RFQ2501.pdf

Rev: 03/09/2018

City of DeLand

REQUEST FOR QUALIFICATIONS

RFQ-25-01

DeLand Airport Consulting Services

City of DeLand 120 S. Florida Ave.

DeLand, Florida 32720

(321) 626-7000

Daytona Beach News Journal Legal Section Ad dated 01/06/25

CITY OF DELAND

NOTICE TO BIDDERS

NOTICE IS HEREBY GIVEN that the City of DeLand will receive sealed proposals at the City Hall 2nd floor receptionist, 120 South Florida Avenue, DeLand, Florida, until 3:00 p.m. on January 28, 2025 and will open the submitted bids in the Commission Chambers, first floor, immediately following the submittal closing time for the following:

"DeLand Airport Consulting Services”

Proposals must comply and be submitted in accordance with the project technical specifications which may be obtained at the office of the City Hall, 120 S. Florida Avenue, DeLand, Florida, any time prior to the bid opening. Questions shall be directed to the office of the Purchasing Manager, Corey McMillen at 386-626-7078 or by email at mcmillenc@deland.org or Purchasing@deland.org.

Michael Pleus City Manager mailto:mcmillenc@deland.org mailto:Purchasing@deland.org

TABLE OF CONTENTS

I. INTRODUCTION

II. SCOPE OF SERVICES

III. RECORD INFORMATION AND SITE VIEWING EVALUATION OF PROPOSALS

IV. SPECIAL TERMS AND CONDITIONS OF THE SOLICITATION

V. SUBMITTAL REQUIREMENTS

VI. EVALUATION CRITERIA

REQUEST FOR QUALIFICATIONS (RFQ)

DeLand Airport Consulting Services

I. INTRODUCTION

The City of DeLand (“City”) is issuing a request for qualifications to provide professional engineering consulting services at the DeLand Municipal Airport and its associated Industrial Park. Services shall include, but not limited to, General Consulting; Funding Procurement & Grant Administration; Economic Feasibility & Impact Analysis; Planning; Engineering; Design;

Permitting; Construction Phase Services; Environmental Analysis; Preparation of DBE Plans and other associated services. Expected contract length is three (3) years with two (2), one

(1) year renewals.

II. SCOPE OF SERVICES

The City has an extensive capital improvements program and most project assignments will be in the area of engineering. Attached (Attachment A) is a copy of the City’s current Airport Capital Improvement Plan. This plan is subject to change.

Project Scope

Professional services required to accomplish various projects at the DeLand Municipal Airport may include but are not limited to:

1. Runway, taxiway and apron construction and rehabilitation

2. Airport navigational aids

3. Airport lighting and signage

4. Fuel Farm

5. Road construction

6. Aircraft hangar construction

7. Industrial Park infrastructure

Attachments

Attachment A – Airport Capital Improvement Plan

Attachment B – Draft Contract

The procurement of these services will be done by competitive selection and negotiation consistent with Chapter 287.055 of the Florida Statutes, "Consultants’ Competitive Negotiation Act," and City of DeLand Purchasing Policy.

Qualified responses will be reviewed and ranked by the City's Selection Committee at a Public Meeting. At this meeting, the Selection Committee may make a final selection of the firm or firms; or the Selection Committee may choose to shortlist a minimum of the three (3) top-ranked firms. If shortlisting is done, the shortlisted firms will be requested to make a presentation to the Selection Committee followed by an interview by the Selection Committee.

At least five (5) business days prior to the presentations/interviews the Selection Committee will provide those firms selected for a presentation/interview with a document that sets forth information regarding how the presentation and interview will be conducted, evaluated and ranked.

After the interviews, the Selection Committee will rank the finalists to determine the selected firm(s). The Negotiating Committee will then negotiate with the top-ranked firm(s). Selection will be made in accordance with the Florida “Consultants’ Competitive Negotiations Act” (§ 287.055, F.S.) and City of DeLand Purchasing Policy. The City reserves the right to revise, delete portions, and/or limit the scope of professional services and to reject any and all Responses.

Responses to this Request for Qualifications for DeLand Airport Consulting Services will be received until 3:00 PM on January 28, 2025.

Qualifications shall be submitted to the City of DeLand, Attn: Corey McMillen, 120 S. Florida Ave., DeLand, Florida 32720.

*NOTE: Please ensure that if you use a third-party carrier (DHL Express, FedEx, UPS, USPS, etc.) that they are properly instructed to deliver your bid only to the City of DeLand at the address above. To be considered, an RFQ must be accepted by the Purchasing Manager or designee no later than the closing date and time.

All firms and their agents are hereby placed on notice that they are not to contact members of the DeLand City Commission or staff regarding this RFQ, with the exception of the designated liaison. Public meetings of the Selection Committee are the only acceptable forum for the discussion of merits of products/services requested by this Request for Qualifications and written correspondence in regards to this Request for Qualifications is to be submitted to the designated liaison.

The staff member designated as the liaison for this Request for Qualifications is Corey McMillen, Purchasing Manager, (386) 626-7078; e-mail mcmillenc@deland.org and purchasing@deland.org.

TIMELINE

Event Date

Solicitation Date January 6, 2025

Question Deadline January 21, 2025 @ 5:00 P.M.

Submission Deadline January 28, 2025 @ 3:00 P.M.

III. RECORD INFORMATION AND SITE VIEWING

Complete package is available on DemandStar® (https://www.demandstar.com) & VendorLink https://www.myvendorlink.com/common/default.aspx.

You may also contact the Purchasing Manager office at:

City of DeLand – Finance Department Attn: Corey McMillen 120 S. Florida Ave.

DeLand, Florida 32720

(386) 626-7078 / Email: mcmillenc@deland.org

The City will not provide access to these sites before the Contractors submittal of their qualifications. Contractors that make the shortlist will be allowed limited access to the sites prior to their presentations and interviews.

1. All responses shall become the property of the City. The details of the sealed response documents submitted by a respondent will remain exempt from public inspection consistent with Chapter 119.071 of the Florida Statutes, General Exemptions from Inspection or Copying of Public Records.

mailto:purchasing@deland.org https://www.demandstar.com/ https://www.myvendorlink.com/common/default.aspx

2. All Contractors must acknowledge and conform to the statement on Public Entity Crimes prior to entering into a Contract with the City.

3. The City will not reimburse a respondent for any costs associated with preparation and submittal of responses to this solicitation.

4. Contractors acknowledge that all information contained within their responses are ultimately public records to the extent required by the State of Florida Public Records Laws.

5. Awards made pursuant to this Request for Qualifications are subject to the provisions of

Chapter 112, Part III, Florida Statutes, "Code of Ethics for Public Officers and Employees.”

All respondents must disclose in their responses the name of any officer, director, or agent who is also an employee of the City. Furthermore, all Contractors must disclose the name of any City employee who owns, directly or indirectly, any interest of five percent (5%) or more in the Contractor’s firm or any of the respondent’s branches or subsidiaries.

6. Contractors, their agents, and associates shall not contact any City official or member of the City staff regarding this Request for Qualifications during the selection process. Failure to comply with this provision will result in disqualification of the Contractor. Only the designated liaison identified in this response may be contacted.

7. Contractor shall not discriminate with respect to age, race, color, gender, religion, disability, or national origin in any manner with regard to this solicitation.

8. The responsibility for determining the extent of the professional engineering services required rests solely with the respondent. Neither the City nor its representatives shall be responsible for determining the final scope of services that may be required.

9. All timely responses will be considered. Contractors are requested to clearly indicate any deviations from the submittal requirements.

10. Each Contractor is responsible for full and complete compliance with all laws, rules and regulations including those of the Federal Government, State of Florida and applicable local ordinances. Failure or inability on the part of the respondent to have complete knowledge and intent to comply with such laws, rules and regulations shall not relieve any Contractor from its obligation to honor its response and to perform completely in accordance with its response.

11. The City, at its discretion, reserves the right to waive minor informalities or irregularities in any response, request clarification of information from Contractors, to reject any and all responses in whole or in part, with or without cause, and to accept any response, which, in the City’s judgment, will be in the City's best interest.

12. Any interpretation, clarification, correction or change to the Request for Qualifications will be made by written addendum issued by the City Purchasing Manager or designee. Any oral or other type of communication concerning the Request for Qualifications shall not be binding upon the City.

13. Responses must be signed by an individual of the Contractor’s organization legally authorized to commit the Contractor’s organization to the performance of the services contemplated by this Request for Qualifications.

14. Any Responses submitted before the deadline may be withdrawn by written request received by the City before the time fixed for receipt of Responses. Withdrawal of any

Response will not prejudice the right of the respondent to submit a new or amended Response as long as the City receives the Response by the deadline as provided herein.

15. For good and sufficient reason, up to forty-eight (48) hours before the advertised deadline, the City may extend the Response deadline.

16. Any consultant or subconsultant selected to prepare the design criteria package for this project will not be allowed to propose or perform design or consultant services as part of the design/build team.

17. E-VERIFY: In accordance with Florida State Law, Executive Order 11-116, any vendor or company that the City enters into contract with, or issues a purchase order, must utilize the E-Verify system.

SCRUTINIZED CONTRACTORS

Awarded Contractor shall certify that it and its subcontractors are not on the Scrutinized Companies that Boycott Israel List. Pursuant to Section 287.135, F.S. If the Agreement is for more than $1,000,000 the Contractor further certifies that it and its subcontractors are also not on the Scrutinized Companies with Activities in Sudan, Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or engaged with business operations in Cuba or Syria as identified in Section 287.135, F.S.

For Contracts of any amount, if the City determines the Contractor submitted a false certification under Section 287.135(5) of the Florida Statutes, or if the Contractor has been placed on the Scrutinized Companies that Boycott Israel List, or is engaged in a boycott of Israel, the City shall either terminate the Contract after it has given the Contractor notice and an opportunity to demonstrate the City’s determination of false certification was in error pursuant to Section 287.135(5)(a) of the Florida Statutes, or on a case-by-case basis the City may choose to maintain the Contract if the conditions of Section 287.135(4) of the Florida Statutes are met. For Contracts $1,000,000 and greater, if the City determines the Contractor submitted a false certification under Section 287.135(5) of the Florida Statutes, or if the Contractor has been placed on the Scrutinized Companies with Activities in the Sudan List, or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, the City shall either terminate the Contract after it has given the Contractor notice and an opportunity to demonstrate the City’s determination of false certification was in error pursuant to Section 287.135(5)(a) of the Florida Statutes, or on a case-by-case basis the City may choose to maintain the Contract if the conditions of Section 287.135(4) of the Florida Statutes are met.

The Contractor agrees to observe the above requirements for applicable subcontracts entered into for the performance of work under this Agreement.

As provided in Subsection 287.135(8), F.S., if federal law ceases to authorize these contracting prohibitions, this section shall become inoperative and unenforceable.

VI. SPECIAL TERMS AND CONDITIONS OF THE SOLICITATION

1. A Contractor with which the City successfully negotiates terms and conditions for the Work shall be required to enter into a contract with the City that incorporates the requirements of this Request for Qualifications and terms and conditions. If the parties cannot agree to the services and/or fees for the project, the City reserves the right to cease negotiations with the subject Contractor and initiate negotiations with the Second-ranked Contractor (and so on).

2. The successful Contractor shall hold harmless, indemnify and defend the City, its Council members, employees, representatives and agents against any claim, action, loss, damage, injury, liability, cost and/or expense arising out of or incidental to respondent’s services under this Agreement. Consideration for this indemnification provision will be included in the Contractor’s hourly rate.

3. The successful Contractor shall not be allowed to substitute project team members named in this response during the course of the contract without prior written permission of the City. This requirement is not negotiable.

4. The successful Contractor, prior to signing of the contract, and before starting work on any projects, shall be required to submit all certificates of insurance as follows:

a. Workers’ Compensation – Workers Compensation insurance providing statutory benefits as required in the State of Florida. The Contractor shall require any subcontractor to provide evidence of this coverage. Additionally, if the contract requires working on or around a navigable waterway, the Contractor and all subcontractors shall provide evidence of United States Longshoremen’s and Harbor Workers (USL&H) coverage and contingent coverage of Jones Act (Marine Employers Liability) in compliance with Federal statutes or proof of exemption. The Contractor shall be responsible for compliance with these requirements by each subcontractor, Contractor or supplier when applicable.

b. Comprehensive General Liability and Auto Liability – Including but not limited to bodily injury, property damage, and personal injury with limits of not less than $1,000,000 combined single limit per occurrence including Contractual Liability incurred under this Contract.

c. Professional Liability Insurance – For errors and omissions in the amounts of $3,000,000 per claim.

5. Tie - Award of all tie rankings shall be made by the Purchasing Manager in accordance with State Statutes, which allows a respondent certified as a Drug-Free Workplace to have precedence. When evaluation of responses to solicitations results in the identical ranking with regards to the responses from two or more Contractors, the City shall determine the order of award using the following criteria in order of preference listed below (from highest priority to lowest priority):

a. Priority shall be given to the respondent certifying that it is a Drug-Free Workplace as defined within §287.087, Florida Statutes;

b. Should a tie still exist, priority shall be given until the tie is broken, to the respondent with the highest total of raw scores for each evaluation criteria, progressing from the highest weighted criteria to the lowest rated criteria. If multiple evaluation criteria have identical weights, the combined total weights of the identically weighted criteria shall be used;

c. In the event that a tie still exists after progressing through a-b, the decision shall be made by lot or coin toss. The drawing of lots or coin toss shall be conducted in the presence of the affected Contractors if they elect to be present.

V. SUBMITTAL REQUIREMENTS

Responses will be evaluated based on the written document submitted as the response to this RFQ; therefore, the response must give a clear, concise, and complete statement of qualifications. For reasons of maintaining fairness and for ease of evaluation, responses to this Request for Qualifications must comply with the following directions and must be presented in this format and in this order:

SUBMITTAL FORMAT:

Submittals shall be printed on 8-1/2 × 11-inch paper, bound, typed in Arial, Century, Courier, or Verdana typeface, in at least 12-point size. Both sides of the page may be printed. Number all pages (limit proposals to 75 pages). Covers, tables of contents, and divider tabs will not be counted in the section page limits. Please submit four (4) paper executed signed copies with the original clearly marked and one (1) electronic copy on USB flash drive. The proposal shall be divided and organized with tabs as follows:

Tab 1: Introduction

Letter of Introduction – include the name and address of the firm and indicate whether the respondent is a subsidiary, individual, partnership, corporation, or joint venture. Name the person or persons authorized to make representation for the respondent and give addresses and telephone numbers for same. If this proposal is a joint venture or involves subcontracting, this should be so stated and all parties must be identified. The letter must be signed by an individual, partner or officer of the organization who is authorized to bind the organization.

Tab 2: Table of Contents

Provide a Table of Contents for material included in the submittal.

Tab 3: Business Experience and Qualifications

Please furnish such information concerning the firm’s finances, facilities, personnel and experience necessary to determine its responsibility and competency to execute the work covered in the submittal. Include the following:

The number of years the respondent has been in the consulting engineering business

List of recent clients and projects similar to those contemplated by the City of DeLand.

Summarize the projects relative to length, status and provide contracts. Include the names, addresses, telephone numbers and email addresses for key contact personnel for clients served

Listing of key personnel who have worked on these projects and are expected to work on City of DeLand projects along with résumés detailing their related experience

List other key personnel, technical consultants and subcontractor firms employed (or to be retained by) the respondent to be involved with this project, along with a detailed description of their role in this project

Standard GSA Form SF330

Provide information on the firm’s insurance status including typical Certificates of Insurance for general liability, workers compensation and professional liability.

The total numbers of full-time employees in the firm, nationally and locally.

Provide EEO information, as applicable

Tab 4: Required Proposal Forms

Public Entity Crime Form

Non-Collusion Affidavit

Proposer’s Certification

Human Trafficking Affidavit

Drug-Free Workplace Form

Financial Statement (separate envelope is acceptable)

Statement of Litigation

W-9 Form

Contractor Affidavit Regarding Scrutinized Company List

VI. EVALUATION CRITERIA

In accordance with Section 287.055, Florida Statutes or most recent supplement, final rankings of the firm will be presented to The DeLand City Commission for approval and authorization to negotiate with top-ranked firms. Each response will be evaluated by the Selection Committee members and subjectively scored on Compliance with Instructions, Introduction, Organizational Profile and Subcontractors, Experience, and Design Approach for a maximum of 100 points as outlined below. The format of the submittal constitutes part of the RFQ response.

Criteria

1. Experience to the proposed firm in providing full consulting services for small to medium sized General Aviation (GA) airports in Florida and the Southeast

US.

(30 points possible)

2. Experience of the firm in obtaining and administering FAA and FDOT grants.

(20 points possible)

3. Perceived ability of the firm to coordinate work assignment through a single point of contact (Project Manager) (20 points possible)

4. Knowledge of DeLand Airport infrastructure

(10 possible points)

5. Construction inspection/administration experience on GA airports.

(20 possible points)

100 Points (Maximum)

PUBLIC ENTITY CRIME FORM

Section 287.133(3)(a), Florida Statutes, on Public Entity Crimes:

A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid/quote/proposal on a contract to provide goods or services to a public entity, may not submit a bid/quote/proposal on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids/quotes/proposals on leases of rental property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list.

Acknowledged: _ ____________ Date:

NON-COLLUSION AFFIDAVIT

State of _________________)

County of_________________)

________________________________________________ being first duly sworn, deposes and says that:

(1) He/she is the _________________, (Owner, Partner, Officer, Representative or Agent) of

______________________________ __, the Contractor that has submitted the attached Proposal;

(2) He/she is fully informed respecting the preparation and contents of the attached Proposal and of all pertinent circumstances respecting such Proposal;

(3) Such Proposal is genuine and is not a collusive or sham Proposal;

(4) Neither the said Contractor nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, have in any way colluded, conspired, connived or agreed, directly or indirectly, with any other Contractor, firm, or person to submit a collusive or sham Proposal in connection with the Work for which the attached Proposal has been submitted; or to refrain from bidding in connection with such Work; or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or conference with any Contractor, firm, or person to fix the price or prices in the attached Proposal or of any other Contractor, or to fix any overhead, profit, or cost elements of the Proposal price or the Proposal price of any other Contractor, or to secure trough any collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the proposed Work;

(5) The price or prices quoted in the attached Proposal are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the Contractor or any other of its agents, representatives, owners, employees or parties in interest, including this affiant.

By:__________________________________

Signature of Individual

Printed Name of Individual

Title of Individual

Signed, sealed and delivered in the presence of:

Witness Witness

State of

County of ______________

The foregoing instrument was acknowledged before me this ________ day of _____________,20 by ________________________________________________, who is personally known to me or who has produced ___________________ as identification and who did (did not) take an oath.

WITNESS my hand and official seal.

NOTARY PUBLIC

(Name of Notary Public: Print, Stamp, or Type as Commissioned)

PROPOSER'S CERTIFICATION

IN WITNESS WHEREOF, the Proposer hereto has executed this Proposal Form this

______ day of _____________________, 20 .

By:__________________________________ Signature of Individual

Printed Name of Individual

Witness

Business Address

City/State/Zip

Business Phone Number Fax Number

State of

County of ______________

The foregoing instrument was acknowledged before me this ________ day of _____________, 20 by ________________________________________________, who is personally known to me or who has produced ___________________ as identification and who did (did not) take an oath.

WITNESS my hand and official seal.

NOTARY PUBLIC

(Name of Notary Public: Print, Stamp, or Type as Commissioned)

CITY OF DeLAND

CONFIRMATION OF DRUG-FREE WORKPLACE FORM

In accordance with Section 287.087, Florida Statutes, "[w]henever two or more bids are equal with respect to price, quality, and service which are received by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. In order to have a drug-free workplace program, a business shall:

(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, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations.

(3) Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection one (1).

(4) In the statement specified in subsection one (1), 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 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 this section."

As the person authorized to sign the statement, I certify that this firm complies with the above requirements and the Florida Statutes Section 287.087. This form is in conjunction with The City of DeLand’s General Conditions, Drug-Free Workplace.

Business Name Bid Number and Name

Authorized Representative’s Signature Date

Name Position

CONTRACTOR AFFIDAVIT REGARDING SCRUTINIZED COMPANY LIST

Awarded Contractor shall certify that it and its subcontractors are not on the Scrutinized Companies that Boycott Israel List. Pursuant to Section 287.135, F.S. If the Agreement is for more than $1,000,000 the Contractor further certifies that it and its subcontractors are also not on the Scrutinized Companies with Activities in Sudan, Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or engaged with business operations in Cuba or Syria as identified in Section 287.135, F.S.

For Contracts of any amount, if the City determines the Contractor submitted a false certification under Section 287.135(5) of the Florida Statutes, or if the Contractor has been placed on the Scrutinized Companies that Boycott Israel List, or is engaged in a boycott of Israel, the City shall either terminate the Contract after it has given the Contractor notice and an opportunity to demonstrate the City’s determination of false certification was in error pursuant to Section 287.135(5)(a) of the Florida Statutes, or on a case-by-case basis the City may choose to maintain the Contract if the conditions of Section 287.135(4) of the Florida Statutes are met.

For Contracts $1,000,000 and greater, if the City determines the Contractor submitted a false certification under Section 287.135(5) of the Florida Statutes, or if the Contractor has been placed on the Scrutinized Companies with Activities in the Sudan List, or the Scrutinized

Companies with Activities in the Iran Petroleum Energy Sector List, the City shall either terminate the Contract after it has given the Contractor notice and an opportunity to demonstrate the

City’s determination of false certification was in error pursuant to Section 287.135(5)(a) of the

Florida Statutes, or on a case-by-case basis the City may choose to maintain the Contract if the conditions of Section 287.135(4) of the Florida Statutes are met.

STATE OF FLORIDA

COUNTY OF __________________

BEFORE ME, the undersigned authority, personally appeared

____________________________________________, who, being by me first duly sworn, made the following statement:

1. The Business address of (name of bidder or contractor) is .

2. My relationship to ______________________________________(name of bidder or contractor) is (relationship such as sole proprietor, partner, president, vice president).

3. I understand that “Boycott of Israel” has the same meaning as defined in §215.4725, Florida Statutes, and means 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. A statement by a company that it is participating in a boycott of Israel, or that it has initiated a boycott in response to a request for a boycott of Israel or in compliance with, or in furtherance of, calls for a boycott of Israel, may be considered by the State Board of Administration to be evidence that a company is participating in a boycott of Israel. The term does not include restrictive trade practices or boycotts fostered or imposed by foreign countries against Israel.

4. I understand that “business operations” means, for purposes specifically related to Cuba or Syria, engaging in commerce in any form in Cuba or Syria, including, but not limited to, acquiring, developing, maintaining, owning, selling, possessing, leasing, or operating equipment, facilities, personnel, products, services, personal property, real property, military equipment, or any other apparatus of business or commerce.

5. __________________________ (name of the bidder or contractor) is not on the Scrutinized Companies that Boycott Israel List, created pursuant to s. 215.4725, Florida Statutes, or is engaged in a boycott of Israel.

6. __________________________ (name of the bidder or contractor) is not on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to s. 215.473, Florida Statutes.

7. __________________________ (name of the bidder or contractor) is not engaged in business operations in Cuba or Syria.

Signature

Sworn to and subscribed before me in the state and county first mentioned above on the ___________ day of ____________________, 20____.

(AFFIX SEAL or STAMP)

Notary Public

My commission expires:

http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0200-0299/0215/Sections/0215.473.html

HUMAN TRAFFICKING AFFIDAVIT

1. I am over the age of 18 and I have personal knowledge of the matters set forth herein and execute this affidavit in order to comply with the requirements of Section 787.06(13), Florida Statutes.

2. I currently serve in the capacity listed below on behalf of the company listed below.

3. The company listed below does not use coercion for labor or services, as those terms are defined in Florida Statute 787.06.

4. This declaration is made in accordance with Florida Statute 92.525. I understand that making a false statement in this declaration may subject me to criminal penalties.

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

Further Affiant sayeth naught.

Date executed __________________.

COMPANY

NAME OF BUSINESS ENTITY

SIGNATURE

NAME AND TITLE