26-35_Respondent_Submittals.pdf

ATTACHMENT 1

REQUIRED FORMS

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 12 of 1045

BID FORM

ITB NO: 26-35

This proposal of , hereinafter called “BIDDER,” organized and existing under the laws of the State of doing business as (Insert “a corporation”, “a partnership” or “an individual” as applicable), is hereby submitted to the Board of County Commissioners, Bay County, hereinafter called “OWNER.”

In compliance with the Advertisement for Bids, BIDDER hereby proposes to perform all work, as detailed in this bid.

By submission of this BID, each Bidder certifies, and in the case of a joint BID each party thereto certifies as to its own organization, that this BID has been arrived at independently, without consultation, communication or agreement as to any matter relating to this BID with any other BIDDER or with any other competitor.

Vendor agrees to perform the entire work as indicated on the drawings and in compliance with the Contract Documents and Specifications, complete in every detail.

The Lump Sum Price is:

(Words)

Submitted By:

Name of Firm/Vendor Submitting This Bid

Bid Prepared By:

Name of Individual Who Prepared This Bid

Contact Email:

Address:

Phone:

Contractor’s License No. (if applicable)

Vendor’s Unique Entity Identifier (UEI) No. ______________________________

Signature of Authorized Representative of Firm/Vendor Date

SEAL: (If bid is by Corporation)

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 13 of 1045

BID FORM (Con’t)

Item No.

Description Estimated

Qty.

Unit Unit Price Total Price

1.

Furnishing all products, materials and equipment and performing all labor necessary to complete and put into operation the Bay County Water Treatment Plant Resiliency Project - Additional Filters, including all work shown on the Drawings and/or specified and not included in Items 2 through 5 below, the total amount of:

Lump Sum

2. Cash Allowances

a. Soils and Concrete Testing ALLOWANCE $ 50,000.00

b. Construction Verification Surveying ALLOWANCE $ 10,000.00

c. Owner’s Contingency ALLOWANCE $ 50,000.00

Florida Trench Safety Act Compliance1

3.

Bidder acknowledges that the Trench Safety Act will be in effect for trench excavations that exceed 5 feet in depth and the costs for complying with the Florida Trench Safety Act are included in unit cost bid items and the total bid price as summarized below:

a. $ $

b. $ $

c. $ $

* * * Additional Work If Ordered By The Engineer * * *

4.

Removal of Unsuitable Material and Replacement with

a. Crushed Stone 250 CY $ $

b. Suitable Earth Material 500 CY $ $

5.

Helical Pulldown Micropile, adjustment for actual length installed vs. Base Bid of 25 vertical feet each (plus or minus).

500 VF $ $

1. List each trench safety measure separately with the Description, Quantity, Unit of Measure, Unit Price, and Total Price for each line item included in the Bid.

BASE BID TOTAL, ITEMS 1 THROUGH 5, INCLUSIVE, THE AMOUNT OF

DOLLARS ($ ).

Bidder acknowledges Unit Prices have been determined in accordance with the General Conditions.

Bidder acknowledges that estimated quantities are not guaranteed, and are solely for the purpose of comparison of

Bids, and final payment for all Unit Price Bid items will be based on actual quantities, determined as provided in the

Contract Documents.

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 14 of 1045

BID FORM (Con’t)

DEDUCT ALTERNATE FOR FOUNDATION SYSTEM

Description of Deduct Alternate:

The Contractor shall submit an alternative deduct in the amount of $________________________ for the deletion of the helical pile foundation system included in design under the base bid and its replacement with a conventional cast-in-place concrete foundation system. This alternate includes, but is not limited to, the following scope of work:

Excavation to the required bearing elevation in accordance with project requirements. Dewatering will be required.

Over-excavation and re-compaction as specified by the project geotechnical report

Furnishing and installing spread footings and/or continuous strip footings

Providing all necessary formwork for the foundation system

Supplying and installing reinforcing steel, anchor bolts, and required embeds

Placing and finishing cast-in-place concrete footings and foundation walls

Applying damp-proofing or waterproofing, as required by the project documents

Installing perimeter drain tile, if specified in the contract documents

Backfilling and compacting excavated areas as necessary

Performing all required soil and material testing to confirm compliance

Engineering Requirements:

The design for the conventional cast-in-place concrete foundation system shall be prepared, signed, and sealed by a licensed professional engineer registered in the State of Florida. In addition, supplemental Standard Penetration Test (SPT) borings shall be conducted at the project site, as needed, to provide adequate subsurface information for engineering analysis and to ensure the foundation design meets project requirements. The signed and sealed design will be submitted for review early during the shop drawing process.

THE SELECTION OF THE PROJECT WILL BE BASED ON THE ORIGINAL DESIGN

PROPOSED IN THE BID DOCUMENTS UNDER THE BASE BID, WITH CONSIDERATION

OF THE ALTERNATIVE PRICE DEDUCTION PROVIDED.

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 15 of 1045

ADDENDUM ACKNOWLEDGEMENT

I acknowledge receipt of the following addenda:

ADDENDUM NO. DATED

ADDENDUM NO. DATED

Name of Firm:

Authorized Signature:

Printed Name:

Title:

Date:

It is the responsibility of the firm to ensure that they have received addendums if issued.

Call (850) 248-8270 or email Purchasing@baycountyfl.gov prior to submitting your bid to ensure that you have received addendums.

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 16 of 1045 mailto:Purchasing@baycountyfl.gov

AFFIDAVIT OF COMPLIANCE WITH SECTION 287.138, FLORIDA STATUTES,

CONTRACTING WITH FOREIGN ENTITIES OF CONCERN

Before me, the undersigned authority, personally appeared (Name of Affiant)

_______________ ____________________, who, after being first duly sworn, deposes and says of his or her personal knowledge the following:

1. Affiant is the (Title) ___________________________ of (Business Name)

_________________________________ which does business in the State of Florida, hereinafter called the “Nongovernmental Entity.”

2. Nongovernmental Entity, pursuant to § 287.138, Florida Statues, certifies that (1)

Nongovernmental Entity is not owned by a government of a foreign country of concern; (2) a government of a foreign country of concern does not have a “controlling interest” in Nongovernmental Entity, as defined by Section 287.138(1)(a), Florida Statutes; and (3) Nongovernmental Entity is not organized under the law of nor has its principal place of business in a foreign country of concern. For the purposes of this affidavit, foreign country of concern means the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab Republic, including any agency of or any other entity of significant control of such foreign country of concern, as defined in § 287.138(1)(c), Florida Statutes.

3. This Affidavit is executed by the Nongovernmental Entity accordance with § 287.138, Florida Statutes, for the purposes of preventing Bay County, Florida, from entering contracts with foreign entities of concern which would provide Nongovernmental Entity access to an individual’s personal identifying information.

Signed and Delivered on this _____ day of __________, 2026.

Signature of Affiant Printed Name of Affiant

STATE OF__________________

COUNTY OF________________________

Sworn to (or affirmed) and subscribed before me by means of □ physical presence or □ online notarization, this ______ day of _____________, 2026, by ___________________________.

Personally Known OR Produced Identification Type of Identification Produced________ __ ____________________________ (Notary Signature)

(SEAL)

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 17 of 1045

AFFIDAVIT OF COMPLIANCE WITH SECTION 787.06, FLORIDA STATUTES,

HUMAN TRAFFICKING ATTESTATION

Before me, the undersigned authority, personally appeared (Name of Affiant) _________________________________, who, after being first duly sworn, deposes and says of his or her personal knowledge the following:

1. Affiant is the (Title) ______________________________ of (Business Name) __________________________________ which does business in the State of Florida, hereinafter called the “Nongovernmental Entity.”

2. Nongovernmental Entity, pursuant to § 787.06(13), Florida Statues, certifies that 1) neither Nongovernmental Entity nor any of its subsidiaries or affiliates uses coercion for labor or services, as terms are defined in § 787.06, Fla. Stat., as may be amended from time to time; (2) Nongovernmental Entity will immediately notify Bay County, Florida, if, at any time in the future, Nongovernmental Entity does use coercion for labor or services, and understands that pursuant to such notification no contracts may be executed, renewed, or extended between the parties; and (3) Nongovernmental Entity has read the foregoing attestation, confirms the facts stated in it are true, ad are made for the benefit of, and reliance by, Bay County, Florida.

Signed and Delivered on this _____ day of __________, 2026.

Signature of Affiant Printed Name of Affiant

STATE OF ___________

COUNTY OF ______________

Sworn to (or affirmed) and subscribed before me by means of □ physical presence or □ online notarization, this ____ day of _____________, 2026, by ___________________.

Personally Known OR Produced Identification

Type of Identification Produced______ _______________________________ (Notary Signature)

(SEAL)

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 18 of 1045

ANTI-COLLUSION CLAUSE

Firm certifies that their response is made without prior understanding, agreement or connection with any Corporation, Firm or person submitting a response for the same services and is in all respects fair and without collusion or fraud.

Printed Name:

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 19 of 1045

CERTIFICATION REGARDING SCRUTINIZED COMPANIES LIST

Respondent Vendor Name:

Vendor FEIN:

Vendor's Authorized Representative Name and Title:

Address:

City: State: ZIP:

Phone Number:

Email Address:

Section 287.135, Florida Statutes prohibits agencies from contracting with companies, for goods or services over $1,000,000, that are participating in a boycott of Israel, are on the Scrutinized Companies that Boycott Israel list, the Scrutinized Companies with Activities in Sudan List, the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or has been engaged in business operations in Cuba or Syria.

Both lists are created pursuant to Section 215.473, Florida Statutes.

As the person authorized to sign on behalf of Respondent, I hereby certify that the company identified above in the sector entitled "Respondent Vendor Name" is not participating in a boycott of Israel, is not listed on the Scrutinized Companies that Boycott Israel List, the Scrutinized Companies with Activities in Sudan List, or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and has not been engaged in business operations in Cuba or Syria. I understand that pursuant to Section 287.135, Florida Statutes, the submission of false certification may subject company to civil penalties, attorney's fees, and/or costs.

Certified By:

AUTHORIZED SIGNATURE

Print Name and Title:

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 20 of 1045

CONFLICT OF INTEREST DISCLOSURE FORM

For purposes of determining any possible conflict of interest, all firms, must disclose if any Bay County Board of County Commissioner(s), employee(s), elected officials(s), or any of its agencies is also an owner, corporate officer, agency, employee, etc., of their firm.

Indicate either “yes” (a county employee, elected official, or agency is also associated with your firm), or “no”. If yes, give person(s) name(s) and position(s) with your firm.

YES NO

NAME(S) POSITION(S)

Printed Name:

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 21 of 1045

DRUG FREE WORKPLACE

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 employees 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.

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

6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section.

As the person authorized to sign the statement, I certify the following:

(Check one and sign in the space provided.)

This firm complies fully with the above requirements.

This firm does not have a drug free work place program at this time.

Printed Name:

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 22 of 1045

SUB-CONTRACTORS

As the bidder, I submit a listing of the Sub-Contractors which I shall use to accomplish the Work. Sub-Contractors are listed by name, address, amount of work and item of work. If none, please state so.

Subcontractor Name and Address:

Work to be performed and $ amount:

Printed Name:

Title:

Date:

*Complete additional forms if needed to list all subcontractors

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 23 of 1045

Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion

Contractor Covered Transactions

(1) The prospective contractor of the Recipient, ______________________ , certifies, by submission of this document, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from participation in this transaction by any Federal department or agency.

(2) Where the Recipient’s contractor is unable to certify to the above statement, the prospective contractor shall attach an explanation to this form.

CONTRACTOR:

By____________________________ Bay County Board of County Commissioners_ Signature Recipient’s Name

_______________________________ N/A_________________________________ Name and Title Division Contact Number

________________________________ 26-35______________________________ Street Address Project Number

City, State, Zip

Date

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 24 of 1045

APPENDIX A, 44 C.F.R. PART 18-CERTIFICATION REGARDING LOBBYING

Certification for Contracts, Grants, Loans, and Cooperative Agreements

(To be submitted with each bid or offer exceeding $100,000)

The undersigned certifies, to the best of his or her knowledge, that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

The Contractor, __________________________________ , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any.

In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any.

Signature of Contractor's Authorized Official

Name and Title of Contractor's Authorized Official

Date

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 25 of 1045

FLORIDA TRENCH SAFETY ACT CERTIFICATION AND DISCLOSURE

STATEMENT

SECTIONS 553.60-553.64, FLORIDA STATUTES

Trench Safety Act. The Contractor shall comply with all of the requirements of the Florida Trench Safety Act, Laws of Florida. Such assurance shall be legally binding on all persons employed by the Contractor and Subcontractors. The Contractor shall acknowledge that included in various items of the proposal and in the total bid price are costs for complying with the provisions of the Act. Additionally, the Contractor is required to break out the costs for complying with the Florida Trench Safety Act.

The Contractor acknowledges that included in the various items of the proposal and in the Total Bid Price are costs for complying with the Florida Trench Safety Act and further identifies the costs to be summarized below:

Trench Safety Units of Unit Extended Measure Measure (Quantity) Cost (Description) (LF, SY)

A.

B.

C.

D.

TOTAL $

DATE , 20

Authorized Signature

Title

Address:

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 26 of 1045

BID BOND

BY THIS BOND, We, as Principal and , a corporation, as Surety, are bound to the Board of County Commissioners, Bay County, Florida, as County, in the sum of $ for the payment of which we bind ourselves, our heirs, personal representatives, successors, and assigns, jointly and severally. THE CONDITION of this bond is such that

1. The Principal has submitted to the County a certain Bid dated

2. If said Bid shall be rejected, or, if said Bid shall be accepted and the Principal shall execute and deliver a Contract, and furnish bonds for the faithful performances of work and for the payment of all persons performing labor and furnishing materials in connection therewith, and shall fulfill all other aspects created by the acceptance of said Bid, then this obligation shall be void. Otherwise, this bond shall remain in full force and effect with it being expressly understood and agreed that the liability of the Surety and for any and all claims hereunder shall, in no event, exceed the amount of this obligation.

This Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and this bond shall, in no way, be impaired or affected by any extension of time within which the County may accept such Bid; and Surety hereby waives notice of any such extension.

Signed, sealed and delivered in three (3) counterparts on

CORPORATE PRINCIPAL

By: Attest:

Its: Seal:

Acknowledged and subscribed on , before the undersigned authority by , as the of the Corporation named as Principal and with due authorization of the Corporation.

Notary Public

SURETY

By: Attest:

Seal:

Countersigned:

By:

Attorney-in-Fact, State of Florida

26-35 Water Treatment Plant (WTP) Resiliency Project Additional Filters Page 27 of 1045