Attachment H: G702 Sample Form Summary

This file is a sample G702 form (Application and Certificate for Payment) attachment prepared by Citrus County, Florida's Department of Management & Budget for Invitation to Bid 25-111, which concerns the milling and resurfacing of S. Apopka Avenue from US 41 to E. Anna Jo Drive, spanning approximately 3.6 miles of roadway. The project is divided into two segments with varying specifications: the first segment (US 41 to Daffodil Street) requires minimum 2.25-inch milling with 2.25 inches of FC-12.5 asphalt using PG 76-22 polymer-modified binder at Traffic Level C, while the second segment (Daffodil Street to E. Anna Jo Drive) requires uniform 2.5-inch milling followed by two 1.5-inch lifts of the same asphalt specification. The mandatory pre-bid conference is scheduled for March 3, 2026 at 10:00 AM via Microsoft Teams, the written questions deadline is March 13, 2026 at 4:00 PM, and bids are due March 24, 2026 at 2:00 PM with public opening at 2:15 PM. Board approval is anticipated for June 22, 2026, and the contractor must achieve Substantial Completion within 90 calendar days and Final Completion within 120 calendar days of the Notice to Proceed.

The project is funded entirely through a Florida Department of Transportation Small County Outreach Program (SCOP) grant (Financial Project Number 449062-1-54-01), with the County budgeting approximately $1,630,270. Pricing shall be submitted on a unit price basis with all asphalt paid at the contract unit price per ton regardless of actual depth or quantities required. Bidders must be prequalified by FDOT in Hot Plant-Mixed Bituminous Courses, and either the prime contractor or a direct subcontractor must hold FDOT prequalification in Pavement Marking. A five percent bid security is required, and successful bidders with total base bids of $100,000 or greater must provide Payment and Performance Bonds each equal to 100 percent of the bid amount. Required insurance includes Commercial General Liability of $1,000,000 per occurrence, Automobile Liability of $1,000,000 combined single limit, Workers Compensation with Employer's Liability limits of $100,000 each accident, and Cyber Insurance of $1,000,000 per claim. Liquidated damages are assessed at $1,685 per day for delays beyond Final Completion dates. A one-year warranty on all materials, equipment, and workmanship effective from the date of final completion is required.