ITB 26-13 Polyurea Floor Coating Annual Contract.pdf

CITY OF FERNANDINA BEACH

ITB 26-13

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

SYSTEM IN CITY FACILITIES

INTRODUCTION

The City of Fernandina Beach, Florida is accepting competitive sealed bids for

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING SYSTEM WITHIN

VARIOUS CITY FACILITIES ANNUAL CONTRACTOR. The work shall include all labor materials, equipment, supervision, and tools to perform the installation of the floor coating system as directed by the City’s designee.

The City of Fernandina Beach will receive sealed submittals electronically via www.demandstar.com. Submittals must be successfully uploaded to Demandstar.com E-bidding system prior to the 10:00AM(EST) deadline on July 30, 2026. The public bid opening will begin promptly at that time via Zoom. (information for the Zoom meeting can be found in the Notice of ITB on the City Website Bids/ Purchasing/Fernandina Beach, FL - Official Website and www.demandstar.com.)

It shall be the sole responsibility of the Bidder to have its Bid submitted electronically via DemandStar website (www.demandstar.com) and uploaded prior to the 10:00AM deadline.

Facsimile, paper or telegraphic submittals will not be accepted. Delay in delivery shall be the sole responsibility of the Bidder. Submittals received after the deadline will not be considered.

Award of the Bid is subject to authorization and appropriation of funds in the fiscal year budget.

The bid shall be submitted on the specified Contact Sheet, hereto attached as “Exhibit A” and Bid Pricing Form, hereto attached as “Exhibit A-1”. The person signing the Bid Response Form shall have the authority to bind the proposer to the Bid. All information on the Bid form shall be provided, or the Bid may not be accepted.

The competitive sealed Bid shall be accompanied by a “Public Entity Crimes”, herein provided as “Exhibit B”, “Drug-Free Workplace Certification” herein provides as “Exhibit C”, “E-Verify Statement” herein provided as “Exhibit D”, “Proposer Acknowledgements and Agreements”, herein provided as “Exhibit E”, “Conflict of Interest”, herein provided as, “Exhibit F”, “Non-Collusion Affidavit”, herein provided as “Exhibit G” and “Dispute Disclosure”, herein provided as “Exhibit H”.

CONTRACTOR SHALL SIGN AND INCLUDE EXHIBITS “A-H”. Failure to do so, may result in rejection of the bid.

“Sample Contract” City of Fernandina Beach provided as separate document.

In accordance with Item 16, General Terms and Conditions, please provide proof the Contractor/Vendor is not listed in the Excluded Parties List System, a federal suspension and debarment listing.

http://www.demandstar.com/ https://www.fbfl.us/86/Bids-Purchasing

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

SCOPE OF WORK

Fernandina Beach is seeking bids from qualified Polyurea or equivalent floor coating and installation Contractors to perform services at various City buildings/facilities. The scope of services are as follows:

• Upon request and coordination by the City, Contractor is to perform a site visit to the facility identified to determine the costs and degree of work to be performed.

• Contractor shall prepare existing floors to a clean surface suitable for the application of the new floor coating.

• All products must meet the specifications listed herein.

• Any floors that contain damage shall be repaired to an acceptable surface utilizing Polyurea mender or equivalent.

• Contractor is to uniformly install a base coat over the concrete surface using a Pure Polyurea coating or product equivalent.

• Contractor shall uniformly “broadcast” vinyl chips with color to be selected by the City.

• Contractor shall uniformly install a Polyaspartic Topcoat or product equivalent.

• If applicable, Contractor is to install 4-8” base cove to all walls that join floor surfaces.

Contractor shall take all precautions to protect furnishings for this project. The Contractor shall follow all applicable safety procedures and practices for each project. OSHA regulations shall apply. The Contractor shall maintain a safe and secure jobsite throughout the time of the project. All debris is to be disposed of either in the Contractor’s dumpster or legally off-site.

Contractor may stage tools, materials, and equipment on the project premises with coordination by the City’s Designee. Contractor may arrange for their own dumpster to be used on site with location of dumpster coordinated and approved the City.

Normal work hours at City Buildings/facilities is 8:00 am to 5:00 pm M thru F. Extended hours may be approved by City as necessary.

Upon completion of the work, the Contractor is to notify the City’s Designee in writing to request a final inspection.

All work must carry a 5-year labor and material warranty against peeling, bubbling, lifting or delamination or other workmanship defects.

Contractor is to provide unit pricing for the project per Exhibit A-1 (below) on this Invitation to

Bid document. The pricing for the services contained within this bid shall remain the same through the term of the agreement beginning October 1, 2026, through September 30, 2027.

Two, one-year extensions may be available based upon mutual agreement and same terms and conditions. (See item 7, Award of Invitation to Bid, General Conditions of Invitation to Bid)

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

QUALIFICATIONS

The Bid Submittal must include evidence of capabilities to complete the project specified. A reference list of similar projects (scope and size) successfully completed in the past. A reference list of subcontractors, and an equipment list, and other information requested by the City of Fernandina Beach.

The Contractor shall provide all necessary barriers and signage and take necessary precautions to protect buildings, general public and Contractor personnel. The Contractor shall at all times guard against damage or loss of City property or to the general public and shall be held responsible for replacing or repairing any loss or damage to the satisfaction of The City of Fernandina Beach.

CONTRACTOR shall perform all work under supervision of a capable supervisor using skilled employees.

AWARD

Award recommendation shall be made to the most responsive and responsible bidder offering the best value. The City reserves the right, based upon its deliberations and in its opinion, to accept or reject any or all proposals. The City also reserves the right to waive minor irregularities or variations to the specifications and in the bidding process.

Successful Bidder is required to have a Business License in the city where their home office is located. If Bidder's business office is located in the City of Fernandina Beach a business tax license is required.

BID PACKAGE

Bid Documents and Specifications are available to download from the City of Fernandina Beach website at www.fbfl.us/bids, and DemandStar at www.demandstar.com. Questions regarding bid package can be directed to Wanda Weaks, Purchasing Specialist, wweaks@fbfl.org.

CONTACT

Specification questions during the bid period shall be submitted in writing to Purchasing Specialist, Wanda Weaks, wweaks@fbfl.org.

Bidders are hereby put on notice that no contact shall be made with any of the City Commission members, other City staff, or others that may be involved in the selection process to discuss this request or to influence the outcome of the selection.

ADDENDA

A written response to bidder questions will be issued via Addendum and posted on the City’s website at www.fbfl.us/bids and DemandStar at www.demandstar.com. It is the bidder’s responsibility to check the City’s website for Addenda prior to submitting their bid. The deadline for questions is ten days before bid opening.

http://www.fbfl.us/bids mailto:wweaks@fbfl.org mailto:wweaks@fbfl.org http://www.fbfl.us/bids

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

If there is an Addendum it becomes part of the original Bid and shall be acknowledged by attaching a copy of the Addendum, signed by an authorized representative of the person or company submitting the bid or proposal. Failure to do so may disqualify the bid or proposal.

INSURANCE REQUIREMENTS

Insurance requirements are outlined in the General Conditions of this Invitation to Bid.

BOND REQUIREMENTS

No Bid Bond is required for this bid.

EQUAL OPPORTUNITY/AFFIRMATIVE ACTION

To the extent allowable by law the City is an equal opportunity/affirmative action employer. To the extent allowable by law the City is committed to equal opportunity employment effort and expects firms that do business with the City to have an affirmative action program.

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

GENERAL CONDITIONS OF INVITATION TO BID

1. PREPARATION OF BID - INVITATION TO BID will be prepared in accordance with the following:

a. The enclosed Contact Sheet/Bid Form attached hereto as “Exhibit A”, must be used when submitting your INVITATION TO BID.

b. All information required by the Contact Sheet/Bid Form must be furnished. The

Bidder must print or type his/her name and manually sign the Form and any continuation sheet on which an entry is made.

c. Unit prices must be shown and where there is an error in extension of price, the unit price will govern.

d. Alternate Bids will not be considered unless authorized by the Invitation to Bid.

e. Bidders will not include federal taxes nor State of Florida sales, excise, and use taxes in prices, as the City is exempt from payment of such taxes. An exemption certificate will be signed where applicable upon request.

f. Bidders must make all investigations necessary to thoroughly inform themselves about any and all conditions related to the performance of the contract. Plea of ignorance by the Bidder of conditions that exists or may hereafter exist as a result of failure or omission on the part of the Bidder to make the necessary examinations and investigations, or failure to fulfill in every detail the requirements provided for in the Purchasing Policy, Purchasing Ordinance and/or State and Federal Statutes.

The City’s Purchasing Ordinance is set forth in Chapter 2-420, et seq.

g. Prices quoted must be FOB City of Fernandina Beach, Florida with all transportation charges prepaid unless otherwise specified in the Invitation to Bid.

h. Deliveries are to be FOB Destination unless otherwise specified in the Invitation to bid

i. Deliveries are to be made during regular business hours.

j. Bids and Bid prices must be valid for a minimum of ninety (90) days, unless otherwise stated on the INVITATION TO BID.

2. SUBMISSION OF BID

a. The City of Fernandina Beach has partnered with DemandStar using their E-bidding platform. All submittals will be received through the DemandStar

E-bidding platform. To register and submit through DemandStar go to www.demandstar.com/registration.

3. REJECTION OF BID

a. The City reserves the right to accept or reject any or all Bids, to waive irregularities and technicalities, and to request resubmission or to re-advertise for the services.

The City will be the sole judge of the submittals. The City's decision will be final.

4. WITHDRAWAL OF BID

a. Bids may not be withdrawn after the time set for the opening for a period of time as specified.

http://www.demandstar.com/registration

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

b. Bids may be withdrawn prior to the time set for the opening. Such request must be in writing.

5. LATE BID

a. INVITATION TO BID and modifications received after the time set for the opening will not be considered.

b. Modifications in writing received prior to the time set for the opening will be accepted.

6. LOCAL, STATE, AND FEDERAL COMPLIANCE

a. Bidders must comply with all local, state, and federal directives, orders and laws as applicable to the INVITATION TO BID and subsequent contract(s) in accordance with the requirements as stated in CFR 200.321, including but not limited to Equal

Employment Opportunity (EEO), Minority Business Enterprise (MBE), and

Occupational Safety and Health Administration (OSHA) as applicable to this contract and as allowable by law.

b. A “Public Entity Crimes Statement”, in accordance with Florida Statutes, Section

287.133 (3) (a), on Public Entity Crimes, attached hereto as “Exhibit B”, must be received at the time of the bid.

c. A “Drug Free Workplace Certification” attached hereto as “Exhibit C”, must be received at the time of the bid.

d. The City of Fernandina Beach requires that the Bidder selected will not discriminate under the contract against any person, in accordance with federal, state and local government regulations and, to the extent applicable, the Bidder shall comply with all executive orders executed by the President of the US and any federal or State of

Florida legislation related to diversity, equity and inclusion

e. An “E-Verify Statement” attached hereto as “Exhibit D” must be received at the time of the bid.

7. AWARD OF INVITATION TO BID

a. The INVITATION TO BID will be awarded to the most responsive and responsible bidder offering the best value to the City of Fernandina Beach.

b. The City reserves the right to accept and award item by item, and/or by group, or in the aggregate.

c. A written award of acceptance (Purchase Order), mailed or otherwise furnished to the successful Bidder will result in a binding contract without further action by either party.

d. Unless otherwise noted in the specifications, the length of the agreement will be one year, with 2 one year renewals possible based on the mutual consent of the parties.

e. Upon award, for construction projects, the Contractor will be required to complete/execute the City’s Contract and General Conditions for Construction

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

f. Services. An example of the contract can be found on the City’s website at www.fbfl.us/bids, Bids and Purchasing web page.

g. Agreement may be cancelled with 60-day notice unless otherwise stated in signed contract documents.

8. NOT RESPONSIBLE FOR COSTS

a. The City will not be responsible for any cost incurred by a prospective Bidder in responding to this INVITATION TO BID.

9. PUBLIC RECORDS INFORMATION

a. Public Records: The City is subject to Florida Public Records laws. Pursuant to

Section 119.0701, Florida Statutes, Contractor/Consultant shall: (a) keep and maintain all public records as that term is defined in Chapter 119, Florida Statutes

(“Public Records”), that ordinarily and necessarily would be required by the City in order to perform the work contemplated by this Agreement; (b) provide the public with access to Public Records, on the same terms and conditions that the City would provide the records and at a cost that does not exceed the costs provided in

Chapter 119, Florida Statutes, or as otherwise provided by law; (c) ensure that

Public Records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law; (d) meet all requirements for retaining Public Records and transfer, at no cost to the City, all public records in possession of Contractor/Consultant within thirty (30) days after termination of this Agreement, however terminated, and destroy any duplicate

Public Records that are exempt or confidential and exempt from public records disclosure requirements and provide the City with a letter confirming that this has been done within thirty (30) days of the termination of this Agreement. All Public

Records stored electronically must be provided to the City in a format that is compatible with the information technology of the City. If Contractor/Consultant does not comply with a public records request, the City may pursue any and all remedies available in law or equity, including but not limited to specific performance.

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 904-310-3115,

CBEST@FBFL.ORG, 204 ASH STREET, FERNANDINA BEACH, FL.

10. ADDITIONAL INFORMATION

a. The City reserves the right to require Bidders to provide references and information on previous similar experience prior to award of the contract.

http://www.fbfl.us/ mailto:CBEST@FBFL.ORG

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

11. QUESTIONS

a. Any questions about the INVITATION TO BID should be communicated per instructions in the INVITATION TO BID.

12. INDEMNIFICATION AND INSURANCE

INDEMNIFICATION

The CONTRACTOR agrees to assume liability for and indemnify, hold harmless, and defend the City, its commissioners, mayor, officers, employees, agents, and attorneys of, from, and against all liability and expense, including reasonable attorney’s fees, in connection with any and all claims, demands, damages, actions, causes of action, and suits in equity of whatever kind or nature, including claims for personal injury, property damage, equitable relief, or loss of use, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the CONTRACTOR, its agents, officers, contractors, subcontractors, employees, or anyone else employed or utilized by the CONTRACTOR in the performance of this Agreement. The CONTRACTOR’s liability hereunder must include all attorney’s fees and costs incurred by the City in the enforcement of this indemnification provision. This includes claims made by the employees of the CONTRACTOR against the City and the CONTRACTOR hereby waives its entitlement, if any, to immunity under Section 440.11, Florida Statutes. The obligations contained in this provision will survive termination of this Agreement and will not be limited by the amount of any insurance required to be obtained or maintained under this Agreement.

Subject to the limitations set forth in this Section, the CONTRACTOR must assume control of the defense of any claim asserted by a third party against the City and, in connection with such defense, must appoint lead counsel, in each case at the

CONTRACTOR’s expense. The City will have the right, at its option, to participate in the defense of any third-party claim, without relieving CONTRACTOR of any of its obligations hereunder. If the CONTRACTOR assumes control of the defense of any third-party claim in accordance with this paragraph, the CONTRACTOR must obtain the prior written consent of the City before entering into any settlement of such claim.

Notwithstanding anything to the contrary in this Section, the CONTRACTOR must not assume or maintain control of the defense of any third party claim, but must pay the fees of counsel retained by the City and all expenses, including experts’ fees, if (i) an adverse determination with respect to the third party claim would, in the good faith judgment of the City, be detrimental in any material respect to the City’s reputation; (ii) the third party claim seeks an injunction or equitable relief against the City; or (iii) the

CONTRACTOR has failed or is failing to prosecute or defend vigorously the third party

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

claim. Each party must cooperate, and cause its agents to cooperate, in the defense or prosecution of any third-party claim and must furnish or cause to be furnished such records and information, and attend such conferences, discovery proceedings, hearings, trials, or appeals, as may be reasonably requested in connection therewith.

It is the specific intent of the parties hereto that the foregoing indemnification complies with Section 725.06, Florida Statutes, as amended. CONTRACTOR expressly agrees that it will not claim, and waives any claim, that this indemnification violates Section

725.06, Florida Statutes, as amended. Nothing contained in the foregoing indemnification will be construed as a waiver of any immunity or limitation of liability the City may have under the doctrine of sovereign immunity or Section 768.28, Florida

Statutes.

INSURANCE

Prior to commencement of any work under this Contract and until completion and final acceptance of the work, the CONTRACTOR/VENDOR must, at its sole expense, maintain the following insurance on its own behalf, and furnish to the CITY certificates of insurance evidencing same and reflecting the effective date of such coverage as follows:

The term "Contractor" as used in the insurance rider, will mean and include Subcontractors of every tier.

A. Worker's Compensation and Occupational Disease Insurance in accordance with the applicable law or laws; Employer's Liability Insurance with limit of at least One Million ($1,000,000) dollars. This includes sole proprietorships and officers of corporations who will be performing work on the job.

B. Commercial General Liability with a combined Bodily Injury and Property Damage limit of not less than ONE Million ($1,000,000) dollars per occurrence and TWO Million ($2,000,000) Dollars in the aggregate. The aggregate must be applicable on a per project basis. Coverage must include the following perils:

1. Broad Form Blanket Contractual Liability for liability assumed under this

Contract and all other Contracts relative to the project.

2. Completed Operations/Products Liability.

3. Broad Form Property Damage

4. Personal and Advertising Injury Liability

5. Independent Contractors

6. Endorsements must be furnished reflecting the inclusion of the interests of

Owner, Construction Manager, General Contractor, Contractor, (your company) , their officers, directors, partners, representatives, agents and employees, and naming each as an Additional Insured on a primary and non-contributing basis.

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

7. Coverage is to be endorsed to reflect that insurance is to be primary and non-contributory with respect to any other collectable insurance, for the Owner, General Contractor, Contractor, (your company) and all other parties required to be named as additional insureds.

8. Coverage is to be provided on an "occurrence" basis with carriers licensed and admitted to do business in the State of [your state] or otherwise acceptable to the Contractor (your company).

9. A copy of policy and/or endorsement(s) and any other documents required to verify such insurance are to be submitted with the appropriate certificate(s), or upon the request of Contractor (your company). Failure to provide these documents is not to be construed as a waiver of the requirements to provide such insurance.

C. Commercial Automobile Liability Insurance covering the use of all Owned, Non- Owned, and Hired Vehicles with combined Bodily Injury and Property Damage Limit of at least One Million ($1,000,000) Dollars.

D. Umbrella I Excess Liability Insurance with a limit of no less than One Million ($1,000,000) minimum per occurrence.

E. During the term of this agreement, (if applicable) the Contractor/Vendor will carry Professional Liability Insurance which will cover liability for any damage or non-performance on account of any error, omission, or other provable negligence caused by the Contractor/Vendor. The amount of insurance must not be less than One Million ($1, 000,000) per occurrence and aggregate.

F. Loss Deductible – If the insurance of any CONTRACTOR/VENDOR contains deductible(s), penalty(s) or self-insured retention(s), the CONTRACTOR/VENDOR whose insurance contains such provision(s) must be solely responsible for payment of such deductible(s), penalty(s) or self-insured retention(s).

G. Where an Off Project Site Property exposure exists, the Contractor at its sole expense must furnish to the Owner and Contractor (your company) Certificates of Insurance and other required documentation evidencing the following coverage which will provide for the interests of [Name of Owner] , [Name of General Contractor] and (your company) to be named as Loss Payees and will contain a provision requiring the insurance carriers to waive their rights of subrogation against all indemnities’ named in the contract.

"All Risk" Property Insurance on all materials, equipment and supplies intended to become a permanent part of the construction stored on premises away from the project site and while in transit, until actually delivered to the project site.

Coverage is to be provided on a replacement cost basis.

H. The above insurances must each contain the following wording verbatim: "[Name of Owner], [Name of General Contractor] , and (your company) are interested in the maintenance of this insurance and it is agreed that this insurance will not be canceled , materially changed or not renewed without at least a thirty (30) day advance written notice to [Name and address of Owner] , [Name and address of General Contractor] and [Name and address of your company] by certified mail-return receipt requested ." The City of Fernandina Beach shall be named as

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

Additional Insured on each required policy. Inability to add the City as Additional Insured is a basis to reject the submittal or cancel the subsequent contract.

I. The amount of insurance contained in the aforementioned insurance coverages will not be construed to be a limitation of the liability on the part of the Subcontractor or any of its Subcontractors.

J. The Contractor must file certificates of insurance prior to the commencement of work with the Owner and the General Contractor which will be subject to the Owner, General

Contractor and (your company) approval of adequacy of protection and the satisfactory character of the Insurer.

K. Any type of insurance or any increase of limits of liability not described above which the Subcontractor requires for its own protection or on account of statute must be its own responsibility and at its own expense.

L. The carrying of the insurance described will in no way be interpreted as relieving the Contractor or Subcontractor of any responsibility of liability under this Contract.

M. Any policies effected by the Contractor on its Owned and/or Rented Equipment and Materials must contain a provision requiring the insurance carriers to waive their rights of subrogation against the [Name of Owner], [Name of General Contractor], [Name of Contractor (your company)] and all other indemnities named in the Contract.

N. Should the Contractor engage a Subcontractor, the same conditions must apply under this contract to each Subcontractor, however, the retained Subcontractor must be required to maintain limits of liability of not less than One Million ($1,000,000.00) Dollars per occurrence and Two Million ($2,000,000) Dollars in the aggregate, with said limits applicable on a per project basis, or such greater limits as may be required by the retaining Subcontractor.

13. PAYMENT

Payment due hereunder must be made by the City to CONTRACTOR/VENDOR in accordance with the Florida Prompt Payment Act.

14. BID PROTESTS

Bid protest conditions and procedures are in accordance with City Ordinances – Part 2, Chapter 2, Article VII, Division 2, Section, 2-444.

15. FEDERAL GRANT MONEY

In the event this project is funded with federal grant monies, CONTRACTOR/VENDOR may not participate in the bid if CONTRACTOR/VENDOR is listed in the Excluded Parties List System (EPLS) a federal suspension and debarment listing. The Federal Government's Excluded Parties List System (EPL) is located at, including but not limited to, https://www.sam.gov. CONTRACTOR/VENDOR must include copy of search results with bid or proposal.

https://www.sam.gov/

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

16. LOBBYING

a. Lobbying is defined as any action taken by an individual, firm, association, joint venture, partnership, syndicate, corporation, and/or all other groups who seek to influence the governmental decision of a Board Member, the City

Manager, and/or any City Personnel during the solicitation process. The lobbying black-out period commences upon the issuance of this solicitation and concluded upon the signing of the agreement. CONTRACTORS must not contact any Commission Member and/or any requesting or evaluating

Department/Office personnel during said black-out period. All questions and procedural matters must be directed to the City Manager. The City

Commissioners and/or the City Manager may disqualify any solicitation response where any Commissioner, the City Manager, and/or City Personnel have been lobbied in violation of the black-out period.

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBITS

EXHIBIT “A” Contact Sheet

EXHIBIT ‘A-1” Bid Pricing Form

EXHIBIT “B” Public Entity Crimes

EXHIBIT “C” Drug-Free Workplace Certification

EXHIBIT “D” E-Verify Statement

EXHIBIT “E” Proposer Acknowledgements and Agreements

EXHIBIT “F” Conflict of Interest

EXHIBIT “G” Non-Collusion Affidavit

EXHIBIT “H” Disputes Disclosure

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “A”

CONTACT SHEET

Name: ________________________________________________________________

Federal Taxpayer ID: ____________________________________________________

Mailing Address: _______________________________________________________

City, State, & Zip Code: _________________________________________________

Telephone: _____________________________________ Fax: __________________

Email: _______________________________________________________________

Submitted By: ________________________________________________________

Title: ________________________________________________________________

Accounting Contact:

Name: ________________________________________Title: __________________

Email Address: ________________________________ Phone: ________________

THIS FORM MUST BE INCLUDED WITH BID/PROPOSAL

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “A-1”

BID PRICING FORM

A. EXISTING FLOOR PREPARATION $_______________(sf)

B. APPLICATION OF BASE COAT $_______________(sf)

C. INSTALLATION OF VINYL CHIPS $_______________(sf)

D. INSTALLATION OF TOPCOAT $_______________(sf)

E. INSTALLATION OF BASE COVE $_______________ (lf)

F. HOURLY RATE FOR ADDITIONAL WORK $_______________/Hour

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “B”

SWORN STATEMENT UNDER F.S. SECTION 287.133(3) (A), ON PUBLIC ENTITY CRIMES

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

OFFICER AUTHORIZED TO ADMINISTER OATHS.

1. This sworn statement is submitted with Bid, Proposal or Contract for

2. This sworn statement is submitted by (entity) ________________________ whose business address is _____________________________________ and (if applicable) Federal Employer Identification Number (FEIN) is _____________________( If a Sole Proprietor and you have no FEIN, include the last four (4) digits of your Social Security Number: ____________.)

3. My name is and my relationship to the entity named above is

4. I understand that a "public entity crime" as defined in Paragraph 287.133(a) (g). Florida

Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction 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 proposal 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.

5. I understand that "convicted" or "conviction" as defined in paragraph 287.133(a) (b), Florida

Statutes, means finding of guilt or a conviction of a public entity crime with or without an adjudication of guilt, in any federal or state trial court of records relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or nolo contendere.

6. I understand that an "affiliate" as defined in Paragraph 287.133(1) (a), Florida Statutes, means:

a. A predecessor or successor of a person convicted of a public entity crime; or

b. 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 City of Fernandina Beach, Florida ownership by one of shares constituting a controlling income among persons when not for fair interest in another person, or a pooling of equipment or income among persons when not for fair market value under a length agreement, must be a prim facie case that one person controls another person. A person who was knowingly convicted of a public entity crime, in Florida during the preceding 36 months must be considered an affiliate.

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

7. 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 the state or of the United States with the legal power to enter into a binding contract for 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, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity.

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

____Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, nor affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989.

____The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. (Please attach a copy of the final order.)

____The person or affiliate was placed on the convicted FIRM list. There has been a subsequent proceeding before a hearing officer of the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer determined that it was in public interest to remove the person or affiliate from the convicted FIRM list. (Please attach a copy of the final order.)

____The person or affiliate has not been placed on the convicted FIRM list. (Please describe any action taken by, or pending with, the Department of General Services.)

Signature Date:

STATE OF FLORIDA

COUNTY OF ____________________

Sworn to (or affirmed) and subscribed before me by means of ☐ physical presence or ☐ online notarization, this __ day of ___________, 20_________, by ________________________________________________, Notary Public Printed Name

My Commission Expires _________________________________

Personally Known ________ OR Produced Identification _____ ID Produced _______.

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “C”

DRUG-FREE WORKPLACE CERTIFICATION

The below-signed INDIVIDUAL/FIRM certifies that it has implemented a drug-free workplace program. In order to have a drug-free workplace prepare, a business must:

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 violation 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 services a copy of the statement specified in paragraph 1.

4. In the statement in paragraph 1., notify the employees that, as a condition of working on the commodities or contractual services that are under proposal, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of nolo contendere to, any violation occurring in the workplace no later than five (5) working days after such conviction.

5. Impose a sanction on, or require fine satisfactory participation in drug abuse assistance or rehabilitation program if such is available in the employee's community, by any employee who is 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 this statement, I Certify that this firm complies fully with the above drug-free workplace requirements.

COMPANY: _______________________________________________________________

CITY: ______________________________STATE: ________ ZIP CODE: _____________

SIGNATURE: ______________________________________PHONE: ________________

NAME (TYPED OR PRINTED): ___________________________TITLE: _______________

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “D”

E-VERIFY STATEMENT

Bid/Proposal Number: _____________________________________________________

Project Description: _______________________________________________________

I/FIRM acknowledges and agrees to the following:

I/FIRM will utilize the U.S. Department of Homeland Security’s E-Verify system, in accordance with the terms governing use of the system, to confirm the employment eligibility of:

1. All persons employed by the FIRM during the term of the Contract to perform employment duties within Florida; and

2. All persons assigned by the FIRM to perform work pursuant to the contract with the

Department.

Individual/Company/Firm: ___________________________________________________

Authorized Signature: _______________________________________________________

Title: ____________________________________________________________________

Date: ____________________________________________________________________

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “E”

PROPOSER ACKNOWLEDGEMENTS AND AGREEMENTS

The undersigned, as an employee or agent of the Proposer, having the authority to sign a binding agreement on behalf of the corporation, company, or firm presenting this submittal, confirms understanding and/or agreement and/or takes exception with any statement in the following sections of this RFP document.

1. INTRODUCTION AND GENERAL INFORMATION

Understands and agrees to all terms.

2. PROPOSAL INSTRUCTIONS, TERMS AND CONDITIONS

Understands and agrees to all terms.

3. EVALUATION AND CONTRACT OVERVIEW

Understands and agrees to all terms.

4. PROPOSER’S RESPONSE: SUBMITTAL INFORMATION

Understands and agrees to all terms.

5. PROPOSER’S RESPONSE: PROPOSED TEAM

Understands and agrees to all terms.

6. PROPOSER’S RESPONSE: PROPOSED COMPENSATION

Understands and agrees to all terms.

Name: ____________________________Title: ________________________________

Signature: _____________________________Date: ____________________________

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “F”

CONFLICT OF INTEREST STATEMENT

This sworn statement is submitted with Bid, Proposal or Contract for __________________.

This sworn statement is submitted by (entity) ________________________ whose business address is _____________________________________ and (if applicable) Federal Employer Identification Number (FEIN) is _____________________( If a Sole Proprietor and you have no FEIN, include the last four (4) digits of your Social Security Number:

My name is and my relationship to the entity named above is__________________.

1. The above-named entity is submitting a Proposal for the City of Fernandina Beach.

2. The Affiant has made diligent inquiry and provides the information contained in the Affidavit based upon his/her own knowledge.

3. The Affiant states that only one submittal for the above proposal is being submitted and that the above-named entity has no financial interest in other entities submitting proposals for the same project.

4. Neither the Affiant nor the above- named entity has directly or indirectly entered into any agreement, participated in any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity’s submittal for the above proposal. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project.

5. Neither the entity not its affiliates, nor anyone associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency.

6. Neither the entity nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project.

7. I certify that no member of the entity’s ownership or management is presently applying for an employee position or actively seeking an elected position with the

City of Fernandina Beach.

8. I certify that no member of the entity’s ownership or management, or staff has a vested interest in any aspect of the City of Fernandina Beach.

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “F” (con’t)

CONFLICT OF INTEREST STATEMENT

9. In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above-named entity, will immediately notify the City of Fernandina

Beach.

Signature Date:

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “G”

NON-COLLUSION AFFIDAVIT

This sworn statement is submitted with Bid, Proposal or Contract for __________________.

This sworn statement is submitted by (entity) ________________________ whose business address is _____________________________________ and (if applicable) Federal Employer Identification Number (FEIN) is _____________________( If a Sole Proprietor and you have no FEIN, include the last four (4) digits of your Social Security Number:

My name is and my relationship to the entity named above is__________________.

1. The above named is fully informed respecting the preparation and contents of the attached proposal and of all pertinent circumstances respecting such proposal;

2. Such Proposal is genuine and is not a collusive or sham proposal;

3. Neither the said Proposer nor any of its officers, partners, owners, agents, representatives, employees, or parties in interest, including this affiant, has in any way colluded, connived, or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Proposal in connection with such Contract, or has 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 proposal or any other Bidder, or to fix any overhead, profit or cost element of the proposal price or the proposal price of any other Bidder, or to secure through any collusion, connivance, or unlawful agreement any advantage against the City of

Fernandina Beach, Florida or any person interested in the proposed Contract; and

4. The price or prices quoted in the attached proposal 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.

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “G” (con’t)

NON-COLLUSION AFFIDAVIT

Signature Date:

INSTALLATION OF POLYUREA OR EQUIVALENT FLOOR COATING

EXHIBIT “H”

DISPUTES DISCLOSURE FORM

Answer the following questions by placing as “X” after “YES” or “NO”. If you answer “YES”, please explain in the space provided, or via attachment.

Has your firm or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulations or any other regulatory agency or professional association within the last five (5) years?

YES NO____

Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years?

YES NO______

Has your firm had against it or filed any request for equitable adjustment, contract claims, bid protest, or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business?

YES NO _____

If yes, state the nature of the request for equitable adjustment, contract claim, litigation, or protest, and state a brief description of the case, the outcome or status of the suit and the monetary amounts or extended contract time involved.

I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation or falsification of facts must be cause for forfeiture of rights for further consideration of this proposal for the City of Fernandina Beach.

Firm Date

Authorized Signature Printed or Typed Name and Title