RFQ_25_26-18 Marina Isle Breakwall Reconstruction Attachments.pdf

City of Sanford | Finance Department | Purchasing Division 300 N. Park Ave, Sanford, Florida 32771

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

September 24, 2026

TITLE: MARINA ISLE BREAKWATER WALL RECONSTRUCTION

ATTACHMENT “A”

Statement of “No Bid Submittal”

If you do not intend to submit on this requirement, please complete and return this form prior to date shown for receipt of proposals to:

City of Sanford, Purchasing Division, 300 N. Park Avenue 2nd Floor Suite 236, Sanford, Florida 32771.

I/WE HAVE DECLINED TO SUBMIT A BID FOR RFQ 25/26-18, titled Marina Isle Breakwater Wall Reconstruction for the following reason(s): [Please place a check mark () next to the reason(s) as applicable]

() Reason

Bid requirements too "restrictive".

Insufficient time to respond to the Invitation for Bid.

We do not offer this service.

Our schedule would not permit us to perform.

Unable to meet requirements.

Unable to meet insurance or bond requirements.

Scope of Services unclear (please explain below).

Other (please specify below).

REMARKS:

Company Name: ________________________________________________________________________________________

Mailing Address: ________________________________________________________________________________________

Telephone Number: ___________________ Fax Number: ___________________ E-mail Address: _______________________

____________________________________ _________________________________ FEIN: ____________________ Authorized Signatory Printed Name

Title Date

Contracts and Construction Projects -

NO UNUSUAL

HAZARDS

(Under $25,000)

Contracts and Construction Projects -

NO UNUSUAL

HAZARDS

($25,000 to $99,999)

Contracts and Construction Projects -

NO UNUSUAL

HAZARDS

($100,000 to $500,000)

Contracts and Construction Projects (Over $500.000 and/or

UNUSUAL HAZARDS)

Professional Services (Construction Services, Architects

/ Engineers / Consultants, Professional Consultants, IT/Computer Systems Related)

(ANY SIZE)

COMMERCIAL GENERAL LIABILITY

General Aggregate $500,000 $1,000,000 $2,000,000 $3,000,000 $1,000,000 Products & Completed Operations Aggregate $500,000 $1,000,000 $2,000,000 $3,000,000 $1,000,000 Personal and Advertising Injury $500,000 $1,000,000 $1,000,000 $2,000,000 $1,000,000 Each Occurrence $500,000 $1,000,000 $1,000,000 $2,000,000 $1,000,000 Project Specific Aggregate (Per Job/Per Location) $2,000,000 $2,000,000 Sexual Harassment, abuse and molestation If applicable If applicable If applicable If applicable If applicable

GARAGE KEEPERS (when required) Aggregate THE CITY WILL ANALYZE ON A CASE-BY-CASE BASIS.

GARAGE LIABILITY (when required) Aggregate THE CITY WILL ANALYZE ON A CASE-BY-CASE BASIS.

Combined Single Limit $500,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000

If vehicles on site If vehicles on site

A. Workers Compensation Statutory* Statutory* Statutory* Statutory* Statutory* B. Employers' Liability

Employer's Liability/Accident $500,000 $500,000 $500,000 $1,000,000 $500,000 Disease Policy Limit $500,000 $500,000 $500,000 $1,000,000 $500,000

Including Fire, Wind & Flood as applicable 100% Completed Value 100% Completed Value

Bodily Injury & Property Damage $1,000,000 (if applicable) $1,000,000 (if applicable)

Policy Aggregate $500,000 (if applicable) $1,000,000 (if applicable) $1,000,000 (if applicable) $1,000,000 (if applicable) $1,000,000 Bodily Injury & Property Damage $500,000 (if applicable) $1,000,000 (if applicable) $1,000,000 (if applicable) $1,000,000 (if applicable) $1,000,000

Data Breach, Media Content, Privacy Liability, Network

$5,000,000 $5,000,000 $5,000,000

INSURANCE CARRIER FINANCIAL

STABILITY (AM BEST RATING)

DEFINITIONS

COMMERCIAL GENERAL LIABILITY

AUTOMOBILE LIABILITY

WORKERS' COMPENSATION AND

EMPLOYERS' LIABILITY

BUILDER'S RISK

POLLUTION LIABILITY

PROFESSIONAL LIABILITY / ERRORS &

OMMISSIONS LIABILITY

CYBER / PRIVACY LIABILITY

Edition: Mar 17, 2025

Designed to cover consumers of technology services or products.

Protects employer's exposures arising out of injuries sustained by employees.

Designed to cover property in the course of construction.

Designed to cover contamination of an environment by substances regarded as pollutants.

Protects the insured against liability claims arising out of damages caused by errors, ommissions, or failure to perform a service.

Protects the insured against liability claims for bodily injury and property damage due to negligence.

Protects the insured against financial loss because of legal liability for automobile-related injuries or property damage to others caused by an insured auto.

CYBER / PRIVACY LIABILITY

All Insurance carrier(s) must have a minimum financial rating of A-, VII or better. Financial Ratings can be verified at: www.ambest.com

NOTES OF IMPORTANCE

The City of Sanford must be named as Additional Insured on all policies EXCEPT workers' compensation and professional liability policies.

If Professional Liability is written on a Claims Made basis, coverage must be provided for not less than three(3) years after project completion.

* Statutory Workers Compensation may not be wavied.

Follow form umbrella or excess liability policies can supplement the underlying general and auto liability to satisfy the coverage limits required.

The above limits are minimum standards and this document is to be utilized as a guide only. Each Scope of Work and estimated cost should be reviewed to determine appropriate limits and/or exceptions. ANY CHANGES TO THE COVERAGE REQUIREMENTS DETAILED IN THIS DOCUMENT SHALL BE APPROVED BY CITY OF SANFORD CITY MANAGER OR ASSISTANT CITY MANAGER.

BUILDER'S RISK

POLLUTION LIABILITY

PROFESSIONAL LIABILITY / ERRORS AND OMMISSIONS LIABILITY

WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY

INSURANCE REQUIREMENTS MATRIX

MINIMUM INSURANCE LIMITS BY TYPE OF PROJECT / AGREEMENTS / EXPOSURE

AUTOMOBILE LIABILITY

http://www.ambest.com/ http://www.ambest.com/ http://www.ambest.com/ http://www.ambest.com/ http://www.ambest.com/ http://www.ambest.com/ http://www.ambest.com/ http://www.ambest.com/

SANFORD

It is noted that Professional Liability, builder's risk, garage keepers and garage liability is not required unless applicable conditions exist. If clarification is needed the CONTRACTOR must request clarification from the City of Sanford Purchasing Office.

Vendor, Contractor, bidder shall provide, to the City of Sanford "City," prior to commencing any work, a Certificate of Insurance which verifies coverage in compliance with the requirements. Any work initiated without completion of this requirement shall be unauthorized and the City will not be responsible.

The City reserves the right, as conditions warrant, to modify or increase insurance requirements as may be determined by the project, conditions and exposure.

> Certification Terms and Conditions

It is noted that the City has a contractual relationship with the named vendor, contractor or provider (collectively referred hereinafter as Contractor) applicable to a purchase order, work order, contract or other form of commitment by the City of Sanford, whether in writing or not and has no such contractual relationship with the Contractor's insurance carrier. Therefore, the onus is on the Contractor to insure that they have the insurance coverage specified by the City to meet all contractual obligations and expectations of the City. Further, as the Contractor's insurance coverage is a matter between the vendor and its insurance carrier, the City will turn to the Contractor for relief as a result of any damages or alleged damages for which the Contractor is responsible to indemnify and hold the City harmless. It is understood that the Contractor may satisfy relief to the City for such damages either directly or through its insurance coverage; exclusions by the insurance carrier notwithstanding, the City will expect relief from the Contractor.

a. The insurance limits required and otherwise referenced are minimum limits acceptable to the City. In addition, all contractor policies shall be considered primary to City coverage and shall not contain co-insurance provisions.

b. All policies, except for professional liability policies and workers compensation policies, shall name the City of Sanford as Additional Insured.

c. Professional Liability Coverage, when applicable, will be defined on a case by case basis.

d. Umbrella Policy / Excess Liability Policy: If applicable, any such policy must provide minimally “follow form” or broader coverage in excess of the underlying general and auto liability coverage.

e. Inthe event that the insurance coverage expires prior to the completion of the project, a renewal certificate shall be issued 30 days prior to the expiration date.

f. All limits are per occurrence and must include Bodily Injury and Property Damage.

g. All policies must be written on occurrence form, not on claims made form, except for Professional Liability.

h. Self-Insured retentions shall not be allowed on any liability coverage.

Section 00618 Insurance Requirements - City of Sanford, Florida

-) SANFORD

i. In the notification of cancellation: The City of Sanford shall be endorsed onto the policy as a cancellation notice recipient. Should any of the above-described policies of Sanford in accordance with the policy provisions.

j. Allinsurers must have an A.M. rating of at least A-VII.

k. It is the responsibility of the Prime CONTRACTOR to ensure that all sub-contractors retained by the Prime CONTRACTOR shall provide coverage as defined here in before and after and are the responsibility of said Prime CONTRACTOR in all respects.

|. Any changes to the coverage requirements indicated above shall be approved by the City of Sanford, City Manager or Assistant City Manager.

m. Address of "Certificate Holder" is City of Sanford; 300 N. Park Avenue;

Sanford, Florida 32771.

n. All certificates of insurance, notices etc. must be provided to the above address.

o. Inthe description of the certificate of insurance inlcude the solicitation number and proiect name.

Signature of Affiant Date

Typed or Printed Name of Affiant Title Name of Company

STATE OF FLORIDA

COUNTY OF

I HEREBY CERTIFY that on this day, before me, an officer duly authorized to administer oaths and take acknowledgments, personally appeared

Qwho is personally known to me or { } who produced as identification and acknowledged before me that s/he executed the same. Sworn and subscribed before me, by by means of { } physical presence or { } online notarization on the __—_ day of

, 202_, the said person did take an oath and was first duly sworn by me, on oath, said person, further, deposing and saying thats/he has read the foregoing and that the statements and allegations contained herein are true and correct.

WITNESS my hand and official seal in the County and State last aforesaid this___ day of ,202_.

(Notary Public in and for the County and State Aforementioned)

SEAL My commission expires:

The City reserves the unilateral right to modify the Insurance requirements set forth at any time during the process of sol/citation or subsequent thereto.

or failure to submit this form may be grounds for disqualification of your submittal Revised 12/22/2022

3 of 3 Section 00618 Insurance Requirements - City of Sanford, Florida

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “C” Conflict of Interest Statement

A. I am the ________________________________of _______________________________________ with a local office in

[Insert Title] [Insert Company Name]

________________________________ and principal office in _________________________________.

B. The entity hereby submits a proposal/offer to RFQ-25/16-18, Marina Isle Breakwater Wall Reconstruction on a Task

Authorization Basis.

C. The AFFIANT has made 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 City of Sanford 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 Attachment “C”, Conflict of Interest Statement, is truthful and correct at the time of submission.

AFFIANT SIGNATURE

Typed Name of AFFIANT

Title

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

STATE OF FLORIDA

COUNTY OF ___________________

I HEREBY CERTIFY that on this day, before me, an officer duly authorized to administer oaths and take acknowledgments, personally appeared ________________________ { } who is personally known to me or { } who produced ________________________ as identification and acknowledged before me that s/he executed the same. Sworn and subscribed before me, by __________________________________ by means of { } physical presence or { } online notarization on the _____ day of _____________, 2026, the said person did take an oath and was first duly sworn by me, on oath, said person, further, deposing and saying that s/he has read the foregoing and that the statements and allegations contained herein are true and correct.

WITNESS my hand and official seal in the County and State last aforesaid this____day of ________________, 2026.

(Notary Public in and for the County and State Aforementioned)

SEAL My commission expires:

PLEASE COMPLETE AND SUBMIT WITH YOUR RFQ RESPONSE

Failure to submit this form may be grounds for disqualification of your submittal

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “D” Non-Collusion/Lobbying Certification

A. This sworn statement is submitted with RFQ Proposal, ITN, or Contract Number RFQ-25/16-18, titled Marina Isle Breakwater Wall Reconstruction on a Task Authorization Basis.

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 bid 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 bid. Failure to submit the executed statement as part of the bidding documents will make the bid 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 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 City appropriated funds have been paid or will be paid to any person for influencing or attempting to influence a member of 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 Attachment “D”, Non-Collusion/Lobbying Certification, is truthful and correct at the time of submission.

Typed Name of AFFIANT

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

I HEREBY CERTIFY that on this day, before me, an officer duly authorized to administer oaths and take acknowledgments, personally appeared ________________________ { } who is personally known to me or { } who produced ________________________ as identification and acknowledged before me that s/he executed the same. Sworn and subscribed before me, by __________________________________ by means of { } physical presence or { } online notarization on the _____ day of _____________, 2026, the said person did take an oath and was first duly sworn by me, on oath, said person, further, deposing and saying that s/he has read the foregoing and that the statements and allegations

WITNESS my hand and official seal in the County and State last aforesaid this____day of ________________, 2026.

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “E” Drug-Free Workplace Certification

When applicable, the drug-free certification form below must be signed and returned with the RFQ response.

In order to have a drug-free workplace program, a business shall:

A. 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.

B. Inform employees about the dangers of drug abuse in the workplace, the business' 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.

C. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in the first paragraph.

D. In the statement specified in the first paragraph, notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of chapter 893, Florida Statutes, 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.

E. 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.

F. Make a good faith effort to continue to maintain a drug-free workplace through implementation of the foregoing provisions.

By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided in Attachment “E”, Drug-Free Workplace Certification, is truthful and correct at the time of submission.

Typed Name of AFFIANT

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

I HEREBY CERTIFY that on this day, before me, an officer duly authorized to administer oaths and take acknowledgments, personally appeared ________________________ { } who is personally known to me or { } who produced ________________________ as identification and acknowledged before me that s/he executed the same. Sworn and subscribed before me, by __________________________________ by means of { } physical presence or { } online notarization on the _____ day of _____________, 2026, the said person did take an oath and was first duly sworn by me, on oath, said person, further, deposing and saying that s/he has read the foregoing and that the statements and allegations

WITNESS my hand and official seal in the County and State last aforesaid this____day of ________________, 2026.

PLEASE COMPLETE AND SUBMIT WITH YOUR RFQ RESPONSE – (if applicable)

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “F” Proposal Acceptance of Proposal Terms and Conditions

I/we, the undersigned, as authorized signatory to commit the firm, do hereby accept in total all the terms and conditions stipulated and referenced in this RFQ document and do hereby agree that if a contract is offered or negotiated it will abide by the terms and conditions presented in the RFQ document or as negotiated pursuant thereto. The signature(s) below in Attachment “F” Acceptance of Proposal Terms and Conditions are an acknowledgment of my/our full understanding and acceptance of all the terms and conditions set forth in this RFQ document or as otherwise agreed to between the parties in writing.

Proposer/Contractor Name: ________________________________________________________________________________

Mailing Address: ________________________________________________________________________________________

Telephone Number: ___________________ Fax Number: ___________________ E-mail Address: _______________________

Title Date

STATE OF FLORIDA

COUNTY OF ___________________

I HEREBY CERTIFY that on this day, before me, an officer duly authorized to administer oaths and take acknowledgments, personally appeared ________________________ { } who is personally known to me or { } who produced ________________________ as identification and acknowledged before me that s/he executed the same. Sworn and subscribed before me, by __________________________________ by means of { } physical presence or { } online notarization on the _____ day of _____________, 2026, the said person did take an oath and was first duly sworn by me, on oath, said person, further, deposing and saying that s/he has read the foregoing and that the statements and allegations

WITNESS my hand and official seal in the County and State last aforesaid this____day of ________________, 2026.

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “G” Addendum Receipt Acknowledgement Certification

The undersigned acknowledges receipt of the following addenda to the solicitation document(s) (Give number and date of each):

Addendum No. Dated:

Addendum No. Dated:

Addendum No. Dated:

Addendum No. Dated:

Addendum No. Dated:

By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided in Attachment “G”, Addendum Receipt Acknowledgement Certification, is truthful and correct at the time of submission.

Proposer/Contractor Name: ________________________________________________________________________________

Mailing Address: ________________________________________________________________________________________

Telephone Number: ___________________ Fax Number: ___________________ E-mail Address: _______________________

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “H” Organizational Information

The Proposer must include a copy of their State Certificate of Good Standing/Articles of Incorporation, which lists the corporate officers.

In addition to the aforementioned documents the Bidder/Proposer must include necessary information to verify the individual signing this proposal/bid and or any contract document has been authorized to bind the corporation. Examples include:

A. A copy of the Articles of Incorporation listing the approved signatories of the corporation.

B. A copy of a resolution listing the members of staff as authorized signatories for the company.

C. A letter from a corporate officer listing the members of staff that are authorized signatories for the company.

TYPE OF ORGANIZATION

(Please place a check mark () next to applicable type)

Corporation Partnership Non-Profit

Joint Venture Sole Proprietorship Other (Please specify)

State of Incorporation

Principal Place of Business (Enter Address)

Federal I.D. or Social Security Number

By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided in Attachment “H”, Organizational Information, is truthful and correct at the time of submission.

Proposer/Contractor Name: ________________________________________________________________________________

Mailing Address: ________________________________________________________________________________________

Telephone Number: ___________________ Fax Number: ___________________ E-mail Address: _______________________

____________________________________ _________________________________ FEIN: ____________________ Authorized Signatory Printed Name

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “I” Proposed Schedule of Subcontractor Participation

No Subcontracting (of any kind) will be utilized on this project. Solicitation Number: RFQ 25/26-18

Title: Marina Isle Breakwater Wall Reconstruction Contract Value Amount: $

Subcontractor Minority Code (if applicable)

Company Name Address Phone, Fax, Email

Trade, Services or Materials portion to be subcontracted

Percent (%) of Scope/Contract

Federal ID Certifying Agency

PERCENTAGE TOTALS FOR SUBCONTRACTOR PARTICIPATION

PERCENTAGE TOTALS FOR MINORITY SUBCONTRACTOR PARTICIPATION

Minority Code Code Description Minority Code Code Description

AA African American NA Native American A Asian/Pacific Islander W Woman H Hispanic SDVBE Service Disabled Veteran

When applicable, the Proposer, will enter into a formal agreement with the subcontractors identified herein for work listed in this schedule conditioned upon execution of a contract with the City. By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided in Attachment “I”, Proposed Schedule of Subcontractor Participation, is truthful and correct at the time of submission.

Proposer/Contractor Name: ________________________________________________________________________________

Mailing Address: ________________________________________________________________________________________

Telephone Number: ___________________ Fax Number: ___________________ E-mail Address: _______________________

____________________________________ _________________________________ FEIN: ____________________ Authorized Signatory Printed Name

Title Date

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “J” References

Proposer shall submit as a part of the Proposal package, a minimum of five (5) of the most significant projects which were performed within the last three (3) years. Additional references may be provided as set forth below. DO NOT USE the City of Sanford as a reference.

Project #1:

Project Name:

Type of Project/Service:

Address:

Contracting Agency/Client:

Contact Name and Phone #:

Contact Email Address and Fax #:

Contract Amount: Date Work Performed:

Project #2:

Project Name:

Type of Project/Service:

Address:

Contracting Agency/Client:

Contact Name and Phone #:

Contact Email Address and Fax #:

Contract Amount: Date Work Performed:

Project #3:

Project Name:

Type of Project/Service:

Address:

Contracting Agency/Client:

Contact Name and Phone #:

Contact Email Address and Fax #:

Contract Amount: Date Work Performed:

Project #4:

Project Name:

Type of Project/Service:

Address:

Contracting Agency/Client:

Contact Name and Phone #:

Contact Email Address and Fax #:

Contract Amount: Date Work Performed:

Project #5:

Project Name:

Type of Project/Service:

Address:

Contracting Agency/Client:

Contact Name and Phone #:

Contact Email Address and Fax #:

Contract Amount: Date Work Performed:

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “K” Contractor Certification Regarding Scrutinized Companies

(Contracts of $1,000,000.00 or more)

Section 287.135, Florida Statutes, prohibits local governments from contracting with companies, for goods or services of One Million and 00/100 Dollars ($1,000,000.00) or more that are on the Scrutinized Companies with Activities in Sudan List, on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List or is engaged in business operations in Cuba or Syria. Both lists are created pursuant to section 215.473, Florida Statutes. In addition, the CONTRACTOR shall not be listed on the Scrutinized Companies that Boycott Israel List, created pursuant to Section 215.4725, Florida Statutes, or is engaged in a boycott of Israel.

As the person authorized to sign on behalf of the CONTRACTOR, I hereby certify that the company identified below in the section entitled “Bidder/Contractor Name” is not listed on the Scrutinized Companies with Activities in Sudan List, is not listed on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List or is engaged in business operations in Cuba or Syria. In addition, the CONTRACTOR is not listed on the Scrutinized Companies that Boycott Israel List, created pursuant to Section 215.4725, Florida Statutes, or is engaged in a boycott of Israel. I understand that pursuant to Section 287.135, Florida Statutes, the submission of a false certification may subject the CONTRACTOR to termination of the Agreement, civil penalties, attorney’s fees, and/or costs.

By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided in Attachment “K”, Contractor Certification Regarding Scrutinized Companies, is truthful and correct at the time of submission.

Proposer/Contractor Name: ________________________________________________________________________________

Mailing Address: ________________________________________________________________________________________

Telephone Number: ___________________ Fax Number: ___________________ E-mail Address: _______________________

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “L” Truth-in-Negotiations Certification

For lump-sum or fixed-fee Professional Service Agreements over One Hundred Ninety Five Thousand and 00/100 Dollars ($195,000.00), the City requires the Respondent to execute this certificate and include it with their submittal.

Upon execution of an Agreement, Respondent hereby certifies that, in accordance with Section 287.055(5)(a), Florida Statutes (as amended), the wage rates and other factual unit costs supporting the compensation under this Agreement are accurate, complete and current as of the time of entering into this Agreement. The Parties agree that the City may adjust the original Agreement price and any additions thereto to exclude any significant sums by which the City determines the Agreement price was increased due to inaccurate, incomplete, or noncurrent wage rates and other factual unit costs. All such price adjustments must be made within one (1) year following the end of the Agreement.

Proposer/Contractor Name: ________________________________________________________________________________

Mailing Address: ________________________________________________________________________________________

Telephone Number: ___________________ Fax Number: ___________________ E-mail Address: _______________________

Title Date

STATE OF FLORIDA

COUNTY OF ___________________

I HEREBY CERTIFY that on this day, before me, an officer duly authorized to administer oaths and take acknowledgments, personally appeared ________________________ { } who is personally known to me or { } who produced ________________________ as identification and acknowledged before me that s/he executed the same. Sworn and subscribed before me, by __________________________________ by means of { } physical presence or { } online notarization on the _____ day of _____________, 2026, the said person did take an oath and was first duly sworn by me, on oath, said person, further, deposing and saying that s/he has read the foregoing and that the statements and allegations

WITNESS my hand and official seal in the County and State last aforesaid this____day of ________________, 2026.

This form is completed when you are awarded the project!

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “M” Solicitation Response Identification Label

NOTICE TO ALL RESPONDENTS: For your convenience, the label below has been provided to properly identify your solicitation submittal. Place your submittal in a sealed envelope or package, type or print the company name and address in the area provided below and affix the label on the outer surface of the envelope or package.

If you are hand delivering a solicitation you must check at the front desk with security and provide identification. You must sign in to enter the building and sign-out when departing the building. Once you have checked in, please deliver to the Finance/Procurement Division 2nd Floor (1st opening near the elevator) hand deliver or drop off at the counter the solicitation submittal envelope, package, or box to our receptionist your package will be date stamped and the appropriate Purchasing Manager will be notified.

PLEASE FILL OUT THE LABEL BELOW AND ATTACH SAME TO YOUR SOLICITATION

RESPONSE ENVELOPE OR PACKAGE.

Cut out the label and tape it to the outer sealed solicitation envelope or package.

**DO NOT OPEN**SEALED SOLICITATION**DO NOT OPEN**SEALED SOLICITATION**

ATTENTION: MARISOL ORDONEZ, PURCHASING MANAGER

SOLICITATION NUMBER: RFQ-25/26-18

TITLE: MARINA ISLE BREAKWATER WALL RECONSTRUCTION

SOLICITATION DUE DATE: ___________________________ TIME: 2:00 P.M. Local Time

FROM: ________________________________________

DELIVER TO: City of Sanford Purchasing Division 300 N. Park Avenue Suite 236 Sanford, Florida 32771

**DO NOT OPEN**SEALED SOLICITATION**DO NOT OPEN**SEALED SOLICITATION**

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “N” E-Verify Compliance Affidavit

The Affiant identified below attests and agrees to the following:

1. That the Contractor is currently in compliance with and throughout the term of the above identified project and will remain in compliance with all controlling law requiring the use of the Department of Homeland Security’s Status Verification (“E-Verify”) System to ensure that all employees of the Contractor and the Contractor’s subcontractors performing work under the above-listed Contract are legally permitted to work in the United States.

2. Each Contractor that performs work under the Project referenced above shall provide the City of Sanford, Florida, a copy of the “Edit Company Profile” screen and any other information required by the City proving, to the satisfaction of the City, enrollment in the E-Verify Program and compliance with controlling law.

3. The Contractor will register and participate in the work status verification for all newly hired employees of the Contractor and for all subcontractors performing work on the above-named Contract.

4. The Contractor agrees to maintain records of its compliance with the verification requirements as outlined in this Affidavit and, upon request of the any authority having jurisdiction over the Project, including, but not limited to, the United States government and the State of Florida, as well as any and all law enforcement agencies of whatever jurisdiction, type of nature, and to provide a copy of each such verification to that authority as well as the City.

5. That all persons assigned by the Contractor or its subcontractors to perform work under the above identified Project will meet the employment eligibility requirements as established by the Federal Government and the government of the State of Florida.

6. That the Contractor understands and agrees that its failure to comply with the verification requirements as set forth herein or its failure to ensure that all employees and subcontracts performing work under the above-identified Project are legally authorized to work in the United States and the State of Florida constitute a breach of contract for which the City may immediately terminate the Contract with the City without notice and without penalty. The Contractor further understands and agrees that in the event of such termination, the Contractor shall be liable to the City for any and all costs incurred by the City, in any context whatsoever, as a result of the Contractor’s breach.

7. The Contractor shall obtain and maintain current affidavits providing proof, to the satisfaction of the City, that each subcontractor has complied with the requirements set forth herein and all controlling law.

8. Specifically, with regard to employment eligibility, the Contractor recognizes and agrees that, upon entering a Contract with the City (to include, but not be limited to, the provision of goods or services under a City purchase order or work order), that the Contractor is obligated to comply with the provisions of Section 448.095, Florida Statutes, entitled "Employment Eligibility", which obligation includes, but is not limited to, utilization of the E-Verify System to verify the work authorization status of all newly hired employees, and requiring all subcontractors to provide an affidavit attesting that the subcontractor does not employ, contract with, or subcontract with, an unauthorized alien. Failure of the Contractor to comply will lead to termination of the Contract with the City, or if a subcontractor knowingly violates the statute, the Contractor must immediately terminate their subcontract with the subcontractor. Any challenge to

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

termination under this provision must be filed in the Circuit Court no later than 20 calendar days after the date of termination. If the Contract with the City is terminated for a violation of the statute by the Contractor, the Contractor may not be awarded a public contract for a period of 1 year after the date of termination and the City will advise any person desiring to be advised of such termination and make such termination a public record available under controlling law for inspection and copying and otherwise available as the City determines in its sole discretion.

9. That for the purposes of this Affidavit, the following definitions apply:

“Employee” – Any person who is hired to perform work in the State of Florida.

“Status Verification System” – The procedures developed under the Illegal Immigration Reform and Immigration Responsibility Act of 1996, as amended, implemented by the United Stated Department of Homeland Security, or its successor or associated agency, and known as the “E-Verify Program”, or any successor electronic verification system that may replace the E-Verify Program.

“Subcontractor” – Any person or entity, whether a sub-vendor/subcontractor/subconsultant, by whatever name or type or description, assisting the Contractor in the performance of the Contract with the City.

10. The obligations set forth herein are continuing in nature, type, effect and scope.

11. The undersigned signatory, under penalty of perjury, affirms that she/he has the plenary authority to bind the Contractor to the provisions hereof.

Contractor Printed Name

Signature of Authorized Representative (Affiant) Date

Printed or Typed Name

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

COUNTY OF __________________

I HEREBY CERTIFY that on this day, before me, an officer duly authorized to administer oaths and take acknowledgments, personally appeared ________________________ { } who is personally known to me or { } who produced ________________________ as identification and swore and acknowledged before me, under oath, that s/he executed the same. Sworn and subscribed before me, by ______________________________________________ by means of { } physical presence or { } online notarization on the _____ day of _____________, 2026, the said person did take an oath and was first duly sworn by me, on oath, said person, further, deposing and saying that s/he has read the foregoing and that the statements contained herein all of which are true and correct.

WITNESS my hand and official seal in the County and State last aforesaid this __ day of ________________, 2026.

SEAL

My commission expires:

END OF SECTION

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “O”

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 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.

Name of entity 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:

PUR 1355 (10/23) Page 22 of 40 Rule 60A-1.020, F.A.C.

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

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “P”

H UM AN T RAF F I CK I N G AF F I DA VI T

In compliance with Section 787.06(13), Florida Statutes, this Affidavit must be completed by an officer or representative of a nongovernmental entity that is executing, renewing, or extending a contract with City of Sanford (the “Governmental Entity”).

The undersigned, on behalf of the entity listed below (the “Nongovernmental Entity”), hereby attests under penalty of perjury as follows:

1. I am over the age of 18 and I have personal knowledge of the matters set forth herein.

2. I am an officer or representative of a non-governmental entity, and I am authorized to provide this affidavit on behalf of such.

3. Nongovernmental Entity, and any of its subsidiaries or affiliates, do not use coercion for labor or services, as those terms are defined in Section 787.06, Florida Statutes, as may be amended from time to time.

4. If, at any time in the future, Nongovernmental Entity does use coercion for labor or services, Nongovernmental Entity will immediately notify Seminole County and no contracts may be executed, renewed, or extended between the parties.

5. I have read the foregoing affidavit and confirm that the facts stated in it are true, and are made for the benefit of, and reliance by City of Sanford.

Nongovernmental Entity:

Authorized Signature: Date:

Printed Name: Title:

STATE OF

COUNTY OF

Notary Public Signature (Affix Notary Stamp or Seal) Print, Type or Stamp Name of Notary:

My commission expires:

This form is executed at the time of the award!

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS GOVERNED BY FLORIDA STATUTE 287.055

Due Date:

Attachment “Q” Florida Public Entity Crimes Statement

SWORN STATEMENT UNDER SECTION 287.133(3) (a), FLORIDA STATUTES: THIS FORM MUST BE SIGNED IN THE

PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS.

A. This sworn statement is submitted with Bid, or Contract Number RFQ 25/26-18 Marina Isle Breakwater Wall Construction.

B. This sworn statement is submitted by_________________________________________ whose business address is [Name of entity submitting sworn statement]

______________________________________________________________________ and (if applicable) it’s 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. I understand that a "public entity crime" as defined in section 287.133(l)(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 in Florida 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 and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.

E. I understand that "convicted" or "conviction" as defined in section 287.133(l) (b), Florida Statutes, means a 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 record 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 contenders.

F. I understand that "affiliate" as defined in section 287.133(l) (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 thirty-six (36) months shall be considered an affiliate.

G. I understand that a "person" as defined in section 287.133(l) (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.

H. 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 with a check mark () which statement applies].

____ Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who is active in the management of the entity, nor any affiliate of the entity have been convicted of a public entity crime subsequent to July 1, 1989.

Phone: 407-688-5030 or 5028 | Fax: 407-688-5021 Solicitation Number:

RFQ 25/26-18

REQUEST FOR QUALIFICATIONS

AS…