RFP26073GR_Proposal_Submittal_Package.pdf

REQUEST FOR PROPOSAL

RFP-26-073-GR

PROFESSIONAL SERVICES – SURVEYING &

MAPPING SERVICES

PROPOSAL SUBMITTAL PACKAGE

BUSINESS INFORMATION: CONTACT INFORMATION:

Company Name (as it appears on the W9) Name of Owner/Partner/Officer

Business Address Title/Position of Owner/Partner/Officer

Business City, State, Zip Contact Address

Business Telephone Number Contact City, State, Zip

Business Email Address Contact Telephone Number

F.E.I.N. Contact Email Address

U.E.I. Number (Replaced DUNS Number)

FOR THIS SUBMITTAL TO BE CONSIDERED VALID,

IT IS MANDATORY THAT THIS FORM BE SIGNED

IN THE SPACE PROVIDED ON THE FOLLOWING PAGE

PROFESSIONAL SERVICES – SURVEYING &

MAPPING SERVICES

The undersigned hereby declares that after examining the Proposal Documents for which proposals were advertised to be returned by 11:00 a.m., Friday, June 26, 2026, does hereby submit a response to the proposal and warrants that:

a. The undersigned is an officer of the organization.

b. The undersigned is authorized to offer a proposal in full compliance with all requirements and conditions, as set forth in the Solicitation.

c. The undersigned has fully read and understands the Solicitation and has full knowledge of the scope, nature, quantity and quality of the work to be performed; and the requirements and conditions under which the work is to be performed.

d. The undersigned, by signing below, is also signing a Truth-In-Negotiation certificate as required by Florida Statutes 287.055(5)(a).

e. If the proposal is accepted, a contract will be issued as proposed subject to any revisions mutually agreed upon by the City and the vendor.

By signing below the Respondent hereby acknowledges receipt of any and all Addenda posted.

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

This Proposal Submittal Form is a mandatory form. An officer or representative who has official authorization to sign proposals MUST sign this Proposal Submittal Form.

Failure to sign in the space provided below will result in the proposal being rejected.

Proposals not received by advertised due date and time will be returned to the sender unopened.

Signing the Proposal Submittal Form affirms that the original Request for Proposal document has not been altered in any way.

Company Name

Name of Owner/Partner/Officer

Title/Position of Owner/Partner/Officer

Signature/eSignature of Owner/Partner/Officer Business Telephone

Fax Telephone

Email Address

Respondents must acknowledge all issued addenda by confirming below. Failure to acknowledge may result in a non-responsive submittal.

The failure of a Respondent to submit/confirm acknowledgment of any addenda that affects price(s), is considered a major irregularity and may be cause for rejection of the Submittal.

The undersigned acknowledges receipt of all issued addenda:☐ Please confirm

PROFESSIONAL SERVICES – SURVEYING &

MAPPING SERVICES

CONFLICT OF INTEREST STATEMENT FORM

A. I am the of with a local office in [Insert Title] [Insert Company Name] and principal office in _.

B. The entity hereby submits an offer to RFP-26-073-GR for Professional Services - Surveying & Mapping Services.

C. The AFFIANT has made a diligent inquiry and provided the information in this statement affidavit based upon its full knowledge.

D. The AFFIANT states that only one submittal for this solicitation has been submitted and tendered by the appropriate date and time and that said above-stated entity has no financial interest in other entities submitting a proposal for the work contemplated hereby.

E. Neither the AFFIANT nor the above-named entity has directly or indirectly entered into any agreement, participated in any collusion or collusive activity, or otherwise taken any action which in any way restricts or restraints the competitive nature of this solicitation, including but not limited to the prior discussion of terms, conditions, pricing, or other offer parameters required by this solicitation.

F. Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise prohibited from participation in this solicitation or any contract to follow thereafter by any government entity.

G. Neither the entity nor its affiliates, nor anyone associated with them, have any potential conflict of interest because and due to any other clients, contracts, or property interests in this solicitation or the resulting project.

H. I hereby also certify that no member of the entity’s ownership or management or staff has a vested interest in any City Division/Department/Office.

I. I certify that no member of the entity’s ownership or management is presently applying, actively seeking, or has been selected for an elected position within the City of Altamonte Springs government.

J. In the event that a conflict of interest is identified in the provision of services, I, the undersigned will immediately notify the City in writing.

By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided in, Conflict of Interest Statement Form, is truthful and correct at the time of submission.

AFFIANT SIGNATURE

Typed Name of AFFIANT

Title

STATE OF

COUNTY OF

Sworn to (or affirmed) and subscribed before me by means of __ physical presence or __online notarization this _____ day of__________________2026, by ________________________, who is personally known to me or has produced ______________________ as identification.

(stamp) _____________________________

NOTARY PUBLIC

PROFESSIONAL SERVICES – SURVEYING &

MAPPING SERVICES

NON-COLLUSION/LOBBYING CERTIFICATION FORM

A. This sworn statement is submitted with solicitation, RFP-26-073-GR Professional Services -Surveying & Mapping Services.

B. This sworn statement is submitted by whose business address is [Name of entity submitting sworn statement] and (if applicable) its Federal Employer Identification Number (FEIN) is (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement.

C. My name is and my relationship to the above is

[Please print name of individual signing]

D. NON-COLLUSION PROVISION CERTIFICATION.

The undersigned hereby certifies, to the best of his or her knowledge and belief, that on behalf of the person, firm, association, or corporation submitting the response certifying that such person, firm, association, or corporation has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action, in restraint of free competitive bidding in connection with the submitted response. Failure to submit the executed statement as part of the bidding documents will make the response nonresponsive and not eligible for award consideration.

E. LOBBYING CERTIFICATION.

The undersigned hereby certifies, to the best of his or her knowledge and belief, that:

1. No Federal and/or City appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence either directly or indirectly an officer or employee of the City, City Council Member of Congress in connection with the awarding of any City Contract.

2. If any funds other than Federal and/or City appropriated funds have been paid or will be paid to any person for influencing or attempting to influence a member of t h e City Council or an officer or employee of the City in connection with this contract, the undersigned shall complete and submit Standard Form-L “Disclosure Form to Report Lobbying”, in accordance with its instructions.

By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided in, the Non-Collusion/Lobbying Certification Form, is truthful and correct at the time of submission.

AFFIANT SIGNATURE

Typed Name of AFFIANT

Title

STATE OF

COUNTY OF

Sworn to (or affirmed) and subscribed before me by means of __ physical presence or __online notarization this _____ day of__________________20___, by ________________________, who is personally known to me or has produced ______________________ as identification.

(stamp) NOTARY PUBLIC

PROFESSIONAL SERVICES – SURVEYING &

MAPPING SERVICES

DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS CERTIFICATION

As required by 2 CFR 200, for persons entering into a contract, grant or cooperative agreement over $25,000 involving the expenditure of Federal funds, the undersigned certifies for itself and its principals that:

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

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

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

D. Have not within a three-year period preceding this application had one or more public transaction (Federal, State, or local) terminated for cause or default; and

Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application.

Printed Name / Title of Representative Contract / Purchase Order Number

Signature of Representative Date

PROFESSIONAL SERVICES – SURVEYING &

MAPPING SERVICES

HUMAN TRAFFICKING AFFIDAVIT

Instruction: “Contractor,” defined as any person or nongovernmental entity seeking to engage in business with the City of Altamonte Springs (“City”), must complete the following form.

The undersigned, on behalf of Contractor, hereby attests as follows:

A. Contractor understands and affirms that Section 787.06(13), Florida Statutes, prohibits the City from executing, renewing, or extending a contract to entities that use coercion for labor or services.

B. Contractor hereby attests, under penalty of perjury, that Contractor does not use coercion for labor or services as defined in Section 787.06(2), Florida Statutes.

I, the undersigned, am an officer or representative of the nongovernmental entity named below, and hereby represent that I: make the above attestation based upon personal knowledge; am over the age of 18 years and otherwise competent to make the above attestation; and am authorized to legally bind and make the above attestation on behalf of the Contractor. Under penalties of perjury, I declare that I have read the forgoing document and that the facts stated in it are true. Further Affiant sayeth naught.

Contractor:

Authorized Signature: Date:

Printed Name:

Title:

STATE OF COUNTY OF

The foregoing instrument was acknowledged before me by means of ☐ physical presence or ☐ online notarization, this day of , 20 , by

, as on behalf of the company/corporation. They ☐ are personally known to me or ☐ have produced as identification.

Signature of Notary Public

Name of Notary Typed, Printed or Stamped My Commission Expires:

PROFESSIONAL SERVICES – SURVEYING &

MAPPING SERVICES

FOREIGN COUNTRY OF CONCERN ATTESTATION

(PUR 1355)

This form must be completed by an officer or representative of an entity submitting a response, proposal, or reply to, or entering into, renewing, or extending, a contract with a Governmental 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.

_______________________ 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:

https://www.flrules.org/gateway/RuleNo.asp?title=GENERAL%20REGULATIONS&ID=60A-1.020

PROFESSIONAL SERVICES - SURVEYING &

MAPPING SERVICES

LIST OF REFERENCES

As per the General Specifications Section, below is a list of at least three (3) client/customer references including company name, contact person, and telephone number. The reference should be similar in scope/ specifications (including size, cost, complexity/uniqueness, etc.) as the project/work/service/item described in this solicitation. If the reference contact information is not correct, current, or unavailable, the City is not responsible for obtaining correct/current/available contact information and may elect to consider the reference as non-responsive. Therefore, the Bidder should ensure the reference contact information is correct, current, and available to the City.

1 Company Name:

Address:

City, State, Zip Code Contact Person Business Phone: Email Address:

Project/Svc/Item Description:

Contract/Order Amount: Completed/Delivered:

2 Company Name:

Address:

City, State, Zip Code Contact Person Business Phone: Email Address:

Project/Svc/Item Description:

Contract/Order Amount: Completed/Delivered:

3 Company Name:

Address:

City, State, Zip Code Contact Person Business Phone: Email Address:

Project/Svc/Item Description:

Contract/Order Amount: Completed/Delivered:

4 Company Name:

Address:

City, State, Zip Code Contact Person Business Phone: Email Address:

Project/Svc/Item Description:

Contract/Order Amount: Completed/Delivered:

5 Company Name:

Address:

City, State, Zip Code Contact Person Business Phone: Email Address:

Project/Svc/Item Description:

Contract/Order Amount: Completed/Delivered:

PROFESSIONAL SERVICES - SURVEYING &

MAPPING SERVICES

SUBMISSION CHECKLIST

Proposal Submittal Package Documents

Contact Information Page completed

Proposal Submittal Form

Signature page completed

Conflict of Interest Statement Form – Notarized

Non-Collusion/Lobbying Certification Form – Notarized

Debarment Form

Human Trafficking Affidavit – Notarized

Foreign Countries of Concern Attestation

List of References Other Requirements: See RFP Document – Minimum Qualifications

E-Verify MOU (Memo of Understanding)

W-9 Form

COI (Certificate of Insurance) – Unendorsed

Business Tax Receipt (BTR)

PROFESSIONAL SERVICES – SURVEYING &

MAPPING SERVICES

PROPOSAL SUBMITTAL LABEL

Cut along dotted line and tape or glue to either a standard #10 envelope, mailing envelope or box.

Company Name: Place

Business Address: Postage

Business Address: Here

City/State/Zip:

HAND DELIVER OR MAIL TO

PROCUREMENT DIVISION

CITY HALL, SUITE 1030

CITY OF ALTAMONTE SPRINGS

225 NEWBURYPORT AVENUE

ALTAMONTE SPRINGS FL 32701-3697

Solicitation #: RFP-26-073-GR

Due Date: Fri., June 26, 2026

Time: 11:00 a.m.