ITB-25-17 FORM PACKET - RETURN WITH BID.pdf

PROPOSAL AND BID FORM

ITB-25-17

Proposal to furnish all labor, materials, equipment, plant and supervision necessary for the “Gravity Main Lining”, in accordance with the Invitation to Bid, Scope of Work, Terms and Conditions, and any other documents prepared for this project.

ARTICLE 1

The Invitation to Bid, Terms and Conditions, and any other Contract documents prepared for this bid, and any addenda issued during the bidding period, are a part of this Proposal and Bid Form.

The Bidder received the following addenda during the bidding period:

Addendum Number _____ Date ______________ Addendum Number _____ Date ______________ Addendum Number _____ Date ______________ Addendum Number _____ Date ______________

The Bidder agrees to complete this project in accordance with the Contract Documents.

ARTICLE 2

The Bidder declares that he makes this proposal in good faith without collusion and without connection with any other person or persons bidding on this project.

Contractor must start within 20 days after receipt of Notice to proceed and project must be completed within 120 calendar days after receipt of Notice to Proceed.

The Bidder declares he has examined the bid documents, visited the site of this project, and fully acquainted himself with all conditions which may affect completion of this project.

ARTICLE 3

The Bidder includes with the Proposal and Bid Form a letter from their bonding company agent stating their current single job limit and aggregate limit as outlined in “Performance of Contract - #4”.

ARTICLE 4

The contractor agrees to pay liquidated damages of $ 500 /calendar day for every day past the 120 calendar days completion time that the project remains uncompleted. No additional time will be allotted for work stoppages not caused by a natural disaster or approved by the City of Winter Haven.

ARTICLE 5

The bidder, along with the Proposal and Bid Form, will provide a list of at least five (5) projects in similar scope and size, as specified in this Invitation to Bid. Form on PBF-2 must be completed and returned.

PBF-1

References: Each Bidder shall submit a list of at least five (5) references in the past five (5) years, including phone numbers of the actual users at the utility departments and NOT Purchasing Agents.

References:

Utility Department Users

Job Date Location/City/State Phone Number

1.

2.

3.

4.

5.

Safety Related Incidents: The Bidder shall also provide a detailed listing of all safety related incidents and sewer spills for the past five (5) years.

Safety Related Incidents: Date of Incidents Additional Comments:

1.

2.

3.

4.

5.

PBF-2

Terminations/Debarments: Bidder shall provide a list of Terminations/Debarments within the last five (5) years.

PBF- 3

The Bidder, proposes and agrees to furnish all plans, permits, labor, material, services, supplies and equipment, and perform the Work required for construction for each item listed on PBF-5.

A City of Winter Haven Procurement Card will be accepted as method of payment. ____ YES ____ NO

NOTE: if Bidder checks “yes” above, Bidder agrees that the City may use a City issued Mastercard for the payment of any and all invoices submitted as a result of the performance of this bid.

By signing and submitting this bid, the undersigned bidder hereby certifies that the company is not on the Scrutinized Companies with Activities in Sudan List, or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or that it does not have business operations in Cuba or Syria (for bid amounts of $1,000,000 or more). Any contract with the City of Winter Haven for goods and/or services of any amount, entered into on or after July 1, 2018, may be terminated at the sole option of the City of Winter Haven, at no cost to the City, if the company is found to have been placed on the Scrutinized Companies that Boycott Israel List or is engaged in a boycott of Israel, or if the company is found to have submitted a false certification as provided under subsection (5) of F.S.287-135.

Date Name of Company

Authorized Signature Mailing Address

Title/Position City State Zip

Printed Name Email address

Federal Employer I.D. # (FEID) Telephone Number

State Registration # State Certification #

PBF-4

Affidavit of Prime Bidder

Non-Collusion: The Contractor is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid; such Bid is genuine and is not a collusive or sham Bid;

neither the said Bidder nor any of his officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted or has refrained from bidding in connection with such Contract; nor in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder; nor has fixed any overhead, profit or cost element of the Bid price, or the Bid price of any other Bidder; nor has secured through any collusion, conspiracy, connivance or unlawful agreement, any advantage against the City of Winter Haven or any person interested in the proposed Contract; and the price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties in interest, including this affiant.

Drug-Free Workplace: The Contractor certifies that it is a drug-free workplace and has a substance abuse policy in accordance with and pursuant to Section 440.102, Florida Statutes.

Affidavit Certification Immigration Laws: City of Winter Haven will not intentionally award City contracts to any contractor/consultant who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324 a(e) {Section 274a(e) of the IMMIGRATION AND NATIONALITY ACT (“INA”). City of Winter Haven may consider the employment by any contractor of unauthorized aliens a violation of Section 274a(e) of the INA. SUCH VIOLATION BY THE RECIPIENT OF THE EMPLOYMENT PROVISIONS CONTAINED IN SECTION 274A(e) OF THE INA SHALL BE GROUNDS FOR UNILATERAL CANCELLATION OF THE CONTRACT BY CITY OF WINTER HAVEN. The contractor/vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Immigration Act and subsequent amendments).

Florida Anti-Human Trafficking Provisions: The Contractor certifies that it does not use coercion for labor or services as those terms are defined in Section 787.06(13), Florida Statutes and as detailed in Section 28 of the City’s General Terms and Conditions.

Foreign Countries of Concern: The Contractor certifies under penalty of perjury that the entity is not owned by the government of a foreign country of concern; the government of a foreign country of concern does not have a controlling interest in the entity; or that the entity is not organized under the laws of, or has as its principal place of business in a foreign country of concern as defined in Section 287.138, Florida Statutes, and as detailed in Section 29 of the City’s General Terms and Conditions.

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

Name – printed

Signature / Date

Title

Affidavit Regarding the Use of Coercion for Labor and Services

State of Florida County of __________________

Name of Vendor: ______________________________________________________________

Address: ____________________________________________________________________

Phone Number: _______________________________________________________________

Authorized Representative’s Name: _______________________________________________

Authorized Representative’s Title: ________________________________________________

Effective July 1, 2024, Section 787.06(13), Florida Statutes, requires all nongovernmental entities executing, renewing, or extending a contract with a governmental entity to provide an affidavit signed by an officer or representative under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services.

As the person authorized to sign on behalf of the vendor, I certify that the vendor identified above does not:

• Use or threaten to use physical force against any person;

• Restrain, isolate, or confine or threaten to restrain, isolate, or confine any person without lawful authority and against her or his will;

• Use 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;

• Destroy, conceal, remove, confiscate, withhold, or possess any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person;

• Cause or threaten to cause financial harm to any person;

• Entice or lure any person by fraud or deceit; or

• Provide a controlled substance as outlined in Schedule I or Schedule II of Florida Statute

893.03 to any person for the purpose of exploitation of that person.

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

The foregoing instrument was acknowledged before me this _____ day of _____, 20____, by ____________________, as ___________of ______________ , a ________________, on behalf of the said ___________________________ who is (___) personally known to me or (____) produced a _______ driver’s license as identification.

Notary Public, State of _____________________ Commission no.: __________________________ My commission expires: ____________________

Affidavit Regarding Foreign Countries of Concern

State of Florida County of __________________

Name of Vendor: ______________________________________________________________

Address: ____________________________________________________________________

Phone Number: _______________________________________________________________

Authorized Representative’s Name: _______________________________________________

Authorized Representative’s Title: ________________________________________________

Effective January 1, 2024, Section 287.138, Florida Statutes, prohibits a Florida governmental entity from entering into a contract that may grant or allow access to any individual’s personal identifying information unless the contracting entity furnishes an affidavit signed by an officer or representative under penalty of perjury concerning foreign countries of concern.

As the person authorized to sign on behalf of the vendor, I certify that:

• The vendor is not owned by 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, or by any agency of or any other entity of significant control of any of such foreign country of concern.

• The government of 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 does not have a controlling interest in the vendor.

• The vendor is not organized under the laws of and does not have its principal place of business in 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.

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

The foregoing instrument was acknowledged before me this _____ day of _____, 20____, by ____________________, as ___________of ______________ , a ________________, on behalf of the said ___________________________ who is (___) personally known to me or (____) produced a _______ driver’s license as identification.

Notary Public, State of _____________________ Commission no.: __________________________ My commission expires: ____________________