SECTION_00_41_13_PROPOSAL_SIGNATURE_FORM_(BP510).docx

SECTION 00 41 13 - PROPOSAL FORM – db-nf-(single-Prime Contract)

PROPOSAL FOR THE GREATER ORLANDO AVIATION AUTHORITY

Date:

The undersigned Proposer hereby certifies the following: (1) it has accurately identified all persons required by the applicable signature block; (2) this Proposal is fair, in all respects, and made in good faith, without collusion or fraud; (3) no officer, employee or agent of the Authority and no spouse or child of an officer or employee of the Authority, has, or will have during the performance of the Contract, any material interest in the business of the Proposer, and (4) Proposer has no knowledge of any potential conflict of interest.

The Proposer further represents that it has carefully examined the site of the Work, the DCP, Contract Documents, the Addenda furnished prior to the opening of the Proposals, and existing Owner records for the Work contemplated during the Proposal submittal period. By submitting a Proposal, the Proposer represented to the Owner that the Proposal and the Contract is inclusive of sufficient compensation for performing adequate investigations of existing site conditions, the DCP, and existing records to sufficiently support the design developed and proposed by the Proposer. The Proposer further acknowledges that any information provided by the Owner was to assist the Proposer in completing adequate investigations. In addition the Proposer represents that it has investigated and is fully informed of the conditions to be encountered, of the character, quality and quantities of Work to be performed and materials to be furnished and has included in the Proposal and Contract all items necessary for the proper execution and completion of the Work in accordance with the requisite time frame, applicable laws, statutes, building codes, regulations, or as otherwise required by the Contract Documents.

If provided with a Notice of Award the Contract by the Owner, the Proposer shall execute and deliver to the Owner all of the documents required by the Contract Documents, including but not limited to, the Contract Agreement and the Performance and Payment Bonds in the form contained in the Contract Documents, furnish the required evidence of the specified insurance coverages, furnish all necessary design, permits, licenses, materials, equipment, machinery, maintenance, tools, apparatus, means of transportation and labor necessary to complete the Work provided for in the Contract Documents for "BP00510, Heintzelman Blvd. Pavement Rehabilitation, Orlando International Airport," Orlando, Florida.

The Proposer shall commence work specified herein within the time limits set forth in the Solicitation, which time limits the Proposer acknowledges are reasonable.

If the Proposer improperly withdraws its Proposal or fails to execute and deliver to the Owner any of the documents required by the Contract Documents, within ten (10) days after the date of the Notice of Intent to Award, the Owner may seek recourse against the Proposal Guaranty as provided for in the Solicitation.

If the Proposer fails to complete the Work within the scheduled time or any authorized extension thereof, liquidated damages, in accordance with the Contract Documents, shall be deducted from the Total Contract Price.

Acknowledgment is hereby made of the following Addenda (identified by number) received since issuance of the shortlist: Comment by Karen Ryan: Delete once confirmed this is in step 2

PUBLIC ENTITY CRIMES ACT

The Proposer represents that it is not precluded from submitting a Proposal under Section 287.133(2)(a), which provides as follows: “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, proposal or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids on leases of real 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 set forth in Florida Statutes s.287.017, for CATEGORY TWO for a period of thirty-six (36) months from the date of being placed on the convicted vendor list.”

LDB/VBE PROGRAM ACKNOWLEDGEMENT

By submitting a Proposal on this Project, Proposer represents that it has reviewed and familiarized itself with the Owner’s Local Developing-Business Program Policy (LDB) and the Veterans Business Enterprise (VBE). See the Solicitation for the LDB/VBE Participation Goal.

SCRUTINIZED COMPANY CERTIFICATION

By submitting a Proposal on this Project:

1. (applicable to all agreements, regardless of value) – Proposer hereby certifies that it is not on the Scrutinized Companies that Boycott Israel List and is not engaged in a boycott of Israel, as defined in Florida Statutes § 287.135, as amended;

AND

1. (applicable to agreements that may be $1,000,000 or more) - Proposer hereby certifies that it is: (1) not on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List as defined in Florida Statutes § 287.135; and (2) not engaged in business operations in Cuba or Syria, as defined in Florida Statutes § 287.135, as amended.

TEXTING WHEN DRIVING

In accordance with Executive Order 13513, “Federal Leadership on Reducing Text Messaging While Driving” (10/1/2009) and DOT Order 3902.10, “Text Messaging While Driving” (12/30/2009), FAA encourages recipients of Federal grant funds to adopt and enforce workplace safety policies to decrease crashes caused by distracted drivers including policies to ban text messaging while driving when performing any work for, or on behalf of, the Federal government, including work relating to a grant or subgrant.

The Contractor must promote and conduct workplace safety initiatives for employees and other work personnel in a manner commensurate with the size of the business, such as:

The Contractor must insert this “Texting When Driving” language in each third party subcontract involved on this project.

PUBLIC ENTITY CRIMES ACT

The Contractor represents that it is not precluded from submitting a bid or proposal under Section 287.133(2)(a), which provides as follows: 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, proposal or reply on a contract to provide any goods or services to a public entity, may not submit a bid, proposal or reply on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real 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 set forth in Florida Statutes s.287.017, for CATEGORY TWO for a period of thirty-six (36) months from the date of being placed on the convicted vendor list.

DISCRIMINATORY VENDOR LIST

The Contractor represents that it is not precluded from submitting a bid or proposal under Section 287.134, which provides as follows: An entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real 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 unless that entity or affiliate has been removed from the list pursuant to Florida law.

FLORIDA DEPARTMENT OF TRANSPORTATION (FDOT) QUALIFICATION (if applicable)

The Contractor represents that neither it nor its affiliates have had their Certificate of Qualification suspended, revoked or denied by the FDOT, or determined by the FDOT to be a non-responsible contractor.

PROPOSAL

FOR ALL WORK REQUIRED IN ACCORDANCE WITH THE APPLICABLE DRAWINGS, SPECIFICATIONS, AND OTHER CONTRACT DOCUMENTS, INCLUDING ALL COSTS RELATED TO THE WORK, AND ANY REQUIRED PERMITS, TAXES, BONDS AND INSURANCE, THE UNDERSIGNED SUBMITS:

THE PRICING TABLE SUBMITTED ON THE E-PROCUREMENT PLATFORM IN OPENGOV

(If Proposer is a corporation, complete this signature block) Fill in the name of the corporation, followed by the signature of the officer signing on behalf of the corporation, name and officer’s title and Secretary attestation.

The below Corporation is organized and existing under the laws of the State of _________________, authorized by law to make this Proposal and perform all work and furnish materials and equipment required under the Contract Documents, and is authorized to do business in the State of Florida.

Fax:_________________________ Name:______________________________________

Title:_______________________________________

Address:___________________________________________________________________________

The full name, address and title of every Officer of the Corporation (including the President, Vice President, Secretary, and Treasurer) is as follows (attach additional pages if necessary):

Name Address Title

Name Address Title

Name Address Title

Name Address Title

(If Proposer is a LLC, complete this signature block) Fill in the name of the limited liability company, followed by the signature and printed name of the Manager who is authorized to sign on behalf of the LLC, The below LLC is organized and existing under the laws of the State of _________________, authorized by law to make this Proposal and perform all work and furnish materials and equipment required under the Contract Documents, and is authorized to do business in the State of Florida.

Address of LLC:______________________________________________________________________

The full name and address and title of every Member and Manager are as follows (attach additional pages if necessary):

Name Address Title

Name Address Title

Name Address Title

Name Address Title

(If Proposer is a joint venture or partnership, complete this signature block)

Fill in name of joint venture or partnership, followed by the signature of each partner of the joint venture or partnership. By signing below, each partner of the joint venture or partnership acknowledges and agrees that the partner is jointly and severally liable for all obligations of the joint venture or partnership pursuant to the Contract (attach additional pages if necessary).

Name of joint venture or partnership:

Federal ID#: Phone: Fax:

Name:

(Please print legibly or type) Address:

Phone: Fax:

Name:

(Please print legibly or type) Address:

Phone: Fax:

(If Proposer is an individual, complete this signature block)

Address:

END OF SECTION 00 41 13