary Public, Stale of_ Florida Personally Known - OR- Produced Identification of. Camrissian TASHAWEEKS q EE 128016 5, W29 ErfpresSEPtemher 6, 2015 wore m. rm rw w..., tuaasnn  6ulPuel 01, 0- EL dd21 PsernV : OZZZ) swalsRS losluoo V swalsRS ROanoaS oS°J - OLO -SL dZIN : IuOwyoellV a N tP ur a - l a lil' YH13 0 IbIW' n L i' S rJti acn Yau ADDENDUM PAGE RFP N13 -010 a The undersigned acknowledges receipt of the following addenda to the Documents (Give number and (late of each): Addendum No. Addendum No. Addendum No. Addendum No. FAILURE TO SUBMIT ACKNOWLEDGMENT OF ANY ADDENDUM THAT AFFECTS THE SCOPE OF WORK IS CONSIDERED A MAJOR IRREGULARITY AND WILL BE CAUSE FOR REJECTION OF THE PROPOSAL. GSC Systems, Inc. NAME 01- BUSINI SS 7 i BY Ibilil fil, l If " L Signature Caralee M. Gibson, President NAME & TITTLE ( type Or print) 15 industrial Street NW MAILING ADDRESS Fort Walton Beach, FL 32548 CITY, STATE, ZIP CODF. 650 -2438872 I ELEPI ONENUMBER L) 950-2442530 FAX NUMBER 5 February 2013 DATE wr2s  Bulpued 060 -£6 cl IN Psemtl : OZZZ) smalsAS loiluoo +g swals/ g 611snsas DS°J - 060-£ 6 ddtl auoui43e11V a Nd N_ rnWu REFERENCES Lardi, s I REP 13 -010 13 010 d YU a Bidder shall submit as a part of the bid package, four (4) Customer references with name of the customer, address, contact person, and telephone number. REGARDING PROPOSER: GSC systems, Inc Letters of Recommendation Attached Name:Project: _. — - West -- End Fire Station Name:. Project: NWFSC Community Svcs Center /EIC DooleyMack Constructors of NWF, I. I. C. Okaloosa County Emergency Managemen Contact; GOn( a' l: Trey Arias, Project Manager Ken Wolfe, Emergency Mgt Coordinator nddre«: nddress: 1 69 Griffin Blvd. Unit 101 90 College Blvd East Niceville, FL 32578 Panama City Beach, FL 32513 Telephone: felopho0c: 850 -541 -2789 850 651 -7150 1= acsimilc; Facsimile 850- 249 -2924 850 651 -8082 Name: Project: Bay County EOC Name: Project: 7th SFG Complex Hensel Phelps Construction Company Bay County Emergency Services - Contact: oby Smith, Communications Division Manage Terry Harshman, Project Manager Addi css: Address: 2125 Soto Can, Loop 700 Highway 2300 Eglin AFB, FL 32542 Southport, FL 32409 1 elephone: — Telephone: - 850 -5024792 850 -248. 6040 Facsimile; Facsimile 850- 270-6663 850784 - 4010 7 nl 28  bulpuel O1. 0- EL d=M Ptemv : OZZZ) swals6S losluoO g swels6S GlunooS OS9 - Of()- Zl d=lu :luawgoelly a Nv f tW it L., lditl, Sti. nd S- ser __ DRUG -FREE WORKPLACE FORM RFP 13 -010 M111 # 3010 d mn a The undersigned vendor, on s February , 2013, in accordance with Section 287. 087, GSC Systems, Inc. does: Florida Statutes, certifies that fcompany] I. Publish a statement notifying employees ( hat the i nlawfid manufacture, distribution, dispensing, possession, or use of a contolled substance is prohibited in the workplace and specifying the actions that will betaken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abase in the workplace, the business's 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 speci Gent in Paragraph I. 4. In the statement specified in Paragraph I, 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 trials of tile statement and will notifythe employer orally conviction of, or plea of guilty or nolo contendeie to, any violation of Chaplet 893 or of any controlled substance law orthe United States or any state, fora violation occun-ing in the workplace no later than five ( 5) days after such conviction. 5. Impose a sanction on, of require ( he salisfactoty participation in a drug assistance or rehabilitation progrann if such is available in the employee' s community, by any croployee who is so convicted. 6. Make a good faith effort to continue to maintain a drug -free workplace through implementation of Paragraphs I through 5. Cheek one: f As the person authorized to sign this statement. I certify that this firm complies fully with above rcquirenrenls. As the person authorized to sign this statement, this firm does not canply fully with the above requirements. NAME OP BUSINESS. 4— GSC Systems, Inc. n r 13 Y: % , iir' Ytl`' - SIGNATURE Caralee M. Gibson, President NAME & TITLE, TYPED OR PRINTED 8. 1- 28  Bulpue-I 01,0 -E1, ddb PJumV : OZZZ) swalsRS IosluoO g swals,(S 6} Isn3aS OSO - OIO- E1, ddu :Iuawg3cIIV aiw ° fun Nrbo l. an l S aS' xc Ill' P NI3 -Ilia N a PUBLIC ENTITY CRIME FORM —RIFT 13 -010 Y