ITB-2025-05_Locklin_Lake_Restoration-Maintenance_Dredge.pdf

Page 1 of 22 Company Name

City of Milton P.O. Box 909, MILTON, FL 32572

Phone: (850) 983-5480

M E M O R A N D U M

TO: Interested Parties

FROM: Michele Williams, Purchasing Officer

RE: ITB 2025.05 Locklin Lake Restoration - Maintenance Dredge Project

DATE: March 13, 2025

Notice is hereby given that the City of Milton (City), will receive sealed bids for ITB 2025.05

Locklin Lake Restoration - Maintenance Dredge Project. The documents contain the necessary information for preparing and submitting your bid for this effort.

Information is available on the City’s web page at https://MiltonFL.org/322/Purchasing. There you may also register through BidNetDirect.com/florida/city-of-milton (there is no charge to join);

and/or through DemandStar.com (there is no charge to join); and/or through Office of Supplier

Diversity (there is no charge to join).

All must review the Project Description and Terms and Conditions as described in this document to ensure their ability to perform as indicated.

The deadline for submitting your sealed bid/proposal is:

Wednesday, April 16, 2025 at 2:00 p.m. (CST)

Hand Delivered: 6738 Dixon Street, Milton, Florida 32570

Mailed: 6738 Dixon Street, Milton, Florida 32570

Bids will be opened on Wednesday, April 16, 2025 at 2:00 p.m. (CST), at the City of Milton

Council Chamber located at 6738 Dixon Street, Milton, Florida 32570.

Questions should be submitted in writing and directed to the Purchasing department via e-mail to mwilliams@miltonfl.org by Wednesday, April 2, 2025, at 2:00 p.m. (CST), and the contact number for the Purchasing department is (850) 983-5480. Answers will be posted in an addendum on the

City webpage, Bid Net Direct, DemandStar.com, and Office of Supplier Diversity by Wednesday, April 9, 2025, at 2:00 p.m. (CST).

The Project Manager contact is Jason Frick, PE, 449 W Main Street, Pensacola, Florida, 32502, phone number: (850) 438-9661, email: jfrick@baskervilledonaovan.com. Sealed bids will be accepted by the City of Milton at 6738 Dixon Street, Milton, FL 32570 for the Project.

Interpretations, clarification of specifications, and requirements or changes to the documents which have a material effect will be documented and communicated only by written addendum posted on the City’s web page, Bidnet Direct, DemandStar, and Office of Supplier Diversity. All are responsible for checking for any addendums that may be issued, and to obtain such addendums.

Michele Williams Michele Williams, Purchasing Officer https://miltonfl.org/322/Purchasing https://www.bidnetdirect.com/florida/city-of-milton https://network.demandstar.com/ https://www.dms.myflorida.com/business_operations/state_purchasing/office_of_supplier_development_osd/vendor_resources/current_bid_opportunities https://www.dms.myflorida.com/business_operations/state_purchasing/office_of_supplier_development_osd/vendor_resources/current_bid_opportunities mailto:jfrick@baskervilledonaovan.com.

Page 2 of 22 Company Name

INSTRUCTIONS

ITB 2025.05 Locklin Lake Restoration - Maintenance Dredge Project I. Deadlines/Dates:

▪ Invitation to Bid Published: Thursday, March 13, 2025

▪ Questions Deadline: Wednesday, April 02, 2025 @ 2:00 p.m. (CST)

▪ Answers Posted by: Wednesday, April 09, 2025 @ 2:00 p.m. (CST)

▪ Bids Due: Wednesday, April 16, 2025 p.m. (CST)

II. Contact Information:

Contact: Michele Williams, Purchasing Officer

Phone: (850) 983-5480

Email: mwilliams@miltonfl.org

III. Bids Must be Complete and Include:

1. Bidder’s/Proposer’s Declaration (page 3-4)

2. Bid Form (page 07)

3. References (page 15)

4. Public Entity Crime Form F.S. 287.133(3)(A) (page 16-17)

5. Drug-Free Workplace Form F.S. 287.087 (page 18)

6. Non-Collusion Affidavit (page 19)

7. Conflict of Interest Disclosure Form (page 19)

8. E-Verify Statement of Compliance (page 20)

9. Certificate Regarding Debarment (page 21)

IV. Copies: Please provide one (1) electronic copy, one (1) original, and one (2) copy of your bid/proposal.

V. Faxed or emailed submittals are not accepted.

Submittals can be delivered to: City of Milton

Attn: Purchasing Department

6738 Dixon Street

Milton, Florida 32570

Submittals must be sealed and marked:

To: City of Milton

VENDOR Name:

SEALED BID * DO NOT OPEN

Sealed ITB# 2025.05

Title: ITB 2025.05 Locklin Lake Restoration - Maintenance Dredge Project

DUE DATE/TIME: April 16, 2025 / 2:00 p.m. (CST) mailto:mwilliams@miltonfl.org

Page 3 of 22 Company Name

BIDDER’S/PROPOSER’S DECLARATION

ITB 2025.05 Locklin Lake Restoration - Maintenance Dredge Project

The bidder/proposer understands, agrees, and warrants:

1. These items apply to and become a part of the terms and conditions of the bid/proposal submitted. Any exceptions must be in writing.

2. All bids submitted shall be subject to acceptance or rejection. The City of Milton specifically reserves the right to accept or reject any or all bids, to waive any technicalities and formalities in the bid process, and to award the bid in part or in any manner deemed to be in the best interest of the City.

3. All proposals submitted shall be subject to acceptance or rejection. The City of Milton specifically reserves the right to accept or reject any or all proposals, to waive any technicalities and formalities in the proposal process, and to award the proposal in part or in any manner deemed to be in the best interest of the City.

4. The City of Milton is exempt from sales tax.

5. Contractors are responsible for any sales tax on purchases for the project.

6. The City of Milton Florida will receive sealed bids from interested parties at Milton City Hall located at 6738 Dixon Street, Milton, FL 32570. Any submittals received after the deadline will not be considered.

7. Bids/proposals will be publicly opened and read at City Hall located at 6738 Dixon Street, Milton, FL 32570, on the submission deadline date.

8. The City of Milton may consider as non-responsive, any bid/proposal in which there is an alteration of, or departure from the bid/proposal form hereto attached.

9. The bid/proposal will be awarded according to criteria stated under Terms and Conditions, Section S of this Invitation to Bid.

10. Interested Parties shall submit all required forms and information simultaneously with their sealed bid/proposal. Forms and information become a part of the property of the City of Milton and will not be returned to the firm unless a written request to withdraw is received prior to opening of bids/proposals.

11. For Bids-Additional Quantities: For a period not exceeding twelve (12) months from the day of the solicitation opening, the right is reserved to purchase any number of additional items at the prices offered in this solicitation. If additional quantities are not acceptable, the bid form shall be noted “offer is for specified quantity only.”

12. For Bids/NOTE: Unless stated on the bid form, the bid submitted will assume all specifications will be met. Please note all exceptions on the bid form.

13. The successful bidder/proposer will be required to submit additional forms, which are available on the City’s website at https://MiltonFL.org/322/Purchasing at the bottom of the page.

▪ Certificate of Non-Discrimination

▪ W-9 Taxpayer Identification Number

▪ Vendor Application

▪ Certificates for Liability, Vehicle, and Worker’s Comp Insurance.

(City of Milton is to be named as additional insured.) Limitations are listed online.

▪ Prompt Payment Affidavit

14. That they have carefully read and fully understand the full scope of the specifications.

15. That they have the capability to successfully undertake and complete the responsibilities and obligations in said specifications.

https://miltonfl.org/322/Purchasing

Page 4 of 22 Company Name

16. All bidders/proposers are responsible for checking for any addendums that may be issued.

Addendums are posted on the City web page, Bid Net Direct, and DemandStar.

17. If required- That they have Liability Insurance, and/or Vehicle and Workers Comp Insurance. (A declaration of insurance form must be provided before any work will begin.)

18. (Service Contracts Only) Pursuant to Florida Statute 119, the contractor must follow all public records law. IF THE CONTRACTOR HAS QUESTIONS

REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA

STATUTES, TO THE CONTRACTOR’S DUTY TO PROVIDE PUBLIC

RECORDS RELATING TO THIS CONTRACT, CONTACT THE

CUSTODIAN OF PUBLIC RECORDS AT (850)983-5402,

FOIA@MiltonFL.org OR P.O. BOX 909, MILTON, FL 32572. A contractor who fails to provide the public records to the City within a reasonable time may also be subject to penalties under Florida Statute 119.10.

19. For all Contracts - Contractors should take all necessary affirmative steps to assure that minority businesses, women’s business enterprises, and labor surplus area firms are used when possible. (Appendix II Part 200 of 2 CFR 200 (B) gov.info)

20. That this bid/proposal may be withdrawn by requesting such withdrawal in writing at any time prior to opening date but may not be withdrawn after such date and time.

21. That by submission of this bid/proposal the firm acknowledges that the City of Milton has the right to make any inquiry or investigation it deems appropriate to substantiate or supplement information supplied by the firm.

22. For partnerships, a general partner must sign any bid/proposal, while for corporations, an authorized corporate officer(s) must sign, and the corporate seal must be affixed.

23. Recommendations are posted on City’s web page via agendas prior to award.

24. Any protests are handled per the City’s Purchasing Policy and F.S. 120.57(3).

Bidder

(Company Name)

(Address, City, State, Zip)

Phone Email

Contact Name Title

Representative Signature Date mailto:FOIA@MiltonFL.org https://www.govinfo.gov/app/details/CFR-2014-title2-vol1/CFR-2014-title2-vol1-part200-appII

Page 5 of 22 Company Name

ITB 2025.05 Locklin Lake Restoration - Maintenance Dredge Project

PROJECT DESCRIPTION

Prepared by Project Engineer: Baskerville-Donovan, Inc., 449 West Main Street, Pensacola, FL 32502

The City of Milton has requested to maintain the maintenance dredge/excavate Locklin Lake to maintain the facilities treatment component by removing sediment that has accumulated through stormwater runoff into the lake. Locklin Lake is located to the east of the Santa Rosa County, parcel number 03-1N-28-2530-

08900-0172.

Locklin Lake features a dam located on the eastern side of the lake, which regulates the lake’s water surface elevation. The dam incorporates a sluice gate mechanism, allowing controlled water level adjustments to facilitate operational and maintenance activities. In preparation for the proposed maintenance dredging and excavation operations, the City of Milton has lowered the lake's water level by fully utilizing the sluice gate, effectively draining the lake and exposing the lakebed.

The proposed excavation cut sections vary in bottom width and elevation, depending on the stationing along the project alignment, and incorporate a 3:1 side slope design for stability. The recommended sections are informed by the existing adjacent lakebed elevations.

The dredging operation will utilize mechanical excavation methods. With the lakebed fully drained, contractors will have direct access to excavate the material, streamlining both the dredging process and material handling. The lakebed material has been exposed and air-dried for months, minimizing or eliminating the need for additional dewatering prior to disposal. The equipment and methodology for the mechanical dredging operation are outlined as follows.

Mechanical dredging will be conducted using bulldozers, front-end loaders, or excavators to collect and transport material from the lakebed. The dredged material will be transferred to an upland Dredge Material

Management Area (DMMA).

The DMMA will be situated on a private upland parcel, previously utilized by the City of Milton for dam construction and initial dredging activities. Permission for the current staging and management use has been obtained from the landowner. The DMMA will be enclosed with a double row of FDOT Type IV silt fencing and supplemented with hay bales for sediment control.

Dredged material will remain within the DMMA until adequately dried, if further dewatering is necessary, prior to disposal. The material will be transported off-site to an approved landfill or disposed of through other legal means. The dredged material will not be utilized for wetland fill, structural fill, or any placement within a water body. Furthermore, the material will not be disposed of on public property or used for public purposes.

Best management practices will be utilized during construction to minimize the potential for erosion and sedimentation. Silt fences will be installed at the limits of the dredge material maintenance area prior to the start of dredging operations. The erosion control facilities shall be maintained throughout the dredging period and until final dredging depths are achieved and approved by the engineer.

Page 6 of 22 Company Name

A. General: Project name is Locklin Lake Restoration – Maintenance Dredge

B. Briefly and without force and effect upon the contract documents, the work of the Contract can be summarized as follows:

1. Construct a spoil cell and receive dredge material and install necessary turbidity/erosion control measures.

2. Perform mechanical maintenance dredging along the lakebed of Locklin Lake.

3. Remove unsuitable materials from the site and legally dispose of.

4. Restore the spoil cell site to preconstruction condition.

C. The work includes but may not be limited to the following:

1. Place and maintain erosion control devices.

2. Place control and limits of construction markers.

3. Create spoil cell adjacent to dredge site as shown in the plan set.

4. Maintain drainage conveyance for base flow into lake.

5. Remove unsuitable materials from the site.

6. Provide testing, means and methods necessary to prevent sediment from leaving the site or exceeding allowable tolerances.

7. Return the spoil cell site and adjacent easements to preconstruction conditions.

22 Company Name

BID FORM

Date: February 2025

LOCKLIN LAKE RESTORATION - MAINTENANCE DREDGE

Bid Form Release for Bid Prepared by: MDD Re viewed By: JJF

Item No.

Item Description Item Qty.

Qty.

Unit

Unit Price

Extended Amount

CONSTRUCTION PREPARATION

C-1 Mobilization/Demobilization 1 LS

C-2 Erosion Control 1 LS

Subtotal

EXCAVATION AND TESTING

D-1 Lake Dredging 1 LS

D-2 Turbidity Monitoring (Note 18, C-101) 1 LS

D-3 Spoil Disposal 1 LS

Subtotal

FINAL SITE PREPARATION

F-1 Site Restoration 1 LS

F-2 Provided As-Builts 1 LS

Subtotal

PERMITS

P-1 NPDES Permit/SWPPP and Implementation 1 LS

P-2 NPDES Permit Fee 1 EA

Subtotal

Total Base Bid:

PAYMENT SCHEDULE SUMMARY

Total cost and time to complete the Locklin Lake Restoration – Maintenance Dredge as indicated in the

Locklin Lake Restoration – Maintenance Dredge project description and engineering construction plans:

Expected Completion Date _______________

FIRM NAME

ADDRESS

CITY, STATE, ZIP

TELEPHONE

E-MAIL

Authorized Representative (Please Print or Type)

SIGNATURE

DATE

TERMS AND CONDITIONS

Please review these Terms and Conditions carefully.

A. LICENSES/QUALIFICATIONS:

1. All Contractors, together with any Sub-Contractors, must be qualified and licensed under the applicable regulations to perform the work required herein. Contractor’s qualifications including equipment to be used for this project will be subject to review and approval by the City prior to award of bid. Contractor must be prepared to demonstrate, through previous experience and references, the ability to safely and successfully perform this pipeline project.

B. INSURANCE:

1. Contractor shall obtain and maintain the minimum insurance coverage set forth below. By requiring such minimum insurance, the City of Milton shall not be deemed or construed to have assessed the risk that may be applicable to the Contractor. Contractor shall assess its own risks and if it deems appropriate and/or prudent, maintain higher limits and/or broader coverage. Contractor is not relieved of any liability or other obligations assumed or pursuant to the Contract by reason of its failure to obtain or maintain insurance in sufficient amounts, duration, or types.

2. Contractor shall carry the following limits of liability as required below: Dollar amounts may change in accordance with the event or project.

Commercial General Liability - ISO CG 001 Form or equivalent.

General Aggregate $1,000,000

Products/Completed Operations Aggregate $1,000,000

Each Occurrence Limit $1,000,000

Personal/advertising Injury $1,000,000

Fire Damage (Any One Fire) $50,000

Medical Payments (Any One Person) $5,000

Automobile Liability

Bodily Injury/Property Damage $1,000,000 each accident

Personal Injury Protection (PIP) Statutory

Workers' Compensation

Coverage A (Workers' Compensation) Statutory

Coverage B (Employers Liability):

➢ Each Accident $100,000

➢ Disease-Each Employee $500,000

➢ Disease-Policy Limit $100,000

SUBCONTRACTORS:

3. Contractor may not subcontract work under this Agreement without the express written permission of the City of Milton. If Contractor has received authorization to subcontract work, it is agreed that all subcontractors performing work under the Agreement must comply with its provisions. Further, all agreements between Contractor and its subcontractors must provide that the terms and conditions of this Agreement be incorporated therein. Contractor may utilize a subcontractor for the proposed regulator station and farm taps with notification and written approval from City of Milton.

C. CONTINUATION DURING DISPUTES:

1. Contractor agrees that during any dispute between the parties, Contractor will continue to perform its obligations until the dispute is settled, instructed to cease performance by the City, enjoined or prohibited by judicial action, or otherwise required or obligated to cease performance by other provisions in this Agreement.

D. TERMINATION FOR CONVENIENCE:

1. The City reserves the right to terminate this Agreement in part or in whole upon thirty (30) calendar days’ written notice.

E. LIQUIDATED DAMAGES:

1. In the event the bidder is awarded the contract and fails to complete the work within the time limit or extended time limit agreed upon, liquated damages will be paid to the City at the amount not to exceed actual damages incurred by the City per day.

F. BID BOND

1. Each bid must be accompanied by a bid bond payable to the City for five percent (5%) of the total amount of the bid. As soon as the bid prices have been checked and compared, the City will return the bonds of all except the three lowest bidders. When the contract is executed, and the payment and performance bonds have been executed and approved, the bid bonds of the remaining bidders will be returned. A certified check may be used in lieu of the bid bond. Each bidder shall guarantee that they will not withdraw his/her bid for a period of 90 days after the bids have been opened.

G. PERFORMANCE AND PAYMENT BOND

1. A performance bond and payment bond each in the amount of 100 percent of the contract price, with a corporate surety approved by the City, will be required for the faithful performance of the contract, when executed. The Contractor whom the contract is being awarded must obtain the performance bond and payment bond on or before ten (10) calendar days following delivery of the Notice of Award. Attorneys-in-fact who sign the payment and performance bonds must file with each bond a current certified copy of their power of attorney.

H. INDEMNIFICATION/LIABILITY:

2. To the fullest extent permitted by law, Contractor agrees to defend, indemnify, and hold the City, its officers, agents, and employees harmless from and against any and all liabilities, demands, claims, suits, losses, damages, causes of action, fines or judgments, including costs, attorneys’, witnesses’, and expert witnesses’ fees, and expenses incident thereto, relating to, arising out of, or resulting from: (i) the services provided by Contractor personnel under this Agreement; (ii) any negligent acts, errors, mistakes or omissions by Contractor or Contractor personnel; and (iii)

Contractor or Contractor personnel’s failure to comply with or fulfill the obligations established by this Agreement.

3. Contractor will update the City during the course of the litigation to timely notify the City of any issues that may involve the independent negligence of the City that is not covered by this indemnification.

4. The City assumes no liability for actions of Contractor and will not indemnify or hold Contractor or any third party harmless for claims based on this Agreement or use of Contractor-provided supplies or services.

5. Extreme care shall be taken to safeguard all existing facilities, site amenities, irrigation systems, vehicles, etc. on or around the job site. Damage to public and/or private property shall be the responsibility of the Contractor and shall be repaired and/or replaced at no additional cost to the

City.

I. SPECIAL CONDITIONS:

1. Extended time may be allowed for the completion of this project due to inclement weather.

2. Decisions to allow days added to the contract due to inclement weather will be based upon weather records as recorded with the State of Florida, Division of Forestry located in Santa Rosa

County, Florida and approved by City of Milton.

3. In the event additional days are awarded the contractor must notify City of Milton at the beginning of work stoppage and each succeeding day until work can be safely resumed.

4. The Project must be completed prior to March 1, 2026.

J. FORCE MAJEURE:

1. Failure by either party to perform its duties and obligations will be excused by unforeseeable circumstances beyond its reasonable control, including acts of nature, acts of the public enemy, riots, fire, explosion, legislation, and governmental regulation. The party whose performance is so affected will within five (5) calendar days of the unforeseeable circumstance notify the other party of all pertinent facts and identify the force majeure event. The party whose performance is so affected must also take all reasonable steps, promptly and diligently, to prevent such causes if it is feasible to do so, or to minimize or eliminate the effect thereof. The delivery or performance date will be extended for a period equal to the time lost by reason of delay, plus such additional time as may be reasonably necessary to overcome the effect of the delay, provided however, under no circumstances will delays caused by a force majeure extend beyond thirty (30) calendar days from the scheduled delivery or completion date of a task unless agreed upon by the parties.

K. CONTRACT:

1. The successful Contractor must execute and return the contract within five (5) calendar days of issuance of Notice of Award.

L. SCHEDULE:

1. Upon receipt of all required documents a Notice to Proceed will be issued.

2. The successful Contractor must commence work within five (5) calendar days of Notice to

Proceed.

3. Contractor to propose construction schedule as part of the bid response.

M. PAYMENT:

1. Contractor to propose payment schedule as part of bid response.

N. EXPERIENCE/REFERENCES:

1. Bidder must include information on similar projects.

2. Bidders must providewith their proposal material for evaluating the ability of the potential

Bidder to execute a project of this type. Therefore, the Bidder is required to provide a minimum of (3) three references which will be verified. The list of references must be attached with the bid proposal on the form provided within these specifications. All reference materials provided become the property of the City and also become public record.

O. CHANGE ORDERS:

1. Notify the City of Milton of any conditions in the project area that are not addressed within the specifications which may require a change order.

2. Change orders to the scope of work or additional work requested by City of Milton must be in written form and initiated by the Contractor.

3. All changes or additions will be approved by City of Milton prior to work being initiated.

P. ADDENDUM:

1. It will be the sole responsibility of the bidder to contact City of Milton prior to submitting a bid to determine if any addenda have been issued, to obtain such addenda, and to acknowledge addenda with their bid.

Q. REQUIRED DOCUMENTS:

1. The enclosed documents must be executed and returned with the bid proposal or the proposal may be considered non-responsive. (Public Entity Crime Statement, Drug-Free Workplace

Form, Non-Collusion Affidavit, Conflict of Interest Statement, E-Verify Statement of

Compliance, Certificate Regarding Debarment, References)

R. AWARD OF BID:

1. The City reserves the right to award the bid to one (1) or multiple contractors on a per item basis or to not award the bid to any of the bidders.

2. Four categories of information will be evaluated: responsiveness, responsibility, the technical proposal and price. All proposals must meet the following responsiveness and responsibility criteria:

A. Responsiveness. Bids will be evaluated to determine whether the proposal complies with the instructions for submitting proposals including completeness of proposal which encompasses the inclusion of all required attachments and submissions. Any proposals that are submitted late will be rejected. Failure to meet other requirements may result in rejection.

B. Responsibility. Bids will be evaluated to determine whether the proposer is one with whom the City can or should do business. Factors that may be evaluated to determine

"responsibility" include, but are not limited to: excessively high or low priced proposals, past performance, references (including those found outside the proposal), compliance with applicable laws, proposer's record of performance and integrity. A proposer must at all times have financial resources sufficient to ensure performance of the contract and must provide proof upon request. FGU and the City reserve the right to inspect and review proposer’s facilities, equipment and personnel and those of any identified subcontractors.

Any failure to supply information, or the quality of the information, may result in rejection.

C. Technical Proposal. Bids will be evaluated to determine how well proposals meet its requirements in terms of the response to the specifications and how well the offer addresses the needs of the project.

D. Price. Each proposal’s pricing will be evaluated.

Company Name

3. The City’s City Council will have final approval to award the bid.

S. EMPLOYMENT ELIGIBILITY VERIFICATION (E-VERIFY):

1. In accordance with State of Florida, Office of the Governor, Executive Order 11-116

(superseding Executive Order 11-02; Verification of Employment Status), in the event performance of this Agreement is or will be funded using state or federal funds, the

CONTRACTOR must comply with the Employment Eligibility Verification Program (“E-Verify

Program”) developed by the federal government to verify the eligibility of individuals to work in the United States and 48 CFR 52.222-54 (as amended) is incorporated herein by reference. If applicable, in accordance with Subpart 22.18 of the Federal Acquisition Register, the

CONTRACTOR must (1) enroll in the E-Verify Program, (2) use E-Verify to verify the employment eligibility of all new hires working in the United States, except if the

CONTRACTOR is a start or local government, the CONTRACTOR may choose to verify only new hires assigned to the Agreement; (3) use E-Verify to verify the employment eligibility of all employees assigned to the Agreement; and (4) include these requirements in certain subcontracts, such as construction. Information on registration for and use of the E-Verify Program can be obtained via the internet at the Department of Homeland Security Web site:

http://www.dhs.gov/E-Verify.

T. ADDITIONAL INFORMATION:

1. The City of Milton reserves the right to request any additional information needed for clarification from any Bidder for evaluation purposes.

http://www.dhs.gov/E-Verify

REFERENCES

List below a minimum of three (3) client/customer references including company name, address, contact person, email address, telephone number and length of time services provided.

(Note: only list references in which a similar scope of work/service was provided)

1. Company Name:

Address:

Business Phone #:

Contact Person:

Email:

Length of time services provided:

Project description:

2. Company Name:

Business Phone #:

Contact Person:

Email:

3. Company Name:

Business Phone #:

Contact Person:

Email:

Company Name

SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(A).

FLORIDA STATUTES ON PUBLIC ENTITY CRIME

THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER

OFFICIAL AUTHORIZED TO ADMINISTER OATHS.

1. This sworn statement is submitted to

By

(print this individual’s name and title) for (print name of entity submitting statements) whose business address is and if applicable whose Federal Employer Identification Number (FEIN) is

If the entity has no FEIN, include the Social Security Number of the individual signing this sworn Statement:

2. I understand that a “public entity crime” as defined in paragraph 287.133(1)(a), Florida Statutes, mean a violation of any state or federal law by a person with respect to and directly related to the transactions 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 any bid or contract for goods or services to be provided to any public entity or any agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.

3. I understand that “convicted” or “convection” 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 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 an “affiliate” as defined in paragraph 287.133(1)(a), Florida Statutes, means:

1. A predecessor or successor of a person convicted of 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 officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an 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 for fair market value under an arm’s length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.

5. I understand that a “person” as defined in Paragraph 287.133(1)(e), 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 into 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, executives, partners, shareholders, employees, members, and agents who are active in management of an entity.

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

_ Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or any affiliate of the entity has been charged with and convicted of a public entity crime within the past

36 months.

_ The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. AND (Please indicate which additional statement applies).

_ The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. However, there has been a subsequent proceeding before a Hearing Officers of the State of Florida, Division of Administrative

Hearings and the Final Order 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. (Attached is 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 THE PUBLIC

ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE

CALENDAR YEAR IN WHICH IT IS FILED AND FOR THE PERIOD OF THE CONTRACT

ENTERED INTO, WHICHEVER PERIOD IS LONGER. 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 OF ANY CHANGE IN THE INFORMATION CONTAINED

IN THIS FORM.

(Signature)

City of

STATE OF FLORIDA

Sworn and subscribed before me this day of , 20 by who is Personally known to me

Or who produced identification -

(Type of Identification)

(Signature) Notary Public—State of Florida

(Printed, typed or stamped commissioned name of notary public)

My commission expires (SEAL)

DRUG-FREE WORKPLACE (F.S. 287.087)

Preference to businesses with drug-free workplace programs.—Whenever two or more bids, proposals, or replies 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 bid, proposal, or reply received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process.

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 bid 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 bid, 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 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than 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.

Vendor Name Date:

We have a drug-free workplace program. □yes; or □no (check one)

Vendor’s Signature

NON-COLLUSION AFFIDAVIT

STATE OF

COUNTY OF

Owner, Partner or Officer of Firm

Company Name, Address, City and State

Being of lawful age, being first duly sworn, on oath says that he/she is the agent authorized by the bidder to submit the attached bid. Affidavit further states as proposer, that they have not been a party to any collusion among bidders in restraint of competition by agreement to bid at a fixed price or to refrain from bidding; or with any officer of the City of Milton or any of their employees as to quantity, quality or price in the prospective contract; or any discussion between bidders and any official of the City of Milton or any of their employees concerning exchange of money or other things of value for special consideration in submitting a sealed bid for:

FIRM NAME:

SIGNATURE:

TITLE:

The foregoing instrument was acknowledged before me this day of

, 20 by the above signed acting on behalf of the organization/company.

He/she is personally known to me or has produced as identification and did (did not) take an oath.

Signature of Notary

SEAL

CONFLICT OF INTEREST DISCLOSURE FORM

For purposes of determining any possible conflict of interest, all bidders/proposers, must disclose if any City of Milton, employee(s), elected officials(s), of if any of its agencies is also an owner, corporate officer, agency, employee, etc., of their business.

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

YES NO

NAME(S) POSITION(S)

Firm Name By (Printed):

By (Signature): Title

Address Phone No.

E-Mail:

E-VERIFY STATEMENT OF COMPLIANCE

Contractor hereby certifies compliance with the following:

Pursuant to § 448.095(2) Florida Statutes (2020), Contractor shall register with and use the E- Verify system operated by the United States Department of Homeland Security to verify the work authorization status of all new employees hired by Contractor while performing work or providing services for the City of Milton. Contractor shall also include in any related subcontracts a requirement that subcontractors performing work or providing services for the City of Milton on its behalf register with and use the E-Verify system to verify the work authorization status of all new employees hired by the subcontractor while performing work or providing services for the City of

Milton. Additionally, Contractor shall include in any related subcontracts a requirement that subcontractors performing work or providing services for the City of Milton on its behalf provide

Contractor with an affidavit stating that the subcontractor does not employ, contract with, or subcontract with any unauthorized alien as defined in 8 U.S.C. § 1324a(h)(3). Contractor shall maintain a copy of such affidavit for the duration of its contract with the City of Milton.

FIRM NAME

SIGNATURE

TITLE

1. The prospective primary participant certifies to the best of its knowledge and belief that it and its principals:

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 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 governmental 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 application/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 proposal.

Name Project Name

Title Project Number

Firm Street Address

City, State, Zip

Certification Regarding Debarment, Suspension, And Other Responsibility Matters Primary Covered

Transactions