Bid_Documents_26-B-54LL,_C2072.pdf

C-2072 26-B-54LL

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BID DOCUMENTS

BIDDERS ARE TO USE THE DOCUMENTS PREPARED FOR THIS BID ONLY

BID CHECKLIST: BIDS SHALL INCLUDE THE FOLLOWING (RESPONSIVE):

Signed, dated, and completed bid proposal.

Delegation of authority if not an officer or principal of the firm.

Bid Form.

Completed Officers and Significant Stakeholders.

Bid Bond (use form provided), Power of Attorney & Financial Statement of Surety.

Experience/Completed projects.

Conflict of Interest.

Compliance with the Public Records Law.

Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions by Prime Contractor (Failure to submit a completed form MAY result in a non-responsive bid).

Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions by Sub-Contractor (Failure to submit a completed form MAY result in a non-responsive bid).

Notification Regarding Public Entity Crime and Discriminatory Vendor List Requirements and Disqualification Provision.

Trench Safety Act Compliance.

Drug-Free Workplace.

Hold Harmless (if applicable).

Completed and signed W9.

Reviewed Questions/Responses in OpenGov.

Certification Affidavit by Prime Contractor as Local Business (Failure to submit a completed form MAY result in a non-responsive bid).

Certification Affidavit by Sub-Contract as Local Business (Failure to submit a completed form MAY result in a non-responsive bid).

Certification Regarding Prohibition Against Contracting with Scrutinized Companies (Failure to submit a completed form MAY result in a non-responsive bid).

Completed Prime Contractor and Sub-Contractor Excel Form (Failure to submit the completed Excel form MAY result in a non-responsive bid).

Contractor’s license: Florida General Contractor

Proof of Insurance: Letter from insurance company or an ACORD form.

Human Trafficking Attestation Form

NOTE: Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion by All Sub- Contractors form is required with the submission of the bid documents from all Sub-Contractors.

*FAILURE TO SUBMIT THE ABOVE INFORMATION MAY RESULT IN A NON-RESPONSIVE BID;

AND THEREFORE, WILL NOT BE CONSIDERED FOR AWARD*

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IMPORTANT NOTICE TO BIDDER:

• The successful Bidder shall be required to submit an ACORD Form with the required insurance specified for the project upon a Recommendation of Award.

• Bid and the Payment and Performance Bond documents cannot be changed or altered after the Bid is submitted.

• Bidder is to only use the forms provided in this Bid document.

• Bid bond cannot be changed or altered and shall be provided on the forms included in this Bid document.

Additionally, if the bonds do not meet the required ratings listed in the Bid documents (Best’s Financial Strength’s Rating of “A” and the Financial Category of “Class X”), they will be rejected. New bonds meeting the requirements shall be resubmitted within five (5) days.

SCRUTINIZED COMPANIES-FL STATUTE SECTION 287.135 AND 215.473:

Contractor must certify that the company is not participating in a boycott of Israel. For Contracts for goods or services of one million dollars or more, Contractor must also certify that Contractor is not on the Scrutinized Companies that Boycott Israel List, not on the Scrutinized Companies with Activities in Sudan List, and not on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List or has not been engaged in business operations in Cuba or Syria.

Subject to limited exceptions provided in state law. The County will not contract for the provision of goods or services with (i) any company participating in a boycott of Israel, and (ii) for Contracts for goods or services of one million dollars or more, any other scrutinized company as described above. Contractor must submit the certification form (Included with required bid documents). Submitting a false certification shall be deemed a material breach of contract. The County shall provide notice, in writing, to the Contractor of the County's determination concerning the false certification. The Contractor shall have five (5) Calendar days from receipt of notice to refute the false certification allegation. If such false certification is discovered during the active contract term, the Contractor shall have ninety (90) days following receipt of the notice to respond in writing and demonstrate that the determination of false certification was made in error. If the Contractor does not demonstrate that the County's determination of false certification was made in error then the County shall have the right to terminate the Contract and seek civil remedies pursuant to Section 287.135, Florida Statutes, as amended from time to time.

B 3

BID PROPOSAL

Submitted ___________, 20___

Name Firm Address City, State, Zip Code

County of Volusia, Florida Purchasing and Contracts Division 123 West Indiana Avenue, Room 302 DeLand, Florida 32720-4608

Subject: BIRD FLIGHT CAGE POOLS

Dear Sir or Madam:

The undersigned, as bidder, hereby declares that the only person(s) interested in the project, as principal(s), is/are named herein and that no other person(s) other than herein mentioned has/have any interest in this project. Furthermore, that this bid is submitted without connection or arrangement with any other person (s), company (ies), or parties making a bid, and that the bid is in all respects fair and made in good faith without collusion or fraud.

The bidder further declares that it has examined the site of the work and that from his/her knowledge and experience, and/or that it has made sufficient test and/or other subsurface investigations to fully satisfy himself/herself that such site is correct and suitable for this work and it assumes full responsibility, and therefore, it has examined the drawings and specifications for the work and acknowledge from his/her experience, and/or from professional advice, that the drawings and specifications are sufficient for the work to be done, and also declaring it has examined the other contractual documents relating thereto, including the legal advertisement for bids, instructions to bidders, bid security or bid bond, contract, separate payment and performance bonds, general and special conditions, technical specifications, drawings and has read all addenda prior to the opening of bids, and that it has satisfied himself/herself fully, relative to all matters and conditions with respect to the work to which this project pertains.

The bidder proposes and agrees, if this bid is accepted, to contract with the County of Volusia, Florida in the form of the contract specified, to furnish all necessary materials, all equipment, all necessary machinery, tools, apparatus, means of transportation, and labor necessary to complete the work specified in the contract documents, and called for by the plans/drawings and specifications and in the manner specified. The bidder further proposes and agrees to comply in all respects with the time limits for commencement and completion of the work as stated in the contract.

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The bidder further agrees to execute a contract and, if required, furnish satisfactory separate one-hundred percent (100%) payment and performance bonds therefore, within ten (10) consecutive days after written notice being given by the County of the award of the contract, and the undersigned agrees that in case of failure on its part to execute the said contract and the contract bonds within the ten (10) consecutive days after the award of the contract, the cashier’s check or bid bond accompanying its bid and the money payable thereon shall be paid to the County of Volusia, Florida as liquidation of damages sustained by the County; otherwise the check accompanying the bid shall be returned to the undersigned after the contract is signed and contract bonds are recorded.

The undersigned agrees to accept in full compensation therefore the total lump sum prices named in the following schedule. It is understood that the unit prices quoted or established for a particular item are to be used for computing the amount to be paid to the contractor, based on the quantities actually constructed as determined by the applicable measurement and payment portion of the technical specifications.

The undersigned is duly authorized to execute this proposal/offer document and any contract (s) and/or other transactions required by award of this solicitation and acknowledge that the information provided in this bid is accurate and true.

Sincerely, Corporate or Authorized Signature

Print Name

Title

BID FORM

County of Volusia, Florida Purchasing and Contracts Division

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123 West Indiana Avenue, Room 302 DeLand, Florida 32720-4608

The undersigned hereby declare that _____________________________________________ has examined the plans and specifications with related documents and the site of the proposed work and, being familiar with all the conditions surrounding the construction of:

BIRD FLIGHT CAGE POOLS

Further declare ________________________________________________________ will furnish all permits, if required, supervision, labor, materials, supplies and equipment to construct the project in accordance with the contract documents, within the time set forth therein, and at the price stated below. The price is to cover all expenses incurred in performing the work required under the contract documents, of which this proposal is a part.

TOTAL BID PRICE: $ ___________________________________________________________________

(TOTAL BID PRICE in words)

Payment and Performance Bonds are not required for this project.

A 5% Bid Bond is required and executed on the bond form provided in this bid package.

The Bidder will be held responsible for any and all discrepancies, errors, etc., in discounts or rebates which are discovered during the Contract term or up to and including three (3) years following the County’s annual audit.

The County reserves the right to reject any or all bid proposals, to waive informalities, and to accept all or any part of any bid proposal as may deemed to be in the best interest of the County.

The County reserves the right to award based on the total bid price or a combination of total bid price and alternate bid price.

It is incumbent upon each bidder to carefully examine all specifications, terms, and conditions contained herein. Any inquiries, suggestions, or requests concerning interpretation, clarification or additional information shall be made in writing, through the Procurement Analyst. The County will not be responsible for any oral representation(s) given by any employee, representative or others. The issuance of a written addendum is the only official method by which interpretation, clarification or additional information can be given.

If it becomes necessary to revise or amend any part of this bid, notice may be obtained by accessing our web site. The bidder in the Bid Submittal form must acknowledge receipts of amendments by signing, dating, and returning the Addenda with the proposal. Each bidder should ensure that all addenda and amendments to this Bid have been received BEFORE submitting the bid. Check the Volusia County web site at http://vcservices.vcgov.org/bidlistnet1 for any addenda.

http://vcservices.vcgov.org/bidlistnet1

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Business Address: _____________________________________________________________________

City: _________________________________________ State: _________ Zip: _____________________

Phone: ( ) _________________ Fax: ( ) _______________ E-mail: ___________________________

License number (if applicable): _______________ Number of Years in Business: ________

DUNS#: _____________________________ (if available) Fed I.D. #: _____________________________

END OF BID FORM

B 7

OFFICERS AND SIGNIFICANT STAKEHOLDERS

Failure to list all officers and significant stakeholders of the business may prevent the proposal/offer from being considered for award.

President’s Name: _____________________________________________________________________

Address: _____________________________________________________________________________

Phone Number: _______________________________________________________________________

E-mail address: _______________________________________________________________________

Vice President’s Name: _________________________________________________________________

E-mail address: ________________________________________________________________________

Secretary’s Name: ______________________________________________________________________

Treasurer’s Name: _____________________________________________________________________

Project Manager’s Name: ________________________________________________________________

Phone Number: ________________________________________________________________________

Cell Number: __________________________________________________________________________

E-mail address: ________________________________________________________________________

Superintendent’s Name: _________________________________________________________________

Cell Number: _________________________________________________________________________

E-mail address: _______________________________________________________________________

B 8

BID BOND

STATE OF ) Bond no.:

COUNTY OF ) ss

KNOW ALL MEN BY THESE PRESENTS that __________________________________, as Contractor, duly authorized to conduct business in the State of Florida, whose principal place of business is located at

___________________________________________, Tel.: ____________, (hereinafter called “PRINCIPAL”), and

____________________________________________, as SURETY, duly authorized to conduct business in the State of Florida, whose principal place of business is located at ___________________________________________, Tel.:

____________ (hereinafter called “SURETY”), are held and firmly bound unto the County of Volusia, Florida, as

COUNTY, a body corporate and politic and a subdivision of the State of Florida, whose address is County of Volusia, 123 West Indiana Avenue, DeLand, Florida 32720, Tel.: ____________, (hereinafter called “OBLIGEE”), in the penal sum of _____________________________ dollars and (_____)/100 ($____________), lawful money of the United

States, for the payment of which sum will and truly to be made, whereof PRINCIPAL and SURETY bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

THE CONDITION OF THIS OBLIGATION IS SUCH that, whereas the Principal has submitted the accompanying bid, dated _______________________, 20___, for:

C-2072, 26-B-54LL, BIRD FLIGHT CAGE POOLS

4965 South Peninsula Drive, Ponce Inlet, FL 32127

Removal of two existing in-ground bird pools and design, construct and install two new pools

NOW, THEREFORE,

A. If the principal shall not withdraw said bid within one hundred twenty (120) days after date of opening of the same or the date of this bond, whichever occurs later, and shall within ten (10) days after the prescribed forms are presented to it for signature, enter into a written contract with the County in accordance with the bid as accepted, and give bonds with good and sufficient surety or sureties, as may be required, for the faithful performance and proper fulfillment of such contract, then the above obligations shall be void and of no effect, otherwise to remain in full force and virtue.

B. In the event of the withdrawal of said bid within the period specified, or the failure to enter into such contract and give such bonds within the time specified, if the principal shall pay the County the difference between the amount specified in said bid and the amount for which the County may procure the required work and supplies, if the latter amount be in excess of the former, then the above obligations shall be void and of no effect, otherwise to remain in full force and virtue.

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IN WITNESS WHEREOF, the above bounded parties have executed this instrument under their several seals, this _____ day of ______________, A.D. 20___, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body.

[Note: If the firm is a sole ownership or partnership including limited liability company, two (2) witnesses are required to attest the signature. If the firm is a corporation, then the corporate secretary shall attest and affix the corporate seal (Attach power of attorney to original bid bond and financial statement of Surety Company)].

PRINCIPAL: ATTEST:

Signature Signature Corporate Officer & Title Corporate Secretary (Affix Corporate Seal)

WITNESSESS:

SURETY: ATTEST:

Attorney-in-Fact (signature) Signature Name & Title Corporate Secretary (Affix Corporate Seal) Name of Local Resident Agent City, State, Zip

____________________________________________ WITNESS:

Telephone:

A.M. Best No.: __________ NAIC No. : _________ ___________________________________________

STATE OF _____________________________

COUNTY OF ___________________________

Before me this day personally appeared __________________________________________ (affiant), who, being duly sworn, deposes and says that he/she is the Attorney-in-Fact for the _____________________________________ (corporate surety) and that this person has been authorized by _________________________________ (corporate surety) to execute the forgoing bond on behalf of the Contractor named therein in favor of the County of Volusia, Florida.

Signature of Affiant

Sworn to / Affirmed and subscribed before me, by mean of ___ physical presence or ___ online notarization, this _____ day of

__________________, 20____, by _________________________________________, who is personally known to me or who produced

_______________________ as identification.

NOTARY PUBLIC – STATE OF

Type or print name: _________________________

Commission No.: ___________________________

Commission Expires: _______________________

(Seal)

END OF BID BOND

B 10

EXPERIENCE/COMPLETED PROJECTS

Firm’s Name: ________________________________________

List below the requested information concerning projects your organization has completed for the type of work required in this project (Use additional sheets, if necessary). A minimum of three (3) of the listed projects must have been completed for agencies/entities other than the County of Volusia.

Project Description Project Location

Contract Value Owner’s Name, Address, Phone, and E-mail

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HOLD HARMLESS AGREEMENT

I,____________________ (print officer/owner’s name), am the officer/owner of _______________________________ (print company name), an incorporated/unincorporated business operating in the State of Florida. As such, I am bound by all laws of the state of Florida, including but not limited to those regarding the workers’ compensation law.

I hereby affirm that I or [the above-named business] employs fewer than four employees, all of whom are listed below, including myself, and therefore, the business is exempt from the statutory requirement for workers’ compensation insurance for its employees. I certify that I will provide the County of Volusia with the name of each new employee together with all required waivers and releases for each prior to any employee being allowed to work to provide services under the contract set forth below. If any such employee is allowed to work without a signed waiver and release, such action will be a material breach of this Agreement. All signed waivers and releases shall be furnished before the commencement of any work by an employee or the undersigned to the County Project Manager or designated county representative.

On ______________, 20___, the County of Volusia and I or [the above-named business] entered into a contract for

___________________________________________________ (please insert name of contract) (hereinafter “Agreement”) which is incorporated by reference herein.

On behalf of myself, my business, and the employees listed below, I and they hereby agree to waive and release any and all workers’ compensation claims or liens under Chapter 440, Florida Statutes, against the County of Volusia and its agents, officials and employees, arising from any work or services provided under the Agreement whether or not it shall be alleged or determined that the act was caused by intention, or through negligence or omission of the County of Volusia or its agents, officials and employees or subcontractors.

In the event that a workers’ compensation claim or lien is made against the County of Volusia and/or its agents, officials or employees by myself or my employees or agents as a result of any work or services performed under the Agreement, I agree to indemnify, keep and hold harmless the County of Volusia, Florida, its agents, officials and employees, against all injuries, deaths, losses, damages, claims, liabilities, judgments, costs and expenses, direct, indirect or consequential (including, but not limited to, fees and charges of attorneys and other professionals) arising out of the Agreement with the County of Volusia, whether or not it shall be alleged or determined that the act was caused by intention or through negligence or omission of the County of Volusia or its employees, agents, or subcontractors. I or the above-named business shall pay all charges of attorneys and all costs and other expenses incurred in connection with the indemnity provided herein, and if any judgment shall be rendered against the County of

Volusia in any action indemnified hereby, I or the above-named business shall, at my or its own expense, satisfy and discharge the same. The foregoing is not intended nor should it be construed as, a waiver of sovereign immunity of the COUNTY OF VOLUSIA under Section 768.28, Florida Statutes.

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Page 2 of 2: Hold Harmless Agreement

Officer/Owner: _____________________________ (print name) _____________________________ (signature)

Employee 1: _____________________________ (print name) _____________________________ (signature)

Employee 2: _____________________________ (print name) _____________________________ (signature)

Employee 3: _____________________________ (print name) _____________________________ (signature)

STATE OF _____________________________

COUNTY OF ___________________________

Sworn to and subscribed before me, by means of ___ physical presence or ___ online notarization, this ____ day of

________________, 20____, by ______________________

________________________________________________, who is/are personally known to me or who has/have produced

____________________________________________________________________________ as identification.

NOTARY PUBLIC – STATE OF ________________

Type or print name:

Commission No.:____________________________

Commission Expires: __________________________

B 13

CONFLICT OF INTEREST DISCLOSURE

I HEREBY CERTIFY that

1. I, (printed name) __________________________________________________________, am the (title)

___________________________________ and the duly authorized representative of the firm of (Firm Name)

_________________________ whose address is ____________________________, and that I possess the legal authority to make this affidavit on behalf of myself and the firm for which I am acting; and,

2. Except as listed below, no employee, officer, or agent of the firm have any conflicts of interest, real or apparent, due to ownership, other clients, contracts, or interests associated with this project; and,

3. This bid submittal is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a bid for the same services, and is in all respects fair and without collusion or fraud.

EXCEPTIONS to items above (List):________________________________________________________

By ________________________________________ Date _______________ (Print Name)

(Signature)

By ________________________________________ (Print Corporate Officer’s Title)

B 14

COMPLIANCE WITH THE PUBLIC RECORDS LAW

Upon award recommendation or thirty (30) days after opening, submittals become "public records" and shall be subject to public disclosure consistent with Chapter 119, Florida Statutes. Bidders must invoke the exemptions to disclosure provided by law in the response to the solicitation, and must identify the data or other materials to be protected, and must state the reasons why such exclusion from public disclosure is necessary. The submission of a bid authorizes release of the firm’s credit data to the County of Volusia.

If the company submits information exempt from public disclosure, the company must identify with specificity which pages/paragraphs of their bid/bid package are exempt from the Public Records Act. The protected information must be submitted to the County in a separate envelope marked accordingly.

By submitting a response to this solicitation, the firm agrees to defend the County in the event we are forced to litigate the public records status of the company’s documents.

Name and Title

Signature

Firm

Street address

City, State, Zip

Date

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Certification Regarding Debarment, Suspension, Ineligibility

And Voluntary Exclusion

TO BE COMPLETED BY PRIME CONTRACTOR

1) The prospective primary participant (contractor) certifies to the best of its knowledge and belief, that it and its principals (subcontractors and suppliers):

(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;

(b) Have not within a three-year period preceding this bid proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.

(c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and

(d) Have not within a three (3) year period preceding this bid proposal had one or more public transactions

(Federal, State, or local) terminated for cause or default.

2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this bid proposal.

Name and Title

Signature

Firm

Street address

City, State, Zip

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Certification Regarding Debarment, Suspension, Ineligibility

And Voluntary Exclusion

TO BE COMPLETED BY ALL SUB-CONTRACTORS

1. The prospective participant (sub-contractor) certifies to the best of its knowledge and belief, that it and its principals (subcontractors and suppliers):

a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;

b. Have not within a three (3) year period preceding this bid proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.

c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and

d. Have not within a three-year period preceding this bid proposal had one or more public transactions

(Federal, State, or local) terminated for cause or default.

2. Where the prospective participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this bid proposal.

Name and Title

Signature

Firm

Street address

City, State, Zip

B 17

Notification Regarding Public Entity Crime and Discriminatory Vendor List Requirements and Disqualification Provision:

A. Pursuant to Florida Statutory requirements, potential Bidders are notified:

287.133(2)(a): A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list.

287.133(2)(b): A public entity may not accept any bid, proposal, or reply from, award any contract to, or transact any business in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO with any person or affiliate on the convicted vendor list for a period of 36 months following the date that person or affiliate was placed on the convicted vendor list unless that person or affiliate has been removed from the list pursuant to paragraph (3)(f). A public entity that was transacting business with a person at the time of the commission of a public entity crime resulting in that person being placed on the convicted vendor list may not accept any bid, proposal, or reply from, award any contract to, or transact any business with any other person who is under the same, or substantially the same, control as the person whose name appears on the convicted vendor list so long as that person's name appears on the convicted vendor list.

287.134(2)(a): An entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or public work;

may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and may not transact business with any public entity.

287.134(2)(b): A public entity may not accept any bid, proposals, or replies from, award any contract to, or transact any business with any entity or affiliate on the discriminatory vendor list for a period of 36 months following the date that entity or affiliate was placed on the discriminatory vendor list unless that entity or affiliate has been removed from the list pursuant to paragraph (3)(f). A public entity that was transacting business with an entity at the time of the discrimination resulting in that entity being placed on the discriminatory vendor list may not accept any bid, proposal, or reply from, award any contract to, or transact any business with any other entity who is under the same, or substantially the same, control as the entity whose name appears on the discriminatory vendor list so long as that entity's name appears on the discriminatory vendor list.

B. By submitting a proposal, the Bidder represents and warrants that the submission of its proposal does not violate Section

287.133, Florida Statutes (2005), nor Section 287.134, Florida Statutes (2005) or their successor.

C. In addition to the foregoing, the Bidder represents and warrants that Bidder, Bidder’s subcontractors and Bidder’s implementer, if any, is not under investigation for violation of such statutes.

D. Bidder should read carefully all provisions of 287.133 and 287.134, Florida Statutes (2005).

Note: Bidder shall complete the “Certification regarding debarment, suspension, and eligibility (Bidder)” and the “Certification regarding debarment, suspension, and eligibility (sub-contractors).”

Print Name & Title: ___________________________________________________ Date: ____________________

Signature: _________________________________________________

B 18

TRENCH SAFETY ACT COMPLIANCE

Section 553.60 to 553.64, Florida Statutes, incorporated the Occupational Safety and Health Administration’s (OSHA) safety standards, 29 CFR s: 1926.650 to 1926.652, Subpart P, as the State Standard. The Department of Labor and Employment Security may adopt updated or revised versions by rule. Other state or political subdivisions may also have standards that are applicable.

If trench excavation in excess of five (5) feet in depth will be required on the project, the contractor shall identify the cost of compliance with the applicable trench safety standards below. If there will be no trench excavation in excess of five feet in depth on the project, write “not applicable” below.

The contractor shall comply with all applicable trench safety standards, during all phases of the work, if awarded the contract. Additionally, the contractor shall ensure that all subcontractors comply with the Act.

Contractor acknowledges that costs for complying with the Trench Safety Act (90-96, Laws of FL), effective October 1, 1990, are included in the bid price and hereby gives assurance that, if awarded the contract, the contractor or subcontractor performing trench excavation work on the project shall comply with the applicable trench safety standards.

The contractor further identifies the cost as follows:

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

Cost A.

B.

C.

D.

E.

F.

TOTAL:

If applicable, this certifies that all trench excavation done within the control of the contractor shall be in accordance with all applicable standards and with the specifications and all requirements of Sections 553.60 to 553.64, Florida Statutes.

FAILURE TO COMPLETE THE ABOVE MAY RESULT IN THE BID BEING DECLARED NON-

RESPONSIVE.

(Additional sheets shall be attached, as needed, and items shall be organized to correspond with the bid format).

Name and Title Date Signature Firm Street address

City, State, Zip

B 19

DRUG-FREE WORK PLACE

The undersigned firm in accordance with Florida statute 287.087 hereby certifies that

___________________________________________does:

(Name of Firm)

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 proposed 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 propose by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contender 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 any 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 that this firm complies fully with the above requirements.

Print Name Date

Title

Signature

Street address

City, State, Zip

B 20

CERTIFICATION AFFIDAVIT BY PRIME CONTRACTOR

AS LOCAL BUSINESS

This form must be signed.

1. This statement is submitted to County of Volusia, Florida Purchasing and Contracts:

By: ____________________________________________________________________ (Authorized individuals name and title)

For: ____________________________________________________________________ (Name of Company/Individual submitting statement)

2. Local Preference Eligibility:

A. Vendor has been in business for a minimum of six (6) months prior to the date of bids or quote

____Yes _____No

B. Vendor acknowledges the ability to provide proof of local business presence in the form of a business tax receipt from a local jurisdiction if required, per Volusia County local preference ordinance found at https://www.volusia.org/core/fileparse.php/4537/urlt/Local-Preference-from-MuniCode.pdf

____Yes _____ No

I understand that the submission of this form to the contracting officer for Volusia County, Florida, is valid through the end of term of the awarded Agreement. I also understand that failure to notify the County of Volusia of a change in address out of the local area may result in breach of Agreement.

(Signature)

B 21

CERTIFICATION AFFIDAVIT BY SUB-CONTRACTOR

AS LOCAL BUSINESS

This form must be signed.

1. This statement is submitted to County of Volusia, Florida Purchasing and Contracts:

By: ____________________________________________________________________ (Authorized individuals name and title)

For: ____________________________________________________________________ (Name of Company/Individual submitting statement)

2. Local Preference Eligibility:

A. Vendor has been in business for a minimum of six (6) months prior to the date of bids or quote

____Yes _____No

B. Vendor acknowledges the ability to provide proof of local business presence in the form of a business tax receipt from a local jurisdiction if required, per Volusia County local preference ordinance found at

____Yes _____ No

I understand that the submission of this form to the contracting officer for Volusia County, Florida, is valid through the end of term of the awarded Agreement. I also understand that failure to notify the County of Volusia of a change in address out of the local area may result in breach of Agreement.

(Signature)

B 22

CERTIFICATION REGARDING PROHIBITION

AGAINST CONTRACTING WITH SCRUTINIZED COMPANIES

I hereby certify that neither the undersigned entity, nor any of its wholly owned subsidiaries, majority-owned subsidiaries, parent companies, or affiliates of such entities or business associations, that exists for the purpose of making profit have been placed on the Scrutinized Companies that Boycott Israel List created pursuant to s. 215.4725 of the Florida Statutes, or are engaged in a boycott of Israel.

In addition, if this solicitation is for a contract for goods or services of one million dollars or more, I hereby certify that neither the undersigned entity, nor any of its wholly owned subsidiaries, majority- owned subsidiaries, parent companies, or affiliates of such entities or business associations, that exists for the purpose of making profit are on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to s.215.473 of the Florida Statutes, or are engaged in business operations in Cuba or Syria as defined in said statute.

I understand and agree that the County may immediately terminate any contract resulting from this solicitation upon written notice if the undersigned entity (or any of those related entities of respondent as defined above by Florida law) are found to have submitted a false certification or any of the following occur with respect to the company or a related entity: (i) it has been placed on the Scrutinized Companies that Boycott Israel List, or is engaged in a boycott of Israel, or (ii) for any contract for goods or services of one million dollars or more, it has been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or it is found to have been engaged in business operations in Cuba or Syria.

Name of Respondent:

By: (Authorized Signature)

Title:

Date: __________________________________

B 23

Contractor Name: ________________________________________________

HUMAN TRAFFICKING ATTESTATION

PURSUANT TO SECTION 787.06, FLORIDA STATUTES

Name of Entity/Contractor: ("Nongovernmental Entity")

This form has been completed by a duly authorized officer or representative of the Nongovernmental Entity in conjunction with the execution, renewal, or extension of a contract with County of Volusia, a governmental entity and political subdivision of the State of Florida, ("Governmental Entity") in compliance with Section 787.06(14), Florida Statutes, (2025).

The Nongovernmental Entity acknowledges that Section 787.06(14), Florida Statutes, provides that when a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services. For purposes of this requirement, “labor” means work of economic or financial value and “services” means any act committed at the behest of, under the supervision of, or for the benefit of another. The term, “services” includes, but is not limited to, forced marriage, servitude, or the removal of organs.

Pursuant to Section 787.06, Florida Statutes, when a contract is executed, renewed, or extended between you, a nongovernmental entity, and Volusia County, a governmental entity in the State of Florida, you are hereby providing this affidavit under penalties of perjury that you do not use coercion for labor or services. Coercion includes, without limitation, using or threatening to use physical force against any person; restraining, isolating, or confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his will; using lending or other credit methods to establish a debt by any person when labor or services are pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined;

destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person; causing or threatening to cause financial harm to any person; enticing or luring any person by fraud or deceit; or providing a controlled substance as outlined in Schedule I or Schedule II of Section 893.03, Florida Statutes, to any person for the purpose of exploitation of that person.

This signed attestation is provided to the Governmental Entity to comply with the statutory requirement. If, at any time in the future, the Nongovernmental Entity does use coercion for labor or services, the Nongovernmental Entity will immediately notify the Governmental Entity and no contracts may be executed, renewed, or extended between the parties.

This attestation is made for the benefit of, and reliance by, the Governmental Entity.

Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated in it are true.

Printed Name:

Title: _______

Signature: Date: