25-11MC Exhibit B Proposal Requirements.pdf

City of Sarasota 1

RFP NO. 25-11MC

Exhibit B Proposal Requirements

EXHIBIT B, PROPOSAL REQUIREMENTS

RFP NUMBER 25-11MC

This section identifies specific information which must be contained within the proposal.

The information provided will be used in the evaluation of proposal responses.

FORMAT OF PROPOSALS

The contents of each Proposal will be organized and arranged in the same order as listed below. The Proposal should contain sufficient detail to permit the City to conduct a meaningful evaluation. However, overly elaborate responses are not requested or desired.

The preferred method for submission of proposal response requirements is electronically via the City eProcurement software Bidnet at https://www.bidnetdirect.com/florida/city-of-sarasota in one continuous file attachment in Microsoft Word or Adobe PDF format. Do not password protect or otherwise encrypt electronic submissions.

A. INTRODUCTION

Include the following in this section of the Proposal.

1. A cover page that identifies Proposer, the RFP by title and the RFP number.

2. An introductory letter/statement that describes your proposal contents in summary form (limit 2 pages).

B. MINIMUM QUALIFICATION REQUIREMENTS

In this section submit the information and documentation requested that confirms Proposer meets the following minimum qualification requirement(s). The information in this section will be used in the determination of responsibleness.

1. Proposer must be registered with the State of Florida, Division of Corporations

(Sunbiz) to do business in Florida.

Provide your State of Florida Sunbiz Document Number.

2. Proposer must have on staff at least two individuals who possess a “Professional

Engineer” license issued by the Florida Board of Professional Engineers (FBPE) OR be licensed by the Florida Department of Business and Professional Regulation (DBPR) as a “Professional Geologist”.

Provide documentation from the FBPE or DBPR that confirms the individual’s license.

https://www.bidnetdirect.com/florida/city-of-sarasota

City of Sarasota 2

Exhibit B Proposal Requirements

3. Proposer has experience in at least five of the following types of work: (1) standard penetration tests, (2) cone penetration tests, (3) test pits, (4) soil borings, (5) triaxial tests, (6) sieve analysis, (7) Atterberg limits tests, (8) moisture content test, (9) shear strength tests, (10) permeability tests.

Provide a list of up to five clients for whom Proposer has provided geotechnical services who are agreeable to provide feedback to the City and validate Proposer’s has provided services in the above types of work. Include the following:

i. Client name

ii. Client address

iii. Client contact name

iv. Client phone and email address

v. Performance period (start/end dates)

vi. Type of work provided

C. REQUIRED FORMS

Provide the completed and executed Forms with the Proposal Response, as instructed.

1. Proposer must have an active registration with the State of Florida Division of

Corporations (Sunbiz) to do business in Florida.

Complete and submit the Acknowledgement Form included in the RFP. All signatures must be provided by an authorized company representative.

The City will verify this registration.

2. Sections 112.313(3) and 112.313(7), Florida Statutes, prohibit certain business relationships on the part of public officers and employees, their spouses, and their children. See Part III, Chapter 112, Florida Statutes and/or the brochure entitled "A Guide to the Sunshine Amendment and Code of Ethics for Public Officers, Candidates and Employees" for more details on these prohibitions.

However, Section 112.313(12), Florida Statutes (1983), provides certain limited exemptions to the above-referenced prohibitions, including one where the business is awarded under a system of sealed, competitive bidding; the public official has exerted no influence on bid negotiations or specifications; and where disclosure is made, prior to or at the time of the submission of the bid, of the official's or his spouse's or child's interest and the nature of the intended business. The Commission on Ethics has promulgated this form for such disclosure, if and when applicable to a public officer or employee.

City of Sarasota 3

Exhibit B Proposal Requirements

If applicable, complete and submit the Interest in Competitive Bid for Public Business Form included in the RFP. If not applicable, write “N/A” at the top of the form.

3. Proposer shall execute an affidavit, in the form provided by the City, to the effect that they have not colluded with any other person, firm or corporation regarding any response submitted.

Complete and submit the Non-Collusive Affidavit included in the RFP.

4. Proposer has not been convicted of a public entity crime per Section 287.133, Florida Statutes or environmental law in the past five years.

Complete and submit the Public Entity Crime form included in the RFP.

5. Drug-Free Workplace Certification.

Complete and submit the Drug-Free Workplace Certification included in the RFP. If not applicable, write “N/A” at the top of the form.

6. In accordance with Florida Statute §287.135 (5), at the time Proposer submits a Response for a contract or before a company enters into or renews a contract with the City for goods or services of $1 million or more, it is not on the Scrutinized Companies with Activities in Iran Petroleum Energy List or engaged in business operations in Cuba or Syria.

Complete and submit the Scrutinized Company Certification form included in the RFP.

7. Proposer does not use coercion for labor or services.

Complete and submit the Affidavit Attesting to Noncoercive Conduct for Labor or Services included in the RFP.

8. Proposer, its principal(s), officers, agents, or proposed subcontractor(s), shall not have any conflicts of interest as it relates to this solicitation.

Attach a statement on company letterhead that:

i. Discloses any City officer, employee, or attorney, their spouses, parents, or children, who is also an owner with more than 10 percent ownership interest in Proposer’s business, OR

ii. Provides a statement to the effect that no conflict of interest exists, if applicable.

9. The Local Vendor Certification Form is used for the application of preferences as

City of Sarasota 4

Exhibit B Proposal Requirements described it the Terms and Conditions for Local Preference and Ties. If proposer is claiming local preference on the Acknowledgement Form, this form is required.

If applicable, complete and submit the Local Vendor Certification included in the RFP.

10. The City of Sarasota tracks statistical information on employees hired in the local area.

Complete and submit the Local Employee Certification included in the RFP.

11. Proposer shall provide a list of any subcontractors they intend to utilize.

Complete and submit the Subcontractors List included in the RFP.

12. The City will send a reference survey to the references listed.

Complete and submit the Contractor/Vendor References form included in the RFP.

D. TRADE SECRETS

Pursuant to Florida Statute, identify any trade secret being claimed. NOTE:

Designation of the entire Proposal as “Trade ‘Secret’, ‘Proprietary’ or ‘Confidential’ is not permitted and may result in a determination that the Proposal is non-responsive and therefore will not be evaluated or considered.

Proposer must submit purported trade secret information as follows:

1. Trade secret material must be segregated in a separate document, from the portions of the Proposal that are not being declared as trade secret. NOTE:

Trade secret requests made after the Due Date and Time are not allowed.

2. Proposer shall cite, for each trade secret claimed, the Florida Statute number which supports the designation. Further, Proposer shall provide a brief written explanation as to why the cited Statute is applicable to the information claimed as trade secret.

3. Proposer shall provide an electronic copy of its proposal to include all items it has designated as trade secrets and an additional electronic copy of its proposal that redacts all items it has designated as trade secrets.

E. PROPOSER STATEMENT OF ORGANIZATION

In this section, provide information and documentation on Proposer as follows:

1. Legal contracting name, including any dba or fictitious name in which Proposer operates.

2. State of organization or incorporation.

City of Sarasota 5

Exhibit B Proposal Requirements

3. Ownership structure of Proposer’s company. (e.g., Sole Proprietorship, Partnership, Limited Liability Corporation, Corporation)

4. Proposer’s Federal Identification Number.

5. Contact information for Proposer’s corporate headquarters and local office (if different). Include the following:

i. Address

ii. City, State, Zip

iii. Phone

iv. Number of years at this location

6. List of officers, owners and/or partners, or managers of the firm. Include names, and work addresses, email addresses, and phone numbers.

7. Provide contact information for Proposer’s primary and secondary representatives who are designated to receive and respond to City communications related to this RSQ to include the following information:

i. Name

ii. Phone

iii. E-mail

iv. Mailing Address

v. City, State, Zip

F. PROPOSER EXPERIENCE

In this section, provide the following information regarding Proposer's (firm’s) experience.

1. Number of years Proposer has been in the business of providing geotechnical services.

2. Narrative of Proposer’s experience with Florida’s environmental and construction regulations.

3. Narrative of Proposer’s experience with Florida’s diverse soil conditions, such as coastal erosion, karst formations, and high-water tables.

4. A narrative summary detailing Proposer’s experience in the following types of work as described in the Scope of Work:

i. Projects requiring maintenance of traffic under FDOT requirements

ii. Testing of foundation excavations

iii. Soil boring for soil type and rock identification

iv. Environmental testing and monitoring for asbestos and lead

v. Environmental testing for water contamination and pollution

vi. Compression strength testing for concrete

vii. Soil and material inspections

viii. In-place density test

ix. Three-point LBR tests

5. Provide five client references for whom Proposer has provided geotechnical

City of Sarasota 6

Exhibit B Proposal Requirements services similar to those specified in the Scope of Work in the past five (5) years and who are agreeable to respond to a request from the City regarding Proposer’s provision of services. (These may be the same clients provided in the Minimum Qualifications section). Do NOT include the City as a reference. The City will review its records relating to previous services provided by Proposer.

Include the following:

i. Entity name

ii. Entity Address, City/State

iii. Contact name(s)

iv. Contact email address

v. Contact telephone number

vi. Dates of service (start/end)

vii. Name of the project

viii. Type of work

6. Detail any recent awards or recognition received by Proposer for geotechnical services.

TEAM’S EXPERIENCE

1. A brief bio of Proposer’s key personnel who will be assigned to City projects to include their name, title, primary area of responsibility, and their experience in the work they will be assigned.

2. Provide details of all licenses and certifications held by Proposer’s key personnel.

3. Detail any recent awards or recognition key personnel have received related to the provision of geotechnical services.

4. If subconsultants are proposed, the name of the subconsultant(s), their primary area of responsibility, and a summary of their experience in the type of work they will be assigned.

5. Provide a recent example of a “problem” that was encountered on a geotechnical services project, the team member(s) that responded, the solution they developed, and the outcome of implementing the solution.

APPROACH

1. A clear and detailed description of Proposer’s general project approach for each of the following:

i. Site Investigation Methods: Proposed methods for soil testing, drilling, and sampling.

ii. Engineering Analysis Techniques: Use of advanced geotechnical modeling, risk assessments, and laboratory testing.

iii. Environmental Considerations: Strategies for mitigating environmental impacts (e.g., groundwater protection, erosion control).

iv. Safety Protocols: Occupational and environmental safety measures in compliance with OSHA and Florida EPA regulations.

v. Use of Technology: Use of technology such as GIS mapping, drone surveys, or automated soil testing.

City of Sarasota 7

Exhibit B Proposal Requirements

2. Proposer’s methodology for engaging with City representatives and availability for meetings, both in person and on-line.

3. Explain Proposer’s approach to.

4. Describe Proposer’s cost control and cost estimating techniques.

CAPACITY

1. Specify the location(s) where off-site work for lab testing will be performed.

2. Details of Proposer’s current workload and capacity to take on new projects.

3. Describe Proposer’s current staffing resources both locally and corporately to include licensed geotechnical engineers, geologists, and Florida licensed technicians.

4. An explanation, in general terms, of Proposers’ financial capacity to provide the services.

5. A narrative detailing Proposer’s current workload, three-month outlook of projected work, and its workforce allocation/capacity to manage the addition of City projects.

6. Details of Proposer's access to necessary equipment such as drilling rigs and field equipment, and technology tools and software.

7. Provide details of any ownership changes to Proposer’s organization in the past year or changes anticipated within six months of the date responses to this RSQ are due (e.g., mergers, acquisitions, changes in executive leadership).

8. Provide documentation supporting Proposer’s ability to obtain the required insurances (e.g., current ACORD form indicating the types and amounts of each type of insurance, a confirmation letter from Proposer’s insurer attesting to Proposer’s ability to obtain the required insurances).

9. Provide details of Proposer’s capacity to provide quick response to City inquiries and projects.

10. Describe any litigation, arbitration, or claims that involved Proposer in the past seven years and explain the outcome.

[END]

Form #1 – Acknowledgement Form Page 1 of 1

City of Sarasota Submittal Acknowledgement

Solicitation Number: _____________

Solicitation Title: _____________________________________________________________

Company Name: ______________________________________________________________

Company Address: ____________________________________________________________

Company City: ___________________________ Company State: ______ Company ZIP: _________

Contact Name: ______________________________________________________________________

Contact Phone Number (include area code): ______________________________________________

Contact Email (Required): ____________________________________________________________

Are you claiming local preference: YES NO If yes, you must include Form #6 Local Vendor Certification.

(1) Employer Identification Number -or- (2) Social Security Number: ** The City of Sarasota collects your social security number for tax reporting purposes: ______________________________________

In submitting this Solicitation, the respondent makes all representations required by the Instructions to respondent and further warrants and represents that: Respondent has examined copies of all the Solicitation Documents and acknowledges that all addenda have been reviewed.

Addendum No.________ through Addendum No.__________

City of Sarasota, Sarasota, Florida In the event of an emergency, Respondent will provide priority service for the City of Sarasota.

CONTINUITY OF OPERATION DURING EMERGENCY? YES NO

The undersigned, as Respondent, hereby declares that no person or other persons other than the undersigned are interested in this Solicitation as Principal, and that this Solicitation is made without collusion with others;

and that we have carefully read and examined the specifications, and with full knowledge of all conditions under which the services herein is contemplated must be furnished, hereby propose and agree to furnish this service according to the requirements set out in the specifications for said service for the prices as listed on the previous pages.

THIS FORM MUSE BE SIGNED BY A PERSON AUTHORIZED TO ENTER INTO CONTRACTS FOR THE COMPANY.

Name of Respondent (Print or Type)

Title of Respondent

Signature of Respondent

Your firm must be authorized to conduct business in the State of Florida, as provided by the Florida Department of State, Division of Corporations.

https://dos.myflorida.com/sunbiz/ https://dos.myflorida.com/sunbiz/

Form# 2 – Interest in Competitive Bid Page 1 of 1

FORM 3A INTEREST IN COMPETITIVE BID FOR PUBLIC BUSINESS

LAST NAME, FIRST NAME, MIDDLE NAME

OFFICE POSITION HELD

MAILING ADDRESS

AGENCY

CITY, STATE, ZIP, COUNTY ADDRESS OF AGENCY

WHO MUST FILE THIS STATEMENT

Sections 112.313(3) and 112.313(7), Florida Statutes, prohibit certain business relationships on the part of public officers and employees, their spouses, and their children. See Part III, Chapter 112, Florida Statutes and/or the brochure entitled "A Guide to the Sunshine Amendment and Code of Ethics for Public Officers, Candidates and Employees" for more details on these prohibitions.

However, Section 112.313(12), Florida Statutes (1983), provides certain limited exemptions to the above-referenced prohibitions, including one where the business is awarded under a system of sealed, competitive bidding; the public official has exerted no influence on bid negotiations or specifications; and where disclosure is made, prior to or at the time of the submission of the bid, of the official's or his spouse's or child's interest and the nature of the intended business. The Commission on Ethics has promulgated this form for such disclosure, if and when applicable to a public officer or employee.

INTEREST IN COMPETITIVE BID FOR PUBLIC BUSINESS (Required by 112.313(12)(b), Florida Statute (1983))

1. The competitive bid to which this statement applies has been/will be (strike one) submitted to the following government agency:

2. The person submitting the bid is: Name Position

3. The business entity with which the person submitting the bid is associated is:

4. My relationship to the person or business entity submitting the bid is as follows:

5. The nature of the business intended to the transacted in the event that this bid is awarded is as follows:

a. The realty, goods and/or services to be supplied specifically include:

b. The realty, goods and/or services will be supplied for the following period of time: _______________________________________

c. Will the contract be subject to renewal without further competitive bidding? Yes ☐ No ☐ if so, how often? ___________________

6. Additional comments:

7. Signature

Date Signed

Date Filed

FILING INSTRUCTIONS

If you are a state officer or employee required disclosing the information above, please filing this form with the Secretary of State at the Capitol, Tallahassee, Florida 32301. If you are an officer or employee of a political subdivision of this state and are subject to this disclosure, please file the statement with the Supervisor of Elections of the county in which the agency in which you are serving has its principal office.

NOTICE: UNDER THE PROVISIONS OF FLORIDA STATUTES #112.317 (1983), A FAILURE TO MAKE ANY REQUIRED DISCLOSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING:

IMPEACHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN

SALARY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED $5,000.00.

Form# 3 – Non-collusive Affidavit Page 1 of 1

NON-COLLUSIVE AFFIDAVIT

(Prime Contractor/Vendor)

State of ______________________

County of _____________________

___________________________________, being first duly sworn, deposes and says that they are (Name of corporate officer)

______________________________________, the party making the fore-going solicitation (Partner or officer of the firm, etc.)

is genuine and not collusive or sham; that said contractor/vendor has not colluded, conspired, connived or agreed, directly or indirectly, with any contractor/vendor or person, to put in a sham solicitation or to refrain from bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or communication or conference, with any person, to fix the solicitation price of affiant or of any other contractor/vendor, or to fix overhead, profit or cost element of said solicitation price, or of that of any other contractor/vendor, or to secure any advantage against the City of Sarasota of any person interested in the proposed contract; and that all statements in said solicitation are true.

(Contractor/Vendor, if the Contractor/vendor is an individual, Partner, if the Contractor/vendor is a partnership, Officer, if the Contractor/vendor is a corporation)

(Company Name)

STATE OF ________________________

COUNTY OF _______________________

The foregoing instrument was acknowledged before me this ____ day of _______________ by

______________________________ (name and title of corporate officer) of ______________________________

(name of corporation), a ____________________ (state or place of incorporation) corporation, on behalf of the corporation. He/she is personally known to me or has produced ___________________ (type of identification) as identification.

(Signature line for notary public)

(Name of notary typed, printed or stamped)

(Title or rank)

My commission expires:

(Serial number, if any)

Form# 4 – Public Entity Crimes Page 1 of 2 SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES

This form must be signed and sworn to in the presence of a notary public or other officer authorized to administer oaths.

1. This sworn statement is submitted to_________________________________________________ (Print name of the public entity) by_____________________________________________________________________________ (Print individual’s name and title) for____________________________________________________________________________ (Print name of entity submitting sworn statement) whose business address is__________________________________________________________

(If applicable) its Federal Employer Identification Number (FEIN) is _______________________

(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement on the attached sheet.) Required as per IRS Form W-9.

2. I understand that a “public entity crime” as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including but not limited to, and bid or contract for goods or services to be provided to any public entity or agency or political subdivision or any other state or of the Unites States, and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.

3. I understate that “convicted” or “conviction” as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.

4. I understand that “affiliate” as defined in Paragraph 287.133(1)(a), Florida Statutes, means:

1. A predecessor or successor of a person convicted of a public entity crime.

or

2. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term “affiliate” includes those offices, directors, executives, partners, shareholders, employees, members and agents who are active in the management of the affiliate.

The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not fair market value under an arm’s length agreement, shall be a facie case that one person controls another person. A person who knowingly enters into a join venture with a person who has been convicted of a public entity crime in Florida during the proceeding 36 months shall be considered an affiliate.

5. I understand that a “person” as defined in Paragraph 287.133(1)(c), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term “person” includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of the entity.

6. Based on information and belief, the statement, which I have marked below, is true in relation to the entity submitting those sworn statements. (Please indicate which statement applies.)

Form# 4 – Public Entity Crimes Page 2 of 2

______ Neither the entity submitted this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity nor affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989.

______ The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, member, or agents who are active in management of the entity, or an affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989.

______ The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, member, or agents who are active in management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearing and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (Attach a copy of the final order)

I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES, FOR CATEGORY TWO OR ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.

(Signature)

(Date)

STATE OF_________________________________

COUNTY OF_______________________________

PERSONALLY APPEARED BEFORE ME, the undersigned authority, _____________________________ (Name of individual signing) who, after first being sworn by me, affixed his/her signature in the space provided above on this_________ day of___________________, 2____.

(NOTARY PUBLIC)

My Commission Expires: _____________________________

Form# 5 – Drug-Free Workplace Page 1 of 1

DRUG-FREE WORKPLACE CERTIFICATION

Preference shall be given to businesses with drug-free workplace programs. Pursuant to Section 287.087, Florida Statutes, whenever two or more competitive solicitations that are equal with respect to price, quality, and service are received by the State or by any political subdivision for the procurement of commodities or contractual services, a response received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing tie responses will be followed if none of the tied providers has 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.

2. 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.

3. Give each employee engaged in providing the commodities or contractual services that are under proposal a copy of the statement specified in Subsection (1).

4. 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 proposal, 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 894, Florida Statutes, 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.

5. Impose a sanction on any employee who is so convicted or require the satisfactory participation in a drug abuse assistance or rehabilitation program as such is available in the employee's community.

6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of applicable laws, rules and regulations.

As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements.

RESPONDENT NAME AUTHORIZED SIGNATURE

Form #5A – Scrutinized Companies Certification Page 1 of 1

CERTIFICATION REGARDING SCRUTINZED COMPANIES LISTS

Respondent Name: __________________________________________________________________

Respondent’s Authorized Representative Name and Title:____________________________________

Address: __________________________________________________________________________

City: _________________________ State: _____________________________ Zip: ______________

Phone Number: _______________________________ Respondent FEIN: _____________________

Email Address:______________________________________________________________________

Section 287.135, Florida Statutes prohibits a company from bidding on, submitting a proposal for, or entering into or renewing a contract for goods or services of any amount if, at the time of contracting or renewal, the company is on the Scrutinized Companies that Boycott Israel List, created pursuant to Section 215.4725, Florida Statutes, or is engaged in a boycott of Israel. Section 287.135, Florida Statutes, also prohibits a company from bidding on, submitting a proposal for, or entering into or renewing a contract for goods or services of $1,000,000 or more, that are on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector Lists which were created pursuant to s. 215.473, Florida Statutes.

Certification:

As the person authorized to sign on behalf of Respondent, I hereby certify that the company identified above in the section entitled “Respondent Vendor Name” is not listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or the Scrutinized Companies that Boycott Israel List. I further certify that the company is not engaged in a boycott of Israel. I understand that pursuant to section 287.135, Florida Statutes, the submission of a false certification may subject company to civil penalties, attorney’s fees, and/or costs.

Certified By: _______________________________________________________________________, who is authorized to sign on behalf of the above referenced company.

Authorized Signature:_______________________________________________________________

Print Name and Title:_______________________________________________________________

Form #5B – Non-Coercive Conduct for Labor or Services Page 1 of 1

Noncoercive Conduct for Labor or Services

When executing a contract with a government entity, the awarded Vendor is required to provide an affidavit, under penalty of perjury, attesting that it does not use coercion for labor or services. Refer to Section 787.06 Florida Statutes for more information and the definition of coercion.

I confirm that [Bidder/Proposer] has read and understands the requirements of Section 787.06 Florida Statutes and, if awarded, will sign an affidavit attesting that it does not use coercion for labor or services.

By:

Signature (authorized representative of Bidder/Proposer) Date

Printed Name Title

Form# 6b – Local Employee Certification Page 1 of 1

Employees:

City Residents: the employee’s residence is located within the City of Sarasota City limits

County Residents: the employee’s residence is located within Sarasota County, but outside the City of Sarasota City limits.

Non-Local Residents: the employee’s residence is located outside Sarasota County

Full-time Employees: The employee works greater than 30 hours per week or greater than 1560 hours per year.

Part-time Employees: The employee works less than 30 hours per week or less than 1560 hours per year.

Expected New Hire Employees: Employees expected to be hired to complete the work specified in this proposal.

Employee Residence Statistics: List number of employees in each category

City Residents County Residents Non-Local Residents TOTAL

Current Full-time Employees

Current Part-time Employees

Expected New Hire Full-time Employees

Expected New Hire Part-time Employees

Sub-Contractor’s Full-time Employees

Sub-Contractor’s Part-time Employees

Form# 7 – Subcontractor/subconsultant List Page 1 of 1

SUBCONTRACTORS LIST

Subcontractor/Subconsultant Name Area Of Work Point Of Contact Or

Project Supervisor Phone Number and Email

Qualifed

MBE

Yes/No

Amount or Percentage of

Total Bid

Please include subcontractors/subconsultants name, area of work (i.e. mechanical, electrical, etc..) and a valid phone number and email. Also include the dollar value or percentage that the subcontractor will be performing. If subcontractors qualify as MBE contractors, provide a copy of the State of Florida certification for each subcontractor/subconsultant listed certified in accordance with Section 287.0943 or 287.0943(1), Florida Statutes.

Form# 8 – Contractor Vendor Reference List Page 1 of 1

Contractor/Vendor References

Name of Company Submitting bid: __________________________________________________

References

Contact Person & Title:

Email Address Phone No.

Company Name:

Mailing Address:

City: State: Zip:

Type of commercial work contracted:

Contact Person & Title:

Email Address Phone No.

Company Name:

Mailing Address:

City: State: Zip:

Type of commercial work contracted:

Contact Person & Title:

Email Address Phone No.

Company Name:

Mailing Address:

City: State: Zip:

Type of commercial work contracted:

Contact Person & Title:

Email Addresss Phone No.

Company Name:

Mailing Address:

City: State: Zip:

Type of commercial work contracted:

Three of the references above will receive electronic surveys from the Purchasing Division. Email addresses are required. Please ensure that your references are willing to complete the electronic survey. Failure to received survey results may result in your company being declared nonresponsive.