RFP 26-0003-Structural Removal & Base Prep.PDF

Request for Proposal (RFP)

RFP 26-0003

Structural Removal and Base Prep

To all interested Parties:

Notice is hereby given that the Hendry County School Board, LaBelle Florida is seeking proposals from qualified contractors to submit proposals for the demolition of a structure and base prep of the area.

The awarded contractor shall furnish all labor, materials, equipment, supervision, and transportation necessary to perform the following services on the two-story structure.

This document is intended to provide specific information regarding the solicitation. Information specific to this solicitation can be provided by Mr. Tony Busin at busina@hendry-schools.net.

Event Details RFP Issue Date: Monday. September 23,2025

Bids Due: Tuesday October 7th by 3:00 p.m. EST.

Public Bid Opening on Wednesday October 8th at 10:00 a.m. EST at the Purchasing Dept. 111 Curry Street, LaBelle, FL 33935.

Questions Questions shall be addressed to Mr. Tony Busin, Director of Operations at busina@hendry-schools.net, and Mrs.Brandynn Arrieta, Procurement Specialist at arrietab@hendry-schools.net

Attachments Vendor(s) must read all attachments and return applicable documents with their submittal.

Line Items Vendors(s) will provide pricing, discounts and any other information requested.

Response Submission Vendors are required to submit the following documents, complete in their entirety.

1. Company name and length of time in business.

2. Company location and the ability to service the Hendry County area specifically Clewiston, FL.

3. Business Licensure with the State of Florida (can provide copy of

Sunbiz web page)

4. Minimum of three (3) client references.

5. Completed and signed Proposal Submittal Form.

6. Completed and signed Detailed Price Proposal Form.

7. Addenda(s) signed and dated if issued.

mailto:arrietab@hendry-schools.net

8. Insurance Requirements Form (attachment A)

9. Debarment Form (attachment B)

10. Drug Free Workplace Form (attachment C)

11. Public Entities Crime Form (attachment D)

12. Scrutinized Company Certification (attachment E)

13. Foreign Country of Concern Attestation, Attachment F.

14. Vendor Affidavit Regarding the Use of Coercion for Labor and

Service, (Attachment G)

Response Instructions

Vendors shall submit three (3) hard copies of their proposals and one electronic copy on USB flash drive via mail to:

Hendry County School District Finance Department Attn: Purchasing Department – Brandynn Arrieta 111 Curry Street LaBelle, Florida 33935

It is the responsibility of the vendor(s) to ensure all information is reviewed and completed prior to submitting a Bid.

VENDOR REGISTRATION: All Vendors are required to submit a vendor application and a current W-9 via the following link: https://www.hendry-schools.org/departments/finance/purchasing-dept/vendor-application

New E-Verify requirements

A. As of January 1, 2021, pursuant to Section 448.095, Florida Statutes, Firms shall register with and use the U.S. Department of Homeland Security’s E-Verify system to verify the work authorization status of all employees hired during the term of this Agreement and must, upon request, provide evidence of compliance with this provision.

B. Subcontractors

1. As of January 1, 2021, Firms shall also require all subcontractors performing work under this Agreement to use the E-Verify system for any employees they may hire during the term of this Agreement.

2. Subcontractors shall provide firm with an affidavit stating the subcontractor does not employ, contract with, or subcontract with an unauthorized alien, as stated in Section 448.095, Florida Statutes.

3. Firms shall provide a copy of such affidavit to the School Board upon receipt and shall maintain a copy for the duration of the Agreement.

Failure to comply with this provision is a material breach of the Agreement and the School Board may choose to terminate this Agreement at its sole discretion. Firm may be liable for all costs associated with the School Board securing the same Services, inclusive, but not limited to, higher costs for the same services.

C. It is the responsibility of the vendor to ensure compliance with E-Verify requirements (as applicable).

To enroll in E-Verify, employers should visit the E-Verify website http://www.uscis.gov/e-verify and follow the instructions. The employer must retain the I-9 forms for inspection.

https://www.hendry-schools.org/departments/finance/purchasing-dept/vendor-application

Davis-Bacon Act, as Amended (40 U.S.C. 276a to A-7):

Vendor, certifies that it is, and will continue for the term of this contract, to be in compliance with the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Pat 5, “Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction”). In accordance with the statute, the Vendor is herein required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, Vendor agrees to pay wages not less than once a week. The Vendor must provide a copy of the current prevailing wage determination issued by the Secretary of Labor in each solicitation. Vendor acknowledges that the decision to award this contract or subcontract is conditioned upon the acceptance of the wage determination which the Vendor accepts. The Vendor agrees to report all suspected or reported violations to the Federal awarding agency and to notify the District concurrently. The Vendor certifies that it is, and will continue to be, for the term of this contract in full compliance with the Copeland “Anti-Kickback” Act (40 U.S.C.

3145), as supplemented by Department of Labor regulations (29 CFR Part 3, “Vendors and Subcontractors on Public Building or Public Work financed in Whole or in Part by Loans or Grants from the United States”). The Act provides that each Vendor or sub recipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non-Federal entity must report all suspected or reported violations to the Federal awarding agency.

Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333)

Vendor, certifies that it is, and will continue for the term of the contract, be in compliance with 40 U.S.C 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C.

3702 of the Act, each Vendor must be required to compute the wages of every mechanic or laborer on the basis of a standard work week of 40 hours. Work in access of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and half times the basic rate of pay for all hours worked in access of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to constructions work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence.

Health and Safety Standards in Building Trades and Construction Industry (40 U.S.C. 3704).

No laborer or mechanic must be required to work in surroundings or under work conditions which are unsanitary, hazardous, or dangerous.

The following instructions have been developed specifically for this RFP and may or may not be the same as previous or future solicitations for this type of service or commodity. This document, and any Addenda issued, will serve as the contract between the District (hereafter “District”, “Owner”, or “Board”) and the awarded vendor (hereafter “Bidder”, “Contractor”, or “Vendor”).

No separate document will be negotiated or executed. The District reserves the right to deem conditional bids (i.e., counter-bids on specific terms and conditions) nonresponsive; any such bids will not be considered.

Scope of Work

I. Purpose

The Hendry County School District (HCSD) is interested in soliciting competitive sealed Bids by qualified developers with sufficient experience and capacity to furnish all equipment, labor, tools and materials necessary for completion of demolition, debris removal and grading of a two story building at 475 East Osceola Ave, Clewiston Florida 33440 .

III.

Scope of Goods and/or Services

This specification established the minimum requirements for this solicitation, listed and described in the body of these specifications, to be used as noted by the School Board.

1. Demolition of Existing Structure

Complete demolition of the existing two-story building located on-site.

Includes all structural components: roof, walls, foundation, footers, and internal partitions.

2. Debris Removal

Load and remove all demolition debris from the site.

Include all necessary labor, equipment, and transportation.

Proper disposal of all debris at an approved facility.

3. Dump Fees

All dump fees are included in the proposal and will be covered by the contractor.

Provide dump tickets upon request for verification.

4. Site Backfill and Grading

Import approximately 40 tons of shell rock for backfill and surface stabilization.

Spread and grade shell rock evenly across the site to provide a level, compacted surface.

Final grade to ensure proper drainage and stability for future use.

II. Evaluation Criteria RFP Process: Bids shall be reviewed and evaluated based on the criteria set forth in this RFP.

The committee will consist of (3) representatives and score each proposal based on the following criteria:

RFP EVALUATION CRITERIA: The Bid must include information documenting how the company meets the evaluation criteria outlined below. Evaluations will be based on these criteria with assigned weighting as indicated. Each company’s Bid must include a Table of Contents and should be organized by specific sections corresponding to the criteria and in the order shown below.

Weight Allocated Score

Weighted Score

Required Documentation:

(30 Points)

All required company information provided and forms signed.

Pricing: 70 Points Proposed service pricing ranked by qualified proposer)

(If a price is not offered that service will receive a 0 score)

Varied by number of proposals

Total Score: Varied by number of proposals

*If all required documentation is not provided score may be invalidated*

REFERENCES: The District School Board of Hendry County reserves the right to conduct reference checks for firms at any stage of the selection process. In the event that information obtained from the reference checks reveals concerns about the firm’s past performance or its ability to successfully perform the contract to be executed based on this RFP, the District may, at its sole discretion, determine that the firm is not qualified to perform the contract and deem the firm not eligible for further consideration. The District also reserves the right to check references from others not identified by the firm.

The Hendry County School District will furnish power to the contracting firm while work is being completed.

Contractor will provide all warranty information regarding materials and workmanship in their proposals to the Hendry County School District.

Subcontracting. Contractor shall not enter into any subcontracts for any of the work required by this Bid, or assign or transfer any of its interest in this Bid, without The Board’s written consent. In addition to any other provisions The Board may require, Contractor shall include in any permitted subcontracts under this Bid a requirement that the subcontractor be bound by this Bid as if subcontractor were Contractor. The Board’s consent to any subcontract under this Bid shall not relieve Contractor of any of its duties or obligations under this Bid. Moreover, approval by The Board of a subcontract shall not result in any obligations or liabilities to the District in addition to those set forth in this Bid, including, without limitation, the agreed rates of payment and total consideration.

Contractor shall be solely responsible for any and all obligations owing to the subcontractors.

Performance and Payment Bonds (Required)

A. For Projects Costing Less than $200,000.

In order to encourage participation in construction, remodeling, and renovation projects by small, woman-owned, and minority-owned businesses, no bid security or performance or payment bond shall be required for bids in an amount less than $200,000, unless it is determined necessary by the Superintendent. If bonds are required, the information will be specified in the project documentation and the provisions of subjection B below will apply.

B. For Projects Costing $200,000 or Greater

Bonds may be required as specified in the bids for construction, remodeling, and renovation of District facilities. Bids must be accompanied by a Bid Security meeting the following requirements for Bids $200,000 or greater:

1. Bid security shall be a certified check, cashier’s check, Treasurer’s check, bank draft, or Bid Bond acceptable to the Board in a form and manner that is acceptable to the Board.

2. Should the accepted Bidder refuse to enter into the contract or fail to furnish

Performance, Materials and Payment bonds, the amount of the Bid security may be forfeited to the District.

The accepted Bidder must deliver Performance and Payment bonds equal to the contract price, no later than the date of execution of the contract or the first request for payment under the contract, whichever is first. Bonds must be issued by Surety companies admitted to do business in the State of Florida and listed in the Federal Register of the U.S. Department of Treasury for Surety Companies Acceptable on Federal Bonds.

Certified Copy of Recorded Bond

Before commencing the work or before recommencing the work after a default or abandonment, the Contractor shall provide to the Board, if required, a certified copy of the recorded Bond.

Notwithstanding the terms of the contract or any other law governing prompt payment for construction services, the Board may not make a payment to the Contractor until the Contractor has complied with this paragraph.

A Bid proposal will be considered a firm offer and cannot be withdrawn succeeding the

Bid opening without the consent of the The Board for a period of sixty (60) days. The Board also reserves the right to secure expert advice in evaluating and selecting the lowest responsive and reasonable Bid proposal.

Bid proposals must be submitted on the attached forms, enclosed in a sealed envelope and returned to the Purchasing Department no later than the due date listed in the Event Details listed above. All Bid proposals received after the designated cut off time will not be considered and returned unopened.

Any Addenda issued subsequent to the release of this solicitation must be signed and returned with the respondent’s Bid.

Reservations: The Hendry County School Board reserves the right to reject any and all Bids, to negotiate changes in the new scope of work or services to be provided, and to otherwise waive any technicalities or informalities.

The Hendry County School District reserves the right to terminate any contract resulting from this Invitation to Bid upon thirty (30) days written notice.

Right of Protest: Failure to file a protest within the time prescribed in Florida Statutes, Section 120.53 (5), shall constitute a waiver of proceedings under Chapter 120, Florida Statutes. It is the responsibility of the vendor(s) to ensure all information is reviewed and completed prior to submitting a response.

The district reserves the right to waive minor informalities in any Bid to accept any Bid which they consider to be in the best public interest, and to reject any part of, or any and all Bids. Failure to read or comply with the terms and conditions in no way relieves vendor(s) from their liabilities arising hereunder. Solicitations cannot be withdrawn prior to Board approval without a valid written explanation from the proposer and written consent of the Director of Operations.

NO PHONE CALLS PLEASE. Requests for information shall be in writing only – refer all written requests to Mr. Tony Busin at busina@hendry-schools.net and Brandynn Arrieta at arrietab@hendry-schools.net.

mailto:busina@hendry-schools.net mailto:arrietab@hendry-schools.net

PROPOSAL SUBMITTAL FORM

Bids received timely will be opened, tabulated and evaluated in the Hendry County School District’s Purchasing Department. An Intention to Award document will be posted at www.hendry-schools.org prior to the Hendry County School Board’s scheduled meeting and if the Bid is awarded during that meeting an Award letter will be sent to the selected vendor.

A Bid proposal will be considered a firm offer and cannot be withdrawn succeeding the Bid opening without the consent of The School Board for a period of sixty (60) days. The School Board also reserves the right to secure expert advice in evaluating and selecting the lowest responsive and reasonable bid proposal.

Bid proposals must be submitted on the attached forms, enclosed in a sealed envelope and returned to the Purchasing Department at the given address in this Invitation to Bid by the date and time listed on the Proposal. All Bid proposals received after the designated cut-off time will not be considered and returned unopened.

I/we hereby certify that I/we have carefully read all instructions pertaining to this Invitation to Bid and that my/our Bid complies, without exception, with all instructions and specifications.

Company Name

Signed Authorization Representative Printed name of Representative

Title of Representative Date

Address City State Zip Code

Contact Numbers:

Email Address:

Structural Removal and Base Prep for Hendry County Schools Price Proposal Summary Form

This document contains a proposal solicitation for the Structural Removal and Base Prep on Hendry County School District Property and sets forth the terms and conditions applicable to the procurement. The pricing proposed in this RFP will be paid based on the payment schedule provided by the selected bidder. This Document shall constitute the Contract between the awarded company and Hendry County School District. The company shall not plead misunderstanding or deception because of such estimate of quantities, or of the character, location, or other conditions pertaining to the proposal solicitation/contract. Proposals shall be submitted using this Proposal Summary form. Proposals must be written in ink or typed in the space(s) provided.

Total cost for removal and base prep of proposed area:

Base Bid: ________________________________________________Dollars (In words)

($____________________________________) (In numbers)

Include all non-service costs including but not limited to Payment and Performance Bond Costs and General Requirement costs in base bid amount. Any discounts, or additional costs pertaining to the service of these units should be included with this price proposal form.

Attachment A – Insurance Requirements Form

Hendry County School District

X 1. Workers’ Compensation – Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government Statutory Limit and Requirements. Policy must include Employers Liability with a limit of $500,000 per incident.

X 2. Commercial General Liability – Bodily Injury & Property Damage - $1,000,000 Single limit per occurrence.

X 3. Indemnification: The Contractor/Vendor, in consideration of One Hundred Dollars ($100.00), the receipt and sufficiency of which is accepted through the signing of this document, shall hold harmless and defend The Hendry County School District and its agents and employees from all suits and actions, including attorney’s fees and all costs of litigation and judgments of any name and description arising out of or incidental to the performance of this contract or work performed there under. This provision shall also pertain to any claims brought against The Hendry County School District by an employee of the named Contractor/Vendor, any

Subcontractor, or anyone directly or indirectly employed by any of them. The Contractor/Vendor’s obligation under this provision shall not be limited in any way by the agreed upon contract price as shown in this Contract or the Contractor/Vendor’s limit of, or lack of, sufficient insurance protection. The first One Hundred Dollars ($100.00) or money received on the contract price is considered as payment of this obligation by The Hendry County School District.

__ 4. Automobile Insurance – Owned, non-owned, hired - $1,000,000 Each occurrence.

X 5. Professional Liability $1,000,000

X 6. Vendor shall insure that any and all subcontractors comply with the same insurance requirements as outlined above.

X 7. The Hendry County School District must be named as Additional Insured on the insurance certificate for all coverages, except Workers’ Compensation and Professional Liability.

X 8. The Hendry County School District shall be named as the Certificate Holder to read as follows:

The School District of Hendry County, Florida

Financial Services

P.O. Box 1980

Labelle, Florida 33975

X 9. Thirty (30) days cancellation notice is required.

X 10. The Certificate must state the BID Number and Title.

Insurance Requirements Continued

CERTIFICATION:

I/We understand the insurance requirements contained in these specifications, and that the evidence of said insurance is required within five (5) business days of the Notice of Award of the proposal. The Hendry County School District must be named as “ADDITIONAL INSURED” on the Insurance Certificate for Commercial General Liability and the Business Auto Liability policies. The Hendry County School District desires proof of insurability at levels required for this proposal.

A current certificate of insurance is attached: _____ Yes _____ No

Bidder Signature

Bidder Name

Bidder Title

Attachment B – Debarment Form

This certification is required by the Department of Education regulations implementing Executive Order 12549, Debarment and Suspension, 34 CFR Part 85, for all lower tier transactions meeting the threshold and tier requirements stated at Section 85.110.

1. By signing and submitting this bid/proposal, the prospective lower tier participant is providing the certification set out below.

2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

3. The prospective lower tier participant shall provide immediate written notice to the person to which this bid is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," " person," "primary covered transaction," "principal," "bid," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this bid is submitted for assistance in obtaining a copy of those regulations.

5. The prospective lower tier participant agrees by submitting this bid that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated.

6. The prospective lower tier participant further agrees by submitting this bid that it will include the clause titled Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion-Lower Tier Covered Transactions, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may but is not required to, check the No Procurement List.

8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

CERTIFICATION: The prospective lower tier participant certifies by submission of this bid/proposal that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by and Federal department or agency. Where the prospective lower tier participant is unable to certify any of the statements in this certification, such prospective participant must attach an explanation.

Bidder Signature: _____________________________

Bidder Name: ________________________________ Bidder Title: _______________________

Attachment C – Drug Free Workplace

The undersigned bidder, in accordance with Florida Statute 287.087, hereby certifies that

__________________________________________ does:

(name of business)

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, 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 proposal a copy of the statement specified in Paragraph 1.

4. In the statement specified 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 guilty or nolo contender to, any violation of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction.

5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee’s community, by any employee who is so convicted.

6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of Paragraphs 1 thru 5.

I certify that this business, named above, complies fully with the above requirements.

Authorized Officer Signature Date

Name Title

Attachment D – Public Entities Crime Form SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, PUBLIC ENTITY CRIMES

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

OFFICER AUTHORIZED TO ADMINISTER OATHS.

This sworn statement is submitted by ________________________________________________ (name of entity) who business address is ________________________________________________________ and Federal Employer ID Number (FEIN), if applicable, is ____________________________. If the entity has no FEIN, you must include the social security number of the individual signing this sworn statement.

My name is _______________________________________________ and my relationship to the __________________________________ (print name of individual signing) entity above is

I understand that a public entity crime, as defined in Florida Statute 287.133(1)(g) means a finding 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 bid or contract for goods or services to be provided to any public entity or an 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.

I understand that “convicted” or “conviction” as defined in Paragraph 287.133(1)(b), Florida Statutes, means a violation 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 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.

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 a 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.

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, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity.

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, not any 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, AND (Please indicate which additional statement applies.)

_____The person HAS __________ or HAS NOT ________ been placed on the convicted contractor list. (Please describe any action taken by or pending with the Department of Management Services concerning removal from the list.)

Authorized Officer Signature Date

Name

Title

State of __________________

County of ________________

____________________________ Appeared in person before me, who is personally known to me or provided the following identification _____________________, affixed his/her signature in the space provided above on this _____ day of _________________, 20____.

NOTARY PUBLIC

My commission expires

Attachment E – Scrutinized Company Certification

I hereby swear or affirm that as of the date below this company is not listed on a Scrutinized Companies list created pursuant to 215.4725, 215.473, or 287.135, Florida Statutes. Pursuant to 287.135, Florida Statutes I further affirm that:

1. This company is not participating in a boycott of Israel such that it is not refusing to deal, terminating business activities, or taking other actions to limit commercial relations with Israel, or persons or entities doing business in Israel or in Israeli-controlled territories, in a discriminatory manner.

2. This Company does not appear on the Scrutinized Companies with Activities in Sudan List where the State Board of Administration has established the following criteria:

a. Have a material business relationship with the government of Sudan or a government-created project involving oil related, mineral extraction, or power generation activities, or

b. Have a material business relationship involving the supply of military equipment, or

c. Impart minimal benefit to disadvantaged citizens that are typically located in the geographic periphery of Sudan, or

d. Have been complicit in the genocidal campaign in Darfur.

3. This Company does not appear on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List where the State Board of Administration has established the following criteria:

a. Have a material business relationship with the government of Iran or a government created project involving oil related or mineral extraction activities, or

b. Have made material investments with the effect of significantly enhancing Iran‘s petroleum sector.

4. This Company is not engaged in business operations in Cuba or Syria.

Name of Company

Authorized Officer Signature Date

Name

Title

ATTACHMENT F

FOREIGN COUNTRY OF CONCERN ATTESTATION

(PUR 1355)

This form must be completed by an officer or representative of an entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending, a contract with a Government Entity which would grant the entity access to an individual’s Personal Identifying Information.

Capitalized terms used herein have the definitions ascribed in Rule 60A-1.020, F. A. C.

__________________________ (name of vendor) is not owned by the government of a Foreign Country of Concern, is not organized under the laws of nor has its Principal Place of Business in a Foreign Country of Concern, and the government of a Foreign Country of Concern does not have a Controlling Interest in the entity.

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

Printed Name: ____________________________________________

Title: ___________________________________________________

Signature: _______________________________________________ Date: ________________

ATTACHMENT G

Vendor Affidavit Regarding the Use of Coercion for Labor and Services

Vendor Name: ______________________________________________________________

Address: ___________________________________________________________________

Phone Number: _____________________________________________________________

Authorized Representative’s Name: _____________________________________________

Authorized Representative’s Title: ______________________________________________

Email Address: ______________________________________________________________

Section 787.06(13), Florida Statutes requires all nongovernment entities (such as Vendor) executing, renewing, or extending a contract with a governmental entity (such as the School Board of Hendry County, Florida) to provide an affidavit signed by an officer or representative of Vendor under penalty of perjury that Vendor does not use coercion for labor or services as defined in that statute.

As the person authorized to sign on behalf of Vendor, I certify that the company 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 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 s.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.

Signature of Authorized Representative

Checklist and Scoring Sheet

Proposal Checklist: All Items and attachments must be provided for qualification

X

1. Company name and length of time in business

2. Company location and ability to service Hendry County (Clewiston, FL)

3. Business Licensure with the State of Florida (Sunbiz web page copy)

4. Minimum of three (3) client references (1 point per reference)

5. Completed and signed Proposal Submittal Form

6. Completed and signed Detailed Price Proposal Form (1 point per item)

7. Addenda(s) signed and dated (if issued)

8. Insurance Requirements Form (Attachment A)

9. Debarment Form (Attachment B)

10. Drug-Free Workplace Form (Attachment C)

11. Public Entities Crime Form (Attachment D)

12. Scrutinized Company Certification (Attachment E)

13. Foreign Country of Concern Attestation (Attachment F)

14. Vendor Affidavit Regarding Use of Coercion for Labor and Services (Attachment G)

Checklist and Scoring Sheet

BIDDER BASE BID

Rank by Proposal

Package REMARKS

Weight Allocated Score

Weighted Score

Required Documentation:

(30 Points)

All required company information provided and forms signed.

Pricing: 70 Points Proposed service pricing ranked by qualified proposer)

(If a price is not offered that service will receive a 0 score)

Total Score:

Scoring: Weight x Allocated Score= weighted score

Overall score= Weighted Score total

*If all required documentation is not provided score may be invalidated*