Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2015-025A
2-,.f o-Z-ols e. L . AGREEMENT Q f 2- BETWEEN - BETWE CUSTODIAL SERVICES ACTOR a Q �s_O� 1 INDIAN RIVER COUNTY RFP N0. 2015014 THIS AGREEMENT for CUSTODIAL SERVICES ("SERVICES"), entered into as of this 10th day of February , 2015 by and between INDIAN RIVER COUNTY, a political subdivision of the State of Florida, ("COUNTY"), and CER Signature Cleaning, ("CONTRACTOR"). BACKGROUND RECITALS: A. Through the competitive Request for Proposal (RFP) process, the COUNTY has selected CONTRACTOR to provide custodial services at various facilities as more fully set forth in Exhibit 1 (Required Duties and Frequencies) and Exhibit 2 (Contractor's Price Proposal Form) attached to this Agreement and made a part hereof by this reference. B. The proposed work consists of scheduled custodial services at County- owned facilities, as described in the Request for Proposal document (RFP 2015014, issued on December 1, 2014, "RFP") ("Services"). C. The CONTRACTOR is willing and able to perform the Services for the COUNTY on the terms and conditions set forth below; and D. The COUNTY and the CONTRACTOR wish to enter into this Agreement for the Contractor's Services for the Project. NOW THEREFORE, in accordance with the mutual covenants herein contained and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows: 1. GENERAL. 1.1 The Background Recitals are true and correct and form a material part of this Agreement. 1.2 CONTRACTOR will provide services at the following facilities: Group 2: Administrative Complex: Administration Building A/1801 27st St., Vero Beach, FL Administration Building B/1800 27th St., Vero Beach, FL Health Department Building (HRS)/1900 27th St., Vero Beach, FL Agreement- 1 2. COUNTY OBLIGATIONS. 2.1 The COUNTY will provide explanation of layout of individual buildings and familiarization with any restrictions. 2.2 The COUNTY shall provide training for operation of security systems. 2.3 The COUNTY shall provide emergency call list for all facilities. 2.4 The COUNTY shall provide the following supplies for utilization for restrooms and offices: a. Paper towels for dispensers b. Toilet paper C. Trash can liners d. Hand soap for dispensers 3. RESPONSIBILITIES OF THE CONTRACTOR. 3.1 The CONTRACTOR agrees to provide the services in accordance with the scope of the RFP. 3.2 The CONTRACTOR shall, during the entire term of this Agreement, procure and keep in full force, effect, and good standing any and all necessary licenses, registrations, certificates, permits, and any and all other authorizations as are required by local, state, or federal law, in order for the CONTRACTOR to render its Services as described in this Agreement. 3.3 A list of holidays the service will not be provided for the term of the Agreement is attached as Exhibit 3. 3.4 The CONTRACTOR shall be responsible for any and all damage to COUNTY equipment, furnishings and facilities directly attributable to his or her negligence or cleaning practices. 3.5 CONTRACTOR shall provide all necessary equipment to execute the work under this Agreement. Such equipment shall be maintained and operated in a safe manner at all times. a. Vacuums used shall be equipped with HEPA filters. CONTRACTOR shall have available a log showing the date and responsible party for replacing the filter cartridge. 3.6 To insure the safety of the public and the employees of Indian River County as the occupants of County facilities, it shall be the policy of Indian River County that the use of any chemicals or materials used in the cleaning and maintenance of County facilities be certified green. If it is determined for sanitary reasons that a non- green product must be used, then it shall only be utilized at times when the employees Agreement— 2 and public are not within the confines of the facilities being cleaned or sanitized. CONTRACTOR shall provide a list of materials used in their daily cleaning routine and provide evidence of their certification as being a green product. 3.6 No person shall be excluded from participation in, denied the benefits of, or otherwise subjected to discrimination in regard to the Services to be performed by CONTRACTOR under this Agreement. CONTRACTOR does hereby covenant and agree that in connection with the furnishing of Services to the COUNTY, it shall not discriminate on the basis of race, color or national origin, sex, sexual orientation, gender identity, age and/or disability. Through the course of providing the Services to the County, CONTRACTOR shall affirmatively comply with all applicable provisions of Title VI of the Civil Rights Act of 1964, the Civil Rights Restoration Act of 1987 and the Florida Civil Rights Act of 1992, as well as all other applicable regulations, guidelines and standards. 3.7 The CONTRACTOR will cooperate fully with the COUNTY in order that all work may be properly scheduled and coordinated. 3.8 The CONTRACTOR shall not assign or transfer any work under this Agreement without the prior written consent of the COUNTY. 4. TERM OF AGREEMENT. 4.1 This Agreement shall remain in effect for a term of one year, unless otherwise sooner terminated as provided herein. The Initial Term may be extended by mutual consent of the parties hereto for a maximum two additional one-year terms. 5. COMPENSATION. 5.1 CONTRACTOR shall bill the COUNTY monthly, after completion of work. All payments for services shall be made to the CONTRACTOR by the COUNTY in accordance with the Local Government Prompt Payment Act, as may be amended from time to time (Section 218.70, Florida Statutes, et seq.). No advance or prepayment will occur. 5.2 Adjustments shall be made to compensation due under any of the following circumstances: a. If any work which is scheduled for daily, weekly or monthly performance is omitted or unsatisfactorily performed, the CONTRACTOR will be notified in writing of the failure or omission. An adjustment or deduction may be made from any monies due or to become due the CONTRACTOR. Adjustments or deductions will be consistent with the per square foot rate for the building the deficiency occurs and for the period of time the deficiency remains uncorrected. b. In the instance where room cleaning has not been satisfactorily performed or portions of the work have been omitted or improperly performed a deduction will be made for the entire room. Agreement— 3 6. INSURANCE AND INDEMNIFICATION. 6.1 The CONTRACTOR shall not commence work on this Agreement until it has obtained all insurance required under this Agreement and such insurance has been approved by the COUNTY's Risk Manager. 6.2 CONTRACTOR shall procure and maintain, for the duration of this Agreement, the minimum insurance coverage as set forth herein 6.2.1 Workers' Compensation: To meet statutory limits in compliance with the Workers' Compensation Law of Florida. This policy must include employers' liability with a limit $1,000,000 for each accident, $500,000 disease policy limit and $100,000 disease each employee. 6.2.2 General Liability: A per occurrence form policy with a combined single limit of not less than $1,000,000 general aggregate. 6.2.3 Business Automobile Liability: Coverage shall include Owned vehicles and Hired/Non-Owned vehicles, for a combined single limit (bodily injury and property damage) of not less than $1,000,000/combined single limit (Bodily Injury/Property Damage); personal injury protection -- statutory limits; $100,000 uninsured/underinsured motorist; $100,000/hired/non-owned auto liability. 6.3 Contractor's insurance coverage shall be primary. 6.4 All required insurance policies shall be placed with insurers licensed to do business in Florida and with a Best's rating of A- VII or better. 6.5 The insurance policies procured shall be occurrence forms, not claims made policies. 6.6 A certificate of insurance shall be provided to the COUNTY's Risk Manager for review and approval, ten (10) days prior to commencement of any work under this Agreement. The COUNTY shall be named as an additional insured on all policies except workers' compensation and professional liability. 6.7 The insurance companies selected shall send written verification to the COUNTY's Risk Manager that they will provide 30 days prior written notice to the COUNTY's Risk Manager of its intent to cancel or modify any required policies of insurance. 6.8 The COUNTY, by and through its Risk Manager, reserves the right periodically to review any and all policies of insurance and to reasonably adjust the limits of coverage required hereunder, from time to time throughout the term of this Agreement. In such event, the COUNTY shall provide the CONTRACTOR with separate written notice of such adjusted limits and CONTRACTOR shall comply within thirty (30) days of receipt thereof. The failure by CONTRACTOR to provide such additional coverage shall constitute a default by CONTRACTOR and shall be grounds for termination of this Agreement by the COUNTY. Agreement—4 6.10 The CONTRACTOR shall indemnify and hold harmless the COUNTY, and its officers and employees, from liabilities, damages, losses, and costs, including, but not limited to, reasonable attorneys' fees, arising out of or related to the negligence, recklessness, or intentionally wrongful conduct of the CONTRACTOR and other persons employed or utilized by the CONTRACTOR in the performance of this Agreement. 7. TERMINATION. 7.1 This Agreement may be terminated: (a) by the COUNTY, for any reason, upon sixty (60) days' prior written notice to the CONTRACTOR; or (b) by the CONTRACTOR, for any reason, upon sixty (60) days' prior written notice to the COUNTY; or (c) by the mutual agreement of the parties; or d) as may otherwise be provided below. In the event of the termination of this Agreement, any liability of one party to the other arising out of any Services rendered, or for any act or event occurring prior to the termination, shall not be terminated or released. 7.2 In the event of termination by the COUNTY, the COUNTY's sole obligation to the CONTRACTOR shall be payment for those portions of satisfactorily completed work. Such payment shall be determined on the basis of the hours of work performed by the CONTRACTOR, or the percentage of work completed as estimated by the CONTRACTOR and agreed upon by the COUNTY up to the time of termination. In the event of such termination, the COUNTY may, without penalty or other obligation to the CONTRACTOR, elect to employ other persons to perform the same or similar services. 7.3 The obligation to provide services under this Agreement may be terminated by either party upon seven (7) days prior written notice in the event of substantial failure by the other party to perform in accordance with the terms of this Agreement through no fault of the terminating party. 7.4 In the event that the CONTRACTOR merges with another company, becomes a subsidiary of, or makes any other substantial change in structure, the COUNTY reserves the right to terminate this Agreement upon 30 days written notice. 7.7 The COUNTY may terminate this Agreement in whole or in part if the CONTRACTOR submits a false invoice to the COUNTY. 8. MISCELLANOUS PROVISIONS. 8.1 Independent Contractor. It is specifically understood and acknowledged by the parties hereto that the CONTRACTOR or employees of the Contractor are in no way to be considered employees of the COUNTY, but are independent contractors performing solely under the terms of the Agreement and not otherwise. 8.2 Request for Proposals. It is specifically understood and acknowledged by the parties hereto that all of the requirements set forth in the Request for Proposals dated December 1, 2014 (including addenda 1 through 3 ) shall be incorporated herein. Agreement— 5 8.3 Merger; Modification. Except as set forth in Section 8.2 above, this Agreement incorporates and includes all prior and contemporaneous negotiations, correspondence, conversations, agreements or understandings applicable to the matters contained herein and the parties agree that there are no commitments, agreements, or understandings of any nature whatsoever concerning the subject matter of the Agreement that are not contained in this document. Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior or contemporaneous representations or agreements, whether oral or written. No alteration, change, or modification of the terms of this Agreement shall be valid unless made in writing and signed by the CONTRACTOR and the COUNTY. 8.4 Governing Law; Venue. This Agreement, including all attachments hereto, shall be construed according to the laws of the State of Florida. Venue for any lawsuit brought by either party against the other party or otherwise arising out of this Agreement shall be in Indian River County, Florida, or, in the event of federal jurisdiction, in the United States District Court for the Southern District of Florida. 8.5 Remedies; No Waiver. All remedies provided in this Agreement shall be deemed cumulative and additional, and not in lieu or exclusive of each other or of any other remedy available to either party, at law or in equity. Each right, power and remedy of the parties provided for in this Agreement shall be cumulative and concurrent and shall be in addition to every other right, power or remedy provided for in this Agreement or now or hereafter existing at law or in equity or by statute or otherwise. The failure of either party to insist upon compliance by the other party with any obligation, or exercise any remedy, does not waive the right to so in the event of a continuing or subsequent delinquency or default. A party's waver of one or more defaults does not constitute a waver of any other delinquency or default. If any legal action or other proceeding is brought for the enforcement of this Agreement or because of an alleged dispute, breach, default or misrepresentation in connection with any provisions of this Agreement, each party shall bear its own costs. 8.6 Severability. If any term or provision of this Agreement or the application thereof to any person or circumstance shall, to any extent, be held invalid or unenforceable for the remainder of this Agreement, then the application of such term or provision to persons or circumstances other than those as to which it is held invalid or unenforceable shall not be affected, and every other term and provision of this Agreement shall be deemed valid and enforceable to the extent permitted by law. 8.7 Availability of Funds. The obligations of the COUNTY under this Agreement are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8.8 No Pledge of Credit. The CONTRACTOR shall not pledge the COUNTY's credit or make it a guarantor of payment or surety for any contract, debt, obligation, judgment, lien or any form of indebtedness. Agreement— 6 8.9 Public Records. Indian River County is a public agency subject to Chapter 119, Florida Statutes. The CONTRACTOR shall comply with Florida's Public Records Law. Specifically, the CONTRACTOR shall: 8.9.1 Keep and maintain public records that ordinarily and necessarily would be required by the COUNTY in order to perform the service. 8.9.2 Provide the public with access to public records on the same terms and conditions that the COUNTY would provide the records and at a cost that does not exceed the cost provided in chapter 119 or as otherwise provided by law. 8.9.3 Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. 8.9.4 Meet all requirements for retaining public records and transfer, at no cost, to the COUNTY all public records in possession of the CONTRACTOR upon termination of the Agreement and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the COUNTY in a format that is compatible with the information technology systems of the COUNTY. 8.9.5 Failure of the CONTRACTOR to comply with these requirements shall be a material breach of this Agreement. The CONTRACTOR shall comply with the provisions of Chapter 119, Florida Statutes (Public Records Law) in connection with this Agreement. 8.10 Notices: Any notice, request, demand, consent, approval, or other communication required or permitted by this Agreement shall be given or made in writing and shall be served, as elected by the party giving such notice, by any of the following methods: (a) Hand delivery to the other party; (b) Delivery by commercial overnight courier service; or (c) Mailed by registered or certified mail (postage prepaid), return receipt requested at the addresses of the parties shown below: County: Indian River County Attn: Chris Burr 4305A 43rd Avenue Vero Beach, FL 32967 Facsimile: (772) 226-3495 Contractor: CER Signature Cleaning Attn: Charles E. Ross 5566 43rd Court Vero Beach, FL 32967 Notices shall be effective when received at the address as specified above. Facsimile transmission is acceptable notice effective when received, provided, Agreement— 7 however, that facsimile transmissions received (i.e., printed) after 5:00 p.m. or on weekends or holidays, will be deemed received on the next day that is not a weekend day or a holiday. The original of the notice must additionally be mailed. Either party may change its address, for the purposes of this section, by written notice to the other party given in accordance with the provisions of this section. 8.11 Survival. Except as otherwise expressly provided herein, each obligation in this Agreement to be performed by CONTRACTOR shall survive the termination or expiration of this Agreement. 8.12 Construction. The headings of the sections of this Agreement are for the purpose of convenience only, and shall not be deemed to expand, limit, or modify the provisions contained in such Sections. All pronouns and any variations thereof shall be deemed to refer to the masculine, feminine or neuter, singular or plural, as the identity of the party or parties may require. The parties hereby acknowledge and agree that each was properly represented by counsel and this Agreement was negotiated and drafted at arm's-length so that the judicial rule of construction to the effect that a legal document shall be construed against the draftsperson shall be inapplicable to this Agreement 8.13 Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed to be an original copy and all of which shall constitute but one and the same instrument. 8.14 Sovereign Immunity. Nothing in this Agreement is intended to, or shall be interpreted to, constitute a waiver or limitation of the COUNTY's sovereign immunity. Agreement—8 IN WITNESS WHEREOF the parties hereto have executed this Agreement as of the date first written above. CER Signature Cleaning INDIAN RIVER COUNTY .»..•••...,, By its Board of County Commissioners r•'Go��MissioyFRs.,•, '�y� � •.ms's By: By O; Printed name: Wesley S. Davis, Chairman Title: 6tt4'1 Pr- Date Approved by BCC: 2/10/15oma; / Date ��l�l% S •.;o;q. o��, :' • RiVEA� . . N. Attest: Jeffrey R mith, Clerk t Circuit Cou Comptrolle By eputy lerk A oved: eph A gird ounty Administrator Approved as to form and legal sufficiency: bylan Reingold County Attorney Agreement—9 Exhibit 1 Required Duties and Frequencies Agreement— 10 Required Duties and Frequencies The following list represents the minimum allowable standards for duties to be covered by this service contract. Some buildings may require more frequent attention due to operating hours/days, traffic or specific use patterns. Proposals should be provided that ensure that acceptable standards are met and adjustment to frequencies can be made in order to maintain these standards. The County shall be the sole determination of acceptable standards. Minimum Allowable Frequencies Daily-Offices, Hallways and Common Areas Empty trash cans; replace liners, police building perimeter for trash • Empty and clean ashtrays and trash receptacles at entrances (big and small) Clean and sanitize drinking fountains and public telephones Spot clean walls, doors, trim and switch plates Clean elevator walls, floors, doors and door tracks Clean entrance doors and surrounding glass (inside and out). Empty recycle containers and place materials in designated bins outside the building Empty wastebaskets and remove trash from building (replace liners) ♦ Vacuum all floors and corridors (both carpet and tile) throughout building Daily-Restrooms ♦ Remove Trash Restock Paper Towels ♦ Restock Toilet Paper • Refill Soap Dispensers Clean Mirrors Damp Wipe Counters and Sinks Sanitize Toilets Sanitize Urinals Clean Toilet Partitions Sweep and Damp Mop Floors Scrub Floors under Urinals Clean Stainless with Stainless Cleaner Agreement- 11 Weekly • Spot clean all floors, including all offices • Dust all Flat Surfaces Monthly Dust all a/c vents and wall mounted fixtures in all corridors and offices Clean mildew off outside metal doors ♦ Dust all furniture and window ledges Damp wipe and sanitize inside and outside of waste receptacles • Wash and spray buff all vinyl floors in kitchen and elevators Quarterly Strip and wax tile floors ♦ Dust light fixtures, window wills and blinds Daytime Building Attendants: 16th St. Complex(Judicial Complex and Main Library) and Administration Complex(Administration Buildings A and B and Health Department) For Group 1: 16"' Street Complex and Group 2: Administrative Complex, the awarded contractors shall provide and include their submitted monthly cost an employee (minimum of 6 hours per day) for the purpose of attending to the daytime custodial needs of specified buildings as a part of this proposal. This person must be able to speak and understand English. Attendant Duties: The attendant position is to supplement the Contractor's work staff by attending to restrooms and other heavily used public areas while the building is open. The attendant's duties shall not impede or significantly interfere with the operation of the building. However, temporary closing of restrooms for cleanup will be allowed. Examples of other duties: Check and refill soap dispensers, toilet paper and paper towel dispensers. • Cleanup of spills and other emergency type cleaning duties. Keep entrance doors and windows clean. Empty trash and smoke receptacles at entrances. Dust baseboards and conference room furniture when not occupied. Perform duties outlined in the daily, weekly or quarterly duties that do not adversely affect the occupants, or visitors to the building. Agreement— 12 Exhibit 2 Contractor's Submitted Price Proposal Form Agreement— 13 M 1pN 04 1 �0 2015014 RFP for Custodial Services-Addendum 1 PROPOSAL PRICING — 2015014 Custodial Services for County Buildings Proposers may submit pricing on one or more groups, however no company will be awarded more than one group. Facility cial ComplexMonthly Amount Annual Amount Group 1:Judi : Judicial Center — $ $ Main Library $ $ Administration Annex Total for Group 1:Judicial Complex $ $ Group 2:Administrative Complex: County Administration Buildings A& B Health Department - Total for Group 2:Administrative Complex $ 1 Group 3:43rd Avenue Complex 43rd Ave. Administration Annex Emergency Operations Center Traffic Operations Center Sheriff's Administration Buildings $ $ ( � r Sheriff's Human Resources (modular) $ C ,� Sheriff's Crime Scene Facility $ , Sheriff's Mall Office $ $ 0171 Total for Group 3:43,d Avenue Complex $ 7Y 3 1--/ C $ 1 Group 4: North County Facilities North County Library _ North County Offices Total for Group 4: North County Facilities $ f Facility Per square foot rate Group 1:Judicial Complex: I Judicial Center — $ Main Library $ Administration Annex $ Group 2:Administrative Complex:_ j County Administration-Buildings A& B Health Department $ Page 21 of 22 0 � ". 2 ^ A I 2015014 RFP for Custodial Services-Addendum 1 Facility Per square foot rate Group 3:43rd Avenue Complex 43rd Ave. Administration Annex Emergency Operations Center $ Traffic Operations Center $ _. j Sheriff's Administration Building Sheriff's Human Resources (modular) �- -Sheriff's Crime Scene Facility Sheriff's Mall Office $, Group 4:North County Facilities North County Library North County Offices $,t,r. The undersigned hereby certifies that they have read and understand the contents of this solicitation and agree to furnish at the prices shown above all of the services specified in the RFP document, subject to all instructions, conditions, specifications and attachments hereto. Failure to have read all the provisions of this solicitation shall not be cause to alter any resulting contract or request additional compensation. Name of Firm — Address Authorized Signature City, State, Zip Code Title Phone r)� �� �ICa��r� I�.l.r2.t C-��``'Uy�1✓1G� j� t'_— t)�4-l2CU.C'c')X7-7 ate Signed E-mail Page 22 of 22 Exhibit 3 Scheduled Holidays Agreement— 16 The following Holidays will be observed during the initial term of the agreement (March 1, 2015 through February 29, 2016) Good Friday Friday, April 3, 2015 Memorial Day Monday, May 25, 2015 Independence Day Friday, July 3, 2015 Labor Day Monday, September 7, 2015 Veterans Day Wednesday, November 11, 2015 Thanksgiving Day Thursday, November 26, 2015 Day after Thanksgiving Friday, November 27, 2015 Christmas Eve Thursday, December 24, 2015 Christmas Day Friday, December 25, 2015 New Year's Day Friday, January 1, 2016 Agreement— 17 CONTRACT DOCUMENTS AND SPECIFICATIONS FOR OLD DIXIE HIGHWAY SIDEWALK IMPROVEMENTS 38th LANE TO 45th STREET BID NO. 2014032 PROJECT NO. 0845B FEDERAL AID PROJECT - FM NO. 423186-2-58-01 PREPARED FOR THE BOARD OF COUNTY COMMISSIONERS INDIAN RIVER COUNTY, FLORIDA PREPARED FOR THE BOARD OF COUNTY COMMISSIONERS INDIAN RIVER COUNTY, FLORIDA PETER D. O'BRYAN, CHAIRMAN WESLEY S. DAVIS, VICE CHAIRMAN COMMISSIONER TIM ZORC COMMISSIONER JOSEPH E. FLESCHER COMMISSIONER BOB SOLARI JOSEPH A. BAIRD, COUNTY ADMINISTRATOR JEFFREY R. SMITH, CLERK OF COURT AND COMPTROLLER DYLAN REINGOLD, COUNTY ATTORNEY CHRISTOPHER R. MORA, P.E., PUBLIC WORKS DIRECTOR CHRISTOPHER J. KAFER, JR., P.E., COUNTY ENGINEER MICHAEL D. NIXON, P.E., ROADWAY PRODUCTION MANAGER 00001 - Project Title Page - REV 04-07.doc 00001 - 1 F:\Public Works\ENGINEERING DIVISION PROJECTS\08458 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documents\Master Contract Documents\00001 - Project Title Page - REV 04-07.doc Section No. Title TABLE OF CONTENTS DIVISION 0 - BIDDING DOCUMENTS, CONTRACT FORMS, AND CONDITIONS OF THE CONTRACT 00001 Cover Sheet 00010 Table of Contents BIDDING DOCUMENTS 00100 Advertisement for Bids 00200 Instructions to Bidders 00300 Bid Package Contents 00310 Bid Form & Itemized Bid Schedule 00430 Bid Bond 00452 Sworn Statement under Section 105.08, Indian River County Code, on Disclosure of Relationships 00454 Sworn Statement under the Florida Trench Safety Act 00456 Qualifications Questionnaire 00458 List of Subcontractors 00470 Equal Opportunity Office Forms 00472 Non -Collusion Affidavit 00474 Certificate Regarding Lobbying 00476 Certificate Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — Primary Covered Transactions 00490 Certification of Non Segregation & Non Discrimination 00492 Buy America Certificate of Compliance 00494 Drug Free Workplace Certification 00496 LAP Certification of Capacity / Status of Contracts on Hand 00500 Certification of Sublet Work CONTRACT FORMS 00510 Notice of Award 00520 Agreement 00550 Notice to Proceed 00610 Public Construction Bond 00620 Sample Certificate of Liability Insurance 00622 Contractor's Application for Payment 00630 Certificate of Substantial Completion 00632 Contractor's Final Certification of the Work 00634 Professional Surveyor and Mapper's Certification -as to the Elevations and Locations of the Work 00010-1 F.\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\Master Contract Documents\00010 - Table of Contents - REV 04-07.doc CONDITIONS OF THE CONTRACT 00700 EJCDC Standard General Conditions of the Construction Contract 00800 Supplementary Conditions to the General Conditions 00942 Change Order Form 00946 Field Order Form 00948 Work Change Directive DIVISION 1 - GENERAL REQUIREMENTS DIVISION 2 — TECHNICAL PROVISIONS APPENDIX A — NONDISCRIMINATION AGREEMENT APPENDIX B - INDIAN RIVER COUNTY FERTILIZER ORDINANCES APPENDIX C - PERMITS (EXEMPT) APPENDIX D —"FEDERAL REQUIRED CONTRACT PROVISIONS" APPENDIX E — "FHWA 1273" + + END OF TABLE OF CONTENTS + + 00010-2 F.\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documentsWlaster Contract Documents\00010 - Table of Contents - REV 04-07 doc SECTION 00100 - Advertisement for Bids BOARD OF COUNTY COMMISSIONERS 1801 27`" Street Vero Beach, Florida 32960 Telephone : (772) 567-8000 FAX: (772) 770-5140 ADVERTISEMENT FOR BIDS INDIAN RIVER COUNTY Sealed bids will be received by Indian River County until 2:00 P.M. on Wednesday, November 12, 2014. Each bid shall be submitted in a sealed envelope and shall bear the name and address of the bidder on the outside and the words "Old Dixie Highway Sidewalk Improvements, 38th Lane to 45th Street" and "Bid No. 2014032". Bids should be addressed to Purchasing Division, 1800 27th Street, Vero Beach, Florida 32960. All bids will be opened publicly and read aloud at 2:00 P.M. All bids received after 2:00 P.M., on the day specified above, will not be opened or considered. INDIAN RIVER COUNTY PROJECT NO. 0845B INDIAN RIVER COUNTY BID NO. 2014032 FEDERAL AID PROJECT - FM NO. 423186-2-58-01 PROJECT DESCRIPTION: The project will consist of the construction of a 5' wide concrete sidewalk along the east side of Old Dixie Highway between 38th Lane and 45th Street, a gross length of approximately 4,500 linear feet. All material and equipment furnished and all work performed shall be in strict accordance with the plans, specifications, and contract documents pertaining thereto. Documents may be obtained from the Public Works Department/Engineering Division, 1801 27th Street, Vero Beach, Florida, 32960, (772) 226-1283 by deposit of a check made payable to Indian River County, in the amount of $75.00 for each set, which represents cost of printing and handling, which is non-refundable and does not include shipping. All other communications concerning this bid shall be directed to IRC Purchasing Division at purchasing@ircgov.com All bidders shall submit one (1) original and one (1) copy of the Bid Proposal forms provided within the specifications. Please note that the questionnaire must be filled out completely including the financial statement. BID SECURITY must accompany each Bid, and must be in the form of an AIA Document A310 Bid Bond, properly executed by the Bidder and by a qualified surety, or a certified check or a cashier's check, drawn on any bank authorized to do business in the State of Florida. Bid Security must be in the sum of not less than Five Percent 00100 - Advertisement for Bids REV 04-07.doc 00100 - 1 F\Public Works\ENGINEERING DIVISION PROJECTS\O845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documents\Master Contract Documents\00100 - Advertisement for Bids REV 04-07.doc (5%) of the total amount of the bid, made payable to Indian River County Board of County Commissioners. In the event the Contract is awarded to the Bidder, Bidder will enter in a Contract with the County and furnish the required 100% Public Construction Bond within the timeframe set by the County. If Bidder fails to do so, the Bid Security shall be retained by the County as liquidated damages and not as penalty. The County reserves the right to delay awarding of the Contract for a period of ninety (90) days after the bid opening, to waive informalities in any bid, or reject any or all bids in whole or in part with or without cause/or to accept the bid that, in its judgement, will serve the best interest of Indian River County, Florida. The County will not reimburse any Bidder for bid preparation costs. A MANDATORY Pre -Bid Conference will be held on Wednesday, October 22, 2014 at 10:00 A.M. in the first floor conference room A1-303 in Building "A" of the Indian River County Administration Building located at 1801 27th Street, Vero Beach, Florida, 32960. ATTENDANCE AT THIS CONFERENCE BY ALL BIDDERS IS MANDATORY. Bidders must sign in before 10:00 A.M. to receive credit for attending INDIAN RIVER COUNTY By: Jennifer Hyde Purchasing Manager For Publication in the Indian River Press Journal Dates: September 28, 2014 and October 5, 2014 For: Indian River Press Journal Please furnish tear sheet and Affidavit of Publication to: INDIAN RIVER COUNTY PURCHASING DIVISION 1800 27th Street Building "B" Vero Beach, FL 32960 * * END OF SECTION * * 00100 - Advertisement for Bids REV 04-07.doc 00100 - 2 F"\Public Works\ENGINEERING DIVISION PROJECTS \0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents \I aster Contract Documents\00100 - Advertisement for Bids REV 04-07.doc SECTION 00200 - Instructions to Bidders TABLE OF CONTENTS Article No. - Title Page ARTICLE 1 - DEFINED TERMS .. 1 ARTICLE 2 - COPIES OF BIDDING DOCUMENTS 1 ARTICLE 3 - QUALIFICATIONS OF BIDDERS 1 ARTICLE 4 - EXAMINATION OF BIDDING DOCUMENTS, OTHER RELATED DATA, AND SITE 2 ARTICLE 5 - PRE-BID CONFERENCE 4 ARTICLE 6 - SITE AND OTHER AREAS 4 ARTICLE 7 -=INTERPRETATIONS AND ADDENDA 4 ARTICLE 8 - BID SECURITY 5 ARTICLE 9 - CONTRACT TIMES 5 ARTICLE 10 - LIQUIDATED DAMAGES 5 ARTICLE 11 - SUBSTITUTE AND "OR -EQUAL" ITEMS . 5 ARTICLE 12 - SUBCONTRACTORS, SUPPLIERS, AND OTHERS 6 ARTICLE 13 - PREPARATION OF BID ... 6 ARTICLE 14 - BASIS OF BID; EVALUATION OF BIDS 7 ARTICLE 15 - SUBMITTAL OF BID .8 ARTICLE 16 - MODIFICATION AND WITHDRAWAL OF BID 9 ARTICLE._17 - OPENING OF BIDS. . ... 9 ARTICLE 18 - BIDS TO REMAIN SUBJECT TO ACCEPTANCE 9 ARTICLE 19 - AWARD OF CONTRACT 9 ARTICLE 20 - CONTRACT SECURITY AND INSURANCE .10 ARTICLE 21 - SIGNING OF AGREEMENT. 10 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10 doc 00200 - i F 1Public Works\ENGINEERING DIVISION PROJECTS10845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)1Admim\bid documents1LAP Documents100200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc SECTION 00200 - Instructions to Bidders TABLE OF ARTICLES (Alphabetical by Subject) Subject Article Award of Contract .......... .. 19 Basis of Bid; Evaluation of Bids 14 Bid Security .. 8 Bids to Remain Subject to Acceptance .... 18 Contract Security and Insurance. 20 Contract Times 9 Copies of Bidding Documents. ... .2 Defined Terms 1 Examination of Bidding Documents, Other Related Data, and Site... 4 Interpretations and Addenda 7 Liquidated Damages 10 Modification and Withdrawal of Bid 16 Opening of Bids .... ... 17 Pre -Bid Conference 5 Preparation of Bid 13 Qualifications of Bidders 3 Signing of Agreement 21 Site and Other Areas 6 Subcontractors, Suppliers and Others .... 12 Submittal of Bid 15 Substitute or "Or -Equal" Items 11 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - F1Public Works\ENGINEERING DIVISION PROJECTS10845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\LAP Documents\00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc SECTION 00200 - Instructions to Bidders ARTICLE 1 - DEFINED TERMS 1 01 Terms used in these Instructions to Bidders will have the meanings indicated in the General Conditions and Supplementary Conditions Additional terms used in these Instructions to Bidders have the meanings indicated below which are applicable to both the singular and plural thereof: A. Bidder --The individual or entity who submits a Bid directly to OWNER. B. Issuing Office --The office from which the Bidding Documents are to be issued and where the bidding procedures are to be administered. C. Successful Bidder—The lowest responsible Bidder submitting a responsive Bid to whom OWNER (on the basis of OWNER's evaluation as hereinafter provided) makes an award ARTICLE 2 - COPIES OF BIDDING DOCUMENTS 2.01 Complete sets of the Bidding Documents in the number and for the deposit sum, if any, stated in the Advertisement or Invitation to Bid may be obtained from the Issuing Office. 2.02 Complete sets of Bidding Documents must be used in preparing Bids; neither OWNER nor ENGINEER assumes any responsibility for errors or misinterpretations resulting from the use of incomplete sets of Bidding Documents. 2.03 OWNER and ENGINEER in making copies of Bidding Documents available on the above terms do so only for the purpose of obtaining Bids for the Work and do not confer a license or grant for any other use ARTICLE 3 - QUALIFICATIONS OF BIDDERS 3.01 To demonstrate Bidder's qualifications to perform the Work, within five days of OWNER's request Bidder shall submit written evidence such as financial data, previous experience, present commitments, and such other data as may be called for below. A. Bidder must have at least five years' experience in the construction of similar projects of this size and larger. B. Bidder must have successfully constructed, as prime CONTRACTOR, at least three projects similar in scope to this project. C. Bidder must have good recommendations from at least three clients similar to the OWNER. D. The Bidder's superintendent and assistants must be qualified and experienced in similar projects in all categories E. Bidder must be able to provide evidence of authority to conduct business in the jurisdiction in which the project is located 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - 1 F -\Public Works\ENGINEERING DMSION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)V\dmim\bid documents\LAP Documents100200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 3.02 Each bid must contain evidence of Bidder's qualification to do business in the state where the Project is located or covenant to obtain such qualification prior to award of the contract. 3.03 The OWNER reserves the right to reject bids from Bidders that are unable to meet the listed required qualifications. ARTICLE 4 - EXAMINATION OF BIDDING DOCUMENTS, OTHER RELATED DATA, AND SITE 4.01 Subsurface and Physical Conditions A. The Supplementary Conditions identify: 1. Those reports of explorations and tests of subsurface conditions at or contiguous to the Site that Engineer has used in preparing the Bidding Documents. 2. Those drawings of physical conditions in or relating to existing surface and subsurface structures at or contiguous to the Site (except Underground Facilities) that ENGINEER has used in preparing the Bidding Documents B. Copies of reports and drawings referenced in paragraph 4.01.A will be made available by OWNER to any Bidder on request. Those reports and drawings are not part of the Contract Documents, but the "technical data" contained therein upon which Bidder is entitled to rely as provided in paragraph 4.02 of the General Conditions has been identified and established in paragraph 4.02 of the Supplementary Conditions Bidder is responsible for any interpretation or conclusion Bidder draws from any "technical data" or any other data, interpretations, opinions or information contained in such reports or shown or indicated in such drawings. 4.02 Underground Facilities A. Information and data shown or indicated in the Bidding Documents with respect to existing Underground Facilities at or contiguous to the Site is based upon information and data furnished to OWNER and ENGINEER by OWNERs of such Underground Facilities, including OWNER, or others. 4.03 Hazardous Environmental Condition A. The Supplementary Conditions identify those reports and drawings relating to a Hazardous Environmental Condition identified at the Site, if any, that ENGINEER has used in preparing the Bidding Documents. B. Copies of reports and drawings referenced in paragraph 4.03.A will be made available by OWNER to any Bidder on request. Those reports and drawings are not part of the Contract Documents, but the "technical data" contained therein upon which Bidder is entitled to rely as provided in paragraph 4.06 of the General Conditions. Bidder is responsible for any interpretation or conclusion Bidder draws from any "technical data" or any other data, interpretations, opinions, or information contained in such reports or shown or indicated in such drawings. 4.04 Provisions concerning responsibilities for the adequacy of data furnished to prospective Bidders with respect to subsurface conditions, other physical conditions and Underground Facilities, and possible changes in the Bidding Documents due to differing or 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - 2 F \Public Works\ENGINEERING DIVISION PROJECTS10845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)V+dmim\bid documents\LAP Documents\00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 unanticipated conditions appear in paragraphs 4.02, 4.03, and 4.04 of the General Conditions. Provisions concerning responsibilities for the adequacy of data furnished to prospective Bidders with respect to a Hazardous Environmental Condition at the Site, if any, and possible changes in the Contract Documents due to any Hazardous Environmental Condition uncovered or revealed at the Site which was not shown or indicated in the Drawings or Specifications or identified in the Contract Documents to be within the scope of the Work appear in paragraph 4 06 of the General Conditions 4.05 Upon a request directed to the ENGINEER (Michael D Nixon, P.E. 772-226-1986), OWNER will provide Bidder access to the Site to conduct such examinations, investigations, explorations, tests, and studies as Bidder deems necessary for submission of a Bid. Bidder shall fill all holes and clean up and restore the Site to its former condition upon completion of such explorations, investigations, tests, and studies. 4.06 This paragraph has been deleted intentionally 4.07 It is the responsibility of each Bidder before submitting a Bid to: A. examine and carefully study the Bidding Documents, including any Addenda and the other related data identified in the Bidding Documents; B. VISIT THE SITE AFTER CONTACTING THE ENGINEER (MICHAEL D. NIXON, P.E., (772) 226-1986) TO MAKE ARRANGEMENTS IN ADVANCE, AND BECOME FAMILIAR WITH AND SATISFY BIDDER AS TO THE GENERAL, LOCAL, AND SITE CONDITIONS THAT MAY AFFECT COST, PROGRESS, AND PERFORMANCE OF THE WORK; C. become familiar with and satisfy Bidder as to all federal, state, and local Laws and Regulations that may affect cost, progress, or performance of the Work; D. carefully study all reports of explorations and tests of subsurface conditions at or contiguous to the Site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the Site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in paragraph 4.02 of the General Conditions, and carefully study all reports and drawings of a Hazardous Environmental Condition, if any, at the Site which have been identified in the Supplementary Conditions as provided in paragraph 4.06 of the General Conditions; E. obtain and carefully study (or assume responsibility for doing so) all additional or supplementary examinations, investigations, explorations, tests, studies, and data concerning conditions (overhead, surface, subsurface, and Underground Facilities) at or contiguous to the Site which may affect cost, progress, or performance of the Work or which relate to any aspect of the means, methods, techniques, sequences, and procedures of construction to be employed by Bidder, including any specific means, methods, techniques, sequences, and procedures of construction expressly required by the Bidding Documents, and safety precautions and programs incident thereto; F. agree at the time of submitting its Bid that no further examinations, investigations, explorations, tests, studies, or data are necessary for the determination of its Bid for performance of the Work at the price bid and within the times and in accordance with the other terms and conditions of the Bidding Documents; 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10 doc 00200 - 3 F:1Public Works\ENGINEERING DIVISION PROJECTS 108458 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documents\LAP Documents100200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 ,G become aware of the general nature of the work to be performed by OWNER and others at the Site that relates to the Work as indicated in the Bidding Documents, H correlate the information known to Bidder, information and observations obtained from visits to the Site, reports and drawings identified in the Bidding Documents, and all additional examinations, investigations, explorations, tests, studies, and data with the Bidding Documents; I. promptly give ENGINEER written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder discovers in the Bidding Documents and confirm that the written resolution thereof by ENGINEER is acceptable to Bidder; and J. determine that the Bidding Documents are generally sufficient to indicate and convey understanding of all terms and conditions for the performance of the Work. 4.08 The submission of a Bid will constitute an incontrovertible representation by Bidder that Bidder has complied with every requirement of this Article 4, that without exception the Bid is premised upon performing and furnishing the Work required by the Bidding Documents and applying any specific means, methods, techniques, sequences, and procedures of construction that may be shown or indicated or expressly required by the Bidding Documents, that Bidder has given ENGINEER written notice of all conflicts, errors, ambiguities, and discrepancies that Bidder has discovered in the Bidding Documents and the written resolutions thereof by ENGINEER are acceptable to Bidder, and that the Bidding Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performing and furnishing the Work. ARTICLE 5 - PRE-BID CONFERENCE 5.01 The date, time, and location for a MANDATORY Pre -Bid conference are specified in the Advertisement for Bids Representatives of OWNER and ENGINEER will be present to discuss the Project. Bidders are REQUIRED to attend and participate in the conference ENGINEER will transmit to all prospective Bidders of record such Addenda as ENGINEER considers necessary in response to questions arising at the conference. Oral statements may not be relied upon and will not be binding or legally effective. ARTICLE 6 - SITE AND OTHER AREAS 6.01 The Site is identified in the Bidding Documents. All additional lands and access thereto required for temporary construction facilities, construction equipment, or storage of materials and equipment to be incorporated in the Work are to be obtained and paid for by CONTRACTOR. Easements for permanent structures or permanent changes in existing facilities are to be obtained and paid for by OWNER unless otherwise provided in the Bidding Documents ARTICLE 7 - INTERPRETATIONS AND ADDENDA 7.01 All questions about the meaning or intent of the Bidding Documents are to be submitted to purchasinq(a�ircgov.com in writing. Interpretations or clarifications considered necessary by ENGINEER in response to such questions will be issued by Addenda mailed or delivered to all parties through the Issuing Office as having received the Bidding Documents. 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - 4 F:\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\IAP Documents\00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 Questions received Tess than ten days prior to the date for opening of Bids may not be answered Only questions answered by Addenda will be binding. Oral and other interpretations or clarifications will be without legal effect. 7.02 Addenda may be issued to clarify, correct, or change the Bidding Documents as deemed advisable by OWNER or ENGINEER. ARTICLE 8 - BID SECURITY 8.01 Each Bid must be accompanied by Bid Security made payable to OWNER in the amount of five percent of the Bidder's maximum base bid price and in the form of a certified check; cashier's check; or an AIA Document A310 Bid Bond issued by a surety meeting the requirements of Paragraph 5.01 of the General Conditions. The Bid Bond shall be executed by such sureties as are named in the current list of "Companies Holding Certificates of Authority as Acceptable Sureties on Federal Bonds and as Acceptable Reinsuring Companies" as published in Circular 570 (amended) .by the Financial Management Service, Surety Bond Branch, U S Department of the Treasury. The Surety must be authorized to issue surety bonds in Florida. The Bidder shall require the attorney-in-fact who executes any Bond, to affix to each a current certified copy of their Power of Attorney, reflecting such person's authority as Power of Attorney in the State of Florida. Further, at the time of execution of the Contract, the Successful Bidder shall for all Bonds, provide a copy of the Surety's current valid Certificate of Authority issued by the United States Department of the Treasury under 31 United States Code sections 9304- 9308. The Surety shall also meet the requirements of paragraphs 5.01 and 5.02 of the General Conditions. 8.02 The Bid security of the Successful Bidder will be retained until such Bidder has executed the Contract Documents, furnished the required contract security and met the other conditions of the Notice of Award, whereupon the Bid security will be returned. If the Successful Bidder fails to execute and deliver the Contract Documents and furnish the required contract security within 15 days after the Notice of Award, OWNER may annul the Notice of Award and the Bid security of that Bidder will be retained by the owner The Bid Security of other Bidders whom OWNER believes to have a reasonable chance of receiving the award may be retained by OWNER until the earlier of seven days after the Effective Date of the Agreement or 61 days after the Bid opening, whereupon Bid Security furnished by such Bidders will be returned. 8.03 Bid Security of other Bidders whom OWNER believes do not have a reasonable chance of receiving the award will be returned within seven days after the Bid opening. ARTICLE 9 - CONTRACT TIMES 9.01 The number of calendar days within which, or the dates by which, the Work is to be (a) Substantially Completed and (b) also completed and ready for final payment are set forth in the Agreement. ARTICLE 10 - LIQUIDATED DAMAGES 10.01 Provisions for liquidated damages, if any, are set forth in the Agreement. 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - 5 F \Public Works\ENGINEERING DIVISION PROJECTS\08458 - Old Dixie Hwy Sidewalk (38th Ln - 45th S»\Admim\bid documents LAP Documents\00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 ARTICLE 11 - SUBSTITUTE AND "OR -EQUAL" ITEMS 11 01 The Contract, if awarded, will be on the basis of materials and equipment specified or described in the Bidding Documents without consideration of possible substitute or "or -equal" items. Whenever it is specified or described in the Bidding Documents that a substitute or "or - equal" item of material or equipment may be furnished or used by CONTRACTOR if acceptable to ENGINEER, application for such acceptance will hot be considered by ENGINEER until after the Effective Date of the Agreement. The procedure for submission of any such application by CONTRACTOR and consideration by ENGINEER is set forth in the General Conditions and may be supplemented in the General Requirements. ARTICLE 12 - SUBCONTRACTORS, SUPPLIERS, AND OTHERS 12.01 If the Supplementary Conditions require the identity of certain Subcontractors, Suppliers, individuals, or entities to be submitted to OWNER in advance of a specified date prior to the Effective Date of the Agreement, the apparent Successful Bidder, and any other Bidder so requested, shall within five days after Bid opening, submit to OWNER a list of all such Subcontractors, Suppliers, individuals, or entities proposed for those portions of the Work for which such identification is required. Such list shall be accompanied by an experience statement with pertinent information regarding similar projects and other evidence of qualification for each such Subcontractor, Supplier, individual, or entity if requested by OWNER. If OWNER or ENGINEER, after due investigation, has reasonable objection to any proposed Subcontractor, Supplier, individual, or entity, OWNER may, before the Notice of Award is given, request apparent Successful Bidder to submit a substitute, without an increase in the Bid 12.02 If apparent Successful Bidder declines to make any such substitution, OWNER may award the Contract to the next lowest Bidder that proposes to use acceptable Subcontractors, Suppliers, individuals, or entities. Declining to make requested substitutions will not constitute grounds for forfeiture of the Bid security of any Bidder. Any Subcontractor, Supplier, individual, or entity so listed and against which OWNER or ENGINEER makes no written objection prior to the giving of the Notice of Award will be deemed acceptable to OWNER and ENGINEER subject to revocation of such acceptance after the Effective Date of the Agreement as provided in paragraph 6.06 of the General Conditions. 12.03 CONTRACTOR shall not be required to employ any Subcontractor, Supplier, individual, or entity against whom CONTRACTOR has reasonable objection ARTICLE 13 - PREPARATION OF BID 13.01 The Bid form is included with the Bidding Documents. Additional copies may be obtained from the Issuing Office 13.02 All blanks on the Bid form shall be completed by printing in ink or by typewriter and the Bid signed. A Bid price shall be indicated for each section, Bid item, alternative, adjustment unit price item, and unit price item listed therein, or the words "No Bid," "No Change," or "Not Applicable" entered. 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - 6 F \Public Works\ENGINEERING DIVISION PROJECTS \084513 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)V\dmim\bid documents\LAP Documents\00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 13.03 A Bid by a corporation shall be executed in the corporate name by the president or a vice- president or other corporate officer accompanied by evidence of authority to sign The corporate seal shall be affixed and attested by the secretary or an assistant secretary. The corporate address and state of incorporation shall be shown below the signature. 13.04 A Bid by a partnership shall be executed in the partnership name and signed by a partner (whose title must appear under the signature), accompanied by evidence of authority to sign. The official address of the partnership shall be shown below the signature. 13 05 A Bid by a limited liability company shall be executed in the name of the firm by a member and accompanied by evidence of authority to sign The state of formation of the firm and the official address of the firm must be shown below the signature. 13.06 A Bid by an individual shall show the Bidder's name and official address. 13 07 A Bid by a joint venture shall be executed by each joint venturor in the manner indicated on the Bid form. The official address of the joint venture must be shown below the signature 13.08 All names shall be typed or printed in ink below the signatures. 13 09 The Bid shall contain an acknowledgment of receipt of all Addenda, the numbers of which shall be filled in on the Bid form. 13.10 The address and telephone number for communications regarding the Bid shall be shown. 13.11 The Bid shall contain evidence of Bidder's authority and qualification to do business in the state where the Project is located or covenant to obtain such qualification prior to award of the Contract. Bidder's state contractor license number or county registration number for the state or county of the Project, if any, shall also be shown on the Bid form. 13.12 All supporting information requested in the Bid Form must be furnished. Do not leave any questions or requests unanswered. ARTICLE 14 - BASIS OF BID, EVALUATION OF BIDS 14.01 Unit Price A. Bidders shall submit a Bid on a unit price basis for each item of Work listed in the Bid schedule. B The total of all estimated prices will be determined as the sum of the products of the estimated quantity of each item and the unit price Bid for the item. The final quantities and Contract Price will be determined in accordance with paragraph 11.03 of the General Conditions. C. Discrepancies between the multiplication of units of Work and unit prices will be resolved in favor of the unit prices. Discrepancies between the indicated sum of any column of figures and the correct sum thereof will be resolved in favor of the correct sum. Discrepancies between words and figures will be resolved in favor of the words. 14 02 The Bid price shall include such amounts as the Bidder deems proper for overhead and profit on account of cash allowances, if any, named in the Contract Documents as provided in paragraph 11.02 of the General Conditions. 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - 7 F\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admimlbid documents\LAP Documents \00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 14.03 The Bidder's attention is called to the fact that any estimate of quantities of work to be done and materials to be furnished under the Specifications as shown on the Bid Schedule, or elsewhere, is approximate only and not guaranteed. The OWNER does not assume any responsibility that the final quantities shall remain in strict accordance with the estimated quantities, nor shall the Bidder plead misunderstanding or deception because of such estimate of quantities or of the character, location of the work, or other conditions pertaining thereto. ARTICLE 15 - SUBMITTAL OF BID 15.01 The Bid form is to be completed and submitted with the Bid security and the following data: A. Itemized Bid Schedule B. Required Bid Security in the form of C. Swom Statement under Section 105.08, Indian River County Code, on Disclosure of Relationships D. Sworn Statement under the Florida Trench Safety Act E. Qualifications Questionnaire F. List of Subcontractors G. Equal Opportunity Office Forms H. Non -collusion Affidavit I. Certification Regarding Lobbying J. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — Primary Covered Transactions K. Certification of Non Segregation & Non Discrimination L. Buy America Certificate of Compliance M. Drug Free Workplace Certification N. LAP Certification of Capacity /Status of Contracts on Hand O. Certification of Sublet Work 15.02 A Bid shall be submitted no later than the date and time prescribed and at the place indicated in the advertisement or invitation to Bid and shall be enclosed in an opaque sealed envelope plainly marked with the Project Title and Bid Number (and, if applicable, the designated portion of the Project for which the Bid is submitted), the name and address of Bidder, and shall be accompanied by the Bid security and other required documents. If mail or other delivery system sends a Bid, the sealed envelope containing the Bid shall be enclosed in a separate 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10 doc 00200 - 8 F \Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St»Admim\bid documents\LAP Documents\00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 envelope plainly marked on the outside with the notation "BID ENCLOSED." A mailed Bid shall be addressed to Indian River County, Purchasing Division, 1800 27th Street, Vero Beach, Florida, 32960. ARTICLE 16 - MODIFICATION AND WITHDRAWAL OF BID 16.01 A Bid may be modified or withdrawn by an appropriate document duly executed in the manner that a Bid must be executed and delivered to the place where Bids are to be submitted prior to the date and time for the opening of Bids. 16.02 If within 24 hours after Bids are opened any Bidder files a duly signed written notice with OWNER and promptly thereafter demonstrates to the reasonable satisfaction of OWNER that there was a material and substantial mistake in the preparation of its Bid, that Bidder may withdraw its Bid, and the Bid security will be returned. Thereafter, if the Work is rebid, that Bidder will be disqualified from further bidding on the Work. ARTICLE 17 - OPENING OF BIDS 17.01 Bids will be opened at the time and place indicated in the advertisement or invitation to Bid and, unless obviously non-responsive, read aloud publicly. An abstract of the amounts of the base Bids and major altemates, if any, will be made available to Bidders after the opening of Bids. ARTICLE 18 - BIDS TO REMAIN SUBJECT TO ACCEPTANCE 18.01 All Bids will remain subject to acceptance for the period of time stated in the Bid Form, but OWNER may, in its sole discretion, release any Bid and return the Bid security prior to the end of this period. ARTICLE 19 - AWARD OF CONTRACT 19.01 OWNER reserves the right to reject any or all Bids, including without limitation, nonconforming, nonresponsive, unbalanced, or conditional Bids. OWNER further reserves the right to reject the Bid of any Bidder whom it finds, after reasonable inquiry and evaluation, to be non -responsible. OWNER also reserves the right to waive all informalities not involving price, time, or changes in the Work and to negotiate contract terms with the Successful Bidder. The County will not reimburse any Bidder for bid preparation costs. Owner reserves the right to cancel the award of any Contract at any time before the execution of such Contract by all parties without any liability to the Owner. For and in consideration of the Owner considering Bids submitted, the Bidder, by submitting its Bid, expressly waives any claim to damages, of any kind whatsoever, in the event the Owner exercises its right to cancel the award in accordance herewith. 19.02 More than one Bid for the same Work from an individual or entity under the same or different names will not be considered. Reasonable grounds for believing that any Bidder has an interest in more than one Bid for the Work may be cause for disqualification of that Bidder and the rejection of all Bids in which that Bidder has an interest. 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - 9 F:\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\LAP Documents\00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 19.03 In evaluating Bids, OWNER will consider whether or not the Bids comply with the prescribed requirements, and such alternates, unit prices and other data, as may be requested in the Bid Form or prior to the Notice of Award. 19.04 In evaluating Bidders, OWNER will consider the qualifications of Bidders and may consider the qualifications and experience of Subcontractors, Suppliers, and other individuals or entities proposed for those portions of the Work for which the identity of Subcontractors, Suppliers, and other individuals or entities must be submitted as provided in the Supplementary Conditions. 19.05 OWNER may conduct such investigations as OWNER deems necessary to establish the responsibility, qualifications, and financial ability of Bidders, proposed Subcontractors, Suppliers, individuals, or entities to perform the Work in accordance with the Contract Documents. 19.06 If the Contract is to be awarded, OWNER will award the Contract to the lowest, responsive, responsible bidder. 19.07 OWNER will forward tabulations of bids to FDOT for approval prior to award of Contract. ARTICLE 20 - CONTRACT SECURITY AND INSURANCE 20.01 Article 5 of the General Conditions, as may be modified by the Supplementary Conditions, sets forth OWNER's requirements as to Public Construction Bond and insurance. When the Successful Bidder delivers the executed Agreement to OWNER, it must be accompanied by such Bond, unless the Bond has been waived due to the total contract being less than $100,000. ARTICLE 21 - SIGNING OF AGREEMENT 21.01 When OWNER gives a Notice of Award to the Successful Bidder, it shall be accompanied by the required number of unsigned counterparts of the Agreement with the other Contract Documents which are identified in the Agreement as attached thereto. Within fifteen (15) days thereafter, Successful Bidder shall sign and deliver the required number of counterparts of the Agreement and attached documents to OWNER. 21.02 OWNER shall return one fully signed counterpart to Successful Bidder. 21.03 Should Bidder to whom the Contract has been awarded refuse or fail to complete the requirements of Article 21.01 above, the additional time in calendar days, required to correctly complete the documents will be deducted, in equal amount, from the Contract time. Or, the OWNER may elect to revoke the Award and the OWNER shall hold the Bid Bond for consequential damages incurred, and the Contract may be awarded as the OWNER desires. * * END OF SECTION * * 00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc 00200 - 10 F:\Public Works\ENGINEERING DIVISION PROJECTS \0845B - Old Dixie liwy Sidewalk (38th Ln - 45th St)Wdmim\bid documents\LAP Documents\00200 - Instructions to Bidders FOR LAP PROJECTS ONLY REV 08-10.doc Rev 05/01 SECTION 00300 - Bid Package Contents THIS PACKAGE CONTAINS: SECTION TITLE SECTION NUMBER Bid Form 00310 Bid Bond 00430 Sworn Statement on Disclosure of Relationships 00452 Sworn Statement Under the Florida Trench Safety Act 00454 Qualifications Questionnaire 00456 List of Subcontractors 00458 Equal Opportunity Office Forms 00470 Non -Collusion Affidavit 00472 Certificate Regarding Lobbying 00474 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—Primary Covered Transactions 00476 Certification of Non Segregation & Non Discrimination 00490 Buy America Certificate of Compliance 00492 Drug Free Workplace Certification 00494 LAP Certification of Capacity / Status of Contracts on Hand 00496 Certification of Sublet Work 00500 SUBMIT (1) ORIGINAL AND (1) COPY OF THIS COMPLETE PACKAGE WITH YOUR BID **END OF SECTION** 00300 - Bid Package Contents - REV 08-10.doc 00300 1 F:\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\LAP Documents\00300 - Bid Package Contents - REV 08-10.doc Indian River County Purchasing Division 1800 27th Street Vero Beach, FL 32960 Date: ADDENDUM NO. 1 October 22, 2014 Project Name: OLD DIXIE HIGHWAY SIDEWALK IMPROVEMENTS (38TH LANE TO 45TH STREET) BID NO. 2014032 PROJECT No. 0845B Bid Opening Date: The Bid Opening date is Wednesday, November 12, 2014 at 2:OOpm A Pre -Bid Conference was held on Wednesday, October 22, 2014 in the Public Works Conference Room A1-303 Indian River County Administration Building A, located at 1801 27th Street, Vero Beach, Florida 32960. TO ALL PROSPECTIVE BIDDERS: TO PROSPECTIVE BIDDERS AND OTHERS CONCERNED: This ADDENDUM is intended to clarify, correct, or change the Bidding Requirements of the Contract Documents. Therefore, it hereby supersedes anything to the contrary in the Bidding Requirements or contract Documents. This ADDENDUM is hereby made a part of and shall be attached to the subject Bidding Requirements and Contract Documents. All questions about the meaning or intent of the Bidding Documents are to be submitted to the Purchasing Department in writing at purchasing@ircgov.com. Interpretations or clarifications considered necessary by ENGINEER in response to such questions will be issued by Addenda mailed or delivered to all parties through the Issuing Office as having received the Bidding Documents. Questions received less than ten (10) calendar days prior to the date for opening of Bids shall not be answered (Deadline is Sunday, November 2, 2014 by Midnight). Only questions answered by Addenda will be binding. Oral and other interpretations or clarifications will be without legal effect. All Bids must be received by the Purchasing Division office located at 1800 27th Street, Vero Beach, FL 32960 prior to the date and time shown above. Late bids will be returned unopened. Addenda may be issued to clarify, correct, or change the Bidding Documents as deemed advisable by OWNER or ENGINEER. Page 1 of 3 F -Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documentstAddendums\Addendum No I IO-22-2014.doc CLARIFICATIONS / CORRECTIONS/ADDITIONS/QUESTIONS: Pre-bid meeting — questions: QUESTION: Can the sidewalk be closed during construction? ANSWER: The sidewalk can be closed during construction. QUESTION: Does a temporary sidewalk need to be in place for the existing segments of sidewalk? ANSWER: Because the existing sidewalk segments are not continuous, both the existing sidewalks within the project area and proposed sidewalks can be closed during construction. No temporary sidewalk will need to be in place during construction. QUESTION: Does the Contractor need to be FDOT Certified? ANSWER: NO QUESTION: Does the concrete need to be from a FDOT Certified Plant? ANSWER: No QUESTION: Is there a preferred end of the sidewalk to start on? ANSWER: The preferred end to start construction is at 45th Street. Once the segment between 45th Street and 41s` Street is complete, It is preferred to open this segment to allow school access in the area. QUESTION: Is a pre -construction conditions video required? If so, is a third party required to take it? ANSWER: The CONTRACTOR shall make provisions, at his expense, for photographs and video tapes of all work areas just prior to construction, and for unusual conditions during construction. The photographs and videos shall show pertinent physical features along the line of construction. The purpose of the videos is to determine any damage to private or public property during construction. The video must be performed by a professional videographer. (See Section 01215 GENERAL QUALITY CONTROL, Division 1 GENERAL REQUIREMENTS of the Contract Documents). QUESTION: What happens in event of rain delays? ANSWER: In the event of rain delays, when mutually agreed upon by county and Contractor, additional time to the contract time can be added. QUESTION: What are the work hours? ANSWER: Work hours are from 7:OOam to 5:OOpm, Monday through Friday, except holidays. (See SC6.02Bof Section 00800 -Supplementary Conditions the General Conditions in the Contract Documents) CLARIFICATION Line Item 527-1 DETECTABLE WARNING ON EXISTING WALKING SURFACES QUANTITY 8, is intended for use on existing walking surfaces. All other detectable warnings and curb cuts are included in the cost of the proposed sidewalk as indicated on the construction drawings. The Federal —Aid Project Wage Rates in the Contract Documents are current. ATTACHMENT: Pre-bid meeting minutes dated October 22, 2014 Page 2 of 3 F'Public Works\ENGINEERJNG DIVISION PROJECTS \08458 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents \Addendums\Addendum No.l, IO.22-20I4.doc L ADDENDUM NO. 1 PROJECT: OLD DIXIE HIGHWAY SIDEWALK IMPROVEMENTS (38TH LANE TO 45TH STREET) BID NO. 2014032 PROJECT No. 0845B *****This Addendum MUST be completed and returned with your Bid********** ADDENDUM NO. 1 is submitted by and Company Name Name: t (Type inted Michael D. Nixon, P.E., Roadway Production Manager r Hyde, Purchasing Manager .nce nt04-410 Title: iteiliCifitt I Authorized Signature: Date: 1 1 1 1 -- l q Telephone: 1.12_ () —A 30 Fax: 77 7 51c Page 3 of 3 Board of County Commissioners 1801 27th Street Vero Beach, Florida 32960-3365 Telephone: (772) 567-8000 Fax: (772) 778-9391 PRE-BID MEETING MINUTES OCTOBER 22, 2014, 10:00 A.M. INDIAN RIVER COUNTY ADMINISTRATION BUILDING 1801 27TH STREET, VERO BEACH, FL 32960 Room A1-303 Project Name: OLD DIXIE HIGHWAY SIDEWALK IMPROVEMENTS (38TH LANE TO 45TH STREET) Project Number: 0845B Bid Number: 2014032 INTRODUCTIONS / SIGN IN SHEET: This is a PRE-BID MEETING; Attendance at this conference by all bidders was mandatory. The following meeting notes set forth our understanding of the discussions and decisions made at the subject meeting. If no objections, questions, additions, or comments are received within five (5) working days from issuance of the meeting notes, we will assume that our understandings are correct. The project will move forward according to the bid plans and specifications and the understandings herein. The meeting was called to order by Michael Nixon. The following is a list of the attendees: Michael Nixon, IRC Engineering James Boyette, IRC Construction Management Jennifer Hyde, IRC Purchasing Manager Ron Rose, Timothy Rose Construction Shane Barry, Florida Site Contracting Dennis Mallory, Stillwater Construction Dan Muschweck, Venergy Group Lori Craig, Marquee Development, Inc. Mary Ann Hataway, K & S / FDOT Paul Brown, FDOT Kevin Trost, Guettler Brothers Construction Jose L. Dato, Dato Construction, Inc. Tony Rake, Kerns Construction Michael Mazzina, FDOT Chlo Ann Lawrence, FDOT Treasure Coast Operations F :Public Works.ENGIREERING DIVISION PROJECTS\0845B - Old Dicic Hwy Sider,al1, (38th Ln - 45111 Sty Admim Meetings Pre-Bid`Pre-hid meeting minmes for 10-22-I4.doc PROJECT DESCRIPTION: The project will consist of the construction of a 5' wide concrete sidewalk along the east side of Old Dixie Highway between 38th Lane and 45th Street, a gross length of approximately 4,500 linear feet. CONTRACT DETAILS: Bid opening: Wednesday, November 12, 2014 at 2:00 PM Contract time: 60 days to substantial completion 75 days to final completion Engineer's Estimate: $175,000.00 Liquidated Damages: $758.00 per day Late Bids will not be accepted. CORRESPONDENCE/LINES OF AUTHORITY/QUESTIONS: Communications concerning this bid shall be directed to IRC Purchasing Division atpurchasingPircgov.com Questions will be limited up to 10 days prior to bid opening, so please review the plans this week. CONTACTS: • Project Manager - Michael Nixon, P.E., Indian River County, Engineering Division, 1801 27th Street, Vero Beach, Florida 32960 during the bid process. mnixonPircgov.com • Construction Manager - Construction Phase will be turned over to D. Howard, Construction Coordination Manager, Indian River County, 180127 Street, Vero Beach, Florida 32960 • Maintenance of Traffic—Jeanne Bresett, Indian River County, Traffic Division, 1801 27 Street, Vero Beach, Florida 32960 PROJECT CONSULTANTS: Indian River County, Engineering Division (In-house design) Construction Engineering and Inspection (CEI): Indian River County, Engineering Division Construction Management Staff UTILITIES - (MAY BE PRESENT ALONG LIMITS OF PROJECT) FPL- No conflicts Vero Beach Electric ATT IRC Utilities - utilities adjustments are included in this project. Comcast Cable Communications Florida City Gas OTHER ISSUES • Maintenance of Traffic: o Contractor shall submit a Maintenance of Traffic Plan to the Indian River County, Engineering Division for approval. o Access for all businesses and residences shall be maintained at all times. o Traffic shall be maintained at all times. o The Maintenance of Traffic Plan shall meet the FDOT Index 600, 2014 edition F `Public \\'orks ENGINEERING DIVISION PROJECTS1.0845B - Old Dixie Hwy Sider alk (38th Ln - 451b St)`Admim.Meetings:Pre-Bid\Pre-hid meeting. minutes for 10-22-14.doc • Environmental permits are exempt. • Coordination with business owners. • Sidewalk —true 6" concrete, 2% max slope (no tolerance). • Testing per- FDOT specifications. • Curb cut ramps in accordance with FDOT Index. • School buses, Sanitation & US Postal Service must be maintained. • Addendums if required — review and comment as soon as possible, no further comments / questions 10 days prior to bid opening (Sunday, November 2, 2014). FEDERAL REQUIREMENTS: • Invoicing • Indian River County (IRC) is required to satisfy the Federal reporting requirements for this project, such as employment reporting, for both Contractor and all Subcontractors. • In order to be eligible for reimbursement by FDOT /FHWA, IRC must comply with all applicable procedures, standards and directives as described in the FDOT Local Agency Program Manual and the Florida Department of Transportation, Equal Employment Opportunity Construction Contract Compliance Workbook, Jan. 2012. • Contractors must meet deadlines in order to be in compliance. All deadlines are strictly enforced or reimbursements cannot be made. • All required forms must be completed and on time or payment could be withheld. • Job Site Bulletin Board is required to be maintained until project is completed. • Summary of required contractor form submittals checklist (Section 200-8 in contract documents). • Current Wage Determination. * Please Note Common/General Laborer Rates (County will verify latest Wage Rates — will send out in addendum if different). • FLORIDA DEPARTMENT OF TRANSPORTATION, EQUAL EMPLOYMENT OPPORTUNITY CONSTRUCTION CONTRACT COMPLIANCE WORKBOOK, JAN. 2014 Available on website: www.dot.state.fl.us/equalopportunity/ DISCUSSION: Questions: Can the sidewalk be closed during construction? Does a temporary sidewalk need to be in place for the existing segments of sidewalk? Does the Contractor need to be FDOT Certified? Does the concrete need to be from a FDOT Certified Plant? Is there a preferred end of the sidewalk to start on? Is a pre -construction conditions video required? If so, is a third party required to take it? What happens in event of rain delays? What are the work hours? Questions will be addressed in Addendum No. 1 No curbing is required with this project. There is a grass strip between the edge of pavement and sidewalk. Grassing will need to be placed if it does not exist. There is a line item for Performance Turf to cover this item. Certified payroll with wage rates will be required to be submitted by the contractor. Bulletin Board, EEO for all subs over $10,000, FH 1273 must be included in all contracts. DBE participation is encouraged. ATTACHED: Sign in Sheet r ;Public \Vorks.ENGINEERING DIVISION PROJECTS`.0815B - Old Dixie Hwv Sidewalk (38th Ln - -51h St r\dmim _Vleetings\Pre-BidP.Pre-hid meeting minutes for IO-22-1S.doc __ •J 4 _ - - - --mss �.: - •-f� - - f'}!:f-s:.4.'� ��:. '=�_ - ��i.,♦ 4-F _ ,•�Ti'. � -ti I _ - =tai " b _gg;:="' - .==II. ,52e.•S 1-4,1 4 _.;{•Ci _X _ - _r-h -��:7 ' ��ya�r-.-^i.r�,Ca 1-. _. „tF,.--; . <�. ,='i_ _^.3,: >•s:ssr_ +" ,.- - - _yam -�i�:., - s.;_rt.�r �t`��^.••re;�• _ _ _�:e •- .'-a - ....c]:': _-C•:4.'a Ja: +" + - . ��='_ '`:+L_:^F . .i� k ' \- 'Z. f A+ ;3 • =3 rX . 3is r.<= =Y:. + AND/ D tX-- • E ' B11 { `rye'tillittefAR :. - _ l/!►�{`��. n�p,+�jF10.;..-- 1-1011SPArtitai.• 7- t" �,-x - r-'k• .a{ •�.��}`� .'i •!if'�.'! - _ i�/y•v��{��� �.i• ••,,•-,n,...--V1-5.,�:f�o' .4+ ;.. .Y•t �ti ; ' . --t•,.. li - • :� p — '----' -fit.+ _ .T 1T'.a' -�"� - � LTZ'' Z �-�'A�-'�''.iv���3%. S, 93NFERENCE _ . • - •.fi r• y - ;k,y%:.:.i r'� :P•�v. Via. �_- ac,-;" ;�5; _ _ •-i � '14::yi. •!.-•�'J:.•� � i .: .: -,,s. _ r;-6.,�'_. �.%i, ��+i t- _ .-3,'o- .-.- :. =� ,--c �. :..- 3 rc":_sr;:_;. P:-�-..e. - ' -_ __ _ ..R._r c.� '+.rr:zr-------11.a ': :2,_f v. ��:1`i �.-:i. }..'1_, `'sS;,j�.; :.`L=t: - - om f•!'.. -i.r y _ ..d�''?�-S^nV�r �ia- .:;.:^ _iin t - :. •YIY. • ?: f-':�ti�f.'�. ..�',, . I =.p `.�•.r-: :'. ftv _�E� - �[� � �.i ^ilk14.-sr:.tYJ1 �1 - f T, L'�e'. 'zyTYti:: tiZ'ey'�.�.':,:.•.:�J.,'Y -:. 7.. - lti i ': 'y ••'� om_ - - " - . - _ : Y' .11'-. '�. •e__ '�L=':ii:L�: �^<''�:�->.�iyit'Y=.� --? - - _ .��:•' Cl �;r. s. 3r_':a,^_ ,_,.:,.°<.:- A�hd. ': ;F•� _-rt;:,• - i��. ' � �Y•_ se i�.: - .�•t :<% =J. ..r : _ ;j�r`:s yp� •rt: 6y. - ter-----.50:_ _ _ •.'�ey3;<.,�-.yam.��'••"• �.r2 •-,•�' T r _ ••ice Sic - - - <{,s� tip,:•.:. vZ..3 %: ijn•�(' �`• sli '+Sf't-1' v3T' � t'� :': 'r4�' : ]�. �'-`- _ •�A R r. t• 2Sr :s f_15 ;4:•a;• J.�8ti:,:; • . -. • Q y"�f•.j��IR� '... 4K r:f-,• T-. 1. f. ;tr- 3. ..._iC1.:...-._.-. aj�'�'4ia,.>_k;:t ::.:�• -_ _ - _ 4t;Ir .;e ; [:'f• :C r"" aC� _ �_/�al_ _r7-1= •: a,�'._ .-i'_- 010� .•_Cr >!u2 **chat / /axonX AG C-17,,,Ccrhsy j)/v1s.`o•,-7 77.? a076-11g 6 FA% 7r72. Z7iii -43?1 ,tea 77 2 .453- 39q a M/!ih an P i rcgov. Com ,.nn"C-6f- -1(L-w evrG e,,it -l_. 772_ 226 - 1 S713- eo rch.-SiY\D z irc 5av . c,r'<w. /-**----;1•1 40-re— • Cp n Pee ems(' t \ COrl." e 421..1 f • AA,* 5,(4,1e_ B ores'( Ronda,.S,- e et 7 7?• -173-/ ',2, '9Y? 33 akv.e_-_ ,,,/ 7? z-7��-- S /94 Vc 4"'"`1et, 30).)41 Awe-1 oma; I 5`tec�•,tr0.efieg. (..01 Dem'0.0%09 s7; 111)-Al-�Q -3Z/-Sok-/Y.2S' CeellA 5T S1, /lwAtes QowS-rult.dN to r1,��.'/.sof p..., M..cNw.c.K �zG „ENey G....,:, '172'955- /09 2 Oa,•,^/t N�' 6 ( c 1-'Tr. C rc���`-off vee �evQioQrnav�-, V3- 9 $-41ci5 0 k .oa - 33b ‘S marc6veeded co,\ . Com --'' - -- - :_- . - ". .., ,:rq.';.F.-.:' :. .7._ •T''f: 'i _ -e- . 111,.'i* - — 'e' , It•--t-s, ....:. :-4:4- =., – 1.- il-li- . -=,-,..,,- .-,• MANDA1ORY PRB1D .- '''''-',--, . „ 4 INGthi _ - -!.-t:.,:frz:::ii.,-r4-tni,-,:..;-.;,,,,A;,-;z.II:.::- ?-14toptittvEROuw. ,-34,:.,-,___it,:,,f:i.,;:53-i•.-,,,.,.:4-1,4i-,11-:-,:ii4eswilii7;..7,., '-'7:•._:: .7'r '-‘. "' * . ' • ! • : ,j, - ,...1: . ..lil.W14,5`,.i. IXtE* (./%:. . A 11 0000., , . : ''•••_:;!,,..i;:' ,.. :eh- . , . . _ -. . ,, ,...‘.,.,.. apppCil...._. -•-,-,,,,,, ----.4„...,„:„ v.::_,, _, ...,_.: :_.., -,:.- -. • , - .. . j! .., : -''' c`..; " _ -..sitt1;13iVi -., ,,,, ,.. t,r74r A .,.- '':•$': ' –,: a- =1- :. , 1,-, .e.' - :44;;,'" : 10.• . , 01. 1-,:s-:''' A 4, --- •''-e-,!V;-',.? -:-. • ,. Tz 1.7.:. :,,.. < -' .i-4,.YILIV•il ' SO. 3, Z-: i• Cif . 0 R.. •-- -a-- -'-'e `7'.:' ..... ;;_ 1 ' x.: *: . . .. . . ; .i•:,-.1..-,7:---.7-eF•:-,t:, - Artitit-Vigti'ig.'Ze';II ..."'.' ;'' !-.47?-:11 'Ti-'-:-.. .4.;;:are•=41'74:0400.000:0000:41atira2af ZatiOlatittAtteiC: r Ann *I Actfruocui -- -3(001 0/ea,1derAi/e' R. pi; ere -7 -7Q — ii-aq - Li cria - cato -IKChairAuJaci 11101Q1111, g dolt. sf.aFt a s , %'i. BRowitv ,c ..17- 0 71- 072)32/-5/34 petal .6n:we, 29 el•v••stak • /is QS Kesi 11.1 -riteisr 6,4 eilT-Elr- SPerrtio c 3ets144,17 q gol ttAtrar44,041 tiffrri rerptcrets- -rt. Nept7 4 -77z- 4(1-e34r 4) -771-44(d-ecAS1 4 17i._. erl....cin kev 1 " Q dv.4e44Ier a:girt-pi...c.f./or. ecoom Jo&E L j41) 1s410 CONSTIZ.V-TIISNI7 It-SC. 032 ‘414' Lt' SW \kRO tCA Ca FL 3 le-16 Z -p • 411. Li TZ. el 454 "f• . geg 6 S g ;'el 2 5 C: 432 35C 4130 J-QeLcuto co y4.61. rot, iN rCeIAT000/NISTRUCTIcKe 4,4,is ce.....srrze./4070-.1 /c.c./ 51, Aomsel3c...)z I s Ls r 'G. -C 1...,..Ac.i e, F. . 344315€0, --7 "I 2.-Sf32 -i:51%0 Ii-evt 1 fe & dire-a s c. -"sneu., „ste04.7._ / ) 1 leHAEL WIEZzi//13 F-D 0 ( -)7z-429-'4g76 d5 CD °5ELP.MEI: in07-.1-TF74-7 mop", L wwce St'i- -fr-efsice ezcsi- opr-R5 --iiz.--4-2q-111 2 _ - -,gi; . iF„�1- -,_:. -.Y �yam �-•J-�.,;:isi:.l-._-.-.v�:':� 4w. -4Y' • ..-•� ;. .-... ter=• :-rr a .rA _ - .c r .- .: _ r �.. _CONFERENCE , - , a= vj �i's, t` _•�_ _ A:,�.-_J':.-- - _ •.iia ___ - - F -- 'z-- ,x _ .S7I 3- ^ MAi ' ?it PRE=81x3 I. T 111 ---.' OFI _CFIDN f� - - - - - - �_r .r.._^• ii. - ,..T^'•si -:_1Fl_•_:�"�:�Y�',v 't._. _ �_ ..�r-.-_,,. ste•:__-r[•..._Cmo~•. h+�•p%'. ,- - _ _ aJ? � ' ^ t 44.• 0 41 ;r -C`'--•!"= _'�._=�f.. _-_ _ •_� � _ a-tic !� ` • _ .-i.•F%• ,.mo� - •,+t= �- %+• -H�_' .tfJC�es. � - ---_ _ -aq. _• _ ,y_�.'="n. •.: �r=rk - TZ:_ - - e Y%7'a"-�-, 1c%�-;;fi:•.,rz. •'F V, > :.t : WCAW.AT;•I fes_ s'- �.; _ . r.,.. 7 Amis �'. 4.77:k.- �y I.a /•r, gt v-ci 61.);;177772,- ! a/ -,-7# f, dice► 433 - opo Lel Gtaoyc-ife a� I r e a v. e,a 3 r A t 1 PROJECT IDENTIFICATION: Project Name: County Project Number: Bid Number: Project Address: Project Description: THIS BID IS SUBMITTED TO: SECTION u _ .; _ =.:: Old Dixie High v,,ay Sidewalk Improvements, 38th Lane to 45' Street 0845B 2014032 Old Dixie Highway from 38th Lane to 45th Street The project will consist of the construction of9 5' wide concrete sidewalk along the east side of Old Dixie Highway between 38th Lane and 45th Street, a gross length of approximately 4,500 linear feet. INDIAN RIVER COUNTY 1800 27th Street VERO BEACH, FLORIDA 32960 1.01 The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with OWNER in the form included in the Bidding Documents to perform all Work as specified or indicated in the Bidding Documents for the prices and within the times indicated in this Bid and in accordance with the other terms and conditions of the Bidding Documents. 2.01 Bidder accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to Bidders, including without limitation those dealing with the disposition of Bid security. The Bid will remain subject to acceptance for 90 days after the Bid opening, or for such longer period of time that Bidder may agree to in writing upon request of OWNER. 3.01 In submitting this -Bid, Bidder represents, as set forth in the Agreement, that: A. Bidder has examined and carefully studied the Bidding Documents, the other related data identified in the Bidding Documents, and the following Addenda, receipt of all which is hereby acknowledged. Addendum Date Addendum Number B. Bidder has visited the Site and become familiar with and is satisfied as to the general, local and Site conditions that may affect cost, progress, and performance of the Work. C. Bidder is familiar with and is satisfied as to all federal, state and local Laws and Regulations that may affect cost, progress and performance of the Work. D. ' Bidder has carefully studied all: (1). reports of explorations and tests of subsurface conditions at or contiguous to the Site and all drawings of physical conditions o -dating to 00310-1 00310 - Bid Form is _:: _ . _C'S ONLY.doc F:\Public Works\ENGINEERING DIVISION PROJECTS!3'_== _ - _ , _ -r:; Sidewalk (38th Ln - 45th St)\Admim\bid documents'L'P _ >__:.e - = _..: _ :_: LAP PROJECTS ONLY.doc +ho existing surface or subsurface structures at or contiguous to the Site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in paragraph 4.02 of the General Conditions, and (2) reports and drawings of a Hazardous Environmental Condition, if any, which have been identified in the Supplementary Conditions as provided in paragraph 4.06 of the General Conditions. E. Bidder has obtained and carefully studied (or assumes responsibility for having done so) all additional or supplementary examinations, investigations, explorations, tests, studies and data concerning conditions (surface, subsurface and Underground Facilities) at or contiguous to the Site which may affect cost, progress, or performance of the Work or which relate to any aspect of the means, methods, techniques, sequences, and procedures of construction to be employed by Bidder, including applying the specific means, methods, techniques, sequences, and procedures of construction expressly required by the Bidding Documents to be employed by Bidder, and safety precautions and programs incident thereto. F. Bidder does not consider that any further examinations, investigations, explorations, tests, studies, or data are necessary for the determination of this Bid for performance of the Work at the price(s) bid and within the times and in accordance with the other terms and conditions of the Bidding Documents. G. Bidder is aware of the general nature of work to be performed by OWNER and others at the Site that relates to the Work as indicated in the Bidding Documents. H. Bidder has correlated the information known to Bidder, information and observations obtained from visits to the Site, reports and drawings identified in the Bidding Documents, and all additional examinations, investigations, explorations, tests, studies, and data with the Bidding Documents. I. Bidder has given ENGINEER written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder has discovered in the Bidding Documents, and the written resolution thereof by ENGINEER is acceptable to Bidder. J. The Bidding Documents are generally sufficient to indicate and convey understanding of all terms and conditions for the performance of the Work for which this Bid is submitted. 4.01 Bidder further represents that this Bid is genuine and not made in the interest of or on behalf of any undisclosed individual or entity and is not submitted in conformity with any agreement or rules of any group, association, organization or corporation; Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid; Bidder has not solicited or induced any individual or entity to refrain from bidding; and Bidder has not sought by collusion to obtain for itself any advantage over any other Bidder or over OWNER. [The remainder of page intentionally left blank] 00310-2 00310 - Bid Form for LAP PROJECTS ONLY.doc F:\Public Works\ENGINEERING DIVISION PROJECTS \0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documents\LAP Documents\00310 - Bid Form for LAP PROJECTS ONLY.doc BIDDER'S NAME: MOBILIZATION LR.C. PROJ:CTI10. 03452,, GM NO O. 2014G32, FM O. 423186-2-58-6i . . j - 'r' 1 t -1 LS ‘14 11, 000- i/000 1 . I MAINTENANCE OF TRAFFIC EROSION & WATER POLLUTION CONTROL CLEARING AND GRUBBING EXISTING SIDEWALK REMOVAL MAILBOX RELOCATION LS. LS LS SY LS 1 1 84 ZCO v., LSO " I(.00 Z 500 REGULAR EXCAVATION EMBANKMENT (COMPACTED IN PLACE) TURNOUTS AND DRIVES (6" THICK CONCRETE) CEMENT CONCRETE PAVEMENT (TURNOUTS AND DRIVES (8" THICK CONCRETE)) VALVE BOX ADJUSTMENT CONCRETE FOR SIDEWALK (6" THICK, 5' WIDE) DETECTABLE WARNING ON EXISTING W CY CY SY SY EA SY 213 18 128 108 3 1,205 fie " 2-'S ZO 1—RZ.0 32- 53 504\1,20 - 00 - 1 .-._;:_.-1-:: PERFORMANCE TURF (MATCH EXISTING) SY 3,000 2 , " (DO 0 0, SINGLE SIGN POST RELOCATE) RETRO -REFLECTIVE PAVEMENT MARKERS (Amber / Amber) THERMOPLASTIC, STANDARD, WHITE, SOLID, 12" THERMOPLASTIC, STANDARD, WHITE, SOLID, 24" THERMOPLASTIC STANDARD, YELLOW, SOLID, 6" THERMOPLASTIC, REMOVE THERMOPLASTIC, REFURBISHMENT, WHITE, SOLID, 12" SIDEWALK IMPROVEMENTS FORCE ACCOUNT TOTAL BID AMOUNT (INCLUDING FORCE ACCOUNT AS EA LF LF LF SF LF 3 8 1,282 23 200 142 CS -0: g ID 3D SUB -TOTAL (...1), 1 s •ZDL <:-, QLiV 04, 2o0. 3-2 15,000.00 TOTAL / 700.52- r :=-F“DJECT BIDAMOUNT IN WORD -II • "/ ae_3__Ce-4 Ljr r AS = Assembly CY = Cubic Var.:, tAl= ach LF = Linear Foot LS = Lump Sum SY = Square Yard capjle__ 00310-3 FAPublic Works\ENGINEERING DIVISION PROJECTS \0845B - Old Dixie Hy Sidewalk (38th Ln - 45th St)\Admitn\ estimates1Old Dixie HighwaiSidewalk 38th Lane to 45th St ITEMIZED BID SCHEDULE 2-26-14.xls •-•i? • . V 4 ,:.•,,s6P. Bid or Proposal Bond Westfield Insurance Company Westfield Groups"' One Park Circle, P O Box 5001 Westfield Center, Ohio 44251-5001 KNOW ALL MEN BY THESE PRESENTS, that we. TIMOTHY ROSE CONTRACTING, INC. asp Principal, and the WESTFIELD INSURANCE COMPANY. an Ohio Corporation, with its principal office at Westfield Center. Ohio, as Surety, are held and firmly bound unto INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS . as Obligee, in the penal sum of 5% OF AMOUNT OF BID DOLLARS, lawful money of the United States of America, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors; administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS the said Principal is herewith submitting a bid or proposal for CONSRUCTION OF 5FT WIDE SIDEWALK ALONG OLD DIXIE HWY BETWEEN 38th LANE AND 45TH STREET NOW THEREFORE, the condition of the above obligation is such, that if the said Principal shall execute a contract and give bond for the faithful performance thereof, if required by the contract, or if the Principal or Surety shall pay the Obligee the difference, not exceeding the penal sum hereof," between the amount of the contract entered into in good faith to perform the work to which the bid or proposal relates and the amount bid or proposed by the Principal,' then this obligation shall be void, otherwise it shall remain in full force and effect. SIGNED this 5th day of NOVEMBER BD 5046 (9-03) TIMOTHY ROSE CONTRACTG, INC. , 2014 Principal By: Westfield Insurance Comp By: CAW LORD ttorney-it t -;act General Power of Attorney CERTIFIED COPY POWER NO 0990102 00 Westfield Insurance Co. Westfield National Insurance Co. Ohio Farmers Insurance Co. Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as "Companies," duly organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these presents make, constitute and appoint CABOT W. LORD, JOSEPH E. COONS, JOINTLY OR SEVERALLY of PALM CITY and State of FL its true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of suretyship LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. and to bind.any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the applicable Company and duly attested by itsSecretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in WESthe TF ELD INSURANemises. Said CEoTE COMPANY, WESTFIELD NATIIONALintment is made under and by forityyINSURANCE COMPANY of the following and OHIO FAolution RMERS bthe INSURANCEBoard fCOMPANYDirectors of each of the "Be It Resolved, that the President, any Senior Executive, any Secretary or any Fidelity & Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney -in -Fact. may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary " "Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting held on February 8, 2000) In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto affixed this 21st day of MARCH Corporate p•aSY•R,w.t�.,y,, C'+,tro4 ,fir aAP .D.,.., 2014 • • ,,,,,,,,,,,,,,, %.0 • SEALSEAL r immv :U'• .r.Seals pa O pAffixedsato `.i State of Ohio County of Medina ss. WESTFIELD INSURANCE COMPANY WESTFIELD NATIONAL INSURANCE COMPANY OHIO FARMERS INSURANCE COMPANY By: Dennis P Baus, National Surety Leader -and Senior Executive K.„„ On this 21st day of MARCH A.D., 2014 , before me personally came Dennis P. Baus to me known, who, being by me duly sworn, did depose and say, that he resides in Wooster, Ohio; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above instrument: that he knows the seals of said Companies; that the seals affixed to said instrument are such corporate seals; that they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order Notarial Seal Affixed State of Ohio County of Medina ss. 0)ezzed,&44. David A. Kotnik, Attorney at Law, Notary Public My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code) I, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; and furthermore, the resolutions of the .Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 5th day of November•...•."A`'i.... 2014 ,.:.,,,,,,,, \agUa.(,���z,4 %,,,(, ,N ., ais - 3 M t SEAL 5i l m SEAL . "Z � IRTF�Ei / ItitAt. Secretary ,1,..'•.� .x.,,r`�ir ;7,' ,=p i, : 1848 N BPOAC2 (combined) (06-02) Frank A. Carrino, Secretary 5.01 Bidder shall complete the price(s) contained in the Bid Schedule th the Contract Documents for the A. The Discrepancies between the mu;-: 3f units of Work and unit prices will be resolved in favor of the unit prices. Discrepancies between the indicated sum of any column of figures and the correct sum thereof will be resolved in favor of the correct sum. Discrepancies between words and figures will be resolved in favor of the words. B. The Owner reserves the right to omit or add to the construction of any portion or portions of the work heretofore enumerated or shown on the plans. Furthermore, the Owner reserves the right to omit in its entirety any one or more items of the Cintract without forfeiture of Contract or claims for loss of anticipated profits or any claims by the Contractor on account of such omissions. C. Bidder acknowledges that estimated quantities are not guaranteed, and are solely for the purpose of comparison of Bids, and final payment for all Unit Price Bid items will be based on actual quantities provided. The quantities actually required to complete the contract and work may be less or more than so estimated, and, if so, no action for damages or for loss of profits shall accrue to the Contractor by reason thereof. D. Unit Prices have been computed in accordance with paragraph 11.03.B of the General Conditions. 6.01 Bidder agrees that the Work will be substantially completed and ready for final payment in accordance with paragraph 14.07.B of the General Conditions on or before the dates or within the number of calendar days indicated in the Agreement. 6.02 Bidder accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work within the times specified, which shall be stated in the Agreement. 7.01 The following documents are attached to and made a condition of this Bid: A. Required Bid security in the form of i-11Qt B. Itemized Bid Schedule C. Sworn Statement under Section 105.08, Indian River County Code, on Disclosure of Relationships -" D. Sworn Statement Under the Florida Trench Safety Act E. Qualifications Questionnaire/ F. List of Subcontractors G. Equal Opportunity Office Forms H. Non -collusion Affidavit I. Certificate Regarding Lobbying 00310-4 00310 - Bid Form ` _-? ONLY.doc F:\Public Works\ENGINEERING DIVISION PROJECTE-.: Ei 5 - O'o Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documerds._== : - _ . _ _—.._- IAP, PROJECTS ONLY.doc E'��'`�•._�:J4 �d..��e_�::.�.�Si''c-"'..��f.-f".'r"ft',.-ai'JLva`'a3"w��'�."9. J. Certification Regarding De. - _ = is ibiIity and Voluntary Exclusion - Primary Covered K. Certification of Non Segrec =- L. Buy America Certificate of Corr;,: =r •' M. Drug free Workplace Certification/ ri-,retion, N. LAP Certification of Capacity / Status of Contracts on Handl 0. Certification of Sublet Work' 8.01 The terms used in this Bid with initial capital letters have the meanings indicated in the Instructions to Bidders, the General Conditions, and the Supplementary Conditions. SUBMITTED on i J aU _ \ ! , 20 IL-+. State Contractor License No. ii -C.-01. 2_gi Bidder is: An Individual Name (typed or printed): By: (SEAL) (Individual's signature) Doing business as: Business address: Phone No.: FAX No.: A Partnership Partnership Name: (SEAL) By: (Signature of general partner -- attach evidence of authority to sign) Name (typed or printed): Business address: Phone No.: FAX No.: A Corporation Corporation Name7170 c)4?_(f +1h r- 'to t .... (SEAL) State of Incorporation: 41- (V- A__ i Type (General Business, Professional, Service, Limited Liability):t. j) A:I Y/4 00310-5 00310 - Bid F. c: _= _ _ ; _ - - =S ONLY.doc F:\Public Works\ENGINEERING DIVISION PROJECTS 1=.3 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)V\dmim\bid docur.;-:s _' = - PROJECTS ONLY.doc - ..rte -_-c,. _.._..-. .. s+'�.�.oS anr..a}�:z'�.a=3•..-`bSvwhif- -.w mtF� -ent`e.mrii By (Signature -- attach evidence of auti- = - Name (typed or printed): ! .',ls,.. Title:1''5,46( 'rCA Attest ,i4141/1o'1 — (Signature of Corporate Secretary) ` Business address: t &f O ' (3 d t i k.4 '%)IJ SUA,i tC p QAAi (,ham (62 Phone No. n2-- S104(7YOO FAX No.:77Z Date of Qualification to do business is /. f . ► `I - (CORPORATE SEAL) A Joint Venture (SEAL) Joint Venture Name: By: (Signature of joint venture partner -- attach evidence of authority to sign) Name (typed or printed): Title: Business address: Phone No.: FAX No.: Joint Venture Name: (SEAL) By: (Signature -- attach evidence of authority to sign) Name (typed or printed): Title: Business address: Phone No.: FAX No.: Phone and FAX Number, and Address for receipt of official communications: (Each joint venturor must sign. The manner of signing for each individual, partnership, and corporation that is a party to the joint venture should be in the mariner indicated above.) * * END OF SECTION * * 00310-6 00310 = _ _•= O _ ECTS ONLY doc F:\Public Works\ENGINEERING DIVISION PROJECTS ".:.::453 - Old Dixie Hwy Sidewalk (38th Ln - 45th Stf4. e -: - " - - '- = 'o' LAP PROJECTS ONLY.doc - -.- - -- crime -•- ;+c -R. :s{.-�..x c a=: ^xT.T�.< H ,.r,�..,?; ...., .. ,....._.c..._ SECTION 00430 AIA DOCUMENT A310 BID BOND The Contractor shall use the document form entitled "AIA Document A310 Bid Bond " END OF SECTION 00430 - Bid Bond REV 04-07.doc 00430 - 1 F:\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documents\Master Contract Documents \00430 - Bid Bond REV 04-07.doc Rev 05/01 SECTIk_ -..s _-} RN STATEMENT UNDER SECTION ; .7",.i1). I N D I AN RIVER COUNTY CODE, ON DISCLOSURE OF Pf LA T IONSHIPS _ M MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER _•_-?.IZED TO ADMINISTER OATHS. sworn statement MUST be submitted with Bid, Proposal or Contract No. O \ Z- tiq \L:utsikkoat&ALIA/ Aft__ k lonvefike n�� D 0( TS .5)- ye : s sworn statement is submitted by: //t144'341/ k) CeOtrad--2-a-- (Name of entity submitting Statement) nose business address is: 1 iSuit is & -3Z. v name is ---17—t (Plea print name of individual signing _rld my relationship to the entity named above is rel. 16641- ,_mderstand that an "affiliate" as defined in Section 105.08, Indian River County Code, means: The term "affiliate" includes those officers, directors, executives, partners,.shareholders, employees, members, and agents who are active in the management of the entity. understand that the relationship with a County Commissioner or County employee that must be sclosed as follows: Father, mother, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, husband, wife, father-in-law, mother-in-law, daughter-in-law, son-in-law, brother-in-law, sister-in-law, stepfather, :epmother, stepson, stepdaughter, stepbrother, stepsister, half brother, half sister, grandparent, or randchild. Based on information and belief, the statement, which I have marked below, is true in relation to the _ntity submitting this sworn statement. [Please indicate which statement applies.] /Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, have any relationships as defined in section 105.08, Indian River County Code, with any County Commissioner or County employee. 00452-1 Works\ENGINEERING DIVISION PROJECTS -C -=5g - Old Dixie Hwy Sidewalk (38th Ln - 45th =.nts\00452 DISCInsIRP. of Rolatinnshins rinr ::t::'-_T.'^'yF.'-_::. a•",' -ice wi•,.vtt;m"•S5i z,u.;..e.a;-.en.>- ._---.Ym"LEi�.�.�FS?•e�^r'.:. n::•L" a: ^�,'�-.e _ = Y"3.. entity submitting this sworn stait__ shanthoiders, employees; -he following relationships with a I Name of C cum: Cisner or emplo ee E we omeers, bireciors, eNecuoves, active in management c:f the enhty Dr County employee: Relationship (Signature) (Date) _nstrument was acknowledged before me this t day of • , 2014, by who ispersonally known to me or who has produced 00452-2 as identification. SIGN: PRINT: NOTARY PUBLIC Y Public, State at large 3242t°tar My Commission Expires: kb (Seal) DEBORAH WEST MY COMMIEUN fi E?-; 3030 111604,myrivir EXPIRES: :lad= 0, 9.!'.1 5 ketftettiv-q-W- ...ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th - - r-' --E--M=0-ter Contract Disclosure of Relationshios.doc frr:r'fi -atteStAr Wk's, - ci T l e i i `h a i t:,. Act SECTION 00454 - Sworn St,tet-:��, -.. �- - . _ .. = i< . -_= ',','-a0 WILL BE RESPONSIBLE THIS FORM MUST BE SIGNED BY + -i_ = , - - - _ OR ITS AUTHORIZED FOR THE EXCAVATION WORK �'I'`� ) REPRESENTATIVE, IN THE PRESENCE OF ANOTARY PUBLIC AUTHORIZED TO ADMINISTER OATHS. 1 This Sworn Statement is n submitted mittto 45.t Street No. 0845B for Old Dixie Highway Sidewalk Improvements, 38 Lane 2. This Sworn Statement is submitted by 110/V0.4 (gal N e of Entity Submitting Sworn Stat ent) 5a hereinafter "BIDDER".0 T e BIDD�� address is 3COlaeI)IA id-twiStutt pVeiofI'ea hR-3 2423-1-2._ BIDDER'S Federal�Employer Identification Number (FEIN) is ( Q and my relationship to the BIDDER 3 My name is (Print Name of iS I certify, through my signature at the end of this Sworn Statement, that (Position or Title) am an authorized representative of the BIDDER. The Trench Safety Standards that will be in effect during the construction of this Project are contained within the Trench Safety Act, Section 553.60 et.seq. Florida Statutes and refer to the applicable Florida Statue(s) and/or OSHA Regulation(s) and include the "effective date" in the citation(s). Reference to and compliance with the applicable Florida Statute(s) and OSHA Regulation(s) is the complete and sole responsibility of the BIDDER Such reference will not orbcheck the B DDER e checked by OWNEs � comr p liance ER with and therench they shall have no responsibility to review Safety Standards. The BIDDER assures the OWNER that it will comply with the applicable Trend) Safety Standards. 6 The BIDDER has allocated and included in its bid the total amount of $ based on the linear feet of trench to be excavated over five (5) feet deep, for,ompliance with the applicable Trench Safety Standards, and intends to comply with said standards by instituting the following specific method(s) of compliance on this Project: The determination of the appropriate method(s) of compliance is the complete and sole responsibility of the BIDDER. Such methods will not be checked by the OWNER or ENGINEER for accuracy, completeness,r any oncer �heck purpose. he BIDDER'Os1comp ante NER and ENGINEER shall have no responsibilityo with the Trench Safety Standards. the total amount of $ ��� rt 7 TThe BIDDER has allocated and included in its bid based on the square feet of shoring itbsaidused shor ngcompliance irementswith bySinstit orinuing saf the ety requirements and intends to comply with following specific method(s) of compliance on this Project 00454 - Florida --_- 00454 - 1 = =ublic Works\ENGINEERING DIVISION PROJECTS-•==== - " Dixie Hwy Sidewalk (38th Ln - 45th St)Vadmim\bid doc:r.e, --snob Safety Act - REV 04-07.doc . 04-07 doc --= - ---=--Florida - r#.`S-,.� .''." ..`r�;l_r.a'zrx.e=¢si•5+'. rc''2s�,! The determination of the appr = responsibility of the BIDDER. = _. ENGINEER for accuracy, cot•--: ENGINEER shall have no reser with the Trench Safety Standard= ince is the !_ornplete and soli: _ : e checked by the OWNER or :--er purpose The OWNER and Dr check the BIDDER's compliance 3 The BIDDER, in submitting this b;~ -e� esen,s that it has obtained and considered all available geotechnical information has utilized said geotechnical information and that, based on such information and the BIDDER's own information, the BIDDER has sufficient knowledge of the Project's surface and subsurface site conditions and characteristics to assure BIDDER's compliance with the applicable Trench Safety Standards in designing the trench safety system(s) for the Pro'-ct. :z:TATEOFROA COUNTY OF 1 Miav( ersonally appeared before me, the undersigned authority, VVLO* ,.,ho after first being sworn by me, affixed his/her signature in the space I day of NOV , 20 v--{- BIDDER: By: 1i 14.440 -6- _ Position or Title: fie. rk(d-- Date: 11.11_ I u 'otary `:*1 mom ic, State at large ission Expires: i0131►� * * END OF SECTION * * vided above on this 00454 - Florida 00454 - 2 F -\Public Works\ENGINEERING DIVISION PROJECT= -: _-• `_ _ - : = Dixie Hwy Sidewalk (38th In - 45th St)V\dmim\bid docum=-:_ Trench Safety AG - REV 04-07.doc . D4-07.doc _- _- - Florida ':i- :� 5%- •s..iirFy; ±r?Sx r isr.,:5�!:;ei�P:sf.+'r:.iSu:.—._.rww slc W ys� ;s .. -^..-s..�n — c-.�.. iK..�..:yg1'T,.4 •-- �Y.Y4h-'.tp'Na- .-a'L£,3�?'t�+.w=�r��Fa i,R,:�?:§ii:={•fig.'=Y'_``F=�.�=ak:.:.><�` _'.,zi:_. .d�r£s �t`-^��'`i;s�:�§.`.�£�i::., _...-.�'�Fs....�p�c-'F.}_: ;.,.-': __. _.. �w,,; �� q:'tse �•moi,::- 0045 - ?(e,'P, ,:, ; ot• s :%UESTIONNAIRE OTICE: THE OWNER RETAINS THE D TO REJECT THE BIDS OF NON- SPONSIBLE BIDDERS. UNDER PENALTY OF PERJURY, the undersigned Bidder Guarantees the truth and accuracy all statements and answers herein contained. Failure to comply with these requirements —1,/ be considered sufficient justification to disqualify a Bidder. Attach additional sheets as -_quired. Documentation Submitted with Project No: 0845B Project Name: Old Dixie Highway Sidewalk Improvements (38th Lane to 45th Street) Bidder's Name /. ddress: 3'ttO J\ai� w 2 Bidder's Telephone & FAX Numbers: -772-54m .11- (�D % 7 �2: j'it, `r , �� Licensing and Corporate Status: a. Is Contractor License current? CS b. Bidder's Contractor License No' (-C.05-291;-6 [Attach a copy of Contractor's License to the bid] c. Attach documentation from the State of Florida Division of Corporations that indicates the business entity's status is active and that lists the names and titles of� all officers. j Number of years the firm has performed business as a Contractor in construction work of the type involved in this contract: 2_5- What S What is the last project OF THIS NATURE that the firm has completed? Cita 1)\‘,11,- Awl az f G t 'e 3. Has the firm ever failed to complete work awarded to you? K1 0 [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which the firm failed to complete the work.] 7. Has the firm ever been assessed liquidated damages? 140 [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which liquidated damages have been assessed.] 8. Has the firm ever been charged by OSHA for violating any OSHA regulations? 3°vO 0045 s .; ___,,c;nnaire doc 00456 - 1 C:1Documents and Settingslmnixon\Local Seuinr_•,e a—: z- ;rnet Files \OLK21\00456 - Qualifications Questionnaire.dec •-•;v r' :•ems �- �•�-i-.= a..y+�•�:.e tre_ =s: ^via• [if your answer is "yes", hien at�- the circumstances and list the :;: for each project iVich OSHA c 0. Has the firm ever been charged NO .: ois questionnaire that explains the Owner's telephone number •li^nce -of any public policy or rules? [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project.] 10. Attach to this questionnaire, a notarized financial statement and other information that documents the firm's financial strength and history. ✓ 11. Has the firm ever defaulted on any of its projects? N a [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which a default occurred.] 12. Attach a separate page to this questionnaire that summarizes the firm's current workload and that demonstrates its ability to meet the project schedule ✓ 13. Name of person who inspected the site of the proposed work for the firm: Name: I i‘ Date of Inspections: O. 14. Name of on-site Project Foreman: Number of years of experience with similar projects as a Project Foreman: 7� 15. Name of Project Manager: 1 vy1,40 Number of years of experience with similar projects as a Project Manager: 2 :� 16. State your total bonding capacity: le VW I LCO C' 17. State your bonding capacity per job:.S V LIU..LLiO r 18. Please provide name,• address, telephone number, and contact person of your bonding company: `kal Q r 1:�\ o%�'P - r -L , ilh ee f V.tn [The remainder of this page was left blank intentionally] LOO iY tOA PCVLIA i es, t,l. vtlJ�Ut_.- lam' .`- Ccr _ '���t.l l�• E—I C'd 1.4 -Li qr1 4-1 00456 se-s'ionnaire.doc 00456-2 C:\Documents and SettingsVnnixon\Local Sett,=;_ -•_,.. _ ; :.met Files\OLK21\00456 - Qualifications Questionnaire.dec SJ lALi E OF FLOR;DA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ROSE, TIMOTHY WILLIAM TIMOTHY ROSE CONTRACTING INC 1360 SW OLD DIXIE HIGHWAY #106 VERO BEACH FL 32962 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is License Efficiently, Regulate Fairly We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR (850) 487-1395 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CGC052940 ISSUED' 07/13/2014 CERTIFIED GENERAL CONTRACTOR ROSE, TIMOTHY WILLIAM TIMOTHY ROSE CONTRACTING INC IS CERTIFIED under the provisions of Ch 489 FS Expiration date AUG 31, 2016 L1407130001474 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD ,LICENSE NUMBER=; CGC052940 The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date* AUG 31, 2016 ROSE, TIMOTHY WILLIAM TIMOTHY ROSE.CONTRACTING INC 1360 SW OLD DIXIE HIGHWAY SUITE 106 VERO BEACH FL 32962 2014 FLORIDA PROFIT CORPORATION ANNUAL REPORT DOCUMENT# S75343 Entity Name: TIMOTHY ROSE CONTRACTING, INC. Current Principal Place of Business: 1360 OLD DIXIE HWY SW STE 106 VERO BEACH, FL 32962 Current Mailing Address: 1360 OLD DIXIE HWY SW STE 106 VERO BEACH, FL 32962 US FEI Number: 65-0284242 Name and Address of Current Registered Agent: ROSE, TIMOTHY W 1360 OLD DIXIE HIGHWAY SW 106 VERO BEACH, FL 32962 US FILED Jan 15, 2014 Secretary of State CC6497847931 Certificate of Status Desired: No The above named entity submits this statement for the purpose of changing its registered office'or registered agent, or both, in the State of Florida. SIGNATURE. Electronic Signature of Registered Agent Officer/Director Detail : Title Name Address City -State -Zip: Title Name Address City -State -Zip: P ROSE, TIMOTHY W 1360 OLD DIXIE HWY SUITE 106 VERO BEACH FL 32962 TREA ROSE, LISA A 1360 SW OLD DIXIE HWY #106 VERO BEACH FL 32962 Title Name Address City -State -Zip. SEC ROSE, RONALD 1360 SW OLD DIXIE HWY #106- VERO 106VERO BEACH FL 32962 Date I hereby certify that the information indicated on this report or supplemental report is tole and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver ortrustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with ell other like empowered. SIGNATURE' TIMOTHY W. ROSE PRESIDENT 01/15/2014 Electronic Signature of Signing Officer/Director Detail Date 8:50 AM 11/04/14 Accrual Basis hy Rase Contracting, incorporated Balance Sheet As of October 31, 2014 ASSETS Current Assets Checking/Savings PNC Operating Account Total Checking/Savings Accounts Receivable Accounts Receivable Oct 31, 14 757,861 10 757,861 10 645,783 42 `rr' Total Accounts Receivable 645,783 42 Other Current Assets Exchange 1,870.83 Invstmnt Morgan Stanley Smith B Cash -Morgan Stanley Investment 410 70 Equities - Morgan Stanley SB 116,838.93 Total Invstmnt Morgan Stanley Smith B 117,249 63 Total Other Current Assets 119,120 46 Total Current Assets 1,522,764 98 Fixed Assets Accum Dep - All Assets -3,130,527 49 Construction Equipment 2,332,345 94 Furniture & Fixtures 17,535.66 Office Equipment 15,459.05 Software 2,083.95 Vehicles 877,716.22 Total Fixed Assets 114,613.33 Other Assets Security Deposits 517 45 Total Other Assets 517 45 TOTAL ASSETS 1,637,895.76 LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable Accounts Payable 286,038.92 Total Accounts Payable 286,038.92 Credit Cards 1st Bank Card 1296 1st Bank Card 9557 American Express CC Total Credit Cards -425 14 -146 01 -22,950 02 -23,521 17 Total Current Liabilities 262,517 75 Long Term Liabilities N/P - ALLY (Escalade) 991.05 23,785.20 N/P Ally 15 Silverado (836.13) 54,722.32 N/P GE Capital 9766086-001 38,412.08 N/P ST JD BH #3824/ BD #4819 5,057 16 N/P ST Loan (1102.57) JD #6669 666.32 N/P Suntrust (09 GMC Sierra) 483.09 PNC - #**68244 2012.Ford truck 30,411 19 PNC #8087 2006 Wheel Loader 20,060.51 PNC Bomag Mixer2/MPH100S/#85809 12,209.83 PNC JD DW544J2613575-L9 23,253 08 Total Long Term Liabilities 209,060 78 Total Liabilities 471,578.53 Page 1 o:5ii A61 11/04/14 Accrual Basis Timothy Rose Contracting, incorporated Balance Sheet As of October 31, 2014 Equity 'Retained Earnings Capital Stock Opening Balance Equity Paid In Capital Shareholder Distribution Unrealized Gain (Loss) on Inves Net Income Total Equity Oct 31, 14 744,049.97 500 00 -96,430.73 277,897 49 -15,000.00 19,254 34 236,046.161:4 1,166, 317.23 TOTAL LIABILITIES & EQUITY 1,637,895.76 Page 2 NC April 1, 2014 To Whom It May Concern: This letter serves to confirm that Timothy Rose Contracting, Inc. maintains a Line of Credit with PNC Bank. This Line of Credit has an available limit of $100,000. There is not a balance outstanding on the Line of Credit. Should you need any additional information please contact me at 772-978-1026. fi&L a ,PYzet--2-L- nda A. Gibson Vice President Business Banker The PNC Financial Services Group 958 20th Place Vero Beach Florida 32960 vAver.pnc.corn Name cf Job Where Located Presidential Streets Sebastian - Cleveland, Washington, Martin Coolidge Street Sebastian - Coolidge Street Englar Drive Sebastian - Englar Drive Drainage Ditches _ Sebastian - Various Streets 17th Street Shoppes Vero Beach - 17th Street Sorenson Office Bldg Vero Beach - 20th Street Old Dixie Resurfacing ' Vero Beach - Old Dixie Highway Oslo Road Vero Beach - Oslo Road kve?..o isow!Fw Mr.M.^! !WM!" Mgr. Irf" ,,Irrtrp!,4 19. " Complete the following table for SIMILAR projects. .! Irrgr,r' rP17.77.1z - Name of Project Date Completed Owner Contact Person: Name/ Email Address/Phone Original Contract Amount — Final Contract Amount Old, \i,\C \A- \ilil ,•1...-Asa.k Akiq-- _ , 4‘,),?1:-.bkie.vviti-\--rzs L-im l 4 , 1 L4 I _.e._. iM, \ c,hc-k, 6- (\.) vvv,,‘,Istion@ANrcspv.w co ma t-; Z--', -II?. 3-7 — 4-1,-,,---1 --1•', '''''..: IvA Ott -a, A .f\lvt.i.-- zkciug02— t • 4tl/PY/1,2111-1 4 _3 Av ma_iive_rr_0490tA__ 2ZI4 ,.... , .---- -. '''.0 e0 \La_ 4,-- . ---7 C.C.: ,2., • ___.... 00456 - 3 C:\Documenls and Settings\mnixon1Local Seltings\Temporary Internet Files\OLK21 00456 - Qualifications Questionnaire.doc 00456 - Qualifications Questionnaire doc 1 y . :OTE. If requested by the County, the B _ - - ences, and other information, --.. "lclently Comprehensive to pern-it an appi_ls._ _ -. c_ as a contractor.1�y�//lJ�,". � ' By eio-&- -- (Signature) (Position or Title) (Date) * * END OF SECTION ** C =_ - a ,::: _> s +: _ __\ionnaire.doc 00456 - 4 Documents and Settings\mnixon\Local Settings\Temcc:ary Internet Files\OLK21\00456 - Qualifications Questionnaire_ac • 'ag'Le'=i • 1 f 1 t SECTION 004a:: The Bidder SHALL list below the name a;-: ::-=: :s :,_ each Subcontractor who will perform , ork under this Contract in excess of one a:f :e:r:srt of the total bid price, and shall also list he portion of the work which will be done by sucn Subcontractor. After the opening of Bids, anges or substitutions will not be allowed unless approved by Indian River County after a -equest for such a change has been submitted in writing by the Contractor, which shall include -easons for such request. Subcontractors must be properly licensed and hold a valid Certificate Competency. Documentation Submitted with Project No. 0845B for Old Dixie Highway Sidewalk improvements, 38th Lane to 45th Street. 3 ao 11 12. 13. 14. 15. 16. 17. Work to be Performed Subcontractor's Name/Address 3 vrtipet,,Act.32762 Note: Attach additional sheets if required * * END OF SECTION * * 00458 -lis: _ : = a _-. _ _ 04-07.doc 00458 - 1 FAPublic Works\ENGINEERING DIVISION PROJECT_ ::-. E Dixie Hwy Sidewalk (38th Ln - 45th St)V\dmim\bid docurre .s :rase :. : _ .:. _ , ._. '? - List of Subcontractors REV 04-07.doc ^r¢;:Yo-�"s-;fir++•�'�:4 a.::� • SECTION 00470 - EQUAL OPPORTUNITY FORMS 275-030.11 EQUAL OPPORTUNITY OFFICE 03/11 Page 1 of 8 DBE Utilization The Department began its DBE race neutral program January 1, 2000. Contract specific goals are not placed on Federal/State contracts; however, the Department has an overall 8.18% DBE goal it must achieve. In order to assist contractors in determining their DBE commitment level, the Department has reviewed the estimates for this letting. As you prepare your bid, please monitor potential or anticipated DBE utilization for contracts. When the low bidder executes the contract with the Department, information will be requested of the contractor's anticipated DBE participation for the project. While the utilization is not mandatory in order to be awarded the project, continuer utilization of DBE firms on contracts supports the success of Florida's Voluntary DBE Program, and supports contractors' Equal Employment Opportunity and DBE Affirmative Action Programs. NOTE: Any project listed as 0% -DBE availability does not mean that a DBE may not be used on that project. A 0% DBE availability may have been established due to any of the following reasons: limited identified subcontracting opportunities, minimal contract days, and/or small contract dollar amount. Contractors are encouraged to identify any opportunities to subcontract to DBEs. If you have any questions regarding this information, please contact the Equal Opportunity Office at (850) 414-4747. DBE Reporting If you are the prime contractor on a project, complete the attached Anticipated DBE Participation Statement and submit the information at the pre -construction or pre -work conference for all federal and state funded projects. This will not become a mandatory part of the contract. It will assist the Department in tracking and reporting planned or estimated DBE utilization. During the contract, the prime contractor is required to report actual payments to all subcontractors through the web -based Equal Opportunity Reporting System (EORS), BizWeb. All DBE payments must be reported whether or not you initially planned to utilize the company. In order for our race neutral DBE Program to be successful, your cooperation is imperative. If you have any questions concerning the completion or submission of this information, contact the FDOT E00 at (850) 414-4747. Bid Opportunity List The Federal DBE Program requires States to maintain a database of all firms that are participating or attempting to participate on FDOT-assisted contracts. The list must include all firms that bid on prime contracts or bid or quote subcontracts on FDOT-assisted projects, including both DBEs and non -DBEs. A form is included to record bidders' information for ALL subcontractors or sub -consultants who quoted to you for specific projects for this letting. If a colitractor quoted to you for more than one project you only need list that contractor once. If you have submitted a bidders list to the Department previously, you need only list new companies who have quoted to you or requested to be on specific projects. If you do not know the answers to numbers 2, 3, 4, or 5 you may leave them blank and the Department will complete them. This information should.be-returned with your bid package or proposal -,package or I submitted.to the Equal Opportunity Office within three days of your submission. It can be mailed or faxed. Please reply to: Florida Department of Transportation . Equal Opportunity Office 605 Suwannee Street, MS 65 Tallahassee, FL 32399-0450 (850) 414-4747 (850) 414-4879 470-1 1 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION ANTICIPATED DBE PARTICIPATION STATEMENT 275-030-11 EQUAL OPPORTUNITY OFFICE 03/11 Page 2 of 8 1 FINANCIAL PROJECT NO. 2. FAP NO. 3. CONTRACT NO. 4. COUNTY(IES) 5. DISTRICT -' % , 5I - `2.31,A0 -Z -S' -o1 wiu.d $z Inchletuc- il 6. PRIME CONTRACTOR NAME 7. FEID NUMBER Tm0 ,o � C ' ± ci it 6s- -0 z- li2.42.. 8. CONTRACT DOLLAR AMOUNT 1291 ZOO :3-2 9. REVISION? IF YES, REVISION NUMBER: 22. EXECUTED DATE 23. PRECON CONF DATE 10. IS THE PRIME CONTRACTOR A FLORIDA CERTIFIED "DBE"? (DISADVANTAGED BUSINESS ENTERPRISE) YES 11. IS THE WORK CONSTRUCTION OF THIS CONTRACT - 1? OR MAINTENANCE ■? ❑ FAX ❑ EMAIL ❑ SHARED FOLDER 12. ANTICIPATED DBE SUBCONTRACTS: DBE SUBCONTRACTOR or SUPPLIER TYPE OF WORK/SPECIALTY DOLLAR AMOUNT PERCENT OF CONTRACT DOLLARS A ii. ' v -----.. ___ . B C D E 12F TOTAL DOLLARS TO DBE'S 12G TOTAL PERCENT OF CONTRACT $0.00 0.00% 13. SUBMITTED BY 14 .DATE 15. TITLE OF SUBMITTER 16. EMAIL RESS OF SUBMITTER 17. FAX NUMBER 18. PHONE NUMBER NOTE: THIS INFORMATION IS USED TO TRACK AND REPORT ANTICIPATED DBE PARTICIPATION IN ALL STATE AND FEDERALLY FUNDED FDOT CONTRACTS. THE ANTICIPATED DBE AMOUNT IS VOLUNTARY AND WILL NOT BECOME A PART OF THE CONTRACTUAL TERMS. THIS FORM MUST BE SUBMITTED AT THE PRE CONSTRUCTION OR PRE WORK CONFERENCE. FDOT STAFF FORWARDS THE FORM TO THE EQUAL OPPORTUNITY OFFICE., _- THE FOLLOWING SECTIONS ARE FOR FDOT USE DIST 19 .PROCESSED BY 20. DATE TO EO OFFICE 21. LETTING DATE 22. EXECUTED DATE 23. PRECON CONF DATE - 24.SUBMITTED TOEO 8Y ❑ FAX ❑ EMAIL ❑ SHARED FOLDER EO OFC 25 .INCLUDED IN DBE PARTICIPATION REPORT OF (M/DN) T-- -----.. ___ . 470-2 w 275-030-11 EQUAL OPPORTUNITY OFFICE 03!11 Page 3 of8 Equal Opportunity Reporting System Information To comply with changes in the Disadvantaged Business Enterprise (DBE) Program, the Department is collecting both actual payments made to subcontractors and sub -consultants, and DBE commitment amounts. Actual payments will be collected through the web -based Equal Opportunity Reporting System (EORS) and commitments will be collected through the Anticipated DBE Participation Statements. It is extremely important that -you continue to submit the Anticipated DBE Participation Statement at t o pre -construction conference for all federal and state funded projects. This primary information is used by the State and Federal Government to evaluate our performance in the DBE Program. In addition, for federal and state funded projects, you must also report actual payments in the;qual Opportunity Reporting System. Revisions were made to the specifications beginning with the October 2000 -letting that states in section 9-6.7: The Contractor is required to report monthly, through the Department's Equal Opportunity Reporting System on the Internet at www.dot.state.fl.us, actual payments, retainage, minority status, and the work type of all subcontractors and suppliers. Since the specifications were revised, we have made some additional modifications to ease the burden on the contractor. We will pursue making the permanent modifications to the specifications. In the interim, each month you must report actual payments to all DBE subcontractors, sub -consultants and suppliers. Payments to all non -DBE subcontractors and sub -consultants will need to be reported either monthly or at the end of the project. Payments to non -DBE suppliers need not be reported at all. This information can be submitted in hard copy form, if necessary. Instructions for accessing the EORS are included. If you have any questions, please contact the Equal Opportunity Office at (850) 414-4747. INSTRUCTIONS FOR ACCESSING THE EQUAL OPPORTUNITY REPORTING SYSTEM Purpose The Florida Department of Transportation, Equal Opportunity Office has been charged with requirements of reporting Disadvantaged Business Enterprise Information to the U.S. Department of Transportation, Federal Highway Administration (FHWA) according to the new 49 Code of Federal Regulations Part 26. The Equal Opportunity Reporting system was developed as a solution to collect this information. Objective The Equal Opportunity Reporting system will collect information of actual payments and retainage paid to the Prime Consultant/Contractor by the Department of Transportation and the Prime, Consultant/Contractor's actual payments and retainage paid to their subs and suppliers, by the type of work they performed. The reporting of this information will be performed by the Prime on a monthly basis for an invoice or estimate number per contract. To establish access to the new Equal Opportunity Reporting System (BizWeb), contact Business Innovations Plus toll-free at 1-877-249-8725. The site location is http://www.bipincwebapps com/bizwebflorida/ 470-3 275-030-11 EQUAL OPPORTUNITY OFFICE 03/11 Page 4 of 8 INSTRUCTIONS FOR COMPLETING DBE/AA PLAN NOTE: THE DBE/AA PLAN MUST BE APPROVED BY THE EQUAL OPPORTUNITY OFFICE AND COMPLETED IN ACCORDANCE WITH CHAPTER 14-78, FLORIDA ADMINISTRATIVE CODE DBE/AA PLANS DBFJAA Plans must be submitted by the prime contractor, be submitted on company letterhead (first page only), signed by a company official, dated and contain all elements of an effective DBE/AA Plan (sample enclosed). Plans that do not meet these mandatory requirements may not be approved. Approvals are for a (3) three year period and should be updated at anytime there is a change in the company's DBE Liaison Officer and/or President. DBE/AA Plans must be received with the contractors bid or received by the Equal Opportunity Office prior to the award of the contract. MAIL PLANS TO: Florida Department of Transportation Equal Opportunity Office 605 Suwannee Street, MS 65 Tallahassee, Florida 32399-0450 Questions concerning the DBE/AA Plan may be directed to the Contract Compliance Section by calling (850) 414- 4747. 470-4 275-030-11 EQUAL OPPORTUNITY OFFICE 03/11 Page 5 018 DBE AFFIRMATIVE ACTION PLAN POLICY STATEMENT It is the policy of + i1► i" t i V`'1. i 1- that disadvantaged businesses, as defined by 49 CFR Part 26, Sulipart D and implemented uncle Rule Chapter 14-78, F.A.C., shaft have the opportunity to participate as subcontractors and suppliers on all contracts awarded by the Florida Department of Transportation. The requirements of Rule Chapter 14-78, F.C., sh. I apply to all contracts entered into between the Florida Department of Transportation andyt1,G Subcontractors and/or suppliers to will also be bound by the requirements of Rule hapter 14-78 F.A.C. atFit , and it's subcontractors shall take all necessary and reasonable steps in accorda e with Chapter 14-78, F.A.C., to ensure that disadvantaged businesses have the opportunity to compete and perform work contracted with the Florida Department of Transportation. C6Il f j , and its subcontractors shall not discriminate on the basis f race, color, religion, nation origin, disability, sex, or age in the administration of contracts with the Department of Transportation. , has designated and appointed a Liaison if) to dev op, maintain, and monitor th -BE Affirmative Action P`laim�plement_a�tign. The Liaison Officer will be responsible for disseminating this policy statement throughout �-t'i� pibT and to disadvantaged controlled businesses. The statement is posted on notice boards of ne Company. X I!-ii,iL" Date X 470-5 , President 275-030-11 EQUAL OPPORTUNITY OFFICE 03/11 Page 5 7 5 I, DESIGNATION OF LIAISON OFFICER I ,i II-- - - will aggressively recruit disadvantaged f Transportation. The businesses as subcontractors . nd suppliers for all contracts Department� accordance with the requirements emenis Company has appointed a Liaison Officer to develop and maintain this Affirmative Action Plan of Rule Chapter 14-78, F.A.C. The Liaison Officer wile have primary responsibility for developing, maintaining, and monitoring the Company's utilization of disadvantaged subcontractors in addition to the following specific duties: The Liaison Officer shall aggressively solicit bids from disadvantaged business subcontractors for all Florida Department of Transportation contracts; (1) ;<3 (2) The Liaison Officer will submit all records, reports, and documents required by the Florida Department of Transportation, and shall maintain such records for a period of not less than three years, or as directed by any specific contractual requirements of the Florida Department of Transportation. The following individual has been designated Liaison Officer with responsibility for implementing the Company's affirmative action program in accordance with the requirements of the Florida Department Transportation. (Liaison Officer's Name) 11144 (Your Company's Name) (Your Company's Address) j3 (03 (Phone Number for Liaison Officer) (Enter FEIN or Tax Id Number) (ej_ }ZDV Qur v k oc�'Jtyt.e, 11, A1C is ''t- 3z%4-- -/2 _Slag.0 II E ACTION METHODS has identified the following known barriers to participation by disadvantaged bcont proposed affirmative action methods: 1. Lack of qualified disadvantaged subcontractors in our specific geographical areas of work; 2. Lack of certified disadvantaged subcontractors who seek to perform Florida Department of Transportation work; 3. Lack of interest in performing on Florida Department of Transportation contracts; 4. Lack of response when requested to bid, 5. Limited knowledge of Florida Department of Transportation plans and specifications to prepare a responsible bid. In vie the bar ers to disadvantaged businesses stated above, it sto all be provide the policy of opportunity._by.utilizing the__fotlowing I WITH � methods l�(1 L affirmativeti• methods t• ensure p�'trcipation on the contracts Willi the Florida Department of Transportation. will: 1. Provide written notice to all certified DBE subcontractors in the geographical area where the work is to be subcontracted by the Company; 2. Advertise in minority focused media concerning subcontract opportunities with the Company; se the ihood of contract 3. goals portions of work to be Performed by ate breaking Ddown contracts Es in order to rintoaeconom economically feasible unitsgto facilitate goals (including, where appropriate, DBE participation); AFFIRMATIVE Owt-brich, -77 In order to formulate a realistic Affirmative Action Plan,Pcgx- corsbefore desing its 470-6 275-036-11 EQUAL OPPORTUNITY OFFICE 03711 Page 7 d 8 4 Provide adequate information about the plans, specifications, and requirements of the contract, not rejecting subcontractors without sound reasons based on a thorough investigation of their capabilities; 5. Waive requirements of performance bonds where it is practical to do so, 6. Attend pre-bid meetings held by the Florida Department of Transportation to apprise disadvantaged subcontractors of opportunities with the Company; 7. Follow up on initial solicitations of interest to DBE subcontractors to determine wittircertainty whether the DBE company is interested in the subcontract opportunity. /Iunderstands that this list of affirmative action methods is not exha istive and will include additioru approaches after having established familiarity with the disadvantaged subcontracting community and/or determined the stated approaches to be ineffective. 111. IMPLEMENTATION -� On contracts with specific DBE goals, 1 1 i �t11�� (fJn-�tc will make every effort to meet contract goals as stated by utilizing its affirmative action meth b . On projects with no specific goals, the Company will, as an expression of good faith, seek to utilize DBE subcontractors where work is to be subcontracted. IV. REPORTING 1 are necessary to d I 'L ✓U -` shall keep and maintain such records as mine the Company's complitdce with its DBE Affirmative Action Plan. The Company will design its record keeping system to indicate: 1. The number of DBE subcontractors and suppliers used by the Company, identifying the items of work, materials and services provided; 2. The efforts and progress being made in obtaining DBE subcontractors through local and community sources; 3. Documentation of all contracts, to include correspondence, telephone calls, newspaper advertisements, etc., to obtain DBE participation on all Florida Department of Transportation projects; 4. The Company shall comply with Florida Department of Transportation's requirements regarding payments to subcontractors including DBEs for each month (estimate period) in which the companies have worked. V. DDE DIRECTORY 1 An by the Florida Depart of Transportation. will utilize the DBE Directory published The Company will distribute Form Number 275-030-01, Schedule A Certification Form Number 1, to potential DBE contractors and assist in their completion. 470-7 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION CONSTRUCTION CONTRACTORS BID OPPORTUNITY LIST Please complete and mail or fax to: Equal Opportunity Office 605 Suwannee St., MS 65 Tallahassee, FL 32399-0450 TELEPHONE: (850) 414-4747 FAX: (850) 414-4879 This information may also be included in your bid or proposal package. 215-030-11 EQUAL OPPORTUNITY OFFICE 03/11 Page B of b Prime Contractor/Consultant: MTh) a a •, Number: 1213 VU OWd Lel h� �-f Address/Telephonet Sy, Up��� Bid/Proposal Number: )c 20/ 3 a J Quote Submitted MM/YR: i t / 1 4 49 CFR Part 26.11 requires the Florida Department of Transportation to develop and maintain a "bid opportunity list." The list is intended to be a listing of all firms that are participating, or attempting to participate, on DOT -assisted contracts. The list must include all firms that bid on prime contracts, or bid or quote subcontracts and materials supplies on DOT -assisted projects, including both DBEs and non -DBEs. For consulting companies this list must include all subconsultants contacting you and expressing an interest in teaming with you on a specific DOT assisted project. Prime contractors and consultants must provide information for Nos.1, 2, 3 and 4 and should provide any information they have available on Numbers 5, 6, 7, and 8 for themselves, and their subcontractors and subconsultants. - 1. Federal Ta ,ID Number:gO -1C303p 6 D DBE lA Non -DBE 2. Firm Name. �1�-.�'' �`��1'�-� 3. Phone: —li Z • 13..4-35'14 4. Address: 2t1) 33 r., C,t SV \IQ BP_cA.r h t_ 3E91025. 9910Z5. Year Firm Established: 20 t3 7. IN Subcontractor ❑ Subconsultant 8. Annual Gross Receipts ® Less than $1 million ❑ Between $1 - $5 million ❑ Between $5 - $10 million ❑ Between $10 - $15 million ❑ More than $15 million 1. Federal Tax ID Number: 6. 0 DBE 8. Annual Gross Receipts 2. Firm Name: 0 Non -DBE ❑ Less than $1 million 3. Phone: 0 Between $1 - $5 million 4. Address: - ❑ Between $5 - $10 million 7. 0 Subcontractor 0 Between $10 - $15 million ❑ Subconsultant ❑ More than $15 million , 5. Year Firm Established: 1. Federal Tax ID Number: 2. Firm Name: 3. Phone: 4. Address: . Year Firm Established: 6. 0 DBE ❑ Non -DBE 7. ❑ Subcontractor ❑ Subconsultant 8. Annual Gross Receipts ❑ Less than $1 million ❑ Between $1 - $5 million O Between $5 - $10 million ❑ Between $10 - $15 million O More than $15 million 470-8 SECTION 00472 - NONCOLLUSION AFFIDAVIT OF PRIME BIDDER lState of �% G County of 1. , being first duly sworn, disposes and says that: (Name/s) They are -p ( e-VIU��0'' of 1 (Name of Company) has submitted the attached bid; the Bidder that (Title) preparation the aration and contents of the attached bid and of all pertinent circumstances 2 He is fully informed respecting INrespecting such Bid; 3 Such Bid is genuine and is not a collusive or sham Bid; Neither the said Bidder nor any of its officers, partners, °onspired, connivedwners, agents, feoragreied directly or indirectly with s or parties in waycolluded, interest, including ir, firmhis affiant, has in anyin anyother bidder, or person to submit a collusive or shorn onBe tion with stu�h Contract orn with the has inntract or anymannern, ch the attached bid has been submitted or to refrain from 9 directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, I orP erson to fix the price or prices in the attached Bid or of any other Bidder, or to secure throusongma any l inion, the conspiracy, connivance or unlawful agreement any advantage against the Countyor an proposed Contract and The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, part of the Bidder or any of its agents, representatives, owners, conn employees, es or unlawful in interest, incl ding thiaffiant. /. employees, or p (Signed) (� (Title) t" STATE OF FLORIDA } COUNTY OF INDIAN RIVER}SS The foregoing instrument was acknowledged before me this 1 1 1_ (Date) who is personal) known to me or who has produced as identification and who did (did not) take an oath. fr- v\ Nota (` . & sign -name) Commission No. DEPOi..- MYO:.hnr.;s:- 3:::;3u39. EXPIRES: Odcxr U3, MI5 00472 F:\Public Works\ENGINEERING DIVISION OF PRIME B DROJECTS\0845B - ld Dixie Hwy IA Sidewalk (38th Ln - 45th St)\Admim\bid documents\P Documents\00472 - NONCOLLUSIONAFFIDAVIT SECTION 00474 - CERTIFICATION REGARDING LOBBYING The undersigned Bidder/Contractor certifies, to the best of his or her knowledge and belief, that: (1) No Federal 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 an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 3 (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for making lobbying contacts to an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit St pdard Form — LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions [as amended by "Government wide Guidance for New Restrictions on Lobbying", 61 Fed. Reg. 1413 (1/19/96). Note: Language in paragraph (2) herein has been modified in accordance with Section 10 of the Lobbying Disclosure Act of 1995 (P L. 104-65, to be codified at 2 U.S.C. 1601, et seq )] The undersigned shall require that the language of this certification be included in the awards documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure [Note: Pursuant to 31 U S.C. 1352 (1)-(2)(A), any person who makes a prohibited expenditure of fails to file or amend a required certification or disclosure form shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such expenditure or failure] The Bidder/Contractor, certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U S.C. A 3801, et seq., apply to this certification and disclosure, if any. Company Name: hNi1,0-0(C011,41(14 (+VI moi► (3) Authorized By: (Sign) Title: T fe lc -e• L 00474 (Print Name) Date: t t. t .___..._ non IGrrvine'SR - nirl flivic Hwv SirlawaIk (IRth Ln - 45th St)Wdmim\bid documents\LAP SECTION 00476 - Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion --Primary Covered Transactions The Bidder certifies that, the firm or any person associated therewith in the capacity of owner, partner, director, officer, principal, investigator, project director, manager, auditor, and/or position involving the administration of federal funds. (a) are not presently debarred, suspended, proposed for debarment, declaredineligible, or voluntarily excluded from covered transactions, as defined in 49 CFR s29.110(a), by any federal department or agency; .; (b) have not within a three-year period preceding gaud orrifics criminal offense iation been n connect ad a civil judgment rendered against it for: commission of f with obtaining, attempting to obtain, or performing itrusastatuteseral, teo �commir local gs onto embezzlemetransaction nt, or public contract; violation of federal or state theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property (c) are not presently indicted for or othmrws e on cof anyyof orthecivIloffensesed a umeratedraln state, or local governmental entity with com paragraph (b) of this certification; and (d) have not within a three-year period preceding hair causes icatorldefhaon d, one or more federal, state, or local government public transactions terminated n with ny The Bidder certifies that it shall notknowingly ns ids enter supended, declared �nel'Igiblea or subcontractor, material supplier, or vendor voluntarily excluded from participation in this project by any federal agency unless authorized by the Florida Department of Transportation." Company Name: Authorized By: Title: 00476 (Print Na Date: l-l.\\_V14 F \Public Works\ENGINEn 47RINGDIIVISI6 - ON PifiaROJEtionRCT$\ 84 B - Old Dixie e Hwy Sidewalk (38th Ln - 45th St)\Admim\bid g rinciimants\LAP Docume SECTION 00490 STATE OF FLUPJUA Ut=Pj:KTIAEMT OF Tf2AN5.ORTA1I0N CERT!F!CATION OF NON SEGREGATION NON DISCRIMINATION SECTION 1: PROJECT IDENTIFICATION 2. F.A.P. No. 275-030-1:! EQUAL OPPORTUNITY OFFICE 1 1 • 1 • f ontractor Su • .iter Rental Co' • an or A . enc Submittin this certification 7.Com.an Na gat SECTI = N 2: CERTIFICATION ST EMENTS CERTIFICATION OF NONSEGREGATED FACILITIES 8. FEID No of Co. In Box 7 on a As a federally assisted construction contrnactor, I Federally funded contract,As a contractor, sub lthistcompany ceor trtifiesrthat it hereby certify: the following for t his company: shall not discriminate on the basis of race, color, national twin or sex in the performance of slidh contracts. A. This company does not maintain or provide any segregated facilities for employees at any of our establishments and we do not permit our employees to perform their services at any location, under our control, where segregated facilities are maintained. B. Agreement that a breach of o this certification e'ty clause is a violation of the equal pP in this contract. C. We will obtain and retain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from ethe visions of the equal opportunity The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT assisted contracts. The company agrees that a failure to carry out these requirements is a material breach of contract, which may result in the contract's termination or such other remedy as the recipient deems appropriate. Each subcontract, rental agreement and or material supplies agreement this company subsequently enters into for this contact will require this same Certification. It is the policy of this company to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, for national origin, age or disability. Actions include: pro co , or transfer,• As used in this certification, the terms "segregated employment, upgrading, demotion, off or facilities" means any waiting rooms, work areas, recruitment or recruitment advertising; layoff restrooms and washrooms, restaurants and termination; rates of pay and other forms of fountains, recreation or entertainment area, compensation; and selection for training, including providedapprenticeship, pre apprenticeship, and/or on-the-job transportation, and housing facilities for training. employees which are segregated by P directives or are in fact segregated on the basis of race, color, religion or national origin because of This certificationnondiscrimination extends to the project identified above and affirms our commitment to Insure habit, local custom, or any other reason. and to take affirmative action to assureequal q opportunity as set forth under laws, executive orders, rules, regulations (28 CFR 35, 29 CFR 16Labo30 and s modified CFR 60) and orders of the Secretary of y the provisions of FHWA-1273. Compliance with Title VI of the Civil Rights Act and the provisions of the American Disabilities Act of 1990 are into • orated In this certification. 9: -Name first/last of co • orate Official si • nin Certification 10. Job Title of .erson•named in Box 9 12. Date of Si • nature 00490-1 r. ,.75-6304 L- E E•POR711N(TY OFFICE - .. (17rn9 Certification of Non Segregation & Non Discrimination :Instructions for Completing Form This form is provided to contractorson federally assisted road and bridge construction projects to affirm their commitmei, to nondiscrimination and non segregated facilities during the term of a -contract. Box 1: Fin. Proj No.=— The Financial Project Number Box_2: FAP No. —The federal Aid Project.Nuniber assigned to federally funded projects or 'non -FAP' Box-3:.FDOT LAP Contract No. — The projecVs Local Area Project ('IAP')number =, . Boz 4: County County or counties paired is being �performed BOX 5: District or Local Agency—The Department's Distract -Number Designation where the project is located Districts are 1-7, and the Turnpike District or the: name of thecity, county or entity administering the contract' Box.6 prime Contractor Name,.Thename of theprinle:Contractor: Box 7 CompanyName of Contractor,:Supplier, Rental Company or Agency Submitting this certification — name of companysubmitting the certification. Box :8 FEID No.— Federal Identification _Number.of.company named in Box. 7 Box a Name (first, last(of corporate official signing certificatio'n. —First name, last name Box 1D: Job Title of person named in '59x 9—job:title. Box 11° Signature of Certifying-Officiai — signature of person named itiBox 9 Box 12: Date of signature.— Moritfi/daylyear of:signature 604.97)-9 SECTION 00492 - BUY AMERICA CERTIFICATE OF COMPLIANCE CERTIFICATE OF COMPLIANCE COMPLIANCE The bidder hereby certifies that it will comply with the requirements of 23 C.F.R. 635.410, as amended, and utilize only iron or steel manufactured in the United States, or components made with iron or steel that meet the Buy America requirements. Bidder acknowledges that it will be required to produce Buy America certification(s) from the producer(s) of the steel or iron or components prior to incorporating any such materials into the work or project. Company Name: i 1 WU0 Q.J3 _IT'ivIV \Yea:4 1,2s Authorized By: ` -0"t - ,0 -0X - (Print N e) Date: 1.\,\\,.0 g (Sign) Title: \r L)c 00492 F.\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\LAP Documents\00492 - BUY AMERICA CERTIFICATE OF COMPLIANCE.doc SECTION 00494 - DRUG FREE WORKPLACE CERTIFICATION The undersigned Bidder, in accordance with Florida Statute 287.087 hereby certifies that (Name of Business) 1. does: 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 violation of such prohibition. 2. 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. 3. Give each employee engaged in providing the commodities or contractual services that are under this bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (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 contendre to any violation of Chapter 1893, or of any contfolled 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 com • lies fully with the above requirements. 00494 Bidders Signature i 1 �'! _l Date F.\Public Worts\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\LAP Documents\00494 - DRUG FREE WORKPLACE CERTIFICATION.doc 11 CONFIDENTIAL 11 SECTION 00496 gf,0-E.12F FLORIDA DEPARTMENT OF TRANSPORTATION LAP CERTIFICATION .OF CURRENT CAPACITY FPI' bids tube received on I t. k (Lptting 'bate). 52-00-z6 PRODUCTION SUPPORT 1?fCP Page 1 of 2 VF Fill, in. your MOT Vendor Number "(nlyapplicab1e 0,FDQT:151P-qwajifiod cpri_trp.ctp[s) CERTIFICATE I hereby certify that the PrnP-vrl(PfPr2Y:Pr9PP§P!.-Ppdmitted-;'by this bidder'ldrthe-abi)ve letting' dPes. not exceed the amount ,of-thq FinreS CURRENT CAPACITY (rriakirntith Capacity- rating lesslOtal UnbomPleted(WOrk). Thelotal: uncompleted worlc:as shown on -tStefus,of'Contracts on Hand" reportIpage 2): -1.q.91-13-33 I further certifythailhe "Stattis,of Contracts on Hand" report i(page 2Ywasprepered asif011ows: 1. -11 the letting is beforethe 251 day,of the month, the certificate and report refleettheftThOcirnpieted.Wcii-k.eS Of:the.15' dayOUthe fnonth, laSt.pretalifig!thertiOnth blthd letting. 2. if the tatting is attorthe,$tb-40y Of the month,.(hecertificateend.report reflects the uncompleted work in progress as of The 151h dayofthe rnpntr“)ttp jetting. 3. All new contracts (and subcontracts) awarded earlier than five days before theletting date are included in the report: end.tharged against bortotai rating. certify that.the inftinti abOVe is 'SWOrrilO and StibStribed tfiisti day Of KIC).1 , It+ - DEBORAH WEST COMMISSION 1 EXPIRES. OctoZzg 02014 IvfY !I ainli:0 ,AncoTnetwotrzyjowthi tofttmottuy..+Diuzrzevntiv: _ t wvo Jn.e _ OF Emm .By: 09496 - 1 C Cri Title 11111 its ism MI INNS STATUS OF, CONTRACTS' ON HAND urnith,scOrriplete infOrmOtiOn.abouteli your cOhtt.acts,, whether prIthe :or subtOhtracth;: Whether in progress or awprded, b,ut npt yetb.egun; !anti :regardless of .WhOrri'contradied with:) 525-010:46 PkODUCTION"SUPPORT 12/09 Psge.261'2 t 2 4 5 6 PROJECTS, OWNER, LOCATION AND. DESCRIPTION _,CON,TOT '0.:_k• ;sUScONTRAtT) AMOUNT AMOUNT .SUBLET TO. OTHERS To L A rC-- 04ANOE OF CONTRACT AMOUNT 'UNCOMPLETED AMOUNT TO:'BE DONE 'BY 'YOU AS PRIME , CONTRACTOR: AS SUBCONTRACTOR Vrec-5 tatia.-Q-371-'ve-ei.s 1 vtionwe,meliA-t-, CY' ('4" ZPIOAS-1;3-4 '" C-Ne-tV442141-' • s . 30i 303 22 _ Qo actiez3tvt rdr 1 wpm ct c.1') r,t;r1 —ZEwt di c 31- - 00 1 . ett uvpes . r\ .. • •J'I.) ir ?I \ SA'','"N URIC -L-014' • --) .i- --- • • 'OA beil,A_ t• --t- .3. 2-140q _%A. : 32 tLICOL4 _ — \temp'-itaA..C--c._ ct TM 1.1 --,.. • .0 - '. i ,i QC --ng sc 1 i.1 -19,-12y 0 -v,tk,s,c_ ,f-e:AA-Af-x-sc:--bcc.-'nes' . . 11-1,e\Y6 , — C- .1 . GOC? 1-j6/iA.-5-1-- • • . ii0.'3 qqZ • v‘ • 0 • • t C). .2 cF, , — k.s3S iScCe ''`' _ • . ..._. . ' • .„.. 'NOTE.. Columns 2 and 3'..to.•showlotat.coptraet: Or st4b,pontrpgt):,pmowit§.,. • collomn, 4. to t?p, OiffprerAce.,, • :between. columns :.: ,ArpounOn colprpris or5**utIciri10100:Pcirt!pnpf:prOoprrj! in..oOlurpn. 4.. All i. amounts. to be shown tb.'neAre$t 1,0.6. The Contractor my/..colitotidweoti:INt.' single item all cofitiradt,tivhioh,„indiviFlually„. do nat'extbed 3,%•ofttowt,,•6nd:whidh, in•the aggregate amount to less than 20% of the total.. 'TOTALB : ? , --) 9 --/ 33, 3 ...... SO..00. 2_4-1 89 1-15 s 3 $0.00 TOTAL UNCOMPLETED Q:OMPLETED WORK:C5N .HAND TO ht.:DONE BY YOU ITOTAL COM MNS,•5• AND By, '211 ci 9 , --) .7,)•.'it s 7:,.... -.-:-.'; $0.00 C: THE STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION vz, art TiII 05`i .13111111118 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION CERTIFICATION OF SUBLET WORK 700-010.3a CONSTRUCTION 10/07 Date: ri (, ),1 4.1, --71 General Info I ( n ,fit 01-741(Seal) Request No.: i �t��U� Prime Contractortr� r jj Contractor d B y� FAP No.: _2-J -t�/ r' -CJ ID Fin. Proj. ID: "- F.E.I.D. # IF CORPORATION, AFFiX SEAL /360Svt / O Id 1v t_c- it/i,Si'uii..) Pa: Cont. No.: Co- O2_8 (-/Z(IZ County: i rY_b.4ri River Total Contract Amount n Address U ( 3Z`�(-� Total Work i?9,Z00.`'2 ,ii, Subcontractor Name 'S..�;� FEID # Subcontract to Whom Work Description,: a.. Total Amt Sublet ili. �::_ 0. :o;• .z ttipkx,e:1 Qo -Uri 3031v -ri,o e,,rvi, N 1 All pertinent provisions and requirements of the prime cont act including but not limited to Required Contract Provisions Federal -Aid Construction Contracts (FHWA-1273) and Special Provisions - Specific Eoual O000rtunity Total Responsibilities (Per 23 CFR -633B of Federal-Ald Policy Guide) will 'be part of the subcontract. It is agreed that an Executed or a certified copy of the subcontract will be submitted upon request, to the State of Flbrida Department of Transportation. All sublets will be In continued compliance with all Contract provisions and that the Contractor will continue to perform the minimum percentage of Contract work with its own organization, as required by said Contract. It is recognized and agreed that, as prime contractor, the undersigned remains responsible for the proper performance of all requirements of said contract'does not relieve or release the undersigned and his surety or either of them of any liability under the contract bond. The Contractor shall send a copy of this form to the subcontractor/ subordinate (with a copy of FHWA-1273'on Federal -Aid Projects) and the Surety Company. The'Prime certify that firms or individuals, debarred or suspended by the FHWA.or the Department, are not being used as subcontractors. A false statement or omission made in connection with this certification is sufficient cause for suspension. revocation, or denial of qualification to bid, and a determination of non -responsibility, and may subject the person and/or entity making the false statement to any and all civil and criminal penalties available pursuant to applicable Federal and State Law. State of Florida County of j -Nr ).n'kuje/ Sworn to and subscribed before me this t j day of NoV ZO , by.C1i (PrintTname of pp son signing Certification) Not Public Commission Expires Personally Known .ocr 03, 2015 ieeosoormy FL Nowa, Ditemst OR Produce Type of Identification Produced Instructions for Form: The contractor must provide enough information through a Schedule "A" spreadsheet to determine which pay-item(s) are being sublet, the amounts, and cost. For sublet calculations, the amount will be calculated based on the actual contract unit price(s) unless there is a partial sublet. For partial sublets, use the unit prices from the actual sub -contract. 1) Enter the Date of the certification of sublet work was prepared. 2) Enter the sequential number of the request starting with number 1. 3) Enter the Federal Aid Project number for the Prime Contractor if any. 4) Enter the Financial Project Identification number of the Contract. 5) Enter the Contract number of the Contract with the Department. 6) Enter the County name where the work is being performed. 7) Enter the Name of the Prime Contractor. 8) Enter the FEID number of the Prime Contractor. 9) Enter the Original Contract dollar amount (round to nearest whole dollar). 10) Enter a "Y" in the space marked Change if any information on the line has changed since the previous certification of sublet work was prepared. Otherwise, leave blank. 11) Enter the Subcontractor names. Enter all the subcontractor(s) regardless of their tier. 12) Enter the tier number for the subcontractor. If the subcontractor works directly for the Prime Contractor, enter a "1". If he works one level below, enter a "2" and so on. 13) Enter the FEID number of the Subcontractor(s). 14) Enter the name of the pertinent Contractor or Subcontractor that hired subcontractor. 15) Enter a short description of the work to be performed. 16) Enter a "P" if any pay -item for the sublet is a partial sublet. 17) Enter the DBE status for the subcontractor: "D" for DBE, "N" for non -DBE. 18) The Department may require subcontractor to be prequalified with the Department as described in the Special Provisions and the Bid Solicitation Notice whenever construction projects contain certain classes of work that require specific expertise. 19) One (1) copy of this form shall be submitted to the District Office by the contractor. 20) To be signed by principal of the firm or someone with the delegated authority and notarized. 00500-2 ( BOARD OF COUNTY COMMISSIONERS February 17, 2015 Timothy Rose Contracting, Inc. Attn: Tim Rose 1360 SW Old Dixie Highway, Suite 106 Vero Beach, FL 32962 NOTICE OF AWARD Reference: Indian River County Bid No. 2014032 Old Dixie Highway Sidewalk Improvements 38th Lane to 45`h Street (IRC Project #0845B) Dear Mr. Rose: It is my pleasure to inform you that on February 17, 2015, the Board of County Commissioners awarded the above -referenced project to your company. The following documents are required before the applicable County department can issue a "Notice to Proceed" letter. 1. Public Construction Bond in the amount of 100% of the contract amount ($129,200.52). 2. Two Signed Copies of Enclosed Agreement. 3. Certificate of Insurance must name Indian River County as additional insured and must provide for a 30 day Notice of Cancellation. In accordance with section 255.05(1)(a), Florida Statutes, you are required to execute a Public Construction Bond for the above referenced project. Please submit the Bond, the Certificate(s) of Insurance and two fully -executed copies of the enclosed agreement to this office at the address provided below no later than Wednesday, March 4, 2015. Failure to comply with the established deadline for submittal of required documents may be grounds for cancellation of award. Thank you for your prompt attention and if you have any questions, please do not hesitate to contact our office. Sincerely, Jennifer Hyde Purchasing Manager cc: Michael Nixon, P.E., Roadway Production Manager Office of Management and Budget • Purchasing Division 1800 27th Street, Vero Beach, Florida 32960•(772) 226-1416•Fax: (772) 770-5140 E-mail: purchasing@ircgov.com SECTION 00520 - Agreement (Public Works) TABLE OF CONTENTS Title Page ARTICLE 1 - WORK 2 ARTICLE 2 - THE PROJECT 2 ARTICLE 3 - ENGINEER 2 ARTICLE 4 - CONTRACT TIMES 2 ARTICLE 5 - CONTRACT PRICE 3 ARTICLE 6 - PAYMENT PROCEDURES 3 ARTICLE 7 - INDEMNIFICATION 5 ARTICLE 8 - CONTRACTOR'S REPRESENTATIONS 5 ARTICLE 9 - CONTRACT DOCUMENTS 6 ARTICLE 10 - MISCELLANEOUS 7 JTHE REMAINDER OF THIS PAGE WAS LEFT BLANK INTENTIONALLY' 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR 00520 - 1 F:\Purcbasing\Bids\2013-2014 FY (2014000)\2014032 Old Dixie Hwy Sidewalks\00520 -Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc SECTION 00520 - Agreement (Public Works) THIS AGREEMENT is by and between INDIAN RIVER COUNTY, a Political Subdivision of the State of Florida organized and existing under the Laws of the State of Florida, (hereinafter called OWNER) and Timothy Rose Contracting, Inc. (hereinafter called CONTRACTOR). OWNER and CONTRACTOR, in consideration of the mutual covenants hereinafter set forth, agree as follows: ARTICLE 1 - WORK 1 01 CONTRACTOR shall complete all Work as specified Documents. The Work is generally described as follows. The project will consist of the construction of a 5' wide east side of Old Dixie Highway between 38th Lane and approximately 4,500 linear feet. or indicated in the Contract concrete sidewalk along the 45th Street, a gross length of ARTICLE 2 - THE PROJECT 2.01 The Project for which the Work under the Contract Documents may be the whole or only a part is generally described as follows. Project Name. Old Dixie Highway Sidewalk Improvements, 38th Lane to 45th Street County Project Number 0845B FM Number: 423186-2-58-01 Bid Number: 2014032 Project Address: Old Dixie Highway from 38th Lane to 45th Street, Indian River County, FL ARTICLE 3 — ENGINEER 3.01 The Indian River County Public Works Department is hereinafter called the ENGINEER and will act as OWNER's representative, assume all duties and responsibilities, and have the rights and authority assigned to ENGINEER in the Contract Documents in connection with the completion of the Work in accordance with the Contract Documents. ARTICLE 4 - CONTRACT TIMES 4.01 Time of the Essence A. All time limits for Milestones, if any, Substantial Completion, and completion and readiness for final payment as stated in the Contract Documents are of the essence of the Contract. 4.02 Days to Achieve Substantial Completion, Final Completion and Final Payment A. The Work will be substantially completed on or before the 60th day after the date when the Contract Times commence to run as provided in paragraph 2.03 of the General Conditions, and completed and ready for final payment in accordance with paragraph 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR 00520 - 2 F\Purchasing\Bids\2013-2014 FY (2014000)12014032 Old Dixie Hwy Sidewalks \00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc 14 07 of the General Conditions on or before the 75th day after the date when the Contract Times commence to run ************************************************************************************************************ 4 03 Liquidated Damages A. CONTRACTOR and OWNER recognize that time is of the essence of this Agreement and that OWNER will suffer financial loss if the Work is not completed within the times specified in paragraph 4 02 above, plus any extensions thereof allowed in accordance with Article 12 of the General Conditions Liquidated damages will commence for this portion of work. The parties also recognize the delays, expense, and difficulties involved in proving in a legal proceeding the actual loss suffered by OWNER if the Work is not completed on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as a penalty), CONTRACTOR shall pay OWNER $758.00 for each calendar day that expires after the time specified in paragraph 4.02 for Substantial Completion until the Work is substantially complete. After Substantial Completion, if CONTRACTOR shall neglect, refuse, or fail to complete the remaining Work within the Contract Time or any proper extension thereof granted by OWNER, CONTRACTOR shall pay OWNER $758.00 for each calendar day that expires after the time specified in paragraph 4.02 for completion and readiness for final payment until the Work is completed and ready for final payment. ARTICLE 5 - CONTRACT PRICE 5 01 OWNER shall pay CONTRACTOR for completion of the Work in accordance with the Contract Documents, an amount in current funds equal to the sum of the amounts determined pursuant to paragraph 5 01.A and summarized in paragraph 5.01 B, below: A. For all Work, at the prices stated in CONTRACTOR'S Bid, attached hereto as an exhibit. B. THE CONTRACT SUM subject to additions and deductions provided in the Contract: Numerical Amount: $129,200.52 v `�( Written Amount: OYNe�ltuna I ofl l , -Q u 1 ) VAtOlit/t3CjAA'n ARTICLE 6 - PAYMENT PROCEDURES 6.01 Submittal and Processing of Payments A. CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the General Conditions Applications for Payment will be processed by ENGINEER as provided in the General Conditions and the Contract Documents 6 02 Progress Payments. A. The OWNER shall make progress payments to the CONTRACTOR on the basis of the approved partial payment request as recommended by ENGINEER in accordance with the provisions of the Local Government Prompt Payment Act, Florida Statutes section 218 70 et. seq. The OWNER shall retain ten percent (10%) of the payment amounts due to the CONTRACTOR until fifty percent 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR 00520 - 3 F \Purchasing\Bids\2013-2014 FY (2014000)\2014032 Old Dixie Hwy Sidewalks\00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc (50%) completion of the work. After fifty percent (50%) completion of the work is attained as certified to OWNER by ENGINEER in writing, OWNER shall retain five percent (5%) of the payment amount due to CONTRACTOR until final completion and acceptance of all work to be performed by CONTRACTOR under the Contract Documents. Pursuant to Florida Statutes section 218.735(8)(b), fifty percent (50%) completion means the point at which the County as OWNER has expended fifty percent (50%) of the total cost of the construction services work purchased under the Contract Documents, together with all costs associated with existing change orders and other additions or modifications to the construction services work provided under the Contract Documents. 6.03 Pay Requests. A. Each request for a progress payment shall be submitted on the application for payment form supplied by OWNER and the application for payment shall contain the CONTRACTOR'S certification. All progress payments will be on the basis of progress of the work measured by the schedule of values established, or in the case of unit price work based on the number of units completed. After fifty percent (50%) completion, and pursuant to Florida Statutes section 218 735(8)(d), the CONTRACTOR may submit a pay request to the County as OWNER for up to one half (1/2) of the retainage held by the County as OWNER, and the County as OWNER shall promptly make payment to the CONTRACTOR unless such amounts are the subject of a good faith dispute, the subject of a claim pursuant to Florida Statutes section 255.05(2005); or otherwise the subject of a claim or demand by the County as OWNER or the CONTRACTOR. The CONTRACTOR acknowledges that where such retainage is attributable to the labor, services, or materials supplied by one or more subcontractors or suppliers, the Contractor shall timely remit payment of such retainage to those subcontractors and suppliers Pursuant to Florida Statutes section 218.735(8)(C)(2005), CONTRACTOR further acknowledges and agrees that: 1) the County as OWNER shall receive immediate written notice of all decisions made by CONTRACTOR to withhold retainage on any subcontractor at greater than five percent (5%) after fifty percent (50%) completion; and 2) CONTRACTOR will not seek release from the County as OWNER of the withheld retainage until the final pay request. 6.04 Paragraphs 6.02 and 6.03 do not apply to construction services work purchased by the County as OWNER which are paid for, in whole or in part, with federal funds and are subject to federal grantor laws and regulations or requirements that are contrary to any provision of the Local Government Prompt Payment Act. In such event, payment and retainage provisions shall be governed by the applicable grant requirements and guidelines 6.05 Acceptance of Final Payment as Release A. The acceptance by the CONTRACTOR of final payment shall be and shall operate as a release to the OWNER from all claims and all liability to the CONTRACTOR other than claims in stated amounts as may be specifically excepted by the CONTRACTOR for all things done or furnished in connection with the work under this Contract and for every act and neglect of the OWNER and others relating to or arising out of the work. Any payment, however, final or otherwise, shall not release the CONTRACTOR or its sureties from any obligations under the Contract Documents or the Public Construction Bond. 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR • 00520 - 4 F \Purchasing\Bids\2013-2014 FY (2014000)\2014032 Old Dixie Hwy Sidewalks \00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc ARTICLE 7 - INDEMNIFICATION 7.01 CONTRACTOR shall indemnify OWNER, ENGINEER, and others in accordance with paragraph 6.20 (Indemnification) of the General Conditions to the Construction Contract. ARTICLE 8 - CONTRACTOR'S REPRESENTATIONS 8 01 In order to induce OWNER to enter into this Agreement CONTRACTOR makes the following representations: A. CONTRACTOR has examined and carefully studied the Contract Documents and the other related data identified in the Bidding Documents B. CONTRACTOR has visited the Site and become familiar with and is satisfied as to the general, local, and Site conditions that may affect cost, progress, and performance of the Work. C. CONTRACTOR is familiar with and is satisfied as to all federal, state, and local Laws and Regulations that may affect cost, progress, and performance of the Work. D. CONTRACTOR has carefully studied all. (1) reports of explorations and tests of subsurface conditions at or contiguous to the Site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the Site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in paragraph 4 02 of the General Conditions and (2) reports and drawings of a Hazardous Environmental Condition, if any, at the Site which have been identified in the Supplementary Conditions as provided in paragraph 4.06 of the General Conditions. E. CONTRACTOR has obtained and carefully studied (or assumes responsibility for having done so) all additional or supplementary examinations, investigations, explorations, tests, studies, and data concerning conditions (surface, subsurface, and Underground Facilities) at or contiguous to the Site which may affect cost, progress, or performance of the Work or which relate to any aspect of the means, methods, techniques, sequences, and procedures of construction to be employed by CONTRACTOR, including applying the specific means, methods, techniques, sequences, and procedures of construction, if any, expressly required by the Contract Documents to be employed by CONTRACTOR, and safety precautions and programs incident thereto F. CONTRACTOR does not consider that any further examinations, investigations, explorations, tests, studies, or data are necessary for the performance of the Work at the Contract Price, within the Contract Times, and in accordance with the other terms and conditions of the Contract Documents. G. CONTRACTOR is aware of the general nature of work to be performed by OWNER and others at the Site that relates to the Work as indicated in the Contract Documents H. CONTRACTOR has correlated the information known to CONTRACTOR, information and observations obtained from visits to the Site, reports and drawings identified in the Contract Documents, and all additional examinations, investigations, explorations, tests, studies, and data with the Contract Documents 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR 00520 - 5 F\Purchasing\Bids \2013-2014 FY (2014000)\2014032 Old Dixie Hwy Sidewalks\00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc I CONTRACTOR has given ENGINEER written notice of all conflicts, errors, ambiguities, or discrepancies that CONTRACTOR has discovered in the Contract Documents, and the written resolution thereof by ENGINEER is acceptable to CONTRACTOR. J. The Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work. ARTICLE 9 - CONTRACT DOCUMENTS 9.01 Contents A. The Contract Documents consist of the following. 1. This Agreement (pages 00520-1 to 00520-9, inclusive), 2 Notice to Proceed (page 00550-1); 3 Public Construction Bond (pages 00610-1 to 00610-3, inclusive), 4. Sample Certificate of Liability Insurance (page 00620-1), 5 Contractor's Application for Payment (pages 00622-1 to 00622-6, inclusive), 6. Certificate of Substantial Completion (pages 00630-1 to 00630-2, inclusive), 7. Contractor's Final Certification of Work (pages 00632-1 to 00632-2, inclusive); 8 Professional Surveyor' and Mapper's Certification as to Elevations and Locations of the Work (page 00634-1); 9 General Conditions (pages 00700-1 to 00700-45, inclusive); 10 Supplementary Conditions (pages 00800-i to 00800-10, inclusive), 11. Specifications as listed in the table of contents of the Project Manual (Divisions 1 and 2, inclusive), 12. Drawings consisting of a cover sheet and sheets numbered 2 through 33, inclusive, with each sheet bearing the following general title: Old Dixie Highway Sidewalk Improvements; 13 Addenda (numbers 1 to t , inclusive), 14. Appendices to this Agreement (enumerated as follows). Appendix A — Nondiscrimination Agreement Appendix B — Indian River County Fertilizer Ordinance; Appendix C - Permits Appendix D - Federal Required Contract Provisions, Appendix E — FHWA 1273; 15 CONTRACTOR'S BID (pages 00310-1 to 00310-6, inclusive), 16. Bid Bond (page 430-1); 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR 00520 - 6 F• \Purchasing\Bids\20132014 FY (2014000)\2014032 Old Di de Hwy Sidewalks\00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc 17. Sworn Statement Under Section 105 08, Indian River County Code, on Disclosure of Relationships (pages 00452-1 to 00452-2, inclusive); 18 Sworn Statement Under the Florida Trench Safety Act (pages 00454-1 to 00454-2, inclusive), 19. Qualifications Questionnaire (page 456-1 to 456-4, inclusive); 20. List of Subcontractors (page 00458-1), 21 The following which may be delivered or issued on or after the Effective Date of the Agreement and are not attached hereto: a) Written Amendments; b) Work Change Directives; c) Change Order(s); d) Notice of Award; 22. Equal Opportunity Office Forms (pages 470-1 to 470-8, inclusive); 23. Non -Collusion Affidavit (page 00472); 24. Certificate Regarding Lobbying (page 00474); 25 Certificate Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — Primary Covered Transactions (page 00476); 26. Certification of Non Segregation & Non Discrimination (pages 00490-1 to 00490-2, inclusive); 27. Buy America Certificate of Compliance (page 00492); 28. Drug Free Workplace Certification (page 00494), 29 LAP Certification of Capacity / Status of Contracts on Hand (pages 00496-1 to 00496-2, inclusive); 30. Certification of Sublet Work (pages 00500-1 to 00500-2, inclusive); 31. USDOL Wage Determination — FL140213; 32 FHWA 1273; ARTICLE 10 - MISCELLANEOUS 10 01 Terms A. Terms used in this Agreement will have the meanings indicated in the General Conditions 10.02 Assignment of Contract 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR 00520 - 7 F.\Purchasing\Bids \2013-2014 FY (2014000)\2014032 Old Dixie Hwy Sidewalks \00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc A. No assignment by a party hereto of any rights under or interests in the Contract will be binding on another party hereto without the written consent of the party sought to be bound; and, specifically but without limitation, moneys that may become due and moneys that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment, no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. 10.03 Successors and Assigns A. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns, and legal representatives to the other party hereto, its partners, successors, assigns, and legal representatives in respect to all covenants, agreements, and obligations contained in the Contract Documents. 10.04 Severability A. Any provision or part of the Contract Documents held to be void or unenforceable under any Law or Regulation shall be deemed stricken, and all remaining provisions shall continue to be valid and binding upon OWNER and CONTRACTOR, who agree that the Contract Documents shall be reformed to replace such stricken provision or part thereof with a valid and enforceable provision that comes as close as possible to expressing the intention of the stricken provision 10.05 Venue A. This Contract shall be governed by the laws of the State of Florida. Venue for any lawsuit brought by either party against the other party or otherwise arising out of this Contract shall be in Indian River County, Florida, or, in the event of a federal jurisdiction, in the United States District Court for the Southern District of Florida. 10.06 Public Records Compliance A. Indian River County is a public agency subject to Chapter 119, Florida Statutes. The Contractor shall comply with Florida's Public Records Law Specifically, the Contractor shall (1) Keep and maintain public records that ordinarily and necessarily would be required by the County in order to perform the service. (2) Provide the public with access to public records on the same terms and conditions that the County would provide the records and at a cost that does not exceed the cost provided in chapter 119 or as otherwise provided by law. (3) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law (4) Meet all requirements for retaining public records and transfer, at no cost, to the County all public records in possession of the Contractor upon termination of the Agreement and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the County in a format that is compatible with the information technology systems of the County B. Failure of the Contractor to comply with these requirements shall be a material breach of this Agreement. 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR 00520 - 8 F' \Purchasing\Bids\2013-2014 FY (2014000)\2014032 Old Di de Hwy Sidewalks\00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc IN WITNESS WHEREOF, OWNER and CONTRACTOR have signed this Agreement in duplicate One counterpart each has been delivered to OWNER and CONTRACTOR. All portions of the Contract Documents have been signed or identified by OWNER and CONTRACTOR or on their behalf This Agreement will be effective on February 17, 2015 (the date the Contract is approved by the Indian River County Board of County Commissioners, which is the Effective Date of the Agreement) OWNER: INDIAN RIVER COUNTY--TITAnin+ et0Sf e�sl-ey� S. Davis, Chairman By: (.l /) A• CONTRACTOR: .‘yGp�1MI (Contractor) 141 • oseplj A. Baird, County Administrat APPROVED AS SUFFI ENCY. By ► �,..ttes. • TO ; - LEC �'.C�.N.>' l ylan Reingol:, o ty Attorney Jeffrey R. Smith, Clerk /Court and Attest: troller (SEAL) Depu erk Designated Representative. Name. Christopher J. Kafer, Jr., P E. Title. County Engineer 1801 27th Street Vero Beach, Florida 32960 (772) 226-1221 Facsimile: (772) 226-9391 Address for giving notices. aki 0-v1 D v./ k-A-wy \k, beel c('t FL 3 29 (0 -z-- License License No. C - GC- 05 Z`�'40 (Where applicable) Agent for service of process Designated Representative. Name.1 AMo glo�G Title P _c1. A Address- V3W Sill old Le_i-W Vab it eAF,t\ Et. 375(.402- Phone. 75'(.(,02 Phone. 11Z.' Facsimile -12. 51g-(. 18 8S6 (If CONTRACTOR is a corporation or a partnership, attach evidence of authority to sign ) * * END OF SECTION * * 00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR • 00520 - 9 F:\Purchasing\Bids\2013-2014 FY (2014000)\2014032 Old Dixie Hwy Sidewalks\00520 - Agreement (Public Works) FOR LAP PROJECTS - FOR CONTRACTOR.doc 2015 FLORIDA PROFIT CORPORATION ANNUAL REPORT DOCUMENT# S75343 Entity Name: TIMOTHY ROSE CONTRACTING, INC. Current Principal Place of Business: 1360 OLD DIXIE HWY SW STE 106 VERO BEACH, FL 32962 Current Mailing Address: 1360 OLD DIXIE HWY SW STE 106 VERO BEACH, FL 32962 US FILED Jan 09, 2015 Secretary of State CC4127399909 FEI Number: 65-0284242 Certificate of Status Desired: No Name and Address of Current Registered Agent: ROSE, TIMOTHY W 1360 OLD DIXIE HIGHWAY SW 106 VERO BEACH, FL 32962 US The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE. Electronic Signature of Registered Agent Officer/Director Detail : Title P Title SEC Name ROSE, TIMOTHY W Name ROSE, RONALD Address 1360 OLD DIXIE HWY SUITE 106 Address 1360 SW OLD DIXIE HWY #106 City -State -Zip: VERO BEACH FL 32962 City -State -Zip. VERO BEACH FL 32962 Title TREA Name ROSE, USA A Address 1360 SW OLD DIXIE HWY #106 City -State -Zip: VERO BEACH FL 32962 Date 1 hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE. TIMOTHY W. ROSE PRESIDENT 01/09/2015 Electronic Signature of Signing Officer/Director Detail Date Page 1 of 5 General Decision Number: FL140213 02/07/2014 FL213 Superseded General Decision Number: FL20130272 State: Florida Construction Type: Highway County: Indian River County in Florida. HIGHWAY CONSTRUCTION PROJECTS Modification Number Publication Date 0 01/03/2014 1 02/07/2014 * ELEC0915-004 12/01/2013 Rates Fringes ELECTRICIAN $ 25.13 34.5%+$0.25 SUFL2013-031 08/19/2013 Rates Fringes CARPENTER $ 15.68 0.00 CEMENT MASON/CONCRETE FINISHER, Includes Form Work $ 15.01 0.00 HIGHWAY/PARKING LOT STRIPING: Operator (Striping Machine) $ 15.57 0.00 HIGHWAY/PARKING LOT STRIPING: Painter $ 12.13 0.00 IRONWORKER, ORNAMENTAL $ 13.48 0.00 IRONWORKER, REINFORCING $ 15.38 0.00 IRONWORKER, STRUCTURAL $ 16.42 0.00 LABORER: Asphalt, Includes Raker, Shoveler, Spreader and Distributor $ 14.05 0.00 LABORER: Common or General $ 10.69 0.00 LABORER: Flagger $ 13.09 0.00 LABORER: Grade Checker $ 14.66 0.00 LABORER: Mason Tender - Cement/Concrete $ 12.58 0.00 LABORER: Pipelayer $ 12.44 0.00 file:///C:fUsers/cn4081k/AppData/Local/Temp/Low/TTOCLJCL.htm 3/12/2014 LABORER: Laborer -Cones/ Barricades/Barrels - Setter/Mover/Sweeper OPERATOR: Backhoe/Excavator/Trackhoe OPERATOR: Bobcat/Skid Steer/Skid Loader OPERATOR: Broom/Sweeper OPERATOR: Bulldozer OPERATOR: Concrete Finishing Machine OPERATOR: Crane OPERATOR: OPERATOR: OPERATOR: OPERATOR: OPERATOR: OPERATOR: OPERATOR: OPERATOR: OPERATOR: OPERATOR: Aggregate, Curb Machine Drill Forklift Gradall Grader/Blade Loader Mechanic Milling Machine Oiler Paver (Asphalt, and Concrete) OPERATOR: Piledriver OPERATOR: Post Driver (Guardrail/Fences) $ 15.97 OPERATOR: Roller $ 12.50 OPERATOR: Scraper $ 12.21 OPERATOR: Screed $ 14.14 OPERATOR: Trencher $ 14.25 PAINTER: Spray $ 19.57 TRAFFIC SIGNALIZATION: Traffic Signal Installation $ 15.11 TRUCK DRIVER: Dump Truck $ 11.86 $ 11.79 $ 14.96 $ 12.88 $ 12.91 $ 15.23 $ 15.44 $ 22.04 $ 18.45 $ 13.04 $ 10.43 $ 14.71 $ 18.20 $ 13.14 $ 17.52 $ 16.04 $ 16.67 $ 15.47 $ 17.23 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 file:///C:/Users/cn4081k/AppData/Local/Temp/Low/TTOCLJCL.htm Page 2 of 5 3/12/2014 Page 3 of 5 TRUCK DRIVER: Flatbed Truck $ 14.28 0.00 TRUCK DRIVER: Lowboy Truck $ 16.25 0.00 TRUCK DRIVER: Slurry Truck $ 11.96 0.00 TRUCK DRIVER: Water Truck $ 13.57 0.00 WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses (29CFR 5.5 (a) (1) (ii)). The body of each wage determination lists the classification and wage rates that have been found to be prevailing for the cited type(s) of construction in the area covered by the wage determination. The classifications are listed in alphabetical order of "identifiers" that indicate whether the particular rate is union or non-union. Union Identifiers An identifier enclosed in dotted lines beginning with characters other than "SU" denotes that the union classification and rate have found to be prevailing for that classification. Example: PLUM0198-005 07/01/2011. The first four letters , PLUM, indicate the international union and the four -digit number, 0198, that follows indicates the local union number or district council number where applicable , i.e., Plumbers Local 0198. The next number, 005 in the example, is an internal number used in processing the wage determination. The date, 07/01/2011, following these characters is the effective date of the most current negotiated rate/collective bargaining agreement which would be July 1, 2011 in the above example. Union prevailing wage rates will be updated to reflect any changes in the collective bargaining agreements governing the rates. 0000/9999: weighted union wage rates will be published annually each January. Non -Union Identifiers file:///C:/Users/cn408lk/AppData/LocaVremp/Low/TTOCLJCL.htm 3/12/2014 Page 4 of 5 Classifications listed under an "SU" identifier were derived from survey data by computing average rates and are not union rates; however, the data used in computing these rates may include both union and non-union data. Example: SULA2004-007 5/13/2010. SU indicates the rates are not union majority rates, LA indicates the State of Louisiana; 2004 is the year of the survey; and 007 is an internal number used in producing the wage determination. A 1993 or later date, 5/13/2010, indicates the classifications and rates under that identifier were issued as a General Wage Determination on that date. Survey wage rates will remain in effect and will not change until a new survey is conducted. WAGE DETERMINATION APPEALS PROCESS 1.) Has there been an initial decision in the matter? This can be: * an existing published wage determination * a survey underlying a wage determination * a Wage and Hour Division letter setting forth a position on a wage determination matter * a conformance (additional classification and rate) ruling On survey related matters, initial contact, including requests for summaries of surveys, should be With the Wage and Hour Regional Office for the area in which the survey was conducted because those Regional Offices have responsibility for the Davis -Bacon survey program. If the response from this initial contact is not satisfactory, then the process described in 2.) and 3.) should be followed. With regard to any other matter not yet ripe for the formal process described here, initial contact should be with the Branch of Construction Wage Determinations. Write to: Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 2.) If the answer to the question in 1.) is yes, then an interested party (those affected by the action) can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7). Write to: Wage and Hour Administrator U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 The request should be accompanied by a full statement of the interested party's position and by any information (wage payment data, project description, area practice material, etc.) that the requestor considers relevant to the issue. file)//C:/Users/cn4081k/AppData/Local/Temp/Low/TTOCLJCL.htm 3/12/2014 3.) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative Review Board (formerly the Wage Appeals Board). Write to: Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 4.) All decisions by the Administrative Review Board are final. END OF GENERAL DECISION Page 5 of 5 file:///C:/Users/cn4081k/AppData/Local/Temp/Low/TTOCUCL.htm 3/12/2014 I. II. III. IV. V VI. VII VIII. IX. X. XI. REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONSTRUCTION CONTRACTS General Nondiscrimination Nonsegregated Facilities Davis -Bacon and Related Act Provisions Contract Work Hours and Safety Standards Act Provisions Subletting or Assigning the Contract Safety' Accident Prevention False Statements Conceming Highway Projects Implementation of Clean Air Act and Federal Water Pollution Control Act Compliance with Governmentwide Suspension and Debarment Requirements Certification Regarding Use of Contract Funds for Lobbying ATTACHMENTS A. Employment and Materials Preference for Appalachian Development Highway System or Appalachian Local Access Road Contracts (included in Appalachian contracts only) 1. GENERAL 1 Form FHWA-1273 must be physically incorporated in each construction contract funded under Title 23 (excluding emergency contracts solely intended for debris removal). The contractor (or subcontractor) must insert this form in each subcontract and further require its inclusion in all lower tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services). The applicable requirements of Form FHWA-1273 are incorporated by reference for work done under any purchase order, rental agreement or agreement for other services. The prime contractor shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Form FHWA-1273 must be included in all Federal -aid design - build contracts, in all subcontracts and in lower tier subcontracts (excluding subcontracts for design services, purchase orders, rental agreements and other agreements for supplies or services). The design -builder shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Contracting agencies may reference Form FHWA-1273 in bid proposal or request for proposal documents, however, the Form FHWA-1273 must be physically incorporated (not referenced) in all contracts, subcontracts and lower -tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services related to a construction contract). 2. Subject to the applicability criteria noted in the following sections, these contract provisions shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractor's immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract. 1 FHWA-1273 — Revised May 1, 2012 3. A breach of any of the stipulations contained in these Required Contract Provisions may be sufficient grounds for withholding of progress payments, withholding of final payment, termination of the contract, suspension / debarment or any other action determined to be appropriate by the contracting agency and FHWA. 4. Selection of Labor: During the performance of this contract, the contractor shall not use convict labor for any purpose within the limits of a construction project on a Federal -aid highway unless it is labor performed by convicts who are on parole, supervised release, or probation. The term Federal -aid highway does not include roadways functionally classified as local roads or rural minor collectors. II. NONDISCRIMINATION The provisions of this section related to 23 CFR Part 230 are applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The provisions of 23 CFR Part 230 are not applicable to material supply, engineering, or architectural service contracts. In addition, the contractor and all subcontractors must comply with the following policies: Executive Order 11246, 41 CFR 60, 29 CFR 1625-1627, Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), Title VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The contractor and all subcontractors must comply with: the requirements of the Equal Opportunity Clause in 41 CFR 60- 1 4(b) and, for all construction contracts exceeding $10,000, the Standard Federal Equal Employment Opportunity Construction Contract Specifications in 41 CFR 60-4.3. Note. The U.S. Department of Labor has exclusive authority to determine compliance with Executive Order 11246 and the policies of the Secretary of Labor including 41 CFR 60, and 29 CFR 1625-1627. The contracting agency and the FHWA have the authority and the responsibility to ensure compliance with Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), and Title VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The following provision is adopted from 23 CFR 230, Appendix A, with appropriate revisions to conform to the U.S. Department of Labor (US DOL) and FHWA requirements. 1. Equal Employment Opportunity: Equal employment opportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws, executive orders, rules, regulations (28 CFR 35, 29 CFR 1630, 29 CFR 1625-1627, 41 CFR 60 and 49 CFR 27) and orders of the Secretary of Labor as modified by the provisions prescribed herein, and imposed pursuant to 23 U.S.C. 140 shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract. The provisions of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) set forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference in this contract. In the execution of this contract, the contractor agrees to comply with the following minimum specific requirement activities of EEO. a. The contractor will work with the contracting agency and the Federal Govemment to ensure that it has made every good faith effort to provide equal opportunity with respect to all of its terms and conditions of employment and in their review of activities under the contract. b. The contractor will accept as its operating policy the following statement: "It is the policy of this Company to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, color, national origin, age or disability. Such action shall include: employment, upgrading, demotion, or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre -apprenticeship, and/or on-the- job training." 2. EEO Officer: The contractor will designate and make known to the contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active EEO program and who must be assigned adequate authority and responsibility to do so. 3. Dissemination of Policy: All members of the contractor's staff who are authorized to hire, supervise, promote, and discharge employees, or who recommend such action, or who are substantially involved in such action, will be made fully cognizant of, and will implement, the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met, the following actions will be taken as a minimum: a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not less often than once every six months, at which time the contractor's EEO policy and its implementation will be reviewed and explained. The meetings will be conducted by the EEO Officer. b. All new supervisory or personnel office employees will be given a thorough indoctrination by the EEO Officer, covering all major aspects of the contractor's EEO obligations within thirty days following their reporting for duty with the contractor. c. All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractor's procedures for locating and hiring minorities and women. d. Notices and posters setting forth the contractor's EEO policy will be placed in areas readily accessible to employees, applicants for employment and potential employees. e. The contractor's EEO policy and the procedures to implement such policy will be brought to the attention of employees by means of meetings, employee handbooks, or other appropriate means. 2 4. Recruitment: When advertising for employees, the contractor will include in all advertisements for employees the notation: "An Equal Opportunity Employer." All such advertisements will be placed in publications having a large circulation among minorities and women in the area from which the project work force would normally be derived. a. The contractor will, unless preluded by a valid bargaining agreement, conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minorities and women. To meet this requirement, the contractor will identify sources of potential minority group employees, and establish with such identified sources procedures whereby minority and women applicants may be referred to the contractor for employment consideration. b. In the event the contractor has a valid bargaining agreement providing for exclusive hiring hall referrals, the contractor is expected to observe the provisions of that agreement to the extent that the system meets the contractor's compliance with EEO contract provisions. Where implementation of such an agreement has the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Federal nondiscrimination provisions. c. The contractor will encourage its present employees to refer minorities and women as applicants for employment. Information and procedures with regard to referring such applicants will be discussed with employees. 5. Personnel Actions: Wages, working conditions, and employee benefits shall be established and administered, and personnel actions of every type, including hiring, upgrading, promotion, transfer, demotion, layoff, and termination, shall be taken without regard to race, color, religion, sex, national origin, age or disability The following procedures shall be followed: a. The contractor will conduct periodic inspections of project sites to insure that working conditions and employee facilities do not indicate discriminatory treatment of project site personnel. b. The contractor will periodically evaluate the spread of wages paid within each classification to determine any evidence of discriminatory wage practices. c. The contractor will periodically review selected personnel actions in depth to determine whether there is evidence of discrimination. Where evidence is found, the contractor will promptly take corrective action. If the review indicates that the discrimination may extend beyond the actions reviewed, such corrective action shall include all affected persons. d. The contractor will promptly investigate all complaints of alleged discrimination made to the contractor in connection with its obligations under this contract, will attempt to resolve such complaints, and will take appropriate corrective action within a reasonable time. If the investigation indicates that the discrimination may affect persons other than the complainant, such corrective action shall include such other persons. Upon completion of each investigation, the contractor will inform every complainant of all of their avenues of appeal. 6. Training and Promotion: a. The contractor will assist in locating, qualifying, and increasing the skills of minorities and women who are applicants for employment or current employees. Such efforts should be aimed at developing full joumey level status employees in the type of trade or job classification involved. b. Consistent with the contractor's work force requirements and as permissible under Federal and State regulations, the contractor shall make full use of training programs, i.e., apprenticeship, and on-the-job training programs for the geographical area of contract performance. In the event a special provision for training is provided under this contract, this subparagraph will be superseded as indicated in the special provision. The contracting agency may reserve training positions for persons who receive welfare assistance in accordance with 23 U.S.C. 140(a). c. The contractor will advise employees and applicants for employment of available training programs and entrance requirements for each. d. The contractor will periodically review the training and promotion potential of employees who are minorities and women and will encourage eligible employees to apply for such training and promotion. 7. Unions: If the contractor relies in whole or in part upon unions as a source of employees, the contractor will use good faith efforts to obtain the cooperation of such unions to increase opportunities for minorities and women. Actions by the contractor, either directly or through a contractors association acting as agent, will include the procedures set forth below. a. The contractor will use good faith efforts to develop, in cooperation with the unions, joint training programs aimed toward qualifying more minorities and women for membership in the unions and increasing the skills of minorities and women so that they may qualify for higher paying employment. b. The contractor will use good faith efforts to incorporate an EEO clause into each union agreement to the end that such union will be contractually bound to refer applicants without regard to their race, color, religion, sex, national origin, age or disability. c. The contractor is to obtain information as to the referral practices and policies of the labor union except that to the extent such information is within the exclusive possession of the labor union and such labor union refuses to fumish such information to the contractor, the contractor shall so certify to the contracting agency and shall set forth what efforts have been made to obtain such information. d. In the event the union is unable to provide the contractor with a reasonable flow of referrals within the time limit set forth in the collective bargaining agreement, the contractor will, through independent recruitment efforts, fill the employment vacancies without regard to race, color, religion, sex, national origin, age or disability; making full efforts to obtain qualified and/or qualifiable minorities and women. The failure of a union to provide sufficient referrals (even though it is obligated to provide exclusive referrals under the terms of a collective bargaining agreement) does not relieve the contractor from the requirements of this paragraph. In the event the union referral practice prevents the contractor from meeting the obligations pursuant to Executive Order 11246, as amended, and these special provisions, such contractor shall immediately notify the contracting agency 8. Reasonable Accommodation for Applicants / Employees with Disabilities: The contractor must be familiar 3 with the requirements for and comply with the Americans with Disabilities Act and all rules and regulations established there under. Employers must provide reasonable accommodation in all employment activities unless to do so would cause an undue hardship. 9. Selection of Subcontractors, Procurement of Materials and Leasing of Equipment: The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract. a. The contractor shall notify all potential subcontractors and suppliers and lessors of their EEO obligations under this contract. b. The contractor will use good faith efforts to ensure subcontractor compliance with their EEO obligations. 10. Assurance Required by 49 CFR 26.13(b): a. The requirements of 49 CFR Part 26 and the State DOTs U.S. DOT -approved DBE program are incorporated by reference. b. The contractor or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT -assisted contracts. Failure by the contractor to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy as the contracting agency deems appropriate. 11. Records and Reports: The contractor shall keep such records as necessary to document compliance with the EEO requirements. Such records shall be retained for a period of three years following the date of the final payment to the contractor for all contract work and shall be available at reasonable times and places for inspection by authorized representatives of the contracting agency and the FHWA. a. The records kept by the contractor shall document the following: (1) The number and work hours of minority and non - minority group members and women employed in each work classification on the project; (2) The progress and efforts being made in cooperation with unions, when applicable, to increase employment opportunities for minorities and women; and (3) The progress and efforts being made in locating, hiring, training, qualifying, and upgrading minorities and women; b. The contractors and subcontractors will submit an annual report to the contracting agency each July for the duration of the project, indicating the number of minority, women, and non -minority group employees currently engaged in each work classification required by the contract work. This information is to be reported on Form FHWA-1391. The staffing data should represent the project work force on board in all or any part of the last payroll period preceding the end of July If on-the-job training is being required by special provision, the contractor will be required to collect and report training data. The employment data should reflect the work force on board during all or any part of the last payroll period preceding the end of July. III. NONSEGREGATED FACILITIES This provision is applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The contractor must ensure that facilities provided for employees are provided in such a manner that segregation on the basis of race, color, religion, sex, or national origin cannot result. The contractor may neither require such segregated use by written or oral policies nor tolerate such use by employee custom. The contractor's obligation extends further to ensure that its employees are not assigned to perform their services at any location, under the contractor's control, where the facilities are segregated. The term "facilities" includes waiting rooms, work areas, restaurants and other eating areas, time clocks, restrooms, washrooms, locker rooms, and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing provided for employees. The contractor shall provide separate or single -user restrooms and necessary dressing or sleeping areas to assure privacy between sexes. IV. DAVIS-BACON AND RELATED ACT PROVISIONS This section is applicable to all Federal -aid construction projects exceeding $2,000 and to all related subcontracts and lower -tier subcontracts (regardless of subcontract size). The requirements apply to all projects located within the right-of- way of a roadway that is functionally classified as Federal -aid highway. This excludes roadways functionally classified as local roads or rural minor collectors, which are exempt. Contracting agencies may elect to apply these requirements to other projects. The following provisions are from the U.S. Department of Labor regulations in 29 CFR 5.5 "Contract provisions and related matters' with minor revisions 10 conform to the FHWA- 1273 format and FHWA program requirements. 1. Minimum wages a. All laborers and mechanics employed or working upon the site of the work, will be paid unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account (except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR part 3)), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment computed at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions 4 of paragraph 1.d. of this section; also, regular contributions made or costs incurred for more than a weekly period (but not Tess often than quarterly) under plans, funds, or programs which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in 29 CFR 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided, That the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination (including any additional classification and wage rates conformed under paragraph 1.b. of this section) and the Davis -Bacon poster (WH -1321) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. b.(1) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (i) The work to be performed by the classification requested is not performed by a classification in the wage determination; and (ii) The classification is utilized in the area by the construction industry; and (iii) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination. (2) If the contractor and the laborers and mechanics to be employed in the classification (if known), or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, Washington, DC 20210. The Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30 -day period that additional time is necessary. (3) In the event the contractor, the laborers or mechanics to be employed in the classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer, to the Wage and Hour Administrator for determination. The Wage and Hour Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30 -day period that additional time is necessary (4) The wage rate (including fringe benefits where appropriate) determined pursuant to paragraphs 1.b.(2) or 1.b.(3) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. c. Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. d. If the contractor does not make payments to a trustee or other third person, the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided, That the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. 2. Withholding The contracting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor, withhold or cause to be withheld from the contractor under this contract, or any other Federal contract with the same prime contractor, or any other federally - assisted contract subject to Davis -Bacon prevailing wage requirements, which is held by the same prime contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work, all or part of the wages required by the contract, the contracting agency may, after written notice to the contractor, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. 3. Payrolls and basic records a. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social security number of each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section 1(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv) that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in section 1(b)(2)(B) of the Davis - 5 Bacon Act, the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. b.(1) The contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to the contracting agency. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be included on weekly transmittals. Instead the payrolls shall only need to include an individually identifying number for each employee ( e.g. , the last four digits of the employee's social security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH -347 is available for this purpose from the Wage and Hour Division Web site at httpJ/www.dol.gov/esa/whd/forms/wh347instr.htm or its successor site. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. Contractors and subcontractors shall maintain the full social security number and current address of each covered worker, and shall provide them upon request to the contracting agency for transmission to the State DOT, the FHWA or the Wage and Hour Division of the Department of Labor for purposes of an investigation or audit of compliance with prevailing wage requirements. It is not a violation of this section for a prime contractor to require a subcontractor to provide addresses and social security numbers to the prime contractor for its own records, without weekly submission to the contracting agency.. (2) Each payroll submitted shall be accompanied by a "Statement of Compliance,"signed by the contractor -or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (i) That the payroll for the payroll period contains the information required to be provided under §5.5 (a)(3)(ii) of Regulations, 29 CFR part 5, the appropriate information is being maintained under §5.5 (a)(3)(i) of Regulations, 29 CFR part 5, and that such information is correct and complete; (ii) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in Regulations, 29 CFR part 3; (iii) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract. (3) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH -347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph 3.b.(2) of this section. (4) The falsification of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of title 31 of the United States Code. c. The contractor or subcontractor shall make the records required under paragraph 3.a. of this section available for inspection, copying, or transcription by authorized representatives of the contracting agency, the State DOT, the FHWA, or the Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, the FHWA may, after written notice to the contractor, the contracting agency or the State DOT, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. 4. Apprentices and trainees a. Apprentices (programs of the USDOL). Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Employment and Training Administration, Office of Apprenticeship Training, Employer and Labor Services, or with a State Apprenticeship Agency recognized by the Office, or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has been certified by the Office of Apprenticeship Training, Employer and Labor Services or a State Apprenticeship Agency (where appropriate) to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to joumeymen on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any worker listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a contractor is performing construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the joumeyman's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. Every apprentice must be paid at not Tess than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the joumeymen hourly 6 rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. If the Administrator determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the event the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved. b. Trainees (programs of the USDOL). Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration. The ratio of trainees to joumeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the joumeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe_benefits,.traineesshall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding joumeyman wage rate on the wage determination which provides for Tess than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program, the contractor will no longer be permitted to utilize trainees at Tess than the applicable predetermined rate for the work performed until an acceptable program is approved. c. Equal employment opportunity The utilization of apprentices, trainees and joumeymen under this part shall be in conformity with the equal employment opportunity requirements of Executive Order 11246, as amended, and 29 CFR part 30. d. Apprentices and Trainees (programs of the U.S. DOT). Apprentices and trainees working under apprenticeship and skill training programs which have been certified by the Secretary of Transportation as promoting EEO in connection with Federal -aid highway construction programs are not subject to the requirements of paragraph 4 of this Section IV. The straight time hourly wage rates for apprentices and trainees under such programs will be established by the particular programs. The ratio of apprentices and trainees to joumeymen shall not be greater than permitted by the terms of the particular program. 5. Compliance with Copeland Act requirements. The contractor shall comply with the requirements of 29 CFR part 3, which are incorporated by reference in this contract. 6. Subcontracts. The contractor or subcontractor shall insert Form FHWA-1273 in any subcontracts and also require the subcontractors to include Form FHWA-1273 in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. 7. Contract termination: debarment. A breach of the contract clauses in 29 CFR 5.5 may be grounds for termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. 8. Compliance with Davis -Bacon and Related Act requirements. All rulings and interpretations of the Davis - Bacon and Related Acts contained in 29 CFR parts 1, 3, and 5 are herein incorporated by reference in this contract. 9. Disputes conceming labor standards. Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR parts 5; 6, and 7 Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and the contracting agency, the U.S. Department of Labor, or the employees or their representatives. 10. Certification of eligibility. a. By entering into this contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Govemment contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). b. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Govemment contract by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). c. The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001. 7 V. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The following clauses apply to any Federal -aid construction contract in an amount in excess of $100,000 and subject to the overtime provisions of the Contract Work Hours and Safety Standards Act. These clauses shall be inserted in addition to the clauses required by 29 CFR 5.5(a) or 29 CFR 4.6. As used in this paragraph, the terms laborers and mechanics include watchmen and guards. 1. Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. 2. Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph (1.) of this section, the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph (1) of this section, in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (1 ) of this section. 3. Withholding for unpaid wages and liquidated damages. The FHWA or the contacting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph (2.) of this section. 4. Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph (1.) through (4) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1.) through (4.) of this section. VI. SUBLETTING OR ASSIGNING THE CONTRACT This provision is applicable to all Federal -aid construction contracts on the National Highway System. 1. The contractor shall perform with its own organization contract work amounting to not less than 30 percent (or a greater percentage if specified elsewhere in the contract) of the total original contract price, excluding any specialty items designated by the contracting agency Specialty items may be performed by subcontract and the amount of any such specialty items performed may be deducted from the total original contract price before computing the amount of work required to be performed by the contractor's own organization (23 CFR 635.116). a. The term "perform work with its own organization" refers to workers employed or leased by the prime contractor, and equipment owned or rented by the prime contractor, with or without operators. Such term does not include employees or equipment of a subcontractor or lower tier subcontractor, agents of the prime contractor, or any other assignees. The term may include payments for the costs of hiring leased employees from an employee leasing firm meeting all relevant Federal and State regulatory requirements. Leased employees may only be included in this term if the prime contractor meets all of the following conditions. (1) the prime contractor maintains control over the supervision of the day-to-day activities of the leased employees; (2) the prime contractor remains responsible for the quality of the work of the leased employees; (3) the prime contractor retains all power to accept or exclude individual employees from work on the project; and (4) the prime contractor remains ultimately responsible for the payment of predetermined minimum wages, the submission of payrolls, statements of compliance and all other Federal regulatory requirements. b. "Specialty Items" shall be construed to be limited to work that requires highly specialized knowledge, abilities, or equipment not ordinarily available in the type of contracting organizations qualified and expected to bid or propose on the contract as a whole and in general are to be limited to minor components of the overall contract. 2. The contract amount upon which the requirements set forth in paragraph (1) of Section VI is computed includes the cost of material and manufactured products which are to be purchased or produced by the contractor under the contract provisions. 3. The contractor shall fumish (a) a competent superintendent or supervisor who is employed by the firm, has full authority to direct performance of the work in accordance with the contract requirements, and is in charge of all construction operations (regardless of who performs the work) and (b) such other of its own organizational resources (supervision, management, and engineering services) as the contracting officer determines is necessary to assure the performance of the contract. 4. No portion of the contract shall be sublet, assigned or otherwise disposed of except with the written consent of the contracting officer, or authorized representative, and such consent when given shall not be construed to relieve the contractor of any responsibility for the fulfillment of the contract. Written consent will be given only after the contracting agency has assured that each subcontract is 8 evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. 5. The 30% self -performance requirement of paragraph (1) is not applicable to design -build contracts, however, contracting agencies may establish their own self -performance requirements. VII. SAFETY: ACCIDENT PREVENTION This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. 1. In the performance of this contract the contractor shall comply with all applicable Federal, State, and local laws goveming safety, health, and sanitation (23 CFR 635). The contractor shall provide all safeguards, safety devices and protective equipment and take any other needed actions as it determines, or as the contracting officer may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to protect property in connection with the performance of the work covered by the contract. 2. It is a condition of this contract, and shall be made a condition of each subcontract, which the contractor enters into pursuant to this contract, that the contractor and any subcontractor shall not permit any employee, in performance of the contract, to work in surroundings or under conditions which are unsanitary, hazardous or dangerous to his/her health or safety, as determined under construction safety and health standards (29 CFR 1926) promulgated by the Secretary of Labor, in accordance with Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 3704). 3. Pursuant to 29 CFR 1926.3, it is a condition of this contract that the Secretary of Labor or authorized representative thereof, shall have right of entry to any site of contract performance to inspect or investigate the matter of compliance with the construction safety and health standards and to carry out the duties -of -the -Secretary under Section 107 of the - - Contract Work Hours and Safety Standards Act (40 U.S.C.3704). VIII. FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. In order to assure high quality and durable construction in conformity with approved plans and specifications and a high degree of reliability on statements and representations made by engineers, contractors, suppliers, and workers on Federal - aid highway projects, it is essential that all persons concemed with the project perform their functions as carefully, thoroughly, and honestly as possible. Willful falsification, distortion, or misrepresentation with respect to any facts related to the project is a violation of Federal law. To prevent any misunderstanding regarding the seriousness of these and similar acts, Form FHWA-1022 shall be posted on each Federal -aid highway project (23 CFR 635) in one or more places where it is readily available to all persons concemed with the project: 18 U S.0 1020 reads as follows: 'Whoever, being an officer, agent, or employee of the United States, or of any State or Territory, or whoever, whether a person, association, firm, or corporation, knowingly makes any false statement, false representation, or false report as to the character, quality, quantity, or cost of the material used or to be used, or the quantity or quality of the work performed or to be performed, or the cost thereof in connection with the submission of plans, maps, specifications, contracts, or costs of construction on any highway or related project submitted for approval to the Secretary of Transportation; or Whoever knowingly makes any false statement, false representation, false report or false claim with respect to the character, quality, quantity, or cost of any work performed or to be performed, or materials fumished or to be fumished, in connection with the construction of any highway or related project approved by the Secretary of Transportation; or Whoever knowingly makes any false statement or false representation as to material fact in any statement, certificate, or report submitted pursuant to provisions of the Federal -aid Roads Act approved July 1, 1916, (39 Stat. 355), as amended and supplemented; Shall be fined under this title or imprisoned not more than 5 years or both." IX. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. By submission of this bid/proposal or the execution of this contract, or subcontract, as appropriate, the bidder, proposer, Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed to have stipulated as follows. 1. That any person who is or will be utilized in the performance of this contract is not prohibited from receiving an award due to -a violation of Section 508 of the Clean Water Act or Section 306 of the Clean Air Act. 2. That the contractor agrees to include or cause to be included the requirements of paragraph (1) of this Section X in every subcontract, and further agrees to take such action as the contracting agency may direct as a means of enforcing such requirements. X. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION This provision is applicable to all Federal -aid construction contracts, design -build contracts, subcontracts, lower -tier subcontracts, purchase orders, lease agreements, consultant contracts or any other covered transaction requiring FHWA approval or that is estimated to cost $25,000 or more — as defined to 2 CFR Parts 180 and 1200. 1. Instructions for Certification — First Tier Participants: a. By signing and submitting this proposal, the prospective first tier participant is providing the certification set out below. b. The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this 9 covered transaction. The prospective first tier participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective first tier participant to fumish a certification or an explanation shall disqualify such a person from participation in this transaction. c. The certification in this clause is a material representation of fact upon which reliance was placed when the contracting agency determined to enter into this transaction. If it is later determined that the prospective participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the contracting agency may terminate this transaction for cause of default. d. The prospective first tier participant shall provide immediate written notice to the contracting agency to whom this proposal is submitted if any time the prospective first tier participant teams that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. e. The terms "covered transaction," "debarred," "suspended," "ineligible," "participant," "person," "principal," and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant" refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). f. The prospective first tier participant agrees by submitting this proposal that, should the -proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. g. The prospective first tier participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions," provided by the department or contracting agency, entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. h. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (httos.//www.eols.gov/), which is compiled by the General Services Administration. i. Nothing contained in the foregoing shall be construed to require the establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of the prospective participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. j. Except for transactions authorized under paragraph (f) of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Govemment, the department or agency may terminate this transaction for cause or default. 2. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — First Tier Participants: a. The prospective first tier participant certifies to the best of its knowledge and belief, that it and its principals: (1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency; (2) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (3) Are not presently indicted for or otherwise criminally or civilly charged by a govemmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (a)(2) of this certification; and (4) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. b. Where the prospective participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. 2. Instructions for Certification - Lower Tier Participants: (Applicable to all subcontracts, purchase orders and other lower tier transactions requiring prior FIiWA approval or estimated to cost $25,000 or more - 2 CFR Parts 180 and 1200) a. By signing and submitting this proposal, the prospective lower tier is providing the certification set out below. b. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Govemment, the department, or agency with which 10 this transaction originated may pursue available remedies, including suspension and/or debarment. c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant leams that its certification was erroneous by reason of changed circumstances. d. The terms "covered transaction," "debarred," "suspended," "ineligible," "participant," "person," "principal," and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant" refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). e. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. f. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all -solicitations for lower tier covered transactions exceeding the $25,000 threshold. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (httos.//www.epls.ciov/), which is compiled by the General Services Administration. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph e of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Govemment, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Participants: 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. XI. CERTIFICATION REGARDING USE OF CONTRACT FUNDS FOR LOBBYING This provision is applicable to all Federal -aid construction contracts and to all related subcontracts which exceed $100,000 (49 CFR 20). 1. The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: a. No Federal 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 an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative -agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. b. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. 2. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 3. The prospective participant also agrees by submitting its bid or proposal that the participant shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such recipients shall certify and disclose accordingly 11 ATTACHMENT A - EMPLOYMENT AND MATERIALS PREFERENCE FOR APPALACHIAN DEVELOPMENT HIGHWAY SYSTEM OR APPALACHIAN LOCAL ACCESS ROAD CONTRACTS This provision is applicable to all Federal -aid projects funded under the Appalachian Regional Development Act of 1965. 1. During the performance of this contract, the contractor undertaking to do work which is, or reasonably may be, done as on-site work, shall give preference to qualified persons who regularly reside in the labor area as designated by the DOL wherein the contract work is situated, or the subregion, or the Appalachian counties of the State wherein the contract work is situated, except: a. To the extent that qualified persons regularly residing in the area are not available. b. For the reasonable needs of the contractor to employ supervisory or specially experienced personnel necessary to assure an efficient execution of the contract work. c. For the obligation of the contractor to offer employment to present or former employees as the result of a lawful collective bargaining contract, provided that the number of nonresident persons employed under this subparagraph (lc) shall not exceed 20 percent of the total number of employees employed by the contractor on the contract work, except as provided in subparagraph (4) below. 2. The contractor shall place a job order with the State Employment Service indicating (a) the classifications of the laborers, mechanics and other employees required to perform the contract work, (b) the number of employees required in each classification, (c) the date on which the participant estimates such employees will be required, and (d) any other pertinent information required by the State Employment Service to complete the job order form. The job order may be placed with the State Employment Service in writing or by telephone. If during the course of the contract work, the information submitted by the contractor in the original job order is substantially modified, the participant shall promptly notify the State Employment Service. 3. The contractor shall give full consideration to all qualified job applicants referred to him by the State Employment Service. The contractor is not required to grant employment to any job applicants who, in his opinion, are not qualified to perform the classification of work required. 4. If, within one week following the placing of a job order by the contractor with the State Employment Service, the State Employment Service is unable to refer any qualified job applicants to the contractor, or less than the number requested, the State Employment Service will forward a certificate to the contractor indicating the unavailability of applicants. Such certificate shall be made a part of the contractor's permanent project records. Upon receipt of this certificate, the contractor may employ persons who do not normally reside in the labor area to fill positions covered by the certificate, notwithstanding the provisions of subparagraph (1c) above. 5. The provisions of 23 CFR 633.207(e) allow the contracting agency to provide a contractual preference for the use of mineral resource materials native to the Appalachian region. 12 6. The contractor shall include the provisions of Sections 1 through 4 of this Attachment A in every subcontract for work which is, or reasonably may be, done as on-site work. SECTION 00550 - Notice to Proceed TO: Dated (BIDDER) ADDRESS Contract For. Old Dixie Highway Sidewalk Improvements, 38th Lane to 45th Street IRC Project No: 0845B IRC Bid No. 2014032 FM No. 423186-2-58-01 You are notified that the Contract Times under the above contract will commence to run on . By that date, you are to start performing your obligations under the Contract Documents. The contract has allocated 60 days for Substantial Completion of this project and 75 days for Final Completion. In accordance with Article 4 of the Agreement the date of Substantial Completion is and the date of readiness for final payment is CONTRACTOR shall not commence work under this Contract until he has obtained all insurance required under Article 5 and such insurance has been delivered to the OWNER and approved by the OWNER, nor shall the CONTRACTOR allow any Subcontractor to commence work on his subcontract until all similar insurance required of the Subcontractor has been so obtained and approved. AH such insurance shall remain in effect until final payment and at all times thereafter when CONTRACTOR may be correcting, removing or replacing defective Work in accordance with Article 13. Also, before you may start any Work at the Site, you must: (add other requirements, if applicable) INDIAN RIVER COUNTY (OWNER) By - (AUTHORIZED SIGNATURE) (TITLE) 00550 - Notice to Proceed REV 1-4-11.doc 00550 - 1 F:\Public Works\ENGINEERING DIVISION PROJECTS\08458 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documents\Master Contract Documents\00550 - Notice to Proceed REV 1-4-11.doc Rev. 05/01 00610 - PUBLIC CONSTRUCTION BOND INSTRUCTION FOR PUBLIC CONSTRUCTION BOND The front or cover page to the required public construction payment and performance bond shall contain the information required by Fla. Stat. 255.05(1)(a), and be substantially in the format shown on the first page following this instruction. The Public Construction Bond shall be in the form suggested by Fla. Stat. 255.05(3) as shown on the second page following this instruction. A Power of Attorney from a surety insurer authorized to do business in Florida, authorizing the signature of the Attorney in Fact who executes the Public Construction Bond shall accompany that Bond. 00610-1 00610 - Public Construction Bond.doc F.\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents Master Contract Documents\00610 - Public Construction Bond doc 3120150(10998 RECORDED IN THE RECORDS OF JEFFREY R SMITH, CLERK OF CIRCUIT COURT INDIAN RIVER CO FL BK: 2825 PG: 821, 2/23/2015 2:45 PM 4. Public Work P.S. Chapter 255.05 (1)(a) Cover Page THIS BOND 15 GIVEN TO COMPLY WITH SECTION 255.05 OR SECTION 713.23 FLORIDA STATUTES, AND ANY ACTION INSTITUTED BY A CLAIMANT UNDER THIS BOND FOR PAYMENT MUST BE IN ACCORDANCE WITH THE NOTICE AND TIME UMITATION PROVISIONS IN SECTION 255.05(2) OR SECTION 713.23 FLORIDA STATUTES. BOND NO: CONTRACTOR NAME: CONTRACTOR ADDRESS: CONTRACTOR PHONE NO: SURETY COMPANY NAME: SURETY PRINCIPAL BUSINESS ADDRESS: SURETY PHONE NO: OWNER NAME: OWNER ADDRESS: OWNER PHONE NO: 0311GBE NAME: at mnbsdthg entity is different from the owner, the aednades public entity) OBLIGEE ADDRESS: OBLIGEE PHONE NO: BOND AMOUNT: • CONTRACT NO: CIappuabty DESCIUP TION OP WORK PROJECT LOCATION: LEGAL DESCRIPTION: at gtptlabla 6086203 Timothy Rose Contracting, Inc. 1360 Old Dixie Hwy Suite 106 Vero Beach. FL 32962 (772)564-7800 Westfield Insurance Company One Park Cirrle P O Roy 5001 Westfield Center, OH 44251-5001 (904) 64? -2144 Indian River County. ..,political subdivision of the state of Florida 1800 '701. Street Vero Beach. FL 360 (772) 226-1416 One hundred twenty-nine thousand, two hundred dollars and 52/00 ($129,200.52) Old Dixie Hiway Sidewalk improvements 3Rth T.ane to 45th Street EUILiTRALIS An other bear pp(.) m damod sebs.gasat to tbb p0 ragard:w or any pap ameba(.) that my be pda tad therm. 00810.2 00810 - Pubfo Conatnellon Bond.doC F era CWorke ENG1NEE,RINO DIVISION PRCJECTS108468.Old Dbde Hwy Sidewalk (38th Ln -451h SDIAdmim\bId documentsVAaater Contract Doa,non 0610 - Public Con8Wdbn Bond.doo A TRUE COPY CERTIFICATION ON LAST PAGE J.R. SMITH. CLERK 13K: 282,`.i.PG: 1322 PUBLIC CONSTRUCTION BOND Bond No. 6086201 (enter bond number) BY THIS BOND, We Timothy Rose Contracting. Inc. , as Principal and Westfield Insurance_Cnronany;, , a corporation, as Surety, are bound to Indian River County. Florida ,herein called Owner, In the sum of $ 129,200.52 , for payment of which we bind ourselves, our heir;, personal representatives, successors, and assigns, Jointly and severally. THE CONDITION OF THiS BOND Is that If Principal: 1. Performs the contract dated Feb 1 Rth , 7n 1 s , between Principal and Owner for construction of Old Dixie Hwy Sidewalk Improvements 38th Lane to 45th Street, the contract being made a part of this bond by reference, at the times and in the manner prescribed in the contract; and 2. Promptly makes payments to all claimants, as defined In Section 255,05(1), Florida Statutes, supplying Principal with labor, materials, or supplies, used directly or indirectly by Principal in the prosecution of the work provided for in the contract and 3. Pays Owner all losses, damages, expenses, costs, and attomey's fees, including appellate proceedings, that Owner sustains because of a default by Principal under the contract and 4. Performs the gudrantee of all work and materials furnished under the contract for the time specified In the contract, then this bond is void; otherwise it remains In full force. .Any action instituted by a •claimant under this bond for payment must be In accordance with the notice and time limitation provisions In Section 255.05(2), Florida Statutes. Any changes In or under the contract documents and compliance or noncompliance with any formalities connected with the contract or the changes does not affect Surety's obligation under this bond. DATED ON February 1 R, 7(115 00610 - 3 Timothy Rose Contracting. Inc. f Name of Principal By (As Attorney in Fact) Cabot W. Lord Westfield Insurance Company (Name of Suretyl 00610 - Public Construction Bond.doc FAPubik works\ ENGINEERING DIVISION PROJECTSt08458.Old Dbde Hwy Sidewalk (38th Ln - 45th SOAdmInAbld doamrentslMaster Contract Doamrents100810 - Public Construction Bond.doc A TRUE COPY CERTIFICATION ON LAST PAGE J.R. SMITH, CLERK BK: 282.1 PG: '823 General Power of Attorney CERTIFIED COPY POWER NO. 0990102 00 Westfield Insurance Co. Westfield National Insurance Co. Ohio Farmers Insurance Co. Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations. hereinafter referred to individually as a 'Company" and collectively as "Companies.' duly organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center. Medina County, Ohio• do by these presents make, constitute and appoint CABOT W. LORD, JOSEPH E. COONS, JOINTLY OR SEVERALLY of PALM CITY and State of FL its true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred in its name. place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of suretyship LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President. sealed with the corporate seal poof the applicable Company and duly attested by itsSecretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in WESTFIELD INSURANremises. Said Cthe Eointment is le under and COMPANY, WESTFIELD NATIy auONAL ority of the following resolution adINSURANCE COMPANY and OHIO F RMERS INSURANCEf COMPANY Directors of each of the "Be It Resolved• that the President. any Senior Executive, any Secretary or any Fidelity & Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney -in -Fact. may be given full power and authority for and in the name of and on behalf of the Company to execute, acknowledge and deliver, any and all bonds, recognizances• contracts. agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder. and any such instruments so executed by any such Attorney -in -Fact shall be as binding upon the Company as if signed by the President and seated and attested by the Corporate Secretary " 'Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorneyor any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile al shall be vald and binding upon the Company with respect to any bond or undertaking to which it is attached.' (Each adopted at a meeting held on February 8, 2000). In Witness Whereof, WESTFIELD INSURANCE COMPANY. WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto affixed this 21st day of MARCH A.D., 2014 Corporate "y ONI ,.,, Seals Yftrlpc�� PttoNAL /'•, Affixed vOv'solo '�4\',$o_vO = .trtiv;s •m SEAL:0 State of Ohio County of Medina ss.- WESTFIELD INSURANCE COMPANY WESTFIELD NATIONAL INSURANCE COMPANY OHIO FARMERS INSURANCE COMPANY -RK"..3By:11�t9w.J'J Dennis P. Baus, National Surety Leader and Senior Executive On this 21st day of MARCH A.D., 2014 , before me personally came Dennis P. Baus to me known, who, being by me duly sworn, did depose and say, that he resides in Wooster, Ohio; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above instrument; that he knows the seals of said Companies; that the seals affixed to said instrument are such corporate seals; that they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order Notarial Seal Affixed State of Ohio County of Medina ss.. ,PeumQ/G� David A. Kotnik, Attorney at Law, Notary Public My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code) I. Frank A. Canino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY. do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which Is still in full force and effect; and furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 18th day of A.D.. 2015,,,,,,,,,,, , ,,, QP�tr)NAt, �SL'P SEAL February BPOAC2 (combined) (06-02) i4"(t8MTElifil .. 1848r r fs Frank A. Canino, Secretary STATE OF FLORIDA '•NN,W,+"'� IUt,:. N RIVER COUNTY T;;.5 IS TO CERTIFY THAT THIS ISA TRUE END CO3;fECT OT THE ORIGINAL ON FILE IN s t:';` °MCE T;i;S WAY HAVE REDACTED INFORMATION STATED aiDA STATUE 119. Secretary OP ID: TJ 'AYYY) �� o= CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/Y15 02/17/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 772-286-4334 Stuart Insurance, Inc. Fax: 772-286-9389 3070 S W Mapp Palm City, FL 34990 CONTACT Rick Halcomb PHONE 772-286-4334 FAX No): 772-286-9389 (AIC. No Ext): E-MAIL ADDRESS: rhalcomb@stuartinsurance.net Rick Halcomb, CIC, ARM PRODUCER TIMOR -1 CUSTOMER IDN: INSURERS) AFFORDING COVERAGE NAIC # INSURED Timothy Rose Contracting, Inc. 1360 Old Dixie Hwy SW, Ste 106 Vero Beach, FL 32962 INSURER A .Westfield Insurance 24112 INSURER B. CMM6079889 INSURERC 06/06/2015 INSURER D . $ 1,000,000 INSURER E . $ 500,000 INSURER F . $ 10,000 • LUVtKAUtb %,GR 11tH,? 1 L 1i V im-n-1s. - - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE JNSR ADDLSUBR WVD POUCY NUMBER POLICY EFF (MMIDD/YYYY) POUCY EXP (MMIDD/YYYY) LIMITS LTR A GENERAL X UABIUTY COMMERCIAL GENERAL LIABILITY X OCCUR CMM6079889 06/06/2014 06/06/2015 EACH OCCURRENCE $ 1,000,000 NTED PREM AMAGE SES (Ea TO Eoccurrence) $ 500,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE PERSONAL SADV INJURY $ 1,000,000 X Contractual Liab GENERAL AGGREGATE $ 2,000,000 X Incl XCU PRODUCTS - COMP/OP AGG $ 2,000,000 GEL AGGREGATE LIMIT APPLIES PER: —1 POLICY n PRO- fl LOC E A AUTOMOBILEUABILITY X X X JFS:T ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WNEDAUTOS CMM6079889 06/06/2014 06/06/2015 COMBINED SINGLE UMIT (Ea accident) E 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per acddent) ( $ $ $ ACMM6079889 UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS-MADE3,000,000 06/06/2014 06/06/2015 EACH OCCURRENCE $ 3,000,000 AGGREGATE E $ DEDUCTIBLE $ $ WORKERS AND ANY (MandatoryIn OFFICER/MEMBER (Mandatory Ii yes, RETENTION COMPENSATION EMPLOYERS' UABILITY PROPRIETOR/PARTNER/EXECUTIVE Yf / N EXCLUDED? I 1 In NH) describe under OF OPERATIONS below N 1 A NC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ A DESCRIPTION Contractors Equip CMM6079889 06/06/2014 06/06/2015 Rented 50,000 Equipment $1000 ded DESCRIPTION RE: Project# general written OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Old Dixie Hwy Sidewalk Improvements 38th Lane to 45th Street (IRC 0845B) -Indian River County is additional insured witih respect to liability for ongoing and completed operations when required by contract. 30 days notice of cancellation, 10 days for non-payment CERTIFICATE HOLDER IRCOU-4 Indian River County 1801 27th Street Vero Beach, FL 32960 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 6cil ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 ® A� o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYY1� 2/17/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER SUNZ Insurance Solutions, LLC ID(Essential) c/o Essential HR, Inc. dba First Star HR 251 O'Connor Ridge Blvd Suite 370 Irving, TX 75038 CONTACT NAME: Jennifer Hauger PHONE EMI 214 92-1986 FAX -4 E-MAIL(o ADDRESS: lennifer.hauger@firststarhr.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A. SUNZ Insurance Company 34762 INSURED Essential HR Inc dba Employee Professionals 251 O'Connor Ridge Blvd Suite 370 Irving TX 75038 INSURER B . Aspen Re - London - Best Rating "A" INSURER c. Catlin Syndicate - Lloyds - Best Rating "A" INSURER D . Brit Syndicate - Lloyds - Best Rating "A" $ INSURERE: INSURER F : • I.UVtRAUtJ l,GR 11r-1t,h , L INV1111... 1 s. LUYUJUUT ---" -- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR . TYPE OF INSURANCE ADDL INSD SUBR WVD POUCY NUMBER POUCY EFF (MM/DD/YYYY) POUCY EXP (MMIDDIYYYY) LIMITS LTR COMMERCIAL GENERAL LABILnY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) S CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE UMIT APPLIES PR PER PRODUCTS - COMP/OP AGG $ POUCY OTHER: JECOT LOC $ UABILITY COMBINED SINGLE LIMIT (Ea accident) S AUTOMOBILE BODILY INJURY (Per person) S ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS JAUTOS NON -OWNED PROPERTY DAMAGE (Per accident) $ HIRED AUTOS _ AUTOS $ LIAB_ EACH OCCURRENCE $ UMBRELLA OCCUR AGGREGATE $ EXCESS UAB CLAIMS -MADE RETENTION $ $ WORKERS DED COMPENSATION WCPE00000184 02 10/1/2014 10/1/2015 iSTA TUTE OER A AND EMPLOYERS' LABILITY Y / N WCPE00000184 01 10/1/2013 10/1/2014 EL EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUl1VE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under OF OPERATIONS below EL DISEASE - POUCY UMIT $ 1,000,000 B C ID DESCRIPTION Workers Compensation Excess Coverage This is for informational purposes and nothing shall create any right under such reinsurance. DESCRIPTION Coverage Effective OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) provided for all leased employees but not subcontractors of: Timothy Rose Contracting, Inc. date: 10/1/2013 CERTIFICATE HOLDER 62200099 Indian River County 1801 27th Street Vero Beach FL 32960 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Glen J Distefano ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERT ND 23463564 Natalie Matthews 2/17/2015 11:58 05 AM (CST) Page 1 of 1 SECTION 00622 - Contractor's Application for Payment Old Dixie Highway Sidewalk Improvements, 38th Lane to 45th Street Application for Payment No. For Work Accomplished through the period of through To: Indian River County (OWNER) From: (CONTRACTOR) Bid No.: 2014032 Project No.: 0845B FM No.: 423186-2-58-01 1) Attach detailed schedule and copies of all paid invoices. 1 Original Contract Price: 2. Net change by Change Orders and Written Amendments (+ or -): 3. Current Contract Price (1 plus 2): 4. Total completed and stored to date: $ 5. Retainage (per Agreement): % of completed Work: % of retainage: $ Total Retainage: $ 6. Total completed and stored to date less retainage (4 minus 5): $ 7. Less previous Application for Payments: $ 8. DUE THIS APPLICATION (6 MINUS 7): $ CONTRACTOR'S CERTIFICATION: UNDER PENALTY OF PERJURY, the undersigned CONTRACTOR certifies that (1) the labor and materials listed on this request for payment have been used in the construction of this Work; (2) payment received from the last pay request has been used to make payments to all subcontractors, laborers, materialmen and suppliers except as listed on Attachment A, below; (3) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of payment free and clear of all Liens, security interests and encumbrances (except such as are covered by a Bond acceptable to OWNER indemnifying OWNER against any such Lien, security interest or encumbrance); (4) all Work covered by this Application for Payment is in accordance with the Contract Documents and not defective; and (5) If this Periodic Estimate is for a Final Payment to project or improvement, 1 further certify that all persons doing work upon or furnishing materials or supplies for this project or improvement under this foregoing contract have been paid in full, and that all taxes imposed by Chapter 212 Florida Statutes, (Sales and Use Tax Act, as Amended) have been paid and discharged, and that I have no claims against the OWNER. Attached to or submitted with this form are: 1. Signed release of lien forms (partial or final as applicable) from all subcontractors, laborers, materialmen and suppliers except as listed on Attachment A, together with an explanation as to why any release of lien form is not included; 00622 - Contractor's Application for Payment - 03-10 rev.doc 00622 - 1 F \Public Works\ENGINEERING DIVISION PROJECTS\08456 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documents\Master Contract Documents\00622 - Contractor's Application for Payment - 03-10 rev.doc Rev. 05/01 2. Updated Construction Schedule per Specification Section 01310, and Dated By: STATE OF FLORIDA COUNTY OF INDIAN RIVER Page 2 of 5 (CONTRACTOR — must be signed by an Officer of the Corporation) Print Name and Title Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared , who being by me first duly sworn upon oath, says that he/she is the of the CONTRACTOR mentioned above and that he/she has been duly authorized to act on behalf of it, and that he/she executed the above Contractor's Application for Payment and Contractor's Certification statement on behalf of said CONTRACTOR; and that all of the statements contained herein are true, correct, and complete. Subscribed and sworn to before me this day of , 20 is personally known to me or has produced as identification. (SEAL) NOTARY PUBLIC: Printed name: Commission No.: Commission Expiration: **************************************************************************************************** [The remainder of this page was left blank intentionally] 00622 - Contractor's Application for Payment - 03-10 rev doc 00622 - 2 F \Public Works\ENGINEERING DIVISION PROJECTS \08458 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\Master Contract Documents100622 - Contractor's Application for Payment - 03-10 rev.doc Rev 05/01 Page 3of5 SURETY'S CONSENT OF PAYMENT TO CONTRACTOR: The Surety, ,a corporation, in accordance with Public Construction Bond Number , hereby consents to payment by the OWNER to the CONTRACTOR, for the amounts specified in this CONTRACTOR's APPLICATION FOR PAYMENT. TO BE EXECUTED BY CORPORATE SURETY: Attest: Secretary Corporate Surety STATE OF FLORIDA COUNTY OF INDIAN RIVER Business Address - BY: Print Name: Title: (Affix Corporate SEAL) Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared , to me well known or who produced as identification, who being by me first duly sworn upon oath, says that he/she is the for and that he/she has been authorized by it to approve payment by the OWNER to the CONTRACTOR of the foregoing Contractor's Application for Payment. Subscribed and sworn to before me this day of , 20 Notary Public, State of My Commission Expires: **************************************************************************************************** [The remainder of this page was left blank intentionally] 00622 - Contractor's Application for Payment - 03-10 rev doc 00622 - 3 F\Public Works\ENGINEERING DIVISION PROJECTS \084513 - Oid Dixie Hwy Sidewalk (38th Ln - 45th St)lAdmim\bid documentslMaster Contract Documents\00622 - Contractor's Application for Payment - 03-10 rev.doc Rev 05/01 Page 4of5 CERTIFICATION OF ENGINEER: I certify that I have reviewed the above and foregoing Periodic Estimate for Partial Payment; that to the best of my knowledge and belief it appears to be a reasonably accurate statement of the work performed and/or material supplied by the Contractor. I am not certifying as to whether or not the Contractor has paid all subcontractors, laborers, materialmen and suppliers because I am not in a position to accurately determine that issue. Dated SIGNATURE CERTIFICATION OF INSPECTOR: I have checked the estimate against the Contractor's Schedule of Amounts for Contract Payments and the notes and reports of my inspections of the project. To the best of my knowledge, this statement of work performed and/or materials supplied appears to be reasonably accurate, that the Contractor appears to be observing the requirements of the Contract with respect to construction, and that the Contractor should be paid the amount requested above, unless otherwise noted by me. I am not certifying as to whether or not the Contractor has paid all subcontractors, laborers, materialmen and suppliers because I am not in a position to accurately determine that issue. Dated SIGNATURE **************************************************************************************************** [The Remainder of This Page Was Left Blank Intentionally] 00622 - Contractor's Application for Payment - 03-10 rev doc 00622 - 4 F:\Public Works \ENGINEERING DIVISION PROJECTS 108458 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documentsWlaster Contract Documents\00622 - Contractor's Application for Payment - 03-10 rev.doc Rev 05/01 Page 5 of 5 ATTACHMENT A 1. List of all subcontractors, laborers, materialmen and suppliers who have not been paid from the payment received from the last Pay Request and the reason why they were not paid (attach additional pages as necessary): 2. List of all subcontractors, laborers, materialmen and suppliers for which a signed release of lien form (partial or final as applicable) is not included with this Pay Request, together with an explanation as to why the release of lien form is not included (attach additional pages as necessary): 00622 - Contractor's Application for Payment - 03-10 rev.doc 00622 - 5 F'Public Works\ENGINEERING DIVISION PROJECTS\08458 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\Master Contract Documents100622 - Contractors Application for Payment - 03-10 rev.doc Rev. 05/01 PROJECT NAME: Old Dixie Highway Sidewalk Improvements, 38th Lane to 45th Street Project No. 08456 Payment Application No. F:\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\Master Contract Documents\00622-Contractor's Application for Payment Spreadsheet Example.doc PREVIOUS APPLICATION WORK COMPLETED THIS PERIOD TOTAL COMPLETED SCHEDULED VALUE % MATERIALS BALANCE TO FINISH Item No. Description Unit Quantity Unit Price Amount QUANTITY TOTAL QUANThLITMY TOTA L^.. QUANTITY UANTITY OTAL TOTAL ST•OBRE/D'fi."�°� QUANTITY _ p p .O 4 S! r r huda ` � t• . , tC ei { u' j , -'TOTAL ;ENS1 r .y SUBTOTAL SUBTOTAL 0.00fi: 0.00 0.00 0..00 0.00 0.00 . Ces� 5 4,.:.'; ' U, It Y u wxF aR, siMuE MIT }d rti` s W. FORCE , ACCOUNT 1 LS tt�u"Isx w� t r xis ff e wa '� � �{ � iS� i t °x 'st`5 iK} it ' - u ?E a Ty, .E c t t�' s e SWF ft MEgd�n"ux'3" 3 GRAND TOTAL TOTAL 0.00 1 _ 1 1 1 I AMOUNT COMPLETED TO DATE MATERIALS STORED TO DATE SUB -TOTAL MATERIALS STORED AND COMPLETED TO D DATE m RETAINAGE AT 10% 0 TOTAL COMPLETED AND STORED LESS RETAINAGE cn iv LESS PREVIOUS PAYMENT 6) AMOUNT DUE CONTRACTOR $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 F:\Public Works\ENGINEERING DIVISION PROJECTS\0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\Master Contract Documents\00622-Contractor's Application for Payment Spreadsheet Example.doc SECTION 00630 - Certificate of Substantial Completion Date of Issuance: , 20 OWNER: Indian River County CONTRACTOR. Project No.: 0845B FM No. 423186-2-58-01 Project Description: The project will consist of the construction of a 5' wide concrete sidewalk along the east side of Old Dixie Highway between 38'h Lane and 45th Street, a gross length of approximately 4,500 linear feet. OWNER's Bid No 2014032 CONTRACT FOR Old Dixie Highway Sidewalk Improvements, 38th Lane to 45th Street This Certificate of Substantial Completion applies to all Work under the Contract Documents or to the following specified parts thereof: To. OWNER And To. CONTRACTOR The Work to which this Certificate applies has been inspected by authorized representatives of OWNER, CONTRACTOR and ENGINEER, and that Work is hereby declared to be substantially complete in accordance with the Contract Documents on DATE OF SUBSTANTIAL COMPLETION A tentative list of items to be completed or corrected is attached hereto. This list may not be all- inclusive, and the failure to include an item in it does not alter the responsibility of CONTRACTOR to complete all the Work in accordance with the Contract Documents The items in the tentative list shall be completed or corrected by CONTRACTOR within days of the above date of Substantial Completion. 00630 - Certificate of Substantial Completion REV 04-07 doc 00630 - 1 F'Public Works\ENGINEERING DIVISION PROJECTS 084513 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)V\dmim\bid documents\Master Contract Documents100630 - Certificate of Substantial Completion REV 04-07.doc The responsibilities between OWNER and CONTRACTOR for security, operation, safety, maintenance, heat, utilities, insurance and warranties and guarantees shall be as follows: OWNER: CONTRACTOR: The following documents are attached to and made a part of this Certificate: [For items to be attached see definition of Substantial Completion as supplemented and other specifically noted conditions precedent to achieving Substantial Completion as required by Contract Documents.] This certificate does not constitute an acceptance of Work not in accordance with the Contract Documents nor is it a release of CONTRACTOR's obligation to complete the Work in accordance with the Contract Documents. Executed by ENGINEER on: (Date). ENGINEER: By: (Authorized Signature) CONTRACTOR accepts this Certificate of Substantial Completion on (date). CONTRACTOR: By: (Authorized Signature) OWNER accepts this Certificate of Substantial Completion on (date). OWNER: INDIAN RIVER COUNTY By: (Authorized Signature) * * END OF SECTION * * 00630 - Certificate of Substantial Completion REV 04-07.doc 00630 - 2 F \Public Works\ENGINEERING DIVISION PROJECTS \084513 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)V\dmim\bid documents Master Contract Documents\00630 - Certificate of Substantial Completion REV 04-07.doc SECTION 00632 - CONTRACTOR'S FINAL CERTIFICATION OF THE WORK (TO ACCOMPANY CONTRACTOR'S FINAL APPLICATION FOR PAYMENT) PROJECT NAME: Old Dixie Highway Sidewalk Improvements, 38th Lane to 45th Street IRC PROJECT NO: 0845B STATE OF COUNTY OF Personally before me the undersigned officer, authorized by the laws of said state to administer oaths, comes , who on oath says: That he is the CONTRACTOR with whom Indian River County, Florida, a political subdivision of said state, did on the day of ,20 , enter into a contract for the performance of certain work, more particularly described as follows: UNDER PENALTY OF PERJURY, affiant further says that said construction has been completed and the Contract therefore fully performed and final payment is now due and that all liens of all firms and individuals contracting directly with or directly employed by such CONTRACTOR have been paid in full EXCEPT: Name Description/Amount who have not been paid and who are due the amount set forth. Affiant further says that: 1. CONTRACTOR has reviewed the Contract Documents. 2. CONTRACTOR has reviewed the Work for compliance with the Contract Documents. 3. CONTRACTOR has completed the Work in accordance with the Contract Documents. 4. All equipment and systems have been tested in the presence of the ENGINEER or his representative and are fully operational with no defects or deficiencies except as listed below. 00632-1 F.1Public Works\ENGINEERING DIVISION PROJECTS10845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documentsWaster Contract Documents100632 - Contractors Final Certification REV 04-07.doc 5. The Work is complete and ready for final acceptance by the OWNER. 6. CONTRACTOR hereby certifies that it has no claims against the OWNER. (Corporate Seal) (Contractor) By: Subscribed and sworn to before me this _ day of , 20 Notary Public State of Florida at Large My Commission expires. + + END OF SECTION + + 00632-2 F \Public Works\ENGINEERING DIVISION PROJECTS \0845B - Old Dixie Hwy Sidewalk (38th Ln - 45th St)\Admim\bid documents\Master Contract Documents\00632 - Contractor's Final Certification REV 04-07 doc SECTION 00634 - PROFESSIONAL SURVEYOR AND MAPPER'S CERTIFICATION AS TO ELEVATIONS AND LOCATIONS OF THE WORK (TO BE COMPLETED BY A FLORIDA PROFESSIONAL SURVEYOR AND MAPPER RETAINED BY THE CONTRACTOR AND TO ACCOMPANY CONTRACTOR'S FINAL APPLICATION FOR PAYMENT) I CERTIFY that I am a Florida Professional Surveyor and Mapper retained by: (Insert name of CONTRACTOR) Who is the CONTRACTOR for the following Project: PROJECT NAME: Old Dixie Highway.Sidewalk Improvements, 38th Lane to 45th Street INDIAN RIVER COUNTY PROJECT # 0845B I FURTHER CERTIFY that I have personally performed the survey work for the preparation of Record Drawings for the CONTRACTOR for this project or that such work was performed under my direct control and supervision. I FURTHER CERTIFY that all constructed elevations and locations of the Work are in conformance with the Contract Documents, except for discrepancies listed below. [Attach additional sheets as necessary] CERTIFIED BY: (SURVEYOR'S SEAL) Printed Name: Florida Professional Surveyor and Mapper Registration Number: Date Signed and Sealed by Professional Surveyor and Mapper: Company Name: Company Address: Telephone Number: 00634 - Professional Surveyor and Mappers Certification REV 04-07.doc 00634 - 1 F\Public Works\ENGINEERING DIVISION PROJECTS\08458 - Old Dixie Hwy Sidewalk (38th Ln - 45th St)Wdmim\bid documentsWlaster Contract Documents\00634 - Professional Surveyor and Mappers Certification REV 04-07.doc Rev. 06101