26-36_Respondent_Submittals.pdf

ATTACHMENT 1

REQUIRED FORMS

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BID FORM

ITB NO: 26-36

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 Monthly 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:

Signature of Authorized Representative of Firm/Vendor Date

SEAL: (If bid is by Corporation)

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BID FORM (Con’t)

Bidder agrees to perform all the work described in the Contract Documents for the following Unit Prices and Lump Sum Prices.

Service Location Bill To:

Container(s)/ # Weekly Pickups Monthly Cost

Mosquito Control Mosquito Control 4 CY Dumpster $

4800 Fire Tower Rd. 4800 Fire Tower Rd. 1

Panama City, FL 32404 Panama City, FL 32404

Contact: Vanessa Hamstra vhamstra@baycountyfl.gov

(850) 248-8720

Roads and Bridges Roads and Bridges 6 CY Dumpster $

4836 Fire Tower Rd. 4836 Fire Tower Rd. 1

Panama City, FL 32404 Panama City, FL 32404

Contact: Terri Frederickson tlfrederickson@baycountyfl.gov

(850) 248-8818

Traffic Control Traffic Engineering 4 CY Dumpster $

4740 Fire Tower Rd. 840 W. 11th Street 1

Panama City, FL 32404 Panama City, FL 32401

Contact: Linda Grannan lgrannan@baycountyfl.gov

(850) 248-8740

Lab Utility Services Department Lab (2) 96 Gal Tote $

3420 Transmitter Rd. 3420 Transmitter Rd. 2

Panama City, FL 32404 Panama City, FL 32404

Contact: Edna Sannicandro esannicandro@baycountyfl.gov

(850) 248-5012

Utility Services Admin Office Utility Services Admin Office (2) 96 Gal Tote $

3410 Transmitter Rd. 3410 Transmitter Rd. 2

Panama City, FL 32404 Panama City, FL 32404

Contact: Edna Sannicandro

Water Treatment Plant Utility Services Admin Office (2) 6 CY Dumpster $

3400 Transmitter Rd. 3410 Transmitter Rd. 2

Panama City, FL 32404 Panama City, FL 32404

Contact: Edna Sannicandro esannicandro@baycountyfl.gov

(850) 248-5012

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Bidder agrees to perform all the work described in the Contract Documents for the following Unit Prices and Lump Sum Prices.

Service Location Bill To:

Container(s)/

Water Treatment Plant Utility Services Admin Office 8 CY Dumpster $

3206 Transmitter Rd. (C Street ) 3410 Transmitter Rd. 2

Panama City, FL 32404 Panama City, FL 32404

Contact: Edna Sannicandro

Animal Services Animal Services 6 CY Dumpster $

6401 Bayline Dr. 6401 Bayline Dr. with Side Opening

Panama City, FL 32404 Panama City, FL 32404 2

Contact: Serina Junger sjunger@baycountyfl.gov

(850) 248-8495

Thomas Dr. Fire District Fire Services 4 CY Dumpster $

2913 Thomas Dr. 700 Hwy 2300 1

PCB, FL 32408 Panama City, FL 32409

Contact: Dana Wadsworth dwadsworth@baycountyfl.gov

(850) 248-6052

Thomas Dr. Fire District Fire Services 96 Gal Tote $

2911 Allison Ave, 700 Hwy 2300 1

PCB, FL 32408 Panama City, FL 32409

Contact: Dana Wadsworth

Thomas Dr. Fire District Fire Services 2 CY Dumpster $

4024 Holiday Dr. 700 Hwy 2300 1

PCB, FL 32408 Panama City, FL 32409

Contact: Dana Wadsworth

West End Fire District Fire Services 4 CY Dumpster $

20800 PCB Pkwy 700 Hwy 2300 1

Laguna Beach, FL 32413 Panama City, FL 32409

Contact: Dana Wadsworth dwadsworth@baycountyfl.gov

(850) 248-6052

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Bidder agrees to perform all the work described in the Contract Documents for the following Unit Prices and Lump Sum Prices.

Service Location Bill To:

Container(s)/

Southport Fire District Fire Services 2 CY Dumpster $

2115 Hwy 2321 700 Hwy 2300 1

Southport, FL 32409 Panama City, FL 32409

Contact: Dana Wadsworth

Sandhills Fire District Fire Services 4 CY Dumpster $

13010 Hwy 77 700 Hwy 2300 1

Southport, FL 32409 Panama City, FL 32409

Contact: Dana Wadsworth

Bear Creek/Youngstown Fire Services 4 CY Dumpster $

11771 Hwy 231 700 Hwy 2300 1

Youngstown, FL 32466 Panama City, FL 32409

Contact: Dana Wadsworth

Bayou George Fire District Fire Services 2 CY Dumpster $

9033 Hwy 2301 700 Hwy 2300 1

Youngstown, FL 32466 Panama City, FL 32409

Contact: Dana Wadsworth

Hiland Park Fire Station Fire Services 4 CY Dumpster $

2801 Lafayette Road 700 Hwy 2300 1

Panama City, FL 32405 Panama City, FL 32409

Contact: Dana Wadsworth

EMS Beach Substation Emergency Medical Services 2 CY Dumpster $

10005 Hutchinson Boulevard 4931 Star Avenue North 1

Panama City Beach, FL 32407 Panama City, FL 32404

Contact: Dana Wadsworth grogers@baycountyfl.gov

(850) 248-6071

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Bidder agrees to perform all the work described in the Contract Documents for the following Unit Prices and Lump Sum Prices.

Service Location Bill To:

Container(s)/

EMS Headquarters Emergency Medical Services 6 CY Dumpster $

4931 Star Avenue North 4931 Star Avenue North 1

Panama City, FL 32404 Panama City, FL 32409

Contact: Dana Wadsworth grogers@baycountyfl.gov

(850) 248-6071

Tax Collector - Callaway Office Facilities Maintenance 95 Gal Tote $

805 S. Tyndall Parkway 840 W. 11th Street 1

Callaway, FL 32404 Panama City, FL 32401

Contact: Michelle Arnold marnold@baycountyfl.gov

(850) 248-8120

Tax Collector - Beach Office Facilities Maintenance 2 CY Dumpster $

10520 Middle Beach Road 840 W. 11th Street 1

PCB, FL 32407 Panama City, FL 32401

Contact: Michelle Arnold

Bay County Jail Facilities Maintenance (6) 8 CY Dumpster $

5700 Star Lane 840 W. 11th Street 3

Panama City, FL 32404 Panama City, FL 32401

Contact: Michelle Arnold

Bay County UF Extension Office Facilities Maintenance 8 CY Dumpster $

2728 E. 14th Street 840 W. 11th Street 1

Panama City, FL 32401 Panama City, FL 32401

Contact: Michelle Arnold

Bay County Facilities Maintenance Facilities Maintenance 30 CY Roll-off $

1326 N. James Ave. 840 W. 11th Street 1 Panama City, FL 32401 Panama City, FL 32401

Contact: Michelle Arnold C&D Roll-off marnold@baycountyfl.gov

(850) 248-8120

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Bidder agrees to perform all the work described in the Contract Documents for the following Unit Prices and Lump Sum Prices.

Service Location Bill To:

Container(s)/

H.G. Harders Park Parks & Recreation (2) 6 CY Dumpster $

8110 John Pitts Rd. 8110 John Pitts Road 2

Panama City, FL 32404 Panama City, FL 32404

Contact: Janie Lucas jlucas@baycountyfl.gov

(850) 248-8730

M.B. Miller Pier Parks & Recreation (2) 6 CY Dumpster $

12213 Front Beach Rd. 8110 John Pitts Road 2

PCB, FL 32412 Panama City, FL 32404

Contact: Janie Lucas

Pier Crew Yard Parks & Recreation 30 CY Roll Off $

7400 McElvey Road 8110 John Pitts Road 1

Panama City Beach, FL 32408 Panama City, FL 32404

Contact: Janie Lucas

Hiland Park Ball Field Parks & Recreation 6 CY Dumpster $

2117 Sherman Avenue 8110 John Pitts Road 1

Panama City, Florida, 32405 Panama City, FL 32404

Contact: Janie Lucas

Rick Seltzer Park Parks & Recreation 6 CY Dumpster $

7419 Thomas Drive 8110 John Pitts Road 1

Panama City Beach, Fl. 32408 Panama City, FL 32404

Contact: Janie Lucas

Simmons Park Parks & Recreation 6 CY Dumpster $

3023 New Church Road 8110 John Pitts Road 1

Southport, Florida, 32409 Panama City, FL 32404

Contact: Janie Lucas jlucas@baycountyfl.gov

(850) 248-8730

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Bidder agrees to perform all the work described in the Contract Documents for the following Unit Prices and Lump Sum Prices.

Service Location Bill To:

Container(s)/

Southport Sports Complex Parks & Recreation 8 CY Dumpster $

8598 Highway 77 8110 John Pitts Road 2

Southport, Florida, 32409 Panama City, FL 32404

Contact: Janie Lucas

Under the Oaks Park Parks & Recreation 6 CY Dumpster $

5817 E. Highway 98 Bus 8110 John Pitts Road 1

Panama City, FL 32404 Panama City, FL 32404

Contact: Janie Lucas

Majette Park Parks & Recreation 6 CY Dumpster $

5304 Old Majette Tower Road 8110 John Pitts Road 1

Panama City, FL 32404 Panama City, FL 32404

Contact: Janie Lucas

High Point Landing Parks & Recreation 6 CY Dumpster $

7925 County Road 8110 John Pitts Road 1

Panama City, FL 32404 Panama City, FL 32404

Contact: Janie Lucas

Lump Sum Monthly Price $

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Adding/Deleting Locations – The County may request additional services under this contract. Such services may include additional container locations and/or increase or decrease in the frequency of pickup. The pricing submitted below will be used for such services.

Number of Weekly Pickups

1x 2x 3x 4x 5x 96 Gal Tote $ $ $ $ $

Number of Weekly Pickups

Dumpster 1x 2x 3x 4x 5x 2 Cubic Yards $ $ $ $ $ 4 Cubic Yards $ $ $ $ $ 6 Cubic Yards $ $ $ $ $ 8 Cubic Yards $ $ $ $ $

Number of Weekly Pickups

Roll-Off Dumpster 1x 2x 3x 4x 5x 10 Cubic Yards $ $ $ $ $ 20 Cubic Yards $ $ $ $ $ 30 Cubic Yards $ $ $ $ $

Roll-Off Dumpster As Needed unscheduled pickup C&D roll-off container 10 Cubic Yards $ 20 Cubic Yards $ 30 Cubic Yards $

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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.

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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)

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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)

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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:

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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:

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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:

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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:

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